California Elder Abuse Lawyer Blog

With the aging of America, more and more older people will be living in nursing homes than ever before. According to available data, there were 39.6 million people in 2009 who were 65 years of age or older. That represented nearly one out of every eight Americans or almost 13% of the U.S. population. Estimates are that there will be roughly 72 million of these older Americans by 2030, causing concerns about the type and extent of prescription medications that are administered to nursing home residents.

Naturally, as we age it is necessary to take various medicines for heart conditions, high blood pressure, high cholesterol levels, diabetes, Parkinson's and Alzheimer's, among other things. Because of this most people 75 years of age or more take over 11 different prescription medications during any given period of a year, according to the American Association of Retired Persons (AARP). This requires a committed nursing home staff to see that medications are administered timely and properly.

Problems are encountered when undertrained and undersupervised staff give the wrong medication, an incorrect dosage or overmedicate their residents, leading to often catastrophic results. An unintentional but common error is the mixing up one patient's medication for another's during a hectic shift. These mistakes can result in serious drug interactions and even death. Another medication issue is the consistency with which it is administered. Many prescription medications require a consistent, rather than sporadic, dosage, in order to be effective and safe for the patient. Finally, there is an overall tendency in nursing homes across the country to overmedicate those who call these facilities home. Sometimes it is caused unintentionally by undertrained and underqualified staff members, and unfortunately sometimes it is intentional in order to calm and restrain a disoriented or combative resident. The use of prescription medication in the form of anti-psychotic drugs to calm or restrain the elderly can be illegal, but studies have shown that roughly 25% of all nursing home patients are given them. Unfortunately, the Food and Drug Administration (FDA) has reported that more than 15,000 nursing home patients die on an annual basis due to the unnecessary administration of these anti-psychotic medications. For others, the administration of these medications serves to diminish the quality of their life as they remain in a drug induced daze.

Continue reading "Medication In Nursing Homes" »

In a report from the Centers for Disease Control and Prevention, it was revealed that the typical nursing home with 100 beds has between 100 and 200 falls per year, with roughly 1,800 deaths per year that can be attributed to falls. As such, falls involving nursing home residents is one of the most serious problems facing the industry.

Adding to the danger of falling is the fragile nature of the patients who live there making them more susceptible to being injured. When people age, their head, bones and joints are no longer able to withstand trauma from a fall that would not affect a younger person. For example, older people are more prone to suffer from subdural hematomas after striking their head in a fall, which can lead to serious injury or death. Osteoporosis is another medical problem associated with the elderly that makes them more susceptible to hip fractures from falling, with some ninety percent being related to falling to the side. Following a hip fracture, there is a long period of functional impairment, possible complications and a twenty percent chance of death within a year from the date of the injury. Studies show that seventy five percent of the hip fractures are sustained by women but the probability of hip fractures in men and women increases exponentially after turning 85 years of age.

Since falls in nursing homes are such a danger to the elderly who live there, nursing homes should constantly assess the patients who exhibit difficulty with walking or equilibrium. There are many things that can be done to prevent falls from happening, such as:
• Providing adequate supervisory staff for staff and residents
• Providing training to staff on fall risk factors and prevention strategies
• Providing alarms to alert when a patient attempts to get out of bed
• Keeping all areas well lit, clean and free of obstacles, and floors dry
• Providing wheelchairs, walkers, tripods and restraints
• Not overmedicating patients
• Providing easy access to call buttons for patients
• Providing training to staff for proper lifting techniques

Even under the best of circumstances, with all of the proper techniques and preventative devices in place, falls are bound to occur resulting in serious injuries or even death to the elderly patients who reside in nursing homes. Often they forget that they have fallen or they don't remember why their head or side hurts. Family members and visitors need to be constantly vigilant in noticing signs of falls or signs of danger in the facility.

Continue reading "Nursing Home Falls Present A Constant Danger To Residents" »

According to a report by Masters in Health Care, there are some very disturbing statistics about the long term care facilities that many of our friends, relatives, family members and loved ones call home.

