Making the decision to place a loved one in a nursing home is often one of the most stressful times in ones life. However, there are many alternatives one can choose to avoid this fearful decision. The most popular alternative is to choose a home health agency that provides health and medical services to ill or disabled individuals through in-home visits.
There a hundreds of different home health agencies across the country, but there is a new agency in Lafayette, Indiana that aims to better the world, one life at a time. Homecare by Design provides in-home skilled nursing services to seniors and people with disabilties. Owner Traci Goudy said some clients receive nursing care 24 hours a day and some just need a few hours of companionship a week. “We offer a variety of layers of care, starting with our catered care one package. Those people may just need a little bit of laundry help or transportation, maybe some cooking and cleaning. All the way through our catered care three package which is more of that hands-on, heavy care for maybe those people who are bed-bound, or wheelchair-bound,” said Goudy.
For Florence Sobczyk, 86, of West Lafayette, Indiana simply having the companionship of someone else is good enough for her. “We just kind of goof around, you know, and that’s about it. We just talk and laugh, and that’s really nice. I really enjoy them” she said. And, for her daughter Judi Jezierski, it puts her mind at ease knowing that her mother is in good hands and is enjoying her later years.
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Four nursing assistants at the Good Samaritan Society nursing home in Albert Lea, Minnesota were recently fired after allegedly physically, sexually and emotionally abusing 15 Alzheimer and dementia disorder residents. The four women were fired after a fifth aide, who was fired for swearing in front of residents, blew the whistle on them. Three additional aides who witnessed or were told about the abuse were also fired for failing to report it. “At this point, individuals who were either deemed to be involved in the alleged abusive actions or had knowledge of the incidents and failed to report in a timely manner are no longer employed at the center,” said Mark Dickerson, spokesman for the Minnesota Health Department.

According to a state report, “To make “work fun” four young nursing home aides abused 15 demented residents by hitting their breasts and genitals, sticking fingers in their mouths or noses to keep them from screaming, and taunting them.” Kris Lohrke, who supervised the Minnesota Department of Health investigation said, “We can’t remember anything quite like this, it’s that rare — both in the number of perpetrators and the range of pretty bad actions.” The facility however will not be punished since officials followed procedures and notified proper authorities.

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On a cold February morning back in 2007, Karen Presto wandered away from the Roscoe Manor Adult Home, then stumbled into the woods about a mile way.  She fell repeatedly and walked in circles until she curled up under a pine tree.  Sadly, that is where police found her frozen body two days later.  She had no shoes or socks and a medical examiner ruled she died of hypothermia.

Preston was 54-years old and suffered from severe schizophrenia.  She was placed in Roscoe Manor because she needed help with daily activities and self-care that an adult home is supposed to provide.  When just a year after Preston disappeared, another Roscoe Manor resident, Ella Maye, walked away from the home. Maye, 78, had dementia and heart disease.  State police conclude she suffered a fatal heart arrhythmia while walking on Rockland Road early on Feb. 23.  They believe she was trying to crawl back to Roscoe Manor when she collapsed on a neighbor’s front lawn and died.

The home was supposed to do hourly bed checks, but Roscoe Manor owner Charles Benson said, “at the time that an employee had failed to do so.  No one noticed Ella Maye was missing.”

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When Edward Monsour’s family left him in the care of the Manor Health Care Center in Las Vegas, Nevada in 2005 to recover from a fall, they thought he would rehabilitate, return home and re-establish himself as the family’s patriarch. However, a year later, Edward was still in the nursing home and was in far worse shape than when he entered. Ultimately, Edward left the nursing home to receive emergency care for bedsores and a large ulcer on his heel that had blackened from gangrene. A few weeks later, Edward died of sepsis, a bacterial blood infection.

Edwards’s family blamed the nursing home for the death. They said there was inadequate supervision, lack of staffing and an untrained wound care nurse who knew nothing about treating ulcers. Ultimately, they filed a complaint against the nursing home and a judge found the facility violated Nevada law when it failed to provide adequate care, causing pain and suffering to both the deceased and his family. The family was rewarded over $750,000 in compensatory and punitive damages, but no amount of money can replace the loss the family incurred.

