California Nursing Home Abuse Lawyer Blog

Many older adults who experience depression may see their risks for developing Alzheimer’s and dementia increase, according to a recent article in the New York Times. This is a serious issue for patients in nursing homes and other elder care facilities. While elder abuse and neglect can take many forms, the failure to provide for a patient’s mental needs, such as depression, may constitute neglect.

Statistics on Depression and Alzheimer’s Disease

The New York Times article reported that current research suggests that “late-life depression” has not only led to increased risks for “social isolation, poorer health, and an increased risk of death,” but it also may lead to Alzheimer’s disease and other forms of vascular dementia. With an increasingly large population of older adults, these facts are concerning.

In fact, according to research published in the British Journal of Psychiatry, depressed older adults aged 50+ “were more than twice as likely to develop vascular dementia and 65 percent more likely to develop Alzheimer’s disease” than other similarly aged adults who didn’t suffer from depression. These numbers are the result of a study that included nearly 50,000 older adults over an approximately five-year span.

What do the numbers mean in terms of how many people will develop dementia? The numbers suggest that “36 of every 50 older adults with late-life depression may go on to develop vascular dementia,” and “31 of every 50 seniors with a history of depression may eventually be diagnosed with Alzheimer’s.”

This news shouldn’t come as a complete shock, since a 2012 study in General Psychiatry reported similar findings. In that study, researchers at the University of California at San Francisco found that people with depression during the ages of 40 to 55 seem to have an increased risk of developing dementia by about 20 percent, while those who suffer from depression at age 55+ appear to increase their risk of developing dementia by about 70 percent. For adults who suffered from depression in both midlife and late-life stages, their risk of developing dementia was reported to increase by nearly 80 percent, compared with others who showed no signs of depression.

These numbers all seem staggering. Should nursing homes and other elder care facilities be more attuned to depression and its dangerous effects?

Does Depression Cause Alzheimer’s?

The British Journal of Psychiatry study emphasized that there is no causal relationship between depression and dementia, and that there’s “no solid evidence yet” that treating depression early on can reduce your risk of developing Alzheimer’s disease later in life.

However, while the researchers emphasized that they can’t say for certain that late-life depression is a direct cause of Alzheimer’s and vascular dementia, they can certainly say that it’s a factor that contributes to these diseases. In fact, Meryl Butters, an associate professor of psychiatry at the University of Pittsburgh School of Medicine, said that “depression is toxic to the brain, and if you’re walking around with some mild brain damage, it will add to the degenerative process.” In short, increasing the quality of life for older adults can be beneficial to their long-term physical and mental health.

In particular, these findings suggest that mental health care for older persons in nursing homes and assisted living facilities can be extremely important. If you suspect that a parent or elderly loved one has been the victim of elder neglect, an experienced nursing home attorney can discuss your case with you today.

See Related Blog Posts:
Dementia Cases and Costs to Drastically Increase in Coming Decades
Administrators Must Now be Wary of Criminal Charges for Acts Under Their Watch

A recent article in the New York Times discussed certain dangers that can await Parkinson’s patients when they’re admitted to hospitals. These patients require specific medications at certain times, and general hospital staff members aren’t educated about the needs that these patients have. As a result, Parkinson’s patients can be the victims of serious medication errors, and they can undergo severe side effects from seemingly routine hospital visits.

If an elderly parent or loved one has been mistreated while in the hospital, an experienced elder justice advocate can discuss the details of your case with you today.

Dangerous Consequences of Medication Errors

The New York Times provided an example of a specific Parkinson’s patient whose medication needs weren’t fulfilled while in the hospital for what was supposed to be “a short stay.” Roger Anderson, who has Parkinson’s, was supposed to have surgery “to relieve a painfully compressed spinal disk.” Anderson and his wife assumed the staff at the hospital in Portland, Oregon would know how to care for him.

Because he has Parkinson’s, Anderson must take certain medications “at precise intervals to replace the brain chemical dopamine, which is diminished by the disease.” His wife emphasized that there isn’t “much of a window” in administering these medications. She explained that, “if you have to wait an hour, you have tremendous problems.” When Parkinson’s patients don’t receive these drugs, they can “freeze” or be unable to move. In addition, they may develop “uncontrolled movements called dyskinesia,” and they can be more “prone to falls.”

However, the Portland hospital staff didn’t understand the severity of the situation, and the hospital rules prevented Anderson’s wife from administering these medications to her husband. As a result, serious medication errors occurred. With his disrupted medication schedule, combined with the stress of surgery, anesthesia, and a wound that became infected after surgery, Anderson was forced to stay in healthcare facilities for nearly three months. In fact, he developed delirium, had a fall, and ultimately lost 60 pounds. He managed to recover and return home, but his disease has since progressed, according to his wife. Unfortunately, Anderson’s experience seems to be the norm.

