The Invisible Problem

9/25/2017

At some point in our lives, this week’s topic will touch us all. And if you think about it, it can keep you up at night. That is, if you’re not already dealing with an elderly relative living in an assisted living or nursing home, odds are one day you will. AND, there is the inevitability that one day, we will faced with the possibility of moving into one of these facilities ourselves!

I suppose, living in such a place is not that bad; but it’s the reason for moving into such a residential community that can be disturbing. That, is, quite possibly, one day we will not be able to take of ourselves or one of our loved ones – most likely, a parent. In all likelihood, that will involve a professional caregiver or a nurse, as our ability – whether due to mental or physical circumstances – will be significantly compromised, making assisted living necessary.

Recently, a story broke where eight (no, make that nine) residents in an assisted living facility died due to poor living conditions. This occurred in the nursing facility in Hollywood, Florida, during the aftermath of Hurricane Irma.

Nursing home officials said it was prepped for the hurricane. The power generator was working, and the staff stocked up on seven days’ worth of food and water. But they didn’t anticipate they would still have to fight the intense heat with fans and portable air conditioner units. By Wednesday, eight of the nursing home’s residents had died (a ninth died a few days later). The causes of the deaths are still under investigation.

Currently, there are over 3.2 million adults that live in nursing homes and other long term care facilities in the U.S. As many as 40 percent of all adults will enter a nursing home at some point during their lives. And as the U.S. population ages, the number of nursing home residents is expected to grow. While many of our elderly are well-cared for, there are a number of residents that appear to be the victim of abuse.

A sobering statistic is that up to 1 in 6 nursing home residents may be the victim of abuse or neglect every year. According to the latest reports, abuse continues to be more prevalent than most people wish to believe and over three-fourths of the cases of nursing home abuse are perpetrated by caregivers.

A congressional report showed that an examination of nursing home records conducted over a two-year period indicates that nearly 1 in 3 nursing homes were cited for violations that had the potential to cause harm and almost 10 percent of all nursing homes have violations that caused actual harm, serious injury or placed residents in jeopardy of death.

Physical abuse may be intentional, such as hitting or pinching, or it may be due to neglect including overuse of restraints and lack of physical care. This last condition, neglect, appears to be the reason for this latest tragedy at the Hollywood, Florida facility as their air conditioning system was not fully functional. While portable A/C units were being used in the facility, the facility was, nevertheless, excessively hot. Without going into the gruesome details, reports indicate that, while this condition was recognized and while fatalities were occurring, it took the chief nursing officer at Memorial Regional Hospital (located almost across the street from the nursing home) to notice the extraordinarily high number of patients coming to their emergency room from the nursing facility.  Deciding to visit the facility, the nursing officer observed the patients were in distress due to the unbearable heat which prompted her to trigger the hospital’s mass-casualty alert. The nursing officer later stated that, “The temperature in that room would’ve definitely been a concern for anybody, not just the elderly.”

As it turns out, last year (February 2016), a federal inspector visited the senior facility unannounced to perform a Life Safety Recertification survey. One of the more notable code violations was a deficiency with the backup generator. The inspector wrote that the facility had “failed to maintain the emergency generator to manufacture and code requirements” When the maintenance administrator at the facility was questioned on the violation and ordered to provide documentation that the backup generator was replaced, he was unable to do so.

One of several reasons people decide that elders with chronic health problems are better off in a nursing home than in their own homes is safety. Unless a family is able to afford a private-care nurse team, or an in-home agency for 24-hour care, assisted living centers and nursing homes can often afford greater safety for the elder than living alone.

The obvious point of safety in nursing homes has always been that there are trained professionals in case of a fall, mediation reaction or other health issue. And today, with advances in technology, nursing homes have advanced in safety measures over and above what they once provided. In addition, good nursing homes are very careful with who they hire. Thorough background checks on their employees to screen out anyone who has been disciplined for abuse or other issues that could affect the way they care for elders are now common practice.

So what happened at the Rehabilitation Center at Hollywood Hills? While this area was in the process of recovering from a major storm (hurricane) and power and other necessary services were drastically affected, this facility was supposed to have back-up generators and a professional staff to oversee the patients’ welfare – especially during such a time as the aftermath of Irma. In addition, it must have been obvious to the staff that their residents were in dire need of assistance, yet appropriate efforts seemed to not have be made to alleviate this condition.

Family members of elderly patients in a nursing home or assisted living facility can help prevent patient abuse. By visiting often, paying attention to social or behavioral patterns, and keeping an eye on the elderly patient’s health conditions, the risk of elder physical abuse is significantly minimized. Talk to the elderly patient, listen to his or her concerns, and pay attention to any medicine the patient may be taking.

Organizations such as the CDC cite elder abuse as an “invisible” problem, due to many patients’ failure to speak up. Some elderly patients struggle with dementia or Alzheimer’s disease, making reports of elder abuse even more unlikely. If you or anyone you know is showing signs of elderly abuse, it is important to report the abuse signs to officials immediately. The Department of Health and Human Services published a paper on how to report allegations of abuse or neglect at nursing facilities and is available at: https://oig.hhs.gov/oei/reports/oei-07-13-00010.pdf.

People demand freedom of speech to make up for the freedom of thought which they avoid

Socrates