There is a vast array of information, including message boards, that discuss in great detail the importance of providing all the necessary medical attention to our parents, being sure that their medications are being taken, in the right amounts, and at the right times. There’s also much information on giving our elderly parents our time and attention, involving them in a variety of activities in and out of the home. Being sure to create and allow for opportunities where our parent can assist with a variety of tasks, whether it be helping prepare or cook a meal, picking up around the house, gardening, etc.

There is also no shortage of posts on message boards and blogs alike wherein writers are barraged with respondents comments about how “unloving, uncaring, unappreciative” some writers supposedly are when commenting on the difficulties they face while fulfilling their responsibilities towards their elderly parents.

We will all be old one day. We all will want and need our children to help us, care for us, love us, be attentive towards us, help with our “needs”, when the time comes that we are deemed an “elderly parent.” We all hope that our children will render us this needed love and care, putting aside any old hurts or slights of the past. Unfortunately, some people choose to hold onto old memories of previous hurts and perhaps even devastating traumas from childhood, choosing not to forgive and forget, but continuing to hold it against their parent/parents as an excuse to forfeit their responsibilities towards their now elderly parent.

Often this leaves most, if not all, the responsibilities on another sibling to carry the heavy and oftentimes burdensome load of providing care for their parents. Some even go so far as to move away so as to make it appear that they “just live too far away”, when in reality they never intended to help in the first place.

Although I do believe that the adult children carry primary responsibility to care for their elderly parents, I also believe there is much to be accomplished with the assistance of grandchildren with respect to their age and abilities. Making it a point to keep in close contact with their grandparents, making regular phone calls and visits, sending cards if for no reason other than to say, “I love you” or “I’m thinking of you”.

There is an abundance of opinion on whether to have elderly parents living with you in your home. Although this is a personal decision for each family, carefully considering all possibilities, the pro’s and con’s of such a venture, sometimes it is determined not to be in the best interests of the family as a whole. It is of this perspective and opinion that I write today.

On two separate occasions, lasting about a year and a half each time, my husband and I and his father lived together. Initially, we all lived together in my father in-law’s house. The floor plan provided private quarters for us, our room and bathroom on the opposite side of the house from his. Being newlyweds, we needed some time to be alone, to become accustomed to each other’s ways, and to settle into married life. My mother in-law had passed away in 1998, three years prior to my meeting my now-husband, having been married over fifty years to my father in-law. It quickly became apparent that having much time alone with my husband would be virtually impossible.

Over a period of time, I began to refer to my husband and his father as “Siamese Twins”, attached at the hip by an invisible umbilical cord. Every step my husband took, my father in-law was in close pursuit. It mattered not if my husband were going from the living room to the front door, from the kitchen to the den, from outside the house to inside the house, to or from the car. “Everywhere that Mary went, Mary went, Mary went…., everywhere that Mary went, her sheep was sure to go.”

My father in-law is a capable man. He is capable of fixing himself something to eat, even if just a sandwich. But, he won’t. He wants and expects someone/anyone, preferably my husband, to do it for him, as my mother in-law had done for the many years of their marriage. This attitude did not sit well with me or my husband, as we firmly believe that my father in-law should do for himself what he is capable of and not expect to be catered to the rest of his life.

The energy and exertion expelled to go to the pantry and retrieve cookies, brownies, Ding-Dong’s etc, is better used slapping two slices of bread together, with cold-cuts and cheese in between. To suggest such an absurd notion inevitably leads to a staring contest, followed by his quick exit with sugar-coated goodies stuffed into both hands.

Maintaining privacy was often a matter of discord, as we would return home from work to find “evidence” that someone had been in our bedroom. Items moved around in dresser drawers, desk drawers, files disrupted. After several attempts to resolve these bothersome problems, we decided to move and got our own apartment. A few months later we learned that my father in-law sold his house, and reluctantly moved in with his daughter, the eldest of the two children. For several months, phone calls were exchanged between my husband and his sister, with her explaining the same behaviors and problems we found to be so unbearable. It was creating problems for her family and marriage, as it had done to us, and we understood all too well what she was dealing with.

A few months later, my father in-law privately begged my husband to allow him to move back in with us, our having just bought a house with rooms to spare. Thinking my husband had experienced temporary insanity at the mere suggestion, I made my displeasure and disagreement crystal clear. Perhaps it was the fierce expression on my face; or perhaps it was my sounding like a screaming banshee; or maybe the sound of a door slamming behind me.

Nevertheless, we discussed it when my blood pressure returned to normal, and determined we would allow my father in-law to move in with us again, only with some firm stipulations. It was to be understood that although he would be living with us in our house, that he was to lead his own life, come and go as he pleased, go and do things/visit with friends etc, fix himself something to eat when hungry (unless we were obviously already preparing a family meal), clean up after himself, do his own laundry etc. But, no more catering to his wants and whims.

