From this week’s Nursing Assistant Trainer Newsletter:

The circulatory system carries blood and lymph throughout your body. Lymph is a fluid created by lymph nodes that contains important substances, including disease fighting white blood cells. This week we’ll review important facts about the blood circulatory system.

The two main parts of the circulatory system are the heart and the blood vessels. The heart is the pump that forces blood through the blood vessels. The circulatory system’s primary functions are to equalize the temperature of the body and carry nutrients and chemicals to its organs and tissues.

The human body has about five quarts of blood pumping through it at any time, and it takes about a minute for the circulatory system to carry all that blood throughout the body.

Blood is composed of red blood cells, white blood cells, and platelets. The red blood cells carry oxygen to the cells of the body and carry carbon dioxide away from the body’s cells, the white blood cells fight infections, and the platelets are involved in the clotting of the blood. The red blood cells, white blood cells, and platelets are suspended in a substance called plasma. Blood cells are manufactured by the bone marrow.

Diseases and disorders of the circulatory system are the number one cause of death in the United States and include:

Hypertension (high blood pressure)
Stroke
Heart disease
Kidney failure
Diseases of the blood and bone marrow
Leukemia
Hemophilia
Anemia
Thrombosis

Source:
from LTC Nursing Assistant Trainer. Property of HcPro, Inc.

Most of us already knew this. Non Profits usually do far better when it comes to care…because money isn’t the end all of the game.

WEDNESDAY, April 27 (HealthDay News) — Nonprofit nursing homes in the United States generally provide better care than their for-profit counterparts, says a study in the April issue of Medical Care Research and Review.

The researchers reviewed 40 comparisons of nonprofit and for-profit nursing home care published between 1990 and 2002. They reviewed data on areas such as staffing, use of restraints and pressure ulcers. The results showed that nonprofit homes generally perform better than for-profit homes, especially in measures of patient care.

Pressure ulcers were more common among residents of for-profit nursing homes, which used psychoactive medications and physical restraints more often than nonprofit homes.

“We don’t really know what it is about not-for-profit homes that allows them to perform better. It could be as simple as them being required to put any profits back into the homes,” study author Michael Hillmer, a doctoral candidate in health policy at the University of Toronto, said in a prepared statement.

FYI…

Dementia Care Conference

Register before May 27 for an $80 discount.

The dynamic program features:
The launch of the Alzheimer’s Association Campaign for Quality Residential Care and an in-depth panel discussion on campaign priorities for this year; food and fluid intake, pain management and social engagement
Sessions focused on staff and management training
A full track on early-stage dementia issues
Several networking opportunities including a Maintain Your Brain™ Walk along Chicago’s breathtaking lakefront

When:
July 26-29, 2005

Where:
Hyatt Regency Chicago Hotel
Chicago, Illinois

About the conference

More than 800 professionals will come together to explore issues related to dementia care. The conference will emphasize management, training and care for nursing home and assisted living staff as well as an entire track dedicated to early stage Alzheimer’s care.

Educational programs, presented by leaders in the field, will give participants insight into the latest developments in dementia care and how to implement new ideas into their programs.

See more about this here—->

From the NY Times, something to consider:

TUPELO, Miss. - At the Cedars Health Center, a traditional 140-bed nursing home here, meals are delivered on trays, hospital style. Hallways floored with linoleum extend in every direction. The smell is sterile and sour.

Cynthia Dunn, 82, lived there until she moved into a Green House, two streets away. Ms. Dunn’s new home, a carpeted ranch-style house that she shares with nine others, has a communal dining table and an open kitchen. Emergency call lights are disguised by decorative stencils. The two staff members who care for the residents answer beepers, not bells, to reduce the institutional cacophony. On a recent visit, the smell at the door was of corn bread baking.

Ms. Dunn, who has her own bedroom and bath at the Green House, pulled herself up in her wheelchair without invitation and expressed her opinion on where she lived. “This is the most wonderful place I’ve been to yet,” she said. “The people, the food, everything.”

The Green House Project, comprising 10 new suburban houses here, is an experiment in reinventing the nursing home. Its creators hope it will herald a new age for old age, although its advantages to residents are yet unproved in health care studies.

Green Houses are part of a broadening movement to humanize care for elderly people with smaller, more domestic settings and a closer sense of community among residents and staff members. And they are an effort to address the fears of being institutionalized, among them anxieties about the loss of independence and the potential for abuse.

Read more—>

This is typical in every state and should not be happening. Criminals need to be known to their neighbors, roomates and anyone else who might become a victim. Crime knows no age boundaries either. I have seen the results of admitting a resident who was a lifelong criminal into an Alheimer’s Unit. Not pretty.

Sixty-one criminals on parole from the state’s prison system are living in 37 nursing homes alongside vulnerable people who have virtually no way of knowing they’re there, state documents obtained by the Chicago Sun-Times show.

Unlike sex offenders — whose names and addresses are disclosed in an online registry — the Illinois Department of Corrections doesn’t publicize identities of paroled murderers, burglars and other criminals living in long-term care facilities. Releasing details about those convicted of non-sex crimes “would constitute a clearly unwarranted invasion of personal privacy,” a corrections official wrote in response to a Sun-Times inquiry.

Read more —->

Work in Arkansas? In a nursing home? Here’s some news…

FORT SMITH, Ark. — A deadline has been set for Arkansas nursing homes to install smoke detectors in every room, state officials said Sunday.

