Wednesday, February 21, 2018

Stopping Abuse Among Nursing Home Residents Requires A Better Living Environment

Elderly woman in a private retirement home

Much of the information that circulates regarding nursing home abuse describes scenarios where staff members neglect and abuse their residents directly. There’s also growing concern about specific types of abuse including sexual abuse and financial abuse, which are often more difficult to detect when committed against elderly people.

But an under-recognized problem in nursing homes is resident-on-resident abuse. A 2014 study aimed to shed light on this chronic problem. Weill Cornell Medical College and Cornell University, with lead author Dr. Mark Lachs, studied over 2,000 patients in 10 different urban and suburban nursing homes in New York.

The month-long study is considered the first of its kind as a large-scale study assessing resident-to-resident abuse specifically. Ultimately, the study concluded that nearly 20% of nursing home patients were involved in some form of aggressive encounter with one or more fellow nursing home residents during the four-week period.

The forms of mistreatment that the patients underwent ranged from verbal to physical violence and aggression to general unwanted encounters. The types of encounters the study examined included the following acts committed by a resident against another resident:

  • Coming into a resident’s room and rifling through their belongings
  • Being run over by a wheelchair
  • Having food taken off their plate without asking
  • Being called names or other verbal assaults
  • Undergoing physical violence
  • Being sexually assaulted

The study included any situation where the victim would suffer physical or psychological distress as a result of the actions of another resident. Based on observations and resident interviews during the study, the results indicated that 75% of encounters were verbal in nature and the remaining 25% of encounters were physical.

While the fact that resident-on-resident abuse does occur in nursing homes doesn’t come as a surprise to experts, the prevalence of these types of incidents is alarming. It’s especially concerning because of the nature of resident-on-resident abuse makes it more difficult to control and rectify.

With abuse committed by staff members, the employee can be fired, sued or prosecuted. But with abuse among residents, the problem needs to be rectified by creating a better living environment for everyone.

Creating a better environment in nursing homes that prevents resident-on-resident abuse starts with understanding why these incidents occur. Elderly people with cognitive degenerative disorders can be easily aggravated by certain environmental triggers. These triggers include lighting, noise or large crowds, which can send dementia patients into violent or distressed states. This creates an overall environment that causes unpredictable behaviors among patients that often results in violent outbursts or mistreatment towards others.

Experts, like those who conducted this study, recommend that nursing homes work with Alzheimer’s disease experts to better understand how to create an environment that prevents resident-on-resident abuse. This includes educating nursing home staff on how to respond to yelling among dementia ward residents so that they can control the noise level.

Hopefully with greater education, nursing homes can start to create a more positive culture that works proactively to prevent abuse among residents. Read more on this study.

References:

  1. http://news.weill.cornell.edu/news/2014/11/study-highlights-prevalence-of-mistreatment-between-nursing-home-residents-pillemer-lachs
  2. http://www.cbsnews.com/news/nursing-home-violence-common-but-from-an-unlikely-source/

Financial Abuse Impacts Caregiver Life Savings

Financial abuse against seniors is a chronic problem causing devastation to families who are left to support their elderly loved ones. This is not just an anecdotal claim. A new survey by Allianz Life Insurance Company of North America has procured some compelling evidence regarding the significant impact of past elder financial abuse cases.

The company surveyed 1,000 individuals and found that the average caregiver spends $7,000 annually on persons 65 years and older. The survey also concluded caregivers spend an average of 10 hours of their own time per week to provide noncash support. This includes activities such as delivering meals, driving the seniors to doctor’s appointments and engaging in social activities.\

But more compelling still, the survey found that caregivers who look after seniors who have been past victims of financial abuse spent 56% more on caregiving costs than those who are caring for elders with no history of financial abuse.

This supports the concerns of seniors advocates everywhere who see elder financial abuse as part of a larger economic and social problem that is affecting far more than just the individual senior. Many families are now having to dip into their life savings to cover the costs of elder financial abuse.

