Columns

World Elder Abuse Awareness Day is being observed today, Wednesday, June 15, 2011. This week’s Senior Power column is the second of two devoted to this subject. Possibly, by the time you read it, World Elder Abuse Awareness Day will have come and gone without great notice. 

Are you aware of any visible or audible action fostering elder abuse awareness on the part of commissions on aging, senior center advisory bodies, communities’ senior services departments, area agencies on aging, city councils, academic gerontologists, sectarian and religious affiliations groups, junior leagues, NOW and OWL, Gray Panthers, AARP? Was there a proclamation (an official public announcement) by any of these or other groups? 

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Nursing homes are potential loci of abuse of old people. A nursing home is a residential facility for persons with chronic illness or disability, particularly older people who have mobility and eating problems. It may be called a convalescent home or long-term care facility. A nursing home has been defined as a facility with 3+ beds that is licensed by the state and usually certified for federal reimbursement as a Medicaid (in California known as Med-I-Cal) and/or skilled Medicare nursing facility. Some other types of residential care facilities are: board-and-care homes, group homes, homes for the aged, adult foster care, assisted living facilities, adult congregate living. 

Nursing home employees are typical offenders, as well as family members (when family exists,) and so-called caregivers. Let’s not play guessing games-- the following statements about nursing homes are all true: Most people in the nursing home population, i.e. patients and workforce, are women. Many of the patients in nursing homes suffer from dementia. The older you become, the more likely you are to reside in a nursing home. No uniform data on the prevalence of abuse in nursing homes exist. Abuse of patients in nursing homes often goes unreported. 

And, all of the following statements about nursing homes are false: The cost of living in a nursing home is covered by Medicare. Highly trained nurses provide most, but not all, of the care in nursing homes. Most nursing homes are nonprofit organizations. No one except their families is looking out for the interests of nursing home patients. Most nursing home patients are single or never married. The state with the largest number of nursing homes is Florida. Most long-term care is provided by nursing homes. 

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Infections are responsible for nearly 400,000 nursing home deaths per year. Although there has been some mainstream media attention, very little empirical research has been conducted on the subject. Fifteen percent of U.S. nursing homes receive deficiency citations for infection control a year, according to a new study published in the May 2011 American Journal of Infection Control. This study analyzed deficiency citation data collected for the purpose of Medicare/Medicaid certification between 2000 and 2007, representing 96 percent of all U.S. nursing home facilities. The team discovered a strong correlation between low staffing levels and the receipt of an infection control deficiency citation. 

If you have been a patient in a hospital or nursing/rehabilitation establishment, you may have overheard “pseudomonas.” According to one bacteriology textbook, Pseudomonas aeruginosa is the epitome of an opportunistic pathogen of humans, meaning that it exploits some break in the host defenses to initiate an infection. It causes urinary tract infections, respiratory system infections, dermatitis, soft tissue infections, bacteremia, bone and joint infections, gastrointestinal infections and a variety of systemic infections, particularly in patients who are immunosuppressed. 

The Centers for Medicare and Medicaid Services (CMS) requires that nursing homes be certified before receiving reimbursement for Medicare and/or Medicaid residents. At Medicare.gov one can “find and compare nursing homes” in several ways. A 5 star rating system considers health inspections, nursing home staffing, and quality measures. Of 5 nursing homes located in Berkeley, one received a 5 star overall rating. It is a nonprofit and participates in Medicaid. 

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Just as abuse of children and abuse of wives received attention, elder abuse has become a term used to spotlight this group of persons who are unable to defend or fend for themselves, positioned by society to lack control of their lives. 

In 1967 a British report titled Sans Everything stimulated concern for abuse of old people in public institutions. (In As You Like It, Age Seven of Shakespeare’s Seven Ages of Man is the age of senility -- "sans teeth, sans eyes, sans everything.") A paper describing ‘granny battering’ in families followed. 

In 1972 the BBC commenced Does He Take Sugar?, a radio series about disabled persons. It pointed up the need for acceptance and the fact that everyone has the same right to dignity, respect and access. Talking past people, talking about them in their presence in the third person, assuming that they are senile or deaf, mindlessly addressing old people as dearie, dad, sweetie… Current events were highlighted, people interviewed, stories told and poetry read. (It’s 2011, and I’m aware of a “service coordinator” who incessantly sweeties old women.) 

One in Five, a New Zealand radio program, underscores that very old people are unlikely to appreciate such imposed familiarity or jolly fatuities as ‘Have we been a good boy today?’ or ‘Have we opened our bowels? 

Daniel R. Levinson is inspector general for the OIG in the Department of Health and Human Services. A newly released report from his office (Cause for alarm: Antipsychotic drugs for nursing home patients) makes clear just how crucial it is for families to monitor and ask questions about medications that such patients receive. The report found that too often, elderly residents are prescribed antipsychotic drugs in ways that violate government standards for unnecessary drug use. [Special to CNN May 31, 2011.] 

