Monday, March 23, 2009


We're all becoming adjusted to calling "nursing homes" elder-care facilities, or assisted-living care centers, etc. But did you know that often, these homes are a depository for severely mentally ill people?
Read on, and learn what to look out for. From the Associated Press:
AP IMPACT: Mentally ill a threat in nursing homes
By CARLA K. JOHNSON, AP Medical Writer Carla K. Johnson, Ap Medical Writer

Sun Mar 22
CHICAGO – Ivory Jackson had Alzheimer's, but that wasn't what killed him. At 77, he was smashed in the face with a clock radio as he lay in his nursing home bed.
Jackson's roommate — a mentally ill man nearly 30 years younger — was arrested and charged with the killing. Police found him sitting next to the nurse's station, blood on his hands, clothes and shoes. Inside their room, the ceiling was spattered with blood.
"Why didn't they do what they needed to do to protect my dad?" wondered Jackson's stepson, Russell Smith.
Over the past several years, nursing homes have become dumping grounds for young and middle-age people with mental illness, according to Associated Press interviews and an analysis of data from all 50 states. And that has proved a prescription for violence, as Jackson's case and others across the country illustrate.
Younger, stronger residents with schizophrenia, depression or bipolar disorder are living beside frail senior citizens, and sometimes taking their rage out on them.
"Sadly, we're seeing the tragic results of the failure of federal and state governments to provide appropriate treatment and housing for those with mental illnesses and to provide a safe environment for the frail elderly," said Janet Wells, director of public policy for the National Citizens' Coalition for Nursing Home Reform.
Numbers obtained through the Freedom of Information Act and prepared exclusively for the AP by the Centers for Medicare and Medicaid Services show nearly 125,000 young and middle-aged adults with serious mental illness lived in U.S. nursing homes last year.
That was a 41 percent increase from 2002, when nursing homes housed nearly 89,000 mentally ill people ages 22 to 64. Most states saw increases, with Utah, Nevada, Missouri, Alabama and Texas showing the steepest climbs.
Younger mentally ill people now make up more than 9 percent of the nation's nearly 1.4 million nursing home residents, up from 6 percent in 2002.
Several forces are behind the trend, among them: the closing of state mental institutions and a shortage of hospital psychiatric beds. Also, nursing homes have beds to fill because today's elderly are healthier than the generation before them and are more independent and more likely to stay in their homes.
No government agency keeps count of killings or serious assaults committed by the mentally ill against the elderly in nursing homes. But a number of tragic cases have occurred:
• In 2003, a 23-year-old woman in Connecticut was charged with starting a fire that killed 16 fellow patients at her Hartford nursing home. A court guardian said Leslie Andino suffered from multiple sclerosis, dementia and depression. She was found incompetent to stand trial and committed to a mental institution.
• In 2006, 77-year-old Norbert Konwin died at a South Toledo, Ohio, nursing home 10 days after authorities said his 62-year-old roommate beat him with a bathroom towel bar. Sharon John Hawkins was found incompetent to stand trial.
• In January, a 21-year-old man diagnosed with bipolar disorder with aggression was charged with raping a 69-year-old fellow patient at their nursing home in Elgin, near Chicago. A state review found that Christopher Shelton was admitted to the nursing home despite a history of violence and was left unsupervised even after he told staff he was sexually frustrated.
Jackson's roommate was 50 and had a history of aggression and "altered mental status," according to the state nursing home inspector's report. Solomon Owasanoye wandered the streets before he came to All Faith Pavilion, a Chicago nursing home, and he yelled, screamed and kicked doors after he got there.
On May 30, 2008, he allegedly picked up a clock radio, apparently while Jackson slept, and beat him into a coma. Exactly what set him off is unclear. Jackson died of his injuries less than a month later. Owasanoye pleaded not guilty to first-degree murder, and after a psychiatric review was ruled unfit to stand trial. He now lives in a state mental hospital.
All Faith Pavilion co-owner Brian Levinson said his staff is trained to deal with aggressive behavior, and he disputed state findings that Owasanoye had a history of aggression. The for-profit nursing home was fined $32,500 for failing to prevent the assault.
Under federal law, nursing homes are barred from admitting a mentally ill patient unless the state has determined that the person needs the high level of care a nursing home can provide. States are responsible for doing the screening. Also, federal law guarantees nursing home residents the right to be free from physical abuse.
Families have sued in hopes of forcing states to change their practices and pressuring nursing homes to prevent assaults. Advocates say many mentally ill people in nursing homes could live in apartments if they got help taking their medication and managing their lives.
The problem has its roots in the 1960s, when deplorable conditions, improved drug treatments and civil rights lawsuits led officials to close many state mental hospitals. As a result, some states have come to rely largely on nursing homes to care for mentally ill people of all ages.
Also, mixing the mentally ill with the elderly makes economic sense for states. As long as a nursing home's mentally ill population stays under 50 percent, the federal government will help pay for the residents' care under Medicaid. Otherwise, the home is classified a mental institution, and the government won't pay.
In Missouri, more than 4,400 younger mentally ill people are living in nursing homes, in part because of a state program that helps the elderly stay in their own homes longer.
Nursing homes "are looking at 60 to 70 percent occupancy, and the statistics tell us they've got to be in the 90s to operate successfully," said Carol Scott, the state long-term care ombudsman for 20 years. "They're going to take anybody they can."
Gaps in staff training leave the homes inept at handling the delusions and aggression of the mentally ill, said Becky Kurtz, the state long-term care ombudsman in Georgia, where nearly 3,300 younger mentally ill people live in nursing homes.
"Often they'll say, 'I hate it there. I'm angry. I don't want to be there.' Sometimes the behavioral issues are the result of being ticked off you're in a nursing home," Kurtz said.
Pat Willis of the Center for Prevention of Abuse said she has seen elderly residents terrified by younger, mentally ill residents who scream and yell, day and night. "The senior residents are afraid," Willis said. "They would prefer to sit in their rooms now and keep the doors shut."
Nursing home operators say protections against frivolous transfer or discharge keep the homes from throwing out some mentally ill residents.
"Many times, the nursing home's only option becomes dialing 911," said Lauren Shaham, a spokeswoman for the American Association of Homes and Services for the Aging.
I hope anyone reading this who has older parents or other loved ones they must provide care for, will pay attention to this article. Perhaps we all should think long and hard about what care we can offer our loved ones, in their own home--or ours--if possible.
There are many caring nurses, nurse-assistants, and even volunteers(through various charities and houses of worship) who are happy to lend a hand. I have already begun setting up what I've termed my "Structure Of Support" (SOS) as I call it--a list of friends, neighbors, relatives I know I can count on, for when times get rough.
And remember to "be there" for the friends, neighbors, relatives who ask for YOUR help, too. It feels good to be of service--and not just because you might need help yourself one day. It feels good, because you know you're doing the correct thing. Every time we choose "goodness"over apathy or neutrality, we feel better. Try "goodness"--I guarantee you'll feel better when you wake in the morning, and everyone else will breathe eassier, too, because you're helping to carry their burden, and they will feel your love, your "goodness".
A few groups to contact, for help(Please note: you don't need to be Roman Catholic to utilize the free services offered by Catholic organizations):
Catholic Charities:
Volunteers of America:
Little Brothers--Friends Of The Elderly

