We are pleased to have Hannah Watson write a guest blog today on how to protect your loved one in a nursing home.

While there are some truly great, caring nursing homes out there, the reality is that many older Americans are at risk of abuse in these long term care facilities. In fact, according to the American Psychological Association, every year an estimated 2.1 Million older Americans are victims of physical, psychological or other forms of abuse and neglect. If you want to learn to keep your loved one safe then follow these tips to help ensure they get the help and support they need to stay well-cared for and happy.

1. Research the nursing home before placement. Before you ever place a loved on into a nursing home make sure that it’s going to be a good environment for them. Research others’ experiences, go to see the facility yourself and spend some time getting background on it to make sure you won’t regret your decision.

2. Monitor your loved one for injuries. One of the most obvious signs that abuse or neglect is taking place is physical injuries. While these can sometimes occur in less than sinister situations, it’s important to find out where they can from and if staff can provide reasonable explanations for them.
3. Visit often and unexpectedly. Perhaps one of the best ways to prevent abuse of your loved ones is to visit them often and vary the times at which you visit. If someone was harming your loved one, it would make it much more difficult for them to do so. Plus, you’ll be better able to monitor your loved one’s health if you see them regularly.

4. Talk to the staff at all levels. Developing relationships with the caregivers at the facility where you are housing your loved one can also be one way to not only find out just how your loved one is cared for but also help establish relationships of appreciation that can change caregivers’ attitudes.

5. Ask for all the information on your loved one’s care. It’s important to know just how much your loved one is eating, what medications they are on and the details of their daily care. After all, signs of malnutrition and other forms of abuse are much harder to spot.

6. Just ask. One of the easiest ways to find out if your loved one is being cared for properly is to ask them themselves. Assure them that you want to guarantee their safety and if you feel it’s at risk remove them from the facility as soon as possible. If they can’t talk, learn the signs of elder abuse and make sure to follow through on any suspicions.

This post was contributed by Hannah Watson, who writes about the nursing school online. She welcomes your feedback at HannahWatson84@ yahoo.com
 

King5 News had an informative article about new technologies that will help prevent falls and injuries in people at risk of falling.  This is great news for nursing home residents if corporate owners actually spend the money to provide these innovative technologies.  Falls are one of the leading causes of hospitalizations and deaths in nursing home residents and most are preventable if the facility has adequate staff, proper training and supervsion, and provide assistive devices and other preventative measures.  Most occur when residents are in their rooms, unattended by staff. This system takes the first of its kind approach in alerting staff before a fall happens.

The article mentions just a few of the new technologies available to nursing homes. State of the art technology is changing the way nursing homes operate.  Inside one Louisiana Alzheimer’s facility, each room is equipped with a fall prevention system.   "We have a ‘smart’ system, which is a computer system that will learn, actually learn patient movement and activity," said Neal Rider, Guardian House CEO.

Each resident has an individual profile that determines their risk for potential falls. If they are categorized as a "fall risk," the computer and motion sensor devices will monitor their every move in bed and alert the staff if anything is abnormal.  "The unauthorized bed exit is coming in and you can see an individual getting out of the bed. It identifies where the person is in the building and where other individuals and staff members are located throughout the building," said Rider.

 "Our residents each have one of these that they wear on their wrists, when they do a bed exit, the computer has programmed that that’s an unauthorized move, it will alert us," said Kathy Richards, Guardian House.   Then a nurse will (hopefully) immediately speak to the resident through the room television. Often times, a simple reminder to stay in bed is all it takes.

 

 

 

The conservative Center for a Just Society had an incredible article from the well-respected Ken Connor discussing tort reform and health care.  The article is below:

"In the state of nature… all men are born equal, but they cannot continue in this equality. Society makes them lose it, and they recover it only by the protection of the law."
Charles de Montesquieu

In the ongoing debate over health care reform, critics on the right are increasingly citing the lack of tort reform as a major deficiency of the current proposals floating around the halls of Congress. Instead of focusing on truly conservative solutions to our nation’s mounting health care crisis, Republican lawmakers and pundits are playing the same old song-and-dance—blaming ballooning health care costs on trial lawyers. This red herring tactic is a classic example of politicians trampling principle in pursuit of politics. In this case, Republicans moonlighting as "conservatives" seek to use tort reform to shield corporate malefactors (who also happen to be their financial benefactors) from full accountability for their wrongdoing. In so doing, they are undermining a bedrock principle of our nation’s justice system.

For years, Big Business and the U.S. Chamber of Commerce have spent millions of dollars in a public relations campaign aimed at demonizing trial lawyers, portraying them as unethical con-artists out to game the system. These corporate interests have a vested interest in keeping the tide of public opinion running against trial lawyers because it deflects attention from the widespread problem of negligent and reckless conduct that injures consumers. This "shoot the messenger" tactic not only enables businesses to avoid financial accountability for wrongdoing—it deliberately undermines the people’s civil liberty.

