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Suppose I see someone with a health concern that doesn't appear to be getting adequate attention, in fact it has become alarming worse. I don't know his mental status but I think there is some level of cognitive impairment. I don't know if he has someone to advocate for him or if his advocate is fully aware of circumstances. I fully acknowledge I don't have all the facts, I only know what I see right in front of me. I know (at least I'm fairly certain) that if I speak I will be patronized and told it isn't my concern. It is hard for me to sit on my hands when I would be raising hε!! if it were my mother. What would you do?

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I would address my concern to the social worker at the facility, telling her/him that you know they can't give you any information, that you want to make sure that someone has looked into his Health issues.
(17)
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Cwillie,
I'd definitely let someone know - maybe not DON but whichever nurse you've built a relationship with or if not then the social worker 

Sadly, I've seen situations go way beyond any reasonable sense and I know others who visit daily have spoken up too 

Caregivers aren't always knowledge and will get folks up after a fall even if there's a broken bone involved 

If there's no response or the situation deteriorates then an anonymous call to the ombudsman ?
(5)
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Ultimately we all have to live with ourselves and it sounds like you’re going to have a hard time with this if you don’t speak up. Talk to people you trust at the facility, hopefully you’ll see a change, and at the least you’ll be able to know you tried your best
(5)
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I suppose that I have a different take on it. If the person that I am concerned about is my family member, then, I'd address the director of the facility with a very serious immediate meeting. However, if I have no connection to this person and have just observed them......I'd probably be worried about repercussions. So, worst case scenario, you discuss it with the social worker or director and then nothing happens. So, now, you have to go over their head and when it gets reported, they know it was you. It might cause me to report it anonymously to adult protective services and the state agency that regulates the facility. I think you can do both without revealing your identity. IMO, ensuring that seniors, children and disabled are properly cared for is everyone's business.
(12)
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CW,
There was an LVN that was working to get her RN at Mom’s NH. When Mom went into NH We hit it off. She really did love my Mom.

She was moved to another wing to care for more medically compromised patients. But everyday she worked she checked on my Mom even though she no longer worked on Mom’s wing. She let me know if there was ever any concerns that weren’t being addressed with Mom.

I did track her down a couple of times and fill her in on a couple of situations on my Moms wing that didn’t concern my Mom but other residents welfare I guess you could say.

The Director of Nursing was unapproachable and just nasty if you could ever find or reach her. She disappeared and a new awesome DON came on board Moms last 6 months alive. I would not have hesitated to talk to her about anything I saw.

You just can’t “unsee” some things you witness in NHs. Especially if the patients don’t have regular visitors. I’m sure you are there often enough to know which patients around your Mom have no Advocates.

Not that it’s you job to become their Advocate but if you see something unsettling you should be able to mention it to a staff member you feel close to or an ombudsman.

You have a big heart!
(6)
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So...
I spoke with a friend who works there, she feels the same way as I do. BUT his family is aware therefore it is up to them - so there is nothing more that can be done. (I wish I could get the family and doc together and bang some heads)
(8)
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CWillie,

You obviously care, and everyone that knows you realizes your concerns are valid.

So, for you, I would recommend the report to the NH Ombudsman.


If it were me, I would speak direct to the patient, find out more.....even if the staff told me not to.


When visiting a rehab, a patient was calling out, distressed, "I'm hungry". I looked over (3 beds in this room, separated by a curtain), as the patient I was visiting shook her head "No" at me.

I told the lady that someone would be coming shortly, and that I would tell the staff. The patient crying out stopped, and rested. And as I left, I did tell a staff member.


What, as compassionate humans, we should no longer speak to others?

f r e e. s p e e c h i n. A m e r i c a ..


