Articles Posted in Uncategorized

https://www.californiaelderabuselawyer-blog.com/wp-content/uploads/sites/132/2020/08/20.08.21-002-300x200.jpgFamily members of an elderly loved one shoulder a lot of responsibilities if the need for nursing home care arises. First, they are tasked with the burden of selecting the right facility to care for a loved one. Then, because nursing homes can’t always be trusted to do the right thing, they also need to play the role of watchdog to ensure the resident gets the proper care they deserve. One of the best ways to do this is know what abuse and neglect look like, trust your instincts, and speak up immediately.

How to Monitor Nursing Homes and Care

There is no substitute for first-hand observation, but there are other ways to hold nursing homes accountable and prevent even abuse and neglect that present no visible symptoms.

https://www.californiaelderabuselawyer-blog.com/wp-content/uploads/sites/132/2020/06/20.05.25-300x300.jpgWhen COVID-19 began to spread, it was a largely unknown foe. Hospitals, doctors, pharmacies, nursing homes, and long-term care facilities were all struggling to find ways to stop the spread, protect patients and employees alike, and understand more about the virus. Now, lobbyists for California’s healthcare providers have asked Governor Newsom to use emergency powers and grant them civil and criminal immunity for their handling of the pandemic. This raises a number of interesting points and issues as it relates to transparency at California nursing homes and concerns of abuse or neglect during the pandemic.

Immunity Request

Not only are hospitals, doctors, nurses, and healthcare plans asking for immunity, California Assisted Living Association and LeadingAge California have joined in the request for an Executive Order to make facilities, plans, doctors, and healthcare employees immune from administrative sanction, criminal liability, or “civil liability or claim for any injury, death, or loss” stemming from care provided during the state of emergency. The protection from liability, however, will “not excuse willful misconduct.”

Meadowbrook Health Care Center, a nursing home located in Hemet, California, received 20 citations for health and safety deficiencies in its most recent inspection, on April 20, 2019. According to Centers for Medicare and Medicaid Services records accessed on February 26, 2020, that figure numbers more than the statewide average of 12.8 citations, and more than U.S. average of 8.0. A for-profit corporation owned by Johnre Care Inc., Meadowbrook Health Care Center is a Medicare and Medicaid participant with 64 certified beds and an average of 48.8 residents at the facility per day. The deficiencies described in the April 2019 citations include the following:

  1. The nursing home did not ensure residents were provided with appropriate treatment. Federal code requires nursing homes to provide residents with “appropriate treatment and care according to orders, resident’s preferences and goals.” An inspection found that Meadowbrook Health Care Center did not provide such in an instance when the facility did not “ensure signs and symptoms of bleeding were monitored” per the plan of care of a resident reviewed for side effects of blood thinner medication. The citation states further that the failure to ensure such “may have contributed” to the resident being sent to the emergency room for rectal bleeding. According to the citation, the resident was receiving an anticoagulant agent to prevent blood clots, and the plan of care stated that they should be monitored for signs and symptoms of excessive anticoagulation. A Licensed Vocational Nurse confirmed to state authorities, however, that “there was no documentation” the resident was being monitored such during the month in question, and “should have been monitored” in the period leading up to the resident being sent to the hospital.
  1. The nursing home did not ensure the competencies of food and nutrition services staff. Federal code requires nursing homes to ensure that its staff have “appropriate competencies and skills sets to carry out the functions of the food and nutrition service.” An inspection found that Meadowbrook Health Care Center failed to ensure its supervisory staff failed to carry out their key functions in an instance wherein the facility’s Dietary Manager and Registered Dietitian “did not provide management and oversight to ensure food was stored, prepared, and served according to facility and industry standards,” as well as that equipment and other food service items were maintained in good working condition. The citation goes on to state specifically that an inspector found that the facility’s RD did not ensure residents were provided with “a comparable in nutrient content alternate” when they requested one instead of the “main entrée.” The inspector also found that the RD did not “report the poor condition” of certain food service items, and that cutting boards and cooking pans were not maintained in good condition. The citation states that these deficiencies resulted in the potential for the facility’s residents to experience “food borne illness and nutritional related health complications.”

Opportunists continue to seek occasions to defraud elders out of money, and one of the many ways they continue to try to do it is through phone scams. In fact, according to the National Consumers League nearly 1/3 of phone fraud victims are over the age of 60. In recent years one of the newest scams involves a caller claiming to be from the IRS.

The scam works like this:

A caller impersonating an IRS employee will call and notify the resident that they owe a substantial amount of money in back taxes. They often then threaten the victim with an arrest warrant, or seizure of property if they do not pay the taxes immediately, via a pre-paid debit card, bringing a check to a particular location, wiring the money, or paying through PayPal. They often state from the start that the “debt” cannot be paid with a credit card.

Identity 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.

Unfortunately, there are far too many opportunists in the world, and the one thing they all share in common is that they are looking for the simplest way to get what they want. As a result, many con-artists specifically target the elderly, knowing that they are often some of the most vulnerable members of society. One way that elders are subjected to financial abuse is through fraudulent phone sales.

