Nursing Home Negligence and Abuse

At Hance & Srinivasan, we believe all persons are entitled to respect and proper care, especially those who are elderly and/or who are unable to care for themselves.

We are experienced in helping persons who have suffered from negligence and/or abuse at the hands of those entrusted with their care. We have represented dozens of families and individuals whose loved one’s quality of life was significantly reduced or whose untimely death was caused due to the neglect and abuse of long-term care facilities.

Nursing homes and long-term care facilities are responsible for providing a safe environment for residents as well as appropriate healthcare services without causing undue harm. In 1987, Congress passed The Nursing Home Reform Act, which required that “a nursing facility must care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident.”

Unfortunately, abuse and neglect happen far to often – especially to those who have the least ability to speak for or defend themselves. According to a 2004 survey conducted by the National Center on Elder Abuse, more than 79% of persons abused, neglected, and exploited are victims over the age of 80, and only one in 14 cases of abuse and neglect ever gets reported to Adult Protective Services.

What is Neglect?
Neglect occurs when there is failure to care for a person in a manner that would avoid harm and pain. Neglect also includes the failure to react to a situation that may be harmful, and neglect may or may not be intentional. Examples of neglect include:

  • incorrect body positioning — leads to limb contractures and skin breakdown.
  • lack of toileting or changing of disposable briefs — causes incontinence and results in residents sitting in urine and feces — leads to increased falls and agitation, indignity and skin breakdown
  • lack of assistance eating and drinking — leads to malnutrition and dehydration
  • lack of assistance with walking — leads to lack of mobility
  • lack of bathing — leads to indignity and poor hygiene
  • poor hand washing techniques — leads to infection
  • lack of assistance with participating in activities of interest — which leads to withdrawal and isolation
  • ignoring call bells or cries for help

What is Abuse?
Abuse occurs when pain or harm are intentional and includes physical, mental, verbal, psychological, sexual abuse, corporal punishment, unreasonable seclusion, and intimidation. Examples of abuse include:

  • physical abuse from a staff member or an intruder or visitor from outside the facility, including hitting, pinching, shoving, force-feeding, scratching, slapping, and spitting
  • psychological or emotional abuse — including berating, ignoring, ridiculing, or cursing a resident, threats of punishment or deprivation
  • sexual abuse — including improper touching or coercion to perform sexual acts.
  • substandard care — often results in one or more of the following conditions: immobilization, incontinence, dehydration, pressure sores, and depression
  • rough handling during care giving, medicine administration, or moving a resident

Injuries from Negligence and Abuse
Falls
According to the Center for Disease Control, about 1,800 older adults living in nursing homes die each year from fall-related injuries. Those who experience non-fatal falls can suffer injuries, have difficulty getting around, and have a reduced quality of life. Environmental hazards in nursing homes cause 16% to 27% of falls among residents. Such hazards include wet floors, poor lighting, incorrect bed height, and improperly fitted or maintained wheelchairs. Plus, the use of physical restraints to prevent falls may cause more serious problems for residents.

Bedsores – Persons who are bedridden, use a wheelchair, or are unable to change their position are at risk for pressure ulcers also known as bedsores. Bedsores commonly form where bones are close to the skin, such as ankles, back, elbows, heels and hips. Bedsores can cause serious infections, some of which are life threatening. The frequency of bedsores can be used as a marker of the quality of care in long-term-care settings. More ulcers usually means poor care, and poor care can potentially mean neglect.

Conventional medical practice is to reposition a bedridden patient every two hours, rotating the patient from lying on the spine to lying on either the left side or the right side. Healthcare providers are required to keep track of the time that a patient is in the current position and to ensure that the patient is turned to a new position. When a facility has a large number of patients in a facility, it may become difficult to keep to a schedule. Plus, the multiple changes in personnel that typically occur during a 24-hour period, can lead to inconsistency in turning patients, hence potential for bedsores through neglect.

Medication ErrorsThe National Coordinating Council for Medication Error Reporting and Prevention defines a medication error as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer.”

A 2006 study on the prevention of medication errors by the Institute of Medicine found that excluding wrong-time errors, omission of an ordered medication is generally the most common type of drug administration error in nursing homes. Other findings of the study include:

  • preventable ADEs (Adverse Drug Events) run at a rate of 50 per 100-bed nursing home
  • the most common medication administration errors are administering an unauthorized drug (44.8%), omitting a prescribed drug (41.5%), administering the wrong dose (11%), administering via the wrong route (2%), and administering the wrong form (0.4%)

Signs of Abuse and Neglect
At Hance & Srinivasan, we think it is important for all persons who have family or loved ones residing in a nursing home facility to know how to look for the signs of neglect and abuse.

Knowing these warning signs could help prevent the suffering or even the death of someone you love:

  • unexplained bruises, pressure marks, broken bones, abrasions or burns
  • sudden changes in behavior, personality or alertness
  • unusual depression, withdrawal from normal activities or changes in eating habits
  • bedsores, unattended medical needs, poor hygiene, dehydration, over-sedation or unusual weight loss (all signs of potential neglect)
  • unsanitary and unclean living conditions (e.g. dirt, fleas, lice on person, soiled bedding, fecal/urine smell, inadequate clothing)
  • staff using belittling remarks or threats
  • frequent arguments or a tense, strained relationship between the caregiver and the resident
  • hazardous or unsafe living condition/arrangements (e.g. improper wiring, no heat, or no running water)
  • laboratory findings of medication overdose or under utilization of prescribed drugs

If you or your loved one is experiencing any one or combination of these signs, contact Hance & Srinivasan immediately for a private, no-cost consultation.