Elder Abuse at Banner Boswell ER in Sun City AZ

Last Sunday I visited my 99 year-old mother (Helen Alder) at her home and found her to be very lethargic, not alert, and generally out of it.  Her caretaker said that her feet had become very swollen, and they had not been when I saw her two weeks before.  The caretaker also said she is barely eating, and has stopped walking from her chair to the bathroom and had started to relieve herself in protective panties.  She only walks in the morning from her bed in the bedroom, to chair the front room, and back again at night.

This is absolutely abnormal for my mother who usually can walk fairly rapidly throughout the house.  That she was not eating, not reading the newspaper or doing crossword puzzles which she always did.  I was very concerned and called her doctor, who responded to my call the next day, and came out to see my mother on Tuesday, performed an evaluation, and drew several vials of blood for testing.  Results came back on Friday morning, June 2.  The nurse practitioner, Susan Ward, called me on Friday morning saying she was quite concerned because two of the blood tests came back with highly abnormal readings.  This coupled with her behavioral change and lack of eating, indicated to her, an urgent need to go to an emergency room to be checked for blood clotting and congestive heart failure.

Paramedics took my mom to the Banner Boswell ER on Thunderbird in Sun City Arizona on Friday, June 2, 11 AM.  Before any tests were taken, the doctor (Jones) walked in the room, just after my mother had her vitals taken by a nurse, very chipper and happy with a loud voice saying, “You look fine.”  I explained the situation and her behaviors, and he asked if she was back to normal now.  I said no, my mother did not even understand sometimes that she was in the hospital, which is totally abnormal for her.  The doctor appeared very unconcerned and says well will find out what is wrong and get her back to normal in no time, and then pranced out.

After several vials of blood were taken and 500 mL of fluids given, and urine obtain from a bedpan, we waited. She did get a chest X-ray and a head CT for some reason.

Now my mother has atrial fibrillation, but refuses to see a cardiologist, and she has stage III chronic kidney disease, which is normal for someone 99 years old, and she did make plans to see a nephrologist.  Her heart is weak because she so inactive, due to the pain in her legs which was recently compounded by the  current urinary infection, as well as her sleepiness, but we did not know there was a urinary infection until that same Friday morning.

Dr. Jones came in again, smiling and jovially saying that she appears to be fine, and is she “acting normal” now?  He intimated that they were going to release her.  I strongly objected, stating my mother is not normal.  She was confused as to where she was.  She did not know what time it was.  She kept sleeping the entire time she was in the bed except when attended to by a nurse or a doctor, which is highly abnormal for her, as usually she is quite alert and talkative. And, she appeared quite confused by all the wires and tubes connected to her, asking “What is this?” time after time.

A bit thereafter a nurse came in with orders to see if my mother was mobile enough to go home, as Dr. Jones had earlier stated that in her condition would probably be dangerous for her to go home with only a caretaker for eight hours.

Well, the “mobility test” consisted of walking from her ER bed to the ER room entrance which was about 7 feet, and then walking back again.  It took my mother all of four to five minutes to walk 14 feet with a nurse holding her, and using a walker. Yet they were determined to release her.

I told the nurse how can they possibly release my mother in her condition, she is not normal.  She is confused, she cannot walk more than 14 feet with somebody helping her and with a walker, she could never make it to 50 feet to bed from her living room chair where she spends most of the day.  I emphasized that this was an entirely new condition, that until a week ago she had not had that much of a problem ambulating, eating, concentrating, reading and doing crossword puzzles. This was not her chronic condition, but was an acute disorientation.

The nurse said he would convey this information to the doctor.  The doctor never came in, instead a social worker came in, and was quite rude. Jones was too timid to face a critical and upset relative so he sent a surrogate.

She said, “Your mother should never have been brought to this emergency room.  There is nothing acutely wrong with her to be treated.”  She went on to say, “What you should do is either put her on full hospice care, or get her the medical care she requires.  You have to decide when you will let her just be comfortable (until she dies), or to get full treatment; it is one or the other, not both.”  Yet Dr. Jones refused to treat, except for the urinary infection they found, and released. Why didn’t they hospitalize her until her alertness and ability to walk come back by treating her infection in-house, and getting a cardiologist consult for her heart?  Her sudden deterioration was unexplained, and not even noted by them.  They ignored my pleas to treat, and that she was far from normal.

Her regular visiting nurse practitioner from PopHealth, is the one who stated that she should be taken to the emergency room based on her observation of my mother and the results of two very abnormal blood tests that indicated possible blood clots and congestive heart failure.  It was not a decision my mother made, nor that I made.  That social worker repeated that my options were to make her comfortable until she died, or give her the care she needs, but she cannot have both.  And she is being discharged now.  She asked whether I could stay with my mom, to which I responded that I was having hip replacement surgery in three days and was getting prepared to go. 

She responded with a very stern voice, “Well, the doctor said she is going to be discharged even if it is to her home with a caretaker there eight hours a day. I think this is medical malpractice on Dr. Jones’ part as well as Banner Boswell. I assume this is their normal protocol with very elderly patients.

They absolutely refused to admit my mother and treat her for any of the conditions that she was suffering from.  My mother has a nurse practitioner that comes to her home every three months and more often if needed, such as when she came out to draw my mother’s blood and ascertained that my mother really needed more extensive evaluation. She also has another nurse coming two times per week to check vitals and prepare medications.

I talked to another ER nurse about my mother’s condition stating my mother should not be released.  She told me that things have changed since Boswell Hospital was taken over by Banner.  She said that since Obamacare came in full effect and Banner came in, they hardly admitted people anymore from the ER, and that the new attitude was get them in quick and get them out quick.  She said in the old days they wanted to admit everyone, but now under Obamacare and at Banner the elderly get the short end of the stick as a result of sucking 800 billion dollars out of Medicare to pay for it. Can you imagine the state of healthcare if another $880 billion is sucked out of Medicaid?


Kerima, my significant other, has worked in retirement homes for 15 years here and in L.A., and the same is happening there.  Even nonprofit homes have completely changed to a bottom-line, for-profit mentality.  The old CEOs are fired, and new “cut out everything” CEO’s take their place with massive firings of older employees making a good salary, to be replaced by little or poorly trained, much younger employees making half as much, skimping on food quality, reducing activities, and failing state audit after audit. Her previous employer, Glencroft, slipped from 5 stars to barely more than 3 after a new CEO initiated massive firings of older and experienced employees.

I did a quick Google search for reviews of Banner Boswell, and found many negative reviews of that hospital’s ER.

https://www.yelp.com/biz/banner-boswell-medical-center-sun-city

https://www.yelp.com/biz/banner-boswell-memorial-hospital-sun-city

The nine or 10 user comments that yelp does not use to determine rankings, as they are mostly negative, and yelp tends to hide those.  There is a link to these comments at the end of the reviews that they do count.

This is not going to end well for Boswell, as after I return from surgery and recover a little, I am going to get to the bottom of this elder abuse at Boswell Banner. I am assuming this is a systemic problem not isolated to that ER.

Edward Muzika, Ph.D.
Medical Editor

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