Falls-related injuries are a major point of concern for nursing home residents. McKnight’s reported on a new study showing the benefits of hip protectors for fall prevention.  Nursing home residents who use a hip protector are three times less likely to suffer fall-related hip fractures than those don’t use them, a new study found.

Patients who fell while not wearing the devices had rates of hip, pelvic and other fractures of 0.92, 0.21 and 0.71 per 100 falls, respectively. The rates of hip, pelvic and other fractures for residents who were wearing the devices during a fall were 0.33, 0.28, and 0.71 per 100 falls, respectively — a three-fold difference.

Experts, investigators, and consumer advocates agree that the findings show clear benefits of using hip protectors “can be achieved in practice” and may have significant impacts on real-world decision making for providers.

“It is one thing to show effectiveness in a clinical trial, where a team of investigators work to maximize adherence,” the authors wrote. “Our study moves beyond the artificiality of the clinical trial environment, to examine the real-life value of hip protectors in reducing hip fractures in LTC homes from a region of (British Columbia) that had attained 60% adherence with hip protectors.”

Researchers used data from residents in 14 long-term care homes who experienced at least one recorded fall during a 12-month period.

The findings were published in the November issue of the Journal of Post-Acute and Long-Term Care Medicine.

Boston 25 News has provided details surrounding the death of a nursing home resident at the Lutheran Rehabilitation and Skilled Care in September.  According to the Department of Public Health’s report obtained by Boston 25 News, a resident was dropped from a mechanical lift while being taken out of bed in September.  DPH says the resident died at the hospital the next day.  This is why it is required and standard to have two people assist when using a mechanical lift.

The resident suffered a subdural hematoma, which is a collection of blood build up outside the brain, cervical spinal fractures, a pneumothorax, a condition where air leaks into the space in between the lungs and chest, two left rib fractures and a spinal fracture.

According to the report, the certified nursing assistant responsible tried to cover up the incident.

She only told fellow staff members and emergency workers they had just bumped the resident’s head on a metal bar.

The hospital didn’t find out about what had really happened until several hours after the resident had been dropped.

Alison Weingartner and Arlene Germaine, who work for the Massachusetts Advocates for Nursing Home Reform said they were mortified after reading about the Department of Public Health’s findings regarding the patient’s death.

“It is horrifying it’s totally unnecessary that this happened,” said Germaine. “It’s horrifying all the way around.”

The department issued a list of things to look out for when choosing a nursing home for your loved ones:

Choosing a nursing home for yourself or a loved one is an important decision, and there are several factors to consider when evaluating a facility. Both DPH and the Executive Office of Elder Affairs (EOEA) have made resources available online to help with decisions about nursing home care.

  • The Guide to Nursing Home Care brochure provides information, tips, and resources to help answer questions about long-term skilled nursing care.
  • The Long-Term Care Ombudsman is an advocate working to resolve problems related to the health, welfare, and rights of individuals living in nursing or rest homes. Ombudsman representatives are regularly onsite at nursing homes and can provide valuable insight when choosing a nursing home for a loved one. To connect with your local ombudsman, call (800) 243-4636 (800-AGE-INFO) or find their contact information online.
  • The Options Counseling Program, funded through EOEA, provides free, unbiased information and support to older adults, family caregivers and people living with disabilities. An Options Counselor can connect MA residents to resources and helps them make decisions related to long-term services and supports based on their specific needs.
  • There are a number of options for long-term services and supports, including assisted living, in-home care, adult day health programs and nursing facilities. To request an Options Counseling session near you, call (800) 243-4636 (800-AGE-INFO).
  • DPH’s Nursing Home Survey Performance Tool and the CMS Nursing Home Compare website are tools that allow consumers to compare certified facilities in their area and determine the facility that will best meet your or your loved one’s needs.
  • There is no substitute for visiting a nursing home. DPH encourages individuals to contact the facility to schedule an appointment for an informational meeting and tour. Prepare questions that can help in the selection process, and ask for a copy of the facility’s brochure, admissions policies, and resident bill of rights.
  • If a resident, their representative, or their family members have concerns about the care they receive while in a long-term care facility, they may contact the facility’s Long Term Care Ombudsman to provide assistance or they may file a complaint with DPH by calling (800) 462-5540.

