Articles Posted in Neglect

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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A June 2013 study published in the Journal of American Medical Directors Association found that apathy is the behavioral symptom most strongly correlated with weight loss in nursing home residents. This comes as a surprise because it was commonly believed that depression was most closely related to weight loss in this demographic. However, the study found that depression, along with agitation and rejection of care did not increase the elderly’s risk of losing weight.

Weight loss is a serious threat to the elderly’s health because it increases their risk for hip fractures, pressure sores, infections, anemia, fatigue, and even mortality. In Alzheimer’s victims in particular, weight loss can lead to a rapid cognitive decline. Therefore, in order to prevent these possible complications, it is important for nursing home caregivers to monitor residents’ weight closely.

This study is significant because it equips nursing home staff with new ways to detect and prevent deterioration in the health of their residents. Subjects in this study who displayed apathetic behavior lost more weight in the following three months than those who did not. This means that if such behavior is counteracted early enough, weight loss can be prevented. It is important to emphasize that there are many non-pharmacological methods to eradicate apathy. First, it is important that nursing homes have enough staff to keep a close watch on residents in order to detect any dulled emotional responses, indifference, poor social engagement or other symptoms of apathy. Also, caregivers should seek ways to eliminate or limit the administration of psychoactive medications because some have been known to cause anorexia.

Sadly, many nursing homes are not properly staffed , leaving many apathetic residents undiagnosed and at risk of weight loss. Apathy is not a behavioral issue like agitation or depression, as it does not cause any disturbance to other residents or staff, making it easier to ignore or leave untreated. However, the long term implications of ignoring apathy due to improper staffing are a serious decline in resident health. Furthermore, improper staffing and poor quality of care at a facility can exacerbate a resident’s apathy. This is why it is necessary for nursing home staff to be properly trained so as to provide the residents with emotional and psychological comfort. It is also important to emphasize that there are many strategies that nursing home staff may use to decrease the prevalence of apathy. Engaging the elderly in simple activities, such as listening to live interactive music or adding cognitive stimulation, have been known to counteract the effects of apathy. In those whose apathy was properly treated through activity engagement, weight loss was curbed and turned into a healthy weight gain.

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According to an article in Bloomberg News, the for-profit private nursing home industry overbills Medicare by 1.5 billion dollars a year by conducting unnecessary procedures and therapy on their patients. This, however, is not the only way that for-profit nursing homes have been using unlawful methods to increase profits. Nursing homes frequently engage in the understaffing of their facilities in an attempt to cut payroll costs and essentially place profits over people. Between the years of 2008 to 2012, federal prosecutors have brought 120 civil and criminal cases against nursing home facilities and other related people that have now been resolved. That is twice the number of cases that were brought in the five years prior to 2008.

One of the most egregious offenders was Skilled Health Care Group Inc., a company that operates 75 nursing homes in the United States. The company was charged with 11 counts of elder abuse at a nursing home in Eureka, California. Prior to the criminal charges being brought forth, Skilled Health Care Group settled six wrongful death civil suits between 2005 and 2012 in California’s Humboldt County. The criminal charges were stemming from incidents occurring at a skilled nursing facility in Eureka, California. This nursing home was one of the 22 company sites that was indentified by the court to be suffering from chronic understaffing and the jury returned a 677 million dollar judgment which was later brought down to 63 million dollars in a settlement. According to documents from the class action suit, patients were left unattended for hours at a time, soiling themselves and not being changed, and being denied meals, which led to suffering and dehydration and malnutrition.

The rise of for-profit institutions in the health care industry, especially with regard to skilled nursing home facilities has led to the cutting of costs that are absolutely necessary to run an efficient and well-maintained nursing facility that provides a high quality of care. At the same time, overbilling and the conducting of unnecessary or even dangerous medical procedures on residents has been on the rise. In the past three years, the U.S. justice department has settled civil fraud complaints against eight hospice companies that enrolled or retained patients that were in improving health and were not dying.

