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Nahon, Saharovich, & Trotz

Caregiver Shortage Strikes Tennessee

For many elderly and disabled residents of Tennessee, help completing day to day tasks can make a huge difference in their quality of life and happiness. Thankfully, Tennessee’s Choices in Long-Term Services and Supports (or Choices for short) program offers a crucial service to help care for adults (age 21 and older) with a physical disability and seniors (age 65 and older). The program provides services to assist eligible residents with daily living activities in their homes, on the job, or in their communities. These daily activities can include home-delivered meals, pest control, household chores, but also services like a personal emergency response system call button that can be used to get help in an emergency. The program allows the disabled and elderly to lead productive lives and stay involved in their local communities, but also provides these services in nursing homes if needed.

While the Choices program provides important benefits to many residents of Tennessee, there is currently a severe shortage of caregivers that is affecting thousands of people in need. Caregivers in the Choices program are required to be hired by managed care organizations, or MCOs, but as of late caregivers have missed appointments with citizens needing their services. Many times, a local senior center has accepted a contract from the government to provide citizens these crucial services. However, the Tennessee Justice Center in Nashville, which fights for those without a voice, recently sent a letter to the state requesting an investigation of just how many MCOs fail to provide regular and timely home based services. It is crucial that MCOs take responsibility for hiring the necessary number of caregivers to provide services to citizens in need, but they must also ensure that caregivers are properly trained and certified.

In a particularly striking example, Knoxville citizen, Army veteran, and cancer patient Joseph Davis’ caregiver missed multiple consecutive appointments at his home in the month before his passing. Joseph Davis’s wife June was unable to assist her husband, and relied on the assigned caregiver to help provide crucial services for Joseph. Their son Matt was forced to miss work frequently without notice to help care for his father when his assigned caregiver missed appointments. The lack of certified caregivers available to assist Joseph Davis receive the care he needed placed a huge burden on him and his family.

Spokespersons for MCOs like the one assigned to Mr. Davis often cite a national caregiver shortage as the reason for missed visits. This can result in nursing homes in Tennessee being understaffed, which means there are not enough staff members to properly care for the patients and check up on them. Without a properly-sized staff, nurses and other employees are forced to pick up extra shifts and work longer hours. This can contribute to fatigue and mental errors in caring for the patients.

When staff members miss visits, a disabled or elderly citizen may not receive services as basic and necessary as meals or medication. While this type of neglect can occur when caregivers miss home visits, it can also occur when caretakers neglect to care for nursing home residents. Neglect can take the form of personal hygiene neglect, when patients don’t receive sufficient help with cleaning, bathing, laundry, or brushing their teeth. Other forms of neglect include basic needs neglect, medical neglect, and emotional or social neglect. Each of these forms of neglect can be a breach of the duty that caregivers or a nursing home owe to their patients, and may result in harm to the patient. If the harm to the patient was a reasonably foreseeable outcome of the caregiver’s negligent actions, legal recourse may be available.