Nursing Home Spotlight: Westside Rehab & Care Center

In the past year, Westside Rehab & Care Center has had 21 total health deficiencies, which is 13 more than the average number of health deficiencies in Illinois and the United States. This was actually an improvement from the total number of health deficiencies in the previous year, when the facility had a shocking 34 health deficiencies. Not surprisingly, Medicare gave this 96-bed nursing home facility located in Frankfurt, IL an overall rating of one-star, which is a much below average rating.

On August 10, 2009, a female resident suffered a leg fracture (broken bone) after falling during a transfer. The nursing home staff did not update her pain assessment in response to this injury, leaving the resident in unnecessary pain for an extended period of time.

During a complaint investigation, the resident told the investigator, “I am hurting! Can’t you help me?” The investigator reported this to the nurse, who then administered pain medication. This same resident was also noted to have dried blood on her face, neck and right arm and hands, with active bleeding on her right wrist. The resident was feeding herself with her fingers that were soiled with dried blood. The facility failed to prevent unnecessary pain and suffering for this resident, which means that the facility did not ensure that this resident maintained the highest level of physical, mental, and psychosocial well-being.

During the same complaint investigation, the investigator determined that the facility failed to ensure that each resident received adequate supervision and assistance to prevent accidents by failing to implement interventions to prevent staff from leaving a total care resident on the toilet alone. This failure resulted in the resident suffering two falls from the toilet.

The first fall occurred in February 2009, when the resident fell from the toilet and had to go the emergency room for evaluation of hip pain. After this fall, the facility should have implemented staff interventions in order to prevent additional falls. However, the facility failed to do so, and the resident fell from the toilet for a second time in June 2009. Falls are particularly dangerous for older adults who have older, weaker bones that are more susceptible to breaks (fractures). Therefore, it is very important that facility’s implement fall precautions in order to prevent resident injury.

Another complaint investigation revealed that the facility staff had knowledge that one resident suffered bruising after being physically restrained for a blood test and another resident was verbally abused. However, the staff did not implement preventative measures or report the potential for abuse to the administration in order to protect these residents and the other 52 residents from actual or potential physical or verbal abuse.

The resident who suffered physical harm was an 85 year old man with diabetes, who displayed behavioral symptoms of resisting care. The nurse woke up the resident in order to perform a blood test. The resident resisted and told the nurse that he didn’t want his blood drawn. The nurse then tried holding down the resident by placing her knee across his abdomen, even after the resident told her to stop. The nurse then called in two certified nurse aides (CNAs) for help in restraining the resident so that she could draw blood.

This incident was viewed by the resident’s roommate, who was awakened by his roommate’s screams. The roommate said that his roommate was shouting, kicking, and screaming for the nurse to stop. As a result, the resident suffered bruising across his abdomen. The nurse was counseled for “inappropriate behavior” and suspended for three days; however, the facility never performed an abuse investigation, as required. Also, the CNAs who were called into the room to help restrain the resident failed to report the mistreatment that they observed firsthand as is required by the internal reporting requirements.

Further investigation revealed that the nurse involved in the above incident was also verbally abusive to another resident. The resident reported that the nurse would yell at her to “move your a—“ and “stop being a baby” when the resident asked for pain medication. The nurse also used the “F” word at the resident. The resident and her roommate told the investigator that they didn’t report the nurse’s behavior because they didn’t want any problems. However, the resident did say that the nurse’s language “hurt her feelings.” Other facility staff members were also aware of the nurse’s verbal abuse and again failed to report the potential for abuse to the administrator in order to prevent abuse and mistreatment.

These incidents of abuse and mistreatment call into question whether Westside Rehab & Care Center can provide adequate and appropriate care for its residents, many of whom rely on the facility’s nurses and staff for activities of daily living. No resident should have to suffer physical mistreatment or verbal abuse such as the incidents reported at the facility. Although the facility has taken steps to improve staff training and intervention, it remains to be seen whether the residents will actually see an improvement in their treatment.

