More seniors, but fewer living in nursing homes

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The past five years have been nothing but accommodating, she said. Even though she shares a bathroom with her 24-year-old granddaughter, she has her own room. If she wants to spend time with the family, she can. If she wants to close her door and crack open a book, she’s able to.HAMILTON — In November 2006, Jean Baker moved from rural Kentucky to a two-story West Chester Twp. home with her daughter, son-in-law and two grandchildren.

“I would never want to go and live in a nursing home or one of those assisted living places,” the 75-year-old said. “I could never afford it.”

Although Butler County is home to a growing number of senior citizens, fewer of them are living in nursing homes. The down trend can be attributed to what is often perceived as high cost for their services and increased accommodations in local programs that benefit senior citizens.

According to newly released 2010 Census data, 55 percent of Butler County’s 42,484 citizens ages 65 and older are living at home alone, with a spouse or with their children. Only 4 percent of the demographic lives in a nursing home.

Baker, who says she has never worked outside the home, is among them. Drawing social security from her deceased husband, she says there are not only financial obstacles in nursing home care, but the facilities themselves do not appeal to her.

“Here with my children I have everything,” Baker said. “We have televisions, computers, everything. My family has these things and they’ve agreed to share them with me.”

County wide, the number of people living in nursing homes has dropped 13.3 percent from 2,322 to 2,012 in the past 10 years.

The fact trends opposite the county’s rising senior population.

About 11.5 percent of Butler County is made up of those 65 and over. Ten years ago the demographic made up 10.7 percent.

Across the state, the percentage of seniors living in nursing homes dropped from 5.6 percent to 4.1 percent over the past 10 years, according to Census data.

Trend away from nursing homes cuts costs for seniors, state

According to AARP, the average cost for nursing home care is more than $50,000 a year and continues to increase. It can also vary widely depending on where a person lives.

About 65 percent of people in Ohio’s nursing homes have their care covered by Medicaid, according to the Council on Aging of Southwest Ohio.

Local programs such as Meals on Wheels and the offering of transportation services through senior centers can reduce costs for seniors, their families and the state of Ohio. The state is obligated to cover a senior’s nursing home costs if the patient qualifies for a level of care under the Medicaid system that requires nursing home usage.

Medicaid will also pay for seniors to be cared for in their homes, but those are much more manageable costs, according to Benjamin Johnson, spokesman for the Ohio Department of Job and Family Services.

“The cost of providing in-home care for a Medicaid patient is less expensive than providing nursing home care for that same patient in most cases,” he said.

Ann Munafo, executive director of the Middletown Area Senior Center, said nursing home costs can be a challenge even for seniors who consider themselves financially stable.

“Even if someone has a healthy retirement (savings), that can eat it up real quick,” she said.

Local programming

Local programming brought on by the creation of the Butler County Elderly Services Program in the late 1990s has gone a long way in contributing to the trend away from nursing homes, said Karen Dages, director of social services at the Hamilton-based Partners in Prime.

The tax levy funds in-home services from homemaking to personal care to Meals on Wheels. Partners in Prime and the Middletown Area Senior Center are two agencies that have contracts with the program to provide these accommodations.

Its levies have been successful when presented before voters, Dages said. Last November, voters approved the 1.3-mill levy with a 65.9 percent majority. In 2005, a five-year 2-mill levy passed with 54 percent of the vote and in 2001, a 1.3-mill levy passed as 57.5 percent of voters approved the initiative.

“I think everyone sees the value in keeping our seniors at home,” Dages said. “For seniors, they want to stay home where they’re comfortable. Children, they know mom and dad are happy. Plus, you’ve got property taxes and other things a city benefits from by living in a house.”

A similar program, PASSPORT, works through Medicaid and is overseen by the Council on Aging.

Betty Carter, of Middletown, said she relies on transportation services from the Middletown Area Senior Center to take her to doctor’s appointments. The 77-year-old had a hip replacement almost 10 years ago, and has since been determined to live on her own.

