Nursing Home Neglect: Signs and Symptoms
Nursing Home Neglect
While Nursing Home Neglect, which is characterized by the failure of Nursing Home Staff to properly care for residents, may not seem as horrific as Nursing Home Abuse, it is more common, the effects can result in serious health issues, and in some cases it may lead to outright elder abuse. One of the most common causes of Nursing Home Neglect is the understaffing of nursing home facilities, leaving workers unable to properly care for all residents. Similarly, Nursing Homes may hire unqualified workers, or fail to train their employees, leading to instances of Elder Neglect. If a nursing home is putting profits ahead of the care of its residents, the result is almost always the neglect of elderly persons in desperate need of care.
Do you suspect your loved one is a victim of nursing home abuse? We can help. Find an experienced nursing home lawyer now.
Types of Nursing Home Neglect
The following is a list of examples of Nursing Home Neglect. The types of neglect that take place in Nursing Homes are far too numerous to list in their entirety. The most common types of Nursing Home Neglect are when the staff of the Nursing Home fails to:
- Provide proper nutrition and hydration
- Assist in personal hygiene when needed
- Provide proper medication dosage
- Take reasonable precautions to prevent falls
- Answer call lights in a timely fashion
- Turn residents in their beds (leading to pressure sores)
- Take residents to the toilet (leaving them in soiled garments or beds)
- Take adequate precautions to prevent injury to the resident
Symptoms of Neglect
The following is a list of the common signs and symptoms of Nursing Home Neglect. It is by no means comprehensive.
Pressure sores, also known as decubitis ulcers or bed sores, are areas of damaged skin and tissue that develop when sustained pressure (often from a bed or wheelchair) cuts off circulation to vulnerable parts of your body. The skin on your buttocks, hips, and heels is the most likely place that a pressure sore will occur. Without adequate blood flow, the affected tissue dies.When nursing home residents are unable to change their position, serious pessure sores can cause infections, some of which are life-threatening. Poor nutrition, weight loss, diabetes, poor hygiene, and dehydration are additional factors that can contribute to the development of pressure ulcers.
There are four stages of bed sores:
- Stage 1 bedsores are minor and are characterized by redness of the skin.
- Stage 2 bedsores are more serious, and are characterized by blisters or abrasions on the skin.
- Stage 3 bedsores involve damage to the full thickness of the skin.
- Stage 4 bedsores extend into the muscle, tendons, and bone.
Most bed sores can be prevented by regular preventative care, including:
- Keeping skin clean and dry
- Changing position every two hours
- Using pillows and other products to relieve pressure
However, when nursing homes are understaffed, staff members are not trained on proper bed sore prevention procedures, or staff members simply choose to neglect residents, pressure sores can develop. They are very painful and as they progress they become increasingly more difficult to treat. In the most serious cases, bed sores can lead to death.
Unsanitary conditions in nursing homes put residents at an increased risk for bed sores, infections, and other health problems. When nursing home staff members fail to provide clean bedding and clothing or allow a resident to remain unwashed after exposure to bodily fluids, potentialy life threatening bed sores can form. Unsanitary conditions in nursing homes can quickly become hazardous, and failure to correct unsanitary conditions is a form of nursing home neglect. When staff members fail to keep the facility clean and ensure proper hygiene for residents, infections can spread throughout the entire nursing home population or create terrible living conditions. Problems that may result from unsanitary living conditions in a nursing home include mold, fleas, lice, rodents, roaches, and other insect infestations. If you notice a strong odor of urine, feces, or body odor when you visit a nursing home, this may be a sign that the residents are being forced to live in unsanitary conditions. A nursing home neglect lawyer should be consulted as soon as possible.
Dehydration occurs when elderly nursing home residents do not have the necessary fluid content in their body to perform normal and crucial bodily functions. Most body systems and organs are drastically affected by water deprivation, and dehydration can be especially harmful in the elderly.
Causes of dehydration in nursing home residents include:
- Increased fluid losses due to illness (e.g., diarrhea, infections, fever)
- Side effects of medications (e.g., diuretics)
- Decreased fluid intake
- Decreased ability of the kidney to concentrate urine
- Decreased thirst sensation
Residents with Alzheimer's or dementia, incontinent residents, and residents suffering from colds or the flu are at an increased risk for dehydration. Changes in functional and cognitive status (e.g., mobility and dementia) may also increase the likelihood that a nursing home resident will suffer from dehydration.
Elderly nursing home residents who do not receive adequate fluids are more susceptible to urinary tract infections, pneumonia, decubitus ulcers, and confusion and disorientation. In addition, life-threatening electrolyte imbalances can occur. Dehydration should be managed through an individualized daily plan to promote adequate hydration. Nursing homes have a responsibility to provide adequate hydration to their residents, and to provide the proper training to their employees to recognize the signs and symptoms of dehydration.
