Patient neglect is becoming a more frequent occurrence among care providers. Admittedly not all patient neglect is intentional. The results of patient neglect are tragic for patients and for family members experiencing emotional upset because of the occurrences. This week I was involved in two similar occurrences, one at a nursing home and one at an assisted living community both reporting to specialize in care for the elderly.

The nursing home is a repeat offender . No matter how many times I as the guardian request communication and coordination between nursing home staff, the physician, and the hospice company this rarely, if ever occurs. The result is that my client experiences patient neglect as evidenced by afternoon anxiety episodes related to dementia and sundowning for which medications have been refused to be ordered by the physician. Instead let’s allow the client to become so anxious that she physically resists care and then experiences bruises on her arms that have to be reported to the department of health for investigation. Patient neglect. Instead let’s allow the client to roll out of bed on the floor and experience bruises. Patient neglect. What about blood pressure rising as the result of being anxious? What happened to being sensitive to the needs of the elderly rather than spouting corporate statements like, “we’re a no chemical community”, or “management has their rules”. Or why don’t you call the family to come and sit with the client.  Since when it is the family’s responsibility to be responsible for care that the nursing home refuses to provide? What happened to the physician code of ethics? What happened to management allowing employees to care for patients rather than be constrained by rules and regulations that illogically neglect patient care?

Similar situations of patient neglect occur with clients living in assisted living communities. Family caregivers are continually faced with situations where staff have promised care only to not deliver. Loved ones have been found in soiled clothing who were not toileted or checked on for hours. Loved ones who were not woken for breakfast and are discovered by family still in bed at noon. The response from staff? It’s the patient right to sleep in late. It seems as if the path of least resistance has become the standard of care. Oh, “the patient refused” is the response from care staff. How easy is it for care staff to ask a yes or no question and then scurry along when a no is received so that they don’t have to provide care but can document that attempts were made. What about management in care communities actually training staff to provide care that includes saying “it’s time for” or “let’s do this” rather than hoping for a no response so that they can move onto the next patient only to hope for the same response.

I’ve worked in the caregiving and healthcare industry for 20+ years. I know and am empathetic to the issues of low staffing, low pay, no benefits, long hours, lack of appreciation, lack of management support, poor working conditions. I appreciate the dedicated and loving caregivers who care. We need more of them! Without them more patients would suffer from neglect. The bottom line accountability resides with the healthcare industry and providers within. What will it take to make patient care a priority? What will it take to support care coordination with families, care managers, advocates and others who support family? It’s time for solutions rather than excuses. It’s time for healthcare to become accountable to the patient, family members, powers of attorney and guardians. It’s time to stop patient neglect.

Check out my book The Caregiving Trap: Solutions for Life’s Unexpected Changes for tips and ideas to advocate for yourself or a love one. My mini-webinar, about 20 minutes, offers information about the benefits of care management.

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