Tapping the Power of Peer Mentoring

This is the second in a series of PHI Expert Interviews, which bring
you insights from four senior PHI staff. They’re an impressive group -
among the nation’s leading experts on long-term care’s direct-care
workforce - and collectively they’ve spent decades studying the
challenges facing the workforce and how to address them. We think
you’ll be interested in what they’ve learned.

Peggy Powell is one of the founders of Cooperative Home Care Associates,
the worker-owned home health agency that started PHI, where she served
as director of education. Since joining PHI in 1991, she has worked
with CHCA and other employers to develop strategies for recruiting,
training, supervising, and supporting direct-care staff.

One of those strategies, peer mentoring, is gaining in popularity
– and no wonder. Done right, a peer mentor program helps new
direct-care workers get oriented to the job and the organization,
bolstering their skills and their confidence. It also creates a career
ladder for experienced workers.

And that’s not all, as Peggy has learned.

AHIP Launches New Long-Term Care Education Campaign

(HealthNewsDigest.com) - WASHINGTON, DC: America Health Insurance
Plans (AHIP) today launched a new national education campaign to better
inform consumers about their risks of needing long-term care and the
valuable financial protection long-term care insurance provides.

揟oo many Americans are not adequately protected against the risks of
needing long-term care,?said Karen Ignagni, President and CEO of AHIP.
揥e are providing consumers with accurate and timely information so they
can better prepare for the unpredictability and soaring expense of long
term care.?br/>
The centerpiece of this campaign is a new
consumer-friendly website, www.MyLifeMyFamily.com, to provide consumers
with basic information about long-term care insurance. The website
provides videos that feature real-life stories from current
policyholders, an interactive online quiz, and additional resources on
long-term care insurance.

AHIP commissioned a series of surveys and focus groups to assess
consumers?perceptions of long-term care insurance. Many Americans
underestimate their risk, underestimate the cost of long-term care, and
many erroneously believe they have long-term care coverage. Moreover,
most are not focused on planning for long-term care and are not taking
appropriate steps to protect their retirement savings should they need
long-term care services.

For the Advanced in Age, Easy-to-Use Technology

IN the 1960s, baby boomers, like most young people, could not wait to leave home.

Today, those boomers are trying to figure out how to stay at home,
even if they are past the age when their parents made the passage to
senior living. Companies that have long profited from the
transformation of the counterculture into the over-the-counter culture
are creating products that they hope will help them do that.

Here
is what you have to look forward to as you enter your 60s and 70s:
deciphering conversations at cocktail parties becomes difficult; you
cannot remember where you put your keys; and your grandchildren think
you are a computer klutz.

Fortunately, technologies are
appearing that can remedy some of these shortcomings, helping those in
their 60s maintain their youthful self-images.

“The new market is old age,” said Joseph F. Coughlin, director of the AgeLab at M.I.T.
“Baby boomers provide a perpetually youthful market.” They are, says
Mr. Coughlin, himself a spry 47, “looking for technology to stay
independent, engaged, well and vital.”

New CMS document to aid states in integrating Medicare, Medicaid for dual eligibles

Original Article-

The Centers for Medicare & Medicaid Services recently released a
tool for states that want to integrate and coordinate Medicare and
Medicaid services for dual-eligible beneficiaries.



The "State Plan Preprint for Integrate Care Programs" allows states to
demonstrate and explain their arrangements with Medicare Advantage
Special Needs Plans (SNPs) that also are providing Medicaid services.
The document also gives states "the opportunity to confirm that their
integrated care model complies with both federal Medicaid statutory and
regulatory requirements," according to a letter from Herb B. Kuhn,
acting director of the Center for Medicaid and State Operations. Many
nursing home residents are dual eligibles, or those who are eligible
for Medicare and Medicaid.



Kuhn notes that the preprint does not replace the need for states to
operate under the appropriate Medicaid statutory authorities. States
also will need to follow the usual process for submitting Medicaid
waiver applications and contracts. They can use the preprint on a
voluntary basis, Kuhn wrote.

