Articles Posted in Reporting Elder Abuse

Elders being admitted to a long-term care facility, such as a Southern California nursing home, are granted certain rights. These rights are protected by regulations on both the State and Federal level. Specifically, these rights are guaranteed by the California Code of Regulations, the California Health and Safety Codes, the California Welfare & Institutions Code, and the Code of Federal Regulations. All California elders entering into a nursing home are granted these rights by law.

Unfortunately, this does not mean their rights are protected and upheld by the facility and staff members. It is important that anyone considering placing an elder into a long-term care facility understands these rights. Rights are granted on pre-admission, while in residence, and transfer and discharge basis.

Pre-Admission Rights
As a potential resident of a long-term care facility, such as a California nursing home, residents’ rights are granted before being admitted. Each potential resident has the right to:

•Visit the facility
•Review the license and certification of the facility
•Review the admission agreement
•Inquire into cost of care, optional services and coverage provided by Medicare or Medi-Cal
•Be informed of all rights in a language that is understandable to the resident
•Be informed of the nursing home’s rules and regulations
•Review all contracts thoroughly before signing
•Be made aware of what basic services are included in cost, and what services are optional
•Be made aware of right to apply for Medicare or Medi-Cal, and be granted assistance in applying for this coverage
•Refuse to have a cosigner
•Refuse to provide a deposit, if you are the beneficiary of Medi-Cal or Medicare
•Refuse to delay rights to receive Medicare or Medi-Cal
•Refuse to sign an arbitration agreement
•Receive the Patient’s Bill of Rights

In-Residence Rights
Federal and State laws further guarantee residents of California nursing homes certain rights while living in the facility, including:

•The right to be treated with respect and dignity
•The right to privacy during treatment
•The right to privacy during personal care
•The right to choose your personal physician
•The right to participate in one’s own treatment planning and decision making
•The right to receive care to ensure proper personal hygiene
•The right to reside in a clean, sanitary facility
•The right to receive proper nutrition in quality and quantity as per physician’s recommendations
•The right to manage your own financial affairs
•The right to refuse care/treatment
•The right to make advance directives including power of attorney, DNR
•The right to voice grievances and/or suggest policy changes to the facility without fear of repercussions
•The right to make and receive phone calls privately
•The right to privacy in visits from family members and friends
•The right to be completely free from abuse, chemical restraints and physical restraints that are not medically required to treat patient’s symptoms
•The right to a monthly itemized bill
•The right to 30 days’ notice of increase in facility rates

Transfer & Discharge Rights

Elders being discharged or transferred from one facility to another, or to return to a private residence are also granted rights under California and Federal laws. Nursing home residents transferring, or being discharged are granted the following rights:

•The right to voluntary discharge without notice
•The right to refuse involuntary transfer except in an emergency
•The right to receive a refund of security deposit within 14 days of account being closed
•The right to remain in the nursing home if insurance transfers from private pay to Medicare or Medi-Cal
•The right to remain in the nursing home if nursing home withdraws from Medicare or Medi-cal
•The right to have a bed held for 7 days if resident is transferred to a hospital

The State of California and the United States Federal Government guarantees these rights and more to all residents of Southern California nursing homes. If these rights are being in any way restricted, or violated, it is time to speak with an elder abuse attorney about your next course of action.
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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. It is unfortunate that these laws alone are not always enough to protect our elders while they are in a long term care facility such as a California nursing home.

Elder abuse in California can take many forms including physical abuse, sexual abuse, financial abuse, neglect, and a form of abuse known as chemical restraint (over-drugging). These forms of abuse may result in pain, suffering, and even death of elders. That’s why it is so important to talk with a nursing home abuse attorney if you believe that an elder is being abused or neglected while in a California nursing home.

Nursing home abuse cases in California may be very complex. However, this should not deter you from speaking with a California elder abuse attorney who specializes in nursing home abuse cases. All consultations at Walton Law, APC are free of charge. During that time, we will sit down with you and discuss your concerns, your suspicions, and your fears in regards to filing a lawsuit against a California nursing home. We will answer any and all of your questions in regards to nursing home abuse in California.

