This is sad-what happened to this woman. I suspect she died of an infection related to the removal of the catheter. Or she simply had a UTI that went undetected. Goes to show how much we really need to document the care and treatments we give. Nursing assessments should have been done as well.

WAUKESHA - A jury deliberated for about three hours Tuesday before awarding the estate of a woman and her late husband more than $700,000 after finding a Brookfield nursing home negligent in its care for the woman.
Helen Nissenbaum, 77, was admitted to the Woodland Health Care Center, 18740 W. Bluemound Road, on Oct. 24, 2001, to recover from an aortic aneurism. But she died Oct. 29, 2004, from what doctors said was probably septic shock from a urinary tract infection.

Her husband, Gabriel, started the suit in Milwaukee County in 2003 but died in 2004, said Jay Urban, attorney for the estate.

After a five-day trial before Circuit Court Judge James R. Kieffer, the jury returned from deliberations Tuesday to announce that it believed Woodland was negligent in its care of Nissenbaum, which caused her pain and suffering and led to her death. It awarded the estate $200,000 for conscious pain and suffering, $14,650 in hospital and funeral bills and $500,000 in compensatory damages.

Urban said that Nissenbaum had been catheterized during a hospital stay prior to coming to Woodland, and the catheter was removed before she went there, leaving her susceptible to a urinary tract infection. The day after Nissenbaum was admitted at Woodland, she began showing a decreased appetite and forgetfulness. By the third day, she was complaining of pain and stated she wished she would die, and she was found on the floor next to her bed, Urban said.

A day later, Nissenbaum was sliding in her wheelchair and yelling. By the following day, she was responsive only to pain stimuli and had decreased vital signs. Family members asked she be moved to Elmbrook Memorial Hospital, where she died.

During her stay at Woodland, there were several gaps in the documentation of her health, which jury foreman Bitty Bitters said was a key factor in the jury’s findings.

“The fact she ultimately died because of a certain ailment that is fairly common among older women in nursing homes was a big factor,” he said.

Attorneys for Woodland declined to comment on the verdict, saying they needed to consult with their client.

Urban said Gabriel and Helen Nissenbaum survived the Auschwitz and Bergen-Belsen death camps and the Warsaw Ghetto during World War II, where almost all of their families perished. They met in a displaced persons camp in Germany and in 1949 settled down in Sheboygan, where he was a cattle trader. Having been through so much with his wife, Gabriel Nissenbaum deserved to be compensated for the two-plus years he lived without her, Urban said.

“I think it was a fair verdict and our attorney and his staff did a wonderful job,” said Martha Gilerovich, the Nissenbaums’ daughter, who wept quietly in court as the verdict was read. “We waited four years for this. The truth finally came out.”

NOW this is a great idea. Activities need to be good. Activities need to be fun. And nursing management/staff need to think outside the box.

MACON - Tea parties, facials, manicures and even water gun fights often take place at Eastern Star Home in Macon off U.S. 51 South.

But on Friday, the ladies at the home decided to take their activities to another level and go joy riding on an all-terrain vehicle.

“My wife, Darlene, who is activity director here at the home, asked me if it was safe to take the ladies out on the four-wheeler. They love being outside and taking a ride kind of brings them back to their younger days,” said Tom Gallion, who is the chaplain at Eastern Star Home. “And they usually have a blast.”

Gallion had taken a few of the ladies on the four-wheeler in August.

He helped the women, mostly in their 80s and 90s, onto the back of the Polaris Sportsman 800 four-wheeler and motored his way down the half-mile driveway leading up to the home and through an empty field on Friday.

Mary Stratman, 100, who had ridden on the four-wheeler over the summer decided to sit this one out. “It’s more fun to watch the others,” she said.

However, she encouraged her friend Edna Manes, 95, to go on the ride. “She’s just a spring chicken,” Stratman said as she laughed and clutched her friend’s hand.

Manes parked her walker by a tree and was assisted onto the back of the four-wheeler by Gallion and the nursing staff.

“It gives you a feeling of freedom that you don’t get in a closed car,” Manes said.

Vera Swearingen, 84, who loves doing different things, took a spin on the four-wheeler twice Friday.

“I told him (Gallion) to go fast because he was only going 25 mph,” Swearingen said. “I told him next time I’ll have to drive.”

