tion’s nursing homes are ‘substandard. ’”4 In 1978, according to
Vladeck, there were still nursing homes “with green meat and
maggots in the kitchen, narcotics in unlocked cabinets, and disconnected sprinklers in nonfire-resistant structures. ” 5 Over 72 percent of the nursing home population is female. Women in nursing
homes are generally widows or never married, white, poorer than
most of their peers (70 percent having incomes under $3000 a year
consisting mainly of Social Security benefits), and have several
chronic diseases. According to
1979), the average age of the person in such an institution is 82 and
50 percent have no family, get no visitors, and are supported by
government money. Conditions are most terrible in nursing homes
supported by government funding of patient care: nursing homes
for the destitute, for those on Medicaid. The policy of the United
States government is that old people must become paupers: * spend
any money of their own that they have, after which the government takes over; the paupers are unable to defend themselves
*See “Loose Laws Make Care of Aged Costly, ” by Gertrude Dubrovsky,
Programs W ork, ” Dubrovsky explains:
“As of April 1977, the last period for which such figures were available,
a nursing-home patient under Medicaid could not have an income greater
than $533. 39 a month. However, should this same person want to remain
at home and receive community-based health-related services, his monthly
income must be less than $200.
“Thus, Medicaid laws are biased in favor of institutional care.
“Morever, Medicaid imposes strict personal-asset limits of $ 1 , 500 for a
single person or $ 2 , 500 for a couple.
“To be accepted by a nursing home under Medicaid, a person must sell
his home, liquidate his assets and turn them over to Medicaid as a gift, in
which case he stays on Medicaid.
“Or, he may give the funds directly to the nursing home as a private
payment until the money falls below the allowable level. When that happens, the patient reapplies for Medicaid, but may be put on a waiting list. ”
against the conditions in the homes in which they are kept. Once
paupers, they must accept confinement on the state’s terms because
they have no money and nowhere to go. The state’s terms all too
frequently are neglect, degradation, filth, and not infrequently outright sadism.
The nursing home population is markedly white. Blacks die
younger than whites in the United States— perhaps the result of
systematic racism, which means inadequate health care, shelter,
and money over a lifetime. Blacks alone comprise a full 11. 8 percent of the U . S. population and yet only 9 percent of the old are people of color, including Asians, Native Americans, and Hispanics. N ationally, so-called nonwhites (including blacks) comprise
only 5 percent of the nursing home population. In New Jersey, for
instance, according to
of 8, 683 beds in eighty nursing homes, blacks occupied 532 and
Hispanics or “others” occupied 38 (6. 5 percent). It seems that
blacks especially are left to suffer the diseases of old age on their
own and to die on their own; and that whites are institutionally