Ask any of my friends, co-workers or family, and they will tell you that I am normally “cool and collected” or “even-keeled”. It takes a lot to make me blow my stack, but if pushed to that point, look out. It didn’t take long at all to find that the attitude and behaviors were not going to change, that my father in-law would not follow any of the stipulations set for him. My husband and I actually began timing how many minutes it would take before my father in-law would appear wherever we were, trying to have a private conversation. Two minutes maximum. I began to search for our marriage decree, so I could look to see if someone had secretly added my father in-law’s name to the marriage document next my husband’s name.

I normally was the first person to get home after work, and within a few minutes, my father in-law was checking his watch and looking to see if I was about to begin rattling pans in the kitchen, since he “hadn’t eaten all day long”. After finishing dinner, while my husband and I began to clean up the kitchen and load the dishwasher, my father in-law would inevitably make his quick exit to ‘parts unknown’, or right back in front of the television where he’d been all day. Any attempt on our part to retrieve the remote and switch channels (it was always on some sort of sports show), would be met with heavy sighs and protests “I was watching that!”. We were guests in our own house. We continued to find that “someone” was rummaging in dresser drawers, private files in the office, and various other intrepid explorations throughout the house.

My father in-law is now eighty-four years young, and for the last year or so he’s been living in an Independent Living apartment on his own, a few short miles from our house. We visit him often, have him over for dinner often, pick him up and take him out to dinner often, have him over to spend the night every couple of weeks, but it’s never enough. We filled his freezer with healthy, frozen meals, that he only needs to nuke in the microwave for a few minutes.

They are all still there in his freezer, left untouched to this day. We keep him supplied with bread, cold-cuts, cheese, fruit, healthy cereals, etc, a fully-stocked refrigerator. Healthy, fresh foods rot and sit waiting for “someone” to throw it out. He is fully capable, physically capable, mentally capable, of fixing himself healthy meals. But, he won’t. A few days ago, he told me that he wants my husband to move in with HIM. That isn’t happening.?

Tweet This Post

A compulsory levy to pay for social care “remains on the table”, Andy Burnham, the health secretary, said yesterday – despite the Conservatives’ blanket refusal to back what they dub a compulsory “death tax“.

His stance came after a conference of about 40 organisations representing carers, the elderly and other social care recipients issued a summary of their discussions supporting the idea of “an element of compulsion” on everyone to help fund social care.

A majority, though not a large one, rejected the other options the government has put forward in its

green paper . Under those approaches everyone would get some help, perhaps a third of costs, with that potentially being allied to private insurance for the remainder, or a voluntary state-backed scheme.

But the conference – which was closed to the media – was clear that rather than the flat rate levy of £20,000 that the government has put forward, payable at or near retirement, or from someone’s estate, any contribution should be progressive, with the better-off paying more.

One of those attending noted that these were “the views of the social care lobby”, not necessarily those of taxpayers’ and voters generally.

But Mr Burnham said that the meeting had been “pretty clear”, and the reason he would not remove the compulsory option – as Andrew Lansley, the Conservative health spokesman, is demanding – is that “the people who are most involved in this [caring] want it to be on the table”.

He underlined, however, that “the government has not taken a decision” and stressed that there are “pros and cons for all the approaches”.

“Compulsion provides peace of mind, even to those who don’t use it because they know it is there. It is cheaper than the voluntary option because everyone is in, and that can bring the overall cost down. But the downside is that it does take away individual choice.”

There was some irritation among attendees at Mr Lansley’s decision to boycott a conference that he dubbed “a party political ploy” by Labour.

One option the conference raised was “soft compulsion” where people would be enrolled into a state-run insurance scheme but retain the right to opt out.

Despite the lack of unanimity, Mr Burnham said he hoped to produce “firm proposals” in a white paper before the election.

?

Related articles by Zemanta

• ‘Death tax’ best for social care (news.bbc.co.uk)
• Tories boycott talks on care for elderly (guardian.co.uk)
• New Tory ad backfires (leftfootforward.org)
• Tory ‘death tax’ poster condemned (guardian.co.uk)
• New crisis talks on care service for the elderly (telegraph.co.uk)
• Parties clash over care for elderly in pre-election skirmishes (telegraph.co.uk)
• Lamb’s challenge to Lansley: let’s get to grips with social care (libdemvoice.org)
• Joan Bakewell enters row over Tory tombstone ads (leftfootforward.org)

Tweet This Post

In a case involving the now-closed Green Country residential home in Fairland, administrators were unaware of the requirement for employee background checks.

