A Dumping Ground For Granny

The sad scenario goes something like this: an elderly man is brought to a hospital emergency room by family members who say he is confused, not eating or wandering away from home. Tests find nothing specifically wrong with him, but when doctors try to contact the family, the phone number they left has been disconnected and the address proves fictitious. Or nursing-home staffers transport a resident complaining of chest pains to an emergency room. When physicians stabilize her and attempt to return her, the nursing home says her bed has been filled-usually by someone better able to pay the fees. Sometimes there is no accompanying paperwork on the patient, so doctors can't determine if the ailment is a chronic condition or something new, and they have to order a battery of expensive tests. Either way, the hospital is left caring for the patient sometimes for days or weeks on end, and sometimes with no one to bill expenses to.

Hospital staffers call it "granny dumping": elderly people abandoned in emergency rooms, under the pretext of illness usually by relatives who are too poor, too tired or too stressed out to continue providing care. No hard statistics have been collected, but in a recent survey by the Senate Aging Committee, 38 percent of the hospitals responding said they had received reports of such "elder abandonments." An informal survey by the American College of Emergency Physicians last May found similar figures; some doctors reported as many as eight elderly patients dumped on their emergency wards every week. Most experts are convinced that the problem is increasing, given the growing numbers of dependent elderly persons and inadequate services to provide for their care. Emergency rooms are "the place of last resort for all kinds of problems and here's just another example," says emergency physician Dr. David Schriger of UCLA Medical Center in Los Angeles.

Some hospitals see a definite increase in abandonments on Fridays. "After you [tell the family] that granny's really not sick enough to come into the hospital as long as she can get meals, that's when they say they're going out of town for the weekend and won't be able to do that," says Dr. Steven Shay, director of the emergency department at St. Mary's Medical Center in Long Beach, Calif. Schriger says that when he worked at Harbor General Hospital in Los Angeles, the ER staff often saw the same families every weekend. "It became almost a joke among the hospital staff," he says. "Ever third Friday or so, you could count dropped off and the family disappearing until Monday. "

Some hospitals have considered filing abandonment charges against family members-but most staffers are too sympathetic to do so. "To blame the families ... is sort of blaming the victim," says Schriger. "These are people who have taken on the responsibility of caring for elderly people and they just become overwhelmed because society doesn't offer any type of respite." Sen. Bill Bradley of New Jersey has proposed a bill that would fund a wide range of respite care services-from home companions to adult daycare facilities-so that family members can take some time off from caring for aged relatives. Some respite services are already available in some communities, through local health departments or area agencies on aging. They maybe limited, but such programs provide far more appropriate help for overtaxed families than overtaxed emergency wards can.