Mechanical lifts in elder care facilities: what residents and families need to know

One of the major issues in nursing home facilities is the frequent heavy lifting or repositioning of residents that exceed the lifting capacity of their caregivers. Many nursing homes and assisted living facilities therefore use mechanical lifting equipment to aid in moving residents.

When properly used by trained caregivers, mechanical lifting equipment benefits residents, their caregivers, and employers. When a resident lifting program is properly established and used, everyone benefits. But when there is insufficient training for caregivers, or inadequate resident lifting policy guidelines, injuries can occur, often with serious results.

There are two main types of lifts that are used at nursing home facilities, both of which require strict adherence to safety rules. The first is a sling lift, also known as a Hoyer Lift. A Hoyer Lift allows patients in nursing home facilities to be transferred between a bed and a chair or other similar resting places, using hydraulic power.

The second type of lift used is called a sit-to-stand lift. This lift is designed to help patients with some mobility but who lack the strength or muscle control to rise to a standing position from a bed or a wheelchair.

Just how important is it that a Hoyer Lift be used properly? The simple answer: extremely important. While falls are a major concern in nursing home facilities, they are not the only risk of improper use of Hoyer Lifts. Nursing home facilities focus on caring for elderly patients. It is vital that great care be taken when dealing with elderly patients. It is well known that any injury or sickness can be much more serious if it occurs to an elderly person.

One such example is Mr. Donahue. At the age of 86, Mr. Donahue was admitted to Embassy House Skilled Nursing and Rehabilitation (“Embassy House”) in Brockton, Massachusetts. The caregivers at Embassy House used Hoyer Lifts to assist when moving patients. Mr. Donahue’s care plan required the use of a sit-to-stand mechanical lift, however, a Hoyer Lift was used when moving Mr. Donahue from his wheelchair to his bed. The Hoyer Lift required two operators for safe and proper use. Unfortunately for Mr. Donahue, this requirement was not followed. A caregiver at Embassy House operated the lift by herself when moving Mr. Donahue. After Mr. Donahue had been transferred to his bed from his wheelchair, the caregiver attempted to remove the pad from under Mr. Donahue. The caregiver unhooked the left side of the sling which caused the hook to immediately strike Mr. Donahue in the head.

The severity of Mr. Donahue’s injury increased substantially as time went on. The day after receiving the injury, Mr. Donahue was rushed to the emergency room. Later that day, Mr. Donahue was transferred to another medical center for treatment and surgery. Mr. Donahue underwent surgery, at which time it was determined that his eye could not be repaired. On September 8, his eye was removed. He passed away approximately six weeks later.

Mr. Donahue’s story shows just what can happen when a Hoyer Lift is used improperly. This whole situation could have been eliminated with proper training of the staff. This is precisely why caregivers that are using such mechanical equipment every day need proper training and guidance. Without proper training, stories such as Mr. Donahue’s will continue to occur.

Aside from injuries sustained such as Mr. Donahue’s, elderly patients are always at risk of falling when Hoyer Lifts are used improperly. While a fall of a young person may have no adverse consequences, it can be life-threatening to an elderly person.

Just how serious are falls? According to the CDC:

  • About 1,800 people living in nursing homes die from falls each year.
  • Each year, a typical nursing home with 100 beds will report 100-200 falls.
  • About 10% to 20% of nursing home falls cause serious injuries; 2% to 6% cause fractures.
  • Roughly 50-75% of nursing home residents fall each year, although many falls go unreported.
  • Patients often fall more than once; the average is 2.6 falls per person per year.

The CDC has produced recommendations for facilities to follow on the safe lifting and movement of nursing home residents. To achieve the fullest possible benefit, however, facilities need to consider more than just what type of equipment to buy. Safe patient handling programs should also involve a comprehensive assessment of the nature of patient and worker needs, policies that encourage the safest techniques for handling patients, and ongoing evaluation and improvement.

If you have a loved one that is in a facility that uses lifts, don’t be afraid to ask if any of the following issues are occurring:

  • Improper Training: Improper training of nursing home staff is among the most dangerous factors contributing to nursing home injuries. When nursing home staff fails to follow proper procedures when using lifts and other mechanical devices, the resident is at extreme risk for injury. Staff members should receive adequate training to learn how to properly attach the sling, as well as how to properly seat a resident in the sling. Improper seating or assembly can result in catastrophic accidents and injuries.
  • Improper Maintenance: If the lift is not properly maintained, the device can become defective, resulting in breakage and possible injury.
  • Inadequate Staffing: Some lift models require two people to safely transport residents. Nursing home staff should never attempt to use these lifts on their own.

