It doesn’t take a professional caregiver to tell you that the thought of an older, frail person falling is the stuff of nightmares.
Take it from the adult child of any aging adult, no matter where they are. Slippery floors, loose rugs, kids toys or even dogs. They all can be the precursor to Grandma going down and never living again in her own house, or on her own two feet.
In long-term care, the precautions seem built into the DNA of a community. And rightfully so, given the lasting pain, suffering and costs that can come with broken hips and other bones.
That’s why a plaintiff lawyer’s recent claim that a nursing home patient has “a right to fall,” was so eye-opening. It came as part of legal case we reported on Thursday that should intrigue everyone in this sector.
My colleague Kim Marselas’ story on it gives full details, and I urge you to read it and then contemplate what you would have done. The bare bones of this case give us all plenty to think about.
When pitting personal freedom against common health interests, what should win out? In this case, a licensed practical nurse was prosecuted for using a gait belt to essentially strap in a chair a patient who had a known history of unawareness and unsteadiness.
Officials in Ohio pitted staff members against one another. They gave plea deals to a nurse aide and an RN while prosecuting the LPN for alleged abduction, tampering with evidence and forgery. I won’t profess to knowing all the details of the case. There is likely more than meets the eye, given the tampering and forgery counts.
But the LPN was found innocent on all charges, as she probably should have been. The coroner’s finding that the patient had died of natural causes the day after the incident in question, no doubt, had a huge bearing on the outcome.
But underlying conditions still deserve a long think. That’s whether you agree with one legal expert’s assertion that the prosecution was politically motivated or not.
The nurses were unquestionably put in a tough spot. Allow the patient his God-given “right to fall,” as the plaintiff’s legal team held? Or do their duty and try to head off any such potential catastrophic injuries? Those undoubtedly could have resulted in either a civil lawsuit for failure to provide appropriate care or even negligent homicide criminal charges.
I think defendant Randi Noel McKinley’s attorney, Rocky Ratliff, put it about as well as anyone could.
“All of our medical people are there to protect us, not to let us fall and then pick up the pieces,” he told a local newspaper covering the case. “This is not a toddler that you’re teaching to walk; this is an elderly person that is facing safety issues. [The] verdict was a message from the public that our healthcare people should have some latitude on doing what they think is right to protect our elderly patients and those with dementia that don’t know their surroundings.”
Perhaps even stronger policies and procedures will result from this. That can be a good thing. But no rules or guidelines will always fairly govern what results when split-second decisions must be made with frail elders.
McKinley, incidentally, not only retained her license, she’s still working in senior care. Now, however, she’s in assisted living — another statistic in the unfortunate recent wave that has seen hundreds of thousands of caregivers flee nursing home settings.
James M. Berklan is McKnight’s Executive Editor.
Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.
