Today is a day to remember what my mother went through at the neglectful hands of Caley Ridge Assisted Living Center.  Never would I ever have imagined that she would be an elder abuse statistic.

To find out what happened to my mother, please read the earlier blogs.  As a short review, she was not secured in her wheelchair in the van when the driver took a turn too fast.  She tipped over, hung upside down screaming for help and her screams fell on ears that did not truly care.  The driver pulled over the van and lifted her down to the floor of the van.  She had a broken femur and the pain was unimaginable.  He called Caley Ridge to see if he should call 911.  “No,” they said.  “Bring her back here and we will evaluate her.”  What were they thinking as they heard her screams.  So, my mother bounced around with a broken femur on the floor of the van for a few miles until they reached Caley Ridge.  Then, and only then, did they determine that an ambulance should be called.  My mother went into active heart failure that night and died a month later from complications.  She had a relatively clear mind before the accident, but became symptomatic of dementia after the accident.   

After she was transferred from the hospital to the nursing home, she complained to my sister that the nursing aide in the middle of the night had become angry with her and hit her around her head and the back of her neck.   She was in additional pain and told my sister of the allegation.  There was an investigation, but the result was that she was confused and therefore not substantiated. 

Many of the elderly can not speak up for themselves.  Often times when they do, they are not believed because they are “confused”.  Elders are treated much like children who suffer abuse.   In reading many of the investigative reports posted on the web, I see much too frequently “charges not substantiated due to the confusion of the patient”.  

Abuse of any kind is confusing.  If a person is symptomatic of dementia and you add abuse to them, they are likely going to appear even more confused.   This confusion appears to prevent detection of abuse unless there is significant trauma to the body.   How often are these reports of abuse accurate and not substantiated and only perpetuates the abuse on other victims.  In my mother’s case, she was in a great deal of discomfort from her broken femur.  Her heart was broken because she couldn’t understand why Caley Ridge did this to her.   Then to endure being beaten around the head was too much for her to bear.  She died a few days later.

Today is a day to remember her and her suffering as well as the many, many other elderly people are missing, abused, and neglected.  Below are some helpful links.

www.ncal.org

www.alfa.org

www.ccal.org

www.metlife.com

www.ncea.aoa.gov

www.inpea.net

 www.findshirley.com

It was a mild Tuesday afternoon in Henderson County, Texas on June 19, 2007.  Shirley Hunt wandered outside her home.   Almost a year later, Shirley is still missing.  This wasn’t the first time she wandered off, but never very far.  The police were notified and a search was conducted but to no avail. 

“Mary, she just disappeared.  How can a person just disappear?” my friend asked with deep sadness in her voice.  Shirley is her aunt, the sister of her mother.

I didn’t know what to say.  I wondered the same thing.  Searches were conducted by dogs and they alerted to her scent, but it appeared the scent just stopped.  There is a strong belief that Shirley was picked up by someone.

Her family distraught made contact with all the news stations and even nationally known psychics.  Initially there was interest, but it quickly faded.  Afterall, she was just another “old” missing person.  I suppose there is no story there and therefore no coverage.

She isn’t just another old person to her family.  She is someone’s mother, sister, aunt, grandmother and she is missing.   The pain and anguish is so great.    Their lives came to a complete stop.  It is all so surreal.  Where did she go?  What happened to her?   Was she lost and scared and confused?  Had someone picked her up and inflicted harm on her?   

I don’t know how an elderly person goes missing and can’t be found.  I know many elderly go missing, but many are found.   A year later and the family has no closure.  Not a day goes by without her on their minds.  Yes, they’ve settled back into their daily lives, but their lives will never be the same.  I know my friend’s mother (Shirley’s sister) has an ache in her heart and there is no way to fill it at this time.  She just wants answers.

As we prepare to move into World Elder Abuse Awareness Day on June 15, 2008 and the year anniversary of Shirley’s missing (June 19, 2008), I ask that you take a moment of silence for Shirley and other missing elderly people. 

For more information on Shirley, please go to www.findshirley.com.  You will find other links there for missing persons. 

If you have experienced similar circumstances or just want to leave words for the family, feel free to comment.

I was researching elder abuse today and came across these definitions of elder abuse published by the Department of Health & Human Services, Department of Administration on Aging (AoA).  I want to publish their definition of Elder Abuse.

Generally Accepted Definitions published by the AoA

Elder abuse is an umbrella term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult.

