Recognizing Abuse in Nursing Homes

The choice to put your parent or elderly family member in a nursing home is never an easy one. These facilities may provide the care your loved one needs, but the nursing home environment can be less than inviting. Regular visitation and communication with your family member is a crucial step for his or her health and continued wellbeing.

Unfortunately, nursing homes can be the sites of a wide range of elderly abuses. These adults, who are often vulnerable to such abuse, may not be entirely aware of their circumstances. It is important to protect your family member from abuse and respond appropriately if you believe they have become a victim.

Nursing home abuse happens in a number of different ways. Physical abuse cases may result from negligent care on the part of a caregiver. Caring for a large number of adults can be a stressful position at times, but it is never reason for abusive or harmful behavior. If you see signs of physical abuse, like bruising or burns, it is important to take proper action.

Emotional or psychological abuse can also occur in these facilities. The manner in which caregivers interact with the residents of a facility plays an important part in their health. Emotional abuse can affect an elderly adult's wellbeing and have real, physical results. Yelling, name calling, or demeaning language does not promote a healthy or comfortable environment.

Finally, sexual abuse is a serious concern in elderly care facilities as well. Sexual assaults between residents or between a caregiver and resident can take a toll on a vulnerable older adult. The embarrassment and physical injuries that can result from this behavior must be addressed to the full extent of the law.

Humiliation in Nursing Homes

Making the decision to move a family member into a nursing home facility is not an easy one. But these facilities do plenty to ensure you that your family member will be well cared for and receive the respect and attention they deserve. It is crucial to ensure that is true if you have decided to place your loved one in a nursing home. Humiliation of residents is an unfortunate reality in many nursing homes.

A person's health or age is never a reason for them to be the victim of abuse. Yet elderly mistreatment is a real concern and does affect many of the clients who live in these facilities. Caregivers need to be held responsible for their actions towards their clients in order to ensure that every person in a nursing home gets the respect, attention, and care that they deserve and that you expect.

One of the dangers of elderly maltreatment is the possibility of humiliation. Many patients in these facilities are heavily dependent on their care givers for many daily functions. Every adult should be treated with respect and not made to feel like a lesser person because of their need for assistance. Care takers can be caring for a person negligently if they are humiliating them in private or in front of other residents.

Humiliation can occur in a number of different forms including public humiliation and sexual humiliation. These can take place in private or in front of other residents and can have devastating emotional and mental effects on a person, no matter their age.

Smoking Related Fires Are a Real Threat to Nursing Home Patients - Is it Time to Put Out the Fire?

It only is a matter of time before another nursing home fire claims the life of another patient. While less publicized, hundreds of elderly people receive burns every year during their admission to skilled nursing facilities. Anyway you look at the situation, fires in nursing homes remain a real-- yet under-appreciated threat to nursing home patient safety.

According to the Government Accountability Office (GAO), from 1994 to 1999 approximately 2,300 nursing homes reported some type of fire at their facility each year. Equally alarming is that the GAO has found the number of severe fire deficiencies in nursing home has increased steadily from 2004 through 2007.

In response to this safety threat, Centers for Medicare & Medicaid Services (CMS) now requires a smoke detector in every patient room and in public areas. Additionally, automatic fire sprinkler systems must not be installed in new facilities and retrofit in existing facilities over the next four years.

While compliance with CMS regulations may help reduce the chance of fires in skilled nursing facilities, owners and administrators should evaluate all activities and determine what policies may be implemented to further promote patient safety.

Step #1: Eliminate Smoking

Smoking in nursing homes can at best be considered counter-productive to patient health. Perhaps more accurately, smoking in medical facilities is threat to all patients and staff. Even when monitored, there is an increased risk of fire in nursing facilities that permit smoking compared with those that do not allow it.

Therefore, I propose nursing homes force patients to toss out their cigarettes or seek alternative facilities.

In addition to safety concerns related to fire, allowing patients to smoke in a nursing home diverts staff resources to the supervision of patients who choose to smoke and away from the task of providing skilled nursing care.

