We have rarely gotten the volume of responses to a blog like the one posted by Laurence on the Senior Watchdog.  Almost all were professionals who had worked in senior care facilities or hospitals and had personally witnessed the over- or under-drugging of patients.  Some agreed, but asked that we consider the state of our healthcare system and the pressures that are on the people who work within its sometimes impossible constraints.  One reader took us to task and we want to share her letter with you.  This is what Bobbi had to say:

Seniorcide.......you have to be joking......before you put information that is misleading onto your web site I suggest you know what you are talking about and be a bit more realistic in your information.

50-60 percent of all seniors die within two years of placement in a nursing home..........yes, a very true statement. BUT what you are NOT saying is that the percentage of seniors you are referring to have multiple complicated health issues and often are at the end stage of their diseases.  The average age of seniors placed in nursing facilities is 70-80 years of age WITH complicated medical issues.

Alzheimer's - basically the same as above, when persons get to the end stage of this disease many other health issues arise.

Long Term Care Insurance quotes that the average length of stay in a nursing facility is 3 years.  WHY....because it is nearer the end of our natural lives.

Bedsores.....are you aware that these do not always occur from neglect of care but often are medically unavoidable due to numerous complicated health issues that deteriorate the body's ability to maintain healthy viable skin?  Nutrition and blood circulation problems can affect a person's skin integrity and over all health in many ways.

Do you realize that many nursing home state tags for abuse are mostly paper compliance issues?  I do agree that their are "BAD" nursing facilities and it is the families' responsibility to tour, investigate and know the facility they are choosing for their loved one.

Staffing Levels.......I have been involved with nursing facilities since 1989....not once has our Federal government increased the amount of staff hours they require for good quality nursing care, yet they continue to place more PAPER compliance on the staff to prove they are giving quality care and following regulations.  To compound this, the acuity level that seniors are entering nursing facilities is much higher than 20 years ago...YET the government has not REQUIRED that the nursing companies increase the staff ratio; therefore, the owners/operators are not going to increase staffing to adequately meet the change in levels of care so that staff may provide quality care.  To compound this further the government continues to cut the reimbursement for care given while continuing to demand higher standards and in some states the facility may wait up to six months to receive payment for services rendered all the while, still having to pay utilities, food and staffing to provide care to our seniors.

Physical and Chemical Restraints - are you aware that these are highly regulated and monitored by our public health?  Physicians must give an order to administer, specific documentation must be in place on alternate methods attempted prior to using either type of restraint first, and when either type is used they have to be assessed regularly and decreased as quickly as possible.  Physical restraints in a nursing home are basically never heard of other than alarms notifiying staff they have put themselves at risk for fall by getting up. 


ALSO.....if you are going to list star ratings on your website, please update as freqently as Medicare does so that the correct up to date information is displayed.  Anyone can list ratings but it is not good to your customer if it is not the correct updated results.

Your efforts to protect seniors may be better spent if focus was put on hospitals which are much less regulated in areas of chemical and physical restraints, notification to families of changes in medications and overall conditions and overall basic care.  They pretty much are allowed to do as they feel is in the best interest of the patient, whether the family is in agreement or not.  And that is just the beginning of the tip of the iceberg in regards to hospitals........maybe someday you will find yourself flat on your back unable to even lift your head and have to depend on hospital staff for everything.......believe me, care, attention and response time is certainly no worse than the worst nursing home.  

In response to the comment that we should “KNOW WHAT THE HELL WE ARE TALKING ABOUT,” I visit more than 250 nursing homes, residential care facilities, assisted and independent living facilities each year.  Most are in the central region of the country and few hospitals are on my list.  In many the owners and staff are dedicated care providers and are simply constrained by the system and funds available.

But more than a few are badly run with uncaring staff.  I also hear from many readers about abuse.  I have witnessed patients who are sitting or lying in soiled diapers for extended periods, talked with physicians who admit to over-medicating patients when pressured by staff, overheard disrespectful and abusive language from staff toward patients and heard from many managers that dismissal of staff for pilfering medication is fairly common.

Medicare is the only national rating system.  Our technology isn’t automated, so the data must be pulled by hand.  So it isn’t easy for us to update and it s only done twice each year.  However, should a rating be found to be inaccurate or outdated we will gladly make changes that are brought to our attention in the interim.  Bobbi is correct in stating that the errors noted during inspections may simply be paperwork.  Also, the ratings from state-to state showed dramatic differences.  Where one state might have the majority of homes ranked a level four or five overall another might have that same percentage ranked at a one or two.   Whether this is a sign of a varying degree of standard compliance from state to state or the level of scrutiny of the investigators involved I cannot say.

But one thing is clear.  Many caregivers are amazing creatures who deal as best they can with the physical and emotional pain of the people in their care.  And Bobbi is right about another thing.  I am likely to find myself flat on my back unable to lift my head and dependent on a hospital staff for everything.  And, frankly, it scares the hell out of me.

In contrast to Bobbi’s letter, we also heard from many individuals who wanted to report tragedies that they claim to have experienced.  Here is one such letter from Carl in New York.

My wife works at (name unpublished here) and comes home with horror stories of neglect and mistreatment of elderly patients by other employees. My wife is a 3pm-11pm supervisor and it's hands-down the toughest shift. You get admits, feeding time, recreation, showers, med pass and more just on that shift, which is already buzzing with activity due to the fact it's in the middle of the day. I worry about my wife's nursing license being tainted from some slacking RN, LPN, or aide's mistake. And the close-calls are daily. Not to mention that two admits dies over the past two months within 24 hours of being admitted. One was apparently a situation where the new trainee gave the wrong medication to a resident. And the nurse’s aides and other employees pocket the patients' Xanax because they think the patient has dementia…

At Great Places, Inc. we are most grateful for your support and feedback.  Please continue to share your thoughts with us!

