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Senior care facilities mix the frail and the disturbed

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Georgie Williams
The nursing home Georgie Williams moved to in her 80s was supposed to be a haven from the deepening confusion of Alzheimer's disease.

The locked unit in the Windsor home did protect her for a while from things like leaving the stove on or wandering away. But on Feb. 16, 2013, danger came looking for her while she lay in bed.

Another resident, a 77-year-old man with a history of dementia and hallucinations, entered her room, sat on her bed and pummeled her face, neck and arms, according to police and medical records.

A nurse responding to Williams' screams caught him with his fist drawn back. It took three nurses to pull him off.

Williams' experience is not commonplace in long-term care, but some experts say the danger is increasing as a widening mix of frail elderly people and those with behavior problems land in nursing homes, assisted-living facilities, group homes and supportive-housing situations.

Elder abuse brings to mind mistreatment by caregivers, but studies suggest resident-to-resident attacks are more common.

A 2014 study by Cornell University found that 1 in 5 nursing home residents were involved in at least one aggressive encounter with fellow residents in the previous four weeks. A 2013 University of Pittsburgh study, funded by the Department of Justice, found that 13 percent of assisted-living residents had been involved in arguments with other residents, 6 percent had experienced an aggressive act, and 4 percent were bullied.

These risks are unfolding on a national stage, where positive trends have led to some negative results:

- People are living longer, putting them at greater risk for dementia, which can lead some to lash out in confusion and anxiety.

- People are surviving serious accidents and war trauma, some with brain injuries that leave them with poor impulse control and aggressive tendencies.

- Those with serious mental illness are being moved out of state-run institutions into communities, putting them in neighborhoods that don't have proper support.

It's a world where assailants and their prey fall into the same category: Victims of disease and disability with fraying family networks who are moving from institutions to places unprepared for them.

"They are invisible populations, but they are there, and they are increasing in numbers," said Dr. Robert Palmer, who directs the Glennan Center for Geriatrics and Gerontology at Eastern Virginia Medical School. "I don't think as a society we have thought enough about how to help them. It's a topic buried deep in the American consciousness."

It's a societal crossroads that Elizabeth Lorenz of Chesapeake never imagined for her grandmother: "I go back to what she must have been thinking lying there: 'Somebody help me.' "

Lorenz and relatives had spent months looking for just the right place for Williams, a longtime Portsmouth resident. They settled on Consulate Health Care of Windsor in Isle of Wight County, and she moved there in 2010.

For a few years, everything went well. As time went on, they noticed some lapses in care. Then one night in February 2013, Windsor police came to Lorenz's door: Her 84-year-old grandmother had been involved in an altercation.

Lorenz drove to Sentara Obici Hospital, thinking her grandmother had gotten into a minor tussle over someone taking something from her room. What she saw stunned her: Dark purple bruises surrounded both eyes. Her grandmother's left cheek was bruised and the skin torn. Her arms were cut and bruised.

Her vision was so blurred from the attack that she couldn't make out visitors. When Lorenz drew close to her, Williams instinctively put her hands up, drawing back in fear.  (Continue Reading)

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