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Elder abuse is a widespread but often under-reported problem. Studies show that only 1 out of every 14 cases of elder abuse are ever reported to the proper authorities. This statistic comes at the heels of data showing that citizens of the United States, and the world, are getting older. Worldwide, the percentage of adults aged 65 years or older is expected to triple to 1.5 billion people by 2050. In a recent survey, over 25% of Americans polled agreed that the growing number of aging adults is a major problem.

Currently, the elderly make up 15% of our nation’s population, and as mentioned above that number is expected to keep rising. If the trend of elder abuse and neglect continues to go unchecked, coupled with our growing population of elderly adults, more Americans will be subject to abuse in their lives. Abuse can take many forms including physical, financial, or sexual abuse.

Lawmakers in Tennessee and throughout the United States recognize the troubling trend of increased elder abuse are taking steps to ensure that our older adults are receiving the protection they deserve. In 2016, Tennessee lawmakers introduced legislation that created Vulnerable Adult Protective Investigative Teams in Tennessee, whose goal is to protect elderly and vulnerable adults. One way of accomplishing this goal is to promote information sharing between government agencies across the state.

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Healthcare fraud, specifically through programs like Medicare and Medicaid, is a major problem in the United States. In fact, it is one of the most prevalent types of insurance fraud committed each year. It is estimated that Medicaid fraud amounted to approximately $140 billion in 2016, while Medicare fraud was very close behind. So who foots the bill and gets hurt when fraud is perpetrated? In the situation of health insurance fraud in nursing homes, the victims are our loved ones.

Medicare coverage is broken into sections, starting with Medicare Part A. Part A covers inpatient hospital care, skilled nursing facilities (i.e. nursing homes), home health care services, and hospice care. Medicare is designed to assist persons over 65 years old and those who are disabled pay for medical expenses. For instance, an individual in a nursing who must undergo a procedure would only pay a percentage of the total cost. The remainder is billed by the medical provider to Medicare, who pays the provider an amount negotiated in advance for the specific procedure performed.

Medicare fraud can occur in a number of different ways. Some of the most common occurrences of fraud include phantom billing and kickback fraud. Phantom billing is probably the most obvious and widely committed type of fraud. This type occurs when healthcare providers bill Medicare for unnecessary medical procedures or procedures that are never performed. Unnecessary procedures can cause side effects that cause complications with a patient’s existing medical conditions. Billing for unnecessary medical equipment or tests also constitutes phantom billing. Kickback fraud refers to when another individual or facility receives some form of “kickback” for assisting in Medicare fraud. This could be criminals who steal patients’ Medicare numbers and data or medical providers receiving money for making false diagnoses or needlessly recommending a patient to another facility that will engage in financial fraud.

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Imagine being attacked by creatures with no way of escaping. The feeling of lying helpless as thousands of tiny insects attack your body, bite after bite. This nightmare became a horrific reality for one 84-year-old nursing home patient in East Alabama. According to reports, the patient was left unattended for over 11 hours, during which time she suffered over 100 painful ant bites. The victim, who was bedridden, was unable to move on her own or call for help, and she required constant care from nursing home staff. This incident led to an investigation by the Alabama Office of the Attorney General as well as three employees being criminally charged with elder abuse.

One nurse and two nursing assistants were responsible for caring for the patient on the night of the attack. All three were licensed to practice in Alabama and employed by Cherokee County Health and Rehabilitation Center, the nursing home where this occurred. A status chart for the patient showed that all three staff members had entered the patient’s room multiple times throughout the night, but surveillance footage revealed that none of the three ever actually entered the room for over 11 hours.

Following the investigation, the three employees were fired from the facility and charged with second degree elder abuse/neglect. Further, Cindy Cline, an Administrator for Cherokee County Health and Rehabilitation Center, confirmed that the incident was reported to the state and the board of nursing immediately.

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Elder abuse and neglect can take many forms. Abuse can occur physically, verbally, psychologically, or financially, while neglect can be reckless or intentional. Unfortunately, the news these days seems to be filled with reports of nursing homes abusing and neglecting their elderly residents. What may come to mind are the images of nursing home staff members physically assaulting the elderly or performing unnecessary and dangerous chemical restraints to subdue patients.

While many nursing home abuse cases involve caregivers harming patients, one particular incident in New York involved one patient abusing another. This occurrence took place last August in a nursing home in Buffalo, New York. According to reports, 82-year-old Ruth Murray was assaulted and beaten to death by another nursing home patient at Emerald South Nursing and Rehabilitation Center.

