August 8, 2004

Newspaper: Boston Globe
By:  Franco Ordonez, GLOBE STAFF

August 8, 2004

Ellen Berman didn’t want to force her weakening mother to leave her Sudbury home. But when Alzheimer’s disease began causing the 83- year-old woman to believe that men on the television were attacking her, Berman knew her mother needed round-the-clock care.

Berman figured her mother, Ruth Ward, would be safer at a Newton assisted-living facility for patients with dementia. But it was there, Berman said, that her mother was really attacked by another resident who pushed her over and hit her in the face with a metal cane.

The fall, in October of 2003, caused Ward to break her pelvis and tailbone. According to Berman, it’s what permanently put her mother in a nursing home.

“To take someone out of place that they’ve known almost all their life and place them into a facility and leave them there is one of the most difficult things that you ever have to do,” Berman said “And then this happens. It’s a violation.”

Berman has filed a lawsuit against the facility, The Falls at Cordingly Dam, in Middlesex Superior Court, alleging that aides there were negligent by not protecting her mother. Berman contends that aides, who allegedly witnessed what happened, knew the aggressor had violent tendencies but did not react quickly enough to stop the incident.

Berman, who is seeking $500,000 in damages, also argues in the suit that the facility neglected to call for medical help until more than a week after the incident.

“That’s a whole lot of pain and suffering,” said David Hoey, Berman’s attorney. The suit was filed July 27.

The Falls at Cordingly Dam is owned by Benchmark Assisted Living of Wellesley Hills. Company officials deny the allegations, saying they maintain the highest safety standards. They would not discuss the specific charges in the suit, but Brooke Tyson, a spokeswoman for Benchmark Assisted Living, said the company did complete a thorough investigation and found no evidence of any wrongdoing.

“We are convinced the allegations are untrue,” she said.

Approximately 51,000 people live in nursing homes in Massachusetts; about 10,000 live in assisted-living facilities. As much as 60 percent of those two groups suffer from Alzheimer’s disease or some form of dementia, according to the Massachusetts chapter of the Alzheimer’s Association.

Violence among Alzheimer’s patients, experts say, is a consequence of the paranoia, agitation, and depression that take effect as the disease eats away at the mind. Experts say attacks inside long-term care facilities some of which have resulted in the deaths of victims are on the rise, prompting health care professionals and state legislators to consider more government oversight.

There are no clear statistics on the scope of the problem, but the trend is expected to worsen as the senior population grows and medical advances allow people to live longer with the disease.

In a recent Journal of the American Medical Association study of resident-to-resident violence in Massachusetts nursing homes and dementia special-care units, researchers found that about 25 percent of such reports filed to the state in 2000 resulted in a physical injury, including fractures, dislocations, and lacerations.

Advocates are quick to point out that aggressors who have Alzheimer’s should not be blamed, because they are not willfully hurting anyone. Indeed, Berman’s suit does not target her mother’s aggressor.

The disease, experts say, distorts a patient’s point of view. A person with Alzheimer’s may think, for example, that he is being poisoned when another person tastes his food. Or a patient might think she is being robbed when a fellow Alzheimer’s sufferer mistakenly wanders into her room.

Consider the case of Geraldine DiLorenzo. Two months ago, according to her twin sister, Kay Trudeau of Waltham, DiLorenzo, who often wandered from her room late at night, was beaten in the face by another resident of Sunrise Assisted Living in Wayland because she invaded his space.

“He must have hit her a number of times,” Trudeau said. “Because her nose, her forehead, her right side, and left side were all black and blue.”

Sunrise Assisted Living officials declined to discuss Trudeau’s allegations, citing patient privacy.

Recent cases like this have drawn the attention of the Legislature’s Joint Committee on Health Care, which is debating whether the state needs to more closely regulate long-term care facilities.

Last Tuesday, the committee held a public hearing with industry representatives at the Waltham Senior Center. State Representative Peter Koutoujian, a Waltham Democrat and cochairman of the committee, said the state is putting pressure on the industry to address the increase in violence. If it doesn’t, he said, lawmakers are prepared to file legislation as early as this fall.

“It’s a painful and difficult decision to send a loved one to any of these facilities,” Koutoujian said in an interview. “Let’s not have them worry about neglect and abuse.”

The state Executive Office of Elder Affairs is working with lawmakers on the issue, said Je’Lesia Jones, a spokeswoman.

Lobbyists for the assisted-living industry acknowledge that violence does occur, but they do not see it as a widespread problem.

As a result of recent reports on physically aggressive Alzheimer’s patients, Massachusetts Assisted Living Facilities Association officials say they are updating training materials on resident-to-resident violence. The organization also held a one-day seminar in Waltham in June for association members on how to identify potentially aggressive behavior.

Emily Meyer, executive director of the trade association, said the industry takes safety very seriously and is constantly working to improve the level and quality of care. Additional state regulations, she said, are welcome.

But Meyer cautioned that overregulation of the industry can potentially lessen the appeal of assisted-living facilities, which are designed to be unlike nursing homes by providing a home-like environment that offers a substantial amount of freedom.

“You don’t want to make it so institution-like that it loses its flavor of being an independent environment,” Meyer said.

Alzheimer’s advocates are not calling it an epidemic, but they do sense that violence is a worsening problem, and they, too, want the state to step in. The state Alzheimer’s Association chapter wants to see mandated minimum staffing levels, required monthly assessments of Alzheimer’s patients, and an increase in training for aides.

James Wessler, executive director of the state chapter, notes that there are no specific state requirements for operating a dementia unit in an assisted-living facility. Just about anyone, he said, can claim to provide a high level of Alzheimer’s care.

To Berman, that’s what The Falls at Cordingly Dam advertises but did not live up to when her mother was there.

“Unfortunately these facilities paint a very rosy picture, but it’s very different behind the scenes,” she said.

Reproduced with permission of the copyright owner. Further reproduction or distribution is prohibited without permission.

Abstract (Document Summary)

Ellen Berman didn’t want to force her weakening mother to leave her Sudbury home. But when Alzheimer’s disease began causing the 83- year-old woman to believe that men on the television were attacking her, Berman knew her mother needed round-the-clock care.

Berman figured her mother, Ruth Ward, would be safer at a Newton assisted-living facility for patients with dementia. But it was there, Berman said, that her mother was really attacked by another resident who pushed her over and hit her in the face with a metal cane.

Berman has filed a lawsuit against the facility, The Falls at Cordingly Dam, in Middlesex Superior Court, alleging that aides there were negligent by not protecting her mother. Berman contends that aides, who allegedly witnessed what happened, knew the aggressor had violent tendencies but did not react quickly enough to stop the incident.

Reproduced with permission of the copyright owner. Further reproduction or distribution is prohibited without permission.