AARP published an article on their website about the GAO Report detailing the lack of regulatory oversight for the emerging and very profitable assisted living industry.

“State Medicaid agencies are required to protect the health and welfare of residents in their assisted living facilities, including monitoring cases of abuse, neglect or exploitation. Yet 26 state agencies could not tell federal investigators how many critical incidents of this kind had occurred in the homes and other places under their supervision, the U.S. Government Accountability Office reported this week.”

State agencies also varied in what types of incidents they monitored, the GAO found. “A number of states did not identify other incidents that may indicate potential harm or neglect, such as medication errors [seven states] and unexplained death [three states],” says the report titled “Medicaid Assisted Living Services.”  See GAO Report on ALFs.

“Thirty-four states made information about critical incidents available to the public by phone, website or in person,” the report says, “while another 14 states did not have such information available at all.”

The reporting gaps prompted the GAO to recommend that federal officials keep a closer watch on state agencies to see that they properly monitor conditions in nursing homes and other facilities to protect residents.

The investigators recommended clarification of state requirements and annual reporting of critical incidents. Officials at the Department of Health and Human Services concurred with the need to clarify and said they would consider requiring yearly state reports.

Agencies in 48 states reported spending more than $10 billion on assisted living services in 2014, covering more than 330,000 beneficiaries.

Freelance Contribution by Anna Kucirkova, for Bay Alarm Medical

Originally Published: October 2, 2017

It’s an unfortunate reality that many seniors find themselves terribly isolated. After a spouse passes away or a debilitating illness hits, it’s common for a senior to be cut off from both friends and family for extended periods of time. Obviously, this isn’t intentional on anyone’s part – it’s simply a disheartening reality.

Isolation is not limited to just a few seniors – it’s a significant, widespread problem. As Sarah Stevenson writes:

According to the U.S. Census Bureau 11 million, or 28% of people aged 65 and older, lived alone at the time of the census.

As people get older, their likelihood of living alone only increases. Additionally, more and more older adults do not have children, reports the AARP, and that means fewer family members to provide company and care as those adults become seniors.

Additionally, living in isolation cause serious problems for older adults:

  • Increased risk of death
  • Mental and physical health problems
  • Possibility of elder abuse
  • Long term illness
  • Depression
  • High blood pressure
  • Unhealthy behaviors
  • And more

It’s a problem that can’t be ignored, but it also presents some significant challenges. If you’re caring for an older adult, how you ensure they receive regular connection with other people? How can they live alone without constantly feeling alone?

Here are 6 simple ways to help older adults feel connected.

Arrange Transportation To and From Social Activities

Perhaps the biggest challenge for many seniors is transportation. As they get older, their eyesight often dims and their reflexes slow. They may voluntarily choose to stop driving or be forced to. And while this may make the roads safer for others, it causes them to keenly feel how alone they are and prevents them from being with friends.

One of the most effective ways you can help the older adult in your life is by making transportation available to them. This can be done in a number of simple ways:

  • If you live near them, offer to regularly drive them to and from different social functions.
  • Create a network of friends who are willing to occasionally drive them to events. Schedule this transportation to ensure it happens on a regular basis.
  • Help them learn the ins and outs of public transportation.
  • Find out if community or senior centers offer support services.

Lisa Esposito writes:

If you’re concerned that a neighbor – or distant family member – is at risk for isolation, contacting the town’s senior center is a good starting point. Many senior centers have social workers to put it all together by determining people’s needs and plugging into the right resources. States offer a variety of services for seniors. “In Massachusetts, we have aging service access points,” [geriatric worker Carrie] Johnson says. Following an assessment, people are connected to Meals on Wheels, homemaker services (which vary by state but may encompass chores like cleaning, laundry and maintenance), grocery-shopping and other programs. They might need personal care assistants to help with bathing. All these providers add to a person’s support system, Johnson says, “both social and kind of eyes on the ground.”

Given that transportation is one of, if not the biggest challenge, meeting this need alone can go a long way toward solving the isolation issue.

