Tuesday, April 20, 2021
Here are some of the highlights:
Facilities should allow indoor visitation at all times and for all residents except in certain specific circumstances.
There are now fewer circumstances under which indoor visitation can be completely suspended.
Fully vaccinated residents can have close contact, including touch, with visitors as long as they wear a mask and practice hand hygiene.
Visitors should not be required to be tested or vaccinated as a condition of visitation.
CMS continues to emphasize that facilities shall not restrict visitation without a reasonable clinical or safety cause and that nursing homes must facilitate in-person visitation consistent with the federal nursing home regulations.
Visitation must be person-centered and “consider the resident’s physical, mental, and psychosocial well-being, and support their quality of life.”
The summaries and significant takeaways are available here.
As well the Consumer Voice has released the Summary of the Centers for Disease Control and Prevention's Guidance on Quarantine for Residents of Long-Term Care Facilities, which is available here.
Monday, April 19, 2021
The National Consumer Coalition for Quality Long Term Care announced the release of a podcast, The Care For Individuals With Dementia. Here's a description of the podcase.
When the needs of residents living with dementia are met, incidences of resident stress are significantly reduced. Practicing person-centered approaches and interventions increase the likelihood that the message being communicated by the resident will be heard and addressed, leading to better outcomes and more satisfaction for the individual. In this episode of the Pursuing Quality Long-Term Care podcast, Dr. Jonathan Evans and Lori Smetanka of Consumer Voice talk about caring for human beings with dementia.
The podcast can be accessed here.
Thursday, April 15, 2021
Kaiser Health News ran an interesting story about aid in dying in Montana. Getting a Prescription to Die Remains Tricky Even as Aid-in-Dying Bills Gain Momentum
[I]n 2009, the Montana Supreme Court had, in theory, cracked open the door to sanctioned medically assisted death. The court ruled physicians could use a dying patient’s consent as a defense if charged with homicide for prescribing life-ending medication.
However, the ruling sidestepped whether terminally ill patients have a constitutional right to that aid. Whether that case made aid in dying legal in Montana has been debated ever since. “There is just no right to medical aid in dying in Montana, at least no right a patient can rely on, like in the other states,” said former state Supreme Court Justice Jim Nelson. “Every time a physician does it, the physician rolls the dice.”
The article discusses the legislative efforts on both sides of the issue. Fascinating story!
The elder justice legislation found in this document was elicited and finalized from the National
Center on Elder Abuse (NCEA) Listserv and independent websites in February 2021. The
compilation is intended to reflect highlights across the nation and does not include all legislation related to elder justice. However, updates will be sent biannually and states are encouraged to send updates on significant legislative action to Ageless Alliance. This document reflects activity in 15 states and highlights at the federal level.
In addition to summaries by state, the highlights include links to the individual legislation.
Oh and btw, mark your calendars now for the 2021 World Elder Abuse Awareness Day, June 15, 2021.
Tuesday, April 13, 2021
WGBH, a PBS station, ran this story a bit ago. New Studies Show Dire State Of Nursing Homes Even Before The Pandemic opens with a focus on staff turnovers and highlights recent studies:
The pandemic has shined a harsh spotlight on nursing homes. Despite less than 1% of the population living in nursing homes and longterm care facilities, they account for about a third of all COVID-19 deaths. Now, two new national studies show that, even before the pandemic, the nursing home industry was in a dire situation. The studies paint a picture of places where it is unappealing to work and risky to stay.
[T]he first national study of staff turnover in nursing homes before the pandemic, published this month in Health Affairs. The study found an extraordinarily high rate of staff turnover, with an average of over 100%.
“That means the average nursing home in the U.S. has their entire nursing home staff change over the course of the calendar year,” [said one study author]. “And we found that some nursing homes had turnover as high as 300%, suggesting the staff is turning over every four months.”
That doesn't necessarily mean that all employees leave during a year. A facility with 10 staff members could have 100% turnover if everyone leaves and is replaced by a new person or if one job is filled 10 different times because the new hires keep leaving.
The article also discusses private equity involvement in the long term care industry.
