Are you or a family member receiving dialysis? ProPublica has done a series of articles in the past month spotlighting the lack of proper oversight of dialysis clinics (Led by California, Inspection Backlogs Weaken Dialysis Oversight) that you should read. They report that in California alone, for example, regulators responsible for ensuring that dialysis facilities meet health and safety standards have not conducted full inspections of at least half of the state's 500 dialysis centers for five years or more.

ProPublica has also posted a database that will let you check the trackrecord of your dialysis clinic and those in your area. ProPublica used the Freedom of Information Act to obtain reports to Medicare by dialysis clinics across the country, going back to 2002. This is data and information that the public should have but which the government has not shared with us. ProPublica analyzed the data and the result is a web database that allows consumers to search for a dialysis clinic by name or location. Using the database, you can see how a dialysis clinic is rated and compares on 15 key quality of service measures, ranging from mortality rate, complications, and hospitalization to transplant rates and infection control. The database will help you make informed choices about where to receive dialysis.

Studies show that when this type of data is made publicly available, in report card type form, the mere fact of getting the data out in the open motivates the health care providers who are reviewed to improve their care, because they don't want to lose out on business that might go to better rated competitors.

I looked at the data for dialysis clinics in Oakland, for example, and there's a big difference in mortality rates among different clinics. Medicare will pay for you to have dialysis at any licensed clinic, so use the data base to make an informed choice about where to go.

The url for the ProPublica database is: http://projects.propublica.org/dialysis ... 2&w=10

To go the the dialysis website, click here.

To read about the faulty federal oversight of dialysis clinics, click here

Felicia Curran
www.ElderAdvocacyBlog.com
www.ElderAdvocacyLaw.com

    

To see true grit, you don't have to go to the movies. Just take a look at 61-year-old Patricia Maisch, one of the heroes from Saturday's shooting in Tucson, Arizona. The Tucson gunman had already fired a full clip of 31 bullets from a Glock 9mm handgun into a crowd of people who had gathered in a Tucson shopping mall parking lot to meet Congresswoman Gabby Giffords. Patricia Maisch was one of the individuals there to speak to Giffords. This is how Patricia described her story to CBS News:



“I heard a shot and I just knew that it was gunshot,” Maisch said. “There was one shot and then a series of shots.

“So I had to make a split-second decision whether I was going to run, or I was going to drop to the ground,” she continued. “And I thought if I ran, I might become a target. So I dropped to the ground.

“He shot the woman that was next to me, and I was just waiting for the next bullet,” Maisch said.

Then Maisch saw the gunman was on the ground near her. “Two gentlemen had knocked him to the ground, and somebody yelled ‘Get the gun,�� Maisch said. “So I knelt up – he was on his right side – I knelt up and reached over him. I couldn’t reach the gun, but as he was doing that he also pulled another magazine out of his left pocket, which he dropped on the pavement, and I was able to get it before he did.

“At the same time, another gentleman had picked up the gun. So he was secured.”

She said she could not get a good look at the gunman’s face. “He had a stocking cap on, and the way he was pushed on the ground, I could only see a little bit of the left side of his face, ‘cause he had the stocking cap almost up to his eyes, both at the side, and above his eyebrows,” she said.

“And I was on his legs when – after I got the clip, he was struggling, and kicking his legs, so I knelt on his legs. And then I noticed that the one gentleman, Bill, who had knocked him down had a head wound, so I asked somebody else to come and take my place and ran into Safeway and got some towels, and made a compress for Bill’s head.”

“I think it’s pure adrenaline,” Maisch said.

Bravo Patricia! You are amazing! We're glad that you were there that day. More people might have been killed without you. Thank you!

Click below to watch Patricia's interview on Countdown:


Felicia Curran
www.ElderAdvocacyBlog.com
www.ElderAdvocacyLaw.com

    

If a senior in your family is taking narcotic pain medications such as OxyContin, Roxicodone, Oxycodone, Narco, or Vicodin, chances are your doctor thought it was the safest alternative compared to either TYLENOL (which can causes liver damage), or NSAIDs such as Ibuprofen, Advil or Aleve. Because "NSAIDs" (nonsteroidal anti-inflammatory drugs) have been reported to cause bleeding ulcers, stroke, and other cardiovascular problems, doctors often recommend narcotic pain killers instead of NSAIDs. So it may be a shock to find out that narcotic pain medicines have more deadly effects than NSAIDs, as reported by the New York Times, in “Narcotic Painkillers May Pose Danger to Elderly Patients, Study Says.” The Brigham and Womens Hospital study compared elderly patients taking narcotics, NSAIDs, and cox-2 inhibitors during 1999 to 2005. It found that, “patients in the narcotic group were four times more likely to experience a compound bone fracture, apparently as a result of a fall, and they were twice as likely to have a heart attack, [compared to patients taking NSAIDs such as Motrin]. The cardiovascular risks posed by narcotics were the same as for drugs like Celebrex and Vioxx, which have come under scrutiny for that hazard. ...The review also found that the rate of gastrointestinal bleeding among patients taking narcotics was about the same as those taking drugs like Advil and Aleve. A principal reason that medical experts have advocated narcotics in older patients is the belief that they reduce such problems.”

Because of the sedative effect that narcotics have, it makes perfect sense that they would increase the risk of falls in the elderly, but it is a shock to read that they make a person 4 times more likely to break a bone due to a fall. The finding that such drugs can double the death rate due to heart attack is also very surprising and disturbing.