Are All Parkinson’s Patients At Risk During Routine Hospital Visits?

According to the National Institute of Health (NIH), older people with Parkinson’s tend to be hospitalized more frequently than other people their age, and often their hospital stays last longer, too. While all elder persons are going to face more dangers during routine hospital stays, neurologists believe that people with Parkinson’s tend to have “particularly hazardous” experiences in hospitals. Dr. Michael Okun, a neurologist at the University of Florida and the national medical director for the National Parkinson Foundation, explained that Parkinson’s is typically a disease that affects older adults, and they’re at greater risk for medication errors “even in good hospitals.”

Primarily, Okun emphasized that Parkinson’s patients “aren’t getting their meds on time, and they’re not getting the right meds.” And what’s worse is that many commonly prescribed drugs during routine hospital stays are actually dopamine blockers. For older patients with Parkinson’s, these drugs can have dangerous interactions and can cause severe results. The New York Times emphasized that “not everyone is as lucky as Roger Anderson.”

This is a serious issue facing older adults. There are some steps you can take to minimize the danger of hospital stays, including getting ahold of a free “Aware in Care” kit that includes a hospital bracelet to identify its wearer as a patient with Parkinson’s. However, many elderly people slip through the system. If an elderly parent or loved one has experienced medication errors while in the hospital, they could be entitled to compensation. Contact an experienced elder law attorney today to discuss your concerns.

See Related Blog Posts:
Nursing Home Patients Dies of Morphine Overdose Despite No Order for the Drug
Study Shows Narcotic Painkillers Increase Risk of Fractures in Elderly

A West Virginia jury awarded $90.5 million in damages to a family who alleged nursing home abuse and neglect back in 2010. The nursing home has taken the case to the West Virginia Supreme Court once already, according to an article in West Virginia’s State Journal. And this time, they’re arguing that the state’s Medical Professional Liability Act (MPLA) should require the court to apportion damages in their favor.

This case could have important implications for nursing home abuse damages in California. While the West Virginia Supreme Court’s ruling won’t bind California courts, it may set the tone for the ways in which damages are approached and apportioned in nursing home abuse cases.

Details of the Nursing Home Neglect

In 2010, 87-year-old Dorothy Douglas died while in the care of a West Virginia nursing home. That same year, Tom Douglas, the victim’s son, filed a claim against Manor Care Inc., HCR Manor Care Services Inc., Healthcare and Retirement Corp. of America LLC, and Heartland Employment Services LLC. He alleged that his mother died because of severe dehydration and malnutrition while in the nursing home.

The nursing home argued instead that Dorothy Douglas died as a result of her dementia, and not from dehydration or malnutrition. The nursing home explained that she had been transferred to a hospice facility 18 days before her death due to her dementia-related health decline.

Jury Awards Whopping Verdict for Tom Douglas

When the case went to trial in Kanawha County Circuit Court, the jury awarded Tom Douglas (and his family) $91.5 million. In so doing, it found that the nursing home had been “responsible for ordinary and medical negligence,” and that it violated its fiduciary duties and portions of the Nursing Home Act in the state.

The jury awarded $11 million for the death itself, or compensatory damages, and $80 million in punitive damages. Punitive damages aren’t typically awarded to compensate the victim in a case, but rather to deter the defendant from engaging in this kind of conduct in the future. In many ways, punitive damages are a way for the jury to punish a defendant who has committed an especially bad act. Due to statutory caps on certain damages, the Kanawha County circuit judge reduced the award to $90.5 million.

The Nursing Home’s Appeals

The nursing home appealed to the West Virginia Supreme Court for a write of prohibition, arguing that there had been an error in the jury verdict form. If granted, a writ of prohibition could prevent enforcement of the Kanawha County Circuit Court’s order, which didn’t include this specific jury verdict form on the record. The West Virginia Supreme Court found in favor of the nursing home, allowing them to add their proposed verdict form to the record.

Now, the nursing home is appealing to the West Virginia Supreme Court again, but this time to reduce Douglas’s damages. The nursing home contends that the MPLA “supercedes the Nursing Home Act.” At the original trial, Douglas argued that damage caps through the MPLA wouldn’t apply because the majority of the jury’s damages were for ordinary negligence, and not medical negligence specifically. However, if the MPLA were to be applied in this case, the medical negligence damages would have to be capped at $594,000. This is significantly less than the jury’s original award. The nursing home makes a few other claims as well, including that damages were incorrectly awarded to Douglas’s daughter, who wasn’t named as a party in the lawsuit.

