Health and Disability

A 38 year old male had suffered severe brain damage, slipped into in a deep coma, and a year after receded into a minimally conscious state. The patient was non verbal, was fed and kept alive through tubes in a long term care facility. Six years later, despite the large amount of damage to the cortex, imaging results showed that some parts of the brain were still functioning. This led a team of neurosurgeons to believe that they would be able to improve the patient’s state through manual stimulation of those undamaged parts of his brain. Upon examination at the time of enrollment, the patient was able to move his eyes sideways (but not up and down), and the rest of his body was out of conscious control.

The results were dramatic – within 48 hours post surgery the patient was able to respond to noise stimuli by turning his head towards the source of the voice. Further, he was able to keep his eyes open for a sustained period of time on his own, as well as move his limbs. Within 50 days with continued stimulation, he was able to bring a cup to his mouth, swallow food, thus becoming independent of his feeding tube.

The patient continued to improve after the experimental phase was over, and eventually was able to put together up to six words to express himself vocally. The cost of care for this patient has since reduced significantly, since he is no longer on a feeding tube and can feed himself manually three times a day.

Old story. but the picture and the site are interesting:

A report issued by the National Commission for Quality Long-Term Care warns of a coming long-term care crisis and includes recommendations to advance long-term care reform in four areas: quality, workforce, technology and finance.

As Home Instead’s The BUZZ continues its look at this report, entitled “Isolation to Integration: Recommendations to Improve Quality in Long-Term Care,” today’s article details recommendations regarding quality. Highlights of the commission’s 26 recommendations include:

· A critical part of long-term care quality is the individual’s quality of life. Giving individuals more choice and control over the services they receive in the settings of their choice will enhance their quality of life;

The House Hearing for the Community Choice Act has been set!

The hearing on CCA and other long term care issues will be held on
Wednesday, January 16, 2008 at 10 am.
The hearing will held by the Health Subcommittee of the House Energy and
Commerce committee. we still don't have the details on what room but we will
let
you know when we get them.

We want a BIG turnout, like we had for the Senate hearing. If you have a
orange shirt, wear it because it showed up very well not only in the hearing
room, but on the internet as well!

This hearing will keep the momentum going for passage of CCA and reform of
the long term services and supports system.

Let's keep pushing MFP and getting it implemented in the states, BUT let's
also focus on passage of CCA! This hearing is the next step.

A very interesting take on LTC and community-based options:

It reminds me way too much, of moving day. That is, moving day to a Long Term Care Facility. The day that our parent or grandparent moves out of their home community and into Long-Term Storage. Dropped off. All looking alike. All gathering dust. Fade out. The end.

Long Term Storage facilities. They all look and act very similar. They are all miles out of town, have a nice long entry driveway through a pastoral setting that ends at a drop-off porte cochere that enters a massive building that houses 50 to 100 residents in a setting that is quite unlike the home these residents have left behind. It is far away from their social network. And, this is really the only option for a lot of people. The only option, by default, is the best option. Also by default, it is the worst....

"Medication errors are among the most common medical errors, harming at least 1.5 million people every year, says a new report from the Institute of Medicine of the National Academies. The extra medical costs of treating drug-related injuries occurring in hospitals alone conservatively amount to $3.5 billion a year, and this estimate does not take into account lost wages and productivity or additional health care costs, the report says."

Wow.

3.5 billion dollars a year? I bet it's way more than that.

Studies indicate that 400,000 preventable drug-related injuries occur each year in hospitals. Another 800,000 occur in long-term care settings, and roughly 530,000 occur just among Medicare recipients in outpatient clinics. The committee noted that these are likely underestimates.

Amazing. Almost 2 million a year.

I agree that the numbers likely represent gross underestimates. The problem, as I see it, is not preventable, nor fixable in the current fragmented environment of health care delivery. Breaking down the problem reveals so many in congruent variables that the current delivery of health care is wide open to errors.

The number of nursing homes nationwide that were cited for placing residents in "immediate jeopardy" increased by 22% from 2000 to 2006, according to a USA Today analysis of CMS records. The citations are the most serious reprimand inspectors can issue and often follow cases in which residents have been physically or sexually abused or did not receive their medications, USA Today reports. Nursing homes that are cited for immediate jeopardy may be fined or prohibited from accepting new Medicaid beneficiaries, "a major source of their income," USA Today reports.

The analysis found that inspectors in 2006 identified nearly 2,000 violations that jeopardized residents at about 850 of the 16,000 nursing homes across the U.S. Those violations account for about 6% of total violations found in nursing homes. CMS records for 2007, which are incomplete, show that more than 1,300 immediate jeopardy citations have been issued.

As someone with a parent in a nursing home, I am very glad to learn that Hillary Clinton and Tom Harkin (D-IA) have introduced a bill "that would force a federal agency to make public its list of the nation's worst nursing homes."

The U.S. Centers for Medicare and Medicaid Services has compiled a list of 128 nursing homes that have repeatedly fallen in and out of compliance with government health and safety regulations and caused harm to their residents. Those so-called "special-focus facilities" are now subject to more frequent government inspections.

Two weeks ago, the agency released an abbreviated, public version of the list that identified only 52 of the facilities. The agency refused to release the full list of 128 homes, even though it had already provided the full list to nursing home association lobbyists at the American Health Care Association.

By bringing together government and academic leaders, consumer advocates and experts from the front lines, we’re working to lay out real solutions to the pressing questions shaping how an aging generation will live: