According to a recent report, more than 90 percent of nursing homes were cited for violations of federal health and safety standards last year, and for-profit homes were more likely to have problems than other types of nursing homes. About 17 percent of nursing homes had deficiencies that caused “actual harm or immediate jeopardy” to patients, said the report, by Daniel R. Levinson, the inspector general of the Department of Health and Human Services. About one fifth of the nearly 40,000 complaints about conditions in nursing homes last year involved the abuse or neglect of patients.

Currently, two-thirds of nursing homes are owned by for-profit companies, while 27 percent are owned by nonprofit organizations and 6 percent by government entities. According to the report, 94 percent of for-profit nursing homes were cited for deficiencies last year, compared with 88 percent of nonprofit homes and 91 percent of government homes. “For-profit nursing homes had a higher average number of deficiencies than the other types of nursing homes,” Mr. Levinson said. “In 2007, for-profit nursing homes averaged 7.6 deficiencies per home, while not-for-profit and government homes averaged 5.7 and 6.3, respectively.” Mr. Levinson also issued a compliance guide for nursing homes that says some homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.”

Researchers have found that people receive better care at homes with a higher ratio of nursing staff members to patients. Bruce A. Yarwood, president of the American Health Care Association, a trade group, said: “We know we have to do a better job. We have been doing a better job, in treating pressure sores, managing pain and reducing the use of physical restraints.”

Deficiency rates varied widely among states. The proportion of nursing homes cited for deficiencies ranged from 76 percent in Rhode Island to 100 percent in Alaska, Idaho, Wyoming and the District of Columbia. The average number of deficiencies also varied, from 2.5 deficiencies per nursing home in Rhode Island to 13.3 per home in Delaware.

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A former employee of a Calabasas, California assisted-living facility, specializing in caring for Alzheimer’s and other memory-impaired patients, was charged on October 6th with torture and multiple counts of elder abuse. The charge stems from the death of an 80-year-old resident last year and the alleged abuse of other residents.

Cesar Ulloa, 20, is scheduled to be arraigned today at Van Nuys Superior Court, and is being held on $1.2 million bail. Ulloa was arrested following an 11-month investigation by the Los Angeles County Sheriff’s Department after an anonymous whistle-blower from Silverado Senior Living said 80-year-old Elmore Kittower was the victim of torture and other hideous acts of elder abuse.

Kittower, a retired engineer, died on Nov. 6, 2007. An autopsy revealed that he died of a blood clot in his lung. However, the investigation revealed that he had been abused for months prior to his death. Ulloa, of Reseda, California was employed as a caregiver between February and November 2007. Ulloa allegedly punched the victim and attacked him numerous times that resulted in numerous rib fractures and assorted injuries. In addition to one count of torture, Ulloa was charged with four counts of elder abuse involving three other victims who were residents at the facility. If convicted, he’s facing up to life in prison.

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To combat elder abuse, Governor of California Arnold Schwarzenegger has signed a package of bills that will ensure care facilities for the elderly are prepared during disasters and power outages, provide law enforcement with more tools to ensure criminals who victimize the elderly are prosecuted and further protect against different forms of financial abuse. “Protecting our growing population of older Californians and helping them feel safe and secure is a priority of mine. I am committed to fighting against elder abuse and these bills will continue to crack down on negligence and criminal acts that too often affect older Californians in our state,” Governor Schwarzenegger said.

In an effort to have more suspected cases of elder abuse reported, the Governor signed AB 2100 by Assembly member Lois Wolk (D-Davis), which requires ombudspersons at long-term care facilities to report cases of alleged or suspected physical abuse, including sexual abuse, and financial abuse to the local district attorney’s office.

The Governor also signed AB 749 by Assembly member Wolk to make sure elderly residents living in residential care facilities are not left vulnerable during and immediately following a natural disaster or other emergency. The bill requires residential care facilities for the elderly to have a comprehensive emergency plan by March 1, 2009 that ensures the facility can remain self-reliant for at least 72 hours. The facility must also make the plan available to residents and local emergency responders.

The Governor also signed several bills to protect the state’s aging population against financial abuses. The Governor also signed AB 225 by Assembly member Jim Beall (D-San Jose) to extend protections to family members and conservators of older Californians who have suffered from elder abuse. The bill allows the family member or conservator to be added to restraining orders that provide protection for the victim of abuse.