While we’ll have to wait to see how the West Virginia Supreme Court decides, experienced nursing home abuse attorneys are available to speak to you today about nursing home neglect and abuse in California. If you or an elderly loved one have been neglected or abused in a nursing home, you may be eligible for compensation. Contact us today.

See Related Blog Posts:
Malnutrition Rates High in Prime Hospitals
Court Grants Access to Victim’s Medical Records in Nursing Home Abuse Case

A recent study in JAMA Internal Medicine confirmed that abused and neglected elderly persons face much higher risks for hospitalization, and not necessarily for injuries suffered as a result of their mistreatment. According to Dr. Theresa Soriano, an associate professor of medicine in geriatrics and palliative care in the Icahn School of Medicine at Mount Sinai, “It is understandable how a vulnerable older person experiencing abuse may fail to prioritize the prevention or care of their health conditions.”

Hospitalization rates especially tend to increase when elderly persons rely upon an abusive family member as a caregiver. They can miss medical appointments, adhere poorly to required diets and medication schedules, and they can experience increased stress and anxiety. As a result, all of these things can contribute to “poor control of any medical conditions and increased hospitalizations,” according to an article in Health magazine.

Details of the Study
The recent study analyzed information from more than 6,500 older adults who participated in the Chicago Health and Aging Project. Dr. XinQi Dong from Rush University Medical Center and Dr. Melissa Simon from Northwestern University Medical Center led the study.

They gathered reports from various social service agencies to identify 106 elder persons who were victims of abuse between 1993 and 2010. The researchers then reviewed hospitalization rates compiled by the U.S. Centers for Medicare and Medicaid Services, and they found that “the annual rate of hospitalization was more than doubled for those who reported elder abuse versus those who did not.”

When drawing final conclusions, the researchers determined that all kinds of elder abuse can affect hospitalization rates—not just physical abuse and neglect. In fact, they concluded that “elderly people who suffered psychological abuse, financial exploitation, caregiver neglect, or two or more types of abuse were hospitalized more frequently than those without reported elder abuse.”

With hospitalization rates increasing for older adults, should we be asking if elder abuse is a growing problem in the U.S.?

Experts Suggest Elder Mistreatment is a Growing Problem
In addition to the medical experts who conducted the study for JAMA Internal Medicine, other experts in the field also worry that elder abuse leading to higher hospitalization rates is a problem that isn’t going away.

According to Dr. Gisele Wolf-Klein, the director of geriatric education at the North Shore-LIJ Health System in New York, about 10 percent of elderly persons in America are victims of abuse, and “the trend is increasing.” In fact, Wolf-Klein indicated that psychological abuse may be a primary culprit for hospitalization.

What can we do? The important thing is to spot elder abuse early and to report it to social services agencies. While this can be a challenge for many reasons, early reporting can help to reduce the rates of elder hospitalization. And Wolf-Klein suggests that some caregivers may be relieved to have assistance from social services agencies. “The ultimate goal for our society,” she explains, “is to enable these social services agencies to provide overwhelmed caregivers of older adults with the support they need on a daily basis, in order to successfully manage the complex demands of frail patients totally dependent on others.”

If you suspect that an elderly loved one has been a victim of elder abuse or neglect, contact an experienced attorney today to discuss your case.

See Related Blog Posts
Nursing Homes As “Safe Places” For Older Adults Facing Abuse?
Quality of Life

Just last week, a South Dakota court granted a nursing home abuse defendant access to the victim’s medical records, according to a news release from the Nursing Home Abuse Center. Heather Lynn Laird, a 36-year-old former employee of the Dell Rapids Nursing and Rehab Center, was indicted last December for felony abuse and neglect of an elderly person. Now, Laird and her attorney have the right to view the victim’s medical records. Laird and her attorney hope that these medical records will prove relevant in the defense.

In January, Laird pled not guilty to the charges against her. Yet her record as a licensed practical nurse (LPN) suggests that this isn’t the first complaint.

Defendant’s History as an LPN Caregiver
In late 2012, the South Dakota Board of Nursing issued an order for summary suspension to temporarily suspend Laird’s nursing license until a hearing to determine whether she could continue to practice as an LPN in the state.

The Board issued this suspension after receiving a complaint from the long-term care facility where Laird had been employed. The complaint indicated that, on “at least five separate occasions,” Laird had been “rude and harsh in her dealing with residents.” In addition, the complaint alerted the Board that Laird “was rough with residents and used profanity toward them.” In each of these cases, Laird’s employer reprimanded her for these incidents and eventually fired her last July.

When the Board receives a complaint like this one, it meets with the accused as part of the investigation. Laird denied all of the accusations. The Board continued its investigation, but before it could meet to make a decision about the status of Laird’s LPN license, it received another complaint from the Dell Rapids Nursing and Rehab Center. This complaint concerned the case for which Laird has been charged with felony abuse and neglect of an elderly person.

