Everyone has his or her own favorite song – a song that reminds them of a happier time or place, something that can put a smile on their face. Now the Maplewood Nursing Home in Bloomer is taking that knowledge and running with it, providing music therapy to its nursing home patients.
The residents at the nursing home receive their own personal playlist after the staff discusses their musical tastes. For some that might be country music, polkas, or waltzes, for others there are specific songs that may remind them of years past.
Despite the fact that these programs are traditionally targeted towards patients who suffer from Alzheimer’s disease, many other benefits are becoming apparent for patients who have no cognitive issues. Studies have shown that music may trigger a memory in anyone. Pleasant memories may be able to distract residents while they have to undergo things that they are otherwise uncomfortable with, measuring blood pressure or drawing blood for example. When playing the song as a distraction, the residents are not acutely aware of what is being done at that moment.
How does music therapy make a difference?
Studies have shown that music therapy is a valid and efﬁcacious treatment for people who have communicative, cognitive, affective, and psychosocial disorders. Both clinical experiences and research results attest to the viability of music therapy. Interestingly enough, it has proven to be successful in people that are resistive to other treatment approaches.
Music provides a form of sensory stimulation that causes an involuntary response because of the feelings of security, predictability, and familiarity associated with it. For most people with mental health concerns, musical interaction is used as a means of expression and communication. The underlying goal of this type of therapy is to help people address issues or develop positive relationships that they may not be able to do using words alone.
Studies show that music therapy signiﬁcantly increased patients’ level of interest in external events, reduced their social isolation, and increased their ability to converse with others. It is relatively inexpensive and has no side effects.
How can this be beneficial?
There are several benefits behind music therapy. Depending on the individual needs of the person, a number of benefits include, but are not limited to:
- Reduction of tension and promotion of relaxation
- Higher physical activity improves recovery time
- Reduced pain
- Increased mobility and coordination
- Better outlook on life and increased self-esteem
- Improvement of memory and recall
- Quality social interaction
- Enhanced engagement levels
- Higher awareness and concentration
Increasing the use of the program
The Maplewood Nursing Home has used the programs for a little over a year. Just last week the Wisconsin Department of Health Services released a statement that confirmed that more than 100 different nursing homes throughout the state are now certified to use this program as well. Ultimately, this is a cost-effective way of improving the lives of these patients. Considering how many times I have mentioned budget cuts negatively affecting the care of nursing home patients before, it is nice to see that steps are taken to ensure that these often-neglected residents have a better quality of life.
It has been an ongoing debate in the professional care community – nursing homes cutting back on staff members and supplies in order to reduce their expenses. Why are they cutting back on expenses you may wonder? In order for these nursing homes to become more profitable. However, an Albany man is filing a lawsuit against a Hickory Creek Nursing Center that alleges seriously faulty care of its residents because of the chronic shortages of staff and supplies.
More information about this lawsuit
The lawsuit is filed on behalf of John Primmer, 66 years old. The defendants in this case are Healthcare Industries Corporation and related companies, the nursing home administrator Dave Miller, Hickory Creek of Athens, Inc., Hickory Creek Nursing Center, and several other parties that are related to the nursing home. The suit alleges that these parties were all aware of the ‘systemic staffing problems’ that affected the patient’s quality of care and caused harm.
The suit alleges that Primmer suffered mental anguish, extreme pain, suffering, and catastrophic injuries. The lawyers representing Primmer argue that both his physical condition and health deteriorated far beyond what is expected in the normal aging process. According to the complaint, this included falls, pressure sores, poor hygiene, and weight loss.
There have been complaints before
Despite the fact that there are no fines or citations leveled against the Hickory Creek Nursing Center from federal regulatory agencies, the Medicare website does provide some interesting information. According to the ratings posted on the site, the facility scores ‘much below average’. According to the Medicare website, the residents at the facility received less than the national average of 45 minutes of direct care from professional nurses daily.
In fact, the facility did not even come close, with 34 minutes for each patient every day. The other statewide facilities provided 2 hours and 18 minutes of direct care from certified nursing assistants, compare that to the 1 hour and 40 minutes that residents receive at the Hickory Creek Nursing Center.
