CW: Neglect & Death
In Oregon, Ki Soon Hyun walked out of the nursing home where she lived on Christmas Eve of 2023. On Christmas Day, police officers who were searching the neighboring woods found her body. She was 83-years old.
State officials sprung into action. Officials closed Mt. Hood Senior Living. The state ombudsman discovered multiple overlooked red flags at the facility. The governor commissioned an audit of the state’s oversight of long term care facilities.
While tragic, Ki Soon Hyun’s story is far too common. According to The Washington Post, more than 2,000 people have wandered away from assisted-living and long- term care facilities or been left alone outside since 2018. It is estimated that around 100 of those people have died. The exact number of fatalities is unknown because no one is counting.
For many, the weather was the only difference between life and death. In cases where a cause of death could be determined, the Washington Post found that 61% died from exposure to extreme temperatures. Others died after wandering into ditches, drowning in nearby bodies of water, or being struck by cars.
Joseph Matthews, 77, died of multiple organ failure after being discovered covered in fire ants and yellow jacket stings 20 hours after leaving his North Carolina facility. It was the second time Matthews had disappeared. Jack Tribble, 79, had been missing from the South Carolina facility where he lived for about two weeks. It was determined that Tribble had drowned in a shallow body of water, according to a coroner’s report released to his widow.
The federal government does not regulate the nation’s approximately 30,000 assisted-living facilities in the same way that it regulates nursing homes. Instead, regulation is left to individual states, few of which have implemented rigorous staffing and training requirements even as the industry estimates that residents nationally have risen to more than one million. The population of nursing homes nationwide is approximately 1.2 million.
The $34 billion industry’s recent rise has been fueled in large part by demand for secure housing for the increasing number of dementia patients, a vulnerable population that now accounts for nearly half of all assisted living residents. These are also the individuals who are most likely to leave. People with dementia may be confused at times, but extremely mobile.
In January, a resident from a Southeast Portland, Oregon nursing home wandered down a major street before spending the day taking busses and walking in circles. That night, temperatures dropped nearly below freezing. The individual was experiencing a decline in their cognitive abilities. However, a friend located them at their old residence the next day.
Cascade Terrace, where the resident lived has 105 beds. The facility “failed to ensure safety interventions and supervision were in place,” inspectors concluded. These incidents “shouldn’t happen” says Elizabeth Halifax. Halifax is a professor at the University of California San Francisco and president-elect of a national advocacy group for long-term care residents.
Sadly, elopements do happen. “It’s because there’s insufficient staffing,” Halifax explained to Lucas Manfield, a healthcare reporter for the Willamette Week. According to a national industry survey, 86% of nursing homes report being moderately to severely understaffed.
Since the beginning of the COVID-19 pandemic, nursing homes have lost more than 200,000 workers. The nursing home workforce is experiencing a shortage of employees not seen since 1994 according to the American Health Care Association and National Center for Assisted Living.
Working in long-term care can be difficult. Some jobs often don’t pay well, provide limited training, and cause a high rate of injury. High patient to staff ratios also impact care.
For example, certified nursing assistants are a crucial member of the staff in long term care facilities. According to The Bureau of Labor Statistics, certified nursing assistants were paid an average of just $18.33 an hour in 2023. CNAs assist people with activities of daily living including eating, bathing, and toileting.
CNAs are also at risk of workplace injury. A 2012 study from RTI International found that 60.2% of CNAs had been injured at work. Injuries varied from cuts and back injuries to black eyes and human bites, and were caused by a number of factors, including lifting, bathing, and handling residents, resident hostility, and accidents involving medical equipment.
Nursing homes and assisted living facilities are entrusted with the care of some of America’s most vulnerable residents. Understaffing means people suffer or die needlessly. People’s lives are at risk without proper care, and employees deserve better working conditions. We need to fix this crisis now because care can’t wait.
Sources:
Carlesso, Jenna, and David Altimari. “CT Nursing Home Residents, Workers Want More Staff, Transparency.” CT Mirror, CT Mirror, 16 Feb. 2023, ctmirror.org/2023/02/16/ct-nursing-home-bill-staff-shortage/.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Nursing Assistants and Orderlies, https://www.bls.gov/ooh/healthcare/nursing-assistants.htm 29 August 2024
Khatutsky, Galina, et al. Work-Related Injuries among Certified Nursing Assistants Working in US Nursing Homes. RTI Press, 2012.
Manfield , Lucas. “Residents of Nursing Homes Keep Wandering Away-and It’s Because the Facilities Aren’t Following State Law.” Willamette Week, City of Roses Newspapers, 28 Aug. 2024, http://www.wweek.com/news/2024/08/28/residents-of-nursing-homes-keep-wandering-awayand-its-because-the-facilities-arent-following-state-law/.
Rowland, Christopher, et al. “Dozens of Assisted-Living Residents Died after Wandering Away Unnoticed.” The Washington Post, WP Company, 17 Dec. 2023, http://www.washingtonpost.com/business/interactive/2023/assisted-living-wander-patient-deaths/.