Placing a loved one in a nursing home can be a difficult decision because we are entrusting the care of a family member to strangers. When our loved one happens to have a health condition, this trust can be even more tenuous because the resident's health condition must be properly understood, managed, and treated. Unfortunately, the sheer amount of medication in nursing homes, combined with mismanagement, lack of staff, or problematic intentions, can lead to medication errors which put the health and safety of your loved one at risk.
Nursing homes must administer hundreds, if not thousands, of medications to patients in their care every day. According to research, 59% of Americans take one prescription medication, while 15% take five or more. When you consider seniors, in particular, some estimates find that the average elderly patient fills between 9 and 11 prescriptions per year. Another study surveyed 2206 adults between the ages of 62 and 85. It found that 87% of those interviewed used one prescription medication, while 36% were taking five or more prescriptions.
Managing Medications in Nursing Homes
In a nursing home, staff must administer medications to many different patients at particular times of the day, and they should follow a strict schedule set up and overseen by a registered nurse (RN). Each cycle of medication administration is called a “med pass.” Although the nursing home staff is allowed to pass out medications, they should not be preparing the medications for administration unless they are a doctor or RN. Each nursing home should have clearly written documents in their file stating their med pass protocols, schedules, and safety precautions.
Types of Medication Errors
Medication errors come in many forms. Some can be relatively harmless, such as skipping the administration of a daily vitamin or administering a medication that had expired a few days earlier. However, the severity of medication errors should not be underestimated, as some drugs can react together in unexpected and even fatal ways if the patient is not correctly monitored. Some of the most common medication errors include:
- Failing to administer a medication with the correct amount of food or water
- Handing out expired medications
- Administering too little of a medication or skipping the dose completely
- Giving too much medication
- Administering the medication at the wrong time of day
- Failing to monitor a resident after giving them their medications
- Following a poorly organized med pass schedule or accidentally following a schedule meant for a different time of the day
- Administering the incorrect medication or “borrowing” medications from other patients
- A doctor prescribing the wrong kind of medication or failing to check how a new medication would interact with one the patient is already taking
- Failure to prepare the medication correctly, such as by crushing or slicing the pill as directed.
Most of the preceding errors would fall under the category of “medical negligence,” meaning that they occurred due to a failure to live up to a certain standard of care. These kind of medication errors can be caused by not living up to standards or protocols set by the facility, a lack of knowledge on the part of the staff about the drugs they are administering, confusion, exhaustion, miscommunication, or sheer human error.
Intentional Medication Errors
Although medication errors often occur by accident, sometimes nursing home residents can become the victims of intentional fraud or medication malpractice. This kind of error can be perpetrated at many points in the line of distribution of medication. For example, sometimes staff people in the nursing homes will choose to disobey instructions given to them by an RN for a variety of reasons. They might find the instructions too tedious or have too much work to complete all the necessary steps and therefore choose to skip or simplify medication administration. Those administering the medication might also “borrow” medication from one patient to give to another if it is more convenient or if the medication for one patient has run out. Alternatively, they might divert the medication either for their own personal use or for sale, as prescription medications can be quite lucrative.
Higher up in the process, there are other errors that might be made. For example, nursing home facilities with poor management or financial difficulties may have a hard time keeping necessary medications stocked, especially if their residents are unable to pay for their meds without support from insurance. If a nursing home runs out of a certain medication, they should never skip doses; however, for the sake of convenience and to avoid potentially losing a resident, this does occur.
Access to Nursing Home Records
If you believe that your loved one might be overmedicated, not receiving their medication, or receiving the wrong drugs consistently, you have reason to be concerned. Even one mismanaged dose of potent medication can have severe effects. Residents of nursing homes have a legal right to be informed about any medical decisions such as changes to their medication schedules, even if they are minor, and all changes should be thoroughly documented. Doing anything to a patient without their consent and the explicit instruction of a doctor is a violation of their autonomy. As a family member, you may have a right to view your loved one's medical records if they have identified you as a person with whom a doctor can share information. Unfortunately, sometimes nursing homes do not wish to share medical records with family members, especially if errors have been made.
Possible Consequences of Medication Errors
The consequences of medication errors range from minimal to fatal, depending on the health of the resident, the interactions between drugs, and the dependence that a resident has on a particular drug for their well-being. Almost all medication errors, however, are preventable, and nursing homes should do everything in their power to keep their residents safe and healthy. If you believe that a loved one has died or developed a health condition as a result of a medication error, the victim and their family may be entitled to compensation. For cases in Maryland, Pennsylvania, or D.C., call personal injury attorneys Charles Gilman and Briggs Bedigian today at 800.529.6162 to discuss your legal options or contact them online.