Are nursing homes doing enough to prevent falls?

Nursing home falls can lead to broken bones, serious injury, and even death.  Considering how devastating falls can be for nursing home residents, the question has to be asked: are Virginia nursing homes doing enough to prevent falls?

One thing that does not prevent falls is routine restraint use.  Some nursing homes will use restraints, thinking that residents will be less likely to fall, but the reverse is true.  Studies show clearly that restraint use actually increases the likelihood that a resident will be injured or killed in a fall.  Not only that, but routine restraint use can be demoralizing for elderly residents and an overreliance on restraints can be equated to abuse.

Nursing homes can prevent falls by using a variety of tactics that include medical intervention, physical rehabilitation and making changes to resident’s living environment.

1. If a patient falls, staff and doctors should evaluate the person to understand what caused them to fall (physical limitations, environmental problems) and treat the underlying problem.
2. Nursing home staff should be educated about fall risk factors and strategies that can be used to prevent falls.
3. Staff can make changes to the nursing home environment to reduce the likelihood of a fall.  Changes include secure railings and grab bars, lower beds, raised toilet seats and ensuring rooms and common areas are clean, well-lit and clutter free.
4. Staff can outfit residents with hip pads that can reduce the likelihood that their hip will break in a fall.
5. Beds can be equipped with alarms that alert staff if a resident who needs help to move tries to get up without assistance.

Read more about nursing home falls in our law library articles “The Danger of Nursing Home Falls in Virginia” and “Virginia Nursing Homes and Restraint Abuse”.

The many faces of nursing home abuse and neglect

Elder abuse isn’t only about bedsores or cuts and bruises.  It can be subtle, and can take many forms.  If you have the feeling that something isn’t quite right at your loved one’s nursing home, don’t be afraid to speak up.

If you are confused about what might be considered nursing home or assisted living abuse, here are some different types:

• Physical abuse that involves hitting or harming an individual’s body
• Neglect is when caregivers fail to meet a person’s basic needs, such as failing to provide medication, causing malnutrition or dehydration by failing to feed or offer drinks, failing to supervise a resident who subsequently falls and hurts themselves, and more.
• Emotional abuse includes yelling, insults, intimidation, threats and harassment of a resident.
• Sexual abuse involves inappropriate sexual touching, conduct or penetration against a resident’s will or without a resident’s consent.
• Financial exploitation happens when somebody misuses a resident’s bank accounts or takes control of their insurance, checking or savings accounts, insurance or other financial documents without consent.

Being alert about the different forms of nursing home abuse is the first step towards prevention.  If you know what to look for, you are more likely to spot a small problem before it becomes a major issue.

Please read “Signs of Nursing Home Abuse and Neglect” to learn more about how to spot nursing home abuse and neglect.

Types of elder abuse at nursing homes and assisted living facilities

Elder abuse is a term that describes any intentional or negligent act by a caregiver, facility staff member, or other person that causes harm or risk of harm to a vulnerable adult.  There are a variety of different kinds of elder abuse and neglect which are summarized below:

·        Physical Abuse – Causing physical pain or injury to a vulnerable elder or threatening to inflict pain or injury.  Physcal abuse can also mean depriving a resident of a basic need.

·        Neglect – the failure to provide food, shelter, health care or protection for a vulnerable elder.  Neglect can be a conscious or act or can be the result of poor care or training.

·        Sexual Abuse - Non-consensual sexual contact of any kind with a vulnerable adult

·        Emotional Abuse – when mental pain, anguish, or distress is inflicted on a vulnerable adult.  Emotional abuse is caused by either verbal or non-verbal acts.

·        Financial Exploitation – Taking, using or concealing funds, property, or assets of a vulnerable elder without permission.

·        Abandonment – when a vulnerable elderly person is deserted by the person responsible for their care or custody (i.e. leaving the person in a public place).

Read more about the signs of elder abuse and neglect in our law library article “Signs of Nursing Home Abuse and Neglect”.

Nursing Home Residents’ Rights

More than two decades ago, the U.S. Congress requested that the Institute of Medicine conduct a study regarding the care of nursing home residents.  The study’s findings were alarming. According to researchers, nursing home residents were often the victims of abuse and neglect.  It was also found that they were not receiving adequate care.  As a result of this study, the Nursing Home Reform Act, which is part of the Omnibus Budget Reconciliation Act of 1987, established guidelines for nursing homes.

Nursing home residents are now protected under the Nursing Home Reform Act and are given certain legal rights.  Nursing home facilities that receive Medicaid or Medicare must provide specific services to residents, including a comprehensive care plan, nursing services, social services, rehabilitation, periodic assessments, dietary services and pharmaceutical services.  If the nursing home has more than 120 beds, there must be a full-time social worker.

One of the major changes that came about as a result of the Nursing Home Reform Act had to do with mandatory reviews.  At least every 15 months, an inspector will go to a nursing home to conduct a survey, which includes interviews with residents.  The survey is unannounced and focuses on the rights of residents, quality of care, quality of life and services being rendered.  If there are complaints being made about a nursing home, a complaint investigation will be initiated.

If a nursing home is in violation of the Nursing Home Reform Act, a citation or deficiency notice will be issued.  The severity of the citation depends on the violation.  Remedies will be given to correct the violation.

Nursing home abuse is devastating for the victim and the victim’s family members.  If you feel that your loved one may be the victim of nursing home neglect or abuse, contact Dulaney, Lauer & Thomas, LLP at 888-907-2631 for the Warrenton office or 800-741-1012 for the Culpeper office.

The article, Nursing Home Reform Act – Rights of Nursing Home Residents, has more information on this topic.