(Currently in production)
NO COUNTRY FOR OLD PEOPLE
The documentary you need to see.
A cautionary tale exposing decades of lethal neglect in Nursing Facilities.
A systemic crisis caused by an industry that subscribes to the notion that honesty is far less profitable than
dishonesty and views human beings as commodities.
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In 2017, I wrote, produced, directed, and co-starred in "My Mom and The Girl”, an award-winning, Oscar Qualified short film I lovingly referred to as a “joyous look at Alzheimer’s". The film is based on my mother, Norma Pecora, who lived with Alzheimer’s for 16 years and it starred Valerie Harper in her final performance
I was motivated to share a story that presented an accurate depiction of a very misunderstood disease. A story that had the potential to change the biased conversations about Alzheimer’s and dementia by replacing denial, fear, and grief with acceptance, understanding, appreciation, and love.
Now, I am compelled to tell an entirely different kind of story also inspired by my mother. A cautionary tale in which I hope to expose a dangerous façade of stability and safety held tightly by Long Term Care (LTC) nursing facilities that has gone largely undetected and perpetuated by a flawed ratings system that has been in place far too long. According to the New York Times, this system provides a badly distorted picture of the quality of care at the nation’s nursing homes; many who rely on sleight-of-hand maneuvers to hide shortcomings and improve ratings.
In a case of every cloud having a silver lining, we have Covid-19 to thank for bringing an awareness to the nationwide Nursing Home crisis. Years and years of underfunding have left America’s nursing home system in desperate need of an overhaul. Unlike many other countries, the U.S. has no comprehensive approach to long-term care. Because funding comes from a variety of payers, all with different rules around eligibility, quality measures and reimbursement incentives, nursing homes have designed structures that may not be in the best interest of public health. The math is simple: Medicaid, the dominant payer of long-term care services, doesn’t fully cover nursing homes’ costs, especially the cost of providing quality care.
COVID-19 has also brought into sharp focus the lack of data captured at the state and federal level about nursing homes. Without comprehensive and accurate data, interventions to improve outcomes and quality are limited and consumers have a difficult time discerning how risky a particular facility might be. Especially when the industry subscribes to the notion that honesty is far less profitable than dishonesty and views human beings as commodities. As a result, nursing home neglect and abuse has been going on for decades. According to Assistant Attorney General of Virginia, Rick Mountcastle (portrayed in the Hulu miniseries Dopesick by Peter Sarsgaard), it all comes down to understaffing. With most not-for-profit nursing homes offering low pay, limited benefits, and not nearly enough training, and for-profit companies (that dominate the industry) having incentives to keep their costs low, which translates to minimal staffing, neglect has regrettably become the industry standard.
In the last six months, I was witness to this systemic crisis. I have seen things I cannot unsee. Things that I must not unsee.
My mother had been a resident at a 5-Star Nursing Facility in Los Angeles for 5 years – a place I took solace in believing she was receiving the very best care possible. And as it turns out, she was. Unfortunately, the “best” turned out to be the worst.
The accepted LTC protocol took an egregious toll on my mother’s physical health and accelerated her cognitive decline. The neglect took the form of a stage 4 pressure wound on her sacrum. A wound that could only reach that level when it is ignored. A wound that can only be ignored when a resident with dementia is left sitting in a wheelchair for hours on end and cannot complain when they need to be changed. A wound that goes unreported until the resident is admitted into the hospital with sepsis, a major UTI, low kidney function, and pneumonia and needs to be intubated to breathe better, is given a temporary feeding tube while on the ventilator, and an internal foley catheter to help with urination while the kidneys regained strength.
When my mother stabilized, she returned to the facility with the feeding tube and catheter still in place and a wound that still required critical attention. Once again, the facility chose to ignore my mother’s needs. This time the neglect included blatant abuse when the facility refused to remove the feeding tube and catheter insisting my mother needed both. They also refused to give her any food or liquids orally despite my mother’s desire and ability to eat and her desperate yearning to have something to drink. They also refused to take her out of bed because of her pressure wound that they continued to ignore.
