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TENNESSEE VETERANS' HOME ATTACKS GO UNCHECKED
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Several residents were identified with memory
problems
common to the elderly that experts said can
result in aggressive behavior.
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http://www.tennessean.com/
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Veterans home attacks go unchecked
State report criticizes Murfreesboro facility
By CLAUDIA PINTO
Staff Writer
Residents at the Tennessee State Veterans' Home in Murfreesboro attacked
other residents and officials failed to prevent the abuse, according to
a report from the Tennessee Department of Health.
Several residents — and some staff members — at the veterans home were
hit, slapped and grabbed by other residents. At least one resident was
treated at a hospital after being punched in the face by another
resident.
Andrea Turner, a spokeswoman for the Tennessee Department of Health,
said the survey uncovered the facility's failure to investigate the
altercations when residents acted violently.
"If the incidents were investigated and dealt with, perhaps it would
have prevented other residents from experiencing it," Turner said.
Ten of the 18 deficiencies uncovered at the Murfreesboro facility were
the most serious type, dubbed "immediate jeopardy," meaning the
violations were serious enough to jeopardize residents' health and
safety.
The home is one of three nursing homes that the state owns and operates
for veterans. The health department barred new admissions to the
Murfreesboro home earlier this week, after finding serious problems
there for the second time in less than a year. This prompted Gov. Phil
Bredesen to stop admissions to the other two homes as a precautionary
measure.
"The (Murfreesboro) facility failed to be administered in a manner that
enabled it to use resources to effectively identify, assess and … plan
to prevent resident-to-resident altercations from occurring and
reoccurring," the report states. "This resulted in immediate jeopardy to
all residents."
Several residents were identified with memory problems common to the
elderly that experts said can result in aggressive behavior.
During a June 3-13 state survey, prompted by complaints, inspectors
found that the 140-bed facility failed to: adequately identify, assess
and intervene with residents with aggressive behavior; report unusual
incidents; ensure psychiatric recommendations were carried out; and
investigate injuries of unknown origin.
Names of residents are not included in the report to protect their
privacy. Here are some of the incidents of abuse the report documents:
• A resident identified as Resident No. 22 struck Resident No. 41 on the
head with a plastic hairbrush and threatened twice to kill the resident.
Resident No. 22 also hit Resident No. 23 and another unidentified
resident, slapped Resident No. 28 and fought with Resident No. 25.
• Resident No. 25 grabbed, pushed, and hit residents and staff on
multiple occasions. He also was found naked in a female resident's room.
• Resident No. 50 pushed Resident No. 42 down and slapped Resident No.
42 in the back of the head four times.
• Resident No. 11 had five injuries of unknown origin since admission
eight months ago, including dark purple bruising to the left eye and
cheek. When the resident was asked what happened, the resident said, "I
don't know."
Lola Potter, a state spokeswoman, said the veterans home is working on a
plan to correct the problems. She anticipated that the plan would be
submitted to the department of health within a few days.
"Until that's released I can't tell you what those plans are going to
be," Potter said.
Turner, the health department spokeswoman, said the facility has a
Thursday deadline.
The veterans homes are owned by the state and operated under the
oversight of the state Department of Veterans Affairs.
Aggression 'not unusual'
Whitney Simmons, a care provider at Centennial Medical Center at Ashland
City's geriatric psychiatry clinic, said it's not unusual for people
with memory disorders to display aggressive behavior.
"Dementia can cause changes in their personality," said Simmons, who has
no involvement with the veterans home and was not commenting about the
situation there. "They are confused. They are unaware of their
surroundings. The fear that comes along with that sometimes results in
aggressive behaviors."
To treat and better handle this population, Simmons said, caregivers
typically first rule out possible medical conditions such as delirium or
urinary tract infections that could cause belligerent behavior. Then
caregivers try nonprescription approaches, including identifying things
that may upset them, reassuring them and reorienting them.
If that doesn't work, psychiatric medications are often tried. When none
of these steps help, patients are sometimes sent to psychiatric
hospitals, she said.
"It's challenging for caregivers of this population," Simmons said.
"Sometimes (these residents) can't tell you why they are upset."
The health department report states that 48 of the home's residents have
"behavior symptoms," which Turner said range from mild memory problems
to things as severe as schizophrenia. Some of the residents who attacked
other residents have been diagnosed with explosive personality disorder,
dementia and psychosis, among other ills, according to the report.
Because of the violations, the veterans home is being forced to pay
$6,500a day in federal fines until problems are corrected, in addition
to being stripped of its ability to accept new patients. The facility
also had to pay $3,000 in fines to the state.
Last June, the facility faced similar punishments after inspectors found
21 violations. Nine were considered serious enough to put residents'
health and safety in jeopardy.
Bredesen ordered that admissions also be suspended at state veterans
homes in Knoxville and Humboldt while the state conducts a review of all
three facilities. In addition, he directed the state nursing home board
to add staff, if needed, at all three homes to make sure patients are
being cared for properly.
"There have not been complaints at the other two homes, but as a measure
of precaution the governor suspended admissions there," Potter said.
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Larry Scott --
