California Elder Law Attorney Blog

Maintaining or improving the ability to move around is one of the most effective ways to minimize the risk of developing bed sores, pressure ulcers also known as decubitus ulcers. People who are not confined to bed should be encouraged to move from bed to chair and to stand and walk. Attention to posture, balance, and weight distribution (eg, shifting weight every 15 minutes) can help people when sitting. People who are bedbound can still benefit from various exercises that put their joints through a range of motion.

Bedbound people should be repositioned frequently to relieve pressure over bony areas. How often someone should be repositioned depends on the person's health and the quality of the supporting surface (eg, some beds are designed to decrease the pressure on bony areas of the body). Older adults at risk of developing pressure ulcers should be repositioned at least every 2 hours.

People who are likely to develop pressure ulcers should be repositioned often, changing from the back to their right side and then to their left side, keeping the back at a 30° angle to the bed surface. This avoids direct pressure on the bony areas of the lower back, hips, heels, and ankles-the sites where 80% of all pressure ulcers develop.

Continue reading "The Best Way to Deal With Pressure Ulcers is to Prevent Them Before They Start" »

Nursing Homes routiningly place patients who weren't incontinent in adult diapers, a practice that is not only humiliating but can also lead to sores, infection and incontinence. here is what transpired in a California nursing home which is currently in litigation:

■ Pressure sores developed and went untreated, leading to infection, bone damage and sometimes amputation.

■ Medication errors were prevalent.

■ Patients suffered from dehydration and malnutrition,

■ For one patient during a period of slightly less than eight months, there were 188 days in which no nursing notes were entered to chart his care.

■ Another patient received only four showers in 43 days .

Former residents or their family members have filed at least three lawsuits alleging the residents failed to receive proper care, a failing that in some instances led to death.

Continue reading "Nursing Home Neglect Causes Unwarranted Litigation For Wrongful Death" »

SB 558 (Simitian) helps prevent physical abuse of elderly and dependent adults by providing stricter civil enforcement of the Elder and Dependent Adult Civil Protection Act (the Elder Abuse Act), which protects the rights of seniors and dependent adults living in nursing homes, other short and long-term care facilities or private homes. SB 558 strengthens enforcement of the Elder Abuse Act, but lowering the burden of proof from "clear and convincing evidence" to "preponderance of evidence."

It is estimated that over 132,000 elders in California are abused every year. However, for every abuse reported, research has found that at least 5 others go unreported, making the actual number of abused people much higher than the reported rate. Studies also show that neglect and abuse of nursing home residents have reached epidemic proportions. Yet many residents who suffer neglect and abuse find it virtually impossible to seek justice in court. The U.S. General Accounting Office (GAO) published a report in March 2002 Entitled "Nursing Homes: More Can Be Done to Protect Residents from Abuse." The report cited the lack of protections afforded to abused nursing home residents.SB 558's " preponderance of the evidence standard" is consistent with financial abuse cases and most other civil causes of action, such as negligence and normal tort cases. The "clear and convincing evidence" standard is nearly impossible to meet, particularly in facilities where few witnesses to the abuse exist, and where the victim is also old, sick or disabled. The Elder Abuse Act has good intentions, but has a very difficult burden of proof for abuse occurring in a nursing homes.

Elder Financial abuse and negligence cases use the "preponderance of evidence"
standard proposed by SB 558.

Nursing home residents need protection from physical abuse already, and the
need will grow as more residents are in nursing homes and watchdog agencies'
funding decrease .

Continue reading "Elder Abuse Standard Of Proof To Be Lowered in California Indicates San Francisco Nursing Home Abuse and Neglect Lawyer Steven Peck" »

Pressure sores, Bed Sores also known as Decubitus Ulcers can be treated, and often cured, by adjusting the patient's position regularly. They are most often caused by sitting in the same position for extended periods of time, which ultimately impedes blood flow to the affected areas. Once the patient has been repositioned, the wound must be cleaned and properly dressed to prevent further infection. It's a fairly straightforward system of care, but if left untreated, pressure sores can extend deep into the tissue, leaving an open wound. In severe cases, the wound will extend to the muscle, tendon, or bone.

Unfortunately, though the steps of treatment are uncomplicated, negligent nursing homes fail to provide this care to residents, which ultimately results in the patient's death. If you or a loved one is in a situation involving nursing home negligence, you may feel that help is beyond reach. Our Peck Law Group nursing home abuse and neglect attorneys have handled hundreds of cases and have fought relentlessly on behalf of mistreated patients, and we will help you!!!