Anti-Psychotic Drug Use In The Elderly Increases Despite Drug Safety Warnings

See the full article

Three regulatory warnings of serious adverse events slowed the growth
of use of atypical antipsychotic drugs among elderly patients with
dementia, but they did not reduce the overall prescription rate of
these drugs, found a research analysis of prescription drug claims data
in Ontario. The rate of use of these drugs actually increased 20% from
the month prior to the first warning in September 2002 to the end of
the study period in February 2007.


About 70% of people receiving antipsychotic drugs lived in nursing homes, and approximately 40% were aged 85 or older.

Neglecting the Voting Rights of Seniors

See the full article

Election officials, said Karlawish, have paid limited attention to two
key issues: assuring that residents of long-term care facilities have
access to the ballot, and preventing unscrupulous persons from
exploiting their vote. Twenty-nine states do not have voting guidelines
to accommodate residents of long-term care facilities. An increasingly
larger number of Americans with cognitive impairments ranging from mild
to severe live in long-term care settings such as assisted living
facilities and nursing homes.

"Elderly voters especially elderly
voters who live in long-term care settings are at the mercy of others
when it comes to exercising their right to vote," said Karlawish. Due
to geographical distances, the lack of transportation to polling sites,
and the lack of assistance to absentee ballot applications, it is other
people who decide whether or not older Americans with issues of
mobility can vote.

Karlawish is developing guidelines for mobile
polling model, similar to programs used in Australia and Canada, to
improve access to voting for older Americans. In this model, election
officials or equivalent groups would visit long-term facilities in
their district to help interested people register, directly distribute
ballots to long-term facility residents, assist with voting, collect
ballots and ensure the ballots are returned safely to a polling site.

Dr.
Karlawish is available to discuss recent research and guidelines to
help reduce voting barriers for older Americans in long-term care
facilities.

2008 Conference: 33rd NCCNHR National Conference and Annual Meeting

See the full article

Wednesday, Oct. 15 - Friday, Oct. 17, 2008

Indianapolis, Indiana

Register Now to Come to the Conference!

Make plans now to join us in Indianapolis – the same great conference in a new location! This
year’s meeting combines presentations on the day’s top long-term care
issues with skills-building to help you translate issues into action
and action into better care. Come to learn, network, and exchange ideas
with advocates from all over the country.

NCCNHR
members spoke, and NCCNHR listened by making the 2008 conference more
streamlined, more affordable, and more accessible. Our plan is to
alternate sites every other year with 2009 returning to DC and 2010
being held in another part of the country. Session topics have been
solicited through an RFP process.

SCIE Research briefing 28: Assistive technology and older people

See the full article

Key messages

• The term ‘assistive technology’ incorporates
  a wide variety of devices.
• Assistive technology
  can be supportive, preventive or responsive.
• The
  increasing proportion of older people in the
  population makes the use of assistive technology
  an attractive option in social services.
• Perceptions
  vary as to whether or not assistive technology
  has sufficient benefits.
• Existing research
  supports the greater use of assistive technology
  but further evaluation and ‘local learning’ is
  needed.
• The views and needs of people
  using assistive technology need to be taken into
  account.

This briefing will focus on various forms of assistive
technology (AT) supplied to people over the age
of 65. AT can be defined as ‘...an umbrella
term for any device or system that allows an individual
to perform a task they would otherwise be unable
to do or increases the ease and safety with which
the task can be performed.’ (1)

Senator Joseph Biden, co-sponsor of the Paul Wellstone Mental Health Parity Act, is a strong supporter of mental health issues.

Senator Barack Obama just appointmented Senator Joseph Biden to be his Vice-Presidential running mate. So I decided to investigate Biden's voting record on mental health
issues. Gratefully I discovered that he is a strong supporter of mental
issues and helping those suffering with a mental illness or a mood
disorder. Senator Joseph Biden was a co-sponsor of the Paul Wellstone Mental Health Equitable Treatment Act.

Below is a letter from Senator Biden to the National Alliance of Mental Illness (NAMI) during his presidential bid:


December 30, 2007

Dear National Alliance of Mental Illness Membership,

Thank
you for the invitation to share information on my mental health
positions. Mental health is an important part of one's overall health
and deserves to be treated equally and be covered by health insurance.

