Articles Posted in Neglect

It is becoming increasingly evident that pharmacological interventions should be a last resort when treating patients with dementia. Due to a lack of resources and staff most skilled nursing home facilities overlook non-pharmacological options. However, studies have shown that non-pharmacological treatments are a safer alternative for patients. While pharmacological interventions are an effortless option for nursing homes and hospitals, they fail to improve the state of the resident. These medications might look like they are improving the condition of the patient however, these drugs sedate them as their condition worsens. In some cases, it could cause sufferers of cognitive disorders to deteriorate rapidly and act out.

The staff at a facility may often focus on the cognitive deterioration of the sufferers of dementia. As such, other symptoms that are linked to dementia may be overlooked. These symptoms generally manifest themselves in the forms of agitation, aggression, eating disorders, loss of appetite, and abnormal vocalization. Many of these symptoms may also grow to be the cause of death. For example, eating disorders and loss of appetite can lead to malnutrition. Furthermore, the use of medications have side-effects including sedation, psychosis, tremors, and may even lead to falls. More recent cases show that the pharmacological treatment of dementia leads to reduced resident well-being and quality of life, and may even accelerate cognitive decline.

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One may feel that by placing their loved ones under the care of a skilled nursing facility, they would be provided with quality care. Unfortunately, that is not always the case. An investigation began on March 29, 2013 when an employee at an assisted living facility, Alzheimer’s Care of Commerce in Jacksonville County contacted authorities to report cases of abuse. The Alzheimer’s Care of Commerce focuses on elders who are suffering from Alzheimer’s disease.

After some investigation, the facility was raided in July 2013. Authorities arrested twenty employees and the owner of the facility following claims that the staff assaulted, restrained, and over-medicated patients. The facility is currently facing a total of seventy two criminal charges. However, according to Mike Ayers, the special agent in charge of the Georgia Bureau of Investigation Athens regional office, there could be more charges. They will not know until the district attorney looks at the files. The abuses that are being reported are cruel, inhumane; and so severe that the case may be forwarded to a grand jury this May.

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More often than not we are forced to do things that we would prefer not to. One example would be placing our loved ones under the care and supervision of a skilled nursing facility. When our loved ones are in a fragile state, we would like to keep them as close to us as possible. Sadly, at times, we are not able to provide our loved ones with the attention and medical care they need. While we would like to think that they are being provided with the highest level of care at a skilled nursing facility, it is regrettably more likely that they are not. An unfortunate example of this would be a recent case at a home in Medford, New York where the neglect of a 72-year-old woman who was under the care of a skilled nursing facility lead to her untimely death.

Evidence shows that the staff ignored all alerts and pages from the patient for more than two hours. The resident stopped breathing and, according to authorities, had likely been dead for some time until a nurses aid finally went to check on her. The level of ignorance and mistreatment in this appalling case is astounding. At a certain point the elderly are unable to breathe on their own, and therefore, are hooked up to a ventilator which regulates their breathing. While it is ludicrous that this resident was ignored for over two hours the resident had orders from her doctor stating that she must be connected to a ventilator machine at night. These orders were blatantly disregarded, which led authorities to believe this was the actual cause of her death.

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Due to the prevalence of nursing home abuse arising across the nation, some states have begun moving towards implementing legislation to explicitly allow surveillance cameras in the rooms of patients residing in nursing homes and long-term care facilities. These surveillance cameras will be used to record evidence of instances of elder neglect and abuse. Some states have taken such steps as a response to nursing home abuse and neglect, with hopes of reducing the incidence of abuse against the elderly. There are currently three states that have passed such laws, with Oklahoma being the most recent state. This new Oklahoma law will allow residents to have cameras in their rooms as long as they sign consent forms which notify the facility. The resident will then have exclusive rights to the footage for use in court. The recorded footage was found to have an impact in Oklahoma, where an aide pleaded guilty to abuse and neglect after being caught on camera.

Both Texas and New Mexico also legalized the use of surveillance cameras in nursing homes in an attempt to catch instances of elder abuse and neglect. Oklahoma passed their surveillance law after an outcry arose over recorded evidence of nursing home aides abusing an elderly resident in the facility. Surveillance footage showed Eryetha Mayberry, a 96-year-old woman, subject to various acts of abuse. For example, the nursing home aides were recorded shoving latex gloves into the resident’s mouth. Other recordings showed nursing home staff taunting Mrs. Mayberry, tapping her head, flinging the elderly woman onto her bed from her wheelchair, and performing heavy handed chest compressions thereafter.

