Nursing Home Abuse & Neglect
Residents of nursing homes and other long-term care facilities often suffer severe injuries as the result of neglect, negligence, or even abuse. Martin, Harding & Mazzotti, LLP is dedicated to upholding the quality of care in our long-term care institutions by seeking compensation for residents who are injured by neglect or inadequate care. Have you or your family member suffered from bedsores, falls, dehydration, malnutrition, chemical or physical restraints, sexual abuse, medication errors or unsanitary or unhygienic conditions? Has a family member wandered in or strayed from a nursing home and suffered an injury as a result? If so, you or your family member may have a case.
These preventable indignities and injuries are not the natural result of the aging process. Long-term care facilities such as nursing homes are required to provide adequate care to maintain and attain the highest practicable level of physical and mental well-being for their residents. Anything less is a violation of New York State and Federal regulations and statutes. If you or a loved one has suffered abuse, neglect, or wrongful death in a nursing home or other long-term care facility, please contact Martin, Harding & Mazzotti, LLP. The initial consultation is free of charge, and, if we agree to accept your case, we will work on a contingent fee basis. It’s Our Free Fee Guarantee™.
When families place a loved one in a nursing home or other assisted living facility, they place their trust in the people who run that home. Sadly, sometimes that trust is terribly betrayed. When nursing home staff and owners abuse, neglect or exploit their residents, they violate older people’s dignity and victimize some of the most helpless people in our society. Frequently, the same ailments that led to placement in a nursing home keep residents from speaking out about abuse. It’s not until a resident suffers terrible consequences that families and the public learn the truth.
When most people think of negligence at an assisted living facility, they think of physical and verbal abuse. Perpetrated on a helpless older or disabled person, this is nothing more than bullying. This type of abuse includes:
- Hitting and slapping
- Unnecessary yelling
- Belittling the victim and name-calling
- Socially isolating the victim
- Using restraints or locking the victim up unnecessarily
- Intentional over- or under-medication
Basic decency and New York State law require that facilities provide adequate food, water and medical care to their residents. Nonetheless, neglect is actually the most common form of negligence at nursing homes and other facilities. Forms of neglect include:
- Inadequate food
- Not enough water
- Allowing patients with mobility problems to fall, which can have serious medical consequences.
- Failure to treat medical problems in a timely manner
- Failure to turn bed-bound patients to prevent bedsores (also known as pressure sores)
- Allowing patients to go without washing
- Allowing an irrational patient to wander into danger
- Medical malpractice
Because older people tend to have a lifetime of savings, they can also be vulnerable to financial exploitation by caregivers. Some greedy people will take advantage of an elder’s failing memory or irrationality to help themselves to cash, jewelry or other valuables. Others go further, gaining legal access to the victim’s bank account or property, or stealing his or her identity. By the time relatives’ notice missing heirlooms or unexpected activity in a bank account, the perpetrator may have been able to steal many thousands of dollars.
Nursing home negligence has effects beyond the immediate harm it does. Older people are more physically and emotionally vulnerable than younger adults, especially if they have an underlying medical condition. When abuse or neglect exacerbates these problems, even if the injuries are unrelated to the underlying health problem, it can trigger a serious decline in health. In some cases, this can lead to an unnecessary, early death. And of course, treating the effects of the negligence can put a severe financial strain on families of ordinary means.
One important way for families to avoid these terrible outcomes is to be very careful about which nursing home they choose. After all, the home they choose will be their loved ones’ long-term home — and as the clients, families have every right to investigate their options carefully. This can be hard for families busy with work, school and other activities, but the extra effort is likely to pay off by limiting the amount of worry and trouble families face later. And the State of New York offers a variety of resources for busy families.
The first consideration, of course, is finding a home that meets your loved one’s needs. Different homes cater to people with different health care needs and levels of independence. Insurance coverage is also a factor — some families must work only with a list of homes that take their insurance or Medicare. You should also consider the distance from the home to the places where family members live. Experts say patients get better care when they have visitors often, and being nearby will make it easier for family members to drop by.
To build a list of nursing homes that meet those needs, you can start with an online database listing nursing homes in each region of the state, maintained by the New York State Department of Health. This database also lists quality-of-care indicators for each home, such as the number of patients who lose too much weight or the number who receive flu shots. Unfortunately, that data is self-reported by the homes themselves, so families should consider following up by requesting reports on each home they’re considering. For the public, the state offers reports summarizing the home’s last inspection; complaints and incidents at the home; and enforcement action against the home. The state Department of Health also offers a detailed guide to selecting a nursing home in New York State and a list of nursing home patients’ rights and homes’ responsibilities.
