Maintaining good physical and mental health past the age of 60 is necessary to maximize life expectancy and quality of the golden years. Seniors who exercise regularly and monitor their diet experience increased levels of energy and general sense of well-being. The human body declines at an increasing rate of speed as seniors head towards the geriatric stages of life. Keeping the body fresh and the mind sharp will prolong the efficiency with which the body works.

After the age of 60, in terms of physical health, any regimen of physical activity and senior exercise should only be started with the approval of a physician. Low-impact workouts are ideal for the senior body, particularly in the 60s and 70s. Swimming and jogging are ideal for seniors looking to optimize cardiovascular workouts without putting too much stress on the joints. Of the two options, swimming is far less stressful on the joints but can be taxing for those who are not experienced. Swimming works more muscle groups than most other exercises and provides an excellent workout for establishing endurance. Any cardiovascular activity will be helpful in keeping the heart rate low. Heart problems are more common over the age of 60 than any other age demographic.

Nutrition plays a critical role in maintaining health and vibrancy past the age of 60. Foods high in Omega-3 fatty acids and low in cholesterol help to keep the body functioning at its highest level. Lean poultry, vegetables and most fish are excellent sources of Omega-3 fatty acids and lean protein. In addition to helping with levels of cholesterol and lean proteins, fatty acids are considered brain foods. Nuts also fall into the brain food category, reserved for foods that promote brain health.

Learning new skills and revitalizing neglected talents are positive ways to engage the brain in active processes past the age of 60. Mental acuity is as vital as physical well-being in keeping a positive mindset and high energy levels. The best way to ensure a healthy body and mind into the years of senior-citizenship is to focus on making positive changes in all aspects of personal well-being. Changing habits in one area may prove effective in enhancing one area of life, but no improvement in overall levels of energy and emotional well-being will be seen if other aspects of the body or mind are neglected. Many communities offer classes and publications for health and wellness over the age of 60. It may be beneficial to group up with other individuals in an effort to form committed bonds with a common goal. Groups of people who start exercise programs together are less likely to discontinue their regimen.

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When someone enters the hospital, he expects to get better of course, not worse. Unfortunately, all too often patients become terribly ill from an infection they didn’t have before entering the hospital. These infections are known as HAIs – healthcare associated infections or hospital acquired infections. With the increase in resistant bacteria, HAIs are on the rise. According to the World Health Organization (WHO), at any point in time, 1.4 million people worldwide are suffering from infections acquired in hospitals.

Unfortunately, hospital or clinic visits are almost unavoidable and usually unplanned. That is one reason it’s even more important for anyone to know the basics of HAI prevention. Surprisingly (or perhaps not surprisingly) the most important methods to prevent HAIs are simple hygiene and sanitation. Cross contamination, also called contact transfer, is the number one cause of HAIs and fortunately, the easiest to tackle. See the following PDF with patient tips:

Patient’sGuide to Hand Hygiene

Two other common HAI types are ventilator-associated Pneumonia (VAP) and Surgical Site Infections (SSIs). There are things both patients and health care professionals can do to prevent HAIs. The ‘Not on My Watch’ Campaign aims to educate both groups about the best ways to prevent infections.  

You can get more information on healthcare associated infections at www.haiwatch.com.

And here is another interesting finding – the most poorly performing homes are distributed UNEVENLY across the states, with eight states having no such homes and ten others have from 21 to 52 such homes. Where do you find the 52 worst nursing homes? According to the GAO, that’s in Indiana. Florida has 16 that make the list, a relatively low number considering there are 664 nursing homes in my Florida Senior Living Advisor database. But we don’t do as well as another popular retirement location – Arizona has just 4 homes on the list.

According to GAO’s estimate, of the 16,000 nursing homes in the US, four percent – or 580 – could be considered the most poorly performing. If you want to understand more about the GAO’s research and conclusions, you can read the summary and recommendations, or even review the entire report. But be patient – it is 57 pages long! (The map showing numbers of poorly performing homes in each state is on page 15.)

