Inside a ravaged Spanish nursing home

MADRID (AP) – Zoilo Patiño was just one of more than 19,000 elderly people to die of coronavirus in Spain’s nursing homes but he has come to symbolise a system of caring for the country’s most vulnerable that critics say is desperately broken.

When the Alzheimer’s-stricken 84-year-old succumbed in March on the same day 200 others died across Madrid, funeral homes were too overwhelmed to take his body and he was instead left locked in the same room, in the same bed, where he died.

Spanish army disinfecting teams going through the Usera Center for the elderly more than 24 hours later were stunned to come across Patiño’s body and it made headlines around the world, with the country’s Defence Minister Margarita Robles describing “elderly abandoned, if not dead, on their beds.”

“What else could we have done? We didn’t even have protective gear to be able to put the body in a bag,” said José Manuel Martín, a staff member who took the soldiers through the home.

The grim find triggered soul-searching over Spain’s nursing homes, which have had more deaths than those in any other country in Europe. Much of the scrutiny has focussed on government-owned homes like the Usera center, where day-to-day operations have been contracted to companies often controlled by multinational private-equity firms that seek to turn profits quickly by cutting staff, expenses – and some say care – to the bone.

Elena Valero shows a picture of her father Alonso, who was one of the residents at the Usera Center for the Elderly who died during the coronavirus outbreak in Spain. PHOTO: AP

An Associated Press investigation into the 160-bed nursing home where Patiño and 41 others died found widespread cost-cutting for years leading up to the pandemic and a series of questionable decisions at the height of the crisis. That included the facility allowing six crucial days to pass before complying with a government order to separate the sick from the well.

Dozens of interviews with workers, relatives and residents themselves, along with publicly available documents, painted a picture of a stripped-down version of elder care, with nurse’s assistants responsible for caring for 10 or more residents at a time, meals often cut short and some residents told to wear diapers to reduce trips to the bathroom.

The private company that operates Usera disputed AP’s reporting of poor care and declined to comment on calls by elder care watchdogs and others to reform a system that puts private-equity profit incentives on public nursing homes. “This model is not working.” Alberto Reyero, the top Madrid regional government official in charge of elder care, warned in February, barely a month before the new virus took hold.

A cacophony of coughing echoed through the Usera Center on the morning of March 12, with dozens of residents falling ill to fevers and other flu-like symptoms.

But an existing protocol in the home to deal with infectious outbreaks had yet to be activated. Masks, gloves and other protective gear weren’t mandated, and testing for COVID-19 was something employees had only seen on TV.

That morning, wearing a mask she bought herself, an auxiliary nurse set out for the top floor of the four-story, red-brick center and was confronted by the facility’s doctor.

“’Take off that crap, it’s useless,’” the nurse, who asked that her name not be used for fear of reprisal, said she was ordered. “He said all I was doing was scaring the residents.”

On March 21, the Spanish government ordered an immediate separation of nursing home residents into four groups: those infected, those with symptoms, those suspected of having had contact with a positive case and those who appeared healthy.