Continue reading "Pressure Sores, Bed Sores also known as Decubitus Ulcers Can be Treated and Cured" »

July is Elder Abuse Awareness Month. Why is that significant? Studies show that in up to 90 percent of elder abuse cases, the abuser is a family member or trusted advisor. According to AARP, the financial exploitation of the elderly costs as much as $2.6 billion per year.

As part of its findings at the beginning of its recently enacted Elder Justice Act, Congress stated that the "proportion of the United States population age 60 years or older will drastically increase in the next 30 years as more than 76,000,000 baby boomers approach retirement and old age." It further noted, "Each year between 500,000 and five million elders in the United States are abused, neglected or exploited." And perhaps most importantly, "most cases ... are never reported."

What is elder abuse? It comes in many forms. The Peck Law Group identifies seven types that, in reality, are not mutually exclusive: physical, sexual, emotional, confinement, passive neglect, willful deprivation and financial exploitation.

Continue reading "Elder Abuse Awareness is Significant" »

At least a third of the 1.9 million nursing home residents in the United States may suffer from malnutrition or dehydration, conditions that can aggravate or cause more severe medical problems such as bed nsores and decubitus ulcers, tooth decay, broken bones, anemia, and low blood pressure--or in some cases even death.

Despite federal laws--including the Nursing Home Reform Act of 1987--that require nursing homes to meet residents' nutrition needs, one study cited in the report found as many as 85 percent of the elderly living in some of the nation's more than 20,000 nursing homes are malnourished. And in some nursing homes, from 30 to 50 percent are underweight. "The extent of malnutrition and dehydration in some American nursing homes is comparable to that found in many poor, developing countries where inadequate food intake is compounded by repeated infections," says California Nursing Home Abuse and Neglect Attorney Steven Peck.

Undernourished residents suffer from any number of ailments that could easily be prevented if they were properly nourished. Unless action is taken, the incidence of malnutrition and dehydration is likely to become an even more serious problem as more Americans live longer.

Malnutrition and dehydration have a variety of causes. Inadequate staffing, a lack of individualized care, high nurse aide turnover, and other structural factors within the nursing home setting contribute to the problem. The understaffing situation at nursing homes is underscored by the fact that one certified nursing assistant (CNA) typically must help seven to nine residents eat and drink during the daytime, and as many as 12 to 15 during the evening meal. Ideally the ratio should be one CNA for every two or three residents who require eating assistance, Compounding the problem is the profession's 93 percent yearly turnover rate, which leads to inconsistent care. Chronic conditions such as depression and cognitive impairment--and the side effects of treatments for these conditions--are also a major factor. Residents suffering from depression, for example, are more likely to experience weight loss, the study says. Another obstacle to good nutrition is that nursing home residents commonly have a limited choice in what they eat, with their cultural and ethnic food preferences frequently ignored. Poor dental health also contributes to inadequate nutritional intake.

Malnutrition, dehydration, and weight loss in nursing homes constitute one of the largest silent epidemics in this country says Elder Abuse Lawyer Steven Peck.

Continue reading "One Third of Nursing Home Residents Suffer From Dehydration and Malnutrition" »

Long-term care residents also are often highly functionally impaired. Many are incontinent, immobile, and confused or demented. The worse the functional status, the greater the likelihood of infection or colonization with resistant microorganisms

For example, incontinence and impaired mental status have consistently been associated with asymptomatic urinary tract infection . MRSA colonization is more likely to be identified in residents with pressure ulcers or fecal incontinence or who are bed bound or require feeding tubes or urinary catheters . In most cases, impaired functional status is a determinant of admission to long-term care and is not modifiable. If the major predictors of infection in long-term care facilities are poor functional status and co-existing chronic illness, and these conditions cannot be altered, to what extent is it realistic to anticipate that endemic infections can be prevented in such residents? In addition, with the number and severity of existing conditions, how much illness or death is attributable to infections per se, rather than to underlying chronic disease? Assessing the impact of infection on patient outcome in evaluating interventions to prevent infection is, thus, often problematic. An example is a decision to provide comfort care but not to treat pneumonia with antibiotics in severely impaired patients.

Continue reading "Infections in Long-Term Care Facilities" »