Types of Nursing Home Abuse

Have you, or someone you care about, been a victim of nursing home abuse? If so, you’re not alone. Unfortunately, it’s quite common.

Handling a nursing home abuse case requires experienced lawyers and legal staff who understand the types of injuries caused by understaffing, neglect, and other dangerous situations in nursing homes. At Edgar Snyder & Associates, we’ve seen families suffer when their loved ones were abused in a nursing home.

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No one deserves to suffer nursing home abuse, especially in the place you trusted to care for your loved one. It’s not right, and we’re ready to help you get the compensation you deserve.

Injuries From Nursing Home Abuse

You may have a family member or a loved one who currently lives in a nursing home. While they may have once been self-sufficient, they may now be totally dependent on the nursing home staff and administration. Assisted care living can cost thousands of dollars per year, so you expect staff will take care of one’s needs.

Patients in nursing homes deserve the best care, but often they do not receive it. Nursing home abuse happens for a variety of reasons – understaffing, lack of organization, inadequate security, and simply poor standards of care.

Injuries from nursing home abuse are often severe and may include:

• Slip, Trips, and Falls
• Physical Abuse
• Mental Abuse
• Sexual Abuse
• Malnutrition
• Bedsores
• Dehydration
• Wandering
• Restraints
• Neglect
• Unexplained Injuries
• Infections
• Unexpected Death

Nursing Home Slip & Fall Injuries

Fall-related injuries are a major health threat for nursing home residents. Older people who live in nursing homes tend to fall more frequently than those who live within the community. When older people fall, their injuries tend to be more severe than younger adults. They don’t heal as quickly, and they may even suffer from permanent damage. Along with their injuries, they may also have an increased fear of falling, which can cause depression, social isolation, and feelings of helplessness.

The law requires nursing home residents to receive adequate supervision and assistive devices to prevent slip and fall accidents. When a resident enters a nursing home, administrators must evaluate them and create a plan of care based on the person’s health – including risk of falling. The nursing home must then take the proper steps to help the resident get around and limit those risks as much as possible.

Unfortunately, however, many nursing home residents fall because of the nursing home’s negligence.

How Do Slip and Fall Accidents Happen in Nursing Homes?

Slip and fall accidents happen in nursing homes for a variety of reasons. Examples include injuries caused by:

• Wet floors
• Poor lighting
• Lack of necessary bedrails and improper bed height
• Bedrails used improperly, resulting in restraint abuse
• Improperly maintained or fitted wheelchairs
• Clutter
• Tripping hazards in rooms or hallways
• Medications, especially psychoactive drugs
• Difficulty in moving patients, or assisting them to the restroom, due to understaffing
• Insufficient staff to answer call buttons
• Lack of working call buttons
• Failing to properly train staff in lifting and handling techniques
• Failing to adequately supervise residents
• Poor foot care
• Restraints
• Weakness and gait problems linked to malnutrition and/or dehydration
• And more

Tips to Prevent Fall-Related Injuries to Nursing Home Residents

The best way to protect your loved one from falling in a nursing home is to develop a fall prevention plan. You should:

• Consult your loved one’s doctor and request placement in a physical conditioning or rehabilitation program that might include exercises to improve strength and endurance, physical therapy, a walking program, etc. Remember, there are many benefits to keeping people mobile as long as possible, including greater muscle strength, independence, ability to interact with the environment, greater sense of well-being, preservation of dignity, and greater self-esteem.
• Request modifications to improve mobility and safety in your loved one’s nursing home room, such as grab bars, handrails, raised toilet seats, and proper bed height.
• Find out if the nursing home has an alarm system that activates when a resident tries to get out of bed or move without assistance.
• Make sure your loved one has regular eye check-ups. Poor vision can put the elderly at a greater risk for falling.
• Know how to use the call bell correctly so you or your loved one can get fast assistance to get out of bed.
• Make sure assistive devices like wheelchairs, walkers, and canes are properly maintained and fitted.
• Make sure their shoes fit properly, are in good condition, and have sufficient tread.
• Review all prescribed medications and discuss their potential risks and benefits with the doctor. Side effects of medication may place an older person at a higher risk for falling.
• Remove throw rugs, electrical cords, and any other items that might cause a person to trip and fall in his or her room. Ensure that the entire facility is well lit.

Trust Edgar Snyder & Associates to Help With Your Slip & Fall Nursing Home Abuse Claim

One fall in a nursing home does not necessarily mean the nursing home is guilty of negligence or nursing home abuse. Accidents do happen, and many elderly residents are at a high risk for slip and fall accidents.

