Tag: state nursing homes

Myths about Nursing Homes

The decision to move either ourselves or a family member to a nursing home is something we have to face as we age. It may be a decision that arrives suddenly after hospitalization, gradually as needs become more difficult to meet in other types of housing.

It is important to learn all you can about nursing homes to arrive at a less stressful decision that is right for you or your loved one. It is also important that you separate the facts from the myths about nursing homes to help you arrive at a decision. There are a lot of negative connotations to the label “nursing homes”, so knowing the truth can help ease some of your worries and bust of those myths.

Often, people think that a nursing home is the only option for those who can’t take care of themselves at home. That is not entirely true. There are a lot of options to help older adults stay at home, ranging from help with laundry and shopping to caregiving and visiting home health services. If staying at home is no longer possible, assisted living is another option if the primary need is custodial care rather than skilled medical care.

People also think that nursing homes are for those whose families do not care about them. This is a myth. If people cannot provide the necessary care for an older family member, the responsible thing to do is to find a place where the family member’s needs are met.

It is also a myth that all nursing homes provide poor care. Information about the facility’s staffing and previous violations are available to the public that will help you make a decision.

Lastly, it is also not true that you cannot leave once you are in a nursing home. That depends if the care that you need is necessary through the end of life. But there are cases where rehabilitative care is only needed and returning home or another housing option may be a better fit.

What Are the Recommended Activities for Older People Living in the Nursing Homes?

Most elderly people who live in nursing homes still have the chance to develop their quality of life by means of joining some exciting physical and mental activities. These activities will help them in maintaining their self-confidence and self-worth.

Providing daily or weekly activities for the elderly is a biggest challenge to all nursing home staff. They have to link the activity to the personality of their residents. However, encouraging depressed senior citizens or those with low self-esteem to join the activities is the hardest part.

Nursing home staff should conduct a therapeutic activity so that the elderly people can benefit from it. In this article, we will give you the list of the recommended activities for older people living in nursing homes.

Counselling
Talking to the elder residents one by one is recommended. Nursing home staff should assess their residents about their physical and emotional status. This activity is helpful since you will know what activities they want. Senior citizens living in nursing homes have a very low self-worth since they think they are already forgotten by their loved ones. Simply talking to them will help them develop their confidence, self-esteem and self-worth.

Early Morning Group Exercise
Early group exercise is the best morning activity for senior citizens. It includes stretching, mild bouncing and kicking. Exercise provides better mental stimulation and physical activity to the elder residents. It also prevents them from having heart and lung problems. Nursing home staff can also utilize gaming consoles such as xbox Kinect or Wii as an exercise tool for people who are in wheel-chairs.

Art activities
Painting is known to be the best mental activity. It helps elderly people think actively. By doing this activity, senior residents are prevented from other mental disorder such as dementia and Alzheimer’s disease. Painting can also relieve series of arthritis attack.

Agricultural activities
Older people are known to be good at this activity. They like to grow plants, trees, flowers in pots. Although some of the residents can no longer do this activity due to sickness. This activity promotes better mental stimulation and muscle activity.

Music Therapy
Music has the capability to uplift the mood and spirit of every person. Nursing homes should include this in their daily activity since it promotes mood relaxation. Residents can also sing and play music together since it promote bond and comfort to one another.

Threats of Understaffed Nursing Homes

Many nursing home facilities are extremely understaffed that they might be endangering the welfare of the patients; this is according to a report by federal health authorities. The report suggests more stringent recommendations that will require thousands of nursing facilities to employ more nurses and nurses’ aides.

According to several studies, under-staffing in nursing homes has led to many issues in patient’s condition like severe bedsores, abnormal weight loss, and malnutrition. It is, of course, hard to maintain the welfare of the seniors if a facility lacks manpower. It has been reported that a huge amount of patients have developed life-threatening infections that could have been avoided if there is proper staffing. 

The US government has already made several vital steps to resolve the issue. It suggests new federal standards to ensure that patients receive no less than two hours of care every day from nursing aides, amongst other things, there must be sufficient amount of nurses and other health professional within the facility. The research states that 54 % of nursing facilities presently fall underneath the suggested minimum standard. This is very threatening, given that it may endanger the life of the senior.

