Good Medical Care for the Elderly and How to Get It

More from the Hartford Courant - Understaffing

The Hartford Courant ran the second of a three-part series today (November 20th) on one of those multi-corporation, tiered nursing homes where the goal is to insulate from liability for harm that befalls the residents through neglect. According to the Courant, the minimum staffing requirements haven't changed in 25 years even though currant research shows serious understaffing in nursing home and shows that this can lead to disastrous results.

The topic this time is understaffing and how this leads to neglect of residents and serious harm or death.  Today, the Courant said:

"For four days in April, Bogardus and his close friend, Leona Brenner, tried to convince the staff of the Haven Health Center in South Windsor that he was dying. Bogardus, who had sought nursing-home care after complications from heart surgery, was coughing, struggling to breathe and couldn't walk the six steps from his bed to the bathroom, he and Brenner said.

Only after Brenner threatened to call 911 herself did the nursing staff finally summon an ambulance, the couple recounted. By the time the 69-year-old retired civil engineer arrived at St. Francis Hospital and Medical Center in Hartford, hospital records show, he was dehydrated and his kidneys were failing." More

Dehydration, malnutrition, and falls in nursing homes

From the Hartford Courant on November 19, 2007 comes an indepth expose of nursing homes operated by Haven Heathcare, which owns 25 nursing homes -- 15 in Connecticut and 10 in other New England states. The article cites a litany of deaths caused by neglect of the nursing home staff and/or understaffing leading to resident harm.

What good is oversight when nursing homes are fined only a few hundred dollars where a resident dies of dehydration after the home has been cited for violations numerous times, has been made to come up with a plan for correcting the deficiencies leading to harm, but continues to neglect its residents?

The Courant also notes that these nursing homes are owned by limited liability corporations in a maze of three and four-tiered structure, such as the New York Times exposed earlier this year. [See Choosing a good nursing home for your loved one, September 23, 2007] Families can spend a year or more suing a nursing home to recover damages for the needless death of their loved one only to learn that they sued the wrong corporation.

See No Haven for the Elderly: Nursing Home Troubles Show Lack of State Oversight.

Stronger FDA warnings for Procrit, Epogen, & Aranesp

Additional boxed warnings and label updates for the erythropoiesis-stimulating agents Aranesp, Epogen, and Procrit have been approved by the FDA. Ths issue causing the new warnings relate to drugs dosages that raise hemoglobin levels over 12 g/dL.

Research shows these high dosages stimulated tumor growth and decreased survival in patients with certain cancers: advanced breast, head and neck, lymphoid, and non-small cell lung cancer. It is important to note that researchers have not ruled out higher mortality and tumor progression when hemoglobin rates are raised to levels under 12 g/dL.

Chronic renal failure patients taking these drugs in order to keep hemoglobin levels over 12 g/dL are at increased risk for death, stroke, heart attack, and heart failure. For these patients, the FDA in recommending that hemoglobin levels be maintained between 10 and 12 g/dL.

FDA press release (Free)

Earlier Blog articles related to initial FDA warning, dosing change for erythropoietin

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