Water, Water Everywhere, but Not a Drop to Drink

Imagine this – you are left in a room with no access to water or you are incapacitated and have had no fluids for several hours or even days.  Worse yet, you are taking medications that also have a diuretic effect and your body is thirsty for fluids.  The only way to replenish any fluids that your body so badly needs is to call for an attendant, but you can’t communicate and no one checks up on you.  What then?

This is too often the case for many nursing home patients.    Dehydration is one of the most common ailments resulting from elder neglect.  It occurs when a patient is not given enough fluids and, as a result, is unable to perform normal body functions.  When a person is dehydrated, his or her body has lost too much fluids and electrolytes.  While dehydration in general is harmful, it is especially so among the elderly as they are more susceptible to contracting urinary tract infections, pneumonia and bed sores.  If the patient is extremely dehydrated, death can occur.

Dehydration can also lead to a severe medical condition called hypernatremia.  Hypernatremia is an electrolyte problem characterized by a decrease in total body water relative to the body’s total sodium levels.  It is caused when the total water intake is less than the total water loss or when a person receives inadequate water intake.  A major symptom of hypernatremia is thirst, but other clinical manifestations can exist including confusion, seizures and coma.  In critical cases, hypernatremia can lead to organ failure.

With nursing homes that are understaffed, overworked, and improperly trained, it is no wonder that dehydration is so prevalent in nursing homes today.  Nursing home patients cannot monitor their fluid intake themselves, often requiring assistance taking fluids.  The responsibility of carefully monitoring and administering necessary fluids to patients falls on the nursing home facility and its employees.

Yet, many nursing home employees do not properly administer fluids to their patients.  This can be a result of carelessness (when employees forget to give their patients fluids), leaving water beyond the reach of their patients, or relying on the patient to drink the water him or herself when the elder is simply incapable of doing so.  They can also create situations which increases the risk of dehydrating the patient, such as exposing the older individual to hot temperatures or not identifying drugs that act a diuretic.  Dehydration can also be caused by excessive fluid losses due to illness, or even side effects from medication.  Diarrhea is the most common cause of dehydration, and vomiting also leads to loss of fluids.

The best way to treat dehydration is to prevent it from occurring.  When patients are bedridden, they cannot be left in their room for hours or days at a time without a nursing home employee carefully monitoring them and administering proper fluids.  They must also be sure not to cause dehydration by leaving patients in hot rooms without water, to make sure all water that is given to patients is within reach and that the patient can drink it (and, if not, the staff must assist the elder), or giving the patient drugs that are diuretics without replenishing the fluids lost.

York Law Firm understands the importance of caring for nursing home patients to enable them to thrive.  When dehydration occurs, injuries resulting reduce their ability to thrive, and may even cause their death.  That’s why York Law Firm is so dedicated to helping patients of nursing home abuse.  If your loved one is a nursing home resident who has suffered injury as a result of dehydration, contact one of our many experienced elder abuse attorney to determine whether you are entitled to recovery.

York Law Corporation
Sacramento, California
www.yorklawcorp.com
Call today: (800) 939-1832
Local: (916) 643-2200

What Nursing Home Facility is Right for my Loved One?

Choosing a nursing home facility is a daunting task.  There are reasons why nursing homes are deemed undesirable – many provide inadequate care, and smell like urine and death.  Here are some steps you can take to ensure that your loved one is receiving the best possible care.
First, get a durable power of attorney for medical care so that you can make health care decisions and review medical records for your loved one.

Second, request a complete facility profile from the State Health Department, Licensing and Certification Department for the facility you intend to use. For more information, visit the website for the California Department of Public Health, or call them at (916) 558-1784.

Third, visit the surrounding facilities.  Pay attention to staffing levels – are their sufficient staff meeting the needs of residents?  Notice how many people in the facility seem overmedicated, excessively sleepy or in bed or unable to walk or talk.  If many patients fall into this category, be wary of overmedication at the facility, especially with the psychotropic drugs Haldol, Thorazine, Thiothixene, Droperidol, Fluphenazine, Midazolam, Benzodiazepine, Lorazepam, Mellaril and Prolixin.

