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(en) cnt-ait: RETIREMENT HOMES and ELDERLY NURSING HOMES (EHPAD): WHEN ABUSE IS INSTITUTIONAL (fr, it, pt) [machine translation]
Fri, 23 Aug 2019 08:40:44 +0300
Currently, since beginning of summer 2019, a huge movement of strike is hitting the Health
care industry in France, and especially the Nursing homes for elderly (EHPAD in French)
and the Hospitals' Emergency unit. ---- This movement fights for dignity for workers and
for hospital patients. ---- What is new is that this movement emerged from the workers
themselves, inspired by the dynamic of the Yellow Vests, outside from the trade-unions
(even if unions are running after the movement to try to catch it and canalize it) ---- To
understand what is at stake, we republish below an article we issued 10 years ago exactly
... when we supported struggles and strikes of staff from different retirement homes. But
at that time those strikes ran only localy, in isolated movements, so it didn't last
enough for a global change.
While the overall situation has not changed from what we described in our article (apart
the name of the Ministers that has changed, but policy stays as ever .. ), maybe the
generalized awareness of the workers in this industry will lead to a general strike (and
not isolated struggles) that would achieve a balance of power sufficient?
RETIREMENT HOMES and ELDERLY NURSING HOMES (EHPAD): WHEN ABUSE IS INSTITUTIONAL
Up-dated version of an article written in February 2009
A permanent scandal
In 1998 over 20 years in 2019, ... The well-known magazine of Consummer's rights "60
million of consumers" published a report on retirement homes. His title? "The scandal". A
word that has not finished coming back every time it is about the subject. And which is
not there by chance!
Faced with the public's emotion in front of this "hermetic world, where too often the only
objective is the lure of gain", we have been promised, then, so many things! Not on the
overall substance of retirement homes - because the leaders of our society, based on
segregation, do not envisage any other way of life, more human, for the elderly. But, on
their form: "We will reform and clean up retirement homes' organization" became the public
Twenty years after, all is continuing, even worst sometimes! Meanwhile a lot of reports or
books have been published, many TV shows broadcasted, a lot of trainings and round tables
organized ... It didn't lack anything to denounce the situation ... but with no change.
Let's take a few examples from people who have little suspicion of anarchosyndicalist
sympathies. After the huge heat wave in 2003, whose lamentable management constitutes a
state crime, "Le Figaro", a highly conservative newspaper wrote under the title
"Retirement homes: the scandal continues": "More than 4,600 of the 15,000 victims of last
summer have died in these institutions that are supposed to protect them. " As
"protection", indeed, we do better ... Guilty of having let die of dehydration 15 000 old
people, the government renews its promises, this time with the key, a "bright" idea: the
creation of a new tax for the workers, the so-called solidarity day (during this day, the
workers are not paid, all their wage is going to the State to abund a special fund for
elderly people), which - the government promised, swore - should definitely improved the
lot of the elderly. Result: workers gave away their Pay Day, but the elderly didn't see
any result in the retirement homes ...
And everything went on as before. Another example among a thousand: in 2007, the
investigation broadcast "Forbidden Zone (M6)"issued a documentary: "Diverted heritage,
unscrupulous retirement homes: the scandal of elderly people abused". Summary of the this
program: "Evil testimonials: Vexations, deprivations, malice ... reasons of absues: the
working conditions: insufficient resources, lack of control, lack of qualified personnel
... in this hidden universe where the law of silence prevails ..." In 2008, other TV shows
with a strong audience made the same observation ("retirement homes, from scandal to
hope", knowing that "the hope" appeared far away ...). Those who want, in 2019, to show
new images are sure to matter!
The more it is changing, the more it is the same
Indeed, if the living conditions are variable from one Nursing home to another, if you
"scratch" a little bit the surface, you would reveal same shameful details! It is enough
to ask the families ... at a distance, because of the law of silence: some homes threaten
to send back any resident whose family would be too loquacious ...
