Saturday, October 3, 2020

New Florida law includes stricter penalties for ripping off military veterans

Perpetrators would also have to pay all court costs and restitution associated with each of their victims

By Nick Givas
A series of Florida laws passed during this year's legislative session went into effect on Thursday, one of which makes it a felony to attempt to financially swindle a veteran out of $50,000 or more.
This bill amends the White Collar Crime Victim Protection Act to say someone "commits an aggravated white-collar crime if he or she obtains or attempts to obtain $50,000 or more by committing at least two associated white-collar crimes against 10 or more veterans."

The action will now be considered a first-degree felony, "ranked at a level 9 out of 10 possible levels for incarceration purposes on the offense severity ranking chart of the Criminal Punishment Code."

People convicted of breaking the new law would also have to pay court costs and restitution associated with each of their victims.

The court may also order payment of a $500,000 fine, or "double the value of the pecuniary gain or loss, whichever is greater."

The bill had similar protections for senior citizens within the text, in an effort to discourage the financially fraudulent schemes often carried out against the elderly.

Full Article & Source:

Muskogee woman enters plea to neglect, financial exploitation by caretaker

By Elizabeth Ridenour

Terri Lynn Russell

A Muskogee woman charged with neglect by caretaker and financial exploitation by caretaker entered a blind plea, and her son, who also was charged, pleaded guilty to financial exploitation by caretaker.

Terri Lynn Russell, 60, entered a blind plea in Muskogee County District Court on Wednesday, and she will be sentenced at 9 a.m. Jan. 6.

A blind plea is when a person charged does not have a sentencing agreement with the state, and they essentially plead guilty and let the judge determine their sentence.

Scott Allen Russell

Russell's son, Scott Allen Russell, 32, pleaded guilty to one of the two charges.

"We let him plead to count two, financial exploitation by caretaker, and he got five years deferred," said Orvil Loge, Muskogee County District Attorney.

The charge of neglect by caretaker against Scott Russell was dismissed, he said.

The victim, who was 81 years old at the time of the Russells' arrest, was bedridden and neglected.

"The house was horrendous, and they just failed to take care of her properly," Loge said.

The mother and son had also been charged with spending the woman's money.

"The victim receives a monthly income and the suspects have access," court documents state. "The elderly victim was found to be living in deplorable circumstances. The victim is unable to speak and is confined to a bed."

Full Article & Source:

Trio of Precious Metals Dealers Accused of $185 Million Scam Targeting Seniors


DALLAS (CN) — The federal Commodity Futures Trading Commission and 30 states announced Friday a lawsuit against three Los Angeles-based precious metal dealers for allegedly scamming over 1,300 elderly investors in a $185 million scam where they were charged 100% to over 300% more than market prices.

The securities regulators sued operator TMTE Inc., Chase Metals LLC, Chase Metals Inc., Barrick Capital Inc. and principals Lucas Asher and Simon Batashvili on Sept. 22. Unsealed Friday afternoon, the complaint lists 30 counts including state securities fraud, commodities fraud, investment adviser fraud and financial exploitation of the elderly. The plaintiffs claim the scam dates to 2017 and involved convincing the elderly victims to transfer their retirement savings to self-directed individual retirement accounts to purchase precious metals.

According to the plaintiffs, nearly every investor “lost the vast majority of their funds” on deposit with the defendants.

“Defendants falsely told investors who questioned the grossly inflated cost of the precious metals bullion after purchase that the precious metals bullion were exclusive and collectible numismatic or semi-numismatic precious metals that carried a premium far above the base melt value of the precious metals bullion.”

The plaintiffs claim marked up the price of one-half ounce Silver Royal Canadian Mint Polar Bear bullion by 213% over spot prices, constituting 58% of sales for over $102.4 million. (page 14) They allege a 120% charge over spot prices for one-tenth ounce Gold Royal Canadian Mint Polar Bear bullion, constituting 15% of sales for over $31.2 million. also failed to disclose to investors that it was subject to at least 12 separate state enforcement actions and disciplinary proceedings dating back to 2019, the plaintiffs say.

Barrick Capital and Chase Metals did not immediately respond to email messages requesting comment Friday afternoon. defended the company’s pricing, stating it sells bullion for cheaper than the U.S. Mint does on its website.

“ has customers from all ages, even as low as 18 years old, and from all political leanings, who enjoy physical coins delivered to them,” the company said in a statement. “We have among the lowest spreads on retail and wholesale prices in our industry between 1% and 29%.”

The defendants’ assets are currently frozen by U.S. District Judge David Godbey, who entered a restraining order Tuesday to permit the plaintiffs to inspect the defendant’s records. He also appointed a receiver to take control of, Barrick and relief defendant Tower Equity, in addition to the assets of Asher and Batashvili.

Texas Attorney General Ken Paxton blasted the defendants Friday for flouting a 2019 agreement with the state to refund 84 investors’ money and strengthen company compliance and training.

“I will not stand by as these companies use deceptive tactics and underhanded attempts to siphon cash from Texans who seek only to wisely invest their hard-earned retirement savings,” Paxton said in a statement. “The abuse of hardworking Texans, particularly senior citizens who look forward to a secure retirement, cannot be allowed to continue. Companies that take advantage of Texans will be held accountable.”

The CFTC said the lawsuit is the “largest joint filing” in the agency’s history with state regulators and the first since a 2018 information-sharing agreement with the North American Securities Administrators Association — a group of state and provincial securities regulators in the United States, Canada and Mexico.

“This case highlights just how geographically broad commodities fraud can be in our rapidly-evolving financial markets and how important it is for regulators at all levels of government to work together to pursue bad actors and protect market participants,” said CFTC chairman Heath P. Tarbert in a statement.

Full Article & Source:

Friday, October 2, 2020

Caregivers relieved, but cautious about eased restrictions for care facilities

By Lucinda Breeding

Amber Reynolds
For the families of Texans living in nursing homes and long-term care facilities, Gov. Greg Abbott’s decision to lift restrictions on visitation came not a moment too soon.

