Archive for the ‘National’ Category

Patient in So-Called “Vegetative State” Knew Doctors Were Dehydrating Him to Death

November 14, 2013

We dehydrate to death helpless people in this country because they have a catastrophic cognitive impairment. Advocates for dehydration say it is just medical ethics, the withdrawal of the medical treatment of tube feeding. (Now, there is even a lawsuit to compel starvation by withholding spoon feeding–not a medical treatment!)

Dehydrating helpless people to death was once unthinkable. Then, in the 80s, bioethicists began advocating withdrawing tube-supplied food and fluids. And so it came to pass.

Advocates for dehydration started by claiming it should be reserved strictly for those who are unconscious. They have, of course, broadened the dehydration caste since. But recent scientific studies have now also shown that many supposedly unconscious patients aren’t unaware at all.

And now we learn some are paying attention to their surroundings!  From the Cambridge University report:

A patient in a seemingly vegetative state, unable to move or speak, showed signs of attentive awareness that had not been detected before, a new study reveals. This patient was able to focus on words signalled by the experimenters as auditory targets as successfully as healthy individuals. If this ability can be developed consistently in certain patients who are vegetative, it could open the door to specialised devices in the future and enable them to interact with the outside world.

And get this:

These findings suggest that some patients in a vegetative or minimally conscious state might in fact be able to direct attention to the sounds in the world around them.

If this is true of other patients, imagine the horror of hearing doctors and family discussing removing your food and water. Imagine the pain of the actual event!

Actually, we know what that is like. Kate Adamson, thought mistakenly to be unconscious after a brain stem stroke, underwent abdominal surgery with inadequate anesthesia. She was then left unfed (but hydrated via drip) during the healing process–and it was more painful than the sensation of being cut open!

Full Article and Source:
Patient in So-Called “Vegetative State” Knew Doctors Were Dehydrating Him to Death

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Rossen Reports: Thieves target seniors at nursing homes

October 26, 2013
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Across the United States, nursing-home residents are having their money stolen by people they know: the homes’ bookkeepers and office managers who handle their trust funds and manage their expenses.

It’s a crime that’s been committed against thousands of nursing-home residents, including Leo Foster’s 89-year-old mother at the Vicksburg Convalescent Center in Vicksburg, Miss.

“It made me feel sick at my stomach,” Leo’s wife Phyllis Foster told TODAY’s National Investigative Correspondent Jeff Rossen. “It just didn’t dawn on me that someone would be so low as to steal from a vulnerable adult.”

Police learned that a woman named Lee Ray Martin, a business office coordinator at the Vicksburg Convalescent Center and Shady Lawn Health and Rehabilitation homes, had been raiding residents’ trust accounts.

“In (a) three-month period there were 12 or 15 cash withdrawals,” Phyllis Foster said of her mother-in-law’s account. “And we knew that there was something drastically wrong.”

In August, Martin pleaded guilty to 29 counts of exploitation of a vulnerable person and one count of conspiracy. She is accused of stealing more than $100,000 from 83 residents’ trust funds and going on shopping sprees at stores like J.C. Penney, Gap, Walmart and American Eagle. In one instance, Martin bought a pair of designer jeans and expensed them to an elderly resident with no legs.

Full Article and Source:
Rossen Reports: Thieves target seniors at nursing homes

Thefts from nursing home trust funds target the elderly

October 18, 2013

The administrator at the Vicksburg Convalescent Center knew something was wrong when she saw the receipt: a $90 debit from a resident’s trust fund account for a pair of designer jeans.

Of all the elderly residents at the 100-bed nursing home, Amy Brown figured, this one was especially unlikely to spend his savings on pricey pants.

Both of his legs had been amputated.

