Nursing Home Abuse Advocate : Idaho Nursing Home Abuse Lawyers & Attorneys : Kormanik Hallam & Sneed Law Firm : ID Assisted Living Neglect, Nursing Home Injuries : Boise, Nampa, Caldwell

In an article out of Cincinnati, Ohio, it is revealed two staff nurses at Woodland Hills Care Center are accused of stealing and selling residents' medications. According to the story, a licensed practical nurse and an assistant administrator of the facility, located in Lawrenceburg, Indiana, are suspected of stealing hydrocodone and oxycodone from residents. What caught my eye about this story, however, is the fact that, apparently, this was not the first time such thefts occurred at the facility. Apparently, a nurse had been charged and convicted for similar conduct previously; that time, the resident whose medications were stolen "slipped into a coma and died" after her pain medications were stolen.

I wonder what safeguards the Woodland Hills Care Center put into effect after the first time a resident suffered and, ultimately, died following the theft of her pain medication. If experience is any guide, even if the facility instituted safeguards, they obviously were ineffective. Shouldn't the facility now bear some accountability for the needless suffering of its residents whose medications were most recently stolen?

If you are a nursing home resident who receives pain medication on a regular basis and you do not receive your medicine, let your family and the facility's administration know, in writing, of the misssed dose or doses. If you are given "medicine" and get little or no relief, you may have been given something other than your own medication. Let your family and medical provider know you are hurting. Finally, if you are the family member of a nursing home resident, be sure to note any changes in the perceived pain level of your loved one and let someone know if it changes. The fact of the matter is, your loved one may not be getting their prescribed pain medication; it may have been stolen by staff members entrusted with the care of your loved one. Only by paying attention and reporting, can needless suffering be avoided and those responsible for such reprehensible conduct be brought to justice.

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In a recent blog post by the California lawyers of the Walton Law Firm, talk about the growing trend against mandatory arbitration of claims arising out of abuse or neglect occurring in a nursing home facility. In two of our most recent nursing home abuse cases, a review of the documentation revealed the presence of an "Arbitration Agreement." Although this "Arbitration Agreement" was "voluntary," if signed by the proper individual, it is, indeed, binding.

Whether you are required to sign an arbitration agreement upon admission, or are asked to sign one, there are several things you should know. If the agreement is signed, it is, absent some very specific circumstances, binding.

Additionally, should you be injured by the negligence of the staff of the facility, you give up certain rights if you signed the arbitration agreement. Examples of just some of the rights you give up are:

• Instead of having your case against the nursing home heard in public and by a jury made up of members of the community, your case will be heard in private by one or more "professional arbitrators";
• You may be responsible for one-half the cost of the arbitration, which can cost you thousands of dollars out of your own pocket; and
• At the conclusion of the arbitration, your right to appeal any award may, and oftentimes is, extremely limited.

I am not in favor of arbitration in the nursing home context. I believe in the jury system and feel that, when a person is injured by the negligent acts of a nursing home facility's staff, that matter should be heard by a jury. Honestly, the private nature of arbitration does not ordinarily benefit the injured party; instead, it is typically the facility who wants to keep its negligence out of the public eye.

When you or a loved one are being admitted to a nursing home or assisted living facility, be careful what you sign your name to. In the mound of paperwork provided by the facility, you may be signing away your right to sue the facility in court if you are injured as a result of negligence. Know what you are signing; it matters.

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With all the news about H1N1 "Swine Flu," focus has turned to methods to protect ourselves from becoming infected. The Swine Flu is serious, no doubt, but the methods for protecting yourself from becoming infected with the Swine Flu apply to ensuring you are not infected by just about any similar contagious disease.

RISKS OF BECOMING INFECTED WITH THE FLU VIRUS

According to the Centers for Disease Control and Prevention (CDC), although people 65 years old and older are least likely to become infected with the H1N1 Swine Flu virus, if such a person does get infected, they are at "high risk" to develop serious complications from the virus. Additionally, the CDC believes those 65 years and older are at "increased risk" for serious complications from the seasonal flu as well. As a nursing home or assisted living facility resident, how can you protect yourself? Simple, wash your hands and make sure all those who come in contact with you do the same.