One of the worse situations we investigate as a nursing home abuse and neglect lawyer in South Carolina is physical abuse by caregivers and resident to resident altercations. Violence and mistreatment between nursing home residents is a common occurrence, according to experts.

In a 2014 study of nursing homes, Cornell University researchers Karl Pillemer and Mark Lachs determined that resident-to-resident elder mistreatment affected nearly 20 percent of residents over a four-week period. Researchers concluded that people who typically engage in resident-on-resident abuse are cognitively disabled to some degree but physically capable of moving around.

Specific types of mistreatment included verbal incidents, such as cursing, screaming or yelling at another person (16 percent); physical incidents, such as hitting, kicking or biting (5.7 percent); and sexual incidents, such as exposing oneself, touching other residents or attempting to gain sexual favors (1.3 percent).

Their underlying dementia or mood disorder often can manifest itself as verbally or physically aggressive behavior, the study found.

In 2015, nursing and residential care facilities were also among the industries with the highest prevalence of nonfatal occupational violence, with a rate of 6.8 per 100 full time workers, according to the U.S. Bureau of Labor Statistics.

One study revealed that nursing assistants at facilities with special units for Alzheimer patients had a significantly high risk for assault injuries and human bites. Thirty-five percent of nursing assistants reported physical injuries caused by aggression from residents, and 12 percent reported experiencing a human bite within the previous 12 months while working.

Travis Harper, in an article for McKnight’s Senior Living, reminded us that September is Fall Prevention Awareness Month.  During this time, a special focus is placed on raising awareness about ways that vulnerable seniors — and caregivers — can prevent falls, the most common negative incident experienced by older adults. The information highlighted is valuable all year.

According to the Center for Disease Control and Prevention, more than one-fifth of assisted living residents are injured in falls every year. Unsteadiness caused by medications, as well as obstacles in the living environment, can contribute to falls.

Preventing falls in senior living communities is much like preventing them in a traditional home. The following prevention strategies can go a long way toward keeping older adults safe in their living spaces:

  • Install handrails in stairways, hallways and bathrooms to ensure steadiness.
  • Clear all clutter, and arrange furniture to create walking space.
  • Immediately clean up spills when they occur.
  • Ensure that older adults don’t stand on furniture to reach for items.
  • Help seniors to always keep walking aids close by.
  • Encourage older adults to have a flashlight within reach and a nightlight in the bedroom in case they need to get out of bed in the middle of the night.

VirtuSense Technologies, or VST uses artificial intelligence to help prevent falls. The motion-based technology was developed in collaboration with the U.S. Department of Defense and the Telemedicine & Advanced Technology Research Center.

How it works:

Many senior falls are avoidable through the identification of issues with balance, gait and overall function of the body. VST uses technologies that allow care providers to detect deficits before a fall or other serious injury occurs. Healthcare professionals can use VST’s evidence-based technology to identify these deficits and create a personalized exercise or therapy plan in response. Each person’s plan will be different and unique to her or his own needs.

Members of Bethesda’s community particularly enjoy VST’s game feature, designed to work on balance and hand-eye coordination. Our residents enjoy playing games that require using their hands to slice virtual vegetables that appear to fly across the screen, or leaning side to side as they snow ski downhill.

Once residents are screened, our employees take the results to craft tailored plans for each individual resident. We then are able to identify fall risks, and wellness coordinators and physical therapists can see specific weaknesses in the tested resident. This personalized care allows us to successfully prevent falls and other injuries, contributing to our ultimate goal of providing exceptional senior living care and services.

 

Pleasant Acres Rehabilitation & Nursing Center was sued because of a woman’s wrongful death. Nancy Young died on Dec. 15, 2018 —only  seven days after her left hip and wrist were fractured from a preventable fall.  Young had entered another resident’s room, and the resident slammed the door on her as she was leaving. Young fell, but no one reportedly witnessed it, according to the lawsuit.

The York County Coroner’s Office ruled the death a homicide because of the action of another person. Young died of blunt force injuries that complicated existing conditions, including heart disease, according to the coroner’s report.