Among the shocking facts revealed are the following:

• Over 30% of nursing homes have had some form of elder abuse either by the staff or other residents, including sexual abuse, physical abuse, psychological abuse, neglect and malnutrition.
• In 2005, nearly 92% of all nursing homes received at least one citation for a deficiency.
• Approximately 90% of the time when there is some form of abuse, it is done by the staff, other residents or non-strangers.
• In 1999 there were 5,000 death certificates for nursing home patients that listed the cause of death to be dehydration, bed sores and food deprivation.
• Most nursing home abuse cases never end up being because of the declining mental capacities of the patients and the failure to detect it by the staff members or the patient's family.
• Over 50% of all nursing home patients have no close family to watch out for nursing home neglect or abuse.
• Many times a nurse's aide or other staff member may be called upon to care for as many as 30 patients.
• Approximately 30% of all nursing home patients are overmedicated with tranquilizers.
• Approximately 92% of all nursing homes have at least one staff member who has a criminal background.
• With the aging of America, there are not enough nursing home beds to keep up with the growing need for long term care facilities.
• In 2007, there were nearly 258,000 complaints registered against nursing homes for an average of 20 for each.
• In 2001, one out of four nursing homes received a citation for serious injury or death of a patient.
• The cost of living in a nursing home continues to rise. In 2003, the average annual cost was $66,000 but by 2021 it is expected to be $175,000.

Continue reading "Disturbing Nursing Home Statistics" »

As more and more Californians reach their Golden Years, many face the horror of dealing with neglect in their long term care facilities such as nursing homes. According to the U.S. Bureau of the Census, the growth of the elderly (age 60 and over) in California is expected to be twice as fast as the total population and the oldest group (age 85 and over) is projected to increase faster than that. This means increasing numbers of the elderly will end up being placed in nursing homes.

While many long term care facilities provide excellent care, others subject their patients to some form of neglect or elder abuse. Some of the most common signs of neglect or elder abuse are dehydration, loss of appetite, pressure (bed) sores, bruises, broken bones and markings from restraints, among other things. The California Welfare & Institutions Code, Section 15610.57, addresses "neglect" in part by saying that it is the negligent failure to exercise the degree of care a reasonable person would have exercised had they had the care and custody of an elderly person. This would include the failure to protect that person from dehydration, bed sores, falls, other injuries caused by safety or health hazards and any type of injury that does not fit the explanation provided by the staff.

Under California law, many are charged with the duty to report indications of elder abuse to the Adult Protective Service Agency (APS) in every county, including doctors and other medical professionals, employees of nursing homes and others who care for the elderly. Unfortunately, this law is not apt to be followed by the nursing home staff or physicians whose neglect might have led to the injuries. For example, bed sores are caused by pressure against the skin that reduces the blood supply causing ulcers and ultimately death of the tissue. These usually are found on the back area, the tailbone, shoulders, hips, elbows and heels but are preventable by providing padding with pillows or foam support pads, frequent changing of the patient's position, sheepskin and powdered sheets. Likewise, falls and other preventable injuries are often covered up by writing an incident report and doctoring records. Since elders in nursing homes are essentially isolated from the outside world and often have reduced mental capacity, they are easily manipulated to believe what they are told. Therefore, it is of utmost importance for family members, relatives, visitors and others to make note of any warning signs of neglect or abuse of their friends or loved ones in nursing homes.

Continue reading "Bed Sores Are a Common Sign of Nursing Home Neglect" »

Approximately 560 nursing homes nationwide and 45 in California received a one-star rating by the federal government for the past three years in a row. The Centers for Medicare & Medicaid Services rating system, introduced in 2008, gives residential care facilities a one to five star rating based on annual inspections, the amount of time staff time spends with residents, and other quality measures. Under the rating system, one-star is the lowest score available and is reportedly assigned to nursing homes that fall far below average when compared with other homes in their respective state. Issues which can have an effect on a facility's rating include mistreatment of residents, the employment of unlicensed staff, and regularly dirty equipment and linens.

The federal rating system is designed to provide citizens with increased transparency about nursing home quality. According to Janet Wells, Public Policy Director at the National Consumer Voice for Quality Long-Term Care, a variety of factors can result in a nursing home quality drop almost immediately. A new administrator, manager, nursing director, and changes in direct care personnel can have a dramatic effect on the quality of care in any particular facility. A change in ownership can also diminish the quality of care.