What this means for you and your loved ones is that sometimes, the care and well-being of patients are not being prioritized over low costs and profits. This, in turn, leads to a culture of cutting corners and lack of training, which can result in neglect, elder abuse, and even death. When for-profit nursing homes cut costs by understaffing, they are putting your loved one’s life at risk. Nearly all injuries that occur in skilled nursing facilities can be prevented with proper staff and training. Such injuries include pressure ulcers, malnutrition, dehydration, and those that result from falls.

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It has been estimated that with the “baby boom” generation now approaching retirement age, nearly 25% of the elderly population aged 65 years or older will spend part of their life residing within a nursing home. While the elderly should both expect and receive excellent, loving care at a facility where they will possibly spend the remainder of their life in, most patients are instead abused and neglected. They are treated not with dignity and compassion, but with contempt and ridicule. With such a large influx of potential patients looming on the horizon, nursing homes desperately need to change the means by which they function and treat their patients.

In the Journal of Women and Aging, a book review was recently conducted on a source concerning the ritual of abuse that currently exists within nursing home systems. The studies actually found that abuse suffered by the elderly most often occurred through four different ways: medical abuse, personal abuse, emotional negligence, and verbal abuse. Many caretakers within the study saw their nursing home residents as “‘unemotional work products’ rather than people in need”. More often than not, this abuse occurs because of a nursing home’s <a href="”>understaffing problems or lack of adequately trained staff. When a facility is understaffed and incapable, they cannot provide the proper amount of care or attention that a resident might need which could result in the development of pressure sores, falls, and even death. The elderly are also more susceptible to dehydration and malnutrition and need to be properly monitored to ensure that they keep up their daily intake.

What is extremely frustrating is that with enough attention and proper care, all of these diseases and health issues can be preventable. The correlation drawn between adequate staffing and the prevention of diseases from developing is not pure conjecture, but has been proven in various studies. One such study highlighted that if nursing home workers are actually trained through a mandatory program, overall communication is improved and hospitalizations can be prevented from occurring in the first place. There is a general consensus that America’s elder care industry is currently broken by the blatant abuse that occurs every day in nursing homes.

The Patients’ Bill of Rights claims that any skilled nursing facility has the obligation to provide their residents with a safe living environment, and to treat them with respect and consideration. It is a grossly unfair situation to the residents of such nursing homes that unfortunately cannot protect themselves from being neglected.

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Recently, the Los Angeles Times reported on a hospital that has been accused of patient dumping. Jesse Bravo, a patient at White Memorial Medical Center here in Los Angeles was admitted to the hospital for treatment of schizophrenia. When he was discharged, Bravo’s wife was not notified and instead, he was dropped off in front of a rehabilitation center. Bravo reportedly never actually went inside and spent several days on the street before police found him and brought him home his wife, who had filed a missing persons report. The couple is now suing the hospital for elder abuse, hospital negligence, and false imprisonment.

According to the article, over the past few years, patient dumping has become a serious problem. In response to this issue, Los Angeles law enforcement authorities have been strictly regulating policies against patient dumping. Chief Deputy City Attorney William Carter said that “The message was sent in the city of Los Angeles that this kind of activity would not be tolerated and would be closely watched.” Unfortunately, similar cases of elder abuse and neglect occur regularly, not only in hospitals, but also in nursing homes and other long-term care facilities.

In skilled nursing facilities, especially those that are understaffed, duties are often carried out carelessly and recklessly. This inattentiveness often leads to errors that are detrimental to the health of patients and sometimes even death. Patients with cognitive disorders such as dementia and Alzheimer’s disease are at an especially high risk of nursing home neglect. While their conditions require additional attention and care, nursing homes often fail to provide for these needs.

In a recent case taking place in a nursing home, a patient with memory problems was allowed to wander out into a seven lane road in forty-eight degree weather, wearing only pajamas. Furthermore, it took the facility two hours to notice the patient’s disappearance before they reported him missing. In another nursing home, a woman with dementia suffered from hypothermia when she was found outside in twelve degree weather at 4:00 a.m.

Although skilled nursing facilities may seem fully staffed, we often find that there is a discrepancy between the staffing levels of different shifts. For example, in the case discussed above, while the facility may or may not have been fully staffed during the day, they were most likely understaffed during their night shift, since the woman was clearly not being closely monitored, as she was able to wander from her bed outside into the cold.

