Tag Archive | elder abuse

Nursing home placement – another form of elder abuse?

Edward Munch Self Portrait

Elder abuse takes many forms. Nursing home placement may be a humane solution, but to many elders it feels like involuntary confinement. I was moved by Jean Henry Mead’s comment on my last post, about the 98-year-old woman who jumped to her death from a nursing home window. My own father experienced a similar sense of abandonment when my stepmother abruptly placed him in a nursing home without consulting the rest of the family.

I was in New York City in my ninth month of pregnancy when I got his furious call from Michigan. She’d betrayed him, he said, and he wanted a divorce. Although he’d suffered from mild dementia, the outrage triggered total lucidity. I’m also convinced it killed him, because a cardiac event – what doctors sometimes call a sympathetic storm – caused his death early the next morning, before my husband and I could help make alternate arrangements.

That wrongful death preyed on my mind for years, and ultimately swayed my decision to choose eldercare as a profession. The same is true of Claire Lindstrom, the protagonist of Eldercide, my novel of medical suspense, as you’ll see if you read to the end:

              The trilling of the cell phone was so subtle that the sound carried barely twenty feet from shore, harmonizing with the chirping of the sparrows and the soft cooing of the mourning doves. If not for her dog Freia, Claire Lindstrom would have missed it entirely, but the big blond Labradoodle was dancing on the dock, wagging happily as she bounced around the little black instrument of torture.

            “Good girl!” Claire murmured as she steered the kayak in for a landing. She’d taught the dog this silent pantomime in deference to the neighbors, most of whom didn’t appreciate being stirred from sleep by a salvo of barks, no matter how magnificent the sunrise.

            Setting down the paddle, Claire grabbed the cell phone and peered at the caller ID. The number was Harriet Gardener’s. 

            A shiver swept over her, despite the rising heat of the early September day. As nursing supervisor for a couple of dozen home care clients, Claire was accustomed to getting calls at all hours of the day and night. Call her compulsive, call her a workaholic, but she’d made it clear to everyone on staff that she wanted to be brought up to speed on anything out of the ordinary, no matter what the hour. Most of the clients at Compassionate Care were elderly, and many were gravely ill. The aides knew better than to leave Claire out of the loop when it came to making judgment calls about the people in their charge.

            But Harriet Gardener was in excellent health, physically at least. She suffered from mid-stage Alzheimer’s and needed supervision to prevent her wandering away or burning down the house with her absent-minded attempts at cooking. But she was strong, and she rarely came down with so much as a sniffle. For the time being, thanks in large part to her live-in aide Dahlia Douglas, her quality of life was excellent. But inevitably that would change. Although they tried not to show it, the fact that she was fated to endure many years of painfully slow decline, culminating in the eventual loss of all her mental and physical functions, distressed her overwrought family no end. . . .

 Halfway across the lawn, she had the cell phone out of the bag, her finger poised over the callback button. She jabbed the button as she set foot on the first step, and the phone was ringing by the time she reached the deck.

Dahlia answered on the third ring, her voice weak and shaky. “Harriet’s gone,” she stammered. “It must have happened sometime in the night.”

Claire’s heart sank. “But Dahlia, how could she get out without your knowing? Everything’s locked up tight. You sleep right across the hall from her, and I know you’re a light sleeper.”

“Not that kind of gone.” Dahlia’s careful diction had yielded to the earthy dialect she usually reserved for the other Jamaican aides, and the melodic lilt of her voice was incongruously at odds with her message. “She’s gone. I mean she passed. I don’t understand. She was fine when I tucked her in bed last night. She had such a strong heart, and you know how the family used to kid around with me. We thought Harriet would outlive us all.”

