Effects of understaffing in nursing homes

Inadequate staffing is a very serious problem in nursing homes. To hold down costs, many nursing homes employ nurse's aides to care for residents. These nurse's aides are usually overworked, underpaid, under-trained, and inadequately supervised.

Even though it takes 30 to 60 minutes to feed a person safely and sufficiently, nurse's aides may be assigned to feed 15 nursing home residents at a time. This understaffing can result in residents being fed quickly, forcefully, or not at all.

The effects of understaffing are even more severe when nursing home residents are cognitively or mentally impaired. It is estimated that 60 to 70 percent of nursing home residents have a mental impairment. Many of these residents cannot feed themselves. Overall, approximately 50 percent of all nursing home residents are unable to eat independently. Due to understaffing, some of these residents may not be fed at all.

In a recent report to Congress, the terrible effects of understaffing on nutritional disorders in nursing home residents was described as follows:

• [B]ecause the food carts had to be returned to the kitchen at a specific time, the staff had only 45 minutes to an hour to feed residents. Feeling pressured to finish within the hour, the staff became impatient with those who ate slowly; they spoke to them authoritatively: 'Open your mouth!' 'Don't talk, eat!' 'Laura, keep quiet. Quiet, Laura, you're eating!' . . . When residents ate too slowly, the staff often mixed the solid food . . . with the liquids . . . and residents were forced to 'drink' their meal. All of the food -- the entree, the vegetables, and the dessert -- were added to the milk, resulting in an unidentifiable, unpalatable mixture. . . Sometimes residents were forced to eat rapidly against their wishes: huge spoonfuls of food were placed in their mouths. Some residents choked and coughed as they were fed large amounts of food too quickly. ¹

Another vivid description of the problem was related by an eyewitness in response to questions from the Senate Committee on Aging at a 1998 hearing:

• One resident two tables directly away from me was partly feeding herself and partly giving spoonfuls of food from the side by the dining room manager. The resident was choking periodically and at one point regurgitated all of her food onto her tray. The manager, who never smiled throughout the meal, looked in disgust at the mess, did not offer assistance and didn't even wipe the woman's face until five or so minutes later. The resident ate no more and was offered no more food.²

Malnutrition and dehydration is a very serious problem in nursing homes that must be stopped.

• To read about some of the ways our firm evaluates cases involving understaffing, click here.

Malnutrition Resources:

• Evaluating dehydration claims
• Evaluating malnutrition claims
• Overview
• Prevention tips

Other Nursing Home Abuses:

• Bedsores
• Dehydration
• Elopement
• Falls
• Malnutrition
• Mental Abuse
• Physical Abuse
• Restraints
• Sexual Abuse
• Wandering
• Wrongful Death

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