Today's Dr. Phil shocker: Nursing home abuse

[GLORIAmunchkin72]

Or more specifically elder abuse.

A woman states this particular nursing home has been abusing her mother for 2 years. Would you wait that long to remove your mother if you believed she was?

Something not quite right here.

[funfunfun550, BSN, RN]

It just isnt fair how some people treat those caring for their loved ones but no one has the back bone to stand up to them!

[psu_213, BSN, RN]

Considering that a person is caring for another human being's welfare, $18,000 is not very much money, especially when it is a family member. I would pay $1,000,000 if I had that money even if it made me 100% broke.... (Which is more important a person or money?) Most nurses make $60,000 median, which is not exactly near the federal poverty level, but definitely middle-income...

No one here has made the argument the money is more important than people. By making the statement that you would make yourself 100% broke to provide home care...well, such a silliness takes all credibility away from your argument--this is the ridiculous hyperbole that you see people make on exploitative talkshows like Dr. Phil and the like.

Suppose your family member needs total care. They need repositioned, the need a mechanical lift for all transfers, they are incontinent, they can't feed themselves. Your logic is that you or some caregiver would always be there. What if it is you time to be there? Suppose their was calloffs from the home health facility, and the burden is on you to be there. What about when you have to go to work (after all, the thousands of dollars--a lot, lot more than the $18000 number you made up--aren't going to appear from nowhere)? What is there is some accident involving another family member and you have to go out to deal with that? What happens if a neighbor knocks on the door and desperate seeks your help for some emergency at the house down the street? Are you going to leave for any other those circumstances? What happens if your loved one overestimates their abilities and falls? (How are you going to explain those bruises and the laceration??) What if they are incontinent, you get held up with this other situation and the are forced to "sit" in their urine and stool for hours? What if you are not there to turn them and they end up with a whopping pressure ulcer? It is admirable that you think you are able to provide good care at home for a loved one. However, continue to be incredibly shortsighted and you continue to propagate you insults of LTC nurses.

[SoldierNurse22, BSN, RN]

Considering that a person is caring for another human being's welfare, $18,000 is not very much money, especially when it is a family member. I would pay $1,000,000 if I had that money even if it made me 100% broke

^^^ THIS mentality is part of the reason this country is in the financial crisis that it's in right now. This attitude of I/my family is owed, I/my family must have ________ regardless of the practical consequences of my actions and despite the availability of other options. Time for this country to grow up a bit and realize that the money pot is not a bottomless barrel!

[SoldierNurse22, BSN, RN]

Adult children most likely to commit elder abuse - Health News, Health - Independent.ie

Article raising awareness that elder abuse does happen in the community and is most likely to be committed by adult children. Irish article.

http://www.ucdenver.edu/academics/colleges/medicalschool/departments/medicine/geriatrics/education/Documents/Elder%20Abuse%20and%20Neglect.pdf

University of Denver article detailing the history of elder abuse, the first reports in the 1970's that focused specifically on LTC facilities, and the prevalence of abuse perpetrated by an adult child vs. the pt's spouse.

And finally, the most damning piece:

Elder Justice Now! » Facts About Elder Abuse in the United States

"Who Commits Elder Abuse?

• In almost 90% of elder abuse and neglect incidents, the perpetrator is a family member.
  
• Two thirds of perpetrators are adult children or spouses. "
  

Makes the thought of a professional LTC nurse who has no financial ties to their elderly patient seem a lot rosier, yes?

[rn2be73]

as a former nursing home aide...we LOVED the kinds of families that were there to provide assistance and comfort to their family member....i had several families that would help not only their loved one but the roommate as well and any other resident they could...also had quite a few of the ones that were there as "watchdogs" to try to "catch" us doing something wrong!!

There are 50 patients that need hygiene assistance and feeding, dressing, walking, toileting and there is only one of me with maybe another aide on a good day.

I am currently going through this with my grandparents... They still live in their own home, he is 93 and she is 82....2 weeks ago he fell and broke his arm and things have gone down hill from there...they now have hospice care, and home health...people in their generation do not accept help easily especially with the kind of care he is requiring...

I now work in a hospital and more often than not the worst cases of "abuse" come from people that are being cared for in the home by loved ones

[InfirmiereJolie]

I *did* in-home care for a woman with Alzheimers. I've also *helped* people do in-home care for non-relatives. (The assumptions that I don't have first hand experience is WRONG, actually, without that experience I had little to no opinion on the subject)

It is a better environment. They want to be home and socialize with people and friends who are not also sick. They want to see their family. For their mind and emotions, it is better for them to be home as they feel more independent as it is more like their every day life before they were sick. They feel more normal.

Institutions are unnatural. They also have small, cramped living quarters (only a small room for their personal space). There's no telling what kind of public funding they get, either. Leaving the institution is unlikely, as they are kept in that building for the most part. It's like their own little world separate from the rest of the world. They rarely see anyone outside this environment. They should not be separate from the community, perhaps if they were around more healthy people, there would be more respect given to the elderly and sick in our country.

