Special Care Units and Memory Care Units

Memory CareHe sits and stares out the window, lost in his own thoughts. Even though he is here in this place, in this time, in front of that window, his thoughts have taken him somewhere else. He is not entirely aware that the world he sees exists only in his mind in another time and place, not the one he is physically living in.

This may describe a regular occurrence for your father, grandfather, aunt or uncle, or other family member suffering from Alzheimer’s Disease or dementia. For many, memory loss, dementia, or Alzheimer’s symptoms can be devastating and lead to the loss of independence. As individuals lose the ability to place themselves in the proper time and place, they may struggle to maintain daily tasks such as preparing meals, managing medication, household chores, and self care. When this happens, many families find themselves facing the difficult decision of placing a loved one in a care facility.

There is more to consider for the overall care and well-being of a loved one suffering from Alzheimer’s or dementia when choosing a care facility. You will still want to research, visit facilities and ask questions, but you will want to do all of this with memory care in mind. Many facilities offer a special wing or floor devoted to memory care. This portion of the facility is specifically designed and staffed with the needs of patients experiencing memory loss, dementia, and Alzheimer’s. In searching for a facility, you will want to ask if the facility offers a Memory Care Unit or a Special Care Unit (SCU).

According to gerontologist Sara Shelton of Seattle Care Solutions, Special Care Units offer a higher ratio of staff to residents than other types of care. Staff for Special Care Units typically have specialized training. In addition, these facilities may offer activity-based patient programs designed specifically for memory care patients. Many units also include secured exits for the safety of patients who may become disoriented and attempt to leave, as well as visual cues that make it easier for patients to navigate their surroundings.

The Alzheimer‘s Association suggests that when researching and visiting Memory Care or Special Care Unit options, you should ask for a special care unit disclosure form. This form is required for state licensing purposes in order for a facility’s unit to qualify as a Memory Care Unit or Special Care Unit. Requirements vary from state to state, and the disclosure form will detail what specific plans and procedures are in place for the facility to qualify as a Special Care or Memory Care Unit.

At Brownstein & Nguyen, we have years of experience dealing with the difficult legal situations and medical complications that arise in cases of nursing home neglect and elder abuse, including those involving patients suffering from memory loss or dementia. Call or contact us today so that we can help you.

What should you do if you are the victim of medical malpractice?

Ask Key QuestionsAll patients have certain rights and responsibilities as outlined by the National Health Council. The saying “a patient is his own best advocate” is true. For the best possible healthcare, a patient should be informed and take the initiative. Investigating and asking questions about general care, health issues and potential procedures is necessary to be proactive regarding one’s health. Having all questions answered before a major or even minor procedure is especially important.

While medical professionals are highly trained and strive to provide the best care possible, medical errors do occur in the healthcare industry. Medical malpractice encompasses a variety of areas and can include many types of errors or mistakes made by a doctor, surgeon, nurse, or other healthcare provider.

If you are a loved one has suffered from medical malpractice, or even suspect that wrongdoing may have occurred, here are a few important suggested steps to follow:

1. Gain access to medical records

It is important to gain prompt access to complete medical records relating to a procedure or event, including the healthcare provider’s records and hospital or facility records. A timely legal and medical review of relevant records must be done to determine if malpractice occurred. Contact medical professionals, hospitals or other facilities involved so that records can be promptly obtained after suspected malpractice has occurred. The law has strict time limits on bringing claims for malpractice; obtaining all records as soon as possible is a critical part of the process.

2. Ask key questions

Not only is it important to be proactive about one’s health before a medical procedure, but it is equally important to be proactive afterwards. If a medical outcome is not as expected or hoped, or there is any uncertainty, ask your doctor or medical professional specific questions to determine if a problem exists and how it might be remedied. If you’re unsatisfied with any answers, seek a second opinion from another medical  professional. Again, as the patient you are your own best advocate.

