Wisconsin A Leader In Pressure Ulcer Initiatives

from Medical news Today:

The Wisconsin Department of Health Services announces that health care
leaders from across the state have formed the Wisconsin Pressure Ulcer
Coalition to help reduce pressure ulcers in Wisconsin's health care
industry, including nursing homes and hospitals.....

The goals of the Wisconsin Pressure Ulcer Coalition are to:


- Decrease the incidence of pressure ulcers in our health care settings

- Continue to educate caregivers and leaders about effective preventive measures

- Improve assessment when an individual is admitted to a health care facility, as well as continue to monitor appropriately

- Develop appropriate prevention strategies within 24 hours if
individual identified to be at risk of developing pressure ulcers

- Improve communication between providers to provide a better continuity of care

for More...

Newspaper Explores LTC Crisis in own Backyard

from PHI:

As the challenge of caring for America’s aging population
intensifies, the issue is beginning to get the increased newspaper
coverage it deserves. Case in point: an in-depth series that has been
offered up from a small daily paper out of Utah (hat tip to The New Old Age).

Gray Area: Utah As It Ages
features sparsely written vignettes examining the lives of elderly
people in Utah when they were young and their current challenges with
aging. Accompanying each story are intimate black and white photos of
wrinkles, smiles, and struggles.

For More...

LETTER OF SUPPORT FOR UNITED CAREGIVERS OF AMERICA

from Gather:

As I write these words thousands upon thousands of elderly people
are being cared for at home, in hospitals, and nursing homes. The
problem is most caregivers lack the proper amount of training and
education to deliver or administer top of the line quality care and
treatment. The nurse aide, home health aide, and family member
caregiver need to be recognized as the most important component in the
long term health care system. They are the ones who make or break the
system. They are the ones who deliver the majority of care to the
patient. Yet they are the ones least recognized and in some cases even
disrespected.

At some point in time all of you reading these
words will be face to face with a basic caregiver. And you better hope,
for your sake, they know what they are doing. For they are the ones who
hold the key to your survival. They are the ones in control of your
care. And in many cases they will be the ones fighting for your life
(or not). How do you know a good caregiver from a bad caregiver? You
don't.

For More......

Care and support - a community responsibility?

from Joseph Rowntree Foundation:

Any new settlement on long-term care and support must address the apportionment of responsibility for its delivery as well as its funding. With the state's capacity limited and family input likely to decline, the wider community must expect to play a growing role. This offers an opportunity to end social care's marginalisation, argues David Brindle.

Author
David Brindle, The Guardian
Key points

    * Social care has become isolated from mainstream society and its recipients are cut off from their neighbourhoods and from each other.

For More......

Disabled people 'bullied at work'

from guardian.co.uk:

Disabled people are much more likely than the able-bodied to be hit,
injured, bullied and humiliated at work, groundbreaking research for
the Equality and Human Rights Commission will reveal today.

In
the first comprehensive survey of discrimination in the workplace, the
commission found 11.6% of employees with a disability or long-term
illness experienced physical violence at work, compared with 5.5% of
other employees.

It said 8.8% of disabled people sustained an
injury as a result of violence or aggression at work, compared with
4.7% of able-bodied people.

For More.....

Nursing Home Litigation

from InjuryBoard.com:

My, My!!

Nursing home cases in Arkansas present unique problems. Many nursing
homes no longer carry liability insurance and have mortgages and liens
against their assets, making collection of any judgment next to
impossible. After a series of large verdicts here in Arkansas the homes
could no longer afford to carry liability insurance.

My advice in selecting a nursing home for your loved one is to inquire
about their history of lawsuits in the past. One good source is the
Medicare website, Nursing Homes Compare.

New Internet Service Delivers Relief to Families of Those in Long-Term Care

from International Business Times:

COLUMBUS,
Ohio and PHOENIX, Nov. 25 /PRNewswire/ -- There is a newInternet
service available that changes the communication paradigm inlong-term
care. Addressing the family's basic need to stay informed, it
allowslong-term care providers to give them regular proactive wellness
updatesthrough a secure web page, by email and text message without
families havingto call, no matter where they are.

Too much to do and too little time. It's a common problem that takes
onspecial significance for the families of the more than 3.8 million
people inthe U.S. living in Nursing Homes, Assisted Living Facilities
or receiving HomeCare as they struggle to stay up-to-date with the
well-being and needs oftheir loved ones.



