Bedsores and Healthcare Negligence

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Bedsores, which are also referred to as pressure ulcers, pressure sores, or decubitus ulcers, are—sadly and unnecessarily—a common occurrence. Since bedsores are caused by immobility, they often occur as a result of negligence on the part of a healthcare provider who fails to attend to the well-being of the patient. Bedsores are painful and in some cases life-threatening, yet they are easily avoided if a healthcare provider takes the proper precautions.

Bedsores are injuries to the skin and tissue beneath the skin (epidermis and dermis) and occur as a result of pressure on the skin, usually from a bed or wheelchair. This pressure decreases blood flow that delivers oxygen and other nutrients to tissues. If the nutrients are not delivered properly, the skin cells and tissue may become damaged and die. Sustained pressure is caused by immobility, which is associated with conditions such as general poor health, sedation, surgery recovery, paralysis, and comatose.

Bedsores often occur on skin protecting bony parts of the body, since the skin faces more pressure due to the friction between the bone and outside surface. As bedridden people or those in wheelchairs are most susceptible to bedsores, they frequently occur on the tailbone, buttocks, shoulder blades, spine, backs of arms and legs, back or sides of head, rims of the ears, hips, lower back, heels, ankles, and the skin behind knees.

There are four stages of bedsores. The first stage is characterized by red, sore, and unbroken skin, which may be tender or warm. The second stage occurs when the epidermis and part of the dermis is damaged or lost and the sore resembles a large blister. The third stage occurs when the sore becomes a deep wound and there is a loss of skin exposing fat. The bottom of the wound is comprised of a yellowish dead tissue and the damage could extend below the layers of healthy tissue. The fourth and final stage of bedsores consists of a large scale loss of tissue and may expose muscle, bone, and/or tendon. The tissue is dead, yellow or dark in color, and crusty. The damage may extend below the wound. Bedsores may also be considered “unstageable,” in that the surface is covered with dark tissue so that the depth of the wound is not visible.

Bedsores can lead to extremely serious, potentially life-threatening conditions. The most common consequence of stage III and IV bedsores is sepsis, which occurs when bacteria enter the bloodstream through the sore. The bacteria rapidly spread throughout the body and infect it. If left untreated, sepsis can lead to organ failure. Bedsores can also lead to cellulitis, an infection of the skin and soft tissues, and bone and joint infections, which are all life-threatening illnesses. In rare cases, bedsores may lead to the development of a cancerous cell that grows specifically in non-healing wounds.

Stage I and II bedsores may be healed within several weeks with effective treatment through the use of pain management medication and antibiotics. Stage III and IV bedsores are much more difficult to treat. If a person experiences signs of a bedsore, the best treatment is to move, if possible. If there are no signs of improvement within 24-48 hours, the wound may be infected, and a doctor must be called. The signs of an infected bedsore include: fever, drainage from the sore, increased heat, and/or redness surrounding the sore. If you are experiencing any of these symptoms, seek immediate medical attention.

Bedsores are caused by immobility; when a person cannot move on their own, it is the responsibility of their caretaker to make sure that they are moved, turned, and bathed regularly. For this reason, bedsores frequently occur as a result of negligence, typically in rehab facilities, hospitals, long term care facilities, or nursing homes.

If you or a loved one is suffering from bedsores due to insufficient attention or the carelessness of a healthcare facility,  contact the New York nursing home abuse and elderly neglect attorneys of Hach & Rose, LLP, at (212) 779-0057 today for a free consultation. Our team is experienced in negligence cases and we are dedicated to protecting the rights of the elderly.

Hip Fractures in the Elderly

Hip fractures are one of the most serious fall-related injuries, which can lead to life-altering complications, particularly for older people. The elderly are more susceptible to fractures after a fall due to weakness, fragile bones, and osteoporosis. Most hip fractures occur in people over the age of 65.  According to Centers for Disease Control and Prevention (CDC), each year over 300,000 elderly people are hospitalized for hip fractures with 95% of hip fractures caused by a fall. However, the number of hip fractures for elderly people will increase as the U.S. population gets older. Women are more susceptible to falls than men.

