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Nursing Homes Have a Duty to Reduce Choking Hazards

Seniors age 65 and older face a higher risk of choking and suffocation

Hundreds of choking deaths occur annually in nursing homes nationwide, including Alabama. People aged 65 and older have a choking and suffocation death rate that is eight times higher than any other age group, according to a recent study.

Seniors are naturally at a heightened risk for choking because many have poor saliva production and difficulty swallowing. Nursing homes know this and have a legal responsibility to reduce choking hazards. Yet too many nursing homes do not regularly screen for choking risks or follow up with residents after an event as they should.

While the object choking a resident may be food, medication, medical equipment, liquid, or something else, the reason for this life-threatening condition is often preventable human error or neglect.

When nursing homes fail to protect elderly residents from choking hazards, victims and their families deserve justice for the pain and damage suffered. An experienced nursing home neglect attorney can help demand answers and accountability.

At Shuttlesworth Law Firm, P.C., that’s what we do. Attorney Perry Shuttlesworth has been helping families in Alabama hold negligent facilities accountable since the 1990s.

Why are nursing home residents at risk for choking?

Choking is a widespread problem among residents in nursing homes due to natural factors like decreased saliva production, compounding factors like medications with mouth-drying side effects, and dehydration. The medical term for difficulty swallowing is “dysphagia.” According to studies, the condition may affect anywhere from 13% to 52% of nursing home residents.

A recent and devastating case of choking at an Alabama nursing home involved a 75-year-old retired truck driver. The man needed help with feeding but had been neglected by staff for so long that he had become malnourished and dehydrated. He died of septic shock and aspiration pneumonia - a strong indication he had been choking on food.

In this case and others, there are signs of a heightened risk for choking. Symptoms and signs typically include:

  • Difficulty communicating
  • Food or drink leakage (drooling)
  • Pain while swallowing
  • Frequent heartburn
  • Regurgitation (vomiting)
  • A sensation of food still being stuck in the throat
  • Coughing during or after eating
  • Voice change after eating or drinking
  • Pneumonia

Choking hazards in nursing homes

Nursing home residents can choke on many things, including medical devices or supplies – like thermometers, tubes, oral case sponges - medicine, and food. It is up to staff to take reasonable, consistent action to prevent this. Yet, infrequent checkups, misperceptions about risks, disregarded mealtime accommodations, and a lack of proper staff training are frequent factors in nursing home choking incidents. Other common contributing factors include:

  • Residents being fed too quickly
  • Improperly fitting dentures
  • Understaffing
  • Lack of mealtime monitoring and screening for choking
  • Medical conditions that make it difficult to swallow (e.g., stroke, Parkinson’s Disease)
  • Enlarged tonsils
  • Neck and throat tumors
  • Inappropriate diet and meal preparation

The role of nursing homes in preventing choking

When nursing homes choose to address choking hazards, they typically adhere to “bolus modification.” This feeding method seeks to aid swallowing and reduce choking by alternating bites of small or mashed pieces of food with sips of liquid. The strategy stresses the importance of:

  • Serving food that is cut into small pieces, mashed, or otherwise easy to chew, like fileted fish, ground meat, soups, chocolate, and applesauce
  • Ensuring residents are in an upright position while eating
  • Providing ample time for residents to eat slowly and chew thoroughly

In many nursing homes, follow-up care is rare for those with heightened choking risks, residents with difficulty swallowing, or a recent choking incident. There are typically two situations in which care is evaluated or reevaluated: either a staff member notices worsening symptoms during mealtime, or the resident complains.

However, there’s a lot more nursing homes can do to properly care for residents at risk of choking. Depending on circumstances, a nursing home could reduce choking hazards by:

  • Having a specialist consultation.
  • Clear, defined means to intervene when residents have eating and swallowing difficulties.
  • Training employees to feed residents properly and spot choking hazards.

Non-fatal choking injuries

Choking events can be fatal for nursing home residents. However, even when a resident survives choking, they may be left with residual damage or life-threatening injuries that require immediate medical attention. Residual injuries and illnesses linked to choking include:

  • Throat irritation and damage
  • Complications from the Heimlich Maneuver, like abdominal injuries and internal bleeding
  • Asphyxiation
  • Hypoxia
  • Brain damage due to a lack of oxygen
  • Aspiration pneumonia due to bits of inhaled food

Talk to a nursing home neglect attorney

Nursing homes have a legally mandated duty of care to provide residents with what they need to be healthy and comfortable. Preventing choking among residents is absolutely part of the care nursing facilities should provide.

Regular screening and monitoring can reduce the risks, yet the number of nursing home-related choking injuries is rising. If your loved one suffered harm due to a choking incident at an Alabama nursing home, it’s important to understand your potential legal options.

For over 20 years, Shuttlesworth Law Firm, P.C. has been a leader in handling complex legal cases involving nursing home neglect and abuse. To learn more about how we can help you, contact us today for a free and confidential consultation.

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