This is just one of the many cases of an ever rising problem of elder abuse in Nevada. Between July 1, 2006, and June 30, 2007, the Nevada State Division for Aging Services investigated 4,476 cases of elder abuse. The division’s elder abuse reporting system doesn’t distinguish abuse cases based on where they occurred. However, in the past six months, 188 cases have been reported to the agency involving elder abuse in nursing or group homes, said Kay Rogne, elder protective service program manager. Hopefully, nursing homes in Nevada and around the country will address the rising numbers of elder abuse and correct this serious problem.

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By law, doctors are required to report suspected elder abuse in their patients. However, most of them never do, even if they believe that silence may subject the elderly person to continued abuse at the hands of a caregiver. The lack of physician reporting is a huge problem, experts say, because as the elderly population continues to grow and doctors become ever more pressed for time in meeting the demands for care, more elder abuse will go undetected.

Every year, roughly 2.1 million elderly Americans are victims of some form of abuse, but Congress says the actual number could be closer to 5 million. According to medical and legal experts, doctors report just 2 percent of the elder abuse and neglect cases recorded each year by state protective service agencies. In Rhode Island for example, law requires anyone who believes that an elderly person is being abused, exploited, neglected or abandoned to make an immediate report to the state Department of Elderly Affairs (DEA). However, according to Corinne Calise Russo, director of the DEA, very few of the 800 to 900 abuse and neglect complaints filed each year with her office are made by physicians.

One of the main reasons for non-reporting by physicians is that they do not know how to recognize signs of elder abuse. Many physicians have not been taught through their medical training on how to properly notice if one of their patients has fallen victim of abuse. “Sometimes physicians don’t know what they’re looking at because, historically, there has not been education on elder abuse provided in medical training,” says one expert. “There are relatively few medical schools that have any specialized geriatrics training and there are relatively few geriatricians.”

To correct this problem, experts believe that more needs to be done to teach physicians about how to recognize the signs of elder abuse. According to Brown University’s Richard Besdine, who has trained more than 90 doctors for careers in geriatrics, “Doctors need to become better educated when dealing with elderly patients, to recognize that the bruises they see on an elderly person might not be from rolling over in bed. Most of the abuse occurs in the process of giving care to needy, frail older people who are not easy to take care of.”

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In mid-June, we wrote about the fight in Congress to invalidate arbitration clauses in admissions contracts and arguments both for and against the Fairness in Nursing Home Arbitration Act.

On Wednesday, July, 30^th, the House Judiciary Committee approved the Fairness in Nursing Home Arbitration Act – which outlaws the signing of an arbitration agreement as a prerequisite to admission in a nursing home.  The committee’s decision now clears the way for the bill to go to the House floor for a full House vote.  Furthermore, “the Senate version of the same bill has been referred to the Senate Judiciary Committee.” The passing of this bill would allow seniors in nursing homes the right to a fair trial in an instance of neglect or poor treatment, if they so choose.

Still long-term care advocates oppose the legislation, arguing that, “arbitration agreements are helpful and allow them to devote limited Medicare and Medicaid resources to providing quality care instead of funding lengthy court trials.”  The battle continues and only time will tell end result of this Act.

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When health care issues are debated, often missing from the public policy debate is the huge value of informal care giving services and, unfortunately, the toll those services take on the caregivers.  National estimates show that thirty to thirty-eight million family caregivers provide ongoing care for loved ones or family members.  These services provided by the caregiver are valued at more than 350 billion dollars annually.  In Oklahoma alone, an estimated five-hundred thousand family caregivers provide more than three-hundred million hours of care.  That amount of time and stress often catches up to them.

Whether the caregiver is caring for a disabled child, someone who is chronically ill or an elderly parent who can no longer live on their own, they all have special needs that require unpaid services, “in hopes of providing their loved ones a better quality of life.”  Often caring for an elderly parent holds a lot of work and also guilt.  The caregiver doesn’t want to place them in a home but often it becomes too much to care for them on their own.

Being a full time caregiver and still trying to retain a job is no easy task.  Symptoms of “negligence, depression, financial problems, anxiety, feelings of detachment, irritability and difficulties in relationships have all been linked to care giving.”  This is where Respite care comes into play.

