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Deep flaws haunt state’s system for attacking elder abuse, report says
November 6th, 2009, 5:00 am · 19 Comments · posted by Teri Sforza, Register staff writer
There are deep flaws in California’s approach to detecting and responding to elder abuse and neglect - flaws that prevent serious cases from ever coming to light, according to a new report form the California Senate Office of Oversight and Outcomes.
California has more than 9,000 nursing and residential care facilities for the elderly, and 290,000 licensed beds, according to federal statistics. Riding herd on them are about 1,000 “long-term care ombudsmen” - people originally meant to be watchdog/mediators, doing spot checks of facilities, following up on complaints, and helping make life better for residents by serving as intermediates, and advocates, with management.
But something else has happened entirely, according to the report.
Because of laws California has adopted, these watchdog/mediators have morphed into the front line for investigating serious reports of elder abuse and neglect. That gives rise to several problems - the least of which may be that there’s no time for the routine spot checks and patient advocacy that was originally envisioned.
Ombudsmen - now legally tasked with very serious investigations of suspected abuse and neglect - can only tell law enforcement about problems if the complaining parties agree to release their names and complaints.
Only one-quarter agree to this. Which means 75 percent of complaints essentially disappear.
What precisely are we talking about here? Assault, sexual harassment, financial exploitation, physical neglect…. grim stuff.
Why won’t people sign their names to complaints? Well, if you had to keep living in the place you were complaining about - or have your most basic and intimate needs attended to by someone you were complaining about - you might be a bit frightened of attaching your name to the complaint, too.
And in cases where suspected abuse is reported by staff - on behalf of a resident with dementia or the like - well, that person can’t give informed consent.
The ombudsmen program had a budget of $5.7 million in 2009, almost 27 percent below where it was in 2007-08, the report says. Not surprisingly, that has corresponded to a tremendous drop in the number of abuse cases ombudsmen recommend for follow-up to law enforcement.
This being a report by the Senate majority - which happens to be Democratic - it blasts the budget cuts imposed by Gov. Arnold Schwarzenegger. But those budget cuts did not cause these problems, so much as lay them bare.
So, what can be done to protect California’s vulnerable seniors?
- Sacramento should pass legislation “to enhance the ability of the ombudsman to act as an independent voice for the elderly, as required under the Older Americans Act, and require the state ombudsman’s office to develop a comprehensive plan of advocacy,” the report says.
- Residents, their family members and staffers should be able to report abuse, and get action, without fear of being exposed. To that end, the Legislature should require the state ombudsman’s office “to develop a detailed protocol for reporting elder abuse even without resident consent if the situation poses an imminent threat to long-term care residents or others.”
- Ombudsmen should be able to return to their watchdog/advocate role, and leave investigation of possible crimes to the likes of local Adult Protective Services offices and law enforcement.
- Ombudsmen volunteers - and yes, there are many of them - should not be tasked with undertaking such serious investigations, at least not without more training.
In 2004, 12 percent of Americans were over age 65.
By 2050, that figure will grow to 21 percent , the U.S. Census Bureau says.
These issues will only get more and more acute.
“The last thing we should do is handcuff those who we entrust to watch over the care and safety of our elderly loved ones with conflicting and ill-conceived mandates, confusing protocol, and inadequate regulations,” said Senate President pro Tem Darrell Steinberg (D-Sacramento) in a prepared statement. “The Senate will take a close look at the thoughtful recommendations provided in this report and respond appropriately.”
You can see the full report here: elder-abuse-report; and the Senate press release here: senate-release.
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It take a coward to abuse anyone that can’t defend himself.
Nursing home workers are paid minimum wages and worked like slaves.
If you are not demented when you enter, you will be soon enough.
They will drug you into “dementia”.
Just being in a nursing home is abuse.
There are many fine, good nursing homes. I work with many of them. But there are many that are bad, and many elders have abusive family/caretakers.
If you know a senior being cared for, don’t assume. Be their advocate and step up. Visit often, and without warning. Visit at odd hours. Come at mealtime and check the food. Be there for them, now, as they were for you when you were young. No matter how busy you are, MAKE the time.
And the OCR needs to stop being two faced by criticizing the very agencies you say shouldn’t exist. They are underfunded, and first cut when there are budget shortfalls. Put up or shut up, OCR, because you can’t have it both ways.
It is the responsibility of family members to constantly check on the well being of their loved ones. Check out facilities before there is a need. From my experience only 25% of nursing homes provide adequate care for the elderly. The rest just do the minimum to pass the state requirements.
Anonymous complaints are hardly a solution. How would Teri Sforza like
it if anyone could ‘drop a dime’ on her and make a serious allegation that
would trigger a possible criminal investigation? Every nursing home administrator would have to have a lawyer on retainer if a disgruntled or terminated employee could simply pick up the phone and claim elder abuse.
