When can you File a Lawsuit for Hospice Malpractice in NJ?
Attorneys Explaining what can be done when Injuries Result from Medical Negligence in Hospice Care
A person with a terminal illness or diagnosis may rely on hospice care during the last stages of their life. While the anticipated outcome of a patient being cared for by hospice healthcare professionals is the presumed death of the individual, this by no means negates the responsibilities of hospice nurses and other medical providers engaged in the process of caring for the patient while he or she is alive. In fact, one could argue that more responsibility lies with those who spend hours, days, weeks, months, or even years with a terminally ill patient. It is incumbent upon hospice care workers to ensure that dying patients are kept comfortable, free from pain, well-groomed, and appropriately medically managed. Failure to do so, when neglectful hospice care leads to injuries or premature death, may be grounds for a wrongful death or medical malpractice lawsuit.
The Purpose of Hospice
Palliative care, otherwise known as hospice care, is meant to diminish a person’s pain or suffering as they cope with a variety of ailments often associated with the end of life. The goal of hospice is not a miraculous recovery or meaningful cure of disease, but instead to optimize the well-being of a person nearing their demise. Often, medication management, daily and regular hygiene measures, therapeutic exercises, and similar measures are involved in hospice care, depending on the particular case.
Medical Professionals Involved in Providing Hospice Care
Registered nurses, like doctors, are educated and trained in essential medicine, but they can specialize in one field or area of medicine. For example, there are ICU nurses, pediatric nurses, oncology nurses, neonatal nurses, and hospice care nurses, to name a few. The hospice nurse is an end-of-life medical professional who cares for dying patients. Sometimes labeled Certified Hospice and Palliative Nurses, or CHPN’s, these nurses provide palliative care or comfort to the dying rather than cures. They often care for patients in the patient’s or relative’s home, but they can also work in hospitals or private facilities. The large umbrella of hospice nurses includes all those who service terminal patients, including admissions nurses, case managers, visiting nurses, and triage nurses.
The Role of the Admission Nurse
The admission nurse is typically the first hospice nurse that a patient encounters. When a patient enters the final months or weeks of life, they may be eligible for hospice care, and the admissions nurse steers the patient and their loved ones through the process. So, for example, the patient’s doctor may refer the patient to hospice care, whether in the hospital, facility, or, more commonly, the home. The admissions nurse helps the family coordinate the evaluation by the hospice doctor, who examines the patients, verifies they qualify for hospice care, and develops a plan for the patient. The admissions nurse prepares the paperwork the patient or legal representative must sign to consent to the process of evaluation and eventual care. They are also there to answer questions.
What the Case Manager Does
The case manager is also a hospice nurse who educates patients and families about care delivery, emergency procedures, and care expectations. As an overseer of the process, the case manager coordinates doctors, visiting nurses, triage nurses, family members, and others to keep the care consistent and adequately delivered. For instance, a patient at home may need a special hospital bed to help keep their head elevated or eat. They may need pain relief medication, like morphine or a nebulizer for breathing. They may need bed guard rails, a bedpan, or a shower stool to sit in the shower for bathing. All equipment, medication, and hygiene products must be ordered, delivered, and dispensed. The case manager is the one to make sure the patient has what they need when they need it. They are typically the ones to call when the patient needs an emergency doctor or nurse visit.
Visiting Hospice Nurses
The visiting nurse is the one who regularly visits the patient, taking and documenting vitals and changes in the patient. They administer medications, assist the patient in walking or going to the bathroom. They may be the one who instructs in-home caretakers other than nurses or family members overseeing the day to daycare of the patient. The visiting nurse relays information about the patient to the caseworker and may consult or request a visit from the physician overseeing the patient from initial assessment to periodic reviews. Unlike the triage nurse, the visiting nurse takes care of non-emergency needs. However, the triage nurses are on-call for emergencies, deciding whether a doctor or nurse visit is required.
Other Personnel in the Hospice Arena
Many medical professionals may become involved in the process of caring for the dying. For instance, there are dietitians, who oversee the patient’s nutritional needs, tailored to their condition and medications. For example, a terminal dementia patient may need dietary supplements to keep from dying of malnutrition or high fiber additives to prevent constipation. As part of the care team, they fulfill the hospice care plan whether at home or a facility. The hospice care team also typically includes a hospital liaison coordinating the hospital medical team that transfers the patient to home hospice care. Most hospice providers are third-party contractors with hospitals or medical groups.
Responsibilities of the Hospice Care Team and Examples of Breached Duties
Since the primary job of hospice nurses and the hospice team is providing pain relief and maintaining the patient’s quality of life as much as possible until the end, they must be vigilant about these responsibilities and educating other caretakers. They must advise them about what to look for, how to alleviate pain, and what to do in an emergency. They must also know the patient’s wishes for their eventual ending. For example, they have a Do Not Resuscitate order and life support waiver in their living will or other documents prepared for those purposes. The patient’s contract with the hospice care provider outlines what those end-of-life palliative services entail. Thus, when the hospice workers breach the agreement and do not provide the care as promised or negligently perform the promised care, they may be liable to the patient and their family for the additional suffering they caused. Moreover, they may be responsible for the premature death of the patient.
In addition, communication failure between medical or hospice care team members is one of the leading sources of malpractice. In these situations, the deceased patient’s family may sue the hospice care services provider for wrongful death due to negligence. A wrongful death lawsuit demands damages for the patient’s suffering due to negligent hospice care and the patient’s premature death. Some other potential failures resulting in injuries due to hospice negligence include:
- Failing to prevent a hospice patient from falling
- Injuring the patient when moving them
- Failing to prevent bedsores or allowing them to worsen
- Neglecting to note and take action in the case of a patient’s well-being diminishing abnormally.
In some cases, the patient will show signs of an injury, such as a broken bone, from an unknown source. This may prompt the family to further investigate what has been happening to their loved one, whether abuse, neglect, or negligence in some form. For example, part of hospice care may be to provide body washing to the bed-ridden patient several times per week, if not daily. If the hospice worker charged with doing so fails to wash the patient as agreed or fails to report aggravated bed sores on the patient to the visiting or triage nurse, the hospice team may be held liable for negligence when the patient dies from infected wounds. In addition, the visiting nurse that failed to instruct the patient’s family or caregivers to reposition the patient daily to avoid the bedsores in the first place may also be responsible.