Fatal dereliction of duty: Inside America’s nursing homes

  Ron Richards, an 84-year-old Kentucky farmer who spent the last days of his life ill in bed. He suffered a fatal heart attack for several days without treatment and care due to a bowel obstruction. While the old man moaned and waited for the doctor all morning, no one came to rescue him.
  Richards’ relatives don’t know the real reason why he ended up dying at the Beverly Health and Rehabilitation Care Home. The truth only emerged a few weeks later, when he was buried. Richards’ daughter, Jane Richards, was attending a church mourning service when a man standing in front of her greeted her. Ron Richards died tragically, the man said, “He didn’t deserve so much pain and no one came to treat him.” This man’s job was to drive the disabled and incapacitated people, Therefore, they often drive to pick up and drop off the elderly from local nursing homes.
  Suffering so much? No one rescued? What Ron Richards’ son Phil and another daughter, Wanda de la Planner, learned from nursing home staff: The father’s death wasn’t very painful. After all, the old man has had heart problems before, and he has also had an attack. The children had believed that the nursing home had taken care of the father well for five years, despite the fact that the nursing home had been cutting staff during that time, leaving the elderly with less personal hygiene than the children had hoped for.
  Born in the Appalachian Mountains of the eastern United States to 10 siblings, Ron Richards worked hard to make ends meet, working almost his entire life growing crops and then driving forklifts for a while. Relatives are heartbroken and outraged at the rumours of the elderly dying due to neglect.
  So several children set out to learn about the situation from the nursing home staff, but got no valuable clues. Delaplanner, who served in the state’s Office of Consumer Affairs, went straight to the state’s department that deals with nursing facilities to demand an investigation into her father’s death.
  In two independent investigations, the care home was found to be negligent in the incident – failing to provide appropriate treatment in a timely manner. Dela Planner also learned that 11 of the nursing home’s 13 on-duty employees were off work at the same time.
  Four years later, on 4 May 2006, a verdict was reached in a seven-week trial. The court ordered the defendants Beverly Nursing Home to pay the victims $20 million. The care home appealed, claiming their treatment was appropriate, and agreed to an out-of-court settlement. Dela Planner has participated throughout the proceedings throughout. “I had to listen to my father’s death with grief every day, but it was worth it,” she explained. “It was the only way to console him and make the truth of his death public.”
  Dela Planner also expected The lawsuit could draw attention to the insufficiency and management of nursing homes across the United States. As the lawsuits have brought to light many incidents, people have seen the truth of how preventable diseases such as malnutrition, dehydration, and bedsore infections are causing countless elderly injuries and even deaths.
  
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  The Detroit Free Press reported in a report based on information from the Centers for Disease Control and Prevention that from 1999 to 2002, nearly 14,000 elderly people died from the various causes mentioned above. This figure is likely to be underestimated because it is calculated by the government based on reports provided by the nursing homes themselves. Here are some recent studies:
  The National Academy of Sciences estimates that in 2003, between 1 million and 2 million people over the age of 65 were “harmed, exploited, or otherwise abused” by at least one nursing facility.
  In 2003, more than 300,000 seniors living in nursing homes were “at great risk of harm due to regrettable inadequate care,” according to the U.S. General Accounting Office.
  A 2006 study by the University of Kentucky commissioned by the National Association for the Prevention of Elder Abuse found that in just one year, adult advocacy groups surveyed 461,135 reports of malpractice and abuse across the country (the latter including Physical, Sexual and Emotional) reports were corroborated in 191,908. Of these cases, 26.1% were attributable to neglect and negligence at the nursing facility.
  But behind the horrific incident is a notorious problem in the aged care industry: not enough employees to take care of the elderly and sick. “It’s clear to everyone that in nursing homes, there’s a constant stream of neglect because they don’t have the staff to care for the elderly,” said Barbara Hurstburke, executive director of the American Federation for the Protection of the Elderly. . She previously worked in Florida as an inspector tasked with understanding nursing home malpractice. In fact, the federal Department of Health and Human Services found that more than 90 percent of nursing homes are understaffed to provide adequate service.
  Janet Walls, a policy expert at the National Coalition for Citizens Nursing Home Reform, pointed out that “we often get calls from nursing home staff that they are looking after more than 30 seniors a night by themselves.” That number is more than double the norm for the number of elderly people each qualified nursing home nurse can care for.
  It is deeply disturbing to the public that most of these aged care facilities are for-profit businesses operating in surplus. However, the employees who work there are often required to work overtime and are not paid well, resulting in high employee turnover. A study by the General Accounting Office showed that in some care homes, the one-year staff turnover rate was close to 100%. In this way, a company’s reputation and continuous knowledge of the physical condition of the elderly are also lost as employees are lost.
  
