Addressing The Unspoken: Incontinence Issue Neglect in California Nursing Homes
Incontinence, a common and sensitive health concern among the elderly, is an often overlooked yet distressing aspect of nursing home care. Around 13 million Americans suffer from urinary incontinence, with a 50% or higher prevalence in nursing home residents. Unfortunately, neglect in managing incontinence has become a growing problem within assisted living facilities, compromising the dignity and well-being of vulnerable residents.
Despite the fundamental right to live with respect and receive proper care, many seniors suffer from inadequate support and understanding in addressing incontinence needs. Recognizing the signs of incontinence, issue neglect, and knowing what steps to take to report neglect can help protect your loved one’s rights and well-being.
What is Elderly Incontinence?
Incontinence is the involuntary loss of bladder or bowel control in elderly residents. It is a prevalent and often sensitive health issue affecting many seniors in long-term care facilities.
Incontinence can manifest in different forms and may occur due to age-related weakening of muscles, neurological diseases, chronic health conditions like diabetes, or physical and mental impairments.
Types of incontinence commonly experienced by nursing home residents include:
- Stress Incontinence: Stress incontinence is marked by the release of small amounts of urine during physical activities that exert pressure on the bladder, such as coughing, laughing, or lifting heavy objects.
The condition stems from the weakening or damage of muscles that keep the bladder closed. Aging often brings about these physical changes in seniors, with 24% to 45% of women over 30 suffering from stress incontinence at some point.
- Urge Incontinence: Also known as overactive bladder, urge incontinence is an intense, sudden urge to urinate, followed by involuntary urine loss. It occurs in 31% of women and 42% of men over 75 years. It’s most often caused by damage to the bladder’s nerves, conditions like diabetes, or neurological diseases such as Parkinson’s or stroke.
- Overflow Incontinence: Overflow incontinence arises when the bladder doesn’t empty completely during urination, leading to an overflow of excess urine. This type may result from blockage, obstruction, or weak or underactive bladder muscles. Symptoms often include frequent urination or constant dribbling of urine, occurring in around 5% of those with chronic incontinence.
- Functional Incontinence: Functional incontinence is not associated with problems with the urinary system but is due to physical or mental impairments that prevent the person from reaching the toilet in time. Conditions like severe arthritis may make unbuttoning pants challenging, while cognitive impairments such as dementia might cause an individual not to recognize the need to urinate.
- Mixed Incontinence: Occurring in 20% to 30% of those with chronic incontinence, mixed incontinence happens when a person experiences more than one type of urinary incontinence. It most commonly involves a combination of stress and urge incontinence symptoms.
- Fecal Incontinence: Fecal incontinence is the inability to control bowel movements, leading to unexpected leakage of stool from the rectum. It can result from muscle damage or nerve damage, chronic constipation, diarrhea, or diseases affecting nerve function like multiple sclerosis or diabetes. Around 42.8% of those in care facilities suffer from some form of fecal incontinence.
When is Failure to Treat Incontinence a Form of Nursing Home Abuse or Neglect?
Failure to treat incontinence can be considered a form of nursing home abuse or neglect when it harms or threatens the well-being of elderly residents. Proper incontinence issue management is crucial to maintaining the dignity, comfort, and overall quality of life for nursing home residents.
Neglect or abuse related to incontinence may include:
- Persistent failure to provide timely assistance with personal hygiene.
- Ignoring or delaying incontinent residents’ requests for toileting or changing.
- Failing to ensure clean and appropriate clothing and bedding for incontinent residents can facilitate the spread of scabies and cause discomfort.
- Neglecting to address incontinence-related medical issues or provide necessary treatments.
- Allowing residents to endure prolonged distress, humiliation, or social isolation due to incontinence.
- Not taking measures to prevent skin irritations, infections like MRSA, or pressure sores caused by prolonged exposure to urine or feces.
In California, neglecting to offer necessary incontinence care falls under the legal definition of elder abuse. Nursing homes, caregivers, or anyone responsible for providing care can be held accountable under the law for failing to treat incontinence, especially when it leads to the decline or well-being of the resident.
What to Do if You Suspect Your Loved One is a Victim
Entrusting the care of a beloved family member to a nursing home is a major decision, and it’s essential to ensure their safety and well-being. If you suspect your loved one is a victim of nursing home abuse or neglect, taking the proper steps can help you protect their rights and dignity.
Step 1: Recognize the Signs
Ensuring your loved one’s well-being starts with knowing what to look for regarding abuse or neglect. The following are common signs and symptoms that your elderly relative may be experiencing mistreatment:
- Behavioral and emotional changes: Pay close attention to any sudden or unexplained behavioral changes in your loved one. Signs of abuse or neglect may include anxiety, fear, depression, withdrawal, or unusual agitation.
- Physical indicators: Look for unexplained injuries, bruises, cuts, or bedsores. Unexplained weight loss, dehydration, or signs of malnutrition may also be red flags.
- Poor hygiene and living conditions: Check for unkempt personal hygiene, soiled clothing or bedding, or unsanitary living conditions in the nursing home environment.
- Unresponsiveness to staff or avoidance: Notice if your loved one seems afraid of certain staff members or avoids interactions with them. For instance, they may become withdrawn or act out when a specific staff member approaches.
Step 2: Report Suspected Abuse or Neglect
If you have clear proof of abuse or neglect, document it as thoroughly as possible and report the mistreatment through appropriate channels. This begins with the nursing home staff and administration but may require filing a complaint with the California Department of Public Health. To start the reporting process, take the following steps:
- Document your concerns: Record any observations, incidents, and conversations with your loved one about the suspected abuse or neglect. Maintain a detailed journal, including dates, times, and descriptions of the incidents.
- Contact the nursing home: Speak directly to the nursing home administrator or director of nursing to report your concerns. You can also speak with the home’s family council, if possible. Share your documented observations and request a thorough investigation into the matter.
- Involve authorities: If the nursing home fails to address your concerns adequately, report the suspected abuse or neglect to the appropriate authorities, such as the California Department of Public Health through Cal Health Find or the Long-Term Care Ombudsman Program.
Step 3: Seek Legal Assistance for a Civil Claim
You may consider filing a civil claim against the nursing home, providers, or staff responsible for the harm caused to your loved one. A nursing home abuse lawsuit can help your family win compensation for physical and emotional damage due to failure to address incontinence issues or other abuse or neglect.
Take the following steps to seek legal representation and pursue a civil claim in California:
- Gather evidence: Work with your attorney to gather all relevant evidence, including medical records, photographs of injuries or living conditions, witness statements, and any previous complaints about the nursing home.
- File a civil claim: If the evidence supports your suspicions, your attorney will help you file a civil claim against the nursing home for compensation and justice on behalf of your loved one. Your attorney will negotiate with the nursing home’s representatives or insurance company to reach a fair settlement for your loved one’s injuries and damages.
- Litigation if necessary: If a fair settlement cannot be reached, your attorney will pursue litigation and take the case to court to seek appropriate compensation and accountability for the nursing home’s actions.
Take Action on Your Loved One’s Behalf Today
If you suspect abuse or neglect of your loved one in a California nursing home, you can take steps to protect their well-being and rights. Swiftly reporting concerns to the nursing home administration and appropriate authorities when you notice signs of neglect can help ensure a timely investigation and protect your loved one.
If neglect persists, seeking legal assistance to file a civil claim can hold responsible parties accountable. Your advocacy and decisive action can safeguard your elderly relative’s dignity and well-being in their nursing home environment.