Long-term care facilities like nursing homes are generally populated with older individuals and people with disabilities. Some residents have physical disabilities and decreased motor function while others are afflicted by mental disability or illness. Many residents suffer from both mental and physical limitations, making them especially vulnerable to illness or injury. Understandably, nursing home staff occasionally have to restrain nursing home residents in order to protect the resident from himself or herself. Things like bed rails or lap cushions can be used to ethically restrict a resident’s movement. Chemical restraints like sedatives may become necessary in extreme circumstances. Unfortunately, a new study shows that many nursing homes are dramatically over-using chemical restraints for nursing home residents with dementia.

Major Report Shows Extent of Chemical Restraint Abuse

The National Consumer Voice for Quality Long-Term Care recently presented its annual Public Service Award in recognition of the Human Rights Watch’s 2018 report “‘They Want Docile’: How Nursing Homes in the United States Overmedicate People with Dementia.” This report includes extensive data collected from over one hundred nursing homes regarding the misuse of antipsychotic medication like Risperdal, Seroquel, and Zyprexa in nursing homes. Medications such as these are designed to treat major mental illnesses like bipolar disorder and schizophrenia. However, these medications are being prescribed to elderly residents who do not have one of these disorders as a means of sedating them. Even worse, these antipsychotic medications have been found to nearly double the risk of death in elderly patients.

The report estimates that a staggering 179,000 nursing home residents are chemically-restrained with unnecessary antipsychotic drugs each week in the United States. Residents who were given antipsychotic drugs described the effects as “powerful.” One woman explained that the pills made her sleep all day while another said they made her a “zombie” with “no personality.” Experts say that the overuse of antipsychotic drugs can have devastating consequences to elderly individuals’ health and quality of life.

Staff members at a Long Island, New York nursing home may be facing jail time due to the death of a resident. In December of 2015, 81-year old nursing home resident Carmela Contrera became disconnected from her ventilator. The machine, which was literally keeping the elderly woman alive, is fixed with an alarm for exactly this purpose. The alarm is rigged to sound a warning signal whenever vital machines such as a ventilator become disconnected from the patient. However, nursing home staff claim the alarm never sounded. Contrera sadly passed away because no one came to reattach her ventilator. Now, prosecutors are saying that the alarm did in fact sound, but that the nursing home staff simply ignored the warning. Two registered nurses and one nursing aide have been charged with several counts of felony criminal negligent homicide as well as willful violation of health and safety laws.

Prosecution Says Nursing Home Workers Ignored Ventilator Alarm for Over Nine Minutes

Understandably, nursing home staff can quickly become busy and overwhelmed. Helping residents bathe and eat, dispensing medication, and transporting residents between areas of the nursing home can be a taxing job. However, nursing home staff have a legal obligation to care for residents to the best of their ability. When nursing home staff do things like overlook a fallen resident, skip administering a dose of medication, or in this case, ignore a medical alarm, they are being negligent. Tragically, nursing home abuse and neglect cause thousands of deaths a year.

Understaffing and Inadequate Maintenance May Have Contributed to Resident’s Death

Like hundreds of nursing home facilities across the country, the Long Island nursing home where Contrera died was understaffed. Many nursing homes struggle to afford enough staff members and other facilities skimp on staff training. The state attorney general’s office claims that inadequate staffing of the nursing home set employees up to fail and that Contrera’s death was a “foreseeable tragedy" which could have been prevented. Furthermore, the prosecution has found evidence that a respiratory therapist on staff had failed to adequately check that ventilators and alarms were working properly and instead falsified reports that the required inspection had been accomplished. If convicted, the three former staff members accused of causing Contreras’s death face up to seven years in prison.

Residents staying in a long-term care facility like a nursing home or assisted living center often have physical and mental challenges which make them especially vulnerable to environmental risks. Nursing home staff have a duty to provide clean and safe living spaces for residents. Unfortunately, issues like understaffing and budget cuts have led to some nursing home’s cutting corners when it comes to the safety of their residents. Nursing home abuse and neglect are sadly not rare occurrences. If you or someone you love has been injured or fallen ill due to an unsafe nursing home facility, please read on to learn what you can do to receive compensation.