I know you will be doing the right thing.
(2)
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Send, I am satisfied that this man has an advocate, I had feared he had no one or that his family hadn't seen him recently. My understanding is that he is waiting to see a specialist, I personally would not be so accepting of the wait but it isn't my decision.
(6)
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cwillie, so glad you found out more!
That was a good thing, imo.
(3)
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Remember, see something wrong, say something.
(3)
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cwillie, what a good thread and I’m glad you got to the point you have, bless you. He deserved that. I join with you and others here, we speak up for those around us! Maybe, maybe, you will have a chance to put a gentle word.. maybe by way of query.. in the ear of one of the family members at a particular moment. So many of us get held back by perceptions of authority, and they may not see options *they* have to speak up, and may be much less educated about the system than you. Good luck, thank you for caring.
(2)
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Okay.

I was in two minds about sharing this story but I'm not now.

Daily Telegraph, Wednesday 25th April 2018

Headline: Woman died after daughter left her in chair for up to a year.

An elderly woman died after her own daughter left her sitting in a chair for up to a year in a house they shared.

Linda Farr, 68, failed to get medical help for Doreen Shufflebotham, 86, who suffered from a string of serious health issues.

A court heard how medical experts estimated the pensioner had not moved from her chair for between eight and 12 months before her death on Sept 6 2016.

Ms Shufflebotham suffered with a catalogue of injuries including a fracture and infection of the femur, a pulmonary embolism, sepsis, deep vein thrombosis as well as acute bacterial meningitis.

Farr was arrested three days after her mother's death at the £300,000 bungalow they shared in Fenton, Stoke-on-Trent, Staffs. She was charged with gross negligence manslaughter and pleaded guilty at Stafford Crown Court in March.

However, at the same court she avoided jail yesterday and was instead handed a 20-month prison sentence, suspended for two years.

Following the hearing, Detective Inspector Dan Ison, of Staffordshire Police, said: "It is very upsetting to hear the extent of negligence in this case. Doreen's injuries were incredibly severe and she must have experienced terrible pain in her last few months as she became increasingly ill.

"This was a very traumatic experience for our investigating officers and I would like to praise their professionalism in the face of horrific injuries and conditions.

"I hope this raises awareness in others that appropriate medical advice should always be sought, especially if an elderly person is involved."

Staffordshire and Stoke-on-Trent both have form when it comes to health scandals. Both authorities, I am sure, will have promised the public that "lessons have been learned."

Apparently not.

In eight months...

How many people noticed that Ms Shufflebotham wasn't around as usual and either didn't ask or didn't ask twice?
How many people called at the house? - can you imagine the *smell*?
How many people talked to Linda Farr and asked how she was getting on?

How many people, I'm getting at, decided it wasn't any of their business?

Much easier to blame the daughter. Then we can feel even better about ourselves by being compassionate to the daughter and acknowledging how much strain she was under.

That woman rotted to death over months, but oh well. You can't interfere, can you.

This story is extreme, obviously. But this and things like it happen day in, day out, year in, year out and yet we NEVER learn.

SEE SOMETHING. SAY SOMETHING.
(7)
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I wish you hadn't shared that CM.
😟😟😟
(1)
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CM, did I understand that story wrong? The daughter did that to her mother and basically got an 'out-of-jail' card? No jail time? "...handed a 20-month prison sentence, *suspended* for two years." No punishment for pleading guilty to gross negligence manslaughter?

If that's the case, there's no deterrent for others to avoid doing wrong since even if they're caught, they will get no jail time, just a slap on the wrist.
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Make an example of her, Book? So, what, so that all the daughters who can only be prevented from confining their mother to a stinking armchair for months on end until their agonised death by fear of a jail sentence will be sent the right message?

What do you suppose the inside of that daughter's head is like right now, today? She sat and watched her mother decompose for months. Those bungalows aren't that big. Probably two bedrooms, living room, dining room, kitchen, bathroom, hall all on one floor.

It's easy for us to think "why the f*** didn't you call an ambulance, dumbo?"

I'm going to look up serious case reviews and see if there was one. But I can tell you what would have happened if the daughter had rung a typical GP. She'd have been told they don't make house calls; and she wouldn't have known a) that you can argue and b) how to argue; and she wouldn't have known who else to call.

