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Disgusting Abuse
Malnutrition and weight loss are also common, she says. "It's not atypical for a nurse to bring the food tray and come back in half an hour and take it away. There are heartbreaking stories of people who need help eating and drinking and don't get it."And that can trigger a string of complications, says Dr. Loren G. Lipson, a geriatric physician who teaches at the University of Southern California. "Once you are malnourished and dehydrated, you are much more susceptible to pressure sores and at risk of compromising your immune system," he says. "The potential for infection is greater, and in severe cases, these conditions can lead to delirium."
Ed Armstrong learned his mother's pressure sores were severe only after an emergency room doctor roused him one morning and told him to get to the hospital. Emily Armstrong, 84, who had been in a St. Petersburg, Florida, nursing home after suffering a stroke, had not been moved or turned enough by staff while she was in bed. Sores had developed, and the doctor stunned Armstrong by showing him a leg wound on his mother that was so hideously infected, the hospital needed to amputate immediately.
Emily had been in the upscale Carrington Place nursing home for less than two months -- but that was enough time for her to develop a massive stage 4 infection that had eaten clean to her sacrum and ankle bone.
When Emily recovered from the amputation of her left leg, Armstrong sued Carrington Place and later reached a settlement with the facility, which has denied any wrongdoing. He then moved his mother to a Catholic facility, Bon Secours-Maria Manor, across the street from his home, where he felt sure her care would be better.
Yet during her stay at Bon Secours, her right ankle was broken. Armstrong suspects it happened when she was being moved in -- but he has received no answers from the home. The break did not heal, and before long, a sore developed and became infected. Once again, Armstrong found himself at the hospital making a second decision to amputate. Armstrong has also decided to sue Bon Secours. The nursing home is contesting the complaint, denying any culpability.
"She was like a carcass at that point," says Armstrong, his voice trembling as he recounts picking up his mother's legless body to lay her into bed. "This is one of my last memories of my mother, and I think, My God, is this the end result of her care?"
With so many documented cases of elder abuse and neglect, and so many more suspected, you'd think oversight would be strenuous. It hasn't been.
At the federal level, the Department of Health and Human Services spends money to train state inspectors, and Congress has legislated quality standards for nursing homes.
But the real hands-on oversight is designed to take place at the state level, with health agencies monitoring the quality of care and being able to impose fines or shut down homes. Every state is also required to have a "long-term care ombudsman program" that fields complaints from families or residents, as well as schedules visits to the facilities to gauge their quality.
However, it's difficult for inspectors to spot signs of neglect during infrequent visits, and it's far too easy for nursing homes to conceal their problems. New York's Attorney General, Eliot Spitzer, announced this past January the arrest of 19 nursing home employees who were caught through hidden cameras neglecting patients. According to law enforcement reports, the caretakers moved call bells out of reach of patients, as well as watched movies, slept or even left the building when on duty. Spitzer contends they then falsified records to document that they had provided care. (To date, 14 have pleaded guilty.)
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