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Archive | December, 2011

Tools to Help Choose a Good Nursing Home

By Carolyn M. Clancy, M.D.

December 6, 2011

Finding a high-quality nursing home for a family member is a daunting task.

Many people have not had to make this decision before. And it’s often made under stress, when asking good questions and thinking carefully about your options are harder than usual.

Fortunately, more information is available that can help you learn about nursing home quality and prepare you to make a well-informed decision.

Start this process with an online tool from the Federal Government called Nursing Home Compare. This lets you look up nursing homes in your area by name, city, county, State, or ZIP Code. First unveiled in 2009, Nursing Home Compare has detailed information on every nursing home certified by Medicare or Medicaid.

Nursing homes are rated using a 1- to 5-star scale, with those earning 5 stars being rated the highest. Ratings are based on how many and what type of staff members they have, how well they perform on health inspections, and how they rank on quality measures. Ratings for each measure are given individually and are also combined into an overall rating.

Starting in 2012, Nursing Home Compare will include a new measure that includes input from the nursing home residents. This new information will take the place of the quality measures that currently appear on Nursing Home Compare. Findings will be part of the ratings starting in April 2012.

Staffing and health inspection data add important information and will continue to be a factor in each nursing home’s overall rating. The staffing measure tells you the average staffing levels—such as the number of registered nurses, licensed practical nurses, and certified nursing assistants—for each resident each day. This is a good benchmark, but it has limits. It does not show the number of nursing staff present at any given time or describe the amount of care give to any one resident. The health inspection measure looks at many major aspects of care in a nursing home. This includes how medicines are managed, whether food is prepared safely, and whether residents are protected from inadequate care. Inspections take place about once a year, but they may be done more often if the nursing home has several problems to correct.

Even with so much good information, the Nursing Home Compare tool and rating system won’t answer all of your questions. For example, the ratings won’t tell you if the nursing home has improved, or gotten worse, in certain areas since it was rated. That’s why it’s important to visit any facility you are considering. Be sure to ask questions of the staff, especially people who provide care to residents. It’s also a good idea to visit a nursing home a second time on a different day of the week and another time of day. You may get a better idea of changes in staff, activities, and other factors that could make a difference in your choice.

An excellent list of questions to ask during such visits is available from a nursing home checklist (PDF File; PDF Help) by the Centers for Medicare and Medicaid Services (CMS). And a new handbook (PDF File; PDF Help) from CMS explains how to pay for nursing home care, describes residents’ rights, and gives alternatives to nursing home care. Another good resource is your State ombudsman; select to find yours.

click here to read more.

Educational Video about the Medicare Program in ASL

The Centers for Medicare & Medicaid Services has a new educational video about the Medicare program in ASL for people who are deaf or hard of hearing. The video gives an overview of the Medicare program, including what Medicare is, who qualifies, the four parts (A, B, C and D), new preventive services under the Affordable Care Act, and help paying Medicare costs.

click here to learn more.

National Caregiver Support Line for Veterans

The Veterans Adminstration has established a National Caregiver Support Line for Caregivers of
Veterans — spouses, children, other family members and friends of Veterans as well as Veteran themselves.  

for more information on the program, please go to https://duttonelderlaw.com/resources/articles.html

Lewey Body Dementia Association Survey

The Lewey Body Dementia Association (LBDA) is conducting a survey to assess if there are differences in how grief is experienced by caregivers for individuals with Lewy bodies, Alzheimer’s disease, Parkinson’s disease with and without dementia, and frontotemporal degeneration.  The survey will also assess the well-being and quality of life for caregivers of individuals diagnosed with the neurodegenerative diseases. Internet access is required to participate in the study, and LBDA needs 500 caregivers who are currently providing care for each different disease that is being studied. 

http://www.lbda.org/go/caregiversurvey

Health Literacy and Older Adults

Health Literacy and Older Adults

CDC Releases Practical Advice on Developing Materials to Match the Health Literacy Skills of Older Adults. CDC’s health literacy web site (www.cdc.gov/healthliteracy) has a new section to help health and other professionals develop materials that will communicate more effectively with older adults and their caregivers. The web site includes self-assessments, background information on health literacy, steps to improve materials and links to resources about older adults and caregivers. The new content builds on CDC’s expert panel report on older adults and health literacy issues. 

www.cdc.gov/healthliteracy/DevelopMaterials/Audiences/index.html

 

Four Drugs Cause Most Hospitalizations in Older Adults

Blood thinners and diabetes drugs cause most emergency hospital visits for drug reactions among people over 65 in the United States, a new study shows.

