South Carolina Nursing Home Lawyer Blog

Sadly, preventable pressure sores (also known as decubitus ulcers and bedsores) frequently occur after an elderly person is admitted to a nursing home. What is a pressure sore? It is an area of skin that has broken down because a person has stayed in one position too long without shifting their weight. Constant pressure on one location will reduce blood supply to the area, and the tissue around that area will die. An estimated 17 to 28 percent of nursing home residents will develop at least one pressure sore.

Nursing home residents are frequently unable to turn themselves or move with normal frequency. As a result, they must rely on their caregivers at the nursing home to move them regularly. But too often, nursing home residents just aren't moved enough.

Bedsores are categorized according to four different stages, from Stage I (the mildest) to Stage IV (the most severe).

Stage I
A reddened area on the skin that does not turn white when pressed. A pressure ulcer is beginning.

Stage II
An open sore or a blister has developed. The skin around the ulcer is often irritated and red.

Stage III
The sore has formed a crater. Damage below the skin can easily be seen.

Stage IV
The sore has become so deep that there is damage to muscle, tissue, bone, tendons, and/or joints.

Pressure sores frequently become infected, and we often hear reports from new clients of a foul odor. Infections can be critically serious. The tissue around the bedsore can become very warm to the touch.

How can bedsores be prevented?
There are a number of things that nursing homes should be doing to prevent pressure sores from developing in their residents. There are also many things that can be done to heal pressure sores before they worsen. Here are a few. First, nursing home residents who are bedridden, or who suffer from diabetes, circulation problems, incontinence, or mental disabilities must be checked for pressure sores daily. Second, they must have their position changed every two hours. Third, items such as pillows and foam products can be used to reduce pressure. Fourth, residents must be provided with enough healthful food and water. Fifth, skin must be kept clean and dry. Sixth, after urination or a bowel movement, make sure the resident's skin is promptly cleaned and dried.

When a nursing home resident develops pressure sores, it can be a sign of a serious neglect problem. We recommend that you obtain photos of the wound, but first and foremost, the nursing home resident needs active medical intervention to prevent pressure sores from worsening.

Continue reading " Pressure Sores and Decubitus Ulcers in Nursing Homes " »

I am very often asked this question. The first thing I tell people is to choose a non-profit nursing home, if you find a suitable one. Non-profit nursing homes are not perfect. In fact, some non-profit nursing homes have seen some shocking neglect and abuse. However, some of the very best care can be found in good non-profit nursing homes. As a general rule, avoid a for-profit nursing home. The reason for this is that the profit motive very often leads some corporate decision-makers to under-staff and under-supply nursing home facilities. However, in many communities there is no suitable non-profit choice, and in any case, there are things you should look out for in any nursing home. Here is a list of things to consider:

1. - Choose a non-profit nursing home, if possible.

2. - Spend a lot of time making multiple visits to various nursing homes before you make a decision.

3. - Visit your final few choices on holidays, on Sundays, and in the afternoon and evening.

4. - Do not become fixated on fancy lobby furniture, art on the walls, or nice indoor plants. Those things are not good indicators of quality care.

5. - Understand that a guided tour of the facility is usually nothing more than a sales presentation. A guided tour is not a good way to judge a nursing home.

6. - Speak with the residents. Ask them what they think of the care they receive at the facility. Take their comments seriously. How is their grooming? Is everyone in a fog, or can some of the residents carry on a normal conversation? Talk to bedridden residents and residents in wheelchairs. If the facility will not let you speak to the residents, this can be a major warning sign.

7. - Eat a meal yourself to judge the food quality. Don't take the nursing home's word at face value. Visit during mealtimes, and observe whether and how much the residents are eating. Are bedridden residents adequately assisted with eating, or are trays of cold food simply left beside the resident without any assistance?

8. - Are pitchers of fresh water within easy reach of every resident's bedside?

9. - How does it smell? If rooms, hallways, and the residents themselves smell of urine, feces, or worse, this probably indicates that the residents are not being changed frequently enough. This is a very serious matter, and can easily become life-threatening, and even fatal.

10. - Are there enough certified nursing assistants (CNAs) on staff during all three shifts? Ask residents if the facility has enough staff in private.

11. - Every facility receiving Medicare funds must have the latest State Survey of the facility ready for you to review. Read the State Survey in detail, and look for potential problems. Also, review Medicare's own online comparison and rating of each nursing home here.

12. - Speak with family members of the residents. Ask them about any problems. Take their answers seriously.

13. - Meet the Director of Nursing, the Medical Director, and the Administrator. Is delivering the highest level of care possible their primary focus? Does the Medical Director visit with each resident frequently (daily or weekly)?

