Alert
Close

Watch the NASCAR race on Saturday at the Bristol Motor Speedway. Join the Drive to End Hunger!

HIGHLIGHTS

Open

2014 NATIONAL EVENT

Health & Wellness
AARP Auto Buying Program

Download the ipad App

AARP-iPad-ePub-app

DRIVER SAFETY

Piggy bank on the road - AARP Driver Safety

Take the new AARP Smart Driver Course!

Contests and
Sweeps

Safe Driving in 2014 Sweepstakes

Learn how AARP Driver Safety can help you stay safe—and enter for a chance to win $1,000. See official rules. 

KEEP BRAIN ACTIVE!

AARP Games - Play Now!

AARP BOOKS

Planning for Long-Term Care for Dummies

Get expert advice on planning for your own or a relative’s future care needs.

Webinars

Learn From the Experts

Sign up now for an upcoming webinar or find materials from a past session.

Learning centers

Get smart strategies for managing health conditions.

 

Arthritis

Heart Disease

Diabetes

Most Popular

Viewed

share your thoughts

What does the health care law mean to you? Your story is important. We read and learn from every story and it helps us in our educational efforts. We may even use your comments (with permission) to brief legislators, inspire readers and more. Please share your story with us. Do

Outrage

Murder in the Nursing Home

Ivory Jackson, a 77-year-old man with Alzheimer’s, was asleep at a nursing home on Chicago’s South Side when his roommate grabbed a clock radio and beat him into a coma. Sadly, Jackson died of brain injuries a few weeks later. His roommate, Solomon Owasanoye, a 50-year-old man with a history of mental illness, was charged in the 2008 attack. He pleaded not guilty to first-degree murder and was later ruled unfit to stand trial. Today, Owasanoye lives in a state mental hospital.

So how could this happen? Why would a mental patient with violent tendencies be placed in a nursing home with older and sometimes frail residents? It happens more often than you would think.

While nursing homes were originally conceived to provide long-term, custodial care to older adults, facilities can legally admit adults of all ages who are disabled or mentally ill. According to data prepared for the Associated Press by the Centers for Medicare & Medicaid Services, U.S. nursing homes have seen a 41 percent increase in young and middle-age residents with mental illnesses between 2002 and 2008. Utah, Nevada, Missouri, Alabama and Texas have seen the steepest climbs.

Why? One reason is that as an increasing number of older adults choose alternative long-term care options—such as assisted living facilities or home health aides—nursing home facilities feel the pressure to admit others to keep beds full and stay afloat.

There’s “such financial pressure to keep the occupancy rate high,” says Jonathan Rosenfeld, a Chicago lawyer who specializes in nursing home abuse and neglect cases. “Everybody they can get in means the facility will be more profitable.”

States also have an economic incentive to mix mentally ill patients with older residents. Federal policy stipulates that as long as a nursing home’s mentally disabled population stays under 50 percent, Medicaid will pay for residents’ care. But if the percentage of mentally ill residents is above half the facility is classified as a mental institution, which federal funds don’t cover, and the state must cover the cost. So in the current economic crisis, it behooves states to place those with mental disabilities—even those who may be a threat to older residents—in nursing facilities that are desperate to fill beds.

“Nursing homes have become a convenient dumping ground,” says Jennifer Mathis, deputy legal director for the Bazelon Center for Mental Health Law, a Washington-based advocacy organization for people with mental disabilities.

But David Grabowski, an associate professor of health care policy at Harvard Medical School, says the issue should not be considered solely as one where residents with mental illness pose a risk. Violence, he points out, has been rare.

“The major issue is that [seriously mentally ill] patients would be much better served in the community,” Grabowski says. “Most nursing homes are ill-equipped to meet their needs and these individuals suffer adverse outcomes due to this inappropriate placement.”

Mathis agrees. “These settings are often not good treatment settings for people with psychiatric disabilities,” she says, “and when people aren’t getting the help they need, they may be more likely to have behavior issues. … It’s just that it’s not a good situation for anybody.”


Elizabeth N. Brown is an online content manager for AARP Bulletin Today.

Tell Us WhatYou Think

Please leave your comment below.

Discounts & Benefits

From companies that meet the high standards of service and quality set by AARP.

Woman trying on glasses in optometrists shop

Members save up to 60% on eye exams and 30% on glasses at JCPenney Optical.

Prescription medication spilling out of bottle

Members get a free Rx card from AARP® Prescription Discounts provided by Catamaran.

AngiesList

Members can save 25% to 45% on their Angie's List membership.

Caregiving walking

Caregiving can be a lonely journey, but AARP offers resources that can help.