Asking questions about a facility’s patient handling program can help you determine if your loved one is in a safe environment. And if you or a loved one has been injured due to the use of mechanical lifting equipment, contact our offices for expert advice and representation if needed.


Massachusetts nursing homes cited

On September 21, state regulators released the names of 51 Massachusetts nursing homes cited for advertising dementia care services that they don’t actually offer, or have not submitted paperwork to verify they are in compliance. Included on the list were some nursing homes that are generally well-regarded for their dementia care services.

The Alzheimer’s Association of Massachusetts/New Hampshire conducted a review in July of how nursing homes advertise their services and found that nearly 60 percent of nursing home facilities advertise memory, dementia, or cognitive care but had not documented the required programs, staffing, or design adjustments needed to be called a dementia special care facility. State regulators issued citations shortly after this review.

The Boston Globe interviewed Helen Magliozzi, Director of Regulatory Affairs for the Massachusetts Senior Care Association, a nursing home trade group, and she noted that the state’s changing rules made complying with the regulations difficult. State regulators completed their nursing home reviews on August 23, just two days after changing their previous guidance to nursing facilities.

“I would suspect that a significant number of nursing facilities had corrected their websites prior to the issuance of the deficiency letters” by the state health department, Magliozzi told the Boston Globe.

It’s extremely important that if you have a family member or loved one receiving at dementia care services at a nursing home, the services meet current state rules and regulations. If your family member or loved one is receiving dementia care services from any of the facilities listed below, it’s a good idea to inquire if the facility has since complied with state regulators.

List of Nursing Homes cited by state regulators:

  • Baldwinville Skilled Nursing and Rehabilitation Center
  • Beaumont Rehabilitation and Skilled Nursing Center of Northboro
  • Blackstone Nursing Home
  • Bourne Manor Extended Care Facility
  • Cardigan Nursing and Rehabilitation Center
  • Corey Hill Nursing Home, Inc.
  • D’Youville Senior Care
  • Excel Center for Nursing and Rehabilitation at Lexington
  • Fairview Commons Nursing and Rehabilitation Center
  • Fall River Jewish Home, Inc.
  • Glen Ridge Nursing Care Center
  • Harbor House Nursing & Rehabilitation Center
  • Hathaway Manor Extended Care Facility
  • Hellenic Nursing and Rehabilitation Center
  • Hunt Nursing and Rehabilitation Center
  • Jesmond Nursing Home
  • Jewish Nursing Home of Western Mass
  • Kindred Nursing and Rehabilitation–Great Barrington
  • Kindred Nursing and Rehabilitation–Braintree
  • Kindred Nursing and Rehabilitation–Hallmark
  • Kindred Nursing and Rehabilitation–Tower Hill
  • Kindred Nursing and Rehabilitation–Harborlights
  • Kindred Transitional Care and Rehabilitation–Highgate
  • Kindred Transitional Care and Rehabilitation–Forestview
  • Kindred Transitional Care and Rehabilitation–Harrington
  • Kindred Transitional Care and Rehabilitation–Highlander
  • Life Care Center of Nashoba Valley
  • Lighthouse Nursing Care Center
  • Lydia Taft House
  • Madonna Manor Nursing Home
  • Maples Rehabilitation and Nursing Center
  • Marian Manor
  • Marian Manor of Taunton
  • Mt. Greylock Extended Care Facility
  • Newbridge on the Charles Skilled Nursing Facility
  • North Adams Commons Nursing and Rehabilitation Center
  • Our Island Home
  • Our Lady’s Haven
  • Overlook Masonic Health Center
  • The Pavilion
  • Pilgrim Rehabilitation and Skilled Nursing Center
  • Plymouth Rehabilitation and Health care Center
  • Recuperative Services Unit
  • St. Joseph Rehabilitation and Nursing Care Center
  • Sweet Brook of Williamstown Rehabilitation Nursing Center
  • Thomas Upham House
  • Wayland Nursing and Rehabilitation Center
  • Willamstown Commons Nursing and Rehabilitation Center
  • Windsor Nursing and Retirement Home
  • Woodbriar Health Center


Assisted living is not nursing home care

Many ALFs claim to be able to care for Alzheimer’s patients. Despite this, many Alzheimer’s patients suffer harm and neglect. Assisted living facilities are rapidly becoming the nursing homes of the future. According to the National Center for Assisted Living, there are over 36,000 licensed assisted living facilities nationwide with an estimated one million residents.

