How Safe are Elderly and Disabled People in Assisted Living Programs?

Older adults and disabled people are some of the most vulnerable in our society, not least because they’re often isolated in care facilities when their families are no longer able to meet their needs. Tragically, the decision to place a family member in care increasingly has to be accompanied by worries about abuse, thanks to a growing list of shocking exposÚs of horrific activities in care homes. The Center for Investigative Reporting, PBS, NPR, and many other journalism organizations have peered deep into the heart of American care facilities and what they have found has been enough to send chills down anyone’s spine.

In California last year, a sustained investigation of facilities for developmentally-disabled adults ultimately prompted major reforms from the state after California Watch exposed sexual assault, rape, physical abuse, neglect and torture of disabled people in California facilities. The Center for Investigative reporting has highlighted similar issues in California’s eldercare facilities, indicating a systemic problem.

Notably, in both cases, journalists documented a widespread disinterest in investigating reports of abuse and neglect. To clear a huge backlog of cases, the state effectively pressured investigators to “close” cases without ever leaving their desks, let alone actually investigating. Consequently, many suspicious deaths went without ultimate closure and justice, and more importantly, the perpetrators of crimes against elderly and disabled residents of institutions were allowed to continue to working in these environments with vulnerable people.

In San Diego County, a detailed drilldown of information about suspicious deaths clearly illustrates that poor care led to the untimely deaths of many seniors, some of whom died of abuse and neglect. Older adults were found with festering wounds, extreme dehydration, jaundice and other signs of profound neglect in crowded, understaffed facilities — when they weren’t accruing mysterious bruises and fractures that were blamed on “falls.”

Some sued, winning judgments in cases citing neglect and abuse in care homes, but it can be difficult to collect judgments. Thus, victims and their families don’t have the funds they need to find a safe care facility or develop an appropriate care program at home.

The growing public awareness about these issues has forced the hand of California officials, making them reconsider policies on investigation, oversight and control of residential care facilities. While the state claims it is recommitting to protection of some of its most vulnerable residents, whether it’s able to follow through remains to be seen. Regulation can be expensive to administer, which is a significant issue for a state as cash-strapped as California. The state would need to expand hiring in order to have enough personnel for investigations, research and spot checks of residential care facilities.

Assisted living and residential care are huge growth industries, thanks to a combination of factors including an aging population and changing family dynamics. As the profit margin rises on such facilities, so does the risk of abuse and neglect, which means that it’s more important now than ever to maintain an aggressive regulatory and investigative presence. Can California do right by its elderly and disabled residents?

Photo credit: Garry Knight.


Emily J
Emily J3 months ago

I managed to find a few helplines for anyone who's experiencing elderly abuse or is worried about someone who's at risk, there are organisations in many other countries as well that could help and survivor programs in some cases. It's disgraceful that more isn't being done to protect older people from some of the most sickening abuse and neglect, and where they may be too afraid of further violence or too unwell to report what's been happening to them. We should be protesting this until every abuser has been kicked out of "care" work and a decent standard of living, healthcare and safety is in place for older people everywhere.

A helpline for elder abuse in Scotland, England, Wales and Northern Ireland is 08088088141

In the United States it's various helplines

For Australia the helpline number is 1800 628 221

In Ireland there's info and at helpline no. is 01 475 6989

Michael Glovre
Michael Glovre5 years ago

Nowadays those assisted living communities have tie up with nursing homes. So one can ensure more care. But still there are several communities which doesn’t provide proper care and safety. My granny living in Prestige Care Inc in Vancouver where they ensure the best possible healthy care for her.

Tammy B.
Tammy B.5 years ago

As a parent of a slightly disabled son, I got a job at a local Stone Belt Arc. I wanted to know of anyone I might be able to know of who could see about my son, when I die. Well while I was working there I discovered the theft of a clients own money. And so I photocopied the proof and took it promptly to the superiors. Then they chewed me out, for making the other employee feel bad for stealing off the client! I admit I was so mad I quit.Because not only did I get the chewing out the client was not really defended by the company in any way and the stupid people gave the thief the wednsday hours I gave up after only sending her home for one week. After that I don't have any faith in any outside organization to take care of my son when I do die. If they don't steal from him they might beat him up or starve him or who knows what?

