America's Best Attorneys

Nursing Home Negligence 

Our affiliated nursing home neglect and abuse attorneys aggressively seek to protect the rights of elderly people and explain to families the causes of their abuse. We and our affiliated counsel have successfully recovered millions of dollars for our clients. We have the skill, experience, and success to effectively represent our client's interests and provide them personal attention.

We understand that everyone in a nursing home was once a vibrant young child and an active adult. We believe that every one residing in a nursing home or long term care facility deserves to be treated with dignity. While nursing homes that receive Medicaid and Medicare are required to undergo inspections, there are still deficiencies in the process and nursing home abuse still occurs.

With people living longer and the aging population on the rise, more and more people are spending the last years living in nursing homes. Unfortunately, due to understaffing and lack of training many elderly people are suffering from nursing home abuse and neglect.

We are committed to ensuring that nursing homes foster a standard level of care for elderly people under their supervision. To do this we all ust hold the owners and operators of nursing homes responsible for their acts and omissions that cause their residents to suffer.

Some of the common signals that nursing home abuse may be occurring include:

• - Pressure Sores, Bedsores, and Decubitus Ulcers

• - Dehydration

• - Excessive weight loss

• - Bruising

• - Infections

• - Inappropriate Use of Physical Restraints

• - Physical, Emotional, and Psychological Abuse

Bed Sores

Bedsores are very serious conditions that in almost all cases are caused by neglgect. The incidence of serious bedsores in a nursing home's population is one factor that should be used in choosng a facility.

WHAT ARE BEDSORES

The definitions of the four pressure ulcer stages are revised periodically by the National Pressure Ulcer Advisory Panel (NPUAP) in the United States. Briefly, however, they are as follows:

• Stage I is the most superficial, indicated by redness that does not subside after pressure is relieved. This stage is visually similar to reactive hyperemia (a technical term for excessive redness) seen in skin after prolonged application of pressure. Stage I pressure ulcers can be distinguished from reactive hyperemia in two ways: a) reactive hyperemia resolves itself within 3/4 of the time pressure was applied, and b) reactive hyperemia blanches when pressure is applied, whereas a Stage I pressure ulcer does not. The skin may be hotter or cooler than normal, have an odd texture, or perhaps be painful to the patient. Although easy to identify on a light-skinned patient, ulcers on darker-skinned individuals may show up as shades of purple or blue in comparison to lighter skin tones.
• Stage II is damage to the epidermis extending into, but no deeper than, the dermis. In this stage, the ulcer may be referred to as a blister or abrasion.

• Stage III involves the full thickness of the skin, extending into, but not through, the subcutaneous tissue layer. This layer has a relatively poor blood supply and can be difficult to heal. At this stage, there may be undermining damage that makes the wound much larger than it may seem on the surface.

• Stage IV is the deepest, extending into the muscle, tendon or even bone.
• Unstageable pressure ulcers are covered with dead cells, or eschar and wound exudate, so the depth cannot be determined.

WHAT ARE THE CAUSES OF BEDSORES

Bed sores are caused by unrelieved pressure on a particular area of the body, usually on lower backs, hipbones, and heels, can create a sore. Elderly nursing home residents who lack mobility must be turned or repositioned regularly to prevent the development of bedsores. Many nursing homes lack adequate numbers of nursing staff. As a result patient care suffers and the frequency of bedsores increases.

WHAT YOU CAN DO

1. Visit often. Residents who have frequent visitors are less likely to be ignored by staff.

Immobility, Contractures and Range of Motion in the Elderly

Contractures are painful, disfiguring deformities of the joints, caused by immobility, and often resulting in reduced range of motion. Muscles shorten when a person endures long periods of immobility. Infrequent use causes the muscles to become rigid or fixed. Joints do not move as freely or smoothly as they once did. Movement is painful when the joint is moved because the shortened muscles are being stretched beyond their ability.

Progression of Contractures

As contractures progress, a person loses all voluntary movement in the contracted joint. Bathing, dressing, and daily care become more difficult. It is harder to position a resident properly because the contracture creates pressure points that may lead to pressure sores

Symptoms of Contractures: The Four Stages

Contractures progress through four stages based on severity.

• Stage I contractures can develop in as few as four days.
• Stage II contractures develop after an additional week or two. Unfortunately, most contractures are not identified until they are at Stage III.
• Stage III contractures need many as 500 days (a year and a half) to work themselves out.
• Stage IV contractures exist when a nursing home resident's muscles and joints are so stiff that the resident is folded into the fetal position.

