Worker's 'cruel sex act' on OAP
Tuesday, 1 July 2008 17:44 UK
A care worker begged a colleague to lie for him after he sexually assaulted an elderly dementia patient at a home in Powys, Cardiff Crown Court has heard.
Gareth Jones, 22, is accused of a "shocking, pitiless" attack on the 77-year-old when he took her to get ready for bed at Mountain's Home at Libanus.
But the court heard he was forced to raise the alarm when the woman started bleeding as a result of her injuries.
Mr Jones denies sexual activity and alternative wounding charges.
The trial heard how the elderly woman needed emergency surgery to save her life.
Mr Jones was supposed to be paired with a female colleague on the night of the alleged attack. "She was subjected to a shocking, pitiless sexual assault by Jones which left her with painful and harrowing injuries.
Ieuan Morris, prosecuting
Senior care assistant at the nursing home near Brecon, Rebecca Morante, told the jury Mr Jones asked her to lie to the police.
He asked her to say he had worked alongside the woman at all times that night but she refused, Mrs Morante said.
"He was begging us not to tell them," she said.
"We said we were sorry but we couldn't lie for him. I'd told him many times before that he should not work alone."
Mrs Morante found Mr Jones in the patient's room after she responded to an emergency alarm.
Ieuan Morris, prosecuting, said Mr Jones had inflicted her injury in a "cruel and deplorable sexual or sadistic act" in February 2007.
"Had she not undergone emergency treatment at hospital she could well have died because she lost so much blood," Mr Morris added.
"She was subjected to a shocking, pitiless sexual assault by Jones which left her with painful and harrowing injuries."
Nursing guidelines recommend carers work in pairs but Mr Jones was working alone on the night of the attack, the jury heard.
Mr Jones, from Trecastle near Brecon, started off as a kitchen assistant before gaining promotion to the carer role two years earlier.
Mr Morris told the trial nine days after the alleged attack checks were carried out at the home.
He said: "It was established there existed a high standard of care at the nursing home and there were no grounds for concerns from the observations."
Mr Jones denies sexual activity, wounding with intent and unlawful wounding and the trial continues.
SOURCE: BBC News
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More Recent Posts from Spotlight on Elder Abuse
July 2, 2008
Resources Available in Caring for Elderly (MI USA)
As our population ages, neglect and abuse of older adults is on the increase. One cause is the growing number of families who try to provide care for their older loved ones while maintaining jobs, raising families and trying to get by during difficult economic times.
There are significant risk factors for elder abuse related to caregiving, such as the inability to cope with stress, depression, lack of support from others, the caregiver's perception that taking care of the elder is burdensome and without psychological reward, and substance abuse.
Several factors concerning elders themselves may increase their risk of abuse:
• The intensity of an elderly person's illness or dementia.
• Social isolation.
• A history of domestic violence in the home.
• The elder's own tendency toward verbal or physical aggression.
Caregivers who have support from friends and the community are better equipped to care for their loved ones. Our community has resources to help.
Caregivers who have support from friends and the community are better equipped to care for their loved ones. Our community has resources to help.
The National Family Caregiver Support Program is a federally funded program providing information, education, respite care, support groups and other services for family caregivers. Locally, these services are provided through Senior Health Partners, a community partnership of Battle Creek Health System, Region 3B Area Agency on Aging and Summit Pointe. For more information call Senior Health Partners at 269-441-0920 or visit the Web site at www.seniorhealthpartners.com.
Another resource is the Legal Hotline for Michigan Seniors at 1-800-347-5297. It offers free legal advice and information regarding the care of an older person. They can answer many concerns of older people, bringing peace of mind and offering real solutions.
In Calhoun County, the Elder Abuse Coalition mission is to reduce abuse of vulnerable seniors through community awareness, education, prevention and protocol. If you are interested in joining the coalition, contact Carrie Taft, Senior Health Partners, at 269-441-0920.
Carrie Taft
Senior Health Partners
SOURCE: Battle Creek Enquirer
----------------------------------------------------
More Recent Posts from Spotlight on Elder Abuse
There are significant risk factors for elder abuse related to caregiving, such as the inability to cope with stress, depression, lack of support from others, the caregiver's perception that taking care of the elder is burdensome and without psychological reward, and substance abuse.
Several factors concerning elders themselves may increase their risk of abuse:
• The intensity of an elderly person's illness or dementia.
• Social isolation.
• A history of domestic violence in the home.
• The elder's own tendency toward verbal or physical aggression.
Caregivers who have support from friends and the community are better equipped to care for their loved ones. Our community has resources to help.
Caregivers who have support from friends and the community are better equipped to care for their loved ones. Our community has resources to help.