Proper nutrition is an integral part of health, independence, quality of life, and physical and mental functioning. However, nutritional deficiencies are common among U.S. nursing home residents, despite federal and state regulations designed to prevent their occurrence. Malnutrition is food deprivation that occurs when residents are not provided with adequate amounts of the vitamins, minerals, protein, and calories according to their nutritional needs. There are both physical and environmental causes that can lead to malnutrition in nursing homes.
Malnurishment can lead to serious heath issues; the decreased ability for the body to fight bacteria and viruses can lead to infections, as well as a higher risk of contracting pneumonia. Other side effects include disorientation and decreased cognitive functioning, and muscle weakness, which in turn can cause increased risk of falls and the development of pressure ulcers. If a senior is being properly cared for in a nursing home, malnutrition should not happen. Nursing homes have a responsibility to ensure that residents maintain good nutritional health by providing them with well-balanced meals and assistance in eating.
As senior citizens begin to experience age-related problems, they may need an increasing amount of assistance from nursing home staff members to perform personal hygiene tasks. Failure to assist in personal hygiene is one form of nursing home neglect. Residents may need assistance when using the restroom, bathing, getting dressed and changing clothes, cutting and brushing hair, shaving, trimming fingernails.
Signs of this form of nursing home neglect include strong body odors, dirty or innapropriate clothing, an unkempt appearance, etc.
If staff members are negligent or the nursing home has not employed a sufficient number of employees to provide adequate care to all residents, seniors may suffer from health problems due to poor hygiene, as well as a loss of dignity and self-respect.
If visitors are made to wait while the staff readies a patient to see them or if the staff does not allow the visits at all, neglect of personal hygiene care could be the reason.
Frozen joint syndrome, also known as adhesive capsulitis, is a painful disorder that results from the chronic inflammation, scarring, thickening and shrinkage of the capsule that surrounds the involved joint. It often occurs in the shoulders or knees. When nursing home residents do not receive proper physical therapy, including the exercise of the joints of their arms and legs, they can sometimes develop frozen joints, in which a patient's knees and/or arms contract to a fetal position. Frozen joints can also be an indication that an elderly person is being neglected and left sitting or in bed for extremely long periods of time without any movement. Frozen joint syndrome can be prevented throughphysical conditioning of the joints, including the associated muscles, tendons and ligaments. The possibility of this health problem highlights the importance of passive and, if possible, active exercise of the limbs of nursing home residents.
Wandering refers to a cognitively-impaired nursing home resident's ability to move about inside the nursing home freely and without an appreciation of personal safety needs. Elopement refers to the ability of a resident who is not capable of protecting himself from harm to leave the nursing home unsupervised and enter into harm's way. A nursing home resident's risk of wandering or elopment must be assessed within the plan of care. A study from the International Research Consortium on Wandering that was published in the Journal of the American Geriatrics Society found one in five subjects (21%) inclined to wander. The study involved over 15,000 cognitively impaired nursing home patients and noted the increased health risks associated with wandering. This study indicates that these are serious problems throughout nursing homes in the United States.
Several factors may increase the likelihood of a nursing home resident becoming injured as a result of wandering or elopment. These include:
- Failure to hire adequate staff to properly supervise the resident
- Failure to properly train staff on how to supervise residents
- Failure to install alarms or other safety devices to prevent wandering
Some of the negative side effects of wandering include higher occurrence of weight loss, disrupted sleep, exhaustion/tiredness, getting lost, falls, and even death. Nursing home residents who elope may get lost, not be able to find the way back to the nursing home, and suffer from heat or cold exposure or another medical crisis. Close supervision of residents suffering from dementia or Alzheimer’s disease is necessary in order to prevent wandering and elopment. The Nursing Home Reform Act of 1987 requires nursing homes to provide residents with adequate supervision to prevent wandering or elopement, and a nursing home may be found liable for failing to prevent wandering or elopment while a resident is in their care.
Most nursing home residents are in a stage of life in which proper dosage of medication is very important for maintaining health and quality of life. Unfortunately, nursing homes sometimes make medication errors that can cause serious injuries and even death. Medication error-related injuries in nursing homes are common and often preventable. The more medications a patient is taking, the greater the chance of interactions, and the greater the risk of errors. Two of the factors that can lead to nursing home medication error occurrences are 1) the high cost of electronic systems for distributing and monitoring medication and 2) the problems that can arise from having multiple doctors and medical personnel treating patients.
