Jesse Waugh is a writer for www.authorityspecialists.com who was kind enough to write the following blog post for us.

There are a lot of assisted living facilities that caters for patients with Alzheimer’s disease. They claimed to have the best trained medical staffs and state-of-the-art facilities, but there is a difference in having skilled professionals in nursing homes compared to non-skilled staffs in assisted living facilities. Most nursing homes have top security measures for the safety of their residents and staffs. As for these assisted living facilities, there is a list of issues that needs to be raised as it involves the security and safety of the elderly residents.

Primary issues with assisted living facilities especially involving elder care with dementia
• Facility entrance and exit doors
• Sign-in registry for visitors
• Surveillance and monitoring measures
• Properly marked hallways
• Accessibility in the facility for the residents
• Staff to patient ratio

Facility entrance and exit doors
We all know that dementia patients are likely to wander off and get lost, which will lead to their injury and in some cases, death. This is really a big concern for most facilities.

Strict visitor registry
There needs to be a strict compliance when visitors come to visit their loved ones. Protecting the well-being of the residents should be taken seriously because the elderly are vulnerable to outsiders that have bad intentions.

Facility’s surveillance and monitoring measures
Knowing the capability of the patients to wander off and get lost, there should be proper measures to track them. Installing GPRS trackers in their residents’ bracelets should be imposed and an alarm system should also be installed in every doors and windows.

Hallways, walkways and rooms should have clear signs installed
For hallways and walkways should have a clear and clearly lit signage for the elderly residents to see. It is highly recommended that they are not written signs but as diagrams.

Accessibility around the facilities
It is easy for residents to wander around and get lost within the facility and might end up in areas that they are not supposed to go and end up in dead ends that will cause them to get more confused. Having a circular layout for facilities would be ideal for every assisted living facility.

Staff to patient ratio
Facilities should have one staff for every patient because elders suffering from dementia requires a 24/7 watch.

Before placing your loved ones (especially with dementia) in an assisted living facility, make sure that the facility have all the necessary security measures keep them safe and secure.

The Associated Press/Washington Post: For many older Americans who lost jobs during the Bush recession, the search for reasonable health care has been one obstacle after another. They’re unwanted by employers, rejected by insurers, struggling to cover rising medical costs and praying to reach Medicare age before a health crisis. These luckless people, most in their 50s and 60s, have emerged this month as early winners under the nation’s new health insurance system. Along with their peers who are self-employed or whose jobs do not offer insurance, they have been signing up for coverage in large numbers, submitting new-patient forms at doctor’s offices and filling prescriptions at pharmacies

The Wall Street Journal wrote an article about the NY prosecutor’s probe which led to civil and criminal charges against the operators and nine employees of a suburban New York nursing home. The 58-page civil complaint states that operators and staff of the Medford Multicare Center for Living, Inc., had shown a "history of neglect of Medford’s vulnerable residents," since the 320-bed facility on eastern Long Island opened in 2003.

Six nursing home employees had previously been prosecuted in 2008 on charges of neglecting patients, and contended conditions at the facility had not improved since. "Medford’s owners have instead dedicated themselves to lining their own pockets and improving their families’ philanthropic reputation at home and abroad while turning a blind eye to the persistent neglect of its residents by senior management and staff."

In the criminal case, one employee identified as Kethlie Joseph is charged with criminally negligent homicide in the October 2012 death of a 72-year-old patient who was supposed to be connected to a ventilator. Court documents allege that the patient’s "pulse oximeter alarm sounded every 15 seconds for two hours during the night shift. No one responded despite the fact that alarms were sounding at three locations on the unit and one staff member was specifically tasked with watching the monitor at the nursing station."

Six others, including the licensed administrator, David Fielding and Christine Boylan, director of respiratory therapy, also were charged with participating in a cover-up of the death, which was eventually reported to authorities by a whistleblower at the nursing home. Two other employees were charged with falsifying documents involving injuries to other patients at the facility.

