That many nursing home patients suffer from varying forms of mental incapacity and are unable to communicate about their surroundings and circumstances can be a scary thought, if you suspect that it is your loved one who is being abused or neglected under their nursing home’s care. Because patients are sometimes unable to communicate directly about feeling violated, it is important to be aware of typical signs of abuse and/or neglect.

Abuse can come in many forms. Victims suffering from emotional, verbal, physical or sexual abuse at the hands of their caregiver(s) will likely show signs, perhaps even immediately following the first act of abuse, that they are suffering the adverse effects of such an offense. Emotional or verbal abuse might cause the patient to become suddenly withdrawn or overcome by anxiety. Those predisposed to signs typical of dementia may experience increased symptoms, such as mood swings, paranoia, biting and sucking.

Physical and sexual abuse can be especially devastating, and often have easily detectable symptoms: Any signs of unexplained bruises, sprains, abrasions, skeletal fractures, burns, bleeding and bruising in private areas, damaged undergarments, sudden behavior changes, or new health problems, especially infections of a sexual nature, are cause for alarm. Recognizing the symptoms of abuse as early as possible is the key to knowing how to take action immediately to prevent further offenses.

Neglect may seem a bit harder to detect in a nursing home situation. Neglect is officially defined as “intent to deprive another of things necessary to their well-being.” All too often in health care facilities like nursing homes, caregivers, although seemingly necessary for someone in their profession, are not willing to act in a compassionate and giving manner to care for others who depend on their help and cannot care for themselves. Neglect is increasingly problematic especially in American nursing homes, and often means not providing enough food or water, not ensuring proper hygiene, and/or not ensuring clean medical tools for patients, which can result in dehydration, malnourishment, and under-medication, among other symptoms.

If you believe you know a victim of elderly abuse, you have the power to help take action immediately. Whatever the details of the crime, it is important to know the symptoms and stop it!

If someone you know has been a victim of nursing home abuse, you have the right to file a lawsuit against the person(s) responsible. Finding the right law firm to pursue your case for you can make all the difference. A Law firm that specializes in nursing home abuse cases is the most sensible option. But how to go about finding a nursing home abuse law firm? And what happens once you’ve hired this firm to pursue your case?

When considering which law firm to hire, look for firms that have handled nursing home abuse cases before and have particular experience in this field of litigation. You’ll also want to know that the firm has noted success in their past cases fighting nursing home abuse. It is very important that the law firm attorneys make you feel comfortable and set the tone for you to be respected at all times and kept informed about further developments in your case. The right law firm knows their job is to protect your best interests, above all.

The law firm you choose will explain your best course of action. For instance, they might suggest the benefits of your filing a civil suit, to remedy damages from the abuse of the victim. In order to proceed with a lawsuit, your firm must prove liability on behalf of the nursing home facility. Liability can result from various types of abuse or negligence. It is common for victims to allege that a caregiver at the nursing home engaged in direct physical or psychological abuse or misconduct and/or that they were negligent in their personal supervision and care of the victim.

Once the law firm has assesed your case and proposed a legal strategy, they should communicate with you regularly to keep you informed of the progression of your case. Attorneys at your firm will communicate with opposing counsel, represent you at court appointments, and advise on paperwork and general legal proceedings, all on your behalf. Your attorneys should also guide you through an overall timeline of events in your case, as well as advise on your options and prospective results of your litigation.

•  Noted experience in handling nursing home abuse and/or negligence case
• Once your case has been filed, your attorney is part of a law firm that employs an entire team of lawyers for additional human resource
• The law firm your lawyer is affiliated with has a noted success record in previous lawsuits
• The law firm is financially stable and can and will handle the costs of pursuing your lawsuit without your monetary help
•  The law firm is affiliated with top doctors for consultation whenever necessary, and also employs full-time licensed nurse paralegals
• The firm only pursues legitimate and ethically sound cases
• Your best interests– as the client– are always taken into consideration when making decisions
• You are treated with respect and communicated with in a dignified manner
• You are kept informed of important developments in your case

Navigating your nursing home abuse case may seem tough, but with the right lawyer and law firm to represent you and your case, the resulting peace of mind will be invaluable to you and your family while enduring a rough time.