Respite care provides short-term relief from the responsibilities of caring for loved ones.  Respite care allows the caregiver to go on vacation, see a movie, or simply run everyday errands.  This gift of time that Respite care gives is crucial in providing the caregiver with a much needed brake.  Care giving can be a full time job and the little things like help from family and friends, or an option like Respite is a good way to help with the stress.

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Under law, there are only six reasons in which a nursing home can evict a resident. They are: if the resident is well enough to go home; need care only available elsewhere; endanger the health of others; endanger the safety of others; fail to pay their bills; or if a facility closes its doors. However, officials are reporting a rising trend in nursing home patients being evicted for none of these reasons.

According to a report in the Wall Street Journal, nursing homes are regularly forcing out frail and ill residents. According to state officials, facilities often go too far, seeking to evict those who are merely inconvenient or too costly. Moreover, residents with dementia or demanding families are among the most vulnerable.

Even though eviction counts are not formally recorded, complaints about nursing-home discharge practices have doubled over a decade, to 8,500 nationally in 2006, making it the second-biggest category tracked by the federal Administration on Aging, trailing only complaints about unanswered calls for assistance. “Across the board, involuntary discharge numbers have risen in recent years,” says Louise Ryan, Washington state’s long-term-care ombudsman, or official resident advocate. “It’s a real problem.”

For example, a recent review of admission agreements at Missouri nursing homes by the National Senior Citizens Law Center found that nearly one in five nursing homes granted itself the right to evict residents without cause. Almost half of the agreements authorized eviction for residents who become “uncooperative and unmanageable,” “unduly noisy,” “objectionably untidy” or for other reasons not permitted under federal law.

Awhile back, we wrote about the troubled Westside Healthcare Nursing Home in Price Hill, Ohio and its operator Abe Fischer. We brought attention to the raid that took place at the home, in which investigators found numerous health code violations. Fortunately for residents, a change in ownership may be near.

A Cleveland-based nursing home operator is in talks to lease the Westside Healthcare Nursing Home and the Terrace at Westside, another assisted living facility operated by Fischer. If the Westside facility is shut down, the Terrace at Westside could also close due to having the same operator. The possible sale of the two homes was revealed today during an administrative hearing about health and safety violations found during the raid.

Fischer, said he is considering selling the properties to an investor who would then lease them to Bill Shackleford, who runs nursing facilities in Cleveland. A sale of the facilities could prevent their closure and the relocation of more than 60 residents from both facilities.

Unfortunately, Westside’s ability to accept Medicaid is still in jeopardy because of the dozen health and safety violations found during previous inspections. Those violations included soiled linens, an unsanitary dishwasher, broken equipment, improperly stored drugs and fire hazards. Even if Westside has a new owner, the facility may still face the possible loss of Medicaid payments, according to state officials. “If they complete a transfer, that doesn’t wipe the slate clean,” said P.R. Casey, an assistant attorney general who represents the Ohio Department of Health. “They essentially have to start over from scratch.”

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Yesterday afternoon caregivers at eight Bay Area California nursing homes held simultaneous demonstrations to pressure their employer, Windsor Healthcare Management, to make much needed improvements in resident care and patient safety.

Hilda Gil, a Certified Nursing Assistant at The Ridge Care & Rehabilitation in Salinas said, “Today, hundreds of nursing home workers came together to fight for our residents’ right to quality and reliable medical care.”

The outcry stems from the hundreds of violations that various Windsor Healthcare facilities have received. Since July 2007, more than 360 violations of health and safety regulations were documented at Windsor facilities during regular federal surveys. Moreover, there were an additional 58 patient complaints ranging from short-staffing to fire hazards.

More than 650 nursing home workers have been in contract negotiations with Windsor Healthcare facilities for more than a year in four facilities and several months at four others in an attempt to improve patient care. Caregivers have made proposals to help ensure quality resident care by reducing staff turn-over and establishing an employee training and education fund. However, Windsor refuses to adopt the caregivers’ proven solutions to raise standards for resident care.

“The biggest responsibility of my job is to provide the best possible treatment to my residents,” said Alicia Perez, a Restorative Nursing Assistant at Skyline Care Center. “All we’re asking is that Windsor agree to our common-sense contract proposals that will greatly benefit patients, employees and the community.”

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