October 2, 2012

A New Way of Thinking about Dementia Care

by Levin & Perconti

Nursing home care is not a one-size-fits-all endeavor. While all those at these facilities need some form of skilled nursing care, there are individualized needs for each resident that must be taken into account. Of course, that is why each resident must be evaluated individually to identify certain risks. How likely is this resident to suffer an injury during a fall? Is wandering a risk? How many risks are present with prolonged elopement? Do they have cognitive challenges that must be taken into account? These and other issues are a standard part of proper nursing home care.

That individual analysis obviously would factor in whether or not a resident is suffering from Alzheimer’s or other dementias. The lawyers at our firm work on many cases where residents with dementia were not handled properly, leading to serious accidents, attacks, and neglect. Complex injury and even death have resulted from these mistakes.

Challenges of Dementia Care
Arguing that cognitive issues like dementia must be properly taken into account at all times should not be taken as a suggestion that dealing with these concerns is easy. The opposite is true. Caring for a senior suffering from dementia is difficult work, but that is exactly why family members seek out help for that care to begin with. Most family members work to provide support to elder loved ones while they can, so that the senior does not have to move into a nursing home. But there are many situations where there is simply no alternative to the professional help available at a long-term care facility.

Unfortunately, we have a long way to go before facilities provide the best care possible for those with dementia. A new article from last month’s Provider Magazine, for example, argues that dementia care needs to be viewed in a new light. The story notes that many individuals who once loved being in the middle of social settings, withdraw and become isolated after developing dementia. Nursing home staff members, friends, and family members all often try to provide the senior with more social engagement opportunities to no avail.

One alternative, clams a medical doctor and expert on dementia, is to place more focus on the individual and not the disease. The doctor recently published a book entitled, “Dementia Beyond Drugs: Changing the Culture of the Care.” His basic idea is that care for these individuals needs to step beyond the actual condition—which results in focus on medication—and instead return to the fact that these individuals are the same but with a “terrifying, shifted reality.”

With a focus on mitigating the decline with medication, the doctor argues that there should be more focus on the “complex cognitive and emotional qualities that can be retained” even by those with advanced dementia. All of this means that the individual’s personality, personal values, life history, and coping styles will not disappear once they begin showing signs of the cognitive disease.

Working this new concept into long-term care setting will not be easy. The doctor notes that the systematic method of treating these residents means that without widespread cultural changes “the system will kill it.” In other words, it is one thing to think that we need to re-shift our focus on these issues, but it is another to actually do anything to translate that idea into action that improves care.

Please click here to read the full review of the important dementia care book.

See Our Related Blog Posts:

First-Hand Portrait of Life Inside and Assisted-Living Facility

Aging Expert Optimistic About Senior flourishing in their Golden Years

September 16, 2012

“Reasonableness” & Dementia

by Levin & Perconti

The civil law is premised on the idea that community members need to act reasonably in their interactions with one another. Not all accidents can be prevented--some things are simply true accidents that involve fluke circumstances. But those incidents are the exception. When analyzed deeply, many accidents that cause harm include unreasonable conduct by one, two, or many different parties. Figuring out that unreasonableness and seeking to compensate those hurt is the root of the civil law.

That is true in all settings, including the care of senior citizens.

One misconception, however, relates to gauging what is or is not reasonable. There are not simple rules, because everything hinges on context. For example, take two similar accidents--a fall in the hallway. Both fall-victims are 67 years old, both falls were caused by the shoes that the person was wearing--they were too big and made it difficult for the senior to walk. One fall took place in an emergency room waiting room--the senior went there to get a few stitches for a small cut. The other fall took place in a nursing home hallway.

Both falls involved the same person and the same underlying cause (shoes), and both were in caregiving locations. Is the legal liability the same? No.

That is because those individual caregivers were not in the same position. Emergency room staff members likely had no idea about the senior’s fall risk, because the patient had simply showed up with a non-life threatening medical situation. Conversely, the nursing home staff members presumably knew the senior resident. They may, in fact, have been the ones who selected the shoes.

What would have been “reasonable” conduct on the part of the nursing home staff members to prevent that fall are much different than what would have been “reasonable” conduct by the emergency room workers. The specific context of the fall makes all the difference.

Dementia, Alzheimer’s, & Increased Accident Risks
Another factor that also affects these types of incidents is the caregivers knowledge of the senior’s particular mental vulnerabilities. For example, if a caregiver knows that a senior suffers from dementia, the “reasonableness” calculation changes even more. That is because those with dementia can be hurt in situations that would pose less risk for those will their full mental faculties.

Just last week the Sun Times posted a sad story on the death of an 80-year old elderly woman with dementia. The senior apparently drowned in a pond behind her own home. Details are still emerging as to how the drowning occurred. However, the woman was known to walk the trails in the area. She may have slipped or otherwise became confused, leading to the accident.

The case does not involve care workers, but it illustrates the unique risks faced by those with dementia. When a resident in a nursing home is known to have cognitive conditions like this, it is reasonable for those conditions to be taken into account when the care plan for the resident is crafted. Failure to create or follow that plan may result in legal liability following an accident.

