Download often overlooked warning signs of nursing home negligence or abuse

A Special Report to Those with Loved Ones in
Nursing Home Residences
OFTEN OVERLOOKED WARNING SIGNS
OF NURSING HOME
NEGLIGENCE OR ABUSE
and What To Do About It
If you have a loved one
in a nursing home,
YOU may be the only one
who can help,
should there be signs
of NEGLIGENCE or ABUSE
Edwards & Patterson Law Firm
321 S Third Street
McAlester, OK 74501
&
1831 East 71st St.
Tulsa, OK, 74136
918-302-3700 or1-877-761-5059
A nursing home can be a life-saver for
persons of any age who are recovering
from surgery, an illness or an accident.
Or for those who are incapable of caring
for themselves, due to some physical or
mental condition, or simply old age.
If you’re a casual or infrequent visitor,
the nursing home your loved one is in
may appear to be an excellent, well-run
facility, with an efficient and caring staff
on duty 24/7/365. However,
appearances can be deceiving.
As major periodicals, elder care
associations and relevant government
agencies have reported, again and again
and again, thousands of nursing homes
throughout America do not measure up to
the high standards you would expect.
And the nursing home your loved one is
in—whether it’s a for-profit,
not-for-profit or government-owned
facility—may be one of them.
2 | Often Overlooked Warning Signs of Nursing Home Negligence or Abuse
Be alert to see possible problems
at your loved one’s nursing home residence.
Published reports have stated the following:
• Nursing homes are typically inspected
only once a year. Therefore, if incidents of
negligence or abuse occurred weeks or
months before an inspection, it may be
difficult or impossible to gather the facts
and interview witnesses.
• One in five nursing homes fail to report
incidents of abuse, or even make sure that
prospective staffers have no history of
abuse.
• False charting,“charting by rote,” is
common, especially where facilities are
severely understaffed. Staffers do not
actually chart the care as they give it,”
one report noted. “They sit down at the
end of the week and just fill in the boxes.”
• The majority of aides are overworked.
They have too many patients to take care
of at one time. It’s a money thing.
Nursing homes don’t want to hire.
As one investigator said in his report: “Most families are unaware that the gravest threat
facing nursing home residents is not what’s done to them. It’s what is NOT done for them.”
• Neglect is the silent killer in nursing
homes. By some estimates, neglect
accounts for half of nursing home deaths
and injuries.
• Many nursing homes systematically fail
to provide staff in sufficient numbers and
with appropriate clinical expertise to
serve their residents.
© 2015 SunTelemedia LLC
• Nursing homes must meet federal
standards as a condition of participating
in Medicaid and Medicare, which cover
more than two-thirds of their residents.
Often Overlooked Warning Signs of Nursing Home Negligence or Abuse | 3
5 STEPS
you should consider
taking, if at all possible, to help
guard against nursing home
NEGLIGENCE, ABUSE, THEFT
OR OTHER CONCERNS
your loved one frequently and vary your visits. Depending on the nursing home’s
• Visit
visiting hours, how strictly they’re enforced, and how far you live or work from the
facility, try to have friends and family visit at least two or three times a week— on
different days and at different times, so staffers are never sure when to expect visitors.
Nursing home residents who rarely or never get visitors may be more likely to become
victims of negligence and abuse.
yourself known. When you visit, let the nursing home’s director and relevant
• Make
staffers know that you’re there, once again, to see your loved one. Mention his/her name
and room number, so they’ll take note of your concern. Notice who is visiting the other
patients, and become familiar with those you see frequently. It is helpful to compare
notes on the level of care, and have another set of eyes to watch for anything amiss.
close-up photos of your loved one, whenever you visit. Look for and photograph
• Take
any bruises, scratches, bedsores, fractures, etc. Include the front page of that day’s daily
newspaper, to mark the date. If a lawsuit should ever prove necessary, some dated
photos, showing how your loved one looked before and after an incident of negligence
or abuse, could prove invaluable.
friendly with your loved one’s attendants. The more they like you, the more
• Become
they’re likely to take good care of your loved one. Be cheerful, and encourage your loved
one to be polite but wary.