The 2011 federal nursing home ratings show 35 percent of the 15,700 nursing homes rated received a one or two star rating. Meanwhile, 43 percent of facilities were given four or five stars. 564 nursing homes were consistently rated one-star for three years straight. About two-thirds of those facilities are operated by for-profit chains. In contrast, only 40 percent of the nearly 16,000 nursing homes analyzed by the government were part of for-profit chains. 448 nursing homes were consistently given a five-star rating each of the last three years.

Some in the nursing home industry believe reducing staff turnover has a dramatic effect on the quality of care residents receive. A voluntary program helped improve care in 17 inner-city nursing homes by focusing on resident quality of life. When direct caregivers are familiar with resident needs, clinical quality generally improves. The program tended to demonstrate higher care quality when the same staff members assist the same patients on a daily basis.

Even with a federal rating system, nursing home quality can be tough to verify. In a perfect world, ratings such as those promulgated by the federal government would help residents determine which facility is right for them. Unfortunately, nursing home residents do not always have a choice regarding which facility is tasked with their care. Because of this, it is important to be on the lookout for signs of elder abuse or mistreatment at any residential care facility. Nursing home abuse often occurs as a result of unqualified direct care staff and may include physical abuse, withholding food, incorrectly or over-medicating, sexual abuse, inadequate medical care, and emotional distress.

Common signs of elder neglect or abuse include pressure sores, overuse of restraints, unexplained accidents, bruises, broken bones, and even scratches. A nursing home resident may also lose his or her appetite, become dehydrated, or become depressed. It is vital for you to take all complaints of nursing home abuse or neglect seriously. If you suspect a nursing home resident is being neglected or abused, contact a qualified California elder abuse lawyer as soon as possible.

Continue reading "169 California Nursing Homes Receive One-Star Federal Rating in 2011" »

The California Department of Public Health has fined three Los Angeles County nursing homes a total of $235,000 over the alleged poor quality of care the facilities provided to residents. The Downey Care Center, Fountain View Subacute and Nursing Center, and the Motion Picture and Television Hospital were issued Class "AA" citations, the most serious violations under California law, over patient deaths which occurred at each facility in 2010. According to Dr. Ron Chapman, Director of the California Department of Public Health, the fines were levied after an investigation revealed each patient death resulted from inadequate nursing home care.

The Downey Care Center must pay $80,000 for failing to properly monitor a resident's blood sugar levels after she returned from the hospital. Because the center purportedly failed to provide appropriate care, the resident fell into a diabetic coma and died.

The Fountain View Subacute and Nursing Center located in the City of Los Angeles received a $75,000 fine for allegedly failing to properly supervise a patient with a record of falling. The nursing home resident died from a brain injury he incurred when he fell out of bed. Additionally, staff at the nursing home could not say how long the man laid helpless on the floor before his injury was discovered.

The Department of Public Health fined the Motion Picture and Television Hospital in Woodland Hills $80,000. The fine stems from an incident during which an Alzheimer's patient reportedly fell down a flight of stairs while strapped into her wheelchair. The nursing home resident died from her injuries one week after her fall. Unfortunately, the resident also fell down the same flight of stairs in the past.

In California, there are approximately 1,300 licensed resident care facilities. When a licensed nursing home fails to comply with applicable state and federal laws designed to ensure residents are properly cared for, the State of California has the ability to impose monetary penalties. The amount of a fine depends on the severity of the resident care facility's violation. A nursing home may be fined anywhere between $100 and $100,000 depending on the violation.

Nursing home abuse occurs when the elderly or infirm are injured or die as a result of mistreatment or negligence in a facility tasked with their care. Although most elder abuse cases result from negligence, they may also be the result of physical abuse, sexual abuse, a failure to provide adequate medical care, withholding food, incorrectly or over-medicating, and emotional distress. Unfortunately, nursing home abuse is frequently the result of improperly trained or unqualified staff.

