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- 11/29/17--22:30: _Webinar focuses on ...
- 11/29/17--23:00: _Kansas nursing home...
- 11/30/17--22:00: _Wells pastor accuse...
- 11/30/17--22:30: _ Who is the patient...
- 11/30/17--23:00: _Lengthy terms, disc...
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- 12/01/17--22:30: _Circuit judge accus...
- 12/01/17--23:00: _Local nursing homes...
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- 11/29/17--22:30: Webinar focuses on guardianship
- 11/30/17--22:00: Wells pastor accused of exploiting elderly
- 12/01/17--22:00: Seniors, leaving the house daily may help you live longer
- 12/01/17--22:30: Circuit judge accused of not paying taxes agrees to resign
- 12/02/17--22:00: Filial laws put kids on the hook for parents' health-care costs
- 12/03/17--22:00: Anaconda woman pleads not guilty to bilking elderly man
- 12/04/17--22:00: Victor Garber Is Raising His Voice to Support Alzheimer’s Caregivers
- 12/04/17--22:30: Lawyer found guilty of stealing more than $400K
- 12/04/17--23:00: Public School in a Nursing Home Benefits Young and Old
The workshop will discuss the implications of guardianship as well as alternatives to guardianship that can be utilized as a student reaches the age of majority on their 18th birthday.
Parents and relatives of children with a disability, professionals who work with individuals with disabilities, and teenagers learning to advocate for themselves may all find this workshop helpful. Pre-registration to Lisa@michiganallianceforfamilies or (906) 483-0442 is appreciated so organizers can plan for materials, etc.
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Webinar focuses on guardianship
Allen Wagner used to light up when his granddaughter entered the room, but when she visits him at his nursing home in Overland Park now, he hardly reacts. He’s sleepy and uncommunicative.
Wagner, 78, has Lewy Body Dementia and Parkinson’s disease. But his wife, Charlene, said it’s hard to tell how much of his lethargy is due to that and how much is due to the anti-psychotic medications he was first given during an extended hospital stay and has continued taking in nursing homes.
“I’ve seen a change since he went to the nursing homes,” Charlene Wagner said. “Not because of the care. The care is good. I believe it’s the medicines.”
Anti-psychotics are contraindicated for people with dementia and include a U.S. Food and Drug Administration warning that they increase the risk of falls, stroke and other potentially fatal side effects.
The federal government started tracking the off-label use of such medications in nursing homes in 2011. Since then, Kansas has always ranked at or near the top in percentage of medicated residents, suggesting there are thousands of residents in the state’s certified nursing facilities who have been given drugs that aren’t medically indicated for them, and could actually harm them.
“There’s something about that dementia coupled with the anti-psychotics,” said Margaret Farley, a board member for Kansas Advocates for Better Care, a group that represents nursing home residents. “This is not just us saying, ‘Gee, that’s not very good, you’re robbing them of their personality, they won’t talk, they’re not active, etc, etc.’ This is hardcore. This is a 1.6 to 1.7 times increase in deaths that most of the time is related to cardiovascular changes or it’s related to the development of pneumonia.”
Kansas also led the nation last year in percentage of skilled nursing facilities cited by the federal government for a broad slate of medication-related violations, some of which relate to anti-psychotic use.
Kathy Greenlee, a former Kansas Secretary of Aging who was appointed to U.S. Assistant Secretary of Aging under President Barack Obama, said the overuse of anti-psychotics is an unintended consequence of removing physical restraints from nursing homes in the 1980s and 1990s.
Now when people visit nursing homes they’ll no longer see residents strapped to beds and wheelchairs. But they will likely see some under “chemical restraint,” through the use of anti-psychotic medications like Haldol and Seroquel, which Charlene Wagner said have caused her husband to deteriorate.
Greenlee said she knows Kansas nursing homes are not the worst in the nation overall. But the rate at which they use anti-psychotics should cause some soul-searching about how they deal with difficult or disruptive behavior of residents with dementia.
“They can be overprescribed to sedate people and then mask the need to deal with these underlying causes (of disruptive behavior),” said Greenlee, who is now vice president of aging and health policy for the Center for Practical Bioethics in Kansas City, Mo.
Groups that represent Kansas nursing homes say the state’s anti-psychotic use ranking is unfairly skewed by a handful of homes that specialize in mental illness and that they face a number of challenges that are outside their control.
It’s hard to find enough qualified staff in many parts of the state. Some facilities rely heavily on Kansas Medicaid and payments under that program have been delayed for years due to bureaucratic changes. There’s also a shortage of psychiatrists in Kansas, especially those who specialize in treating older people.
“All of those I believe do factor into our ability to continue to really tackle this issue,” said Debra Zehr, the president and CEO of LeadingAge Kansas.
Cindy Luxem, the president and CEO of the Kansas Health Care Association, said Kansas homes have brought rates down, but they need help to reduce them further.
“We’re going to take a lot of responsibility on this topic, but at the same time we look at it as something where we really better start getting family members involved,” Luxem said. “Physicians, pharmacists, you name it.”
Zehr said that when doctors and nursing home workers use anti-psychotics on people who don’t have a mental illness, it’s not ideal, but it’s done with good intentions.
“Anybody who’s spent time with people in the throes of dementia and has seen the kind of internal anguish and volatile behaviors of people with dementia at certain stages, they’re trying to help,” Zehr said.
But some facilities have found better ways to handle those behaviors. Farley said more should follow their example.
“It’s not an easy thing to be able to take care of bad behaviors without these medications, but we’ve become far too dependent upon them,” Farley said.
The fight over the rankings
On average, 20 percent of all Kansas long-term nursing home residents received an anti-psychotic medication at some point in 2016, tying it for the highest rate in the country with Oklahoma and Mississippi. The national average is 16 percent. Missouri ranked near the top at about 19 percent.