Monday, April 12, 2021
If you haven't seen this yet, check out the new website, Alzheimers.gov. This site compiles a significant amount of great info. As the website explains
Alzheimers.gov is the federal government portal to information and resources on Alzheimer’s disease and related dementias, including Lewy body dementia, frontotemporal disorders, and vascular dementia. Alzheimers.gov is managed by the National Institute on Aging (NIA) at the National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services (HHS). HHS is the U.S. government’s principal agency for enhancing the health and well-being of all Americans.
. . .
A primary goal of Alzheimers.gov is to connect people to the many federal resources available to educate and support people whose lives are touched by these devastating diseases in their various roles. Whether you are living with dementia, a family member or friend, health care provider or other health care professional, researcher, or advocate, Alzheimers.gov is designed for you.
. . .
Sunday, April 11, 2021
Pew's recent FactTank released this, 7% of Americans don’t use the internet. Who are they? Want to take a guess who are in this 7%? "Internet non-adoption is linked to a number of demographic variables, but is strongly connected to age – with older Americans continuing to be one of the least likely groups to use the internet. Today, 25% of adults ages 65 and older report never going online, compared with much smaller shares of adults under the age of 65." There is also a correlation between education and the income of a household with being online. There has been some movement. "For example, 86% of adults ages 65 and older did not go online in 2000; today that figure has fallen to just a quarter." Think about this info and recall how important technology use became during COVID.
Thursday, April 8, 2021
A recent study, Family Matters: Multigenerational Living Is On The Rise And Here To Stay, was recently published.
Generations United wanted to learn more about the effect of the vast COVID-19 pandemic on multigenerational living specifically, and at the end of January 2021 commissioned a public opinion poll, conducted online by The Harris Poll, to determine if multigenerational households were growing and what makes them tick. The survey results reported here give us insights as to the growth, why families plan to continue living together – and why it helps them be strong and resilient.
The findings are very interesting:
Our results are clear: multigenerational living is indeed on the rise in 2021, with more than 1 in 4 Americans (26%) living in a household with 3 or more generations. Given our finding in 2011 that 7 percent of Americans lived in a multigenerational household,4 this means that multigenerational living has nearly quadrupled in the past decade (a 271 percent increase from 20115 to 2021). This finding is incredibly striking, and our survey reveals some of the impetus for this staggering growth. As expected, the pandemic does play a strong role. Among those living in a multigenerational household, nearly 6 in 10 (57%) say they started or are continuing to live with multiple generations because of the pandemic.
The full report is available here.
Wednesday, April 7, 2021
Published recently in the Washington Post, Diane Rehm tackles ‘death with dignity’ again, this time in a new documentary. "In 2016, Diane retired from NPR station WAMU after working there for more than 30 years. Since then, she has championed what she and other advocates call “death with dignity.” On Wednesday, PBS will broadcast her new documentary, 'When My Time Comes.'" The article is a Q&A with the author about her book and the resulting documentary. Check it out!
Tuesday, April 6, 2021
The Long Term Care Community Coalition is offering a webinar on April 20, 2021 at 1 eastern on an Antidote to Ageism in Nursing Homes. Here's the description
Residents thrive when helped to achieve their highest practicable level of physical, mental, and psychosocial wellbeing. When the requirements of the Nursing Home Reform Act of 1987 are realized, the colonial, custodial injustice of long-term scare will finally end. In this webinar, Cathy Unsino, LCSW, will talk about how to transform nursing homes into warm, vibrant communities in which residents and staff thrive.
Click here to register.
POLST and other advance medical planning should not be a one-time conversation according to a recent study.
Two new studies from Indiana University and Regenstrief Institute focus on POLST, a medical order form widely used in nursing homes that documents what life-sustaining treatments a person prefers to receive or not receive, such as hospitalization or comfort-focused care. The studies, published online ahead of print in the Journal of the American Geriatrics Society (JAGS), found discrepancies between medical orders recorded in the POLST form and nursing home residents’ (or surrogate decision-makers, for those unable to make their own decisions) current treatment preferences and explore reasons for the lack of agreement.
The researchers found that less than half of all POLST forms of the 275 study participants matched current treatment preferences for resuscitation, medical interventions, and artificial nutrition. However, the POLST was more than five times as likely to agree with current treatment preferences when these orders reflected preferences for comfort-focused care. In interviews, participants reported the mismatch was due to factors including a lack of key information when they filled out the form and not revisiting POLST when the resident experienced a change in condition.
