Dutch legislator: Let doctors deny surgeries to patients older than 70

(Life Site News) A Dutch environmentalist legislator has suggested restricting surgeries for patients older than age 70 by allowing hospital geriatricians to decide whether or not to operate and continue to provide treatment.

Corinne Ellemeet of Groenlinks (the Green Left) made the proposal in February and recently presented it in the Lower Chamber of the Netherlands.

In technically advanced countries, 70 is not exactly equivalent to “old age.” In the Netherlands, people born after 1955 will only receive a state pension when they are 67 years and 3 months old. This limit is expected to rise to 70 as the population ages. Life expectancy is slightly above 81.

Ellemeet insisted that she is only interested in giving the elderly the best possible care.

“It’s not about saving money,” she said, but about avoiding “overtreatment,” because operations are not always beneficial and can even put undue strain on the patient.

However, the logic of her proposal is based on cost-effectiveness. She underscored that 70 percent of patients in Dutch hospitals are over 70, suggesting they should not receive the same treatment as younger patients as a matter of course. A screening process should be put into place when advanced and costly treatment is under consideration, she said – including heart operations, cancer treatment, kidney dialysis and the like.

“The central issue is this: What are we doing to the patient? Hospitalization, anesthesia, pain, and a deluge of drugs. Research shows overtreatment of elderly patients is still an everyday occurrence,” she said.

In concrete terms, the patient’s will to go on living and fighting would no longer play the determining role, but a geriatrician’s opinion on what the patient’s quality of life expectations would be. Stopping treatment would amount to “adding to the patient’s quality of life,” explained Hanna Willem, president of the Dutch association of Clinical Geriatrics, who supports Ellemeet’s suggestion.

Last September, a study in the Netherlands found that over 65s account for one half of all health costs in the country. In 2017, care for the elderly amounted to 28 billion euro (about $31.5 billion US), equivalent to 8,650 euro (almost $10,000 US) per person. One in five persons is over 65 in the Netherlands, or a total of nearly 3.3 million souls. By 2030, the proportion is expected to reach one in four. Nearly 2,000 people are 100 or older.

Clearly, the issue is a social and political one.

Ellemeert’s suggestion sparked some criticism in the Netherlands and also in neighboring Belgium, where the French-speaking daily Le Soirpublished a series of articles last Tuesday citing a “recent” study about public acceptance of health care savings. Clearly, her ideas are gaining traction in the general population.

More than 40 percent of Belgians favor abstaining from giving a cardiac device to patients over 85, according to the study by the federal center for healthcare expertise (KCE). Almost as many – 37.1 percent – agree that to save social security money it would be “acceptable” to stop offering vital but costly treatment to prolong the life of over 85s.

On the last point, less than 35.2 percent think such costly treatments should be administered and 27.7 percent neither agree nor disagree.

Le Soir commented the results of the study, which involved a lengthy questionnaire presented to 6.000 Belgian nationals in 2013. The 2014 study was kept “secret,” according to the news source.

The left-wing Parisian daily Libération has shown that this was not the case: the KCE study was in fact mentioned in a short report by Belga, the Belgian press agency in 2014, when it was published. The report was picked up in a brief article in a Flemish paper and was available on the site of INAMI, the Belgian social security. But, at any rate, it was “discreet.” And it certainly sheds light on what can happen in the near future in countries where public opinion appears to be nearly ready to accept rationing of health care on a quality of life basis.

In its highly visible report, Le Soir commented: “We can guess where that will lead: we’d soon have two-tiered medical care, with on the one side patients who would have to make do with social security and on the other those who are rich enough to pay themselves for unreimbursed drugs or costly operations.”

The Flemish Dutch-speaking panelists were more inclined to approve the refusal of costly care to the elderly than the French-speaking Walloon. The divide may have something to do with the fact that euthanasia is more frequent in Flanders than in Wallonia.

Le Soir added that in the neighboring Netherlands, patients over 75 no longer get pacemaker implants because of their age. This is in fact not a general rule, but it is true that a number of operations – including hip replacement after a fracture and the placing of cardiac stimulators – are only performed after an assessment of the patient’s general condition, life expectancy, existing dementia, and so forth. In such societies, where euthanasia is widely considered to be acceptable, this can be seen as a way of managing the rising costs of healthcare for a rapidly aging general population.

A representative of the INAMI (the Belgian social security) that ordered the report, called the results “shocking.”

The predominantly left-wing mainstream Belgian and French press also appeared shocked at the results. Libération wrote: “The fact that it dates back five years and was not in fact a secret does not take anything away from the information – quite chilling information if the study is correct – that more than one Belgian out of three should be, or was, prepared to reduce care for the elderly to save money.”

