Injured Senior Podcast: Recent Episodes
Steven H Heisler, Billie Mintz, Steve Heisler
We are all living longer, which means we may need to rely on others to help us or our parents. Thus, like it or not, the Senior and Elderly population is vulnerable to negligence committed by medical professionals, Nursing Home and assisted living facilities, pharmaceutical and medical device companies, insurance companies and everyday individuals and businesses. Do you know who to trust? The Injured Senior Podcast will educate and inform you about legal issues of importance to the injured Senior and Elderly population such as medical malpractice, Nursing home and assisted living abuse and neglect, defective drugs and medical devices, age discrimination, on the job injuries, and personal injuries such as motor vehicle injuries and slip and fall. Your Host Steve H. Heisler is a lawyer and creator of the National Injured Senior Law Center and has been advocating for seniors’ rights for over 30 years. He is also a senior. The show will include many interviews with experts in the aforementioned areas of law as well as advice from Steve's personal experiences and past cases. Tune in each week to learn what you may not have even known to ask before. Welcome to The Injured Senior Podcast.
Several practices, often implemented in bundles, appear to reduce UTI in nursing home residents such as improving hand hygiene, reducing and improving catheter use, managing incontinence without catheters, and enhanced barrier precautions. Tune in as Dr. Johnny Cascone answers the frequently-asked question: How to stop Urinary Tract Infections in Nursing Homes.
Meet Dr. Johnny Cascone
Johnny Cascone board-certified internal medicine and infectious disease physician. His internal medicine residency was done at the University of Kansas and infectious disease fellowship at the University of Missouri-Columbia. Johnny Cascone the medical director of nursing homes in southwest Missouri. His medical practice includes the care of residents in long-term care facilities, infectious disease consultations, and telemedicine infectious disease services to rural facilities. He has a special interest in the diagnosis and treatment of sepsis, Clostridium difficile colitis, Staphylococcus aureus bacteremia, antimicrobial stewardship, and pressure ulcers. Johnny Cascone lives in Joplin, Missouri with his family.
Resources:
Linkedin: John Cascone
If you’ve ever had a Urinary Tract Infection, you know how painful and frustrating it can be, especially if they keep coming back. To say goodbye to burning, frequent urination, and other unpleasant symptoms, start with these changes today. The key is to keep bacteria out of the system. In today’s episode, listen to Dr. Johnny Cascone talks about preventing Urinary Tract Infections from progressing to sepsis.
Meet Dr. Johnny Cascone
Johnny Cascone board-certified internal medicine and infectious disease physician. His internal medicine residency was done at the University of Kansas and infectious disease fellowship at the University of Missouri-Columbia. Johnny Cascone the medical director of nursing homes in southwest Missouri. His medical practice includes the care of residents in long-term care facilities, infectious disease consultations, and telemedicine infectious disease services to rural facilities. He has a special interest in the diagnosis and treatment of sepsis, Clostridium difficile colitis, Staphylococcus aureus bacteremia, antimicrobial stewardship, and pressure ulcers. Johnny Cascone lives in Joplin, Missouri with his family.
Resources:
Linkedin: John Cascone
Urinary Tract Infections are caused by microbes such as bacteria overcoming the body’s defense in the urinary tract. They can affect the kidneys, bladder, and the tubes that run between them. Join us in this episode as Dr. Johnny Cascone explains more about the common causes and symptoms of Urinary Tract Infections.
Meet Dr. Johnny Cascone
Johnny Cascone board-certified internal medicine and infectious disease physician. His internal medicine residency was done at the University of Kansas and infectious disease fellowship at the University of Missouri-Columbia. Johnny Cascone the medical director of nursing homes in southwest Missouri. His medical practice includes the care of residents in long-term care facilities, infectious disease consultations, and telemedicine infectious disease services to rural facilities. He has a special interest in the diagnosis and treatment of sepsis, Clostridium difficile colitis, Staphylococcus aureus bacteremia, antimicrobial stewardship, and pressure ulcers. Johnny Cascone lives in Joplin, Missouri with his family.
Resources:
Linkedin: John Cascone
In this episode of The Injured Senior Podcast, Dr. Johnny Cascone, an Infectious Disease physician, joins host Steve Heisler to discuss Urinary Tract Infections and their prevalence in the nursing home community. You'll also learn risk factors, signs, symptoms, and even the best practices on preventing and treating UTIs so they don't become septic and lead to shock - or even death. Tune in to hear more from Dr. Cascone and his tips and information on Urinary Tract Infections, especially if you're a caregiver to an elderly loved one.
In This Episode:
- [03:00] Dr. Johnny Cascone speaks about the prevalence of UTIs in the elderly population, how often and why they can occur
- [05:00] Dr. Cascone explains common symptoms and types of UTI's and how an untreated UTI can turn into sepsis
- [09:00] Risk factors, Common causes, and predispositions of urinary tract infections
- [11:00] How untreated infections affects the body and can lead to sepsis and septic shock and best practices for prevention of UTIs and sepsis
- [15:00] Why UTIs are common in nursing homes and how the use of catheters can affect the probability of an infection
- [19:30] The best way to deal with UTIs and recognizing symptoms as a caregiver of an elderly person
Key Takeaways:
- Urinary Tract Infections are more common in women and occur in 25-50% of women over the age of 80 and live in nursing homes. Most of this is due to their anatomy.
- If patients get treated, it's relatively easy to recover from, however, left untreated for a long time can lead to sepsis, septic shock, and even death.
- UTI's fall into two categories: cystitis, a lower urinary tract infection mainly the urethra and bladder and is most common. Pyelonephritis is the other category and is more commonly known as a kidney infection.
- The best practices for preventing UTIs are practicing good hygiene and being aware of your body and any symptoms you might be having. Early treatment for symptoms is key.
Meet Dr. Johnny Cascone
Johnny Cascone is a board-certified internal medicine and infectious disease physician. His internal medicine residency was done at the University of Kansas and infectious disease fellowship at the University of Missouri-Columbia. Dr. Cascone is the medical director of nursing homes in southwest Missouri. His medical practice includes the care of residents in long-term care facilities, infectious disease consultations, and telemedicine infectious disease services to rural facilities. Dr. Cascone has a special interest in the diagnosis and treatment of sepsis, Clostridium difficile colitis, Staphylococcus aureus bacteremia, antimicrobial stewardship, and pressure ulcers. He lives in Joplin, Missouri with his family.
Early detection is more difficult in the elderly because the typical signs and symptoms, such as fever, are usually absent. Tune in as Martha Kelso answers the frequently - asked question which is: How families of elderly wounded patients detect infections.
Meet Martha Kelso:
Martha Kelso is the Chief Executive Officer of Wound Care Plus, LLC, the largest mobile wound care provider in the Midwest. Her decades of experience providing advanced wound care, while being a visionary and entrepreneur in the field of mobile medicine, has allowed her to pursue a relentless passion for educating others by offering training and lecturing nationwide. Her team of wound specialists pride themselves on bringing advanced wound care and clinical excellence, supported by evidence-based medicine to the bedside clients and caregivers alike. Kelso is a published author and member of several national advisory boards. Clinical research is important to her and she has served as principal investigator on several clinical research studies/trials. Additionally, Kelso serves as an expert witness for wound litigation cases and serves as a clinical editor for two national publications. Kelso has been a featured speaker at more than 300 educational events and is widely recognized as being a pioneer in the advanced wound care arena, working tirelessly to shape the future landscape of healthcare.
Resources:
www.mywoundcareplus.com
@MarthaRKelso
Facebook: www.facebook.com/MarthaRKelso/
LinkedIn: https://www.linkedin.com/in/martha-r-kelso-5209741/
Instagram: martha.r.kelso
In today’s episode, listen as Martha Kelso talks about Moleculight. An imaging device that is a portable, noninvasive, real-time camera used to visualize the bacterial load in a wound.
Meet Martha Kelso:
Martha Kelso is the Chief Executive Officer of Wound Care Plus, LLC, the largest mobile wound care provider in the Midwest. Her decades of experience providing advanced wound care, while being a visionary and entrepreneur in the field of mobile medicine, has allowed her to pursue a relentless passion for educating others by offering training and lecturing nationwide. Her team of wound specialists pride themselves on bringing advanced wound care and clinical excellence, supported by evidence-based medicine to the bedside clients and caregivers alike. Kelso is a published author and member of several national advisory boards. Clinical research is important to her and she has served as principal investigator on several clinical research studies/trials. Additionally, Kelso serves as an expert witness for wound litigation cases and serves as a clinical editor for two national publications. Kelso has been a featured speaker at more than 300 educational events and is widely recognized as being a pioneer in the advanced wound care arena, working tirelessly to shape the future landscape of healthcare.
Resources:
www.mywoundcareplus.com
@MarthaRKelso
Facebook: www.facebook.com/MarthaRKelso/
LinkedIn: https://www.linkedin.com/in/martha-r-kelso-5209741/
Instagram: martha.r.kelso
As the percentage of our population over age 65 increases, infectious diseases among the elderly are becoming a serious public health concern. But why? Join us in this episode as Martha Kelso explains more about why infections are so prevalent among seniors and elderly.
Meet Martha Kelso:
Martha Kelso is the Chief Executive Officer of Wound Care Plus, LLC, the largest mobile wound care provider in the Midwest. Her decades of experience providing advanced wound care, while being a visionary and entrepreneur in the field of mobile medicine, has allowed her to pursue a relentless passion for educating others by offering training and lecturing nationwide. Her team of wound specialists pride themselves on bringing advanced wound care and clinical excellence, supported by evidence-based medicine to the bedside clients and caregivers alike. Kelso is a published author and member of several national advisory boards. Clinical research is important to her and she has served as principal investigator on several clinical research studies/trials. Additionally, Kelso serves as an expert witness for wound litigation cases and serves as a clinical editor for two national publications. Kelso has been a featured speaker at more than 300 educational events and is widely recognized as being a pioneer in the advanced wound care arena, working tirelessly to shape the future landscape of healthcare.
Resources:
www.mywoundcareplus.com
@MarthaRKelso
Facebook: www.facebook.com/MarthaRKelso/
LinkedIn: https://www.linkedin.com/in/martha-r-kelso-5209741/
Instagram: martha.r.kelso
In this episode of The Injured Senior Podcast, Martha Kelso is back with us again to talk about a new device that’s emerging in long-term care that recognizes infection in seniors. Martha is bedsore and pressure wound expert and the CEO of Wound Care Plus, LLC, a mobile wound care provider in the midwest. Her expertise in this field has allowed her to share her passion and knowledge with many others and she joins us on this episode to chat with host Steve Heisler. Tune in to this episode to learn all about the new exciting technology that is revolutionizing health care for seniors.
In This Episode:
- [03:23] The problem with diagnosing infections in seniors
- [05:24] Autoimmune disorders in the elderly and the effect on infections
- [09:37] Martha speaks about the emerging device, Moleculight, that is changing long-term care for seniors
- [12:11] How physicians use the device to target and remove bacteria which helps reduce the use of antibiotics for seniors
- [19:35] Getting this technology accessible to be used across all long-term health care facilities
- [25:00] Martha shares with Steve what family members of long-term residents should look for when managing their wounds and care
Key Takeaways:
- Avoiding antibiotics in the elderly population is essential to reduce the risk of antibiotic-related side effects like confusion or developing C Diff that can be very difficult to recover from.
- The non-invasive medical device, Moleculight, is like a portable camera with a filter and takes the guesswork out of identifying infection and has a 95% reliability rate. This is a game-changer for the elderly population because they can catch infections before they become worse or septic.
- Hidden abscesses in wounds can now be detected, drained, and cleaned more easily reducing the risk for the person to be hospitalized.
- Being involved in your family member’s care is an important step in keeping them healthy and well taken care of. In today’s age, if you can’t be there in person make sure to use technology to your advantage and stay in communication with their care team.
Meet Martha Kelso
Martha Kelso is the Chief Executive Officer of Wound Care Plus, LLC, the largest mobile wound care provider in the Midwest. Her decades of experience providing advanced wound care, while being a visionary and entrepreneur in the field of mobile medicine, have allowed her to pursue a relentless passion for educating others by offering training and lecturing nationwide. Her team of wound specialists prides themselves on bringing advanced wound care and clinical excellence, supported by evidence-based medicine to the bedside clients and caregivers alike. Kelso is a published author and member of several national advisory boards. Clinical research is important to her and she has severed as principal investigator on several clinical research studies/trials. Additionally, Kelso serves as an expert witness for wound litigation cases and serves as a clinical editor for two national publications. Kelso has been a featured speaker at more than 300 educational events and is widely recognized as being a pioneer in the advanced wound care arena, working tirelessly to shape the future landscape of healthcare.
We need to change America’s healthcare system, and take power out of the insurance company’s hands. Listen as Carol Stern and author David Black shares how to fight against the medical system.
Meet Carol Stern:
Carol Stern is the wife of Gary Stern, the subject of Ripped Apart: Living Misdiagnosed, a true story of one of the largest medical malpractice awards in U.S. history. This real-life account of how a husband and wife’s love was tested during the darkest of times. It pulls back the curtain in detail what it is like to suffer due to doctors’ mistakes and their refusal to admit they made them. Carol recounts in honest detail how her husband Gary spent three years with his internal organs on the outside of his body. More importantly, Carol reveals how she stopped at nothing to make sure Gary was under the best possible care at all times, even if that meant taking things into her own hands.
Resources:
Ripped Apart: Living Misdiagnosed
Ripped Apart Facebook Page
Ripped Apart: Living Misdiagnosed, Gary and Carol Stern's Epic Fight Against Malpractice in the American Health Care System author David Black discusses how he got involved with Carol and Gary’s story.
Meet Carol Stern:
Carol Stern is the wife of Gary Stern, the subject of Ripped Apart: Living Misdiagnosed, a true story of one of the largest medical malpractice awards in U.S. history. This real-life account of how a husband and wife’s love was tested during the darkest of times. It pulls back the curtain in detail what it is like to suffer due to doctors’ mistakes and their refusal to admit they made them. Carol recounts in honest detail how her husband Gary spent three years with his internal organs on the outside of his body. More importantly, Carol reveals how she stopped at nothing to make sure Gary was under the best possible care at all times, even if that meant taking things into her own hands.
Resources:
Ripped Apart: Living Misdiagnosed
Ripped Apart Facebook Page
In this episode, we are going to talk about one of the biggest medical malpractice verdicts in the U.S with Carol Stern and author David Black of Ripped Apart: Living Misdiagnosed, Gary and Carol Stern's Epic Fight Against Malpractice in the American Health Care System.
Meet Carol Stern:
Carol Stern is the wife of Gary Stern, the subject of Ripped Apart: Living Misdiagnosed, a true story of one of the largest medical malpractice awards in U.S. history. This real-life account of how a husband and wife’s love was tested during the darkest of times. It pulls back the curtain in detail what it is like to suffer due to doctors’ mistakes and their refusal to admit they made them. Carol recounts in honest detail how her husband Gary spent three years with his internal organs on the outside of his body. More importantly, Carol reveals how she stopped at nothing to make sure Gary was under the best possible care at all times, even if that meant taking things into her own hands.
Resources:
Ripped Apart: Living Misdiagnosed
Ripped Apart Facebook Page
Carol Stern, the wife of the late Gary Stern, and author David Black, join us to speak on the subject of medical malpractice and living misdiagnosed. David Black is the author of Ripped Apart: Living Misdiagnosed, Gary and Carol Stern's Epic Fight Against Malpractice in the American Health Care System. Carol reveals how she met Gary Stern and speaks about Gary’s background with medical problems. Tune in as we talk about the biggest misconceptions around medical malpractice and what seniors can do to avoid these life-threatening mistakes.
In This Episode:
- [04:00] Carol Stern explains how she met Gary Stern. Then, Carol speaks about Gary’s background with medical problems.
- [08:05] How being misdiagnosed can lead to serious health complications and eventually death.
- [15:20] Author David Black discusses how he got involved with Carol and Gary’s story.
- [19:30] The lack of medical ethics education is scary for seniors who are under hospital care.
- [24:20] Carol reveals the biggest misconceptions seniors have about medical malpractice.
- [29:50] All about Carol’s charity and how she wants to help the senior community.
Key Takeaways:
- We need to change America’s healthcare system, and take power out of the insurance company’s hands.
- Insurance companies should not be able to deny patients proper medications or proper testing.
- There should be a universal medical history system. An ER doctor should be able to pull up your records no matter what state you’re in.
Meet Carol Stern
Carol Stern is the wife of Gary Stern, the subject of Ripped Apart: Living Misdiagnosed, a true story of one of the largest medical malpractice awards in U.S. history. This real-life account of how a husband and wife’s love was tested during the darkest of times. It pulls back the curtain in detail what it is like to suffer due to doctors’ mistakes and their refusal to admit they made them. Carol recounts in honest detail how her husband Gary spent three years with his internal organs on the outside of his body. More importantly, Carol reveals how she stopped at nothing to make sure Gary was under the best possible care at all times, even if that meant taking things into her own hands.
Resources:
Ripped Apart: Living Misdiagnosed
Facebook
This episode guides you through the reasons to think twice before you talk to the insurance company after a fall injury.
In this week’s episode, the National Injured Senior Law Center brings you the six steps every senior should take after a slip or trip and fall injury in a public setting. Knowing these steps before a fall happens can save you valuable time and effort fighting for your case with insurance companies or in court. It’s important to take these steps after a fall to ensure you are properly cared for because the insurance companies want you to settle for less than you deserve. Implementing the six steps listed in this episode can help you achieve the best possible outcome!
In This Episode:
- [00:53] Make sure to report a fall injury that happens in public places.
- [06:51] Look around for witnesses who could have seen your injury.
- [08:27] What photos should you be taking at the scene of the injury?
- [12:57] Should you speak with the insurance company?
- [15:06] What an attorney can do for you.
Key Takeaways:
- Knowing how to properly handle a fall that has happened at a public place.
- Always report a fall injury that happened in public, no matter the severity.
- Insurance companies want to make you settle for less, however, you don’t have to!
- An attorney can be a great ally for you in your injury case.
Links Mentioned:
Website: https://www.injuredseniorhotline.com
Call: (410) 625-4878
First and foremost, What is a reverse mortgage? Seniors over the age of 62 who own their home outright or have significant equity in their home often tap into that equity by taking out a reverse mortgage. Join us in this episode as Attorney Ron Drescher explains more about Filing Bankruptcy for Seniors.
Meet Ronald Drescher
Ronald Drescher is the owner and operator of Drescher & Associates, a law firm in Pikesville, Maryland focusing on bankruptcy and creditors' rights. He is licensed in Maryland, Delaware, Pennsylvania, Virginia, and the federal courts of the District of Columbia.
Resources:
Website: www.drescherlaw.com
Facebook: https://www.facebook.com/MarylandBankruptcyLawyer
Twitter: https://twitter.com/rondrescher
LinkedIn: https://www.linkedin.com/in/mdbankruptcylawyer
In today's episode, listen as Attorney Ron Drescher joins us to answer the question: Should seniors choose chapter 7 or chapter 13 bankruptcy for medical bills?
Meet Ronald Drescher
Ronald Drescher is the owner and operator of Drescher & Associates, a law firm in Pikesville, Maryland focusing on bankruptcy and creditors' rights. He is licensed in Maryland, Delaware, Pennsylvania, Virginia and the federal courts of the District of Columbia.
Resources:
Website: www.drescherlaw.com
Facebook: https://www.facebook.com/MarylandBankruptcyLawyer
Twitter: https://twitter.com/rondrescher
LinkedIn: https://www.linkedin.com/in/mdbankruptcylawyer
Medical debt is more common than you think. It’s not a personal failure, however; it’s a common affliction. Tune in as Attorney Drescher answers the frequently- asked questions about Medical Bill Debt.
Meet Ronald Drescher
Ronald Drescher is the owner and operator of Drescher & Associates, a law firm in Pikesville, Maryland focusing on bankruptcy and creditors' rights. He is licensed in Maryland, Delaware, Pennsylvania, Virginia and the federal courts of the District of Columbia.
Resources:
Website: www.drescherlaw.com
Facebook: https://www.facebook.com/MarylandBankruptcyLawyer
Twitter: https://twitter.com/rondrescher
LinkedIn: https://www.linkedin.com/in/mdbankruptcylawyer
Seven million elderly Americans are struggling with paying their medical bills and accrued medical debt over time. Even with Medicare and Medicaid, 12% of American adults, 65 and older, have issues paying for health-related costs. This brings up the question, can bankruptcy be an option for our injured senior nation? Luckily, Attorney Ron Drescher joins the show. Ron Drescher is the owner and operator of Drescher & Associates, a law firm in Pikesville, Maryland, focusing on bankruptcy and creditors' rights. Tune in as Ron talks about why seniors may want to consider filing for bankruptcy, the different types of bankruptcies, and the three significant alternatives for bankruptcy.
In This Episode:
- [04:20] Should the injured senior nation consider bankruptcy when they're faced with mounting medical bill debt?
- [06:40] If I file bankruptcy, can I lose my house?
- [11:20] The difference between chapter seven and chapter eleven bankruptcies.
- [16:50] If a collection agency is harassing you, then tell them to talk to your attorney.
- [20:55] Ron reveals the three major alternatives for bankruptcy.
Key Takeaways:
- If you are faced with mounting medical bill debt, you should absolutely consider bankruptcy.
- Any person that says they should not consider bankruptcy does not understand the process and the bankruptcy system.
- You need to find an attorney before you file bankruptcy; that way, you can maximize the assets you are allowed to keep.
- Direct all communications with collection agencies to your attorney’s office.
Meet Attorney Ronald Drescher
Ronald Drescher is the owner and operator of Drescher & Associates, a law firm in Pikesville, Maryland focusing on bankruptcy and creditors' rights. He is licensed in Maryland, Delaware, Pennsylvania, Virginia, and the federal courts of the District of Columbia.
Resources:
Website: www.drescherlaw.com
Facebook: https://www.facebook.com/MarylandBankruptcyLawyer
Twitter: https://twitter.com/rondrescher
LinkedIn: https://www.linkedin.com/in/mdbankruptcylawyer/
The life of breast implants varies by person and cannot be predicted. That means everyone with breast implants may need additional surgeries, but no one can predict when. Patients can also request additional surgeries to modify the aesthetic outcome, such as size or shape. Tune in as Maria Gmitro explains the breast implants and safety measures of it.
Meet Maria Gmitro
Maria Gmitro holds a Master's Degree in Instructional/Educational Technology from the University of Central Florida and is the Director of Community Outreach & Patient Advocacy for TrackMy Solutions, a medical device tracking/patient alerting company. Maria experienced illness from newly FDA approved breast implants and regained health upon removal. After healing, she decided to take action by supporting other women suffering from breast implant illness and BIA-ALCL through various support groups. She testified in front of the FDA at the most recent hearing on the safety of breast implants in March 2019.
Maria is President and co-founder of Breast Implant Safety Alliance (BISA Nonprofit). In September of 2019, she and her BISA organization were the first patient advocacy group given a booth at the American Society of Plastic Surgeons “Plastic Surgery The Meeting.” Through her experience, she learned of the greater issues with medical devices and advocates in DC for medical device safety. She serves as a breast implant representative for Medical Device Problems Advocacy of ASHES Nonprofit. She also serves as a breast implant patient representative for the National Center for Health Research’s Breast Implant Working Group, the American Society of Plastic Surgeons Patient Group and the Breast Device Collaborative Community.
Maria currently lives in Charleston, South Carolina with her husband and two daughters. She hopes to raise public awareness because individuals need accurate information to make informed health decisions.
Resources:
Website: https://www.breastimplantsafetyalliance.org & https://trackmysolutions.us
Facebook: https://www.facebook.com/breastimplantsafetyalliance/
Twitter: https://twitter.com/bisanonprofit
Linkedin: https://www.linkedin.com/in/maria-gmitro/
Instagram: https://www.instagram.com/trackmymaria/
BISA on Instagram: https://www.instagram.com/bisanonprofit/
Should I get breast implants? Should they be saline or silicone? Which style? Those are common questions people have when considering breast implants. Join us in this episode as Maria Gmitro deeps dive into the types of illnesses associated with breast implants.
Meet Maria Gmitro
Maria Gmitro holds a Master's Degree in Instructional/Educational Technology from the University of Central Florida and is the Director of Community Outreach & Patient Advocacy for TrackMy Solutions, a medical device tracking/patient alerting company. Maria experienced illness from newly FDA approved breast implants and regained health upon removal. After healing, she decided to take action by supporting other women suffering from breast implant illness and BIA-ALCL through various support groups. She testified in front of the FDA at the most recent hearing on the safety of breast implants in March 2019.
Maria is President and co-founder of Breast Implant Safety Alliance (BISA Nonprofit). In September of 2019, she and her BISA organization were the first patient advocacy group given a booth at the American Society of Plastic Surgeons “Plastic Surgery The Meeting.” Through her experience, she learned of the greater issues with medical devices and advocates in DC for medical device safety. She serves as a breast implant representative for Medical Device Problems Advocacy of ASHES Nonprofit. She also serves as a breast implant patient representative for the National Center for Health Research’s Breast Implant Working Group, the American Society of Plastic Surgeons Patient Group and the Breast Device Collaborative Community.
Maria currently lives in Charleston, South Carolina with her husband and two daughters. She hopes to raise public awareness because individuals need accurate information to make informed health decisions.
Resources:
Website: https://www.breastimplantsafetyalliance.org & https://trackmysolutions.us
Facebook: https://www.facebook.com/breastimplantsafetyalliance/
Twitter: https://twitter.com/bisanonprofit
Linkedin: https://www.linkedin.com/in/maria-gmitro/
Instagram: https://www.instagram.com/trackmymaria/
BISA on Instagram: https://www.instagram.com/bisanonprofit/
In today's episode, Maria Gmitro joins us to share an inspiring story about breast implant illness. Listen now!
Meet Maria Gmitro
Maria Gmitro holds a Master's Degree in Instructional/Educational Technology from the University of Central Florida and is the Director of Community Outreach & Patient Advocacy for TrackMy Solutions, a medical device tracking/patient alerting company. Maria experienced illness from newly FDA approved breast implants and regained health upon removal. After healing, she decided to take action by supporting other women suffering from breast implant illness and BIA-ALCL through various support groups. She testified in front of the FDA at the most recent hearing on the safety of breast implants in March 2019.
Maria is President and co-founder of Breast Implant Safety Alliance (BISA Nonprofit). In September of 2019, she and her BISA organization were the first patient advocacy group given a booth at the American Society of Plastic Surgeons “Plastic Surgery The Meeting.” Through her experience, she learned of the greater issues with medical devices and advocates in DC for medical device safety. She serves as a breast implant representative for Medical Device Problems Advocacy of ASHES Nonprofit. She also serves as a breast implant patient representative for the National Center for Health Research’s Breast Implant Working Group, the American Society of Plastic Surgeons Patient Group and the Breast Device Collaborative Community.
Maria currently lives in Charleston, South Carolina with her husband and two daughters. She hopes to raise public awareness because individuals need accurate information to make informed health decisions.
Resources:
Website: https://www.breastimplantsafetyalliance.org & https://trackmysolutions.us
Facebook: https://www.facebook.com/breastimplantsafetyalliance/
Twitter: https://twitter.com/bisanonprofit
Linkedin: https://www.linkedin.com/in/maria-gmitro/
Instagram: https://www.instagram.com/trackmymaria/
BISA on Instagram: https://www.instagram.com/bisanonprofit/
Maria Gmitro is President and co-founder of Breast Implant Safety Alliance (BISA Nonprofit). Sadly, Maria experienced illness from newly FDA-approved breast implants back in 2014. After getting the implants removed, Maria felt instantly better. Now, Maria loves to educate others and help people who are experiencing symptoms from their breast implants. There are many illnesses and system symptoms related to breast implants, including fatigue, brain fog, joint pain, anxiety, depression, and more. Tune in as Maria explains what you can do if you think you’re suffering from an illness related to breast implants or other medical devices.
In This Episode:
- [04:35] Maria speaks about her journey with illness from breast implants.
- [12:50] The illnesses that are associated with breast implants.
- [20:25] Breast implant recalls: what you need to know.
- [29:00] Everyone reacts differently to a medical device; think about the symptoms before getting an implant.
- [31:30] Do extensive research before getting anything implanted into your body.
Key Takeaways:
- The most common systemic symptoms from breast implants are fatigue, brain fog, joint pain, anxiety, hair loss, depression, rash, autoimmune diseases, inflammation, and weight fluctuation.
- Memory loss, depression, anxiety, autoimmune disorders, and neurological deficits may not be from aging; instead, they may result from your breast implants.
- Everyone will react differently to a medical device or breast implants; you may have severe symptoms or no symptoms at all.
- Before getting breast implants or a medical device, do your research and find out about any adverse events.
Meet Maria Gmitro
Maria Gmitro holds a Master's Degree in Instructional/Educational Technology from the University of Central Florida and is the Director of Community Outreach & Patient Advocacy for TrackMy Solutions, a medical device tracking/patient alerting company. Maria experienced illness from newly FDA approved breast implants and regained health upon removal. After healing, she decided to take action by supporting other women suffering from breast implant illness and BIA-ALCL through various support groups. She testified in front of the FDA at the most recent hearing on the safety of breast implants in March 2019.
Maria is President and co-founder of Breast Implant Safety Alliance (BISA Nonprofit). In September of 2019, she and her BISA organization were the first patient advocacy group given a booth at the American Society of Plastic Surgeons “Plastic Surgery The Meeting.” Through her experience, she learned of the greater issues with medical devices and advocates in DC for medical device safety. She serves as a breast implant representative for Medical Device Problems Advocacy of ASHES Nonprofit. She also serves as a breast implant patient representative for the National Center for Health Research’s Breast Implant Working Group, the American Society of Plastic Surgeons Patient Group and the Breast Device Collaborative Community.
Maria currently lives in Charleston, South Carolina with her husband and two daughters. She hopes to raise public awareness because individuals need accurate information to make informed health decisions.
Resources:
Website: https://www.breastimplantsafetyalliance.org & https://trackmysolutions.us
Facebook: https://www.facebook.com/breastimplantsafetyalliance/
Twitter: https://twitter.com/bisanonprofit
Linkedin: https://www.linkedin.com/in/maria-gmitro/
Instagram: https://www.instagram.com/trackmymaria/
BISA on Instagram: https://www.instagram.com/bisanonprofit/
Listen now as Dr. Dori Mintzer talks about the must have conversations between couples after retirement.
Meet Dr. Dori Mintzer
With 50 years of clinical experience, Dr. Dorian (aka Dori) Mintzer is a speaker/retirement transition, money, relationship, and executive coach/ therapist/ consultant/ writer. She weaves adult development, holistic life planning and positive psychology into programs that tap and shape clients’ energies into roadmaps for wiser, more enhanced living. She hosts the popular monthly Revolutionize your Retirement Interview with Expert’s Series on the 4th Tuesday of each month, open to professionals and the public. She provides Keynotes, breakout sessions, webinars and podcasts and facilitates workshops for professional and community groups.
Dorian is co-author of the award winning book, The Couples Retirement Puzzle: The 10 Must-Have Conversations for Creating an Amazing New Life Together, co-producer of The Career Playbook: Second Half Plays and has contributed to a number of other books. She has been featured in a variety of print and digital outlets such as the NY Times, WSJ, USA Today, CNN Money, Forbes, Next Avenue, The Financial Times, NPR, ABC Evening News and the Today Show and has given a Ted X talk focused on “Embracing your Bonus Years: A Time to Learn, Grow and Evolve.”
