The Fresno Bee reported on the nursing home resident of Bella Vista Memory Care Community who contends that he had to have his right eye removed after staff at the nursing home allowed him to be attacked twice by his roommate.  Josh Dansby Jr. is seeking compensation for injuries suffered as a result of the facilities failure to protect him.  The lawsuit says Bella Vista is understaffed and has a history of being issued deficiencies by the California Department of Social Services.

Sierra Meadows Senior Living, LLC runs Bella Vista and has called the lawsuit a “shakedown”.

The lawsuit states that Dansby suffers from Alzheimer’s and dementia and has a history of strokes and heart attacks. Around February 2017 he became a resident of the nursing home.  Bella Vista placed Dansby with a roommate who had a known history of aggressive propensities and physical assault.  In September, the roommate attacked Dansby.

After this assault, Dansby’s family complained to the Bella Vista staff, asking that Dansby be protected from the roommate including moving rooms or changing roommates. Bella Vista refused to make any changes.

Dansby was attacked by his roommate again in December. After the attack, Bella Vista staff did not provide Dansby with care for days. He was later taken to Saint Agnes Medical Center’s emergency room, where he was determined to have suffered a corneal detachment. Doctors removed Dansby’s right eye.



Newsweek reported that a new study published online in Acta Neuropathologica suggests that eight young adults who developed serious brain plaque buildup may have been “infected” with amyloid proteins via dirty medical instruments during brain surgeries in their youth.

Brain plaque buildup is one of the most recognized characteristics of Alzheimer’s disease, as well as other neurodegenerative diseases, such as Creutzfeldt-Jakob Disease (CJD), also known as “human” mad-cow disease, New Scientist reported. Eight patients in England experienced brain plaque buildup caused by excessive amyloid proteins so severe it caused blood vessels in their brain to burst.

Researchers from University College London reviewed the cases of eight young patients who had experienced cerebral amyloid angiopathy (CAA), a condition where amyloid proteins build up in blood vessels in the brain. Not only are both CAA and Alzheimer’s disease both characterized by brain plaque buildup, but both illnesses are also found in much older patients. All eight patients were under 60-years-old, therefore not yet at risk for brain plaque buildup. In addition, none of the patients were at predisposed genetic risk for this disease, New Scientist reported. Instead, the researchers found these patients shared one salient common factor: brain surgery during adolescence.

Lead researcher Sebastian Brandner, a professor of neuropathology at University City London and his UCL team, hypothesized that the amyloid proteins may have been transferred into the patients’ brains during surgery by hitching a ride on surgical instruments that had not been cleaned well enough, New Scientist reported.

The theory is that medical instruments previously used on Alzheimer’s patients were then used on these young adults. If the tools were not properly cleaned, amyloid proteins from the Alzheimer’s patients could then be transferred to other patients operated on with the same tools.

Brandner told Newsweek that there are no other risk factors that can explain such early onset CAA, and this suggests that transfer of proteins via medical tools is likely why these patients developed the disease so young.

“Brain surgery is so far the most likely cause,” said Brandner. “In theory other routes are thinkable, but we have no evidence.”

This is not the first time researchers have proposed that brain proteins can be transferred from patient to patient via surgery. A 2015 study also led by Brandner also suggested that fragments of sticky amyloid proteins spread among patients through contaminated surgical tools, The Guardian reported.

Brain protein buildup in young people is rare but not completely unheard of. Another study from 2015 suggested that plaque buildup in young people could simply be a sign that the “resource” and “machinery” needed to make these protein clumps already exist in young people.

“The implication appears to be that if we want to prevent these clumps from forming when a person becomes old, we may need to intervene much earlier than we have thought, to try and get rid of amyloid very early in life,” the 2015 study co-author Changiz Geula, a professor at the Northwestern University Feinberg School of Medicine in Chicago who focuses on Alzheimer’s disease, told CBS News.

CNN had a great article on the new Human Rights Watch report, “‘They want docile:’ How Nursing Homes in the United States Overmedicate People with Dementia.”  “Children complained about parents who were robbed of their personalities and turned into zombies. Residents remembered slurring their words and being unable to think or stay awake. Former administrators admitted doling out drugs without having appropriate diagnoses, securing informed consent or divulging risks.”  The under-staffing of nursing homes is a major factor of such over-medication.

