When families choose a nursing home for a loved one, the number one criterion is safety. As much as we might prefer to avoid having to move into institutional care, most of us probably assume that, at a minimum, a nursing home is a safe place to grow old.

Tragically, based on extensive new research, that may not always be the case. We were profoundly disturbed when we read this recent article on the Kiplinger website in which editor and reporter Elaine Silvestrini presents an overview of a shocking 141-page report just issued by the Long Term Care Community Coalition. On page after page, based on at least 100 publicly-available reports on nursing homes around the country, the group documents how residents are afraid to report abuse, cowed into silence by fear of retribution. The ominous title of this chilling report:         They Make You Pay. 

Let’s look more deeply into Silvestrini’s article to see what families need to know to protect those they love.

Fear of Punishment Triggers Silent Suffering

According to a recent, horrifying report by the Long Term Care Community Coalition, patients in nursing homes are experiencing abuse at the hands of staff and yet remain silent for fear of being punished or penalized by the very people meant to care for them. This was reported recently on the Kiplinger website.

They Make You Pay is the chilling title of the report, and it was inspired by the story of a Florida nursing home where residents received consistently poor care yet refused to report it for fear of retribution. “One resident said staff would ‘make you pay’ by delaying care or sabotaging meals of complaining residents,” Silvestrini writes.

Excerpts Paint a Chilling Picture

We took a look at the Long Term Care Community Coalition report. From the outset, the study paints a bleak and disheartening picture. “Fear of retaliation is a pervasive problem that results in emotional, psychological, and physical harm to vulnerable and frail residents,” the introduction states. “In far too many U.S. nursing homes, retaliation is a tool to scare and muzzle residents.” 

But remarkably, the public as well as policy experts remain clueless. “Unfortunately, this phenomenon has been largely overlooked in policy and in academic literature,” the report states.

The report also brings home its painful message when describing how the exhaustive document got its name. “In an interview with the surveyor, a [Florida] resident said she did not file a grievance ‘because they get back at you…They are watching even now to see which rooms you go to and listen to what you ask.’ According to the resident, staff and administration at this nursing home retaliated by delaying resident care or sabotaging meals. ‘They make you pay,’ she said.

“The resident then asked the surveyor to leave and return later because staff were lingering at the door.”

Fear Itself is Often Worse Than Any Punishment

The fear of anticipating punishment can be even more damaging than the punishment itself, according to the report’s findings. “Too often, fear of staff retaliation – the fear itself – prevents residents from voicing concerns and from receiving the care and services to which they are entitled. Ultimately, this inaction leads to unnecessary emotional, psychological, and physical harm to vulnerable residents,” the report states.

A study at the University of Connecticut Center on Aging measured this phenomenon by surveying residents in long-term care homes. One question on the survey asked, “Do you worry about retaliation if you were to report a complaint or concern?”

“According to the report,” Silvestrini writes, “23 percent of nursing home residents said they did worry about retaliation if they were to report a complaint or concern. In addition, 4 percent reported that they do not want to complain and 1 percent reported not wanting to get people in trouble.”

“Also,” she adds, “the Atlanta Long-Term Care Ombudsman reported that 44 percent of the residents who had seen abuse of other residents did not report it; half of the residents did not report it due to fear of retaliation.”

If you or someone you know has an experience you would like to share, or if you would like more information on how to address long-term care issues, you can find extensive state and federal resources at  https://nursinghome411.org. 

Staffing Shortfall, High Turnover Plague the Industry 

Along with the disquieting reports of abuse and silencing, the coalition has also been diligently gathering data about the long-term care industry’s endemic lack of staffing, which President Biden has pledged to address.

According to that report, “Nursing homes are turning over more than half of their staff over a 12-month period. The median total nursing staff turnover is 53 percent, including 50 percent RN turnover. Higher turnover is associated with worse quality of care.”

This staffing issue varies region to region within the United States. Silvestrini writes, “Staffing levels are different in different parts of the country, with the lowest staffing levels in the region that includes Arkansas, Louisiana, New Mexico, Oklahoma and Texas.  The highest staffing levels are found in the region that includes Alaska, Idaho, Oregon and Washington.”

The coalition website also has information about finding a good nursing home. Data about specific nursing homes, including staffing levels, can be accessed at the Center for Medicare and Medicaid Services Care Compare website.

Rajiv’s Response: Be Diligent About Family Care

We asked Rajiv for his response to this sad commentary. His answer was succinct. “Actually, I’m not too surprised,” he said. “Depending on what numbers you read, there are almost 20,000 skilled nursing homes in the U.S., and there aren’t enough qualified employees to go around. Some facilities are good places, but with staffing problems and other issues, it’s no wonder some places offer so-called care that borders on elder abuse!”

So, what’s the answer? Rajiv says families need to do their homework with extra diligence. “The research is available,” he states. “Check the CMS website. Ask others who have shopped around. Visit the facility, not just once but multiple times. Talk to the residents, not just the salesperson.”

Another helpful tool, says Rajiv, is for families to hire a professional care coordinator. “For a fee, a care coordinator will do a lot of the homework for you,” he says. “In my experience, it’s money well spent.” Contact us and we can provide helpful resources and guidance.

Of course, for many seniors the goal is to stay out of institutional care in the first place. While some may need the acute care that a nursing home offers, others can live well in their own home, provided that they plan ahead. AgingOptions and Life Point Law can definitely help you there, too!

Breaking News: Rajiv’s New Book is Here!

We have big news! The long-awaited book by Rajiv Nagaich, called Your Retirement: Dream or Disaster, has been released and is now available to the public.  As a friend of AgingOptions, we know you’ll want to get your copy and spread the word.

You’ve heard Rajiv say it repeatedly: 70 percent of retirement plans will fail. If you know someone whose retirement turned into a nightmare when they were forced into a nursing home, went broke paying for care, or became a burden to their families – and you want to make sure it doesn’t happen to you – then this book is must-read.

Through stories, examples, and personal insights, Rajiv takes us along on his journey of expanding awareness about a problem that few are willing to talk about, yet it’s one that results in millions of Americans sleepwalking their way into their worst nightmares about aging. Rajiv lays bare the shortcomings of traditional retirement planning advice, exposes the biases many professionals have about what is best for older adults, and much more.

Rajiv then offers a solution: LifePlanning, his groundbreaking approach to retirement planning. Rajiv explains the essential planning steps and, most importantly, how to develop the framework for these elements to work in concert toward your most deeply held retirement goals.

Your retirement can be the exciting and fulfilling life you’ve always wanted it to be. Start by reading and sharing Rajiv’s important new book. And remember, Age On, everyone!

(originally reported at www.kiplinger.com)