The L.A. Times had an article on the future need for more health care workers.  “The healthcare industry will spawn 5.6 million new jobs by 2020 – most of them high-paying – but most unemployed Americans won’t have the expensive schooling necessary to land them.”

A new report from Georgetown University’s Center on Education and Workforce reveals the following:

–Americans pay more per capita for healthcare than the average Chinese citizen earns in an entire year;

–The healthcare industry makes up 18% of the U.S. economy;

–Including support positions, such as hospital accountants, pharmaceutical sales representatives, doctor’s office secretaries and more, 13% of all U.S. jobs will be in healthcare.

–82% of the expected influx of jobs will require post-secondary education and training. Even nursing candidates, whose opportunities will increase 26%, will need advanced degrees.

–Healthcare also has the highest percentage – 22% – of foreign-born employees compared with other sectors.

The pay gap is enormous,” said lead author Anthony P. Carnevale in a statement. “The average professional worker makes 2.5 times as much as the average support worker.”

 

Kaiser Health News reported a study from the National Institute of Medicine that shows that the U.S. health care system is not prepared for future mental health needs based on demographics and lack of specialists. Aging patients will not receive treatment for depression, dementia and other conditions. “In addition, some experts are concerned that the baby boomer population, which is a growing component of the nation’s older demographic, have an unaddressed problem with substances – namely misuse of prescription medications.”

The Institute of Medicine report says all health workers who see older patients — including primary care physicians, nurses, physicians’ assistants and social workers — need some training to recognize the signs of geriatric mental health problems and provide at least basic care. To get there, it called for changes in how Medicare and Medicaid pay for mental health services, stricter licensing requirements for health workers, and for the government to fund appropriate training programs.

The government is pushing to improve mental health staffing for military veterans, an especially vulnerable subset of the elderly population. In April, the Department of Veterans Affairs announced that it would add around 1,900 psychologists and other staff.

The Washington Post also had an article on the study.  The article states at least 5.6 million to 8 million Americans age 65 and older have a mental health condition or substance abuse disorder

Brown University released a study funded by the National Institute on Aging and published in the May 14th edition of the Archives of Internal Medicaine.  The new study led by Brown University researchers reports that percutaneous endoscopic gastric (PEG) feeding tubes may make the pressure ulcers more likely to develop or not improve.

“This study provides new information about the risks of feeding tube insertion in people with advanced cognitive impairment,” said lead author Dr. Joan Teno, a gerontologist and professor of health services, policy, and practice in the Public Health Program at Brown. “We see a substantial risk of people developing a stage II and higher pressure ulcer. We believe these risks should be discussed with family members before a decision is made to insert a feeding tube in a hospitalized nursing home resident with advanced cognitive impairment.”

Over a particular timeframe, they compared thousands of patients with and without ulcers who received a feeding tube to three times as many statistically similar patients with and without ulcers who did not get a tube.

–35.6 percent of those with a feeding tube ended up with at least a stage II ulcer.

–19.8 percent of patients without a feeding tube did.

The chance of getting an ulcer was 2.27 times higher for people with feeding tubes than for those without. The risk of developing a more serious stage IV ulcer was 3.21 times higher for those with feeding tubes compared to hospitalized nursing home residents without a feeding tube.

Among patients who already had an ulcer, the researchers found that 27.1 percent of patients with a feeding tube saw short-term improvement, but 34.6 percent of those without a feeding tube experienced healing in a comparable timeframe.

The odds of an ulcer getting better for people with a tube were 0.7 times as high for people without a tube, meaning their chances for improvement with a tube were less than for people without a tube.

The new findings should lead doctors, nursing homes, and families to ask more questions about whether feeding tubes are appropriate treatments, compared to careful hand feeding with assistance and encouragement, for patients who have become so cognitively impaired that they can no longer eat independently.

 

The L.A. Times reported on a new survey with a surprising result:  Elderly Americans on Medicare are substantially happier with their insurance coverage than their younger counterparts who rely on commercial insurance.   Americans feel they have much better access to medical care through Medicare than do Americans who rely on private coverage.  Medicare recipients are more likely to rate the quality of their care as excellent and less likely to report problems paying their medical bills or accessing needed care because of cost.

Commonwealth Fund president Karen Davis, lead author of the report published in the journal Health Affairs. “It is important to remember how well Medicare performs.”

33% of people who bought insurance on their own reported unhappiness with their coverage.   20% of those with employer-based coverage gave their insurance plan low marks.
Only 8% of Medicare beneficiaries 65 or over rated their coverage “fair” or “poor,”.

Republicans, including former Massachusetts Gov. Mitt Romney, the presumptive GOP presidential nominee, want to convert Medicare into a what they call a “premium support” program that gives beneficiaries vouchers to buy a private insurance plan of their choosing.

 

The Daily Beast and About.com have published interesting articles that address the tricky subject of sex in nursing homes. As the article on About.com explains, many long term care residents will spend the remainder of their lives in a nursing home so the responsibility falls to the facility to ensure that their residents live the rest of their lives with as much dignity and enjoyment as possible.  The nursing home is their home.

However, nursing home residents face many obstacles to enjoying themselves in a safe environment.  Doors without locks, single beds, and roommates all serve as structural obstacles to normal consensual sexual activity.  Additionally, as The Daily Beast explained, residents of nursing homes are frequently treated as children and their sexual desires are ignored or discouraged.

Dementia further complicates things.  Residents suffering from the disease may be more aggressive and violent, and are a greater risk of being impulsive.  Also, memory loss from dementia can cause a resident that has been married for years to forget that he or she has a spouse or cause them to mistake another resident for an intimate partner.  More importantly, the inevitable problem of sexual abuse of a vulnerable adult makes sex in a nursing home even more difficult to control.

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Iowa’s CBS 2 KGAN news reported on yet another incident of a nursing home employee stealing drugs from residents.  Darla Frotmann, an employee of Sunnycrest Manor in Dubuque county has been arrested and accused of stealing prescription pain medications.

In an interview with police Frotmann admitted stealing more than 250 pills during the time she worked at the facility. Even more incredible is the fact that Frotmann was previously charged with a misdemeanor count of prohibited acts with prescription drugs earlier this year, yet she was not only permitted to work at the facility, but trusted to work in an environment where she was constantly around prescription medications.

The case exemplifies the lack of concern nursing homes show when hiring staff to work with and around vulnerable adults. Incidents like this really show the dire need for nursing homes to conduct more stringent background checks and to use better judgement and higher standards when hiring people to be trusted to care for a family’s loved one.

Libby Mead of Killer Infographics Social Media and Marketing Manager wanted us to share an infographic about Alzheimer’s that her company finished putting together for Fedelta.  It is about the history of Alzheimer’s and research that has gone into understanding this horrible disease.

 

Alzheimer’s has been affecting one in every eight elderly Americans since it was first publicly diagnosed in 1910. So much so that it has become the 6th leading cause of death in the US. Today, senior care for Alzheimer’s patients has grown to over $200 billion annually.  The infographic explains the decades of breakthroughs toward Alzheimer’s research, as well as the endless community building and programs created by its awareness over that time. Take a look and see how far we have come and how much further we will be able to progress toward a cure to Alzheimer’s
 

The New American Magazine reported on the positive benefits that animal-visit therapy can have on nursing home residents.  For residents that will have to spend a significant amount of time in a nursing home it is important for the facility to feel as much like home as possible. This means allowing family members to visit as much as possible. Jamie Snow the Assistant Director of Child Life and Social Work at Texas Children’s Hospital explains, “When there is a patient in the hospital for a significant amount of time, we think it is important to have their entire family here. And some people consider pets family members.”

Many health care professionals agree that good health is not just dependent on medical care but also depends on social, psychological, and behavioral aspects. Research has found that behavior such as the loving and sympathetic connection between humans and domesticated animals can have many positive health benefits.

The article explains, “For many years now it has been recognized that letting nursing home patients hold and pet cats and dogs has been shown to have strong therapeutic effects upon the patients.”

In the past, many people have been leery of the potential hygiene issues that pets could pose in a health care facility.  However, experts have established safe protocols to make pet therapy visits safe for nursing home residents and the animals.  Precautions such as ensuring the animal has current vaccines, regular baths, and preforming a “behavior check” to make sure the animal has the right temperament can make animal therapy safe for nursing homes.

Jean Pottinger, an infection prevention expert from the University of Iowa Healthcare, explained the safety of pet therapy saying, “There has never been an instance of a pet bringing any infection into the hospital.”

New Jersey’s Fair Lawn Patch News reported that an employee of Maple Glen Center nursing home in Fair Lawn has been charged with forgery, theft, and impersonation after she allegedly conned more than $100,000 from a resident.  Kye Giacalone worked as the admissions director at the facility when she “befriended” the resident and gained power of attorney. She then used it to open credit cards in the victim’s name which she paid for with money from the man’s bank account.  Fair Lawn followed it up with an article that reported charges include four counts of forgery, four counts of impersonating another and one count of second degree theft.

Even after the resident moved to another nursing home Giacalone continued to steal money from his account to purchase personal items for herself. Incredibly, the administrator of Maple Glen Center claimed that the facility had not suspected any wrong doing until the day police came to the facility to arrest Giacalone.

The administrator defended the facility’s judgment saying, “All Maple Glen Center employees are subject to a background check.”   Incidents such as this one show that the background check policies that many nursing homes have in place are not serving their intended purpose-to prevent harm and protect the residents.

Employing a higher standard of people should be made a top priority especially when these are the people entrusted to care for a family’s vulnerable loved one.

Mercury News reported that Creekside Health Care and its parent corporation, Mariner Health Care in San Pablo, California is facing a lawsuit for understaffing which caused multiple problems at the facility.  Five families blame the lack of staff subjected residents to abusive and inhumane conditions.  The families allege that inadequate staffing levels at the facility caused residents to be neglected for long periods of time, often left to sit in their own feces and urine.  The staff, to compensate for the lack of staff, caused residents to be over medicated known as a chemical restraint. Nursing home workers were also unable to turn or reposition as needed so many residents developed pressure ulcers that would otherwise have been easily preventable.

The suit also explains that a lack of staff allowed a visitor to sexually assault four residents from as long as January until May 2010. The lawsuit states, “During the assaults, residents screamed for help, sometimes for more than thirty minutes, but no one came.”   It is outrageous that residents were screaming for someone to help them and no one was able or willing to intervene.

All too often national for-profit nursing home facilities controlled by corporate ownership are only motivated to generate greater profits.  This disregard of resident care is exemplified by by cutting labor costs and reducing staffing.