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Making the decision to place a loved one in a nursing home is often one of the most stressful times in ones life. However, there are many alternatives one can choose to avoid this fearful decision. The most popular alternative is to choose a home health agency that provides health and medical services to ill or disabled individuals through in-home visits.
There a hundreds of different home health agencies across the country, but there is a new agency in Lafayette, Indiana that aims to better the world, one life at a time. Homecare by Design provides in-home skilled nursing services to seniors and people with disabilties. Owner Traci Goudy said some clients receive nursing care 24 hours a day and some just need a few hours of companionship a week. “We offer a variety of layers of care, starting with our catered care one package. Those people may just need a little bit of laundry help or transportation, maybe some cooking and cleaning. All the way through our catered care three package which is more of that hands-on, heavy care for maybe those people who are bed-bound, or wheelchair-bound,” said Goudy.
For Florence Sobczyk, 86, of West Lafayette, Indiana simply having the companionship of someone else is good enough for her. “We just kind of goof around, you know, and that’s about it. We just talk and laugh, and that’s really nice. I really enjoy them” she said. And, for her daughter Judi Jezierski, it puts her mind at ease knowing that her mother is in good hands and is enjoying her later years.
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Four nursing assistants at the Good Samaritan Society nursing home in Albert Lea, Minnesota were recently fired after allegedly physically, sexually and emotionally abusing 15 Alzheimer and dementia disorder residents. The four women were fired after a fifth aide, who was fired for swearing in front of residents, blew the whistle on them. Three additional aides who witnessed or were told about the abuse were also fired for failing to report it. “At this point, individuals who were either deemed to be involved in the alleged abusive actions or had knowledge of the incidents and failed to report in a timely manner are no longer employed at the center,” said Mark Dickerson, spokesman for the Minnesota Health Department.

According to a state report, “To make “work fun” four young nursing home aides abused 15 demented residents by hitting their breasts and genitals, sticking fingers in their mouths or noses to keep them from screaming, and taunting them.” Kris Lohrke, who supervised the Minnesota Department of Health investigation said, “We can’t remember anything quite like this, it’s that rare — both in the number of perpetrators and the range of pretty bad actions.” The facility however will not be punished since officials followed procedures and notified proper authorities.

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On a cold February morning back in 2007, Karen Presto wandered away from the Roscoe Manor Adult Home, then stumbled into the woods about a mile way.  She fell repeatedly and walked in circles until she curled up under a pine tree.  Sadly, that is where police found her frozen body two days later.  She had no shoes or socks and a medical examiner ruled she died of hypothermia.

Preston was 54-years old and suffered from severe schizophrenia.  She was placed in Roscoe Manor because she needed help with daily activities and self-care that an adult home is supposed to provide.  When just a year after Preston disappeared, another Roscoe Manor resident, Ella Maye, walked away from the home. Maye, 78, had dementia and heart disease.  State police conclude she suffered a fatal heart arrhythmia while walking on Rockland Road early on Feb. 23.  They believe she was trying to crawl back to Roscoe Manor when she collapsed on a neighbor’s front lawn and died.

The home was supposed to do hourly bed checks, but Roscoe Manor owner Charles Benson said, “at the time that an employee had failed to do so.  No one noticed Ella Maye was missing.”

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When Edward Monsour’s family left him in the care of the Manor Health Care Center in Las Vegas, Nevada in 2005 to recover from a fall, they thought he would rehabilitate, return home and re-establish himself as the family’s patriarch. However, a year later, Edward was still in the nursing home and was in far worse shape than when he entered. Ultimately, Edward left the nursing home to receive emergency care for bedsores and a large ulcer on his heel that had blackened from gangrene. A few weeks later, Edward died of sepsis, a bacterial blood infection.

Edwards’s family blamed the nursing home for the death. They said there was inadequate supervision, lack of staffing and an untrained wound care nurse who knew nothing about treating ulcers. Ultimately, they filed a complaint against the nursing home and a judge found the facility violated Nevada law when it failed to provide adequate care, causing pain and suffering to both the deceased and his family. The family was rewarded over $750,000 in compensatory and punitive damages, but no amount of money can replace the loss the family incurred.

