Nursing home abuse, and under the greater scope of elderly abuse, is, unfortunately, a more common occurrence in modern society than many wish to acknowledge.
While there are many excellent nursing home facilities and elder care options Canada-wide, there are still those that are negligent and abusive towards residents, leading to unexplained deaths, serious injuries, and preventable illness.
Reports on the conditions of nursing homes and nursing home abuse have been released within the past decade. Most prominently, these conditions were highlighted during and after the pandemic in stories of neglect.
As a nursing home abuse lawyer in Toronto, we are dedicated to ensuring the rights of our elderly are respected.
Overview Of Nursing Home Abuse In Toronto
A nursing home is not where anyone expects to find themselves at risk of neglect, injury, or death.
Yet elderly people who live in settings other than their own homes and apartments are at an increased risk of abuse and neglect. Many elderly individuals suffer from one or more chronic diseases as well, limiting physical and cognitive functioning, and causing them to be dependent on others.
The elderly living in nursing facilities are some of the most vulnerable members of society. They are dependent upon the nursing home for everything from food to medicine, medical care, dental care, and shelter.
Nursing home abuse occurs when a resident is not being properly cared for. Any act or lack of action that causes harm or distress to a senior, or that risks their health or welfare is considered by legal standards to be elder abuse.
Abuse can be hard to discover as signs are not always evident on the surface, requiring a family member or friend to have to ask questions and watch for signs.
Recognizing Signs Of Elderly Abuse In Nursing Homes
Elderly abuse can be identified best by paying attention to your loved one’s physical and emotional state. If you ever suspect there could be nursing home abuse, visit the facility more frequently and vary the time of day you visit.
Provide your loved one the opportunity to come forward to say something. Do understand that, whether it’s an elderly parent, grandparent, or friend, they may not want to report abuse. They may fear that coming forward, the abuse will worsen or that there will be retaliation on the part of the nursing home towards the resident.
With this in mind, it’s important to recognize the signs of elderly abuse yourself if you suspect a loved one is being affected. Here are the most common signs of physical abuse and neglect to watch for.
Untreated bedsores
Wounds, cuts, bruises, or welts that have not been treated
Torn clothing or broken personal items
Fleas, lice, and/or dirt on a resident or in a resident’s room
Excessive and sudden weight loss may indicate an issue with their eating patterns or sickness
The odor or presence of feces or urine
Poor personal hygiene
Abnormally pale complexion
Speaking to the staff of a nursing home and watching how they operate, you may notice or pick up on several things as well that could indicate abuse and neglect. This includes a lack of proper heating or cooling, sudden changes in a resident’s medication without prior warning or notice, a refusal to allow visitors to see residents alone or during certain times, and/or a caregiver’s inability to explain a resident’s physical condition.
The Role Of Medical Malpractice Lawyers In Elder Abuse Cases
Medical malpractice is frequently confused with elder abuse, with many medical malpractice lawyers offering services in both categories of law. They are two different forms of personal injury law, however.
Medical malpractice refers to a personal injury in which a healthcare provider has committed an act that falls below the standard of care. Comparatively, elder abuse is an intentionally harmful act or the failure of a caregiver to use the degree of care that a reasonable person would use in providing for an elderly person’s needs.
While you might seek out a medical malpractice lawyer depending on the nature of the abuse, you will want to ensure the lawyer you’re hiring has experience specifically in nursing home abuse cases.
Understanding Medical Malpractice Lawsuits In Elder Abuse
Preparing a medical malpractice lawsuit or an elder abuse case has many similarities between them. Both are highly complex.
In medical malpractice, one is dealing with a healthcare provider whereas with elder abuse and nursing homes, you’re dealing with a caregiver or staff. A healthcare provider has certain standards that must be upheld in a given situation which is what a medical malpractice lawsuit focuses on – a standard of care not having been met.
In nursing homes, the caregiver is often the healthcare provider which is where medical malpractice and nursing home abuse overlap.
Where medical malpractice and elder abuse continue to differ is in how compensation is provided. With elder abuse, should the burden of proof be met, the victim and their family can ask the nursing home to pay for the cost of their lawyer and all costs of litigation as well as for any pain and suffering caused.
