Preventing Elder Abuse -
Long-Term Care Facilities

WHAT IS LONG-TERM CARE ?

Long-Term Care encompasses a wide variety of settings and services designed to specifically meet the special needs of vulnerable adults. It may include medical assistance, ambulation assistance, or performing rehabilitation therapy, but more often involves assistance with the activities of daily living, including personal hygiene, dressing, bathing, meal preparation, feeding, and travel. "Long-Term Care" facilities are typically licensed by the State.

If your loved one is in the care of a nursing facility or living in assisted living the following signs does not necessarily mean that abuse is or has occurred. Instead, treat them as signs that diligent attention or investigation is needed.

WHO IS CONSIDERED A VULNERABLE ADULT?

Any adult 60 years or older who cannot take care of him/herself is considered a vulnerable adult. Other adults considered vulnerable are 18 years or older and:

• Have a legal guardian;
• Have a developmental disability;
• Live in a facility licensed by DSHS/ADSA;
• Receive services from a DSHS contracted individual provider;
• Receive in-home services through a licensed health, hospice, or home care agency;
• Have a personal care aide who performs care under his/her direction for compensation.

WARNING SIGNS OF ABUSE

Physical Warning Signs:

• Call light (or whatever mechanism is available to summon help) is not functioning or is removed from resident's reach
• Development or worsening of pressure sores
• Soiled or dirty bedding
• Excessive weight loss
• Unusual or recurring scratches, bruises, skin tears or welts
• Bilateral bruising (bruises on opposite sides of the body)
• "Wrap around" bruises (bruises that typically encircle the arm)
• Torn, stained or bloody underclothing
• Signs of excessive drugging
• Foul smelling, uncombed or matted hair
• Patches of hair missing or bleeding scalp
• Injuries that are incompatible with explanations
• Injuries caused by biting, cutting, pinching, or twisting of limbs
• Burns caused by scalding water, cigarettes or ropes
• Any injuries that reflect an outline of an object, such as a belt, cord or hand

Behavioral Warning Signs:

• Withdrawn
• Confused or extremely forgetful
• Depressed
• Helpless or angry
• Hesitant to talk freely
• Frightened
• Secretive
• Any unexplained and sudden changes in behavior or mood

HOW TO CHOOSE A LONG TERM CARE FACILITY

Things to consider before choosing a long-term care facility When making the decision to put a vulnerable adult in long-term care, make the choice after extensive research.

• Make sure that a site visit is done, preferably several at different times of the day and week
• Discuss what the facility can and can't do in terms of treatment
• Inquiry about the level of training that the staff receives, both prior to hiring and as ongoing education
• Ask to see the facilities license and a copy of their latest inspection report
• Contact the Long-Term Care Ombudsman for information about the specific facility
• Check the DSHS website to see if there are citations against the facility
• Be observant - how do other residents seem to be, is the facility clean, is the staff friendly and helpful, etc.
• Don't be afraid to ask questions and ask for clarification if the answer is not clear

Once a facility has been chosen there are several things that can and should be done to ensure that the best possible care is provided for the vulnerable adult:

• Keep diary of loved one care and store it away from the facility
• Visit often and vary your visit times
• Question anything that may be of concerns to you
• If uncomfortable with something immediately call 911
• If you call one of the complaint lines, always ask that a copy of the follow up investigation that was done is forwarded to you

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