Pennsylvania Nursing Home Abuse Lawyer Blog

According to an article on USAToday.com, there are four common medications that are responsible for sending an estimated 100,000 seniors to the hospital from drug reactions.

"Of the thousands of medications available to older patients, a small group of blood thinners and diabetes medications caused a high proportion of emergency hospitalizations for adverse drug events among elderly Americans," said lead study author Dr. Daniel Budnitz, director of the U.S. Centers for Disease Control (CDC) and Prevention's medication safety program.

According to the article, two medicines for diabetes and two blood-thinning agents account for two-thirds of the drug-related emergency hospitalizations.

CDC researchers, working with a nationally representative database, identified more than 5,000 cases of drug-related adverse events that occurred among people aged 65 and older from 2007 to 2009. They used these numbers to make their estimates for the whole population.

According to the study, 48 percent of the hospitalizations occurred among adults 80 and up, with 66 percent as a result of unintentional overdoses.

Among the blood thinners, warfarin (Coumadin, Jantoven), used to treat blood clots, was involved in 33 percent of emergency hospitalizations.

Insulin, used to control blood sugar in diabetic patients, was involved in 14 percent of cases.

Antiplatelet drugs such as aspirin and clopidogrel (Plavix), used to prevent blood clots, were involved in 13 percent of cases.

Oral hypoglycemic agents (diabetic medications taken by mouth) were involved in 11 percent of cases.

With antiplatelet or blood thinning drugs, bleeding was the main problem. For insulin and other diabetes medications, about two-thirds of cases involved changes in mental status, including confusion, loss of consciousness, and seizures.

Dr. Michael Steinman, an associate professor of medicine in the division of geriatrics at the University of California, San Francisco, said, "This study highlights a few key issues that are important for doctors and patients to be aware of. The first is that serious adverse reactions to drugs are common among older people, particularly among people over 80. But even those 65 and older are at substantial risk of having an adverse effect from their drugs."

To reduce risks, Steinman said that doctors and patients need to discuss whether the drug is truly necessary. For people with very high blood pressure or blood sugar, Steinman said, "The answer is almost always 'yes,' you should treat it. But if you have only mildly elevated blood pressure or blood sugar, the benefits of treating it versus the harms start to shirt. Do these drugs really provide enough benefit that it's work taking them?"

Physicians should consider a person's age, overall health, and other medications they take.

The attorneys and staff of Michael J. O'Connor & Associates wish you and your family a Happy Thanksgiving and safe journey to those who are travelling this holiday weekend!

Elder care advocates rallied in Washington Nov. 17, uniting to help ensure services are not cut for older
Americans.
Led by Vermont Sen. Bernie Sanders, a long-time senior advocate, congressional advocates and others
were asked to stand together at 10 a.m. in the Dirksen Senate Office Building.
According to elderneglect.org, a bi-partisan "super committee" of federal lawmakers is currently
meeting to discuss ways to trim the federal deficit and is expected to release a plan to combine revenue
enhancements and program cuts to improve the nation's financial outlook. Analysts are stating certain
options like cuts to Medicare and Medicaid would have a devastating effect on seniors and Americans
with disabilities, including financial assistance for nursing home care and assisted living facilities as well
as personalized home care that allows many older and disabled citizens to remain in their own homes.
The National Consumer Voice for Quality Long-term Health Care states more than 70 percent of nursing
home residents depend on Medicaid to pay their costs which can range from $75,000 to $150,000. Cuts
in Medicaid could mean more seniors could unable to afford nursing home care, or fewer workers would
be available to provide quality care.

A small pilot program involving nursing homes in five Oregon counties made voting in last week's elections a cinch for residents. Instead of heading out to the polls, they voted via iPad tablet notebooks.

According to an article on McKnights Long-Term Care News & Assisted Living, election officials brought iPads and portable printers to the nursing homes and community senior centers. This allowed the state's elderly and disabled constituents to vote in an election that replaced one of their state representatives.

Voting with the iPad gave those who are visually impaired the option to increase the ballot's font size as well as adjust the screen color to enhance readability. The iPads could also read each candidate's name and information about them to the voter. A "sip-and-puff" device used to control the iPad's screen was beneficial for those with mobility difficulties.

We applaud Oregon election officials and their efforts to assist the elderly to vote. We look forward to these changes happening here in Pennsylvania.

