Outsourcing the care of our elderly. To India.

After three years of caring for his increasingly frail mother and father in their Florida retirement home, Steve Herzfeld was exhausted and faced with spending his family’s last resources to put the couple in a cheap nursing home.

So he made what he saw as the only sensible decision: He outsourced his parents to India.

Today his 89-year-old mother, Frances, who suffers from advanced Parkinson’s disease, gets daily massages, physical therapy and 24-hour help getting to the bathroom, all for about $15 a day. His father, Ernest, 93, an Alzheimer’s patient, has a full-time personal assistant and a cook who has won him over to a vegetarian diet healthy enough that he no longer needs his cholesterol medication.

Best of all, the plentiful drugs the couple require cost less than 20 percent of what they do in the U.S., and salaries for their six-person staff are so cheap that the pair now bank $1,000 a month of their $3,000 Social Security payment. They aim to use the savings as an emergency fund, or to pay for airline tickets if family members want to visit.

In the end, it’s always about money over much else. I find this option, as it is, a sad example of the selfishness of American people.

Changing models of care: Quite the process.

MANITOWOC — Felician Village, the county’s largest senior housing facility, is transitioning toward a future unlike its past — a future driven, in part, by baby boomer expectations.

The local transition reflects changes taking place nationwide. Depression-era residents who tend to be satisfied with whatever retirement housing is available soon will be replaced by independent, tech-savvy boomers likely to expect the comforts they’ve enjoyed throughout their lives to remain accessible during retirement.

Highlights:

The shift from a medical emphasis to a residential one doesn’t merely affect facilities. It calls for a change in staff as well that could eliminate the traditional hierarchy altogether in an effort to create a family-like structure.

Staffing is 65-70 percent of Felician Village’s total budget, Kaldor said. For independent living facilities, the ratio is about one staff member for ever 20 residents on a day shift, whereas nursing home staff is much more dense. With the upcoming changes, the institution will see a reduction in staff at St. Mary’s and workers will be moved to other facilities, she said.

“Any employee may be doing more than one aspect of care — it’s more the concept of a universal worker,” McLaughlin said. “We’re really maximizing their use … that same staff will work more directly with the resident on a continual basis, building a stronger relationship with them.”

That means a major shift in quality of life for the nursing home sector.

“They should tell us when to eat breakfast, when to go to sleep. They should decide what they’d like to do each day,” Slack said. “The staff then would help those residents live their lives.”

Any program that reduces the numbers of management people is worthy of a serious second look…and directing the mission to the resident vs. the staff is a good start. I would like to see the term “resident” changed, to customer. After all that is what they are.

More evidence linking corporate owned nursing homes to poor care.

BROCKTON— Many of the area nursing homes that were ranked below average in a recent state survey are owned by the same national corporation, an Enterprise inquiry found.

The survey from the state Division of Health Care Quality included 450 nursing homes in Massachusetts, including 33 locally. It asked family members of nursing home residents to rate their satisfaction with several factors, such as “resident’s needs met” and “personal care.”

Nineteen of the area’s nursing homes ranked above the state average rating, and 14 ranked below it.

Among the below-average homes, five of them are owned by a single national company — Kindred Healthcare Inc. of Louisville, Ky. Those homes are Blue Hills Alzheimer’s Care Center of Stoughton, Colony House Nursing & Rehab Center of Abington, Embassy House Skilled Nursing & Rehab Center of Brockton, Forestview Nursing & Rehab Center of Wareham, and Goddard Rehabilitation & Nursing Center of Stoughton.

All five of the homes earned a rating below the state average of 4.19, out of a possible high of 5.0. One of the company’s area nursing homes, Sachem Skilled Nursing & Rehab Center of East Bridgewater, ranked above the state average.

Kindred Healthcare, a Fortune 500 company that claims 600 facilities in 38 states, did not return a message seeking comment Monday.

Goddard Rehabilitation, which earned the lowest rating of any area nursing home, said in a statement that it is working to make needed improvements, including changing its administration.

“Resident care and safety is our number one concern,” the statement reads.

care and safety? After what profit margin?

