New Study Examines Culture of Safety at Nursing Homes

The Joint Commission Journal on Quality and Patient Safety recently published a story on the culture of safety that does (or does not) exists at certain nursing homes. Obviously, this research has very clear implications on the prevalence and prevention efforts of nursing home neglect and abuse. The comprehensive study can be read in full here.

Essentially, the research effort sought to connect accreditation by an independent non-profit organization called the Joint Commission and the improvements in quality of care and safety cultures at nursing homes. Used in this way, “safety culture” refers to “patterns of attitudes and behaviors observed in health care.” Each Chicago nursing home neglect lawyer at our firm has worked on countless cases were nursing home neglect was alleged which, at the end of the day, could be traced back in some way to inadequate facility commitment to maximizing safety protocols each and every day.

In the past, research has confirmed that accreditation from the Joint Commission led to better safety initiatives and better patient outcomes at hospitals. This new research sought to test the same concept in nursing homes. A few previous efforts had studied some aspects of nursing home accreditation. One of those efforts found that accredited facilities had fewer inappropriate medication prescriptions, fewer medication errors, and less restraint-use. All of these outcomes are welcome, strongly indicating that the accreditation standards outlined by the Joint Commissions should be pursued by all facilities with a commitment to maximizing quality of care for their residents.

This latest research sought to expand on those previous efforts by examining the effect of accreditation on the overall safety culture at the facilities, beyond just individual adverse outcomes or instances of nursing home neglect. The effort was centered on thousands of surveys with senior managers, caregivers, and residents, at various long-term care facilities throughout the country.

What did they find?

At a basic level, expectedly, those facilities that are accredited by the non-profit organization indicated a more favorable resident safety culture when compared to non-accredited facilities. This basic finding held even when various other factors were taken into account which might affect safety commitments. Those other factors include profit status, organizational structures, and staffing levels. Each Illinois nursing home abuse lawyer at our firm knows this doesn’t meant that staffing and profit-status don’t affect care levels—they do. Instead, this suggests that even for-profit facilities with low staffing levels can comparatively improve their own care by seeking out Joint Commission accreditation. Yet, receiving accreditation often requires changes in staffing levels and procedures, often limiting the workload of each individual staff member.

In addition, the research effort found that residents themselves in nursing homes that were accredited had their feedback responded to more favorably. This was expected considering that the Joint Commissions standards in this regard demand prompt and significant attention be paid to all resident complaints, particularly as they relate to “sentinel events.” This requirement demands that facilities conduct a thorough analysis of the incident, develop action plans to prevent similar harms in the future, and then properly monitor that plan’s implementation.

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Yesterday we discussed the demographics inside nursing homes and the fact that many local elderly residents would prefer to age in place rather than move into a long-term care facility. Each Chicago nursing home neglect lawyer appreciates that fact that few seniors prefer to be in these facilities anyway, which is what makes their mistreatment at the home that much worse.

As the total number of seniors grows and resources dwindle, it will become increasingly important for local residents to have access to alternative forms of long-term care. Considering the current amount of Illinois nursing home neglect, without huge changes in the running of these facilities there will likely be much more neglect when more and more seniors enter these homes in need of long-term care. Obviously one way to fix the problem is to improve the quality of care at all of these facilities. That is a worthy goal that must always be pursued. However, in addition, it is important to also work on ways to keep seniors from being forced to move into these homes in the first place.

Fortunately, there are a growing number of businesses that cater to this need and some changes in the works with programs like Medicaid which might allow more seniors to age in place who otherwise might not be given the chance. However, it is important not to assume that proper care is guaranteed to be provided just because one receives support at home instead of a nursing home. Elder neglect, mistreatment, and exploitation can occur at one’s own home as well. In fact, when perpetrated by friends and family members, this sort of mistreatment may actually be even more common than abuse in long-term care facilities.

For this reason, it is crucial to ensure that at-home care agencies be researched so that families understand the standards that are applied to all workers who will be involved in providing the services.