Daughter-in-law Barbara Young, who is executrix of Nancy Young’s estate, filed the wrongful death lawsuit in York County alleging that the nursing home did not provide enough staffing to care for Young as well as other residents.

Pennsylvania requires a minimum of 2.7 hours of care per resident per day. However, the state Department of Health found that the home was providing 2.44 hours of care per resident as of Oct. 26, 2018.  The state put the home on notice again in November about a staffing problem, the lawsuit states. Both times, the home submitted plans for correction. A former employee of Pleasant Acres and loved ones of residents complained earlier this summer to the York County Commissioners about the state of the home. They described it as being short-staffed.

In their efforts to maximize revenues/profits, Defendants negligently, intentionally, and/or recklessly reduced staffing levels below the level necessary to provide adequate care to residents, which demonstrated a failure to comply with the applicable regulations and standards for nursing home facilities,” the lawsuit alleges.

 The facility was well aware that Young was at risk for falls, and “if she fell, there was a likelihood she would be seriously hurt,” the lawsuit states. She needed to use a walker and to wear shoes while walking in the halls. Despite the facility knowing that she was at risk for falls and needed assistance and supervision to maintain her safety, Young fell several times after being admitted. Young’s family repeatedly met with staff, and interventions were planned to prevent falls, such as ensuring that her walker was within reach when nurses checked on her.

The night that Young fell, she was found lying on her back with only slipper socks on. She did not have her walker, the lawsuit states.

A recent New Jersey case really made me think about criminal intent in nursing home caregivers.  Monique Beaucejour, a nursing home aide was charged with reckless manslaughter for failing to seek emergency care for a patient who later died after suffering a head injury, said acting Essex County Prosecutor Theodore N. Stephens, II.

Beaucejour found the 85-year-old resident on the floor of her room at the Waterview Center nursing home but placed her back in bed instead of seeking help. Investigators determined, however, that Beaucejour had placed Fannie McClain in bed and “returned to the room later and acted as if she just discovered her injured,” Stephens’ announcement said.

McClain’s 62-year-old daughter, Fangela McClain, said she had previously raised concerns about her mother’s care and said the nursing home did not have enough staff to adequately care for all of the patients. She said her mother, who had dementia, had fallen previously and another time she sprained her ankle.

In addition to reckless manslaughter, the prosecutor charged Beaucejour with hindering, obstruction and neglect of the elderly, Stephens said.

WFMZ reported that a lawsuit was filed over the preventable death of a nursing home resident at Cedarbrook Nursing Home caused by a staffing shortage, a federal lawsuit claims. The suit claims the county-owned facility was “intentionally and grossly understaffed” when resident Shirley Liebenguth fell and later died in 2017.

On July 5, 2017, Liebenguth was being moved by a certified nursing assistant when she was dropped, hitting her face and knees and causing major injury, the lawsuit says.  She needed extensive assistance for all activities of daily living including transfers and bed mobility. Cedarbrook medical records note Liebenguth “rolled out of bed while she was being changed,” but the suit says her fall was “due to the CNA’s lack of training, instruction, supervision…”

She was hospitalized with femur fractures and other injuries, but ultimately died nearly 10 hours later after suffering cardiac arrest and being resuscitated several times, the suit says.

The suit claims Cedarbrook was “intentionally and grossly understaffed” causing a “significant decrease in care that should have been provided” in the two years that Liebenguth was a patient.

 

New British research suggests that high-tech “robopets” are the next best thing for nursing home residents unable to have a beloved pet or those suffering from loneliness.  The robopets stimulate conversations and trigger fond memories of pets or past experiences.

In the new study, Abbott’s group analyzed data from 19 studies involving 900 nursing home residents, family members and staff at centers worldwide. Five different robopets were used in the studies: Necoro and Justocat (cats); Aibo (a dog); Cuddler (a bear); and Paro (a baby seal).

Many nursing home residents were entertained by the robopet even if they realized it wasn’t a real dog or cat. Of course, “residents’ responses could vary according to whether they were living with dementia and according to the severity of the dementia,” Abbott’s team noted.