The 157-page report estimates that each week more than 179,000 people living in US nursing facilities are given antipsychotic medications, even though they don’t have the approved psychiatric diagnoses — like schizophrenia — to warrant use of the drugs. Most of these residents are older and have dementia, and researchers say the antipsychotic medications are administered as a cost-effective “chemical restraint” to suppress behaviors and ease the load on overwhelmed staff.
What’s revealed in this report echoes the findings of a CNN investigation published in October. The CNN story described how one little red pill, Nuedexta, was being misused and overprescribed in nursing homes. What’s more, CNN learned that this overuse benefited the drugmaker to a tune of hundreds of millions of dollars, largely at the expense of the US government. The CNN report prompted an investigation into a California-based pharmaceutical company.
The Food and Drug Administration has not deemed antipsychotic drugs an effective or safe way to treat symptoms associated with dementia — including dementia-related psychosis, for which there is no approved drug. In fact, the FDA cautions that these drugs pose dangers for elderly patients with dementia, even doubling the risk of death, the report shows. Other possible side effects outlined in the report include an onset of nervous system problems that may cause “severe muscular rigidity” or “jerking movements,” as well as low blood pressure, high blood sugar, blood clots and other problems.
There are plenty of ways to deal with dementia-related symptoms or behaviors that don’t involve pharmaceuticals, the report lays out. Improvements can be achieved through providing activities, reducing loneliness, creating routines, encouraging relationships with familiar staff members, offering exercise and promoting programs like music therapy and pet therapy.
The government has long-recognized the problem of overusing antipsychotic medications and is required to monitor the use of such drugs, the report shows. In fact, in 2012, the Centers for Medicare & Medicaid Services established the National Partnership to Improve Dementia Care in Nursing Homes in acknowledgement of this issue.  “The US government pays nursing homes tens of billions of dollars per year to provide safe and appropriate care for residents,” said Hannah Flamm, a New York University Law fellow at Human Rights Watch. “Officials have a duty to ensure that these often vulnerable people are protected rather than abused.”

USA today reported that Phyllis Campbell, a nursing home resident with dementia and a history of wandering off, was outside in temperatures hovering around zero for about eight hours before staff members noticed she was missing and found her dead from hypothermia, a state investigation found.

The state’s findings say Campbell had wandered into the courtyard twice during the week before she died and that she got out of her room several times that day and said, “I’m going home.”

The woman told a nurse’s aide she was going home.  She went through a door into a courtyard even though she was wearing a monitor that should have set off alarms, the report said.  Tests later showed the sensors did not always work, the state’s report said. Staff members also told investigators the device didn’t always work.

Two aides told investigators they did not do scheduled checks that night even though they were marked as completed, according to the Ohio Department of Health investigation.  She was found in the courtyard about 30 feet from its doors the morning of Jan. 7.

The Star Tribune reported on the tragic and preventable death of Delores Rowan.  Rowan suffocated and died on May 31, according to the Ramsey County medical examiner’s office. The woman’s injuries included fresh bruising on her neck, the autopsy found.  The facility is at fault for allowing Rowan’s head to become trapped between the mattress and the bed’s grab bar.

Langton Place, which is operated by Presbyterian Homes, “had no policy, procedure or system to ensure the proper sizing of mattresses, the fit of the grab bars [or the proper] space between the mattresses and the grab bar device to reduce the risk of entrapment,” according to a state Health Department report released last week.  The report said a nurse saw the resident on her back and asleep about 4 a.m. In a routine check 90 minutes later, the woman was discovered with her head wedged between the mattress and a grab bar. Resuscitation efforts failed.

Her husband, Michael Rowan, said that his wife’s suffocation “wasn’t the only problem we had with that place.”  Langton Place one day ran out of the liquid nutrition she was fed through a tube. He also said she came down with cellulitis, a bacterial skin infection, and needed to be hospitalized. He said he also found caked feces in his wife’s pubic area.

CNN had an article with a video showing a resident assaulting another resident for several minutes before staff intervened.  The video is tough to watch.  The beating, which was first reported by the Gainesville Sun, lasted on and off for nearly 2 minutes. The beating occurred October 3 in a secure unit of Good Samaritan, a 45-bed assisted living facility.  It occurred in a common area of a secured unit within the facility while other residents ate and watched television mere feet away. The video of a resident beating another resident raises new questions about the safety of the elderly in places meant to protect and care for them.

In the video, a 52-year-old resident is seen punching an 86-year-old resident with dementia more than 50 times as the older man lay curled up on the floor. The younger resident accused the older resident of eating his cupcake, according to law enforcement.  At the time the beating took place, there was no staff member attending to residents in the unit, and no one had been assigned to monitor the unit’s video surveillance, according to official reports.
The video was taken by the facility’s closed circuit surveillance system in October and later turned over to the police, who shared it with CNN.
The facility — the Good Samaritan Retirement Home in Williston — had a history of violations, and more sanctions in the past five years than any other assisted living facility in Florida. In December, two administrators were arrested in connection with separate incidents on charges of neglect of the elderly.  One of the facility’s administrators, Nenita Alfonso Sudeall, later broke down and cried as she told police she was “overwhelmed” at the facility, which she said was short-staffed and had poorly trained employees, according to a police report.
The elderly resident was hospitalized with bruising and swelling to his face, as well as hip pain, according to the police report.
Also earlier this year, a CNN report found that the federal government has cited more than 1,000 nursing homes for mishandling or failing to prevent alleged cases of rape, sexual assault and sexual abuse at their facilities between 2013 and 2016.
“There are far too many cases of abuse and neglect happening in nursing homes and assisted living facilities,” said Brian Lee, executive director of Families for Better Care, a national advocacy organization for residents and their families. “We’ve been seeing cases for decades. This one incident in Florida shows how bad the problem can be.”