Unfortunately, not all at-home aides have pure motives. For example, just this weekend the Chicago Tribune reported on an at-home care worker who was charged with senior financial exploitation after stealing from an elderly resident for whom she was supposed to be providing at-home care. According to the story the employee worked for Help and Home, Inc. and was hired by an 83-year old Englewood resident to clean her home. However, according to the charges filed, the woman used the opportunity to take the senior’s checkbook. She made out a range of checks to herself (a total of eleven) while forging the senior’s name. She then cashed the checks, trying to take a total of $1,400 from the unsuspecting senior. The theft apparently took place over a period of about two months at the end of last year.

As with choosing a nursing home, our Chicago senior care lawyers remind all local seniors and their families to ensure that due diligence is part of all senior care choices—from picking a nursing home to choosing at at-home aide for cleaning chores. It is sad that so many local residents view vulnerable seniors as a way to enrich themselves. Yet, it is better to do a bit more research than necessary at the outset to ensure that seniors feel comfortable in not being taken advantage of in any way while allowing another into their home to provide the support that they need.

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Women with Older Partners More Likely to End Up in Nursing Home

Considering the frequency with which Illinois nursing home neglect takes places and the dissatisfaction of so many residents, our Chicago nursing home neglect attorneys appreciate that one important way to lower the mistreatment at nursing homes would be to simply lower the total nursing home population. Admittedly, the majority of residents explain that if they had their choice they would rather age in place than be forced to move into a long-term care facility. Unfortunately, for many residents, that is simply not possible.

Nursing home stays usually come in one of two forms: short rehabilitation following serious medical procedures or long-term stays because of overall declining health and life circumstances. In both cases, the stays are usually required for one of two reasons: (1) the medical care needed is so significant that it simply cannot be provided at home; or (2) the resident does not have the private resources to pay for the at-home care needed.

Finances are often at the heart of these decisions. At-home care providers exist which can often help seniors stay in their own home longer without the need to move into a separate facility. However, many residents struggle to find the resources to pay for that care. Because of the cost, many seniors rely on Medicaid support for long-term aid. Medicaid programs have very specific requirements that often force a senior into a home instead of proving at-home assistance.

Of course, each nursing home neglect lawyer at our firm knows that one way around the challenge might be for family members to provide the aid needed. Spouses are obviously the ideal individuals to provide close senior care. Unfortunately, in many situations the senior’s condition has deteriorated to the point where it is impossible for the spouse to provide the care needed as well. This is particularly true in cases where the ill partner is facing serious mental challenges like dementia or Alzheimer’s.

In other situations, one spouse may be just as frail as the other, and so it is difficult for care to be provided outside of the nursing home. That seems to be one reason why women who marry older partners are more likely to end up in a nursing home, according to a new research effort on the facility demographics. As reported in MedlinePlus, the study which appeared in the Age and Aging journal found that older men are usually less likely to be able to provide at-home support to ailing spouses. Those spouses often need to enter a nursing home.

The study analyzed data from more than 20,000 people, and the majority of women had partners who were sicker than they were. As a result, women were 40% more likely than men to be admitted to a nursing home. This was because their partner either died first or was too sick to provide at-home care. Of particular importance the study found that, contrary to some misinformation, senior men are not less likely to choose not to care for their partner. Instead, they are simply physically incapable of providing the care that is often needed.

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Family Alleges Nursing Home Abuse Hurt Mother

My Fox News 8 reported this week on new nursing home abuse allegations raised by the daughter of a senior resident. According to the story, local authorities are investigating the matter after the caregivers at the facility discovered that the 86-year old woman had serious injuries on her head. The facility also contacted the senior’s daughter at that time. The injuries were consistent with a severe physical blow to the head—not something that would develop naturally.

The senior suffers from dementia and was unlikely able to fully appreciate what was happening to her or able to share the problem with others. The senior’s daughter was understandably outraged by the situation. She indicated that she trusted the facility to provide around-the-clock care for her mother to ensure that she wouldn’t be taken advantage of or harmed in these sorts of ways.

“She’s eighty six and defenseless, and I wasn’t here to protect her.” the daughter lamented.

Our Illinois nursing home neglect lawyers understand that many local families have the same emotions upon discovering the mistreatment perpetrated against their loved one.