It
is estimated that 26.2 percent of Americans over 18, approximately 57.7
million people, suffer from a diagnosable mental disorder in a given
year. Even though mental disorders are widespread in
the population, mental disorders and people suffering from them face
great stigmatism and discrimination. We must work to reduce the stigma
attached to mental illness, and to create opportunities for people to
seek help and treatment for their illness.

Congress cries foul over report of inaccurate DME fraud prevention claims

Many lawmakers are outraged after allegations surfaced that the Centers
for Medicare & Medicaid Services misled Congress into thinking it
had significantly reduced the number of fraudulent claims for durable
medical equipment (DME).



In 2006, CMS claimed it had prevented billions of dollars in fraudulent
claims from being processed, and reduced the cost of DME fraud to $700
million. But according to a report in The New York Times this week,
these claims are inaccurate and improper spending on fraudulent claims
totaled about $2.8 billion. The Times cited a confidential draft of a
federal inspector general's report as proof of the allegations. Sen.
Charles Grassley (R-IA) has called the situation "outrageous." Rep.
Pete Stark (D-CA) told the Times he isn't surprised by the
irregularities, calling CMS an incompetent agency.



Meanwhile, CMS reportedly is preparing to implement its competitive
bidding program for durable medical equipment, prosthetics and
orthotics suppliers (DMEPOS). The program originally was scheduled to
begin on July 1 of this year, but recently was delayed by Congress for
18 months and will not begin until 2010. The competitive bidding
program, CMS hopes, will reduce DME costs to Medicare and, at the same
time, reduce fraudulent payments. Some opponents of the program have
argued that smaller businesses will not be able to compete with larger
DME suppliers for contracts.

DCWs Mentioned in DNC platform

From PHI:

It’s just one sentence out of 52 pages - not including introductions
and appendixes - but direct-care workers got a mention in the 2008
Democratic National Convention platform.

In a section titled Renewing the American Community, under the subtitle “Seniors,” the platform (pdf) reads:

“We will take steps to ensure that our seniors have
meaningful long-term care options that are consistent with their
individual needs, including the option of home care. We believe that we
must pay caregivers a fair wage and train more nurses and health care
workers so as to improve the availability and quality of long-term
care.”

Could this be a sign that a political will is stirring to improve home care jobs?

Democrats See Light, Put Long-Term Financing on Platform

Long-term care financing is like a long dormant volcano that is starting to fizz again.

The last time long-term care financing was a serious national topic
of discussion was in the late 1980s into 1990 when The Pepper
Commission, a bi-partisan commission led by the late Rep. Claude Pepper
(D-Fla.) made long-term care financnig part of a national health care
reform blueprint. In fact, in 1990, then Presidential candidate George
H.W. Bush said he’d give long-term care “the attention it deserves.” Then . . . THUD.

The issue is getting new life.

For the first time Democrats have put long-term care financing in
their draft platform “Renewing America’s Promise” that will be approved
in the upcoming convention. As first reported by Future of Aging, the American Association of Homes and Services for the Aging blog, here is the draft language:

Empowerment and Support of Older Americans and People with Disabilities.

Seniors and people with disabilities should have access to
quality affordable long-term care services, and those services should
be readily available at home and in the community. Americans should not
be forced to choose between getting care and living independent
and productive lives.

Seniors

We will take steps to ensure that our seniors have meaningful
long-term care options that are consistent with their individual needs,
including the option of home care. We believe that we must pay
caregivers a fair wage and train more nurses and health care workers so
as to improve the availability and quality of long-term care. We must
reform the financing of long-term care to ease the burden on seniors
and their families. We will safeguard social security. We will develop
new retirement plans and pension protections that will give Americans a
secure, portable way to save for retirement. We will ensure a safe and
dignified retirement.

Give Input on the Republican Platform

The Republicans will soon announce their platform, but you can still
urge them to include long-term care financing it. Here’s how:

• Visit GOP Platform 2008.
• Click “create platform account.”
• Create an account.
• Click on “submit text entry” and enter your own version of the following platform statement:

“Any effort at health care reform must also include long-term
care financing reform. The responsibility of care giving will only
increase as the baby boom generation ages and needs additional
services. America needs a fiscally responsible approach for long-term
care financing based on the principles developed in the successful
state-based Cash & Counseling programs. These principles, including
a cash benefit, offer the maximum choice, independence, and personal
responsibility for seniors and persons with disabilities, while
ensuring fiscal integrity.”