3. Contact an attorney

Since malpractice laws vary from state to state, it is highly recommended that an experienced attorney be contacted if malpractice is suspected. The medical malpractice attorneys at Brownstein and Nguyen have over 20 years of experience in medical malpractice cases in the greater Atlanta metropolitan area. They will review your case free of charge, discuss your potential claim(s), and provide expert legal advice regarding your options.

Contact Brownstein and Nguyen regarding any medical malpractice questions or concerns that you may have.

Bedsore Prevention and Awareness

Pressure ulcers or decubitus ulcers, commonly referred to as bedsores, are serious and sometimes fatal injuries typically afflicting the elderly, bedridden and wheelchair populations including stroke victims, paralysis and dementia patients. Most bedsores occur in hospital or nursing home settings. With proper care and prevention, however, the risk of bedsores and resulting complications can be greatly reduced, if not eliminated, for at-risk patients.

High risk population for bedsoresWhat is a pressure ulcer or bedsore?

A pressure ulcer or bedsore is as an area of unrelieved pressure in a defined area, usually over a bony prominence (such as the tailbone, ankle or elbow), resulting in ischemia, cell death, and tissue necrosis. Essentially, the pressure prevents blood from getting to the tissue, which breaks down and eventually dies. Once a bedsore develops, depending upon age, nutrition and other medical factors, the skin may not heal and a life-threatening systemic infection can result. Risk factors for pressure ulcers include inactivity, immobility, diabetes, advanced age, impaired cognition, and bowel or bladder incontinence.

Pressure ulcers are classified and treated according to clinical “stage” based on certain criteria. Assigning a pressure ulcer stage is based on visual inspection to determine the extent of tissue destruction and wound depth. Pressure ulcer staging also requires an understanding of the anatomy of skin and underlying tissues. In stage I, the skin is not broken but is red or discolored without fading thirty (30) minutes after pressure is removed. By stage II, the topmost layer of skin is broken, creating a shallow, open, painful sore.  A stage III pressure ulcer is a full-thickness skin loss involving damage or necrosis of the underlying tissue that may extend down to, but not through, muscle or bone. Drainage may or may not be present in stage II and stage III pressure ulcers. Stage IV describes a pressure ulcer involving extensive destruction of tissue with tissue necrosis or damage to muscle, bone, or supporting structures. Usually, dead tissue and drainage are present in stage IV pressure ulcers.

According to the National Quality Forum, a non-partisan consortium of healthcare professionals and organizations, stage III and IV and unstageable pressure ulcers that develop after admission to a facility are considered Serious Reportable Events (SRE) that are preventable and should never occur. Unfortunately, bedridden, wheelchair bound and other at-risk patients don’t always receive the necessary care to prevent pressure ulcers. All too often, infected pressure ulcers lead to systems failures and ultimately death for at-risk patients at hospitals, nursing homes, acute and long-term care facilities. According to the National Pressure Ulcer Advisory Panel, a non-profit devoted to the prevention and care of pressure ulcers, each year approximately 2.5 million patients are treated for pressure ulcers in U.S. acute care facilities and as many as 60,000 U.S. hospital patients die each year from pressure ulcer complications.

Causes and prevention of bedsores

Pressure ulcers or bedsores are commonly caused by a combination of four factors: pressure, shearing forces, friction and moisture. The key to prevention is pressure reduction.

Good skin care begins with an initial risk assessment and the creation of a skin care plan specifically tailored to the patient’s condition and setting. Prevention of skin breakdown, pressure ulcers and tissue or blood infections is an essential aspect of care. Upon admission to a hospital, acute care or other facility, patients should be evaluated by a physician, qualified nurse of other medical professional for the risk of skin breakdown taking into account numerous variables and risk factors. Thereafter, regular skin assessments should be performed on a regular basis (daily in an acute care setting), especially if a skin problem is suspected or has been observed. Initial and periodic assessments should contain accurate measurements of the length, width, and depth of a wound. Drainage type, color and odor, and the color of wound tissue should be noted, as well as staging of the wound.