Central to this problem is the notion that elder financial abuse is a chronically under-reported and under-recognized social and economic issue. As the population ages, this issue may only continue to worsen. It’s important for all seniors and caregivers to be aware of the potential for financial vulnerability and the possibility of financial abuse.

An earlier survey by Allianz Life from 2014 called Safeguarding Our Seniors, found that 20% of people reported knowing someone who had been a victim of elder financial abuse. Experts believe that financial abuse among seniors is massively underreported for many reasons. If this is the case, elder financial abuse could be a much more pervasive problem than we currently know.

That’s why Allianz Life and other organizations work to study and assess the current landscape of financial fraud among seniors so that it can be prevented. This starts with acquiring a better understanding of who perpetrates financial abuse against seniors. It’s a common misconception that telemarketing, mail and internet scams are responsible for the majority of financial fraud against seniors. However, the reality is that over half of financial abuse against seniors is committed by a family member, friend, caregiver or someone the person is familiar with.

Most significantly, this latest Allianz Life survey found that the average monetary loss among victims of senior financial fraud is $36,000. And in 90% of cases, the family members or caregivers of these victims are also directly affected. The hope is that with increased studies like these more seniors and their families will be better equipped to protect themselves and their life savings. Read more on the results from this survey.

References:

  1. http://newsok.com/mind-your-own-business-financial-elder-abuse-leaves-caregivers-strapped/article/5543156?nextgen=true
  2. https://www.allianzlife.com/about/news-and-events/news-releases/Press-Release-October-15-2014
  3. http://www.businesswire.com/news/home/20161114005212/en/Allianz-Life-Study-Shows-Incidence-Impact-Elder

CNN Investigative Report Identifies Widespread Sexual Abuse in Nursing Homes

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CNN recently published a multi-part investigation into seriously disturbing cases of rape and sexual abuse by nursing assistants. They reported more than 1,000 nursing homes across the country had been cited for mishandling incidents where various forms of sexual abuse were suspected, including rape.

One part of the report followed the trail of a nursing aide who showed a pattern of being a serial sexual offender. CNN documented this suspected offender as he moved from one facility to another despite having a history of sexual abuse allegations against him. He continued to be employed in the nursing home profession.

The CNN report raised an extensive alarm with the public and within the nursing home industry. Many asked why more action isn’t being taken to prevent and stop sexual abuse against defenseless and vulnerable residents, some of whom can’t communicate what has happened to them and often not believed when they try.

CNN interviewed family members who believed their loved ones were being violated as well as nursing home employees who claim to be forced from their jobs for disclosing sexual abuse suspicions. They also spoke to advocates for the elderly and to industry insiders who agreed that immediate change is needed in regards to how alleged sexual abuse reports are handled.

The National Association of Health Care Assistants responded with a pledge to act. They stated to be “saddened and sickened by the CNN investigative report” and planned to increase training and education within its membership. They said this includes ensuring that nursing assistants know how to identify warning signs of potential abuse and the proper mechanism for reporting it to higher authorities.

But dealing with higher authorities might become more difficult, the CNN report goes on to say. On one hand, the State of Missouri is taking measures to allow hidden cameras within nursing homes to catch offenders. However, other legislation is aimed at making it much harder to take legal and punitive action against nursing homes that have a problematic past.

A Senate bill introduced by a Republican from Iowa is aimed at limiting the legal liability of nursing homes as well as doctors and facilities in the medical industry. The Senator claims it’s aimed at cutting health care costs that are seriously affected by huge lawsuit amounts and are driving overall health expenses beyond a practical threshold. Advocates for nursing home abuse victims are strongly opposed to this legislation. They point out that without the threat of litigation, nursing home companies are free to operate without proper accountability.

CNN’s investigative report also gives viewers clear direction on how to check a specific nursing home’s history in the federal Nursing Home Compare website. Here you can find detailed information on whether a nursing home has been reported for sexual or other abuse violations. Read more on CNN’s report.