Possible Age Bias Among Emergency Medical Personnel

An article appearing in the August issue of Archives of
Surgery reports on potential unconscious age bias among
emergency medical services personnel: they are less likely to bring
elderly trauma patients to a trauma center compared to younger patients.



David C. Chang, Ph.D., M.P.H., M.B.A. (Johns Hopkins School of
Medicine and Johns Hopkins Bloomberg School of Public Health,
Baltimore) and colleagues note that by 2050, some 39% of all trauma
patients will be 65 years of age or older. They write: "Evidence-based
clinical practice guidelines strongly recommend that elderly trauma
patients be treated as aggressively as non-elderly patients...However,
some studies have suggested that age bias may still exist in trauma
care, even in the prehospital phase of that care."



With 10 years of data from the statewide Maryland Ambulance Information
System, the researchers presented findings to emergency medical
services (EMS) and trauma center personnel at EMS conferences and grand
rounds between 2004 and 2006. They then surveyed the EMS personnel to
further explore the issue. In the registry, there were 26,565 trauma
patients (those who met criteria set by the American College of
Surgeons (ACS) and were declared level I status - critically ill or
injured and requiring immediate attention - by EMS personnel).



Chang and colleagues found that 49.9% of patients older than 65 were
undertriaged - not taken to a state-designated trauma center - compared
to just 17.8% of younger patients. Statistical adjustment for
confounding factors revealed that being 65 years or older was linked to
a 52% less likelihood of being taken to a trauma center. Further, the
investigators note that the reduced likelihood begins at age 50 and
decreases again at age 70.

Allsup Outlines Five Critical Issues For Caregivers Preparing To Take On Financial And Healthcare Responsibilities, USA

Each year millions of individuals suffer a sudden or progressive
impairment that makes it difficult or impossible for them to make sound
financial and healthcare decisions on their own, according to Allsup,
which offers services that support the financial well-being and health
of individuals with disabilities. Stepping in for these individuals are
caregivers, generally family or friends who don't have professional
financial consulting experience. In addition, these caregivers now are
in the very serious role of making critical decisions for the
individual they've agreed to care for.

"The most important
thing caregivers can do is to educate themselves on their
responsibilities once they've taken on this role," said Paul Gada, an
attorney and personal financial planning director of the Allsup Disability Life Planning Center .
"It's not easy and can be further complicated by the emotional
involvement the caregiver often has with the person they're caring for,
be it a spouse, parent, other close relative or friend.

"It's
also important, however, that caregivers recognize they are not alone
and that they seek help when they need it," Gada added.


Having committed to be a caregiver, there is a lot of work that will
need to be done. Following, Allsup outlines five crucial first steps.

Prudential Study Sheds Light On The Increasing Costs Of Long-Term Care

Prudential's Cost of Care study sheds light on the State-specific
average costs associated with nursing homes, assisted living
facilities, and home health care services. The study results show the
average assisted living costs and average nursing home costs in Alaska
as the most expensive in the country at $82,956 per year and $183,595
per year respectively. Detroit ranked the highest for home health care
hourly rate at $38.

In addition to the report being available to consumers on
www.prudential.com, Prudential is also launching an updated interactive
consumer cost of care mapping tool on its website at
http://www.prudential.com/insurance/longtermcare, designed to provide more
in-depth State-specific cost detail – and in some cases City-specific –
aimed at arming consumers with essential facts to help them make better
financial decisions. "While consumers understand the importance of
planning for their financial future, they continue to have
misperceptions about the costs of long-term care services and the
benefits of long-term care insurance. Our resources can help them
dispel these myths and put them on the right path to securing their
retirement," added Mako.

Home Care Agencies Staffing Challenge Solved With Caregiverlist.com

Chicago, IL - Caregiverlist.com, the nation's online destination
dedicated to connecting seniors with quality senior care choices, is
helping home care agencies keep up with the demand for senior in-home
care services as the caregiving recruitment source for the industry.
Nearly 1,000 senior home care independently owned and franchise
agencies across the nation including Senior Helpers, Home Instead, Home
Helpers and Right-at-Home are using Caregiverlist.com to find
individuals who are caring, trustworthy and self-motivated.