Kansas has dropped from a high of about 26 percent in 2011, but other states’ rates have fallen more since then. (Click to Continue)
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Kansas nursing homes have ‘become far too dependent’ on mind-altering meds
|Peter Leon of Wells|
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Wells pastor accused of exploiting elderly
MIDDLETOWN - Investigations into alleged patient abuse at the Whiting Forensic Division of Connecticut Valley Hospital are continuing.
In the meantime a close family friend and the co-conservator to the patient at the center of the abuse shared insight into who the patient is with FOX61.
“He was fun, he had a sense of humor and he had a sense of purpose,” Dr. Karen Kangas, the co-conservator of the patient and a mental healthcare advocate, said. She told FOX61 she’s know the man at the center of abuse allegations for decades.
“He once said in a letter that he wrote, he said I don’t know that I have any friends and I’ve never had a girlfriend, so much of what he’s missed in life,” Kangas said.
Along with the patient’s brother, Kangas says she’s the only person left to advocate for the 59-year-old man who remains in the care of the Whiting Forensic Division of CVH. The Whiting Forensic Division is the maximum security unit of the hospital whose patients are most often court ordered to be there.
Kangas told FOX61 the patient was court ordered to Whiting Forensic back in the 1990’s when he was charged with killing his elderly father. He was found not guilty by reason of insanity.
Kangas also said the patient served out his court ordered sentence, but remained at the hospital for the last 10 years due to a lack of improvement in his mental health and a concern for his ability to be able to reintegrate back into society.
The abuse that allegedly went on over at least in a one month period involved taunting, antagonizing, physical, and abuse sexual in nature, according to police arrest warrants of the accused staff members. The police investigation and an inspection by the Department of Health and Human Services states the alleged abuse was all captured on surveillance video used in the patient’s room. Those cameras were intended for 24 hour a day patient monitoring, according to the reports.
This abuse surfaced in April. Since then, a total of 10 workers from Whiting Forensic have been arrested and charged with multiple counts of cruelty to a person. A total of 37 workers have been suspended from the hospital as well.
FOX61 obtained transcripts of the bi-annual, state mandated hearings held for the patient. In these hearings doctors for Whiting Forensic are required to present a patient status update to the state’s Psychiatric Review Board.
The transcripts included conversations about the patient’s “aggressive behavior” and “self-injury” triggering an order for two-to-one patient care with 24 hour monitoring.
The transcripts also reveal the patient was put in restraints 157 times over one two-year period.
The initial report of abuse triggered a full unit inspection by the Department of Health and Human Services this past spring. In that report,the inspectors claim the hospital had a long list of “failures” including a failure to “ensure the restrain and seclusion rooms were free from dirt, debris, or maintained safety.” Another “failure” cited was that the hospital and its workers did not properly report abuse or harassment.
FOX61 received an anonymous letter on the issue that makes claims workers in the hospital tried to report abuse but were disregarded or retaliated against.
"I've learned it recently. I met with the staff at Whiting and with some of the patients and that is something that they talk about so that is very concerning,” responded Miriam Delphin-Rittmon, Commissioner of the Department of Mental Health and Addiction Services who oversees the hospital.
"We investigate all instances of abuse and then act accordingly,” she added. She said the department is actively responding to the allegations and working on making a wide-range of improvements.
“This is something that we are taking very seriously, I take this very seriously. The fact that this happened is just … is just beyond words really, that somebody in our care could be treated so inhumanely,” Delphin-Rittmon said.
She also said she is working on a task force made up of people within the department at all levels to try to assess the changes needed within the hospital.
“Certainly the fact that this abuse happened and it wasn’t reported, that’s something that I’m trying to better understand. That’s a central question in our HR investigation, that how is it that this could happen and people didn’t come forward,” Delphin-Rittmon said. She added the department continues their own internal investigations into the matter.
In the meantime, Kangas said she and the patient’s brother are looking into what options they have to move the patient out of Whiting.
The patient is currently in a new unit on the Whiting Forensic floor, but under care of new staff, according to Kangas,
This is a really difficult time, a really difficult time in history to think that this goes on and I don’t think anyone would look back and want this to ever happen again,” Kangas said.
Connecticut Valley Hospital is a state-run facility which was $174 million to operate in fiscal year 2016.
Since the abuse allegations surfaced, the state leaders heading the Connecticut Public Health Committee launched their own investigation into the matter. They will hold a public hearing Monday at the State’s Legislative Office Building.
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Who is the patient at the center of the Connecticut Valley Hospital abuse allegations?
Amid the recent string of bad news about the bench, calls are intensifying for Maryland to establish a program to evaluate judges — a method endorsed by the American Bar Association and recommended nearly two decades ago by the state’s leading legal minds.
Maryland judges serve what are believed to be the longest terms in the nation — 15 years for elected Circuit Court jurists, a decade for appointed District Court justices. But unlike 17 states and the District of Columbia, Maryland does not routinely evaluate the performances of judges with the type of program that watchdogs say is essential to maintaining public trust, informing voters and helping judges improve.
“Judges in Maryland are kings and queens in their own courtrooms, so it’s hard to enforce best practices,” said Laurie Duker, executive director of Court Watch Montgomery, which examines judges in domestic violence cases. “They don’t like to be told what to do.”
Six states post evaluations publicly, according to the Quality Judges Initiative at the University of Denver’s Institute for the Advancement of the American Legal System. Others publish summaries, or give the reports privately to judges or those who appoint them to improve performance.
Jennifer Yim is executive director of Utah’s Judicial Performance Evaluation Commission. The state agency’s program is considered one of the nation’s most exhaustive.
“Most voters don’t see the inside of a courtroom, so it’s hard for them to have information they can know and trust about judges’ performance,” Yim said.
That’s true in Maryland, Johns Hopkins political scientist Matthew Crenson said, where jokes abound every election year about how to cast ballots for judges whom no one seems to know.
“Those who do vote have no information whatsoever,” Crenson said.