Resources:
Email: dorian@dorianmintzer.com.
Website: www.revolutionizeretirement.com
Twitter: https://twitter.com/dorianmintzer
Facebook: https://www.facebook.com/RevolutionizeRetirement/
LinkedIn: https://www.linkedin.com/in/dorianmintzer/
YouTube:https://www.youtube.com/channel/UC0Z4cUEHI7peIn6jaMhWQyw
It's best to plan ahead to ensure a successful and happy retirement. But it's not just financial planning that's important. It's important to plan out your activities as well. Join us in today’s episode with our guest Dr. Dori Mintzer.
Meet Dr. Dori Mintzer
With 50 years of clinical experience, Dr. Dorian (aka Dori) Mintzer is a speaker/retirement transition, money, relationship, and executive coach/ therapist/ consultant/ writer. She weaves adult development, holistic life planning and positive psychology into programs that tap and shape clients’ energies into roadmaps for wiser, more enhanced living. She hosts the popular monthly Revolutionize your Retirement Interview with Expert’s Series on the 4th Tuesday of each month, open to professionals and the public. She provides Keynotes, breakout sessions, webinars and podcasts and facilitates workshops for professional and community groups.
Dorian is co-author of the award winning book, The Couples Retirement Puzzle: The 10 Must-Have Conversations for Creating an Amazing New Life Together, co-producer of The Career Playbook: Second Half Plays and has contributed to a number of other books. She has been featured in a variety of print and digital outlets such as the NY Times, WSJ, USA Today, CNN Money, Forbes, Next Avenue, The Financial Times, NPR, ABC Evening News and the Today Show and has given a Ted X talk focused on “Embracing your Bonus Years: A Time to Learn, Grow and Evolve.”
Resources:
Email: dorian@dorianmintzer.com.
Website: www.revolutionizeretirement.com
Twitter: https://twitter.com/dorianmintzer
Facebook: https://www.facebook.com/RevolutionizeRetirement/
LinkedIn: https://www.linkedin.com/in/dorianmintzer/
YouTube:https://www.youtube.com/channel/UC0Z4cUEHI7peIn6jaMhWQyw
Stay tuned as Dr. Dori Mintzer explains the most common problems retirement poses for seniors in this episode.
Meet Dr. Dori Mintzer
With 50 years of clinical experience, Dr. Dorian (aka Dori) Mintzer is a speaker/retirement transition, money, relationship, and executive coach/ therapist/ consultant/ writer. She weaves adult development, holistic life planning and positive psychology into programs that tap and shape clients’ energies into roadmaps for wiser, more enhanced living. She hosts the popular monthly Revolutionize your Retirement Interview with Expert’s Series on the 4th Tuesday of each month, open to professionals and the public. She provides Keynotes, breakout sessions, webinars and podcasts and facilitates workshops for professional and community groups.
Dorian is co-author of the award winning book, The Couples Retirement Puzzle: The 10 Must-Have Conversations for Creating an Amazing New Life Together, co-producer of The Career Playbook: Second Half Plays and has contributed to a number of other books. She has been featured in a variety of print and digital outlets such as the NY Times, WSJ, USA Today, CNN Money, Forbes, Next Avenue, The Financial Times, NPR, ABC Evening News and the Today Show and has given a Ted X talk focused on “Embracing your Bonus Years: A Time to Learn, Grow and Evolve.”
Resources:
Email: dorian@dorianmintzer.com.
Website: www.revolutionizeretirement.com
Twitter: https://twitter.com/dorianmintzer
Facebook: https://www.facebook.com/RevolutionizeRetirement/
LinkedIn: https://www.linkedin.com/in/dorianmintzer/
YouTube:https://www.youtube.com/channel/UC0Z4cUEHI7peIn6jaMhWQyw
With 50 years of clinical experience, Dr. Dorian (aka Dori) Mintzer is the co-author of the award-winning book, The Couples Retirement Puzzle: The 10 Must-Have Conversations for Creating an Amazing New Life Together. Today, Dr. Mintzer teaches us how to revolutionize our retirement. First, we chat about how retirement has significantly changed over the years. No longer is retirement the end of your life. Instead, retirement is just a new beginning. We talk about how to make that new beginning something meaningful. Plus, Dr. Mintzer reveals some of the must-have conversations for creating a new life together in retirement with your partner.
In This Episode:
- [04:25] How the notion of retirement really has been changing over the years.
- [08:45] Retirement is a great time to consider what interests you have.
- [11:50] Finances and health are the two most significant pieces of the retirement puzzle, and they impact everything else.
- [16:10] Examples of seniors who have revolutionized their retirement.
- [21:50] The importance of using your wisdom for mentorship in retirement.
- [25:05] About The 10 Must-Have Conversations for Creating an Amazing New Life Together.
Key Takeaways:
- Retirement is a transition in your life; think about what you want the next stage of your life to look like.
- When you retire, you can grow, learn, evolve, and explore.
- Consider your future hobbies before retiring; open yourself up to this idea of new beginnings and possibilities.
- Build some aspects of connection, engagement, and purpose into your life during retirement.
Meet Dr. Dori Mintzer
With 50 years of clinical experience, Dr. Dorian (aka Dori) Mintzer is a speaker/retirement transition, money, relationship, and executive coach/ therapist/ consultant/ writer. She weaves adult development, holistic life planning and positive psychology into programs that tap and shape clients’ energies into roadmaps for wiser, more enhanced living. She hosts the popular monthly Revolutionize your Retirement Interview with Expert’s Series on the 4th Tuesday of each month, open to professionals and the public. She provides Keynotes, breakout sessions, webinars and podcasts and facilitates workshops for professional and community groups.
Dorian is co-author of the award winning book, The Couples Retirement Puzzle: The 10 Must-Have Conversations for Creating an Amazing New Life Together, co-producer of The Career Playbook: Second Half Plays and has contributed to a number of other books. She has been featured in a variety of print and digital outlets such as the NY Times, WSJ, USA Today, CNN Money, Forbes, Next Avenue, The Financial Times, NPR, ABC Evening News and the Today Show and has given a Ted X talk focused on “Embracing your Bonus Years: A Time to Learn, Grow and Evolve.”
Resources:
Email: dorian@dorianmintzer.com.
Website: www.revolutionizeretirement.com
Twitter: https://twitter.com/dorianmintzer
Facebook: https://www.facebook.com/RevolutionizeRetirement/
LinkedIn: https://www.linkedin.com/in/dorianmintzer/
YouTube: https://www.youtube.com/channel/UC0Z4cUEHI7peIn6jaMhWQyw
Listen now as Madris Kinard talks about the safety of both hip and knee replacement implants.
Meet Madris Kinard
Device Events was founded by Madris Kinard in 2015 after she worked for the FDA. and discovered that safety information for medical devices was hard to come by for patients and physicians. Madris identified that patient safety and health outcomes were being critically impacted by the inaccessibility of information on adverse events caused by medical devices.
That information is now easily accessible through clear, comprehensive, metrics, reports and signal alerts that healthcare professionals can use to improve health outcomes and patient safety while reducing risk for their organizations.
Resources:
Website: www.deviceevents.com
Twitter: https://twitter.com/deviceevents
LinkedIn: https://www.linkedin.com/in/madris/
Why metallosis is so common with metal hip replacements? Madrid Kinard answers the frequently asked questions about Knee and Hip replacements in this episode!
Meet Madris Kinard
Device Events was founded by Madris Kinard in 2015 after she worked for the FDA. and discovered that safety information for medical devices was hard to come by for patients and physicians. Madris identified that patient safety and health outcomes were being critically impacted by the inaccessibility of information on adverse events caused by medical devices.
That information is now easily accessible through clear, comprehensive, metrics, reports and signal alerts that healthcare professionals can use to improve health outcomes and patient safety while reducing risk for their organizations.
Resources:
Website: www.deviceevents.com
Twitter: https://twitter.com/deviceevents
LinkedIn: https://www.linkedin.com/in/madris/
Knee and Hip Replacement — is it safe for seniors to undergo in this surgery? Join us in today’s episode with our guest Madris Kinard as she speaks about Knee and Hip Replacement.
Meet Madris Kinard
Device Events was founded by Madris Kinard in 2015 after she worked for the FDA. and discovered that safety information for medical devices was hard to come by for patients and physicians. Madris identified that patient safety and health outcomes were being critically impacted by the inaccessibility of information on adverse events caused by medical devices.
That information is now easily accessible through clear, comprehensive, metrics, reports and signal alerts that healthcare professionals can use to improve health outcomes and patient safety while reducing risk for their organizations.
Resources:
Website: www.deviceevents.com
Twitter: https://twitter.com/deviceevents
LinkedIn: https://www.linkedin.com/in/madris/
This episode is all about the safety of both hip and knee replacement implants. Approximately 600,000 individuals in the United States receive a total knee replacement every year, and 450,000 get total hip replacements by surgeons. Sadly, at least 80,000 deaths have occurred since 2008 from medical devices in the United States. Madris Kinard of Device Events joins to explain why medical device adverse events have doubled over the past five years. Tune in as Madris reveals what you need to consider before getting a knee or hip implant and some common issues that may occur.
In This Episode:
- [03:30] Sadly, medical device adverse events have doubled over the past five years. Madris explains why.
- [08:10] Why metalosis is so common with metal hip replacements.
- [13:30] What patients should consider before getting a knee or a hip implant.
- [18:15] The reason you may have to get your metal implants replaced multiple times.
- [20:55] Advice from Madris about getting a knee or hip implant.
Key Takeaways:
- Medical device adverse events have doubled over the past five years because many patients are getting multiple devices simultaneously.
- Typically, a senior’s hips will dislocate because of the patient's anatomy or because the wrong device was chosen.
- Sadly, there are deaths associated with medical device knees; there can be issues with the materials in the metals.
- Always ask the physician how frequently they see issues with their patients with the device they want to implant.
Meet Madris Kinard
Device Events was founded by Madris Kinard in 2015 after she worked for the FDA. and discovered that safety information for medical devices was hard to come by for patients and physicians. Madris identified that patient safety and health outcomes were being critically impacted by the inaccessibility of information on adverse events caused by medical devices.
That information is now easily accessible through clear, comprehensive, metrics, reports and signal alerts that healthcare professionals can use to improve health outcomes and patient safety while reducing risk for their organizations.
Resources:
Website: www.deviceevents.com
Twitter: https://twitter.com/deviceevents
LinkedIn: https://www.linkedin.com/in/madris/
Listen now as Dr. Teaster speaks about the problem of sexual abuse in residential care settings.
Meet Pamela Teaster
Pamela Teaster is a professor of human development and family science at Virginia Tech and director of the Virginia Tech Center for Gerontology.
Teaster has a long history of serving the public interest in ensuring that older Americans receive protection from exploitation and abuse by those in positions of power or trust. Her ongoing research focuses on the mistreatment of elders and vulnerable adults, public and private guardianship, end-of-life issues and decision-making, ethical treatment and human rights issues of vulnerable adults, and public affairs and policy. She is the coauthor or coeditor of four books and more than a hundred peer-reviewed articles, reports, and book chapters.
In addition to her scholarship, Teaster is on the editorial board of the Journal of Elder Abuse and Neglect. She is a fellow of both the Gerontological Society of America and the Association for Gerontology in Higher Education. She is an active board member and former president of the National Committee for the Prevention of Elder Abuse. She also serves as secretary on the Board of Trustees for the Center for Guardianship Certification and secretary general of the International Network for the Prevention of Elder Abuse.
Before joining the Virginia Tech faculty, Teaster served as director of the Center for Gerontology and chair of the Department of Gerontology at the University of Kentucky, where she also served as director of the Ohio Valley Appalachia Regional Geriatric Education Center, director of doctoral studies, and associate dean for research at the College of Public Health. She founded the Kentucky Guardianship Association and was its first president. She also founded the Kentucky Justice Center for Elders and Vulnerable Adults.
Resources:
Center for Gerontology: https://liberalarts.vt.edu/research-centers/center-for-gerontology.html
Email Dr. Teaster: pteaster@vt.edu
Public Guardianship is made for an incapacitated person who have no willing or qualified family members or friends and who do not have adequate income or assets for the compensation of a private guardian. Dr. Pamela Teaster gives some helpful insights on the problems associated with public guardianship in this episode.
Meet Pamela Teaster
Pamela Teaster is a professor of human development and family science at Virginia Tech and director of the Virginia Tech Center for Gerontology.
Teaster has a long history of serving the public interest in ensuring that older Americans receive protection from exploitation and abuse by those in positions of power or trust. Her ongoing research focuses on the mistreatment of elders and vulnerable adults, public and private guardianship, end-of-life issues and decision-making, ethical treatment and human rights issues of vulnerable adults, and public affairs and policy. She is the coauthor or coeditor of four books and more than a hundred peer-reviewed articles, reports, and book chapters.
In addition to her scholarship, Teaster is on the editorial board of the Journal of Elder Abuse and Neglect. She is a fellow of both the Gerontological Society of America and the Association for Gerontology in Higher Education. She is an active board member and former president of the National Committee for the Prevention of Elder Abuse. She also serves as secretary on the Board of Trustees for the Center for Guardianship Certification and secretary general of the International Network for the Prevention of Elder Abuse.
Before joining the Virginia Tech faculty, Teaster served as director of the Center for Gerontology and chair of the Department of Gerontology at the University of Kentucky, where she also served as director of the Ohio Valley Appalachia Regional Geriatric Education Center, director of doctoral studies, and associate dean for research at the College of Public Health. She founded the Kentucky Guardianship Association and was its first president. She also founded the Kentucky Justice Center for Elders and Vulnerable Adults.
Resources:
Center for Gerontology: https://liberalarts.vt.edu/research-centers/center-for-gerontology.html
Email Dr. Teaster: pteaster@vt.edu
Public Guardianship — Is it made with the best interest of incapacitated people in mind? Join us in today’s episode with our guest Dr. Pamela Teaster as she talks about Public Guardianship.
Meet Pamela Teaster
Pamela Teaster is a professor of human development and family science at Virginia Tech and director of the Virginia Tech Center for Gerontology.
Teaster has a long history of serving the public interest in ensuring that older Americans receive protection from exploitation and abuse by those in positions of power or trust. Her ongoing research focuses on the mistreatment of elders and vulnerable adults, public and private guardianship, end-of-life issues and decision-making, ethical treatment and human rights issues of vulnerable adults, and public affairs and policy. She is the coauthor or coeditor of four books and more than a hundred peer-reviewed articles, reports, and book chapters.
In addition to her scholarship, Teaster is on the editorial board of the Journal of Elder Abuse and Neglect. She is a fellow of both the Gerontological Society of America and the Association for Gerontology in Higher Education. She is an active board member and former president of the National Committee for the Prevention of Elder Abuse. She also serves as secretary on the Board of Trustees for the Center for Guardianship Certification and secretary general of the International Network for the Prevention of Elder Abuse.
Before joining the Virginia Tech faculty, Teaster served as director of the Center for Gerontology and chair of the Department of Gerontology at the University of Kentucky, where she also served as director of the Ohio Valley Appalachia Regional Geriatric Education Center, director of doctoral studies, and associate dean for research at the College of Public Health. She founded the Kentucky Guardianship Association and was its first president. She also founded the Kentucky Justice Center for Elders and Vulnerable Adults.
Resources:
Center for Gerontology: https://liberalarts.vt.edu/research-centers/center-for-gerontology.html
Email Dr. Teaster: pteaster@vt.edu
To get some help today, we have Dr. Pamela Teaster with us to talk about public guardianships and whether it is in the best interest of incapacitated people. Dr. Teaster is a human development and family science professor at Virginia Tech and director of the Virginia Tech Center for Gerontology. First, Dr. Teaster explains what public guardianship means. When a person is deemed to lack capacity and has no responsible person to make decisions on their behalf, the state will then appoint a public guardian. Sadly, not many people know about this unconstitutional process called public guardianship. Tune in as Dr. Teaster explains why we should be concerned about public guardianship and what seniors need to know about sexual abuse in residential care settings.
In This Episode:
- [02:55] What exactly public guardianship means, and why older adults are appointed guardians more often than younger adults.
- [07:20] The history behind public guardianship.
- [10:00] Why seniors should be concerned about public guardianship.
- [14:15] With public guardianship, the guardian becomes the state – it’s a critical distinction to understand.
- [18:00] Dr. Teaster speaks about the problem of sexual abuse in residential care settings.
Key Takeaways:
- Your civil rights are under fire because of public guardianship – look up the laws in your state about this complicated process.
- Total guardianship will reduce an adult to the legal status of a child.
- You want to try to stay out of the public guardian program as much as you possibly can.
- Sexual abuse in residential care settings is more likely to happen with another resident than a staff member.
Resources:
Center for Gerontology: https://liberalarts.vt.edu/research-centers/center-for-gerontology.html
Email Dr. Teaster: pteaster@vt.edu
Meet Pamela Teaster
Pamela Teaster is a professor of human development and family science at Virginia Tech and director of the Virginia Tech Center for Gerontology.
Teaster has a long history of serving the public interest in ensuring that older Americans receive protection from exploitation and abuse by those in positions of power or trust. Her ongoing research focuses on the mistreatment of elders and vulnerable adults, public and private guardianship, end-of-life issues and decision-making, ethical treatment and human rights issues of vulnerable adults, and public affairs and policy. She is the coauthor or coeditor of four books and more than a hundred peer-reviewed articles, reports, and book chapters.
In addition to her scholarship, Teaster is on the editorial board of the Journal of Elder Abuse and Neglect. She is a fellow of both the Gerontological Society of America and the Association for Gerontology in Higher Education. She is an active board member and former president of the National Committee for the Prevention of Elder Abuse. She also serves as secretary on the Board of Trustees for the Center for Guardianship Certification and secretary general of the International Network for the Prevention of Elder Abuse.
Before joining the Virginia Tech faculty, Teaster served as director of the Center for Gerontology and chair of the Department of Gerontology at the University of Kentucky, where she also served as director of the Ohio Valley Appalachia Regional Geriatric Education Center, director of doctoral studies, and associate dean for research at the College of Public Health. She founded the Kentucky Guardianship Association and was its first president. She also founded the Kentucky Justice Center for Elders and Vulnerable Adults.
Tune in as Dr. Sugar explains the importance of joint tenancy and the reason why seniors should not be making visits to banks, credit unions, and/or brokerages.
Meet Dr. Sam Sugar
Sam J. Sugar, MD, is a Board-Certified Specialist in Internal Medicine and Founder and President of Americans Against Abusive Probate Guardianship (AAAPG), a 501c3 organization designed to help expose the systematic corruption of this nation’s guardianship systems. Dr. Sugar received his MD from the Abraham Lincoln College of Medicine at the University of Illinois, Chicago. He achieved certification as a specialist in Internal Medicine from the American Board of Internal Medicine and is distinguished as a Fellow of the American College of Physicians.
Dr. Sugar’s book, released in 2018, “Guardianships and the Elderly-The Perfect Crime” -- an Amazon #1 New Release ---sheds light on this complex, opaque system, which all too often enables those in-the-know to commit “the perfect crime.”. Dr. Sugar writes frequently at www.aaapg.net and is a Certified Florida Probate Court Examiner.
A native Chicagoan, Dr. Sugar now lives in Hollywood, Florida, with his wife, Judy.
Resources:
Website: www.aaapg.net
Facebook: https://www.facebook.com/AAAPG.net/
Preventing the appointment of a professional guardian over your estate is a very important move in your advanced directives. Join us in this episodes as Dr. Sam J Sugar deeps dive into why advanced directives are important to prevent guardianships.
Meet Dr. Sam Sugar
Sam J. Sugar, MD, is a Board-Certified Specialist in Internal Medicine and Founder and President of Americans Against Abusive Probate Guardianship (AAAPG), a 501c3 organization designed to help expose the systematic corruption of this nation’s guardianship systems. Dr. Sugar received his MD from the Abraham Lincoln College of Medicine at the University of Illinois, Chicago. He achieved certification as a specialist in Internal Medicine from the American Board of Internal Medicine and is distinguished as a Fellow of the American College of Physicians.
Dr. Sugar’s book, released in 2018, “Guardianships and the Elderly-The Perfect Crime” -- an Amazon #1 New Release ---sheds light on this complex, opaque system, which all too often enables those in-the-know to commit “the perfect crime.”. Dr. Sugar writes frequently at www.aaapg.net and is a Certified Florida Probate Court Examiner.
A native Chicagoan, Dr. Sugar now lives in Hollywood, Florida, with his wife, Judy.
Resources:
Website: www.aaapg.net
Facebook: https://www.facebook.com/AAAPG.net/
In today's episode, Dr. Sam Sugar joins us, he is a Board-Certified Specialist in Internal Medicine and Founder and President of Americans Against Abusive Probate Guardianship (AAAPG). Listen now as he shares some important tidbits and nuggets to help Seniors avoid the ever-increasing threat of winding up in a guardianship during their lifetime.
Meet Dr. Sam Sugar
Sam J. Sugar, MD, is a Board-Certified Specialist in Internal Medicine and Founder and President of Americans Against Abusive Probate Guardianship (AAAPG), a 501c3 organization designed to help expose the systematic corruption of this nation’s guardianship systems. Dr. Sugar received his MD from the Abraham Lincoln College of Medicine at the University of Illinois, Chicago. He achieved certification as a specialist in Internal Medicine from the American Board of Internal Medicine and is distinguished as a Fellow of the American College of Physicians.
Dr. Sugar’s book, released in 2018, “Guardianships and the Elderly-The Perfect Crime” -- an Amazon #1 New Release ---sheds light on this complex, opaque system, which all too often enables those in-the-know to commit “the perfect crime.”. Dr. Sugar writes frequently at www.aaapg.net and is a Certified Florida Probate Court Examiner.
A native Chicagoan, Dr. Sugar now lives in Hollywood, Florida, with his wife, Judy.
Resources:
Website: www.aaapg.net
Facebook: https://www.facebook.com/AAAPG.net/
Today, we have Dr. Sam Sugar back for a second time. Dr. Sugar is a Board-Certified Specialist in Internal Medicine and Founder and President of Americans Against Abusive Probate Guardianship (AAAPG). He is here to give some critical information on how seniors can avoid the ever-increasing threat of winding up with guardianship during their lifetime. The reason why prevention of guardianship is so vital is related to the reality that getting out of guardianship or terminating a guardianship is essentially impossible. Sadly, preventing guardianship is extremely difficult because they usually result from family dysfunction. Tune in as Dr. Sugar explains the importance of joint tenancy and why seniors should not be making visits to the bank.
In This Episode:
- [03:20] Why preventing guardianship is critical for our senior community.
- [05:00] Sadly, we can’t rely on the government to put restrictions on guardianships of the elderly.
- [10:25] Dr. Sugar reveals the best ways for seniors to avoid being placed under guardianship in the first place.
- [13:20] Why you should never ask a lawyer to solve family disputes.
- [21:30] The reason seniors should not be making visits to banks, credit unions, and/or brokerages.
- [25:40] Why seniors should put their home and assets in joint tenancy.
Key Takeaways:
- Seniors should not be making visits to the bank. The very act of giving away money can put a senior at risk of something really unpleasant and horrifying – guardianship.
- It's much easier for the court to take control over an account with only one signatory; that’s why it’s essential to put all your assets in joint tenancy.
- Preventing the appointment of a professional guardian over your estate is a very important move in your advanced directives.
- An estate attorney will be able to assist you best with avoiding professional guardianship.
Meet Dr. Sam Sugar
Sam J. Sugar, MD, is a Board-Certified Specialist in Internal Medicine and Founder and President of Americans Against Abusive Probate Guardianship (AAAPG), a 501c3 organization designed to help expose the systematic corruption of this nation’s guardianship systems. Dr. Sugar received his MD from the Abraham Lincoln College of Medicine at the University of Illinois, Chicago. He achieved certification as a specialist in Internal Medicine from the American Board of Internal Medicine and is distinguished as a Fellow of the American College of Physicians.
Dr. Sugar’s book, released in 2018, “Guardianships and the Elderly-The Perfect Crime” -- an Amazon #1 New Release ---sheds light on this complex, opaque system, which all too often enables those in-the-know to commit “the perfect crime.”. Dr. Sugar writes frequently at www.aaapg.net and is a Certified Florida Probate Court Examiner.
A native Chicagoan, Dr. Sugar now lives in Hollywood, Florida, with his wife, Judy.
Resources:
Website: www.aaapg.net
Facebook: https://www.facebook.com/AAAPG.net/
It has its pros and cons, but should you really put your loved one who’s suffering from Alzheimer’s in a nursing home? Let’s hear Pat Moffet’s story.
Meet Pat Moffet
Pat Moffett married the love of his life Carmen in 1976 and moved to Great Neck Long Island where they raised their five children together. In 1998, Pat was recognized as Long Island's International Executive of the Year. That same year, Carmen was diagnosed with Early Onset Alzheimer's. After years of struggling with the disease, Carmen was finally admitted to a nursing home. It was then that Pat decided to write a book based on his and Carmen's love story and its tragic turn after she was diagnosed, the internationally acclaimed ICE CREAM IN THE CUPBOARD.
After Carmen's death in 2010, Pat continued to work with the Alzheimer's Association and Carmen's doctor, Gisele Wolf-Klein, raising awareness and providing support for the caregivers and loved ones of Early Onset Alzheimer’s victims. In 2012 he received the "Tikkun Olam (Translation: Repairer of Lives) Award" from the Sid Jacobson J.C.C. In 2014 he was recognized by the Alzheimer's Association as "Humanitarian of the Year". Pat's dream is to honor Carmen and to provide hope and comfort to as many people as possible who have been affected by Alzheimer's. He is confident that bringing his book to the big screen will help even more families understand this devastating illness. The Feature Film ICE CREAM IN THE CUPBOARD is directed by Drew Pollins.
Resources
Website: https://www.patmoffett.com
YouTube: https://www.youtube.com/channel/UCu0g_KSp1bX_v1p35h4SmvA
Email: GarrisonBooks2014@gmail.com
Whether you have a loved one or you are a caregiver for people on the early onset of Alzheimer’s, this episode is for you.
Meet Pat Moffet
Pat Moffett married the love of his life Carmen in 1976 and moved to Great Neck Long Island where they raised their five children together. In 1998, Pat was recognized as Long Island's International Executive of the Year. That same year, Carmen was diagnosed with Early Onset Alzheimer's. After years of struggling with the disease, Carmen was finally admitted to a nursing home. It was then that Pat decided to write a book based on his and Carmen's love story and its tragic turn after she was diagnosed, the internationally acclaimed ICE CREAM IN THE CUPBOARD.
After Carmen's death in 2010, Pat continued to work with the Alzheimer's Association and Carmen's doctor, Gisele Wolf-Klein, raising awareness and providing support for the caregivers and loved ones of Early Onset Alzheimer’s victims. In 2012 he received the "Tikkun Olam (Translation: Repairer of Lives) Award" from the Sid Jacobson J.C.C. In 2014 he was recognized by the Alzheimer's Association as "Humanitarian of the Year". Pat's dream is to honor Carmen and to provide hope and comfort to as many people as possible who have been affected by Alzheimer's. He is confident that bringing his book to the big screen will help even more families understand this devastating illness. The Feature Film ICE CREAM IN THE CUPBOARD is directed by Drew Pollins.
Resources
Website: https://www.patmoffett.com
YouTube: https://www.youtube.com/channel/UCu0g_KSp1bX_v1p35h4SmvA
Email: GarrisonBooks2014@gmail.com
In this episode, Pat Moffet joins us as we discuss the early signs and diagnosis as well as the surprising behaviors that challenged Pat's preconceived ideas of what Alzheimer's behaviors look like.
Meet Pat Moffet
Pat Moffett married the love of his life Carmen in 1976 and moved to Great Neck Long Island where they raised their five children together. In 1998, Pat was recognized as Long Island's International Executive of the Year. That same year, Carmen was diagnosed with Early Onset Alzheimer's. After years of struggling with the disease, Carmen was finally admitted to a nursing home. It was then that Pat decided to write a book based on his and Carmen's love story and its tragic turn after she was diagnosed, the internationally acclaimed ICE CREAM IN THE CUPBOARD.
After Carmen's death in 2010, Pat continued to work with the Alzheimer's Association and Carmen's doctor, Gisele Wolf-Klein, raising awareness and providing support for the caregivers and loved ones of Early Onset Alzheimer’s victims. In 2012 he received the "Tikkun Olam (Translation: Repairer of Lives) Award" from the Sid Jacobson J.C.C. In 2014 he was recognized by the Alzheimer's Association as "Humanitarian of the Year". Pat's dream is to honor Carmen and to provide hope and comfort to as many people as possible who have been affected by Alzheimer's. He is confident that bringing his book to the big screen will help even more families understand this devastating illness. The Feature Film ICE CREAM IN THE CUPBOARD is directed by Drew Pollins.
Resources:
Website: https://www.patmoffett.com
YouTube: https://www.youtube.com/channel/UCu0g_KSp1bX_v1p35h4SmvA
Email: GarrisonBooks2014@gmail.com
Patrick Moffett joins Steve Heisler to talk about his experience in caring for a loved one with Alzheimer's. Patrick’s wife was diagnosed with early-onset Alzheimer's. Early-onset Alzheimer's is a form of dementia that strikes people younger than age 65 and only 5% of Alzheimer's patients will develop symptoms before age 65. Today, at least 300,000 people in this country have early-onset Alzheimer's. Tune in as Patrick reveals some of the most significant challenges he faced as a caregiver and communication tips for caregivers.
In This Episode:
- [02:55] The early signs and diagnosis as well as the surprising behaviors that challenged Pat's preconceived ideas of what Alzheimer's behaviors look like.
- [12:00] The most significant challenges Pat faced as the caregiver.
- [23:25] Pat speaks about his experience putting a loved one into a nursing home.
- [27:25] The number of caregivers that help out with Alzheimer's in the United States.
- [28:20] All about Pat’s book and feature film, Ice Cream in the Cupboard: A True Story of Early Onset Alzheimer's
Key Takeaways:
- The caregiver has to take care of themselves, or else the disease will claim two victims: the caregiver and the patient.
- Pat Moffett recommends keeping your job and look for a Alzheimer's day center.
Meet Pat Moffett
Pat Moffett married the love of his life Carmen in 1976 and moved to Great Neck Long Island where they raised their five children together. In 1998, Pat was recognized as Long Island's International Executive of the Year. That same year, Carmen was diagnosed with Early Onset Alzheimer's. After years of struggling with the disease, Carmen was finally admitted to a nursing home. It was then that Pat decided to write a book based on his and Carmen's love story and its tragic turn after she was diagnosed, the internationally acclaimed ICE CREAM IN THE CUPBOARD.
After Carmen's death in 2010, Pat continued to work with the Alzheimer's Association and Carmen's doctor, Gisele Wolf-Klein, raising awareness and providing support for the caregivers and loved ones of Early Onset Alzheimer’s victims. In 2012 he received the "Tikkun Olam (Translation: Repairer of Lives) Award" from the Sid Jacobson J.C.C. In 2014 he was recognized by the Alzheimer's Association as "Humanitarian of the Year". Pat's dream is to honor Carmen and to provide hope and comfort to as many people as possible who have been affected by Alzheimer's. He is confident that bringing his book to the big screen will help even more families understand this devastating illness. The Feature Film ICE CREAM IN THE CUPBOARD is directed by Drew Pollins.
