130 million Dead COVID- Trump will not require the #1 deterrent -Masks

July 9, 2020

Number 1 Prevention of COVID -19 Wearing A Mask

The Coronavirus yesterday reached the 3 million mark in mark in cases The number one preventative step we could have taken is to wear masks

Citing Lone Ranger-TRUMP Refuses National Order For Masks

Yet, President Trump refuses to issue a federal order to wear masks and leaves it up to the states. In Texas, where the coronavirus rampages, the Republican governor has also refused to issue a state order to wear masks. Like ordering the US to wear masks, has something to do with his looks, Trump said a mask makes him look like the Lone Ranger. The Lone Star state topped over 1000 cases 5 days in a row

33 Million Would Not Be Dead if Masks Ordered in October

A new study says wearing masks would have saved 33 million lives since last October. Yet there are still no federal mask requirements.

Lack of President’s National Response Leading to New Depression- Says World Bank

This lack of federal response, like no federal order to wear masks, is not only killing huge swaths of the world population but has torpedoed our economy. President Trump wants to reboot the economy yet by not using federal controls, according to the World Bank the President is moving us to a recession and the cusp of depression worldwide.

Less than half the States Require Masks

Only 20 states require masks as Trump, instead of requiring masks, has left it up to the states. He relented recently, narcissistically, saying he thought he looked good- like the lone ranger in a mask but ordered no federal requirement.

Dr. Anthony Fauci predicts a few days ago that the huge COVID spread could leave 100 million a day dying. Masks are our # 1 deterrent again this slaughter by the omission of using federal powers

33 States Now in Crisis Surge of Virus Sunbelt Devastated

A total of 33 states now have a coronavirus surge with 7 states in the southwest at a crisis level.

Without required preventative steps from the Trump government and the wildfire surge immolating ¾ of our states, COVID 19 is not going away, in fact, may last well into 2021

Mixed -Messaging by President, States, Counties Gives Families no Path to Virus Safety

The problem is made more confusing by the administration’s mixed messaging with different states, cities, counties telling residents what to do to be safe. Families have no idea which way to turn to keep themselves and the most vulnerable senior family members safe.

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Nursing Home Still Deaths Camps, 40,000 Dead – Feds Skew the Stats

June 14, 2020

Rachel Maddow once again, now the House of Representatives swept a spotlight on the despicable nursing home mortality rate of COVID -19. Nursing Home residents remain the largest % of deaths in the US. Although only 0.6 of the population they represent a whopping 42 % of the deaths

Feds Statistics Insanely Wrong

Highlighting the Do Nothing attitude that continues in the Trump federal government, CMS just released data collected from nursing home national wide that is cast as insanely wrong. Nursing home officials said their data were somehow scrambled, either because nursing home personnel reported in the wrong columns, or the numbers were loaded incorrectly somewhere between the CDC and CMS.

Yesterday the House Select Committee Briefing Confirms Urgent Need for Federal Action to Protect Nursing Homes from Coronavirus

Chaired by Rep. James E. Clyburn, they explored the devastating impact of the coronavirus pandemic on nursing home residents and workers, including the deaths of more than 40,000 Americans in nursing homes across the country.

Chairman Clyburn called on the Trump Administration to take action to protect nursing homes, stating: “[W]e need the federal government to ensure our nursing homes have enough testing and personal protective equipment to stop the virus from spreading. That means providing coordination and resources—not just leaving it up to the states.”

Dr. David Grabowski of Harvard Medical School explained, “Rather than pushing the logistics and costs of testing and PPE to states and nursing homes, the federal government needs to own this issue. The federal government should set a consistent policy across all U.S. nursing homes and then provide states and nursing homes with the resources to achieve it.” He concluded, “The buck has to stop there.”

The Trump administration failed to provide nursing homes with testing and protective equipment.

We have focused on a lack of PPE in hospitals but what about nursing homes. Asked if the federal government has done enough to stem the outbreak in nursing homes, Dr. Grabowski replied: “Absolutely not, the guidance was not sufficient. I’ve actually called it ‘non-guidance guidance’ in that there were no teeth or dollars behind it. And if you don’t put logistics, if you don’t put costs into this guidance, if it’s just simply a theoretical set of guidance for the nursing homes and for the states; it’s not actually going to happen.” He concluded, “I would have liked to have seen federal leadership.”

Dr. Grabowski stated that nursing homes in many states still “can’t get testing fast enough” and “are really struggling to find the tests.” He explained, “The federal government should’ve put the testing in place and actually paid for it.” He stated, “Until we get rapid and accurate testing for all staff and residents, we won’t be able to contain COVID.”

Mr. Carlson explained that nursing homes face serious shortages of PPE and that “shipments from FEMA have been a bit late and inadequate.” He also explained that “the lack of federal coordination” has “impeded facilities’ ability to identify infected persons and to provide care.”

