Disturbing Nursing Home Story

SmilingBluEyes · Dec 11, 2003

And what I fear is this is just the beginning....with the Baby Boom generation JUST hitting middle age and nursing in an acute shortage of people willing to work, we are SUCH BIG TROUBLE. This is bound to become much more common in the next 20-30 years. Scary.

Jay-Jay, RN · Dec 11, 2003

i've been meaning to post about this myself, but haven't had the time, because i've been too busy trying to cope with exactly the sort of thing these articles are exposing:

https://allnurses.com/forums/showthread.php?postid=609362#post609362

and if you think it's anything new, check out the following article:

dec. 9, 2003. 01:00 am

sadly, we've heard it all before

thomas walkom

the star's series on the deplorable conditions in some ontario nursing homes makes grim reading.

last week, reporter moira welsh recounted in horrifying detail one case in which an elderly patient was left to literally rot in bed. citing government reports and first-hand accounts, she wrote of other cases of nursing home residents who were malnourished, dehydrated and living in desperate straits.

the picture she painted of some nursing homes was horrendous: of patients strapped into chairs for hours by staff members too busy to care for them, of families afraid to complain for fear of retribution, of the overwhelming smell of urine and feces.

in one case, staff shortages were so acute that residents were roused at 4 a.m. so they could be washed, dressed and put into chairs in time for breakfast.

grim reading indeed.

in fact, it was almost as grim as the star's 1985 series on nursing homes.

that series, too, found nursing homes understaffed, families afraid to complain and residents left strapped in chairs for hours on end-often stewing in their own waste.

the 1985 series was not that different from a 1983 star expose that found some nursing homes characterized by bad food, little attention to personal hygiene, lack of privacy (in one case, a female patient was undressed by staff in full public view) and the overwhelming smell of urine.

that, in turn, was not dissimilar to a march, 1982 star series on nursing homes that documented cases of overmedication, rough or indifferent care, understaffing, relatives afraid to complain and insufficient government inspection.

as did a 1981 globe and mail series on nursing homes.

as did a 1980 star series on retirement homes, or rest homes as they were known then.

in 1978, the star reported extensively on new democratic party demands for a public inquiry into nursing homes.

the ndp cited-you guessed it-malnourishment, neglect and an overwhelming fear among relatives that if they complained matters would only get worse.

in 1965, a chatelaine magazine reporter working undercover at several nursing homes reported that patients were bruised by rough handling and that, amid the nauseous stench, the helpless were left sitting in sodden piles of wet rags.

and on and on.

the point is not that newspapers keep writing the same story. it is that little has improved.

back in 1959, the toronto board of health told of old people kept restrained in their nursing home beds because of lack of staff. in june, 1965, the ontario welfare council reported that 40 per cent of the province's nursing homes were inadequately staffed.

in 1984, the canadian medical association weighed in with a task force report calling the standard of care in many nursing homes "grossly inadequate."

in language that sounds eerily familiar today, the cma report said physicians on contract to nursing homes often provided only cursory care, patients were too often helpless and private operators too often consumed with the bottom line.

twenty-two years ago, an advocacy group called concerned friends of ontario citizens in care facilities reported that many nursing home residents are malnourished, emaciated, dehydrated and suffering from potentially gangrenous bedsores.

two years ago, advocates made much the same report, adding, "if any family were neglecting a parent the way that so many are now neglected in nursing homes, law enforcement would get involved."

they'd made the same point in october, 1986.

so what does government do?

in 1982, following one of the star series, the then conservative government announced a sweeping review of nursing homes and vowed that all would be made right.

in 1990, after the provincial auditor reported that thousands of elderly patients were at risk because of inadequate government inspection of nursing homes, then new democratic premier bob rae promised swift action.

"there is no room in this province for places where people are not well cared for," he said.

in 2000, then tory health minister elizabeth witmer said she found it "outrageous" that government inspection of nursing homes was still inadequate. she promised to do more.

on sunday, when presented with photos of one nursing home patient who had developed gangrene from bedsores, liberal ontario health minister george smitherman was so shocked that he broke into tears.

"we will fix this," he vowed.

we shall see. we have heard all of this before.

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Lalage · Dec 11, 2003

I'm so sorry Jay Jay:o This is nothing anyone should have to see a loved one go through. I just hope that these 'expose' articles continue to be published, and hopefully each time, a few more changes are made. You'd think with the boomers getting older, they'd pay more attention to their options for future nursing care. The one nursing home I worked in stopped providing us (the health care aides) with gloves. We were given thin gloves I've seen food handlers use in Subway sandwich shops instead of the the regular protective gloves. They said we should just increase our hand washing. Would you want to clean up poop with a glove that was so thin, picking up the wash cloth from the basin (with the thin glove on) would leave my skin soaked!? I started buying my own, for my protection and the protection of the residents. It was no surprise when things like UTI's trippled in a matter of weeks.