The Washington Post reported on a novel – and seemingly effective – method of restoring the minds of dementia-stricken residents: recreating nostalgic environments to provoke their memories and stimulate their brains.  Allowing residents to see, hear, and touch items from their youth help their cognition and sometimes increase their functional capabilities.

The Conversation reported on the epidemic of resident to resident assaults in nursing homes.  Many preventable deaths in nursing homes are a result of aggression between residents. This most commonly occurs in people with dementia, their research has found.  Published in the Journal of the American Geriatrics Society, they examined records for all resident-to-resident aggression-related deaths among nursing home residents reported to a coroner in Australia between 2000 and 2013.

Their study examined the frequency and nature of resident-to-resident aggression resulting in the most severe outcome – death. In their analysis, almost 90% of residents involved in resident-to-resident aggression had a diagnosis of dementia. Three-quarters had a history of behavioral problems, including wandering and verbal and physical aggression, which are common symptoms of dementia.

The rising global prevalence of dementia, particularly in the nursing home population, means aggressive behaviors between residents will increasingly be an issue. Two high-level reports on elder abuse in aged care in Australia have recommended better reporting systems so we can understand and prevent all such deaths in nursing homes.

Resident-to-resident aggression is an umbrella term that includes physical, verbal or sexual interactions that are considered to be negative, aggressive or intrusive. These behaviors can cause serious physical harm or psychological distress.

The prevalence of aggression between nursing home residents is difficult to determine. Recent research estimates at least 20% of nursing home residents in the US were involved in such incidents.

Most incidents appeared to be unprovoked, or were triggered by communication issues or a perceived invasion of personal space. Importantly, only one of the 18 studies reported a single death as the result of physical resident-to-resident aggression.

Our research found most exhibitors of aggression (85.7%) were male. The risk of death from aggression between residents was twice as high for male as for female residents. Those who exhibited aggression towards other residents were often younger and more recently admitted to the nursing home than their targets.

Incidents commonly involved a “push and fall”. Seven (25%) related deaths resulted in a coronial inquest, but criminal charges were rarely filed.

However, this is likely to be just the tip of the iceberg as there is much potential for underreporting and misclassification of resident-to-resident aggression deaths. We have limited data on how often incidents of aggression between residents in Australia occur but do not result in death.

Fox 8 reported that police are investigating a suspicious death at Concord Care and Rehabilitation Center in Ohio after a confrontation between two nursing home residents.  Police Detective Joe Rotuno said Richard Cain, 65, was found unresponsive in his room at Concord  around 7 p.m. Thursday.  Rotuno said Cain’s roommate, who is 63 and usually in a wheelchair, told staff Cain was lying on the ground, and he believed he was dead. Staff then found Cain clutching a chunk of his roommate’s hair and called police, according to investigators.

The roommate told officers that the pair had argued over whether to close the room door when Cain began choking the roommate, according to Rotuno. He said the roommate reported he then punched Cain in the stomach, causing him to fall backward and hit his head.

Rotuno said both roommates suffered from mental health and other issues, and that staff reported the roommate had a history of anger issues. He said they had gotten into arguments in recent weeks.  “We’ve heard there’s been a lot of verbal altercations between the two,” Rotuno said. “Our suspect does have a history of being what we would call ‘angry’ at the facility, having issues with other residents, having issues with other staff.”

“If his roommate had to defend himself, I don’t blame him at all. I blame the nursing home and staff for not paying attention,” said Bonnie Cain. “They’ve been in several verbal confrontations weeks prior and nobody’s done anything about it. Why couldn’t you separate them?”

She said she wants justice and more training for nursing home staff.

“Every time I close my eyes I see my dad, and it’s just so heartbreaking,” Cain said. “Why couldn’t something be done? Maybe my daddy would still be with me today.”



National Geographic published Maja Daniels’ series “Into Oblivion,” a documentary project that exposed some of the many issues surrounding Alzheimer’s patients while also highlighting society’s generational disconnect from its elders. Shot over the course of a three-year period, “Into Oblivion” was the inaugural winner of the Bob and Diane Fund, a photographic grant that supports visual storytelling about Alzheimer’s and dementia.  The Bob and Diane Fund was started by National Geographic Creative employee Gina Martin in honor of Martin’s mother, Diane, who died from Alzheimer’s in 2011, and her father, Bob. The winning photographer receives a $5,000 grant to support his or her work.

While on a tour of a geriatric hospital in France, photographer Maja Daniels came across a locked door with portholes in it. Behind it, someone was trying to get her attention. When she asked, Daniels learned that the door led to a protective unit for the hospital’s Alzheimer’s patients, meant to keep them safe and to keep  them from wandering off and getting lost.

“I was just struck by the image of that door,” says Daniels.

When Daniels showed the staff her photos, they were shocked by the images of people by the door.

“Sometimes the hardest things to see are the things that are closest to us,” Daniels says.

Shortly after, they covered the door with wallpaper to make it blend in and defer patients away from it.

“Even those smaller changes are really important,” Daniels says.