At a minimum, patients identified as at-risk for skin breakdown should be repositioned at least every two (2) hours. However, regular repositioning may not be enough for patients at higher risk levels or if a pressure ulcer has already formed. A pressure-reducing surface like a foam or inflatable mattress cushion should be used for those patients. To minimize the risk of skin breakdown from shearing forces, the head of the bed should be maintained at the lowest degree of elevation necessary based on medical conditions and other factors. Friction injuries may be reduced by the use of protective dressings and barriers. Pressure ulcers must be kept clean, dry and protected from sources of contamination such as feces and urine. This typically requires frequent cleaning of the patient and changing of the wound dressing.

What to look for?

Pressure ulcers can develop quickly – within days or even hours – depending on a patient’s condition and setting. The most common site where pressure ulcers occur in bedridden patients is the buttocks area, over the tailbone. Because of this, developing bedsores may be difficult to detect for family members not involved in the daily care of a patient. There are, however, certain observable factors and symptoms might indicate the presence of a bedsore warranting further examination and treatment. They can include:

  • lengthy period of immobility
  • generalized or local discomfort or pain when not being moved or touched
  • generalized or local discomfort or pain when being repositioned, turned, or moved
  • foul odor from of undetermined origin
  • evidence of lack of proper turning or re-positioning
  • poor hydration and/or nutrition
  • lack of proper hygiene and cleaning of incontinent patients

What to do?

If you suspect that a family member or loved one is at-risk or suffering from a bedsore, you should immediately notify the healthcare professionals in charge of their care. Proactive oversight and management of your loved one’s care is the best way to ensure they are receiving the proper care.

If your loved one is the victim of negligent care resulting in a pressure ulcer or decubitus, contact the experienced Atlanta Georgia elder care, bedsore and medical malpractice attorneys at Brownstein & Nguyen today for a free consultation. We handle cases involving preventable bedsores and the serious health complications and deaths that result. We’ll confidentially review the case, and discuss your legal rights with you.

Preventable Deaths from Medical Negligence

In a September 2013 article, the Journal of Patient Safety reported that patient deaths as a result of medical errors are on the rise. The article estimates that the range of annual premature deaths that are associated with preventable harm in hospitals is between 210,000 and 400,000. This estimate represents a significant increase from the reported range in the 1999 article To Err Is Human: Building a Safer Health System, which estimated the annual range of premature deaths to be between 44,000 and 98,000.

39169436These articles and the research behind them point to a harsh and unfortunate reality: our health care system is not safer and is failing to take necessary steps to prevent death and serious injury resulting from medical mistakes. In fact, the problem has gotten much worse. An increase of between 400 and 500 percent in 15 years in the number of preventable deaths from human error is totally unacceptable. In 1999, the authors of To Err Is Human outlined several steps recommended by the Quality of Healthcare in America Committee of the Institute of Medicine to improve safety and help decrease the number of preventable deaths and injuries. Some of these suggestions seem obvious, such as implementing better hygiene and patient safety protocols for the delivery of care to reduce mistakes such as preventable infections and medication errors. Apparently, either these suggestions have not been implemented industry-wide or they have been ineffectively implemented.

Perhaps the health care industry as a whole should revisit the original strategy for the improvement of care proposed by the Institute of Medicine.  That proposal included a four-tiered approach, which included:

  • Establishing a national focus to create leadership, research, tools, and protocols to enhance the knowledge base about safety.
  • Identifying and learning from errors by developing a nationwide public mandatory reporting system and by encouraging health care organizations and practitioners to develop and participate in voluntary reporting systems.
  • Raising performance standards and expectations for improvements in safety through the actions of oversight organizations, professional groups, and group purchasers of health care.
  • Implementing safety systems in health care organizations to ensure safe practices at the delivery level.

For the victims of medical mistakes and their families, the devastating losses associated with these errors such as overdosing patients and other medication errors, surgical mistakes, and acting on incomplete or incorrect patient health histories, do not make sense. How does one come to accept that their loved one’s death was the result of an error? How does one recover from such a devastating and preventable loss?

Atlanta law firm, Brownstein and Nguyen, has first hand knowledge and experience in working with families who have suffered tragic losses from preventable deaths and serious injuries due to medical mistakes. We are dedicated to advocating for families and loved ones who suffer. For more information about medical malpractice and negligence cases, click here. Contact us today for a free consultation and case review.