See Our Related Blog Posts:

Illinois Nursing Home Lawsuits Alleges Neglect at VIP Manor

Nursing Home Neglect Leads to Patient Death, Lawsuit Filed

June 27, 2010

Study Finds Nearly Half of Alzheimer's Patients Abused

by Levin & Perconti

A recent study from the University of California, Irvine, examined the treatment of the elderly who have been diagnosed with Alzheimers or similar disorders. Shockingly, the study found that nearly half of the elderly individuals had suffered from mistreatment by their caregivers. The research is only the latest example of the prevalence of elder abuse throughout the country.

The study involved observation of 129 elderly residents and their caregivers. Throughout the study, a panel met each month to sift through the observations and data to make determinations about the degree of psychological abuse, physical abuse, and neglect. Overall, 47% of caregivers were found to have abused their patients in one form or more, with psychological abuse being the most prevalent.

The researchers discovered that the best indicator of mistreatment was examination of the behavior of the dementia sufferer toward the caregiver. Mistreatment was most likely to have occurred when the elderly resident exhibited psychological and physical aggression toward the caregiver (i.e. pushing, shoving, and swearing at the caregiver). The physical, emotional, and psychological damage caused by the mistreatment is difficult to ever reverse.

Elder abuse centers across the country like the one at the University of California, Irvine continually discover the shocking breadth and scope of mistreatment of vulnerable elderly residents. The abuse occurs both in at-home caregiver situations as well as nursing home and assisted living facilities. In Chicago, our nursing home abuse lawyers at Levin & Perconti have worked for the victims of this abuse for decades. Just as important as identifying elder abuse is the need to hold the abusers responsible for their contact. If you suspect elder mistreatment in any form, be sure to contact an elder abuse attorney to ensure that the abuse stops, the abuser is punished, and future victims are spared neglect.

June 20, 2010

Caregiver at Nursing Home Charged with Murdering Resident with Morphine

by Levin & Perconti

A caregiver at a North Carolina nursing home was charged with murdering Rachel Holliday, an 84-year-old Alzheimer’s nursing home resident, with morphine. The nursing home caregiver, Angela Almore, also faces charges of felony abuse, which are related to the hospitalization of six other Alzheimer’s patients whom authorities suspect she also gave morphine. This investigation began when authorities suspected abuse after the Alzheimer’s patients tested positive for morphine. The State believes that the patients were likely given morphine to make them more manageable.

Overmedication is a problem that arises too often in nursing homes. An October report in the Chicago Tribune investigated this issue, finding that nursing home staff will resort to overmedicating their residents in order to make it easier to manage them. This usually stems from nursing homes being understaffed or insufficiently trained to handle the complex needs of residents with dementia. Of course, this decision to overmedicate, or to medicate without a physician’s order, is against the standard of care. Further, overmedicating residents in nursing homes can have potentially detrimental effects on their health, and can deteriorate their fragile and vulnerable nature. As evidenced by the article mentioned above, and many similar cases throughout the country, overmedication can and does cause death in nursing home residents.

Our attorneys at Levin & Perconti are very familiar with the effects of overmedicating nursing home residents. Most recently, one of our attorneys, Partner, Steve Levin, filed a wrongful death lawsuit against the licensee of Woodstock Residence, in Woodstock, IL, a former nurse, and former nursing director, for administering a heavy dose of morphine that caused the premature death of a resident.

April 9, 2010

New Alzheimer’s Disease Test Offers Hope of Early Detection

by Levin & Perconti

A new test offers hope that Alzheimer’s Disease can be diagnosed and treated at an earlier stage. The Journal of Alzheimer’s Disease reports in its April issue that researchers have developed a new test, called a computerized self test, to detect brain conditions such as Alzheimer’s Disease. The short and interactive online test gauges impairments in a person’s basic functions of thinking and processing information that are affected by brain injuries and cognitive impairment like Alzheimer’s Disease. The new test is easy for medical providers to administer to patients and is much more effective at detection than older tests. While current tests used to diagnose Alzheimer’s Disease are approximately 70% accurate, this new test has a 96% accuracy rate. Accuracy is extremely important because early detection of Alzheimer’s Disease means a better chance for a patient to receive effective treatment for this brain disorder. The researchers developed the test after recognizing that 60% of Alzheimer’s Disease cases were not diagnosed in a primary care surrounding, leading to a delayed detection and lost treatment opportunities.

The Alzheimer’s Association defines Alzheimer’s Disease as an incurable, progressive brain disorder that destroys brain cells, causes memory loss, and creates thinking and behavior problems. If Alzheimer’s Disease is diagnosed at an early stage, people who suffer from it have more time to make life choices and plan for their future, and have an increased chance of benefiting from treatments that delay the debilitating effects of this brain disorder.

The effects of Alzheimer’s Disease can be severe and patients are often moved into nursing homes so that medical providers can provide permanent care for them. According to Alzheimer’s Association, half of all nursing home residents suffer from Alzheimer’s Disease or a similar disorder. Chicago nursing home lawyers at Levin & Perconti are experienced at representing residents suffering from Alzheimer's who have been victimized by abuse and neglect. For example, our Illinois nursing home negligence lawyers received a $700,000 verdict for the family of a nursing home resident affected by Alzheimer’s Disease who was hit by a car and died when nursing home staff negligently allowed the resident to wander away from the nursing home.

