As far as I know, no residents I have worked with in recent years took asprin for pain. They all took either acetaminophen or ibuprofen…and once in a while narcotics, for serious pain. This article puts it all into a new light for me:

FRIDAY, May 20 (HealthDay News) — Daily aches and discomfort may become more common with age, but elderly Americans shouldn’t have to increase their dosage of narcotic pain relievers to keep up with the pain, researchers report.

On the other hand, people under 50 years of age may need to ramp up their dosage of these opioid pain-relieving medicines — drugs like morphine, OxyContin and Percocet — to achieve ongoing relief, reports a study in the June issue of Anesthesia & Analgesia.

“Opioids are very safe if they’re used and dosed appropriately. The elderly should realize that these are very viable options for severe pain and they shouldn’t worry so much about the stigma attached to these drugs,” said researcher Dr. Pamela P. Palmer, professor of anesthesia and director of the pain management center at the University of California, San Francisco.

“Older people won’t have to escalate their dose much,” Palmer added. “However, tolerance is a very real issue in younger patients. Daily chronic use of opioids in young patients may not be getting them anywhere in the long run because our data shows that the average pain score was not improved” with a higher dose.

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We all know this too…But it’s good to see it in writing just in case some forget.

AKRON, Ohio - A noisy manufacturing plant. The fast-moving traffic of busy city streets. A landfill active with heavy machinery.

A nursing home.

How does the sedate environment of a residential health-care facility end up on this list?

Like the others, it’s one of the most hazardous places to work in the United States.

According to the U.S. Department of Labor Bureau of Labor Statistics, the nursing home industry’s worker-injury rate was third highest among 84 industry groups in 2003, the most recent year for which data are available.

Unlike the other high-risk industries, however, nursing homes are not governed by direct standards set by the Occupational Safety and Health Administration. And while efforts are being made to improve worker safety, the issues are complicated and the solutions are costly.

Meanwhile, the health aides who bear the brunt of those injuries are in one of the fastest growing occupations in the region.

”Ten years ago, we didn’t even pay attention to nursing homes,” said Rob Medlock, director of Occupational Safety and Health Administration’s Cleveland-area office. ”People thought, ‘Nursing homes? They cared for my grandfather, I know they’re good.’ ”

The trouble is, in caring for those who can’t care for themselves, workers sustain their own injuries.

Nursing assistants, in particular, hurt their backs, necks and shoulders while lifting patients.

Also, they face the often-unspoken hazards of working with individuals whose medical conditions make them prone to lash out, kick or even strike their caregivers.

In March, OSHA sent informational letters to about 14,000 employers with higher than average work-related injury and illness rates based on a 2004 nationwide survey of 80,000 employers.

When I read this, I got defensive. Of course falls should not happen, ever. But they do and that is the reality of being older. Whether a fall occurs at a nursing home or at home…makes a difference I guess. More elderly fall at home than do at nursing homes-and no nursing home can prevent every fall. It’s just impossible.

SAGAMORE HILLS — You put your loved one in a nursing home hoping he or she is safe from harm.

Yet, each year, 35,000 residents are injured or killed in a nursing home fall.

Even in the best facilities, falls are common. But in some cases, could they be prevented?

Carl Monday found it’s a problem that’s become a nursing home nightmare for some residents and their families.

“My Aunt Mary was in my life since the day I was born,” said Michelle Starcher.

That’s how Michelle Starcher wants to remember Aunt Mary Kish.

Instead, she’s haunted by photographs of the frail 85-year-old woman shortly after a shower room fall two years ago at the Brentwood Health Care Center in Sagamore Hills.

“She did not deserve this,” Starcher said.

Sam McCoy is the director of elder rights services for the five county area agency on aging. “[This] shouldn’t have happened,” McCoy said when looking at the disturbing pictures.

Two months ago, McCoy sent a staffer into Brentwood to investigate Mary Kish’s fall. The accident happened two years ago. Why the delay? McCoy says until recently, no one reported the fall to his agency and no one reported it to the state.

“The nursing home has a responsibility to report significant injury like this to the department of health,” McCoy said.

