New UCLA study reports bedsores can be fatal

Actor Christopher Reeve is a famous example of the complications of bedsores. The famous actor, who became quadriplegic after falling from his horse, succumbed to complications of a pressure ulcer, more commonly known as a bedsore. Bedridden patients not uncommonly develop bedsores. A new UCLA-led study published in the October issue of the Journal of the American Geriatrics Society has reported a direct correlation between hospital bedsores and patient mortality.

Researchers affiliated with the UCLA School of Nursing report that they believe that their study is the first of its kind to use data directly from medical records to assess the impact of hospital-acquired pressure ulcers on Medicare patients at national and state levels. The study authors note that seniors who developed pressure ulcers were more likely to die during their hospital stay, to have longer stays in the hospital, and to be readmitted to the hospital within 30 days of their discharge. They evaluated data on more than 51,000 randomly selected Medicare beneficiaries hospitalized across the United States in 2006 and 2007. “Hospital-acquired pressure ulcers were shown to be an important risk factor associated with mortality,” noted Dr. Courtney Lyder, lead investigator on the study and dean of the UCLA School of Nursing. He added, “It is incumbent upon hospitals to identify individuals at high risk for these ulcers and implement preventive interventions immediately upon admission.”

The investigators noted that individuals at the highest risk are those with existing chronic conditions, such as congestive heart failure, pulmonary disease, cardiovascular disease, diabetes and obesity, as well as patients on steroids. While conducting the study, the investigators discovered that there is no large single database to help determine the incidence of pressure ulcers among hospitalized Medicare patients. This prevented a challenge; thus, they extracted the data from Medicare’s claim history, a national surveillance system designed to identify adverse events — or “unintended harm” — within the hospitalized Medicare population. They evaluated this data to determine the cause and patterns of hospital-acquired pressure ulcers.

The researchers found that 4.5% of the patients tracked acquired a pressure ulcer during their hospital stay. The majority of these bedsores were found on the tailbone or sacrum, followed by the hip, buttocks and heels. The study also revealed that of the nearly 3,000 individuals who entered the hospital with a pressure ulcer, 16.7% developed at least one new bedsore on a different part of their body during their hospitalization. “This is a serious issue, and now we have data that can help the healthcare system address this ongoing problem,” explained Dr. Lyder. He added, “When individuals enter the hospital with the risk conditions that we’ve identified, it should send up an immediate warning signal that appropriate steps should be taken to minimize the chance of pressure ulcers occurring.”

Take home message: If a loved one is hospitalized at a facility such as Ronald Regan UCLA Medical Center, steps to reduce the risk of pressure ulcers will be taken to prevent pressure ulcers. If they occur, they will be promptly treated. However, some hospitals and nursing homes do not provide the same level of care as that provided by UCLA. Furthermore, many bedridden seniors are cared for at their home. These individuals are at significant risk of developing a pressure ulcer. If you have a loved one at risk for pressure ulcers, you must assume the role of an advocate to insure that he or she does not develop a pressure ulcer and if one develops that it is promptly treated.

A bedridden should be checked for pressure ulcers every day. A head-to-toe examination should be conducted. Pay special attention to the areas where pressure ulcers often form. Look for reddened areas that, when pressed, do not turn white. Also look for blisters, sores, or craters.

Take the following steps to prevent pressure ulcers:

• Change position at least every two hours to relieve pressure.
• Use items that can help reduce pressure: pillows, sheepskin, foam padding, and powders from medical supply stores.
• Insure that the patient is eating well-balanced meals that contain enough calories to promote health.
• Encourage the patient to drink plenty of water (8 to 10 cups) every day.
• Assist in a daily exercise program, including range-of-motion exercises.
• Keep the skin clean and dry.
• After urinating or having a bowel movement, check to see that the area is clean and dry.
• Apply physician-recommended creams to help protect the skin.