Working at these facilities is not easy as it is. Nurses and nurses aides are scatched, bitten or hit by their patients as they try to care for them. In no other job in the world would that be tolerated by management of the public. If I were to hit a hotel maid or bite a waitress I would be subject to arrest yet nursing staff routinely endure
such attacks from those they care for! Abuse should not be tolerated
but nursing staff should not be sanctioned for forcibly restraining a violent out of control patient either.
sangell3’s point is true….how do you care for someone who acts out against you out of fear or pain or confusion from drugs?
I just know that I never want to be put there, never.
Everyone seems to be missing the actual point - and that is that 99% of the Ombudsman who are to investigate abuse in licensed facilities are volunteers. Adult Protective Service workers are understaffed and overworked with cases coming in fast and furious. Teri Sforza and the like only seem to focus on “the pensions” and benefits that everyone is getting instead of looking at the real problem and that is that we are unprepared for the onslaughter of elder abuse cases.
The elderly infirmed in this country are privileged! Wealthy or poor, they whine, make strange noises and always want their prescription medication. Many of these people could simply walk out of bed and lead a normal life but they crave the attention of medical care and abuse ever corner the Medicare system.. “I’ve fallen and I can’t get up..! Stay down granny and expire with dignity…!
How old are you?
How many nursing homes have you visited?
I work with hundreds of seniors and not one of them would choose to be a nursing home.
When your time comes, you better hope that those who think like you do are no where near your nursing home.
Many have fallen and CAN’T get up.
How old are you?
How many nursing homes have you visited?
I work with hundreds of seniors and not one of them would choose to be a nursing home.
When your time comes, you better hope that those who think like you do are no where near your nursing home.
Many have fallen and CAN’T get up.
Ombudsman shouldn’t be volunteers - they should be licensed social workers with the knowledge and training to investigate and refer abuse for criminal investigation.
Nursing home workers are afraid to report abuse; they’re fired and chastised - and will have a hard time finding a job afterward. The system isn’t set up to help people - it’s set up to protect the corporations that own nursing homes. Do your homework before you place a family member in a nursing home!
Thanks for the great article. You are a writer with a lot of heart and Thank- You for always writing the truth. Senior abuse is a BIG Can of WORMS .In fact, there are many ways seniors are abused including in MANY Homeowner associations were they live. Too many people except seniors to just take their medicine and shut up..Its very sad, as so many are frail and defenseless. I have seen a lot of seniors bullied and intimidated just for trying to speak their mind or ask questions. Well thanks to seniors, WE ARE HERE today. They Shouldn’t be treated with abuse or intimidation. One day soon we too will be seniors, how would we like it.
There are more kinds of abuse under the sun than “just” physical. The abuse going on in all sorts of living circumstances would curl the hair of the people who are unaware or who would rather make impolite jokes about the elderly.
Frequently the only recourse is via civil action and that is expensive. Seniors tend to be living on finite amounts of money which must last for unknown lengths of time. That makes civil action difficult if not impossible for most.
Getting the attention of law enforcement or legislators on any level also proves to be difficult to the point of people becoming so frustrated they just give up trying.
Senior abuse is HUGE and it has legs.
I could write for hours what the problems and solutions could be. I agree that the Ombudsman should have well paid social workers. Being a licensed social worker isn’t as important as training and street smarts and getting paid a reasonable pay. CPS (Child Protective Services) and APS (Adult Protective Services) have very well trained social workers - most with a Masters degree. CPS is a court program and they can yank out children for their protection until decisions can be made.
With seniors the problem is not the workers - the problem with elder abuse is that the cases rarely make it past law enforcement to the DA’s office and to prosecution. The number one problem is that there is no basic system to take abused seniors into an Orangewood type of location for safety and then easy access to the court system. There is no 5150 for dementia patients to be whisked out to a safe location. Social workers battle every day with no weapons to use for the help and welfare of seniors.
No one believes the amount of elder abuse which occurs daily in our beloved Orange county, but nursing homes are not the evil incarnate. Nursing homes are at least monitored by the Department of Health and the Ombudsman.
Readers should check the Social Consience op ed piece in the Nov. 8 Commentary section of the Register. Nita Weis, brilliantly explains that sometimes Skilled Nursing Facilities are a necessary choice when the family can no longer meet the needs of their elder loved one. Everyone who has been alive for any length of time realizes that the squeaky wheel gets the most oil. This is true for nursing home care as well. If you have a loved one in a nursing home, be you loved one’s advocate. Most nursing homes will accommodate your concerns if you bring them to the attention of the nursing or administrative staff. If they do not accommodate your concerns, there is recourse with the Department of Health and the Ombudsman.