March 12, 2010

Hope for New Alzheimer Drug Lost - New Study for another Treatment Provides Promise

by Levin & Perconti

According to an article in the New York Times, hopes were recently crushed crushed when an Alzheimer drug failed in its first late-stage clinical trial. The companies working on the drug, a start-up in San Francisco called Medivation and the world’s largest drug company, Pfizer, said that the drug, called Dimebon, “had shown virtually no effect after six months in treating the cognitive decline or behavioral problems associated with Alzheimer’s when compared with a placebo.” The companies are now determining whether they will abandon other trials for Dimebon or whether Pfizer, which has been paying a majority of the costs, pulls out.

On a more positive note, researchers at Rush University Medical Center in Chicago have found that people who view life with a sense of purpose and who set goals are less likely to develop Alzheimer's disease or dementia. These findings could provide new treatment interventions for elderly adults. The report appears in the March issue of the Archives of General Psychiatry.

Nursing home attorneys at Levin & Perconti represent a number of people suffering from Alzheimer’s disease. As such, the attorneys at Levin and Perconti remain up to date on the latest ways they can best assist clients suffering from Alzheimer's both inside and outside the courtroom.

October 3, 2009

More than 35 Million People Have Dementia Worldwide

by Levin & Perconti

New statistics on the worldwide prevalence of Alzheimer’s disease and related dementias are being released today as countries across the globe joint together in recognition of World’s Alzheimer’s Day. According to the World Alzheimer Report, an estimated 35.6 million people worldwide will be living with dementia in 2010. This is a 10% increase over previous global dementia prevalence reported in 2005. It is important to have elderly people screened for dementia. Unchecked, dementia will impose enormous burdens on individuals, families and the global economy. Many residents in nursing homes suffer from dementia and are oftentimes the victims of nursing home abuse. To read more about the dementia statistics, please click the link.

August 17, 2009

Nursing Home Aide Charged with Assault at Nursing Home

by Levin & Perconti

A nurse’s aide accused of punching and threatening an 83-year-old nursing home resident who has Alzheimer’s disease was arraigned on assault and battery charges. The woman allegedly punched the victim twice in chest and stomach, pushed her down onto her bed, and ordered her not to get up again. The elderly woman had gotten out of bed at the nursing home and was apparently wandering around her room when the aide entered and starting hitting her. Investigators say that the victim’s roommate witnessed the elderly attack and an investigation was launched. The woman was charged with assault and battery on an elderly person and threatening to commit a crime. The aide has been fired after the elderly abuse. Physical abuse is all too commonplace in nursing homes. To read more about the elderly abuse, please click the link.

August 6, 2009

Illinois Nursing Home Facing Fines for Abuse

by Levin & Perconti

LaSalle County could face federal and state fines of $20,000 or more for violating codes at a nursing home where a male patient is accused of sexually molesting 10 women. The Illinois Department of Public Health recommended that the U.S. Centers for Medicare and Medicaid Services fine LaSalle County $20,000 plus $100 for each day between the times that the complaint was filed until a review showed the nursing home was back in compliance. The Illinois Department of Public Health spokesperson stated the violations resulted from “systemic problems” at the LaSalle County Nursing Home, problems that resulted in the man abusing other patients. The male patient abused dementia patients from December until May. Nurses, employees and patients interviewed by the state health department said that the male resident touched female residents’ breasts, tried to kiss them and used foul language in talking about sex in the nursing home’s common areas. The report stated that due to the administrative staff’s failures to implement policies and procedures for elderly abuse, failure to recognize abuse, and failure to effectively manage facility resources, sexual abuse occurred for 10 residents. The fines levied to LaSalle County were typical for the types of violations found at the home. To read more about the nursing home violations, please click the link.

May 9, 2009

Alzheimer’s Drug Seroquel Causes Side Effects

by Levin & Perconti

Research has found that Seroquel anger is a serious side effect that can cause injury to patients who are taking this antipsychotic medication. Elderly patients who are taking Seroquel for the treatment of dementia or Alzheimer’s seem to have the greatest risk of suffering from the anger side effect. Additionally, studies have indicated that Seroquel use can actually worsen a patient’s dementia and Alzheimer’s symptoms. Seroquel anger is a serious side effect that is commonly observed in older patients who are taking Seroquel to treat this very symptom and other injurious dementia symptoms. Patients at nursing homes should be aware of the effects of Seroquel. If you have experienced Seroquel anger find a Chicago lawyer. To read more about the Alzheimer’s drug, please click the link.

April 13, 2009

HBO Debuts “The Alzheimer’s Project” in May

by Levin & Perconti

HBO is showing a 4-part documentary series that focuses on Alzheimer’s. Hopefully the documentary series will draw attention to the traumatic disease that affects the elderly. The documentary series starts May 10 at 9 P.M. Oftentimes those will Alzheimer’s end up in nursing homes. Elderly patients with dementia are prey to nursing home abuse. To see the trailer, please click the link.