Articles Posted in Physical Restraints

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.

Based on a 2012 study investigating the implications of injuries suffered by senior residents of nursing homes, some “24,190 fatal and 3.2 million medically treated non-fatal fall related injuries” were reported across the U.S. This startling figure demonstrates just how serious and prevalent nursing home injuries linked to falls can be. In the same study, researchers discovered that the 2012 related medical costs of these nursing home falls totaled $616.5 million for those falls that proved fatal, while another $30.3 billion in costs were linked to non-fatal nursing home falls.

Another disheartening aspect of the study revealed that those injuries and the related costs are on the rise. In 2015, nursing home fall-related healthcare costs jumped, with the cost of fatal fall injuries rising to $637.5 million, while costs related to non-fatal fall injuries rose to $31.3 billion.

Though the study highlights an injury epidemic across America’s nursing homes, it also detailed the profound economic impact that nursing home related injuries have on the healthcare economy and on the elders who sustain the injuries. The study also noted that the risk for falls—and the associated cost and economic impact of these fatal and non-fatal injuries—increases as nursing home residents age. The statistical risk factor continues to climb if the nursing home resident is a woman, as well.

Elderly woman in pain
Psychological abuse, also referred to as emotional abuse, can be difficult to notice at first glance. The damage often reveals itself in the form of changed behavior, as opposed to physical bruises and marks. It’s important to know that abuse can happen anywhere the elderly person resides, even in a nursing home or other long-term care facility, and can be sustained by any type of caregiver (paid, unpaid; professional, amateur). The National Center on Elder Abuse (NCEA), directed by the U.S. Administration on Aging, states, “most cases of elder abuse are perpetrated by known and trusted others, particularly family members (including children, spouses, and others).”

Examples of psychological abuse by caregivers, friends, or even family:

• Screaming or yelling;

An investigation by ABC 10 in Sacramento has unveiled that powerful tranquilizers are being over prescribed to nursing home residents who are diagnosed with dementia. In fact, studies by the Centers for Medicare and Medicaid Services in conjunction with the Government Accountability Office (GAO) show that 33% of elders in nursing homes, who are diagnosed with dementia are actually prescribed antipsychotic medication, in spite of the fact that the FDA has warned that certain types of these drugs can prove fatal to elders. Death is most often the result of heart failure/cardiac disorders.

All the same, the data from those studies shows that these powerful drugs are far too often prescribed when they are not warranted. This practice, known as chemical restraint, or over-drugging of elders in nursing homes in California is a form of abuse, and is illegal.
Chemical restraining of elders is most often done to sedate residents, but in worst cases has been utilized as a means of punishing and/or intentionally abusing elders.

pills.jpgSymptoms that an elder is being over-drugged, or prescribed an anti-psychotic inside a California nursing home include:

*Extreme lethargy, sleepiness, and/or confusion.

*Noticeable and extreme behavioral changes.

*Sudden unexplained changes in overall health.

Elder abuse in California 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.
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NBC-7 San Diego recently reported a story exposing that:
“At 85 years old, Lynn Murphy’s health was failing, her memory fading fast. So, in October 2013, her daughter Kathe Murphy put her mother into the Oakmont of Roseville retirement community, near Sacramento.

While Lynn was in Oakmont’s memory care unit, Kathe said the staff wasn’t doing their job. She took photos of her mother’s dirty clothes, room and bathroom. She said the staff was supposed to be doing Lynn’s laundry and cleaning her living quarters. Kathe said her mother wasn’t being properly taken care of.

These were issues that Kathe said
Webshe knows about first-hand since she worked as a paralegal for 20 years for the Department of Social Services’ licensing division — the same state agency responsible for regulating and licensing elder care facilities in California.

“I said this is elder abuse. Nobody’s done anything,” Kathe said.

She took her mom out of the facility in April 2014 after she said her mom was put in bed and not checked on for almost 24 hours. Her mother died 3 weeks later.”

The tragedy has brought to light the question of whether or not installing cameras in nursing home residents’ rooms would help to prevent elder abuse and neglect. While many advocate for the installation of cameras, others declare that the installation of cameras would constitute a breach of privacy.

Current laws allow for video surveillance in common areas of a residential care facility. Yet the California Department of Social Services does not allow for cameras in resident’s rooms, citing privacy concerns.

According to the NBC-7 Story:

“The Department of Social Services Deputy Director of Public Affairs Michael Weston said the client’s right to privacy is a concern for the department.

“We view these as people’s homes, and we want people to have rights in their own home and balancing that between a business and a residence,” Weston said. “We want to be careful about.”

Weston said the department has developed proposed guidelines which would allow video cameras in private rooms under specific conditions. He said those guidelines are still being reviewed and expects to release them this spring.”

Click here to read the full story from NBC-7 San Diego.

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 typically includes any physical or financial abuse, neglect, or abandonment resulting in physical or mental harm.

If you believe that someone you know has been abused while residing in a California Nursing Home, contact an award winning elder abuse attorney today.
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Isolation is a form of Elder Abuse in California, per California Penal Code §15610.43. Elder abuse is a violation of the rights of elders by those charged with caring for them in facilities, such as California nursing homes. California nursing homes are required to provide reasonable care, and any intent to do otherwise constitutes a criminal action.
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Elder Isolation may include:

*Any intentional actions, which prevent an elder resident from making or receiving phone calls, or having contact with family and friends outside of their residential, nursing facility.
*Any intentional actions which prevent the elder resident from speaking with their physicians, their attorneys, law enforcement or even members of their religious organization.
*Actions such as placing an elder in a locked room, or restraining them in another capacity without their consent.
*Confinement of an elder (which can also be deemed false imprisonment).