Causes of Contractures

Joint movement is affected by age, body size, genetics, and the presence or absence of disease. The normal movement of the joints is called range of motion. Healthy people do range-of-motion movements many times each day during normal activities. Nursing home residents in long term care facilities may not move each joint through its normal range each day. The muscles atrophy and eventually shrink leading to a reduced range of motion called a contracture.

Prevention of Contractures

For the prevention of cantractures ask the nursing home staff about what type of exercises you can help the resident do. Check with qualified professionals before attempting new exercises or routines, and follow the general guidelines for exercises listed below. Encourage a nursing home resident who can still move independently to exercise frequently. Remind a nursing home resident with limited mental abilities when it is time to exercise in order to prevent cantractures.

Nursing Home Staff and the Prevention of Contractures

Nursing home staff members must exercise an immobile nursing home resident's joints to prevent deformities. Nursing home staff should be trained to perform exercises on residents with various physical and mental conditions.

Active range-of-motion exercises are done independently by nursing home residents each day. Residents with limited mental ability may need reminders to exercise. Some may need to use stronger muscles and joints to exercise weaker ones. That's O.K., as long as the exercises get done.

Range of Motion Exercises to Prevent Contractures

Active-assistive range-of-motion exercises may be started by the nursing home resident and completed with the help of a nursing home aide, or they may started by the aide and completed by the resident. A nursing home resident may use elastic bands, pulleys or other equipment to perform the exercise.

In passive range-of-motion exercises, a nursing home aide manually manipulates the joints of a resident who is physically or mentally incapable. Passive range-of-motion exercises should be performed two to three times a day to prevent contractures and deformities. These exercises maintain flexibility, but they do not strengthen muscle.

Preventative Exercises for Prevention of Contractures

Like pressure sores, contractures are much easier to prevent than to cure. Contractures are prevented by maintaining a resident's range of motion. Range-of-motion exercises can be conducted without a physician's order unless the resident has osteoporosis, severe arthritis or other joint or bone-related illnesses.

Range-of-motion exercises prevent contractures and atrophy. Range of motion exercises stimulate circulation (thereby reducing the risk of blood clots), and they improve the resident's general sense of well-being.

Guidelines for Range-of-Motion Exercises

• Check with a medical professional before performing range-of-motion exercises with a resident who has specific movement limitations, osteoporosis, arthritic deformities, or healing fractures.
• Do not exercise the resident's neck without a physician's order.
• If the resident physically resists range-of-motion exercises or has very stiff joints, it may be helpful to perform the exercises in a bathtub or whirlpool.
• Make enough space to accommodate a full range of movements.
• Position the nursing home resident on his or her back, in good body alignment, before beginning range-of-motion exercises.
• Respect the nursing home resident's dignity. Cover the resident and expose only the part of the body being exercised.
• Encourage and help the resident to relax.
• Talk to the resident. Explain the range-of-motion exercise before doing it, even if the nursing home resident is mentally confused.
• Perform each range-of-motion exercise at least three to five times. The more active, the better, though beware of fatiguing the nursing home resident or causing injury.
• Work systematically from the top of the body to the bottom.
• Support each joint during the range of motion exercise by placing one hand above and one hand below the joint.
• Move each joint slowly and consistently.
• Stop briefly at the end of each range of motion exercise before repeating.
• Avoid pushing the joint past a point of resistance.
• If the nursing home resident has a muscle spasm, hold the joint in position for a few seconds, applying gentle pressure.
• Stop the range of motion exercise if the resident resists or complains of severe pain.
• Stop the range of motion exercise if the resident's condition changes.
• There may be a problem if the nursing home resident experiences pain, shortness of breath, sweating, or a change in color.

WHAT YOU CAN DO

1. Visit often. Residents who have frequent visitors are less likely to be ignored by staff.

2. Ask your loved one how they are.

3. When you visit check for signs of injury or loss of mobility in their hands or elsewhere

4. Don't be afraid to look under the sheets for the presence of bedsores. Bedsores usually develop on the lower back or buttocks and frequently are found on patients with contractures.

If you find any signs of contractures, injury or abuse, immediately bring it to the attention of the facility. Speak to the nurses, ask them what they know. Remember to document everything.

