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A recent study has found that a class of drugs known as anticholinergics may increase the risk of dementia in patients aged 55 years and older. Commonly used in antidepressants, antihistamines, and antimuscarinics, the drugs have long been associated with side effects like confusion and memory issues. The new study, published in JAMA Internal Medicine, suggests more powerful side effects than medical professionals have previously understood.

As a report by the New York Times explains, anticholinergics encompass a variety of medications. Examples include clozapine, an antipsychotic; diphenhydramine, an antihistamine used in Benadryl, among other products; paroxetine, an antidepressant; tizanidine, a muscle relaxant; and scopolamine, an anti-nausea medication. Anticholinergics owe their wide range of applications to their function in blocking acetylcholine, a neurotransmitter involved in nervous system functions like muscle regulation, respiratory activity, digestion, and the opening and contraction of blood vessels. “Older adults are more likely to be prescribed many of these medications,” the Times explained, “simply because they tend to have more health issues.”

The JAMA Internal Medicine study examined 58,769 patients who had been diagnosed with dementia, with 225,574 matched control patients. Researchers examined dementia patients’ medical records, scrutinizing what medications doctor prescribed them between eleven years and one year before they were diagnosed with dementia. The study took into account 56 separate anticholinergic drugs, accounting for the dosage patients were prescribed and the length they were prescribed the drugs in question. What researchers ultimately discovered was a 50% increase in the risk of dementia in patients “who used a strong anticholinergic drug daily for about three years within that 10-year period,” according to the Times. This risk was strongest in patients who used anticholinergics to treat depression, psychosis, epilepsy, and bladder regulation issues. The study also found a stronger association between anticholinergics and dementia in patients who received their dementia diagnoses before they reached 80 years of age, and in patients with vascular dementia in comparison to those with Alzheimer’s disease.

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According to the World Health Organization, dementia is one of the major causes of disability and dependency among older people. Dementia, which is a syndrome in which there is a deterioration in memory, behavior and thinking, causes many who suffer from it to lose the ability to perform their regular activities.

Elders are stricken with dementia far more than any other age group. In many cases, dementia is the reason an elder moves into a nursing home. Dementia is also often to blame for what is known as “elopement” or in layman’s terms, wandering. Elders with dementia may develop wandering tendencies, wherein due to cognitive impairment, they begin to wander around their nursing home unsupervised and without an escort.

Wandering may lead to serious injury as the result of falling. In some cases wandering has even led to death, in cases where residents have wandered outside of their residential facility. Though rare, wandering is dangerous enough that lawmakers included provisions to protect against it in the 1987 Nursing Home Reform Act. The law required that nursing homes must provide residents with adequate supervision in effort to prevent elderly patients from wandering. That means of course, that nursing homes must be properly staffed.

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Elder abuse typically refers to the knowing, intentional, or negligent act by a custodial care provider, caregiver, or any other person that causes harm to a vulnerable adult. In California, anyone aged 65 and older is protected by the Elder Abuse and Dependent Adult Civil Protection Act. The laws are designed to help prevent neglect and abuse to California seniors. Neglect falls within the definition of elder abuse, and unfortunately may have dire consequences to the victim.

In broadest terms, neglect is a type of elder abuse wherein a caregiver fails to provide the elder with basic needs including water, food, shelter, heat/air-conditioning, personal hygiene products and medical assistance. Failure to adequately move or reposition a bedridden elder, for example constitutes neglect, just as failing to keep elders properly nourished and hydrated constitutes neglect.

Neglect is particularly dangerous for elders, as it can lead to life-threatening consequences. Such consequences of neglect include:

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The Elder Abuse and Dependent Adult Civil Protection Act (Act) was strengthened in 1991, when California legislature added Welfare & Institutions Code §15657 to the Act. This was done to specifically address the needs of California elders and the unique struggles they face, to include elder abuse, neglect, and abandonment.

Because elders may be seen as a disadvantaged class, California elder abuse attorneys who advocate for elders who have been abused, or the families of those who have passed away, are able to charge attorney’s fees and costs to the defendant (abuser). This helps those whose loved elders were mistreated by others who intentionally acted in a reckless, malicious, fraudulent, or oppressive manner to recover damages for the elder, or the family if the elder is deceased.

