Tuesday, January 31, 2012

Hospital Visits May Lead To Nursing Home Infections

It is not uncommon for elderly nursing home residents to be in poor health or in need of medical assistance. In some of these situations, an emergency room visit may be essential for that patient.  However, an emergency room visit may also lead to infection in the nursing home later on.


An article published by University of Pennsylvania's School of Medicine recently explored this phenomenon.  According to the article, an ER visit may lead to 3x risk of respiratory and gastrointestinal infections for nursing home residents.  Within the nursing home setting, the rate acute respiratory or GI infections was at 5% within a week of an emergency department visit as opposed to 2% when not the resident did not leave the long-term care facility.  After accounting for other variables, residents at such homes were actually 3.9x more likely to acquire an infection following a trip to the emergency department.  One researcher is also quoted as saying, "If they acquire an infection while in the emergency department, these residents may be the source of an outbreak upon return to their facility".

All in all, hospital visits from a nursing home lead to high-risk periods for all of the nursing home residents once the sick person returns.  New nursing home residents transferred from hospitals may pose an even higher risk for an outbreak of illness within the facility.  Applying this knowledge, if someone you know has been recently admitted into a nursing home from a hospital, has recently been to the hospital, or has friends in the nursing home that have just returned from the hospital, it will be crucial to monitor those people for any changing conditions or health issues.  If you feel that your loved one needs more care than they are currently being given by the nursing home staff, you may need to discuss changes with the nursing home employees.  

Attorney Doug Stoehr is a central Pennsylvania lawyer specializing in nursing home abuse and negligence.  For more information on his practice, please visit his website

Monday, January 30, 2012

Fall Risks and Antidepressants

There are many factors that influence how and at which times nursing home residents are more susceptible to injuries.  In addition to understaffing, negligence, and abuse, falls are a very common source of injury in nursing home situations.  Some conditions lead to an increased likelihood of injury due to falling.  One of these conditions is the use of SSRIs by residents.

SSRIs, or selective seratonin reuptake inhibitors, are prescription medications commonly used to treat symptoms of depression and other anxiety disorders.  Recent research has also shown that the use of SSRIs may be linked to increased risk of falls in nursing homes from residents that are taking the drug.  A study performed in the Netherlands, taking data from over two years and 248 nursing home residents, resulted in some interesting findings.  According to the study, a total of 683 falls were experienced by 61.5 percent% of the nursing home residents. This data, looked at a year's span, results in a fall incidence of 2.9 falls/person/year. 220 of these falls resulted in injury or death. The investigators also found that the risk of having a fall resulting in injury was three times higher for residents taking SSRIs than for those who didn't take them. This particular statistic was found for both genders of a wide variety of ages. This fall-related risk of injury increased further when the residents were also given sedatives, such as sleeping pills.

It is important to monitor your loved one's medication, including type and dosage, in order to help minimize the risk of injury due to falls.  If your loved one has recently fallen in a nursing home setting and is now seriously injured, and if you feel that the nursing home has neglected your loved one, it may be time to seek legal assistance.  Attorney Doug Stoehr is a personal injury attorney specializing in nursing home abuse and negligence. For more information on him and his firm, please visit our website or call us at (814) 946-4100.

Thursday, January 26, 2012

Nursing Home Falls and Injuries


Falls in nursing homes are somewhat common occurrences and can lead to serious injury or even death.  Fall prevention practices and guidelines are not always clearly defined or effective.  Unfortunately, some residents labeled as fall risks fail to be properly attended to or given the extra help that they need to complete certain activities.

A study by Nyrop, Zimmerman, and Sloane (2011) studied the phenomenon of nursing-home related falls and how prevention guidelines could address those fall risk patients.  In their study, titled “Physician Perspective on Fall Prevention and Monitoring in Assisted Living: A Pilot Study”, they offered a wealth of information and background knowledge on falls in nursing homes.

According to the study, out of the 1.5 million Americans in nursing homes, an average of 43% of residents will fall every year; those numbers can actually go as high as 75% of residents in a given home.  Additionally, 10-25% of those falls lead to serious injury, such as bone fractures.  Nursing homes residents all together account for about 20% of fall-related deaths in people over 65.  The American Association of Medical Directors is one of a few organizations that have created fall prevention guidelines used by nursing homes.  However, these guidelines are general for all long-term care facilities and not address nursing homes in particular.

If your loved one has recently fallen in a nursing home setting and is now seriously injured, and if you feel that the nursing home has neglected your loved one, it may be time to seek legal assistance.  Attorney Doug Stoehr is a personal injury attorney specializing in nursing home abuse and negligence. For more information on him and his firm, please visit our website or call us at (814) 946-4100.

