Articles Posted in Nursing Home Abuse/Neglect

Early one morning in late August, an 82-year-old woman wandered away from her Batesburg, SC, nursing home. She was found nearly eight hours later; fortunately, she was unharmed. If this incident had occurred during winter weather, or if she had wandered into the path of a vehicle, the outcome could have been tragic.

In elder care terminology, this nursing home resident “eloped.” The National Institute for Elopement Prevention and Resolution defines elopement as “when a patient wanders away, walks away, runs away, escapes, or otherwise leaves a care-giving facility or environment unsupervised, unnoticed, and/or prior to their scheduled discharge.” Another term sometimes used is “critical wandering.”

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In 1791, James Madison wrote the Bill of Rights to provide constitutional protection for individual liberties and prevent the abuse of governmental power. Nearly 200 years later, in 1987, the federal Nursing Home Reform Law was written to include the guarantee of certain rights to some of our country’s most vulnerable citizens — nursing home residents. All nursing homes which participate in Medicare or Medicaid must meet the requirements of this bill of rights. Additionally, some states – South Carolina included – have enacted state laws to protect the rights of residents of nursing homes, assisted living facilities and adult care homes.

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beatlesWhen I get older, losing my hair, many years from now
Will you still be sending me a valentine, birthday greetings, bottle of wine?
If I’d been out ’til quarter to three, would you lock the door?
Will you still need me, will you still feed me when I’m sixty-four?

This Beatles tune became familiar to most Baby Boomers back in 1967. Some may still be asking these questions, but others are more worried that in their later years their medical symptoms will be misread by their physicians, attributed to normal aging instead of disease or treatable conditions.

“If you believe that your family doctor or specialist is ready to successfully handle your increasingly complex health care needs as you age, you are very likely wrong,” writes Bruce Brittain, a geriatric care consultant. Geriatrics is the medical specialty focusing on the health care needs of “the elderly” (frequently defined as those over the age of 64). The Baby Boomer generation began turning 65 in 2011, a slow-motion explosion which Brittain warns will create “77 million cranky old sex addicts with multiple medical complaints, worn out body parts but less hair.” His characterization may be debatable, but his conclusion isn’t: “There won’t be nearly enough trained geriatricians–and I’m talking about a huge gap because the number of geriatricians is shrinking–to provide appropriate care. The end result will be millions of misdiagnoses, over-medication (already a troubling problem), unnecessary and expensive procedures (likewise) and a reduced quality of life for millions of Boomers who would otherwise do quite nicely with correct care.”

There are currently about 7,600 certified geriatricians in the United States, representing just 1.2% of physicians in the country. That’s somewhere around one for every 2,600 Americans age 75 and older, according to the American Geriatrics Society. Ideally, there should be one for every 300.

Question #1: Why don’t more doctors in training become specialists in this field where the number of patients is growing exponentially?

First, it is not an especially lucrative specialty. A geriatric physician can expect to make about $200,000 per year, while other specialists average $400,000. Medicare and private insurers have established reimbursement caps, so many general practitioners briskly churn through a large caseload each day to maximize their income. To properly diagnose an elderly patient who presents with multiple complaints, a physician needs to spend time questioning and listening, something that many health care professionals avoid because it cuts down on their billable opportunities. In America, doctors are rewarded for procedures, not conversations.

Second, the curriculum at most U.S. medical schools treats geriatrics as an elective, not a required field of training. And, according to the U.S. Department of Health and Human Services, out of the 145 medical schools in the U.S., only 11 have a geriatric department. In Great Britain, every medical school has a department of geriatrics, as do one half of Japanese medical schools.

Medical school curricula have been slow to adapt and offer specialized instruction in the diagnosis and treatment of the aged. Dr. Adam Gordon, a consultant and lecturer in geriatrics at England’s Nottingham University Hospital, said, “Most medical school curriculums evolved in the last century, when the type of medicine we practiced was very different. And the way to teach doctors of old was to teach them about the heart, lung and liver and hope that they’ll somehow learn to join up the dots.” Yikes!