If this seems like an overwhelming amount of information, you can get help through the state’s long-term care ombudsman program. This program connects long-term care patients and their families with a local person who is a professional advocate for patients, particularly in disputes with the patients’ nursing homes. There is a long-term care ombudsman for each county; you can find yours here. An ombudsman cannot recommend a particular home, but he or she can help you understand your rights, answer questions and help resolve any disputes that come up.
Once you have a list of nursing homes that meet your needs, you should visit them to make sure they have created the kind of environment your loved one deserves. In fact, experts recommend that you visit more than once, if possible. Ideally, these visits should take place at different times of day, particularly in the evenings. Though it may seem polite to call ahead, consider not calling ahead every time you visit, so you can see how the home operates when visitors aren’t expected. Take advantage of offers to eat and socialize with residents. Do not be afraid to ask questions or insist on seeing facilities like the kitchen and bathrooms. After all, you are the client. Things to watch for include:
- The home’s license — it should be up to date.
- Policies the home follows, which staff should provide to you. Watch out for policies that might cause problems later, such as restrictions on short trips away.
- Personal space for the residents — they should have privacy and be able to make their space their own.
- Safety issues, including working and up-to-date medical equipment.
- Residents’ level of activity and mental engagement. Feel free to politely ask questions of the residents.
- Staff interactions with residents — these should be friendly and respectful and never controlling.
- Mechanisms in place to resolve disputes between residents, or between residents and staff.
- Staff turnover and training levels. The more consistency and training, the better.
- Quality and appeal of the food, and attention to special dietary needs.
- Access to outside medical and religious care.
- Visiting hours and policies.
Signs of Nursing Home Abuse & Neglect
As the U.S. population ages, nursing homes have become the primary residence for many of our elders. Elder abuse in nursing homes across the country has become a serious and tragic issue that is increasing each year, with neglect being one of the most common forms of this type of abuse. It should be noted that abuse and neglect are not exactly the same. Abuse implies a willful act intended to harm another, while neglect involves a breach of duty by the nursing home to those under its care, often in the form of inadequate, substandard care that causes harm to its residents.
An astonishing 95% of nursing home residents have stated that they had been neglected or seen another resident neglected. Worse yet, in one study over 50% of nursing home staff admitted to mistreating older patients, with two-thirds of those incidents involving neglect.1 Compounding this problem is when residents are unable or unwilling to communicate with family members about what they’re going through, either because of physical or mental infirmities, or because they fear retaliation from nursing home staff members.
However, there are signs of nursing home neglect you can watch for in order to protect your elderly loved ones. It should be noted that neglect can take many forms, and while no single factor is definitive, neglect may very well be occurring if more than one of the following signs are present:
Issues with Personal Hygiene
Elderly nursing home residents often need help with their basic personal hygiene needs. Nursing home staff should be providing this assistance, including help with bathing, laundry, brushing of teeth, doing hair and clipping nails. When nursing homes are understaffed, or the staff is poorly trained, residents are left to rely on themselves to complete these regular self-care tasks, resulting in an unkempt appearance and poor personal hygiene.
Unsanitary Living Conditions
Nursing homes should be free of dirt and debris, pests, mold, etc. Residents should be provided with fresh bedding and towels, and their rooms and living areas should be clean and well-maintained. What’s more, federal law requires nursing homes to “establish and maintain an infection control program designed to provide a safe, sanitary, and comfortable environment . . . and to help prevent the development and transmission of disease and infection.” Serious health issues can easily arise when these standards are not met.
Nursing homes should have good lighting, floors that aren’t slippery, safe mobility equipment (wheelchairs, walkers, etc.) and safe furnishings in the residents’ rooms. Failing to provide a safe environment can lead to accidents and falls, the consequences of which are more serious for the elderly. While a younger person can sustain a fall with minimal harm, the same fall for an older adult often results in sprains and bone fractures.
Malnutrition, defined as receiving too much or too little nutrients for basic health, occurs in up to of 85% of American nursing home residents.2 Residents are often completely reliant on staff for their meals, and malnutrition happens when staff are not offering enough food to residents and/or are not overseeing their residents’ proper nutrient consumption. All nursing homes should have the equipment and skilled staff needed to screen residents to ensure they are receiving proper nutrition. Too often they fail to do so, which negatively affects the elder’s physical, mental and emotional health. Some signs of malnutrition include: weight loss, canker sores, red or glassy eyes, fatigue, yellowing skin, white fingernails, and bed sores.