Thanks to my friend Morris Klein for sending me the link to this story.
Friday, March 26, 2021
Published a few days ago in the New York Times, Fully Vaccinated and Time to Party: If You Are 70, notes "[o]der people, who represent the vast majority of Americans who are fully vaccinated against the coronavirus, are emerging this spring with the daffodils, tilting their faces to the sunlight outdoors. They are filling restaurants, hugging grandchildren and booking flights." The article features a number of elders who are resuming their pre-COVID lives now that they have been vaccinated. Or, as the author describes it, "[f]or now, about two-thirds of Americans over 65 have started the vaccination process and nearly 38 percent are fully vaccinated, compared with 12 percent of the overall population, giving the rest of the nation a glimpse into the after times."
The stories will make you smile.
Thursday, March 25, 2021
The World Health Organization released the Global Report on Ageism, which "outlines a framework for action to reduce ageism including specific recommendations for different actors (e.g. government, UN agencies, civil society organizations, private sector). It brings together the best available evidence on the nature and magnitude of ageism, its determinants and its impact. It outlines what strategies work to prevent and counter ageism, identifies gaps and proposes future lines of research to improve our understanding of ageism."
The executive summary is available here, discussing nature, scale, determinants, and impact of ageism, as well as strategies to reduce it and suggestions for actions. The entire 202 page report is available here.
Wednesday, March 24, 2021
First, have you read this article from the New York Times? Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public
Twelve years ago, the U.S. government introduced a powerful new tool to help people make a wrenching decision: which nursing home to choose for loved ones at their most vulnerable. Using a simple star rating — one being the worst, five the best — the system promised to distill reams of information and transform an emotional process into one based on objective, government-blessed metrics.
The star system quickly became ubiquitous, a popular way for consumers to educate themselves and for nursing homes to attract new customers. During the coronavirus pandemic, with many locked-down homes unavailable for prospective residents or their families to see firsthand, the ratings seemed indispensable.
But a New York Times investigation, based on the most comprehensive analysis of the data that powers the ratings program, found that it is broken.
Then, a couple days later, another article from the New York Times, this time about California, California Sues Nursing Home Chain, Saying It Manipulated Ratings System
California prosecutors sued the country’s largest chain of senior living communities on Monday, accusing the company, Brookdale Senior Living, of manipulating the federal government’s nursing-home ratings system.
* * *
The lawsuit is among the first of its kind to accuse nursing homes of submitting false information to Medicare’s ratings program. The system assigns stars — one being the worst, five being the best — to the nation’s more than 15,000 nursing homes.
Health News Florida explained that COVID Cases Plummet 83% Among Nursing Home Staffers Despite Vaccine Hesitancy, "Federal records show a steep decline in staff cases since December, when health care workers at thousands of nursing homes began getting their shots. Still, many are reluctant to get vaccinated."
Then, this New York Times article from Canada, Elderly, Vaccinated and Still Lonely and Locked Inside
Long-term care homes, as they are called in Canada, were prioritized for the first precious doses of vaccines, to few objections — they were ground zero for the pandemic’s cruel ravage. Around 66 percent of the country’s terminal Covid-19 victims lived in nursing homes, among the highest rates in the world.
But while the vaccines have given the majority of nursing-home residents protection from death by the virus, so far they have not offered more life....
March 24, 2021 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, International | Permalink | Comments (0)
Tuesday, March 23, 2021
DOJ's Elder Justice Initiative is offering this webinar, Tackling Transnational Robocall Scams: The Importance of State and Federal Partnerships on April 13 at 2 eastern time. Here's info about the webinar
Consumers report losing approximately $500 million per year to phone scams. Phone scammers often impersonate government officials, such as officials with the Social Security Administration, FBI, IRS, and local law enforcement entities. This webinar will discuss what the scams are and how they work. It will delve into local and state law enforcement’s vital role in the fight against these scams. It will also describe investigative techniques that state and local law enforcement can use in the fight against transnational scammers. Finally, it will touch upon public education tools that can help community members protect themselves from scammers.
Jolee Porter, Assistant US Attorney, Northern District of Georgia, currently detailed to the Transnational Elder Fraud Strike Force at the US DOJ Consumer Protection Branch
Senior Special Agent Jon Heslep, Office of Inspector General, Social Security Administration
Detective Margaret Moore, Aiken Department of Public Safety, South Carolina
To register, click here.