Signs of elder abuse can be tough to detect. A nursing home resident may experience a loss of appetite, unexplained weight loss, dehydration or depression. Residents may also exhibit bruises, broken bones, scratches, bed sores, unexplained accidents, and complain of missing personal items. In order to safeguard the rights of the elderly, it is important to take all complaints of nursing home abuse and neglect seriously. If you suspect a nursing home resident is being neglected or abused, contact a qualified California elder abuse attorney to discuss your concerns.

Continue reading "Three Los Angeles County Nursing Homes Fined over Preventable Resident Deaths" »

The elderly are prime targets for financial scams. Persons over the age of 50 control over 70% of the nation's wealth. Yet senior citizens are more likely to have disabilities or impairments that make them vulnerable to manipulation and prevent them from taking action against their abusers. Some older people are unsophisticated about financial matters or unaware of how much their assets have appreciated. Others cannot help but follow a predictable pattern of receiving and cashing in their monthly checks, making it easy for predators to guess when they have money or need to go to the bank. Many times, the very family members and helpers they depend upon are the perpetrators who unduly influence and exploit them.

Financial abuse refers to the theft or embezzlement of an elder's money or property. It includes a wide range of conduct, from the immediate theft of money and property to the use of deception, coercion, or undue influence over time. Perpetrators may also reap financial gain by forging the elder's signature, forcing them to sign a deed, will, or power of attorney, placing charges on their credit cards without permission, or using any fraud, scam, or deceptive act to financially exploit the victim. Sadly, the perpetrator does not have to be in proximity with the victim; AARP estimates that Americans lose $40 billion each year to fraudulent sales pitches that promise a lottery win, prize win, travel package, or "amazing home loan." Over 56% of the victims targeted are aged 50 or older. Some widespread forms of financial elder abuse include:

• Identity theft
• Predatory lending
• Telemarketing fraud
• Estate planning scams
• Home improvement scams

Financial abuse is devastating for elders who already have a hard time providing for themselves. As such, it is important to recognize some of the most common signs of financial abuse:

• Unusual bank account activity
• Sudden withdrawals or transfer of assets
• Additional names on bank signature card
• Unexplained changes in spending patterns
• Forged signatures on checks and legal documents
• Unpaid bills, notices to discontinue services or evict

The California Welfare and Institutions Code defines financial elder abuse as the taking, secreting, or appropriating of an elder's real or personal property for wrongful use or with intent to defraud. The Financial Elder Abuse Reporting Act of 2005 (Act) requires the reporting of any fraudulent use of an elder's drafts, checks, or orders drawn upon any bank, credit union or savings association. Any person who suspects financial elder abuse should report it the local Long-Term Care Ombudsman, local law enforcement agency, or the Bureau of Medi-Cal Fraud and Elder Abuse. Pursuant to the Act, the police, sheriff's department, or district attorney investigating the abuse can then request detailed financial records to corroborate the report.

Continue reading "Recognizing and Reporting Financial Elder Abuse--California's Financial Elder Abuse Reporting Act " »

Following the death of Johnnie Esco at a Placerville facility, an investigation of similar complaints revealed nearly 150 cases of alleged chart falsification in California nursing homes. In Esco's case, the Department of Justice reopened its criminal investigation of El Dorado Care Center (Center), the nursing home that allegedly altered Esco's charts to reflect treatment she never received. After 13 days of neglect, Esco experienced massive bowel obstruction, ultimately leading to her death. Her family sued the Center, alleging fraud, elder abuse, and wrongful death. The family accused the Center of falsifying and altering Esco's medical charts since her admission. The facility remains under civil and criminal investigation for fraud.

Johnnie Esco, 77, was supposed to be recuperating from a bout of pneumonia at a nearby nursing home when her condition suddenly declined. Like many elderly patients, Esco suffered from chronic constipation, which could result in fecal impaction if left unmanaged. Esco's physician therefore ordered that nurses perform routine assessments, checking Esco on every shift for possible constipation. The physician also ordered that Esco receive a laxative or stool softener and milk of magnesia daily. Esco's chart, however, showed no history of constipation or laxative use. The nurses never performed an assessment or asked for Esco's history.

