Minnesota’s Star Tribune reported that a resident at Lake Ridge Care Center in Buffalo, Minn. did not receive her needed potassium-replacement medication which caused her premature death. The Health Department determined that Lake Ridge Care Center provided "inadequate medication administration."  The investigation also found mishandling of other medications for the woman and for several other residents at the home in late January and early February of the same year.

According to the report:

The woman entered Lake Ridge on Jan. 14, 2010, with diagnoses of congestive heart failure and low potassium. Her doctor’s orders that day called for her to receive three two-tablet doses of potassium a day. In all, the woman missed 26 of those doses over more than eight days.  She was sent to the emergency room on Jan. 23 for an "unresponsive episode." While there, she suffered a severely abnormal heart rhythm and died early that afternoon. Her potassium level was found to be extremely low when tested in the emergency room. Potassium helps to keep blood pumping through the heart. Her official cause of death was ruled cardiac arrest.

 

 

New polling concludes that the majority of Americans are concerned that the House Republican budget plan will adversely affect elderly Medicaid and Medicare recipients.  The Ryan budget turns the healthcare system for the elderly into a private program, which will double the cost of healthcare in 10 years for future seniors, according to the Congressional Budget Office.

The Ryan privatization plan is deeply unpopular: Polling found that Americans think they would be worse off if Ryan’s Medicare proposal is adopted by a margin of 57 percent to 34 percent — including 58 percent of electorally key independents who dislike the plan.

When informed about the cuts to Medicaid including forcing many seniors to be kicked out of their nursing homes, 63 percent of respondents said they were "very" concerned. That figure was 69 percent for seniors and 64 percent for independents.

In fact the pollsters found that while the Medicaid-nursing home question elicits the greatest concern, there are several issues that tip likely voters’ meters over into "very concerned" territory.

The ideas include that pre-existing medical conditions would no longer be covered, that Ryan’s plan privatizes Medicare, that Ryan’s budget hits seniors while sparing oil companies and that the Medicaid cuts would hurt children and the disabled in addition to the elderly.

 

 

WSPA had a story where they interviewed Bill Birmingham, COO of one of South Carolina’s largest nursing care providers, about Medicaid budget cuts.   He says that means no new patients and, possibly, force some elderly patients out of long term care facilities.

Nursing homes typically get about 70% of their funding from medicaid. The state reimburses that cost in terms of "permit days".  Next year each facility will get about 8% fewer days than the year before.  WSPA’s 7 On Your Side contacted dozens of Upstate providers who all said they would reduce the number of beds available to medicaid patients.

Birmingham said he thinks the state will end up with about 600 fewer beds in nursing homes. Other administrators have put that number closer to 800.

What is Nikki Haley thinking?

Many states are placing the financial burden of caring for seniors with Alzheimer’s from Medicaid to families.  But the shift will create new needs – additional support services for family caregivers, more home health workers, and new technologies and treatments to slow the disease’s relentless advance.  Such services keep seniors healthier longer and give caregivers – often spouses or adult children – a much-needed break. Alzheimer’s, a form of dementia, is a progressive disorder that, over time, strips away memory, judgment, language and the ability to perform the most basic tasks.

5.4 million Americans are diagnosed with Alzheimer’s, which affects 13 percent of adults 65 and older. Cost of their care runs $172 billion a year, including about $34 billion in state and federal Medicaid funds.

By 2050, the Alzheimer’s Association projects, about 16 million Americans – 16 percent of adults 65 and older – will have the disease. The numbers are rising because Americans are living longer and being diagnosed more accurately. But the cost of this care also will rise – topping $1 trillion annually. 

Alzheimer’s is the nation’s sixth-leading cause of death. While deaths from cancer, heart disease, stroke and other major killers have declined over the last decade, deaths from Alzheimer’s increased 66 percent from 2000 to 2008.

 For people who don’t require nursing home care, adult day programs help people in the early stages of dementia remain active for as long as possible.