(If your loved one is a particularly difficult person, encourage them to be selectively
critical and focus complaints on truly urgent matters!)
note of your loved one’s surroundings, personal property and (if possible) finances.
• Take
When visiting, look around you. Notice if, for example, the room is too hot, too cold or
drafty…if window coverings are torn or missing…if there are enough pillows and
blankets…and if there’s a reasonably safe place to keep your loved one’s wallet or purse,
checkbook, credit cards and petty cash. If you have access to his or her monthly credit
card and checking account statements, see if there are any suspicious payments, charges
or deductions.
Have a question about Nursing Home negligence or abuse? Call Toll Free: 1-877-761-5059
3
4 | Often Overlooked Warning Signs of Nursing Home Negligence or Abuse
13 Common Warning Signs
of Nursing Home NEGLIGENCE or ABUSE
PRESSURE ULCERS (bedsores)
These can be found on about 25% of nursing
home residents, most often because they’ve
been left unattended for too long in their bed,
a wheelchair, a bathroom or elsewhere.
Bedsores usually appear on the buttocks,
lower back, ankles, heels or backs of the
knees. They may also appear on the elbows,
upper back, back of the head or even the
ears. They result from prolonged pressure
(for as little as two hours,) usually when the
skin is pressed between a bone and a bed,
wheelchair, cast or other surface. Typically,
they start with redness of the skin, and if
undetected or untreated may penetrate
through the layers of the skin all the way to
underlying muscles and bone, and can
become infected, perhaps very seriously.
POOR HYGIENE
Your loved one doesn’t look, smell or feel
clean. For obvious reasons, this is more
prevalent when residents are unable to care
for themselves and, when noted earlier, they
rarely or never have visitors checking up on
their care.
SEXUAL ABUSE
Bruises on or around “private parts.” Notice
if your loved one acts fearful or pulls back at
the appearance of certain staff members or
other residents, or if they complain about a
certain person bothering them but aren’t
specific as to why, as they might be
embarrassed to say.
VERBAL ABUSE
Belittling, threats or other uses of power and
control by nursing home employees, other
residents or visitors (theirs or their
roommate’s.)
STRAINED OR TENSE RELATIONSHIPS
Becomes increasingly argumentative, or
becomes uncharacteristically withdrawn.
CHANGES (SHORTAGES)
in your loved one’s financial situation,
including cash in a wallet, purse or bedside
drawer, or funds in a checking or savings
account.
INJURIES
Bruises, pressure marks, broken or fractured
bones, abrasions, scratches, burns, a black
eye, a bloody nose, ripped clothing, etc.
UNEXPLAINED WITHDRAWAL
from normal activities, a sudden change in
alertness, and unusual depression.
(Continued on page 5)
Have a question about Nursing Home negligence or abuse? Call Toll Free1-877-761-5059
Often Overlooked Warning Signs of Nursing Home Negligence or Abuse | 5
MALNUTRITION
(a.k.a. UNDERNOURISHMENT)
One out of every six older adults is
undernourished, especially those who live in
a nursing home. As one elder care specialist
explained it: “Under-nutrition may result
from eating too little food (i.e., too few
calories) or foods that do not contain enough
of the needed nutrients, particularly protein,
vitamins and minerals…. Residents of nursing
homes usually do not get to choose the foods
they are served, and cannot get food when
they want it. Meals may be served and taken
away at specific times, without any
consideration of whether a person is hungry.
(Or even awake.) Occasionally, residents are
neglected—not given the help or the time
they need to eat. ‘Hot’ food may be cold
when it arrives, or become cold while the
resident is waiting for someone to help them
eat it. Consequently, they may not eat enough.”
There may also be other reasons; e.g., certain
disorders cause symptoms that interfere with
a person’s ability to meet nutritional needs.
Or, your loved one may be suffering from
malnutrition simply because the food is
terrible and he or she would rather starve
than eat it! If you can visit during meal times,
taste the food yourself and judge it.
FILTHY CONDITIONS
Filth has no place anywhere in a nursing
home. It needs to be as clean as possible, for
both medical reasons and appearance. If you
notice that a loved one’s room and bathroom,
the dining hall, the kitchen (if you can gain
access) or any other part of the nursing home
is not clean, take action.