 

Nursing Home Employee Sentenced to 1 Year in Prison After Assaulting Resident

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Stacy Williamson, the daughter of an 85-year-old woman assaulted at her Ohio nursing home, is asking the public to check on their loved ones in nursing homes daily. This warning comes after her mother, Leona Alexander was violently assaulted by a nursing home staff member in March 2016.

Alexander was admitted to Westmoreland Place in 2010 after she suffered a stroke that left her almost fully paralyzed. This led Alexander to require 24-hour care as she only has limited use of one hand. After the attack, Alexander was moved to another care home forcing her to be separated from her sister, who remains a resident at Westmoreland Place.

The attack left Alexander bruised and bloodied. But what’s worse is the enduring trauma the incident has caused. According to Williamson’s victim impact statement read in court,  the incident had caused her and her family tremendous distress. Following the incident, Alexander was unable to be left alone. She would call for help at all hours of the night as she feared she would be attacked again. This forced family members to have to remain with Alexander throughout the night for several months. Williamson stressed that she is most upset at the fact that Alexander’s remaining time is now ruined because of this senseless attack.

Thankfully for the victim and her family, they will see justice served. Twenty-year-old Kali Jo Craiglow pleaded guilty to a fourth-degree felony for patient assault. This conviction has earned her a one-year prison sentence.

According to records and statements, during the incident, Craiglow had punched Alexander in the face then thrown a glass of water in her face. Craiglow then threatened that things would get worse for Alexander once she had brought her into the shower. The incident resulted in Alexander having suffered black eyes, torn skin, and ripped clothing. There was even blood on the woman’s pillow case as a result of her injuries.

Craiglow, who has a history of drug abuse, was fired shortly after the assault. Her lawyer, Michael Hess, claims that Craiglow has experienced such a horrible history of drug abuse that it’s difficult for her to understand why she committed the assault. In court, Craglow showed remorse for her actions, apologizing to the family and claiming she wished she could take it back. She stated that she has changed and that the person she was during the incident is not who she is now.

For the family, of course, this is of little comfort. Williamson doesn’t believe that Craiglow’s apology is sincere. Williamson feels rather that Craiglow is sorry she’s going to prison. Williamson is relieved, however, that Craiglow will be placed behind bars for what she did. Read more on this story.

Negligence and Violence Incidents Show Crisis in Israel Nursing Home Abuse

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Abuse in Israel’s nursing home system became a public crisis after three aides and a registered nurse were criminally charged with abuse and neglect on aging and helpless patients. This followed disclosure at the Naiot Kipat Hazahav nursing home in Haifa and a report by an investigative journalist published in Yedioth Ahronoth that identified severe instances of violence, abuse and humiliation at other Israeli nursing homes.

The indictment describes numerous and serious counts of abusing helpless persons in care. The three aides are accused of aggravated assaults while the nurse in charge of them is alleged to have known about the ongoing acts but failed to report the abuse as required by duty and the law.

Details of the alleged offenses include:

  • Incidents where patients were placed in wheelchairs in the middle of the night and left to sit alone in the dark awaiting meal times.
  • Placing sticks in wheelchair spokes to immobilize patients from freely moving about the facility.
  • Tying patients spread-eagled to bed rails and leaving them incapacitated.
  • Violently changing patients’ soiled diapers and refusing them access to toilet facilities.
  • Forcibly holding patients down with full body weight while changing their clothing.
  • Punching and hitting patients with hands and elbows causing bruising and bleeding.
  • Washing patients while in restraining harnesses and leaving them to air dry in the cold.
  • Threatening patients with further physical harm if they disclosed abuse.
  • Staff drinking on the job that aggravated verbal and physical assaults.

Although the three aides were responsible for the majority of the abuse, some caught on camera, much responsibility is claimed to fall on the registered nurse who was in charge when the alleged abuse occurred. It raised the question by the nurse’s defense lawyer who asked what was happening to other people in supervisory roles who were aware of the abuse but did nothing about it. That includes doctors and senior facility managers.

