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Bedsores and Other Signs of Nursing Home Neglect

As our population grows older the prevalence of nursing home neglect unfortunately seems set to rise as well. A nursing home that is understaffed, lacks adequate training protocols, or doesn’t provide proper management and supervision can leave residents with insufficient care. Under Nevada law neglect is defined as a failure “to provide food, shelter, clothing or services within the scope of the person’s responsibility or obligation, which are necessary to maintain the physical or mental health of the older person.” NRS 41.1395(4)(c). Family and friends who visit residents of nursing homes can protect their loved ones from neglect by watching for these common signs:
  • Bedsores. Bedsores, or pressure ulcers, can result if a person is left in a single position in a bed or chair for a long period of time. The sores can be painful at first and can lead to more serious problems, like damage to underlying tissues. A nursing home should have procedures in place to prevent bedsores.
  • Unexplained injuries. A nursing homes should follow strict procedures to document injuries to residents. An undocumented injury should be treated as a warning sign that the staff is not doing an adequate job of watching over the residents. Of course, a resident may fall or injure themselves while a staff member isn’t looking. But if the injury goes unnoticed and undocumented, broader problems may be at work.
  • Malnutrition or dehydration. Nursing home residents often lack the ability to take care of their own food or water intake. Inadequate food or hydration may result in visible signs or may be revealed in a routine blood test.
  • Lack of bathing or cleaning. Nursing home residents typically need considerable help keeping themselves, their clothes, and their living spaces clean. Common problems with incontinence make sanitation especially important in nursing homes. A home that doesn’t take care to keep its residents reasonably clean may be committing neglect.
Nursing home neglect is a serious problem that isn’t necessarily easy to discover. Facilities that aren’t well run may try to mask inadequate procedures in various ways. Family members and friends of residents need to pay attention to details and trust their instincts if they think something is wrong. A medical exam by an outside physician may be needed to establish that something isn’t being handled well. For more than 45 years the law firm of Greenman Goldberg Raby Martinez has represented clients in personal injury cases. We have a long tradition of providing authentically caring service to clients who are faced with difficult circumstances. If you have questions about potential neglect at a nursing home, please reach out to us today for a free attorney consultation. Call us at 702-388-4476, or ask us to call you through our contact page.

Overmedication in Nursing Homes

Placing a loved one into the care of a residential nursing facility involves a high degree of trust. Caregivers in nursing homes, from unlicensed assistants to the licensed nurses and doctors who oversee medical services, are placed in a challenging position of managing the wellbeing of people who cannot fully care for themselves. Dispensing medication is a key function of nursing homes. It can also be a source of problems. Overmedication can be a consequence of abuse, where the dispensing employee is deliberately trying to harm the patient. But it can also arise where a facility’s staff overuses medication to keep residents under control.

Professional negligence in a nursing home context

Given the complex challenges involved in caring for especially infirm patients, it’s easy to understand why caregivers can make choices that, after the fact, appear to have been wrong. The nursing home context may on the one hand give some leeway for professionals to administer medication for palliative purposes. But the risks in the nursing home context only heighten the importance of good practices and careful medication management. Overmedication could be a sign of professional negligence. In Nevada, professional negligence is defined as “the failure of a provider of health care, in rendering services, to use the reasonable care, skill or knowledge ordinarily used under similar circumstances by similarly trained and experienced providers of health care.” NRS 41A.015. The definition of “provider of health care” for professional negligence purposes is limited to (among other things) licensed physicians and nurses, as well as licensed hospitals, clinics, and other organizations that employ such professionals. It’s worth noting that the operator of a nursing home may not fall under this definition if it has “outsourced” its medical care. Instead, the licensed professionals overseeing and administering care, as well as their employer, will need to be identified. The complex conditions in a nursing home may make a professional negligence claim more difficult than might be the case in an ordinary case of medical malpractice (i.e., objects left in a patient’s body after surgery). The decisions made in connection with a resident’s care will be measured according to a “reasonableness” standard, which leaves ample room for professionals to use their judgment when doing things like administering medicine. To successfully sue, the plaintiff will need to gather supporting facts to show that the nursing home staff administered medications in a way that was not reasonable under the circumstances. For example, it may be unreasonable to keep a patient continuously sedated for the convenience of the staff rather than because the patient is especially prone to risky behavior.

When negligence turns into abuse

Unfortunately, abuse in nursing homes is more common than one would hope. Nevada law defines unlawful abuse as the willful and unjustified infliction of pain, injury, or mental anguish upon a victim who is 60 or older or is physically or mentally impaired. NRS 41.1395. If nursing home staff is intentionally overmedicating a patient not for professionally reasonable purposes but rather to deliberately cause the patient injury, an abuse claim may apply. A successful claim of abuse can recover double damages. Cases involving overmedication will involve difficult questions of proof. Blood testing or an autopsy may reveal that the patient had toxic levels of medication in their system. However, the question is not just whether too much medicine was administered, but whether the medicine was justified under the circumstances. Once again the professional judgment of the caregivers will be carefully examined. Perhaps the patient needed to be perpetually sedated due to a tendency toward self-harm. On the other hand, evidence like statements about a desire to hurt patients could shift the analysis the other way.

Call a Las Vegas personal injury lawyer to discuss your case

If you are concerned that your loved one may have suffered neglect or abuse in a nursing home it’s essential to speak to an attorney as soon as possible. Greenman Goldberg Raby Martinez has helped clients in the Las Vegas area recover compensation in personal injury cases for over 45 years. For a free attorney consultation call us at 702-388-4476 or contact us through our website.

Potential Signs of Nursing Home Abuse

As a population, residents in a nursing home are especially at risk for abuse. The families and loved ones of nursing home residents should understand the signs of abuse so they can take steps to stop it. In some cases, it may be appropriate to pursue legal action to recover compensation for the suffering the abuser has caused. Abuse in a nursing home can take many forms. Some forms are more visible than others, and repeat abusers will often try to mask their wrongdoing in various ways, making detection that much harder. Regardless of the form abuse takes, one of the tell-tale signs that abuse may be occurring is an institution’s unwillingness to provide straightforward answers to questions about the wellbeing of a resident. Another red flag is if the nursing home does not allow a resident to be alone with family members or other visitors. In practical terms the forms of abuse can be grouped into several categories:
  • Physical abuse involves an intentional infliction of pain or injury upon a person’s body. Included within the notion of physical abuse are behaviors that affect the person’s wellbeing, such as withholding food (for example, as a form of punishment), or deliberately withholding prescribed medications or administering incorrect medications. Physical abuse may be immediately visible, in the form of bruises, cuts, or broken bones. If a nursing home is unlawfully restraining a resident the resident may have bruises or other injuries on wrists and ankles.
  • Emotional abuse can be more difficult to detect, especially in a person who has difficulty communicating, as is often the case with advanced dementia patients. Emotional abuse includes bullying behavior (yelling, insulting, terrorizing) as well as purposeful neglect and isolation. Signs of emotional abuse often come from context, where the victim behaves in strange ways, such as by being unusually withdrawn or uncommunicative, or by adopting repetitive tics.
  • Neglect is a distinct category of abuse that applies in situations where a caregiver, such as a nursing home, has expressly agreed to assume responsibility for elements of a person’s wellbeing and has failed to perform those services. If a nursing home is failing to provide contracted-for services, such as food, laundry services, cleaning, or bathing, it may be committing acts of neglect. Unlike physical or emotional abuse, the nature of neglect often hinges on the specific language of the contract governing the resident’s stay in a nursing home.
Nevada’s elder abuse law, NRS 41.1395, applies to abuse of people who are 60 years of age or older, whether they live in a residential community or not. In some situations plaintiffs under the law can recover double damages and may also qualify for separate reimbursement of legal fees. Every personal injury case requires careful consideration of facts, and elder abuse is no different. What can set elder abuse apart, especially with an institution as the potential defendant, is the added layer (or layers) of resistance and lack of cooperation one can expect to encounter, especially if a nursing home is committing unlawful acts that could threaten its ability to attract new clients or put its licensure at risk. For over 45 years the law firm of Greenman Goldberg Raby Martinez has helped clients in the Las Vegas area recover compensation in matters of personal injury. If your loved one has suffered abuse in a nursing home and you would like to discuss your legal options, call us today for a free attorney consultation at 702-388-4476 or send us a request on our contact page.

Nevada’s Elder Abuse Laws

Nevada’s population of people over the age of 65 has steadily increased over the years, thanks to an aging population and the popularity of our warm climate as a retirement destination. Unfortunately, the elderly can be susceptible to abuse and neglect by people who live with or care for them. Nevada law provides a range of options for someone who is the victim of elder abuse to seek compensation.

Three causes of action in elder abuse cases

Nevada’s elder abuse law, NRS 41.1395, protects anyone who is 60 years of age or older by providing that an injured plaintiff may recover twice their actual damages and, in some situations, attorneys’ fees. To recover double damages, an older person must have suffered a personal injury or death that is caused by abuse or neglect, or suffered a loss of money or property caused by exploitation. Attorney’s fees can be awarded in cases where the plaintiff shows by a preponderance of the evidence that the person who is liable for damages acted with recklessness, oppression, fraud, or malice. The statute provides three potential causes of action:

1. Abuse.

Abuse involves the willful and unjustified infliction of pain, injury, or mental anguish, or deprivation of food, shelter, clothing, or services that are necessary to maintain the older person’s physical or mental health. NRS 41.1395(4)(a). The requirement that an act be willful is an important limitation for abuse claims. It is not enough that someone be merely negligent. Some cases may also hinge on whether a given service was “necessary” for the wellbeing of the older person. For example, the amount of food that must be provided to maintain the health of an infirm person may be difficult to establish.