This is not enough to silence the witnesses, even if they are forced to witness
anonymously. Here, "the cleaning of the morning do not finish until around 11 o'clock
then, so we are force to have the breakfast around 11:30!!!". There, "little things
alerted me, when I came and I fed my mother she devoured as if she had eaten nothing for
15 days, then a young intern with whom I had sympathized told me, "Your mother has been
sitting for a whole afternoon tied in her chair with her glass of water in front of her on
the table, but as she can not drink on her own she kicked in the table to make it fall. So
I gave it to her myself. "Elsewhere" My 92-year-old mother, who lives in a
nine-square-meter room, never leaves her floor. She didn't get outside since months
because the lift is too small for her wheelchair." Or also this assessment from a
Physician: "drug prescriptions are far too numerous, with many sedatives and
psychotropes". A nice euphemism to say that they are stupefied with sedatives. And not to
mention the soiled patients who wait for hours to be cleaned, all on the background of
emotional and psychological misery.
The reason behind the abuse: greed ...
The reason for this institutional abuse and mistreatment is obvious and well known, "...
the only goal is the lure of profit" already said "60 Million consumers" 20 years ago.
Hence the exorbitant price for elderly Nursing Homes. It's easy to understand:
politicians' lack of attention to the aging of the population (a highly predictable
phenomenon) has created a shortage. As a result, the occupancy rate of retirement homes
has reached 98% and there are waiting lists! Hence also the reduction of "production
costs" and above all, the compression of labor's costs, and therefore a constant
under-staffing and under-qualification. Not to mention the small profits that are made on
absolutely everything by lowering the quality of meals, of heating, of bedding ... As for
outings and distractions, and even the real day-to-day functional rehabilitation, they
melt like snow in the sun.
Jean Charles Escribano, author of "We finish off well our elderly" and renowed expert of
the question, gave very interesting figures in an interview at "Monthly University". He
compares with the datas from the Association of Belgian nursing homes: in this country,
there is on average one professional per elderly person - against one for two elderly
people in France. And yet, the basic rate is for families of about 1,300 euros per month
in Belgium, against more than 2,300 euros in France (sums to which should be added, in
both cases, public funding to the Nursing Homes, which are equivalent in both countries).
As the cost of living in Belgium and France is the same, the difference of price for
Nursing homes should not be lost for everyone ...
The organization of abuse
Indeed, the standard for dealing with a population of elderly people with a high
proportion is bedridden should be an employee for one person (to cover the needs, day and
night, year-round). By keeping their staffs half-staffed, retirement homes organize
institutional abuse: the staff, despite all their goodwill, have no choice but to work
quickly, very quickly. One would like to push them to make mistakes, that one would not do
Here too, the situations are variable from one Nursing home to another, but the
testimonials (often from professionals who have left the circuit, the law of silence
requires) abound: Marie-Claude, nurse: "At XXX, there is only one woman to perform 15
resident's cleaning, clean 25 rooms and serve 25 breakfasts in three and a half hours ".
Mathilde, former cleaning lady: "At our Home, for the night shift, there are only two of
us for 96 elderly people, many of whom are heavily dependent, sometimes in palliative
care, and of course, there is not a single skilled nurse the night shift. We have to
"handle things" by ourselves. When a patient dies during the night, we are forbidden to
wake up the Director, as it could disturb her husband... We must do the mortuary toilet.
Morally, it is hard , especially when they are people to whom we are attached. We are
dying from this situation. "Jeannine:" Our job is like slaughterhouse, like in a factory.
We work with a tight flow. Due to lack of time and staff, some elderly people do not have
more than one shower per month. "All this leads to tragic situations such as in this
retirement home in Saint-Germain-en-Laye where, under a heap of mattress and a pile of
boxes was discovered the corpse of a resident ... missing for a year. A house yet
certified, like all the others, by the Regional Health Agency (DDPP). This does not
surprise the professionals: Management always knows well in advance the dates when DDPP
will perform checks, so they can "do the right thing" to clean up the mess before the
Institutional abuse: employees suffer too
In a situation of constant understaffing, the staff are deeply mistreated and abused.
