Health Care Advocates Guide

Health Care Advocate’s Guide to Medical Malpractice in Nursing Homes

Every day, family members are forced to make difficult decisions about the care of their precious loved ones. When a family member’s medical needs prove to be more than what loved ones are able to provide, a nursing home or long-term care facility may be the best option. These facilities are responsible for providing necessary and sometimes critical medical care for the elderly in a compassionate and “home-like” environment.

Unfortunately, sometimes good reviews and a pleasant tour are not enough to assess the reality of the care that nursing homes provide their residents. Even the most studious family members who have done all their research can end up inadvertently placing their loved one’s care in the hands of negligent or abusive caregivers. The World Health Organization estimates that at least one in six elderly individuals over the age of 60 experience some form of abuse or neglect in a nursing home setting each year.

What can concerned family members do to protect the health and safety of their loved ones? Plus, what can they do if they suspect that abuse or neglect is taking place? You are your loved one’s best advocate. With the help of the legal team at Spiros Law, P.C., you can protect your loved one’s rights.

What Should I Do If I Suspect My Loved One is Experiencing Nursing Home Abuse?

Types of Abuse and Identifying Warning Signs

“Abuse” is not necessarily just physical. Understanding that is the first step in identifying troubling abusive trends within a nursing home setting. Nursing home abuse can be any type of intentional harm that is inflicted on a nursing home resident by someone in a trusted position of authority, such as a caregiver.

Nursing home abuse appears in a variety of guises, including:

• Physical abuse
• Emotional or psychological abuse
• Sexual abuse
• Financial abuse
• Neglect

With so many different forms of abuse to be aware of, looking for the warning signs can seem overwhelming. While abuse can take many forms, the warning signs of abuse may be similar in nature. On an individual experiencing physical abuse, you may see marks and bruises. However, they can also present some of the same classic warning signs as psychological abuse, including changes in sleeping patterns, anxiety, and depression.

In fact, any noticeable and significant change in a loved one’s appearance, demeanor, or medical status should be carefully examined. Some of the most common warning signs of nursing home abuse include:

• Unexplained marks or bruises
• Signs of restraint (marks on the wrists or legs)
• Burns
• Multiple falls, dislocations, or broken bones
• Blood in or on underwear or bed sheets
• Changes in eating and sleeping patterns
• Changes in mood
• Anxiety
• Depression
• Suicidal thoughts or suicide attempts
• Withdrawing from family and friends
• Withdrawing from favorite activities
• Significant change in financial status
• Missing personal possessions
• Soiled clothing or bedsheets that go unchanged
• Significant change in appearance
• Poor dental care or personal hygiene
• Dehydration
• Malnutrition
• Sudden or unexplained change in their medical status or a medical condition
• Refusing to cooperate with certain caregivers

You are your family member’s best advocate. Consider that most cases of elder abuse go unreported. The WHO estimates that only 1 in 24 cases of abuse ever come to light. A variety of factors play into those statistics, including a resident’s fear of retaliation by the abusive figure. Many abuse victims also lack the cognitive or physical ability to report abuse.

How to Report Nursing Home Abuse

Reporting nursing home abuse is never easy. It can feel like an overwhelming and daunting process, even when you know it is in the best interest of your family member. Many people simply don’t know where to start or who to turn to for help. If you suspect or have evidence that abuse is taking place in a nursing home facility, consider these reporting options:

Illinois Department of Public Health

• One of the first things you will want to do is to report a complaint to the Illinois Department of Public Health. This government department is in charge of investigating quality of care issues across Illinois. Visit their website for information on filing a complaint. 