Regarding these types of lawsuits, with elder abuse, a claim can only be brought against someone with a custodial caretaking relationship with the victim. While a doctor may be involved in the care of a nursing home resident, a doctor does not have a custodial caretaking relationship with the nursing home resident. Therefore, a doctor cannot be sued in this context.
Types Of Abuse: From Physical To Financial
There are many types of elder abuse found in nursing homes, including physical, emotional, sexual, financial, and neglect.
Physical Abuse
Physical abuse is one of the easier types of elder abuse to detect because the signs are visible. Unexplained bruises, cuts, broken or fractured bones, sprains, welts, pressure marks, restraint marks, broken glasses, bleeding, bite marks, and other signs of trauma on the skin
Emotional Abuse
Examples of emotional abuse include degrading statements, humiliating language, intentionally causing long waits for care or food, interfering with an elderly person’s decision-making, making false accusations, verbal aggression, and/or an act as simple as placing assistive devices out of reach.
Signs of emotional abuse do not present on the surface and can be harder to discern.
Indications that there is emotional abuse are if there’s a sudden change in behaviour or mood, withdrawal from social activities, or a change in interactions between them and staff.
Another sign of emotional abuse can be if there are staff who will not leave you alone with your loved one. If someone is remaining in close proximity during your visits, they may be trying to ward off a confession or conversation about what’s going on.
Sexual Abuse
Sexual abuse in nursing homes is any forced or non-consensual sexual contact. This extends to sexual contact with elderly patients who have dementia, Alzheimer’s, and cognitive disabilities that make it so that they aren’t able to give consent.
If you notice fear and/or discomfort in front of certain staff, this may be a sign of sexual abuse.
More signs of elder sexual abuse include bleeding from the anus or genitals, bruised genitals or inner thighs, new sexually transmitted diseases or infections, pain felt in the anus or genitals, unexplained pelvic injuries, and/or problems walking or sitting.
Financial Abuse
Financial abuse can be tougher to detect if you aren’t actively watching over an elderly person’s bank accounts.
Look for large unexplained cash withdrawals that your loved one does not remember or cannot explain.
Sudden changes in their will or power of attorney without a reason.
Additional names that you are not familiar with or that your loved one does not know have been added to bank accounts.
Bills are no longer being paid on time or there are bills showing up in account statements that you do not recognize.
A caregiver taking an unusual interest in their finances and/or asking questions about their financial status.
An unwillingness to discuss their finances.
Neglect
Neglect is a form of elder abuse that we see a lot of as lawyers in this field.
Neglect can present as a decline in an elderly patient’s appearance, a clear lack of bathing and personal care, bedsores, unattended sores or lesions, sudden weight loss, incontinence, medication errors, dehydration, malnutrition, and overall unsanitary living conditions.
An elderly person may not even be aware of all the ways in which they are being neglected. As their family member or friend, you can ask them how they are, if they like staying where they are, and how the staff is treating them.
Nursing Home Neglect: A Silent Epidemic
It has been found that nursing home neglect or abuse is as high as one in every six old people in nursing homes being a victim. The proliferation of abuse has led to some experts calling it an epidemic in both Canada and the United States.
Why this is has everything to do with the fact that the population is aging. Nursing homes are needed to house a lot of our elderly and they’ve proven to be very profitable businesses, with some corporations establishing multiple locations across the province.
An influx of customers in addition to a need to be the most profitable has resulted in some nursing homes cutting corners, maintaining flawed organizational infrastructures, or hiring and keeping on staff individuals who lack the proper training and skillset to care for the elderly.
Multiple studies have shown that violence in nursing homes has been on the rise for some time. Cases of reported abuse between residents or caregivers in long-term care facilities have increased significantly in the past decade.
Despite the fact that, when loved ones move into a nursing home, family only wants good things for them, abuse still happens. The sad part of this is that a lot of the abuse or neglect remains undetected. Some elderly residents are threatened with silence, are too ashamed to report anything, or are incapacitated in a way where they cannot speak out.
