Nursing Home Negligence

Nursing home neglect can range from food or water deprivation to administering medications incorrectly, to failing to respond to calls for assistance. It can also include allowing patients to wander. When an elder is living in a nursing home, the staff has a duty to provide care and safety. If they allow the resident to get hurt or injured by wandering around without supervision, that may constitute nursing home abuse and/or neglect. Keep reading to learn more about protecting your loved one’s safety and their rights.

Reasons for Wandering

Patients with dementia are the most likely to wander. In fact, according to the Alzheimer’s Association, nearly 6 in 10 dementia patients have at least one wandering incident. Patients wander because they are confused and looking for somewhere familiar, but they also wander in search of food and water, medication, or a bathroom. Sometimes, nursing home residents wander due to confusion brought on by medications.

Types of Wandering in Nursing Homes

Wandering can refer to any situation where a care facility allows a patient who needs supervision to roam the facility alone. Wandering may be classified in any of the following categories:

• Agitated Purposeful Wandering — These patients tend to be upset, though the reason can be real or imagined. They may be aggressive or unwilling to cooperate. To prevent wandering, the nursing home needs to address the underlying cause of their agitation.
• Recreational Wandering — Sometimes residents simply want to walk around because they need more activity. Recreational wandering tends to happen when the facility fails to provide ample exercise and fitness opportunities.
• Elopement — Elopement occurs when staffing and security is so inadequate that patients can wander out of the facility on their own.
• Environmental Cuing — Different environmental factors can trigger wandering behavior. Even something as simple as a long hallway can cause some to wander.
• Fantasy and Reminiscence — When a patient is no longer aware of their actual surroundings, they sometimes wander through an imagined environment such as an old home where they used to live.

Risks of Wandering Incidents

When allowed to wander, patients may leave the building, which puts them in danger from being hit by vehicles, falling, or drowning. They may get lost and potentially become the victim of sexual or physical abuse. In the winter, wandering can lead to hypothermia, frostbite, and complications with cardiovascular and respiratory diseases. Wandering inside the facility can increase the risk of falls and life-threatening accidents, or the patient may end up in the kitchen or other areas where there are dangers such as knives and stoves.

How to Prevent Wandering

Identifying at-risk residents is the first step to reducing wandering incidents. At-risk residents should be encouraged to sit with other residents at lunch, join social activities, and get regular exercise. Often, wandering incidents happen in the first few days when a patient is in a new facility, and during this time period, the staff needs to be especially vigilant.

Additional prevention measures include the following:

• Train staff to identify patients who are at the highest risk for wandering
• Have ample staff members
• Secure doorways to prevent elopement
• Place alarms on doors or use video surveillance so that staff know if patients try to leave
• Consider using GPS technology to track patient locations
• Implement systems that notice when patients are missing
• Lock doors leading to unsafe areas, such as kitchens and roofs

When nursing homes don’t take reasonable precautions to protect their residents, the nursing home may be negligent and by extension, they may be liable for any injuries that occur.

Nursing Home Liability

When a nursing home lets a patient wander, that’s a serious indication that the facility is not taking precautionary measures to keep residents safe. People live in nursing homes because they need supervision, help with daily activities, and access to doctors and nurses.

Typically, they cannot take care of themselves, and wandering puts them in a situation where they are often alone and without any assistance. If injuries or even death occurs because they are allowed to wander, the nursing home is liable.

If your loved one has been hurt or if they have died due to a wandering incident, you may be entitled to compensation. A nursing home abuse attorney can talk with you about your case, help you assess your damages, and fight for justice.

At Mazow | McCullough, we helped the family of a victim of nursing home neglect win a $625,000 settlement, and we may be able to help you. Contact us today for a free case evaluation.

The majority of nursing homes are understaffed. This serious problem has plagued nursing homes for decades — it puts patients in danger and is a major contributor to nursing home neglect. If you or a loved one has been subject to negligence or abuse related to inadequate staffing in nursing homes, you may be entitled to compensation for your damages.

Reasons for Understaffing

Costs are a major contributor to understaffing. Nursing home managers often claim that they have to cut payroll costs so that they can afford the rest of their overhead, but in many cases, this is simply an excuse to safeguard their profit margins. Additionally, due to low wages, nursing homes tend to have difficulties attracting and retaining quality staff members.

Staffing Trends

Prior to 2010, nursing homes self reported their staffing levels to the government, and typically, their reports were unverified. As of 2010, the Affordable Care Act requires nursing homes to submit payroll records to Medicare. According to some of the payroll records that have been collected, the staff-to-patient ratio at most nursing homes fluctuates regularly from 1:8 to 1:18, or even higher. When patients need a lot of care, one staff member for every 18 people isn’t enough.

