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Monitoring Nursing Home Residents

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Nursing home residents ages 65 and older are especially at risk of contracting a life-threatening infection, experiencing severe side effects of medication, becoming dehydrated or choking. That’s why it is important that senior citizens receive an adequate amount of care and monitoring by nursing home staff. For the most part, nursing home residents are unable to care for themselves. Negligence of any kind by those trusted to care for our elders puts them at risk.

Risk of infections in nursing homes

Due to environmental factors in many nursing homes, residents are at risk of contracting an infection. The number of residents, visitors and staff at any given time can increase the presence of germs that can cause illness. Bacteria that exists in many nursing homes can become immune to antibiotics, creating a high risk for residents with weakened immune systems.

Common infections in nursing homes that can cause life-threatening complications include:

  • Influenza: Also known as the flu, this illness is highly contagious and causes respiratory complications as well as severe inflammation of the body. Residents who come down with the influenza virus often suffer from fevers, chills, cough, sore throat, runny nose, body aches, head pressure and extreme fatigue. In severe cases, the influenza virus can be fatal, particularly in elderly residents who may have weak or compromised immune systems.
  • Methicillin-resistant Staphylococcus aureus (MRSA): Typically, a staph infection (also known as Staphylococcus aureus) affecting the surface of the skin can be treated with antibiotics and other methods. However, Methicillin-resistant Staphylococcus aureus doesn’t respond to most antibiotics. Even healthy residents carry staph in their bodies, even if it doesn’t cause infection. But staph can affect the skin if a resident suffers from a wound, cut or scrape. The infection can be treated with advanced antibiotics. However, MRSA eventually adapts to the most advanced methods of treatment. If MRSA travels deep into the bloodstream and organs, it can become fatal.
  • Clostridium difficile: This bacterium affects the colon, causing severe diarrhea and abdominal cramping. If the condition is untreated or worsens, it can be life-threatening. Residents can suffer further complications of rapid heart rate, nausea, fever, chills, blood in the stool, dehydration, increased white blood cell count and kidney failure.
  • Urinary Tract infection (UTI): This type of infection affects the kidneys, ureters, bladder and urethra. Women are typically at a higher risk of UTI, but men over the age of 50 are often affected as well. A UTI is generally a treatable infection, but when care providers are negligent, serious complications can occur. If the infection becomes severe and affects the blood or kidneys, a UTI can be life-threatening.
  • Pneumonia: This infection causes inflammation of the lungs and can result in respiratory complications. The air sacs in the lungs become filled with fluids, making it difficult for oxygen to pass through. Other symptoms such as severe coughing, fatigue, chest pain, nausea and fevers can occur with pneumonia. If the infection is left untreated or worsens, it can be life-threatening.
  • Pressure sores: When residents are immobile for too much time, they are at risk of developing pressure sores or pressure ulcers. This happens when a resident has been in the same position for more than two hours, resulting in cell death of the affected area; that’s why nursing home staff need to regularly turn residents in bed, preventing pressure sores from forming. Pressure sores typically only affect the surface of the skin, but if untreated, they can grow deep below the surface and into the bloodstream. Pressure sores that affect internal organs can be deadly.

Severe side-effects of medication

Nursing home staff must take the rights of residents into consideration when implementing and monitoring prescribed medications. Residents can choose to accept or deny the use of medication at their own will. However, if a resident suffers from dementia, Alzheimer’s disease, or any other condition that inhibits his or her ability to decide, another party must be responsible for decision-making. Whether it involves a family member, court-appointed guardian, or state-appointed health care surrogate, the responsible party must practice caution when monitoring the use of medication.

Commonly used medications in nursing homes include:

  • Antibiotics: Problems can arise for residents who are treated with too many antibiotics. Most notably, bacteria can evolve beyond the scope of antibiotic treatment. As a result, infections can become more life-threatening over time. That is why the use of antibiotics in nursing homes should be limited, closely monitored and only used in the case of a severe infection.
  • Psychotropic medications: Residents who suffer from dementia, Alzheimer’s disease, depression or anxiety may require treatment with psychotropic medication. The use of psychotropic and antipsychotic drugs should be heavily monitored. Poor management or overuse of such drugs can result in serious side effects, including cardiovascular complications and death.

