Underpaid, over worked, and poorly trained staff are at the heart of most nursing home/assisted living nightmares. Even caregivers with wonderful attitudes and the ability to engage with elderly residents find it a difficult setting in which to work when the ratio of caregiver to resident is typically anywhere between 1:7 – 1:25.
In California it’s high time better guidelines were implemented to keep the elderly safe and comfortable when living in a group home operated by administrators who are profit minded. To that end, reform bills are on the ballot that, if voted in, will take effect as early as 2015.
With over 75,000 seniors in nursing homes and residential care facilities for the elderly (RCFE) in California, reform is critical to allowing them to live out the last years of their lives in dignity and comfort.
As the clock ticks on passing of the bills, news outlets are covering the history of the crisis and the latest developments on regulating the industry.
h/t: The California Report
This week, lawmakers in Sacramento get busy on 15 bills that together constitute the most comprehensive overhaul of assisted living facility regulation in three decades.
Assisted living is an alternative to more expensive — and often more institutional — care in a skilled nursing facility. In assisted living, staff help seniors with daily needs, such as meals, medicine-taking and bathing. The homes range from small mom-and-pop places with six beds to corporate chains with over 100 beds. A growing number offer dementia care.
But while these facilities are licensed, the laws regulating them have not had a major update since 1985, and California has lagged behind other states in updating its rules.
h/t: The Center for Investigative Reporting
California regulators routinely have conducted cursory and indifferent investigations into suspected violence and misconduct committed by hundreds of nursing assistants and in-home health aides – putting the elderly, sick and disabled at risk over the past decade.
From 2004 to 2008, the state’s health regulators accumulated more than 900 cases in Southern California, including alarming allegations that involve suspicious deaths.
“I was appalled,” said Marc Parker, who was the public health department’s investigations chief for much of the past decade. “There were hundreds and hundreds and hundreds of unassigned, uninvestigated complaints in file drawers.”
Then, on top of their normal workload, investigators were ordered by supervisors in Sacramento to begin clearing the backlog at a rapid pace, until they were nearly all dismissed by 2011. On average, cases had lingered for two years before they were cleared.
Little is known about theses cases because they were not fully investigated. But internal case logs kept by the state in Sacramento offer a chilling, yet faintly detailed outline of allegations – including suspicious deaths, severe injuries, numerous sexual assaults, egregious neglect and theft of belongings.
One log entry lists a caregiver who allegedly “hit, peed on and seduced” a patient, but does not list a facility, city or county. Another notes a nursing assistant at an unnamed Los Angeles facility who was accused of exposing himself and asking for oral sex from a resident.
In 2009, the state Department of Public Health quietly ordered its investigators to dismiss nearly 1,000 pending cases of abuse and theft – often with a single phone call from Sacramento headquarters. The closing of cases en masse came after officials determined their swelling backlog had become a crisis.
Four years later, state investigators are opening and closing investigations into suspected abuse without ever leaving their desks, The Center for Investigative Reporting and KQED have found. In some instances, caregivers who have sexually assaulted or abused patients have retained their licenses and moved to other facilities.
Meanwhile, the number of cases closed without action has soared. Statewide, public health investigators in 2012 finished 81 percent of their cases without taking action against an accused caregiver, up from 58 percent in 2006.
I truly hope I never have to reside in an assisted living situation or nursing home. Boredom would engulf me, and I would die a slow, agonizing death from it. MEtv, with endless reruns of Rifleman and Andy Griffith would just not cut it. Spare me, please.
In the meantime, I would love to see vast improvements in caregiver training and ratios of clients to caregivers, allowing cognitive activities to become more widely implemented, for currently there is a serious void of intellectually stimulating activities. That’s sad, too, because engaging with others and feeling worthwhile are keys to thriving in nursing homes and residential care facilities.
by T.M. Burroughs
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