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Dutch legislator: Let doctors deny surgeries to patients older than 70

The Proven Value of Workers Over 50

Credit: S. Smith Patrick

 

“People are always asking me, ‘Why do you hire people over 60 to be on your team?’” says Angela Bovill, CEO of Ascentria Care Alliance, a New England-based organization that provides wraparound services for vulnerable children and families. She has a ready answer.

“Having older people on staff creates a calming force for an organization,” says Bovill. “There is less panic. They have seen a lot and are less jittery, less anxious than they may have been earlier in their career.”

A recent survey offers compelling proof of the value of hiring, and having, older workers. What’s more, the survey data from the Second Acts for Strong Communities Initiative suggests that intentionally including older adults as part of the workforce can change the attitudes of organizational staff and leadership about that value older people bring.

Second Acts is a three-year initiative at nine demonstration sites within the Alliance for Strong Families and Communities (a strategic action network of social sector organizations). The pilot sites, including Bovill’s Ascentria Care Alliance, implemented a range of strategies for engaging and leveraging older adult talent within the organization as volunteers, staff or both.

Views Before Bringing On Older Workers and After

Twice in two years, the initiative asked organizational staff for their views on four statements about 50+ workers. Their opinions were markedly higher after they had brought them into their workforce and seen their usefulness:

50+ talent will help our organization meet its mission.

Year One: 47 percent

Year Two: 76 percent

50+ talent will contribute to the sustainability of their organization.

Year One: 39 percent

Year Two: 73 percent

Our organization will be better able to serve our community because of 50+ talent.

Year One: 50 percent

Year Two: 86 percent

50+ talent will help our organization better reach its intended audience. 

Year One: 49 percent

Year Two 78 percent

3 Reasons for Changed Perception of Older Workers

What accounts for the striking shift in perception? Bovill, and other members of the national initiative, suggest three contributing factors

1. Hiring Encore Fellows: Each demonstration site hired an Encore Fellow, an older, experienced professional contributing skills in a part-time role to the organization to provide leadership on the project. The Fellows also suported the recruitment and placement of additional older adult talent.

The most effective Encore Fellows recognized that their success required working within organizational culture, while also working to change it.

Laura Melvin, director of human resources at Lad Lake, describes how Encore Fellow Harry Muir approached culture change:

“Harry is humble and understands the culture and context that was there before he got there. He is patient and figures out how to work within our culture to achieve his goals. That makes staff more receptive to his ideas. For example, he spent time listening and observing our meetings, talking to the staff and finding out about their work. By doing this, he was able to offer suggestions on how to change the structure of our meetings and how to make the older volunteers and the staff more comfortable.”

2. Creating a cohort: Many of the pilots that engaged volunteers 50+ brought them together as a group so they could develop relationships with, and support, one another. Bovill describes the cohort design like this:

“It gave them another tribe… For a group sometimes feeling left out and devalued, this was critical. This support network made them more resilient in working with clients and program staff. The strength they developed among themselves helped build their credibility; they became a force to be reckoned  with! This was much more powerful than if we had engaged them individually.  

3. Building on success: By starting small, staff members who were more skeptical about engaging adults 50+ were able to quickly see tangible benefits.

“This work is changing the thinking of our staff,” Bovill says, “from thinking volunteers are a burden…to rather seeing them as an opportunity.”

After watching these shifts in perception, Bovill and her team are exploring how to integrate older adults into both their volunteer and paid workforce, and scaling the work across the organization. She notes: “We have to equip the organization with the tools and and training to leverage this resource.”

Seeing Older Workers as a Solution

Bovill often hears from people having a hard time finding qualified staff, which baffles her. “How are people not seeing older workers as a solution? How are people not pursuing this? We have an opportunity sitting right in front of us!” she says.

And that opportunity will be growing. By 2024, 25 percent of workers will be 55 or older. Finding new ways to make the most of an increasingly intergenerational workforce is in everyone’s interest.

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The Proven Value of Workers Over 50

14 Years After They Starved My Sister to Death, We Must Never Forget Terri Schiavo

Every year, I write to honor my sister, Terri Schiavo, on March 31^st, the anniversary of her death. For those who do not remember, Terri, at the age of 26, experienced a still inexplicable collapse resulting in a severe brain-injury. As a consequence of her brain injury, she was unable to swallow using conventional utensils, and like many Americans required nutrition and hydration by feeding tube in order to live.

Terri did not have a medical directive specifying who would make her health care decisions in the event she was incapable of making them herself. Therefore, it was her husband, Michael Schiavo, who was appointed by the court to be her medical caretaker and was ostensibly the only person who would decide what type of care, if any, Terri would receive.

