Columnist Susan Snyder: Nursing home care is cause for concern

Sunday, April 9, 2000 | 10:48 a.m.

On Tuesday morning Alice cried.

A small bruise had emerged on her hand. A hand rumpled and rendered useless by a stroke. The stroke has stolen so much from her -- walking, speaking, the ability to relax her fingers. It's what put her in a Las Vegas Valley nursing home three years ago.

Alice can laugh. And she smiles when Isaac arrives at 7 each morning to bring her a Krispy Kreme donut and keep her company throughout the day.

But that morning she cried, unable to tell her husband why. By lunch time Isaac had figured it out with the help of another patient down the hall. It was the new nursing assistant, the woman told him.

"He's so rough," she said.

Alice nodded when asked about it. Isaac was angry. There's no way for Alice to bruise her own hand. She can't use it for anything.

It's the hand Isaac took in marriage more than 40 years ago. The same hand he places in a brace every day, gently uncurling the fingers from an unyielding fist.

"It hurts her. I know it hurts her," Isaac says, his eyes misting a bit.

He sat at the kitchen table in the couple's mobile home, which seems awfully big for one person these days.

The couple's real names are being withheld, as is the name of the nursing home. He's afraid of repercussions. He says he doesn't want any trouble. But something just isn't right.

He says he gets on everyone's nerves because he visits Alice every day to sit with her, talk to her and watch what goes on in what he describes as a typical, moderately priced Clark County nursing home.

Certified nursing assistants cover most of the bases the best they can, he says. Still, residents' call buttons often stay lit for 30 minutes or more. Some get bed sores because their wet undergarments aren't changed soon enough or often enough.

He says a nurse told him the staff is supposed to have eight patients each. But one assistant said he sometimes has 14 or 27 or 34 residents to dress, take to meals and tend. Double shifts are common.

"On weekends there are no supervisors. The day after payday nobody shows up for work," Isaac said. "The days off and holidays are when you worry." Everyone should worry. Alice lives in a Nevada nursing home that has filed for bankruptcy. With a third of its nursing homes facing bankruptcy, Nevada has the nation's highest bankruptcy rate.

Most of the homes stay open, sending letters to assure clients that pending legal actions by their owners or parent companies will not affect qualities of care.

Isaac's not so sure. He spends most of each day and evening with Alice. Then he goes home to get a little supper and go to bed. His days are long and routine, like hers. He's lost 20 pounds the past couple of years.

They used to have a motor home and traveled around the country. Now their journey is headed somewhere else. Somewhere not as carefree.

"I haven't missed a day being with my wife," Isaac said. "My son says I'm there too much. But that's why you get married."

He promised he'd take care of her, and he's doing his best.

It's just so hard when she cries.