The Washington Post is out with an interesting article about a growing national trend – younger patients are ending up in nursing homes. According to the article, approximately one in seven nursing home residents in the United States is under the age of 65, a number that has grown significantly just in the last eight years. This development has raised all kinds of issues for the nursing homes that take these younger patients like Adam Martin, at 26-year-old quadriplegic who is living in a nursing home.

“It’s just a depressing place to live,” Martin says. “I’m stuck here. You don’t have no privacy at all. People die around you all the time. It starts to really get depressing because all you’re seeing is negative, negative, negative.”

Older residents have their own issues with it as well, and frequently complain about loud music and rowdy visitors. And while most nursing homes try to house younger residents together, new steps are being taken to address this growing problem.

A Northern California nursing home is claiming that the local hospital, Mercy Medical Center, killed one of its residents. According to news accounts, 74-year-old Robert Nelson, a developmentally disabled adult residing in skilled nursing facility Shasta House, was taken to Mercy in December for “digestive problems.” Nelson used a feeding tube for nourishment, and could not take any food by mouth. The nursing home said that the hospital was informed of this.

Visitors to Nelson at the hospital, however, said they caught hospital staff trying to feed Nelson by mouth on several occasions, including attempts to administer pills by mouth. The attempts continued, allegedly, even after warnings were given to hospital staff.

Not long after his admission for the digestive problems, Nelson came down with aspiration pneumonia, an inflammation of the lungs and airways, usually caused by the breathing of foreign material such as food. People with swallowing difficulties are at risk of acquiring aspiration pneumonia, but Nelson should not have been as his condition required no food by mouth.

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This is the time of year that families crisscross the country to see each other and celebrate the holidays, but it’s also a good time to check in older relatives who might be living alone, and under the care of someone. It is estimated that up to two million American seniors have been mistreated or abused by someone they rely on to provide car. For every case of elder abuse reported to Adult Protective Services, five cases go unreported.

Experts couldn’t agree more. Holiday visits, they say, offer a perfect opportunity to assess the needs and health of elderly relatives, whether they’re living independently or in a care facility. “You should visit with a checklist in your head,” says San Francisco social worker Mary Twomey. She advises people “to look for red flags: Has your parent lost weight, are they no longer interested in things they once enjoyed, are there any signs of physical abuse?”

Read more here from the LA Times here.

From the New York Times:

A study from the Archives of Internal Medicine found that elderly people who take narcotic-based drugs for pain face an elevate risk of bone fractures, heart attacks and death than those who take a non-narcotic pain reliever. In what is considered the first large-scale effort to examine the safety risks associated with narcotic pain relievers, researchers concluded that narcotics were more dangerous than non-narcotics, contrary to popular belief.

“Doctors should not assume that opioids are a safer alternative,” said Daniel H. Solomon, the study’s researcher, said in a telephone interview on Monday. “They seem to carry profound risks to cardiovascular system as well as increased risk fractures and appear to be associated with increased risk of death.”

Homicide detectives in San Diego were investigating the death of an elderly woman from the Palm City area. According to reports, the woman was being cared for by a professional “caretaker.” When a relative of the 83-year-old victim called police to check on the victim, police went to the woman’s home and found her dead in the bathroom.

According to police, there were no signs of trauma but that elder abuse was suspected. Police arrested caretaker Maria Moore on suspicion of elder abuse and booked her into county jail. A cause of death has not been determined.

News accounts do not state where Moore was employed by a home health agency or whether or she was working on her own. If is determined that the victim’s death was due to neglect, Moore and the agency she works with (if there is one) may face civil liability under California’s Elder Abuse and Dependent Adult Civil Protection Act.

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Peer-on-peer abuse in the nursing home setting is a problem that gets very little attention, but occurs with more and more frequency. A horrific example of this occurred two weeks ago at Chino Valley Health Care Center in Pomona. On November 23rd, John Lazzaro, a 91-year-old resident of the rehabilitation hospital, was killed after being attacked by fellow resident Matthew Harvey, who was only 47.