Brown pored over the trust fund books. There were receipts to back up every charge, so audits had found nothing amiss. But she spotted “receipts for things I knew the residents wouldn’t buy” — North Face jackets and Ugg boots, hair dryers and makeup, even a baseball bat. “I felt sick,” Brown recalls.
Suspicions fell on Lee Martin, an office staffer at the Mississippi facility and an affiliated nursing home across town. Martin was charged in 2012 with billing $101,000 in personal expenses to the trust accounts of 83 residents at the two facilities. She pleaded guilty in August to multiple counts of exploitation of vulnerable adults.

“These (residents) are vulnerable; the nursing home is supposed to take care of them,” says Phyllis Foster, 67, whose 89-year-old mother-in-law had funds embezzled by Martin. “I was surprised there wasn’t more oversight.”

Thousands of residents in U.S. nursing homes and other long-term care institutions for the aged and disabled have had their personal savings raided or mismanaged after relying on the facilities to safeguard the money in special trust fund accounts, a USA TODAY investigation shows.

Full Article and Source:
Thefts from nursing home trust funds target the elderly

Medicare Drug Program Putting Seniors, People With Disabilities At Risk

October 17, 2013

Ten years ago, a sharply divided Congress decided to pour billions of dollars into subsidizing the purchase of drugs by elderly and disabled Americans.

The initiative, the biggest expansion of Medicare since its creation in 1965, proved wildly popular. It now serves more than 35 million people, delivering critical medicines to patients who might otherwise be unable to afford them. Its price tag is far lower than expected.

But an investigation by ProPublica has found the program, in its drive to get drugs into patients’ hands, has failed to properly monitor safety. An analysis of four years of Medicare prescription records shows that some doctors and other health professionals across the country prescribe large quantities of drugs that are potentially harmful, disorienting or addictive. Federal officials have done little to detect or deter these hazardous prescribing patterns.

Searches through hundreds of millions of records turned up physicians such as the Miami psychiatrist who has given hundreds of elderly dementia patients the same antipsychotic, despite the government’s most serious “black box” warning that it increases the risk of death. He believes he has no other options.

Some doctors are using drugs in unapproved ways that may be unsafe or ineffective, records showed. An Oklahoma psychiatrist regularly prescribes the Alzheimer’s drug Namenda for autism patients as young as 12; he says he thinks it calms them. Autism experts said there is scant scientific support for this practice.

The data analysis showed widespread prescribing of drugs such as carisoprodol, which was pulled from the European market in 2007. In 2010 alone, health-care professionals wrote more than 500,000 prescriptions for the drug to patients 65 and older. The muscle relaxant, also known as Soma, is on the American Geriatrics Society’s list of drugs seniors should avoid.

The data, obtained under the Freedom of Information Act, makes public for the first time the prescribing practices and identities of doctors and other health-care providers. The information does not include patient names or the reasons why doctors prescribed particular drugs, so reporters interviewed the physicians to learn their rationales.

Medicare has access to reams of data about its patients, their diagnoses and the medical services they received. It could analyze all of this information to determine whether patients are being prescribed appropriate drugs for their conditions.

But officials at the Centers for Medicare and Medicaid Services say the job of monitoring prescribing falls to the private health plans that administer the program, not the government. Congress never intended for CMS to second-guess doctors – and didn’t give it that authority, officials said.

“CMS’s payments don’t go to physicians, don’t go to pharmacies. They go to plans, which is how our oversight framework has been established,” Jonathan Blum, the agency’s director of Medicare, said in an interview. The philosophy “really has been to defer to physicians” about whether a drug is medically necessary, he said.

Asked repeatedly to cite which provision in the law limits their oversight of prescribers, CMS officials could not do so.

The Office of the Inspector General of the Department of Health and Human Services has repeatedly criticized CMS for its failure to police the program, known as Part D. In report after report, the inspector general has advised CMS officials to be more vigilant. Yet the agency has rejected several key recommendations as unnecessary or overreaching.

Other experts in prescription drug monitoring also said Medicare should use its data to identify troubling prescribing patterns and take steps to investigate or restrict unsafe practitioners. That’s what state Medicaid programs for the poor routinely do.