The Pennsylvania Department of Aging recognizes November as National Family Caregiver Month.
According to the state agency, Pennsylvania has about 1.2 million unpaid caregivers, making it the fourth largest caregiver population in the country. These caregivers contribute more than $13,000 of free service every year the agency estimates and as the older population increases, more adults will assume the role of caregiver.
According to a 2009 National Alliance on Caregiving and AARP survey, 23 percent of those taking the survey who worked as caregivers for five or more years reported a decline in health.
The Department of Aging assists caregivers through its Family Caregiver Support Program, offering information, respite care, training, assistance with home modifications and financial assistance for some expenses.
The program is administered through local Area Agencies on Aging. For more information about the program visit www.aging.state.pa.us

November is National Alzheimer's Disease Awareness Month. According to an acticle on CNN.com, about 60% of the nation's 5 million Alzheimer's patients will wander - a huge risk to many Alzheimer's patients and their loved ones.

It may not be possible to keep an eye on your loved once 24 hours a day, 7 days a week. But we found that this article offered a few tips to help decrease the likelihood that an Alzheimer's patient may wander.

Keep wandering top of mind: With family members are concerned with other aspects of the disease, such as leaving the stove on or asking the same questions over and over again, it's easy to forget that wandering can be a risk.

Pick up on the red flags of wandering: Wandering often happens when someone with dementia is in unfamiliar surroundings. They may leave clues that they are about to wander, such as, "It's time to go to work," or "I want to go home."

Distract them: If they do mention that they need to go to work, don't try to reason with them. Try to distract them by saying, "Let's go find your shoes." Usually, by the time they find their shoes, they will have forgotten about going to work.

Block or disguise the exits: Never lock or trap a person with dementia in a home alone. You can block the doors with screens that disguise the fact that it's a door. You can put a lock at the bottom of the door. You can put a mirror or stop sign on the door. You can also try putting a dark rug in front of the door. People with late-stage dementia will think it's a hole and won't go near it.

Label your rooms: The Mayo Clinic suggests putting a picture of a toilet on the door to the bathroom or food on the door to the kitchen. This can help those with Alzheimer's more easily find what they need.

Keep them busy: Watching television for hours at a time can cause some patients to become bored. Keep them busy with tasks such as washing dishes or folding clothes. Adult day care programs can also provide interesting activities for them.

Take a walk: Walking and exercising can keep Alzheimer's patients active and may keep them from wandering in search of company.

Consider technology: GPS devices can be attached to a loved one's bracelet or in a shoe. You can then go online to track them if they do wander. Some alarm systems alert you if a door is opened in the house. The Alzheimer's Association has an overview of electronic devices that can help keep track of patients.

Find the right facility: Sometimes a family is not able to keep their loved one with dementia at home. There are nursing homes and assisted living facilities that can help, but it's important to research and see if the facilities have had problems with patients wandering if doors are monitored either electronically or by staff.

According to a Pittsburgh television station investigating team, seven personal care homes across the state were shut down last year, while three others had their licenses revoked.
Target 11 investigator Rick Earle and photographer Tim Holoman interviewed Ron Melusky, the state director of Adult Residential Licensing in Harrisburg last month.
Melusky said there are 1,300 personal care homes housing almost 50,000 people across the state. He said the homes are inspected yearly.
The top violation inspectors find is problem tracking patients medications; number two is not doing thorough criminal background checks on employees; and the third biggest violation is having poisons such as criminal products unlocked or out in the open according to the Target 11 team.
It was reported more than $1.5 million in fines were given out last year, some stemming from minor violations like dirty mattresses, cigarettes piling up in non-smoking areas, sharp objects exposed and emergency plan problems. Homes are given from five to 15 days to correct the violations before fines are imposed.

In our blog on Oct. 28, we reported that in September of 2010 the Pennsylvania Department of Health was notified of a life-threatening group A streptococcus (GAS) breakout that had occurred in a Pennsylvania skilled nursing facility. The report did not name the facility, but it did describe it as having 150 beds, specializing in ventilator weaning, spinal-cord injury care, and short-term rehabilitation. Now an article on Philly.com has identified the facility as AristaCare at Meadow Springs in Plymouth Meeting, the only nursing facility in Montgomery Count that matches the report's description.

According to the article, Rhea Goodwin, administrator of AristaCare at Meadow Springs, confirmed that her facility had an outbreak of strep. However, she said there was no "direct link" between the bacteria and the deaths of 2 patients.

The CDC's Mobidity and Mortality Weekly Report said that between Oct. 12, 2009, and Sept. 22, 2010, 13 residents had invasive strep and two died. Ten residents had noninvasive strep infections.

The report said the facility had "multiple infection preventions deficiencies" including ineffective staff "hand-hygiene practices." To combat GAS, the CDC recommends good hand washing habits, especially after coughing and sneezing and before preparing foods or eating.