However, if the nursing home knew a resident was at risk for slipping and falling, staff members must take the right steps to prevent accidents. If they didn’t, the nursing home can be held liable for negligence or responsible for allowing a type of nursing home abuse to occur.

In evaluating a potential case involving a fall and injury, we review the medical chart for the following information:

• How many falls occurred, and how soon after admission to the home?
• Was the fall witnessed by a staff member, other resident or family member?
• What documentation of the fall exists on the medical chart?
• Did the staff complete a fall risk assessment and care plan when the resident was admitted to the home?
• If so, was the plan of care followed, updated when necessary, and were safety precautions taken to prevent falls?
• What were the physician orders regarding how much assistance a resident needed to get out bed and walk?
• Was the resident on medication that caused drowsiness, confusion, or weakness?
• What injuries did the resident suffer as a result of the fall?

If the injuries sustained as a result of the fall are not serious, such as bruising, and injuries did not require medical treatment, they may not justify the cost of filing a lawsuit. On the other hand, if the injuries are serious, especially if the resident has a history of prior falls at the nursing home, you should contact our law firm for a consultation. You may have a case.

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Physical Abuse

Physical abuse is illegal – including in nursing homes. However, it happens all too often. By definition, physical abuse is intentionally using physical force that may result in bodily injury or pain. The injuries that a nursing home resident may suffer as a result of physical abuse can be very serious, because many older people are fragile. A nursing home resident can suffer serious injuries from something as simple as a shove or slap. An elderly person’s skin is also more susceptible to bruises, cuts, and tears.

If you’ve been a victim of physical abuse in a nursing home, or you suspect your loved one is being abused physically, contact the Pennsylvania law firm of Edgar Snyder & Associates right away for a no obligation, free legal consultation.

Types of Physical Abuse

The following are examples of the types of physical abuse that nursing home staff members can inflict on elderly nursing home residents:

• Hitting or beating the resident with an object or with a hand
• Pushing or shoving the resident
• Shaking, slapping, kicking, or pinching the resident
• Burning the resident
• Force-feeding the resident
• Using chemical or physical restraints that are unnecessary
• Throwing the resident into a bed, or pushing the resident to try to get them to hurry up
• Pulling the resident’s hair
• And more

Signs Your Loved One May Be a Victim of Physical Abuse

The following signs may indicate that your loved one is the victim of physical abuse in a nursing home:

• Broken bones
• Sprains
• Black eyes
• Rope marks or belt marks, particularly around the wrists, ankles, and neck
• Cuts and bruises
• Internal injuries or bleeding
• Unexplained hair loss
• Unexplained injuries
• A nursing home staff member refuses to allow the resident to have private visitors
• Any unexplained change in the resident’s behavior, particularly showing fear, stress, anxiety, or a strong reaction when a certain staff member approaches
• When the resident makes excuses or stories to explain any of the above signs of physical abuse, and you suspect he or she isn’t telling the truth

When You May Need a Nursing Home Abuse Attorney

Physical abuse in nursing homes occurs for a variety of reasons. When physical abuse occurs for any of the following reasons, the nursing home may be liable for negligence:

• Failing to conduct background investigations on employees who have a history of physical abuse
• Failing to properly supervise staff members
• Failing to hire a sufficient amount of supervisory staff
• Failing to properly train employees on how to spot physical abuse
• Failing to provide the proper ratio of staff to patients means that some caregivers may snap under the pressure and take their stress out on patients

If you suspect that a nursing home staff member has physically abused your loved one, do the following:

• Talk to your loved one – calmly but firmly. If your loved one admits that he or she was the victim of physical abuse, immediately report the incident to the police and get emergency medical help.
• Often, elderly people are afraid or embarrassed to admit they were the victim of physical abuse, or they may be too physically or mentally impaired to tell others about it. If you notice signs of physical abuse, call the police and get your loved one to an emergency room if necessary.
• If your suspicions aren’t strong enough to call the police immediately, report the incident to the nursing home administrator and discuss your observations with your loved one’s doctor. Stay alert and watch for continued signs of physical abuse. If they continue, contact authorities.
• Contact Edgar Snyder & Associates for a free legal consultation. Our attorneys can’t erase what happened or make up for the physical abuse, but we can bring the nursing home to justice and help your loved one regain their dignity.

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Mental Abuse

Nursing home residents have the right to be treated with dignity and respect. Unfortunately, mental abuse is a common form of nursing home abuse, and it’s heartbreaking.

