Justice, A Single Word

All the great things are simple, and many can be expressed in a single word: freedom, justice, honor, duty, mercy, hope.

Winston Churchill

So you are in long-term care or you have a family member (or very close friend)  in one of the following types of care facilities: 

Nursing Home

Hospital Long-Term Care Unit

Home for the Aged

County Medical Care Facility

Adult Foster Care 

Assisted Living Facility

     Whether or not you placed the patient in the facility, the patient appears to decline dramatically and unexpectedly. You suspect something is wrong, or the patient tells you something is wrong. You may be this person's only advocate, while you are in a tailspin. In addition time is not on your side. Report immediately. Begin the reporting process with supervisory and management personnel of the facility. Memorialize meetings with written correspondence. 

      Speak with everyone else closely involved. Speak with medical personnel and the patient's medical providers. Step up the frequency of visits and the visibility of guests, even if you must enlist the help of other friends and family. Make the times and dates of visits unpredictable. Visitors should maintain journals and carry cameras. Don't hesitate to talk to neighboring residents, their friends and family about the level of care Look at the patient. This is very important. No-one wants to demean or intrude on a patient's privacy, but injuries, bruising, and sores may be hidden under gowns, pajamas, robes, socks and shoes. Someone of the same sex, who is close to the patient must check the patient frequently. Weight loss is concerning, so see that the patient is regularly weighed and does not show signs of dehydration.

 Ask yourself and others close to the patient, whether management or supervisory staff can and will readily correct the issues. Look for classic signs of neglect or abuse, while deciding whether there is criminality involved. There is a language to learn, and there are steps to be taken, the sooner the better. Here are some legal guidelines regarding criminal issues, together with examples:

a) What is criminal neglect?

Is the patient experiencing any of the following: a) suspicious or questionable injuries or death; b) unexpected and serious weight loss; c) severe dehydration; d) painful bed or pressure sores.

b) What is criminal assault and/or battery?

As disgraceful as it is, employees of residential care and skilled nursing facilities assault and batter residents every day.You may have to ask the right questions, because a fearful patient may endure abuse, rather than reveal it. If a patient is fearful, anxious, or talks about being hurt or bullied, listen carefully and observe. If there is widespread or serious bruising, bruising at unlikely sites, sprains or broken bones, or signs of over-medication, criminal acts may have occurred. Employees of nursing homes and residential health care facilities may not: a) threaten or strike patients; b) use unauthorized physical or chemical restraints. 

c) Mental abuse is abuse!

Certain levels of bullying, reprisal and threats rise to the level of criminal behavior or preface criminal acts. Mental abuse is as unacceptable as physical abuse.

d) What constitutes criminal financial exploitation? 

Nursing home and residential health care employees may not: a) wrongly remove funds from a resident's person, checking or savings account; b) accept or obtain a "loan" or "gift" from a resident; c) use a resident's personal information illegally to obtain credit cards (i.e., commits identity theft.) 

e) Define criminal sexual conduct.

No employee of a residential healthcare facility or nursing home may engage in unlawful sexual conduct with a patient (that is to say, sexual contact was non-consensual.) That distinction aside, any sexual contact between an employee and a patient/resident, consensual or not, should be a firing offense.

     If you are not satisfied with responses, or with the timeliness of responses, you may have to know how and where to report in your state and county. In a subsequent post we'll talk about reporting in Colorado and state-by-state.