Initially, my family did not anticipate this would be an issue. But that changed after Michael obtained a million-dollar medical malpractice settlement on Terri and his behalf. Before the settlement, Michael discussed continuing rehabilitation. Afterwards, he tried to deny her antibiotics when Terri came down with a urinary tract infection. But when my family sued, he relented.

It was in 1997, and as a consequence of Michael not having the permission to end Terri’s life by denying treating her UTI, Michael petitioned a Florida court, for consent to remove Terri’s feeding tube with the intent being that she dies by starvation and dehydration.

My family objected vehemently and offered to care for Terri in her disabled condition and provide ongoing appropriate therapy that was positively impacting her brain-injury. By this time, Michael was living with a woman he called his “fiancé,” with whom he eventually sired two children.

Despite this clear personal conflict of interest – and the financial benefit he would receive by inheriting Terri’s estate from the malpractice case – the judge believed testimony that Terri simply “wanted” to die.

Sadly, after a protected legal battle, Michael was successful, and on March 18^th, 2005, Terri’s feeding tube was removed, beginning a steady and extended death lasting almost two-weeks. I witnessed the process. Believe me, it was an agonizing and merciless demise.

It was during my families very public battle with Terri’s husband that we were often asked whether Terri documented who would care for her in the case of her incapacitation. In other words, did she have an advanced medical directive that specified a health care surrogate. That’s an important issue.

Each year there are over a million Americans who experience brain-injury. In fact, brain-injury is leading cause of death and disability in the US and can, at least initially, impact a person ability to make competent medical decisions. Indeed, with no previously chosen person to act as your medical decision maker and depending on the laws of the state where you live, a large portion of these cases will default to a spouse or family member deciding next medical steps.

In worse case scenarios, and depending on the circumstances, patients can be subjected to medical decisions that are made by the hospitals where they are admitted. This is because hospitals are now empowered to decide whether treatment will be continued or stopped by what is termed as “futile care theory”.

Even those who sign an advance directive requesting continuing care are not necessarily safe. “Medical futility”, sometimes called “futile care” or “inappropriate care,” permits strangers – bioethicists or doctors – to have the final say about a patient’s care, even if the patient has expressly detailed their medical treatment wishes in an advance directive or by identifying a health care surrogate.

These “futile” care determination can happen by either denying (or withdrawing) care when they conclude that a patient’s “quality of life” is arbitrarily “too low” to justify care or the cost of treatment that is, in fact, working by allowing them to continue living. For example, it would be as if doctors vetoed a decision by Michael and my family to continue Terri’s care.

Exacerbating these situations is the legality (and the common practice) to deny/withhold food and water (via feeding tubes). Understand that these are not cases of refusing extraordinary and disproportionate care when one is truly near death, rather the denial/withdrawn of basic and ordinary care to knowingly cause death.

Unfortunately, this is the economic and ideological reality of today’s health care system and is the reason the autonomy of a patient is susceptible by hospital refusal to provide the life-affirming treatment that patients are requesting, and treatment that is helping them.

Ironically, as medicine and ethicists push for a patient’s autonomy, the direction of today’s health care is to control treatment (or the patient) even in such case when a patient is clearly asking for certain treatment as in futile care judgments.

Notwithstanding these possible scenarios, executing a health care power of attorney can help safeguard access to treatment, including basic care, food and water, as well as other forms of appropriate care.

It is harder to impose futile care on a patient who has stated in writing they want treatment and have appointed a surrogate to carry out those instructions. A health care power of attorney is a document that allows you to designate a specific, trusted person to make critical medical decisions if you are not able to speak for yourself.

Equally important is whoever you designate your health care surrogate, they will need to understand the patient’s rights, without being frightened by clinicians or hospital administrators if there is a disagreement over medical treatment.

Appointing a health care surrogate is a simple and not only the smart way, but the best way to ensure that ethical and appropriate decisions are made by someone trusted and can act in a way that advance directives simply are unable to do.

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14 Years After They Starved My Sister to Death, We Must Never Forget Terri Schiavo

Disgraced Tampa lawyer faces prison for stealing $2 million from clients

David Land Whigham, 51, sits in a Hillsborough County courtroom Friday during his sentencing hearing. Whigham was a Hyde Park lawyer who handled estates and trusts and admitted stealing more than $2 million from his clients. He has been stripped of his law license and now faces up to 20 years in state prison [Photo courtesy of WTVT-Fox 13]

TAMPA — David Land Whigham wanted all his life to be an attorney. Six years after graduating law school, with the help of a family loan, he established his own firm in upscale Hyde Park, specializing in estates, wills and trusts.