JL A5 years ago

too much of the care is now in the hands of major corporate entities where decisions from afar harm those they have never met

Chris C.
Chris C5 years ago

My Mom was in an "assisted care" facility. All of us children spent lots of time with her, joining her for dinner etc. She had a nice room with a pretty view, a kitchenette. Our family is a pretty gregarious group so we were known by most of the staff and tenants. Her first year there, Mom was crowned Valentine Queen. We all got a huge kick out of that and teased my Mom. She acted like it was no biggee but she was secretly pleased. The meals were hearty and good, her room was cleaned for her, her clothes washed. My sister in law even trained the hairdresser there how to do Mom's hair. I used to bring Bink, my mom's cat, to visit. I used to bring little gifts for the ladies that took care of Mom.
I would suggest getting Long Term Insurance while you're still younger and healthy. Reserach it well though before you buy. I got mine when I was 50 and the premium is a little over $1000 a year. It could keep you in your home longer.

Deborah W.
Deborah W5 years ago

Increased awareness usually begins when family, friends or self find a need for such coverage and begin investing in the research (if you're nearing this phase in your life, start early is my best advice).

Add a decrease in concern based on the overall humane quality of the populous, rules, regulations,cutbcks and short-staffing imposed, and the problem becomes clear.

Huge growth industry says it all -- greed and money rule, damn the means to that end. Care has become a game of numbers not quality as the first priority. (Ever visit or tour a nursing facility where you were privy to observe or interact with residents and their families? Nothing more needs to be said here.)

How sad that we have been unaware and non-vocal for so long that now things are almost set in stone and will take forever to reverse the trend.

That being said, all things are possible if the effort remains strong and ongoing. Time will tell ...

Read more:

Kathy Crews
Kathy Crews5 years ago

Part 2

The huge difference that an AG facility makes each month yet having to provide the exact same care makes it very difficult for the provider to stay within the regulations so what usually happened was low wages for the CNA staff and very low staff so the staff is over worked casing stress and often causing mistreatment of the resident due to stress/overworked or just plain anger over work conditions....possibly even the provider hiring poor staff just to have bodies on the floor in an attempt to meet the state regulations. Their income just doesn't cover what they need to take adequate care of the AG resident yet the Private Pay facilities refuse to take the AG residents. So, there is a huge problem. What would happen to these people if there WEREN'T facilities like the AG facilities that could take them? Unfortunately when I first began running my AG facility back in '91 the AG rate then was only $789 a month or around that if memory serves me correctly. When I left running the AG facilities it had only gone up to a little over $900 in over 14 years. How sad is that?? And I can tell you we had to fight tooth and nail to get those increases during that time. It is a terribly flawed system of which I can't just blame the providers for....this is an entire system failure in my opinion.

Kathy Crews
Kathy Crews5 years ago

I ran Assisted Living Facilities for over 20 years. I ran top notch facilities and NO abuse was either tolerated or ever complained about during my time at the helm. I wish that I could say that the same held true at ALL ALF. I was the Chairman of the Virginia Assisted Living Association for many years as well as holding other positions within the organization. We represented ALL of the facilities here in VA and was more than aware of those facilities that faced complaints such as those mentioned in this article. Sadly the facilities that I most found this to be true of were the one's that we here in VA call AG or Auxiliary Grant facilities which means that they had residents that only received small SSDI or SSI checks monthly and had to be supplemented by the Department of Social Services to pay for their monthly fees for care. As a result, the state determined what the amount the facility could charge monthly for each residents care. So, as an example an AG facility can only charge, hypothetically, $1100 per month for an AG residents care where a private pay facility usually charges a minimum of $2200-6000 monthly per resident (Average is usually around $3800. The huge difference that an AG facility makes each month yet having to provide the exact same care makes it very difficult for the provider to stay within the regulations so what usually happened was low wages for the CNA staff and ven low staff so the staff is over worked casing stress and often causing mistreatment

Nancy Gizuk
Nancy Gizuk5 years ago

As I teeter in the "middle age" zone with no family to speak of, the concept of elder care becomes more real and much more personal. The concept is terrifying.

GGma Sheila D.
Sheila D5 years ago

As in any place, there are good and bad assisted living and nursing homes. In my small town we have a very well run complex that includes assisted living, apartments for retirees, and nursing home. It's kept clean and neat, it even has a small playground seniors can be outside with their grandchildren. An old neighbor moved into the assisted living two years ago and, though skeptical at first, is happy there.