“Certainly it’s been difficult, regardless of what the level is with your abilities,” said Mike Danks, president of the Denton State Supported Living Center Family Association.

Danks and his wife haven’t seen their adult daughter, whom they preferred not to name publicly, since the first week of March. She has severe autism, and the Danks found the private homes inadequate to care for her. Without proper supervision and a careful medication schedule, their daughter has a tendency to have violent outbursts. The Danks said they found DSSLC a better fit.

Like other Texas families with loved ones in care facilities, the Danks have had to make do with video chats. Their daughter will interact by phone for a short time, and is accustomed to video calls with her grandparents.

“If you’ve got family and you can’t visit them, it’s difficult,” Danks said. “It’s been difficult for us because we haven’t been able to visit her. And it’s difficult because we haven’t been able to see mom and dad, either. I think it’s tough across the board.”

As of Thursday, Abbott’s orders allowed families to designate up to two essential family caregivers to get the necessary training to safely go inside a facility for a scheduled visit. The order allows the designated caregivers to enter the resident’s room.

The order is the first to allow designated caregivers this degree of access “to help ensure their loved one’s physical, social, and emotional needs are being met” since the state-mandated lockdown in March.

Designated caregivers don’t have to practice physical distancing, but only one caregiver can visit a resident at a time.

Angela Biggs made sure she had a negative COVID-19 test, which is required along with personal protection equipment training, so she could see her daughter on Thursday. She wore safety glasses and a mask. She arrived at the center with flowers and cupcakes.

“She definitely knew it was me,” said Biggs, whose daughter, Amber Reynolds, 29, has lived since at the center since 2014. Amber suffered a brain injury at birth and, after years of seeking treatment, was diagnosed with severe mental retardation and severe bipolar disorder with psychosis.

“I used that moment. I looked at Amber and I said ‘Amber, look at me eye-to-eye. I thought about you and prayed for you every day.’ And I made her say ‘day.’ I told her ‘I couldn’t come in, Amber.’”

Biggs said she was careful not to mention the staff, whom she praises and says give her daughter love and care. She didn’t want to risk Amber getting angry at the men and women who have taken care of her throughout seven months of lockdown. In March, the center was hit hard by the coronavirus that causes COVID-19.

Biggs said she was able to give her daughter the flowers — Amber loves yellow, and grinned over the bright, mostly yellow bouquet. The staff had to inspect the cupcakes to comply with pandemic health and safety rules.

Biggs could only stay for an hour and a half. She spent the short time chatting with her daughter, trimming her nails and inspecting her room for clues about how Amber fared without consistent, face-to-face contact with her mother.

“She’s not sleeping in her bed,” Biggs said. “She’s been sleeping on her couch. She’s not keeping warm. I can just tell this has been hard on her.”

Olivia Lilley and her husband, Bryan, have been caring for Bryan’s 88-year-old mother, Marylin, since she was diagnosed with Alzheimer’s Disease years ago. Marilyn lived next door to her son just outside of Aubrey for years — until her disease progressed to the point when round-the-clock supervision was needed.

In 2012, the Lilleys moved Marilyn into Willowbend Assisted Living & Memory Care in Denton. Olivia said her mother is still in the assisted living portion of the facility, where she has her own room. Marilyn’s condition causes her to self-isolate, and her memory seems to last for less than a minute. Lilley said she and her husband visited almost daily before the pandemic. Bryan works for Fox Sports covering the NFL, and when he travels for work Olivia takes over her mother-in-law’s care.

Olivia said her family couldn’t do without the love and care of the staff and director of Willowbend.

“They’re doing absolutely everything they can,” Olivia said. “We know that. Their hands are tied by the governor’s orders. It’s just so frustrating, and back at the end of August Byran and I were at the end or our rope. We were thinking about breaking her out.”

The Lilleys had good reason to be alarmed. Willowbend decided to close its dining room to protect vulnerable residents. The residents suddenly had to stay in their rooms at all times.

Olivia was glad she and her husband had mounted a camera in the living area of her mother’s room. But what she saw was frightening. Marilyn didn’t seem to understand her meals were being brought to the room. She wasn’t eating, and eventually, she was sitting on her floor, playing solitaire from 7 p.m. to 7 a.m. She was losing weight and growing agitated.

“She called my husband and asked, ‘When are you coming to get me?’” Olivia said. “He was so heartbroken. You have to meet people with Alzheimer’s where they are, and he told her ‘I’m coming, mom.’ Then we watched her pack up entire room. She took pictures off the wall. She found the camera and took it down. She did that a few times. She packed up her whole room and waited for him to come pick her up.”

The Lilleys have taken advantage of the gradual easing of restrictions. They’ve done window visits and porch visits.

“Before COVID-19, I’d take her to get her hair done once a week. It was a chance for her to get a really good shampoo, and it was with a hairdresser who loves her and knows how to talk to her. Like, she knows to talk to her and not just ignore her and talk to me,” Olivia said. “I’m sorry to get emotional, but it’s been hard to hear middle aged women talking about needing to get their nails done. My mother-in-law hasn’t had a haircut in seven months. It breaks my husband’s heart to see her looking so unkempt.”

Olivia said her family is trying to decide whether to leave Marilyn in assisted living. With flu season approaching, the Lilleys worry that Marilyn will once again be shut in her room, where she can’t see or hug loved ones.

Caregivers live with competing feelings: They praise the staff and directors of the facilities for doing their best to care for resident and comply with the state. But they and the government can’t satisfy infuriating questions that keep loved ones from the routines they need.

“I just want someone to tell me, how long is a negative test good?” Biggs said. “You do everything in your power to keep your child safe. You can’t do everything.”

Danks said the rules aren’t a guarantee.

“The way I look at it, the negative test is good until I walk out the door of the place you got the test,” Danks said. “But the negative test is a little better than no test at all. There’s no perfect world.”

Olivia said Abbott simply can’t understand what caregivers are going through, and they don’t seem to imagine what the lockdown has done to Texas’ most vulnerable residents.

