Intentional Act of Mishandling - Term Paper Example

The Abuse and Neglect of the Elderly in Nursing Homes Introduction Thesis Statement: “The US government should impose a heavy licensing on health care workers and strictly implement federal and state laws including serious penalties on nursing homes that are reported abusing and neglecting the elderly patients.” Abuse is ‘to use improperly or injuriously; to misuse, to hurt by treating wrongly; to injure or to speak in coarse or bad terms.’ (Funk and Wagnall, 1987) In other words, abuse is an intentional act of mishandling, maltreating, or even verbally degrading a person. Therefore, one should be able to distinguish the difference between an ‘accident’ and abuse. On the other hand, neglect is ‘failure to give proper care or attention to an elderly’ such as depriving the residents with food and water, over-medicating the patients or failure to turn around the patient from time to time to avoid bed sores. (Funk and Wagnall, 1987) Abuse and negligence is a widespread problem in the United States. These problems may arise from different causes. Perhaps the caregiver, nursing assistant, nurses and even doctors have some personal problems or are unhappy with their own lives. Some of these health care providers may take the negative feelings out on everyone around them. Sometimes, negligence on the part of nurses and other health care providers could be due to improper health care system that has been adopted and implemented by the nursing home. It can also be due to personal or short-term memory problems the nurses and other health care personnel are experiencing. Since some of the nursing home owners are business people, they tend to cut the operational costs and quality care in exchange for profits. Cutting down on operational costs has a huge trade-offs with regards to the quality care being provided to the elderly patients. These operational costs include providing the necessary trainings for the caregivers and other health care team, cutting down on manpower, offering cheaper salary, etc. Many times, overworked and underpaid caregivers result to immediate irritation and abusive acts. These people tend to be abusive to vulnerable elderly patients over time. Either abuse or neglect violates the human rights of a person. Therefore, it is a crime and is punishable under the state law. Proposed Solution Aside from imposing a heavy licensing on health care workers and strictly implementing a federal and state laws including serious penalties on nursing homes that are reported abusing and neglecting the elderly patients, a reward system should be given to those who would report abuse and neglect of nursing homes to the authority and/or monetary compensation should be awarded to the victim. On the other hand, serious penalties like cancellation of the nursing home operating license, and revoking the license and work permits of abusive and negligent caregivers and nurses, and other health care professionals. The government should also fine the nursing homes which do not directly report any case of abuse and neglect caused by their staff. The Need to Address the Abuse and Neglect in Nursing Homes Back in 1989, a survey was conducted on nursing staff regarding the instances that they have abused their elderly patient confined in a nursing home. Forty percent (40%) of the nursing staff admitted to have committed at least one (1) psychologically abusive act towards an elderly patient and ten percent (10%) admitted that they have physically abused their elderly patient. (Moskowitz, 1998) At least 5% of the elderly patients, roughly 1 or 2 million instances of elderly abuse occur each year. (Oberlon, 2000) The number of abuse and neglect of elders in a US nursing home is continuously increasing. Some of which may have been reported to the authority while some are not. Elders who are suffering from Alzheimer's disease, comatose and/or other forms of speech, motor, memory or mental disorders and have lost contact with their loved ones are the one that suffers most. These people are the common victims of abuse simply because they lose control of their own bodily functions and motor skills due to old age. Since they are physically and mentally weak to fight for their own human rights, some of these people will remain a victim unless someone would stand up for them. Despite the fact the nursing homes are licensed as ‘skilled nursing facilities,’ this does not guarantee that the patient will really receive a special care from a skilled health care provider because of the fact that they generally provide both skilled and custodial care. Facts about the ‘Elder Law’ or ‘Senior Law’ and Other Responsible Support Groups / Agencies Elder law or Senior Law is a part of the legal system in the United States. It is defined as “the legal practice of counseling which represents the aged people and their representatives.” (Fischer, 2007) It aims to promote and protect the human rights, health and economic well-being of the senior citizens of the United States by providing them with necessary information, advocacy and some legal advice. Attorneys representing a case of elderly abuse or neglect should advise the clients to file a complaint with the U.S. Department of Health & Human Services (HHS) as soon as possible. (Marshall, 2000) HHS will be able to refer the