The National Family Caregiver Support Program is a federally funded program providing information, education, respite care, support groups and other services for family caregivers. Locally, these services are provided through Senior Health Partners, a community partnership of Battle Creek Health System, Region 3B Area Agency on Aging and Summit Pointe. For more information call Senior Health Partners at 269-441-0920 or visit the Web site at www.seniorhealthpartners.com.
Another resource is the Legal Hotline for Michigan Seniors at 1-800-347-5297. It offers free legal advice and information regarding the care of an older person. They can answer many concerns of older people, bringing peace of mind and offering real solutions.
In Calhoun County, the Elder Abuse Coalition mission is to reduce abuse of vulnerable seniors through community awareness, education, prevention and protocol. If you are interested in joining the coalition, contact Carrie Taft, Senior Health Partners, at 269-441-0920.
Carrie Taft
Senior Health Partners
SOURCE: Battle Creek Enquirer
----------------------------------------------------
More Recent Posts from Spotlight on Elder Abuse
Abuse of Seniors Needn't Remain Unspoken
Sixty Plus: Abuse of seniors needn't remain unspoken
By Sarah Lemnah
Free Press Columnist
July 21, 2008
Horrifying stories of children being abused and exploited are too common in the daily headlines. Not making the front page, but just as concerning: the 2.5 million seniors who the National Center on Elder Abuse reports are neglected, abused and exploited each year in the United States.
Abuse can take on many forms: neglect, threats, isolation, physical and emotional abuse, sexual abuse and financial exploitation.
As people get older and their health declines, many seniors rely on caregivers, family and health-care professionals to help take care of them or provide services to enable them to live independently. However, the people seniors trust to take care of them sometimes become their tormenters. In Vermont alone, there are 902 people listed on the Adult Abuse Registry. Many seniors are vulnerable.
According to the National Center on Elder Abuse, more than 90 percent of seniors who are abused know their abuser. Many seniors do not know how to get out of unhealthy situations.
Abuse is not a family issue, abuse is a crime.
SOURCE: Burlington Free Press
---------------------------------------------------
More Recent Posts from Spotlight on Elder Abuse
By Sarah Lemnah
Free Press Columnist
July 21, 2008
Horrifying stories of children being abused and exploited are too common in the daily headlines. Not making the front page, but just as concerning: the 2.5 million seniors who the National Center on Elder Abuse reports are neglected, abused and exploited each year in the United States.
Abuse can take on many forms: neglect, threats, isolation, physical and emotional abuse, sexual abuse and financial exploitation.
As people get older and their health declines, many seniors rely on caregivers, family and health-care professionals to help take care of them or provide services to enable them to live independently. However, the people seniors trust to take care of them sometimes become their tormenters. In Vermont alone, there are 902 people listed on the Adult Abuse Registry. Many seniors are vulnerable.
According to the National Center on Elder Abuse, more than 90 percent of seniors who are abused know their abuser. Many seniors do not know how to get out of unhealthy situations.
Abuse is not a family issue, abuse is a crime.
Sarah Lemnah writes on senior issues for the Champlain Valley Agency on Aging, a private, nonprofit United Way organization. For more information on services for seniors call the Senior HelpLine at (800) 642-5119 . To report abuse
Seniors deserve to be treated with respect. Abuse is abuse whether it is committed by a stranger or a loved one or whether the victim is a child or a senior. If you suspect abuse of a senior or are a victim, call:
Division of Licensing and Protection's Reporting and Complaint Helpline: 800-564-1612
Area Agency on Aging: 800-642-5119
Warning signs That are warning signs that people should look for that could indicate a senior is being mistreated:
- Seems depressed, withdrawn or isolated and never accepts invitations to spend time away from their family or caregiver;
- Seems afraid to make their own decisions;
- Seems to be hiding something about the caregiver;
- Seems to have too many household accidents and puts off going to the doctor.
SOURCE: Burlington Free Press
---------------------------------------------------
More Recent Posts from Spotlight on Elder Abuse
July 1, 2008
Twenty-One Cases of Elder Abuse in New Zealand Last Year
Updated 3:25PM Monday June 30, 2008
Twenty-one cases of elder abuse were reported in New Zealand last year but the number is small relative to the number of people in care, an industry body has said.
The Ministry of Health and police are investigating after an elderly woman's mouth was taped shut by an Auckland rest-home worker because she made too much noise.
The rest home, Belhaven, is a member of the country's largest association of aged care residential providers, Healthcare Providers.
CEO Martin Taylor said Healthcare Providers would be launching its own investigation into Belhaven to ensure it met the organisation's code of conduct.
"If they haven't then we'll cancel their membership," he said.
But he said 40,000 elderly were listed as being in care in 2007 and the number of complaints reported was relatively small.
Age Concern's elder abuse coordinator for Auckland Emsie Walters said the case is "out of the ordinary" but abuse does happen in rest homes.
