The consequences of lack of communication between hospitals and skilled nursing facilities (SNFs) are not new knowledge. According to a 2013 study, in the U.S. alone, more than 5 million patients transition from hospital to SNFs yearly. These transitions heavily rely on the thorough communication of healthcare professionals and paraprofessionals to ensure adequate care for patients. However, hospitals and local SNFs typically operate as separate entities causing a myriad of miscommunication. Communication issues that may happen between the facilities include incomplete, contradicting and/or mismatching verbal and written care plans. These problems may cause SNF staff to delay—or never deliver—proper care for patients, resulting in potentially fatal consequences. For example, noting the wrong medication can cause a stroke patient to relapse into another stroke and an avoidable hospital readmission. While many factors can be used as scapegoats to explain these mistakes, these problems are not new, and as professionals in the field, SNFs should establish better communication and points of accountability before accepting a patient to ensure the dignity and quality of care of patients. A recent study published by the Journal of the American Geriatrics Society by multiple medical doctors have indicated that a significant number of hospital readmissions from SNFs were likely preventable.
With more than 47 million people worldwide suffering from Alzheimer’s disease and other forms of dementia there is a growing need to identify the cause of these diseases as well as treatments for them. Millions of dollars have gone into the improvement of technologies and the research of brain mapping. At the USC Stevens Neuroimaging and Informatics Institute, Arthur Toga and Paul Thompson have been leading projects that are changing the world of neuroimaging. Toga and his team of researchers are on a quest to use digital imaging to map the brain. They believe that this type of detailed brain mapping will lead to solutions for neurodegenerative diseases such as Alzheimer’s and Dementia. Recent developments have led these scientists closer to the goal of better understanding these diseases and providing a breakthrough in how to prevent them.
As we begin to age our bodies react to the changing conditions and often sleep disturbances can begin to occur. The effects of aging can have an impact on the sleep cycles of the elderly. Sleep disturbances, common amongst seniors, bring about less meaningful REM sleep and shorter sleep periods in general. This puts them at risk of developing serious health conditions and increases the risk of injuries.
While the elderly need about 7-9 hours of sleep a night, many of them do not manage to sleep undisturbed for this long. About 50% of elders’ experience sleep insomnia and about 30% suffer from excessive daytime sleepiness. Both insomnia and excessive daytime sleepiness can bring about muscle strength loss, impaired mobility and balance, slower gait speed and awareness, often leading to accidents that could injure a senior. Other conditions, such as increased inflammation or insulin resistance, can also develop from these sleep disturbances.
According to a recent report by the International Psychogeriatrics Association, one in five older adults living in Europe with a functional impairment receives long-term care in a long-term care facility. Over 50% of these older adults suffer with dementia and often are challenged by some kind of neuropsychiatric symptoms throughout the progression of the disease. These patients commonly express challenging behaviors that include verbal and physical aggression, depression, agitation, wandering, sleep disturbances, oppositional behaviors, and psychotic symptoms. Presently, not many pharmacologic options exist for the treatment of neuropsychiatric symptoms. However, elderly residents with dementia are frequently prescribed psychotropic medications.
The prevalence of chronic wounds located in the lower extremity area is high among older adults. Not only can they be extremely deleterious and pose major health risks, they also increase socioeconomic burden because of the high expenses of wound care, long duration of healing time, increased complication rate and negative effect on patients’ and loved ones’ quality of life. Chronic wounds are related to heightened mortality and significant morbidity because of infection, loss of ability to perform daily activities, pain, and psychosocial issues. Health care clinicians must be trained to identify and diagnose wounds, as well as provide proper management of their etiology. The four most common chronic wounds are venous leg ulcers, diabetic foot ulcers, pressure ulcers, and arterial ulcers. Although there have been recent advances in wound care, care providers are still struggling to provide the best quality of care in this area, especially for elderly people living in nursing homes and assisted living facilities.