Studies suggest that patients receive only a minimum of 12 minutes each day of care from nurses. Presently, 31 percent of nursing facilities don’t meet that standard amount of nurses. Though the government has intentions in resolving the problem, it is still impossible for the government to propose minimum staffing recommendations since they were supplying insufficient subsidies under Medicare insurance and State Medicaid programs. Many senior care authorities explained that it is also hard to attract and retain good employees because of the status of the economy. Making the job appealing for nurses and developing a program will increase the quality of healthcare service that our seniors will receive in a nursing home. 

Considering a Nursing Home

A nursing home is a provider of custodial care for older people who can no longer take care of themselves. They differ from other senior housing facilities since they provide a much higher level of medical care. Assistance with feeding, bathing, and dressing are part of the services they offer as well as physical and speech therapy. Some nursing homes are designed to look and feel like home, which makes the mood more at ease and won’t make the elderly feel like a patient.

It may be painful to send a family member to a nursing home, it is still the best option to ensure the safety, health maintenance and as well as practicality. Most nursing homes provide residents with nursing aides and skilled nurses who will who will be on hand 24 hours a day.

So when should you consider sending your family member to a nursing home? Here are some of the things you need to ask yourself before making a decision:

Is your family member can no longer take care of himself?  If yes, then it would be risky to leave him alone at home when everybody’s at work or at school. Most of the elderly became forgetful, like wandering and forgot the way back or leave a stove that may lead to a disaster. Bringing him to a nursing home where nurses can provide him basic services will then be an option.

Are there any family members who are available to take care of him? In some situations when the need for a nursing home is just temporary, family members can rotate care or hire a health worker who can work part-time when it is needed.

Are you ready to be separated? It would be hard to send him away when you are used to living with him. But you can visit him anytime at the nursing home whenever you have a free time.

Is the nursing home you know can provide his needs? The senior’s medical needs must be provided and a 24-hour supervision is must. The center must also have programs and conducts activities that will keep the elderly active and healthy.

Care Lapses in Nursing Homes

Eight Connecticut nursing homes have been penalized by the state Department of Public Health for lapses in proper care. On Nov. 7, Beacon Brook Health Center in Naugatuck was penalized $2,180 in relation to a citizen who passed away May 23 of cardiopulmonary arrest and a bowel impediment, DPH records show. DPH discovered that the house’s healthcare record did not indicate that an abdominal evaluation was done on May 23 after the citizen reported of feeling sick and a stomachache on May 22. Also, healthcare records did not indicate that a doctor had seen the citizen after May 21 and the home did not have a policy about stomach tests. On May 23, the citizen was discovered without a pulse and CPR was started. The citizen passed away after paramedics came and took over the CPR.

In a similar case, a Beacon Brook citizen with congestive heart failure incorrectly was not given drugs for fluid retention and no excess weight factors were mentioned in the resident’s history that would have activated a doctor’s notice. The citizen gained nine pounds between July 10 and July 21 and was put in the medical center for difficulty breathing and liquid excess. DPH discovered that the drug was mentioned in a doctor’s purchase but not in the drugs history, so the elderly care facility ceased providing it to the citizen on July 9. The citizen spent five days in the medical center.

Beacon Brook’s manager, Betty Garcia, said that the occurrences happened before she took over, so she could not comment. On Nov. 6, Manchester Manor Health Care Center was penalized $2,250 in connection with two occurrences, including one on May 29, when a nurse’s assistance had left a citizen in a bathroom, heard a thump and then discovered the citizen on his or her legs with a deep cut on the temple. The cut required five stitches to close and personnel discovered that the assistance had breached a safety rule at the nursing home by leaving the citizen alone.

A health professional was observed on Oct. 30 providing a citizen with Alzheimer’s disease coffee without a lid in breach of a doctor’s order that the citizen be given a lid on all hot drinks. State records show the citizen had been burnt off on the hip and legs Aug. 2 and on the stomach on Oct. 2, after dropping hot coffee that was provided without a lid. Administrator Jane Ellen Gaudette said the staff has been retrained since the occurrences and the property is in full conformity with state guidelines. These lapses in care, although minor can have very relevant effects in nursing homes.