Full Article & Source:
New UCLA study reports bedsores can be fatal

The Genesis of Incapacity

Probate courts use the magic phrase "incapacitation" to cash in on Guardianships illegally imprisoning 10's of thousands of American citizens each year. This video explains why the term is the password to these criminally imposed "guardianships".

Source:
YouTube:  The Genesis of Incapacity

'The Age of Dignity: Preparing for the Elder Boom in a Changing America'

The baby boomers are getting older: This year, 4 million people in America will turn 65.
In her new book, The Age of Dignity: Preparing for the Elder Boom in a Changing America, author Ai-jen Poo says that means the country is on the cusp of a major shift.

"The baby boom generation is reaching retirement age at a rate of 10,000 people per day," she tells NPR's Arun Rath. "What that means is that by 2050, 27 million Americans will need some form of long-term care or assistance, and that's the basis for this book."

Poo is the director of the National Domestic Workers Alliance and the co-director of Caring Across Generations, an organization focused on improving the long-term care system in U.S. She says that the current approach of caring for the elderly comes from "a place of scarcity and fear," which has led to a flawed health care model.

Weaving research with stories from seniors and caregivers, she lays out solutions on how to avoid a potential nightmare.

Source:
As America Grays, A  Call for Dignity in Aging and Elder Care

Steve Miller: Private "Guardian" Jared E. Shafer's Racket Exposed by Nevada's Largest Newspaper

For more than a year, Las Vegas Review-Journal investigative reporter Colton Lochhead has been quietly preparing a feature story on the activities of local for-hire guardian Jared E. Shafer, and the men and women who enable him and others in his racket to bilk the fortunes of helpless senior citizens and disabled people living in Southern Nevada.

In three front page stories published in the Sunday, April 12, 2015 RJ, Nevada's largest newspaper, Lochhead describes Shafer's rise from snake oil salesman to one of Sin City's leading political players, all at the expense of hapless well-to-do Las Vegas and Henderson retirees and others who had the misfortune of being "discovered" to be in need of special "help" by one of Shafer's Clark County Family Court judges.

In his stories, Colton weaves between Shafer's involvement in a Ponzi Scheme wherein he used money taken from his court appointed "wards" to enrich himself and his CPAs Bruce Gamett and Shawn King, to a strange political billboard company owned by an LLC run by Shafer's attorneys Patricia Trent and Elyse Tyrell, and managed by Shafer's assistant Amy Deittrick from his Pecos Road guardian office. A sign company that coincidentally donates or rents billboards to local judges and politicians who could - in a pinch - help Shafer maintain his power over the elderly without local or state court or government intervention.

Since 2013 when INSIDE VEGAS first attempted to schedule an interview with the shadowy guardian, he has refused to answer numerous telephone calls, emails, or faxed requests, and has held true to his lack of transparency by also refusing to talk to reporters from KTNV TV ABC News or the RJ to tell his side of this sordid story of elder exploitation - a story that if widely known could put a damper on one of Southern Nevada's most lucrative industries, retirement.

Full Article and Source:
Private "Guardian" Jared E. Shafer's Racket Exposed by Nevada's Largest Newspaper

Half the states look at right-to-die legislation

More than a dozen states, plus the District of Columbia, are considering controversial medically assisted death legislation this year.

The laws would allow mentally fit, terminally ill patients age 18 and older, whose doctors say they have six months or less to live, to request lethal drugs.

Oregon was the first state to implement its Death with Dignity Act in 1997 after voters approved the law in 1994, and four other states — Montana, New Mexico, Vermont and Washington — now allow for medically assisted death.

As of April 10, at least another 25 states have considered death with dignity bills, according to Compassion & Choices, a Denver-based nonprofit organization that advocates for these laws. Some of those bills already have died in committee.

"The movement has reached a threshold where it is unstoppable," said President Barbara Coombs Lee of Compassion & Choices, who was also chief petitioner for the Oregon Death with Dignity Act.