It's not idealistic to say we are #38 in the world according to the World Health Organization and similarly as low (in the 30's) in terms life-span according to the OECD. We are one of the countries which spends the least on in-home healthcare, yet we are the #1 spenders in pharmaceuticals and other areas.

Nevertheless, which do we want? Do we want more institutions, with the healthy separate from the sick, making them feel less independent, and disrespect for the elderly due to little knowledge of their conditions due to never seeing them? Or, do we want more in-home healthcare, which would cost more (publicly and privately), but would give a higher quality of living for the elderly? If everyone had medical devices in their homes and knew how to use them, don't you think it would increase the overall life-span?

Why do we shove them aside and stick them in institutions, saying they are abnormal because they are old and sick? Why do the wealthy have the opportunity to prove 1 on 1 care for their loved ones, and the poor resort to institutions (which receive public funding)? There is no telling how a single person can care for 40 residents without there being a medical mistake.

There are significant problems here, realistically speaking, and there needs to be a shift.

For now, I hope the people who are reading this thread are nurses or future nurses who will question other nurses STAT if they see abuse and stop it. Also, more in-home healthcare (1 on 1), with knowledgeable professional medical caregivers (I never said by relatives, but for relatives to be in more contact, knowing what is going on), is (hopefully) going to be more prevalent in the future as it is the better choice for the person's welfare.

I *did* in-home care as a RN. It doesn't even appear that you're in nursing school as of yet.

There are a lot of barriers to in-home care that you can't really grasp unless you've actually done it. Some are practical, which I've already mentioned. Some are psychological, which others have mentioned. Many are financial.

There are certainly abuse hazards to be had with private care giving, as well. In an institutional setting, there are usually other people around -- as well as institutional checks, often times cameras, etc. that make elder abuse *less* likely to happen because you'll get caught. In a private setting, with family members that may not even be present on a weekly or monthly basis and no one to answer to, neglect and even outright abuse can pretty easily slide under the radar.

Anyway, I'm not going to go on. Your posts seem more like you're writing a quick generalized paper for school without having actually done any research than actually replying to people. I'm sure your views will become slightly more nuanced once you have some life experience under your belt.

Really? You do realize that going "100% broke" paying for home care will only result the family and their aged loved one winding up on the street together. But as long as they're there together I suppose the power of love will see them through. Or something.

And $18k is not enough to provide care for someone who needs 24/7 care, as the vast majority of LTC residents do. Just how much were you planning to pay these home care givers? They already make pathetic wages. Most of them, I'm sure, are wonderful people. But let's be honest, you get what you pay for.

They are *not* nurses. They are in no way prepared to do anything beyond basic custodial care. Many LTC residents are medically fragile and NEED a licensed nurse physically present around the clock. Not some on call RN who is also on call for 50 other home cases. Many of my residents would be dead in a week if their care was managed by a home health aide....

Just so it doesn't seem I'm dumping on home care workers, let me stress that they provide a valuable and necessary service. But home care is NOT a viable alternative to skilled nursing. They are two completely different things. Most LTC residents need more than a HHA popping in once a day. Even having a HHA 24/7 isn't enough because these people really do need a licensed nurse present to supervise care at all times. There just isn't enough money and resources to provide this level of care in home 24/7, unless you're insanely rich. And this is why nursing homes exist and won't be replaced by home care anytime soon.

Thank you. Our little friend who is so enamoured of home health might want to include a plan on how is is going to be PAID FOR!! Whether an infant, a pet, or an elderly family member, one-on-one care is ALWAYS more expensive than communal care, and very few families can afford 24/7 assistance at all, let alone NURSING care around the clock for Uncle Frank. So, are we to have our debt-ridden governments pay instead? With funding from......where??

Ideals are lovely, but immaturity and wishfull thinking have never solved a problem. Sadly, the unicorn who poots gold nuggets had gone missing...

I think people who have issues with placing loved ones in LTC would be surprised just how many residents actually *flourish* after being placed there. Sometimes it's not "the only option left". Sometimes it's the *better* option, even in cases where the family does have the money and time to care in home.

As for abuse, well, I see far more bedsores and bruises on residents the day they're admitted than I do a year after they've been living in the facility. Take from that what you will....

My mother in law, God rest her soul, was one of those very idealistic women who vow never to put their loved one in a home so she took on the care of her own mother and gave it a heck of try, but even with help she had to cry uncle. One cannot take care of an invalid all day and all night and expect to last for months and years. She did the next best thing and put her mother in a nursing home. BUT she got involved in her care, got to know the staff, realized that you don't have a private aid and that you have to share so she came often to feed and do little things to make her mother comfortable. She wasn't there to get in the way or bark orders. Simply put she tried to make the best of the situation.