The tragic event occurred after Murray wandered into the room of an 84-year-old dementia patient. According to medical records, the attacker suffered from extreme dementia and, as part of his care plan, was supposed to be checked on every 15 minutes by nursing home staff.  At the time of the incident, however, both the victim and her attacker were unsupervised, which allowed the attack to take place. The New York State Department of Health cited the nursing home for failing to provide adequate care and fined the facility $10,000, its harshest fine.

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Nursing homes are meant to be places of safety and comfort for elderly adults, meaning they should feel assured at all times that they are receiving proper medical care, including specialized medical treatment when needed. It is natural for everyone to require more medical attention as they age. We trust that when we place our elderly loved ones in these homes that they will receive just as much care and attention from their healthcare providers as they would from their own family, if not more. Further, we trust that the physicians and nurses who treat our loved ones are adequately trained and proceed with the highest degree of skill and caution.

However, unfortunately, physicians and nurses do make mistakes. Due to the frail physical nature of many nursing home residents, these mistakes could lead to unwanted diseases that can ultimately cost them their lives. Medical malpractice is a complex branch of personal injury law whereby injured patients can recover against doctors, nurses, or medical facilities for their action or inaction in causing the patients’ injuries. In order to prevail on a medical malpractice claim, the injured party must prove that the healthcare provider breached the relevant standard(s) of care while treating or diagnosing him or her. Within the context of the medical field, the standard of care can comprise accepted practices and procedures of the medical community within a medical provider’s geographic area when treating similar patients with similar medical histories.

In order to recover compensation, just like in all personal injury claims, the injured party must prove that the breach of the standard of care caused his or her injuries. Common types of medical malpractice claims within the context of nursing homes can include misdiagnosis, prescription errors, ignoring patients’ medical needs, or an abuse of medical restraints. Qualified expert witnesses can review medical records and provide testimony needed to meet the plaintiff’s legal burden of proof in court.

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A nursing home in Idaho is facing a lawsuit and severe penalties following findings of neglect. Holly Lane Rehabilitation and Healthcare Center in Nampa, Idaho is one of the latest nursing homes to be hit with allegations of gross neglect of its residents. According to findings by state inspectors in 2016, residents of the home were dehydrated, left to sit in their own feces and urine, and frequently battled infections brought on by the neglect of the nursing staff.

87-year-old Jerry Carr has filed a lawsuit against Holly Lane and its parent company, Orianna Health Systems, which is based out of Bartlett, Tennessee. Carr is seeking undisclosed damages in excess of $100,000. In 2015, Carr had been living at Holly Lane for 12 years when he suffered a serious fall that required surgery and left him hospitalized for two months before he could return to Holly Lane. Upon returning to the home, Carr required constant and detailed attention from nursing staff. The lawsuit alleges many complaints of inadequate care from the facility and its employees.

Among his claims, Carr alleges that the nursing home and its employees did not change his clothes when he soiled himself, did not provide him with his prescribed pain medication, failed to keep him hydrated, and failed to take steps necessary to prevent the fall that caused his severe disabilities. As a result of the neglect, Carr contracted a MRSA infection, which to elderly adults like Carr, can be a death sentence.

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An Oklahoma woman has been charged with 17 different counts of elder abuse. Robyn McKinney owns and operates Branding Brook, an assisted care living facility in Vinita, Oklahoma. The facility specializes in caring for patients with extreme limitations or disabilities. Due to the extreme nature of many of the patients’ disabilities, they are unable to communicate or move effectively, essentially rendering them helpless and completely reliant on McKinney and her staff to take care of them.

This makes it all the more unsettling to hear reports that McKinney had been abusing these residents for years. McKinney, who was responsible for keeping track of residents’ finances and medications, had been psychologically and physically abusing residents by withholding their money and verbally attacking them, according to complaints made by residents. Reports further claim that McKinney had even put a padlock on the facility’s refrigerator. This knowledge comes at the heels of a 911 call placed by someone who reportedly witnessed McKinney attack and bite a resident on the nose.

One of the only ways to stop nursing home abuse from happening is to report it. Reporting can come from a resident, a resident’s family member, or an employee who witnessed the abuse or neglect of a patient. Reporting nursing home negligence is critical because it only becomes more of a problem the longer it is allowed to continue. Unfortunately, facilities that neglect patients continue to operate daily. Elder abuse is all too prevalent, and often under reported. A study found that 30% of nursing homes in the United States were cited for almost 9,000 instances of abuse over a two year period. This same study also found that the percentage of nursing homes cited for abuse has increased every year since 1996.