Unless a family member is keeping a watchful eye out, many elderly people are left to suffer silently.
Legal Advocacy By Personal Injury Lawyers
A nursing home abuse lawyer with experience has handled abuse claims and neglect claims before. They can be your legal advocate as you proceed with a court case and ensure your loved ones get the justice that’s due to them.
Some of what they can offer after an initial consultation is to:
Set up an investigation with the relevant authorities to determine if there is abuse.
Find medical experts to carry out medical testing that may be able to prove abuse.
File a case of abuse against the nursing home on your behalf.
Structure a case to get a win and compensation for you and your aged relative.
Examining Medical Malpractice In Nursing Home Settings
Medical malpractice can occur in nursing homes, particularly those that are tailored toward assisted living services.
Common examples of medical malpractice can be a failure to administrate medications, botched medical treatment, a failure to provide treatment altogether, a failure to monitor a patient leading to injury or death, and/or a failure to update a patient’s records.
While most medical malpractice falls outside the parameters of what is offered in a nursing home, any time there is medical treatment offered and provided, when the standard of care is not met, this opens the possibility of medical malpractice.
Protecting Nursing Home Residents: Legal Perspectives
A nursing home has to prioritize dignity and respect when making decisions, such as time to eat, go to bed, and what activities to do. Care plans have to be designed with dignity and respect in mind. This is fundamental to operating a nursing home or care facility.
The Fixing Long-Term Care Act outlines a Residents’ Bill of Rights that must be followed. Among the rights included are the following.
The right to be treated with politeness, dignity, and respect.
The right to have your choices respected regarding how you want to live your life in the home.
The right to take part in decisions about all aspects of your life in the home.
No one is allowed to abuse you physically, financially, sexually, verbally, or emotionally.
The right to not be neglected by the owner or staff at the home.
The right to meet and talk with people in private.
The right to make friends and spend time with them, and to take part in activities at home if you want to.
The right to be alone with your spouse or partner, or a person you want to be intimate with.
The right to a clean and safe place to live.
The right to get the care and services you need.
A violation of any of what is mentioned in the Bill of Rights can result in legal action being taken.
Every nursing home must have a way for residents and/or other parties to file a complaint if the Bill of Rights is not being respected. Under this legislation, inspectors from the Ministry Of Long-Term Care must inspect a nursing home when someone makes a complaint.
If action is not being taken to enforce the rights outlined in the Bill, residents can take a nursing home to court.
As so much care in a nursing home happens behind closed doors, it is not always an easy task to protect nursing home residents’ rights when there is abuse or neglect present. If you know about or have reasonable grounds to suspect abuse at a long-term care facility or retirement home, you are required by law in Ontario to report it.
The Spectrum Of Abuse: Emotional, Sexual, And Physical
Abuse is any intentional act that causes harm or distress. This can refer to the emotional, sexual, and/or physical of a person.
Any of these three are equally serious and you can file a nursing home abuse claim on any of the three.
Physical abuse may involve a minor or serious injury, directly or indirectly causing physical harm, broken bones, ignoring the requirements of informed consent, physical restraints, pressure ulcers, and worse.
There is emotional abuse which may be a lack of access to medical treatment, damage to personal property, knowingly making a medical error, abandonment, isolation, deprivation of medical care, causing fear or distress, intimidation, and more.
There is also sexual abuse which can involve a range of abusive actions all with a sexual intent or sexual definition.
Legal Rights And Protections For Nursing Home Residents
Ontario’s Fixing Long-Term Care Act plays a key role in reinforcing the legal rights of nursing home residents.
The Act states that a long-term care home is to be operated as a place wherein a resident may live with dignity and in security, safety, and comfort while having their physical, psychological, social, spiritual, and cultural needs met.
In this, a resident in a nursing home must be protected from emotional, financial, physical, sexual, and verbal abuse. It also stipulates that a resident must not be neglected. Neglect is defined as, ”the failure to provide a resident with the treatment, care, services or assistance required for health, safety or well-being, and includes inaction or a pattern of inaction that jeopardizes the health, safety or well-being of one or more residents”.