Wednesday, January 25, 2012

Nursing Home High-Risk Times

When an elderly person is admitted to a nursing home, there are several periods of time that are higher-risk for injury than other periods.  This phenomenon has been studied and documented by numerous researchers.  One study by Doupe et. al. (2011) titled "Nursing Home Adverse Events: Further Insight to Highest Risk Periods" talked about some of these situations.  For example, some of the highest-risk periods are:


-New residents account for a disproportionately high percentage of nonhip fractures and bedsores
-Hospitalized falls, hip fractures, and respiratory infections are most common immediately before resident death
-Skin ulcers are most likely for new nursing home residents coming from a hospital; this is independent of mobility


All in all, transition periods, either just being admitted to a nursing home or in the late stages of life immediately preceding death, are the high-risk periods for nursing home residents.  New nursing home residents transferred from hospitals pose an even higher risk for some conditions.  Applying this knowledge, if someone you know has been recently admitted into a nursing home, the first three months are critical to monitor for any changing conditions or health issues.  If you feel that your loved one needs more care than they are currently being given by the nursing home staff, you may need to discuss changes in your relative's individualized care plan.  

Attorney Doug Stoehr is a central Pennsylvania lawyer specializing in nursing home abuse and negligence.  For more information on his practice, please visit his website.

Tuesday, January 24, 2012

The Future of Nursing Home Studies

Over the summer, the Journal of American Medical Directors Association published an interesting and insightful article on the future of nursing home research and practice. Within this journal, many topics relevant to nursing home research and practices are discussed, as well as issued targeted directly at the elderly population.


According to the journal article, entitled "A Research Agenda For Nursing Homes", the authors state that "
In the past several decades, the fields of geriatrics and gerontology have focused on creating, organizing, and coordinating geriatrics facilities, and little attention has been given to research that would improve clinical practice…because most nursing home residents suffer from dementia, clinical research on dementia is needed to validate new approaches to deal with the most significant problems encountered by nursing homes that care for those with severe dementia, including aggressive behaviors, problematic vocalizations, emergency hospitalizations, the need for physical restraints, anorexia, and end-of-life issues." 

This move to more applied and forward-thinking research will be helpful in allowing nursing homes to realize how to care for and better serve their patients. With this in mind, nursing homes may be able to modify their practices and staffing procedures to decrease their incidents of negligence, abuse, and under/inefficient staffing.  Attorney Doug Stoehr is a central Pennsylvania lawyer specializing in nursing home abuse and negligence.  For more information on his practice, please visit our website.

Friday, January 20, 2012

Sleep and Chronic Pain

As discussed time and time again in this blog, chronic pain and lack of sleep often go together.  Pain reduces your ability to fall asleep and stay asleep, and the resulting fatigue often leads to more intense and long-lasting pain.  It is a vicious cycle that is difficult to break.


An article on CNN Health also discussed this phenomenon.  According to the article, "Patients with any pain syndrome often come in complaining of fatigue or tiredness. Their bodies have trouble falling and staying asleep. Sleep and pain are both ultimately controlled by the central nervous system. Poor sleep and pain form a vicious cycle - uncontrolled pain makes sleep difficult (if not impossible) and, in turn, the resulting poor sleep makes it more difficult to adequately control the pain."  Additionally, chronic pain sufferers spend more time in the light stages of sleep and therefore do not reach the deeper, more refreshing stages of REM sleep.  They also tend to have abnormal EEGs during sleep, called "alpha intrusion".  Although the cause of this is unknown, it is often linked to disorders that involve sleep and/or chronic pain.  


Chronic pain is a serious and life-altering diagnosis.  If you have been having trouble sleeping and have also had consistent pain lasting over six months, it might be time to consult with a doctor.  If this pain was caused by an accident due to the fault of another, it may also be time to consult with an attorney.   If you would like more information about this page or central Pennsylvania attorney Doug Stoehr's areas of practice, contact our Altoona, Pennsylvania, law firm by calling 814-946-4100.

Thursday, January 19, 2012

Psychological Therapy for Chronic Pain

Chronic pain sufferers sometimes cannot find relief with their existing drug and physical therapy/exercise routine.  Instead of feeling relief, patients often feel over-medicated and/or sedated by their drug use.  Since this lack of relief is a relatively common occurrence, the disease is gaining more press and some patients are finding relief through other publicized mediums.  One of these alternative pathways is through a psychological approach of cognitive-behavioral therapy.  Cognitive-behavioral therapy, or CBT, is a type of therapy that allows patients to reflect on how you think about and manage your pain mentally.  From that reflection, you then reconstruct your thinking and modify your behavior to reduce stress, manage anxiety, and improve quality and duration of sleep (lack of sleep is extremely common in sufferers of chronic pain).

