The Lives of Elders

Everyone has a story...

Today a great article was filed in the New Jersey Star-Ledger. Columnist George Berkin paints a great picture of what it’s like to have a loved one in a long term care facility. In all honesty it sounds like his mother has been placed in an ideal nursing home with great care. Please take 3 minutes and read this article. I think you will find that you will relate as a caregiver or family member.

 

http://blog.nj.com/njv_george_berkin/2009/01/visit_to_elderly_parent_in_nur.html

 

It is important to spread good stories like the one above. Behind every elder there is a loved one or a great caregiver that is part of their story. For many of you, you are a part of their life story. Remember this the next time you get discouraged or frustrated.

 

Protecting our Elders

  A new form of elder abuse is rearing its head in nursing homes around the country. Only this time it isn’t physical or mental… it’s monetary. In early December the woman pictured, Jacqueline Anne Lumpkin of Birmingham is alleged to have stolen the credit card of a 98 year old resident of a nursing home. If this is true the worst part is Jacqueline Lumpkin is the same person who was getting paid to take care of her.

Identity theft is nothing new to any of us. We all know how to be safe on the internet, shred sensitive documents and keep an eye on our credit scores. But do 98 year old women in nursing homes have to be concerned that their identities will be stolen by their nursing assistants? Let’s hope not!

The report alleges that Ms. Lumpkin charged up over $5,000 worth of purchases on this resident’s credit card and then disappeared. Her location is not known right now but the Birmingham police are looking for her. What could be even more disturbing is they cannot determine if there are more victims.

Some advice to caregivers and family members, If your elder or loved one has the need for a credit card, have a safe place for them to hide it. Get a small safe, have them keep it with the front office, find a safe hiding place for their valuables. Do anything that will deter people from stealing their ID. Talk with your family member about how easy it is for people to get their information and ruin their bank accounts.   They must have a heightened sense of this type of fraud.  

We must continue to demand that all people that come in contact and take care of our elders are thoroughly examined before given the job. Proper background checks and drug testing are just a start. No matter if they are temporary or full time we need to be assured that the people that give our elders a high quality of life are trustworthy and upstanding people. 

Filling in the Gap

It is unfortunate that we continue to see elders in a certain class not able to afford long term care. These are the people that are stuck in the “black hole” between Medicaid subsidized care and having enough money to pay for their long term care out of their own pocket.

Anyone who needs quality long term care should be able to take advantage of those services.  This may be a utopian idea but how can we continue to let only the very poor and very rich take advantage of long term care services.

A new government program that is focusing on central Texas is aiming to help solve this gap in the system. A grant obtained by Scott & White health system is attempting to provide resources to elders and caregivers to help them with their long term care. As it is currently laid out the program will target elders who are on the brink of having to enter a long term care facility but do not meet Medicaid requirements or have enough money to pay for it themselves. What this will provide these elders is a $750 a month “stipend” to help offset the cost of being able to remain at home and not enter a long term care facility. This money can be used to hire in-home personal or retrofit a house to accommodate medical needs. They would also be allowed access to certain medical resources that haven’t been readily available in the past.

The hope of this program is to give the caregivers the assistance they need to help keep elders out of long term care or at least delay it. By doing this there could be tremendous cost saving measures for the government, caregiver and elder, while allowing the elder to continue living in the comfort of their home.

This is a very innovative program that I hope can gain some traction. By giving caregivers the resources they can apply them to the individual needs of their specific elder. There will always be a great need for long term care facilities, but by being able to delay elders with borderline needs we will see an increase in quality of care for all elders, and hopefully long term care facilities will be able to allocate their resources to the truly needy residents.

 

 

Geriatric Physicians Apply Within...

I recently read a statistic that I’d like to share: Every 8 seconds a baby boomer turns 60. Luckily with the advances in medicine and healthcare 60 is the new 50 or even 40,  60 is not considered elderly like it was 50 years ago.

With these advances in medicine that continue to impress me everyday you’d expect that in 10 years we will see a statistic reading "Every 9 seconds a baby boomer turns 70". While many of us will live well beyond our 70’s, when you reach that age you have to start thinking about some of the ailments and issues that come as a result of age.  You need a specialized doctor that is familiar with arthritis, osteoporosis, strokes, heart disease and the list goes on. Unfortunately for the Boomers the chances of these specialized doctors being in place when we need them are pretty slim.

Here is the most concerning statistic I have seen in awhile: the number of certified geriatricians in the U.S. has declined 19 percent in the last 10 years, to 7,000. At this point we have more geriatric physicians retiring than joining the workforce. When you couple this with the fact that more people will need the services of a geriatric specialist over the next 10 years we are going to see a catastrophe of gigantic proportions. Aging people with nobody to care for them!

While taking care of the elderly may not be the most “sexy” job in the world, it is a job that needs to be done by qualified people. We need our leaders to take notice and see not only do we need an economic stimulus we need an elder care stimulus. We need incentives for student doctors to focus their training on geriatrics. This could be handled by giving scholarship incentives for students with a focus on geriatrics. It could be a bonus given by hospitals or care facilities to newly trained geriatric physicians. It could even be short term low interest loans for doctors opening up their own geriatric practices. We need some big people to take notice and see that if we don’t prevent this from happening there will be serious consequences in the near future.