Residents in poorly managed or staffed nursing homes often suffer from dehydration because drinks are not being provided in a timely manner. In fact, dehydration is the most common type of neglect elders living in nursing homes experience. Some elderly people may not display a strong thirst drive, and therefore need regular supervision of their fluid intake to ensure they’re getting enough water. Other elders, because of disability or language barriers, may not be able to communicate that they are thirsty and what type of fluids they prefer. Dehydration in the elderly can cause or complicate serious risks to their health, including brain swelling, seizures, kidney failure and coma. A resident may be dehydrated if they show signs such as thirst, having dry, papery skin, or decreased urine output/urination frequency. Symptoms of more serious, late-stage dehydration include confusion, irritability, inability to sweat, sunken eyes and cheeks, low blood pressure, delirium and rapid breathing.
Loss of, or Lack of Mobility
A good nursing home should have programs and policies to help keep their residents mobile. Regular movement helps maintain muscle mass and mobility, and can greatly help with balance and circulation issues. If your loved one has lost some or all of their mobility, it may be because they are left sitting or lying in bed for long periods of time. Bedsores and other infections can also develop when elders are not given the opportunity for regular movement.
Also called pressure ulcers, bedsores are injuries to the skin and underlying soft tissue caused by prolonged pressure on the skin. They most commonly develop on areas of the skin that cover bony areas of the body, such as the heels, ankles, hips and the tailbone, and can be difficult to treat. The elderly in nursing homes develop bedsores when they are confined to beds or chairs for long periods without the opportunity, or needed assistance, to regularly move. Individuals with spinal cord injuries, paralysis or other neurological disorders need to be moved frequently to prevent these sores. Dehydration and malnutrition, discussed above, make the formation of bedsores more likely as the resident loses weight (and thus the fatty tissue that protects them from sores) and their skin becomes thin and papery. Bedsores often become infected.
Many nursing home residents need help taking care of themselves and moving about. A nursing home’s staff should be there to help. If they aren’t, patients will often try to do these things themselves, and acts as simple as getting out of bed or walking unassisted down a hallway can result in falls and injuries such as cuts, bruises, sprains and bone fractures. More troubling are signs of bruises or irritation on the resident’s wrists or ankles, which can indicate that the person has been restrained to a bed or wheelchair.
Normally, the human body’s response to an infection is to fight it off. But when the body over-responds to an infection, immune system chemicals in the bloodstream cause inflammation throughout the entire body. This can lead to damage to multiple organ systems. The elderly are at high risk for developing sepsis, and it is the most common reason for the hospitalization of nursing home residents. Any type of infection can lead to sepsis, but the most likely for the elderly in nursing homes are pneumonia, urinary tract infections, and bedsores. Sepsis can occur in nursing homes when the facility is not following state and federal guidelines with regard to infection control measures.
Infections in nursing homes are common. Those most frequently encountered in the nursing home setting are MRSA (a type of skin infection that is often introduced through breathing tubes, catheters, and other methods that allow access to the bloodstream), urinary tract infections (caused in nursing homes by the use of catheters as well as by dehydration), pneumonia, influenza, food poisoning caused by a staph infection, and infections arising from bedsores. Nursing homes infections often arise out of a failure of the facility to have proper infection control programs in place, as well as poor resident hygiene care.
If a nursing home resident shows fear or apprehension toward caregivers, is reluctant to interact with staff members, or displays anger or resentment toward them, they may be suffering from neglect. Emotional neglect can also involve ignoring the resident, socially isolating the resident, and constant unkind treatment by staff. Ongoing neglect of this type can cause depression, and residents may begin to withdraw from friends and family members as a result.
If you suspect nursing home neglect . . .
- Contact local law enforcement. If the person is in immediate physical danger or is in danger of developing serious health issues, police and paramedics can remove them to a safe care environment and an investigation will be launched.
- Reach out to a local long-term care ombudsman. If the matter is less urgent but still of concern, a local ombudsman should be contacted. These ombudsmen serve as advocates for nursing home residents and can follow up on concerns regarding neglect and, if necessary, assist victims in taking legal action.
- Speak to a representative of your state’s Adult Protection Services. These social service providers help adults who are unable to protect themselves in non-urgent cases of abuse, neglect, financial exploitation or other harm. They can investigate these cases and provide services such as safety monitoring, as well as connect victims and their families to other social service providers with the relevant expertise based upon the circumstances of the case.