Just like my father. Claire shivered. She took Dahlia’s report, somehow got through the formalities, hung up. Then, suddenly wobbly, she sank onto a chaise. Nine years ago, on a flawless September morning much like this one, she’d gotten a call from the nursing home where he’d been admitted the day before, suffering from mild dementia. He had gone to bed ostensibly healthy, died sometime in the night. A previously undiagnosed cardiac problem, they said. Or, as Claire always thought of it, a broken heart. He’d been furious when her mother shunted him off to a nursing home against his wishes, vowed to get out if it was the last thing he did. He had fulfilled his vow, although not the way he planned.

He shouldn’t have died that way, abandoned and alone in an institutional bed. His death shocked Claire into abandoning graduate school and entering nursing. She found her way into home care, where she could help keep people away from those warehouses for the dying. All these years spent making amends, and now it had happened again.

 Read the entire first chapter of Eldercide here on my blog. You can order the novel from Amazon or directly from me – see the page on how to order my books for contact information. I did the cover illustration for Eldercide – perhaps you can see that Munch is one of my inspirations.

World Elder Abuse Day – a cause near to my heart

Reading Dear Abby this morning, I learned that today, June 15, is World Elder Abuse Day. It’s a subject close to my heart. As President of my own licensed home care services agency, ElderSource, Inc., I witnessed the extreme pressures that can lead to potentially abusive situations, even among loving families who are doing their best to provide quality care for their elders.* Unfortunately, most seniors are not nearly as well off as our clients were.

The National Center on Elder Abuse estimates that as many as one in ten elders experience some form of abuse, but only one in five cases gets reported. They define elder abuse as “neglect, exploitation or ‘painful or harmful’ mistreatment of anyone 65 or older,” and the abuse can be financial, physical or psychological.

We’ve all heard the horror stories that surface regularly in the news – the abusive caregivers, the financial scams that can cost gullible elders their homes. Perhaps less obvious is the neglect that can stem from isolation, especially when dementia, mental illness or substance abuse are involved. Elders living alone, far from involved family, can suffer from self-neglect when they’re unable or unwilling to care for their own needs.

My 81-year-old brother in the Bronx has a wonderful support network of neighbors he’s come to know over 30 years in the same apartment building, but suburban neighborhoods of single-family dwellings don’t offer the same comfortable familiarity. Personally, I plan to age in place – our home is already too small for all our stuff, and I can’t picture downsizing any further. But it’s not a prospect I look forward to with great enthusiasm, and it’s all too easy to envision myself as a neglected recluse in some not so distant future.

What can you do to help prevent elder abuse, including self-neglect? First, learn more about how to recognize the signs and symptoms by visiting informative websites like the following:

Center of Excellence on Elder Abuse and Neglect, University of California at Irvine (www.centeronelderabuse.org)

National Center on Elder Abuse (http://www.ncea.aoa.gov/)

Keep in contact with your older friends, neighbors and relatives so as to help decrease isolation, a risk factor for mistreatment. Be observant for signs of abuse or neglect.

Report possible mistreatment or neglect to your local adult protective services agency or to 911.

Contact your local Area Agency on Aging office to help identify possible sources of support like Meals on Wheels.

Volunteer, either formally or informally. With elderly neighbors living on either side of us, my husband and I drove them to doctors’ appointments and ran errands. I’m grateful for the stories they told me and the closeness we developed near the ends of their life spans, and I hope my own younger neighbors may reciprocate someday. More formally, as administrator for the Memorial Society of the Hudson-Mohawk Region, I help educate people about affordable funerals and how to avoid one of the most common financial rip-offs that plague our seniors.

But why get involved in yet another cause, when there are so many clamoring for our attention? Because we’re all part of a beloved community, both globally and locally, and the person who needs your help may be as close as your next-door neighbor.

 *My experience as President and CEO of ElderSource inspired my novel Eldercide, which addresses the question, “When quality of life declines with age and illness, who decides if you’re better off dead?” The book explores elder abuse taken to the extreme, but fortunately it’s pure fiction – at least from my perspective. Unfortunately, the plot is all too plausible. You can read more about Eldercide on this site.