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On October 15, 2013, California Governor Jerry Brown signed the Home Care Services Consumer Protection Act of 2013. The passage of this Act followed after the veto of a similar bill by the governor last year. It has served as a response to critics who have continually argued that the home health care industry has not been subject to enough regulation and oversight. The loose regulation of this industry has created room for caregivers to engage in acts of neglect and abuse towards their elderly clients, as was demonstrated in a study conducted by the California Senate Office of Oversight and Outcomes.

The study was released in April 2011, and demonstrated how California failed to screen employees who cared for the elderly in their homes. Some of these caregivers had criminal records, but had not been screened prior to employment. This documentation of elder abuse and neglect resulted in an increased push for tight industry regulations in California. The Act will impact approximately 120,000 caregivers and 1,400 home care agencies, and is representative of an effort being made to protect consumers receiving services within this industry.

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Many elderly residents who are hospitalized or living in nursing homes frequently develop pressure ulcers, the development of which risk further complications and even death. Consequently, caretakers for the elderly, particularly those in hospitals and nursing homes, must take precautions to prevent pressure ulcer development within this population. Studies have been conducted demonstrating a correlation between hypotension, or low blood pressure. Specifically, hypotension has been demonstrated to be an important risk factor in the development of pressure ulcers because research has found that hypotension in elderly patients, particularly those in poorer health, contributed to decreased blood flow at pressure points. This, in turn, would contribute to the death of cells and tissue in that area, leading to pressure ulcers.

However, a legal doctrine known as the ‘egg-shell skull’ rule can apply in this context. This rule holds an individual responsible for all consequences arising from their injury-causing actions towards another, even if the resulting injury to the victim is one that is unusually severe due to an underlying or pre-existing condition. Therefore, those caring for the elderly must be especially vigilant in protecting patients against pressure sores, particularly if an elderly patient is at risk for hypotension. This can be done by promptly identifying which elderly patients have hypotension, or those who are susceptible to developing hypotension, and allocating proper attention and resources to such patients. By doing so, caretakers can identify which elderly patients are particularly vulnerable to pressure ulcer development due to their clinical condition and can take early preventative measures before pressure ulcers arise and complications occur.

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A recent investigation by the Center for Investigative Reporting revealed that the California Department of Public Health dismissed about 1,000 pending cases in 2009 which alleged caretaker abuse and theft, without taking any action. This hurried dismissal of cases occurred to alleviate the Department’s extreme backlog of cases. These closed cases involved caregivers accused of assaulting or abusing their patients, some of which involved elderly patients. The closing of these pending cases has allowed for these caregivers to retain their licenses, thereby allowing them to continue to work in nursing homes, hospitals, and other health care facilities throughout Southern California. These abuse cases have been reported from facilities in Los Angeles, Riverside, San Diego and Santa Barbara, ranging from abuse and neglect to suspicious deaths. Therefore, we must remain vigilant in ensuring that instances of abuse against the elderly in such facilities go reported and ensure such caregivers are removed from their positions to prevent further harm.

The investigation found that the Department of Public Health rarely took action against these caregivers, despite clear evidence of allegations of abuse, and that the number of caregivers removed from their jobs for their wrongful actions has declined. Specifically, investigators found that about 81% of cases were closed in 2012 without taking any action against an accused caregiver. What is even more worrisome is that there was also an extreme drop in the number of cases involving suspicious deaths from abuse that were sent to law enforcement to be investigated and prosecuted. It should be noted that this decline in action is not due to a decrease in complaints, but rather, is correlated with the hurried removal of the Department’s backlog of pending cases. As a result, even though accused caregivers and their employers may have engaged in wrongful conduct, they are still licensed to work and care for vulnerable patients and are not being held accountable.

