Nursing Home Abuse Injuries                

Overview

As the population increases and the median age rises, there are more and more people who will have to avail themselves of the services of a nursing home. Whether it be from illness or injury, or because of age and infirmity, there are times when the family cannot care for the ill or injured person and the services of a nursing home are required. Currently, there are approximately 34,000,000 American over the age of 65. Approximately 40% will be admitted to a nursing home, and approximately 20% will have a residence longer than 5 years.

Residents of Illinois nursing homes have important rights and protections regarding their care and treatment, which are described in the Nursing Home Care Act of Illinois and the Omnibus Budget Reconciliation Act of 1987 (OBRA '87). Primary among these protections are the right to be free from neglect or abuse; the right to receive adequate assistance with meals, dressing, movement, bathing or other personal needs; and the right to have general supervision and oversight of a resident's physical and mental well being. Failure of a nursing home to comply with these rights can give rise to a lawsuit.

Each resident's particular circumstances must be appreciated and physician's orders/ treatment followed, if a nursing home is to be more than a mere warehouse for the aged or disabled. Nursing home residents under both Illinois and Federal law have specific protections designed to ensure the quality of their care and treatment, and preserve their human dignity. These rights must be protected, especially given the fragile and often vulnerable status of a nursing home resident. Families can play a significant role in making sure that a loved one in a nursing home is in fact receiving appropriate care and treatment, and to trigger legal action should it be appropriate.

If you have any reason to believe that you that your or a love one has been injured or neglected in a nursing home or assisted living facility call 800-437-2571 anytime for a free no obligation consultation with one of our attorneys experienced in handling nursing home abuse cases or use our convenient Free Case Evaluation submission form.

 

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Warning Signs of Nursing Home Abuse

There are many things that can indicate abuse or neglect in a nursing home. You should keep an eye out for anything unusual, especially unexplained physical marks such as bruises or fractures. Any noticeable change in your loved one's behavior or personality can be a signal that he or she is being mistreated. Remember, many times elderly people may be too embarrassed or ashamed to speak about their abuse. To keep your family member safe, you need to get involved and ask questions. Below are a few lists of common warning signs that may indicate abuse or neglect:

General Warning Signs

• Bed/pressure sores

• Low self-esteem/depression

• Use of physical or chemical restraints

• Use of unauthorized medication

• Bruising or fractures

• Malnutrition

• Poor personal hygiene

• Frequent illness/failure to report illness

• Unexplained or unexpected death of resident

• Rapid weight loss or weight gain

• Failure of staff to report any changes in condition

• Serious injury requiring hospitalization

• Dirty living quarters, odors

• Lack of privacy

• Loneliness or Inactivity

• Unanswered calls for help

• Signs of Physical Abuse

• Assault

• Battery

• Sexual Assault

• Sexual Battery

• Rape

• Unreasonable physical restraint

• Prolonged or continual deprivation of food or water

• Use of a physical or chemical restraint or psychotropic medication for any purpose not consistent with that authorized by the physician

• Giving too much medication

• Not giving needed medication

• Unexplained injuries

• Caretaker cannot adequately explain condition

• Open wounds, cuts, bruises or welts

• Elder reports of being slapped or mistreated

• Slapping, pushing, shaking, beating

• Forcing an older person to stay in a room

• Heavy medication or sedation

• Any incident involving broken bones, especially a fractured hip

• Injuries requiring emergency treatment or hospitalization

• Any injury or death occurring during or shortly after an episode of wandering (including outside the facility) when the staff is not aware that the resident is missing for some period of time

• Bruises, especially in clusters or regular patterns in areas such as the neck or groin

• Black eyes, welts, lacerations, rope marks, bone fractures, broken bones, skull fractures, open wounds, cuts, punctures and untreated injuries in various stages of healing;

• Burns (commonly on soles, palms, or buttocks);

• Laboratory evidence of medication overdose or failure to administer prescribed drugs;

• An elder's sudden withdrawn behavior, or the refusal of the caretaker to allow visitors to see the elder alone.

