Articles Posted in Elder Abuse

In their ongoing series on nursing oversight in the State of California, Tracy Weber and Charles Ornstein of ProPublica are out with another story about California’s shortcomings in regulating healthcare professionals. Weber and Ornstein reveal that the national database that tracks dangerous or incompetent caregivers is missing serious disciplinary actions against “what are probably thousands” of health care providers. The revelations apparently surprised federal health officials, who just last month proclaimed that “no data is missing.”

For almost twenty years the federal government has kept a database of disciplinary actions against doctors and dentist, and in 1999 individual state boards were required to include in the database reports on all other healthcare professional, including nurses, whose licenses were restricted or revoked. In California, however, not all penalized caregivers were included in the federal database. For example, California has formally disciplined 84 psychiatric technicians over the last two years, yet the federal database does not contain a single report of discipline against a psychiatric technician in the State of California.

The dangers of an incomplete database are obvious, as Dr. Sidney M. Wolfe of the Public Citizen’s Health Research Group observed, prospective employers of health care professions could be given “a false sense of security that somebody who may be really dangerous isn’t, because their name isn’t there.”

In 2007, Dr. David Graham, a drug safety expert with the FDA, testified before Congress and stated that approximately 15,000 people die each year in U.S. nursing homes from the off-label use of anti-psychotic drugs. Off-label use is the use of the drug for a condition it was not intended. In California, it has been estimated that up to 60% of all nursing home residents are given psychoactive drugs, which is an increase of 30% in only 10 years. It’s no wonder that when we think about nursing homes, we think of isolated elderly people sitting hunched over in wheelchairs, or in bed, segregated from the world. That life is a sad realty for many.

To combat the misuse of psychoactive drugs, the California Advocates for Nursing Home Reform have released a publication called Toxic Medicine – What You Should Know to Fight the Misuse of Psychoactive Drugs in California Nursing Homes. The 20-page booklet provides an overview of what psychoactive drugs are, their purposes, the risks associated with them, and an overview of the resident’s rights.

Primary among those rights is the requirement of consent. Before a psychoactive drug can be used, a physician must inform the resident (or his/her decision-maker) about the drug, why it is being recommended, and the risks associated with it, and then must obtain consent before prescribing it. The guide also provides a list of questions that should be asked of a doctor who is recommending a psychoactive drug, and what to do if it is suspected that the drugs are being used without proper authority.

This story is flat-out disturbing, and started with a concern we have heard many times from the families of our nursing home abuse clients. It began with Phyllis Peters could not wake up her 97-year-old mother, who was residing in Kern Valley Nursing Home. When she complained to Gwen Hughes, the nursing home’s director, Hughes would “chemically restrain” the patient by giving her powerful anti-psychotic drugs to shut her up. Hughes did this to other residents in the nursing home, and three of them died.

In a report from the California Attorney General, Hughes ordered one patient drugged because she “glared” at her. Another was given high doses of an anti-psychotic drug for throwing a carton of milk. Several residents became severely malnourished, and were left in bed drooling and emaciated.

“In a couple cases, elderly people were actually held down, restrained against their will, and given excessive amounts of medicine to keep them quiet,” said AG Jerry Brown.

When a person has very serious concerns that a nursing home resident has been subject to abuse or neglect in the home, a complaint may be filed with the state. The California Department of Public Health (DPH) licenses and certifies all nursing homes in California, and maintains a process for investigating all complaints made against nursing homes.

The process of filing a complaint with the DPH is fairly straightforward, and the California Advocates for Nursing Home Reform have summarized it nicely:

1. Who Can File a Complaint? Any person, or even an organization, can file a complaint about nursing home neglect with the DPH. While it is usually a family member, it doesn’t have to be.

A Ventura nursing home called Fillmore Convalescent Center, its owner, and one of its employees were hit with a $7.75 million verdict yesterday after a jury found them liable for elder abuse. It has to be one of the largest verdicts in California in a case involving nursing home abuse or neglect.

The facts are egregious. In 2006, the family of 71-year-old Maria Arellano, a stroke victim who was also non-verbal, began to notice suspicious bruising. They complained to the nursing home administration, but it failed to look into it. The family then placed a hidden camera in Ms. Arellano’s room, which caught caregiver Monica Garcia slapping Arellano, pulling her hair, bending her fingers, and treating her violently. When the tape was revealed, Garcia was charged with criminal acts, and the family brought an elder abuse lawsuit against the nursing home.