Question #2: What’s so different about treating older patients?

Would you take your two-year-old to your own physician? More than likely you would seek the expertise of a pediatrician. Advocates for the elderly say that geriatric medicine is as different from routine medicine as pediatrics is.

To begin with, older patients are likely to have multiple chronic conditions that overlap. A doctor may be challenged to assess which condition is implicated by a newly reported symptom. Elderly people often have multiple underlying disorders, such as hypertension or diabetes, that increase the potential for harm if a complaint is misdiagnosed. Even when a proper diagnosis has been made, the appropriate treatment of an elderly patient is likely to be different because older bodies absorb drugs more slowly and respond differently to certain protocols than younger bodies.

General physicians may dismiss some symptoms, regarding them as normal signs of aging. Things like confusion, unsteadiness, muscle weakness or gait oddities may be assumed to be typical characteristics of the elderly rather than signs of depression, nutrition or hygiene problems, or a urinary tract infection. Certain diseases are much more common among the elderly (diastolic heart failure, Alzheimer’s disease, normal pressure hydrocephalus) and may be more readily recognized by a geriatric specialist.

Conversely, doctors should take into account the natural effects of aging and not mistake pure aging for disease. For example, slow information retrieval is not dementia.

If a rose is a rose is a rose, isn’t a doctor a doctor? In a word, no. Dr. Joseph G. Ouslander, Founding Director of the Boca Institute for Quality Aging in Boca Raton, Florida, said, “I’ve worked with some truly outstanding physicians during my career but I’ve seen cases where they poison or misdiagnose their elderly patients due to ignorance of geriatric medicine.”

Question #3: Are there any solutions to the problem of the shortage of geriatric specialists?

Actually, South Carolina established an innovative program to attract more doctors with specialized training in geriatric medicine to our state. In 2005, the South Carolina General Assembly approved the first Geriatric Loan Forgiveness Program in the country. It offers up to $35,000 per year in loan forgiveness for those receiving training in an accredited geriatric fellowship, in exchange for their establishing and maintaining a geriatric or geropsychiatric practice in South Carolina for five consecutive years immediately following completion of fellowship training. With the average medical resident carrying a debt of $170,000, according to the Association of American Medical Colleges, this is a powerful incentive. Since 2006, 23 physicians have received loan forgiveness awards to establish practices in South Carolina, increasing the number of geriatricians in the state by over 50%.

Navigating safely through our later years is a challenge, and that includes finding a physician who correctly diagnoses and treats the physical and mental afflictions encountered in those years – one who takes the time necessary and who has the training and skills required and who doesn’t misread us when we’re 64 . . . or 74 . . . or 84 . . .

If you or your elderly loved one has been the victim of medical negligence or misdiagnosis, contact the Louthian Law Firm at 1-888-440-3211. We will help you seek truth and find justice.

Columbia Hospital Injury

Bed rails are metal bars used on the sides of beds to keep sleeping people from rolling out onto the floor. They’re most often used by parents of small children or families and caregivers of the elderly. While they may help prevent a rude awakening, they can also inflict injuries and death when a person becomes entrapped or strangled by the device.

According to the Federal Drug Administration (FDA), there are about 2.5 million hospital and nursing home beds in use in the United States, many of which are equipped with bed rails, and hospital-type beds are also often used in residences where elderly patients receive home health care. Bed rails used in these situations are considered medical devices and are overseen by the FDA. The agency provides manufacturers of bed rails with guidance on the design of safe and effective hospital beds and bed rails and requires manufacturers to adhere to certain medical device regulations, such as the timely reporting to the FDA of problems associated with bedrails.

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An August 4 article in the New York Times brings to light the danger many nursing home patients face as a result of inadequate dental hygiene. It quotes Dr. Sarah J. Dirks, a San Antonio dentist who treats nursing home residents, who says that the lack of daily oral care in nursing facilities is “an epidemic that’s almost universally overlooked..