If necessary, report it to the appropriate
authorities.
LIGHT-HEADEDNESS; DRY SKIN, EYES
OR NASAL MEMBRANES;
A DECREASE IN URINE; DARK URINE;
OR A FALL IN BLOOD PRESSURE
Any of these symptoms may be a warning
sign of dehydration—not having enough
fluid (especially water) in the body. If the
condition is not diagnosed and treated, it
might even result in death. The relatively
simple treatment includes replacing lost
fluids with water, dilute broth, or a fluid
containing some sodium or other
electrolytes.
DIRTY BANDAGES, UNTREATED CUTS
OR BRUISES, SCRATCHES,
FRACTURED OR BROKEN BONES, ETC.
Dirty dressings and untreated injuries are
obviously signs of neglect. Staff members not
have examined your loved one often enough
and/or have ignored the need for medical
care. Fractured or broken bones are common
in nursing homes that house older residents,
who are often prone to falls and other
physical injuries. But they may also be
caused by altercations with other residents,
staffers or even visitors. If your loved one
shows any of these warning signs, identify
the cause.
UNUSUAL WEIGHT LOSS
If not due to any the above, this may be the
result of not having enough food to eat (a
roommate or staffer might be stealing some),
loose or missing teeth, poorly fitting dentures,
liver failure, lactose intolerance, taking drugs
that decrease appetite, cancer, infections,
smoking, etc. Perhaps they need help eating,
and are reluctant to ask to be fed. Again, if
you can visit during a mealtime, check on the
quantity and quality of the food being
provided, and notice any difficulty in eating.
Have a question about Nursing Home negligence or abuse? Call Toll Free: 1-877-761-5059
6 | Often Overlooked Warning Signs of Nursing Home Negligence or Abuse
TYPES of Nursing Home ABUSE or NEGLECT
You Should Be Aware of
PHYSICAL ABUSE
Inflicting, or threatening to inflict, physical pain or injury on residents, or depriving them of
one or more basic needs; sub-standard care; over-crowding; inappropriate restraint; failure to
protect residents against untrained, troubled or predatory workers; failure to restrict
roommates from smoking, yelling, loud TVs, etc.; frequent room changes, with little or no
advance notice; being forced to share a room with a seriously-ill, deranged or unclean
resident.
FAILURE TO PROVIDE THE PROPER FOOD, SHELTER, PERSONAL CARE
OR OTHER NEEDS
Nursing home residents should certainly not be treated like prisoners without any rights or
consideration. But many are, especially if they rarely or never get visitors and/or are unable
to voice their grievances. Many residents fear retaliation if they regularly (even if justifiably)
complain about their food, clothing, bedding, room temperature, mail, phone, reading
materials, roommate, TV set, unwanted visitors, required activities, room location, bathroom
facilities, etc., or when they call for assistance but the response usually takes too long…or
never comes.
EMOTIONAL ABUSE
Inflicting mental pain, anguish or distress through verbal or nonverbal acts, such as threats or
intimidation; denying residents the right to exercise personal choice in such matters as when
they want to eat, get up or go to bed; exclusion; isolation; denial of privacy when bathing;
"labeling" troublesome individuals, resulting in depersonalized treatment and exclusion.
EXPLOITATION
Illegal taking, misuse or concealment of a resident’s funds, property or other assets. In
extreme cases, a lonely resident is befriended by a nursing home employee and, over a period
of months or years, the resident’s will is changed and/or the resident’s funds are taken, by
various means, by the staffer. Patients themselves may naively start to give away items, such
as jewelry or clothes, when complimented on them, or be intimidated when asked if they can
have them.
FAILURE TO PROVIDE THE CORRECT MEDICINES AT THE CORRECT TIMES
AND DOSAGES. FAILURE TO CHANGE DRESSINGS AS OFTEN AS NECESSARY
TO PREVENT INFECTION
These failures can quickly worsen a medical condition and, depending on what the condition
is, might even prove fatal. Some nursing homes (particularly those that are understaffed) may
falsify a resident’s medical records to hide these failures.