Details of the Dell Rapids Case
According to the order issued by the South Dakota Board of Nursing, the complaint from Dell Rapids Nursing and Rehab Center concerns an altercation in which Laird attempted to administer medication to a resident by force. The resident is the alleged victim in the current case against Laird.

In the early morning of November 3, 2012, Laird went into the victim’s room and woke her up to administer medication. When the victim seemed surprised, Laird “forcefully tried to get the medication into her mouth.” When she tried to sit up, Laird allegedly used her knee to hold the victim down, and proceeded to throw water in her face. Laird then “grabbed the resident’s breast and squeezed it tightly, causing a noticeable bruise.”

According to ArgusLeader.com, Laird’s lawyer indicated that if the victim’s medical records show signs of dementia or Alzheimer’s, they could be helpful in Laird’s defense to prove that the victim had been aggressive. And these questions of mental health might extend to the victim’s husband, as well. Laird and her attorney indicated that the husband has a history of violence, and they claim that he might have caused the bruising on the victim.

Judge Patricia Riepel granted Laird’s request for access to the victim’s medical records, explaining that this kind of information is essential to provide at this stage of a case, since both parties are still in discovery.

If you are concerned about an elderly loved one’s safety in a California nursing home or long-term care facility, contact an experienced nursing home abuse attorney today.

See Related Blog Posts
Felony Charges in Nursing Home Death Implicate California Department of Social Services
San Diego Care Center Cited for Patient’s Choking Death

Last month, a California nursing home abuse case was delayed when the defendant requested extra time to weigh her options for a plea deal. The California Attorney General charged Sylvia Cata with involuntary manslaughter for the death of a dementia resident in her care. Do you have a loved one in a nursing home or a private care facility? This case raises questions about the level of oversight from the California Department of Social Services (CDSS).

History of the Case
Cata operated “Super Home Care” out of her own home since the mid-1990s. According to an article in the Sacramento Bee, Cata’s home was located on “a dead-end street in Sacramento’s Gardenland neighborhood, a residential enclave flanked by tire shops, lube and oil joints, and a check-cashing store on the corner.” This description doesn’t sound like an ideal site for an elder-care facility, and the CDSS suspected as much.

For most of the years that Cata’s business operated, the CDSS “expressed exasperation and dismay” with her work. As a result, Cata’s in-home operation underwent a number of complaint investigations, and it was also subject to “deficiency reports, citations, fines, and plans of correction.”

In fact, between 1996 and 2012, Cata received 40 citations for failing to follow California requirements for nursing home operation, according to a report from the Nursing Home Abuse Center. Of those 40 citations, 26 were Type A deficiencies, which are “the most serious violations under state regulations.” They’re issued when there are “direct and immediate risks to residents’ health, safety, or personal rights.” Yet, despite these serious citations, Super Home Care remained open and Cata kept her license until the 2012 death of a resident finally shut its doors.

Details of the Case
Cata’s involuntary manslaughter charge arises from the death of an 88-year-old resident in her care, Georgia Holzmeister. Holzmeister suffered from dementia, and she had been living at Super Home Care for more than five years. During the final days of her residency, Holzmeister developed a “Stage IV bedsore” during spring 2012. When Cata finally called emergency medical services that June, Holzmeister was unconscious. The patient was transported to the hospital where she received emergency treatment, but she never regained consciousness. Five days after being admitted to the hospital, Holzmeister passed away.

In February 2013, California’s attorney general charged Cata with involuntary manslaughter. The Sacramento Bee reported on the seriousness of the charge, indicating that this was “a first for state prosecutors in an elder-care case.” In addition to the involuntary manslaughter charge, the attorney general also charged Cata with “a second felony count of elder or dependent adult abuse, resulting in death.” With the latter charge, Cata could face up to 12 years in prison.

The attorney general issued felony charges based on Cata’s “deliberate and complete reckless disregard for performing the essential duties as Holzmeister’s caretaker.”

In addition to targeting Cata for her poor patient care, the attorney general and the state of California also hope to illuminate the ways in which the CDSS erred. Cata’s facility was classified as a “Residential Care Facility for the Elderly” (RCFE), meaning that it was licensed to house up to 6 residents and was regulated by the CDSS’s community care licensing division. Due to budget constraints, the community care licensing division tends to conduct approximately one unannounced inspection every five years, and it currently oversees approximately 7,500 RCFEs. Many advocates believe that Holzmeister’s death could have been prevented with better CDSS oversight.

If you have a loved one in a nursing facility, and you’re concerned about abuse, contact an experienced nursing home abuse attorney today to discuss your case.

