Cheryl Weisel

Duration: 1hr: 2mins
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Interview with: Cheryl Weisel
Interviewed by:
Date: February 13, 1975
Archive Number: OH 189

Interviewer
0:00:00.0 Interview with Mrs. Cheryl Weisel, February 13, 1975. Ms. Weisel, perhaps it would be best to start off by getting a brief background of your professional activities and your training. Where did you receive your MSW?

Cheryl Weisel
I got my bachelor’s degree in social work and my master’s degree in social work at the University of Wisconsin in Madison, and I graduated in ’69 with my MSW.

Interviewer
When did you first come to Houston?

Cheryl Weisel
My husband and I came to Houston in September of that year—in ’69.

Interviewer
Is Houston where you began your professional career?

Cheryl Weisel
I worked through graduate school and had some experiences—mostly which were research oriented—with the University of Wisconsin, Milwaukee, the summer before. That summer of ’69, I worked at the Herman M. Adler Zone Center in Champaign, Illinois, where we lived at the time. I did some work there with teaching—working with parents of emotionally disturbed and mentally retarded children using audio-visual equipment to watch them in interaction and then to play back video tapes and show them how they interact with other children. But that was a very brief 3-month project, and it was complicated but effective. We didn’t get the audio-visual equipment until almost the end of the summer, so there were problems there. I don’t know whether that particular project continued after I left. Then when we came to Houston, I looked for a job, and it was kind of rough at first—just being a brand new graduate—but I had an opportunity in October to take a job with what was at that time—and I think it still is—called the Mental Health Screening Service, which was run through Mental Health and Mental Retardation, and I worked there for 2 years.

Interviewer
0:02:17.8 What were your duties there?

Cheryl Weisel
I was the social worker on the Protective Services for the Aged Project, and basically the project was designed to prevent unnecessary hospitalization of geriatric patients to the state hospitals. We were trying to keep these people in the community and arrange for their care locally rather than shipping them off to the state hospital—which was temporary at best and inadequate by all means—mostly because these commitments were short term and the patients returned back to the city. We still had to make plans for them. I stayed there, like I said, for 2 years, then after that there were some problems with mental health screening services at the time, and there was a change—the director left and a number of her staff left with her, myself included. I had an opportunity to go to Sheltering Arms—which is a United Fund agency here—to work with geriatric patients and their families. I was originally hired for the area-wide, model project homemaking area. They had—Sheltering Arms had gotten the contract for model cities, and at the time I was hired I was going to be the social worker working with the homemaker and the case aide. That didn’t work out as planned because of budgetary problems, and I stayed there for 5 months. There was some question about whether that project in fact was going to continue to be funded, and it was of some concern for me because of the possibility that it wouldn’t be a very stable job for me and that it might end.

I had a job offer to work at Jewish Family Services. Unfortunately, I was somewhat hesitant to leave Sheltering Arms because it was difficult to keep changing jobs, and it seemed like I was doing that. But I did move over to Jewish Family Service. I stayed there for a year and a half, and I worked with geriatric clients to a great extent. I did do counseling, and I had a varied caseload where I did some family therapy and community education. I spoke to various community groups about aging, and I consulted to the Jewish Community Center to their daycare for older adults program. I consulted to the Country Place Nursing Home once a week around problems they were having with patients. This came about because at the time I had started to work at Jewish Family Service, there was quite a long waiting list for the Jewish Home for the Aged, and arrangements were worked out with this new nursing home to accept older Jewish geriatric patients with the hope in mind that when bed space opened up at the Jewish Home for the Aged, those people could move over to the Jewish home who chose to; but it did create some problems within the home, and I worked at that home as consultant.

0:05:56.3 After a year and a half at Jewish Family Services, I had to leave for personal reasons, and I had 2 choices of jobs that I was offered—2 choices—and chose to go to Hermann Hospital, which is the University of Texas teaching school hospital. When I first came here, I moved on to medicine service, which I very quickly became tired of because I felt like all I was doing was placing old people in nursing homes, and the social worker on that service was moved over to psychiatry. I’m sorry, the social worker on pediatric service was moved to psychiatry, that position became open, and I wanted to go into that area.
Presently, I have been with Hermann Hospital since October of ’73. I’m the social worker for pediatrics and obstetrics and gynecology. I provide social services to both inpatients and outpatients of the hospital—both staff patients and private patients—and work on the basis of referral pretty much, although I do some outreach when I can. And that’s where I am presently.

Interviewer
It seems like you’ve had a great deal of experience working with the elderly.

