Most Baby Boomers are Unprepared to Care For Aging Parents | The Intentional Caregiver

Yesterday, I was fortunate to be able to interview Mr. Jeff Huber, President of Home Instead Senior Care, the largest provider of in-home care services for seniors in the world and was the first company to offer franchise opportunities.

Most professionals involved with eldercare are aware that adult children are not prepared to care for their parents when they receive “that call” that throws them into the caregiving role.  But the Home Instead Senior Care network  wanted to learn more about that and so in conjunction with The Boomer Project, a study of 600 baby boomer aged adults was conducted. 

The results surprised me:

• Less than 50% were knowledgeable about their parents’ medical history
•  49% were unable to name any of their parents’ current medications
• More than 30% did not know just how many medications their parent(s) was taking

via takingcareofthefolks.com

Thank you Shelley for bringing attention to this critical topic. It is a phone call we will each be getting eventually. It is much better to be prepared.

Click on the "VIA" link to read the full article.

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Nursefriendly, Inc. A New Jersey Corporation.
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Are senior citizens being overmedicated? – The Chart - CNN.com Blogs

Strong, antipsychotic drugs are being prescribed more often to senior citizens in U.S. nursing homes, setting off a debate about whether it's the right treatment for the elderly suffering from dementia.

Daniel Levinson, inspector general for the Department of Health and Human Services, believes this increase - detailed in a recent study by his office - is a cause for alarm.  "The report found that too often, elderly residents are prescribed antipsychotic drugs in ways that violate government standards for unnecessary drug use," he wrote in a commentary for CNN.com.

Psychiatrist Daniel Carlat disagrees, saying the study Levinson cites is a "blizzard of statistics" that doesn't tell the entire story.  "When these drugs are successful, they soothe the inner turmoil that makes life intolerable for these patients, improving their quality of life dramatically," Carlat wrote in his commentary for CNN.com.

via thechart.blogs.cnn.com

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Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

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Nursing Home Rehabilitation Stay Proves Terminal. Was Quality of Care Given An Issue?

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See also: Medical, Legal Nurse Consultants, Clinical Nursing Case of the Week, Clinical Charting and Documentation, Nurses Notes, Courtrooms, Disability, Discrimination, Employment, Expert Witnesses, Informed Consent, Medical Malpractice, Nursing Practice Acts, Pensions, Search Engines, Torts and Personal Injury, Unemployment, Workers Compensation, Workplace Safety:

Each week a case will be reviewed and supplemented with clinical and legal resources from the web. Attorneys, Legal Nurse Consultants and nursing professionals are welcome to submit relevant articles. Please contact us if you'd like to reproduce our material.

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Summary: Nursing homes are frequently a patient's destination for
rehabilitation following surgery.  Common conditions fitting
this bill include large bone fractures, hip replacements and stroke.
Following these acute episodes, the patients are too unstable to
go home and not "sick" enough to have their hospital stays
reimbursed by insurance companies.  The purpose of admission
to a nursing home is to help the patient regain lost function,
strength and health.  In this case, the patient would remain in the
Nursing Home till her death of complications.

The patient was admitted to a state owned nursing home
following repair of a femoral fracture.  Her treatment plan
emphasized Physical, Occupational therapy and Nursing care
to provide for rehabilitation.

She had successfully undergone surgery to repair a fractured
femur.  The length of stay projected was six weeks.  During
this time, the patient's condition would worsen rather than
improve.

This is not an isolated incident.  Media attention is continuously
focusing on conditions in nursing homes.

"A TIME investigation has found that senior citizens in nursing
homes are at far greater risk of death from neglect than their
loved ones imagine. Owing to the work of lawyers, investigators
and politicians who have begun examining the causes of
thousands of nursing-home deaths across the U.S., the grim
details are emerging of an extensive, blood-chilling and for-profit
pattern of neglect."2

The patient's skin was intact and she was continent on admission.
She would develop multiple pressure ulcers on her bony
prominences.  These are frequently the consequence of inadequate
turning and poor nutrition.  Monitoring of both of these factors
are direct responsibilities of nurses and nursing home personnel.
If either is inadequate, a duty is owed to the patient by the nurse
to inform the physician.  The physician, once made aware, is
then charged with taking additional measures as needed.

The patient would have a Foley catheter inserted supposedly
for urinary incontinence.  Documentation would later show
that need for catheterization had not been established.

The patient had been fully continent on admission.  Her
rehabilitation plan called for her to ambulate to the bathroom
when needed.  An assessment of her ability to go on her own
was nowhere to be found at the time of her Foley catheter
insertion.  Development of a urinary tract infection is a known
complication of catheter use.  The patient would develop a
UTI soon after.

"In the last year, complaints against nursing homes in Texas
are up over 60%. Medication errors, under-staffing, unsanitary
conditions, neglect, lack of care, substandard care and injuries
from dangerous products, are but a few of the dangers. The
administrators of these facilities contend that the level of care
is excellent in Texas nursing homes but, state investigators and
Texas juries have been sending a different message."3

On the initial trial, the court dismissed the claims.  They based
this on the fact that the nursing home personnel were "state"
employees and supposedly immune from liability.

