Jonathan Rosenfeld's Nursing Homes Abuse Blog : Jonathan Rosenfeld's Nursing Homes Abuse Blog | Lawyer & Attorney : Strellis & Field Law Firm | Bed Sores, Senior Neglect, Elder Abuse, Sexual Abuse: Chicago, Illinois

"Can a nursing home tie my dad to a wheelchair if he has had episodes of wandering around the facility?"

                                                                                           -Sam, Memphis, TN

After a recent post about a nurse tying a resident to a wheelchair with a bed sheet, I received several emails from concerned people regarding the use of restraints in nursing homes with their loved ones.  Restraints among nursing home residents are only permitted when a physician orders them to protect the resident and with the approval of the resident or his representative.  Federal law prohibits nursing homes from using restraints for the convenience of the facility or as a way of punishing the patient. (Code of Federal Regulations, 483.13(a). 

A restraint is considered to be: "any manual method or physical or mechanical device, material or equipment attached or adjacent to the resident's body that the individual cannot remove easily which restricts freedom of movement or normal access to one's body."  According to this definition, almost all medical equipment found in a nursing home could be used in this capacity to restrain a patient.

Rather than rely on restraint devises, staff in the nursing home should re-direct patients who have a tendency to wander.  If staff are unsuccessful in their attempt to re-direct, they should use electronic devices such as bed / chair alarms to alert them when a patient begins to move from the area where he was sitting / sleeping and the help the staff keep track of his whereabouts.

Compared with the nursing homes of the past, the use of restraints in nursing homes today is relatively uncommon.  Much of the reduction in use of restraints can be credited to studies that have demonstrated that the use of restraints in nursing home patients can be not only de-humanizing, but also downright dangerous.

Restrained nursing home patients are at risk for injury in the following situations when restraints are used:

• Falls
• Pressure ulcer / decubitus ulcer / bed sore
• Strangulation
• Loss of mobility
• Reduction of bone and muscle mass
• Incontinence
• Constipation
• Increased stress

Related:

Nursing Homes Curtail Use Of Physical Restraints With Residents

Nursing Home Sued After Resident Fractures Both Hips In Separate Falls

California Nursing Home Issued Most Severe Citation After Patient Fall And Death

• Email This
• Print
• Comments (2)
• Trackbacks

Two falls within a 24-hour period resulted in the death of a California nursing home patient.  The incident involved a patient was was recently admitted to the facility for rehabilitation following hip surgery.  The falls took place on May 9th and 10th at Aviara Healthcare Center in Encinitas, CA. 

After the first fall (that did not cause any injury), the staff put a bed alarm on the patients bed to alert the staff if he got out of the bed. Despite the bed alarm, staff at the nursing home failed take notice when the man got out of his bed and entered the nearby hallway.   In an effort to stabilize himself, the man grabbed on to a lift that was parked in the hallway and it fell on top of him resulting in multiple trauma.  Three days later, the man died from his injuries.

An investigation into the matter revealed that the facility should have never allowed the lift machine to remain in the hallway it posed a risk to residents due to its propensity to fall.  Investigators also determined that the facility failed to have proper guardrails that may have further contributed to the man's death.

The facility was fines $100,000 for this incident.  Read more about the fines related to this California nursing home here.

The importance of investigations by state agencies

One of the things that jumped in my head after learning abut this fall incident was how valuable inspections by state agencies are.  Inspectors have access to facilities where they can do a physical inspection of the equipment involved in an alleged incident-- but perhaps most importantly is that they have access to nursing home employees and administrators who have knowledge of an incident-- these people have no choice but to speak with these investigators.

In nursing home litigation cases, these inspections frequently provide the necessary information to successfully prosecute a case.  In most situations, by the time a nursing home negligence lawsuit is filed, the employees involved in an event have long since left the facility and it is difficult-- if not downright impossible to find them.  In the case of a disabled to deceased plaintiff, the testimony is essential to prove the case.

All this is to reinforce the importance of notifying the state department of health immediately upon learning of an event where a loved one was injured or killed.  A timely investigation by state authorities can mean the difference between a successful prosecution of a matter and an 'unfortunate tragedy'.

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

Never Event #1: Hospital Falls & Trauma

• Email This
• Print
• Comments
• Trackbacks