Two entities that are close to my heart collided recently..…

It shakes me to the core that violence - suicide and murder can occur within a skilled nursing community. 

As a professional who gave several years of my life to serving others within long term care in several capacities…and as a homicide survivor serving others for over 44 years, I am horrified that this could happen! 

The 1987 Nursing Home Reform Law was an effort to guarantee residents rights and promote the best quality of life possible.

There are many rights that a resident of a long term care community has covering several categories- including -several items within each category regarding -

• The right to be fully informed about….

• The right to participate in one’s own care….

• The right to complain about…

• The right to visits…

• The right to privacy and confidentiality…

• The right to dignity, respect and freedom…

• Rights during transfers and discharges…

• Rights to make independent choices…

**See the full itemized list here- -https://portal.ct.gov/ltcop/content/resident-rights/your-rights-as-a-resident-of-a-long-term-care-facility

 (Compliments of the Connecticut Long Term Care Ombudsman Program)

Self determination is one of those nebulous terms that falls within the right of  dignity, respect and freedom. From a social work perspective, it means residents have the right to make their own decisions and choices.

This embodies making decisions about their health and well-being, understanding the consequences of their choices, and in a general sense, implementing the decisions they make.

Social workers, long term care ombudspersons and nurse managers frequently assist residents, helping them to-

1) Comprehend resources available and their choices; 

2) Collaborate with them to set meaningful and attainable goals;

3) Helping to prioritize the goals, the time frame and and how to intervene, 

HOWEVER, personal rights do not include any harm caused to one’s self or others.  The professional MUST intervene swiftly if either of these situations are suspected. 

The Story - On Friday, October 5, 2024, an elderly man, age 82 entered a skilled nursing facility in Connecticut, with 75 residents. He was there to visit his wife, age 81, who had been a resident since 2021.

Reportedly, at 11 am, the man concealed a gun, walked into his wife’s room, shot her to death and then killed himself with a self inflicted shot. No witnesses were in the room. Few details are known as the investigation is ongoing.

WHY???

As a homicide survivor, I immediately wondered if the wife may have been chronically ill and the husband could not bare to see her in pain and ‘took matters into his own hands’

Was it perhaps a silent death pact, between them with depression, financial worries, no longer having the will to live for several reasons?

Was it done impulsively, out of anger and frustration ‘for the greater good’ as he may have perceived it?

 We will never know….We do know it was a very desperate and ultimately a very selfish act (even if he thought it was merciful). 

There were options which can now never be realized….

There are resources and support for families… if only they avail themselves.

I do understand that octogenarians  (as my mother was one) who were brought up in the era in which you kept ‘family issues’ and personal problems private.

You did not ‘share’ and it was very difficult for my Mom to attend support groups with me following my Dad’s homicide. But, she did it! I was so proud of her. 

Perhaps this crazed man felt he had nowhere to turn.(Which in no way excuses his behavior!)

According the the CDC Morbidity & Mortality Report - National Violent Death Reporting System (May 2023) 

Men aged 85+ years had the highest rate of suicide 51.3 per 100,000 population.

Information regarding violent deaths occurring in nursing homes could not specifically be located. 

Under-reporting of such data would be likely for many reasons such as irreperable damage to the corporate entity, physicians perhaps ‘signing off’ on a lesser etiology on paper etc. 

According to the non profit, ‘Compassion and Choices,’ there are currently ten states and Washington DC that authorize physician assistance with dying forthe terminally ill. 

The Ripple Effect

Whether we label these perpetrators as sick, deranged or grieving, the fact remains he/they still committed the act of homicide (and suicide).

When these acts are committed, the evildoers don’t comprehend the severe ‘ripple effect’ that permeates the environment, the victim’s family, extended family, friends, co-workers, all of the staff, residents, other visitors as well as the town, state, city and the nation, contributing to the ever increasing violence in public places and the feeling of vulnerability and insecurity!  

These shooters are the cause of post traumatic stress disorder and a variety of physical and mental illnesses that will follow each and every person for their lifetime! 

Every time they see, hear smell, touch any number of things associated with a nursing facility, or an elderly person in general, they ‘may be triggered’ back to the event.  It is not an event occurring in a vacuum. Nothing could be further from the truth!

A New Normal for Long Term Care??

Having been a Connecticut State employee for 21 years, I would predict that during the next legislative session, at least a few bills will be created to increase security  in long term care settings as a result of this horrific incident,  (As was done after the Newtown /Sandy Hook Mass Murders).

In June 2021, during the pandemic, CT  Public Act No. 21-55 was passed, which essentially allowed nursing home residents to use technology of their choice, including cameras, for virtual monitoring and visitation, with certain privacy protections and consent requirements in place. This bill was enacted in response to concerns raised during the COVID-19 pandemic about limited visitation access. 

Questions-

• Will we see metal detectors at SNFs as in schools?   

• Will there be armed security guards at all entrances?  

• Will our freedom to walk freely within a community be stopped?  

• I am not sure… But we must be prepared for it when the uncivilized continue to take away what is most precious to us! 

***May we keep Barbara Brandt and everyone at Apple Rehab, Cromwell, CT in our thoughts and prayers!  

 “Safety is not an intellectual exercise to keep us in work. It is a matter of life and death. It is the sum of our contributions to safety management that determines whether the people we work with live or die.” – Sir Brian Appleton, Technical Adviser to the Enquiry on Piper Alpha Accident

DRG