Most ALFs, promote special Alzheimer’s disease Units, and are accepting residents with significant cognitive impairment. The reality is that many of these facilities have staffing that is inferior to the staffing levels present in nursing homes and simply cannot meet the needs of the higher acuity residents. The end result is that residents are suffering from serious injuries.

There is very little in regards to regulations (safety rules) for this industry. There are no federal guidelines or requirements only state to state, The regulations that do exist provide a very minimal protection for the residents.

Your assisted living facility search starts with the set up of the facility, the design of the facility and the marketing of the facility. First start with the analysis as to whether the facility is committed to Alzheimer’s awareness and care as they often say they are.

The assisted living industry specifically markets for residents suffering from Alzheimer’s. This requires special knowledge and training in the care for Alzheimer’s. There are also risks associated with caring for Alzheimer’s residents if you don’t know how to address Alzheimer’s issues.

When evaluating an assisted living Alzheimer’s unit look to determine whether the facility followed the standard of Alzheimer’s care, or commonly called, care practice recommendations. It is referred to in the industry as care practice recommendations and are recommended and supported by the Alzheimer’s Association, But, largely, the standard of Alzheimer’s care is outlined by experts in the field. First and foremost there has to be a commitment to Dementia care. Look at the facility’s Mission Statement. The Mission Statement should state the goals of the facility and how they plan to get there. Next is to approach training. Training can’t be a one day seminar or video tape. Training has to be ongoing. Recommended are 12 hours of initial training and 1 additional hour of training each month. The training shouldn’t stop there. Each staff member should be updated on each resident. Most often the staff have no idea about the residents’ backgrounds, family history, medical conditions, needs, safety precautions and other needs. Training ties directly to staffing. The staffing patterns should ensure that residents with dementia have sufficient assistance to complete their health and personal care routines and to participate in the daily life of the residence. Look for the level of staff communication with the resident’s family. This is critical to helping a family understand the progression of the resident’s disease. For the complete guide go to www.alz.org and look for Dementia Care Practice Recommendations for Assisted Living Residences. The care practice recommendations consist of three areas: Adequate Food and Fluid Consumption; Pain Management; Social Engagement and Involvement in Meaningful Activities.

Understanding that the standard of care is different than that of a nursing home and understanding Alzheimer’s disease is two important parts of evaluating an assisted living facility.

The most common type of injury occurring in assisted living is resident on resident assaults and abuse. More likely than not between two residents suffering from Alzheimer’s. In one particular case one resident beat another resident to death. Both suffered from Alzheimer’s. Ask the obvious questions: What are the causes of Alzheimer’s disease? What are the Symptoms? How is it diagnosed? How is it treated? What are the dangers associated with the disease. Often times, the hands on personnel can not answer these questions.

The most common type of ALF litigation are falls, staff competency issues, e.g. medication errors, skin problems and responses to adverse incidents. Even though, ALF do not consider themselves in the healthcare field they should have a fall prevention program for the simple reason that, because of age, Alzheimer’s and medications, people living in assisted livings arc nt risk for falling.

Even though the assisted living facility will rely on the fact that there isn’t federal (and in most states) regulations (safety rules) like for nursing homes; and that they do not provide medical care they have to follow the duty of care for treatment of Alzheimer’s since they specifically market for, accept and agree to care for Alzheimer’s. Alzheimer’s is a medical condition which requires medical attention and specific training in awareness, treatment, diagnosis and injury prevention.


