Before I write another word, let me very clear I'm not out to hang any nursing home or institution .I just intend to bring out into the public domain practices in Care of the Elderly Nursing Homes that I've worked in since 2006 that I found to be abusive and demeaning to the elderly . Let me now state that I have no finiantial reasons for doing this, put simply, my only desire is that the elderly people in our society be treated with the respect they so deserve.I have almost 26 years nursing experience behind me,16 in paediatrics, the rest in care of the elderly. The experience I've gained is both through agency nursing and as an Assistant Director of Nursing. The most concerning issue I have is that the HSE inspectors passed all of these homes on each inspection as 'generally compliant' and deserving of continued practice.
In one particular Southside private Nursing Home the HSE inspectors walked past seven elderly people tied to their armchairs by broken belts and failed to notice this horrific abuse.
Home 'A': approx 8 residents in their eighties and nineties being gotten out of their beds before 6am to feed them porraige., this was to ensure they were fed before the day staff came on. 28 residents being cared for at night in a three story building by 1 nurse and 1 care attendant. In one horrific case I came on duty to be told one of the ladies had died earlier that day, at approx 18:00 hrs. When I went to check on her body which had been left in the 7 bedded room behind closed curtains, I found her still sitting up in bed, propped up by pillows, and rigor mortis had set in. The day nurse hadn't had a chance to lie her down or straighten up her hands and feet, or close her eyes. I won't go into the detail of the difficulties the undertakers had in getting her into the coffin.
Home 'B', a nurse and an attendant to look after 32 residents, 5 very confused, 18 needing intensive care, and and the rest left to fend for themselves because the nurse was stuck with the heavy dependency residents. When I complained and stated this was complicit with elder abuse, I was told by my nursing agency to shut up if I wanted to keep getting work. A very frail 90 year old man fell and broke his leg because there weren't enough staff to watch him as well as the other 31. He normally lived with his family, and they cared for him very well. He was taken into the unit to give them a break. A broken leg at this age can cause serious problems due to surgery,immobility and loss of autonomy.
Home 'C': Eight residents tied to chairs by thin belts. The armchairs had the belts looped through the arms of the chairs, and then knotted around the waist of each resident. I managed to stop this practice by threatening to inform the HSE social workers. Already there have been deaths from this form of restraint, but chest and underarm injuries are most common injuries sustained. But besides the injuries - what about dignity?. Would you like your mother or father tied up?.
Home 'D': Residents put back to bed at 13:30hrs after only being gotten up at 10am. This means out of 24 hours, the resident spent 20.5 lying in bed. No social contact, no stimulation, no meaningful existance. If the families called they were told the resident was 'tired' or 'doesn't feel well'. The reason for putting them back to bed was because there were less staff on duty in the evenings, cost cutting of course. In this particular home there were usually 7 staff to look after 40 residents in the morning. From 2pm onwards, there were 4. One also had to do the laundry from 12midday to six pm. To put this in perspective - the HSE institution I work in has 6 staff to 25 people - and on the wards with these ratios, it's considered very busy.
Home ' E'; A seventy year old lady with advanced alzymers in need one member of staff to stay with her constantly because she was extreamly confused and disorientated, being new to the unit. The Manager assured her very relieved family that she would be well taken care of.The woman was then put in the care of very stressed out nurses who couldn't cope with her needs and certainly couldn't stay with her - three members of staff looking after twenty eight residents made one to one care impossible. The result?, a woman with dementia who cried loudly all day and night. The other residents were totally freaked out.
There are many other examples which I will add to here when I get the time, and also with this forum being made available to the public, I'll add their stories also.
For years I couldn't say anything if I wanted to keep working. As an agency nurse I had to keep my mouth shut even when I saw situations that were degrading and abusive.
The only reason I can now speak out is because I've been employed by the HSE, and my job is secure.Otherwise I'd have to be like other nurses, I'd have to 'tow the line' and hope I could make a difference in some way, or put up with the abuse.
How many nurses like me are complicit with elder abuse because they've no other choice, speak out and get no more work - or continue working and hope in some way to make a difference?.