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The transition to living in a nursing home can be overwhelming and stressful. A change from independent life to assisted living often makes our elderly loved ones angry, frustrated, and anxious. It is no surprise that before nursing homes were so heavily regulated, the use of sedatives as a means to calm rowdy patients was a widespread practice. Using sedatives to calm an elderly nursing home resident is referred to as “chemical restraint,” and it involves the use of potent antipsychotic and other psychoactive drugs to involuntarily sedate unruly patients.

Common types of sedatives are benzodiazepines and antipsychotics, which tend to produce a calming effect. Around 300,000 nursing home patients are receiving some kind of antipsychotic drug to combat the anxiety and aggression frequently found with dementia as a byproduct of Alzheimer’s disease. Drugs like Seroquel and Risperdal are effective in the fight against dementia and other psychotic disorders, but should only be used as a last resort. Additionally, Federal and state laws prohibit the use of chemical restraint for the convenience of nursing home staff. Chemical restraint may only be used if patients pose a threat to themselves or others. Federal and state regulations have done wonders to prevent doping of healthy patients, but cases of unwarranted chemical restraint are all too common.

For example, a lawsuit was recently filed in Chesapeake, Virginia, accusing nursing home staff members of practicing chemical restraint. 84-year-old nursing home patient Alice Mackey claims that she was tied down by two nurses and injected with a heavy sedative. Mackey claims that the restraint was purely to “silence” her. After she was sedated, Mackey was left bound to a wheelchair for the remainder of the night, where she ended up urinating on herself and was left to sit in her own filth.

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The dreaded phone call comes, and you just cannot believe that it could be true. The call comes from a loved one who resides at a nursing home. The loved one tells you she has been sexually assaulted by one of the nurses or caregivers at the facility. The disturbing trend of nursing home employees sexually assaulting patients is becoming more and more widespread. Even harder to believe is that some nursing homes go to great lengths to cover up sexual abuse or quickly dismiss these allegations instead of conducting a meaningful investigation to find the truth.

It is well known why people are placed in nursing homes in the first place. For starters, they are unable to live independently and adequately care for themselves. Loved ones may not be able to provide them with the necessary care either. Oftentimes, nursing home residents are elderly, sick, and disabled. They have medical conditions preventing them from driving and functioning independently, including Alzheimer’s and dementia. Others have medical conditions requiring them to be monitored 24/7.  Some patients are wheelchair-bound which completely limits their mobility.

Sexual abuse is one form of nursing home abuse. When sexual predators are allowed to work in nursing homes, they are given an opportunity to prey on residents in their most weakened states. For example, a male nursing aid in Minnesota was sentenced to eight years in jail for raping an 83-year-old nursing home patient who had dementia. He was caught molesting the woman in her bed at Walker Methodist Health Center. The eight year sentence was one year more than what prosecutors were seeking. In defense of the sentence, the judge noted how the nursing aide “violated a position of trust” when he abused the patient.

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A recent study shows that delirium can be linked to mortality rates in nursing homes. The report, authored by Dr. Martin M. Forsberg of the Rowan University School of Osteopathic Medicine, found that roughly 18% of the nursing home population suffers from delirium. Delirium is a serious disturbance in mental abilities that results in confusion, abnormal thinking or behavior, and affects perception, attention, and mood. Another characteristic of delirium is restlessness.

At first glance, the signs of delirium may look a lot like dementia, which is a byproduct of Alzheimer’s disease, but the two are different conditions. Dementia as a result of Alzheimer’s primarily affects an individual’s memory and intellectual abilities, while delirium is displayed more in abrupt spurts of confusion. One key difference is inattention, as individuals suffering from delirium have trouble focusing on one idea or task. On their face, the two conditions may appear almost indistinguishable, which is why many nursing home patients who suffer from delirium are misdiagnosed as having Alzheimer’s, which means they do not receive the proper medical care.

The two also differ by how they are brought on. Dementia as a result of Alzheimer’s is not always a normal part of aging. Currently, there is no cure for Alzheimer’s. Delirium, on the other hand, is normally caused by a combination of factors that make the brain vulnerable and trigger a malfunction in neuropathic activity. There may be a single contributing factor or a combination of factors including malnutrition, dehydration, sleep deprivation, emotional distress, chronic illness, and surgery or other medical procedures that involved anesthesia. For instance, a patient may suffer from a serious illness while simultaneously facing neglect from caregivers. Certain environmental factors may play a role in delirium. For example, the absence of a clock, television, or phone in a nursing patient’s room has been found to worsen the symptoms of delirium.

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