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Articles Posted in Reporting Elder Abuse and Neglect

One may feel that by placing their loved ones under the care of a skilled nursing facility, they would be provided with quality care. Unfortunately, that is not always the case. An investigation began on March 29, 2013 when an employee at an assisted living facility, Alzheimer’s Care of Commerce in Jacksonville County contacted authorities to report cases of abuse. The Alzheimer’s Care of Commerce focuses on elders who are suffering from Alzheimer’s disease.

After some investigation, the facility was raided in July 2013. Authorities arrested twenty employees and the owner of the facility following claims that the staff assaulted, restrained, and over-medicated patients. The facility is currently facing a total of seventy two criminal charges. However, according to Mike Ayers, the special agent in charge of the Georgia Bureau of Investigation Athens regional office, there could be more charges. They will not know until the district attorney looks at the files. The abuses that are being reported are cruel, inhumane; and so severe that the case may be forwarded to a grand jury this May.

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More often than not we are forced to do things that we would prefer not to. One example would be placing our loved ones under the care and supervision of a skilled nursing facility. When our loved ones are in a fragile state, we would like to keep them as close to us as possible. Sadly, at times, we are not able to provide our loved ones with the attention and medical care they need. While we would like to think that they are being provided with the highest level of care at a skilled nursing facility, it is regrettably more likely that they are not. An unfortunate example of this would be a recent case at a home in Medford, New York where the neglect of a 72-year-old woman who was under the care of a skilled nursing facility lead to her untimely death.

Evidence shows that the staff ignored all alerts and pages from the patient for more than two hours. The resident stopped breathing and, according to authorities, had likely been dead for some time until a nurses aid finally went to check on her. The level of ignorance and mistreatment in this appalling case is astounding. At a certain point the elderly are unable to breathe on their own, and therefore, are hooked up to a ventilator which regulates their breathing. While it is ludicrous that this resident was ignored for over two hours the resident had orders from her doctor stating that she must be connected to a ventilator machine at night. These orders were blatantly disregarded, which led authorities to believe this was the actual cause of her death.

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Due to the prevalence of nursing home abuse arising across the nation, some states have begun moving towards implementing legislation to explicitly allow surveillance cameras in the rooms of patients residing in nursing homes and long-term care facilities. These surveillance cameras will be used to record evidence of instances of elder neglect and abuse. Some states have taken such steps as a response to nursing home abuse and neglect, with hopes of reducing the incidence of abuse against the elderly. There are currently three states that have passed such laws, with Oklahoma being the most recent state. This new Oklahoma law will allow residents to have cameras in their rooms as long as they sign consent forms which notify the facility. The resident will then have exclusive rights to the footage for use in court. The recorded footage was found to have an impact in Oklahoma, where an aide pleaded guilty to abuse and neglect after being caught on camera.

Both Texas and New Mexico also legalized the use of surveillance cameras in nursing homes in an attempt to catch instances of elder abuse and neglect. Oklahoma passed their surveillance law after an outcry arose over recorded evidence of nursing home aides abusing an elderly resident in the facility. Surveillance footage showed Eryetha Mayberry, a 96-year-old woman, subject to various acts of abuse. For example, the nursing home aides were recorded shoving latex gloves into the resident’s mouth. Other recordings showed nursing home staff taunting Mrs. Mayberry, tapping her head, flinging the elderly woman onto her bed from her wheelchair, and performing heavy handed chest compressions thereafter.

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While no one can deny that certain demographics are aggressively protected, as evidenced by campaigns launched to protect children’s rights, women’s rights, or civil rights, it is not often that we hear about protecting our elderly’s rights. This is particularly shocking because the elderly are an especially vulnerable population, and one that is common to all nations. Elderly abuse is not an issue that is particular to any one country; it does not discriminate between developed or underdeveloped nations. For this very reason, it is important that a world-wide effort is made to spread knowledge about the risks of elder abuse and how best to prevent it.