The lawyer for Arellano, Greg Johnson, must have done an excellent job. He told the Ventura County Star that he offered to settle the case for $500,000, but was rebuffed. The nursing home, through its attorney Tom Beach, never offered a dime to resolve the case. “There was a lot of arrogance,” said Johnson.

The Fallbrook Hospital District Skilled Nursing Facility was fined $90,000 by the California Department of Health in a case involving the fall and subsequent death of a resident. The citation was the most severe of its kind arising from inadequate care leading to the death of the resident. Although the resident was known to have a high risk for falling, the Fallbrook nursing home failed to take adequate measures to prevent the fall. The resident fell, broke his leg, and died four days later as a result of complications from the surgery to repair his leg.

The Walton Law Firm successfully prosecutes cases involving injuries caused by falls in the custodial care setting. If you have questions about falls, please submit your confidential question online, or call Walton Law Firm for a free consultation. We can be reached toll free at (866) 607-1325 or locally at (760) 607-1325

When police came to a San Bernardino board-and-care home looking for 23-year-old Trevor Castro, they found Castro and a whole lot more. Upon arrival they found a bucket of urine outside the door, and inside found outright squalor. The discovery led to the arrest of the home’s owner, 61-year-old Pensri Sophar Dalton, who is currently being held on 16 counts of felony elder abuse.

According to reports, Dalton, who was called “Mama Sophar,” ran a prison-like home – which was unlicensed – for 22 elderly and mentally ill residents in San Bernardino County. The home was surrounded by cinderblock walls with barbed wire atop. Several residents lived in converted chicken coops with no plumbing. A bucket was used for a toilet.

“None of [the chicken coop rooms] were up to code,” said City Atty. James Penman. “They had some with padlocks on the outside and no emergency exits, which concerned us because it could be used to lock people in as well as lock people out. The smell of urine was horrific; it permeated the entire place.”

Aggressive behavior by nursing home residents is on the rise, and is becoming a big problem in nursing homes and residential care facilities around the country.

Resident-on-resident aggression is substantially more common than previously thought,” said Dr. Karl Pillemer, a Cornell University gerontologist. “While they are mentally impaired, they are not physically impaired. They can do considerable damage.”

It is estimated that roughly half of Americans over the age of 85 suffer from Alzheimer’s disease or some other form of dementia. With the population of elderly set to explode in the next 20 years – those 65 or older will make up 20 percent of the U.S. population – most experts agree that the problem is only going to get worse.

Police arrested a nursing home resident after he punched a fellow resident because he thought the man was stealing his food. According to new accounts, Ardyce Nauden was charged with aggravated battery after punching 72-year-old and wheelchair-bound Andres Cardona in the face, knocking him unconscious.

Nauden allegedly stated, “He was trying to steal my food and that is why I hit him. I held onto the bed with my right hand and hit him with my left hand.”

Peer-on-peer resident abuse in the nursing home setting is not uncommon. A study by Cornell University found that aggression and violence between residents is more prevalent than abuse or neglect from nursing home employees. According to the Cornell study, peer abuse is nursing home is a problem that has received little attention.

The California State Assembly voted overwhelmingly to approve Assembly Bill 392, which would immediately restore $1.6 million to Long-Term Care Ombudsman programs throughout the state. Much of the funding to the programs was cut last year when Gov. Schwarzenegger vetoed the Ombudsman funding request.

In June 2009, a nursing home owner was arrested on allegations of criminal abuse and neglect, when a resident of his facility was so severely neglect that pressure sores went untreated and led to a fatal infection. Numerous nursing homes throughout the state have received citations for failing to provide adequate care of residents. Without an Ombudsman program, it is difficult to monitor the care the residents of these facilities.

“We need to take every step we can to protect seniors who may be at serious risk of abuse or exploitation,” said Assembly member Mike Feuer (D-Los Angeles), who authored the bill. “The funds provided to Ombudsman programs in AB 392 fill this important need during the next year. Isolated and vulnerable residents of nursing homes and assisted living facilities have nowhere else to turn, and their lives depend upon these programs being restored immediately.”

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