More nursing home residents require dental care than in the past, because more seniors are keeping their natural teeth due to advances in hygiene and fluoridation programs. But aides and other caregivers often fail to provide nursing home patients with dental assistance because of the many other needs of toileting, dressing, and eating which take precedence.
Poor dental hygiene can lead to a host of other physical problems, some of which can be especially dangerous in the elderly population. One such ailment is pneumonia. A study published in The Journal of the American Geriatrics Society found that about one in 10 cases of death from pneumonia in nursing homes could be prevented by improving oral hygiene. Untreated oral infections also increase the risk of diabetes mellitus, cardiovascular disease and respiratory disease, according to PrevMED Dental Case Management. Dental problems can cause weight loss and increased frailty, as well.

Brushing the teeth of residents who cannot do it themselves is such an important task that it was federally mandated in the Omnibus Budget Reconciliation Act of 1987, which set new standards for nursing homes. OBRA ’87 makes each nursing home directly responsible for providing both routine and emergency dental services.

Under federal law, facilities must help the resident make dental appointments and arrange transportation to and from dentists’ offices. They must promptly refer residents who have lost or damaged dentures to a dentist. Medicaid residents must be assisted to secure routine dental care to the extent covered by the state plan. Medicare residents may be charged extra for dental services, and the regulation clarifies that the facility is under no obligation to pay for routine dental services.

Dental care for nursing home residents in South Carolina is also covered by Regulation Number 61-17 of the Standards for Licensing Nursing Homes, promulgated by the Board of Health and Environmental Control. Section 1006 provides as follows:
(A) When a person is admitted to a nursing home, an oral assessment by a physician, dentist or registered nurse shall be conducted within two weeks to determine the consistency of diet which the resident can best manage and the condition of gums and teeth. A written report of this assessment shall be placed in the medical record.

(B) Each nursing home shall maintain names of dentists who can render emergency and other dental treatments. Residents shall be encouraged to utilize dental services of choice.

(C) Residents shall be assisted as necessary with daily dental care.

“I always say you can measure quality in a nursing home by looking in people’s mouths, because it’s one of the last things to be taken care of,” said Dr. Judith A. Jones, chairwoman of the department of general dentistry at Boston University, in the New York Times story. If you notice that a family member has decaying teeth, is not eating as much food, or is having trouble chewing, they might be suffering from severe dental problems. Ask the nursing home about what dental services are being provided.

Look for broken, loose or decayed teeth. Observe whether gums are inflamed or bleeding and whether food debris is found in the mouth. Listen for complaints of mouth pain or chewing problems. All of these could be signs of nursing home neglect and abuse.

Inadequate dental care for nursing home patients can lead to conditions just as painful and dangerous as bedsores. Our elderly loved ones deserve to have all of their bodily needs met, including care of their mouth and teeth. If you suspect that your family member has experienced dental neglect or any other form of nursing home abuse, contact the Louthian Law Firm today toll free at 888-662-0434 or locally at 803-454-1200. We are family owned and family focused.

A Pickens County nursing home is back in the news again – and not in a good way.

Thirty-six elderly patients at Majesty Health and Rehab in Easley were forced from their rooms in the middle of the night because of a gas leak.

Each year there are more than 20,000 complaints of elder care abuse in South Carolina retirement homes.

Individuals who are injured as a result of South Carolina nursing home negligence – and surviving family members if they are killed – may have a right to bring a lawsuit seeking financial compensation.

Following is a news report on the gas leak evacuation:
The Easley fire chief said the department responded to the Majesty Health and Rehab on Ann Drive after someone smelled gas.

News 4 was told that 36 patients were evacuated to another part of the building, but they did not have to go outside.

The chief said firefighters found a couple of leaks in the kitchen, and at that point, the gas was cut off and the area was ventilated.