Ms Walters said threats against rest home residents were often not physical but "you do this or else".
She said elder abuse covered sexual abuse, physical abuse, financial abuse and psychological abuse.
Ms Walters said psychological abuse was the most prevalent because it went "hand-in-hand" with other forms of abuse.
Age Concern operates a service where abused elderly people can contact them for help. They also provide education and awareness sessions in rest homes.
"There aren't enough of us and there are times when the law does not protect old people because they are so vulnerable. They're often isolated," Ms Walters said.
A study commissioned by the Families Commission and released in January found that older people were less likely to be abused if they understand their rights, have a strong sense of self worth and positive relationships with families.
The study found that elderly people living in isolation with poor mental or physical health and stressed families are more likely to face abuse and neglect.
Abridged
SOURCE: NZ Herald
-----------------------------------
The number of elder abuse quoted above, must refer to just the reported cases. We can be sure that the actual number of elder abuse cannot be ascertained because most of the victims fear reprisals; or may not know their rights.
We must promote awareness of elder abuse. It is real and it is out there. Many seniors are not aware that they have the right to a life of safety and dignity.
----------------------------------------------------
More Recent Posts from Spotlight on Elder Abuse
Twenty-one cases of elder abuse were reported in New Zealand last year but the number is small relative to the number of people in care, an industry body has said.
The Ministry of Health and police are investigating after an elderly woman's mouth was taped shut by an Auckland rest-home worker because she made too much noise.
The rest home, Belhaven, is a member of the country's largest association of aged care residential providers, Healthcare Providers.
CEO Martin Taylor said Healthcare Providers would be launching its own investigation into Belhaven to ensure it met the organisation's code of conduct.
"If they haven't then we'll cancel their membership," he said.
But he said 40,000 elderly were listed as being in care in 2007 and the number of complaints reported was relatively small.
Age Concern's elder abuse coordinator for Auckland Emsie Walters said the case is "out of the ordinary" but abuse does happen in rest homes.
Ms Walters said threats against rest home residents were often not physical but "you do this or else".
She said elder abuse covered sexual abuse, physical abuse, financial abuse and psychological abuse.
Ms Walters said psychological abuse was the most prevalent because it went "hand-in-hand" with other forms of abuse.
Age Concern operates a service where abused elderly people can contact them for help. They also provide education and awareness sessions in rest homes.
"There aren't enough of us and there are times when the law does not protect old people because they are so vulnerable. They're often isolated," Ms Walters said.
A study commissioned by the Families Commission and released in January found that older people were less likely to be abused if they understand their rights, have a strong sense of self worth and positive relationships with families.
The study found that elderly people living in isolation with poor mental or physical health and stressed families are more likely to face abuse and neglect.
Abridged
SOURCE: NZ Herald
-----------------------------------
The number of elder abuse quoted above, must refer to just the reported cases. We can be sure that the actual number of elder abuse cannot be ascertained because most of the victims fear reprisals; or may not know their rights.
We must promote awareness of elder abuse. It is real and it is out there. Many seniors are not aware that they have the right to a life of safety and dignity.
----------------------------------------------------
More Recent Posts from Spotlight on Elder Abuse
Gagging of an Elderly Woman "Totally Unacceptable" (New Zealand)
Clark warns of `very serious trouble' over gagging
By MARCUS STICKLEY and NZPA - Nelson
Monday, 30 June 2008
The gagging of an elderly woman in an Auckland rest home is "totally unacceptable" and the facility is likely to face intense Health Ministry scrutiny, Prime Minister Helen Clark says.
Age Concern Nelson says it deals with cases of elder abuse "all the time" but cases of physical abuse are rare. Theft and psychological abuse are the most common cases.
The Health Ministry and police are investigating after a tradesman visiting the Belhaven Rest Home in Epsom on Friday secretly took a cell phone photo of the gagging and reported it. A staff member has been sacked.
Health Ministry staff who visited the rest home within a couple of hours of the abuse being reported found the woman still with her mouth gagged by medical tape. Belhaven specialises in brain injuries and psycho geriatric residents.
On Monday Miss Clark condemned the incident, which she hoped was not the tip of the iceberg.
"Most people who run rest homes pride themselves on the quality of care and the living environment they provide, but this is clearly totally unacceptable," she said on TVNZ's breakfast programme on Monday.
"I would think that rest home is in very serious trouble with the Ministry of Health."
Miss Clark said on NewstalkZB the rest home was likely to have breached several rules.
Age Concern Nelson chief executive Dave Nelson said on Monday that his organisation was "dealing with elder abuse cases all the time". However, "the vast majority do not involve physical abuse".
"What happened up north (at Belhaven) is pretty bad and I would say the whole residential care industry would be mortified that one of the facilities had this happen to them.