Encourage Attendance At Places Of Worship

While this one will only apply to older adults who are religious, it’s certainly a healthy practice. Given the weekly rhythms of most places of worship, they offer a constant, positive place to find social interaction.

Additionally, many attendees of these places are more than willing to help transport seniors to and from their functions. They see it as a way of caring for those in their midst.

Finally, some churches will have ministries specifically geared toward older adults, including transportation to functions, visits from members, and more. You can help the senior in your life avoid isolation by connecting them to a church, mosque, synagogue, or other place of worship where they’re comfortable.

Encourage Ownership

One of the great challenges of growing older is that you aren’t caring for others as much. When you were younger, you took care of kids or a spouse or house or employees, but as you get older those things tend to fade. The only person depending on you is you.

This can cause older adults to feel unimportant, not needed or wanted, and purposeless. They no longer have anyone depending on them, which can cause them to feel apathetic.

One simple way to help seniors avoid isolation and give them a sense of being needed is to give them a pet. The pet provides companionship and is dependent on the owner for feeding, hygiene, and exercise.

Aging Care notes:

Psychologist Penny B. Donnenfeld, who brings her golden retriever mix Sandee to her New York City office, has even witnessed animals’ ability to rev up elder owners’ memories. “I’ve seen those with memory loss interact and access memories from long ago,” she says. “Having a pet helps the senior focus on something other than physical problems and negative preoccupations about loss or aging.”

Additionally, having a pet can create new social connections. It’s not uncommon for one dog owner to stop and talk to another dog owner, which can sometimes lead to friendship.

By giving an older adult a pet, you can give them have a fresh sense of being needed, which can infuse life and energy back into them.

Help Them Volunteer

One wonderful way to connect isolated seniors with people is to ask them for help. Volunteering allows them to meaningfully contribute to the lives of others, which can give them a renewed sense of purpose and worth.

The volunteering doesn’t need to be complex. Depending on the health of the person, some options include:

  • Local schools
  • The local library
  • The humane society
  • The local hospital
  • Religious places of worship
  • The Girl Scouts/Boy Scouts

If they have a particular skillset, such as accounting or counseling, connect them those who need help in these areas.

There are hundreds of needs that aren’t being met, and older adults can easily fill those gaps.

Encourage Their Health

Fewer things create more isolation than poor health. When an older adult has an ongoing health problem, they’re much less likely to maintain social contact, often because of discomfort. Additionally, hearing and vision loss can make it challenging and even embarrassing for them to interact with others, causing them to stay away.

One simple way to combat this is to encourage their health in as many ways as possible. Regularly check in on them, asking them how they feel and then paying close attention to any symptoms you notice. Ensure they have a way to get to doctor’s appointments and help them get hearing and vision tests.

If they need adaptive technology, such as a walker, hearing aid, or wheelchair, do everything in your power to provide this for them.

Encouraging exercise can also give them enormous benefits. Allison Miller notes:

Research shows multiple benefits of increased physical activity for older adults. A study published in the Archives of Internal Medicine followed older adults’ physical activity longitudinally over 18 years (Stessman, Hammerman-Rozenberg, Cohen, Ein-Mor, & Jacobs, 2009).

The research showed that older adults who exercise not only have an increased life span but also experienced a decrease in falls, fractures, and joint and musculoskeletal pain –

(Stessman et al., 2009). In addition, research shows that balance training decreases fall occurrences (Sherrington et al., 2008). Stessman et al.’s (2009) research also demonstrated that as little as 4 hours per week is as effective as more intensive and time-consuming exercise.

By nurturing their health, you can prevent loneliness.

Stay In Touch With Neighbors

Neighbors can be a helpful safety net for seniors. They can keep an eye out for any unexpected problems, check in on the person, and even help with simple household chores. Additionally, the neighbors can help get the senior involved in the community, which can be especially helpful if you live some distance away.

Connecting the senior with the those around them can put extra eyes on them in case something goes wrong.


Getting older can be difficult, especially if you’re alone. Loneliness and isolation can create health problems, a sense of purposelessness, depression, and a host of other issues. It’s something to be taken seriously.

Thankfully, there are actions that can be taken to ensure the seniors in your life don’t experience those things. These actions don’t need to be complicated or labor intensive. They simply require some thought and intention.