With 76 million baby boomers turning 65 in the next two years
and the increased desire for in-home care, the recession proof home
care industry is constantly hiring. "Caregiverlist.com has been an
excellent resource for helping us identify and contact qualified and
motivated caregivers," said Ray Willard, Marketing Director, Senior
Helpers of San Diego. "The detailed information provided, allows us to
review and screen caregivers before we make contact with applicants."
"Caregiverlist.com has enabled us to keep up with the increased desire
for in-home care services as well as changing client care needs while
reducing our recruitment advertising expenses."

Senior home care agencies registered with Caregiverlist.com
gain their own provider mini website and tools to effectively screen,
interview and hire caregivers. Senior home care agencies are also
automatically sent email alerts when a new job application is
submitted.

Medicare Part D Long-Term Care Patient Protection Act of 2007

To amend title XVIII of the Social
Security Act to provide for patient protections under the Medicare
prescription drug program for residents of long term care facilities.

Medicare Could Lower Long-Term Costs, Avoid Physician Fee Cuts By Reducing Hospital Readmissions, Opinion Piece Says

Reducing hospital readmissions by Medicare beneficiaries could play a
large role in reducing program spending enough to avoid cutting
physician fees, Robert Pozen, a trustee of the Commonwealth Fund, and Cathy Schoen, senior vice president of the fund, write in a Boston Globe
opinion piece. According to Pozen and Schoen, Medicare must reduce
expenses by $20 billion annually over a decade beginning in 2010 to
avoid reducing fees to physicians.

They write that "there is a
straightforward way to pay for half of this fix" through reducing
hospital readmissions. The authors note that a Medicare Payment Advisory Commission
study found that 75% of all 30-day hospital readmissions of Medicare
patients in 2005 were potentially preventable -- or 13% of total
admissions. If these readmissions were eliminated, Medicare could save
$12 billion annually, or more than half of its unfunded liability,
according to the authors.

According to Pozen and Schoen, in
order to achieve these savings, Congress should address three
objectives: decreasing complications during hospital stays, improving
patient communication during the discharge process and tracking
patients after discharge. However, for these measures to work,
"Medicare needs to create the right incentives" because hospitals
currently receive higher payments for patients being treated twice,
according to the authors. The authors write that Congress should
require readmission rates to be public. They continue that hospitals
whose readmission rates are above the national average should receive
lower reimbursements for a beneficiary's second stay, while hospitals
who have rates lower than the national average should receive higher
reimbursements for a beneficiary's first hospital stay.

Long-Term Care Workers Struggle With Elderly Population Boom

As America's aging population increases, so does its need for long-term
care. And the workers who provide these services often lack the support
they need - particularly in the area of pay and work relationships,
according to "Better Jobs Better Care: New Research on the Long-Term Care Workforce," the latest special issue of The Gerontologist (Volume
48, Special Issue 1). Those aged 65 and older are projected to
represent at least 20 percent of the total U.S. population by 2030,
with the number of those 85-and-older increasing the most. The growth
of this demographic will have a major effect on the demand for and
supply of long-term care services.


Better Jobs Better Care (BJBC) was the nation's largest single
initiative created to reduce the high vacancy and turnover rates of
direct care workers and improve workforce quality through both policy
and practice changes.

Consumer Event Highlights Successful Mental Health Intervention

This Event was picked up by Reuters Press Service!