Falling is a serious issue in nursing homes and leads to deleterious consequences. Every year, 4% of falls result in fractures and 11% result in soft tissue damage. Patients who fall experience functional loss, self-imposed functional limitations due to fear of falling, and restraint from activity imposed by care givers.
This November, there will be an important proposition on the ballot that all advocates of older adults should be aware of. The Troy and Alana Pack Patient Safety Act, also known as Proposition 46, is a ballot initiative that will protect patients from corporate greed in healthcare services. It is imperative that anyone concerned with elder abuse vote Yes on Proposition 46.
Proposition 46 will accomplish three things: 1) require health care providers to check a uniform database before prescribing medication to prevent drug abuse; 2) require doctors to take a drug and alcohol test; and 3) increase the limits on noneconomic damages for medical malpractice cases.
Older adults take many prescription medications. National Institute on Drug Abuse states that, older adults make up more than a third of all outpatient prescription medication cost even though they are a minority of the general population. California currently has a database that monitors how medication is prescribed and dispensed to prevent various types of drug abuse. This is called the CURES program, or Controlled Substance Utilization Review, and is administered by the Department of Justice. Proposition 46 mandates that physicians and pharmacists check CURES before prescribing or dispensing medication. Doctors would be advised through CURES about existing prescription, especially for strong painkillers (such as Vicodin and OxyContin) that carry a high risk of abuse.
Throughout the 21st century, technology has evolved and become a monumental necessity in our everyday lives. The technological advancements have unfolded exponentially throughout recent years and have modernized prominent industries, including the medical field. According to the Boston Globe, a major innovation in the medical realm is the initiation of electronic medical records. Electronic Medical Records have many potential rewards but an unlimited amount of risks associated. The Obama administration “poured $30 billion in taxpayer subsidies into the push for digital medical records beginning in 2009, with only a few strings attached and no safety oversight of the vendors who sell the systems.” Accounting for the sudden push of electronic medical records by the government, multiple healthcare facilities including hospitals have adopted the electronic medical record system. Continue reading
It is becoming increasingly evident that pharmacological interventions should be a last resort when treating patients with dementia. Due to a lack of resources and staff most skilled nursing home facilities overlook non-pharmacological options. However, studies have shown that non-pharmacological treatments are a safer alternative for patients. While pharmacological interventions are an effortless option for nursing homes and hospitals, they fail to improve the state of the resident. These medications might look like they are improving the condition of the patient however, these drugs sedate them as their condition worsens. In some cases, it could cause sufferers of cognitive disorders to deteriorate rapidly and act out.
The staff at a facility may often focus on the cognitive deterioration of the sufferers of dementia. As such, other symptoms that are linked to dementia may be overlooked. These symptoms generally manifest themselves in the forms of agitation, aggression, eating disorders, loss of appetite, and abnormal vocalization. Many of these symptoms may also grow to be the cause of death. For example, eating disorders and loss of appetite can lead to malnutrition. Furthermore, the use of medications have side-effects including sedation, psychosis, tremors, and may even lead to falls. More recent cases show that the pharmacological treatment of dementia leads to reduced resident well-being and quality of life, and may even accelerate cognitive decline.
One may feel that by placing their loved ones under the care of a skilled nursing facility, they would be provided with quality care. Unfortunately, that is not always the case. An investigation began on March 29, 2013 when an employee at an assisted living facility, Alzheimer’s Care of Commerce in Jacksonville County contacted authorities to report cases of abuse. The Alzheimer’s Care of Commerce focuses on elders who are suffering from Alzheimer’s disease.
After some investigation, the facility was raided in July 2013. Authorities arrested twenty employees and the owner of the facility following claims that the staff assaulted, restrained, and over-medicated patients. The facility is currently facing a total of seventy two criminal charges. However, according to Mike Ayers, the special agent in charge of the Georgia Bureau of Investigation Athens regional office, there could be more charges. They will not know until the district attorney looks at the files. The abuses that are being reported are cruel, inhumane; and so severe that the case may be forwarded to a grand jury this May.