PPE Feds Send Looks like Blue Plastic Trash bags

NPR reported the PPE is either never delivered, flimsy, and much less than ordered or looks like remade trash bags. Instead of proper medical gowns, many packages hold large blue plastic ponchos.

In late April I blogged about the national COVID epidemic in nursing homes. It has been a month and a half and death toll, which was 10,000 rocketed up to, 40000, now – that’s 30,000 more deaths in just a month and a half.

Workers in the facilities still have inadequate PPE to protect themselves from the virus, and CMS in some fabulist attempt to look like it actually cares about Medicare and Medicaid, comes up with an outcome study that seems to be run by drunks or charlatans.

Now Rachel Maddow is showing us nothing has changed except the bodies are piled higher and higher in nursing homes. I care and I assume every senior agency that gets this does but put that caring into action. Write your Congressman, or maybe just adopt a nursing home and raise money in the community to buy PPE for them. This is, of course, pathetic but the government does not care, CMS does not care and President Trump certainly does not care about older people.

Advanced Directives AND COVID-19- Do You Know When To Initiate in the Pandemic

May 5, 2020

Covid-19 Makes Signing Advanced Directives Critical

Advanced directives are even more critical with COVID-19 patients, who are often elders. The New York Times had a story about an older woman who was suffering from Covid-19 When she entered the hospital no one asked about advanced directives. After several weeks on a ventilator, the hospital asked about advanced directives, she had none. All her elderly sisters could recall was what she had said about dying when she was young.

WHEN DO YOU DISCUSS ADVANCE DIRECTIVES?

Advanced Directives should be part of your initial psychosocial assessment. Once the COVID-19 diagnosis is known with an elderly client, the care manager who has added end of life services to their agency is often the one who will initiate and guide advance care planning discussions. As difficult as these discussions may be, the burden on the family is significantly lessened if decisions about advance care planning are made before the client’s condition worsens.

Hopefully, this has already been done but many people put it off for fear of death. A recent study found that less than 50% of severely or terminally ill patients had an advance directive in their medical record.

Advance Directives

Advance directives are legal documents that allow clients to make decisions about their health care and finances in advance of when they are not mentally or physically able to do so. These documents must be signed, dated, and witnessed naming another person to make decisions for you.

Your job as a care manager is the make sure the dying client has these documents:

• A durable power for an attorney for healthcare

• A living will

• A do not resuscitate order DNR (efforts to restart the heart after it has stopped

If the client does not have these legal documents and wishes to create

them, the Geriatric Care Manager will suggest that the documents be put in place with the oversight and consultation of an elder law attorney. But if hospitalization is imminent, getting the patient to consider signing with legal consultation maybe your own option, with the family’s permission.

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The 2 Deadliest US Sites of COVID-19 Nursing Homes & Prisons

May 2, 2020

PRISON INMATES AND NURSING HOME PATIENTS NOT 6FT APART – 6 FEET UNDER

70% of inmates in federal prisons have COVID-19. In Kansas, the Lansing Correctional Facility had a riot of inmates over COVID-19 lack of care or protection It took the rebellion to get the coronavirus testing PPE and care. The Bureau of Prisons in Kansas confirmed finally that 79 staff have coronavirus and 88 prisons and prisoners dead.

Older residents in nursing homes cannot rebel like prisoners. Many can’t even walk. The Atlantic Magazine just published an article, We are Killing Elders Now. The writer states “In at least six states, these fatalities account for half of all COVID-19 deaths, and according to the World Health Organization, half of all coronavirus fatalities in Europe have been traced to nursing homes too. Some of this mortality is linked to long-term-care facilities that are shoddily run or that violate health standards. But most of them are doing the best they can with what they have. And they don’t have much”.

KAISER FOUNDATION NURSING HOME STAFFING AND USE OF PPE NOT REQUIRED IN MOST STATES

Kaiser reports -Staff Screening. It is more common for states to recommend rather than require daily screening of staff for illness in NFs (24 states recommend, 16 states + DC require)

Use of PPE. More states recommend (23 states) than require (7 states + DC) staff to use PPE

Two States that require testing for coronavirus of ALL residents of nursing homes are Maryland where 556 have died as of the Washington Post article. and Tennessee

THE FEDS HAVE NO CMS FEDERAL GUIDELINES OR REPORTING

We have no federal guidelines for safety testing according to an article by the Kaiser Foundation

It is now estimated that 16,000 deaths have occurred in nursing homes and that is without the federal government revealing any numbers and not making available any testing. But the numbers are probably huge- if we could just do testing.

