Appearing on the front page of the Sunday edition of the Arizona Republic (5.21.23), the first paragraphs of an extended feature article point to the potential for harm to residents and the consequences of staff shortages or inattention at Arizona facilicities caring for residents with dementia. Two women in their 90s are residents of an elegantly appointed assisted living facility– but as the article begins they are covered in blood — and the investigation of what happened there is hampered by the inability of anyone to give clear explanations.
The feature, based on the newspaper’s review of “thousands of pages of police and state regulatory reports,” offers multiple reasons for such injuries in “senior living” facilities, including a lack of clear reporting rules and the absence of investigation by state agencies, especially for facilities licsenced for “assisted living” as opposed to “nursing home” care. From the feature:
In memory care units, anything can become a weapon — toilet plungers, shoehorns, electric razors, TV remotes, metal trash grabbers and walking canes. Hundreds of vulnerable seniors, particularly those with dementia, contend with violence at the end of their lives in the very places that promise to keep them safe.
Shortages of staff– brought on by companies looking to maximize profits or stave off financial losses — lead to more harm. Assisted living facilities can keep resident clashes underwraps [in Arizona] because regulartors don’t make facilities report incidents to their state licensing agency. Federally regulated nursing homes have to report but little attention is paid to the problem.
The Arizona Republic combed through thousands of pages of policce and state regulatory reports to find more than 200 clashes at senior living facilities from mid-2019 to mid-2022. Residents punched, hit, pushed, kicked, poked scratched, bit, elbowed or spat on other residents or employees.
Experts consulted by the Arizona Republic noted that one “key [to reducing problems] is tailoring a [resident’s] care plan to each resident’s needs, equipped with activities that bring their lives a sense of purpose.” Further, “[a]ssisted living facilities commonly get in trouble for having inadequate, delayed or out-of-date plans for residents that outline their need or for failing to follow those plans.”
The article cautions that if a problem is not tracked, “it doesn’t exist”:
The Arizona Department of Health Services licenses facilities and is responsible for investigating complaints but assisted living centers don’t have to report nonfatal injuries to the agency.
That’s not normal. Most states require facilities to report to their licensing agency when residents get hurt, according to The Republic’s review of state laws.
The feature suggests that “Arizona lawmakers and regulators have prioritized the needs of assisted living and nursing home companies over their residents,” comparizing Arizona to “[a]t least 17 states [that] require assisted living facilities to get inspected about once a year, with a few even requiring two inspections per year. ”
For the full Arizona Republic feature published in its print version on May 21, 2023, look for “Arizona seniors at risk of harm: Facilities experiencing staff shortage, residents with dementia enable violence,” by reporters Caitlin McGlade, Melina Walling and Sahana Jayaraman. The extended Sunday feature appears to follow several shorter articles available online in May from the same reporting team.