Is The Nursing Home Giving Your Loved One Adequate Care?

If you have a family member already placed in a nursing home, there are steps you can take and problems to look for to help ensure that your family member gets adequate care. If a facility is resistant to your involvement and is uncooperative with you, you need to go to the highest level, usually the Administrator and the Director of Nursing. If you are unsuccessful with the Administrator, you may want to think about transferring your family member to another facility.

Experienced Attorneys In Nursing Home Neglect Cases

At the law firm of Maples, Nix & Diesselhorst in Oklahoma City, our lawyers handle cases of serious injury and wrongful death due to negligent care in nursing homes. However, we'd rather help you avoid a serious injury. If you have concerns about the care your loved one is receiving, call us at 800-539-0652 to schedule a free, confidential consultation.

If your family member is able to walk or wheel himself or herself around the facility unassisted, able to feed themselves without assistance, and able to use the toilet without assistance, your family member may do quite well in many facilities without your constant involvement. However, if your family member cannot toilet, feed or turn himself or herself without assistance, you must be alert for serious and life-threatening illnesses that can result from lack of care in these areas.

15 Warning Signs Your Loved One May Be Neglected In A Facility

Here is some information that you should watch for concerning a bedridden family member or a family member who needs assistance with daily care:

1. Federal law requires that all patients have a "Plan of Care" developed for them. They should have included the family in the writing of the plan of care. Ask to see the plan of care and read it carefully. Obtain a copy and keep it with you when you visit your family member in order to verify that the required care is being provided. The plan of care contains all the promised care that they say they are providing to your family member. If the plan of care does not address some of your family member's needs, talk to the Director of Nursing to make sure that these needs are included in the plan of care. Also ask the Director of Nursing if the Certified Nursing Assistant (CNA), who takes daily care of your family member, sees the care plan to know what type of daily care is needed. Many nursing homes do not allow the CNAs to see the care plan, and the CNAs can be clueless about the special needs of your family member.

2. Ask how many Certified Nursing Assistants (CNAs) are on the morning shift, afternoon shift and evening shift, and compare that to the total number of patients. If the ratio is more than nine patients per CNA, you need to make sure that you visit as much as possible to know that your family member's needs are being met. Even if the ratio is lower than nine patients per CNA, watch the CNAs to see if they can handle the workload. If there are a lot of room call lights on without a prompt answer and the CNAs appear to be running from one patient to another, there may be too many high maintenance patients for the amount of CNAs on that shift. Lack of CNA help is one of the first steps to lack of care, abuse and life-threatening diseases.

3. Make sure that your family member is drinking enough water and eating well. This is often overlooked by families. Don't always rely on the staff telling you your family member is eating "just fine" or the CNA charting on how much each resident is eating because they can be notoriously inaccurate. Make sure that you visit at mealtime and check the food. If your family member is able to feed him or herself, make sure that the food is served warm and is palatable. It is a good idea to bring nutritious snacks from home to supplement the institutional food of the nursing home. Also make sure that cold water and other drinks are available for your family member and encourage them to drink a lot of fluids. Nutritious food and enough fluid intake are vital to help prevent diseases and to keep skin from deteriorating and breaking down. Dehydration and malnutrition can also cause confusion and dementia, which could even be misdiagnosed as Alzheimer's disease.

4. If your family member is unable to feed himself or herself and/or unable to get his or her own drink, you must be very vigilant. Malnutrition and dehydration can cause other diseases that are life-threatening, including urinary tract infections, kidney failure, skin breakdown that can lead to decubitus ulcers (bedsores), confusion and dementia, and a weakened immune system. Families often do not recognize beginning malnutrition and dehydration. CNAs rarely offer water on a regular basis, so you need to get the family member to drink every time anyone visits. You need to go to the facility at mealtimes and watch how your family member is fed. If your family member is fed at their bed, watch to see if the CNA drops the tray off and promises to return. Often, the CNAs don't have the time to finish feeding all residents, and the kitchen help will take the tray away with the food uneaten.

5. If your family member is fed in the dining room, watch to see how many CNAs or feeding assistants are there to the number of residents. Also watch how they feed the residents. If the CNA is rushed, he or she will try to quickly shovel the food down a resident's throat. This can cause choking and aspiration that can lead to aspiration pneumonia. Often the CNA will shove the spoon into the resident's mouth at a rapid pace and the resident will lean back because they are eating too fast. The CNA then will assume that the resident is finished eating and move on to the next resident, leaving the rest of the food uneaten.

