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NURSING HOME INFORMATION
In the next 30 years, over 65 million American will be 65 years
of age or older. With advances in science and medicine and changes
in lifestyle, the life expectancy rate for Americans has sky rocketed,
and will almost certainly continue to do so. Combine these facts
with a recent study stating that 40% of senior citizens will reside
in a nursing home at some point in their lives, and the reality
is clear: nursing homes will serve as homes for large populations
of older Americans. With this development, the frequency of abuse
in nursing homes will almost certainly increase.
Over 2 million Americans currently live in nursing homes and more
than 15,000 nursing homes exist in this country. As the number of
older Americans who reside in these nursing homes rises, the incidence
of abuse in nursing homes has risen. Both the state and federal
governments have responded to inadequate facilities and/or poor
treatment by enacted certain laws and provisions to better safeguard
nursing home residents.
Perhaps the most important legislative action was the Omnibus Budget
Reconciliation Act (OBRA) amendments of 1987. OBRA mandates that
nursing homes conduct individual assessments for residents, reduces
the uses of physical and medicinal restraints, creates individualized
care plans, and provides the appropriate training for staff to deal
with special need residents. One of the overriding stipulations
of the law is that residents should not be subject to mistreatment,
abuse, and inadequate facilities.
» A Legal Perspective
» Proving Abuse In Nursing Homes
» Common Inadequacies &
Abuse in Nursing Homes
A LEGAL PERSPECTIVE
As previously mentioned, nursing homes are federally regulated
by the OBRA laws of 1987. Each separate facility is licensed in
the state where they operate. Facilities that receive federal funds
through Medicare and Medicaid must comply with OBRA. However, federal
law does not give nursing home residents a right of action to enforce
compliance with federal regulations. Rather, OBRA is not intended
to limit other state and federal laws or regulations.
In the past, it has been very difficult for victims of abuse in
nursing homes (the plaintiff) to collect legal and monetary remedy
for these actions. The principal reasons for this has been the fact
that these cases have been tried as negligent cases or as medical
malpractice cases. The verdicts, when they are for the victims,
have typically been less than acceptable because of how tough it
is to prove damages. (Damages are based on life expectancy, lost
wages, and lowered quality of life.) Unfortunately, these factors
are much lower for elderly individuals than for others. For example,
a 35 year man who makes $200,000 per year and maintains a very active,
exuberant lifestyle would be eligible for much greater damages in
a negligence case.
However, this courtroom trend has been changing in favor of those
who bring these suits to court (plaintiffs). Much of this is directly
the result of state and federal legislation previously mentioned
that now makes proving damages in nursing home cases much easier.
As well, many attorneys for victims of nursing homes have become
more effective in presenting their cases as corruption, neglect,
and abuse inside of nursing homes. The result has been more appropriate
justice for victims of nursing mistreatment or abuse.
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PROVING ABUSE IN NURSING HOMES
Gathering as much information in a timely matter is the best way
to insure that the facts of any activity of abuse in nursing homes
will be established. Residents should always have a personal chart
that records anything that occurs to them. Nursing homes that receive
federal funds are required to provide these records within 2 days.
However, this leaves open the door for alterations to be made to
the chart. Staff members who fear reprisal or a possible lawsuit
may make changes to the chart to escape blame. Getting a copy of
the chart immediately reduces the chances of any mysterious changes
occurring.
Often times, there is a witness or witnesses to the mistreatment
or abuse in nursing homes. This is especially true if the abuse
is ongoing. Witnesses may actually want to come forward because
of the guilt they feel over seeing someone treated this way. Witnesses
can be family members, other residents in the nursing home, or other
staff members. These individuals should immediately be asked to
record in writing what they saw in as much detail as possible.
The victim of the alleged abuse in nursing homes should also record
in writing exactly what happened. Time can muddy the recollection
of individuals. This is especially true with elderly individuals.
Visual evidence is very compelling in cases involving abuse in
nursing home. Photos of the injuries should be taken, as well as
photos of where the incident occurred. The photos should be taken
before the injury is allowed to heal in order to document the full
extent of the abuse or mistreatment.
Former staff members may be able to provide valuable information
on how residents were treated or mistreated, on what goes on behind
closed doors, and they may have stories of abuse or mistreatment
that they can relate. This is often a powerful way to establish
a pattern of abuse and neglect that has occurred at a particular
nursing home.
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COMMON INADEQUACIES & ABUSE IN
NURSING HOMES
All too often, nursing homes try to keep costs down by keeping
the number of staff members down. Improperly staffed facilities
can take away needed attention and services that are guaranteed
under OBRA. The results for the residents can be extremely serious.
Some of the more common occurrences of abuse in nursing homes include:
- Inadequate amounts of food or missed meals
- Insufficient amounts of fluids
- Not taken to the restroom when necessary (may be left lying
in their own urine or feces)
- Uncomfortable and health body and pressure sores
- Over- or under-medicated
- Ignored or left in bed all day where they are not turned (one
of the causes of bed sores)
- Attendant light not answered or ignored
- Not properly cleaned or groomed
Other inadequacies include:
- Altered or obliterated records
- Unrealistic care plan goals
- Failure to follow physicians' orders
- Unexplained decline in weight, skin integrity or physical condition
- Failure to assess or report change of condition
These less serious examples of neglect are more common but often long
term inadequacies of abuse in nursing homes. Less common but much
more serious are actual mistreatment such as dropping a resident or
intentional abuse. These examples of abuse in nursing homes can result
in serious injuries or death to residents. This is especially true
given the fact that elderly individuals have more fragile bones, etc.
In addition, nursing home residents are dependent on the staff for
nearly all of their daily needs--food, water, medicine, toileting,
grooming, and intellectual/social contact. When corporate owners are
more concerned about profits, nursing home staff can become overworked
and not have necessary training. This can result in inappropriate
or abusive behavior to vulnerable residents who simply want the basic
rights guaranteed to them under the law.
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