Why these cases matter
According to the lawsuit, these problems stem from the fact that the home did not hire enough certified nursing assistants, LPNs, and registered nurses. According to the lawsuit, many staff members quit working or missed work because conditions at the home were “deplorable” or they were overwhelmed by the work that needed to be done without the assistance of enough coworkers.
Many long-term care facilities across the country are suffering from issues directly related to a lack of staffing. These residents and their family members depend on the care from these staff members and can suffer greatly if the facility fails to provide adequate care to meet the needs of these patients. These types of lawsuits are not about making money or even ‘merely’ about compensation. They are about forcing these companies to make a change. Force them to either accept fewer residents or hire more staff members in order to look after each resident properly. Unfortunately, oftentimes the only way to ensure lasting change is to take these types of corporations to court.
We expect nursing home workers to be as kind as we are to our family members, to be patient with elderly residents, but sometimes we find out that these nursing home workers are in fact – just people. The recent scandal at the Hillcroft nursing home makes this painfully obvious.
More about the abuse
According to the court records, four nursing home workers were sentenced for abusing elderly residents. These four people were sentenced under the Mental Capacity Act 2005 for wilful neglect and ill-treatment of a person with lack of capacity. The following sentences were passed out:
- Gemma Pearson – age 28 – 12 months of community order
- Carol Moore – age 54 – four months in jail
- Katie Cairns –age 27 – five months in jail
- Darren Smith – age 35 – eight months in jail
According to the court documents, these four tormented, bullied, and mocked residents, primarily because the residents would have no memory of the abuse. According to the facts presented to the court, the abuse went beyond verbal abuse as well. One resident was tipped out of his wheelchair while another had his foot stamped on deliberately.
Perhaps even more shocking is the fact that in order to ‘entertain themselves’ the four would pelt the residents with balls and beanbags, aimed directly at the elderly resident’s heads. These victims were between 70 and 85 years old.
Feelings of guilt from the family
While these actions are horrendous, perhaps the most heartbreaking aspect is the fact that the families of these elderly residents feel guilty. One family member spoke of the guilt he felt having to place his father into a nursing home after being diagnosed with Alzheimer’s disease. Because they were unable to look after him, the man believed that it would be best to have diligent professionals look after his father. Instead, his father was subject to ill-treatment and humiliation at the hands of those who they entrusted with his care.
Part of the problem
According to the judge who handed out the verdict, part of the problem with the facility was the lack of proper management. This not only allowed this type of conduct to happen, but also carry on. The court also found that in September 2011, there were previous suspensions after abuse allegations made by a cleaner and a receptionist. The matter was not referred to the police or social services and those parties involved were only given a warning.
The abuse is unacceptable – speak out
The truth is that when we place someone in an assisted living facility or nursing home, it can be a heart-wrenching decision. However, we do so because we believe that these places are able to meet their day-to-day living and medical needs. We entrust them to care for our loved ones in the same way that we do. However, this is not always the case.
Nursing home abuse is not only unacceptable, but it is despicable as well. We entrust the frailest members of society to these individuals, and the response that we see with these four is horrific. If you feel that someone close to you is suffering from nursing home abuse or neglect, remember that it is always important to speak out and seek legal representation.
With the Baby Boomer generation growing older, it is becoming increasingly important to ensure that our senior care options are not only improved, but increased as well. However, the needs of seniors throughout the country vary greatly. We have seniors who need round-the-clock care and we have those who may just need a little extra help around the home.
One of the most controversial topics in relates to elder care has been assisted living facilities. In fact, California lawmakers released a dozen legislative proposals to the public that all aim to stiffen the regulations at California assisted living facilities. Considering that California has 7,700 assisted living facilities throughout the state, changes here may set an interesting precedent for other states.
What are these proposed changes?
When looking at these proposed changes, it is obvious that the overarching philosophy behind it is that prevention should always come first in relates to nursing home or assisted living abuse. If passed, these proposed regulations would mandate that these facilities receive a yearly inspection. It would also increase the size of financial penalties that the state of California is able to levy in the event that these facilities fail to provide adequate care.
