Articles Posted in Useful publications 2

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Long-term living locations catered to seniors are often referred to as “skilled nursing facilities” (nursing homes) and “assisted living facilities.” The basic distinction between these types of homes is the level of care provided to residents. Assisted living facilities provide only general aid, perhaps with meals, cleaning, laundry, and other day to day tasks. Conversely, skilled nursing facilities can provide actual medical care. Seniors with more serious health care issues usually need the support that is provided at a traditional nursing home instead of an assisted living facility.

However, the fact that skilled nursing facilities are able to provide some medical care also means that they may commit medical malpractice. One of the most common ways this happens is when nurses and aides make errors with regard to medication. Obviously many seniors in long-term care facilities rely on the various medications to help control different medical issues. When medication is not provided properly, serious harm can result.

A recent Legal Examiner story touched on that very issue. The article points to a study that we have referenced before from the Journal of the American Medical Informatics Association. That research project found a significant number of medication problem in nursing homes. As noted, the most eye-popping statistics from the research effort is that observers identified that about 21.2% of all dispensals of medication involved some error.

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Studies show repeatedly that seniors with cognitive injuries–dementia and Alzheimer’s–are far more likely to face neglect and abuse. Our own work as Chicago elder neglect lawyers mirrors that, as we have worked with many local residents and their families following various incidents which were affected in one way or another by a resident’s degenerative brain injury.

As the country ages, more and more seniors continue to face these conditions. In the future years and decades providing better (and safer) care to those with these injuries will become even more imperative. That will likely include better caregiver training and dissemination on alternative ways to provide care beyond excessive medicating and the use of chemical restraints.

Also, it is important for researchers to continue their work understanding how Alzheimer’s develops and possible ways to minimize the consequences. Fortunately, researchers have been working on these issues with more vigor recently and some new information in emerging which may one day help tackle the problem.

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Over the last several years many seniors and their families were affected by problems with metal-on-metal hip implants that they received. From the Depuy hip recall to those affecting Stryker products, tens of thousands of residents faced the anxiety of potentially problematic medical devices installed in their bodies. Many had to undergo complex revisions surgeries and deal with serious medical complications.

In the aftermath of these high-profile problems, many began asking questions about the federal approval process for these products. After all, not just any device can be sold and used in medical procedures, right? Isn’t there a stringent safety process for these tools to ensure these very mass-recalls are prevented?

The truth is quite complicated, and a wake-up call for all consumers who assume that federal regulations protect them from inherently dangerous products. A recent New England Journal of Medicine (NEJM) article provides a comprehensive summary of the complex history behind the metal-on-metal hip implants and the Food and Drug Administration approval process. All those interested in these issues should check out the full article.

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The changing demographics of the United States are well-known: the country is getting older. This certainly holds true in Chicago and throughout Illinois. The aging of the Baby Boomer generation and increasing longevity (due to advances in medicine) have made individuals in their 70s and 80s the fastest growing group of community members. It is incumbent upon society to take these demographics into account–particularly policymakers. Understanding the best course of action on any number of fronts–health care, taxes, transportation, accessibility, and more–requires an understanding of the actual make-up of the country.

It is from that perspective that the American Association of Retired Persons (AARP) recently published its annual report- Across the States 2012: Profiles of Long Term Services and Supports.

The full report can be accessed here.

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The new Congress that was sworn into office in Washington D.C. last week will soon begin debating a variety of hot button issues. Many of those matters will be of particular interest to all those concerned with proper healthcare for the elderly or fair treatment for all medical patients. In particular, the specter of medical malpractice “reform” will once again rear its head in many committee debates and policy calls.

In that discussion a claim will often be made about “savings” to be had if tort reform legislation is passed. The basis for that claim is generally linked to a single Congressional Budget Office analysis from a year and a half ago. That analysis has been shown severely flawed, as with so much of the information used to push the takeaway of legal rights for patients. The Center for Justice and Democracy published a detailed examination of the errors in the CBO analysis.

Overall, the claims of money saved are taken almost solely from a handful of studies that actually contradict one another. One of those studies even goes so far as to claim that changes to the current structure would allow may cause more than 50,000 more people to die from medical errors each year-on top of the almost 98,000 who already do.