Chants were heard by the staff, “Maggie Maggie” as they edged on another resident to take a ride on the four-wheeler.

Maggie Jessup, 88, had never ridden on a four-wheeler before, and it took her awhile to decide whether to do it.

Jessup was slowly eased onto the back of the four-wheeler along with the home’s administrator, Teri Jo Lynch, for support. Both women held on tightly to Gallion as he drove off down the curving roadway.

“It was a smooth ride,” Jessup said, after returning from the short journey.

The exclusive home is only for ladies who are members of Order of the Eastern Star.

What had originally been a mansion on a vast piece of land in Macon in 1895 was turned into a residential facility for the ladies of Eastern Star, said Lynch.

She said after a fire broke out and damaged the home in the 1950s, it was rebuilt into a beautiful brick facility and continues to be refurbished.

Can you imagine the smiles on these ladies faces after those rides? Doing something so different must have made them feel good about themselves, again. More nursing home activities need to be like this.

An incentive plan that has worked…

WOODSTOCK – McHenry County officials are lauding a trial program to reduce costs at Valley Hi Nursing Home that saved more than $20,000 in its first three months.

After shelling out nearly $900,000 to staffing agencies last year for registered nurses and certified nursing assistants, the county hatched a plan in April to reward nurses and orderlies who showed up for work with a cash incentive.

By paying them a lump sum equal to $1.78 for every hour they worked, the county saw a 32 percent reduction in its use of more expensive temporary workers in the third quarter.

“It did more than what I thought it would do because talking to some of the people out there, they are very happy with it, they are not calling in sick one day because they want the extra money,” said Mary Lou Zierer, R-Harvard, chairman of the Valley Hi Committee.

The county spent $64,567 less on agency nursing staff during the third quarter than it did last year and saved almost $21,000 after it paid out the cash bonus.

Because the nursing home must provide a state-mandated amount of staff at the 117-bed facility, it is forced to hire agency orderlies at around $23 an hour. A full-time certified nursing assistant with benefits costs the county about $16 an hour, one of the lowest-cost positions on the payroll.

Frequent sick calls and a high turnover rate – 43 percent last year – among nursing staff have caused consternation in the nursing-home administration. But now officials believe that they have a way to combat the problem and save money.

While county officials want to make the incentive plan permanent, they will run it for another quarter before making a final decision, Zierer said.

Here’s an excellent article.

PITTSBURGH — A group of academics, business leaders and residents are convening this week to bring together the region’s large elderly community, private industry and university programs in medicine and technology.

The resulting conference is a look into the region’s latest innovations involving technology and aging. From virtual communities on the Web to remote medication monitoring, technology is something that can be used to empower the elderly, said Judith Tabolt Matthews, one of the organizer’s of Friday’s meeting.

For decades, researchers have been exploring ways that the elderly can utilize technology to enhance their quality of life. An article by a psychiatrist and computer scientist in a 1972 journal called The Gerontologist concluded technology was necessary to keep the elderly independent.

Matthews said Pittsburgh’s large elderly population gives researchers here an advantage. About 16% of the city’s 334,000 residents are over 65, well above the national average of about 12%.

“We are engaging older adults or users of whatever the technology is in the development of it, and that, I think, makes it a much stronger process,” said Matthews, an assistant professor in the Department of Health and Community Systems at the University of Pittsburgh School of Nursing.

Jim Osborn, executive director of Carnegie Mellon University’s Medical Robotics Technology Center, said technology could be used in many ways to help the elderly live more independently, such as with remote medication monitoring. But, he said, there is a challenge.

“We have to come up with ways of using technology to simplify technology,” said Osborn, who is also CMU’s coordinator of the University Life Science Initiatives.

He said the Pittsburgh region’s elderly population, old infrastructure and the challenges of the geography make the area an ideal place for research.

“Part of the reason we want to do this here is because we recognize we could be doing a great service to our indigenous population,” Osborn said. “Also if you can solve problems here, solutions for other places will be that much easier.”

Jeff Pepper founded a company in 1999 that encourages the elderly to use the Internet, and makes it easier for them do to so. One of the many services the Oakmont-based Touchtown Inc. provides is an e-mail service that can be used by dictation instead of typing, allows users to click on a picture of someone instead of typing in their e-mail address and is easily viewed with large type and high contrast.

