Pressure ulcers (also known as decubitis ulcers or bed sores)
- One of the most tragic things we often see as nursing home lawyers, is bed sore or pressure ulcer related injuries and deaths. It has long been understood by the nursing industry and medicine that, for the most part, pressure ulcers and bed sores are very often the result of negligence. The government has become so disturbed at hospitalizations for preventable bed sores and pressure ulcers that it has also passed regulations refusing to pay for pressure ulcers caused by nursing homes.
John's work in this field actually began with the observation of a pie-sized pressure ulcer on his own mother's back while she was dying from cancer in a nursing home. All she needed at that time was someone to make sure she was turned frequently. Patients have the right to be free from preventable ulcers. Unfortunately, the cockroaches of microbiology, including staph bacteria, often march through these preventable holes and cause life threatening infections, including sepsis and pneumonia.
If your family member is developing a bed sore, it is imperative that it be treated aggressively to prevent worsening. These are urgent matters and you should call the physician and make sure skilled wound care experts are involved right away. Often, in our experience, family members don't know that bed sores have started until it is too late. It is important to be informed about your family member's care. It may be somewhat difficult emotionally to inspect your loved one's skin, but it can be life-saving to do so. Often, pressure ulcers form on bony prominences, especially in the coccyx area and on heels.
Preventable falls - As nursing home abuse and neglect attorneys, we have also seen many injuries and deaths from falls. We have handled cases involving more than 30 falls in one year. Recently we handled a case involving a resident that fell 12 times in a three month period. Often, falls are recurring in precisely the same manner because there is no progressive care planning once they start. Nursing homes sometimes seek to have family members sign documents, saying that they accept the idea that their family member will fall or that they do not want them restrained, when a simple releasable seat belt or other remedies like pressure alarms may sometimes save lives by preventing falls on to the head or severe fractures.
It is a known medical fact that numerous deaths among the elderly occur within a year of hip fractures that resulted from a fall. It is imperative that nursing homes and assisted living facilities not be allowed to run programs that permit residents to fall while under the pretext that falls are not preventable. There are a large number of care planning measures that can readily be implemented, ranging from assistance with walking, the use of adaptive equipment, to lowered beds, or the placement of mattresses on the floor by beds, to the employment of sitters or companion care. It is an axiom in nursing home and assisted living care systems that you cannot admit or keep a resident whose needs you cannot meet.
Residents have a right to be free from preventable accidents. Often nursing homes accept post-surgical patients for rehabilitation and allow them to fall again by failing to employ simple precautions. A single fall causing severe injury or death can sometimes be as negligent as a pattern of previous falls.
Degradation - Residents have the right to quality of life, dignity and to be free from warehousing. It is said by nurses sometimes that you can smell bad care. Residents have the right to be free from such neglect. We often hear that residents are being left degradingly in their own waste. This is totally unacceptable in a civilized society and cannot be excused by short staffing.
Nursing homes and assisted living facilities often insist on using incontinence products rather than taking the time to answer call lights and assist residents to the bathroom. One frequent citation of nursing homes by CDPHE is for failing to respond timely to call lights.
Dehydration - As experienced nursing home lawyers, we unfortunately have also frequently seen cases involving death and serious injury from dehydration and even starvation. We have handled cases involving patients starving to death or dying from dehydration while supposedly being fed by facility staff through scheduled tube feedings. We have seen instances where people have gone as long as eight days without fluids.
Patients have a right to adequate nutrition and hydration. While we are not doctors, doctors regularly state that signs of dehydration can include lethargy, dry mucous membranes and laboratory tests which show significantly increased sodium levels or other changes. Nursing home staff often fail to take the time to assist people with eating or fluid consumption even when they are known to be failing to obtain adequate nutrition and hydration. Sometimes people only need temporary IVs to recover from dehydration.
If you suspect serious dehydration or nutrition problems, demand a care conference or call the physician, it is often treatable. You may want to become directly involved with assisting your family member with eating and hydrations.
Sexual, physical and emotional abuse - One of the most shocking and tragic areas of nursing home abuse and neglect involves resident on resident violence or sexual assaults by staff members on elderly and disabled residents. These events are not uncommon and can be fatal or profoundly traumatic. Failure to sufficiently staff dementia units, in our experience as nursing home attorneys, has actually resulted in residents killing each other. Failure to investigate staff criminal backgrounds has too often resulted in grim staff abuse of residents, including even sexual assault and rape.
If you suspect that your family member has been the subject of sexual assault, you should insist on their being taken promptly for a rape kit at a hospital so that perpetrators can be identified. The police and the State Health Department should be promptly contacted in these types of cases to investigate complaints of assault. Nursing homes and assisted living facilities have a duty to properly protect and supervise residents to ensure their safety and freedom from such abuse, neglect and criminal conduct.
Other common types of nursing home or assisted living abuse and neglect – Other factors that are considered abuse and neglect include:
- Untreated Infections
- Delay in Timely Transferring of Residents to Hospitals
- Medication Errors
- Wandering and Elopement
- Reckless Transfers
- Preventable Immobility Leading to Pneumonia
- Other Serious Failures to Respond in a Timely Fashion to Changes in Condition