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Explaining the Basics: Texas Nursing Home Abuse

According to the Nursing Home Report Card, Texas has been ranked as the worst nursing home state for both 2013 and 2014. We scored “Fs” in multiple areas such as “direct care staffing hours”, “health inspections”, “professional nurse staffing hours”, and the amount of filed complaints. While some infractions may seem insignificant, they are, in fact, serious because there are laws protecting the residents of nursing homes that make those infractions illegal. Actually, any form of elder abuse in Texas is a felony, and depending on the severity of the issue it could be a first, second, or third degree felony. This article outlines what nursing home abuse is defined as, how it manifests, and the steps to take in order to receive justice and compensation.

Elder Abuse in Texas

The Texas Attorney General describes elder abuse as “involuntary seclusion, intimidation, humiliation, harassment, threats of punishment, deprivation, hitting, slapping, pinching, kicking, any type of corporal punishment, sexual assault, sexual coercion, sexual harassment, verbal abuse, or any oral, written, or gestured language that includes disparaging or derogatory terms, regardless of the person’s ability to hear or comprehend.” As cited, abuse can be physical, emotional, verbal, or mental, and all types of abuse are punishable by Texas law. The following is a list of a few specific types of abuse or neglect that affect the health and well-being of the resident, and, in addition, are punishable by law.

  • Over-medication or under-medication. Over-medication is a big problem in crowded and under-staffed nursing homes. If a patient is particularly active or verbal, staff members will give them too much medication (often sleeping pills) in order to keep them subdued. Not only does this compromise the health of the patient, but it also compromises their standard of living. Under-medication can happen when the resident’s health is not monitored closely enough, or when the workers do not remember to give the resident his or her prescribed medication.
  • Failure to assist in personal hygiene. Personal hygiene includes making sure the residents are bathed and groomed (washed hair, clean linens and/or unsoiled clothing, clean hands and fingernails, brushed teeth, etc.)
  • Failure to provide adequate access to water. Dehydration can cause a large amount of other health issues. Many residents are unable to hydrate themselves or even ask for something to drink. These residents must be given special attention, whether that includes making sure they have water at all times, stopping in frequently to offer them a drink, or having frequent scheduled times where hydration is administered.
  • Failure to monitor. If residents are not monitored properly, many accidents can occur that affect that resident’s well-being. Residents in wheelchairs must be monitored so that they do not fall out, residents with memory complications should not be allowed to wander off unattended, staff must not take too long to answer call lights, and all residents, especially those with dietary needs, must be monitored in order to prevent choking.
  • Emotional or verbal abuse. It is important to note the above-mentioned distinction from the Texas Attorney General, that all verbal abuse is wrong and punishable, even for patients who are unable to “hear or comprehend.” Sadly, many workers will take their frustrations out on residents that they think can’t understand what they are saying to them, but those residents are still subject to the same rights and respect as those who are able to understand. In addition, what a resident understands is often subjective and can only be speculated by other people.
  • Physical abuse. Any form of physical abuse or threat of physical abuse is punishable by law, and is considered a felony.
  • Sexual abuse. Any form of sexual abuse, assault, or harassment is punishable by law, and is considered a felony.

Physical Signs of Abuse

Now that we’ve covered types of abuse, here is a list of signs to watch out for in order to determine whether or not your loved one is being abused and why some injuries that may not seem serious, can actually often be very serious.

  • Dehydration. Watch for a dry mouth, swollen tongue, decreased urine, weakness, or weight loss. Dehydration can cause bladder infections, kidney failure, and eventual death.
  • Bed Sores. Look for red, irritated skin in areas where the skin of the body is pushed against a surface, such as hips, tailbone, ankles, etc. People who are confined to beds or wheelchairs should be moved or turned often to prevent bed sores from occurring. Bed sores are very painful, difficult to treat, and can often take months to heal. If bacteria from the sores enters the bloodstream it can be life-threatening.
  • Urine or feces odor. Prolonged exposure of the skin to urine or feces, besides being uncomfortable and degrading, can cause more serious issues such as bedsores, bladder infections, and other infections. In addition, not answering call lights in a reasonable amount of time can result in accidents which may be humiliating to the resident.
  • Skin Tears. Look for separation of the skin on the extremities or face. Although skin does become more sensitive with age, this is not an excuse to devalue the seriousness of these wounds. Skin tears should be avoided by providing padding for any hard edges during moving and transfer, and the resident should wear shoes and avoid having any bare skin on legs and arms during the moving process. If a skin tear does happen, the wound should be properly sterilized, dressed, and changed to avoid more serious infections.
  • Weight Loss. Weight loss can occur from a medical condition, lack of nutrition, or lack of will to survive. Large amounts of weight loss should be taken seriously, and in severe cases, medical attention should be sought immediately.
  • Fear/anxiety. Pay attention to whether or not a resident is afraid of certain workers or residents. Not only have there been cases where a worker is abusing a resident, but often a roommate or neighbor in the nursing home will lash out at another resident. There have been cases where one resident was even killed by another because of a failure to monitor.
  • Cries for help. Cries or pleas for help should always be taken seriously and investigated, regardless of whether or not the
    person can communicate or understand effectively. A person’s disability should not depreciate their standard of care.
  • Bruising or lacerations. Bruising is often the first sign that someone in a nursing home is being abused. Any bruises from every day bumps should be reported to the family. Listen to the explanations about the bruises and decide if they are plausible. If there are multiple bruises or bruises that have not been reported, further investigation should be pursued.

Crimes Punishable by the Law

As mentioned earlier, nursing home abuse is considered a felony. Perhaps the worst thing about nursing home abuse is that the majority of abuse cases go unreported. Either the resident is unable to communicate the abuse, forgot the abuse happened, is afraid to say anything for fear of backlash, or somehow feels they deserve punishment. There are ways to report neglect and abuse of the elder and disabled populations. You can call the Texas Attorney General at (800) 621-0508, the Texas Department of Aging and Disability Services (DADS) (855) 937-2372, the Texas Abuse Hotline at (800) 252-5400, or the Texas Department of Human Services at (800) 621-0508. Contacting these services is always a good idea, but these methods are not always the most effective. In one abuse case, a representative from DADS stated that the nursing home could not be issued a citation or fine because they were unaware that the abuse was happening. Even when they do investigate, it may take months for them to finally reach the home, and at this point, it could be too
late.

Negligence and Medical Malpractice in Texas: How to Get Help

Nursing homes should be held to a high standard of care, meaning that they should go out of their way to keep residents safe, In the field of personal injury, “negligence” means that someone has breached their duty to provide this standard of care. In some instances, this would be a personal injury or wrongful death case, and in others, it may also be considered a medical malpractice case, especially those involving medical issues such as over- or under-medicating, dehydration, bed sores, etc.

If you or a family member is experiencing nursing home abuse, there are a few steps to take. You should do some of your own research if possible, try to move to a different facility, file complaints with police and abuse prevention agencies, and in most cases, it is also a good idea to hire a lawyer. Though in most personal injury cases there is a two year time period in which you are able to file, it is better to file as soon as possible in order to prevent any future abuse from occurring. At Grossman Law, we’ve experienced first hand how the elderly and disabled are taken advantage of, and our experienced and passionate attorneys want to help you and your family find justice. Call us at (855) 326-0000. Even if you aren’t ready to file a claim, we are happy to answer any of your questions.

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