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Norton man charged in Needham pedestrian’s death

A 29-year-old local man was killed after being struck by a vehicle on Route 24 north in Randolph early Sunday morning.

A Norton man has been charged in the motor vehicle accident on Route 24 that resulted in the death of a 29-year-old Needham man.

Following an investigation, Shane Wilson, 20, of Norton, was charged with leaving the scene after causing personal injury resulting in death, David Traub, spokesman for Norfolk District Attorney Michael W. Morrissey, said in a press release sent out Sunday evening.

Earlier in the day, State Police had issued a BOLO for a red Hyundai with recent front-end damage, believing a vehicle matching that description had struck the Needham man, identified as Adam T. Trudeau, 29, while he was standing on Route 24 north in Randolph at around 1:15 a.m. Sunday.

At around 8:20 p.m. Sunday, Traub reported that a man had identified himself to State Police as possibly the driver in the crash, after seeing the press coverage of the crash. He willingly submitted his vehicle for the investigation.

According to reports, the man told police that he had stopped his vehicle after striking something in the roadway, but that he had thought it was a deer.

Officials have said that Trudeau was standing in the roadway when he was struck by the vehicle, although it is unclear why he was there.

“Initial investigation indicates that the deceased may have been stationary and facing oncoming oncoming traffic in the center lane of Rte. 24 northbound at the time that he was struck by a red car, driven by a male party, which initially stopped, but left the scene before speaking with police,” Traub said in the press release.

Route 24 northbound was closed for about four hours on Sunday as a result of the investigation.

Wilson will be summonsed to Quincy District Court on the charge.

Source:  patch.com


Nursing Home Negligence

Falls in Nursing Homes

Litigators who work with cases involving long term care know how significant the issue of falls can be. Falls are the leading cause of injury and death by injury in adults over 65. Approximately half of the 1.6 million nursing home residents in the U.S. fall each year, and a report by the Office of the Inspector General found that about 10% of Medicare skilled nursing residents experience a fall resulting in significant injury; and, more than 1/3 of hospital falls result in injury. In the rehab setting, rates are often higher – for example, fall rates among stroke patients have been shown to be very high. Immobility and falls can lead to poor outcomes.

Fear of falling is defined as a geriatric syndrome. It not only occurs in older adults who have fallen, but in those with impaired mobility and is associated with decreased physical ability and depression. Care of older adults requires that clinicians be aware of the myriad of issues related to falls including knowledge of this syndrome, increased risk and interventions needed to prevent injury related to falls.

Just about every resident in a long term care setting, including assisted living and sub-acute rehab, is at risk for falling. Between medications, functional and medical issues and advancing age, older adults in most settings are prone to falling.

There are well established standards of care related to fall prevention; but, as I continue to review records related to issues like falls, I am amazed at how often these basic standards are not being practiced. The basics of a fall prevention program include assessment and ongoing reassessment of risk, ensuring a safe environment, medication review, providing therapy as needed, individualized interventions, and staff education.

Basic nursing practice includes assessment, planning (Care plan), putting interventions in place and then evaluating outcomes to determine if those interventions are appropriate and effective. Assessment includes completing fall risk assessments on admission and then as needed. Very often, the fall risk assessments completed by nurses in LTC are inaccurate. The tools utilized in long term care typically include these risk factors: history of falling, use of ambulatory aids, gait/balance issues, medications, secondary diagnoses (i.e. diabetes) and mental status. Care planning is the next step in nursing care - it is the standard of care that as the resident’s status changes, assessments and care plans must be updated, and often, are not. For example, with each fall, there should be updates, or if there is a new diagnosis, i.e. stroke, or worsening dementia, updated interventions should be put into place, with ongoing evaluation of effectiveness.

Care planning and interventions very often are generic and not individualized. For example, a toileting schedule that includes only after meals and before bedtime may not be appropriate. If a resident has issues with constipation or incontinence, this may lead to the need for more frequent toileting to prevent falls. The “make certain call bell is within reach” for residents with dementia is an example of a generic intervention. Older adults with dementia may not recognize a call bell or remember to use it. The debate about use of bed and chair alarms go on – they are a part of an individualized care plan, not a solution to preventing falls. Often, I see delays in putting interventions in place, i.e. with the resident who is incontinent NOT being put on a toileting plan immediately. The other common issue I see when reviewing records is the lack of updating care plans as the resident’s status changes – with every fall, with worsening dementia, physical decline, or new medical diagnosis (i.e. Parkinsonism).

Nurses reviewing records need to pay attention to the MDS, risk assessments, care plans and Interdisciplinary notes with attention to where the standard of care is not being met.
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6 days ago  ·  

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