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Choking In Nursing Homes....A Clear And Present Danger.


What Causes Choking in Nursing Home Residents?
Nursing home residents are at significant risk for choking.  There are a lot of things that can cause the elderly to be at higher risk for choking than others.  The most common is simply age.  It takes about 50 muscles and nerves to swallow, so it just makes sense that as we age those muscles and nerves break down, just like other muscles.  Neurological damage, such as a stroke or a brain injury and neurological disorders such as Parkinson’s disease can also cause difficulty in swallowing.  

Many residents will have swallowing difficulties that put them at risk for choking, while others have problems with their teeth that make it hard for them to adequately chew their food.  For residents with dementia they may not understand that they need to fully chew their food before swallowing.  For others the distractions that take place in a nursing home dining room may be enough to put them at a higher risk of choking.    


Whether it is illness, distractions or old age, it is up to the nursing home employees to regularly assess each of their residents to identify those who are at risk for choking and ensure that those residents receive the proper care and supervision to prevent choking. 


Most of the time, once a swallowing problem is identified, the resident can be kept safe with some minor interventions and staff supervision.  In the most serious cases, the resident may require a feeding tube where nutrition is placed directly into the resident’s stomach through a tube, but that is not the only way to prevent a resident from choking.


Can Choking Really Be Prevented In Nursing Home Residents?
Yes!  So what must a nursing home do if a resident is at risk for choking?  First and foremost, the nursing home must provide sufficient supervision and assistance for that resident.  When a resident is eating or drinking the nursing home must ensure that a properly trained employee is providing that resident with the assistance that particular resident needs.   This means that is the resident requires an hour to be safely fed, then the facility must ensure that an employee spends an hour with that resident. 
Nursing homes companies don’t like it when employees have to spend significant time with a single resident because then they are supposed to increase their staffing levels.  Increasing staffing levels costs them money…(and nursing home owners don’t like to do anything that cuts into their profit!).  

Keep in mind, the law requires that a nursing home must meet the needs of each individual resident. So to avoid having employees working with an individual resident, nursing homes place several residents who need assistance with eating at the same table so one employee can assist three or four (or five or six) different residents at the same time.  Placing those who need assistance in a feeding assembly line hardly meets each resident’s individual needs.  How can an employee adequately monitor one resident for choking when she has five others in the feeding assembly line?  Short answer...they can't.


When a resident chokes, they are unable to breath which leads to lack of oxygen which, after just three to six minutes, results in irreversible brain damage.  When a lack of supervision and assistance can result in devastating brain damage or death, nursing homes must make sure that they have a sufficient number of employees to meet the needs of each resident even if that means that they incur some higher staffing costs.  Unfortunately, most nursing homes choose to roll the dice rather than regularly providing a safe eating environment for each resident.


The Terry Law Firm is dedicated to being a voice for nursing home residents and their families.  If you have concerns about a family member in a nursing home, call our office at 314-878-9797.
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