“I didn’t know I was supposed to have an (Oklahoma State Bureau of Investigations report) on her,” a staff member told an inspector, according to a Health Department report.

At Quality Living Residential Care in Bluejacket, criminal checks were not completed on three employees, including the administrator.

“I didn’t think we needed one,” said the administrator in a 2006 report.

In 2007, the Heartland Plaza of Duncan failed to obtain background checks for three employees. One had been convicted four times of larceny as well as distribution of a controlled substance and possession with intent to sell.

The woman worked at Heartland Plaza 18 months before being fired and rehired again.

The administrator told investigators she didn’t believe the woman committed the crimes. Rather, the administrator simply thought the woman “ran with the wrong crowd,” state reports show.

But the administrator knew the home shouldn’t employ the woman.

“(The administrator) told me if ya’ll show up, I’m supposed to leave out the back door,” the employee told state investigators.

Dorya Huser, the state Health Department’s chief of long-term care service, said she didn’t know how the convictions fell through the cracks.

Heartland was fined $1,722 in November 2008 for the willful violation of the state’s background check requirement.

The administrator has left Heartland Plaza.

Lorena Afable, who has been the Heartland supervisor for two years, said they are now careful to get a background check on every employee.

Homes for the developmentally disabled, called Intermediate Care Facilities for People with Mental Retardation (ICFMR) have also failed to perform background checks.

Country Lane Cottage in Beggs hired two direct-care staff in late 2008 and completed the criminal background checks but never reviewed the results, Oklahoma State Department of Health reports show.

It took nearly a year of employment and an inspection by the state to discover that both employees were felons. One had been convicted of false impersonation, the other with enabling child sexual abuse.

Owner Scott Pilgrim disagreed with the findings, saying one had charges pending and the other involved extenuating circumstances with a family domestic dispute. However, he said the home fired the employees.

“A background check is important because we don’t want someone here who has problems. We have a sacred responsibility,” Pilgrim said.

Pilgrim said some OSBI checks have shown no criminal histories and later found some issues were present. As an added measure, the home has an agreement with the local police department to do background checks in addition to the state check.

“It helps with our community relations and it is a good in-depth background,” Pilgrim said. “The OSBI checks do not catch everything.”

At Gatesway Foundation in Tulsa, about 25 percent of applicants failed the criminal background screening, said executive director Judi Myers. The home does not allow people to work until the screening is complete.

“I don’t want to take that chance,” Myers said. “People are too vulnerable.”

While OSBI checks are required and cost $35 each, some homes contract out for national searches.

When Home of Hope in Vinita hired Jerald Ray Bishop in October 2005, it completed a review of his driver’s license, previous employment, community service work, nurses’ aid registry and an OSBI background check, which indicated he did not have a criminal record in the state.

Two years later, a resident claimed he had touched her in a sexual manner without consent on several occasions while she worked at an on-site job. Bishop is awaiting trial in Craig County on three felony charges — rape by instrumentation, sexual battery and abuse by caretaker. He is being held at the Craig County Jail.

After the sexual abuse allegations surfaced, Vinita police discovered a criminal history in California dating back to 1987, including one charge of sex acts involving a child younger than 14, the affidavit states.

Bishop had a conviction and served jail time and probation, the affidavit states.

The home had an OSBI check on a different applicant showing no convictions, but a national search firm found a felony conviction from Oklahoma County.

In August 2007, Home of Hope implemented the additional employee background to include a national criminal search by a private firm, sex offender list review and Social Security number validation. Employees also undergo random drug testing.

Carolyn Chapman, human resource officer with Home of Hope, said officials at the Oklahoma Attorney General’s Office said not all counties in Oklahoma routinely update their criminal database.

“We are confident that our dual process significantly has improved our ability to ensure that we do not hire undesirable employees,” Chapman said. “Had Bishop been screened after 2007, it is unlikely that he would have been offered employment.”

Jessica Brown, an OSBI spokeswoman, said the state’s background checks are based on records supplied by local sheriff’s offices and municipalities. She said they’re the most reliable but still could be incomplete.

“Our records are going to be the best available,” Brown said. “Are they perfect? No.”

Read more from this Tulsa World article at http://www.tulsaworld.com/news/article.aspx?subjectid=11&articleid=20100221_11_A8_Sincer449958?

