Eagle Rock, California

Welcome to the City of Eagle Rock’s nursing home and assisted living elder abuse and neglect website for Yeroushalmi Law. Mr. Yeroushalmi is an experienced attorney in elder law. He and his team of associate attorneys and experts are dedicated to representing older adults who have been victims of abuse and neglect in a long-term care facility.

Nestled in Los Angeles County, Eagle Rock was given its name after a peculiarly shaped large rock that looked like an eagle with outstretched wings. The city was born in 1911 and became part of Los Angeles in 1923. Occidental College, which is known as Los Angeles’ oldest liberal arts college, was established in Eagle Rock in 1914. There are 30 assisted living facilities and 5 nursing homes near Eagle Rock.

Chronic illnesses and diseases impose significant physiological and psychological burden on older adults, particularly for elderly residents in nursing homes and assisted living facilities toward the end of life. A recent study found that during the last years of life, the number of nursing home residents with dyspnea and pressure ulcers more than tripled to above 30%, pain more than doubled to above 25%, and the prevalence of aspiration increased from about 10% to 40%. Not only are these rates unacceptably high for symptoms that are modifiable, they also cause unnecessary suffering and increased health care costs. Solutions to ameliorate suffering and address this quality and cost issue must be founded on better knowledge of modifiable symptom burden, and on the connections between symptom burden and modifiable aspects of nursing home work environments.

The rising prevalence of dementia among nursing home residents at more advanced ages plays a key role in increasing symptom burden. Thus, aspects of a nursing home’s work environment, such as leadership, culture, feedback systems, and available information resources, are given increased importance for quality and safety in health care and are deemed modifiable. Currently, little is known about the influence organizational context has on the nursing home environment in general, and in the care of distressing symptoms in residents at the end of life, specifically.

A recent study examined symptom burden at the end of life in a cohort of nursing home residents and aimed to determine if organizational context or dementia status influenced symptoms prevalence.

The study’s results showed that there was an increase in the prevalence of symptoms over time. In the last quarter before death, participants with dementia experienced challenging behavior as their most frequent symptom. Participants without dementia experienced delirium as their most frequent symptom and urinary tract infections as their least frequent symptom. Facilities that had more favorable context had significantly higher prevalence of challenging behavior and delirium and significantly less use of antipsychotics without diagnosis of psychosis.

The conclusion of the study was that although symptom burden increases toward the end of life, it differs between high- and low-context facilities and between residents with and without dementia. Nursing home facilities should focus on trajectories of treatable, burdensome symptoms near the end of life for quality improvement. Modifiable features of organizational context tied to symptom burden provide the opportunity for new potential strategies and interventions for quality improvement.

We believe that older adults are entitled to continuous quality of care while under the responsibility of long-term care facilities. If you or someone you love has been under nursing home or assisted living facility care and has experienced abuse or neglect, please contact our office today for a free consultation.