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Nursing Homes Lack Expertise in Recommending Hospice & delay results in needless pain for dying patient

How can family members trust health care providers when the concern for money and self interest overrides the care needs of their family members at an especially critical time of life? This choice should not be a decision made by facility staff but the decision of the individual or family member involved>

Your loved one is terminal, and terminal does not just mean dying of cancer, it includes elder patients who are on the path to death. The signs are usually unmistakable. Unfortunately, it is almost always after your love done has endured unnecessary & needless pain & suffering. A Study of major Nursing Homes throughout the United States clearly showed that the staff, while understaffed and not properly trained to handle end stages of life where able to pinpoint the exact time of the dying patients turn for the worse. How scary is it to learn this information? What does it tell us when the staff answered in the study that while of course they recognized the signs of impending death; most did nothing to improve the quality of life during the dying process?

Your family member, sick and in pain, is in a hospital or nursing home and no one is available to help because the person is the next room is in critical condition and the entire floor staff is rushing around to help this person. You empathize thinking that if you were in a similar situation you would want everyone rushing around to save you. What you really do not know is that this emergency is due in some cases to financial self interest or lack of staff education regarding critical or end of life care. Most individuals do not fear death as much as the experience of a painful death and many nursing homes and assisted living facility staff do not have the training or desire to educate family members about hospice and palliative care services.

How can we make the stress of having a sick loved one, piled on top of daily stress easier for all involved when hospitals, nursing homes and assisted living locations often provide end of life care? Whether you recently experienced the loss of someone you know or are currently experiencing the decline of a loved one there are steps that can be taken to ease the journey but you must be the one to ask questions because many facility staff lack training in hospice and palliative care.

According to research by

Lisa

Welch

,

Ph.D.

few nursing homes or assisted living facilities have written procedures for regularly assessing residents’ terminal disease status or eligibility for hospice care. Instead, many staff members base their timing and referral of hospice based on their ability to recognize decline, their personal beliefs about hospice services and their initiative in raising hospice as an option. What happens when facility staffs have little or no education relative to palliative or hospice care and family members rely on their level of experience to help their loved ones? The result is often family frustration.

In Dr. Lisa Welch's extensive study of nursing homes being ill equipped to take care of dying patients some of what she reports is so disturbing. In fact, Dr. Welch reports that she has been personally told by Nursing home staff

that their administration does not want them recommending outside hospice services because that means that money leaves the building. Or, as the research mentions, if there is no family requiring support, hospice is not recommended and is instead provided by their own staff, lacking hospice background. In these cases, offering hospice becomes a territorial issue founded by concerns over money and staffing. How can family members trust health care providers when the concern for money and self interest overrides the care needs of their family members at an especially critical time of life? This choice should not be a decision made by facility staff but the decision of the individual or family member involved.

“Additionally, timing of hospice referrals is often delayed because staff members believe that hospice is appropriate only for the very end of life. There was often a discrepancy of weeks or months between when staff reported recognizing terminal decline and when referral to hospice occurred.” It is clear that training needs exist for staff relative to recognizing declines and understanding the benefits of hospice services. In defense of facility staff, I have experienced instances where fear of breaking rules or regulations or chastisement by a superior prevents staff from doing the right thing. However in these cases mysteriously a phone call or recommendation is made and I become involved to help families navigate the situation.

Until the level of palliative and hospice care education catches up with the need, family members will have a greater level of responsibility navigating the care of loved ones experiencing declines in health. It’s never too early to ask about palliative or hospice care; however it can be too late. Too late is when a loved one is days away from passing and has already likely experienced a high degree of pain and discomfort. In the instance you ask and it is not quite time for palliative or hospice care, at least you have been proactive in your own education and when the time does come you’ll be more prepared and less reliant on others to recognize the signs or request assistance.

Welch,

Lisa

C.

Ph.D.

et. al. Referral and Timing of Referral to Hospice Care in Nursing Homes: The Significant Role of Staff Members. The Gerontologist. Vol 48, No. 4, 477-484.

