Rehoboth teen killed in late-night accident in Somerset

SOMERSET — A family in Rehoboth is grieving after a teenager from the town died in a car crash in Somerset late Sunday night.

Police have identified the victim in last night’s fatal accident on Lafayette Street as Timothy Swass, 19, of Rehoboth.

Swass was alone behind the wheel of a 1993 Ford Probe during the fatal crash, when the vehicle slammed into three utility poles and smashed into a parked car on Lafayette Street in Somerset, Somerset Police Chief George McNeil said.

McNeil said speed appears to have been a factor, adding that the preliminary investigation does not show that Swass applied his vehicle’s brakes before the crash.
“We haven’t got anything back from toxicology on whether he was distracted,” McNeil said. “The only obvious thing was speed was a factor.”

The Somerset police and fire departments responded to several 911 calls reporting a car that struck the utility poles in front of 254 Lafayette St. The responding officers and firefighters found two poles snapped in half. Swass’ car also struck the third pole before bouncing off and hitting a vehicle in the driveway, McNeil said.

Somerset firefighters removed Swass from his vehicle. He was pronounced dead at the scene, McNeil said.

The Massachusetts State Police Accident Investigation team responded to the scene to assist the Somerset Police Department.

The car Swass was driving was traveling east on Lafayette, toward Route 138, and was coming off an S turn.

Gary Braz, of 319 Lafayette St., directly across the street, said he was awakened by the crash and, when he looked out his window, saw the two cars on the front lawn at 254 Lafayette St. He said the other car had been parked in his neighbor’s driveway and was knocked onto the lawn.

Braz said Gary said people from farther up west on Lafayette Street came down to the accident scene and said they had seen the car traveling very quickly, at an estimated 100 mph.

“They said the car just flew by,” Braz said. “On a street like this, with a curve like this, you’re not going to make it doing 100 mph.”

McNeil said he believed that Swass was living with grandparents in Rehoboth. McNeil also said that Swass may have lived in Somerset prior to that.

Dighton-Rehoboth Regional School District Superintendent Anthony Azar confirmed that Swass was not a graduate of Dighton-Rehoboth, but he also offered comment about the tragic death.

“This is heartbreaking news at any level,” Azar said. “In the event of a situation like this, or something similar, we provide counseling opportunities for all students. We hope and pray that this situation never happens to anyone.”

“I know the family is grieving,” McNeil said. “Let the family grieve.”

Source: Herald News

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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