by Cindy Hasz
American Reporter Correspondent
San Diego, Calif.
March 10, 2002
CARE FACILITIES COMPLICIT IN ELDER ABUSE by Cindy Hasz
SAN DIEGO -- There was important news on elder abuse this week: The Senate Special Committee on Aging presented findings from its 18-month investigation of crime in nursing homes; what they found was that when crimes against the elderly do occur in nursing homes, they often go unreported.
That's no surprise to anyone who's worked in one.
There are many ways to "abuse" a frail, vulnerable person, and chances are the crime will look like an accident. Even when the incident is clearly evident, there's organizational reluctance towards full disclosure. I'm sorry for statingthe obvious, but I want to pan away from the individuals involved in what are conveniently called "isolated events" and sharpen the focus on where the true culpability lies.
The spectrum of abuse can go from minor injuries, like ripped skin on arms and legs caused by carelessness during patient transfer, all the way to intentional use of force as a means to intimidate and traumatize. And that's just the abuse suffered at the hands of staff members. When no one is minding the store, things can get even more chaotic and deadly.
Barbara Becker testified last week before the committee about how her 83-yr. old mother-in-law was killed by a fellow patient in the nursing home where they lived. She was picked up by both shoulders and slammed against the wall and fell to the ground unconscious. She died 22 days later.
The mentally ill man's history of violence was well known to the nursing home, but management had never taken any steps to ensure the safety of other residents. After the incident, Mrs. Becker reports that the killer again was given free access to the nursing home's residents.
As terrible as homicide is, it's the insidious, largely overlooked abuse called neglect that creates the context for these bigger, more shocking events. We might even call neglect a "gateway crime;" when desensitization is commonplace, the stage is set for tragedy.
"Hear no evil, see no evil, speak no evil" is the theme song of those who monthly take thousands from their residents and in return understaff their facilities and then feign disbelief when a patient is hurt by workers acting out both personal and organizational dysfunction.
Rarely is anyone caught in the act of hurting an elderly person. I don't want to malign those who work the night shift, but abuse often happens there. At night, there is often less visibility and accountability; skeleton night shifts are pushed beyond their limits doing multiple "changes" of incontinent patients as well as answering any call lights or emergencies that arise during the graveyard hours.
It is common to have only one licensed nurse on duty for 50 or morepatients on the night shift, and usually that nurse is too busy attending to her mandatory duties to closely monitor her nursing assistants, let alone help them.
With scanty and underpaid staff and precious little real supervision, "off-hours" shifts are an accident waiting to happen - and management is virtually assured that high-risk situations will develop. Of course, no nursing home manager take kindly to this diagnosis, but denial is as virulent in the nursing home business as any antibiotic-resistant germ.
Of the nearly 26 percent of nursing homes cited across the country over two months in 2000 for violations in patient safety, less than two percent were for actual harm done to patients; the remaining citations were for the failures of administration and management to implement policies that would prevent abuse.
It is clear to me from the U.S. Senate's statistics - and even more from personal experience as a nursing home supervisor - that the plague of elder abuse in nursing homes is clearly the product of neglectful, and in some cases, criminal management.
When we start imposing meaningful fines onowners-operators who've institutionalized abusive policies in theirfacilities, and also reporting incidents of elser abuse to police and following up with prosecutions of individual and corporate perpetrators, we may see substantive change. I urge you to write to your U.S. Senator to demand gard-nosed legislation that can stop elder abuse.
Until then, we can only weep.
Cindy Hasz is a nurse and writer living in San Diego. She can be reached firstname.lastname@example.org