See Related Blog Posts
Jury Awards $42 Million in Nursing Home Bedsore, Dehydration Case
Caregiver Charged with Crime for Bed Sore Related Death

Do you have a loved one who is suffering from Alzheimer’s or another form of dementia? According to a recent article in the New York Times, dementia care costs are projected to double by the year 2040. This story comes just a few days after a new report in The New England Journal of Medicine that measured the monetary costs of dementia in America.

What do these new figures mean for nursing home costs and long-term care facilities in the San Diego area? While experts can’t make definitive predictions, many researchers fear that “it’s going to swamp the system,” creating more elderly persons in need of care than there are available caregivers and facilities.

How the Study was Conducted
The study found that the financial burden to care for those suffering from dementia is “at least as high as that of heart disease or cancer, and is probably higher.” The more salient information in the report is that “the number of people with dementia will more than double in 30 years, skyrocketing at a rate that rarely occurs with a chronic disease.”

This research was conducted by the Health and Retirement Study (HRS), which is a “nationally representative longitudinal survey of persons 51 years of age or older” that began its work in 1992. HRS catalogued the results from research conducted by the Aging, Demographics, and Memory Study (ADAMS), which is a “nationally representative study of dementia in the United States.” It assessed 856 HRS respondents, who underwent an “in-home clinical assessment for dementia,” which lasted for about 3-4 hours per person. The study considered whether these respondents were experiencing key symptoms of dementia, including their ability to perform activities of daily living (ADLs).

After determining the level of dementia for the respondents, HRS worked to measure the cost of care for each of these patients. The study attempted to include all forms of spending that occur when a person suffers from dementia, including out-of-pocket spending, spending by Medicare, net nursing home spending, and other varieties of formal and informal home care. According to the language of the study itself, “someone with a probability of dementia . . . would be expected to incur $33,329 more in health care costs than someone whose probability of dementia was zero.” In other words, the study found that the approximate cost for each dementia patient averages out to more than $33,000.

Cost Implications for Nursing Homes and Our Health Care System
It’s important to keep in mind that this $33k number is a low-end figure. In fact, most nursing homes indicate that they tend to spend between $41,000 to $56,000 per dementia case.

Right now, approximately 15 percent of people who are aged 71 or older suffer from dementia. That’s about 3.8 million Americans. Since the study found that the number of people with dementia is expected to rise to nearly 9.1 million by the year 2040, that means an increase in dementia-related health care costs by at least $175 billion by 2040. In all likelihood, health care spending will actually rise to anywhere between $279 billion to $511 billion—a sharp increase from the $159 billion to $215 billion reported in 2010.

One of the key issues for dementia-related spending in the coming years will be “helping patients in nursing homes” to “manage the most basic activities of life as they become increasingly impaired,” both cognitively and physically. In response to the figures reported by The New England Journal of Medicine, other researchers continue to assess the likely economic impact of the predicted increase in dementia cases. But the New York Times reminds us that this economic cost doesn’t reflect the “emotional cost” of dementia, which can be much higher.

If you have questions about nursing home care in the Southern California area, contact a licensed attorney today.

See Related Blog Posts
San Diego Care Center Cited for Patient’s Choking Death
Hidden Videotape Exposes Serious Nursing Home Abuse

[Image courtesy of Wikimedia Commons]

The California Department of Public Health (CDPH) cited the San Diego care facility Villa Rancho Bernardo Care Center (Center) for inadequate elder care, which resulted in the death of one of its residents. According to a story from NBC San Diego, the Center received the most severe penalty under state law, a “AA” citation that is accompanied by a $100,000 fine from the State of California. This isn’t the first time the Center has been cited by the CDPH. In fact, a previous citation occurred only a few years ago. Is this care center safe for patients?

What Led to the Recent Citation?
The Center had specific physician’s orders for a 61-year-old dementia patient’s diet. The patient had been admitted to the facility with a diagnosis of dementia, and his physician’s orders later stated that he had cognitive/behavior impairment (or decreased mental status).

As a result of his diagnosis, the patient required a “special chopped diet” that entailed having his food cut into very small pieces every day. According to a healthcare services manual, a “mechanical chopped diet” such as this one requires that meats be chopped “to the consistency of small dice,” or approximately ½ inch. This special diet had been prescribed because the patient had exhibited past behaviors in which he’d grab food and immediately stuff it into his mouth.

On October 31, 2012, the staff at the Center failed to have the patient’s food chopped, and the patient was served two pancakes and two uncut sausages. The patient proceeded to put all four of these food items into his mouth, and he then choked and died. The CDPH report described the Center’s negligence as the “direct proximate cause of the death of the patient.”

