South Carolina Nursing Home Lawyer & Attorney : Poliakoff & Associates Law Firm : Elderly Care, Senior Care

Studies show a significant decline in quality of nursing home care for blacks compared to whites.
Elderly black Americans in nursing homes get worse care than that enjoyed by their white counterparts.  "If you're black, you're much more likely to get your care in a nursing home that's not so good, relative to nursing homes that are serving predominantly white patients," Dr Vincent Mor, head of the department of community health at Rhode Island-based Brown University's school of medicine, told AFP on Tuesday.

Mor was a lead author of the study which looked at "racial segregation in US nursing homes and its relationship to racial disparities in the quality of care."  The study cited race data from nursing homes found US nursing homes remain relatively segregated by race.

"Blacks are much more likely than whites to be located in nursing homes that have serious deficiencies, lower staffing ratios, and greater financial vulnerability," the study showed.

Another study led by Brown University researchers and due to be published in June in the Health Services Research medical journal, looked at the rate of hospitalization of nursing home residents.
That study showed that 24.1 percent of black nursing home residents required hospitalization  compared with 18.5 percent white residents.   It found that nursing homes "with high concentrations of blacks had 20 percent higher odds ... of hospitalization than residents in nursing homes with no blacks", and linked the quality of care to the reimbursement policies of Medicaid, the US program for those unable to pay for healthcare.

The rate of hospitalization was an indicator of performance, as were "a whole variety of different measures of quality in terms of regulatory compliance, staffing levels, and so on," Mor explained.

"Both studies clearly suggest that nursing homes which have a predominance or much higher proportion of African-American residents perform more poorly," Mor said.

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Extending Life, Waiting for Death at Nursing Home in Florida

Review by Dave Shiflett

Jan. 14 (Bloomberg) -- Growing old isn't for sissies. Anyone who doubts that should tune into ``Andrew Jenks, Room 335,'' which airs on Cinemax tomorrow at 7 p.m. New York time.

The 90-minute film about life and death at a Florida assisted-living facility is depressing and inspiring. It provides a peek into the likely futures of millions of baby boomers, who may want to ditch all those life-stretching diets and exercise regimens when they see what awaits them.

Jenks was 19 when he spent a month at the posh Harbor Place near Port St. Lucie. From the outside, it looks like a fancy hotel. Inside, time has stripped many residents to the bone.

The opening shots show faces familiar to anyone who has ever visited a nursing home: residents snoozing in wing chairs, heads tilted back, eyes closed tight and mouths wide open. The smartest fashion accessory may be a drool bib.

``All your friends die on you,'' a resident says. ``You miss the people you had so much fun with all your life. They go one by one.''

``My bones are like lace,'' says another.

Yet many residents still have some fire in their bellies, even if their eyes, ears and bladders aren't fully dependable.

Bill, a gruff 80-year-old Army vet, is fond of Hawaiian shirts, twisting arms and playing the tough guy. Yet he walks over a mile each day to buy chocolate bars that he shares with his less-mobile companions.

Pig Latin

Then there's Tammy, a spry and chirpy 95-year-old who is scared of elevators and wields a sharp tongue. ``I can't understand that pig Latin you use,'' she tells one pal. Tammy keeps her spirits up even after a bum heart lands her in the hospital.

A sense of resignation seems to prevail, though Jenks does find an undercurrent of resentment. When he asks Tammy why there are no blacks or Hispanics at the facility, she insists those ethnic groups take care of their elderly members at home.

``Years ago, nobody ever got sent to a place like this,'' she says. ``This generation can't be bothered.''

The long days are punctuated by bingo games and watching ``Jeopardy.'' One resident tries to play ``Edelweiss'' on the piano, but her efforts are doomed by all the sour notes.

Death is never far away. We see a shriveled woman named Dotty, who has no immediate family, gasping for air in a hospital bed with a few friends and a priest hovering nearby.

At one point, Jenks tells Dotty he would like to say a prayer. Suddenly, she lifts her ancient hands and clasps them. Dotty died soon thereafter.

