Articles Posted in End of Life

With the pandemic  tearing through the United States and overwhelming U.S. health care system,  we pause from the grim news to tally  some of the nation’s blessings in this time.

We can be thankful for the courage, fortitude, dedication, and skill of an army of health workers of all kinds. They have put themselves and their loved ones at formidable risk and strain to treat patients under unprecedented duress. They have dealt with fear and uncertainty, giving little quarter, and approaching their own breaking points. Some health workers have themselves fallen ill, with some dying. Their sacrifices cannot be forgotten, and we need to give sustained and extra support to health workers as the pandemic enters its next perilous phase.

srabuse-150x150The coronavirus pandemic’s terrible toll on nursing homes and other long-term care facilities may be much worse than now estimated, as resident advocates, watchdog groups, and experts  tally “excess deaths” in the facilities — perhaps one additional casualty beyond any two formally attributed to Covid-19.

These fatalities are unacceptable, resulting from frantic and low-paid health workers’ inability to care for the aged, injured, and chronically ill infected with the coronavirus while also dealing with the needs of people so frail they require institutionalization. It’s tough reading, but here is what the Associated Press reported:

“As more than 90,000 of the nation’s long-term care residents have died in a pandemic that has pushed staffs to the limit, advocates for the elderly say a tandem wave of death separate from the virus has quietly claimed tens of thousands more, often because overburdened workers haven’t been able to give them the care they need. Nursing home watchdogs are being flooded with reports of residents kept in soiled diapers so long their skin peeled off, left with bedsores that cut to the bone, and allowed to wither away in starvation or thirst.

apnursinghomesurgechart-270x300Coronavirus cases are spiking among residents and staff at nursing homes and other long-term care facilities. They increased four-fold between May’s end and late October — even as deaths among the vulnerable also doubled, disturbing new data show.

Those are the findings of Rebecca Gorges and Tamara Konetzka, University of Chicago researchers who analyzed federal data at the request of the Associated Press. They focused on 20 states hard hit by the latest pandemic surge.

Konetzka said the data raise major questions about the Trump Administration’s efforts to safeguard the aged, ailing, and injured in institutional care by sheltering them from infections in their surround areas and increasing testing for residents and health workers. But Koentzka, an expert on long-term care, told the AP this about such a plan:

elderaide-300x200Nursing homes put their residents at heightened health risks by scrimping on personnel costs and failing to deal with significant staffing shortfalls, especially as the coronavirus inflicted some of its highest death and infection tolls on the elderly, sick, and injured in long-term care, media investigations have found.

The profit-focus by health providers is not unique, and it has put huge burdens on poorly paid, lightly trained, and over worked home health aides. They have toiled to keep the vulnerable out of institutional care, even as the agencies that employ them give them little support.

Here is what the Wall Street Journal reported about long-term care facilities, based on its “analysis of payroll-based daily staffing data released … by the Medicare agency …  [for hundreds of] nursing homes that reported to the federal government virus-related deaths in the first half of 2020″:

covimask-300x159While Americans have been riveted for days about incremental shifts in election results, other confounding numbers raced ever higher and into worrisome places. Just consider these numbers: 128,000, 9.6 million plus, and 235,000 and more.

“Covid, covid, covid. By the way, on Nov. 4 you won’t hear about it anymore,” President Trump asserted during his closing re-election campaign rallies.

If only. The nation’s coronavirus pandemic is unchecked and showing signs of worsening, bigly, with records shattering on consecutive days for infections diagnosed: 100,000 on Nov. 4, 120,000 on Nov. 5, and 128,000 on Nov. 6.

chairinhomeDisturbing new data shows that a much-promoted plan by federal watchdogs to protect vulnerable residents of nursing homes and other long-term care facilities from Covid-19 resulted in dismal outcomes, with inspectors dispatched by the Centers for Medicare and Medicaid services largely dismissing infection-control concerns as the deadly pandemic raged.

“During the first six months of the crisis [inspectors] cleared nearly 8 in 10 nursing homes of any infection-control violations,” even as tens of thousands of facility residents were infected and died from the coronavirus, the Washington Post reported.

The newspaper’s investigation found this:

dementiadiagram-300x204Even as news organizations reported that the coronavirus pandemic has taken a grievous toll on seniors institutionalized with dementia, a presidential panel on nursing home care split over common sense but limp recommendations on how the nation might reduce Covid-19’s savaging of the old, sick, and injured in long-term care facilities.

The unsurprising, 180-plus pages of recommendations from the Coronavirus Commission on Safety and Quality in Nursing Homes to the Trump Administration and specifically its long-term care facility watchdog Centers for Medicaid and Medicare Services (CMS) included calls for: “More money for testing, for personal protective equipment (PPE), for registered nurses, for infection control training and staff salary increases,” the Washington Post reported.

Seema Verma, the CMS chief who has led a calamitous federal response in long-term care that has left at least 77,000 vulnerable residents dead — 40% of all the coronavirus fatalities in the nation — and not quite a half million infected, tried to spin the commission’s findings.

marylandlogo-300x177It turns out there is more to be said about Maryland’s recently completed, pandemic-related checks on hundreds of nursing homes and long-term care facilities.

Three facilities, indeed, got expensive rebukes from state inspectors, but dozens more were hit with milder fines that also suggest widespread issues in the institutions, notably with the crucial concern of infection control.

In contrast to the Washington Post’s previous coverage of the sizable fines for Collingswood Rehabilitation and Healthcare Center ($275,000) and Potomac Valley Rehabilitation and Healthcare Center ($120,000), and Kensington Healthcare Center ($294,000), the Baltimore Sun said it, too, had obtained Maryland records indicating:

aged-199x300For the old, sick, and injured who are institutionalized, the Covid-19 pandemic and the efforts to halt the spread of the disease into care facilities has created debilitating side-effects: isolation, loneliness, silence, fear, and worries of abandonment.

Facility lockdowns, combined with the relentless governmental bungling of the coronavirus response, are taking a terrible toll that may not soon be eased, the New York Times reported. Dr. Jason Karlawish, a geriatrician at the University of Pennsylvania, told the newspaper this about the situation in all too many nursing homes and other long-term care facilities:

“It’s not just Covid that’s killing residents in long-term care. It’s the isolation, the loneliness.”

hhslogoaug20-300x300In response to the shattering harms of the Covid-19 pandemic, Congress sought to shore up the U.S. health care system with billions of dollars in emergency aid. But the federal agency that helps to oversee the institutional care for the elderly, sick, and injured performed poorly as a steward of taxpayers’ hard-earned money.

The Health and Human Services department, instead, shoveled hundreds of millions of dollars, “no strings attached,” to dubious owners or operators of facilities nationwide. These “for-profit nursing home providers … have faced accusations of Medicare fraud and kickbacks, labor violations or widespread failures in patient care,” the Washington Post reported.

The newspaper said its analysis of HHS allocations of big sums in the Coronavirus Aid, Relief, and Economic Security Act, or Cares Act, also showed that:

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