The patient's family appealed.

Questions to be answered:

1. Could the nursing home personnel in a public facility be
held liable for negligence in the care of the patient?
Specifically, could they be sued for not maintaining the
standards of care required by the state?

2. Were the "incidents" leading up to the patient's deterioration
reasonably "foreseeable" by a prudent caregiver in a
similar situation?

On appeal, the plaintiff presented multiple pieces of evidence
documenting neglectful incidents.

This documentation included fractures during transfers (one
requiring re-hospitalization and extensive surgical repair),
the development of skin breakdown, the development of
infections of the respiratory, urinary and gastrointestinal tract.

Each of these events suggested that care for the patient could
be falling below accepted standards.  Each of these events
could be identified as necessitating further therapy and
increasing the patient's length of stay.

In reviewing the Tort Immunity Acts of Illinois, it was
determined that liability could be assessed for acts of
negligence or omission in the patient's care.

It was clear from physical, mental and health status changes
that the patient was deteriorating.  These changes, specifically
the multiple injuries during transfers, development of skin
breakdown and infection could be traced to negligence in the
omission of required care.  Any time the treatments prescribed
by the physician are not carried out, or if it is not documented
that they have been carried out, the possibility of omission and
negligence is raised.

It is highly unlikely that if the treatments and care prescribed
had been given that the gross deterioration would have occurred.
In this case, documentation of care was not present.  Documentation
of "likely results of neglect" was present.

This underscores the necessity of properly documenting the care
you give.   Many facilities are adopting "charting by exception"
policies.  These are dangerous in that they may not account for
basic care given.  In saving time and nursing costs for a facility,
not fully charting care given can raise the question of a nurse's
omission and negligence later in court.

If the temptation to chart care that is not given is present, keep
this in mind.

If time for giving proper treatments and care is not there,
falsifying records is patently illegal.  It is an offense that
could cost you your license if reported to the State Board.

In the case of a lawsuit, it is much cheaper for a facility to
scapegoat a nurse, than defend one.  If reporting you to the
State Nursing Board, or threatening to will give their attorney's
a bargaining chip to keep an employee "quiet," about existing
conditions they'll use it.

"Generally, the nursing-home industry likes to settle lawsuits
quietly and often hands over money only in exchange for
silence."2

A nurse must decide if saving facility money by spending
less time charting or on patient care is worth possible liability
or loss of licensure down the road.  It is highly unlikely that
a nursing home or hospital will defend a nurse named in a
lawsuit.  This chiefly will happen only when the facility's
assets are at stake.

If conditions in a nursing home are visibly substandard, a
nurse must ask if it is wise to continue working in the facility.
Ask yourself.  Is the administration receptive to suggestions
for improvement?  Do they raise concerns over overtime and
time involved to complete care and charting?

As media attention and lawsuits increase, more nurses will
find themselves involved in legal actions.  If it's determined
that poor conditions existed yet nothing was done about
them, the cost in liability could be high.

"Palo Alto attorney Von Packard has studied the death
certificates of all Californians who died in nursing homes
from 1986 through 1993. More than 7% of them succumbed,
at least in part, to utter neglect--lack of food or water,
untreated bedsores or other generally preventable ailments.
If the rest of America's 1.6 million nursing-home residents
are dying of questionable causes at the same rate as in
California, it means that every year about 35,000 Americans
are dying prematurely, or in unnecessary pain, or both."2

Many states have "elder abuse" legislation mandating abuse
be reported.  Whistle blower legislation is slow in coming.
Currently the employer's interests are put first rather than the
patient's or employees in most cases.  Protections for nurses
that do report abuse are questionable in their effectiveness.
The risk of employer retaliation is high.

The chances of a nursing home or hospital defending you
against the State Board of Nursing when your license is
at stake over an incident are almost none.  In fact, it is
common for complaints to be filed by the facility where
a nurse has worked.

Unless you have a personal malpractice insurance policy,
you will be forced to pay for this representation out of pocket.
For less than the cost of a typical day's pay (around $70-$90
per year), most personal policies will provide representation at
no additional cost to you.

Related link Sections:

Direct Patient Care Links on: The Nurse Friendly
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htm

Ethics:
http://www.nursefriendly.com/nursing/directpatientcare/ethics.htm

Foley Catheterization:
http://www.nursefriendly.com/nursing/directpatientcare/foley.catheterization.htm

Informed Consent:
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/informed.co...

Mechanical & Physical Restraints:
http://www.nursefriendly.com/nursing/directpatientcare/mechanical.physical.re...

Medical Legal Consulting Nurse Entrepreneurs:
http://www.nursefriendly.com/nursing/ymedlegal.htm

Operating Room (Surgical) Links on: The Nurse Friendly
http://www.nursefriendly.com/nursing/directory/spec/operatingroom.htm

Nursing Homes, Long Term Care Links:
http://www.nursefriendly.com/nursing/nursing.homes.long.term.care.htm

Wound Care:
http://www.nursefriendly.com/nursing/directory/business/woundcar.htm

Sources:

1. 39 RRNL 12 (May 1999)

2. Time Magazine.  October 27, 1997. Fatal Neglect. Retrieved July 11, 1999 from the World Wide Web: http://cgi.pathfinder.com/time/magazine/1997/dom/971027/nation.fatal_neglect....