The investigation into the situation is on-going, and so there are not yet many answers to figure out exactly what happened. The woman’s daughter explained that her mother is incredibly vulnerable. She is unable to walk or even get out of bed.

The daughter elaborated that she is concerned about the care for all of those at the facility. While the investigation is still underway, the daughter admitted her suspicions that the attack must have been perpetrated by an aide at the facility. It will obviously be important for the family to remain closely involved with the investigation to ensure justice is provided.

Fortunately local authorities are involved in the investigations to ensure that a neutral third-party can help figure out what actually went on. When nursing homes investigate these situations on their own there is often significant incentive for the facility to reach conclusions that limit their own responsibility for the attack. An experienced nursing home attorney knows that any time that a senior suffers a head injury like this there is often negligence or intentional abuse at the bottom of it.

Each Chicago nursing home abuse lawyer at our firm is very familiar with this type of situation. Most cases of nursing home neglect and abuse are uncovered after family members that come forward following injury to their loved one. Seniors are rarely in a position to explain the harm that they’ve suffered. After all, their unique vulnerabilities are what necessitate their stay in the long-term care facility in the first place.

In addition, seniors often do not know themselves what constitutes passive neglect. Unfortunately, many seniors are loathe to criticize those who are providing them aid. Therefore, when the care they receive is substandard, many seniors are not very vocal about complaining or even aware that they have the right to better treatment. In this way, senior abuse continues without any recourse. The tendency to stay quiet about these situations makes it even more imperative or outside observers to step in and demand redress where appropriate.

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Family of Deceased Man Files “Quality of Care” Suit Against Retirement Facility

A lawsuit has been filed against a Redlands retirement facility for allegedly failing to provide the quality of services promised to an elderly resident, reports the Redlands Daily Facts. The complaint also alleges the facility, Mission Commons Retirement Residence, is not staffed or operated in compliance with California law. Our San Bernardino elder neglect lawyers work with families in many surrounding communities and often hear from families that are concerned about the care their loved ones are receiving in California nursing homes and long-term care facilities. It is natural to have such concerns, and while we cannot endorse any one way to locate an appropriate facility, we do recommend doing as much research as possible on the nursing homes in your area and making site visits to those facilities.

According to the lawsuit against the Redlands retirement home, former resident Jack K. Hanson, Sr. lived at the independent and assisted living facility from June 2009 until his death in April 2011. His family says that residents at the facility do not receive the quality of services they pay for. Initially, Mr. Hanson paid $5,000 per month to live at the facility. In exchange, Mission Commons Retirement Residence promised to provide care that complied with California law and the level of care described in its “Admissions Agreement,” which was signed by both parties.

When he first entered the facility, Mr. Hanson was part of Mission Commons’ independent living facility. However, as his condition worsened, his family agreed to pay more money, $5,500 a month, to move him to another part of the facility with the promise of better care. The complaint, filed in the Los Angeles County Superior Court, claims the elderly man suffered a fracture and pressure sores due to the negligent care he received. Those injuries, as well as general neglect, allegedly led to the man’s death. handshake.jpg

The agreement between Mr. Hanson and the Redlands facility stated the facility would provide timely assistance in residents’ dressing, grooming, bathing, and other personal hygiene needs, as well as assistance with taking medication and monitoring of food intake. The family alleges none of this was done and that the facility failed to provide them with status reports regarding the man’s condition, including the advancement of his Parkinson’s and dementia.

A California nursing home abuse attorney filed the suit on behalf of Hanson’s family. Apparently, the living conditions and hygiene at the facility were sub-par. The man was allegedly left alone for hours with soiled clothing, spending long stretches of time in his own waste.

Specifically, the complaint alleges violations of California’s Consumer Legal Remedies Act and of the Business Professions Code. The Consumer Legal Remedies Act is intended to protect consumers and to provide them with an avenue through which to pursue legal remedies if they do not receive the services for which they contracted and paid.

The Walton Law Firm takes San Diego elder abuse and neglect very seriously, and we are recognized as a leading law firm in this area of law. If you are concerned that a loved one is suffering from California nursing home abuse, please contact a qualified professional today.

