How to Deal with Suspected Elder Abuse

I want to be very clear, however, that there can be abuse. It happens. There is neglect. That happens even more often. And very often, the understaffed centers are overworking their aides because they have no choice. The pay is low. The work is hard. And not everyone is suited to the kind of work they must do. So, understaffing is a huge problem and vigilance on the part of the family is important.

My feeling about this man was that he was pressed for time. He happened to be a physically large man, tall and strong, and perhaps when he hurried he seemed rough. I learned through the years that he very was kind and gentle. Did our complaint help make him so? I think he was like that all the time, but perhaps the ordeal made him more aware of how he approached people.

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What should we have done? We should have taken a deep breath and gone through the proper channels. In this case, we should have started with the floor nurse, but below is the preferred routine:

1. If possible, talk nicely with the CNA or hands-on person you think may need some direction. Talk kindly, and take some of the load off by saying, "Mom can be sensitive, and I know that. Is there a better way we can handle this?"
   
2. If you don't get anywhere with that (all of this advice only applies if there isn't obvious abuse – if that is so, skip to the last step), talk with the floor supervisor, often a nurse.
   
3. If that still doesn't get you a listening ear and some change – and if you are being realistic about your requests – then talk with the home administrator.
   
4. If talking doesn't get you anywhere, write a letter and state the complaint and say that you will be contacting your state ombudsman. An ombudsman is an independent advocate who handles consumer complaints about government-regulated agencies. Since nursing homes are government-regulated agencies, they qualify. Assisted living centers may not, but it's worth a try.
   
5. Then do so. You can go online to your state's website and look up aging services or you can go to the national site and find the National Long Term Care Ombudsman Resource Center at www.ltcombudsman.org. You will then type in the location of the home and you will find contact information. Carry through, and this person will investigate.

Don't ever be afraid to involve the ombudsman. That person is there for the families and is not affiliated with any homes. This is your right. But often, as in my case, things can and should be settled by going through the proper channels within the home. Most of the time the people in the facility want to do a good job. They may not even be aware of any problem.

One reason references for care centers are not always reliable (though I still recommend checking them) is that what one person thinks is great, another thinks is terrible. People have different expectations. Our problem with this CNA was passion for our elders and the feeling of powerlessness. Acting the way we did made us feel like we had some control even though we weren't with our loved ones all the time. We weren't mean spirited or too demanding, but we were not educated in getting the best care for our elders.

Making friends with the staff – which I did over the years – is very helpful. Let them get to know you. Let them know that you aren't demanding the stars and the moon, but that you are visiting often and want the best care possible for your loved one. Let them know that you, or someone you can trust, will be available to assist them. That friendly partnership type of attitude will generally get you farther than a demanding, adversarial, contrary attitude can.

However, the bottom line is this: If there is any suspicion of abuse or neglect, look into it. Depending on the severity, follow the steps and go up the chain of command. Take a moment to discuss the problem with someone who is more detached from the situation than you, so you can know your aren't being over-emotional. If there is obvious abuse, go right to the state level and find the ombudsman in your area. Or call the county officials. Keep in mind that you are the one who will ultimately make the decision, but try to do so armed with realistic expectations balanced with an educated approach.