Resources:
Website: https://www.patmoffett.com
YouTube: https://www.youtube.com/channel/UCu0g_KSp1bX_v1p35h4SmvA
Email: GarrisonBooks2014@gmail.com
Stroke survivors need to be their own healthcare advocates. Unfortunately, not everyone gets the opportunity to be an advocate, especially for people with aphasia. It would help if you had someone who is taking care of you as a stroke survivor. Having a health advocate in the room will be essential for staying healthy. If you can speak after a stroke, then you need to be your own caregiver as you start to take your independence back.
Meet Marcia Moran
After successfully building her business over the last twenty-plus years, Marcia Moran thought she had life by the tail. Little did she know what was in store. Marcia has written over fifty business plans, and helped entrepreneurs strategize over how to differentiate their companies in changing environments. After helping other entrepreneurs start their companies, she decided to found her own business consulting practice, Performance Architect, in 2012 and co-founded Positive Business DC that same year.
She suffered a major stroke in 2014. Marcia applied her skills in planning and strategy as she strived to become whole. She never gave up. Over time she learned to walk again, but Marcia struggled with aphasia, a language disorder. She joined Toastmasters International® hoping to regain her speaking abilities. It helped some, but in August 2017 she discovered a technological breakthrough that minimized her speaking disability. She then pushed beyond her comfort zone to become a Toastmasters International Club Officer in 2017, then Area Director in 2019.
Marcia created Stroke FORWARD because she felt there is a need to share hope with stroke survivors and their caretakers. Learning to become her own health advocate one step a time and exploring holistic methods for healing are keys to her recovery. Marcia speaks and shares her message of hope, inspiration, healing, and a way forward as she goes across the country. She welcomes new opportunities to help individuals affected by major health crises move ahead.
Marcia lives with her husband Jim, two very loud cats, and two birds near Washington, DC. Jim played a role of caretaker and advocate. His observations and experiences are also captured in Stroke FORWARD. On weekends, Marcia, Jim, and the cats go to Deep Creek, Maryland where Marcia paints watercolors. In the evening Marcia and Jim sit out on the deck and watch fireflies flit by.
Marcia holds a B.S. in Political Science with a magna cum laude from the University of North Dakota and a Master’s in Business Administration, from Chapman University, in California. A woman of many talents, she attended school in Sandefjord, Norway to study art. She also earned a certificate in Well-being Foundations of Personal Transformation from the Personal Transformation and Courage Institute in Virginia.
Resources
Top 12 Tips for Recovery: https://www.strokeforward.com/bookbonus
Website: www.StrokeForward.com
Facebook: https://www.facebook.com/StrokeForward
Twitter: https://twitter.com/Stroke_Forward
LinkedIn: https://www.linkedin.com/in/marciamoran/
Three and a half years after Marcia Moran's stroke, she discovered Neurofeedback. It is a type of biofeedback that uses real-time displays of brain activity, most commonly electroencephalography, in an attempt to teach self-regulation of brain function. And yes folks, it was life-changing.
Meet Marcia Moran
After successfully building her business over the last twenty-plus years, Marcia Moran thought she had life by the tail. Little did she know what was in store. Marcia has written over fifty business plans, and helped entrepreneurs strategize over how to differentiate their companies in changing environments. After helping other entrepreneurs start their companies, she decided to found her own business consulting practice, Performance Architect, in 2012 and co-founded Positive Business DC that same year.
She suffered a major stroke in 2014. Marcia applied her skills in planning and strategy as she strived to become whole. She never gave up. Over time she learned to walk again, but Marcia struggled with aphasia, a language disorder. She joined Toastmasters International® hoping to regain her speaking abilities. It helped some, but in August 2017 she discovered a technological breakthrough that minimized her speaking disability. She then pushed beyond her comfort zone to become a Toastmasters International Club Officer in 2017, then Area Director in 2019.
Marcia created Stroke FORWARD because she felt there is a need to share hope with stroke survivors and their caretakers. Learning to become her own health advocate one step a time and exploring holistic methods for healing are keys to her recovery. Marcia speaks and shares her message of hope, inspiration, healing, and a way forward as she goes across the country. She welcomes new opportunities to help individuals affected by major health crises move ahead.
Marcia lives with her husband Jim, two very loud cats, and two birds near Washington, DC. Jim played a role of caretaker and advocate. His observations and experiences are also captured in Stroke FORWARD. On weekends, Marcia, Jim, and the cats go to Deep Creek, Maryland where Marcia paints watercolors. In the evening Marcia and Jim sit out on the deck and watch fireflies flit by.
Marcia holds a B.S. in Political Science with a magna cum laude from the University of North Dakota and a Master’s in Business Administration, from Chapman University, in California. A woman of many talents, she attended school in Sandefjord, Norway to study art. She also earned a certificate in Well-being Foundations of Personal Transformation from the Personal Transformation and Courage Institute in Virginia.
Resources
Top 12 Tips for Recovery: https://www.strokeforward.com/bookbonus
Website: www.StrokeForward.com
Facebook: https://www.facebook.com/StrokeForward
Twitter: https://twitter.com/Stroke_Forward
LinkedIn: https://www.linkedin.com/in/marciamoran/
Marcia Moran created Stroke FORWARD to share hope with stroke survivors and caretakers on their journey to recovery. Marcia tells the chilling details of her catastrophic stroke that happened in 2014. We dive into the differences between ischemic and hemorrhagic strokes, and Marcia explains the advantages and disadvantages of administering tPA (tissue plasminogen activator). Marcia also discusses the medical technology that helped her overcome her inability to speak after the stroke (otherwise known as Aphasia). Tune in as Marcia speaks about how to become your own healthcare advocate on your recovery journey.
In This Episode:
- [03:30] Marcia tells the story of her catastrophic stroke that happened in 2014.
- [07:15] The difference between ischemic and hemorrhagic strokes. Plus, the advantages and disadvantages of administering the tPA.
- [10:50] What it is like learning how to talk again after a stroke.
- [16:15] Advice for stroke survivors on becoming their own healthcare advocate.
- [24:40] Marcia gives her last pieces of advice for stroke survivors.
Key Takeaways:
- Eighty percent of strokes are preventable.
- The National Aphasia Association says that if you're not cured within the first two or three months of having aphasia, you will probably have it for life.
- Take your healthcare recovery into your own hands; you are your best advocate.
- Don't ever give up; you can get better as long as you think you can.
Meet Marcia Moran:
After successfully building her business over the last twenty-plus years, Marcia Moran thought she had life by the tail. Little did she know what was in store. Marcia has written over fifty business plans, and helped entrepreneurs strategize over how to differentiate their companies in changing environments. After helping other entrepreneurs start their companies, she decided to found her own business consulting practice, Performance Architect, in 2012 and co-founded Positive Business DC that same year.
She suffered a major stroke in 2014. Marcia applied her skills in planning and strategy as she strived to become whole. She never gave up. Over time she learned to walk again, but Marcia struggled with aphasia, a language disorder. She joined Toastmasters International® hoping to regain her speaking abilities. It helped some, but in August 2017 she discovered a technological breakthrough that minimized her speaking disability. She then pushed beyond her comfort zone to become a Toastmasters International Club Officer in 2017, then Area Director in 2019.
Marcia created Stroke FORWARD because she felt there is a need to share hope with stroke survivors and their caretakers. Learning to become her own health advocate one step a time and exploring holistic methods for healing are keys to her recovery. Marcia speaks and shares her message of hope, inspiration, healing, and a way forward as she goes across the country. She welcomes new opportunities to help individuals affected by major health crises move ahead.
Marcia lives with her husband Jim, two very loud cats, and two birds near Washington, DC. Jim played a role of caretaker and advocate. His observations and experiences are also captured in Stroke FORWARD. On weekends, Marcia, Jim, and the cats go to Deep Creek, Maryland where Marcia paints watercolors. In the evening Marcia and Jim sit out on the deck and watch fireflies flit by.
Marcia holds a B.S. in Political Science with a magna cum laude from the University of North Dakota and a Master’s in Business Administration, from Chapman University, in California. A woman of many talents, she attended school in Sandefjord, Norway to study art. She also earned a certificate in Well-being Foundations of Personal Transformation from the Personal Transformation and Courage Institute in Virginia.
Resources:
Top 12 Tips for Recovery: https://www.strokeforward.com/bookbonus
Website: www.StrokeForward.co
Facebook: https://www.facebook.com/StrokeForward
Twitter: https://twitter.com/Stroke_Forward
LinkedIn: https://www.linkedin.com/in/marciamoran/
Have you ever wondered, how common is sex in long-term care facilities? Well, there’s one thing that we know for sure: it’s not uncommon!
Meet Dr. Nicole Didyk
Dr. Nicole Didyk received her medical degree at McMaster University where she also did her training in Internal Medicine and Geriatrics, and a Masters in Education. She has a busy community Geriatric Medicine practice in Southern Ontario, Canada, and is also the founder of "The Wrinkle", a website and YouTube channel that helps you make the connections you need to age successfully.
Resources
Website: www.TheWrinkle.ca
Facebook: https://www.facebook.com/TheWrinkle2
Twitter: https://twitter.com/TheWrinkle2
LinkedIn: https://www.linkedin.com/in/nicole-didyk-877857182/
YouTube: www.youtube.com/c/TheWrinkle
Instagram:
https://www.instagram.com/thewrinkle2/
When one partner becomes the caregiver for the other, how does that affect the dynamics of a senior's sexual relationship? Join us as Dr. Nicole Didyk, founder of "The Wrinkle," a website and YouTube channel that helps you make the connections you need to age successfully, answers this question.
Meet Dr. Nicole Didyk
Dr. Nicole Didyk received her medical degree at McMaster University where she also did her training in Internal Medicine and Geriatrics, and a Masters in Education. She has a busy community Geriatric Medicine practice in Southern Ontario, Canada, and is also the founder of "The Wrinkle", a website and YouTube channel that helps you make the connections you need to age successfully.
Resources
Website: www.TheWrinkle.ca
Facebook: https://www.facebook.com/TheWrinkle2
Twitter: https://twitter.com/TheWrinkle2
LinkedIn: https://www.linkedin.com/in/nicole-didyk-877857182/
YouTube: www.youtube.com/c/TheWrinkle
Instagram:
https://www.instagram.com/thewrinkle2/
Frankly, aside from the ageism problem in our society, there are also a lot of sexual stereotypes when it comes to sexuality in older adults. We address this problem in this episode with Dr. Nicole Didyk!
Meet Dr. Nicole Didyk
Dr. Nicole Didyk received her medical degree at McMaster University where she also did her training in Internal Medicine and Geriatrics, and a Masters in Education. She has a busy community Geriatric Medicine practice in Southern Ontario, Canada, and is also the founder of "The Wrinkle", a website and YouTube channel that helps you make the connections you need to age successfully.
Resources
Website: www.TheWrinkle.ca
Facebook: https://www.facebook.com/TheWrinkle2
Twitter: https://twitter.com/TheWrinkle2
LinkedIn: https://www.linkedin.com/in/nicole-didyk-877857182/
YouTube: www.youtube.com/c/TheWrinkle
Instagram:
https://www.instagram.com/thewrinkle2/
Dr. Nicole Didyk is the founder of "The Wrinkle," a website and YouTube channel that helps you make the connections you need to age successfully. This episode is all about something that is on everyone's minds but rarely talked about: sex. We have a profound and frank discussion about the ridiculous stereotypes regarding sexuality in older adults. For instance, we talk about the stereotype that older people showing affection is "cute" and "childish" – these thoughts are merely ageist! Plus, we chat about what a sexual relationship can be like with someone who also happens to be a caregiver.
In This Episode:
- [02:40] About Dr. Nicole Didyk.
- [04:55] There is ageism in our society when it comes to sexuality and older adults.
- [07:55] The reasons there should be more awareness about sexuality in the older age group.
- [10:00] How sex will change as people get older.
- [12:40] Often, one partner will become a caregiver for the other. We talk about how this will affect the sexual relationship.
- [18:30] Dr. Nicole Didyk answers this question: how common is sex in long-term care facilities?
- [22:30] Advice for having conversations with your elderly parents about their sex lives.
Key Takeaways:
- When doctors don't ask about sexual health, they won't hear about challenges and miss out on giving seniors comprehensive healthcare.
- High blood pressure, diabetes, and cardiac disease can affect sexual function as well.
- As we get older, some things stay the same regarding sexual health. For instance, the need for connection and the interactions that we have will stay consistent.
- Sometimes you have to take your sexual needs into your own hands.
Meet Dr. Nicole Didyk
Dr. Nicole Didyk received her medical degree at McMaster University where she also did her training in Internal Medicine and Geriatrics, and a Masters in Education. She has a busy community Geriatric Medicine practice in Southern Ontario, Canada, and is also the founder of "The Wrinkle", a website and YouTube channel that helps you make the connections you need to age successfully.
Resources:
Website: www.TheWrinkle.ca
Facebook: https://www.facebook.com/TheWrinkle2
Twitter: https://twitter.com/TheWrinkle2
LinkedIn: https://www.linkedin.com/in/nicole-didyk-877857182/
YouTube: www.youtube.com/c/TheWrinkle
Instagram: https://www.instagram.com/thewrinkle2/
People with Alzheimer's have their visions impaired. And that's where a lot of falls occur. Listen now as Dr. Rein Tideiksaar discusses how can trips to the bathroom be so hazardous.
Meet Dr. Rein Tideiksaar
Rein Tideiksaar Ph.D., PA-C (or Dr Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, NJ, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. Author of textbooks, professional training manuals and director of numerous research projects on fall prevention, Dr Tideiksaar has been active in this field for over 30 years, and has developed fall prevention programs in the community, assisted living, home care, acute care hospital, and nursing facility setting. Dr. Tideiksaar's blogs appear @ecarediary.com, seniorlist.com, and rightathome.net.
Resources
Email Dr. Tideiksaar at drrein@verizon.net
LinkedIn: http://www.linkedin.com/pub/dr-rein/6/759/592
Dr. Tideiksaar is the president of FallPrevent, a consulting company that provides educational, legal, and marketing services related to fall prevention in the elderly. Tune in as we reveal some effective strategies on how you can prevent older adults with Alzheimer's disease from falling.
Meet Dr. Rein Tideiksaar
Rein Tideiksaar Ph.D., PA-C (or Dr Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, NJ, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. Author of textbooks, professional training manuals and director of numerous research projects on fall prevention, Dr Tideiksaar has been active in this field for over 30 years, and has developed fall prevention programs in the community, assisted living, home care, acute care hospital, and nursing facility setting. Dr. Tideiksaar's blogs appear @ecarediary.com, seniorlist.com, and rightathome.net.
Resources
Email Dr. Tideiksaar at drrein@verizon.net
LinkedIn: http://www.linkedin.com/pub/dr-rein/6/759/592
The most significant risk of falling in for people with Alzheimer's disease is cognitive problems. And according to Dr. Rein Tideiksaar, the visual aspects of Alzheimer's disease can also put people at risk of falling in terms of their inability to match and integrate their position with their surrounding environment.
Meet Dr. Rein Tideiksaar
Rein Tideiksaar Ph.D., PA-C (or Dr Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, NJ, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. Author of textbooks, professional training manuals and director of numerous research projects on fall prevention, Dr Tideiksaar has been active in this field for over 30 years, and has developed fall prevention programs in the community, assisted living, home care, acute care hospital, and nursing facility setting. Dr. Tideiksaar's blogs appear @ecarediary.com, seniorlist.com, and rightathome.net.
Resources
Email Dr. Tideiksaar at drrein@verizon.net
LinkedIn: http://www.linkedin.com/pub/dr-rein/6/759/592
Dr. Rein Tideiksaar is the president of FallPrevent, a consulting company that provides educational, legal, and marketing services related to fall prevention in the elderly. Dr. Tideiksaar explains Alzheimer's disease and its connection to falling. Did you know about one-third of older people over the age of 65 will fall four times per year? For people with Alzheimer's disease, the percentage of falls increases by 50%. The most significant risk for falling is cognitive problems. Tune in as we dive into those risk factors, what caregivers can do about those risk factors and the importance of fall prevention evaluations.
In This Episode:
- [03:10] How common falls generally are in the senior and elderly communities due to Alzheimer’s.
- [04:05] Common risk factors among Alzheimer’s patients for falling.
- [07:30] The systemic effects that are part of common injury risk factors.
- [11:45] One of the best things that caregivers can do when taking care of older people.
- [14:30] How to cut down the risk of falling for people with Alzheimer’s.
- [17:00] The importance of finding a geriatric care manager to do a fall prevention evaluation.
- [21:10] Additional strategies to prevent falling for Alzheimer’s patients.
Key Takeaways:
- People living with Alzheimer's who fall are suffering from a cognitive issue such as confusion.
- The visual aspects of Alzheimer's disease can also put people at risk of falling in terms of their inability to match and integrate their position with their surrounding environment.
- Caregivers should observe the person with Alzheimer’s walking around within their environment. That way, they can see how the environment provides safety for them or hinders their safety.
- During the late afternoon, Alzheimer’s patients can be less manageable. Make sure they are taking naps frequently to prevent confusion.
Meet Rein Tideiksaar
Rein Tideiksaar Ph.D., PA-C (or Dr Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, NJ, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. Author of textbooks, professional training manuals and director of numerous research projects on fall prevention, Dr Tideiksaar has been active in this field for over 30 years, and has developed fall prevention programs in the community, assisted living, home care, acute care hospital, and nursing facility setting. Dr. Tideiksaar's blogs appear @ecarediary.com, seniorlist.com and rightathome.net.
Resources
Email Dr. Tideiksaar at drrein@verizon.net
LinkedIn: http://www.linkedin.com/pub/dr-rein/6/759/592
Is misdiagnosis or failure to diagnose cancer medical negligence or malpractice? It depends on the case. Listen as Steve Heisler discusses some real-life cases of cancer diagnosis failures.
To find out more about the National Injured Senior Law Center or to set up a free consultation, go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Medical errors are now the third leading cause of death in the U.S, surpassing respiratory diseases. And according to recent studies, more than 440,000 people die every year due to medical mistakes. Hg.org says diagnosis error affects 20% of the population in the United States.
To find out more about the National Injured Senior Law Center or to set up a free consultation, go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
A recent study by Johns Hopkins asserts that over 250,000 people in the United States die from medical errors every year. Other studies put the number to be more than 440,000. Medical errors are now the third-largest cause of death in the United States, according to the CDC. According to HG.org, diagnosis errors affect 20% of medical cases in the United States. This episode is about some of the issues faced by individuals affected by the failure to diagnose, delayed diagnosis, or the misdiagnosis of cancer.
- Approximately 40,000 cancer patients die annually due to failure to diagnose, misdiagnosis, or delayed diagnosis.
- Is the failure to diagnose and misdiagnosis of cancer considered medical negligence or medical malpractice? It depends on the case.
- In your case of misdiagnosis or failure to diagnose, it may not be clear if the standard of care has been met by a medical professional. However, you should always make sure you talk to a medical malpractice attorney and have it investigated.
- If you have a case for medical malpractice because of a failure to diagnose, misdiagnosis, or delayed diagnosis, that means something really, really bad has happened to you.
- If you are ever skeptical about what a doctor is telling you, then always get that second or third opinion again because you don't want to have a medical malpractice case on your hands.
To find out more about the National Injured Senior Law Center or to set up a free consultation, go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
A study published in The Journal Neurology reveals that older adults who regularly sit in a hot sauna are less likely to suffer a stroke. Listen now to learn more about the ways on reducing risks of suffering from a stroke.
To find out more about the National Injured Senior Law Center or to set up a free consultation, go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Steven was diagnosed with pneumonia 13 years ago. In this episode, he shares how his health condition changed completely after the regular use of sauna and its benefits for stroke fatalities.
To find out more about the National Injured Senior Law Center or to set up a free consultation, go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
In this episode of The Injured Senior Podcast, I explain the devastating impact strokes have on seniors and why the use of saunas can reduce the chance of a stroke. Strokes cause more significant long-term disability than any other disease, and seniors are at higher risk for stroke. Today I share my experience with dry saunas and how I used the sauna to recover from a serious upper respiratory problem I had in the past.
- There are a lot of health problems that regular sauna use can help to prevent.
- Stroke reigns as the fourth leading cause of death in the U.S
- Ischemic stroke is caused by a blood clot or blocked artery leading to the brain.
- A broken blood vessel is usually the cause of Hemorrhagic stroke. This causes bleeding in the brain which leads to problems with speaking, thinking, or walking.
- A study published in The Journal of Neurology says that older adults who regularly sit in a hot sauna are less likely to suffer from a stroke.
- Dry saunas have hot rocks inside where you pour water over it, where it causes to give off dry heat.
To find out more about the National Injured Senior Law Center or to set up a free consultation, go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Join us as Billie Mintz explains what you should do if someone you know is suffering from this type of abuse.
Meet Billie Mintz
Billie Mintz, founder of INNOV8R, is an award-winning filmmaker who has produced and directed seven feature-length documentaries and several narrative short films. Billie has directed numerous award-winning short films, commercials, and social media campaigns that have been screened at over 40 international film festivals. Billie has dedicated his career to social justice, raising public consciousness, and advocating for those who have no voice. His belief in the power of story to inspire policy change is a driving force in his life as a filmmaker.
Resources
Website: www.billiemintz.com
Facebook: www.facebook.com/billiemintz
Imagin8r on Facebook: www.facebook.com/imagin8r
LinkedIn: www.linkedin.com/billiemintz
AAAPG: https://aaapg.net
Billie Mintz, founder of INNOV8R, is an award-winning filmmaker who exposed the professional guardianship industry's filthiness in his film, The Guardians. Tune in as Billie tells us petrifying stories about abusive probate guardianship.
Meet Billie Mintz
Billie Mintz, founder of INNOV8R, is an award-winning filmmaker who has produced and directed seven feature-length documentaries and several narrative short films. Billie has directed numerous award-winning short films, commercials, and social media campaigns that have been screened at over 40 international film festivals. Billie has dedicated his career to social justice, raising public consciousness, and advocating for those who have no voice. His belief in the power of story to inspire policy change is a driving force in his life as a filmmaker.
Resources
Website: www.billiemintz.com
Facebook: www.facebook.com/billiemintz
Imagin8r on Facebook: www.facebook.com/imagin8r
LinkedIn: www.linkedin.com/billiemintz
AAAPG: https://aaapg.net
A guardianship is a legal relationship created when a court appoints an individual to care for an elderly person. On this episode, Billie Mintz explains how it can be a horrifying situation when the guardian takes advantage of stealing every single financial asset that the older adult owns.
Meet Billie Mintz
Billie Mintz, founder of INNOV8R, is an award-winning filmmaker who has produced and directed seven feature-length documentaries and several narrative short films. Billie has directed numerous award-winning short films, commercials, and social media campaigns that have been screened at over 40 international film festivals. Billie has dedicated his career to social justice, raising public consciousness, and advocating for those who have no voice. His belief in the power of story to inspire policy change is a driving force in his life as a filmmaker.
Resources
Website: www.billiemintz.com
Facebook: www.facebook.com/billiemintz
Imagin8r on Facebook: www.facebook.com/imagin8r
LinkedIn: www.linkedin.com/billiemintz
AAAPG: https://aaapg.net
Billie Mintz is a documentary filmmaker who exposed the professional guardianship industry's corruption in his film, The Guardians. Guardianship is a legal relationship created for an older adult who can no longer care for himself or herself. Unfortunately, guardianship can go wrong when the guardian decides to take advantage of the older person. Tune in as Billie tells stories about abusive probate guardianship. Plus, we talk about which states abusive probate guardianship is most likely to happen in and what are some things that you can do to combat it.
In This Episode:
- [02:00] About Billie Mintz. Billie explains what guardianship means.
- [05:45] What guardian abuse can look like.
- [09:40] The types of calls that Billie gets about his documentary.
- [13:50] Billie tells stories about people who are actively in trouble right now with abusive guardianship.
- [21:50] What’s next for Billie.
Key Takeaways:
- Guardianship is a legal relationship created when a court appoints an individual to care for an elderly person who is no longer able to care for himself or herself.
- Guardian abuse happens when the Guardian takes advantage of the Ward and often pilfers all of the financial assets that the person has.
- Florida, Arizona, New York, Michigan, and Pennsylvania are all hot spots for corrupt guardianship; pay extra attention in these states.
- American Against Abusive Probate Guardianship (AAAPG), was founded by Dr. Sam J Sugar. AAAPG has been at the national forefront of focusing attention on the plight of guardianship abuse victims.
Meet Billie Mintz
Billie Mintz, founder of INNOV8R, is an award winning filmmaker who has produced and directed seven feature length documentaries and several narrative short films. Billie has directed numerous award-winning short films, commercials, and social media campaigns that have been screened at over 40 international film festivals. Billie has dedicated his career to social justice, raising public consciousness, and advocating for those who have no voice. His belief in the power of story to inspire policy change is a driving force in his life as a filmmaker.
Resources
Website: www.billiemintz.com
Facebook: www.facebook.com/billiemintz
Imagin8r on Facebook: www.facebook.com/imagin8r
LinkedIn: www.linkedin.com/billiemintz
AAAPG: https://aaapg.net
Hospital infections are definitely a serious, significant problem especially in the elderly and aging population communities. According to a study done by the National Institute of Health, the risk of developing a healthcare-associated infection increases with age. Join Steven Heisler on the newest episode of The Injured Senior Podcast as he shares the 14 ways to reduce your chance of getting hospital infection.
- Ask the hospital staff to clean their hands before treating you and ask visitors to do the same.
- Before your doctor uses a stethoscope on you, ask them to wipe the diaphragm with alcohol.
- If you are required to have a central line catheter, ask your doctor about the benefits of a central line catheter that is antibiotic-impregnated or silver chlorohexidine-coated to reduce infection.
- If you need surgery, choose a doctor with a low infection rate.
- Three to five days before your surgery, shower or bathe daily with chlorhexidine soap.
- Ask your doctor to have you tested for Methicillin-resistant Staphylococcus aureus or MRSA.
- Stop smoking long before you have surgery.
- On the day of surgery, remind your doctor that you may need an antibiotic one hour before the first incision.
- Ask your doctor to keep you warm during the surgery.
- Do not shave the surgical site.
- Avoid touching your mouth and do not set food or utensils on furniture or bedsheets.
- Ask your doctor to monitor your glucose levels.
- Avoid a urinary tract catheter if possible.
- If you must have an IV, make sure that it's inserted and removed under clean and sanitary conditions and changed every three to four hours.
The 14 tips are courtesy of the Committee To Reduce Infection Deaths: www.hospitalinfection.org
To find out more about the National Injured Senior Law Center or to set up a free consultation, go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
It’s essential that you are aware of the four elements necessary to have a viable medical malpractice claim. Listen as Steven Heisler reveals these four elements in this episode.
To find out more about the National Injured Senior Law Center or to set up a free consultation, go to https://www.injuredseniorhotline.com/ or call 855-622-6530.
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Medical experts revealed that over 250,000 individuals in the United States died as a result of medical mistakes. We have a crisis in our healthcare system. Listen to our latest episode as Steven Heisler discusses medical errors in the United States.
To find out more about the National Injured Senior Law Center or to set up a free consultation, go to https://www.injuredseniorhotline.com/ or call 855-622-6530.
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Medical errors are the third leading cause of death in the United States. We have a crisis in our healthcare system. It’s essential that you are aware of the four elements necessary to have a viable medical malpractice claim:
- A legal duty must exist between a healthcare provider and the patient.
- Show that the legal duty has been breached.
- Show that the breach of duty by the doctor resulted in an injury to the patient.
- Damages: there has to be a catastrophic injury in order to have a winnable case and meet the damage requirements.
To find out more about the National Injured Senior Law Center or to set up a free consultation, go to https://www.injuredseniorhotline.com/ or call 855-622-6530.
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Financial exploitation is growing in the older community; it’s the second most common form of elder abuse. Tune in as Dr. Peter Lichenberg tells us how to minimize the elder senior's risk of financial exploitation.
Meet Dr. Peter Lichtenberg
Peter A. Lichtenberg, Ph.D., ABPP is the Director of The Institute of Gerontology and the Merrill Palmer Skillman Institute. He is also a Professor of Psychology at Wayne State University. He received his bachelor’s degree from Washington University in St. Louis, and his master’s and doctorate in Clinical Psychology from Purdue University.
After his internship he completed a post-doctoral fellowship in geriatric neuropsychology at the University of Virginia Medical School where he also became a faculty member. A clinician and researcher throughout his career Dr. Lichtenberg, one of the first board certified Clinical Geropsychologists in the nation, has made contributions to the practice of psychology across a variety of areas including in Alzheimer’s disease, medical rehabilitation and with those suffering from late life depression.
He is particularly interested in the area of intersection between financial capacity and financial exploitation; finding ways to balance autonomy and protection for older adults. His work in this area led him to be a contributor to the 2008 Assessment of Diminished Capacity of Older Adults: A Handbook for Psychologists published jointly by the American Bar and American Psychological Associations. In 2013 he published the first nationally representative study on predictors of older adult scam victims.
In 2015 he published the Lichtenberg Financial Decision Making Rating Scale, and the Lichtenberg Financial Decision Screening Scale, and has contributed several empirical studies on the scales since then. These tools can be used to assess major financial decisions and/or transactions of older adults. He has authored 7 books and over 190 scientific articles in Geropsychology including being the senior editor for the American Psychological Association’s Handbook of Clinical Geropsychology.
Resources:
Email: p.lichtenberg@wayne.edu
Website: https://olderadultnestegg.com
Facebook: https://www.facebook.com/iog.wayne/
Twitter: https://twitter.com/IOGWSU
LinkedIn: https://www.linkedin.com/in/peter-lichtenberg-0aaa932/
In this episode, Dr. Peter shares how seniors can avoid financial exploitation and what happens after your loved one falls prey to a scam.
Meet Dr. Peter Lichtenberg
Peter A. Lichtenberg, Ph.D., ABPP is the Director of The Institute of Gerontology and the Merrill Palmer Skillman Institute. He is also a Professor of Psychology at Wayne State University. He received his bachelor’s degree from Washington University in St. Louis, and his master’s and doctorate in Clinical Psychology from Purdue University.
After his internship he completed a post-doctoral fellowship in geriatric neuropsychology at the University of Virginia Medical School where he also became a faculty member. A clinician and researcher throughout his career Dr. Lichtenberg, one of the first board certified Clinical Geropsychologists in the nation, has made contributions to the practice of psychology across a variety of areas including in Alzheimer’s disease, medical rehabilitation and with those suffering from late life depression.
He is particularly interested in the area of intersection between financial capacity and financial exploitation; finding ways to balance autonomy and protection for older adults. His work in this area led him to be a contributor to the 2008 Assessment of Diminished Capacity of Older Adults: A Handbook for Psychologists published jointly by the American Bar and American Psychological Associations. In 2013 he published the first nationally representative study on predictors of older adult scam victims.
In 2015 he published the Lichtenberg Financial Decision Making Rating Scale, and the Lichtenberg Financial Decision Screening Scale, and has contributed several empirical studies on the scales since then. These tools can be used to assess major financial decisions and/or transactions of older adults. He has authored 7 books and over 190 scientific articles in Geropsychology including being the senior editor for the American Psychological Association’s Handbook of Clinical Geropsychology.