The reality is that trial lawyers are the people’s first line of defense to secure redress of grievances for private or civil wrongs committed against them. The most highly publicized of these kinds of cases usually involve David and Goliath-type scenarios—think of the massive frauds committed by WorldCom, Enron, or Bernie Madoff and you get an idea why trial lawyers are essential to securing justice for those wronged at the hands of well-heeled rogues with deep pockets and limitless legal resources. And yes, sometimes these cases involve substantial claims against doctors or hospitals accused of malpractice.

Despite unfair characterizations to the contrary, medical malpractice is no joke. Every day thousands of Americans walk into doctors’ offices, emergency rooms, and operating rooms trusting their lives to the expertise and integrity of the medical system. Errors in diagnosis, misread charts, medication errors… all can cause irreparable harm to their victims. And these kinds of accidents happen often—far more than Republican advocates of "reform" are willing to admit and far more than most people realize. According to several studies conducted over the last decade, up to 98,000 people die every year as a result of an estimated 15 million instances of preventable medical errors. These statistics place death by malpractice as the 6th leading cause of death in the United States.

For the victims and their families, the tragedy inflicted as a result of medical malpractice is very real, and the process of seeking a just remedy can be overwhelming. It is for precisely these kinds of situations that the 7th Amendment to the United States Constitution guarantees all Americans the right to a fair trial before a jury of their peers. This right is a foundational principle of our civil liberty and should be a core tenet of conservatism because it affirms the responsibilities citizens have in a free society and the accountability of all before the law.

Nevertheless, the importance of the civil justice system and the right to trial by jury is poorly understood by many conservatives because trial lawyers are constantly demonized by special interests seeking to evade justice. Many Republicans have been wrongly led to believe that tort "reform" is some kind of Reaganesque trickle-down solution to the high cost of insurance and the high cost of medical care. The facts, however, don’t support such a notion. Skyrocketing insurance premiums are not a result of malpractice litigation, and the high cost of medical care stems more from "offensive medicine" (profiteering by doctors seeking to make an extra buck), rather than "defensive medicine" purportedly resulting from fears of malpractice suits.

In 2007, the Congressional Budget Office estimated that costs associated with medical malpractice claims only amounted to 2% of overall health care spending. Furthermore, multiple studies suggest that the high cost of medical insurance has virtually no correlation with the frequency or amount of malpractice payouts but is actually a result of insurance companies playing the market and—in some cases—intentionally misrepresenting the influence of malpractice payouts in order to keep premiums high. Doctors are not fleeing the medical profession from fear of lawsuits, and those who are sued for medical malpractice are often permitted to continue working with little to no professional censure for the harm they inflicted.

The truth is that corporate moguls push for tort reform because they have little use for a civil justice system that puts the little guy on the same plane as the rich and powerful. These so-called fiscal conservatives don’t like equal justice. They want preferential treatment—something they are accustomed to getting from politicians because of their hefty campaign contributions.

Conservatives need to educate themselves about the importance of a civil justice system that protects everyone and treats all litigants—rich and poor alike—as equals before the law. Furthermore, true conservatives ought to resist attempts to federalize tort law and impose one-size-fits-all solutions to "problems" that are, in large part, the fictional creations of special interest lobbyists seeking to enrich the coffers of their wealthy clients. Any change in medical malpractice laws should occur at the state level and be tailored to meet conditions in the individual states. The people in Topeka may approach the same problem differently from the folks in Tallahassee. They may be experiencing different problems, or perhaps, none at all. In any event, the residents of Attapulgus, Georgia don’t want Chuck Schumer and Olympia Snow dictating the remedy they can pursue when a doctor leaves a pair of scissors in the site of their incision or causes avoidable brain damage to their newborn.

Tort reform subsidizes wrongdoing by shielding wrongdoers from accountability for the consequences of their misconduct. It is an affirmative action program for corporate miscreants. Incorporating tort reform into health care reform will do nothing to cut medical costs. It is, however, guaranteed to result in more, not fewer, cases of medical malpractice. Furthermore, federalizing tort laws will only result in the accretion of more power in the hands of the central government and the emasculation of the rights of states and individuals.

If Republicans are truly sincere in their commitment to protecting the rights and liberties of the American people against more and bigger government, they should resist any attempt to federalize the laws of medical malpractice.