"As one of the millions of people in the U.S. with family in
long-termcare," said Neil Moore, founder and chief executive officer
ofConnect4Healthcare, the company that developed the service, "I was
shocked tofind that with all of the technology available to us today,
the only way wecould find out how our loved-ones were doing was to
visit or call the careprovider. Most of us can't do that as often as we
want; our lives are just toohectic."



After spending almost 20 years in the healthcare IT business, Moore
knewhe could do better. "That's why we created Connect for
Healthcare(TM). It'sbecome my personal mission. We (families) want and
need the information; carefor our loved ones is better when we are
better informed, and good careproviders want to communicate with us. It
helps everybody involved."



The Connect for Healthcare(TM) service was developed by the company
withinput from families and care providers. "Although our primary
objective is tohelp families and their loved ones," says Moore, "the
role of the long-termcare provider in our process is critical. Staff
time and money continue to betheir key challenges. The simplicity of
our software and our unique businessmodel address them both."



Today, the company is introducing their service to long-term
careproviders but plans to begin marketing directly to consumers early
next year."In the meantime," says Moore, "families that want the
service should call thecare provider and ask for it. Send them to our
website or have them contactus. We can have them ready to start sending
you updates in less than a day."

Nursing home suicide rates have not improved in 15 years

from McKnight's:

While instances of suicide among community-dwelling seniors have fallen
in recent years,the same has not been true for long-term care
residents, according to a recent study.



University of Michigan researchers studied the rate of suicide among
seniors aged 60 and over in New York City between 1990 and 2005. During
that time, the relative rate of nursing home suicides did not decline.
The most at-risk cohort were men between the ages of 60 and 69.

Storytelling in Long Term Care Facilities

from Novice to Expert:

This article really resonated with me. I truly believe in the value of
storytelling and if stories carried actual physical weight, I would
weigh a lot more than I did when I first started in nursing because of
the patients' stories I carry with me.

This article from Provider Magazine, Creative Tasks Spark Imagination,
outlines three techniques used in a long term care facility for
residents along the continuum of memory impairments (from none to
late-stage Alzheimer's or dementia). The first technique is based on Timeslips, which promotes social interaction. It helps to reduce the isolation that many persons with dementia may experience.

The second technique involves storyboarding which can be done by the resident or by the family, if the resident is not able to participate. Upon completion of the storyboard, a celebration is held to celebrate the individual's life.

In the third technique, individuals write their life stories in a 6-10 week storytelling workshop.

Disabled couple see independence intertwined with will to live

from The Sacramento Bee:

Kevin Terrell and Beverly Evans-Terrell are married. They live in an
apartment in the Country Club neighborhood of suburban Sacramento. They
have both been disabled since birth and depend on services provided
through the state to remain independent and live outside of nursing
homes.

Kevin Terrel

I grew up in a nursing home in Southern California. Nursing homes are a zoo.

You live with at least 50 other people and you have 50 people working
in various positions. I don't like them. I am the king of
claustrophobia. I need my space. I need my privacy. I will not go back
to a nursing home without a fight. It's not going to happen.

If nursing homes cost so much, why is California trying to cut these
programs that do their best to keep us out of nursing homes? That is
what I would like to know.

Beverly Evans-Terrel

I was born with spina bifida. I was raised at home until I was 13 and
then I lived in Sonoma State Hospital. When I was 24 I asked to be
placed in a place where they would teach us to be somewhat independent.
Now I live on my own, with Kevin.

If we have to go back to nursing homes we will lose the will to live.
Living on my own I have the responsibility to take care of myself. I'm
free from dictators. I can go anywhere I want to go. I can go to bed
when I want to.

In Housing Slump, Elderly Forgo Assisted Living

from The New York Times:

Maybe a reason for more in-home supports!

The housing crisis has kept thousands of older Americans who need
support and care from moving into retirement communities or
assisted-living centers, effectively stranding them in their own homes.

Without selling their houses or condominiums, many cannot buy into
retirement homes that require a payment of $100,000 to $500,000 just to
move in. So they are scratching themselves off waiting lists, canceling
plans with packing services and staying put, in houses that fit well 30
years ago, but over the years have become lonely, too large or too
treacherous to navigate.