In the beginning, the prospect of hiring a nursing home abuse attorney can seem like a daunting process: What kind of lawyer should you look for? How do know you’re hiring the right lawyer or law firm for your case? What should you expect in a nursing home abuse lawsuit? It’s not as challenging as you might think to find the right attorney for your case.

When meeting a nursing home abuse lawyer or law firm for the first time, a truly professional attorney should provide personalized attention from the start, and evaluate your case with you on an individual basis. They should aim to make you feel comfortable and to ensure that your legal rights are fully assessed and protected. An attorney can explain what you can expect at every step of your case, and will take action — researching the law, interacting with witnesses, consultants, opposing counsel and legal staff, and planning appropriate legal strategies — on your behalf.

Once you’ve found an attorney you feel comfortable with, your lawyer should be able to fully understand the legal parameters of your case, and build a strategy accordingly. The right lawyer will keep you informed and explain all necessary details so that you are always aware of current status and new developments, as they relate to your case, in and out of the courtroom. You should feel confident in knowing you have a competent and knowledgeable lawyer or law firm representing your family’s rights and protecting your best interests.

Your lawyer will guide you through the steps of your case. Nursing home abuse cases are often lengthy and expensive, and, as with any lawsuit, perhaps unpredictable at times. However, an experienced lawyer at a reputable law firm will be able to anticipate the twists and turns to the best of his or her abilities, as they should be fully aware of the law as it applies to your case. If you’ve selected an attorney who is especially familiar with this kind of lawsuit, you may find this gives you greater peace of mind in bringing your case to trial.

Of course, one of the most intimidating elements of a lawsuit can be interacting with opposing counsel. Most average people involved in a suit do not understand the legalities of such a situation.  It is your lawyer’s responsibility to you, as a client, to represent you in a legal setting, generally speaking, but it is also his or her duty to communicate with the opposing side, so that you feel comfortable and protected. at all times. With the right legal support, you should feel certain that your case was presented effectively and accurately, and that every reasonable effort possible to win your case against those who imposed abuse or neglect on your loved ones, was made.

For more about hiring a nursing home abuse lawyer, visit nursinghomeabuse.net.

In 1987, Congress passed the Nursing Home Reform Act in an attempt to improve the rights of the elderly who reside in such facilities. This Act entitles all residents “…to receive quality care and live in an environment that improves or maintains the quality of their physical and mental health.” What this means is that residents of a nursing home are entitled to freedom from neglect, abuse, and misappropriation of funds, which are criminal acts. The individuals who commit these wrongs can be charged criminally for their actions, and the facilities themselves may be sued in a civil court for damages that arose as a result of operating the facility in which the abuse or neglect took place.

Neglect is defined as the failure to care for a person in a manner, which would avoid harm and pain, or the failure to react to a situation which may be harmful. This neglect may or may not be intentional, meaning that neglect can occur if someone is poorly trained and not giving the proper care, whether or not they meant any harm is irrelevant. Neglect includes incorrect body positioning, meaning the position of the patient leads to skin lesions or limb injuries. It also includes a lack of assistance in eating and drinking which could cause malnutrition and dehydration. Neglect also can mean a lack of toileting or changing of disposable briefs that could cause incontinence, indignity, and result in a patient lying in excrement. A lack of assistance in walking that leads ultimately to poor mobility is yet another kind of neglect. Some other types are lack of bathing, poor hand washing that leads to infection, lack of assistance with participating in activities of interest if this leads to isolation and withdrawal. Ignoring call bells or cries for help are also grounds for neglect. If any of these actions are happening to the degree that an injury occurs, there may be a case of neglect which should be reported.

Abuse is a different form of injury that can occur in nursing homes. Abuse means that intentional pain or harm is caused. This harm can include physical, mental, verbal, psychological, and sexual abuse, corporal punishment, unreasonable seclusion, and intimidation. Types of physical abuse could be hitting, pinching, shoving, force-feeding, scratching, slapping, spitting, or anything resembling these kinds of actions. Sexual abuse could be in the form of coercion into performing sexual acts, or inappropriate touching. Abuse could even be considered treating a resident roughly during daily routine care, or substandard care that causes either psychological or physical injuries.