Regarding neglect, there is also non-criminal negligence that can be turned into a civil tort guided by the Fixing Long-Term Care Act as well as the Occupier’s Liability Act, and other regulations and legal precedences. An example of this is if a staff member or caregiver fails to follow an established plan of care for a resident and this resident suffers an injury because of it, or if security procedures are not followed and a resident with a diminished mental capacity leaves the premises and experiences an injury in the process.
Navigating The Legal Process In Elder Abuse Cases
For an elder abuse case or nursing home abuse, the Ministry of Long-Term Care in Ontario has established procedures for complaints.
Urgent Complaints
For urgent complaints, the process starts by contacting the Long-Term Care Family Support And Action Line.
The Ministry will then launch an investigation based on the information you provide to them which should include the name and address of the nursing home, a full description of what has happened including when and who was involved, and how you would like the complaint to be resolved.
Typically, the Ministry will investigate the complaint, inspect the facility and ensure they are complying with the law, and contact you within a few business days to provide a copy of any inspection report.
For life-threatening harm or clear elder abuse, it’s also recommended to contact the police.
Non-Urgent Complaints
For non-urgent complaints, should be reported directly to the nursing home.
By law, staff must acknowledge receipt of the complaint within ten business days and contact you to explain what they are doing or have done to resolve the complaint.
You may also want to call or write to the Ministry of Long-Term Care and/or Patient Ombudsman if you have further concerns.
Filing A Lawsuit
Discuss with a lawyer if you believe a nursing home abuse claim should be filed and a lawsuit should proceed.
If there is clear evidence of a crime, and audio, video, or images of the abuse, in addition to any charges that police have opted to pursue, this all supports launching a lawsuit.
That said, it is advised to wait to file a lawsuit until formal complaints to the Ministry and/or police are fully resolved. Your lawyer may still request patient care records and medical records in the meantime to review. The early stages of a lawsuit can be prepared at this time as well, such as identifying and investigating witnesses, medical experts, and more.
If the abuse or neglect has resulted in a death, family members can bring forth a wrongful death claim against the nursing home and/or specific staff.
Under Ontario’s Family Law Act, spouses, children, grandchildren, and siblings are allowed to make claims in this context. If the negligence has resulted in either injury or damages, with no death, it is then filed as a form of personal injury claim.
In certain cases, you may also speak with a nursing home abuse lawyer and be advised that your case is not actionable and that you may not want to pursue a lawsuit. In the place of filing a claim, you may wish to file a complaint with a regulatory body or find ways to work with the facility to implement real change to protect other residents.
The Importance Of Medical Evidence In Abuse Cases
Just like in medical malpractice, when it comes to nursing home abuse cases, medical evidence is central to a case.
A lawyer for a plaintiff will rely on expert medical evidence often given in court directly by a qualified medical expert. They will testify to prove that there was a failure to act reasonably in a given case and confirm that it caused harm.
Medical evidence is established with every medical visit. A document is created to detail the injuries, the patient visit, the treatment recommended or provided, and what the follow-up is. In some cases, medical evidence may not exist when there was/is no medical appointment carried out and when no doctor was seen.
It is best to consult with a lawyer on how to obtain medical evidence as this is crucial to structuring a nursing home abuse claim.
The Family’s Role In Detecting And Preventing Abuse
Family members are often central to identifying and stopping elder abuse in nursing homes and long-term care.
Elderly residents are vulnerable. They are susceptible to exploitation or attack. Many are limited by physical disabilities, poor health, cognitive limitations, dementia, and age-related illnesses.
Some may not be fully aware of the abuse they are on the receiving end of due to these issues, however, a family member who knows what to look for and what questions to ask may be able to tell when their loved one is experiencing abuse or neglect.
It is highly recommended that if you have concerns and cannot visit with your loved one regularly in person, hire a personal support worker or send a trusted friend who can visit with them and be equally attentive to the conditions of the environment.
You may also opt to employ video monitoring if the elderly resident consents to having cameras installed in their private room.