I’m mad as hell about the way our elderly population—our parents, relatives, our senior relatives and friends—are shoved aside, tormented, victimized and abused.  This, the so-called “mature” or “silent” generation, has lived through World War II and the Great Depression.  They consider themselves to be moral, value-driven and honest.  

Our seniors also tend to trust strangers.  They’re the easiest targets for sweepstakes scams, door-to-door flimflams, pyramid schemes and every other conceivable hoax. They’re also the most likely victims of mistreatment and brutality, often at the hands of their “loved ones.” And older Americans are less likely to complain because they’re too ashamed to admit they’ve been hustled or abused.

A so-called “victimless” crime is an activity that violates the law but doesn’t cause harm to a victim. Gambling is a good example: Although the conduct is criminal, the gambler isn’t hurt by it—except, perhaps, financially. That’s why “victimless” crimes are considered to be consensual. For some reason, our society treats offenses against seniors as if they are victimless crimes. Well, they’re not, and we’re mad as hell!

Why, you may ask, are we so angry about how our seniors are treated?  Here’s just one example:  The plight of defenseless seniors committed to nursing homes.

Nursing homes are where we send our frail, helpless elders to suffer. And die. In that order: suffer; die.  Remember the stories about how Eskimos deposited their elders on ice floes and sent them out to sea? This practice, which was uncommon, ended in 1939. American nursing homes, on the other hand, continue to enjoy a booming business:  today, there are 1.5 million Americans in these hellish places.  

If you think that a nursing home is where frail, helpless elders will enjoy “nursing” that will return them to health, or if you think that a nursing home is like “home,” well, that’s because you’ve never visited one. Consider these facts:

·        One-quarter of all deaths in this country happen in nursing homes. Between 50 and 60% of people admitted to care homes die within the first two years. At least half of Alzheimer’s residents die within the first 12 months;

·        Every year, 30% of nursing homes are cited for instances of abuse, ranging from death to malnutrition, dehydration, bedsores, falls, inadequate medical care and excessive chemical and physical restraints, to name only a few;

·        Forty-four percent of nursing home residents suffer abuse. 48%—almost half!—report that they’ve been treated or handled “roughly.” About 40% say they’ve seen other residents being abused;

·        Fewer than 20% of nursing home abuse cases are ever reported;

·        Ninety percent of U. S. nursing homes have staffing levels that are too low to provide adequate care for their residents.

Go ahead, if you dare, and commit mom and dad to a nursing home. But when you do, you know there’s a 50-50 chance they’ll be abused there and die in a couple of years or less. You’ll want to say your good-byes early and often.

Here at Great Places, we’re mad as hell about how American seniors are treated. If the outrages committed against seniors in nursing homes—the physical, sexual and emotional abuse perpetrated by on-site personnel, for example—occurred in the general population, you can imagine how the media, the politicians, and the general public would respond.

We’ll identify and expose the villains—the people, the companies, the institutions--who commit these offenses. We’ll provide the details. We’ll name the names. We’ll post the mug shots.

I’m betting that you’re mad too. We’ve dedicated ourselves to ensuring justice and fair treatment for the nearly 40 million of our elders. 

That’s it from Laurence Harmon, your Senior Watchdog.  I’m on the case.

I’m mad as hell about the way our elderly population—our parents, relatives, our senior relatives and friends—are shoved aside, tormented, victimized and abused.  Our seniors are also the most likely victims of mistreatment and brutality, often at the hands of their “loved ones.” And older Americans are less likely to complain because they’re too ashamed--or unable--to describe how they’ve been hustled or abused.

I've introduced you to 
Brianna Broitzman, the Albert Lea, Minnesota nursing home “caregiver” who was charged with 11 criminal counts for abusing and sexually humiliating elderly residents suffering from Alzheimer's and dementia. Broitzman pleaded guilty, and was sentenced to 180 days in jail. 

Today, the Senior Watchdog shines the spotlight on Ashton Larson, Broitzman’s co-defendant and co-conspirator.  Both were charged with spitting into residents’ mouths, groping their breasts and genitals, among other abusive crimes

Larson also admitted to getting into bed with a resident and making “humping motions,” and inserting her finger into a resident’s rectum, claiming that she was trying to initiate a bowel movement. 

Broitzman admitted that she and Larson took photos and made videos of these helpless residents “for fun.” 

Michael Larson, Ashton’s father, was interviewed on
NBC TV’s “Today” show shortly after the arrest.  He claimed that some of the allegations against his daughter were not “as they appear” and “have been distorted” in the news accounts of the charges.  He added, "My daughter was doing nothing more than performing the duties of her job." (The Senior Watchdog wonders if Ashton's duties included any humane treatment of her victims.)

Perhaps as an attempt to explain or justify her conduct, on the day the charges were filed and the mug shot at right was taken, Ashton Larson wrote on her MySpace page "i hate when there is nothing to do ... i cant stand being bored ... ah its fun gettin to know new people ... im up for anything."

Here's the
criminal complaint that charged Larson with her crimes. 

We at Great Places are appalled every time a senior is a victim of a crime.  That's why we'll name names, publish mug shots and describe in detail the kinds of crimes that are committed against them.  Brianna Broitzman and Ashton Larson are only two of the vicious criminals who specifically target helpless elders.  There are dozens--hundreds--of others like them.  THE SENIOR WATCHDOG is on the case.

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