How Did This Happen?
According to the report, a series of people failed to notice the dietary error including: the cook, the dietary line checker, the licensed nurse, and the certified nursing assistant. None of these staff members verified “that the prescribed diet, in the correct consistency, was checked prior to bringing the meal tray into [the patient’s] room.”

The incident violated the Center’s policy on “Choking Prevention,” which states that, prior to serving meal trays to its residents, the licensed nurse assigned to the dining room is required to check that each meal matches the “diet slip” provided by each resident’s physician. Then, the Certified Nursing Assistant (CNA) is required to “double check” the tray after the licensed nurse checks it. The CNA does this in order to check “for any missed items or wrong diet” that the licensed nurse may have overlooked.

While the report doesn’t indicate how the licensed nurse and the CNA both failed to identify the problem with the resident’s meal, the CDPH is holding the Center accountable. And this isn’t the only case in which the Center has failed to provide adequate care.

History of “AA” Citations at the Center
In February 2010, less than three years before the choking death of the patient discussed above, the Center received another “AA” citation and $100,000 fine for the death of another dementia patient, who also suffered from psychosis. According to that report, the resident “sustained fatal head injuries after falling down a concrete stairwell” outside the Center. The resident, who was confined to a wheelchair, opened an emergency door and “fell down 20 concrete steps” while he was “still restrained in his wheelchair.” At the time of the fall, he was completely unsupervised. He died two days later from the injuries he sustained during the fall.

If you have an elderly loved one who has sustained injuries due to nursing home neglect, an experienced attorney can discuss your case with you. Contact us today.

See Related Blog Posts:
Glendale Nursing Home Criminally Indicated After Patient Death
Elder Abuse Investigations: Coming Soon to a Care Center Near You

We often hear stories about elder abuse in nursing homes, but there are other places where seniors face threats of abuse. Perhaps we don’t like to think about older adults being abused by their caregivers, but according to a recent report in US News, nearly 10 percent of adults over the age of 60 experience some kind of abuse, and “it’s often perpetrated by a victim’s own offspring.”

In the past few years, certain nursing homes have been taking action to help these elder adults to find a safe place for shelter, medication, and care.

What Kinds of Abuse Occur in the Home?
Seniors can be targets of various kinds of abuse according to a USA Today story, including physical, financial, sexual, and emotional abuses. The article explains that the “dismal economy” may be one of the causes of high tensions between adult children and their aging parents. When money is tight, elders are often forced to live with their children and grandchildren, and sometimes these caregivers are tempted to take financial advantage of these older persons.

In fact, while physical abuse and emotional abuse may be the most common forms of abuse in nursing homes and assisted-living facilities, older adults living with their children seem to be at greatest risk for financial abuse. In fact, financial abuse is the most common type of documented elder abuse.

How Does This Happen?
Sometimes, seniors become ill and they “unknowingly sign over their assets to people who care for them.” When this happens, elder adults can recover from their illnesses to find that their checking and savings accounts have been completely cleaned out, or that their homes have been sold. Many reports also cite adult children cashing their parents’ social security checks and keeping the money for themselves, according to Dan Reingold, the president and CEO of a long-term care facility in New York. In fact, a 2011 MetLife Mature Market Institute study showed that on average, elder victims of financial abuse lose $2.9 billion per year.

Physical abuse can also come into play in home-care settings, in which children and other caregivers are charged with withholding food and medicine, and perpetrating physical beatings.

How Nursing Homes Are Helping to Combat Abuse
Elder abuse is a serious problem in our country, but most people aren’t aware of it the same way they are of child abuse or domestic abuse—awareness efforts tend to wane when it comes to elder abuse. So, are adult childrens’ homes safe for their aging parents? In many cases, they’re not. In reaction to rising rates of elder abuse in family members’ homes, some nursing homes have established shelters in which seniors can seek “emergency short-term housing and health care services.”

In 2005, the Hebrew Home, a facility in Riverdale, New York, created an on-site shelter. It was the first of these types of efforts, and six other nursing facilities have “replicated the approach.” Hebrew Home has also been in talks with other facilities around the country to develop similar shelters for older adults who have been abused by family members and other in-home caregivers.

Elder care advocates continue to push for more shelters like the Weinberg Center at the Hebrew Home, and they’re establishing campaigns to raise awareness about elder abuse in our communities. If you have worries about an older adult’s care, it’s important to talk to someone about your concerns. An experienced attorney can discuss these issues with you today.

See Related Blog Posts
Know Your Rights: Money
To Protect and Defraud?

