When someone has trouble breathing in an emergency situation, doctors often employ intubation, a method of helping patients to breathe by inserting a tube down their throat and connecting them to a ventilator to help or replace the process of breathing. Because of its function, many people think of intubation as a miracle procedure — or at least one that works well. It’s supposed to help keep people in serious, painful conditions alive. But, especially for elderly and geriatric patients, that might not be the case.

For an elderly patient, whose condition would be easily weakened or changed, the process of intubation can be particularly invasive. Aside from removing the patient’s ability to speak and sedating them, the process also shows the potential of causing damage and danger to the lungs, throat, and other vital bodily functions.

The New York Times published an article about the unknown dangers of intubating elderly patients at hospitals. It shows, through evaluation of different scientific studies, that elderly patients rarely benefit from intubation. Instead, they are at risk for many more complications as well as pain, injury, and even death as a result of those complications.

In realizing the danger intubation poses toward older patients, doctors have looked to methods of “noninvasive ventilation” as alternatives to intubation, which would cause less physical distress to the body. For example, BiPap devices fall under this category, using a mask over the face instead of a tube down the throat to facilitate healthy breathing. It also gives patients better options in terms of communicating and controlling their own faculties, in addition to running a much lower risk of death or extensive treatment after it’s employed.

When it comes to elderly patients, it’s easy to think of them as an exception. If they don’t naturally react well to a process like intubation, any outsider could think their fragility or susceptibility to pain would be unavoidable due to their age or preexisting conditions. On the other side, family members of elderly patients who have to choose whether to allow intubation are likely to believe their loved one will be an exception to the risks involved in the procedure and follow the more dangerous path.

But these patients don’t necessarily have to live with those risks and pains, and their family doesn’t necessarily have to make such a heavily weighted decision. If innovations in noninvasive ventilation continue to come through, many elderly patients and their families will be saved serious heartache.

Listed as one of America’s poorest nursing facilities, Wentworth Rehab in Chicago has a reputation for miserably insufficient maintenance and patient care, as reported in the Chicago Tribune. It’s known for events like the death of Letasha Mims, whose family finds Wentworth to blame for her passing after she became desperately ill during her time there.

Even more recently, a 79 year old man was allowed to smoke while using an oxygen machine at Wentworth, which eventually caused a fire that killed him and caused massive damage in the nursing home. It was reported that the man had a history of destructive behavior and should have been more carefully surveyed for such danger, and also that the staff had acted in a dangerously negligent manner, with one nurse looking on carelessly as the man was burning to death and another nurse attempted to save him.

To those familiar, these kinds of events would not be surprising. None of this even mentions the seeming inescapability of insects and rodents in Wentworth Rehab. Inspectors have reported unidentifiable food being served to patients. Residents can be seen plainly in areas of the nursing home with unimaginably poor personal hygiene. When asked about any of this, Wentworth’s parent company, Alden Management Services, will either deny its facility’s negligence or decline to comment altogether.

There are plenty of bad nursing homes in the United States, many on the same lists as Wentworth. There are even plenty of other bad nursing homes in Chicago, where it’s not hard to imagine a need for affordable or accessible nursing homes. But with its history of lying, neglecting, and ignoring, Wentworth Rehab stands out as a hallmark of bad behavior in nursing homes and a way of looking at any facility’s character.

Freelance Contribution by Jessica Walter

Only a third of America’s fifty million senior citizens are living independently, outside of nursing homes. If you’re concerned about being able to afford a nursing home and healthcare when you are 65 or older, you should know that modern financing options are out there. While saving for retirement is the best defense against financial problems during your golden years, there are innovative ways to find money, even if you haven’t saved enough.

Move to a Smaller Space

The median price of a South Carolina home is $157,600 according to Zillow. A home is typically the biggest expense that a person has and plenty of costs are involved with maintaining a property. When you choose to downsize, you’ll pay less per month for your mortgage and this will allow you to put more money away for the future. If you don’t want to move, consider upgrades which make your home less expensive to run, such as energy-efficient home improvements.

