Elder abuse is going to increase over the next foreseeable future! (See following article)
Elder abuse manifests itself as:
- Pressure sores which are caused by staff failing to turn and reposition patients every 1-2 hours and cleaning them after every bowel movement and wet bed episode.
- Dehydration which is caused by staff failing to offer fluids every meal and between every meal and to assist the elder in drinking the fluids. It is also caused by staff failing to measure intake and output when needed.
- Malnutrition which is caused by staff failing to assist patients in eating their meals. It is also caused by staff that does not provide its patients with food they can chew and/or food preferences they have requested.
- Weight loss which often goes unnoticed because staff fails to weigh its patients as often as required. When the patient is weighed and it is noted they have lost 10 pounds, it is almost impossible to put that weight back on.
- Repeated falls without adequate interventions to prevent additional falls. Allowing a patient to fall over and over again is never acceptable or excusable.
- Bowel impactions which occur when the staff fails to maintain an accurate record of bowel movements and calls the physician for an order as soon as the patient’s normal bowel habits are late. Failure to assess a patient’s abdomen, take complaints of abdominal pain seriously and keep an accurate record of bowel movements will lead to a bowel impaction with a potentially serious outcome.
- Failure to manage pain. Many of our elderly suffer from ongoing, chronic pain. It is debilitating, and failure to manage it leads to depression, and eventually, failure to thrive. The standard of care requires proactive 24-hour-a-day pain management as opposed to reactive pain management for patients with chronic pain. The nursing scope of practice includes implementation of appropriate pain management.
Our Very Unfortunate Future in Elder Abuse
By 2050, an estimated 27 million Americans will require long-term care – up by more than 100 percent from the 13 million Americans receiving long-term care in 2000. Elderly Americans now comprise the fastest growing segment of the U.S. population, and the first of the baby boom generation hit retirement age in 2011.
The Need for Long-Term Care Funding Stability
Nursing facilities were the second largest employer in the health care industry in 2008, employing approximately 23 percent of all health care workers during that timeframe.
Unfortunately, as the demand for long-term care continues to rise, the nation’s supply of skilled caregivers is shrinking. In addition, federal and state payment policies have delivered a number of severe funding cuts to long-term care in recent years that further threaten staffing levels. These include:
Severe Medicare cuts:
Health care reform: $16.9 billion in Medicare cuts over 10 years from productivity adjustments/reductions in the market basket update starting in 2012
2010 regulation: $12.1 billion in Medicare cuts over 10 years from the forecast error adjustment
2011 regulations: Estimated $2.2 billion in Medicare cuts over 10 years from the 0.6 percent forecast error cut in the 2011 market basket update – plus an estimated 7-8 percent in cuts to Medicare Part B therapy payments to skilled nursing facilities in 2011
Chronic Medicaid underfunding:
Although 65 percent of nursing home residents rely upon Medicaid to cover their costs of care, the program is persistently funded far below the actual costs of caring for our nation’s seniors. Following a temporary increase in Federal Medical Assistance Percentage (FMAP) funding, which was included in the American Recovery & Reinvestment Act (ARRA) and (expired) on June 30, 2011, most state legislatures are now either freezing or cutting Medicaid payments to long term care to cope with the economic downturn.
Adequate Staffing Necessary for Quality Care
Labor constitutes approximately 70 percent of nursing facilities’ operating expenditures. This covers employee compensation, benefits and other labor-related costs, and maintains the necessary levels of front-line caregivers who deliver round-the-clock services to residents.
With continued payment cuts and funding instability, facilities will be forced to cut jobs of these skilled caregivers and other staff contributing to residents’ care outcomes and quality of life.
Reference include the following:
CPSC Issue Brief: Funding Stability and Long Term Care Staffing, Quality
Organization: Coalition to Protect Senior Care