Studies have shown that psychoactive drugs (antipsychotics, antidepressants, sedatives and hypnotics) and anticoagulants were the most common medications associated with preventable adverse drug reactions in nursing homes. Adverse drug reactions include oversedation, confusion, hallucinations, delirium, falls, and bleeding. Nursing home medication error risks can be considerable because many patients are on a number of prescriptions and already have compromised physical health conditions. Nursing home and medication error risks are also exacerbated by the fact that nursing homes are often understaffed, increasing the likelihood of mistakes in dosage and frequency of medication administration.
Nursing home medication errors may involve a number of different circumstances, including:
- Lack of proper patient assessment
- Lack of monitoring for medication's efficacy
- Lack of reassessment for continuous need for medication
- Lack of monitoring for adverse drug reactions (ADRs)
- Lack of recognition of ADRs
- Attributing symptoms of ADRs to other causes
- Inadequacies in nursing home staff education or training
- Nursing home employees stealing medication and substituting another in its place (for example, substituting Aspirin for Oxycontin)
- Administering medications late
- Missing a medication and giving double dosage at a later time
- Administering the wrong medication
Close living quarters, inadequate care, and a frail population create an ideal setting for infections to occur in nursing homes. Failure to promptly diagnose and treat infections in nursing home residents can lead to serious health consequences, and in some cases can be fatal. Nursing home staff members must be constantly on the lookout for signs of an infection and take precautions to prevent the spread of an infection from one patient to another. Every nursing home should abide by basic cleanliness standards, and frequent infections among nursing home residents may indicate that nursing home staff is failing to employ proper hand washing techniques.
There are several other causes of infection in nursing homes where neglect occurs. Most of these causes involve residents not getting the right medications or the hygiene care needed to keep infections from occurring. Some of the major causes of infections due to nursing home neglect are:
- Urinary infections that occur when residents must wait too long for someone to escort them to the bathroom
- Urinary infections caused by failure to clean or change catheters when needed
- Infections that spread and become worse when staff members do not administer antibiotics as directed
If your loved one gets frequent infections that can’t be adequately explained by a new or existing medical condition, you may want to contact an nursing home abuse attorney.
If nursing home residents suffer from frequent illness, this may be a sign that they are not receiving the quality care that they deserve. Although advanced age can increase a senior's susceptibility to illnesses, the nursing home is responsible for providing care that minimzes the risk of disease and treating an existing illness in the most efficient and effective manner possible. Malnutrition, dehydration, medication errors, and unsanitary conditions are all forms of nursing home nelgect that may contribute to frequent illnesses for residents. When illnesses are not promptly reported to the physician and the resident's family, this is another red flag that nursing home neglect may be the cause of the illness. In addition, illnesses that can be easily treated may become serious if the initial signs of illness are overlooked due to the nursing home staff's inattention, inadequate staff training, or an insuffucient number of staff members.
According the Centers for Disease Control and Prevention, an average nursing home with 100 beds reports 100 to 200 falls each year and about 1,800 older adults living in nursing homes die each year from fall-related injuries. As these statistics reveal, falls are serious problem among nursing home residents. A good nursing home should assess a patient for risk factors for falls, such as walking and gait problems or medications that could affect balance. Patients who are at anincreased risk for falls should have fall prevention strategies in place, which might include protective padding or alarms that go off when patients try to get out of bed or move without help. In addition, nursing home staff members should be educated about fall risk factors and prevention strategies. The law requires nursing home residents to receive adequate supervision and assistive devices to prevent accidents, such as falls.
There are a variety of reasons why a nursing home resident might fall, including weakness and gait problems associated with old age. However, some falls occur because of the nursing home's negligence. This include falls caused by:
- Wet floors
- Poor lighting
- Lack of necessary bedrails and improper bed height
- Improperly maintained or fitted wheelchairs
- Failure to assist residents to the restroom due to understaffing
- Failure to have sufficient staff to answer call buttons
- Failure to have call buttons that are in proper working condition
- Failure to properly train staff in lifting and handling techniques
- Failure of the staff to properly supervise residents
- Untreated medical conditions
- Sudden Death
- Specific complaints by residents going ignored
What to do if you Suspect Neglect
Victims of nursing home neglect may be embarrassed and reluctant to speak out because of threats or intimidation by staff members. Furthermore, they may be physically or mentally unable to complain about the neglect. If you suspect nursing home neglect, you should first get medical attention for the victim, if warranted by the cicumstances. Gather as much information as possible about the individuals involved in the suspected neglect (e.g. names, ages, addresses). Then you should report the neglect to the nursing home administrator. Then file a complaint with the department in your state that regulates nursing homes and contact the local police.
Have you or someone you know become a victim of nursing home abuse or neglect? If so, contact one of our experienced nursing home lawyers today. Help End Nursing Home Abuse.