California Nursing Home Abuse Lawyer Blog

Understaffing in Los Angeles Nursing Homes Contributes to the Inability of Dementia Patients to Receive Proper Nutrition during Mealtimes

February 2, 2012 | by Law Offices of Ben Yeroushalmi

In skilled nursing facilities, one of the busiest and most hectic times of the day is mealtime. For dementia patients, mealtime is an extremely significant indicator of quality of life. Recently, a study titled “Factor’s Affecting Independence in Eating among Elderly with Alzheimer’s Disease” was published in the journal of Geriatrics & Gerontology International. Researchers who conducted the study noticed that patients who suffered from dementia often experienced a decline in the ability to eat independently. Because of their need for feeding assistance, it is important to recognize the signs of dementia by monitoring residents during their mealtimes.

The study observed that patients with dementia and other cognitive disorders, such as Alzheimer’s disease often had difficulty beginning their meals by themselves. This could be a result of an inability to recognize the material on their trays as food. Sometimes, even when patients were able to identify their food, they were unable to comprehend how much food to transfer to their mouths, and by what means to do so. For example, patients with dementia often had difficulty using their utensils properly to scoop the proper amount of food, either scooping too little food or too much food all at once.

Often, dementia patients also had difficulty distinguishing between food and non-food items. Even when they were able to identify their food, as a result of visuospatial impairments, these residents sometimes only recognized portions of their meals as food, and left the remainder untouched. Other patients with dementia who suffered from attention disorders or disorientation were unable to stay focused on eating during the entire mealtime. Some were distracted by other activities, while others were unable to remain alert and fell asleep during their mealtime.

Unfortunately, nursing homes are often inadequately staffed and unable to provide their residents with the one-on-one feeding assistance that they often need. Especially in patients with dementia, nursing home neglect during mealtimes has serious consequences. According to the study, one of the most common symptoms of dementia during mealtimes was the inability to begin eating. Consequently, patients often become anorexic or malnourished because facilities are understaffed and nurses are far too overwhelmed during mealtimes.

The study also pointed out that in most skilled nursing facilities today, each individual care provider is permitted to use their own judgment on how to feed patients. While this may be acceptable in nursing homes with qualified and well-trained nurses, such as licensed practical nurses (LVNs) and registered nurses (RNs), many facilities leave meals to the discretion of care aides and certified nursing assistants (CNAs) who often are not thoroughly educated on the dangers of malnutrition and dehydration. Therefore, skilled nursing facilities should have set guidelines or rules that must be followed during mealtimes. Instead, trial-and-error experiments are generally accepted in determining the best foods to feed residents. However, this is extremely dangerous, because just one simple error in feeding that is not in adherence with physician’s orders can have serious consequences, and even lead to death. For this reason, nursing homes should also employ dieticians during mealtimes, to ensure that doctor’s orders are being followed and to maintain the highest practicable nutrition and physical health of patients.

The study suggested altering the texture of meal or adjusting the patient’s posture in order to encourage independent eating. Additionally, certain therapies exist to improve and maintain the swallowing function. However, once dementia reaches more serious stages, it is difficult to perform these rehabilitation exercises. Therefore, nursing staff need to be aware of the symptoms discussed above that patients with dementia often show during mealtimes. It is the responsibility of the nurse to identify the onset of dementia early on in its progression, and to implement the proper therapies and treatments to encourage independent eating.

Study Shows that C. Difficile Infections Are Ten Times More Prevalent in Los Angeles Nursing Homes that Are Understaffed and Unable to Uphold Safe Infection Control Policies

February 1, 2012 | by Law Offices of Ben Yeroushalmi

Clostridium difficile, abbreviated as C. difficile, is just one of the many infections that are common in nursing homes. Caused by inflammation of the colon, some symptoms include diarrhea, nausea, vomiting, loss of appetite, fever, and cramping. Because residents of skilled nursing facilities live in such close quarters, infections are able to spread rapidly. Therefore, it is crucial that the nursing home staff take extensive measures to prevent the spread of infection. An article, titled “High Prevalence of Clostridium difficile Colonization among Nursing Home Residents in Hesse, Germany” and published in the January 2012 issue of Plosone Journal studies the outbreak of C. difficile infections in skilled nursing facilities.