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  Look at the following case again.
  McCox, 82, ran a small life insurance agency in Green Bay, Wisconsin, and has five children. He was admitted to a nursing home for recovery after knee surgery. Although he suffers from Parkinson’s disease and diabetes, his condition is stable and his physique is relatively normal. “He looked good,” recalls Carroll McCox, 52, the old man’s daughter, “so we expected the father to be able to walk after physical therapy in the nursing home.”
  McCox was admitted to the hospital, however. After the first week, the health got worse and worse. He seemed to be getting a little trance, insensitive to the outside world. According to Carroll, when other relatives in the family questioned the hospital, “they just said it was due to antibiotics.” But a physical therapist noticed a rash-like red patch on the old man’s knee next to the bandage.
  ”Subsequent facts indicated that the paramedics had not changed dressings or looked at the wounds for six days,” Carroll said. “When they put my dad in the wheelchair, his facial muscles kept twitching. I was shocked, my dad was in pain!”
  McCox was immediately taken to the hospital, where his kidneys began to function. collapsed and developed sepsis – a developing ulcer on the heel. “Death is indeed beckoning to him.” Carroll claims. McCox’s knee required three debridements, which meant doctors had to strip ligaments and tendons while removing the pus, which was predictably painful. He may never be able to walk on his feet again. The nurses involved in the debridement were in tears when they saw the symptoms of the wound. Carroll continued, “The medical staff present were all ashamed that the nursing home allowed this to happen.” McCox’s family eventually reached a settlement with the nursing home (which denies any wrongdoing). protocol.
  In March 2006, Janeworth Financial Corporation, which operates a long-term care insurance business, pointed out in a nationwide research report that many families paid exorbitant fees to send their elderly relatives to nursing homes. $62,500 for a semi-private. But the troubling thing is that this kind of fee still does not guarantee the basic level of care, which makes the elderly suffer from some preventable diseases. “Dehydration happens a lot in hospitalized patients,” Walls said. “It’s a bizarre problem. People are just thirsty, but they don’t get water.” Malnutrition and inadequate diet are also common problems. Walls further pointed out, “The typical practice of nurses is to deliver meals first and then retrieve dishes after half an hour. Many elderly people need help to eat and drink, but they are ignored.”
  Geriatrics, who teaches at the University of Southern California According to Dr. Loren G. Lipson, a medical expert, this condition can cause a series of complications. “Older people who suffer from malnutrition and dehydration are highly susceptible to ulcers and compromise the immune system,” he said. “Because of the increased potential for infection, in some severe cases the symptoms can lead to insanity. .”
  
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  Ed Armstrong got a call from the emergency room doctor one morning to come to the hospital, and he learned that his mother’s condition had become serious. His mother, Emily Armstrong, 84, was admitted to a nursing home in St. Petersburg, Florida, after a stroke. She lay in bed unable to move, and no one often helped her turn over. As a result, he developed bedsores on his leg and became seriously infected, and the doctor told him that he must amputate immediately. Emily’s nursing home, Carrington Place, is of a higher grade, but less than two months into the hospital, her infection level has reached level 4 – her sacrum and ankle bones are eroded .

