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Concerns Regarding Nursing Home Residents with Alzheimer’s or Dementia

February 19, 2021/in Blog/by Yao Dinizulu

CHICAGO, IL – Approximately 44 million people worldwide are living with Alzheimer’s disease or some form of dementia (Alzheimer’s News Today). Nursing home residents who suffer from Alzheimer’s or dementia may struggle to recall memories, and accurately interpret the world around them. Those who suffer from Alzheimer’s or dementia may become confused easily and even combative with other residents and nursing home staff. If your loved one suffers from dementia and is living in a nursing home, it’s important to understand some of the unique issues he or she may face while living in a nursing home.

Wandering and Elopement

Nursing home residents who suffer from cognitive impairment due to dementia or a related illness are at a high risk of wandering and elopement. A confused resident may wander into dangerous parts of the facility and be seriously hurt.

Four patterns of wandering as described by Myra A. Aud, PhD, RN to Sage Publications is described as:

Direct Travel: movement from one area to another without diversion.
Random Travel: roundabout or haphazard movement to many locations within an area without interruption.
Pacing: a repetitive movement that involves walking back and forth in a limited area.
Lapping: a repetitive movement that involves following a circular path around a larger area.

Safety issues related to wandering include both falls and wandering away (elopement). In long-term care settings, wandering interferes with caregiving activities. For example, if a resident who tends to wander infringes on territorial spaces of other residents, this may provoke a personal conflict.

Elopement is the act of wandering away from a safe residence, which is extremely dangerous for those who suffer from a cognitive impairment. An estimated 60 percent of residents with Alzheimer’s disease or dementia will wander away at least once.

Wandering is not only dangerous, but is difficult to predict where a resident could go next. All cognitively impaired long-term care facility residents that are cognitively impaired are presumed to be at-risk for wandering, even if they have no past history of doing so. Although some residents with Alzheimer’s or dementia may inadvertently wander away from a safe area by following staff and visitors as they leave while others actively test locked windows or doors and express a desire to leave.

Possible reasons for wandering include, but are not limited to:

A desire for variety such as leaving a confined area for the setting viewed through windows and doors.
A desire to go home or to work.
A desire to leave the current environment and its stresses.

Wandering and elopement can result in a resident being seriously harmed or even deadly.

Physical Abuse and Sexual Abuse

Nursing homes should be a safe place for the elderly community. Unfortunately, that’s not always the case. Some nursing home residents are victims of physical, psychological, emotional, and sexual abuse. Residents who suffer from Alzheimer’s disease and dementia are more vulnerable to this type of malicious treatment. Perpetrators may target these residents knowing they will likely struggle to report the abuse and could possibly continue to abuse this resident if they think no one may believe them.

Common people who can commit sexual abuse in nursing home facilities:

Nurses, aides, or other staff members.
Criminals who invade the facility.
Fellow residents.

Signs of sexual abuse may include:

Physical signs of abuse, such as bruising or blood-stained bedding.
Elderly person contracting a sexually transmitted disease.
Displaying fear towards a particular caregiver or resident at their long-term care facility.
Newly developed depression or anxiety.
Withdrawal from normal activities.

Sexual abuse in nursing homes is often underreported and is due to the social stigma behind sexual assault, or fear or retribution by the perpetrator. According to the Administration for Community Living (ACL), there were 20,000 complaints of sexual abuse in nursing homes over the past 20 years. On average, about three people a day in nursing homes are sexually abused.

The National Consumer Voice for Quality Long-Term Care mentions female nursing home residents who suffer from Alzheimer’s or dementia are more likely to be sexually abused. According to the Centers for Disease Control and Prevention (CDC), “1 in 5 women have been either raped or suffered an attempted rape, compared to 1 out of 38 men.”

Medication Mistakes

Most residents in long-term care facilities often rely on one or more prescription medications. They may not remember if they took their medication or not on any given day. Medication mistakes often go unnoticed and residents who suffer from cognitive impairments are at high-risk for missed medications, mixed-up medications, incorrect administration techniques, and other medication mistakes.

Contact a Cook County Nursing Home Injury Lawyer

Nursing home staff are required to provide residents with the standard of care and should take precautions to ensure that residents suffering from dementia and Alzheimer’s disease are safe. If your loved one suffered from nursing home abuse or nursing home neglect, you may be able to hold the facility responsible and recover damages through a nursing home injury claim. Contact one of our experienced nursing home abuse and nursing home neglect attorney’s today for a free consultation at (312) 384-1920 or visit our website for more information.