 

Signs of Neglect

• Physical neglect: disregard for the necessities of daily living

• Medical neglect: lack of care for existing medical problems

• Failure to prevent dehydration, malnutrition, and bed sores

• Failure to assist in personal hygiene, or in the provision of food, clothing, or shelter

• Unsanitary and unclean conditions

• Infections

• Failure to protect from health and safety hazards

• Poor access to medical services

 

Signs of Verbal or Emotional Abuse

• Resident appears emotionally upset or agitated

• Resident is extremely withdrawn and non-communicative

• Unusual behavior (sucking, biting, rocking)

• Resident exhibits humiliating, insulting, frightening, threatening or ignoring behavior towards family and friends

• Resident prefers isolation

 

Types of nursing home injuries

Abuse and neglect in a nursing home can include assault, battery, sexual assault, sexual battery, rape, unreasonable physical constraint, prolonged deprivation of food and water, failure to give necessary medical care, use of physical or chemical restraint or psychotropic medication for any purpose not consistent with that authorized by physician, and many others.

 

Physical Abuse

Sadly, physical abuse of senior citizens is not that uncommon. For their safety and protection, we must understand the definition and signs of physical abuse. Physical abuse is force that causes injury or pain. Striking, hitting, beating, pushing, shoving, shaking, slapping, or kicking are considered physical abuse. Abuse can also involve the inappropriate use of physical restraints,which include tieBdowns or straps. If restraints are left in place too long, bruises may result. Freedom of movement becomes limited, and over a period of time the use of restraints may result in deconditioning and muscle atrophy.

Elders should not be given drugs to restrain them, unless these medications are necessary to treat their medical symptoms. Overmedicating a nursing home resident with tranquilizing drugs for the convenience of the staff is abusive. Employing psychotherapeutic or antipsychotic drugs for patient discipline is abusive. If a nursing home or hospital patient is in severe pain, providing inadequate pain medication may also constitute elder abuse. Similarly, failing to administer prescribed drugs may be neglect or physical abuse.

 

Mental/Emotional Abuse

An elderly loved one can be harmed by words alone. Emotional or psychological abuse is the infliction of pain or distress, usually through insults, threats, intimidation, humiliation, or harassment. If emotional abuse in nursing homes is occurring, the family members should immediately notify the facility. The facility should amend the situation at once, but if the emotional abuse in the nursing home persists, the family should take further action. The chances of the emotional abuse in nursing homes occurring to just one resident is very slim, so other residents are probably suffering as well. Emotional abuse in nursing homes can include humiliation, harassment, threat of punishment, deprivation, and intimidation, as well as other behaviors.

 

Neglect

Federal and State laws require that nursing homes develop a plan of care and employ sufficient staffing to provide ALL the care listed on the care plan. Because most corporate owned nursing homes today are not sufficiently staffed, they cannot provide ALL the care listed on the care plan. Consequently, residents are not taken to the toilet when necessary, they are often left lying in urine and feces, develop painful and life threatening pressure sores (decubitus ulcers), are not fed properly, are not given sufficient fluids, are over-medicated or under-medicated, are dropped causing painful bruises and fractures, are not cleaned or groomed, are ignored and not included in activities, are left in bed all day, are not turned, call lights not answered promptly or not at all, etc., all forms of neglect.

Neglect means the negligent failure of any person having the care or custody of an elder or a dependent adult to exercise that degree of care which a reasonable person in a like position would exercise.

Neglect includes, but is not limited to:

• Failure to assist in personal hygiene, or in the provision of food, clothing, or shelter;

• Failure to provide medical care for physical and mental health needs;

• Failure to protect from health and safety hazards;

• Failure to prevent malnutrition; and

• Failure to prevent dehydration.

 

Malnutrition

Nutritional well-being is an important part of successful aging. Improper nutrition or malnutrition can lead to infections, confusion, and muscle weakness resulting in immobility and falls, pressure ulcers, pneumonia, and decreased immunity to bacteria and viruses. Malnutrition is costly, lowers the quality of nursing home residents' lives, and is often avoidable. Based on the nutritional assessment, the facility must take steps to ensure that the resident maintains good nutritional health and must provide residents with a well-balanced, palatable meal.

