Elder abuse is a term referring to any action or non-action that results in harm to an elderly or older helpless person. Abuse can happen anywhere, in the older person's home, nursing home or hospitals and it can happen no matter the person's socio-economic group, culture or race.
This problem and its resulting consequences have personal meaning for me because my mother had been abused while a resident in a nursing facility.
My mother had suffered a massive stroke which affected her speech and left her paralyzed on her right side. Because of the severity of the stroke and her declining health, she needed on-going nursing care so she had to be placed in a nursing home.
She lived in this facility for 4 years. My children and I were constant visitors and we knew the administrative staff and caregivers very well, or so we thought.
One day while visiting my mom and after a lovely walk around the grounds I was getting up to leave and said I would take her back to her room. She didn't want me to leave or to go back in. Her aphasia prevented her from verbalizing words but one sound she could make was "waiter". She was able to understand things, so for the next hour I tried coming up with reasons why she didn't want me to leave when finally I was inspired to ask if she was afraid of something. That was the breakthrough question and when she nodded affirmatively, I knew there must be more to this fear of hers.
Monday, April 20, 2009
Friday, April 17, 2009
Restraint Use Declining in Nursing Homes
There was an article in USA Today recently that described a decline in the use of restraints in nursing homes in the United States. This is good news for nursing home residents across the country, and for those of us who advocate for seniors.
Restraints were once commonly used in nursing facilities to control the behaviors of residents with dementia or other psychiatric conditions and to prevent falls. The use of restraints in facilities has declined over time, but education is still needed to help families and health care professionals seek alternatives. In fact, California is one of the U.S. states with the most room for improvement. The most recent data from Medicare in 2007 indicated that 10% of nursing home residents in CA were restrained, while the national average was 5.5%
What is a restraint? The National Consumer Voice for Quality Long-Term Care (NCCNHR) defines a physical restraint as an object or device that an individual cannot remove easily and which restricts freedom of movement or normal access to one's body. Common restraints include: seat belts on wheelchairs, vest restraints, geri-chairs, hand mitts, side rails and lap trays.
Many families and health care providers believe that restraints help nursing home patients to be "safer," though research shows that often times the opposite is true: individuals who are agitated frequently become more agitated when they are restrained. Behavioral approaches such as validation and redirection, as well as activity engagement, can often help agitated people to become less agitated.
As a Geriatric Care Manager monitoring the well-being of clients in nursing homes and in the home setting, it is my responsibility to advocate for no restraint use, or minimal restraint use that is re-evaluated frequently and discontinued as soon as possible.
Restraints were once commonly used in nursing facilities to control the behaviors of residents with dementia or other psychiatric conditions and to prevent falls. The use of restraints in facilities has declined over time, but education is still needed to help families and health care professionals seek alternatives. In fact, California is one of the U.S. states with the most room for improvement. The most recent data from Medicare in 2007 indicated that 10% of nursing home residents in CA were restrained, while the national average was 5.5%
What is a restraint? The National Consumer Voice for Quality Long-Term Care (NCCNHR) defines a physical restraint as an object or device that an individual cannot remove easily and which restricts freedom of movement or normal access to one's body. Common restraints include: seat belts on wheelchairs, vest restraints, geri-chairs, hand mitts, side rails and lap trays.
Many families and health care providers believe that restraints help nursing home patients to be "safer," though research shows that often times the opposite is true: individuals who are agitated frequently become more agitated when they are restrained. Behavioral approaches such as validation and redirection, as well as activity engagement, can often help agitated people to become less agitated.
As a Geriatric Care Manager monitoring the well-being of clients in nursing homes and in the home setting, it is my responsibility to advocate for no restraint use, or minimal restraint use that is re-evaluated frequently and discontinued as soon as possible.
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