Some of his clients were parents whose children were physically disabled and needed help paying for medical treatments. Others were people who wanted to leave their savings to charity after they died.

In a courtroom on Friday morning, they were called victims.

Over the course of several years, prosecutors said Whigham dipped into his clients' funds to pay his business and personal expenses. All told, he stole $2.2 million.

Whigham, 51, pleaded guilty in November to nine counts of grand theft, one for each former client. A prosecutor asked Friday for a sentence of 20 years in prison, plus restitution.

“These are not your typical victims and the defendant for years on end preyed on them,” Hillsborough Assistant State Attorney Marisa Pupello told the court. “Each of them was personally emotionally harmed.”

Whigham’s attorney, Assistant Public Defender Jospeph Larrinaga, asked for a sentence of less than the 11 years in prison suggested by state guidelines. He noted a psychologist's report that Whigham was diagnosed with major depression and alcoholism.

The defendant stood silently throughout the three-hour sentencing hearing Friday, at times breathing deeply, swallowing hard, and closing his eyes. He spoke briefly, struggling to find words that seemed adequate.

“I can’t explain why I made the decisions I did,” he said. “I promise the court I’ll dedicate the rest of my life to making restitution.”

The thefts were uncovered after Whigham repeatedly failed to distribute more than $900,000 that one of his clients held in a trust for a relative. After the relative died in 2011, the money was supposed to be given to the Shriners Hospital for Children and a schizophrenia research foundation.

But for more than five years, representatives from the Shriners repeatedly asked why the hospitals had not received the money. Whigham offered excuses, blamed the accountant in charge of the trust, blamed it on the court clerk, and eventually stopped responding altogether.

In 2016, he admitted to an attorney for the Shriners that the money was gone. When asked where it went, he said he had used it to pay office expenses.

The Florida Bar subsequently suspended his law license. He was later permanently disbarred.

Florida Department of Law Enforcement investigators conducted a year-long probe into Whigham's finances in 2016. They identified nine victims, all of whom had entrusted Whigham with their money.

There was an 11-year-old boy with chronic physical and memory problems due to injuries he suffered after a car accident. Whigham took $216,000 from him.

There was a woman who had been severely disabled since birth, whose medical expenses exceeded $17,000 a month. Whigham took $289,000 from her.

By the time the thefts were discovered, the victims’ accounts had been nearly depleted.

“He chose his victims carefully,” said Special Agent Patty Thompson, who was a state investigator on the case and testified Friday. “He chose these victims because he knew they were vulnerable.”

The lawyer used the stolen funds to pay for his home mortgage, restaurant meals, fishing trips, vacations, hunting and shooting excursions and his family’s personal expenses. Some of the expenses that investigators noted were eye-catching: $11,000 for a hotel stay in Costa Rica; $2,700 to the University of South Florida Bulls Club; $3,800 for firearms ammunition.

Although he offered no explanations, Whigham’s family members gave the court a glimpse at a possible motive.

When he started his law firm, they testified, he did it with a loan from his wife's parents. When his business started to go south, he feared bankruptcy would cause them to lose their home. His family noticed he started drinking more. He seemed depressed.

Near the end, they told the court he tried to pay back some of the money he had taken. But it wasn't nearly enough.

“I believe what happened was a desperate man trying to protect his family,” said Sharon Whigham, his younger sister. “He started acting irrationally and drinking too much ... At some point you realize you're in too deep and there's nothing you can do.”

Hillsborough Circuit Judge Christopher Nash said he would sentence David Whigham on Monday morning.

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Disgraced Tampa lawyer faces prison for stealing $2 million from clients

Remember Love (A Song About Alzheimer's & Living in the Moment)

SPECIAL MUSIC VIDEO:

This exceptional song, "Remember Love", captures those moments that connect us to our loved ones struggling with loss of memory, and living in that moment.

Remember Love (Lyrics)

You’re on the outside looking in
Not quite sure of where you’ve been
Unnamed faces, familiar places
Will you connect it all again

Can’t hold the moments that made you mine
We’re losing Who and How and When
Missing traces, time erases
Won’t lose who you are, just where you’ve been

You Remember Love, so you remember me
In the darkness of the night
Let me be the light you see
Oh, you remember me

There was a time when I lost my way
Was so confused, until you said
Our mind deceives us, but heart redeems us
Follow you heart, it’ll show you the way

Tonight let’s both forget the past
Our moment’s now, let’s make it last
Time, it binds us, Love, it finds us
With open hearts, we’ll hold today

You Remember Love, so you remember me
In the darkness of the night
Let me be the light you see
Say, you remember me

I’ll be your breath, I’ll be your sound
When no one hears you, and there’s no one around
I’ll be your song, I’ll be your bright light
When every star in the sky goes out

You Remember Love, so you remember me
In the darkness of the night
Let me be the light you see
I know you remember me


Source:
Remember Love (A Song About Alzheimer's & Living in the Moment)

Bed sores, smeared faces, helplessness: New reports paint dismal picture of care at VA nursing homes

A hall at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford.