Not all though. There is a notable exception: the Nursing Home's Directors. In our country
where even dog-poo on the sidewalks are regulated, there is something that is escaping yet
to any regulation: being a retirement home manager. It shows how the State is concerned by
the security of the elderly ... To date, in practice, anyone can run a retirement home.
In February 2007, a decree was nevertheless taken to impose a minimum of competence on the
Directors, but it leaves them a period of ... almost 10 years to comply with!
But such leniency does not apply to basic employees. For them (they are essentially
women), working conditions are extremely hard: they have to work every day, day or night
work, holidays also, ... at the whim of the employer who has every facility to change the
schedules. Premises are often unsuitable (hence work overload); beds and equipment just as
unsuitable (hence musculotendinous diseases, sciatic ...), confrontation with aging and
death without support (hence depression, anxiety) ... and pressure for them to make
technical acts that they do not have the right to do (such as distributing drugs for
service personnel), all for lousy wages: minimum hourly wage (SMIC) or barely more (often,
to avoid seniority bonuses, these shock bosses manage to sack the oldest employees).
Moreover these real industries with high profitability rates often impose their employees
part-time, condemning them to precariousness.
There are plenty other abusive practices: unexpeted changes of schedules (which is a way
used by managers to push the employees to resignation. Case of Latifa for example: ten
years of seniority without any reproach, for which the schedules had suddenly become
incompatible with the placing of her children in day nursery ); bonuses different from one
employee to another with no real reason, just to apply the famous principle "Divide and
control the staff" ... A lot of Nursing homes seek to put the burden of institutional
abuse on their employees. This guilt, with the threat of dismissal and even prosecution,
is a constant sword of Damocles on their heads. Not to mention the Managements that make
excessive use of "layoff" ... So many ways to harass employees.
The government's response: repression and "hot air"
The government also brandishes another sword of Damocles with cynicism: the professional
malpractice. In Nice, an overworked emergency doctor works quickly (but well), has been
put in custody! In Paris, a nurse who runs everywhere for lack of a sufficient number of
colleagues, is mistaken about the bottle has been also kept in custody, and put on trial!
The Emergency Dispatchor In essones District didn't find, despite 27 calls, any single
room for a dying personn, the Minister of health express publicly its surprise and
suggests that he is incompetent! Meanwhile, the real responsible for this worsen situation
still do not feel guilty. Between overseas tanings sessions or few evenings between
"famous peopoles" dining with fine food and wines, they play naive, "we didn't know", and
continue the same policy. And hospitals or retirement homes, it's the same. Far from
recognizing its immense responsibilities, the Power wields the stick (threats and custody)
and the carrot in the form of the "famous-training -which-will-finally-teach-us-soon-how
to work well". All on the background of the famous verse "We will reform and clean-up
Nursing retirement homes." But still, the Power pretends to forget the essential: it must
start by doubling the number of basic staff!
Finally new: employees and families are determined to not let themselves crushed
There are still new things. The first is that everyone now knows that institutional abuse
is organized to increase profitability and it is a reality. In particular, families
understand that what happens to them is not an isolated case, a local malfunction, due to
a "bad employee" but the consequence of a system that takes full advantage of its
rapacity. The second is that the workers themselves are beginning to understand that elder
abuse and staff harassment are never more than two sides of the same coin!
This is not the first time that at CNT-AIT union we are dealing with retirement homes.
Each time, and this is the case this time again, it is in support of employee actions.
Defending workers dismissed under the most misleading pretexts, we note that these
mini-actions leave a mark. Understanding of the stakes and fighting spirit are manifested,
sometimes where it was least expected. Just as it becomes clear to a growing number of
employees that these "Top Managers" are ultimately only idols with feet of clay, and that
it would not take too much to stop their scandalous practices: a little "hyphen" between
all the concerned, workers, residents and families. A links between families and
employees, carefully avoiding all "mediators" whose role is to make sure nothing will
never change ("representatives" of workers, collaborative trade-unions, ...). Spread the
word. If we are more numerous to understand it, to say it, to do it, some managers, those
for example who will feel targeted by reading the testimonies, could be forced to change
Read also:[In the private sector, how to strike without the unions?
Original article in French:
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