If you notice abuse or signs of negligence in a nursing home, notify the appropriate authority as quickly as possible.
Medical Negligence And Its Impact On Elderly Residents
Medical negligence is the third leading cause of death in North America. It can have far-reaching consequences for an elderly resident and their families. Medical negligence causes physical, emotional, and mental distress, and can easily put a person’s life at risk, if not result in a loss of life.
Common forms of medical negligence include improper conduct during treatment, mistakes or mistreatment, and declining to provide proper care. For the doctors and medical professionals who are there to provide a duty of care, a failure to provide that care or meet that standard can lead to a medical malpractice claim being made against them.
Medical negligence can either have been a one-time occurrence or be a pattern.
It is a physician’s responsibility to ensure that there is no negligence in how they treat a patient in a nursing home. Patients, for example, have to be informed of known risks of taking certain medications or doing certain therapies. A doctor must ensure they are diagnosing their patients correctly and not misdiagnosing or failing to diagnose.
Any attendant or caregiver in a nursing home must also adhere to standards of medical care, from recognizing when medical treatment is needed to ensuring medication administration is carried out every day.
Litigation Strategies For Nursing Home Abuse Cases
With many nursing home abuse cases, defendants are often insurance companies or medical facilities that will be aggressive in how they handle litigation. They will argue what they can to minimize payouts or avoid liability altogether.
Your lawyer should be equipped with the right litigation strategies to ensure the extent of the injuries cannot be disputed and demonstrate clear evidence that the nursing home is at fault.
In elder abuse cases, evidence matters a great deal. A skilled lawyer will build their case using medical records, eyewitness testimonies, expert opinions from medical experts, and documents or records that relate to the care and treatment provided at the facility. All of this information has to be analyzed and presented effectively to support their case.
A common litigation strategy is to sort through collected evidence to identify patterns or indications of systemic issues.
For a more in-depth look into how to best strategize the litigation for your case, speak to a nursing home abuse lawyer at Joshua Goldberg Law.
Understanding Civil Litigation In Elder Abuse
Nursing home negligence and abuse cases fall under civil litigation and follow civil procedure.
This begins with a free consultation with a nursing home abuse lawyer at Joshua Goldberg Law. In this consultation, we discuss the facts of what is brought to us and suggest options on how to move forward regarding whether civil litigation is a possibility.
If the case is actionable, a review is then conducted of all documents, records, and evidence to prepare for the exchange of pleadings.
A Statement Of Claim is given, outlining a claimant’s injuries, identifying the parties responsible, establishing what is sought in the form of compensation, and presenting the facts that support the claims being made. In return, from the defendants, a Statement Of Defence is prepared and served.
After A Statement Of Claim is served, at any time from that point on, negotiations may begin toward a settlement. Typically though, negotiations do not begin until after Discovery or during mediation which comes after discovery.
Mediation is legally required in three specific jurisdictions in Ontario – Toronto, Ottawa, and Windsor. Why mediation is advantageous is because it avoids the cost, time, and uncertainty of a trial for all parties. It allows the lawyers to settle a matter on mutually agreeable terms and faster than what is done in court.
In the event that a settlement cannot be reached, a pre-trial conference is set. It’s here that a judge will hear from the lawyers, ask questions about their positions, and identify for them the strengths and weaknesses of their respective arguments. This may prompt the lawyers to engage in settlement negotiations again or another round of meditation.
Once again, if a settlement cannot be reached, a trial must be held. A judge and/or jury listens to the evidence presented, reaches a verdict, and potentially awards damages.
Warning Signs Of Abuse And Neglect In Nursing Homes
Nursing homes sometimes lack the resources to provide the care for their residents that they promise. Therefore resident care suffers.
For a family member, they may notice a loved one’s nursing home being understaffed, seemingly hiring under-qualified personnel, or see overworked nursing home staff who are having difficulty providing necessary care to patients.
When nursing home staff are stressed, it may not be long before call lights are ignored and residents with limited mobility or certain medical needs are essentially stranded. It may not even necessarily be direct abuse or neglect. It might simply be a by-product of a nursing home infrastructure malfunctioning.