Resources:
Email: p.lichtenberg@wayne.edu
Website: https://olderadultnestegg.com
Facebook: https://www.facebook.com/iog.wayne/
Twitter: https://twitter.com/IOGWSU
LinkedIn: https://www.linkedin.com/in/peter-lichtenberg-0aaa932/
Financial exploitation is considered a form of elder mistreatment; the person abuses the trust of the senior and abuses or misleads the older adult into a scam. Listen to our newest episode as Dr. Peter explains what financial exploitation is for seniors.
Meet Dr. Peter Lichtenberg
Peter A. Lichtenberg, Ph.D., ABPP is the Director of The Institute of Gerontology and the Merrill Palmer Skillman Institute. He is also a Professor of Psychology at Wayne State University. He received his bachelor’s degree from Washington University in St. Louis, and his master’s and doctorate in Clinical Psychology from Purdue University.
After his internship he completed a post-doctoral fellowship in geriatric neuropsychology at the University of Virginia Medical School where he also became a faculty member. A clinician and researcher throughout his career Dr. Lichtenberg, one of the first board certified Clinical Geropsychologists in the nation, has made contributions to the practice of psychology across a variety of areas including in Alzheimer’s disease, medical rehabilitation and with those suffering from late life depression.
He is particularly interested in the area of intersection between financial capacity and financial exploitation; finding ways to balance autonomy and protection for older adults. His work in this area led him to be a contributor to the 2008 Assessment of Diminished Capacity of Older Adults: A Handbook for Psychologists published jointly by the American Bar and American Psychological Associations. In 2013 he published the first nationally representative study on predictors of older adult scam victims.
In 2015 he published the Lichtenberg Financial Decision Making Rating Scale, and the Lichtenberg Financial Decision Screening Scale, and has contributed several empirical studies on the scales since then. These tools can be used to assess major financial decisions and/or transactions of older adults. He has authored 7 books and over 190 scientific articles in Geropsychology including being the senior editor for the American Psychological Association’s Handbook of Clinical Geropsychology.
Resources:
Email: p.lichtenberg@wayne.edu
Website: https://olderadultnestegg.com
Facebook: https://www.facebook.com/iog.wayne/
Twitter: https://twitter.com/IOGWSU
LinkedIn: https://www.linkedin.com/in/peter-lichtenberg-0aaa932/
There is nothing more despicable than the exploitation of the aging population. Elder abuse occurs in many forms, including financial exploitation. That's why I have Peter A. Lichtenberg, Ph.D., ABPP, join the show. He is the Director of The Institute of Gerontology and the Merrill Palmer Skillman Institute. In this episode, we discuss the financial exploitation of seniors and the elderly. Tune in as Dr. Peter reveals the risk factors for elder financial exploitation. Plus, we speak about how seniors can avoid financial exploitation and what happens after your loved one falls prey to a scam.
In This Episode:
- [03:00] Meet Dr. Peter A. Lichtenberg. Dr. Peter explains what financial exploitation is for seniors.
- [07:00] Risk factors for elder financial exploitation.
- [16:00] How Dr. Peter helps seniors avoid financial exploitation.
- [21:55] About the financial exploitation survey – find out if you are at enhanced vulnerability.
- [26:35] How to intervene when financial exploitation is taking place.
- [30:40] Why you need to have a difficult conversation with your loved ones.
Key Takeaways:
- Financial abuse and exploitation account for thirty-six billion dollars in losses to seniors.
- Financial exploitation is considered a form of elder mistreatment; the person abuses the trust of the senior and abuses or misleads the older adult into a scam.
- Financial exploitation is growing in the older community; it’s the second most common form of elder abuse.
- Psychological vulnerability is a significant risk factor for elder financial exploitation.
Meet Dr. Peter A. Lichtenberg
Peter A. Lichtenberg, Ph.D., ABPP is the Director of The Institute of Gerontology and the Merrill Palmer Skillman Institute. He is also a Professor of Psychology at Wayne State University. He received his bachelor’s degree from Washington University in St. Louis, and his master’s and doctorate in Clinical Psychology from Purdue University.
After his internship he completed a post-doctoral fellowship in geriatric neuropsychology at the University of Virginia Medical School where he also became a faculty member. A clinician and researcher throughout his career Dr. Lichtenberg, one of the first board certified Clinical Geropsychologists in the nation, has made contributions to the practice of psychology across a variety of areas including in Alzheimer’s disease, medical rehabilitation and with those suffering from late life depression.
He is particularly interested in the area of intersection between financial capacity and financial exploitation; finding ways to balance autonomy and protection for older adults. His work in this area led him to be a contributor to the 2008 Assessment of Diminished Capacity of Older Adults: A Handbook for Psychologists published jointly by the American Bar and American Psychological Associations. In 2013 he published the first nationally representative study on predictors of older adult scam victims.
In 2015 he published the Lichtenberg Financial Decision Making Rating Scale, and the Lichtenberg Financial Decision Screening Scale, and has contributed several empirical studies on the scales since then. These tools can be used to assess major financial decisions and/or transactions of older adults. He has authored 7 books and over 190 scientific articles in Geropsychology including being the senior editor for the American Psychological Association’s Handbook of Clinical Geropsychology.
Martha says that increasing age drive up the risk of diabetes if you've had poor exercise and poor nutrition throughout your lifespan. The more years you combine poor habits, the greater, the likelihood that you will develop diabetes.
Meet Martha Kelso
Martha Kelso is the founder and Chief Executive Officer of Wound Care Plus, LLC, the largest mobile wound care provider in the Midwest.
With over 20 years’ experience in advanced wound care, Kelso is a visionary and entrepreneur in the field of mobile medicine. “We identified a pressing need for access to high-quality wound management across the entire continuum of care.” This is what motivated her to establish Wound Care Plus. Their skilled and caring wound specialists use innovative products and cutting-edge technology to treat individuals with wound or skin issues at almost any site of care. They pride themselves on bringing advanced wound care and clinical excellence, supported by evidence-based medicine, to clients and caregivers alike.
And they don’t stop at wound prevention and treatment. Kelso and her team have a relentless passion for education as a vehicle to elevate the art and science of wound healing. They have educated thousands of health care professionals and caregivers, not just on the practicalities of wound care, but also on federal regulations and national guidelines. “This pragmatic approach to wound care education paired with our holistic treatment methodology has positioned Wound Care Plus as an industry leader.”
Kelso is a published author and a member of several national advisory boards. She is frequently called upon as a legal expert witness and has been a featured speaker at more than 300 educational events. She is currently the Principal Investigator for a CMS funded Clinical Research study on the efficacy of Platelet Rich Plasma. Kelso is widely recognized as being a pioneer in the advanced wound care arena who works tirelessly to shape the future landscape of healthcare.
Resources:
Wound Care Plus: https://mywoundcareplus.com
CDC: https://www.cdc.gov
ADA: https://www.diabetes.org
Wound Care Plus on Instagram: https://www.instagram.com/woundcareplus/
Wound Care Plus on Twitter: https://twitter.com/mywoundcareplus
Wound Care Plus on LinkedIn: https://www.linkedin.com/company/wound-care-plus-llc/
Wound Care Plus on Facebook: https://www.facebook.com/woundcareplusllc/
Managing blood sugars is amazing because it helps ward off issues; however, it still doesn’t protect you from the long-term devastating effects of diabetes. Listen to our newest episode as Martha explains how glycemic control can halt diabetes.
Meet Martha Kelso
Martha Kelso is the founder and Chief Executive Officer of Wound Care Plus, LLC, the largest mobile wound care provider in the Midwest.
With over 20 years’ experience in advanced wound care, Kelso is a visionary and entrepreneur in the field of mobile medicine. “We identified a pressing need for access to high-quality wound management across the entire continuum of care.” This is what motivated her to establish Wound Care Plus. Their skilled and caring wound specialists use innovative products and cutting-edge technology to treat individuals with wound or skin issues at almost any site of care. They pride themselves on bringing advanced wound care and clinical excellence, supported by evidence-based medicine, to clients and caregivers alike.
And they don’t stop at wound prevention and treatment. Kelso and her team have a relentless passion for education as a vehicle to elevate the art and science of wound healing. They have educated thousands of health care professionals and caregivers, not just on the practicalities of wound care, but also on federal regulations and national guidelines. “This pragmatic approach to wound care education paired with our holistic treatment methodology has positioned Wound Care Plus as an industry leader.”
Kelso is a published author and a member of several national advisory boards. She is frequently called upon as a legal expert witness and has been a featured speaker at more than 300 educational events. She is currently the Principal Investigator for a CMS funded Clinical Research study on the efficacy of Platelet Rich Plasma. Kelso is widely recognized as being a pioneer in the advanced wound care arena who works tirelessly to shape the future landscape of healthcare.
Resources:
Wound Care Plus: https://mywoundcareplus.com
CDC: https://www.cdc.gov
ADA: https://www.diabetes.org
Wound Care Plus on Instagram: https://www.instagram.com/woundcareplus/
Wound Care Plus on Twitter: https://twitter.com/mywoundcareplus
Wound Care Plus on LinkedIn: https://www.linkedin.com/company/wound-care-plus-llc/
Wound Care Plus on Facebook: https://www.facebook.com/woundcareplusllc/
In this episode, Martha Kelso, founder and Chief Executive Officer of Wound Care Plus, LLC, explains to us how diabetes can affect wounds.
Meet Martha Kelso
Martha Kelso is the founder and Chief Executive Officer of Wound Care Plus, LLC, the largest mobile wound care provider in the Midwest.
With over 20 years’ experience in advanced wound care, Kelso is a visionary and entrepreneur in the field of mobile medicine. “We identified a pressing need for access to high-quality wound management across the entire continuum of care.” This is what motivated her to establish Wound Care Plus. Their skilled and caring wound specialists use innovative products and cutting-edge technology to treat individuals with wound or skin issues at almost any site of care. They pride themselves on bringing advanced wound care and clinical excellence, supported by evidence-based medicine, to clients and caregivers alike.
And they don’t stop at wound prevention and treatment. Kelso and her team have a relentless passion for education as a vehicle to elevate the art and science of wound healing. They have educated thousands of health care professionals and caregivers, not just on the practicalities of wound care, but also on federal regulations and national guidelines. “This pragmatic approach to wound care education paired with our holistic treatment methodology has positioned Wound Care Plus as an industry leader.”
Kelso is a published author and a member of several national advisory boards. She is frequently called upon as a legal expert witness and has been a featured speaker at more than 300 educational events. She is currently the Principal Investigator for a CMS funded Clinical Research study on the efficacy of Platelet Rich Plasma. Kelso is widely recognized as being a pioneer in the advanced wound care arena who works tirelessly to shape the future landscape of healthcare.
Resources:
Wound Care Plus: https://mywoundcareplus.com
CDC: https://www.cdc.gov
ADA: https://www.diabetes.org
Wound Care Plus on Instagram: https://www.instagram.com/woundcareplus/
Wound Care Plus on Twitter: https://twitter.com/mywoundcareplus
Wound Care Plus on LinkedIn: https://www.linkedin.com/company/wound-care-plus-llc/
Wound Care Plus on Facebook: https://www.facebook.com/woundcareplusllc/
34.2 million Americans have diabetes, and 88 million people in the United States have prediabetes. Diabetes often goes unrecognized, and people can live and have diabetes with little to no symptoms. When someone’s vision or kidneys fail, that’s when people finally understand that they have the condition. Martha Kelso, founder and CEO of Wound Care Plus, LLC., jumps into how diabetes can affect wounds. Amputation is fifteen to forty times greater for people with diabetes. Plus, people who have diabetes often end up with strokes, heart attacks, and other significant issues. Tune in as we talk about the importance of glycemic control, the foods to avoid, and different ways seniors can positively adjust their lifestyles.
In This Episode:
- [03:30] Meet Martha Kelso. Martha explains why diabetes is such a killer.
- [07:00] How diabetes can affect wounds.
- [10:35] About glycemic control and the foods that you should avoid.
- [16:30] Why seniors may be at risk for developing diabetes.
- [21:30] The correlation between poor glycemic control and cognition.
- [23:55] The types of exercise to do
Key Takeaways:
- The symptoms of diabetes are easily brushed off as something else; that’s why it goes undiagnosed for so long.
- Unmanaged diabetes will negatively impact the microvascular blood flow.
- Managing blood sugars is amazing because it helps ward off issues; however, it still doesn’t protect you from the long-term devasting effects of diabetes.
- Managing blood sugars is imperative so our cells can be healthy and use glucose as energy for our body.
- If you’re diabetic, follow the diet prescribed by your doctor and learn how to count carbs.
Meet Martha Kelso
Martha Kelso is the founder and Chief Executive Officer of Wound Care Plus, LLC, the largest mobile wound care provider in the Midwest.
With over 20 years’ experience in advanced wound care, Kelso is a visionary and entrepreneur in the field of mobile medicine. “We identified a pressing need for access to high quality wound management across the entire continuum of care.” This is what motivated her to establish Wound Care Plus. Their skilled and caring wound specialists use innovative products and cutting-edge technology to treat individuals with wound or skin issues at almost any site of care. They pride themselves on bringing advanced wound care and clinical excellence, supported by evidenced-based medicine, to clients and caregivers alike.
And they don’t stop at wound prevention and treatment. Kelso and her team have a relentless passion for education as a vehicle to elevate the art and science of wound healing. They have educated thousands of health care professionals and caregivers, not just on the practicalities of wound care, but also on federal regulations and national guidelines. “This pragmatic approach to wound care education paired with our holistic treatment methodology has positioned Wound Care Plus as an industry leader.”
Kelso is a published author and a member of several national advisory boards. She is frequently called upon as a legal expert witness and has been a featured speaker at more than 300 educational events. She is currently the Principal Investigator for a CMS funded Clinical Research study on the efficacy of Platelet Rich Plasma. Kelso is widely recognized as being a pioneer in the advanced wound care arena who works tirelessly to shape the future landscape of health care.
Resources:
Wound Care Plus: https://mywoundcareplus.com
CDC: https://www.cdc.gov
ADA: https://www.diabetes.org
Wound Care Plus on Instagram: https://www.instagram.com/woundcareplus/
Wound Care Plus on Twitter: https://twitter.com/mywoundcareplus
Wound Care Plus on LinkedIn: https://www.linkedin.com/company/wound-care-plus-llc/
Wound Care Plus on Facebook: https://www.facebook.com/woundcareplusllc/
According to Dr. Janet Stout, an infectious disease microbiologist, twenty percent of people who get the Legionnaire’s disease will die from it. Legionella bacteria are found in warm water. The most significant contributions come from cooling towers, hot tubs, decorative water features, faucets, and showers. Fifty percent of buildings have Legionella bacteria in them. Visit SpecialPathogensLab.com and Special Pathogens Lab on Facebook.
Meet Dr. Janet E. Stout
Dr. Janet E. Stout is president and director of Special Pathogens Laboratory, and research associate professor at the University of Pittsburgh Swanson School of Engineering in the Department of Civil and Environmental Engineering. An infectious disease microbiologist, Dr. Stout is recognized worldwide for seminal discoveries and pioneering research in Legionella. Her expertise includes prevention and control strategies for Legionnaires’ disease in building water systems. Dr. Stout’s more than 30 years of research is published in peer-reviewed medical and scientific journals. She also has authored textbook chapters on Legionella and Legionnaires’ disease, including the Legionella chapter in the APIC Text. An advocate for prevention, Dr. Stout assisted in developing the first Legionella prevention guideline (1993) in the United States, which continues to serve as a model for national and global health agencies and organizations. Additionally, she serves on the ASHRAE Legionella standard committee for Legionella Guideline 12 and the SPC 188 committee for ANSI / ASHRAE Standard 188-2015 Legionellosis: Risk Management for Building Water Systems, the first U. S. standard for Legionella risk management. She is the first certified instructor of the ASSE 12080 Legionella Water Safety and Management Specialist Certification training.
Connect with Dr. Janet E. Stout
Website: www.specialpathogenslab.com
Facebook: https://www.facebook.com/specialpathogenslab
Twitter: https://twitter.com/specialpathlab
Linkedin: https://www.linkedin.com/in/janet-e-stout-ph-d-32607612
Senior folks are at a greater risk for getting Legionnaires’ disease; treatment is effective if started early, so make sure to advocate for yourself.
Meet Dr. Janet E. Stout
Dr. Janet E. Stout is president and director of Special Pathogens Laboratory, and research associate professor at the University of Pittsburgh Swanson School of Engineering in the Department of Civil and Environmental Engineering. An infectious disease microbiologist, Dr. Stout is recognized worldwide for seminal discoveries and pioneering research in Legionella. Her expertise includes prevention and control strategies for Legionnaires’ disease in building water systems. Dr. Stout’s more than 30 years of research is published in peer-reviewed medical and scientific journals. She also has authored textbook chapters on Legionella and Legionnaires’ disease, including the Legionella chapter in the APIC Text. An advocate for prevention, Dr. Stout assisted in developing the first Legionella prevention guideline (1993) in the United States, which continues to serve as a model for national and global health agencies and organizations. Additionally, she serves on the ASHRAE Legionella standard committee for Legionella Guideline 12 and the SPC 188 committee for ANSI / ASHRAE Standard 188-2015 Legionellosis: Risk Management for Building Water Systems, the first U. S. standard for Legionella risk management. She is the first certified instructor of the ASSE 12080 Legionella Water Safety and Management Specialist Certification training.
Connect with Dr. Janet E. Stout
Website: www.specialpathogenslab.com
Facebook: https://www.facebook.com/specialpathogenslab
Twitter: https://twitter.com/specialpathlab
Linkedin: https://www.linkedin.com/in/janet-e-stout-ph-d-32607612
Dr. Janet E. Stout is an infectious disease microbiologist; Dr. Stout is recognized worldwide for seminal discoveries and pioneering research in Legionella. Discover what is Legionnaire’s Disease on our latest episode!
Meet Dr. Janet E. Stout
Dr. Janet E. Stout is president and director of Special Pathogens Laboratory and a research associate professor at the University of Pittsburgh Swanson School of Engineering in the Department of Civil and Environmental Engineering. An infectious disease microbiologist, Dr. Stout is recognized worldwide for seminal discoveries and pioneering research in Legionella. Her expertise includes prevention and control strategies for Legionnaires’ disease in building water systems. Dr. Stout’s more than 30 years of research is published in peer-reviewed medical and scientific journals. She also has authored textbook chapters on Legionella and Legionnaires’ disease, including the Legionella chapter in the APIC Text. An advocate for prevention, Dr. Stout assisted in developing the first Legionella prevention guideline (1993) in the United States, which continues to serve as a model for national and global health agencies and organizations. Additionally, she serves on the ASHRAE Legionella standard committee for Legionella Guideline 12 and the SPC 188 committee for ANSI / ASHRAE Standard 188-2015 Legionellosis: Risk Management for Building Water Systems, the first U. S. standard for Legionella risk management. She is the first certified instructor of the ASSE 12080 Legionella Water Safety and Management Specialist Certification training.
Connect with Dr. Janet E. Stout
Website: www.specialpathogenslab.com
Facebook: https://www.facebook.com/specialpathogenslab
Twitter: https://twitter.com/specialpathlab
Linkedin: https://www.linkedin.com/in/janet-e-stout-ph-d-32607612
Dr. Janet E. Stout is an infectious disease microbiologist; Dr. Stout is recognized worldwide for seminal discoveries and pioneering research in Legionella. Dr. Stout explains why getting a Legionnaires’ disease diagnosis is challenging. Unfortunately, twenty percent of people who get the disease will die from it. Legionella bacteria are found in warm water. The most significant contributions come from cooling towers, hot tubs, decorative water features, faucets, and showers. Fifty percent of buildings have Legionella bacteria in them. Tune in as Dr. Stout explains the importance of getting tested for Legionnaires’ disease, where the hotbeds for Legionella bacteria are, and why seniors are the canary in the coal mine when it comes to Legionella exposure.
In This Episode:
- [03:10] Meet Dr. Janet E. Stout. Dr. Stout explains her passion for special pathogens.
- [05:45] About Legionnaires’ disease and where the Legionella bacteria is found.
- [11:20] How many cases of Legionnaires’ disease are documented in the United States.
- [14:00] Certain areas that are considered hotbeds for Legionnaires’ disease.
- [19:25] How to advocate to your local politicians about Legionella bacteria.
- [24:05] Why you are less likely to have Legionella bacteria in your home.
Key Takeaways:
- The common symptoms of Legionnaires’ disease is a lower fever, cough, and diarrhea.
- If a physician thinks you have pneumonia, get tested for Legionnaires’ disease, and get an antibiotic as soon as possible.
- Hotels are a place where we can be exposed to Legionella bacteria.
- Senior folks are at a greater risk for getting Legionnaires’ disease; treatment is effective if started early, so make sure to advocate for yourself.
- Seniors are the canary in the coal mine for hospitals because there is no requirement to test hospitals for Legionella bacteria.
Meet Dr. Janet E. Stout
Dr. Janet E. Stout is president and director of Special Pathogens Laboratory, and research associate professor at the University of Pittsburgh Swanson School of Engineering in the Department of Civil and Environmental Engineering. An infectious disease microbiologist, Dr. Stout is recognized worldwide for seminal discoveries and pioneering research in Legionella. Her expertise includes prevention and control strategies for Legionnaires’ disease in building water systems. Dr. Stout’s more than 30 years of research is published in peer-reviewed medical and scientific journals. She also has authored textbook chapters on Legionella and Legionnaires’ disease, including the Legionella chapter in the APIC Text. An advocate for prevention, Dr. Stout assisted in developing the first Legionella prevention guideline (1993) in the United States, which continues to serve as a model for national and global health agencies and organizations. Additionally, she serves on the ASHRAE Legionella standard committee for Legionella Guideline 12 and the SPC 188 committee for ANSI / ASHRAE Standard 188-2015 Legionellosis: Risk Management for Building Water Systems, the first U. S. standard for Legionella risk management. She is the first certified instructor of the ASSE 12080 Legionella Water Safety and Management Specialist Certification training.
Connect with Dr. Janet E. Stout:
Website: www.specialpathogenslab.com
Facebook: https://www.facebook.com/specialpathogenslab
Twitter: https://twitter.com/specialpathlab
Linkedin: https://www.linkedin.com/in/janet-e-stout-ph-d-32607612
Suppose you’re within six feet of someone for longer than fifteen minutes without a mask. In that case, your risk of acquiring the virus from another person is pretty significant. Tune in as Dr. John Cascone reveals why so many people in nursing homes are coming down with Covid.
Meet Dr. John Cascone
John Cascone is a board-certified internal medicine and infectious disease physician. His internal medicine residency was done at the University of Kansas and infectious disease fellowship at the University of Missouri-Columbia. He is the medical director of nursing homes in southwest Missouri. His medical practice includes the care of residents in long-term care facilities, infectious disease consultations, and telemedicine infectious disease services to rural facilities. He has a special interest in the diagnosis and treatment of sepsis, Clostridium difficile colitis, Staphylococcus aureus bacteremia, antimicrobial stewardship, and pressure ulcers. He lives in Joplin, Missouri with his family.
LinkedIn: https://www.linkedin.com/in/john-cascone-m-d-a43283a1/
Comorbid conditions increase the elderly’s risk of having a bad outcome from Covid-19. Listen to the episode for more information on the statistics around Covid-19 and health with our guest Dr. John Cascone, board-certified internal medicine and infectious disease physician.
Meet Dr. John Cascone
John Cascone is a board-certified internal medicine and infectious disease physician. His internal medicine residency was done at the University of Kansas and infectious disease fellowship at the University of Missouri-Columbia. He is the medical director of nursing homes in southwest Missouri. His medical practice includes the care of residents in long-term care facilities, infectious disease consultations, and telemedicine infectious disease services to rural facilities. He has a special interest in the diagnosis and treatment of sepsis, Clostridium difficile colitis, Staphylococcus aureus bacteremia, antimicrobial stewardship, and pressure ulcers. He lives in Joplin, Missouri with his family.
LinkedIn:
https://www.linkedin.com/in/john-cascone-m-d-a43283a1/
As of 2020, the number one health crisis in America is Covid-19. According to the CDC, eight out of ten Covid-19 deaths have been adults sixty-five years or older.
Meet Dr. John Cascone
John Cascone is a board-certified internal medicine and infectious disease physician. His internal medicine residency was done at the University of Kansas and infectious disease fellowship at the University of Missouri-Columbia. He is the medical director of nursing homes in southwest Missouri. His medical practice includes the care of residents in long-term care facilities, infectious disease consultations, and telemedicine infectious disease services to rural facilities. He has a special interest in the diagnosis and treatment of sepsis, Clostridium difficile colitis, Staphylococcus aureus bacteremia, antimicrobial stewardship, and pressure ulcers. He lives in Joplin, Missouri with his family.
LinkedIn: https://www.linkedin.com/in/john-cascone-m-d-a43283a1/
The number one health crisis in America is Covid-19. According to the CDC, eight out of ten Covid-19 deaths have been adults sixty-five years or older. The elderly have more comorbid conditions, which increases their risk of having a bad outcome from Covid. The most dangerous risk factors are hypertension, cardiovascular disease, and obesity. The people who are long-haulers will suffer symptoms long-term. Over half of the patients with Covid will have fatigue, shortness of breath, coughing, and joint pains. Close to forty percent of those patients will return to baseline three weeks later. A long-hauler will have brain fog, and the symptoms will drag on. Tune in as Dr. John Cascone reveals why so many people in nursing homes are coming down with Covid.
In This Episode
- [06:20] Meet Dr. John Cascone. Dr. John speaks about the unique circumstances of the coronavirus pandemic.
- [11:25] Factors that make Covid especially risky.
- [14:00] What seniors can expect to experience as a long-hauler.
- [16:20] What happens when a patient gets intubated for Covid-19.
- [17:45] Why so many people in nursing homes are coming down with Covid.
- [22:50] About the treatments that people are receiving for Covid and how close we are to a vaccine.
Key Takeaways
- If you are 80+ years of age, your risk of dying of Covid is 15%. If you compare that to a 20-year-old, their risk of dying is 0.2%.
- Hypertension, obesity, and cardiovascular disease are the most prominent risk factors that will give someone a bad outcome from Covid.
- Once a patient gets intubated for Covid-19, the mortality starts to go up astronomically.
- Suppose you’re within six feet of someone for longer than fifteen minutes without a mask. In that case, your risk of acquiring the virus from another person is pretty significant.
- We can expect the vaccine data to come out in early December. We can expect distribution after the first of the year.
Meet Dr. John Cascone
John Cascone is a board-certified internal medicine and infectious disease physician. His internal medicine residency was done at the University of Kansas and infectious disease fellowship at the University of Missouri-Columbia. He is the medical director of nursing homes in southwest Missouri. His medical practice includes the care of residents in long-term care facilities, infectious disease consultations, and telemedicine infectious disease services to rural facilities. He has a special interest in the diagnosis and treatment of sepsis, Clostridium difficile colitis, Staphylococcus aureus bacteremia, antimicrobial stewardship, and pressure ulcers. He lives in Joplin, Missouri with his family.
Connect with Dr. John Cascone:
LinkedIn: https://www.linkedin.com/in/john-cascone-m-d-a43283a1/
CONNECT WITH STEVE H. HEISLER:
Website: https://www.injuredseniorhotline.com/
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
COVID-19 has made caregiving all the more complicated. Unfortunately, people who need caregiving are becoming more isolated than ever. The more human contact a patient gets, the better the quality of life they have.
Meet Roz Jones:
Rosalind Marshall-Jones is an innovative speaker with more than fifteen years of progressive experience as an entrepreneur and leader in the caregiving industry. Rosalind has an extensive medical background that afforded her the opportunity to see the gap and need for quality care. As a seasoned health care provider, Rosalind built upon her strong medical foundation, by opening Jacksonville’s Best Caregivers, an organization that provides short and long-term health care.
Website: https://thecaregivercafe.net/?fbclid=IwAR2XTXxWg0GvhIeXAEVNedsg3QsWlU1gKeAaT_zjFV9sWlR_fanfgcF6VH0
Facebook: https://www.facebook.com/jacksonvillesbestcaregivers/
Twitter: @RozMarshallJon2
LinkedIn: https://www.linkedin.com/in/rosalind-marshall-jones-7a91b29b
Instagram- @rozjonesenterprises
Youtube - Jacksonville's Best Caregivers https://www.youtube.com/channel/UCDFP2FF5QBbjVyaphhh3zdA
Due to current technology and medicine, people can live longer than ever. Assisted living facilities are seeing patients later in their disease.
Meet Rosalind Marshall-Jones
Rosalind Marshall-Jones is an innovative speaker with more than fifteen years of progressive experience as an entrepreneur and leader in the caregiving industry. Rosalind has an extensive medical background that afforded her the opportunity to see the gap and need for quality care. As a seasoned health care provider, Rosalind built upon her strong medical foundation, by opening Jacksonville’s Best Caregivers, an organization that provides short and long-term health care.
Website: https://thecaregivercafe.net/
Facebook: https://www.facebook.com/jacksonvillesbestcaregivers/
LinkedIn: https://www.linkedin.com/in/rosalind-marshall-jones-7a91b29b
Youtube - Jacksonville's Best Caregivers:
https://www.youtube.com/channel/UCDFP2FF5QBbjVyaphhh3zdA
Twitter: @RozMarshallJon2
Instagram- @rozjonesenterprises
Roz Jones is a leader in the caregiver industry as the President and CEO of Jacksonville’s Best Caregivers, an organization that provides short and long-term health care. Caregivers have a broad array of roles. Rob Jones tells us it can array from simply monitoring the patient to giving full-time in-home care. Visit TheCareGiverCafe.net and Jacksonville's Best Caregivers on YouTube.
Meet Rosalind Marshall-Jones
Rosalind Marshall-Jones is an innovative speaker with more than fifteen years of progressive experience as an entrepreneur and leader in the caregiving industry. Rosalind has an extensive medical background that afforded her the opportunity to see the gap and need for quality care. As a seasoned health care provider, Rosalind built upon her strong medical foundation, by opening Jacksonville’s Best Caregivers, an organization that provides short and long-term health care.
Website: https://thecaregivercafe.net/
Facebook: https://www.facebook.com/jacksonvillesbestcaregivers/
LinkedIn: https://www.linkedin.com/in/rosalind-marshall-jones-7a91b29b
Youtube - Jacksonville's Best Caregivers:
https://www.youtube.com/channel/UCDFP2FF5QBbjVyaphhh3zdA
Twitter: @RozMarshallJon2
Instagram- @rozjonesenterprises
Rosalind Jones joins the Injured Senior Podcast to educate us on caregiving and how it is replacing long term care facilities. Rosalind is a seasoned health care provider who built upon her strong medical foundation by opening Jacksonville’s Best Caregivers, an organization that provides short and long-term health care.
Rosalind confirms that caregivers can provide more than a facility can. There is more one on one human connection, and that person’s quality of life can extend 3-5 years. Being at home gives people an extended period of life; they are more comfortable, can get their hair done, go to the movies, and get the human interaction they need.
Long-term care facilities are necessary later on in a person’s illness or age, as opposed to early on. This is because technology and medicine allow people to live in the comfort of their home.
In This Episode:
- [05:00] Meet Rosalind Jones.
- [6:22] Rosalind shares how she started in caregiving. She began as a sitter in the hospital with on the job training
- [12:15] Sometimes people are afraid to ask for help. They are afraid their car, house, or identity will be taken away from them. This can cause isolation.
- [12:40] Now that caregiving is an industry, is it replacing the nursing home
- [16:50] What caregivers can give, that facilities cannot
Key Takeaways:
- We have all been caregivers
- The role of the caregiver is to come in and monitor the health of your loved ones, monitor that they are taking medication. Care can range from just checking in, to full time
- You can be a caregiver on a long term or short term basis, depending on if it’s a slip or a disease.