National Senior and Disability Advocates Agree on Principles for Financing Long-Term Services and Supports

from MarketWatch:

WASHINGTON, Nov 20, 2008 /PRNewswire-USNewswire via COMTEX/ --
In a historic step toward a healthier, more equitable and affordable
system for financing long-term services and supports, the Leadership
Council of Aging Organizations (LCAO) and the Consortium for Citizens
with Disabilities (CCD) have agreed on a set of joint principles for
reform.

The principles are:

    1. National Problem, National Solution -- Recognize that although states,<br />       communities, families, and individuals have important roles to play,<br />       financing for long-term services and supports is a national problem that<br />       requires a national solution.<br />    2. Universality with Limited Opt-Out -- Create a public program that allows<br />       all people, including individuals with disabilities and those near<br />       retirement, the opportunity to contribute to and prepare for the costs of<br />       long-term services and supports.  Make participation as convenient as<br />       possible but give people the limited choice to opt out.<br />    3. Public/Private Partnership -- Provide a strong foundation of protection<br />       while providing opportunities for personal planning that include a role<br />       for private sector options.<br />    4. Affordability and Risk Pooling -- Provide for broad pooling of risk and<br />       appropriate low-income subsidies to make premiums affordable enough so<br />       that all people, regardless of income and health status, can participate.<br />       Ensure that a new program does not force people to impoverish themselves<br />       to qualify.<br />    5. Fiscal Responsibility -- Provide actuarially sound funding, such as<br />       through voluntary premiums that build reserves over time sufficient to<br />       pay for future needs in a way that is affordable to individuals and to<br />       society as a whole.<br />    6. Relieve Pressure on Medicaid -- Provide additional long-term services and<br />       supports funding mechanisms that will help take the pressure off of<br />       future Medicaid expenditures, while preserving the guaranteed safety net.<br />    7. Consumer Choice and Control -- Promote independence and dignity across<br />       the broad continuum of services and supports by ensuring beneficiaries<br />       the right to control and choose what services they receive, how and where<br />       they are delivered and who provides them.<br />    8. Support Family Caregivers -- Recognize and support the central role<br />       families and other informal caregivers play in planning for and providing<br />       long-term services and supports, including developing strategies to<br />       support working caregivers to maintain their financial security.<br />    9. Invest in Quality Care and Quality of Life -- Target additional funding<br />       to ensure sufficient training and compensation for the workforce and to<br />       strengthen oversight, enforcement, and advocacy programs that improve<br />       quality of life and quality of care in all settings.<br /><br /><br /></pre>
        <div class="p">
            About CCD ( <a class="lk001" target="_blank" href="http://www.c-c-d.org/">http://www.c-c-d.org</a>)

        </div>
    
        <div class="p">
The Consortium for Citizens with Disabilities is a coalition of
approximately 100 national disability organizations working together to
advocate for national public policy that ensures the self
determination, independence, empowerment, integration and inclusion of
children and adults with disabilities in all aspects of society </div>
    
        <div class="p">
            About LCAO ( <a class="lk001" target="_blank" href="http://www.lcao.org/">http://www.lcao.org</a>)

        </div>
    
        <div class="p">
The Leadership Council of Aging Organizations (LCAO) is a coalition of
national nonprofit organizations concerned with the well-being of
America's older population and committed to representing their interest
in the policy-making arena. The 56 members offer expertise and advocacy
on a broad range of issues affecting the elderly and those who care for
them. The coalition focuses on ensuring social justice and fiscal
responsibility for an aging society. </div>
    
        <div class="p">
            SOURCE  Consortium for Citizens with Disabilities

        </div>
    <pre> <a class="lk001" target="_blank" href="http://www.c-c-d.org/">http://www.c-c-d.org</a><br /><br />

Updated Nursing Home Care Resources Released by IQ Nursing Homes

from Transworld News:

IQ Nursing Homes has recently updated its
Nursing Home Resources and is now providing information about nursing
home admission, paying for long term care, and nursing home services.
The IQ Nursing Homes website has been created with the goal of
providing a comprehensive source of nursing home information, and this
recent update marks another step in our progress toward achieving this
goal.

 Visit http://www.iqnursinghomes.com/
to review these new resources. You can also find up-to-date nursing
home news and information about signs of elder abuse and nursing home
neglect on this site.  IQ Nursing Homes offers a free
nursing home abuse claim form, which will be reviewed by a qualified
nursing home attorney within 36 hours. Nursing home employees who have
witnessed neglect can report it anonymously.

