"Sick, Dying and Raped in America's Nursing Homes"

[Prosecco6247]

Everyone who has a family member, male or female, in a nursing home or who personally contemplates the possibility of ever having to resort to long term care in a nursing home or assisted living facility should read this article:

Some of the victims can't speak. They rely on walkers and wheelchairs to leave their beds. They have been robbed of their memories. They come to nursing homes to be cared for.

Instead, they are sexually assaulted.

The unthinkable is happening at facilities throughout the country: Vulnerable seniors are being raped and sexually abused by the very people paid to care for them.   (Bold & italics mine.)

It's impossible to know just how many victims are out there. But through an exclusive analysis of state and federal data and interviews with experts, regulators and the families of victims, CNN has found that this little-discussed issue is more widespread than anyone would imagine.

Even more disturbing: In many cases, nursing homes and the government officials who oversee them are doing little -- or nothing -- to stop it.

Sometimes pure -- and even willful -- negligence is at work. In other instances, nursing home employees and administrators are hamstrung in their efforts to protect victims who can't remember exactly what happened to them or even identify their perpetrators.

Read more here:  http://www.cnn.com/interactive/2017/02/health/nursing-home-sex-abuse-investigation/?iid=ob_lockedrai...

I regularly keep up with articles regarding the abuse and neglect of women and girls but I must admit that this is a difficult article to read.  It's not a far reach for anyone with an empathetic nature to imagine his or her own parent, grandparent or disabled relative at the mercy of a psychopath, sexual predator or serial sexual abuser in a nursing home or long-term care facility. 

With all of the causes AARP champions, this one would seem to be ripe for their attention given the numbers of retired and elderly people who may be caught up in this situation...as children & relatives responsible for the health and well-being of the victims and the actual victims themselves.

And do not kid yourselves...it's not just the women residents.  Male residents are targeted for sexual abuse as well.  We all need to educate ourselves regarding this tragic practice and hold HHS, Medicare/Medicaid, state licensing and oversight boards and the institutions involved accountable.

"More than 16,000 complaints of sexual abuse have been reported since 2000 in long-term care facilities (which include both nursing homes and assisted living facilities),according to federal data housed by the Administration for Community Living. But agency officials warned that this figure doesn't capture everything -- only those cases in which state long-term care ombudsmen (who act as advocates for facility residents) were somehow involved in resolving the complaints."  

(source:  CNN in previously cited internet article)

[JaneCares]

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@Prosecco6247 wrote:

Everyone who has a family member, male or female, in a nursing home or who personally contemplates the possibility of ever having to resort to long term care in a nursing home or assisted living facility should read this article:

Some of the victims can't speak. They rely on walkers and wheelchairs to leave their beds. They have been robbed of their memories. They come to nursing homes to be cared for.

Instead, they are sexually assaulted.

 ......

And do not kid yourselves...it's not just the women residents.  Male residents are targeted for sexual abuse as well.  We all need to educate ourselves regarding this tragic practice and hold HHS, Medicare/Medicaid, state licensing and oversight boards and the institutions involved accountable.

"More than 16,000 complaints of sexual abuse have been reported since 2000 in long-term care facilities (which include both nursing homes and assisted living facilities),according to federal data housed by the Administration for Community Living. But agency officials warned that this figure doesn't capture everything -- only those cases in which state long-term care ombudsmen (who act as advocates for facility residents) were somehow involved in resolving the complaints."  

(source:  CNN in previously cited internet article)

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Thank you, Prosecco, for reminding us of this terrible problem. 

I'm glad they mentioned ombudsmen (who are often women): their jobs is to investigate any hint of this kind of thing. I hope everyone with a loved one in a nursing home has this number in their phones. The ombudspeople are hired by each county to be a resource for families and residents. 

Any ideas on how to substantiate?  I think of the recording cameras that are masked in teddy bears or pictures on the wall which can film the abuse. There's also the process of examining the body to look for tears or injury. 

Absolutely horrible. Thanks for sharing. 

[GailL1]

Prosecco6247 wrote

"The unthinkable is happening at facilities throughout the country: Vulnerable seniors are being raped and sexually abused by the very people paid to care for them. "

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One thing that seems to be left out -

that is, it is not just the staff that could be causing the harm.

Other patients can also act out in inappropriate ways - 

Staff, professional, paraprofessional or otherwise, cannot be everywhere - they have duties to attend to and many times more than a work shift can bear.

We have been trying to move away from nursing home residency because it is so expensive.  But of course, the ones that go there for their living environment,

are now the most extreme care patients.