Moreover, it would also increase the mandatory training for assisted living employees and might require facilities to hire registered nurses in some instances. Finally, the inspection results would be posted online where the public is able to review the results, thereby making a more informed decision for their loved ones.
Why these changes matter
California is home to more assisted living facilities than any other state in the nation. Yet the state also has some of the loosest regulatory regimes. This includes infrequent inspections (only once every five years is mandatory) and minimal fines (sometimes as little as $150 in cases of abuse or fatal neglect).
Unlike the traditional physical rehabilitation centers and nursing homes, these assisted living facilities do not provide around-the-clock medical care. However, these assisted living facilities may have several hundred beds and provide assistance of the disabled and elderly.
These proposed changes are beneficial
Despite the fact that the people behind the introduction of these legislative proposals suggest that it is still important for families to be active in overseeing care, they also realize that state agencies responsible for senior care facilities have to make family members feel comfortable. One of the new pieces of legislation would make it impossible for these facilities to accept new residents if they have unaddressed serious health or safety violations or unpaid fines.
This would allow family members to rest a little easier, knowing that those who are in violation are not allowed to continue operating with immunity. Governor Brown is clearly taking the situation seriously, adding 71 new employees and an additional $7.5 million budget for the upcoming fiscal year to increase the oversight of these California assisted living facilities. While it may be a belated step in the right direction, it clearly shows that the governor is listening to the many complaints that people have about the assisted living facilities in his state.
Most people will accept the fact that immobile elderly residents need more assistance. We accept that these elderly might need extra help getting out of bed and to the bathroom. However, few people realize just how vulnerable these patients are during an emergency. The small Bas-Saint-Laurent village of L’Isle-Verte will stand as evidence of the dangers that immobile elderly residents face.
The small village rests along the snowy southern bank of the St. Lawrence River and is home to only 1,500 people. On January 23, a fire in a senior’s home ended the life of 32 of the residents here. The Résidence du Havre burnt down in a blaze. The recovery effort was also initially hampered because of the sub-freezing temperatures. The -4 Fahrenheit temperatures caused the equipment to freeze.
The fire started around 12:30 a.m. on a Thursday and spread quickly. While the firefighters were on the scene in eight minutes of the alarm going off and several local fire departments responding to the call, the fire’s intensity prevented them from carrying out a complete evacuation.
While we are not sure what the cause of the fire was (though it is believed that a resident’s cigarette is what started the fatal blaze), what is known is that many residents never had a chance to escape. The majority of patients were in wheelchairs or walkers, had little or no mobility, and were older than 85.
Part of the problem
One of the most obvious problems was that the facility has been in operation since 1997 and expanded in 2002. However, the facility only had a partial sprinkler system according to a Quebec Health Department document. According to the responsible fire chief, it was the newer part of the building that triggered the alarm. The older portion of the building remained inaccessible as the fire continued.
Why was the facility allowed to operate without a complete sprinkler system? Especially if we consider local government must have known about there not being a sprinkler system in the original part of the facility after the renovations in 2002. While there is no sense in speculating, could the outcome have been different if there was a sprinkler system available throughout the entire facility?
Why it is important to speak out
The truth is that accidents do happen. We may not want to think about it, we may want to close our eyes to that particularly harsh reality, but accidents happen. When they happen, it is important to have adequately prepared staff members and facilities designed to aid patients. The real reason that it is important to have adequate staffing throughout the day and night is not necessarily for when things are going right – it is for situations like these when things go horribly wrong.
If you believe that senior facilities are not providing adequate safety procedures, it is important to speak out. If you notice that nothing is being done to alleviate your concerns, it may be in your best interest to speak to a lawyer to ensure that changes are enforced. We should not wait for accidents such as these to remind us that these elderly patients need extra attention and protection.