Another category of abuse and neglect is the misappropriation of property and/or funds. This includes stealing or embezzling funds or property such as jewelry, or not handling the funds given to the nursing home for the care and treatment of the resident.

Most states have Adult Protective Services laws. Although these laws may differ from state to state, most revolve around the idea that there is a duty for a caregiver to act. What this means, is that the caregiver generally has a legal duty created by the law that they act in a way that benefits the resident. This duty is created by the contract a resident enters into with the facility and the caregiver regarding their long-term care. A caregiver who fails to act accordingly has breached this duty, which could result in legal action.

It is imperative to know what abuse and neglect are in order to identify it, and put an end to it. To find out more about details involving what may or may not constitute abuse or neglect in the nursing home, visit the National Center on Elder Abuse website at http://www.ncea.aoa.gov/.

Source: National Center on Elder Abuse, Administration on Aging http://www.ncea.aoa.gov/

According to the NCCHR, a not-for profit coalition that looks to protect long-term care resident’s rights, the right to complain can mean a few different things. It can mean that the resident has the right to complain directly to staff and administrators in the facility without fear of reprisal or backlash, and that these complaints will be taken seriously with efforts to resolve the problems. It can also mean that the resident of the facility may complain to the ombudsman program. Ombudsman programs exist at the state and federal level and are citizen representatives whose job it is to hear and address complaints. The resident may also complain to the local or state agency which is in charge of licensing and certifying such facilities. Many states also have adult protective services departments, which will take and investigate claims of abuse or neglect. It is also important to note that a resident always has the option of calling the local police or state law enforcement. A useful resource in determining who to report nursing home abuse to is the National Center on Elder Abuse, which part of the U.S. Administration on Aging. Their website can be found at http://www.ncea.aoa.gov/.

If you or someone you know is a victim of abuse or neglect in a nursing home, it is important that you report the allegation to one of the agencies listed above immediately. The longer the abuse goes unreported, the more the pain and suffering is likely to continue. It is important to write everything down, to be specific about people, times, and places, and to keep a copy of the report. When writing down the people involved, some things to think about are who the victim is (including their age and address), the name of the nursing home, the people responsible for the residents care, as well the person who was allegedly responsible for the abuse or neglect. When recording what happened, it is important to identify not only the type of abuse or neglect, but also the extent of the damage or harm done. Times and dates are another detail to consider when making a report. The key here is detail. The more detailed a report, the quicker the problem can be addressed, and hopefully fixed.

After filing a report with one of the many agencies that can help, it is important to follow up on the report. If you are not the victim, but a friend or family member, it is best to find out if the abuse or neglect is no longer happening. Any reports that can be obtained showing what actions were taken against the facility or the nursing home should also be obtained for the victim’s records. Usually these types of reports can be found with whatever state board is in charge of licensing or certifying long-term care facilities.

Remember, the most important aspects of filing complaints are that any further harm can come to a stop, and the more detailed the report, the quicker action may be taken. In cases involving nursing home abuse or neglect, both criminal and civil action may be sought. The person committing the abuse or neglect will likely face criminal charges from the state, but the facilities owners and operators may also face civil penalties for that damage caused to the resident.

Source: National Center on Elder Abuse, Administration on Aging http://www.ncea.aoa.gov/

One of the rights that the law protects is the right of a resident to be informed of their care. This includes the right to information concerning the costs associated with receiving care. Costs for care should be transparent so that residents know exactly what they are paying for. Residents have the right to know the rules of the home, and to receive a written copy of these rules. Residents should also have access to numbers of state agencies they can call in case there are any problems to report. Residents also have a right to be informed of any potential changes in rooming, or arrival of new roommates. If a resident has a sensory impairment such as blindness, they have a right to assistance. Residents also have a right to all of the above information in a language they can understand. Information is the key to understanding the ins and outs of the facility and the care that is being provided.

