We Don't Want to Think About It.

If you follow the news you can find evidence that abuse does happen in some nursing homes. It also happens in some homes and sometimes it is the children who do the abusing.  Its not pleasant to imagine, but being aware of the possibility is important.

According to an article in Senior-Site, the most striking finding in a survey of healthcare professionals is that nearly all respondents indicate abuse is a problem in nursing homes. The abuse comes from a variety of sources, including families and visitors, but most of the perceived abuse was attributed to overworked and under trained aides and orderlies.

It is important to say here that most health care workers do a wonderful job out of genuine concern for their patients.  It would be unfair and damaging to say this is a widespread problem, however it does happen and families should be aware of what it looks like. Family should also be aware that abuse sometimes happens in the home.   

Abuse could be any of the following:

1.Physical abuse --infliction of physical pain or injury.
2.Misuse of restraints --chemical or physical control of a resident beyond physician's order or outside accepted medical practice.
3.Verbal/emotional abuse --infliction of mental or emotional suffering.
4.Physical neglect --disregard for the necessities of daily living.
5.Medical neglect --lack of care for existing medical problems.
6.Verbal/emotional neglect --creating situations harmful to the resident's self-esteem.
7.Personal property abuse --illegal or improper use of a resident's property for personal gain.

Across the USA, the federal report concluded that in nursing homes:

•24% improperly administered drugs according to the written orders from the attending physicians (60% in New Jersey);
•26% did not provide adequate personal hygiene (67% in the state of Washington);
•21% did not follow proper isolation techniques to prevent the spread of infection;
•20% did not provide each resident with a urinary catheter with proper routine care;
•36% did not follow rules requiring that food be stored, prepared, and served under sanitary conditions (62% in Alabama);
•18% failed to provide patients' bathroom needs according to federal standards (33% in Michigan);
•12% didn't properly treat bedsores; and
•15% didn't provide patients with privacy during treatment and personal care.

USA Today said, "The numbers are abominable." They mean thousands of people whose dignity should be respected are being humiliated, mistreated, and neglected because they've grown old.

Is it like this in Canada?  We have fewer "for-profit" nursing homes where some of these concerns are more likely to be found.  We have a better health care system that better looks after the most vulnerable.  Even so, it does happen and it is the responsibility of those who most deeply care to be aware of its possibility.

Mental Health in Nursing Homes

•The rates of psychiatric disorders in nursing homes have been estimated to be at least 50% to 94% of the population; these people are in need of mental health consultation.

•It is likely that widespread overuse and misuse of psychoactive medications add to the psychological woes of nursing home residents (a news article in SF Chronicle claims 44% of nursing home patients in U.S. are controlled by powerful psychotropic drugs, 70% in California). First, when psychotropic drugs are used inappropriately they may cause depression, agitation, sedation, and confusion. Second, they may mask psychological disease and make depression, anxiety, and confusion difficult to recognize.

•Some say there is a substantial unmet need for trained nursing home staff to care and to cope for mentally disordered geriatric patients, for mental health services, and for funding them.

•Faced with heavier levels of care, such as residents with more debilitating diseases, frustrated staff take out more of their stress on the residents. Many believe stress is caused by the difficulties of caring for impaired and dependent residents, who require help in many of the activities of daily living.

•Much of the abuse cannot be attacked directly because it is never reported.

•Health aides who provide most of the care for nursing home residents sometimes have no training.

What You Can Do!

There is a strong need for family involvement in:

•The patient's course of treatment;
•Setting strict standards for rehabilitation; and
•Providing stronger mechanisms for complaints against negligent facilities.

As a family member or friend of a resident you can:

•Continue to monitor the nursing home's treatment of their residents, not just for one resident but for others as well;
•Participate as much as possible in the home's activities to gain firsthand knowledge of what actually goes on;
•Examine the medication records to see that the resident is not being overmedicated;
•Get involved in filing complaints if you find there are real problems and abuses.

Get Help - 

For example "The Advocacy Centre for The Elderly is a community based legal clinic for low income senior citizens. ACE is managed by a volunteer board of directors at least half of whom are seniors. ACE is funded through Legal Aid Ontario and is the first legal clinic in Canada to specialize in the legal problems of seniors".