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Articles Posted in Preventing Elder Abuse

In recent years the Centers for Disease Control and Prevention has drawn attention to a source of increasing concern for nursing home residents: Candida auris, also known as C. auris, a fungus that causes “bloodstream infections and even death” in those it affects. Like many infections, C. auris infections are particularly dangerous for those who are already suffering from other conditions. Described by the CDC as “a serious global health threat,” C. auris poses a special risk for nursing home residents.

What makes C. auris so dangerous? A few things. The CDC notes that the fungus is frequently resistant to numerous antibiotic medications; that it is “difficult to identify with standard laboratory methods”; and that it is even prone to misidentification by laboratories without certain technology. This places elderly populations, especially those in nursing homes and other long-term care facilities, at heightened risk. A New York Times report published in September 2019 described a June 2019 study that found “patients and residents in long-term care settings have alarmingly high rates of drug-resistant colonization, which means they carry the germs on their skin or in their bodies, usually without knowing it, and can pass them invisibly to staff members, relatives or other patients.” The study in question “focused on Southern California,” finding that 85% of nursing home residents “harbored a drug-resistant germ.” The CDC has also found that the infection proliferates in long-term healthcare centers

The Times reported that 800 cases of C. auris infection have been identified in the US since the fungus was first reported here in 2015. In August 2019, the CDC updated that count to 806. That includes 388 confirmed cases in New York; 227 confirmed cases in Illinois; 137 confirmed cases in New Jersey; 24 confirmed cases in Florida; and five confirmed cases in California. The Times attributes C. auris’ easy spread through nursing homes to a few factors, in addition to the prevalence of nursing home patients on multiple antibiotics to which the infection has already developed a resistance. Nursing homes are frequently understaffed and under-resourced, according to the Times, and struggle to “enforce rigorous infection control.” They often cycle infected persons in and out of hospitals, putting those hospitals’ patients at risk of the infection too. One health expert told the Times, “You’ll never protect hospital patients until the nursing homes are forced to clean up.” Basic hygienic measures, such as “using disposable gowns and latex gloves,” are essential to combating the infection, yet often unfollowed by long-term care centers, according to the Times. Experts also attribute the infection’s spread in the US to healthcare economics “that push high-risk patients out of hospitals and into skilled nursing homes.” Under the US’s healthcare system, these experts told the Times, “nursing home facilities are reimbursed at a higher rate to care for these patients… providing an economic incentive for poorly staffed or equipped facilities to care for vulnerable patients.”

Each year, more than one in three seniors in San Diego sustain falls and serious injuries. In some instances, falls are the result of elder or nursing home abuse and/or neglect. But in other instances, falls are purely accidental.

More and more elders (defined by California statute as those over the age of 65) are choosing to reside in their own home versus living in an assisted living facility or with relatives. Although there are wonderful reasons to live in your own home as long as possible, it’s important to note that elders are at risk of suffering injuries from a fall, which often times could have been prevented.

Typically, falls are responsible for 60% of in-home injuries. However, statistics show that programs to help prevent falls in the home are effective.

According to the World Health Organization, dementia is one of the major causes of disability and dependency among older people. Dementia, which is a syndrome in which there is a deterioration in memory, behavior and thinking, causes many who suffer from it to lose the ability to perform their regular activities.

Elders are stricken with dementia far more than any other age group. In many cases, dementia is the reason an elder moves into a nursing home. Dementia is also often to blame for what is known as “elopement” or in layman’s terms, wandering. Elders with dementia may develop wandering tendencies, wherein due to cognitive impairment, they begin to wander around their nursing home unsupervised and without an escort.

Wandering may lead to serious injury as the result of falling. In some cases wandering has even led to death, in cases where residents have wandered outside of their residential facility. Though rare, wandering is dangerous enough that lawmakers included provisions to protect against it in the 1987 Nursing Home Reform Act. The law required that nursing homes must provide residents with adequate supervision in effort to prevent elderly patients from wandering. That means of course, that nursing homes must be properly staffed.

Elder abuse typically refers to the knowing, intentional, or negligent act by a custodial care provider, caregiver, or any other person that causes harm to a vulnerable adult. In California, anyone aged 65 and older is protected by the Elder Abuse and Dependent Adult Civil Protection Act. The laws are designed to help prevent neglect and abuse to California seniors. Neglect falls within the definition of elder abuse, and unfortunately may have dire consequences to the victim.

In broadest terms, neglect is a type of elder abuse wherein a caregiver fails to provide the elder with basic needs including water, food, shelter, heat/air-conditioning, personal hygiene products and medical assistance. Failure to adequately move or reposition a bedridden elder, for example constitutes neglect, just as failing to keep elders properly nourished and hydrated constitutes neglect.

Neglect is particularly dangerous for elders, as it can lead to life-threatening consequences. Such consequences of neglect include:

Making the transition from an independent life to living in a nursing home is rarely easy for an elderly person.  Fear, anger, anxiety, and many more emotions can make the anticipation of this lifestyle change dangerous.  What are the risk factors and methods of mitigation that can be used to prevent a tragedy?

Transitioning from Home to Nursing Home

The time period between when the decision is made to move to a nursing home and the actual move-in date is critical.  In some cases, the prospect of this lifestyle change is enough to make an elderly person consider suicide as an option.  Some of the reasons for this include:

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.

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!

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:

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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