John Hancock Announces Results of National Long-Term Care Cost of Care Study

from Virtualization:

BOSTON, Nov. 20 /PRNewswire-FirstCall/ -- John Hancock Life Insurance
Company (John Hancock) today announced the results of an in-depth study of the
2008 costs of long-term care (LTC), which found that LTC costs have been
increasing in line with inflation in recent years.

Including information from more than 11,000 care providers nationwide, the
study of national care costs conducted by CareScout, based in Wellesley, MA,
revealed average costs of care in the U.S. are roughly $75,000 annually for a
private room in a nursing home; $67,000 annually for a semi-private room in a
nursing home; and $35,000 annually for an assisted living facility, while the
average cost of home care was found to be about $19 per hour.

A comparison of the 2008 national averages to those of a similar study
conducted by Harris, Rothenberg International for John Hancock in 2002,
indicates that the increases in costs over the past six years appear to be
tracking inflation, as measured by the Consumer Price Index (CPI) during the
same time period. According to the study, the average annual increase in the
cost of long-term care is trending in line with the 3.3 percent average annual
increase in the CPI during the same time period as noted below.

PHI has supported such alternatives by developing training for staff who were moving from traditional nursing home environments to Green Houses®. THE GREEN HOUSE Project was initially developed by Dr. William Thomas, a professor at the University of Maryland’s Erickson School and leader in the elder culture change movement, who writes a blog called Changing Aging.org. The first Green Houses® opened in Tupelo, Miss., in 2003, to provide seniors of all incomes with more dignity, autonomy, and choice in long-term care. The name stems from the focus on encouraging personal growth among residents. The idea is that Green Houses® cost no more to run than traditional homes because they produce less waste and require less infrastructure.

from Wall Street Journal:

As Budget Shortfalls Force Reductions in Home Care, Low-Income People May Face Nursing Homes, Advocates Say

Faced with widening budget shortfalls, several states are rolling
back support services for the elderly and disabled. The move is making
it tougher for them to continue living on their own, advocates say.

At least 15 states, including Alabama, Virginia and Massachusetts,
are targeting such funding, mostly for programs that allow low-income
shut-ins to receive personal care -- like cooking, cleaning and basic
health services -- in their own homes, according to the Center on
Budget and Policy Priorities, a liberal-leaning Washington, D.C. think
tank that studies state budgets.

The cutbacks are exacerbating the already long waiting lists for
home-care support services in many states. That leaves the low-income
elderly and disabled to dip into their meager incomes to hire their own
help, reach out to family or charity, or seek more restrictive and
expensive care in a nursing home, advocates say.

"We are beginning to see serious cuts and we are expecting those
cuts to get worse," says JoAnn Lamphere, director of state government
relations at AARP, an advocacy group for the elderly.

As the economy falters, declining revenues and tax receipts have led
state agencies to cut spending, with 41 states facing current or
looming deficits, according to the Center on Budget and Policy
Priorities.

A burgeoning market for assisted living and senior living facilities in Mexico is drawing retirement-age baby boomers, according to The Dallas Morning News. Many factors contribute to the appeal of a Mexican retirement, including quality of care, climate and cost, the newspaper reports. A recent MetLife survey places the average cost of assisted care in the U.S. at just over $3,000 per month, while many facilities in Mexico can provide similar care for $1,100 per month, according to the newspaper. Also, many expect that Mexican culture—one that values taking care of the elderly at home—will be suited for the long-term care field. But precisely because of its home-care oriented culture, nursing homes in the country are sparse. The industry is almost entirely deregulated, leading some to question the safety of a Mexican retirement.

from PHI:

Pioneer Network,
a national organization leading the movement for radical change in the
culture of long-term care, is launching the Small House Online
Networking Initiative to bring together key stakeholders to explore the
idea of community-based “small houses” for older adults.

With the support of the Robert Wood Johnson Foundation, the new
initiative aims to enhance communication and shared learning among
those interested in the financing and delivery of person-directed
long-term care through small houses—an alternative to institutional
nursing homes. The virtual meeting place will also provide a forum for
providers who currently run small house initiatives to exchange
information.

PHI has supported such alternatives by
developing training for staff who were moving from traditional nursing
home environments to Green Houses®.

