My mother was in a nursing home for two years, from age 87 until she died just before her 90th birthday. The facility had three separate units, which usually marked the sequence during the elderly person's downward path. One was independent living in small apartments, next was skilled nursing in hospital-like rooms and the third was hospice ... total medical ... care.

My mother's facility, considering others throughout the country, gave fairly good care. Most members of the staff were poorly educated and on minimum wages. As a regular visitor, I could observe many worked only as much as was required, and there was no sense of empathy or dedication to their duties. They did a lot of sitting around, and at the main nurses' station, they also frequently ignored patients who came to them with complaints.

However, basic needs were met and I could observe no deliberate abuse nor neglect. There were specific rules the staff had to follow, and medical inspectors from city and state authorities roamed through once a month or so. Management seemed to try to keep the facility operating smoothly, but frequent staff turnover forced the senior workers to spend much of their time training new employees. Most of the jobs were one step up from welfare, and motivating employees to put in an honest day's work was always a problem.

Duties in nursing homes are never pleasant, especially in the hospice area, where patients had been housed when they lost all mental and physical control. Inspectors and management staff can't possibly supervise every minute of every day while patients are being cared for, and bad incidents occur. In the most extreme situations, mistreatment also happens.

Legislation and efficient inspections are the overall official requirement needed to stop mistreatment of the elderly in senior facilities. However, the ultimate responsibility to see that the mistreatment is stopped or prevented is with the families of the patients. As my mother's physical and mental conditions worsened, examples of poor treatment became more frequent. She lost clothing, fell down and showed bruising and, unfortunately, on several occasions was left without clean-up care for hours. We realized we had to do something fast and positive to stop the mistreatment.

To fight against this abuse, we set a family visiting schedule that had a member at her bedside for at least an hour daily. If we found something wrong, we wouldn't criticize the care aide on duty. We went directly to management. If treatment wasn't improved, we threatened to go to higher authority beyond the nursing home. It made for some ruffled feathers, but was always effective because the staff knew we'd persist until the problem was solved.

We also found that understanding and consideration of the staff's tough work schedules were just as helpful as official complaints. We brought candy, homemade cakes and other gifts to the aides. As they became more familiar with us, we shared family stories with them. It was very effective, because they knew they would see one of us daily and our complaints and suggestions were offered in a friendly and understanding manner.

Of course, mistreatment happens, and legislation brings it to the attention of the public and sets down laws of dealing with it. However, the most effective way to stop it with each of our institutionalized elderly loved ones is to be right there to deal with it promptly.

Learn more about this author, Ted Sherman.
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