First of all, it’s important to visit your loved ones regularly and at different times: weekends and weekdays, mornings, mid-day and evenings. Varying your visiting pattern will show the range of their behavior, their interactions with others, their most lucid and active times and the times of day that are the most challenging for them and for those who care for them.

What to Look For When Visiting Your Elderly Loved One:

• How do they look? Well fed, relatively steady on their feet with the proper assistive equipment (canes, walkers)?
• How much food is in the house and is it edible?
• Are they wearing clean clothes in good repair?
• What is your loved one’s mood? Are they essentially the same or is there a change in personality? Are they exhibiting signs of depression, including withdrawal? Are they becoming angry or aggressive? Confused? Are they acting out verbally, physically or sexually? Any of these personality changes or significant new behaviors need to be investigated by a geriatric psychiatrist and/or a neurologist.
• Do they have any recent injuries or scars? How do they explain them?
• How do they smell? Does their body and hair seem clean? Can they still brush their teeth or do they need assistance? Who is helping them with self care items and are they getting enough assistance?
• Are there any new people hanging about whom you never knew before? Who are these people, what is their role and are they getting paid or asking for/receiving money from your loved one? Follow up to make sure they are not taking money from your loved one, taking advantage of their naivete.
• Check the mail. If the number of charitable solicitations, sweepstakes or credit card offers seems especially high, this is cause for great concern. This should lead to someone talking to them about who they are giving money to, and in what amount. Charitable organizations are notorious for upping the amount of solicitations based upon regular, small amounts of donations, which is very enticing to older people, who are often not only generous, but forgetful of when they last donated.
• What is the quality of their help? Do they seem honest? How are they compensated? Do they know too much about how to access funds? Are they working hard enough and giving enough attention?
• What is the state of your loved one’s belongings, especially jewelry and furniture as well as cars? Take a picture of their environment, especially their valuables so you can help them keep track of what’s significant. If items are missing, follow up immediately with their paid help, or with nursing home supervisors.
• If they wear glasses or dentures, are they wearing them regularly and do they fit properly? Losing dentures is a serious problem for the elderly. Once they have lost their false teeth, they lose interest in eating, including the sociability of meals. If they don’t wear their dentures for an extended time, getting new ones to fit comfortably is difficult, so this “edentulous” state can become permanent and depressing.
• For seniors living in communal housing, what are the other residents like? Do any of them wander into your loved ones’ rooms? Are any of them violent? Who controls the situation? Is your loved one safe or do they need to find a safer new place to live?

Visiting loved ones serves a dual purpose. Firstly our visits ideally provide some companionship, diversion and comfort to them. But we also have to use these encounters to gently investigate how they are doing, if they are well-cared for or if more assistance is needed to keep them safe and prevent elder abuse in all of its varieties.

In general, when we move our loved ones into a nursing home, we are doing so to help protect them and to care for them. Ironically, we have moved them from one unsafe environment to another environment that could also, without supervision, be unsafe. Although there are many fine care facilities for the aged, one should still be aware of the following statistics:

• In a study of 2,000 interviews of nursing home residents, 44% said they had been abused and 95% said they had been neglected or seen another resident neglected. (Broyles, 2000)

• Over 50% of nursing home staff admitted to mistreating (e.g. physical violence, mental abuse, neglect) older patients within the prior year in one study. Two thirds of those incidents involved neglect. (Ben Natan, 2010)

So, when you go to visit your friend or relative in a nursing home or care facility, be aware of the following signs of abuse:

• Your loved one’s dementia makes it easy to dismiss their reports of problems. Missing items, not feeling loved or cared for are common complaints that seniors make when first moving into a care facility. Take their complaints seriously, however.
• Be aware of tension between the caregiver(s) and the elderly person.
• Note changes in personality, particularly signs of depression and withdrawal.
• Be on the lookout for any signs of injury, like bruises, cuts and scars.
• Make sure that stories about any injuries add up.
• Monitor that medication is taken in the right amount and at the right times (this means visiting the care facility at a variety of times of day and night)
• Be on the lookout for missing or broken eyeglasses or dentures. This is a tangible sign of inattentive staff.
• Report immediately any interactions in which a caregiver is rude or threatening.
• Take care to notice any significant weight loss or signs of poor nutrition or dehydration.
• Check for bed sores.
• Look around at living conditions:  are they sanitary and clean?

If you are concerned, bring these concerns to the immediate attention of the administration of the care facility. If your concerns are not being addressed, contact us at Turner and Turner.

Last week, we detailed the categories that most cases of nursing home abuse and neglect fall into.  Today, we want to give you some information about what you can do to help protect your loved ones from abuse and neglect.

1. Don’t make your visits predictable.  Visit frequently, and at different times on different days.
2. Don’t be afraid to ask questions about care.
3. Check for bedsores, unexplained bruises and sensitivity to pain.
4. Note the cleanliness of the residents and the facility.
5. Check for weight loss and/or dehydration
6. Keep a small journal for notes after visits.
7. Take your camera.  On each visit, heave your photo taken with your loved one, and date it.
8. Report any suspected abuse.

If, indeed, you do suspect abuse taking place in a nursing home or similar care facility, you may have different avenues  of legal recourse.  Contact Turner & Turner for a free consultation to discuss all of your legal options.

The Office of the Attorney General in Michigan has identified four categories that criminal abuse and neglect generally fall into:

1.  Harmful Neglect: A resident of a nursing home or residential health care facility may be suffering from harmful neglect if they experience:

• Suspicious or questionable injuries or death;
• Unexplained substantial weight loss or severe dehydration;
• Painful bedsores 

2.  Assault or battery is committed if an employee of a nursing home or residential care facility threatens or strikes a resident or uses unauthorized physical or chemical restraints

3.  Criminal sexual conduct occurs when an employee of a residential healthcare facility or nursing home engages in unlawful sexual conduct with a patient.

4.  Embezzlement or theft of a resident’s funds occurs when a nursing home or residential health care facility employee wrongfully removes funds from a resident’s account, improperly obtains a financial “loan” or “gift” from a resident, or uses personal information illegally to obtain credit cards, etc., resulting in identity theft.

Next week: Which facilities are subject
to investigation & ways to protect your
loved ones from abuse & neglect.