THE GREEN HOUSE Project was initially developed by Dr. William Thomas,
a professor at the University of Maryland’s Erickson School and leader
in the elder culture change movement, who writes a blog called Changing Aging.org.

The first Green Houses® opened in Tupelo, Miss., in 2003, to provide
seniors of all incomes with more dignity, autonomy, and choice in
long-term care. The name stems from the focus on encouraging personal
growth among residents. The idea is that Green Houses® cost no more to
run than traditional homes because they produce less waste and require
less infrastructure.

More U.S. seniors enjoying golden years south of border

from McKnight's:

A burgeoning market for assisted living and senior living facilities in
Mexico is drawing retirement-age baby boomers, according to The Dallas
Morning News.



Many factors contribute to the appeal of a Mexican retirement,
including quality of care, climate and cost, the newspaper reports. A
recent MetLife survey places the average cost of assisted care in the
U.S. at just over $3,000 per month, while many facilities in Mexico can
provide similar care for $1,100 per month, according to the newspaper.
Also, many expect that Mexican culture—one that values taking care of
the elderly at home—will be suited for the long-term care field.



But precisely because of its home-care oriented culture, nursing homes
in the country are sparse. The industry is almost entirely deregulated,
leading some to question the safety of a Mexican retirement.

Elderly People Requires Better Fire Prevention

from Medical news Today:

If you are over seventy years old, your chances of dying in a fire at
home are four times as high as they are for the rest of the population.
It is also a fact that half of all women who die in house fires are 70
or older.

These are among the results of a report from SINTEF
Norwegian Fire Laboratories, which also identifies measures that could
reduce the number of fires, particularly those of electrical origin or
that are due to the inappropriate use of electrical equipment. Taken
together, these are the most frequent causes of fires in Norway.

Elderly Cancer Survivors' Ability To Function Improved By Home-Based Interventions

from Medical News Today:

Climbing stairs, carrying groceries, taking a shower - these are
activities that we take for granted; however, after a cancer diagnosis,
many survivors are unable to function as they used to. Home-based diet
and exercise interventions may improve physical functioning in older,
long-term cancer survivors, according to data presented at the American
Association for Cancer Research's Seventh Annual International
Conference on Frontiers in Cancer Prevention Research.


Wendy Demark-Wahnefried, Ph.D., professor of behavioral
science at the University of Texas M. D. Anderson Cancer Center,
focused this study on survivors older than 65 years old. She said this
age group often suffers long-term side effects of cancer and its
treatment which could threaten the ability to live independently.
"Younger cancer patients are usually able to bounce back, but older
patients may need a structured program to stop functional decline and
retain independence," said Demark-Wahnefried.


Those in the intervention group received tailored mailed print
materials on diet and exercise, a pedometer and exercise bands. For the
first three weeks, participants received weekly phone calls, which
tapered off to every two weeks and then once a month until the end of
the study.


At the end of one year, researchers evaluated physical
function, diet quality and physical activity using standard measures.
Participants in the intervention group demonstrated significant
improvements in their diet and exercise behaviors, and their weight
status. What's more, according to the SF-36 physical function test,
participants in the intervention group had a 2.5 point decline compared
with a 5.3 point decline in the control group. Similar differences were
seen in measures of basic lower extremity and advanced lower extremity
functioning. Overall, the magnitude of effect was similar to preventing
physical function losses comparable to that imposed by ischemic heart
disease.

from Market Watch: LIFE Foundation Reviews Five Facts You May Not Know about Long-Term Care Insurance and Encourages Americans to Assess Their Needs With significant losses to their savings and investments, and economists warning of a prolonged recession, many Americans are feeling uncertain about their retirement security and their ability to pay for long-term care services. According to a new survey by the nonprofit LIFE Foundation, 64 percent of Americans age 45 and older say that the recent economic downturn has had a major negative impact on their ability to pay for long-term care services should they become unable to take care of themselves for an extended period of time. Considering that 70 percent of Americans who reach age 65 will need such care at some point in their lives, according to the U.S. Department of Health and Human Services, these findings show how financially vulnerable many people are without a long-term care plan. Released to coincide with Long-Term Care Awareness Month in November, the LIFE survey found that most adults recognize the reality of needing long-term care services:

from health Care for Health Care Workers:

A testimonial by Cheryl D., a home care consumer in Pennsylvania:

At the age of 14, a cardiac arrest left my son Renzo with a severe
anoxic brain injury. For the last seven years, he has been completely
dependent on the help of direct-care workers. I pay at the higher end
of the wage scale ($10.50 - $15 per hour), but I can’t afford health
benefits for his workers.

