NJ Online had a great article about protecting loved ones from elder abuse quoting esteemed nursing home advocate/attorney Saul Gruber. Our senior citizens are the heart of the population, but are often times forgotten when placed into long-term care facilities.
“The nursing homes get to a point where they are trying to make money and the biggest expense is labor, so that’s where they make cuts,” Gruber said. “Understaffing is the biggest problem. The employees are OK, but they can only do so much. If they are told to feed eight people at each meal, but those eight turn into 14, it’s tough.”
Federal guidelines were first put into place in 1987, Gruber said. “Everything was put on paper,” he said. “Everything they had to do to maintain patient care. They know what they’re supposed to do. The problem is they aren’t doing it.”
Signs of elder neglect or abuse
Bed sores – Pressure ulcers or bedsores occur when a patient is not being moved often enough and not being fed a proper diet, according to Gruber. “We see those a lot,” he said of neglect cases. “I call them rotting, smelly holes in someone’s back.”
Falls – Gruber said it is the staff’s responsibility to do whatever is necessary to prevent falls. “There are a lot of things they can do,” he said. “If they fall out of bed, be sure the bed is near the wall. Use rails. If person seems to fall at 3 a.m., maybe take them to the bathroom at 2:30 a.m. so they don’t have to get out of bed. They are supposed to try to prevent falls. Prevention is key.”
Strange smells – Gruber suggests conducting a “smell test.” “Bad smells are a give-away for many different issues,” he said. “Even if it’s a very antiseptic feel and smell, it’s not really a home, and what is that smell covering up?”
Care assessments – When a patient is admitted to a long-term facility, staff members are required to perform a “care assessment.” “They should be assessed so the staff knows what they need, what problems they have, and how to care for them,” Gruber said. “These assessments need to be done all the time because patients change.” Care assessments look for a patient’s “red flags” – such hazards as falling due to instability, pressure ulcers due to lack of movement, choking, and malnutrition.
“Then they are supposed to make up a care plan – it’s not magic,” Gruber said. “What are they at high risk for? And here’s what to do to prevent these issues and care for the patient.” Then, that plan must be utilized faithfully.
“If a care plan is put into place to prevent falling and the patient continues falling, the staff can’t just say ‘oh well.’ They have to do more,” he said.
Be familiar with the staff – Gruber said, once your family member is settled, get to know the staff members who will be caring for your loved one.
“When you put someone into a facility, you have to become friendly with the staff because they will tell you what’s happening,” he said.
Vary your visitation – If a patient is being neglected or abused, staff members may pay attention to when the the family comes in and be sure that the situation looks perfect.
“Go visit at different times of the day,” Gruber said. “Don’t always go at 3 p.m. and don’t tell them when you are coming, and just see what’s happening.”
Check online – Gruber said medicare.gov publishes reports on the performance of each of the approximately 300 nursing homes throughout the state.
“Each nursing home has to be inspected a minimum of once per year,” he said. “It’s called a survey. They pull random charts, and interview staff and families, to make sure doing what they are supposed to be doing.” These reports can show you what areas a facility has had problems with.
“When picking, look online at reports,” Gruber said. “If you think you don’t like a nursing home, don’t go there. If you’re already there and think something is wrong, it probably is.” Gruber said the most import aspect is being present.
“You’ve got to be there,” he said. “some families are afraid that if they raise trouble, then when they are not there, their loved one won’t be cared for properly. Let (staff) know you will know if they neglect the patient.”
He said one of the most difficult parts of his job is dealing with a family’s guilt.
“I’ve sat here with clients crying, saying, ‘Why did I put my mom there? I knew it was bad and now she’s dead,'” Gruber said.