Ways To Know If Your Loved One Is Suffering Neglect
Knowing the signs of nursing home neglect and abuse could save the life of your loved one. There are some basic signs of abuse and neglect that should alert you to the fact that your loved one may not be in a safe place and may need help.
Bedsores, also called pressure sores or decubitus ulcers are sores that appear on the skin and if left untreated, can become deep enough to leave muscles, tendons and bones exposed. Bedsores are caused by prolonged pressure due to residents being forced to lie in one position for long periods of time.
This pressure on the skin causes tissue death as the skin and muscle tissue does not receive adequate nutrients from the blood. Often, the dead tissue requires painful surgical removal. There is simply no excuse for bedsores. Bedsores are easily preventable by proper care such as changing a resident’s position regularly and providing adequate nutrition.
Nursing Home Abandonment
Citizens in advanced age and declining health often require a great deal of time, attention and care from those around them. Missing a scheduled medication or remaining in one position too long can have serious consequences in both their short- and long-term health. Sadly though, a 2014 study by the National Center on Elder Abuse, Bureau of Justice Statistics reveals that of the approximately 2,150,000 new cases of elder abuse each year, a staggering 60 percent of those involve some form of severe neglect.
This inaction primarily involves the outright disregard of a senior’s needs and his or her daily abandonment while in a supposedly professional nursing facility. Some of the more common type of abuse we have encountered include:
- Failure to turn bedridden patients over, resulting in bedsores and other skin complications
- Failure to respond to a patient’s calls for assistance or help
- Failure to properly distribute essential medication on time
- Failure to feed, bathe or hydrate patients in a timely fashion
- Failure to change bedding or maintain sanitary conditions in a patient’s room
- A general trend of neglect or ignorance that puts the patient’s health and well-being at risk on a consistent basis
What Should I Do If I Suspect Nursing Home Abandonment?
Above all, it is vital to remain calm and collect evidence, while documenting everything. The moments following such a realization can end in rash, unplanned action that may result in making things worse for your loved one — or yourself. The way to successfully bring nursing home staff and management to justice is by building a case. The only exception to this would be if you or a loved one is in imminent danger, in which case, you must contact the local police department immediately.
- Speak with the resident director — There is a good chance that management has little to no idea what is actually happening in its wards, let alone to specific patients. Nursing homes in Oklahoma and America in general can be woefully understaffed and undertrained. While speaking with the head of the facility may not yield any direct results, due to their own complicit behavior or incompetence, it will provide evidence that you did in fact go through the proper channels.
- Document everything — Take photos of anything you believe to be out of the ordinary. This includes suspicious injuries, missing personal items, distressing behavior in your loved one, and unsanitary or filthy living conditions. Request daily reports from the floor nurses and any documentation that concerns activity in the room of your loved one.
- Contact Adult Protective Services — Each state and its respective counties have an APS department that will respond to reports of abuse within a nursing care facility in that particular area. While this could take a considerable amount of time, it is worth contacting its office to file an official report.
Pharmaceutical errors can result in serious injuries and illnesses when they occur to any patient, but nursing home residents are at an even greater danger of suffering the consequences of such mistakes. Because nursing home residents rely on workers to maintain their medication and administer regular and correct doses, they often do not realize they are being given the incorrect medication. Additionally, some residents are unable to recognize their own symptoms of being given improper medication or are unable to communicate to staff that something is wrong, leading to worse and longer-lasting effects that may result in death.
Common Types Of Pharmaceutical Errors
Because of the nature of medicating nursing home residents, there are a wide variety of pharmaceutical errors that can occur, each with their own causes and effects. Some of the most common errors include:
- Improper preparation: Some medications must be shaken well, crushed or otherwise prepared before being administered. If not done correctly, a wrong dose or concentration may be given to the patient, and while some medications are more likely to cause harm in such cases, all such incidents are considered errors.
