Assisted Living Facilities vs. Skilled Nursing Homes

The term “assisted living” became popular in the 1980’s and is used within the retirement industry to refer to programs available in many retirement residences, senior apartment facilities and residential care facilities in California. Many retirement residences recognized a growing need for personal care programs. These types of programs allow residents to remain independent in their apartment. The cost of living in an assisted living facility is about $3200 a month on average, as compared to approximately $5,000 a month for a semi-private room in a nursing home.

Residents in assisted living facilities require less care than residents of nursing homes. Typically, a residence in an assisted living facility will require some assistance with one or more of the following: help with bathing or dressing, assistance with taking medication, assistance with toileting or incontinence, and special dietary requirements. Assisted living facilities are not permitted to provide skilled nursing services, such as diabetic insulin injections or colostomy care, although they may contract with an outside provider for these services.

Assisted living facilities are licensed by the Community Care Division of the California Department of Social Services http://ccld.ca.gov/. Nursing homes are licensed by the California Department of Health Services http://www.dhcs.ca.gov/Pages/default.aspx and are given a higher level of scrutiny by the licensing authority since they are considered a health care facility.

As the population ages, the popularity of assisted living facilities has grown. Claims against assisted living facilities are also increasing. Some assisted living facilities have been accused of holding on to residents in declining health that should have been referred to nursing home facilities or a hospital. Unfortunately, one challenge that plaintiffs face is collecting on a judgment; assisted living facilities are often uninsured.

Thanks for reading. Feel free to leave a comment or reply to this posting, but keep in mind that your response will not be confidential. If you have a question or need assistance regarding a possible claim involving an assisted living facility or nursing home, contact me for help and immediate assistance.

Sexual Abuse in Nursing Homes

A nightshift nurse at an Ohio nursing home has been charged with raping a blind and partially paralyzed patient and abusing at least 13 others. John Riems allegedly confided to authorities that he has abused almost 100 patients since the 1980’s, but could only provide specific information on about two dozen victims. Riems has worked at 13 different hospitals and nursing homes in Ohio.

Other nurses at the facility noted that Riems tended to spend a great deal of time behind closed doors with patients. He would sometimes spend up to an hour in a patient’s room, alone, with the door closed. When a colleague asked him why he was in a patient’s room for so long, he reportedly answered, “None of your business.”

Some nurses commented that patients appeared to be fearful of Riems, who was known to have an explosive temper. One colleague reported to supervisors that Riems was verbally abusive to patients and would swear and throw things when angry. Despite these warning signs, Riems was allowed to have unfettered, unsupervised access to patients.

Riems selected his victims carefully, choosing the most defenseless victims who were unable to communicate that the abuse was occurring. In addition to raping the blind and partially paralyzed man, police believe he has 14 victims, both male and female, at the nursing home where he worked from 2002 to the time of his arrest. Police have acknowledged that there are ten other “suspected” victims of Riem who reside at other facilities where Riems worked, although they declined to identify the location of these other suspected victims.

How can you protect your loved one from becoming the victim of sexual abuse in a nursing home? Here are some pointers:

1. Visit frequently and don’t announce when you are coming.
2. When you visit, observe the staff and see if your loved one appears to be apprehensive or fearful of any staff members.
3. Talk to the staff and let them know that you are actively involved in the care of your loved one.
4. Trust your instincts; if a staff member’s behavior strikes you as being odd, alert the appropriate supervisors.
5. Watch for physical signs of abuse, including:

• Bruising around breasts, thighs or genitals
• Bleeding from the vagina or anus
• Presence of a sexually transmitted disease
• Pain or discomfort in sitting
• Infection, irritation or itching in the genital area

Thanks for reading. If you have a question or comment, feel free to reply to this posting, or send me an e-mail. If you suspect a loved one is being physically or sexually abused in a nursing home, contact me for help and immediate assistance.

Identifying Financial Elder Abuse

It’s often been said that elder abuse is a pervasive problem without any boundaries; it transcends all economic and social lines. The recent case of Brooke Astor, the New York socialite and philanthropist, illustrates that elder abuse can occur even to the wealthiest members of society. Elder abuse can take many forms; there is physical abuse, neglect, and financial abuse. In the Astor case, there are allegations of both neglect and financial abuse by her only son, Anthony Marshall. Astor was reportedly living in squalor while her son allegedly sold her assets without her knowledge or consent.

Unfortunately, it is often those closest to an elderly person who engage in the abuse, especially where financial abuse is concerned. It is not uncommon for a caregiver or relative to take advantage of an elderly person’s lack of capacity. Seniors are often easy victims of scams, fraud, identity theft and other forms of financial abuse.