“What would Gov. Abbott do if he was locked in a room and his wheelchair was taken from him? I want to know,” she said. “Because that’s what our loved ones have been living. Everyone wants to protect this group of people. I totally get that. ‘This is the Greatest Generation,’ they say. ‘They must be protected at all costs.’ But what is the cost? Because this is prison. I’m sorry, but it just is. And what’s going to happen this winter? We can’t do another lockdown with my mother-in-law.”

Full Article & Source: 

Hospital Employee Is Fired After Speaking to The New York Times

Credit...Nick Hagen for The New York Times
By Jessica Silver-Greenberg

NeuroBehavioral Hospital, a psychiatric hospital in Crown Point, Ind., fired an employee last week after she was quoted in a New York Times article about nursing homes and their illegal dumping of unprofitable patients at emergency rooms and psychiatric hospitals.

The employee, Kimberly Jackson, was a discharge planner at the hospital. Her employment was terminated last Thursday because she violated the hospital’s media policy, said Rebecca Holloway, the hospital’s corporate director of human resources.

Ms. Jackson said she had spoken to The Times to help expose how nursing homes in Illinois and Michigan routinely sent elderly and disabled patients to the hospital where she worked in an apparent effort to evict the residents. The article, published on Sept. 19, quoted her as saying that most of those patients were not psychotic and should not have been sent to the hospital.

“The homes seem to be purposely taking symptoms of dementia as evidence of psychosis,” Ms. Jackson said in the article. She cited the example of a resident who a nursing home had claimed was psychotic because the resident yelled at a staff member.

The article described how nursing homes are seizing on common symptoms of dementia to get rid of patients who are poor or need extra care. The article reported that after hospitals discharged the patients, the nursing homes often refused to let them return, an apparent violation of federal law.

Ms. Jackson said she was shocked that she had been fired for speaking to the media.

“I saw something that was wrong, and I called it out,” she said. 

Full Article & Source:

Nursing homes are evicting unwanted patients

by Caitlin Owens 

Nursing home workers hold a vigil outside of the Downtown Brooklyn Nursing and Rehabilitation Center. Photo by Stephanie Keith/Getty Images

Nursing homes are finding ways to evict their most expensive patients — often by claiming those patients have psychiatric problems, the New York Times reports.

How it works: Nursing homes send patients to emergency rooms or psychiatric hospitals, claiming they need psychiatric care, and then refuse to let the patient return.

  • The nursing homes pounce "on minor outbursts to justify evicting them," NYT writes. The practice is sometimes in violation of federal law.
  • Officials in 16 states told the Times that nursing homes have continued dumping patients during the pandemic, with some saying the problem has gotten worse.

Between the lines: Most nursing homes are for-profit, and make the least money caring for the poorest and sickest patients.

  • They make the most from short-term patients who are privately insured or on Medicare. Poor people who are at the nursing home long-term are covered by Medicaid, which pays a significantly lower rate than Medicare or private insurance.
  • When Medicaid patients with conditions like dementia require extra care, that further exacerbates the financial imbalance between patients.

The bottom line: "Even before the pandemic, there was tremendous pressure to get rid of Medicaid patients, especially those that need high levels of staffing," Mike Wasserman, a former chief executive of Rockport Healthcare Services, told NYT. "The pandemic has basically supercharged that."

Full Article & Source:

Thursday, October 1, 2020

Company at center of 7 Action News guardianship investigation barred from doing business

By: Heather Catallo

(WXYZ) — The guardianship company at the heart of a 7 Action News investigation has been banned from working in Michigan.

'I just want my parents back.' Woman says company imprisoned her parents in their own home

According to a new court order obtained by the 7 Investigators, Cathy Kirk and Caring Hearts Michigan Inc. are “permanently restrained from operating, in any form, a professional guardianship or conservatorship entity.”

Caring Hearts Michigan backs out of disputed guardianship case in wake of 7 Action News report

In 2019, family members said they were prevented from seeing Barbara Delbridge and Robert Mitchell after Caring Hearts installed a six-foot-tall privacy fence around their Utica home.

The 7 Investigators exposed how Caring Hearts Michigan Inc. hired a company called Executive Care and brought in multiple caregivers to stay in Barb and Bob’s home 24 hours a day. Both companies were owned by Catherine Kirk, who as guardian and conservator, billed Barb and Bob’s estate that was worth about $2.7 million for all that care.

Family members were later awarded guardianship of the couple after our stories exposed the case. Sadly, both Barb and Bob have since passed away.

The latest court order is an agreement with the Michigan Attorney General’s Office and Caring Hearts Michigan and resolves the AG’s intervention in the case. It does not prevent the AG from pursuing a criminal investigation.

The AG launched a probe shortly after the 7 Investigators first made the case public in May 2019, and the Michigan Supreme Court asked the Attorney General to step in.

Under the permanent injunction, Kirk must immediately cease operations. The order “shall not be construed as an admission of any liability and/or wrongdoing of any kind by any of the foregoing parties.”

Full Article & Source:

Disabled man says Richmond nursing home threw him out

Click to Watch Video

By Diane Walker

RICHMOND, Va. (WWBT) - Steven Brown says medical professionals put his life in jeopardy when Bonview Rehabilitation and Healthcare in Richmond, threw him out on the street.

On Your Side Investigator Diane Walker continues her look into the allegations, including what Brown says happened to him last year.

Bonview isn’t commenting except to say it’s not at liberty to discuss patients and says they’re focused on keeping patients safe and protected during the pandemic.

Walker started investigating Bonview last year after several people called her about problems that they say they reported but couldn’t get anyone to take action. Walker has the findings of an unannounced Medicare-Medicaid investigation confirming some complaints Brown told her.

Resident #6 was in “immediate jeopardy,” wrote the state - discharged against his will, in an unsafe manner despite his pending appeal. Resident #6 is Steven Brown in the state’s October 16, 2019 inspection.

“When you go through something like this, it’s kind of horrific,” Brown said.

