A caregiver may face the overwhelming decision to place a loved one in a nursing home after a sudden event such as a fall or a stroke. Sometimes, there is more time to prepare, as in cases where the loved one suffers from a chronic or debilitating disease, including diseases where the patient is expected to deteriorate over time.

Once a loved one is safely tucked into a nursing home bed, a caregiver may feel a sense of relief. However, nursing home staff members are notoriously overburdened with the everyday tasks involved in caring for their elderly patients. Nonetheless, it is the responsibility of nursing home staff and management to ensure that each resident receives the care he or she needs.

Continue Reading What Are the Signs of Nursing Home Neglect?

When a loved one moves into a nursing home, staff members have a duty to continually provide the resident with the appropriate level of nursing care, medical care and personal attention.

Nursing home staff members are responsible for the residents’ well-being and are required to report all signs of abuse or neglect, including those arising from resident-to-resident interactions.

One form of abuse or neglect that may be overlooked by staff members is senior bullying. Continue Reading Is My Elderly Parent Being Bullied?

Just this week the New Jersey Attorney General, Christopher Porrino, and the Division of Consumer Affairs announced an exciting new program to protect individuals from the abuses of home healthcare providers. It is called the Safe Care Cam program and the purpose of the program is to provide micro-surveillance cameras for free 30 day loans to families that suspect an in-home care giver is abusing or neglecting their loved one.

Continue Reading NJ Attorney General Introduces New Program to Protect Residents from Abuse

Special kudos to the Reading Eagle on its recent series on nursing homes – in particular the editorial We Must Demand Better from Nursing Homes, Regulators, published on December 11, 2016. For those of us who work hard to hold nursing home corporations accountable when seniors are neglected, abused, seriously injured, or die, this series of articles is a vindication.

Continue Reading Newspaper Highlights Problems with PA Nursing Homes

In our practice, we represent individuals, who are often diagnosed with Alzheimer’s and dementia, and their families. It is not uncommon for individuals with Alzheimer’s and dementia suffer from poor safety awareness and poor decision making. This can lead to devastating results and injuries if a nursing home does not properly care for the resident’s individual needs and safety. Due to the debilitating nature of Alzheimer’s and dementia, researchers have been studying the disease and there appears to be some good news on the horizon.

A November 21, 2016, article by Liz Szabo posted on CNN.com discussed how a recently published study showed that dementia rates have fallen nearly 24% from 2000 to 2012. The significant rate of decline is attributed to Americans’ rising educational levels and better heart health.

The study, which was published in JAMA Internal Medicine, began in 1992 and focused on people over 50 years old. The researchers collected data from the participants every two years. The data included interviews, physical tests, body measurements, blood samples, and saliva samples.

Researchers are not certain why dementia rates are declining, but the evidence is mounting that higher education and better heart health are related to the decline.

This is promising news because currently, according to Alzheimer’s Association of America, as many as 5.1 million Americans suffer from Alzheimer’s disease and dementia. It is also estimated that a half million Americans under 65 have some form of dementia.

Urinary Tract Infections (UTI) can be a serious problem for the elderly in nursing homes. Those afflicted with UTIs can have delusions, dementia-like symptoms, and will feel the urge to urinate all the time. This can be a recipe for disaster for a person that requires help to get to the bathroom. Many serious and fatal falls occur because residents with UTIs will constantly feel like they need to get to the bathroom, forget to use the call bell, and will get up on their own.

Additionally, if UTIs are not treated they can lead to sepsis and death.

One of the historically typical and easiest solutions to avoid UTIs was to just drink cranberry juice. Unfortunately, a new study published in the Journal of the American Medical Association and reported by KFOR places this common wisdom into doubt.

Although drinking cranberry juice was not discouraged, the study showed taking cranberry capsules (pills with cranberry extract) had a “limited potential effect.”

Families know their loved ones best, and many times it is families that diagnose UTIs and not a facility. Watch for signs of increased urination, delusions or odd behavior, fever, or general lethargy. With quick treatment, most UTIs clear up, but if they go untreated they can be lethal.

I’ve written before about how important it is to know what prescription medications are being administered in nursing homes and long term rehab facilities. Many do not have good efficacy, may be dangerous, or may cause problems when mixed with other medications. A new study indicates it is now also important to find out what over the counter (OTC) medications are being given.

The study, reported in the Observer, showed a link between certain medications in the class called anticholinergics and cognitive impairment in the elderly. OTC medications in this class include Dimetapp, Dramamine, Benadryl, and Unisom. This class of medications also includes the prescription medications Toviaz, Paxil and Seroquel. In the study, people using these types of medicines exhibited reduced brain function and increased brain atrophy. Specifically, the study showed that use of these meds affected immediate memory recall and cognition, and may also induce cell death.

Continue Reading New Study Shows Common Medications Cause Cognitive Problems in Elderly

Often, many of the problems that occur in nursing homes are a direct result of terribly insufficient staffing. This knowledge is born out in studies that show a direct correlation between staffing ratios and quality of care.

Despite all of this clear evidence, many facilities only meet the bare minimum hours required under state regulation. Some aides have told me the ratio on their day shift at a nursing home was as high as 1 aide to 14 residents. For those unaware, aides are the people who feed, bathe, and transfer residents, and they are also responsible turning and repositioning any residents who are at risk for developing bed sores. Having only 1 person in charge of caring for 14 patients at the same time is a catastrophe waiting to happen.

Continue Reading New Jersey Looks to Improve Staffing Ratios

Often, elderly people are prescribed blood thinners, otherwise known as anti-coagulants, like Coumadin and several others. While these drugs can significantly help with conditions such as DVTs (deep vein thrombosis) and strokes, they also present unanticipated dangers. If you have a loved one who is on one of these medications, it is important to know the dangers that can occur with their regular use.

It shouldn’t be much of a surprise to learn that the number one issue safety issue for the elderly is the risk of falling. When the elderly fall, it can be very dangerous for two primary reasons. First, they can suffer bone fractures, most particularly to the hip. Hip fractures lead to immobility and many times death as a result. Second, if there is a head trauma, there can be internal bleeding in the brain. This is called either a subdural hematoma or epidural hematoma, depending on where the blood is pooling in the skull.

Continue Reading The Lurking Dangers of Blood Thinners in Nursing Homes

CMS is currently considering whether or not to ban pre-dispute arbitration documents from nursing home admission contracts. The patient or their family members must sign home admission contracts before they can be admitted, and these contracts are often lengthy and complex. Unfortunately, sometimes these contracts contain a pre-dispute arbitration document, and if the patient signs off on that contract, they will be unable to take a case to court if something terrible happens.

Instead, this document means that they will have to go to private closed-door arbitrations, where families generally have to pay arbitrators large sums of money, and arbitrators are not obligated to follow any of the typical laws and rules of the court.

A recent McKnight’s Long-Term Care News article describes one case in which a nursing home resident died, and an autopsy revealed that she had over 20 times the proper amount of diabetes medication in her blood. After the family was forced into arbitration, the arbitrator ruled in favor of the facility.

A recent article by The New York Times also chronicles how arbitration has been used and abused by businesses and nursing homes to shirk any responsibility to their patients, employees or customers.

If you think inserting pre-dispute arbitration documents into admissions contracts are a bad idea, you’re not alone. 34 U.S. Senators and 15 attorney generals signed a letter banning the practice in nursing homes.

Write your congressperson and ask them to tell CMS to get rid of these unjust documents. Hopefully, the Centers for Medicare and Medicaid Services will end this abusive practice soon.