Police Open Investigation Into Refusal of CPR for Elderly California Woman
Nursing Home
Ok. Many of you saw or heard this on the news. Would you have let the old lady die if you were a nurse? Is there even any question about this? Well, the police must think so. The Bakersfield police have launched an investigation into the refusal by a nurse in a independent living facility to give CPR to a resident.
The woman identified as 87 year old Lorraine Bayless, who collapsed in the dining room of the retirement home and later died at an area hospital. According to Bakersfield Police Department spokeswoman Michaela Beard, a police dispatcher first got the call from the facility last week and immediately routed the call to the fire department emergency services.
The second dispatcher pleaded with the caller, who identified herself as a nurse to do CPR, who refused. The dispatcher then added or find someone who would, a passerby, gardener or anyone, even another resident. The Dispatcher can be heard pleading in the released 911 call, and telling the nurse the woman would die without CPR.
Beard said that she could not make further comment, since this incident is being looked into and is an ongoing investigation. Officials said Monday that the dispatcher followed protocols in pleading with the nurse to perform CPR on the woman.
Glenwood Gardens defended the nurse stating that she had followed policy in not providing CPR for the 87 year old woman. The call that occurred on February 26th began with the nurse requesting paramedics come to the facility to help the woman. The 911 phone call lasted for 7 minutes and 16 seconds, with 911 dispatcher Tracy Halvorson pleading for the worker who identified herself as a nurse to start CPR.
Halvorson said at one point, I understand if you cannot do it because of your boss, but as a human. Then Halvorson began asking about anyone that could help, she told the nurse to give the phone to a stranger on the street and said I bet they would help. The nurse said not at this time.
The dispatcher told her without help the 87 year old, who’s breathing was shallow and was unconscious that she would die without CPR being started. Halvorson told her that if anything went wrong during CPR that the local emergency system would take liability for the call.
Kern County Fire Department Deputy Chief Michael Miller said Halvorson followed procedure, until she ran out of options, with the caller refusing to perform CPR or allow anyone else to do it. Miller said it isn’t uncommon for someone to refuse to do CPR, when they are physically unable to or are too upset to function. He said this call was unique in the way the conversation was and was very frustrating to anyone listening that no one was helping this woman in need of CPR.
When emergency ambulance personnel arrived on the scene, seven minutes after the call came in, the 87 year old had no pulse and was not breathing. They found her lying on the floor, and started CPR, Bakersfield Fire Department spokesman Anthony Galagaza said. The woman was transported to Mercy Southwest Hospital, where she was pronounced dead.
Glenwood Gardens executive director Jeffrey Toomer said that the nurse followed policy and in the event of health emergencies at the independent living community our practice is to immediately call emergency medical personnel for assistance. Toomer said this is what the nurse did and continued to follow policy by staying with the individual until emergency personnel arrive.
Toomer said that residents of the facility are informed of the policy and agree to it when they move in, but this policy does not apply at the assisted living and skilled nursing facility. According to the Bakersfield Police Department, Bayless did not have a do not resuscitate order in place.
Assembly woman Mariko Yamada, chair of the California Assembly of Aging and Long-term Care Committee, said that this is a tragedy and a wake-up call. She said it is terrible it took this kind of event to bring this to our attention. Would you have let the woman die? As a nurse, can you say yes? Is this ethical medicine?
Over 50% Of Nursing Homes Abuse Elders?!
Nursing ethics and tort lawyers
By Attorney Michael Ehline – Ethical nursing is a duty of all professional nurses and doctors. But a recent study shows that tough laws are not enough to keep old folks safe.
Elder abuse is defined here. The only thing it takes for evil to succeed is for good people to do nothing. When seniors are abused, an attorney is the last line of defense. Prevention is reporting of that abuse is the key. The National Center for the Protection of Older People at the University College Dublin carried out research that determined more than one in four employees stated they had seen psychological. The psychological abuse has consisted of swearing, insulting and shouting at residents.
One In Eight Employees Has Observed Abuse Like Swearing Pushing and Shouting!
Research shows that one in eight employees have observed physical abuse of nursing home residents. Most frequently this was in the form of grabbing, pushing, shoving, pinching or unnecessarily restraining the patient.
