San Antonio Personal Injury Lawyer - Nursing Home & Elder Abuse - Most Commented

Stabilizing the CNA Workforce

Beth Janicek — Mon, 25 May 2009 09:44:06 GMT

Certified Nursing Assistants (CNAs) handle the direct care of 1.5 million nursing home residents in the United States, providing about 8 out of every 10 hours of resident care. According to the study “The National Nursing Assistant Survey: Improving the Evidence Base for Policy Initiatives to Strengthen the Certified Nursing Assistant Workforce” current demographic, economic, and policy trends suggest that the supply of CNAs could significantly worsen in the coming decades.

The study found that almost half of CNAs are minority and the vast majority is female with no more than a high school diploma, or GED. The median average wage found in 2004 was $10.04. Almost half of the CNAs were living on a single income due to being divorced, separated, widowed, or never married. Although it was found that CNAs work full time (36.8 hr/week), almost 2/3 lived on an annual family income of less than $30,000, and between 20% and 40% had at some point received public benefits, such as food stamps or rental subsidies. About 16% of CNAs working in nursing homes were uninsured, and in addition to that, 42% did not participate in their employer-offered health insurance because they could not afford the plan.

The study stated,

“More than half (56%) of CNAs incurred at least one injury on the job in the previous year. Among the CNAs injured, almost half (45%) sustained scratches, open wounds, or cuts; about one fifth had back injuries (18%), black eyes or other bruising (16%), or other strains or pulls (16%); and about one tenth had human bites (12%) or other injuries (7%; not shown). Of the CNAs who had been injured at least once in the previous year, almost one quarter were unable to work for at least 1 day due to the injury.”

Some of the main reasons for CNA injuries are lack of equipment (ex. for lifting and transferring residents), lack of training on the proper use of equipment, lack of training on managing resident behaviors, and working short staffed. This study makes it possible to do a closer examination of and comparison between facility and CNA reports of when injuries occur, injury prevention training offered, availability of safety equipment, frequency of working short staffed, and extent of vacancies and turnover.

Findings from this study will hopefully allow policymakers to assess and plan for sustainable solutions for the CNA nursing home workforce. It has been found that low wages contribute to high turnover and the need of working overtime or even working an additional job. Long hours may add to mistakes, affecting the residents’ safety and the quality of care. The elderly deserve better care.

Originally posted at InjuryBoard by Beth Janicek

$11 Million Verdict in Assisted Living Case

Beth Janicek — Tue, 31 Mar 2009 10:11:02 GMT

An Arizona jury awarded $11 million, the largest verdict ever awarded against an assisted living facility in the United States, to the widow of a 36-year-old man with a traumatic brain injury who died after ingesting foreign objects while in the care of Liberty Manor Residency. The verdict included $2 million for the decedent, $5 million for the wife, and $4 million in punitive damages. Lydia Scherrer, widow of Earl Scherrer, said “I want this to be a lasting victory for all individuals with TBI or other disabilities living in assisted living centers or group homes.”

Earl Scherrer suffered a severe traumatic brain injury as a result of a car accident in 1996. He remained in a coma for 16 months before he began to slowly emerge. Mrs. Scherrer worked with her husband every day and eventually he slowly started to speak. She devoted many hours a week to her husband’s recovery, but was forced to turn to an assisted living facility to provide the 24-hour care that her husband required. For years she visited him faithfully, even checking him out of the facility and taking him home on her days off, every Tuesday and Wednesday.

Mrs. Scherrer placed her husband in Liberty Manor Residency on April 7, 2006, a facility that claimed to provide 24-hour supervision of its residents. Exactly one month later, on May 7, 2006, Mrs. Scherrer received a call saying that her husband had been vomiting. She rushed over to Liberty Manor and brought her husband home and gave him a bath. Within minutes he began vomiting black matter and died in her arms.

The autopsy results showed plastic bags, unopened catsup packets, candy wrappers, and paper towels were found in Earl Scherrer’s stomach and small intestine. The medical examiner determined that these objects were significant contributing factors to his death. The autopsy report read “hypertensive heart disease due to mechanical obstruction of the gastrointestinal tract from foreign objects.”