It has been estimated that Americans are bilked out of tens of billions of dollars each year via phony phone scams. Of those who lose money due to fake sales over the phone, more than half are over the age of 50, according to AARP. In order to ensure that you, or a loved elder does not fall prey to phone scams, keep the following in mind:

*Do NOT give anyone your credit card information or other sensitive information (social security number, date of birth, or bank account numbers) over the phone.

In its simplest form, financial elder abuse involves taking money or property from an elderly person with the intent to defraud them. It is a growing problem in California given the state’s increasing senior population. The signs of financial elder abuse can be difficult to see. Though the presence of any of the following signs associated with financial elder abuse is not absolute evidence of abuse, it should prompt further investigation:

• Elder is withdrawn.

• Elder is confused and tends to be more forgetful than usual.

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 includes any physical or financial abuse, neglect or abandonment resulting in physical or mental harm. Diminished capacity due to the elder’s advanced age, physical confinement, and medical condition make it difficult for victims to speak out about their abuse. Even when they do, perpetrators may blame the complaints on the elder’s senility, confusion, or dementia. Many victims have no family or friends left to care for them. They rely entirely upon the staff and caregivers at their nursing home or facility. That is why it is important for anyone who witnesses elder abuse to recognize the symptoms and report the abuse.

Signs of physical abuse include unexplained weight loss, malnutrition, and dehydration. While lack of appetite is a common complaint amongst the elderly, caretakers are required by law to provide the food and service necessary to the patient’s health and wellbeing. Unfortunately, poor nutrition often leads to easy bruising, another sign of physical abuse. Look for bruises and skin damage in the shape of fingerprints or clustered marks from repeated striking or beating. Also notice any new scratches, cuts, welts, or fractures. Marks indicating pinching, choking, or gagging evidence acute instances of abuse, while increased bedsores show neglect, as when the patient is not turned over enough in bed.

While not as visible, suspicious behavior may also indicate abuse. Watch for undue agitation, anger, or defensiveness. These may be signs of mental suffering. Patients may also become non-responsive, hesitant, and anxious when asked to explain their abuse. They may feel increasingly isolated as they lose contact with family and friends. Always look for signs of fear, withdrawal, depression, and helplessness in determining whether there has been abuse. Remember that any social isolation, absence of assistance, or indifference toward the needs of the elderly may constitute abuse. Even if you are not related to the victim, report any suspicious activity to the proper authorities.

For many Californians the time comes when their loved elderly parent or family member may need some help within their home. Whether they need help with meal preparation, personal health and hygiene, or just some help around the home and with errands, finding the right person to care for your elder can be stressful.

Types of in-home caregivers for elders may range from a weekly housekeeper to a certified nursing assistant, or skilled care worker. The range of services provided may be cleaning the home, dispensing medication, helping the elder with transportation, or home care workers may help with personal care such as bathing, and monitoring overall health.

Once you determine the type of care your loved elder needs, there are many places to find compassionate, qualified in-home caregivers. Consider beginning your search by asking for referrals from friends and family, or from a doctor specializing in senior care. You can also check job postings such as those found in the newspaper, or online on sites including www.Caring.com.

When interviewing a potential caregiver for your loved one, be sure to:

*Photocopy a Valid California Driver’s License
*Obtain Proof of Certifications
*Check References
*Run A Background Check
*Spend Time Getting to Know Them

After you’ve hired an in-home caregiver, make sure to stay in contact with your loved elder. In addition, be sure to schedule consultations with the caregiver at least once per week to remain current on your loved one’s wellbeing. Wherever possible make unannounced visits while their caregiver is there to make sure that the relationship between the two is one of mutual respect and care.

The decision to hire an in-home caregiver for your loved elder is a big decision and warrants time and careful screening of candidates to ensure you’ve selected the best person for the job.
Continue reading

According to WebMD, “Clinical depression in the elderly is common. That doesn’t mean it’s normal. Late-life depression affects about 6 million Americans age 65 and older. But only 10% receive treatment for depression.”

Depression in elders can be particularly troubling, as it tends to increase the likelihood of prolonged illnesses, and/or the onset of disease. WebMD states: “Depression in the elderly often increases their risk of cardiac diseases. Depression doubles an elderly person’s risk of cardiac diseases and increases their risk of death from illness. At the same time, depression reduces an elderly person’s ability to rehabilitate. Studies of nursing home patients with physical illnesses have shown that the presence of depression substantially increases the likelihood of death from those illnesses. Depression also has been associated with increased risk of death following a heart attack. For that reason, making sure that an elderly person you are concerned about is evaluated and treated is important, even if the depression is mild.”

Signs and symptoms of depression in elders may include:

Memory problems
Confusion
Withdrawing from friends, family
Loss of appetite
Weight loss
Complaints of pain
Insomnia
Irritability
Delusions
Hallucinations
Ongoing sadness
Excessive worrying
Pacing/Fidgeting
Frequent crying

Depression is a serious mental condition and must be treated. According to the Geriatric Mental Health Foundation, untreated depression in elders may lead to a worsening of symptoms of other illnesses, premature death, disability, or even result in suicide.
If you believe an elder you love is showing signs of depression, speak with their physician.

You may also find helpful information here:
Geriatric Mental Health Foundation: www.GMHFonline.org
National Mental Health Association: www.NMHA.org
American Geriatrics Society: www.americangeriatrics.org
National Institute of Mental Health www.nimh.nih.gov Continue reading

Contact Information