According to The National Fire Protection Association, elderly people are more than three times more likely to suffer a smoking-related injury than their younger counterparts. One need not look far to see examples of smoking accidents in nursing home and assisted living facilities:

Dallas, Texas- Woman dies in a fire at an assisted living facility. The fire inspector determined the fire started due to 'improper use of smoking material'

Chicago, Illinois- Two patients died at Hampton Plaza Nursing Home from smoke inhalation. The fire department concluded that the fire was started by smoking materials stored in a patient's closet.

Whittier, California- A nursing home patient with dementia ignited himself while attempting to light his cigarette. A investigation into the matter revealed the staff was unaware that the man was even outside of the facility.

Lebanon, Indiana- An oxygen dependent patient started a fire at an assisted living complex when the oxygen tank exploded as she smoked.

I doubt we will see nursing homes flocking to change their policies to 'smoke free' overnight. In the meantime, facilities should take steps to develop a smoking policy that is both realistic to implement and enhances patient safety. Here are some suggestions for developing a smoking policy:

Designate a smoking area for patients that is supervised and well ventilated.

Ban all smoking in patient rooms. Studies have shown that the risk of fire increases when people smoke in bed.

Establish an evacuation policy in case of a fire or emergency. Similarly, inform all staff and patients as to the location of fire extinguishers and teach them how to use it.

Keep all smoking materials including lighters and matches in possession of staff and locked at all times.

Provide ashtrays and smoking aprons (outerwear made from fire-proof material that reduces the chance of a stray ash igniting a patients clothing)

Develop a smoking cessation program.

Make sure your facility has smoke detectors and a sprinkler system.

Allow patients to smoke only when supervised by staff members.

Develop a set of consequences for patients who fail to follow the policy.

Write down your facilities smoking policy and give a copy to all patients and their families.

While the above guidelines may reduce the chance of fires in nursing homes, eliminating smoking remains one of the easiest ways to improve the overall living conditions for all patients and nursing home staff.

Jonathan Rosenfeld is an attorney based in Chicago who handled elder abuse and neglect cases in the Midwest and across the country. Mr. Rosenfeld works on the following types of cases:

Bed Sores, Pressure Sores, Decubitus Ulcers
Falls
Dehydration / Malnutrition
Medication Errors
Impacted bowels
Sex Abuse
Medical Errors

Feel free to contact Jonathan for a free case evaluation. (888) 424-5757

Divorce and Separation After Brain Injury - Findings of 3 Research Studies

It's a common belief that most marriages end in separation or divorce after a spouse has a traumatic brain injury. Certainly the physical, cognitive, social, behavioral and communicative changes caused by brain trauma can affect a couple's relationship. These changes are just the primary losses. Additional changes, known as secondary losses, can range from loss of income, to loss of friends, jobs or careers. As roles and responsibilities formerly shared by a couple are reexamined and redistributed after a spouse is injured, the relationship between a husband and wife changes in many ways. There is very little scientific research on marital relationships so much is still unknown about the impact of brain trauma on marriage. Reasons for a marriage dissolving are always complex, but this may be even more so when one partner has a disability or impairment due to a brain injury. So it is important to look at the findings from 3 research studies on this topic.

• One study conducted by Thomsen in 1984 found a very high rate of 78% for marital breakdown. But it is important to note that this was a very select group of individuals who were studied. It examined only 9 couples who were 10-15 years post-injury. In addition, many of them had severe brain injuries and most were living in a residential assisted living program. So one must question how applicable these findings are today.


• The second study led by J.C. Arango-Lasprilla was more recent in 2008. It also was much larger, including 927 individuals who were injured. In contrast to the earlier study, the marital breakdown rate was only 15% within the first 2 years post-injury. This study offers much more hope for relationships to survive the stresses and challenges of daily living after a partner has been hurt.


• The third study led by J. Kreutzer in 2007 not only found that 25% of relationships broke down but that this occurred an average of 4.1 years after a spouse's injury.

Research has found that several factors make a difference in whether couples stay together or separate after one of the partners has a brain injury. The highest rates of marital breakdown are found among younger couples and in shorter or more recent marriages. Another risk factor is domestic violence. Couples with a more severely injured member were also found to be at greater risk for separation or divorce.Much more research is needed to understand why some couples manage to stay together and others separate. But one thing is clear - research does not support the common belief that there is a much higher incidence of marital separation and divorce when one partner or spouse has a brain injury.

Physical Therapist Salary - Income Advice For New Therapists

Injuries are very much part of every professional athlete's life. At certain points in their careers, they may suffer injuries in varying degrees of severity. When this happens, the services of physical therapists are very much needed in order to ensure proper rehabilitation by developing a plan using treatment techniques to restore function, reduce pain, to promote the ability to move and to some extent, to prevent disability. Physical therapy workers are some of the better paid healthcare professionals because of this important role they play in injury treatment. The physical therapist salary is very competitive compared to many healthcare salaries.

Athletes are not the only group of people which need physical therapy services, as virtually anyone who has an unfortunate accident or disease that causes movement dysfunction, limiting the individual's abilities to move and perform functional activities would be a candidate. This type of therapist also develops fitness and wellness-oriented plans for patients to prevent their loss of mobility before this gets out of hand.

Most people that are interested in entering this career may want to know how much money they'll receive per year or per hour. Half of all these types of therapists employed in the United States receive $74,480 a year or $35.81 an hour; translating to $76,220 in mean annual salary, or a $36.64 mean hourly wage. The lowest 10% of therapists earning the least salary receive $52,170 in annual wage, while those upper 10% earning the highest physical therapist salary earn $105,900 a year.

Physical therapists in ALF or assisted living facilities earn the highest salary these days, as of September 2010, with an estimated salary of $99,000. Occupational physical therapists working in correctional facilities on the other hand, earn almost $60,000 in annual physical therapy salary. Homecare physical therapy workers receive $75,000 annually, the same with physical therapists in inpatient and outpatient work setting.

To give you a clearer perspective on the trend of the physical therapy salary, the salary index for this occupation in October 2008 was 1.0 and in July 2010, the salary index is about 1.15 with a high of 1.35 at the beginning of this year.

In relation with this increase in therapist salary, the Bureau of Labor Statistic reported that there will be a growth in the need for physical therapy in the next ten years growing by 30%. There are reported changes in the restrictions on physical therapy service reimbursements by third-party payers that will increase the number of patients with access to services, increasing the demands for physical therapists. This is in addition to the growing number of elderly people who will be needing physically oriented therapy services in the years to come.

Having a job in a physical therapy is a rewarding career in terms of the physical therapist salary one receives and the satisfaction of being able to help an individual survive an accident or a debilitating disease and recover fully again.

Assisted Living Facilities Should Take Advantage of the Recession

The Common Reaction To An Economic Downturn

Yes, we are in a recession. And the odds of a double-dip are increasing. In such times, typical business owners, including assisted living management, batten down the hatches. They cut spending, consolidate responsibilities, and attempt to weather the storm.

As monthly financial statements and census reports come in, owners stress out. Compared to last year, things look grim. Margins are down, sales are down, and morale is down. Does this sound familiar?

Could There Possibly Be Any Good News In A Down Economy?

The recession has a bright side. It comes from the fact that your competition is facing the same situation. They are most likely reacting to the recession in the typical fashion mentioned in the first paragraph. So, if everyone is using the same strategy based on spend less and do less, who has the strategic advantage? It could be you.

I suggest a change in perspective. Take advantage of what the recession has to offer:

• Increase in market share. This takes precedent over profits. While competition scales back, you should be aggressive in marketing and communications, as well as maintaining and even adding services.


• Refine operations. The big cutback during a recession should be the cutback in the waste of time, talent and systems. Efficiency can allow you to do what is necessary to increase market share while containing costs.

The Strategy Is Proactive

Step #1:

Especially in a down economy, it is critical to make each dollar spent responsible for a result. When an employee is given a job, they are held accountable to complete the task. Treat your dollars the same way. Employ your marketing expenditures to produce revenue, improve productivity, and/or increase customer loyalty. And make them report their results - utilize tracking.

By holding dollars accountable, unnecessary expenses are automatically cut. At the same time, dollars spent that attain desired results may be increased. This prevents the numbers oriented, "across-the-board" expense cuts that stifle productivity and devastate morale. And it encourages investment and growth in areas that prove successful.