“If they didn’t have the services they offer here, you’d have to go to a nursing home,” she said of the position many seniors are in. “You couldn’t do it yourself.”

Senior centers also provide a sense of security, she said.

“If something were to happen and I couldn’t clean my house, I could call and have someone help me out,” she said. “That means a lot.”

Ultimately, the decision falls to seniors and their families, said Gary Horning, vice president of marketing and communications for Otterbein senior communities in Warren County.

“There will never be a need to eliminate 24-hour skilled nursing care,” Horning said. “In the grand scheme of things, there will always be a demand for a variety of wellness choices.”

Contact this reporter at (513) 705-2871 or asedlak@coxohio.com.

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Tragic Toll From Medical Errors'

BUFFALO, N.Y. When Mary Brennan-Taylor lost her mother to a series of preventable medical errors, she wasn't interested in suing the hospital where the mistakes had been made. 

"I wasn't interested in a lawsuit because that wouldn't help anyone," she says, "I was interested in culture change."

Now, Brennan-Taylor is bringing that culture change directly to students at the University at Buffalo. This summer, she was appointed adjunct research instructor of family medicine at the UB School of Medicine and Biomedical Sciences, a volunteer faculty appointment.

"Mary Brennan-Taylor came to being a patient safety advocate the hard way, after her mother died from a health care-acquired infection," says Lisa McGiffert, director of the Consumers Union Safe Patient Project. "She transformed her grief into action, collaborating with a unique University at Buffalo program that educates future doctors and nurses about the human impact of medical harm and the actions they can take to prevent such harm."

On Aug. 22, Brennan-Taylor, a Consumers Union patient advocate, will give a presentation on what happened to her mother to a class of third-year medical students at UB. In this video, she describes her story and discusses how UB is training medical students: http://www.youtube.com/watch?v=zY0DgygzCmg

By the end of the fall semester, she will have told her story to all UB students who will obtain their MD degrees in 2013.

"Every doctor that graduates from UB will hear Mary's story," says David Holmes, MD, associate vice chair of medical student education in the UB Department of Family Medicine and clerkship director. "Her story adds a very human dimension to our discussion about medical errors. It helps the students realize that it's not just statistics that we are talking about, it's somebody's Mom."

In July 2009, Alice Brennan, a vibrant, 88-year-old woman who lived independently, went into the hospital for a common medical problem that was not life-threatening. She died six weeks later from multiple hospital-acquired infections and from polypharmacy, the use of numerous medications, often more than are clinically indicated.

"It was a health care system failure," says Brennan-Taylor. "My mother was put on medications that I now know should never be given to elderly patients. It was a deadly cocktail. Then she contracted, not one, not two, but three hospital-acquired infections: MRSA (Methicillin-resistant Staphylococcus aureus), C. diff and VRE (vancomycin-resistant enterococci).

"There should have been some alerts from the pharmacy, there should have been some infection-control procedures. I never thought that a doctor or nurse intended to harm my mother, but there was an utter breakdown in the system," she says.

After her mother's death, Brennan-Taylor began searching for answers. She found that unfortunately, her experience was far from rare.

She learned that as many as one in three hospitalized patients will experience some form of medical error and that, according to a recently released report from the Office of the Inspector General, 180,000 Medicare patients die as a result of medical error every year. "That's just unacceptable," Brennan-Taylor states.

From that tragedy, Brennan-Taylor developed a passion for making sure that what she and her family experienced becomes an extremely rare event.

"I felt that I would be remiss if I didn't reach out," she says.

The UB medical school presentations start with a talk by Ranjit Singh, MD, assistant professor of clinical family medicine at UB and associate director of the department's Patient Safety Research Center; Brennan-Taylor then discusses her mother's case in detail.

Last semester, Brennan-Taylor also served as lecturer and coach to nursing students as part of an innovative patient-safety course (http://www.buffalo.edu/news/12641) in the UB School of Nursing.

