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.

In nursing-home neglect and abuse cases, the victims of the nursing-home negligence or abuse often suffer from some form of dementia, including Alzheimer’s, which is a specific type of dementia that accounts for 60 to 80 percent of dementia cases.

Alzheimer’s is a progressing disease. That means that it worsens over time, causing cognitive and behavioral problems. For example, cognitively, a person may have difficulty thinking and trouble understanding. They may also experience forgetfulness, confusion, and disorientation. And behaviorally, a person may exhibit irritability, agitation, lack of restraint, and difficulty with self care.

Behavioral Changes

For many, the behavioral changes present the most challenging and distressing symptoms from Alzheimer’s. The symptoms stem from a progressive brain-cell deterioration. Importantly, they may become worse through medication, environmental influences, and some medical conditions.

Environmental Triggers for Behavior Changes

Beyond the physiological reason for the behavior symptoms, changes in a person’s surroundings also often play a role in triggering those symptoms.

When I interview family members and nursing-home nurses in preparation for litigating a nursing-home negligence or abuse case, they often describe events or changes in the person’s surroundings that have created additional stress that can be difficult for an Alzheimer’s patient to manage. Some of those events and changes include:

  • Moving to a new residence, nursing home or new room within a nursing home;
  • Changes in a familiar environment or caregiver arrangements;
  • Misperceived threats;
  • Admission to a hospital; or,
  • Being asked to bathe or change clothes.

So, while the patient is trying to make sense out of an increasingly confusing world, those environmental factors increase the patient’s fear and fatigue while exacerbating the patient’s exiting irritability, agitation, lack of restraint, and difficulty with self care.

Standard of Care for Nursing Homes

Nursing homes and the nursing-home corporations that operate them know, and have reason to know, that environmental changes place the Alzheimer’s or dementia patient at greater risk of experiencing a serious nursing-home injury.

When I depose a Director of Nursing in a nursing-home neglect and abuse case, the nursing director admits and acknowledges the serious risk of injury that Alzheimer’s patients face while in the nursing-home facility. Also, the nursing director admits that the nursing-home corporation and its nursing staff must provide those patients with treatment and services that meet a specific standard of care.

The standard of care requires that the nursing home develop an individualized care plan to promote the patient’s health, protect the patient’s safety, and secure the patient’s dignity. The nursing-home staff must implement the treatment and care, from the care plan, on a daily basis—without fail. And then, the nursing home must evaluate that treatment and care to ensure its effectiveness and make changes to the plan when appropriate.

Nursing Home Negligence and Abuse

When a nursing-home corporation and its nursing-home staff follow the required standard of care, the nursing home can prevent the patient from experiencing preventable catastrophic falls, avoidable pressure ulcers, and other serious injuries.

If the nursing-home corporation and the nursing-home staff fail to follow the required standard of care, then the patient may experience serious physical injury, and the nursing-home corporation is responsible for the harms and damages that follow. If you or someone you know has been involved in a nursing home negligence incident it is recommended that you consult with an attorney immediately to discuss your rights.

Placing someone in a long-term care facility is a very difficult decision to make. Many times, this decision is not due to physical limitations, but mental ones. Older folks who suffer from dementia or Alzheimer’s may be physically mobile, but due to cognitive issues, they require 24-hour supervision. They may forget where they are, get lost driving, forget to eat and drink or take their medications.

A new report was released by the Institute of Medicine and reported by ABC News and study co-sponsor AARP. The study examined the aging process and the brain. Not surprisingly, AARP found that staying mentally sharp was a top concern for its members.

The study recommended many things, including:

  • Avoid isolation and keep socially active;
  • Avoid excessive alcohol consumption;
  • Get a good night’s sleep;
  • Be physically active;
  • Participate in the arts; and,
  • Maintain a healthy diet.

You can read the articles by ABC News (click here) and AARP (click here). Download the full report for free from the Institute of Medicine by clicking here.

Many times I meet with families who were not told about medication changes or what a resident was prescribed.  It is easy to know what a resident is prescribed.  There is a document called a Medication Administration Record.  Nursing home staff refer to this document as a MAR.  It lists what a person is prescribed, what dosage, and when and how gave the medication.

This information is important to know for many reasons, one of which was recently highlighted in an excellent article in the LA Times.  A new study reported on in the LA Times showed the use of certain medications for anxiety and sleep increase risk of Alzheimer’s.   Unfortunately, the medications – the class called benzodiazepines that includes Xanax, Ativan, Valium, and Klonopin – are common prescribed in nursing homes.

The study indicated that those who took high doses for short periods of time, or lower doses, did not show problems.  It seems as though the problems are for those who took long-acting or high doses over several months.  You can read the full article here.