Nursing home neglect is generally caused by employees who are overworked or in a bad working environment where they do not get paid enough money, and so they become very apathetic. They start allowing a lot of problems to slip through the cracks, which leads to problems with dehydration, problems with malnutrition, and there can also be problems with bedsores or breakdown of the skin.
There could be severe problems if a person had bedsores, because they could get an infection and end up dying, which is something we normally see on the neglect side. Emotional abuse is probably seen more often on the abuse side, and tends to be caught when a change in the family member's personality is noticed. The person would have to be careful when judging this if their family member already had some dementia, because it could just be a progression of the disease.
The person in the nursing home might be scared and not tell their family that they were being abused, or that the nursing assistant or CNAs are being nasty or throwing things at them or allowing them to sit in their urine or in their feces. This might happen because they would be afraid that if they told their family, they would do something about it, and the staff might retaliate against them when their family was no longer there. It is a lot like abusive situations between husband and wife or abusive situations involving children. A child who is being abused becomes fearful of going to their teacher, their minister or the police because they are afraid there might be retaliation, which is the same thing that can be seen happening in nursing homes and assisted living facilities.
Are There Cases Where One Person Has Multiple Instances Of Abuse Of Clients?
I have heard of them, although I have not been particularly involved with somebody who might have a sexual abuse problem and abused more than one resident or something along those lines. I have been involved in cases with one resident in which multiple layers of employees dropped the ball, because the CNA did not report things to the nurse properly, and then the nurse did not report things properly to whoever they were answerable to. I have seen multiple layers of failure on one person but I have not personally been involved in cases where there was a bad employee who should have never been there.
What Are Some Misconceptions About Nursing Home Abuse And Neglect?
As a society we have a tendency to throw our older people away and cast them aside. Probably one of the biggest misconceptions we see is the idea that the life or quality of life of somebody who is older is just not as valuable as somebody in midlife or younger, which is just unfair and also not true, because if someone only had 5 or 6 years to live, then each day would be more precious for them than it would be for somebody who had 50 years to live. It is a common misconception that because the resident is old, their life would not be worth anything, so it would not be worth bringing a claim. Some people look at the situation and ask what the person bringing a claim might be expecting because the victim was 86, and they were going to die anyway.
Is There Anything Else People Should Know About Nursing Home Abuse And Negligence?
I am passionate about the bedsores or pressure sore problems and falls. There is a set procedure that needs to be followed when somebody goes into a nursing home, and a lot of times, somebody who goes into a nursing home is a Medicare or Medicaid recipient. Under federal law, a screening procedure called MDS would have to be done, and there would be a history and examination procedure after that, which would decide which specific screening the person would then need to go through. There is a special tissue breakdown test called the Braden Score that would need to be performed on someone at risk for tissue breakdown. When somebody was admitted, it would be the job of the nursing home or the evaluator to find out what the person's risks were for skin breakdown, for malnutrition, if they had any side effects to medication and their fall risk.
There are protocols and individual care plans that need to be set out based on the history, the initial intake and the MDS. There are specific protocols that need to be followed for skin breakdown, because it can be prevented by frequent inspection of the skin, good intake of water or fluids, good intake of food and by frequent turning and repositioning of the resident. There would never be anyone with a stage 3 or stage 4 pressure ulcer if these things were done, and even Medicare states that if somebody developed stage 3 or stage 4 pressure ulcers, then they would not pay for the treatment because those are events that never happen.
It is the same with fall risk. It would need to be charted if somebody had previous falls, had problems with vertigo or dizziness, had certain cardiovascular problems or was taking a medication that caused them to be lightheaded, because then a fall risk assessment could be done to determine whether protections needed to be put in place so the resident could stay safe. They could arrange for a lower bunk, a mat under the bed, a chair or bed alarm, or in certain cases the person might even need restraints, so all of those protocols and procedures would need to be put in place. There would be a problem if somebody fell and broke their head open and died, because it would mean the nursing home did not do their job upfront to protect them or assess them properly.
How Much Training Do CNAs (Certified Nursing Assistant) Have?
Not much at all. In some places a CNA program is for three months, whereas other places have six month programs and it is more like a vocational thing. CNAs get paid $7 to $10 an hour and are supposed to monitor blood pressure, monitor the vitals and clean people up, so it is a lower-end job. There is an RN or a registered nurse in nursing homes, who is probably like a supervisor, and they also have an LPN (Licensed Practical Nurse), who is one step down, who might also act as a supervisor. The CNAs actually have the most contact with the nursing home residents and they do most of the work with them, except for administering meds, because that is the job of the RN or the LPN. A CNA who had to take care of 8 or 10 rooms could be taking care of anywhere between 10 and 20 residents, and they could be very overworked, for example if they had two people on the call button at the same time, who both needed to go to the bathroom. There are also residents who are just cantankerous and constantly hinder the person from doing their job, which is just one of the problems, so it takes a special person to work in a nursing home.
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