<span>DETROIT, May 27 /PRNewswire/ -- More than 400 mental health consumers are<br />expected to attend "Empowerment Day," an event organized by consumers to<br />celebrate recovery from mental illness and advocate for improved mental health<br />services, on Friday, May 30, between 9 AM and 3 PM at The Samaritan Center at<br />5555 Conner Ave. Detroit, MI 48213.<br />    The third annual event will feature entertainment performances and<br />personal storytelling by consumers who have recovered from severe and<br />persistent mental illness and now live independently after mental health<br />intervention. Many of the consumers were once homeless.<br />    "We want to show that when consumers are supported in their long journey<br />to recovery, there is no telling what they can accomplish," said Gerald<br />Butler, chairperson of the Peer Support Empowerment Committee, which is<br />presenting the event. The Committee is a group of mental health consumers<br /></span>

Fire Safety Requirements for Long Term Care Facilities, Automatic Sprinkler Systems

<pre>SUMMARY: This final rule requires all long term care facilities to be <br />equipped with <a href="http://cryptome.org/hhs081308.htm">sprinkler systems by August 13, 2013</a>. Additionally, this <br />final rule requires affected facilities to maintain their automatic <br />sprinkler systems once they are installed.<br /><br />DATES: These regulations are effective on October 14, 2008. The <br />incorporation by reference listed in the rule is approved by the <br />Director of the Federal Register October 14, 2008.<br /><br />FOR FURTHER INFORMATION CONTACT: Danielle Shearer, (410) 786-6617; <br />James Merrill, (410) 786-6998; Marcia Newton, (410) 786-5265; or <br />Jeannie Miller, (410) 786-3164.<br /></pre>

State Medicaid Agencies Routinely Fail To Notify Federal Authorities When They Sanction Providers, HHS OIG Report Finds

States regularly fail to notify the HHS Office of Inspector General
when they have expelled health care providers from their Medicaid
programs for incompetence, fraud and other reasons that would prohibit
them from receiving federal reimbursements, according to federal
investigators, the AP/San Francisco Chronicle reports.
The lack of notice keeps the providers off OIG's reimbursement
exclusion list, making it easier for barred providers to work in other
areas of the country and continue to receive federal funds, according
to the report.

Federal investigators surveyed states to
determine how often Medicaid programs sanction a provider in a way that
would place them in OIG's exclusion database. Reasons for exclusion
include fraud convictions, patient abuse, licensing board sanctions and
default on federal education health loans. No federal payments can be
made for any services that an excluded provider performs, orders or
prescribes, according to federal law. Forty-seven states responded to
the survey.

Does Your Content Work for an Aging Population?

Read the Whole Article. It's great!

I’m getting older. You are too. It’s a fact of life that no matter
how young we are now, one day we’re going to start feeling the creaks
and groans of age settling in.

I can’t stay up as late at night. I’m a little slower to get going
in the morning. When I’ve been writing for a long time, I feel stiff as
I rise from my chair. Oh, yeah, and my eyesight is going, too.

Somewhere about the time we realize that
we’ve flipped into middle age, little physical effects of aging sink
in. They’re small at first and what gets noticed is what hurts most.
Then other changes come to light, slowly but surely.

Lately, I’ve noticed I’m squinting a little more to read text on my
monitor. I’m not keen on grey fonts and black on white serves me best.
I don’t like Arial 6 (or 8 or 10, for that matter) fonts on websites,
and I have to lean in and strain to read or give up and click away.

That’s important. How you write is key to online success. What you
write is even more so. But what your content looks like has a huge,
huge impact on your future.

Nursing-home study: Inspection system 'broken and can't be fixed'

A leading nursing-home association is calling for an independent panel
to come up with new methods for overseeing nursing facilities. The
association's task force issued 31 recommendations Tuesday,
highlighting steps that can be taken until such a panel can be convened.



"The frustration of good providers has reached a boiling point," said
Tim Veno, executive director of the Kentucky Association of Homes and
Services for the Aging, and a task force member. On Tuesday, the
American Association of Homes and Services for the Aging (AAHSA) issued
its report, "Broken and Beyond Repair: Recommendations to Reform the
Survey and Certification System."



"Our short-term suggestions alone won't bring the system back to the
intent of OBRA 87-achieving optimal, quality-based, resident-centered
care-but they will tide the system over until broad systemic change can
occur," said Bonnie Gauthier, CEO of Hebrew Health Care in West
Hartford, CT, and co-chair of the 20-member task force. Immediate
changes needed, according to report authors echoing years-long provider
sentiment, include better public reporting of survey results, joint
education of providers and surveyors, and greater overall consistency
in the process.