We represent victims of nursing home abuse and neglect.  For a free consultation, contact us (toll free) 888-424-5757.  We are here to help.

Sources:
IDPH: Westside Rehab & Care Center

Medicare: Westside Rehab & Care Center

Chicago Tribune: Compromised Care: West Side nursing home probed after death

Reflex Sympathetic Dystrophy (RSD) In The Elderly: A Real Cause For Concern Or More 'Funny Medicine'?

Several years ago my office represented an elderly woman who suffered a broken arm related to a fall at an assisted living facility.  The severity of the fracture required the application of a cast to align the bones.  A round of physical therapy also ensued after removal of the cast.  Despite the efforts of the doctors and physical therapists, pain originally thought to originate from the fracture continued on long after the bones had healed.  As it turned out, our client was suffered from a relatively little known medical condition known as reflex sympathetic dystrophy (RSD), also referred to as complex pain syndrome.

During the course of litigation, I learned a fair amount of information regarding RSD, but ultimately I was left with the impression that this disabling condition is grossly misunderstood amongst many in both the medical and legal communities.

What is Reflex Sympathetic Dystrophy?

Reflex Sympathetic Dystrophy Syndrome is a chronic pain condition that usually affects your arm or leg and displays a group of typical symptoms including pain (intense burning or aching pain), tenderness, swelling, discoloration, and altered temperature. Type 1 occurs after an injury or illness that does not directly damage the nerves in the affected limb; whereas, Type 2 (causalgia) occurs after a distinct nerve injury. Oftentimes, the pain is disproportionate to the severity of the injury.

What are the causes of RSD?

The cause of RSDS is still poorly understood. It usually follows a trauma-related injury, but again, it is not well understood why injuries can trigger this condition. Theories include irritation and abnormal excitation of nervous tissues which leads to abnormal impulses along the nerves affecting blood vessels and skin.

What are the symptoms of RSD?

RSDS can display a gradual or rapid onset of symptoms, and it may not display all typical symptoms. The symptoms may change over time and will vary from person to person. Typical symptoms include:

  • Burning pain
  • Increased skin sensitivity (allodynia)
  • Changes in skin temperature, color, and texture
  • Changes in hair and nail growth
  • Joint stiffness, swelling, and damage
  • Muscle spasms, weakness, and loss (atrophy)
  • Decreased ability to move the affected body part

RSDS often starts with swelling, redness, changes in temperature, hypersensitivity.  In many RSD patients the symptoms may worsen over time, the involved limb may become cold and pale, displaying skin and nail changes, and suffering muscle spasms and tightening.  Like most medical conditions, the symptoms associated with RSD differ from person to person.

What are the treatments for RSD?

There is no cure for RSDS. Instead, most treatment options seek to relieve the painful symptoms of the disease. Treatment for RSDS is most effective when started early. Usually, once the limb becomes cold and pale and the limb has muscle spasms and tightening, the condition is often irreversible.

A doctor will usually perform a physical exam and collect your medical history. Sometimes bone scans, x-rays, and MRIs (magnetic resonance imaging) can provide important clues in diagnosing RSDS. These tests can show increased circulation to affected joints, loss of minerals from your bones, and tissue changes.

The treatment for RSDS is specifically tailored for each case. Treatment options include various medications and therapies. Doctors might prescribe over-the-counter nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen, and Aleve) to ease pain and inflammation, antidepressants to treat pain from damaged nerves, corticosteroids (prednisone) to reduce inflammation, and bone-loss medications (Fosamax and Miacalcin) to help treat symptoms.

Your doctor might also recommend various therapies to help treat and improve symptoms. These therapies can include: applying hot and cold compresses, topical analgesics to reduce hypersensitivity, physical therapy to help improve range of motion, spinal cord stimulation for pain relief, electrical nerve stimulation to help ease chronic pain, and sympathetic nerve-blocking medication to block pain fibers in the affected nerves. Most medications and therapies merely help treat the pain and inflammation caused by the disease.

