One elderly woman was left sitting in a hospital driveway as a car sped away. Another was wheeled into an emergency room with a note saying, "Please take care of her," pinned to her purse.
Emergency room workers call it "granny dumping," a phenomenon they say is becoming familiar across the country as families crumble under the strain of caring for relatives who are living longer than ever."It's tough," says Dr. Jack Allison, president of the American College of Emergency Physicians. "There's a systemic involvement here, a reflection of the health care system that leaves these patients abandoned."
An informal survey by the ACEP drew 169 responses from emergency rooms across the country, reporting an average of eight abandonments a week, he said.
The American Association of Retired Persons, which recently met in San Francisco, raised the problemin a recent issue of its "Bulletin," describing abandonment as a small but "rapidly growing" problem.
Elderly abandonment seems to be most noticeable in states like Florida, California and Texas that have large retirement communities, said Dr. Toni Mitchell, director of Tampa General Hospital's adult emergency department.
Actual abandonment on the doorstep of the emergency room, a new twist on the baby-on-the-church-steps scenario, is relatively rare.
But it does happen.
Recently, the Tampa emergency room staff found a woman sitting in a wheelchair, a note pinned to her that said, "She's sick. Please take care of her." Mitchell calls these cases "the positive taillight sign. They roll them in the door and all I see is the taillights vanishing in the distance."
Another woman was literally dumped in a hospital driveway, recalled Allison, chief of services for the emergency department of Pitt County Memorial Hospital in Greenville, N.C.
Family and staff had faded away as the elderly woman developed a drinking problem, leaving one housekeeper who "one day, was just absolutely undone by the whole situation, loaded up granny, (drove to the emergency room), opened up the door, shoved her out on the concrete and drove away," he said.
More commonly, the elderly person is brought in or transferred in by landlord or nursing home under pretext of illness. Then, when the emergency room is ready to send the patient home, there's suddenly no one in sight, the boarding room is taken or the nursing home opening is gone.
"We refer to it as the `packed-suitcase-syndrome,' " Allison said. "When they show up with all of granny's belongings in one or two suitcases and they say, `Put her in the hospital and take care of her. We can't take care of her any more.' "
In San Francisco, the most common manifestation of the problem is family members who leave a relative with a host of suggested ailments, said emergency department physician Ellen Taliaferro.
"At 3 a.m. it turns out the phone number they gave us doesn't work," she said.
In one case, doctors tracking the movements of a frequent patient realized that the family was dropping the man off, working an 8-hour shift, and then reappearing to reclaim him, she said.
"The patients that are most common here are the people who have sort of been abandoned by life. They get too sick to stay in the shelter and they're not quite sick enough to stay in the hospital and they don't have friends or relatives or resources to take care of them," she said.
One reason elderly abandonment seems to be becoming more visible now is that overtaxed emergency rooms can no longer absorb the strain of being an unofficial placement center, doctors said.
"We are so overwhelmed with all of the ills of society," Mitchell said.
About one-third of the respondents to the ACEP survey rated the problem as a "four" or higher on a severity scale of one to six. The most common reason for abandonment, they said, was due to depletion of emotional, not financial resources.
Mitchell and Allison would like to see social service agencies providing more outpatient and in-home services to help families cope with elderly relatives.
In California, "there are services and programs available," said Paige Talley of the California Department of Aging. "I do feel that the families just get so frustrated that they don't know what to do."
The government in March reported that life expectancy in the United States had reached a record 75 years, up from 62.9 years in 1940.