The real hope is that someone will find a treatment that stops the disease in its tracks early or slows it down.   Source Cincinnati Community Press.

The State newspaper reported the investigation into the campaign contributions of South Carolina Lt. Governor Ken Ard.   His office is responsible for regulating and overseeing nursing homes in South Carolina.  The campaign donor list is primarily members of the nursing home industry and their lobbyists.  This is an inherent conflict of interest.  Attorney General Alan Wilson is investigating but it is doubtful that he will find wrongdoing against his fellow Republican.  See article from Go Upstate here.

Nearly all of the cash Ard raised came from nursing homes, elderly care providers and the South Carolina Health Care Association. Ard’s part-time job pays $46,545 and includes oversight of the state Office on Aging.

Some of the contributors now say they never gave Ard any cash.   The concern is that donors may have reached their legal limit on contributions and additional cash was shifted to another person’s name or the list was padded to show more donors than Ard really had, to give the illusion of more widespread support.  Some of the reported contributors were campaign workers.

Ard was charged more than 100 ethics violations for improper use of campaign money. Ard spent campaign cash after his November election on gaming equipment, a flat-screen television, a family vacation and football tickets, among other purchases. The fines took into account inaccurate statements made to ethics investigators.  Ard agreed to pay the state Ethics Commission a $48,000 fine and $12,500 to cover investigation costs.

 

The growing rehabilitation business is helpful for both patients and nursing homes. Seniors have somewhere to go short-term while they recuperate.  Nursing homes profit from serving more patients with higher-paying health coverage.  Seniors today stay healthier as they age, delaying the need for long-term care.

"The nursing homes are more and more focusing on the rehab portion of the long-term care business," said Steve Morrisette, president of the Virginia Health Care Association. "They’re always looking to provide the niche for what people need."

"Nine out of 10 older Americans want to stay in their home for as long as possible, and most do just that," said David DeBiasi, associate state director of advocacy for AARP Virginia. "The last desired possibility is a nursing home."

That leaves Medicaid, the state and federal government insurance for people with low incomes, to pay for most nursing-home patients: more than 60 percent in Virginia, according to the American Health Care Association. In 2010, Virginia’s Medicaid paid $793 million – or 12 percent of its expenditures – to nursing homes for long-term care of the elderly and disabled.

Many facilities are looking to increase their Medicare services and limit their Medicaid for really no other reason than the difference in reimbursement. Nursing homes gradually have been adding short-term rehabilitation services for years – since a change to Medicare’s payment policies encouraged hospitals to discharge patients sooner.

See The Virginian-Pilot article here.

Not Guilty!

By Ken Connor

Casey Anthony’s acquittal of the killing of her precious child, Caylee, has shocked the nation. Many who watched the trial on TV – and who were not constrained from taking into account inadmissible evidence, the punditry of various talking heads, or the overwhelming public sentiment against Ms. Anthony – have been critical of the jury’s verdict. Among those most vehement in their condemnation of the jury are TV notables Bill O’Reilly and Nancy Grace. Their indignation is shared by those who feel the verdict represented a gross miscarriage of justice.

Cases like this call the value of trial by jury into question for some. But critics should take some important points into consideration: In American jurisprudence, an accused wrongdoer is presumed innocent. The burden is on the prosecution to prove guilt beyond and to the exclusion of every reasonable doubt. The jury is not permitted to consider evidence that doesn’t reach a certain threshold of reliability and they aren’t permitted to take into account matters outside the evidence. They aren’t entitled to discuss the case among themselves, or even form an opinion about the case, until all the evidence is in. They can’t discuss the case with anyone other than their fellow jurors, and if any reasonable doubt exists about the crime(s) charged, they cannot convict. It is not enough for the jury to "know" that the accused is guilty as charged. The charges must be proved beyond a reasonable doubt. Most freedom loving people agree that these are important safeguards which must be met before one accused of a crime can be deprived of their life or liberty.