Complications associated with RSD

If RSDS is not properly diagnosed and treated at an early stage (within a few months of your first symptoms), the disease can progress into more severe symptoms including muscle wasting (atrophy) and contracture (tightening of your muscles which can leave your limb contracted in a fixed position).

RSDS can also occasionally spread from its source to another area of your body. The symptoms can travel from the initial site of the pain to a nearby area, or spread to an opposite limb, or even leap to a distant part of your body.

RSD & Nursing Home Patients

The mystery surrounding the cause and treatments for RSD leaves many nursing homes ill-equipped to adequately treat patients who suffer from this condition. When a resident is suffering from Reflex Sympathetic Dystrophy Syndrome (RSDS), the resident might experience pain that is more severe than one would expect with the sort of injury or trauma that they sustained.

Many times, nursing home staff do not properly diagnose the condition, leaving the resident in horrible and unnecessary pain as the condition worsens. This is because residents with RSDS often have pain and disability that cannot be explained on the basis of objective physical findings. For this reason, it is important to ensure that a nursing home facility takes your pain seriously.

It is imperative that nursing home facilities properly train their staff to recognize symptoms of RSDS because early treatment is so important in preventing the continuing progression of the disease. Facility staff should monitor residents’ pain and notify a doctor if the resident experiences constant, severe pain in a limb especially when moving the affected limb.

Elderly nursing home residents have an increased risk for dangerous slips and falls. These falls can result in broken hips, which often require surgery, bone fractures, bruising, head injuries, and other injuries. These injuries, which often affect the limbs, can be a source of trauma that puts them at increased risk to develop RSDS. If the nursing home facility does not properly monitor the resident’s pain and recovery following an injury, the resident might not be properly diagnosed with RSDS, which can lead to additional and often irreversible damage to the limb.

Many nursing home residents are often unable to communicate with nursing home staff members because of disease or mental illness. The facility staff might notice the resident crying out in pain for no apparent reason, but this pain, especially if constant and severe, can be an indicator of RSDS. Many nursing homes have large resident populations, which increases the likelihood of a resident’s pain being ignored or concern over constant pain being minimized.

If you or a family member experiences constant and ongoing pain, it is important to notify the nursing home facility and ensure that the pain is properly managed and treated. There is no excuse for nursing home facilities to ignore a resident’s pain, even if there is no apparent source. This pain could be an indicator of Reflex Sympathetic Dystrophy Syndrome or other underlying medical conditions.

Thank you to Heather Keil, J.D. for her assistance with this Nursing Homes Abuse Blog entry

Resources:

Medicine Net: Reflex Sympathetic Dystrophy Syndrome (RSDS)

Mayo Clinic: Complex Regional Pain Syndrome

National Institute of Neurological Disorders and Stroke: Complex Regional Pain Syndrome Information 

Grimes & Teich: Reflex Sympathetic Dystrophy (RSD)

Indiana University: Reflex Sympathetic Dystrophy (RSD) After Blunt Trauma: A Survey of Recent Literature

Nursing Home Patients Have More Post-Surgical Complications Than Their Peers

In the ever mounting pile of problems facing nursing home patients, we can now add another-- nursing home patients are more likely to die following gastrointestinal (GI) operations than their peers living independently.  A study compared the mortality rates for nursing home patients who underwent six types of GI operations including: bleeding GDU's, benign colon disease, colon cancer, cholecystitis and appendicitis.

After evaluating data from 30,721 nursing home patients and 1.18 million Medicare beneficiaries, the studies authors determined that nursing home patients are more than three times more likely to die following the surgical procedures than those living in the community.

The dramatic differences in the surgical outcomes are believed to be the result of a variety of factors that the study was unable to assess including poor conditioning and malnourishment.  

Despite the obviously disappointing data, surgeons are still convinced that GI surgery is necessary for some nursing home patients as that many of these conditions have almost certain mortality when left untreated. 

Now that the medical community knows that this problem exists, they must work to develop a plan to minimize some of these health known problems.  "If we can tease these things out, that's when we can try to design interventions that would optimize outcomes in terms of preparing these patients for surgery and developing pathways and interventions postoperatively," said senior author Emily Finlayson, MD, MS, an assistant professor of surgery at the University of California, San Francisco.

Though I would never hold myself out as an expert post-surgical care, my experience has been that orthopedic injuries such as hip fractures and limb fractures that require surgery are particularly devastating for nursing home patients.  Sadly, I see many of these people deteriorate physically and emotionally after this trauma.  Perhaps this research would be useful for orthopedic patients as well?

Resource:

Nursing Home Patients Suffer Higher Post-op Mortality Rates, General Surgery News, March, 2010

Nursing Home Operators May Be Responsible For Injuries Due To The Negligent Removal Of Snow & Ice

As winter weather sets in, the city is often covered in a blanket of snow and ice. While the slippery weather conditions present a danger to all of us, snow and ice are particularly dangerous for older adults who are already more likely to suffer from a fall and also more likely to suffer bone breaks and injuries.

Nursing home residents rely on the nursing home property owners (nursing home operators and manager) to provide a facility free of dangers that might cause dangerous falls or accidents. This responsibility includes the removal of snow and ice, which creates a serious risk of falling.

In Illinois, according to the Premises Liability Act (740 ILCS 130), owners or occupiers of land owe invitees and licensees a duty of “reasonable care under the circumstances regarding the state of the premises or acts done or omitted on them.” An owner or lessee must provide a reasonably safe means of access to its business. If you bring a premises liability claim, you, the plaintiff, have the burden of proving that your injuries were caused by a condition on the property that was not reasonably safe that the owner knew or should have known of by the exercise of reasonable care.

However, this duty of reasonable care is different in the case of snow and ice on property. In Illinois, absent a contractual obligation, if you are walking down the street and happen to slip and fall on a snow or ice covered sidewalk or parking lot, the property owner owes you no duty to remove the natural accumulation of snow, water, or ice. (Illinois Snow and Ice Removal Act – 745 ILCS 75).

The Act states that it is undesirable for any person to be liable for damages due to his snow removal efforts, unless his actions amount to “clear wrongdoing.” Illinois follows the natural accumulation rule, where a property owner is only liable for a snow or ice related accident only if their alleged misconduct was willful and wanton or there was an unnatural accumulation of snow or ice or a natural condition that is aggravated by the owner. (McBride v. Taxman Corp., 327 Ill.App.3d 992 (1st Dist.2002); Ziencina v. County of Cook, 188 Ill. 2d 1 (1999)).

Natural accumulation is the result of natural weather conditions; whether accumulation is natural or not is oftentimes a difficult factual question. Examples of natural accumulation are: a sidewalk that has not been shoveled, puddles of water inside buildings from melting snow, ice formed by snow being packed down by pedestrians. Unnatural accumulation would be any actions by the property owner that cause snow or ice to accumulate in a specific location. One exception to the natural accumulation rule is if there is a contractual obligation to remove snow or ice; for example, if the property owner or manager has a provision in a lease providing that the owner agrees to remove snow or ice. If this is the case, the owner may be held liable.

Nursing home facilities must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of its residents. Part of this responsibility is ensuring that “the resident environment remains as free of accident hazards as is possible” (Requirements for States and Long Term Care Facilities – 42 CFR 483).

Therefore, nursing home operators owe residents a higher level of duty than a regular invitee or licensee, which under premises liability would only require them to exercise ordinary or reasonable care in maintaining the premises in a reasonably safe manner. Nursing home residents are more vulnerable than the regular invitee or licensee, and the degree of care owed is greater in recognition of that vulnerability.

Absent any dangerous winter weather conditions, nursing home residents are already more vulnerable to dangerous slips and falls, which can lead to serious injuries such as broken hips and head injuries. Even minor falls can be dangerous because elderly people are more susceptible to bone fractures than younger people because as bones age, they lose the ability to resist the formation and growth of cracks which can lead to bone breaks. The federal code regulating nursing homes is sensitive to nursing home residents’ vulnerability to falls, even specifying a standard for flooring; “the facility must have floors that have a resilient, nonabrasive, and slip-resistant surface.”