• Physical abuse is inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder, or depriving them of a basic need.
• Sexual abuse is the infliction of non-consensual sexual contact of any kind.
• Emotional or psychological abuse is the infliction of mental or emotional anguish or distress on an elder person through verbal or nonverbal acts.
• Financial or material exploitation is the illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable elder.
• Neglect is the refusal or failure by those responsible to provide food, shelter, health care, or protection for a vulnerable elder.
• Self-neglect is characterized as the behavior of an elderly person that threatens his/her own health or safety.
• Abandonment - The desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.

For more information on AoA please go to their website:   http://www.ncea.aoa.gov

Keeping our elderly safe is challenging.  Because many elderly people in assisted living places and nursing homes experience some degree of dementia, their cries often go unheard and unsubstantiated.  It doesn’t mean that the abuse didn’t happen.  What it means is that the facilities can cover up by calling the elder as confused and delusional.   In reading my mother’s case in some of the investigations, report of abuse was unsubstantiated because they said she was confused.  In reading other cases, I am amazed at home many reports of abuse are made in a facility and how many of those are unsubstantiated.

So, how do we protect the elderly in nursing homes and other facilities?   You help by getting involved.

Here are some websites that might help.

www.ncal.org

www.alfa.org

www.ccal.org

www.metlife.com

www.ncea.aoa.gov

www.inpea.net

It has been over a year since mother transitioned.  My brother, sister and I have all moved on in our own way.  It hasn’t been easy.

You see, our family is not close knit.   We came from an incredibly dysfunctional home and learned to function in this world in our own way.   We didn’t come together and support one another.  I’m not sure if we could.  Perhaps we just didn’t know how.  Instead, the distance between us seem to have grown.   Working in the deathcare environment (funeral homes and cemeteries), I’ve seen this quite a bit.  It didn’t surprise me a bit.

My sister continued dealing with the aftereffects.  Mother left her as executrix.   The effects of grief wore on her and affected her physically and emotionally.   She misses her mother.  She experiences guilt as she deals with the reality of not taking mother to the doctor’s appointment that day.  Although, my sister was recovering from surgery and in no condition to take on that responsibility that day, it runs through her mind “what if.”  I know there is more for her, but it isn’t my place to tell her story.

My brother copes in his own way.  Hurt because of the family division, he is ready to make changes in his life and move forward.  He misses her, too.   Again, it is not my place to tell his story.

Me, well life goes on.  Mother and I weren’t close.   There was too much damage between us throughout my lifetime.  I loved her nonetheless.   I hated to see her suffer so much.   I hated what she had to endure.  One of my challenges for me personally is that mother and I argued and that was the last interaction with her before the accident.  Her words hurt me and my words hurt her.   I carried my own guilt.   I’ve let it go as I drove to South Carolina for Christmas.   I felt responsible to my brother and sister to fill in the void that mother left for them.   That didn’t work so, I let it go as I realized it wasn’t my void to fill.

Caley Ridge - they continue in their business.  I am sure there are some who find them absolutely wonderful.  Mother loved it there.  She had made good friends.  Caley Ridge didn’t respond in love.  They didn’t provide her safety or protection.  That probably, was the greatest pain my mother bore emotionally - the pain of betrayal.  They didn’t see the effects of their neglect.  They didn’t hear her screams as she writhed in pain.  Like any abuser, they closed their ears and their eyes careful to only protect themselves.

Caley Ridge’s decision actions and subsequent decisions had a devastating effect on the life of mother, the lives of her children, grandchildren and great grandchildren. 

I really would like to hear from you regarding your experiences or the experiences of your loved one regarding neglect or abuse.  I would like to hear from you about how you coped with the death of a loved one whether tragically or naturally. 

“Mary, we didn’t get the rehab place after all even though they have a place for mother,” cried my sister.

“What happened?” I asked.

“The social worker at Sky Ridge told them I was difficult to deal with and that they would be better off refusing her a bed,” my sister said through sobs.  She had done so much and fought so hard.

“They are releasing her to a nursing home.  I haven’t told mom yet.  That is the last thing she wanted,” she said.  “I just wanted to give her excellent care.”

Many, many times my mother begged the 3 of us to please not send her to a nursing home.  She was terrified she would die there.  We all knew that and yet felt powerless to do anything about it.   My brother and I lived in other states.  My sister recently had gone through her own surgery could not physically care for her.