Betty Friedan said, “Aging is not lost youth but a new stage of opportunity and strength.”

We wholeheartedly agree.

The Times Herald-Record had an article on Sapphire Nursing and Rehab at Goshen.  The residents’ experience includes being “caked in excrement for hours, waiting 30 minutes or more for aides to respond to call bells, getting meals an hour late, receiving the wrong food, and wandering off unattended for extended periods.”  The allegations come after the state Health Department’s recently launched investigation into complaints at the 120-bed home following significant staff cuts by its new owners.

A renowned nursing home researcher said the home’s staffing levels appear to be potentially hazardous and below safe industry standards.  “They have very bad, dangerous staffing,” said Charlene Harrington, an emeritus professor of nursing at the University of California San Francisco, who helped the Record analyze the home’s staffing data. “They’re going to have a lot of bad things happen with those staffing levels.”

“The care of my mother by the new owners has made me sick,” said Majorie Fox of the Town of Wallkill, whose mother, Florence, is a Sapphire resident. “I have been to the doctor with high blood pressure. I’ve spoken about the cuts to everyone at Sapphire and the Department of Health when they were there.”

Sapphire Regional Administrator Jay Pepper acknowledged the home’s new owner, Goshen Operations, LLC – which bought the former Elant home and its three sister facilities in the fall – had “hit some bumps in the road” with staff resignations and “slight” staff cuts.

Between layoffs and resignations from September to December, Sapphire’s nurse tally plummeted 54 percent to 15 licensed practical nurses and two registered nurses, who are supervisors, according to 1199 SEIU United Healthcare Workers East, the employees’ union. Before the cuts, there had been 12 RNs and 25 LPNs, the union said.  In addition, more than a half-dozen of the home’s leaders and staff members, from administrators to kitchen help, have either resigned or been laid off since mid-December, and the home’s certified nursing assistant total is down 10 to 59, according to the union.

In recent weeks, the Record has communicated with about a dozen current and former staff members, relatives of residents and one former patient. The consensus: The home has skidded far and fast downhill since new owners took over in September.  Goshen Operations, LLC, promised “no significant changes to staffing levels” to the state Department of Health when it bought the four facilities in the fall.

Based on a full home, in a typical day, Sapphire’s Goshen location provides 1.87 hours of care per patient per day from CNAs, 0.73
from LPNs and no dedicated non-supervisor RN hours. The home should provide 2.58 from CNAs, 0.71 from LPNs and 1.32 from RNs based on the home’s federally reported acuity level, Harrington said.   Harrington said “the facility appears to have over-reported its staffing by a lot” to the federal government, based on Sapphire’s Medicare filings. “You can compare what the union reports as actual staffing with what they should have and see that they only have a small percent of what they should have.”



New York Magazine had an article on Trump’s lack of response to the opioid crisis.  His indifference is killing people.  Since taking office, Trump has put far more effort into promoting policies that would exacerbate the opioid epidemic than into ones that would mitigate it.

“The year Donald Trump was elected president, drug overdoses killed 63,600 Americans. That was 21 percent more drug deaths than America had seen in 2015, which had been the worst year for such fatalities in our nation’s history. It was also more unnatural deaths than gun violence, HIV/AIDS, or car accidents had ever caused in the United States in a single year. The scale of devastation wrought by the opioid epidemic was so vast, life expectancy in the United States fell for the second consecutive year — the first time that had happened since the early 1960s.”

The death toll will grow in 2017, according to preliminary data from the Centers for Disease Control and Prevention.  If the use of synthetic opioids like fentanyl continues to grow at its current rate, Stat News forecasts that more than 650,000 Americans will die from drug overdoses over the next decade.  In 2015 alone, the opioid crisis cost the American economy $504 billion, according to the White House Council of Economic Advisers.

“The drug-overdose crisis is concentrated in white, rural America (a.k.a. Trump Country). And on the campaign trail, the GOP nominee pledged to make ending the drug crisis a top priority of his administration. But since taking office, he has put far more effort into promoting policies that would exacerbate the epidemic than into ones that would mitigate it.”