Neglect in Nursing Homes

Many of today’s nursing homes are managed by thoughtless and selfish business people whose main objective is pleasing their investors. They are compensated with nice incomes and rewards for team cutting and other cost-cutting methods. Profits are spent in powerful lobbying groups that enjoy effective influence over law makers and authorities. These organizations respond to medical negligence legal cases, not with training learned and corporate mandate to improve care, but with tort change, introduced and passed into law by greedy and recompensed congress. Eighty percent of the sector’s payments come from community funds, Medical health insurance and State health programs and we are not getting our entire worth.

Health and Human Services revealed that medical health insurance paid $5.1 billion dollars for poor elderly care facility care in 2009. Harmless repercussions of poor care have taught this market that it’s more profitable to offer poor care and pay an occasional fine than it is to hire and train staff to offer proper care. Sequestration cuts are further weakening the bite of regulating agencies that view themselves as in “partnership” with the very market they’re charged with watching. Charges are meager, inconsistently gathered and do not act as preventives.

Silence and inaction are daily pointers that our community doesn’t want to think about old individuals suffering neglect and abuse in nursing. Even organizations with “aging” and “health care” in their titles don’t want to cross the nursing-home limit. The realities of life and death in nursing homes are too dark and our man’s instinct surrenders to more enjoyable matters. Accounts of abuse are as ignored as the sufferers themselves and reform supporters are continuously advised they can’t force individuals to good care. There are no children or pet dogs or cats to save in these experiences. They are old individuals who can no longer protect and defend themselves. Unfortunately, the number of individuals willing to rebel against this highly effective profit-motivated industry continues to be low. This is why true change and proper care remain out of our reach. We simply need more individuals to care and to be counted.

Nursing Homes Quality

Ohio tax payers are paying large numbers to nursing homes that don’t succeed to fulfill minimum state specifications for looking after their citizens, falling short of a bar many say is too low. Even three nursing homes on a government watch list for high numbers of inadequacies over long periods, two in Cincinnati and one in Youngstown, met Ohio’s quality measures, which give a passing quality even if a service flunks 75% of state specifications. In all, $12.7 million was invested to take good care of sufferers living in nursing homes that did not achieve at least five of 20 measures for great quality care, according to research for the financial year that ended June 30 from the Ohio Department of Medicaid. Still, less than 1% fell short of that standard, only nine of the 926 nursing homes. One has since closed. None is in central Ohio.

“We’ve got some good signs, but the floor is so low everybody can fulfill those,” said Robert Applebaum, home of the Ohio Long-term Care Research Project at Miami University. He also served on the advisory board that released suggestions to congress for enhancing care. “We need to do a better job of getting rid of bad-quality homes, but we also need to do a better job of reimbursing the high-quality homes.”

Medicaid, which provides coverage of health to poor and impaired Ohioans, will pay for approximately 70% of nursing-home care in the state. On average, the federal-state program includes about 58,200 long-term-care citizens. Last year, in an effort to improve institutional care, the state started demanding features to fulfill at least five of 20 high quality measures to earn a full State Medicaid programs payment, which earnings $165 a day per person. The measures include giving citizens meal options, enabling them to choose when they get up and go to bed and the opportunity to customize their bedrooms. The nine nursing homes unable to fulfill the mark lost 10% of the payment, or nearly $16.50 of the per-resident daily subsidy. Those funds are to be allocated to the more than 900 facilities meeting the standard.

Owning Nursing Homes

92% of county-owned nursing homes outside New York City lost money in 2010 and are struggling to survive, a report uncovered. Counties have been looking to leave the nursing-home business as expenses rise and as they face fiscal demands from flat tax earnings to pay for government operations. The report from the Rochester-based Center for Governmental Research said 33 areas own nursing homes, down from 40 in 1997. Eight, including Rockland County, are in the process of selling their features and five plan to put them on the block.

The New York State Health Foundation, a private Albany-based group, requested the research. “In the past few years, six areas have marketed or closed their houses, with mixed results ranging from improvements in proper care expressing closing of one poorly performing house,” said Donald Pryor, the study’s author, said in a statement. “Other areas have kept their houses but are dealing with an increasingly rugged landscape.” Counties traditionally considered running an elderly care service as a way to take care of its elderly, particularly those who are poor. Yet at a time of cost constraints, counties are finding the mission affected as more private houses are built.