Symptoms:

  • Pain areas: hip or groin;
  • Abnormal walking, bruising, stiffness, swelling around the hip area;
  • Inability to move after a fall;
  • Shorter leg on the side of your injured hip.

Treatment:

A hip fracture is a serious injury that might require surgical repair or replacement. After the surgery, there is usually a lengthy recovery and physical therapy process. The extent of the break often depends on the force that caused the break. According to University of Chicago Medicine (UCM), only one in four hip fracture patients are likely to make a full recovery.

Although surgery is successful in most cases, you may have complications afterwards. A hip fracture can keep an elderly person immobile for a long time, which can lead to serious complications such as:

  • Bedsores;
  • Pneumonia;
  • Urinary tract infection;
  • Blood clots in your legs or lungs

Additionally, hip fractures have a higher tendency of recurrence. If an elderly care facility or one of its employees has failed to take reasonable steps to prevent a fall, contact the New York nursing home abuse and elderly neglect lawyers of Hach & Rose, LLP, at (212) 779-0057 today for a free consultation. Our team is experienced in negligence cases and we are dedicated to protecting the rights of the elderly.

Elder Care and Nursing Home Abuse

Many families have experienced the stress and expense involved in finding the right elder care facility or nursing home for a loved one. Placing someone in a nursing home is a very difficult decision and you can only hope that they receive the best possible care and attention. Unfortunately, many nursing home residents become victims of the “hidden crime” of elder abuse and neglect. While most of these cases go unreported, nearly 6 million nursing home residents suffer from abuse or neglect on some level.

Nursing home victims are often reluctant to report this mistreatment for various reasons, such as fear of retaliation, or a lack of cognitive ability to report. Often this abuse is due to shortage of staff, lack of adequate employee training, or a lack of procedure for detecting abuse.

According to the National Center on Elder Abuse (NCEA), “elders who experienced abuse (even modest abuse) had a 300% higher risk of death when compared to those who had not been abused.” California, Florida, New York, Texas, and Pennsylvania have the most cases of elder abuse annually in the nation. Elder care abuse occurs in care facilities by service providers, staff members, other patients, or even guests (visitors).

Nursing Home Abuse and Neglect

Most nursing home residents are unaware of elder care law and its protections. Nursing home residents are often unable to communicate this abuse and/or neglect from their caregivers. Victims of nursing home abuse can suffer severe physical, emotional, psychological, and financial abuse.  It is possible that a nursing home resident is being abused if the staff member refuses to let a visitor see a resident or insists on being present during visitation.

Signs of abuse can be emotional (behavior and/or personality changes), physical (unexplained accident or injury), and sexual (unexplained venereal diseases such as genital infections, vaginal or anal bleeding, bruising of the breasts, or inner thighs).

Other examples of abuse can include:

  • Intimidation or use of threats
  • Medication errors
  • Poor bathroom facilities
  • Not providing food at the specified time or at a prescribed schedule
  • Failure to treat or provide emergency care
  • Lack of adequate supervision, such as when a patient leaves the facility without authorization
  • Abandonment (inadequate daily care)
  • Failure to groom and/or clean residents

Nursing Home and Elder Law

By law, nursing homes must provide the highest standard of care to their residents. Federal and state laws are designed to protect nursing home residents from abuse or neglect, as well as regulate the quality of care required. Elder abuse can cause illness, discomfort, or death, and is often referred to as “institutional abuse.”

Most state laws require doctors, nurses, and other health care professionals to report suspected institutional abuse to the designated state office. Other laws mandate annual inspections, impose sanctions for violations, and require nursing homes to be licensed in order to operate.

Elder Care Legal Help

If a family member or someone you know has been abused in a nursing home or other facility, you should report the matter to the proper authorities immediately and consider taking legal action. To learn more about the rights of those in nursing homes, contact the New York nursing home abuse and elderly neglect lawyers of Hach & Rose, LLP, today by calling (212) 779-0057 to speak with a qualified member of our legal team.