- Technology and medicine are keeping people healthy longer. Facilities are now needed later, as opposed to early on.
Meet Rosalind Marshall-Jones
Rosalind Marshall-Jones is an innovative speaker with more than fifteen years of progressive experience as an entrepreneur and leader in the caregiving industry. Rosalind has an extensive medical background that afforded her the opportunity to see the gap and need for quality care. As a seasoned health care provider, Rosalind built upon her strong medical foundation, by opening Jacksonville’s Best Caregivers, an organization that provides short and long-term health care.
Website:
https://thecaregivercafe.net/?fbclid=IwAR2XTXxWg0GvhIeXAEVNedsg3QsWlU1gKeAaT_zjFV9sWlR_fanfgcF6VH0
Jacksonville's Best Caregivers YouTube:
https://www.youtube.com/channel/UCDFP2FF5QBbjVyaphhh3zdA
Facebook:
https://www.facebook.com/jacksonvillesbestcaregivers/
LinkedIn:
https://www.linkedin.com/in/rosalind-marshall-jones-7a91b29b
Twitter: @RozMarshallJon2
Instagram: @rozjonesenterprises
According to data from the Census of Fatal Occupational Injuries Program of the US Bureau of Labor Statistics, older workers are more likely to die on the job than workers in general. The number of aging adults that are mortally injured on the job has increased since 1992. Learn what to do if you notice a hazard or unsafe working conditions to make your workplace safe to work.
- Report the hazard or any unsafe working conditions to your employer.
- Go to Occupational Safety and Health Administration (OSHA) if the employer doesn't respond to alleviate the unsafe working condition.
- You have the right to speak up. OSHA has a program that can protect your information where you can file a complaint anonymously.
- If the employer decides to take disciplinary action against you, contact the union, the union has the right to file a grievance to get your job back.
- Visit https://www.osha.gov/ to find out more about the whistleblower protection.
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Empowering people to thrive – no matter what disability or cognitive disorder they may live with – is the focus of Benjamin Surmi's work as a social gerontologist. Currently, Benjamin works in Vancouver, Washington, with Koelsch Communities. There are lots of different issues related to aging. However, the world of dementia is in dire need of innovation. Finally, we realize the problems with Alzheimer's – it's a cultural issue. The United Kingdom has transformed itself into a dementia friendly community. They train people to understand and know how to work with people who live with dementia. That way, they won't suffer as much as they do. Tune in as we speak about how life is in a dementia-friendly society and how we can help patients living with dementia.
In This Episode:
- [05:50] Meet Benjamin Surmi. Benjamin explains what exactly a social gerontologist does.
- [09:45] How life can be better for people with Alzheimer’s.
- [18:20] What happens when an Alzheimer’s patient can’t be found in a dementia-friendly society.
- [21:10] How to refer to someone who is living with dementia.
- [26:20] Using headphones to speak to patients living with dementia.
Key Takeaways:
- The issue of dementia is cultural. We need to make sure that someone with dementia can still function in society.
- The suffering involved with dementia is because our community is not set up to support people with dementia.
- People working retail can be trained on how to gently lead people with dementia away from mirrors.
- A person with dementia should be able to leave their home; we need to help them leave their home safely.
- Suppose you're going to talk about someone with dementia. In that case, that person likes to be called "a person living with dementia" instead of a dementia patient.
Meet Benjamin Surmi
Empowering people to thrive – no matter what disability or cognitive disorder they may live with – is the focus of Benjamin’s work as a social gerontologist. Caregiver, activity director, lifelong learning center director, and home repair coordinator were each roles that shaped his understanding of the unique needs of seniors. Currently, he guides the person-centered training for over 2,100 employees in 8 states and is currently implementing an evidence-based approach to care from France called Humanitude. He coaches 70+ wellness directors and 32+ Executive Directors who support over 1,500 seniors. His passion is imagining the impossible and building alliances that make it possible.
Resources:
Website: www.koelschcommunities.com
Connect on Facebook
Twitter @benjaminsurmi
Linkedin
Koelsch YouTube
According to the National Council on Aging, more than 40% of Americans 55 above are still employed. Seniors can be more susceptible to getting hurt on the job. In this episode, we will talk about the six rules to follow after a job injury.
- Report it immediately in writing.
- Get the names of all witnesses.
- See a medical professional immediately.
- Follow the claim with the Workers Compensation Commission or Industrial Compensation Board.
- Don't give a recorded statement to the insurance company for your employer until you've spoken to an attorney.
- Speak to an attorney to get an assessment of your case and advice on what you should do.
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Sean Marchese, a registered nurse and oncology writer at The Mesothelioma Center with a background in respiratory and thoracic oncology clinical trials, joins the show again. First, Sean reveals why cancer is so prevalent in firefighters. In fact, cancer is the leading cause of death in firefighters. They have a higher risk of cancer because these men and women consistently put themselves in danger. When you’re engulfed in smoke and toxic chemicals, that exposure will build up over time. Tune in as Sean dives into the dangers of asbestos, how firefighters can protect themselves from asbestos exposure, and resources for firefighters with health conditions.
In This Episode:
- [02:25] Meet Sean Marchese. Sean explains why the top cause of death for firefighters is cancer.
- [05:35] About mesothelioma. Sean dives into the most prominent cause of mesothelioma – asbestos.
- [12:40] Those involved in the 9/11 attacks were heavily affected by the dust cloud that remained in the air for days.
- [13:45] The other conditions that can come from asbestos exposure.
- [15:45] How firefighters can protect themselves from asbestos exposure.
- [19:50] Resources for firefighters who suspect they are having health issues.
Key Takeaways:
- There is long-term damage for firefighters who are exposed to chemicals and smoke. Often, this damage will lead to cancer.
- Firefighters are two and half times more likely to develop mesothelioma compared to the regular population.
- Asbestos is the most common cause of mesothelioma.
- When a firefighter brings their equipment home, they could be exposing their family to asbestos.
- Mesothelioma can show up twenty to forty years later.
Resources:
Asbestos: https://www.asbestos.com
Email: PatientAdvocates@asbestos.com
Phone: 407-569-3185
Twitter: https://twitter.com/themesocenter
Facebook: https://www.facebook.com/themesocenter
YouTube: https://www.youtube.com/user/TheMesoCenter
Sean’s Email: SMarchese@Asbestos.com
International Association of Firefighters: https://www.iaff.org
National Fire Protection Association: https://www.nfpa.org
International Associate of Fire Chiefs: https://www.iafc.org
Firefighter Cancer Support: https://firefightercancersupport.org
Firefighter Cancer Foundation: https://www.ffcancer.org
Meet Sean Marchese
Sean Marchese is a registered nurse and oncology writer at The Mesothelioma Center with a background in respiratory and thoracic oncology clinical trials. He has assisted physicians with the development of chemotherapy and surgical planning for patients with early-stage and extensive-stage head, neck and thoracic cancers. As a registered nurse, Sean has worked with cancer patients undergoing pain management therapies and patients with brain and nervous system cancers in an inpatient setting. Sean graduated with a Master of Science in medical sciences at the University of South Florida in 2012 and a Bachelor of Science in microbiology and cell science from the University of Florida in 2010.
He has over 10 years in clinical experience and over six years in clinical research. Sean has planned and led experimental clinical trials in oncology involving TTFields, immunotherapy, chemotherapy and radiation therapy. He has been a member of the American Nurses Association since 2017.
Did you know that 1 million individuals go to the ER every year due to a slip and fall accident? That's 2,000 people every day. A lot of those individuals are seniors and the elderly part of the aging population. In this episode, you will learn about the five most important steps to take after a slip trip and fall.
- Report it immediately
- If you're injured, see a doctor right away
- Take photos; a picture proves that there was a defect.
- Do not give a recorded statement to the insurance company. You may give them a short written statement, but do not give a recorded statement.
- Consult with an attorney.
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Dr. Joe Casciani has over 30 years of specializing in geropsychology, nursing homes, mental health practices, and innovative clinical programs. Joe opens the show by explaining why older adults get depressed. Depression comes from our attitudes, self-talk, and how we interpret events. For seniors, it doesn’t necessarily have to be a chemical imbalance; it can be the setbacks that cause depression in older adults. If you focus on what’s wrong, you’re going to find it. While on the other hand, if you focus on what’s right, you’ll find the positive.
We need to practice looking for what’s positive in any situation & observe our self-talk. Tune in as Dr. Casciani speaks about the Living to 100 Club and how we can live a more fulfilling life.
In This Episode:
- [02:25] Meet Joe Casciani. Joe explains why older adults get depressed.
- [08:00] How chronic mental disorders will accompany medical conditions in older individuals.
- [09:50] Dr. Casciani reveals ways to overcome depression.
- [16:30] The importance of exercise on our mental health.
- [19:30] About the Living to 100 Club.
- [24:00] How we can start living a better and more fulfilling life.
Key Takeaways:
- Older adults have more life stressors; therefore, they are more prone to depression.
- Depression will narrow our perspective.
- We need to observe our self-talk. When we have a setback, we need to accept it, fix it, and move on.
- Staying physically active will assist with depression & living longer.
Meet Dr. Joe Casciani
Joseph M. Casciani, PhD, is the founder and Chief Curator of the Living to 100 Club, the author’s new voice for delivering recommendations and inspiration about aging with a positive mindset – no matter how hard the journey. His insights about living longer, healthier, and happier lives reflect the author’s experience with older adults and their families, with paid and unpaid caregivers, writing and public speaking, and the hundreds of mental health professionals and scores of hospitals and long-term care facilities with whom he has worked with since the early 1980s. After four decades of clinical work, Dr. Casciani is now powering a positive attitude about aging through this new book, Living Longer IS the New Normal, through membership in his Living to 100 Club, and through his live weekly radio show on aging and longevity
Resources:
LinkedIn Joe Casciani
Twitter
Facebook Living to 100
Living to 100 Website
About Father Doyle: Tom Doyle, is a truly heroic advocate for transparency and accountability in the Catholic Church, in all churches and synagogues and mosques. There are more than 19,000 people who endured abuse by American priests from 1950 to July 2017. And those are just the ones that can be confirmed and that we know about. For more than 30 years father Doyle has examined approximately 1000 clergy sex abuse cases across the globe, and is an expert witness and consultant to victims of clergy sex abuse. He served as a pastor in Illinois beginning in 1971, was appointed as an advocate for the Metropolitan tribunal of the Archdiocese of Chicago in 1974. He served as Secretary canonist at the Vatican Embassy in Washington DC until 1986. In 1986, he was also commissioned a reserve officer in the US Air Force and was on active duty until 2004. Here has received numerous awards for his tireless advocacy on behalf of victims and survivors of clergy sex abuse. He also wrote a groundbreaking 90 page report in 1985, titled, The problem of sexual molestation by Roman Catholic clergy. And he published a book in 2006 Sex, Priests, and the Secret Codes.
In this episode, Steve and Father Doyle discuss:
1. When did you first become aware that sex abuse being perpetrated on children in the church was going on? When did that first kind of come onto your radar screen?
- I knew that there was an issue of priests becoming sexually involved with minors and children, but I don't remember when I first learned about it. I do recall, high school I went to when my family lived in upstate New York, the principal was a priest. And now I graduated high school in 1962. The principal was a priest. And I remember finding out we all did that he had taken off left run away with one of the senior girls. And they apparently had been carrying on and they attempted marriage. The marriage ended. I don't know when but that's the first time that it came close to home. And of course, everybody at the time was totally stunned. Because in the 60s, much more so than now priests were held on. I mean, you were way up on the ladder, and the ladder was about a 25 storey ladder. So everybody was stunned.
2. The Catholic Church has done everything in their power to conceal this from the public but also to not apologize to victims or not to acknowledge it and basically not be accountable or transparent. Is that that accurate?
- That's very accurate. That's been the default for centuries. Not just now, our lens looking at this issue is a very narrow lens, it just focuses on our era, it came to the surface in 1984 with a case in Louisiana that broke the lid off the very thick cover of secrecy, then we begin to understand that this wasn't going on all the time, everywhere. But it was far more extensive than any of us imagined. This, the default approach from the Catholic Church has been, as you've described it, secrecy. Protect the image of the church, deny as much as you possibly can, disappear the perpetrator and hands off the victims. But one of the things that truly scandalized me and made me furious with the institutional Catholic Church is they've systemically not only ignored the victims over the years, but they have demonized and in some instances publicly blamed them. So adding insult to injury, they've ignored them.
3. But because you became much more active in pursuing what was going on, did you get any pushback at all from the Archdiocese?
- I did get a lot of pushback, and I thought I was doing the right thing by the church. And I thought this is what the bishops would want and I was talking to other bishops, because this was publicly known. So other bishops that I saw that were regularly coming there and asking for their advice, “What should we do?” And finally, I told him that, you know, we're writing this report. And I remember one Bishop who became a cardinal, he said that report was necessary, he said that the way you wanted to lay it out as question and answer, so that the bishops will read it. They have nothing to go on right now. Nothing. Okay, so we wrote the report. My boss, the Archbishop, was supportive of what we were doing. He was in, he couldn't wrap his mind around this whole thing because he'd been in the diplomatic corps since he was two years ordained. So he was something he hated. He was in lala land, he was living in another world. We finished the report, it was divided up into sections- civil law, canon law, pastoral, psychological, plus a bunch of recommendations where we take care of the victim, pull the priest offline, and report this, and be open and honest with the media. My boss, the new CEO, on our behalf tried to submit this to the bishops conference in the United States for consideration and they rejected it. And they stated publicly at a couple of news conferences that they didn't need it because they knew everything that was in it. This is 1985, they knew everything that was in the report and everything was under control. And then they turned around and they accused. The accusation came through their office of attorney, their civil attorney, General Counsel. They accuse Peterson of creating this issue, to benefit from it financially, to sell our services to the various bishops, which was a complete and total lie. It was, I was stunned. And that's when I began to realize something's going on here that I don't know about what it was, was the beginning of our realization of a conspiracy to try to control this issue, which obviously, they couldn't.
4. Could trace it all the way up to the Pope?
- Sure. I’m not sure when they were first informed what was going on in Louisiana, however, at one point in January, I suggested that we find a bishop that we can trust and send them down to Louisiana to see exactly what's going on, because it's a mess. And by mess, I mean, there were all these forces trying to cover up for the bishop and protect the bishop and prevent a trial from happening, because they knew what was going to happen. If there's a trial, it's all going to come out. And if the forces were important people, one of them was the husband of the former governor of Louisiana, a guy named Ray Blanco. And the another one, oddly enough had been at one point Ted Kennedy's father in law, a judge named Reggie Edmund who was a judge, and they were supporting trying to help the bishop. So we got this going on. I wrote a report that was 42 pages long, it was detailed, and it was explicit. This is what this priest does to these little boys, anal sex, daisy chains, with the kids to connect, photography and so on, was all right there. He knew that had to go directly to the pope as quickly as possible. He had to cut through all the layers of bureaucratic and aristocratic nonsense that went on the people’s court. So we arranged to have that report, hand delivered to Cardinal Crowell, who was the Archbishop of Philadelphia at the time. On a Sunday night, he was flying to Rome the next morning. And he told me because I arranged this with him by phone, I will personally hand that to the Pope, and ask him to read it and tell them this is urgent. By Thursday, we knew he had read it because we received the cable allowing us to appoint this Bishop is a special investigator. So the Pope in March 1985, had read a very detailed explicit report on sexual abuse of children by clergy, so the Vatican knew. By then they had a clear cut picture of what was going on over here.
5. Do you think it was a coincidence that a year or two later you were fired from your job as working at the Vatican?
- I don't think it was a coincidence at all. But the way they do businesses, you never really know straight up what's going on. So I was never really told you're fired, because you've been pushing this issue too hard. But I remember my boss told me one day he said, “If you stay with this, it's going to ruin your career in the church, if you keep pushing this issue.” Well, I made a decision then and there- I don't care about a career in the church, I'm too committed to this. So I was told that we had a new man coming in, and we need your office space for him. Now, that's a nice way of saying you're going out the back door and not coming back here. So that was the end of my career.
6. Whatever happened with the Louisiana case?
- A couple that brought the lawsuit that went to trial, and their son, who was 10-11 years old at the time was a very, very brave boy, because this was the first time this went on. And he's faced with a tank of sharks that we're trying to defend the bishop. But fortunately, he had a really smart lawyer. So they testified, they won, they received a few million dollars in an award for him. The priest never went to trial, they settled before trial. He got 20 years in prison, but he actually only served 10 but he never functioned as a priest again, that's for sure. And he could never go back to Louisiana because he'd be a dead man because he had sexually abused hundreds of kids. These Cajun fathers, nobody's gonna mess with their family. I'm surprised that more priests weren't actually killed.
7. So a lots happened since then. What have you been doing since you left the Vatican embassy in 1986? Right after 1986, what did you do to advance the cause of trying to really show this or get this exposed to the public?
- This manual that we refer to, the press got ahold of it. So it became publicly known, which meant my name and Michael Pierce's name were out there. The three of us started getting requests from bishops, to go to their dioceses and put on seminars for the priests, mandatory seminars about this issue. We had a number of them around the country, and also religious orders, Not all of them, but a significant number, 15-20. Some of these bishops honestly wanted to do the right thing. But one Bishop said to me, “My problem is that the conference itself, the leadership of the conference, isn't helping, they're stonewalling on this, they are the ones that wanted to control it, stonewall it, and create the conspiracy.” Now it's cost the church in this country, probably five and a half billion dollars. But this is the same outfit that said, in 1984-85, “We've got this under control. We know everything about it, we know how to handle it, we don't need this manual.”
8. But there's still concealing and lying as of today, right?
- Yeah, it's still going on but they're on the defensive, they've been on the defensive all along but even more now because, although they're trying to manipulate things, those things are not right, because the victims and their attorneys and their supporters are driving this bus. We're the ones that are handling this thing. And it's getting bigger and bigger and bigger, if that can be believed. I think 12 states are being investigated by state attorneys general, what happened in Pennsylvania was earth shattering. That blew a lot of minds.
9. And for our listeners that don't know about that, can you just briefly talk about what has happened in Pennsylvania?
- The Attorney General of the state of Pennsylvania, a very fine man named Josh Shapiro, sat a grand jury and proceeded with the grand jury investigation of every Catholic Diocese in the state of Pennsylvania, with the exception of the Diocese of Philadelphia, because Philadelphia had already been subjected to three grand juries. Those those reports were unbelievable. In July 2018 they published their report, which was mind bending. That got a lot of other attorneys general moved on this so they began doing the same thing. Another time unheard of in history, where you have a country like the US, where church and state are separated, and you've got the civil authorities realizing and finally treating the Catholic Church, not with all this deference, but this is criminal behavior. And it doesn’t matter who you are, if you're a bishop a cardinal or a Pope, if you commit crime, your a criminal, and that's how it's going.
10. The report stated that there were over 300 priests that had engaged in this type of activity, is that that accurate? And this is going on now in 12 other states?
- That was an understatement, because they said they could only report that many at that time. They wanted to get the report done, but they had verified about another 300, so you're probably talking 700 or more. I'm involved in the District of Columbia, as a consultant, DC, Virginia, New York, Texas, New Mexico, California. I've been a consultant in New Jersey, but I don't know if they've done anything yet.
"One of the things that truly scandalized me and made me furious with the institutional Catholic Church is they've systemically not only ignored the victims over the years, but they have demonized and in some instances publicly blamed them. So adding insult to injury, they've ignored them." — Father Doyle
You can hear all this and more on this episode of The Injured Senior Podcast.
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Get Father Doyle’s book Sex, Preists, and the Secret Code here:
https://www.amazon.com/Sex-Priests-Secret-Codes-Catholic/dp/1566252652
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
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Show notes by Podcastologist: Strickland Bonner
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Sam Sugar: Dr. Sugar is a medical doctor and a founder and president of Americans Against Abuse of Probate Guardianships, AAAPG, an organization designed to expose the corruption of the nation's guardianship systems. Dr. Sugar received his medical degree from the Abraham Lincoln College of Medicine at the University of Illinois, Chicago. He achieved certification as a specialist in internal medicine from the American Board of Internal Medicine and was distinguished as a fellow of the American College of Physicians. He has served as a director for managed care at Evanston, Northwestern Healthcare, and is taught at both Northwestern University's Feinberg School of Medicine and the Chicago Medical School. In 2014, after experiencing the horrors of guardianship firsthand, Dr. Sugar created Americans Against Abuse of Probate Guardianships.
In this episode, Steve and Sam Sugar discuss:
1. What was the horror of guardianship that you experienced firsthand?
- When we discovered that this guardianship process had been subverted to a racket, basically a very profitable racket for the entire for-profit guardianship industry, which includes the court insiders, the judge, the lawyers, the guardians, and an army of people downstream who profit from it, by virtue of straw man sales, underhanded kickbacks, and the like. It's a gigantic industry, it's enormously profitable and the people in it will do anything to keep it going.
2. Was that the driving force for you to create the Americans Against Abuse of Probate Guardianship?
- In the midst of the early portion of this ordeal, my wife and I kind of came to the conclusion, we're just really unlucky, this probably only happened to us. There are probably no other people in the world that could have the bad luck to run into a judge like that, lawyers like that, and horrible people in that system.
I was invited out of the blue to attend a political breakfast for someone who was running for the school board where I lived and it was a free breakfast so I went. While I was there, I raised my hand and I said, “Do you have a position on probate guardianship,” which, in retrospect, was a crazy question to ask, But he answered it as best he could. And then I was stopped afterward by another woman, who said, “Why did you ask about that?” One thing led to another and we discovered that the two of us were involved in that. Then two became four and four became eight and now it's about 1000 families, not individuals, families, who are on our website, mailing list, and social media.
3. Is this unique to just the retirement states of the country such as Florida, Arizona, California, and Nevada?
- Well, it's certainly present in every state to a varying degree and I will tell you, much to my surprise, Over the years, the absolute worst state in the country, which is saying a lot, is Michigan, of all places. Their system is absolutely breathtakingly corrupt, everybody knows it, and nobody's willing to do anything about it. Over the years, our work has spawned an advocacy group in Michigan, which is really very well populated, very active, and getting great results called The Voice run by one of our advocates.
4. Can you tell our injured senior community a little little bit about what guardianship is?
- Guardianship is a legal process by which a court can remove the rights of someone who hasn't broken the law, or done anything wrong. Someone can be alleged, usually by a lawyer, to be in need of protection from abuse, neglect, and exploitation. Usually, the lawyer brings an allegation, an unsubstantiated or unverified unsworn, just one lawyer talking, saying, “Your Honor, there's someone in our community in your jurisdiction, who may be being abused, neglected or exploited,” period. That's the magic sentence. At that point, the judge has the ability and the initiative to appoint what's called a substitute decision-maker. That is an individual who ultimately will be given what's called letters of guardianship, at which point that guardian has wards and a ward needs a guardian. So that's what you call a person who's in the situation, either an allegedly incapacitated ward. The guardian then owns that person and I want to say that again, for emphasis a ward is the property of his or her guardian, and the guardian can do pretty much whatever they want to do, as long as they have a court order with that person, that's a guardian of the person, or with their money that's a guardian of the estate, or both.
5. Is there a distinction between kinds of guardians?
- There's a huge distinction between professional, and family guardianships. Family guardianships do constitute the great majority of guardianships in the country. In the last 30 years or so, there has arisen an entire group, a class of what's called professional for-profit guardians. Why are there so many professional guardians? In Florida, I'm talking about now, because nobody knows. The answer is like what Willie Sutton said, “that's where the money is.” Not only do we not know how many professional guardians there are in the United States, but we also don't even know how many Guardianships there are in the United States. The best guess, by the GAO is somewhere between a million and a half and 4 million in Florida, where the numbers have been provided to us by one of the premier clerks of court, who actually surveyed all 57 clerks of court in Florida. There are somewhere between 50 and 65,000 active Guardianships today in Florida, and they're being created at a rate of between seven and 8000 new ones a year.
6. Are all these 55 60,000 guardianships in Florida?
- I wish I could give you those numbers, but because court records for guardianships are considered mental health issues. The court records are typically sequestered, meaning that people like us can't research these numbers. Although they do exist. The Department of Elderly Affairs knows all this information but is constitutionally forbidden to share it. So this is a system and a business that generates many billions of dollars a year for its “perpetrators” if you want to use that clause. If you have the ability to be recognized by the court as a professional guardian. People ask what does it take? I thought that's a great job. What do I need to do? Do I have to have a graduate degree? Do I need certification? Well, the answer is no. Here are the requirements generally speaking to be a guardian and in Florida. Ready? Yep, got to be a team. You got to have to have a high school diploma, a GED is good enough. You can't have had a conviction for a criminal offense for felony. Parking tickets are okay and you have to complete a course that's supposed to be 40 hours long, but can be completed in a weekend at a junior college. If you pay a few bucks, then all you have to do is submit your application and not lie about previous bankruptcies, which we've seen done repeatedly, and boom, you are a guardian. In order to become a professional guardian and recognized as such, you have to have been appointed at least three wards.
7. Once someone gets certified, what is the level of regulation or oversight by the state?
- Part of the problem was to an abject failure of monitoring and supervision of not only guardianships, not only the lawyers but the judges and even though Florida statute and statutes in every state really provide a mechanism for supposed oversight over the courts and these guardianships, we realized that the laws were insufficient, and we went down to our state capitol in Tallahassee, and we were successful two years in a row to change the statute 744, to include more monitoring, oversight, supervision, and to create a new agency called the Office of Public and Professional Guardians, the OPPG, and those pieces of legislation were accepted unanimously. Ultimately, there was applause in the chamber of the legislature, the combined legislature. If you ask me now, five years or four years later, what difference they've made? The answer is zero.
8. What aresome ways that individuals can prevent becoming award of a guardian and also the families, what they can do to prevent a guardianship?
- In the first place, make sure you have valid and recent advanced directives. Advanced directives are two types of documents. One is a durable power of attorney for your financial matters and the other one is a healthcare power of attorney. To determine who you want to make medical decisions for you at a time where you can't, those have to be perfect. Most importantly, in your durable power of attorney, there must be a clause that says something like, “I specifically prohibit any court, or any other governmental entity from appointing for me, any professional guardian, at any time, for any reason, in perpetuity” because if you don't have that, in your advanced directives, I've seen one case where a judge has said, you know, “I'm looking at these advanced directives, and it doesn't say anything about I shouldn't appoint a guardian. So I will.” You need to make sure that those advanced directives are easily available and retrievable by people you trust, you can't hide them in a safe, because when you need them, they won't be able to be found. That's the first thing. The second thing is the hard part, solve your family disputes, I cannot tell you how important that is. If you've got family members, even a distant aunt or uncle or cousin or niece or nephew, they can start this process even if they haven't seen you for 10 years, if they're what's called interested parties. Heal your wounds, heal your divisions and lessen the likelihood that somebody is going to go after you when you're at your weakest.
9. What is really the reality of how these are actually becoming guardianships?
- The really sad reality that strikes me is that the very institutions and people that are supposed to be assisting those who are in need possibly are where the worst guardianship abuses take place. For example, hospitals, a large number of hospitals, hospitalized individuals, who maybe broke their hip had a heart attack had a stroke, on dialysis, is visited by friendly social workers, or other hospital staff who are concerned, “gosh, this person hasn't had a visitor in a day or two. They must be all alone. They must need help and I must need the bounty that I'll collect by reporting it to a lawyer.” That happens a lot. These guardians hang out and can be found in senior centers, in doctors offices, in clinics, in daycare centers, in dialysis centers, anywhere where an elderly frail person can be found. You will find individuals complicit in this corruption, including doctors, nurses, social workers, ER technicians, therapists because disgustingly there are bounties for referring them. So are they solicited by these professional guardians? I can't prove that, but I strongly suspect it. Okay. Not just the guardians, but their attorneys as well.
10. Are their family lawyers also part of this whole scheme?
- No, actually, one has to understand who the lawyers and probate really are and there are two distinct classes of Estate Attorneys and probate attorneys. The first is your garden variety estate attorney, whose primary job is to create documents and create documents that can be relied upon in court and that clearly states the wishes of their client. There's a second variety of lawyers that are called litigators. They're the ones who challenged those doctors. They're the ones who have this ability to bill unlimited hours.
"Did you know that a judge can divorce you during a proceeding to take away your right to inherit from a spouse?" — Sam Sugar
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Sam Sugar:
Facebook: https://www.facebook.com/AAAPG.net
Website: aaapg.net
Book: Guardianships and the Elderly: The Perfect Crime
Email: drsam@aaapg.net
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Laura Williams: She is the host of the podcast, Sepsis Survivor Stories. She is herself a Sepsis survivor and she was just minutes away from death. She interviews other sepsis survivors on her show. Laura is an experienced podiatrist. She's a graduate of the University of Brighton and educates health professionals on Sepsis.
In this episode, Steve and Laura discuss:
1. What was it that motivated you to start the Surviving Sepsis Stories podcast?
- Sepsis Survivor Stories actually came about because I just wanted to make a difference. I have been on a number of Facebook groups, and I connected with a few people and a number of people said that they felt really alone afterward and that it was a very isolating experience. I felt that after I got home and there was no help and that is a very common occurrence.
2. Did you have the experience of feeling alone, depression, or post-traumatic stress disorder?
- Very much so and at the moment, I'm actually dealing with a lot. I've been wearing face masks and it's having the same effect as wearing an oxygen mask. Oxygen is really important when it comes to sepsis.
3. Was that the reason why you started the podcast because you just wanted there to be sepsis awareness?
- I think both. I've always been an education kind of person. A few years ago, I published a book on diabetes and at that point, I was really into my diabetes education. When I was in University, my dissertation was on health education, and it's always been a massive passion of mine. The funny thing was the Christmas before my Sepsis experience, I wanted to write a blog on Sepsis, but I didn't know how to start. So I started it while I was in the hospital.
4. In Sepsis Survivor Stories. there's an episode with Diane Burnett, who is an American retired school teacher, who developed Sepsis from a urinary tract infection. Tell us about her.
- It's all about the one thing I always think is, how amazing everybody's stories are. And the similarities to where everybody is, they needed to actually get to the hospital, ASAP, because the time is key when it comes to sepsis. Like 30 million people a year have Sepsis, and 11 million people die. And this is worldwide, one in five deaths worldwide, because of sepsis. Like COVID, you've got pneumonia, you've got a UTI, you've got meningitis, they all can come into Sepsis. For me, it's something that I know that I survived for a reason and if I can save one person's life, I've done a good job. This is the one thing that I kind of get from the podcasts that I've done already. Everybody else is also feeling that feeling of gratitude and feeling of giving back and actually wanting to save somebody else because they don't want other families to go through what they've done, what they've had to go through and it can be tough, but like when it comes to it, a urinary tract infection, people just think, go to the doctors, get some antibiotics, but when it comes to a lot of people, they're just like, “Oh, okay. I'm not well, but I need to get on with life and I'm I was very much like that as well”. If it doesn't feel right, you need to seek help, because it might not be right.
5. Are toe amputation a result of Sepsis?
- As a complication, you can get blood clots in the extremities. I've met quite a few people who have had to have legs amputated, hands amputated, and it is heartbreaking.
6. So you are now the unofficial world ambassador for Sepsis awareness and education?
- I like to think so.