Nursing Homes Must Meet Certain Criteria

Both state and federal laws require that nursing homes meet certain standards when it comes to cleanliness and safety. For example, showers and toilets should be fitted with grab bars so that residents with physical disabilities can safely maneuver in the bathroom. Kitchen areas should be cleaned and sanitized regularly, and precautions should be taken to avoid contaminating food. Unfortunately, these protocols are not always followed.

Environmental Risks Can Increase the Chance of Falls, Injuries, and Illnesses

Because the majority of nursing home residents have serious physical and/or mental disabilities, it is critical for their living environment to be as risk-free as possible. Things like hazardous chemicals, poor indoor air quality, unsafe living conditions, and poor food preparation hygiene can be life-threatening to someone whose body is already weakened by age or illness.

Illinois law dictates that individuals receiving treatment at a nursing home be free from abuse and neglect. Tragically, because of issues like understaffing and inadequate staff training, nursing home neglect and abuse continue to occur. Often nursing home abuse does not look like other forms of abuse. One way nursing home and assisted living residents are cruelly mistreated is with unreasonable restraint.

Most long-term care facilities have patients with cognitive or medical problems who may occasionally need to be restrained from moving. Unfortunately, many nursing homes are dramatically overusing both physical and chemical restraints. Residents can suffer physical injuries as well as emotional scars from unreasonable restraint. Unwarranted restraint is a major violation of the rights of the nursing home patient. If you or a loved one has been unreasonably restrained, you may be entitled to compensation.

Physical Restraints Without Justification is Abuse

Residents in a nursing home should be treated with compassion and given as much autonomy as safely possible. Unscrupulous or ignorant nursing home staff may use chemical and physical restraints as a means of keeping “high maintenance” residents subdued. Physical means of restraining residents include items such as straps, ties, bed guardrails, tightly-tucked sheets, and arm and hand restraints. Any type of physical force that restricts a resident’s movement is considered restraint as well. Physically restraining a patient should be reserved only for times a resident presents a risk to himself or others. If physical restraints are used excessively or in a way which causes a resident injury, this may be considered abuse.

The average, healthy person probably does not give much thought to the dangers of falling. This is rather understandable because a fall is not a very common thing for most people—at least those who are still fairly young. For a senior citizen or the resident of a nursing home, a fall can be absolutely devastating. The injuries sustained in a fall can be quite serious and even fatal. In fact, a recent report from the Centers for Disease Control and Prevention (CDC) reports that falls represent the leading cause of accidental death and injury for Americans aged 65 and older.

A Growing Segment of the Population

According to the CDC, older Americans suffered some 29 million falls in 2014. About 10 percent (2.8 million) of these falls required emergency medical treatment, and about 800,000 were hospitalized as a result of their falls. More than 27,000 falls eventually led to death. In 2016, about 3 million older adults required emergency care for falls, and nearly 30,000 victims died.

Considering that approximately 10,000 Americans reach age 65 every day, these numbers are expected to continue growing for the foreseeable future. “Older falls are increasing and, sadly, often herald the end of independence,” said Dr. Tom Frieden, Director of the CDC.

You have probably heard about the condition known as sepsis. Sepsis refers to a particular type of complication that can arise from an infection in a person’s body. Unfortunately, the kinds of infections that are at risk for sepsis are all too common among patients in hospitals and nursing homes. When sepsis is not treated properly, it can cause a host of problems for the patient, including death. If you have a loved one in a nursing home, it is important to know as much as you can about this dangerous condition.

What Is Sepsis?

Also called septicemia, sepsis occurs when certain chemicals are released into the bloodstream to fight an infection and those chemicals cause inflammatory responses throughout a person’s body. The inflammation can then lead to a chain reaction of events that could cause damage to vital organs, eventually shutting them down. If sepsis continues without treatment, the patient’s blood pressure could drop dramatically—a condition known as septic shock. Septic shock can be quickly fatal.

Failure to Diagnose or Treat Sepsis

When a person is inpatient at a hospital or is a resident of a nursing home, he or she should be under appropriate supervision. This means that they are to be monitored regularly for any signs of an infection or sepsis. Those who have recently had surgery or who have open wounds are generally at the highest risk for infection. It is up to the nursing staff to test often for infections, especially among residents who are at risk.