Related articles by Zemanta

• A Tale of Two Reference Check Responses – Liability for One, But Not the Other (myventurepad.com)
• backgroundchecks.com Introduces MyClearStart Expungment Service (eon.businesswire.com)
• Black Hills youth coach accused of attempted rape (theolympian.com)
• Date Check: The Perfect App For Crazy Ladies (manolith.com)
• Police background checks of volunteers soaring (cbc.ca)
• Paterson Aide’s Quick Rise Draws Scrutiny (nytimes.com)
• Paterson Aide’s Quick Rise Draws Scrutiny (harlemworldblog.wordpress.com)
• Escort sting brings $134,000 in fines (cbc.ca)
• Wear clean underwear to your next job interview … (timesunion.com)

Tweet This Post

One found that putting nursing home residents with failing kidneys on dialysis didn’t improve their quality of life and may even push them into further decline. The other showed many with advanced dementia will die within six months and perhaps should have hospice care instead of aggressive treatment.

Medical experts say the new research emphasizes the need for doctors, caregivers and families to consider making the feeble elderly who are near death comfortable rather than treating them as if a cure were possible — more like the palliative care given to terminally ill cancer patients.

”We probably need to be offering a palliative care option to many more patients to make the last days of their lives as comfortable as possible,” said Dr. Mark Zeidel of the Beth Israel Deaconess Medical Center in Boston, who was not involved in the studies.

Palliative care focuses on managing symptoms of a disease and a main goal is to relieve pain at the end of life.

End-of-life care became a divisive issue in the national health care reform debate this summer after one proposal included Medicare reimbursement for doctors who consult with patients on end-of-life counseling. Critics called the counseling ”death panels” and a step toward euthanasia. The Obama administration denied those claims, yet has signaled the Medicare benefit will be dropped.

The new studies are published in Thursday’s New England Journal of Medicine.

In one study, doctors looked at health records of 3,702 nursing home residents nationwide who started dialysis between 1998 and 2000. The average age was 73 and many had other health problems, including diabetes, heart disease and cancer.

Within the first year, 58 percent died and another 29 percent declined in their ability to do simple tasks such as walking, bathing and getting dressed.

Kidney dialysis helps remove waste from blood, and the vast majority of patients with kidney failure benefit. However, in the case of seniors with failing kidneys, it is less clear whether the benefit outweighs the burden.

The findings call into question the common practice of transporting dialysis patients near the end of life to dialysis centers several times a week and hooking them up to a machine for hours at a time.

”We may be overestimating the benefits of dialysis in some of these patients and downplaying the burdens,” said lead author Dr. Manjula Kurella Tamura, a Stanford University kidney specialist.

The study did not include a comparison group of patients who didn’t get dialysis, so it’s unknown if more elderly are dying after starting dialysis than not. Kurella Tamura said there’s no one-size-fits-all recommendation for which nursing home residents should go on dialysis, and she suggests patients talk with their doctors about realistic expectations.

The second study followed 323 people with advanced dementia from Boston-area nursing homes. Their average age was 85 and they could not recognize loved ones and were unable to talk or walk.

One out of four died within six months and half died during the 18 months they were followed. Nursing home residents with advanced dementia were more likely to die of pneumonia, fever and eating problems related to their dementia than from strokes or heart attacks.

During their final three months, 41 percent received aggressive care including being hospitalized and tube feeding. However, if the person making their medical decisions was aware of their poor prognosis, they were less likely to receive aggressive care near the end of life, the research found.

”We often temporarily inflict discomfort or pain on patients. We try to minimize it, but we accept it because we think the trade-off is curing or healing,” said Dr. Greg Sachs of Indiana University School of Medicine.

In an accompanying editorial, Sachs recalled how his grandmother, who suffered from Alzheimer’s and lived in a nursing home, was aggressively treated with antibiotics for every infection in her final months and had to be restrained. He said that people with dementia could benefit from hospice care inside a nursing home or in the community.

Sachs cited research that found nursing home residents who had hospice care during the last month of their life were half as likely to be hospitalized. What’s keeping dementia nursing home patients from getting hospice care is that dementia is not widely recognized as a terminal illness. It’s also harder to predict when a dementia patient has six months or less to live — a criteria for Medicare-paid hospice care.

The National Institutes of Health funded the studies. The dementia study was led by the Harvard-affiliated Hebrew Senior Life Institute for Aging Research in Boston. In the dialysis study, Kurella Tamura has received grant support from Amgen, which makes a drug for people with kidney disease undergoing dialysis.

Tweet This Post

But dementia is a physical illness, too — a progressive, terminal disease that shuts down the body as it attacks the brain. Although the early stages can last for years, the life expectancy of a patient with advanced dementia is similar to that of a patient with advanced cancer.

The lack of understanding about the physical toll of dementia means that many patients near the end of life are subjected to aggressive treatments that would never be considered with another terminal illness. People with advanced dementia are often given dialysis and put on ventilators; they may even get preventive care that cannot possibly help them, like colonoscopies and drugs for osteoporosis or high cholesterol.