representative of the victim to the Adult Protective Services (APS) Unit, Area Agency on Aging, or the County Department of Social Services. These agencies are responsible in receiving and investigating cases of elderly abuse and neglect. In case the investigators have confirmed that the case of abuse or neglect was evident, the group of investigators will arrange for the needed services to help protect the victim. Other agencies including non-profit organizations like the State Agency on Aging, Law Enforcement Agency, Medical Examiner / coroner’s office, hospitals and medical clinics, State Long-term Care Ombudsman’s Office, Public Health Agency, Area Agency on Aging, Mental Health Agency, and Facility / Certification Agency are also active in protecting the elderly victims. (NCEA, 2006) Ways on How to Report Cases of Abuse and Neglect There are a lot of ways to investigate abuse in nursing homes. For instance, the case of physical abuse can be traced in many ways. Some physical indicators of abuse includes bruises, lacerations, broken bones, burns, black eyes, welts, scars, open wounds, sprains, wounds in various stages of healing, etc. (Williamson, 2005) Bruises and discoloration that are visible on the inner arms and thighs, thumb and/or finger prints, choke marks, different colored bruises, the presence of old and new bruises in the same body area, and suspicious marks caused by belts, coins, cords, etc. simply tells us the level or degree of physical abuse that these elderly patients have been experiencing inside the nursing home. (Williamson, 2005) Many times, the nursing home personnel would report that these bruises was due to a physical accident such as frequent bumping while walking or the patient accidentally hit his/her arm or thigh on the bed railings, or the oral medicine the patient had affects the blood clotting of the patient, etc. Sometimes these reports are true. But often times, it is not. As an investigator, one should not stop by asking the nurses or the resident about the cause of the physical injury or scar. Conducting further investigation regarding the cause of physical marks such as bruises is very important. If possible, insist on inspecting the medical chart of the patient. As much as possible, it is best to choose a nursing home located near the residents area of the elderly patient since the patient can recover faster with regular visits from their loved ones. There is also a higher chance that the patient will receive a better quality care considering that the staff knows that visitors would often visit the patient unannounced. During each visits, the family members or loved ones could get a chance to monitor and assess the patient’s physical and over all health condition. This way, chances that the patient would suffer from abuse and neglect will be lessened. It is rather more difficult to trace negligence in a nursing home as compared to physical abuse. (Goldberg, Persky & White, 2005) Since the patient could be reluctant in reporting or to even talk about the issues of negligence, investigators should keep on searching for other signs and evidence of negligence. For example, the bathroom should be clean all the time, check on the odor of the bed and/or the patient’s clothing, check on the patient’s grooming – hair and nails condition. Sometimes the weight of the patient could tell us whether the patient is receiving adequate food and water. The emotional condition of the patient could also be used as an evidence of whether he/she is receiving enough care from the nursing home. In case the patient does not feel confident about his/her personal grooming or hygiene, there is a possibility that the health care providers are not providing the patient with the necessary services and care needed by the patient. Once the evidences of abuse and neglect has been confirmed, report the case immediately to the nearest U.S. Department of Health & Human Services (HHS), Adult Protective Services (APS) Unit, Area Agency on Aging, County Department of Social Services, and other related agencies. Another option is to call the ‘Elder Abuse Hotline’: 1-800-392-0210; National Center on Elder Abuse: 1-202-682-2470 or 1-202-682-0100; and/or the local law enforcement such as 911 or the local police number. Be prepared to give the reporter’s name, complete home address, age, phone number, and details on what is observed and reason for reporting the case. (Woolf, L.M., 1998) Desired Outcome and Evidence in the Success of the Proposed Action Normally, private care in a nursing home costs around $4,500 – $6,000 per month. (CAHNR, 2000) Regardless of the amount, it is the duty and responsibility of the nursing home owners and its management team to return back the money being paid to them with quality health care services such as treating the elderly patients with dignity and respect, giving a close supervision to wandering patients and patients with memory problem including a combative behavior. Imposing a strict elder abuse laws and penalties will force the nursing home owners and their staffs to provide a quality health care that our senior citizens deserve. A reward system will be used in motivating the elderly patient’s family, relatives and friends as well as those people around the patient to report cases of abuse and neglect of nursing homes. Lastly, implementing a law