Fox Learning Systems, was recently commissioned to create an entire video based curriculum for students considering the field of geriatrics in the hopes that more physicians, nurses and social workers will enter the field of geriatrics.   I will keep you updated on the progress of this project.

Economic Impact on Nursing Homes

To this point the economic impact on nursing homes has been fairly minor. There has even been some good news about federal spending accelerating for nursing homes. But with the increasing instability in the global financial market, and businesses in every sector cutting back staff and reducing budgets, the impact on long term care will be felt sooner rather than later

This is a time for creative thinking for the nursing home industry. How can they maintain and raise quality of care for their residents and maintain a solid financial position? It’s no secret that a successful nursing home “chain” can be an extremely lucrative for-profit business in the good times. Even well managed nursing homes will be fine in hard financial times.

The nursing homes that scare me are the ones that consistently have staff and compliance issues. These are nursing homes that have high staff turnover and low staff morale. These are the nursing homes that will struggle through this hard economic time.

It’s easy for a corporation to save money by reducing staff. When you are dealing with manufacturing or retail style field staff reduction is easily done with little consequence to the consumer and corporation. But when we start to hear that staff is being reduced in the care fields it becomes scary. Just this week two companies have announced layoffs of staff citing the economy as a problem. We can’t let corporations reduce their quality of care by reducing their staff. Their commodity is people in need not sellable goods.  By finding ways to make budgets without reducing staff or quality of care will be a difficult thing for managers and board members. But they have no choice! Selling assests, restructuring loans, revising their business plan are all options that should be acted upon before staff reduction.

In the coming months you will see the types of nursing homes that are managed correctly and the ones that aren’t by the headlines in the health section in the paper.

Importance of Handwashing

New Year, New Norovirus Outbreak. What a great way to kick off the 2009 year of blogging, talking about a preventable virus that rears its head every winter in long term care communities. We all know the Norovirus as it hits the news about once a year when a cruise ship has to return to port as a result of passengers getting sick from a “mysterious” illness. This always turns out to be the Norovirus which is an easily preventable, but highly contagious flu like virus that is passed quickly through human contact. This year many nursing homes on the east coast are having serious issues preventing and containing the Norovirus in their facilities. One facility in New York had 34 of its 103 residents having some form of the Norovirus.

When we hear about cruise ships or college dorms coming down with a case of the Norovirus, there is cause for concern, but in general these are healthy people that are just getting sick. It becomes much more serious when a nursing home contracts the Norovirus. In some cases these are extremely frail people with low immune systems that could have difficulty fending off this potentially deadly virus. The elderly dehydrate quickly with an illness like the Norovirus. This can result in the hospitalization of an elder that contracts flu like symptoms.

This is easily preventable as long as good hygiene is practiced. Facilities that stress good hand washing procedures will have little issue with illness like Norovirus. These practices should be used in our daily lives. Anytime you do anything that could put you in direct contact with other people’s germs, wash your hands. It’s as simple as that. Also when you are around people that are sick keep your hands out of your eyes, nose and mouth, these are gateways into your body.  For a more complete understanding of proper handwashing techniques, we are providing you a free video on our course on techniques.  This is just a small sample of the work we do on infection control.

The Diabetic Nightmare

When it comes to diabetes in the elderly you really only need to understand one fact: 1 in 4 elders have diabetes, with many more at risk of developing it meaning 25% of elderly people have diabetes! Diabetes can be a debilitating illness that can control your life if you do not get a firm handle on it.

In Monday’s Washington Post there was a good article about diabetes care in nursing homes. The article states that nursing homes are having a hard time keeping up with the diabetes “daily routine” or testing blood and administering insulin as needed. The Diabetes Care publication found that the testing of blood glucose levels was monitored at an excellent rate of 98% of the time. But the long term care facilities failed at actually interpreting those results into better levels. The publication found that only 38 percent met short-term glucose goals and 67 percent met long term goals.

The article goes onto quote the director of research at the Institute for the Future of Aging Services "One of the key differences in managing diabetes in a nursing home is that it's often not the condition of primary importance." With such a life altering disease like diabetes, long term care facilities need to be aware that the side effects of diabetes are sometimes worst than diabetes itself.

I recently had the opportunity to interview a neurologist at a local hospital on the subject of strokes. Although the subject of diabetes was never on my initial list of questions to ask, it became a major portion of the interview. This doctor candidly stated that if we find a way to manage and control diabetes, we can significantly see a huge reduction in strokes, heart attacks, and a number of other life threatening diseases.

We have learned a lot about the details of diabetes through my companies work with Rite Aid on the Giving Care for Parents campaign. I’m sure you already know this is a scary disease that is becoming way too common in our society. Especially for baby boomers and generations following we need to control our weight, exercise, stop smoking and monitor our cholesterol and blood pressure.