Get Rid of Debt

Debt means interest and these payments can really add up. For this reason, you should focus on eliminating debt. When you do, you’ll be primed to put money away for retirement, rather than giving it to lenders. One ultra-modern option is debt consolidation. By getting a debt consolidation loan, you’ll be able to make one monthly payment on your debt, for an interest rate that is likely lower than what you’re used to paying. The California Teacher’s Association asserts that it’s possible to save ten percent on interest when you consolidate.

Negotiate with Nursing Homes

If you’re advocating for a senior that you care about, you should be aware that it’s possible to negotiate with nursing homes.There is often room for negotiation for the long-term costs of care. For example, a nursing home will be willing to accept a private pay rate that’s lower than average, provided the rate remains higher than the rate from Medicaid.

Get an Affordable Loan

Big banks aren’t your only option when it comes to accessing funds for long-term care. These days, a lot of alternative lending solutions are available, from personal loans from third-party financiers to peer-to-peer lending and beyond. Finding a low interest rate is what it’s all about. Think outside of the box by exploring alternative lending solutions that don’t come from major financial institutions. Then, compare interest rates and loan terms to what the big banks are offering.

Start Planning for Retirement

Thinking about the cost of retirement can be stressful. Careful planning, well ahead of time, is the best way to take the pressure off. However, it’s never too late to start thinking about how to finance the cost of a nursing home, which may run as high as 7.500 USD per month. So, why not come up with a financial plan for retirement today?

The Star Tribune reported that nursing home employee Francisco Javier Ramirez, a nursing assistant at the Good Samaritan Society nursing home, was transferring a female resident, Evelyn Augusta Schweim, out of a bathtub using a mechanical lift chair but failed to follow correct procedures. The resident slid out of the chair — which was raised to its highest level of about 5 feet — and then sustained multiple fractures. The fall was so severe that the woman’s left foot was almost detached from her leg, and the bones of her left leg were visible, according to a Minnesota Department of Health investigation last year of the incident. When she was found, pools of blood had formed around the woman’s ankle and she was complaining of knee and neck pain, the report said.

 After the fall, Ramirez again violated safety protocols by moving the resident away from the door by pulling on her gown, and then leaving her alone in the bathroom as he went to get help, state investigators found.  Schweim, died on Sept. 17 from complications of multiple skeletal fractures resulting from the fall.
 The state Health Department investigation concluded that Ramirez violated multiple safety protocols and was responsible for neglect. The violations include failing to obtain assistance from a second staff person, as required; failing to operate the mechanical lift properly; and leaving the resident alone in the bathroom instead of using his phone or walkie-talkie to call for help. Ramirez also violated protocol by raising the woman to the highest level on the lift. Standard procedure was to lift the chair no higher than 1 to 2 feet, according to the criminal complaint.
Ramirez has been charged with second-degree manslaughter, two counts of criminal neglect and one count of mistreatment of patients.

The Toronto City News reported the tragic and preventable death of Danny McNeill trapped in his bed rail, his 69-year-old body fighting desperately to escape the very rails that were supposed to protect him.  Danny McNeill died alone at the Maple Manor Long Term Care Home in Tillsonburg.

According to Health Canada there have been 25 reported incidents involving bed entrapment over the past two years, seven were fatal. Since 2008 Health Canada has issued several safety communications about the use of bed rails as restraints in hospitals and long term care homes — most recently in April 2017 — yet they are still used in most homes and hospitals.  The home has been cited for safety violations involving both the use of restraints and bed rails in the past — including in 2016 when inspectors found that the “licencee (had) failed to ensure that no resident of the home was restrained by the use of a physical device.”

In 2015, the home was cited for failing to ensure that where bed rails were “used in the home (it) had taken steps to avoid patient entrapment” and later that year, 36 of 108 beds were identified as “failed” — in some cases because of a lack of mattress keepers or rails that required ongoing tightening.

