Often elderly family members need medical attention or constant care that their families cannot provide. Frequently, these loved ones are placed in a nursing home to obtain the nurturing and care they need. Unfortunately, nursing homes do not always care for their patients in a proper manner. Whether there is physical abuse, emotional abuse, or simply neglect, this can result in malnourished patients, dehydration, infections, unnecessary falls, depression, anxiety, and even death.
Many of the cases involve repeating fact patterns. Areas of neglect may be viewed many times as institutional negligence. Many times the nursing homes are understaffed for the service they are attempting to provide and/or are not managed properly. It is important to know what can be learned about the history of the nursing home.
Common fact patterns which are seen include:
1) Pressure Sores – these are also called decubitus ulcers, decubitus sores, and can range from stage 1 through 4. When patients are not turned often enough and/or are not kept clean or given clean bedding then this sets the stage for skin breakdown and infection. Patients who are bed bound should be repositioned every couple of hours. Some of the beds have an air type mattress although most of them do not. The decubitus sores may range from a stage 1 which is a slight redness all the way to stage 4 which is a complete skin breakdown with an open infected wound which may lead to sepsis which is a type of blood poisoning which very often leads to death.
2) Falling – Another common fact pattern is staff permitting patients to fall. Some of the beds have bed alarms. Some of them do not. The current trend is to leave the rails down on the side of the bed and to put mats down next to the bed so that if the patient rolls out of bed the bed is lowered as low as possible and there is a soft mat rather than a tile surface to fall on. This change came about due to patients literally choking themselves to death by being wedged between the bed and the bedrail and/or climbing out over the top of the rail to land on a hard tile surface.
It is important in connection with falls to look at the care plan. Often times a facility will have the care plan requiring a two person assist to help the patient from the bed to the wheelchair or geriatric chair. Some of the care plans mention a hoyer lift for extremely heavy patients. This is a mechanical device to help lift patients. These are not frequently used because they are difficult to use. However, the care plan is a beginning point to look at a fall if it occurred during a transfer. First, was the care plan adequate for the patient’s needs? Maybe it was, perhaps it was not. Was the care plan followed? Many times a very clear care plan requiring a two person assist will involve a fall with only one person assisting. Failure to follow the care plan is a breach of the nursing standards of care.
3) Other common problems which are seen include dehydration and malnutrition. Many older people having difficulty swallowing. Some have senile dementia or Alzheimer’s Disease and unless they are assisted in eating and drinking they will not have sufficient intake of water and nutrients. Thus, what happens without assistance is dehydration and malnutrition which leads to a variety of health problems but ties back into the earlier discussion as contributing to skin breakdown and pressure sores or decubitus sores. This is only one of the many manifestations of dehydration and malnutrition.
4) The failure of the LPNs and/or techs to notify the RN and/or Direct of Nursing and/or treating physician of a “change in condition” is a recurring theme. Many times the LPN and/or tech will not notify those above them in the chain of command regarding a change in condition. The nursing home is responsible for each failure by staff. The nursing home is responsible for the actions of its staff.
Attorney D. Russell Thomas has over 32 years or experience in handling civil damage suits including nursing home negligence. If you believe you or a loved one has been the victim of nursing home negligence or abuse, please contact our office immediately for a free case evaluation.