Pepper said the services they offer, including private channel television systems at retirement communities, help the elderly learn to embrace technology instead of shunning it. The elderly won’t use technology if they feel it’s too complicated, he said.

“An older person has a great deal invested in their self-esteem and they don’t want to look like a fool in front of their kids or grandkids. So they tend to be unwilling to take risks with technology,” Pepper said.

Matthews said the key is developing something that fits their needs — and works.

“Older adults are very accepting of technology,” Matthews said, “as long as it is intuitive to use and reliable.”

I have often said that it would be MUCH cheaper to keep people OUT of nursing homes just by adapting their homes for them. People would be so MUCH happier too to stay at home. Here is how one area is doing just this:

It took a wheelchair ramp to get Floyd Hartley out of a nursing home.

And a stair glider. And a special mattress.

In all, the state’s Medicaid program, which doesn’t normally pay those kinds of expenses, shelled out about $6,200. The modifications allowed Hartley, now 52, to move in with his mother and sister in a neat East Baltimore rowhouse.

The state program also pays $22,500 a year for a personal care aide and the same amount to Hartley’s sister to watch over him several hours a day - costs Medicaid doesn’t usually bear.

That’s still cheaper than keeping Harley in a nursing home, which in Maryland costs $60,000 a year and up.

Hartley is one of about 400 disabled people enrolled in a pilot program designed to get people out of nursing homes. A similar pilot program for the elderly is capped at 2,800.

Now Maryland is moving to broadly expand its efforts to move patients and dollars from nursing homes to home care, assisted living, adult day care, group homes and other home and community-based programs.

The reason is compelling: Maryland Medicaid already spends almost as much on 22,000 nursing home residents - more than $800 million a year - as it does to provide full health insurance to 400,000 adults and children.

With a growing older population and rising health costs, the state’s nursing home tab - which has more than doubled in a decade - is bound to increase.

The initiative, called CommunityChoice, promises to reshape the way the state cares for tens of thousands of frail elderly and people with disabilities.

“We hope to create new kinds and levels of care we don’t have now, to give more or better care in home or in home-like settings,” said S. Anthony McCann, secretary of the state’s Department of Health and Mental Hygiene (DHMH). “In general, it’s the right thing to do, to give options to the patient,” McCann said. And, he noted, “it’s cost-effective.”

Imagine all the money each state would save, and therefore the federal government (and therefore you and me) if each nursing home resident had an honest assessment down- what would be needed to return this resident to their homes? Add up the costs of the needed things and I bet in almost every instance it would be WAY cheaper than nursing home care.

This is a first I think. I’ve never heard of anyone suing a state because of lack of action taken into complaints. It may be a good thing.

Exasperated by what they say are years of state indifference to nursing home complaints, two San Jose-area women and a watchdog group are suing the Department of Health Services in hopes that the courts can force the agency to follow its own rules.

State law requires nursing home complaints — written or oral — to be acknowledged within two days and investigated within 10 days. That seldom happens, say critics of the department. And a department spokeswoman said Tuesday that in only about 40 percent of the less serious cases — those that do not involve an immediate threat to life — are investigations begun within 10 days.

“More and more complaints are not investigated at all, or not on a timely basis,” said Patricia McGinnis, head of California Advocates for Nursing Home Reform, one of the plaintiffs in the lawsuit.

The timing is crucial, because “with each day of additional delay in responding to complaints, memories fade and evidence disappears,” the lawsuit argues.

Other plaintiffs

The other plaintiffs are Patricia Ann Bryant of San Jose and Julie Fudge of Los Gatos.

The lawsuit charges that neglect by Terenno Gardens Extended Care in Los Gatos “was instrumental in the decline and premature death” of Bryant’s mother, Catherine Ann Bryant, 85. The neglect involved failure to treat a pressure wound that became infected.

Fudge’s mother, Marian Rodgers, 93, a six-year resident of Saratoga Retirement Community Health Center, was allowed to become dangerously short of oxygen, went into a coma and died, according to the lawsuit. Representatives for the two nursing homes were unavailable Tuesday evening.

Both women filed complaints with the Department of Health Services. In Bryant’s case, it was seven weeks before the department went out to investigate. In Fudge’s, it was several months. Bryant’s complaint was eventually substantiated; Fudge’s was not, although the lawsuit argues that “an `unsubstantiated’ finding does not mean that the abuse, neglect and other conduct complained of did not actually occur.”