7. You have an online course, right?
- Yes. So with that, I go over what is Sepsis, the signs, and symptoms. I also talked about Sepsis six, which is available in 20 different countries. Whereas in some states, it is part of the procedure, but not in all states. There is a petition to make it to be mandated in every single state in America.
8. What is Sepsis six?
- It's a framework to basically help save lives. It's about making sure that you get a senior clinician. Having your blood taken, IV put in. So being on oxygen, being on IV having fluids monitoring your urine levels, because when it comes to Sepsis, you need to ensure that you monitor your urine levels because lack of urination means that your kidneys are doing something funky.
9. Does Sepsis usually come after infection?
- Yes. So it always starts with the localized infection and then basically, it takes over the body. So it's a massive inflammatory response and then all hell breaks loose, basically.
10. What are other things you talk about in your online courses?
- When it comes to the online courses, I'm also talking about post sepsis syndrome, which is something that a lot of healthcare professionals actually don't know a lot about as well. So this is something that affects 40% of all survivors. So if you're thinking 19 million survivors each year worldwide, that's 7.6 million people each year having lasting effects
"If you suspect you or a loved one has sepsis go to the ER and if they want to send you home, insist that they do more tests." — Laura Williams
A World Sepsis Day Virtual Launch Event: The 10th of September at 7pm. British Standard Time
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Laura Williams:
Instagram: https://www.instagram.com/laurawilliams.sepsiseducator/
Show: Sepsis Survivor Stories at https://podcasts.apple.com/us/podcast/sepsis-survivor-stories/id1521453294
YouTube: https://www.youtube.com/results?search_query=Laura+Williams%2C+sepsis%2C+education%2C+Worthing%2C+Sussex
LinkedIn: https://www.linkedin.com/in/laura-williams-6b028b79/
Email: laura.sepsisedducator@gmail.com
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Colin Hoobler: Colin is a Doctor of Physical Therapy and he's been a Doctor of Physical Therapy for 19 years. He is an author and trainer, the creator and host of the action 30 podcast, as well as the fitness show on PBS. He's a medical expert for his local NBC affiliate. By the way, injured senior community he is out in Oregon. So I'm here in Baltimore. So he is literally on the other coast. He's a health writer for The Oregonian Newspaper and he's the Founder and CEO of S3 Balance LLC. He will talk a little bit about that later on in the episode. Well, welcome to the show Collin, it's so good to have you here.
In this episode, Steve and Colin discuss:
1. How serious of a problem is sitting and remaining sedentary to the aging population?
- Sitting carries the same or greater risk, an actually greater risk than smoking a pack of cigarettes every day. So if you're a non-smoker, but you decide to be sedentary and sit, you know, eight to 10 hours a day, which most seniors do, unfortunately, especially if you're in a community like Memory Care assisted living, then basically if you're a nonsmoker, you are adding risk to your life. It's basically like smoking a pack of cigarettes a day. On top of that, you're talking about an increased risk of suicide, increased risk of chronic pain, osteoporosis, Parkinson's, diabetes, I mean, the list is so long, you're definitely going to fall more. Worst of all, that there's a strong link between sitting that much and becoming disabled. So you will no longer be able to care for yourself.
2. You've got a lot of seniors who say, Well, I have to sit a lot because my knees ache, or I've got a back problem. So it's just better to sit. So if I don't sit and I stand, I'm putting myself at risk for a fall and a broken hip, do you hear that a lot from your patients?
- Yeah, I hear that a lot, even from non-patients, especially independent living, where they're supposed to be independent, and staff is not supposed to be able to touch the residents. So they need to be able to get up on their own, they got to be able to walk on their own. Saying that, well, I can't stand up, because I'm afraid this will happen, is extremely understandable. I understand that the fear is there. But let's look at why that's the case. That's the case because you are sitting too much. So yes, there is a greater risk initially, for a fall, there's a greater risk for discomfort initially. But what I see 100% of the time, over and over again, is you do it once, even if you have somebody stand up for 20 to 30 seconds, and they sit back down because they just got tired, the next time they get up, even if it's a minute or two later, they get up faster, and then they don't want to sit down. So then they're up to two to 300% more time, the second time, and it's just this thing that just keeps going downhill. It's like a snowball. So really, the key is, how do you just initiate that process?
3. How do we get the senior and elderly community to change the behavior?
- It depends on the person. But there is one term that tends to resonate with seniors more than anything else and that is wheelchair. Yeah, and if you want to make yourself disabled, so you want to make it, so you have to depend on others, which that whole concept is very painful, not just for older adults, but young, middle-aged old kids, there's something about losing your autonomy that is devastating. From a human standpoint, that is really, it's not tolerable.
4. Is there a blood test for inactivity?
- No, but there are tests for balance, right? There are tests for A1C, which is measured for diabetes, right? But do you want to use A1C's? Yep, got to keep that low. There are other tests that the more you sit, you will become less and less independent? Do you like using a walker sit more and that will turn into a wheelchair eventually,
5. Do you think that television has anything to do with it?
- A lot of times if they if they're watching a TV program that doesn't initiate any movement, that there's literally sitting there watching TV for four or five hours, they're like, well, I guess I got to get to go to the bathroom, they come back and then they reset another four or five hours. That's what we're talking about that deficit they got to get up.
6. Should the senior and elderly community be doing exercises more like Tai Chi or gentle yoga?
- Yeah, Thai Chi is great, that kind of thing. But for Free, you can go to s3balanced.com, and it's free, you can look and click on exercises and there are over 40 or 50 videos of exercises, they could do another using the s3 device, you don't have to have the s3 device, you can do it with a loved one we're, we're a loved one just stands in with the arms out and is touching you so that to prevent you from falling, and you know what will happen, you won't need that person after doing that for too long. It's extremely powerful, very fulfilling to see that happen. Every time you do it.
7. So 1 to 2 million of our senior and elderly population are in assisted living or nursing homes. Do you think there's any responsibility on the part of the nursing homes or the assisted living facilites to be a little more proactive in getting their residents or the patients to move around a little bit more?
- Not a little accountable, a lot of accountability? As it stands right now, if Steve owns his own memory care unit, or assisted living facility, the law states that you only need to provide activities, there's no rule that you need to educate or get people up. So as long as you provide these types of services, that's enough for the law. But it's not enough for me and it's not enough for the residents and their families, because they still sit all day long. So I think the first step with these communities, whether it's assisted living, memory care, skilled nursing, they owe it to the residents to number one, they got to educate them. So they make an informed decision. Rather than are you how are you? Are you 100%? comfortable, great stay sitting there? No, you've got to find out, Sharon, what do you like to do every day? Well, we've got to get you up and doing that every day. Because if you don't use it, you lose it. And I just started a coalition, by the way, just did that last week, it's called the Coalition for Active Residents in Engagement and Care and I'm going to start legislating, I'm going to start pushing for legislation to hold these communities more accountable. We need to have stricter standards for education to avoid that ignorance and devastating policies that they have now just well, if they get up, that's fine. If they don't, that's fine too.
8. Do you think the role of medication plays a part of this sedentary lifestyle for people in their 60s 70s and 80s?
- Yeah, you need to look no further than the research on that. The research says that the vast majority of older adults are grossly over medicated. For example, I think hormone replacement therapy or blood pressure medication, well, a lot of these caught cause fatigue, a lot of them can and they state and these people are on the medications for far too long. The doctors are not proactive enough to not just get them we to wean them off the medication, but to do so in a way that couples it with the most powerful medication we have, which is exercise and standing. So that the medication piece it's the responsibility to have the doctors the geriatricians there are some fantastic geriatricians that they will only medicate to a point knowing that they're going to motivate the person to exercise and then that exercise will take the place of medication, but that doesn't happen very often the research says that less than 25% of the time that physicians even mentioned, exercise, even still the elderly, it's just not something that's done. So we have to change this whole, it's like racism, right? We've got to start in order to get away from that you got to face it and acknowledge that it is a problem. Age is a big problem. We stigmatize weak, we pigeonhole people, well, you're old. So you need to just, you need to just not burden me with your problems, sit there, and then just enjoy your last years of life, your last years of life needs to be spent in vertical, not horizontal, life's too valuable to skip.
9. Do you see now that the individuals who are in their 50s might be a little more open to more activity? Or are not as sedentary?
- Yeah, but it's a generational thing. The older generation, they were during the age range, right, that occurred before the fitness boom. So it just wasn't really the thing, especially women. So they don't really, a lot of them tend not to have that mindset, but they're smart people, they're influential, they follow what each other, do what they do and so if you can get them to motivate each other, especially in communities, get one person to lead the classes and please don't do it in sitting, that's defeating the whole purpose. I mean, how many times you go into these communities, and there's five chairs in a circle, and I'm just, I just shake my head and go, what's the point? I mean, it may increase circulation a little bit but all it really is, therefore is to appease the administration, to be able to say we offer activities, it really doesn't do much of anything, it doesn't reduce falls, it doesn’t do anything.
10. When somebody has been used to sitting nine hours a day, when they begin to transition to trying to be more active and standing. Is it okay for them to start with a walker? Or is crutches or just something to get them up on their feet?
- Yeah, it depends on how low level they are. If they can walk with a walker, now they need to walk with a walker more. So rather than just going to and from the bathroom, or just around the house, it's time to start thinking about leaving the house or doing going around the house more. But it's just it's like putting money in the bank only more powerful than money because once you lose your independence, when and you can feel it happening, you know, you start to realize, boy, things are getting harder, it's already getting harder to tie my shoes. It's getting harder to go and I'm becoming more nervous going to the airport or leaving my home. It's starting to happen, and you got to do something.
"Your’re body is a slave to your brain." — Colin Hoobler
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Colin Hoobler:
Twitter: @losetheweight
Facebook: Colin Hoobler
Email: ch@action30.com
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Emmett Irwin: Emmett is a social security disability and Elder Law Attorney in Baltimore, Maryland, who previously was paid by hospitals and nursing homes to get disability and medical benefits for patients. Several years ago, Emmet started his own law firm, so he could work for private clients, and is the co-chair of the disability benefits section of the Maryland Association for Justice, the Vice-Chair of the elder law and disability Right section of the Maryland State Bar Association and a member of the peer review of the state of Maryland. Emmitt is also a former Division Three basketball player.
In this episode, Steve and Emmett discuss:
1. So how long have you been handling SSD cases?
- Since 2008, so, years.
2. Can you give me a ballpark figure as to when you started seeing early-onset dementia cases?
- It's been since I started but they were fewer and far between back then. They've been getting more and more prevalent. As you know, the population starts to age, the silver tsunami, as you would say, baby boomers are getting a little older, and some people are starting to have some issues with dementia.
3. What would you say are the average age of an early onset dementia client?
- People I’m seeing are from 58 to 64 years old, 65 years old, after 65 SSD really isn't an issue because you hit full retirement age at 66 or 67 years old. So we're really not applying for SSD, for people older than about 65.
4. You only take cases up to 65 because after 65 they automatically get social security, retirement, whether they're disabled or not correct?
- That's correct.
5. what is the likelihood of the person that comes to you at 58 years old, and they've got early onset dementia or Alzheimer's, being able to get social security disability within a reasonable period of time?
- It's a really great chance. Early-onset Alzheimer's and other kinds of dementia, we see vascular dementia, we see Frontotemporal dementia, but the symptoms are really very similar. What happens is short term memory issues, their concentration issues. Most of the clients that I see have higher-level type jobs, very skilled type jobs. Sedentary jobs where they need the brain functioning very well and then once the early signs that the short term memory problems hit, and the concentration issues hit, there's really no way they can do those jobs anymore. So they either quit or get fired or take an early retirement. Then they come to me and ask, Well, what can I do about this? Really, the driving force in an SSD case is the symptoms, just the diagnosis of one of the dimensions isn't going to get social security to approve disability. They're really going to look at the symptoms. How much are the short term memory issues impacting your daily life? How much are the concentration issues affecting your daily life?
6. What are some examples of how it can affect their daily life or affect their ability to do their job?
- Some of the examples are, there'll be complex problems. I have a client, that was at it at a relatively high level IT job as a middle manager, and would have to project manage these very complex international projects. As you can imagine that, if you're trying to manage one of these projects, and you keep forgetting what you just read, that that's going to have a big, big impact on your job and that's really one of the first things forgetting what you read is, you know that happens with age anyway, to a certain extent, but when you're having to read things two or three more times, to understand them, then that can be indicative of a problem, the mental fatigue from concentration issues. That is one of the problems that I'm seeing where what you have to do in a 10 hour day and concentrate, the great majority of that time, you start at 8 am. and by about 1 pm, you just can't concentrate on anything anymore. That's one of the issues that I see in people that have this diagnosis also.
7. Are the people who are white-collar workers, who have to do a lot of thinking and reading and basically concentrating so that they can show that they just can't do that, they just don't have the faculties now to be able to do that job. If they show that, and you can prove it, then what is the likelihood that Social Security is going to approve them?
- It depends on associated issues, such as physical issues, though, when someone's 60 something years old, and they have dementia, it's usually not the only thing that they have. So it's a fairly easy case. If, for example, there are knee problems, documented back problems, documented knee problems, some kind of problems, physical in nature, if we can document those problems and document the cognitive issues Then it's generally a pretty easy case if there are not any physical issues at all, and it's just the cognitive issues, that it's a little more difficult and probably will take a little more time. But in the end, we're successful with 90% of these cases. I mean, these are, these are generally really good cases to get approved for SSDI social security disability.
8. Would it actually be easier if blue-collar workers got the same symptoms that we described earlier? With the concentration and with memory and just their ability to function mentally, even though they don't need to do that for their job. The fact that if they have those symptoms, as well as a lot of physical issues, is it actually going to be a smoother ride for them?
- Well, it's just inherently a smoother ride for blue-collar workers, although we are seeing a lot of denials coming down now for some reason. But traditionally, it's been a really smooth ride for blue-collar workers, and then adding on the cognitive issues is the cherry on top. Oftentimes not necessary, but we're never comfortable with the amount of evidence we have. We always want more evidence of someone's inability to function at 100% on a day to day basis. Whether that functioning is physical knee problems, back problems, or mental with cognitive issues, short term memory issues, concentration issues. The frustration involved also is a factor because as you notice the somebody whose cognitive abilities are going downhill usually gets really easily frustrated, and some depression can kick in also, and we use all of that because social security looks at all of that. And the combination of impairments generally does help with a case.
9. Is Social Security particularly hostile to this type of case? Are the denials just global as far as that, it could be for any type of condition or any type of injury or disease, or is it just focused on the early onset of dementia individuals?
- It's everything so it's across the board and the older people are being affected along with everybody else, but I think it's particularly damaging to our older clients and older people in general, because of the multitude of problems that they have.
10. What is the Social Security Administration looking for? Is there anything written that says if you have this, this, and this, you automatically are eligible for benefits or it's going to increase your chances of getting the benefits? So what, specifically are they looking for in early-onset dementia cases?
- What Social Security is looking for are activities of daily living away from work that are being affected. I don't know why that is. I have no idea. Because I would think that it would matter quite a bit. What happens in the workplace. It really doesn't matter at the initial application level. What they're looking for is daily evidence of loss of complex attention. executive function, learning, and memory, loss of language ability, something called perceptual-motor, which means is that you're having trouble picking things up. You're having trouble judging stares, for example, because your brain isn't perceiving what's around you correctly. There’s also then social cognition, which means you’re losing your ability to understand what's socially acceptable.
"What I prefer is a really good psychiatrist to document things." — Emmett Irwin
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Emmett Irwin:
Facebook: Disability Benefits Channel
Website: EBI Law
Phone: 443-839-0818
YouTube: Disability Benefits Channel
Email: ebi@ebilaw.com
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Billie Mintz: Billie has dedicated his career to social justice, raising public awareness, and advocating for those who have no voice - including a reporter for the departed. His belief in the power of story to initiate people and for policy change is a driving force in his life as an investigative journalist and filmmaker. He is represented by the Creative Artists Agency (CAA)
In this episode, Steve and Billie discuss:
1. What gave you the idea to do this type of movie?
- In documentary filmmaking and in social justice, you don't really have the liberty to think of what kind of movie you want to make you sort of discover something that's going on and you realize that you're the person that needs to expose this to a larger audience. As you said, you didn't realize it was going on. These are the type of crimes that exist in the United States, only because people don't know it's going on until it's too late. I had discovered this, that it was happening through one individual that I met and I looked into it. Then I realized that this is something that's happening to thousands upon thousands of people in the United States, specifically elderly people and I just knew that there was something that I had to do about it to sort of ring the warning bells. There are people out there that are looking and have very organized in order to exploit you and take advantage of you and take away your liberties and there is really very little way to fight back.
2. Is this the first time that you were delving into the social justice arena?
- Growing up I was a neurotic Jew, I always grew up with the concept of life was unfair, and I had to do something about it and that's sort of turned into my profession.
3. Can you share with our injured senior community, the backstory of how you were able to move forward and make this documentary a reality?
- Basically, I learned that there was a criminal conspiracy running through family courts all across the United States, where lawyers and judges and what people call themselves as professional and public guardians, people who are supposed to be taking care of vulnerable people. They are we're using the color of law in order to basically legally kidnap elderly people take guardianship over their lives and their money and incarcerate them in nursing homes against their will, and what I uncovered was in state diagnosis of dementia. So basically what happens is somebody knocks on your door, and you don't even know who they are, but they actually already have legally been able to take over your life and your finances and there's a whole backstory that was happening without your knowledge where you possibly somebody in your health care was involved and what's happening is that elderly people are being targeted by an entire system that's completely legal, unethical, but legal, that's running through the court system, which is set up to entrap and snare you and take away all your money and your liberty.
4. How did you find out about this?
- Well, interestingly enough, a total different story was I was looking for my next film, and I kind of asked the powers that be meaning, whether it be the universe or God, whatever you believe of, you know, where's my next story, and I heard a very strong voice to go to Serbia to go to Belgrade and I'd never been there and then I was confused. So I flew to Belgrade showed up and immediately within five minutes met a man who asked me, what am I doing here? I told him the story I just told you that I just kind of got this premonition to find my next story in Belgrade. He kind of laughed and then immediately introduced me to a man whose parents were taken in a guardianship scam. I had no idea what that meant and so I met with this man and his parents were basically kidnapped by their accountant who became their executor so I went to look into it and found out that there were actual full organizations that were set up in order to help elderly people but nobody had written about it. Nobody had made a film about it. So I did a couple of years worth of research, and then found some cases in Las Vegas and decided to just focus on one county and I exposed all of the players that were basically being parasites and vultures and doing terrible things to elderly people in Vegas.
5. Who are the players, from the beginning before a person knocks on the door? Where does the whole scenario start?
- Well, it's interesting because where it starts for the individual is the knock on the door, but it actually started a long time earlier, unbeknownst to the person who is getting that knock on the door, and once they knock on your door, you're already done you’re already part of the system, and if you're one of those unlucky people that get your door knocked on, and it could very much happen to you so don't think it can't because it happens to hundreds of thousands of people in the United States. In fact, there are 1.5 million people right now under guardianship, and it's unknown how much of that is on lawful guardianship or it's actually legal but unethical guardianship or guardianship, what we call guardianship abuse.
6. Who is really the one that is running the show, and is the mastermind of it?
- Think it's probably different in each scenario of what state or what county is operating. There's definitely a playbook. All across the states, we've learned that they all operate from the same playbook. They're all doing the same system and when you have, let's call them wolves. It just depends who the alpha is, and who's the scariest and who's running the whole thing. You have a lot of corrupt people that are all coming to the same trough and eating from the same place. In the case of my film, The Guardians in Clark County, Las Vegas, in Nevada, it's basically a gentleman by the who was by the name of Jared Schaffer, who had been the Public Guardian before so he kind of created all the laws around how to deal with all these elderly people.
7. So can you tell our injured senior community once there's that knock on the door, and everything's already been decided it's already been adjudicated? They're toast. So what happens from there?
- Well, they're given in submitted cases that I've followed, they're given a couple of choices from this guardian. Now keep in mind this Guardian does this every day different people. They are not compassionate. They're a sociopath. They're extremely dangerous and they're trafficking humans. That’s all they're doing to this person. That's another cash cow. It's another person who tried they need to get you out of your house, which they have the legal now the legal right to do so because they have a legal binding piece of paper that says you cannot take care of yourself and you have dementia. They get you out. They take you to a nursing home. Sometimes the nursing homes in the know sometimes they're not. It all depends, they take you to the nursing home, they drug you up. You're saying hey, what is going on, you're confused. You don't know what's happening and then the very next day, they show up in a U-haul, because there's just systemic and they go through your house. They find your cash, they find everything they already have access to your stocks, your bank accounts, etc. They have to wait on that because they have to they only have temporary guardianship of you at this point. There's going to be another trial coming up, but you're not going to know that it's going to happen, and you're not going to be able to show up to it because you're going to be incarcerated in this nursing home. I know that sounds terrible. It is terrible. It sounds like a horror story and it sounds like it's not true but it's true and it happens all the time and it's I've seen it happen to so many thousands of people that I don't doubt it at all anymore. I did at the beginning. What they do is when you're in temporary guardianship, they try to keep you incarcerated in the nursing home. They keep you drugged up because they say you have dementia and they put on all sorts of psychotropics, and if you resist, they then take you to the psych ward, a lot of people have been taken to the psych ward, where if you keep giving them all the time, they'll do something about it that would probably have more permanent effects. But what they do is they go through your house, they find all the cash, and then they empty your house, they sell everything, just to see what they can because they're getting your house ready to sell because a lot of this is a real estate rapid as well.
8. What happens if elderly individuals knew what was going on and they were not going to leave that house so it's like a standoff?
- Usually, if somebody comes to your house, who's official and says they're an officer of the court and they threaten you, they give you three choices. They say you either come with us and we'll figure this out, we'll take you to a nursing home and we'll figure this out and they lie to you. They say we're just going to do some tests on you for a couple of days. The second choice is where we bring the police and you go to jail, or we will take you to a psych ward, you're going to choose to go with these people because you don't know any better because it seems legit and you don't want to call a lot of people. How they get these people is, if they do have children to call. You don't want to call your kids because you're embarrassed because you want to figure this out for yourself. You don't want to scare anybody, but and that's how they get you they prey on you it's very uncomfortable. It's very embarrassing to have this kind of thing happen to you. The biggest advice is, first of all, don't go ask for the police and call whoever you know, right away and tell them this is happening.
9. How are the children or family members allowed to be shut out of the process before you get the knock on the door?
- There are different theories. In the film, we found a couple of cases, we found one case and other suspected cases of mail fraud, which obviously, in any court proceeding, there needs to be due process for it to be constitutional. So basically, if there's going to be a court hearing about you, it's not legal unless you know about it so they have to mail some information to you. What's actually happening and what is consistent is that these people are not getting anything in the mail. They're not being told that this is happening and that's where this is a federal crime is that they are not following due process in the federal crime. So what they're doing in some cases, is they are taking guardianship and changing your mailing address, and then sending out the mail knowing full well that the mail is not going to get to you. So that's one way that they do it.
10. Are the lawyers, police, and the criminal justice system also complicit?
- It's a police matter, but at the same time if that Guardian shows up at your door, and you don't go with them in the order, it allows them to call the police and I can tell you thousands of times that we've had to come and help get those elderly people out of their homes by police force.
"It was a total bogus document that the courts accepted that it was just part of their scam. They were all in on it." — Billie Mintz
Mentioned: How The Elderly Lose Their Rights- The New Yorker
The Guardians Documentary
The Ponzi Scheme
Jesus Town USA
Portrayal (Coming Soon)
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Billie Mintz:
Website: billiemintz.com
Email: info@billiemintz.com
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Rob Schenk: Rob's law firm Schenk Smith is based in Atlanta, Georgia, and is focused on representing individuals injured in nursing homes and assisted living facilities. He's also the co-host of the Nursing Home Abuse Podcast. A bi-monthly video podcast dedicated to educating families on nursing home care.
In this episode, Steve and Rob Schenk discuss:
1. In Episode Six, you refer to assisted living facilities as the Wild Wild West. What exactly did you mean by that?
- Primarily the fact that if you and I are talking about nursing homes, there's going to be uniformity with regard to how they're regulated from state to state. Assisted living facilities, what we're calling assisted living facilities. There is no uniformity and regulation and guidelines across the country. Every state handles things differently and I believe that it's the wild wild west, because that, in turn, causes a lot of, quote-unquote, brand confusion. What are you getting out of these facilities? it's a gray area, in my opinion.
2. What is the difference between a nursing home and an assisted living facility?
- A nursing home is defined by the federal government and doesn't differ from state to state and it's essentially a facility that provides skilled nursing care according to those guidelines. Because an assisted living facility is different from state to state, there's no broad definition. However, typically, there are no skilled nursing services provided at an assisted living facility, like there is in a nursing home. An assisted living facility is a facility that typically only provides what's called personal services and assistance with daily living activities.
3. Are administrators advising people that there are no skilled professionals at the assisted living facilities?
- Well, hopefully, so by way of example, in Georgia, there are state regulations about who is even qualified to go into assisted living facilities. So it's the facility’s obligation to do an assessment to determine if this person can even come in or needs proper 24-hour skilled nursing care. Also, from that, they're required to tell them the services that they're going to get there. But you know how that works. I mean, like, if you ever made a huge purchase, like a house or car, whatever the case may be, you're signing 16 different pages. A lot of times these are decisions that aren't made weeks in advance. These types of things grandmother fell, and now she can't do the things herself. We got to get her into a place quickly. So there's a lot of moving parts to sitting down in that admissions office and talking about these things that go over overlooked.
4. Would it be fair to say that for the most part people that are going into assisted living facilities, their health care concerns are not as serious, as ones that are going into nursing homes?
- That's a fair assessment. I think that's kind of the concept behind the assisted living facility. Ideally, it's for someone who only needs assistance with what we would call ADLs. For the most part, ADL is being activities of daily living. So, if your grandmother needs help with personal hygiene, toileting, transferring locomotion, these types of things, otherwise, she's okay. Then that's probably the candidate for assisted living facilities across the country. That's usually what it is. What you're finding though, is that these are individuals that need more than that. They need somebody that has eyeballs on them and can tell whether or not that is a wound that is a pressure ulcer or that this person has a cognitive impairment such that if there was some type of issue, they would not be able to find their way out of the building. On our podcast Will and I talked about how people think that it’s Driving Miss Daisy? Like it's something where it's a perfectly capable lady that just needs a friend. That's oftentimes not what you get in assisted living facilities. That's kind of the idea is that you have someone that can pretty much take care of themselves in some activities, but just needs a little bit of help from somebody that doesn't necessarily need to be qualified as a nurse.
5. So, in assisted living facilities where you've got somebody who's maybe making a little over minimum wage, who's got a high school diploma, how are they going to be able to detect that type of wound or that type of problem since they have no training?
- That's exactly right. That hits a particular issue about the differences between the two. In a nursing home, the staff is obligated to assess skin and for by way of example, skin integrity risk, and based on that assessment, put in place a care plan, and revise the care plan as they have observed it to be working or not working. In the state of Georgia, you have to do an assessment in an assisted living facility. But it's not as in-depth because you're not obligated to do anything with regard to skin integrity, preventing pressure ulcers and things like that. Therefore, these things will happen, particularly if the person shouldn't be in there. So that level of care isn't quite the same and it's not the obligation to provide that care is not the same.
6. Is it that the problem is that while they're in there as they continue to age or that things happen, the adequate staff that has the qualifications to diagnose or to treat are just not there?
- Yes and no, I think that to the extent that any assisted living facility advertises memory care, and such that the public believes that well, my grandfather has Alzheimer's and is only lucid five minutes a day and can't recognize me and believes that they're living in 1976. That person, in my opinion, is not going to get the correct level of care in an assisted living facility. They've kind of progressed out of that level. But yet, assisted living facilities are advertising care for these types of people. In my opinion, there is no difference between an 87-year-old person with advanced Alzheimer's in an assisted living facility versus a nursing home, they're under the same level of risk for fall, skin integrity, these types of issues. So that's what creates the gray area. That's what creates the problem. That's why it's kind of like the Wild West. At what point does someone graduate from an assisted living facility to a nursing home and I don't think that most assisted living facilities can determine that appropriately.
7. Is it true that half the people with COVID or who have serious consequences from COVID come out of assisted living facilities and nursing homes?
- That's exactly right. It's a vulnerable population. Now, I'm not saying that you can't have an intermediary between somebody living independently at home and needing 24-hour skilled nursing. I think we can all agree that that's okay to have in the middle spot. I think the issue that needs to be addressed is there needs to be heightened care. They need to have a set parameter for who is working in these places
8. In your opinion, why has the assisted living facility industry basically been left untouched, and unregulated?
- 99.9% of nursing homes receive Medicare or Medicaid money, and that allows the federal government to regulate the facility. So nursing home A, in whatever state, if they want to receive Medicare funding reimbursement for taking care of these people, they have to follow these rules. That by and large is not the case for assisted living facilities. I'm not quite sure how it is across the states but Medicare and Medicaid are not paying for assisted living facility stays.
9. Would you agree that it is like an insult to injury when the state does come in when there are deaths and they cite the facility for a lack of safety safeguards for the residents and only fine them $150?
- I would absolutely agree. I think that's why it's important to always have a strong civil justice system because if we can agree that a citation or regulation is not going to act as a deterrent, then certainly a large verdict would.
10. To the best of your knowledge, are infections more prevalent in nursing homes, assisted living facilities, or elsewhere?
- I actually don't have an answer to that. All I can tell you is that the federal regulations regarding infection control that would apply to nursing home facilities are pretty stringent. Each facility has to have hand hygiene protocols when PPE should be used, these types of things. There should be an infection control preventionist that oversees those policies. With assisted living facilities that's not the case. Now, each state might have infection control, you know, regulations for assisted living facilities, but in Georgia, they're not very strong in my opinion, and they're not really enforced. So whether or not there's led to some, you know, wide gap between infections and assisted living facilities and nursing homes. I don't know. I don't know the answer to that.
"It's simple online research, depending on what state you're in, almost all states have some type of database where you can look up the facility and you can look up whether or not it has been cited." — Rob Schenk
To get the rest of the story about assisted living facilities: go to www.injuredseniorhotline.com/podcast to hear the rest of the episode.
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Rob Schenk:
Twitter: @Schenk Smith
Facebook: Rob Schenk
Instagram: @Schenk_Smith
Website: Schenk Smith Trial Attorneys
Show: The Nursing Home Abuse Podcast
LinkedIn: Rob Schenk
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Danielle Roberts: Danielle Roberts is a founding partner at Boomer Benefits. A National Agency specializing in Medicare-related insurance products since 2005. She serves thousands of Medigap policyholders in 48 States. Boomer Benefits help baby boomers learn the ropes regarding Medicare and is a nationally recognized expert in the Medicare sector of the health insurance industry. Danielle is a past President of the Fort Worth chapter of the National Association of Health underwriters, and a Forbes financial council member. She's been featured and or quoted by major news outlets around the country such as Fox, Yahoo finance, and Business Insider.
In this episode, Steve and Danielle discuss:
1. Why do people feel so overwhelmed about Medicare when they're approaching age 65?
- I think it's because your whole working life, you've had someone choose your health insurance for you, you work for a company, that company has an HR department HR department reviews a bunch of group health insurance plans, and they come and say here, you know, you can sign up for this plan. Here's what it's going to cost you out of your paycheck. And that's what happens. Maybe you work for a company that gives you a choice between a PPO and an HMO. They have two plans to choose from, but you never have to do any of the heavy lifting and learn what deductibles and coinsurance are. You just sign up and go with whatever insurance that's given to you. Well, when you turn 65, and you're retiring. You're leaving that group health insurance at 65 or later, either way, you've got to learn this National Health Insurance Program, which is a beast with four parts, 10 supplements, and literally thousands of Medicare Advantage or Part D drug plan options.