CBT  has been shown in recent studies to be more effective than standard care in managing pain.  One study compared patients who exercised, patients who exercised and used CBT, and patients who only used CBT.  The CBT and CBT/exercise groups reported the highest improvement in their well-being (37% and 33%, respectively).  This therapy is also effective because it is short in duration, lasting only 8-10 sessions, and attacks the cognitive aspects of pain from the angles of behavioral activation, lifestyle change, and cognitive restructuring.  These aspects aim to improve the occurrence of fun and rewarding activities, identifying and eliminating negative thoughts, and improving diet and exercise habits.  


CBT could be a great complement to a chronic pain sufferer's existing pain management regimen if done properly and with commitment.  If you are interested in seeking CBT therapy, you might want to consult with your pain management physician.


If you would like more information about this page or central Pennsylvania attorney Doug Stoehr's areas of practice, contact our Altoona, Pennsylvania, law firm by calling 814-946-4100.

Wednesday, January 18, 2012

A Nursing Home Horror Story

In this blog, there are many posts relating to the hazards that can be found within nursing home settings.  Additionally, the topics of abuse and negligence, as well as understaffing, have also been discussed.  To put this in perspective, the following is a real case involving a claim against a nursing home within the last year.

An elderly woman was admitted to a nursing home in early fall of 2009.  Upon arrival, the staff assessed her as a high risk for injury and/or falling.  This was recorded in her individualized care plan.  She was also assessed by the nursing home as needing two persons at all times to use the bathroom, and for transfers and overall bed mobility.  About a month after her admittance, this woman had a new low air loss mattress  (for use for bed sores)  installed in her room, replacing the bariatric pressure redistribution mattress she had previously used.  This new mattress was neither recommended by a doctor (since the woman had no bed sores) nor properly installed.

Around this same time, there was a re-assessment of the woman's care plan, which did not account for or acknowledge her pronounced declining condition.  It also did not mention her recent stroke, cognitive impairment, left-sided hemiplegia, or new air loss mattress (and associated bed rails and risks). 

A few days after this re-assessment of care plan, the woman was found unconscious in her room with her head and neck stuck in the rails of the improperly installed bed.  Her lips were blue and she had no vital signs.  A nurse and another person removed her from the rails and called an ambulance.  The nursing home failed to inform both the emergency responders and hospital about how the woman became injured.  The woman died at the hospital and the hospital listed her causes of death as pneumonia and CVA.  The cause of death was also listed as natural. 

The doctor who signed the death certificate was not made aware of the circumstances surrounding the woman's death until after signing the certificate.  Additionally, the woman's son was not informed by the nursing home of the nature of his mother's injury and ultimate cause of death. In fact, the nursing home lied and told her son that the woman died of natural causes.

This atrocious case is just one of many that attorneys across the country come across in their practice.  Nursing homes can be dangerous places if not properly run and staffed.  If you suspect that you or a loved one is in a nursing home and is not receiving proper or appropriate care, it may be time to consult with an attorney.  Attorney Doug Stoehr is a central Pennsylvania lawyer specializing in nursing home abuse and negligence.  For more information on his practice, please visit our website.

Monday, January 16, 2012

Managing Chronic Pain

When a person suffers from chronic pain, they often have a combination of treatments to help them control daily pain.  Most often, this involves multiple medications; these medications sometimes need to be taken in different amounts and at different times during the day.  In order to avoid serious harm to oneself, it best to follow the guidelines listed below when trying to manage a pain medication regimen:


1) Keep a list of all your medications, dosages, and amounts in the same place.  Also include the time of day and whether or not they can be taken with food or water.  In that way, you will always have a reference guide when you are asked by a doctor about your prescriptions.


2)  Consult with your doctor when playing around with dosages or new types of medication.  Be aware of how certain medications interact with each other, and specifically ask what the side effects of your drugs are so you know what to look out for.  

3)  Also re-confirm with your doctor that the medications you are already on are compatible with your new medication. Don't assume that your doctor has already completely thought about all your medications and how they interact with each other.  This is especially true if different specialists have prescribed different medications.


4)  Monitor your body's reactions to your drugs when beginning to take a new medication.  If you experience bad side effects or feel that the medication is not working properly (or at all) do not hesitate to talk to your doctor or go to the hospital, if necessary.


