Nursing Homes Abuse Blog - By Jonathan Rosenfeld

I've been focusing some recent Nursing Homes Abuse Blog entries regarding using various web resources for the selection of a nursing home or assisted living facility.  We've spent a fair amount of time discussing the resources available via: states' Department of Health, court websites and medicare, but there are many privately run sites that provide a terrific source of information-- and even candid reviews of facilities.

Below is an entry provided to me by the good folks at OurParents, an online resource that can help navigate families though the tricky world of securing proper living arrangements for the elderly.

Caring for elderly parents is something that many of us who are over 50 have to undertake. We are all living longer now and, therefore, more people over 50 have living parents and many of those parents either require care now or will do in the future. Some organizations and individuals advocate the “70/40 Rule.” That is, when your parent is 70 or older, and you are 40 or older, it is time to start thinking and have conversations about the subject.

Sometimes there is a specific event, like an illness, an injury, that trigger the beginning of the discussion, and sometime it is the onset of symptoms of aging, whether physical or mental, that causes us to start considering the options for our loved ones.

It is always best to be able to think and plan for the future when time is abundant, and there is no immediate crisis. Whilst it shouldn't be something that we worry unduly about before the event, to the possible detriment of our own enjoyment of later life, neither is it something that we can totally ignore. Like anything else, a bit of forward planning will make life much easier if and when the time comes.

Also, if we have thought about it and planned for it in a calm and considered way, then it won't be so traumatic when it happens. This will actually help us to find better solutions and therefore be happier with the outcome.

The fact that you are here at OurParents means that you are trying to understand your options, and we would like to assist you in the deliberation.

Before you begin the search there are five major areas that you should be thinking of:

• First and foremost is your loved ones age & health. How mobile is she? Is her memory functioning well? What is her ability to take care of herself on a daily basis and how independent is she? Does she require any special care ? These issues will determine the breadth of the options available to you. Anywhere from staying at home and receiving in-home care to moving to a nursing home, would depend mainly on her health and mental ability.

• You need to consider the financial situation. What is your loved ones ability to pay for care? Are there any savings or other assets that have been made available for this purpose? Are there any long term care insurance in place? You need to understand, as this would be a critical factor in your decision as to what care options are available to you. You also need to understand, what are the government aids available to you to assist with the financial burden? Are Veteran options applicable? What does Medicare cover and is your loved one eligible?

• You also need to understand your family’s situation and its willingness to support your loved one on this journey. Who will be the primary caregiver? Is it just yourself? Are siblings or other family members, willing and able to assist?

• Another consideration is your parent’s emotional readiness for the transition. Do you know whether a move will prove to be a big issue for them, and they will fight it, or are they ready for the change, and accept it as a necessary move? Have you had “the conversation” yet? Do you know what to expect or are you in for a surprise reaction?

• Last but not least to consider is location. Would you be looking for a place in the vicinity of your loved one’s current home? Would it make more sense to move closer to yourself or to another sibling? Perhaps it makes sense to move a warmer climate?

Having good answers to these questions will help you better assess your options and assess your alternatives that generally fall under the following 3 categories:

• Staying in their own home, or staying with you with various possibilities for in-home care.

• Moving to a Senior Community

• Moving to an Assisted Living Community or Nursing Home, be it a traditional one or an alternate Micro Community.

At OurParents, we have devised the ground-breaking Care Options Advisor™ to help you assess and prioritize your options. We recommend that you make it a starting point for your search.

I think anyone who reads a recent article by Dean Olsen in The State Journal Register will likely be left with the feeling that the world is a better place due to people like Olga Perry.  Hardly a household name, Ms. Perry is one the the thousands of mainly volunteer ombudsman across the country who provide a variety of assistance to people in nursing homes.

After 10-years volunteering for the long-term care ombudsman program, Ms. Perry's dedication to the rights of the elderly was finally recognized when she was presented with the 2010 Outstanding Long Term Care Ombudsman Award by the Illinois Department on Aging. 

Unlike other agencies that assist nursing home patients, ombudsmen many times act as an intermediary to amicably resolve problems between nursing home patients and the facilities themselves.  However, when ombudsmen do encounter a situation involving abuse or violence, they are to report the situation to law enforcement for further handling.

Ms. Parry works out of the Springfield regional ombudsmen center which covers nursing home patients in the following Illinois counties: Sangamon, Cass, Christian, Green Jersey, Logan, Macoupin, Mason Menard, Montgomery, Morgan & Scott.

Congratulations to Olga Perry and thank you for all the work you do to improve the quality of life for many who are incapable of helping themselves.

Related:

National Long Term Care Ombudsman Resource Center A great resource for ombudsmen in your area

How can nursing home ombudsmen help with problems encountered in a long-term care facility?

Nursing Home Watchdogs: Ombudsmen

City Of Chicago Recruits Ombudsmen To Improve Nursing Home Care For Patients

One of the more sobering parts of my job is when I tell someone about a nursing home negligence case that I'm working on--  only to get a response of 'so what' or the ever compassionate 'that guy was going to die anyway'.  Of course, death is an inevitable part of life, but older people have just as much right to live as younger people. 

For too long our culture has accepted poor nursing home care as an inevitable part of the the aging process.  Regardless of a person's age or physical condition, they deserve the best feasible care. Cutting a person's life short due to neglect or abuse can not be tolerated in our society.

With these quality of life thoughts in mind, I was pleased to see an article in the TheSunNews.com detailing South Carolina's new State Law Enforcement Divisions Vulnerable Adults Investigative Unit (SLED) to 'investigate abuse, neglect, exploitation and deaths in government nursing homes.'

SLED was created by legislators in 2007 in response to a report from a non-profit group, Protection and Advocacy for People with Disabilities that demonstrated the state's existing state agencies ineffectively investigated the deaths of nursing home patients allegedly due to abuse. 

According to SLED agent Matt Brown,

"A patient might be 105, but maybe he wasn't supposed to die that day. He has the same right to live as 5-year-olds with their whole lives head of them."

Since the creation of the SLED, 725 complaints of suspicious deaths were reported to the unit. 474 deaths were investigated and determined to be related to natural causes. 12 deaths were related to accidents.  One of the investigated deaths was related to suicide.  231 of the reported death cases remain open or have yet to be investigated due to time time constraints.

I'm all for any program to help families get answers as to what may have happened to their loved one.  However, in the case of the SLED program, it seems substantially under-funded to adequately investigate the cases pending before it.  The fact that a substantial portion of the reported claims remain uninvestigated-- years after they have been reported-- is particularly disheartening because many of the key witnesses will likely be impossible to locate given the long lag time.

Abuse In South Carolina Nursing Homes

If you suspect a South Carolina Nursing Home has abused or mistreated your loved one, there are several agencies to report the conduct to.  In addition, you may contact a nursing home attorney to act as your 'private investigator'.  Rosenfeld Injury Lawyers proudly represents individuals and families in nursing home negligence matters throughout the country.  We would honor the opportunity to speak with you.  (888) 424-5757

• State Law Enforcement Divisions Vulnerable Adults Investigative Unit (SLED) (866) 200-6066
• South Carolina Long Term Care Ombudsman, (800) 868-9095
• South Carolina Department of Social Services, (803) 898-7318
• South Carolina Attorney General, (888) 662-4328

I am overwhelmed by the generosity of blog readers who contribute their time to offer advice, criticism and comments on many issues we routinely discuss relating to nursing homes around the country.  Thank you!  I have put together a survey to try to quantify some of these topics.  Please take a few minutes to answer this survey. The survey will be available for the next week.  Be sure to check back as we review the results. 

http://www.zoomerang.com/Survey/?p=WEB228SRLR3GSB

If you've never heard of EveryBlock.com, you may want to check it out to find out what is going on in your city.  EveryBlock is a useful compilation of public records in: Boston, Charlotte, Chicago, Los Angeles, Miami, New York, San Francisco, San Jose, Seattle and Washington, D.C.  You can search by zip code or address to find out news and topical information that is happening in your area.

A client who's mother was assaulted by a nursing home worker forwarded me this site as a reminder of just how much crime occurs in nursing homes and retirement communities.  Most of this information never makes the news headlines, but to those who have loved ones in a nursing home this information will surely cause you to pause and think about their safety.

A review of EveryBlock revealed the following crimes occurring in Chicago Nursing Homes in January alone:

• 7 death inquiries
• 9 accidental injuries in nursing home
• 24 reports of assault / battery occurring within a nursing home
• 14 reports of a missing person from a nursing home
• 1 report of a convicted sex offender living in a nursing home that failed to register
• 6 reports of theft in nursing homes
• 1 kidnapping from a nursing home
• 3 reports of criminal sexual abuse
• 2 reports of financial exploitation of the elderly

Am I the only one who finds the number of violent crimes occurring in an environment where we place our most fragile downright appalling?

Last week, I had the honor of being invited to Martin Sabel's, a/k/a Mr. Eldercare, radio program, 'Ask Mr. Eldercare' to discuss the new Medicare rating system for nursing homes.  It was great fun to discuss this new development in nursing home care with such a knowledgeable man.  Martin has helped thousands of families handle the financial problems encountered when faced with placing a loved one in a nursing home or assisted living facility.   Listen to the full interview here.

With the holidays upon us, many of us will be visiting friends and relatives in nursing homes. In order to make the visit rewarding, for you and your loved one, some advanced thought should be put into your visit.  I came across this valuable list of recommendations for nursing home visits compiled by Jennifer Davis, on staff at Hebrew Senior Life. 

For residents that are alert the following is recommended:

• Keep them connected to the outside world with news about neighbors, family, friends and current events. Talk in a quiet place. Try to be at eye level with the person and speak slowly and clearly.
• Encourage reminiscing. Bring photos or objects to share. Stimulate conversation about past achievements. If your loved one always tells you the same story, accept this. It’s your listening that shows that you still care.
• Sometimes it’s enough to sit and just hold hands.
• Empathize with a relative’s feeling of distress. Don’t try to deny its existence or argue with the resident who may be confused. It only gets the resident more agitated, and causes further loss in self-esteem.
• Don’t use visits to give advice, scold or argue with the resident.

