Care for Elderly Lacking

By Andrew Conte; Mike Cronin | Tribune-Review/Pittsburgh Tribune-Review, February 15, 2009 | Go to article overview

Care for Elderly Lacking


Andrew Conte; Mike Cronin, Tribune-Review/Pittsburgh Tribune-Review


One Alzheimer's patient cried out for water before going to the hospital with dehydration. Another broke an eye socket when a wheelchair rolled down a ramp and crashed.

A patient at a third nursing home died when workers adjusted a breathing tube. Two at yet another home weighed less than 80 pounds each.

In other cases, inspectors cited nursing homes after a resident complained about not getting a hair wash for nearly four weeks, and another was told to "go in your pants" when requesting help with going to the bathroom.

Those cases and more were drawn from a Tribune-Review analysis of state surveys conducted at 118 nursing homes in Western Pennsylvania over the past three years. Inspectors cited homes for 3,798 deficiencies, and in 33 cases, found serious lapses posing "actual harm" or "immediate jeopardy," under federal definition.

Among the lower-level deficiencies, inspectors noted hundreds of incidents that caused pain or discomfort for nursing-home residents. Those violations have the "potential for more than minimal harm." They include failures to treat skin ulcers or to help patients eat when they can't feed themselves.

Most often, problems related to quality of care or unsanitary conditions.

"There's a whole lot wrong with our long-term care system," said Marielle Hazen, a Harrisburg attorney and president of the National Academy of Elder Law Attorneys' state chapter. "People should be concerned, and I do think as a country, we do need to take a look at how we care for seniors and what options there are to care for them."

Nursing home experts said mistakes do happen, but the industry, in general, has improved its level of care. The industry is among the nation's most regulated, and homes can be cited for minor faults to ones resulting in death.

"There are so many regulations out there -- that really try to micromanage everything -- that we kind of lose sight of what's happening," said Dr. David Nace, director of long-term care at the University of Pittsburgh's Institute on Aging. "What I see is that there has been improvement over the years. ... The facilities we have today are better than they were 15 to 20 years ago."

Rosalie Kane, a professor of public health at the University of Minnesota, disagreed that the quality of life for nursing-home residents has dramatically improved -- even if surveys don't find as many alarming violations.

"Those surveys don't make nursing homes better over time," Kane said. "They just represent the lowest common denominator keyed to issues that are considered unacceptable."

Nursing homes that regularly harm residents should be closed, said Lauren Shaham, spokeswoman for the American Association of Homes and Services for the Aging, a national trade association. But society needs to pay more attention to nursing homes to make sure they have necessary resources, she said.

"Nursing homes have been the stepchild of the health care system for years, (have been) asked to care for very frail, very sick, complicated cases and to do it on very limited resources," Shaham said.

The Trib's review followed the November arrests of five employees at Kane Regional Center in Glen Hazel, who were charged with abusing and tormenting a 94-year-old Alzheimer's patient. Four of the suspects faced preliminary hearings Feb. 10, and a fifth faces a hearing Wednesday.

More than 2,800 complaints of abuse or neglect of nursing home patients are substantiated each year, according to the inspector general for the Department of Health and Human Services.

Because of tight regulations, nursing home violations are common, occurring in more than 91 percent of homes in each of the past three years, the inspector general found. In 17 percent of cases, however, facilities had serious deficiencies.

"You're going to find deficiencies almost anywhere, but the questions you have to ask are: What type, how often and are they corrected? …

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