Medicare rates nursing home facilities.  My state also licenses and rates them and one can view any issue (and resolution) which they have been written up.

Family and friends should visit often and keep an eye out for signs of any abuse.

Whenever government is involved, they want to pay the lowest rate possible so nursing homes have to adjust or they just go out of business.

In Japan, since they are moving away from family taking care of family, now has a compulsory long term care insurance.  But as we have seen within the PPACA (Obamacare), the CLASS Act was determined to be unworkable financially.

[nyadrn]

Thank you for posting this.  It is not a warm and fuzzy subject but it is serious and scary.  Articles like this are sadly, nothing new and prompted my father to make his children promise never to put him in "one of those nursing homes".  My dad suffered a stroke and was hospitalized.  Fortunately he recovered quickly. The morning following his first night in a regular room, he told us that during the night a nurse had made him sit in a chair and tied his arms to the chair arms after he had asked her to assist him in getting to the bathroom.  Was there proof.. no.  He could not identify which nurse or aide it was.  But he never spent another night alone there until his discharge.  He was fortunate that his family all lived close and were not willing to leave him there alone and scared.  At the time, we wished that we had video to check.

There are many things that I do not understand.   Most of us will require care in our older ages and may be confined for some amount of time in a care facility.  Doesn't it worry us to think that we or our loved ones could be put in a situation like this?  Even if you have loving and caring family, they often cannot be with you 100 percent of the time.   Why are not all of the rooms equipped with video  monitoring.  I understand the need for privacy but is that the most important concern.  Mothers use nanny cams!  Worse, what if you have no family.  Who would you appeal to for help.   And why do we value the personal care so little that we pay bottom of the barrel wages to these care givers.  And where is the oversight of these facilities.   I don't think that waiting for the govt to do something will work.  People need to start with thinking about their future and then finding someone or some program who is working towards improving this situation that they can support financially and personally.

Why do we accept that these situations and conditions exist?

[JaneCares]

I don't think that waiting for the govt to do something will work.  People need to start with thinking about their future and then finding someone or some program who is working towards improving this situation that they can support financially and personally.

Why do we accept that these situations and conditions exist?

Hi Nyadrn. I agree with except for one thing. I do think there is a role for government. I heard a professor share his questioning of the use of the word 'regulation' and he suggests we use 'protection' instead. Yes there are regulations on car exhaust, how much polllution is acceptable in factory emissions, how much lead is permissable in water, how many nursing assistants are a safe minimum, whether there is an RN in the building at night, etc. Those are PROTECTIONS. Not the only thing we should think of when we are reviewing how to improve long term care for our most vulnerable human beings. But a big part of the solution.

[Prosecco6247]

Thanks to everyone for the thoughtful responses and @retiredtraveler for the link!

I think we all agree that this is a multifactorial problem and it's going to take a lot of effort and a lot of money directed toward the problem for the underlying problems to change.  Still, that doesn't mean we should sit on our hands and allow ourselves to be gagged while nothing is being done.  Change starts with a single voice and there are many here who have something to say.  I still feel we should address this issue with our elected representatives and to those who purport to speak for older Americans, the disabled and the infirm.  We should also plan for the day when we will need such care and have a fixed strategy in place.

Regarding fellow patients who may be sexually aggressive towards those who cannot fend off advances...yes, this is true and it happens with alarming frequency.  There are also those who welcome the attention of a fellow resident and nursing homes have been learning how to deal with such activities.

The article deals with sexual predators  and psychopathic behavior.   For that matter, even a regular visitor could create a problem...much less likely, but not out of the realm of possibiity. This is why it's so alarming.  

[Prosecco6247]

@nyadrn  Thank you for your very thoughtful response.  

I don't know why we continue to accept problems without questioning their existence.  We must not ever accept the status quo when we know it's there's something terribly wrong.  I would encourage people to speak up, speak out, write their senators and congressional representative and demand an investigation into the problems.  They should also write their representatives in the state !and make the same demands.  Keeping silent because we, as individuals, cannot think of appropriate solutions is not the answer.  The answer is to shine a light on the problem and bring it out in the open.  As they say, "sunlight is the best disinfectant!"

[retiredtraveler]

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"...I don't know why we continue to accept problems without questioning their existence.  We must not ever accept the status quo when we know it's there's something terribly wrong....".

If you're really interested in this subject, I would read this report.

Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2009 ...

This is my big takeaway. We can help solve this problem as soon as the vast majority of people needing nursing home care can pay $100,000 a year to get quality care,good staffing, more nurses. Yeah right.