What Can Happen After a Fall?

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Recurrent falls are common causes of hospitalization and death among the elderly. According to the Centers for Disease Control and Prevention (CDC), approximately 2.5 million older people are treated in the emergency department for fall-related injuries per year, and over 50% of falls among elderly people result in an injury with long-term implications (e.g. decreased physical function or fear of falling). The fear of falling can discourage older people from keeping active which can increase joint stiffness, weakness, and reduce mobility. Fear of falling can also cause a person to change or cut down their usual daily activities, which may result in isolation or being institutionalized. Most elderly people cannot get up without help after a fall, sometimes remaining stationary for hours, increasing the risk of dehydration, pressure ulcers, rhabdomyolysis, hypothermia, and pneumonia.

Falls can result in significant injuries such as broken bones and head trauma.  Head injuries can be very serious and it is advisable that an older person seek immediate medical attention after a fall to make sure they don’t have a brain injury. Other injuries such as hip fractures can impact mobility, sense of freedom/fear of being institutionalized.

Research has identified several conditions that contribute to falling:

  • Vision impairment.
  • Lack of balance or deficits in postural balance: An elderly person may lack the ability to maintain or recover balance from a fall.
  • Foot pain.
  • Multitasking while walking.
  • Failure to notice environmental hazards (broken or uneven steps, lack of handrails in the bathroom or stairs).
  • Vitamin D deficiency.
  • Lower body weakness.
  • Use of medicines (a psychoactive drug or psychotropic substance): the number of drugs taken and the use of drugs contributes to the risk of falls.

While these risk factors are the leading causes of most falls, healthcare providers can help to reduce or eliminate these factors.

Families can also take active steps to help reduce loved one’s risk of falling. These steps include:

  • Ask a healthcare provider to evaluate the risk of falling.
  • Ask a pharmacist or a doctor to review the side effects of medications that may contribute to falls.
  • Exercise: do strength and balance exercise to make your legs stronger and improve balance.
  • Encourage to schedule annual appointment with an ophthalmologist (MD) or an osteopathic (DO).
  • Remove all obstacles that can make someone trip over.
  • Add grab bars in the bathroom and railings on the stairs.
  • Add bright bulbs around the house.

If an elderly care facility or one of its employees has failed to take reasonable steps to prevent a fall, contact the New York nursing home abuse and elderly neglect lawyers of Hach & Rose, LLP, at (212) 779-0057 today for a free consultation. Our team is experienced in negligence cases and we are dedicated to protecting the rights of the elderly.

Bed Rail Injuries

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Bed rails, which are metal bars placed around a bed, are designed to prevent falls. Typically found in homes, hospitals, nursing homes, and assisted living facilities, bed rails provide many benefits to users. However, they may also pose several health and safety risks.

In addition to fall prevention, bed rails make it easier for a patient to move around in bed and reposition themselves. Bed rails aid in a patient’s transitions in and out of bed, giving them a greater sense of independence, as a patient will not be reliant on nursing home staff for assistance. Additionally, many bed rails contain side pockets which allow the patient easier access to personal items and bed controls. Perhaps most importantly, bed rails help a patient feel safe and secure as they sleep and rest in bed.

Bed rails are recommended to patients who are generally weak, have poor balance, face difficulty moving around, and are prone to falling out of bed. They are a safer, more efficient, and less expensive alternative to bed restraints.

While bed rails are of great help to most users, they can also prove to be harmful. On some occasions, a patient may become entangled within the bars of the bed rail or stuck between the mattress and the bed rail. A user may also attempt to climb out of bed over the rails, leading to a dangerous fall. These accidents can cause bruising, cuts, scrapes, other bodily injuries, and even death. Between 1985 and January 2009, there were 803 incidents of bed rail accidents reported to the U.S. Food and Drug Administration. These incidents lead to 480 deaths and 138 nonfatal injuries. Not all incidents were reported to the FDA– there were 37,000 individuals brought to a hospital emergency room as a result of bed rail injury between 2003 and 2011 alone. In addition to causing physical injury, bed rails may also be psychologically detrimental if a patient feels isolated or needlessly restricted.