The Maryland State Bar Association expressed opposition last year to contested elections for Circuit Court judgeships, in part, the organization said, because voters have a “a lack of familiarity” with jurists that may lead them to vote based either on party or, worse, the alphabetical order in which they appear on the ballot.
Such a process, the association said, is “a poor formula, to be sure, for a fair and impartial judiciary.”
The association convened a committee in 1998 to study judicial performance evaluation programs.
The panel was co-chaired by Steven I. Platt, a retired Circuit Court judge, and attorney Nell B. Strachan, and included two of the state’s most accomplished jurists: former Court of Appeals Chief Judge Robert M. Bell and current Court of Appeals Judge Sally D. Adkins. Members recommended establishing a mandatory evaluation program to be run by the Administrative Office of the Courts.
The recommendation went nowhere.
“We’re coming up on 20 years,” Platt said recently. “I do think it’s needed. We’d be better with it than without it. Judges should be as subject to as much criticism as anyone else.”
Circuit Court judges in Maryland are appointed by governors from lists developed by the state’s judicial nominating commissions. They then face voters in the next election.
District Court judges are appointed by a similar process, but never face election.
Platt said the nominating commissions expend tremendous amounts of time, effort and money to vet candidates for the bench — but they never formally follow up on their performance.
“Is anyone watching them?” Platt asked.
Strachan, Platt’s co-chair on the bar association committee, said an evaluation program would give the public more confidence in judges.
“There’s plenty of room for improvement,” she said. “But a project like that requires commitment of time, energy and money — and a lot of follow through.
Utah spends $400,000 annually on its Judicial Performance Evaluation Commission over the past five years, according to budget documents. To understand how the 13-member commission works, consider the case of Utah District Court Judge Su Chon.
Before election day last year, the commission posted reviews of all judges up for re-election. Chon was subjected to a scathing 10-page review in which survey respondents called her a “rude” and “indecisive” judge who had “failed to meet the minimum performance standard for legal ability.”
The opinions were developed through extensive surveys with lawyers, courthouse staff, jurors and litigants. Volunteer observers with no legal training watched judges for basic etiquette.
The commission’s advice to voters: remove Chon from the bench.
Chon countered in the report that she had been vetted and appointed by Utah’s governor in 2012, and none of her rulings had been reversed on appeal.
When the ballots were tallied, Chon ended up keeping her job. The victory did not bother Yim. The commission’s executive director was satisfied that voters had an exhaustive report to use when they cast their ballots.
Some in Maryland say the vetting by the state’s nominating commission, elections and disciplinary process are sufficient.
“Currently, the delivery of justice is guided by strict ethical rules for judges and attorneys,” Maryland Public Defender Paul DeWolfe wrote in an email. “These rules are more than minimum standards but rather stringent guidelines. Granted they are not a measure for concepts like ‘quality’ and ‘effectiveness,’ but they demand of judges (and attorneys) that they behave with integrity and impartiality.”
Some warn an evaluation of a sitting Circuit Court judge could give an advantage to an opponent who had no record on the bench to evaluate. That would chip away at how the system, they say, and the lengthy 15-year terms, help insulate circuit judges from politics.
A lengthy term “protects the independence of the judiciary from political influence,” said Russell McClain, a professor at the University of Maryland’s Carey School of Law.
“We want to have independent decision-makers,” McClain said. “We don’t want them to be worried about being reappointed or re-elected.”
“Oversight is hard unless someone is sitting in the courtroom monitoring how decisions are being made.”
That’s exactly what Court Watch Montgomery does. Duker, the group’s co-founder, said a statewide evaluation program with courtroom observers as in Utah would improve the administration of justice.
The judiciary is “such a closed process,” she said. “There is a lot of clubbiness to it.”
Court Watch Montgomery deploys 70 volunteers to observe 500 protective order cases and 500 domestic violence criminal cases each year.
In 2011 and again in 2015, the group reported that judges were not using staggered exits out of courtrooms that are meant to keep victims from encountering abusers in hallways or parking garages. The District Court quickly enacted a new policy six years ago and issued a reminder in 2015.
The group also pushed judges to stop ordering parental visitations and exchanges of children in areas where victims could easily be abused again. In response, this month Montgomery County is opening a “safe passage” center for supervised visits and exchanges.
Duker said judges now appreciate the feedback, and will go to her with tips about colleagues.
The Quality Judges Initiative at the University of Denver has found that judges do not view the programs as a “threat or a challenge to their competence.” Instead, they see the process as an effective way to improve.
Recent research has shown that some surveys used in evaluation programs can be “systematically biased against minority and women judges,” according to the National Center for State Courts. “States must remedy weaknesses in their [Judicial Performance Evaluation] surveys if they wish to preserve the credibility of JPE programs in the public’s eye and within the court community.”
A spokesman for the Maryland Judiciary said the courts are not considering an evaluation program. The judiciary is using a data-collection process developed by the National Center for State Courts as part of an “approach to continuous improvement and quality service.”
The process, called CourTools, examines closure rates of cases and time management, not judges’ performance.
The last time the Maryland Judiciary conducted the system’s “statewide user survey at every court location” was in 2008, the judiciary said in a report. A new one is scheduled for next year.
Others say Maryland’s Commission on Judicial Disabilities is an effective process for rooting out problematic judges.
The commission ruled in October that Baltimore Chief Judge Alfred Nance should be removed from the bench for misconduct stemming from his “persistently disrespectful and unprofessional” interactions with a public defender. The commission had investigated Nance at least twice before during his 20-year career, and publicly reprimanded him in 2001 after female prosecutors complained that he had an explosive temper and commented on their appearance.
The commission’s recommendation now goes to the Court of Appeals for a decision.
Complaints filed with the commission — which come mostly from the public — are considered “confidential and not available to the public” unless the panel takes action.
Complaints to the commission have doubled over the past decade, from 117 in the fiscal year 2007 to 234 in fiscal 2017. Of the 234 verified complaints in 2017, three ended in charges. One ended in a public reprimand, and another resulted in an extension of probation.