The legally blind Navy veteran, diagnosed with major depressive disorder, anxiety disorder, hypertension and rheumatoid arthritis, relies on a rollator to steady his steps and keep from falling says when Bonview evicted him, he lived the first day and a half homeless inside a Walmart.

“It was very shameful so you kind of try to blend in,” Brown said.

Walker sat down with Steven in his extended stay motel room last year after that eviction, but many months would pass before the state investigated what Steven says happened when John Bernadyn, the former Executive Director, was in charge.

“I was in the hallway. They walked up to me. He said, ‘Mr. Brown, today you have to get out. After discussing it with my team, you have to go right now,’” Brown said.

A group of seven he says confronted him aggressively, even the business office manager had words.

“She’s standing in the door of the room saying, ‘we don’t want you here... Why won’t you just leave’...She said, ‘I can guarantee you this tomorrow, I’m going to call the police. They will get you out of here,’” Brown said.

“And you left that day?" Walker asked.

“Yes. In the rain, pouring down,” Brown said.

“They didn’t care about where you were going? Did they make arrangements to send you someplace else?” Walker asked.

"No. No, Ma’am,” Brown said.

He filed complaints with Bonview, its owner Consulate Healthcare and the state telling their investigators the same accounts he told NBC12.

“Why did John [Bernadyn] put you out in the rain?” Walker asked.

“He targeted me because of things I would say. Things that were wrong,” Brown said.

Steven says he advocated for his dying roommate and always spoke up when he thought the nursing home was slipping. He says they grew tired of him complaining and evicted him on a made-up allegation that he was threatening to staff.

“I’m not a profane person. Because I’m 6′4”, 340 pounds, extremely dark. OK, I’m the boogie man," Brown said.

The unannounced Medicare-Medicaid investigation found that Steven was not a danger to anyone and his June 2019 discharge was a life-threatening violation. In the report, the Director of Nursing admits a person thrown out the way Steven was - could bottom out - could die.

According to the report, Steven left with a male friend and did not disclose where he was going. He was discharged with no glucometer, no physician’s evaluation, no reason for discharge, no staff signature and with 50 tablets of Lorazepam, a controlled narcotic. Also in the report, Steven called back asking for help with his medications. Employee P told Steven it was not her area and she did not document or follow up with anyone else at Bonview about his request for help.

The report states Bonview offered to readmit Steven four months after his eviction. He said no.

Bonview was also cited in the report for contacting Social Security and becoming the payee without Steven’s permission causing him to lose his apartment and belongings because he couldn’t access his own money. Bonview refunded him, but by then it was too late.

“They had taken control of my check. My Social Security. I didn’t even know they were getting that. They had changed me from physical therapy to long-term. I didn’t even know this,” Brown said.

While it’s impossible to undo what was done to Steven, he still worries about others. One former resident in particular.

“There was a man in there. He died. He died. I was in the building when it happened. The CNA’s got fired. They tied him to the bed because I guess they got tired of him falling or getting up. Tied this man to the bed...You don’t tie a dog to nothing. That dog has life. You are going to tie a human being to something? What’s going on in your mind?” Brown said.

Walker started digging through inspections during the time Steven was at Bonview and found the March 1, 2019 inspection. A nurse discovered Resident #1 restrained to his bed on Feb. 15 with sheets tied around his waist and to both side bed rails. The inspection says the nurse and former executive director reported it to the Board of Nursing and fired the two CNA’s who did it - one says not to harm him but because she couldn’t get work done when he wandered the halls.

Resident #1 was 75-year-old Clifford Wayne Amos, an Alzheimer’s patient who died six days after he was restrained. The report does not mention Amos' death but says after he was untied, he was “immediately assessed and no physical or psychological changes were noted.” Walker also found his family and spoke with two members who say they are saddened and hope it never happens to another family. They say Bonview told them he had been restrained but Amos' family thought another patient had tied him up - not two certified nursing assistants.

“It’s like you’re just concerned about one thing, which is the profit. You don’t care how many falls. You don’t care how many deaths. You don’t care how many situations that you contribute to...Based on my experience, it was deplorable. It was disgusting. What I’ve seen when family members are not around. What those people go through in there. It’s disgusting,” Brown said.

Steven is homeless. Walker spoke with him just a few days ago. That night he says he was sleeping in a friend’s car. The Navy veteran says he could not afford the hotel room long-term and shelters don’t take blind people.

Also, the former executive director called Walker once after he no longer worked for Bonview. The two agreed to meet but John Bernadyn did not show up for that meeting. Again, Bonview and Consulate Healthcare have declined to comment. There are state and federal laws that govern discharge and restraining patients.

Full Article & Source: 

New Yorkers Desperate To See Loved Ones In Nursing Homes Say Visitation Rules Do More Harm Than Good

By Ross Barkan

Outside Cliffside Nursing Home in Queens in May. John Minchillo/AP/Shutterstock

Sandra Monahan has not seen her 93-year-old mother in person since the beginning of March. While other New Yorkers have been reuniting with family in the months after the end of the statewide COVID-19 lockdown, Monahan has not been so lucky.

Her mother, who she visited every day before the pandemic, is isolated in a nursing home in a Rochester suburb. Once upbeat and highly alert, she is now losing weight and experiencing depression.

Monahan has not been able to see her because the nursing home, in the town of Pittsford, never went 28 full days without a coronavirus case from a resident or staff member.

“I’ll wear a hazmat suit, I don’t care,” Monahan said, anguish rising in her voice. “I feel like I’m at a loss. I don’t know what else to do.”

Monahan is part of a small but increasingly vocal number of New Yorkers who are desperate to see their friends and family in nursing homes again. They have formed an organization, NY Families for Visitation Now, to lobby Governor Andrew Cuomo and his Health Department to relax guidelines to allow for far more frequent visits.

Their argument is simple: while coronavirus still poses a threat, sustained isolation worsens health risks like dementia and failure to thrive. The pandemic has led to a surge in Alzheimer’s deaths nationwide.

Monica Ryser, a member of the organization, said her 97-year-old mother’s dementia has worsened since March, her appearance and ability to speak drastically declining in their Zoom calls.