 

Often, when a person is diagnosed with Dementia, they and their loved ones view the conditions as a death sentence. However, rather than focusing on the limitations of person with Dementia, we should embrace their abilities and celebrate their strengths.

 Theresa Klein, an occupational therapist at Augustana Emerald Crest Assisted Living in Minneapolis states that by focusing on what matters most, caregivers can help Alzheimer’s patients optimize their daily potential. The most important thing caregivers and loved ones can do is to get educated about the disease. Alzheimer’s makes up 80% of those diagnosed with Dementia. It is NOT strictly a disorder of memory, it affects a person’s ability to pay attention and put together rational thoughts.

After an initial diagnosis, a person with Alzheimer’s can live an additional 15-20 years. In Klein’s 23 years of practice, she has discovered that the most important element in a person with Dementia’s life is routine. Her first observance of this was in her grandfather’s ritual of attending weekly mass. Typically mute, when attending mass, her grandfather was brought back to a more vial version of himself during the service.

Klein advocates that caregivers actively engage patients in these types of ritual activities. She has witnessed across-the-board positive effects by having patients sing hymns and ring bells during services. We must always remember that a person suffering from Dementia, regardless of the stage, is still a person, with feelings and emotions. We must always care for them with the compassion and respect they deserve.

See article at The Atlantic.

KFOR-TV reported that advocates with A Perfect Cause, one of Oklahoma’s leading advocates for nursing home safety, seek the resignation of seven high ranking state officials from the Oklahoma Department of Health and Oklahoma DHS. The founder of A Perfect Cause, Wes Bledsoe, believes those seven state officials are not doing their jobs and not protecting nursing home residents.

Blesdoe believes the state routinely fails to protect nursing home residents by not performing proper and independent investigations in cases of alleged wrongdoing.

“The state is allowing nursing homes to self investigate themselves,” said Bledsoe. “How can we trust nursing homes to do an unbiased investigation of itself.”

 

 

The Washington Post had an article on Washington D.C.’s Office on Aging launch of its Nursing Home Transition Program which allows people to avoid nursing homes and receive in-home care instead.  This approach is a stark change from the past, when institutionalization was the preferred solution for those who needed help with day-to-day living. Those who qualify for Medicaid can receive Medicaid-funded services at home; for those who don’t, the Office on Aging helps find other funding for in-home care. The office also offers nonmedical help such as transportation, meals, and homemaker services to all District residents 60 and older, regardless of income, in accordance with the federal Older Americans Act.

“The program reflects a trend nationwide toward providing older and disabled people with in-home care rather than keeping them in nursing homes. To encourage this shift, the 2010 Affordable Care Act makes Medicaid benefits more broadly available to people living at home and increases federal funding to states that make more home care services available to those who would otherwise be in nursing homes. So far, 17 states, including Maryland, have been approved for additional funding.”

A major reason for the change is the high cost and inadequate care of institutional care. As the population of older Americans grows, advocates say, it won’t be economically sustainable to have so many live in nursing homes. The average annual cost per person for nursing home care is about $75,000 nationwide. In the District, it is $110,000. Providing in-home services costs an estimated $30,000 to $60,000 a year, according to the city’s Office on Aging.

“The District program serves people who are ineligible for a federal Medicaid program called Money Follows the Person, which also helps older people and those with disabilities return to their communities from nursing homes, but has requirements such as that a person must have been in a nursing home or hospital for at least 90 days and must have received Medicaid in the last month of services there.”

 

Almost everyone today knows someone who has some form of dementia, and has heard about Alzheimer’s Disease.  What you may not know is that Alzheimer’s disease doesn’t only affect the elderly.  For those suffering from Young Onset Alzheimer’s Disease, the stigma that it is a disease for the elderly simply isn’t true.