At trial it was proven that Liberty Manor made numerous false entries in its charts with respect to Mr. Scherrer’s care. There were notations of care on days when Mrs. Scherrer had checked him out of the facility, and Liberty Manor was unable to produce Mr. Scherrer’s alleged caregiver.

Lydia Scherrer’s attorney Craig Knapp said, “Lydia Scherrer did not walk away from her husband, in life or in death. Her hope is that this verdict will force the assisted living facility industry to set and meet higher standards of care for their residents, resulting in enhanced protections for the defenseless individuals trusted to the care of others.”

Cases like this one should not happen. It is enormously important for assisted living facilities, as well as nursing homes, to provide the care that they promise. If Liberty Manor Residency could not provide the 24-hour supervision of Mr. Scherrer, he should have immediately been transferred. Most cases, such as this one, are based on the fact that the assisted living facility failed to transfer the resident once it became apparent that they were no longer capable of caring for them. In addition to failing to provide the promised 24-hour supervision of Mr. Scherrer, Liberty Manor Residency falsified nursing documents in an attempt to cover up that fact that he was not receiving adequate supervision.

Originally posted at InjuryBoard by Beth Janicek

Sex Offenders in Nursing Homes

Beth Janicek — Sat, 11 Jul 2009 10:38:00 GMT

A male resident at La Salle County Nursing Home who molested 10 female residents earlier this year has been moved from the nursing home to an unidentified psychiatric facility. Incidents, such as this one, have led to the questions:

Can sex offenders live in county homes?
What has the county done to protect women at nursing homes?

The La Salle County Nursing Home has taken more than a dozen steps after the Illinois Department of Public Health said that administrators failed to protect female residents from the molestations of a male resident. Steps included four staff meetings addressing matters of abuse prevention, resident rights, and incident investigation. Female residents were questioned and care plans were updated. In addition, the chairman of the La Salle County Board’s Nursing Home Committee will start directly supervising and overseeing the homes administration.

Even though the male resident has since been removed from the home, according to records there is still a registered sex offender in the county home. There is no indication that he had anything to do with the series of incidents involving a resident molesting several female residents. However, there are specific guidelines that must be followed by nursing homes involving sex offenders.

In Illinois, the nursing home is required to tell the Illinois Department of Public Health about any resident who is a sex offender and must do a “risk analysis” of the offender to determine whether staff will be able to care for the offender and to prepare a care plan. The sex offender must be placed in a private room and the home is required to tell residents, prospective residents, and families they can ask whether an offender lives at the home.

I am currently handling a claim involving the nursing homes standard of care in protecting residents from sexual assault. A male resident returned home from a baseball game after being served alcohol, gained entrance to a cognitively impaired female resident’s room and sexually assaulted her. The nursing home failed to protect the resident from being sexually assaulted resulting in the physical and mental injury of the resident. It is exceptionally important for facilities to properly monitor and supervise to ensure the safety of all their residents.

Originally posted at InjuryBoard by Beth Janicek

Lack of State Investigations into Nursing Homes

Beth Janicek — Thu, 11 Dec 2008 12:24:24 GMT

I am continually amazed when I read the TDADS investigations into nursing home complaints. TDADS is the regulatory agency that regulates nursing homes. I have been handling cases against nursing homes for many years and have been reviewing these investigations. I have noticed a lack of any true investigations by the agency. It is a rare occasion that I ever find an investigation that substantiates the complaint.

Recently I reviewed a group of investigations by TDADS of incidents including one that I am litigating now. My client was injured when the ropes to the Hoyer lift slipped and she fell face forward and fractured her neck. See the video of how to use a Hoyer lift. Hoyer lift.

The TDADS investigation determined the claim of negligence was unsubstantiated (unfounded). The State investigator talked to the nurse aids involved with the transfer. They told the State investigator that the ropes were secure prior to them transferring with the Hoyer lift and that the disabled resident must have untied the ropes herself. Although it would be very difficult for this woman, who was dependent on the staff for all of her needs, to be capable of untying the ropes since she has no use of her right arm as the result of a stroke. Regardless, the staff should have been present during the whole transfer and would have seen this disabled woman untying the ropes! The state investigator never even references this very obvious point! Not any of the investigations were substantiated including another where the resident had choked to death.

