If you have a loved one who is being cared for at a nursing facility and who you believe is being abused, there are many resources available in order to gain information on the topic, as well as to help put a stop to the abuse.
Nursing Home Reform Act
The Nursing Home Reform Act is an act that was established in the mid-1980s to make sure that nursing facility residents receive adequate care and a better sense of psychosocial, physical and mental wellbeing. This act reinforces excellent care and helps provide services to nursing facility residents. It also establishes a resident Bill of Rights.
Nursing home facilities that want to apply for state funding must comply with the Nursing Home Reform Act. This includes Medicaid and Medicare Services. Each state is responsible for certifying that the nursing home complies with the criteria as set forth by the act.
Resident Bill of Rights
As defined by the Nursing Home Reform Act, nursing home residents have certain rights that are protected by the law. These rights are in place to protect the individuality, privacy, medical needs and dignity of every resident. Each elderly resident has the right to receive care that is abuse-free and provides them with the proper medical treatment.
According to the Residents Bill of Rights, the nursing facility resident has the right to:
- Free communication
- The meeting of their mental, physical and psychosocial needs
- The right to dignity
- The right to exercise self-determination
- The right to voice grievances
- The right to be treated without physical restraints
- The right to participate in resident and family groups
- The right to be a participant in their own care plan
Required services under the act include:
- Access to dietary and pharmaceutical care
- Access to a full time social worker
- A comprehensive care plan
- Periodic assessment of their health
- Access to social, nursing and rehabilitative care
According to Nursing Home Reform Act, the state can conduct unannounced surveys that include interviews with residents. These surveys can be no further than 15 months apart. Surveys are to evaluate the residents’ rights, quality of care, quality of life and services offered.
Targeted surveys can be undertaken whenever there is a complaint and the state can take action against any deficiency. The nursing home has the opportunity to correct any deficiency prior to having legal action taken against them.
Violation criteria include whether or not the deficiency jeopardizes the resident acutely and whether or not the deficiency was isolated or part of a pattern within the facility. If the facility violates any guideline set by the Nursing Home Reform Act, the state may monitor the facility, manage the facility temporarily, deny payment, deliver monetary penalties, as well as terminate the agreement.
Types of Nursing Home Employees
Each state requires the administer of the nursing home to have a state license.
Direct care staff include:
- Licensed Practice Nurses (LPNs)
- Registered Nurses (RNs)
- Certified Nursing Assistants (CNAs)
Support staff can include:
- Maintenance workers
- Cleaning staff
There are also departments related to accounting, management and human resources. Nursing home facilities are also required to have physical therapists and dieticians on site.
Each state has an agency for the management of eldercare and an advocacy unit for nursing home reform and abuse. According to the Administration on Aging and Medicare, there must be platforms for families and the elderly to ensure that they choose the right nursing facility for them.
Elderly residents are also entitled to a qualified patient advocate with a background in medicine. Many Registered Nurses go on to become patient advocates, as they have experience with many types of health conditions and understand management needs.
A family member has the choice to be a patient advocate. In that sense, they know their advocate personally, but it may not be the best choice from a medical standpoint. Family members may not be able to help the elderly resident make the correct health decisions in the same way an experienced nurse would.
Removing a Patient From a Nursing Facility
Removing an elderly patient can be a difficult task to undertake. If the resident has been found to have been a victim of abuse, it can be difficult to deal with in many ways.
Family members may be worried that care provided by a certain facility is not ideal for the resident. Also, the care facility may not be certified to manage the health condition the patient has. There are often better care facilities available locally that have the skills to manage the conditions the resident has.
If the family disagrees on the living conditions for the resident, there is usually a concern that the resident is not mentally capable to make their own living decisions. In this situation, the choice of care the elderly resident makes depends on many factors, including their financial resources. If the resident has dementia, a designated legal advocate will make the decision as to where the resident lives. The designated advocate is usually a family member, but it can be a lawyer or anyone who has been given the power of attorney by the elder.
If there is suspected abuse of the resident by the nursing facility, the advocate may remove the resident from the facility. The local authorities may have to become involved in order to investigate the allegations. If a single resident has suffered from elder abuse, there are likely other residents that are suffering from similar issues.
Instances of anxiety, substance abuse or personal issues can negatively impact the resident’s care and this includes sustaining elder abuse. Caregivers might blame the resident for their financial difficulties and for taking up too much of their time. Family members carrying out acts of abuse may feel as though the abuse is somehow deserved.
Stress on the part of the caregiver is the leading cause of elderly abuse. Personal issues of the caretaker can lead to abuse of the senior in residential nursing facilities. While these issues do not justify abuse of the elderly, it is important to understand that a problem is present. There are various ways to help a caretaker work through their stress and issues in healthy ways, which should decrease the incidence of abuse.
About 29 percent of America is made of people who act as unpaid caregivers to their elderly relatives. The stress of caring for these people can lead to anxiety and psychological difficulties in the caregiver. Caregivers may relieve their anxiety and stress in different ways, including using drugs and engaging in elder abuse.
About 90 percent of abuse of the elderly happens in residential settings, with adult children being responsible for the abuse. The reasons listed include drug use and increasing anxiety or stress. As the issues regarding the caregiver get worse, there may be unhealthy actions at play that lead to worsening elder abuse.
Finding a Quality Nursing Facility
The selection of the right nursing facility is a decision the family must make together. If the wrong facility is chosen, this can be devastating to both the family and the resident. A good resource checklist for finding and selecting a quality skilled nursing home facility is the Medicare.gov Skilled Nursing Facility Checklist.
Federal Government Departments and Agencies
- National Center on Elder Abuse (NCEA)
- Centers for Medicare & Medicaid Services
- Department of Health and Human Services
- National Institutes of Health
- Agency for Health Care Research and Quality (AHRQ)
- Medicare Quality Improvement Clearing House
- San Diego County Council on Aging
- Elder Options of Texas
- Montana Independent Living Project
- Golden Years Living Solutions
- Senior Residents 55+
- Special Needs Chicago Transportation
- Patriarch Placement
- Crossing the Creek
- Angels of the West Indies
- John C. Green Insurance
- LI Balance-Balancing Your Health and Life
- Long-Term Care Insurance Association
- Accessible Virginia