While most people are spending their days bundled up to avoid the cold, some senior citizens may be walking outside in below-freezing temperatures because of confusion. In fact, over a three-day stretch, the cold has been blamed for several area deaths
According to Dr. Walter Hofman – the Montgomery County Coroner – an 84-year-old woman from Collegeville wandered from her nursing home and was found dead the next day. Unfortunately, there was no immediate information on how the woman left the facility undetected or what facility the woman came from.
The problem that wandering poses
Unfortunately, issues with wandering are common among nursing home residents. Especially at these extreme temperatures, it may pose an extremely dangerous threat. Those patients suffering from dementia or Alzheimer’s are at a significantly higher risk.
Every nursing home resident must have his or her own unique and thorough care plan. There is no ‘one-size-fits-all’ approach when it comes to elder care. When creating this plan, it is vitally important to consider the risk of unexplainable absences and wandering. Residents with dementia and Alzheimer’s disease run the highest risk of wandering and must therefore be monitored at all times. In those cases, it is important to take special precautions, especially because we know that these illnesses may progress at a rapid rate.
These problems may occur when the resident wanders away from the nursing home grounds without supervision or authorization. Residents with cognitive impairments may be confused when they leave the facility. These residents may believe they need to get home to their families, attend school, or go to work.
According to the Alzheimer’s Association, more than half of the nursing home residents suffer from some form of dementia or cognitive impairment. We often associate wandering with dementia and it may happen when a resident travels throughout the nursing home confusedly or aimlessly. This may have terrible consequences, including harm to oneself or others. While wandering in its own right is dangerous enough, the idea of elderly residents leaving their nursing facility during extreme cold weather invites many other dangerous aspects into the equation.
How you can make a difference
Nursing home companies, especially those who operate for profit, may attempt to increase revenue by employing fewer workers than necessary. If there is evidence of consistent and dangerous wandering or elopement, it may be possible to hold the nursing home responsible for elder abuse. A failure to modify the necessary care in order to prevent these incidents from happening poses a serious safety risk.
This is especially painful when basic safeguards such as keeping an attendant at a desk or having a nightly bed check may prevent these issues altogether. If your loved ones suffer injuries or other issues because of elopement or wandering, you may be entitled to compensation. This is not necessarily about receiving a cash settlement, it is about sending a message to the nursing home. A message that the current budget cuts they are implementing are not excusable.
Losing a loved one is never easy – but to lose someone because of neglect or negligence in a nursing home will make the loss far more difficult. Two residents died because of neglect at the McKenzie Towne Care Centre in Calgary
. These two residents passed away because of badly infected bedsores. The care center is now mandated to track these wounds on a computer, to ensure that nothing goes unnoticed or untreated in the future.
More about the situation
Revera Inc. runs the home that these two patients died in – this is a private care company that has a contract with the province. However, according to Health Minister Fred Horne, it would not be necessary to rescind the contract with Revera Inc. after the company promised to explore ways to give families more say, implement updated care plans for residents, and provide more training for its staff.
According to Horne, the findings of the AHS report would suggest that the residents who live in the facility are ‘safe’. What Horne identified as mere quality issues might surprise some readers. Some examples include:
- Chemicals and oxygen left unsafely stored in unlocked rooms
- In some cases, the management of violent and aggressive behavior of residents was not up to standard
- Gaps in basic resident information and in documenting ongoing resident care
The two cases of blood poisoning
While Horne apparently believes that these are minor problems that can be resolved, those who have family members in those facilities may feel differently. For example, the bedsores led to very complex wounds, wounds that no one at the facility had the knowledge of how to treat. Violet MacDonald – aged 73 – suffered from dementia. The staff let Ms. MacDonald sit in a soiled diaper for two days. This infected the existing bedsores, which would lead to the fatal blood poisoning. The family of Ms. MacDonald alleges that the staff made it impossible for family to enter her room by propping up a chair as well. Ms. Wyonne Somers – aged 75 – died after leg sores and a severe urinary infection. According to the family members, the staff at the facility misled them about how serious the situation was.
For those families that are without their loved ones, it is heartbreaking to realize that these nursing homes do not provide the proper care that our elderly citizens deserve. According to studies, as much as 25 percent of nursing home residents may have issues with bedsores. Because we know that immobile patients are already in a weakened physical condition and have an increased chance of developing bedsores, it is important that staff be extra cautious with these patients.