Mental abuse is not okay anywhere, including in a nursing home – where residents depend on staff to take care of them and preserve their quality of life.

If you, or someone you love, suffered mental abuse while living in a nursing home, contact Edgar Snyder & Associates right away. You may have a nursing home abuse case, and it’s time to hold the nursing home responsible for its actions.

Types of Mental Abuse

Mental abuse is sometimes referred to as psychological or emotional abuse. By definition, mental abuse is the intentional infliction of anguish, humiliation, fear, or distress through verbal or nonverbal acts.

Mental abuse in nursing homes occurs in any of the following ways:

• Verbal Degradation – This type of mental abuse is common in nursing homes. Although many nursing home employees offer kind words to residents, some do not. These staff members may yell or scream at the resident. They may also make sarcastic remarks or insult the resident about his or her inability to control bodily functions.
• Verbal Threats – This is more severe than verbal degradation. Verbal threats are often directed toward a particular resident. An example of a verbal threat is when a nursing home employee tells a resident that they will get spanked if they keep soiling their bed or eating sloppily. Another example is telling the resident that they will miss their next meal if they don’t eat in a certain way or if they don’t finish all of their food.
• Emotional Manipulation – Many nursing home residents are insecure, because they are dependent on the nursing home for many activities they used to do themselves. It can be very hard for a resident who has lost his or her independence. This can lower a person’s self-esteem and put them in danger of being manipulated by a caregiver. For example, a nursing home resident may be fearful of the consequences of asking for a drink of water or a snack. As a result, they may place themselves at a greater risk for dehydration or malnutrition.
• Emotional Threats – This occurs when a nursing home resident is placed in a position that keeps him or her from speaking out. For example, if one resident sees another resident being abused and the employee does something to keep the witness silent, the witness may feel they will be the next victim if they speak out. Many nursing home residents quickly learn that they are at a disadvantage in the nursing home, so they are easily silenced because they don’t want to become the next victim of abuse.
• Isolation – This occurs when a nursing home staff member gives the resident the silent treatment or isolates the resident from family, friends or regular social activities.

Why Does Mental Abuse Occur in Nursing Homes?

Mental abuse occurs in nursing homes for a variety of reasons, including:

• Failing to conduct background investigations on employees who have a history of mental abuse
• Failing to properly supervise staff members
• Failing to hire a enough supervisory staff
• Failing to properly train employees on how to spot mental abuse
• Failing to provide the proper ratio of staff to patients (some caregivers may snap under the pressure and take their stress out on the patients)

If a nursing home fails to do any of the things mentioned above, it can be held liable for negligence.

Symptoms That a Resident May be Suffering From Mental Abuse

The following signs may indicate that your loved one is the victim of mental abuse in a nursing home:

• Exhibiting feelings of helplessness
• Being withdrawn or unresponsive or being unwilling to communicate
• Unusual behavior, like sucking, rocking, or laying in a fetal position
• Fear of family and friends
• Any unexplained change in the resident’s behavior, particularly any showing of fear, stress, anxiety, or a combative reaction when a certain staff member approaches
• Being depressed

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Sexual Abuse in Nursing Homes

It may come as a surprise, but one of the more common types of nursing home abuse is sexual abuse. Elderly nursing home residents are easy prey for sexual predators because they are often weak and defenseless. They may also fall victim to sexual abuse because they had a stroke or other medical condition that caused them to lose their speech or motor skills. When a nursing home resident is unable to protect themselves or speak, the likelihood of becoming a victim of sexual abuse increases.

Sexual abuse is any form of non-consensual sexual contact, including unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually-explicit photographing, and sexual harassment. It would include situations where the nursing home resident was forced, coerced, tricked, or manipulated into unwanted sexual contact and where the nursing home resident is too ill, frail, or mentally incapacitated to give consent. A nursing home resident can be sexually abused by a nursing home staff member, another resident, a stranger, or a family member in a variety of situations, including:

• Sexual abuse by a nursing home staff member – Sexual abuse of a nursing home resident by a staff member often occurs, because the nursing home fails to conduct background investigations of potential employees. Some staff members are minimum-wage employees who go from one job to the next and have a lot of contact with nursing home residents. They may help residents bathe, dress, and go to the bathroom, which may create the opportunity for sexual abuse.When a nursing home fails to properly screen an employee who has a history of sexual abuse and that employee sexually abuses a resident, the nursing home can be liable for negligence. Sexual abuse by a staff member can also occur because the nursing home fails to properly supervise employees. This may result from understaffing or poor training. When a nursing home fails to properly supervise employees or properly train employees on how to spot sexual abuse and sexual abuse occurs, the nursing home can be held responsible.
• Sexual abuse by another resident – Oftentimes, nursing homes are co-ed. In such settings, normal male-female relationships are bound to develop. Unfortunately, however, co-ed settings in nursing homes can give rise to the sexual abuse of one resident by another. Those residents who are weak and unable to resist or unable to speak may be an easy target for sexual abuse by another resident who knows of the potential victim’s mental or physical challenges, or who isn’t in a good state of mind.The nursing home can be held liable for negligence in these cases as well. The nursing home may not have supervised or trained staff members as well as it should have, or it may be understaffed.
• Sexual abuse by a stranger – Sexual abuse by a stranger often occurs because the nursing home lacks adequate security and allows strangers to enter the facility. Strangers can also enter the facility when nursing home employees step outside to take a break or smoke and fail to lock the door when they re-enter. If a nursing home resident is sexually abused by a stranger who gains access to the facility under these circumstances, the nursing home may be liable for negligence.
• Sexual abuse by a family member – When a person is placed in a nursing home, the resident’s spouse may miss the relationship the two shared when they were at home. When the resident’s mental or physical condition prohibits consensual sexual relations between spouses, the sexual act may rise to the level of sexual abuse. In these situations, nursing home staff members may fail to report the incident because of the legal relationship between the couple, and allow the abuse to continue. Under these circumstances, the nursing home may be liable for negligence.

Tips to Prevent Sexual Abuse Injuries in Nursing Homes

The following signs may indicate that your loved one is the victim of sexual abuse in a nursing home:

• Unexplained difficulty with walking or sitting
• Bruising and/or thumbprints on the inner thighs, genital area, buttocks, and/or breasts
• Unexplained vaginal and/or anal bleeding
• Unexplained sexually transmitted disease or genital infection
• Unexplained genital irritation, injury, and/or redness
• Presence of sperm in the vagina or anus
• Torn, stained, or bloody underclothing
• Stained or bloody sheets
• Rope burns on wrists or ankles
• Fear, stress, anxiety, or a another strong reaction when a particular staff member approaches to help the resident with bathing, dressing, or toileting

If your loved one shows any of the above signs, you should:

• Calmly but firmly express your concerns to your loved one. If your loved one tells you that he or she was the victim of sexual abuse, immediately report the incident to the police and get emergency medical help. Oftentimes, however, elderly people are afraid or embarrassed to admit that they were the victim of sexual abuse. Others may be too physically or mentally impaired to communicate the incident. In these situations, if you believe the warning signs are severe enough, call the police and get your loved one to the emergency room as soon as possible.
• If your suspicions don’t warrant immediate police intervention or emergency medical treatment, report the incident to the nursing home administrator and discuss your observations with your loved one’s doctor. Then monitor the situation. If the warning signs continue, you should contact authorities.

Do You Have a Sexual Abuse Case Against a Nursing Home?

A nursing home that neglects residents fails to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness. Abuse is defined as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm or pain or mental anguish, or deprivation by an individual, including a caretaker, of goods or services necessary to attain or maintain physical, mental, and psycho-social well-being.

Federal and state law have regulations that a resident in a nursing home has the right to be free from verbal, sexual, physical, and mental abuse, as well as involuntary seclusion. There are also federal and state regulations to prevent employing individuals convicted of abusing, neglecting, or mistreating individuals in a healthcare-related setting. Nursing homes must be thorough in their investigations of the past histories of individuals they consider hiring. The facility should do a record check with the Pennsylvania State Licensing Division and the State Nurse’s Aide Registry.

If you or a loved one suffered from sexual abuse in a nursing home, or by an in-home caregiver, you may have a case.

If you have a nursing home abuse case and choose Edgar Snyder & Associates, we go to work for you. We investigate the nursing home to see if it performed a proper background check, or if the home was aware of any previous incident of neglect or abuse by the nurse’s aide, staff member, or even another resident of the home. We gather evidence and use all the resources available to build a strong case and get you the compensation you deserve.

And remember, there’s never a fee unless we get money for you – we guarantee it.

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Malnutrition

Malnutrition, or lack of proper nutrition, can be a serious, life-threatening medical problem for older adults.