Therefore, nursing home operators must take extra precautions to make the nursing home facility premises safe for elderly residents. This includes installing slip-resistant flooring and removing dangerous snow and ice. Nursing home operators have a contractual duty to make the premises free of accident hazards, including hazards posed by snow and ice.  

Unnatural Accumulation Of Snow & Ice

If the nursing home operator removes snow or ice in a negligent manner or creates an unnatural accumulation of snow or ice, they may be liable for the resident’s injuries.  Similarly, if you are visiting a family member at the nursing home and happen to slip and fall on snow or ice, you may bring an action against the nursing home even though you are not a party to the contract because you are a foreseeable user of the premises.  

If you or a member of your family has suffered a dangerous fall because of dangerous snow or ice accumulation at a nursing home, you have the right to hold the nursing home owner or operator responsible for those injuries. The nursing home is obligated to provide a safe environment for all residents, and that includes an environment free of dangerous snow and ice.

Thanks to Heather Keil, J.D. for her assistance with this Nursing Homes Abuse Blog Entry

Resources:

Illinois General Assembly – Nursing Home Care Act 210 ILCS 45
Illinois General Assembly – Premises Liability Act, 740 ILCS 130
Illinois General Assembly – Snow and Ice Removal Act, 745 ILCS 75

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New Technology Promises To Reduce Falls In The Elderly Population

There's no doubt about it, falls in the elderly population are a major cause of injury and even death.  The New York Times, ran an encouraging article that by incorporating relatively simple (and inexpensive technology) the number of falls can be reduced.

Using wireless sensors on clothes and strategically placed within rooms, scientists can monitor many different aspects that may be responsible for causing falls including: cardiovascular weakness, changes in medication, early stages of dementia and muscle degeneration.

The data from the sensors can be sent to a person's doctor to help in monitoring overall health and their likelihood of falling with the goal of taking interventional steps before a fall occurs.

The technology seems to work.  According to a recent study sponsored by the Technology Research for Independent Living, fall rates in a sample group of 60 to 94-year-olds were reduced by 30% when doctors used the sensor data to customize a rehabilitation and medication plan in accordance following data analysis.

With an annual cost of more than $75 billion per year, this fall-sensor technology may be a great investment for insurance companies and long-term care facilities because each unit costs less than $200-- certainly less than a trip to the emergency room or surgically repairing a hip fracture.

Obviously, more research needs to be done, but this technology seems to be very encouraging from both a quality of life and economic standpoint. 

Facts About Nursing Home Falls

  • About 1800 people die each year due to falls in nursing homes
  • 10 to 20% of nursing home falls result in serious injury
  • 2 - 6% of falls result in fractured bones
  • 3 out of 4 people living in a nursing home will fall this year
  • Most people are 'repetitive fallers'- After a first fall, there is a substantial likelihood that you will fall again
  • Most falls go unreported

Strellis & Field represents individuals and families in claims and lawsuits against nursing homes and long-term care facilities across the country.   If your loved one has suffered an injury or died in a fall, we are always available to discuss your legal options. (888) 424-5757

Related:

Fall In Nursing Home Claims The Life Patient-- Less Than 24-Hours After Admission

Even Common Falls Put Elderly At Risk For Developing Subdural Hematomas

Bone Fractures In The Elderly Require Special Attention To Improve Recovery & Prevent Complications

What Is Hypostatic Blood Pressure & Why Is There An Associated 'Fall Risk'?

Bone Fractures In The Elderly Require Special Attention To Improve Recovery & Prevent Complications

Many elderly people suffer broken bones during admissions to nursing homes due to; falls, being dropped, or perhaps improper care from staff.  Regardless how the fracture occurred, a fractured bone in the elderly must be timely identified and treated.

What is a fracture?

A fracture is a broken bone that requires medical attention. Fifty percent of women over age fifty and twenty-five percent of men over age fifty will suffer from an age-related bone fracture sometime in their lifetime.