But the Ohio Department of Health says it has no record of Mary Kish’s fall. It says nursing homes are not required to report falls unless there’s clear evidence of neglect or abuse.

McCoy says his investigator couldn’t document the cause of the fall. After all, it was two years later. But, he says his agency was still concerned, especially after his investigator observed an employee ignoring a motion alarm set off by an elderly resident.

“It’s a problem,” said McCoy. “It’s a problem for the 100 residents at that facility. The potential is there. The risk is there.”

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I think most of us already know this…but it’s a good read anyway.

NEW YORK (Reuters Health) - The likelihood of and elderly person committing suicide is significantly higher if he or she has been hospitalized for a medical illness in the previous 2 years, according to Danish researchers.

However, the suicide risk in this population is still lower than that in middle-age people.

Dr. Annette Erlangsen, and colleagues from the University of Southern Denmark, Odense, evaluated the effect of hospitalization for medical illness on the risk of suicide in 1,684,205 people at least 52 years of age living in Denmark during 1996 to 1998. The subjects were divided into three groups: older than 80 years of age (oldest old), 65 to 79 years (old), and 52 to 64 years (middle-age).

A total of 1184 subjects committed suicide during the 3-year study period, including 779 men and 405 women, the investigators report in the Journal of the American Geriatrics Society.

The oldest-old men who had been hospitalized during the previous 2 years had an increased risk of suicide, at 113 per 100,000 versus 80 per 100,000 in the general population of men of the same age.

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I don’t know why Patti hasn’t put this up here before. Or maybe she has and I don’t know it. Anyway this is a comprehensive site that devotes it’s content to nursing home inspection results…For all the USA. The site keeps a WATCH LIST for each state too. If you’re a nurse or CNA/LNA, I would check out potential employers here too. Look to see how your nursing home rates.

The Registry lists 16,000 homes by state. Click on the state whose homes you want to check. (Files for larger states such as Texas, California and Pennsylvania may take a couple of minutes to download.) The homes for each state are listed alphabetically. You will the results of the past three government surveys for each home. If a home also appears on our National Watch List, there will also be a link to that information. Homes on the National Watch List have had recent survey violations or have had substantiated complaints of actual harm or immediate jeopardy.

If you live in Louisiana this might be good news. More and more states are doing this, following the lead of Colorado and New Hampshire 6 years ago.

Following its smash-hit Web site giving sanitation inspection results for every restaurant and fast-food spot in Louisiana, the Department of Health and Hospitals has opened a similar site for nursing home inspections.
It doesn’t show details about what inspectors found wrong. But it does have a color-coded system: green for nursing homes which passed inspection; yellow if inspectors found a problem that could cause more than “minimal harm,” orange if they found that actual harm had been done, and red for “immediate jeopardy.”

It also lists — often at length — the rule that was broken, so that one can learn, for instance, whether the infraction was a matter of abuse, food handling, general sanitation or something else.

Another column lists whether the inspection was the result of a complaint, the annual health inspection, a follow-up check on problems or a “life safety code inspection” — bureaucrat-speak for fire code inspection.

Each inspection report is identified by number. People who want all the details can write the department to ask for the report, Department of Health and Hospitals spokesman Bob Johannessen said.

I have heard from aides who work in NY nursing homes. They would agree with this article 100%.

ALBANY, May 15 - State health inspectors routinely failed to identify problems at New York nursing homes over the last three years, and those problems only came to light during follow-up visits by federal inspectors, according to a study by a consumer advocacy group.

Federal inspectors were also more rigorous than their state counterparts in rating the problems they uncovered as either endangering people or being widespread, said the study by the Long Term Care Community Coalition, a nonprofit group that has long been critical of the state’s Department of Health for being lenient on long-term care providers.

The study drew its main conclusions from a comparison of the findings in 12 cases in which federal inspectors double-checked the work of state inspectors within weeks of their visits. But it also compared national data and found three significant problem areas in New York: that nursing staff levels fall below the national average; that inspectors verify fewer complaints about poor conditions; and that the numbers of deficiencies identified per nursing home are fewer than in 38 states.

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