“You can go to an intensive-care unit in most places,” said Dr. Greg A. Sachs, chief of general internal medicine and geriatrics at Indiana University School of Medicine, “and you’ll find people with dementia getting very aggressive treatment.”

The continued focus on treatment to prolong life often means that pain relief is inadequate, and symptoms like confusion and anxiety are worsened. A new study suggests that family members would be far less likely to subject their loved ones to such treatment if they had a better understanding of dementia as progressive, debilitating illness that ultimately shuts down the body after years of mental deterioration.

Harvard researchers recently followed 323 residents of 22 nursing homes. All had end-stage dementia, meaning that they no longer recognized family members, could speak fewer than six words and were incontinent and bedbound. During the 18-month study period, more than half of the patients died.

During the last three months of life, 41 percent of the patients received at least one “burdensome” treatment, like transport to the emergency room, hospitalization, feeding tubes or intravenous treatments. Advanced dementia patients are particularly prone to infections because of incontinence, risk of bedsores, a depressed immune response and inability to report symptoms.

When the investigators looked more deeply into the reasons for treatment decisions, they discovered stark differences based on what family members knew about dementia. When they understood its progressive and terminal nature, only 27 percent of the patients received aggressive care. For family members who did not understand the disease, the figure was 73 percent.

“When family members understood the clinical course of dementia and the poor prognosis, the patients were far less likely to undergo these distressing interventions,” said the study’s lead author, Dr. Susan L. Mitchell, senior scientist at the Institute for Aging Research of Hebrew SeniorLife in Boston. “Dementia is a terminal illness and needs to be recognized as such so these patients receive better palliative care.”

The study also found that pain control was often inadequate. One in four subjects were clearly suffering from pain, but that number may understate the problem, because the patients were unable to talk about their pain.

Dr. Sachs, at Indiana, notes that care for patients with dementia has changed very little in the past 30 years. As a teenager, he watched his grandmother decline from Alzheimer’s disease. During her final months, she was repeatedly treated for infections and put in restraints or sedated to control agitation.

“Seeing my grandmother in that state was so distressing that my mother eventually stopped taking the grandchildren to visit,” Dr. Sachs wrote last week in an editorial in The New England Journal of Medicine. “My grandmother had little in the way of comfort or company toward the end. In my medical training, I learned how my grandmother’s final months were typical for people dying from dementia.”

A 2005 report from the Alzheimer’s Association showed troubling trends in care at the end of life. In a sweeping review of the medical literature, the investigators found that 71 percent of nursing home residents with advanced dementia died within six months of admission, yet only 11 percent were referred to hospice care, which focuses on comfort rather than active treatment.

Simply transferring a dementia patient from the nursing home to a hospital can lead to confusion, falls or a decline in eating — which in turn, often leads to further aggressive treatment.

Geriatricians say a large part of the problem is that the patients are unable to make their wishes known. In the absence of a living will, family members often struggle with guilt and are afraid to stop aggressive treatment because they do not want to be seen as abandoning a loved one in mental decline.

Dr. Sachs says doctors need to spend more time explaining the prognosis for advanced dementia, making it clear that palliative care does not mean less care.

“We’re not talking about aggressive care versus no care,” he said. “Palliative care is aggressive and attentive and focused on symptom management and support of the patient and family. It’s not any less excellent care.”

Tweet This Post

First Posted Posted August 4, 2009.

By Serena Gordon
HealthDay Reporter

TUESDAY, Aug. 4 (HealthDay News) — When seniors stop taking proper care of themselves, their risk for death increases nearly sixfold, a new study shows.

In addition, elderly people who are abused physically, emotionally, financially or through withdrawal of care don’t fare much better. Their risk for dying more than doubles, the researchers report.

“Elder self-neglect and abuse really have severe consequences,” said study author Dr. XinQi Dong, an associate professor of medicine at Rush University Medical Center in Chicago.

Though people often associate dementia or Alzheimer’s disease with self-neglect, the researchers found that “it’s not just the cognitively impaired” who are affected, Dong said. “Even more capable seniors face a higher risk of premature death from self-neglect.”

The findings are reported in the Aug. 5 issue of the Journal of the American Medical Association.

Elder self-neglect is the most common reason that someone is referred to adult protective services, according to Dr. Thomas Gill, author of an accompanying editorial in the same issue of the journal. The inability to care for oneself, which characterizes self-neglect, can include failing to provide adequate food, water, clothing, shelter and necessary medications and not following basic hygiene practices, according to the study and editorial.

Abuse can include physical or sexual abuse, confinement, emotional abuse, caregiver neglect, deprivation or financial exploitation, the study reported.