Most complaints are dismissed because the commission finds them to be unsubstantiated or the actions reported do not amount to “sanctionable conduct.”
Among complaints that ended in warnings, judges were found to be “demeaning,” “threatening,” “condescending,” “irritable,” “short-fused,” “snide,” “rude,” and “racist,” or to have lacked impartiality.
Critics of the process say it can take too long, and does not always change behavior.
The commission held a hearing Thursday on charges filed against District Court Judge Mary C. Reese of Howard County. Duker said the case is a perfect example of how long complaints can take.
The Women’s Law Center of Maryland filed two complaints with the commission in July 2015. The commission ruled in April, nearly two years later, that Reese’s actions were “manifesting bias.”
Reese rejected the request of a 17-year-old girl for a temporary peace order against a man who had left her with a black eye visible in the courtroom. The girl told the judge she had blocked the man’s phone number to avoid contact with him.
“It looks to me like she’s taking care of it,” Reese said in court transcripts.
In a different domestic violence case, Reese told a woman that if she picks a fight with her abuser “you’ve got to expect to lose it,” according to transcripts.
In a response to the complaint, Reese called the allegations “a targeted attack on Judge Reese by an advocacy group with a political agenda.” She said she ruled correctly in both cases.
Michelle Daugherty Siri, executive director of the Women’s Law Center of Maryland, said she would not comment because the case is still pending.
The commission said its investigation “revealed sanctionable conduct by Judge Reese with regard to her unprofessional comments and behavior.”
A decision by the commission can take weeks or months.
Duker called the process inadequate.
“We need far better — and swifter — judicial accountability,” she said.
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Lengthy terms, discipline process cloak Maryland judges from scrutiny
New research finds that older people who leave their homes every day are likelier to live longer than those who remain indoors, regardless of their health status or functional capacity.
Lead study author Dr. Jeremy Jacobs, from the Hadassah Hebrew-University Medical Center in Israel, and colleagues recently reported their findings in the Journal of the American Geriatrics Society.
According to a 2015 study, approximately 2 million older adults in the United States never or rarely leave their homes, primarily due to functional difficulties.
Not only does this have implications for their physical health — due to lack of exercise, for example — but it can harm their psychological health, too. Research has shown that those who are confined to their homes are more likely to develop depression, anxiety, and other mental illnesses.
For their study, Dr. Jacobs and colleagues set out to investigate whether or not the frequency with which an older adult leaves their home might be associated with mortality.
Staying indoors linked to greater death risk
The research included 3,375 adults aged between 70 and 90 years. All adults were enrolled in the 1990–2015 Jerusalem Longitudinal Study.
As a part of the study, participants completed questionnaires about how often they left their homes each week. They were divided into three groups, based on their answers: daily (six to seven times weekly), often (two to five times weekly), and rarely (less than once per week).
"What is interesting is that the improved survival associated with getting out of the house frequently was also observed among people with low levels of physical activity, and even those with impaired mobility," says Dr. Jacobs. "Resilient individuals remain engaged, irrespective of their physical limitations."
Previous research has shown that people who spend more time outdoors — particularly in natural environments — may experience lower levels of stress and improved physical and mental health.
What is more, going outdoors provides greater opportunity for social interaction, which studies have linked to better overall health and well-being in seniors.
So, it seems that simply going outside to chat with the neighbor or taking a quick trip to the local grocery store could do the world of good for older adults' health.
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Seniors, leaving the house daily may help you live longer
The Arkansas Judicial Discipline and Disability Commission said Friday that Saline County Circuit Judge Bobby McCallister will resign, effective Dec. 15. The panel says it unanimously accepted McCallister’s agreement to step down.
Prosecutors say McCallister failed to pay or file taxes from 2012 to 2014 and in 2016. He’s been charged with four felony counts of failing to pay or file taxes.
The Judicial Discipline and Disability Commission said McCallister was “candid” and cooperative with the panel during its investigation.
Gov. Asa Hutchinson will appoint a replacement to the position.
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Circuit judge accused of not paying taxes agrees to resign
|A room at Brighton Place in San Diego|
The nursing homes, all owned by Los Angeles-based Brius Management Co., were accused of paying kickbacks to hospital staffers in violation of anti-kickback laws, the U.S. Attorney’s Office said in a news release.
The four nursing homes were Point Loma Convalescent Hospital, Brighton Place in San Diego, Brighton Place in Spring Valley and Amaya Springs Health Care Center in Spring Valley, according to the news release. Brius Management could not be reached for comment.
The settlement resolves a lawsuit brought by a former employee of one of the nursing homes under federal whistleblower laws, the statement said. The employee, Viki Bell-Manako, will receive 20 percent of each settlement payment.
In a deferred prosecution agreement with the U.S. Attorney’s Office last year, the four nursing homes admitted employees conspired to pay kickbacks, and did so without the owner’s knowledge, the statement said.
The nursing homes also admitted employees used corporate credit cards to buy gift cards, massages, tickets to sporting events and a cruise for hospital staffers in exchange for referrals, according to the statement.
The settlement announced Thursday calls for Brius Management Co. to pay $1,785,967 to the United States over three years, and a single payment of $240,950 to California, the statement said.
It also agreed to pay $4.9 million to the U.S. government if certain “operational contingencies” are met and to enter into a corporate integrity agreement with the U.S. Department of Health and Human Services, the statement said.
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Local nursing homes agree to pay up to $6.9 million to settle kickback and fraud allegations
The case, Health Care & Retirement Corp. of America v. Pittas, showed how filial laws, on the books in about 30 states, can wreak financial havoc on families that don't prepare for long-term-care needs.
Some observers point to a more recent case, though, to demonstrate the breadth of how courts enforce filial laws, which basically establish that children have a duty to care for their parents, and which experts believe will become more relevant as lifespans increase and healthcare costs swell.
The case, Eori v. Eori, broadens the net of financial responsibility — while the Pittas case was an example of an institution recouping money from a patient's child, the Eori case pits siblings against each other. It determined that each had a financial responsibility to financially support their ailing mother, who required in-home care.
