Nursing home neglect and abuse is a national disgrace˳ In fact, this is a widespread — and increasing — problem in the United States˳ An analysis of the death certificates of persons who died in California nursing homes between 1986 and 1993 revealed that over 7%, or 1 in 15, of the deaths of seniors in nursing homes, resulted at least in part, to utter neglect, lack of food or water, untreated bedsores, or other generally preventable ailments˳ Since that study, this nation’s nursing home population has risen sharply˳ If the 1˳6 million Americans now in nursing homes are dying of questionable causes at the same rate, then every year about 35,000 elderly citizens die prematurely or in unnecessary pain, or both˳ According to a survey published in the Journal of the American Geriatrics Society, 30% of those polled said they would rather perish than live in a nursing home˳
The U˳S˳ Congress and state legislatures have taken steps to make nursing homes accountable˳ The federal Nursing Home Reform Act states that a nursing home must provide “services and activities to attain or maintain the highest practicable physical, mental, and psycho-social well-being of each resident in accordance with a written plan of care˳” However, you still need to be alert to your own loved one’s needs, and if necessary, demand that the nursing home respect all of his or her legal rights˳ Listed below are examples of positive steps you can take to prevent problems and ensure proper treatment in a nursing home for your relative or friend˳
Signs of Nursing Home Abuse
It is important to watch for signs that your loved one may be a victim of abuse or neglect˳ Most nursing home residents must depend on the staff for most or all of their daily needs, including food, water, medicine, toileting, grooming, stimulation and turning˳
Although most facilities provide good care, some cause needless suffering and death˳ Sadly, many nursing home residents are starved, dehydrated, over-medicated, and suffer painful pressure sores˳ In addition, they may be isolated, ignored, and deprived of social contact and stimulation˳
The following is a list of some forms of nursing home abuse:
- Assault and battery
- Sexual assault and battery
- Rape
- Unreasonable physical constraint
- Prolonged deprivation of food or water
- Use of physical restraints, like straps or bels
- Use of chemical restraints, like sedatives or sleeping medications
- Use of psychotropic or other medications for any purpose not authorized by a physician
- Excessive dosages of medication
- Withholding needed medication
- Confinement to a room or fixed location
Nursing home abuse victimizes the most vulnerable individuals˳ Although many residents can report mistreatment, some cannot even describe what happened˳ If your relative or friend is a nursing home resident, you can help by watching out for signs of abuse, including:
- Unexplained injuries
- Inability of nursing home staff to give an adequate explanation of a resident’s condition
- Open wounds, cuts, bruises, welts, or bedsores
- Slapping, pushing, shaking or beating
- Non-verbal signs from the nursing home resident that something is wrong, such as:
- Unusual emotional outbursts or agitation
- Extreme withdrawal or lack of communication
- Unusual behavior, like sucking, biting, rocking, etc˳
- Humiliating, insulting, frightening, threatening or ignoring behavior towards family and friends
- Desire to be isolated from other people
Signs of Nursing Home Neglect
Neglect means the negligent failure by any person with care or custody of an elderly or a dependent adult to exercise that degree of care that a reasonable person in a similar position would exercise˳
Neglect includes, but is not limited to:
- Failure to provide food, clothing, shelter, or help with personal hygiene
- Failure to provide medical care for physical and mental health needs
- Failure to protect from health and safety hazards
- Failure to prevent malnutrition or dehydration
- Failure to provide the necessities of daily living
- Failure to prevent bed sores
- Failure to provide sanitary conditions
- Failure to prevent infections
Specific Examples of Common Nursing Home Abuse or Neglect Injuries
Bedsores
Bedsores are also known as pressure ulcers, pressure sores, and decubitus ulcers˳ The primary cause of bedsores is unrelieved pressure to a particular part of the body˳ They also may result from friction, like rubbing against something like a bed sheet, cast, brace, etc˳, or from prolonged exposure to cold˳
Any area of skin tissue directly over a bone is a potential site for a bedsore˳ These areas include the spine, coccyx or “tailbone,” hips, heels, and elbows˳ The factors that contribute to formation of a bedsore include poor nutrition, poor hygiene, weight loss, diabetes, and dehydration˳ The least serious kind of bedsore looks like skin discoloration, and may disappear within a few hours after relieving pressure on that area˳ However, more severe bedsores are profound wounds, which can extend through skin tissue into internal organs or bones˳
Medical professionals have identified similarities between bedsores and burns˳ Like a first-degree burn, a mild bedsore may involve mild redness of the skin and/or blisters˳ A third-degree or fourth-degree burn, or severe bedsore, may have a deep open wound with a lot of blackened tissue, which is called “eschar˳” The primary treatment for bedsores starts with removing all pressure from the affected area, to prevent further tissue decay and promote healing˳ The victim must be turned or repositioned frequently and get enriched nutrition˳ The affected area must be kept clean, and dead or necrotic tissue should be removed to minimize the risk of infection˳ The worst bedsores often require a surgical procedure, known as debridement of dead tissue˳
If you suspect that a relative or friend is suffering from a bedsore, you need to get immediate medical attention for that individual˳ In addition, help your loved one get legal assistance˳ Very frequently, severe bedsores result from abuse and neglect˳ Federal regulations confirm that there rarely is a valid medical reason for a bedsore to develop into a massive deep wound, which is known as the stage 4 level˳
Suffocation and Strangulation
A frail nursing home resident can suffocate or strangle to death in a hospital bed, if ignored or neglected by nursing home staff˳ Between 1993 and 1996, there were 74 of these cases reported, and probably many more went unreported˳
The design of the side rails on a nursing home bed may contribute to the danger˳ Often side rails have slats that are spaced six or more inches apart˳ That space may trap an elderly person’s head, causing him or her to strangle, or allow a thin individual to squeeze between the rails and fall to the floor˳ If the mattress on a nursing home bed does not fit properly in the bed frame, a patient may be trapped and strangle in a gap between the mattress and side-rails˳
Broken Bones or Fractures
For the elderly, falling is the most frequent cause of fractures˳ Nursing home staff must regularly evaluate each patient; determine his or her risk for falling, and provide safety devices and services that each individual needs to minimize the risk of injury˳ Some of the risk factors for harmful falls include:
- Previous falls
- Cardiac arrhythmias (irregular heartbeat)
- Stroke
- Central nervous system disorders, such as Alzheimer’s disease, Parkinson’s disease, or dementia
- Problems with mobility and gait
- Low blood pressure (orthostatic hypotension) when trying to stand up
- Bowel or bladder incontinence
- Dizziness
- Dehydration
- Visual impairment (i˳e˳ macular degeneration, cataracts, etc˳)
- Use of restraints
- Medication side effects
- Slipping or tripping hazards, like torn or loose rugs or mats
The Cost of Nursing Home Abuse or Neglect
The cost can be quite high for the treatment of a victim of nursing home abuse or neglect˳ Often the resulting injuries are permanent, and may require hospitalization or a higher level of medical treatment and nursing care than your loved one previously needed˳ This can be an extreme hardship for the victim and his or her family˳ If the injuries are the fault of a nursing home, then it should have insurance to pay for those substantial bills, other expenses, and damages for pain and suffering˳ Proving a nursing home abuse or neglect case is a complex process˳ To succeed, you need a lawyer who is well versed in the complicated laws that govern these legal actions˳
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