Author Archives for Herb Weiss

Medical Staff Shortage Hits Nursing Homes

Published in the Pawtucket Times on April 2, 2001

In 2001, a crisis is looming in how we care for the frail elderly in nursing homes throughout the state.

Both nursing home providers and long-term care advocates are working together to publicize this tragic crisis, a shortage and turnover of certified nursing assistants in the state.

High job turnover rate of certified nursing assistants is drastically impacting the quality of care provided in both nursing homes and home health agencies.

And this direct care staffing shortage is also financially hurting facilities, too, reducing their financial stability.

According to Hugh Hall, nursing home administrator and Chairman of the Nursing Home direct Care Staffing Task Force, testifying at the hearing at the General Assembly, vacancy rates for certified nursing assistants, in nursing facilities has reached 21 percent with turnover skyrocketing to over 82 percent.

With these startling statistics, this staffing problem must be on the radar screen of Governor Almond’s policy staff, state legislators and state officials. If not, we’re edging closer to a quality care disaster in nursing homes.

Nursing home administrators live with a staffing shortage every day, most are forced to temporarily hire certified nursing assistants from nursing pools at the rate of $ 23.50 an hour.

Quick fixes, like relying on nursing pools, are quickly chipping away at the facility’s financial stability. And the state’s Medicaid program drastically under reimburses for these staffing costs.

Every day, it takes compassion, ongoing training and continuing education, physical and emotional endurance and perhaps a sense of humor for certified nursing assistants to care for frail elderly nursing home residents.

But, like in many professions, money talks.  With an average starting wage of $ 7.69, large numbers are now beginning to walk away from the long-term care field. Yes, its obviously easier and less stressful to work at a fast-food restaurant. One has employment options especially when the local newspapers are filled with help wanted ads. This is reflected by the testimony of a concerned Hugh Hall who recently stated at the members budget hearing of the Department of Human Services that only half of the 26,000 licensed certified nursing assistants in Rhode Island are currently working in the long-term care field.

Like other states, the percentage of Rhode Islanders who are over 65, age 75, and even age 85, who require increased skilled nursing and medical are rapidly growing.

The number of Rhode Island centenarians, now numbering over 200 is expected to dramatically increase too. Moreover, the growth of the over 85 population, who will require more services and supports from certified nursing assistants, will drastically strain the existing long-term care delivery system.

The certified nursing aide crisis impacts on family members too, states Roberta Hawkins, Rhode Island’s Ombudsman and Executive Director of the Alliance for Better Nursing Home Care.

Hawkins says, “Children, grandchildren, and aging spouses, are all worn out from making daily “feeding visits” to help short-staffed facilities ensure that loved ones receive (and eat) hot meals.” The informal helping hand is now an unpaid, but very necessary part of the facilities daily care team, she says.

With the demographic time bomb ready to explode, its time to get serious to fix this problem. Governor Almond’s proposed FY 2002 budget which allocates $ 10 million dollars across the health care continuum to address this critical shortage is an inadequate response.

Both nursing home providers and the Alliance for Better Long-Term Care, the state’s Ombudsman for the frail elderly, call for an infusion of $ 14.1 million of state funds to leverage $16 million in federal dollars to pay a living wage for direct care workers.

Increased funding is only the first step to fix this problem. Both consumer advocates and nursing home providers also see a need for a career ladder for certified nursing assistants, and increased funding for training sites for individuals to become certified nursing assistants. Some have said that a society is judged by how well it takes care of its elderly. If so, let’s  hold up states to that high standard, too. The Rhode Island General Assembly must make a commitment today’s commitment to today’s home residents for their families, and to the growing number of baby boomers who might require nursing home care in the upcoming years.

Alzheimer’s News often Confusing to Interpret

Published in Pawtucket Times on March 26, 2001

Everyday hundreds of thousands of caregivers scan newspapers, senior papers, Time, Newsweek, Modern Maturity or even National Enquirer in hopes of learning a little more about new, effective treatments for Alzheimer’s Disease.

Oftentimes it is confusing to determine which treatments are promising and which ones that are not, due to the diverse opinions in the research community. For instance, one article might report on Vitamin E; others might state how Ginko really improves your memory and is good for Alzheimer’s patients to take. Others might describe studies that indicate that estrogen replacement therapy is not really an effective treatment for Alzheimer’s Disease for some women. Or some might even warn the reader “Don’t eat off of aluminum plate

s” because research seems to indicate that an accumulation of heavy metals, such as aluminum, in the brain may surely cause Alzheimer’s.

Here are some helpful tips for unraveling the mysteries of Alzheimer’s Disease as reported in media.