Do you have an elderly parent or loved one who has survived cardiac arrest in a nursing home or assisted-living facility? A recent post in the New York Times blog “The New Old Age” suggested that recent medical studies show encouraging results for patient survival after experiencing a heart attack or other medical situation requiring resuscitation. This new study may have implications for certain patients’ medical decisions and advanced health care directives in nursing homes and assisted-living facilities.

In many cases, elderly patients have already made “do not resuscitate” (DNR) decisions, indicating that, in the case of cardiac arrest, the patient does not want to receive cardiopulmonary resuscitation. Depending on the type of “code blue” that the patient experiences, resuscitation can involve either an electric shock to the heart with a defibrillator, or a medication that’s intended to restore circulation. While cardiac arrest in a medical facility is “more often than not a killer,” you have a greater chance of living through the incident than in years past, and some doctors suggest that this may be a good reason to re-think a DNR decision in your advanced health care directive.

Study Shows Better Odds for Resuscitation Patients
A recent study in the New England Journal of Medicine shows that for older patients admitted to a hospital for cardiac arrest, approximately 18 to 20 percent left the hospital alive. This statistic may seem grim, but it’s actually a significant improvement from previous survival rates in the early 2000s. Of the group of patients who left the hospital alive, the study found that 58.5 percent were still living a year later, and 48 percent of that group had “little or no neurological impairment.”

While brain damage often is significant in cardiac arrest patients, Dr. Paul Chain, the lead author of this new study, finds the results to be a “reason for hope.” He said, “if you make it out alive, you have a significant chance of being alive one year later,” and he emphasized that the results suggest we may want to reconsider our opinions about resuscitation for elderly patients. Another clinical researcher, Dr. Benjamin Abella, echoed Chan’s position, indicating that “improvements in resuscitation done in hospitals have changed outcomes significantly, including among elderly patients.”

If many of these surviving patients had made different DNR decisions, they may not be alive today. However, the decision not to resuscitate may still be the best option for some patients in nursing and hospice facilities.

How Do DNR Decisions Affect End-of-Life Care in Nursing Homes?
Last month, an article in the Seattle Times suggested that a patient’s ability to make a DNR decision might not be upheld in nursing facilities or other long-term care residences. For elderly patients at the end of life, a DNR order may allow them to pass away peacefully, without unnecessary invasive medical procedures.

For example, in Washington state, nursing-home patients can fill out official forms called “Physician Orders for Life-Sustaining Treatment” (POLST), which allow them to decide whether they want to be resuscitated in the event of a heart attack or other “code blue” situation. The story in the Seattle Times referred to the form as a “sort of portable do-not-resuscitate order that could go with end-of-life patients wherever they went.”

However, some state laws have legal “loopholes” that patients can fall into. In Washington, the state informed nursing-home providers that they “might not have legal immunity” if they abided by patients’ DNR orders. In the sickest and oldest patients, DNR orders are “essential tools” for these elderly patients who “want death to occur naturally at home.” When they’re given electric shock, medications, and CPR despite their own wishes, they can face “very invasive, very painful, [and] very unpleasant care.”

Often, advanced healthcare directives can ensure that your loved one receives the care that she or he plans for in the case of a “code blue” situation. Do you have questions about DNR decisions, advanced healthcare directives, and patients’ rights in California nursing homes? Contact one of our experienced attorneys today to discuss your concerns.

See Related Blog Posts:
Post-Holiday Worries: Finding Elder Care for a Family Member
Administrators Must Now be Wary of Criminal Charges for Acts Under Their Watch

Do you have an elderly parent or loved one in a Southern California nursing home? A recent study of nursing facilities within our state found that in 20 out of 22 facilities tested, the drug-resistant and often deadly skin infection “elderly residents.

Until recently, researchers tended to focus on the spread of MRSA in hospitals, often neglecting to track the infection in nursing-home settings.

What is MRSA and what does its presence mean for nursing homes in California? Keep reading to learn more about this infection that is resistant to many “common antibiotics” used in nursing facilities.

MRSA
MRSA is an acronym for methicillin-resistant Staphylococcus aureus (MRSA). According to the National Institute of Health (NIH), MRSA infections can be community-based or can form in healthcare settings. Community-based strains are those that begin in the “general outside world” (instead of in hospital settings or other healthcare venues) and are carried into places like long-term care facilities and nursing homes.

MRSA can lead to “bloodstream infections [and] abscesses and pneumonia.” The NIH emphasizes that MRSA infections are especially dangerous in nursing home settings.

MRSA infections are spread through contact. You can catch staph infection by touching someone with the bacteria (including a patient or a physician) or by touching an object that has come into contact with the bacteria.

Solutions
Between October 2008 and May 2011, University of California-Irvine researchers visited 22 nursing homes, swabbing the noses of the residents at those facilities. After finding MRSA at 20 of these facilities, the research team concluded that Southern California nursing homes require more “infection control interventions.”