After observing and analyzing various nursing homes for the presence of C. difficile the survey moved to study the general population. In comparison, the result of the study revealed that the prevalence of C. difficile was ten times higher in skilled nursing facilities than in the general population. This statistic was consistent with similar studies of C. difficile in the United States and the United Kingdom. This shows that although the study was conducted in Germany, the dangerous spread of infectious diseases in nursing homes is an issue that occurs internationally, including within our own local Los Angeles skilled nursing facilities.

The study cited antibiotic use as a common factor among nursing home residents that increased the prevalence of C. difficile. Certain antibiotics are known to kill the bacteria in the intestines that regulate C. difficile bacteria and ultimately prevent C. difficile infections from occurring. Because the use of antibiotics in skilled nursing facilities to treat various infections is so common, elder adults become more susceptible to contracting C. difficile.

Incontinence is another condition that increases the risk of the rampant spread of C. difficile in nursing homes. Patients who suffer from fecal incontinence must be monitored frequently and changed immediately, especially those also infected by C. difficile bacteria. According to the study, even up to several weeks after the disappearance of infection symptoms, 15 to 20 percent of patients are still at risk of a recurring infection and therefore still able to infect other residents. Because mere contact with the bacteria is enough to cause an outbreak of the infection among other residents of the facility, hand hygiene of nurses is an extremely important prevention technique. The facility, especially bathroom surfaces and other shared common areas, must be kept sanitized, in accordance with state and federal health codes.

Furthermore, the study alleged that although C. difficile was ten times more prevalent in skilled nursing facilities than in the general population, an entire 27 percent of the nursing homes studied failed to instigate specific infection control and management guidelines. Often, this is because the preventative measures and techniques outlined above are difficult and nearly impossible to execute effectively when the nursing home facility is understaffed.

However, it is the responsibility of the skilled nursing facility to not only employ an adequate amount of staff to sufficiently care for its residents, but also to ensure that this staff is qualified and able to recognize and accurately diagnose infections early on, and to instigate infection control measures when necessary. Failure on behalf of the nursing home to fulfill this duty is an egregious act of neglect and elder abuse that violates your loved one’s rights as a patient.

Recent Study Identifies Pharmaceuticals that May Increase the Risk of Adverse Drug Reactions Among Los Angeles Nursing Home Patients

January 27, 2012 | by Law Offices of Ben Yeroushalmi

While polypharmacy, the use of multiple drugs simultaneously, is known to have dangerous effects on the physical and psychological health of patients, other causes of adverse drug reactions among the elderly population are lesser known. A study, titled “Geriatric Conditions and Adverse Drug Reaction in Elderly Hospitalized Patients,” published in the February 2012 issue of the Journal of American Medical Directors Association, seeks to discover another explanation for the occurrence of adverse drug reactions, focusing on the relationship to geriatric conditions.

After assessing 506 patients, the study concluded that hematologic, neuropsychiatric, and respiratory drugs are the most likely to lead to adverse drug reactions. With respect to geriatric conditions, patients who experienced adverse drug reactions suffered from cardiovascular, dermatologic, gastrointestinal, and psychiatric disorders. They also experienced a loss of independence, including incontinence and an inability to perform other activities of daily living.

Fortunately, incontinence is not a disease, but a symptom, that can be improved with the proper care. One treatment technique is called prompted voiding and involves the coordination of a patient’s bathroom schedule with a schedule of food and liquid intake. Nurses and dieticians also need to manage the nutrition and fluid intake of their residents. According to Patients’ Rights, the nursing staff is obligated to maintain the hygiene and dignity of your loved one if he or she suffers from incontinence. When proper care is not provided and patients who soil themselves are not changed immediately, incontinence can have serious consequences, such as the development of pressure ulcers. Needless to say, adequate staffing is absolutely necessary in order for treatment to be successfully executed and for hygiene and dignity to be preserved.