BakersfieldNow.com had another article about the criminal prosecutions of nursing home employees who drugged against their will.  The article mentions that Kern Valley Hospital administrator Pamela Ott was charged Tuesday on eight felony counts of elder abuse for allowing staff to forcibly administer psychotropic medications to patients for their own convenience, rather than for their patients’ therapeutic needs.  The druggings led to the deaths of three nursing home residents.  Medical complications, including lethargy and the inability to eat or drink properly, resulted from the forced medications.  Twenty-two patients were given high doses, and one surviving patient was greatly harmed, the investigation determined.  Three other people were charged in February for their alleged roles in the case. All of the defendants worked for Kern Valley Healthcare District’s skilled nursing facility including the former director of nursing Gwen Hughes, former pharmacist Debbi Hayes and staff physician Dr. Hoshang Pormir.

Management at the nursing home ordered staff to give high doses of psychotropic medications to Alzheimer’s and other dementia patients to make them more tranquil and easier to control.  The medications were given to patients who argued, made noise or were otherwise disruptive.

"As hospital administrator, Pamela Ott was ultimately responsible for safeguarding the welfare of her patients," Attorney General Jerry Brown said in a news release. "Instead, Ott abdicated her responsibility and allowed the staff of the Kern Valley Hospital to forcibly sedate patients who questioned their care."

Prosecutors said last month that former pharmacist Hayes was placed on probation and agreed to cooperate with the attorney general’s office in its prosecution of the other defendants.

The NY Daily News had the tragic story of Verda Henry.  She entered a Westchester County nursing home in 2005 after she fell and injured her arm, thinking she would receive therapy and be home in a month.  Two years later, after repeated denied requests to go home, she in the  nursing home because of a horrific, infected bedsore.

Her daughter, Patricia Henry, said she and her children visited her normally active mother every day at Sutton Park, often for eight hours. The family complains that the facility was short-staffed.  "There would be a nurse and she would run between floors and they had no time," Henry said. "Nobody checks on her. Nobody feeds her. Every time we asked to take her home there was a reason we couldn’t."

One day, Patricia Henry went to change her mother’s gown and noticed the bedsore, already in an advanced stage, over her mother’s tail bone.   Within days the sore was infected and she heard her mother’s last words – screams – as doctors scraped at blackened skin.

"You could put your whole hand down in her back," she said. "You could see the bones and spinal cord. It was like raw meat. Mommy screamed until she couldn’t scream no more."   Henry wants justice for her mother, who died a painful death because of a negligent system.

Bedsores, or pressure ulcers, are lesions caused by unrelieved pressure on the skin. They are largely preventable with adequate nutrition and by making sure a patient is regularly moved or turned every two hours, but are also often fatal once infected.

 

 

 

There is a new study from WellPoint: Institute of Health Care Knowledge that shows why the U.S. spends so much on health care costs in comparison to other Western countries despite the quality being lower than in those countries.  The study states:

Despite the common belief that costs increase due to excess insurer profits, the aging of America and the high cost of medical malpractice, these factors have little if any impact on health care premiums. The key drivers of health care premium increases are advances in medical technology and subsequent increases in utilization, excess price inflation for medical services, cost-shifting, the high cost of regulatory compliance and patient lifestyles (e.g., physical inactivity and increases in obesity). Though still a factor, prescription drugs contribute less significantly to rising health care costs due to the increased use of generic medications.

Popular explanations for the upward spiral of health care and health insurance costs include the impact of an aging U.S. population, the high cost of medical malpractice insurance and “excess” insurer profits. None of these, however, is a primary driver of health care costs and the resulting rise in health insurance premiums.

Here is a copy of the study.  Tort reform does nothing to lower the cost of health care and medical malpractice awards do not affect the overall cost of health care.

We are pleased to have Adrienne Carlson, who regularly writes on the topic of nurse practitioner schools, write the following guest article.

It’s a situation that we hope never comes to our loved ones, but if we are practical, we know that it could happen to even the healthiest of us. When elderly family members become sick and infirm and need constant round-the-clock care, we may not be able to provide what they need because we are too busy with our lives, work, social commitments and families. So we do the next best thing, choose a nursing home that caters to their every need and keeps them in comfort for the rest of their lives. When it comes to choosing a nursing home for your loved ones, here are a few salient points to keep in mind:

Location matters: You’re going to want to visit frequently and check up on your loved one often. So choose a home that is near you, preferably not more than an hour’s drive away. The further your loved one is, the more you’re going to come up with excuses not visit and this could end up making your relationship deteriorate.

Check it out: Never choose a home without checking it out at least twice. If possible, take your loved one with you so that they too have a say in where they’re going to live. They may also want to move in with a friend or loved one who is in a nursing home, so take their wishes into consideration too. Loneliness can weigh heavily on their mind, so it’s important that they have a friend in the facility.

Talk to residents and staff members: Your instinct will tell you how good or bad a nursing home is. When you talk to people at the home, be it staff or residents, take in all their comments and answers without forming an opinion right away. Write down important aspects, then go home and discuss options with your loved one.