"...Medicaid is the primary payer source for most certified nursing facility residents, with more than six in ten (63%) of residents having Medicaid as their primary payer in 2014...".

I won't start a political discusion, but much of this issues comes from the fact that Medicaid has nowhere near the funds to address this issue. We have an increasing population of boomers with little to no savings who fill flood these facilities. We also have stagnant wages for much of the current working, population.  Where will the money come from? 

[retiredtraveler]

"...Why are not all of the rooms equipped with video  monitoring.  I understand the need for privacy but is that the most important concern.  Mothers use nanny cams!...".

In a public facility where residents are being changed, toileted, bathed, etc???  No way.

...And why do we value the personal care so little that we pay bottom of the barrel wages to these care givers....".

Can you, or resident, afford the cost? To pay higher wages and more staff, would estimate that it would be $80,000 a year for care.  It's already $60,000+.

Why do we accept that these situations and conditions exist?

No money.

"...As a result of your experiences while working in a facility, did you make any specific plans to deal with these issues for yourselves?  Do you have any suggestions?...".

We are in the small minority of people who have the financial resources to hire services or go to a 'boutique' facility. That could help, but not necessarily. Depends on how good the caregiver is, and no guarantees on that.  No, I don't know how to protect DW, or her protect me, 24-7 if in a facility.  Let's be real --- there are bad people everywhere. There isn't a day that goes by that a school employee doesn't do something to a kid.   And that has nothing to do with low wages or a tough job. 

   One (possible) answer would be to have security people who do rounds all day, and all night, checking continuously on residents.  Breaks privacy rules and again, expensive. 

[retiredtraveler]

"....Everyone who has a family member, male or female, in a nursing home or who personally contemplates the possibility of ever having to resort to long term care in a nursing home or assisted living facility should read this article...".

Ok. Then what? I was a CNA for 4 years, part of the time working in a nursing home. We've discussed nursing homes in the past. I've always stated that except for a very few 'boutique' facilities, they are always understaffed and care is 'spotty'.

   The good part is that CNA requirements have become more rigorous in most states --- background checks and more schooling that there used to be. But, as this article showed, this was someone who passed a background check and 10 years older than I am. Who woulda' thought?

   Another issue that won't change because it's simply too expensive, and difficult, to get more staff and more oversight in these facilities. They pay roughly the same as Walmart, except in my experience, most facilities actually have pretty good benes. But the work is physically and emotionally draining, and turnover is high.  To put is bluntly, you're spending a good part of your day, day-after-day, cleaning bodily fluids/waste on adults, bathing, toileting. Its an awful job and rarely good enough to satisfy the family members (if there are any) that visit. 

There aren't the resources to pay better and increase staff.  

[JaneCares]

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@retiredtraveler wrote:

"....Everyone who has a family member, male or female, in a nursing home or who personally contemplates the possibility of ever having to resort to long term care in a nursing home or assisted living facility should read this article...".

Ok. Then what? I was a CNA for 4 years, part of the time working in a nursing home. We've discussed nursing homes in the past. I've always stated that except for a very few 'boutique' facilities, they are always understaffed and care is 'spotty'.

   The good part is that CNA requirements have become more rigorous in most states --- background checks and more schooling that there used to be. But, as this article showed, this was someone who passed a background check and 10 years older than I am. Who woulda' thought?

   Another issue that won't change because it's simply too expensive, and difficult, to get more staff and more oversight in these facilities. They pay roughly the same as Walmart, except in my experience, most facilities actually have pretty good benes. But the work is physically and emotionally draining, and turnover is high.  To put is bluntly, you're spending a good part of your day, day-after-day, cleaning bodily fluids/waste on adults, bathing, toileting. Its an awful job and rarely good enough to satisfy the family members (if there are any) that visit. 

There aren't the resources to pay better and increase staff.  

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There aren't the resources to pay better and increase staff.  

Dear retiredtraveler,

I appreciate your posts whenever i come across them. And i'm glad you're traveling!

Regarding your last sentence: I really think there ARE resources and they are not being directed where they should be, to long term care, health care, and social services. If Exxon paid ANY taxes, if the richest 5 percent paid much more of a fair share of taxes, there'd be PLENTY of money to pay CNA's adequately, to provide more community based sources of care with creative innovations like grocery stores that demented people can 'shop' in whether they remember to pay or not (see Netherlands) or where young people can get free housing if they hang out (under supervision) with older people in the same residence for several hours a month (Denmark). We KNOW what to do. We do not, as a country, seem to have the political will to provide true tax reform and FUND what we will all need sooner or later: care. And support for our family caregivers if we are lucky enough to have willing family caregivers.

