Elder abuse can occur in private residences and in long-term care facilities such as nursing homes. In private residences, when elder abuse exists, it is usually committed by someone close to the elder--a spouse, adult child, sibling, friend, or other caregiver, and is often the result of financial difficulties or substance abuse problems with the caregiver. By the time the abuse has been noticed, the time for prevention has passed and it is time to focus on its termination. The nature and severity of the abuse will dictate the type of corrective measures to take. If the abuse is life-threatening, then the person discovering the abuse should immediately call 9-1-1 or the police. If the abuse is not life-threatening, then reports should be made to other family members of the abused elder and/or to the California Attorney General's Office Elder and Dependent Adult Abuse Reporting Hotline at (888) 436-3600.
The material below will deal mainly with preventing elder abuse in a facility, although some of the things mentioned will also apply to preventing abuse of elders cared for in private residences.
One of the best ways to prevent elder abuse of a loved one in an institution is to do what is necessary to select the best possible facility in the first place. This is not a quick or an easy task, and can sometimes be made more difficult by pressures of time and money. But it is certainly worth taking the required steps, to ensure that your loved one is given the best possible care.
ELDER ABUSE PREVENTION
Elder abuse prevention is not a simple task There are many steps that must be taken to ensure that your loved one is properly cared for. Those steps include the following:
PRIOR RESEARCH
Get referrals from doctors, family members, friends, and other trusted sources. Start with facilities close by and fan out in widening circles. The closer the facility, the more frequent will be the visits, and statistics show that residents who receive more frequent visits get better care. But, of course, a near proximity is not the only consideration, or even the most important one. The goal is to find a high-quality facility that is a close as possible.
SEARCH THE INTERNET
Search the Internet under the topic “nursing home compare,” and check out the sites that appear helpful. The U.S. Government has an official site that compares different nursing homes for people with Medicare. The comparison report details the number and severity of inspection deficiencies noted in the most recent inspection for each home. The site may be reached at www.medicare.gov/nhcompare/home.asp.
VISITING THE FACILITIES
After comparing nursing homes on the Internet, it is important to compare them in person. You will want to visit several homes of those you have researched and make comparisons. Don't just accept the first one you see. And when visiting the homes, it is a good idea to have a checklist of the important items to consider, such as Food and Water; Health, Safety and Sanitation; Medication and Medical Care; Adequacy, Ability, Attitude and Attention of the Staff; Activities; and Financial Policies. In making visits to facilities, certain “do's” and “don'ts” are advised.
MORE ON ELDER ABUSE PREVENTION
DOs AND DON'Ts
DOs
- Have a checklist.
- Meet with the Administrator of the facility.
- Meet with the Medical Director is possible.
- Meet with the Director of Nursing.
- See different areas of the facility.
- Visit at different times of the day.
- Visit on weekdays and weekends.
- Visit at mealtime.
- Smell or taste the food.
- Walk the halls.
- See common areas.
- See individual rooms.
- See activity areas.
- See toilet facilities.
- See regular dining areas.
- See assisted dining areas.
- Talk to different residents.
- Talk to family members of residents.
- Keep the family's doctor if possible.
- Have your doctor inform the facility that he/she will make periodic visits and that adequate care is expected.
DON'Ts
- Don't decide from marketing brochures.
- Don't decide from guided tours.
- Don't decide from nice furnishings in the lobby.
- Don't decide just from conversations with “nice” administrators.
- Don't consider facilities that restrict your access.
- Don't automatically accept the facility's referred/contracted doctor.
YOUR GOALS
Among the things you want to learn from your personal visits and comparisons of different homes are the following:
- Does the food smell and taste palatable?
- Do residents who need help eating, get the help they need?
- Do residents have enough time to eat?
- Do residents eat at least half their food?
- Are pitchers of ice water always available?
- Is the facility clean?
- Is the facility free of safety hazards?
- Is the facility free of the smell or urine or feces?
- Are residents given their medication on a timely basis?
- How frequently does the Medical Director see the residents?
- How many nurses and certified nurses aides (CNAs) work each shift, especially nights?
- What is the ratio of CNAs to residents?
- Check state licensing regulations for staff-to-resident ratios.
- Are staff members schooled and trained for their work? As a policy of the facility?
- Are there enough staff members to do their tasks properly and without rushing?
- Do the staff members seem happy?
- Do the residents seem upbeat and happy, or confused or depressed?
- Does the facilities have real activities such as arts and crafts or pottery?
- Does the facility follow federal regulations about not hiring abusive aides?
- Does the facility screen prospective employees for substance abuse, criminal backgrounds, domestic violence, ability to manage their stress and anger, etc?
- Can you pay for care at the facility?
- If you need help from Medicaid, does the home accept Medicaid?

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