"By far the greatest majority of elder abuse happens outside residential care, often involving family members rather than health professionals."
SOURCE: Stuff dot Co NZ
----------------------------------------------------
Elder Abuse is UNACCEPTABLE, in any way or form. It is good to see that this case has been given so much media attention. However, let us remember that the majority of the elder abuse happens in private homes. We need to remind ourselves that it is easier to identify the physical "gag" than the psychological ones. Those are the "invisible" victims. They lose out on all fronts.
More Recent Posts from Spotlight on Elder Abuse
By MARCUS STICKLEY and NZPA - Nelson
Monday, 30 June 2008
The gagging of an elderly woman in an Auckland rest home is "totally unacceptable" and the facility is likely to face intense Health Ministry scrutiny, Prime Minister Helen Clark says.
Age Concern Nelson says it deals with cases of elder abuse "all the time" but cases of physical abuse are rare. Theft and psychological abuse are the most common cases.
The Health Ministry and police are investigating after a tradesman visiting the Belhaven Rest Home in Epsom on Friday secretly took a cell phone photo of the gagging and reported it. A staff member has been sacked.
Health Ministry staff who visited the rest home within a couple of hours of the abuse being reported found the woman still with her mouth gagged by medical tape. Belhaven specialises in brain injuries and psycho geriatric residents.
On Monday Miss Clark condemned the incident, which she hoped was not the tip of the iceberg.
"Most people who run rest homes pride themselves on the quality of care and the living environment they provide, but this is clearly totally unacceptable," she said on TVNZ's breakfast programme on Monday.
"I would think that rest home is in very serious trouble with the Ministry of Health."
Miss Clark said on NewstalkZB the rest home was likely to have breached several rules.
Age Concern Nelson chief executive Dave Nelson said on Monday that his organisation was "dealing with elder abuse cases all the time". However, "the vast majority do not involve physical abuse".
"What happened up north (at Belhaven) is pretty bad and I would say the whole residential care industry would be mortified that one of the facilities had this happen to them.
"By far the greatest majority of elder abuse happens outside residential care, often involving family members rather than health professionals."
SOURCE: Stuff dot Co NZ
----------------------------------------------------
Elder Abuse is UNACCEPTABLE, in any way or form. It is good to see that this case has been given so much media attention. However, let us remember that the majority of the elder abuse happens in private homes. We need to remind ourselves that it is easier to identify the physical "gag" than the psychological ones. Those are the "invisible" victims. They lose out on all fronts.
More Recent Posts from Spotlight on Elder Abuse
Elder Abuse More Financial Than Physical (New Zealand)
Elder abuse more financial than physical
The Timaru Herald
Tuesday, 01 July 2008
South Canterbury elderly are more likely to be financially harmed than physically abused by their family says the region's elder protection co-ordinator.
Geeta Muralidharan said elder abuse had always happened in communities but it had recently become more apparent with the rising elderly population.
It was back in the spotlight after a tradesman alerted authorities when he saw an elderly woman gagged at her Auckland rest home on Friday.
The most common form of elder abuse Mrs Muralidharan saw in South Canterbury was financial and emotional abuse. It can be a son or daughter telling their elderly parents they will not let them see their grandchildren if they do not sell their house, or using their money without their parent's knowledge.
Mrs Muralidharan said emotional and financial abuse often stemmed from money troubles and a lack of respect for the elderly. Last month a Timaru woman was found guilty of theft from her elderly mother.
Neglecting the elderly is another growing problem with the risk that people in rural areas can fall off the radar of community groups. Mrs Muralidharan hoped monthly forums around the region would help address this issue in small communities.
"There's no easy answer."
Age Concern chief executive Ann Martin said at least two older people are abused or neglected every day in New Zealand, the majority by their own family members. The abuse can be physical, psychological, financial, or sexual.
She said asking for help at any time can be especially traumatic in elder abuse and neglect situations.
"Older people may fear retribution or be unable to tell anyone that abuse or neglect is occurring, and families and caregivers can be reluctant or fearful, or just not aware that their actions are abusive."
She said people need to speak up because ending elder abuse is the community's responsibility.
She believed the tradesman who first identified the gagging of a resident of an Auckland rest home should be commended for taking action.
"Older people have the right to be treated with respect."
SOURCE: StuffNZ
-----------------------------------------------------
More Recent Posts from Spotlight on Elder Abuse
The Timaru Herald
Tuesday, 01 July 2008
South Canterbury elderly are more likely to be financially harmed than physically abused by their family says the region's elder protection co-ordinator.
Geeta Muralidharan said elder abuse had always happened in communities but it had recently become more apparent with the rising elderly population.
It was back in the spotlight after a tradesman alerted authorities when he saw an elderly woman gagged at her Auckland rest home on Friday.
