Archive for March, 2009

An update about the NC nursing home tragedy, and how to help.

Via McKnights LTC News:

Staff members, families and residents of Pinelake Health and Rehab in Carthage, NC, are still in shock after a lone gunman went on a shooting rampage that left eight people dead and three injured at the small skilled nursing facility.

Craig Souza, president of the North Carolina Health Care Facilities Association, told McKnight’s that the facility is still grappling with what happened.

I think this small community will be in shock for awhile.

The 2,000 residents of Carthage have turned out in force to do everything they can to alleviate as much of the suffering as possible. It’s a close-knit community, Souza said. All those who work at Pinelake live within 10 miles of the facility.
[...]
“The community has really rallied around this building, and they’re just all doing everything they possibly can, not only for the families of the victims, but for the patients in the building and the employees and the families who visit,” Souza said. “I’m comfortable that they’re doing the best they can with that.”

This is an example of America’s best trait: Helping others in their hour of need.

If you want to help:

To assist with recovery from this tragic event, the North Carolina Health Care Facilities Association has set up a charity for the victims and their families. The Carthage Crisis Assistance Fund will provide coordination and a focal point for the already overwhelming outpouring of support from the public, according to the NCHCFA.

Donations to the relief effort may be sent payable to:

Carthage Crisis Assistance Fund
North Carolina Health Care Facilities Association
5109 Bur Oak Circle
Raleigh, NC 27612

Contributions may also be taken to any branch of Capital Bank.

Also, Eleanor Feldman Barbera, PhD has some advice for coping with this horrible event. Dr. Barbera is the author of our previously highlighted blog, My Better Nursing Home.

Now this is encouraging. The state of Oregon is doing something good with some of the federal money it’s getting. Too bad more states aren’t doing this.

SALEM, Ore. (AP) — Hundreds of new nursing home jobs will be created around Oregon with the help of federal stimulus money, state leaders said Friday.

A combination of state and federal dollars will help pay for more than 300 new nursing assistants in long-term care facilities in all 36 Oregon counties, they said.

300 jobs is a good start! When we consider how many openings/positions there are, this is really good news. Many nursing homes are not hiring right now due to the poor economy- this program should alleviate some of this.

A lot of the federal stimulus money that’s going to Oregon and other states will pay for jobs in construction and other industries that employ mostly males, Goldberg said.

The nursing assistant positions that the federal aid will help create “will be primarily staffed by women,” he said.

“Women comprise the majority of the nursing assistant work force,” he said. “This is really an entry level job that hopefully is going to create careers for many women in Oregon.”

Exactly. Women compromise most of the CNA workforce. Many will go on to become nurses. Many will chose to stay working as aides. Also, I am willing to bet more than a few women will enter this program as a means to get off the welfare rolls. This is win-win situation.

Nursing Assistants Week – June 11-18, 2009

And, National Career Nursing Assistants Day – June 11, 2009

From the National Network of Career Nursing Assistants:

Now as never before, attention is being directed to care of our elders and disabled citizens and greater attention also is directed to the workers who provide hands- on- care and caring. The question is not just about skills and training but also how to bring more stability, respect, decency, consideration, support and collaboration to the fabric of everyday life for both resident or client and worker. In order to do this we must be able to work in tandem with our role models, peers, supervisors, clients, families, community, legislators, public policy officials, media and others.

And National Nursing Assistants’ Week provides a timely opportunity to foster and showcase the wonderful things that can happen for residents and workers when we work together for quality care and respect.
Can WE do this?
“Yes, WE can”

So CNA’s and others: CNA week and CNA day isn’t just about YOU. It’s about advocating for better working conditions and “homes” for those we care for!

We complain a lot about the lack of respect we get. Part of the problem is a lack of awareness of WHAT exactly, it is, WE DO…No one is better suited to educate people than US. Perhaps, as a way to celebrate our work this year, we can choose to be active members of groups of like minded co workers. These groups can offer some real substance and insight into this work we love. Even better, nursing homes and other facilities that employ CNA’s can come together to join forces.

NNCNA has always promoted this and here’s some ideas on what TO DO:

Day 1 – Honoring our Wisdom Keepers ©
Day 2 – Honoring the power of “WE” ©
Day 3 – Teamwork, the Language of “WE”
Day 4 – Lightning the Load
Day 5 – Solving Problems Together
Day 6 – Taking our Place at the Table
Day 7 – Sharing Outcomes
Day 8 – Reaching Out to Peers

• Involve NAs in planning
• Ask your local newspaper to write a story about your NA who has the most years of service
• Plan a group project to submit to the National Nursing Assistant Authors Club
• Invite your local congress man or mayor to discuss NA related issues with a group of NAs.
• Plan a style show featuring your NAs as models
• Collaborate with the Ombudsmen or other local groups to plan an Award or Recognition Program.
• Purchase t-shirts, lapel pins or certificated to commemorate this event to your NAs.