Although the government doesn’t require nursing homes to have a certain staff-to-resident ratio, it does require nursing homes to have a registered nurse on hand for at least eight hours a day, seven days a week. In spite of that rule, payroll records from the last quarter of 2017 reveal that a quarter of all facilities did not have any registered nurses working.

Since 2014, health inspectors have cited one in eight nursing homes for having too few nurses on staff. The weekends tend to be the worst — on average, nursing homes have 11% fewer nurses working on the weekends and 8% fewer nursing aides than they do during the week.

Understaffing Consequences to Staff

When a facility doesn’t have enough staff members to take care of its operational needs, the existing staff members face an overabundance of tasks. That creates a stressful environment with employees frequently working long back-to-back shifts without breaks, leading to even more turnover and exacerbating the understaffing problem.

Overwhelmed employees are more likely to make mistakes administering medication, and they tend to skip necessary tasks such as changing bed linens, helping patients with physical therapy, bathing patients, and even feeding patients. Additionally, as the stress mounts, some employees become abusive.

Understaffing Consequences to Patients

The vulnerable patients who live in nursing homes depend on their caregivers for food, medication, bathing, grooming, exercise, and other essentials. If the nursing home is understaffed, the patients face a greater risk of malnutrition, bedsores, dehydration, infection, and pneumonia. Over time, these issues can become worse and worse.

When a facility is understaffed, there aren’t enough caregivers to perform simple tasks such as turning a bed-ridden patient. When these patients aren’t moved regularly, they tend to get painful skin conditions, infections, or bedsores, and they may experience muscle atrophy due to the lack of movement. That, in turn, places even more pressure on the already overwhelmed staff members. If they are not able to give the patient help, the infections and bed sores spread, and the muscular atrophy becomes even more serious.

Similarly, if patients don’t receive their medications due to understaffing, their symptoms can worsen. If they aren’t fed, they are likely to become malnourished and weak. Again, that creates a repetitive cycle that can become nearly impossible to break. Often, when family members come into the nursing home, they end up feeding their loved ones or providing other care that should be provided by the staff at the nursing home.

What to Do When Your Loved One Has Been Affected by Understaffing

If your loved one has been affected by understaffing at their nursing home, they may have suffered from malnutrition, lack of medication, or a variety of other issues, and they may be entitled to compensation for hospitalizations, medical bills, and pain and suffering related to their mistreatment and neglect.

If your loved one died in a nursing home and you believe understaffing may have contributed to their death, your family may also be able to get compensation for your loss — although money can never bring back a loved you, a wrongful death suit can help you to pay for old medical bills and get justice for your loved one.

At Mazow | McCullough, PC, we recently helped a woman win $625,000 in a case involving nursing home neglect, and we may be able to help you. Contact us today for a free case evaluation.

Sexual abuse in nursing homes and care facilities is on the rise. This form of elder abuse is arguably the worst possible kind, and although it’s mostly a hidden problem, it’s also a nationwide epidemic. If you believe that you or a loved one is a victim of nursing home sexual abuse, you are not alone, and there are ways to get help.

Sexual Abuse by the Numbers

The Administration for Community Living monitored sexual abuse in nursing homes in all 50 states, and over a 20 year period, the group received reports of over 20,000 cases of sexual abuse in nursing homes. That figure doesn’t take into account abuse committed by other residents, and it also doesn’t take into account the countless cases that go unreported every year.

A study by the minority staff of the Special Investigations Division of the House Government Reform Committee, found that U.S. nursing homes were cited for 9,000 cases of abuse between January 1999 to January 2001. Shockingly, as 5,283 nursing homes were involved, that’s nearly one third of all nursing homes in the United States.

Most of problems included untreated bed sores, malnutrition, dehydration, preventable accidents, inadequate medical care, and lack of sanitation and hygiene, but 1,601 of the violations caused physical or sexual harm to the residents. In some cases, nursing home staff were accused of physical or sexual abuse, and in others, staff were cited for failing to protect residents from other residents. The report also stated, that nursing home abuse has increased every year since 1996.

Why It’s a Hidden Secret

With such high rates of abuse, it can be hard to figure out why nursing home abuse and sexual abuse in particular seem to be such a hidden secret. Sometimes, facility owners don’t want to reveal or deal with abuse because they’re worried about their reputations and profits. Families often don’t want to face the abuse or just may not believe that it’s actually happening.

Tragically, many sexual abuse victims have conditions such as Alzheimer’s that hinder their ability to communicate and alter their perceptions of reality. As a result, when these patients report sexual abuse, it’s often dismissed by the nursing home staff, the managers, and even the victim’s own family. Additionally, the low wages offered to most nursing assistants makes it nearly impossible for facilities to find and retain quality and qualified workers, and workers often lack the required training to spot sexual abuse, which also keeps offenses from even being reported.