No one here has made the argument the money is more important than people. By making the statement that you would make yourself 100% broke to provide home care...well, such a silliness takes all credibility away from your argument--this is the ridiculous hyperbole that you see people make on exploitative talkshows like Dr. Phil and the like.

Suppose your family member needs total care. They need repositioned, the need a mechanical lift for all transfers, they are incontinent, they can't feed themselves. Your logic is that you or some caregiver would always be there. What if it is you time to be there? Suppose their was calloffs from the home health facility, and the burden is on you to be there. What about when you have to go to work (after all, the thousands of dollars--a lot, lot more than the $18000 number you made up--aren't going to appear from nowhere)? What is there is some accident involving another family member and you have to go out to deal with that? What happens if a neighbor knocks on the door and desperate seeks your help for some emergency at the house down the street? Are you going to leave for any other those circumstances? What happens if your loved one overestimates their abilities and falls? (How are you going to explain those bruises and the laceration??) What if they are incontinent, you get held up with this other situation and the are forced to "sit" in their urine and stool for hours? What if you are not there to turn them and they end up with a whopping pressure ulcer? It is admirable that you think you are able to provide good care at home for a loved one. However, continue to be incredibly shortsighted and you continue to propagate you insults of LTC nurses.

Adult children most likely to commit elder abuse - Health News, Health - Independent.ie

Article raising awareness that elder abuse does happen in the community and is most likely to be committed by adult children. Irish article.

http://www.ucdenver.edu/academics/colleges/medicalschool/departments/medicine/geriatrics/education/Documents/Elder%20Abuse%20and%20Neglect.pdf

University of Denver article detailing the history of elder abuse, the first reports in the 1970's that focused specifically on LTC facilities, and the prevalence of abuse perpetrated by an adult child vs. the pt's spouse.

And finally, the most damning piece:

Elder Justice Now! » Facts About Elder Abuse in the United States

"Who Commits Elder Abuse?

• In almost 90% of elder abuse and neglect incidents, the perpetrator is a family member.
  
• Two thirds of perpetrators are adult children or spouses. "
  

Makes the thought of a professional LTC nurse who has no financial ties to their elderly patient seem a lot rosier, yes?

[nursel56]

I *did* in-home care for a woman with Alzheimers. I've also *helped* people do in-home care for non-relatives. (The assumptions that I don't have first hand experience is WRONG, actually, without that experience I had little to no opinion on the subject)

It is a better environment.

Is it a better environment when the caregiver steals narcotics from a person who's body is so twisted from their neuromuscular disease that their pelvis faces sideways and the only thing they can see is their ceiling? How about if the IHHS trains and pays a family member to be a primary caregiver and they are left alone while that person goes off to their cash under-the-table job? What if bugs are crawling on the disabled person and nobody cares enough to brush them off? All true.

Sounds like you're visualizing all homehealth as like a Hallmark Card and all ALF/LTCs as the pit of hell when the truth is each one of those is both to one degree or another. This is sort of a sore point with me because I know from reading this board how many nurses bust their butt every day to give these residents the best care they can while waging an uphill battle.

One thing I often hear them say is "remember this is their home" They are very aware of the sense of loss their residents may feel and sometimes try to supply the attention and support their family members do not. If the family can't bother themselves to take an interest in their relative while they are living in a facility how do you suppose they will fare when nobody's looking?

As far as the not getting out thing, my friend's aunt lived in a place that had a knitting circle and a van they would drive the residents to go out shopping once a week. Lots of places do that sort of thing. I almost asked her if there were any vacancies there. :-)

[fultzymom]

If my parent were in an abusive situation in a nursing home I wouldn't leave the facility until my parent was on a gurney heading out the door to a new facility. As a DON I have asked a couple of families how they can leave their parent/loved one in a facility where they think they have been taken such poor care of. In my opinion if you leave your loved one in a neglectful or abusive situation you are just as guilty as the person who is actually doing the abusing or neglecting.

[KRSLPN, LPN]

I am a nurse in a LTC facility. Am I and my co workers perfect every single day? NO, but one thing I can say is this, a LOT of us spend our own hard earned money buying things such as nice smelling body washes, perfumes, body sprays and mens's toiletries for our residents because their dear family members who live minutes away never bother stopping by. Us not so perfect people are also the ones who sit with your dying family member because you don't want to cut your vacation short because Mom or Dad is dying.

The point I am attempting to make is this, although we are not perfect, we give it 100% when it comes to caring for our residents and it makes me angry when people act as if ALL LTC facilities are torture chambers. There is good and bad in every situation and if this person felt their family member was being abused and nobody was truly taking any action, then they should have removed the person from the facility and NOT waited 2 years.

[mappers]

Good luck hiring 1 on 1 quality care for $18,000. I wouldn't take that job.