Disturbing Parallels: How Often Does Aged Care “Fly the Friendly Skies”?

by, Dr. Al Power, ChangingAging Contributor

The shocking video of a United Airlines passenger who wouldn’t give up his seat being forcibly dragged from the airplane has the Internet world buzzing. And yet, after a quarter century in and around the care of older adults and those living with dementia, I can only see some very disturbing parallels.  This is going to be a rough post, but so be it.

Consider the following:

United calls security police who forcibly remove a man from his seat when he does not wish to give it up. He is injured in the process.

A person who does not wish to be bathed is forcibly showered against her will by a group of staff members.

United’s CEO adds insult to injury by stating the person was “belligerent,” as if raising his voice was an excuse for a physical assault.

Reports of forcing care on “belligerent” residents abound, as if that justifies the same treatment.

Make no mistake; the United incident was a physical assault. And there will be a lawsuit, perhaps a fine as well.

If a person declines care (see the federal regulatory F-tag about resident rights) and it is forced on her, this is also an assault. How does removing a person’s clothes or forcing her to shower against her will become okay if it happens within the confines of a nursing home? And if we force ourselves on a person against her will and get injured in the process, who is to blame?

United used the need to move crew and the airline’s policy (all US airlines have this policy, by the way) as justification for the inhumane treatment of the doctor on board.

What is most disturbing to me is that such treatment would likely not raise the amount of outrage in a viral nursing home video as the United video did. Too often, it’s “business as usual.” Also disturbing is that managers and even family members are often complicit in forcing such treatment, justifying it as “for the person’s own good.” If someone grabbed a piece of cake out of your hands and shoved a salad in your mouth because it was “for your own good,” how might you respond?

There were a number of ways in which United could have approached this differently, from finding the four passengers to be bumped before boarding, to offering a larger payout, to a more nuanced negotiation with the person, to finding other crew members to move to Louisville.

In aged care, there are also many options. But like those above, they take time, an empathic listening ear, and creativity. (Just one simple example is that offered in the Bathing without a Battle video, which was sent to all US nursing homes 15 years ago, but for some reason most of the people I‘ve met have never seen.)

And please don’t tell me you do not have time to use a slower, gentler or more creative and collaborative approach. If that is the case where you work, be aware that your license—and your humanity—is on the line, every single day.

Finally, (yes I am going there) we have to talk about “intersectionality”; that is, the concept that the many “isms” in our society can have a cumulative effect on people’s rights. This is not an allegation, but a question: Is it possible that the response of the Chicago officers could have been influenced by the man’s ethnicity and accent?

When it comes to rights in aged care, we need more studies to determine whether—in addition to ageism and able-ism—our approach to those in our care can also be affected by the many other labels they carry.

In my evolving understanding of how best to support people living with dementia, I came to realize several years ago that it was never really about antipsychotic drugs—it was about well-being. And more recently, I have come to realize that it wasn’t really about well-being either—it’s about humanity and human rights.