Tuesday, August 4, 2015

Nursing Home Abuse



The news media has brought national attention to the issue of abuse and neglect in nursing homes around the county with horrific stories and case studies. The following outlines some important information to keep loved ones safe in nursing home environments.

Risk Factors and Victim’s Rights   

The administration and staff at nursing homes are entrusted to care for the health, welfare and safety of the residents but are often the perpetrators of abuse.  It’s important to remember though that abuse can come from many different places including other residents, visiting family members and even strangers that enter unsecured facilities.

The physical and mental frailty of many nursing home residents increases their vulnerability and lessens the chance that abuse will be reported and remedied. Patients suffering from dementia, other impaired cognitive functioning and high degrees of dependence can leave victims particularly vulnerable and are often seen as the highest risk for victimization.

Further, several studies have shown that poor staffing and institutional indifference create conditions for abuse. Assessing risk factors associated with abuse are often an important step in the investigative process.

Does the facility have any abuse prevention policies in place?
What is the level of staff training and what are the staff background screening procedures?
What is the staff to patient ratio and are there high staff turnover rates?
What is the facility’s history of deficiencies and complaints?  
What is the physical layout of the facility?

In addition, the quality of a resident’s relationships with family and their caregivers should also be given consideration. Residents who do not receive visits often may be more vulnerable because there no one from outside the facility to regularly check on their care. However, in some situations, over-zealous family members may actually impede the provision of care. Similarly, the risk rises if resident-staff interaction includes past conflicts, or there is little time available to develop personal relationships.

When abuse and neglect occur at a facility, even if staff are not the accused, the facility can still be held liable for the harm for reasons including the following: negligence in the provision of care, the supervision of residents and employees, the hiring of staff, and the maintenance of premises and equipment.

Nursing home residents are provided a number of legal rights found both in federal and state laws in addition to the basic right to be protected from abuse. These typically include rights to privacy and confidentiality, choices in treatment and care, clear and accessible grievance procedures, and equal treatment by facility staff.

Types of Abuse Patients Have Reported

Abuse and neglect can take many forms within a nursing home facility; forced feeding, over or improper medicating, neglecting the basic needs of a resident such as feeding, clothing and bathing along with the following which have been the most frequently reported in nursing home abuse cases.

Emotionally threatening a resident – A resident can feel threatened directly or indirectly.  These allegations usually focus on staff using demeaning and cruel language or threatening harm to a resident, often when it’s perceived the resident is not being compliant with demands.

Residents can also witness the mistreatment of other residents and observe that no one is stopping this from occurring.  They learn from these situations that they have no control over their situation and must keep silent to prevent themselves from being a target.  Residents may be of assistance when checking for witnesses of abuse but are often reticent to talk.

Physically injuring a resident-- There are many ways that a resident can be physically injured while in a nursing home. In addition to intentional physical abuse, dropping or mishandling a resident as well as forced manipulation of the person while standing, bathing or feeding have all been reported.  Elderly residents have added complications due to age and disease. Bones become more brittle with age and are easily broken. Failing to take extra care while handling a person can cause the skin to be damaged making sometimes the most routine activities a cause for caution.
  
Failing to turn patients who are bed ridden can lead to bed sores which can become infected and quite painful for a resident.  While bed sores can be a common ailment among those confined to their beds, more often they are the result of neglect and reports of serious bed sores (also reported as decubitus ulcers) are quite common in reports to adult protective services and other investigators. 

Sexually abusing a resident -- Residents who have developmental disabilities, physically unable to speak or unable to defend themselves may become a victim of sexual abuse. Sexual abuse may come from a staff member, another patient, a family member or a complete stranger. Even when it comes from a staff member, other employees are often too busy to notice unusual signs or they may neglect to report the incident out of fear.  Many times, with residents who may be nonverbal, it’s a series or infections or unexplained sexually transmitted disease that becomes the first indicator that a sexual assault has occurred.

Conclusion 
As our population ages and more find themselves having to use the assistance of nursing home care, the rates of abuse in nursing homes will continue to increase. Understanding the complex nature of abuse in nursing homes, the systems in place to protect nursing home residents and knowing the resources available, including hiring experienced private investigators to do surveillance and other investigative work, can go a long way in protecting those in nursing home settings.