From my perspective a more hidden concern is the Alzheimer Care facilities. While the Department of Health must inspect nursing homes once a year, Community Care licensing, the regulatory agency for most Alzheimer Care units, is only required to inspect Residential Care facilities once every FIVE years. This for the most vulnerable people in Orange county. What’s worse is the lack of training required by the Alzheimer Care unit to care for these frail and needy people.
This is where the real reform is needed.
you can always count on to california nursing homes negligence attorney for the support and services they render regarding this matter. it’s high time to give the verdict these nursing homes deserve!!!!
Thank you for bringing to light the challenges that the State of
California is facing with regards to the process of detecting and
responding to instances of elder abuse and neglect. Unfortunately,
elder abuse is a pervasive problem that reaches beyond elder care
facilities and into the private homes where older Americans are being
cared for by their spouses, relatives, friends the professional
caregivers.
Recent studies have indicated that between one and two million
Americans age 65 and older have been injured, exploited, or otherwise
mistreated by someone on whom they depended for care or protection. It is also estimated that for every one case of elder abuse, neglect,
exploitation, or self-neglect reported to authorities, about five more
go unreported. As such, Laura’s House, a non-profit organization based
in South Orange County, has developed the “Project to End Family
Violence in Later Life.”
This is a pilot program at Laura’s House designed for adult women and men aged 55 years and above who are at-risk for abuse, or its recurrence in their residences, or living quarters. What makes this program unique, is that rather than duplicating existing resources for elders, the Project to End Family Violence, examines elder abuse through the lens of power and control, acknowledging the specific dynamics of domestic violence, as we age. Laura’s House offers emergency shelter, counseling & legal services regardless of the ability to pay.
For your readers who are concerned about elderly friends or family
Members or they themselves have experienced such abuse, we
encourage them to contact Laura’s House 24-hour hotline at (866)
498-1511. More information about Laura’s House can be found at
http://www.laurashouse.org.
This is an important issue, and we hope that more people will become
more aware of the steps that they can take to end the cycle of
domestic violence.
I would like to inform people, elder abuse is not limited to the nursing and residential care facilities. At least they are ‘monitored’ by the Ombudsmen, whether they are short staffed or not. There is someone to notify.
My mother received elder abuse in the hospital she ended up dying in. We tried to locate somebody, anybody, somewhere to help us, but the Ombudsmen wouldn’t help either because it was a ‘hospital’.
I did get the OC Health Dept interested enough to go there and write a report, which I added to all my notes, names, dates/times and the 3 people at the hospital that even admitted their guilt.
The hospitals are not monitored or checked out either. This particular one doesn’t notify the State, which is required by law, of a developed situation. There were 2 nurses at the end that refused to hide the situation, as they were required by law to take pictures and have the State notified. The damage had been done for over a week by that time. The abuse had been repeated for so long by that time, it was too little and too late.
Hospitals need to be included with the other establishments and held responsibile. They should not be able to get away with cruel treatment and abuse. Why are they allowed to? Why are they considered special?
As far as, “Why won’t people sign their names to complaints”, I would have and I gave my full name to every person I called and pleaded and begged for help.
Nobody would listen - it wasn’t their job.
I need help, recently my father age 80 was removed from his home on a 5150 charge that his wife age 50 fabricated. He was diaganosed with mild dementia and she no longer wanted to take care of him. She stopped making house payments after she had her name removed from the deed and allowed the bank to foreclose. She kept my father in a board and care facility and would not allow the facility or my father contact his adult children. She kept this secret and issued a no contact order to his children. We reported suspected abuse on several occassions to APS and police. The isolation began in January of 2009, 5150 in april 2009 and our father died from depression by refusing to eat or drink anymore aug 2009. I was contacted the night they expected him to die but he lived for 5 more days. Long enough for me to copy partial medical files and file for conservatoship but he died
before the judge ruled. Since his dealth we have uncovered witnesses to emotional and physical abuse, an affair and mislead / misdiagnosed medical condition. My father went from mild dementia to final stages of ALZ in 5 days????? His death cirtificate stated he died from ending stages of alz and that he had it for 5 years????? This is not true and can be proven if only his medical files would be supeonaed but the attorneys claim it will be very long and costly…..We are still waiting for the DA’s decision. Statue’s continue to run… We don’t have any money and we don’t want any money we want JUSTICE for our father but not sure if it exist anymore. Where are the attorneys who fight for JUSTICE at???? If I hear there must be a POT OF GOLD somewhere one more time I’m going to paint and flower pot gold and plant a tomatoe tree in it and put it on there door step…Because that is what my father would be planting in his backyard if he was still alive……Please contact me if you know someone who still believes in JUSTICE not monotary gain….