Remembering 9/11

There are no words that I can say to describe 9/11. Today’s news casts and stories give me goose bumps. Here are the lyrics to America the Beautiful:

O beautiful for spacious skies,
For amber waves of grain,
For purple mountain majesties
Above the fruited plain!
America! America!
God shed His grace on thee,
And crown thy good with brotherhood
From sea to shining sea!
o beautiful for pilgrim feet
Whose stern impassion’d stress
A thoroughfare for freedom beat
Across the wilderness.
America! America!
God mend thine ev’ry flaw,
Confirm thy soul in self-control,
Thy liberty in law.
o beautiful for heroes prov’d
In liberating strife,
Who more than self their country lov’d,
And mercy more than life.
America! America!
May God thy gold refine
Till all success be nobleness,
And ev’ry gain divine.
o beautiful for patriot dream
That sees beyond the years
Thine alabaster cities gleam
Undimmed by human tears.
America! America!
God shed His grace on thee,
And crown thy good with brotherhood
From sea to shining sea.


A Memorial Day tradition

Every Memorial Day weekend since 1948 the Army 3rd Division, Infintry Regiment place American flags at the 220,000 fallen soldiers buried at Arlington National Cemetary. Take a moment this weekend, pause, and remember those who sacrifised for our country. There are an estimated 1,981,000 American WWII veterans are still alive. There is no count as to how many reside in a nursing home but for those who do, and if you know of any, bring them an American flag to hold this Memorial Day and thank them for their service.


What happened to dignity and respect?

A nursing home must promote care for residents in a manner and in an environment that maintains or enhances each resident’s dignity and respect in full recognition of his or her individuality. This is the Rule. This is the Law.

However, some nursing home owners and operators do not teach their staff this rule and law. Recently, in a Massachusetts nursing home a pattern of lack of respect and maintain dignity by the staff was exposed. Certified Nursing Aides have been accused of videotaping and mocking elderly residents who suffer from dementia and texting nude photos of residents. There are also residents at this facility that suffered from life threatening fractures because they were not assisted correctly. Why does this happen? One reason is cultural differences. Most CNAs are immigrants and were not raised with American history and respect for our elderly. So how can they understand the “Greatest Generation”? Most CNA’s will not take responsibility and accountability for their actions because they do not know how to be responsible or accountable. It is something that was not taught to them. Nursing home operators and owners know this but do little to nothing about it. American history, culture and heritage must be part of the CNA’s orientation and training. Once the CNA’s understand and realize what our elderly have gone through and how they made this country great maybe they will be more inclined to maintain dignity and respect.

The BOTTOM LINE is that a nursing home must never needlessly endanger their residents. If they do they must be held accountable and responsible for their actions.


Still remaining WWI veteran poses question on veterans day

This week we recognize Veterans Day. Veterans Day is an annual US holiday honoring military veterans. It is celebrated on November 11, the anniversary of the signing of the Armistice that ended World War I. (The conflict of WWI were formally ended at the 11 th hour of the 11th day of the 11th month of 1918). Then President Woodrow Wilson first proclaimed an Armistice Day for November 11, 1919. In proclaiming the holiday, he said:

“To us in America, the reflections of Armistice Day will be filled with lots of pride in the heroism of those who died in the country’s service and with gratitude for the victory, both because of the thing from which it has freed us and because of the opportunity it has given America to show her sympathy with peace and justice in the councils of the nations.”

In 1954 Congress replaced “Armistice Day” with “Veterans Day” to honor and remember ALL veterans who protected our country.

There is only one WWI veteran left in the country (four in the world). His name is Frank Buckles and he has a web site and Facebook page. On his web page Frank asks a question: “How will America honor my comrades?” Think about that. How will we? As lawyers there is one way and that is to use the jury system for the protection and safety of the people that our veteran’s fought to protect. Our office represents many WWII veterans and their families and their stories need to be told. One way to preserve their story and tell the story is to ajury.

My grandfather, John B. Hoey, was a pilot in the South Pacific during WWII. One of his proudest moments was when I became a lawyer -true Americanism. Please remember our Veteran’s this week and please remember the sacrificies our clients made during those years for all of us to be Americans.


Standing up for seniors: how the civil justice system protects elderly Americans

Civil suits help uncover abuses by nursing home and insurance companies, according to a new report by the American Association for Justice.

“Where regulatory and legislative bodies have been unable to cope with this distressing rise of neglect and abuse of our elderly, the civil justice system has stepped into the breach,” said AAJ President Gibson Vance, a partner in the Montgomery, Ala., office of Beasley Allen, in a statement accompanying the release of the report, “Standing Up For Seniors: How the Civil Justice System Protects Elderly Americans.”