Now at the same nursing home a resident was beaten to death by another resident. I have not seen the state investigation into this incident but I am curious as to what they will find. Perhaps if the state would put forth genuine effort in investigating these incidents the safety in nursing homes would increase due to fear of punishment by the state. But for now Texas nursing homes can rest easy because they do not have to fear lawsuits due to state caps on damages and they have no fear of TDADS doing a sincere investigation.

Originally posted at InjuryBoard by Beth Janicek

Abuse at Nursing Home by Teens

Beth Janicek — Fri, 05 Dec 2008 10:33:07 GMT

In a horribly shocking story reported yesterday, two teen-age girls are accused of abusing nursing home residents, with four other girls accused of failure to report the abuse. The girls worked as nursing aids in the afternoons and were hired to perform tasks such as brushing the residents’ hair and teeth or helping the residents who suffer from Alzheimer and dementia with other daily tasks. Unfortunately, instead of helping these vulnerable people, they taunted and tortured them. The police report lists horrible abuse such as spitting on the patients, sticking their fingers in the elderly victims’ mouth until they would scream, and several other appalling acts.

On the surface, these girls appeared to be normal high-school students, but something is obviously not normal with their moral sense of right and wrong, and they failed people who were relying on and trusting them. How do we protect our elderly friends and family, especially when appearances can be so deceiving? A good start is to research long-care facilities. Medicare.gov has guidelines on their website on what to look for when deciding on a long-care facility for a loved one. Also look for state-specific websites where there may be postings of individual nursing home investigations by the state. For Texas, go to the Attorney General’s website for more information. Another helpful research tool is the sex offender’s database. Many people do not realize that a sex offender could be living in a nursing home as a resident. Check the addresses of nursing homes on the DPS Sex Offender Registry database to make sure there are no offenders living in the nursing home with a loved one. In addition, talk to the staff, talk to the other residents and their family. There’s no perfect guarantee, but with education and action maybe we can help stop future abuse.

Originally posted at InjuryBoard by Beth Janicek

Medication Abuse in the Elderly by Nursing Homes

Beth Janicek — Wed, 25 Jun 2008 16:01:25 GMT

A recent New York Times article is criticizing the use of antipsychotic drugs for patients with dementia. The drugs have not been approved by the FDA to treat dementia but are often prescribed for “off label” use by physicians.

The use of antipsychotic drugs to control agitation and combative behavior of dementia patients has in the increased in the elderly.

Sales of newer antipsychotics like Risperdal, Seroquel and Zyprexa totaled $13.1 billion in 2007, up from $4 billion in 2000, according to IMS Health, a health care information company.

These drugs are used and abused by some physicians. Many physicians caring for nursing home patients do not want to take the time to assess a patient or monitor their response to the medications. Some nursing homes encourage the prescriptions to help control their patients.

These medications create various problems for nursing home patients. For more information on this topic, see my prior post: Elderly Dementia Patients Given Antipsychotic Drugs

Originally posted at InjuryBoard by Beth Janicek

Assisted Living Facilities

Beth Janicek — Tue, 10 Jun 2008 18:18:02 GMT

Assisted Living Facilities (ALF) are a welcomed alternative to nursing homes for many families. However, there are issues which arise with these facilities and expose their owners to liability. The most common problem, I have seen in the cases I have handled, are that the needs change for the resident and the ALF is no longer able to adequately provide for the needs of the individual yet the ALF continues to allow the resident at the facility and the ALF continues to receive a large monthly check. For example, the resident’s dementia advances to needing constant help with their daily living activities or the resident receives an injury which makes them unable to care for themselves. The ALF is responsible for telling the family members when they can no longer meet the needs of the resident.

I recently ran across Assisted Living Facilities Position Statement Health Care Systems Committee, American Geriatrics Society.

This position statement is a good review for anyone considering an ALF. It outlines the issues that arise with these facilities and could identify good issues for people to discuss with the facilities.