2. Exploitation.

Exploitation has two components. NRS 41.1395(4)(b). First, the defendant must be someone in a position of trust, such as a caregiver or family member, or must hold a power of attorney or legal guardianship with respect to the older person. Second, the defendant must have taken money, property, or other assets from the older person. The taking can be through an act of deception, intimidation, or undue influence, or can simply be an act of conversion. In either case, the taking must be intended to permanently deprive the older person of use and benefit of the taken asset. A clear example would be someone taking money from an older person’s wallet. But the statute provides that “undue influence” does not include “the normal influence that one member of a family has over another.” In other words, to show undue influence there must be something more than, for example, a family member making poor choices with the older person’s money.

3. Neglect.

A neglect claim can be brought only against someone who has assumed responsibility for the care of an older person, such as a home care provider. The defendant has to have expressly acknowledged his or her assumption of responsibility, verbally or through a written contract. The defendant must have failed “to provide food, shelter, clothing or services within the scope of the person’s responsibility or obligation, which are necessary to maintain the physical or mental health of the older person.” NRS 41.1395(4)(c). The specific requirements in the definition of neglect that may complicate a lawsuit. The “express acknowledgment” requirement may pose challenges outside the context of contracted services. For informal arrangements, determining when someone has assumed responsibility for an older person may be subject to different opinions. Another issue in such contexts will be the scope of a caregiver’s responsibilities.

GGRM can help you pursue an elder abuse claim

For over 45 years the law firm of Greenman Goldberg Raby Martinez has helped clients in the Las Vegas area recover for personal injuries. If you or a loved one has suffered elder abuse and you have questions about your legal rights, our attorneys are happy to review your case. Call us today for a free consultation at 702-388-4476, or reach us through our contact page.

How to Handle Negligence by an In-Home Caregiver

How to Handle Negligence by an In-Home Caregiver
In-home caregivers provide many kinds of services to the people they serve. Personal caregivers help the elderly and people with disabilities with nonmedical needs, like bathing, cooking, and household chores. When a caregiver causes an injury through negligent behavior, families may have questions about their legal options.

Nevada’s laws against abuse and neglect of the elderly and disabled

Under NRS 41.1395, a caregiver who abuses, neglects, or exploits an older (60 years of age or older) or disabled person and causes personal injury or other losses can be sued for double the actual damages suffered by the harmed person. The law provides for recovery of attorneys’ fees where the caregiver’s actions weren’t just negligent, but involved recklessness, oppression, fraud, or malice. There are three distinct causes of action under NRS 41.1395. Abuse involves (1) a willful and unjustified infliction of pain, injury, or mental anguish, or (2) deprivation of food, shelter, clothing, or services that are necessary for the health of the individual. Exploitation involves taking advantage of an individual’s trust to take his or her money or other valuable assets. The third cause of action is neglect. Neglect involves a failure to provide food, shelter, clothing, or services by someone who has agreed to provide such care either through contract or by voluntary assumption of those responsibilities.

The scope of “neglect”

An important point about neglect is that it can be applied to someone who doesn’t have a formal written agreement, but has “expressly acknowledged” that he or she has taken responsibility for providing care. Depending on the circumstances, this could extend to someone who verbally agrees to look after a vulnerable person and fails to provide responsible care. Another point is that a caregiver’s responsibility to provide services is limited to those services “within the scope of the person’s responsibility or obligation.” One can expect this phrase to be a focus in cases involving a verbal agreement. For example, a family might informally hire through Craigslist a non-professional “companion” to spend an afternoon with an elderly client making conversation, preparing a light meal, and helping with minor housework. In such a role the caregiver can be expected to take reasonable steps to protect the client’s health, such as calling 911 in the event of an emergency. However, such a caregiver probably can’t be expected to provide medical services that would require licensure or specialized training, such as assistance with oxygen or medication.

Suing a caregiver for damages in cases of neglect

One reason to hire caregivers through licensed agencies rather than through informal networks is to have access to the agency’s insurance in the event that something goes wrong. Nevada law requires numerous steps for an agency to be licensed to provide personal caregivers in a home. Among these are requirements that an agency carry adequate insurance, provide sufficient training to their staff, and screen employees’ criminal histories and professional credentials. Once in operation, an agency must comply with numerous regulations.

GGRM helps Las Vegas families

The law firm of Greenman Goldberg Raby Martinez prides itself on providing clients with personalized, compassionate service. If you or a loved one has suffered neglect at the hands of a caregiver and you would like help understanding your legal options, our attorneys are here to help. To speak to an attorney at no cost, please give us a call today at 702-388-4476. We can also be reached through our contacts page.