“For Medicare to just turn a blind eye and refuse to look at data in front of them . . . it’s just beyond comprehension,” said John Eadie, director of the Prescription Drug Monitoring Program Center of Excellence at Brandeis University.

“They’re putting their patients at risk.”

Although Medicare hands responsibility to private insurers, experts say they are ill-equipped for the task. Insurers have access solely to the prescriptions for their members – not to a provider’s prescriptions across multiple health plans.

Only Medicare can see that.

“A red flag can turn out to be nothing, or it can turn out to be something really, really horrible,” said Kathryn Locatell, a California physician who specializes in geriatrics and elder abuse. “You won’t know unless you flag it.”

In lawsuits and disciplinary records, state and federal authorities cite a number of reasons that doctors prescribe improperly. Some run mills where patients get prescriptions if they pay cash for a visit. Others have relationships with drug companies that influence what they prescribe. Regulators say some doctors choose inappropriate medications under pressure from families or facilities.

Research also shows that doctors often don’t keep up with the latest studies and drug warnings.
ProPublica’s examination of Part D data from 2007 through 2010 showed that, in many cases, Medicare failed to act against providers who have been suspended or disciplined by other regulatory authorities.

Doctors barred by state Medicaid programs for questionable prescribing remain able to dole out the same drugs under Medicare. So can dozens of practitioners who have been criminally charged or convicted for problem prescribing, or who have been disciplined by state medical boards.

The Part D records detail 1.1 billion claims in 2010 alone, including prescriptions and refills dispensed. ProPublica has created an online tool, Prescriber Checkup, to allow anyone to search for individual providers and see which drugs they prescribe.

About 70 providers each churned out more than 50,000 prescriptions and refills in 2010, the data show, averaging at least 137 a day.

A few had high tallies because they work in institutional settings, such as nursing homes, or operate busy clinics. In other cases, doctors said they think the prescriptions of their colleagues were attributed to them. They acknowledged in interviews that their numbers should have sparked questions.

Some families say they, too, think Medicare should be paying closer attention.

When 79-year-old Mable “Nanny” Webb’s family put her in a nursing home near Fort Worth in 2004 to rehabilitate her back, she came under the care of Adolphus Ray Lewis, who would later become one of Medicare’s busiest prescribers.

Records show that the Texas medical board temporarily restricted Lewis’s license in 1998 for improper prescribing of painkillers and that he was sued repeatedly for malpractice. But Webb’s family didn’t know that.

While under Lewis’s supervision, Webb developed a urinary tract infection that went untreated and was given a painkiller in doses that were excessive and dangerous for her condition, court testimony shows. Within a month, she died.

Webb’s relatives sued. During the 2008 trial, Lewis admitted responsibility for her death, testifying that he had not reduced the dosage ordered by a nurse he supervised.

A jury ordered Lewis to pay $1.6 million in damages to Webb’s relatives. They later settled for a lesser amount – one of at least eight malpractice settlements in cases involving Lewis since the mid-1990s, according to court records and interviews.

Yet Lewis continued to prescribe, racking up nearly 99,000 Medicare prescription claims including refills in 2010, fifth-most in the country. He wrote 46,000 more under Medicaid that same year. He declined to comment for this article.

Webb’s granddaughter, Michelle Wheeler, said that though it’s too late for her family, information about a doctor’s drug choices could help others decide who should care for their loved ones.

“Everybody should be able to know that,” she said.

Full Article and Source:
Medicare Drug Program Putting Seniors, People With Disabilities At Risk

Guardianship: Time for Accountability

October 13, 2013

Guardianship abuse seems to be one of the most profitable scams of the day!  Are you safe from it?  Not necessarily.

Professional guardians, and professionals who become guardians, in some states, can isolate the ward (even from family and friends), bill outrageous amounts, sell houses and other property, take over bank accounts and make the ward’s life absolutely miserable as they do.  Don’t believe it?  Neither did many others, until it happened to them.

