I came across a thoughtful blogger who documented his/her grandmother’s alleged abuse at a Virginia nursing facility after years of otherwise wonderful care in an assisted living facility. It is a very thorough documentation of abuse and that struck me. Unfortunately there was a bad ending to the story and that haunted me and scared me.

Here was a family that was in the facility 25 hours a week advocating for their loved ones and they still could not get results. They lived in fear that the grandmother would be thrown out of the facility with each growing complaint. And that is a culture we must change. It needs to happen on several fronts. The nursing home staff have to be connected to a higher calling of helping their residents lead a quality life. No amount of legislation can change a bad culture.

Nonetheless this blogger has some thought particularly on Virginia legislation that would help curb abuse. I will list some of those here, many of which are applicable not just in Virginia but across the country.

1) Procedure by which residents and/or family members can voice concerns and file formal complaints/requests for correction of care without the fear of retribution, either by means of maltreatment or displacement from the facility.

2) Formal written procedures should be in place allowing each request that is made by a resident or family member to be documented and followed in order to avoid family requests for medicine, hydration treatment, special diets, and other standard routines being ignored or going unanswered.

3) Provision for the availability and use of in room cameras that can be installed and used by residents and residents‰Ûª family members to document and ensure proper care via internet access (viewing and recording), at the request of the resident or family members.

4) Requirements for the automatic reporting of incidents of deaths and subsequent investigation of deaths resulting from causes that suggest neglect such as dehydration and infections not associated with a preexisting medical condition.

And specific to Virginia –

5) Section VA 5-371-150 should be amended to require that a resident‰Ûªs rights and complaint/grievance procedures be reviewed and explained to the resident and family members not just annually, but upon admission to the facility.

6) VAC 5-371-170 Quality Assessment and Assurance needs to be amended to require that internal quality assessment and assurance committees consist of at least two people who are current residents and of sound mind to actively participate or who are family members of current residents and should be attended by a representative of the state OLC (Office of Licensure and Certification).

For those in Virginia, support our blogger. And everyone else heed the warning. You can live in the facility with a loved one and that is still no guarantee they will get treated right. And do what this blogger did, keep a journal documenting care but act on it daily.