Eventually, Brennan-Taylor hopes to develop a patient-safety guide or tool kit for consumers. She is working with the UB Patient Safety Research Center on a pilot project aimed at identifying and studying avoidable adverse events to understand what went wrong and how patients and caregivers could have intervened.

"UB is ahead of the curve on this," says Brennan-Taylor. "Instead of circling the wagons, they are asking, how can we be better doctors and nurses?"

In the meantime, she says, patients and their loved ones can help ensure better outcomes. She suggests:

--Before being admitted to a hospital, ask about the infection rate of the hospital and the surgeon who will perform the procedure. Ask if there has been an outbreak of C. diff, MRSA or VRE and how it was handled. Are infected patients isolated? Are visitors required to gown up before visiting infected patients?

"If the hospital can't tell you what its infection rate is and what its infection control procedures are, you might want to shop around," she says.

--Take sterile wipes when admitted to a hospital. "Wipe down the bed trays, the handrails, the telephone, any surfaces that you will be touching," she says.

--Talk to everyone who comes into your room, whether they are nurses, doctors, cleaners or visitors.

"Tell them to wash their hands before they touch you," she says. "If they open a privacy curtain with their hands and are about to perform a procedure on you, tell them to wash their hands first."

--If possible, have a family member or loved one with you at all times.

"This person is your advocate," she says, "they can be telling hospital personnel to wash their hands and they should also be asking lots of questions. Ask everyone who comes in to do a procedure on a patient, what is the procedure, why are they doing it? What is this medication and why is it being prescribed? What are the test results? What is the prognosis? What is the next step?"

--Have your advocate write everything that happens in a notebook. If possible, patients also should keep a notebook with them to record things where possible.

"Make sure you ask questions and that you get answers to your questions," Brennan-Taylor says. "And if you don't get answers, keep asking until you do."

The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. UB's more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.

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Clinical Research Aesthetic Nurse Counsellor Jobs in London

Clinical Research - Aesthetic Nurse Counsellor Job in London Are you a fully NMC registered General Nurse? Do you have fantastic patient skills alongside proficiency within a target driven environment? Are you looking for a challenging new career outside of the NHS? Flame Health are working alongside one of the UK’s leading Cosmetic Surgery groups who work within the field of aesthetic plastic surgery to offer the ideal candidate the exceptional opportunity to join their committed, friendly, professional and patient focused team based within their modern, state of the art facilities. The Role As a Aesthetic nurse/counsellor you will be working within a challenging sales/target driven environment, providing consultations and treatments to patients who are considering laser hair removal and associated aesthetic/cosmetic surgery treatments. You will be responsible for increasing awareness of the client’s products, treatments and procedures. The Person You must be a fully NMC Registered General Nurse ideally with post registration experience. Your ability to communicate with a wide variety of people is also of high importance as is the mind set to be flexible, friendly, approachable and a team player. We are looking for registered nurses who are looking to develop their career within an exciting, professional and commercial environment. An in depth understanding and passion to work within this target driven environment is essential. A successful track record in sales would be advantageous but is not essential. You must have the ability to demonstrate exceptional organizational, relationship building, communication and presentation skills. The Benefits 

•  Expert patient care consultancy sales, cosmetics surgery and aesthetic treatment training 
• Attractive hours including evenings and weekends 
• Pension 
• Private Healthcare 
• Life insurance 
• Maternity benefits 
• Home and car insurance 
• discounted 
• Childcare vouchers. 

Salary: £28,000 pa 

Category: Clinical Research 

Detailed Category: Flame Pharma / Clinical Research / Medical Affairs 

Location: London 

Detailed Location: Greater London Date Posted: 12/08/2011 Company: Flame Pharma 

To apply for this job or enquire about additional Aesthetic Nurse Counsellor Job Opportunities in London or the Greater London Region - Contact Flame Health on 0800 085 0858 - careers@flamehealth.com Flame Health LLP operates as an Employment Agency & Employment Business

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