Elder Abuse??????

Marie_LPN, RN, LPN, RN · Mar 24, 2006

I feel like you did the right thing. This pt. has obvious needs that the family are trying to block.

chadash · Mar 24, 2006

This is a non professional observation, but wow, I don't blame you a bit. Poor lady.

Bird2 · Mar 24, 2006

I turned in a family member today to the Ombudsman for suspected elder abuse, and I'm not sure if I've done the right thing. There have been several occurences with this family and their mother. The first one I experienced was over a bill from the pharmacy for a multivitamin. The daughter was very upset over this bill for $3.00 for a 30 day supply. I told her we would begin using our stock supply and she wouldn't have to worry about it (normally we don't use our stock supply for the private pay residents). The next time I dealt with them the MD had recommended an annual EKG for the resident because she is on Mellaril. The family said absolutely not...it costs too much. We have had to get clothes for this res. from the Salvation Army because the family doesn't provide them and her clothes were literally falling apart. The final straw for me was when the resident fractured her foot, and the family only wants her to receive Tylenol (which we supply). She has been on Tylenol QID for years, so I know it has lost its effectiveness. The resident doesn't speak, but has been crying and moaning and showing obvious symptoms of pain. The Tylenol is not helping, and the family won't let me ask for something stronger. To me this is blatant abuse/neglect. I'm not sure what category it falls under. I've heard that there is a lot of money involved when this resident dies. Any opinions? Did I do the right thing?

The facility is responsible for meeting the residents needs if the family won't. I believe that the family can not dictate the care. For example if this resident had a pressure ulcer and the family would not pay for the dressings the facility would get cited for improper nursing care if they did not provide the care and put interventions in place. The MD and care planning team should be deciding what is best and of course getting the families input and keeping them informed You may have to supply the meds etc then attempt to go after the family for the financial costs. Keep us posted I am curious which way this situation will go for this resident and your facility. Anyone else out there with any insight???

CoffeeRTC, BSN, RN · Mar 24, 2006

The facility is responsible for meeting the residents needs if the family won't. I believe that the family can not dictate the care. For example if this resident had a pressure ulcer and the family would not pay for the dressings the facility would get cited for improper nursing care if they did not provide the care and put interventions in place. The MD and care planning team should be deciding what is best and of course getting the families input and keeping them informed You may have to supply the meds etc then attempt to go after the family for the financial costs. Keep us posted I am curious which way this situation will go for this resident and your facility. Anyone else out there with any insight???

Yes. The family does have input into the care, but when they are neglecting the pts needs, it doesn't mean the facility should too. Is SW involved? Calling ombudsman is a great plan. Getting them involved is totally necessary. Private pay residents tend to nickle and dime everything (and really should....I know I would review the bill for my aunt...found out they were chaging her 100-1000 a month for a bed rental!!) Not treating pain....big issue. Forgive me because I don't remember mellaril...will look it up. This might be a debatable issue with the family. Will you treat the resident any different depending on the test results. Sometimes our docs order totally unecessary labs and tests. The clothing issue is something I see so often...yep..literally rags or ill fitting clothes that the family would have them wear. (we do the salvation army thing, donations from other residents or deceased residents or will even take a collection together for clothing) Not sure if the state would go after them for abuse on the clothes. But denying them necessary medical care is a biggy.

Antikigirl, ASN, RN · Mar 24, 2006

Right on the money! It is your responsiblity as a healthcare provider to provide care, not handle the bills and struggle with family over it...that is what the administration and billing departments are for! So not only is the family dropping the ball...your facility is!!!

That is abuse pure and simple and sadly it will come back to the facility and other healthcare folks that didn't do what you did! But it is the only and right thing to do! There is no reason why this lady shouldn't be provided dignity, comfort, healthcare, security, and safety..and it looks like all those have been breached!

Good for you!!!!!

JLW,RN · Mar 25, 2006

You did the right thing. Good for you. Let us know how it worked out.

Antikigirl, ASN, RN · Mar 25, 2006

I was thinking of this thread last night at work...sadly because I ran into this situation last night...and it was heartbreaking!

There was an elderly demented lady, whos son was 'caring' for her in her old home. Guess the son was taking in her money she got for assistance and using it for drugs and what not. He didn't care for her at all...stuck her in a chair in the corner of the house, little to no food, no tranfers, no ADL's! She was incrusted in feces and urine...so much urine on her legs it took 3 day of debridement basically to get them out of her wounds, openings, and other spots eaten away off her flesh from the urine and feces! Her teeth were falling out...she was starved...and startled at anything in a protection flench (obvious physical abuse). Her hair was mangled and coming out in clumps...and I don't know how long she was there before she was found!!! Worse thing I have ever seen!!!!!!

I guess the son got a sudden onset of chest pain then inner leg pain. Threw a clot I guess from the rumors. So he called 9-11 and got assistance. The paramedics saw the house, which was beyond condemable...then saw the poor little lady who was so dehydrated she was barely conscious!

They rescued her, and the son is in ICU...awaiting charges! We are mending her back to health and finding perminent placement in a nice facility (whatever is the finest medicare will allow), and apparently the house will be officially condemed (so no money for that for her ). She did live on a few acres so perhaps the land will be worth quite a bit for her.

I don't know about other family!

This was heartbreaking and thank GOD for those paramedics who found her and got her out of there! She is just a sweet little thing...and I enjoyed my time with her last night providing care, security, safety and dignity! She is a doll...I just love her!

I am sure she will be doing fine once we get her condition under control and mend the wounds/damaged skin/dehydration/electrolyte imbalance/malnutrition and emotional damage. She is now amist people that care :).

I hope this guy gets attempted murder charges!!!!!