Malnutrition means more than not having enough to eat. It means not getting enough vitamins and minerals into your body, which is very important for nursing home residents. Malnutrition can lead to a variety of serious health problems, including:

• Confusion and memory loss
• Weakness, resulting in immobility, falls, & bedsores
• Pneumonia
• Inability to fight off sickness
• Inability to recover from an existing illness
• Loss of muscle mass
• Problems with organ function
• Infection
• Anemia
• Poor teeth or poor oral hygiene
• Depression or dementia
• Difficulty swallowing
• Slow eating pace resulting in food getting cold or in the staff removing the tray before the resident has finished eating
• Stroke, resulting in paralysis
• Death

Symptoms of Malnutrition

Potential signs and symptoms of malnutrition are:

• Pale skin
• Dull eyes
• Swollen lips
• Swollen gums
• Swollen and/or dry tongue
• Poor skin turgor (when you pinch the skin, it stays indented and doesn’t go back to normal quickly)
• Swelling in lower legs
• Weight loss
• Muscle wasting

Negligence Related to Malnutrition and Dehydration

Two out of five nursing home residents suffer from malnutrition, and it can occur for a variety of reasons. Dehydration can occur for a variety of reasons as well, including diarrhea and the effects of medication. Unfortunately, malnutrition and dehydration can also occur due to a nursing home’s negligence in a variety of situations, including:

• Not having enough staff, which results in the staff’s inability to properly feed residents
• Not paying enough attention to residents who need assistance with eating
• Not educating the staff properly on nutrition and feeding methods
• Not providing proper supervision over staff members who help feed residents
• Relying on liquid supplements instead of making sure each resident eats enough food, calories, and nutrients

If you notice that your loved one has signs of malnutrition or dehydration, or if you think that they are not getting enough food or fluids at the nursing home, take action right away. Notify the nursing staff and physician, and ask the doctor to set up a meal plan to begin to repair the damage. If you believe the nursing home is responsible for your loved one’s malnutrition, contact authorities to report the nursing home for abuse.

Legal Consultation of Malnutrition Claims

Many residents suffer from malnutrition. The sad truth is that it often can be prevented with proper care – the care that your loved one deserves in the first place. When you contact the Pennsylvania law firm of Edgar Snyder & Associates to find out if you have a nursing home abuse case, we go to work for you.

First, we offer a free legal consultation to find out if you do have a case. Then, if you do and you choose our law firm, we will evaluate the records to look for evidence that the resident received proper nutrition. We investigate whether the nursing home performed a nutrition assessment when your loved one became a resident. Did the nursing home ever re-evaluate your loved one or alter his or her food intake based on weight? Did the nursing home try to improve your loved one’s condition after he or she showed signs of malnutrition?

We will judge whether the staff’s concerns regarding signs and symptoms of malnutrition are clearly documented, and whether the nursing home communicated with the physician about your loved one’s nutrition plan. We will also look for documentation that the resident’s nutritional status was being monitored by checking for:

• Weight gain or weight loss
• Laboratory values – a simple blood test can be done to check the resident’s nutritional status. If some levels are below normal range, such as the protein or albumin level, it may be an indication of malnutrition.

In some cases, it may not be possible to provide adequate nutrition because the resident may be very sick. If your loved one refuses to eat or is unable to eat due to a serious medical condition, talk with the physician and determine what alternatives are appropriate, such as supplements or tube feedings.

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Bedsores

Bedsores, also known as pressure sores or decubitus ulcers, can be very serious. Unfortunately, elderly nursing home residents and hospital patients are typically the ones who develop them. Bedsores are painful and result from putting too much pressure, for too long, on an area of the body that has a bone and a thin covering of flesh – such as the tailbone, heels, elbows, and shoulder blades.

A variety of factors cause bedsores, including:

• Skin moisture due to unchanged diapers and wet sheets
• Malnutrition and dehydration
• Immobility
• Residents staying in one position for too long

To prevent decubitus ulcers, residents must be turned and repositioned frequently. Nursing home staff need to help those who cannot move on their own to turn and reposition themselves every two hours to prevent skin breakdown.

Bedsores may not seem that serious, but they can be fatal. Even scarier is that as many as a quarter of nursing home residents fall victim to bedsores at some point during their stay. Residents at high risk for pressure sores include those who are:

• Age 75 and older
• Having problems with feeding or are totally unable to feed themselves
• Relatively immobile or need help repositioning themselves
• Unable to sense the need to reposition
• Underweight
• Suffering from decreased mental state
• Suffering from dry skin
• Incontinent (can’t control going to the bathroom)
• Being treated for a variety of conditions, including diabetes, cancer, and multiple sclerosis

The law requires that nursing homes must ensure that resident do not develop bedsores, unless the residents medical conditions show that the bedsores were unavoidable. It is also important to note that the law also requires the nursing home to keep bedsores from progressing while the resident is staying at the nursing home.

