Nursing Home Abuse and Neglect
Abuse
Resident abuse in nursing homes is more common than anyone would like to believe. A case that came to our attention was that of a blind woman from Providence who had suffered a stroke and needed help going to the bathroom. She rang the call bell to request a nurse's assistance, but no one responded. She was forced to ring the bell again and again until a nurse finally came to help. When the nurse arrived, she grabbed the blind woman's hand, squeezed it, told her never to use the call bell again, and shoved her against the headboard of the bed, causing significant injuries. Sadly, this case is not unusual. The American Medical Association estimates that about 1 in 4 older persons experiences some form of physical abuse. The vast majority of elder abuse cases go unreported. A recent study in Massachusetts concluded that only 1 in 14 cases of nursing home abuse come to the attention of state authorities.
Warning Signs of Abuse
It should be reported whenever signs of nursing home abuse are noticed, including:
- Unexplained bruises, cuts, burns, sprains, or fractures in various stages of healing
- Vaginal or anal bleeding; torn, stained, or bloody underclothing
- Sudden changes in behavior such as withdrawal
- Staff refusing to allow visitors to see resident or delays in allowing visitors to see resident
- Staff not allowing resident to be alone with a visitor
- Resident being kept in an over-medicated state
- Loss of resident's possessions
Many residents do not report abuse or mistreatment because of embarrassment, fear, threat of further abuse, and other reasons.
Liability for Abuse
Many cases of abuse, neglect, and mistreatment in nursing homes and assisted living residences can be traced to understaffing as well as poorly qualified, untrained, and overworked personnel. Nurses and nursing aides are often overworked and stressed, and sometimes take their frustrations out on residents.
Neglect
Nursing home neglect is a term that covers many different kinds of injuries and causes of death. Falls, bedsores, elopement, dehydration, malnutrition, and choking on food are all signs of resident neglect. Neglect in nursing homes is frequently due to inadequate staffing. It is estimated that staff salaries are 70 percent or more of the cost of running a nursing home. Many facilities cut personnel to increase profitability. As a result, there is simply not enough staff to bath, feed, toilet, and attend to residents. In one of our cases, an 88 year-old man entered a nursing home in Middletown, Rhode Island, happy, cheerful, and cooperative. He was unresponsive 13 days later and died because of malnutrition and dehydration. The nursing home failed to assess adequately his condition on admission regarding nutrition and hydration. The nursing staff threw his dentures out with the trash, did not notice that he had thrush, an infection of the mouth, and did not give him the dietary supplements that were recommended by the dietician.
Signs of Neglect
It should be reported immediately whenever you notice signs of neglect, including:
- Allowing the development of pressure sores Link to Practice Area (bedsores) or frozen joints
- Failure to prevent malnutrition [Link to Practice Area] or dehydration [Link to Practice Area]
- Failure to take adequate precautions to prevent falls [Link to Practice Area]
- Failure to adequately supervise residents according to proper care plans
- Failure to assist in personal hygiene, or in the provision of food, fluids, clothing, or shelter
- Failure to take the person to the toilet when necessary
- Leaving persons lying in urine and feces
- Over-medicating nursing home residents
- Failing to provide pain medication when necessary
- Failure to respond to call lights
- Retaliation for making a complaint or filing a grievance.
Liability for Neglect
A nursing home can be found liable for neglecting a resident in their care. Federal and state laws require that nursing homes develop an individualized plan of care for each nursing home resident and employ sufficient staff to provide all the care listed on the care plan. There are also staffing levels mandated by federal, Rhode Island, and Massachusetts regulations.
Physical and Sexual Assaults
Sexual assault is an even more troubling form of patient mistreatment in nursing homes. We handled a case not long ago involving a Westerly, Rhode Island, woman who was molested by a janitor. When she told the nursing home staff what happened, they did not believe her. The nursing home sent her to a psychiatric hospital against her will for several weeks because they said she was hallucinating and delusional. The janitor sexually assaulted 2 other residents before he was caught and went to jail.
Another case involved a Alzheimer's resident from Worcester, Massachusetts who suffered an long and deep laceration to her vagina. The emergency room physician concluded that she was raped with an object consistent with a plunger handle. The nursing home failed to investigate six months of unexplained vaginal bleeding before the last attack occurred.
A nursing home may be found liable for neglecting or abusing a resident in their care. Lawsuits against nursing homes, assisted living residences, and other healthcare facilities hold wrongdoers accountable, recover money damages for injured persons, help families gain emotional closure and make our community safer by protecting others from similar harm.