Category: Elderly

Antipsychotics Prescribed For Elderly Patients

The world’s eighth largest drug manufacturer, Johnson & Johnson, agreed to pay as much as $2.2 billion earlier this month to settle US probes into the marketing of antipsychotic drugs – including Risperdal – to older adults, children and the disabled. According to a New York Times article The Justice Department has determined that the company promoted psychiatric medications for uses not approved by the Food and Drug Administration and may have even offered incentives for physicians to frequently prescribe them.

This latest lawsuit kindles concerns
that antipsychotics are being widely and
improperly prescribed to millions of Americans each year.

The American Chemical Society, based in Washington DC published that Antipsychotic drugs like Risperdal work by blocking dopamine, the chemical in the brain that contributes to high risk behaviors. Use of antipsychotics nearly tripled in the past two decades in the United States, with more than 16 million annual prescriptions for drugs such as Abilify, Clozaril and Seroquel. According to a study by Stanford University in 2008, more than half of prescriptions were for “off-label” use not approved safe and effective by the FDA. This latest lawsuit kindles concerns that antipsychotics are being widely and improperly prescribed to millions of Americans each year.

Particularly worrisome is the use of antipsychotics to treat vulnerable patients, including elderly nursing home residents. The federal government alleges that Johnson & Johnson and its subsidiaries promoted the use of the Risperdal for elderly patients with dementia, despite evidence that this would increase their risk of stroke, weight gain and diabetes. According to an audit by the US Department of Health and Human Services, Medicare claims were filed for antipsychotic drugs for 1 in 7 nursing home residents over the age of 65, with 83% attributed to off-label use.  Antipsychotic drugs are increasingly used to treat problems related to dementia in older adults, though the medication has proven more effective for sufferers of schizophrenia and can cause serious side effects.

Antipsychotics are not the only drugs that are commonly misprescribed among the elderly. In 2011, a study published by the British Medical Journal suggested that the prescription of antidepressants may need to be reevaluated as well. The study showed that adults over 65 who took newer generation antidepressants – known as serotonin reuptake inhibitors (SSRIs) including Prozac and Zoloft –  had a greater risk of having a stroke, seizures and higher salt levels in the blood than those who took older medications, known as tricyclic antidepressants (TCAs). These findings are contrary to the prevailing view that SSRIs are safer than TCAs.

In 2012, antidepressants were tied to a higher risk of falls
for nursing home residents, especially those with dementia. 

While antipsychotics are used to manage psychosis symptoms related to schizophrenia and bipolar disorder, antidepressants are used to treat disorders like depression or anxiety and are intended to alter mood. As with antipsychotics, the use of antidepressants has increased since 1990 and has been a subject of much debate. Medical News Today reported that in 2012, antidepressants were tied to a higher risk of falls for nursing home residents, especially those with dementia.

Although all prescription medications can have adverse side effects, physicians and drug manufacturers have an ethical obligation to disclose the associated risks and potential
alternatives to patients or family members.

The American Journal of Geriatric Pharmacotherapy reported in 2011 that nearly 50% of nursing home residents are given antidepressants, though there is little knowledge available regarding how antidepressants are prescribed. Many may be dispensed solely on the basis of nurses’ observations or patient’s behavior rather than a proper diagnosis by a doctor.
Although all prescription medications can have adverse side effects, physicians and drug manufacturers have an ethical obligation to disclose the associated risks and potential alternatives to patients or family members.

The prevalence of lawsuits associated with antipsychotic and antidepressant drugs sends a strong message to drug manufacturers that they must practice full disclosure regarding the possible side effects, uses and abuses of psychiatric medications – and practitioners should exercise much greater caution in prescribing them.

Okun Oddo & Babat specializes in Medical Malpractice and Medical Negligenceclaims. Contact us today or call or call us at 212.642.0950 to arrange an appointment with one of our experienced New York attorneys.

Article by Shea Bergesen for Lavery Design Associates, Ltd. copyright 2013. This article may not be reproduced without permission from the author.

Poor Hygiene and Inadequate Care in Nursing Homes

When a loved one is no longer able to live independently due to age or illness, many families decide to place them in the care of a nursing home. According to the Center for Medicare Services, approximately 3.3 million Americans will live in an elder care facility in 2013.

In the over 16,000 facilities nationwide, federal and state regulations are in place to protect nursing home residents from harm and ensure they are receiving proper care. However, a National Center for Elderly Abuse study of 2,000 nursing home residents in 2000 reported that 44% said they had been abused in some way and 95% reported witnessing or experiencing neglect. Instances of mistreatment may involve extreme abuse, including physical or sexual assault. However in many cases, neglecting personal hygiene and facility sanitation are the cause of illness, injury or even the death of a resident. Because many elderly patients are unable to take care of personal grooming without assistance, failure to maintain a consistent hygiene routine with residents — including not bathing them or changing dirty clothes/bed linens for hours or days at a time — can lead to serious physical and emotional problems.

Poor hygiene and inadequate care in nursing homes can result in:
• Bed sores
• Ulcers
• Skin and eye infections
• Internal parasites
• Ingrown fingernails/toenails
• Cataracts
• Kidney infections
• Malnutrition
• Oral pain and gum infections
• Dehydration
• Depression
• Lowered sense of well-being and self-esteem

Because their immune systems may already be compromised by preexisting medical conditions or advanced age, elderly people are more likely to develop infections from germs spread by poor hygiene. The US Department of Health and Human Services reports that infections are a leading cause of death in long term care patients, with an average of 1.5 to 2 million infections occurring in nursing homes each year. The risk of infectious and bacterial diseases such as colds and influenza can be significantly diminished by hygienic practices such as proper bathing, hand washing and oral care. Instead, these infections impact the health of thousands of people and cost billions of dollars in medical costs, with an estimated $1.4 billion spent each year.

