California Nursing Home Abuse Lawyer Blog

The Needs of Stroke Survivors Living in Long-Term Care Facilities Must Be Sufficiently Met

August 26, 2015 | by Law Offices of Ben Yeroushalmi

A stroke can cause major burden to the victim. An estimated 30 million people around the world are stroke survivors. Approximately one-quarter of residents in nursing homes and assisted living facilities are stroke survivors. A recent review aimed to integrate the existing knowledge from literature regarding stroke and analyze themes around the care of stroke survivors in long-term care facilities. Continue Reading

Telehealth Services May Not Provide Significant Benefits for Assisted Living Residents

August 25, 2015 | by Law Offices of Ben Yeroushalmi

Aging in place has been increasingly supported by public policies in the United States by allowing frail older adults to remain at home. Policymakers often view assisted living facilities and home healthcare services as more economical and less institutional alternatives to nursing home care. Both home healthcare agencies and assisted living facilities face the challenge of caring for sicker patients with complex medical issues, providing opportunities to services in markets with nursing shortages, and finding efficient means of delivering care. The lack of appropriate nursing care may cause assisted living residents to be relocated to a nursing home when their care needs are not met and consequently increase their vulnerability. One method for assisted living facilities and home healthcare agencies to foster aging in place is to utilize telehealth services to monitor safety and health status remotely. Continue Reading

Assisted Living Facilities and Nursing Homes Should Strive to Optimize Residents’ Eating Performance

August 24, 2015 | by Law Offices of Ben Yeroushalmi

The prevalence of cognitive impairment among residents of assisted living facilities and nursing homes is significantly high (68-72%), among which 42% have moderate to severe impairment. Older adult residents in long-term care who are cognitively impaired suffer greater functional decline pertaining to eating compared to those without dementia. 22% of assisted living residents with cognitive impairment showed functional loss in eating and needed assistance, among which 24% had moderate impairment and 65% had severe impairment. Nursing home residents with severe cognitive impairment showed the greatest loss in eating ability compared with the other activities of daily living (ADLs) within half a year after admission. Eating performance is the functional ability to transfer food into the mouth, and is a critical predictor of physical and psychosocial health, as well as quality of life for long-term care residents. The negative effects of compromised eating performance include inadequate intake and weight loss, malnutrition and breathing problems, eating disability, and even death. Continue Reading

Long-Term Care Providers Should Screen Older Adult Patients for Declining Swallowing Function

August 21, 2015 | by Law Offices of Ben Yeroushalmi

Japan is a country that has been known for its longevity and low ageing rate of 25% (compared to other countries), which has spurred a vast amount of age-related research pertaining to the Japanese population. Much of this research has placed significant attention of sarcopenia, along with the accompanying decrease in muscle strength and motor function, as these factors can lead to weakness and increase the need for nursing care for older adults. Past studies have shown that a systemic decrease in muscle mass is a marker for low nutritional status and less frequent physical activity. Moreover, associations between swallowing function and systemic disease, oral function, and nutritional status among the elderly who need nursing care have also been disclosed. However, not many studies have examined the connection between swallowing function and the systemic decreases in muscle mass.

Past studies have shown various risk factors for dysphagia among elderly people who need nursing care. For example, if a systemic decrease in muscle mass lowers one’s swallowing ability, their nutritional status could also decrease, leading to a vicious cycle. However, muscle mass can be enhanced by improving nutritional status and physical activity, and it may be an important guideline for examining swallowing rehabilitation in instances of dysphagia that are caused by aging. Thus, a recent study used skeletal muscle mass (as examined using the Skeletal Muscle Index [SMI]) as a marker of nutritional status and physical activity, and aimed to clarify the association between SMI and dysphagia in these patients. Continue Reading

Nursing Homes are Giving Patients an Inappropriate Amount of Therapy for the Sake of Medicare Benefits

August 19, 2015 | by Law Offices of Ben Yeroushalmi

Nursing home patients who receive what is deemed as “ultra high” therapy—at least 720 minutes per week—generate many nursing homes’ largest payments from Medicare. According to a Wall Street Journal analysis of billing records, Medicare’s ultrahigh rate was estimated to be about $560 per day in 2013. The estimate was $445 per day for “very high” therapy of 500 to 719 minutes and $325 for what was deemed the “low” category, 45 to 149 minutes.

Failure to Give Physician Treatment Orders to Nursing Home Patients Can Diminish End-of-Life Care

August 18, 2015 | by Law Offices of Ben Yeroushalmi

Older adult patients residing in nursing homes are often vulnerable and have limited life expectancy. As a result, critical thinking of desirability of future medical interventions is crucial. Advanced care planning (ACP) is often encouraged as a way to make decisions about future medical care. ACP calls for the continuous process of the patient and care provider making joint decisions about future medical care, in the event the patient is not able to consent to or refuses to receive treatment or other care. Several studies have shown ACP to have beneficial effects on end-of-life care, with a decrease in hospitalizations, enhanced patient and family satisfactions, greater concordance between patient’s past preferences and treatments received, and a decrease in distress of kin. The primary goal of ACP is to adapt medical care to the preferences and life goals of the patient.

Health Care Staff Need to Screen their Patients with Dementia for Dysphagia

August 13, 2015 | by Law Offices of Ben Yeroushalmi

Dementia imposes various hazards that increase a patient’s vulnerability and risk of mortality. Patients with advanced dementia often experience difficulties in swallowing, known as dysphagia. Oropharyngeal dysphagia is the most common cause of aspiration, and pneumonia, presumably caused by aspiration, is the most common cause of death in people with dementia. An estimated 13% to 57% of patients with dementia experience dysphagia. Due to an almost tenfold risk of aspiration pneumonia in patients with dysphagia, aspiration pneumonia is the primary cause of death in people with dementia.

Nursing Facilities Should Aim to Implement More Person-Centered, Interdisciplinary Care

August 12, 2015 | by Law Offices of Ben Yeroushalmi

Approximately 20% of hospitalized patients are discharged to a skilled nursing facility for post hospitalization sub-acute care. The prevalence of frailty, unresolved acute health problems, a history of chronic illness, and various functional and psychological needs among these patients is high. The complexity of post-acute care needs has not matched the development of innovative and effective skilled nursing facility care models. Furthermore, no standardized systems of care have been implemented and care delivery at a given skilled nursing facility may vary significantly from that of others. Thus, it is no surprise that many skilled nursing facilities fail to go by evidence-based guidelines for medical management for various illnesses and health outcomes.

Health Care Providers Should Regard Frailty as a Predictor for Future Falls

August 11, 2015 | by Law Offices of Ben Yeroushalmi

The older population is highly heterogeneous. Although the general development of diseases and disabilities is similar as they age, the trajectory and rate of change in health and functional ability is widely varied in each individual and those with the same chronological age can have extremely different biological ages. Thus, it is difficult to measure the heterogeneity of the aging process in older people.

Assisted Living Facilities Should Implement More Gender-Specific Physical Activities for Their Residents

August 10, 2015 | by Law Offices of Ben Yeroushalmi

Aging causes individuals to become more vulnerable to chronic diseases and functional disabilities, which in turn diminishes quality of life and incurs more healthcare costs. Thus, improving the health of older adults is a critical concern in healthcare. As the older population rapidly increases, so does the need for long-term care. Compared with elderly people in nursing homes, those in assisted living facilities have greater health potential. However, the care needs of older adults will need to be modified as their health and functional levels change.