Tuesday, June 30, 2009
Monday, June 29, 2009
Abuse concerns aired
Contrary to popular opinion, abuse is rarely deliberate. Very few people set out to harm or hurt their elderly parents or relations in any way. Usually the main problem identified is the sheer frustration and sense of helplessness a carer feels when faced with looking after a person they love, and knowing that they simply aren't able to cope.
Sometimes it can also be a case of the carer not actually knowing what constitutes abuse. For example, did you know if you're the named person collecting the pension for an elderly dependent, and you haven't accounted for every euro spent of this money in their name - you could be open to a charge of fraud?. More on this later.
If you feel you need help either because you're afraid that you're not able to cope with caring for an older person, or if you feel an older person you know might be suffering abuse - contact me fhorsmanhogan@eircom.net.
As a nurse specialising in Care of the Elderly, what I can't answer myself, I can refer to my social worker, nurse or doctor friends. The important thing here is that you can express your concerns here without fear of exposure. Full anonymity is guaranteed. With your permission, and only with your permission, your query will be put up for others to benefit from. However it will be sanitised in such a way that no person or place will be identifiable. Only health care workers will be involved in seeking help for any queries. The above email is my personal one - not linked to this blog.
Sometimes it can also be a case of the carer not actually knowing what constitutes abuse. For example, did you know if you're the named person collecting the pension for an elderly dependent, and you haven't accounted for every euro spent of this money in their name - you could be open to a charge of fraud?. More on this later.
If you feel you need help either because you're afraid that you're not able to cope with caring for an older person, or if you feel an older person you know might be suffering abuse - contact me fhorsmanhogan@eircom.net.
As a nurse specialising in Care of the Elderly, what I can't answer myself, I can refer to my social worker, nurse or doctor friends. The important thing here is that you can express your concerns here without fear of exposure. Full anonymity is guaranteed. With your permission, and only with your permission, your query will be put up for others to benefit from. However it will be sanitised in such a way that no person or place will be identifiable. Only health care workers will be involved in seeking help for any queries. The above email is my personal one - not linked to this blog.
Thousands of unreported cases in Ireland
Thousands of cases of elder abuse go unreported each year in Ireland, an older people's charity has claimed.
Speaking to mark World Elder Abuse Day, Age Action Ireland said that many older people suffer abuse in silence, despite the existence of a dedicated support network to help them resist ill-treatment.
The charity estimates that between 14,400 and 24,000 Irish people may have suffered elder abuse at some stage of the latter years of their lives. However, the specialised Elder Abuse Service set up by the HSE has received just 2,767 complaints in the two years since its inception.
Age Action chief executive Robin Webster said that the burden of identifying cases of elder abuse must be shared more equally between the HSE and the network of friends, neighbours and organisations who work closely with older people.
"An analysis of the elder abuse complaints received by the HSE in 2007 and 2008 shows that the majority of complaints were reported by public health nurses and other HSE staff," he said.
"In contrast, other voluntary and statutory organisations accounted for less than five per cent of referrals.
“Age Action is really concerned that many people are suffering unnecessarily, not knowing that help is at hand which could stop the abuse," he added.
Although information on the pervasiveness of abuse among elder populations is relatively scarce, according to the report of the Working Group on Elder Abuse published in 2002 between 3 and 5 per cent of elderly people in the Republic experience some form of mistreatment.
In 2008, close to 80 per cent of alleged abusers in cases referred to the HSE were family members, yet just 15 per cent of cases of elder abuse were reported by family members. Mr Webster said that this was indicative of the need for greater education of the wider community on the problems of elder abuse.
“Within this context groups which work with older people have a greater responsibility to educate their members about the possible indicators of elder abuse, and what steps should be taken when it is suspected an older people is being abused.”
Age Action Ireland urged any older person who is being abused, or members of the public who suspect that abuse is occurring, to contact the HSE. Details on how to contact dedicated elder abuse officers are available from HSE regional offices or by telephoning the HSE’s information line on 1850 24 1850.
Speaking to mark World Elder Abuse Day, Age Action Ireland said that many older people suffer abuse in silence, despite the existence of a dedicated support network to help them resist ill-treatment.