PROPER HANDWASHING IS A SIMPLE AND EFFECTIVE PREVENTATIVE MEASURE

The CDC believes: "Handwashing is a simple thing and it is the best way to prevent infection and illness." Although handwashing seems like a simple process, which all of us have seemingly been doing since we were 2 years old, the CDC provides the following guidelines for effective and proper handwashing:

When washing hands with soap and water:

• Wet your hands with clean running water and apply soap. Use warm water if it is available.
• Rub hands together to make a lather and scrub all surfaces.
• Continue rubbing hands for 15-20 seconds. Need a timer? Imagine singing "Happy Birthday" twice through to a friend.
• Rinse hands well under running water.
• Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet.
• Always use soap and water if your hands are visibly dirty.
• If soap and clean water are not available, use an alcohol-based hand rub to clean your hands. Alcohol-based hand rubs significantly reduce the number of germs on skin and are fast-acting.

When using an alcohol-based hand sanitizer:

• Apply product to the palm of one hand.
• Rub hands together.
• Rub the product over all surfaces of hands and fingers until hands are dry. 

A simple and effective method of ensuring people wash their hands is to purchase a container of alcohol-based hand sanitizer and put it on a table in your room. Do not be shy about asking people to use it! It is up to you to make sure people who come into your room wash their hands.

Protect yourself from infection by making sure those who come in contact with you, whether they be staff caring for you or friends and family visiting you, wash their hands. The alternative, becoming infected with a contagious disease to save a few minutes of time just is not worth the risk. 

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In a recent New York Times blog entitled "Easing Tensions In The Nursing Home," author Paula Span addresses the important issue of tension between family members and nursing home staff. As you can imagine, most, if not all, of the issues contributing to this tension is a family's belief their loved one is not being cared for in an appropriate manner against the staff's belief to the contrary.

According to Ms. Span, the tension between family and staff leaves the family concerned that, if they voice their concerns, their family member will suffer because unhappy staff will, in some way, retaliate against the resident for the complaints of the family. To avoid, or at least lessen, the chance for tension between family and staff, Ms. Span provides the suggestions of Karl Pillemer, a gerontologist at Cornell University, and the sociologist J. Jill Suitor of Purdue University:

• Take complaints and requests to the right place. While aides do most of the hands-on care in nursing homes: “They’re almost never the ones who are making decisions about it. You’ve got to go high enough up the chain to make sure the person you talk to has the ability to influence what goes on.” The staff social worker is a starting point.
• When a problem involves an aide’s duties, practice “clear and respectful communication.” “Avoid blaming the other person. As people get angry, there’s a tendency to insult the other party, and it escalates.” A demand or reproach — “How come nobody’s shaved my father?” — puts overworked staffers on the defensive. Try phrasing it this way: “I noticed my father isn’t shaved. This is very important to him. How can we make sure he’s shaved every day?” After the conversation, summarize to clarify the agreement you have reached: “I understand that you were short-staffed today. But he will be shaved every morning — is that what you’re saying?”
• Keep visiting, and monitoring. “The amount of visiting people receive is directly related to the quality of care. Families do need to advocate for their relatives, but they need to do it in the right way.”
• Give positive feedback as often as possible.

In a previous blog post, entitled "The Ombudsman for the Idaho Commission on Aging is on the Side of Idaho Nursing Home Residents," I addressed the role of the Idaho Ombudsman for long term care in addressing concerns regarding teh care of nursing home and assisted living facility residents. Regardless of the involvement of the Ombudsman, it is important you, as a loving and caring family member, are able to effectively communicate your concerns with the proper individual at the facility so your family member does receive the proper care. As Ms. Span and Mr. Pillemer suggest, perhaps the most important contact at any nursing home or assisted living facility is the social worker or, if none is available, the director of the facility.

I suggest not only approaching the appropriate individual with your comment or concern, but also following up with that person in writing. A written summary of your concerns, the discussion which you had with the appropriate upper-level employee and the outcome or change in care you expect are all good things to write down. This way, if the concern is not addressed, you can again voice it or contact the Ombudsman. If the concern is addressed, you will be able to follow up with a "thank you" to the staff of the facility caring for your family member or loved one.

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