Choking Hazards in Nursing Homes

We receive calls all the time from families whose loved one has choked in a nursing home. 

There are numerous hazards in nursing homes that our clients should be aware of.  

If someone you love has been neglected or abused in a nursing home, please call us at 1-800-OHIO LAW as we would be happy to talk with you and help you in any way that we can.

DENTURES

If your loved one has dentures, the nursing home must make sure to keep their dentures clean and to put their dentures in every day so that they can use them to eat their meals.  Their dentures must fit properly.  If their dentures don't fit properly, they can cause irritation which can make their mouth sore. 

If a nursing home resident has a sore mouth, they may not eat when they are supposed to.  If they don't eat on a regular basis, they can lose weight which can lead to weakness.  Not receiving enough nutrition can lead to dizziness, which can lead to falls.  Lack of nutrition can make them more susceptible to skin breakdown.  Lack of nutrition can make it harder to heal skin breakdown if they have skin breakdown. 

If they are not eating enough, they may be tired.  They may not get out of bed as often as they should.  They may not get the activities that they should.  This can lead to a series of problems.  Nursing home residents should be kept active.  They should get up every day.  They should go to therapy.  They should move around as much as possible. 

If they remain in bed or they remain in a chair all day, they can suffer skin breakdown.  And they can have a number of other issues.  If your loved one is not wearing their dentures they may not be able to eat certain foods safely.  This can lead to them choking.

DYSPHAGIA

Some residents have swallowing problems, including a condition known as dysphagia.  If a resident has swallowing difficulties, they might need to be on a special diet.  You must make sure that your resident is on the appropriate diet for their needs. 

You also want to make sure that they are receiving that diet.  We recommend that you visit your loved one during mealtimes.  Are they receiving the appropriate diet?  Is someone assisting them if they need assistance?  

Every resident's chart should have a care plan which details their needs and how their needs are being accommodated, including their need for certain types of foods.  Their care plan should indicate if they need to have their foods prepared a certain way.

FOOD PREPARATION

Some residents need to have their foods pureed.  Some residents can only eat soft foods.  We have tragically seen cases where people have died as a result of receiving improper foods. 

Some residents can't chew properly so they can't be served meat.  They can't be served hot dogs.  They can't be served foods that they can't chew properly.  Some residents have to receive thickened liquids because of their swallowing problems.

THE NURSING HOME SHOULD MONITOR THEIR RESIDENTS’ WEIGHT

The nursing home should be monitoring your loved one.  If your loved one is experiencing unintended weight loss, you should look into why this is occurring. 

Unintended weight loss can lead to a series of problems and can even be fatal.  Unintended weight loss can be caused by a series of issues, a number if which can be very serious. 

Likewise if your loved one is gaining weight that should be questioned.  Are they eating a healthy diet?  Are they active?  Are they retaining water?

SOME RESIDENTS NEED SUPERVISION WHILE EATING   

If your resident has dementia or Alzheimer's Disease or if your loved one suffers from mental retardation, they may need supervision while eating. 

We represented the family of a woman who tragically died because she was left unattended during meals.  She suffered from mental retardation and did not pace herself when eating.  She would stuff large quantities of food into her mouth.  She literally choked to death alone in her room.  It was a completely avoidable, heart breaking tragedy.  

In addition to the hazards posed by food, some residents who suffer from dementia or Alzheimer's or other type of confusion, can ingest things that they shouldn't. 

Nursing home residents need to be monitored.  We tragically represented the family of a woman who wandered into the kitchen and consumed cleaning products and died as a result.

STRANGULATION  

In addition to the hazards posed by food and various cleaning supplies and chemicals in the nursing home, some residents suffer strangulation.  One of the reasons that a nursing home typically does not put the bed rails up on a resident's bed is because the resident can get caught in the bed rails and literally strangle. 

For this reason, somebody who is at risk for falls should be placed in a low bed or on a mattress on the floor, with a mat next to their bed, not have the rails of their bed raised.  

NURSING HOMES MIST HAVE A COMPREHENSIVE CARE PLAN FOR EACH RESIDENT

If someone you love is at risk for choking for any number of reasons, you should ask the nursing home to show you the care plan and show you how the nursing home is addressing the fact that they are at risk for choking.  You should also ask the nursing home to show you where they are documenting how they are implementing that care plan. 

Most nursing homes have a section of the chart known as the Documentation Survey Report or the Treatment Administration Record or TAR, and in that report or that TAR there should be different rows for different meals and then different columns for every single day of the month.  

So, for example, on February 3 there should be a row for breakfast and a row for lunch and a row for dinner and, in some cases, a row for a snack.  In each square for each meal for each day, there is typically a code.  This code explains the resident's needs, how many people they need to help them, and what kind of help they need. 

For example, some residents just need their meals set up.  The staff simply needs to bring them their food, set them up in a chair or in their bed with utensils, make sure all the wrappings are taken off the food, and the residents can feed themselves.  Some residents need assistance with eating.  If an aid helps a resident with their meal, they typically initial the Treatment Administration Record or the Documentation Survey Report and show that they helped the resident with the meal.

Often residents eat in the dining room.  However, some residents who eat in the dining room still need assistance.  We represented the family of a man who died because he ingested a large piece of plastic food wrap and choked to death while eating a meal in the dining room.  The aid who was supposed to be watching him wasn’t.  

Tragically, we receive dozens of phone calls every year regarding cases that involve choking.  If someone you love is in a nursing home, and they are at risk for choking, you must talk to the nursing home. 

You must make sure that your loved one is comprehensively assessed for all of their needs, including their needs with respect to eating meals.  You must make sure that their care plan addresses all of their needs.  You should also ask to see documentation that the care plan is being implemented.  