Bedsore Abuse Prevention Tips

Because most bedsores are preventable, taking measures to prevent them is important.

• Because malnutrition and dehydration can cause decubitus ulcers, make sure your loved one is getting enough food and water.
• Because spending a lot of time in bed makes a person prone to bedsores, nursing home residents should get as much exercise as possible to increase mobility. Consult your loved one’s physician and request placement in a physical conditioning or rehabilitation program that might include exercises to improve strength and endurance, physical therapy, a walking program, or gait training.
• Request grab bars and other devices so that repositioning is easier for the resident.
• Take care of your loved one’s skin, or make sure that the nursing home is taking this care. Ask your doctor to suggest a good lotion to keep skin moist and supple.
• If your loved one is incontinent, make sure adult diapers are changed regularly and that sheets are dry and clean.
• Always pay attention to the ratio of staff to residents. Because understaffing is a problem linked to poor care, you should always be concerned about how many staff members are available to care for your loved one.

If someone you care about has developed a pressure sore while in a nursing home, you should:

• Tell their doctor immediately, and discuss causes, cures, and future prevention techniques.
• Get your loved one emergency medical help at a hospital immediately. Remember that decubitus ulcers are serious and can be life-threatening.
• If you believe the nursing home was responsible for the pressure sores, submit a complaint with the nursing home administration. Consider contacting the organizations listed on our nursing home online resources pages. And, be sure to contact the Pennsylvania law firm of Edgar Snyder & Associates for a free legal consultation – to find out if your loved one has a nursing home abuse case.

Bedsore Injury Claims

If you, or your loved one, suffered from bedsores – and you believe the nursing home is to blame – know that nursing home abuse cases can be very complicated. That’s why you need the help of experienced lawyers and a law firm that has the resources to gather the right evidence and build a solid case.

If you hire Edgar Snyder & Associates, we will work to answer the following questions:

• What was the resident’s skin condition before admission to the nursing home?
• What medical problems did the resident have? Some medical problems such as diabetes, kidney failure, and paralysis place the resident at risk of developing bedsores.
• Was good care provided, such as turning and proper positioning of a patient, use of devices to relieve pressure such as special mattresses, beds, and padding to protect areas at risk for breakdown?
• Was the resident kept clean and dry to prevent skin breakdown?
• Did the resident receive adequate nutrition and fluids?
• Was the resident identified as being at risk for pressure sores, and if so, was a preventative care plan was implemented?
• How many bedsores developed, how severe, and where are they located on the body?
• Was a doctor and/or wound care specialist consulted and were they were actively and consistently involved in treatment?
• Is there accurate documentation in the medical chart of skin assessments, turning and repositioning, and treatment of decubitus ulcers?
• Are there pictures of the bedsores?
• Did the bedsores lead to serious complications such as infection, amputation, and sepsis (the spread of the infection to the bloodstream) that can lead to death?

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Dehydration

Dehydration occurs when a person’s loss of body fluids exceeds their intake of fluids. Like malnutrition, dehydration can lead to a variety of serious health problems, such as confusion and disorientation, urinary tract infections, bedsores, pneumonia, and even death.

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Increasing age is a major risk factor for dehydration. In fact, people between the ages of 85 and 99 years are six times more likely to be hospitalized for dehydration. It is very important that healthcare providers in nursing homes recognize that the elderly are at risk for developing dehydration and do everything possible to avoid it.

Signs that may indicate that your loved one is suffering from malnutrition and/or dehydration:

• Weight loss
• Cracks around the mouth
• Pale lips and mouth
• Complaints that dentures no longer fit
• Unexplained confusion
• Mouth sores
• Thinning hair
• Loose, flappy skin
• Dry skin
• Sunken eyes
• Urinary tract infection
• When the resident eats or drinks more when a friend or family member assists with feeding
• If you observe patients being fed in a circle by one nurse’s aide. This could indicate that there is not enough staff to ensure all residents are eating enough food and drinking enough liquids.

A person at risk for dehydration should have a hydration program in place at the nursing home – assisting the person with drinking, offering fluids at mealtime and in between meals, looking for signs and symptoms of dehydration, notifying the physician if such signs and symptoms are present, recording the residents’ state of health, and replacing fluids intravenously when the physician deems it necessary, etc..

