Lawyer Resources for Dehydration

Hydration in the Nursing HomeNext to oxygen, water is the most important building block for sustainable life makes up most of our bodies. Our blood is comprised mostly of water and our brain and muscles are made up of a high concentration of it as well. When we get older, however, we lose much of our water weight and are much more prone to dehydration. It is for this reason that those who care for our loved ones pay close attention to the signs of dehydration and to make proper provisions to keep them hydrated.

The Natural Risk of Dehydration in the Elderly

The average elderly person’s body may contain up to seven liters less water than a younger person. Because of this stark difference, the elderly are at an automatic risk of being dehydrated and to exacerbate the situation is the fact that many older people may not even feel the symptoms of dehydration until it becomes a severe problem. Some elderly patients may even refuse to drink more fluids out of the false fear that it will require them to make more trips to the restroom if they drink too much. The result is a series of sudden and swift symptoms that can be life threatening.

prescriptionThe reported settlement of a nursing home negligence case in involving a medication mix-up caught my attention because of my perceived increase in the frequency with which medication errors are occurring at nursing homes across the country.

Like many nursing home patients, the patient involved in this incident was a frail, elderly woman, who was dependent on the staff at the skilled nursing facility to provide her with the medications prescribed by her physician.

Also, similar to other errors involving nursing homes injuries– such as deadful bed sores, the errors related to this incident are reflective of mistakes made by several employees providing care to the same patient.

Dietary Supplement In Nursing Home Patients A Connecticut nursing home has been cited by the Department of Health for discontinuing a dietary supplement without first consulting any doctors, dieticians or nurses.  The abrupt discontinuation is believed to be responsible for a sizable– 11% weight loss in a patient at South Windsor Rehabilitation and Nursing Center.  When at the facility, state inspectors discovered another patient with a similarly drastic weight loss— losing 22 pounds over the course of three months at the facility.

Incidentally, serious money troubles have plagued South Windsor over the past year and according to new reports the nursing home is now in receivership.

As a nursing home lawyer who sees many facilities focused on their bottom lines at the expense of patient care, I find these reports to be completely disgusting.  My guess is that at some point an administrator at the facility elected to stop providing the dietary supplement as a cost cutting measure.

beaker.jpgDehydration poses a major threat to the overall health of nursing home patients as the condition may exacerbate existing complications or cause other conditions to manifest themselves.  Dehydrated patients may be at risk for conditions such as kidney failure, low blood volume (hypovolemic shock), electrolyte imbalances, development of decubitus ulcers or death.

Consequently, nursing homes must appreciate the risk of patients becoming dehydrated and implement measures to ensure that patients remain well hydrated.  Depending on the person’s risk for dehydration, a nursing home may order fluid intake and output to be measured by staff either during a specific time period or over an extended period of time. 

Many nursing homes have adapted I & O monitoring for the following patient / conditions: tube feeding, catheterized patients, urinary tract infections, physician orders for increased / decreased fluids, patients receiving intravenous fluids or other medical conditions that put the patient at risk for fluid imbalance.

Dehydration Death Of PatientAfter just two hours of deliberation, a West Virginia jury has awarded a family of a deceased woman $91.5 million in damages against Heartland of Charleston, a Manor Care facility.  The verdict is comprised of $11.5 million in compensatory damages and $80 million in punitive damages against the facility.  The nursing home lawsuit alleged that Heartland’s failure to provide life’s elemental needs— food and water– contributed to her death just weeks after her initial admission.

Allegations of nursing home neglect

Like many families coping with a family member’s declining health, Tom Douglas knew it was time for his mother needed additional care that a skilled nursing facility could allegedly provide.  After recognizing that he was having difficulty caring for his mother at home, he sought out a facility that was uniquely equipped to care for her various ailments including: Alzheimer’s, Parkinson’s and dementia,

As is we need another statistic to confirm the extensive problems facing nursing home patients, here’s some more fuel to add to the fire– 35% to 85% of nursing home patients suffer from malnourishment according to a study published in Commonwealth Fund.

In response to this epidemic, an international group of nutrition experts has released new definitions to help medical professionals better equip themselves to identify and treat malnutrition.

Nursing Home Patients Suffer From Malnourishment According to the new guidelines, adult malnutrition can now be classified in one of three categories:

Dehydration & Malnutrition In Nursing Home LawsuitA Kentucky jury is hearing evidence in wrongful death lawsuit against a nursing home that allegedly failed to provide sufficient nutrition and fluids which in turn contributed to her death.

The lawsuit was initiated by a physician who is a relative of the deceased patient.  According to information contained in the lawsuit and remarks made by attorney’s during opening statements, the woman was admitted to Woodland Oaks from May 24, 2003 to June 30, 2003 for rehabilitation from a recent hip fracture.

It was during her admission that staff failed to provide proper care and allowed her to become dehydration and malnourished. As a result of the dehydration and malnutrition, the woman developed a severe urinary tract infection amongst other medical problems that lead to her death on August 3, 2003.

The California Department of Health has rendered its most severe citation (AA) and a $80,000 fine following an investigation into the death of an 86-year-old woman at Walnut Whitney Care Center (California).  An investigation determined that the woman was admitted to the facility in March, 2008 for medical care related to injuries she sustained in a fall.

Nursing Home Fined After InvestigationJust five weeks after her initial admission, the woman was transferred to a hospital emergency room where she diagnosed as having septic shock.  Less than 24-hours after her hospital admission she died from resulting complications.

Specifically, the investigation determined that the nursing home failed to:

Picture-812I’ve seen a significant number of cases where an Alzheimer’s patient gets admitted to a nursing home or assisted living facility only to have their health rapidly decline within a brief period.  In several cases, I’ve seen patients deteriorate so significantly that within a few weeks of their admission they needed to be rushed to a hospital due to rapid weight-loss and dehydration.

The event likely leads to a hospitals request that a feeding tube be surgically implanted in patient to provide life sustaining nutrients.  Unfortunately, further complications typically arise with the use of the feeding tube adding further problems to a typically messy situation.

A recent New York Times article, “Feeding Dementia Patients With Dignity” reinforced the obvious, feeding patients with dementia and Alzheimer’s is difficult and time consuming. Moreover, the alternative in installing a feeding tube can lead to anger in the patient and negatively impacts the patients quality of life.

Some of my angriest clients contact me after a loved one was transferred from a nursing home to another nursing home or hospital only to learn of serious medical problems their loved one likely acquired during their original admission.  

Of course, breaking disappointing news is difficult for anyone to do.  Yet, in the case of nursing homes— this is something they simply are required to do under the law.  Similarly, nursing homes must notify the patients doctor if their condition deteriorates.

Undisclosed Complications With Nursing Home PatientsI see many cases where there is no doubt an intention on the part of the original facility to cover up change in condition– but also injuries related to situations involving improper care.

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Jonathan did a great job helping my family navigate through a lengthy lawsuit involving my grandmother's death in a nursing home. Through every step of the case, Jonathan kept my family informed of the progression of the case. Although our case eventually settled at a mediation, I really was impressed at how well prepared Jonathan was to take the case to trial. Lisa
After I read Jonathan’s Nursing Home Blog, I decided to hire him to look into my wife’s treatment at a local nursing home. Jonathan did a great job explaining the process and the laws that apply to nursing homes. I immediately felt at ease and was glad to have him on my side. Though the lawsuit process was at times frustrating, Jonathan reassured me, particularly at my deposition. I really felt like Jonathan cared about my wife’s best interests, and I think that came across to the lawyers for the nursing home. Eric
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