Tips On How to Protect Yourself from Financial Abuse

• Cancel credit cards you are not using
• Don’t allow friends or family members to use your credit cards or ATM card to purchase things for you. Whenever possible, give them cash or reimburse them with a check.
• Don’t keep your ATM pin number in your wallet. If you must write it down, keep it in a secure place.
• Balance your checkbook every month, and report any suspicious activity to Adult Protective Services at 1(877) 4-R-SENIORS or to your local police department.

When to Suspect Financial Abuse

• When you notice unusual activity on a bank account, including unexplained withdrawals
• When you see recent changes to estate planning documents, including changes to a Will or Trust, or creation of new Powers of Attorney
• When bills begin to pile up when the elderly person should have the ability to pay them
• When the elder lacks basic necessities, such as clothing and grooming items, when the elder should have the ability to pay for these items
• When a friend, family member or caretaker asks for a loan, but doesn’t sign a promissory note or other documentation evidencing the loan, or asks for the loan to be kept “secret” or “confidential”.

Financial abuse of an elder is often tied to neglect and/or physical abuse. The elder is often subjected to physical abuse or threats in order to intimidate the elder into complying with the abuser’s demands for money or assets. Once the elder becomes the victim of financial abuse, the elder’s needs are often neglected as the elder’s income and assets are diverted to the abuser. If you suspect that someone you love is the victim of elder abuse, contact me for immediate assistance.

New Information Regarding the Monitoring of Adult Guardianships

The Los Angeles Times reported this week that the Members of the Senate Special Committee on Aging are pushing for action to improve how adult guardianships are monitored.

Along with mandatory quality standards for guardians, the Senate Special Committee wants an infusion of federal funds to better support local court supervision programs and to establish nationwide data collection procedures on guardianship cases.

Also this week, the AARP and American Bar Association also released a blueprint for creating monitoring programs that work. This blueprint model studied six programs from Tarrant County, Texas to Broward County, Florida that have developed exceptionally effective monitoring programs on adult guardianships.

California has a long way to go in implementing programs that effectively monitor adult guardianships. Thanks to high profile cases such as the arrest of the son of the late New York socialite Brooke Astor, the media as well as the public is calling for the court system to enforce that conservators and guardians act in the wards' best interest.

Thanks for reading!

Long Term Care, Medicare and Medicaid

"Long-term care" is the care for a person with a chronic illness or disability. Generally, long-term care includes medical and non-medical services provided in the person's home, assisted living facility, or nursing home.

Most people who require long-term care rely on a combination of financial sources to meet their long-term care needs, including: family, friends, private sources and government assistance such as Medicare and Medi-Cal.

Medicare will only cover medically necessary health care. This means that Medicare will not pay for assistance with "custodial care" services such as dressing, bathing and going to the bathroom.

Also, don't confuse Medicare with Medi-Cal. Medi-Cal is a state and federal program for people with limited assets and low income. Unlike Medicare, Medi-Cal has the right to seek reimbursement from your estate. The California Department of Health Services website has answers to frequently asked questions about Medi-Cal.

The best time to consider long-term care is before you need assistance. For a list of services to think about, visit the Medicare website.

Thanks for reading!

Finding out About Nursing Home Performance

There are approximately 1.5 million elderly people living in nursing homes in the U.S., and we spend about $72.5 billion annually in tax dollars to subsidize the cost of nursing home care.

Any nursing home receiving federal funding must go through periodic inspections to assess whether the facility meets certain safety and quality of care standards. Unfortunately, too many facilities that get cited for serious deficiencies fail to make adequate improvements.

If you are in a nursing home, or you have a loved one in a nursing home, you have the right to know how well that nursing home is performing. Some of the resources you can look to for this information are:

• Medicare Website called "Nursing Home Compare"
• U.S. Department of Health, Center for Medicare and Medicaid Services
• California Nursing Home Ombudsman Information
• California Advocates for Nursing Home Reform
• AARP Website

I hope this information is helpful. Thanks for reading!

What is Elder Abuse?

California law says that an "elder" is a person who is 65 or older. Elder abuse can be in the form of physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering. To deprive an elder person of goods and services that result in physical harm or pain or mental suffering is also elder abuse.

Unfortunately, the elderly are often vulnerable to mistreatment. The National Center on Elder Abuse estimates that between 1 million and 2 million elderly Americans have been victims of elder abuse. We can imagine that the numbers are probably much higher due to incidents that go unreported.

The purpose of my blog is to disseminate information about elder abuse in the United States. I hope that by doing so, we can better identify situations where our beloved elderly need our assistance in preventing an abusive situation that can hamper their lives.

I will post again soon. Feel free to contact me if you have specific questions, or respond to this blog for general comments.

Thanks for reading.