What are the signs of neglect or abuse of a nursing home resident?
Many people ask us what to look for to see if a nursing home resident is being neglected or abused.
Nursing homes are obligated to notify a resident's physician any time they have a significant change in condition, and they are obligated to document that notification.
Further, if the nursing home resident is not mentally competent, if the nursing home resident has dementia or some other condition such that they are not able to tend to their own affairs, then the nursing home is obligated to contact their family member any time there's a significant change in condition. The nursing home is also obligated to document that notification.
So if someone you love is in a nursing home, and you find out that they had a significant change in condition, you need to investigate whether or not their doctor was notified, and you need to determine whether a member of your family was notified. These notifications should be documented in the records, and the staff at the nursing home should be able to show you that documentation. If these notifications are not being made that is a significant red flag for that nursing home.
A significant change in condition would include the development of skin breakdown. So if your loved one's skin is intact and then they begin to show signs of skin breakdown, that's a significant change in condition.
If they have some skin breakdown and it gets worse, that's a significant change in condition. If they have a bedsore and it's a Stage 1, which is a reddened area that's not open, and that progresses to a Stage 2, which is an open area of their skin, the nursing home is obligated to contact you and notify you of that change in condition. They are also obligated to contact the resident’s doctor.
If the wound begins to show signs and symptoms of infection, it's red, it's draining, it has an odor, that's a significant change in condition, and the nursing home is required to contact you and the doctor about that change in condition.
If your loved one has changes in condition and you're not being notified and their doctor is not being notified, we recommend that you strongly consider moving your loved one to a different nursing home. A nursing home that's providing proper care involves the family in the plan of care and keeps the doctor informed of the condition of the resident. A nursing home that is providing substandard care does not notify the family when there's a change in condition. Sometimes this is due to understaffing. If there simply aren't enough people to provide appropriate care for your loved one, then one of the things they neglect is contacting the doctor and contacting the family. This can be very dangerous. The nursing home needs to contact the doctor so that he or she can be involved in the care planning of the resident and in determining what that resident needs in terms of care and treatment to address whatever their significant change of condition is. Furthermore, you as the family are entitled to be kept informed about the condition of your loved one so that you can be involved in their care planning and also in their care and treatment.
One thing to observe when you are with your loved one in the nursing home, particularly if they are not able to communicate with you, is how they react to the staff. We represented Esther Piskor and her family in a lawsuit. Ms. Piskor's son hid a camera in her room to keep an eye on her. The staff used to leave her window open to cool her room off because she liked her room very warm. Her son was trying to figure out who was leaving her window open. Tragically, as he reviewed the recording, he found out that multiple staff members were assaulting her. Two of the staff members in the nursing home eventually went to prison. One of the things that was apparent as we reviewed the recordings was how Ms. Piskor reacted to different staff members. Even though she was unable to communicate, it was very apparent from observing her that she was afraid of certain staff members. These were the staff members who were abusing her. There were other staff members who she was not afraid of because they were providing her with proper care.
So one of the things that you should pay attention to is, how does your loved one react to different staff members in the nursing home? Is she afraid of them? Does she pull away from them? Or is she relaxed when they enter the room.
You also should monitor your loved one's behavior and demeanor. Do they seem withdrawn or depressed or anxious? Some of this may be a natural result of admitting your loved one into a nursing home. If your loved one has gone from living at home to living in a nursing home, this is a huge change that can have a major affect on their demeanor. Further, if your loved one's condition is changing such that they now need nursing home care, those changes can result in changes in their behavior and their demeanor. In other words, if your loved one is no longer able to live at home because of various changes in their mental status, that can also account for behavioral changes.
However, the nursing home should provide them with appropriate social services and psychological care to address their psychosocial needs. They should be encouraged to participate in activities. They should be encouraged to enjoy their meals in the dining room with the other residents. The nursing home should offer your loved one activities to participate in. Many people resist being admitted to a nursing home, particularly if that admission is long term. Many people are very unhappy to go from living in their own home to living in a nursing home. However, sadly, often living in their own home is no longer safe, particularly if they live alone. So, oftentimes, a nursing home admission is required. However, you should make sure that you are admitting your loved one to a good nursing home, and you should make sure that they are getting the care and the services that they need to be happy.
If your loved one appears to be particularly drowsy, you should confer with their doctor and make sure that the staff is not overmedicating your loved one. Nursing homes are not permitted to medicate nursing home residents for convenience. They are not permitted to give them medication so that they are drowsy or stay in bed all day.
You should definitely check and see if your loved one has any new bruises or cuts or skin breakdown. You should definitely observe to see if your loved one has any sudden fluctuation in their weight.
As I have said many times in the articles on this website, the best way to keep your loved one safe is to visit often at all different times of the day and to ask the staff questions about your loved one's condition.
If someone you love has been neglected or abused in a nursing home, please call us at 1-800-OHIO LAW as we would be happy to talk with you at any time and help you in any way that we can.