They call it Elder Abuse: but it's still Murder...talking to CANHR

Why not murder charges?

My mind has wrangled with the notion of why we differentiate between elder abuse and murder, rather than simply applying the same rules to all of us, no matter what age.

I made a call to the California Advocates for Nursing Home Reform, an organization which has been actively addressing issues such as the use of psychotropic drugs in nursing homes since 1983, to discuss my concerns. http://www.canhr.org/

It wasn't more than a moment before Pat McGinnis, who took my call, recognized the KVHD case. "Yes, I know which case you're talking about, it was terrible."

As three defendants formerly of the Kern Valley Healthcare District head to Kern County Superior court today to answer to charges that they were knowingly "drugging" patients for staff convenience, McGinnis explained there are other issues involved.

I wanted to clarify what is meant by "staff convenience" which sounds more like the staff asked that they have a new microwave and comatose patients.

McGinnis said this is nothing against the staff themselves, but another way of saying, "short staffed," reflecting more on the management and their financial policies. With lack of staff comes a need to keep patients quiet and requiring less attention they would get if the nurses were in sufficient supply to deal with the needs of the patients.

I asked McGinnis if there was a place for psychotropic medications in nursing homes or if she thought they should be eliminated entirely.

She said the issue is more about "informed consent" which is where patients or family members are given the opportunity to find out what medications are being used. And yes, the website, is full of alternatives other than drugs. It is good reading for anyone with a family member in a nursing home.

In one case she explained four daughters were watching carefully over their mother but found she had suddenly changed, more sleepy and "drooling." She had been given new medications.

"...they never told the daughters or next of kin."

Problems with oversight

There are currently no laws where the state surveyors check to make sure that families are told exactly what medicines and changes to medications are being made.

When these annual surveys are done there are many "tags" they use to identify problems, but so far, there are none which check to make sure the family has been notified of all treatments.

McGinnis said she was contacted by one of the family members in the KVHD elder abuse case, and he was apparently not even told that his father had died let alone any medication usage.

As the news of the KVHD elder abuse case reached many organizations, it was apparent, McGinnis, feels there needs to be much more backing for change in relation to nursing home laws and the people who oversee the care of the elderly.

The question which has been bothering me

I alerted McGinnis the elder abuse case would be in court today, and told her about some of the interviews I had done with nurses who saw things such as a "mass destruction" of evidence such as medicine containers, paperwork regarding the patients, and threats of being fired for telling the truth.

She wasn't shocked to hear that the staffing director fought with CEO, Pam Ott, over the lack of nurses in the SNF, and was told to put down "secretaries" on forms to make sure it looked as if the center was properly staffed.

McGinnis said that she had heard the complaint came through the "ombudsman," (I believe her name was Cathy Shields) which I refuted as that was a "late complaint" as the employees had been trying for months to get help which really never came. (we will find out later today)

I think she may have raised an eyebrow as I told her the employees had gone to the board of directors and made the complaint of short staffing, in Oct. 2006, and were sent packing. They were, however, placated with a "committee" called "recruitment and retention" which met once as the nurses who made the complaints quit shortly thereafter.

So, I asked McGinnis, who still had "the fight" in her voice, though she has been advocating for the elderly for more than 25 years, why they call it elder abuse and not murder.

"You need to ask Brown's office," she answered sarcastically.

Then she said, "They have to go with what they can get. Murder, would be hard to prove, they actually wanted to kill the patients."

I said, I still don't understand why if you are elderly it isn't murder. "I agree," McGinnis said, but the situation is more of what they can do within the constraints of the laws as they stand right now.

Would having a psychiatrist changed anything?

I was also curious about a new program in the skilled nursing center, voted in by the board of directors last month, and that is "telepshyciatry."

McGinnis questioned what if anything a psychiatrist could do over a television with a nursing home resident.

She also said that there is little in compensation for these residents and that "medi-cal" would likely not cover the costs. I explained that our CFO, Chet Beedle, told the board of directors and audience that the new service would be covered by Medi-Cal.

She gave me a phone number of someone who could confirm the cost reimbursement Beedle claimed would be covered for the KVHD SNF patients. I'll let you know on that.

Update later...