“She thinks we’ve abandoned her,” said Ryser, whose mother lives in a Rochester nursing home. “I don’t want my mother to die, to be honest.”

On Tuesday, the families of nursing home residents won a concession. The Department of Health announced the 28-day period, instituted in July, would be reduced to 14 days and socially-distanced visits would be allowed.

The announcement follows a change in DOH policy that expanded visitation policies for pediatric nursing homes and adult care facilities.

“DOH understands how painful it is for families to not see their loved ones, and the challenges facilities face as they work to protect residents from the asymptomatic spread of COVID-19 while trying to reopen to outside visitors,” said Jeffrey Hammond, a Department of Health spokesman. “The number of nursing homes that are eligible to reopen to visitors, and the number that have taken the next steps, shows they are being smart and cautious.”

Visitors would have to present a negative coronavirus test within seven days of entering the nursing home. The number of visitors to the nursing home must not exceed 10 percent of the resident population at any time and only two visitors will be allowed per resident at a given time.

Visitors must undergo temperature checks and wear face coverings. Children under the age of 18 are prohibited from making visits.

Nursing homes allowing visitors would be required to send their visitation plan to DOH and show that they are following the rules.

The problem, however, is that some family members of nursing home residents had served, pre-pandemic, as de facto caregivers, helping to feed, dress, and groom them. Touch will still not be permitted.

Even with protective gear, negative coronavirus tests, and temperature checks, visitors won’t be granted the same privileges as staff. Some nursing homes may still not be able to meet the two-week coronavirus-free threshold.

In neighboring states, visitation restrictions for nursing homes have been less strict for a longer period of time.

Pennsylvania announced at the end of June nursing home could accept visitors after a 14-day period of no positive cases. New Jersey expanded its visitation policy for indoor visits in early August. Without a 28-day restriction, Connecticut began allowing socially distanced visits in June.

None of these states have experienced an apparent spike in nursing home cases or deaths related to the relaxing of visitation rules so far.

“Everyone except the Health Department believes strongly that the visiting regulations are imposing serious harm on nursing home residents,” said Assembly Richard Gottfried, the chairman of the Health Committee. “It doesn’t just make them feel bad. It endangers their health because being without visitors can impair your health. When you’re in a nursing home, having family come to visit makes the staff take better care of the resident and enables the family to see problems that need taking care of.”

Cuomo does have reasons for proceeding with caution. More than 6,600 New Yorkers died in nursing homes from COVID-19, the most in the nation, though the numbers could be far higher due to the unorthodox way New York counts nursing home deaths.

In March and April, nursing homes across the state were epicenters for the pandemic, as staff and vulnerable residents were rapidly infected. Some nursing homes lacked protective equipment and others were faulted for their mismanagement in the early days of the crisis.

Cuomo has drawn criticism for his March directive, later reversed in May, that forced nursing homes to readmit residents with coronavirus who were discharged from hospitals but may have still been recovering. His administration argued the policy was put in place because of fears that local hospitals wouldn’t have the capacity to handle these patients.

Meanwhile, families and advocates are hoping their loved ones, having survived the worst of the pandemic, can stay alive and active in isolation, even with visitation restrictions still in place.

“I feel helpless for my mother,” Monahan said. “It breaks my heart.”

Full Article & Source:

Wednesday, September 30, 2020

Pandemic isolation has killed thousands of Alzheimer’s patients while families watch from afar

One man fights from doorway of nursing home to save his wife

Maybe, Dan Goerke figures, if he can talk to his wife, Denise, from the doorway of her nursing home near Atlanta, that will be the spark that keeps her alive. (Kevin D. Liles for The Washington Post)

By William Wan

If only Dan Goerke could hold his wife’s hand.

Maybe she would talk again. Maybe she would look at him and smile as she used to. Maybe she would eat and stop wasting away.

Since the pandemic began, Goerke’s wife, Denise — 63 years old and afflicted with Alzheimer’s disease — had declined dramatically. Left alone in her nursing home, she had lost 16 pounds, could not form the simplest words, no longer responded to the voices of her children.

In recent weeks, she had stopped recognizing even the man she loved.

Goerke, 61, could tell the isolation was killing his wife, and there was nothing he could do but watch. “Every day it gets a little worse,” he said. “We’ve lost months, maybe years of her already.”

Beyond the staggering U.S. deaths caused directly by the novel coronavirus, more than 134,200 people have died from Alzheimer’s and other forms of dementia since March. That is 13,200 more U.S. deaths caused by dementia than expected, compared with previous years, according to an analysis of federal data by The Washington Post.

Excess deaths due to Alzheimer’s and dementia

A Washington Post analysis of weekly deaths data from the CDC found about 13,200 excess deaths due to Alzheimer’s and dementia since March.

Overlooked amid America’s war against the coronavirus is this reality: People with dementia are dying not just from the virus but from the very strategy of isolation that’s supposed to protect them. In recent months, doctors have reported increased falls, pulmonary infections, depression and sudden frailty in patients who had been stable for years.

Social and mental stimulation are among the few tools that can slow the march of dementia. Yet even as U.S. leaders have rushed to reopen universities, bowling alleys and malls, nursing homes say they continue begging in vain for sufficient testing, protective equipment and help.

“It’s like we as a country just don’t care anymore about older people,” said Goerke, as he drove to his wife’s nursing home in Atlanta’s northern suburbs. “We’ve written them off.”

In recent weeks, Goerke has struggled with anger — at U.S. leaders and at people who continue to reject simple measures such as wearing masks. As long as the virus keeps spreading, Goerke knows there’s no way to safely visit his wife.

His worst fear is that by the time he can hold her hand, it will be to say goodbye.

With cases in Georgia still high, the closest thing Denise’s nursing home has allowed is for Goerke to stand for a few minutes by the front door, while attendants wheel his wife to the lobby.

