The National Center on Elder Abuse estimates that one in 20 nursing home patients is the victim of abuse or neglect although, in reality, the number may be much higher because mistreatment often goes unreported. The issues are many, ranging from nutrition and hygiene to overuse of antipsychotic drugs to neglect and outright physical abuse. People with Alzheimer's disease and other forms of dementia, stroke and cardiac patients, people with mental illness or retardation, and people with limited mobility or inability to communicate are all at risk of abuse at the hands of caregivers. Many nursing home residents, especially those with Alzheimer's disease and other forms of dementia, are unable to articulate the kind of treatment they receive, and if they do report abuse, the complaint may be dismissed as untrue because of the patient's potential for confusion and questionable memory. Moreover, many patients and their families do not report abuse out of fear of retaliation from staff.
Staffing – both numbers and quality – is often a problem, even for the best-run facilities. Many nursing homes and rehabilitation facilities are understaffed and personnel are poorly trained, creating the potential for neglect as too few staff members struggle to care for too many patients.
According to the Wall Street Journal, many nursing homes overuse antipsychotic drugs to control agitated patients, but these drugs increase the risk of death in patients with dementia. Some sleep medications can be dangerous for nursing home residents because they cause disorientation and impair balance, increasing the need for more attention from nursing home staff and, unfortunately, increasing the risk of falls. Beyond the risks to the patients, these drugs are costly to the Medicare program, which reportedly spent $7.6 billion on this class of drugs in 2011, according to the Centers for Medicare and Medicaid Services (CMS).
The New York Times reported last year on another serious health issue among nursing home patients: lack of proper oral hygiene care. Residents whose teeth and mouths are not cleaned regularly can suffer pain, broken teeth, and gum disease, all of which may interfere with the ability to eat properly. They may develop infections, including pneumonia, when oral bacteria enter the bloodstream.
Elder care advocates say families must be alert to signs of abuse and neglect, some of them subtle, and act on them. One of the most obvious signs of nursing home neglect is when a resident suffers a bedsore. Bedsores can develop when the patient is left in bed for long periods without repositioning. Other signs of abuse include: weight loss because the facility does not have adequate staff to ensure patients have the help they need to eat; frequent injuries, which can be the result of falls or rough handling of frail individuals; poor hygiene; and changes in the patient's mood and demeanor.
New York Attorney General Eric T. Schneiderman has vigorously pursued incidents of nursing home abuse. "When families make the difficult decision to place the care of their loved ones in the hands of a nursing home, there's an expectation that they will be shown compassion and respect—not physical abuse and neglect," Schneiderman said, in commenting on a guilty plea in an abuse incident at an Albany facility. "Those who exhibit a blatant disregard for these responsibilities will be held accountable under the law." New York law firm Parker Waichman LLP has helped many families take action against negligent facilities and abusive staff members.
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