By Kelly Riddle
I recently became involved in a travesty of justice regarding the nursing home industry. The family of a lady who had been in a nursing home asked me to look into the facility where their mother was a resident because they suspected she had been mistreated. During the course of my investigation, I located and interviewed 20-30 former employees of the nursing home. What I found after interviewing these people led me to one inescapable conclusion — I would never put a relative of mine into a nursing home without investigating them with a microscope.
The majority of the nursing home employees had worked for four or five other nursing homes, and they indicated that the abuse and neglect occurs in various degrees almost every place. It would have been one thing if only one or two employees told me some of the horror stories, but almost everyone interviewed agreed that the patients were mistreated. It is hard to believe that someone would intentionally abuse the elderly, especially when you realize that they could be your mother or father.
During the interviews of the fomer employees, I was told that it was common for the staff to move the emergency call light buttons away from the patients to keep them from being annoying. Some had even unplugged the call light and replaced it with a "dummy" plug that they put into the electrical socket to keep the call light from going off. If a patient became agitated for some reason, the employees indicated they would often place the patient into physical restraints without a doctor's order. If they didn't want to be that obvious, they would give the patient a "chemical restraint,” which would knock them out. Thefts were also a major problem, according to the employees. Some stated that when businesses had donated clocks, radios and tape players for the elderly just before Christmas, within two days none of them could be found anywhere in the nursing home.
Almost every employee indicated they knew when a state audit was coming because all nursing homes keep a closet full of new sheets, curtains, tablecloths and things of that nature that can be put out while the audit is in progress and taken away afterwards. The employees on the 3:00-11:00 p.m. and 11:00-7:00 a.m. shifts said that it was common to find other employees working those shifts sleeping in the TV room, which created more problems for an already understaffed floor. According to the information, it was not uncommon to find aides giving out medicine, starting G-tubes or signing charts that only licensed LVN's or RN's are supposed to handle.
Then I learned about "slam-dunking." This term is given to those patients who are in wheelchairs and get lifted out to be placed into bed. According to the employees, slam-dunking occurs when the aid "throws" or otherwise roughly mishandles a patient while putting them back into bed. Since the elderly usually have brittle bones to begin with, this can cause breaks and bruises.
Every employee interviewed indicated that staffing is a problem in all nursing homes and because of the shortage of staff, a lot of "bad apples" get into the nursing homes. Although almost every home has a policy that the patients have to be turned every two hours to prevent bedsores, it became obvious that this didn't occur due to understaffing and the laziness of employees. The nurses indicated that suspicious bruises were not to be reported on the patient's charts, as this would create problems with the state. Therefore, only the most severe abuse appears to be documented.
Other interviews revealed that patients’ food would be taken away from them as a source of punishment if they acted up in any way. The elderly have enough problems with nutrition as it is without having it withheld from them. Some nursing homes have gone the adult diaper route in an attempt to cut down on laundry and soiled bedding. Unfortunately, this also meant that the patients did not have to be checked as often.
I then stumbled onto some situations which are more unique but which could have the possibility of being repeated. For instance, I was told about an occurrence when an aid was called into work early. She arrived at 5:00 a.m., visibly upset due to a conflict at home. The nurse on duty gave her some medication to calm her down and she ended up overdosing and having to be rushed to the hospital. Then there was the aid that would get upset whenever the elderly would have a bowel movement in their bed. She was caught using the patient's own bowel movement on the patient as toothpaste.
It became apparent from this one investigation that the nursing home industry is in need of some serious policing. The state offices that have the responsibility to regulate the nursing homes are understaffed themselves, which contributes to the problem. One thing is for certain, if my relatives are ever forced into a nursing home, I will check out the nursing home thoroughly and put hidden video cameras in their room as protection.
With more and more people reaching the age of retirement, problems like these are bound to become more prevalent. Before considering a nursing home, I would suggest the following:
Even after you take all of these precautions, there’s still a risk of abuse. However, you will at least have made an informed decision that will give you and your family greater peace of mind.
Kelly E. Riddle is the President of Kelmar and Associates Investigations (www.KelmarGlobal.com) as well as a certified member of the Texas Association of Licensed Investigators (https://www.tali.org/).