CBC reported a horrific case of neglect and abuse at Harbourstone Enhanced Care nursing home.  The family found their mother bloodied and bruised in her nursing home room.  Daughter Lois Foster has filed complaints with the police and the province over her mother’s injuries, which she says are the result of a lack of care.

“It’s disgusting, unnecessary negligence,” said Foster.

Foster says she received a call on March 18 that her mother, Kathleen MacDougall, had fallen.

“When I went over to the home, the ambulance attendant told me to brace myself,” she said.

Foster, a nurse herself, was shocked.

“She had bruises on both arms, both shoulders, her legs, the skin ripped off her arm, her face on both cheeks, all down her neck,” said Foster. “She had the worst facial appearance that I’ve seen in any of my clients in my 35 years of nursing.”

Foster says her 95-year-old mother’s injuries are a result of neglect she suffered while in her nursing home. She said she’s asked to have the nursing home’s surveillance camera footage reviewed.

“They couldn’t have been caring for her to have her look like this,” said Foster. “That’s not care. They have a duty of care, and there’s there’s no way even a half-hour check could end up with her looking like that.”

She said she wants to see changes implemented so that other families won’t experience similar issues.

“They need more staff, they need more trained staff, and they need to individualize their care,” said Foster.

Foster said concern for her own mother as well as others compelled her to speak out.

“I also thought it was a responsibility of mine as a nurse,” she said. “I can’t sit back and let this happen to another person. It isn’t right. Something must be done.”

Freelance Contribution by Karen Weeks

Losing weight tends to be a universal goal, but did you know that your age plays a factor in how you go about it? Our bodies tend to age a lot faster than our mind, so seniors looking to lose weight and get their health on track need to follow some safety precautions to ensure they are doing so in a healthy manner. If you are trying to slim down and lead a healthier lifestyle, check out these tips before diving in.

 

How Much Do You Need?

 

Recommendations by the Centers for Disease Control and Prevention (CDC) state that each week seniors should strive for either 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise, paired with at least two days of targeted muscle strengthening. By meeting the requirements, you can fight back against some of the most common aging ailments such as arthritis, cardiovascular disease, osteoporosis and diabetes. Furthermore, you can get a mental health boost, too.

 

According to Qunomedical, the incidences of depression are at their highest in seniors and is often the result of the loss of mental and physical abilities, independence, family members and friends. Regular exercise not only maintains and improves physical abilities, but the accompanying release of feel-good neurotransmitters gives you surge of energy and a mood boost.

 

Adjust Your Mindset

 

If you are under the impression that weight gain is a normal part of aging, then it’s time for you to change your mindset. Why? Well, it simply isn’t true, and by thinking this you could be preventing yourself from meeting your weight-loss goals. Come up with a positive mantra and say it to yourself daily. You might find it helps to join together with other seniors looking to improve their health, giving you a source of support as well as someone to hold you accountable. With patience and dedication, losing weight is possible at any age, you just might have to take things down a notch.

 

Perhaps you have to walk instead of run on the treadmill, or lift half the weight you did when you were younger, but that’s OK. Pushing yourself too far, too fast can lead to injury, putting a serious hiccup in your weight-loss journey.

 

Maintain/Build Muscle Mass

 

Muscle mass is crucial for seniors to be able to maintain their physical independence and prevent disability. In order to lose weight while still maintaining or building up muscle mass, resistance training is highly recommended in order to achieve the right balance. According to a study conducted by researchers at Wake Forest University, seniors who dieted, along with weight lifting (resistance training) and walking lost more fat.

 

In addition, the group who participated in resistance exercises kept more muscle mass, losing only 1.7 pounds compared with 3.5 and 2.2 pounds respectively in the groups who dieted/walked and dieted only. A great way to build up muscle includes lifting weights and using resistance bands, but less intense physical activity such as yoga or gardening work just as well. Check out these great strengthening exercises that are perfect for seniors and incorporate them into your routine.

 

Adjust Your Diet

 

When it comes to adjusting your diet, the importance of maintaining muscle and bone mass again comes into play. Be sure to eat foods with plenty of protein, calcium, and vitamin D. In addition, watch your portion sizes. The general consensus is that with each passing decade, you need 100 few calories to stay at your current weight. However, keep in mind that your body needs fuel, so cutting out too much will leave you feeling sluggish and can be detrimental to your health. If you are serious about switching up your diet, talk with your doctor or a nutritionist about the best way to do so to be sure that you are still getting the proper vitamins and nutrients based on your age. Make small changes such as eating grilled instead of fried or using a smaller plate.

 

It doesn’t matter what age you are, it’s never too late to shed a few pounds and get your health in order. Following the recommended weekly exercise amounts, get in the right mindset, focus on maintaining mass and make small changes to your diet to maximize your weight loss. Just like the tortoise and the hare, slow and steady wins the race.