My sister advocated endlessly for my mother.  She did an amazing job.  The professionals at the hospital resented her advocacy.  They thought she was “bitchy”.  If she were (and she wasn’t), it was out of love for our mother.  She advocated for her with doctors, hospitals, agencies, and Caley Ridge.  It seems that when you are dying and you are old, people just don’t want to respond. 

Mother began experiencing pain her neck and head and stated that the night aide beat her around her head and she hurt.  The nursing home, of course, denied the allegations.  If you look at their web site you will see this is a common occurrence at this nursing home.  Usually the allegations are not substantiated because the patient was “confused.”

This same nursing home would crush her sustained release medication for her epilepsy.   My sister once again advocated for mother.  The response, which I find, deplorable, was for the doctor to pull her inside mother’s room and tell her that she is being a “bitch” to the nurses and to back off.   She was horrified and exhausted.  She had done so much as she is the one who lived in Colorado near mother.

At that point my sister began the process of moving mother to her home.  She began making arrangements for beds, assistance, etc.  It seemed to be the answer for mother.

On Thursday, February 22, 2007, 37 days after her accident I received a call from my sister.  “Mother just died.” 

I gulped as she said the words and kept driving.  “Was it peaceful, I asked?” 

“Yes.  She was very tired of fighting and she just died,” my sister cried.

My mother died as a result of injuries sustained by gross neglect of a van driver and the decisions of management at Caley Ridge Assisted Living. 

Mother transitioned.  As is often the case for those transitioning through tragic circumstances, it wasn’t the end for us.  

If you have witnessed elder abuse or had a family member suffer through it, please comment.  Your comments may really help other people.  It is through sharing that we can make a difference.  

A scream pierced the quiet halls of Sky Ridge Hospital. 

They were moving her one night.  She still wasn’t stable for surgery.   She screamed - her pain was so great.  It wasn’t her first scream, but I remembered it so clearly.  I stepped out of the room.  I was crying-her pain too much to stand.  I walked down the hall.   The scream penetrated the walls.  The loved one of another patient approached a nurse in the hall.

“Can’t you keep her quiet!?” this woman demanded.  “She is disturbing my . . .”

I looked at the woman incredulously. 

“She has a broken leg and she is in pain,” I quietly said as if I thought she would understand. 

She glared at me and walked away.  I was appalled and I was sad. 

I walked away and down the hall.  I thought about all that she had been through the past few days.  The Caley Ridge Assisted Living driver who took the turn too fast causing her to hang upside down in her seat.  Thinking about his continuing on driving and not helping. 

I thought of her begging for help, her screams going unanswered perhaps responded to just as this woman in the hall at the hospital.  I thought about Caley Ridge not responding to her screams denying her assistance.  I thought about her bouncing around the floor of the van once he moved her to the floor and drove her back to Caley Ridge.  All this with a broken femur.

Her scream that night reminded me of all that she endured because of the neglect of Caley Ridge Assisted Living.  Her scream that night reminded me of all the unheard screams of our elderly .  The response of the woman in the hall at Sky Ridge Hospital is just a reflection of the attitudes of the staff at Caley Ridge.  

Just keep her quiet so no one is disturbed.   Her leg was in great pain.  Her heart was broken.  If screaming helped her endure it, then I am glad she screamed. 

I only wished that the staff at Caley Ridge Assisted Living would have responded to the scream so her suffering would not have been so great.

“Who are you?  Don’t I know you?”

My mother spoke those words to me as I walked into her hospital that Monday night.  My sister had awakened her so she could see me.

She couldn’t figure out who I was that night.  Some may think it is funny.  I didn’t.  I don’t.   She behaved as if she had dementia, but I knew she didn’t.  She recently had a neurological work-up and the doctor reported no signs of dementia.

 That night I was a nun, I was God, and for a brief moment I was me.  She had come around after I had been there some time and asked me when I got there.  I guess you could see humour in all of that.  I just didn’t.

I laughed to release tension - easier than crying. 

She was drugged pretty heavily because of the pain, and she was crashing from heart failure.  There was liquid oozing from her stomach.  Her kidney’s weren’t working.   You could hear her struggling to breathe.  Fluid was building up in her body.

I am not a nurse and have no desire to be one.  I don’t know medical terms or situations.  I only observed and speak what I saw and it wasn’t good.   

I didn’t want to go back to my sister’s that night.  I didn’t know if she would live through the night. 

I felt anger about Caley Ridge’s lack of concern.  I felt angry with the driver for driving too fast.  I felt helpless because I couldn’t make everything okay. 

