Articles Posted in Senior Health Care


It is never an easy decision to make decisions for another person when it is the other person who has to live with the consequences of those decisions. That is doubly true when there is not any family relation or close ties that bind you. When you are deciding for a family member, say for example an aged parent or grandparent, at least you have the benefit of years worth of conversations and their larger thoughts on certain key matters of health and health decisions. You can look back and remember what they did or said in certain similar scenarios. What about those who do not have any such close relatives who decide for them? There is a class of professional guardians across the state and country who are professional in every sense of the term. They examine an issue and consider the best way to get the answer by asking further questions of the experts, such as doctors, therapists, social workers and so on. The hardest decision that any guardian has to make, regardless of whether or not they had the benefit of ties of affinity, is whether or not to terminate treatment for an incompetent patient. By what yardstick do they measure their decisions?

If a patient already expressed their clear desire in the past as to what they want to do, the decision that the guardian must make will be much easier. The 1972 New Jersey case of In Re Quinlan sums up the decision making in this case best. In Quinlan, a young woman was in a vegetative state from which she was not likely going to recover. Her father applied to the Court to be her guardian so he could have the life supporting medical apparatus removed. The trial Court denied this application, although the state Supreme Court found a Constitutional right to privacy in such decisions to remove oneself from life support that the state cannot intervene in. Since she could do it personally, her guardian could do the same in her absence. The legal protections that control a guardian’s decisions ensure that guardians do not make their decisions with improper motive.

Elder care advocates are understandably up in arms following reports about questionable evictions from a Brooklyn facility catering to seniors. The sad situation is a reminder of the continuing struggles faced by so many local families in their quest for quality, reliable long-term care and support. It is also a troublesome sign that most communities remain drastically unprepared to provide the aid that will be needed in coming decades as the New York population ages.

NY Nursing Residents Evicted After Facility Closure

As reported by the NY Daily News last month, a group of over 100 Brooklyn seniors are currently scrambling to find alternative living arrangements following the announcement of the sudden closure of the Prospect Park Residence. The Park Slope facility has been a home for senior for over 15 years. But that will end in May, as the facility is slated to shut its door by the beginning of June.

The face of New York nursing home care has been changing in recent years. The traditional model of individual counties throughout the state owning and operating facilities to provide care to ailing seniors is being phased out in may places. Instead, the counties are selling the homes to private companies to operate. The moves are spurred in almost all cases by financial realities–the facilities are too expensive for the county to operate.

Understandably, elder advocates worry about the effect of the change on senior care. In the past, some analyses have suggested that privately-run nursing homes, on average, show more “deficiencies” than their public counterparts. The assumption is that private homes are motivated by profit and more willing to cut resources to residents and refuse to pay wages for the best caregivers in order to boost their bottom line.

But is is important to remember that no two homes are identical, and “averages” do not mean that all privately run homes are rampant with neglect and need to be avoided. Early reports out of Ulster County, for example, offer a hopeful reminder that quality decreases may not automatically follow private nursing homes sales.

Elder care is not one-size-fits-all. There are a wide range of different needs for seniors, from simple help with travel to extensive, around-the-clock medical support. Fortunately, more and more experts are working to accommodate many different needs, providing the ideal fit for residents that preserves individuality and freedom as much as possible.

One particular strand of elder care that has received more focus in recent years is support for those with cognitive ailments–like dementia and Alzheimer’s. Residents with these memory challenges face particular vulnerabilities. Even the more all-encompassing caregiving options (like a move into a nursing home) may not provide the best fit for these residents. The need for solid elder care planning is particularly important for those at risk of dementia, to ensure that proper care is available if necessary. Unfortunately, many do not identify their condition until it is too late.

But how do you know if you are at risk of dementia?

Nursing home horror stories abound, and everyone has likely heard some tale of seniors suffering neglect at a New York long-term care facility. It is for that reason that elder care advocates always suggest doing your homework before making a final decision about where to receive skilled nursing care.

One of the most well-regarding nursing home ranking system is the federal “Nursing Home Compare” website. The site lists most nursing homes and gives them a star rating, from one to five. The rating is based on health inspections, staffing levels, and various quality measures. As a general guide, browsing the rankings of all local New York homes is a very helpful way to get an idea of home performance.