When you place a loved one in a nursing home, you have the right to expect that he or she will be treated with kindness, compassion, and most importantly, appropriate care. After all, the entire point of a nursing home is to provide a level of care that patients cannot easily receive at home. Unfortunately, the “nursing” part of many nursing homes around the country is at frighteningly low levels. In fact, a recent study found that a large majority of nursing homes in the United States fall below recommended federal guidelines in regard to nurse staffing.

Analyzing Staffing Levels

It can be confusing to read reports and studies that address nursing home staff shortages because measuring the care offered by a staff member is quite difficult. For this reason, staffing metrics are often broken down as time per patient per day. For example, if a nursing home has two registered nurses each working a ten-hour shift on a given day, the total nursing time would be 20 hours. If those nurses provided care for 20 residents, the staffing level for that day would be reported as one hour per resident day. If the nurses cared for 40 patients, the level would be 30 minutes per resident day.

In 2001, a federal study estimated that the clinical needs of nursing home patients can usually be met with between 0.55 and 0.75 registered nurse hours per resident day. The same analysis found that residents also need about 4.1 hours of direct care staff time. Direct care staff includes orderlies, nursing assistants, technicians, and other staff members who are not registered nurses.

A large majority of nursing home patients will spend the rest of their lives in such facilities. Patients like these often have physical or mental health conditions that make them unable to live at home or even in in assisted living facility. At the risk of being too blunt, this means that death is a part of everyday operations at the average nursing home in Illinois.

Most residents who die in nursing homes eventually succumb to their existing conditions. At a certain point, there is only so much that modern medicine can do as people age and become weaker. There are, however, far too many examples of nursing home residents who have died prematurely because of the actions or negligence of facility staff. Last month, the Illinois Department of Public Health (DPH) announced that it has fined two separate Illinois nursing homes over preventable patient deaths this year.

Lincoln Facility Fined $50,000

In January, a 64-year-old woman was involved in a car accident and was admitted to a nursing home in Lincoln, IL to receive treatment. An investigation by the DPH determined that the woman suffered from asthma and sleep apnea. She reportedly had been having trouble breathing for about three days, but the nursing staff did not notify her doctor until the third day—by which point her issue had become an emergency. The woman was given an inhaler, but she was found unresponsive the next day. State records show she died a few days later. The official cause of death was a Staph infection. The DPH fined the home $50,000 for failing to take timely action.

If you have an elderly loved one in a nursing home, you should know that while many nursing home staff have the residents’ best interest at heart, nursing home abuse and neglect is a sad reality. Sometimes it is due to maliciousness and other times, understaffing, poor staff communication, or inadequate staff training. Regardless of how or why it happens, nursing home abuse and neglect is unacceptable. It is up to friends and family of nursing home residents to be their advocates and watch out for signs of neglect or abuse. Physical abuse is usually easier to spot than emotional abuse. It is important, however, to learn about the main types of emotional abuse and how to notice if your loved one is being mistreated in a nursing home.

Purposely Demeaning or Humiliating Residents

Getting older and needing the around-the-clock-care that a nursing home provides can be an incredibly hard thing for some nursing home residents to accept. Many people who eventually need to relocate to a long-term care facility led vibrant, independent lives before being weakened by age, injury, or illness. This is why it is vital that nursing home staff treat residents with respect and dignity. Sadly, some staff may make fun of residents or mock them as amusement. Staff may be making what they think are private jokes among themselves at the resident’s expense, but the resident hears the ridicule. Unscrupulous staff may consider this behavior harmless, but in reality, mocking, jeering, and poking fun at residents in a type of emotional abuse.

Threatening a Resident

Admittedly, being a caretaker of elderly and sometimes cognitively-challenged nursing home residents is a challenging job. Sometimes residents refuse to eat meals, shower, or take their medicine. While this is understandably frustrating, staff resorting to making threats against a resident is deplorable and abusive. If you have a loved one in a nursing home who shows fear, apprehension, or suddenly becomes quiet around certain staff members, this may be a sign the staff is mistreating him or her.

It can be extremely disheartening to read about case after case of nursing home abuse and neglect. Some of the stories are mostly sad, while others are downright horrific. Even worse is the idea that only about one in 14 cases of elder abuse—including nursing home abuse—are actually reported. This means that the stories we hear about are just the tip of the proverbial iceberg.  

If you have a loved one who requires the type of care that is only offered in a nursing home, you may be wondering how you can prevent the unthinkable from happening to him or her. Fortunately, there are some things you can do to minimize the risks.

Do Your Homework

Perhaps the most important way to protect your loved one from abuse or neglect in a nursing home is to educate yourself on the quality of the homes that you are considering. Keep in mind that “educating yourself” means more than a cursory Google search or simply looking at how many stars a particular facility received. Recently, both the Department of Veterans Affairs and Medicare have been forced to take a new look at their respective quality rating systems, which means that it is difficult to trust even a full five-star rating.

Just weeks after news outlets exposed the often deplorable conditions in many nursing homes managed by the Department of Veterans Affairs, now a new story about inadequate nursing home conditions is making headlines. Medicare rates nursing homes on a five-star system, with five stars being the best and one star being the worst. Nursing homes' failures to keep the facilities adequately staffed with registered nurses or to provide records showing staffing information result in a lower score. Medicare just significantly reduced its quality ratings in 1,400 United States nursing homes because of concerns regarding staffing.

Governing Bodies Cannot Rely on Self-Reported Data from Nursing Homes

Medicare began gathering and disseminating statistics on nursing home care after the Affordable Care Act of 2010 (ACA) was instituted. Before the ACA required Medicare to keep tabs on nursing homes, the program relied solely on self-reported and unverified information from nursing homes. Unfortunately, it seems as if nursing homes were not entirely truthful about the number and quality of staff at their facilities. After Medicare received payroll archives from nursing homes, it became apparent that many facilities were critically understaffed.

Medicare Requires At Least One Nurse to Be on Duty

Payroll records reveal that many nursing homes do not have an adequate number of staff supervising and caring for residents. Medicare requires that at a minimum, one registered nurse must be available for at least eight hours a day in nursing home facilities. Nurses are the highest-trained caregivers involved directly in patient care at long-term care facilities and are an irreplaceable asset. In addition to helping nursing home residents with medical needs, nurses are also tasked with supervising other caregivers and aides. Many of the nursing homes which received lowered ratings were given the deduction because the facility did not meet the registered nurse requirement.

When you decide to place your loved one in a long-term care facility such as a nursing home, you trust that the staff employed in that facility have the residents’ best interest at heart. Unfortunately, just like in any other profession, some nursing home staff simply do not have their hearts in the job. Even worse, some nursing home staff actually openly ridicule or mock nursing home residents. Cruel treatment can tragically go undetected when patients suffer from debilitating illnesses and cannot report inappropriate staff behavior.

Hospice Workers Share Sick Video of Dying Woman

Three employees at an assisted living center in Georgia have been arrested after their cruel Snapchat video was discovered by authorities. The employees—three women aged 19-21—were watching over a resident who had recently suffered a stroke until the hospice nurse could arrive. During that time, they decided to create and share a video of themselves smoking a vape pen, making obscene gestures, and cursing–all while the elderly resident lay dying in the background. The shockingly callous and invasive video was titled “The End.” Local authorities charged the three young women with exploiting an elderly and disabled person, and all three have been fired from their positions at the assisted living facility.

The New York State Department of Health is also currently investigating a possible violation of residents’ rights by nursing home staff members’ use of Snapchat. The state received reports of staff members taking photos of residents in a Western New York nursing home and posting them on social media. The nursing home in question said that individuals involved were fired and that it will implement further staff training to prevent future violations.

While most of the “Greatest Generation” is gone, there are still thousands of military veterans who require the type of care that is only available in a nursing home. Our nation owes the brave men and women who have served a debt of gratitude, but it seems those who are in need of skilled nursing care are often not able to get it through the government agency that purports to protect veterans. Following a scathing report by USA Today and the Boston Globe, the House Veterans’ Affairs Committee announced this week that it plans to investigate the care being provided at the 133 nursing homes run by the Department of Veterans Affairs (VA) nationwide.