3. Law Offices of James K. Burnett, P.C. 1999.  Nursing Home Negligence. Retrieved July 11, 1999 from the World Wide Web: http://www.nursinghomenegligence.com/
 

The Uniform Resource Locator (URL) or Internet Street Address of this page is
http://www.nursefriendly.com/nursing/clinical.cases/071199.htm

Send comments and mail to Andrew Lopez, RN

Created on July 11, 1999

Last updated by Andrew Lopez, RN on Monday, February 28, 2011

via nursefriendly.com

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

http://www.4nursing.com
http://www.inspirationalnursing.com
http://www.legalnursingconsultant.com
http://www.nursefriendly.com
http://www.nursingcasestudy.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com
http://www.nursinghumor.com

Elderly Patient Repeatedly Injured In Nursing Home "Accidents." Negligence, Coincidence or Abuse?

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See also: Medical, Legal Nurse Consultants, Clinical Nursing Case of the Week, Clinical Charting and Documentation, Nurses Notes, Courtrooms, Disability, Discrimination, Employment, Expert Witnesses, Informed Consent, Medical Malpractice, Nursing Practice Acts, Pensions, Search Engines, Torts and Personal Injury, Unemployment, Workers Compensation, Workplace Safety:

Each week a case will be reviewed and supplemented with clinical and legal resources from the web. Attorneys, Legal Nurse Consultants and nursing professionals are welcome to submit relevant articles. Please contact us if you'd like to reproduce our material.

For a free subscription to our publication:
Please send a blank e-mail to: clinicalnursingcases-subscribe@topica.com

Summary:  As the elderly population continues to increase, more and more families are faced with the decision to place loved ones in nursing homes.  When a family member is placed in a facility, a certain standard of care is expected.  In this case, a resident was injured repeatedly while under their care.  When the patient died a few days after being "dropped" the family sued.

The patient was a 95 year old woman who was placed in a Missouri nursing home when the family was no longer able to care for her needs.

"Approximately 1.5 million people live in the nation's 17,000 nursing care facilities. . .The typical nursing home resident is a woman in her 80s displaying a mild form of memory loss and dementia. Although physically healthy for a woman her age, she needs help with approximately 4 of 5 activities of daily living (eating, transferring, toiletting, dressing, and bathing)."2

During her admission the patient would sustain  multiple injuries over the course of her stay.  In 1993, on two occasions, the patient's legs were broken with fractures diagnosed.  Each time the patient was transferred to the hospital for treatment and then returned to the nursing home.

Each time the documentation would show that the family had been "made aware."  This was reflected in incident reports that had been filed.  The incident reports did not specify which family members had been notified.

A third injury took place in 1995 when the patient was being transferred from her bed.  Documentation of the incident stated that the patient had been "dropped" during a transfer.  The charted notes documented that a head injury was sustained and that family members were notified.

The patient was again transferred to the hospital and was evaluated in the Emergency Department.  Interestingly, when examined by a physician, the day after the incident, the physician stated that there was no evidence of head injury.  Five days following this examination, the patient died.

The family would sue the nursing home.  They would allege that standards of care had not been met.  They would accuse the nursing home of rendering negligent care.

It is no secret that nursing home abuse occurs.  It can take many different forms and have devastating consequences on residents and their families.

"The United States Department of Health and Human Services researchers identified seven categories of abuse. Ninety-five percent of those surveyed said they felt that all seven are problems for nursing home residents:

Physical abuse --infliction of physical pain or injury.

Misuse of restraints --chemical or physical control of a resident beyond physician's order or outside accepted medical practice.

Verbal/emotional abuse --infliction of mental or emotional suffering.

Physical neglect --disregard for the necessities of daily living.

Medical neglect --lack of care for existing medical problems.

Verbal/emotional neglect --creating situations harmful to the resident's self-esteem.

Personal property abuse --illegal or improper use of a resident's property for personal gain."3

The basis of the family's lawsuit centered on the assumption that a certain standard of care, and a "duty" is owed to nursing home residents.   This duty it was assumed, included safe living conditions, freedom from harm and timely medical treatment.  They alleged that these standards had not been observed by the nursing home.

In the initial trial, a review of the charting and documentation showed that in each "incident," facility protocols had been followed.  Upon discovery of the injuries, medical treatment and family notification had been provided.

The Defense moved to have the charges dismissed.  The court agreed.

The family appealed.

Questions to be answered.

1. Was there clear evidence of either neglect or abuse on the part of the nursing home staff in either of the three documented incidents of injury?

2. Had standards of care been met in regard to treating an injured patient and providing safe and reasonable care.

Chiefly due to the timely documentation of the incidents, the records were used to demonstrate adequate care being given.

The family's lawsuit chiefly targeted the "handling" of the incidents rather than the "cause" of injury.  The documented interventions and notifications on the part of the nursing staff provided sufficient proof that standards were upheld.

It is common knowledge that documented nurses' notes and the medical chart are legal records.  They should be written and treated at all times as if a jury will later examine them.

