Nurses laugh as a 89-year-old veteran dies in nursing home

An 89-year-old World War II veteran in a nursing home bed called for help, saying he couldn’t breathe.

A hidden camera recorded nurses failing to take life-saving measures for the patient and laughing as he struggled to breathe, and eventually died. The man’s family had secretly recorded a video, which was kept from the public for 3 years until a television station, WXIA-TV, persuaded courts to unseal it.

The family of James Dempsey of Woodstock, Georgia, sued the Northeast Atlanta Health and Rehabilitation Center in 2014. Two nurses lost their licenses after the video was made public in September, with a link sent to the Georgia Board of Nursing. The nurses did not start CPR immediately and did not follow emergency procedures; then they laughed while trying to start his oxygen machine.

The nursing home issued a statement claiming that care has improved since the incident, under different leadership. But records show continued problems at the home, including $813,000 in Medicare fines since 2015.

Watch the video here: https://youtu.be/lU6NlK3OQDc

The video will probably cause families to think seriously about care options for their loved ones, including home care in some cases. A long term care insurance policy can support care either at home or in a facility. Find out more and get insurance quotes at Guide To Long Term Care.

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The rate of dementia among seniors is going down

The rate of Alzheimer’s and other forms of dementia among seniors has declined significantly over the last ten years, according to a new study.

The Einstein Aging Study followed 1400 men and women age 70 and older from 1993 through 2015. When they entered the study they did not have dementia. Carol Derby, research professor at the Albert Einstein College of Medicine in New York City, analyzed the data. The report was published in JAMA Neurology.

Of 369 people born before 1920, 73 ended up with dementia. Of 285 born 1920-24, 43 developed dementia. Of 344 born 1925-29, 31 developed dementia. Of 350 born after 1929, only 3 got dementia. Similar declining rates have been found in Europe.

Researchers say the reasons for the decline in dementia cases are not known, but there is also a declining rate of stroke and heart attack from one generation to another (though diabetes is increasing).

Efforts to prevent cardiovascular disease in recent decades may be paying off; the incidence of stroke has declined. Since dementia risk is correlated with the health of blood vessels in the brain, it makes sense that the rate of dementia is falling alongside the rate of strokes. A recent study found that healthy lifestyles, including exercise, good diet, no smoking, and proper treatment of chronic medical conditions could prevent 35% of dementia cases.

Although the rate of dementia is going down, the actual number of people with dementia is increasing dramatically as the baby boomer generation ages, inflating the percentage of elderly people in the U.S. population.

Around the world, more than 47 million people suffer from dementia, and 7 million new cases develop each year. The number of cases of dementia is projected to double every 20 years. The number of people with Alzheimer’s disease is expected to reach 106 million by 2050.

Dementia is one of the most expensive health conditions, costing patients and families in medical fees and caregiving time. Long term care insurance can help pay for the costs. You must insure before the diagnosis! For more information see the Guide To Long Term Care – Alzheimer’s.

 

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Want to live longer? Take care of someone

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Seniors who take care of others live longer than those who do not.

This observation comes from an international research project in which scientists analyzed data from the Berlin Aging Study that followed 500 adults over the age of 69 from 1990 to 2009. About half of the subjects took care of friends, children, or grandchildren; these caregivers were still alive 10 years after their first interview in 1990.

For those who took care of non-family members, half were still alive seven years after the first interview. For those seniors who did not take care of anyone, 50 percent had died within four years of the first interview.

However, moderation in caregiving is essential. Other studies have shown that too much caregiving responsibility is stressful and can endanger one’s health.

Long term care insurance can help pay for needed care at home or in an institution. Some companies offer a cash benefit that can be used to pay a friend or family member for care. Get more information here: GuideToLongTermCare.com

 

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Eye Scan for Alzheimer’s

Scanning the eyes is a new way to detect Alzheimer’s disease.

Researchers at Cedars-Sinai Medical Center in California say Alzheimer’s affects the retina, in the back of the eye, in a similar way to how it affects the brain. A high-definition eye scan can show the buildup of toxic proteins that indicate Alzheimer’s.

The plaque showing in the retina matches the plaque in a corresponding part of the brain. Through repeated scans of the retina over time, doctors will be able monitor the progression of the disease.

At one time, the only way to diagnose Alzheimer’s was by examining the brain after a person died. Now doctors can use brain scans to diagnose the disease in living patients, but these scans are expensive and invasive. The non-invasive eye scans will help doctors to detect the disease earlier, making it possible to intervene with medications and lifestyle changes before more symptoms appear.

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If you do not plan for your long term care who will? See the Guide To Long Term Care for more information on Alzheimer’s and how to prepare for long term care needs.

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Everyone should do some estate planning.

Everyone—regardless of how small their wealth—should do at least some estate planning. 

Some things to consider include:

• A will: This is the most basic of estate-planning documents, yet a Caring.com survey this year showed that more than half of Americans don’t have a will. That’s surprising and troubling all at the same time. A will can provide certainty and clarity and eliminate  the grey areas when property is moving from one generation to the next. Don’t just assume everything will end up with the people you want it to if you fail to leave specific instructions.

• A trust: Not everyone needs a trust, but it often makes sense. Basically, a trust allows you to control your assets from the grave. You can set certain restrictions, which is especially helpful if your kids are young or they don’t really manage money well. That way you may be able to keep them from blowing their inheritance all at once. For example, a restriction might be that they don’t receive the money until they earn a college degree.

• Power of attorney: It’s important to assign someone power of attorney so that if you become incapacitated that person can speak on your behalf and sign important documents. You can also have a living will to outline your wishes, which could help your family make tough decisions about your healthcare.

If you don’t plan for your long term care who will?

