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    Abuse and Neglect in Long-Term Care Facilities

    When children are being abused or neglected in Wisconsin's licensed day care settings, most people know to contact the police or social services. When vulnerable, disabled, or elderly adults are being abused, neglected, or exploited in Wisconsin's residential settings, most people do not know where to turn or even whether to intervene. Wisconsin's vulnerable citizens deserve appropriate treatment and protection across their lifespan, regardless of the facility in which they reside.
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    Wisconsin Lawyer
    Vol. 77, No. 8, August 2004

    Abuse and Neglect in Long-Term Care Facilities

    As our population ages, the civil justice system will be called on more frequently to represent and protect our elderly citizens. Lawyers who serve as advisors, guardians ad litem, estate planners, and litigators, will be asked to protect the civil rights of victims of abuse and neglect. To better serve your elderly clients, read what state and federal laws regulate long-term care facilities, the warning signs of abuse and neglect, and the potential legal claims and remedies available to victims and their families.

    elderly womanWhen children are being abused or neglected in Wisconsin's licensed day care settings, most people know to contact the police or social services. When vulnerable, disabled, or elderly adults are being abused, neglected, or exploited in Wisconsin's residential settings, most people do not know where to turn or even whether to intervene. Wisconsin's vulnerable citizens deserve appropriate treatment and protection across their lifespan, regardless of the facility in which they reside.

    The elderly population in the United States is expected to double by 2025; of that, the "frail elderly" population is expected to nearly triple.1 Since 1997, the number of available licensed nursing home beds has decreased by more than 14 percent.2 Those residing in nursing homes have complex treatment needs. In contrast, the capacity in regulated assisted living facilities has grown by approximately 60 percent since 1994.3 The elderly comprise the majority of individuals residing in assisted living settings. Other persons who reside in assisted living facilities include those with mental illness, dementia, or Alzheimer's disease; physical disabilities; developmental disabilities; alcohol or other drug dependency; terminal illnesses, traumatic brain injuries, and AIDS; and pregnant women and correctional clients. The range of service and treatment needs is broad.

    Members of the "sandwich generation" - adults who provide care for both their children and aging parents - are more media savvy, technologically literate, and politically active than were past generations. As a result, they've drawn more attention to the issues of quality care. Congress has held public hearings and released a number of reports addressing the problems that have been brought to light concerning care in regulated residential settings. In a recent report, the U.S. House of Representatives Committee on Government Reform noted that almost one in three nursing homes were cited for abuse violations between 1999 and 2001.4 Many of the violations caused serious harm to nursing home residents or placed them in jeopardy of death or serious injury.5

    Many issues facing vulnerable, elderly, and disabled clients affect lawyers' practices, regardless of practice areas. Estate planners should be concerned not just about protecting assets, but understanding long-term care systems and alternatives. Guardians ad litem should understand the changing landscape for care, treatment, and living alternatives available to their wards. Prosecutors and defense attorneys need to understand the different forms of abuse, neglect, and exploitation perpetrated in residential health care settings. All practitioners should understand the various requirements and interplay of state and federal law and the options available in order to respond appropriately to clients' concerns about abuse, neglect, or financial exploitation in residential health care settings.

    The following three articles provide a framework for practitioners facing these issues. The first provides an overview of available options within the civil justice system. The second addresses the state's regulatory responsibilities and responses to preventing abuse and neglect in residential health care settings. The third addresses criminal prosecutions of abuse, neglect, and financial exploitation of Wisconsin's vulnerable citizens.

    1U.S. Bureau of the Census, Wisconsin's Population Projections: 1995 to 2025.

    2Dep't Health & Family Services, Bureau of Quality Assurance http://dhfs.wisconsin.gov/provider.

    3Dep't Health & Family Services, Bureau of Quality Assurance, Assisted Living Section.

    4Minority Staff, Special Investigations Division, Committee on Government Reform, U.S. House of Representatives, Abuse of Residents Is A Major Problem In U.S. Nursing Homes (July 30, 2001).

    5Id.




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