Sunday, January 25, 2009

Where is our moral compass: nursing home abuse

I was reading about the case of teenagers who are being charged with abusing elderly nursing home patients under their care. Two of the teens were arraigned on Thursday and the newspaper dubbed them "mean girls". I am disturbed by the headline because it inappropriately sensationalizes the story.

Brianna Broitzman, 19, and Ashton Larson, 19, reportedly spit at, poked and rubbed the genitals of at least seven residents at the Good Samaritan Society nursing home in Albert Lea, Minn., according to a criminal complaint filed in December and obtained by

And there's more - more teens involved, some of whom failed to report the incidents. Allegations of patting of a patient's buttocks, spanking a patient with a cane on the buttocks, lying in bed with a patient and inserting a finger into a patient's rectum, poking a patient in the breasts and taking videos and pictures of patients.

The abuse allegedly went on between January and May 2008 and happened to patients with Alzheimers and dementia, a vulnerable population that can't even speak up. If they do, people assume they are imagining what is seen as a bizarre story.

The case is also being called an "abuse for thrills" case, continuing the theme that this is more about those who abused, than those who were abused. It is as if our desire to understand the "why it happened" exceeds our interest in looking at ways to prevent it again. There is no information in the article about any changes made in the level of supervision of nursing assistants who work with such a vulnerable population at this nursing home or any other.

The director of the nursing home is quoted as saying

"Our hearts are in the right place. We're moving forward. Our heads are held up high."

Not so fast. Let's rewind the tape here. It's time for society, for all of us, to own our accountability when the most vulnerable among us are treated this way, especially when we fail to enact change so it doesn't happen again.

Prosecutors say that those charged put their fingers in residents’ mouths and noses to quiet their cries and screams, hit and rubbed their breasts and genitals, and sexually “humped” some residents. The aides allegedly called the abuse “work fun or to get a good laugh.”

This story is not just about those who are being tried for these allegations. It is about those in nursing homes and institutions who remain vulnerable. We need to ask the tough questions here before we move on. In order to do that, we need to get past "mean girls" headlines. We need to figure out why there is more supervision and accountability in jobs at Best Buys and McDonald's, where if an employee walked up to a customer and violated boundaries like this, the police would be called and there might be a store camera filming it too. But that's different, some might say. It's a public place.

Exactly. Which is why there need to be more protections in place for those who are isolated and away from the public view. For those who may not even be able to speak. We need a higher level of accountability and transparency when dealing with caregivers of vulnerable populations, not a lower one.

The question asked by a watchdog group "Where is the moral compass of these employees?" needs to become where is our society's moral compass? What importance do we, as a society, give to the care of those who are most vulnerable? Is their safety our responsibility and, if so, how do we provide ways and means to ensure that? Is their dignity important to us? Is their well being our responsibility?

And, if we answer yes (and I hope we do), what can we do? Can the fact that our government monies go toward paying for this care be used to set in place better protection and advocacy for patients and their families? Shouldn't we scrutinize the level of supervision set in place? Should we have cameras in institutions for better oversight and accountability?

These questions aren't easy ones. But let's not move on until we at least ask them.


Greg said...

I agree with you Ruth, so much more needs to be done to protect patients!

Terri said...

This story is absolutely horrifying to me as a human being. To me as a nurse who works in long term care, it is nauseating. I would be very interested in how many elders are on this floor and how the staff is trained, aculturated and supervised. Is the focus of this home on getting care tasks done or on making lives for human beings?(How are a bunch of teenagers alone with residents for the amount of time it would take to do all of this??)

I would want smaller groups of elders and smaller groups of staff with more oversight and more relationship. I would not opt for anything that made things less personal and more institutional because that atmosphere allows people to behave in less personally responsible ways.

I am horrified for these elders, their families, and for the families of these girls who surely never thought this is what they were bringing up their daughters to allegedly do...


sanabituranima said...

This is despicable, and I agree with most of what you say. But are cameras reallty the answer? Isn't that justb another violation of the residents' privacy?

Wheelie Catholic said...

sanabituranima- You make a good point, although I was thinking that cameras and /or monitors would assist supervisors in their job, and who has access to the equipment could be limited, I can see privacy issues outweighing that for many patients. It's possible that with some patients who cannot speak, however, more monitoring is needed.

Terri - your suggestions about smaller numbers and certainly changes in supervision levels and how it's done, make total sense. thanks.

Greg- thanks for your comment.