Troubling Numbers

Last month, an investigative report by USA Today and the Boston Globe revealed that many of the VA’s nursing homes were providing substandard care to their residents. The report also pulled back the proverbial curtain on the VA’s secret ratings and quality measures. The reports’ findings suggest that Department was happy to keep its quality indicators a secret because the numbers were not good. In fact, nearly half (60) of all VA nursing homes received just one star out of five for overall quality—using the VA’s own ranking system.

Other documents obtained by the news outlets showed that patients in over two-thirds of VA nursing homes were more likely to suffer from bedsores and pain than patients in private-sector facilities. Overall, the VA’s nursing homes scored poorly against private facilities in most key quality indicators, including patients’ decline in daily living skills and the rate of use of anti-psychotic medications.

Hardly a week goes by without another headline about the poor conditions or substandard care in nursing homes in Illinois and around the country. Staffing issues and a lack of resources often contribute to the problems, as nursing facilities often to struggle to care for their patients. There is, however, a particularly heinous issue that plagues many nursing homes: the problem of sexual abuse. While it may seem hard to believe, it is not unusual for sexual predators to victimize the most vulnerable members of our society.

Preying on Patients

It is almost unbelievable that any person would engage in acts of sexual abuse of a patient in a nursing home. Of course, that is exactly why abusers feel “safe.” In most cases where sexual abuse has been alleged, nursing home staff members, administrators, and even the believe were reluctant to believe the victims or their advocates. In other cases, the victims were simply unable to remember that they were abused or could not communicate their experiences to anyone else due to conditions such as Alzheimer’s or dementia.  

Sexual abuse in the context of a nursing home can take many forms, including:

Nursing home residents deserve to be treated with respect and dignity at all times. Sadly, some nursing home staff do not treat elderly or disabled residents as well as they should.

The warning signs of physical abuse are generally much more obvious than the signs of psychological or emotional abuse—especially for residents with cognitive issues like dementia. If you have a loved one in a nursing home, it is your responsibility to be vigilant for subtle signs of abuse or neglect.

What Does Emotional Abuse Look Like?

Many residents of nursing homes find that moving to the facility is a tremendously emotional event. For a person who has been autonomous their entire adult life to now need help using the bathroom or eating can be extremely disheartening. This is why it is so important for nursing home staff to do what they can to keep residents’ spirits up and treat them with respect. Nursing home staff who are overworked, under-trained, or have hateful attitudes toward residents may purposely do things to hurt residents. Examples of psychological or emotional abuse include, but are not limited to:

The arm of the federal government tasked with providing health care coverage to seniors and the disabled is taking aim at “boomerang hospitalizations” of nursing home residents. Medicare officials have begun taking steps to address high hospital readmission rates, especially for patients who already require skilled nursing care and will reportedly increase those efforts on the nursing home side by this fall.

What Is a Boomerang Hospitalization?

Many nursing home patients require acute medical attention in a hospital at some point during the stay at a nursing home. This is understandable, considering those in nursing homes are there because they are already dealing with fairly serious injuries, illnesses, and other conditions. The problem, however, seems to be beginning when patients are released from the hospital and sent back to their nursing homes. According to reports, 20 percent of Medicare patients who are discharged from a hospital to a nursing home are readmitted to the hospital within 30 days. This number is 27 percent higher for Medicare nursing home patients than for Medicare patients who do not require nursing home care.

The phenomenon of a quick readmission is called a “boomerang hospitalization” as a reference to the thrown hunting tool that returns to the thrower in midair. Experts suggest that government payment policies have inadvertently led to a pattern of back-and-forth transfers between hospitals and nursing homes for far too many patients.

You have probably heard many news stories of nursing home abuse and neglect. Individuals staying in nursing homes generally need a higher level of care than those at other types of facilities and are therefore more vulnerable to abuse and neglect. However, mistreatment does still happen at assisted living facilities, and it is just as unacceptable as mistreatment at nursing homes. If you or a loved one has suffered due to negligence or abuse while living in an assisted living facility, you may be able to sue for damages.

