Where the Caring Ends

Twenty-four terrifying hours in a ritzy New York suburb's House of Horrors nursing and rehab home

It comes to me in snippets, while I’m driving, during a tedious work meeting, while I’m struggling with writer’s block. But mostly, the snippets arrive at night, sliding into my dreams, taking their toll. Every morning now, I’m more tired than when I went to sleep.

If I wake up during the snippets, I talk myself down. “This is just a dream. It’s not real. I’m safe. Everyone is still alive.”

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~ snippet one ~

I had a bad feeling that Friday afternoon in August as I followed the ambulance out of the hospital parking lot.

But when we finally enter the 54-acre retirement and rehab campus, it looks beautiful: stately buildings, manicured gardens, trees labeled in Latin. The “cottages” are homes for wealthy retirees, and the restaurant lights at independent living look welcoming.

Then we reach the Semi-Acute Pavilion.

This is the place that nearly kills my father. The place that almost breaks me.

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~ snippet two ~

My father, 87, is a week out from hip replacement surgery. He has a broken back, a traumatic brain injury, and post-operative delusions. The EMTs pull him from the ambulance and run him inside as rain beats down. It’s deserted in there. No one greets us. The EMTS get lost finding his room. The lights flicker off before a generator hums to life.

The EMTs need help transferring my father from the gurney to the bed. But there is no one around, so they ask me to help.

I am told to take my father’s feet, and to be mindful of that new hip, that broken back. We heave him onto the bed. He screams, and my body absorbs the sound, where it still lives in me.

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~ snippet three ~

The intake session does not go well. A man with a clipboard appears out of nowhere to quiz my father about the day, month, year—the good old PIMS Dementia Test. Useless, except for labeling patients for Medicare billing.

My father fails because he’s dazed, delusional, and certain he’s arrived at a pleasant vacation destination after a bumpy flight. He doesn’t know that it’s Friday at 4:43 p.m., he just got wheeled off an ambulance, and he’s just checked into hell.

Two nursing aides appear without introducing themselves and tell me to step out because they must “examine his skin.” Moments later, my father’s screaming begins—prolonged, desperate. He’s begging them to stop touching him, to leave him alone, to stop humiliating him.

I push the door open. The aides—a man and a woman—are holding him down in bed, my naked flailing father, a diaper halfway up his legs. He’s yelling at them to stop.

My father does not need a diaper. This detail matters. I tell them that he is not incontinent. You see, my father lives on his own. He wakes up every morning at 6:45 am and takes a shower and gets dressed (he still dry cleans his shirts and pants) and shaves and comes downstairs to pay bills, check his stocks, and wait for the caretakers who will bring him out to lunch and food shopping.

I try to tell them this. They tell me to leave. I hesitate, then obey because I’m disoriented, scared that any pushback will result in retaliation against my father.

When they emerge, one pulls me aside. “Your father tried to assault us,” she says. “I won’t tell anyone—especially her,” pointing down the hallway at a person I assume is a nurse, “because she’ll make us use restraints on him.”

I freeze. I don’t yet know it’s illegal in New York State to restrain a patient—that it’s even illegal to use a bedrail to prevent a patient from falling out of bed. It is very against the law to restrain a sweet, frail, elderly man for defending himself.

Also. My father’s arms are bleeding.

I start to cry. She watches this.

I haven’t hardened up yet. I stay the night on the chair next to my father’s bed, which they have lowered to floor level so he doesn’t fall out. I later learn that they took at least one photo of my father during the episode, wild-eyed and terrified.

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~ snippet four ~

The next day is Saturday. I wake up when I hear a scream.

Please help me.

Another one. Please help me.

Panicked, I chase the screams through a pale yellow hallway until I find her. Slumped in a chair, head tilted, eyes staring at nowhere.

I step close.

“Can I help you?” I ask, heart hammering. “Are you in pain?”

Please help me.

I look into her empty eyes. Eyes like my mother’s eyes towards the end of her ten-year battle with dementia. This woman is not capable of telling me what’s wrong. So I run again down that pale yellow hall, finally finding an aide. “Can’t you hear that screaming for help?” I ask.

The aide shrugs. “She does that all day.” She walks away from me.

The scream rises again. Please help me.
And again.
No one listens. No one cares.

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~ snippet five ~

Around 10 a.m. a nurse finally appears at our door—I will soon learn that she is one of the two good nurses here. She is not the nurse from last night who would put my father in restraints.

She examines the new purple bruises that have risen up my father’s arms since last night, but she says nothing. She does tell us that my father will most likely get no physical or occupational therapy—it’s the weekend. Then she adds that his medications haven’t been ordered yet.

