Nursing homes in California continue to receive warnings from the U.S. Food and Drug Administration (FDA) about the use of antipsychotic medications given to elderly residents, yet the use of chemical restraints continues. Indeed, according to a recent news story from ABC News 10, nearly fifty nursing homes in our state “rate below average for the use of antipsychotic drugs.” Does the use of chemical restraints constitute nursing home abuse?3056268889_8235784d86

Dementia and Antipsychotic Medications

Many of us know that elderly nursing home residents, particularly those who have been diagnosed with dementia, may be prescribed antipsychotic medications in order to chemically “restrain” them. For those of us with loved ones residing in these facilities, it can be frustrating to learn that off-label drug use is taking place when it’s unnecessary and could lead to serious harms.

According to a recent article in the Orange County Register, Kerri Kasem has been heavily involved in a campaign against elder abuse that aims to both educate the community and change the laws on visitation. Kasem is the daughter of Casey Kasem, the radio personality who passed away last June. Given Kerri’s concerns that her father was suffering elder abuse at the hands of his wife, Kerri began campaigning for elder abuse awareness in California.9736400153_2289e66888

Family Caregivers Can Be Responsible for Abuse

Back in 2013, Kerri Kasem’s father had been suffering from Parkinson’s disease and was recently diagnosed with Lewy body dementia. He had previously been residing in a nursing home, but his wife, Kerri’s stepmother, soon became his sole caregiver. At that time, Kerri’s stepmother prevented any of Casey’s children from seeing him, and she cut off the former radio personality’s contact with the outside world.

According to a recent story from ABC 7 Eyewitness News Los Angeles, “California’s largest nursing home chain has come under fire from government regulators, facing a flurry of citations and penalties.” Indeed, Brius Healthcare Services will have to account for the numerous elder abuse allegations against its facilities across the state.341653009_14c3f29e39

Serious Violations in Brius Health Services Facilities

Over the course of the past year, Brius facilities have been investigated by the police, they’ve been sued for nursing home abuse, and they’ve been the target of investigations conducted by state and federal agencies that have issued violations. The company has 81 facilities in California, and they cover a wide expanse of the state. Indeed, the facilities stretch from “San Diego to Roseville to Eureka.”

Every year on June 15th, the National Center on Elder Abuse (NCEA) and the Administration on Aging (AoA) provide awareness resources and prevention information for World Elder Abuse Awareness Day (WEAAD). According to a press release from the AoA, WEAAD was established in 2006 by several different global organizations that partnered to help stop elder abuse across the world.4015324803_d0e5839192

Elder Abuse and Neglect Occurs Across the Globe

In conjunction with the International Network for the Prevention of Elder Abuse and the World Health Organization at the United Nations, the NCEA and AoA hope to “provide an opportunity for communities around the world to promote a better understanding of abuse and neglect of older persons.” What kind of tools are necessary to help global citizens understand elder abuse and neglect? While age is a primary risk factor for sustaining injuries resulting from elder abuse, nursing home abuse and neglect isn’t limited to just one socioeconomic or ethnic group.

According to a recent article in the Courthouse News Service, a California senior’s family filed an elder abuse lawsuit against “the nation’s largest nursing home chain” after the patient was accidentally given a fatal dose of morphine. The victim, Jonathan Bell, had been a dialysis patient at American River Center in Sacramento when his nurse mistakenly administered the morphine. Bell’s family has alleged that the nursing home “refused to let an ambulance take the catatonic man to a hospital” after the medical mistake occurred. Bell died the following day.1921401904_b3e2bdfd81

Nursing Home Concerned About Sanctions

Why wouldn’t staff members at American River Center allow an ambulance to take Bell to the hospital for care? His daughters argue that “the nursing home feared sanctions for giving him the wrong treatment and tried to cover up its mistake by letting Bell remain in a catatonic state for more than 24 hours without medical attention.” Indeed, according to the family’s lawyer, “they tried to bury their mistake and buried his life.”

When a 911 call originates from a nursing home or assisted-living facility, the responding paramedics are often the first objective eyes to enter a resident’s living space. Because they bridge the gap between the private confines of a care facility and the public healthcare system, emergency medical responders (EMRs) are in a unique position to identify signs of abuse or neglect that might otherwise remain hidden behind closed doors.

As noted in reports from KRCR News regarding elder care in Northern California, first responders are frequently the “canary in the coal mine.” Their observations during those first few minutes on the scene can be the difference between a senior remaining in a dangerous situation or receiving life-saving intervention.red-cross-29930_1280

California Law and the “Mandated Reporter”

Back in September, we discussed a federal lawsuit concerning nursing home abuse in Watsonville. According to a recent article in the San Jose Mercury News, the leaders of those two Watsonville nursing homes involved in the suit have agreed to a $3.8 million settlement. The lawsuit alleged that the owners “provided ‘substandard or worthless services,’ overly medicated residents, and submitted false Medicare and Medicaid claims.”2189387168_cc27c053e0

Background of the $3.8 Million Nursing Home Abuse Settlement

Filed eight months ago, the lawsuit alleged gross misconduct related to elder abuse and neglect. Now, almost a year later, the leaders of those Watsonville nursing homes have agreed to settle the case. The facilities include Country Villa Watsonville East (now renamed as Watsonville Nursing Center), and Country Villa Watsonville West Nursing and Rehabilitation Center (now renamed as Watsonville Post-Acute Center). Other named parties included the CF Watsonville East, LLC, CF Watsonville West, LLC, and the entities overseeing the finances and nursing home management of the facilities.

How dangerous are psychiatric medications when they’re prescribed for dementia patients in nursing homes? According to a recent article in Modern Healthcare, the benefits of the long-term use of psych meds when they’re prescribed for the disorders for which they’re designed—would “need to be colossal to counter known harms associated with their use.” And while the off-label use of antipsychotics to treat dementia symptoms appears to have declined, it remains a significant problem in Southern California and throughout the country.

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Stopping Use of Psychotropic Drugs

Researchers across the globe are speaking out about the dangers of antipsychotic drugs. To be sure, a debate about their efficacy and long-term effects recently sprung up on the website for the journal of the British Medical Association. According to Dr. Peter Gøtzsche, who serves as the director of the Nordic Cochrane Center, the lack of benefit from these medications, particularly when they’re used in an off-label manner, means that “we could stop almost all psychotropic drugs without causing harm.” For even when they’re used to provide short-term relief, he emphasized, they pose serious long-term harms.

Given the sheer number of nursing home abuse complaints that have created a backlog in Southern California, it sounds like good news that state officials are hoping to change nursing home inspection and oversight duties. Indeed, according to a recent article in the Los Angeles Times, officials in Los Angeles County are changing the way they handle nursing home neglect complaints “as part of a drive to better manage a backlog of investigations.”

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However, the reorganization may not be sufficient to yield a significant change. To be sure, “some patient advocates say the proposed changes aren’t likely to significantly improve conditions, and could make matters worse.”

Investigation Practices in Los Angeles County

When you learn that an elderly loved one has died while in the care of a nursing home or assisted-living facility, you may suspect that she didn’t receive the proper treatment. In some cases, however, it’s difficult to discern whether an older adult suffered injuries as a result of medical negligence or because of elder abuse.6811278733_eca62c5091

In California, nursing home abuse and neglect is a serious problem throughout the state. At the same time, medical malpractice can occur in a variety of healthcare settings, including nursing homes. According to a recent article in the National Law Journal, differentiating medical negligence and elder abuse cases can be complicated in California.

Characterizing a Healthcare Provider’s Actions

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