The nursing home called a private contractor to test all the lines and make necessary repairs, according to the chief.

Last summer, Majesty Health and Rehab made headlines after an 84-year-old woman died when the facility’s air conditioning system broke down.

The state Department of Health and Environmental Control investigated and found “substandard quality of care and/or immediate jeopardy.” The cause of death was over-medication and overheating. DHEC cited Majesty Health and Rehab for “failure of facility to take action to ensure residents were provided a comfortable and safe environment..

The victim’s family has hired an attorney and is in the process of filing a South Carolina nursing home negligence lawsuit against Majesty Health and Rehab.

People who have a loved one in a nursing or retirement home should be alert for signs of potential nursing home abuse, including sudden swings in patient health, complaints from other patients of mistreatment, emotional agitation, or a refusal of staff to allow you to be alone with your loved one.

Source: WYFF-TV News 4 Greenville

Too many U.S. nursing homes are using dangerously strong antipsychotic drugs to keep patients with dementia drugged, according to the U.S. Centers for Medicare and Medicaid Services (CMS). In fact, 2010 data shows that 17 percent of nursing home patients had daily doses above recommended levels.

Claire Curry, a consumer advocate, said, “The drugging of nursing home residents has long been a national disgrace..

To help curb the misuse of drugs in nursing homes and elder care facilities, CMS announced that it’s beginning a Partnership to Improve Dementia Care, which will include efforts to eliminate drug misuse for dementia patients. Officials say they hope the program will help reduce the use of antipsychotic drugs by 15 percent before the end of 2012.

As advocates like Claire Curry point out, improper and potentially dangerous misuse of drugs is a problem that affects hundreds of thousands of nursing home and long-term care patients. In the case of antipsychotic drugs, the drugs themselves even come with so-called “black box” warnings from the Food and Drug Administration, stating that the drugs can cause the death of patients with dementia.

Dr. Shari Ling, CMS deputy chief medical officer, has said that the use of powerful antipsychotic drugs among nursing home patients has grown in recent years–much of it among patients with dementia. This is particularly dangerous because, as Ling points out, dementia patients often cannot communicate their needs.

The government efforts to reduce drug misuse among elderly patients or those with dementia in nursing homes will include training for nursing home staff focused on care standards, making information about antipsychotics more available to nursing homes, and recommendations for alternatives to drugs. Those alternatives include things like outdoor activity, exercise and pain management therapy.

Whether these efforts will actually reduce improper prescriptions remains to be seen. The Food and Drug Administration has been warning doctors and caregivers against prescribing antipsychotic drugs to the elderly–especially those with dementia–since 2005. In a 2011 report, government researchers warned that improper use of the potentially dangerous drugs would probably continue, as alternative therapies and policies cost too much for many nursing homes to actually use.

About The Louthian Law Firm
The Louthian Law Firm, P.A., of Columbia, S.C., has been obtaining fair compensation for personal injury victims since 1959. The firm was founded by Herbert Louthian, who has more than 50 years of trial experience and is licensed to practice in all courts in South Carolina. The Louthian Law Firm focuses on personal injury cases involving nursing home abuse; medical malpractice; car, truck and motorcycle accidents; and other serious and catastrophic injuries throughout South Carolina. For a free, confidential case evaluation, contact the firm by phone at 888-662-9820 or through its online form.

Columbia, S.C., March 01, 2012 – Reacting to a Charleston TV station’s recent report, South Carolina nursing home abuse attorney Bert Louthian said today that the state’s nursing homes should alert residents and their families when a registered sex offender moves into the facility.

Louthian also said that nursing home operators need to take more steps to guard against sexual abuse in long-term care facilities.

“Sexual abuse in nursing homes poses a grave threat to residents,” Louthian said. “Placing known sex offenders in a facility without issuing alerts or installing safeguards increases the risk that a resident will become a victim of nursing home sexual abuse..