At the Veterans Affairs nursing home in Brockton, a severely impaired veteran with dementia sat trapped in his wheelchair for hours, his right foot stuck between the foot rests. Inspectors watched as staff walked past the struggling man without helping.

In the Cincinnati VA nursing home, one resident in six months developed five bedsores, tissue injuries that happen when frail people are left in the same position for too long. During their visit, inspectors said no one moved the man or put cushions under him for hours.

At the Bedford VA, meanwhile, inspectors watched elderly veterans smear their faces with food or drop much of their meals on the floor because they couldn’t feed themselves and staff didn’t help.

Nine months after USA Today and The Boston Globe reported that veterans received substandard care at many Department of Veterans Affairs nursing homes, newly released inspection reports paint a discouraging picture of the care that sick and frail veterans continued to receive at these federal nursing homes.

From April through December 2018, outside inspectors found deficiencies that caused “actual harm” to veterans at 52 out of the 99 VA nursing homes they reviewed. In three facilities, they found veterans’ health or safety in “immediate jeopardy.” In eight, inspectors found veterans both harmed and in jeopardy.

Non-VA nursing homes are rarely cited for causing actual harm to residents.

“That is really bad. It’s really bad,” said Richard Mollot, executive director of the Long Term Care Community Coalition, a New York-based nonprofit advocate of nursing home care improvement. He added that it’s difficult to compare VA findings with non-VA findings because those inspections may not be as rigorous.

Inspectors found that staff at more than two dozen VA nursing homes, including in Brockton, Bedford, and Cincinnati, failed to take steps to ensure existing bedsores healed or new ones didn’t develop.

Bedsores are “almost always preventable, and quickly treatable,” Mollot said. “So there’s just no excuse.”

In a statement issued when they released the inspection reports earlier this month, VA officials said residents in their nursing homes are more difficult to care for than residents in private facilities. They said 42 percent of residents last year had conditions related to military service, leaving them severely disabled.

“Overall, VA’s nursing home system compares closely with private sector nursing homes, though the department on average cares for sicker and more complex patients in its nursing homes than do private facilities,” VA Secretary Robert Wilkie said.

VA spokesman Curt Cashour said Wednesday that non-VA nursing homes also have problems. He said that, by publicly posting the VA reports for the first time, “we hope to drive improvements throughout the system.”

But Mollot said VA officials have no excuse for poor care.

“You don’t accept somebody in unless you have the ability to provide care for them, period,” he said. “It’s incredible to me that one has to even say that.”

The inspection results were made public nearly a year after the Globe and USA Today disclosed that the VA possessed the reports as well as the results of a star-based rating system for VA nursing homes. The reports’ release provides valuable information for the 41,000 elderly and infirm veterans who stay in the homes each year, as well as for their families.

“The results of these independent inspections show that serious deficiencies in care remain at VA nursing homes in Brockton and Bedford, among others,” said Senator Elizabeth Warren of Massachusetts. “We must keep conducting rigorous oversight until performance and quality of care issues are fully addressed and our veterans are receiving excellent care across the board.”

Widespread deficiencies

Across the country, inspectors found that VA nursing homes failed in one of their most fundamental duties: taking steps to prevent and control infection.

At two-thirds of VA nursing homes, they found staff often didn’t follow simple protocols, such as wearing sterile gowns and gloves when treating residents.

In Des Moines, inspectors found that managers didn’t ensure staff adequately cleaned a veteran, who contracted six urinary tract infections in seven months.

Reviewers found residents weren’t properly monitored or were subjected to hazardous conditions at more than 50 VA nursing homes.

Water used for washing hands and bathing was so dangerously hot at nursing homes in Carrollton, Ga., Martinsburg, W.Va., and St Cloud, Minn., that it could scald residents — particularly those with dementia or other conditions that make them less sensitive to pain or heat. The high temperatures — up to 128 degrees — were designed to kill legionella bacteria, but were too high to be safe, inspectors said.

In Bedford, inspectors concluded veterans were in “immediate jeopardy” because a resident with dementia who was physically unable to hold, light, or extinguish a cigarette was allowed to go outside to smoke by himself. And it wasn’t the first time. Previously, he had returned with burn holes in his clothing and on the seat cushion of his wheelchair.

