Respecting and Protecting Elders
By Elliot A. Boxerbaum, CPP, and Patrick F. Donaldson
Security Management, May 2005
As the U.S. population ages, and more people reside in long-term-care facilities, security professionals must learn to assess and address the unique risks of these facilities.
According to the United States Census Bureau's projections on aging, more than 40 million U.S. citizens will be of retirement age by 2010, including approximately 6.1 million who will be 85 years old or older. By 2050, the government projects that some 86.7 million Americans will be age 65 and above and 20.9 million will be 85 or older. Many of these people will enter eldercare facilities, convalescent care centers, extended care facilities, and independent living or congregant care communities. And because residents of these facilities are often weak and vulnerable, the potential for them to be victimized is great. Among the threats are theft of personal property, abuse, physical assault, diversion of assets, extortion, and other crimes. Security professionals must know how to assess and address the risks.
Long-term-care facilities vary greatly in size, but whatever the size of the facility, it will face some of the same issues, many of which are unique to that environment. For example, during hospital stays, patients are encouraged to leave valuable items and keepsakes at home. But for many individuals, the long-term-care facility is their primary domicile, and residents bring these items with them. Thus, security of those items must be addressed.
Unfortunately, as residents continue to age, their memories and cognitive abilities may deteriorate to the level of unreliability. Because of this, reported incidents of property loss are sometimes written off as imagined events and not fully investigated. That type of response clearly does not serve the residents or the facility well.
Currently, the long-term-care (LTC) community includes more than 20,500 nursing homes. Most are for-profit institutions, placing them squarely in the purview of private security. However, a recent search of the ASIS International membership revealed fewer than a dozen members who list nursing homes, long-term-care facilities, convalescent facilities, or similar organizations as their primary employer. Based on the authors' experiences, this is because security services to the eldercare facilities are generally provided by contractors who report to facility administrators. In some instances, security is the responsibility of the maintenance or nursing supervisor. At hospital-based facilities, by contrast, there is usually an in-house security director or manager. Perhaps as the LTC industry matures, its approach to security will also evolve.
…..
Those within. Crimes at LTC facilities are not limited to those perpetrated by trespassers or burglars. Staff may also pose threats, especially as a resident's vulnerability increases and he or she becomes more dependent on caregivers. Elements to consider when assessing threats within an LTC environment include current employee recruitment processes, screening and background checks, and supervision of employees.
In some communities, the demand for entry-level resident care and custodial workers is high. Staff turnover in these jobs is also high, and some organizations have chosen to reduce costs by cutting back on reference checks that provide vitally important information about potential employees. These organizations run the risk of both increased security incidents and increased resultant liability costs. Negative publicity could also taint the reputation of the facility.
Additionally, the facility's incident reporting policies and procedures should be reviewed, as well as resident property tracking and management, and the training and regular reevaluation of both the security and care staff. Internal security audits should also be studied.
Another concern is the threat that residents may pose to one another. For example, more than 400 registered sex offenders were LTC residents, according to a 2004 study, "Predators in America's Nursing Homes, Registered Sex Offenders Residing in Nursing Homes Analysis," conducted by A Perfect Cause, a disability and elder-rights advocacy organization.
The study identified one 144-bed skilled-care and intermediate-care facility in Ohio as the residence of 15 registered sex offenders-more than half of whom were convicted rapists. A Missouri nursing home mentioned in the study was reportedly the home of 12 sexual offenders. The study also cited multiple cases of offenders committing assaults and rapes in the facilities where they were housed.
Because of these incidents, LTC providers and advocacy groups debate whether a facility has a responsibility to notify residents and their families when residents who may pose a threat-especially registered sex offenders-are admitted.
One way to address the risk of patient-on-patient crime is a patient-background screening program similar to employee preemployment screening. Checking the backgrounds of residents can be controversial, however.
If patient background checks are conducted, the intent should not be to reject a resident, but rather to provide the facility with information that it may need to ensure the safety of that resident, other residents, visitors, and staff. Confidentiality of information, communication of adverse information, and other related issues need to be addressed in well-constructed policies and procedures. Certain types of background checks may require a signed release by the resident or disclosure of the results by the requesting organization. Policies such as this should be reviewed by legal counsel prior to implementation.
…..
To protect residents, family, and staff, LTC facilities should assess their needs, understand the risks and threats inherent in their unique environment, and develop strategies to address them. Following this course of action will help to ensure that the residents' golden years will not be tarnished.