“That’s why I’m here, to let people know that they’re being used. Our family members are using them and getting their heads trapped in them,” Kevin McNeill told CityNews. “I’m disgusted.”

“He got trapped between the bars of his bed rail and mattress. That was the call. They said he had died and that was pretty much it,” McNeill says, recalling the phone call he got from the home last Sunday.

McNeill doesn’t know why the restrains were in use. He says an alarm should’ve sounded when his father fell from the bed.

“If he was to fall off the bed or make a movement, the alarm would go off and notify the nursing station and buzz at the bed as well. In the case of falling, the alarm goes off,” he explains.

“The alarm should have been going off as soon as he probably left the area of the pad. He made it to the floor and got his head trapped for too long. That was the case. We really don’t know how long it took until that alarm was heard. I don’t know if they heard.”

Staff at the home told Ministry of Health inspectors that they had received no training on rail safety.

McNeill is still very much grieving the loss of his father but says the practice of using bed rails has to be re-examined.

“Maybe they’ve got to change those rails and make sure we’re not using them as restraints, just using them for getting out of bed. i didn’t know what they were used for until I did some research myself. gotta let people know.”

It’s no secret that some nursing homes will neglect their residents in the interest of their own greed for profits and wealth, but less well known is the fact that those nursing homes are often rewarded by the government for that mistreatment. NPR recently published an article on this topic, citing statistics like one in five nursing home residents sent from hospitals on Medicare are returned to the hospital within thirty days.

Rather than taking care of their patients to the best possible extent, hospitals and nursing homes choose to send them back and forth to one another because it benefits them financially. For one thing, it’s cheaper for each facility to treat a patient as little as possible. For another, both hospitals and nursing homes have historically received encouragement from the government for this behavior, getting financial rewards for things like admission, readmission, and discharge to and from the facility.

As an example, an elderly woman could be admitted to a hospital for a severe injury. She could then be transferred from there to a nursing home earlier than the injury demands because it’s in the hospital’s financial interest to move her out as fast as possible. Then, at the nursing home, she doesn’t receive the care she needs because the place is understaffed and it costs more money than they wish to pay to properly treat and rehabilitate her. So she gets sicker and they eventually send her back to the hospital. This act of “boomeranging” patients back and forth is well known in the world of health policy.

Noticing this trend, the government has begun its efforts toward fixing the situation. According to NPR, “In 2013, Medicare began fining hospitals for high readmission rates in an attempt to curtail premature discharges and to encourage hospitals to refer patients to nursing homes with good track records.” There are also plans to incentivize nursing homes to improve in similar ways.

These moves are a step in the right direction, but most believe there’s still a lot to do here in the interest of patient care.

The Stamford Advocate reported that St. Camillus Center was fined only $6,000 by Connecticut’s health department and three employees were fired following the death of a resident who hadn’t been checked on for 12 hours.  The footage also showed staff had not opened the door to the resident’s room or checked on the resident between 6:26 p.m. on Feb. 15 and 5:19 a.m. on Feb. 16.

In the Feb. 16 incident in Stamford, a resident with lung cancer was found unresponsive and without a pulse, according to DPH, and video footage subsequently showed staff waited 10 minutes to administer CPR.  The resident was taken to the hospital and later pronounced dead. A registered nurse, licensed practical nurse and nurse aide subsequently were terminated, DPH said.

Past incidents at St. Camillus

2016 – Inspectors report observing 40 violations at the nursing home over the past year, including an incident in which a nursing aide called patients fat. As a result of the observations from unannounced visits in 2015 and 2016, the nursing home failed to meet certain state Department of Health standards during annual licensing inspections.

2014 – The facility receives a $1,680 fine related to protection of patients’ rights and/or failure to monitor patient condition.

2010 – The state Department of Social Services threatened to shut down the center and revoke its eligibility to collect Medicaid after investigators find patients’ health in immediate jeopardy.

