Unnatural deaths in nursing home patients.

Nursing home residents comprise a large and rapidly growing segment of the national population. Despite this fact, the majority of deaths occurring in nursing homes are not investigated because of the significant medical illnesses suffered by most residents. Herein, we report a series of unnatural deaths in nursing home residents, including two homicides and seven accidental deaths. In four of the deaths, there was an attempted concealment of the cause and manner of death. Fearing criminal or civil proceedings, nursing home personnel may attempt to conceal homicidal or accidental deaths in nursing home residents. Because of the serious, chronic illnesses suffered by these patients, attending physicians are often willing to sign death certificates without personally investigating the circumstances surrounding the patient's demise. The authors contend that unnatural deaths of nursing home patients are significantly underreported. Attending physicians and death investigators should be urged to investigate more fully sudden deaths in nursing home patients.