In 2017, CNN reported that over 1,000 nursing homes had been cited for mishandling suspected cases of sexual abuse. But these reports also showed that the police tend to be reluctant to believe victims’ allegations of abuse, due to their failing memories or confusing allegations. Beyond that, regulators have failed to flag patterns of repeated allegations against single caregivers. These systemic failures make it difficult for victims to get justice, while also making it easier for sexual predators to get away with their crimes.

Know the Signs of Sexual Abuse

Again, due to age, dementia, fear of their abuser, or other conditions, victims of sexual abuse are not always able to tell their families or loved ones they’re being abused. For that reason, it’s important to understand the physical and emotional signs of abuse:

• Unexplained infections or sexual transmitted diseases
• Ripped or bloody underclothes
• Unexplained bruising, particularly in intimate areas
• Visible and excessive fear and apprehension around certain persons
• The elder person blaming themselves for minor problems
• Visible depression or anger, especially when these symptoms have not been present in the past
• Rocking, sucking, or mumbling (referred to as false dementia)

It’s also critical to remember that both women and men are subject to rape and other forms of sexual abuse.

If you are a victim of nursing home sexual abuse or if you believe that your loved one is being abused, it’s important to report it. Always be careful about approaching the nursing home, unless you truly believe that the management will help you and not rush to cover the abuse. If you believe that the nursing home may be at fault, speak with an attorney and the police first. Notifying the nursing home may give them time to erase records and destroy evidence.

If the district attorney determines that there is substantial evidence to substantiate criminal behavior, the state will file charges against the nursing home. However, even if no criminal charges are brought forward, you may still be able to bring a civil suit against the nursing home or other liable entities.

Legal Help for Nursing Home Sexual Abuse

Unfortunately, lawsuits against nursing homes are difficult and complex. Many nursing homes are owned by corporations that avoid lawsuits by flooding the opposing legal team with paperwork. If you decide to bring a suit against a nursing home, you need to hire an attorney who is ready and able to handle the process. Ideally, you want a personal injury lawyer with experience in nursing home and sexual abuse cases. To set up a free case evaluation, contact us today at Mazow | McCullough, PC.

The National Safety Council reports that choking is the fourth leading cause of unintentional injury death in the country. Of the approximately 5,000 people affected annually, over half are older than 74. Tragically, choking isn’t always an accident. In nursing homes, choking can be due to neglect. Often, caregivers ignore risks associated with choking, and they fail to supervise or assist patients who ultimately end up choking to death.

Negligence at Mealtimes

In terms of choking, the most dangerous time in a nursing home is mealtime, especially for residents who require very attentive care. Sadly, a lot of nursing homes are understaffed, and they have employees who simply dish out plates of food without monitoring the patient’s consumption. This inattentiveness can result in malnutrition and dehydration, but also serious choking incidents.

Primary Causes of Choking in Nursing Homes

Elders, especially those in nursing homes, often suffer from medical conditions that heighten their risk of choking. Patients with dementia, Alzheimer’s disease, and various other conditions cannot eat safely on their own. It is imperative that nursing home personnel assist these residents while they eat to make sure they don’t fill their mouths too full and that they safely swallow their food.

Even though federal laws require that nursing homes keep adequate staff on duty, many patients don’t get the assistance they need. Nursing home residents may choke for any of the following reasons:

• Ill fitting dentures
• Inability to control muscles due to nerve damage or peripheral neuropathy related to strokes or neurological disorders such as diabetes, Parkinson’s disease, dementia, Alzheimer’s disease, Muscular Dystrophy, Multiple Sclerosis, or Lou Gehrig’s Disease.
• Dehydration causes a dry throat and a thick tongue, making it difficult to chew and swallow.
• Epilepsy or seizures due to other conditions
• Failure to accommodate dietary needs — for instance, if a patient needs foods cut into small pieces so they can swallow, failure to do that can lead to choking
• Eating without supervision or assistance
• Failure to perform the Heimlich maneuver or other life saving remedies in a timely fashion

As you can see from the examples above, swallowing food can be difficult for some nursing home residents. When nursing homes don’t enforce dietary restrictions or when they employ staff who fail to assist or supervise residents, they put people at risk of choking, which may cause serious injury or death.

Preventing Nursing Home Residents from Choking

Nursing homes are required to keep their patients safe, and that includes taking precautions to prevent patients from choking. Patients who have difficulties swallowing should also be examined to assess the severity of their conditions. If their doctor prescribes a specialized diet or monitoring to prevent choking, those instructions should be included in the patient’s chart and all nursing home caregivers should be made aware of these guidelines. If a staff member is underqualified or not properly trained and someone dies from choking, the nursing home could be held accountable.

