Q: You've probably addressed nursing homes before, but we're facing a personal tragedy with having to place our mother in one. We think we've exhausted all avenues and neither she nor my sister and I can afford assisted living.

Mom's mind is still sharp but she suffers from enough health problems that she simply can't care for herself in her home any longer. I've heard horror stories about

Tennessee's nursing homes. Are they true? -- Worried Wanda

A: Dear Wanda: I addressed nursing homes and how to investigate prospective facilities on July 26.

However, with so many boomers and our elderly relatives facing this prospect, it doesn't hurt to make more information available.

After my mother's stroke and broken hip resulted in a nursing home confinement, I saw first-hand the all-too-often ratio of one nursing assistant caring for 18 to 20 patients.

This is the time I comprehensively began advocating for the elderly -- one of our most vulnerable populations.

Nursing home neglect is the most alarming and dreaded outlook for those of us confronting this type of confinement. Primarily, the neglect and even abuse results from too few staff caring for too many frail people, as in the illustration of my mother.

In all my research and efforts on behalf of the elderly, I've discovered way too many statistics that substantiate these problems occur because of staffing decisions made by corporate nursing home owners.

All too often, neglect ultimately results in starvation, dehydration or deadly infections in patients. And, worse by far, outright abuse occurs and owners and management too often turn a deaf ear and a blind eye.

Regrettably, even when their loved ones become victims, families rarely call the authorities or bring charges, because they believe (and rightly so in many cases) their family member will suffer even more at the hands of their caretakers. (My sister and I plead guilty.)

Tennessee's rankings are among the lowest in the nation, and -- just as with those facilities in other states -- the public must be vigilant, regardless of whether we actually know a resident or not. Just as with other powerful lobbying organizations, Tennessee's nursing home lobby is a formidable one. Its attempts to remove legal penalties against nursing home owners who permit neglect or abuse by refusing to eliminate or prosecute offenders are nothing short of horrendous.

In fact, after the nursing home industry pushed legislation to limit compensation for patients who suffer the most extreme abuse and neglect (sometimes even resulting in death), the Tennessee Housing Subcommittee virtually rejected the legislation in April.

While I'm pretty sure the Tennessee Health Care Association (financed by most of the state's nursing homes) and the National HealthCare Corp. haven't given up their fight, I'm also determined to fight to protect those who need it most. Won't you join me?

Ellen Phillips is a retired English teacher who has written two consumer-oriented books. Her Consumer Watch column appears on Saturdays in the Business section of the paper. An expanded version is at www.timesfreepress.com under Local Business. E-mail her at consumerwatch@timesfreepress.com