Another death of an older man tied up in a residence comes to light | Madrid

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Two and a half years ago the horrific event but no one has told: a man died on July 14, 2019 at the El Álamo residence apparently trying to free himself from the straps that held him to the bed, as EL PAÍS has learned from sources. of the Madrid Prosecutor’s Office, which is investigating the possible criminal liability of the residence’s staff.

This newspaper revealed last week another death due to ties in another Madrid residence that had remained silent for seven months. The elderly associations warn that deaths of this type that are known may only be “the tip of the iceberg”, because the judicial and regional authorities, on which the inspection depends, do not report these cases on their own initiative. The State Attorney General’s Office does not have official prevalence data “because the statistics do not reflect the circumstances of the deaths.”

The 2019 case is still alive because the Prosecutor’s Office has requested extensions to the investigation so that it does not expire for the maximum period established by law. The judge of number 4 of Navalcarnero, the judicial district to which the small municipality of El Álamo (9,908 inhabitants in the southwest of the Community of Madrid) belongs, is aware of these events. The man, whose identity this newspaper has not been able to know, died on his knees, with his body on the railing that surrounded his bed.

The associations of the elderly have been calling for an end to restraints for almost two decades, because they consider that they violate the dignity of people and cause physical and psychological damage. The ties can even cause death, they explain, when people inadvertently strangle themselves with them. The fastening mechanisms are diverse and can tie the person at the waist, chest, hands, feet and head. Tens of thousands of older people, especially those suffering from advanced Alzheimer’s or schizophrenia, are tied up daily in Spanish residences. To tie up a resident, state and regional laws require the informed consent of the elderly or their family and the prescription of a doctor, an order that often comes from the staff doctor of the residences.

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A center with 303 places

The San Juan de Dios residence is a private center with 303 places, one of the largest in the Community of Madrid by number of residents. The management defends its absence of responsibility in the event. “We are not responsible for anything at all, since this residence has always complied with the required legality at all times. The center is collaborating in everything that is required of us, and we will continue to do so for the well-being of our residents, hoping that this issue will be clarified and resolved as soon as possible,” the director, Soraya Míguez Vicente, told this newspaper.

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The residence was sanctioned in 2019 by the Community of Madrid with a fine of 6,000 euros, after an inspection detected that the staff was insufficient for the size of the center. In 2017 it was also sanctioned with another fine of 3,000 euros for failing to comply with the rules that regulate the sector. However, on its website it prides itself on having the excellent Madrid seal of quality, a seal of the Autonomous Government that companies in the region can apply for. Sources from the nursing home sector consulted highlight that since its foundation in the mid-1980s, San Juan de Dios has stood out for introducing quality innovations. For example, at that time the residence already had a team of sociocultural animators, a rarity at the time.

The center was one of the group homes hardest hit during the first wave of the coronavirus pandemic when 82 people died, of whom only 30 were transferred to the Rey Juan Carlos de Móstoles hospital, which, like the entire Madrid public network, applied a triage that resulted in the denial of health care to thousands of people.

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In June, a woman appeared dead and tied in her bed in the residence of a small town in Madrid, Villa del Prado, according to this newspaper last week. Sources familiar with the event revealed that the woman hanged herself trying to free herself from the restraining straps and the information was confirmed in an email by a spokesperson for Sacyr Social, the company that manages that center owned by the Community of Madrid. “During a midnight round, one of the residents was found suffocated in her bed with one of the restraint belts,” that email says.

Two days later, after the outrage caused by the news of such a grisly death, the company contacted this newspaper to retract what it had said. According to the spokesman, the company had verified that the doctor who filled out the death certificate indicated that the woman lost her life “due to multiple organ failure that led to cardiorespiratory arrest”, without specifying that asphyxiation occurred. As medical research has shown, frail people can also die suddenly from the anxiety of being tied down. Apparently an autopsy was never done. The Prosecutor’s Office abandoned the investigation in October.

Used for convenience or as punishment

Nursing homes use restraints on the grounds of preventing seniors from falling, but there are signs that society’s tolerance for these methods is changing. Several associations in Spain call for the elimination of its use or a drastic reduction that limits its use to very limited cases such as when there is a risk of self-harm, for example people with schizophrenia.

In a sign of a change in attitude towards these methods, the Attorney General of the State, Dolores Delgado, distributed last week an instruction that asks the prosecutors to be more zealous in the verifications that they must make of the use of ties in residences. The document prescribes the “exceptionality, proportionality, provisionality and prohibition of excess, and restraints must be applied with the minimum intensity possible and for the time strictly necessary.”

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In his instruction, Delgado asks the prosecutors for a proactive action to withdraw restraints when it is verified that the residences are using them for convenience or as punishment.

The associations that represent relatives of residences denounce that the restraints are a habitual practice due to the shortage of personnel. The hidden deaths do not surprise them since it is a hermetic sector, says Carmen López, spokesperson for the state platform of relatives Marea de Residencias.

“We fear that there will be more cases because few people report it and if it is reported it does not amount to anything. It is considered a punctual accident. Revealing these deaths can help encourage relatives to tell them,” says López.

The Madrid association Pladigmare denounces that the residences convince the relatives with the argument that the restraints prevent falls, but with that pretext they abuse them. “In most cases it is to ignore restless, disoriented or bedridden residents,” criticizes the president of this association, Miguel Vázquez.

“The lack of personnel in our country is reflected in the chilling fact that, in Germany, according to studies published by the Junta de Castilla y León, the number of direct care workers for a resident with the highest degree of dependency gives them to cover five hours a day. In Spain, the average is less than two hours”, says Vázquez. “In Germany, they have calculated, according to these studies, that they would need between 150,000 and 190,000 more direct care people, to properly attend to the elderly”

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George Holan

George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.

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