When healthcare facilities are understaffed and are failing to provide your loved one with the care that he or she needs, they are violating the Patient’s Bill of Rights and committing elder abuse. Under the circumstances that their carelessness and neglect directly contribute to the death of a patient, the successors of the resident may be able to make a Wrongful Death claim.

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On December 11, 2011, the Detroit Free Press published a series of articles investigating nursing home neglect. The first article, titled “Nursing Homes with Good Staff, Stopgaps Can Still Fail”, reports the accidental death of a man as a direct result of nursing home neglect. After having an accident, James Culbert was sent to a care facility to recover. Instead, he died a painful, devastating death by suffocation because the night staff had forgotten to connect his ventilator and check his vital signs. By the time the staff realized their error, it was much too late. Unfortunately, deaths as a result of careless errors are a common occurrence in nursing homes. In the second part of its series, titled “Troubled Nursing Homes Aren’t Closed,” the Detroit Free Press discusses how care facilities are able to remain open, despite major violations of state and federal codes, and incidents, such as James Culbert’s, that often result in death. Finally, the last portion, “Nursing Homes: A Caring Staff Makes All the Difference,” emphasizes the importance of an adequate, highly-qualified staff.

Staffing is the fundamental problem directly linked to all other issues that may occur in nursing homes. While care facilities are legally obligated to meet the minimum of 3.2 nursing hours per patient per day, they are also held accountable for providing high-quality care for their patients. In your search for the best nursing home for your loved one, the Detroit Free Press cautions against automatically correlating quality of care to the physical appearance of the facility because looks can be deceiving. Surprisingly, the Detroit Free Press found that the newest facilities that market luxurious living and provide generous accommodations are sometimes ranked lowest in quality of care. Instead, the article emphasizes the importance of an adequate, qualified staff.

Unfortunately, many nursing homes lack such a staff. The Detroit Free Press investigated various deaths that occurred in nursing homes and found that many of them could have been prevented with a more attentive staff. Falls were among the most common causes of death, simply because a patient would fall down and hours would pass before a staff member even noticed, often much too late. Another common staffing error involves medications. The Detroit Free Press reported one death in which a man was given another patient’s diabetes medication. When patients’ lives are on the line, it is crucial that caregivers avoid making such careless mistakes. In some serious cases, caregivers even forgot to feed patients, who eventually starved to death. This raises the issue of malnutrition and dehydration, which provides clear evidence of nursing home neglect, even when it does not directly lead to death.

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As of late, our nation has concerned itself with the widespread nature of obesity; however, this has resulted in inadequate attention to the problem of malnutrition or under-nutrition. Unfortunately, protein under-nutrition and malnutrition is regularly plaguing elderly residents of nursing facilities in California. A recent article by John E. Morley MB, BCh’s entitled “Undernutrition: A Major Problem in Nursing Homes,” in the May 2011 issue of Journal of the American Medical Directors Association, addresses this often neglected issue, describing in detail the various causes of and solutions to under-nutrition.

According to Morley, for every form of malnutrition, there are proven steps that nursing homes can take toward countering such grave and life threatening injuries. For example, Anorexia, as a form of under-nutrition, causes elderly individuals to be more susceptible to losing weight when illness strikes. Morley found that by improving food quality and environments, nursing homes can help prevent depression, which is a major cause of this form of weight loss. Cachexia can also result from anorexia, but exercise, creatine, and vitamin D can aid in the fight against this form of malnutrition. Additionally, poor cognition can arise from under-nutrition, but a well balanced diet can easily combat this tendency.

Morley’s research indicates that nursing homes have the solutions for further under- nutrition deficiencies, including low Vitamin D, Vitamin B12, and zinc levels, as well as dehydration. To increase Vitamin D levels, nursing homes simply need to ensure that their residents are exposed to more sunlight. For those with Vitamin B12 deficiencies, basic injections or inhalations of Vitamin B12 can bring their levels to a healthy state. Zinc replacement is the proven method for treating patients with low zinc levels. Finally, dehydration is common for elderly people because they do not know when they are thirsty, but nurses making “fluid rounds” consistently can make sure that patients are staying hydrated.

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