Over the years, Renzo has seen more than 40 workers come and go. His
short-term memory is challenged. It’s not until he has had somebody for
two to three months that he can remember their name. And it takes
workers at least a month to understand his patterns of speech.

For every aide that comes in, I am the trainer. I have to teach them
how to help him eat through a straw, how to manage his toileting needs,
and how to help him therapeutically regain limited skills. He has never
really learned to use the augmentative communication device because he
has not had a consistent person to work with him long enough.

Nursing-Home Sex Becoming More Acceptable

from Fox News:

Nursing-home
residents have sexual needs too. And now researchers are finding ways
to educate staff on the taboo topic and provide accommodations for the
elderly to shack up under some privacy.

"Most
staff have the same mindset many of us do, which is 'I don't want to
think about my parents having sex, let alone my grandparents,'" Gayle
Doll, who directs Kansas State University's Center on Aging, told
LiveScience.

The researchers suggest educating staff about sexuality and making sex in nursing homes less hush-hush.

In
the long run, they hope federal guidelines will help all nursing homes
deal with sexuality in a positive way, especially as baby boomers age
and bring their 1950s and 1960s attitudes about sex with them to the
facilities.

Survey Finds Economic Downturn Has Had a Major Negative Impact on Americans' Ability to Pay for Long-Term Care Services

from Market Watch:

LIFE Foundation Reviews Five Facts You May Not Know
about Long-Term Care Insurance and Encourages Americans to Assess Their
Needs

With significant losses
to their savings and investments, and economists warning of a prolonged
recession, many Americans are feeling uncertain about their retirement
security and their ability to pay for long-term care services.
According to a new survey by the nonprofit LIFE Foundation, 64 percent
of Americans age 45 and older say that the recent economic downturn has
had a major negative impact on their ability to pay for long-term care
services should they become unable to take care of themselves for an
extended period of time. Considering that 70 percent of Americans who
reach age 65 will need such care at some point in their lives,
according to the U.S. Department of Health and Human Services, these
findings show how financially vulnerable many people are without a
long-term care plan.

Released to coincide
with Long-Term Care Awareness Month in November, the LIFE survey found
that most adults recognize the reality of needing long-term care
services:

Brainline,org

from Brainline:

This site is supported by the Defense Centers of Excellence.  It is intended to support veterans and other people with brain injuries.  Lots of stuff!

2008 MetLife Assisted Living and Nursing Home Surveys

from Homewatch:

In October 2008, MetLife published their 2008 survey results of Nursing
Home and Assisted Living costs across the US. Nursing Home rates
essentially stayed the same from 2007 to 2008 at at an average of
$212/day for a private room or approx. $80,000/ year. Assisted Living
costs rose by 2% and averaged $3,031 per month or $36,500/year for the
"base rate" which doesn't include some "a la carte" services.
For the full MetLife survey,http://www.metlife.com/FileAssets/MMI/MMIStudies2008NHALCosts.pdf

Integrated Managed Long-Term Care forum

from Patti's Blog:

From the Michigan Department of Community Health:

INVITATION

The Long-Term Care Supports and Services
Advisory Commission
Finance Work Group

is hosting an:

INFORMATIONAL FORUM ON INTEGRATED MANAGED LONG-TERM CARE

December 11, 2008 from 2 to 4 PM
State of Michigan Library Auditorium
Click here for flyer for more info.

CMS issues new guidelines for Medicare Advantage Special Needs Plans

from McKnight's:

The Centers for Medicare & Medicaid Services last Thursday laid out
new guidelines governing Medicare Advantage Special Needs Plans that
serve Medicare beneficiaries with chronic conditions.  



"Based on the panel's recommendations, we are defining the chronic
conditions that certain Medicare special needs plans must use to
identify the beneficiary populations eligible for enrollment," said CMS
Acting Administrator Kerry Weems.