 

McKnight’s had an interesting article about a pilot program that decreases turnover and increases retention. The National Fund for Workforce Solutions issued a case study of five nursing homes in conjunction with the Massachusetts Senior Care Association and SkillWorks.  Supervisory coaching is one way facilities can attract and retain entry-level employees, the report explained.

It is well known that quality of care suffers when turnover is high.  Efforts to improve frontline supervision can improve the quality of entry-level jobs in long-term care and lead to higher retention of certified nursing assistants and better patient care.  The yearlong pilot trained supervisors in interpersonal communication and conflict management methods, and researchers reported an improvement in workplace culture. Specifically, the study found comprehensive training can reduced disciplinary actions and improve workers’ ability to communicate with coworkers and patients to solve complex problems.  

Staff satisfaction and engagement rose, and one study site quickly expanded the training program to all of its supervisors.

When staff feel supported, quality of care increases,” said Tara Gregorio, the association’s president. “Partnering with the National Fund and SkillWorks for this pilot program, allowed us to provide some funding and expertise to create more positive workplace environments, which in turn, can help reduce turnover and increase job satisfaction.”

“The long-term care industry has been facing a staffing crisis for years and the demand will only increase as Americans continue to live longer,” said Kelly Aiken, Vice President for the National Fund of Workforce Solutions. “Focusing on job quality will help America be more competitive and adapt to changing economic and business realities.”

The American Bar Association Commission on Law and Aging (ABA Commission) is taking inventory of elder/adult abuse fatality review teams (EAFRTs) across the United States.

The ABA Commission has created a survey to seek information about multidisciplinary teams that review deaths that were or might have been related to elder abuse, domestic violence in later life, or abuse of adults with disabilities. The project focuses on learning about teams that are currently functioning, are no longer functioning, or are in development.  

If you have or know of an EAFRT, participate in this survey to accurately reflect the extent of elder abuse in this country.

The Laurinberg Exchange reported the alleged rape of a resident with mental deficiencies at Willow Place Assisted Living.    The brother of the rape victim contacted police to report that his sister had been raped by another resident.  An employee of the facility called the brother to let him know about the incident, the family said.

Last year, the facility was cited for 16 violations and issued a provisional license. One of the charges was, failure to protect a resident from another violent, combative resident suffering from Alzheimer’s.

Following the spring 2017 inspections, Willow Place was cited for having violated serious state codes concerning patient care and staffing during. The short staffing caused issues with patients’ personal care and safety because patients with dementia were not being kept in a separate hall or being properly monitored.

DHHSR conducted a second inspection in August to deal with additional complaints from patients and their families. Following that investigation, Willow Place was written up for an additional 18 violations some of which the home had been cited for in the first inspection.

The assessment determined that the home failed to follow state regulations for staffing after investigators sampled records for 10 days between June and July and found that “the facility failed to assure staffing met minimal requirements according to the census, for 36 of 45 shifts sampled,” according to the report.

If the facility had adequate staff, they could fulfill their duty and responsibility to supervise the residents and protect them from rape and assault.

 

U.S. News reported that Kansas may require nursing facilities to get written permission from residents or their guardians before administering antipsychotic drugs.  The federal government recently enacted similar informed consent rules that will help reduce improper antipsychotic use.

However, the powerful nursing home industry opposes the safety measure.  For years, the U.S. Food and Drug Administration has warned that antipsychotics increase the risk of falls, stroke and other potentially fatal side effects for people suffering from dementia.  Kansas has been at or near the top in percentage of medicated residents, The Kansas City Star reported.  Kansas also leads the nation in the percentage of skilled nursing facilities cited by the federal government for several medication-related violations, some of which relate to antipsychotics.

The Dayton Daily News reported on a social media post that went viral.  The relative of a resident posted on social media that the man was being neglected Laurels of Huber Heights Nursing and Rehabilitation Centers.  Sara Vagedes wrote in a Facebook post that her 89-year-old grandfather was ‘badly’ in need of attention when she visited him at .

The elderly man, also a veteran, was aspirating with food piled up in his brace, fruit punch spilled across the bed sheets and trash everywhere.  Vagedes’ Facebook post, which included photos of her grandfather, went viral, and was shared nearly 20,000 times.

A reporter talked to a relative of another resident at Laurels of Huber Heights.  WHIO-TV reporter Lauren Clark asked the woman, who did not want to be identified, if she’d had any experience like the Vagedes family.

The woman said, “I think they’re really shorthanded here. And nobody can take care of a loved one like you can.”

The Ohio Department of Health has investigated nine complaints at Laurels of Huber Heights, according to the Ohio Department of Health’s website. For instance, in November, the facility was instructed to develop and implement neglect and abuse policies after the agency learned that one of the nursing home’s  employees had disqualifying criminal convictions for theft and drug possession.

Vagedes’ grandfather was transported to Grandview Medical Center and is in the intensive care unit, the family said.

