Nursing Home Neglect - How Widespread is the Problem?

It is never an easy decision to place a loved one in a nursing home - as anyone who has ever done that knows only too well. Naturally, you hope and trust that the nursing home you have chosen is well run, safe and efficient. However, most people are surprised to realize just how widespread the problem of nursing home neglect is.

We have all seen the TV advertisements and infomercials for attorneys who promise to help you if you have an issue with nursing home neglect. And unfortunately, this emotive subject often makes the headlines as well - in February 2007, a California nursing home was fined $90,000 for its alleged role in the death of a resident from blood infection.

There are around 17,000 nursing homes in the United States, containing an estimated 1.5 million residents. In fact, Americans aged 85 and over are now the fastest growing segment of the population - in 2030, it is estimated that around 20% of Americans will be senior citizens.

Most nursing home neglect is actually unintentional, and neglect is more common than deliberate abuse. There is perhaps a fine line between what might be defined as neglect and what might be termed abuse - in general, neglect is often accidental, while abuse is often deliberate. But whether it is described as neglect or abuse, the numbers are alarming. Almost one million senior citizens in nursing homes and other facilities are neglected or abused each year - and around 30% of facilities are cited in one way or another.

For the period from 1999 to 2002, almost 14,000 deaths in nursing homes were caused by some kind of neglect - much of it admittedly indirect. It can often be difficult to differentiate between deaths which are caused by neglect and natural deaths in an environment where residents are naturally elderly and in poor health anyway.

The main type of nursing home neglect is neglecting the basic needs of residents. Some neglect is not easy to observe. According to a 2000 report by the national Coalition for Nursing Home Reform, nationwide, almost 25% of nursing home residents have bedsores. And around 35% suffer from poor nutrition or dehydration - conditions which many of us would not be qualified to diagnose.

A common fault in nursing homes is not providing adequate food and water or not assisting those who need help. Anyone who has spent time in a nursing home has probably observed residents being given food only to have it removed several minutes later uneaten. Some neglect is caused by a staff shortage, not having enough staff on duty to see to the needs of the residents. The recommended ratio of staff to residents is around one caregiver to every 15 residents, but according to the Department of Health and Human Services, almost 90% of facilities don't have enough staff.

If you are trying to choose a potential nursing home for a loved one, you have the right to inquire about the staff to patient ratio. Ask about the level of staffing for different shifts - day and night. If necessary, check with your state licensing rules about staff to resident ratio requirements. Try to get a feel for how many residents are bedridden or confined to a wheelchair, thus requiring extra care.

The reasons are clear why many facilities don't have enough staff. Many caregivers are underpaid or overworked - many also have a second job. And caring for the elderly and the infirm can be a challenging, unpleasant and stressful occupation. Not surprisingly, employee turnover in nursing homes is high - an estimated 93%.

And if you suspect nursing home neglect what then? A realistic first step is to talk not only to the residents, but to the staff and residents, families as well, if you possibly can. It may be an isolated incident of neglect, or there may be a pattern. You also have the legal right to see a copy of the latest state survey of any nursing home, according to Medicare regulations.

If you feel you need to take the matter further, every state has a department within the Department of Health which deals with the enforcement of nursing home regulations. They also investigate any complaints filed by family members. Remember, your loved one may not be able to give you the full story.