Nursing-HomesWestchester County marketed its elderly care service to the Westchester County Nursing Center and the service was closed in 2009. Dutchess County sold its elderly care service in 1998. Monroe County has struggled with growing expenses of its nursing home and in Albany County; there has been a delivered debate about whether to sell its service. Broome and Chemung counties also own nursing homes. The troubles are expected to grow as the population ages, the research discovered. In the upstate areas with assisted living features, there will be 180,000 more residents older than 75 by 2030. The research said wages grew at all assisted living features 37 % since 2001 and were up 45 % at county houses.

While county houses are about 8 % of all assisted living features in the state, they represent about 11 % of all the beds in the state because they are among the state’s largest facilities. Many of the patients rely on State Medicaid programs, yet the payments haven’t kept up with the expenses by as much as $100 a day, the review said. State Medicaid programs represented 71 % of county-owned homes’ revenue in 20130, in comparison to 55 % for other houses. County assisted living features reported a lack of $201 million in 2010, double the decrease in comparison to 2005, the review said.

Nursing Homes Vacancy

At the House Rehabilitation & Nursing Center in Simsbury, 17 of the nursing home’s 73 beds sat vacant last spring, a 23% opening rate that would have been unlikely five years ago. The home’s occupancy has decreased despite its above-average medical care quality ratings in the government national rating system. “There are a lot of aspects, a lot of projects out there now to keep people out of nursing homes,” said Keith Brown, the home’s manager. “And with the increase in home care, we’re seeing a weaker citizen population. So we have fewer citizens with greater skill.” The Simsbury home is not unique: Nearly one-third of Connecticut’s nursing homes are less than 90 % filled.

Of the 68 homes with higher-than-average opening prices, 20 were only 60-80% filled, leaving hundreds of beds unused. State-wide, even though 15 nursing homes have closed since 2008, at least 2,450 beds were vacant as of May. The state information show that occupancy prices decreased in all but two areas since 2004, falling from 96% to 88% in Tolland; 95 to 88% in Litchfield; 95 to 91% in New Haven; 93 to 90% in Hartford; 95 to 92% in Middlesex; and 97 to 93% in Windham. The exclusions were Fairfield County, where the occupancy rate stayed at about 92% and New London, where it increased from 88% to 92%.

Overall, Connecticut’s nursing home occupancy rate has tumbled in the past years, from 93.3% in 2003, the third maximum in the nation, to 89.8%, the Tenth maximum, according to March government information. The latest state Department of Social Services nursing home demographics put the statewide occupancy amount at just above 90%. Only 11 of the 230 certified nursing homes in the state were full to capacity as of last spring. Nursing home directors say the opening rate has been motivated by a number of aspects, including state projects to keep more seniors and impaired citizens in home and community configurations, as well as the ballooning assisted-living industry, generally controlled in Connecticut.

Cause of Hospitalization from Nursing Homes

A primary cause of hospitalizations from nursing homes, discussed in industry literature for more than 20 years, is the inadequate health professional employment levels in nursing homes. Last fall, the Kaiser Family Foundation released two studies about the hospital stay of elderly care facility citizens. Their findings about why elderly care facility citizens are hospitalized confirm earlier research in this field and point to the need to increase health professional employment in nursing homes as a way to improve quality of care in assisted living features and reduce hospital stay and re-hospitalization of patients.

The Kaiser study, “Financial Incentives in the Long-Term Care Context: A First Look at Relevant Information” determined the economical incentives that encourage hospital stay of elderly care facility citizens.[6]  These incentives include Medicare payment policies for doctors, skilled assisted living features, and hospice services as well as the dual roles of healthcare director and attending physician frequently being held by the same individual.

A companion study, based on interviews with doctors, nurses, social workers, and close relatives of residents, determined 10 factors that encourage hospital stay of elderly care facility residents: the limited capacity of assisted living features to address healthcare issues; physicians’ preference for inpatient settings; concerns with liability for not hospitalizing; economical incentives for doctors and facilities; inability of assisted living features to address residents’ healthcare needs; lack of relationship between facility staff, doctor, and family; lack of advance care planning; family preference; and behavioral health problems. Although several factors impact a decision to hospitalize an elderly care facility resident, a key factor determined in the Kaiser reviews and other studies mentioned is the lack of sufficient professional and paraprofessional medical staff in nursing homes.  The insufficient employment in assisted living features has been recognized for a long period.