"This should open [financial advisers'] eyes to, even if you don't have that client that ends up in a nursing-care facility, they're still going to have end-of-life costs, and if they become indigent or broke and rely on others, that could have a big impact on all the family members," said Jamie Hopkins, professor of retirement income at The American College of Financial Services.
Roughly half of Americans turning age 65 today will require long-term care. In 2017, the national median monthly cost for a home health aide was about $4,100, according to Genworth Financial Inc. The monthly cost swells to more than $7,100 for a semi-private room in a nursing home.
While states' filial laws differ, the Eori case — also from Pennsylvania — is a "fair reading" of what may be expected in other states, Mr. Hopkins said.
While there haven't been many lawsuits involving filial laws and long-term care in the public eye, Hyman Darling, president of the National Academy of Elder Law Attorneys, believes it's "just a matter of time before there are more of these cases," especially because a few have gotten some traction in the courts.
"When it gets out there and people see it, they know there's an opportunity to hang their hat on it to try to get some money," said Mr. Darling, who's also a partner at law firm Bacon Wilson.
The Eori case pitted Joseph Eori, who helped care for his 90-year-old widowed mother Dolly, against his siblings Paulette and Russell (who, after the lawsuit began, changed his name to Joshua). Because they weren't providing financial assistance to their mother, Joseph sued under the state's filial laws.
The mother had cancer, dementia and Alzheimer's disease, and required 24-hour care that came via adult day care as well as three in-home caregivers, the cost of which exceeded her Social Security income, according to a court document.
Ultimately, a Pennsylvania state court mandated in 2014 that the brother, Joshua, pay $400 per month in support — or, $4,800 a year — which was upheld on appeal. The daughter consented, before appeal, to also pay $400 a month.
Interestingly, the court found that the mother wasn't "destitute," but needed extra income to help meet her monthly expenses and therefore was considered "indigent."
"Now, we've seen a court say, 'You do have to pay up, Family Member No. 2 and 3,'" Mr. Hopkins said.
Observers believe financial advisers would be wise to become more aware of filial responsibility laws, which underpin the importance of having a conversation with clients around long-term-care planning.
"The people who don't know it should, because it's going to become more prevalent," Mr. Darling said.
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Filial laws put kids on the hook for parents' health-care costs
ProPublica story in April that described how nursing homes and their pharmacies nationwide throw away hundreds of tons of valuable medicines — and how one Iowa nonprofit successfully recycles them — two states are working to create similar programs.
Other states, including Vermont, are exploring the idea as well.
“All that medicine is perfectly good and perfectly safe,” said Rep. Nicholas Duran, D-Miami, who co-sponsored a bill in Florida modeled on the Iowa program. “Rather than being burned up, it could be put back to some great use.”
ProPublica’s story detailed how the nursing home industry dispenses medication a month at a time, but then is forced to destroy it after patients pass away, stop using it or move out. Some send the drugs to massive regional incinerators or flush them down the toilet, creating environmental concerns.
In Iowa, a program called SafeNetRx retrieves the excess medication, inspects it and dispenses it for free to needy patients. Almost 80,000 Iowans have used SafeNetRx to obtain medication — from cheap antibiotics to cancer drugs worth thousands of dollars per month.
The state funds the program for about $600,000 a year and in fiscal 2016 it recovered and distributed drugs valued at about $3.4 million. This year it’s on pace to hand out more than $6 million of reclaimed medicine.
Many states have laws that allow the donation of drugs, but they don’t have programs that get the drugs safely from nursing homes to those who need them.
After reading ProPublica’s story, Duran, who is also the executive director of the Florida Association of Free and Charitable Clinics, said he visited a long-term care pharmacy and saw firsthand how much valuable medication was being destroyed.
The people at Polaris Pharmacy Services, he said, told him they’d love to donate the medicine, but can’t legally. The new law would create a program to transfer the drugs so they can be dispensed free to patients, he said.
About $400,000 worth of the drugs Polaris dispenses each month are returned because they’ve been stopped for some reason, said David Rombro, the pharmacy’s chief executive. The drugs come back in the same sterile packaging, untainted and unexpired.
Polaris can get credit for about half the unused medication, but the remaining drugs — worth about $2.5 million a year — must be taken away for incineration, he said. Based on the size of his pharmacy and how many others exist in Florida, he estimates about $50 million worth are destroyed annually statewide.
“It’s perfectly good medication,” Rombro said. “There are people that need drugs that don’t have them.”
In New Hampshire, radio show host Arnie Arnesen became excited about the idea after featuring the ProPublica story and the executive director of SafeNetRx on “The Attitude with Arnie Arnesen.” She pitched the drug donation idea to New Hampshire Sen. Dan Feltes, D-Concord, urging him to make it happen in New Hampshire.
“This makes so much sense,” she recalled saying to the senator. “It even fits in with our thrifty values.”
Feltes is now the sponsor of a New Hampshire bill that would create a commission to research how to start a drug donation program like Iowa’s.
Vermont leaders also say the Iowa program would be a good fit for their state, where the “ethos” favors recycling, being environmentally conscious and improving access to medication, said Meg O’Donnell, director of government relations at The University of Vermont Medical Center. There’s a chance Vermont would even hire SafeNetRx in Iowa to run its program, she said.
“We can say pretty confidently there are some real opportunities,” O’Donnell said.
It costs money for nursing homes or pharmacies to properly dispose of the unused medication, Rombro said. Polaris employs two people full time to process the excess drugs, and pays about $5,000 a month to incinerate them.
Other companies and nursing homes simply flush them and trace amounts of pharmaceuticals have been found in water supplies throughout the country. In Florida, wastewater is treated and then pumped into the aquifer, or used to water lawns and golf courses, said Jay Sheehan, senior vice president of Woodard & Curran, a company that runs two utilities in the state. But Sheehan said the wastewater is not treated for possible pharmaceutical contamination.