While poor personal hygiene may seem minor compared to more egregious forms of neglect in nursing homes, it is a serious hazard that can result in severe medical conditions and even death. Nursing homes are required by law to maintain good hygiene for their residents.

If a resident has been injured or suffers premature death as a result of improper hygiene at a nursing home facility, a lawsuit may be the logical next step and can result in compensation awarded to the victim and/or their family. Contact Okun, Oddo & Babbat to arrange a consultation with one of our experienced attorneys.

Sources and Resources:
www.centeronelderabuse.org
www.ncea.aoa.gov
www.hhs.gov/ash/initiatives/hai/actionplan
www.cdc.gov/nchs/fastats/nursingh.htm
www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/NHs.html

Article by Shea Bergesen for Lavery Design Associates, Ltd.
copyright 2013. This article may not be reproduced without permission from the author.

Property Owner’s Responsibility For Slips & Falls

According to the Center for Disease Control and Prevention, every 8 seconds someone is hurt by a slip and fall. The odds that you will have a slip and fall accident requiring medical attention in a given year are 1 in 35. Injuries sustained from this type of accident can range from minor scrapes and bruises to broken bones, fractures, head and spinal cord trauma or even death.

The CDC reports that falls account for nearly 8 million visits to the emergency room each year, or 33.3% of all visits. In 2011, falls were the number one cause of non-fatal injuries. Of these incidents, approximately 1 million involved slipping. Slips are often caused by insufficient friction between the ground and a person’s shoes as a result of a slick floor, spill or poor treading. A fall involves a complete loss of balance, sometimes from a platform higher than ground level.

In the United States, there are more than 21,000 fatalities each year as a result of slip and fall accidents. While injuries are equal among men and women, studies show that men are more likely to be involved in fatal accidents.

Seniors and children are more likely to be involved in a slip and fall accident. 40% of all nursing home admissions are a result of care needed after a fall, and approximately 2 million Americans over 65 are treated in emergency rooms annually after falling. They are the 6th leading cause of death among people over 70, with nearly 1,800 older Americans succumbing to injuries each year.

Slips & Falls in the Workplace
The Bureau of Labor Statistics reports that slips and falls are consistently in the top 4 causes of death in workplaces and in 2011 resulted in 58% of disabling injuries. Employees were forced to miss more than 30 days of work in 25% of these cases. Though slips and falls are not the most common cause of workplace fatalities, they are the cause of most work-related time off. According to the Occupational Health and Safety Organization, they cost employers an estimated $70 billion in compensation costs each year.

Workplace accidents are not the only instances where another party may be liable for damages. With any slip and fall that occurs in a public space such as a restaurant, store, hotel, etc. where the establishment has not provided safe conditions, a lawsuit may be pursued. Negligence in these cases includes slick or uneven floors, obstacles scattered in walking areas, poor lighting and failure to adequately remove hazards caused by weather.

When slips and falls are caused by a property owner’s failure to provide a safe environment for pedestrians or during performance at work, the victim should pursue compensation for any medical bills incurred. Wherever they happen, slips and falls can result in missed work, disability, the need for long-term care and pain and suffering damages that should be recovered.

Contact Okun, Oddo & Babat to arrange an appointment with an experienced New York attorney to review the details of your case.

Article by Shea Bergesen for Lavery Design Associates, Ltd.
copyright 2013. This article may not be reproduced without permission from the author.

Senior Care & Skilled Nursing Home Negligence

It’s a difficult decision to place someone you love in a nursing home. After screening facilities and ultimately making a decision, it’s important as a family member to be mindful of the circumstances and monitor for any signs of negligence since elders are in many cases are emotionally and/or physically unable report inadequate care. Be aware of the patients care needs including hygiene, medication and nutrition, develop a regular rapport with nursing and specialized staff to discuss care and be mindful of the physical appearance of the patient upon visiting. It’s important to take notes and ask for questions and explanations as issues arise. A report should be filed immediately if any physical or emotional changes are evident.

Neglect can be difficult to determine since the aging process itself can take a physical and emotional toll on the body. One of the most common signs of neglect is the development of skin ulcers, better known as bed sores. When patients are left resting in one position for long periods of time, bones and skin are subject to friction and pressure, resulting in painful skin sores which can develop and worsen very quickly. Nurses are required to regularly turn patients to prevent the development of bed sores, which are not only very painful, but have the potential to lead to very serious and sometimes life threatening infections. If bedsores are present and reported, nursing home staff should treat them immediately.

Staff members who are unwilling to respond to inquiry immediately or who refuse to allow family or friends to visit unattended should be reported to supervisory staff. Other types of nursing home abuse may be:

• Witholding food or not providing food according to prescribed schedule

• Poor hydration

• Failing to dispense medication on schedule

• Medication errors

• Poor sanitary and toiling facilities

• Inadequate daily hygiene, care and grooming

• Improper supervising

• Verbal, mental or physical abuse

• Failure to recognize need for or provide emergency care

If you notice signs of depression, personality changes and changes in physical appearance and suspect any care neglect or nursing home abuse, please call Okun, Oddo & Babat at 212-642-0950 immediately for a consultation and evaluation. You may also email us. We pride ourselves on being advocates for elders in these unfortunate circumstances.