The most common form of elder abuse Mrs Muralidharan saw in South Canterbury was financial and emotional abuse. It can be a son or daughter telling their elderly parents they will not let them see their grandchildren if they do not sell their house, or using their money without their parent's knowledge.
Mrs Muralidharan said emotional and financial abuse often stemmed from money troubles and a lack of respect for the elderly. Last month a Timaru woman was found guilty of theft from her elderly mother.
Neglecting the elderly is another growing problem with the risk that people in rural areas can fall off the radar of community groups. Mrs Muralidharan hoped monthly forums around the region would help address this issue in small communities.
"There's no easy answer."
Age Concern chief executive Ann Martin said at least two older people are abused or neglected every day in New Zealand, the majority by their own family members. The abuse can be physical, psychological, financial, or sexual.
She said asking for help at any time can be especially traumatic in elder abuse and neglect situations.
"Older people may fear retribution or be unable to tell anyone that abuse or neglect is occurring, and families and caregivers can be reluctant or fearful, or just not aware that their actions are abusive."
She said people need to speak up because ending elder abuse is the community's responsibility.
She believed the tradesman who first identified the gagging of a resident of an Auckland rest home should be commended for taking action.
"Older people have the right to be treated with respect."
SOURCE: StuffNZ
-----------------------------------------------------
More Recent Posts from Spotlight on Elder Abuse
Doctors Say Medication is Overused in Dementia
Doctors Say Medication Is Overused in Dementia
By Laurie Tarkan, The New York Times
June 24, 2008
Ramona Lamascola with her mother, Theresa Lamascola.
Ramona Lamascola thought she was losing her 88-year-old mother to dementia. Instead, she was losing her to overmedication.
Last fall her mother, Theresa Lamascola, of the Bronx, suffering from anxiety and confusion, was put on the antipsychotic drug Risperdal. When she had trouble walking, her daughter took her to another doctor — the younger Ms. Lamascola’s own physician — who found that she had unrecognized hypothuroidism, a disorder that can contribute to dementia.
Theresa Lamascola was moved to a nursing home to get these problems under control. But things only got worse. “My mother was screaming and out of it, drooling on herself and twitching,” said Ms. Lamascola, a pediatric nurse. The psychiatrist in the nursing home stopped the Risperdal, which can cause twitching and vocal tics, and prescribed a sedative and two other antipsychotics.
“I knew the drugs were doing this to her,” her daughter said. “I told him to stop the medications and stay away from Mom.”
Not until yet another doctor took Mrs. Lamascola off the drugs did she begin to improve.
The use of antipsychotic drugs to tamp down the agitation, combative behavior and outbursts of dementia patients has soared, especially in the elderly. Sales of newer antipsychotics like Risperdal, Seroquel and Zyprexa totaled $13.1 billion in 2007, up from $4 billion in 2000, according to IMS Health, a health care information company.
Part of this increase can be traced to presciptions in nursing homes. Researchers estimate that about a third of all nursing home patients have been given antipsychotic drugs.
The increases continue despite a drumbeat of bad publicity. A 2006 study of Alzheimer's patients found that for most patients, antipsychotics provided no significant improvement over placebos in treating aggression and delusions.
In 2005, the Food and Drug Administration ordered that the newer drugs carry a “black box” label warning of an increased risk of death. Last week, the F.D.A. required a similar warning on the labels of older antipsychotics.
The agency has not approved marketing of these drugs for older people with dementia, but they are commonly prescribed to these patients “off label.” Several states are suing the top sellers of antipsychotics on charges of false and misleading marketing.
“Our health care system isn’t set up to address the mental, emotional and behavioral problems of the elderly,” said Dr. Gary S. Moak, president of the American Association for Geriatric Psychiatry.
Nursing homes are short staffed, and insurers do not generally pay for the attentive medical care and hands-on psychosocial therapy that advocates recommend. It is much easier to use sedatives and antipsychotics, despite their side effects.
Used correctly, the drugs do have a role in treating some seriously demented patients, who may be incapacitated by paranoia or are self-destructive or violent. Taking the edge off the behavior can keep them safe and living at home, rather than in a nursing home.
If patients are prescribed an antipsychotic, it should be a very low dose for the shortest period necessary, said Dr. Dillip V. Jeste, a professor of psychiatry and neuroscience at the University of California, San Diego.
To family members looking at a nursing home for an aging parent, experts recommend seeking out homes with low staff turnover, a high ratio of staff members to patients, and programs with psychosocial components.
The Medicare Web site has basic information on individual homes at Medicare.gov - Nursing Home Compare - Geography Questions. The National Citizens’ Coalition for Nursing Home Reform, at National Citizen's Coalition for Nursing Home Reform offers a consumer guide to choosing a nursing home.
