From The Silver Standard’s Elder Abuse Reform Now Project: In 2020 America Animals Receive More Humane Care Than Our Senior Citizens

By Mary West

Studies show that the care of America’s elderly and infirmed not only fails to meet federal nursing home regulations but federal laws governing the treatment of animals 

Just how badly are some nursing home residents treated? Do they receive better care than animals in a zoo or dogs in a kennel? A recent report issued by the Long Term Care Community Coalition (LTCCC) compared animal care standards to the experiences of individuals in long-term care facilities. The authors concluded that care of the elderly and infirmed often not only fails to meet federal nursing home regulations—it also falls short of requirements for humane animal treatment.

A 2014 study by the OIG found that one third of Medicare 

beneficiaries who enter a nursing home are harmed 

within approximately two weeks. 

 

The LTCCC report was based on research that evaluated several categories such as abuse, nutrition, and medical supervision. Guidelines for animal care mandated by federal law and oversight agencies served as standards on which to base the comparisons of nursing home experiences. Each category assessed revealed cause for alarm. It’s frightening to think that a precious parent, grandparent, aunt, or uncle may not receive even the basic treatment due a pet.

Abuse and Neglect

According to the Standards for New World Primates, physical abuse and punishment-based training should never be used in handling non-human primates. While federal standards prohibit the abuse of nursing home residents, state and federal oversight agencies are lax in enforcing them.

Mistreatment and neglect top the list of concerns relating to long-term care because they cause suffering that takes many forms. The harmful effects can be so severe that they culminate in death.

Statistics like a 2019 report issued by the U.S. Department of Health and Human Services Office of Inspector General (OIG) underscore how abuse has serious outcomes. It estimated that one in five Medicare claims from nursing home residents visiting the emergency room stemmed from mistreatment.

Furthermore, once someone is admitted to a long-term care facility, the abuse frequently starts quickly. A 2014 study by the OIG found that one third of Medicare beneficiaries who enter a nursing home are harmed within approximately two weeks.

46 percent of older residents in long-term care facilities 

had impending or current dehydration 

 

Nutrition and Hydration

The Animal Welfare Act states that hamsters and guinea pigs should be fed daily and that the chow needs to be palatable, free of contamination, and sufficiently nutritious to meet the animals’ needs. Federal standards for nursing home residents stipulate that meals be appetizing, healthy, and appropriate in size.

Sadly, individuals in long-term care facilities aren’t always treated as well as rodents. It’s not unusual for them to receive insufficient food and water, the fundamental necessities for life.

A 2004 study published in the Journal of Gerontology discovered that 64 to 80 percent of nursing home residents consumed less fluid and food than amounts recommended in federal guidelines. In a 2020 article featured in Age Ageing, the authors estimated that 46 percent of older residents in long-term care facilities had impending or current dehydration.

Dehydration is a condition that can be life threatening if not caught in time. In a 2019 hearing held by the U.S. Senate Committee on Finance, legislators heard the account of an Alzheimer’s resident in an Iowa facility who was denied water for several days. The person died after developing dehydration.

Food and water safety is also an issue. A 2019 report in Fair Warning detailed often-unreported problems in nursing homes such as moldy ice machines and food-borne disease outbreaks.

Freedom from Restraints

Guidelines from the 2016 American Association of Zoo Veterinarians note that physically restraining animals without sedation should be reserved for use only during medical procedures. Federal requirements mandate that nursing homes shouldn’t use physical or chemical restraints on residents for purposes of convenience or discipline.

All of us have felt sympathy for a dog that is chained much of the time and not allowed to run loose within a fenced-in enclosure. Individuals in long-term care facilities are sometimes similarly restrained.

Bedrails, one form of physical restraint, represent a source of preventable harm because residents can climb over and around them. A New York Times review reported that from 1995 to 2012, bedrails were implicated in 550 deaths. These restraints are sometimes necessary, but they shouldn’t be used without supervision.

Nursing homes frequently use drugs to sedate residents for the convenience of caregivers. A 2018 Human Rights Watch report said that in an average week, they administer antipsychotic medications to 179,000 individuals who haven’t been diagnosed with the disorders. The drugs promote docility, but their sedating actions have significant side effects. Use of medications as chemical restraints is unacceptable.

Skin Care

In 2020, standards listed by the Associations of Zoos & Aquariums advise staff to inspect the skin of elephants daily and treat problem areas. Federal nursing home standards specify that residents receive skin care to prevent and treat pressure sores.

Because of mobility limitations, individuals in long-term care are in constant danger of pressure sores, but they aren’t afforded the skin care recommended for elephants. LTCCC reported that more than 93,000 nursing home residents have these maladies. Pressure sores can become infected and take months to heal; if untreated, they result in complications, some of which lead to death.

Medical Supervision

Under the Animal Welfare Act, attending veterinarians should examine each marine animal in their care once a month, which must include an interview with a staff member familiar with the creature. Federal rules for nursing homes call for a doctor to examine every resident once a month for the first three months after admission and once every two months thereafter.

Adequate medical supervision can prevent or reduce many perils of living in a long-term care facility. If problems are caught early, they can often be remedied; but when staff is short, many issues go undetected. Data from Medicare.gov showed that in 2018, oversight agencies issued 3,876 citations for insufficient numbers of nurses and doctors in nursing homes.

The LTCCC report cited several cases of disorders that occurred due to a lack of doctor and nursing care. One involved the failure to monitor an individual getting intravenous therapy, which resulted in electrolyte imbalances and a decline in neurological functions. In another case, the lack of staff compliance to provide doctor-ordered range of motion exercises and splints to a resident’s impaired joints led to the worsening of contractures. Surveyors noted both violations as “no harm.”

Most people have heard of the mistreatment that some nursing home residents endure, but it’s sobering to know the extent and scope of the problem. The reality that individuals often don’t get the quality of care experts advocate for animals is a terrible indictment of America’s health care system. Although we treasure our pets, the value of human life is so much greater. Our country’s seniors, who have given decades of love and service to their families and communities, deserve that the same care be reciprocated to them when they are frail and infirmed.

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In 2020 America Animals Receive More Humane Care Than Our Senior Citizens