Victims’ family members agree that more individuals need to be held accountable. Families cite irresponsibility at high levels and claim they were only told about abuse incidents on their loved ones once the investigative report became public and the charges were laid. They also ask, “What about the others, who knew but kept silent?”

Details of the Haifa abuse complaints caused an uproar in the overall nursing home industry. They’ve prompted government officials to act, including putting forth a motion to have video cameras permanently installed in all nursing care homes to record and prevent abuse. Greater accountability within nursing homes is a main issue.

Government critics cite a lack of funding to Israel’s healthcare system. They call for increased spending and importing qualified foreign labor to boost understaffed facilities. It’s suggested that 2,400 foreign workers are needed to bring staffing to an acceptable level. Read more on this Israeli nursing home abuse story.

Hidden Camera in Massachusetts Nursing Home Captures Assault on 93-Year-Old Patient

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The family of a 93-year-old dementia patient in a Sharon, Massachusetts nursing care home clandestinely installed a hidden video camera in the elderly lady’s room. The family members had suspicions their grandmother was being physically abused despite the senior’s ability to lucidly communicate.

Fox25 News in Boston received a copy of the video footage from the alleged victim’s granddaughter. It shows the lady in her room at the Wingate at Sharon nursing home being assaulted by two nursing care staff members. In the images, it’s evident the workers are trying to place the patient into a wheelchair when a verbal and physical altercation occurs.

The patient, identified only as “Dorothy”, tells the staff members to get away from her, as if defending herself. One nursing home aide shows Dorothy their fist and verbally demeans her. The other care aide then grabbed Dorothy by the back of her hair and yanked her head back. There are more verbal and physical exchanges between the three.

Dorothy’s granddaughter stated, “She can’t really hurt you. She’s only 98 pounds. She was just trying to defend herself and the staff members were picking her up and winging her around.” The granddaughter continued to describe the emotional trauma suffered by Dorothy as well as all the family members over this violent incident.

Fox25 Boston reports the two staff members had been fired and were charged with assault and battery on a person over 60 years of age. The care workers were identified as two men aged 49 and 61. Both are before the courts awaiting disposition.

Wingate at Sharon management responded with a comprehensive statement confirming the incident occurred and the two nursing home aides were immediately dismissed. The nursing home public release called the incident “deeply upsetting”. They claimed this was an isolated incident and they “moved quickly to conduct a full investigation and work with authorities”.

Part of Wingate at Sharon’s remedial action was to bring in a counselor for the victim and family members. They also undertook to re-educate their staff on “appropriate and compassionate patient care”. The official statement indicated their staff members “work hard every day to ensure dignity and safety of their residents. Nonetheless, it’s heartbreaking”.

Since this nursing home abuse incident, the granddaughter has been lobbying lawmakers to reconsider an electronic monitoring bill proposed 15 years ago that would permit nursing home residents to have monitoring cameras in their rooms as a safeguard against all forms of nursing home abuse. Read more on the original story.  

 

Austin Nursing Home Employee Posts Disturbing Photos on Snapchat

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A controversial issue recently surfaced through social media when an Austin, Texas certified nursing assistant posted three disturbing photos on Snapchat. One picture showed an elderly female resident in the Windsor Nursing and Rehabilitation Center with what was apparently fecal matter on her hand. Two more photos displayed an unidentified individual tickling the woman’s nose so her soiled hand was automatically raised to her face.

This distasteful story was picked up by KXAN Austin television. They located the male nursing assistant who posted the online photographs. The poster declined to be interviewed but his family members appeared on camera in his defense. Their faces were blurred for privacy, however, they did issue an apology for how the assistant handled this matter.

KXAN reporters approached this story from two viewpoints. One was the question of ethics where a state-certified professional nursing assistant chose to public display the unsightly images on a public forum rather than using formal channels available through the nursing home administration as well as the Texas Department of Aging and Disability Services. The DADS maintains its own private tip line for reporting these types of alleged nursing home abuse incidents.