Sunday, March 21, 2021
Kaiser Health News recently published a story, Texas Winter Storm Exposes Gaps in Senior Living Oversight. The storm
brought power failure and burst water pipes to millions of homes and businesses throughout Texas. But the impact, as is often the case in emergencies, was most profound on the state’s most vulnerable — including residents of senior living facilities.
Of the state’s 1,200 nursing facilities, about 50% lost power or had burst pipes or water issues, and 23 had to be evacuated, said [the] long-term care ombudsman for Texas. Of 2,000 assisted living facilities, about 25% had storm-related issues and 47 were evacuated. Some facilities reported building temperatures in the 50s.
The article discusses revisions to the regulations regarding emergency preparedness and the industry's responses, as well as the issues with other types of supportive housing. The article also highlights how these "disasters of a century" are actually occurring more frequently, and the focus on disaster preparedness includes a conversation about requiring facilities to have generators. "In Texas, assisted living facilities are required to have emergency plans but not generators. The legislation introduced in the wake of [the recent] winter storm ... seeks to change that. Independent living facilities ... might not be covered, though; they already have even fewer state guidelines to follow."
Friday, March 19, 2021
Educate yourself on the various scams, how they work and how to protect yourself by listening to these 7 podcasts from the New York Times. 7 Podcasts About the Art of the Scam "delve deeper into scam stories you may already know from the headlines ... and also illuminate some less familiar, like the extraordinary saga of how thousands of people were conned into blowing their life savings on a plot of worthless land in California."
Thursday, March 18, 2021
California has released its Master Plan FOR Aging. Here's the rationale for having a master plan:
Aging is changing and it’s changing California. California’s over-6o population is projected to diversify and grow faster than any other age group. By 2030, 10.8 million Californians will be an older adult, making up one-quarter of the state’s population.
The Master Plan for Aging outlines five bold goals and twenty-three strategies to build a California for All Ages by 2030. It also includes a Data Dashboard on Aging to measure our progress and a Local Playbook to drive partnerships that help us meet these goals together.
This is not a plan simply for today’s older adults. Instead, the Master Plan is a blueprint for aging across the lifespan. The Master Plan calls on all California communities to build a California for All Ages: for older Californians currently living through the many different stages of the second half of life; for younger generations who can expect to live longer lives than their elders; for communities of all ages – family, friends, neighbors, coworkers, and caregivers – surrounding older adults. As Californians, we can create communities where people of all ages and abilities are engaged, valued, and afforded equitable opportunities to thrive as we age, how and where we choose.
The five goals address health, housing, equity and inclusion, affordable aging, and caregiving. The plan is available here.
PHI issued a report regarding the direct care workers and the California Master Plan For Aging. Quality Jobs Are Essential: California’s Direct Care Workforce and the Master Plan for Aging
[P]rovides a detailed overview of the state’s direct care workforce and examines how California’s Master Plan for Aging can improve jobs for this rapidly growing workforce. It describes how the Master Plan supports this workforce, highlights where it incorporated the LTSS Subcommittee’s recommendations, and proposes where and how the Master Plan can be strengthened. This report also includes various stories from direct care workers in the state.
The report is available here for download.
Wednesday, March 17, 2021
The housing market is hot! We didn't need this New York Times article to tell us that, but it does and tells us more. In this article, Where Have All the Houses Gone? let's start with this quote: "[a] majority of homeowners in America are baby boomers or older — a group at heightened risk from the coronavirus. If many of them have been reluctant to move out and downsize over the past year, that makes it hard for other families behind them to move in and upgrade.... There are lots of steps along the “property ladder,” ... that are hard to imagine people taking mid-pandemic: Who would move into an assisted living facility or nursing home right now (freeing up a longtime family home)?"
This article is not about the Boomers and home ownership, but since this is the elderlawprof blog, I thought it was important to mention the elder-aspect of this housing boom. There are lots of reasons why the housing market is so tight, and the article explains them well.
Tuesday, March 16, 2021
Check out this new factsheet from the National Center on Elder Abuse, Role of Guardian Standards
in Addressing Elder Abuse. This five page fact sheet answers 16 wide-ranging FAQs and includes resources both within some of the FAQs and at the end of the fact sheet. It's worth checking out!