Illinois State Long-Term Care Ombudsman

• A long-term care ombudsman is an advocate that serves nursing home residents by helping them address complaints with nursing home staff, caregivers, or the facility itself. They can offer emotional support and have a great wealth of resources at their disposal. These resources can help residents and their families understand the situation and what their options are for reporting abuse. Their mission is to improve the quality of life for all Illinois nursing home residents and raise the standard of care. 
• Illinois Long-Term Care Ombudsman Program

Illinois Adult Protective Services

• The state also has a division of government dedicated to protecting elderly individuals from abuse and neglect. In July of 2013, the state of Illinois passed legislation that expanded its Adult Protective Services program. Caseworkers can conduct investigations into abusive situations and work with elderly residents to resolve abuse, neglect, and financially abusive situations. 
• Illinois Adult Protective Services
• Illinois Department on Aging

Eldercare Locator

• The Eldercare Locator is an online tool that allows families and seniors to locate advocacy services in their area. They provide information and resources on government assistance, health, and transportation services. They also have resources on elder rights, abuse prevention, and reporting abusive situations.
• Eldercare Locator

The Nursing Home

• Family members concerned about abuse can also file a complaint with the nursing home itself. This is a good first step as it establishes a paper trail. If further investigation is needed into the abuse claims, the nursing home cannot claim that they didn’t know that there was a problem. After a complaint is made, family members need to keep the lines of communication open and make sure that the nursing home is taking appropriate steps to address the complaint. In addition to filing a formal complaint with the nursing home, family members may also want to consider investigating the other options outlined above. 
• To make an effective complaint, put it in writing. When outlining the grievances, remain factual and specific. Try to include the times when the incidents occurred, witnesses, which staff members were involved, and other specific information. Conclude your information with a way to contact you and ask for a follow-up.
• Keep in mind that while many nursing homes want to do right by their residents, some facilities will cover up claims or fail to conduct a complete investigation into abuse claims. This is because some nursing homes worry about the financial repercussions, such as fines, lawsuits, and closer government scrutiny over their operations. Be diligent. Pursue a valid investigation.

Medicare

• Complaints may also be filed even if the nursing home resident is on Medicare. Medicare has what is known as a Medicare Quality Improvement Organization or QIO. This organization may be able to investigate abuse and neglect claims. Contact information is broken up by region. Illinois is included in Region 5. 
• Filing a QIO complaint
• Region 5- Illinois information

How to Request Medical Records

Requesting and keeping a copy of your loved one’s personal medical records is a good way to track medical care. It is also a good way to recognize patterns of neglect and abuse. Keeping tabs on medical conditions, prescriptions, required treatments, and numbers of doctor’s visits and hospital admissions can be valuable evidence when it comes to substantiating claims of abuse. Illinois law allows anyone to request a copy of their own medical records or the records of someone for whom they are responsible.

Many hospitals and doctor’s offices have information on how to request medical records on their websites. Typically, the patient is required to fill out a written request or form and submit it to the medical records division. Due to privacy laws, medical records can only be requested and then given to the patient themselves. If a family member has been declared legally incompetent, a family member may request medical records if the request is submitted with a medical authorization signed by the executor of the patient’s estate or their legal guardian.

Consult with an Experienced Nursing Home Abuse Attorney Today 

At Spiros Law, P.C., we understand that you are going through an emotionally difficult time right now and that the process of reporting abuse and getting claims taken seriously can be overwhelming. While there is a wealth of resources available to victims of abuse and their families, it can still feel like a daunting challenge getting involved, gathering evidence, and waiting for results.

Consider one more valuable resource in your pursuit of answers and justice: an attorney. Hiring an attorney to help investigate abuse claims, gather evidence, and do the heavy lifting for you can remove a heavy burden from a family member’s shoulders. An attorney is also a valuable resource because they can protect your loved one’s rights, hold negligent nursing homes or caregivers accountable for their actions, and pursue compensation for your loved one.

If you suspect abuse is taking place at a nursing home, or your loved one has complained of being abused while under the care of a nursing home, consider talking to an experienced and skilled nursing home abuse attorney. We can guide you through the legal process with dignity and compassion. Ready to speak confidentially with an attorney about abuse? Contact us at (815) 929-9292, and we’ll help you get started.