Looking at individual residents or patients, you may see first-hand the warning signs of abuse and neglect.
Bedsores and injuries to the skin.
Muscle atrophy and a decrease in muscle tissue which is associated with prolonged immobility.
Infections which are a result of improper care, poor hygiene, untreated wounds, and a lack of proper medical care.
Incidents of falls and fractures which could indicate a lack of assistance with mobility or improperly maintained environments.
Prolonged incontinence, including residents being left in soiled clothing or bedding can translate to skin infections, urinary tract infections, and physical discomfort.
Delayed medical attention as a result of staff not noticing or not having time to promptly address health concerns.
Psychological distress felt by some residents who feel abandoned, anxious, depressed, or hopeless.
Unaddressed personal hygiene needs, resulting in unnecessary skin conditions and lowered self-esteem.
Decreased social interaction which can be seen in increased feelings of loneliness and isolation.
Poor nutrition from meals not being provided in a timely fashion or assistance to eat being non-existent.
Expert Legal Support: Choosing The Right Lawyer
To find the right nursing home abuse lawyer, here are some key points to be aware of as you search for lawyers.
Find a lawyer with experience handling nursing home abuse cases and this type of law.
Contact a lawyer with knowledge of medical terminology and who can explain the legal aspects of pursuing an elder abuse claim.
They should have a track record demonstrating to you their success rate in obtaining settlements, compensation, and what to expect.
Any lawyers with experience will have a public reputation you can review. Look online. Read past clients’ experiences. Ask for references from the lawyer you are speaking with.
Not all lawyers are excellent communicators. Find a lawyer who responds promptly to queries and who you are confident can keep you updated on the progress of your case.
Ensure you are comfortable with the lawyer you choose. After all, this is the health of a loved one you’re fighting for. Have a lawyer who is empathetic, patient, and willing to provide honest advice on what to do and how to move forward.
Understand the cost of hiring a lawyer and how they will get paid before you partner with a legal team.
The Journey To Compensation: What Families Should Know
When a nursing home abuse claim is filed, it can take years for such a case to resolve. Out-of-court settlements may occur within 2-3 years. If your case goes to trial, however, the timeline for compensation can be longer.
Throughout this process, it can be emotionally draining to go through having to relive and discuss elder abuse.
The benefit of filing a nursing home abuse claim and seeing it through, however, is knowing that justice is being served. It puts you in a position of control over a betrayal of trust and/or an act of harm by an authority that made you feel out of control.
Your lawyer will work to ensure the maximum compensation for the suffering and abuse put on the plaintiff’s family. In this, a lawyer can navigate negotiations with nursing homes or insurance companies, oppose defendant tactics and defendant counsel arguments, and more.
The compensation you are entitled to is based on the severity of the abuse, the extent of the injuries, and related costs, such as out-of-pocket medical expenses, and pain and suffering.
You may be able to collect compensation for non-economic losses in addition to financial damages you qualify for. If your loved one has passed away from abuse or neglect from a nursing home or long-term care facility, you may qualify for wrongful death damages as well.
All of this is to be discussed with your lawyer who can outline for you what to expect in the form of compensation.
Strengthening Legal Protections Against Elder Abuse
As lawyers who have handled elder abuse cases and nursing home abuse claims, it has been a large part of our work to remain committed to strengthening legal protections against elder abuse. Every claim we’ve launched in elder abuse has been an intervention that has ultimately had justice served and prevented violence against a senior.
From a societal standpoint, there is still a lot to be done to protect our seniors and elderly nursing home residents in Canada.
Public discussion of elder abuse, investing in security protocols and procedures, and establishing clear penalties related to elder abuse, are all ways we can advance legal protections for some of our most vulnerable.
The abuse of older adults should not be hidden. It should be outed. Thousands of seniors this year will experience nursing home abuse. Whether it’s physical abuse, emotional abuse, psychological abuse, financial abuse, or sexual abuse, now’s the time to put an end to it.
If you or a loved one requires the help of a nursing home abuse lawyer, reach out to the team at Joshua Goldberg Law today.
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