Some residents talked to the robopet as if it were, in fact, alive and a real animal. Some even made an emotional connection with the “pet.” For example, one resident told staff, “I woke up today and thought, today is going to be a good day because I get to see my friend.”

For others, just holding and stroking the robopet brought “them back into a space in their life where they feel loved,” as one nursing home caretaker put it in the study.

As to whether the robopet felt “real,” one resident’s family member said that it “doesn’t matter, because I can see that the robotic cat has an impact on my dad’s quality of life.”

Besides their other benefits, robopets appeared to boost social interaction with other residents, family members and staff, often by acting as a trigger for conversation, according to the research.

“Of course, robopets are no substitute for human interaction,” she said, “but our research shows that for those who choose to engage with them, they can have a range of benefits.”

The study, which received no private industry funding, was published May 9 in the International Journal of Older People Nursing.

USA Today had the tragic and preventable story of James “Milt” Ferguson Sr., a blind World War II veteran, who died from a head injury suffered at a VA nursing home in Iowa. Ferguson was removed from one-on-one supervision, and he wandered into other residents’ rooms repeatedly, medical records show. When he rolled his wheelchair into one room unsupervised Dec. 20, 2018, his son said VA staff told him the resident of the room flipped Ferguson backwards out of his wheelchair. He landed on his head, causing a massive brain bleed.  A surveillance camera captured footage of James Ferguson Sr.’s fatal injury at a Veterans Affairs nursing home.

People are outraged that he wasn’t monitored more closely and what policies are in place to prevent a similar injury or death.  A USA TODAY investigation that chronicled Ferguson’s case and what specialists say was a concerning series of decisions by VA staff, before and after his deadly injury.

Nursing staff didn’t report the incident for 40 minutes, according to the records and surveillance video. They didn’t take him to the emergency room for more than two hours and he wasn’t transferred to a trauma hospital until five hours after the fall. He died from the injury two days later.
Ferguson was admitted to the acute psychiatry ward at the VA Medical Center in Des Moines in November after his dementia worsened. He had been in a private nursing home but became aggressive and wandered into other residents’ rooms. VA healthcare providers adjusted his medications and placed him on one-on-one observation with an aide to prevent him from straying into other rooms.

But on Dec. 11, 2018, staff removed the strict observation even though he was still determined to be a danger to himself and others, the medical records show. He was transferred to the VA nursing home on the medical center’s campus the next day. Ferguson continued to enter other residents’ rooms repeatedly, but records show staff did not reinstate strict observation.

After the head injury at 3:49 p.m. Dec. 20, Ferguson wasn’t taken to the emergency room until about 6:30 p.m., and he wasn’t transferred to a trauma hospital until 8:55 p.m.

A jury has awarded $6 million to the wife of James Romano, a nursing home resident confined to a wheelchair after breaking his hip in a fall at Clove Lakes Health Care and Rehabilitation Center nursing home.  Romano fell out of a wheelchair on April 14, 2011.  Romano had been brought to the facility a week earlier to undergo short-term rehabilitation for a back fracture suffered when he fell at home on April 1, 2011.

He was supposed to remain for about three or four weeks and then be released home in ambulatory condition.  The nursing home failed to supervise and offer assistance which allowed him to fall while attempting to stand up out of the wheelchair.

Romano suffered a left hip fracture, resulting in partial hip-replacement surgery at Staten Island University Hospital on April 15, 2011. He remained at University Hospital until April 26, when he was returned to the nursing home.  Romano stayed there for about three more years, confined to a wheelchair due to the hip fracture, until his death at age 87 on March 22, 2014.

Delores M. Romano, the victim’s wife, sued the nursing home.  She alleged Clove Lakes was negligent in failing to take preventive measures, such as using a seat belt, restraining belt or a table tray, to prevent Romano from falling out of the wheelchair. In addition, she alleged there wasn’t sufficient staff on duty, and Romano wasn’t properly supervised.

“It made the last three years of his life very difficult,” said the lawyer. “It stole time from his wife and family.”

Herbert said the trial began with opening statements on April 11, and the jury reached a unanimous verdict on April 17.

The panel deliberated about two hours before finding in favor of the plaintiffs, he said.