Illinois Nursing Home Abuse & How to Report

March 26, 2020/in Blog/by Yao Dinizulu

Nursing home neglect happens more often than you think. An estimated 5 million adults 65 and older are abused and neglected each year in the U.S. Neglect is an form of elder abuse committed against an older adult in a nursing home that breaches the duty that may harm a resident.

You’re more than likely going to experience a family member or someone you know being in a long-term care facility. Nearly 1.5 million people live in a nursing home in the U.S., according to the Centers for Disease Control and Prevention (CDC). When someone else is taking care of your loved one, it’s important to do research on the facility you ultimately choose.

Illinois has one of the highest rates of nursing home abuse in the nation. It’s important to be aware of the signs and symptoms to look out for when suspecting abuse and know how to report a case.

Anyone can commit elder abuse; in fact, in almost 60% of elder abuse and neglect incidents, the perpetrator is a family member and two thirds are adult children or spouses according to the National Council of Aging (NCOA). However, perpetrators are not limited to just family members and may include caretakers or other residents.

What is elder abuse?

Elder abuse or neglect “refers to the mistreatment of a person 60 years of age or older who lives in the community,” according to the Illinois Department of Human Services (IDHS).

IDHS states abuse and neglect includes any of the following:

Abuse – physical, sexual, or emotional mistreatment and/or willful confinement.
Neglect – the failure of a caregiver to provide the older person with the necessities of life, including but not limited to food, clothing, shelter, and medical care.
Financial exploitation – the misuse or withholding of the older person’s resources by another to the disadvantage of the older person and/or the profit of another.

What makes an older adult vulnerable to abuse?

Older adults who are in nursing homes are socially isolated and those who have mental impairments such as dementia or Alzheimer’s disease makes them more susceptible to being abused or neglected. Studies have shown that those with dementia have experienced a form of abuse or neglect.

Most common types of abuse:

According to the Illinois Department of Aging (IDOA) victims often experience more than one form of abuse. 67 percent of victims are female, while 33 percent are male; however, 51% of abusers are females, while 49% of abusers are male.

Based on the 2017 annual report, the most common forms of abuse in Illinois were:

Financial exploitation, (8,604)
Emotional abuse (6,476)
Passive neglect (6,679)
Physical abuse (3,782)
Willful deprivation (2,268)
Confinement (1,381)
Sexual abuse (765)

What to do if you suspect abuse:

If you suspect your loved one is experiencing abuse in their nursing home, talk to the staff immediately. If the problem isn’t resolved, you can talk to one of the following:

Call 911, especially if they are in life threatening danger
Supervisor
Social worker
Director of nursing
Administrator
Doctor

Families should document signs of nursing home abuse and indicate any change in their loved ones behavior, take pictures of the injuries and note if injuries worsen, and write or record any witnesses that has seen the abuse or from the victim themself.

How to report nursing home abuse:

There are several ways you can report nursing home abuse. In case of emergencies, please dial 911. You can also contact:

Long-term care ombudsman
- You can find your local ombudsman here.
Professional medical experts like doctors or nurses
Nursing home administrator

To confidentially report abuse:

A 2019 report by GAO states, “nursing home abuse often goes unreported mainly because residents are afraid of what will happen if they speak out.” Residents fear that staff may treat them worse, or abuse will continue and worsen.

A nursing home report can often remain confidential when complaints are filed with a long-term care ombudsman, unless consent is given otherwise. Confidentiality eases the concern of addressing a problem.

File a Lawsuit

If you suspect your family member or loved one is the victim of nursing home abuse or neglect, it’s important to take legal action right away to protect their rights. In Illinois, the statute of limitations limits the amount of time you have to file a lawsuit which is 2 years from the injury date.

Throughout the litigation process, the attorney’s at Dinizulu Law Group collect evidence to build your case against the nursing home and staff and inform you of the steps we take along the way. Please call our firm today for a free consultation at (312) 384-1920 to learn how you can obtain justice for your loved one.

The Severity of Medication Errors

November 20, 2019/in Blog/by Yao Dinizulu

CHICAGO, IL – Medication errors are one of the most prevalent problems in the healthcare industry. Experts estimate that more than 7 million Americans experience a medication error each year. In the study, it stated mistakes have cost more than $21 billion – which are all preventable. Some individuals are able to handle the unintentional consequences of improper medication administration, but for seniors and young children, this can be life threatening.

Medication errors are particularly found in nursing homes due to under-staffing. Many say that errors are common and not life-threatening; however, there are errors that are likely to be under-reported which the medical coding system makes easy to cover up error-related deaths. The Centers for Disease Control and Prevention (CDC) argues medication errors are the third most common cause of death among nursing home patients.

