Nursing Home administrators are lisensed and they are where the BUCK stops…when it comes to issues about abuse, neglect and other problems within their assigned homes. This means that they can be held accountable as in this case:

PROVIDENCE — The former administrator of Hillside Health Center in Providence has been charged with 11 counts of felony patient neglect in connection with problems at the now-closed nursing home, the state attorney general said Thursday.

Attorney General Patrick Lynch announced that James Janetakos, 64, has been charged with intentionally failing to provide appropriate care and services to 11 patients, following a probe into allegations of substandard treatment at the home.

The Providence nursing home closed its doors in May 2004 after going into receivership. Soon after, reports surfaced of poor patient care.

The state alleges that the 11 victims’ health and safety suffered because of a lack of basic humane care and treatment at the facility while Janetakos administered it.

Patient neglect is a felony punishable by up to three years in prison and a $3,000 fine.

The attorney general’s office said there were other patients who suffered due to poor care, but they selected for prosecution the 11 cases in which they had the best evidence of neglect.

The charges against Janetakos conclude only part of the investigation into the former nursing home’s problems, the attorney general’s office said. Thursday’s announcement did not include any charges against Antonio Giordano, the former home’s owner. It was not immediately clear if he will face charges.

According to the attorney general’s office, its Medicaid Fraud and Patient Abuse Unit began investigating Hillside in September 2003 when it received a complaint from the spouse of one of the patients named in Thursday’s charges.

Janetakos is scheduled to appear in Providence Superior Court on July 11 for a pre-arraignment conference.

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Some questions from comments, answered here in a post:

1) Is it O.K. to copy articles for clinical group?
Yes. If you are copying something we have LINKED too, you would need to give full credit to the source.

2) Lots of questions about how to become a CNA. Go to a local nursing home and ask if they are holding training classes. Call your local chapter of the Red Cross-they have an excellent program. Also, try local votech colleges.

3) Online CNA Courses
STAY AWAY from these. While you might gain good info, most states will not accept this for hands on, clinical training. Anyone who wants to become a CNA SHOULD want to have the hands on stuff. Much of what we do in our work revolves around caregiving skills that require our hands…trust me.

4) Hello, I am getting ready to enter my CNA training. I need to interview somoeone who is already a CNA and unfortunately I do not know anyone. If someone would please be willing to answer a few questions for me I would greatly appreciate it!
Ask away! Go to the discussion forum as well.

Another strike….a walkout…who is taking care of the residents? I want to know the outcome of this action. Will the strikers get what they want? Without forcing the facility to make cut backs in other areas? I doubt it.

(June 14, 2005) — Workers at two nursing homes plan a one-day walkout today to protest stalled contract negotiations.

About 200 unionized staff members at Arbor Hill Care Center and Jennifer Matthew Nursing Center are taking part in the walkout, joining workers at seven other nursing homes in the Oswego, Watertown, Albany and Buffalo areas.

The workers are staging walkouts this week to highlight their fight for a contract that they say will give them adequate pay and health care benefits, among other things, said Bruce Popper, vice president of Service Employees International Union Local 1199 Upstate.

The following “reason” given for this walk out is absurd. It doesn’t take this extreme action to get answers about potential funds marked for staffing programs. Did they try a letter writing campaign? Or a petition? Did they go and visit their elected officials first? I bet not.

The union is also using the walkouts to call upon the state Legislature to free up $80 million that has been earmarked for upstate nursing homes, money that would help the facilities improve staff retention and recruitment, he said. Although the money was included in the state budget, it has not been released because legislators never decided how to distribute it.

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An awesome idea. Let’s get rid of the nursing homes…really…they are not really good for most residents, who tend to lose their humanity once admitted. I agree that by going to the more home like settings of assisted living, residents would have far better outcomes. And for those who read this, and think…there is no way nursing homes would ever NOT be needed…Think again. People don’t like how residents are treated, cared for…everything we do as aides…is not always in the best interests of our beloved residents. It’s time to start thinking outside the box.

BATON ROUGE (AP) — A bill designed to encourage nursing homes to diversify into residential care — offering less institution-like settings for the elderly and disabled — awaits debate on the House floor with Gov. Kathleen Blanco’s backing.

Already passed by the Senate, the bill would encourage nursing homes to move into what is called assisted living, where residents live independently in apartment-like settings and receive limited assistance and access to medical care.

Blanco wants to provide more home- and community-based care for the elderly and disabled and has been encouraging nursing homes to broaden the kinds of care they offer. The bill by Sen. Joe McPherson, a nursing home owner, would set guidelines for a potential pilot medical residential program that would be financed with Medicaid money.