  Ed Armstrong sued the Carrington Place Nursing Home after Emily’s left leg was amputated and recovered. But the care home also denies any negligence. The parties eventually settled out of court… Ed Armstrong then transferred his mother to a Catholic care facility close to his home. He thought things might be better there.
  But shortly after his mother entered the nursing home, her right ankle bone was broken again. Armstrong then suspected that his mother was broken in the hospital when he was first admitted – but he did not get any answer from the hospital. The fractured part never healed, and after a while, the infection developed, so Armstrong had to send his mother to the hospital for a second time for amputation, and decided to file a lawsuit, and the nursing home also defended, denying any wrongdoing…
  ”My mother was like a corpse,” Ed said in a shaky voice as he recounted putting his mother’s legless body on the bed. “This is one of my last memories of my mother, God! Is this the result of being sent to a nursing home?”
  
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  So how is the supervision of the nursing home industry implemented? At the U.S. federal government level, the Department of Health and Human Services allocates funds each year to train state-level inspectors, and Congress has special legislation that sets service quality standards for nursing homes. In terms of the specific operation method, the health department at the state level monitors the operation of each nursing home, and in the event of an accident, it can decide whether to fine or close it. Each state has established a “long-term supervisor system for nursing units” in accordance with the requirements. Its function is to collect opinions from nursing home residents and their families, and regularly visit each unit to check the quality of services.
  However, it is obviously difficult to expect inspectors to discover the dereliction of duty and negligence within the nursing home within a short period of regular inspection. New York State Attorney General Elliott Spitzer recently announced that in January 2006, 19 nursing home employees were detained on charges of negligence, and the evidence came from hidden cameras. According to law enforcement reports, some delinquent staff have placed alarm bells out of reach of the elderly; others watched TV, slept, and left work during business hours. Even more intolerable, Spitzer noted, is the fact that individual employees have even falsified work records to falsely claim to have provided services (14 people have been convicted in court so far).
  In February 2006, Michigan Attorney General Mark Cox indicted eight employees of the state’s Mitron nursing home with 18 felonies — causing the death of a 50-year-old occupant (all eight claimed no crime).
  Sarah Commell, who was suffering from respiratory and kidney problems at the time, suffocated to death due to the neglect of her dizziness and the failure to replace her oxygen cylinder in time. In the subsequent autopsy report, the officers concealed the fact that there was no oxygen in the oxygen cylinder. Cox pointed out that the hospital also changed the medical records of the deceased in an attempt to cover up the truth of Commell’s suffocation.
  Many experts believe that such incidents are like icebergs in the ocean, with only the tip of the iceberg exposed, and much of the problem hidden. U.S. law requires nursing homes that receive federal Medicaid and Medicaid for the poor to report incidents of abuse — but this self-reporting system has struggled. Randy Thomas, chairman of the National Council for the Prevention of Elder Abuse, said, “If a nursing home is in charge of enforcing a reporting system, and the result is a dereliction of duty, why does it have to report it? Someone may deliberately cover up and try to make the incident look less bad. .”
  
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  For decades, U.S. senators and congressmen have been trying to get the entire nursing home industry to do better, with little success. California Congressman Henry Waxman recently submitted a bill on nursing homes, requiring nursing homes across the United States to have enough nurses on duty to provide each resident with more than four hours of service a day. Florida has earmarked funds for a similar bill that would require the state’s nursing homes to provide a minimum of 2.9 hours of direct services per resident per day. Arkansas passed a reform bill in 1999 that required an autopsy of every resident who died in a nursing home. According to Pulaski County Coroner Mark Malcolm, who drafted the bill, in the first six months of the bill, the county examined a total of 489 deceased patients from nursing homes, 21 of which were caused by hard to accept.
  ”Today, if we found out that the cause of death was sepsis from a bedsore infection, the nursing home side couldn’t just say that someone was too old and someone would investigate the truth,” Malcolm said. “There are several nursing homes. It was closed because of the evidence we provided.”
  Still, the best oversight of a nursing home comes from relatives of the elderly. Randy Thomas travels across the United States, instructing law enforcement officers, judges, inspectors, forensic assistants, and others on how to identify personal injuries caused by negligence. He sent his admonition to all children and relatives who have seniors in nursing homes: “If these seniors are not regularly visited, and the seniors themselves have cognitive impairments, then the nursing home employees will It is possible to ignore them to the point of forgetting that they are real people… So my best advice to these families is: “Visit your loved ones often! ”

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