Smoking Accidents in Nursing Homes

You're watching Fighting For What's Right, with personal injury attorney, Barry Doyle.

Another kind of case that you handle are smoking accidents. I guess I was kind of surprised to hear that people are allowed to smoke in nursing homes.

The first time I heard about it too, I guess I was a little surprised as well, given that nursing homes are healthcare institutions, but nursing homes are homes, these are these people's residences, and as adults, they have a full range of rights, and one of those rights is to go ahead and smoke. Now, in this particular setting, there are restrictions on how people can use tobacco products, and part of that is related to the safety reasons that are associated with that.

Pam: So how do accidents occur?

Barry: There are a few main scenarios as to how these kind of accidents happen. One of the really common ones is where you have people who are smoking near concentrated oxygen, and the mixture of the flame from the cigarette and the concentrated oxygen is something that's just a recipe for disaster. The other real common way that you see these kind of accidents occur is with mishandling or dropping of smoking materials. Where this tends to happen is where you have residents who have motor difficulties. In other words, they have a hard time holding onto things and they drop either lighters or cigarettes, most commonly into blankets or clothing if they're seated or in a wheelchair, and eventually what happens is that it starts to smolder, and it sets either their clothing or a blanket on fire.

Nursing homes often set aside a specific area within the nursing home for smoking activities. And the last place where you tend to see these kinds of accidents occur, is where you have tobacco or smoking products like lighters being used outside the designated area, where it's really not being monitored. And the whole issue of misuse, mishandling, becomes a lot more acute because there isn't anybody to catch it when it occurs.

Pam: So then, where does the nursing home have any responsibility for this?

Barry: It's part of the care planning process. If there are risks that are associated with smoking above and beyond just, it's bad for you, such as risks that are involved with smoking near concentrated oxygen, or for mishandling of smoking materials because of difficulties physically handling cigarettes or lighters or what have you, then these are things that need to be specifically care-planned for. Most often the care plan would include limiting access to smoking materials, and making sure that smoking is only being done under supervision in the designated areas that are set aside for smoking. When those things don't happen, that tends to be where you have accidents occur. Where the care plan either isn't being put into place, or it's a situation where the care plan isn't being implemented on a day-to-day, shift-to-shift basis, where somebody is being left to smoke unsupervised or being allowed to smoke near concentrated oxygen.

Pam: So lastly, do you have any advice for families?

Barry: If you have a parent who's in a nursing home who is still a smoker, you need to ask whether there is a care plan that's in place and specifically what is in that care plan, and whether that care plan is actually being carried out, day-to-day, shift-to-shift, because these are the kinds of accidents that really can happen in a flash of time, and they're absolutely horrific when they occur.

That's awful. This is Fighting For What's Right, with personal injury attorney, Barry Doyle. Please visit our website, at

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