Elderly people are particularly susceptible to broken bones because as bones age, they lose the ability to resist the formation and growth of cracks that can lead to bone breaks because they cannot withstand as much pressure as younger bones.  Unfortunately, as we age, our bodies ability to heal fractures is compromised.

Nursing home staff can take steps to help maintain bone health in elderly nursing home residents:

  • Regular exercise
  • Adequate amounts of calcium
  • Adequate amounts of vitamin D (essential for calcium absorption)

Osteoporatic Nursing Home Patients and fractures

Elderly nursing home residents who have osteoporosis (porous weak bones) or other conditions that lead to weakened bones or decreased bone density are at risk for bone fractures. Weak bones have low levels of calcium, phosphorous, and other minerals in the bones, which makes people more susceptible to fractures because the bones are more brittle. 

Women suffering from osteoporosis are twice as likely to suffer from bone fractures than men with osteoporosis.  Fractures from osteoporosis are most common in the spine and hips (bones that directly support your weight), and the wrists from bracing. Therefore, nursing home staff should take extra precautions to prevent falls and provide adequate nutrition to maintain the well-being of residents.

Diabetic Nursing Home Patients and fractures

Many nursing home residents also suffer from diabetes. A recent study suggests that there is an association between a drug introduced in the 1990s to help treat type 2 diabetes (thiazolidinediones) and bone fracture. The increased risk of fracture increased as the duration of the drug treatment increased and was observed in both men and women. Therefore, nursing home residents who have been treated with this drug also might have a further increased risk of bone fractures. 

Medical treatment for fractures in the elderly

Treatment for bone fractures depends on the location of the break. For most fractures occurring in the arms, legs, hands, and feet, the initial treatment is splinting the injured limb and immobilizing the joints above and below an injury to prevent movement at the fracture site. Then, the splint is removed and replaced by a cast. 

Some breaks might also require surgery in order to properly align bone fragments, increase stability, and ensure that bones will heal properly. Some fractures might also require metal hardware (pins, plates, or rods) to hold the bones in place. Older adults heal slower than younger people, which can cause additional complications and mobility issues for nursing home residents. 

How we can help

Depending on the circumstances regarding the fractured bones, the medical facility may be responsible for the damages relating to the fracture.  In many cases, we have successfully recovered damages for our clients', medical bills, medical equipment, pain and disability.  If you believe that a nursing home is responsible for your broken bone, we would be honored to speak with you to discuss your legal rights. (888) 424-5757

Resources:

Mayo Clinic: Fractures

Lawrence Berkeley National Laboratory: Why Older People Suffer More Bone Fractures

Science Daily: Risk of Bone Fractures Associated with Use of Diabetes Drug

Related Nursing Homes Abuse Blog Entries:

Nursing Home Staff Must Take Precautions While Moving & Transferring Disabled Patients To Minimize Risk Of Dropping

Fall In Stairwell Results In Paralysis-- And Ultimately Death Of Chicago Nursing Home Resident

Nursing Home Sued After Resident Fractures Both Hips In Separate Falls

Nursing Home Cited For Mistreatment Of Resident Following Investigation Of Resident's Fractured Neck

Nursing Home Sued After Resident Fractures Both Hips In Separate Falls

A nursing home negligence lawsuit has been filed against Stearns Nursing and Rehabilitation Center after a 95-year-old resident fell on multiple occasions and suffered hip fractures. The lawsuit alleges that the facility failed to implement fall precautions despite the fact the facility knew the resident suffered from Alzheimer's, was generally confused and considered to be a 'high fall risk'.

The lawsuit claims, Stearns suffered multiple falls resulting in injuries during her admission from May 25th through July 7, 2007. In particular, the lawsuit alleges the following specific incidents:

  • On May 27, the resident wandered the hallways, unattended, and fell fracturing her left hip.
  • On June 6, while left unattended in a wheelchair and with a shut-off personal alarm, she fell out of the wheelchair.
  • On June 15, the resident pulled herself out of her wheelchair and roamed the hallways un-assisted and fell, fracturing her right hip

The lawsuit is pending in Madison County Circuit Court.  Read more about this lawsuit against Stearns Nursing and Rehabilitation Center here.