According to Medicare’s website, St. Camillus has 124 beds and has not received any federal penalties or payment denials by Medicare in the last three years. However, the site received a lower-than-average health inspection rating a year ago after being cited nine times for deficiencies in quality of life and care as well as other issues.

 

 

Tracey Mitchell was fine with the notion of placing her father in the care of a nursing home when it became necessary, and while he was there everyone was happy with the quality of care in the facility. In the years before the lawsuit when Mitchell’s father was a resident, there was no discussion of fees or bills for her father’s stay.  But when Mitchell was served a lawsuit years into his stay, alleging she owed $49,000 for her father’s care, she was stunned.

When her father was admitted, Mitchell told the facility, Alaris Health at Cherry Hill, he didn’t have the means to pay, so she was told to file for Medicaid in his place and then to sign his admissions agreement.  Then she was just told one day, mere months before her father’s death, that she owed the facility a massive amount of money. It turned out the document she signed on her father’s behalf put her next in line to pay whatever costs her father or Medicaid couldn’t take on, though before this time she’d never received a bill.

Even more stunning, when Mitchell consulted her attorney about the matter, she found out the contract she signed was illegal. In the document she is named a “third party to guarantee payment,” meaning whatever costs weren’t payed by her father or Medicaid, she would cover. However, under federal law and New Jersey state law, it is illegal for a nursing home to hold a third party liable for those costs.

The case is now over, but plenty of people are vulnerable to the kind of experience this family had. According to Mitchell’s lawyer, “[His] theory is if they sue 10 people like this, they will find maybe one with an attorney who knows the law and nine will pay.” It’s incredibly easy for a nursing home to find that a resident’s bills haven’t been payed off by the patient themselves or Medicaid and find the solution in an unknowing family member. Experts say the best course of action is to work with an attorney or a Medicaid specialist before signing these kinds of contracts to avoid running into issues with them later.

New York Magazine recently published an article on findings that the Purdue Pharma company was aware of its product OxyContin’s popularity and addictive nature long before the company’s executives admitted in testimony under oath.  They intentionally ignored and covered up the dangers to exploit consumers and increase their profits.

In the 1990’s, when OxyContin was created, it was dubiously advertised as less addictive than other painkillers and much safer for long-term use than its competitors. Of course, knowing now the opioid crisis America faces, this is not the case. But when asked about their knowledge of their drug’s popularity in the world of drug abuse, Purdue’s top executives said they didn’t know until the early 2000’s.

Then, the Justice Department produced a report with proof that Purdue Pharma knew about OxyContin’s addictive nature and abuse by the late 1990s, only years after the drug was first produced.

Though the administration handling the case at the time did not view it as anything more than a misbranding case, this corporation’s lack of action against the harm its product caused is shameful at the least.

The West Virginia Record reported on a lawsuit by the estate administrator against Saddle Shop Road Operations LLC, which does business as Hilltop Center, Genesis Healthcare Corp. and Brian Chapman, alleging that the deceased, Harold Gene Nutter, received improper care while he was a resident of the Hilltop Center nursing facility.

Estate administrator Charles Fitzwater filed a complaint May 3 in Fayette Circuit Court, alleging that Nutter suffered serious and permanent injuries on May 8, 2017 that resulted in his death.

Fitzwater also alleges that Nutter’s surviving family members have suffered sorrow, mental anguish and loss of society, companionship, comfort and guidance, as a result of the negligence of the defendants in providing inadequate health care and protective and support services to the decedent.

Specifically, the plaintiff claims the defendants failed to employ a sufficient number of staff and failed to ensure that residents received the proper care, treatment, hydration and hygiene requirements.

The plaintiff requests a trial by jury and seeks a judgment against defendants for damages, attorney’s fees, costs and expenses, punitive damages and other relief that the court deems just. He is represented by Jonathan R. Mani of Mani, Ellis & Layne PLLC in Charleston.

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