2. Why haven't they made it easier to comprehend or done some type of Medicare course to help people get introduced and acclimated with Medicare?
- Yeah, you're speaking my language. We have a private Facebook group where we allow people to join and ask their Medicare questions. I have heard that same question. Probably hundreds of times, people will say, Why didn't anyone prepare us and I often like to say, there should be a class when you're 50 that you have to take online, and they could do it in an hour, but preparing you for things that people generally don't know about Medicare, namely, that it's not free, that you're going to pay for it, and also that it doesn't cover 100% of the cost of your healthcare so that you have time get ready for that. Because we have met over the years, many, many people turning 65 getting ready to retire who were just blown away to find out that there's a cost to this healthcare that they're going to pay their whole life, that it's going to be deducted from the cost, their social security check, and they're not ready. So we've seen a lot of people decide to work a few more years because they were so caught off guard. So the government really does need to do a much better job. They send out a handbook. It used to be mailed to you now not even everyone gets the book in the mail. There's some legislation too, that's in Congress right now to take place to try to do a better job of preparing people for when they should enroll. So they don't end up with penalties that they incurred just because they didn't know when and where and how they should have signed up for Medicare.
3. Is it because they're so confused or just so not in the know about what it actually involves and what it’s gonna entail? Usually when there's things that people don't really know anything about, and they're a little nervous about, they tend to avoid it.
- Yes, people will procrastinate until the very last minute, or they just don't make any decision at all. They sometimes end up in trouble for that. One example that we're dealing with a lot now is that people who don't have employer insurance who've been insured the last few years through the private health care exchange, they have had a subsidy which, helps to make that insurance, very inexpensive for them. So they might be paying 50 or $100 a month for a health insurance plan because the government picks up part of the cost of the premium under the Affordable Care Act and so they're like, well, I love the insurance coverage I have I’m just not going to sign up for Medicare. Well, what they find out later, is that it was never intended that the ACA replace Medicare, they're supposed to leave and enroll in Medicare at 65. So not only will they pay a late enrollment penalty for signing up for Medicare because of that, but furthermore, once the government catches up with them, they'll make them pay back all the subsidy dollars that they've been given since age 65. And you can just imagine there are literally thousands of people in that bucket who don't know any better. So it's so important that people start doing their research early. The early 60s is a good time, but certainly no later than age 64. You need to dive in and learn the parts of Medicare and learn the enrollment periods and familiarize yourself with all that so that you don't accidentally make a huge blunder that is going to affect your coverage and what you pay for it for the rest of your life.
4. Can you fill in our listeners on exactly what that entails when you start becoming eligible for Medicare as far as price?
- So part of the reason people think Medicare is free is that during your working years, you pay FICA taxes, and you see on your paycheck stub, the amount that's pulled out of your paycheck to go toward Medicare and to go towards social security. So people think that they're prepaying and that Medicare will cost them nothing when they get there. And on one part, that's true, Part A, which is your inpatient hospital coverage under Medicare that is funded by the FICA taxes that you pay throughout your working life or if you were married to someone, you have to work at least 10 years here in the US or be married to someone who did to get Part A for free, and most people do work so about 99% of all Medicare beneficiaries, enrolling in part A will pay nothing for it. A lot of times immigrants who are recent to America, maybe don't have that work history, you can purchase it, but for most people, Part A costs nothing.
5. What exactly is Part A?
- Part A is your inpatient hospital coverage. If you're admitted into a hospital, Part A is the fund that pays for inpatient hospitals, skilled nursing, hospice, blood transfusions, things like that, that would occur in a hospital setting.
6. So that doesn't cover all the other stuff? It only covers if you get sick, and you have to go into a hospital or you have to get skilled nursing?
- Sometimes, people who can't afford or didn't know they have to pay, won't sign up for the Part B which is the outpatient coverage, and that's a big mistake if Medicare is going to be your primary coverage if you don't have other coverage, such as through the VA or through retiree coverage through an employer, because although Part B does pay for outpatient things like you and I would think of as outpatient like doctor visits and lab work, it also covers things which may happen in the hospital because physicians perform services at a hospital and physicians fall under Part B. So if you were to have outpatient surgery or chemotherapy or radiation in a hospital, Part B is actually the part that covers those services. Part B is not free currently in 2020. The base premium, the standard base premium for Part B that most people pay is $144.60 per month. That typically goes up a little bit every year. People in higher income brackets about 5% of Medicare beneficiaries pay substantially more than that because they're in a higher income bracket.
7. What about the senior or the aging person who doesn't want to pay $144 for part B, and has either a pension which includes health benefits or is still working and has health benefits, do they need to get Part B?
- They don't. If you work for an employer, past age 65, and that employer has more than 20 employees, then you can keep your employer coverage and it's going to pay primary and Medicare will pay secondary.
8. What is Part C?
- Part C is the Medicare Advantage program. To understand how that works, I'll first state that when you have your Medicare benefits in place. They work similarly to other insurance that you've had in the past when you have employer group health insurance. When you go to the doctor, you have a copay. If you go to the hospital, you pay a deductible. Well, Medicare has those same things. You have a deductible when you go to the hospital, there's an outpatient deductible, and then Medicare covers only about 80% of your outpatient expenses. So you need some sort of supplemental coverage that's going to cover that other 20% and also pay those deductibles for you. So you could choose to enroll in a traditional Medicare supplement that goes alongside the original Medicare that picks up those things for you or you could opt for the Medicare Advantage Program instead. And that is just a way where you can get your original Medicare Part A and B benefits through a private insurance company that operates a local network in your area.
9. What's the difference if someone wants to do Part C and Part D, they can either get that through Medicare, or they could get it through private companies such as Boomer Benefits?
- The Medicare Advantage program is not something Boomer Benefits offers, you would enroll in a private insurance company, and all the same companies that you're used to that operate in the under 65 world. They offer Medicare supplements and Medicare Advantage plans. So in your local area, you might be signing up with United Healthcare or Blue Cross or Aetna or Cigna Anthem. There are dozens of carriers that offer these plans. The main differences are with original Medicare and a Medicare supplement. Medicare is the primary payer and if you have a Medicare-approved claim which Medicare approves most medically necessary care. Medicare pays its share and then sends the rest of your supplement company and the supplement company picks up their share, leaving you little out of pocket. And the advantage of sticking with original Medicare and going that route is Medicare doesn't have a network There are over 1 million providers that participate in Medicare across the United States. So you can see any doctor you want anytime you don't have to pick a primary care doctor, you never have to get a referral.
9. If I was over 65 I could use any doctor, even in another state under my part C?
- Original Medicare with a Medicare supplement is the one that you could see any doctor Part C is the one that has a local network.
"What’s really important to know Is that Medicare has election periods and you need to know how they operate and when to use them."
— Danielle Roberts
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Danielle Roberts:
Facebook: Medicare Q&A with Boomer Benefits
Instagram: @boomerbenefits
Website: https://boomerbenefits.com/
Pinterest: Boomer Benefits
YouTube: Boomer Benefits
Phone: 855-732-9055
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About John Stolarz: John is the head partner at the Stolarz Law Firm. His practice specializes in representing employees for discrimination on the basis of age, sex, disability, or race and for wage theft by an employer. He's been practicing since 1980 and represents employees in the state of Maryland and federal courts.
In this episode, Steve and John discuss:
1. How prevalent is age discrimination in the United States workforce today?
- It happens all the time. The problem is that employees don't really know when it's happening and when they do realize that that may have been the case, they have not taken any steps to protect themselves and that is a real problem. It is difficult to determine what the motivation of an employer is when they take any type of disciplinary action against the employee or start picking up their work or transferring their work to people who are younger. So it's very prevalent and it's very difficult to protect against themselves unless one knows what to look for.
2. What protections against age discrimination to older employees have in the workplace?
- The protection that they have is the two statutes of federal and state statutes. The federal law is The Age Discrimination and Employment Act and the Maryland law also has a statute in the state government article, generally. The laws and they're both relatively saying, protect an older employee when he or she applies for a job and when they are not hired, and this is very difficult to prove, of course, but if there's something during the course of the interview, perhaps that can lead the applicant for an employer for a job to kind of figure out that the employee is not going to be employed, because of their age, the protections are there for older employees.
3. At what age are you considered an older employee?
- Generally and under federal law, an employee over the age of 40 is an employee who feels that there is discrimination going on because of preference, for example, of younger employees. That entitles the employee to proceed with an action against the employer. On your Maryland law, there is no age limit under Maryland law, and all the workers, if there's a preference for a younger worker, for example, or if the employee is not getting jobs, but a younger employee is getting those jobs, for example, it doesn't matter what the age is.
4. In other states are there the same protections that Maryland gives to its older employees?
- Most of the states have their own rules which are similar to The Age Discrimination and Employment Act, but usually, in other states, there are no such protections. They are protected by federal law, assuming there are certain interesting commerce requirements are fulfilled, but those are usually not very hard to do.
5. Should a person who believes that they've been discriminated against because they're a part of the aging population, or older than 40, make claims under both the federal law and their respective state law?
- Once the employer determines that there may be some sort of age discrimination going on. If the person is still employed, the first thing that person should do contact the HR department and make a legitimate complaint about that. If you start filing a lawsuit without taking the steps in the workplace that the employee has available to him, in case there's discrimination, in court, you won't fare so well. So the most important thing for an employee to do, if the employee feels that he's there's some sort of discrimination is to contact the Human Relations Department, in the company. Most importantly and many people don't do their due diligence and look in their employee handbook and see what they should be doing if they feel there is discrimination and follow those rules that are in the handbook. That will protect the employee from retaliation because if the employee makes a complaint about age discrimination in the HR department whether they're right or wrong, the employee is protected from any type of retaliation by the employer for making those complaints.
6. Are you saying that they could pursue a wrongful termination or retaliatory termination type case if they were actually fired because they reported it or complained about it?
- Let's break it into two parts here. First is if the employee is still employed, and he feels that there's age discrimination going on, or that the employer is starting to move towards replacing that employee and with somebody younger, the employee needs to make the complaint. If the employee doesn't make a complaint, but then goes to the EEOC process and the employer will say, well, we would have taken the necessary steps to correct the problem. So that's why it's important to raise it in the workplace if they're still employed there. So that employer cannot, later on, come in and say, Oh, we would have taken care of the problem if we were told something about it. I hear those types of complaints in age, race, sex discrimination all the time.
7. What is the best way to make a report to HR, by just talking to them or in writing?
- If an employee feels that there's age discrimination going on, the first thing that employees should do is keep good notes. Keep good notes of what happened in the workplace, get what was said, who said what, and keep those details as they go along until they do have that feel enough to be able to approach the HR department.
8. So no matter what state they're in, in order to make a federal claim that they've been the subject of age discrimination, they have 300 days from when the discrimination ended?
- If it's a continuous type of action. It's from when, from the date the last date, but that's always a tricky question. What's continuing action? Discrimination taking place is a tricky legal question. So the employee should always make the complaint as soon as possible and not wait.
9. So federally, there are 300 days, but the sooner you make the EEOC claim on the federal side, the better because you don't want to get in a situation where you made the claim too late. And it's barred by what's called the statute of limitations?
- That’s correct.
10. If they want to make this state claim as well, they should check with their local civil rights commission or Human Relations Commission to see what the deadline is there. If they missed the state statute, if it's under 300 days, they can still make the federal claim correct?
- That's correct. He or she usually cross files with the state version of the EEOC and all around the country. But they're protected when they file with the EEOC because then their protection falls under The Age Discrimination and Employment Act.
"By filing with the EEOC, whether the EEOC investigates. Whether they find anything or not, it doesn't matter because there comes a point in time where you can get what's called a right to sue letter from the EEOC, regardless of whether they found anything or not and at that point, you can file a lawsuit." — John Stolarz
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with John Stolarz:
Website: http://www.stolarzlaw.com
Email: stolarz@verizon.net
Phone: 410-532-7200.
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Martha R Kelso: Martha is the Chief Executive Officer of Wound Care Plus, LLC, which is the largest wound care provider in the Midwest and they have been so successful that she's now in Florida and New York. She's well on her way to becoming a national mobile wound care company. Her company uses the most innovative products and cutting-edge technology to treat individuals with wound care or skin issues at almost any site of care and has educated thousands of healthcare professionals and caregivers on wound care issues, federal regulations, and national guidelines. She is a published author and on several national advisory boards.
In this episode, Steve and Martha discuss:
1. Are bedsores and pressure ulcers considered wounds?
- That's correct. Anything that is a break in the skin or damaging the underlying tissue, you could define as a wound or an ulcer.
2. Is it accurate to say that bedsores and pressure ulcers are mostly caused by actual pressure from sitting in one position for too long or from shearing on someone who has multiple co-morbidities?
- I totally agree. Yes.
3. What type of wounds would you say are most common in the senior and elderly community?
- According to generic averages, about 25% of the time is pressure, 25% of the time are arterial, 25% venous, and then the other 25% is variety.
4. Martha, are you saying that there is misdiagnosis that is happening where the medical professionals or long-term care settings are actually not properly diagnosing these wounds and they actually are cancer?
- Correct. In the document that I published called Why All the Pressure About Pressure?, I list two cases that were wrong diagnosis cases. We have situations where the primary care physician, the medical director, or even another specialist have ordered studies to determine the etiology, like potential arterial disease; so we're ordering an ABI, or arterial ultrasound, and they're canceling our orders saying, nope, it's pressure. It is a systemic issue in healthcare.
5. Is that just a lack of just general training about wounds, or why is this happening so much?
- What's interesting is in the healthcare world, taxonomy codes are what define what a doctor or nurse practitioner does. So, taxonomy code may list them as a general surgeon or an emergency medicine physician. There is no taxonomy code for wound care. There is one for hyperbaric oxygen, but there is not one for wound care, which basically means anybody can decide that they're going to a specialist. There are certification programs and board certification programs out there that specialists can take. However, the majority of them require that you've been doing wound care for at least two years before you're eligible to sit for the board certification. So, I believe in getting board certified in wound care, at the same time experience over and over and over and over and over again is what differentiates between a good wound specialist versus someone that maybe doesn't know what they're doing.
6. Has wound care been dropped to the bottom as far as priorities for the medical establishment? Shouldn't it be required that they become certified in wound care? Not only long-term care setting employees or directors or nurses but also the actual internist or doctors in general?
- In my opinion, we have to have more training in wound care. I've been in the industry for 27 years and even when I went years ago for my LPN program, there was zero wound care training in our LPN program and my very first job was at a hospital as an LPN. I can remember the doctor coming out of the room saying he needs to get a wound vac put on and to go put it on. That was inherent, “Oh my gosh, I don't know how to do a wound vac” and then feeling guilty but you're a nurse, you should know how to do wound care. Well, you're right, I should know. But yet nobody had trained me. Some of it is the industry having to say “forget it, not one more day”. We have to have wound training in our doctor's programs and NP school, PA school, LPN, RN, PT. The whole industry kind of needs to stop. Some people are making good headway and adding that into their programs, but it's certainly not universal.
7. Are wounds common in the aging population?
- Correct, anytime you have somebody with multiple comorbidities, multiple diagnoses, and then you add age on top of it, the skin is kind of our barometer, right? It kind of tells us what's going on inside the body, skin is an organ. So, if our body is not in a state of homeostasis or balance, we get out of balance the skin is usually one of the things that shows that imbalance whether it's through a rash or a breakdown in an ulcer or a dry patchy spot or blister formation.
8. Is the skin more of a barometer of the general health of the person who's affected by it?
- Generally speaking, most times, that's the case.
9. How chronic are diabetic foot ulcers and is that an arterial issue, a venous issue, and then how systemic is it?
- Diabetes is an atherosclerosis issue, more like hardening of the arteries, which also impairs the microvascular blood flow. So, the capillaries that are feeding blood, nutrients, and oxygen to your tissue, are impaired. The interesting thing is that anybody that's had diabetes for any length of time, even if you manage your blood sugar perfectly, you will still end up with microvascular impairment and atherosclerosis. So, the longer you've had it the more damage there is. Diabetic wounds are generally going to occur in the lower extremity, but diabetic lesions can occur anywhere on the body.
10. The wounds on the feet are because the feet are the farthest from the heart, and the blood flow is affected and circulation is not good?
- Correct. So, in following that same school of thought, let's say they don't have diabetes, but they've had a heart attack or a stroke. That is a huge clue that they have significant arterial disease throughout their body, even if they don't have wounds on their lower extremities yet, the fact that they've already had a heart attack or a stroke means that they are at high risk of developing wounds of their lower extremity because they have some form of blood flow impairment throughout their body.
"Anybody that develops shingles, their immune system is already in a weakened state." — Martha R Kelso
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Martha Kelso:
Twitter: https://twitter.com/mywoundcareplus
Instagram: https://www.instagram.com/woundcareplus/
Facebook: https://www.facebook.com/woundcareplusllc/
Website: https://mywoundcareplus.com/
LinkedIn: https://www.linkedin.com/in/martha-r-kelso-5209741/
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Brian Therrien: Brian is the owner of the disability digest, which is a free digital resource that helps disabled individuals get their disability benefits and maximize their disability benefits as well. Now, Brian has helped nearly 200,000 people maximize their disability benefits and their income opportunities. And back in Episode Four, Bryan educated our listeners about who is eligible for Social Security Disability and how seniors can go about applying for and getting Social Security Disability.
In this episode, Steve and Brian discuss:
1. How do you help aging individuals get their disability benefits?
- A quick recap on how we help people get approved for disability faster is people can become a member for free here at the disability digest. What we have done is we put together a disability approval course is what we call the entire piece and when somebody registers and they're going through the process, they get contacted by one of our advocates an actual real live person. So yes, we are digital, but we do have an interactive component with people and the advocate will meet with the individual over the phone and get an understanding of their situation, then assign them a strategy and the right components of the course so that they can go forward, clearly understand what they need to do, how they need to do it, to get their benefits approved fast, simple things like what you need to do to get doctor's support. And if your doctor doesn't support you, then what do you do? It's just one quick example. So what this has done is just given people the control and the answers to get the right information to Social Security, which is what they're looking for, and as a result, the approval times are much faster than somebody doing it on their own.
2. What steps can be taken to maximize the chances of keeping disability benefits in the event of a post-COVID-19 review, and why are there reviews?
- Social Security is going to review their case to determine if they're still disabled. The second piece is to understand what you need to do to keep your benefits. When you are going through the approval process, the general rules of the game are that you need to have conditions that are being treated by a doctor and those conditions are putting limitations on you that prevents you from working. When you have been approved, you have to be able to support the same. In this delicate time with COVID some people are having a challenge getting to their doctors, and the reviews right now have been paused for that reason.
3. Did you mention the home-based workout journal?
- Within most of these Medicare Advantage plans, they do have the SilverSneakers gym membership that you can go to but most of the gyms are closed, but many of the plans have at home structures or different ways that you can get coached, counseled, even for fitness, stretching, flexibility, pain relief regimes that one can do.
4. How much money can one make while still receiving their benefits?
- First of all, for those that are going through the disability approval process, they have one amount that they can make and apply for their disability benefits. At the time of this recording is $1,260. So you can work and earn money. That's the concept. However, word of caution to those of you trying to go through work and get approved. Those cases are very, very difficult to get awarded because as Social Security will look at it and say, geez, you know, you can do a little bit of work and earn some money. Maybe with reasonable accommodations, you could do some more or different jobs. So just be very careful about that. If you're a member of the disability digest, we can talk to you more in-depth or listen to some of our information. So that's one part. Once you're approved for disability, the figure is different. It is right now at the time of this recording $910 that you can make. So how that works is if you are working and collecting a paycheck, a W two like you're employed by somebody, then it's the gross amount of money that you make on a monthly basis. If it's under $910, then there is no impact on your benefits. There is you know, you just report to social security that you're working consistently with your award letter. Now if you're doing something like an independent contractor, you know, maybe you're running a YouTube channel or whatever it is petsitting or, or that then it is your net income after expenses, your net annual income.
5. That's if you're like an independent contractor or you're self-employed as opposed to working at McDonald's?
- Right, and if you choose to go above the $910, there are also options that Social Security provides. There's a program called the Ticket to Work program that provides gradual re-entry with no risk of losing your benefits so that you can earn above that $910. So it's structured Steve so that people can test the waters with no risk of losing their benefits four or five 600 all the way up to $910. We always coach people that once you get stable there and you think you want to go for it, then it's time, but try to do something on a limited basis first, and prove that you can consistently perform there.
6. If you are involved with the Ticket to Work program, is it expected that you are going to at some point come back into the workforce, and your disability benefits will stop?
- Well, perhaps they could, but the Ticket to Work program, in my opinion, it's not successful. I think it's maybe 10% of the people that enter into it succeed. It's difficult to get approved for disability. Most people have legitimate long term impairments that just are not able to work. So going back to full time has proven historically not to be successful.
7. With COVID-19 what other ways can disability recipients who are not going to be able to go back to work find ways to supplement their income?
- I think it's been fantastic for people with disabilities for a variety of reasons. One is that COVID has forced people to go online and some that weren't online before. Now they've had to go online and they might stay there. So creating online jobs is ideal for this marketplace. I was on the phone with GoDaddy earlier today and speaking with one of their service team members, and they've remoted everybody now, and they and which they hadn't before, and that looks like it's gonna stick after COVID because it's working so well. Online positions, working from home, is an advantage for people with disabilities and a lot more businesses are doing it. What that has done is it's created a demand for more home-based workers, large companies that haven't done it are now doing it or doing more of it.
8. Is it an especially good time to be involved in an online occupation, or part-time work, something that you can do remotely from home. On your computer?
- Yeah, and just a few tips for people out there thinking about it. You do need to have some basic tools in place high-speed internet access, a recent computer, typing skills, email management skills, other things like that that you might need. You might want to give some thought to do some practicing up like doing some volunteering or doing something if you're not able to find your ideal job right away so you can start getting those skills brought up to speed.
9. What if you're a senior or elder and are a little intimidated by the computer and might need some type of beginner course and just how to get the basic skills down to operate a computer and to be able to earn a part-time income on the computer?
- If you are on Social Security Disability there are vocational rehabilitation people that would love to do that. That's what they'll do, you go in, they'll assess you, they'll find out what you need. So that's definitely a place to start.
10. If you're on disability benefits now and you want to get those skills, do they just contact their local social security office to get hooked up with a vocational rehabilitation counselor, or how in actual practice how does that work?
- You can just open a browser and search for my local Vocational Rehabilitation Center. If you're working with somebody here at the disability digest on your journey, they'll point you in the right direction.
" A lot of insurance markets now have become so competitive that they offer a cash back feature by moving to their plan. " — Brian Therrien
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Brian Therrien:
Facebook: The Disability Digest Brian Therrien
Website: The Disability Digest.com
YouTube: The Disability Digest
LinkedIn: Brian Therrien
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Sean Marchese: Sean is a registered nurse at the Mesothelioma Center He has experience developing and managing respiratory oncology, clinical trials, and treatments. As a medical writer, he helps patients learn about new therapies in the fight against mesothelioma.
In this episode, Steve and Sean discuss:
1. What is asbestos?
- Asbestos is actually the name given to six different naturally occurring minerals. These minerals are found in the dirt and what makes them so dangerous is that they're comprised of this friable fibrous needle-like material that is microscopic and can degrade and be released from these minerals pretty easily. Asbestos minerals that are mined from the ground were found to be resistant to heat, electricity, and corrosion. So they ended up being used in thousands of consumer products construction materials for over a century.
2. Why is it that in the 70s and 80s ship workers, and a lot of blue-collar workers were coming down with asbestos?
- Blue-collar workers are the primary population that has been affected by this business over the years. And that's because asbestos is linked to industrial engineering fields, and also the military. So the United States military has used as best as in their Navy ships primarily for decades. While they weren't necessarily part of the cover-up of asbestos health issues that occurred throughout the 20th century, they definitely were using the material in many of their vessels and ships. Veterans actually make up a significant portion of about 30% of mesothelioma lawsuits. Again, blue-collar workers are the number one population to be affected by working in industries, such as mining, construction, all sorts of blue-collar fields.
3. Loads of asbestos have been found in housing in Europe specifically the UK United Kingdom. Why would they use it in housing or in the building materials?
- Asbestos was primarily used for construction materials throughout the 20th century starting in like the 1920s 1930s. One of the big manufacturers was Turner and Newell over in Europe and they were using asbestos for roofing tiles as best as cement for piping, pretty much from top to bottom. Most housing materials can be traced back to having asbestos and again it's because that material, those natural minerals are resistant to heat, electricity, and corrosion. They can be used in shingles in floor tiles and insulation because it was a great material to use at the time and the health benefits weren't really brought to light until much later around the 1970s
4. Isn't asbestos fire retardant or fire resistant?
- Exactly, yes, that's one of the reasons it's so popular.
5. How did asbestos get into the Johnson and Johnson talcum powder product?
- Johnson and Johnson were aware of asbestos in its talc dating back to the 1970s and, asbestos isn't necessarily a useful product in talc, but talc that gets mined for products such as baby powder and makeup is sometimes cross-contaminated with asbestos mined in similar locations in the earth. So asbestos can end up in talc. Johnson and Johnson knew about asbestos in their talc, but they didn't really make it public or do anything to help the production of these consumer products.
6. What are the health consequences of asbestos exposure?
- Yeah, the primary disease related to asbestos exposure is Mesothelioma, and more than 3000 cases are diagnosed every year in the US and Mesothelioma is a type of cancer. Specifically, it's a cancer of the Mesothelium, which is a type of tissue that lines the inside of the body. The most common type of mesothelioma is called pleural mesothelioma accounts for about 75% of the cases and that affects the lining, the tissue lining that surrounds the outside of the lungs, the chest wall, and the diaphragm. So most of the structures in the thoracic cavity have this tissue lining called the pleural mesothelioma. So tumors can form against the chest wall on the outside of the lungs on the top diaphragm and that's pleural mesothelioma. There are other types as well.
7. Do the fibers from the asbestos fall to the bottom of the pleural region of the lungs and it's dangerous because it gets to the bottom and inside where it's can do the most damage?
- Once it's in the lungs, it can actually spread to any physical area of that plural tissue. So as the fibers get inhaled through the nose and mouth, they end up in the lungs, and they do fall to the bottom of the lungs, but they're transported by the body through the lymphatic system, which is kind of like the drainage system of the circulatory system, and those fibers can't escape outside of the lungs. The body can't break them down, and they can't go anywhere else. Instead, they cause inflammation, tissue scarring over the course of many years, several decades. So this disease builds up over time and sometimes symptoms appear 30-40 years later when it's much too late to have caught it earlier.
8. You're not going to inhale it and then show signs of it a couple of days later. It manifests itself decades later?
- Correct. The earliest we've seen symptoms appear, or the formation of mesothelioma, from asbestos, is about 10 years. Typically, it's about 20 to 30 years.
9. What is the average age of the person who comes down with mesothelioma?
- The average age of a mesothelioma patient is 69 years old. That's primarily the age group that's most affected because of that long latency period. So these people were affected during their working years, right from their 20s to their 40s. And then symptoms show about 30 years later, and that's when they're diagnosed with mesothelioma.
10. So once diagnosed with mesothelioma, what is the life expectancy?
- It's an insidious disease and mesothelioma patients survive for about 12 months on average after they're diagnosed with aggressive treatment. If it's caught early enough, survival can be up to two years. Sometimes patients do go into remission and can survive for multiple years after their diagnosis, but average life expectancy is about 12 months.
"Asbestosis is what happens when these asbestos fibers in the lungs just continually damage, kill, and scar healthy lung tissue." — Sean Marchese
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Sean Marchese:
Phone: 407-569-3185
Twitter: @TheMesoCenter
Facebook: The Mesothelioma Center
Website: Mesothelioma Center
Asbestos.com
YouTube: The Mesothelioma Center
Email: SMarchese@Asbestos.com
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
In this episode, Steve and Joe discuss:
1. At what point in your life did you start purchasing urgent care centers?
- When I finished fellowship, I began to practice and realize that infectious disease doctors are at the low end of the pay scale for physicians, and that, combined with student loan debt, made me interested in seeing how I might be able to mitigate the set of circumstances and it happened that urgent cares were up and coming at the time, and there was not one in my hometown.
2. Did you see senior and elderly patients?
- Yes, quite a few.
3. Is it accurate to say that the research showing that the senior and elderly population like to go to their primary care doctor first is correct?
- Absolutely. That's where the trust lies. That's where people feel most comfortable is with the physician that they have a relationship with.
4. Did you start seeing some of those seniors and elders either coming over from their primary care doctor or just circumventing the primary care doctor and coming right to urgent care?
- Well, both actually, probably the most common was their primary care sending the patient over to me over to be seen in the urgent care because the primary wanted the patient to be seen and they weren't available, or they wanted some ancillary service that we provided, such as an X-ray, a chest X-ray, for example. And their office didn't have that. We could do the X-ray and read it for him.
5. What was the most common issue that seniors and elders were coming in with?
- Upper respiratory, bronchitis or pneumonia even, and urinary tract infection.
6. Do you have to send a lot of them over to the ER, or what would you do when they came in?
- If it was simple and could be treated in urgent care with a dose of IV antibiotics and follow that with discharge them with a prescription for oral antibiotics, that would work fine most of the time. However, if it was more advanced, and the patient was becoming bacteremic, or even septic, you know, their life depends on early intervention, you know, immediate intervention with IV antibiotics so the first task would be to get a dose of IV antibiotics on board and then to ship them to the hospital where their treatment needed for an IV treatment needed to be continued.
7. What is it about the urgent care centers, which I don't know if it's often but you're seeing that maybe they haven't gotten the best care coming in and these UTIs or upper respiratory infections were not dealt with properly?
- I've seen that. Yes.
8. Can you tell our injured senior community a little bit about the problem that you're finding with urgent care centers?
- Many people recognize that urgent care centers can be profit centers, they can be very profitable. It doesn't require the investor physician to be doing everything to generate income. In other words, he owns urgent cares and they produce income for him. The issue comes about when the physician that owns tries to run too many centers and what he does is he hires what's known as physician extenders. Physician extenders are people such as physician's assistants and nurse practitioners. Now, the law is that as long as the physician is present someplace within the state and available by phone, that the PA or the NP can act autonomously, and when they have an issue or question, they can phone the physician. Most states have statutes that define the scope of practice for physician extenders.
9. In your situation in Rhode Island, the physician extenders could operate as long as the doctor was within the state and was available by phone?
- Correct, and what that often meant was that one set of urgent care centers was owned by one group that owned eight or nine urgent cares had one doctor and maybe 15 or 16, extenders acting at any given time.
10. As a result of that, what did you see occurring?
- As a result, the extender was acting almost completely on its own. If the case came in, that was serious, the extender who was on his own would first have to recognize that he had a serious case, and then after recognizing it would have to phone the physician to get help. That is very unlikely to happen in clinical practice, in reality.
11. How do you know that this is going on in other urgent care centers?
- I know of the centers, I know of the people involved, and I know of the practices involved. I know what I did to keep things safe.
12. Do you have any evidence that this is a national issue? We know that urgent care centers are growing and we know that there are chains of urgent care centers. Are you saying that that is happening across the country?