Thus far, my father has not had any issues, and (knock on wood) I don’t foresee any in his future. But when I came across this article from The Washington Post about contracts at continuing care retirement communities, I figured it was worth sharing. It makes reference to a specific CCRC in Northern Virginia, but the concepts are universal.

Scrutinize any contract to avoid nasty surprises at continuing care community

By David S. Hilzenrath

If you are considering moving to a continuing care retirement community, you would do well to consult a lawyer and read the fine print of any contract to determine whether the potential benefits outweigh the risks. A “Residence and Care Agreement” for Ashby Ponds, an Erickson community in Ashburn, illustrates some of the trade-offs the decision could entail.

You might be drawn to Ashby Ponds by the potential to avoid another disruptive move when you are least able to cope with it, but there is no guarantee you would be able to move to an assisted-living or nursing facility on the same campus — even when those facilities are completed. If the assisted-living and nursing home beds at Ashby Ponds are full, management could arrange for you to go elsewhere.

Some delay in building those facilities is routine at Erickson developments, said Ronald E. Walker, chairman of a nonprofit group associated with Erickson campuses. Though Ashby Ponds opened in September 2008, the assisted-living and skilled-nursing portions were not expected to open until the end of 2011 or the beginning of 2012, according to a May report from the community’s management.)

The deposit you post to move in does not limit the amount you could be required to pay on a monthly basis; management can raise the monthly fees. In addition, the fees can go up as you move from one level of care to the next. At Erickson communities, the average monthly fees range from $1,750 for singles in independent living to $5,178 in assisted living and $307 per day — as much as $9,517 per month — in the nursing homes, Erickson spokesman Mel Tansill said.

Management can decide to transfer you to a higher level of care. If you refuse to go, management can kick you out and hold on to your deposit until 60 days after it finds a new tenant. To gain admission to the community, you have to pass financial and medical reviews. If you marry a nonresident, your new spouse would have to pass such a review before being allowed to move in.

To reassure management that you have the ability to pay expenses, you must agree not to give away any assets that would bring your net worth below a minimum requirement. Evan H. Farr, a Fairfax lawyer who specializes in issues facing the elderly, recommends putting any extra assets in an asset protection trust before you move in.

Unlike a real estate investment, the deposit you post to enter the community does not grow as property values rise. But it can shrink as property values fall. If it takes management a long time to replace you, you may be offered the option of accepting a smaller payout so that management can in effect cut the price of admission for the next tenant to occupy your apartment.

In addition to those obligations, I was busy on Friday and Saturday attending an amazing conferenced about social media and blogging. It was called “Izeafest” – a reference to the company that organized it, Orlando’s Izea, Inc. I learned so much and met so many wonderful people. I’m still going through all of my notes, mapping out next steps for this blog and for the Florida Senior Living Advisor website. But I know one my priorities needs to be to find other websites and blogs to link to me. So this is my first shout-out: if you know of a useful blog that focuses on issues such as senior care, senior living facilities, nursing homes, assisted living facilities, Alzheimer’s disease, Medicare, really ANYTHING of interest to seniors, please tell me about the site in a comment below. I also want to know about these sites so I can add them to my “Helpful Links” section of Florida Senior Living Advisor.

This headline in Sunday’s South Florida Sun-Sentinel caught my attention. Halfway through reading the  article, I was speechless. Thanks to reporter Sally Kestin and the Sun-Sentinel for allowing me to re-publish the article here on the Florida Senior Living Advisor blog.

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By Sally Kestin, Peter Franceschina and John Maines South Florida Sun Sentinel

Florida seniors and disabled adults too frail to live on their own have been beaten, neglected and robbed by caregivers with criminal records.

A cancer patient at a Pompano Beach assisted living facility watched helplessly from bed as a nurse’s aide with a record for theft rifled through her handbag and stole $165.

“What are you doing with my bag?” a police report quoted her as saying. “You have no right. Put it down.”