Had the incident not been documented as thoroughly or had incident reports not been filled out, it might have been a different story.  It was the clear and concise charting of the nursing homes staff's handling of the incidents that saved the facility from a potentially costly lawsuit and trial.

This was particularly evident when the family accused the nursing home staff of "failure to notify" the family members.  As long as efforts were documented in the notes to notify the family, the facility was covered.

It is a bit strange that the specifics as to "who" was notified was not included in the chart.  Under a different set of opinions, this could easily be interpreted as a "red flag."  In this case it was not.

This documentation of  "notification" could have been seen as the nursing home staff charting to cover themselves regardless of whether a family member had been contacted.

To minimize suspicions of impropriety it is suggested that when a family member is contacted, the name and phone number also be documented.  All evidence is subject to interpretation.  This can be applied to physician notification as well.

When a patient has an attending, consulting physicians and residents responsible for their care, "MD made aware" leaves much room for debate as to who was notified.  If the name of the physician is noted, the guesswork is removed and accountability easier to establish.

What was not addressed in this case was the nature of the "accidental" injuries.  It is not difficult to imagine a 95-year-old patient falling as she tries to get out of bed.  It is common for patients to fall on their way to or from the bathroom.  The pertinent question is "could the injuries have been avoided."

It is clear from published studies that indeed many can be.

""We found that neither complaint investigations nor enforcement practices are being used effectively to assure adequate care for Nursing Homes residents and the prevention of nursing home abuse and neglect. As a result, allegations or incidents of serious problems, such as inadequate prevention of pressure sores, failure to prevent accidents, and failure to assess residents' needs and provide appropriate care, often go uninvestigated and uncorrected."4

Lawsuits against nursing homes are common and on the rise.  If you are working in a nursing home, you need to be aware that you are responsible for documenting adequate care.  You are equally responsible for prevention.  If a dangerous condition or "accident waiting to happen" is identified, steps must be taken and documented to correct it.

If a patient is at risk for falling they may refuse to call for assistance.  If they try to get out of bed anyway, it should be documented that the patient was instructed to "call for assistance," and did not.

If a patient is clearly a danger to himself or herself and others, restraints may be indicated.  The family or the physician may refuse to allow or write an order for them.  The nurse must document that the need for them was communicated, to whom and the response.

Even with adequate care being given accidents can happen with legal consequences.  Nursing homes are currently the focus of intense governmental supervision and regulation.  The effectiveness of the regulation is debatable.  There are many that feel that the only "solution" to correcting problems are legal actions against nursing homes.

If this approach is to be paralleled to eliminating medical malpractice, a solution may be a long way off.  What can be anticipated is increased pressure from the government, from consumers and the courts.  This will result in increased litigation and increased pressure on nursing home staff and facilities.  Each member of the nursing staff would be wise to document carefully daily care and especially incidents that result in injury.

Related Case Studies:

June 13, 1999: Felony Child Abuse Conviction, Made Possible Thanks to Nurse's Documentation.
State v. Gillard, 936 S.W. 2d 194 - MO (1999).
http://www.nursefriendly.com/nursing/clinical.cases/061399.htm

June 6, 1999: Emergency Department Nurse Verbally Abused, Physician History Well Documented
Gordon v. Lewiston Hospital, 714 A.2d 539 - PA (1998)
http://www.nursefriendly.com/nursing/clinical.cases/060699.htm

May 30, 1999: Patient Left Unrestrained, Patient Injured. Nurses Judgement Call
Gerard v. Sacred Heart Medical Center - 937 P. 2d 1104 (1997)
http://www.nursefriendly.com/nursing/clinical.cases/053099.htm

Related Link Sections:

Abuse:
http://www.nursefriendly.com/nursing/directpatientcare/abuse.htm

Clinical Charting and Documentation, Nurses Notes:
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htm

Emergency Department Nurses on the Nurse Friendly:
http://www.nursefriendly.com/nursing/directory/spec/ed.html

Ethics:
http://www.nursefriendly.com/nursing/directpatientcare/ethics.htm

Head Injuries:
http://www.nursefriendly.com/nursing/directpatientcare/head.injuries.htm

Mechanical & Physical Restraints:
http://www.nursefriendly.com/nursing/directpatientcare/mechanical.physical.re...

Medical Legal Consulting Nurse Entrepreneurs:
http://www.nursefriendly.com/nursing/ymedlegal.htm

Nursing Homes, Long Term Care Links:
http://www.nursefriendly.com/nursing/nursing.homes.long.term.care.htm
 

Sources:

1. 40 RRNL 1 (June 1999)

2. American Health Care Association.  September 1998. Profile: Nursing Facility Resident: Retrieved June 27, 1999 from the World Wide Web:  http://www.ahca.org/secure/nfres.htm

3. Seniors-Site.  No date given.  Nursing Home Abuses to Senior Citizens.   Retrieved June 27, 1999 from the World Wide Web: http://seniors-site.com/nursing/abuses.html

4. United States Senate.  March '99. Excerpts from Committee On Aging Hearings.  Retrieved June 27, 1999 from the World Wide Web: http://www.jeffdanger.com/