Nursing Home Falls

More than 1,800 people die each year in nursing home falls.  All health care professionals in the nursing home setting must work together to help encourage nursing home safety.  Nursing homes are required to conduct a fall-risk assessment for every resident to determine who may be at risk for falls.  This puts the staff on notice as to who may need special attention and sets forth what accommodations should be in place for each resident.

Additionally, staff should always be on the lookout for residents who may require assistance getting about.  If residents have a history of falls, the facility should consider using alarms on chairs or beds to notify the staff when the person attempts to walk on their own.

Falls in nursing homes occur for a variety of reasons.  Some of the more common causes for falls  are:

  • Muscle weakness and walking or gait problems
  • Hazards in the nursing home- wet floors, poor lighting, improper be heights, improperly maintained wheelchairs, equipment left out of place
  • Medications-  Drugs that effect the central nervous system, such as sedatives and anti-anxiety drugs (psychoactive drugs)
  • Improperly fitting shoes or incorrect walking aids
  • Frequent use of restraints
  • Inadequate staffing levels that fail to provide sufficient assistance to residents

If your loved one sustained a fall during a nursing home admission, our nursing home litigation team will provide a free case analysis to determine if a lawsuit against the facility is warranted.  Why not put our experience advocating on behalf of the elderly to work for you today?

Related Nursing Homes Abuse Blog Entries

How Many Falls Is Enough To Impose Responsibility On Nursing Home?

Nursing Home Cited For Mistreatment Of Resident Following Investigation Of Resident's Fractured Neck

Falls Amongst The Elderly Can't Be Ignored

Nursing Home Waits 19 Hours To Provide Medical Treatment To Resident Who Fractured Her Hip During Sabina Lift Transfer

A recently disclosed Minnesota Department of Public Health report concluded the Good Samaritan Society of Albert Lea was guilty of 'neglect' due to its delay in providing medical treatment to a resident who fell during a transfer from her bed to her wheelchair.  The episode took place on November 21st when a worker at the facility improperly used a Sabina lift to move a resident with dementia into a wheelchair.  During the transfer, the resident fell and fractured her hip.

A 'care plan' specifically stated that the resident was to wear shoes or gripper socks during transfers. At the time of the incident, the resident was wearing stockings that "enabled her feet to slip from the base of the lift, causing her to fall onto her right hip," according to the state's investigative report.

The resident involved in the incident suffered a stroke prior to her admission and was unable speak and was dependent on the staff for daily living activities.  Despite the resident's disabilities, six staff at the facility were aware of the resident's fall and the possibility of her injury because she was behaving differently after the episode-- yet no medical attention was provide for more than 19 hours after the fall occurred.

The morning following the incident, the resident was transferred to a hospital where and x-ray confirmed the woman's hip was indeed fractured.  The hip fracture required surgery.

Good Samaritan terminated the employee who was operating the lift and the nurse-supervisor following their own investigation into the matter.  According to the nursing home's own investigation, the employee responsible for the lift also failed to provide 'satisfactory' care to two other residents in the days following the lift incident.

Read more about this nursing home injury during a transfer here.

Transfers In Nursing Homes

A 'transfer' in a nursing home setting generally refers to moving a patient from a bed to a wheelchair. Transfers are usually done two ways: using nursing assistants or mechanically (Hoyer / Sabina lift). The type of transfer depends mainly on the patients physical condition.  If a patient is capable of providing some assistance, a staff lift (one or two person transfer) is generally done.  However, if a patient is paralyzed or suffers from physical disability, the use of a mechanized lift may be required to safely transfer the patient.

The choice of how to transfer a patient from a bed to a wheelchair is up to the facility.  A determination of the type of transfer should be part of the evaluation when a person is admitted to the facility and for quarterly reviews of nursing home patient needs.  It is crucial for the staff at the facility to use the properly predetermined transfer technique or the nursing home resident is at risk to injury. 