Southern California elders – particularly those residing in nursing homes, or skilled nursing facilities – are unfortunately prone to developing life-threatening bedsores. Bedsores, which are also known as pressure ulcers, can lead to a host of health problems, particularly in elders whose health may already be compromised. Similarly, because many elders may be confined to a bed or wheelchair, their risk for developing these sores is increased.

According to the Mayo Clinic:
People are at risk of developing pressure sores if they have difficulty moving and are unable to easily change position while seated or in bed. Immobility may be due to:

•Generally poor health or weakness
•Paralysis
•Injury or illness that requires bed rest or wheelchair use
•Recovery after surgery
•Sedation
•Coma

However, more specific risk factors affecting elders which make them so susceptible to bedsores may include advanced age, which results in thinner, drier, less elastic skin, which is generally more fragile. Elders may also develop bedsores after significant weight loss, which can accompany a long-term illness. Poor nutrition and/or dehydration also make elders susceptible to developing dangerous bedsores. Illnesses such as diabetes, and vascular diseases may also lead to damaged skin tissue, making it easier for a bedsore to develop. Likewise, elders who suffer from bowel or bladder incontinence are also likely to develop bedsores if soiled clothing isn’t removed and replaced immediately.

Similarly, elders who are in a state of mental decline are typically more likely to develop dangerous bedsores. Those who have limited mental alertness may be unaware that sores are developing, leading them to progress into dangerous infections before being discovered. By the same token, any elder who has diminished sensory perception, such as those who are paralyzed, may also not discover bedsores until they have reached a dangerous stage.

The key to prevention (and treatment) of bedsores is to relieve pressure. This can be accomplished most effectively by repositioning an elder regularly, particularly once a bedsore has developed.

For elders residing in a Southern California nursing home, inspection of the skin should be a routine part of care. Unfortunately, all too often patients suffer from bedsores due to neglect or lack of an appropriate care plan implemented in the California nursing home. If you have found a bedsore on an elder you know, a doctor needs to be notified immediately. Bedsores can often be resolved with appropriate detection and treatment.

While many long-term care facilities in California provide excellent care, others subject their patients to many forms of neglect or elder abuse. The California Welfare & Institutions Code §15610.57, addresses “neglect” in part by stating 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 elder from dehydration, bedsores, falls, other injuries caused by safety or health hazards and any type of injury that does not fit the explanation provided by the staff.
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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.

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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Understaffing nursing homes is incredibly dangerous to adults over 65 residing in long-term care facilities such as Southern California nursing homes. That’s precisely why specific laws and regulations are in place which mandate proper staffing at long-term care facilities.

Under California law, “The facility shall employ an adequate number of qualified personnel to carry out all of the functions of the facility” Health & Safety Code § 1599.1(a). Moreover, Health & Safety Code §1276.5-1276.65 mandates that nursing homes must provide a minimum of 3.2 nursing hours per patient per day.

Unfortunately, many facilities choose to ignore the California law. Even worse, the understaffing of nursing homes has been directly correlated to abuse and neglect of elders. Indeed, understaffing in California nursing homes leads to substandard care over and over again. Substandard care in nursing homes then leads to illness, injury, and too often, death.

In California, financial elder abuse is defined in Welfare and Institutions Code §15610.30. The code states: “Financial abuse of an elder or dependent adult occurs when a person or entity… takes, secrets, appropriates, obtains, or retains [or assists in doing any of these] real or personal property of an elder or dependent adult for a wrongful purpose or with intent to defraud or both.”

Although financial abuse is far too prevalent, the best defense against opportunists who would seek to defraud elders out of their money, property or belongings, is preventing the abuse in the first place. Although there is no surefire way to ensure that your loved one’s finances are protected at all times, there are warning signs to look for, which can indicate that financial abuse is taking place.