Stealing
Approximately 1.2 percent of staff members have other employees taking valuables from a resident. In this study, there were more than 1300 nurses and healthcare assistants in 64 nursing homes that were surveyed in the country.
According to the report by Dr. Jonathan Drennan of UCD School of Nursing, Midwifery and Health Systems, said that the study shows Ireland compares with similar studies conducted internationally, in reporting a lower level of elder abuse.
Restraining
False imprisonment is defined here. When a nurse unlawfully restrains someone, this is called false imprisonment and is also a civil battery. In RTE’s News at One, he said that there need to be initiatives that will reduce the practices that lead to abuse. Dr. Drennan said the research shows that staff has observed a range of abuses taking place in nursing homes. He said of physical abuse, the most prevalent was restraining residents longer than necessary at the time and the use of restraints.
Dr. Drennan said only in an extremely small number of cases the staff reported they saw a staff member slap or hit a nursing home resident. But who cares? Restraining, shouting, and pinching is horrible. The moral of the story is, look after your elders people. Don’t make your first meeting with an attorney the one where he is being hired as your nursing home abuse lawyer.
Other Sources:
http://m.rte.ie/news/2012/1206/elder-abuse-study-ucd.html
http://blog.heritage.org/2012/08/28/morning-bell-how-obamacare-robs-medicare-and-hurts-seniors/
Michael Ehline
Los Angeles
,CA 90071
United States
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Nurses Unethically Make Their Jobs Easier?
By Jonathen Rosenfeld – The federal government has undertaken an initiative to reduce the amount of anti-psychotic medication administered in nursing facilities by about 40%. It is commonly believed among federal regulators that the medications are being hastily prescribed to patients who are in no medical need of them in order to quiet angry outbursts and other irregular behavior.
Even among patients who are diagnosed with dementia, regulators believe that there is an excessive use of anti-psychotic drugs and would like to see alternative measures taken in order to address agitation and aggression among patients. This initiative will also have the effect of lowering the amount of incidents in which medication is used to cover up cases of negligence.
Improper Prescribing of Anti-psychotic Medications across the Country
Over one fifth of the patients in nursing facilities in the United States who have been prescribed anti-psychotic medications do not have a medical condition which requires them. Many family members and physicians actually believe that the prescriptions are for the good of the patient in many cases, but research is showing that the side effects and the risks inherent to these forms of medications are not worth the potential benefit.
The Food and Drug Administration has needed to issue two warnings in the last seven years alone against the use of anti-psychotic medication in elderly patients with dementia because the side effects often have the potential to kill those taking the medicine. Despite these warnings, many nursing facilities continue to administer the drugs— often in doses that are considered to be extremely dangerous.
Using Alternative Methods to Treat Patients with Dementia
One of the root causes of many cases of nursing home negligence is a lack of education or proper training of the staff members. Federal regulators wish to see training programs in place which will educate caregivers on alternative treatment options for patients with dementia so that medicating them is no longer the first option that comes to mind. Because of the possible lethality of the anti-psychotic medications, prescribing such medicines should be considered the last resort when treating patients with dementia or similar illnesses.
The Potential for Unnecessary Medication as a Form of Nursing Home Abuse
Understaffed facilities that lack an adequate number of staff members may prescribe anti-psychotic medications as a means of quieting the outbursts and aggressive behaviors of patients who are agitated. This is a sign that the facility is not giving patients proper treatment and is using medication as a way to compensate for the inability to attend to the individual needs of the patient. Federal regulators have responded with an immediate initiative to reduce the total use of anti-psychotic medications by 15% this year alone with the ultimate goal of a 40% reduction. Because many facilities will lose the ability to use anti-psychotic medications as often; many cases of nursing home abuse may surface as the under-staffing problem that many facilities have becomes harder to conceal.
The regulation of the use of potentially harmful medications is a large stride in the right direction and will reduce the number of instances of negligence that are caused by improperly medicating the elderly. This is one of many steps that we must take in order to ensure the proper treatment of those who we love and care about and if the doctors or nurses in the facility we have entrusted with the care of our loved ones wish to administer anti-psychotic medications, we must always ask the question why. Questioning the motives of a nursing facility is the first step in ensuring that our loved ones receive the best care and that we are able to find out quickly if they are receiving anything but.