My mother’s sheer will to live kept her alive for 6 months devoid of any quality of life aside from the couple hours I spent every day at the facility talking and singing to her and letting her suck on a sponge soaked in juice. A toll that had robbed my mother and our family of the precious time we had left with her.
Despite my advocating on a daily basis, my mother died July 17, 2022, from severe nursing home neglect and abuse. I can’t imagine what is happening to the residents without advocates.
This is my mother’s story…
…but it could be yours.
My mother is just one of the millions who have suffered dearly as a result of Nursing Home Neglect and Abuse. In No Country For Old People, I intend to use my mother’s story as the thread that weaves in other accounts of neglect, testimonials from Nurses, CNA’s, Doctors, Specialists, Centers for Medicare and Medicaid, and Elder Abuse Lawyers who have represented victims and/or their families in cases of abuse or neglect by hospitals, doctors, nursing homes, assisted living facilities, home health agencies and other care providers, as well as little known practices that include the “Death Panel”, early hospice, and equivocal euthanasia. This documentary will be a much-needed gut punch intended to force people to look at a health-care system that is literally collapsing around us. ~ Susie Singer Carter
DR. JESSICA ZITTER
Dr. Zitter is Harvard and UCSF-trained to practice the seemingly disparate medical specialties of Critical Care and Palliative Care medicine. This vantage point has provided her a unique perspective on how we care for patients with serious and end-stage illness. She works at the public hospital in Oakland, California. Dr. Zitter’s first book, Extreme Measures: Finding A Better Path to the End of Life, offers an insider’s view of intensive care in America and its impact on how we die. Her essays and articles have appeared in the New York Times, The Atlantic, Time Magazine, and the Journal of the American Medical Association, among others. Dr. Zitter’s work is featured in the Oscar and Emmy-nominated short documentary Extremis, available on Netflix. She produced and directed the award-winning, 2020 short documentary Caregiver: A Love Story. She is at work on her third film, The Chaplain of Oakland, which explores the devastating problem of racial healthcare inequities at the end of life.
Mr. Mountcastle is a federal prosecutor working at the U.S. Attorney’s Office in Virginia and is portrayed in the Hulu miniseries Dopesick by Peter Sarsgaard. Dopesick is a drama series created by Danny Strong based on author Beth Macy’s non-fiction book of the same name. The series revolves around the legal case lead by Mountcastle against Purdue Pharma and the company’s development, testing, and marketing of the drug OxyContin. Mountcastle also led the investigation and prosecution of Abbott Laboratories for its false marketing of the epilepsy drug, Depakote to nursing homes to “mentally tether” residents resulting in criminal and civil penalties totaling $1.5 Billion (at the time the largest pharmaceutical settlement involving a single drug in U.S. history).
Ms. Tumlinson leads the nation in setting the direction of aging and disability policy. She is Founder and CEO of ATI Advisory, a national research and consulting firm that shapes public policy and business strategy to reform care delivery for individuals with complex care needs and their families. ATI produces insights, strategic advice, and objective research to prepare a wide range of organizations for a rapidly changing healthcare and aging services environment. Anne also founded and runs Daughterhood, an online and in-person community that connects family caregivers with each other for support and information. She serves on the non-profit boards of the Caregiver Action Network and Mary’s Center, an FQHC in Washington, DC. She serves on advisory boards for aging technology companies and the board of directors for Bluestone Physician Services and Harmony @ Home. Anne is a member of the National Academy of Social Insurance, was named an Influencer in Aging by Next Avenue, and serves as a Nexus Fellow. Anne spent her early career working in government, first as a healthcare advisor to Congressman John Lewis (D-GA) and then as the lead for Medicaid program oversight at the Office of Management and Budget. She joined Avalere Health in 2000, leading the firm’s provider practice and developing business intelligence products for 14 years.
JODY C. MOORE, ESQ.
Ms. Moore is the Founding Partner of Johnson Moore Trial Attorneys and primarily litigates cases involving claims of elder abuse and neglect in a nursing home or residential care facility setting, wrongful death, medical malpractice and other catastrophic personal injury cases. Ms. Moore is dedicated to improving community safety through legal advocacy. Ms. Moore is an accomplished lecturer on the topic of Long-Term Care litigation to lawyer groups across the United States. Last year, Ms. Moore represented ten nursing home residents and delivered a ground-breaking $13.5 million verdict for neglect and negligence.