“We have a problem and we need to collectively address it,” Sheehan said. “The more we can [donate excess drugs] the better we are as a holistic community, because everything is connected.”
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More States Hatch Plans to Recycle Drugs Being Wasted in Nursing Homes
“I’m just stunned,” said Barbara A. Petersen, who is the president of the First Amendment Foundation in Tallahassee, an open-government group. “Government serves the people. They are doing a disservice, and one with potentially grave consequences.”
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Florida spent $22,000 to remove online nursing home info from public view
Anaconda woman pleads not guilty to bilking elderly man
At the conclusion of a preliminary hearing in Richmond County Civil Court for Tamika Burns, 41, presiding Judge H. Scott Allen found probable cause to send felony charges of operating an unlicensed personal care home and exploitation of an elderly or disable person to the grand jury. He dismissed a third charge of neglect of an elderly or disabled person.
Burns has been held without bond since her arrest Nov. 7. Richmond County Deputy Marshal Stephen Billman obtained the warrants for Burns’ arrest after investigating a complaint emailed to the Crimes Against the Vulnerable and Elderly task force, he testified Thursday.
Billman said he went to the home at 3541 Biltmore Place where he found four disabled people living in the dirty and roach-infested house. One of the residents was confined to a wheelchair and unable to move or speak, Billman testified. Another resident told him that she took care of the physically disabled man and kept house in exchange for $20 a month, he said. Both she and two other residents needed medication for mental illnesses.
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Augusta woman faces possible indictment in unlicensed personal care home case
Some preventable deaths in nursing homes are a result of aggression between residents. This most commonly occurs in people with dementia, our new research has found.
Ours is the first study to examine the frequency and nature of resident-to-resident aggression resulting in the most severe outcome – death. In our analysis, almost 90% of residents involved in resident-to-resident aggression had a diagnosis of dementia. Three-quarters had a history of behavioural problems, including wandering and verbal and physical aggression, which are common symptoms of dementia.
Published in the Journal of the American Geriatrics Society today, we examined records for all resident-to-resident aggression-related deaths among nursing home residents reported to a coroner in Australia between 2000 and 2013.
We identified 28 deaths resulting from aggression between nursing home residents in Australia over the 14-year study period. This is within around 3,000 deaths that occurred from non-natural causes. However, due to reporting limitations, the number of deaths due to resident-to-resident aggression is likely to be the tip of the iceberg.
The rising global prevalence of dementia, particularly in the nursing home population, means aggressive behaviours between residents will increasingly be an issue. Two high-level reports on elder abuse in aged care in Australia have recommended better reporting systems so we can understand and prevent all such deaths in nursing homes.
Aggression in nursing homes
Resident-to-resident aggression is an umbrella term that includes physical, verbal or sexual interactions that are considered to be negative, aggressive or intrusive. These behaviours can cause serious physical harm or psychological distress.
The prevalence of aggression between nursing home residents is difficult to determine. Recent research estimates at least 20% of nursing home residents in the US were involved in such incidents.
These typically occur between residents with a cognitive impairment or diagnosis of dementia. A recent analysis of the international literature revealed physical forms of aggression between residents occurred most frequently in communal areas of the nursing home and during the afternoon. This is when the behavioural and psychological dementia symptoms usually manifest (also known as “sundowning”).
Most incidents appeared to be unprovoked, or were triggered by communication issues or a perceived invasion of personal space. Importantly, only one of the 18 studies reported a single death as the result of physical resident-to-resident aggression.
Our research found most exhibitors of aggression (85.7%) were male. The risk of death from aggression between residents was twice as high for male as for female residents. Those who exhibited aggression towards other residents were often younger and more recently admitted to the nursing home than their targets.
Incidents commonly involved a “push and fall”. Seven (25%) related deaths resulted in a coronial inquest, but criminal charges were rarely filed.
However, this is likely to be just the tip of the iceberg as there is much potential for underreporting and misclassification of resident-to-resident aggression deaths. We have limited data on how often incidents of aggression between residents in Australia occur but do not result in death.
Our limited data are primarily due to how our mandatory reporting framework is structured. The Aged Care Act 1997 and associated Accountability Principles 2014 require nursing home providers to report allegations or suspicions of abuse to the federal health department and police within 24 hours. These allegations include unlawful sexual contact, unreasonable use of force, or assault against care recipients.
According to the Productivity Commission’s annual report on government services, the Commonwealth Department of Health received 2,625 notifications of assaults in nursing homes in the 2014-15 financial year. This is around 1.1% of all residents receiving care during that period. The majority (84%) of these reports were for alleged or suspected unreasonable use of force.
However, the legislation includes a discretion for providers not to report incidents of resident-to-resident aggression if the alleged offender has a previously assessed cognitive impairment and a behaviour management plan has been put in place for the care recipient within 24 hours of receipt of the allegation or suspicion of assault.
This means that the most common types of resident-to-resident aggression incidents (those involving cognitively impaired residents) are never collated and publicly reported. So we have no way of knowing the scale and severity of the problem.
The annual report statistics are also limited to identifying only the number of incidents. They do not include an analysis of the relationship between the target and exhibitor of aggression. This means we don’t know how many of the incidents were between residents or between residents and staff.
Finally, no other contextual information on the incidents is available in the annual report statistics.
This represents a significant gap in knowledge on resident-to-resident aggression. In-depth analysis of contributing factors can help provide evidence to inform prevention strategies.
Preventing aggression between residents
This issue has not gone unnoticed. In its June 2017 report on elder abuse, the Australian Law Reform Commission recommended that aged care legislation should provide for a new serious incident response scheme. The scheme would require approved providers to notify an independent oversight body of any allegation or suspicion of a serious incident in their facility.
In relation to resident-to-resident aggression, these notifications would include incidents of physical abuse causing serious injury, or incidents occurring as part of a pattern of abuse.
