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no way affiliated or endorsed by Kaiser Permanente In Copyright Since September 11, 2000 Link for Translation of the Kaiser Papers PATHFINDER(search) | ABOUT US | CONTACT | WHY THE KAISERPAPERS | RESEARCH GUIDES BY SUBJECT | A READER'S GUIDE | Mirrored for historical purposes from:http://www.nea.org/activelife/0411/contribution.html My Contribution Striking a Blow Against an HMO
Her friends told her that Kaiser Permanente, one of the nation's
largest
health maintenance organizations, was too big to fight. Her lawyer
warned
her it would be a hard case to make. Others told her to get on with her
life. But California member Mary-Edith Blum refused to accept the substandard care she felt she received by her HMO. So Blum sued Kaiser under California law for "elder abuse," and last year, after a four-day arbitration, she won the case and was awarded $100,000. Blum not only won a large sum of money in the settlement that day, though—she also won a battle for seniors who are misunderstood or mistreated by hospitals and medical personnel due to their age. "Because I was 83, they act like you're on your way out," Blum says. "I didn't really want to get involved in a lawsuit, but I finally said...somebody's got to speak up." Blum's problems with West Anaheim Medical Center started after a major surgery and got worse when she was discharged over her protests from the hospital just 11 days later, without any explanation or prior notice. She was sent to a nursing home where she endured nearly a month of poor treatment until she was sent home. "I couldn't get out of bed alone,
I couldn't stand alone, but they sent
me home," Blum said. "And it was miserable [at the nursing home]; you'd
have to wet the bed because they wouldn't come around for an hour and
40
minutes" to assist with getting to the lavatory. "And then they'd say
you
were drinking too much water. Twice I was told, ‘Well, this
isn't the Hilton.'" After being discharged from the
nursing home, Blum wrote letters to
Kaiser describing the specific problems she had with her care and
treatment
at the hospital and nursing home. Getting no response, Blum hired
attorney
Susan Mogilka. "My allegation was that the full scope of care was not
given
because of her [Blum's] age," Mogilka says. "This is the first case I
had
where the elder herself was really coherent enough to report her own
abuse.
The arbitrator was also very impressed with her ability to speak for
herself." After
four days listening to testimony and examining other evidence,
the arbitrator concluded that although Blum had been given appropriate
medical care by the hospital and nursing home staff, her emotional
needs
had not been met. Medical
providers "simply did what needed to be done from a medical
standpoint and totally ignored her emotional needs," the arbitrator's
report
states. For example, the report documented instances in which Blum was
put through extensive testing by the hospital staff without being told
the purpose or results of the tests, and it noted that the nursing home
staff was, at times, confrontational and indifferent to her concerns.
Although she still suffers
emotional scars from the experience, Blum
is now in much better health—living on her own, driving
herself around,
and swimming regularly for therapy. "It's a very educational thing to
go
through," Blum said. "I've lived through it all by prayer and by having
good health to begin with." —Donna
Chiu For More Have
a problem with your health care or need legal advice? The national
network of Area Agencies on Aging (AAoA) may be able to help you. Many
local programs offer health insurance counseling and legal advice, in
addition
to the more widely known services such as Meals on Wheels. To find an
agency
in your area, contact Eldercare Locator at 800-677-1116. © 2002, 2003, 2004 NEA.org all rights reserved. |