Saturday, July 14, 2012

More Abuse In Kentucky Nursing Homes

In fiscal 2011, state adult protection workers determined that abuse and neglect probably had occurred in about 28 percent of cases they investigated involving residents of Kentucky's nursing homes.That is up from fiscal 2010, when workers substantiated probable abuse in 18 percent of investigations involving long-term care residents, according to a report from the state."These are very disturbing statistics, and they reinforce the fact that we've got to get serious about elder abuse in nursing homes in Kentucky," Bernie Vonderheide, founder of Kentuckians for Nursing Home Reform said.The data comes from an annual report compiled in part by the Cabinet for Health and Family Services, titled Elder Abuse in Kentucky. The report says social workers conducted 2,090 investigations of adult abuse and neglect in nursing homes, assisted-living homes and other long-term care centers last year. Abuse and neglect probably occurred in 583 investigations, according to the report. Multiple investigations can involve a single resident.

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Wednesday, July 11, 2012

Florence nurse charged with neglecting patient

A 54-year-old registered nurse has been arrested in connection with the death of a patient at a local nursing home.
Elizabeth Rush, of 816 Marion St., was arrested Tuesday and charged with neglect of a vulnerable adult, according to Florence County Detention Center booking reports.
Rush's arrest was the result of an ongoing investigation into the death of a 76-year-old nursing home patient, Florence Police Maj. Carlos Raines said.
The patient's roommate and another staff member at the nursing home told police they informed Rush that the victim was having chest pains and needed assistance but she did nothing to help. The patient later went into cardiac arrest and died, according to the arrest warrant.
Rush was released from the detention center on a $25,000 personal recognizance bond Tuesday afternoon. The investigation is ongoing, Raines said.

Feeding tubes may worsen pressure ulcer risk

A new study led by Brown University researchers reports that percutaneous endoscopic gastric (PEG) feeding tubes, long assumed to help bedridden dementia patients stave off or overcome pressure ulcers, may instead make the horrible sores more likely to develop or not improve.
The analysis of thousands of nursing home patients with advanced dementia appears in the May 14 edition of the Archives of Internal Medicine.
“This study provides new information about the risks of feeding tube insertion in people with advanced cognitive impairment,” said lead author Dr. Joan Teno, a gerontologist and professor of health services, policy, and practice in the Public Health Program at Brown. “We see a substantial risk of people developing a stage II and higher pressure ulcer. We believe these risks should be discussed with family members before a decision is made to insert a feeding tube in a hospitalized nursing home resident with advanced cognitive impairment.”
In the new study, Teno and her team asked two basic questions: “How does having a gastric feeding tube affect the chances of preventing a stage II or greater pressure ulcer?” and “Does having a gastric feeding tube help heal an existing pressure ulcer?”
Previous studies, which were much smaller in scope, had produced inconclusive findings. By using a combination of federally gathered data from nursing homes and Medicare claims, the researchers essentially mimicked a randomized controlled trial through the use of “propensity match cohort” study. Over a particular timeframe, they compared thousands of patients with and without ulcers who received a feeding tube to three times as many statistically similar patients with and without ulcers who did not get a tube.

The risk of feeding tubes

What they found was that among patients who did not start with an ulcer, 35.6 percent of those with a feeding tube ended up with at least a stage II ulcer, while only 19.8 percent of patients without a feeding tube did. After statistical adjustment, they found that the chance of getting an ulcer was 2.27 times higher for people with feeding tubes than for those without. The risk of developing a more serious stage IV ulcer was 3.21 times higher for those with feeding tubes compared to hospitalized nursing home residents without a feeding tube.
Meanwhile, among patients who already had an ulcer, the researchers found that 27.1 percent of patients with a feeding tube saw short-term improvement, but 34.6 percent of those without a feeding tube experienced healing in a comparable timeframe. The adjusted odds of an ulcer getting better for people with a tube were 0.7 times as high for people without a tube, meaning their chances for improvement with a tube were less than for people without a tube.
The conventional wisdom among physicians — three-quarters of them according to one study — is that if anything, the nutrition delivered by feeding tubes should help patients resist ulcers. Perhaps with the idea of such a benefit in mind, physicians frequently don’t discuss the risks of feeding tubes with patients’ families, Teno has found.
The study did not measure how feeding tubes could cause ulcers, but Teno and her co-authors posit that because many patients become agitated by having a tube, they are often physically restrained and sedated with drugs. At the same time, feeding tubes can also increase the incidence of diarrhea. These circumstances, she said, may account for the development and worsening of pressure ulcers.
The new findings should lead doctors and families to ask more questions about whether feeding tubes are appropriate treatments, compared to careful hand feeding, for patients who have become so cognitively impaired that they can no longer eat independently, Teno said.
“To me this article is a game changer,” Teno said. “It provides solid evidence that there is a risk and that we need to discuss it. I’m hoping that people now can use this study to make better decisions in light of a patient’s goals and values.”
In addition to Teno, other authors of the paper were Pedro Gozalo, Sylvia Kuo, and Vincent Mor of Brown; Susan Mitchell of the Hebrew Senior Life Institute for Aging Research in Boston; and Ana Fulton of Butler Hospital.
The National Institute on Aging funded the study.
Feeding tubes may worsen pressure ulcer risk | Brown University News and Events

Sunday, July 08, 2012

Suit alleges neglect of residents at San Pablo nursing home

Five people have sued Creekside Health Care Center in San Pablo and its parent corporation, Mariner Health Care, alleging that patients in the nursing home are subjected to abusive conditions because of inadequate staffing levels.
The lawsuit, filed Monday by San Francisco law firm Stebner & Associates, alleges that Creekside residents are regularly left unattended for long periods, often in soiled garments, are overmedicated and develop preventable bed sores because of poor care.
The suit also alleges that inadequate staffing and security allowed a man visiting the facility to sexually assault four residents between January and May 2010.
Julio Mestre was arrested May 9, 2010, and later convicted of four counts of sexual battery on an institutionalized victim, according to the suit.
"During the assaults, residents screamed for help, sometimes for more than 30 minutes, but no one came," the lawsuit states.
"The reason for the lawsuit is to try to bring about change at this facility in a systemic way," attorney Kathryn Stebner said. "Our case includes small statutory damages, but the main focus is to force the owners of the facility to follow state and federal regulations."
Suit alleges neglect of residents at San Pablo nursing home - San Jose Mercury News