The federal government’s recent review of aged care regulation supported this recommendation. The review was initiated in response to revelations of abuse and neglect in South Australia’s Oakden Aged Mental Health Service.
Ensuring accurate reporting of incidents of aggression between residents, and raising community awareness of ageing-related issues, are important first steps to improve our aged care system and prevent harmful interactions between vulnerable older adults in care.
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Violence between residents in nursing homes can lead to death and demands our attention
5:00 pm PST … 6:00 pm MST … 7:00 pm CST … 8:00 pm EST
Join us this evening as Carly Walden from Hospice Patients Alliance reveals more about the mission of Hospice to hasten the end of life. Joining her will be Janice Whitten who has had direct experience with Hospice and the nightmare they endured while Hospice was involved. Far from being the good Samaritan organization it was once known to be, Hospice is the death knell for the elderly.
Carly will explain how to revoke Hospice, where to find the forms needed and how to proceed.
As people reach the age of 60, or become disabled, your life expectancy is being drastically reduced through a government policy of medical murder. All of it hidden under the guise of deeming you terminally ill with 6 months or less to live. But what if the diagnosis is wrong...or the terminal illness never existed to begin with? And even if an individual is terminally ill, why would that give Hospice the right to end their life as expediently as possible?
LISTEN to the show live or listen to the archive later
Victor Garber lost both his parents to Alzheimer's. It was a long and difficult journey for family members.
“My father was in London, Ontario,” he recalls. “My brother became the primary caregiver, along with my father's wife. My mother lived in Los Angeles, so I was more involved in her progression.”
As a caregiver, Garber developed a deeper appreciation for others who've helped loved ones fight the disease. “You basically have to give up your life, and that's difficult for so many reasons. Alzheimer's rips people apart and, in some ways, is as difficult for the primary caregiver as it is the person going through it.”
Garber recalls how music comforted his ailing mother as he watched her slowly slip away. Caring for her was instinctive and emotional. “She became so helpless and so dependent. I was fortunate because I had money to put her in a facility that was extremely comfortable, and someone was always with her when I was working. I'm not the typical Alzheimer's caregiver by any stretch of the imagination. That's why I have such empathy for people who have to quit their jobs because they can't leave their husband or wife alone.”
Garber is committed to using his fame to shed light on the issue, whenever possible. “On ‘Alias,’ everybody on the show became an advocate. Jennifer [Garner], Michael [Vartan], Ron [Rifkin] and Bradley [Cooper] all knew my mom. Celebrity does draw people in. I will take advantage of it and do whatever I can, when I'm asked.
“It's very hard for me to see friends going through it,” he adds. “Both my parents are long gone, so it's not in my daily life, except for the statistics, and that's scary.”
Creating a network of support
When tending to an Alzheimer’s patient gets to be too much, Garber says asking for help is crucial to survival. "Go to any organization in your area. Reach out to family and friends. You can't do it alone. You have to sometimes put yourself first, which is really hard to do. “Take care of yourself, because you have to function. Make sure you have support in place, in any way that you can.”
Garber adds, “We need a cure. It's about the scientists, the technicians and other people working in the industry, and where the money has to go. That has to happen.”
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Victor Garber Is Raising His Voice to Support Alzheimer’s Caregivers
Robert Searfoss III, 40, of Perrysburg was convicted by a jury in Wood County Common Pleas Court of two counts of aggravated theft, four counts of engaging in a pattern of corrupt activity, four counts of money laundering, three counts of theft, and one count of grand theft.
The jury also found Searfoss responsible for 20 of 22 specifications that sought forfeiture of money as well as property purchased with the stolen money.
Prosecutors said Searfoss was in serious personal financial straits when he dipped into the trust of Eric Walker to buy a house and pay off debt, including back taxes, child support, and a home equity loan.
Defense attorney Rick Kerger contended Walker had borrowed the money from Mr. Walker's trust to be paid back with interest as a way of helping Mr. Walker shield the trust from his ex-wife.
Common Pleas Judge Alan Mayberry is to sentence Searfoss Jan. 2.
Searfoss has been held in the Wood County jail since his indictment in May.
Full Article & Source:
Lawyer found guilty of stealing more than $400K
Lawyer arraigned on 14 theft charges
“I was thrilled,” she says. “I have nine grandchildren, and I don’t get to see them very often. It fills a void to be around the kids. I love it.”
Although a number of nursing homes have onsite child care centers, it is rare for a public school to have such a partnership. “It’s something we’re very proud of,” says nursing home administrator Scott Bushong. “We view it as a collaborative extension to connect Grace Living with the greater community.”
School in a Nursing Home: The Birth of an Idea
The concept was the brainchild of Don Greiner, whose for-profit chain owns Grace Living.
He approached the school system in 1998. Putting his money where his mouth is, Greiner spent some $200,000 to construct two classrooms, a playground, an ice cream parlor and a beauty salon that looks into a classroom. The school system pays $1 annual rent, making it essentially cost-neutral. For the nursing home, the primary cost — other than construction and modest utilities and maintenance — is the salary of a liaison to the school.
Bushong says the rising generation of boomer elders sees retirement “as a time to create purposeful living.” To that end, the intergenerational curriculum focuses on three areas that benefit young and old alike: lifelong learning, wellness and physical fitness, and the arts and humanities.
Among the activities: joint exercise class, reading buddies, shared learning (making self portraits and friendship bracelets), dramatic play and singing.
A Winner for Kids
“When they start their school day, I drop them off, and the aides are there with the residents — we call them Grandmas and Grandpas (or “Grands” for short),” says Sarah Koehling, who has had three children attend school there. “They greet each other and give high fives or hugs. It gives a resident a reason to get up and get dressed and get moving.”
Wednesdays are a highlight for her 5-year-old twins, as they line up with the Grands for the ice cream social. When the kids (known as the Littles) participated in the PTA’s jog-a-thon fundraiser, the Grands lined up inside the nursing home to cheer them on, holding handmade signs and playing musical instruments. The Grands also help with activities like the fall carnival and, together with the Littles, decorate the building for holidays. The children eat lunch at small tables in the hallways and Grands can join them.