Cheryl Weisel
I really like it. I would prefer to continue to work with the elderly, although I do like what I’m doing now. I find old people fun and exciting and alive, but it depends on the setting. In a hospital setting, you see the old, the sick, and the infirm, and some of the joy of working with old people is taken away. That’s why I asked to be moved off the service.

Interviewer
Do you find much reluctance among social workers to work with the elderly?

Cheryl Weisel
Oh, yeah. I have a very close friend who I worked at with Jewish Family Service who recently moved to Boston. The only job that she could take there—because jobs are so tight—is in a nursing home, and I get letters from her all the time. She’s very unhappy working in that setting—which I would find very exciting, I think, if I had the chance because I think there’s a lot that can be done in nursing homes to improve the conditions for those people who find themselves in that circumstance. I never took a geriatric sequence in graduate school. I had no experience at all when I had my first job in geriatrics. Everything I know—I’ve experienced—has been through the actual doing, and I’m not sure many of the students in graduate school would choose to go into it because of misconceptions about the aging process and our own feelings about it. I would choose a job again working in geriatrics if the opportunity came up, but not in a hospital.

Interviewer
0:09:17.9 Since you have had close contact with the elderly, I would like to ask you a very generalized question to begin our discussion of the subject. It may be difficult for you to answer at first, but perhaps it would be a point for us to begin. What is the quality of care for the aged in Houston?

Cheryl Weisel
Do you mean in terms of nursing homes?

Interviewer
Yes, in terms of nursing homes.

Cheryl Weisel
Well, I’ve been out to a number of the nursing homes and seen a lot of them firsthand. I guess among the social-work trade—when we talk about putting people in nursing homes, to me it’s a very difficult decision, and sometimes we get involved in doing it all too routinely. Oh, this person can’t live at home. Let’s put them into a nursing home. My own personal philosophy is that a nursing home is a last resort for a patient, and I will do whatever is in my power to make arrangements for an older person to go into the community—hopefully with relatives and friends to look after him, if they’re able—and to use community resources available. For example, there are a number of different agencies that provide services to the elderly in their homes—Sheltering Arms, which I’m familiar with, Visiting Nurse, Public Health Nurse, home health care agencies, Upjohn Home Acres—these sorts of services, which are theoretically designed to bring services to the elderly, often are bogged down in red tape which makes it difficult for old people to stay in their home.

I think there are a number of factors that have to be taken into consideration when you think about placing an older person. One has to look at the patients’ ability to care for themselves above all. I look at the interests of the relatives and friends and neighbors in this particular person. I try to look at how they’ve coped so far and try to make some assessment of how I think they would cope if they had community assistance. I think in a nursing home setting we have to cope with the doctors so much that sometimes the doctor says, “I want this patient out. Put him in a nursing home,” and we’re way too quick to jump and say, “Yes, let’s put him in a nursing home.” The social workers on medicine service are really good about this in trying to talk to the doctors and the families before making that choice too quickly and try to make an assessment. And the reason I think we’re so careful is because there are very few nursing homes that I‘ve seen that I would put my mother in.

0:12:49.3 There are very few good nursing homes, and when we’re talking about the cost of care, we’re talking about basically $900 to $1000 dollars or more a month for a decent nursing home. Most of the nursing homes are vendor nursing homes—Medicaid vendor—and the state is only required to pay a certain amount of money each month for that person’s care, depending on the level of care they need. You probably know that nursing homes choose the kinds of patients they want. Some nursing homes choose just to take custodial and intermediate-care patients. Others choose to take intermediate and skilled-care patients. I don’t think there are enough incentives to people who work in nursing homes to get the best-qualified people, and I think what goes on in a lot of nursing homes is degrading and humiliating.

Interviewer
For example?

Cheryl Weisel
We all hear stories about patients who are fed poor-quality food and not allowed—well, for example, may be allowed to lie all day in their own excrement. We hear these horror stories—problems with medications—nursing homes that have certain pharmacies that provide medication and the cost is doubled or tripled for the medications. I’ve had patients come from some nursing homes that have told me that they’ll never go back to certain nursing homes, and the social workers talk among themselves, and we all say, boy, that nursing home is a last resort. We would never put anybody there unless we absolutely had no choice, and the patient had to go to a nursing home, and they had no money, and then we know who to call. We know who’ll take the patient, and we hate to do it. It really is a last resort. I just don’t like to make nursing home placements under those circumstances. If a family member comes to me and says, “I want to place my mother in Paul’s Nursing Home,” and we say, “Have you thought it out carefully, and have you visited the home? Have you looked around?” And they say, “Yes, that’s where we want momma,” we say, “Well, I have certain reservations about that choice based on my experience. But this is your decision, and if you choose to place your parent there, then we will help you make that placement.” But we encourage them at the same time to visit their parent—to take an active interest, to come at odd times—and do as much as they can for that older person while their parent is in that nursing home.