The Uniform Resource Locator (URL) or Internet Street Address of this page is
http://www.nursefriendly.com/nursing/clinical.cases/062799.htm

Send comments and mail to Andrew Lopez, RN

Created on Saturday May 23, 1999

Last updated by Andrew Lopez, RN on Monday, February 28, 2011

via nursefriendly.com

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http://nursingentrepreneurs.ning.com/

StumbleUpon,
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******************************************************

Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

http://www.4nursing.com
http://www.inspirationalnursing.com
http://www.legalnursingconsultant.com
http://www.nursefriendly.com
http://www.nursingcasestudy.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com
http://www.nursinghumor.com

Geriatric Nurses on: The Nurse Friendly

See also:

• Geriatrics Associations
• Geriatrics Clinical Resources

New

Carol J. Rhodes RN, LNC, Medical-Legal Remedies Inc (MLR):"Medical-Legal Remedies Inc (MLR) provides medical-legal Litigation Support Services for Legal Professionals that include Legal Nurse Consulting, Paralegal Litigation Support, a Medical Information Service called Virtual Legal Nurse and Medical Expert Referral Service for Attorneys, Insurance Companies, Hospital Risk Managers, Government, and Claims Management. MLR MLR's Paralegal Staff and Legal Nurse work together as a team to assist our legal clients with comprehensive medical-legal litigation issues and are committed to serve clients by offering our extensive experience and expertise to provide specialized high quality medical-legal litigation support services. By utilizing Medical-Legal Remedies Inc Paralegal/Legal Nurse Team allows the litigator to control costs and increase revenues while securing the competitive advantage with superior work products. So whether your firm or company needs a Paralegal, a Legal Nurse, or both - MLR will assist your firm or company with any medical-legal litigation case project."
Carol J. Rhodes RN, LNC
14286-19 Beach Blvd. #248
Jacksonville, FL 32250
(904) 223-3969
Carol@JaxLegalNurse.com or Carol@VirtualLegalNurse.com
LinkedIn: http://www.linkedin.com/pub/carol-j-rhodes/30/81b/685
http://www.jaxparalegal.com/

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National Gerontological Nursing Association (NGNA):"We are the first and only nursing specialty organization dedicated to helping you realize your full potential as a gerontological nurse. We are a growing, dynamic and dedicated group of professionals who share ideas and information that improve the quality of nursing care for our elderly.
National Gerontological Nursing Association (NGNA)
7794 Grow Drive
Pensacola, FL 32514
Tel:(850) 473-1174 or (800) 723-0560
Fax:(850) 484-8762
email: ngna@puetzamc.com
http://www.ngna.org/

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Mark Ballinger RN BSN Partners In Care, Nebraska, Temporary Staffing, Medical-Surgical & Geriatrics
http://www.nursingentrepreneurs.com/ballinger/

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Dominique Ann Bernard, RN, BSN, Virginia Nurse Entrepreneurs:"My goal is to work from home. Currently I am employed in a psychiatric facility and I work part time in a geriatric setting. My interests are varied."
http://www.4nursing.com/bernard

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Tina Berkofsky, RN, CLNC, Florida Legal Nurse Consultants, Nursing Entrepreneurs
http://www.nursingentrepreneurs.com/berkofsky/

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Folts, Mark, MSN, CNS, Michigan

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Tracy McClelland, RN, MSN, Ycarte Health Career Center, Georgia Nursing Entrepreneurs:"Opening doors to the Nursing Profession is our primary concern. We are a nursing tutorial facility designed to assist our community by training healthcare professions with the most updated nursing information and training equipment. We focus on assisting individuals who want to advance in the healthcare profession, or begin with an entry level into healthcare. Our goal is to bring education to you in a comfortable non-threatening environment that allows for learning. Whether you are new to healthcare or desire to advance in this profession, we can provide you with the training you need."
Tracy McClelland, RN, MSN, Ycarte Health Career Center
North Pointe Plaza
1214 North Peterson Ave. Suite P
Douglas, GA 31533
Phone: (912) 384-8680
Fax: (912) 384-4390
info@ycartehealth.org
http://www.nursingentrepreneurs.com/mcclelland

Categories: ACLS (Advanced Cardiac Life Support)
Adult Critical Care Nursing
BLS (Basic Life Support)
Career Alternatives For Nurses
Certification for Nurse Aid Students
Certification Program for Nurses
Continuing Education Provider
Critical Care Nurses
EKG Technician (New Class)
ER
Georgia Nurse Entrepreneurs, Nurse Owned Businesses
Geriatrics Nurses
Intensive Care Unit (ICU)
Masters Prepared Nurses
Medical/Surgical Nursing
Motivational speaker
Motivational Workshops
NCLEX-Reviews for RN's & LPNs
Neonatal Intensive Care Unit (NICU) Nurses
Nurse Aid Training Provider
Nursing Education
Nursing Entrepreneur
Nursing Educators
Nursing Educators
Nursing Workshops for CE hours
Operating Room (OR)
Pediatric Intensive Care Unit (PICU) Nursing
Pediatrics Nurses
Professional Nurse
Public Speaker
Remediation NCLEX Review (One- on- One)

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Mary Rosabell Higgins, BSN, Registered Nurse, M. R. Higgins & Associates Legal Nurse Consultants:"M. R. Higgins & Associates-Legal Nurse Consultants, a professional service company specializing in litigation review. Established in 1997, the company is headquartered in San Francisco, California.