Perhaps most impressive, the children at Grace Living Center make remarkable progress in reading, thanks to the regular one-on-one time with their older book buddies, like Maccourt.
“Sometimes we just visit,” she admits. “The kids are so full of knowledge, it just blows my mind.
That comes from good parenting and the teachers here.” She also enjoys gardening with the children, together sampling their harvest of carrots, green beans and radishes.
Jenks West Elementary has pre-K and kindergarten classes in both the traditional school setting and the nearby nursing home.
Principal Suzanne Lair has tracked reading progress for years, comparing the students at Grace Living Center with their peers in the traditional classroom. Consistently, 25 to 30 percent of first-graders at Jenks West overall are not reading at grade level, compared to less than 4 percent of those who attend Grace Living for pre-K/kindergarten. That benefit continues through third grade, Lair says.
Building Character in Kids
Tricia Travers, who teaches pre-K and also is mother to a kindergartner at Grace Living, says the intergenerational program, which serves 46 children, has far exceeded her expectations.
“One thing that’s huge is how character-building the program is,” she says. “[The children] are really empathetic toward people of all ages. They see people with walkers, wheelchairs, breathing tanks, whose legs have been amputated. A parent told me it allowed her to teach compassion.”
Another parent, whose children are now in college and high school, told Travers her kids continue to be “very empathetic. They become so comfortable [with older adults] at such a young age, that has carried on through their lives.”
Dementia and Death
Children also encounter residents with dementia. “Something is hardwired in us, whenever those little kids are around, [those with dementia] flip a switch,” says teacher Katy Wilson. “They may not remember what they had for breakfast, but they are happy when they hear those babies. They are almost completely different people when the children are there.”
Wilson says the kids learn early on “how to regulate their actions.” They know to rein in their energy and walk calmly in the hallways to avoid jostling a Grand. “When they do a fist bump, they do it very gently,” she adds.
Inevitably, the children are also exposed to the death of a beloved Grand. “We talk about it with the children when we’ve lost a grandma or grandpa,” says Lair. “The children prepare a celebration of life booklet for the family. That’s been therapeutic. We talk about it in a very natural way.”
Lair says in the program’s early days, some parents were concerned about the children’s safety. “I remember having to call and plead with parents to consider it,” she recalls. But in 18 years, no problems have arisen. Today there is a waiting list for the nursing home classrooms.
The Benefits for ‘Grands’
Ensuring that the intergenerational encounters go smoothly and safely is the job of Adele Burnett, the nursing home’s liaison with the school.
Having such a position is key to the program’s success. She or other staff members are always on hand when Grands and Littles are together. Roughly one-third of residents participate, in addition to those who enjoy sitting and watching the kids on the playground or through the glass walls into the classroom.
“A couple times a day I might cry when I see the relationship between a child and a resident,” Burnett says. One recent example: a resident never left her room, saying she had no interest in getting up. Burnett persisted in trying to engage her with the children. “I told her maybe it would make her happy, and it would make the children happy,” she says.
The resident finally gave it a try. She later thanked Burnett for not giving up on her. “It’s really brought me back to life,” the resident said. “When I first came here, I thought my children were leaving me to die. This has given my soul a purpose.”
Bushong, the Grace Living administrator, says the program also provides an opportunity for the older generation to pass on their stories, “whether it’s about hard work and sacrifice or a sense of our roots as a country and trying to instill that in upcoming generations.”
Impact on Both Generations
Donna Butts, executive director of Generations United, a national nonprofit, says that little research has been conducted on the long-term benefits of intergenerational programming in nursing homes. But “what we hear is that young people who have been around older adults have a tendency to be more patient and be more accepting of differences than people who have not been socialized around older adults,” she says.
As for nursing home residents, “when you think about intergenerational programming, one of the important impacts is that it decreases social isolation and provides social connection and purpose,” says Butts, a 2015 Next Avenue Influencer in Aging. “They have a reason to stay alive. The more in-depth the relationship, the more impactful the experience for both generations.”
This is the first of a three-part series on model intergenerational programs. The series is written with the support of a journalism fellowship from New America Media, the Gerontological Society of America and the Silver Century Foundation.
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Public School in a Nursing Home Benefits Young and Old
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Couple charged with scamming home, cash from 92-year-old neighbor with dementia
|Mark Wayne Miller|
According to Tulsa World, Mark Wayne Miller, 48, formerly pastor of the Broadway Baptist Church, was arrested by Sand Springs police and charged with two counts of obtaining money by false pretenses following a year-long investigation.
Police state that seven members of the church stated that Miller bilked them out of $46,000, with police suspecting the amount could be larger after ten other parishioners who also lost money chose not to become involved in case.
“For what we could tell, (Miller) first started borrowing money in October of 2016,” said Sand Springs Police Capt. Todd Enzbrenner. “That victim tried to recoup the money, and when that didn’t happen she called us and filed a report.”
According to the court filing, Miller told some victims that he needed money to pay for his daughter’s college tuition only to later claim he lost the money in a bulk aluminum deal.
The report states that Miller, who served at the church for 14 years, the last four as the lead pastor, bilked one elderly church member out of $30,000 and another for $11,500.
Miller then obtained another $5,000 for what he described as a “great vacation opportunity” and then reportedly used the money to take his family on a trip.
Miller additionally pressed the elderly woman for another $39,000 to pay for his son’s college tuition, but she declined to give him the money
Police state that when Miller was interviewed by investigators in August 2016 he told detectives that he was addicted to painkillers and gambling, adding that he attempted to recoup the money given to him by trying to win it back with more gambling.
Miller stepped down as the lead pastor at Broadway Baptist on Aug. 1, 2017 after being confronted by church officials over the money given to him by church members.
Full Article & Source:
Former pastor busted for bilking elderly parishioners out of $46,000 to pay for vacations and drugs