Beware of glitzy headlines. Time limitations keep people from reading every article in their daily, weekly or monthly newspapers. As a result, many readers just quickly scan the headlines for information. Don’t judge an article by its glitzy title. The content of an article is much more balanced than the headline that is catchy and written to draw the readers in.

Look for authoritative commentary. You can consider an article more credible when it provides multiple quotes on the indications of an Alzheimer’s treatment. The reporter has done a good job in reporting if there is authoritative commentary on the significance of the study.  Two likely sources might be staffers from either the National Alzheimer’s Association  or the National Institutes of Health, a major funder of Alzheimer’s research studies.  Remember that the National Alzheimer’s Association’s point of view tends to be less biased and a more reliable opinion that those of researchers that have ties to a pharmaceutical company that issued the press release.

Disputes on findings. Keep in mind that even if a research study is reported there might be those persons who believe that the study is not well designed or has major research flaws. On the other hand, the study might just be accepted by the scientific community as a solid study. However, there might still be serious disagreements about how to interpret the results or how to classify it. Some researchers might consider it a major study while others would categories it as a minor one.  A well-researched article will include the quotes of those who oppose the findings.

Are you still confused by how to cull articles for tips on safe and effective treatments for Alzheimer’s? Where do we go from here? Caregivers should view any articles written about new Alzheimer’s treatments as informational in nature. The article can open the door to the researcher community and it now becomes your responsibility to do homework and find out more details about what the research findings indicate.

If the article describes the results of an actual published research study, obtain the scientific journal with the published study and carefully read it. If the findings are reported from a presentation at a conference, attempt to track the researcher down for more information.  Finally, cruise the Internet and check out the official Web sites of the Alzheimer’s Association or the National Institute of Aging to determine if they can provide information about a reported new treatment.

Finally, don’t hesitate to call your local chapter or the National Alzheimer’s Association to solicit their comments. They will gladly share all the information they have. Remember these groups closely monitor research studies and their implications for treatment.

Bipartisan Support Key for Passage of Aging Proposals

Published in Pawtucket Times on March 19, 2001

The operative word in national legislative circles these days in bipartisianship.

Both sides of the political aisle working together will have to be part of the picture if the long-term care field is going to see any significant legislative changes, policy sources indicate.

Why is that so? In the Senate, “there’s a 50-50 split between the two major political parties,” notes Bill Benson, President of Benson Consulting Group, a Maryland-based organization. What’s more, the division “has resulted in an unprecedented agreement between Senate Democrats and Republicans to share power,” according to Benson, a former top official with the U.S. Administration on Aging.

Democrats and Republicans alike have been following the failing health of Republican Senator Strom Thurmond, 98, of South Carolina.

If Thurmond retires or dies before the end of this term in 2002, it’s likely that his state’s Democratic governor would appoint a Democrat, a move that would shift the majority in the Senate to the Democratic Party.

Yet, Benson says that any legislative proposal would still need bipartisan support to get out of the Senate. “To get a Republican proposal enacted, you will either have to get lots of Democrats to cross party lines, or bring in Vice President Cheney to be a tie breaker,” he noted.

Meanwhile, in the House, the Republican majority holds but a razor thin margin.

“Like in the Senate, if both parties don’t work together in the House, you’re looking at legislative gridlock,” he says.

Benson notes that the Bush Administration is also moving to stall the lengthy regulatory and administrative actions taken by Clinton toward the end of his administration.

One such item that is temporarily halted is Clinton’s guidelines for managed care organizations that serve Medicare beneficiaries.

President Bush campaigned on Medicare reform and wants to bring his proposal to Congress.

His proposal provides a private sector alternative to traditional fee-for-service Medicare by offering block grants to states to help seniors pay for their pharmaceuticals.

This approach may be derailed by the Democratic Party, which added to its seats in Congress during the recent election, Benson explains.

He notes that Senator Charles Grassley (IA), Chairman of the Senate Finance Committee, has declared that he will not push Bush’s Medicare or prescription drug plans because they lack votes for passage.

Yet, Benson also predicts that the fact that Congress is closely divided increases the chance that something will be done about providing prescription drug coverage to seniors through Medicare. Otherwise, Benson adds, Medicare reform will amount to nothing more than talk this year.

Meanwhile, Robert Greenwood, American Health Care Association for Homes and Services for the Aging (AAHSA), says that bold, revolutionary proposals won’t be forthcoming from the nation’s evenly divided Congress.

Instead, legislators will take an incremental approach toward program development.

“A long term care agenda has not emerged yet,” Greenwood observes. “We don’t even have an administrator for the Health Care Financing Administration, the agency that manages the Medicaid program.”

Greenwood says, in the long run,” We’re hopeful that the Bush Administration will take seriously its responsibility to provide long-term care providers with the needed resources to provide quality of care and to fund a regulatory system that allows providers to do their job while still protecting vulnerable residents.”