How To Prove Nursing Home Negligence
Nursing home negligence is one of the worst violations of trust common in U.S. society. It is nothing less than a callous disregard for the well-being of the vulnerable. Unfortunately, nursing home abuse cases have been increasing since the COVID-19 pandemic.
Nursing home residents require steadfast care. They may not have the wherewithal to stand up for their own rights. They may even be easily isolated from their loved ones to prevent them from reporting the negligence.
“It often falls to the loved ones to notice the signs of negligence and prove it in a court of law,” reports Pennsylvania attorney Michael McKarski. It often falls to the loved ones to notice the signs of negligence and prove it in a court of law. Loved ones often face the strenuous objection of the nursing home and the many obstacles they throw in their way.
Read on for signs of nursing home negligence and how to go about making a case:
Fifteen Signs of Nursing Home Negligence
The first step to proving nursing home negligence is to recognize the signs that it is happening in the first place. The indicators can be subtle, but knowing what to look for can go a long way towards catching it.
Common signs of nursing home negligence may include:
1. Mysterious Injuries
Be on the lookout for bruises and cuts. They may be under clothing and your loved one may want to put on a brave face. Prepare to be proactive and ask repeatedly. Ask the nursing home staff to explain the injuries. If there is no satisfactory explanation forthcoming, it might be cause for concern. Abuse is behind one in five ER visits from nursing home residents but sadly, this abuse is underreported, says CNN.
2. Falls and Bone Fractures
Senior citizens are the group most likely to suffer a fall (around 36 million falls a year, as per the CDC). While some falls could happen in the best of nursing homes, negligence can be a major contributing factor to these potentially life-altering incidents.
In the wake of a fall, ask the nursing home for an incident report. If one does not exist or provides vague or flimsy information, it could be a red flag and warrant an additional investigation.
3. Dehydration or Malnutrition
Nursing care providers have a duty to keep charges fed and hydrated. Signs of malnutrition and dehydration can be hard to spot, especially since some of them reveal themselves privately in the bathroom and many symptoms cross over with other causes.
Malnutrition can manifest as:
- Weight loss
- Weakness and fatigue
- Brittle hair and nails
- Dry or flaky skin
- Slow healing of wounds
- Frequent illness indicating immune system suppression
- Paleness, indicating anemia
- Edema (swelling)
- Confusion, forgetfulness, and difficulty concentrating
- Tooth decay and gum disease
Dehydration can manifest as:
- Thirst (naturally)
- Dark urine
- Infrequent urination
- Dry mouth
- Dry skin
- Sunken eyes
- Dizziness or lightheadedness
- Fatigue
- Rapid heartbeat
- Confusion and irritability
4. Poor Personal Hygiene
Nursing care residents often need help grooming themselves. If you notice body odor, dirty clothing, sweaty or greasy skin and hair, unbrushed teeth, or similar, take note. These could be signs that a facility is providing substandard hygiene care.
Look to your town for an expert. For instance, those in Bethlehem can contact a Bethlehem nursing home abuse lawyer to discuss a possible case against a skilled nursing facility.
5. Bedsores
Also known as pressure ulcers, bedsores can be as mild as red areas on the skin (which develop very quickly) or as severe as wounds to the muscle or bone. They develop when too much pressure is placed on a certain part of the body for too long, and are a likely sign that your loved one is being neglected in their bed or chair without routine moving and shifting to prevent these painful and dangerous injuries.
6. Medication Mishaps
If your loved one missed doses of medication, got the wrong dose at the wrong time, or was given the wrong medication altogether, that could be the fault of the nursing home. Look for changes in mood or behavior, and physical symptoms such as dizziness or nausea, and check the medication labels if possible.
7. Lack of Supervision
When you visit your loved one, look around. Do residents seem to be left on their own for long periods of time? This is a potentially dangerous lack of attention that could lead to serious injuries and complications.
8. Changes in Mood or Behavior
Your loved one may be unwilling to talk about abuse or negligence, preferring to be stoic and maintain a veneer of self-sufficiency. However, their frustration or fear may manifest as moodiness, paranoia, sullen silence, or other changes in mood or behavior.
Many families find it tricky to know if behavioral changes are due to conditions like dementia or other types of cognitive decline or the results of abuse. When that happens, reach out to medical and legal experts in your area. A nursing home abuse lawyer in Allentown should be familiar with Allentown and Pennsylvania. This gives you some of the best chances to get to the bottom of the matter and find a solution for your loved ones.
9. Delays in Medical Care
You may notice that medical attention is rendered far too long after an incident — hours or possibly even days. Careful perusal of medical records, incident reports, and witness interviews may tease out this detail.
10. Social Isolation
When you visit, gauge how much social engagement the nursing home facilitates. Does your loved one get to interact with other residents, staff, and volunteers regularly, or are they left on their own for long periods of time? Social isolation can be very hazardous to mental and even physical health.
11. Safety Hazards in the Facility
When you visit, look for slippery floors, trip hazards, lack of banisters and grab bars, excess steps and stairs, exposed flames or electricity, and anything else that might represent a safety hazard to a person with limited mobility or self-sufficiency.
