Articles Posted in Nursing Care

candidaauris-300x224The battle to reduce the sky-high cost of hospital care may have created its own unforeseen and harmful consequence: By hastening to get patients out of traditional hospitals and into skilled nursing facilities and long-term care centers, doctors and policy-makers may be contributing to a medical nightmare — serious infections acquired in health care institutions.

The New York Times reported that “public health experts say that nursing facilities, and long-term hospitals, are a dangerously weak link in the health care system, often understaffed and ill-equipped to enforce rigorous infection control, yet continuously cycling infected patients, or those who carry the germ, into hospitals and back again.”

Hospital-acquired infections (HAIs) pose significant risks to already ill and injured patients, as well as adding to the fearsome costs of institutional care, the Leapfrog Group, an independent patient safety and advocacy group has found. As Leapfrog has reported:

asstdcareunaffordable-300x188As the nation rapidly grays and income disparities widen by the day, a sizable number of Americans — a group that built the nation to greatness and has been its economic bedrock — is headed to yet another ugly indignity: More than half of middle-income seniors won’t be able to afford their medical expenses and the cost of assisted housing they will need at age 75 and older.

New research published in the journal “Health Affairs” has projected what already soaring medical and housing costs will mean to those whose incomes fall between $25,001 to $74,298 per year and are ages 75 to 84. These middle-income elders will increase in number from 7.9 million now to 14.4 million by 2029 and soon will be 43% or the biggest share of American seniors.

But the picture for them and their finances, housing, and medical expenses may be glum. Projections show they will lack the money, even if experts calculate in their home equity, to afford assisted living they may need in their late years.

care-300x180Americans have real reason to fear a health care catastrophe: If loved ones suffer major injury or illness, who will feed, bathe, and care for them 24/7 after they get out of the hospital and recuperate at home? Who will take time off from work to set up and take them to unending and long medical appointments? Who will wait for and get all the pills and devices they need?

The nation has been locked in a decade-long battle over health insurance that helps cover medical costs, but caregiving, a crucial part of the social safety net, gets short shrift, writes Aaron E. Carroll, a professor of pediatrics and health research and policy expert at Indiana University School of Medicine. As Carroll noted in a timely and personal column for the New York Times “Upshot” feature:

Americans spend so much time debating so many aspects of health care, including insurance and access. Almost none of that covers the actual impossibility and hardship faced by the many millions of friends and family members who are caregivers. It’s hugely disrupting and expensive. There’s no system for it. It’s a gaping hole.

With the nation fast graying, a long-term care crisis looms, and too many Americans may not realize that not only will nursing home care be tough to find and afford, it also may be less than ideal. But what happens if seniors themselves — especially the frail old — are asked how care-giving services might best serve them, so they not only can stay in their homes but also enjoy their lives more?

That’s the experimental approach taken by a health care team in Denver, working in the long-titled program, “Community Aging in Place — Advancing Better Living for Elders.” CAPABLE staff intervene with the aged, asking them how, even with disability and debilitation, to improve their lives. The program offers them six visits by an occupational therapist, four visits by a registered nurse, and home repair and modification services worth up to $1,300.

Nursing homes, by scrimping on their staffing to maximize their profits, put their residents at grave risk for infections that too often have grisly and deadly results. Low-rated facilities run by Uncle Sam to care for elderly veterans also may be concerning. And those oft-pricey assisted living facilities may have their own response to dealing with difficult to care for elders — putting them out on the street.

Kaiser Health News Service, the Chicago Tribune, USA Today, and the Boston Globe all deserve credit for their digging into problems at facilities caring for the old, focusing on issues that should be at the fore for regulators, policy-makers, and politicians as the nation grays.

carehands-300x205Life can be hard, lonely, and difficult for adults who must become caregivers for their parents. If that sounds like the challenging story for tens of millions of millennials and Gen-Xers, yes, it’s true. But Judith Graham, in a column for the Kaiser Health News Service, describes what may be an even tougher role for startling numbers of seniors who find themselves solo caregivers for still older moms and dads.

Graham reported that a new analysis from the Center for Retirement Research at Boston College has found that 1 in 10 Americans between the ages 60 and 69 take care of parents in their 80s, 90s, and even older. For those 70 and older, the numbers increase, so 12 percent of these seniors care for even more elderly relatives. The research is based on data from 80,000 interviews (some people were interviewed multiple times) conducted from 1995 to 2010 for the Health and Retirement Study.

The analysis found that roughly “17 percent of adult children care for their parents at some point in their lives, and the likelihood of doing so rises with age. That’s because parents who’ve reached their 80s, 90s or higher are more likely to have chronic illnesses and related disabilities and to require assistance.”

krumholzIn many parts of the developing world, families play a big part in patients’ hospital care. They not only sit for long hours with loved ones, supporting and encouraging their recovery. They also may help with direct services, bathing and cleaning patients, tending to their beds and quarters, and even assisting with their medications and treatments.

Such attentiveness from loved ones— once common in this country, too —  may be deemed by many now as quaint and unnecessary, what with the rise of big, shiny, expensive American hospitals.

But think again: As Paula Span reported in her New York Times column on “The New Old Age,” care-giving institutions across the country have become such stressful, disruptive places that seniors, especially, not only heal poorly in them but also may be launched into a downward cycle of repeat admissions.

cafire-300x173When a raging wildfire — feeding off blowing winds and weeks of desiccating heat, also whipped up a freak, blazing tornado-like vortex with 140-mile-an-hour gusts and a 500-yard diameter — common sense might have dictated that affected Northern Californians should flee as fast and as far as possible.

While many did, correctly heeding authorities’ emergency evacuation pleas, some courageous residents of Redding, Calif., pop. 91,000, decided to stay.

No, they were neither daring nor foolish. They were doctors, nurses, and medical personnel, who — along with first responders like police, fire fighters, and civil defense personnel — put the care and safety of others’ lives ahead of their own.

Many grown-ups may love to grin, coo, and snuggle with babies and little kids, telling themselves that they’d bust through walls for the sake of adorable youngsters’ well-being. But evidence indicates the nation has a far way to go to better children’s health.

Although the U.S. spends more per capita than most wealthy, democratic nations on kids’ health care, American kids have lagged in the beneficial outcomes. Indeed, youngsters in this nation have a 70 percent greater chance of dying before adulthood than do their peers in industrialized nations.

us-cash-184x300Here’s something that many Americans likely would want to think twice about letting happen: Should good health and long lives be just another of the spoils reserved to the rich?

Vox, a news and information site, has posted a provocative dig into national data on longevity — a measure that has raised experts’ concern with its recent rare, two-years-in-a-row dive, notably due to fatal overdoses of opioid drugs, including prescription painkillers, heroin, and fentanyl.

Experts scrutinizing the data, Vox says, keep finding that “what’s often lost in the conversation about the uptick in [U.S.] mortality … is that this trend isn’t affecting all Americans. In fact, there’s one group … that’s doing better than ever: the rich. While poor and middle-class Americans are dying earlier these days, the wealthiest among us are enjoying unprecedented longevity.”

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