How to Identify and Tackle Nursing Home Abuse
In brief, what is abuse and neglect understood to mean in the context of nursing homes?
There is really no ‘official’ definition of nursing home abuse. I think the easiest way to define the issue is that any time that a resident at a nursing home is mistreated should be considered an episode of abuse or neglect. I tend to think of abuse as more of intentional act when caretakers harm residents in nursing homes and other long-term facilities.
Neglect is likely what is behind the majority of episodes involving an injury or fatality in a skilled nursing facility. This occurs when staff simply do not provide the medical care that residents require according to their specified requirements or as dictated by their condition.
How does this abuse often manifest?
There is essentially an endless type of abuse that can occur in a nursing home setting. When facilities control every aspect of a patient’s care and living arrangements, there is a lot of room for errors. As the person that families may call after an incident, I do see some patterns in terms of common situations such as:
- Neglect of a residents basic needs resulting in an injury
- Physical abuse perpetrated by staff or other residents
- Sudden deterioration of health
- Sexual assault
- Emotional abuse
- Weight loss
- Physical injuries such as bed sores or broken bones
How are cases of nursing home abuse tried? What is the process involved?
There is definitely a process to pursuing a nursing home abuse case. The initial step involves obtaining the medical records from the facility where an incident occurred. While getting a copy of the resident’s medical chart may sound relatively basic, getting the records can be an ordeal if the facility does not keep organised records or is hesitant to produce them.
After the records are received, we typically have the chart organised and reviewed by a nurse in our office who can ensure the chart is complete and we are not missing any vital information. After ensuring the medical records are complete, we then review them to determine how the incident or neglect occurred. Usually, this means looking at the resident’s care plan to assess what type of care was set to be provided according to the plan versus what was actually done (or not done) by the staff at the facility. This is where we usually find issues.
Assuming there are deficiencies with the care provided, we will usually have a report prepared to clearly set forth where the errors were made. At this time we may approach the facility or their insurance company to see if the case can be resolved prior to litigation.
Depending on the facility and the issues involved, the case may get resolved. If the facility is unwilling to negotiate or does not offer a fair settlement, we will likely file a lawsuit against the facility.
The nursing home litigation process can be lengthy. Families need to be prepared for the fact that their case may go on for some time. While most cases get resolved at some point during the litigation process, some cases do go to trial. There are a lot of variables involved, so having an attorney who reports back with the status of the case and what is next with the process is important and a factor that families should consider when retaining a lawyer.
What are some common signs of elder abuse or neglect that loved ones should watch out for?
Families need to trust their instinct when it comes to the care of their loved one in a nursing home or other type of long-term care facility. When they see physical or emotional changes, they should speak up and bring their concerns to the attention of the facility staff or administrator to address the issue before it becomes a critical issue.
Nonetheless, as an attorney who has seen many types of cases, some of the common signs of elder abuse involve:
- Pressure sores: Despite claims from facility staff that wounds are inevitable, most cases involving pressure sores are due to inadequate care over a lengthy period.
- Broken bones: No one should have a fracture of any type at a facility. Many fractures are due to falls where a patient was not properly monitored.
- Malnutrition: Unfortunately, when facilities are not staffed properly, staffing levels may be reduced to a bare minimum and residents who require assistance with meals may go unattended. Malnutrition can lead to a spiral of declining health and complications.
- Changes in behaviour: Particularly sudden changes in behaviour may be indicative of abuse, depression or larger issues involving abusive treatment.
- Heavy medication or sedation.
What should one’s first steps be upon discovering signs of abuse or neglect?
Depending in the severity, families need to assess the situation and immediately take action. If the situation is critical, families need to contact law enforcement who can provide immediate assistance for their loved one.
Absent an emergency, families should report the situation to the state’s nursing home department. Usually this means having an investigator (surveyor) from the Department of Health go out to the facility and conduct an investigation into the incident. Not only will contacting the Department of Health provide useful information into the care of their loved one, but this will also likely protect other residents at the facility who are likely similarly situated. Assuming there is improper care, a report generated by the Department of Health can be extremely useful if there is litigation forthcoming.
If your loved one is in immediate danger or having a medical emergency, dial 911 to report nursing home abuse and get help as soon as possible.
Do you have any initial pieces of advice that you would give to family members of an elderly abuse victim seeking justice?
First, family members should not feel guilty or ashamed. Unfortunately, elder abuse is a massive problem that occurs in all settings and geographic areas. Not only is it their legal right to take actio, but it also helps protect other residents at the facility and future residents.
Families need to understand that the long-term care industry is frequently controlled by large corporations who have little or no experience with senior care. They look at each patient as a commodity that can be replaced with another body.
Operators of facilities are notorious for keeping their facilities staffed at bare-bones levels — hiring the staff they are obligated to under the law and no more. Moreover, they typically pay the lowest wages to staff, which tends to attract the least skilled and qualified.
By pursuing a legal claim, families are taking a stand and showing that they will not tolerate poor care. In many respects, facilities only make improvements in patient care when they feel the pinch in their pockets.