The public is led to believe they have the right to pick the person they wish to make decisions for them, should they become unable to do so or need some help.  However, in Florida, it appears, judges are allowed to ignore the person’s wishes and place him or her under the care of a professional guardian.  Once that appointment has been made, the family can be completely excluded from the ward’s life.  Worse, if there can be a worse, the ward is completely at the mercy of the guardian for better or for worse.

A guardian should be someone who is looking out for the best interest of the ward — not the ward being a money-making product to be billed to pennilessness.

When a guardian has already been chosen by the person, the courts should not be allowed to ignore that wish and appoint a professional guardian, unless there are some serious extenuating circumstances.

In my opinion, one of the first signs something is terribly wrong with a guardian situation is when the ward is isolated from family and friends.  This action alone suggests there is something to hide.  If not, then why would a guardian worry about the ward associating with all the people that had meant so much to him or her?

People who don’t understand the harm isolation can do, should spend a couple of months alone in a room with no stimulation and the only human contact (and brief words exchanged) being when someone brings a meal and picks up the tray.  That experiment will give you a taste of what many under guardianship go through and what you may one day be looking forward to, if the laws are not changed.

The courts should not have the right to over-ride a person’s wishes, without true cause to do so.  This is a person’s life after all.  And family members and friends should be considered for guardianship prior to any professional being thought of.

Professional guardians should be held to the strictest of standards and there should be no immunity for them not also given to a family member or friend acting in the same capacity.

Guardians should not be allowed to create bills and then sell off the ward’s home and possessions to make payment, as easily as it seems it can be done in many jurisdictions.

Wards should not lose the right to fight for their freedom from guardianship, especially if it is a wrongful one.  As it is, if the guardian has all the say — the ward can be silenced and kept from fighting against an abuse guardianship situation.  How is that right?  Doesn’t that defeat the very purpose of guardianship?

Full Article and Source:
Guardianship: Time for Accountability

Don’t Sign Arbitration Agreements in Nursing Homes

October 4, 2013

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Don’t Sign Arbitration Agreements in Nursing Homes

Alzheimer’s Cure on the Horizon

September 24, 2013
 

In a recent interview with Ira Flow at NPR, Stephen Strittmatter explained his new research published in the journal Neuron.  He is Vincent Coates Professor of Neurology at Yale University’s School of Medicine and cofounder of Axerion Therapeutics, a private biotechnology company specializing in the research and development of treatments for Alzheimer’s disease.  His new study offers key insights into Alzheimer’s disease and gives hope that a cure might be on the horizon.

Since we have not proven what actually causes the disease, Strittmatter worked off the theory that Alzheimer’s disease is caused by abnormally folded proteins called amyloid oligomers.  It is believed that these toxic oligomers are the primary cause of all amyloid-related degenerative diseases.   They interact with neurons in the brain to damage synaptic function, creating memory deficits.  According to this theory, amyloid plaques build up in the brains of patients suffering from Alzheimer’s as a result of these protein interactions.  Strittmatter focused his study on figuring out exactly how these irregularly folded proteins interact with the neurons.  They already knew that the bad proteins interact with prion proteins on the neuron’s surface, but they didn’t know how the interaction was communicated to the inside of the cell.

The study’s main discovery was the protein called mGlur5 or Metabotropic Glutamate Receptor Five.  It is the protein responsible for the communication between the abnormally folded proteins and the inside of the neurons in the brain, triggering the internal chemistry that changes the synapses causing the neuron to lose synaptic function.  In essence, the protein mGlur5 crosses the cell membrane of the neuron and activates changes on the inside of the cell triggered by the bad, misfolded proteins causing the damage to the synapse.  Additionally, Strittmater found that blocking the mGlur5 protein using a drug called MTEP not only prevents the damage to the neuron, but may even reverse the loss of synaptic function, bringing back the lost memory.  This new knowledge of Alzheimer’s means a cure could be on the horizon.