According to the study, falls, in particular, were strongly linked to the usage of neuropsychiatric drugs. Because falls are so dangerous, as they can lead to injuries, such as hip fractures and head trauma, and sometimes death, caregivers need to be even more careful with patients who are using neuropsychiatric drugs. This requires communication between the patient’s physician and the nursing staff. Unfortunately, the nursing staff does not always have your loved one’s best interest at heart, so it is important for you to ensure that such communications are taking place and that physician’s orders are being followed.

On the contrary, nurses sometimes use drugs as restraints, in an attempt to prevent falls. Often, antipsychotic drugs are used as chemical restraints to sedate patients. The use of chemical restraints is not only a violation of rights, but is also dangerous, as it puts patients at a higher risk for death. You should check that your loved one’s medications are prescribed for medically sound reasons, and also ensure that your loved one is not being physically restrained either.

Recent Study Identifies Risk Factors that Increase the Chance of Falling in Los Angeles Nursing Homes and Determines that Most Falls are Preventable with Proper Staffing

January 25, 2012 | by Law Offices of Ben Yeroushalmi

Each year, approximately 1.7 falls occur per nursing home bed. Because falls can lead to hip fractures, head trauma, and other injuries that may lead to death, analyzing the causes of falls and establishing prevention techniques is extremely important in assuring that your loved one’s nursing home is promoting the safety and well-being of its residents. With this goal in mind, the Journal of American Medical Directors Association published an editorial titled “Increasing Awareness of Factors Producing Falls: The Mini Falls Assessment” in its February 2012 issue.

The Mini Falls Assessment is a questionnaire that was developed at Saint Louis University. With just seventeen basic question categories, the assessment determines individuals who are at a higher risk of falling. The assessment inquires about polypharmacy, vitamin D use, blood pressure, sitting and standing balance, strength and gait, fear of falling, falls in the past six months, foot deformity, physical ability, weight loss, and frailty. Points are assigned to each question, and each patient is given a score, which, depending upon their answers, can total to thirty. The developers emphasize, however, that the scores are relatively unimportant because an answer of “no” to even just one question already puts the patient at a higher risk for falling.

Of all the risk factors that increase the likelihood of nursing home residents falling, the two that are most preventable are related to diet and exercise. In your search for the ideal nursing home, make sure that the facility not only employs a qualified nursing staff, but that there is also an adequate amount of indirect care staff. During mealtimes, a dietician should always be present. Malnutrition and dehydration can lead to weight loss, fatigue, dizziness, and frail joints and bones. These are all factors that significantly increase the risk of falls in elderly adults. Physical therapists should also be present to guide residents in exercises and activities that will improve their muscle strength. A recent therapy that has proven to be extremely effective is progressive resistance training, in which participants perform exercises against an external, opposing force that increases as the patient’s muscle strength improves.

It is no secret that patients who are susceptible to falls require additional care and assistance from nurses. Recent studies have discovered that elderly adults who reside in nursing homes fall three times more frequently than those who live independently. Inadequate staffing explains this shocking statistic. Many skilled nursing facilities are understaffed and are therefore unable to give each and every individual patient the attention that he or she needs and deserves from a skilled nursing facility. Consequently, residents fall, and even more shocking is the fact that they often are not found until much later, after they have already suffered the pain of their injuries for hours on end. If your loved one has died from a fall-related injury as a direct result of understaffing and nursing home neglect, you may be able to make a Wrongful Death claim.

Sometimes, instead of using fall prevention techniques, understaffed facilities employ the use of physical restraints. This is a direct violation of Patients’ Rights, which state that patients can only be restrained for medical purposes, and even then, they may refuse treatment. You must be cautious, for nurses often justify the use of physical restraints by claiming that they promote the safety of patients, as well as everyone around them. However, physical restraints are actually a direct cause of many health ailments, such as pressure ulcers and incontinence and also lead to a decline in independence and mobility.

Of all liability cases filed against skilled nursing facilities, 60 percent are a result of fall-related injuries. With the proper staffing and a hazard-free environment, the occurrence of falls in nursing homes can be avoided. If your loved one has sustained any fall-related injuries, he or she may likely be a victim of nursing home neglect because such injuries are preventable.