Interviewer
0:15:59.9 You touched on one of the points that I want to discuss with you. What cooperation do you get from relatives?

Cheryl Weisel
That depends on the relatives. That’s kind of a loaded question because it depends on the relationship that the adult children have had with their parents throughout their lifetime. It’s not something that just happens. It’s an expansion of their relationship.

Interviewer
Let me narrow it down a little more. In your work, has it been your experience that most of these relatives simply want to get rid of their parents and put them in an institution as a matter of convenience?

Cheryl Weisel
I don’t really think that’s true of the majority of people. I think the cultural expectations are changing. Years ago, it used to be that you had an older person and you kept them in their home—in your home. This is true of my own family. When my brother and I were born, my grandmother lived with us, took care of us, and helped my mother. Nowadays it’s changed a little bit. The expectation is that the adult children often times move away to different communities, and the older person is expected to maintain their own home and live independently. And when they get ill or require hospitalization or nursing home care, it’s more or less expected that the older person is institutionalized. I have had some situations where the adult children under no circumstances would take the older person in their home, and perhaps in some ways it would be best because in these kinds of families there’s always been conflict, and they’re not about to change things now. In other situations, I’ve had adult children tell me that it would be over their dead body if they’d place momma in a nursing home, and they would make whatever sacrifices were necessary to keep that person at home including having, for example, the wife—the adult wife—quit her job and stay home and take care of the person.

So again, I think it depends on the individuals involved as to how they feel about it. I’ve had adult children tell me that my mother took care of me when things were rough, and now she’s old and sick, and I want to take care of her, and she’s not going to a nursing home. And so we will do whatever we can to help that person do that. Sometimes, however, it’s difficult. The person is so debilitated, so senile—if you want to use that word—so ill that it would require a super-human person to keep momma at home or daddy at home. Sometimes we do try to counsel with these people that maybe it would be in their parent’s best interest to put them in a good nursing home if the family can afford it.

Interviewer
0:19:28.5 When you say good nursing home—let’s go back. How much does a good nursing home cost?

Cheryl Weisel
About $1000.

Interviewer
Per month?

Cheryl Weisel
Per month, that’s right. I speak of a good nursing home. What I may consider good 1 week may not be good the next week because when you talk about good nursing homes we’re talking about basically the philosophy of the nursing home, the people who work there at any given time. People come and go. Aides come and go. And we’re not necessarily talking about the administration. I’m talking about the people who provide the day-to-day care. And your good aides don’t stay around very long. They get frustrated, and they move on to better things. And the pay isn’t that good, so they don’t stay long. So, when I say good I mean the general reputation of any given nursing home. I would say my general experiences with Saint Anthony’s Center, the Jewish Home for the Aged, and the Christian Home for the Aged— these are good nursing homes basically. There are other nursing homes that I would not list as good nursing homes. I think there are other decent nursing homes, but again, the quality changes depending on the personnel. There are some very bad nursing homes—from my experiences with my clients—who have not gotten the kind of care that I would have liked to have seen. Even at the hospital, we had a patient come in—this is while I was still on medicine service, so it’s been about maybe 9 months or a year ago. A patient came in from a nursing home with terrible decubitus ulcers on his back and his legs—just terrible ulcers! That patient died at the hospital.

Interviewer
0:21:33.5 Was this from neglect in the nursing home?

Cheryl Weisel
Neglect. The patient died. And the complaint was that the nursing home tried to get the doctor—this is another whole big problem—trying to get the physician of the nursing home to come out and see the patient. And he didn’t come, and he didn’t come, and he didn’t come. And by the time they got the doctor out there, this decubitus ulcer was—I don’t know how big it was. I didn’t see it, but the other worker—one of the other social workers that was involved in the case was asked by the doctor to come up and take a look, and she couldn’t believe it. She was upset the rest of the day. She couldn’t believe how big the ulcer was, and there was no excuse for that ulcer to have gotten that big. Now, who do you blame—the doctor? The nursing home? The family? This is not an isolated case. This happens frequently, and there should be no reason for this sort of thing to happen.

Interviewer
You made an interesting statement a few moments ago. You mentioned the philosophy of a nursing home. What do you mean by that?