Chronic pain is a tricky diagnosis in terms of finding the right medication combination that will work, but will not lead to overmedication.  Working with your physician and seeing what is right for you is the only way to find an effective, realistic pain management treatment.



If you would like more information about this page or central Pennsylvania attorney Doug Stoehr's areas of practice, contact our Altoona, Pennsylvania, law firm by calling 814-946-4100.

Friday, January 13, 2012

New Medication Options For Chronic Pain


Many sufferers of chronic pain cite that one of their most common and persistent complaints is the inability to find an effective pain management regimen.  Most pain management treatment is multi-faceted, and involves not only medication, but physical/occupational therapy, massage therapy, and exercise.  However, most patients rely on medication daily to help ease or eliminate the bulk of their pain problems.  Effective medication dosage and type is different for every person, but many patients cannot find true relief with any combination of prescription and over-the-counter medications.
 
 Due to the high rate of chronic pain sufferers, many scientists are looking further into how chronic pain occurs and affects the body.  By knowing how chronic pain symptoms persist in people, scientists will be able to develop more effective drugs to treat the condition.  Interestingly, a recent article came out in nature.com that explained some new research pertaining to chronic pain drug options.  Referencing research data from Science magazine, the article explained that a study was done that has shown that very high dosages of opiate medications can greatly reduce or completely relieve chronic pain symptoms in most patients.  By exposing the irregular chronic pain nerve pathways to high amounts of opiates, it can somewhat re-wire those pathways to change how the body perceives pain.   This new research, with further testing, could prove to be the most promising answer to truly eliminating chronic pain.

If you would like more information about this page or Attorney Stoehr's areas of practice, contact our Altoona, Pennsylvania, law firm by calling 814-946-4100.

Thursday, January 12, 2012

Standards of Care in Nursing Homes

Standards of care in nursing homes is an area that many do not fully understand.  Most people unfamiliar with nursing home practices or the health profession assume that the care they hear about is common, standard practice.  Unfortunately, some of the cases people hear about is actually below the official standards of care. 

Standards of care established by nursing homes is the minimum level of care a patient should expect to receive in that institution.  Fortunately, some nursing homes treat patients at a level above their mandated standards of care.  On the other side of that statement, many patients also regularly receive care that is below the minimums set by the applicable federal and state regulations.  Furthermore, because so many nursing homes deliver substandard care, they tend to rationalize their choices by comparing themselves to other nursing homes in the area (who are also tending to deliver substandard care). Obviously this is negligence and will lead to injuries. 

In addition to not meeting standards of care as a whole throughout the facility, other factors need to also be considered.  For example, the minimum standard of care from one patient to the next may be very different on a day-to-day basis.  A wheelchair-bound resident may need more care daily than a fully mobile resident might need; however, they are both held to the same, general standards of care.  All nursing homes must have individual care plans for every resident to meet these varying needs, but they should also be aware that these care plans need to meet minimum standards of care for the overall facility.  With this in mind, it is important to research the many options available to your family if you are deciding to put a loved one into a nursing home. By gaining the most information possible, you can make the best decision to avoid elder abuse and substandard care.

Substandard care in a nursing home often leads to neglect and injuries.  Nursing home litigation is a relatively new field of negligence law.  We suggest you consult with an attorney who understands the complex federal and state regulations that apply to care plans in nursing homes.    For more information on Attorney Doug Stoehr and his central Pennsylvania law firm, please visit our website  or call us at (814) 946-4100.

Tuesday, January 10, 2012

Tort Reform in Nursing Home Negligence Cases

Recently, there has been some backlash against personal injury attorneys and their lawsuits against nursing homes and hospitals.  One such article, written in a large healthcare magazine, even went so far as to suggest that some attorneys use understaffing of workers as an excuse to create lawsuits for cases that would not otherwise be valid.  These same writers are arguing for tort reform, which would also put a cap on awards for injury or negligence.  They argue that, if there was a cap on awards in the state of Pennsylvania, there would be fewer legal claims and nursing homes may be able to use more workers. They also noted that arbitration decreases the projected expense and awards of cases.

These facts are not completely accurate.  Arbitration does NOT decrease the expense and value of claims in all cases; in fact, they may increase the awards from claims in some cases.  Additionally, nursing home cases are not as "easy to prove" as these proponents of tort reform would make you believe.  Nursing home cases can be difficult to prove, as well as time-consuming. Therefore, the implications that most nursing home negligence cases are easy to prove and will most likely result in large awards are inaccurate.