Have a question about Nursing Home negligence or abuse? Call Toll Free1-877-761-5059
Often Overlooked Warning Signs of Nursing Home Negligence or Abuse | 7
The Rights of
Nursing Home residents
As noted by Medicare and other sources,
neglect and abuse are not the only
concerns faced by nursing home residents.
Residents have rights that are usually part
of their residence contract, but these rights
are often trampled on.
For example: nursing home residents have
patient rights and certain protections
under federal or state law. The nursing
home is required to list and give all new
residents a copy of these rights, which
usually include:
Respect
The right to be treated with dignity and
respect.
Money
The right to manage your own money or
choose someone you trust to do it for you.
Privacy
The right to reasonable privacy, and to
keep and use your personal belongings
and property, if it doesn't interfere with
the rights or safety of others.
Medical Care
The right to be informed about your
medical condition and your medications,
to see you own doctor, and to refuse
medications and treatments.
Your loved one, as a nursing home
resident, has the legal right to be free of
abuse, negligence and other concerns,
since they can seriously affect his or her
comfort, peace of mind, safety and
well-being.
What Should You Do,
If You Notice or Suspect
That Your Loved One is a
Victim of Nursing Home
NEGLIGENCE or ABUSE?
You should know that—depending on the
particulars and the severity—nursing home
negligence or abuse may be classified as a
crime…as grounds for a civil lawsuit…or
both.
By definition: “NEGLIGENCE is the failure
to exercise that degree of care that, in the
circumstances, the law requires for the
protection of other persons or those interests
of other persons that may be injuriously
affected by the want of such care.”
A definition of ABUSE is: “to treat in a
harmful, injurious, or offensive way.”
Whether or not the authorities (if notified)
consider it a criminal offense, when nursing
home negligence or abuse results in an
injury or loss to your loved one, one or both
of you may decide to file a civil action for
compensation—a negligence suit or a
damage suit.
(Continued on page 8)
Have a question about Nursing Home negligence or abuse? Call Toll Free: 1-877-761-5059
8 | Often Overlooked Warning Signs of Nursing Home Negligence or Abuse
But first, you may want to meet with the nursing home director, to express your concerns and
request corrective action. The director may claim to be unaware of the situation, and promise
to take the necessary action. You may be told that the staffer who was negligent or abusive is
no longer with the facility, but that should not relieve the nursing home from any
responsibility. The injury or loss did occur, your loved one has suffered because of it, and a
civil lawsuit may be the only way to fight back and receive the compensation your loved one
rightfully deserves.
But, like most legal endeavors, it should not be a do-it-yourself activity. You’ll need an
attorney with years of experience in handling nursing home cases.
That’s because many nursing homes are no stranger to lawsuits. Some have been sued dozens
or hundreds of times—by federal or state agencies and/or by residents or their loved ones.
They have skillful attorneys on retainer or even on salary, full time. And they know that it’s
difficult or impossible to prove negligence or abuse without some proof, along with
knowledge of how nursing homes operate.
To guard against losing a lawsuit, some nursing homes may falsify or destroy relevant
medical records…“lose” residents or staff who are key witnesses, by moving them elsewhere
or threaten employees who have knowledge of the incident(s) with undesirable duties, pay
cuts, or dismissal if they plan to testify in court.
You’ll need an attorney with expert knowledge of: federal
and state nursing home laws and regulations; abuse and
negligence case law; medical record research techniques;
elder care; nursing home operations, personnel and
equipment; safety hazards; employee background checks;
government agencies and associations dealing with nursing
homes; witness interviewing; schemes and crimes
involving personal finances; and the newest strategies and
techniques for maximum recovery. Obviously, most attorneys in general practice— handling
everything from DUI cases to real estate transactions— do not have this kind of expertise.
You’ll want to choose a law firm that handles nursing home cases on a contingency basis.
That is, no upfront costs (except for minor expenses) and no fee (an agreed-upon percentage
of the award) unless you win the lawsuit. For more information, and a free, no-obligation
phone consultation, please call:
Edwards & Patterson Law Firm
321 S Third Street
&
1831 East 71st Street
McAlester, OK 74501
Tulsa, OK, 74136
918-302-3700 or 1-877-761-5059
We handle cases involving nursing homes in Oklahoma
Attorney Advertising. Past results do not guarantee a similar outcome.