In an e-mail to congressional aides earlier this month, Bedford VA director Joan Clifford said that the new findings were better than the last inspection in 2017 because inspectors identified only six problem areas compared to nine the previous year. However, the six remaining deficiencies were serious, including three that caused actual harm or immediate danger to residents.

In Chillicothe, Ohio, the VA allowed a family to hire a private aide to care for a patient with Parkinson’s disease. As the aide lay on the man’s bed looking at a cellphone, the veteran leaned dangerously forward. He had fallen four times in less than two months, once sustaining a head injury that the aide said required stitches.

The same aide was supposed to feed the man a semi-liquid diet because he had trouble swallowing, but the aide often fed him fast food. When confronted by inspectors, facility leaders agreed to immediately stop allowing untrained aides to feed residents.

The nursing home in Jackson, Miss., performed the worst of all the facilities, with failures cited in 12 areas. Residents suffered in serious pain. A veteran didn’t have a bowel movement for days, but staff didn’t tell doctors until his temperature spiked to more than 100 degrees. Veterans languished without staff-assisted exercise to help them gain or maintain muscle tone.

In just seven cases, VA nursing homes passed inspections with no identified problems. Those facilities are in Topeka and Wichita, Kan.; Orlando; Houston; Miles City, Mont.; Fargo, N.D.; and New Orleans.

Uneven transparency record

Despite the vast public investment in VA nursing homes — more than $3.6 billion in 2018 — the agency until recently had kept the findings of its annual inspections of its nursing homes confidential. The Globe and USA Today revealed last June that the VA had quietly tracked the quality of care at its nursing homes through inspection reports as well as star ratings.

Under pressure from the Globe and USA Today, the VA pledged to release the inspection reports. But that did not happen until this month, when the VA posted the reports for 99 of its nursing homes. The agency said in a release that it planned to post the remainder — 35 more reports — by October.

The news organizations reported that more than 100 VA nursing homes scored worse than private nursing homes in 2017 in quality ratings. At more than two-thirds of the homes, residents were more likely to have serious bedsores, as well as suffer serious pain.

The newly released inspection results add more depth to those findings and chronicle the misery of some veterans such as the Augusta, Maine, patient whose back wound had penetrated to the bone and who did not receive adequate medication.

“The resident moaned throughout the wound care and the moaning increased during wound cleansing and measuring,” noted an inspector who witnessed the episodes in July.

Experts say caregivers should be assessing and adjusting medications or trying other methods to make sure residents get pain relief.

“There’s very little quality of life” when you’re in constant pain, said Robyn Grant, director of public policy and advocacy at the National Consumer Voice for Quality Long-Term Care. “And veterans have gone through so much, the last thing that they should be facing is relentless pain, especially if it could be mitigated.”

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Bed sores, smeared faces, helplessness: New reports paint dismal picture of care at VA nursing homes

Editorial: Action must be taken to protect vulnerable elderly

An elderly woman, debilitated by end-stage Alzheimer’s, is raped in an assisted living facility.

A 71-year-old is put in a locked memory care unit by a relative, who systematically isolates her from other family members and attempts to take control of her finances.

A nursing home resident is wrongly accused of lying and abusing alcohol when she reports the theft of a valuable ring and cash from a locked box in her room.

In each of these real-life cases, the State Ombudsman for Long Term Care stood with the victims to find truth and bring justice. An independent consumer advocate, the ombudsman is authorized through the Older Americans Act to investigate abuse complaints from nursing home residents, other long-term care residential services, home care services and hospitals.

It is everyone’s hope that these inconceivable acts are rare. Unfortunately, this is not the case.

The ombudsman’s office saw a 150 percent increase in cases of abuse, neglect and financial exploitation of vulnerable elderly from 2015 to 2018. The State Office of Health Facility Complaints reported receiving 400 allegations each week.

Just as with everything, when rarity morphs into common occurrence, sensitivity diminishes. This must not happen when addressing abuse of our elderly. The level of unacceptability of one incident of abuse must be magnified exponentially with each rise in incidents. Only then will our tolerance level remain solidly zero for even one elderly person being raped, robbed or preyed upon.

The “baby boomer” generation will dominate the state’s demographic landscape for years to come. We must create measures to ensure that NO senior citizens are victims of abuse, exploitation or mistreatment.

Elder abuse was identified by the Elder Justice Center as the “next big crime wave” at a 2016 conference at the U of M. Emily Johnson Piper, then Minnesota Department of Human Services commissioner, reported the statewide elder abuse hot line was receiving more than 1,000 tips a week.