Bed rails must be used carefully. Upon entering a healthcare facility, a patient should be assessed to determine their compatibility with bed rails. The elderly and those with mental or physical limitations must be frequently monitored to ensure their safety. In order to prevent unnecessary and potentially unsafe exits from the bed, it is imperative that a patient’s healthcare team determines and meets the patient’s present and future needs regarding thirst, hunger, restlessness, pain, and bathroom use. It may also be helpful to lower the portion of the bed rail located at the foot of the bed so that in the case that the patient wants to leave, they can do so safely as opposed to climbing over the rail.

To make sure that the patient does not become trapped between the mattress and the bed frame, the healthcare facility should use mattresses fitted to the bed rail. Most importantly, a patient’s healthcare team should check in frequently, asking the patient if he or she needs anything and ensuring that they are comfortable in bed.

It is essential that a patient’s healthcare team talk to the patient and the patient’s family to make sure that the use of a bed rail is the right choice. In some situations, the risks associated with the use of a bed rail outweigh the benefits. However, in other cases, this scenario is reversed. If it is determined that bed rail use is the best course of action, then the patient’s need for a bed rail should be reassessed regularly.

If you or a loved one has been injured or has died from an accident involving a bed rail or lack thereof, you can reach the experienced New York nursing home abuse and elderly neglect attorneys at Hach & Rose, LLP at (212) 779-0057 for a free case consultation.

Understanding the Emotional Effects of Nursing Home Abuse

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As Americans enjoy extended life spans, the elderly population grows. In fact, the National Center on Elder Abuse (NCEA) estimates that the elderly population of those 65 and over will increase to 83.7 million by 2050. In many cases, the elderly require constant care from trained professions/caregivers available only in nursing homes and assisted living facilities. As a result, in 2014, there were 1.4 million nursing home residents.

Many families entrust their loved ones to nursing or extended-living care facilities when they can longer provide the care and attention that they require. Finding the right facility to care for an elderly family member can often be a challenging endeavor. Given the level of care expected for our loved ones, we go to great lengths to ensure that the facility we choose is looking after the best interests of their residents. While most nursing homes provide quality care to their elderly residents, the fact remains that nursing home abuse and negligence continues to be a national epidemic. According to the National Ombudsman Reporting System (NORS) data, in 2014 there were 188,599 complaints filed against elder care facilities; of these complaints, 14,258 (7.6%) involved incidents of abuse, and neglect. Unfortunately, most complaints of elderly abuse and injury go unreported.

There are a number of ways elder abuse can occur in nursing homes or similar care facilities. The most common forms of abuse involve emotional trauma, including shouting, criticism, social isolation, neglect, and threats. This form of abuse negatively impacts an individual’s emotional well-being and is considered negligence on the part of the facility and its staff.

Another serious concern is financial exploitation of vulnerable elderly residents. Nursing home residents are frequently forced by their caregivers to disclose and/or permit access to sensitive personal information such as bank accounts, credit cards, social security numbers, and even cash. This misconduct clearly violates an individual’s privacy and may lead to further instances identity theft or embezzlement. If your loved one is currently or soon to be in a nursing home, it is important to be vigilant in making sure they do not become a victim to their surroundings. It is recommended that you monitor your loved one’s personal property as well as their demeanor and emotional state. For example, it is important to observe your loved one’s behavior when a caregiver is around, question them about the type of care they are receiving, and make certain their financial affairs are in order.

In sum, nursing home negligence robs victims of their dignity, sense of security, and emotional stability. If your loved one has suffered abuse or other indignities in a nursing home, contact the New York nursing home abuse and elderly neglect attorneys of Hach & Rose, LLP, at (212) 779-0057 today.