Another strong plea for change in America's health-care system,
this time with nursing homes under the spotlight. The graying of
America has provided a gold-making opportunity to some, according
to Diamond (Sociology/California State Univ.), who says that
caretaking is a nationally subsidized business in which governments
dispense enormous sums of Social Security, Medicare, and Medicaid
moneys to corporations that pay workers sub-poverty-level wages and
dehumanize patients into units called "beds." To get the inside
story, Diamond became a certified nursing assistant and for over a
year worked in three Chicago-area nursing homes, with both
private-pay and Medicaid patients. An astute observer, he describes
how vocational schools prepare - or rather fail to prepare -
nursing assistants for "the firing line of health care," and how
this care is administered in nursing homes. His fellow workers were
almost entirely women of color from Third World countries, forced
to hold down two jobs to survive. Diamond reports on how patients,
80 percent of whom are women, arc gradually pauperized under the
government's spend-down policy, whereby individuals must exhaust
their own resources before becoming eligible for Medicaid. By
inspecting and certifying nursing homes, the state, Diamond says,
implicitly endorses poverty wages for workers and the pauperization
of patients. In such a dynamic, he contends, quality care is
unlikely if not impossible. The picture Diamond paints is not a
pleasant one, but there is a note of optimism in his final
"I-have-a-dream" chapter, where he sees the road to change through
unionization of nursing-home workers and greater input into care
issues by residents and their families. Revelatory eyewitness
descriptions, plus sobering analysis, add up to a commendable
addition to the growing literature on what's wrong with our
health-care system. (Kirkus Reviews)
This first hand report on the work of nurses and other caregivers
in a nursing home is set powerfully in the context of wider
political, economic, and cultural forces that shape and constrain
the quality of care for America's elderly. Diamond demonstrates in
a compelling way the price that business-as-usual policies extract
from the elderly as well as those whose work it is to care for
them.
In a society in which some two million people live in 16,000
nursing homes, with their numbers escalating daily, this
thought-provoking work demands immediate and widespread attention.
"[An] unnerving portrait of what it's like to work and live in a
nursing home. . . . By giving voice to so many unheard residents
and workers Diamond has performed an important service for us
all."--Diane Cole, "New York Newsday"
"With "Making Gray Gold," Timothy Diamond describes the
commodification of long-term care in the most vivid representation
in a decade of round-the-clock institutional life. . . . A personal
addition to the troublingly impersonal national debate over
healthcare reform."--Madonna Harrington Meyer, "Contemporary
Sociology"
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