Just four medications or medication groups — used alone or together — were responsible for two-thirds of emergency hospitalizations among older Americans, according to the report. At the top of the list was warfarin, also known as Coumadin, a blood thinner. It accounted for 33 percent of emergency hospital visits. Insulin injections were next on the list, accounting for 14 percent of emergency visits.

Aspirin, clopidogrel and other antiplatelet drugs that help prevent blood clotting were involved in 13 percent of emergency visits. And just behind them were diabetes drugs taken by mouth, called oral hypoglycemic agents, which were implicated in 11 percent of hospitalizations.

All these drugs are commonly prescribed to older adults, and they can be hard to use correctly. One problem they share is a narrow therapeutic index, meaning the line between an effective dose and a hazardous one is thin. The sheer extent to which they are involved in hospitalizations among older people, though, was not expected, said Dr. Dan Budnitz, an author of the study and director of the Medication Safety Program at the Centers for Disease Control and Prevention.

“We weren’t so surprised at the particular drugs that were involved,” Dr. Budnitz said. “But we were surprised how many of the emergency hospitalizations were due to such a relatively small number of these drugs.”

Every year, about 100,000 people in the United States over age 65 are taken to hospitals for adverse reactions to medications. About two-thirds end up there because of accidental overdoses, or because the amount of medication prescribed for them had a more powerful effect than intended.

As Americans live longer and take more medications — 40 percent of people over 65 take five to nine medications — hospitalizations for accidental overdoses and adverse side effects are likely to increase, experts say.

In the latest study, published in The New England Journal of Medicine, Dr. Budnitz and his colleagues combed through data collected from 2007 to 2009 at 58 hospitals around the country. The hospitals were all participating in a surveillance project run by the C.D.C. that looks at adverse drug events.

A common denominator among the drugs topping the list is that they can be difficult to use. Some require blood testing to adjust their doses, and a small dose can have a powerful effect. Blood sugar can be notoriously hard to control in people with diabetes, for example, and taking a slightly larger dose of insulin than needed can send a person into shock. Warfarin, meanwhile, is the classic example of a drug with a narrow margin between therapeutic and toxic doses, requiring regular blood monitoring, and it can interact with many other drugs and foods.

“These are medicines that are critical,” Dr. Budnitz said, “but because they cause so many of these harms, it’s important that they’re managed appropriately.”

One thing that stood out in the data, the researchers noted, was that none of the four drugs identified as frequent culprits are typically among the types of drugs labeled “high risk” for older adults by major health care groups. The medications that are usually designated high risk or “potentially inappropriate” are commonly used over-the-counter drugs like Benadryl, as well as Demerol and other powerful narcotic painkillers. And yet those drugs accounted for only about 8 percent of emergency hospitalizations among the elderly.

Dr. Budnitz said that the new findings should provide an opportunity to reduce the number of emergency hospitalizations in older adults by focusing on improving the safety of this small group of blood thinners and diabetes medications, rather than by trying to stop the use of drugs typically thought of as risky for this group.

“I think the bottom line for patients is that they should tell all their doctors that they’re on these medications,” he said, “and they should work with their physicians and pharmacies to make sure they get appropriate testing and are taking the appropriate doses.”

link to original posting in the New York Times.

 

Medicare D

Just a reminder, Medicare beneficiaries have until December 7 to enroll in, or change, Medicare D coverage.

For Resources on Medicare D, please go to www.medicare.gov; www.medicareinteractive.org; www.insurance.illinois.gov/ship

Who Are We?

Dutton & Casey, PC (Elder and Disability Law)

Advocates for Elders, Persons with Disabilities, and their Loved Ones.

The law firm of Dutton & Casey, P.C., is committed to serving our clients with the comprehensive and personally tailored service they need and deserve. With 50 years of combined legal experience, we have acquired the depth and breadth of knowledge necessary to address the full scope of elder law and disability issues. 

Our Areas of Concentration:

  • Medicaid Eligibility
  • Elder Abuse, Neglect, and Financial Exploitation Litigation
  • Estate and Disability Planning
  • Guardianship
  • Litigation
  • Mental Health Law
  • Probate Administration
  • Public Benefits
  • Special Needs Planning
  • Trust Administration

* Full Time Social Worker/Certified Care Manager On Staff

Office Locations:

Arlington Heights, Chicago, Skokie, and Vernon Hills, Illinois.

Phone / Video Conferencing  Appointments are also Available.

Contact Information:

Telephone:      312-899-0950 or 847-261-3584

Website:          www.duttonelderlaw.com 

 

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