Five years ago, the first edition of The Maturing of America, undertaken by the National Association of Area Agencies on Aging, reported that most communities had not begun to plan for the great changes that are forthcoming. By 2030, the proportion of people older than 65 is expected to swell from 13 percent of the nation’s population to nearly 20 percent. The second edition of The Maturing of America was released this month. Paula Span writes “It sounds to me like local governments get a C minus, to be generous, in preparing for this seismic change. Exercise classes and volunteer opportunities matter, but housing, long-term care at home, effective transportation — these cost real money, a scarce commodity in today’s cities and towns.” [New York Times. June 3, 2011. “Good News, and Bad, About Community Services”] 

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Physician-assisted suicide crusader Dr. Jacob "Jack" Kevorkian died on June 3, 2011. [See “Dying is not a crime” Senior Power column, November 24, 2010 Planet issue.] 

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MARK YOUR CALENDAR: June, July, August. Be sure to confirm date, time and place. 

Wednesday, June 15 Annual World Elder Abuse Awareness Day. Advocates from around the world set out to promote awareness, in an attempt to prevent elder abuse, the “silent epidemic” that is unacceptable in any language or circumstance. 

Wednesday, June 15 1:30 P.M. Berkeley Commission on Aging. Meets on 3^rd Wednesday at South Berkeley Senior Center, 2939 Ellis. Check to confirm. (510)9081-5178.  

Saturday, June 18 11 A.M. – Noon. Landlord/Tenant Counseling, Central Berkeley Public Library, 2090 Kittredge St. Housing Counselors from the Berkeley Rent Stabilization Board offer free, one-on-one counseling sessions. (Third Saturday each month) They assist both tenants and landlords by answering questions and making referrals on housing related topics-- including security deposits, rent control, evictions, unpaid rent and other difficult issues. Contact Jacquelyn Morgan for more information at 510-981-7368 Ext 4917. 

Tuesday, June 21, 10 A.M. Mastick Senior Center, 1155 Santa Clara Avenue, Alameda. 

Victoria’s Legacy on the Island. Judith Lynch (local author, teacher and resident) serving on the City of Alameda historical Advisory Board will provide an overview on Victorian history and culture, highlighting the 19th century building of Alameda. This program will meet for 6 weeks, and include 4 slide presentations and 2 walking tours to show you how to recognize architectural details and distinguish among the various styles of fancywork homes that abound in Alameda. Sign up in the Mastick Office or call 747-7506. Class limited to 25 participants 

Wednesday, June 22 5:30 – 8:30 P.M. evening programs begin Enjoy the computer lab, Line Dancing classes, a game of Pool, working on quilting or sewing projects, a movie, art classes, visiting the library or a cup of coffee in our air-conditioned facility. For more information, visit the Mastick Senior Center Office or call 747-7506. 

Wednesday, June 22 1:30 P.M. - 2:30 P.M. Albany branch of the Alameda County Library, 1247 Marin Ave. The Great Books Discussion Group meets on the fourth Wednesday of the month. This month's book is A Room of One's Own by Virginia Woolf. Rosalie Gonzales facilitates the discussion. Come to one meeting, or all meetings. Books are available at the Library. (510) 526-3720 x16 

Thursday, June 23 1:30 P.M. Mastick Senior Center. Music Appreciation Class discussion and performance “Leroy Anderson: American’s Master of Light Music” 

Tuesday, June 28 1 P.M. Mastick Senior Center. California Relay Service & YOU! 

A representative from Hamilton Relay (one of two providers of the California Relay Service (CRS) free service offered through the California Public Utilities Commission will explain the various programs available. Register in the Mastick Office or call 747-7506. 

Tuesday, June 28 3-4 P.M. Tea and Cookies at the Central Berkeley Public Library. A book club for people who want to share the books they have read. (Monthly on the 4th Tuesday ) (510) 981-6100. 

Wednesday, June 29 2-3:30 P.M. Be an Expert: become a genealogical super sleuth at Central Berkeley Public Library Electronic Classroom. Ready to research your family history but not sure where to start? Introduction to Ancestry.com, an online resource that offers searchable census tracts, immigration records, photos, stories and more. 

Wednesday, June 29 Noon-1 P.M. Playreaders at Central Berkeley Public Library. 

Meets weekly to read aloud from great plays, changing parts frequently. Intended for adult participants. 

Wednesday, July 6 Noon – 1 P.M. End of Life Planning Workshop at Central Berkeley Public Library. Responsible end-of–life planning can save heartache and help preserve family legacy. Come learn the basics about wills, trusts, powers of attorney, advanced health care directives and more in a supportive setting. 

Friday, July 15 8 A.M. – 2 P.M. Compassion & Choices of Northern California is a participant in the Healthy Living Festival. Oakland Zoo, 9777 Golf Links Road. For information, email admin@compassionandchoicesnca.org 

Wednesday, July 20 1:30 P.M. Berkeley Commission on Aging. Usually meets on 3^rd Wednesday at South Berkeley Senior Center, 2939 Ellis. Check to confirm (510)9081-5178.  

Saturday, August 6 11 A.M. – noon. End of Life Planning Workshop. Berkeley Public Library West branch, 1125 University Av. Responsible end-of–life planning can save heartache and help preserve family legacy. Come learn the basics about wills, trusts, powers of attorney, advanced health care directives and more in a supportive setting. 

(510) 981-6270. 

Wednesday, August 10 10 A.M. – 2 P.M. Compassion & Choices of Northern California is a participant in the Healthy Aging Fair Festival. Chabot College, 25555 Hesperian Boulevard, Hayward. For information, email admin@compassionandchoicesnca.org