Many things can cause malnutrition in nursing home residents. The following are factors that may prevent a resident from receiving adequate amounts of the vitamins, minerals, protein, and calories the resident needs:

 

Physical Causes:

• Illness

• Adverse drug effects such as nausea, vomiting, diarrhea, cognitive disturbances, or sleepiness

• Food and drug interactions which decrease the ability of the body to absorb vitamins and minerals

• Depression

• Swallowing disorders

• Mouth problems such as tooth loss, dentures that do not fit properly, mouth sores, and mouth pain

• Tremors, which affect the residents' ability to feed themselves

 

Environmental Causes:

• Inadequate attention from staff for residents who need assistance eating

• Staff who are uneducated about malnutrition and proper ways to feed residents who need help

• Reliance on liquid supplements

• Special diets

 

Signs That A Resident is Malnourished:

Ask the following questions to determine whether your loved one is demonstrating signs of malnutrition:

• Do the clothes fit more loosely than usual?

• Are there cracks around the mouth?

• Do the lips and mouth look pale?

• Has the resident complained that his/her dentures no longer fit?

• Has the resident's hair been thinning or growing more sparse?

• Do wounds seem to take longer to heal?

• Does the resident appear confused (not as a result of a disease such as Alzheimer's)?

• Is the resident's skin breaking down?

• Does the resident's eyes look sunken?

• Does the resident appear to be losing weight?

 

Dehydration

Dehydration should be managed through an individualized daily plan to promote adequate hydration based upon identifying the risk factors, which include:

• Alzheimer's, or other dementia

• Major psychiatric disorders

• Depression

• Stroke

• Repeated infections

• Diabetes

• Malnutrition

• Urinary incontinence

• History of dehydration

• 4 or more chronic conditions

• Use of diuretics, antidepressants, psychotropics, or anti-anxiety medications, laxatives, or steroids

• Chronic cognitive impairment

• Inadequate nutritional status

• Acute situations: vomiting, diarrhea and/or fevers

A facility may be found guilty of neglect by either causing dehydration while the resident is in their care, or failing to treat the problem of dehydration properly.

 

Bed injuries

Some siderails extend the full length of the bed. Others, called half rails, are about 2-1/2 feet long. Some are metal, others plastic. Most can be raised or lowered. Siderails are divided, either vertically or horizontally, with slats spaced about six or more inches apart. This space can trap an elderly person's head, causing him or her to strangle. A particularly thin, frail person could potentially squeeze between the rails and fall to the floor. Often mattresses fit loosely in the frame, leaving gaps large enough to trap the resident between the mattress and siderail, also leading to suffocation.

 

Pressure ulcers

Pressure ulcers are also referred to as pressure sores, bedsores, and decubitus ulcers. A pressure ulcer can range from a very mild pink coloration to the skin which disappears in a few hours after the pressure is relieved, to a very deep wound extending to and sometimes through a bone into internal organs.

All pressure ulcers have a course of injury similar to a burn wound. This can be a mild redness of the skin and/or blistering, such as a first degree burn to a deep open wound with a lot of blackened tissue in it, such as a third or fourth degree burn.

The primary cause of pressure ulcers is unrelieved pressure. It can also occur from friction by rubbing against something such as a bed sheet, cast, brace, etc. or from prolonged exposure to cold. Any area of tissue that lies just over a bone is more likely to form a pressure ulcer. These areas include the spine, coccyx or "tailbone", hips, heels, and elbows. Other contributing factors to the development of pressure ulcers are poor nutrition, weight loss, diabetes, poor hygiene, and dehydration.

The development of pressure ulcers may be an indication of potential problems in the care being delivered to the nursing home resident. Even in good nursing homes, small wounds may develop, but with quick attention, these wounds will heal and not progress to massive wounds. According to federal law, in most situations there is no medically valid reason for a pressure ulcer to progress to a Stage IV situation (a massive deep open wound).