Understaffing is also a significant and problematic issue in many large nursing homes, and that should not be belittled or explained away.  When nursing homes are seriously understaffed, the residents may seriously suffer or injure themselves as a result. In our law office, we have seen understaffing result in very serious injury, such as untreated bed sores and slip-and-falls that result in significant and lasting problems.  Articles such as the one described above are written with a definite slant, so be a critical and thoughtful reader when browsing articles.

Attorney Doug Stoehr is a personal injury lawyer practicing in the western and central Pennsylvania region.  For more information on his firm, please click here.

Friday, January 6, 2012

State Department Fighting For Nursing Home Residents

Many of the posts in this blog talk about the poor conditions currently existing in some nursing homes and the abuse and neglect that some residents suffer in these facilities. The different types of abuse and neglect can sometimes be difficult to spot, which is why specific cases can occur for years without the family becoming aware of the condition. In addition to family members being vigilant and attentive to conditions within nursing homes, the state government also keeps an eye on the facilities as well.

The Pennsylvania Department of Health serves many roles for our state. One of these roles is to examine and inspect nursing home facilities to make sure that they are meeting the physical, mental, and emotional needs of their residents appropriately. Using several people and a multi-faceted approach, the DOT sends in a team of surveyors to nursing homes to inspect every aspect of the operations of the facility. Nursing homes that have had more violations are inspected more frequently. If a nursing home fails to meet expectations in certain areas, they can be fined, be subject to other penalties, or have parts or their entire operation shut down. In 2010, the Department of Health exercised state enforcement actions in 31 situations, and ranged from revoking licenses to bans on admissions. In this way, the state government keeps an eye on nursing home operations just as family members are doing.

Attorney Doug Stoehr is a personal injury lawyer specializing in nursing home abuse as wellas automobile accidents. For more information on his firms, please click here.

Wednesday, January 4, 2012

PA Nursing Homes See Outbreaks Of Illness

In general, hospitals and nursing homes are places that are susceptible to outbreaks of disease and illness. Due to the close quarters in which the residents or patients live, the spread of disease is common-even in seemingly sterile or controlled environments. It does not help that workers in nursing homes and hospitals at often overworked and lack the appropriate support staff. This can also lead to easier disease spread, since workers are attending to many patients on the same shift, both sick and healthy.

Last month, the results of a Pennsylvania report were released, which targeted illnesses and outbreaks in nursing homes. According to the statistics within the report, PA saw an increase of 6% for reported respiratory tract infections (including pneumonia) and an increase of 28% for influenza-like illnesses from 2010 to 2011. The committee responsible for this report noted that, when workers had mandatory vaccines for these illnesses, the percentage of sick residents decreased significantly. Additionally, mandatory staff safety training and basic hygiene practices for workers to utilize for themselves and their patients also decreased the spread of illnesses.

Nursing home-related deaths due to illness are not insignificant, especially when given the fact that the elderly have weakened immune symptoms. If you feel that a loved one in a nursing home has an unaddressed or worsening illness, it is important to seek medical assistance immediately. If you feel that the nursing home has neglected your loved one, it may be time to seek legal assistance.

Attorney Doug Stoehr is a personal injury attorney specializing in nursing home abuse, as well as automobile accidents. For more information on him and his firm, please visit our website or call us at (814) 946-4100.

Monday, January 2, 2012

Nursing Homes Across The Country

Many of the posts in our blog highlight specific nursing home and residential care facility issues as they relate to the legal world. These issues are important, but are better viewed through the perspective of the state of nursing homes in the United States in general. The general public sometimes does not realize how many of our nation's aging citizens are in nursing homes and what their living conditions may be like. The following paragraph serves to shed some light about nursing homes and their residents.

According to the Center for Disease Control (2004), there are over 16,000 nursing homes in the US, holding over 1.7 million beds. These homes are at an average capacity of 86%, which amounts to over 1.4 million residents. Additionally, the average length of admission is 835 days. That's over 2.5 years! The same survey also broke these numbers down by state. Unsurprisingly, Pennsylvania had high numbers of both total nursing homes and total number of beds (711 and 88,861 respectively) as of 2009.

This data was only expected to increase in numbers since the American population contains a large number of retiring and elderly citizens. With this in mind, it is important to research the many options available to your family if you are deciding to put a loved one into a nursing home. By gaining the most infomation possible, you can make the best decision to avoid elder abuse and other possible problems.

For more information on Attorney Doug Stoehr and his law firm, please visit our website at www.stoehrlaw.com or call us at (814) 946-4100.