It's an old joke that "business ethics" is an oxymoron. But it is not a joke, nor is it a simple subject. And LTC for the elderly is its own set of special problems. Bottom line imo is that there are some things businesses should not/cannot do that government can and must do. Among them policing businesses. A young man with a gun is lucky if he does not throw his life away in a bad moment. But a corporate criminal stealing for years and doing magnitudes greater harm and damage may only lose a year or a few years, and in many cases preserve his life and prospects for a return to life and well-being, even if he has destroyed the lives, prospects, and well-being of thousands of others.

I am no fan of Communist China, but it seems every few years they make a point of shooting some drug-dealers and some criminal business managers. i don't endorse the practice, but I buy the underlying philosophy, which I understand as making clear that sometimes the bad guys have to pay.

But which government is governing the mutlinational businesses?
Which government is internalising the external effects the multinational businesses create across borders?
Which government has the power to even persecute or demand extradition of criminal business managers (think of the Charles Ghosn case)?

This is a very old problem, with a straightforward solution. Back in the good old days, you never knew if the merchant's weights and measures were accurate or not, you never knew whether your bread flour had been adulterated with chalk or your wine with antifreeze, or the concrete for your skyscraper was made with beach sand full of salt.

This was annoying and dangerous, and nothing could be done by corporations because if there was one unscrupulous trader, he could undercut all the honest traders and put them out of business. But behold, the government invented red tape.

Red tape has a bad reputation as limiting innovation and slowing business down and costing money.
It consists of rules and regulations and standards, along with officious and powerful inspectors and enforcers. Health and safety, food standards agencies, building inspectors, electrical standards, car manufacture controls, toxicity controls so that kids no longer play with lead soldiers or lead painted toys and furniture. Every aspect of life is regulated and inspected by 'the man', including care homes and the certification of doctors.

Everyone hates it until it's not there and they experience the lethal alternatives. It's expensive, complicated, petty, and intrusive. It forbids short-cuts, make-dos and cover-ups. Whether they're government controlled, corporate owned, or charity run, care homes need inspecting often and in detail, and they need to be held to a complicated detailed standard of care that is rigorously enforced This costs a lot of money, and we have to pay for it and suffer the inconveniences, or care becomes careless. and end of life care becomes life-ending care.

What I much admire about some non-Western cultures is their general belief in and practice of not placing their aged family members in long-term care homes. — FrankGSterleJr

Usually it isn't an option that they decide not to take. Without an ample welfare net, the family in general has a far more important role to the individual. I think that this basically is because of necessity, not only because off the differences in culture. In the West people don't think to have children in order there to be someone to care for them when they are old. You simply make savings for your retirement.

This said, the cultural differences are still noticeable. Yet it may be changing. From an older study about the US:

In the past, the use of formal long-term care services by Blacks, Hispanics, and Asians, age 65 and older, has been shown to be substantially lower than that of non-Hispanic Whites. Cultural preferences, language differences, and lower income may explain some of the limited use of services.

However, the use of formal services has changed gradually over time for Blacks as anti-discrimination laws and public funding have provided greater access to nursing homes and home health services. Data from the 1999 National Nursing Home Survey (NNHS) indicate that, while nursing home utilization rates have declined for Whites, utilization rates have increased for Blacks and now surpass those of Whites.

Although data on the use of formal services by Asians, Hispanics, and Native Americans are limited, a study by Himes et al. provides evidence that nursing home utilization rates are much lower among these groups than among Whites or Blacks. Using 1990 U.S. Census data on persons age 60 and older, their study shows that nursing home use was 3.3% for Whites, 3.1% for Blacks, 2.3% for Native Americans, 1.6% for Hispanics, and 1.2% for Asians. Lower rates for Asians, Hispanics, and Native Americans may reflect a cultural preference for family caregiving.

Usually it isn't an option that they decide not to take. Without an ample welfare net, the family in general has a far more important role to the individual. I think that this basically is because of necessity, not only because off the differences in culture. — ssu

To be fair, I think the test ultimately should rest on choices available, then we could see how differences in outlook reflect on how people treat the elderly. One family may have the resources or the means to put an old parent in a homecare, but they refuse to do so and decide instead to take care of the parent.

Honestly, to me, the best choice is for the old loved ones to spend their days with family -- yes, to the busy family it could be an inconvenience or emotionally taxing -- but what happened to skills? How come, we put so much importance in social skills in the workplace, we try to be in our best behavior, participating in social gathering, smiling, being nice and sharing; but when it comes to family members, it's an option to be mean or abusive, it's conditional love?

I also hope that we think about our pets as family members.

Honestly, to me, the best choice is for the old loved ones to spend their days with family — Caldwell

That people can live at their own home would be also one very important thing. We all hope that when the end comes, we still will be sharp in mind and have some ability to take care of ourselves. In truth, being totally dependent on others is not an ending I would hope to have. The question is what kind of life is worth living. Today the most crucial thing is to plan and act before you are in a situation where you simply cannot be at home and basically someone else has to decide where you stay. People can have only plans what to do, but not the will to implement them.

Who would want to live in a long term care home? There can be those good examples of this.

I remember my great-uncle, a former ambassador and a career diplomat, decided with his wife that simply staying at home, going to the supermarket was starting to be too exhausting and hence they went looking for a care home and found a nice one. Then they invited the whole family and relatives to see their now living quarters, basically a normal small flat with their furniture from their old home. I think their success was to make the change before either of them was in too frail condition.