Dong and his colleagues followed a group of 9,318 Chicago residents, all older than 65, who were participating in the Chicago Health and Aging Project. During the study period, from 1993 to 2005, social service agencies received reports of self-neglect on 1,544 of the participants, and 113 were reported as being abused. During about seven years of follow-up, 4,306 of the participants died.

The researchers found that elder self-neglect was associated with a 5.82 times increased risk for mortality in the year after a report of self-neglect. For abused seniors, the chance that they would die in the year after the abuse was reported was more than twice as great as it was for seniors who were not abused.

Dong said the researchers controlled the data to account for numerous factors — such as medical conditions, socioeconomic status, health habits and memory — but still found a strong association between abuse and self-neglect and the risk for premature death.

That suggests, he said, that it’s the abuse and self-neglect that lead to the physical decline that ends in death.

“This degree of mortality risk is usually reserved for acute conditions, like an acute heart attack or stroke, and these findings really emphasize the importance of reporting abuse and self-neglect as well as the need to respond promptly with social service and medical intervention and prevention,” Dong said.

The study points to an imminent problem, according to Dr. Karin Ouchida, medical director of the Montefiore Medical Center Home Health Agency in New York City.

“The situation is kind of grim right now,” Ouchida said. “The population is going to get larger, and the population of people armed to care for them is getting smaller. I think this study really raises a red flag.”

“Whether it was some decline in medical function that led to self-neglecting behavior, or the other way around, these people are in crisis, and social services and medical services need to have more communication and interaction,” she said.

Anyone who suspects that an older family member, neighbor or friend is being abused or might be self-neglecting need to report those suspicions, both Ouchida and Dong said. A sudden change in weight, hygiene, or worsening medical conditions, such as being more short of breath, are clues that people might be neglecting themselves. Abuse can be harder to detect, but any unexplained bruises or sudden change in doctors could be clues.

Financial abuse and exploitation are probably getting worse in the recession, they said. Possible signs of this can include more telephone, mail and even in-person solicitations. Or, if older people start running out of money when they never did before or things are suddenly missing from their home, they could be in trouble.

Error, no group_id specified! Check your syntax or contact an administrator!

Related articles by Zemanta

• Older adults subjected to abuse or self-neglect at greater risk of mortality (scienceblog.com)

Tweet This Post

(CBS) Investigating physical abuse and outright neglect of patients, CBS News has been exposing the horrors inside some of this country’s nursing homes.

If you’re wondering what the government is doing about this, CBS News Correspondent Vince Gonzales reports the answer is: not nearly enough.A distress call came from a frightened family.

“I was told you could be helpful to me, and I’m really anxious to talk to you,” said a voice on Ila Swan’s answering machine.

It’s a call to action for Swan of the Association for Protection of the Elderly.

“I went through it with my mother, and nobody was there to help me,” Swan explains. Outraged by the harm a nursing home did to her mother, she is now a wig-wearing crusader who goes undercover and looks for signs of abuse and neglect for others – for free.

Families contact her because, it seems, no one else is listening.

Swan reports her findings to the families and files reports with state regulators who routinely dismiss them.

“You try the system,” she says. “The system’s broken. It’s well known the system’s broken.”

In a series of reports, government investigators reached the same conclusion – that the state and federal system is “inadequate to protect residents.”

Well, what about the police?

“You can’t get the police to come in there. Their jurisdiction, as far as I have seen, stops at the front door of the nursing home,” Swan says.

Police did investigate Martha Merritt’s death. They had to. The coroner ruled the nursing home resident’s death was “homicide,” that she was “assaulted by another person.” Police found an eyewitness. They had a suspect who worked at the nursing home. But the district attorney refused to file any charges.

“I don’t think that they really care about elderly people,” says Donna Geise, Meritt’s daughter.

“I’d say elder abuse today is where domestic abuse was about five years ago. Investigations and prosecutions and convictions of domestic abuse five years ago were few and far between,” says elder abuse investigator Paul Hodge. It’s hard for the law to ignore evidence of abuse on videotape. One victim was 99 years old, paralyzed and unable to speak. The certified nurse’s assistant got six months in jail and lost her license. Nationwide advocates for the elderly are pressing to get video cameras into nursing homes.

Swan says of all the homes she had been in (close to 600), she would only put one of her loved ones in about six of them.

“I don’t agree with that. The vast majority of providers in our country deliver high-quality care,” says Charles Roadman of the America Health Care Association.

How do you find the good homes? Swan says take the tour, then return unannounced.

“What you want to do is go back and see what the patients look like. Are they well kept? Is their hair combed?” Swan advises.

Also watch the staff. Are they overwhelmed? Check recent inspection reports. And if a family member is in a home, visit often and not always at the same time.

The number of nursing home residents will double in the next 20 years. And millions of aging baby boomers probably will want the system to be fixed before that.