Cheryl Weisel
Nursing homes are in it for a whole lot of different reasons. The nursing home business is a difficult profession. Nursing home administrators hopefully are trained administrators—at least they must be by law in this state. But the philosophy of the nursing home to me is the unwritten goal that the nursing home has. The goal can be to make money, to provide a minimal level of nursing care to the patient, or to provide the best services possible to each and every patient in the nursing home to make their life meaningful and productive in their later years. I’ve been in nursing homes where patients sit in front of the television set and only move to go to the dining room table for breakfast, lunch, and supper. And I have been involved in nursing homes where there is an active occupational therapy/physical therapy program—people who come into the nursing home and bring organizations with them that entertain older people. They get them involved, and the difference is amazing. The difference is amazing in terms of what the older person thinks about himself as he grows older.

Growing old is very hard. I don’t want to grow old. None of us do, but we have to. And if the philosophy of the nursing home is to say, “We know you’re here because you have to be here, and we’re going to do our very best to make your life as productive and meaningful as possible and in your later years to give you some sense of security and warmth,”—that’s a beautiful thing if they can carry it through. And the only way they can carry it through is by the staff. If you hire people, and you screen them, and you take an active stand and say, “If I catch anybody doing anything to these old people, you’re going to be fired. It’s not within professional standards.” And that may mean treating them badly in terms of physical care or emotional care—abusing them verbally or physically—and it happens. When I say quality of life, I don’t just mean the physical care, I mean the emotional care that these people get, and I think it’s degrading to have to go to a nursing home and be humiliated by your caretakers. On the other hand, some people need it and we know this. We recognize this. There are some people that have to be handled in a nursing home. But it’s not my first choice, and I will if possible try to make arrangements in the community for care before I will consider a nursing home. That’s my own personal philosophy.

Interviewer
0:25:52.9 I’d like to go back for one moment to the qualifications of the aides and personnel who work in these nursing homes. Are there any minimum standards set by the state?

Cheryl Weisel
Oh, Louie, I don’t know. I wish I could speak more directly to that. I know that there has—depending on the—I know for a fact that for LPNs and nurses there are. Now, when we get down to the case-aide level, I’m not so sure what the minimum qualifications are. But I know, for example, in a skilled nursing care facility there must be an RN at each nursing station on every shift. The standards do vary according to the type of home that’s run. For example, an intermediate-care home may not require an RN—a custodial care home, rather, may not require an RN on all shifts. So I think this varies, but I’m not so sure—an RN is an RN is an RN. I’m not just talking about professional qualifications. I’m talking about empathy and caring, and those are things that you can’t really put down in black and white. It’s a feel you have. What’s the person’s motivation? Why is he in it? Could this—these nurses who work in nursing homes could probably do a lot better financially working in a private doctor’s office, working in a hospital system, doing a lot of different things. What motivates them to go into nursing home care? I don’t know.

It’s much harder to choose a person to work in a nursing home based not only on their academic qualifications but their feeling. I don’t think too many nursing homes do this, and I’m not sure that it’s reasonable to ask them to. Because it’s so hard to get people to work in nursing homes, it might not be realistic to try to really search out people who are empathetic because they’re hard to find. There are a lot of good people who work in nursing homes. There are a lot of good, warm, giving, understanding, empathetic people. But then there are a lot of people who work in nursing homes who don’t care, and I don’t know how you get around that.

Interviewer
0:28:36.2 Are the salaries for these people adequate?

Cheryl Weisel
I don’t know what people make, but I would guess that they’re not. I really would have question about what nursing home employees make. I don’t know what they earn, but I just don’t think it could be that high particularly when you’re talking about a vendor nursing home with costs that the state pays—the money that the state pays for the support is limited. There’s only so much you can pay your people based on that. It’s not very much. I think it’s changed. I don’t know the exact figures because I haven’t worked with it for about a year, but the cost of care for skilled nursing home patients is somewhere around 360, 380—I’m just not sure about the exact figure. That doesn’t go very far.

Interviewer
You mentioned in the example of the intermediate nursing home that an RN is required.

Cheryl Weisel
In a skilled nursing home an RN is required.

Interviewer
Do you mean then that there are different levels of nursing homes in which perhaps there would be no need for an RN?

Cheryl Weisel
A custodial-care nursing home—and again, I’m not sure of the law. It’s changed, and I’m not real sure is all I could say. I’m fairly sure that in a custodial-care nursing home it is not required by law to have an RN on each shift. You see, the main thing is, for example—it’s interesting. The thing that determines whether a home is skilled or not is that an RN has to be on duty to administer medications on the 11-7 shift. So, if when I make a determination that a patient is a skilled-care patient or not, he could be in bed with a catheter and leg casts, and if an RN doesn’t have to give that patient an injection on the 11-7 shift, then that’s not a skilled-care patient. And that’s a kind of funny way of defining it.