According to the report, over 1.5 million elderly Americans are in nursing facilities, the vast majority of which are owned by private corporate chains, making it difficult for consumers to hold them accountable for abuse.

The report also asserts that insurance companies are more likely to take advantage of older patients with practices like miscalculating mortality rates, denying claims and cutting off benefits for needed treatments.

The report outlines how, through litigation, trial attorneys across the country have uncovered evidence of corporate programs aimed at terminating seniors’ benefits as well as evidence of nursing home abuse and neglect.

The report warns that efforts to combat nursing home abuses through civil suits are hampered by the use of mandatory arbitration clauses in nursing home and insurance contracts.

Read the entire report here.

 

The nursing home abuse attorneys and elderly neglect lawyers at Hoey Law protect the rights and dignity of Senior citizens throughout Massachusetts and New Hampshire. We serve all of Massachusetts including the communities of Greater Boston, Boston, Worcester, Springfield, Cambridge, Lowell, Brockton, Quincy, New Bedford, Fall River, Lynn, and Cape Cod.

Our attorneys serve all regions of New Hampshire including the communities of Manchester, Nashua, Concord, Derry, Dover, Portsmouth, Rochester, Keene, Laconia, the lakes region, and the White Mountain region.


Civil justice system uncovers abuse and neglect of elderly Americans

New AAJ report shows how litigation holds nursing homes, insurance companies accountable when they target nation’s seniors

Washington, D.C.—A new report released today by the American Association for Justice (AAJ) illustrates how the civil justice system is the most effective force in uncovering abuses by corporate nursing homes and insurance companies that target elderly Americans.

There are 1.5 million elderly Americans currently residing in nursing homes – facilities that are now operated by mostly large corporate chains banking on the upcoming influx of baby boomers. Many of these vulnerable residents have suffered abuse by staff members and even died from dehydration or infection caused by inadequate care. The report explains how litigation has revealed this neglect and abuse and allowed residents and their families to hold offending corporations accountable.

“Corporate nursing homes and insurance companies have continually chosen to put profits ahead of the well-being of our most vulnerable population,” said AAJ President Gibson Vance. “Where regulatory and legislative bodies have been unable to cope with this distressing rise of neglect and abuse of our elderly, the civil justice system has stepped into the breach.”

A common theme in the report is abuse by insurance companies taking advantage of senior citizens. It highlights the story of a South Dakota farmer named Rudy, who was one of a flood of patients that companies signed up for long-term care insurance in the 1990s. Rudy moved into a nursing home at his doctor’s suggestion, only to have his benefits cut after three years when the company declared his care was no longer “medically necessary,” despite faithfully paying his monthly premium.

Thousands of seniors met similar fates as insurance companies miscalculated mortality rates and searched for ways to deny claims and cut off benefits, figuring few of their terminated policyholders would fight back. Trial attorneys across the country eventually found evidence of corporate programs aimed at terminating seniors’ benefits, and helped stop these deplorable practices.

Unfortunately, while litigation has revealed incidences of abuse and neglect, many other offenses never see the light of day due to nursing homes inserting forced arbitration clauses in the fine print of lengthy admission contracts. Residents and their families often sign these contracts while under considerable stress and anxiety without realizing they are being stripped of their access to court. Congress has introduced legislation to ban forced arbitration in nursing home and other consumer contracts.

The report, titled “Standing up For Seniors: How the Civil Justice System Protects Elderly Americans,” can be found at www.justice.org/seniors.


Nursing home neglect in Massachusetts

MASSACHUSETTS DEFINES NEGLECT AS:

Neglect: Failure to provide goods and services necessary to avoid physical harm, mental anguish or mental illness. In determining whether or not neglect has occurred, the following standards shall apply:

(1) A patient or resident has been neglected if:

(a) An individual has failed to provide appropriate care, treatment or service to the
patient or resident; and

(b) The individual’s failure to provide the treatment, care or service to the patient or resident
is either intentional or the result
of carelessness; and

(c) As a result of the failure to provide the treatment, care of service, the individual has failed
to maintain the health or safety
of the patient or resident, as evidenced by harm to the patient or resident, or a deterioration in the patient or resident’s physical, mental or emotional condition.