North Carolina appears to be leading the nation in the effort to reduce drug over-prescription abuse in nursing homes. A report released by the Federal Center for Medicare and Medicaid services shows that the rate of antipsychotic drug use in North Carolina has fallen twenty-three percent. Many nursing homes in America prescribe these drugs in order to control and calm their patients. As a side effect, these patients are more likely to fall and can become too drugged to participate in activities they previously enjoyed.

A North Carolina expert says that to offer better treatment and reduce the dependence on these drugs, a well trained staff is essential. They should pay close attention and build strong relationships with the patients. Some alternative treatments include music therapy and massage for agitated patients. Hopefully other states will take notice of North Carolina’s strides towards improving elder care and follow suit with more efforts to reduce the use of unnecessary prescriptions to control patients.  See full article at WUNC.

Alarming new numbers released by the U.S. Centers for Disease Control document a huge rise in opioid pain reliever prescription use over a ten year span. Opioids are a class of drug commonly prescribed for pain-relief that include Dilaudid, Percocet, Hydrocodone, OxyContin, Oxycodone, Vicodin and Morphine. They are classified as highly addictive and can easily become lethal if too much is given. Deaths due to overdoses of prescription opioid drugs rose 415% among women and 265% among men from 1999 to 2010. A Mayo Clinic report shows opioid pain-killers are now ranking among the three most common types of prescriptions given to Americans. It also showed that women and the elderly are more likely to receive more prescriptions than the average person.

The CDC Director cites aggressive and misleading marketing of these drugs aimed at doctors as one reason for the spike in overdose deaths. The CDC urges doctors to take a second look at pain-management strategies for their patients, and consider alternative therapies such as physical therapy and exercise. Leading the way is Washington state, which has successfully worked with prescribers and insurers on better guidelines for opioid prescriptions and has since seen a 23% decrease in opioid-related deaths.
See article from Healthline here.

In a report by the Chronicle, Augusta resident Lashanda Johnson has been arrested for battery of a disabled adult. When the patient resisted Johnson’s attempts to change her sheets in the middle of the night, Johnson pushed the patient and said she would hit them if they fought back. A bump was found on the patient’s head, prompting the calling of authorities. The patient’s room was under video surveillance and clearly showed the exchange between Johnson and the patient.

In a report on the unbelievable abuse against nursing home residents, Fox 4 in Dallas details the shocking and alarming treatment that four residents suffered at the hands of caregivers.  The original report, in video format, shows videos and photographs of the abused. The photos are shocking, detailing injuries that arose from workers’ abuse and carelessness, but the videos are much worse.

Three videos detail the horrendous treatment that these gentle vulnerable residents suffered. Among the abuses were pinching, slapping, name calling, hair pulling, and general roughness. Minnie Graham suffered numerous abuses at the hands of her caregivers, two of whom consistently used unnecessary force when handling her, and one slapped her in the face multiple times in the course of a few minutes. Her helpless cry of ‘Somebody help me’ is heart wrenching. When she gathered the courage to say something back to her tormenters, the aide shoved his middle finger in her face. Mrs. Graham died about a month later. Her granddaughters, who had placed the hidden camera in her room and captured the abuse, said that they believe she died because of a broken spirit.

The authoritative body in Texas never charged Winters Park Nursing and Rehabilitation Center with anything. Had the home been charged, they would have faced a paltry fine. Texas, like South Carolina, is among the lowest states in the nation for nursing home fines. If the facility agreed to pay the fine, another 35% would have been taken off. In Texas, the home is responsible for the abuse, and when paying the price, they get a discount.

The two aides who abused Mrs. Graham still held their licenses, one even worked at another nursing home. Fox 4 asked the police why one aide had never been arrested. The police response: We couldn’t find her. But Fox 4 found her – at the same address that was listed in her records. The lack of concern for prosecuting this woman, investigating the home, and enforcing the rights of nursing home residents reveals a terrifying lack of consideration for the elderly on all levels, the nursing home, the police, and even the department responsible for nursing home regulations and investigations.

Many times, reading the statistics, or looking at figures of beds and financial costs, it is easy to forget the reason that nursing homes exist: to care for those who cannot care for themselves. However, when the care that one is receiving more closely resembles abuse than assistance, it is clear that nursing homes need to constantly be reminded that their residents are people. They hear, they talk, they feel. They should be treated like the human beings that they are. Instead, they are treated as less than human, simply because they cannot fight back. Don’t let this become your mother, or your father, or you.