While Esco did not have a bowel movement for five consecutive days, her chart indicated a "zero" constipation. When the doctor ordered an evaluation of the patient's abdominal distention, no one performed it. Esco lay critically ill, but her chart showed she had an "extra large" bowel movement and a temperature of 98.8. While she was bedridden and unresponsive, the Center billed Medicare for 170 minutes of physical therapy and 65 minutes of occupational therapy. It seems nobody looked in on Esco before she died. An autopsy revealed a severe bowel obstruction and fecal impaction, contradicting the notes in Esco's chart.

Esco is not the only patient with a falsified medical chart. A supervisor at a Carmichael facility admitted altering the medical records of a 92-year-old with massive, rotting bedsores. A Santa Monica facility was fined $2,500 for claiming a patient received five days of physical therapy when the nurses responsible for performing the therapy were not at work on those days. Investigations into Medi-Cal Fraud and Elder Abuse reveal that falsification of records in nursing homes is an insidious practice, even when it leads to disastrous human consequences.

Falsifying medical records is a misdemeanor under California law. The California Code of Regulations and Business and Professions Code both require mandatory reporting of the offense. Nevertheless, this is what some providers do "to get the work done." Nursing assistants admit to charting "in bulk," documenting medication and treatment that were never given. Some administrators even re-create records to hide neglectful care. Others falsify forms to sedate patients or backdate forged documents to settle disputes. In a practice where providers rely upon the accuracy of medical charts, sloppy or fraudulent record-keeping takes a serious human toll.

Continue reading "Investigation Reveals California Nursing Homes Falsify Medical Records" »

Under California law, elder abuse is both a criminal and civil offense. Criminal elder abuse describes the willful infliction of physical or emotional suffering on an elder. Civil elder abuse includes any physical or financial abuse, neglect or abandonment resulting in physical or mental harm. Diminished capacity due to the elder's advanced age, physical confinement, and medical condition make it difficult for victims to speak out about their abuse. Even when they do, perpetrators may blame the complaints on the elder's senility, confusion, or dementia. So many victims have no family or friends left to care for them. They rely entirely upon the staff and caregivers at their nursing home or facility. That is why it is important for anyone who witnesses elder abuse to recognize the symptoms and report the abuse.

Signs of physical abuse include unexplained weight loss, malnutrition, and dehydration. While lack of appetite is a common complaint amongst the elderly, caretakers are required by law to provide the food and service necessary to the patient's health and wellbeing. Unfortunately, poor nutrition often leads to easy bruising, another sign of physical abuse. Look for bruises and skin damage in the shape of fingerprints or clustered marks from repeated striking or beating. Also notice any new scratches, cuts, welts, or fractures. Marks indicating pinching, choking, or gagging evidence acute instances of abuse, while increased bedsores show neglect, as when the patient is not turned over enough in bed.

While not as visible, suspicious behavior may also indicate abuse. Watch for undue agitation, anger, or defensiveness. These may be signs of mental suffering. Patients may also become non-responsive, hesitant, and anxious when asked to explain their abuse. They may feel increasingly isolated as they lose contact with family and friends. Always look for signs of fear, withdrawal, depression, and helplessness in determining whether there has been abuse. Remember that any social isolation, absence of assistance, or indifference toward the needs of the elderly may constitute abuse. Even if you are not related to the victim, report any suspicious activity to the proper authorities.

Administrators, supervisors, and licensed staff of elderly care facilities must report actual or suspected abuse. Even if you are not a "mandated reporter," you can still report suspected incidents of elder abuse to each of the following agencies:
• The Licensing and Certification Division of the Department of Public Health (DPH)
• Local Law Enforcement, including the Police, Sheriff, and District Attorney's office
• Office of the State Attorney General, Bureau of Medi-Cal Fraud and Elder Abuse
• Long-Term Care Ombudsman Program
• Adult Protective Services (APS) in your county
To report health-related or financial abuse, contact any of the following:
• Office of the Attorney General, Bureau of Medi-Cal Fraud and Elder Abuse
• Health Insurance Counseling and Advocacy Program (HICAP) or the California Senior Medicare Patrol
• For consumer scams, contact the appropriate county office of the District Attorney.
• For questionable annuity practices, contact the State Insurance Commissioner's Office

Continue reading "California Guidelines for Recognizing and Reporting Elder Abuse" »

Criminal elder abuse describes the willful infliction of physical pain or mental suffering on an elder. In the absence of intent, criminal abuse also includes the reckless endangerment of an elder's life by placing the elder in a situation the person has reason to believe would be dangerous. The California Penal Code sets forth rules governing criminal elder abuse. Civil elder abuse is governed by the California Welfare and Institutions Code, which defines elder abuse as the physical or financial abuse of an elder, whether through neglect, abandonment, isolation, abduction, or other treatment causing physical or mental harm to the elder. Care custodians may inflict physical harm or mental suffering on elders by depriving them of goods or services necessary to daily functioning.

Elder abuse is an intolerable fact of life for many people 65 years or older who are too afraid, too frail, or discouraged to speak out for themselves. As many as five million elders in the United States are abused, neglected, or exploited each year and 90 percent of these cases are perpetrated by family members or trusted advisors. As 76 million baby boomers approach old age and retirement, the population of adults aged 65 years or older will increase dramatically, forcing elder abuse to the forefront of important legal issues confronting senior citizens, their caretakers, and families.

The California Code of Regulations, Code of Federal Regulations, and Health and Safety Code guarantee elders specific rights to living accommodations, medical care, and quality of life in both nursing homes and residential care facilities. One example is the elder's right to voice complaints or grievances without fear of retaliation. Elders must also receive care in a manner which "promotes and enhances" their quality of life, including being given food of the "quantity and quality" meeting their needs and preferences.

Indeed, elders and those who love them should be vigilant in identifying signs of physical, financial, emotional abuse, and neglect. Some signs of elder abuse include unexplained injuries, failure to assist in personal hygiene, unreasonable isolation, and withdrawn or confused behavior. Those who suspect elder abuse should document their findings and report them by filing a complaint with any of the following entities: local law enforcement, the Office of the State Attorney General, the California Department of Public Health, the Department of Public Services, the local Long-Term Care Ombudsman, or the Bureau of Medical Fraud and Elder Abuse.

Elder abuse is both a criminal and civil offense. In addition to criminal fines and imprisonment, those convicted of elder abuse are liable for compensatory and punitive damages as well as court costs and attorney's fees. Nursing homes and care facilities are likewise subject to loss of license, censure, and fines for committing elder abuse.

Continue reading "Under California Penal Code and Welfare and Institutions Code, Elder Abuse Gives Rise to Criminal and Civil Actions" »

The Department of Health and Human Services recently released a report revealing the excessive amount of "potentially lethal" antipsychotic drugs that nursing homes are dispensing to their residents. Aside from being a huge waste of taxpayer money (Medicare paid and estimated $116 million in unnecessary drugs, during a six-month period in 2007), it presents a dangerous health risk to our elderly population - particularly those who suffer from dementia.

Psychoactive drugs, also referred to as antipsychotic or psychotropic drugs, contain powerful chemicals that affect the brain and have dangerous side effects. These drugs essentially sedate the individual, which directly affects the individual's personality, behavior and mood. Psychoactive drugs typically fall into four major classes, including: (1) antipsychotics such as Zyprexa and Haldol; (2) anti-anxiety drugs such as Ativan and Valium; (3) anti-depressants such as Prozac and Zoloft; and (4) sedative/hypnotics such as Halcion and Restoril. They are particularly appealing to the nursing home industry because they can serve as a substitute for the individualized care the person truly requires.

Elderly patients with dementia are particularly vulnerable to dangerous side effects, including death. Nevertheless, many nursing home residents with dementia continue to receive psychotropic drugs that are not designed or approved for their condition. According to California Advocates for Nursing Home Reform, it is presently estimated that nearly 60% of California nursing home residents are given psychoactive drugs. The problem has become so critical that the U.S. Food and Drug Administration (FDA) issued a "black box warning" that antipsychotic drugs can cause individuals with dementia to die.

