Often when talking to a family about their resident’s care they comment on things about the facility which they do not realize are signs of neglect. But, as experienced nursing home lawyers, we see them for what they really are. One of these types of issues is recurrent urinary tract infections (UTI). While a UTI is not an uncommon issue, recurrent UTIs are a red flag which may signal neglect. They can be very dangerous, and can lead to serious injury and death.
A UTI is an infection in the bladder, urethra or kidney. UTIs cause pelvic pain, back pain, nausea, vomiting, fever, and an increased urge to go to the bathroom. There may also be blood in the urine. Understanding how residents may get UTIs from negligent care is very important to stopping the issues which are contributing to the problem.
Many residents and nursing homes are “incontinent” of bladder and/or bowel. This simply means that they cannot control when they urinate or have a bowel movement. In most instances, these people will wear an adult diaper. Changing their diapers is very important. Aside from the rather obvious issue of preserving dignity, it is medically important to get folks out of soiled diapers quickly; particularly for women. When residents, especially women, are left to sit in soiled diapers for extended periods, they can easily develop a UTI.
UTIs area also a significant concern for residents who are catheterized. While some residents certainly need indwelling catheters, in our experience some residents are left catheterized solely because it suits the convenience of the nursing home, which may not have enough staff to properly assist residents with their toileting needs. To be clear, a nursing home cannot catheterize residents for its own convenience, and prolonged catheterization should be avoided when possible. Use of a catheter, as with any object is inserted into the body, brings with it a risk of infection. This risk does not dissipate simply because the instrument in use suits a medical purpose, such as with a catheter. Once again, and to be clear, use of a catheter, even when necessary, increases a person’s odds of developing an infection. This is why medical professionals avoid catheters wherever possible.
Since either being left in soiled diapers and/or catheterization can leadto UTIs, when we at Davis & Brusca hear of residents who are experiencing recurrent UTIs, we are concerned about neglect.
UTIs can be an extremely dangerous condition for two main reasons.
First, an untreated UTI, like any other infection, can migrate into the blood. Once an infection migrates into the blood the person has developed “sepsis.” Sepsis can progress to an overwhelming infection in the blood and is often lethal in the elderly.
Second, a resident suffering from a UTI can experience hallucinations along with a consistent urge to go to the bathroom. This is a dangerous combination because it increases the risk that they will forget to ask for help with using the bathroom, placing them at risk for falls which can lead to fractures and death.
If your loved one is suffering UTIs you can immediately call for a care conference to find out the supsected cause of the UTIs and what is being done to address the issue and prevent them in the future. If you yourself have found your loved one sitting in wet and soiled diapers, bring that to the director of nursing’s attention and insist that it be addressed immediately. If your resident is catheterized, discuss with their physician whether or not the catheterization is absolutely necessary. If it is, verify that the facility is following proper catheter care protocols. These simple, but important steps, will insure your loved one is receiving the best possible care under the circumstances.