Denise, 63, has quickly deteriorated in isolation and can no longer recognize her children or husband. Dan, 61, takes his mask off during a visit, hoping it will help her remember him. (Kevin D. Liles for The Washington Post)

So for months, he has been traveling to that doorway and calling out — trying to get a reaction, to cut through the thickening fog of his wife’s dementia.

“I still believe a spark of her is in there,” he said, as he arrived once more at her door on a recent Saturday.

He phoned the nursing aides inside. A few minutes later, they pushed Denise into the lobby — her body now so frail it was disappearing into the wheelchair.

Goerke took off his mask in case it would help her recognize him. And he called out.

“Hi, Denise!”

Inside the darkened lobby, he thought he saw his wife’s lips move.

No reason to get up anymore

America has counted tens of thousands of excess deaths since the pandemic began. These are deaths not recorded as due to the coronavirus and occur from causes such as hypertension or sepsis. But they are occurring at much higher levels than in the past. Many of the deaths are likely undiagnosed cases of coronavirus, experts say, while others are likely due to indirect effects from the pandemic — hospitals being overrun or care being delayed.

Among the sources of excess deaths, dementia has produced by far the most — more than the next two categories, diabetes and heart disease, combined.

For one man in Indianapolis, the rapid deterioration of his dementia made it harder to swallow. Food that went down the wrong way led to a lung infection and eventually death, his daughter said. For a woman in Boston, her body — no longer able to move — became so atrophied and frail that a slight fall sent her into a death spiral of hospitalizations, her doctor said.

Other cases have been more subtle. In isolation, many are suddenly struggling with severe depression. “We have clients who have lost almost 30 pounds,” said Sharon O’Connor, who runs a program for dementia patients at Iona Senior Services, a D.C. nonprofit. “Some just don’t have reason to get up anymore, so they stay in bed all day. Others sit by themselves in a dark room.”

In interviews with The Post, people with dementia who are still able to communicate said they felt trapped and doomed. Activities that used to stimulate their minds — music therapy, game nights, Jazzercise — have ground to a halt. At most facilities, residents aren’t even able to eat lunch together anymore.

One woman in D.C. — who has not seen her children, grandchildren or siblings since March — described the horror of witnessing her mind deteriorate in isolation. “I not talking with the whole sentence anymore,” she wrote in a series of text messages about her decline. “Not got balance. Painful cramping.”

It’s not just the loss of interaction, said Jason Karlawish, an Alzheimer’s expert at the University of Pennsylvania. “Families fill in a lot of gaps at nursing homes. They do much of the feeding and bathing. They advocate and communicate,” he said. “If you think of Alzheimer’s as a disability, family members are almost like a cognitive wheelchair for patients who have lost part of their mind. They’re essential.”

Two years after her diagnosis, Denise and Dan traveled in 2014 to Washington to advocate for Alzheimer's research. (Dan Goerke)


Light amid the fog

In 2012, when Goerke and his wife got word of her diagnosis, Denise made him promise to never put her in a nursing home.

But after four years of juggling his work as a commercial real estate broker with the full-time care Denise needed, Goerke worried constantly that his wife would accidentally hurt herself when he wasn’t looking.

The day he moved her to a long-term care facility, he felt relief, shame, guilt. The one consolation: He could visit anytime.

Seven days a week, he fed her lunch, combed her hair, showed her pictures of their kids.

They had been together for 23 years. Both had been divorced, and they spent their first five years taking turns getting cold feet before realizing their love was stronger than any fears about the future.

Denise had worked as a saleswoman for Xerox, but she was an artist at heart. Her children recalled growing up in a house filled with projects in progress, walls constantly being painted or being evaluated for a repaint. And she was a social creature. Even later at the nursing home, with seven siblings, three children and three grandkids, there were days when they had to coordinate all their visits.

More often than not, they would be greeted by the Denise they knew — eager to laugh at their jokes, interjecting with a word or nod, always reaching out for their hands.

Then came the pandemic.

State pandemic rules forbid Dan from entering his wife's nursing home. He has tried to make her feel less alone through frequent calls and videos. (Kevin D. Liles for The Washington Post)

Denise’s nursing home had long struggled financially, even before the virus. Now, it was suddenly fighting to buy protective equipment and retain staffers afraid of falling ill.

Only a tiny portion of the U.S. population lives in nursing homes, yet nursing homes have accounted for roughly 40 percent of U.S. deaths from covid-19, the disease caused by the coronavirus. Overwhelmed, Denise’s facility announced in late April that it was closing.

Goerke immediately started dialing other residences. Many, desperate to keep the virus out, refused to take anyone new.

It took two weeks and rejections from 15 nursing homes before he found one willing to take Denise. By then, his wife was the only resident left at her old facility.

Her last four days before the move were spent alone, except for a few employees preparing to shutter the building. She stopped eating and simply lay in her room at the end of a long, empty hallway.

“I wasn’t sure she would live long enough for us to get her to the new place,” said Goerke, who checked in daily by phone and FaceTime. “She looked ashen. Her skin became paper-thin.”

At the new nursing home, staff began scheduling window visits for families. That’s when Goerke saw the full extent of the pandemic’s toll.

The bright blond hair he used to comb was dull and sparse. Her face pale and gaunt.

Goerke had to yell through the thick window to be heard. The first few weeks, Denise reached out her hand. He could see through the glass that she was confused about why he wouldn’t come in, and the look on her face felt like an accusation.

Worse yet was when Denise stopped reaching out a few weeks later and just sat in her wheelchair with a vacant stare.

For the first few months of the pandemic, one of the only ways Dan could see his wife was through a window. But as she declined mentally, she stopped recognizing him and simply sat with a vacant stare. (Dan Goerke)


A flicker of hope

“It’s me,” Goerke shouted from the doorway, during his recent Saturday visit.

The only reply from the nursing home lobby: silence.

Undeterred, Goerke kept the conversation upbeat, pausing every few words to give Denise a chance to respond: “It’s a hot one out here. … Almost 90 degrees. … You’re lucky to be inside.”

On this particular Saturday, Goerke had invited others in the hope they might jog his wife’s memory.

