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Medical Issues Associated with Nursing Home Abuse

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Falls, injuries and other medical issues are a reality for many older adults. Some accidents, however, are preventable. Poor care, abuse and neglect in nursing homes are often associated with dangerous and potentially life-threatening medical conditions that would not have occurred if not for the abuse or neglect.

If you or your loved one has suffered falls, fractures, pressure sores, malnutrition and dehydration, bed injuries, medication errors, other injuries or even death in a nursing home setting, substandard care may be to blame. You may wish to contact a personal injury lawyer who can investigate your claim and help determine if you have grounds for a nursing home abuse lawsuit that can help defray the cost of care and deter the facility from continued poor conduct. To learn about the various types of nursing home abuse, please read our article covering this topic.

Common Medical Issues

Falls and Fractures
It is estimated that as many as three out of four nursing home residents fall each year. Possible injuries from falls include cuts, bruises, infections, swelling, pain, fractures and head injuries. The long-term effects of falls can be very serious, possibly resulting in disability, functional decline, isolation, depression and reduced quality of life. Worse still, as many as 1,800 nursing home residents die each year from fall-related injuries.

Probability of Falling

There are several risk factors associated with the probability of falling in patients older than 75 years, including:

  • Sedative use
  • Cognitive impairment
  • Lower extremity disability
  • Palmomental reflex (an involuntary reflex of the muscles of the chin)
  • Abnormal balance/gait
  • Foot problems

The probability of falling is 8 percent with no risk factors, 19 percent with one risk factor, 32 percent with two risk factors, 60 percent with three risk factors and climbs to 78 percent when more than four of these risk factors are present.

Source: New England Journal of Medicine

Older adults are at a greater risk of falling because of mental and physical challenges associated with this population (see sidebar). However, in many cases the nursing home may be responsible for a resident's fall. For example, an estimated 16 to 27 percent of falls are attributable to environmental hazards in nursing homes, such as wet floors, poor lighting, incorrect bed height, and improperly fitted or maintained wheelchairs.

Pressure Sores
According to a recent report, 11 percent of nursing home residents have pressure sores. Pressure sores are painful ulcers resulting from prolonged pressure on a bony area of the body such as the hip, back, buttocks or ankle. While some pressure sores are caused by medical conditions, often times they are caused or exacerbated by inadequate care in the nursing home. A nursing home may be liable for pressure sores and any ensuing complications if they were caused by:

  • Malnutrition and dehydration
  • Failure to change and/or correctly reposition residents, especially those who are wheelchair bound or bedridden.
  • Moisture from unchanged diapers, clothing and sheets
  • Failure to report pressure sores by nursing home staff

Complications relating to pressure sores can be very serious, including sepsis (life-threatening infection in the bloodstream), bone and joint infection and death. Actor and activist Christopher Reeve was paralyzed in an accident and subsequently died as a result of an infected bedsore.

Elder Abuse and Dementia

People with dementia are at a greater risk of elder abuse. In fact, a recent study found that almost half of all people with dementia experience some type of abuse. Dementia affects a very large population and the problem is only getting worse. As many as 50 percent of all people over the age of 85, and more than 5 million Americans in total, currently suffer from Alzheimer's disease or some other type of dementia. In addition, adults over 85 are now the fastest growing population segment in the United States, and by 2025 most states are expected to see an increasing incidence of Alzheimer's disease.

Source: Center of Excellence on Elder Abuse and Neglect, University of California at Irvine

Malnutrition & Dehydration
Federal law requires nursing homes to assess residents for risk of malnutrition and dehydration upon admission and every three months thereafter. If a resident is at risk for malnutrition and dehydration, the nursing home should establish a program for the resident which includes assistance with eating and drinking. In addition, the nursing home should offer fluids at mealtime and in between meals. Malnutrition and dehydration can lead to many serious health problems, including:

  • Muscle weakness
  • Pressure sores
  • Pneumonia
  • Fall fractures due to weakness or immobility
  • Loss of muscle mass
  • Anemia
  • Confusion and disorientation
  • Urinary tract infections
  • Anemia
  • Death

If a nursing home fails to take reasonable steps to prevent dehydration and malnutrition, such as properly educating the staff on nutrition and feeding methods, or to prevent nursing home abuse of any kind, it could be liable for nursing home abuse.

Medication Errors
Recent studies suggest approximately 800,000 preventable drug-related injuries occur each year in long-term care settings. Medication errors, particularly with sedatives and anti-anxiety medication, can increase the risk of falls and fall-related injuries. Other potential medical complications from medication errors include:

  • Depression and confusion
  • Adverse drug interactions
  • Severe allergic reactions
  • Sudden cardiac arrest
  • Death

Instances where the nursing home may be liable for drug-related injuries include administering medication to the wrong patient, administering the incorrect dose of medication, dosing at incorrect intervals and failing to monitor drug reactions.

Physical restraints (e.g., waist vests, bedrails, and geri-chairs) and chemical restraints (e.g., sedatives) can be effective tools to prevent residents from hurting themselves and others. However, poor outcomes associated with restraints include:

  • Body system changes such as poor circulation, constipation, incontinence, weak muscles and bone structure, pressure sores, agitation, depressed appetite, infections
  • Bleeding, bruising, cuts, head injuries and death relating to use of excessive force
  • Entrapment and side rail deaths by strangulation and suffocation caused by improper application of restraints
  • Isolation and depression

Nursing home abuse or neglect may exist when restraint injuries are associated with excessive or improper application of force applied as punishment, for staff convenience, to compensate for inadequate staffing, or otherwise.

Legal Liability

There are a multitude of federal and state laws that seek to protect the rights of nursing home residents. If a resident is harmed as a result of a nursing home's failure to report nursing home abuse or to abide by one or more of these laws, there may be grounds to make a claim for compensation. Different claims, such as negligence, breach of contract, assault and battery, and wrongful death, have different time limits in which you can file. Speak to a lawyer as soon as possible so that you do not run out of time to bring your case.

Did You Know?

At least twice as many adults in nursing homes fall as compared to older adults living in the community.

Source: Centers for Disease Control


Over 20 percent of the United States population is expected to be over the age of 65 by 2030.

Source: Department of Health and Human Services, Administration on Aging