Trial by jury is not a recent phenomenon. It dates back over a thousand years, and its use has been documented in a variety of civilizations. The right to trial by jury has been particularly prominent in the American system of law and justice. When the Founders enumerated their grievances in the Declaration of Independence, King George’s denial to the colonists of the right to trial by jury was in the forefront of their complaints. George Mason famously refused to sign the Constitution unless the right to trial by jury was made explicit. Thomas Jefferson made clear the value he placed on juries when he said, "I consider trial by jury as the only anchor yet imagined by man by which a government can be held to the principles of its Constitution." Its importance is highlighted by the fact that the right to trial by jury is expressly referenced in not one, but three of the amendments that comprise the Bill of Rights.

As Americans, we tend to take the right to trial by jury for granted; but it should not difficult to imagine the horror of living in a society in which the State possesses absolute power. Millions of people around the world live in societies that don’t allow for trial by jury. When they are accused of wrongdoing, they aren’t afforded an opportunity to defend themselves. No jury of their peers decides their guilt or innocence. Their lives and freedom are subject to the whims of those who hold power. Their tribunals – if they exist at all – are mere kangaroo courts which serve only as an eye wash. "Verdict first, trial later" is their modus operandi. Even here in America there was a time when perverted justice prevailed, when the word of a single white man could spell death for a politically and legally powerless African American.

This is why the right to trial by jury is essential.

Our Founding Fathers recognized that the collective judgment of ordinary people, while not perfect, is the most reliable, most just method of resolving conflicts in America’s courtrooms. Does the jury system and its protections mean that sometimes the guilty will go free? The answer is yes. Alan Dershowitz addressed this in a recent article discussing the Casey Anthony verdict:

"For thousands of years, Western society has insisted that it is better for 10 guilty defendants to go free than for one innocent defendant to be wrongly convicted. This daunting standard finds its roots in the biblical story of Abraham’s argument with God about the sinners of Sodom. Abraham admonishes God for planning to sweep away the innocent along with the guilty and asks Him whether it would be right to condemn the sinners of Sodom if there were 10 or more righteous people among them. God agrees and reassures Abraham that he would spare the city if there were 10 righteous. From this compelling account, the legal standard has emerged."

A justice system that allows for the possibility of the guilty going free is undoubtedly unpalatable for those who wish to see Caylee Anthony’s death avenged, but it is a standard that recognizes and upholds the notion that life and liberty should not be deprived without due process of law. It’s not a perfect system, but none better has yet been devised by man.

Ken Connor is an attorney and co-author of "Sinful Silence: When Christians Neglect Their Civic Duty" He is also Chairman of the Center for a Just Society. For more articles and resources from Mr. Connor and the Center for a Just Society, go to www.centerforajustsociety.org

 

The Minnesota Star Tribune reported Augustana Health Care Center failed to properly care for a resident who fell out of his wheelchair and suffered a fatal head injury last March, according to a state investigation. Staff  "did not assess, monitor and treat [the resident] in a timely manner" after his March 8 fall, according to the Minnesota Health Department’s Office of Health Facilities Complaints.

In addition to citing the home for neglect, the agency noted its history of "substantial past noncompliance" by failing to meet professional standards for handling head injuries.  The man died March 10 of a "massive intracranial hemorrhage," or bleeding that put pressure on his brain and deprived him of oxygen, according to the investigation and death certificate.

Nursing homes must monitor a resident’s condition.  Nursing homes must assess residents after a fall.  Nursing homes must recognize changes in a resident’s condition. 

Four hours after the man fell, his condition deteriorated significantly. He was taken to a hospital and died two days later.

 

The National Institute on Aging (NIA), part of the National Institutes of Health, has some advice for helping older people avoid heat-related illnesses, known collectively as hyperthermia.

Hyperthermia occurs when the body overheats. Conditions involving hyperthermia have different names, including heat stroke, heat fatigue, heat syncope (lightheadedness or fainting in the heat), heat cramps and heat exhaustion.

Risk of heat-related problems increases with age.  Older people can face risks related to hot weather. As people age, their bodies lose some ability to adapt to heat. They may have medical conditions that are worsened by heat. And their medications could reduce their ability to respond to heat.

Health-related factors that may increase the risk of hyperthermia include:
Pre-existing diseases such as congestive heart failure, diabetes and chronic obstructive pulmonary disease
Decreased ability to move around
Dementia or cognitive impairment
Certain medications that may cause dehydration or that may affect the responses to heat by the heart, blood vessels or sweat glands.
Being substantially overweight
Drinking alcoholic beverages
Being dehydrated
Age-related changes in the skin, such as decreased functioning of small blood vessels and sweat glands

Lifestyle factors that can also increase the risk of hyperthermia include hot living quarters, lack of transportation, overdressing, visiting overcrowded places, and not understanding how to respond to weather conditions. Older people, particularly those at special risk, should pay attention to any air pollution alert in effect. People without fans or air conditioners should go to shopping malls, movie theaters, libraries or other places with air conditioning. In addition, they can visit cooling centers which are often provided by government agencies, religious groups and social service organizations in many communities.

Heat stroke is an advanced form of hyperthermia. It occurs when the body is overwhelmed by heat and unable to control its temperature. In heat stroke, the body temperature is at least 104 degrees Fahrenheit. Someone with heat stroke may have a strong rapid pulse, lack of sweating, dry flushed skin, faintness, staggering and mental status changes such as confusion, combativeness, disorientation or even coma. Seek immediate medical attention for a person with any of these symptoms, especially an older adult.

If you suspect that someone is suffering from a heat-related illness:
Move them into an air conditioned or other cool place
Urge them to lie down and rest
Remove or loosen tight-fitting or heavy clothing
Encourage them to drink water or juices if they are able to drink without choking, but avoid alcohol and caffeine
Apply cold water, ice packs or cold wet cloths to the skin.
Get medical assistance as soon as possible.

The Low Income Home Energy Assistance Program (LIHEAP) within the Administration for Children and Families in the U.S. Department of Health and Human Services helps eligible households pay for home cooling and heating costs. Individuals interested in applying for assistance should contact their local or state LIHEAP agency. For more information, go to www.acf.hhs.gov/programs/ocs/liheap/ or www.acf.hhs.gov/programs/ocs/liheap/brochure/brochure.html.

For a free copy of the NIA’s AgePage on hyperthermia in English or in Spanish, contact the NIA Information Center at 1-800-222-2225 or go to http://www.niapublications.org/agepages/hyperther.asp, or www.niapublications.org/agepages/hyperther-sp.asp for the Spanish-language version.

The NIA leads the federal government effort conducting and supporting research on aging and the health and well-being of older people. The Institute’s broad scientific program seeks to understand the nature of aging and to extend the healthy, active years of life. For more information on research, aging, and health, go to www.nia.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

 

Matthew Reed writes articles for http://lpntornbridge.org/, a website dedicated to providing students with the information and tools needed in order to pursue their LPN to RN program.  He sent us the latest article called " 25 Reasons to Become An RN".  

With 2.6 million jobs and counting, the career path of the registered nurse (RN) can take a whole host of paths in the medical field. With hiring opportunities in hospitals, doctor’s offices, nursing homes, labs, clinics, specialty care facilities, and more, becoming an RN can be as rewarding as the nurse or student themselves dictates. However, with loads of different careers from licensed practical nurse to nurse practitioner available and in demand, which is the best for you?

To help those considering a move into the world of the registered nurse, we have gathered the below 25 reasons to become an RN. They include many statistics, figures, and even words of wisdom from registered nurses themselves on the subject. So whether you’re looking for an anecdote or just some serious salary information, they are all contained in the article.