The 31 recommendations include short- and long-term goals, such as
improving communication to surveyors and providers about new
requirements and changes to the survey process; standardized job
descriptions for surveyors; and flexibility to adapt to culture change.
The full report can be found at: http://www.aahsa.org/advocacy/nursing_homes/documents/SCTF_Report_FINAL.pdf.

Obtaining Justice in Cases of Abuse and Neglect in Florida Nursing Homes and Other Related Long Term Care Facilities

The law firm of Urban Thier Federer & Jackson, P.A. is proud to
protect residents from abuse and neglect in Florida nursing homes,
assisted living facilities, adult family-care homes, board and care
facilities, and other similar residential adult care facilities, or, at
minimum, seek justice for those already injured in these settings. The
firm is most active in the Central Florida area, including Brevard,
Lake, Orange, Osceola, Polk, Seminole, and Volusia Counties, but has
also handled cases throughout the state of Florida, including Baker,
Clay, Flagler, Marion, Citrus, Hernando, Sumter, Pinellas,
Hillsborough, Manatee, and Sarasota Counties.

After years of defending physicians working in long term
care facilities and, to an even greater degree, defending the
facilities themselves – both in Texas and in Florida – I, and this
firm, now serve the needs of those being abused and neglected in the
long-term care setting. Although experience has shown that there are
compassionate care givers who work in the long-term care industry, not
all of the staff working at such facilities care about the needs of
their facilities’ elderly and vulnerable resident population. Moreover,
even those who enter the profession with high ideals and a desire to
provide a high level of care to the residents within their charge often
become jaded because they are overworked and underpaid for their
efforts by their employers – the very facilities charged with ensuring
the welfare of its residents. Corporate greed leads to inadequate
facility budgets and compromises the ability to provide the level of
care legally mandated by the “Resident’s Bill of Rights,” as reflected
in the Florida Statutes. Corporate greed also undermines the moral
obligation to care for those who number amongst the most frail and
defenseless in our population. All too often my conferences with staff,
as the defense attorney for the long term care facility, led to
comments by registered nurses, licensed practical nurses, and certified
nursing assistants that they were so overworked that if they actually
provided all of the care that residents were supposed to receive on a
daily basis then they would not reach all of the residents in their
care and some would even die. Thus, these caregivers learn to cut
corners and skip steps in the care plan – some of which result in
disastrous consequences for the residents in their supposed care.

Case Western Reserve University Study Finds Caregivers Of Spouses With Dementia Enjoy Life Less

Spouses of husbands and wives with dementia pay an emotional toll as
they care for their ailing spouse. This has prompted a call for new
interventions and strategies to assist caregivers in coping with the
demands of this difficult time, according to a study from Case Western
Reserve University's Mandel School of Applied Social Sciences.


"Caregivers have a long exposure to stresses and losses from the
dementia and fatigue that comes from caring for their spouses, so they
experience fewer positive emotions," said Kathryn Betts Adams,
assistant professor of social work at the Mandel School. "Some may have
feelings of guilt about participating in activities with friends or in
the community when their loved ones are no longer able to do so."


Adams added that caregivers also report sadness and loneliness.

Facing into the challenge of long-term care

from The Irish Times:

THAT'S MEN: Carers involved in long-term or chronic care need to remind themselves that they are choosing to care

IN
A RECENT column, I wrote about the stresses involved in caring for
somebody whose condition is terminal, and also about the stresses
involved in being the person who is cared for.

Subsequently, I
wrote about the tendency of human beings in conflicts to torment
others, and about the importance of personal and moral choices in
avoiding such behaviours.

A reader pointed out that both of
these columns are particularly applicable in cases where a person is
caring for somebody with a chronic illness. The person with a terminal
illness is coming to the end of his or her life. Chronic conditions,
however, can go on for decades. This can be very stressful indeed for
both parties involved in the caring.

Nursing-home evictions raise bigger questions

Some disturbing news appeared last week in The Wall Street Journal.
The highly respected newspaper found that nursing homes are evicting
long-term, frail residents—many on Medicaid—to make room for short-stay
residents.