Saying THANK YOU to CNA’s:
1. Display photos of your NAs with notes about favorite foods, hobbies or families
2. Plan an awards ceremony and invite your mayor and local and state legislators.
3. Conduct a Poster Contest or Essay Contest about Teamwork.
4. Select teams of nursing assistants to conduct Daily Dialogues during the 8 days of National Nursing Assistants’ Week
5. Create a poster consisting of “thank you” notes from family members and staff. Include pictures of your nurse assistants. When complete, enlarge your poster to 5X8 feet and post it in a prominent place
6. Provide computer training for nursing assistants and encourage them to connect with resources and nursing assistant groups in other areas
7. Ask NAs to write and star in a video about your nursing home

Special attention should be given to those who choose to be CAREER CNA’s.

For more resources and ideas, check out National Network of Career Nursing Assistants.

I received an email notifying us of a brand new continuing education web site for CNA’s…literally it’s Just For CNA’s.

In The Know manages this venture, which offers many opportunities for CNA’s to get CE credits at a reasonable cost. This is very important since the state survey processes will be looking more closely at employee records for just this.

Here’s just a few of the titles of the educational modules:
Feeding Your Clients
The Importance of Activity for the Elderly
Using Assistive Devices
Performing Mouth Care
Working With Difficult & Combative People
Understanding Drug-Resistant Bacteria
Understanding Advance Directives
Taking Care of Your Back

There are many more. CNA’s can download these in services, read and study the materials provided then go online and take a quiz. After this, CNA’s are taken to a page that will show them their score and the correct answers to any that were wrong. At this point, a Certificate of Completion is available for download. CNA’s will need this to prove you took the in service.

Each module cost 9.95 and can paid for with a credit card, ECheck or Pay Pal. I think this makes it much more accessible to CNA’s- using ECheck or Pay Pal!

I’ve used Pay Pal for many online purchases and it’s easy to set up an account with them. You deposit funds into an account there as you wish- then the money is available when you need it. It’s just like cash.

Today we learn of a horrible event at a nursing home in NC.

CARTHAGE, N.C. (AP) – A gunman burst into a North Carolina nursing home Sunday morning and started “shooting everything,” killing seven residents and a nurse and wounding at least three others.

Robert Stewart, 45, of Moore County, was charged hours later with eight counts of first-degree murder and a single charge of felony assault of a law enforcement officer. Authorities offered few other details, allowing only that Stewart was not a patient or an employee at the nursing home, and isn’t believe to be related to any of the victims.

This happened at 10am or so…right in the middle of morning get ups. The aides were all busy doing personal care, showers; perhaps some activities had just started. Being a Sunday, no administration would have been around.

The victims were identified as residents Tessie Garner, 88; Lillian Dunn, 89; Jessie Musser, 88; Bessie Hendrick, 78; John Goldston, 78; Margaret Johnson, 89; Louise Decker, 98; and nurse Jerry Avent, whose age wasn’t immediately available.

This brings tears to my eyes. The most vulnerable people- with the least amount of security available for protection. There isn’t much info about the killer- who he is, what his motive was- answers to the questions that are nagging many of us. And the other thoughts: What can nursing homes do to up the security so this doesn’t happen again? Sadly, will anyone even care since the victims were old folk and not college students?

One thing: The staff who worked at the facility today will need a lot of support in the coming days. And prayers. The families of the murdered residents will need the most help…but imagine how the surviving residents and families feel right about now?

How volunteering can keep people out of nursing homes.

In an article about the costs of health care, a CNA speaks up about how the facility she works for canceled insurances for it’s staff. It’s a lot more common then people think, and it will come back to bite everyone soon enough.

WASHINGTON (AP) – American workers – whose taxes pay for massive government health programs – are getting squeezed like no other group by private health insurance premiums that are rising much faster than their wages.

While just about all retirees are covered, and nearly 90 percent of children have health insurance, workers now are at significantly higher risk of being uninsured than in the 1990s, the last time lawmakers attempted a health care overhaul, according to a study to be released Tuesday.
[...]
The problem is cost. Total premiums for employer plans have risen six to eight times faster than wages, depending on whether individual or family coverage is picked, the study found.
[...]
For the Ramer family of Denver, Iowa, it’s already too late. Husband Jim, a truck driver for a road-building company, died of a heart attack in 2005 at the age of 59. He was uninsured and trying to cope with diabetes, a chronic disease that requires prescription drugs and follow-up medical care to keep under control.