 

WFAA had an interesting article discussing the problem of short-staffing and chemical restraints at nursing homes.  This article was Part 4 of WFAA’s continuing investigation of nursing home abuse and neglect. (See Parts 1, 2 and 3 ).  The ongoing WFAA investigation into Texas nursing homes has already revealed questionable practices in the hiring of criminal caregivers – and now WFAA has uncovered inappropriate and unnecessary drugging of residents.

In effort to cut costs, troubled nursing homes may drug the elderly rather than hire needed staff. The practice has been dubbed “chemical restraints.” It’s a practice of using powerful drugs to sedate or quell agitated, disruptive or violent patients.  When a facility is chronically short-staffed, often the staff will administer medications that sedate the residents so the residents are easier to take care of for the overworked and burnt-out caregivers.  In the latest report, called “Drugged and Dying,” News 8 investigative reporter Charlotte Huffman found that 96 percent of Texas nursing homes admit they’re giving drugs to residents who don’t need them.

According to the FDA, unnecessary use of antipsychotic medication kills 15,000 nursing home patients every year. Of all the drugs used as chemical restraints, antipsychotics are the most widespread and may be the most dangerous.

The federal government has previously caught drug manufacturers improperly promoting their antipsychotic drugs for use in nursing homes. (See here and here.)

Before nursing homes can give residents antipsychotics, new federal guidelines require doctors to diagnose them with at least one of three mental illnesses, the most common being schizophrenia.  A WFAA analysis of nursing home data shows that, after this new rule, the number of residents diagnosed with schizophrenia has skyrocketed 26 percent.  Schizophrenia develops in a patient’s early 20s, not later in life, experts say.

Various healthcare officials and advocates, when reached for comment, have found WFAA’s findings troubling:

“There’s no doubt that it raises a big red flag,” said Amanda Fredriksen, AARP Texas director of advocacy and outreach. “It’s pretty disturbing when people are that motivated to drive their numbers down to falsify medical records or to make up diagnoses. But to the extent that that’s happening, that’s a real serious issue.”

Dr. Daniel Pearson, head of psychiatry at Methodist Hospital, questions a first-time schizophrenia diagnosis of an elderly nursing home resident. He said such a diagnosis, especially to sedate, may be inappropriate, and possibly dangerous.  “Does that surprise me? No. Are those diagnoses legitimate? Probably not,” Dr. Daniel Pearson told WFAA.  “If you are using it just to keep people quiet, there are significant risks that are associated with that…increased risk of cardiac death, increased risk of falling, breaking a hip,” added Dr. Pearson, who spent a decade as a psychiatrist in nursing homes.

About 70 percent of a nursing home’s expenses are staffing,” said attorney Ernest Tosh, who handles nursing home lawsuits. “So, if they can cut back on staffing, they can directly increase their profitability.”

Last year, the state of Texas warned nursing home administrators about inappropriately drugging residents.

That same watchdog created this brochure to inform nursing home residents about the dangers of them being inappropriately drugged.

Here is a link to federal government regulations dealing with medication administration and monitoring – see p. 505.

Watch a 2011 U.S. Senate hearing on antipsychotic drug use in nursing homes.

 

 

 

 

WYMT reported that Kentucky Rep. Rick Nelson of Middlesboro filed a bill that would require minimum staffing standards in Kentucky nursing homes.  Nursing homes and other long-term care facilities would have to meet minimum staff-to-resident ratios for licensure or re-licensure after July 30 of this year under House Bill 573.

Ratios of one nurse aide to every nine residents and one nurse per 21 residents at all times during the day would be among the requirements.

Additionally, facilities with 75 or more beds would be required to have a registered nurse supervisor during day and evening shifts, in addition to the other required staff.

Larger facilities would carry more requirements, including the need for a full-time assistant nursing director and education director.

Facilities that do not comply with the minimum staffing requirements for two consecutive days would be prohibited from accepting new patients until they have complied for six consecutive days, according to the bill. Fines of up to $1,000 per day could also be assessed against the facility.

 

The Herald & Review reported the disturbing story of James Rellihan who is accused of removing opioid patches from the bodies of residents at two nursing homes, including one where he worked as a registered nurse.  Rellihan is charged with burglary and theft under $500.

In a statement read in court, Assistant State’s Attorney Jeff Horve detailed two visits Rellihan allegedly made, one on Feb. 24 to Bloomington Rehabilitation and Health Care Center, and another on Feb. 26 to Heritage Health in Normal.

At the Bloomington facility, Rellihan removed three fentanyl patches from a terminally ill man, telling the patient, “It will be OK,” said the prosecutor.   The 31-year-old nurse was seen by co-workers who questioned why he was at the facility on his day off.
On Feb. 26, Rellihan showed up at the Normal nursing home where he had worked. He went to a patient’s room where he removed a fentanyl patch from a man with dementia, according to the charges.
When questioned by police, Rellihan “denied taking, using or selling” the patches, Horve told Associate Judge Amy McFarland.