Members of the Cobb Elder Abuse Task Force met May 7 to discuss how to make sure the right people have the right information when contagious illnesses like scabies occur at senior homes.
The meeting came as one Georgia case has been making headlines nationwide. It was recently reported 93-year-old Rebecca Zeni, a resident of a senior home in Walker County, died in 2015 following a particularly grisly scabies infection. In Zeni’s case, the infection appeared to have gone on for months or years, according to news reports, with a forensic pathologist reporting millions of the microscopic mites inside her body, leading the family to sue the nursing home for neglect.
At least one case of scabies has been reported in a Cobb County assisted living home in recent months, according to the Georgia Department of Public Health and a family member of the woman who was diagnosed with the condition.
State Rep. Sharon Cooper, R-east Cobb, chairs the House Health and Human Services Com-mittee and works with the task force. She said the senior task force is not looking to point fin-gers, but to find a way to quickly curtail future outbreaks.
“We’re trying to solve a problem and prevent future problems of the same kind,” she said.
The MDJ spoke with a Smyrna woman who said her mother, a 78-year-old dementia patient, lived at Elmcroft of Milford Chase in southwest Cobb for three years and contracted the para-sites about six months before her recent diagnosis.
A representative of Elmcroft of Milford Chase declined to answer questions by phone and the home did not respond to an email asking for comment.
The daughter, who did not want to be identified to protect her mother’s privacy, said the home realized there was a problem quickly, but the doctors there and an outside dermatologist failed to diagnose the communicable disease over a period of months.
“In the beginning, it was a rash,” the daughter said. “It was obvious to the nurses and the doc-tors. They prescribed her some creams to help her with the itching because she scratched a lot, and it got better. But then in February, she had a big, big breakout again and that’s when the nurse and the facility said you probably want to take your mom to a dermatologist.”
Scabies is caused by microscopic mites that burrow into the skin and lay eggs. It can be spread by prolonged skin-to-skin contact and often manifests as an intensely itchy rash.
According to the Centers for Disease Control and Prevention, nursing homes, extended-care facilities, child care centers and prisons are often the sites of scabies outbreaks because they have a large number of people in close contact.
The CDC says scabies occurs worldwide among all economic classes, and can be transmitted from one person to another before symptoms begin to show.
Scabies is not typically fatal on its own, but can lead to bacterial infections that can be deadly, especially among the elderly. Zeni’s family alleges her Walker County nursing home was negli-gent in allowing her disease to progress so far that it led to her death. If properly diagnosed, it can be treated with a simple prescription lotion or cream, according to the CDC.
The Smyrna woman said she took her mother to a Marietta dermatologist four times over the course of two months on the advice of the home, but did not receive the proper diagnosis. That doctor believed an allergic reaction to medication was causing the rash, the daughter said.
After finding no help, the woman took her mother to a different dermatologist, who diagnosed the parasites right away.
“The dermatologist we went to about a week ago, they scraped (her) hand … put it under the microscope, and two minutes later, they confirmed scabies,” she said.
The daughter said her mother has shown an almost instant improvement and is expected to completely recover from the scabies.
“Once she got the proper medications last week, she looked tremendously better within just a couple of days,” she said. “I was over there Sunday, and instead of crying and screaming in pain and not sleeping, she was blowing kisses.”
The Smyrna daughter said she is relieved her mother is now doing better, but still upset doc-tors took so long to figure out what was going on. She said she would like to see reforms to the state’s nursing homes, including more oversight and mandatory reporting to relevant govern-ment agencies when a communicable disease like scabies occurs in a group home.
“(Nursing home staff) had to be told to contact the Cobb County Health Department by the hospice nurse that my mother sees,” she said. “They didn’t even know what to do, or they didn’t want to do it because it’s bad press, bad for business. There needs to be a lot more oversight on these nursing homes and assisted living facilities. When something like this happens, it needs to be reported all the way to the state.”
Rep. Cooper said those reforms could be coming.
She said in the Walker County case, part of the problem was that state officials did not act. She said shortly before Zeni’s death, an employee with the Georgia Department of Public Health mailed the nursing home a pamphlet on how to deal with scabies, but nobody came to investi-gate the reported outbreak.
Cooper said the public health department is not required by law to visit facilities after learn-ing of an outbreak, and that is something she will look into changing.
“It could be we can change some of the regulations about reporting or change laws to say cer-tain people have to report to public health or must report some of the outbreaks under the De-partment of Community Health … I’m going to call other legislators as soon as the primaries are over … (and) call a meeting of some of my members on the HHS (Committee), and we are going to start looking to see if there are any applicable protocols and regulations for care homes, nurs-ing homes or assisted living homes or for doctors and other state agencies,” she said. “We’re go-ing to see … if a ball was dropped, if, somehow, the reports are not getting to the correct people, the procedures are not being followed so the proper people know about these incidents sooner and can initiate correct intervention.”
The Smyrna daughter said she has been in touch with attorneys and Zeni’s family to discuss a lawsuit. She said she does not plan on suing, but still wishes something had been done differ-ently.
“They weren’t neglectful, but I think the doctors they bring in every week, the nurses, some-one should have figured this out months ago,” she said.
Senior Assistant District Attorney Jason Marbutt, who chairs the Cobb Elder Abuse Task Force, said lack of proper care of the elderly can take many forms, but he thinks more people are beginning to recognize the importance of protecting the aged.
“This is something we have been working on for years,” he said. “I think we are recognizing that we have an aging population and they are vulnerable to abuse, neglect and exploitation … The numbers are certainly increasing, and law enforcement, particularly in Cobb County, is working very diligently to make sure we stay abreast of the rising tide.”
Marbutt touted a trio of bills signed by Gov. Nathan Deal just before the meeting meeting, which he said represent an unprecedented step toward protecting seniors and other vulnerable adults. They will strengthen background checks for those who care for seniors, provide harsher punishments for people who say they will take care of elders and then leave with their money and allow district attorneys to set up working groups on elder abuse.
Marbutt said those who suspect elder abuse should report it to the proper authorities.
“If there is abuse, neglect or exploitation, whether it is in a facility or outside a facility, the proper places are the licensing agency, or if it’s outside the facility, to adult protective services and law enforcement. It would be the Cobb County Police Department, Cobb County Sheriff, Powder Springs, Smyrna, Marietta, all the different agencies should be receiving reports,” Mar-butt said.