Articles Posted in Medication Error

shutterstock_1717046857-300x203Nursing home residents are confronted with numerous safety issues while living in the facility. Although some accidents seem almost inevitable because nursing homes house mostly older people, there are ways to be proactive. Nursing home staff should have safety measures in place to deal with obvious problems, so that they can mitigate injuries and lessen the impact. If you have a loved one who is a nursing home resident, you will want to recognize their vulnerability and how you can help them. Read on to learn about top three safety issues facing nursing home residents.

  1. Falls: This is one of the biggest concerns for nursing home residents. This shouldn’t come as a surprise because many individuals realize that falls are one of the main causes of fatalities for seniors. Ironically, getting help with moving around (to shower and bath, for instance) is one of the reasons that people move into nursing homes; they want to reduce the risk of falling. However, falls can still occur in nursing homes, due to negligent staff or poor design of the facility. Here are some things that you can check to see if the nursing home staff is doing their best to help prevent trips and falls:
  • Does the staff help the residents stay physically active, so they are less likely to fall?

shutterstock_657828892-300x225Many nursing home residents depend on the assistance of staff to help administer their medication. This is a very important aspect of their lives because medication can be needed to help manage existing health conditions and to ensure that the residents can maintain healthy lives. However, there are times when nursing homes improperly use medication as a chemical restraint.

What is a Chemical Restraint?

Thankfully, most nursing homes would never consider using a physical restraint. However, many institutions do indeed use chemical restraints in the form of psychotropic drugs. These drugs can impact the resident’s thoughts, physical responses, and general behavior.

shutterstock_6578288924-300x225According to the FDA, medication errors account for over 1 million injuries annually. A nursing home medication error is defined as a preventable drug-related mistake that impacts a nursing home resident. If you or your loved one is in such a facility, then it’s important to learn more information about this topic.

 Common Types of Medication Errors

The majority of nursing home residents use some kind of prescription medication, and there are a lot of ways things can go wrong when it comes to dispensing it. Here are some examples:

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,

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:

It is no secret that many people have difficulty asking others for help. Elders living in Southern California are no different. Even though physical and mental capabilities may start to diminish with aging, it is still not easy for many seniors to let others know they are struggling.
That is why it is up to all of us to keep an eye on aging family members or friends. Here is a list of warning signs that a senior you love may need help from family members or professionals.

1. Abnormal or repeated phone calls If your grandmother, mother, father, or other elder family members begin making phone calls to you repeatedly, or at peculiar times of day, it may indicate confusion. It may also be a sign of memory loss, or could indicate that the elder is feeling lonely or depressed. If you notice these types of calls, try scheduling set calls with your loved one every day to see if they stick to those times and calls. If they don’t, it may be indicative of cognitive decline.

2. Weight loss/lack of food in the home When you visit your loved one, take notice of their appearance. Are they maintaining a healthy weight? If they’ve lost a substantial amount of weight, take a look in the refrigerator to confirm that there is food, and that the food has not spoiled. If there is nothing to eat, this can indicate that your loved elder is finding it difficult to shop and/or cook, and are thereby not taking proper care of themselves. This may be a sign that they need your help in shopping, preparing meals for the week, or even that they need to see a physician.

3. Mail is piled up, unopened or has not been retrieve from the mailbox When you visit your loved senior, take notice of unopened mail piled up, or even in the mailbox. Signs that your loved elder may be overwhelmed by once routine tasks may indicate that they are feeling depressed or confused.

4. Their home is suddenly messy If your aging parents or grandparents have traditionally kept a neat home, but you find their home is cluttered or dirty, this may be a sign they need help. They may be in physical pain and unwilling to clean, or they may be too tired, or even depressed. If you notice a sudden change in the appearance of the home it can be a warning sign that your loved elder is having a hard time, and needs assistance.

5. Cooking and baking pots and pans are burnt If you see scorch marks on pots, pans, or baking sheets, it may indicate difficulty with short-term memory. Your loved one may be forgetting they have left the stove or oven on after making a dish. This is a warning sign you should never ignore, as it has safety ramifications not only for your loved elder, but also for neighbors.

6. They aren’t changing their clothes or are wearing clothing inappropriate for the weather If an elder you love seems to be wearing the same clothes over and over, or shows signs of poor personal hygiene it may be a signal that they are struggling, mentally, emotionally, or physically. They may have difficulty doing laundry because it is located on a different level of the home, or it may indicate depression, or cognitive decline wherein they are having difficulty assessing the proper clothing to wear for the weather.

7. They are missing doctor’s appointments and/or medication Missed appointments may indicate memory problems, or difficulty in securing transportation to their appointments. This can be dangerous for elders who need medication, so if you determine that they are missing their appointments and and/or are not taking their necessary medication, it may be time to consider hiring help for them.

