Since March 26 is “Purple Day,” a day to raise epilepsy awareness, it is fitting to address living with epilepsy in nursing homes. Unfortunately, there has been an outbreak of new-onset epilepsy in elderly (65+) nursing home residents. The most common cause of new-onset epilepsy in elderly residents is a cerebrovascular disease. In fact, 20% to 50% of epilepsy in the elderly is related to cerebrovascular disease. Conversely, about 10% of patients with stroke are at risk of developing seizures within 5 years.
Another common cause is a neurovascular disease like Alzheimer’s. Patients with Alzheimer’s disease have a ten-fold higher risk of epilepsy and 10-22% of patients with Alzheimer’s have seizures. The last common cause of epilepsy in elderly residents and others is a head injury, unfortunately, there are multiple cases in which nursing home staff does not diagnose or misdiagnoses epilepsy as a singular seizure due to that head injury.
Seizures may present in a variety of ways. Depending on the initial presentation, the differential diagnosis includes syncope, transient ischemic attacks, transient global amnesia, confusional migraine, drug intoxication, infections, metabolic disturbance, sleep disorders, psychiatric disorders, and dementia. All of these are common symptoms of a wide variety of ailments nursing home residents live with every day. For this reason, under-diagnosis in nursing homes is fairly common, according to RE Ramsey, doctors considered epilepsy in only 73% of patients during their initial evaluation who were ultimately diagnosed to have epilepsy. Once diagnosed, family members and nursing home staff must come up with a plan to manage symptoms to better care for loved ones.
There are multiple sources for “nursing care plans,” for example on nurseslabs.com there is an article laying out “4 Seizure Disorder Nursing Care Plans.” All four plans emphasize the importance of preventing or controlling seizure activity, protecting the patient from injury, maintaining respiratory function, promoting positive self-esteem, and becoming informed.
Unfortunately for those diagnosed with epilepsy while living in nursing homes, there is a high percentage of nursing home residents who become victims of elder abuse or neglect. As we mentioned earlier, a large majority of those who have epilepsy go undiagnosed, of those undiagnosed a large majority will go untreated. If you feel your loved one is a victim of elder abuse or neglect what do you do? There are multiple routes you can take. You can call Adult Protective Services or you can address the problem one on one.
What do you do once it’s too late? Once your loved one has been hurt due to their abuse and/or negligence? For example, someone is moved into a nursing home with common symptoms of aging, their epilepsy goes undiagnosed, therefore, their epilepsy goes untreated. Due to this lack of treatment, they have a seizure in the middle of the night causing them to fall off their bed, severely injuring themselves, which in turn causes internal bleeding and damage to their kidneys. The nursing staff is negligent, they don’t answer the call page for an hour, your loved one’s condition gets worse. By the time your loved one makes it to the hospital, is treated, and days later discharged, their condition is 3 times worse than when you took them to the nursing home. Due to their kidney problems and injuries, your loved one now needs help for basic tasks, tasks they could easily do on their own before this accident. Sadly, this is not an exaggeration, things like this happen.
The costs that come with epilepsy are high, the costs that come with letting go untreated are worst. This is when you find an attorney to help you not only pay for the growing costs of the consequences but to incentivize those that hurt your loved one to never do it again. Who better than someone who emphasizes on elder abuse from nursing homes? Pick Law focuses on cases like this when elder abuse or negligence leads to horrible consequences. Though there are many different circumstances like this one, if you feel your loved one is being treated unjustly, call us.