The corporate business model is quite toxic in this case. But I would argue that this is also a problem for the other part of life, when being a child and being in a kindergarten. Kindergartens can also be extremely lousy when lead by profit focused leadership. One alarming indicator is when the personnel (be it a long term care home or a kindergarten) is constantly changing. This usually reflects that the working conditions are not good, the pay is low and there's not motivation to go around.

We all hope that when the end comes, we still will be sharp in mind and have some ability to take care of ourselves. — ssu

We have studies to turn to for topics like this. If you look at profiles of people working well into their 80s and early 90s -- by working, I mean, gainfully employed -- you'll know this is real. So all is not bleak.

People can have only plans what to do, but not the will to implement them. — ssu

Pretty common. So, part of our preparation before we find ourselves in old age situation is to have the will to live and plan accordingly. You don't have to have a lot of money to achieve this -- but sharpness of mind and willingness are definitely a must.

I remember my great-uncle, a former ambassador and a career diplomat, decided with his wife that simply staying at home, going to the supermarket was starting to be too exhausting and hence they went looking for a care home and found a nice one. Then they invited the whole family and relatives to see their now living quarters, basically a normal small flat with their furniture from their old home. I think their success was to make the change before either of them was in too frail condition. — ssu

They are lucky to be able to do this. But many in their old age have a lot less to work on. I guess, we should add that, when old age comes, often the old people are at the mercy of their family members, not the other way around.

They are lucky to be able to do this. But many in their old age have a lot less to work on. I guess, we should add that, when old age comes, often the old people are at the mercy of their family members, not the other way around. — Caldwell

The real cultural divide happens with how large is the "family", where do people draw the line in seeing as an obligation to help the elder person in the family. The natural thing even today in the West is that it's the responsibility of the direct offspring, the children, to help at least in some way, if possible. Yet to help an aunt or uncle or a more distant relative starts to be more rare, unfortunately. The focus on the nuclear family has eroded the larger network that earlier families have provided, at least in where I live (in Finland). This still can differ from family to family.

Add to this that many don't have children and a lot more are single than before, and you have a genuine problem of basically loneliness, which comes to be a bigger problem at old age.

The focus on the nuclear family has eroded the larger network that earlier families have provided, at least in where I live (in Finland). This still can differ from family to family.

Add to this that many don't have children and a lot more are single than before, and you have a genuine problem of basically loneliness, which comes to be a bigger problem at old age. — ssu

Okay, I agree. These are issues we must take into consideration. But going back to the point, given a choice -- do we want to take care of old people in our own homes, or allow the business of care providers to do it? A lot of what goes into the care of the elderly is compassion and kindness -- money cannot often buy these, especially a business who must make a profit.

What I much admire about some non-Western cultures is their general belief in and practise of not placing their aged family members in long-term care homes. — FrankGSterleJr

You might admire these cultures for this reason, but are there other things about those cultures that you don't admire?
I used to work for an international charity and I have read some of the reports about these non western societies.
In a lot of these countries women's rights to employment do not exist, so they stay home and look after the kids and the in_laws or parents if they have not been forced into marriage.

Many non western societies see having a lot of kids as a way to assure a reasonable old age, the more the better. Unfortunately not all of the survive, they don't have enough money to feed them all. In some cases when they do survive they are sold of as workers, especially the girls, to "help" maintain the brothers and sisters.

Most big business are big because of their success at selling their service or product. When people stop paying for them the stop being big.

So the solution, as you say, would be not to use the care homes and for everyone to keep their old folks at home. So which of the parents of the school children would have to quit their job to look after the old ones? Obviously it would be the child of the old ones wouldn't it.

So the man of the house brings mom and dad home one day and calls out as he enters the door
"Honey I'm home. By the way I brought mom and dad here to stay. But don't you worry about a thing, they will not be a burden to you or the kids. I quit my job to look after them."

The next day, as the lady of the house is leaving for work. "Honey, could you pass by the supermarket and do the shopping for next week and don't forget the mortgage is due on today"

If everyone took responsibility for themselves and made sure that they had enough money in the bank their would be no need for care home except for those that decided they needed to live in one.
Oh, how stupid of me!! We are trying to get rid of big business, right. I forgot about that.

So if we get rid of the money makers how is anyone going to have a chance of putting money in the bank?

But, as clearly evidenced by the many needless care-home resident Covid-19 deaths, big business does not always know or practice what's best for its consumers. — FrankGSterleJr

It was politicians, not corporations that caused the nursing home deaths. There's a major scandal about Cuomo right now. He's the governor of NY state, not a corporate CEO. He ordered covid patients into nursing homes, where they died and infected others. Then he lied and covered up the numbers of deaths.

There's no question that the pursuit of the dollar often leads to a multitude of sins. Corporations have a long history of trying to get away with unethical practices in the name of cost cutting and profit. That's the primary reason why there are professional standards and binding legislative frameworks - to protect humans from corporate malfeasance, whether it be selling cigarettes or asbestos products. Like other companies, aged care service often cut costs to make money or 'increase profit' and this heightens risks which can lead to death/s. If your primary focus is on making money this is hardly surprising. And yes, politicians in granting contracts or cutting back laws, or passing others can be enablers for corporations to conduct some dubious business practices.

That said, there are many good companies which run aged care services and not all companies are bad. That's also obvious.

But a corporate criminal stealing for years and doing magnitudes greater harm and damage may only lose a year or a few years, and in many cases preserve his life and prospects for a return to life and well-being, even if he has destroyed the lives, prospects, and well-being of thousands of others. — tim wood

We call those politicians around here...

We call those politicians around here... — creativesoul

Politicians and businessmen commit the same sins, around here. I can't generally tell them apart.

The 2008 crash.