Residents May Be Afraid to Come Forward

Residents of an assisted living facility are usually slightly more independent than residents at a nursing home. They may only need limited assistance with daily living activities and are less likely to suffer from serious dementia or other memory or cognition issues. Even though they are more self-sufficient than nursing home residents, those living at an assisted living facility can still be taken advantage of and mistreated. Sometimes assisted living abuse and neglect goes unreported because the victim is afraid to speak up. Other times, residents fear that an abusive staff member will retaliate if they report the mistreatment. Other residents are simply unaware of what their rights are at an assisted living facility or put up with bad care because they do not realize they deserve better.

Examples of Assisted Living Abuse and Neglect

Assisted living abuse can occur not only between staff and residents, but also among residents themselves. In cases in which a resident is being abused by another resident, the assisted living staff have a responsibility to implement interventions to prevent future abuse incidents. Assisted living abuse can involve:

Did you know that laws exist to define and protect the rights guaranteed to people in a nursing home? The Illinois Nursing Home Care Act was created with the explicit purpose of protecting the sick and elderly from receiving less than adequate care while living in a skilled nursing facility. The statute confirms that nursing home residents have every right that all Illinois citizens have and cannot be denied any of those rights while staying in a nursing home. The Act also establishes more specific guidelines and boundaries to which Illinois nursing homes must adhere.

If you have a loved one who is currently residing in a nursing home, it is important to know and understand the rights that he or she has.

Residents Have the Right to Be Free from Neglect and Abuse

In general, nursing home residents have the right to be free from abuse or neglect. Additionally, nursing home residents have the right to:

Data shows that about 1.5 million individuals are living in nursing homes across the United States. As the “Baby Boomer” generation ages, more and more people will need the intensive care that nursing homes and assisted living facilities offer. It has never been more important for those with loved ones in nursing homes to hold the facility and staff within it responsible for their actions. Many nursing homes are understaffed or have staff members who have not been adequately trained. This can result in the residents receiving poor care and consequently worsened medical conditions. One way inadequate staff put residents at risk is through medication errors.

Fragile Health Means Medication Mistakes Can Be Deadly

Those who live in a nursing home are usually there because they have numerous medical conditions, are functionally impaired, have cognitive deficits such as dementia, and are currently on medication which requires supervision. For some residents, their health issues are purely physical, but approximately 70% of residents experience cognitive impairment which makes them unable to understand and remember everything which happens to them. The combination of serious medical issues and cognitive impairment can leave nursing home residents extremely vulnerable to mismanaged medication. In fact, needing help taking their required medications is one of the main reasons some individuals end up in nursing homes. Unfortunately, nursing home staff sometimes make errors with resident’s medication which can put them at risk of injury, illness, or even death.

Examples of Medication Errors That Put Residents at Risk

There are countless ways that nursing home staff can make mistakes when administering medication to residents. MEdciation errors which most frequently occur include:

Inadequate hygiene in nursing homes can be deadly to vulnerable residents. Poor hygiene is often the consequence of ineffectively trained staff members or facilities that have too high a resident to staff ratio. Other times, poor hygiene can be the result of staff who are not properly educated about safe health care practices.

Not Using Proper Hygiene Is Neglect

Elderly individuals or those with physical or mental disabilities in a nursing home deserve to be kept safe and clean. Some residents are not physically capable of doing hygiene tasks on their own while others have cognitive impairments which makes it hard for them to remember hygiene. Sadly, reports of nursing home residents left in soiled clothes, diapers, or beds are not uncommon. Nursing home residents deserve to be treated with dignity and respect and this includes cleanliness. Unsanitary conditions can increase the risk of infection, illness, and other medical conditions.

Staff May Take Unsafe Shortcuts When It Comes to Their Own Hygiene

When nursing home staff are not properly educated about caretaker hygiene, the results can be deadly. A staff member who does not wash his or her hands after helping a resident with bathroom-related tasks and then interacts with another resident can spread dangerous bacteria to the second resident. Most residents have compromised immune systems due to illness, injury, or old age and are especially susceptible to germs. When staff are not regularly cleaning common areas, kitchens, or bathrooms, the facility becomes a breeding ground for dangerous bacteria and viruses. This places residents in further unnecessary risk.