Interviewer
0:31:18.2 We’ve been hearing quite a bit lately about abuses in nursing homes. In your experience working in this area, have you noted many abuses in the Houston area? Is it a problem? Do you see it as a serious problem here?

Cheryl Weisel
Yes. I think it’s a problem everywhere. I don’t think Houston is any different than any other community. I think the quality of care provided in all the nursing homes has to be upgraded. I think there’s going to be a crisis one day. How many times have we heard of nursing homes that go up in smoke and 10, 15, 20 older people die? And then when they look into that nursing home, the conditions were really horrendous—nursing homes with filthy kitchens, inadequate medical care, doctors who don’t follow through. It’s so difficult to get a doctor, for example, to follow a patient in a nursing home. Each nursing home has a list of physicians who, for example, the family is asked to contact, and they tell the family to call these doctors and see if you can get one of these doctors to follow your mother in the nursing home. Well, most of these doctors don’t want to be bothered with it, and I can’t blame them to an extent because they don’t know the patient, and if an emergency should come up they really don’t know these people very well—particularly if the patient’s been followed by another doctor who’s turned over the case to the nursing home physician—and the medical care is really kind of tenuous. I think there have been abuses to patients—poor treatment leading to hospitalization, patients who are dehydrated—really dehydrated—and there’s no excuse for a patient to be dehydrated. It never occurs to some nursing home people that maybe some older person can’t get water, and they’re thirsty, and they’re unable. And we get a lot of dehydration cases from nursing homes. Is that neglect? I think it is.

Interviewer
Don’t the members of the family see these abuses occurring?

Cheryl Weisel
Sometimes. Sometimes they do. And where family is involved, the chances of there being neglect are greatly reduced. But many of these people are alone, abandoned. Their families do dump them. They stopped caring for the older person—not necessarily the family’s fault because, like I say, there’s a long history of this kind of family problem. They’ve never been close. They’ve never cared about each other. It just so happens the older person gets sick, and they have to go into a nursing home. And if the family doesn’t follow through and visit, then the chances that that patient gets the attention that he or she needs is greatly reduced. And where a family is involved, I would say that the quality of care for that patient is greatly improved. My own guess would be that where families are involved we would see far less abuse in nursing homes because a concerned, active family isn’t going to put up with it.

0:34:48.1 When I’ve gone out to nursing homes, these families who are really interested and concerned are up at the administrator hollering and yelling at them to get something done for their mother. And I say more power to them. It may make the aides mad because they get chewed out by the administrator, and one would be concerned that if they get chewed out they’re going to go back and do something to the old person in the next bed.
Some of the indecent things that older people experience are intentional. I think they’re thoughtless—leaving an old man half exposed. He has pride. He should be covered. The sheet shouldn’t be half off of him to expose him. And the new thing that’s coming up—I have to laugh—but the new thing is the privacy of couples in a nursing home. They have a right to their privacy. Of course, you can’t have a lock on the door because if the older person locks it and there’s a fire, it’s a real problem. A lot is being done in terms of providing enough privacy so that an older couple—a married couple—could have relations in a nursing home. It’s their right. They’re married.

I saw an article I think last week about a social worker—interestingly enough—who arranged for 3 strippers to go to a nursing home and entertain the old men in the nursing home. And it was a really interesting concept. I don’t know that I would feel comfortable with that, but it’s interesting, and I think that we’re probably going to be moving more and more into this direction of providing a certain amount of privacy for these people. Just because they go into a nursing home doesn’t mean that they can have a nurse walk in any time of the day that they feel like it and perform things on them that may be required medically, but they can be done with a certain amount of respect.

Interviewer
From what you’ve just said, it would seem that the nursing homes hinder or even attempt to prevent normal relations between an elderly married couple if they’re living there together.

Cheryl Weisel
I think it’s a real problem. I think it’s a real problem because an aide or RN or anybody can walk into a patient’s room, and how do you—how do you get your privacy if anybody can walk in? I think this is changing. I think some of the nursing homes are much more advanced in this area where they will respect the older person’s privacy, but it’s the old saying—old people don’t have any interest in sex. They don’t want to have relations. And with all that’s being done now, we know that older people oftentimes lead active sex lives in their 80s and 90s. Maybe not as often, and it may take a lot longer—you know, they still have that right if they so choose.