However, can the star system be relied upon exclusively? Is admission to a home with four or five stars a guarantee that the care provided will be proper?

Bedsores, also known as pressure ulcers, develop for many reasons and are a sign of nursing home abuse. A bedsore forms in an area of the body where there is too little fat between the skin and the bone to cushion against forces of pressure. The common causes of bedsores include sustaining shearing or friction injury to the skin, too much exposure to moisture, incontinence, not being repositioned frequently enough or the overgrowth of a pathogen or infection in a wound site. Diabetic residents also have a high likelihood of developing diabetic ulcers, which are pressure ulcers that occur on the lower extremities. Bedsores are largely avoidable when the appropriate preventive measures are taken. There are many things that can be done by nursing home residents and care providers alike to avoid the risk of developing a pressure ulcer.

Repositioning and Bracing Immobilized Residents

Immobilized residents, and residents who have limited mobility often rely on nursing staff to reposition their bodies multiple times a day. These residents are at a higher risk of developing bedsores because they have a higher likelihood of sustaining pressure to a localized area of the body for extended periods of time. Bedsores can develop within 12 hours if a person is not repositioned regularly. Nursing staff should be committed to a schedule for each immobilized resident that requires repositioning every 2-3 hours, and a visual inspection of the resident for signs of developing bedsores every 6-8 hours.

We often emphasize the need for prudent elder care planning to ensure that your senior loved ones will have access to the best care possible, if necessary. Unfortunately, not all long-term care facilities are of the same quality. The poorest performing homes often make the same caregiving mistakes again and again, causing serious harm.

Nursing Home Medication Errors

For example, many Americans, especially those with loved ones in nursing care facilities, are aware of the dangers of over-medication and what this form of negligence can do to the health of a loved one. But what about cases in which a person is either under-medicated or not given medication at all, and his or her life depends upon that medicine?

News regarding New York nursing home care in recent months has centered on one development–the privatization of formerly public-owned facilities. In the past, most New York counties owned and managed their own facilities to provide long-term care for seniors in their community.

However, due to a range of factors, those homes became significant financial weight on county budgets. Local officials looking for ways to get out of the red increasingly decided to sell off their nursing home operations to private companies. The idea often made intuitive sense, considering the facilities often cost the county millions more each year than they brought in. New York Medicaid reimbursement amounts often fail to cover the actual cost of providing support to each senior resident.

However, the privatizations have worried many elder care advocates who wonder if the quality of care will decrease post-sale. Thus far it is hard to say with certainty if private homes automatically provide lower quality care. It remains incumbent upon each family to investigate the quality of each individual home to find the location that is the best fit for your elderly relative.

The aging process is never easy–for the senior or their family. Thoughts of mortality aside, the challenge of dealing with the day to day vulnerabilities of elderly friends and family is something that is impossible to fully appreciate until you experience it first-hand. From figuring out how to get groceries, doing to the laundry, emptying the dishwasher, and countless other tasks, seniors who are facing physical and mental decline connected to their age have a myriad of daily struggles.

One of the most acute challenges faced by aging New Yorkers relates to driving. It is easy to forget how much one relies on driving until the privilege is taken away. Considering the importance of driving, it is little wonder than most seniors do everything they can to keep their traveling options open, even when their frailties make it unsafe. Friends and family members of New York seniors must be prudent about monitoring this risk and stepping in when necessary.

Senior Driving Fact Sheet

Checking Facebook, updating Twitter, adding a quick blog. These tasks are becoming ubiquitous among all New Yorkers, including older residents. Social media is a critical part of many lives, and it is the primary way that some stay in touch with family, friends, and acquaintances. However, the medium has risen in popularity so quickly that many rules and customs about how to use these services have yet to develop. For that reason it is important to step back and ensure that you are following best practices when it comes to how you are sharing information via these web programs.

For example, last week Forbes published an interesting story that discusses some social media considerations unique to elder caregivers.

Most importantly, advocates are issuing a call for prudence and caution when posting information about the health and well-being of seniors. Privacy concerns should be considered carefully, particularly when discussing others who may not be able to consent to the information being made available to anyone online.

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