Is Choking Abuse?

The National Center on Elder Abuse and the US Department of Health and Human Services defines elder abuse as “any knowing, intentional or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult”. Elder abuse can include physical and emotional abuse, exploitation, and neglect.

Similarly, nursing home abuse refers to knowingly or recklessly causing harm to a nursing home resident. There are many different types of nursing home abuse:

• Harmful or unwanted physical contact
• Physical restraint or isolation
• The inappropriate use of medicine
• Physical restraint, isolation, or inappropriate use of medical procedures used as punishment or against doctor’s orders
• Inappropriate conduct likely to cause physical or psychological harm
• Threatening or menacing conduct that results in fear or mental distress to a resident

Based on these definitions, allowing someone to choke when the situation is avoidable can be a form of elder abuse.

If you or a loved one has choked due to neglect from your caretaker or your nursing home, you may be entitled to compensation. Depending on the situation, you may be able to receive compensation for medical bills, physical pain, mental suffering, emotional distress, and loss of enjoyment of life as well as other damages. To learn more about nursing home abuse, contact us at Mazow | McCullough, PC for a free case evaluation.

Sadly, women are generally more likely to be affected by nursing home abuse than men. There are multiple reasons for the increased risk, and to protect yourself or your loved ones, you should understand the signs and be proactive in cases where you believe abuse is occurring.

1. The Majority of Elders Are Women

A primary reason more women are likely to face nursing home abuse than men is simply because there are more women than men in long term care facilities. There are only 89 men for every 100 women between the ages of 65 and 69, and the difference grows as people get older. For people over the age of 90, there are only 38 men for every 100 women. Overall, there are approximately 3.6 million more women over the age of 65 than men.

2. Women Often Have More Risk Factors Than Men

There are certain risk factors that are strongly linked to nursing home abuse, and women are more likely to have these risk factors than men. Women live longer, and age typically correlates with an increased risk of elder abuse. Additionally, many elder women are widows, and social or familial isolation can also cause someone to be more prone to abuse.

A prior history of abuse has also been linked to an increased risk of nursing home abuse, and throughout their lives, women have statistically faced more abuse than men. For example, 90% of sexual assault victims are women.

3. Many Women Face Sexual Abuse in Nursing Homes

Women often deal with physical, emotional, and financial abuse in nursing homes, but they may also face sexual abuse and rape in care facilities. There are limited statistics on the number of women who experience sexual abuse in nursing homes, but federal data shows 16,000 complaints from 2000 to 2017. That’s approximately 1,000 cases per year, but many cases go unreported so the actual numbers may be even higher.

4. Women with Disabilities Often Deal with Higher Rates of Abuse

When a woman has a disability, she may face an even greater risk of nursing home abuse. In one study of institutionalized adult women, 21% reported nursing home abuse in the form of interpersonal violence, but one third of women with disabilities reported issues. That is an increase of over 50%.

5. Many Nursing Homes Have Multiple Citations Against Them

The federal government has cited over 1,000 nursing homes around the country for sexual abuse. When you take into account that there are only 15,600 nursing homes in the country and that many cases of sexual abuse are never reported, those numbers are shocking. Additionally, 100 of these nursing homes had multiple citations related to rape or sexual assault.

6. There Are Many Signs of Nursing Home Abuse in Women

Generally, if a woman is facing nursing home abuse, there are often visible signs. Victims of physical abuse may go to the emergency room more often, and they tend to have unexplained bruises and fractures. In cases of sexual abuse, women may have urinary tract infections, pelvic pain, or bruises on their upper thighs.

These women may be reluctant to let anyone see their injuries because they often fear that their abuser may retaliate if anyone finds out about the abuse. They may start showing changes in emotions or behavior, and they may begin to recoil when friends or loved ones try to touch them.

7. Financial Abuse is a Factor for Women Too

Women often face financial abuse as well, especially in cases where a woman may be suffering from medical conditions that result in deteriorating memory or a decreased ability to communicate. The signs of financial abuse can be easy to spot if you know what to look for. For example, an elderly woman who is facing financial exploitation may not have enough money to pay her expenses. She may suddenly change her will, give possessions to others, or make unusual purchases with her credit card.

If your loved one is female and currently lives in a nursing home, it’s even more important that you are aware of the signs of nursing home abuse. If you suspect that abuse is happening, get help as soon as possible. Contact Mazow | McCullough, PC to learn about your rights and determine if you should bring forward a lawsuit.