A video camera caught an aide at a North Miami Beach group home for the disabled shoving a cerebral palsy patient face-first to the floor, busting her lip. The aide had previously pleaded guilty to aggravated assault and never should have been working there.

More than 3,500 people with criminal records — including rape, robbery and murder — have been allowed to work with the elderly, disabled and infirm through exemptions granted by the state the past two decades, a Sun Sentinel investigation found. Hundreds more slipped through because employers failed to check their backgrounds or kept them on the job despite their criminal past.

In Palm Beach County, a woman with pending forgery charges got a job at a nursing home, where she assaulted a patient.

Glades Health Care Center in Pahokee did a background check on Phillina Anderson in 2004, but it did not turn up the charges, said Francine Hennessy, chief operating officer of the Council on Aging of Florida, Inc., which owns the facility. If it had, the nursing home would not have hired her, Hennessy said.

Anderson was still on probation in that case when she was arrested for abusing patient Cora Edwards.

Near the end of her shift on July 13, 2007, Anderson became upset with Edwards, a stroke victim with Alzheimer’s disease, according to an arrest report.

Anderson told Edwards to “shut up” and slapped her “extremely hard” across the face.

“Why did you hit me?” the elderly victim cried out, according to the report. “I never did anything to you.”

Anderson was convicted of abuse on an elderly person and served three months in jail. Hennessy said the nursing home learned after her arrest that she had been accused of abusing a resident at another facility that did not report it.

“We were very surprised,” she said. “Her background check was clear.”

Screening gaps

Florida has a patchwork of controls for checking caregivers of the elderly that seems to put more emphasis on protecting against embezzlement than safeguarding patients.

Inconsistencies in state law are glaring — facility owners, administrators and people who handle money require a nationwide FBI check, but not employees caring for patients. With some exceptions, they are checked only for crimes in Florida.

For nursing homes, a background check must be complete before anyone can work. But for assisted living facilities and home health aides and companions, employees can begin work before screening results come back.

“It ought to be consistent,” said Bob Blancato of the Elder Justice Coalition, an advocacy group based in Washington, D.C., that supports nationwide background checks for all employees.

Holly Benson, head of the Florida agency that regulates health care facilities, said the discrepancies are a result of different laws passed over more than a decade. “A lot of the way that this policy evolved is just kind of hit or miss,” said Benson, secretary of the Agency for Health Care Administration.

Of more than 100,000 people screened through AHCA over the past 3 1/2 years, more than 3,420, or 3 percent, were rejected because of a criminal history for offenses that included murder, exploiting the elderly and elder neglect, a Sun Sentinel analysis shows. The jobs include positions at clinics and treatment centers as well as nursing homes and agencies caring for the elderly.

Under Florida law, certain crimes disqualify someone from working with seniors or the disabled unless they obtain an exemption by showing evidence of rehabilitation.

Until this year, the disqualifying offenses did not include financial crimes that can lead to abuse and exploitation. An expanded list takes effect Thursday — eight years after a committee of prosecutors and state regulators recommended adding crimes such as burglary, fraud and forgery.

The patchwork screening system puts Florida’s most vulnerable adults at risk, the Sun Sentinel found.

Latoera O’Neal was able to care for seniors for two years in the Panhandle because she was screened only for offenses she might have committed in Florida.

In Ohio, O’Neal was an admitted cocaine dealer and served time in prison for a drug offense. Her out-of-state record only came to light when she switched jobs to work with the disabled.

Florida’s Department of Children & Families conducts nationwide criminal background checks of employees who work with the mentally and physically disabled. DCF first found O’Neal was disqualified as a caregiver, but gave her an exemption to work in 2004 after she said she had found God and being a caregiver brought joy to her heart.

While working at a group home in Fort Walton Beach in 2007, O’Neal dragged a mentally disabled man out of a van by his feet, slamming his head on the floorboard and the pavement, an arrest report said. She now faces a charge of abusing a disabled person.