So what does this say about nursing homes? Extensive investigations have taken place and research has shown as many as 95 percent of nursing homes in the United States are understaffed, causing neglect to most patients. Nursing home staff is expected to work longer hours and care for double, or even triple, the amount of residents they are normally expected to care for.

Types of Errors

The Nursing Home Law Center requires skilled nursing facilities to keep errors within a 5 percent margin. Although this margin is broadly defined, it includes errors such as not mixing medication as directed, giving medications at improper times, or not dosing the last small portion of medication.

Errors within this 5 percent margin do not impact licensing because these types of administration errors are likely to be made at home when self-administering, as well. More serious errors can lead to tremor, coma, or even death – resulting in legal action against nursing facilities.

Prevention Process

Nursing homes must begin to increase staffing levels exponentially and invest in better prevention practices to help prevent nursing home abuse. Nursing facilities are chronically understaffed due to the notorious low-paid and poor management resulting in high turnover rates. High turnover rates cause staff to be unfamiliar with patients needs and care regiments, and are more likely to make mistakes.

Nursing homes need to implement a medication reconciliation program that evaluates a complete list of medications used by each patient. These programs are critical as many patients will not be able to independently which is used to verify their course of treatment.

Finally, nursing homes need to minimize high-risk behaviors, such as disposing of discontinued medications or medications from discharged patients, improperly transporting medications, or administering medications without a full review of the label directions.

As a society, we must come together to protect nursing home residents who are some of the most vulnerable members of our society. They deserve to be treated fairly and just with careful and appropriate treatment. This is critical on management as they will need to be client-focused and to implement changes immediately by taking responsibilities more serious.

The Alarming Reality

For one family, their loss of a loved one was tragic and very much preventable. A recently widowed 71-year-old female was hospitalized for uncontrolled hypertension and acute kidney injury. Her past medical history was significant for coronary heart disease with hypertension, persevered ejection fraction, and type 2 diabetes. The patient had a history of being a cigarette smoker and was under significant stress due to the death of her husband.

During her stay of hospitalization, she clinically improved after receiving temporary hemodialysis and her anti-hypertensive medications were adjusted. At the time of discharge, her prescription medications included amlodipine (Norvasc) 10mg twice daily with two refills allowed, metoprolol 50mg twice daily, doxazosin 2mg daily, and torsemide 10mg daily.

Over the course of 3 months, she experienced worsening fatigue, personality changes, became lethargic, and slower movements – all of which was noted in medical records. Her blood pressure was no longer controlled, and she was re-hospitalized for chest pain and underwent angioplasty. When admitted to the hospital, she saw multiple specialists and ancillary staff. As an outpatient, she was seen by her family physician twice. After several weeks had passed, she was eventually diagnosed with anxiety and depression, and prescribed citalopram and alprazolam.

The patient then entered the emergency room for a third time after a fall. She demonstrated several side effects of the multiple medications she was prescribed to take. Lab work was conducted and was noted for elevated creatinine and a CT of the head and brain revealed no acute abnormalities. Admission medication reconciliation (MED REC) revealed she was taking metoprolol, doxazosin, alprazolam, citalopram, and thiothixene (Navane) 10 mg twice daily.

Upon review of her pill bottles, it was found that her outpatient pharmacy accidentally dispensed Navane, an anti-psychotic, instead of Norvasc, and she took this medication religiously for 3 months. A diagnosis of thiothixene-related drug-induced Parkinsonism was made.

Errors were made at a multitude of care levels, including prescribing, initial pharmacy dispensation hospitalization, and subsequent outpatient follow-up. Adverse drug events account for more than 3.5 million physician office visits and nearly 1 million emergency department visits per year that affects patients, providers, and the economy.

Despite the countless opportunities for intervention, multiple health care providers overlooked her symptoms. Our population is continually growing with a longer life-expectancy, the frequent occurrence of medication errors and polypharamacy will likely increase. Efforts must be made to improve overall physician communication and transition of care to decrease preventable errors.

What to do if Your Loved One has been Neglected or Abused in a Nursing Home

It’s important to reach out to an experienced nursing home abuse attorney immediately to begin reviewing the facts of your case. In the case discussed, the woman is entitled to legal action against the hospital, providers, and specific staff members who neglected her, among others. Due to the statue of limitations, an attorney must begin to work on your case immediately.

Do not wait to hear what the facility is going to do going forward to address this issue – contact an attorney right away. The attorney’s at Dinizulu Law Group specialize in nursing home abuse and neglect and use their experience with a dynamic and honest approach so appropriate parties are held accountable for the abuse your loved one has endured. Please call our office to schedule a free consultation. For additional information, please visit our website.

Contact Information:

(312) 384-1920

221 N. LaSalle St., Suite 1100
Chicago, IL 60601