At least one in 10 older Americans experience some form of maltreatment, Attorney General Keith Ellison said recently, promoting awareness of the Minnesota Vulnerable Adults Act. The act, passed in the early 1980s, makes employees and volunteers of public and private agencies who care for vulnerable adults (including those who do not provide direct care) mandatory reporters of abuse. Encouraging voluntary reporting, Ellison added the act provides immunity from civil or criminal liability for a good-faith report of abuse.

The 2018 reports on the high number of unresolved elder abuse cases resulted in some legislative action but much more needs to be done.

Current elder protection efforts that need support from legislative leaders include:

• Adding 31 staff members to the State Ombudsman for Long Term Care office and increasing the “boots on the ground” staff of every department which responds to elder abuse reports. These staff increases are necessary to adequately address every report. Currently, Minnesota is one of the lowest in the nation in nursing home bed to state ombudsman staff ratio.

• Providing expanded government oversight of assisted living facilities, or at least establishing a report card process to alert consumers of deficiencies.

• Expanding support statewide for nonprofit attorney organizations that provide free legal aid for low-income seniors who are victimized.

• Establishing requirements for electronic monitoring in nursing facilities and assisted living housing.

• Protecting seniors in supportive housing from termination of services without just cause.

Ensuring the safety and protection of Minnesota’s elders is vital to their living fulfilled lives. Even if we successfully avert the dire predictions of shortages of resources and services needed by the ballooned “baby boomer” generation, if our elderly do not feel safe wherever they are living among us, we have failed.

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Editorial: Action must be taken to protect vulnerable elderly

As elder abuse cases rise, Lutheran Community Services launches a project to combat gaps in system

Young Kwak photo
Victims advocates Ligeia DeVleming (left) and Kristina Hammond assist vulnerable adults through the legal system.

Mary couldn't believe it was happening. She didn't want to believe that her adult son, whom she had raised as a single mother and still lived with her, would abuse her. He destroyed their house in Spokane, throwing plates around and smashing everything in sight, Mary says. He wrote "hateful" messages on the wall. He poured scalding hot water on her. When she changed the locks of the house, her son, in his early 20s at the time, tried to kick down the door before smashing through the front window, says Mary, who asked to be identified only by her middle name.

"I thought I fell into a bad movie," Mary tells the Inlander. "And someone told me, 'No, you fell into a horror movie.'"

When she finally wanted to report the abuse two years ago, Mary found herself facing a legal system she didn't know how to navigate. She wasn't quite old enough for the state's Adult Protective Services to step in. And since her abuse wasn't from an intimate partner, but from her son, she couldn't get domestic violence services from the YWCA.

Eventually, she found Lutheran Community Services (LCS). Her experience, and others like hers, served as the catalyst for the recent expansion of Lutheran Community Services' Elder Justice Project, which assists vulnerable adults through the criminal justice process. Kristina Hammond, who now leads the project, says LCS has seen a spike in reported abuse of vulnerable adults in recent years. And with the older population rising in Spokane County, she hopes the project's expansion can lead to greater understanding of how to serve older abuse victims not abused by an intimate partner.

"We're trying to fill gaps that are already in the system," Hammond says. "And right now we're the only ones filling this gap."

The physical abuse Mary says she suffered from her son is only part of the story. There was verbal and financial abuse, too, she says.

"It was just untenable," she says. "I didn't raise him to be that way."

It's a situation not uncommon in cases of elder abuse, says Ligeia DeVleming, the victim advocate at LCS for Mary. Situations like that typically involve a cycle of power and control, and it can include financial exploitation, psychological and emotional abuse. Without assistance, older adults can be lost when it comes to connecting with counseling or legal services, especially if they're not old enough to qualify for help from Adult Protective Services.

"They don't know where else to go," says DeVleming. "We petitioned for this grant because we noticed that not only people later in life, but people with disabilities or vulnerable populations aren't able to have a direct contact to services and we wanted to fix that."

It's difficult to get a handle on how prevalent abuse of older adults is locally. And that's a problem, says Spokane County District Court Judge Patti Walker. The court system doesn't keep statistics that separate intimate partner violence from other types of domestic abuse like what Mary experienced.

The state's Gender & Justice Commission, which Walker is part of, has asked state lawmakers to collect data about domestic violence cases and distinguish between intimate partners and other family relationships.

"[We would like] to get a valid number so that we know what resources we need to provide to those individuals," Walker says.

Overall, however, the data does seem to indicate that elder abuse is on the rise in Washington. Reports made to Adult Protective Services have tripled in the last decade, in part due to an aging baby boomer population. In Spokane County, the population of those 65 and older has increased by roughly 20,000 since 2012, according to the state Office of Financial Management.