A study is being done on the effects of certain dietary supplements on Alzheimer’s Disease.

The University of Michigan is seeking volunteers to participate in a national study to determine whether taking supplements like fish oil or omega-3 capsules slows the onset of Alzheimer’s disease.

Millions of Americans spend money on the daily supplements. While there’s some evidence that they work, they’ve never been evaluated in such a rigorous, scientifically controlled study.

A total of 51 health centers across the country are part of the study, funded by the National Institute on Aging, which is part of the National Institutes of Health. U-M is the only health center participating in eastern Michigan.

Men and women who are at least 50 years old and have been diagnosed with mild to moderate stages of Alzheimer’s disease are being recruited for the study. Sixty percent of study participants will be randomly assigned to take capsules of DHA daily for 18 months, while the rest of the participants will take an inactive placebo.

DHA is a specific type of omega-3 fatty acid thought to protect cells in the brain from an amyloid protein that is a leading culprit in the progression of Alzheimer’s disease.

The participants’ health will be assessed during the study period. Neither the participants, nor the researchers, will know who gets which substance until the end of the study.

Determining whether the supplements really work is important because five million Americans have Alzheimer’s, and that number is expected to increase rapidly in the coming decades.

“It’s a devastating disease,” said Dr. R. Scott Turner, associate professor of neurology at the U-M Medical Center who is leading the study. “Millions of people are affected and our goal is to try to, first, prevent further decline in someone who has memory problems, to keep them out of nursing homes, and to determine whether all the money spent on (the supplements) is really money wasted or money well spent.”

For more information or to take part, call 734-647-7760 or follow the link to the DHA study at www.med.umich.edu/alzheimers.

A Tennessee nursing home cannot accept any new admissions.

NASHVILLE, Tenn.- Poor conditions at a local nursing home prompted the state to prohibit the facility from admitting new patients.

The state suspended any new patients from being admitted to the Cornelia House. This decision came after an investigation wrapped up just days ago. The Cornelia House has been under fire, not once, not twice, but five times.

Resident James Holt likens his stay at The Cornelia House to a prison sentence, but the state said security is precisely what’s lacking.

“We’re confined, and we’re only allowed out every two hours to smoke. And we can’t smoke after 11:00. Can’t nobody go out after 11:00,” said Holt.

A State Health Department review paints a different picture, detailing a successful escape this past April, in which a patient with dementia walked out a smoking door and was found down the street at a local business.

Effective Friday, Cornelia House is banned from admitting new residents because staff just can’t seem to keep patients from escaping. The state said residents there are in “immediate jeopardy.”

“There are specific things that are supposed to be done to prevent patients from running away, and those haven’t been done. So, all of these deficiencies have to do with operational issues,” said Andrea Turner, TN Department of Health.

State inspectors also cite inadequate resident care plans, and failure by the staff to keep patients with feeding tubes from choking. The state slapped Cornelia House with a $7,500 fine and is recommending a federal penalty of $6,200 a day.

The state issued penalties in February of 2003, March of 2004, February of 2005, and August of 2006.

For the next 10 days the nursing home is forbidden from taking new patients, and it’s being slapped with daily fines.

Investigators discovered problems with quality of care, nursing services, and resident protection. The investigation also revealed staff was not following through with several procedures. The Cornelia House is a 159-bed nursing home located on Porter Road in Nashville.

Again I tried to find information about who owns this nursing home and nothing shows up. If anyone knows please leave the info in comments.

Life Care Centers of America has been arraigned in the death of a MA woman- the state of MA is going after the chain.

CAMBRIDGE, Mass. (AP) - A Tennessee nursing home corporation indicted in the 2004 death of a woman who lived in their facility in Acton, Massachusetts, pleaded not guilty today.

Life Care Centers of America, based in Cleveland, is charged with manslaughter, abuse and neglect of a long-term care resident.

The company is also accused of making a false Medicaid claim in connection with the death of 74-year-old Julia McCauley.

Investigators said McCauley — who was confined to a wheelchair — was under doctor’s order to wear a device that would sound an alarm if she wandered too close to an exit door.

On the morning of April 17th, 2004, McCauley was found dead in her overturned wheelchair down a stairway. Authorities say she wasn’t wearing the monitoring device.

It’s the first time in Massachusetts that a nursing home corporation has been indicted for manslaughter.

We will be watching this case closely and will update as news becomes available.

A Texas nursing home has been taken over by the state.

Attorney General Gregg Abbott has taken action responding to a report the Texas Department of Aging and Disability Services (DADS) provided after investigating Amberwood Care Center in Celina.

DADS inspectors responded to a complaint about the facility, and their findings were represented by the Texas Office of the Attorney General in court. At the attorney general’s request, a Travis County District Court submitted a temporary restraining order against Amberwood Care Center and Owner James Jewel on July 20.

“Texans will not tolerate those who abuse and neglect our senior citizens,” Abbott said. “These horrific conditions posed a severe threat to the health and safety of patients who deserve far better. The Office of the Attorney General and the Department of Aging and Disability Services are committed to protecting seniors and aggressively prosecuting those who neglect them.”

Among their findings, DADS investigators documented the following:

• Patients suffering from bed ulcers, infections and chronic pain. Several languished in various stages of dehydration.

• Many residents told investigators that they were not being properly cared for, including an elderly woman who said she had to endure days of pain before a urinary tract infection was treated with antibiotics. • Investigators reported unsanitary conditions throughout the facility. One DADS report described a patient’s tracheotomy tube as being “coated with crust.” The same patient had a catheter inserted into his arm which was several days old, putting him at risk of serious blood infection.

• Machines used to test blood sugar levels of diabetic patients were improperly calibrated.

• Ventilators that provided critical breathing assistance were set at dangerously high oxygen flow pressures.

• The facility had only 30 bedsheets for 42 residents.

I looked for information about this nursing home and strangely, I could not find much. But it is a for profit home, which says much I think.

I never thought hip protectors did any good. Now a study proves me right!

BOSTON, July 24 — Hip protectors designed to lessen the impact of falls among older adults do not appear to reduce the incidence of hip fractures, researchers here found.

In a large clinical trial, nursing home residents actually had a higher rate of hip fracture when wearing foam-covered polyethylene pads than when unprotected (3.1% versus 2.5%, P=0.70), reported Douglas P. Kiel, M.D., M.P.H., of Harvard and Hebrew SeniorLife, and colleagues, in the July 25 issue of the Journal of the American Medical Association.

The results confirm “the growing body of evidence that hip protectors are not effective in nursing home populations,” they wrote.

There are some conflicting points in this article and it’s hard to follow the process used in this study. The bottom line was simple though: Hip protectors don’t protect hips.

This is a good idea.

Senator Charles Grassley is proposing a new “watch list” for nursing homes that aren’t meeting federal health and safety standards. “That would include nursing homes that yo-yo in and out of compliance by using grace periods to correct deficiencies, but only then on a temporary basis,” Grassley says. “We never seem to get consistency of safety and quality at these nursing homes.”

The public would be better able to judge whether a nursing home is the right place for their loves one if a “watch list” disclosed which homes aren’t up to snuff, according to Grassley. “It’s kind of a right to know approach,” Grassley says. Sanctions against nursing homes are often withdrawn before they go into effect because the homes are given time to correct deficiencies, according to Grassley, so the public often never knows of serious health and safety violations.

“The fixes that turn out to be only patches mask permanent problems,” Grassley says. “The whole situation warrants a watch list that would identify the nursing homes that repeatedly fall out of compliance.”

We all know how these places manage to get by with this Plan of Correction bulloney. Everything is made to look good but in the long term, nothing changes. Repeat offenders should be red flagged.

Working with certain populations of people, in our line of work, can be very dangerous. We expect it from those patients who are mentally ill. BUT we should not endure threats and abuse from our own PEERS.

Is this a case of Aides Gone Wild??

I don’t want to comment too much on this; but I can say that this is the result of very bad management.

Just go read the article!