Step #2:

Market aggressively and apply the responsible dollar strategy to your marketing plan. By tying revenues to marketing costs, expenses become responsible for results. By testing campaigns and coding responses, inefficient marketing expenditures can be stopped. On the other side of the coin, marketing expenditures that increase customer base, utilize key employees, and/or boost profit are continued, or may even be increased.

Step #3:

Service, service, service your customer. Add improvements, even when your service leads the competition by a mile. This makes sure the customer continues to feel special and drives word-of-mouth marketing. The least little extra is a big deal to your customer because services are being cut everywhere else. These extras can have little or no cost.

Remember: Superior service is an attitude.

Service improvements give you leverage in the market when all other variables (price, quality, features) are equal. Also, with an increase in business failures eminent during a recession, this leverage turns into increased market share. In fact, I recommend that you have a plan in place to be the hero if you hear that a competitor is closing. (Be prepared to buy a portion of the distressed business - appropriate residents who choose to move to your facility along with the best employees. In many instances you can pay over time with the new revenue, keep residents with staff members they know and love, and save some jobs.)

This Opportunity Is There For Those Who Want It

Does all this sound easy? No. The strategy is simple. But it takes hard work planning, discipline, teamwork, trust, the ability to change, and patience. Can this be managed during these difficult times?

Now is the perfect time! The pain of the recession is the ally of opportunity. It creates the leverage you need to institute and sustain changes in operations. It unites management and staff to fight for the good of the company. And it offers chunks of market share to those planning to grow out of the recession

Database Technology - Educational Options

In order for businesses, colleges, and government agencies to use the information stored on computers employees must be able to retrieve the data. Setting up computer databases store all the information needed by employees. Students can learn how to work with stored information by entering a degree program in database technology.

Students can enter programs through a college's computer science or information technology department. Educational options are offered at all levels leaving students with the option to work as:

• administrators


• data architects


• database librarians

and more. The curriculum worked through inside a degree program teaches how to work with computer databases to handle all areas from developing to managing databases. The wide skill set is usually taught at every level and knowledge becomes more advanced as students enter higher degrees. The use of a database has to be maintained and updated to ensure the best possible function and to use the best information retrieval methods. Employees rely on databases to work correctly so they can perform their job duties at the optimal level. Students thinking about entering education should research all of the industries options before beginning a degree program.

Learning to program and troubleshoot systems can be learned through a two-year associate's degree. Schooling stresses learning different applications and software programs. C++, Delphi, and more are some programming languages that students will become familiar with inside a degree program. Curriculum may cover topics on:

• visual basic programming


• database analysis


• algorithm design

and more to provide students with an educational base of the industry. To gain a complete understanding, students need to continue education at the bachelor's degree level.

The entire industry is covered inside a bachelor's degree program. Students work through specified courses that teach them how to create, develop, and implement a database. Further study is entered to prepare students to manage and distribute stored information on databases. At this point in education students can branch out and work through a specialty within database technology. Some areas include database software, programming, design, and analysis. Curriculum changes based on the concentration students enter but all students take some general courses. Courses could include:

• database concepts


• microcomputer applications


• communications


• information systems


• relational databases

and more. Students learn through a comprehensive degree that provides them with the knowledge to work in every area of the industry. Businesses use databases to store information on an increasing scale making education on how to operate and manipulate data a highly coveted skill.

Students who continue education at the graduate degree level should expect to be trained in advanced concepts and learn to become an administrator. Knowledge expands to include supporting, installing, and designing systems. Courses on architecture of databases and development techniques explore how to work as a leader. A PhD examines:

database design

• data mining


• retrieval


• application usage

and more. Students work through a concentration and conclude with a dissertation paper on their specialty.

Students can enter all four-degree levels and enter the field successful. The skills learned through each degree option are directly relatable to a career. Complete an accredited database technology degree program and enter the field a must have employee. Full accreditation provides proof that the program offer students the best quality education possible. Agencies like the Accrediting Council for Continuing Education and Training ( http://www.accet.org ) are approved to fully accredit schools and colleges.

DISCLAIMER: Above is a GENERIC OUTLINE and may or may not depict precise methods, courses and/or focuses related to ANY ONE specific school(s) that may or may not be advertised at PETAP.org.

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