That has coincided with victim advocates at Lutheran Community Services seeing a rise in vulnerable adults who have experienced abuse. In the span of just a few years, Hammond says the number of elderly or vulnerable adults she had jumped from roughly 20 percent of her caseload to, last year, 80 percent. Hammond typically handles dozens of clients per year.

The $250,000 grant LCS received from the Washington Office of Crime Victim Advocacy will give the Spokane community two more dedicated victim advocates to increase services to elder abuse victims. Walker says having more advocates is extremely valuable because the court relies on advocates for safety planning and to provide access to resources.

"When [victims] are suffering from trauma, it can be overwhelming and scary," Walker says. "Having advocates there is tremendous."

LCS will be able to meet elder abuse survivors at first appearances in courts and assist with civil orders of protection.

But helping victims navigate through complex systems is just one part of the Elder Justice Project. The other? Finding ways to improve the system itself.

When Mary reported being assaulted to the police, she didn't want to get a no-contact order to protect herself.

"It was my son, and I felt like that was punishing him," Mary says.

But it can be hard to get that sort of protection even when people do want it. Prosecutors in district court last year started to drop the domestic violence label from cases if they didn't involve an intimate partner like a spouse or significant other, according to the minutes of a November meeting of the Spokane Regional Domestic Violence Coalition. Removing that label could prevent those victims from getting a criminal no-contact order. When victim advocates complained, prosecutors agreed to keep the DV labels but moved those cases out of the specialized DV courtroom.

Mary's assault case was filed in municipal court in 2017, and the DV tag wasn't taken off. Justin Bingham, Spokane city prosecutor, says the DV tag is dropped only "in very particular situations" and is done on a case-by-case basis.

The Elder Justice Task Force, started last August, tries to address other issues that may impact victims as well. Already, Hammond says they identified a communication issue with Adult Protective Services and local law enforcement.

"Having all those people every month at the table to discuss emerging issues and gaps is really wonderful," Walker says.

Mary says she's doing better than she was two years ago. She isn't in contact with her son, who has moved away from the state and has a warrant out for his arrest. She credits the help she got from LCS.

"I had to be safe," she says. "And what this agency did was restore my confidence in being safe." ♦

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As elder abuse cases rise, Lutheran Community Services launches a project to combat gaps in system

Tim Conway 'Unable to Make His Own Healthcare Decisions,' Conservatorship Granted to His Wife

Tim Conway‘s wife and daughter have settled their differences about the actor’s health.

According to court documents obtained by PEOPLE, on Tuesday, Conway’s wife Charlene was appointed conservator of her husband after the court found “clear and convincing evidence” that a conservatorship of Conway was necessary. Charlene was found to be “suitable and qualified” by the court, and Conway consented to her appointment.

According to the filing, Conway, 85, is “unable to make his own healthcare decisions.”

PEOPLE previously reported that the Carol Burnett Show star is suffering from dementia, with his wife and daughter at odds over his medical treatment.

Tim Conway with wife Charlene Conway

Greg Mathieson/REX/Shutterstock

Conway’s daughter Kelly filed court documents in August asking to be appointed the conservator of her father, because she alleged Charlene was “planning to move [Conway] out of the excellent skilled nursing facility he is currently at” and place him into a lesser quality home.

At the time, she claimed her father cannot “properly provide for his personal needs for physical health, food, and clothing” and is “almost entirely unresponsive.”

A week later, Kelly was granted a temporary restraining order, preventing Charlene from moving Conway to a new residence.

Then, in September, according to MyNewsLA, a judge rejected Kelly’s petition for a temporary conservatorship. In October, Charlene said in court papers that she did not believe Conway needed a conservator, but that she should be the one appointed if need be.

Charlene is Conway’s second wife. The veteran actor was previously married to Kelly’s mother Mary Anne Dalton from 1961-78. (In addition to Kelly, they share daughter Jackie and sons Jaime, Tim Jr., Pat, Corey and Shawn.)

The actor starred on McHale’s Navy, co-starred on the 1970s comedy The Carol Burnett Show, acted as the voice of Barnacle Boy on Spongebob Squarepants and even made a special appearance on the second season of 30 Rock, for which he received an Emmy.

He also won a Golden Globe Award for best supporting actor for The Carol Burnett Show, on which he was best known for characters including the Oldest Man and Mr. Tudball.

Conway’s other TV credits include guest appearances on Married… With Children, Mad About You, Glee, Two and a Half Men and Mike & Molly.

Full Article & Source:
Tim Conway 'Unable to Make His Own Healthcare Decisions,' Conservatorship Granted to His Wife