Hannah's Story

Louisiana's Long-Term Care Crisis: How Greed, Understaffing, and a Failing Healthcare System Abandon the Elderly and Disabled


The following account reflects my experiences navigating Louisiana's healthcare system while caring for my father, who has vascular dementia, cardiac disease, and multiple complex medical conditions. Over the past several years, I have interacted with memory care facilities, skilled nursing facilities, hospitals, home health agencies, and hospice programs. What I witnessed repeatedly was a system that often appeared more focused on reimbursement, discharge metrics, occupancy rates, and cost containment than on providing compassionate, competent care.

This is not a scientific study, nor is it intended to be an indictment of every healthcare worker in Louisiana. I encountered many kind nurses, aides, therapists, and support staff who genuinely cared about my father. However, my overall experience led me to conclude that Louisiana's healthcare system routinely fails elderly and disabled patients with complex medical needs.

Most disturbing of all was the realization that the system often seems designed to manage decline rather than support longevity. Instead of helping elderly and disabled patients live as long and as well as possible, many healthcare institutions appear to prioritize moving patients quickly through the system while shifting the burden of care onto families.

***** Memory Care (2020) *****

After my mother died in early 2020, I became responsible for my father's care. He moved into a private-pay memory care facility that cost more than my monthly salary. I assumed that the extraordinary cost would translate into extraordinary care. I was wrong.

My father experienced repeated falls, yet staff continually offered excuses rather than solutions. At one point, I was told he was intentionally sleeping on the floor because he was "reverting to childhood." Only after I repeatedly complained was I permitted to enter the facility as an essential caregiver.

I quickly learned that expensive long-term care does not necessarily mean quality care. Private-pay facilities advertise extensive services, but when medical needs arise, many respond with the same explanation: "We're not a nursing home."

I witnessed residents suffering while staff claimed they were unable to administer medication or provide basic medical interventions. I filed multiple complaints with the state, two of which resulted in findings of noncompliance. Others did not.

One experience continues to haunt me. Another resident had two fractured hips and had reportedly gone two weeks without pain medication. She cried continuously. Staff members privately acknowledged how upsetting her suffering was, yet little seemed to change. I eventually called 911 in an attempt to get her help.

Then COVID-19 arrived.

The facility repeatedly assured me that no employees in memory care had COVID-19. Days later, residents were notified that the facility was under lockdown because of a positive case.

I repeatedly requested COVID testing for my father, who was clearly symptomatic. The facility delayed testing while insisting that no one had been exposed. Meanwhile, I was monitoring him remotely and could see that he was coughing, weak, and visibly ill.

When I finally removed him from the facility and took him to urgent care, he immediately tested positive.

Had I trusted the facility's assurances, I genuinely believe my father might have died there. Instead, I brought him home, arranged monoclonal antibody treatment, and ultimately watched him recover.

That experience permanently changed my view of long-term care.

People spend enormous amounts of time discussing the cost of long-term care and how families should financially prepare for it. What they rarely discuss is the uncomfortable reality that extremely expensive care often translates into surprisingly little actual care. In my experience, the system was willing to collect thousands of dollars every month while providing services that I frequently had to supplement myself. These experiences are described throughout my account.

***** Skilled Nursing Facility #1 (2023) *****

In 2023, my father was transferred from a hospital to a skilled nursing facility for short-term rehabilitation.

The contrast between what I expected and what I found was shocking.

He arrived in a nearly empty room containing a worn loveseat, an outdated bed without proper safety features, and food that was inappropriate for someone with congestive heart failure.

I was told that rehabilitation staff generally left by midafternoon and were unavailable on weekends. Supervisory personnel were often absent. When I expressed concern that my father would fall while trying to get out of bed, I was told that staff could place a mat on the floor.

I began spending nearly ten hours every day at the facility while simultaneously working remotely.

The more time I spent there, the more disturbing the environment became. I frequently heard residents calling for assistance and being ignored. Staff members openly stated that residents who needed assistance after certain hours might simply have to use a diaper because there would be no one available to help them.

I became increasingly concerned that the rehabilitation program was little more than a billing mechanism. Medicare covered the first twenty days of his stay, and despite my repeated requests to discharge him earlier, obstacles continually appeared.

Only after I spoke directly with a social worker did I learn that many of the explanations I had been given regarding discharge were inaccurate.

This experience reinforced a troubling conclusion: many nursing facilities are operating under financial incentives that do not always align with the best interests of patients. Families often believe they are sending loved ones to specialized rehabilitation centers, only to discover that they have been placed in understaffed nursing homes where rehabilitation may be secondary to reimbursement.

***** Hospitalization and Skilled Nursing Facility #2 (2024) *****

My father's second skilled nursing facility experience was catastrophic.

Following a hospitalization, he was transferred to another facility, where a nurse practitioner prescribed medication to control his persistent diarrhea.

I specifically warned staff that he had a history of fecal impaction.

I was assured it would not happen.