stating that any health care provider and staff who is directly involved with abusing and neglecting an elderly patient are mandated to give a monetary compensation to the elderly patient being abused and neglect will itself act as a strict leverage on the quality of care being provided. The monetary compensation should be in according to the degree of abuse and neglect. Aside from the monetary compensation and depending on the degree and seriousness of the case, the elderly patient as well as the reporter should anytime receive a ‘life protection’ from the government to prevent and avoid reporting victimization. This strategy would lessen the fear from reporting an abuse and neglect to the authorities since some of them could be at the risk of receiving life threats. Serious criminal penalties like cancellation of the nursing home operating license and revoking the license and work permits of the abusive and negligent caregivers and nurses, and other health care professionals; including the institution where these people are working would also help minimize, prevent cases of elderly abuse and neglect, and maintain the quality of care provided by the nursing homes. Imposing a fine to nursing homes that fails to directly report any case of abuse and neglect caused by their staff will also motivate and encourage the nursing home owners to do their part in ensuring a quality performance coming from their health care staffs. According to Denise Nelesen, a senior counselor working in the county Office of Aging and Independence Services, “Failure to report elder abuse holds a possible sentence of six months in jail and a $1,000 fine. If the abuse resulted in great bodily injury, the penalty for not reporting it could be one year in jail and $5,000.” (Nelesen, 2002) The federal and state laws serve as a ground for human justices. A legal system protects and respects the human rights through sufficient evidences that a person is being harmed within or by a part of a society. Back in February 2000, Bill Number SB 1862 which was introduced by Senator Vasoconcellos stating that Section 12528.5 to the Government Code and amend several sections of the Health and Safety Code related to health facilities. The Bill mentioned that “the legislature to establish a system for the imposition of civil sanctions against long-term health care facilities that violates the estate laws and regulations related to patient care, an inspection and reporting system, and a provisional licensing mechanism.” (Vasconcellos, 2000) This bill is the key for the authorized director to issue a provisional license to a licensee such as hospitals, nursing homes, and other related health care facilities. Conclusion Government interventions through the federal and state laws can be used in regulating the quality health care service provided by the nursing homes. On the other hand, imposing strict rules such as penalties particularly on fine, suspension and revoking of licenses is one way of motivating these health care workers to work in accordance to the quality of care they are responsible to deliver with every patient they handle. Only through a strict government and security intervention could help lessen the number of abuse and neglect of elderly in nursing homes. In the absence of such laws, the cases of abuse and neglect will continue to increase since the demand for nursing homes also increases over time. Failure to control the nursing homes now could result to a lot of senior citizens suffering from maltreatment and abuse. *** End *** References: 1 CANHR (2002) ‘How to Choose a Nursing Home’ California Advocates for Nursing Home Reform ™ Page Last Modified: May 28, 2002 Retrieved: March 24, 2007 < http://www.nursinghomeguide.org/ > 2 Fischer, C. (2007) ‘Elderly Abuse in Nursing Homes’ USD Retrieved: March 24, 2007 < http://www.usd.edu/ > path: archive 3 Funk, P. and Wagnall, A.W. (1987) ‘Abuse’ Funk & Wagnall’s Standard Dictionary Publisher: Signet (August 5, 1987) ISBN-10: 0451142772 4 Goldberg, Persky & White, P.C. (2005) ‘Signs & Symptoms of Elder Abuse & Neglect’ Nursing Home Abuse. Last Updated: December 13, 2005 Retrieved: March 24, 2007 < http://www.elderly-abuse.com/ > 5 Marshall, R. (2000) ‘Eye on Abuse: Report Neglect and Abuse’ 1999 American Lawyer Newspaper Group, Inc. Retrieved: March 24, 2007 < http://www.fcsl.edu/ > 6 Moskowitz, S. (1998) ‘New Remedies for Elder Abuse and Neglect’ Dated: January 12, 1998. Prob, & Prop. pp. 52 – 53 7 NCEA (2006) ‘The Community Response: Adult Protective Services’ National Center on Elder Abuse (NCEA). Last Updated: October 2, 2006 Retrieved: March 24, 2007 < http://www.elderabusecenter.org/ > 8 Nelesen (2002) ‘Elder Abuse Training Means More Calls’ Eldercare Directory. July 20, 2002 Retrieved: March 27, 2007 < http://eldercare.uniontrib.com/ > path: news 9 Oberlon, H. (2000) ‘A Call to Legislative Action: Protecting our Elders from Abuse’ 45 S.D. L. Rev. 655, 655 (2000) 10 Vasconcellos (2000) ‘Bill Number: SB 1862’ Retrieved: March 27, 2007 < http://info.sen.ca.gov/ > path: publication 11 Williamson, K. (2005) ‘Elder Abuse in Nursing Homes: Does Bruising Tell a Story?’ Dated: November 2004 Retrieved: March 24, 2007 < http://www.law.ku.edu/ > 12 Woolf, L.M. (1998) ‘Elder Abuse and Neglect’ Webster University Retrieved: March 27, 2007 < http://www.webster.edu/ > Read More