Signs To Look For

There are several different types of nursing home abuse, each of which has certain signs to watch out for. They include:

• Physical abuse is generally characterized by unexplained injuries including bruises, fractures, sprains, open wounds, internal bleeding, and more. In many cases, these injuries are caused when the patient is hit, slapped, kicked, or otherwise physically violated. However, malnutrition and medication under- and overdoses may also be signs of physical abuse.
• Verbal, mental, and/or emotional abuse is marked by severe emotional anguish and agitation, withdrawal, and non-responsiveness and is often brought on by repeated insults, humiliation, threats, intimidation, harassment, and more.
• Sexual abuse includes any inappropriate touching or sexual contact, rape, and forced nudity among other things. Signs of sexual abuse include unexplained genital infections, bruising around the breasts or genitalia, torn or bloodied underclothing, and more.
•  Exploitation occurs when a nursing home resident’s personal funds, property, or assets are illegally or improperly used. Missing personal effects and/or checks, sudden changes in a will or other financial documents, and unpaid bills may all be signs of exploitation.

NURSING HOME NEGLECT AND ABUSE

Many complex factors lie at the root of negligence in nursing homes, but in the end, it may be a matter of numbers. Medicaid pays for the care of more than 65% of patients in nursing homes nationwide, with the federal government paying 60% of the costs, and the states paying the remainder. But the gap between Medicaid payments and the actual cost of maintaining a patient in a nursing home is estimated at about $10 per patient, per day, on average. Consequently, staff recruitment, retention, and development compete with corporate profits for scarce resources. Patient neglect and abuse is the end result.

Staffing Shortages Lead to Negligence in Nursing Homes

Staff burnout due to high patient loads and excessive overtime is considered by many experts to be the primary cause of abuse and negligence in nursing homes.

In 2002, the U.S. Department of Health reported to Congress that 9 out of 10 nursing homes have inadequate staffing levels, estimating that understaffed facilities would need to increase their workforces by 50 percent to reach levels required for good patient care.

Why is it so hard to adequately staff a nursing home? Nurse aides in long-term care facilities are paid low, even poverty-level wages to do work that is demanding, unpleasant, and frustrating and often requires mandatory overtime and double shifts.

With patient loads of 20, 30, or even 40 patients per aide and high levels of care required by each patient, aides cannot keep up with the demand—changing and making beds, transferring patients from bed to chair, bathing, dressing, turning, feeding, and hydrating patients, assisting with bathroom needs and emptying bedpans. In addition, caregivers are at higher risk for on-the-job injuries than steelworkers or coal miners, according to the Occupational and Safety Health Administration (OSHA). It's not difficult to see why nursing home negligence is becoming more widespread.

The American Health Care Association claims that 107,000 additional health care workers would be needed to provide acceptable levels of care for patients in nursing homes in the United States—a need that will continue to rise with the graying of the population.

Insufficient Background Checks

Most states require background checks for some nursing home employees, but no state requires national background checks, and caregivers with a record of nursing home negligence or abuse in one state may be hired unwittingly by a facility in another state.

In addition, no checks are required for support staff, such as maintenance workers, and caregivers are often allowed to begin work before background checks are complete.

Inadequate Staff Training

Federal law requires 75 hours of training for nurse aides, and while some states may require more, that training still may be inadequate. Training in caring for patients with dementia and other serious illnesses may be particularly lacking, even though these cases pose the greatest challenge for the caregiver.

With staff turnover rates varying by region from 49 percent to 143 percent annually for nurse aides and from 28 percent to 59 percent for registered nurses, retaining a trained and qualified staff is a monumental challenge.

Limited Negligence Investigation Resources

By federal mandate, each state has a long-term care ombudsman program to identify and investigate complaints of nursing home negligence. The power of these programs is limited, however, and often vulnerable to political pressure.

Many of the volunteers in ombudsman programs eventually quit out of frustration at their inability to effect change, and many paid staff have been thwarted in their attempts to speak out when their position is at odds with the agenda of local or state officials.

Predictable timing of periodic mandatory inspections by state or local agencies may further hamper enforcement efforts. If a facility is aware of an impending visit by inspectors, they may temporarily clean up problems to avoid penalties and fines imposed for nursing home negligence.

Signs of Nursing Home Abuse

* Unexplained injuries or bruises
* Over or under medication
* Visible cuts, bruises, or welts
* Rapid weight loss or weight gain
* Dehydration, malnutrition, and bedsores
* Unsanitary living conditions
* Infections
* Broken bones
* Sudden death

The law limits the amount of time after a patient incurs an injury to file suit. The amount of time varies based on the theory of liability and the state in which the patient files the suit. One should consult with a lawyer as soon as practicable for advise as to you rights.