While these reports identify problems with patient documentation and wound care, the swift dismissal from the Health Minister is problematic. Especially if we consider the problems would have never been investigated unless families speak out the way they have in these instances. Unlike the insinuation of the Health Minister, these are not isolated incidents. The only way to stay ahead of the problem is through tougher monitoring.
When families realize that they are no longer able to provide the necessary care for their aging loved ones, they want nothing but the best professional care for them. One of the greatest fears for these families is that harm comes to their aging relatives. That fear came true for a family in Albany, New York. Sarina Francis – a certified nursing assistant – acknowledged that she broke an elderly patient’s arm while the woman was under her care.
The court and state records show that the nursing home aide did not only break her arm, but two supervisors ignored the woman’s pleas for help for several hours. According to the Albany Times Union, Francis pled guilty to endangering the welfare of a vulnerable elderly adult. Her sentence, expected in March, may be as high as four years.
More about the incident itself
Francis was escorting the 84 year-old woman to her room when the incident occurred. The certified nursing assistant alleges the woman became combative. The response from Francis was to grab the woman’s wrist and twist her arm behind her head. This caused a fracture in the forearm.
It may have been easy to suggest that the combative nature of the woman was such that Francis overreacted in her response, but upon putting the woman in her room, Francis took off the woman’s incontinence brief. According to the court, Francis would then hit the elderly woman in the head with that brief with such force that the urine splashed across her. The Albany Times Union reports that at that time, Francis once again grabbed the woman’s wrists and forced the elderly resident to hit her own face with her hands repeatedly.
Making matters worse is that it took close to 12 hours before the resident received the medical care she clearly needed. A nursing supervisor examined the woman and despite the bruising and swelling, determined (without the use of an X-ray) that the arm was not broken. It was not until another nursing supervisor ordered an X-ray that the elderly resident finally received confirmation that her arm was in fact broken. The state cited the Hudson Park Nursing and Rehabilitation Center because it put the safety and the health of an individual at risk.
Where was the care?
This unfortunate case highlights a number of troubling developments. Not only does a person who is supposed to care for the patient harm her, but then, despite the injured resident’s numerous pleas to the contrary, the supervisors fail to take responsible action. If there was a possibility of injury (which there clearly was in this case), the facility is responsible for determining whether the harm is real. Delaying an X-ray for another 12 hours causes unnecessary suffering.
Despite the worker’s claim that she ‘lost her temper’, that type of reaction is unacceptable and those type of individuals are clearly not capable of working with elderly patients at a long-term care facility. Especially in these cases, where there are obvious mistakes and willful maltreatment of residents, it is important to hold these homes accountable. This goes beyond the abuse; the abuse merely highlights the lack of caring and professionalism in these facilities. Especially considering that these patients require a lot of extra attention and patience, we are left to wonder – where is the care in these senior facilities?
One of the worst trends in the nursing home industry is the fact that it is becoming increasingly ‘for profit’. With the federal and state government trying to save as much money as possible, many nursing homes now operate under private equity. What this means is that care facilities are being run as though they were a business – meaning that more attention is paid to the bottom line rather than the actual needs of the people who live in these facilities.
The case of Bruce Rauner
One of the recent cases that bring this problem into the national spotlight is Bruce Rauner and his GTCR private equity firm. Rauner, a Republican candidate for Illinois governor, promises that he is going to run Illinois ‘like a business’ if he is voted as governor. However, the problem is that Mr. Rauner does not have an excellent record of accomplishment when it comes to compassionate business.
Rauner’s former private equity firm was involved in multiple lawsuits. In order to take advantage of the change in the Medicare reimbursement because of the Balanced Budget Act of 1997, both GTCR and Rauner co-founded Trans Healthcare Inc. While the investment made Rauner a lot of money – Ms. Arlene Townsend is an example of what can go wrong when nursing homes operate ‘for profit’.
