Are nursing homes like jail?
You’ve probably never heard of Charles Todd “Bud” Lee, though he was an award-winning photojournalist whose work has been published in “Life” magazine, “Esquire,” “The New York Times Magazine” and even “Rolling Stone.” His photo of a bleeding 12-year-old boy in Newark, New Jersey, who had been caught in the crossfire of a police shooting, appeared on the cover of “Life” magazine in July 1967. Almost exactly 16 years later, however, Bud suffered a stroke that left him semi-paralyzed and put him in a nursing home in Florida.
It turns out that Florida law requires nursing home care for Medicaid recipients, rather than allowing them to live where they choose. Bud is still there, at the Community Care Center in Plant City, Florida, as an involuntary resident, more than five years later, and he’s really pissed off.
Last September, Bud’s plight caught the attention of Matt Sedentsky, a writer for the Associated Press. Sedentsky’s subsequent September 21 article, arguing that Florida nursing homes, fearful of losing money, have successfully lobbied politicians to make it harder for Medicaid recipients to get alternatives like home health care.
He reported that Bud Lee has filed a lawsuit in federal court on behalf of the estimated 8,500 Floridians who are similarly institutionalized. Bud succinctly described his situation: “Most people come here to die, so you want to die. It’s a prison. I can’t escape.”
A recent study found that older people fear moving to a nursing home and losing their independence much more than death. In fact, according to the study commissioned by Clarity and the EAR Foundation, 89 percent of older Americans want to age in place and will use adaptive technology to stay independent. Their baby boomers, the study noted, are equally concerned about caring for their parents in a nursing home, and are eager to support their parents in this quest.
More than a quarter of the study respondents cited loss of independence as a fear, which is closely related to fear of nursing homes. Moving from home to a nursing facility is a fear of 13 percent of seniors, while only three percent of research study participants identified a fear of death.
These fears appear to be justified. A recent report from the Department of Health and Human Services found that about 17 percent of nursing homes had deficiencies that caused “actual harm or immediate danger” to patients, including infected bedsores, medication mix-ups, poor nutrition, and patient abuse and neglect. . In fact, approximately 20 percent of the complaints verified by federal and state inspectors involved abuse or neglect of nursing home patients.
Last May, the 18,000 residents of Albert Lea, Minnesota, were shocked to learn that 15 residents of the Good Samaritan nursing home, all with Alzheimer’s or dementia, had been verbally, emotionally and sexually abused by girls from the school. local high school who worked at the facility. The subsequent report from the Minnesota Department of Health quoted an employee who said that “When (the students) did these things, they would pull the curtain back far enough so that when they heard a door open, they could stop. They were pretty smart about what they were doing. The ones they were targeting were those who had Alzheimer’s so bad they wouldn’t be able to tell or remember it.”
The report found that the abuse involved spitting and putting fingers in the mouth, pricking the breasts and nipples, touching and touching the genitals, slapping the buttocks on the face, rubbing the buttocks and penises, anal insertion, and restraining the males. residents and make fun of them.
Following investigation by state and local authorities, a 19-year-old and an 18-year-old were charged with felony misdemeanors, carrying a maximum sentence of one year in jail and a $3,000 fine on each count. One of the teens faces 11 charges; the other, 10, included abuse of a vulnerable adult by a caregiver, abuse of a vulnerable adult with sexual contact, disorderly conduct, and failure to report suspected abuse. Four of the others, all 17 at the time of the alleged abuse, were charged in juvenile court with failing to report the abuse.
More than 1.5 million people live in the country’s 15,000 nursing homes, which are normally inspected annually. They are required to meet federal standards as a condition for participating in Medicaid and Medicare, which cover more than two-thirds of their residents, at a cost of more than $75 billion a year.
Although there are obvious acts of nursing home abuse (long-term overmedication, for example), others are more subtle or, as in the Albert Lea situation described above, difficult to detect due to the patient’s dementia. Consequently, these cases can be easily overlooked by family members. The following are some indicators of abuse:
Pressure ulcers or open wounds are common cases of neglect or abuse. Nursing home staff often state that pressure ulcers are normal among frail or immobile older people. Unfortunately, concerned family members are misled by these explanations, and their parents and loved ones suffer pain and sometimes die from these sores. Experts say that almost all cases of bedsores are caused by abuse or neglect. The guidelines require nursing homes to move patients regularly and ensure sheets and clothing are kept dry. If a family member finds a pressure ulcer, she insists that the victim be taken to a medical facility for treatment.
Unexplained bruises, cuts, burns, or fractures are often evidence that staff are dropping or mistreating residents. This often occurs when the older person is in a medicated condition. Family members are encouraged to ask questions for clarification in these situations, and vague or questionable answers often indicate abuse.
Torn, bloody, or stained garments are the best evidence of sexual abuse, which, as described earlier in Albert Lea’s story, frequently occurs in nursing homes, where victims are often on medication or suffering from Alzheimer’s or dementia. Refusal to allow contact with a resident, or unexplained delays in making the resident available for a visit, indicate underlying abuse, i.e. nursing home staff are trying to intimidate or prevent the victim from reporting the abuse or negligence.
Modifications to a resident’s financial documents, including wills and trusts, are cause for suspicion, particularly if these changes occur abruptly or if the resident cannot adequately explain why they occurred. These changes suggest that the resident may have been coerced or threatened.
Each of these warning signs should spur action among family and friends, including reporting to the police. Suspicions of sexual or physical abuse require changing nursing facilities as well as police involvement. Frequently abused nursing home residents nevertheless have civil rights that need to be protected, most often unfortunately by concerned family and friends.