Jenks was clearly moved by his month at Harbor Place.

``We're all going to grow old at some point,'' he notes. ``Does this mean we're going to be neglected, too?''

Here's the lesson I learned: Longevity, like most other things, should be taken in moderation.

(Dave Shiflett is a critic for Bloomberg News. The opinions expressed are his own.)

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Spectrum News has an article discussing a study that shows elderly citizens to fear nursing homes and loss of independence more than death. 

89% of America’s seniors want to age-in-place and are willing to use adaptive technology allowing them to maintain their independence, according to a study commissioned by Clarity and the EAR Foundation. The same study found that their boomer children share the same concerns and are willing to support their parent’s efforts. 

In a recent survey, seniors rated loss of independence (26 percent) and moving out of their home into a nursing home (13 percent) as their greatest fears. Death was listed as a fear by only 3 percent of the respondents.

Seniors cited three main threats to their independence. Health problems were the main consideration followed closely by memory problems and the inability to drive.   Most seniors stated an openness to new technologies that help them avoid nursing homes.

The children of seniors, today’s boomers, were also interviewed and their answers echoed the parental desires and concerns over aging in place and living independently.   The vast majority (94 percent) feel that it’s important their senior parents are able to age-in-place. More than three-fourths (79 percent) are concerned about their parents’ ability to do so, and more than half (57 percent) are very concerned.

Despite the boomers’ parents’ belief that they receive no support from their children, 63 percent of the boomers surveyed stated that they are providing some kind of assistance to allow their parents to age-in-place. Much of the assistance reportedly provided by boomers was with household maintenance, transportation, medical issues, help with financial decisions and financial support.

Surprisingly, senior parents appeared to be more open to aging-in-place technology than their boomer children. Only 14 percent of the tech-savvy boomers have actually looked into technological solutions to help them ensure the health and safety of their parents.

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I do not understand how nursing homes continue to say that they can't make any money taking care of their residents.  The corporate executives of Manor Care will get more than $200 million for their sale to the Carlyle Group.  See the article here.

The head of America’s biggest nursing-home company is about to get intensive financial treatment. 

Chief Executive Paul Ormond will receive $118 million to $186 million from cashing in his company stock when the deal is completed this year.  Sixteen other top executives and recently retired officers at the firm to be purchased by the Carlyle Group, of Washington, can receive a total of $68 million for their stock.

In total, Manor Care officials stand to receive $200 million or more from their stock holdings.

The amount to be paid by Carlyle, a global private-equity firm that owns stakes in more than 500 companies and real-estate developments, may not be known for weeks.

The buyer said it will purchase Manor Care for $6.3 billion and hopes to complete the deal by the end of the year.

Mr. Ormond, CEO and chairman of the company that had $167 million in profits on $3.6 billion in revenue last year, is typically among the top-compensated corporate CEOs locally each year. Last year, he was compensated $18.8 million, an SEC filing shows.

The biggest chunk of looming stock payouts from Carlyle are to Mr. Ormond, whose 1.8 million company shares will be worth more than $118 million. They could be worth another $68 million if options on another 1.9 million shares he has are exercised for prices ranging from $20 to $53 each.

But the most recent regulatory filings show $55.5 million in stock payments could go to R. Jeffrey Bixler, former vice president and general counsel; Geoffrey Meyers, former executive vice president and chief financial officer; and M. Keith Weikel, former senior executive vice president and chief operating officer.

Company officers, directors, key employees, and some retirees stand to collect about $200 million for their existing stock, and possibly more than $250 million if unexercised stock options can be cashed in, the new SEC filings show.

Manor Care, No. 565 on the Fortune 1,000 list of the largest U.S. corporations, was once part of Owens-Illinois Inc. and started acquiring health-care facilities in the early 1980s. It spun off and became Health Care & Retirement Corp. and in 1998 merged with Manor Care Inc. of Gaithersburg, Md.

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Movie explores love, life and Alzheimer’s Disease in nursing home setting.