As with any approved drug, its use is not always harmful and the benefits can outweigh the risk. That said, if your loved one is presently taking these drugs, or if their use is being proposed, you have the right to better understand the risks and to decline the drug if you choose. Psychoactive drugs cannot be prescribed without first obtaining informed consent. In California, the key informed consent regulations are found within Title 22 of the California Code of Regulations, sections 72528 and 72527(a)(4-5). Essentially, the health care provider must explain any proposed treatment. This discussion should include the benefits versus risks of the proposed treatment as well as the reason for its use and reasonable alternatives. Furthermore, the resident or legal representative must agree to the treatment. Giving these drugs without first obtaining informed consent is a form of elder abuse and neglect and a direct violation of patient's rights.

Continue reading "Overuse of Psychoactive Drugs in California Nursing Homes Reaches an Alarming Rate" »

As we age and certain everyday tasks become more difficult, we become more dependent upon the care of other people. These may be members of the family, in-home caregivers, or caregivers at a nursing facility. While many caregivers are skilled and dedicated, too often there are those who mistreat the people in their care. The result is that elder abuse is one of the most widespread forms of abuse.

Elder abuse generally falls into three categories that frequently overlap: physical, emotional, and financial abuse. Physical abuse can range from active harm by the caregiver to physical neglect. Emotional abuse may include intimidation through threats or yelling, routine humiliation, blaming or scapegoating, ignoring the elderly person, or terrorizing that person. Financial abuse can range from stealing the person's money outright to misusing his or her credit cards and personal checks. Elderly people are especially vulnerable to telemarketing scams and identity theft. A lonely elderly person might crave attention, even from a stranger over the phone -- leading him or her to give out personal information that the thief uses to steal credit card numbers and wipe out savings accounts.

Why is elder abuse so widespread? In many cases, unscrupulous people look to take advantage of those who are vulnerable. In other cases, care facilities may lack staff that is properly trained. Many family members also lack proper training and are generally overwhelmed by having to care for someone with significant physical and mental needs. Nonetheless, elder abuse is a crime and should be reported as quickly as possible. If you suspect an elderly neighbor of being abused, you can also find a California elder law attorney to obtain relief in a physical or financial abuse situation.

Here are the top 10 signs of elder abuse:

1. The person shows signs of physical trauma, such as burn marks, unexplained bruises and welts, and injuries that often don't match the explanation.

10. The person's will undergoes suspicious changes, such as changing the primary beneficiary to a caregiver who is not part of the family.

Continue reading "The Top Ten Signs of Elder Abuse" »

As a nursing home abuse and neglect lawyer, one of the most common questions is, "how do I choose the right nursing home for my loved one?" Unfortunately, there is rarely an easy answer to this question. However, there are some important guidelines listed below that I believe will assist in selecting the most appropriate nursing home for you or your loved one.

Make a List:

Similar to any other big decision in life, there is no substitute for doing your homework and acquiring as much information as you can. Start by making a list of the nursing homes in a community close to relatives, friends and/or people that will visit your loved one while in the nursing home. To obtain a list of nursing homes, you can contact your local California Department of Public Health District Office. Alternatively, California Advocates for Nursing Home Reform maintains an online nursing home guide that is very helpful.

Location:

Although mentioned earlier, location cannot be stressed enough. If at all possible, you should always select a nursing home that is convenient for those who will visit your loved one the most. It is a proven fact that nursing home residents that enjoy frequent visitors are happier and healthier. It is also true that your loved one will likely receive better care if there is somebody constantly monitoring the environment.

Medicare/Medi-Cal Issues:

Nursing homes are expensive and ability to pay is often a concern. It is estimated that the daily cost for a nursing home is approximately $6,000.00 per month. As a result, many will need the assistance of Medicare and/or Medi-Cal to help offset the high cost. If this is a concern, either now or in the future, it is important to locate a nursing home that participates both Medicare and Medi-Cal.

More Homework on the Nursing Homes That Have Made Your List:

Every nursing home has a public record maintained by the state Department of Public Health. Contact your Department of Public Health District Office to review the most recent surveys and inspections. While you are there, take a few moments to review some of the complaints that have been lodged and the results of the investigation. Each county has an Ombudsman Program that provides advocacy services for nursing home residents. You may also contact your local Ombudsman for any additional information they may offer about the nursing homes that have made your list.