The issue of medically assisted death rose to prominence last year with the case of Brittany Maynard, 29, who was told she had six months to live after being diagnosed with brain cancer. Maynard was a strong advocate for Death with Dignity, and when she learned of her grim prognosis, she moved from her home state of California to Oregon where terminally ill patients are allowed to end their own lives.  (Click to continue reading)

Full Article & Source:
Half the states look at right-to-die legislation

Bank teller sentenced for theft

SUMMERSIDE — A former city bank employee has been sentenced for stealing thousands of dollars from sick and elderly clients.

Heather Sue Morrison, 56, of Sherbrooke was sentenced Tuesday to three months in jail, plus three years of probation.

A request for her to serve her time in jail on weekends so she could continue with her extensive and long-standing volunteer work, was denied.

She was also ordered to pay back $20,491 to her former employer.

In sentencing Morrison, Judge Jeff Lantz made it clear that the court was granting leniency in this case because of her terminal cancer prognosis.

Otherwise, said Lantz, the gravity of the offence, given the position of trust she was in and her choice of vulnerable victims, would have warranted a harsher sentence.

Morrison was employed with the Bank of Montreal in Summerside between 2002 and 2014 as a financial services co-ordinator and backup teller.

In December of 2013, BMO corporate security approached Summerside Police Services with a case it had been working on involving Morrison. Branch management had received complaints from a handful of customers regarding unauthorized withdrawals from their accounts.

In total, $20,491 was taken from 16 accounts via several transactions over about 10 months.

Morrison was charged following a police investigation and pleaded guilty to theft over $5,000 in January 2015.

Full Article & Source:
Bank teller sentenced for theft

Tonight on T.S. Radio: Marti Oakley's special guest is Carole Herman

After a three-year uphill battle with apathetic officials, files that mysteriously disappeared, several closures of her Aunt’s case with no action, and a pattern of stonewalling by state agencies created to protect patients from abuse and poor care, two things happened: The district administrator of the agency that licensed and monitored nursing homes was fired and Carole Herman, who fought the system for three years, founded FATE, Foundation Aiding The Elderly.

Carole protects the weak, fights the powerful, demands government do its job and doctor's to fulfill the Hippocratic Oath.

In October 2001 Carole was a Volunteer Spirit Award winner receiving the Lifetime Achievement Award for her work with FATE on behalf of the elderly and in February 2002 Carole was presented with a Resolution from the Sacramento County Board of Supervisors for "her dedication and care for the elderly of our community."

Today, FATE has affiliated organizations and colleagues fighting elderly patient's rights in Texas, Kansas, Ohio, Tennessee, Illinois, Nebraska, Oklahoma and South Carolina. FATE has helped families all over the country.

Civil actions have been filed on behalf of patients and their families. And the movement to illuminate and reverse the all-too-common incidents of abuse such as neglect, psychiatric drugging and criminal assaults of the elderly is growing.

FATE fulfills a vital and increasing need of providing direct action advocacy and education that will ensure that care is received with the dignity that everyone deserves.
Website: http://www.4fate.org/html/about_fate.html

4:00 pm PST … 5:00 pm MST … 6:00 pm CST … 7:00 pm EST

LISTEN LIVE or listen to the archive later

Courts, Lawmakers Working on Protection for Weakest Citizens

Judge David Hardy

 

By COLTON LOCHHEAD
LAS VEGAS REVIEW-JOURNAL

Judges and lawyers responsible for Clark County’s flawed guardianship system acknowledge they have a problem.

They just say they’re powerless to fix it.

Guardianship Commissioner Jon Norheim and his supervisor, Family Court Judge Charles Hoskin, say they lack the money, staff and authority to prevent the financial exploitation of county wards detailed Sunday by the Las Vegas Review-Journal.

But in Washoe County, a single judge is credited with making sweeping reforms that cleaned up a similarly troubled guardianship system.