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Our Illinois elder abuse lawyers frequently warn local residents of the dangers of senior financial exploitation. Unfortunately, there are many who are not hesitant about taking advantage of vulnerable seniors in order to enrich themselves. This financial abuse takes many forms. Money can be stolen outright. Seniors can fall for scams where services are paid for but not provided. In other cases, individuals in a position of authority or trusted confidence can use their position to get the senior to unknowingly do something against their own interests.

Our Chicago elder abuse lawyers appreciate that all of these cases are difficult to uncover, because they often involve victims who don’t even realize that they are being taken advantage of. In a long-term care facility, nursing home abuse involving theft is generally only uncovered with family members or friends follow-up on their suspicions to investigate the situation.

Uncovering mistreatment in other contexts is even harder.

For example, The Star recently shared the story of one senior who is trying to get control of her house and life savings back from her former caregiver.

According to a new suit filed in the case, the senior signed a “home care agreement” whereby the senior spent a considerable amount of her life savings to buy a nearly $500,000 house for a woman in exchange for the woman providing caregiving services. The 83-year old woman was very close to the defendant. The caregiver used to have power of attorney for the senior and was also the former beneficiary under the senior’s will.

The senior originally thought that she would be the owner of the house. She was shocked to learn that instead she only had a life interest in the house, with the caregiver as the primary owner. In other words, once the senior passed on, the caregiver would return full ownership of the property.

The senior first met the caregiver during a short rehabilitation stay at a nearby nursing home. After her release the caregiver began helping the senior full-time. It was then that she slowly began isolating the woman and trying to take advantage of her financially, according to the court documents. Authorities only learned about the problem when the senior’s neighbor called the police after learning that the senior was a virtually prisoner in her own home.

The lawsuit claims that the caregiver used her power and position with the woman to exert unfair and harmful influence for her own gain. Besides getting the senior to purchase the house, the suit also claims that nearly $30,000 in loans were given to the caregiver and furniture and other possessions were stolen.

Of course our legal system protects all residents. But it is particularly necessary to help those who are otherwise vulnerable of being taken advantage of by those in a position of power or authority. That often includes seniors who have few alternative ways of being vindicated and supported following mistreatment.

Our Illinois nursing home abuse lawyers encourage all local residents to keep an eye out for the seniors in their life. That includes being on the look-out for signs of abuse at long-term care facilities as well as among seniors who live at home. If problems are identified it is important to first ensure that the senior is taken from any unsafe situation. After that, all proper legal options should be considered to help hold the wrongdoer accountable and help the senior recover some of the losses that they might have experienced.

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Chicago Nursing Home Abuse Attorney Steve Levin Featured in Story

This week a story and video was posted at that tackled the issue of nursing home abuse and neglect. Our Illinois nursing home abuse attorney, Steve M. Levin, was the featured legal professional in the piece. Attorney Levin shared information of general interest for families who suspect that their loved one might not be receiving adequate care at a long-term care facility. In addition, the article discussed a case of Chicago nursing home neglect on which our firm worked involving a local resident who suffered severe injury at local long-term care facility that ultimately led to his death.

The local case involved a Chicago resident, Paula Lingo, who discovered two years ago in 2010 that her uncle may not have received reasonable care while living at a local long-term care facility. Her uncle had suffered a stroke, and he was living at the nursing home for what was supposed to be a short-term stint for rehabilitation. However, like many residents who initially are only supposed to be at the facility for a short time, he would actually never be able to live on his own again.

Ms. Lingo was shocked to learn that her uncle’s body was covered in pressure sores. As blog readers know, these sores are caused by constant pressure on bony prominences of the body. They are almost always preventable and can be prevented with proper rotation of the body, sufficient nutrition and hydration, and other basic caregiving techniques. However, when these standard treatments are neglected, the harm to the patients can be severe. As Ms. Lingo noted, “It was horrific to see how severely injured his body was.”

Unfortunately, while this case represents tragic suffering experienced by seniors as a result of inadequate care, it is not necessarily a unique case. Nursing home residents are hurt every single day in our area, and much of it goes unreported. Some estimates suggest that as many as one out of every three nursing home residents suffer some kind of abuse. That amounts to over 1 million Americans hurt in this way. Those figures are unacceptable. Yet, much of that abuse is swept under the rug or never uncovered, and so the mistreatment continues without the national outrage that it should receive.