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Dehydration

Perhaps the most disturbing and most common medical problem found among nursing home residents is dehydration. All human beings need water to survive. In a study published by the American Geriatric Society in 1999 that included 40 nursing home patients from two facilities, it was determined that 39 of the 40 (97.5%) nursing home residents were not provided enough fluids to sustain a healthy life. More disturbing 24 of 40 (62.5%) were found to have illnesses related to dehydration. :

There is no excuse for anyone not to receive adequate fluids while a patient in a nursing home. Inadequate staffing coupled with a patient population that is unable to speak up for themselves are some of the causes.

Researchers have concluded that some of the reasons are that "when staffing is inadequate and supervision is poor, residents with moderate to severe dysphagia, severe cognitive and functional impairment, aphasia or inability to speak English, and a lack of family or friends to assist them at mealtime are at great risk for dehydration. Adequate fluid intake can be achieved by simple interventions such as offering residents preferred liquids systematically and by having an adequate number of supervised staff help them to drink while properly positioned." : J Am Geriatr Soc. 1999 Oct;47(10):1187-94. J Am Geriatr Soc. 1999 Oct;47(10):1187-94. Links.

WHAT YOU CAN DO

1. Visit often. Residents who have frequent visitors are less likely to be ignored by staff.


2. Ask your loved one what and how much they are eating or drinking.

3. When you visit check for signs of fever, lethargy or other illness.

4. Don't be afraid to look under the sheets for the presence of bedsores on your loved one. Bedsores frequently occur in patients who are malnourished or dehydrated.

If you find any signs of dehydration, injury or abuse, immediately bring it to the attention of the facility. Speak to the nurses, ask them what they know. Remember to document everything.

 

PleaseGetMeAnAttorney.com can help you find an experienced Nursing Home Abuse Litigation Attorney.  We have "THE BEST" Nursing Home Abuse Attorneys.
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Malnutrition

Our elders need good nutrition to lead healthy lives. Sadly, many nursing homes fail to provide nursing home residents with adequate nourishment.

State and Federal laws require that nursing homes take steps to ensure that each resident maintains good nutritional health and must provide all residents with a well-balanced, palatable meal.

Many things can cause malnutrition in nursing home residents. The following are factors that may prevent a resident from receiving adequate amounts of the vitamins, minerals, protein, and calories the resident needs:

Physical Causes:

• Illness
• Adverse drug effects such as nausea, vomiting, diarrhea, cognitive disturbances, or sleepiness
• Food and drug interactions which decrease the ability of the body to absorb vitamins and minerals
• Depression
• Swallowing disorders
• Mouth problems such as tooth loss, dentures that do not fit properly, mouth sores, and mouth pain
• Tremors, which affect the residents' ability to feed themselves

Environmental Causes:

• Inadequate attention from staff for residents who need assistance eating
• Staff who are uneducated about malnutrition and proper ways to feed residents who need help
• Reliance on liquid supplements
• Special diets

Signs That A Resident is Malnourished:

Ask the following questions to determine whether your loved one is demonstrating signs of malnutrition:

• Do clothes fit more loosely than usual?
• Are there cracks around the mouth?
• Do lips and mouth look pale?
• Has the resident complained that his/her dentures no longer fit?
• Has the resident's hair been thinning or growing more sparse?
• Do wounds seem to take longer to heal?
• Does the resident appear confused (not as a result of a disease such as Alzheimer's)?
• Is the resident's skin breaking down?
• Does the resident's eyes look sunken?
• Does the resident appear to be losing weight?

WHAT YOU CAN DO

1. Visit often. Residents who have frequent visitors are less likely to be ignored by staff.

2. Ask your loved one how they are. Are they eating?

3. When you visit check for the signs of malnutrition listed above.

4. Don't be afraid to look under the sheets for the presence of bedsores. Bedsores usually develop on the lower back or buttocks and are frequently found on patients suffering from malnutrition.

If you find any signs of malnutrition, dehydration, injury or abuse, immediately bring it to the attention of the facility. Speak to the nurses, ask them what they know. Remember to document everything.

PleaseGetMeAnAttorney.com can help you find an experienced Nursing Home Abuse Litigation Attorney.  We have "THE BEST" Nursing Home Abuse Attorneys.
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Abuse

Nursing home abuse is on the rise.