6. You need to closely watch for any weight loss by your family member. Do not rely on the nursing home's stated weight because sometimes they fudge on the weight to hide weight loss. Federal regulations require certain corrective measures if there is a significant weight loss. Good places to check for weight loss are the upper arm and calves. Aging people tend not to lose weight around the abdomen. To check for dehydration, you should look at skin tone and dryness in the mouth and lips, along with pinching the skin on the forehead or the sternum. If the skin sticks together and leaves a ridge, there could be dehydration problem. If you suspect there is a problem, have your doctor run blood tests that determine dehydration and malnutrition such as the albumin level in the blood.

7. If your family member is immobilized in bed or in a wheel chair, he or she is at risk for bedsores (pressure sores or decubitus ulcers). Someone from the family should regularly check the pressure points on the buttocks, legs, elbows and heels to make sure that he or she is not developing pressure sores. Pressure sores start out as reddened areas that do not blanch when pressed and then cause the underlying muscle and veins to break down, bleed and become infected. Federal law says that residents are not to develop pressure sores while at a facility. It is a direct sign of lack of care, and you should meet with the Director of Nursing if a pressure sore appears and ask about his or her plan of correction for healing and prevention. Do not let pressure sores go untreated, or they could cause a life-threatening situation.

8. If your family member needs assistance with using the toilet, the facility with insufficient staffing will have the motivation to get him or her in diapers instead because it is less work. Don't let them start down that road because it will be very difficult for your family member to become self-regulating, and they will use it as an excuse to keep him or her in the nursing home instead of assisted living. Insist that your family member is taken to the toilet regularly and if he or she is starting to have accidents, complain that it is because the call light is not being answered instead of an incontinence problem. This can also lead to urinary tract infections (UTIs), so make sure you ask your family member frequently if he or she has any symptoms, such as burning urination, and dark, cloudy or foul smelling urine. Federal regulations state the residents are to become as self-functioning as possible including bowel and bladder retraining programs. Incontinence can lead to other health problems, especially if there is a lack of care so it is important to avoid it as long as possible.

9. If your family member starts showing signs of confusion and/or dementia after entering the nursing home, don't let the nurses or a doctor convince you that these symptoms are just part of normal aging. These symptoms are usually caused by some type of disease or can be triggered by malnutrition or dehydration. Insist that the facility and the doctor run blood tests to rule out disease or malnutrition and dehydration. Don't let your doctor label these symptoms as early Alzheimer's until everything else is ruled out and you have gotten a second opinion.

10. Make sure that the facility is following through with any rehabilitation it has promised. Someone needs to be there occasionally while your family member is doing his or her exercises and see if he or she appears to be effective.

11. Have someone in your family visit the facility often between 4 and 8 p.m. That is usually when the facility is at its worst. It is a good idea to randomly show up so that they never are sure when you are coming.

12. Make sure that your family member is fully bathed at least three times a week. Ask your family member about the baths since the facility may misrepresent the number of baths given. Your family member should not have any body odor or scaling skin. These baths are very important to prevent skin breakdown especially if he or she is immobilized.

13. Make sure that your family member gets outside for sun and fresh air on a regular basis. Be careful that the CNAs don't take him or her out to the patio and dump them there because of the chance of severe sunburn.

14. In general, let the facility know that you are watching it and that you know what it is required to do. Don't be afraid to let it know that you are aware of the state and federal regulations and expect the facility to follow them.

15. Watch for any signs of pneumonia or other infectious diseases such as staph or scabies because infection control is usually poor in many nursing homes. Nursing homes are often reluctant to call doctors until symptoms become serious. It is important for you to insist on a doctor's diagnosis before the problem becomes life-threatening. Older, bedridden residents have a harder time recovering from illnesses if they are not treated promptly. If you believe that your family member is in a life-threatening situation, insist that the nurses call an ambulance for the emergency room. If they refuse, dial 911 and get an ambulance yourself. Family members in trouble can die while you argue with a reluctant nursing staff or if you are waiting for a doctor to call back. Don't let them tell you that it is "the time" for your family member to die.

Contact Our Nursing Home Attorneys

If you or a loved one has suffered personal injury or death and you are seeking an attorney to protect your rights and represent you, Maples, Nix & Diesselhorst Attorneys At Law has the solution. Contact Maples, Nix & Diesselhorst 24 hours a day, seven days a week, for a free consultation and case evaluation with our experienced Oklahoma personal injury lawyers. You may reach us at 800-539-0652 or via email by completing our contact form.