Full Article and Source:
Alzheimer’s Cure on the Horizon

Aging AIDS population causes new challenges for health care system

September 24, 2013

WASHINGTON —
Half of the HIV/AIDS population in the United States will be 50 or older by 2015, a pivotal development that brings new challenges to the treatment and prevention of the disease, experts told a congressional panel Wednesday.

Drug resistance, other diseases, high rates of depression and a lack of prevention, screening and early diagnosis could all pose significant problems as the population of Americans with HIV or AIDS ages, they said during a hearing of the Senate Special Committee on Aging.

As research for a cure for AIDS continues, there is a vital need to examine the aging AIDS population, since any drug or vaccine must now work on an older population, said Sen. Bill Nelson, D-Fla., the committee’s chairman.

“The so-called graying of the population comes with the need to refocus our work on these new challenges,” Nelson said.

Older Americans tend to take fewer precautions against HIV, get diagnosed later and respond less to antiretroviral therapy, said Dr. Ronald O. Valdiserri, a top infectious diseases official with the Department of Health and Human Services.

Older people with HIV are more likely to develop cardiovascular disease, cancer, and liver and kidney disease, as well as depression, the experts said.

Full Article and Source:
Aging AIDS population causes new challenges for health care system

Survey Finds Disability Abuse Widespread

September 8, 2013

More than 7 in 10 with disabilities say they’ve been abused, according to a new national survey, and in many cases individuals say the problems occur repeatedly.

In what’s believed to be the largest survey of its kind, over 7,200 people with disabilities, family members, advocates, service providers and other professionals were polled between May and October 2012.

The findings, released this week, suggest that abuse of people with disabilities is widespread across the country and often overlooked.

More than 70 percent of those with disabilities polled said they had been abused and over 60 percent of family members indicated that their loved one with special needs had been mistreated.

In about half of cases, victims said they experienced physical abuse. Some 40 percent reported sexual abuse and nearly 90 percent of those who said they had been violated indicated they were verbally or emotionally harmed. Neglect and financial abuse were also frequently cited.

“Too many people are abused too much, with very little on the response side to help in the aftermath,” said Nora J. Baladerian, director of the Disability and Abuse Project, which conducted the survey. “The extent of abuse is epidemic, and the inadequate response is disturbing.”

Among those who were victimized, more than 9 in 10 said they were abused more than once with 57 percent indicating they had experienced mistreatment more than 20 times, the survey found.

Incidents of abuse were not reported in about half of cases and even when authorities were alerted, survey results indicate that arrests were made only about 10 percent of the time.

Full Article and Source:
Survey Finds Disability Abuse Widespread

Advocacy Group Publishes Nation’s First-Ever, State-By-State Nursing Home Report Card

September 6, 2013

TALLAHASSEE, FL) – Families for Better Care, a Florida-based nursing home resident advocacy group, published the first-ever state-by-state nursing home report card.

The group scored, ranked and graded states on eight different federal quality measures ranging from the percentage of facilities with severe deficiencies to the number of hours frontline caregivers averaged per resident per day.

“We’re excited about getting this report into the hands of public officials, nursing home owners, advocates, and—most importantly—residents and their families,” said Brian Lee, Families for Better Care’s executive director.  “Our goal is to applaud those states that provide good care while motivating improvement for those that score poorly.”

Top nursing home states included Alaska, Rhode Island and New Hampshire while Texas, Louisiana and Indiana hit rock bottom.

“A distinctive trend differentiated the good states from the bad states,” Lee exclaimed.  “States whose nursing homes staffed at higher levels ranked far better than those with fewer staffing hours.”

Three states (Alaska, Hawaii, and Maine) scored “superior” grades in every staffing measure and each ranked among America’s best nursing home states.  Conversely, of those four states with failing marks (Georgia, Louisiana, Tennessee, and Texas) each scored below average grades.

Full Article and Source:
Advocacy Group Publishes Nation’s First-Ever, State-By-State Nursing Home Report Card

See Also:
Report Says Texas Nursing Homes Are the Worst in the Country, And This Video Might Just Convince You