seniors%20on%20bench.jpg At a time when reports of elder abuse are on the rise across the nation, our San Diego elder abuse attorney knows it is important to be aware of the various types of abuse and the associated signs and symptoms.

Typically, elder abuse or neglect is often thought to be physical or sexual. For example, at negligent nursing homes some indicators of physical abuse may include unexplained bruises or signs of use of restraints such as rope burns or other suspicious marks. Neglect can include untreated infections, serious bed sores, or a lack of proper supervision.

Elder financial exploitation is also common. According to the San Jose Mercury News, 563 reports of financial abuse of people over 65 were filed in one central California county in 2010 alone.

For nearly half a century California has been a pioneer in the field of adult day health care, creating a system designed to provide health and social services to the elderly and disabled. The Adult Day Health Care (ADHC) system was established in the 1970s, in part as a response to stories of nursing home abuse or neglect like bed sores, infections, falls, inadequate supervision, misuse of medication, malnutrition, and dehydration. elder%20abuse.jpg

The California ADHC benefit provided a system of community services to medically needy elderly and disabled individuals by qualified health care providers, including nurses, social workers, and physical therapists. According to an article in the Times-Standard, which called the California legislature’s recent elimination of the ADHC model the “unkindest cut,” the California ADHC benefit served approximately 55,000 seniors and people with disabilities annually. The ADHC benefit aimed to keep elderly loved ones out of institutions while also easing the caretaking duties of family members. Thus, for the past forty years, the California ADHC benefit has protected some of our most vulnerable citizens and has helped to prevent California elder abuse.

Our San Diego elder abuse attorney knows that the recent budget cuts may soon render elderly and disabled citizens more vulnerable. In March of this year, California legislators voted to eliminate the ADHC’s network of support. California is now grappling with its difficult decision and its subsequent, and somewhat hastily assembled, plan to transition elderly and disabled patients who are currently receiving care under the ADHC benefit to alternative facilities and placements. What was once the nation’s “gold standard” for elder care is now placing elders and their families at risk. Seniors who were receiving community care may have to be placed in nursing homes, increasing their risk for abuse and straining the finances of their families.

Most instances of California nursing home neglect are indirectly harmful situations –such as when a resident develops problems like pressure sores or experience a deadly fall because staff members failed to provide close care and observation. However, some instances of outright abuse are also reported. These are situations where nursing home employees engage in knowing or intentional actions that harm these vulnerable residents. Our San Diego nursing home abuse attorney knows that these are often the most stomach-turning cases where justice demands both civil and criminal accountability.

One of the more shocking nursing home abuse cases to be brought to light recently involved an apparent “prank” between employees at a long-term care facility with unsuspecting residents used as the props. According to reports, two nursing home workers at the Valley View Skilled Nursing Facility orchestrated a prank where they apparently rubbed down the bodies of several residents with an ointment. The elderly dementia patients were covered from head to foot with the gel so that they would be slippery when handled. The employees wanted to have a laugh with the evening shift of staff members that were arriving. The workers bizarrely assumed that it would be considered funny for the next crew to have difficulty working with the slippery residents.

Fortunately, some of those who learned about the situation did not find it funny and reported the situation to authorities. The full extent of the situation came out during the investigation. The two leaders of the prank were charged with elder abuse while three other employees were cited for failing to report elder abuse after learning about the situation but staying silent. All five employees had their nursing assistant licenses revoked. The Huffington Post reports that last week two of those employees were also sentenced after being found guilty of California elder abuse. They will each spend 20 days in county jail, will be placed on two year probation, and must perform community service. petroleum%20jelly.jpg

restraints.jpgSan Diego nursing home neglect is often difficult to identify, because it can take so many forms. In many cases the neglect causes already fragile residents to develop secondary complications and it is those complications which lead to severe injuries or the death of the resident. Many families are ultimately left unaware that their loved one would likely still be alive if they had received the level of care to which they were entitled. Helping residents identify and prove mistreatment is a key role played by a San Diego nursing home attorney.

There are often many signs and symptoms that if identified can be a good indicator of neglect. One of the more complex forms of California nursing home abuse that occurs with far too much frequency involves misuse of medication. As the Consumerist explained last week in an elder care story, many area nursing homes seek to control residents by essentially drugging them into submission. Appropriate care at these facilities necessitates that the individual needs of each resident be addressed. However instead of providing that care, many nursing homes instead chose to give these residents powerful antipsychotic drugs.