14. - Ask if the facility allows you to install a computer camera (a so-called "granny cam"), so that you can monitor your loved one's room when you are away. If the answer is "no," ask yourself why such cameras wouldn't be encouraged.

Continue reading " How to Choose a Nursing Home for Your Loved One " »

Here are some more warning signs that could mean that your loved one is being neglected or abused:

1. Your loved one frequently becomes ill, and you and/or the physician are not immediately notified.

2. Incidents involving fractures or broken bones, particularly broken hips.

3. Over-medication.

4. The unexplained death of your loved one.

5. Another resident injuring your loved one.

6. Injuries occurring during a so-called "wandering" episode, where the staff is not aware that your loved one has gone missing for a period of time.

7. Neglecting your loved one's daily necessities, including food, water, and clothing.

8. Failing to care for your loved one's existing medical conditions.

9. Your loved one becomes malnourished or dehydrated.

10. Your loved one's clothing goes missing.

11. Your loved one's personal hygiene suffers.

12. Failing to provide necessary medical attention.

13. Forcing your loved one to stay in their room.

14. Slapping, pushing, shaking, or beating your loved one.

15. Your loved one suddenly has open wounds or cuts.

16. The nursing home cannot or will not explain your loved one's condition.

17. Under-medicating your loved one.

18. Unreasonable physical restraints.

19. Over-use of chemical restraints or psychotropic medications.

20. Sexual Assault or Rape.

21. Physical Assault or Battery.

22. Your loved one suddenly wants to be isolated all of the time.

23. Unusual behavior suddenly develops in your loved one.

24. Sudden personality change.

25. Your loved one suddenly becomes withdrawn.

26. Your loved one is very upset emotionally or becomes extremely agitated.

Continue reading " More Warning Signs of Nursing Home Abuse and Neglect " »

As the percentage of seniors in our society gets larger and larger, more and more people are being cared for in assisted living communities, rest homes, and nursing homes. The quality of care in these homes must be at a high level, because the medical issues facing their residents are as complex as they are numerous. Sadly, however, many nursing homes are staffed by an inadequate number of nursing assistants. Nursing staffs are frequently not given proper training, adequate supplies, or sufficient compensation. They work longer hours than they should. They aren't given the tools they need to do their job. It is a disaster waiting to happen - and disasters are happening in many nursing homes and assisted living facilities all over our country. It is a silent epidemic.

Nursing home residents are a highly vulnerable population. Very often, the residents are relatively isolated, too, and this makes them an easy target for substandard care.

Warning signs include:

injuries requiring hospitalization or emergency treatment,

extreme weight loss,

repeated falls,

medication errors,

elder reports of abuse,

unexplained bruising,

pressure sores (decubitus ulcers), and

infections.

These are just some of the warning signs. There are many more.

So, what can you do? First and foremost, visit frequently. Visit on Sundays, on weekends and holidays, and at varying times of day. Second, talk to the Administrator, the Director of Nursing, the Doctor (Director of Medicine) and the nursing home's Social Worker. Third, talk to the nursing staff. Fourth, talk to the ombudsman in your state. If your loved one was or is in a South Carolina nursing home, feel free to call me at (803) 808-9600, and I can provide you with the name and telephone number of the ombudsman assigned to the appropriate county.

Continue reading " What Should You Do If You See Warning Signs? " »

People frequently ask me, "What exactly is elder abuse?" The phrase "elder abuse" simply means the physical, emotional or sexual abuse or neglect of an older person. Every year, many thousands of older Americans are mistreated in their own homes, in elder care facilities, and in nursing homes. We see an increasing number of older people being abused and neglected in nursing homes, and many believe that the root of the problem is greed.

Let me explain.

A lot of nursing homes and elder care facilities are for-profit. That means that behind all of the niceties, their chief motive is to make as much money as they possibly can. There is nothing wrong with earning a profit, but some nursing homes take things too far. A lot of facilities are intentionally understaffed - to save costs and boost profits. The care of your loved family member is often left to poorly-trained, overworked, and under-paid nursing assistants (sometimes called CNAs). A lot of facilities make it a habit of operating with far less staff than is required by state law. Many facilities do not perform background checks on their new hires, so you don't really know who is given the responsibility to take care of your loved one. The work is highly stressful, too, so burnout, lack of sympathy for the nursing home residents, negative job attitudes, and ultimately sometimes abuse can occur.

It's scary, but it is preventable, too. Nursing homes do not have to let their facilities get beyond their control. A lot of these homes rake in unbelievable amounts of profits. It is when patient care suffers at the hands of profits that we are called upon to step in.

Continue reading " What is Elder Abuse? " »