Denise’s son Steve Ayotte soon arrived, along with his wife and their 2-year-old daughter.

“Hi, Mom,” Steve said. He turned to his daughter, “Can you say hi to nana?”

“Hi, Nis-ey,” the girl said shyly.

Finally, it was one of Goerke’s more energetic “hellos” that seemed to hit home.

The sudden response emerged from his wife’s lips with a startled tone, as if Denise was surprised to find them all suddenly before her: “Hi.”

To Goerke, that small word was everything.

It was proof his wife had not yet reached the final stages of her disease. More than that, it was a bulwark against that encroaching future.

All these days he has spent talking to himself at her doorway, he said, were worth it if it helped engage her mind even a little. They were worth it if it meant some part of her heard him and felt a little less alone.

A plea for help

Goerke, who used to feed Denise daily, recently asked her caregivers about her meals. He was alarmed when they said they now have to persuade her to open her mouth. He worries that Denise — no longer able to speak — may be expressing distress the only way she still can.

Everyone is suffering in some way these days during the pandemic. But it feels at times, Goerke said, as though the suffering of people in nursing homes has been shoved into a corner to make room for everyone else’s. Even now, as the country debates about reopening schools and protecting the economy, there’s little urgency about the plight of people like his wife.

Countries like the Netherlands have safely reopened their nursing homes without any increase in coronavirus cases by providing ample protective equipment, testing and rigorous protocols.

But in the United States, little of the trillions in emergency funding has gone to nursing homes. For months, the Trump administration has talked of getting more testing into nursing homes, but the effort continues to be plagued with problems.

This month, Florida and Arizona said they want to reopen nursing homes but have yet to explain how they will do so safely, given shortages in equipment, staffing and testing.

The situation is especially difficult in Goerke’s state, Georgia, which rushed this spring to reopen tattoo parlors, hair salons, movie theaters and restaurants. Even as the state had the country’s highest rate of new cases, Georgia Gov. Brian Kemp (R) pursued a weeks-long lawsuit to stop Atlanta from requiring masks and only dropped the case last month.

Desperate for help, Goerke sent a letter to the governor two weeks ago. “I am Denise’s spouse, caregiver, and advocate,” he wrote. “I believe the state of Georgia can help my family, and others like mine.” He pleaded for rapid testing in nursing homes. He proposed convening a task force and offered suggestions. He begged the governor to rescind his emergency rules putting facilities on lockdown.

As long as they remain in place, there is only one way Goerke will be able to hold his wife. The rules include one exception for families to enter nursing homes — deathbed visits.

Dan does most of the talking during the couple's doorway visits. These days, he is grateful and treasures even the smallest response from Denise. (Kevin D. Liles for The Washington Post)


‘I’ll be back’

As Goerke and the rest of Denise’s family wrapped up their visit at her door, they talked about what they’ve already lost.

Goerke recalled the last time he had heard Denise laugh. It was four months ago during a FaceTime call just after the nursing home had given Denise a haircut.

“I told her how good she looked, and she smiled and gave me a little laugh,” he said, grinning at the memory.

Later, in private, he would explain just how much that laugh had meant to him.

“It’s like you’re a ship stuck in the fog, and suddenly you see the lighthouse. It’s golden. It’s the world. It’s the only thing I hope for when I visit,” he said. “It’s like there’s my Denise, and for a moment, we’re back home together.”

There would be no laugh that Saturday at the doorway. The startled “hi” murmured earlier by Denise turned out to be her only response.

When it came time to leave, Goerke chose his words carefully. Goodbyes were the one occasion, since the pandemic began, when Denise’s dementia now worked in their favor.

Instead of goodbye, he gently told her, “I gotta go run some errands. I’ll be back.”

For better or worse, Goerke said, his wife no longer remembered him well enough to miss him.

Denise and Dan in 1997, shortly after the couple met and fell in love. (Dan Goerke)

Full Article & Source: 

My Mom Just Wants a Hug: Families Unite to Open Up Nursing Homes

The pandemic has brought family caregivers together to lobby for change

By Beth Graham
Credit: Courtesy of Beth Graham

Beth Graham and her mother Betty at Betty's nursing home in Jacksonville, Fla. in 2019

I didn’t hug my mom Betty for 200 days because her nursing home in Jacksonville, Fla., was on lockdown. Before that, my brothers and I saw her virtually every single day. She suffered a debilitating stroke and was left with aphasia (a brain disorder), so she is unable to communicate and has cognitive deficits. While technology has been the solution for many, talking to her through a video screen isn’t an option for us. 

Not long after the lockdown, my mother’s facility opened up window visits. But sitting on the sidewalk on a noisy street and seeing her through a grainy window screen is more frustrating than it’s worth. My mom either closes her eyes or cries. She doesn’t understand. She misses my morning visits when I’d show up with coffee and donuts. 

And there’s no way to explain this to her. Our pleading and begging with the facility’s administrators have fallen on deaf ears. They’re just following government mandates and, I believe, they genuinely want to protect their residents from this deadly virus.

Residents of these facilities felt imprisoned. Punished. Cut off. And like my mom, they felt unloved.

On Sept. 17, the Centers for Medicare & Medicaid Services (CMS) released new guidance easing some nursing home visitation restrictions, but facilities may interpret the guidelines differently.

I’m sure you’ve seen the stories in the news and heard the outcry from families who fear that their loved ones in these locked-down facilities are declining. Family engagement, love, human touch and hugs are all important to everyone, but especially to those who may be suffering from physical and mental decline.

Caregivers for Compromise

The first few months of lockdown, I was just going about my business, griping to anyone who would listen about how cruel this process was. Residents of these facilities felt imprisoned. Punished. Cut off. And like my mom, they felt unloved. Some quit eating due to depression. Some died. It felt like my brothers and I were fighting an uphill battle. 

That’s when I stumbled upon a Facebook group called “Caregivers for Compromise – because isolation kills too!” It was started by a woman in Jacksonville who got a job as a dishwasher at her husband’s memory care facility, just so she could see him.