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Research on the prevalence of physical abuse in nursing homes has been difficult to conduct because there are significant flaws in the method of collecting the data. Both nursing home staff and resident families often harbor a sense of guilt which causes under-reporting in surveys conducted to address this issue. Nursing home staff may be less inclined to report instances of elder abuse because they or a colleague may be the perpetrators of the abuse. Similarly, family members may be hesitant to report elder abuse because they may feel a sense of culpability for having admitted their loved one to the facility in which they were victimized. Unfortunately, allowing abusers to continue performing their jobs puts more elderly at risk of being physically abused.

A study published in the Journal of Elder Abuse and Neglect found that the overall prevalence of physical abuse in nursing homes is 24.3 percent. This study challenges the previously held belief that physical abuse correlated with increasing age in nursing home residents. In fact, it found that with each increasing year the chance of being physically abused decreased by 49 percent. This may be due to the fact that the prevalence of cognitive deficiencies increases with age, meaning that such residents need more group supervision than one-on-one staff to resident supervision. The increase in group supervision takes some responsibility off an individual staff member, allowing for a decrease in frustration or annoyance. This means that in order for there to be more successful monitoring of older residents, nursing homes must hire enough staff to ensure that their current staff members are not over-burdened with responsibility and performing poorly.

Another important finding in this study indicated that “needing help moving” was the only category which predicted abuse in the elderly. This study is significant because it reveals that those that are most in need of long term care, such as those with mental health issues and mobility problems are most at risk for physical abuse at these facilities. More importantly, this discovery highlights the need for better staff training at nursing homes, so that staff may be better equipped to deal with a highly dependent or troublesome resident with patience and respect. Because the majority of physical abuse of elderly in nursing homes involves caretaker mistreatment, an improvement in the quality of training would likely decrease the overall prevalence of nursing home abuse.

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Johnson & Johnson initiated a product recall of their antipsychotic drug, Risperdal Consta, on Wednesday due to mold contamination of their product. Risperdal Consta is an antipsychotic medication that has been approved for use in patients with bipolar 1 disorder and schizophrenia. It should be noted that this recall only impacts the injected drug Risperdal Consta, and not the oral pill medication Risperdal.

While the company has stated that the risks to patients are low, patients should be aware that the effects of using the contaminated product include reactions or infections at the injection site. Additionally, those who have compromised immune systems may also be at risk of developing a systematic infection. The elderly are a particularly vulnerable population, and caregivers must be cautious and vigilant in ensuring that the elderly patients taking Risperdal Consta are not administered a contaminated batch.

When nursing homes neglect to monitor medications properly due to a lack of time or a disruption in their communication, elderly residents suffer the consequences by having to be admitted to the hospital for an adverse drug reaction. Such has been the case in many nursing homes, and many residents have continuously been victimized. The attorneys at the Law Offices of Ben Yeroushalmi believe that your loved ones deserve attentive, high quality care. If you believe your loved one is a victim of elder abuse or neglect, call us immediately at (888) 606-3453 so that we may work together to put an end to elder abuse and neglect. With offices in both Northern and Southern California, we can help you regardless of what part of the state in which you reside.

A recent New York Times article brought to attention the growing oversight and neglect of dental hygiene in elderly residents in nursing homes. While the Elder Abuse Act states the failure to assist in personal hygiene constitutes an example of neglect, family members are finding their loved ones in nursing homes suffering from such neglect as oral health is not prioritized. Elderly residents in nursing homes all over the United States currently suffer from a range of dental hygiene issues, such as gum disease and cavities, partly due to the failure to maintain proper dental health. Several states conducted surveys to assess the oral health of nursing home residents, finding many suffered from substantial oral debris, along with broken teeth.

While the number of elderly residents in nursing homes continues to increase, understaffed nursing home workers struggle to provide even basic oral hygiene such as brushing residents’ teeth twice a day. Regrettably, it appears that such care falls secondary to providing other basic care such as providing food and repositioning residents to prevent bedsores. However, nursing home employers must provide medically necessary care and this includes oral care and hygiene, a requirement that is mandated in the Omnibus Budget Reconciliation Act of 1987.

Unfortunately, many elderly residents in nursing homes also suffer from dementia along with other medical issues. Thus, many of these residents must take prescription drugs which can have the effect of drying out the mouth and reducing saliva. As a result, without proper oral hygiene, these elderly residents are particularly susceptible to rapid deterioration of oral health.

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