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The antibiotic is considered one of the greatest achievements in the history of mankind.  However, scientist have been studying antibiotic resistance since the 1940’s.  In 1947, penicillin became ineffective against its first bacterium.  Unfortunately, only as recent as 2017 have nursing homes been forced to develop, implement, and maintain an antibiotic stewardship program.

An Overview of the Problem

In any long-term care facility, the spread of bacteria and viruses is all but inevitable.  Mitigation techniques such as hand washing, frequent bathing, linen changes, and contact precautions do help, but at some point, this is not enough.  Increasingly, nursing home residents are being prescribed antibiotics even when their indications do not meet the criteria.  You may be surprised to know that, according to the CDC, 50%-70% of nursing home residents are prescribed antibiotics in any rolling 12-month period.  Additionally,

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Though much of the conversation around elder abuse is centered on nursing home malpractice, the leading issue many elders are currently facing is self-neglect. Self-neglect is defined by the National Adult Protective Services Association as, “an adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care…”, and is something that happens far too often within the older population worldwide. With many different factors to appreciate, it’s hard to always know exactly what to look for when trying to detect the symptoms of this epidemic.  

Who is most likely to experience self-neglect?

When having the conversation about self-neglect, it’s important to be aware of what some of the most vulnerable groups are. Though there has yet to be a study of adequate sample size and population diversity, researchers are already starting to see early trends of which demographics are more likely to have this problem.

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It is nearly impossible to avoid any medication error at a nursing home, meaning every individual establishment is required by state inspectors to keep their error rate below 5 percent. This mandate only includes minor errors, with essentially no acceptance of major medical incompetence. However, even with these regulations in place, nursing homes are not infallible.

What Constitutes a Medication Error?

There are many different forms of medication malpractice ranging from minor mistakes with little to no consequence, all the way to life threatening errors. These are some of the most common errors:

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Choosing to place yourself or a loved one in a nursing home can be extremely difficult.  Finding the right one is even harder.  A wealth of information exists online and much of it is useful, but this decision should be informed by experience and conversations with the people that matter most as well.

1 – Identify All of Your Options

Go online and find every nursing home in your area.  A great place to identify these facilities is on the medicare.gov website.  Using their Nursing Home Compare feature, you can type in your zip code and quickly compare all of the care facilities in a given radius.  You may have more options than you originally thought!

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Dehydration is a serious health risk, especially in elderly people.  Individuals over 65, who live alone or with their elderly partner, are at a higher risk of dehydration than other age groups because they may forget to stay hydrated or they are too tired to get a drink.  However, in a nursing home, dehydration should never happen and, in some situations, is an example of elderly abuse.

How Wide Spread Is This Issue?

One elderly person dying from dehydration in a nursing home is unforgivable.  People who live in nursing homes are there because they need help of varying degrees to survive.  One of the necessities of life is water.

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One of the most vulnerable and overlooked populations in the United States is people over the age of 65.  Loved ones are usually on the lookout for things such as physical, verbal, and psychological abuse of the elderly.  However, too often, financial abuse is overlooked.  To make matters worse, the perpetrators of financial abuse are frequently the family, friends, and caregivers of the elderly.

What is Financial Abuse?

The Elder Abuse and Elder Financial Exploitation Statutes define elder financial abuse as:

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If you have a loved one in a long-term care nursing home, you know how difficult it can be to visit more than once or twice per week.  You are the eyes and ears of your elderly family member, but who is looking out for them when you are not around?  The Long-Term Ombudsmen of Riverside County do just that.

What Is a Long-Term Care Ombudsman?

In 1978, amendments to the Older Americans Act mandated that each state create an Ombudsman Program.  The Older Californians Act further solidified the funding and presence of the program by supporting the development of the Office of the State Long-Term Care Ombudsman (OSLTCO).

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Nursing homes are often under-staffed in an effort to maximize profits or because they are underfunded.  With the number of elderly people requiring care increasing at a record pace, some institutions use prescription drugs to make their residents more “manageable”.  Legal and ethical issues notwithstanding, the health implications of the use of chemical restraints are terrifying.

What Is a Chemical Restraint?

Put simply, a chemical restraint is when someone’s movement or actions are restricted through pharmaceutical intervention.  Types of drugs used as chemical restraints are:

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One of the largest generations in American history is beginning to transition into the elderly stage of human life.  In this stage, many people become less independent and, as a result, require assisted living and clinical care.  As aging individuals become dependents, they tend to lose their mobility.  Pressure ulcers are a direct result of the inability of a person to reposition their body unassisted.  In nursing homes and hospitals, elderly people are too often neglected and the price they pay can be severe.

Pressure Ulcers and Their Stages

Pressure ulcers (often referred to as bedsores, decubitus ulcers, and pressure sores) are a form of breakdown of the skin caused by prolonged and unalleviated pressure, incontinence, dirty or untidy bedsheets, and more.  Typically, they form in areas such as the heels, hips, buttocks, tailbone, shoulder blades, and elbows.  They are categorized based on severity:

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Dementia is described by the Alzheimer’s Association as “an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities.” Indeed, there are a variety of types of dementia, depending upon the types of brain cells damaged, and where specifically that damage has occurred within the brain.

Regardless of the type of dementia an elder may have, it is important that symptoms are recognized as soon as possible in order to ensure the safety and wellbeing of your loved elder. Even if an elder is receiving care or assistance from a family member, in-home caregiver, or residing in a nursing home or skilled nursing facility, it is still vital to recognize symptoms of mental decline in elders. This is partly due to the fact that unfortunately, it is believed elders who suffer from some form of dementia are thought to be at greater risk for abuse or neglect than elders who do not have some form of dementia.

In fact, according to one research brief released by the NCEA, three different international studies have found that the rates of elder abuse for elders with dementia ranges from 34%-62%.

Symptoms that a loved elder in your life may be developing dementia include cognitive changes and psychological changes. Some of these changes may include:

*Memory loss/problems
*Trouble choosing the right words
*Disorientation or getting lost
*Challenges in planning/organizing
*Coordination or motor function difficulties
*Agitation or paranoia
*Inappropriate behavior
*Lack of proper personal care and poor nutrition/eating habits
*Difficulty sleeping
*Injuries/personal safety problems

If you believe that a loved elder in your life is beginning to show symptoms of dementia, it is important to take action, though it’s advisable to tread lightly, per the helpful website DementiaToday.net, which provides DementiaToday.net for how to talk to a loved elder about your concerns.

If you have reason to believe that a loved elder with dementia is being abused physically, financially, psychologically, or sexually, it is important that you report your suspicions to the proper authorities:

• The local Law Enforcement, including the Police, Sheriff, and District Attorney’s office. The San Diego County Sheriff’s Department can be reached at (858) 565-5200. The San Diego County District Attorney may be reached at (619) 531-4040.
• Long-Term Care Ombudsman Program provide a 24/7 Crisis Complaint Hotline at (800) 231-4024.
• Adult Protective Services (APS), in San Diego County, you may contact: San Diego County Aging and Independent Services (858) 495-5660.

You may also want to seek the advice of an experienced San Diego elder abuse attorney who can inform you and your loved one of your rights.
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