sueb · Dec 11, 2003

Oh please. Reading this kind of stuff really makes me sick!!! Having worked in a lot of nursing homes I KNOW that the majority of them are GOOD! The media loves to pick on the few that have problems!!!!!! Yes, nursing homes have problems, they are understaffed as are hospitals. But I would rather be in a nursing home than a hospital!! Yes pts. in nursing homes are dehydrated and ?malnourished. But it's not because we don't try to get them to eat or drink. Sometimes they just REFUSE and they refuse for long periods of time..and interventions are taken. Yes, pts. in nursing homes have bruises. They are not caused by mishandling. Elderly pts. have fragile skin and this is usually documented. The Media loves the hype!!! I could go on and on, but i'm sure you see my point. Yes, there are a few bad nursing homes but the majority are very good and I would not hesitate to place a loved one in them (or myself for that matter)! Oh and I need to add that the majority of bedsores that nursing homes see are the ones that come to us from home or the hospital!

Geeg · Dec 11, 2003

When friends/family members ask me about nsg homes I tell them to stay out any which way they can. Then they counter with:"What if mom falls down the stairs and nobody finds her for a few days?" I tell them, that scenario is still the lesser of two evils when compared to nsg home confinement.

Luv2banurse2004 · Dec 11, 2003

There was a report on the evening news, and various newspaper articles about this incident. At a nursing home in Illinois this past Sunday, a 79 y/o resident filed acomplaint accusing one of the caretakers at the assisted-living center of stealing several hundred dollars from her room.

The next morning (Monday) after the resident didn't show up for breakfast, a staff member found her found her in her room, dead from multiple stab wounds to the chest. According to one news report she'd been stabbed over 20 times. The CNA who the resident thought was stealing from her was charged Tuesday with two counts of first-degree murder and could face the death penalty.

Apparently the CNA snuck back into the residents room after midnight using her keycard, took a knife from the kitchen area, and repeatedly stabbed the resident around the neck and abdomen while covering the victim's mouth and face. This was an attempt to cover up the theft. This was a CNA with no previous violations according the the state health dept.

Now how much scarier can this be? You can't protect residents from something like this when there is no prior warning and no record of past behavior on the part of the caregiver. Just made me shudder learning of this.

suehp · Dec 11, 2003

Originally posted by sueb
Oh please. Reading this kind of stuff really makes me sick!!! Having worked in a lot of nursing homes I KNOW that the majority of them are GOOD! The media loves to pick on the few that have problems!!!!!! Yes, nursing homes have problems, they are understaffed as are hospitals. But I would rather be in a nursing home than a hospital!! Yes pts. in nursing homes are dehydrated and ?malnurished. But it's not because we don't try to get them to eat or drink. Sometimes they just REFUSE and they refuse for long periods of time..and interventions are taken. Yes, pts. in nursing homes have bruises. They are not caused by mishandling. Elderly pts. have fragile skin and this is usually documented. The Media loves the hype!!! I could go on and on, but i'm sure you see my point. Yes, there are a few bad nursing homes but the majority are very good and I would not hesitate to place a loved one in them (or myself for that matter)! Oh and I need to add that the majority of bedsores that nursing homes see are the ones that come to us from home or the hospital!

I have to agree with Sueb...there ARE bad nursing Homes but dont tar us all with the same brush. I am a nursing home manager and my residents get excellent care...majority of my staff have been there 10 yrs plus, and see our residents as family. As Sueb has already said residents DO refuse to eat/drink, yes they do bruise easily...but EVERYTHING gets documented correctly..... AND some of my residents have gone into hospital and come out in a worst state than they went in i.e. pressure sores, MRSA, Clostridium, weight loss etc etc...... isnt it the same that not all hospitals are good.......

It is right to expose the BAD nursing homes but DONT think ALL nursing homes are the same ...

LydiaGreen · Dec 11, 2003

I have to agree with some of the posters... saying that all nursing homes are bad, is not correct. I have seen four and found only one of them to be deplorable. Perhaps the other three were not the best that we would hope for, but I would certainly say that they were doing the absolute best that they could without the adequate funding and staff that they needed. A lack of staff is not the fault of the staff or of the management... the government does not supply the funding that is required for more staff (this is in Ontario, the subject of the OP's post). The staff that is there does the very best that they can. The only "bad" nursing home that I have seen was privately run (not saying they are all that way, this is the only privately run home I have been in). All three of the government funded ones were certainly doing all that they could not only to provide physical care but emotional care as well.

Dehydration is an occurrence that we all know happens very quickly in the elderly. The thirst sensation is decreased in the elderly. Some of them refuse to eat or drink because they are depressed. Residents in the LTC here are allowed mini-fridges in their rooms. All residents have water jugs that are refilled three times a day with fresh water and ice. Many senior citizens in nursing homes are confused and "forget" to eat and drink. Staff members do their best to remind them but when they are reminded they will have a sip, put the cup down and forget about it again.