What does this mean? According to Medline Plus, nursing homes physicians and staff must pay more attention to signs of spreading drug-resistant infections. As well, these facilities should employ infection-control measures such as “enhanced environmental cleaning” or “skin decolonization.”

In particular, nursing facilities need to be aware of community-associated strains of the infection. In fact, one of the authors of this recent study indicated that nursing home residents are especially susceptible to the community-acquired strain of MRSA, since nursing homes often encourage socializing.

This means that budgets need to increase. A local Elder Advocacy Center indicated that the high prevalence of MRSA in nursing homes may be due to low staffing—many of these facilities attempt to save money by limiting the number of staff they employ.

MRS Prevalence and Nursing Home Law
When a nursing home detects MRSA infections within the facility, a physician is required to inform an elderly resident’s family, and is supposed to explain how they can help to limit the spread of the infection.

In the local ABC 10 News story, Marian Hollingsworth, whose elderly father resided in a San Diego nursing home, was horrified to find that he contracted MRSA after being in the facility for only a day. She never learned that MRSA had been found in the nursing home prior to her father’s residency, and she also learned that her father had been “kept near the front desk in a wheelchair,” meaning that “everyone who went in and out of the facility was exposed to him.” As a result, Hollingsworth and her family members were unable to touch her father in his final days. She explained that “there were no last hugs, no last kisses, no time to hold his hand as he lay dying.”

If your elderly parent or loved one has contracted MRSA in their nursing home, or if you’re concerned about the duties of your loved one’s physician within their nursing facility, speak to an experienced elder law attorney today.

See Related Blog Posts:
Los Angeles Nursing Home Fined After Resident Dies
What Nursing Homes Won’t Tell You

[Image courtesy of Wikimedia Commons]

Are you concerned that a loved one may be experiencing nursing home abuse or neglect? Recently, New Yorker Diana Valentin suspected that her grandmother’s care in a Bronx nursing home might have been substandard after noticing physical injuries to her grandmother’s arms. Valentin’s grandmother raised her, and she wanted to ensure that her grandmother was receiving quality care. In order to find out whether her suspicions were accurate, she installed a hidden camera in the elderly woman’s room. According to a report from the Nursing Home Abuse Center, the “results were devastating.”

While this case occurred in New York, the San Francisco Chronicle ran a detailed article about this particular instance of abuse, alerting us to the possibility of similar harm in California nursing homes.

What Led to Suspicion of Abuse?
The nursing home at issue is Gold Crest Care Center in the Bronx. According to a local ABC News station, Valentin noticed “unusual marking and bruisings” on Ana Louisa Medina, her 89-year-old grandmother. Medina already suffers from dementia and Alzheimer’s according to the report, and Valentin worried that her grandmother’s injuries may have had nothing to do with her illness.

Valentin questioned the staff at Gold Crest Care, who repeatedly informed her that Medina’s bruises were a result of her dementia and Alzheimers. They explained that “she had gotten the bruising on her hands by banging on the bed railing.” However, Valentin decided to find out for herself.

What Were the Consequences at the Nursing Facility?
In June 2012, Valentin placed a hidden camera inside a decorative plant base, from which she recorded “more than 600 hours of footage.” When Valentin viewed the tapes, she was horrified. In the very early segments of the footage, she saw Sandra Kerr, a 55-year-old nurse’s aide at Gold Crest Care, grab Medina’s arm and twist it backward, actually lifting her off the bed and then slamming her back into the bed. Kerr has since been arrested and charged with misdemeanor endangering the welfare of a physically disabled person. After the arrest, Medina was transferred to a nursing home in New Rochelle, where she is reportedly safe from abuse.

It’s important to know the signs of nursing home abuse and what you can do if you’re concerned about a loved one.

How to Recognize Nursing Home Abuse or Neglect
According to a follow-up article in the San Francisco Chronicle, there are different varieties and levels of nursing home abuse. It can come in the form of bruises and other physical marks, as in Medina’s case, but it’s also important to stay alert to other indicators. For instance, abuse can also show itself in the form of depression and weight loss in your loved one.

If you’ve seen “slap marks, unexplained bruises, pressure marks, burns or blisters” on your elderly parent, or any signs of psychological abuse or neglect, you should alert the nursing home administrators. Remember, nursing homes have a duty to protect their residents. However, if you have witnessed any unexpected injury or illness, your loved one may be suffering from abuse or neglect. Do you suspect that your loved one is not being properly cared for? Our attorneys specialize in nursing home abuse and neglect cases. Contact us today to discuss your concerns.

See Related Blog Posts:
Nursing Home Director Heading to Prison
Strict Screening for All Nursing Home Employees