In an effort to best protect a loved elder from financial abuse including a loss of their property, assets or money, be on the lookout for these warning signs that a caregiver, a family member or even a staff member at a California nursing home is victimizing elders:

*Missing items (jewelry, appliances)
*Unpaid or past due bills
*Excessive credit card charges
*Unusual bank activity (large withdrawals or checks)
*New credit cards opened in the elder’s name
*Changes to trusts, estates, wills
*Unusual investments in ventures, real estate, businesses
*Bulk sales of stocks
*Unusual charitable contributions or gifts to unknown people/organizations
*Large purchases (property, cars, electronics)

One of the best means of ascertaining that a loved one and their finances are safe is through frequent contact with the elder. Simply by calling and/or visiting them you can often pick up on cues as to their overall well-being. Volunteering to help them once or twice a month with their finances, including paying bills will also give you a good picture of their financial health at all times. Furthermore, take advantage of the opportunity to help your loved elder obtain their free annual credit report, and review it with them to make sure that all records are correct. Paying attention to the relationships your loved elder has with others will also help to illuminate any potential opportunists in their lives.

If you suspect, or confirm that your loved elder is the victim of financial abuse in California there are certain steps you should take. You may report any suspicion of abuse to the National Elder Abuse Hotline at 1-800-677-1116. In California, reports can be made to the local county Adult Protective Services Agency or to local law enforcement.
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Nearly 70% of elder abuse victims are women, according to the Bureau of Justice Statistics. It is worth noting that the population of elder women is much larger than the population of elderly men in the United States, however, that does not make these alarming statistics any less disturbing.
Why are women the victims of elder abuse more often than men? There are a few reasons most experts tend to agree upon.

1. Elderly females may be seen as easier targets for physical, financial, emotional, or even sexual abuse.
2. Women tend to live longer than men, and many live alone putting them in a position where they may be more likely to be abused.
3. Women tend to develop crippling physical diseases such as osteoporosis, which may take a long time to recover from.

Statistics conclusively show that elders who are disabled are far more likely to be abused than those who are not. As a matter of fact, according to the National Center on Elder Abuse, Administration on Aging:

“Institutionalized adult women with disabilities reported a 33% prevalence of having ever experienced interpersonal violence (IPV) versus 21% for institutionalized adult women without disabilities…when considering lifetime abuse by any perpetrator, a sample of 200 adult women with disabilities indicated that 67% had experienced physical abuse and 53% had experienced sexual abuse.”

Elderly women are far more likely to be sexually abused than men. Reports in the Journal of Elder Abuse and Neglect found that elderly women were six times more likely to be sexually abused than elderly men. Sexual abuse of elderly women occurs most often in nursing homes, or other assisted living facilities.

If you suspect that an elder –whether male or female–is being abused, it is vital to report your concerns immediately. Under California law elder abuse can be both a criminal and civil offense. The state of California has taken a firm stance and zero tolerance policy towards elder abuse in any capacity. As part of their mission to encourage all Californians to report suspected elder abuse, the state has created The Citizen’s Guide To Preventing and Reporting Elder Abuse, which can be viewed in its entirety here.

If you believe 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 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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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.

pexels-photo-119597-300x185Wandering 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.

pexels-photo-259200-300x200Identity theft continues to arise as a harsh reality for millions of Americans each year. In fact, according to the Justice Department, more than 11 million Americans fall victim to some form of identity theft/fraud each year. That accounts for more than $20 billion in lost money, with the average injury to victims at more than $4,000.

Elders may be at an increased risk of becoming victims of identity theft because according to information provided by the FTC, “Senior citizens are particularly vulnerable to this crime because their personal information may be easily accessible by numerous individuals.”

Unfortunately for elders, particularly those in nursing homes, this does ring true. Personal and sensitive information may be attained by those with bad intentions. Therefore, it is important that elders and their loved ones keep a close eye on personal information, including social security numbers, driver’s licenses and credit cards. These identifying numbers and accounts can be accessed easily, and drain an elder of savings in some cases. In others debt in an elder’s name may be accrued.

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.pexels-photo-12971-300x200

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