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Problems in Assisted Living
Long Term Care and Assisted Living Abuse Problems

There are roughly 12,000 complaints lodged with the Department of Social Services in California every year - claims like beatings, theft and deaths due to neglect.

And that's just California.

Reported Crimes

  1. A caregiver sprays insecticide on a resident. The facility cited for the personal rights violation, but not mentioned an offence.
  2. An employee at another facility managed a resident's finances, accepted money for the service and pay off the staffer's fines from a drunken-driving charge.

A true story (names and places omitted for privacy)

The son was never told!

Abuse in Assisted Living
Abuse in Assisted Living

Mr. Victim was 81 when he tumbled out of his wheelchair at Assisted living facility at Anywhere, USA. He landed face-first on the floor that day in 2010, breaking his neck in two places. According to state records, the staff reported that Mr. Victim insisted he was fine. A visiting doctor suspected Mr. Victim suffered a stroke and recommended he move to a hospital but that did not happen immediately, a report notes.

Mr. Victim was taken, several hours later, to Anywhere Memorial Hospital, where he died the next day.

"Based on the evidence obtained during this investigation, the allegations of neglect substantiated the questionable death," the licensing record said.

The Assisted Living officials said the staff responded to the emergency immediately and appropriately.

The Anywhere Police Department says it was not informed of the case. And no one from the Department of Social Services shared its findings with Mr. Son of Victim. He, the son, surprised to learn of his father's death and its questionable ruling.

"Why bother paying a guy from the state to investigate if they're just going to throw the report on a shelf?" he asked.

State law enforcement officials are aware of Community Care Licensing Division's small number of referrals to prosecutors for years.

The Attorney General's Bureau of Medi-Cal Fraud and Elder Abuse was so troubled by the lack of references to his office he tried to formalize a reporting protocol in a memo signed by top officials from both agencies.

It did not result in an immediate jump in cases presented to the elder-abuse team. State records show the attorney general received fewer referrals and saw a small increase in subsequent years.

Patterns of Elder Care Abuse

Is this difficult to believe? See for yourself. Do an online search for the term "problems in assisted living." What did you get?

Here are article titles returned from my search (just the first page):

  1. Investigation Finds Pattern of Problems for Elder Care in Assisted Living
  2. Addressing problems in nursing homes and assisted living facilities
  3. Ten things assisted-living homes won't tell you
  4. How to Solve Problems in an Assisted Living Facility
  5. Investigation Uncovers Fatal Care Issues at Assisted Living Facilities
  6. Abuse in Assisted Living Facilities | Nursing Home Abuse Center
  7. Nightmare in Assisted Living Exposed On PBS - Forbes
  8. Nightmare in Assisted Living Exposed On PBS - Forbes

Guess what? There is a total of 2,820,000 results for the term "problems in assisted living."

Now, do one on elder abuse in assisted living, actually, don't. You get the point.

The places to start, even before placement, know the patient's rights and the patient's responsibilities. The John Hopkins Hospital put together an easy read on the Patient Rights in this nifty brochure. Read the Bill of Rights. It applies to all 50 states healthcare system including hospitals, nursing homes, assisted living, etc.

Unfortunately, some of the most commonly reported problems are appalling.


What is it?

Elderly Abuse

The short list falls into five categories of injury: physical, psychological, and sexual abuse, financial exploitation, and neglect. These can cause permanent disability or death. Having open wounds and bed sores are a sign of abuse through neglect.

The U. S. Government and Accountability Office completed a report on senior housing that revealed the deficiencies of homes within four states. The total number of facilities in the report was 622 assisted living facilities in California, Florida, Ohio, and Oregon. The study found; failure to provide sufficient care to residents after an accident, unqualified or insufficient staff, failure to provide medications or inadequate storage of medications, and failure to follow admission and discharge policies.

Abuse by Caregivers

The U. S. Government and Accountability Office stated the primary factors relating to the abuse problems are primarily due to inadequate staff training and high staff turnover.

It brings up a red flag (you must pay attention to) if the staff has enough knowledge of the residents and their physical and mental health problems. For residents living with dementia, the residents are at risk because they may not know the staff well enough to feel safe and in good hands opening the door to aggressive mistreatment and emotional abuse.

Financial Fraud and Exploitation

People in authority abuse their position. NOT all staff members fall in this category. There are a few bad seeds. The ones who are abusive extort money from a trusting elderly person-one who is lonely and vulnerable to a pleasant approach.

What starts out as stealing a few dollars turns into full-blown scams, depleting life savings.

Here's how it plays out. A caregiver mistreat the credit card or a bank account. It's common for a caregiver to have access to financial information. Reports of identity theft are more complicated than others, but it does happen

A growing scheme is healthcare fraud. It works like this; money charged for services that aren't delivered. Charges are for services or medications that the person needs but often, not received.

Con Artists and perpetrators target the elderly. Two, in particular, happens more often than we care to think about. They go like this.

Prize: A senior received a phone call and told about a prize they won. Before its delivered or mailed, there's an up-front fee to claim it.

Charity: Another is a fake charity. The not for profit or charity tailored to a person's soft spot and personal interests, like for pets or a make a wish foundation. The check or monies go to the con artist.

Sexual Abuse

Yes, even in senior housing.

Not consensual sex but the non-consensual sexual contact or interaction, the kind that's between the caregiver and an elderly person. Here again, the person (caregiver) abuses their position of authority, power, and dominance over the elderly resident.

This form of abuse does not necessarily pertain the physical body. It can also include the forcible viewing of pornographic material or sexual acts, or forcing the elderly person to undress without cause.

Signs of Neglect

  1. Frequent falls - 36 percent of preventable hospital emergency room visits made by nursing home residents is injury due to a fall.
  2. Personal Hygiene - Without help, residents are left to care for themselves for a clean change of clothes or even such basics as al hygiene.
  3. Medical - Pressure sores, or bed sores, are a major problem and result from sitting in a chair or lying in a reclined position for too long.
  4. Basic needs - Food and water is not given and needs neglected--produces dehydration and malnutrition.
  5. Emotional neglect is devastating. When staff ignores an elderly resident, they retreat to their rooms and withdraw from social activities. Leaving them in need of support and connection.

The "Guide to Choosing a Nursing Home" prepared by the Centers for Medicare & Medicaid Services (CMS). CMS and states oversee performance of nursing homes. State and Federal government agencies certify nursing homes to participate in Medicare and Medicaid.

Call 1-800-MEDICARE

(1-800-633-4227), or visit to get the most current information. TTY users should call 1-877-486-2048.

This report ordered by the Agency for Healthcare Research and Quality through a sub-contract with Westat to review:

  • State monitoring and oversight practices of assisted living facilities.
  • Information that is available on State agency Web sites to consumers and family members about assisted living.

State Monitoring Oversight

State monitoring and oversight practices of assisted living are similar to, although not as extensive as, those used by States to review nursing homes. Assisted living monitoring and survey tools track each State's own regulatory requirements and are not standardized across States.

A review of the Web sites of State licensing agencies found that 48 States post licensing regulations; 46 provide access to a database or list of licensed facilities; 12 post survey findings on their Web site; and 14 States post a guide to help consumers and family members learn about and choose a facility. Twenty-six States offer information to facility administrators and staff on a Web site. The information ranges from licensing application and renew a l forms, administrator requirements, bulletins, information about the survey process, technical assistance materials, and incident and complaint forms

Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.