NPWT is a topical negative pressure, sub-atomospheric pressure dressing or vacuum sealing technique generally indicated for the management of wounds, burns, ulcers, flaps and graphs. NPWT apply negative pressure to the wound in order to remove fluids, including wound exudates, irrigation fluids and infectious materials. The system is thought to benefit wounds healing by removing wound fluid and dessicated tissue, decreasing the level of bacteria in the wound, improving blood flow in the wound and surrounding tissue, promote granulation tissue, and pulling the wound edges together and stimulating cell growth.

However, the FDA has received reports of six deaths and 77 injuries associated with NPWT systems over the past two years. Bleeding was the most serious complication, occurring in all six deaths and in 17 of the injuries. These complications can occur in hospitals, long-term care facilities, and at home.

Of the 83 reports to the FDA, 27 reports indicated worsening infection from original open infected wounds or from pieces of dressing that remained in the wound, and 32 reports noted injury from foam dressing pieces and foam sticking to tissues or clinging to the wound. Most of these patients required surgery, additional hospitalization, and antibiotics.

The agency is advising health care professionals to select patients for NPWT carefully, after reviewing the most recent device labeling and instructions. Risk factors and characteristics that should be considered before NPWT use include patients at high risk for bleeding and hemorrhage; patients on anticoagulants or platelet aggregation inhibitors; patients with infected blood vessels, infected wounds, exposed organs, or sharp edges in the wound (such as bone fragments); and patients with spinal cord injuries. A full list of risk factors and contraindications can be found on the FDA’s letter to healthcare practitioners.

Patients should be monitored frequently in an appropriate setting by a trained practitioner, and should be vigilant for potentially life-threatening complications, such as bleeding, and be prepared to take prompt action if they occur. Patients who use NPWT at home should receive adequate training from their health care provider on how to use the NPWT device; understand the possible complications that may be associated with using the NPWT device; get NPWT patient instructions their doctor, NPWT distributor, or the manufacturer’s Web site; and talk to their doctors if they do not feel capable of managing the NPWT device at home.

Consumers may report adverse reactions related to negative pressure wound therapy to FDA’s MedWatch Adverse Reporting Program.

SOURCE: Nursing Home Abuse › FDA warns of death, complications from type of wound therapy

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Ombudsmen provide a valuable service to the elderly. Not only do they serve as advocates to nursing home residents, they also investigate and resolve complaints and make unannounced visits to nursing homes to ensure residents’ needs are being met. An estimated 40 percent of nursing home residents have no family or friends to visit with or advocate for them.

A spokesperson with Ombudsman Services of Northern California says mandatory reporting of incidents has dropped though the number of residents in the homes has increased – a formula which doesn’t make sense. The group is concerned that the 1,600 northern California nursing homes and assisted living facilities regularly serviced by the program will begin to see a rise in senior abuse.

Instead of visiting assisted living facilities once a month and nursing homes weekly, since the budget cuts ombudsmen visits have dropped to once a year for assisted living facilities and monthly for nursing homes.

According to the report, Assemblyman Dave Jones, (D) Sacramento, has co-authored legislation to restore ombudsman funding. That bill would direct money to the ombudsman programs from fines levied against care home operators who break the law.

SOURCE: Nursing Home Abuse › CA long-term care facilities suffer from cuts to ombudsman program

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The bipartisan Fairness in Nursing Home Arbitration Act of 2009 “prevents nursing homes from deliberately hiding clauses within the fine print of contracts that force seniors to surrender their right to trial by jury and enter an unfair and one-sided mandatory binding arbitration process,” according to the American Association for Justice.

This is good news for the thousands of nursing home residents and their families, many of whom have already signed these one-sided agreements that leave them defenseless, like the family of Dean Cole.

In January, we told you about Cole, whose family had filed a wrongful death lawsuit against the nursing home where Cole lived for just 22 days. During his short stay at Golden Living Center Greeley, Cole, who suffered from dementia and required assistance, stopped eating or taking medication and dropped an alarming 20 pounds. Even after his wife questioned nursing home staff about his weight loss, they told her Cole was fine. He was later admitted to the hospital and diagnosed with severe dehydration, renal failure, pneumonia and colitis. He died 10 days later.

Unfortunately, Cole’s family was made to sign a one-sided mandatory binding arbitration clause, which denied them the right to trail by jury. The case is still pending.

“The Fairness in Nursing Home Arbitration Act will make sure negligent nursing home corporations can be held accountable by our most vulnerable citizens,” said American Association for Justice President Les Weisbrod. “This bill will prevent nursing home corporations from unfairly preying on seniors and stripping away their legal rights. Arbitration should only be voluntarily, not hidden away in the fine print of contracts during our seniors’ greatest time of need.”

SOURCE: Nursing Home Abuse › Bill protects nursing home residents from signing arbitration clauses

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But as Catherine moved into her sunset years at the Lutheran Towers facility in Georgia, she had one regret she just couldn’t shake. She always wanted to graduate from Emory.

National nonprofit organization Second Wind Dreams got word of Catherine’s desire, dressed her in a cap and gown, and presented her with the distinction of being a member of Emory University’s Class of 1028.

For more than a decade, Atlanta, Ga.-based Second Wind Dreams has been enriching the lives of seniors by granting wishes. Many of these residents live in nursing homes or assisted living facilities. To date, more than 235 facilities in 40 states, Canada and even India have see wishes granted by Second Wind Dreams.