- Incorrect medication: Nursing home staff handles a large amount of medications every day for their residents, each of whom have special needs and medication requirements. As such, staff may make a mistake in giving out medications. Many residents won’t be able to tell if the medication is wrong and will therefore be unable to prevent such accidents from occurring.
- Incorrect dose: Overdosing or underdosing a patient can occur by a simple error when pouring out medications. Often, a worker may forget how much a patient needs or may be not paying attention, either of which may lead to errors that are difficult for residents to spot.
- Improper administration: Many medications must be given under certain circumstances such as with food, via eye drops, with an inhaler or through other means of administration. If a worker fails to administer the drugs in their needed way or does so in a dangerous or reckless manner, severe complications can ensue.
Complications From Pharmaceutical Errors
Nursing home residents often need care that cannot be provided elsewhere. This regularly includes long-lasting conditions that require medication in order to be kept under control, which errors may worsen. The complications that occur from pharmaceutical errors are directly related to what type of error a resident has been subjected to. When a resident is not given his or her medication or is given less than the correct dose, the condition it is for will worsen and may result in death or injury if allowed to continue. The same event occurs if given the wrong medication, but he or she may also be harmed by that drug’s side effects for those that are not meant to take it.
Being overdosed or incorrectly administered with a medication can result in toxic effects that can harm a person’s body. These errors can poison a person, leading to organ failure and death shortly after, with even the most common medications becoming deadly at a high enough concentration. The effects of a medication error can develop slowly over time or happen relatively quickly, but even one instance or error can have lasting consequences that harm a resident.
There are a variety of causes for a nursing home staff member to attack a resident such as stress, personal frustrations, arguments or issues with the elderly, but none of them are justifiable or reasonable. Due to nursing home staff’s power and access to each resident, often without supervision, many types of physical assaults may occur. When these attacks are not stopped by the administration, or are covered up by the staff, they can easily worsen.
Physical assault that frequently occurs in nursing homes includes hitting, slapping, pushing, tripping, shaking, beating, burning and pinching. These actions are meant to hurt the resident, as well as intimidate and coerce him or her into compliance with some actions or to obey the perpetrator. Assault can also be applied to the threat of violence, scaring the victim into compliance.
The Effects Of Physical Assault
Due to the often fragile physical condition of residents, physical assault can easily worsen any injuries that they had prior to the incidents and inflict new trauma. Physical assault on a resident of a nursing home can often result in:
- Cuts and bruises — Most assaults result in at least these injuries, which may be evidence that attacks are occurring. However, staff may say that it was caused by an accident and inflict pain where it is not as easily noticed.
- Broken bones — Much harder to heal from when older, but can be unnoticed if the resident was already bedridden prior to the injury.
- Constant fear — The victim may live in continual fear of the person hurting him or her, as staff have access to rooms and control over many aspects of residents’ daily life.
- Mental and emotional trauma — Being assaulted is frightening for all, which may leave lasting psychological and emotional scars from the pain and that it was done by a person who was supposed to show care.
- Hospitalization — While staff may send the victim to the hospital, they may claim the injury was caused by an accident. The cost of hospitalization may be placed on the victim’s relatives.
- Traumatic brain injury — Brain trauma from an assault can seriously damage a victim’s bodily and cognitive functions and may lead to death. Injured elders may be unable to tell of their injury or staff may be unable/unwilling to diagnose the injury and treat it.
Physical Assault Cover-Ups
While many instances of physical assault are quickly reported by residents or discovered by other staff or administration and swiftly dealt with, there are many other cases where such abuse is hidden in some manner. The perpetrator will often attempt to hide the assault, but other staff and even the administration may try to cover up the incident, either because they do not want the staff member to get in trouble or they do not want the center to be penalized. Hiding the act for fear of a lawsuit is also common, as nursing homes will try to avoid the loss of money that often comes with such claims. These cover-ups are at the expense of the resident, as it will often result in him or her not receiving the proper injury care and the staff member continuing his or her assaults.