Tierra Henry got a job in 2004 at a North Miami Beach group home operated by United Cerebral Palsy of South Florida.

Henry had served a year of probation for a 2001 charge of aggravated assault with a deadly weapon. Henry, then 19, hit a 15-year-old girl in the head with nunchuks, a martial arts weapon, a Miami-Dade Police report said.

“I told them straight up before they even hired me,” Henry said in an interview. “I told them I had a fight with a girl from high school … They gave me the job, no problem.”

DCF reviews the results of national FBI checks on caregivers of the disabled, while criminal history searches in Florida go directly to employers, who may miss disqualifying charges or fail to remove people as required.

United Cerebral Palsy thought Henry was clear after receiving a letter from DCF showing no record on her FBI check, said Leigh Kapps, an executive director. But Kapps’ agency should have checked her background in Florida and disqualified her based on the aggravated assault offense, a DCF spokeswoman said.

A year later, a video camera at the group home recorded Henry approaching a 22-year-old resident with cerebral palsy, grabbing her arm from behind and pushing her to the floor. Henry pleaded guilty to aggravated abuse of a disabled adult and is serving four years’ probation.

Rules ignored

Patients and their families have no way of checking employees’ criminal histories. Personnel files are confidential, as they are for any private business.

The Agency for Health Care Administration relies on employers to check the backgrounds of employees working with the elderly. State inspectors are supposed to ensure screening requirements are met but inspect nursing homes on average only once a year and assisted living facilities every other year.

Inspection data shows the system fails to weed out employees with disqualifying records and is slow to remove them once hired.

Screening problems are among the four most common violations in assisted living facilities, adult day cares and nursing agencies. Home health agencies and nursing homes are also cited, but less frequently.

At nursing homes, where a completed background check is required before starting, some employees had worked as long as seven years without any check.

A nurse in West Palm Beach was on the job despite several “misdemeanors and felonies” in the personnel file, and another worked more than a year without undergoing screening “due to lack of facility funds to pay for the background check,” a state inspector reported in April 2008. A background check costs about $25.

Supervisors at a Sunrise nursing home knew about a housekeeper’s record for cocaine trafficking and possession but kept him on because they felt he “deserved a break,” a June 2008 inspection found.

“The teeth aren’t long enough or sharp enough,” said Don Hering, head of Florida’s Long-term Care Ombudsman Council, which investigates elder facilities. “People who know how to game the system, they fine them, they give them 30 days to clean up their act, then it’s back to business as usual.”

‘Last thing on your mind’

Joan Loughman never thought about the pasts of the staff at the Lyford Cove assisted living facility in Fort Pierce when she admitted her ailing father in 2002, said her husband, Tom.

Loughman selected the facility after meeting its marketing director, Andrew Gosciminski, at the hospital treating her father. Gosciminski helped her move her father’s belongings and admired her 2-carat diamond ring and other jewelry worth $40,000, records show.

“That for me set off an alarm,” said Tom Loughman, who remained in the couple’s Danbury, Conn., home. “I called her and said that conversation really bothered me. I told her, ‘You have to be careful.’”

On Sept. 24, 2002, the day before she was scheduled to fly home, Loughman, a grandmother and Girl Scout volunteer, was found dead in her father’s Hutchinson Island home, her throat cut and her jewelry missing. That night, Gosciminski gave his girlfriend a diamond ring, according to court testimony.

Gosciminski was convicted of murder and sentenced to death, but the Florida Supreme Court overturned the verdict last fall based on insufficient physical evidence. Jury selection in his retrial began last week.

Gosciminski, who had felony theft and worthless check convictions in Broward County, did not even need a background check to work at Lyford Cove. He fell into a category of employees not required to undergo screening — administrators who do not provide “personal services” to residents.

“They claimed they were given the OK by the state to hire him because he wasn’t actually doing hands-on care of residents,” said Bennie Lazzara Jr., a Tampa attorney who represented Loughman’s family in a lawsuit against the facility.