This is just one of the many cases of an ever rising problem of elder abuse in Nevada. Between July 1, 2006, and June 30, 2007, the Nevada State Division for Aging Services investigated 4,476 cases of elder abuse. The division’s elder abuse reporting system doesn’t distinguish abuse cases based on where they occurred. However, in the past six months, 188 cases have been reported to the agency involving elder abuse in nursing or group homes, said Kay Rogne, elder protective service program manager. Hopefully, nursing homes in Nevada and around the country will address the rising numbers of elder abuse and correct this serious problem.

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By law, doctors are required to report suspected elder abuse in their patients. However, most of them never do, even if they believe that silence may subject the elderly person to continued abuse at the hands of a caregiver. The lack of physician reporting is a huge problem, experts say, because as the elderly population continues to grow and doctors become ever more pressed for time in meeting the demands for care, more elder abuse will go undetected.

Every year, roughly 2.1 million elderly Americans are victims of some form of abuse, but Congress says the actual number could be closer to 5 million. According to medical and legal experts, doctors report just 2 percent of the elder abuse and neglect cases recorded each year by state protective service agencies. In Rhode Island for example, law requires anyone who believes that an elderly person is being abused, exploited, neglected or abandoned to make an immediate report to the state Department of Elderly Affairs (DEA). However, according to Corinne Calise Russo, director of the DEA, very few of the 800 to 900 abuse and neglect complaints filed each year with her office are made by physicians.

One of the main reasons for non-reporting by physicians is that they do not know how to recognize signs of elder abuse. Many physicians have not been taught through their medical training on how to properly notice if one of their patients has fallen victim of abuse. “Sometimes physicians don’t know what they’re looking at because, historically, there has not been education on elder abuse provided in medical training,” says one expert. “There are relatively few medical schools that have any specialized geriatrics training and there are relatively few geriatricians.”

To correct this problem, experts believe that more needs to be done to teach physicians about how to recognize the signs of elder abuse. According to Brown University’s Richard Besdine, who has trained more than 90 doctors for careers in geriatrics, “Doctors need to become better educated when dealing with elderly patients, to recognize that the bruises they see on an elderly person might not be from rolling over in bed. Most of the abuse occurs in the process of giving care to needy, frail older people who are not easy to take care of.”

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In mid-June, we wrote about the fight in Congress to invalidate arbitration clauses in admissions contracts and arguments both for and against the Fairness in Nursing Home Arbitration Act.

On Wednesday, July, 30^th, the House Judiciary Committee approved the Fairness in Nursing Home Arbitration Act – which outlaws the signing of an arbitration agreement as a prerequisite to admission in a nursing home.  The committee’s decision now clears the way for the bill to go to the House floor for a full House vote.  Furthermore, “the Senate version of the same bill has been referred to the Senate Judiciary Committee.” The passing of this bill would allow seniors in nursing homes the right to a fair trial in an instance of neglect or poor treatment, if they so choose.

Still long-term care advocates oppose the legislation, arguing that, “arbitration agreements are helpful and allow them to devote limited Medicare and Medicaid resources to providing quality care instead of funding lengthy court trials.”  The battle continues and only time will tell end result of this Act.

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When health care issues are debated, often missing from the public policy debate is the huge value of informal care giving services and, unfortunately, the toll those services take on the caregivers.  National estimates show that thirty to thirty-eight million family caregivers provide ongoing care for loved ones or family members.  These services provided by the caregiver are valued at more than 350 billion dollars annually.  In Oklahoma alone, an estimated five-hundred thousand family caregivers provide more than three-hundred million hours of care.  That amount of time and stress often catches up to them.

Whether the caregiver is caring for a disabled child, someone who is chronically ill or an elderly parent who can no longer live on their own, they all have special needs that require unpaid services, “in hopes of providing their loved ones a better quality of life.”  Often caring for an elderly parent holds a lot of work and also guilt.  The caregiver doesn’t want to place them in a home but often it becomes too much to care for them on their own.

Being a full time caregiver and still trying to retain a job is no easy task.  Symptoms of “negligence, depression, financial problems, anxiety, feelings of detachment, irritability and difficulties in relationships have all been linked to care giving.”  This is where Respite care comes into play.

Respite care provides short-term relief from the responsibilities of caring for loved ones.  Respite care allows the caregiver to go on vacation, see a movie, or simply run everyday errands.  This gift of time that Respite care gives is crucial in providing the caregiver with a much needed brake.  Care giving can be a full time job and the little things like help from family and friends, or an option like Respite is a good way to help with the stress.

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