By Elliot A. Boxerbaum, CPP, and Patrick F. Donaldson
Security Management, May 2005
As the U.S. population ages, and more people reside in long-term-care facilities, security professionals must learn to assess and address the unique risks of these facilities.
According to the United States Census Bureau's projections on aging, more than 40 million U.S. citizens will be of retirement age by 2010, including approximately 6.1 million who will be 85 years old or older. By 2050, the government projects that some 86.7 million Americans will be age 65 and above and 20.9 million will be 85 or older. Many of these people will enter eldercare facilities, convalescent care centers, extended care facilities, and independent living or congregant care communities. And because residents of these facilities are often weak and vulnerable, the potential for them to be victimized is great. Among the threats are theft of personal property, abuse, physical assault, diversion of assets, extortion, and other crimes. Security professionals must know how to assess and address the risks.
Long-term-care facilities vary greatly in size, but whatever the size of the facility, it will face some of the same issues, many of which are unique to that environment. For example, during hospital stays, patients are encouraged to leave valuable items and keepsakes at home. But for many individuals, the long-term-care facility is their primary domicile, and residents bring these items with them. Thus, security of those items must be addressed.
Unfortunately, as residents continue to age, their memories and cognitive abilities may deteriorate to the level of unreliability. Because of this, reported incidents of property loss are sometimes written off as imagined events and not fully investigated. That type of response clearly does not serve the residents or the facility well.
Currently, the long-term-care (LTC) community includes more than 20,500 nursing homes. Most are for-profit institutions, placing them squarely in the purview of private security. However, a recent search of the ASIS International membership revealed fewer than a dozen members who list nursing homes, long-term-care facilities, convalescent facilities, or similar organizations as their primary employer. Based on the authors' experiences, this is because security services to the eldercare facilities are generally provided by contractors who report to facility administrators. In some instances, security is the responsibility of the maintenance or nursing supervisor. At hospital-based facilities, by contrast, there is usually an in-house security director or manager. Perhaps as the LTC industry matures, its approach to security will also evolve.
…..
Those within. Crimes at LTC facilities are not limited to those perpetrated by trespassers or burglars. Staff may also pose threats, especially as a resident's vulnerability increases and he or she becomes more dependent on caregivers. Elements to consider when assessing threats within an LTC environment include current employee recruitment processes, screening and background checks, and supervision of employees.
In some communities, the demand for entry-level resident care and custodial workers is high. Staff turnover in these jobs is also high, and some organizations have chosen to reduce costs by cutting back on reference checks that provide vitally important information about potential employees. These organizations run the risk of both increased security incidents and increased resultant liability costs. Negative publicity could also taint the reputation of the facility.
Additionally, the facility's incident reporting policies and procedures should be reviewed, as well as resident property tracking and management, and the training and regular reevaluation of both the security and care staff. Internal security audits should also be studied.
Another concern is the threat that residents may pose to one another. For example, more than 400 registered sex offenders were LTC residents, according to a 2004 study, "Predators in America's Nursing Homes, Registered Sex Offenders Residing in Nursing Homes Analysis," conducted by A Perfect Cause, a disability and elder-rights advocacy organization.
The study identified one 144-bed skilled-care and intermediate-care facility in Ohio as the residence of 15 registered sex offenders-more than half of whom were convicted rapists. A Missouri nursing home mentioned in the study was reportedly the home of 12 sexual offenders. The study also cited multiple cases of offenders committing assaults and rapes in the facilities where they were housed.
Because of these incidents, LTC providers and advocacy groups debate whether a facility has a responsibility to notify residents and their families when residents who may pose a threat-especially registered sex offenders-are admitted.
One way to address the risk of patient-on-patient crime is a patient-background screening program similar to employee preemployment screening. Checking the backgrounds of residents can be controversial, however.
If patient background checks are conducted, the intent should not be to reject a resident, but rather to provide the facility with information that it may need to ensure the safety of that resident, other residents, visitors, and staff. Confidentiality of information, communication of adverse information, and other related issues need to be addressed in well-constructed policies and procedures. Certain types of background checks may require a signed release by the resident or disclosure of the results by the requesting organization. Policies such as this should be reviewed by legal counsel prior to implementation.
…..
To protect residents, family, and staff, LTC facilities should assess their needs, understand the risks and threats inherent in their unique environment, and develop strategies to address them. Following this course of action will help to ensure that the residents' golden years will not be tarnished.
posted by David at
2:12 PM