Other Sources:
http://main.uab.edu/show.asp?durki=60834 <<< Overmedicating
http://www.opposingviews.com/i/society/alarming-claims-against-doctorand-his-colorado-family-clinic <<<<< Overmedicating to hide negligence
http://www.nursingethicsnetwork.org/
Investigating Abusive Nurses a High Priority for AG
Cameron Park resident Don Esco, who died last month at 82, spent his last years suffering the loss of his wife Johnnie, since her death at a Placerville nursing home. Esco who settled a civil lawsuit with the El Dorado Care Center in Placerville, said that was not enough. He blamed the nursing home for his 77 year old wife’s death in March 2008.
He said was never about the money and was convinced it was a criminal matter and the state of California agreed, when they filed charges against two nurses. Thursday was four years, seven months and twenty-four days since Johnnie Esco died, when one of the two nurses charged with felony elder abuse by the state pleaded no contest to the charges in the death. Rebecca LeAn Smith, 39 in the plea agreement also agreed to cooperate with prosecutors in the criminal case against her former nursing supervisor, Donna Darlene Palmer.
Don Esco died prior to witnessing Thursday’s plea agreement in El Dorado Superior Court. His persistence to hold the nursing home and nursing staff accountable has made a difference in California. As this case moves forward in the prosecution of Palmer, in turn County prosecution of nursing home staff continues. Attorney General Kamala D. Harris’ representatives said the state will begin aggressively prosecuting criminal cases throughout the state.
Three Specalized Teams Being Assembled
Three specialized teams are being put together by Harris’s office, with one in Sacramento and two in Southern California, which will pursue criminal charges against nursing home administrators and employees were systemic problems are suspected.
Harris said in a prepared statement elder abuses a predominantly tragic crime, since it targets older adults, our parents, aunts, uncles and others at a vulnerable time in their lives. She said these crimes are “serious and often hidden.” Harris said we know elder abuse is becoming more prevalent, and we must become more resolute in our protection of older adults.
Elder Abuse Prosecution
In the state of California and other states, criminal prosecution of nursing home staff or their employers has been rare. Generally allegations of elder abuse or neglect, are handled in civil court. The actions of Harris, could create changes to reverse the number of criminal actions the state files involving elder abuse. Over the past decade there has been a steady decline in the state’s criminal actions involving elder abuse cases. California general attorney’s office complaints filed has dropped from 112 in the fiscal year 2002-2003, to only 60 during the fiscal year 2001-2000, according to state figures.
The plan that Harris is putting into place, each of the three teams will have an attorney, an auditor, a nurse and support from a medical professional specializes in geriatrics. According to Mark Zahner, chief prosecution for the AG’s Bureau of Medi-Cal Fraud and Elder Abuse, the teams will develop criminal cases of “systemic abuse” in nursing homes or long-term care facilities where the patient’s daily activities are overseen.
Zahner said his teams are not looking for isolated incidences, were a low-level employee makes an error on the job. He said people are human beings and mistakes can occur. He said we are after the real bad guys, the ones that are more concerned about how much they have, “boats, yachts and mansions,” rather than providing proper care for the people in their facilities.
We are after the people who put profit ahead of the care they are providing, Zahner said. There is skepticism about what the attorney general’s office will really do, especially in regard to prosecuting corporate owners. Sacramento attorney Lesley Ann Clement, who represented the Esco family in their suit against Horizon West, was shocked that the state did not charge the chain owners.
Clement, who specializes in nursing home cases, said the question is why did this happen? She said the answer is there is not enough staff and that occurs at the corporate level. AG spokesman Lynda Gledhill said the corporate owners were not charged, since investigators determined the owners of Horizon West management were “were very cooperative and took action as soon as the situation came to light.”
Criminal cases will not be easy Zahner and other state officials admit. They said prosecution of elder abuse cases are labor-intensive and expensive, with extensive medical records, which must be examined and expert testimony assembled. There are the defendants that come represented by a team of legal experts, provided with the funding of the corporation. Then the key witnesses are often too feeble to testify or have already passed away.
Then there are the fundamental legal questions, can the state prove the case? Can they prove beyond a reasonable doubt the administrator or worker had intentions of harming the patient? Which of the many caregivers should be singled out and held responsible to be prosecuted?