Related articles by Zemanta

• Alzheimer’s carers awarded £300000 after NHS refuses to pay care costs (telegraph.co.uk)
• Family told by NHS: Alzheimer’s is not a ‘health condition’ (telegraph.co.uk)
• Older adults subjected to abuse or self-neglect at greater risk of mortality (scienceblog.com)
• Should More Women Be Screened For Domestic Violence? [Domestic Disturbances] (jezebel.com)
• New Legal Protections for the Elderly (time.com)

Tweet This Post

What do you do when faced with a difficult decision?

Would you react differently if you knew someone was watching?

What if your dinner out was ruined by kids running wild and out of control while an oblivious parent ignored the chaos?

What do you do when faced with a difficult decision?

Would you react differently if you knew someone was watching?

What if your dinner out was ruined by kids running wild and out of control while an oblivious parent ignored the chaos?

Of those people who intervened in our “Primetime” hidden-camera experiment, many had personal knowledge or understanding of elder abuse or were health-care professionals experienced in working with the elderly.

When Joe Insigna witnessed the caregiver abusing the elderly man, he called 911.

“My brother was in a nursing home,” he said. “He was paralyzed. And a few of the nurses were pretty abusive to him. So I know what it’s like to be helpless and not be able to defend yourself.”

Lorraine Jacobson, walking her dog in the park, persuaded her son, Scott, a lawyer, to stop and talk to the caregiver.

“I’ve worked with Alzheimer’s patients, developmentally disabled patients, but this is not the way to deal with a patient,” she said.

‘The Way You’re Talking to Him Is Abuse’

Women were just as likely as men to get involved and question the caregiver’s abusive treatment of his client.

Adriana Peel, a special education teacher, ran right up to the elderly man to question him about his care.

“Is this the way this man speaks to you all the time?” she asked.

The man in the wheelchair nodded, but the caregiver kept abusing the old man.

“You’re like a little girl, that’s what you are,” the actor posing as the abusive caregiver said.

Peel was furious.

“Listen, I’m in the health field, and the way you’re talking to him is abuse,” she said.

“Abuse?” said the caregiver. “I think you’ve been watching too much ‘Oprah.’”

With that, the woman pulled out her cell phone and dialed 911.

Patty Leitch, walking in the park with her toddler, Rocky, approached the two men and engaged them in conversation. The caregiver tried to elicit some sympathy, but Leitch didn’t have much.

“Imagine a child who never grows up,” the caregiver said, sharing his frustration.

“That’s your job, dude,” Leitch responded. “You chose it. Get out of the profession if you don’t like it, man.”

After being told that both the abusive caregiver and the elderly man were actors and that the scene had been staged as part of “Primetime’s” experiment, Leitch explained why she had gotten involved and recalled the important role an older person played in her life.

“I was very close to my grandmother who was in a home, and we made sure she wasn’t treated this way,” she said. “I think our elderly need to be much more respected than they are.”

Berni Patten, the diminutive 90-year-old actor playing the elderly man, found this to be one of his most satisfying roles.

“I always figured that people would just pass by and do nothing. But more and more, I see people beginning to care about old people. And that makes me feel good,” Patten said.

Related articles by Zemanta

• Practical solutions for long-term care (timesunion.com)
• Cash For Codgers (weirdnursingtales.blogspot.com)
• London Nurse’s Death: ONA appeals Ministry of Labour investigation conclusions (newswire.ca)

Tweet This Post

However, the judge in the case told the wheelchair-bound Clifford Morin if he had been younger, healthier or without reasons for his behaviour toward his now-deceased mother, he would have sent him off to a penitentiary.

“I would not have had the slightest hesitation in sending you to jail,” said Justice Jack Watson, noting the elderly members of society must be protected by the law.

Watson called it a “very difficult” and “tragic” case and said he accepted that Morin’s criminal behaviour was the result of him being stressed due to being “overwhelmed” by having to care for both himself and his mother.

“You were simply charged with a responsibility that you could not cope with,” said Watson, telling Morin, who now lives in Vancouver, he doesn’t believe he has an “evil streak” in him. “You’re not a bad person.”

That said, the judge told court there must still be sanctions because there is a “line we do not cross,” and referred to the abuse and bullying of the elderly.

Morin was convicted of unlawful confinement and uttering threats last month, following a more than four-year-long trial delayed by Morin’s physical and mental issues.

At the time, Watson found Morin had put mittens on his mother’s hands, bound her to a chair and covered her with blankets in an intentional and angry effort to stop her from scratching herself while they lived together in his Edmonton apartment between 1999 and 2002.

He also found Morin, in a fit of anger, had threatened to throw his mother, Elizabeth Lussin, off the balcony.