A billion dollar settlement
One of Rauner-controlled nursing homes was forced to pay the family of Ms. Townsend $1.1 billion in a landmark settlement. This comprise of $1 billion in punitive damages and $100 million in compensatory damages. According to the jury in Polk County, Florida, the ‘misconduct’ perpetrated by the facility was akin to ‘complete corruption’. The jury also suggested that the nursing home was under-supplied and short-staffed.
More underhanded dealings
According to the testimony from an expert forensic accountant, the Boards of Directors at GTCR was made up entirely of bankers and investors. Interestingly enough, there was not a single health care official on the board. With billions in revenues at that time and 220 facilities throughout the nation, GTCR quickly became one of the largest health care operators without any knowledge about the industry.
One of the most disturbing findings presented by the forensic accountant was that the former company leaders made illegal political contributions but received reimbursements through tax dollars after charging those contributions back to the government through Medicare reports. In short, this means that the company was using Medicare in order to make campaign contributions.
Drawing attention to the problem
Perhaps the most damning statement that came from the entire trial was the fact that this went beyond the extreme negligence shown by the nursing home. The investors were planning to run the nursing home chain into insolvency, without actually thinking twice about the level of care for the residents. While there is no denying that some privately owned nursing homes take far better care of their residents, the truth is that private equity and professional care facilities are clearly not compatible. One means caring about the wants and needs for the residents while the other is about making as much money as possible, oftentimes disregarding ethical and moral objections.
While the case is notable because of the spotlight it places on Bruce Rauner, perhaps the looking glass that it puts these nursing homes under will reveal that these two ideas are in fact not compatible. While it may be difficult to take private equity out of the nursing home industry, it appears that it is absolutely necessary.
It would seem to make perfect sense, if someone abuses an elderly patient that is placed in his or her care, it is prudent to bring a lawsuit against this person and/or her employer. Despite the fact that nursing home abuse is on the rise and the fact that an increasing number of people are speaking out against it, it might be difficult to pursue an elder abuse lawsuit in the event that the patient passes away depending on the state you would file in.
The case that is forcing change
The physical and sexual assaults of 15 residents in an Albert Lea nursing home back in 2008 are one of the best examples of such a case – and serves as a prompt for a change in state law. According to the criminal complaint, the defendants’ taunted residents, groped their breasts and genitals, poked them, and even spat in residents’ mouths. Charges were brought against two employees for failing to report suspected maltreatment, disorderly conduct, abuse of a vulnerable adult with sexual contact, and abuse of a vulnerable adult by a caregiver (all gross misdemeanors).
As the victims and family members filed lawsuits against the nursing assistants and the nursing home owner to seek justice for the mistreatment of their loved ones, the civil cases in Minnesota ended up being dismissed by October 2011. The reason for it was that the victims had passed away.
The problem with continuing prosecution is ‘Minnesota’s Survival Law’. This law requires that a personal injury case be dismissed if the victim dies of unrelated causes. The Albert Lea case and the fact that Minnesota is one of only four states with such a legal requirement are clear indicators that something needs to change.
The strange argument against the law
Just last year during the last day of session of the Minnesota Senate, a bill designed to eliminate the Survival Law was defeated. Part of the reason behind this is that both the Minnesota Hospital Association and Minnesota Insurance Federation lobbied against it.
These groups argue that Minnesota law is intended to compensate the victim of the injury or mistreatment, not the family members. The vice president of public affairs with the Insurance Federation of Minnesota – Mark Kulda – even went so far as to suggest that the damage was to the people themselves and not to the families.
What Mr. Kulda seems to forget is that a lawsuit is not necessarily about the damages. It is about holding people accountable for their actions. We would not let someone walk away from a burglary if the victim just happened to be involved in an unrelated car accident three weeks later. Why would we accept this when it comes to elder abuse?
Why a change is necessary
The truth is that accountability has to be in place. While a statute of limitations is one thing, it is unreasonable to put such a limit on pursuing elder abuse lawsuits. Considering the age and fragility of many of the victims, it is unethical to make it impossible to hold those parties responsible accountable for their actions.