12. Substandard Sanitation
Check for unclean bathrooms — especially urine, feces, and soiled linens or paper products exposed. Check kitchen and dining areas for cleanliness and signs of mold growth or infestations in all quarters and common areas.
13. Staffing or Personnel Issues
There is no one-size-fits-all guideline for staffing ratios of caregivers to residents in nursing homes. Regulations vary by state and region, and staffing needs may vary by patient needs. However, it’s rarely a good sign if the staff looks overwhelmed or frustrated by the workload, or if you can wander the facility and it seems like you never run into a staff member.
14. Lack of Communication
One of the biggest red flags for nursing home neglect is if the nursing home refuses to communicate with you and cuts you off from communicating with your loved one. Whatever their reason, chances are high that they are hiding something they don’t want you to find out.
15. Strange Financial Transactions
Financial exploitation of nursing home residents is depressingly common. If you have fiduciary care or access to your loved one’s finances, look for any unexplained transfer of funds, loans, liens, credit pulls, court filings, etc.
How To Prove Nursing Home Negligence
Noticing the signs of nursing home negligence is one thing. Proving nursing home negligence is another. To get a court to take action and order changes or award damages, you must meet burdens of proof that seem maddeningly high. Nevertheless, if you suspect nursing home negligence, the best action is to roll up your sleeves and go to work to prove it.
Review a general guideline on how to prove nursing home negligence:
Document Everything
In court, it’s all about what you can prove. Start documenting everything. Start a file or spreadsheet where you describe everything you notice, including dates and times. Often this can be used to find corroborating witnesses and catch the nursing home in fibs. More comprehensive documentation than your opponent can go a long way in a court of law.
Obtain Medical Records
Medical records often contain courtworthy clues of nursing home abuse, including the nature of injuries, medications discovered in toxicology reports, explanations of incidents, and time between incidents and administration of care.
The nursing home or even the medical provider might fight you, but HIPAA entitles people to obtain their own medical records. That right often extends to close family members and legal representatives.
Take Pictures
A picture is worth a thousand words. If you notice unsafe or unsanitary conditions, take a picture. Take pictures of any wounds, injuries, or changes in physical condition. Consider taking video or audio recordings if your loved one seems disoriented or confused. Nursing home staff may not like you taking pictures, so be covert with your phone camera or consider a hidden body camera.
Interview Witnesses
Other residents and even conscientious staff members may be a wealth of information as to the operation of the nursing home. Of course, everyone involved may fear reprisals — loss of privileges, termination of employment — from a nursing home that goes into self-defense mode, so this can be delicate.
Scrutinize the Policies of the Facility
Obtain the facility policies and read them thoroughly. You may discover policies that violate regulations or represent inadequate care. Unmet regulations or violations are evidence that the nursing home doesn’t hold itself to the required standards of care.
Talk to Doctors and Experts
Bring your evidence to doctors and other experts in nursing care and get their informed opinion. Get them to swear to those opinions in affidavits. Courts take expert opinions seriously, and the experts may be less vulnerable to reprisals from the accused nursing home.
Check Staffing Levels
Again, there are no set rules of staff-to-resident ratios but obtain a staff roster anyway. A staff-to-patient ratio that seems grossly out of whack may sway a judge or arbiter that something is amiss.
Research the Regulatory History of the Nursing Home
Research is usually part of the due diligence in selecting the nursing home in the first place, but if you suspect negligence, do some deeper research. If the nursing home has a history of regulatory violations, this could undermine its credibility in arguing against your evidence in court.
Talk to Your Loved One
Your loved one is a critical primary source for allegations of elder abuse. It’s happening to them, and they can best describe it. Keep in mind that out of pride, fear, shame, or stoicism, they may be reluctant to fully disclose the negligence, so persistence and delicacy is key.
Preserve Evidence
Back up everything you obtain as both physical and digital copies in multiple places. Store them in secure files or safe deposit boxes, and file them with an attorney or public document registry if possible.
Seek Legal Advice
Any time you intend to seek a legal remedy, it is wise to seek legal counsel. If it’s not professionally handled by an experienced legal operator, even an airtight case can fall apart. Some nursing homes may have deep pockets to hire quality lawyers to depend on them and find issues with your evidence.
If you want the court to enforce your loved one’s rights, consider recruiting an attorney specializing in nursing home negligence as their champion. Talking with an Easton nursing home abuse lawyer, for example, can be a great place to start.
How To Prove Nursing Home Negligence With Legal Assistance
Proving nursing home negligence can be frustratingly complicated, but our vulnerable loved ones count on us to look out for their interests when they cannot. Above all, don’t hesitate to seek legal representation. An attorney who specializes in nursing home neglect can make expert recommendations on how to verify to court standards your gut feeling that all is not well with your loved one’s nursing care.
Sources:
Who must follow HIPAA? | HealthIT.gov
Malnutrition: Symptoms, causes, diagnosis, and treatment | Medical News Today
Nursing home abuse frequently goes unreported, government agency finds | CNN
US: Concerns of Neglect in Nursing Homes | Human Rights Watch
Keep on Your Feet—Preventing Older Adult Falls | Features | Injury Center | CDC