The problem is particularly prevalent for dementia and Alzheimer’s patients. Often these seniors are given vast quantities of drugs intended to be used by those with bipolar disorder or schizophrenia. These drugs have the effect of turning many of these residents in virtual zombies. Tragically, family members often visit their loved one at a facility only to discover that their relative appears lifeless or lacking a vigor that they previous had. Most states require that all residents give informed consent before they are given these drugs. Not surprisingly, many facilities fail to get that consent before administering the medication.

Many of these antipsychotic drugs are given to patients who have not even received a diagnosis for a condition in which the medication was designed to treat. This represents an incredibly dangerous form of abuse. The United States Food and Drug Administration recently explained how the use of these antipsychotic drugs on older dementia patients for unapproved uses can nearly double their risk of death. With sobering statistics like that there is no reason why any facility should even consider using these drugs in this way and putting vulnerable resident lives on the line.

It is important for family members to understand the warning signs of these “chemical restraints” and to know that help is out there. The California Advocates for Nursing Home Reform have actually put together a helpful packet for those in this situation entitled “What You Should Know to Fight the Misuse of Psychoactive Drugs in California Nursing Homes.”

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A California nursing home neglect case can come in many forms. The most common situation involves a senior resident who begins living in a facility and develops health problems caused by substandard care. In many of these cases it is the family members of the victim who notice the problem, have suspicions about negligent care, and then contact a California nursing home abuse attorney to initiate the legal action. However, with a growing array of at-home care arrangements, many lawsuits now stem from poor care provided in different assisted-living contexts.

For example, Outpatient Surgery News reported this weekend on the latest actions in a Southern California negligence case against a nursing home chain that provided at-home assistance to a disabled resident. The victim in the case was only 24 years old when she underwent surgery to implant a spinal cord stimulator to reduce pain cause by a previous ankle injury. Several months later she underwent a second surgery to reposition the device. nurse.jpg

Following these procedures she required at-home nursing care to aid in her recovery. As is common in these cases, the young woman hired a nurse employed by a nursing home firm to provide that necessary assistance. The worker was supposed to visit the woman twice a day for the first week after her surgery. Specifically, the nurse was needed to hook up a morphine pump at the designated intervals. Unfortunately, the care worker was unfamiliar with the processes of using the pumping mechanism. She mistakenly activated the device six times within the first four hours of use, causing it to lock out.

A few hours later the victim’s mother called 911 after being unable to rouse her sleeping daughter. Emergency responders arrived and administered a morphine reversal agent after finding her unconscious. The young woman was eventually diagnosed with hypoxic encephalopathy caused by the morphine drip error. She suffered a permanent brain injury likely necessitating around the clock care for the rest of her life.

Following the tragedy the family of the young woman initiated a California nursing home lawsuit on her behalf. They sought to hold the company which employed the nurse liable for the debilitating injuries caused by her negligence. Upon hearing the evidence in the case the jury eventually awarded the victim $9.9 million to cover the necessary medical care for the rest of her life. A California appeals court recently upheld the decision last week.

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One of the main challenges faced by victims of San Diego nursing home abuse is the difficulty in identifying and documenting specific instances of poor care. Many area nursing home residents do not understand their right to receive proper care or recognize when they have received substandard treatment. Even when they are aware of negligence by employees, many seniors and their families are unsure what they should do to document the problem. elder%20hands.jpg

Documentation is often important in these matters, because judges, juries, and state regulatory bodies often rely on a paper trail to understand the sort of care that a resident received. Unfortunately, there remain lax standards when it comes to keeping track of reports of San Diego nursing home neglect. The problem exists throughout the state as facilities in all corners of California are currently not required to document when a resident or family member files a complaint suggesting substandard treatment.

One local advocate is seeking to change that, and is urging that the state pass legislation which would force nursing homes to keep track of neglect and abuse charges. The North Country Times reported on the legislative push last month. The effort is being spearheaded by Lynda Tammone, an area resident who became frustrated after her husband received substandard treatment while spending a year in a nearby nursing home following sudden health problems.

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Southern California elder abuse occurs with surprising frequency, affecting thousands of area seniors. Unfortunately, in many ways it remains a hidden problem because most cases of elder abuse and neglect are never reported and wrongdoers are rarely held accountable for their conduct. This sad reality was brought home in an SF Weekly post on Monday which explained how fewer than one in one hundred cases of elder abuse ever result in a criminal conviction.

A comprehensive report conducted by the area police department uncovered the infrequency of punishments for elder abusers. The data mirrors similar research by state agencies which also highlighted the infrequency with which this conduct is ever brought to light. For example, the state’s Department on the Status of Women found that only one in five cases of California elder neglect are even reported to authorities.