Lyford Cove settled the lawsuit for undisclosed terms and is under different ownership.

Tom Loughman, an accountant, said family members assume employees caring for their loved ones have been thoroughly checked out.

“When you’re under the gun of trying to find a place for your relative and they’re in the hospital and they’re dying, it’s the last thing on your mind as to whether it’s a safe facility,” he said. “You assume with the state regulating them, that’s a given.”

Sally Kestin can be reached at skestin@SunSentinel.com or 954-356-4510.
Peter Franceschina can be reached at pfranceschina@SunSentinel.com or 954-459-2255. ]]> http://www.flseniorlivingadvisor.com/blog/2009/09/30/felons-working-in-florida-nursing-homes-newspaper-investigation-finds-yes/feed/ 1 http://www.flseniorlivingadvisor.com/blog/2009/09/25/the-veranda-of-pensacola-offers-range-of-care/ http://www.flseniorlivingadvisor.com/blog/2009/09/25/the-veranda-of-pensacola-offers-range-of-care/#comments Fri, 25 Sep 2009 19:20:12 +0000 Florida Senior Living Advisor http://blog.flseniorlivingadvisor.com/?p=226 Today’s “Friday’s Featured Facility” is The Veranda of Pensacola, a Florida continuing care retirement community. This means that The Veranda offers both independent living and assisted living options, which allows elderly residents to “age in place” – ie – transition from independent to assisted living as their needs increase.

According to their website, the apartments at The Veranda retirement community are spacious, modern and well-equipped one and two bedroom units with fully equipped kitchens.  Utilities and expanded cable TV are included. The amenities at The Veranda include common areas inside and out, an indoor heated pool, fitness center, and a own stadium seating movie theatre.

The Veranda provides housekeeping, linen and laundry service, scheduled transportation for independent residents and coordination of transportation for assisted living residents, a personal emergency response system and maintenance inside and out. The Veranda also has 24-hour camera surveillance.

The dining service provides a healthy breakfast, lunch (main meal of the day) and light meal in the evening. When it is time for community outings, shopping and personal appointments, the professional staff at The Veranda retirement community will schedule the necessary transportation.

The Veranda is just one of many Florida continuing care retirement communities. To see a complete list, searchable by region, visit Florida Senior Living Advisor. The database also includes assisted living facilities, nursing homes, adult day care centers, independent living communities, hospice and skilled nursing units.

According to the 2009 World Alzheimer Report, newly released today from Alzheimer’s Disease International (ADI), a London-based nonprofit, international federation, the number of people with Alzheimer’s or another dementia is expected to nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050.  It is estimated that there is a new case diagnosed every 70 seconds.

Much of the growth will be fueled by longer life spans and population growth, especially in developing nations.

“The number of people affected by Alzheimer’s is growing at a rapid rate, and the increasing personal costs will have significant impact on the world’s economies and health care systems. We must make the fight against Alzheimer’s a priority here in the United States and worldwide,” said Harry Johns, President and CEO of the Alzheimer’s Association.

According to Johns, some other countries, like the U.K., have a national Alzheimer’s plan in place. But in the United States, federal spending on research for Alzheimer’s is far lower than some other diseases, like cancer and AIDS. And, there’s no national plan in place that deals with long-term care for people with dementia, as well as “care coordination” of the many different health-care professionals who are often needed to care for patients with Alzheimer’s.

Although there is no cure, experts say that patients who receive active, early medical care may be able to delay progression and experience a higher quality of life. Also, caregivers who receive supportive services early on are better able to manage their loved ones’ illness at home and reduce institutionalization.

The Alzheimer’s Association website provides this very interesting interactive tour that shows how Alzheimer’s affects the brain. Inside the Brain: An Interactive Tour.

If you are trying to find care for a loved one with Alzheimer’s or dementia, many of the nursing homes and assisted living facilities in the Florida Senior Living Advisor database offer memory care services. Visit the individual websites or call for more information. Another option is in-home care, which I wrote about on this blog last week.

