Nursing home facilities often house young and middle-aged residents suffering from mental illness (including schizophrenia, depression, and bipolar disorder) with older nursing home residents. In some cases, this has led to violence against already frail elderly residents.
Younger mentally ill people now make up more than 9% of the nation’s almost 1.4 million nursing home residents. Last year, there were almost 125,000 young and middle-aged adults with serious mental illnesses living in nursing homes in the United States. This was a 41% increase from 2002, when only 89,000 mentally ill people ages 22 to 64 lived in nursing homes. The federal government helps pay for nursing home residents’ care under Medicaid so long as the facility’s mentally ill population stays under 50%. If the population of mentally ill residents is above 50%, the facility is classified as a mental institution and is no longer eligible to receive funds under Medicaid.
Illinois has the highest number of mentally ill adults under age 65 living in nursing homes. This is in part because Illinois only has 1,480 public hospital beds for mentally ill patients since the state shut down seven state-run mental hospitals since 1980. Under federal law, nursing homes may only admit mentally ill patients if the state has determined that the person needs the high level of care the nursing home can provide.
Mentally ill nursing home residents are often younger and stronger than the elderly nursing home population. This leaves elderly residents less able to protect themselves when younger mentally ill residents suffering from behavioral problems and become aggressive and violent. There are also correlations between nursing home residents suffering from dementia and increased aggression despite antipsychotic drugs.
Elderly nursing home residents are already at greater risk of injury because of frail or weak bones, underlying disease, and weakness. In addition, many nursing home residents are bed-bound, restricted in movement, or in wheelchairs, also making it more difficult for them to remove themselves from potentially dangerous situations involving mentally ill residents.
In May 2008, a Chicago nursing home resident (Ivory Jackson – age 77, suffering from Alzheimer’s) at All Faith Pavilion was beaten with a clock radio by his roommate who was almost thirty years younger. Mr. Jackson later died from his injuries. The attacker, who had a history of aggression and “altered mental status,” was ruled unfit to stand trial and now resides in an Illinois state mental hospital. All Faith Pavilion was fined $32,500 for failing to prevent the deadly assault.
In January 2009, a 21-year-old mentally ill nursing home resident suffering from bipolar disorder with aggression was charged with raping a 69-year-old fellow nursing home resident at a facility in Elgin. The mentally ill resident was admitted to the nursing home facility despite a history of violence and was left unsupervised even after telling staff that he was feeling sexually frustrated.
In light of recent violent episodes (assaults, rapes, and murders) occurring in nursing homes, Illinois lawmakers have organized a Nursing Home Safety Task Force to improve Illinois’ nursing home system and ensure the safety of residents. The Task Force hopes to deliver recommendations for improving the state nursing home system to Governor Quinn by January.
What can you do?
If you are concerned about the living conditions of a loved one, here are some simple suggestions:
- Ask the facility about their policy with respect to accepting patients with criminal backgrounds and/or mental illness.
- Look at your state’s sex offender registry, many states offer the opportunity to input a specific address– such as a nursing home– to see if any convicted offender live there
- Visit a facility multiple times before placing a loved one there. Does it seem safe?
- Check with your local police and see if any reports of violence have been reported at the facility.
- Report all violence to the police immediately
US News: Health Buzz: Mentally Ill in Nursing Homes