It did.

He developed a severe fecal impaction while simultaneously experiencing constant diarrhea and severe pain. He repeatedly begged for help, describing intense rectal pain. Blood appeared in his stool.

Despite obvious warning signs, I repeatedly received assurances that he was not impacted.

Eventually, another nurse became concerned enough to arrange transportation to the hospital.

There, physicians discovered a massive fecal impaction measuring approximately 9 × 9 × 9 centimeters. He required multiple blood transfusions.

What I witnessed over the following days was one of the most traumatic experiences of my life.

He remained in severe pain for days before the impaction was finally removed.

By the time he was discharged, my father had suffered permanent physical decline. He has never walked again.

In my opinion, what happened was not simply an isolated medical error. It reflected systemic failures involving understaffing, inadequate assessment, poor communication, and an apparent inability or unwillingness to provide basic bowel management.

When these failures occur in settings that continue receiving public funding through Medicare and Medicaid, families have every right to ask difficult questions about accountability and oversight.

***** Louisiana Healthcare: A System That Prioritizes Metrics Over Patients *****

Louisiana's healthcare market is dominated by a small number of major healthcare systems. My experiences led me to question whether modern healthcare incentives have shifted attention away from individualized patient care and toward financial and administrative metrics.

Repeatedly, I encountered pressure to discharge my father before he was medically stable.

Repeatedly, I was encouraged to consider hospice.

Repeatedly, I was forced to advocate for additional testing, additional treatment, and additional time.

At one point, I had to insist that physicians order an MRI after I noticed signs suggesting that my father might be experiencing a stroke.

I was also forced to identify a serious pressure injury that had either developed or worsened during hospitalization and skilled nursing care.

Again and again, I felt as though I was serving as my father's primary physician, nurse, case manager, and patient advocate while simultaneously caring for him around the clock.

No family member should be placed in that position.

Healthcare systems often speak about quality metrics, value-based care, reducing unnecessary hospitalizations, and improving outcomes. Yet families caring for elderly patients with dementia and multiple chronic illnesses frequently experience something entirely different.

Many of us are left wondering whether the goal is to help our loved ones recover or simply to move them through the system as quickly and inexpensively as possible.

***** The Pressure to Choose Hospice *****

My experience with hospice discussions was deeply troubling.

During one hospitalization, a physician initiated an end-of-life discussion almost immediately after meeting my father.

My father repeatedly expressed that he wanted treatment. Yet the conversation quickly shifted toward hospice.

I understand that hospice serves an important role for many families and that countless hospice professionals provide compassionate care. However, my experience led me to believe that hospice was sometimes presented as the preferred solution before all reasonable medical options had been explored.

More than eighteen months later, my father remains alive.

What ultimately improved his condition was not hospice. It was the implementation of consistent bowel management and hands-on care that addressed an underlying problem that had been repeatedly overlooked.

His laboratory values improved.

Hospitalizations stopped.

His overall condition stabilized.

These improvements fundamentally changed my perspective on the care elderly and disabled patients receive in Louisiana. Too often, I felt that the healthcare system focused on managing decline rather than supporting recovery or maximizing longevity.

***** Greed, Incentives, and the Value of Human Life *****

The most painful lesson I learned is that there is a profound disconnect between the cost of healthcare and the quality of care many elderly and disabled patients actually receive.

The long-term care industry is a multibillion-dollar business. Nursing homes, rehabilitation facilities, hospital systems, home health agencies, and hospice organizations all operate within financial structures that influence decision-making.

My experiences left me believing that financial incentives too often take precedence over patient care.

When facilities charge thousands of dollars each month while residents remain understaffed, neglected, or inadequately monitored, families are justified in asking whether profit has become more important than people.

When hospitals repeatedly attempt to discharge medically fragile patients before they are stable, families are justified in questioning whether financial and operational metrics are driving those decisions.

When elderly patients with multiple disabilities are repeatedly encouraged to accept less aggressive treatment without a thorough exploration of alternatives, families are justified in asking whether the system truly values their right to continue living.

The elderly and disabled deserve more than a system that simply manages decline.

They deserve competent medical care.

They deserve dignity.

They deserve aggressive treatment when they want it.

And they deserve the opportunity to live as long as possible.

My father's story convinced me that Louisiana's healthcare system often falls far short of those goals. Until meaningful reforms address understaffing, accountability, oversight, and the financial incentives embedded throughout long-term care, families will continue carrying an impossible burden.

No one should have to fight an entire healthcare system simply to ensure that a parent receives basic, humane care.

Yet that is exactly what I have spent the past several years doing. And I know I am not alone.


***** I was interviewed by reporter Kelli Maria Korducki from Business Insider regarding the situation caring for my dad:

https://www.businessinsider.com/millennial-daughters-boomer-parents-career-savings-penalty-2026-4
https://www.aol.com/articles/americas-biggest-career-hurdle-being-081301000.html


***** TO BE CONTINUED... *****