If someone you love has been neglected or abused in a nursing home, please call us at 1-800-OHIO LAW as we would be happy to talk with you and help you in any way that we can.

Ohio Nursing Homes Need to be Properly Staffed 24 Hours a Day, 365 Days a Year.

Here at The Dickson Firm, we receive many calls from people who have visited their loved one over the holidays and have concerns about their care. Many people do not live near enough to their loved one to see them in person on a daily basis. They talk to them over the phone. They have other family members who live close check in on them. However, when they see them in person, they often have concerns about their care.

One of the things to remember is that nursing home residents need care 24 hours a day, 7 days a week, 365 days a year. They need the same level of care every single day. Every single day, nursing home residents who need assistance need to be helped to get up out of bed. They need help with toileting. They need help with bathing. They need help with eating. And they need the same level of help every single day. This may seem like a very simple statement. However, we see many, many nursing homes who are understaffed around the holidays.

While we certainly understand that it is challenging to maintain proper staffing around the holidays, nursing homes have an obligation to give their residents proper care at all times. Of course, people want to be home with their families on Christmas Eve and Christmas Day and New Year's Eve and New Year's Day. Of course, people want to be with their families over Thanksgiving. Of course, people want to have time off during July 4 weekend or Labor Day weekend or Memorial Day weekend.

However, it is the obligation of the owners and the operators of the nursing home to make sure that their residents receive proper care every single day. Nursing homes get paid the same amount to care for each resident every single day.

Nursing homes get paid the same amount on Christmas Day as they do on January 12 to take care of their residents. Nursing homes owe the same duty to their residents every single day. They owe a duty to their residents to keep them safe. They owe a duty to their residents to provide them with proper care. They owe a duty to their residents to make sure that their needs are met. They owe a duty to their residents to provide them with adequate supervision to prevent accidents. These duties do not change on Christmas Day or New Year's Day or during the Super Bowl. These duties are the same every single day.

If someone you love has been neglected or abused in a nursing home, please call us at The Dickson Firm at 1-800-OHIO LAW as we would be happy to talk with you and help you in any way that we can.

Nursing homes need to communicate to their staff, just like all healthcare organizations, that they have to provide the same level of care every single day. Nursing homes have to talk with their staff about the fact that people are going to have to work on Christmas Day. They are going to have to work on New Year's Day. They are going to have to work during Thanksgiving.

Healthcare workers often cannot be with their families when they would like to be because they have an obligation to take care of their residents and their patients. Everyone who works in healthcare understands this. They understand that they need to provide care to their patients and their residents at all times. This includes during the holidays.

So what can you do? If you are visiting a loved one over the holidays, make sure you go to the nursing home during all different times of the day. Make sure you go in the morning. Make sure you go at lunch time. Make sure you go in the evening. And make sure that you see an adequate number of employees taking care of the resident.

If you are sitting in your resident's room, push their call light. See how long it takes for someone to respond. If you are waiting for 30 minutes or an hour for someone to respond to a call light, imagine what goes on when you are not there. Imagine what happens when your loved one is there by themselves.

Make sure you observe your loved one at meal time. If they need help eating, is someone helping them? One of the biggest things that we see in the cases that we review are nursing homes residents who need
assistance with eating who do not get it. We review the chart of somebody who is malnourished or dehydrated and we find out that while they were supposed to have somebody help them eat every meal, often the food was just dropped off in their room where it lay uneaten until somebody took it away.

And the thing that is really troubling is that nobody recognized that the resident was not eating. The person that dropped the food off did not check their chart to see that they needed assistance with eating. And the person that picked the tray up did not note that it was untouched and did not tell anybody that that resident was not getting proper nutrition.

Nutrition and dehydration are huge problems in nursing homes. They lead to skin breakdown. They lead to infection. They lead to the resident becoming weak and less mobile, which leads to all kinds of problems. Residents who become weak and less mobile and spend more time in bed suffer more skin breakdown. They are susceptible to pneumonia. It also causes their muscles to atrophy. The more muscle a person loses, the less mobile they are, the more prone they are to fall. It makes it more difficult for them to balance.

We see many residents who were admitted to the nursing home to get physical therapy and occupational
therapy and instead, are left to sit in their bed all day without anybody providing the care and the
therapy that they need.

When you visit your loved one in the nursing home, do you see staff? Is there somebody at the nurses' station? Do you see nurses and aides walking around, going into the residents' rooms? As indicated above, when you push the call light does somebody come? At mealtimes, is somebody there to help your loved one eat?

If you are thinking about admitting someone to a nursing home, ask the director of nursing or the administrator how they maintain proper staffing during the holidays. Ask them what the staff ratios are. During the nightshift on the wing where your loved one resides, how many nurses and how many aides are on duty, and how many residents are they expected to take care of. These are very important questions.

One of the biggest causes of neglect and abuse in nursing homes is understaffing. Nursing homes simply do not have enough people to care for their residents. This is not because they cannot afford to have enough people care for their residents.

Nursing homes make millions of dollars. They purposely understaff so the nursing homes can make more money. Every nursing home only has a certain number of beds. Once those beds are filled, the nursing home is earning as much money as it can. The only way to improve profits beyond that is to reduce costs. The largest line item on any nursing home budget is staffing. Nursing homes routinely replace RNs with LPNs. They replace LPNs with nurse's aids. They staff the facility with the people who they can pay the least. This leaves the residents with very few qualified, well-trained people to take care of them. This leads to falls. It leads the residents being neglected into developing bedsores. It leads to all kinds of issues.

If someone you love has been neglected or abused in a nursing home, please call us at
The Dickson Firm at 1-800-OHIO LAW as we would be happy to talk with you and help you in
any way that we can.