Prescott Cole, senior staff attorney for the San Francisco based California Advocates for Nursing Home Reform said, in a nursing home situation there are three different shifts, with staff members taking over care at different times. Who did what, is going to be one of the problems for prosecutors.
Cold said that the local district attorney can file criminal charges in nursing home cases, in the state of California, most of them do not. Then it falls mostly on the attorney general’s office, which is often the underdog in court, against corporations within the nursing home industry with deep pockets.
Death Sentences
California Association of Health Facilities attorney Mark Reagan, said how well support for the attorney general’s initiative is take, depends on how they “handle prosecutorial discretion.” State prosecutors must determine which cases should be handled in civil court, criminal court or administratively, Reagan said.
Reagan said the organization believes there is absolutely no place for abuse and neglect in long-term care facilities.
If a nursing home owner is convicted, Reagan said, of criminal elder abuse, even in the event it is an isolated incident, it is a death sentence. The facility is required to be excluded from receiving Medicaid and Medicare funding.
Palmer and Smith in the Esco case, according to the attorney general provided substandard care to Johnnie Esco and both failed to adequately supervise the staff. This contributed to the deterioration of the patient and death. The nurses helped to oversee Esco’s care for 13 days at the El Dorado Care Center in Placerville. This was a skilled nursing facility owned at the time by Horizon West Healthcare Inc., of Rocklin.
Horizon West Health Care Inc. sold its 27 nursing homes last year, which included the El Dorado Care Center, to a San Marcos based chain, who since have changed the nursing facility’s name.
Smith said that she was raised to take responsibility and negotiated a plea agreement to take responsibility for her actions. Smith, who is now living in Louisiana, said she believes the care provided for Esco could have been better and for that she is deeply sorry. Thursday, when leaving court Smith said that her heart aches and tearfully said “I wish there would have been done at the time.”
Attorney Patrick K. Hanley, who is representing Palmer, said he was surprised by Smith’s plea, and said there is no evidence supporting the charges that have been filed against the nurses. He said the attorney general’s office was showboating in court and only filed charges, after the storey came out in the media.
The Bee chronicled the Esco story in a series, to expose falsified records in nursing homes. After the series ran, the attorney general’s office then reopened its criminal investigation.
The Esco family filed a lawsuit in civil court, which alleged the medical chart for Johnnie showed evidence of being altered, was sloppy and failed in accurately relaying her medical condition. Johnnie Esco’s husband Don, who recently died, enlisted in the Army Air Corps at the age of 15 and will be buried this month next to his wife of almost 61 years, at Arlington National Cemetery.
Don Esco testified in August, since the prosecutors were concerned about his failing health, to preserve his statements for the record. Don Esco died on October 8th in Sacramento. (Read more.) Prior to his death, last year he told The Bee, his purpose in life was to stop the pain and suffering in nursing homes and ensure the guilty parties are punished.
Citations:
http://www.sacbee.com/2012/11/03/4959807/california-attorney-generals-office.html
http://www.sacbee.com/2012/11/02/4956042/nurse-enters-plea-in-elder-abuse.html
Menigitis Outbreak Resources Safety Information
The recent outbreak of fungal meningitis still has many unanswered questions but there are certain things you can do right now to protect yourself if you have had a steroid injection recently as the governmental entities resposible to protect its citizens have provided answers to some questions. The two biggest question should be:
1. Am I at Risk for Contracting Meningitis
2. If So, What Should I do About It
The best source for information apart from you doctor who administered the steroid injection is the Center for Disease Control. (CDC) They have a home page dedicated to information regarding the outbreak. The home page has multiple links that serve to answer many questions.
They tell you that they are working with the FDA and state and local health departments to investigate the disease. The first thing they want you to know is that it is not contagious. So widespread panic has been well contained
What is the Current Situation
1. The investigation includes injection in the spinal area as well as injections in the knee shoulder ankle.
2. The CDC’s fungal disease laboratory has confirmed the presence of the fungus Exserohilum in 10 people with meningitis and the fungus Aspergillus in one person with meningitis.