 

Falls and fractures

Falls are the most frequent causes of fractures in the elderly. Nursing home residents are at increased risk for falls, primarily due to advanced age of the population. There are many other factors which place individuals at risk for falls. Nursing home personnel are regularly required to assess patients to determine their risk for falling, and provide safety devices and services to minimize the risk of injury to the resident. When nursing home staff members are negligent, these risks are ignored and residents sustain physical injury as a result. Some of the risk factors for falls include:

• Previous falls

• Cardiac arrhythmias

• Stroke

• Central nervous system disorders such as Alzheimer's disease, Parkinson's disease, dementia and others

• Problems with mobility and gait

• Low blood pressure (orthostatic hypotension) on standing up

• Bowel or bladder incontinence

• Dizziness

• Dehydration

• Visual impairment

• Use of restraints

• Medications

 

If you have any reason to believe that you that your or a love one has been injured or neglected in a nursing home or assisted living facility call 800-437-2571 anytime for a free no obligation consultation with one of our attorneys experienced in handling nursing home abuse cases or use our convenient Free Case Evaluation submission form.

 

Find a qualified injury attorney in your area

 

What you can do if you suspect abuse or negligence

• Visit frequently. Vary your visits to different times of the day and evening to assess the care provided during all times of the day, night, weekends, and holidays.

• Talk to nurses and aides about your concerns.

• Talk to the Director of Nurses, Social Worker and Administrator.

• Talk to the doctor.

• Call the ombudsman. Most states have a long term care ombudsman program. Their success rate and true commitment to quality care depend on each ombudsman program. In general, ombudsmen can help you get a new mattress for your family member, make the nursing home pay for lost or stolen items, and other types of simple problems; however, they may not be able to tackle serious problems involving lack of care. There are some aggressive ombudsman offices, but they are at the mercy of the state health department bureaucracy. It is best to use this office for non-life threatening situations.

• Call your state survey agency. In each state there is a division of the State Department of Health that deals with oversight of nursing homes and enforcement of nursing home regulations. This agency conducts yearly surveys of each nursing home and also investigates complaints filed by family members. Find out who the state licensing agency is from your nursing home. They are required to provide this information to you when your place a resident in the nursing home.

• If you believe the nursing home resident is a victim of any form of abuse or neglect by the nursing home, you can and should file a complaint with state Licensing and Certification; they are required to investigate your complaint. The Licensing and Certification division of each state may substantiate your complaint; if they do so, the agency has the authority to issue a citation against the facility, impose a fine, and require corrective action.

• You can file a complaint with Licensing and Certification, and they must investigate the complaint. Licensing and Certification can either substantiate or unsubstantiate your complaint. If the complaint is substantiated, this agency can issue a citation and impose a fine and require corrective action.

• Make sure to have good independent documentation of your charges, such as doctor or hospital records, that show the true nature of the problem.

• Many family members are concerned that if they make a complaint and their relative is still in the nursing home, the facility may try and retaliate on the relative. Since you cannot be at the nursing home twenty four hours a day, this could be a real concern, especially if your relative is unable to communicate well and tell you about any retaliation. Some family members wait until they move their relative out of the facility to file a complaint. Of course, you can always file a complaint if your relative dies, especially if you think that the lack of care or abuse was a factor in the death.

• State Civil Litigation - One of your remedies is to take private legal action against the nursing home in state court. Each state has a different set of laws, but the most common suits are for abuse and neglect or wrongful death. Some states also have unfair business practice laws that allow any individual to sue, but usually without much compensation. If your state has an effective unfair business practice law, your attorney may use it along with a neglect and abuse or wrongful death case to get remedial action.If you suspect a loved one may be in danger in a nursing home, call an experienced attorney. It won't cost you anything to discuss your concerns, and you may decide that moving forward with a claim of abuse or neglect is your best option. Don't let your loved one suffer at the hands of an unethical nursing home

 

If you have any reason to believe that you that your or a love one has been injured or neglected in a nursing home or assisted living facility call 800-437-2571 anytime for a free no obligation consultation with one of our attorneys experienced in handling nursing home abuse cases or use our convenient Free Case Evaluation submission form.

 

If you notice any one of these signs of nursing home abuse or neglect, you need to
Find an experienced nursing home negligence attorney to start a prompt investigation to find out if your loved one is being mistreated. They'll do everything they can to hold the facility accountable for the harm they've caused and work hard to make sure it never happens again.

 

Find an experiened Nursing Home Abuse attorney in your area