Special needs plans are a type of Medicare Advantage plan that serve
only beneficiaries living in institutions, eligible for both Medicare
and Medicaid, or living with severe or disabling chronic conditions.
The new guidelines, which are based on recommendations from the Special
Needs Plan Chronic Condition Panel, will take effect in 2010. They
identify 15 chronic conditions that will dictate eligibility for a
Chronic Care Medicare Advantage Special Needs Plan. The 15 chronic
conditions include dementia, chronic heart failure, diabetes mellitus,
and stroke.



To view the panel's full report, go to www.cms.hhs.gov/SpecialNeedsPlans.

Another Extendicare Class Action Lawsuit Filed over Nursing Home Neglect in Wisconsin

from Aboutlawsuits.com:

Nursing home operator Extendicare faces a third class action suit,
this time filed on behalf of all residents of their nursing homes in
Wisconsin. Similar Extendicare class action lawsuits
have been filed in Washington and Minnesota, with all of the cases
alleging that the company places profits over patient care by admitting
residents that they are not properly equipped to handle.

The Wisconsin Extendicare lawsuit was filed Friday in the Circuit
Court for Milwaukee County by one resident, but seeks class action
status on behalf of all residents who have been treated at 26 different
nursing homes operated by Extendicare in the state.

Extendicare is one of the largest nursing home operators in the
United States and Canada, with as many as 226 homes in North America
and over 30,000 beds.

The lawsuit alleges that Extendicare fraudulently advertises
services that they are not capable of performing and admits ill
residents without hiring the necessary staff to provide even adequate
care.

New Comprehensive Study of Hispanic Family Caregivers

from Market Watch:

A study released today from UnitedHealth Group's
Evercare(R) organization and the National
Alliance for Caregiving (NAC) finds that more than one third of Hispanic
households (36 percent) have at least one family member caring for an
older loved one --a larger percentage than all
U.S. caregiving households which is 21 percent (one in five), according
to the Evercare Study of Hispanic Caregiving in the U.S. The
study, the largest comprehensive look at Hispanic caregivers, also
revealed that caregiving caused a major change to the working situation
of Hispanics, which could have dramatic personal implications as the
current fiscal crisis continues to unfold in the United States.
Additionally, the emotional and physical tolls of caregiving might also
impact the local and national economies, given that more than eight
million Hispanics provide care to older loved ones nationwide.

Curious Consent Standards in Nursing Home Admissions

from Nursing Home Administrator's Blog:

Nursing home administrators face an unexpected ethical (and legal)
dilemma when admitting new residents to skilled nursing care. The
Nursing Home Care Act undercuts a traditional notion of informed
consent in such a way that many residents may be admitted to a nursing
home without ever consenting to treatment, or having a meaningful
surrogate consent to their treatment. This is clearly an issue of
nursing/medical ethics, as well as a font of potential legal liability
for providing unauthorized care.

American health care law is predicated on the notion of patient
autonomous-direction. Within this notion exist a number of inter-linked
rights: the right to self-determination, the right to give consent
before treatment, the right to information forming the basis of consent
and many others. Curiously, in senior care, as in perhaps no other
major area of American health care law, the status of patient
autonomous direction, especially with respect to consent before
treatment, is less sacrosanct, the exceptions more numerous. This is
especially true in the legal quagmire of involuntarily placing adults
in nursing homes.

I am most familiar with the Illinois Nursing Home Care Act and it
will thus form the background of this discussion, but the Illinois Act
is not dissimilar to Nursing Home Care Acts in many other states, at
least inasmuch as the acts address the issue of involuntary admission.
Clearly involuntary admission of a resident to a nursing home presents
moral and ethical issues most families are not experienced in dealing
with, not to mention attendant feelings of guilt for the family members
and likely betrayal for the patient herself. However, for the health
care provider, the nursing home, the struggle is a balance between
determining the self-interest rights of the resident and the interests
in rendering care.

Better LTC jobs will boost economy, says Kuttner

from PHI:

Economics writer Robert Kuttner has some advice for President-Elect Barack Obama in his new book Obama’s Challenge: America’s Economic Crisis and the Power of a Transformative Presidency.

Kuttner makes a strong case for professionalizing the human services
sector – jobs which are harder to outsource – to boost the U.S. economy.

Last week, he told NPR’s Fresh Air,
“All jobs taking care of America’s children and taking care of
America’s old people and taking care of America’s sick people, by
definition, these are jobs that have to be close to home.”