Think of the cost factor: If you expect Medicare or similar programs to pay for the nursing home, you will be restricted to choosing one that is approved by the state under the guidelines of these programs. Visit those close to your location and choose one that is clean and has good service. Also ensure that adequate medical facilities are available to provide care during emergencies and for common conditions that occur with old age.

Visit frequently: The only way to ensure that you’ve made the right choice of nursing home is to visit often and see that your loved one is well cared for and satisfied. If you’re not able to visit frequently, at least call and check if everything is ok.

Nursing homes are meant to be a home away from home for the elderly. So ensure that your loved ones are well taken care of when you put them in such facilities.

Adrienne welcomes your comments and questions at her email address: adrienne.carlson83@yahoo.com
 

HEALTHCARE REFORM AND MEDICAL MALPRACTICE:

• Medical malpractice has no place in the healthcare debate. Healthcare reform is about making sure that every American has access to quality, low-cost healthcare, not about limiting the legal rights of innocent patients harmed by medical negligence.

• Tort reform does not improve the quality of our healthcare system or produce cost savings. Forty-eight states have already enacted at least one medical malpractice tort reform measure. Yet, these legal restrictions have done nothing to improve our health care system—forty seven million Americans still have no health care, costs are still escalating and 98,000 Americans still die each year from preventable medical errors. Limiting the legal rights of injured patients will do nothing to fix these problems.

• Medical malpractice is about real people, with real injuries. The Institute of Medicine estimates that 98,000 people die each year in the US from preventable medical errors. And, this number does not even include the countless other people who are injured by medical errors. Rather than reforming the legal system that provides protections to these injured patients, we must focus on reforming the medical system in this country to prevent these errors from ever happening in the first place.

• There is no medical malpractice crisis. In 2008, medical malpractice payments accounted to 0.2 percent of all health costs – the lowest level on record. Furthermore, researchers at the Harvard University School of Public Health have found that nearly all medical negligence claims are meritorious, with 97 percent of claims involving medical injury and 80 percent involving physical injuries resulting in major disability or death.

• Americans should not have to give up rights, in order to gain the right to healthcare. President Obama has repeatedly stated that in America, healthcare is a right. Likewise, Americans should not have to relinquish their constitutionally protected 7th Amendment rights in order to gain access to quality healthcare.

• Lawmakers should focus on the key issues. Achieving consensus on the health reform is an extremely delicate balance. Lawmakers must not unnecessarily insert extraneous, controversial issues such as tort reform into an already complicated issue.

• Health courts would be an expensive, bureaucratic nightmare. They would exchange a patient’s constitutional right to a jury trial for a schedule of pre-determined outcomes that would be handed out by judges more interested in appeasing special interests than rendering justice to the injured patients standing before them. And health courts would not protect patients from wrongdoers, but instead, would shield doctors and hospitals from accountability for their careless, harmful acts. Health courts truly are an unfair proposition for patients.

For more information, go to www.peopleoverprofits.org
 

The Milwaukee-Wisconsin Journal Sentinel had an article about several nursing homes in Wisconsin providing powerful prescription drugs such as Fentanyl and OxyContin to patients without a doctor’s authorization, in violation of federal rules.   Federal rules on dispensing those drugs were not followed, including rules on filing required paperwork, according to an affidavit filed by the U.S. Drug Enforcement Administration’s Milwaukee office.

Drugs in the Wisconsin nursing home kits came from PharMerica, a nationwide pharmaceutical services firm with offices in Pewaukee, according to the affidavit.   Acting on a tip that the law was being broken, DEA agents searched PharMerica’s Pewaukee office and six nursing homes across Wisconsin in late July, according to documents.

The nursing homes were:

Beaver Dam Care Center in Beaver Dam; Colony Oaks Care Center in Appleton; Heritage Square in Greendale; Mount Carmel Milwaukee in Greenfield; Village Gardens in Green Bay; and Woodstock Health and Rehab in Kenosha.

PharMerica specializes in providing pharmacy services in institutions such as nursing homes. It is registered with the DEA to distribute controlled substances and is responsible to ensure they are distributed with a prescription, according to the affidavit.   It had net revenue of $1.9 billion and profits of $284.6 million in 2008, according to the company’s financial statements.

The infamous Golden Living, a company that runs nursing homes nationally, owns two of the nursing homes inspected by the DEA – Heritage Square and Beaver Dam.  In May, agents in the DEA’s Milwaukee office received a call from a tipster saying PharMerica was routinely breaking federal law by improperly delivering powerful schedule II drugs.  DEA agents found paperwork to back up the tipster. On May 13, agents visited PharMerica’s Pewaukee office and discovered unsigned prescriptions for schedule II controlled substances on the pharmacy operations manager’s desk.

A police report filed by PharMerica showed that a nurse had "dropped" one of the kits, containing OxyContin pills, and lost it. OxyContin is often sold on the street to illicit drug users.