Originally posted at InjuryBoard by Beth Janicek

Elderly Dementia Patients Given Antipsychotic Drugs

Beth Janicek — Thu, 29 May 2008 16:29:55 GMT

Canadian researchers said on Monday that elderly patients with dementia that were prescribed antipsychotic drugs are three times more at risk for serious health problems or dying within a month of treatment. Some of the health issues include infections and heart problems prompting the U.S. Food and Drug Administration to require warnings on packaging. Previous research shows these drugs cause dry mouth and difficulty swallowing which can lead to pneumonia and dizziness which can increase the risks for falls.

Doctors are using the medications to treat aggression in people who are not psychotic or schizophrenic, but this does not come without risks, according to Dr. Paula Rochon of the Institute for Clinical Evaluative Sciences in Toronto.

"Of residents newly admitted to a nursing home, 17 percent are started on antipsychotic drugs within 100 days of their admission," often for short periods to control delirium, delusions or aggressive behavior, Rochon wrote.

When prescribing these antipsychotic drugs, they should be prescribed with caution even if only prescribed for a short period of time.

Atypical antipsychotic drugs by brand name include Risperdal marketed by Johnson & Johnson; Zyprexa made by Eli Lilly and Co.; and Seroquel sold by AstraZeneca Plc.

In my experience with residents in nursing homes, our elderly are given not only antipsychotic drugs but other medications for all the wrong reasons. Due to understaffing of these nursing home facilities, residents are given various drugs to over medicate them so they are easier to take care of alleviating the nursing home staffs’ work load. If their patients are over medicated and sleeping during most of their shift, this drastically decreases the amount of work. Over medication also leads to residents becoming confused and disoriented which potentially leads to falls. Residents in nursing homes are generally frailer than older adults living in the community. They tend to have more chronic illnesses and have difficult walking. When a nursing home resident falls it greatly increases their chance of death due to their frail state and their ability to heal and rehabilitate.

For more information on falls in nursing homes the following websites are useful:

http://www.ext.colostate.edu/pubs/consumer/10242.html

http://www.cdc.gov/ncipc/duip/FallsPreventionActivity.htm

Originally posted at InjuryBoard by Beth Janicek

Jury Holds Nursing Home Accountable for Nursing Home Rape

Beth Janicek — Mon, 26 Feb 2007 09:34:05 GMT

Nursing homes often do not provide adequate protection for their venerable residents. Recently, a jury found against the nursing home for not having adequately protected one of their residents who was raped. The jury awarded $750,000 to the family. A repeat sex offender was admitted to the facility and committed the rape.

If your loved one has suffered abuse or neglect in a nursing facility then contact me to discuss holding the facility accountable.

Originally posted at InjuryBoard by Beth Janicek

Elderly women choked at San Antonio Nursing Home

Beth Janicek — Tue, 13 Oct 2009 10:58:23 GMT

Janice Maier, 77, was a sleep in her bed at a senior care facility when she was awaken early Saturday morning when a man entered her room, climbed into her bed and began to choke her and repeatedly hit her in the face. The attack occurred at Clare Bridge Specialized Memory Care, a Brookdale Senior Living facility on the Northeast side. Maier was transported to the hospital and was in stable condition on Saturday night.

The San Antonio Police Department incident report said that Maier had never seen her alleged attacker before. Daniel Villarreal, 25, was arrested at the scene after employees called police when they saw him covered in blood in the living facility and then discovered Maier, also covered in blood, on the floor of her bedroom. Maier told police that Villarreal hit her and choked her until she huddled inside a blanket on the floor beside her bed, where he started kicking her. It is unclear how Villarreal gained entry to the facility, which requires key code access.

The police asked Villarreal why he was there and he stated that he was “looking for something.” When asked what he was looking for, he replied, “A lady to choke.” He was “mad at his life and wanted to choke someone.” As of Saturday evening, Villarreal was in the Bexar County Jail on a first-degree felony charge of injury to the elderly with serious bodily injury.

This incident needs to be investigated and the facility should be held responsible for lack of security. Residents are entrusted to their care, and it is their obligation to provide a safe living environment. In addition, an employee should have spotted Mr. Villarreal before he ever made it into a resident’s room. This may be an issue of lack of training, or even a sign that the facility is understaffed. Whatever it is, there is no excuse for this type of attack to occur.

Originally posted at InjuryBoard by Beth Janicek