CTV News reported that four employees from St. Joseph’s at Fleming long- term care facility in Ontario, Canada have been suspended with pay after video footage showed them abusing a patient. The footage was captured by Camille Parent, who installed a camera in the room of his mother, Hellen MacDonald, an 85 year-old patient at St. Joseph’s suffering from dementia. Parent was prompted to install the camera after his mother suffered a suspicious black eye.

The footage shows a staff member blowing his nose in Mrs. MacDonald’s sheets while making her bed, another staff member changing her diaper with the door open, and yet another shoving a rag covered in fecal matter in Mrs. MacDonald’s face. The incidents all occurred within a period of three weeks.

In 2010, the Long- Term Care Homes Act was passed, enacting a zero tolerance for abuse policy in Ontario extended care facilities. When asked whether or not the footage depicted what he would classify as abuse, Alan Cavell, CEO of St. Joseph’s, told CTV news, “I don’t want to give my opinion directly. I would think that most people would say that it was.” Investigations are under way by both St. Joseph’s and the Ontario Ministry of Health.

CTV News reported that there were over 10,000 incidents of seniors suffering abuse in nursing homes in Canada last year. In light of these disturbing figures, Parent continues to raise awareness about residents’ safety and the quality of care they receive in long-term care facilities through his new organization, Ontario Cares.

 

Slate’s Matthew Yglesias wrote an interesting article titled American Doctors are Overpaid.

"The last time the OECD looked at this, they found that, adjusted for local purchasing power, America has the highest-paid general practitioners in the world. And our specialists make more than specialists in every other country except the Netherlands. What’s even more striking, as the Washington Post’s Sarah Kliff observed, these highly paid doctors don’t buy us more doctors’ visits. Canada has about 25 percent more doctors’ consultations per capita than we do, and the average rich country has 50 percent more. This doctor compensation gap is hardly the only issue in overpriced American health care—overpriced medical equipment, pharmaceuticals, prescription drugs, and administrative overhead are all problems—but it’s a huge deal."

He concludes "When it comes to the federal budget, Medicare is a problem. An uncapped commitment to finance the health care needs of elderly Americans is a big challenge for an aging country. But when it comes to the question of health care costs overall, Medicare is the solution. Its vast bargaining clout lets it get much better prices than any private insurer, and we should be relying on it more to pay our bills, not less."

MSN Healthy Living had an article on the 9 warning signs of bad care.  Below is a summary.

1. Marked emotional or physical changes. Look first to your loved one. You should be concerned if she is less able to function as usual, has stopped taking part in activities, or has become withdrawn and uncommunicative. If Mom is experiencing emotional abuse—such as being ignored or talked down to—she may be agitated and withdrawn, fearful, or experience loss of weight or appetite and sudden changes in mood or sleep pattern. Physical abuse or neglect may be a concern if Dad has unexplained bruises, pressure ulcers, or skin tears, particularly in areas that are not regularly visible, like the upper back, hips, and thighs.

2. Unanswered or deflected questions. "I don’t know, but I will find out" is an acceptable response—but not regularly, and you shouldn’t get the feeling there’s something to hide. "If staff are evasive with your questions, unable to answer your questions, or refuse to discuss your loved one’s care with you, this is a big red flag that care may be suboptimal," says Amy Jo Haavisto Kind, an assistant professor in geriatrics at the University of Wisconsin School of Medicine and Public Health.

Some questions, such as, "My mom is losing weight, what is the plan?" should always have a ready answer. "If all a person gets is blank stares or a dismissal—’Old people just do this, don’t worry about it’—then that is concerning," says Uy.

What’s the ultimate wrong answer? "I get more concerned when someone says, ‘This is how we do things here,’ and has no desire to help," says Jatin Dave, a physician at the Brigham and Women’s Hospital’s Center for Older Adult Health.

3. Frantic, discordant, or inadequate staff. A busy, thin-stretched staff may be unavoidable at times, experts say. But does it always feel chaotic when you visit? Are staff working well together, or do they seem to have bad attitudes? At meals, do they talk only among themselves or do they mingle with residents? Does important information get lost between shift changes?

