Nursing Home and Elder Abuse: Nursing home abuse

» Madison - Nursing home abuse

I just finished reading several articles on elder abuse, and want to share my thoughts, and get opinions and support from others about yearly state suveys, and abuse/neglect investigations, and what we can do as advocates to help solve this problem, and prevent future residents from suffering the same treatment.
I've worked in several nursing homes across the country as a consulting occupational therapist who is in the building 40 hours a week. The things I have seen, and reported to nursing, make me so mad! There is no excuse for what goes on in these places, and how it is handled. I have reported resident abuse by CNA's to administration, and seen how they handle an abuse "investigation". In one home in California, the administator came out of her office (a rare occourance) to read nursing notes about the "alleged" victim. "No entries were made by nursing
reporting abuse" I was told, (the victim was non-verbal, his room-mate reported the incident to me privately) "and no entries were made about bruises or marks on the victim." The room-mate was interviewed, and the CNA was interviewed. The CNA denied charges, the room-mate was labeled "demented" (he was a retired doctor, and had aphasia, but no cognitive deficits) and the case was dismissed!!! This CNA had been reported several times for abuse in a short period, and the cases were all dismissed. Another CNA told the administrator this same CNA was smoking "crank"(methamphetimine)in a patients bathroom during am care! Dismissed. It makes me sick! I've seen administration get the facility all spiffy looking, and all charts "doctored" to cover negligance, and the phony acts of a "caring, attentive staff" that are put on for the surveyers. All this disappears after the surveyors leave. (I've even seen one administrator hang pictures for the visit, then take them down after!) Residents were not normally toileted ALL DAY or diapers changed. Residents sat in soiled clothing up to 6 hours! I've heard residents cry how they need to use the bathroom, to be told by CNA's "go in your diaper!", residents with dysphagia fed lying flat in bed, not allowing time to finish chewing before next bite is forced in (yes, forced.The patients head was cradled and mouth pried open) I could go on forever. My thoughts are this. Why is this allowed to go on? Is it because nursing homes are now a "business" and are operated as such, rather than peoples homes? Money. As long as the facility makes money, it is rewarded. Administrators are awarded handsomely if they meet quotas,make profits and are praised and recognized for their excellence in running a "quality home". To get this, they will often "pay-off" the surveyors to give them a good survey, (not too many deficiencies) and not tarnish their reputation as the one who made the home the quality place it has been named. This DOES happen. Not in all places, I want it understood that any comment I make is not applicable to every home or every nursing home worker. Great staff DOES exist also. If homes are fined, it is possible to have the fine dismissed. WHY? What good does this do to correct the problem sited? Why do the administrators know when the state is coming? Its all a business. Patient care is just the front for fraud, abuse, neglect, and greed. Why can't we get laws passed that are enforceable? Why can't the federal government regulate the homes? Why can't the surveyors come in disguise as a visitor or volunteer, and be unknown until it's over? Why can't surveyors be trained volunteers who do it because they WANT to, not for the money? Why are surveys conducted yearly almost to the day? Why can't they come in throughout the year, several times, rather than 1 week strait? Why aren't families, volunteer workers, friends, and cognitively aware patients interviewed? Why is the staff spot questioned only about such things as location of fire alarms, and dirty linen disposal rather than patient care and observations? Why isn't there a law that enforces that a set percentage of CNA's be hired per number of resdents for personal care?(I think something like this is being pursued now, let's hope it passes!) Why can't competency tests be mandated and administered by the federal govt yearly? Why is it possible for a CNA to work without certification?(I know it is required, but 3 were found at my facility who were not! why?) Why is it possible for a fine to be dismissed? Why can't documentation done on non-retrievable computer program that goes strait to medicare, or other insurance companies, or patient records to make "doctoring" charts impossible? Why are witnesses of elder abuse scared to talk? Why doesn't the law protect them? I know the answer is money. Money breeds coruption. Why are insurance companies allowed to determine the need of the patients care? or length of rehab, or stay? Wouldn't a multi-disciplinary team on staff be better qualified? Who are these people who make the rules? Are they doctors, therapists, or social workers? I doubt it. Every persons case is different, and their needs can't be grouped into catagories. The residents suffer. We hear about "Medicare fraud" and the epidemic it has become. Well, do you know how easy it is to do? Its a matter of a check mark and initials in a box on a piece of paper for rehab workers. Why don't they make it more difficult? The world is unfortuntely a dishonest place. Cameras are put in department stores or donut shops to stop theft, is the $.39 spent on a donut more important than than the billions lost yearly from fraud? When did mothers, fathers,family,veterans,respectable citizens, someones child at one time, human life, become less important than money? America prides itself on our strong economic country, land of opportunity. What about morals, integrity, respect and love of fellow man? I never hear America sold on these qualities. I know they still exist, or you wouldn't be on this web site. E-mail me, lets be the ones to initiate a change, instead of sitting back and waiting for it to happen, waiting for others to address it. Let's write our Federal government officials, send petitions around, anything we can think of to make the voices of the abused and neglected heard, and changes made to protect and give their dignity and deserved respect back to them. I'll help with any suggestion you have, just please join me, let's be the ones who initiate and make the changes! Thanks for reading this long speech. I'm getting off my soap box now. M.

-- posted by Madison