Scabies Is a Sign of Nursing Home Neglect

Scabies is an itchy skin condition caused by mites that can cause infections. A severe type of scabies, crusted scabies (Norwegian scabies), can affect large parts of a nursing home resident’s body and can be difficult to treat. Unlike milder cases of scabies that involve about 10-15 mites, a resident who has crusted scabies may have millions of mites.

According to the US Centers for Disease Control and Prevention (CDC), outbreaks of scabies have occurred among the residents of nursing homes, long-term care facilities, and hospitals. Outbreaks are normally due to delays in diagnosis and treatment of crusted scabies – among debilitated, immunocompromised, institutionalized, or elderly persons. Diagnosis and treatment of crusted scabies may be improper because the characteristic itching and rash of scabies may be missing. By the time one nursing home resident or staff member develops scabies, there’s a good chance that many other residents and staff members also have scabies.

What is scabies?

According to the Mayo Clinic, scabies is caused by eight-legged mites. The female lays eggs under the skin. The mite larvae then move to the skin’s surface, other skin areas, and other people. Scabies can spread by close skin-to-skin contact and by sharing bedding or linen. The need to scratch occurs where the mites burrow.

Complications include infections caused by staph bacteria or strep bacteria. The treatment for scabies includes medicated skin creams or pills that kill the mites and their eggs – although itching may continue for weeks.

Crusted scabies affects many people including nursing home residents who are ill or old and people with weakened immune systems. This form of scabies is much harder to treat.

What are the symptoms of scabies?

In addition to itching (often worse at night), the symptoms of scabies may include “thin, wavy tunnels made up of tiny blisters or bumps on the skin.”

Scabies can be found between the toes and fingers, around the waist, in a resident’s armpits, on the inner elbows, along the insides of a resident’s wrists, around the belly button, on the soles of the feet, in the groin area, and other locations. People who have had scabies previously will develop symptoms a few days after exposure. Otherwise, symptoms may take six weeks to develop.

Why are nursing home residents susceptible?

Nursing homes need to anticipate that their residents may develop scabies due to their age, weakened immune systems, and close contact with other people. Preventive steps that nursing homes should take according to the Mayo Clinic include:

• Wash the residents’ clothes and linens. Heat does kill mites and their eggs. Dry with a high heat and dry-clean items that can’t be washed. The nursing home staff should use hot, soapy water to wash all bedding, towels, and clothing used in the three days prior to the start of treatment.
• Starve the mites. Items that can’t be washed should be placed in sealed plastic bags and stored in a place that isn’t used for a week. Mites who don’t have food die after a few days.
• Clean and vacuum. The nursing home should clean and vacuum the carpets, floors, and furniture to prevent scabies from spreading.

The CDC recommends that health professionals in institutional settings such as nursing homes and assisted-living facilities follow these guidelines to prevent or reduce the risk of scabies:

• Have procedures in place to detect infested patients and staff as early as possible.
• Be suspicious. Undiagnosed skin rashes are often due to scabies.
• Screen new patients and staff members for scabies.
• Notify local health departments of any outbreaks and other institutions where a resident or staff member may have been.
• Keep records about the resident’s name, room number, sex, roommates, skin scraping status, and the names of all staff members who came/come into contact with the residents – for several months because it can take several months for any symptoms to appear.
• Analyze the records by:
  • “Building, room, floor, wing, occupation (for staff), dates of admission, and onset of scabies-like condition to determine:
    • Levels of risk for patients and staff
    • Extent of the outbreak (e.g. confined or widespread in the facility;
    • Temporal relationship among cases.”
  • Avoid skin-to-skin contact with any resident who may or does have scabies. Instead, the staff members should use gloves and immediately wash their hands after providing care.
  • Avoid skin-to-skin contact with anyone who has scabies for eight or more hours after application of a scabies treatment.
  • Help protect family members who may visit a resident who may or does have scabies.
  • Provide residents with their own towels, washcloths, and linens.
  • Inform residents and staff about the signs of scabies.
  • Provide prompt treatment for anyone who does have scabies.

Nursing homes and assisted living facilities need to take proactive steps to understand when scabies may be present anywhere in the nursing home. Failure to take prompt action may constitute abuse and neglect. Aggressive actions are necessary if the nursing home suspects that crusted scabies may be present in the nursing home. Skin scrapings should be analyzed for the signs of scabies mites and any possible infections.

Nursing home owners, managers, and attending healthcare professionals should be held liable for a resident’s personal injuries or wrongful death if your loved one developed scabies that could have been prevented. If a resident, a family member, or a friend develops scabies, the elder abuse and nursing home lawyers at Garcia & Artigliere have the experience and resources including working relationships with medical professionals to assist you.

Our team is ready to answer all of your questions and explain the rights of any resident who contracts scabies due to nursing home neglect. Residents may be entitled to substantial compensation if t hey develop scabies. Contact our firm to schedule your free and confidential case review today. We have offices in Long Beach, Los Angeles, Louisville, Phoenix, and New Orleans.

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