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Pleasant Law Blog
Pleasant Law BlogNursing Home Abuse & Neglect
Nursing Homes Sometimes Use Unnecessary and Harmful Tactics to Save Time Due to Understaffing
The New York Times ran an article on June 24, 2008 regarding nursing homes overuse of medications, in the sense that certain drugs are being given simply to keep residents calm, and to decrease the nursing home residents' care needs. this is sometimes referred to as they "chemical restraint." the interesting point that this article raised was that often the effects of the drug lead family to believe that their loved one is experiencing/developing dementia or Alzheimer's disease. this over use of medications to keep nursing home residents "happy" is part of a pattern seen in nursing homes -- a pattern that is harmful inappropriate. For example, a 2003 study published in the Journal of the American Medical Association found that feeding tubes were used on nursing home residents suffering from dementia and/or Alzheimer's disease in greater proportions, despite that these residents were capable normal feeding methods. The implication is, of course, that these nursing home residents were more easily cared for through the use of a feeding tube. It takes much more time and effort to feed a nursing home resident by normal feeding methods than it does by simply "plugging in" a feeding tube. The problem is, though, that feeding tubes -- if not necessary -- may increase the risk of injury or harm to the nursing home resident. At least at the time of that study, the Medicare reimbursement amount for needing to use arguably provided nursing homes and incentive to use more feeding tubes than was truly necessary because it helped the nursing home make more money. I have also heard anecdotally that some studies have shown that feeding tubes are used as proportionately in the poor/minority nursing home resident population. Perhaps this simply reflects discrimination in care (in other words, nursing home staff finds ways to provide less care for the poor and/or minorities). In any event, families of nursing home residents should carefully consider and evaluate the use of drugs and feeding tubes on their loved one. If you are concerned about nursing home injuries, abuse, neglect, or even a possible wrongful death; feel free to contact my office with any questions. It may be that simply discussing your concerns with the nursing home administration will help. We are available to discuss your matter, and you can reach us to hold free at 888.435.7156.Comments
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Nursing Home Neglect: Urinary Tract Infections Acquired From Foley Catheters
legalanchor.com
Frequently, patients in full-time nursing facilities have urinary catheters inserted simply for ease of care. While this implementation may assist in keeping the patient dry, the catheter may result in far-reaching, negative ramifications.
Studies show that a single catheterization increases the infection rate to 1-3%. In patients who have a catheter for less than 7 days, the rate of infection is 10-40%. In long-term indwelling caths (greater than 28 days), the prevalence of infection approaches 100%. Abuse of catheterization can also lead to urinary incontinence in the previously continent patient. Moreover, decreased ambulation is associated with catheter use. The predictable outcome is the onset of decubitus ulcers.
In addition, one of the first signs of a urinary tract infection in the elderly population is confusion (not fever or flank pain as one would expect). Given the fact that the patient is already in a long-term care facility, and the factors surrounding that admission, it is important that a thorough nursing assessment be performed and regularly updated to quickly identify changes in mental status. A prompt physician notification is nursing standard.
UTI’s, if untreated, can quickly go to the blood stream causing bacteremia, septicemia, and, subsequently, death.
Kaye Miller, RN, CN-III, CAPA, CLNC
NORTH STAR LEGAL NURSE CONSULTING
anchor@legalanchor.com
270-535-3679