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Elder care goes on trial in Oslo

Norway’s much-vaunted cradle-to-grave security was under legal scrutiny this week after the City of Oslo went on trial over its often-criticized elder care. At issue is whether the city was negligent and ultimately responsible for the deaths of two elderly women who police believe should have been placed in nursing homes.

Many elderly simply need a hand to hold, others extensive care and help. The City of Oslo is on trial after two elderly women died because of what police believe was negligence. PHOTO: Sarpsborg kommune
Many elderly simply need a hand to hold, while others require extensive assistance. The City of Oslo is on trial after two elderly women died because of what police believe was negligence. PHOTO: Sarpsborg kommune

Jorunn Marie Bukkøy, age 83, was found in a snowbank outside her apartment in downtown Oslo in March 2010. Police said Bukkøy froze to death after she had wandered outside in the middle of the night. A month later, another elderly woman, Gunhild Bringaker, was found dead in her Oslo apartment. Police determined she’d died at least two weeks earlier, and had been unattended.

Both women were supposed to be receiving hjemmehjelp, the help offered at home to those who aren’t granted or don’t want a room at a local nursing home. Oslo, along with many other communities in a country where elder care is administered through local governments, has a chronic shortage of nursing home capacity. Help at home is often the only form of help available.

“It’s very serious when two women die in the way they did,” prosecutor Pål Fredrik Hjort Kraby of the Oslo Police District told Norwegian Broadcasting (NRK). “It was important that we determine what happened here.” After a lengthy investigation, and state regulatory review, police noted that Bukkøy was dement, incontinent and suffered from various pain and infections. She also had a tendency to fall, yet the city region where she lived, Bydel Gamle Oslo, did not place her in a nursing home and its so-called “round-the-clock” care only amounted a short visits by city health care staffers totaling around two hours a day. It did not prevent Bukkøy from wandering outside on a cold late winter night and freezing to death.

Oslo has a chronic shortage of nursing home capacity. Pictured here, the Langerud Sykehjem on Oslo's east side, built in 1976. PHOTO: Wikipedia
Oslo has a chronic shortage of nursing home capacity. Pictured here, the Langerud Sykehjem on Oslo’s east side, built in 1976. PHOTO: Wikipedia

The police thus fined the city NOK 500,000 for negligence, but the city refused to accept blame or pay the fine. That’s why the case involving the two deaths has finally landed in court, five years after the deaths occurred. The city claims it gave Bukkøy help and services in line with “a certain minimum standard,” while Bringaker didn’t want much if any help at home. City officials claim they couldn’t force help upon her. Health authorities at the state level contend the city should have investigated whether the women were capable of acting in their own best interests.

As the case got underway on Wednesday, with the city pleading “not guilty” to charges of negligence, a local professor who specializes in geriatrics said he thinks more such cases will land in court. “If we continue to view the elderly only as a cost item who need to be taken care of in the simplest manner, this won’t be the last case of this character,” Professor Torgeir Bruun Wyller told NRK.

Elder care ‘not good enough’
While hospitals in Norway are funded and run by the state, nursing homes are administered through municipalities. When an elderly patient is ready to be released from the hospital, their local authorities are supposed to provide nursing home care. All too often the local authorities fail to do so, meaning the patients linger at the hospital on the state’s bill or are sent home and can’t care for themselves. Families generally step in, and private options are available to those who can afford them, but many elderly are single with no family in the vicinity, and thus are on their own.

Torgeir Micaelsen, health policy spokesman for the Labour Party that held government power for eight years until 2013, admitted earlier this year that its own elder care policies “have not been good enough.” Standards of elder care, long seen as a public sector responsibility in Norway, vary far too widely around the country and Labour now thinks the sector needs centralized management, to make sure state funds allotted to elder care get used for elder care, and aren’t funneled into other areas of municipal budgets.

Human rights violations
While clean, well-functioning nursing homes are found, the standards of some elder care in Norway can be so low that the Norwegian Center for Human Rights recently released a report claiming that the human rights of the elderly were regularly violated at Norwegian nursing homes. Residents were seldom taken outdoors in the fresh air, for example, or weren’t helped to the toilet, were forced to use diapers and showered too infrequently, according to the report. No one made sure elderly residents were eating properly, or getting enough fluids. Nursing home management blamed a lack of staffing, while the elderly themselves are a vulnerable group who often are unable or unwilling to complain or demand their rights.

The Progress Party, which now shares government power with the Conservatives, has long campaigned on a platform of improving elder care nationwide. Newspaper Aftenposten reported recently, though, that the Progress Party’s “Elderly uproar” social media site, on which it regularly shared tales of long waiting lists for nursing home rooms and poor care at the nursing homes, went silent after the party assumed office. It apparently was easier to criticize elder care while the party was in opposition than after it came into position.

Health Minister Bent Høie from the Conservatives has acknowledged substandard nursing home care in Norway and vowed improvements, but it was unclear whether they will come and, if so, whether they’ll be in the form of funding, administration or both. The government has been huddling in its first budget conference this week, where Prime Minister Erna Solberg warned of reductions in Norway’s welfare state unless Norway’s oil-fed economy restructures and becomes less reliant on oil and gas revenue that recently has been declining. Berglund



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