This disturbing investigative piece by Matt Sedensky at the Associated Press finds that nursing homes are becoming increasingly aggressive about getting rid of residents whose needs are more intense than others:

NEW YORK (AP) — Nursing homes are increasingly evicting their most challenging residents, advocates for the aged and disabled say, testing protections for some of society’s most vulnerable.

Those targeted for eviction are frequently poor and suffering from dementia, according to residents’ allies. They often put up little fight, their families unsure what to do. Removing them makes room for less labor-intensive and more profitable patients, critics of the tactic say, noting it can be shattering.


In our 20 years of experience of dealing with nursing homes big and small, good and bad, we have found that almost always there are not enough staff members to help patients the way they deserve. Even if a patient has only one physical diagnosis, that condition can manifest in complex ways that require one-to-one attention, and that’s hard to find.

Aging Solutions’ Advice:

We approach such complex situations by first looking at the patient’s medications. For this, you need a doctor who really knows medications, and that’s usually NOT the day-to-day primary care physician (PCP). So often we have found that a prescription medication audit, or even just the tweaking of a dosage can make an enormous difference in behavior. For an elderly patient with behavior issues, it’s worth finding and consulting with a geriatric psychiatrist.

Second, consider bringing in an outside non-medical care agency to shoulder some of the burden on the family and to add an extra set of eyes. However, it’s important to have a third-party advocate (like Aging Solutions) set up protocols ahead of time so that the outside agency knows what their employees should look for.

Third, familiarize yourself with your state’s Patients’ Bill of Rights. If you are in California, there is also the long-term care Ombudsman program, although funding for these folks varies wildly from county to county. Some may have lots of resources and clout with the local nursing home industry, but others, not so much.