As such, those who can sue for Elder Abuse in Southern California will include both the family members of the abused elder (if the elder is deceased), or the elders themselves. If the suspected victim has died as the result of abuse or neglect while residing in a California nursing home, the family has the right to file a lawsuit on behalf of their deceased elder, and the court proceedings will ensue as if the elder were still living.

In many cases, where the elder has died, and the family believes the death was caused by misconduct, negligence, or abuse by the hands of another, two cases will evolve. One case will directly address the abuse, and proceed as if the elder were still alive. The second will be a wrongful death case filed on behalf of the survivors. The cases are very different. The injury/abuse case will take into account the injuries sustained by the elder, which will then be granted to the deceased elder’s estate. The wrongful death suit will serve to compensate the family and heirs of the elder who has passed away.

If you are unsure as to whether or not you have a case for an elder abuse lawsuit, contact Chris Walton today for a free consultation. Chris is an award winning elder abuse attorney who is based in San Diego, CA. Walton Law, APC focuses their entire practice on advocacy for elders who have been abused, or those who have suffered grave personal injury. Click here to schedule a consultation.
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Making the transition from an independent life to living in a nursing home is rarely easy for an elderly person.  Fear, anger, anxiety, and many more emotions can make the anticipation of this lifestyle change dangerous.  What are the risk factors and methods of mitigation that can be used to prevent a tragedy?

Transitioning from Home to Nursing Home

The time period between when the decision is made to move to a nursing home and the actual move-in date is critical.  In some cases, the prospect of this lifestyle change is enough to make an elderly person consider suicide as an option.  Some of the reasons for this include:

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The antibiotic is considered one of the greatest achievements in the history of mankind.  However, scientist have been studying antibiotic resistance since the 1940’s.  In 1947, penicillin became ineffective against its first bacterium.  Unfortunately, only as recent as 2017 have nursing homes been forced to develop, implement, and maintain an antibiotic stewardship program.

An Overview of the Problem

In any long-term care facility, the spread of bacteria and viruses is all but inevitable.  Mitigation techniques such as hand washing, frequent bathing, linen changes, and contact precautions do help, but at some point, this is not enough.  Increasingly, nursing home residents are being prescribed antibiotics even when their indications do not meet the criteria.  You may be surprised to know that, according to the CDC, 50%-70% of nursing home residents are prescribed antibiotics in any rolling 12-month period.  Additionally,

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Though much of the conversation around elder abuse is centered on nursing home malpractice, the leading issue many elders are currently facing is self-neglect. Self-neglect is defined by the National Adult Protective Services Association as, “an adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care…”, and is something that happens far too often within the older population worldwide. With many different factors to appreciate, it’s hard to always know exactly what to look for when trying to detect the symptoms of this epidemic.  

Who is most likely to experience self-neglect?

When having the conversation about self-neglect, it’s important to be aware of what some of the most vulnerable groups are. Though there has yet to be a study of adequate sample size and population diversity, researchers are already starting to see early trends of which demographics are more likely to have this problem.

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It is nearly impossible to avoid any medication error at a nursing home, meaning every individual establishment is required by state inspectors to keep their error rate below 5 percent. This mandate only includes minor errors, with essentially no acceptance of major medical incompetence. However, even with these regulations in place, nursing homes are not infallible.

What Constitutes a Medication Error?

There are many different forms of medication malpractice ranging from minor mistakes with little to no consequence, all the way to life threatening errors. These are some of the most common errors:

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Choosing to place yourself or a loved one in a nursing home can be extremely difficult.  Finding the right one is even harder.  A wealth of information exists online and much of it is useful, but this decision should be informed by experience and conversations with the people that matter most as well.

1 – Identify All of Your Options

Go online and find every nursing home in your area.  A great place to identify these facilities is on the medicare.gov website.  Using their Nursing Home Compare feature, you can type in your zip code and quickly compare all of the care facilities in a given radius.  You may have more options than you originally thought!

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Dehydration is a serious health risk, especially in elderly people.  Individuals over 65, who live alone or with their elderly partner, are at a higher risk of dehydration than other age groups because they may forget to stay hydrated or they are too tired to get a drink.  However, in a nursing home, dehydration should never happen and, in some situations, is an example of elderly abuse.

How Wide Spread Is This Issue?

One elderly person dying from dehydration in a nursing home is unforgivable.  People who live in nursing homes are there because they need help of varying degrees to survive.  One of the necessities of life is water.

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