In fact, one pill—his painkiller—won't arrive before he leaves this facility in three weeks. The Head of Nursing will keep lying about it, demanding to know which staff have been speaking to us. Meanwhile, the two nurses tell us each day that there’s no painkiller in the cart for him. Each day, they end up taking one from another patient’s drawer.

I ask this nurse when my father will be helped to the bathroom—and when the diaper will be removed.

“Oh honey,” she says. “I can’t help. Try the call button.”

I press the button. My father starts panicking because he really has to use the bathroom. I use the call button over and over again. 5 minutes go by. 10 minutes. 20. At 35 minutes my father can’t hold it anymore. I explain to him that he’s wearing a diaper but he can hardly wrap his mind around this concept, especially not with his post-op fogged-up mind. He nearly cries in defeat.

At 44 minutes, I flag down an aide wandering down the hall, and she rolls her eyes as she comes into the room.

“You need to leave the room now. He had an accident in his diaper.” She drawls that out, loudly, within earshot of my already humiliated father.

What I will soon learn is the biggest horror of this place that calls itself a rehab center. They have NO intention of taking the diaper off my dad or any other patient there. They refuse because they have no intention of walking anyone TEN FEET to the bathroom in a timely way. This place is not about rehab, I realize.

They will continue to change the goal posts throughout his stay, first telling us that my father is too confused to walk to the bathroom. When we prove that wrong, they will tell us that he is a “two-person carry” (meaning two people need to help him). And then when PT says he only needs one person, they will simply refuse to change his protocol. And when we ask again, pointedly this time, they tell us that his walking is not improving, and he must leave the facility in exactly two weeks.

In other words, my father, who can use a bathroom perfectly by himself, will be forced to wear a diaper for weeks because this rehab place refuses to bring people to the bathroom ten feet away. They will tell me they are understaffed as I watch aides sitting around on their phones. The entire time I am there, no one will ever come to the room in less than 20 minutes from the time I push the emergency call button.

Of course, the other unspoken issue is that the longer you force elderly adults to wear diapers, the more likely they will become incontinent forever.

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~ snippet six ~

When PT comes on Monday and move my father out of his bed, I am relieved. There is hope, I think, that he can learn how to walk and go home soon. My father does not scream when PT moves him, unlike he howls after he soils is diaper (because he is not allowed to go to the bathroom) and they have to turn him over to clean him.

Later, I ask the aides why they are hurting my father so much that he is screaming when they clean him daily—and why that doesn’t happen when the PT staff moves him.

They laugh incredulously—three of them at once.

“We are not PT. We’re not trained to move patients around,” they say. “We can’t do it any better than this.”

They say this without anger or any recognition of how incredible it sounds to hurt people because you are not qualified or competent at your job.

The irony of this is not lost on me. In my family, we would never say we can’t try to do something better. We are always striving to do better. And we learned this from our father.

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~ snippet seven ~

I decide to calmly walk around and figure out this place. It’s a series of long hallways and patient rooms, but the doors are mostly closed.

That’s when I come around a corner and find them—the “Rehab Patients.”

They sit propped in wheelchairs, like actors in a horror movie—necks twisted, eyes vacant. Only one small woman breaks the spell, lifting a hand to wave before recoiling in fear when I wave back.

A television hums in the corner, broadcasting nothing but its own blank reflection.

I will find them there off-and-on every day—morning, afternoon, evening. Always alone. Often on weekends, they sit at tables where dozens of half-eaten trays of food are left piled up for hours.

In all the weeks that we are here, I will never, ever hear one staff member speak kindly to them. Not even a “good morning.”

---

This is just the first 24 hours. My father was there for several weeks. I don’t know if I can get through writing down all the snippets that still visit me nightly. There’s the lady found lying on the bathroom floor, and the nurses and aides were talking openly about how they didn’t have to report it because they found her there and didn’t see her fall. Then there was the front desk aide who screamed every time she saw a mouse running around in the evenings—she kept a can of Raid next to her. And the fact that a rat trap sat underneath the table outside my father’s room—the same table where my father’s half-empty food trays sat for hours.

Then there’s the situation (as we like to call it) where my father sprang a fever, and when I arrived early the next morning to check on him, the nurses put a huge Do Not Enter on his door and told me he had pneumonia (not true). That same day, they decided he needed a catheter and fumbled the insertion until he bled and then they gave him the diagnosis of blood in his urine.

The good news? All of this got my father released to a wonderful hospital that saved his life.

The last parting gift? The Head of Nursing showed up for the paperwork as my father was wheeled out of rehab on the way to the hospital. She wrote in the paperwork that my father pulled out his catheter himself—an outright lie that made the ER doctors shake their heads in disgust.

My dad is home now, and maybe that’s all that matters.