Visit the Nursing Home:

Now it is time to visit each nursing home on your list. Here are some tips/ideas you may consider during your visit.
• Ask to see the entire facility - not just he lobby and unit they show you.
• Observe staff and resident interactions.
• Observe resident-to-resident interactions.
• Does it appear home-like or like an institution.
• Speak to residents who live there as well as their families.
• Try to visit more than once at different times.
• Visit during mealtimes and observe residents eating in the dining room.
• Look into what activities are offered (ask for an activity calendar).
• Ask how many residents on average each nurse is assigned to.
• Ask about access to emergency care, dentists, podiatrists and eye doctors.
• Make sure they offer the services you require.

As you can likely tell, finding the right nursing home for your loved one is not a simple process. But it's probably one of the more important decisions you will make in your lifetime. All of the guidelines listed above are important to assist you in making such an important decision. Once your loved one is placed in a nursing home it is critical to make personal visits as often as possible. You may strategically choose to visit at different times, so the staff doesn't know when to expect you. If you run into a problem, speak to the Director of Nursing or the Administrator of the facility immediately. If you are unable to resolve your issue within the facility, contact your local Ombudsman office or the Department of Public Health for additional guidance. Just remember, many of our elderly population are vulnerable and you may serve as their only advocate.

Continue reading "Guidelines to Selecting A Nursing Home for Your Loved One" »

Contrary to what the nursing home industry wants us to believe, bedsores can be prevented. A bedsore, also commonly referred to as a pressure ulcer or decubitus ulcer, is basically an injury to the underlying tissues of the skin. They most often occur when an individual remains in the same position for an extended period of time, creating prolonged pressure that affects the necessary blood flow and nutrients to the skin.

Residents in nursing homes are often at most risk because many of them have medical conditions that limit their ability to move. The necessary pressure to create a bedsore can result from sitting or lying for a prolonged period of time. People in wheelchairs often suffer from bedsores on the tailbone, spine, and the back of their arms or legs. For those that are bedbound, they often occur on the heels, hips, ankles, shoulders or their head.

The number one key to prevention (and treatment) is relieving pressure. This can be accomplished most effectively by repositioning a person regularly, particularly once a bedsore has developed. A second strategy is to ensure the appropriate support surfaces are utilized. There are all types of special mattresses and cushions that are designed to relieve pressure.

Once you recognize a bedsore, you should contact your doctor immediately. Bedsores can often resolve with appropriate detection and treatment. Aside from relieving the pressure, your doctor will access the severity of the bedsore and likely consider removing any damaged tissue and/or cleaning and dressing the wound. It is also critical that a patient maintain nutrition and hydration to promote health skin tissues.

If you or a loved one reside in a nursing home, detection of the skin should be a routine part of care. Unfortunately, all too often we see patients that suffer from bedsores due to neglect or lack of an appropriate care plan. The following are just a few of the precautions and safety measures that should be taken to prevent the formation of bedsores.

• Periodic reassessment of the patient's risk;
• Appropriate bathing routine;
• Constant nutrition hydration;
• Repositioning to relieve pressure; and
• Use of appropriate support surfaces.

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An Oroville, California nursing home, Olive Ridge Post Acute Care, was recently cited fifteen times by the Department of Public Health for failing to follow laws in place to protect residents from improper eviction. According to public documents, Olive Ridge attempted to move out many of its long-term residents to increase beds for short-term rehabilitation residents who are often times required to pay more for their care.

Long-term residents in nursing homes are often considered extremely vulnerable, which is why there are several laws in place intended to protect them from unplanned evictions. According to the citations, Olive Ridge failed to follow several State and Federal laws when it decided to suddenly close down an entire wing of the nursing home and relocate up to fourteen residents that were suffering from severe cognitive issues. To make matters worse, some of the residents were relocated more than 150 miles away from their family with virtually no notice. This understandably created a tremendous amount of anxiety and burden on these residents and their families.

The California Department of Public Health is responsible for overseeing the nursing homes operating within the state to ensure they comply with all state and federal regulations. If you have a complaint that cannot be resolved through direct discussion with the nursing home or an ombudsman, you should contact your local Department of Public Health Licensing and Certification office. A list of the district offices and phone numbers can be found at the CA Department of Public Health website.

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