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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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If a loved elder in your family is showing signs that they need assistance in their lives because they are no longer able to manage everything as they once did, it’s time to consider what type of help/assistance they need. There are many different types of assistance available, ranging from housekeepers to attorneys.

Here’s a look at the different types of assistance available for seniors in San Diego.

1. Emergency Response Alarms Because so many elders fall each year, with many facing grave injuries or illness as the result of a fall, it’s imperative that an elder at risk for falling have an in-home emergency response device installed. This will ensure that an elder who has fallen will receive appropriate and immediate treatment.

2. Non-Medical In-Home Assistance The types of services offered through non-medical in-home assistants may include transportation to appointments, help with grocery shopping and meal preparation, bill paying, housekeeping and even just companionship. However, it’s crucial that you thoroughly check references of any one who will be assisting a loved elder. Seek out only those who are bonded and insured for added assurance that your loved elder will be well cared for.

3. Respite Care/Spousal Care Respite care or spousal care is available for family members who choose to care for their loved elder themselves. Because caregivers and spouses may face challenges in caring for their loved ones, you may wish to contact the San Diego Regional Office of Respite Services to help find assistance so that the caregiver may have time off to attend to personal tasks and obligations.

4. Residential Care Assisted Living Homes
Assisted living homes will generally offer elders a wide variety of services including meals, laundry, daily activity assistance, medication supervision and/or transportation services. To find an assisted living facility in San Diego, you may consider visiting SeniorHomes.com to begin your search for the best facility for your loved one.

If you are uncertain as to what type of assistance your loved elder needs, you may want to consult a Geriatric Care Manager, such as those available at www.eldercareguides.com. These San Diego experts will work with you to determine what types of care your elder may require, and provide you with a host of options to meet your needs.
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Financial abuse of elders is an unfortunate reality. In fact, elders are often specifically targeted by criminals looking to commit fraud and identity theft. There are many ways to prevent fraud and identity theft. It is important for elders, or their loved ones, to monitor their credit, and regularly review account statements to try to prevent or stop financial abuse.

All Californians are entitled to one free credit report per year from each of the three major credit reporting bureaus, Experian, Equifax, and TransUnion. To get your free annual credit report visit www.annualcreditreport.com. This federal government approved website will enable you to pull your credit, or the credit of a loved senior, and receive a full report once each year.

While one free credit search is made available each year, elders would be smart to check their credit 2 or 3 times per year. Credit reports typically cost less than $20, and provide invaluable peace of mind by confirming that unauthorized accounts have not been opened, nor have illegitimate items been charged.

In addition to obtaining regular credit reports, it’s a good idea to have duplicate copies of monthly account statements sent not only to the elder, but to their trusted Financial Advisor, attorney, CPA, or a trusted family member. This will provide additional confirmation that all charges appear accurate, nobody has acquired the account number, and it is not being used without the consent of the elder.

Warning signs of fraud on bank statements may include:

*Withdrawals from outside of the elder’s primary area residence;
*Repeated withdrawals, particularly if the elder spends most of their time at home; and
*Checks written to unusual or unfamiliar people, organizations, or stores.

Keeping an eye on credit is important for Californians of all ages. However, it is especially important to monitor credit statements and account balances for elders who may have declining mental capacities, or medical conditions such as dementia that put them at greater risk for becoming a victim of financial elder abuse.

If you suspect, or confirm that your loved elder is the victim of financial abuse in California there are certain steps you should take. You may report any suspicion of abuse to the National Elder Abuse Hotline at 1-800-677-1116. In California, reports can be made to the local county Adult Protective Services Agency or to local law enforcement.
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According to the World Health Organization (WHO), “Elder abuse is a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person.”

In a study conducted by the WHO in 2017, it was estimated that 15.7 percent of people aged 60 or older experienced some sort of abuse, such as physical, verbal, emotional and/or financial, when the WHO reviewed collected data from 52 studies in 28 countries. Of note, in institutions such as nursing homes and long-term care facilities, 2 out of 3 staff members reported committing elder abuse within the past year. The WHO described abuse in institutions to include, but not be limited to, “physically restraining patients, depriving them of dignity (for instance, by leaving them in soiled clothes) and choice over daily affairs; intentionally providing insufficient care (such as allowing them to develop pressure sores); over- and under-medicating and withholding medication from patients; and emotional neglect and abuse.”

The need for innovation and transformative procedures is highly desired in the elder community. In a press release issued last month by Senators Cory Booker and Bob Menendez, they announced that Rutgers’ Institute of Health, Healthcare Policy and Aging Research School is setting out to change those statistics and was permitted over $1.4 million in federal grants from The Elder Justice Innovation Grants which was established by the Administration for Community Living (ACL) in 2016. In their joint press release, Sen. Booker and Sen. Menendez agreed that Americans should not have to worry about falling prey to exploitation and abuse as they age, especially when suffering from an incurable disease such as Alzheimer’s.

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