But perhaps the most disturbing aspect of this study is that we are not learning about deadly effects of these drugs from the Food and Drug Administration (the governmental agency who is supposed to regulate these drugs and warn us about the dangers) or from the companies that make and sell us these drugs. Why is that these drugs have been on the markets for years but this is the first time these kind of deadly effects on the elderly are being made known? Have the drug companies known about the risks for the elderly and not told us? They certainly make enough money from selling these drugs to be able to do this kind of study. What kind of follow-up is the FDA going to do on this issue? Are they going to require the drug manufacturers to warn doctors and patients about these risks? If not, why not?

The conclusion of the study appears to be that if you're a senior on OxyContin, Roxicodone, Oxycodone, Vicodin, or other narcotics, you should talk to your doctor about getting off of them, and switching to NSAIDs instead. Bring a print out of the New York Times article or the Archives of Internal Medicine abstract to the doctor’s appointment.

To read the New York Times article, click here.

To read the abstract from the Archives of Internal Medicine, click here.

To contact the FDA, call 1-888-INFO-FDA 1-888-463-6332

Felicia Curran, Esq.
www.ElderAdvocacyBlog.com
www.ElderAdvocacyLaw.com

    

Clay Greene, the gay elder who was forcibly separated
from Harold Scull, his partner of 20 years, has obtained a settlement of his elder abuse lawsuit against defendant County of Sonoma, for six hundred and fifty thousand dollars ($650,000). The case, which was filed in Sonoma County Superior Court more than a year ago, was scheduled to go to jury trial this month. The timing of the settlement, right up against the trial date, indicates that the County only settled due to the pressure of the looming trial date.

The National Center for Lesbian Rights, which brought the lawsuit on Clay's behalf (together with The Law Office of Anne N. Dennis, and Stephen O'Neill and Margaret Flynn of Tarkington, O'Neill, Barrack & Chong) issued a press release that struck a cautionary note:

"What Clay and Harold lost can never be replaced, but this settlement brings a measure of justice to their story," said Amy Todd-Gher, Senior Staff Attorney for the National Center for Lesbian Rights,.... This victory sends an unmistakable message that all elders must be treated with respect and dignity, regardless of their sexual orientation, and that those who mistreat elders must be held accountable. Even as we celebrate this victory, however, we are deeply troubled that the County of Sonoma continues to refuse to take responsibility for their egregious misconduct and violations of the law in this case. We urge every citizen of Sonoma County to demand more oversight of the Public Guardian’s office. They need to be watched."

They need to be watched indeed. If you read the County of Sonoma's website, it says that the reason it settled the lawsuit was "to avoid costs associated with a lengthy trial." They added, "The County must manage taxpayer money prudently." Did they forget about justice and doing the right thing? The only errors that the County acknowledges relate to Clay Greene and Harold Stull's property:

"The County acknowledges that some administrative errors occurred in the handling and disposition of the plaintiffs’ property, which led to improvements in Public Guardian policies with respect to procedures for property disposition and case management. The County remains confident in its position that there was no discrimination in this case....."

They apologize for violating property rights but can't bring themselves to acknowledge they violated Clay's civil rights, as an elder, to be free from elder abuse, and as a gay man, to be free from discrimination. Sonoma County could have brought this episode to a more satisfactory resolution by admitting its mistake and promising it won't happen again. Instead, this case concludes with Sonoma County, which used to known just for fine wine, taking its place in the history of civil rights violators, alongside places such as Little Rock, Arkansas and Birmingham, Alabama.

By the terms of the settlement, only $25,000 of it relates to "property damage." By paying Clay Greene a very large settlement, that is as close as they come to admitting the magnitude of their mistakes. A large settlement for a huge injustice.

To read the press release by the National Center for Lesbian Rights, click here.

To read the press release by Sonoma County, click here.

Felicia Curran
www.ElderAdvocacyLaw.com
www.ElderAdvocacyBlog.com

    

Based on new biomarker tests that allow the diagnosis of Alzheimer’s disease some ten years before symptoms begin to appear, the National Institute of Health (NIH) is proposing to change the diagnostic criteria of Alzheimer’s disease, to permit diagnosis of the disease before a patient has started to exhibit the telltale signs of memory loss that are the hallmark of the disease. Scientists believe that the brain of patients who will go on to develop Alzheimer’s disease start to exhibit detectable changes in the brain (such as plaque or amyloid) some 10 years before the patient exhibits symptoms such as memory loss and confusion. Recent scientific advances, such as a PET scan of the brain developed by Dr. Daniel Skovronsky M.D. (recently reported on in The New York Times) allow scientists to detect these changes in the brain that are the precursors of Alzheimer’s disease. The NIH is proposing that doctors be able to diagnosis Alzheimer’s disease when these biomarker tests show the brain changes associated with Alzheimer, even if the person has not yet exhibited clinical symptoms. Within the next few years, it is expected that these tests will be available to the general public.

That means that you or your family members will be able to be tested before you have become impaired. Right now, the prospect of being tested when there is no cure seems like a scary one. But doctor’s ability to diagnose Alzheimer’s disease before a patient has started to exhibit memory loss carries with it the promise of being able to treat the disease and prevent it from progressing to the stage where memory loss is present. Scientists are optimistic for the first time that treatment will be available in the coming years to diagnose and treat Alzheimer’s disease before impairment sets in.

What the NIH is doing is important, to assure that patients receive early treatment for the disease. Insurance companies are not big on paying for preventive treatment, and by labeling certain persons as having Alzheimer’s, before memory loss appears, it will be easier for such persons to qualify for insurance coverage for whatever pre-memory loss treatment that becomes available.

To read the New York Times article (Promise Seen For Detection of Alzheimer's) about Dr. Skovronsky’s test for Alzheimer’s disease, click here.

To read the Times article ("Rules Seek to Expand Diagnosis of Alzheimer's) about the proposed change in diagnostic criteria for Alzheimer’s disease, click here.

Felicia Curran
www.ElderAdvocacyLaw.com
www.ElderAdvocacyBlog.com