She didn't know what to do. So she didn't do anything. And the longer she didn't do anything, the more terrified she became that she didn't know what to do. And Nobody Paid Any Attention.

I would want their phone records, their bank statements. I want to know who they were in contact with for the full two years before the mother died, so you can compare before and after the leg injury and judge how hard everybody around had to work just to ignore what was happening.
(2)
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Oh it gets better and better.

Message from Google when I typed in serious case reviews and the name...

"Some results may have been removed under data protection law in Europe."

I'm sure no individuals were to blame and Lessons Have Been Learned. That's the usual conclusion.
(2)
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Sounds like your concerns should be addressed to Ombudsman. Contact info should be posted by NH in a place that's clearly visible.
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This happened to me, kind of...when my mother was in skilled nursing home...the Haitian nurses or workers there did not like my mothers bedmate - at all...with due reason...she had dementia and would hit or call names to the Haitians, obviously my mother’s bedmate might have been prejudiced..she would not want them to touch her or anything...she would throw her food tray, when they tried to serve her...well, this was a big no bueno for this bedmate because they ended up not treating her very well..my mother was witness to it,,so my mother told me what was going on..and then I contacted this bedmate’s daughter...my mother told the daughter to call me and to that end, I told the daughter everything..I told the daughter that I did not want repercussions to my mother so to ensure that nothing is said about mom or I. She did that. The daughter reported it to appropriate people there, but it was too late anyway, her mother ended up dying - due to the nurses there. One thing I have learned...and which to was my mother’s benefit is my mother is French and Haitians speak French (Creole)...they love when white people speak their language so my mother had an advantage...but what I have learned,,,is when someone is in a nursing home, you do EVERYTHING YOU CAN so they like you...big job for an elder with dementia like mom’s bedmate and it’s terrible you have to be that way...but my mother constantly said “thank you” and “please” and all those cordials you can think of and it works.
(2)
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I agree with the others - ALWAYS say something.

If you're concerned, you can always start with: "you might know about this, but I need to know that you know....."
(3)
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I would send notice in writing to the higher ups as high as possible and let them know your concerns. They have more to lose and would investigate thoroughly.
(1)
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This isn't a case of me seeing overt abuse, the gentleman in question has a growth that you couldn't miss unless you were blind and it is growing at an alarming rate. I know that even supposedly "harmless" squamous cell skin cancers can be deadly if they are neglected, I'm wondering what they are waiting for and if the oncologist that is making him wait has any idea he has more that a tiny lesion.
(3)
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Even trickier, CW. How long before he gets seen, do you know?

Is there any possibility of your just "happening" to fall into casual conversation with any family members..? So that you could shake your head in sympathy and say goodness me, perhaps if it were REPORTED TO the oncologist how RAPIDLY this is developing you'd think he could bring the appointment forward, ON REQUEST, wouldn't you...? and try not to poke them in the face or dig them too hard in the ribs.

Takes me back to watching my best friend's children's ringworm get more and more florid, while I assumed that... it's bright red and in a ring formation... what did you think it was..?

Stone me, turned out she'd had absolutely no idea and was desperately searching her house for allergens.
(2)
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As a Christian you should report it an eldercare advocate. If a person cannot speak for themselves there are advocates to help them. Abuse should not be tolerated on any level of care. Please treat this situation as if it was your loved one and help them. Contact them and report the nursing home anonymously. God will bless you for helping someone who cannot help themselves.
(0)
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CM,

Let's look at the other side for a moment. Was the woman mobile. Me personally Don't want to be stuck in a wheelchair all day. They are not that comfortable. Could she sleep in a bed? My MIL chose to sleep in a lounge chair because of her hips. It said £, I am assuming this is England. Does England provide in home services? Was the mother refusing to see a doctor. I have heard it takes months to see a Specialist?
Yes, I agree, it may have been abuse. Just showing that it's not always the caregivers fault.
(1)
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A thought just popped into my head. How old is the man? Maybe the family has chosen not to do anything. He may have a bad heart and can't be put under. Maybe other health issues. The NH abides by the family and doctor's wishes. Just saying.
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What ever the why, when in doubt - speak out.