Recent Study Confirms Link between Adequate Staffing and Avoiding Unnecessary Hospitalizations

January 18, 2012 | by Law Offices of Ben Yeroushalmi

In a recent issue of the Canadian Journal on Healing, the Canadian Association on Gerontology conducted “A Survey of Nursing Home Organizational Characteristics Associated with Potentially Avoidable Hospital Transfers and Care Quality in One Large British Columbia Health Region.” The researchers first examined previous studies on avoiding hospitalization in nursing home patients, which have shown that transfers to hospitals often lead to a decline in quality of life for the patient, and that skilled nursing facilities with the proper resources are often better equipped than hospitals to treat certain conditions. However, not all nursing homes are prepared to treat your loved one in the case of an emergency. In this study, the researchers aimed to identify the specific conditions that are required in order for nursing homes to be more effective than hospitals in treating patients. The survey was organized with various questions surrounding some main themes.

The first category of questions analyzed staffing. The study showed that higher levels of staffing were directly linked to lower levels of hospitalizations. Direct care staff members were considered to include registered nurses (RNs), licensed practical nurses (LPNs), and care aides. The results of the study also emphasized communication between staff, particularly care aides. Despite the fact that they usually engaged in the most contact with patients directly, care aides were often excluded from everyday decision-making processes concerning patients.

While most facilities employed all three types of direct care staff, the presence of non-nursing staff, such as dieticians and rehabilitation and activities directors, varied. However non-nursing staff are also very necessary to provide your loved one with the quality of care that he or she needs. For example, a dietician should be present during mealtimes, to ensure that your loved one is receiving the proper nutrients to support his or her health, and to prevent the possibility of malnutrition.

The study also took note of each facility’s nursing hours per patient per day, which shows the importance of adequate staffing. On average, nursing hours per patient per day was calculated to be 3.17. However, according to California state law Health & Safety Code §1276.5-1276.65, the minimum staffing level is 3.2 nursing hours per patient per day. It is important not only to ensure that your loved one’s rights are not being violated and that the care facility is fulfilling staffing level requirements, but also that they are receiving high-quality care from well-trained professionals.

The second theme of survey questions focused on physician care. The results of the survey showed that continuity of care contributed to lowering the amount of hospitalizations. When a patient is continually examined by the same doctor, the physician establishes a familiarity with the patient’s medical history and is better able to treat the patient effectively, thus avoiding unnecessary hospitalizations. However, we must warn you to be cautious with who and what you believe because nursing homes have an incentive to manipulate their patients’ diagnoses. While upcoding is advantageous because it involves reporting more serious health conditions to receive more funding from the government, downcoding, which involves intentionally underestimating the seriousness of a condition, is also beneficial for the nursing home because it reduces the facility’s liability. Therefore, if you sense that something is wrong, it is important for you to get another doctor’s second opinion.

The third type of questions analyzed palliative care. All too often, nursing homes neglect patients whom they perceive are dying and leave them to suffer in the last days of their lives. In other cases, the facility often instigates a transfer of the patient to a hospital, so that he or she can die there. However, nursing homes can usually provide better, more comfortable end-of-life care than hospitals, and those with palliative care standards, which are pre-signed orders from a certified physician, usually involving the prescription of narcotics to ensure a death void of as much suffering and pain as possible. Although most of the facilities had updated palliative care orders, a significant 22% of nursing homes did not have any form of palliative care at all. Therefore, you should take the precautions to ensure that palliative care orders exist for your loved one in the necessary cases.

Los Angeles Nursing Homes Manipulating Patients’ Medical Conditions for Their Own Personal Gain

January 16, 2012 | by Law Offices of Ben Yeroushalmi

Recently, as reported by The Baltimore Sun on January 12, 2012, certain health care groups have been engaging in a practice called “upcoding.” This increasingly prevalent practice involves healthcare providers reporting more serious medical conditions to the government, in order to receive higher reimbursement rates. In this specific case, an orthopedic company was accused of manipulating patients’ files to make it seem as though patients had a serious form of malnutrition, called kwashiorkor. The company denies these claims and is fighting back.

However, malnutrition is a serious problem that must not be underestimated. The most obvious sign of malnutrition is weight loss. Malnutrition has many health implications, including pressure ulcers, infections, pneumonia, and falls.

Usually, malnutrition is a direct result of understaffing. When there are not enough nurses working during mealtimes, residents do not receive the proper food and nutrition that they need. Furthermore, mealtime should be a time for positive social engagement, which must be initiated and encouraged by nurses. Often, nursing homes appear to be fully staffed during day shifts, but during night shifts and mealtimes they are actually inadequately staffed. When choosing a skilled nursing facility for your loved one, make sure to visit during mealtimes so that you can get a first-hand experience of what your loved one’s mealtimes will be like. If possible, try a sample of the food your loved one will be eating, and check if a dietician is present. You should also make sure that your loved one is not suffering from dehydration, which often accompanies malnutrition.

Interestingly enough, while some healthcare facilities are “upcoding,” others are “downcoding.” Although “downcoding” entails that the facility receives less funding from the government, nursing homes use this practice to lower their liability. For example, pressure ulcers are relatively easy to downcode because there are different levels of severity. Instead of accurately diagnosing a pressure sore as stage four, which is very serious, nursing homes often claim ignorance and diagnose these sores as being in their early stages of development. They allow patients to continue suffering until the problem is so serious that they must be sent to the hospital. At this point, nurses often claim that previously, the sore was not a severe one, and that it just recently developed into a stage four pressure ulcer. This allows them to attempt pass the responsibility on to the hospital or new care facility to which the patient is transferred. Once again, the development of pressure ulcers, as well as any other health ailments in nursing homes, is usually a direct consequence of understaffing. Regardless, nurses are fully responsible for the prevention of pressure ulcers, and must also be knowledgeable enough to accurately diagnose them, when necessary.

While the list of problems experienced in skilled nursing facilities is extensive, the main purpose of this blog is to emphasize how simple it is for healthcare facilities to manipulate their patients’ health records. For this reason, it is imperative that you are extremely cautious in allowing others to care for your loved one. Even if the facility makes claims and promises to you, it is important for you to ensure that the caretakers are following through with these promises. If you notice that something is wrong, or if your loved one is diagnosed with an illness, we advise you to get a second opinion. All too often, the elderly are taken advantage of and forced to suffer because skilled nursing facilities misdiagnose their patients. Do not allow this to happen to you or your loved one.

Nursing Homes and Pharmaceutical Companies Are Cheating Government Health Programs for Profit

January 13, 2012 | by Law Offices of Ben Yeroushalmi

On January 10, 2012, Bloomberg News featured a story about Omnicare, a pharmaceutical company, that adjusted its billing records and reported false information to government health programs, such as Medicare and Medi-Cal, in order to increase its own profits. According to the report, the government may have lost millions of dollars from Omnicare’s fraud. Despite the story making it to news headlines, the truth of the matter is that health facilities cheat the government fairly often. Previously, Bloomberg News reported another situation that involved nursing homes that were incorrectly billing Medicare. To read more about that story, click here.

Incentives for cheating the government vary. In some cases, such as this most recent one, companies are simply seeking profit. In other situations, health facilities take advantage of Medicare by unnecessarily ordering drugs that were never prescribed by doctors. These drugs are usually used by nurses to chemically restrain patients. Antipsychotic drugs are the most common chemical restraints because of their power to sedate patients. However, these drugs that are intended to treat mental illnesses are more often used to treat patients with dementia. Because dementia patients are often subject to episodes of aggravation, nurses find it more convenient to subdue them with antipsychotics rather than to take the time to calm them down with behavioral techniques.

Specialists confirm that the best treatment for dementia-related aggravation is therapeutic, not pharmacological. Because aggravation is often caused by polypharmacy, or the excessive use of multiple drugs simultaneously, it only makes sense that adding more medications will only worsen patients’ conditions. Some types of treatments that have proven effective are pet and music therapy, as well as encouraging social interaction among patients, especially during mealtimes.

Beyond the ethical implications of using drugs to restrain patients, the improper use of antipsychotic drugs also poses many risks. Studies have shown that the use of antipsychotics in dementia patients more than doubles their chances of death. Additionally, patients are put at a higher risk for falls, depression, and isolation. You should also learn more about the dangers of physical restraints, and make sure that your loved one is not being restrained in any way by his or her nursing home, either physical or chemical.