Negligence Related to Malnutrition and Dehydration

Two out of five nursing home residents suffer from malnutrition and dehydration for a variety of reasons:

• Failure of the nursing home to employ enough staff, which results in the staff’s inability to properly feed the residents
• Failure of the staff members to pay enough attention to residents who need assistance with eating
• Failure of the nursing home to properly educate the staff on nutrition and feeding methods
• Failure of the nursing home to provide proper supervision over those who help residents eat or drink
• Relying on liquid supplements instead of making sure each resident eats enough food to get necessary vitamins, minerals, protein, and calories

If you notice that your loved one has signs of malnutrition or dehydration, or if you think they are not getting enough food or fluids at the nursing home, you should notify the nursing staff immediately and the physician to prevent potentially serious, life-threatening consequences. In addition, patients in nursing homes often need more water than the average person because of the medications they take.

Tips to Prevent Malnutrition and Dehydration

• Make sure your loved one in a nursing home drinks plenty of water. Eight glasses a day is recommended, unless there is a medical reason for restricting fluids. In addition to water, your loved one should drink plenty of juice.
• Insist on a pitcher of water and cups in the room. Make sure the resident can handle the pitcher and cups. If needed, insist on oversized cups with lids and built-in straws.
• Make sure your loved one eats three well-balanced meals per day.
• Insist on a daily weigh-in with accurate record keeping. Review weight records to monitor gain or loss.
• Make sure the food tray isn’t placed too far away, making it difficult to reach.

If your loved one shows even one of these signs, you should:

• Immediately inform the doctor and staff members of your observations.
• Request a care planning conference with the physician to discuss possible causes for the symptoms and to set up a plan for meals and feeding assistance.
• Monitor the situation. If it does not improve within days, you should contact authorities to report nursing home abuse.
• If you even remotely suspect the situation may be life-threatening, take immediate steps to get your loved one to a hospital emergency room.

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Elopement and Wandering

The law requires nursing home residents to receive adequate supervision to prevent elopement (escaping from the nursing home) or wandering. When a resident enters a nursing home, administrators must develop a plan of care based on the person’s state of health, nutrition status, and risk of elopement and/or wandering. Residents who have a cognitive or mental impairment or entered a nursing home against their will are especially at risk for elopement or wandering.

A nursing home may be liable for negligence if it does not take the proper steps to prevent elopement or wandering, which is a type of nursing home abuse and can pose serious risks for your loved one’s safety.

Elopement

“Elopement” refers to the ability of a resident – who is not capable of protecting himself or herself from harm – to successfully leave the nursing home unsupervised and unnoticed. Depending on your loved one’s health, elopement can have serious consequences. Your loved one could walk in front of a car, be stranded in the cold, get lost, etc. If your loved one needs to take medicine for a condition or disease and leaves the nursing home, the medical complications could even cause death.

For many families, situations like these are nightmares that have become reality. We hear about elderly people who escape from nursing homes on the news and who disappeared, but we never expect that it could happen to our own loved one. It’s devastating to find out that the nursing home – which is supposed to keep a loved one safe from harm – neglected to do so.

Wandering

On the other hand, “wandering” refers to a cognitively-impaired resident’s ability to move about inside the nursing home aimlessly and enter into a dangerous situation. The nursing home must assess the resident’s risk of wandering and include it within the plan of care.

Negligence Related to Elopement and/or Wandering

When a nursing home resident who is not capable of protecting himself or herself from harm, or who is impaired mentally, elopes or wanders and gets hurt, the nursing home may be negligent. At Edgar Snyder & Associates, we know there are many situations in which the nursing home may be responsible, including:

• Failing to hire enough staff to properly supervise residents
• Failing to properly train staff on how to supervise residents
• Failing to have alarms or other devices to prevent elopement and/or wandering
• Failing to take the right measures to allow residents to exit and enter the nursing home unattended
• Hiring staff members who failed to properly respond to an alarm previously

Elopement Abuse Prevention Tips

Tips to prevent elopement and wandering injuries:

• Choosing a nursing home is a very important decision. If elopement or wandering concerns you, you should request detailed information from any nursing home about how they prevent elopement and wandering. Don’t be afraid to ask lots of questions – your loved one’s safety is critical, and you want peace of mind knowing he or she will be safe in a nursing home.
• You should also get detailed information on the staff to patient ratio. Although this information should always be considered when choosing a nursing home, it is even more important when the potential resident is an elopement or wandering risk.
• If you find out a resident eloped or wandered at any time from a nursing home, do not consider that nursing home.