State officials said 125 of Arkansas’ nursing homes will fall under a new federal safety law that requires the smoke detectors. The state’s remaining nursing homes already have full sprinkler systems, officials said.

Most nursing homes that 40/29 contacted on Sunday said they already meet the requirements of the law.

Any facility that is not in compliance with the new law has until May 2006 to meet federal standards.

Wow. Read this. Russia has a long way to go before it catches up with the US when it comes to healthcare for disabled. Sickening.

A federal appeals court granted asylum eligibility Thursday to the family of a Russian child with cerebral palsy who, at birth, was dumped into a hospital waste disposal bin, then institutionalized against his parents’ wishes, denied medical care and beaten and tormented until the family fled to California.

The abuse suffered by Evgueni Tchoukhrova was typical of the discrimination faced by disabled children in Russia and amounted to persecution that makes him and his parents eligible for asylum, said the Ninth U.S. Circuit Court of Appeals.

The boy was born in 1991 in Vladivostok and was afflicted with cerebral palsy chiefly through negligence during childbirth, the court said. He survived the disposal bin, then was kept for two months under filthy conditions in a state institution, where most such children are held for life, the court said. His parents got him out and brought him to the United States for treatment, but after his return he was denied medical care and schooling, and was taunted, spat at and assaulted when in public, suffering a broken arm on one occasion and head injuries on another.

Read more—->

Here is more from the NH Abuse site:

There are a myriad of remedies for you if you have an abuse or neglect situation that includes complaints made to various government agencies. Some remedies are more effective than others and the remedy you use will often depend on the severity of the abuse and neglect. In pursing any remedy, be prepared to be frustrated but you must remain persistent.

Ombudsman - Most states have a long term care ombudsman program. Their success rate and true commitment to quality care depend on each ombudsman program. In general, ombudsmen can help you get a new mattress for your family member, make the nursing home pay for lost or stolen items, and other types of simple problems but they may not be able to tackle serious problems involving lack of care. There are some aggressive ombudsman offices, but they are at the mercy of the state health department bureaucracy. It is best to use this office for non life threatening situations.

State Department of Health - The Division in a State Department of Health that deals with the oversight of nursing homes and enforcement of nursing home regulations is, in most states, called the Division of Licensing and Certification. This bureaucracy licenses the nursing home facility for the state and is also responsible for certifying the facility for participation in the federal Medicare and Medicaid programs each year. The state conducts yearly inspections, called surveys, of each nursing home and also investigates complaints. Some of the state surveyors are quite good, but there is enormous pressure on the state bureaucracy and legislature by the powerful nursing home lobby to keep remedies and fines to a minimum.

You can file a complaint with Licensing and Certification and they must investigate the complaint. Licensing and Certification can either substantiate or unsubstantiate your complaint. If the complaint is substantiated, this agency can issue a citation and impose a fine and require corrective action. The nursing home as a right to appeal a substantiation finding by the state and you have the right to an informal hearing on a unsubstantiated finding. Unfortunately, the nursing home often gets a fine reduced and often only temporarily corrects the problem. The surveyors often rely on the nursing home records in their investigation and these records can be falsified or “cleaned up”. The nursing home, through deduction or leaks usually finds out who made the complaint.

Surfing around the web, I came back to this site that has some good stuff about nursing home abuse. The site is for consumers, and I think it is always a good idea to read what info they are getting.

The Certification Survey

Under federal law, nursing homes that are participating in the Medicaid and Medicare programs, are to undergo an annual survey and certification process. The purpose of the survey process is to assess whether the quality of care, as intended by the law and regulations, and as needed by the resident, is actually being provided in nursing homes. Nursing homes must be in substantial compliance with Medicaid and Medicare care requirements as well as state law. If a nursing home is found to be out of compliance, federal law sets forth enforcement options such as denial of payment for new admissions, civil money penalties, revocation of Medicaid and Medicare certifications, transfer of residents and the imposition of temporary management. In implementing the survey and certification process, several expectations of nursing homes were established. These expectations were:

Nursing homes participating in the Medicaid and Medicare programs remain in substantial compliance with the Medicaid/Medicare care requirements.
All deficiencies will be addressed promptly.
Residents will receive the care and services they need to meet their highest practicable level of functioning.

Surveys are supposed to emphasize resident outcomes through observations, interviews and review of medical records. Surveyors are to ascertain whether a nursing home is actually providing the required and needed care and services, rather than whether the facility is capable of providing the care and services.

Certification surveys are conducted on an annual basis by a state or local survey agency that has entered into an agreement with the Health Care Financing Administration (HCFA). In California, the survey agency is the Department of Health Services, Licensing and Certification. Surveys, by law, are supposed to be unannounced.

Listed below are the survey tasks conducted by the survey agency for each survey:

Task 1. Entrance Conference

Task 2. Obtain Resident Sample

Task 3. Tour of the Facility. Resident Needs. Physical Environment. Meeting with Resident Council Representatives. Tour Summation and Focus of Remaining Survey Activity.

Task 4. Observation/Interview/Medical Record. Review of Each Individual in the Resident Sample (including drug regimen review).

Task 5. Drug Pass Observation.

Task 6. Dining Area and Eating Assistance Observation.

Task 7. Forming the Deficiency Statement.

Task 8. Exit Conference.

The New Food Pyramids are available. Check them out.

The U.S. Department of Agriculture released a new food pyramid, which breaks food categories into a spectrum to emphasize variety. Exercise was introduced as a component of the food pyramid, and 12 individualized intake profiles were added.