 Choking risks in nursing homes

Guided One reports that over 2,000 deaths of seniors ages 65 or older were the result of choking. Choking risks in nursing homes often attributed to lack of monitoring food intake or safety in the presence of bedrails.

There are a number of factors that could potentially lead to choking. They include:

  • Lack of teeth or poorly fitted dentures: This can make it difficult for residents to chew properly. Solid food should not be served to residents with missing teeth or poorly fitted dentures.
  • Lack of fluids: Nursing home staff should always monitor the amount of fluids residents are consuming, especially with meals. Lack of fluid consumption during a meal can cause complications with swallowing.
  • Respiratory infections: Chewing and swallowing can be difficult with residents who suffer from respiratory or breathing complications
  • Dementia and Alzheimer’s disease: Residents who suffer from memory loss may not be able to handle food intake without assistance.
  • Parkinson’s disease: Residents with Parkinson’s disease may lack muscle control in the jaw and throat, making it difficult to chew and swallow.
  • Bedrails: Far too often, residents are not properly fitted or adjusted when laying in bed. If a resident gets caught between the bed and bedrail, he or she is at risk of choking.

Risk of dehydration

Nursing home staff are responsible for ensuring that residents are hydrated and consuming an adequate amount of fluids throughout each day. For residents ages 65 and older, dehydration can contribute to urinary tract infections, constipation, pressure sores, and other complications that have the potential to be life-threatening.

It is important for staff to promote and monitor a healthy intake of fluids for residents. This includes offering more fluids if a resident is finished and assisting residents with conditions that may hinder their ability to consume fluids.

What you can do

When admitting our elders into a nursing home, we expect that they’ll receive the best care possible. It is the responsibility of nursing home staff to monitor daily activities and routines, medication intake, food and fluid intake and potential hazards within the premises.

It only takes one act of negligence to put the health and lives of residents at risk. That’s why nursing home staff must always keep a watchful eye on residents. If a loved one has suffered a health complication or death because of the negligence of nursing home staff, you need to speak to an experienced attorney who will relentlessly pursue your case. Negligent care for our elders is never acceptable.

 

Sources

  1. Guided One (2015). Minimizing the Risks of Choking Death in Nursing Home Residents. – via http://www.goriskresources.com
  2. Infectious Disease Clinics of North America (2007). Infections in Residents of Nursing Homes. – via geriatrics.uthscsa.edu
  3. AARP (2014). What Caregivers Need to Know About Monitoring Medications for Nursing Home Residents. – via www.aarp.org
  4. NCBI (2005). Technology for Improving Medication Monitoring in Nursing Homes. – via www.ncbi.nlm.nih.gov
  5. BMC Geriatrics (2017). Effect of Training and Structured Medication Review on Medication Appropriateness in Nursing Home Residents and on Cooperation Between Health Care Professionals: the InTherAKT Study Protocol. – via bmcgeriatr.biomedcentral.com
  6. Alzheimer’s Association (2009). Dementia Care Practice Recommendations for Assisted Living Residences and Nursing Homes. – via www.alz.org
  7. Nursing Times (2015). Reducing Dehydration in Residents of Care Homes. – via www.nursingtimes.net
  8. EOS Surfaces (2017). Nursing Homes and Infection Control: The Most Common Infections. – via eoscu.com
  9. A Place for Mom (2017). The 5 Most Common Infections in the Elderly. – via www.aplaceformom.com
  10. S. Food & Drug Administration (2010). A Guide to Bed Safety Bed Rails in Hospitals, Nursing Homes and Home Health Care: The Facts. – via www.fda.gov
  11. Mayo Clinic. Urinary tract infections (UTI). – via www.mayoclinic.org
  12. Mayo Clinic. Pneumonia. – via www.mayoclinic.org
  13. Family Doctor (2017). Pressure Sores. – via familydoctor.org
  14. eMedicine Health (2017). Antibiotics Side Effects and Types. – via www.emedicinehealth.com
  15. Michigan Medicine – University of Michigan (2015). Are Antipsychotic Drugs More Dangerous to Dementia Patients Than We Think?. – via www.uofmhealth.org
  16. Web MD. Parkinson’s Disease and Swallowing Problems. – via www.webmd.com
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