When patients are deemed to be threats to themselves or to others, medical staff may employ use of restraints of various nature in order to prevent someone from being harmed. While use of such restraints is often seen when dealing with people who are suffering from mental disorders, seen as being suicidal, or otherwise dangerous, these restraints have been used on residents of nursing homes. While they may be employed for various reasons, restraints often cause harm to elderly patients rather than preventing harm.
What Are Physical Restraints?
Physical restraints are meant to render a person harmless or helpless by keeping them in captivity via use of ropes, straps, handcuffs, fetters, straightjackets, and even physical force from a person or group of people. When physical restraints are used in nursing homes, staff must prove their necessity in connection with poor cognitive function in the subject such as delirium, confusion and other dementia-related conditions. Staff must use high levels of caution when restraining a patient and assess the environment for potential hazards and provide a greater amount of supervision including regular checking on the subject and a position closer to staff.
Consequences from physical restraints include:
- Urinary incontinence
- Agitation or confusion
- Trip-and-fall accidents
- Nerve injury
- Musculoskeletal injury
- Decline in physical abilities and functions
- Strangulation or asphyxiation
- General decrease in care for the patient
What Are Chemical Restraints?
Chemical restraints are the use of drugs to restrict the freedom and movement of a subject or to sedate him or her. Use of chemical restraints is meant to be used only in emergency situations or acute and psychiatric settings in order to control unruly patients that are interfering with care or may cause harm. Benzodiazepines (such as Ativan, Versed and Valium) are frequently used as chemical restraint medications, as they have a sedative, sleep-inducing, muscle-relaxing, amnesic and anti-anxiety effect. However, chemical restraints have been shown to be used by medical staff for their own convenience, rather than improving the patient’s health.
Common chemical restraint side effects are:
- Worsening of medical conditions due to inability to communicate
- Unexpected medical events from medication’s effects
- Lasting cognitive impairment
- Alterations in mood and behavior
- Chemical dependence
- Withdrawal syndromes
- Deep unconsciousness or death from overdose
- Toxic effects from drug or combination of drugs
- Decrease in medical care and attention
Sepsis is a severe illness that occurs when a bacterial infection enters the bloodstream. The blood circulates the bacteria to all parts of the body, where they can easily infect major body organs, including the brain. Once sepsis occurs, it can be difficult to treat, and the condition is often fatal.
Because elderly patients often have suppressed immune systems, they are at a higher risk for sepsis than a younger, healthy adult would be. Common places for a sepsis infection to begin include the following:
- The kidneys, due to an untreated urinary tract infection or pyelonephritis
- The bowel, due to peritonitis
- The liver or gall bladder, due to an untreated or aggressive infection
- The lungs, during a bout of bronchitis or pneumonia
- The skin, especially if cellulitis is present
- The brain, due to a meningitis infection
Common sites of infection that can lead to sepsis in medical facilities include places where an IV or catheter is inserted, surgical incisions, and wound drainage systems. It is crucial that these be kept scrupulously clean, that they be checked regularly, and that only sanitized equipment be used.
In addition to these, elderly patients in nursing homes are also at a higher risk of sepsis due to bedsores. Bedsores occur when a part of the body is pressed against the bed or a chair for an extended period of time, making them a common risk among people who are bedridden or must rely on wheelchairs. The longer a bedsore is left untreated, the greater the risk of infection.
Symptoms of sepsis are sometimes difficult to pinpoint, since they mimic the symptoms of many other conditions. Common symptoms include fever, chills, difficulty breathing, rapid heart rate, confusion or disorientation, and rash.
The sooner sepsis is diagnosed, the better chance the patient has of recovering. Sepsis infections are usually diagnosed with a blood test. However, patients who are already on antibiotics may produce a false negative on a sepsis blood test. To help ensure that a diagnosis does not miss a sepsis infection, other tests may also be used. These include tests of blood gases, kidney function tests and tests for white blood cell counts. The specific tests used may depend on where a suspected sepsis infection is most likely to have started.