I will state that there is NEVER a reason for the development of a decubitus ulcer! Not in a hospital, not in a long-term care facility. If something like this was to develop in a client of either the hospital or the LTC in my community, there would be @#$% to pay. This would not be tolerated and there would be no excuses.

Also, statistics show that the more involved a family is in the care of their loved one in a nursing home, the better the care is, and the happier the resident is. I believe that this is because the resident is happy to still be valued and loved by their family members and friends. I have seen the residents whose families never come to visit and seldom call. They wake up early, take a lot of care to get ready and make themselves as well put together as possible. They sit in their wheelchairs in the hallway, watching the elevator door on Christmas Eve, Christmas Day, and Boxing Day. And no one comes. This is devastating for them. So they quit eating, they quit drinking and their condition deteriorates. Yes, some families are wonderful and visit as often as possible. Some families are unable to visit because they are too far away, but they do pick up a phone and make a weekly call that the resident looks forward to. But there are still many senior citizens who are dumped in an LTC and forgotten about by their families... the family shows up two years later when "Grandma" has a stroke and are "shocked" at the change. Duh!!!!!

Yes there are bad nursing homes, but there are also some very good ones. Please don't assume that they are all the same.

jkaee · Dec 11, 2003

I have been in LTC for over 8 years now, the place that I am now is by far the best one I have seen. Yes there are poorly run nursing homes, just as there are poorly run hospital floors, doctor's offices, and other health care facilities. Geer, to say that you would rather have someone live at home alone rather than be confined to a nursing home misrepresents what LTC nurses work hard to do, and gives a false impression of the field as a whole. Of course, most people would not want to put a loved one in a NH, but many people can't (or WON"T) take care of their loved ones themselves. All aspects of the interdisciplinary team at my facility work hard to make sure our residents medical, nursing, spiritual and recreational needs are met. A lot of these residents do more in a day than I do. The staff truly cares for these people, it is not just a job to them. As for the medical complications that occur, IE dehydration and decubs....well, these occur in the hospital setting, too. I can't tell you how many residents come back from the hospital with decubs, and bruises, and whose family members said they were restrained the whole time. Does this mean I tell everyone I speak to to stay out of hospitals? Of course not. All nurses are doing the best we can with what we have, which isn't much. When I work the floor, I have over 40 pts, and sometimes I'm supervisor on top of that. I make sure I do the best I can for all of my residents, and sometimes despite all we do, it just isn't enough to give everyone the care they deserve.

FranEMTnurse, CNA, LPN, EMT-I · Dec 11, 2003

There is a very popular county nursing home in our county. I worked there as a nursing student. What the public sees there isn't necessarily the full view. Their comments vary from, "I would choose that nursing home anytime over the others because the nurses give such loving care" to, "I like that place a lot. I have several friends there, and it's always so clean."

Unfortunately, one of the major problems is again, staff shortage, and not only RNs and LPNs, but CNAs as well. What happens a lot is, a staff member is either a no show, or calls in sick, and not all of those who call in are physically sick, but are sick of carrying the load of those who cannot be relied on.

Yes, the nursing home I mentioned is a lot better than one that has a horrendous reputation where nobody wants to work. But there are private nursing homes that are beautiful and clean. Although that county nursing home does have a good reputation, I for one would NOT want to work there due to the lack of county funding. When I worked there they covered the incontinent residents with reusable adult diapers. Hopefully that has been improved.

Also, being on the receiving end myself, and being told by both nurses and doctors that I may have to go to a nursing home, the very thought of it frightened me. I much prefer being cared for at home, which is gaining in popularity, both because it's less costly, and because it has been proven to be a more positive environment for the patient. I am living proof of that.

Fran:nurse:

kate930 · Dec 11, 2003

This is a tough situation for any of us to be in, unfortunately, it's one we all will face sooner or later.

Last year my mother-in-law was diagnosed with stage 4 colon cancer. We all agreed that we would do everything possible to keep her from going into a nursing home or dying in a hospital.

We have all taken turns staying with her at her house, until it reached a point where our own lives were becoming overwhelmed by being away from our own families and jobs. So, we have spent the past 4 months months rotating who she stays with. A few weeks she stays with us, then she goes to her daughter's, and then her other son's.

It's not easy for any of us.... but I couldn't imagine how horrible it would be for her to spend her last days in a nursing home, where she would spend most of her time alone.

Early last year, my grandmother died. Before she died, she spent several years in a nursing home. She shared a room with her sister. Well, my aunt (my grandmother's daughter), went to the nursing home every morning with a biscuit and coffee for her mother and aunt (my grandmother and great aunt) until my grandmother died. This was her way of still "taking care" of her mother in her final years. She was the only one who lived within 1,000 miles of my grandmother.

When my grandmother died, my great aunt cried because she was afraid that my aunt wouldn't come to see her everyday since her mother had died. What a horrible way to spend your last days.

Thankfully, my aunt still goes to see her aunt everyday with a biscuit and coffee.... otherwise, she'd never have any visitors or anyone to make sure she's being taken care of.