Fourth, when reviewing the Admission Agreement, do not agree to and do not initial any arbitration clause.  An arbitration clause is a provision in the admission agreement that tries to force families to waive your right to a jury trial for any potential claims you or your loved one might have against the nursing home.  You are not obligated to agree to or initial an arbitration clause as a condition to having the patient be admitted to the facility.  Arbitration clauses are not favorable to consumers, as it is a waiver of your right to a jury trial and potentially limits your ability to hold a nursing home accountable for neglect or abuse.

Fifth, visit your family member at different times during the day, including meal times. Take notice of the types of food and nutritional balance. Dehydration can lead to major problems (hypernatremia, neurological losses, increased risk of developing bed sores, death).  So always make sure that water is available at all times and that it is easily accessible to the resident.  If your loved one cannot access water due to a disability or limitation (e.g., blind, hand injury, etc.), consult with the nursing facility so that a care plan can be addressed to ensure that your loved one receives adequate fluids throughout the day.

Sixth, be involved in care conferences.  Tell the Administrator or Director of Nurses that you want to be informed of and present at all care conferences to know what the plan of care is for your loved one.

Take seriously any complaints the patient has about mistreatment by the staff, such as “they pull my hair” or “they are mean to me.” Don’t accept the facilities’ statement that the patient is old and doesn’t know what is going on.

Report any signs of bad care to the state licensing office in your state that licenses and regulates nursing homes. Be sure to follow up on the complaint to insure accountability.  The California Department of Public Health’s number is (800) 236-9747, or you can fill out a formal complaint online.  You can also contact your County hotline to report instances of abuse.

Do not be intimidated by threats from the facility such as kicking the patient out of the facility because of complaints or the facility’s refusal to cooperate with requests for information.

York Law Firm is dedicated to providing people with the knowledge to avoid nursing home abuse of their loved one.  If you do need an attorney to help protect your legal claim, we encourage you to contact us.  We specialize in nursing home abuse cases.

York Law Corporation
Sacramento, California
www.yorklawcorp.com
Call today: (800) 939-1832
Local: (916) 643-2200

Medicare Attempts to Reduce Health Care Costs and Promote Patient Safety

Certain types of medical errors should never happen.  According to the California Association of Health Plans, preventable medical errors are a leading cause of death in the United States, resulting in over $4.5 billion in additional health spending annually.  Beginning in October 2008, in an attempt to increase and promote safety and wellness and to reduce health care costs, Medicare, Aetna, and other major health care insurers have banned payments for “never events.”  Specifically, Medicare no longer provides additional payment to hospitals unless the events were present at admission. Think about it, it makes sense – why should Medicare insure hospitals and nursing home facilities for events that should never have happened in the first place?

“Never events” are conditions that could have reasonably been prevented.  There are 28 preventable adverse health events that are listed as “never events.”  To be a “never event,” an event must be characterized as the following:

• Unambiguously identifiable and measurable;
• Preventable; and
• Resulting in serious injury or disability, or even death.

Not surprisingly, among the list of “never events” is stage 3 or 4 pressure sores acquired after admission to a healthcare facility.  Pressure sores, also known as pressure ulcers or bed sores, are a result of hospital or nursing home neglect.  When a person is bedridden or in a wheelchair for an extended period of time, circulation is cut off to parts of the body and the sustained pressure creates areas of damaged skin and tissue.  Prolonged pressure on one area of the body can quickly develop into pressure sores.

So why are pressure sores listed as “never events”?  Because all it takes is an attentive caregiver to reposition the patient to eliminate the risk of developing one, along with proper hydration and nutrition.  Pressure sores are an unequivocal sign of neglect.  They wouldn’t happen were it not for the hospital or nursing homes failure to reposition the patient.  Period.

York Law Firm believes this is the first step of many steps to prevent nursing home abuse and neglect.  We understand that pressure sores are extremely dangerous to elders, as they can rapidly progress and can become infected, causing systemic infection and even death.  Unfortunately, too many of our nursing home clients have sustained bad pressure sores, and we have helped them understand their legal rights, held the nursing home accountable and have obtained compensation for their injuries.

York Law Corporation
Sacramento, California
www.yorklawcorp.com
Call today: (800) 939-1832
Local: (916) 643-2200