As part of the story, Attorney Levin explained how understaffing is often a central cause of the chronic mistreatment. That is why it is important for loved ones to be particularly vigilant about the condition of friends and relatives and be ready to step in if warning signs are spotted. Bed sores or pressure ulcers, falls, broken bones, malnutrition, dehydration, medication errors, physical abuse, and other indicators are all too common. If you suspect that your loved one has been hurt it is important to contact facility officials immediately. In addition, families are often well served by visiting with legal professionals to be aware of the potential legal ramifications of certain actions.

Please take a moment to view the video above. However, be aware that some of the images included in the above clip are graphic. Pictures of various injuries frequently seen in cases of nursing home neglect cases are shown. Pressure sores and other injuries are depicted in the story to emphasize the seriousness of the consequences for these breaches of care.

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Staffing Levels and Nursing Home Abuse

Each Illinois nursing home neglect lawyer at our firm has worked on many cases where understaffing played the pivotal role in the underlying mistreatment. It cannot be emphasized enough that if there are not sufficient care workers at a facility then nursing home residents will not receive the level of care that the law demands. This is true no matter how skilled, devoted, and passionate the care providers are—they cannot be in two places at once. Unfortunately, in a drive to lower expenses and increases profits for owners and investors, those in charge of making decisions about staffing levels often cut direct care employee levels to the bone. When this happens it is the residents who suffer most.

Earlier this month a story at U.S. News discussed the crucial role that staffing levels play at these facilities. The article was summarizing a new research project from the Center for Retirement Research at Boston College. The underlying point of the research was something that our Chicago nursing home neglect lawyers know well—loss of staff members at nursing homes is deadly. In particular the researchers found that lower employment rates at nursing homes correlates strongly with rising death rates for senior women. This was attributed to the fact that nursing homes are disproportionately filled with elder women because women outlive men on average.

These are particularly timely issues because more and more Americans are retiring, the overall demographics are shifting, and long-term care will undoubtedly rise in prominence in the future. Getting a handle on these problems as soon as possible is crucial, because the challenges are only going to increase. The fastest growing age group in the country is people over 80 years of age. This is a product of both the overall national demographics as well as increases in medical care which are keeping more people alive longer.

While better medical care is obviously a welcome development, it comes with a stark challenge. Will we have enough younger care providers for these seniors? A mathematical certainty of a larger percentage of seniors is a smaller percentage of younger Americans. But with more seniors, there will be an increased need for more young Americans to work in caregiving roles. If those caregiving roles are not filled it is a near certainty that there will be an increase in nursing home neglect with seniors not getting the care they need. Lives will be lost as a result.

Our Chicago nursing home neglect lawyers appreciate that part of the problem is that these front-line nursing home workers often have pay rates and benefits cut severely. This is usually not because owners and operators are facing some financial crisis. Instead it is often done simply to ensure maximum profits for those who are using these facilities as financial investments. The poor pay rates make it difficult for these facilities to find quality help and retain that help for longer periods of times. This leads to frequent shortages and high turnover. Nursing home owners are still able to collect large profits in these situations, but the seniors who rely on them are the ones who suffer from the poor staffing situation.

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Criminal Charges in Elder Abuse Case

The Oklahoman recently shared the story of two aides who were arrested for nursing home abuse and charged with crimes for neglect by a caretaker. The charges stem from the treatment of a 96-year old dementia patient at the facility where the aides used to work. They were both fired shortly after they were arrested by authorities.

The elder abuse was apparently uncovered as a result of footage caught by a hidden camera in the senior’s room. The woman’s family had placed the camera in the room after having concerns about the quality of care that their loved one was receiving. They were also worried that someone was stealing from the woman’s room Our Chicago nursing home neglect lawyers know that use of these surveillance cameras is increasing in virtually all locations—including nursing homes. We have worked on many different civil cases where camera footage played a crucial role.