Betrayal takes many forms.  Caley Ridge Assisted Living betrayed my mother that day.  Some will say perhaps this is God’s will and how everything is supposed to be.  Maybe or maybe not.  I don’t know for sure.  What I do know is that I never want another human being to suffer the same way.

“I’m so sorry,” my mother sobbed.

What does she have to be sorry about?  She did nothing wrong.  Caley Ridge Assisted Living didn’t apologize for their choices.

My mother then told the whole lurid story about what happened to her.

“I begged him to slow down!  He wouldn’t listen to me.”

She begged him.  She was afraid.  He didn’t listen to her.

“Why didn’t he listen?” Mother wept uncontrollably. 

Do you know what it is like to see your loved one weeping.  She was in so much pain physically.  In addition, the emotional pain and suffering was equal.  She loved this man - this driver.  She loved her friends at Caley Ridge and loved her staff at Caley Ridge Assisted Living. 

The staff at Caley Ridge betrayed her.  They betrayed her trust and our trust.  They didn’t protect her.  They didn’t take appropriate action.  They made her suffer and endure this. 

I am sure she felt so alone and so disappointed.

Life isn’t fair, I understand that and accept it.  This isn’t about fairness.  This is about basic human rights and injustice against my mother.  Unfortunately, I am sure others have suffered similar injustices.

She went into heart failure that night.  The shock and trauma was too great for her body to manage.  They couldn’t do surgery to stabilize the broken femur and ease some of her pain.  Instead they had to fight to save her life.

All this because Caley Ridge Assisted Living Failed to take appropriate action in protecting my mother.

“Nancy, your mom had a little fall.  We are sending her to the hospital,” the staff at Caley Ridge Assisted Living.

A little fall they tell her minimizing the whole accident.

“Is she hurt?” my sister asked groggily.  She was recovering from surgery herself.

“She may be hurt this time,” responded the staff person at Caley Ridge Assisted Living.

 ”Do I need to hurry?” asked my sister.  

“No, no need to hurry,” replied Caley Ridge Assisted Living.

They did not explain to my sister what had happened at all.  They didn’t even act as if it were important.  They notified my sister and essentially communicated to her it was no big deal. 

 Because of the communication with Caley Ridge, my sister did not sense she needed to race there.  She pulled herself together and her friend just dropped her off at Sky Ridge Hospital. 

 My sister walked into the room where she was supposed to be and nobody was there.  This puzzled her.  She asked what was going on and no one would tell her except to say she was in x-ray. 

Can you imagine what it felt like to walk into a hospital room to check on your loved one and they aren’t there?  That was her first inkling something was going on. 

Eventually, they brought our mother back into the room.  She took one look at my sister and started sobbing.

I imagine the scene at Sky Ridge.  I imagine my sister’s confused and dazed look.  I see my mother’s pale and drawn face.  I am sure these are not unusual experiences in the emergency room at Sky Ridge.  I imagine they are just going about their business. 

In my mind’s eye I see my mother and my sister.  I wasn’t there, but somehow I see the suffering in her face.  She is in pain.

It was unnecessary for this to happen.  The decisions that the driver and the Caley Ridge staff made that day impacted the life of my mother and her children, grandchildren and greatgrandchildren.  The ramifications are still being experienced today.

“Mary,” my sister said, “after the long drive back to Caley the “Professionals” evaluated her and decided that they better call 911.”

” They made her endure bouncing on the floor of a van with a broken leg before making that determination.  Can you imagine that?”

I couldn’t imagine it.  Why didn’t they listen to my mother.  She knew she needed help.  No one listened.

The “Professionals” at Caley Ridge Assisted Living failed to take precautions in over seeing my mother’s well-being.  I am not in the medical field, but I can tell you that making her bounce around with a broken leg is not appropriate.  Common sense would tell most of us to pull over, get the patient/client comfortable and call 911.  

“The ambulance came and took her to Sky Ridge Hospital.  They are the ones who called me,” continued my sister.  (I was incorrect.  Please see Part 6 for correction.)

“When I arrived, she was in xrays.  No one had bothered calling the police.  So, I called and each county did not want to accept responsibility.”

Caley Ridge didn’t even call the police.  No great surprise.

Mother went into Caley Ridge Assisted living because she couldn’t live on her own any more.  She needed assistance but she was far from dying.  She found friends and a social life.  She found a home.  What she didn’t expect to find was neglect and abuse.