Healthcare-Associated Infections

Hospital care is often required for those who are ill or injured. However, there are unseen dangers involved in our healthcare system according to a recent report from the Centers for Disease Control (CDC). This report detailed the prevalence of healthcare-associated infections (HAI) that can be contracted during the course of hospital care.

Hospital infections and medical malpracticeIt is amazing that in 2014 it is still possible to contract an infection as a result of a lack of hand washing. However, the numbers reported in recent studies show that healthcare-associated infection is more than just a possibility – it is a danger all hospital patients face. According to CDC Director Tom Freyden, more than 200 Americans will die each day as a result of an infection contracted during a hospital stay. Freyden goes on to state: “The most advanced medical care won’t work if clinicians don’t prevent infections through basic things such as regular hand hygiene. Health care workers want the best for their patents; following standard infection control practices every time will help ensure their patient’s safety.”

The Multistate Point-Prevalence Survey of Healthcare-associated Infections, published in the New England Journal of Medicine, reports the most common infections related to hospitalization. These include pneumonia, surgical site infections, gastrointestinal infections, urinary tract infections, and bloodstream infections. While not all of these infections result in death, it is certain that these infections make recovery from surgery, illness, or other reasons involving hospitalization, more difficult.

Infections that result from a lack of hand washing and other preventive measures or safety issues such as unsterilized equipment, unsafe handling of blood and other substances, etc. may fall in the category of medical malpractice. Medical malpractice claims in Georgia are difficult to pursue, but the attorneys at Brownstein and Nguyen in Atlanta have extensive experience in litigating these types of cases. If you or someone you know has suffered from a serious infection as a result of medical malpractice or negligence, contact our Georgia malpractice attorneys for a free consultation today.

Have you had to place a loved one in the care of a nursing home?

The number of individuals that are able to simply answer “yes” to this question is growing as our population ages. According to the U.S. Census the population of individuals aged 45 to 64 grew 31.5% from the 2000 Census to the 2010 Census. This generation is commonly referred to as Baby Boomers. With the population of Baby Boomers aging, more individuals find themselves looking for additional resources to help care for the healthcare needs of their parents and loved ones. The decision to place a loved one in a nursing home is often not an easy one. In choosing a facility, one important factor to think about is possible abuse or neglect.

32141277.thbNursing Home Abuse and Neglect

It is unfortunate, but true, that many have suffered from abuse or neglect while residing in nursing homes. Not all nursing homes are managed and operated in the same manner, and caring for patients with such a wide range of specific needs can be difficult. This is especially true when nursing homes and healthcare workers seem to be overworked and underpaid.

Nursing home abuse and neglect can manifest itself in several ways. This is a short list of things to be on the lookout for:

  • Pressure sores (sometimes referred to as decubitus ulcers) or bedsores
  • Skin breakdown and lesions
  • Falls and/or broken bones
  • Infections
  • Excessive bruising
  • Burns and other skin lesions
  • Infections from improperly placed or maintained catheters
  • Bowel impactions as a result of chronic constipation
  • Malnutrition
  • Dehydration
  • Medication errors
  • Improper or over-sedation
  • Poor personal hygiene
  • Dry skin and/or chapped lips
  • Unexplained weight loss
  • Reduced appetite of the inability to eat
  • Verbal abuse
  • Physical abuse
  • General disregard for health and welfare of residents

It is always highly suggested that family members research options in acute care or rehabilitation facilities in advance of making a decision to admit a loved one. We suggest reading, Three Key Things to Consider when Looking for an Assisted Living Facility, and visiting Skilled Nursing Facilities to help you in this process.

Should your loved one have the unfortunate experience of experiencing neglect or if you notice signs of neglect as a result of care in a long term care facility, Brownstein & Nguyen has first hand experience in dealing with the issue of nursing home abuse and neglect.  We are your premier lawyers within the Greater Atlanta area in helping to fight for your loved ones’ rights while living in a managed care facility. If you have noticed any of the above issues, or are concerned that a loved one may be suffering, call or contact our nursing home neglect and elder abuse lawyers today.