This timely information (See more at http://www.mcknights.com/News-report-Illegal-nursing-home-evictions-on-the-rise/article/113572/)
comes as nursing homes are openly courting the short-stay population.
These residents—who typically come for rehabilitation or treatment and
stay for 30 days or less—are on Medicare, which, pays much more per day
to nursing homes than Medicaid.

The industry, which reportedly argued that evictions are not common,
cannot deny it is going out of its way to woo this lucrative group. My
InnerView, a research company that performs many long-term care
surveys, recently published a story called “The Changing Landscape from
long term care to short-term stay: What are your short-stay customers
saying?” It appears on the Web site of Provider magazine, the journal
of the American Health Care Association, the largest association of
nursing homes. (You can see it at www.providermagazine.com.)

The article stresses the need to meet short-term residents’
expectations as a way to enhance facilities’ reputations in their
communities and improve their abilities to attract short-stay
admissions.

“As the trend to shorter stays, more acute patients, and more
admissions and discharges continues to grow, providers’ reliance on
this population for their success becomes ever more important,”
according to the article, which was written by Brad Shiverick, chief
quality officer for My InnerView

Democratic Platform Draft Addresses Long-term Care

This weekend, Democratic leaders endorsed an outline of their
party’s policy platform for delegates to review and ratify during the
party’s upcoming convention in Denver.

The document, Renewing America’s Promise,
is the result of more than 1,600 listening sessions in communities
across the country. It addresses issues ranging from education reform
to climate change. And thanks to the hard work of our staff and AAHSA’s Long-term Care Solution ambassadors,
it also includes a call for our country to make it affordable to care
for older Americans and disabled individuals. Here are two passages
from the outline that reflect this commitment to action:

Empowerment and Support of Older Americans and People with Disabilities.

Seniors and people with disabilities should have access to
quality affordable long-term care services, and those services should
be readily available at home and in the community. Americans should not
be forced to choose between getting care and living independent
and productive lives.

Assisted living: a risky business

The freedom to "age in place" conveys hope for seniors-a chance to
enjoy the final season of life without being institutionalized and
without burdening family members. As evidenced by exponential growth in
assisted living, independent living and community-based programs,
consumers are driving the long-term care market and they demand
options, autonomy and the freedom to make choices-including choices
that entail risk. Balancing autonomy with safety, however, presents a
serious challenge to assisted-living facilities striving to deliver on
the hope of aging in place for their frail and elderly residents.



Risk abounds



In a community of residents with an average age of 84 who depend on
assistance for many daily tasks, risk abounds. Just consider the
obvious risks in a population where 86% require assistance with
medications, 68% with bathing, 47% with dressing and 25% with eating.
And do not minimize the fact that, on average, half the residents also
suffer from some form of dementia. Falls, elopements, abuse,
medication issues and contagious infections are just a few of the more
common problems that keep both administrators and family members up at
night.



But there is another layer of less obvious risks. Some seniors, who
thought they bought the complete lifetime package, will face the risk
of eviction. Glossy marketing brochures that assured prospective
residents of services to meet all needs of all residents all the time
have faded away leaving only a trail of broken promises.



Jim Moore, a respected assisted living consultant, refers to it as the
"million dollar wake-up call" for assisted-living facilities. He notes
that by adding just 60 minutes of assistance per day for just 40% of
residents, a facility's costs can increase by $123,000 per month.
Unless the facility can cover those expenses with higher prices,
promises are broken. Even in the wake of broken promises, many
residents will resist the need to move along the continuum of care.
Likewise, many administrators who find themselves under constant
pressure to keep the facility full may not pursue a transfer.



The confluence of these factors leads into another equally undesirable
set of risks. Although the phrase "aging in place" conjures up
favorable images for the majority of seniors, the reality may be a
disappointment for them and their family members. Because
assisted-living facilities are not regulated by the federal government,
and only loosely regulated by state government, the level of services
provided from facility to facility varies significantly. In an effort
to minimize operating expenses, many facilities depend heavily on
unlicensed personnel (universal workers) for a majority of resident
care, including the administration of medication. For seniors with
deteriorating health conditions and multiple chronic diseases, lack of
adequate nursing care and nursing supervision can spell disaster. In
fact, most mistakes that result in injuries to residents are typically
rooted in staffing issues.