Nursing homes are ubiquitous in the United States. According to recent statistics (May 2012) from the Centers for Disease Control and Prevention, there are 16,100 nursing homes in the United States, providing 1.7 million beds. The number of current residents is 1.5 million persons, accounting for an occupancy rate of 86 percent. The average length of admission for current residents is 835 days — more than two years. Medicaid programs have made nursing home care available to low-income seniors, further burgeoning nursing home populations.
Sadly, abuse in nursing homes is a common phenomenon, whether resulting from willful misbehavior or simple neglect. Such abuse strikes at one of the most vulnerable segments of society, and seniors in nursing homes often don’t have friends or relatives nearby who can monitor their care. If you have a loved one in nursing home care, it’s critical to make frequent visits; if you’re distant from the nursing home, then recruit someone locally to visit your loved one on your behalf.
Abuse in nursing homes can take many forms. The largest single cause of hospital visits by nursing home residents is injuries because of simple falls, accounting for 36 percent of all hospital visits. A typical nursing home experiences 100 to 200 falls each year, or more than one per resident; more than one third of these falls happen to residents who are incapable of walking. In a well-run nursing home, most falls are preventable. Nurses and other staff should be particularly attentive to residents moving around the facility, providing proper footwear and walking aids. Environmental hazards, which account for some 30 percent of falls, are entirely preventable; such hazards include incorrect bed height, poor lighting, and slippery floors.
Another common form of abuse in nursing homes is manifested in bed sores. Also known as pressure sores, these wounds are caused when there is unrelieved pressure on the skin, which can occur when a nursing home resident lies prone or sits in one position for long periods of time without moving. Bed sores most commonly appear in areas of the body where the bone and the skin are in close contact, such as elbows, hips, ankles, and heels. They are a sign that nursing home staff are not monitoring resident activity; it’s important for residents to change positions regularly, at least every two hours in bed and every fifteen minutes in a wheelchair. Staff should ensure that residents are not immobile for long periods of time, and should inspect residents’ skin on a regular basis.
More serious neglect can lead to dehydration and malnutrition. Nursing home residents may be physically unable to get their own drinks, or to voice concerns if they feel symptoms of dehydration. Likewise, residents suffering from dementia may lose interest in food; others may have dental problems, making eating difficult. Staffing shortages at nursing homes may make it difficult for your loved one to receive personal care during each meal, but nevertheless the staff must be responsible for ensuring that residents are eating (and drinking) properly.
Most nursing home residents are on medication; it occurs all too often, however, that overworked nurses administer incorrect medications or dosages, giving one resident a medication that was meant for another. Obviously, the ramifications can be serious, particularly as different medications interact and cause dangerous side effects. While incorrect medication is usually the result of simple error, there are also many cases of willful overmedication and chemical restraint of residents who are unable to control their own behavior. Physically restraining a resident with straps is illegal except as a last resort, so some staff, sometimes even encouraged by their supervisors, administer dangerous levels of unprescribed antipsychotics. Each years, as many as 15,000 nursing home residents die from excessive quantities of antipsychotics.
Unfortunately, abuse in nursing homes is sometimes direct and deliberate. Although sexual abuse of patients is not widespread, when it does occur, the victim is often unable to communicate with others, and repeated abuse can go undetected for weeks, months, and longer. The abuser can intimidate the victim by threatening to withhold food, medication, and other necessities. The physical, mental, and emotional trauma on the victim can eventually become life threatening. If you suspect sexual or other physical abuse, first, contact local law enforcement authorities to document your claim, and second, consult with a nursing home abuse lawyer, who can provide further advice on how best to proceed.
Any of the above scenarios, tragically, can lead to wrongful death. Malnutrition, infections from bed sores, wrong medications or excessive medications, and physical and sexual abuse can all become fatal circumstances for elderly patients already in weakened physical condition. If your loved one has passed away under what you believe are suspicious circumstances, or if you believe that the nursing home is not giving you a full picture, then speak with a lawyer. There is no way to undo the grief of losing a loved one, but a legal or criminal investigation may save the lives of other residents in the nursing home’s care, and may also result in compensation for the loved one’s family. Be sure to take action expeditiously.
Most nursing homes in the United States are professionally managed and take a genuine interest in the wellbeing of their residents. However, understaffing, underfunding, and other conditions may lead to a drop in standards, perhaps causing the nursing home to fill new staff positions with unqualified workers. Be sure to monitor your loved one’s day-to-day life at the nursing home carefully, to ensure that he or she does not become a victim of abuse.