0:38:20.1 When I worked at Sheltering Arms, I worked with a man who claimed he was the personal chaplain for Teddy Roosevelt—with the Rough Riders. This man was—I’m trying to remember. He told me he was about 107, I believe. When I first began working with him, he was in his own apartment. It was fairly well kept—not really nicely furnished, but it was adequate. And he had done this by himself for years. He’d had no help from any of the other agencies. Shortly after I met this man we had a talk, and he told me that he had been married 3 times, and the last marriage had occurred just a few years before—after he was well after 100. And he told me confidentially that he didn’t touch his third wife until after they were married. I got such a tickle out of that. I laugh about it to this day—this 108-year-old man telling me this. Shortly after that time he had a stroke, and he ended up in one of the nursing homes on the north side of town. It was just heartbreaking to see this very vital, exciting, interesting man be bedridden. He died in that nursing home about a year later. But he was fascinating. He really was.

Interviewer
Have you or do you regularly visit patients in the nursing homes? Do you have much close contact?

 

Cheryl Weisel
No. This last year, as I say, I’ve been transferred to pediatrics service, and my involvement in the nursing homes is not at all at this point. Other social workers on occasion have visited in a nursing home, but the demands of the caseload—there’s really very little time, and we have to trust 2 community agencies to do followup when we can’t. It’s just a question of the number of cases we have and our time. We just can’t do it, and we do work with the families and encourage them to visit the older person as much as possible.

Interviewer
When you did have close contact with them, what appeared to be their major concern?

Cheryl Weisel
The nursing home or the family?

Interviewer
0:40:58.4 In the nursing home.

Cheryl Weisel
I’m not sure I know what you mean by their—

Interviewer
Was it loneliness perhaps? Was it being removed from the community and placed?

Cheryl Weisel
The older person?

Interviewer
Yes.

Cheryl Weisel
Oh, the question of loneliness is paramount. These people are desperately lonely. They’ve lost family members, their peers who have since passed away. The isolation from people that they’ve been close to all their lives is devastating. We so often see depression in nursing homes—acting-out depression sometimes and violence. We know that nursing homes tend to overmedicate the geriatric patients to keep them calm because they don’t want to have to deal with them. They medicate them. I would guess that there are many nursing home patients who are on tranquilizers that they don’t need to be on. It’s unfortunately one of the ways that nursing homes have of controlling behavior because they don’t have the staff to deal with this kind of behavior. I don’t say it’s right by a long shot, but I would think that if there was an investigation of patients in nursing homes—and somebody would take a look at the medications that many of these patients have—that a very high percentage of them would be on a tranquilizing drug. But as far as the patients are concerned, the nursing home residents’ loneliness is the hardest thing. They’ve been active and vital people their whole lives, and they’re committed to sitting in a nursing home watching TV. In some of the better nursing homes there’s an activity program, but not in every nursing home.

It’s depressing and that’s why I think we see so many older people with the feeling that when you get old nobody cares about you anymore. Your whole value in life has been thrown out. Nobody cares. Your family doesn’t visit. You’ve been dumped, deserted. Loneliness is a—it’s really hard to work with old people because of it. It really makes you look at yourself and see where you might be 50 or 60 years from now. I hope. If we’re lucky.

Interviewer
0:43:36.5 If we’re lucky.

Cheryl Weisel
If we’re lucky, I hope.

Interviewer
Are the nursing homes in Houston integrated?

Cheryl Weisel
Yes, theoretically, by law.

Interviewer
Can you elaborate a little more on that?

Cheryl Weisel
Well, by law there can’t be any discrimination. On the other hand, we all know that there are certain nursing homes that are white, certain nursing homes that are black. For example, what do you do with a patient who’s been a southern belle all her life and she suddenly finds that she needs nursing home care? Are you going to refer this lady to the St. Thomas Home? Or to Eliza Johnson? These are black—basically black nursing homes. Or do you suggest that she go to the Christian Home for the Aged? Or to the Blalock Nursing Home? It’s a very difficult dilemma. And vice versa. You are a black patient. Do you recommend to the family that they choose Eliza Johnson? Or do you say, let’s talk about the Blalock Nursing Home? What I try to do is this because it’s a difficult question. I ask the family if they have any preferences, and if they have a preference for a nursing home we follow up on that. If they have no preference, I give them a list of nursing homes—3 or 4—and I ask them to go out to all of the nursing homes and visit them and let them decide. The way we choose the nursing homes basically is area. If the family says something on the north side of town on the east side of the freeway, then I know basically what nursing homes are in that area, and I give them a list.