Pamela D.Wilson , The Care Navigator, specializes in consulting, planning and education for families and individuals experiencing transitions in health care. Contact her at The Care Navigator or visit The Care Navigator Blog for free information Article Source: http://EzineArticles.com/?expert=Pamela_Dombrowski-Wilson

Thanks & Compliments to Dr. Lisa Welch for the above stats and information. Maybe with someone as compassionate as Dr. Welch working on the side of the dying patient; we just may get some help for the elder and dying patients.

Please read the entire article

http://www.wellnesspick.com/health-wellness-guide/nursing-homes-lack-expertise-in-recommending-hospice-care-placing-your/?k=nursing+home+reform+act

WHAT IS NURSING HOME NEGLECT

What is Nursing Home Negligence?

I most often get this question when I tell someone I just met that I am a malpractice attorney and file law-suits, on behalf of residents and families, for nursing home negligence.

Well, what exactly is nursing home negligence?

To begin, let us discuss the word “negligence.” Webster’s dictionary states that “negligence” is a noun and is the “failure to act with the prudence that a reasonable person would exercise under the same circumstances. “ Webster also defines negligence as “the trait of neglecting responsibilities and lacking concern.”

 

Webster’s first definition is very similar to the one used by Virginia courts. When you claim a doctor or nurse was negligent, you must prove to the jury their actions or the care they provided “fell below the standard of care.” More simply put, you have to prove that their actions (or failure to act) were not what a reasonable doctor or nurse in Virginia would have done under the same circumstances.

 

In other words, if they were being graded you would have to convince the jury that the doctor or nurse received a D or an F, with C being the “standard of care” grade.  

 

How do nursing homes fail to provide the level of care?

This is the sad part of my job – learning about the many ways that loved ones have been neglected in local nursing homes. In the last two years alone, we have received, tried, settled, or heard about cases which involve the following:

• Elopement – when residents have left the facility alone, unattended, often times wandering away from the nursing home into dangerous situations, like traffic, into parking lots, etc.
• Pressure Ulcers – when residents have not received proper skin care, nutrition, hydration, and turning resulting in large bed sores or pressure ulcers begin to form. These ulcers/sores most often develop on heels and the sacrum (bottom) of elderly residents and can allow infection to directly enter blood stream;
• Resident on Resident Abuse – from physical to sexual assaults, we have seen too many cases where residents have caused harm to other residents;
• Malnutrition – failing to provide proper nutrition and sufficient protein in the resident’s diet;
• Dehydration – failing to provide sufficient water for body and organ systems to work;
• Medication Errors – too much…too little… wrong medication – any way you can imagine mistakes being made, we have seen them;
• Falls – Falls can be from a wheelchair, walker, bed, or while walking. Brittle bones make falls very dangerous and the resulting injuries can be life-threatening. Even one fall can cause permanent injury and or death;
• Bed Rails – it is a little known fact but every year residents get caught in, and strangled by, bed rails;
• Infection Control – in a 110 bed facility with nurses going from room to room, infection can spread like wild fire!
• Failure to Diagnose – You rarely have doctors walking around the nursing home so nurses serve as their eyes and ears… overworked nurses mean we see cases where serious medical conditions have been overlooked by staff, and physicians not notified.
• Staff Abuse – although I have never had a case of outward abuse by a staff person, I know nurses in Virginia have lost licenses for verbally or physically attacking residents.

Conclusion: I don’t believe nursing homes purposefully abuse, mistreat or neglect the residents. However, I do think most employees are over worked, underpaid, and without higher staffing levels and qualified care providers, many of our loved ones in Virginia nursing home may fall victim to nursing home neglect. 


 THIS ARTICLE BROUGHT TO YOU BY LAUREN ELLERMAN, A RECOGNIZED AUTHORITY IN THE U.S ON NURSING HOME NEGLECT & A POWERFUL & SUCCESSFUL LAWYER DEFENDING THE RIGHTS OF OUR MOST VULNERABLE CITIZENS; THE NURSING HOME CONFINED.