Thread by @hamandcheese

"You might think that those 40,000-plus deaths would be a major national scandal. But so far the response has been subdued. Yes, there has been ample news coverage, but there are no riots in response, no social movement to 'clean up the nursing homes'..."
bloomberg.com/opinion/articl…

My grandmother and grandfather lived to 94 and 93, surviving their last decade or so in an "assisted living facility" (home-like apartments with round the clock nursing staff).

The terrible management of those facilities was a daily conversation.

I see a few factors that may explain why nursing home reform isn't a national priority.

1. Nursing homes are as much a service to the extended family who would otherwise have elder care duties as they are to the residents themselves. This introduces a principal-agent problem.

2. Many nursing home clients are unusually shy / embarrassed about complaining to staff or other residents (less so to family). A generational difference?

At the same time, there are often confused and cantankerous clients who complain about everything, reducing signal:noise.

3. Reporting on nursing home issues is a victim of the decline in local watchdog journalism.

Old people are more likely to interface with local news, and through offline formats like newspapers and TV.

Video can make local news go viral, but that's rare.
fox2detroit.com/news/online-vi…

4. Veterans organizations like the Royal Canadian Legion have historically advocated for higher quality long term care, but have rapidly declining membership. Thus the social capital (clubs, associational culture) of nursing home residents is depleting. theglobeandmail.com/canada/toronto…

5. Lastly, reforming nursing homes requires fixing the financing of long term care, which is messed up in complicated ways that can't be easily put into a slogan.

Eg. Higher wages for nurses might reduce turnover and viral transmission, but who pays?