The physical abuse of elderly assisted-living patients in Clearfield is a warning of problems to come as the aging Baby Boomer population floods Utah’s senior care centers, according to victims’ advocates and key people in the system.
“The wave is going to hit hard,” said Jeremy Atwood, an elder law attorney in Layton. “The Baby Boomers are aging, and we are not prepared for it when it really hits.”
Long-term care regulators won’t be able to keep up, even if there are sufficient safeguards to begin with, Atwood said in an interview Thursday.
The case of Jason Harold Knox, sentenced Monday in Farmington’s 2nd District Court to a year in jail and a pair of suspended prison sentences, has sparked rumination among state and county officials and others charged with seeing to the safety of vulnerable elderly Utahns.
Knox, a nurse’s aide, pleaded guilty to abusing a 71-year-old man and an 89-year-old woman who lived at Chancellor Gardens in Clearfield. The attacks occurred in September and October 2018.
Video captured by a camera placed by a relative showed Knox slamming the man into a wall and forcefully driving his elbow into the man’s midsection. The 30-year-old also admitted to roughing up the woman.
The assisted living center fired Knox and cooperated with authorities.
“He’s just an example of the types of things we’re running into,” Atwood said.
About 1 in 10 adults over age 60 are abused, neglected or financially exploited, either at home or in a care center, the National Institute on Aging says.
Officials and victims’ advocates outlined several issues that may portend trouble:
• All forms of elder abuse are rising, especially financial exploitation.
• Police may lack sufficient training about elder abuse issues, making them more likely to disregard problems as civil issues when criminal prosecution options may be available.
• Elderly residents and their family members lack adequate knowledge of their rights and ways they can improve their safety from physical, emotional or financial abuses.
• The state Adult Protective Services agency has suffered budget cuts, limiting its reach to prevent and investigate cases of abuse.
• Chronic health care labor shortages, plus poor pay and high turnover of certified nursing assistants, affects consistency of services.
• Although nursing assistants are required to maintain state certification, it is up to employers to police it. Knox was still working at Chancellor Gardens even though his certification expired in 2013.
“Unfortunately some places just don’t keep up on it,” said Debbie Booth, spokeswoman for Adult Protective Services.
“In situations where there is abuse, we should have ways to provide protection for these folks,” Booth said. “We don’t have enough resources, in terms of ways to help them in the facility. That’s what they’re (care centers) supposed to be doing.”
Booth said assisted living centers are licensed by the state, “but they’re not regulated very much.”
Nursing homes, meanwhile, face strict requirements for nurse-to-patient ratios, Booth said, although assisted-living centers do not have equivalent requirements.
She added, “In assisted living you could have one CNA at night for 30 to 40 patients.”
Scott Monson, treasurer and a board member of the Utah Assisted Living Association, challenged assertions that the businesses face lax regulation.
Although ratio requirements are not spelled out, he said Utah administrative rules mandate that centers prepare and adhere to care plans for each patient that ensure adequate services. Those plans are reviewed by state health department enforcement personnel and violators can be subject to fines.
“We are regulated extremely well,” Monson said.
“The sad truth is that elder abuse is widespread, and takes many different forms, from physical violence, financial fraud and scams, to abandonment and inadequate care,” the UALA said in a prepared statement.
“To combat this problem, UALA is dedicated to raising awareness, providing ongoing training and being a resource for providers, seniors and families.”
Booth and Daniel Musto, the state’s long-term care ombudsman, stressed awareness of the mandatory abuse reporting law.
Residents, relatives and staff members are required to report elder abuse, Booth said. Care center administrators, police and Adult Protective Services need to be told.
“We need to know about it,” Musto said. “A lot of times someone may suspect but aren’t really sure, but it is better to be safe than sorry.”
In Davis County, a coalition of health department, law enforcement and state officials meet monthly to bore into issues of the elderly, with a focus on abuse prevention.
“The last several years has seen a significant increase in elder abuse reports,” said Kristy Cottrell, the county health department's senior services division director, adding that authorities have not been able to keep up with the case load.
Cottrell invited Kellie Bingham, a daughter of the man abused by Knox, to testify to the group at a recent meeting. The group is called CAPE, or Coalition Abuse Prevention of the Elderly.
“I always think it’s important to have the voices of survivors,” Cottrell said.
In an interview Wednesday, two days after Knox’s sentencing, Bingham was unsparing in her comments about the phenomenon of elder abuse.
Her father has been in and out of four assisted living centers, Bingham said, as the family searched for better care. She pays attention to staff-to-resident ratio.
“We have a huge uphill battle, fighting businesses that do not want to have more employees,” she said. “There’s money to be made. They make millions and billions.”
She would like to see legislation “that makes them have to care for these people.”
“They want heads in beds and as few state regulations as possible,” she said. “Business has no conscience.”
Bingham has contacted several Davis County state legislators, urging them to support more protections for the elderly.
“I hope I can make a difference,” she said. “It doesn’t end because this guy was sentenced. It’s not just about my dad. What about everyone else?”
Atwood, the elder law attorney, said the legal system, regulators, police and others must work together to protect the elderly as the aging population booms with the Boomers.
“A lot of folks don’t get help until a lot of bad things have happened,” Atwood said.