If you notice any of these warning signs that a loved elder in Southern California may need help, don’t be afraid to speak up. Often times an elder may need something as simple as transportation a couple of days a week, or a housekeeper a few times a month. In other cases, they may need to be relocated into an assisted living facility. It’s important to realize though, that they may not ask for help, so you need to ask them questions, and ascertain as best as you can, whether or not they are still capable of living without any assistance.
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Elder abuse in any form is strictly prohibited by California law. In addition to physical abuse and neglect, medication errors in nursing homes are considered a form of elder abuse. Unfortunately, due to insufficient staffing in many long-term nursing facilities, errors in the type and amount of medications administered to residents occur with alarming frequency. While in many cases there may be no detrimental side effects to an elder who is given the incorrect medication, or the wrong dosage; in many other cases, the error can prove fatal.

For example, if two patients’ medications are mixed up, and incorrectly administered, the outcome can be disastrous. A diabetic who is mistakenly given a fellow patients’ heart medication may not under normal circumstances have a negative reaction. However, if that heart medication happens interacts with other medications he or she is taking, or causes side effects that the patient can’t sustain; the mistake can result in death.

Other medications must be taken consistently in order for them to be effective. Therefore, missing a dose of the proper medication can have devastating consequences on the elder who has missed their dosage. Other medication errors that may occur in nursing homes include:

The use of physical and chemical restraints in California nursing homes is sometimes a necessary way of protecting patients from injuring themselves and others. When used excessively and, more importantly, without consent, the practice becomes outright abusive. Often this method is used not simply to protect the patient, but rather to make a staff member’s job easier. Overuse of restraints is exacerbated by the growing number of understaffed nursing facilities.

Physical restraints are used to keep patients from wandering around the facility, a potential hazard for the patient and others. A nursing home is required by law to have the resident’s consent before using a physical restraint. Symptoms of physical restraints include sores or bruising on the arms and legs, usually on the ankles and wrists.

Chemical restraints involve the administering of powerful psychotropic drugs to sedate and confine the patient by taking away his or her cognitive abilities. These drugs are not permitted under any circumstances unless the nursing care facility outlines a legitimate medical reason for their use and further provides the frequency and dosage. Because most people are not familiar with the side effects of psychotropic drugs, it can be more difficult to identify chemical restraints than physical restraints.

Each year, more than one in three seniors sustain falls, which result in serious injuries. In some instances, falls are the result of elder or nursing home abuse. But in other instances, falls are purely accidental. An experienced San Diego attorney specializing in elder abuse or nursing home abuse, to include neglect, can help you distinguish if an injury from a fall was an accident or caused by the negligence or wrongdoing of another.

As we age, the likelihood of being diagnosed with a medical condition or disorder requiring prescription medication(s) is almost guaranteed. Because of this, far too many elders run the risk of being over-medicated, or experiencing dangerous side effects which increases the risk that an elder may fall. Many seniors are prescribed medications that have dangerous interactions when taken in conjunction with other medications.

To reduce the risk of experiencing potentially dangerous prescription interactions, it is recommended that seniors use caution when taking prescriptions or even over-the-counter (OTC) medications.

Society erroneously assumes prescription medication is only abused by the younger generations. Studies show, however, prescription drug abuse plagues men and women of all ages, including the elderly.

According to an article in the National Institute on Drug Abuse, “Persons aged 65 years and older comprise only 13 percent of the population, yet account for more than one-third of total outpatient spending on prescription medications in the United States.” The article goes on to suggest that there are several ways in which an elderly person can abuse prescribed medication, such as:

• Abusing medication prescribed to a friend or family member in order to save money.
• Alternatively, the elder person has his/her medication taken by a friend or family member and running out of his/her supply early.
• Taking the incorrect dosage or type of medication to do mental decline.

Awareness is everyone’s responsibility, so be vigilant. There are cues that family, friends, and caregivers can recognize in order to intervene and get help as early as possible.

What should we be looking for?

• A loved one is showing signs of an unhealthy relationship with their medication, such as:

– Frequently talking about medicine

– A fear of running out or not having enough medication

– Taking a defensive stance after you ask about the medication

– Taking more than the prescribed amount or taking more often than prescribed

– Hiding or hoarding pills

• A loved one’s behavior and mood is changing, even if it seems associated with “old age” or illness. This could be a sign of chemical dependency.

• A past history of drug/alcohol abuse can make a person more susceptible.

If you suspect a loved one is abusing prescription medication, take action and talk to someone about it. A good first step is to contact the doctor prescribing the medication. He or she can help verify and/or validate your concerns, allowing you to take further action, if necessary.
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