3. Clinicians should continue to contact patients who have received medicines associated with three lots of preservative-free methylprednisolone acetate (80mg/ml) from the New England Compounding Center (NECC) that were recalled on September 26, 2012. The potentially contaminated injections were given starting May 21, 2012
So if your injection before May 21, 2012 there should not be a big concern. But epidural steroid injections are not without other risks so if you feel ill after any injection get to a doctor or emergency room.
4. The CDC actually gives it’s definition of a probable case of fungal meningitis arising from the NECC product;
Probable Case:
A person who received an injection with methylprednisolone acetate produced by the New England Compounding Center who developed any of the following:
Meningitis1 of unknown etiology following epidural injection after May 21, 2012.
Stroke following epidural injection after May 21, 20122, who has not received a diagnostic lumbar puncture.
Spinal osteomyelitis or epidural abscess of unknown etiology at the site of injection following epidural or sacroiliac injection after May 21, 2012.
Osteomyelitis or worsening inflammatory arthritis of a peripheral joint (e.g., knee) of unknown etiology diagnosed following joint injection after May 21, 2012.
The guidance still in effect is to contact the doctor who performed the proceudre to see if you received the potentially contaminated medicine. if for some reason you are not trusting of your doctor then contact your local health depatment. (my guidance)
If you have received a potentially contaminated medication, seek medical attention if you have symptoms. Infected patients have had very mild symptoms that are only slightly worse than usual. For example, many infected patients have had slight weakness, slightly worsened back pain, or even a mild headache. Patients with infections have typically developed symptoms within 1-4 weeks after their injection. However, shorter and longer time frames between injection and onset of symptoms have been reported. The time frame is still being investigated. Patients should watch vigilantly for symptoms if they were injected with potentially contaminated steroids and see a doctor if they have any of the symptoms.
Where Can I Go For Legal Help
There are many lawyers interested in helping victims of this outbreak. Some do not require that you contracted meningitis, but only that you received the tainted injection and had to go through a spinal tap to determine if you had contracted meningitis. One of the few web sites I have seen by an attorney solely related to the issues involved in the fungal meningitis outbreak is www.meningitis.attorneys.us published by Attorney Anthony Castelli an Ohio personal injury trial lawyer.
It has frequently asked questions about the outbreak, the government advisories, and a meningitis blog. interstingly enough Anthony Castelli’s office is less than a mile from one of the four facilities in Ohio that have been identified as administering the tainted steriod.
Resource: CDC web site http://www.cdc.gov/hai/outbreaks/meningitis.html
Related Posts: http://blog.castellilaw.com/cincinnati-pain-management-named-as-facility-that-used-tainted-steriods.html
http://blog.castellilaw.com/fungal-meningitis-outbreak-update.html
Caring For Dementia
How To Care For Someone With Dementia
If a person is suffering from dementia they are losing their mental skills that will have an effect on their everyday life. It may be time to seek Memory Care. Dementia is a gradually deteriorating condition that be brought about by strokes and if a person suffers from Parkinson?s disease. Also, Alzheimer?s disease is a type of dementia.
Dementia is different in each case, but it leads to memory problems, the ability to think clearly, and problems with daily planning. Depending on the stage of dementia people can function for some time while suffering from it, but since it gradually gets worse they need to be taken care of the more they suffer from it. Here are some tips on how to care for a person that suffers from dementia.
Medication
Since memory loss and forgetfulness is a symptom of dementia, it is important that if a person is on medication for dementia that they continue to take it as prescribed.
Healthy Living
Importance Of Choosing A Positive, Healthy Atmosphere For Your Loved One
Very few people want to think about where our loved ones will live when they are no longer able to care for themselves at home, but it’s an important thing to plan for. Ideally, it would be a discussion between adult children and their parents when everyone is in good health, so that the seniors are able to have a significant amount of input as to their living arrangements. However, if that time period has already passed, it is still possible to make the best decisions for all of the involved parties.
Your loved ones deserve to live in a place that is not only able to meet their health care needs, but allows them to grow spiritually and enjoy a variety of activities that are appropriate for them. This means that when you are looking at the different options, unless someone needs the full services of a nursing home, that it is a good idea to look at all of the different options that are available. That can include everything from a senior apartment complex to assisted living and even home health aides in assisted living. Many nursing homes are quality centers, but if your loved one doesn’t need full care yet, there is no reason for them to live there.