If retribution is a concern I would just contact APS, they investigate and ensure the facility that people are watching.
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This specific situation seems to have been addressed by talking to a staff member who said the patient's family is doing something. Perhaps the family could use a hint; but without knowing the patient's health directives, you could be considered an unwelcome busybody. Furthermore, it probably violates HPPA for a staff member to talk to anybody about the gentleman's condition.

This I know: It is illegal to not report suspected child abuse. You don't need to have proof, or even know for yourself that happened. If you SUSPECT it, you are required by law to report it. I honestly don't know if this law applies to elderly abuse, but imo, it should.

If there is a local Adult Protective Service office, or County Welfare or Health office, I would hope that they would be responsive to a report of suspected abuse. There is probably a State office that responds to reports of nursing home abuse. The authorities would be able to launch an investigation unconstrained by HPPA; and if the situation is being properly addressed, then no harm was done by the report.
(1)
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Definitely say something! What if this were your parent or maybe you one day? That's the problem with nursing homes--- too many people turning their heads. These are human beings that deserve better care. It is not going to happen until we all together do something!
(1)
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"Don't worry, they are old anyway" Is often the attitude these days.
In the case of this poor lady I don't think we know all the facts. Maybe the daughter was mentally challenged and simply did not know who to ask for help. Perhaps mum weighed 400 lbs and the daughter simply did not know or physically could not take
care of her. Maybe Mum fell and managed to get into that chair and could never move again.
When my hip broke a passerby helped me to my feet and I managed to get back in the car and drive home. pulled into the garage managed to haul myself into the house and collapsed onto a kitchen chair and yelled for hubby. There was no way i could get up out of that chair and the EMTs carried me out to the ambulance in that chair.
All these possible circumstances may have lead the court to treat her leniently. If she loved her mother and i assume she did can you imagine what she was going through for those two years. Many people still believe they will get in trouble if they call an ambulance. it is also possible that Mum ruled the rest and forbade daughter to call for help because she was afraid of what would happen to her in the hospital.
The press loves a good story and they make the most of the gory details. i am not suggesting that this was not reported the way it was written but the truth is that there are services available in these circumstances but they vary from area to area and of course the patient's Dr has to be involved to receive services.
As far as the neighbors are concerned maybe they thought mother and daughter were a bit strange and unfriendly. perhaps they asked how Mum was doing and daughter just said that she was fine just not able to get out now.

We just don't know so should not judge. Not everyone looks out for their neighbors like Church Mouse
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I have a confession to make. I hope I will feel better for making it, because this has been on my conscience for some twenty five years and is still painful.

In my old suburban house, I had a garden shed the window of which looked over my neighbour's fence. I had two kittens at the time. My neighbour had a mature female cat. They had all been plagued by a bullying tom cat whose territory we lived in.

One afternoon, in passing, my neighbour said "I'm sure I saw that black cat in your shed window." "Oh really?" I replied "Goodness, he is being a nuisance."

I thought no more of it. I also didn't use the shed much, having three children under ten and therefore a neglected garden.

Months passed. Then one bright day the kids, on their school break, went to get their pushbikes from the shed - and ran screaming back into the house.

I wrapped the cat's mummified remains in an old pillow case, then (I hang my head) in a bin liner, and [whisper] put it into the garbage. I was shrivelled with shame and could not think how I could ever put this right.

Well. I couldn't put it right. I hadn't listened to what my neighbour was saying. She had never said anything further. Between us, but mostly me, I starved that poor cat to death, and I don't find it any comfort to know that I didn't hear anything and I didn't see anything and if I HAD realised it was stuck in the bloody shed then OBVIOUSLY I would have let it out. I still don't know how it got IN.

I have occasionally wondered if my neighbour could honestly have believed that I was doing it to get rid of him. Could she REALLY have thought that, and done nothing?

I don't ever not check things any more.
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