Can a Care Facility Protect its Residents from Each Other?
We have been talking about nursing homes, particularly the nursing home rating system established by the Centers of Medicare and Medicaid Services (CMS). The Nursing Home Compare site offers a lot of information about Medicare- and Medicaid-certified facilities, including the results of health and safety inspections. Do those inspections look at abuse by nursing home residents?
CMS collects data about different types of inspections. There are inspections of the physical plant—is the building falling down or rat-infested? There are inspections for fire safety systems—are the sprinkler systems up to code and working? And there are health inspections that rate how successfully a certified nursing home is meeting more than 180 regulatory standards.
Those standards cover a lot of ground. Inspectors want to know that the facility is managing residents’ medications properly. They want to see that the food is safe, healthy and appropriate for the residents. The list goes on.
Abuse by Nursing Home Residents
One measure has become particularly noteworthy lately. Inspections look for how effectively a facility protects its residents from physical and mental abuse. It’s a complicated issue. As one woman said in the wake of a loved one’s experience, you worry about neglect or theft when you admit a loved one to a nursing home. You don’t imagine a brutal beating at the hands of another patient. But abuse by nursing home residents does happen.
This woman, whose grandmother died after another resident assaulted her, urges people to ask facilities an important question before signing any papers: Is the staff trained to deal with aggression? The aggressor, in that case, was a man suffering from dementia. He was physically fit but mentally unstable. He had already been disruptive and aggressive with others in the facility when this incident occurred; after this most serious assault, he was held on a detainment order and then moved to a psychiatric hospital.
Residents suffering from dementia or Alzheimer’s disease pose a particular challenge to care facilities. First, many are still in good physical shape. Second, some people become uncharacteristically aggressive during certain stages of their decline. Not everyone goes through this, and it’s difficult to predict whether it will happen, when it will start or how long it will last.
Also, the more general risk to patients comes from their tendency to wander. Memory care floors are designed to keep people in. The challenge, of course, is to figure out which patients can safely be kept in together.
Data Source: The Virginian-Pilot/New America Media, “Elder Abuse Rising in Care Facilities Mixing the Frail and the Disturbed,” Elizabeth Simpson, Feb. 25, 2015
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