A important thing to remember is that when someone is bored or not stimulated intellectually, they are likely to decline more quickly. An ideal place for your loved ones to stay will incorporate as many aspects of their lives as possible. Therefore, you should expect to see different types of classes and activities, including day trips at the facilities you are considering. You should also closely look at the people at the facilities you are looking at and determine their feelings about where they stay. You may even be given the opportunity to talk with the residents at some of the facilities.
A positive, healthy atmosphere for your loved one is the best way for them one to flourish in their new home. You will also see that when they are comfortable in their new home, and are near people in a similar age group with similar abilities, that they are going to be happier. Being home alone, with only the television to look forward to and occasional visits from family and friends for company can become very depressing, very quickly. Being in a place where most of the people have similar abilities and where there are a number of activities to choose from can be an amazing experience that makes life fun again.
Choosing the most appropriate senior living situation for your loved ones will probably take some time. There are many different factors to consider, including cost, location, reputation of the facility, training of the staff and overall happiness of the residents currently at the facility. It’s an important decision that will have a significant impact on the quality of life that your loved ones experience for many years to come.
Seniors Keep Up With Technology
Just because seniors didn’t grow up with technology, doesn’t mean they don’t appreciate it now. In fact, with children and grandchildren scattered around the country, technology is becoming more and more important to them – both in terms of keeping in touch with family and keeping themselves safe.
Computers are one way to stay current and in touch. While many of the older generation still like to get their news from the good old newspaper or evening news broadcast, more and more are finding that it’s easy to catch breaking news online. Email, Facebook and Skype aren’t just for teenagers anymore. These have all provided avenues of communication between old friends and families. Want to see the new baby at ten minutes old? Find the pictures on Facebook. A group email has become the fastest way to organize who brings what to the next reunion. And if you want to see someone opening their Christmas gift while on another continent, you’re only a click away with Skype.
For those seniors that may have hung back due to the expense – and complexity – of a computer, there’s the Apple iPad. Not only is the Internet and email at their fingertips, but now it’s portable as well. People can Google while they watch TV or take a photo of Grandma’s garden and post it online within seconds.
The iPad also serves as an e-reader for seniors who want the convenience of only carrying one device instead of five books while traveling. Seniors also report liking the size compared to hard-covered books. It’s easier to hold in arthritic hands and easy to read in bed with no room lights glaring.
Zoning: How to Get Aging Loved Ones Closer to Home
Zoning, or the process of assigning types of construction to certain kinds of property in a given town or county may seem like it doesn’t mean much for senior living. A number of operators are finding out that these boards are having a real impact on where they can build, renovate or even construct additions.??
Take New York City, a town where the value of square feet is measured in the hundreds, if not thousands of dollars. Along the Upper West Side, Jewish Home Lifecare was trying to build an extensive skilled nursing facility, but that’s been held up by local residents.??The location is just about a mile away from the existing facility, but residents have voiced a number of concerns. They note that a local school is adjacent to the proposed construction site, and that the road could be blocked by the increased traffic that such a facility would represent over the existing parking lot, reports DNAInfo.??Even though the senior living advocates argued that the facility didn’t actually need approval, residents still pushed for, and got, a public hearing on the issue.
And that’s on a project that was already slated for approval.?? Elsewhere, a number of counties and towns don’t actually have zoning specifically for senior living facilities for independent living, assisted living or nursing home care. This can lead to problems because these are multi-resident units, which may not be allowed in residential areas, for example. Or on the other hand, a commercial zone that has a nearby hospital might not be available to developers.??Younger adults and even adult children of aging residents should be aware of these issues. The reason that facilities are generally clustered in certain areas is because of these zoning restrictions.
If you are aware of a project that could be a great fit for a loved one, there are a number of options that could speed approval.?? The first is to simply show up at a zoning board meeting where the developer plans to present. All too often, these are lightly attended affairs, and putting a human face to who will end up in one of these homes can help board members understand the value to a town or city.?? Another is to be on the lookout for issues on ballots that are related to zoning, ones that are either up for a vote in a town council or as part of an upcoming election. Being active can pay dividends in either case.?? The U.S. is facing a senior population that is set to double by 2050, and the laws don’t yet reflect that. But by acting locally, you may just find that you can help speed up the process in individual cases.