In 2006, the International Network for the Prevention of Elder Abuse and the World Health Organization at the United Nations designated June 15th as the 1st annual World Elder Abuse Awareness Day (WEAAD) . This day is designated as an international day to focus on ways to prevent elder abuse, in whatever form it may manifest. Very often, the elderly are physically abused by the very people responsible for their well-being. While this abuse may be as evident as acts of violence resulting in bruising or fractures, it may also be more difficult to detect, such as over-medicating to make them easier to handle. It may also be that they are simply being neglected, left unclean and alone for long periods of time resulting in pressure ulcers , infection, and depression. The psychological harm done to these elderly can be just as powerful and destructive as the physical damage. Many nursing homes use physical restraints to calm residents, which offends their sense of dignity and impacts their mental and emotional health. However, abuse is not limited to these categories; our elderly may also be victims of financial abuse. Just in the United States, elders lose upwards of 2.6 billion dollars annually due to financial abuse.

On June 15th, we must all make a collaborative effort to speak about the untold cruelties that many of our elderly are subjected to. We can no longer accept ignorance as an excuse to allow these atrocities to continue, and we must remember that our silence makes us enablers of these cruelties. On this day, people are encouraged to visit an elderly person, volunteer at a nursing home, or submit editorials about elder abuse to their local newspapers. The goal is to spread knowledge about an existing problem, ways to detect it, and steps to prevent or eradicate it.

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Welfare and Institutions Code section 15610.07 provides that abuse of an elder includes “[p]hysical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering” or “[t]he deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering.” (Welf. and Inst. Code §15610.07.) Neglect means “negligent failure of any person having the care or custody of an elder or a dependent adult to exercise that degree of care that a reasonable person in a like position would exercise,” which includes, but not limited to, the failure to assist in personal hygiene; the failure to provide medical care for physical and mental health needs; the failure to protect from health and safety hazards; and the failure to prevent malnutrition or dehydration. (Welf. and Inst. Code § 15610.57.) Physical abuse means, inter alia, assault, battery, prolonged deprivation of food or water, unreasonable physical restraint, or sexual assault. (Welf. and Inst. Code § 15610.63.)

Nurses and care coordinators in community care settings are in a position to easily detect and assess any elder abuse or neglect problems because they are able to observe their client’s home environment and the client’s relationship with the caregiver. However, handling elder abuse or neglect cases is challenging because nurses and care coordinators have to consider the elder client and caregivers’ health and social conditions, their relationship and the possible outcome of their intervention. (Many times, unfortunately, the perpetrator is the victim’s daughter or son and not a spouse or partner.) The intervention is also more effective when they collaborate with managers of their agency and the elder protective services in discussing the cases and identifying available community recourses for intervention.

According to a recent article titled, “Challenges in handling elder abuse in community care. An exploratory study among nurses and care coordinators in Norway and Australia,” and published in the Journal of Clinical Nursing in September 2011, the major problem in handling various types of elder abuse cases was due to the conflict between the nurses’ duty of care and the clients’ right to refuse help. The nurses and care coordinators who participated in this study were mainly concerned about how to secure and support the older victim by individualizing the intervention to alleviate or reduce abuse and their effect, especially when the victim refuses the help.

For their intervention to be effective, it needs to be individualized based on the type and seriousness of the abuse and the victim’s cognitive capacity. (Reduced cognitive capacity was always present in case of elder neglect.) The victim with decision-making capacity has to find his or her own solutions to the problems, and nurses and care coordinators can support the victim by monitoring the situation and by offering suggestions and options to ensure the victim’s basic needs, health and well-being, to reduce the impact of the abuse. If there is no improvement in the situation, nurses and care coordinators need to step out of the caring role and apply for residential care to protect the victim from further abuse. Collaboration with other service providers, such as protective services, would be very important in such case.

The study concludes that community care agencies “need to be aware of the huge impart of the managers’ involvement and the services’ responsibility and capacity to support professionals in the handling of elder abuse.” Individual nurses’ ability and willingness to interact with both victims and abusers are essential, and the community care agencies’ policies and procedures should be in place to promote efficient and appropriate intervention in handling elder abuse or neglect cases.

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