KXAN also raised the issue of the alleged victim’s right to privacy, which appears violated by having her image publicly displayed against her will. They cited the privacy rights of the woman as well as her extended family, noting they should be protected from involuntary social media sharing regardless if the posting was made with apparently good intentions of disclosing an abuse incident.

Management staff at the Windsor Nursing and Rehabilitation Center took the matter seriously. They would not comment on specifics of this case, again referring to individual privacy concerns, but responded with a statement that an internal investigation was underway. The matter had also been reported to the police who were looking into whether criminal offenses had been committed.

If so, there may be two separate violations. One would be the nursing home abuse where a resident was assaulted by forcing feces to her face. The other would be a breach of privacy by way of posting unauthorized and offensive images. Both are Class “A” Misdemeanor offenses under the Texas Penal Code.

The Snapchat posting generated fiery online exchanges regarding the responsibility to report nursing home abuse compared to the right of victims’ privacy. One comment read, “Imagine if that was your parent…”

The KXAN television article also reported the Windsor Center being cited for repeated resident safety infractions, indicating that abuse may be ongoing in this particular facility. The TV piece referred viewers to a DADS website that scores all nursing home facilities throughout the state and makes all reports including their outcomes available to the public. Read more on this incident.

Abuse Cases Raise Questions About Ohio Nursing Home Care Quality

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Two separate abuse incidents at the same Cleveland, Ohio nursing home have raised questions about the overall state of care in the State’s care facilities. In one case, a staff member intentionally sprayed cleaning solution into the eyes of a man who was unable to move or speak. The second involved a patient who died after staff failed to clean his breathing apparatus tube as directed by a physician.

Both abuse complaints occurred at the Park East Care and Rehab Center, a 218-bed nursing home in Beachwood. According to the federal government’s Nursing Home Compare system, Park East has the lowest possible score at one out of five stars. The Centers for Medicare and Medicaid Services that created the rating system to help consumers wisely choose care homes, also fined Park East $22,870 for other care lapses preceding these two recent abuse reports. This is the largest fine levied against an Ohio nursing home.

The less serious incident involved a former nurse’s aide who had worked at Park East for six weeks. 26-year-old Chrishelle Worley pleaded guilty in criminal court to the first-degree misdemeanor of patient abuse. Worley was given six months in jail but had her sentence suspended to a year probation after she admitted to spraying cleaning solution into a disabled 41-year-old resident’s face and eyes. Worley could not explain why she did it; only that she thought it was a joke. The man was not permanently injured.

The far more serious case of abuse involved a 39-year-old male resident of Park East who’d been admitted for close supervision after undergoing a tracheostomy after suffering severe respiratory ailments. This medical procedure required a breathing tube be inserted into his windpipe. The overseeing physician gave written direction that the tube must be cleaned or suctioned every four hours and be documented on the patient’s chart.

Somehow, this failed and the patient died as the result of an improperly installed and maintained apparatus. According to a state report, there was no supporting documentation on the chart and an internal investigation by Park East’s management claimed that the registered nurse overseeing and responsible for the patient at the time of death had the opinion that suctioning wasn’t necessary. This was counter to the doctor’s order. The nurse was suspended pending further investigation.

A spokesperson for Park East declined to comment on the two abuse cases citing privacy laws. The report claims that Ohio nursing homes are among the lowest rated care facilities in the nation in regards to quality of care. Dozens of patients have died in Ohio nursing homes from lack of proper care in the past few years. Read more about these two Park East abuse cases.

Nursing Home Sued for Negligence in the Death of 88 Year-Old Woman

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In 2015, at the age of 88, Kathryn Miller died at the Alden Court Nursing Care and Rehabilitation Center in Fairhaven, MA. Now, her son, Stephen P. Miller is suing the care facility for negligence resulting in her death.

In the lawsuit, Miller alleges the nursing home failed to take the proper steps to respond to Kathryn’s distress calls. The suit goes on to claim that this negligence is what resulted in Kathryn’s death.

The alleged initial negligence is only one part of the overall story. Miller also claims that Alden Court is covering up the incident in order to protect its nursing home staff who were believed to have been involved in the incident. Alden Court denies all claims and continues to protect the identities of four nurses who are employees at the care home.

