Nursing homes

April 5, 2020

Rethinking end-of-life plans and nursing home care for ourselves and loved ones

The Covid-19 pandemic is forcing many Americans to think and act on tough issues they otherwise might wish to avoid, and they’re getting thoughtful reminders on ways they may want to proceed with advanced or end-of-life medical planning and decisions on whether to keep elderly loved ones in nursing homes and other long-term care facilities or to bring them into their residences.

These are hard topics to deal with in the best of times. But failing to do so can leave families with not only a lifetime of regrets but also possibly significant financial consequences. Americans long have insisted that they want to have maximum control over medical decisions that affect their care.

So, thinking ahead about our own advanced medical plans, and revisiting the institutional care of beloved seniors may not only be appropriate, but necessary as the world struggles with the Covid-19 pandemic and medical caregivers are overwhelmed and may be stretched to their limits.

March 9, 2020

As virus spreads, concerns surge about testing, hospitals, and nursing homes

by Patrick A. Malone

The coronavirus outbreak spreading across the globe may be providing Americans with an unhappy view of the dirty downsides of the too-often dysfunctional U.S. health care system as it grapples with spiking Covid-19 infections.

Congress has appropriated more than $8 billion, so the federal government can provide the nation the support it needs in battling the respiratory illness that exploded out of central China a few weeks ago. Almost 100,000 people globally have been infected with the virus, which has killed thousands. The deaths in this country are rising into the dozens, while infections are increasing into the hundreds. In Italy, the government took a drastic step in dealing with steeply rising infections and ordered a virus-related quarantine of much of the northern part of the country — a tough lock down because the Lombardy area is the largest economic powerhouse of the nation.

In the U.S., federal efforts to stockpile needed medical supplies, notably masks, gloves, and gowns — personal protective equipment or PPEs — continue to lag. The administration is under fire for its slow and ineffectual roll-out of virus testing kits. Vice President Pence promised that big numbers of screening supplies would be available quickly — at least 1 million, asap — but he since has been forced to walk back that pledge. Even as he talked about 75,000 test kits becoming available soon, the Atlantic magazine reported that as few as 1,895 Americans have been tested so far for the virus.

February 21, 2020

Will voters buy $1 trillion in U.S. health care cuts, as ’21 budget proposes?

by Patrick A. Malone

President Trump’s 2021 budget proposal is thicker than an old-fashioned phone book. Lots of the document became little more than chaff the instant it was printed, due to the likelihood of big changes in the spending plan by congressional Democrats and lawmakers of the president’s own party.

The fiscal wish list, unsurprising at its contents were, may raise a big political question: How, with evidence like this, does the leader of the free world campaign on a counter-factual argument that his policies and practices protect and advance the health of the American people — a prime concern, pollsters say, of the voting public?

The $4.8 trillion Trump budget, for example, proposes to slash the Medicaid and food stamp programs by $1 trillion over a decade, with presidential critics noting the various, sometimes bureaucratic means to do so, ultimately, will reduce desperately needed social supports and throw millions of vulnerable Americans off aids for their health care. (Federal courts, including the appellate panel overseeing Arkansas, have rejected the latest way the administration and GOP states have sought to reduce Medicaid costs by imposing draconian work, reporting, and qualifying rules.)

February 6, 2020

With U.S. health care costs sky-high, why gouge programs to help vulnerable?

by Patrick A. Malone

If rigorous research drove policy making in a more optimal fashion than it now apparently does, how might politicians and regulators react to findings like these:

The well-respected Commonwealth Fund has revisited earlier studies, finding anew that the United States “spends more on health care as a share of the economy — nearly twice as much as the average [industrialized Western European] country — yet has the lowest life expectancy and highest suicide rates among the 11 nations. The U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the average [in comparable Western industrialized and European countries.] Americans had fewer physician visits than peers in most countries, which may be related to a low supply of physicians in the U.S. Americans use some expensive technologies, such as MRIs, and specialized procedures, such as hip replacements, more often than our peers. Compared to peer nations, the U.S. has among the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths.”

Even while spending more than any other nation on health care and getting poorer outcomes, which Americans bear the heaviest burdens of the system’s costs? Here’s what researchers at the nonpartisan and independent RAND Corporation have found in a newly published study:

December 2, 2019

Grim way to increase nursing home profit: Toss out frail seniors and disabled

by Patrick A. Malone

Profit-hungry nursing home operators persist in throwing out vulnerable seniors and disabled patients from needed care, too often because the facilities find they can get higher-paying patients to fill their already costly beds.