We had a recent inquiry by officials—I think associated with the state—who had come to the hospital and they asked for—well, what they did is they had 2 Latin-American patients who had been placed in nursing homes, and they were investigating whether the hospital was being discriminatory in their placement and wanted a list of patients placed in nursing home by race and which nursing home, and so on. And I think the interesting thing about our staff in particular is that the reasons that the patients were placed where they were were either by family choice or by economics. Family choice and location. And economics. In other words, the 1 patient who was placed in a nursing home that I would consider substandard was placed because they had absolutely no money. And while an application had been made for Medicaid, very few of the nursing homes at that time would take the Medicaid-applicant patient who did not in fact have their Medicaid number, and this home was one of the few that would that had a vacancy. And it was imperative that the patient be in a nursing home. It was a difficult decision. It was not one of choice in terms of yes, that’s where we should put her. But that’s all we’ve got.

0:47:18.2 So, my own philosophy is that it’s up to the family, and I feel very free to use and recommend whatever nursing homes I would consider of the best quality in the given area that the family wanted the patient. But I think the families select out—in other words, if I suggest a basically black nursing home to a family, by the time they get out to look at the home, they’ve pretty well decided that they still think that their mother would be comfortable there. And the other way around. I have some black patients who choose to be—families prefer that for them to be—in a black nursing home. But if that’s their choice, that’s fine. But I feel very comfortable in recommending the Blalock Nursing Home—an integrated nursing home. And I would feel very free if I had a nursing home administrator tell me they wouldn’t take a patient because that patient was black, I would report them. But some of the nursing homes in town are—like I said, by law they’re integrated, but some do tend to take mostly black patients, and some do tend to take mostly white patients. As far as I know, I think a percentage of them are integrated—really integrated.

Interviewer
How do the black—well, we know they aren’t segregated as such, but the ones that are predominantly black—how do they rate as far as quality goes in comparison with the predominantly white nursing homes?

Cheryl Weisel
That depends on what you’re comparing them to really. There are some basically white nursing homes that I think are really poor. I’m not familiar with all the black nursing homes. I know there’s a new one—Manda Ann—that opened up, and I don’t know anything about that one. I’ve heard things, but I don’t know for myself. I guess in all honesty I’d have to say that I would suspect the black nursing homes provide much less for their patients and are basically substandard in comparison.

0:50:02.9 I passed a nursing home in the northeast part of town when I worked at Sheltering Arms, and I was just aghast—just from the outside. I’ve never been in it, and I still haven’t been in it—just from the outside appearance of the nursing home and the old people lined up—all their wheelchairs lined up in front of the nursing home. I would hope that the federal government and the state government actively look into the nursing home situation in Houston and make some very drastic changes. Now, in terms of black nursing home, white nursing home or integrated—which I don’t think is the issue. I think the issue is the quality of care that’s provided in the nursing home, and that cuts across all ethnic lines because we’re talking about the dignity of older people, and it shouldn’t matter whether they’re white or they’re black or they’re Chicano.

Interviewer
You mentioned before that you worked for Jewish Family Services, and that they have a home for the aged.

Cheryl Weisel
Right. Jewish Family Services is a separate agency from the Jewish Home. What I did in connecting or in conjunction with the Jewish Home was work with patients who were on the waiting list and still in the community—while they were in the community bring some resources to them and do some counseling with them and their families. I was on the admissions committee as representative from Jewish Family Services. I met once a month with the Jewish Home for the Aged’s admissions committee.

Interviewer
Was that strictly for Jewish persons?

Cheryl Weisel
No. Actually, you can’t—not only can you not by law segregate racially, you cannot segregate religiously. Anybody who wants to get into the Jewish Home can make application. Most of the non-Jewish community would feel—I think feel in truth that they don’t want to go to a Jewish home for the aged, but it is within their right to do so, and their application would be considered. The guidelines of the Jewish Home take into consideration whether or not, for example, the person keeps kosher. A person on the waiting list would have a much higher priority if he kept kosher because it would be impossible to provide that person kosher meals in almost every other nursing home. Certain things are taken into consideration there and considered a priority. Jewish Home, as I understand it, was set up to take those people in need so that priority is given to the people who can’t pay before priority is given to somebody who can pay.

Interviewer
0:53:11.1 Have you had much contact with other social agencies in the city, such as the Public Welfare Department?

Cheryl Weisel
Oh, yes. I would say I’ve probably had contact with state welfare, Sheltering Arms, Visiting Nurse, and Public Health Nurse.

Interviewer
Have you had much contact with the Department of Public Welfare?

