This is withholding or otherwise failing to provide proper medical care or treatment. Medication errors, including administering the wrong medicine, or providing incorrect dosages or doses at incorrect intervals, are a frequent form of medical neglect. Failure to summon staff or outside medical doctors in a timely manner is also medical neglect. In addition to not adequately treating illness, medical neglect can allow an illness to progress and cause what may have been avoidable damage to the patient’s health, or death.Certain medical conditions require nursing homes to provide a higher level of attentiveness or continual monitoring to ensure the resident’s safety. Nursing home personnel must not neglect:
Fall prevention protocols. Certain medications, illness, and the frailty of age increase the risk of falls and fall-related injuries. Nursing home residents fall more than two and a half times a year on average, according to the Centers for Disease Control and Prevention. Elderly people who fall are highly likely to suffer traumatic brain injuries (TBIs) or hip fractures, either of which immediately diminishes the quality of life and is a potentially fatal injury. Fall protocols should be in place and followed to monitor and assist residents at risk of falling.
Periodic repositioning of immobile residents. Bed sores (pressure ulcers, pressure sores) are open wounds that are caused by lying or sitting still for long periods of time. They are highly painful and susceptible to infection. Residents who are immobile must be regularly repositioned or “turned” to prevent bed sores. Staff should be trained to turn patients on schedule, and be kept abreast of which residents require turning.
Wandering and elopement prevention. Individuals who have developed early-stage Alzheimer’s disease are likely to wander. Nursing homes should accommodate and supervise residents’ need to walk or otherwise be active, but failure to keep wanderers safe is neglect. Nursing homes have an obligation to ensure residents likely to wander or elope (leave the premises) are protected by staff supervision, electronic / coded latches on doors, security cameras, warning devices triggered if residents cross boundaries, etc.
Withholding adequate food and drink, including nutritional supplements, is neglect that can damage health. Nursing homes must also be prepared to help residents who have physical or mental problems that keep them from feeding themselves or chewing and swallowing, or that inhibit their desire to eat. Lack of food or lack or the ability to absorb the nutrients in food can cause malnutrition, weakening the individual and increasing the risk of falling and being injured, and developing infections or other medical problems.Dehydration, an insufficient intake of liquids, adversely affects all body functions. Dehydration is a symptom of malnutrition but can also be caused by high fever, diarrhea or certain medications, such as diuretics.
Failure to help nursing home residents keep themselves and their environment clean is negligent. Lack of personal cleanliness, as well as unsanitary conditions in bedrooms and bathrooms, or affecting beds, bedding, clothing, toiletries, etc., can lead to disease or infection, including staph infections.
Nursing home staff members have an obligation to provide some level of companionship to individuals under their care. Proper emotional support includes patiently and individually spending time with residents, providing appropriate physical comfort, listening and responding appropriately, and empathizing and providing feedback about problems and concerns. Isolating a resident from activities they can and want to participate in through inaction, i.e., not going to get a resident who needs assistance or not prodding them to join a group or activity, is social neglect.Social and emotional neglect may cause psychological problems, such as depression, distress, regressive behavior, regression in personal care and/or withdrawal from caregivers or family.
Unsafe conditions in nursing homes can lead to injuries from accidents, illness and, in case of intruders or elopement due to security lapses, even assault. In addition to falls caused by illness and infirmity, such conditions caused by faulty maintenance, such as wet floors, loose tiles or rugs, poor lighting, etc., increase the risk of slip-and-fall accidents. Poor cleaning and sanitation habits in a facility can cause the spread of illness. Poor security, i.e., lack of doors and windows that lock, as well as lack of proper surveillance of the premises, can lead to elopement or intrusion by individuals who easily prey on the elderly and infirm.
Nursing homes must be properly staffed to provide the level of medical and socialization care, security and premises maintenance that residents require. This includes ensuring staff members are qualified and available to provide one-on-one care and assistance. Managers and other supervisory personnel are responsible for hiring, training, scheduling and supervising staff to ensure nursing home residents receive proper care 24 hours a day. Lapses due to staff changes should be dealt with swiftly and effectively, and in a manner that does not diminish the level of care provided to residents.