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BOOK 21 PAGE 43C$
<br />to hospitals are
<br />Y THOMAS GOLDSMITH
<br />S IAFF WRITER
<br />The number of people with mental
<br />llness in North Carolina rest homes
<br />Ias grown by 15 percent - to more
<br />ban 6,200 - since 2002. Family
<br />nembers, doctors, lawmakers and
<br />esidents themselves call the mix trou.
<br />desome and, at worst, deadly.
<br />Adult-care homes are designed and
<br />taffed to meet the needs of frail el-
<br />lerly people. Advocates for the men-
<br />ally ill say it is challenging enough to
<br />erve this core population without
<br />doling adults who have schizophre-
<br />ia, bipolar disorder and other kinds
<br />f mental illness.
<br />But for lack of other options, some
<br />dult-care homes have become clump-
<br />being phased out faster than local care options are being developed
<br />VOLATILE BLEND
<br />Who lives in adult-care homes? State fig-
<br />ures show that:
<br />® About one in five of the state's rest
<br />home residents has mental illness as a pri-
<br />mary diagnosis.
<br />12 In 20 percent of the state's rest homes,
<br />more than half of residents have a mental ill-
<br />ness diagnosis.
<br />M In licensed family-care homes, which
<br />have two to six residents, at least half have
<br />mental illness.
<br />ing grounds for mentally ill adults.
<br />"That [dumping ground] charac-
<br />terization is a crude way of saying
<br />that we don't have that range of al-
<br />ternatives, and no one disagrees
<br />with that," said Carmen Hooker
<br />Odom, secretary of the state De-
<br />partment of Health and Human Ser-
<br />vices. "We haven't seen the neces-
<br />sary commitment of resources,
<br />locally or nationally."
<br />Most everyone with a stake in
<br />North Carolina's elder care and men-
<br />tal health systems - including par-
<br />ents with mentally ill adult children,
<br />industry leaders, regulators and aca-
<br />demics -agrees that blending the
<br />two groups can be dangerous.
<br />Rest home files, criminal records
<br />and state agency reports reveal prob-
<br />lems when younger adults with men-
<br />tal illness are mixed in homes with
<br />older people.
<br />HOMES
<br />CONTINUED FROM PAGE IA
<br />0 suffered from smoke inhalation
<br />before rescuers could cut him free
<br />from the restraints.
<br />® In 2003 and 2004, adult-care
<br />residents younger than 60 who
<br />had mental health problems gen-
<br />erated more than 380 instances of
<br />criminal activities and violent,
<br />threatening or inappropriate sex-
<br />ual acts, a statewide ombudsman
<br />reported in 2005.
<br />"To place somebody who is 32,
<br />with bipolar disorder, in a room
<br />with someone who's 86, who's
<br />just had a hip replacement, that's
<br />not the best setting for either of
<br />those folks," said John Tote, ex-
<br />ecutive director of the state Men-
<br />tal Health Association.
<br />L~
<br />Needs neglected
<br />Such incidents focus attention
<br />on older people living side-by-side
<br />with those discharged from men-
<br />tal hospitals. But those with men-
<br />tal illness can also suffer when
<br />they do not get the kind of treat-
<br />ment their conditions require.
<br />Jimmy Meadows, 60, has lived
<br />at an Angier rest home for 21
<br />years. Diagnosed with bipolar dis-
<br />order, the poetry-writing college
<br />graduate shares a room with a 23-
<br />Year-old man recently discharged
<br />from a state mental hospital.
<br />Meadows worries that when he
<br />feels "hairy," or at the manic end
<br />of his disorder, he could become
<br />aggressive toward other residents.
<br />I worry that I will," he said. "I
<br />can't fight good."
<br />Advocates say people such as
<br />Meadows need an environment
<br />specifically tailored to people with
<br />mental illness. That means more
<br />privacy, structured daily activi-
<br />ties and better monitoring of his
<br />illness.
<br />At rest homes, state guidelines
<br />require a staffing ratio of one care-
<br />giver for every 20 patients during
<br />day shifts, and one caregiver per
<br />30 residents at night. At Dorothea
<br />Dix Hospital, a state-run institu-
<br />tion in Raleigh, the most recent
<br />records show a staff-to-patient ra-
<br />tio of about 1-to-4.
<br />The mix of population often
<br />leaves mentally ill people with un-
<br />met needs, leading to problems.
<br />® Between August and Novem!
<br />2006, three female residents o
<br />Louisburg rest home reported tl,:
<br />were raped - two of them, ages
<br />and 80, by the same 20-year-old m:
<br />resident with mental illness. In s
<br />other case, a staff member is s,_
<br />pected of raping a 33-year-old wom
<br />with mental illness. The incidents ;
<br />main under investigation.
<br />® In December 2005, a 71-ye:
<br />old former cocaine user died a fc
<br />weeks` after' setting fire to a fivi-
<br />room at a Robeson County rest hors;
<br />Employees had left him alone it
<br />chair, his feet and chest bound in
<br />sponse to his agitated behavior. I
<br />SEE HOMES, PAGE 12A
<br />According to state records.
<br />® A resident of a Cabarrus
<br />County rest home died in 2005
<br />after the home failed to supply
<br />multiple psychiatric medications
<br />as ordered. The resident, not
<br />named in the records, hit his
<br />head and needed physical and
<br />chemical restraints on the way to
<br />the hospital.
<br />® Over the past four years, the
<br />state Division of Facility Services
<br />has fined individual adult-care
<br />homes in Durham, Caswell,
<br />Forsyth, Buncombe and Pender
<br />counties for leaving residents with
<br />severe mental illness without any
<br />supervision. The problem is of
<br />long standing. The state fined a
<br />Cumberland County rest home
<br />$10,000 in 2001, then shut it
<br />down, after a resident with a se-
<br />rious mental disorder overdosed
<br />
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