Spotting Signs of Dementia

As illustrated in my post on December 29, 2008, elders suffering from mental impairment are generally more vulnerable to abuse and neglect. Consequently, it is important for loved ones to spot the signs of dementia so that extra precautions can be taken to prevent abuse and neglect.

Dementia is a general term that describes a significant loss of intellectual abilities, including memory, the ability to reason, and other cognitive and behavioral changes that can interfere with daily life. Alzheimer's disease is by far the most common form of dementia in people age 71 and older.

While dementia presents itself differently from individual to individual, common symptoms include:

• Memory loss that increases over time
• Language problems, such as difficulty finding words or understanding spoken or written communication
• Disorientation, eventually extending to familiar places
• Persistent confusion, including about the date or time of day
• Face-recognition issues, eventually extending to familiar people
• Lack of self-regard, including neglect of personal safety or hygiene
• Inability to perform routine tasks
• Erratic behavioral and psychological changes, such as paranoia, hallucinations, depression, temper tantrums, or insomnia

While federal regulations require nursing home staff to report drastic changes in a resident's mental and/or psychosocial behavior, you shouldn't rely solely on the staff to watch for and report warning signs of dementia. Take it upon yourself to monitor your loved one's mental health.

If you do spot any of these warning signs, report it to the nursing home immediately, and follow up to ensure that the resident's written medical plan addresses these issues.

Alzheimer's Patients At Risk

Nursing home residents who suffer from Alzheimer's or other mental impairment are at greater risk of being abused or neglected because these residents often lack the awareness to recognize and report the mistreatment.

Sad news emerged out of Pittsburgh, PA this Christmas season:

On December 24, 2008, Allegheny County police announced that, for months, a group of five caretakers at Kane Regional Hospital abused a 94-year-old Alzheimer's patient, cursing and laughing at her, punching her, throwing oranges at her, and, in one instance, pouring lotion over her head. All five caretakers were arrested and charged.

The women were arrested after other staff members at the county-operated nursing home told police they saw the suspects assaulting Ms. Bryant over the course of at least six months, criminal complaints say.

The criminal complaints detail several instances during which staff members said they saw the caretakers physically assaulting the victim, calling her obscenities and striking her -- even as she cried out and begged them to stop.

One witness told police that on Oct. 29, she watched as Ms. Taylor hit the victim in the eye with her fist as she was seated in her wheelchair near the nurse's station on the second floor of the hospital. The same witness told detectives she heard Ms. Taylor cursing at the victim on "multiple occasions," and "also witnessed the victim being struck by an orange that Ms. Taylor threw" at her, the complaint said.

That same month, a Kane employee told police, she saw Ms. Keene walk past the victim and stomp on her foot. She returned a few minutes later and "struck the victim in the forehead with her hand," the complaint said.

Ms. Keene verbally assaulted and stomped on the victim's feet "a number of times," actions that went on for at least six months, another witness told police. And a third witness said she heard the victim cry, "Oh, stop hitting me," and "Ouch, you're hurting me," while Ms. Keene struck her, according to the complaint.

The victim would "often cry out, 'You are hurting me,' when Ms. Perry would strike" her, the complaint said. A witness told police she saw Ms. Perry hit the victim with her fist in the chest on at least four occasions. At least once, the complaint says, Ms. Perry threw oranges at the victim's face.
In another incident, Ms. Perry poured lotion on the victim's head "and then laughed," the complaint said.

www.EndElderAbuse.com
1-888-LAW-3010

Who's In Charge?

When elder abuse or neglect occurs, the blame often can be traced to poor management. After all, management is in charge of nurse staffing levels, quality control, and safety measures implemented in their nursing home or assisted-living facility.

Knowing who manages the facility and how it is managed is important for several reasons. First, you will know who to talk to if problems or warning signs arise. Second, you will gain insight into the character of the individuals running the facility. Are they committed to promoting the health and welfare of their residents? Or do they seem indifferent or "too busy" to speak with you?

Federal regulations require every nursing home (that receives federal funds) to have a governing body. A nursing home "must be administered in a manner that enables it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident." 42 C.F.R. § 483.75. This includes compliance with federal, state, and local laws, regulations, and codes. Additionally, the staff must always work within "accepted professional standards and principles that apply to professionals providing services" in nursing homes. 42 C.F.R. § 483.75(b).

A nursing home must be administered in an efficient and effective manner. Not only is this a sound business practice, but it will also preserve residents' dignity and promote their general welfare. Part of efficient and effective management is the implementation of a governing body. The federal standards state that a nursing home "must have a governing body, or designated persons functioning as a governing body, that is legally responsible for establishing and implementing policies regarding the management and operation of the facility." 42 C.F.R. § 483.75(d)(1). The governing body must appoint an administrator who is responsible for management of the facility. 42 C.F.R. § 483.75(d)(2). Additionally, many states require such an administrator to have a special license.

The administrative body is charged with ensuring that the facility runs effectively and meets requirements. These duties (set forth at 42 C.F.R. § 483.75) include:

• Ensuring nursing aids are qualified, competent, and licensed.
• Ensuring a sufficient number of qualified staff to care for residents.
• Ensuring all services provided meet professional standards.
• Ensuring the facility provides quality radiological and diagnostic services.
• Maintaining clinical records within accepted professional standards.
• Maintaining an effective disaster and emergency plan.
• Implementing transfer agreements to get residents to the hospital and back when required.
• Maintaining a quality assessment and assurance committee.
• Disclosing ownership when required by law.
• Ensuring that only trained feeding assistants help residents with eating issues.

In short, know who is running your nursing home. It's management who sets the tone for how residents will be treated. When management is lax or indifferent to the quality of resident care, the risk of elder abause and neglect soars.

Nursing Home Rating System Unveiled

A New York Times article published today discusses The Center for Medicare and Medicaid Services' (CMS) new nursing home rating system ("Nursing Home Industry Worries About New Ratings"). The rating system ranks nearly all of the nation's 16,000 nursing homes on a 5-star system.

An astonishing 22% of all nursing homes received the lowest ranking (1 star), while only 12% received the highest ranking (5 stars).

The 5-star system uses three years worth of inspection data previously available to the public on CMS' website--the rating system makes it much easier for individuals to digest the data and helps in making an informed comparison of different nursing homes. Data pertaining to independent health inspections and staffing levels weighed most heavily on a nursing home's rating.

Both the nursing home industry and consumer watch groups admit that the 5-star system is not entirely accurate and that there is much room for improvement with the system. But there is simply no denying that this is a move in the right direction and a great tool for nursing home residents and their loved ones.

Access the 5-star rating system here

Purpose

This blog is intended to be an informational resource on elder abuse & neglect--a growing problem in the United States.

News related to the nursing home and assisted-living industry will be discussed on this blog. Changes in regulations and laws will be noted, and studies related to the industry will be analyzed and explained.

Advice will be offered on how to spot warning signs of abuse and neglect and how to stop the abuse and neglect. Further, obtaining compensation for injuries suffered by an elderly person will be addressed.

For more information on elder abuse and neglect, I encourage you to visit my law firm's website at www.EndElderAbuse.com. If you have questions about one of my posts or an issue not addressed on this blog or the website, don't hesitate to contact me by email at brett@trumanlaw.net or by phone at 1-888-LAW-3010.