- Contact an elder abuse attorney. If you suspect a loved one may be the victim of elder abuse or neglect, or if you think a loved one may have died due to a nursing home’s negligence, an experienced attorney can offer guidance on how best to ensure their well-being and protect the their legal rights. An attorney can also take legal action to recover compensation from the offending nursing home.
At Martin, Harding & Mazzotti, LLP, we have decades of experience fighting for those hurt or killed as a result of nursing home abuse and neglect. Call us and an experienced legal professional will review your case free of charge. Call today at 1-800-LAW-1010, 24 hours a day, 7 days a week. Helping you is what we do.℠
One sign of potentially serious negligence at a home that deserves special attention is bedsores. Also called pressure sores or decubitus ulcers, bedsores are a serious problem for bed-bound and wheelchair-bound patients, both at home and in assisted living facilities. Bedsores develop when the patient’s weight is on one area, especially a bony area, so long that blood to the area is cut off. This leads to damage and death of the affected tissues, causing deep sores that can reach into muscle and bone. Healthy people don’t develop these sores because they can simply change positions when they get uncomfortable, something that disabled people cannot do.
To find bedsores, families should look for any sores or discoloration of the skin in the areas where the patient is most often lying or sitting. In beginning stages, bedsores look like a reddening of the skin that does not disappear when the pressure is taken away. (This is more difficult to see on darker-skinned people, making it important for families of dark-skinned patients with mobility problems to stay aware.) Stage II bedsores look like blisters or scrapes. By Stage III and Stage IV, bedsores are ulcers that extend into the tissues below the skin, sometimes including muscle and bone. In some cases, dead skin cells or fluids from the wound may block the ulcer and make it difficult to tell exactly how deep it goes.
Bedsores are important to New York nursing home negligence lawyers because they are one of the most common results of neglect in residential care facilities. In 2004, a study by the Centers for Disease Control estimated that 11% of all nursing home patients had bedsores. Generally, caregivers should prevent bedsores by turning patients every two hours and being careful about how they position patients. They should also be aware of the medical conditions that make bedsores more likely, including diabetes, smoking and vascular disease. In fact, because pressure sores are easy to prevent, federal law cuts off Medicare funding for any facility that allows avoidable bedsores to form on a patient who did not have them when entering the facility.
Even a little negligence can cause or worsen bedsores:
- Failure to turn patients often enough
- Failure to check patients for bedsores often enough
- Failure to treat known bedsores or notify family and doctors
- Allowing the patient’s skin to have prolonged contact with moisture, for example, by failing to change soiled sheets
- Dehydration and malnutrition
Pressure sores are easy to prevent with proper care, but may be fatal if left untreated too long. In fact, according to research by the federal Agency for Healthcare Research and Quality, pressure sores send more than 503,000 people a year to the hospital. The same study found that one of every 25 hospital admissions for pressure sores ends in death. Because bedsores cause tissue to die, they create a breeding ground for bacteria that can lead to an infection, including life-threatening infections. Other serious complications of pressure sores include gangrene, anemia, kidney failure and amyloidosis, a potentially fatal disorder affecting the organs. Doctors can treat early-stage pressure sores without surgery, but for more serious sores, they typically must cut away the dead tissue and use skin grafts or pressure therapy to close the wound.
In addition to damaging patients’ bodies and inviting life-threatening complications, bedsores are very painful. In many cases, the patients cannot call for help because of the same disabilities that leave them dependent on caregivers in the first place. Caregivers who fail in their duty to provide this basic care are guilty of serious medical neglect, and families can and should hold them legally responsible.
After the fact, families can and should report abusive and neglectful homes to the New York State Department of Health, which has the power to punish wrongdoers and shut them down. However, in many cases, it’s too late to stop the harm. Nor can regulatory agencies compensate families for the emergency medical costs, time away from work and the cost of finding a more suitable home for the victims. To recover these costs and expose abusive and neglectful homes to the public, families may file a New York State nursing home negligence lawsuit. That’s true regardless of whether regulators choose to pursue criminal prosecution or professional sanctions against the home and its staff.
Martin, Harding & Mazzotti, LLP® is proud to represent victims of nursing home negligence and their families in these lawsuits. In addition to recovering all of the costs of the abuse, victims and their families can claim compensation for their physical injuries, emotional trauma and any wrongful death resulting from the abuse. To learn more about filing a legal claim against a negligent nursing home or assisted living facility, call the law firm of Martin, Harding & Mazzotti, LLP®, The Heavy Hitters® at 1800LAW1010® (1-800-529-1010).