And Nevada lawmakers are considering three reform bills that are opposed by professional private guardians but supported by advocates for the elderly and the incapacitated.

EASY TO BEAT SYSTEM
Becoming a private professional guardian in Nevada is as simple as showing a certification from the Center for Guardianship Certification, a not-for-profit organization based in Harrisburg, Pa.

The requirement is that hard to meet, the Government Accountability Office reported in 2010.

Undercover agents for the investigative agency used false background information on applications to the Center for Guardianship Certification. They were not required to give a Social Security number, nor was there any kind of background credit check, the agency reported.

The agents were certified after providing fake ID and passing the center’s written test.

Then, as now, Nevada doesn’t license or even do its own background checks on professional private guardians. If it did, it might have had reason to question the qualifications of Patience Bristol, who worked in the office of private guardian Jared Shafer while going through Chapter 13 bankruptcy from 2005 to 2010.

Bristol became a certified private guardian and opened her own office in 2012. She is now serving three to eight years in prison for stealing at least $200,000 in money and property from four of her wards. Prosecutors said much of the money went to cover major gambling losses.

In a curious foreshadowing of the Bristol case, the 2010 GAO report referred to an unidentified case manager in a Nevada county’s public guardian office who started her own guardianship business and was accused of stealing at least $200,000 from wards’ accounts to support a gambling problem. Details in that case — some three years before Bristol’s arrest — were not available from the GAO.

Hoskin and Norheim acknowledge Nevada’s guardianship system is especially vulnerable to exploitation by someone like Bristol, who worked for the county from 1998 until 2003.

Someone who knows the intricacies of the system “would have a much better idea of how to work the system than somebody who didn’t have that background,” Hoskin said.

Blatant “conversion” — theft — brought Bristol the attention of a bank investigator who blew the whistle.

Prosecuting a guardian who is exploiting a ward by overcharging for legitimate services can be far more tricky, said attorney Michael Olsen, who represents one of Bristol’s victims, Kristina Berger.

As in other cases examined by the Review-Journal, Berger’s guardians ignored the state’s minimal requirement of an annual report to the court showing spending from a ward’s estate. Neither Shafer nor Bristol ever made a report during Berger’s five-year guardianship, and the court never noticed.

“We do have some rules on the books that also need to be better enforced,” Olsen said. “I think we need to continue to develop the statutes.”

Olsen, who has been a practicing family and elder law attorney in Las Vegas for more than a decade, would like to see other changes to better protect the vulnerable, such as an increase in court monitoring. He would end the practice of letting guardians finance legal battles with the families of their wards with the ward’s own money.

Even without those reforms, Bristol’s prosecution could set a precedent, Olsen said.

“I would like to see (Las Vegas police) continue to be increasingly diligent in looking out for the seniors and the vulnerable who have been taken advantage of and prosecuting those cases criminally,” Olsen said. “I think that will have more of a deterrent effect than anything we can do on the civil side.”

MORE OVERSIGHT NEEDED
Hoskin and Norheim say they need more money to adequately oversee the county’s guardianship system, including additional funding for the public guardian’s office, adding more compliance officers to monitor guardians and funding a volunteer program to represent wards in court.

“We only need private guardians because the public guardian’s office is inadequately funded,” Norheim said.

But one Nevada county has dramatically reduced exploitation by guardians without having more money to spend.

Washoe County District Judge David Hardy said he recognized the need to better protect wards in his early days as a private practice elder law attorney.

“The guardianship system itself contemplates that one person will be in charge of another person’s finances. When that happens, you’re going to have a small percentage of people who serve themselves,” Hardy said. “It’s easy to take from somebody who can’t defend himself or herself.”

Now Washoe County’s chief judge, Hardy worked with his colleagues to develop protocols giving wards more of a say in their treatment and narrowing the authority of guardians.