Nursing Home abuse can take several forms. It can include physical, mental, verbal, psychological, and sexual abuse, corporal punishment, unreasonable seclusion, and intimidation. Examples include:

• Physical abuse from a staff member or an intruder or visitor from outside the facility -- including hitting, pinching, shoving, force-feeding, scratching, slapping, and spitting;

• Psychological or emotional abuse -- including berating, ignoring, ridiculing, or cursing a resident, threats of punishment or deprivation;

• Sexual abuse -- including improper touching or coercion to perform sexual acts;

• Substandard care which often results in one or more of the following conditions -- immobilization, incontinence, dehydration, pressure sores, and depression;

• Rough handling during care giving, medicine administration, or moving a resident.

 

WHAT YOU CAN DO

1. Visit often. Residents who have frequent visitors are less likely to be ignored or abused by staff.

2. Ask your loved one how they are.

3. When you visit check for signs of injury.

If you find any signs of injury or abuse, immediately bring it to the attention of the facility. Speak to the nurses, ask them what they know. Remember to document everything.

PleaseGetMeAnAttorney.com can help you find an experienced Nursing Home Abuse Litigation Attorney.  We have "THE BEST" Nursing Home Abuse Attorneys.
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Check your loved one

With an increasingly aging population, stories of nursing home abuse are becoming more common place. Reports of physical, mental, emotional and even sexual abuse frequently appear in the news. Nursing home abuse and neglect should not occur. All of us must take steps to prevent elder abuse.

The root cause of this crisis is the chronic understaffing of nursing homes. Most facilities are owned by large corporations or individual investors who in order to increase profits cut staffing to the bone. As a result patients or residents are frequently provided little if any care. Some residents' most basic needs, including even food and water are not provided.

The lack of care that is pervasive in these homes fuels an atmosphere of neglect that places all nursing home residents at risk.

WHAT YOU CAN DO TO PROTECT YOUR LOVED ONES:

1. Visit often. Residents who have frequent visitors are less likely to be ignored by staff.

2. Ask your loved one about any incidents or problems they've had in the facility.

3. Check your loved one for signs of injury or physical abuse. Report and document and document by photograph any suspicious bruising or injury.

4. Don't be afraid to look under the sheets for the presence of bedsores on your loved one.

If you find any signs of injury or abuse immediately bring it to the attention of the facility. Speak to the nurses, ask them what they know. Remember to document everything.

PleaseGetMeAnAttorney.com can help you find an experienced Nursing Home Abuse Litigation Attorney.  We have "THE BEST" Nursing Home Abuse Attorneys.
(please fill out the form to the right)

Bill of Rights

Your rights:

1. You are entitled to be treated with courtesy and consideration at all times by your lawyer and the other lawyers and personnel in your lawyers office.

2. You are entitled to an attorney capable of handling your legal matter competently and diligently, in accordance with the highest standards of the profession. If you are not satisfied with how your matter is being handled, you have the right to withdraw from the attorney-client relationship at any time (court approval may be required in some matters and your attorny may have a claim against you for the valued of services rendered to you up to the point of discharge).

3. You are entitled to your lawyer's independent professional judgment and undivided loyalty uncompromised by conflicts of interest.

4. You are entitled to be charged a reasonable fee and to have your lawyer explain at the outset how the fee will be computed and the manner and frequency of billing. You are entitled to request and receive a written itemized bill from your attorney at reasonable intervals. You may refuse to enter into any fee arrangement that you find unsatisfactory.

5. You are entitled to have your questions and concerns addressed in a prompt manner and to have your telephone called returned promptly.

6. You are entitled to be kept informed as to the status of your matter and to request and receive copies of papers. You are entitled to sufficient information to allow you to participate meaningfully in the development of your matter.

7. You are entitled to have your legitimate objectives respected by your attorney, including whether or not to settle your matter (court approval of a settlement is required in some matters).

8. You have the right to privacy in your dealings with your lawyer and to have your secrets and confidences preserved to the extent permitted by law.

9. You are entitled to have your attorney conduct himself or herself ethically in accordance with the Code of Professional Responsibility.

10. You may not be refused representation on the basis of race, creed, color, religion, sex, sexual orientation, age, national origin or disability.

PleaseGetMeAnAttorney.com can help you find an experienced Nursing Home Abuse Litigation Attorney.  We have "THE BEST" Nursing Home Abuse Attorneys.
(please fill out the form to the right)




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