Medication Misuse Risky for Patients in Nursing Homes

by | Published on Feb 15, 2017 | Medical Review Services

It is estimated that close to 4 million adults live in long term care facilities including nursing homes in the United States. Though most of this population are well-cared for, nursing home abuse is also a stark reality. Elder abuse in residential care facilities is difficult to identify and many cases go unreported. Nursing home abuse lawyers depend on medical review solutions to review the medical records of the victim, which is a very important process in identifying the nature of the abuse. The medical chart of a nursing home resident provides details regarding the person’s ongoing medical care.

Abuse in a nursing home can include:

  • Physical abuse: This is an event or condition that causes physical harm to the resident. It may be intentional or unintentional – the former involves hitting or causing physical impact on the person, while the latter mostly stems from neglect including lack of physical care.
  • Psychological abuse: This may involve shouting at the patients, criticizing them, or humiliating them. Typically, patients who experience this kind of abuse may exhibit behavioral changes.
  • Neglect: Mostly neglect is inadvertent, and it occurs when the patient’s needs are not met. Such patients may not be receiving adequate food, clothing and water. His/her personal hygiene may be compromised, and so on. Typically, nursing home neglect leads to bed sores, skin infections, dehydration and malnutrition.
  • Financial abuse: This occurs when a care provider exploits his/her access to a patient’s financial matters. They may steal from the patient – either directly or from the patient’s banking accounts. They may also apply for credit in the patient’s name.

Signs of abuse may include the following, and which are revealed via a personal examination:

  • Bruising and cuts
  • Broken bones/fractures
  • Bed sores
  • Infections
  • Signs that the patient is emotionally upset
  • Refusal to speak with others, or preferring to be alone
  • Lack of appetite and weight loss
  • Lack of cleanliness

Medication misuse is a form of nursing home abuse that can have life-threatening consequences. A fairly recent study by ProPublica along with the Washington Post found that common anticoagulant medications were improperly administered in nursing homes. The study data for the period 2011 to 2014 shows that the improper administration of Coumadin (Warfarin) led to the hospitalization of 165 nursing home patients. Many of these cases were never investigated. If they were, the improper use of this drug could have been established as the cause.

Coumadin and Warfarin are prescribed to millions of patients in the US every year.

  • Inadequate dose of this medication can lead to formation of blood clots and development of various dangerous conditions the drug is intended to prevent.
  • If there is an overdose, the patient could experience heavy and uncontrollable bleeding. This risk also exists if the anticoagulant is combined with some other drugs.
  • Medical errors can happen if this medication is administered without the prescription of a doctor, without conducting proper blood work, or when the results of the patient’s blood test are not reported to the physician treating the patient.
  • Even the patient’s diet can create problems.

When these details emerged, CMS called upon agency inspectors to investigate into anticoagulant related medical mistakes. They wanted the investigators to find out whether nursing home facilities are taking appropriate steps to prevent such adverse events, and to report the same to them if they do occur.

  • The investigators would look into the training and education of the faculty
  • Find evidence that the facility is properly monitoring the lab results for patients taking anticoagulants
  • They have to ensure that the facility has an efficient system that ensures communication with the physician, especially in emergency situations
  • They will also have to make sure that the system will alert physicians and nurses in case an anticoagulant was being prescribed along with another blood thinner that could cause excessive bleeding.

Relatives and friends of people being admitted into nursing homes and other such care facilities should clearly understand the policies the organization has as regards administering and monitoring medications. It would be best to make enquiries of the staff regarding the medications being given. In case they are not happy with the response of the facility, it is important that they do not hesitate to move the resident to another facility that meets their specific requirements.

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