The organization focuses on individuals living in long-term care facilities or in hospice care. Many of these individuals are without family support or financial resources. Dreams come in the form of motorcycle rides, bowling games, special first dates, and camel rides.

Eighty-six-year-old Virginia from West Virginia, dreamed of conducting a symphony orchestra. Second Wind Dreams arranged for her to take the podium at the West Virginia Symphony.

At a time when more than 90 percent of our nation’s nursing homes are cited for federal health and safety violations, it is rewarding to see an organization dedicated to making the lives of the elderly happy. A dream come true for one person, can warm the lives of many. As witnessed by Second Wind Dreams: “Long after a dream has been fulfilled, the effects linger, giving all involved a second wind.”

SOURCE: Nursing Home Abuse › Second Wind makes seniors’ dreams come true

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Five years ago my sister and I found ourselves in a similar situation. Our mother, who was an only child, had passed away years earlier. Her parents – our grandparents – lived more than 2,000 miles away. Their health was rapidly declining. My grandmother had been diagnosed with breast cancer and Alzheimer’s disease just six months apart. My grandfather was battling diabetes and was simply unable to care for my grandmother. (We suspect it was because my grandmother had spoiled him for so many years!)

Our visits to their house became more and more worrisome. Food was left rotting in the refrigerator, medications were left sitting out, and my grandmother had taken to wandering outside in the middle of the night. (One night she was spotted walking along their neighborhood lake in her nightgown.)

When my grandfather was diagnosed with terminal cancer, we had to act quickly to get them both in facilities that could provide the medical and custodial care they needed. Unfortunately, we had to separate them.

Their health had declined to the point that neither could be moved closer to my sister and me. Working long-distance arrangements was daunting, especially since states differ in how they structure levels of care. Hospital social workers were a tremendous help, as were online resources.

For those who are finding themselves in similar situations with family members, the online magazine CityView offers a detailed listing of care options. It has a 10-point check list for choosing a facility, explains who pays for long-term care, and gives an overview of Alzheimer’s disease and options for those suffering from memory loss disorders.

Statistics of neglect and abuse in long-term care facilities can make the decision to place a family member in one even more stressful. Good facilities do exist but you must know how to identify them. Research several facilities and take time to visit each. Be aware of the environment: Are calls from residents being answered quickly? Does the home look and smell clean? Does staff appear friendly and know the residents by name? Do residents look comfortable?

I also encourage you to question staff and talk with other family members about their experience with the facility. And once your family member is placed in long term care, remain in contact with staff, visit your family member as much as possible, and continue to be aware of the surroundings. Know the signs of abuse and neglect, and report any suspicious behavior.

For more tips on what to look for in a long-term care facility, click here.

SOURCE: Nursing Home Abuse › Do your research when considering options in long term care

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The Patient Safety and Abuse Prevention Act is sponsored by New Mexico’s senior senator, Pete Domenici, R-N.M., and Sen. Herb Kohl, D-Wis.

This process could greatly reduce the number of nursing home abuse and neglect cases that plague the long-term care industry. These are tragedies we hear about daily in the news, like the report two days ago of the Jacksonville, Ill., woman suing her father’s nursing home for his wrongful death just 19 days after he was admitted; or the painfully sad story last month of the four nursing home aides in Minnesota who taunted and molested 15 residents suffering from Alzheimer’s and dementia simply to “get a good laugh.”

“This bill is an important step in providing the safeguards needed to prevent abuse and mistreatment by those who care for our elderly and disabled,” Sen. Domenici was quoted as saying in The Daily Times. “I hope the Senate will pass it during this legislative session.”

SOURCE: Nursing Home Abuse › Senate to consider Patient Safety and Abuse Prevention bill

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Nursing home residents and their families who sign mandatory arbitration clauses when being admitted into long-term care facilities, are one step closer to regaining their rights to hold those facilities accountable in court for abuse and neglect, according to the Senior Journal. The Journal reported that the Senate Judiciary Committee this week approved the bi-partisan bill - the Fairness in Nursing Home Arbitration Act of 2008. The bill moves to the Senate for approval.

According to the Senior Journal the bill would invalidate mandatory arbitration clauses in nursing home, assisted living, and other long-term care facility contracts. Under the bill, residents and families could voluntarily choose to arbitrate an issue after a problem occurred, but they would no longer have to agree to give up their right to sue the facility if it severely abused, neglected, or financially exploited the resident.

The Journal noted that nursing homes often are a last resort for families, and many times decisions made during admission are done under desperate or emergency situations. “Individuals and families have little or no opportunity to fully consider and understand the consequences of an arbitration provision buried within and 40- or 50-page admissions document that they are asked to sign during the admissions process.  In many cases, individuals are unaware that they had signed an arbitration agreement,” according to the Journal report.

SOURCE: Nursing Home Abuse › Nursing home residents closer to regaining right to sue

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According to a report in the Senior Journal, the Government Accountability Office estimated in a July 2004 report that automatic sprinkler systems can decrease the chance of fire-related deaths by 82 percent. In March 2005, CMS began requiring all long-term care facilities that did not have sprinklers to install battery-operated smoke alarms in all patient rooms and public areas, the publication reports.

By 2013, all nursing homes will have to have sprinkler coverage in areas including resident rooms, kitchen, dining and activity areas, corridors, attics, canopies, overhangs, offices, waiting areas, closets, storage areas for trash and linen, and maintenance areas.

SOURCE: Nursing Home Abuse › Lifesaving: not an option

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