Residents have a right to participate in their own care. What this includes is receiving notice of changes in medical condition, participation in all levels of planning of care, refusing treatment or medication, review of medical records, and to not be charged for the services that Medicare and Medicaid already cover. Participating in one’s own care means having control of the quality and level of services received at a nursing home.

The right to complain is another right that is protected. This right is extremely important in the relationship between the resident and the facility. Every resident can complain to the staff, the police, or to any state or federal agency knowing that their complaint will be taken seriously. When a complaint is made, a resident should not have to fear negative consequences, which is why this right exists.

Privacy and confidentiality are also essential rights protected by the Nursing Home reform law. This means private and unrestricted communication with anyone inside or outside the facility. This also means privacy and confidentiality in dealing with medical, personal and financial matters, as well as during everyday treatment and care.

Elderly residents living in nursing homes also rights that relate to the handling of transfers and discharges. Transfers or discharges may happen if it necessary for the welfare of the resident, if the resident’s health has improved so as not to need care, the transfer or discharge is necessary for the health and safety of the staff, or if the resident fails to pay bills after reasonable notice has been given. If a transfer or discharge is going to occur, the facility must give a thirty day notice that explains the reason, date, and location of the discharge. The notice must inform the resident of their right to appeal the decision, and give contact information of the state long-term care ombudsman who can assist the resident in any matters related to the facility. In addition, the resident must be safely transferred or discharged by the nursing home.

Residents also have a right to have visitors. This includes not only relatives and friends, or anyone else the resident wishes to see, but also physicians of the residents choosing, or anyone from any state or local service, as well as those providing other services including legal, health, or social services.

The right to make independent choices is another guarantee. This includes the right to make personal decisions, have personal needs and preferences attended to, choose one’s own physician, participate in activities in or outside of the nursing home, form resident backed councils, and manage one’s own financial matters.

These rights are all meant to treat nursing home residents with the dignity, freedom, and respect they deserve. This includes being treated with consideration, being free from all types of abuse and neglect, to not worry about the security of their possessions, and to make one’s own decisions to the best of their ability. All of these rights are federally protected by the Nursing Home Reform Law of 1987. Anyone who believes that these rights have been infringed upon should contact family, friends, local and state law officers, the state ombudsman, and seek legal advice to ensure that these rights remain protected.

Sources: The National Consumer Voice for Quality Long-Term Care, Formerly NCCNHR

http://www.theconsumervoice.org/resident/nursinghome/residents-rights

National Center on Elder Abuse, Administration on Aging http://www.ncea.aoa.gov/

1. The Right to be Informed:

1. Of all services available and the costs associated with them.
2. Of the home’s rules and regulations.
3. Of government agencies and advocacy groups that protect nursing home residents.
4. To see, upon request, annual state survey reports.
5. Of room or roommate changes in advance.
6. Of transfer or discharge from a nursing home 30 days in advance.
1. Residents may only be discharged or transferred if:
1. They pose a threat to those around them.
2. It is in their best interest.
3. They have failed to pay the facility what they owe.
4. They no longer need assistance.

2. The Right to be Treated Respectfully:

1. This includes freedom from:
1. Mental and physical abuse.
2. Coerced seclusion.
3. Unwarranted restraints (both physical and chemical).
1. Restraints are considered anything that prevents a resident from freely moving; being tucked in too tightly in bed, sitting in a wheelchair that has been positioned in such a way that prevents movement, and being given unnecessary medicine such as sedatives, are all considered to be restraints.
2. Restraints may be issued if all other options are exhausted, and a doctor has written an order for the use of them.

1. By speaking to a resident in their native language and with respect in general.

3. The Right to File Complaints:

1. With the nursing home itself, with full expectations of a grievance receiving attention and being resolved.
2. With state agencies.
3. With advocate groups.

4. The Right to Make Choices:

1. To use a personal physician.
2. To participate, or not, in community activities.

1. E.g. Religious services outside of the home, Resident Council inside of the home, etc.

1. Regarding personal matters, such as:

1. What a resident will wear.
2. When, where, and what a resident will eat.
3. How a resident will decorate their room.

1. Under the condition that said décor does not pose a threat to others.

1. Personal finances.

5. The Right to be Good Health and Health Decisions:

1. Receive sufficient care.
2. Be updated on his/her health status.
3. Refuse medical treatments, medications, and restraints.

6. The Right to Privacy:

1. When a resident has a family member or friends visit.
2. Of medical treatment and history.
3. Regarding personal and financial matters.

The Most Commonly Violated Rights in Nursing Homes are:

1. The right to sufficient care.
2. The right to make choices.
3. The right to be treated with respect.

These rights are violated in the following ways:

1. Understaffing.
2. Under-representation of care services.
3. Overmedication.
4. Unnecessary medication.
5. Abuses, which include: Neglect, and emotional, physical, sexual, and financial abuse.
6. Coerced isolation.
7. Some nursing homes claim family members may only visit at certain times, which is false.

The first stage of a bedsore is when the skin is still intact; it may or may not be discolored and the abrasion site will be painful.  The second stage of a bedsore is when part of the skin is missing or damaged.  The skin may be pink or red in color and have a broken or unbroken blister.  When a bedsore has entered stage 3, the site of skin loss reveals fat, looks sunken in, and may reveal yellow, dead tissue.  By stage 4, muscle, bone, and tendons may be exposed and the revealed tissue may be yellow or dark.

How to Care for a Bedsore

Bedsores are best cared for by a physician.  However, those that are not severe can be cared for by the following process:

First and foremost, you must investigate what caused the bedsore so as to ensure that further damage does not occur.  Bedsores are caused by too much pressure, friction, and/or “shear” (i.e. friction that occurs when two surfaces move in opposite directions).

If the bedsore is a stage one, water and a mild soap can be used to gently clean it.  If the bedsore is in stage 2, it can be cleaned with a saline solution.  You should never scrub or put a lot of pressure on the bedsore.  Cleaning the bedsore is a very important step because it keeps the wound from contracting further infections.

Next, all of the dead tissue and scabs should be removed; removing these tissues is necessary for the wound to begin the healing process.  The wound should then be gently patted dry.

Afterwards, the wound should be dressed, to guarantee it stays moist, and bandaged; dressings and bandages protect the wound from infection.

Finally, direct pressure on the wound should be avoided.  Your loved one should be repositioned frequently to avoid both pressure on the wound and future wounds.  If he/she is bedbound, this should be done every two hours.  If he/she is bound to a wheelchair, this should be done every hour.

Cleaning, dressing, and bandaging the wound should be done very frequently.

To prevent bedsores in the future, your loved one should:

• Be bathed frequently.
• Be inspected for sites of pressure habitually.
• Be properly elevated in bed.
• Engage in regular exercise (for those not completely disabled).
• Be repositioned frequently.
• Place cushioning devices in bony areas; this should be done with caution as these devices can also become a source for a bedsore.
• Protect skin areas prone to moisture.
• Eat a nutritionally balanced diet.
• Be sufficiently hydrated.

Stay Calm and Rational

The very first thing you should do is speak with the assisted living facility’s manager or administrator; this is of course under the condition that your loved one’s life is not in immediate danger, in which case you should call 9-1-1.  If the manager or administrator is not available immediately, then you should take immediate action to set up an appointment with them as early as possible.

When you meet with the manager or administrator, you should remain calm and rational; you need to listen in order to fully understand if he/she plans to remedy the situation.

Contact the Authorities

If the administrator or manager’s action or inaction does not fully solve the problem, or if the problem persists, you should contact your state and file a complaint.  Each state is different in respect to which agency you will contact.  The National Council of Aging and Medicare websites have information to point you in the right direction, but usually one of the following should be contacted:

• Adult Protection Services (APS).
• The Area Agency on Aging.
• Local State Department of Health Licensing/Certification office.
• The main office of the state health agency.
• The county Department of Social Services.

After you have filed the complaint, a state inspector will make a surprise visit to the facility to investigate the claim, as they are required to by law.  If they find that the claim has merit, they will take the appropriate actions.

Contact an Attorney

If, after the lengthy process of the state investigation, you feel that your loved one’s crime was not fully brought to justice, you may want to consider contacting an attorney to pursue the matter.