Washington DC Nursing Home Negligence Attorney
Licensed To Represent Clients In Washington, D.C., Maryland And Virginia
Constipation and impaction of residents are common in the long-term care setting. Significant impaction can be a sign of serious neglect. In fact, the federal surveyors who inspect nursing homes consider impaction to be a “sentinel event” or an event that can be an indicator of significant neglect.
There are many conditions that predispose our elderly to bowel problems. Older adults often experience changes in their GI system that can impair digestion and elimination. Things that can cause such changes include reduced mobility, decrease in acid secretions, weakened muscles in the large intestine and reduced size of the liver. Regular and healthy food intake can help support proper functioning of the colon. For example, a diet rich in fiber can assist in elimination. In addition, inadequate fluid intake can cause thickening of the feces and constipation. Nursing homes are required to track food intake and waste elimination for their residents. Some nursing homes are more thorough in tracking this information than others. If a resident has not had a bowel movement in 2-3 days, a nurse should bring this to the attention of a medical provider.
Constipation is generally considered a symptom that is associated with the decreased frequency in bowel movements accompanied by prolonged or difficult passage of hard, dry stool. Fecal impaction results when constipation is not relieved. It is the collection of hardened feces generally wedged in the rectum which cannot be discharged. In cases of severe impaction, the mass can extend up into the sigmoid colon.
Elderly patients who suffer from dementia can be at increased risk for impaction as they may not be able to articulate their symptoms or feelings (like the urge to have a bowel movement). Lengthy bed rest and lack of regular exercise can contribute to constipation or impaction. In addition, medical providers must consider whether certain medications (ie, tranquilizers, opiats, anticholinergics, iron diuretics, antacids with calcium, and anti-parkinsons drugs) may be contributing to the problem. Constipation can also be caused by GI abnormalities like an ilieus, diverticulitis or bowel obstruction. Whether or not a particular impaction or constipation has resulted from neglect may not always be apparent. You may need to have medical records reviewed to determine whether a particular adverse result is due to negligence versus a resident’s underlying medical condition. If you have any questions about whether your loved is being properly cared for you may want to ask to see the bowel and bladder records. If more than 3 days have gone where there is no notation that a resident has voided, you should bring this to the attention of the nursing staff.
Serious cases of fecal impaction can result in death. Once the body is unable to discharge waste, the digestive tract becomes unable to absorb nutrients resulting in general organ failure. If you suspect your loved one died as a result of fecal impaction, you may want to request that an autopsy be done.
If you have additional questions relating to constipation or fecal impaction, please contact us for a free consultation or additional information.