Signs of Elder Abuse

July 14, 2020

Recognizing Emotional Abuse in California Nursing Homes

In 2018, 52 million Americans aged 65 and older accounted for 16 percent of the country’s population. The size of this group, set to nearly double in the next 40 years, accounts for the high demand of nursing home and long-term care needs in the United States. As people make the difficult decisions about the care of elderly loved ones, it’s reasonable to expect any facility tasked with caring for a family member to exhibit the highest levels of professionalism, compassion, and respect for them at all times.

Unfortunately, far too often this is not the case. Understaffing, lack of proper training, and insufficient supervision of staff members, nurses, nursing assistants, and health aides all contribute to the abuse of these vulnerable patients. It can be difficult to spot emotional or psychological abuse of a patient – unlike physical abuse that results in bruises or broken bones, they often don’t present obvious signs that something is going wrong.

The difficulty is even greater with the ongoing COVID-19 pandemic, which has resulted in family members being allowed little or no in-person contact with nursing home residents to visit and observe them for signs of abuse. However, it’s still possible to understand common types of emotional abuse and look for signs it may be occurring, even if the victim won’t admit outright that they are being abused.

January 16, 2020

What Is Candida Auris?

By Walton Law, A.P.C.

In recent years the Centers for Disease Control and Prevention has drawn attention to a source of increasing concern for nursing home residents: Candida auris, also known as C. auris, a fungus that causes “bloodstream infections and even death” in those it affects. Like many infections, C. auris infections are particularly dangerous for those who are already suffering from other conditions. Described by the CDC as “a serious global health threat,” C. auris poses a special risk for nursing home residents.

What makes C. auris so dangerous? A few things. The CDC notes that the fungus is frequently resistant to numerous antibiotic medications; that it is “difficult to identify with standard laboratory methods”; and that it is even prone to misidentification by laboratories without certain technology. This places elderly populations, especially those in nursing homes and other long-term care facilities, at heightened risk. A New York Times report published in September 2019 described a June 2019 study that found “patients and residents in long-term care settings have alarmingly high rates of drug-resistant colonization, which means they carry the germs on their skin or in their bodies, usually without knowing it, and can pass them invisibly to staff members, relatives or other patients.” The study in question “focused on Southern California,” finding that 85% of nursing home residents “harbored a drug-resistant germ.” The CDC has also found that the infection proliferates in long-term healthcare centers

The Times reported that 800 cases of C. auris infection have been identified in the US since the fungus was first reported here in 2015. In August 2019, the CDC updated that count to 806. That includes 388 confirmed cases in New York; 227 confirmed cases in Illinois; 137 confirmed cases in New Jersey; 24 confirmed cases in Florida; and five confirmed cases in California. The Times attributes C. auris’ easy spread through nursing homes to a few factors, in addition to the prevalence of nursing home patients on multiple antibiotics to which the infection has already developed a resistance. Nursing homes are frequently understaffed and under-resourced, according to the Times, and struggle to “enforce rigorous infection control.” They often cycle infected persons in and out of hospitals, putting those hospitals’ patients at risk of the infection too. One health expert told the Times, “You’ll never protect hospital patients until the nursing homes are forced to clean up.” Basic hygienic measures, such as “using disposable gowns and latex gloves,” are essential to combating the infection, yet often unfollowed by long-term care centers, according to the Times. Experts also attribute the infection’s spread in the US to healthcare economics “that push high-risk patients out of hospitals and into skilled nursing homes.” Under the US’s healthcare system, these experts told the Times, “nursing home facilities are reimbursed at a higher rate to care for these patients… providing an economic incentive for poorly staffed or equipped facilities to care for vulnerable patients.”

October 6, 2019

Do Anticholinergics Increase Dementia Risk?

By Walton Law, A.P.C.

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.

June 2, 2019

Elderly Suicide in Long-Term Care Facilities

By Walton Law, A.P.C.

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:

April 24, 2019

Self-neglect: The Latest Elder Epidemic

By Walton Law, A.P.C.

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.

March 19, 2019

Dehydration in Nursing Homes: An Epidemic

By Walton Law, A.P.C.

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.

February 27, 2019

Nursing Homes Nationwide Are Using Chemical Restraints to “Manage” Residents

By Walton Law, A.P.C.

Nursing homes are often under-staffed in an effort to maximize profits or because they are underfunded. With the number of elderly people requiring care increasing at a record pace, some institutions use prescription drugs to make their residents more “manageable”. Legal and ethical issues notwithstanding, the health implications of the use of chemical restraints are terrifying.

What Is a Chemical Restraint?

Put simply, a chemical restraint is when someone’s movement or actions are restricted through pharmaceutical intervention. Types of drugs used as chemical restraints are:

February 20, 2019

When Is a Pressure Ulcer the Result of Elderly Neglect?

By Walton Law, A.P.C.

One of the largest generations in American history is beginning to transition into the elderly stage of human life. In this stage, many people become less independent and, as a result, require assisted living and clinical care. As aging individuals become dependents, they tend to lose their mobility. Pressure ulcers are a direct result of the inability of a person to reposition their body unassisted. In nursing homes and hospitals, elderly people are too often neglected and the price they pay can be severe.

Pressure Ulcers and Their Stages

Pressure ulcers (often referred to as bedsores, decubitus ulcers, and pressure sores) are a form of breakdown of the skin caused by prolonged and unalleviated pressure, incontinence, dirty or untidy bedsheets, and more. Typically, they form in areas such as the heels, hips, buttocks, tailbone, shoulder blades, and elbows. They are categorized based on severity:

August 20, 2018

7 Warning Signs You Shouldn’t Ignore When it Comes to Your Elderly Loved One

By Walton Law, A.P.C.

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.

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.

July 20, 2018

Females are More Likely to be Abused, Studies Show

By Walton Law, A.P.C.

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.

Elderly females may be seen as easier targets for physical, financial, emotional, or even sexual abuse.