California Elder Abuse Lawyer Blog

How does an elderly demented woman get locked in a retirement home walk-in freezer? According to news reports a 94 year old resident of Silverado Senior Living, in Calabasas, California went "missing" and was found in the walk-in freezer. Seriously, how does that happen? These facilities have lots of kitchen staff. Did no one see her wander through? The kitchen is to be off-limits to residents, but according to news reports, the lock to the kitchen was "not working." Why? Did the facility know it was "not working?" If so, why not fix it? Isn't this a basic safety measure? If a child wandered into a school cafeteria and found his or her way into a freezer, wouldn't we have something to say about that? Residents with dementia, like children, lack safety awareness. The freezer is one hazard, but the rest of the kitchen is as well. Hot boiling water on a stove, sharp knives, toxic chemicals, etc.

Silverado is a chain of luxury assisted living facilities which cater to residents with dementia. While assisted living facilities typically house residents who are ambulatory and able to meet some of their own needs, their primary reason for living in this type of environment is for their protection and safety. And residents and their families pay a steep price for a certain level of monitoring and security, somewhere in the neighborhood of $6,000 per month. At that price point, shouldn't we be able to keep the locks working and the resident's safe? Facilities such as Silverado tout that residents are well- supervised, protected, and that safety is a primary function. Silverado features locked and alarmed entrance and exit doors, elaborate closed circuit cameras, and fenced perimeters - all selling points to concerned families willing to pay a premium to ensure their loved one's safety. How is it that a significant danger - a hazardous industrial kitchen is left open and accessible, and a freezer is unlocked and unattended right under the noses of facility management and staff? Families institutionalize their family members for many reasons; their inability to live safely around common household hazards chief among them. Silverado is not reimbursed by Medicare. This national chain is well experienced with issues and concerns that affect demented elders and must deliver on the promises they have made to families and for which they are handsomely remunerated with private dollars.

An 82 year old male who, during a rehabilitative stay following treatment for back spasms, suffered two falls in the middle of the night, one on October 1 and a second fall on October 2. The second fall resulted in a brain injury. He suffered bleeding in the brain which caused pressure, which had to be relieved by surgically boring holes in his skull. He was hospitalized for nearly 6 weeks and spent another 6 weeks recuperating from treatment and complications from the falls at another nursing home, before he was able to return home. He required a feeding tube, had wore diapers, he had to regain strength to walk and care for his own needs.

Nursing homes charged with a responsibility to assess a residents "risk" for falling and then to take reasonable steps to both (1) minimize the risk of falling and (2) minimize injury in the event of a fall. In this case, the patient was undoubtedly a high fall risk, given his back spasms and the use of pain medications. However, the facility failed to assess him as "high" risk. Accordingly, the resident was not provided with a fall-related care plan (a set of documented actions nursing will implement to resolve problems identified by assessment and re-assessment) indicating what safeguards the nursing staff should take to prevent falls and/or to prevent or minimize injury from falls.

In this case, the resident tried to get up to go to the bathroom in the middle of the night when he suffered his first fall. This put the facility on notice that the patient would attempt to get up unassisted. Once on notice, the facility needed to take steps to keep him safe. Such steps might include lowering the bed to the floor, pushing it up against a wall so there is only one side to get in and out of the bed, putting a pad on the floor next to the bed to cushion a patient if they fall, padding the corners of the furniture and other hazards, using siderails while the patient is in the bed to make it difficult to get up unassisted, using pressure pads in the bed that alarm and alert nursing staff when the patient shifts weight in an effort to get out of bed, implementing a frequent toileting schedule (offering assistance to the bathroom or a bedpan every hour or two in the nighttime), use of a bedside commode (so the resident doesn't have to walk very far to the bathroom, particularly in the night). These are just examples of the types of interventions that keep nursing home residents safe. Acceptance of the axiom that "old people fall" is not the norm.

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