Nursing Home Neglect: Contracture

Contractures develop when the normally elastic, flexible skeletal muscle tissue attached to the bone is replaced by rigid, inelastic fiber-like tissue. Muscles or tendons can become shortened and frozen in a fixed position, preventing normal movement of the joint (frozen joint syndrome).  Contractures are preventable but, once they occur, they are difficult to alleviate and can only be treated by aggressive orthopedic surgery. It is often the result of nursing home neglect.

Who is at risk for contractures in nursing homes?

The rate of contractures occurring in nursing home residents is unacceptably high. According to a recent study, nearly 30% of nursing home patients suffer from contractures, a 20% increase since 1999.  This is especially troubling because the condition can be prevented by physical and occupational therapy, walking, soft-tissue manipulation, splinting, heat application, and other measures that focus on restoring limited range of movement.

What causes contractures in nursing homes?

Contractures result from prolonged periods of inactivity and immobility.  They are particularly common after a stroke and most often affect the shoulder.  Pain and limited mobility in the shoulder makes it hard for residents to perform tasks such as eating, drinking, dressing, and personal hygiene.  In addition, immobility increases the risk of osteoarthritis, osteoporosis, bedsores, incontinence, constipation, cardiac problems and depression. The frailer and more physically dependent a resident is, the greater the chance of contracture.

Some residents are prone to falls or suffering from dementia and may be physically restricted to a medically-ordered bed or chair.  Nursing home staff may believe that restraint is necessary to protect these patients from injury.  However, without assistance in increasing mobility in the fingers, wrists, elbows, shoulders, hips, knees and ankles, patients with restricted movement face a heightened risk of contracture.  Over time, patients with limited mobility are less and less able to care for themselves.  In addition, due to the rigidity of their limbs, residents with contractures are more difficult for staff to handle during bathing and transfer from bed to wheelchair.

How can we prevent contractures in nursing homes?

It is best to prevent nursing home neglect and abuse to avoid contracture. Some nursing home residents are affected by diseases or conditions that expressly limit their mobility.  These patients are prime candidates for programs that help to restore and maximize movement and prevent the downward spiral toward contracture.  All nursing homes residents, however, benefit from interventions that improve their physical functioning.  Not only do restorative nursing care measures increase mobility and prevent contractures, they also help residents to achieve a better quality of life by feeling more self-confident, independent and socially active.

If your loved one is in a nursing home and has been affected by contracture, discuss the matter with a qualified attorney to see whether legal action is warranted.

Contact our NYC elder abuse law firm today at (646) 647-3398.