Elders are often isolated by nursing home staff as a way of dominating and/or instilling fear in the elder resident. The consequences that the elder may experience as the result can be traumatic. Elders who have been isolated often experience depression, anxiety, stress, and fear. In the worst cases, the lasting effects of isolation may result in suicide or death.
If you suspect that a loved elder may be experiencing intentional acts of isolation while in a his or her nursing home, speak up. Often elders who are being victimized in any way feel helpless to do anything about the abuse, for fear of repercussions.

If you suspect an elder you know is being abused in any capacity while residing in a California nursing home, report it to the following agencies immediately:
• Local Law Enforcement, including the Police, Sheriff, and District Attorney’s office. The San Diego County Sheriff’s department can be reached at (858) 565-5200. The San Diego County District Attorney may be reached at 619-531-4040 • Long-Term Care Ombudsman Program. They provide a 24/7 Crisis Complaint Hotline at 800-231-4024 • Adult Protective Services (APS). In San Diego County, you may contact: San Diego County Aging and Independent Services (858) 495-5660.
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Unfortunately, in spite of the fact that unnecessarily restraining elders while in a long term skilled nursing facility or nursing home is against the law, countless elders are physically restrained in nursing homes every year. It is important that if you know someone who is being unnecessarily restrained in a California nursing home, that you notify the proper authorities immediately.

Physical restraints include leg and arm restraints, hand mitts, vests, ties, or strategic positioning of an elder so as to restrict their movement. Methods for restraining elders in California nursing homes have included belts, using bars, trays, tables, bed rails, or positioning a wheel chair against a wall so that the elder cannot move.

The fact that this misuse of authority continues to victimize elders is unfathomable, as there are so many alternatives to restraint to ensure that elders remain safe while in the care of a nursing home. However, some people still using restraints under the guise of “keeping the elder safe.” The truth is, there are many ways to keep elders safe, without physically restraining their mobility. These include things such as:

Elder abuse can take many forms including physical abuse, sexual abuse, financial abuse, neglect, and a form of abuse known as chemical restraint (over-drugging). Chemical restraint includes using powerful medications (including anti-psychotics) to sedate elders in nursing homes. In the worst cases, chemical restraint has been used as a means of punishing elder residents in nursing homes.

Also known as over-drugging, this practice is unfortunately all too common, though it is not always reported. However, chemically restraining elderly residents of nursing homes is absolutely illegal in California.

In particular, nursing homes have been accused in many instances of administering strong anti-psychotic medications to elderly residents who do not require them. In more than one instance, residents of nursing homes have died as the result of this form of elder abuse. Thankfully, legislators are beginning to take notice of the problem of over-drugging elders in nursing homes, and last year California nursing homes saw a reduction of unnecessary use of anti-psychotics by 8.5%. This is great news compared to 39 other states, but fell fall short of the goal of reducing the use of these drugs by 15%.

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 can includes any physical or financial abuse, neglect or abandonment resulting in physical or mental harm. The unnecessary use of physical restraints in California nursing homes is illegal and may rise to the level of both a criminal and civil offense.

Physical restraints may be used to prevent an elder in a nursing home from falling out of a bed or a chair. In certain cases, the use of these devices, such as bedrails, may be helpful. In other instances however, the use of physical restraints may be deadly. Sadly, as a result of diminished capacity due to a senior’s advanced age, physical confinement, and medical condition, it is often difficult for victims of elder abuse to speak out. That is why it is important for anyone who witnesses or suspects than an elder is being physically restrained against their will in a nursing home, to speak out.

Signs and symptoms that a loved one may be physically restrained without their consent may include:

•Weak muscles
•Chronic Constipation
•Bed sores
•Loss of mobility
•Frequent illness
•Poor circulation

If you suspect an elder is being abused in any capacity, including being physically restrained while in a long-term care facility such as a nursing home; report the incident to both the Local Long-Term Care Ombudsman and your local law enforcement.
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In spite of the fact that in California, the use of physical restraints on residents of long term care facilities is illegal, many elders are victims of this type of abuse. Unfortunately the use of physical restraints on elders in California is not only illegal, but gravely dangerous as well. Although physical restraints are often used, recommended or prescribed, most studies have shown that the use of physical restraints provides far more risks than benefits.

Every resident of every nursing home in California has the right to be free from any restraint imposed by the staff, unless specifically ordered by a doctor to treat a medical condition or to help the resident to function better. That means that you cannot be restrained by any staff member of a nursing home without your explicit consent.

But what exactly is considered a physical restraint? Generally speaking, physical restraints are defined as anything used to restrict the movement of an elder resident in a nursing home. These may include:

•Arm restraints
•Hand mitts
•Leg restraints
•Soft ties

Other types of physical restraining methods involve the placement of items in the path of an elder resident so as to restrict their movement and mobility. Examples include:

•Placement of trays, bars, belts on wheelchairs
•Placement of wheelchair so that resident cannot move it
•Placement of bedrails so that resident cannot get out of bed
•Sheets tightly placed on the bed of elderly patient preventing movement.

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 or without consent, the practice becomes outright abusive. Too often physical restraints are used o make a staff member’s job easier, rather than help the resident. Overuse of restraints is exacerbated by the growing number of understaffed nursing facilities.
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