Services include: comprehensive medical research; investigation of medical records to determine accuracy and or tampering; translation of medical terminology and deposition reports; and, interpretation of health science literature and documents. Consultation also comprises developing chronological summary reports from medical records.

Specialty Areas:

• Gerontology
• Legal Nurse Consultant
• Medical Malpractice, Negligence
• Pediatric
• Personal Injury
• Psychiatric/Mental health
• Workers compensation
http://www.nursingexperts.com/higgins/

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Ronald Parlee, LVN, California:
Specialty Area: Geriatrics
http://www.nursefriendly.com/parlee

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Lynne Ploetz, R.N., C., B.S.N., CCM, Minnesota Nursing Entrepreneurs, Care Management, Nurse Consultants, Consulting, Patient Advocacy
Adult Critical Care, Community Health, Geriatrics

http://www.nursingentrepreneurs.com/ploetz

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Angela M Rowe, RN, LNC, GCM, Senior Care Solutions, Alabama Nursing Entrepreneurs:"Senior Care Solutions provides Geriatric Care Management Services to aging adults and their families in Central Alabama. Our goal is to help seniors and disabled individuals to obtain the assistance they need to maintain safety, dignity, and quality of life. Senior Care Solutions provides advocacy, evaluation, education, and support services to seniors in Alabama."
3049 Lansdowne Drive
Montgomery Alabama 36111
Phone number: 334-834-9483
Fax number: 214-279-6602
http://www.nursingentrepreneurs.com/rowe

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Liz Sake, BSN, RN: Liz Sake & Associates: As Legal Nurse Consultants, we determine the merits of a medical malpractice case, review and translate medical records, chronicalize events, determine; damages/injuries, future health needs, causation and standards of care. An information discovery program through research of medical literature and the latest on-line information. We prepare written summaries and reports of medical records, research findings, and expert witness information. We identify and obtain expert witnesses as needed. Basically, we are here to make the med/mal attorney's life easier by synthesizing, sorting, and condensing medical information to be used as exhibits and for MD expert review.
Categories: Blood Banking

Case Management, Critical Care, Expert Witness Home Health, Legal Nurse Consultant, Managed Care, Oregon Legal Nurse Consultants, Rehabilitation http://www.nursingexperts.com/sake/

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Stephanie Salings, RN,CRNAC, LNC
Kentucky Nurses, Legal Nurse Consultant, Nurse Entrepreneur, Nursing Expert

Specialty Areas: Geriatrics, Home Health
http://www.nursingexperts.com/salings/

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Terrell Sr. Steven, LPN, Iowa

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Wells, Carla,RN BScN MN ET, Newfoundland, Canada:

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Melissa Wogoman, RN: Ohio, Ambulatory, Hemodialysis, ICU, Legal Nurse Consultant, Nursing Home
http://www.nursefriendly.com/wogoman/

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See also:

AgingInfoUSA:"Sue Salach-Cutler has worked in the geriatric healthcare field for close to 20 years and is the Author of "Along Comes Grandpa", a caregiving resource guide, and the novel "If I Walked in Her Shoes" (http://www.AlongComesGrandpa.com). As a National Speaker, Sue utilizes her personal and professional experiences to educate and empower professionals on the work/life affects of caregiving. ;As CEO of AgingInfoUSA she partners with companies to evaluate the cost of employee caregiving on their bottom line and implement cost effective solutions. Sue was the 2010 recipient of the YWCA Marguerite Henry Leadership Award for Communications/Technology and the Influential Women in Business Award from the Business Ledger and NAWBO. AgingInfoUSA received the 2010 Excellence in Business Award from the Business Ledger and was nominated for the Chicago Innovation Award."
651 S. Sutton Road - Suite 204
Streamwood, IL 60107
call: 847-630-0381
fax: 630-889-9886
Facebook: http://www.facebook.com/AgingInfoUSA
LinkedIn: http://www.linkedin.com/in/suesalach
Twitter: http://twitter.com/susanavello
Youtube: http://www.youtube.com/aginginfousa
http://www.aginginfousa.com/

Categories: Care Givers, Facebook/, Geriatric Resources, Geriatric Nurses, LinkedIn, Long Term Care (LTC), Twitter, Youtube

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Articles:

Nursing Shortage Serious For Seniors:"There is a threat to the health of every older adult in the United States and Canada looming on the horizon. It is not a virus or new type of bacteria that is causing this threat. The threat to health is a result of the increasing shortage of nurses in both countries."
http://seniorhealth.about.com/cs/prevention/a/nurse_shortage.htm

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Senior-Fitness.com:"Senior Fitness provides wellness and fitness information for seniors and those who will be senior citizens. The Stretching In Bed guide helps promote mobility, feeling better, looking better, and lets people feel less stiff, more flexible, more independent, and less fatigued. The How To Prevent Falls book is the only book that has the very successful Balance System® to prevent falls, reduce injuries, and strengthen legs. It uses 35 fun, effective, easy exercises and is a valuable program support for senior citizen centers, nursing homes, elder day care, and your family and mine.
http://www.senior-fitness.com/

