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Housing Mentally Ill in Nursing Homes Sometimes Leads to Violence

Mar 24, 2009 | Parker Waichman LLP

Sadly, it seems that nursing homes are increasingly housing the elderly alongside patients with mental illness.  The problem is that, in some cases—said U.S. News & World Report, citing the Associated Press (AP)—violence, sometimes with deadly consequences, has been reported.

U.S. News noted that there is insufficient housing in psychiatric units, mental institutions are closing, and nursing homes have more room now that the emerging elder population is healthier or remaining in their own homes longer.  Because of these logistical and health changes, younger, seriously mentally ill residents—some suffering from depression, schizophrenia, or bipolar disorder, said the AP—can be found in nursing homes along with the frail and defenseless elderly.

According to AP reports and based on exclusive information it obtained via the Freedom of Information Act, nearly 125,000 mentally ill young and middle-aged adults were living in U.S. nursing homes last year, versus 89,000 in 2002, an increase of 41 percent, noted MedPageToday, which reported that some states showed increases of 75 percent or greater. The current population of mentally ill patients in nursing homes accounts for nine percent of the total nursing home population, said MedPageToday, citing Center for Medicare and Medicaid Services (CMS) data.

MedPage pointed out that Medicaid pays housing for those with so-called chronic psychiatric disorders assuming the mentally ill population in a facility does not exceed 50 percent; age is not a factor in this case.  According to the AP, families have sued to try to change these practices and consumer advocates argue that, with proper care, the mentally ill can live in their own housing.

The AP noted that there is no tracking of killings or serious assaults by mentally ill nursing home residents against the elderly and that nursing home training does not always include what it necessary to treat seriously mentally ill patients, leaving the mentally ill angry and the elderly frightened and reclusive.

The AP pointed to a variety of violent, sometimes-fatal crimes committed against elderly residents by mentally ill patients in nursing homes.  These incidents and the CMS data point to the fact that nursing homes have become "dumping grounds" for the mentally ill, the report said, quoted MedPage:

  • A 77-year-old Alzheimer’s patient died after being hit in the face with a clock radio.  The man’s roommate was a mentally ill 50-year-old man with a history of aggression and “altered mental status,” who—after being found covered in blood—was arrested and charged, but found unfit to stand trial.  He was committed to a mental institution.
  • A 23-year-old woman was charged with starting a fire that resulted in the deaths of 16 patients at the nursing home where she resided.  The woman suffered from multiple sclerosis, dementia, and depression; was found not competent to stand trial; and was moved to a mental institution.
  • A 77-year-old patient died 10 days after his 62-year-old roommate beat him with a bathroom towel bar; the roommate was found incompetent to stand trial.
  • A 69-year-old patient was raped by a 21-year-old man diagnosed with bipolar disorder with aggression; had a history of violence; and was left unsupervised, despite telling staff he was sexually frustrated.

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