Ms. Cornish is a renown author, founder of the Dementia & Alzheimer's Wellbeing Network (DAWN®), creator of the DAWN Method® of dementia care, and a retired elder law attorney.
Ms. May is a corporate leader, business advisor, author, speaker, and nationally recognized podcast host of “Eldercare Success”. She has spent her career working with CEOs, Boards of Directors, and senior leaders in the public and private corporate sectors. These experiences gave her the strength and foundation to step in and provide her parents with guidance and support, both as their POA and Trustee, and diehard advocate as they aged. She has transitioned these competencies and life lessons to into her new business, CareManity, LLC, which focuses on providing family caregivers structured ways to obtain practical knowledge, resources, and access much-needed support. She is also the author of “How to Survive 911 Medical Emergencies: Step-by-Step Before, During, After
SUSIE SINGER CARTER - PRODUCER/DIRECTOR
Ms. Singer Carter is a multi-award-winning filmmaker, podcast producer/host and Caregiver Advocate. She is best known for writing, directing, and producing the 2018 Oscar Qualified short film, “My Mom And The Girl” starring Valerie Harper in her final performance, writing and producing “Bratz the Movie” for Lionsgate, co-producing “Soul Surfer” for Sony, writing the animated feature “Twinkle Toes 2” for Skechers/WB. Most currently, Ms. Singer Carter wrote the screenplay, “Plain Jane”, based on the book with the same name and is attached to direct along with Anthony Katagas (Oscar winner for 12 Years a Slave), who will be Executive Producing. Attachments: Leighton Meester & Rose McIver. Ms. Singer Carter is also produces and hosts the podcast Love Conquers Alz – awarded BEST PODCAST 2020 by New Media Film Festival and is listed #4 on Feedspots’ 2022 25 Best Alzheimer’s Podcasts. She also is the co-creator, co-writer, and director of the outrageous horror/comedy narrative podcast “I Love Lucifer”. Susie serves as California Caregiving.com Champion and can be seen in several Alzheimer’s awareness campaigns for Alzheimer’s Los Angeles where she trained to be a volunteer speaker.
DON PRIESS – PRODUCER/EDITOR
For years, Don Priess has shunned sleep in order to become a highly sought-after, award-winning editor, writer, producer, and voice-over artist. After co-founding Modern Media Group, one of the top marketing and infomercial production companies in the world, he spread his wings, editing hundreds of TV and radio commercials, web and social media videos, including for the #1 hairstyling tool in the world, InStyler and for the newest, hottest accessory in the cannabis community, OTTO - all told, generating over 1.5 billion dollars in retail sales. Additionally, his credits include projects for CBS, Fox Television Studios, Nickelodeon, TNT, AMC, Lifetime, Hanna-Barbera, Paramount Pictures, Playboy Entertainment and more. Recent highlights include, co-creating and writing the animated pilot “Surviving Hawking” starring Bryan Cranston and Adam Brody for Fox TV Studios, editing and producing the Oscar-qualified short film, “My Mom and The Girl” featuring Valerie Harper in her last performance and co-creating, writing and editing the outrageous horror/comedy narrative podcast “I Love Lucifer”. He is also the co- host of the New Media Awards Best Podcast 2020, “Love Conquers Alz” with producing partner (Go Girl Media) and renowned caregiver-activist, writer, director Susie Singer Carter.
ROSANNE CORCORAN – CO-PRODUCER
Ms.Corcoran was a primary, sandwich, in-home caregiver for her mother for over 12 years and was the 2021 Caregiver Visionary Award recipient. Ms. Corcoran is a regional Daughterhood Circle Leader supporting caregivers, Producer and Host of Daughterhood The Podcast: For Caregivers to assist caregivers in navigating the healthcare system while providing information and support on various topics.
Honesty, for the most part, is less profitable than dishonesty.