Three Key Things to Consider when Looking for an Assisted Living Facility

With the effects of Alzheimer’s disease often requiring special care, it is highly likely that the number of families that must turn to a Skilled Nursing Facility (or nursing home) will rise. In searching for a facility for your loved one, there are many things to consider. Here are three key things that you should keep in mind:

Researching a Skilled Nursing Facility1. Research Facilities In Advance

Before visiting a specific facility, do your research. Visit sites such as skillednursingfacilities.org and the Georgia Department of Community Health to review facility ratings and reports. Look closely at the numbers of complaints and violations if there are any.

2. Visit the Facility

After carefully researching the facilities and determining which ones may best meet the care needs of your loved one, set up an appointment to visit. This can easily be done through calling or emailing the facility to schedule a tour and meet with an onsite administrator. Make sure that you observe the residents, the employees, and the overall environment while visiting.

3. Ask Questions

It is wise to be prepared with questions before visiting a facility. Think about what you would like to ask the manager, the healthcare providers, and even the residents. The National Institute on Aging provides several suggested questions. This is a big decision, and it is important to investigate all angles.

While researching and visiting facilities, it is important to be aware of any signs of nursing home neglect or elder abuse. You will want to make sure that you address any questions or concerns that you have regarding any potential warning signs in this area. It may also be helpful to consult with a lawyer that is familiar with cases of nursing home neglect or abuse prior to visiting a facility and before agreeing to admit a family member. At Brownstein & Nguyen, we have years of experience in dealing with the difficult situations that arise in cases of nursing home neglect and elder abuse. Call or contact us today so that we can help you.

Alzheimer’s Rates May be Much More Prevalent

Recently the journal Neurology found that the number of deaths as a result of Alzheimer’s disease in the United States may be much larger than what has been commonly reported. This is attributed to the fact that the debilitating disease has many side effects and complications that are often recorded as the main cause of death on death certificates. According to the study from the Rush University Medical Center in Chicago, Alzheimer’s disease could be responsible for over 500,000 deaths each year. If this is true, Alzheimer’s disease would come in at a close third for the leading cause of mortality in the United States. Heart disease and cancer are at the top of the list.Alzheimer's More Prevalent

Early diagnosis of Alzheimer’s is difficult as families often miss the indirect signs to help identify it. However, once a physical decline begins, its progression is quite rapid and this leads to the secondary causes of death. It is important to be on the lookout for possible signs of Alzheimer’s. The Alzheimer’s Association offers a wealth of resources regarding Alzheimer’s disease, including 10 Warning Signs of Alzheimer’s.

The Alzheimer’s Association identifies these 10 signs as:

  1. Memory loss that disrupts daily life.
  2. Challenges in planning or solving problems.
  3. Difficulty in completing tasks at home, at work or at leisure.
  4. Confusion with time or place.
  5. Trouble understanding visual images and spatial relationships.
  6. New problems with words in speaking or writing.
  7. Misplacing things and losing the ability to retrace steps.
  8. Decreased or poor judgment.
  9. Withdrawal from work or social activities.
  10. Changes in mood or personality.

With the distinct possibility that Alzheimer’s is much more prevalent than previously known, families are left with many difficult decisions regarding the long term care of their loved ones. As lawyers in Atlanta specializing in elder abuse, medical malpractice, and nursing home neglect, Brownstein and Nguyen is here to help you understand things you should prepare for as your loved ones age and experience signs of Alzheimer’s disease.  Call or contact us today.

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Atlanta Elder Abuse & Medical Malpractice Blog

Welcome to the Atlanta Elder Abuse & Medical Malpractice Blog, provided by Atlanta, Georgia law firm Brownstein & Nguyen. This blog page is dedicated to legal issues and matters concerning medical malpractice and elder abuse in Georgia. We hope it is informative and helpful.

The information and opinions provided on this page are not legal advice. Please consult with an attorney to discuss your legal issue.