Nursing Home Neglect - Stotis & Baird

Recognizing and Responding to Nursing Home Neglect by Eric Parker

Turning over the care of a loved one to a nursing home is a difficult necessity that many people must accept each year. In the U.S. approximately 1.6 million people live in approximately 17,000 licensed nursing homes. Although costly, good nursing home care can enable a resident to enjoy a better quality of life.

Unfortunately, bad nursing home care can also make life dangerous and unpleasant for the resident. In 2001 the Minority Staff of the Special Investigations Division of the House Committee on Government Reforms issued a report stating that abuse of residents “is a major problem in U.S. nursing homes.” This report found that during 1999 and 2000 nearly one-third of all certified facilities had been cited for some type of abuse violation that either could have harmed residents or did actually harm residents.

What are some of the factors contributing to the abuse and neglect of nursing home patients? Despite the phenomenal cost of nursing home care, many facilities are reducing staff, thus creating a self-imposed staff shortage. Fewer staff leads to staff burnout and poor patient care. In addition, nursing homes may cut costs by using minimally trained staff to perform nursing and medical tasks. Finally, some homes simply do not adequately monitor the health of their patients. Even in a “good” nursing home, it is important for family members to closely monitor their loved one’s care. Below are some warning signs of nursing home abuse and neglect. If you notice any of the following, immediately follow up and investigate:

Frequent trips to the emergency room
Unexplained bruises or scars
Any broken bones – especially hip, leg, and ankle fractures
Muscles that are stiff or deteriorating from lack of restorative exercises
Significant unexplained weight loss
New or worsening bed sores
Injuries caused while the patient has been “wandering” outside the facility
Heavy medication or sedation
Injuries occurring while the patient has been restrained
Illnesses which are not promptly reported to a physician
Any unexplained death
Injuries caused by another resident
Signs of malnutrition
Untreated depression
Lack of personal hygiene
Declines in independence

If you observe one or more of these signs, there are steps that you can take to protect your loved one. If the changes in the patient’s condition are fairly subtle, it may be as simple as communicating your concerns to the staff. You can educate yourself on the level of care that your loved one should be receiving by reviewing the state and federal guidelines (available online at www.access.gpo.gov and www.idph.state.il.us. With the patient’s permission, you can also ask to review his or her medical chart. Most importantly, you can talk to the doctor who is ultimately responsible for the patient’s care. By asking questions, many simple issues can be resolved.

For more serious incidents you will likely need to consult resources outside of the nursing home. Nursing homes fear lawsuits and state investigations; as a result, when a more serious instance of neglect occurs, the staff may be less willing to discuss the incident. Fortunately, however, there are other good resources available. One of the best resources is your regional long-term care ombudsman. Ombudsmen act as advocates for the patients and have legal rights to view patient records and conduct investigations. The Illinois Department of Public Health also investigates incidences of neglect or abuse.

When abuse or neglect has occurred it may also be wise to contact an attorney. Illinois law is relatively strong in the area of nursing home neglect. For example, a person who wins a neglect lawsuit against a nursing home may be entitled to attorney’s fees. These types of lawsuits are usually handled on a contingency fee, so that you do not pay if you do not recover any money. Choose an attorney who does not charge for initial consultations in order to avoid unnecessary costs.

The most important thing that you can do for your loved one is to visit him or her regularly. Observe his health and mood. Notice how she interacts with her care team and other residents. Visit at odd hours and in the evening to make sure he or she is receiving high-quality care at all times. Finally, if you notice a problem, be sure to address it immediately.

Eric Parker is an attorney with Stotis & Baird in Chicago. Eric’s areas of practice include Elder Law, Personal Injury, Medical Malpractice, and Business Litigation. Recently Eric was appointed to the Evanston Commission on Aging.

Strahan, 1997; Hawes, Rose, & Philips, 1999; Hawes et al, 1995.
U.S House of Representatives, 2001.
U.S House of Representatives, 2001; Hawes, 2002.