Although the use of chemical restraints is an undoubtedly cruel act, nurses sometimes feel that they are left with no other choice. Nursing homes are often so understaffed that caregivers must take shortcuts in order to provide enough time to tend to each of their patients. Unfortunately, this abbreviated care is never sufficient in providing your loved one with the quality of care that he or she needs.

Understaffing and Lack of Resources in Los Angeles Nursing Homes Leads to Improper Prevention and Treatment of Pressure Sores and Puts Patients at Risk for Wound Infections

January 3, 2012 | by Law Offices of Ben Yeroushalmi

In the January issue of the Journal of American Medical Directors Association, an article titled “When is a Chronic Wound Infected?” studies various methods of determining when a chronic wound is infected and judges which of these methods is most accurate. The article begins by explaining that the skin is a major barrier against infection, and therefore, the risk of a wound becoming infected is extremely high when skin starts to break down. The criteria for a wound to be considered infected requires that bacteria be present in the wound, and that this bacteria is producing tissue damage. There are many different types of wounds, but this particular article studies chronic wounds, such as pressures sores.

Physicians and wound care specialists use colony forming units (CFU) per gram of tissue to measure the presence of bacteria in a wound. They have established the “10^5 Rule,” which asserts that in the surgical closure of ulcers, spontaneous healing will occur at bacteria levels lower than 10^5 CFU. This rule implies that once spontaneous healing occurs, the possibility of infection is diminished and caretakers can conclude that the chronic wound is not infected. However, according to the American Medical Directors Association, the “10^5 Rule” may be inaccurate because there are factors other than the quantitative measure of bacteria that contribute to the development of infections. One such factor is the virulence of the bacteria. For example, certain infections, such as staphylococcus aureus, pseudomonas aeruginosa, and Bacteroides fragilis are so virulent that even at levels below105 CFU, infection is highly likely and requires treatment.

The article determined that a tissue biopsy is the most accurate method of determining whether or not a patient is suffering from an infected wound. However, most skilled nursing facilities do not perform biopsies. Instead, they obtain a surface swab of the wound and test the sample for the presence of infectious bacteria because this process is less costly and much simpler than a tissue biopsy. Despite its practical benefits, the use of surface swabs to determine if a wound is infected can be misleading. Often, the infection is incorrectly diagnosed and consequently, patients do not receive proper treatment and are unable to make a full recovery.

However, laboratory tests are not completely at fault when an infected wound is incorrectly assessed. In nursing homes that are understaffed, as well as in those that employ unqualified nurses, infected wounds are often overlooked, ignored, or inaccurately diagnosed. In fact, pressure sores are usually preventable and it is therefore the responsibility of the nursing staff to take these preventative measures, so that your loved one may avoid the pain and suffering that is caused by an infected wound. In the case that a pressure sore becomes infected, it is the duty of the nursing staff to ensure proper treatment. In addition to the usage of medications, some treatments include pressure relieving techniques, such the use of special mattresses and the repositioning of the patient, as well as the cleaning and dressing of the wound.

Recent Study Proves Exercise Is Effective in Reducing Loss in Muscle Strength and Encourages Los Angeles Nursing Homes to Use It

December 30, 2011 | by Law Offices of Ben Yeroushalmi

Loss of muscle strength in elderly adults is an extremely serious problem because it occurs within the entire elderly population. Between the ages of fifty and seventy, adults lose thirty percent of their muscle strength. As they approach the age of seventy, elderly adults experience a loss in muscle strength of 1.5 percent per year. Because loss of muscle strength is associated with physical frailty, increased dependency, and a decline in strength, balance, coordination, reaction time, flexibility, and muscular and cardiovascular endurance, it is important to prevent or delay its onset for as long as possible. Lower muscular endurance and balance, specifically, are directly responsible for the occurrence of falls.

Fortunately, treatments and exercises exist to increase and improve muscle strength in elderly adults. One treatment, called progressive resistance training, was recently studied by the American Medical Directors Association and published in the November issue of its journal. Progressive resistance training involves exercises that are performed against an external, opposing force that increases as muscle strength increases. The study proved that this type of exercise is effective in improving muscle strength in elderly adults.