Peace, kids.


Georg said...

Hallo Lisa,

This kind of problem will be aggravated in the coming years for demographical reasons.

The only way out I see is to make legal provisions people can painlessly end their own life if they wish to do so.

Like the old guy in Soylent Green who who slept into nothingness with Beethovens 6th Symphony and a panoramic video showing a wheat field at sunset.


an average patriot said...

With no more insane asylums they dump them where they can. My wife's parents are both in the same one and one of her Father's room mates messed up but for now just sits there. I have a friend who was in one and was lucky enough to come back out. She is 86 now and does she ever have some horror stories!

Lisa Allender said...

Hi Georg--Thanks for your input. I think it's fine for someone to choose "no artificial means"(tubes, ventilator, etc.) to extend their life, and choose to die a "natural" death, but I do not believe suicide is a viable option, for anyone. This kind of thinking leads to what the Catholic Church has called our world's "culture of death". Certainly, a person in severe pain should be offered as much medication as they want, but for someone to choose death instead of life?
I believe where there's life, there's always, hope.

Average Patriot--Thanks for commenting. I know there are many horror stories, which is why we ALL need to be aware of the choices/provisions/networking we can make now, while we and our families are healthy.

Dave Dubya said...

I worked in a psychiatric setting for 30 years and have a lot of personal experiences in the field. Some were very therapeutic and productive, and others were nightmares of handling out-of-control violence. I still walk with a limp from one such incident.

This story proves even more a dire need for universal health care. We will not be a civilized country until we get it.

Don't Feed The Pixies said...

Unfortunately many institutions such as nursing homes are still being run for profit above care and the actual treatment of the people staying there is hit and miss.

A recent expose of day care for children showed how easy it is for someone with no qualifications or experience to get in to a job there. My friend recently had to take nearly 18 months of work due to being worked to the bone at a care home.

We also have "care in the community" which often leaves people alone to cope as best they can with an elderly relative. With an increasingly aging population its way past time something was done.

Still - we should perhaps remember that its only 50-60 years since people with mental health problems were left alone in cold rooms in the hope that they would die from influenza

Lisa Allender said...

Dave Dubya--Thank you for your unique perspective on this subject.Sorry to hear you suffer from injuries incurred in such settings...I'm with you! Options for Universal Health Care, for sure!
Pixies--Hi, thank you for commenting.It IS scary.
And you're right--"dumping" the mentally ill(which has been done for years) and the elderly(common the past 20 years or so) has become the "norm", and it does not have to be like this.