The latest inspection report of Regents Park, conducted by the Florida Agency on Health Care Administration in August, gives the facility just one star out of five in most categories. According to the AHCA website, “The fewer stars a facility receives, the more the facility was found to be in noncompliance with the regulations governing nursing homes.” The Federal Centers for Medicare and Medicaid Services also publishes a Nursing Home Compare web site that provides additional information to compare nursing homes in Florida and the nation.

In this particular incident, a witness told police she heard something from one of the rooms, and when she went in she saw Njorge engaged in a sexual activity with a woman in the room. The woman is disabled.The witness told police she reached for her cell phone, but Njorge tried to stop her.She was able to make a call and someone else came into the room. That witness told police she saw Njorge cleaning up and then throw something in the disposal room.

DCF Spokesperson John Harrell says his agency has investigated eight allegations of abuse at Regents Park in the past year, though none have been verified.

“Of those eight reports, four showed no findings, but four had some findings, including inadequate supervision [of patients]. That happened a couple of times,” Harrell said.

Njorge also worked at Life Care Center, another Southside nursing home. DCF is now looking into whether the attack is an isolated incident.Police are withholding any further information due to the nature of the crime and the investigation. Njorge remains in jail on a $500,000 bond.

Florida Senior Living Advisor offers a complete searchable database of all senior living facilities in Florida, including nursing homes, assisted living facilities, adult day care centers, skilled nursing units, independent living, continuing care retirement communities and hospice. As part of your research on particular facilities, you can check their rating in the AHCA guide; of course, you should always visit and inspect a facility in person before making such an important decision.

• Determine what type of facility the person needs. You can read my definitions to learn the differences between nursing homes, skilled nursing units, assisted living facilities, continuing care retirement communities and adult day care centers. In general, most people hope to retain as much independence as possible. (An increasingly popular option is in-home care. I’ll write more about a great home care company located in Central Florida in one of my next blogs.)
• Decide what part of the state of Florida your loved one is interested or willing to live. I’ve divided my database into the following regions: Panhandle, North Florida, Central Florida, Central Gulf Coast, Southeast Coast, Southwest Gulf Coast, South Central Florida. You can also look at my map to understand where those regions are.
• Conduct a search of the Florida Senior Living Advisor database, based on your answers to the above two questions. If a facility has a website, I provide a direct link to it from the database. So look at the facility’s website to get more information. Of course, keep in mind that some of these Florida senior living facilities provide very detailed information on their websites, others do not. If a facility you are interested in does not have a website, you will need to call to get more information.
• Look at Florida Senior Living Advisor’s “Evaluating Facilities” page for a list of the questions that I asked – and some I wish I had asked – as I was researching facilities for my elderly father. The answers you receive can help you start to narrow down your list of options.
• Of course a big deciding factor is cost. This will vary greatly from facility to facility.

And don’t forget good, old-fashioned word-of-mouth. Talk to friends and neighbors. This is what lead me to help my father find the perfect facility – a casual conversation at a social event with an acquaintance I had not seen in several months. When she asked, “What’s new?” I proceeded to explain how I was immersed  in helping my father select a Florida senior living facility. She responded by telling me about a facility she had just visited with her elderly mother. And the rest, as they say, is history.

One more idea: if you feel like you need more help, someone to walk you through the process, consider hiring a senior care management company. I  recently met a wonderful woman named Patrice Antony who owns and operates Elder Advocates, Inc. in the Orlando area. Patrice is a Physical Therapist and Geriatric Clinical Specialist with more than 27 years of experience in working with the handicapped and the elderly. Patrice and her staff will do as much or as little as you need – from helping you research and select a senior facility, to consulting with medical staff on a client’s behalf, and negotiating with insurance companies. For more information, visit the Elder Advocates website.

I’d love to hear back from anyone currently going through this search process for an elderly family member. Comment on this blog or send  me an email at mitra@flseniorlivingadvisor.com.