Morin was acquitted of charges of assault and assault with a weapon after Watson ruled he was not convinced beyond a reasonable doubt that he had intentionally struck or slapped his mother or used weapons on her.

At trial, court heard an taped police interview of the 87-year-old victim done just months before she died. In the chilling, beyond-the-grave testimony, Lussin described the 32 months of abuse at her son’s hands as horrible.

“It was pretty grim for a long time,” said Lussin. “He used to get that glazed look in his face and then he’d start pounding me in the head with his fists. He always went for my eyes and, of course, I am blind.”

Lussin said she moved into her son’s apartment in November 1999 after her second husband died.

She said he punched her, hit her with a cellphone, a hair brush and his cane, and tied her to her bed and a chair.

“He used to hit me something terrible. He used to pound me on the head until I saw stars. It was awful,” she said.

Lussin said she was too afraid to tell anyone and her son would lie about her injuries to her home-care worker.

Lussin said her son also yelled at her, slapped her face, choked her and picked her up by her hair.

Lussin said the years of abuse finally ended after her daughter, who was assaulted by Morin when she confronted him over her mother’s black eyes, went to police.

Related articles by Zemanta

• Pie tosser jailed for 30 days for attempt on premier (calgaryherald.com)
• Police blame justice system for failures in mother daughter suicide case (telegraph.co.uk)
• Jury in Toronto gang trial asks judge for clarification (canada.com)
• Who Did Jury Believe in Teen’s Murder? (abcnews.go.com)

Tweet This Post

In the affluent Moreton Hall area of Bury St Edmunds in Suffolk, average life expectancy is 93.4 years – the highest in the country.

But in the deprived Middlehaven district in Middlesbrough, it’s 67.8 – the lowest.

That is a difference of almost 26 years, a startling statistic revealed in a report into heart disease and stroke by the health watchdog, the Care Quality Commission.

Its study highlights the postcode lottery of care in the Health Service and exposes massive variations in the quality of services for sufferers of cardiovascular disease (CVD).

It is classed as Britain’s biggest killer, claiming 200,000 lives annually.

The report says residents of deprived areas – where death rates from heart attacks and stroke are highest – receive the worst service from their GPs.

And it warns that the disparities will get far worse as the obesity epidemic gathers pace.

The two communities at the top and bottom of the life expectancy league highlight the differences in lifestyle in two-tier Britain.

Moreton Hall, at the top of the tree, is a residential area on the eastern outskirts of Bury St Edmunds.

It is named after a country house – now used as a prep school – and is surrounded by almost 2,000 large houses, all built since the 1980s, and at the other end of the scale is Middlehaven, a dockland area in Middlesbrough that has been badly hit by industrial decline.

Unemployment is high and many of the terrace homes in the district lie abandoned.

The CQC report analysed data on the performance of 8,300 GP practices and 152 primary care trusts and found that GPs are not doing enough to record cases of CVD, particularly in deprived areas such as Middlehaven.

As a result, around 1 per cent of the total population may have CVD without knowing it and therefore do not access services.

This equates to around 350,000 people in England not getting the help they need.

GPs are not testing enough patients for cholesterol levels, especially patients in deprived areas, says the report.

And even where they are testing, in many cases they are doing nothing to help patients get their rates down.

The Government has already met its target of cutting heart disease deaths among under-75s by at least 40 per cent by 2010 – but the commission says more can be done.
The UK still has one of the highest rates of CVD in Europe. Caused mainly by obesity and smoking, CVD costs the country more than £ 30billion a year.

Barbara Young, who chairs the commission, said: ‘We cannot accept that more people die here prematurely from CVD than in other countries. And we cannot rest while health inequalities exist on the scale they do.

‘People in the richest area can expect to live up to 26 years longer than people in the poorest.

‘We have to raise the bar of acceptable performance, upping the level GPs and primary care practitioners are being asked and incentivised to perform to.’

Another finding of the report was that GPs in deprived areas were less likely to prescribe nicotine-replacement products to patients, despite them having some of the greatest need.

A separate scientific study, published today in the British Medical Journal, reports that smoking and obesity can cut up to 15 years off life expectancy.

Related articles by Zemanta

• Combined lifestyle risks cut men’s life expectancy by 10 years (guardian.co.uk)
• NHS heart care ‘must get better’ (news.bbc.co.uk)
• Middle-Age Heart Risk Factors Shorten Men’s Lives (nlm.nih.gov)
• Findings: To Explain Longevity Gap, Look Past Health System (nytimes.com)
• Shameful Research: Poorly Conceived Metastudy May Cost You Your Feet and Kidneys (diabetesupdate.blogspot.com)

Tweet This Post