And thus began a groundswell of concerned, disgruntled and downright angry family members who were being kept from their loved ones. What began as a group to connect with others and share stories and commiserate, became state-by-state grassroots action chapters rallying legislators and politicians to find ways to let families reconnect with their loved ones in assisted living facilities, nursing homes and group homes. It’s a place of angry and frustrated voices, but also an idea bank where real solutions are being developed and shared. It’s social media at its best.

In Florida, a group of volunteers put together a white paper for the governor and made heart-wrenching videos to garner media attention.

Other states followed suit. Word spread through the Facebook groups that Minnesota had successfully lobbied for the Essential Family Caregiver Program which granted family members who had previously provided essential caregiving services to their loved ones access to the facilities. This became the rallying cry and buzzword for other states.

Reporters joined these groups so they could feature families in their nightly newscasts. As family members, our voices were finally being heard.

But our ultimate goal was to lift the lockdowns and allow us to see our loved ones.

PPE, Testing and Social Distancing

As a family member and an advocate, it’s a tough situation. I want to spend time with my mom but that also means allowing other people into my mom’s facility, which increases the risk of spreading COVID-19.

I’m a masker and a distancer, but how could I know if other residents’ visitors were equally as vigilant? I certainly didn’t want my mom exposed to the virus.

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I know from speaking to other families that we would all go to great lengths to be able to see our loved ones even for periodic visits. We’d get tested regularly, wear all forms of PPE, quarantine if necessary and even socially distance, which is tough because I really want to hug my mom. She doesn’t speak, so human touch is our only form of communication.

I generally hug my mom 365 days a year. I’ve only hugged her twice in the last six months.

The 51 chapters of Caregivers for Compromise continued to feed off one another. There were letter-writing campaigns to legislators. Sit-ins in parking lots of facilities. Media interviews. Tweet campaigns. Anything that could tear at the heartstrings of those in charge.

Families have learned that there is strength in numbers. And that we really are all in this together.

Even within states, there is little standardization about visitors.

Some facilities have usurped the government orders and created their own protocols, while others have gone to the extreme of barring any contact at all, even window visits.

But these family members are all about accountability. They’ve shared form letters and emails holding corporate owners and facility administrators responsible for failures in the daily care of their loved ones. It’s the true definition of grassroots. And those grassroots efforts have led to media coverage, which then prompted some states to revise their visitation policies.

Beth Graham and mom
The key message on behalf of all families is pretty much the same: there are safe ways to allow us access to our loved ones: PPE, distancing and testing. We want to keep residents and ourselves safe, too. 

Slowly, states are lifting the mandates on lockdown, but many facilities are still left grappling with the logistics of how to re-open to visitors safely. And I get that.

In August, Florida’s governor opened up access, but most facilities are still closed to visitors as corporate owners and internal staff reckon with “safe access.” 

Families have learned that there is strength in numbers. And that we really are all in this together. Keeping each other motivated and informed is the key to successfully fighting the system.

These days, my visits with my mother are very limited; I’m allowed two one-hour visits per week. I don’t like this new normal and hope we can return to our daily visits.

It’s been a long, hard fight, but one in which I was never alone. 

Full Article & Source:

DPH announces new COVID-19 guidelines allowing visitation at long-term care facilities

by: Alex Ceneviva, Kent Pierce

HARTFORD, Conn. (WTNH)– Governor Ned Lamont and the Department of Public Health have released new COVID-19 guidelines for visitation at long-term care facilities.

The newly issued directive, which is from the Centers for Medicare & Medicaid Services (CMS) and the Connecticut Department of Public Health (DPH) Acting Commissioner Deidre S. Gifford MD MPH, rescinds the previously issued orders that limited visitation at those long-term care facilities, which included nursing homes.

Those orders were issued to protect the residents from the COVID-19 pandemic, but as of Monday, the new guidelines mean that long-term care facilities in the state are permitted to resume indoor visitation effective immediately, provided that certain conditions are met.

Those conditions, according to the DPH, include “that there has been no new onset of COVID-19 cases in the last 14 days and the facility is not currently conducting outbreak testing. Indoor visitation will be suspended if there is a positive COVID case among staff or residents.”

Facilities and visitors also must adhere to the following conditions:

  • Screening for all who enter the facility;
  • Hand hygiene recommendations;
  • Personal protection equipment as applicable;
  • Social distancing requirements;
  • Instructional signage throughout the facility;
  • Cleaning and disinfecting high frequency touched surfaces in the facility;
  • Effective cohorting of residents as applicable;
  • Visitors should be able to adhere to the core principles and staff should provide monitoring for those who may have difficulty adhering to core principles;
  • Facilities should limit the number of visitors per patient at one time and limit the total number of visitors in the facility one at a time (based on the size of the building and physical space).
  • Facilities should consider scheduling visits for a specified length of time to help ensure all patients are able to receive visitors; and
  • Facilities should limit movement in the facility. For example, visitors should not walk around different halls of the facility. Rather, they should go directly to the patient’s room or designated visitation area.

Governor Lamont released the following statement on the new guidelines:

“Making the decision to limit in-person visits at nursing homes is one of the hardest things I’ve had to do as governor, but amid the outbreak of this pandemic that is impacting the lives of so many people in our senior population, I knew it was the right thing to do. Each facility is strongly urged to develop a visitation plan and strictly adhere to it to the greatest extent possible so that we can keep this virus from spreading and impacting our most vulnerable patients.”

Governor Ned Lamont

Acting DPH Commissioner Gifford also released a statement:

“With this new guidance from the federal government, indoor visitation is now allowed in nursing homes under specific conditions. I urge nursing homes to work closely with family members to arrange for the type of visitation that is most appropriate for each resident’s physical, mental and psychosocial wellbeing. There will be protocols in place to make sure the visitation is as safe as possible, including personal protective equipment to limit the spread of COVID-19 among our most vulnerable population.”

Acting DPH Commissioner Deidre S. Gifford, MD MPH

You can read the full release on the new guidelines from the DPH below:

Full Article & Source: