Awareness of Issues and Abuse in Nursing

Awareness of Issues and Abuse in Nursing Homes

Mykkell Mathison

Nursing Homes

November 27, 2017

Professor Tina Babel

Awareness of Issues and Abuse in Nursing Homes

        Preparing for the possibility of needing Nursing Home services is an important task, especially when coming close to senior age. The selection process can be a little bit complex and there are multiple factors to look at. When selecting a nursing home for your loved one, you must factor in their medical conditions and history, past experiences, and most importantly how well the specific nursing home handles their residents and how much your local government is involved with the safety and regulation of these facilities.

A Florida nursing home under investigation for the deaths of 13 patients after Hurricane Irma says in a letter to Congress that staff members did everything possible but couldn’t overcome a lack of power to the center air conditioner (Spencer, 2017). This caused the local government to respond in a way that negatively affects those in need of nursing home services. Gov. Rick Scott’s administration is making it harder for you to access nursing home incident reports, death investigations and facility inspection reports (Sun Sentinel, 2017). During the selection process for a nursing home, it is crucial to be able to know the history of the local nursing homes. The history lets you know if the food is safe, if the staff is knowledgeable about their profession and required practices, if the facility is clean, and if it is an overall comfortable environment for your loved one.

At last count, the CDC says there are 15,600 nursing homes in the United States, housing 1.4 million Long-Term Care (LTC) residents (Dubois, 2017). These residents require staff that are responsible and that can provide any care that is needed.  The Health and Human Services inspector general’s office issued an unusual “early alert”

recently, based on preliminary findings from a large sampling of cases in 33 states. The inspector general’s report blamed Medicare for failing to enforce federal law, which requires that nursing homes immediately notify the police in abuse cases (Schlein, 2017). This indicates that, albeit a small portion of the 1.4 million LTC residents, abuse in nursing homes is a larger problem than what is known to the general public.

Seniors at nursing homes are not getting the proper care that they need. They experience neglect from staff in various forms and often are powerless to do anything about it. One such neglect is the eviction or dumping of residents. There are a multitude of reasons for why a nursing home may legitimately need to (or unfairly want to) discharge a resident. Some residents need more care than the nursing home feels it can provide, or the resident is problematic with other residents or the staff. A facility may want to discharge a resident whose family is making complaints, threats and high demands about their care. Alas, it is usually a financial matter, where the resident has exhausted funds and has fallen behind in paying the facility.

As NPR reported, “Nationwide, eviction is the leading complaint about nursing homes. In California last year, more than 1,500 nursing home residents complained that they were discharged involuntarily. That’s an increase of 73 percent since 2011 (Singletary, 2017).” That’s an alarming amount of seniors that have to find care, shelter, and assistance on their own which virtually renders them homeless. William Alvarado Rivera, AARP Foundation’s senior vice president for litigation says, “The problem of patient dumping is one of the most troubling complaints of nursing home residents throughout the country. This is basically a form of abuse by nursing homes that dump these patients, especially Medicaid patients, to fill their beds with ‘better’ residents. Until someone holds them accountable, they can keep doing these things (Singletary, 2017).”

Nursing home staff is usually not trained to deal with sicknesses and illnesses and some don’t care about their resident’s well-being. As a direct result, there has been an increase in transfer rates. In every calendar year, roughly 25% of all the patients in a nursing home are transferred to a hospital or emergency room (Yeroushalmi, 2012). This increase is due to staff not knowing what to do and them ultimately resulting in hospitalizing their residents which leads to an increase of stress. For example, a recently released video shows Mr. Dempsey “calling for help six times before he goes unconscious while gasping for air,” according to WXIA. The footage also details numerous care lapses that occurred after he stopped breathing. Staff members failed to consistently perform CPR on Mr. Dempsey, and another nurse failed to check the veteran’s vital signs. Other staff laughed when nurses faced challenges getting Mr. Dempsey’s oxygen machine operational. Additionally, WXIA cites state records indicating about an hour gap between when nursing home staff found the patient unresponsive and when they called 911 (Gooch, 2017). Nursing facilities should prioritize preventing transfers that aren’t necessary. There are specific programs that nursing facilities can adopt to educate staff in practices such as: proper and timely communication between other nursing facilities and hospitals, how to notice problems early, and how to respond correctly to any problems. The failure of a nursing home to adequately train staff violates the patient’s right to be cared for by knowledgeable and qualified care-givers, set down in Health and Safety Codes (Yeroushalmi, 2012).

Proper communication is essential to resident care. Admitting into a nursing home is a time of change in family dynamics, filled with confusion, stress, financial burdens, exhaustion, and even anger. The family has less control over many aspects of their loved ones’ care. The staff must be aware of this and in order to better communicate with families, staff must be able to communicate better with each other. When her team examined this phenomenon, they found that “interventions for older adults generally require multiple components. Staff must intervene in multiple risk factors, and that requires a great deal of communication and coordination among a variety of staff and disciplines. They lacked the connections and communication to coordinate that care. We thought if we could strengthen the communication and problem-solving capabilities of the staff, we could boost the ability to implement interventions,” Dr. Colon-Emeric told Medscape Medical News (Kling, 2013). The establishment of effective communication between nursing home physicians, nursing facilities, hospitals, and the families of residents is paramount to the provision of high-quality care that is responsive to their needs, values, and preferences, and enables them to make informed decisions.

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