Health Care 'Saints' Are Low on Priority List

The handwritten list had been stored in a box for years, but when I pulled it out I recognized the loopy backhand of my mother.

The three pages were titled "The Duties of a Nurse Assistant on a Mental Health Unit (The Day Shift — 7 a.m. to 3:30 p.m.)."

Meticulously, she had listed her 46 different job duties as a nurse's aide at our hometown hospital. I can imagine how and when the list came about.

My mother took the job when I was in high school to help pay for college. She probably wrote notes during a staff meeting, then later sat down at our dining room table to copy a neater version so that she could memorize it.

Dozens of duties fell to her in addition to changing bedpans and giving sponge baths. She wrote:

— Do not be afraid to stay with a violent patient.

— Expect to spend a lot of time with depressed or suicidal patients.

— Be able to discuss patients' progress with the doctors when necessary.

— Help the RNs whenever necessary.

— Conduct an exercise class with patients every other day.

On and on it went. Her pay never rose much above minimum wage. In the last years of her life, she shifted to home health care work. She could provide more one-on-one care, she said.

Some of her patients had disabilities. Others were in hospice care. Some were just old. All of them had families that depended on workers like my mother to keep them alive. She never made more than $8.25 an hour, even on 12-hour days, with no benefits.

Earlier this week, the U.S. Supreme Court ruled that home health care workers are not entitled to overtime pay under federal law. AARP lawyer Sarah Lock told USA Today that the decision was a "great disappointment" for baby boomers caring for parents and looking ahead to their own health care needs. William Dombi of the National Association for Home Care and Hospice told me such workers are the "saints of home care, the main reason a patient can remain at home."

"We're trying to come to some solution," Dombi said.

"This is not management versus labor; this is management and labor versus payer." The best solution, he said, is to change the compensation provided by Medicare and Medicaid, state by state. That means higher taxes, but the numbers offer a sobering reminder of how we as a country determine our priorities.

Right now, Dombi said, we're spending $50 billion a year on home health care. That's less than $1 billion a week, which still sounds like a lot until you compare it to what we're spending on the war in Iraq. That price tag is $2.5 billion a week — more than double what we're investing to care for a population of Americans that promises only to grow as more of us live longer.

And that work force and their patients are overwhelmingly women — women like my mother, which is why I couldn't help but think about her when the court's decision was announced.

My mind's trajectory was inevitable, I suppose. The longer we live, the more we see snippets of our own lives in the stories of others. An aging athlete struggles with dwindling talent, forcing a sympathetic sigh from the former high school jock unable to see the belt buckle around his waist. The news of a teen driver killed on the road sends shudders down the spines of parents with their own kids clamoring for the keys. For me, I read about home health care workers and think of my mother, and how she always told me she loved her patients no matter what she was paid.

She always hoped that America's priorities would change, that we would take better care of those workers who build intimate relationships with us when we're at our weakest, our most needy. Surely, she said, America would come to understand why that matters.

As I write this, I look up and there she is, smiling from the photo of her ID badge hanging from the bulletin board over my desk. My mother has been gone nearly eight years, but the lessons of her life live on. There was no time clock on my mother's love for her patients.

Some things money can't buy, she always said.

Maybe not, but in the end, somebody always pays.

Connie Schultz is a Pulitzer Prize-winning columnist for The Plain Dealer and the author of two books from Random House: "Life Happens" and "… And His Lovely Wife." To find out more about Connie Schultz (cschultz@plaind.com) and read her past columns, please visit the Creators Syndicate Web page at www.creators.com.

COPYRIGHT 2007 CREATORS SYNDICATE INC.