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I wonder if this intervention could be adapted for use in nursing homes? It would take a lot of work, dedication of staff from nursing, activities and dietary…but the effort seems like it would be worth it.

Behavioral techniques that are known to improve sleep in non-demented institutionalized older adults may benefit patients with Alzheimer’s disease who have nighttime insomnia, according to the findings of a small study published in the Journal of the American Geriatrics Society.

Dr. Susan M. McCurry and colleagues from the University of Washington, Seattle, examined whether a comprehensive sleep education program — dubbed Nighttime Insomnia Treatment and Education for Alzheimer’s Disease (NITE-AD) — could improve sleep in Alzheimer’s disease patients living at home with family caregivers. A total of 36 patients and their caregivers were included in the study.

All subjects received handouts describing age- and dementia-related changes in sleep and principles of good sleep hygiene.

Seventeen caregivers in the NITE-AD intervention group were given recommendations about developing a sleep hygiene program for Alzheimer’s disease patients. They also received training in behavior management skills. The patients in this group were instructed to walk daily for 30 minutes — in practice, usually accompanied by a caregiver — and to increase daily light exposure by 1 hour using a light box.

The 19 subjects assigned to the other group just received general dementia education and caregiver support.

A wrist-movement recorder was used to measure levels of sleep-awake activity before the intervention, and again two months and six months after the intervention. Secondary outcomes included measures of sleepiness, depression, memory and behavior.

Patients in the NITE-AD group spent an average of 36 minutes less time awake at night — a 32-percent reduction from the start of the study — and had 5.3 fewer nightly awakenings — also a 32-percent reduction from the start of the study — than control subjects, McCurry’s team reports.

Depression levels were also significantly lower in NITE-AD patients and they had lower ratings of daytime sleepiness than control subjects after accounting for level of mental functioning.

Treatment gains were maintained at six months.

“Whether all components of the NITE-AD intervention are necessary to achieve treatment effects and whether the timing of walking and light therapy sessions are important to treatment outcome need to be evaluated, and strategies to enhance long-term treatment adherence should be identified,” the investigators note.

SOURCE: Journal of the American Geriatric Society, May 2005.

We have posted many articles here about elderly and eating habits…all for within the nursing home environment. Lack of appetite happens at their homes too, and it is often the first sign of problems.

ST. LOUIS - Madeline Thompson was a home economist who cooked three square meals a day for her family in Springfield, Ill.

But as she and her husband aged, they began losing their appetites. Denture problems made it hard for John Thompson to chew his food. Depression, dementia and other health problems followed.

The couple, now 89 and 90, didn’t complain but their daughter noticed.

“They started out with a great breakfast, but as the day wore on, they’d eat very little, half a sandwich, half a banana, a glass of milk. They were not eating healthy,” said Jan Winter, who eventually moved her parents to a nursing home near her in St. Louis.

They are better nourished now with round-the-clock care, and are more interested in eating when Winter brings them to her house for Sunday dinners or takes them out to an ice cream parlor.

I think a lot of it is about the social aspects of eating. Who wants to cook for just themselves, and then eat and do all the dishes?

Loss of appetite is often an early warning sign of something gone wrong.

“There’s a fair amount of evidence that suggests if you lose appetite as an older person, in the next six months, you’ll have a higher chance of dying,” said Dr. John Morley, geriatrics director at Saint Louis University Hospital, and a professor of medicine.

Despite conventional wisdom, weight loss is not a normal part of aging.

“They’re not supposed to wither before they die,” said Dr. Margaret-Mary Wilson, who teaches and researches geriatric medicine at Saint Louis University, and has a practice.

Older adults are more susceptible to malnutrition because the stomach empties more slowly in later years, and the sight, smell and taste that used to make eating so enjoyable are diminished.

“The battle to maintain nutritional status is uphill,” Wilson said. “And restrictive diets only make the problem worse.”

Registered dietitian Ann Gallagher, a Fort Wayne, Ind., dietary consultant to nursing homes, estimated that half of new admissions to long-term-care facilities are malnourished and it’s difficult to recover from that.

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Wow. A DON in trouble here….she’s been accused of trying to cover up abuse at the nursing home she managed.
She would have been just telling the truth.

SIOUX FALLS, S.D. - A former Garretson nursing home worker won’t go to court, but the state nursing board has suspended her license after concluding she tried to cover up claims of abuse against a resident.

Minnehaha County State’s Attorney Dave Nelson said there is not enough evidence to bring criminal charges against Jeanette Kreitel, the former director of nursing at Palisade Manor Nursing Home.

But in court documents filed this week, the South Dakota Board of Nursing claims Kreitel lied to law enforcement officers and tampered with an incident report.

She has appealed the suspension and is fighting in court the agency’s attempt to recoup $15,328 in costs and fees.

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