If medications are necessary, a family member should communicate with the prescribing doctor, learn the goal of each medication and be involved in making the decision.
Dr. Moak, of the psychiatry association, emphasized seeking out the doctor. Family members, he said, “often speak through the nursing staff, and that’s a huge mistake.”
This article has been revised to reflect the following correction:
Correction: June 25, 2008 An article on Tuesday about the use of antipsychotic drugs in dementia patients misspelled the names of two drugs in a different class, sometimes used to treat the symptoms of Alzheimer’s and Parkinson’s diseases. They are Exelon and Namenda, not Exalon and Menamda.
Abridged
SOURCE: NewYorkTimes
-----------------------------------------------------
More Recent Posts from Spotlight on Elder Abuse
By Laurie Tarkan, The New York Times
June 24, 2008
Ramona Lamascola with her mother, Theresa Lamascola.
Ramona Lamascola thought she was losing her 88-year-old mother to dementia. Instead, she was losing her to overmedication.
Last fall her mother, Theresa Lamascola, of the Bronx, suffering from anxiety and confusion, was put on the antipsychotic drug Risperdal. When she had trouble walking, her daughter took her to another doctor — the younger Ms. Lamascola’s own physician — who found that she had unrecognized hypothuroidism, a disorder that can contribute to dementia.
Theresa Lamascola was moved to a nursing home to get these problems under control. But things only got worse. “My mother was screaming and out of it, drooling on herself and twitching,” said Ms. Lamascola, a pediatric nurse. The psychiatrist in the nursing home stopped the Risperdal, which can cause twitching and vocal tics, and prescribed a sedative and two other antipsychotics.
“I knew the drugs were doing this to her,” her daughter said. “I told him to stop the medications and stay away from Mom.”
Not until yet another doctor took Mrs. Lamascola off the drugs did she begin to improve.
The use of antipsychotic drugs to tamp down the agitation, combative behavior and outbursts of dementia patients has soared, especially in the elderly. Sales of newer antipsychotics like Risperdal, Seroquel and Zyprexa totaled $13.1 billion in 2007, up from $4 billion in 2000, according to IMS Health, a health care information company.
Part of this increase can be traced to presciptions in nursing homes. Researchers estimate that about a third of all nursing home patients have been given antipsychotic drugs.
The increases continue despite a drumbeat of bad publicity. A 2006 study of Alzheimer's patients found that for most patients, antipsychotics provided no significant improvement over placebos in treating aggression and delusions.
In 2005, the Food and Drug Administration ordered that the newer drugs carry a “black box” label warning of an increased risk of death. Last week, the F.D.A. required a similar warning on the labels of older antipsychotics.
The agency has not approved marketing of these drugs for older people with dementia, but they are commonly prescribed to these patients “off label.” Several states are suing the top sellers of antipsychotics on charges of false and misleading marketing.
“Our health care system isn’t set up to address the mental, emotional and behavioral problems of the elderly,” said Dr. Gary S. Moak, president of the American Association for Geriatric Psychiatry.
Nursing homes are short staffed, and insurers do not generally pay for the attentive medical care and hands-on psychosocial therapy that advocates recommend. It is much easier to use sedatives and antipsychotics, despite their side effects.
Used correctly, the drugs do have a role in treating some seriously demented patients, who may be incapacitated by paranoia or are self-destructive or violent. Taking the edge off the behavior can keep them safe and living at home, rather than in a nursing home.
If patients are prescribed an antipsychotic, it should be a very low dose for the shortest period necessary, said Dr. Dillip V. Jeste, a professor of psychiatry and neuroscience at the University of California, San Diego.
To family members looking at a nursing home for an aging parent, experts recommend seeking out homes with low staff turnover, a high ratio of staff members to patients, and programs with psychosocial components.
The Medicare Web site has basic information on individual homes at Medicare.gov - Nursing Home Compare - Geography Questions. The National Citizens’ Coalition for Nursing Home Reform, at National Citizen's Coalition for Nursing Home Reform offers a consumer guide to choosing a nursing home.
If medications are necessary, a family member should communicate with the prescribing doctor, learn the goal of each medication and be involved in making the decision.
Dr. Moak, of the psychiatry association, emphasized seeking out the doctor. Family members, he said, “often speak through the nursing staff, and that’s a huge mistake.”
This article has been revised to reflect the following correction:
Correction: June 25, 2008 An article on Tuesday about the use of antipsychotic drugs in dementia patients misspelled the names of two drugs in a different class, sometimes used to treat the symptoms of Alzheimer’s and Parkinson’s diseases. They are Exelon and Namenda, not Exalon and Menamda.