Rant over

Jane

[Prosecco6247]

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@retiredtraveler wrote:

"....Everyone who has a family member, male or female, in a nursing home or who personally contemplates the possibility of ever having to resort to long term care in a nursing home or assisted living facility should read this article...".

Ok. Then what? I was a CNA for 4 years, part of the time working in a nursing home. We've discussed nursing homes in the past. I've always stated that except for a very few 'boutique' facilities, they are always understaffed and care is 'spotty'.

   The good part is that CNA requirements have become more rigorous in most states --- background checks and more schooling that there used to be. But, as this article showed, this was someone who passed a background check and 10 years older than I am. Who woulda' thought?

@retiredtraveler  Thank you for your observations.  I have read your responses about nursing homes in the past and your points are well taken.

I will say this, however, it's not always the non-professional staff who are to blame.  There was a case in my city about 15 years ago that involved a male RN who was tried and convicted of raping a comatose female patient in the ICU "step-down" unit of a local hospital.  Another nurse, suspecting something amiss, saved the patient's linen and submitted a sample of a liquid substance deposited on the sheet.  It was identified as s*m*n and the evidence was turned over to the police for DNA analysis.  The state crime lab identified it as belonging to the suspected perpetrator.  Her quick thinking and willingness to get involved (a) identified a problem that the family was not even aware of and (b) provided the identity of the perpetrator and preserved the evidence leading to his subsequent arrest and conviction.  Sexual predators don't necessarily fit into a particular category and there is sometimes no reliable way to identify them before a crime takes place.  They can identify potential victims and quietly go about their work until they determine the right windows of opportunity to commit the offense.  Frequently, when a patient must be turned or the complete bed linens changed, help is summoned for the job, sometimes from another unit, so the patient may also have been identified by additional predatory individuals as well. 

CNAs do have a difficult job, this is true.  Nursing homes save money by having less professional staffing and more CNAs, so there is definitely a lack of oversight because the charge nurse is swamped with paperwork and administrative duties and therefore spends less time in actual patient care.  There are CNAs who genuinely have a calling and love doing one-on-one care.  My ideal situation is to have in-home care by a private-duty CNA for as long as possible.  We've done this in my family and it has worked well.  Of course, none of us knows what the future will bring.

Regulatory & certification agencies must be "beefed up" and CMS/Medicare/Medicaid must cut off reimbursement for those institutions that don't make the grade.

Videocamera recordings might be a good deterrent.  They can, at least, document who enters and exits a patient area and how long they stay.  Privacy issues are a big consideration when bedside care is given, so that must be worked out if video is used.  Continuing education regarding sexual and physical abuse and ethical considerations must be incorporated both for professional and non-professional staff and all employees should be encouraged to report suspicious activity when they encounter it.

Denial of a problem by administration and professional staff can sometimes be an issue that thwarts identification of abuse.  They must be open to the idea that it can and does happen more regularly than they would like to admit.  State regulatory boards must create programs to address this particular issue so that it is not swept under the rug and there should be a dedicated hotline to report problems anonymously as well.

[nyadrn]

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@retiredtraveler wrote:

"....Everyone who has a family member, male or female, in a nursing home or who personally contemplates the possibility of ever having to resort to long term care in a nursing home or assisted living facility should read this article...".

Ok. Then what? I was a CNA for 4 years, part of the time working in a nursing home. We've discussed nursing homes in the past. I've always stated that except for a very few 'boutique' facilities, they are always understaffed and care is 'spotty'.

   The good part is that CNA requirements have become more rigorous in most states --- background checks and more schooling that there used to be. But, as this article showed, this was someone who passed a background check and 10 years older than I am. Who woulda' thought?

   Another issue that won't change because it's simply too expensive, and difficult, to get more staff and more oversight in these facilities. They pay roughly the same as Walmart, except in my experience, most facilities actually have pretty good benes. But the work is physically and emotionally draining, and turnover is high.  To put is bluntly, you're spending a good part of your day, day-after-day, cleaning bodily fluids/waste on adults, bathing, toileting. Its an awful job and rarely good enough to satisfy the family members (if there are any) that visit. 

There aren't the resources to pay better and increase staff.  

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Thank you for your observations, esp since they are first hand.  If I spend my life planning for my financial needs including paying off the house, paying for vacations, etc.. I should probably think about my end of days and plan for those as well.   As a result of your experiences while working in a facility, did you make any specific plans to deal with these issues for yourselves?  Do you have any suggestions?