Degradation of the elderly in Sweden’s privatised care system

The greatest fear I have of getting old is not so much the pain or suffering or sickness or debilitation but the degradation one may have to undergo.

I have always perceived the care of the elderly (and children) in Sweden as being perhaps the most compassionate and advanced in the world – especially the care from the public sector. The best care anywhere in the world is no doubt when it happens – and it does not always happen – within the family environment. In times past it was the care of the elderly within extended family groups, where up to 4 generations lived together, which probably provided the best care possible. But as family groups have become smaller, the wherewithal for the best geriatric care possible has shifted to institutions.

But recent events within the Swedish system where the public sector has been outsourcing geriatric care to private enterprise are not pretty.  In the chase for profit margins the level of degradation being meted out seems to have increased. The equation is no longer “the best care possible at the lowest allowable cost” and it seems instead to have become “not more than the cost absolutely necessary to avoid public complaints”. And in this new equation the level of degradation that the elderly are subjected to carries no weight. And the degradation is of relevance only if it leads to noisy complaints from others.

Something is not quite right and and it only reinforces my equating ageing with degradation.

The case of the private care company Carema has been the subject of a series of investigative articles by Dagens Nyheter and the latest episode of weighing diapers is not only degrading to the elderly patients but also, I think, for those being forced to implement Carema’s profit objectives:

Dagens Nyheter (free translation):

Ethel Lundkvist’s mother died after five weeks at Carema’s Koppargården. The staff almost never changed her diapers, although she was often incontinent. “They said she would only pee a little more. Mom’s backside was all inflamed and sore from all the moisture “.
 Ethel’s mother came to Carema’s Koppargården in the middle of February last year. Pretty soon Ethel and her sister noticed that things were not as they should be. Every day her mother phoned weeping that the staff did not want to change her wet diaper. She was not given a new diaper because they said that she would just pee a little more. Ethel and her sister complained sharply to the staff who promised to change. “But when we came to visit, mother  still sat in the same wet diaper. It happened several times. Mom was in shock”.

 Ethel and her sister started going there with their own diapers and changing her many times daily. After five weeks, she died. “It was horrible. We felt like criminals who had placed mother there”.

The Local

Employees at the scandal-stricken care provider Carema’s nursing homes in Sweden are instructed to weigh old age pensioners’ diapers to assess if they are full or could be used longer, according to staff. 

“We’re not allowed to change the diaper until it has reached its full capacity. The aim is clearly to keep consumption down and save money,” an anonymous member of staff told daily Dagens Nyheter (DN). The result is that the old people are left with wet diapers for hours before they are changed, staff claims. 
Sources have described to DN how staff is also instructed to weigh the diapers regularly to ascertain how many hours the patient can wear it before it starts leaking. This way, staff can work out which brand to use in order to have to change the diapers as seldom as possible and avoid “unnecessary” changing. … 

The company also announced on Thursday that they are scrapping their controversial bonus program whereby management were said to reward the homes that managed to save the most money.


‘Secret’ bonus scheme at nursing homes revealed 

Stockholm elderly care scandal widens 

Maltreatment reports increasing in Swedish geriatric care

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