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Geriatric Associations American Geriatrics Society:"The American Geriatrics Society (AGS) is the premier professional organization of health care providers dedicated to improving the health and well-being of all older adults. With an active membership of over 6,000 health care professionals, the AGS has a long history of effecting change in the provision of health care for older adults. In the last decade, the Society has become a pivotal force in shaping attitudes, policies and practices regarding health care for older people."
American Geriatrics Society
The Empire State Building
350 Fifth Avenue, Suite 801 New York, NY 10118
Phone - 212/308-1414 Fax - 212/832-8646
Email - info@americangeriatrics.org
http://www.americangeriatrics.org

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Alzheimer's Association
http://www.alz.org/

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California Advocates for Nursing Home Reform:"Since 1983, California Advocates for Nursing Home Reform has been fighting for the rights of long-term care residents in California.CANHR has directed its resources toward the following long term care issues."
CANHR
1610 Bush St., San Francisco, CA 94109
Consumer Information Hotline: (800) 474-1116 (consumers only please)
Other Inquiries: (415) 474-5171 Fax: (415) 474-2904, info@canhr.org http://www.canhr.org/

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Coalition of Women in Long Term Care (COWL):"Long term healthcare (LTC) is, in many respects, a women's issue. Women comprise 75% of the nursing home resident population, 97% of professional long term caregivers and the vast majority of family members caring for relatives at home. This demographic reality gives rise to a lot of issues, from healthcare delivery to pay equity and fringe benefits. Ironically, but not surprisingly, the majority of leadership and policy-making positions, both in long term care and in government, are occupied by men. The question becomes: How can we bring women's unique perspectives and situations, as they pertain to long term care, to the full attention of the board rooms, the legislatures, and the executive agencies of the government?"
P.O. Box 2789
Lebanon, TN 37088-2789
Phone: 615-444-1836 Fax: 615-444-0366
Webmaster: WebMaster@COWL.Org
http://www.cowl.org/

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Council of Gerontological Nursing, North Carolina Nurses Association (NCNA):"The Council of Gerontological Nursing is an organizational unit within the North Carolina Nurses Association (NCNA). The Council provides an opportunity for nurses to share expertise and discuss relevant concerns and issues critical to promoting quality care for older persons. A unique appreciation of the process of aging as a "work in progress" characterizes the philosophy of many gerontological nurses. For aphorisms about the aging process, click here (see page entitled Aphorisms about Aging)."
Gail Pruitt, RN, NCNA representative/liaison
103 Enterprise Road, Box 12225 Raleigh, NC 27605-2025
919-821-4250, 800-626-2153 fax 919-829-5807

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National Hospice Organization:"The National Hospice and Palliative Care Organization (NHPCO) is the largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. The organization is committed to improving end of life care and expanding access to hospice care with the goal of profoundly enhancing quality of life for people dying in America and their loved ones. Considered to be the model for quality, compassionate care at the end of life, hospice care involves a team-oriented approach of expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient's wishes. Emotional and spiritual support also is extended to the family and loved ones. Generally, this care is provided in the patient's home or in a home-like setting operated by a hospice program. Medicare, private health insurance, and Medicaid in most states cover hospice care for patients who meet certain criteria."
National Hospice & Palliative Care Organization (NHPCO)
1700 Diagonal Road, Suite 625 Alexandria, Virginia 22314
703/837-1500 (phone) 703/837-1233 (fax)
NHPCO Helpline: 800/658-8898
info@nhpco.org
http://www.nhpco.org/

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Administration on Aging - Information on Older Persons and Services for the Elderly:
http://www.aoa.dhhs.gov/

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Agency for Health Care Policy and Research: "The Agency for Health Care Policy and Research (AHCPR) was established in December 1989 under Public Law 101-239 (Omnibus Budget Reconciliation Act of 1989). AHCPR, a part of the U.S. Department of Health and Human Services, is the lead agency charged with supporting research designed to improve the quality of health care, reduce its cost, and broaden access to essential services."
Office of Health Care Information: Christine G. Williams (301) 594-1360 Executive Office Center, Suite 501 2101 East Jefferson Street Rockville, MD 20852
http://www.ahcpr.gov/

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Aging Network Resource Page:
Aging Network Resource Page

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American Geriatrics Society:"The American Geriatrics Society (AGS) is the premier professional organization of health care providers dedicated to improving the health and well-being of all older adults."
770 Lexington Ave Suite 300 New York, NY 10021 212-308-1414 Fax: 212-832-8646, info.amger@americangeriatrics.org
http://www.americangeriatrics.org/