Thousands of complaints about potentially improper discharges or transfers from nursing homes and assisted living facilities dominate the work of ombudsmen, whose work is federally required, and state supported, an NBC News investigation found.

The broadcast journalists reported:

November 19, 2019

Superbugs’ deadly rise has plunged planet into risky ‘post-antibiotic’ era

by Patrick A. Malone

Federal officials have put out some scary new findings about the state of patients’ health in the 21st century: Superbugs may be more common and potent than previously believed. And we may now have plummeted into what experts are calling the perilous “post-antibiotic age.”

This all amounts to far more than a hypothetical menace. It could affect you if you get, for instance, a urinary tract infection. Or if you undergo a surgery, say, for a joint replacement or a C-section. Depending where and how you live, you may see the significance of this health problem if you contract tuberculosis or some sexually transmitted diseases.

As the news website Vox reported of the startling new information from the federal Centers for Disease Control and Prevention: “Every 15 minutes, one person in the U.S. dies because of an infection that antibiotics can no longer treat effectively.”

October 29, 2019

Who will step up to deal with dementia and Alzheimer’s?

by Patrick A. Malone

With as many as 14 million Americans potentially suffering from various forms of dementia by 2040, including the common Alzheimer’s disease, and with the costs of the care for them forecast to soar soon to more than $500 billion, a frenzied race is on for ways to deal with the debilitating cognitive syndromes. But will individual initiative or Big Pharma products matter most for seniors and their loved ones in the days ahead?

Industry analysts and patient advocates alike were stunned when drug maker Biogen reversed itself and announced that it would seek federal Food and Drug Administration approval for aducanumab, which the New York Times reported “is a monoclonal antibody, an expensive type of drug that attaches to specific proteins in order to disable them. The drug clears a key protein in Alzheimer’s disease — beta amyloid — that accumulates in plaques in patients’ brains. Aducanumab is given as an intravenous infusion once a month.”

Biogen had spent heavily on multiple tests of this drug, suddenly pulling the plug on it last spring, declaring with the counsel of an independent advisory board that the prospective prescription medication — and possibly the line of inquiry about beta amyloids and Alzheimer’s that had led to its creation — was a failure.

October 11, 2019

Vulnerable nursing home residents face yet another hazard: sickening food

by Patrick A. Malone

To the myriad struggles that residents of nursing homes endure, from poor health to inattentive staff, add this new one: “crappy conditions” in kitchens and other areas where their food gets prepared and served.

Marjie Lundstrom, a Pulitzer Prize-winning reporter, conducted a five-month, nationwide investigation for the consumer web site Fair Warning, with the results also shared by NBC News. The dirty dig found this about nursing home food prep:

“Flies buzzing the under cooked hamburgers. Cockroaches scurrying for cover behind the oven. A moldy ice machine. Mystery debris, clinging to the crevices of a meat slicer. Hundreds of mouse droppings, trailing across the hood of the stove. These incidents are not logged in any restaurant inspector’s notebook. They are among the thousands of food safety violations discovered in the last three years in America’s nursing homes, where fragile residents can least tolerate such lapses. While allegations of elder abuse and neglect dominate the horror stories in long-term care settings — bedsores, falls, medication errors, sexual assaults — food handling remains a consistent and often overlooked hazard …”

September 20, 2019

Nursing homes and long-term care facilities may be infection ‘cauldrons’

by Patrick A. Malone

The 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:

September 13, 2019

Home care for the aged has become a quiet calamity for all involved

by Patrick A. Malone

Americans are confronting a care-giving calamity with the elderly at home, and the alarms are sounding loudly about it. But are experts and politicians grasping the severity of this crushing health care shortfall?

The New York Times, Vox, Washington Post, and Forbes all published detailed and solid news articles about the nation’s quiet nightmare with the workforce needed to deal with the booming population of aging baby boomers.

Just a reminder: This is a huge group that is graying rapidly, with 10,000 boomers each day turning 65 and this startling reality continuing for the next decade or so. Seniors long have said they prefer to age at home, that they dread and may not be able to afford nursing home care, and they are panicked about who will help them in their daily lives as they become debilitated, especially with dementia or Alzheimer’s — conditions predicted to explode in prevalence and cost as the nation’s elderly population increases.