The details of the attack are kind of sketchy, but according to news accounts Lazarro was found in his room with severe wounds to his arm and face. So severe were the wounds to his arm it required amputation. It is very likely that Mr. Lazzaro couldn’t survive the surgery and died shortly thereafter.

The nursing home industry (and nursing home lawyers) was stunned earlier this year when a Humboldt County jury returned a class action verdict against the nursing home chain of $677 million dollars. The plaintiffs alleged, and the jury believed, that Skilled Healthcare, the owner of many nursing homes in several states, routinely understaffed its California nursing facilities, compromising patient care in an effort to maximize profits.

The case was a battle. ”Everything was fought tooth and nail,” Timothy Needham, lead trial lawyer for the team of plaintiff lawyers told the Times-Standard. The trial lasted six months. But the verdict was so big it created practical problems for the victors, and potentially fatal concerns for Skilled Healthcare, a publically traded company. Because of the size of the verdict, Skilled Healthcare could not afford to pay such a huge judgment and could not appeal the result (appeals require the posting of a bond, which is a percentage of the verdict), and the plaintiffs really didn’t want to take over the company. So, smartly, everyone agreed on a settlement.

It was announced yesterday that the verdict of $677 million was settled for $62.8 million.

The giant nursing home neglect verdicts continue to come in around the country. Last week, a jury in Kentucky awarded the family of a neglected nursing home resident $42.75 million after the resident became lethally dehydrated and malnourished, and arrived at the hospital covered in bed sores. The resident died as a result.

According to news accounts, 92-year-old Joseph Offut had been a resident of Harborside nursing home for only nine days prior to his death. The World War II veteran had been very active up until the age of 90, when he suffered a stroke and was cared for by his wife of 58 years. Like many, after some difficult conversations the family ultimately decided that Mr. Offut needed professional care and placed him in a nursing home.

After his death, Offutt’s family filed a lawsuit for wrongful death against the nursing home’s parent company, Sunbridge Healthcare Corp. The lawsuit alleged that caregivers at the nursing home neglect Offut, causing him to suffer severe dehydration, malnutrition, decubitus ulcers, and ultimately death.

The unspoken problem with California nursing homes is staffing. Not enough of it, and poor training for those who do it. Who knows what caused this major screw up, but you can be sure it’s related to staffing. A 94-year-old resident of Silverwood Senior Living Facility, a skilled nursing facility, went missing last month. Staff searched everywhere for the dementia patient, but couldn’t find her.

Thankfully, someone thought to check the walk-in freezer in the nursing home kitchen. There they found the resident locked inside the freezer where the temperature was set at five degrees. Thankfully she was unharmed. Still no one knows just how she got in the freezer, and the home, who has a history of regulatory violations, self-reported the incident as required by law.

Mark Mostow, a VP for the nursing home, released this obligatory statement about the resident: “We immediately conducted an investigation, and took appropriate corrective action against two employees. It’s an unfortunate incident, and we’re very sorry that it happened, and we’ll do everything in our power to ensure this does not happen again.”

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It is being reported by California Watch that the U.S. Department of Justice is investigation what is being described as lax care at several California nursing homes, and even threatening criminal and civil actions against those homes. Specifically, the investigators will be examining the use of psychotropic drugs in these facilities and those injured by the misuse of such drugs. Also being investigated are the nursing homes that prematurely discharge patients whose condition requires them to stay.

The investigation was triggered in part by the federal health reform law that includes the Elder Justice Act. That act allows for the coordination between the U.S. attorney general’s office and local and state law enforcement to crack down on elder abuse and neglect. The Northern California office of the Justice Department retained the services of a consultant, who interviewed local ombudsmen’s offices about nursing home complaints. Out of those interviews, several facilities were identified.

U.S. Attorney Melinda Haag told California Watch that her office hired the consultant approximately two months ago, shortly after a California Watch article about the decline in the prosecution of elder abuse cases. “My office is in the process of evaluating the complaints our consultant gathered and will prosecute, to the fullest extent of the law, those individuals who are in violation of federal statutes,” Haag said in a written statement.

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