Nursing Homes Abuse Blog - By Jonathan Rosenfeld

By some accounts, more than 66% of nursing home patients are currently being treated for a complete or partial loss of bladder control.  Unknown to many, patients with a loss of bladder control suffer serious physical and psychological consequences.  Emotionally, patients may withdraw due to embarrassment of having an accident in public. 

Physically, nursing home patients suffering form incontinence tend to suffer higher rates of medical complications than their peers due to the fact that they may suffer from more rapid de-conditioning, dehydration (because they are scared to increase their fluid intake), higher rates of falls (rushing to get to the toilet) and perhaps most problematic-- an increase in the rate in development of bed sores.

Bed sores, also referred to as: pressure sores, pressure ulcers or decubitus ulcers, are wounds that develop when a nursing home or hospital patient remains in one position for an extended period of time.  Patients suffering from bowel or bladder incontinence are at a heightened risk for developing bed sores due to the caustic nature of feces and urine.  When the urine and feces remains in contact with the skin, the skin breaks-down faster than under 'normal' conditions.

I was happy to read about a new approach to treat urinary incontinence currently being implemented at Golden Living at Phoenixvile, a Pennsylvania nursing home.  The nursing facility utilizes a team-approach to analyze and implement an treatment plan for each patient according to their physical and cognitive abilities.

Typical urinary incontinence treatment plans include:

• Strengthening exercises for the pelvic region, hips and abdomen
• Behavior modification programs to help patients relax
• Modifying medication dosages and types
• Simple, practical methods such as: scheduling bathroom trips, modifying clothing to make removal easier and changes in eating routines

The urinary incontinence program appears to be working. "Loss of bladder control is not just a condition of the aging process," according to Roxanne Higgins, Rehabilitation Coordinator at Golden Living at Phoenixville.  "Our UI programs can help successfully treat many patients and help them enjoy more active lives."

Related:

Are incontinent patients at an increased risk for developing bed sores?

In order to prevent pressure sores, it is important to analyze the factors that make a person susceptible to developing them.

6 Most Common Causes Of Bed Sores & How Caregivers Can Help

Lack Of Cleanliness & Incontinence Contributes To Development Of Bed Sores In Nursing Home Patients

Incontinence Amongst The Nursing Home Population

Have you ever tried to read a nursing home patient's chart?  Were you able to read everything?  If so, please shoot me an email, because I surely have a difficult time sorting through many entries in charts.

A new collaboration between Golden Living and Microsoft may help to improve not just the legibility of medical records, but also aid in transmission of individuals medical records from one provider to another.  The system known as Microsoft Amalga Unified Intelligence System (UIS) stores each patients medical records on-line to allow ease of access by both the patient and subsequent health providers.

"The use of Microsoft Amalga allows the bridge of information between the various care settings and build a robust view of the patient across the enterprise no matter where they've been," said Brad Savage, a senior vice president and chief information officer for Golden Living.

Given the complexity of many nursing home patients' medical records, I'm all for any tool to help assist medical professionals with their treatment.  Especially, in situations involving critical care, where a patient may be unconscious or uncommunicative, this new technology may prove to be a literal life safer.

Read more about this new technology here.

About Golden Living:

Golden Living is a national company that provides medical care in a variety of settings.  In particular, Golden Living strives to serve people:

• Recovering from Joint Replacement Surgery
• Recovering from a Stroke
• Progressive Dementia or Alzheimer's Disease
• Assistance with Activities of Daily Living
• Managing a Chronic Disease
• Declining Health that Requires Long-Term Care
• Managing a Terminal Illness

There are more than 300 Golden Living nursing homes and assisted living centers located in more than 20 states. 

Karen Buck, a CNA in Muncie, Indiana, is facing Class D felony (abuse of individuals who are physically or mentally disabled) battery charges after allegedly slapping a 94-year-old nursing home resident in the mouth.  The alleged incident took place in June 2, 2007 at the Golden Living Center after the nursing home resident became agitated when Buck began to change the dressings on her feet with open wounds.  The resident was unable to speak due to complications from a stroke.  Authorities were tipped off to this incident following the report from Buck's co-worker who saw the nursing home abuse taking place. 

Officials from the nursing home claim the incident was investigated by officials from the state, ombudsman and police without any substantiated findings of abuse.  Despite the nursing homes claims, the case against Buck is proceeding to trial on April 24th.  Additionally, the family of the elderly woman who was involved in this incident has filed a civil lawsuit based on nursing home negligence against the the CNA as well as the nursing home for the woman's injuries.

Frequently, criminal cases like this never proceed to trial due to evidentary problems.  In this case, the prosecutor must rely exclusively on the CNA who allegedly witnessed this battery and reported it to authorities.  As with many nursing home workers who grip tight to their jobs, it will be interesting to see if this CNA will be willing to tell her story to a jury.  Read more about this case of nursing home abuse in Indiana here.