Sepsis treatment typically takes place in the hospital — often, in an intensive care unit (ICU). Patients receive large doses of antibiotics via IV to fight the body-wide infection sepsis causes. Oxygen, fluids and medications to keep blood pressure up may also be administered. Some patients also respond well to treatment with powerful anti-inflammatory medications, like corticosteroids. These are often administered via an IV as well.
In some cases, kidney dialysis may be used to help clear the body of infection. If infection began at an injury or surgical site, like a wound or a bedsore, additional surgery may be required to clear that site of infection.
Sepsis infections have a high rate of death, especially among patients who have weakened immune systems or an underlying chronic illness. Among elderly patients, the body may not be able to handle the antibiotic treatment. The longer a sepsis infection goes without being treated, the lower the patient’s chances of recovery, regardless of how healthy the patient was to start. The best treatment for sepsis is prevention.
Slip And Fall Injuries
According to the U.S. Centers for Disease Control and Prevention (CDC), one out of every three adults age 65 or older suffers a fall accident each year. Falls are the leading cause of injury death for the elderly as well as the leading cause of nonfatal injuries and trauma-related hospital visits.
Common slip-and-fall or trip-and-fall hazards found in nursing homes include:
- Wet floors, caused by spills, cleaning or other accidents
- Poor lighting, keeping residents from seeing hazards
- Medication side effects, which unbalance patients
- Uneven or broken floors
- Throw rugs or mats that can trip up a walker
- Scattered materials left on the floor
- Physical restraints that trip up elders or keep them from avoiding a fall
- Defective or broken walkers, canes, etc.
The Impact Of An Elderly Slip-And-Fall Accident
Being involved in a slip-and-fall accident can cause injuries to victims of any age, but the more fragile nature of the elderly, especially as they age further and if they are dealing with some form of disability, makes serious injuries much more common. The sudden occurrence of a slip and fall can cause an elderly person to suffer:
- Lacerations from the impact or any objects they fall on;
- Hip fractures, which are very common due to the way a victim lands;
- Head trauma due to striking one’s head against the ground;
- Other common bone fractures affect the spine, forearm, ankle, leg, hand and upper arm;
- Muscles and joint injuries, affecting overall mobility and physical capabilities; and
- A fear of falling, causing them to limit physical activities, which in turn decreases physical fitness and increases the chances of another, more serious, fall.
When a nursing home resident suffers a fall, he or she will often need immediate medical treatment for the injuries as well as long-term rehabilitation to recover as much as possible.
Sudden Or Ongoing Weight Loss
Weight loss is very dangerous as it leads to dehydration and malnutrition. When the body loses weight, water is lost. Water is vital to proper organ functioning and without enough water, dehydration can occur, reducing the blood’s ability to deliver nutrients to the body.
When a person doesn’t eat regular, balanced meals, the body will burn fat deposits for energy. When the fat deposits are gone, the body will begin to burn muscle, including heart muscle. A frail, elderly person is at severe risk for becoming malnourished and developing a life-threatening infection or illness.
Nursing home residents may be especially prone to weight loss if they are not receiving or finishing their meals. Certain medications can affect the appetite and sense of taste and smell. If a resident is restrained, this will lead to weight loss as the resident may not be allowed or able to eat. If your loved one is experiencing sudden or ongoing weight loss, this could be a sign of abuse or neglect. You should expect the nursing home to provide healthy, appetizing meals that your loved one receives in a timely manner and is encouraged to finish.
If you or a loved one has been harmed while a nursing home resident, contact our attorneys for advice about protecting your legal rights and seeking recompense for injury. Please contact us for a free case evaluation about the injury suffered by your loved one. Call the lawyers at Maples, Nix & Diesselhorst in Oklahoma City at 800-539-0652.