By Joseph B. Landy
Residents at nursing homes are at a high risk of abuse and neglect. Affirmative action by family members, however, will decrease the associated risks.
First and foremost, be proactive. Visit regularly, interact with the staff, and participate in the care plan meetings. The more you are involved, the great chance you will have to discover the abuse.
Secondly, check your loved one’s skin. Many residents spend large amounts of time in bed and/or in a wheelchair. As a result, there is significant pressure placed on their coccyx (behind) and heels. These are bony areas where the skin is thin. As we age, our skin thins. Inadequate hydration or malnutrition can rob the body of the vital nutrients it needs to stay healthy. All of these factors place nursing home residents at increased risk of “skin breakdown”, also known as “pressure sores”, “decubitis ulcers” and “bedsores”. Bedsores start at a stage one, which is a reddened area. Under the wrong conditions, the area may quickly advance to a stage four wound, where the area is open and down to the bone. The open wound is a potential portal for infection and places the nursing home resident at increased risk of gangrene, sepsis, septic shock and even death. If you notice a reddened area on your loved one’s coccyx or heels, request an immediate meeting with the Director of Nursing. Also, demand that the issue is “care planned”. This is a meeting of the appropriate staff where they come up with a plan devised to correct the condition and prevent it from reoccurring in the future.
Third, be aware if your loved one is a fall risk. Are they on medications which may cause them to lose their balance? Do they have dementia? Do they tend to wander at night? Have they fallen in the past? A fall can result in a broken hip, subdural hematoma or death. If they are at risk for a fall, make sure the issue was care planned. The bed should be placed in low position, mats should be left bedside, and a bed alarm should be in place.
Finally, be certain that your loved one is getting adequate nutrition and hydration. If they are losing weight, find out why. They may need encouragement to eat during meal times, or a better selection of foods. Their input of both calories and water can be documented. Lack of appropriate hydration and nutrition can compromise the immune system and cause the body to rapidly deteriorate.
Nursing home abuse can be prevented. Be smart, be involved and be vigilant.