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Dying at Home

Most people (70%) want to die at home, in a familiar place surrounded by loved ones. However, only about 25% do. Nearly 50% of Americans die in a hospital, and another 20% die in a nursing home or long-term care facility.

The trend is for more people to die at home, with a 29.5 percent increase from 2000 to 2014, according to the Centers for Disease Control and Prevention. During the same time period, the percentage of deaths in hospitals, nursing homes and long-term care facilities has dropped.

Seven out of ten Americans die from chronic disease, and more than 90 million Americans are living with at least one chronic disease. The Centers for Disease Control (2007) listed the ten leading causes of death in America (in order):
1.
heart disease
2.
cancer
3.
stroke
4.
chronic lower respiratory disease
5.
accidents
6.
Alzheimer’s
7. diabetes
8.
influenza
9.
pneumonia
10.
kidney disease and sepsis.

Almost a third of Americans see ten or more physicians in the last six months of their life. And almost 30% of Medicare’s budget each year is spent on patients who are in the last 12 months of their lives.

According to LongTermCare.gov about 70% of Americans over age 65 will require long-term care. If a person has an extended illness requiring long-term care, long-term care insurance will help cover those expenses whether in a hospital or at home. Studies show that those with long-term care insurance stay at home longer because the insurance provides more money for care. This includes extra money for home modifications like a wheel-chair ramp, a medical alert system and a stair lift.

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It is often the lack of money that prevents people from staying at home when they need care. Who pays for long-term care? In some cases they will spend all their savings and now are forced to rely on Medicaid (welfare health care). With a Partnership asset-protection insurance policy you will be exempt from the Medicaid spend-down requirement, the exemption is based on the total benefits your policy has paid out for care.

More than 80% of patients with chronic diseases say they want to avoid being in a hospital or intensive care unit when they are dying. While dying at home is usually preferred by the patient, it can be difficult for the caregiver. Hospice services can help.

Hospice care is for those in the last six months of their lives. More than 88% of hospice patients are Medicare beneficiaries.

Traditionally, for a patient to qualify for Medicare-supported hospice, a doctor must certify that the patient has: a home, a diagnosis of six months or less to live, a full-time caregiver, and a willingness to give up curative care and receive only palliative care.

In 2016 the Medicare Care Choices Model began offering some patients “concurrent care”: the choice of continuing curative care while starting palliative care and hospice care. An evaluation of concurrent hospice in non-elderly patients showed this plan improves quality of life and reduces costs.

The Medicare hospice benefit emphasizes home care, with almost 60% of patients receiving their care at home as of 2014. Medicare coverage is limited, additional care would be paid for out-of-pocket. Do you really want to spend-down your hard-earned savings and investments leaving open the option that Medicaid will require your estate to repay Medicaid for your care costs? There are 30 states with a filial responsibility law that could require your family to reimburse Medicaid.

Home care is much less expensive. Inpatient hospice services are used when the patient’s pain and symptoms must be closely monitored in order to be controlled, when medical intervention is required to control pain or symptoms, or when the family needs a rest from the stress of care giving.

A hospice team arranges for doctors, nursing care, medical equipment like wheelchairs and walkers, medical supplies, prescription drugs, hospice aide and homemaker services, physical and occupational therapy, speech-language pathology services, social workers, dietary counseling, grief and loss counseling for the patient and family, short-term inpatient care, and short-term respite care.

After evaluation by a doctor, a patient can enroll in hospice care for two 90-day benefit periods, followed by an unlimited number of 60-day benefit extensions. A patient can decide to stop hospice care at any time.

A recently proposed bill, The Patient Choice and Quality Care Act of 2017 (H.R. 2797), aims to give patients and families living with advanced and life-limiting illnesses the information and services they need.

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Listening to their favorite music may help people with dementia

Nursing home residents with dementia had fewer behavior problems and were able to cut back on antipsychotic and antianxiety drugs when they listened often to their favorite music, according to a recent study.

Researchers at Brown University in Providence, RI studied over 25,000 residents in 196 nursing homes around the country. They used a program called Music & Memory which provides Alzheimer’s and dementia patients with individualized music playlists.

In a national campaign led by Medicare, gerontology experts and patient advocates are seeking non-pharmacologic interventions to reduce the use of antipsychotic and anti-anxiety medications.

In nursing homes that used the program, residents with dementia were more likely to discontinue antipsychotic and anti-anxiety medications, and engaged in fewer disruptive behaviors, than in homes where the music was not used. However, the study did not show a significant improvement in mood.06_ALIVE-INSIDE_Photo-Courtesy-of-BOND360

Caregivers and family members in a documentary called “Alive Inside,” say that personalized music helps even patients with highly advanced dementia. They observe that patients look more at ease after listening to their favorite music.

The researchers studied residents who had dementia and cognitive impairment, but were not in hospice care or comatose.

The rate of discontinuation of antipsychotics rose to 20.1 percent in 2013 compared to 17.6 percent in a similar period before. The discontinuation rate of anti-anxiety meds rose to 24.4 percent compared to 23.5 percent before. In the studied nursing homes that did not use the music program, the rates did not improve.

Behavioral improvement increased to 56.5 percent in program homes from 50.9 percent before the program. Improvement in the behavior of residents helps the treated patients, but also enhances the quality of life for residents around them. Also, improvement in patients’ behavior raises the morale of nursing home staff, and may reduce staff turnover.

The study was published in the American Journal of Geriatric Psychiatry. To improve their evaluation, Baier, Thomas and their colleagues plan to conduct a second study. 

Nursing home or memory care can be costly. Long term care insurance provides not only money for care but a support system for both those needing care and their families. For more about long term care and insurance visit GuideToLongTermCare

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