The negligence itself, claims Millers, stems from an incident involving a clam that became lodged in Kathryn’s throat. This is allegedly what caused her to choke and eventually die as a result of asphyxiation. According to Miller, his mother’s death certificate states her cause of death was asphyxiation, however, Alden Court claims her death was caused by a seizure.

Miller has stated in an interview with The Standard-TImes, that his mother was in good health and was not sick prior to the incident surrounding her death. She arrived at Alden Court for rehabilitation after being treated for a broken hip at St. Luke’s Hospital due to a fall she suffered previously.

Miller has stated he’s undergone tremendous stress regarding the whole incident. He’s also expressed that he received little sympathy from Alden Court nursing care staff. He questions how his mother could have even been in a position to ingest a clam in the first place when her dietary restrictions didn’t allow her to eat clams. Alden Court states that they don’t even serve clams. All of this has no doubt caused much confusion and continued distress for Miller and other concerned members of the community.

There is also a discrepancy in how the incident unfolded. Alden Court had claimed that on the evening of her death, Kathryn returned to her room after just finishing a meal, and a staff member discovered she was having a seizure. This is what was reported when the EMS personnel who arrived on scene. However, Alden Court’s official records indicate that three hours passed between the time that Kathryn finished her meal and the time she suffered the alleged seizure.

Alden Court’s official statements do not address the timeline discrepancy involved in Kathryn’s death. Rather they simply claim that Alden Court “does not serve clams”. Miller’s attorney, Philip N. Beauregard is asking for $1 million in compensation and damages from Alden Court as a result of their alleged negligence. Read more on this story from The Standard-Times.

A New York County Law Requires Strict Reporting From Nursing Homes to Family Members

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In response to a shocking incident involving the beating death of an 82-year-old female nursing home resident committed by a fellow resident, an Erie County, NY executive is pushing for a new law.

In honor of victim, Ruth Murray, “Ruthie’s Law” would require nursing home staff to report directly to family members within an hour of any injury suffered that requires hospital treatment.

In addition to the required one-hour timeframe for reporting, the law would also give Erie County’s commissioner of senior services the right to subpoena nursing home reports in order to review them and ensure compliance with regards to reporting protocols to family members.

Ruthie’s Law is important in understanding the overall bigger picture of the problem of nursing home abuse incidents. Because the law requires nursing homes to report on incidents, the resultant data can help the senior services commissioner understand the frequency and extent of future patient-on-patient or staff-on-patient acts of abuse. Ultimately, this data can help shape future policy and continue to deter nursing homes from deceiving families, like Ruth’s when it comes to serious incidents residents are involved in.

Ruth Murray was the victim of a violent attack committed by an 84-year-old man who beat her to death after she mistakenly wandered into his room in the dementia ward. Ruth’s family was initially told that she had only suffered “minor cuts, lacerations and bruises”. An inspection eventually found that the nursing home “failed to provide adequate supervision to prevent accidents and ensure resident safety”.

Now Erie County is taking a stand to demonstrate that deceiving families about incidents that involve their senior loved ones is unacceptable. Officials are asking that the nursing homes be required to pay higher fines when they are found to be negligent in following proper procedures that ultimate end up jeopardizing a resident’s health.

As part of the crackdown coming from Ruthie’s Law is the creation of a public website that will publish nursing home rankings in Erie County. By having access to this information online, families can make more informed decisions about which facilities they choose to place their trust in. The website can be accessed at erie.gov/saferseniorhomes.

Erie County is further committed to deterring and preventing these incidents from happening. They are publishing a “Know Your Rights” guide to distribute to local families. This will further help families understand the actions they can take in protecting their senior loved ones from violent incidents like the one that tragically killed Ruth Murray.

Thankfully, Ruthie’s Law has been implemented to help protect innocent seniors and prevent any future injuries or fatalities of this horrific nature. Read more on the announcement of Ruthie’s Law.

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