When a relative is too ill to talk:

• Hold hands; provide touch by rubbing the person’s back.
• Sing songs or play tapes of the person’s favorite music.
• If you can, just sit and share being there without feeling like you have to do or say something.
• Get to know staff, other residents and families to make the visit more pleasurable.

The Elder Law Prof Blog prepared by Professor Kim Dayton, Director of the Center for Elder Justice and Policy at the William Mitchell College of Law, recently reported on a new service on the Medicare website for elder caregivers.  The new Medicare website provides useful information to help home caregivers with questions such as:

• How to enroll in Medicare
• What doctors take Medicare?
• Are there alternatives to nursing homes?
• What billing forms need to be completed?
• How to choose a nursing home

Today there are more than 44 million Americans (one out of five) provide daily care for a chronically ill or aging loved one, friend, or neighbor.  The value of the care services is valued at $350 billion annually, according to AARP.

I came across this post in Bill Jackson's Elder Abuse Blog regarding the selection of a nursing home.  We are so connected to the internet and its resources for checking on people and facilities that we have become disconnected with actually going out and getting our hands dirty when investigating nursing homes for a loved one.  Preliminary research may be effectively done on a computer, but as Bill Jackson recently wrote in is blog, nothing can take the place of your senses.

A visit with the following in mind will give you the best idea of how your loved one will live on a daily basis at each facility.

Look

Look at the residents and staff.  Do they seem rushed and frantic?  Are the residents alert or do they seem glassy eyed?  Are people smiling?

Listen

What do you hear?  Is it resident's yelling in pain?  Worse yest do you hear staff speaking to the residents in a harsh tone?  Is the tv blaring in a room where a resident is sleeping?  Are call bells continually going off? 

Smell

Does the facility smell clean?  Go into the cafeteria, does it smell like food?  Is the smell of urine, vomit or feces anywhere?  If so, your on site inspection is done.

If you suspect an elderly friend or relative is the victim of abuse or neglect, it is important to report the episode to authorities.  Making reports to the proper agency does three important things: 

1. Alerts authorities to current situation and allows them to get your loved one to safety.
2. Creates a records of the incident with authorities regarding the nursing home, hospital or long-term care facility.
3. Allows authorities to correct abusive and dangerous situations to prevent similar situations from happening to others.

The National Center on Elder Abuse has created a centralized database for reporting elder abuse in every state.  The site has links for: nursing home abuse hotlines, licensure and certification agencies, fact sheets on nursing home reform and listing of state ombudsman.  Help create safer environments for our elderly and report incidents of abuse and neglect today.

The Centers for Medicare and Medicaid Services (CMS) have recently released a listing of sub-standard nursing homes.  Nursing homes rely on government payments for approximately 80% of their budget, the potential loss of funding effectively forces them out of business.  In order to continue to receive government funding from Medicare and Medicaid, nursing homes are subjected to random visits from federal and state inspectors.  Inspectors identify any deficiencies and require the problems to be corrected.  If problems are not corrected within 18-24 months, the facility will lose its funding.

CMS has grouped the problematic nursing homes into a listing called 'Special Focus Facility Initiative' (SFF).  Nursing homes on the list have: more serious problems that most facilities and a pattern of problems that continues over time.  The facilities on the SFF list are grouped into 5 categories:  Table A- New Additions, Table B- Not improved, Table C- Improving, Table D- Recently Graduated, Table E- No longer in Medicare and Medicaid.

Nursing Homes in Illinois on the Special Focus Initiative are:

• Harrisburg Care Center
• Berkshire Nursing & Rehab
• Embassy Health Care Center
• International Village

View the full listing of Special Focus Facilities here.

Looking for a listing of nursing homes in Chicago?  Looking for an address of a Chicago Nursing Home?  Looking for a telephone number of a Chicago Nursing Home?  Here is a list compiled by the City of Chicago.  Check out the listing of Chicago Nursing Homes here.

Criminals will no longer be able to work in Illinois Nursing Homes.  More than two years ago, Illinois Governor Rod R. Blagojevich signed a House Bill 2531 into effect to protect nursing home residents.  Under the new law, nursing homes must do a full background check, including running fingerprints on a national database, prior to hiring employees who have direct interaction with residents. 

In addition to employees at nursing homes, the new law also screens prospective employees at: community living facilities, home health agencies, hospices, assisted living facilities, day training programs and community living arrangements.

The new law is welcome news to many nursing home residents who are more likely to become victims of violent crime in a nursing home than at any other time in their life.  Prior to implementation of this law, it was up to nursing home owners to implement their own screening process.  Many violent offenders simply changed their name or provided false information to avoid a 'name only' background search.  Unfortunately, the most commonly reported crimes involving nursing home residents are: sexual molestation, assault, battery, robbery and identity theft.