The charity estimates that between 14,400 and 24,000 Irish people may have suffered elder abuse at some stage of the latter years of their lives. However, the specialised Elder Abuse Service set up by the HSE has received just 2,767 complaints in the two years since its inception.
Age Action chief executive Robin Webster said that the burden of identifying cases of elder abuse must be shared more equally between the HSE and the network of friends, neighbours and organisations who work closely with older people.
"An analysis of the elder abuse complaints received by the HSE in 2007 and 2008 shows that the majority of complaints were reported by public health nurses and other HSE staff," he said.
"In contrast, other voluntary and statutory organisations accounted for less than five per cent of referrals.
“Age Action is really concerned that many people are suffering unnecessarily, not knowing that help is at hand which could stop the abuse," he added.
Although information on the pervasiveness of abuse among elder populations is relatively scarce, according to the report of the Working Group on Elder Abuse published in 2002 between 3 and 5 per cent of elderly people in the Republic experience some form of mistreatment.
In 2008, close to 80 per cent of alleged abusers in cases referred to the HSE were family members, yet just 15 per cent of cases of elder abuse were reported by family members. Mr Webster said that this was indicative of the need for greater education of the wider community on the problems of elder abuse.
“Within this context groups which work with older people have a greater responsibility to educate their members about the possible indicators of elder abuse, and what steps should be taken when it is suspected an older people is being abused.”
Age Action Ireland urged any older person who is being abused, or members of the public who suspect that abuse is occurring, to contact the HSE. Details on how to contact dedicated elder abuse officers are available from HSE regional offices or by telephoning the HSE’s information line on 1850 24 1850.
Introducing Elder Abuse
As a nurse working in Care of the Elderly, the most common form of familial abuse I’ve seen is finiantial, where the relative is collecting their pension, but refusing to buy them clothes or any other day to day necessities. This is not only abuse, but its fraud, and the relatives can and should be prosecuted for it. The family home is firmly shut to the efforts of social workers and Public Health Nurses to help, even when the effects of physical abuse are present.
Figures released June 2009 show as many as 23,000 older people may be suffering such abuse every year according to Robin Webster of Age Action Ireland; horrifically the official number reported to the HSE is only approx 1,800.
So what are the tell-tale signs that an older person is being abused? According to the American National Centre of Elder Abuse, the symptoms of abuse vary with the nature of that abuse, but things to look out for include:
Unusual or unexplained injuries, such as cuts, bruises or burns, for which strange and inconsistent explanations are given
Unkempt appearance
Pressure or bed sores
Evidence of confinement, such as being tied to furniture or locked in a room
Dehydration or malnutrition without a medical cause
Fear, withdrawal, depression, or anxiety
Visits to many doctors or hospitals
Helplessness
A hesitation to talk openly
Sometimes when abuse is suspected, it is not clear who might be perpetrating it. In the case of an older person living with their family, any one of a number of relatives, or even friends or neighbours, could be responsible. Similarly, in a care environment, a number of carers might share responsibility for the older person. Obviously, anyone who verbally assaults, threatens or insults an older person is the most likely person to be committing any abuse that might be occurring.
Figures released June 2009 show as many as 23,000 older people may be suffering such abuse every year according to Robin Webster of Age Action Ireland; horrifically the official number reported to the HSE is only approx 1,800.
So what are the tell-tale signs that an older person is being abused? According to the American National Centre of Elder Abuse, the symptoms of abuse vary with the nature of that abuse, but things to look out for include:
Unusual or unexplained injuries, such as cuts, bruises or burns, for which strange and inconsistent explanations are given
Unkempt appearance
Pressure or bed sores
Evidence of confinement, such as being tied to furniture or locked in a room
Dehydration or malnutrition without a medical cause
Fear, withdrawal, depression, or anxiety
Visits to many doctors or hospitals
Helplessness
A hesitation to talk openly
Sometimes when abuse is suspected, it is not clear who might be perpetrating it. In the case of an older person living with their family, any one of a number of relatives, or even friends or neighbours, could be responsible. Similarly, in a care environment, a number of carers might share responsibility for the older person. Obviously, anyone who verbally assaults, threatens or insults an older person is the most likely person to be committing any abuse that might be occurring.
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