Louthian’s Columbia personal injury law firm, The Louthian Law Firm, P.A., represents nursing home abuse and neglect victims across South Carolina.

He was reacting to report on Charleston’s WCSC Live 5 News. The report revealed that at least three registered sex offenders are living in Charleston area nursing homes.

There is no state law requiring facility managers to notify residents and their families or guardians about their presence. According to the report, the only way to find out if a sex offender resides at a long-term care facility is to check the address on South Carolina’s sex offender registry.

That’s not enough, Louthian said.

“To better protect residents from sexual predators, nursing home operators need to provide active, written notifications before a sex offender arrives at the facility,” he said.

“If a sex offender is placed at a home, management must install adequate security measures to keep other residents safe from any potential abuse threat,” he said.

According to A Perfect Cause, an Oklahoma-based nursing home safety advocacy group, there are more than 2,000 sex offenders living in nursing homes across the country.

The group told WCSC Live 5 News that it has documented more than 80 instances where sex offenders have committed rape, assault and murder while residing in U.S. long-term care facilities.

“It’s not a question of if; it’s already happened. The only question is when it’s going to happen again,” Wes Bledsoe, the founder of A Perfect Cause, told the TV station, referring to the likelihood of a nursing home resident falling victim to a sex offender.

A Perfect Cause makes these recommendations for decreasing the threat of nursing home sexual abuse:

  • Establish separate and secure long-term care facilities for violent and sexual offenders.
  • Post conspicuous notification if offenders are residing in facilities
  • Require criminal background checks for all residents.
  • Install video and radio frequency monitoring systems.
  • Hire onsite security personnel.
  • Provide basic state or federal correctional training for all staff.
  • Develop an offender management and re-entry program.
  • Track all criminal acts in long-term care facilities and the assailants who commit these acts.

Louthian, a South Carolina elder abuse attorney, said it is important for residents and family members to report sexual abuse in nursing homes.

In addition to pressing criminal charges against the perpetrator, the victim may be entitled to recover money damages in an elder abuse lawsuit against the nursing home if it failed in its duty to protect residents, Louthian said.

“If an elder loved one has suffered sexual or other forms of abuse or neglect at a South Carolina nursing home, they or their family should talk to a qualified Columbia elder abuse attorney to find out their legal options,” Louthian said.

About The Louthian Law Firm, P.A.
The Louthian Law Firm, P.A., of Columbia, S.C., has been obtaining fair compensation for personal injury victims since 1959. The firm was founded by Herbert Louthian, who has more than 50 years of trial experience and is licensed to practice in all courts in South Carolina. In addition to nursing home abuse claims,the Louthian Law Firm also handles personal injury cases involving medical malpractice; car, truck and motorcycle accidents; and other serious and catastrophic injuries throughout South Carolina. For a free, confidential case evaluation, contact the firm by phone at (866) 410-5656 or through its online contact form.

The family of an elderly woman suffering from Alzheimer’s, dementia, Parkinson’s disease and several other conditions, received $91.5 million in damages from a Charleston, West Virginia nursing home. The elderly woman was a patient for just three weeks at Heartland of Charleston nursing home where the workers failed to feed and care for her leading to her death just one day after transferring to another facility.
The lawsuit alleged that while living with her son, the woman’s health had improved to where she could walk, speak and recognize family members. However, when she was checked into Heartland the staff confined the woman to a wheelchair, labeling her a fall risk.
The family’s lawyer argued that Heartland did not have enough staff to properly care for the woman and the other patients. Some former Heartland workers testified properly caring for all of the residents was impossible.
Heartland of Charleston is owned by ManorCare Inc, the parent company named in the lawsuit.
Many experts estimate nursing home patient neglect or abuse is grossly underreported. If you or someone you care about has been the victim of nursing home abuse or neglect, contact a qualified nursing home injury attorney at Louthian Law Firm today. Call toll free at (866) 454-1200 or use our online contact form for a free evaluation of your case.

Nursing Home Neglect