Articles Posted in Nursing Care

nhomehall-300x206Covid-19 infections and deaths are spiking anew in nursing homes and other long-term care facilities, hitting worrisome levels not seen since months ago in the pandemic. The unchecked mess in centers nationwide, but especially in the South and West, is prompting more attention to them — from lobbyists boasting White House ties, health worker “strike teams,” and Big Pharma investigators.

But even as the nation’s top overseer of long-term care calls on institutions to step up their infection control and other coronavirus-fighting efforts, researchers say that 1 in 5 nursing homes and other long-term care facilities report they lack enough personal protective equipment and staff. This occurred as recently as in July — not just at the start of the pandemic.

Even as Seema Verma, the head of the Centers for Medicare and Medicaid Services, told the owners and operators of care facilities that her agency has “deep concern … that even in nursing homes that are doing testing on a regular basis, we are still seeing significant spread,” experts from Harvard and the University of Rochester published findings on nursing homes in a health care policy journal, concluding:

covidSEvetcenter-300x200To paraphrase the late, great writer and activist Maya Angelou, nursing homes and other long-term care facilities are showing the public in the middle of this pandemic just truly what they are.

It is hard to believe, still, the shabby way they are treating the aged, sick, and injured. Just consider this sampling of recent news reports:

“Care” facilities — including centers dealing with veterans — have been too willing to subject residents to risky medical experimentation to fight the novel coronavirus, including what appear to be  inappropriate treatments with a much-promoted anti-malarial drug. This echoes a situation involving nursing home residents in Galveston, Texas,  and their facility’s dosing them with hydroxychlorquine without their loved ones’ knowledge and iffy circumstances about their individual capacity to consent to receiving the drug. As the Washington Post reported of a Philadelphia area veterans’ facility (shown in federal photo above):

covidpleasantview-home-300x111Owners and operators of nursing homes and other long-term care facilities have mounted a “nimfy” (Not My Fault) defense for the tens of thousands of deaths and infections of their residents during the Covid-19 pandemic. They claim they did the best they could under tough circumstances. And now they want not only special legal protections from those who suffered harms but also taxpayer bailouts.

But the industry’s disingenuous bleating has a big problem: It gets undercut by the second by infuriating actions — including by profit-mongering facilities “dumping” thousands of aged, sick, and injured residents on the streets or into flophouses, and by homes that still fail — despite warnings and penalties — to take basic steps to safeguard the vulnerable.

The New York Times — conducting the kind of sleuthing that real federal watchdogs could be taking on — reached out to “more than 80 state-funded nursing-home ombudsmen in 46 states” to detail “involuntary discharges.” As the newspaper explained of these inappropriate evictions by care giving centers, which may number more than 6,400 nationally:

covidnhnoplan-276x300With hurricanes, wildfires and other calamities, authorities pound home to the public the importance of preparedness. So why should preparing for an infection outbreak be any different? Yet more disclosures have raised disturbing questions about the dearth of crucial emergency planning by nursing homes and other long-term care facilities, their owners and operators, and federal and state regulators.

Taxpayers likely will foot hefty bills — a new estimate says it may be $15 billion  —in the days ahead for facilities’ active resistance to oversight and forward thinking. These lapses played a part in the terrible toll in failing to safeguard the old, sick, and injured, and first responders and health care workers, too, reported ProPublica, a Pulitzer Prize-winning investigative site.

It cites data from AARP about the nationwide deaths in long-term care centers inflicted by the novel coronavirus:

covidmdnatguard-300x174Federal and state officials almost seem as if they are competing with each other to race to new lows in their wrong-headed failure to protect elderly, sick, and injured Americans who require institutional care and whose health and lives are being savaged by the novel coronavirus.

An estimated 1.5 million Americans live in long-term institutions, including nursing homes, assisted living centers, skilled nursing facilities, memory care hospitals and the like. Covid-19 has taken a terrible toll on these frail, chronically ill, or seriously injured and debilitated people with more than 27,000 residents and staff dying from the novel coronavirus — roughly a third of all the disease fatalities nationwide. A third of the coronavirus deaths in the District of Columbia have been in skilled nursing facilities, while 40% of the Covid-19 deaths in California, the nation’s largest state, have been in nursing homes.

In the latest baffling response, President Trump and Vice President Mike Pence both suddenly have  “recommended” that states get nursing homes and other similar facilities to step up the testing of residents and staff.  They did not make this common-sense step mandatory, nor did they offer any word on how the federal government could help achieve this. As the Associated Press reported:

sagepoint-300x176With nursing home operators bleating up a storm of weak defenses and denials, soaring Covid-19 infections and deaths have laid siege to far too many long-term care facilities in Maryland, Virginia, and the District of Columbia. The consequences have been dire.

In Maryland, the Baltimore Sun reported:

“Nearly three-fifths of Marylanders killed by the coronavirus are residents of long-term care facilities, according to [a recent state] update of nursing home data …The Maryland Department of Health reported that 793 of the state’s 1,338 victims, almost 60%, were residents of nursing homes, rehabilitation facilities and similar long-term care facilities. An additional 11 deaths were staff members of those facilities, with more than one of every five of Maryland’s confirmed infections being a resident or staff member of congregate living facilities.”

grayillustration-213x300Although Americans may have particular wishes as to how their lives might close out, they aren’t getting these optimal outcomes for themselves and their loved ones.

Instead, the much-desired option of dying at home is proving to be stressful and draining to the extreme for families, and, when it comes to the dreaded loss of control involved with Alzheimer’s disease and dementia, drug therapies seem elusive in a concerning and crushing way.

Older workers’ health is becoming a startling concern, too, for many more employers as seniors stay on the job longer than they have before — leading to more workplace injuries and deaths.

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.

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