His wife, Cindy, 58, works full time caring for mentally disabled people as a certified nursing assistant. But the nursing home that employs her canceled its medical coverage several years ago because it had become too expensive. Ramer is now uninsured and hasn’t had a regular checkup in about three years. Instead, she goes to health fairs for bone-density measurements and other screening tests.

“I don’t think it’s fair that I’m caring for people and helping them with their health care, and I don’t have adequate, affordable health care of my own,” said Ramer. “I’m not asking for a handout. I’m just asking for something I can afford, and won’t have all these restrictions that they’ll cover this and won’t cover that.” Ramer says she can afford to pay about $100 to $150 a month.

It’s sad. She wants to take care of herself so she can do her part to keep health care bills lower, but because she has no insurance she cannot afford preventative care. As mentioned in the article, her taxes pay the costs of health care for others. We need to fix this problem.

How has the LTC industry been doing during the recession? Well, I say it’s been in a self-imposed recession for years so it’s faring quite well. But I digress…

Keeping people OUT of nursing homes through the use of home health aides, or volunteers, is a much preferred option to the very people this effects the most- the elderly. It baffles me to wonder why this option isn’t discussed more. The money this country could save, and apply towards other programs is immense.

Ohio could save millions in Medicaid spending by making greater use of home- and community-based care for those needing long-term care, but it won’t be an easy transition.

As Ohio’s elderly population increases, the number of potential caregivers — those ages 25 to 64 — is shrinking, making it difficult for friends and family to provide care, according to a new study.

An updated economic study of long-term care costs in Ohio found the state ranks 44th in the nation in the percentage of Medicaid spending on home- and community-based care.

In 2008, a third of Ohio’s long-term care budget went toward such care, while two-thirds went toward costlier nursing-home care.

If Ohio were able to meet the 2004 national average of 39 percent for home care — the latest national figures available — the state could save at least $140 million a year, said Howard Fleeter, an economic analyst who conducted the study for the Ohio Council for Home Care.

State officials have been aware of the potential savings and in recent years have been pushing to expand home-care services for Medicaid patients like the state’s popular PASSPORT program and a new assisted-living program.

I think President Obama and his team should further evaluate this. I realize there will always be some people who truly need nursing home care. Let that be. But for the majority of residents I see, they could live at home or in a smaller group home setting for a lot less money. The care would be much better. The “residents” would become “people” again and THAT is a very important factor. We seen to forget that.

Aides working in nursing homes could become home health aides- and that would improve a lot of the numbers mentioned in the article. Address the (CNA) pay and benefit structures with the money saved from less use of expensive nursing homes- I think we have a solution right before our eyes. As it stands now, we get what we pay for. That can change if people really think outside the box.

Mentally ill people: Do they belong in nursing homes? Since states began closing mental institutions under a federal law, nursing homes have been a “dumping” ground for many who simply don’t belong there. It’s a sad reality: There aren’t enough specialized group homes for this population. Problems abound when frail elderly people are mixed with those with bi polar disorders and schizophrenia.

Over the past several years, nursing homes have become dumping grounds for young and middle-age people with mental illness, according to Associated Press interviews and an analysis of data from all 50 states. And that has proved a prescription for violence, as Jackson’s case and others across the country illustrate.

Younger, stronger residents with schizophrenia, depression or bipolar disorder are living beside frail senior citizens, and sometimes taking their rage out on them.

“Sadly, we’re seeing the tragic results of the failure of federal and state governments to provide appropriate treatment and housing for those with mental illnesses and to provide a safe environment for the frail elderly,” said Janet Wells, director of public policy for the National Citizens’ Coalition for Nursing Home Reform.

Numbers obtained through the Freedom of Information Act and prepared exclusively for the AP by the Centers for Medicare and Medicaid Services show nearly 125,000 young and middle-aged adults with serious mental illness lived in U.S. nursing homes last year.

That was a 41 percent increase from 2002, when nursing homes housed nearly 89,000 mentally ill people ages 22 to 64. Most states saw increases, with Utah, Nevada, Missouri, Alabama and Texas showing the steepest climbs.

Younger mentally ill people now make up more than 9 percent of the nation’s nearly 1.4 million nursing home residents, up from 6 percent in 2002.

In my experiences, mentally ill people have been admitted to nursing homes on a short term basis, usually while waiting for a group home bed to become avaliable. Or, some other placement is found. The residents with MI must be watched at all times, often requiring a 1:1 aide or family member to supervise them. Nursing homes cannot afford to staff for these people. Yet, the harm that other residents are at risk for is great.

Does your facility house MI people? If so, how does this effect the overall operation? Have other residents been hurt or threatened? How are the MI residents staffed?