In this case, the family was likely shocked when they watched the tape and saw the conduct of the two aides who were paid to provide reasonable care to the senior. The footage shows one of the aides shoving a latex glove into the resident’s mouth and then forcibly kept it inside. The aide then lifts the patient into bed before pushing the side of her face onto the pillow to force the woman to lie down. The other aide merely watches as this all takes place.

It remains unclear why any of this nursing home abuse actually took place. Each Illinois nursing home abuse lawyer understands that it is shocking to most that anyone would engage in this sort of unnecessary abuse of vulnerable seniors. Sometimes there is little explanation for the conduct other than naked displays of power or use of their position to take out frustrations on those too weak to properly defend themselves.

Intentional elder abuse is perhaps the most egregious type conduct that often leads to nursing home abuse lawsuits and/or criminal penalties against those who engaged in the conduct. Nursing home residents are protected by the same criminal laws as others against unwanted physical intrusions. In addition, some criminal laws are specifically written to protect seniors from this sort of conduct and discourage other from taking advantage of the individual’s vulnerable position.

Of course, those criminal charges are wholly separate from civil actions that might result for intentional nursing home abuse. Criminal charges essentially represent society taking umbrage with the conduct of the citizens and demanding that they face a punishment as a result of the conduct. Punitive, deterrent, and rehabilitative motivations are involved in these criminal charges.

On the other hand, civil lawsuits represent private citizens seeking accountability from other private citizens for the specific losses that they experienced as a result of the unreasonable or intentional conduct of the other. These suits often also involve the companies which own the nursing home, because the law logically requires businesses to be held accountable for the conduct of their employees when on the job. This is another incentive for these companies to ensure that they hire employees who are properly trained and without the disposition to unnecessarily harm those who are relying on them.

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New Documentary Delves Into Impact of Music on Nursing Home Residents

Most viral internet video includes adorable animals or break-out entertainment acts. However, over the last week and a half there has been steady buzz about a unique Youtube clip related to senior care and well-being. The viral video which can be seen above is a clip from a new documentary called “Alive Inside” that explores the therapeutic benefits of music for those in nursing homes, including those with serious cognitive issues like dementia and Alzheimer’s.

Each Illinois nursing home lawyer at our firm hopes that the stories shared in these materials will emphasize the need to focus real resources on senior thriving and well-being. Nursing homes cannot be viewed merely as places to house certain residents. Instead they must be flourishing places where seniors are still able to use their skills, pursue their passions, and engage in the world around them. With so many stories shared about nursing home neglect and mistreatment, it is important not to skip over the stories of new techniques that make the lives of residents better.

The idea behind this music therapy is very simple: providing seniors with iPods filled with favorite songs and see the effect that the music has on them. The results, evident even after watching this short clip, are stunning. Residents who had spent years languishing without much animation or interaction are transformed.

One man in this clip, Henry, has lived in a nursing home for ten years after his health deteriorated to the point that his wife could no longer provide proper care for him on her own. In the past Henry was very docile, rarely talked to anyone, and was said to have trouble answering yes or no questions.

After a bit of time listening to his favorite music, that all changes.

Henry is immediately visibly engaged with the music, swaying and quietly singing. Even after the iPod is taken away, the positive effects of the music are evident. In ways he never would have before, Henry opens up to the interviewer, explaining who his favorite singer is and even giving a short rendition of his favorite song—“I’ll Be Home for Christmas.”
Amazingly, Henry then goes on to describe exactly how the music affects him and makes him feel. “It gives me the feeling of love, of romance. I figure right now the world needs to come into music, singing. You’ve got beautiful music here,” Henry explained.

Our Chicago nursing home neglect attorneys appreciate that these simple techniques—like sharing music from their youth—can often makes a huge difference in the lives of local seniors. What is particularly encouraging is that these activities have little cost. All that is needed is some simple resources, time, and the ability of caregivers to be proactive in their commitment to maximizing the well-being of the residents.

This latest documentary was created by a senior care organization called “Music and Memory” that is committed to getting iPods to nursing home residents. The group’s efforts are part of a larger well-documented trend on the effects of music. Over the past several years researchers have found that music can help seniors arouse old memories and might even help those with dementia form new memories. The documentary premiered this week in New York.

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