Elder care advocates explain that many seniors do not report mistreatment because of what they call the “fatigue factor”—where seniors are reluctant to engage in a legal battle following poor care. In the nursing home context, unfamiliarity with their rights is also a factor in the underreporting of neglect. Many vulnerable residents of long-term care facilities are unaware of the level of care to which they should be entitled. Therefore, if a nursing home employee fails to provide them with the assistance they need many seniors are unlikely to share the situation with concerned friends or family members. Similarly, most nursing home residents are not familiar with more nuanced forms of nursing home neglect, such as the failure to properly supervise residents or allowing resident-on-resident attacks.

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A skilled nursing facility in Montrose was indicted for criminal abuse and neglect after a committed suicide by discharging a fire extinguisher down his throat. A grand jury indictment asserts that the facility, Wellness Centre, and its former administrator were complicit in the death of 34-year-old patient Charles Morrill. It was the third time Morrill attempted suicide.

“On and between January 22, 2009 and February 28, in the County of Los Angeles, the said Verdugo Valley Skilled Nursing Wellness Center and Phyllis Paver did, under circumstances and conditions likely to produce great bodily hard and death, knowingly and willfully cause and permit Charles Morrill, a dependent adult, to suffer, and inflicted theron, unjustifiable physical pain and mental suffering and, having the care and custody of said person, willfully caused and permitted him to be placed in a situation in which his health was endangered, and knew and reasonably should have known that said person, Charles Morrill, was a dependent adult.”

The indictment came after an investigation by the California Department of Public Health, which had a long history with the facility. Glendale Police told reporters that over the last few years it had received numerous calls about residents wandering away from the facility, 911 hang ups, and accusations of assaults at the nursing home.

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Iris Ramirez owns four residential care facilities for the elderly in San Diego called Ambassador Senior Retreat. Those facilities, like all licensed RCFE facilities in California, are overseen by the California Department of Social Services – Community Care Licensing (CCL). That means licenses can only be issued by CCL, inspections are made by CCL, and in the event of a complaint, investigations are performed by CCL. In short, CCL is the regulatory agency that gives residents of these facilities (and their families) the assurance that laws will be followed, regulations enforced, and that proper care will be provided.

Ramirez apparently didn’t want to take any chances with CCL investigators, and, according to news accounts, offered bribes to the very people charged with overseeing her assisted living facilities. The investigators have been identified as Conchita Valero, Lydia Williams and Christina Nepomuceno.

A search warrant executed this month alleges that Ramirez purchased airline tickets for Valero and Williams to travel to the Philippines for a vacation, and also gave Valero cash in the sum of $2,800. In exchange for the tickets and the cash, the CCL employees fast-tracked Ramirez’s licenses to operate her facilities. Apparently you don’t need brains to operate a residential care facility. According to the news accounts, Ramirez told investigators that she was “probably” getting preferential treatment because of the bribes.

In addition to Ramirez, the investigation has focused on Selma Teer, the owner of the Eternal Sunshine Care assisted living facility on Quince Street in San Diego. According to court documents, Teer wanted to open another facility, and offered investigator Nepomuceno a $3,000.00 bribe to expedite the process. Like Ramirez, Teer made no effort to conceal her expectation of a quid-pro-quo. When Nepomuceno went on medical leave and did not return Teer’s calls, Teer left her a rather incriminating message on Nepomuceno’s state-issued cell phone:

“(You are) not returning my call. You are not paying my money back. You want a bribe for my application for my license. You lied. You are such a liar. You want a bribe, do your job. You don’t do your job; you give me my money back.”

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blalock_t593.JPGA patient at the San Diego Health Center nursing home wandered away from the nursing facility on Wednesday and police have been unable to locate her. Verna Blalock, 76, who suffers from dementia was last seen at the facility located on Meadowlark Drive near Starling Drive. San Diego Health Center is one of San Diego County’s largest nursing homes, with over 300 beds, and includes a secured section for people with memory impairment like Ms. Blalock.

Ms. Blalock is described as 5 feet 4 inches in height and weighs approximately 135 pounds. She was wearing a pink and white striped shirt at the time of her elopement, which the nursing home says was the first time she has wandered away from the facility. It is currently unknown how she was able to escape from the building.

Anyone with any information about her whereabouts is asked to call San Diego Police at 619 531-2000, or the nursing facility at (858) 277-6460.

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