Legal Consultation of Elopement or Wandering Claims

Many residents in nursing homes are confused and disoriented and must be protected from walking out of the home and becoming lost or injured. When evaluating these claims, a nursing home attorney will check to see if the nursing home took the proper steps to prevent elopement and wandering:

• Assessing the resident for elopement and wandering risk (dementia, Alzheimer’s disease, and medications that cause confusion, attitude about entering a nursing home)
• Prior history of elopement, wandering, and forgetting whereabouts
• Restraint use on the resident in a nursing home or hospital previously

If a resident is at risk for elopement or wandering, the nursing home should take the following precautionary measures:

• Use preventive devices such as alarms or electronic devices on the patient, alarms on the bed, or alarms on the exit doors
• Monitor the exit doors of the home
• Move an at-risk resident to a room that allows for closer observation

If the nursing home neglected to do any of these things or allowed the resident to elope or wander, they may be liable for the injuries your loved one suffered as a result of the elopement or wandering. When you choose Edgar Snyder & Associates, we know your loved one’s safety is your priority, and we’re ready to protect your loved one’s legal rights and hold the nursing home accountable for its actions.

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Restraint Abuse and Injury

Did a nursing home staff member use restraints on you or someone you love? Do you feel that the restraints were used simply to “control,” and not for the right reasons?

If so, you may have a nursing home abuse case. Our experienced attorneys at the Pennsylvania law firm of Edgar Snyder & Associates can help you get the compensation you deserve.

Restraints & Resident Rights

Nursing home residents have the right to be free from physical and chemical restraints used to discipline them or to make it convenient for nursing home staff. Restraints may be used only to ensure the physical safety of the resident or other residents and staff, when a doctor writes an order that describes when and for how long to use restraints, and in an emergency.

Although the use of restraints in nursing homes has decreased, it’s still a common type of nursing home abuse. Residents who are commonly restrained include those who:

• Have limited ability to carry out many activities of daily living
• Have low cognitive performance
• Take antipsychotic medications
• Have a history of falls

Many nursing homes that are understaffed use restraints simply to “control” the residents.

Effects of Restraints & Injuries

Using restraints can cause emotional, mental, and physical problems, including:

• Disorientation and confusion
• Decreased cognitive function (ability to think and process)
• Decreased activities of daily living
• Increased agitation
• Loss of dignity and self-sufficiency
• Depression
• Bedsores
• Urinary incontinence or retention
• Chronic constipation
• Loss of muscle function
• Increased bone fragility
• Cardiopulmonary de-conditioning
• Contractures (muscles shorten and make it harder to stretch and move)
• Lower extremity edema (condition where there is insufficient flow through the veins and can cause swelling, extra pressure in the veins, fluid retention, etc.)
• Fractures that result from a slip and fall accident caused by the use of a restraint
• Unexpected death

Nursing home staff members use restraints to help residents avoid falls and injuries, but unfortunately, they don’t always prevent them. Restraints may prevent nursing home residents from wandering around on their own, but at the same time, residents don’t get enough exercise. Their muscles become weaker, and it may become harder for them to walk or keep their balance. Many nursing home residents become disoriented and confused as well, which can contribute to more falls and injuries.

Types of Restraints

Nursing homes use several different types of restraints in an attempt to protect their residents or ease the burden of understaffing.

• Physical restraints – hand mitts, restrictive chairs such as Gerichairs, vests that tie nursing home residents to their chairs or beds, wrist and ankle restraints, etc.)
• Chemical restraints – medications given to residents to lessen pacing, restlessness, and uncooperative behavior
• Bedrails

Bedrail Injuries

Doctors are required by law to write an order for bedrails to restrain a nursing home resident, but many nursing homes don’t get them. Most people believe that bedrails are either an effective safety device, or that they pose no harm.

The most common bedrail injuries occur when a nursing home resident climbs over the rails and falls to the floor. Also, the use of bedrails increases the likelihood that a resident will spend more time in bed and lose muscle strength – putting them at greater risk for injury when out of bed.

The combination of bedrail restraints and any other physical restraint attached to the body (like a vest or wrist restraint) can cause serious injuries, including:

• Chest compression
• Strangulation
• Suffocation
• Wrongful death

Tips to Prevent Restraint Injuries

• Review the resident’s care plan to determine the risk for using restraints. Risks factors include problems with falling, positioning, and elopement or wandering.
• Learn about the drugs you or your loved one is taking. Many books are available that contain easy-to-understand descriptions, side effects, and what medical conditions drugs treat.
• Remember that the law requires the doctor to write an order for restraints that details the duration and circumstances under which they can be used. Ask to see the order.
• After reading the order, discuss the restraint use with the physician and ask how the restraint will help the resident’s function. If you are dissatisfied with the explanation and believe restraints are unnecessary, contact authorities.

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