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National Association of Geriatric Nursing Assistants:"The National Association of Geriatric Nursing Assistants was formally established in 1995 by former certified nursing assistants Lori Porter and Lisa Cantrell. Initially working as CNAs, both moved up the nursing home management ladder, Lori eventually becoming a licensed nursing home administrator and Lisa a director of nursing. Throughout their careers, they remained focused on their years as CNAs, realizing that nursing assistants are both the backbone and the heart and soul of the nursing home profession."
National Association of Geriatric Nursing Assistants
2709 West 13th Street Joplin, Missouri 64801
Phone: 417-623-6049 • 800-784-6049 Fax: 417-623-2230
Email: info@nagna.org
http://www.nagna.org/

Categories: Alzheimers Disease, Dementia & Senility, http://www.4nursing.com/alzheimers/
Associations, Organizations, Patient Education, Healthcare, Medical, http://www.4nursing.com/healthcare
Care Givers, Caregiving, http://www.nursefriendly.com/caregivers/
Certified Nursing Assistants (CNAs), http://www.nursefriendly.com/cna/
Geriatrics Nurses, http://www.nursefriendly.com/geriatric/
Hospice, Death, Dying, End of Life, Palliative Care, http://www.4nursing.com/hospice/
Long Term Care Nurses, http://www.nursefriendly.com/ltc/
Missouri Nurses, http://www.4nursing.com/missouri/
Private Duty Nursing, http://www.nursefriendly.com/private/

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National Institute on Aging:
http://www.nia.nih.gov/

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National Institute of Standards and Technology: The National Institute of Standards and Technology (NIST), an agency of the U.S. Commerce Department's Technology Administration, takes an active role in promoting science and technology education throughout the Gaithersburg, Md., community.
Public Inquiries Unit, (301) 975-NIST, NIST, 100 Bureau Drive, Gaithersburg, MD 20899-0001. Technical website questions: webmaster@nist.gov.
HTTP://www.nist.gov/

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Canadian Links:

Older Adult Centres' Association of Ontario:The Older Adult Centres' Association of Ontario ensures that older adults in Ontario have opportunities and choices that lead to healthy, active lifestyles
http://www.oacao.org/

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Southern Saskatchewan Stroke Prevention and Management Unit:
http://www.medi-fax.com/stroke/stroke.html

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Government:

Health Care Financing Administration (HCFA): The federal agency that administers the Medicare, Medicaid and Child Health Insurance Programs.
http://www.cms.gov/

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Medicare: The Official US Government Site for Medicare Information
http://www.medicare.gov/

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Listservs:

What is the ALZHEIMER list?:"ALZHEIMER is an email discussion group for patients, professional and family caregivers, researchers, public policy makers, students and anyone with an interest in Alzheimer's or related dementing disorders in older adults. ALZHEIMER is intended to provide interested individuals from various perspectives an opportunity to share questions, answers, suggestions and tips."
Washington University School of Medicine Alzheimer's Disease Research Center
4488 Forest Park Blvd., Campus Box 8111-ADRC Saint Louis, MO 63108-2293
VOICE: (314) 286-2881/2882 FAX: (314) 286-2763
Send your questions, comments and ideas to: ALZHEIMER-Owner@lists.biostat.wustl.edu
http://alzheimer.wustl.edu/adrc2/alzheimerlist/

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Schools:

Institute of Gerontology: Wayne State University, Detroit, Michigan.
http://www.iog.wayne.edu/

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For Health Information you can use, Follow, Connect, Like us on (Most Invites Accepted): http://www.nursefriendly.com/social/:

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Posterous.com, http://nursefriendly.posterous.com

StumbleUpon, http://www.nursefriendly.com/stumbleupon

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See also:

Nursing Topics, A to Z:

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If you do any Browsing or Windowshopping online, please visit our online Mall:
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Gifts For Nurses:
http://www.nursefriendly.com/gifts/

4nursinguniforms.com:"Choose from Top Nursing Uniform Companies. All sizes, styles and popular name brands available. Large selection of accessories as well: Accessories Blood Pressure Cuffs, Sphygnomanometers Nursing Tote Bags, Carry-Ons, Medical Bags Clinical, Medical Supplies, Nurses Discount Outlet: Angels, Books, Clothing , Equipment, Figurines, Holidays, Home Decor, Jewelry, Nurses, Office Decor, Scrubs, Shoes, T-Shirts Footwear, Shoes, Sandals, Discount, Bargains Gifts For Nurses (Nurses Week) Hosiery, Socks, Stockings Hats, Jackets, Jumpers Jewelry, Earrings, Necklaces, Watches Luxury Spas, Facials, Manicures, Pedicures Perfumes, Fragrances, Phermones Shoes, Boots, Sandals, Footwear, High Heels, Slippers Stethescopes, Nurse Kits, Replacement Parts Swimwear (Tan-Through) Women's Lingerie "
4nursinguniforms.com

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Nursing Chat, Nurse Discussion Forums:
http://nursingdiscussions.com

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The Uniform Resource Locator (URL) of this page is
http://www.nursefriendly.com/nursing/directory/spec/geriatric.html

Send comments and mail to Andrew Lopez, RN

Last updated by Andrew Lopez, RN on Wednesday, March 23, 2011

via nursefriendly.com

rWayneWDyer
The more you work at just being yourself, the more likely you'll feel purposeful and significant in your life
--

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For Health Information you can use, Follow, Connect, Like us on (Most Invites Accepted):
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Blogger:
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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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