Cheryl Weisel
Yes. I had a lot of contact with them because of course a lot of our older people are on state assistance. Of course that’s changed with the Supplemental Security Income program, which is now with Social Security. The Old Age Assistance Program is now under the Social Security Administration so that people can receive their Social Security and Medicare benefits and have supplemental support from SSI. That program is administered through SSI. The Medicaid part of the program is administered through the state.

Being old nowadays is not easy financially. The level of assistance is so low, and with all the economic problems we’re having now anyway it’s rough, and I don’t know how these older people do it. It is not to be believed what one has to go through to get food stamps. I understand the program is going to be maintained through this month because President—not this month, I’m sorry, this year—thanks to the actions of Congress. President Ford wanted to reduce the benefits—the food stamp benefits—to people, and when we talk about reducing benefits we’re really talking about the people who are suffering the most now already—the old, the poor, the infirm, the disabled—and in any economy like we have now, these are the people who are suffering. Middle-class people suffer, too. But having to live on Welfare or your Social Security is degrading. It’s difficult. There’s just never enough money, and what one has to go through to get the benefits is difficult. These people wait months. They make an application for their Social Security or their SSI, and they wait months sometimes before they’re approved. And then when they are approved, they get so little for the wait.

0:56:30.4 I think really what we’re going to see is the complete revamping of the social welfare system. Most people think it’s pretty unacceptable for a lot of different reasons. Whether you consider it giving it away or charity or relief or whatever, I think the system’s unacceptable. I’m not sure that any of us have a good answer or a good plan. There’s a lot of talk about income maintenance. I’m not sure that that’s the answer either, but I think there’s going to have to be some changes in the state welfare program—in the way it’s handled, in the levels of support, and the indignities it causes people to suffer in order to get the help. I’m not real satisfied with the program, but you work with what you have, and you learn how to work with the agencies—and sometimes without the agencies—to get the services to the people that they need.

Interviewer
0:57:41.0 We’ve been talking a great deal about the abuses and the inadequacies of nursing homes, but are there any alternatives?
Cheryl Weisel
I think that’s a good question. I guess it starts with where your philosophy is about growing old. In other countries the old are looked upon as people to be cherished, to be taken care of, to be loved—to try to give them something back in their later years that they have given the community. I would like to see more of an effort made to develop and maintain situations in which older people can go into homes—for example, foster homes—where other people would keep and care for these people in a homier, more natural environment where they would feel more comfortable. I think there are other alternatives to nursing homes. There will probably always have to be some nursing homes for those people who really require the care, but I think the government’s going to have to take a long, hard look at where we are with nursing homes—make some decisions as to where we’d like to be. Because really, we’re all going to grow old. And I’ve heard too many people say, “I hope when I grow old I have a quick heart attack and die because I don’t want to ever have to go to a nursing home.” And in a way it’s sad.

But we have to remember that most older people don’t go to nursing homes. There’s a very small percentage of people who really have to go to nursing homes. I think we tend to focus more on those people because it’s so blatant. They can’t manage at home, and we do have to care for them. But if a person has to go to a nursing home, I think it’s imperative that we provide the best possible care for these people who have given so much of themselves and who for various reasons can’t live alone and require the care. I think there’ll have to be some other alternatives opened—group home situations, apartment setups where older people maintain their own apartments but perhaps have a common dining area with medical care available on the facility—for example, a nurse on duty who can come to the particular apartment. This is being done already. This is nothing new. But I think it’s a good idea, and it may be an alternative for some older people who maybe don’t need the level of care that nursing homes offer—that can’t live alone—and just need some support, some supervision in their everyday activities. And I think that there are some facilities—even here in Houston—that are providing this, but they are few and far between, and the cost is generally prohibitive to the general public.

Interviewer
1:00:54.6 We’ve covered a great deal in a short time. I’m sure there might be some points that you want to make that didn’t come up—the opportunity didn’t arise, and if you would like to add anything at this point please feel free to do so.

Cheryl Weisel
No, I think I’ve pretty well covered the high points of how I feel. I really do like working with older people. They’re rich and rewarding, and helping the families make the decisions that are required—that’s some of the hardest part. The only thing I guess I would really want to say is that I think the families need a lot of help when it comes to making a nursing home plan. Sometimes they can be helped to see that this may or not be the best solution—and to deal with their guilt at having to place an older person—and it’s not an easy decision. I hope I never have to make it.

Interviewer
Thank you for your views. It’s been a most informative interview, and on behalf of the Houston Metropolitan Archives and Research Center, I want to thank you for your cooperation.

Cheryl Weisel
You’re welcome.

1:02:23.6 (end of audio)