If you or a relative sustained an injury during a 'transfer' to wheelchair, walker or toilet, there is a strong likelihood the staff responsible for supervising made an error.  We have handled many similar lift-related injury cases.  Put our experience to work for you.  To speak with our team of nursing home attorneys, call (888) 424-5757.

A Video Diagram Of A Hip Replacement Surgery

Hip fractures are one of the most common problems affecting nursing home residents.  As we age our bones thin and become more brittle increasing the likelihood of a sustaining a hip fracture due to a fall or being dropped by nursing home staff. Most hip fractures require surgical repair when the hip joint is actually replaced with hardware. Here is a useful step-by-step explanation of how a hip replacement surgery is done.

Prevention of falls should be a priority in all nursing homes.  To minimize the risk of falls the following fall prevention measures should be taken.

  • Remove clutter from floor
  • Remove improperly fitting slippers and other clothing
  • Keep bed rails up when patients are sleeping
  • Provide adequate staff and equipment when transferring into and out of bed
  • Install handrails in areas where patients need stability
  • Keep call lights within reach of residents in bed at all times.  Residents can request assistance easily.
  • Lock wheels on wheelchairs and beds when transferring patients
  • Monitor patients with low blood pressure

If a loved one sustained a fractured hip or femur during a stay at a nursing home, it may be due to the negligence of the facility.  Our office can work with you and determine if you have a viable cause of action.  Speak to an experienced nursing home attorney anytime. (888) 424-5757

Past Nursing Home Abuse Blog Articles on falls:

Never Event #1: Hospital falls & Trauma

ï»żImproper Transfer Leads To Fall & Untimely Death of Rehab Patient

Study Links Medication Use With Falls

Why Bother With Hip Pads?

Following my recent post on the frequency of hip fractures in nursing homes, I received several responses from blog readers who asked me about the effectiveness of hip pads in preventing injury and hip fractures to nursing home residents.  For those that don't know, hip pads are usually similar to underwear with built in plastic and foam pads.  The overwhelming evidence suggests that hip pads do little to prevent hip fractures amongst the elderly.  In fact, a recent study of 1,000 nursing home residents was terminated because the hip pads were so ineffective in preventing fracture.

According to the study's author, Dr. Douglas Kiel, of Harvard Medical School, 'In the United States, nearly 340,000 hip fractures occur per year, more than 90 percet of which are assiciated with falls, and the number of hip fractures may double or triple by the middle of this century.' Further, 'The highest incidence rates of hip fractures have been reported in nursing home residents, where 50 percent of residents fall each year.' 

So the question remains, why do nursing homes and facities use hip pads in the first place?  I really con not think of any reason other than the fact that some nursing homes would rather use a device to take the place of staff involvement and supervision of their residents.  The only effective way to prevent nursing home falls is to identify people who may be prone to falls and to provide adequate assistance to residents throughout their daily living activites.

Read more about hip pads in nursing homes here.

Hip Fractures And Some Unsettling Statistics

Hip fractures are a frequent result of falls in nursing homes.   In fact, an elderly person living in a nursing home is more likely to sustain a hip fracture while at the facility than they would living independently.  Most hip fractures require surgery.  The type of surgery required depends on where the break is and how bad it is. Your doctor may put metal screws, a metal plate, or a rod in your hip to fix the break. Or you may need to have all or part of your hip replaced.

The outcome for nursing home residents who sustain a hip fracture are disappointing:

  • 17% to 33% mortality rate for the year following the fall
  • 25% to 33% of residents are unable to walk following surgery and physical therapy
  • Up to 15% of hip fracture patients suffer from pressure sores

Nursing homes must take the risk of falls and hip fractures seriously.  The best prevention of a hip fracture is for a nursing home to identify residents who may be at risk of falling and to have adequate staff in the facility to provide assistance to residents. 

If you or a loved one has suffered a fall in a nursing home and sustained a hip fracture, the facility is responsible for damages from the initial fall, all subsequent medical care and decay in physical conditions.