“In the old days, we used to appoint the guardian and then expect that the guardian would show up a year later with the accounting,” Hardy said. “Sometimes they would, sometimes they wouldn’t.”

With the help of a federal grant, the Washoe courts and the Reno-based National Center for State Courts recently completed a study that recommended reorganization and reallocation of resources, making it possible to hire a guardianship compliance officer to better monitor cases without additional funding, Hardy said.

Nevada advocates for the elderly credit Hardy’s reforms with greatly reducing complaints about his county’s guardianship system.

“It’s very easy for these cases to fall through the cracks unless we have the resources within the court to monitor those cases,” Hardy said. “In Washoe County, we have a thousand guardianship wards that are subject to orders, yet we focus every single week on new appointments. We grow this backlog of cases where there are living, vibrant people. And we focus our resource attention on the appointment, and too often neglect the appointment monitoring and supervision of cases.”

PENDING LEGISLATION
While critics of the guardianship system say much can be done at the county level, they also are pushing state lawmakers to adopt major reforms.

The Legislature is considering three bills pertaining to Nevada guardianships. Senate Bill 262, sponsored by Sen. Becky Harris, R-Las Vegas, would remove the requirement for a guardian to be a resident of the state. Assembly Bill 9, from the Legislative Committee on Health Care, would prohibit the courts from granting summary administration of a ward’s estate if that person is suffering from any form of dementia.

Assembly Bill 325, sponsored by Assemblyman Michael Sprinkle, D-Sparks, which would require annual licensing and regular audits of private professional guardians, appears to be facing the biggest fight — from the private professional guardians.

In a letter to lawmakers, Shelly Register, a private professional guardian in Sparks, warned that if AB325 passes, it is “likely to put private professional guardians out of business.”

But Barbara Buckley, executive director of the Legal Aid Center of Southern Nevada, is helping push the bill.

“We have regulatory bodies for things such as barbers,” Buckley said. “But not have a similar body when we’re talking about the lives of vulnerable seniors?”

Buckley, a former Assembly speaker, said the system totally lacks oversight of private guardians.

“We need someone looking into the practices of guardians,” Buckley added. “We have seniors who are being told where to live, how much of their own funds they will receive. We need proper oversight to make sure these people aren’t being exploited.”

Sally Ramm, an elder rights attorney with the state’s Elder Protective Services, said current court oversight isn’t enough. She argues that the need for licensing, monitoring and oversight is crucial as the industry expands along with the number of older Americans needing help.

Ramm echoed Hoskin and Hardy in saying courts need more investigative powers as well as the funding to put it to use.

Adding a licensing aspect to guardians would both enforce more restrictions on guardians and give people another avenue to file official complaints against guardians, she said.

Full Article & Source:
Courts, lawmakers working on protection for weakest citizens

Throw Back Thursday! 'Documentary: America's Secret Wealth Exchanges'

NASGA recently received the following comment to an older blog post:  As I was interviewing a probate lawyer, he suggested doing a 'court approved sale,' then described how it would be advertised out of state. It didn't make sense, but I asked him if this wasn't something we could decide later. He said 'yes,' but he had documents for me to sign (that he didn't want me to read first) that had a court approved sale as a limit to probate. I later learned that most such sales are a cash auction and only one person bids on the house (after all it was advertised out or state, so only the insider knows about it) and that person usually gets the house for way under market value. In bank foreclosures, the banks get made whole (by the taxpayers)through an agreement with congress, but the heirs of guardianship houses just lose. In every case of a court approved sale I came across, the house sold for way under market value. In every instance in which there was a market offer, it was shut out or turned down and the house sold in the court approved sale for much less.
The original post:

This documentary is the story of a woman who lost her husband then was plunged into the ugly world of greed, corruption, and legal abuse via unnecessary and predatory litigation. The widow was intentionally kept from mitigating damages to the Estate due to the insider activities between lawyers, and an asset management company....

Source:
Documentary:  America's Secret Wealth Exchanges