Don’t overlook the leadership. Is the director nowhere to be found and unknown to residents? "I have never seen a place with strong, involved leadership that had bad care," says Barbara Bowers, associate dean for research at the University of Wisconsin-Madison’s School of Nursing, who researches long-term care delivery.

4. High staff turnover. "Some regular staff turnover is an unfortunate reality at most nursing homes," says Kind. "However, if you notice that your loved one’s nursing home constantly is training new staff to the point that no one on the staff knows your loved one—well, it is time to look for a new nursing home." Consistent staff-resident pairing is important in the quality of care Mom gets.

5. "I don’t want so-and-so to care for me." Your loved one should never feel distressed or uncomfortable around any staff member, experts say. Even if Dad suffers from cognitive problems, "take these statements seriously and investigate them thoroughly with the nursing home leadership," says Kind. "They may be signs of mistreatment or neglect."

And even if Dad doesn’t say anything, observe him when staff enters the room. Does he seem happy? Or is he anxious, fearful, or uncomfortable?

6. Constantly ringing phones and unanswered call lights. It should raise an alarm if the nursing staff doesn’t have the time to pick up the phone, says Elisa Gil-Pires, section chief of geriatric medicine and palliative care at Saint Francis Hospital and Medical Center in Hartford, Conn.

And if Mom says she’s waiting a long time after pushing the call button, "find out for yourself," says Erin Hilligan, a licensed nursing home administrator at Ebenezer Ridges, a long-term care facility in Burnsville, Minn. "Put the light on. Note if the delay is during a specific time of day—shift change or a meal time, maybe. Then bring up your concern to a staff person and note how it is handled." Of particular concern, adds Sewell, is if Mom says something like, " ‘I waited as long as I could for someone to help me to the bathroom and then I just could not wait any longer, and so I got up on my own.’ "

7. Dehydration and malnourishment. "One of the most frequent and insidious signs of neglectful nursing home care is dehydration," says Kind. "If a nursing home does not have the adequate number of high-quality staff, residents in that home may not receive all of the food or fluids they need to remain hydrated and nutritionally sound. Meals may even be completely missed." Act immediately if you suspect this is occurring, Kind says.

8. Status quo reigns. Ask staff what improvements the nursing home has recently put in place, especially since your loved one moved in. In particular, ask about anything they told you would be updated by now. "It is easy to identify nursing homes that are trying to improve and ones that are trying not to get shut down," says Uy.

9. A bad feeling. Ultimately, your gut knows. "Most of these warning signs will be the family member’s concern that something is not right, or a feeling of uneasiness when they visit," says Gil-Pires.
 

The San Francisco Chronicle reported another incident of abuse and neglect recorded by hidden camera.  The family suspected abuse at Gold Crest Care Center after noticing bruising and unusual markings on her grandmother, Ana Louisa Medina.

Granddaughter Valentin told ABC News that the hidden camera recorded 600 hours of footage including employees grabbing her grandmother’s arm, twisting it back, lifting her off the bed and slamming her into the bed, the report states.  After watching the videos, Valentin said she transferred her grandmother to an emergency room and later to a different nursing home, the article said.

 

 

The Daily Journal reported that two former employees of the Momence Meadows Nursing Center, who turned whistleblowers against their employer in 2004, helped convince a jury in federal court that the nursing home abused its residents and filed phony Medicare and Medicaid claims — prompting a $28 million verdict against the former owner.

Following a two-week trial in Urbana, a jury found that Jacob Graff oversaw a home that "provided worthless services to the residents," and hit him with the stiffest civil penalty it could.

 

 

Fox 59 reported the arrest of a nursing home employees following a credible report of abuse. 
Six employees at Providence Home Health Care Center, an Indiana nursing home, face charges in connection with the reported abuse of an adult resident.  Some of the abuse was recorded.

In one videotaped encounter, the employees rolled the patient aggressively, hitting his head on a bed rail. They’re also accused of hitting the man when he wouldn’t cooperate with being rolled over, the probable cause affidavit said.  Tonya N. Sanders, Loogootee; Blaine T. Ballard, 33, Jasper; Casey M. Hill, 28, Taswell; and Wendy M. Sutherlin, 28, Taswell, were arrested Monday on charges of felony battery, neglect and intimidation.

Two other workers–Katrina L. Patterson, 40, Jasper, and Sheryl A. Rockett, 52, Washington–face face misdemeanor charges of failure to report abuse of an endangered adult.