Abridged
SOURCE: NewYorkTimes
-----------------------------------------------------
More Recent Posts from Spotlight on Elder Abuse
Elderly Claim Beat Policing Needs Improvement (India)
Elderly claim beat policing has taken a beating
29 Jun 2008, 0510 hrs IST,
By Dwaipayan Ghosh,TNN
NEW DELHI: Delhi Police's tall claims of emerging as the saviour of the city's vulnerable senior citizen population and providing them emotional support has fallen flat on its face.
Even as the number of elderly people who registered with the senior citizens' cell touched 7,388 — a jump of 2,000 over last year — they are a disillusioned lot. The good intent, they say was there only for the first few months when the beat constable was a regular visitor. But now, all that has fizzled out and they continue to live in apprehension.
"It is difficult to keep in touch with the beat constable. Initially, they visited our house twice every month, but with the passage of time, these visits became erractic. Though, the police promised us to be there whenever required — even to run small errands — the promise never materialised. Worse, some policemen posted even at the cell do not try to understand our problems," said Atul Mathur, a retired bank employee living in Kalkaji.
Added another senior citizen of Mayur Vihar, citing the example of his servant verfication. "It is almost four months since I applied for my servant's verification. The process is yet to be completed. Who guarantees my safety in the interim?" he said.
Police too are concerned over the rising number of elderly who are forced to stay alone, and blame this trend on breakdown of family traditions. In south Delhi district alone, the rise has been phenomenal. From a total of 1,723 citizens last year, south Delhi at present has 2,580 senior citizens living alone. Incidentally, most of the crimes against senior citizens have occurred in this district.
Abridged
SOURCE: TimesOfIndia
----------------------------------------------------
More Recent Posts from Spotlight on Elder Abuse
29 Jun 2008, 0510 hrs IST,
By Dwaipayan Ghosh,TNN
NEW DELHI: Delhi Police's tall claims of emerging as the saviour of the city's vulnerable senior citizen population and providing them emotional support has fallen flat on its face.
Even as the number of elderly people who registered with the senior citizens' cell touched 7,388 — a jump of 2,000 over last year — they are a disillusioned lot. The good intent, they say was there only for the first few months when the beat constable was a regular visitor. But now, all that has fizzled out and they continue to live in apprehension.
"It is difficult to keep in touch with the beat constable. Initially, they visited our house twice every month, but with the passage of time, these visits became erractic. Though, the police promised us to be there whenever required — even to run small errands — the promise never materialised. Worse, some policemen posted even at the cell do not try to understand our problems," said Atul Mathur, a retired bank employee living in Kalkaji.
Added another senior citizen of Mayur Vihar, citing the example of his servant verfication. "It is almost four months since I applied for my servant's verification. The process is yet to be completed. Who guarantees my safety in the interim?" he said.
Police too are concerned over the rising number of elderly who are forced to stay alone, and blame this trend on breakdown of family traditions. In south Delhi district alone, the rise has been phenomenal. From a total of 1,723 citizens last year, south Delhi at present has 2,580 senior citizens living alone. Incidentally, most of the crimes against senior citizens have occurred in this district.
Abridged
SOURCE: TimesOfIndia
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Hidden Cruilty in Our Resthomes (New Zealand)
By Laura Franklin, Editor Bay of Plenty Times NZ
30.06.2008
WRAPPING medical tape around the mouth of an elderly rest home resident to keep her quiet is clearly the work of a sick and cruel individual who should never have been employed as a caregiver in the first place.
However, with the low-wage, no-qualification, little-training nature of the job, those who take on the role for vocational reasons are rare gems, while many others _ particularly in our larger centres _ have fallen into rest home jobs because the work is readily available.
While there are wonderful carers who are efficient, kind and compassionate, it's a sad fact that many others lack the empathy, skills and patience to treat the vulnerable elderly charges with the respect and attention they deserve.
Caring for the elderly can be emotionally draining and physically demanding. Workers will have to deal with distressed, frustrated, even violent patients. They must nurse people through pain and confusion, in shifts that see them on deck at any time, day or night.
Despite this, it remains one of our lowest-paid forms of work.
If the profession was valued more highly, with a corresponding increase in wages and conditions, perhaps the right kind of workers would be easier to attract and retain. Earlier this month, a Families Commission report into care of the elderly _ released to coincide with World Elder Abuse Awareness Day _ found that institutions with good monitoring systems and policies, with well trained and well paid staff, were less likely to have neglect or abuse.
The particular Epsom care facility where this latest sordid incident happened will find itself the subject of a round of inspections and investigations.
Other rest homes should also take this episode as a reminder to take a good long look at themselves and their practices.
Entrusting our mothers, fathers or grandparents to a rest home is often a heartbreaking decision for a family, and the public must be able to have confidence in the treatment they will receive.
SOURCE: BayofPlentyTimesNZ
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More Recent Posts from Spotlight on Elder Abuse
30.06.2008
WRAPPING medical tape around the mouth of an elderly rest home resident to keep her quiet is clearly the work of a sick and cruel individual who should never have been employed as a caregiver in the first place.