It is important to ensure that your loved one’s skilled nursing facility is not only providing treatments and exercises to prevent loss in muscle strength, but also preventing avoidable injuries, such as falls. Although exercises can improve muscle strength, a gradual decline in strength is, unfortunately, sometimes inevitable in elderly adults. It is therefore the responsibility of the skilled nursing facility to prevent falls from occurring. The key to preventing falls is to draft an individualized care plan for each resident. More importantly, nurses must abide by this care plan in their daily caretaking. However, nursing homes are often understaffed, which makes it difficult for nurses to carry out care plans. Unfortunately, therefore, preventable falls occur much too often in nursing homes.

Sometimes, skilled nursing facilities utilize physical restraints, in order to reduce the risk of falls. However, recent studies have shown that the use of restraints, over time, does not effectively decrease the rate of falls in nursing homes.

Furthermore, the use of physical restraints can lead to an array of health problems, such as pressure sores, incontinence, and depression. It is also a direct violation of Patients’ Rights, which state that restraints may only be used for medical purposes, and even under such circumstances, patients may refuse treatment.

Because falls are avoidable through proper prevention techniques, it is completely inexcusable that falls occur so often in nursing homes. If your loved one has suffered injuries from a fall that eventually led to death, you may be able to make a Wrongful Death claim. Such claims are warranted when a nursing home’s neglect is directly responsible for a resident’s death.

Nursing homes must encourage residents to partake in activities and exercises to increase their muscle strength. Although progressive resistance training has proven effective, elderly adults still remain at a high risk for falls. Therefore, skilled nursing facilities must also take precautions to lower the risk of falls.

Study Shows That Understaffing Is Directly Linked to Poor Treatment of Pressure Sores in Los Angeles Nursing Homes and Leads to an Overall Decline in Quality of Life

December 29, 2011 | by Law Offices of Ben Yeroushalmi

Pressure sores, also known as decubitus ulcers or bed-sores, are common in elderly adults who are not properly cared for or neglected. They are especially prevalent among those who reside in nursing homes, often as a direct result of neglect by caregivers.

Pressure sores can occur when a patient remains in one position without moving, putting pressure on one area of the body for an extended period of time. There are varying degrees of seriousness, but all levels require an attentive and qualified staff. It is the responsibility of the nursing home to take preventive measures, such as repositioning their patients, in order to decrease the risk of pressure sores developing or getting wore.
Treatments for pressure sores also require a high amount of involvement from qualified and well-trained nurses.

One type of treatment involves multi-layer bandaging of pressure sores, as well as special footwear for patients. This treatment has proven to be highly beneficial to patients with pressure sores, as it improves healing and increases overall quality of life. However, despite its benefits, this practice is not commonly used in skilled nursing facilities.

In a recent study, the Australian Wound Management Association and the New Zealand Wound Care Society sought to discover the reason for such low usage of bandaging practices in nursing homes. They hypothesized that, perhaps, lack of funding was the reason for the low usage of bandage treatments in nursing homes. Two different groups were formed to conduct the study. One group received funding for bandage treatments and the special footwear that it requires, while the other group did not receive any funding. However, in the end, both groups were found to have the same rate of usage of bandage treatments. Because there was no significant difference between the group that received funding and the group that did not, the researchers concluded that usage of bandaging in skilled nursing facilities is not effected by the cost of treatment or lack of funding. Instead, the study discovered that the reason for such low usage of bandaging in nursing homes is directly related to staffing issues.

Although the cost of special footwear is substantial, the most expensive requirement for the treatment of pressure sores is nursing care. Because it is such a high cost, care facilities often opt out and hire less staff in attempts to save money and increase profits. However, adequate staffing is absolutely necessary for the proper treatment and prevention of pressure sores. Nurses must also be qualified and knowledgeable. The study found that often times, bandaging was not used because nurses failed to notice the onset of a pressure sore or poorly assessed its level of severity and therefore were unable to provide immediate treatment to patients. In homes that do use bandaging, the study discovered that nurses were often applying the bandages incorrectly, thus lowering the effectiveness of the treatment.