The CBO analysis uses an extreme form of tort reform legislation that no single state has ever accepted, including a hard $250,000 limit on non-economic damages and a one year statute of limitations on claims. The group’s own evidence also suggests that these reforms may actually increase costs, not save them. In states with the most widely used type of reform-limits on joint and several liability-the costs of healthcare actually increased following the legislation.
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One nursing home has five residents over the age of 100 who have all lived in the same nursing home for several years. What do they have in common? All of the residents were assisted by employees that worked at the nursing home for 20 years. Turnover and the impact on residents in nursing homes have been greatly researched. One study found that when there is a loss of administrator there are increasing pressure ulcers, resident catheters and the use of psychoactive drugs. There are also more deficiencies and citations. This could occur because when the administrator leaves the normal turnover of staff doubles. The turnover for administrators in assisted living facilities ranges from 43%-70% annually. This results in increasing workloads for the remaining staff. It is evident that turnover weakens nursing homes and affects residents. In order to keep staff longevity staff must value their relationships. This will obviously help decrease nursing home negligence. To see the full results of the study, please click the link.

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American Association of Retired Person’s Public Policy Institute just released a new report on federal and state approaches to background check screening of home care workers to protect vulnerable from harm. Currently states increasingly require criminal background checks for home care workers to protect vulnerable adults from harm. Forty-six states mandate some form of background check for Medicaid-funded workers, however there is no uniform protocol for screening and disqualifying candidates. There also needs to be robust scholarship on the relationship between criminal behavior and the risk of elder mistreatment. The paper offers an up-to-date assessment of practices including: implementing promising state-level practices to increase accuracy, speed, cost-effectiveness and fairness to job applicants. Also, states should use multiple, complementary screening tools, not just criminal background screening. Criminal background checks will greatly reduce nursing home abuse. To read more about background checks, please click the link.

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The National Consumer Voice for Quality Long-Term Care has designated this week as Resident’s Rights Week. Residents’ Rights Week is celebrated the first full week in October each year to honor residents living in all long-term care facilities. It is a time for celebration and recognition. This is also an opportunity for every nursing home to focus on and celebrate awareness of dignity, respect and the value of each individual resident. Ombudsmen, citizen’s advocacy groups, family and residents councils and long-term care facilities across the country are honoring residents with several events. NCCNHR has put together five ways to participate in resident’s rights week. First visit a resident of a nursing home. While there, encourage a facility to use one of the activity examples from NCCNHR’s Residents’ Rights Week packet. Also you should educate families and the community about Residents’ Rights by writing a letter to the editor of your local newspaper about Residents’ Rights. Finally host a residents’ rights week event. To read more about ways to celebrate residents’ rights week, please click the link.

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The Direct Care Workers (DCWs) are integral to addressing the many elderly family members that live in both nursing homes and need personal care takers. The DCW is also a liaison to the nursing home staff, reporting the care-receiver’s medical and emotional status. The DCW is responsible for the actions of many of the elderly residents. They affect: when and whether the resident gets out of bed; how long the resident has to lie in wet pants; whether the resident’s teeth are brushed; if the nurse is notified of bed sores; whether the resident is malnourished and whether the resident has taken to any morning activities. These are vital activities to both a resident’s day and their stay at a nursing facility. Therefore the DCW is responsible for ensuring that nursing home abuse and negligence does not occur. One way to ensure this is through individualized care plans. Also supervisor training and dementia training can decrease elderly abuse. To read more about the DCW importance, please click the link.

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One of the most under-reported types of abuse is elder abuse. With the economy in shambles, experts expect elder abuse cases will go up. When children move home, or parents move in with their children, elder abuse frequently rises. This is especially true in financial exploitation. One county usually receives 500 calls per month concerning elder abuse. Now that number has risen to 600 a month, partially from the economy and partially from the aging demographics. These experts believe that only one out of every five cases of elder abuse gets reported. Many people are hesitant to report elder abuse and older people are not as visible as children who have the abuse discovered at school. The only thing the experts are quite certain of is that as the population ages, elder abuse will grow. To read more from the elder abuse experts, please click the link.