CMS announced it would have a meeting of a “panel” of experts “ sometime at the end of May”. After probably 20,000 older people died and the feds did nothing this shows their sense of urgency about this pandemic’s national “elder cleansing”.

WHAT CONNECTS PRISONS AND NURSING HOMES – CONCENTRATION CAMPS

So, what is the connection between the viral spread of COVID-19 in nursing homes and prisons- 6 feet ? Prisoners and residents, in nursing homes, and prisons cannot social distance. Jails and prisons have human beings crammed together with no choice. Nursing homes have 2 beds or if you are on Medicaid three to a room. Neither group has a choice to social distance. They are ” concentrated” as in concentration camps or death camps.

Do SOMETHING – HELP NURSING HOMES PREVENT MORE CARNAGE

So, as someone who has spent her career in aging, I am calling out to everyone, especially professional in aging – do something. Since the feds appear to be doing little- call your congressman, write a letter to the editor.

BE KIND LIKE RACHEL MADDOW REPORTS LA JEWISH HOME LA WAS

Rachel Maddow suggests calling your local nursing homes and see what they need. Be kind like the LA Jewish Home was to a smaller nursing home LA Brier Oaks. They wanted to test their residents and had no tests and the larger LA Jewish Home had tests and shared them with the smaller as a good neighbor. What they found was ravaging but it also showed caring and generosity. Care and be generous and show the helpless elders in nursing homes in your town you are opposed to -nursing home being prisons or concentration camps.

Why is Rachel Maddow Telling Aging Professionals About Nursing Homes Death Instead of the Feds????

April 27, 2020

Nursing Homes Turning into Death Camps

I have been learning that nursing homes are turning into death camps from Rachel Maddow not the federal government or aging community. I watch her every night as she is someone who reports the news fairly, focuses on facts and science,not what politicians and the president says. She reports what politicians actually do to avoid what the Trump camp calls fake news. This enrages me as why aren’t I hearing this from the aging community?

I learned that 17 dead bodies piled up in an NJ Nursing Home a week ago . Three days ago it was reported by the Kaiser Family Foundation that Nationwide, among the states reporting data, states indicate that cases have occurred at more than 4,000 facilities, and nearly 51,000 cases and over 10,000 deaths have been reported by in-long-term-care-facilities/

No Fed Requirements To Report Covid-19 Deaths

According to the Kaiser Foundation until recently, there was no federal requirement for nursing homes to report coronavirus outbreaks and COVID-19 deaths. This lead to an information gap for families, residents, and policymakers. After gutting the Obama regulations to improve care in nursing homes in 2017, On April 19, 2020,( many days after Rachel Maddow and the NY Times were reporting the horror(,CMS released guidance that would require nursing homes to report cases of coronavirus directly to the Centers for Disease Control and Prevention (CDC).This move is totally hypocritical after Trump is the one who caused the horror by slashing regs that would have prevented deaths. This new data is not yet available, but there are a number of states that are already reporting data on long-term care facilities.

When I saw the carnage of nursing home deaths, yet SNF’s asking feds for immunity I was even further outraged.

We Need Inquiry Into Federal Response

I blogged about the root of this problem a week ago We need an inquiry but more than that we need a federal response, which there is none and national coverage which is just starting to occur after the most vulnerable on the planet were locked up in buildings where no one could visit, filled with the people with the highest risk, and staff going from facility to facility as they need three jobs to keep them afloat and spreading the virus then becoming ill themselves

TRUMP CUT BACKS IN NURSING HOME STAFFING INFECTION CONTROL

This lack of staffing and cut back in infection control federally mandated by the Trump government. Trump cut back regulation upgrades mandated by the Obama administration

The Obama administration effort, finalized in 2016, requiring all long-term care facilities to develop infection control and prevention plans to detect, report and contain communicable diseases.

It also covered telemedicine, so required publishing infection control rates weekly in Nursing homes that manage from 1.6 million to 3.8 million infections each year, according to the Centers for Medicare and Medicaid Services. A 2017 analysis by Kaiser Health News found that 74 percent of nursing homes have been cited for lapses in infection control — the most frequent type of health violation.

So, aging professionals, I am going to give you Rachel Maddow’s sage advice,

Sound the alarm- Aging Professionals

Read your local paper for nursing home problems in your area. Now they are only being reported cumulatively by the New York Times and major papers. Send letters to the editor. Write to your governor. Alert your Area Agency on Aging.

Call Your Local Nursing Homes

Call the nursing homes locally and ask what you can do. Besides setting off the alarm can you organize PPE by getting a local club or group of women who sew to help, Even kids have contributed like this child in Boston who sews masks.

Scream to the top of your lungs.

A holocaust is happening and the Trump administration is ignoring the carnage – Rage against the coming of the night for the older people we all love and have devoted our lives to helping.