A new movie, “Away From Her,” is set in a nursing home and examines a couple’s struggle with Alzheimer’s Disease as well as love within the context of life and aging.   An Ontario couple who has been married for over 40 years decides to seek nursing home placement for the wife (played by Julie Christie) after she wanders away from home.

For the first time in the five decades of their relationship, they are forced to undergo a long separation since the nursing home has a “no-visitors” policy for the first 30 days of a resident’s stay so they can adjust to their new surroundings. When the husband visits after the adjustment period, he is devastated to find out that not only has his wife seemingly forgotten him, she has transferred her affections to another man. The other man, also a nursing home resident, is mute and wheelchair-bound. The husband then starts spending time with the male resident’s wife, played by Olympia Dukakis. Dukakis’ own mother had Alzheimer’s Disease.

Source: www.npr.org, May 16, 2007; http://www.imdb.com/title/tt0491747/

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How do I blame thee?  Let me count the ways

Trial; May, 2006

Lynn R. Laufenberg’s article discussing the "blame the patient" defense in medical malpractice litigation is divided into three categories, each one relates to a different way the plaintiff can be blamed for the negligent care received. The author describes each one and offers suggestions on how to counter-act this type of affirmative defense through discovery, pretrial motions, and jury instructions.

Laufenberg first discusses contributory negligence and offers the example of a past case in which Susan, a life-long smoker, sought treatment from a new primary care physician for a chronic cough. Chest films reviewed by a radiologist revealed an abnormality in the upper lobe of Susan’s right lung and recommended a comparison with prior films. The comparison was never done and when Susan presented with persistent cough and shortness of breath to another doctor in the same group two years later, a CT scan was ordered. The scan revealed a four-centimeter mass in the upper lobe of the right lung. The malignant mass was too far advanced to be removed and chemotherapy and radiation treatment were unsuccessful. Susan died a year later.

During litigation the defense asserted contributory negligence as an affirmative defense saying that Susan’s doctor had repeatedly explained the risks of smoking, that she caused her cancer by smoking and continuing to smoke after being diagnosed with lung cancer. The plaintiff filed pretrial motions to preclude mention of contributory negligence at trial on the basis that case law "recognizes that the plaintiff seeks compensation only for those injuries that the failure or delay caused. The physician’s duty is to accurately diagnose and properly treat the outpatient’s condition, regardless of the circumstances that produced it." The author continues by saying most courts dictate that a patient’s conduct must be concurrent or contemporaneous with the physician’s negligence to be considered contributory.

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TO REMEMBER ME

The day will come when my body
will lie upon a white sheet neatly tucked
under four corners of a mattress located in a
hospital busily occupied with the living and the dying.
At a certain moment a doctor will determine
that my brain has ceased to function and that,
for all intents and purposes, my life has stopped.

When that happens, do not attempt to instill
artificial life into my body by the use of a machine
and don't call this my deathbed. Let it be called the
Bed of Life, and let my body be taken from it
to help others lead fuller lives.

Give my sight to the man who has never seen
a sunrise, a baby's face or love in the eyes of a woman.

Give my heart to a person whose own heart has
caused nothing but endless days of pain.

Give my blood to the teen-ager who was pulled
from the wreckage of his car, so that he might live
to see his grandchildren play.

Give my kidneys to one who depends on a
machine to exist from week to week.

Take my bones, every muscle, every fiber and nerve
in my body and find a way to make a crippled child walk.

Explore every corner of my brain. Take my cells,
if necessary, and let them grow so that someday,
a speechless boy will shout at the crack of a bat and
a deaf girl will hear the sound of rain against her window.

Burn what is left of me and scatter the ashes to
the winds to help the flowers grow.

If you must bury something, let it be my faults,
my weaknesses and all prejudice against my fellow man.

Give my sins to the devil.

Give my soul to God.

If, by chance, you wish to remember me, do it with
a kind deed or word to someone who needs you.

If you do all I have asked, I will live forever.

by Robert N. Test

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