“The president has tried to pass trillion-dollar cuts to Medicaid, one of the top sources of funding for addiction treatment in the United States; called for reducing spending on preventative anti-drug measures; proposed slashing the budget for the Office of National Drug Control Policy by 95 percent; neglected to nominate anyone to lead the Drug Enforcement Agency; declined to implement the vast majority of his own opioid-commission’s recommendations; declared the opioid crisis a “public health emergency” — but refused to ask for a single penny in additional funding to combat the crisis, even as he called on Congress to add $1.5 trillion to the deficit for the sake of cutting taxes; and put Kellyanne Conway, a career pollster and pundit — with no experience in public health — in charge of his administration’s opioids agenda.”

• Lawmakers “who have been leaders on opioid policy,” like West Virginia senator Shelley Moore Capito, “haven’t seen outreach from Conway or her cabinet.”

• One of the few people working on Trump’s “public education campaign” is “Andrew Giuliani, Rudy Giuliani’s 32-year-old son, who is a White House public liaison and has no background in drug policy.”

• The office’s big idea for combating the drug-overdose crisis is a “just say no”–style ad campaign, which would have premiered during the Super Bowl broadcast, if Conway’s staff hadn’t failed to put it together in time.

There is a long list of evidence-based reforms that he could implement to save thousands of Americans from its ravages. To take just one example, the most effective remedy for opioid addiction, bar none, is medication-assisted treatment (MAT). Under MAT, addicts are provided with methadone and buprenorphine — less powerful opioids that satiate most addicts’ cravings, and arrest their withdrawal symptoms, without inducing heroin’s debilitating, euphoric high. Decades of research, the World Health OrganizationCDC, and National Institute on Drug Abuse have all demonstrated MAT’s efficacy. Some studies suggest that the treatment reduces mortality among drug addicts by more than 50 percent. And yet, the therapy is only available in about 10 percent of America’s conventional drug-treatment facilities.

The New York Times had an incredible (and scary) article on assisted living facilities. Billions of dollars in government spending is flowing to assisted living industry even as it operates under vague standards and limited supervision. “Federal investigators say they have found huge gaps in the regulation of assisted living facilities, a shortfall that they say has potentially jeopardized the care of hundreds of thousands of people served by the booming industry.”

The federal government lacks even basic information about the quality of assisted living services provided to low-income people on Medicaid according to the Government Accountability Office, a nonpartisan investigative arm of Congress.  The report provides the most detailed look to date at the role of assisted living in Medicaid, one of the nation’s largest health care programs. Titled “Improved Federal Oversight of Beneficiary Health and Welfare Is Needed,” it grew out of a two-year study requested by a bipartisan group of four senators.  See GAO Report on ALFs here.

States reported spending more than $10 billion a year in federal and state funds for assisted living services for more than 330,000 Medicaid beneficiaries, an average of more than $30,000 a person, the Government Accountability Office found in a survey of states.

States are supposed to keep track of cases involving the abuse, neglect, exploitation or unexplained death of Medicaid beneficiaries in assisted living facilities. But more than half of the states were unable to provide information on the number or nature of such cases.

Just 22 states were able to provide data on “critical incidents — cases of potential or actual harm.” In one year, those states reported a total of more than 22,900 incidents, including the physical, emotional or sexual abuse of residents.

Congress has not established standards for assisted living facilities comparable to those for nursing homes. In 1987, Congress adopted a law that strengthened the protection of nursing home residents’ rights, imposed dozens of new requirements on homes and specified the services they must provide.

The Orlando Sentinel had an article about the need for enforceable Resident Rights in Florida (and elsewhere!).  Because of facilities with track records of putting their patients in danger, some advocates and industry experts want to change the Florida Constitution, adding a nursing home and assisted-living facility residents’ bill of rights. Doing so, they say, would not only add more protections, but it also would shield residents from state legislators and presidential administrations that might roll back existing regulations under pressure from the nursing home industry.

The public is completely in the dark about what happens in some of these facilities,” said Brian Lee, a former nursing-home watchdog for the state who now heads the national advocacy group Families for Better Care. “Even the tragedy of 12 nursing home residents dying from neglect after Hurricane Irma — deaths that were categorized as homicides — has not been enough to shame the industry into making changes.”

The Rehabilitation Center at Hollywood Hills in South Florida was evacuated Sept. 13 after power was knocked out by the storm and temperatures inside soared. A dozen elderly residents ultimately succumbed to heat exposure; one had a body temperature of 109.9 degrees. That facility is still fighting to keep its license.

It also prompted the governor to ask the state’s Constitution Revision Commission — which examines the Florida Constitution every 20 years for possible changes — to look at whether there are ways that the document could offer better protection for residents of long-term care facilities.

Proposal 88 establishes the right for residents to be treated “courteously, fairly and with the fullest measure of dignity,” given “adequate and appropriate health care” and live in “a safe, clean, comfortable and homelike environment” with “reasonable precautions” against natural disasters and extreme climatic conditions. , which is now being aired in public hearings throughout the state. If approved by the commission, it would go before voters in November.

It also says residents have the right to access courts, have speedy trials and sue without limitations for damages, that they can’t be asked to waive those rights, and that the facilities must carry liability insurance sufficient to ensure that residents and their families are “justly compensated.”

The industry as a whole is adamantly opposed to any such language in the state’s Constitution — even though some of the rights are already part of laws previously enacted by the Florida Legislature and the proposal doesn’t spell out the consequences for nursing homes that don’t comply.

Record-setting bed valuations, billions in guaranteed revenues and robust profit margins have pushed the senior care market to become one of the fastest growing, most highly profitable health care sectors.

The Pilot reported an astonishing video of a drugged up employee at Tara Plantation of Carthage.   An employee of the assisted living facility shared video of what appears to be an unconscious coworker on social media.  “The video was recorded about 5:20 a.m. on Monday, Feb. 12, by Stephanie Alston, a former nursing assistant at Tara Plantation of Carthage. In the nearly three-minute clip, a female employee who appears to be sleeping or heavily sedated is slumped over in a swivel chair with her head between her knees.”

According to Alston, the video was sent to the Moore County Department of Social Services. Alston claims she and her coworker Rachel Hough, who is heard talking to Alston in the video, were fired the next morning for filming the incident. Tara Plantation is now the subject of a multiagency investigation involving DSS, the Carthage Police Department and the state Division of Health and Human Resources.

“We was wrongfully terminated from my job today because I wanted to protect the residents that were in danger,” Alston wrote in video’s description. “I’m leaking this to the world to show everyone what your family could be dealing with on a regular basis.”  He went on to state “I don’t feel bad about losing my job over this,” Alston said. “God has bigger plans for me.”

Hough said the employee in the video has a history of passing out on the job. Angel Dooley, the acting administrator of the facility, was made aware of previous incidents, Hough said, but “nothing was done.”

“I just want justice for the residents that deserve better,” Alston said in an interview with The Pilot. “It’s not right for a family’s loved ones to live in those conditions and pay $2,000 and $3,000 (per month).”

Alston also shared photographs of Tara Plantation that show wastebaskets overflowing with trash and disposable cups left sitting out with food still in them. One of the photographs shows a visibly soaked adult diaper lying on the floor.

Tara Plantation
Some of the photographs of Tara Plantation shared on Facebook by Stephanie Alston.

Tara Plantation is an 80-bed assisted living facility that cares for patients suffering from dementia and Alzheimer’s disease.  The nursing home was roiled by a previous controversy when the facility’s then-director and four other employees were charged with conspiring to sell medication that had been prescribed to residents.

The Fresno Bee reported on the nursing home resident of Bella Vista Memory Care Community who contends that he had to have his right eye removed after staff at the nursing home allowed him to be attacked twice by his roommate.  Josh Dansby Jr. is seeking compensation for injuries suffered as a result of the facilities failure to protect him.  The lawsuit says Bella Vista is understaffed and has a history of being issued deficiencies by the California Department of Social Services.

Sierra Meadows Senior Living, LLC runs Bella Vista and has called the lawsuit a “shakedown”.

The lawsuit states that Dansby suffers from Alzheimer’s and dementia and has a history of strokes and heart attacks. Around February 2017 he became a resident of the nursing home.  Bella Vista placed Dansby with a roommate who had a known history of aggressive propensities and physical assault.  In September, the roommate attacked Dansby.

After this assault, Dansby’s family complained to the Bella Vista staff, asking that Dansby be protected from the roommate including moving rooms or changing roommates. Bella Vista refused to make any changes.

Dansby was attacked by his roommate again in December. After the attack, Bella Vista staff did not provide Dansby with care for days. He was later taken to Saint Agnes Medical Center’s emergency room, where he was determined to have suffered a corneal detachment. Doctors removed Dansby’s right eye.



Newsweek reported that a new study published online in Acta Neuropathologica suggests that eight young adults who developed serious brain plaque buildup may have been “infected” with amyloid proteins via dirty medical instruments during brain surgeries in their youth.

Brain plaque buildup is one of the most recognized characteristics of Alzheimer’s disease, as well as other neurodegenerative diseases, such as Creutzfeldt-Jakob Disease (CJD), also known as “human” mad-cow disease, New Scientist reported. Eight patients in England experienced brain plaque buildup caused by excessive amyloid proteins so severe it caused blood vessels in their brain to burst.

Researchers from University College London reviewed the cases of eight young patients who had experienced cerebral amyloid angiopathy (CAA), a condition where amyloid proteins build up in blood vessels in the brain. Not only are both CAA and Alzheimer’s disease both characterized by brain plaque buildup, but both illnesses are also found in much older patients. All eight patients were under 60-years-old, therefore not yet at risk for brain plaque buildup. In addition, none of the patients were at predisposed genetic risk for this disease, New Scientist reported. Instead, the researchers found these patients shared one salient common factor: brain surgery during adolescence.

Lead researcher Sebastian Brandner, a professor of neuropathology at University City London and his UCL team, hypothesized that the amyloid proteins may have been transferred into the patients’ brains during surgery by hitching a ride on surgical instruments that had not been cleaned well enough, New Scientist reported.

The theory is that medical instruments previously used on Alzheimer’s patients were then used on these young adults. If the tools were not properly cleaned, amyloid proteins from the Alzheimer’s patients could then be transferred to other patients operated on with the same tools.

Brandner told Newsweek that there are no other risk factors that can explain such early onset CAA, and this suggests that transfer of proteins via medical tools is likely why these patients developed the disease so young.

“Brain surgery is so far the most likely cause,” said Brandner. “In theory other routes are thinkable, but we have no evidence.”

This is not the first time researchers have proposed that brain proteins can be transferred from patient to patient via surgery. A 2015 study also led by Brandner also suggested that fragments of sticky amyloid proteins spread among patients through contaminated surgical tools, The Guardian reported.

Brain protein buildup in young people is rare but not completely unheard of. Another study from 2015 suggested that plaque buildup in young people could simply be a sign that the “resource” and “machinery” needed to make these protein clumps already exist in young people.

“The implication appears to be that if we want to prevent these clumps from forming when a person becomes old, we may need to intervene much earlier than we have thought, to try and get rid of amyloid very early in life,” the 2015 study co-author Changiz Geula, a professor at the Northwestern University Feinberg School of Medicine in Chicago who focuses on Alzheimer’s disease, told CBS News.

A while back, we published a post about Seniors and Sleep detailing the adverse effects of not getting enough sleep and the sleep problems seniors face. Today, we bring you another look into seniors and sleep, with an article from Candace Osmond. This page details sleep problems and solutions. See below for an excerpt.

When you’re struggling to drop off, or if you’re battling the demands of work and home life, you can find yourself wondering how much sleep you can get away with. Is it ok to have just four or five hours or must you get a solid eight or nine hours every night?

If you’re suffering from insomnia, or just the demands of a newborn baby, you may be wondering – how much sleep do you need?

No matter what your circumstances, we’ve answered that question and given you all the information and facts you need to make sure you get the right amount of sleep every night.

For more information about sleep, read the full article here.