However, with the low-wage, no-qualification, little-training nature of the job, those who take on the role for vocational reasons are rare gems, while many others _ particularly in our larger centres _ have fallen into rest home jobs because the work is readily available.
While there are wonderful carers who are efficient, kind and compassionate, it's a sad fact that many others lack the empathy, skills and patience to treat the vulnerable elderly charges with the respect and attention they deserve.
Caring for the elderly can be emotionally draining and physically demanding. Workers will have to deal with distressed, frustrated, even violent patients. They must nurse people through pain and confusion, in shifts that see them on deck at any time, day or night.
Despite this, it remains one of our lowest-paid forms of work.
If the profession was valued more highly, with a corresponding increase in wages and conditions, perhaps the right kind of workers would be easier to attract and retain. Earlier this month, a Families Commission report into care of the elderly _ released to coincide with World Elder Abuse Awareness Day _ found that institutions with good monitoring systems and policies, with well trained and well paid staff, were less likely to have neglect or abuse.
The particular Epsom care facility where this latest sordid incident happened will find itself the subject of a round of inspections and investigations.
Other rest homes should also take this episode as a reminder to take a good long look at themselves and their practices.
Entrusting our mothers, fathers or grandparents to a rest home is often a heartbreaking decision for a family, and the public must be able to have confidence in the treatment they will receive.
SOURCE: BayofPlentyTimesNZ
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More Recent Posts from Spotlight on Elder Abuse
Elder Abuse is Unacceptable (New Zealand)
David Cunliffe
29 June, 2008
The abuse of older people in our society is completely unacceptable.
“The alleged abuse of an elderly rest home resident is abhorrent,” said Ruth Dyson Minister for Senior Citizens and Minister of Health David Cunliffe said.
“While I can’t comment on this incident as the police are now involved, such abuse is totally unacceptable. As a community we need to change social attitudes by raising community awareness about the abuse and neglect of older people. It saddens me that such an incident can occur, but the abuse of older people is often a hidden problem,” said Ruth Dyson.
Minister of Health David Cunliffe said he had sought urgent information on the alleged case.
“I would expect if any rest-home or care-provider was found to have allowed any form of abuse to have occurred then steps would be swiftly taken to ensure the safety of some of our most vulnerable citizens is protected and action taken against any perpetrator,” Mr Cunliffe said.
“If the facts of this case are verified as they appear I would expect the MOH to urgent action against the rest-home concerned,” Mr Cunliffe said
"The Government has worked on a range of initiatives to stop the abuse of older people and has taken significant steps to promote positive ageing. To achieve this, the government funds prevention services in 24 communities,” said Ruth Dyson.
Government initiatives to help prevent abuse of older people:
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More Recent Posts from Spotlight on Elder Abuse
29 June, 2008
The abuse of older people in our society is completely unacceptable.
“The alleged abuse of an elderly rest home resident is abhorrent,” said Ruth Dyson Minister for Senior Citizens and Minister of Health David Cunliffe said.
“While I can’t comment on this incident as the police are now involved, such abuse is totally unacceptable. As a community we need to change social attitudes by raising community awareness about the abuse and neglect of older people. It saddens me that such an incident can occur, but the abuse of older people is often a hidden problem,” said Ruth Dyson.
Minister of Health David Cunliffe said he had sought urgent information on the alleged case.
“I would expect if any rest-home or care-provider was found to have allowed any form of abuse to have occurred then steps would be swiftly taken to ensure the safety of some of our most vulnerable citizens is protected and action taken against any perpetrator,” Mr Cunliffe said.
“If the facts of this case are verified as they appear I would expect the MOH to urgent action against the rest-home concerned,” Mr Cunliffe said
"The Government has worked on a range of initiatives to stop the abuse of older people and has taken significant steps to promote positive ageing. To achieve this, the government funds prevention services in 24 communities,” said Ruth Dyson.
Government initiatives to help prevent abuse of older people:
- The New Zealand Positive Ageing Strategy, launched in 2001, encourages older people to participate in their communities and recognises the value of their knowledge, skills and experience.
- The Government’s Pathway to Partnership investment into the community based family, child and youth services will also strengthen the capacity, capability and sustainability of existing elder abuse and neglect services.
- The Family Violence Intervention Guidelines: Elder Abuse and Neglect have been released to support health providers to assist older people experiencing abuse.
- The Protection of Personal and Property Rights Act 1988 has been amended so that the enduring powers of attorney provisions are strengthened. This will provide greater protections for people whose mental incapacity requires them to rely on other people to make care, welfare and property decisions on their behalf.
- A code of practice for home equity release schemes has been developed. The code will help to protect older people's financial interests.
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