Michael Ellenbogen recounts his tale of Young Onset Alzheimer’s in an article for Everyday Health. Ellenbogen tells what it’s like to live with a deteriorating mental and physical state as a result of Alzheimer’s. A middle aged man, he can no longer live the life he used to; he even has to have a friend write the article because he can’t.

His struggle is magnified by the lack of attention paid to those with Young Onset Alzheimer’s, and is thwarted by his inability to determine his own fate.  Ellenbogen would like to be able to make his own decisions for his future, and whether he must endure the total deterioration of his life and become a burden on his family. The cost of his disease is astronomical, both in medical costs, personal costs, and in dignity. Ellenbogen uses his experience as a plea to people everywhere. For more of his story, read the article here.

A bill recently signed into law in Oklahoma allows for the use of video monitoring in nursing homes by family members. Families can now monitor their loved ones by placing cameras in their rooms and common areas at the family member’s expense.  This will protect residents by preventing abuse and neglect from going unpunished.

This new law is a reaction to the poor quality of Oklahoma’s nursing homes, which received an F rating by the Families for Better Care. Out of 50 states, Oklahoma’s nursing homes rated 48th because of abuse and neglect. Some of the administrators are concerned about privacy and dignity because of cameras being placed in private rooms. The law prohibits facilities from refusing to admit patients who want to take advantage of the new law.  See article here.

Smart phones can be silly, providing an avenue for apps and games, but they can also be serious, allowing users to access news and current events instantaneously.  A study published in the Journal of the American Medical Directors Association cites another use for smart phones: saving lives.  The study revealed that using smart phones to access patient’s medical information could greatly reduce the amount of adverse drug effects, or drug-drug interactions.

Approximately 93,000 deaths in nursing homes occur as a result of drug events, and according to the study, about half of these could be avoided. Additionally, drug events are costly, with estimates that they represent $4 billion in preventable health care costs.  Many doctors use smart phones and drug-reference software to check a patient’s prescription history so that adverse drug effects can be avoided. Nearly 90% of doctors who used the software avoided a harmful drug effect in the past month. When surveyed, only 42% of nursing home doctors use smart phones and drug-reference software. What this means: drug effects aren’t being prevented. A majority of the doctors surveyed found the software to be helpful in decreasing adverse drug effects, and felt it increased patient medication safety.

With an easy and inexpensive way to save almost 47,000 lives, why aren’t more nursing home doctors using this software? The scariest part about this survey is what it doesn’t say, that many doctors aren’t currently checking prescriptions of nursing home residents and are prescribing additional medications without knowing if there will be a harmful effect or not. Do we care so little about the elderly in this society that this is acceptable? The elderly often take a number of prescriptions, which should require that doctors be even more careful when dealing with their medications. What this study shows, however, is that this isn’t the case. For the safety of your loved ones, don’t let this practice be acceptable.

Brian Kent is on a mission to keep The Villages of Orleans Health and Rehabilitation Center under county ownership.  He plans to achieve this goal by creating a documentary consisting of over 12 hours of interviews, and other video.  Kent is producing this documentary to provide an exposé on county officials. These officials advocate selling the nursing home, saying that private ownership is the :fiscally responsible choice”. Kent disagrees. “If it became private, the profits would go out of county, Intergovernmental Transfer funds would disappear and we’d still be left with the bond,” he said.

Kent plans to use his documentary to educate citizens about the home and why they should keep it under county control.  His plan to keep funds in the county is part of a larger ambition to make Orleans County a retirement destination.  His work is one small part of a larger advocacy movement in Orleans, where the Concerned Citizens of Orleans County worked hard to save the nursing home, even challenging long standing incumbents for county official seats.

Sadly, the CCOC did not have enough support to prevent the sale of the nursing home.  Despite their various efforts, which included the documentary, political campaigning, and lawsuits, the home will be sold. Two private chains will be the final bidders for the home have been announced, and The Villages of Orleans Health and Rehabilitation Center, despite the gallant efforts of the citizens, will be sold in the coming year.