- I can tell you that in recent years, there's a good amount of case law that's come out, which highlights this issue.
13. Do you contend that they're putting the patient's safety in jeopardy?
- Yeah, the equation is simple. If I hire a physician assistant, it costs me less money than to hire an M.D. or D.O.
14. Can you give our listeners an example or two of some really bad things that happened to seniors or elders as a result of going to an urgent care center where they didn't see a doctor or they saw a patient extender or doctor extender who made a mistake?
- A case that comes to mind that's relatively recent is a case out of Florida a 75 year old male had uncomplicated UTI, went to an urgent care canter and it was missed and not treated by I think nurse practitioner who somehow missed the diagnosis. The patient got worse, went back to the urgent care, and this time they recognized it and what they did and they sent him home on an oral antibiotic that he had resistance to. Now, the problem here is that and the reason it was resistant is that he had previously had a UTI a year prior that was treated and found resistant to this particular drug. Now, the patient extender didn't look back into the records that she had available to her. She didn't realize that the patient was organism resistant and the patient ended up dying.
15. Do you believe that in general, urgent care centers are understaffed, on top of the fact that a nurse practitioner or a physician's assistant is not a doctor? They also might be seeing more patients than they should be seeing?
- Certainly. Steve. I want to be clear, nurse practitioners, PAs, and MDs, we all have our place. We all have legitimacy in the health care system. I'm not putting down extenders, what I'm saying is that they’re being misused.
16. Is it realistic to expect them to tell you that there is or there isn't a doctor on staff or presently in the facility?
- Well, I think most often people are going, to tell the truth, I would.
17. Does it also make sense to check the Better Business Bureau or go online and see if there have been any problems with that particular franchise or chain or urgent care center?
- Oh, absolutely. It's very easy to find the reputation of a given place online.
18. Do you have any other tips or advice to our injured senior population listening to this podcast as far as urgent care centers are concerned?
- I think it's important that any physician that you see is board certified. I think it's important and I think it's important that if you are going to go to urgent care, it's very reasonable to ask if the people that are going to see you are board-certified in either family medicine, internal medicine, or emergency medicine, that's an additional safeguard.
19. Can you just briefly tell our listeners, how you become board certified or, what exactly board certified means?
- A doctor doesn't have to be board-certified to practice in any state. On the other hand, after a doctor completes training, for example, internal medicine training, which is a year of internship and two years of residency, after that, they sit for an exam. If they pass that exam that's when they're given what we call board certification. The significance of that is that Dr has mastered his craft instead of not taking, preparing for, and being diligent in studies and in going through residency and internship. They're technically knowledgeable about the particular fields.
20. So the board-certified physicians are the cream of the crop?
- In my view, and most people in my shoes, our view is that being board-certified is kind of a bare-bones requirement.
21. Is there a high percentage of physicians that are board-certified?
- I would say over 50% are board-certified.
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Joe Grillo:
Website: DrJFGconsulting.com
Facebook: https://www.facebook.com/Joseph-Grillo-MD-Medical-Legal-Consulting-2459082640778409/?modal=admin_todo_tour
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CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
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LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Richard Mollot: Richard is an attorney and the Executive Director of the Long Term Care Community Coalition, or LTCC for short. The LTCC is a nonprofit, nonpartisan organization dedicated to improving care and quality of life for residents in nursing homes, assisted living, and other residential care settings, through policy analysis and advocacy.
In this episode, Steve and Richard discuss:
1. How has the long term care industry handled protecting our seniors and elderly from COVID-19?
- We know that nursing homes are not great places to live, generally speaking, that care tends to be pretty poor and living conditions aren't great. I think that most people were really shocked to see that preventing infections was such a big issue and the implications of not having enough staff on a regular basis has greatly amplified the harm that residents have experienced both directly to COVID-19 and indirectly, due to what we're seeing more and more of the past at least a month and a half has been just abject neglect and substandard care.
2. Are you also concerned that the industry is not checking the temperatures, vetting their staff, or other people that were coming in and out of their facilities?
- The Trump administration just started as of earlier this month, May 8, 2020 requiring for the first time that nursing homes report the cases among residents staff, suspected cases, deaths, both related to COVID and non-related to COVID as well as the variability of ppe and other necessary equipment for dealing with this pandemic. We did go March and April without having any of that information recorded. We do know that there has been a tremendous, frankly horrifying impact on residents in nursing homes and adult care facilities and that the only people who have been coming in and out of those facilities since early March when families and ombudsman were blockaded are the staff.
3. What is the state of infection control presently in the nursing home community?
- Leading up to COVID-19, and for years we've known that inadequate infection control and prevention is a serious problem.
4. Why do you believe that one-fourth or one-fifth of the nursing home and assisted living population is dying?
- Nursing homes are allowed to operate without providing good care and without having enough staffing. Most of it comes down to staffing, especially when you talk about infection prevention. We're talking about hand washing, we're talking about changing gloves.
5. Is the lack of staff causing more infections, or is it staff indifference and really not caring about proper sanitary measures like washing their hands?
- I think it's lack of staff. There are certainly bad apples in terms of care staff and most people who go into nursing homes want to do a good job, but the nursing home is such a toxic working environment that it makes it impossible. So the residents are dehumanized and to some extent, care staff is also dehumanized.
6. Has the federal nursing home reform law helped or made the situation better? Is it just an enforcement issue?
- That's exactly right. The standards have been around for quite some time and the standards are really good. One of the small changes that were important that was made in 2016 to address this very issue of infection control and prevention in facilities, and the long standing failures to undertake appropriate protocols is that nursing homes are required to have on a part-time basis an Infection Preventionist. But unfortunately, when the Trump administration came in they have been undertaking a lot of regulatory reduction, which in the nursing home world means reducing safety standards, and one of the things that they proposed is to actually reduce that requirement for having an infection preventionist on a part-time basis.
7. Is sterilization of equipment a problem in nursing homes?
- Yes. It is that the just the equipment is not cleaned appropriately, even equipment that is in contact with a feeding tube, or something else that is actually going into a resident’s body. The standards are really good. They're just not enforced. The industry is extremely powerful in the state capitals and Washington DC so they fight against enforcement, even before the Trump administration for many years. They have worked successfully to weaken enforcement. So we do have persistent issues of not only poor infection control and prevention with respect to washing hands and just basic cleanliness of some of the equipment.
8. Why is there such a problem with linen control in that residents can’t get clean linens but instead have dirty linens that are also causing infections?
- One problem is the lack of enforcement of the rules. Another issue is that there is virtually no accountability for how nursing homes spend the money that they receive to provide care. Just to get the linen issue, you can be a nursing home and you can own a laundry company, you can own a therapy service company, you can own the underlying property to own nursing home and pay yourself whatever you want for those linens services, for the rent on the underlying property, for therapy, services, etc. There's so little accountability of what's going on here, both in terms of where's the money going, how it's being spent? Are the ensuring that the residents are getting good services? It's an utter absence of both the regulatory enforcement of those safety standards and the integrity of the Medicare and Medicaid programs that pay for most care to ensure that the money spent is actually going to clean the laundry, for reasonable rent, and etc.
9. What are some of the most common infections that you're seeing in nursing homes and assisted living facilities?
- There's not a lot of good tracking there. In terms of infection it may be pressure ulcers, that can lead to infection. MRSA has been an issue. Influenza is not an infection, but it's related to COVID-19.
10. As bad as things are in nursing homes are they worse in assisted living facilities?
- Yes, it really varies. You could have facilities that are good that have an RN on staff, but most facilities don't. The ownership may change or they want to save money or, cut back on costs. The RN who was there when you signed, the contract could be gone. The issue, as I see it is that those facilities operate, as far as the state is concerned, kind of like a hotel, or like an independent housing facility. When they're in fact providing more and more care services to people who have vulnerabilities and needs that are similar to those in nursing homes, but without any of those protections that we've been talking about.
11. Is infection control actually less effective in assisted living than it is in nursing homes?
- Yeah, absolutely. That's true, pretty much for everything. The staffing requirements are different. The skilled nurse staffing in nursing homes, you have to be at least a certified nurse aide to provide care in a nursing home that requires a minimum of 75 hours of training. Under federal regs and assisted living. You could have paid 15 hours of training and there'd be no RN, maybe no one who's even awake 24 hours a day in the building to provide and to ensure that a resident in need is cared for in some way.
12. Is the assisted living facility population growing more, as opposed to nursing homes?
- Yeah, the trends are that they are growing in most states, I think 48 states now have some kind of Medicaid assisted living program to enable people who are on Medicaid, to avoid a nursing home placement, and go into assisted living. It's considered a home community-based service. We are seeing growth there but we're not seeing the regulations that ensure that care is safe and appropriate for those residents.
13. What are some actionable steps that can be taken if you're a resident of a long term care facility such as nursing, home assisted living, or a loved one of a member to prevent or protect against infection?
- Be a strong advocate for yourself, or for your loved one, to monitor to the extent you can. I would strongly recommend forming a family council or resident council. Those can be very, very powerful in terms of sharing information, sharing your experiences, and speaking out in a united voice, which makes it much more likely that will be heard by the administrator of the facility. And certainly speaking out when you have a concern. Filing a complaint can be useful, but sometimes it's not because the state some do a great job. In respect to oversight, we're saying speak to your congressional office, call your state legislator and let them know.
14. Can you briefly explain to our injured senior community what the role of the Ombudsman is?
- The Long Term Care Ombudsman Program is in every single state under the Older Americans Act. Under that act, Ombudsman have the right to help the resident personally, have the right to go into a facility anytime, they have a right to review a residents medical records from the facility with the resident or the residents representatives permission, and they can help and they can oftentimes be very effective in helping residents address some of these issues.
15. If a nursing home gets sued for millions of dollars in damages for the resident, do you think that that has some effect on implementing reform?
- Absolutely. That is something we have always strongly supported. Most people don't want to sue even when something terrible has happened to their residents, but our position has always been based upon everything we're talking about today that the rules are there and lawsuits are based upon those rules, not being when there's a failure to implement them, that if the state is not holding, and CMS is not holding centers for Medicare, Medicaid services, accountable for meeting these minimum standards, the only way that will happen is if facilities and in the industry are sent a message and a lawsuit. Not only is it compensation for the harm and the suffering of that resident and the heartbreak of the family, but it sends a message to the facility and to the industry in the community, in the state. That this is not acceptable. You're not going to get paid and get away with providing such substandard care.
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Richard Mollot:
Twitter: @LTCconsumer
Facebook: LTCCC
Website: NursingHome411.org
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Rein Tideiksaar: Dr. Rein is the President of Fall Prevent LLC, which is a consulting company that provides educational, legal, and marketing services related to fall prevention in the elderly. Dr. Rein is a gerontologist, which is a health care professional who specializes in working with the elderly, and a geriatric physician's assistant. Dr. Rein has been active in fall prevention for over 30 years and is the author of textbooks, professional training manuals, and director of numerous research projects regarding fall prevention. Additionally, he has developed fall prevention programs in the community assisted living home care, acute care hospitals, and nursing facility settings.
In this episode, Steve and Rein discuss:
1. Why is it that the elderly are so prone to falls?
- As one gets older you acquire all sorts of physical and mental health problems. Those in combination with medications that are used to treat the underlying health causes can lead one to have difficulty with walking or difficulty with balance.
2. Where are the falls occurring?
- The majority of falls that occur indoors occur to those individuals who are the frailest in terms of physical conditions. The group of elderly who fall outdoors tend to be much more healthy or robust. In a protected population, for instance, the nursing home, those falls tend to mostly occur within the bedroom and the bathroom of the individual residents.
3. What are some reasons for falls due to dizziness?
- Dizziness could be due to loss of fluids, for instance not drinking enough water, loss of body fluids in terms of losing blood, a vestibular problem that you have with the balance apparatus within the nervous system, and dizziness could be due to low blood pressure or taking too many medications.
4. Is poor vision also a factor in falls?
- Poor vision is a very strong risk factor for falls because if you can't see what's in front of you, you're more liable to trip or slip.
5. The falls in the elderly that are happening in bathrooms and bedrooms would be the case for falls in the assisted living facilities and the nursing homes, Correct?
- That's basically correct.
6. Are stairs a major risk factor for falls?
- Studies have shown that if one has stairs in the home, they actually have more muscle strength in the lower extremities because you're going up and down the steps. So in that sense that stairs when you're much younger and age can be a protective factor in terms of preventing falls. But as you get older, then stairs become a real hazard.
7. Stairs have banisters, Is that helpful in preventing falls?
- Yes, and when everybody's anybody's putting handrails into their stairs, they should have them on both sides, just not one side of the stairwell.
8. Why are bathrooms one of the highest risk areas for falls?
- Bathrooms have a high-risk factor for falls for a variety of reasons. One of the strongest risk factors for falls is urinary incontinence. So people are generally hurrying to the bathroom and if you're hurrying, particularly if you have underlying problems with walking and balance that places you at increased risk for falls. A lack of grab bars to hold on to and you have poor mobility, decreased ability to transfer get up and down safely, that places you at risk for falls, as well. Other factors in terms of the bathroom are that everything in the bathroom is hard. It's all porcelain. There's nothing soft in the bathroom so if you do fall, and you hit your head, your shoulder, your hip, whatever, it's a greater risk for falls. Of course, the biggest problem in terms of falls in terms of the home is the shower area because porcelain is very slippery. So the best thing you can do is to put in grab bars, shower chairs. transfer benches, and extended shower hoses.
9. Does getting out of bed at night while drowsy or groggy make it even more dangerous?
- Absolutely. Individuals who have difficulty sleeping and they're getting sleep medications that make them drowsy so they are wobbly when they get up and they’re balance is insecure.
10. Do all the assisted living facilities have grab bars in a bathroom?
- They should. The problem with grab bars is the grab bars are at a certain height and certain angle, etc, etc. But not all individuals are built the same or they have the same stature.
11. So handrails are not custom made?
- It’s that one size fits all. The staff from the facility and the family of the individual need to observe the patient’s movements and functions. If they are able to and can function safely, that's fine. If they can't, then you need to do some modifications to the grab bars and other furnishings within the residence environment.
12. What role can the family play to increase the chances that there will not be a fall and injury?
- A family is aware of any risk factors their loved ones might have and they need to alert the nursing staff if they notice anything that's going awry with their loved ones. Now, on the other hand, if the individual falls, they fall for a reason, and it's important that the families hold the facility accountable for why the individual has fallen.
13. Is there a plan that the nursing home facility normally would construct in order to assess whether or not the person is going to be a high-risk factor? What should they do if they identify that person as a high-risk factor?
- Yes, all facilities do have fall risk assessments and there are a variety of fall risk assessments. The most important factor is to assess is does the individual have a past history of falls before coming into the facility? A past history of falls is the strongest indicator of future falls. Does the person have a cognitive problem? Do they have difficulty with their mobility? That's gait and balance and transfers. Does the patient have early urinary incontinence, those are the four main risk factors for falls.
- Now, if you have those risk factors, what should be done? Well, the nurses should refer the resident to the doctors and other health professionals for evaluation in terms of why do they have that problem?
14. So if you're the family of someone in a nursing home that does not have a fall risk assessment?
- What I have done in the past is to enlist a doctor know as a geriatrician. Either internal medicine doctors or family medicine doctors who have special training in geriatrics, and they're all over the country. And I think that what you can do is you can enlist one of these physicians as the primary care physician for your resident within the nursing home and let the physician you know, the death charge or battle or questions against the nursing facility in terms of how they've done the proper risk assessment, and the care plan, etc, etc.
15. So a geriatric doctor is more well suited for that type of action?
- Absolutely. Because they're advocates for older people.
16. What are some other injuries that you're seeing when senior or elderly people are experiencing falls?
- In the nursing facility, about 10% of falls will result in significant injuries and significant injury are hip fractures, head injury, And spinal cord trauma. 30% of falls will result in minor injuries, muscle bruises, sprains, skin tears, those kinds of events. The other interesting thing is about 30 or 40% of individuals who fall repeatedly, who have multiple falls, even without injury will restrict their mobility over time. And if you restrict your mobility, your muscles get weaker, and you'll have difficulty with walking balance transfers, etc. One of the reasons that they restrict their activity because they fear additional falls.
17. Do you find that the senior and elderly patients that have a series of falls where they receive bruises or scrapes, will eventually have a fall that leads to a hip fracture, a brain, or other injuries?
- That could happen. I don't know what the prevalence of something like that. I've had patients myself who have fallen a few times and they have bruising of the hips, and then a third fall and they have a significant hip fracture. So what you can develop is something called fractures and then after a while that leads to complete breaking of the bone.
18. Is there any technology or any type of flooring that what you're seeing nowadays that might be able to absorb a fall?
- Several companies put out more products that you can install in the bathroom and the product so that if you fall down, it's not a hard surface, but he has some give some absorption.
19. What are 2 or 3 things we can do to prevent falls?
- The most important thing to understand that falls are not a normal consequence of aging. It is not normal for people to fall Yes, people can trip and slip and falls can occur. But if you have a lot of underlying health conditions, then it's imperative that you get your loved one to a physician, particularly a geriatrician who can evaluate why the individual has fallen. And so they can look at the causes.
20. Should they do that before they get admitted into the nursing home?
- I would suggest that if people have difficulty with falls and mobility in the home, that they do an assessment of the home and the individuals condition and can the person remain within their home and even if they can't, is going from the home to an assisted living facility preferable to going into a skilled nursing facility.
21. What things are you doing now with fall prevent?
- I have regular blogs that I do in terms of educating individuals in the community about falls, and also the nursing facility.
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Rein Tideiksaar:
Twitter: @DrRein2
Website: PedagogyEducation.com
Email: DrRein@Verizon.net
Books: Falls in Older People
After the Fall
Managing Falls in Adult Day Services
Guide to Bed Safety
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About John Cascone: Dr. Cascone, is a Board Certified Internal Medicine and Infectious Disease Physician. His internal medicine residency was done at the University of Kansas and infectious disease follow up at the University of Missouri, Columbia. He is the Medical Director of nursing homes in southwest Missouri. His medical practice includes the care of residents in long term care facilities, infectious disease consultations and telemedicine and infectious disease services to rural facilities. He has a special interest in the diagnosis and treatment of sepsis, C diff, colitis, staphylococcus aureus, antimicrobial stewardship, and pressure ulcers. He lives in Joplin, Missouri with his family.
In this episode, Steve and John discuss:
1. What is C. diff?
- C. diff refers to the organism that formerly was identified as Clostridium difficile, but has now been changed to Clostridioides difficile. So the organism and as we'll refer to it as C. diff, is essentially an organism that resides in our bowel and it is a spore forming organism, meaning within the gut exists as a bacteria that produces toxin that leads to the diarrhea that we'll talk about in a bit. Outside of the gut, it converts to a spore. That spore is very hardy, difficult to kill and difficult to get rid of, which leads to the significant risk of transmission that occurs.
2. What is a spore?
- A spore is essentially a non replicating form of an organism, meaning it is a hibernation type of the existence. So, the organism is no longer replicating in the way antibiotics work in killing bacteria. Typically bacteria has to be dividing and increasing in number. So a spore is a vegetative state that is highly resistant and impermeable to antibiotics.
3. Is it dangerous?
- It is dangerous and very contagious.
4. What is a bacterial infection as opposed to a viral infection or another type of infection?
- An infection refers to the invasion of an organism in a normally sterile site that leads to inflammation and disease. In this case, we're talking about the bowel. So it doesn't necessarily have to be a sterile site, but it has an organism that has led to some degree of inflammation and subsequent infection, whether it be a bacterial etiology or a viral etiology. The end result is inflammation of tissues, disruption of tissues and symptoms.
5. Is the affected organism the colon?
- No, the effective organ is the colon. I said originally a sterile site. That is not a sterile site, the colon, but the organism leads to inflammation within that site.
6. So the spore or the seed is what causes the inflammation in the colon?
- The way that works is C. diff is outside of the bowel. It is a replicating organism, it's a bacteria. In the way C. diff causes colitis with diarrhea, it's not the bug itself it is the toxin that is produced from the C. difficile. It produces two toxins toxin A, toxin B and in certain cases can produce a third toxin called a binary toxin. Those toxins are poisonous to the lining of the gut and they cause the gut to get inflamed, to leak water and leads to diarrhea and all types of other manifestations of the illness.
7. Is diarrhea the main symptom of C. diff?
- Yes, so they have C. diff colitis and C. diff infection colitis. There has to be an infection of the colon to have had diarrhea. If there's no diarrhea, then you do not have C. diff infection. You may still have C. diff in the bowel and up to 20% of people who are hospitalized, in 50% of people who reside in long term care facilities if you check their stool, will have C. diff present. But unless the patient has diarrhea, there's no evidence of an infection. So you have to have the diarrhea to have the infection. A good rule of thumb for diarrhea is that the stool can no longer hold up a popsicle stick. So if it can't hold up the stick, then that is considered diarrhea by definition.
8. If there's no diarrhea, but there is C. diff in the bowel then it's kind of laying dormant or it's there and can lead to infection?
- It's there, it can lead to transmission, but if there's no indication you don't treat that. You shouldn't be testing stool for C. diff in the first place. You should only perform C. diff studies or C. diff laboratory studies on stool in the presence of diarrhea.
9. In your opinion what exactly is the cause of C. diff?
- The primary cause of C. diff is the use of antibiotics and antibiotics used to treat other infections in any antibiotic administration, even one dose can cause C. diff. That's an unfortunate event, but that’s when used inappropriately. If antibiotics are used to treat a urinary tract infection, and are used inappropriately, then it increases the risk of C. diff. That's what has caused this rise of C. difficile colitis or C. difficile infections in this country over the last 10 to 15 years. The appropriate use of antibiotics requires that a BB gun be used as opposed to a shotgun. So, the most specific antibiotic to kill that infection, say a urinary tract infection to treat that for an appropriate duration. For instance, a urinary tract infection should be treated for three days. So, if antibiotics are used, or they are too broad a spectrum and are used for a long period of time, longer than what is indicated, it increases one's risk of getting C. diff colitis.
10. Isn't there a recognized protocol for how many days somebody should be taking antibiotics for urinary tract infection? Why would they be treated for more than the recommended protocol?
- There are recommended protocols. The whole shift of infectious disease has been less antibiotic or more specific antibiotic for a shorter duration, we're finding that, for instance, pneumonia, five days of treatment is adequate, no longer 10 to 14 days. There are medical guidelines, the Infectious Disease Society of America guidelines tell us how to treat infections, what antibiotics to use and for the duration. There's no indication and there's no reason to use anything longer than three to five days at the upper end of it for a simple urinary tract infection.
11. The aging well article that I referred to earlier also mentions a weakened immune system, long institutional stays and GI surgery as other causes of C. diff. So if you don't have diarrhea, but you had a bad result from GI surgery, you stay in a nursing home and have been there a long time and your immune system is weakened, is that something that without diarrhea would not make the doctors even consider that it’s C. diff?
- No they wouldn't treat you for C. diff without diarrhea. They shouldn't really even be finding C. diff because there's no reason to do stool studies. Certainly, C. diff colitis is diarrhea but certainly those risk factors that you've mentioned, can lead to C. diff colitis. Not only the advanced age, but in antibiotic use, hospitalization, chemotherapy, inflammation and inflammatory bowel disease are all risk factors.
12. Most people in those situations are on antibiotics so all of it together creates the perfect storm, Correct?
- Correct. That's why you want to be vigilant in using antibiotics judiciously, not over prescribing them and keeping patients out of harm's way when they don't need to be there.
13. How dangerous is C. diff? What can be expected in a mild case of C. diff, as opposed to a severe case of C. diff?
- The mortality of C. diff has a lot to do with the underlying condition of the patient. As we get older, we typically have more comorbid illnesses and we're on other medications. We have other disease processes that are being treated, and then increases our risk for a bad outcome. C. diff can have a mortality of upwards 16 to 20% and, of course, if you're sick with other illnesses, that mortality can go up even higher. The way C. diff presents as we talked about, it's diarrhea but could also be worsening symptoms other than diarrhea, and that is abdominal distension, fever, nausea, vomiting, abdominal pain, or cramping. If C. diff colitis gets bad enough, it can actually shut the entire gut down, and patients no longer have bowel movements. So it can lead to constipation on the far end of the spectrum.
14. What can happen if not adequately dealt with what can be the consequences from that point on?
- First and foremost, patients can become dehydrated from the diarrhea. In volume, salt water that's passed to the stool. So dehydration, sepsis can certainly occur as a result of the inflammation in the colon, then multi organ failure and as mentioned in 15 to 20% of patients death.
15. Are seniors and the elderly the highest at risk part of the American population or world population? Why?
- They probably are the population that is at highest risk for acquiring C. diff, and they are the population that is at highest risk for bad outcome. That is because the older we get, we typically have multiple other medical problems. That impairs our ability to fight infection, we're typically on more medications that impair our ability to fight infection and our overall ability to overcome is reduced as we get older, we become more vulnerable. The health care provider needs to make sure that patients are appropriately diagnosed and treated and not over prescribed antibiotics to reduce the incidence of C. diff in our elderly patients.
16. What is it about senior care facilities or nursing homes that increase the risk of C. diff?
- In senior care facilities, one increases the risk of contracting C. diff. Those facilities are where antibiotics are prescribed to other patients in the facility. So if there's antibiotics prescribed in the facility where you live it impacts the risk of other patients getting C. diff, and then you contract it from somebody else. That's the primary cause, just being close to others who are getting antibiotics and potentially could get C. diff and pass it to you.
17. Do you see C. diff in little kids or schools or only in the senior and elderly population because of the weakened immune system and all the aging?
- It's the weakened immune system in the population more at risk for getting C. diff and for having a bad outcome. Interesting about kids. The reason you don't see C. diff in infants and nurseries, is because they don't have the receptors for the toxin to bind to and cause inflammation. So they still have C. d-ff in fact, some people think they're reservoirs of C. diff, but they don't get C. diff colitis because the toxin is ineffective in them.
18. They're probably not being over prescribed antibiotics like our senior and elderly population are?
- Exactly. If you look at a gut it is populated with millions and billions of organisms. Bacterias that, for the most part, help us have a nice healthy bowel and the bacteria also keep the bad bacteria at bay. C. diff still is one of those bad bacteria. When somebody is prescribed antibiotics for a urinary tract infection or pneumonia, that antibiotic not only kills the bacteria causing the urinary tract infection, pneumonia, but it also kills all the good bacteria in the gut. When the good bacteria are killed the bad bacteria, like C. diff, are allowed to start repopulating and then cause colitis and diarrhea.
19. Would you advise our listeners to begin taking probiotics as a way to increase the good bacteria in the gut?
- The jury really is out on probiotics. I don't think there's anything wrong with doing it. I'm just not sure it's going to provide you with any benefit. Certainly, keeping the gut populated with good bacteria will be a benefit. The primary thing our elderly patient should do is when their doctor prescribes them an antibiotic, they should inquire and make sure that the physician is giving them the right antibiotic for the right duration. Shorter is better than longer when it comes to duration.
20. When our listeners are getting the information about what antibiotic they were recommended or prescribed and how long it was prescribed for, how do they know whether it's over prescription or not?
- Starting the dialogue with your provider should force him to think about his decision and the antibiotic that he's using and for what duration. Some antibiotics that are really notorious are Levofloxacin, Levaquin, or Ciprofloxacin and these high powered antibiotics, really do a number if you will, on the gut and on the normal flora, the good bacteria in the gut, and cause severe bouts of C. diff colitis. It's important to always be inquisitive, to always ask your providers and take nothing for granted when they prescribe antibiotics. I think they're probably the most overused, inappropriately used of all the drug classes out there.
21. What are nursing homes and senior care facilities doing to address the problem of overuse of antibiotics?
- There's been a real push and rightly so, toward antimicrobial stewardship in long term care facilities and hospitals. Microbial stewardship essentially is somebody such as an infectious disease physician, overseeing the use of antibiotics in a facility and making sure the antibiotics are used for an appropriate diagnosis and that the antibiotic prescribed is a narrow spectrum as opposed to a broad spectrum antibiotic and it is prescribed for the appropriate duration. That push with regards to the use of antibiotics appropriately, really has done wonders to reduce the incidence of C. diff. The other things nursing homes do and should do is good hand hygiene. Because the alcohol based solution that you rub on your hands does not kill C. diff. You need to wash your hands with soap and water for two minutes and in fact, the soap and water does not kill the C. diff. What it does is some mechanical action that gets the spores off of the hands in patients who have it. If you're in a long term care facility, and your roommate has C. diff, you should be isolated from your roommate because there's a risk of them giving it to you.
22. Wouldn't disinfection of hospital rooms on a consistent basis, and healthcare providers wearing gowns and gloves also be part of the protocol?
- Important preventive measures that are used in contact isolation when a patient has C. diff requires a gown, gloves, a throw away stethoscope so that the spores don't get on your stethoscope and you pass to another patient. In addition room disinfecting is an important measure. The spores as I mentioned are very hardy and even the best disinfection of a room is not always adequate. In fact, studies have shown that if a patient in the room before you had C. diff, you are more likely to acquire C. diff during your stay in that room.
23. If somebody is demonstrating symptoms of C. diff, is there a standard test that they should be given or what is the test that is being utilized by the medical community to see if they have C diff? How reliable is it?
- We use a standard test that's called a PCR or a NAAT test, that looks for the toxin in the gut. It's very reliable and if it's present, you have it. If it's not present, you don't have it.
24. Do they just take a stool sample and put it under the microscope?
- They take a stool sample that has to be a diarrheal stool sample. It has to be diarrhea, and then they run a chemical test on it, which looks for the production of toxin in the diarrheal stool.
25. What would be the gold star treatment for somebody with C. diff?
- Antibiotics, and the antibiotics we use our oral antibiotics, vancomycin, or fidaxomicin is the first choice. It is orally given by mouth and what it does is it stays within the gut and it does not get absorbed into the systemic system. It stays within the gut and it is specific for killing the C. difficile bacteria within the bowel. That treatment is 10 to 14 days. Sometimes you can be prescribed vancomycin for a longer period of time, if you're on other antibiotics to treat another infection, sometimes they have to overlap. But typically it's 10 to 14 days.
26. Are fecal transplants one of the additional types of treatments for individuals who have severe C. diff, and the antibiotics aren't working?
- Yes, fecal transplants are actually a very effective treatment for C. diff colitis. Fecal transplants provide stool from a donor and that stool is populated with all the good bacteria that normally resides in our bile. That sample is then put into the gut of the patient who has C. diff colitis and when you do that, you repopulate all the normal bacteria. The way vancomycin works is to kill the C. difficile. The way a fecal transplant works is to repopulate the good bacteria to suppress the production of the bad bacteria, which in this case is C. diff.
27. Fecal transplants sound a little radical, but how effective are they?
- It's very effective and oftentimes can be life saving.
28. What is the risk level for the general American population to develop C. diff?
- 1% of patients that are hospitalized, will get C. diff colitis. It's important to note that there is such a thing as community, associated C. diff colitis. These are patients who have not been hospitalized have not been on antibiotics and develop C. diff colitis. What I don't want our listeners to think is just because I haven't been in the hospital, just because I haven't gotten any recent antibiotics. There's no way I can have C. diff. It’s uncommon, but it's still possible and your doctor should check you for it.
29. What would you say to our listeners if they are in a nursing home, or they have a loved one in a nursing home, or a senior care facility and they're starting to show symptoms of C. diff? What action steps would need to be taken?
- If an elderly patient is in a nursing home and begins to develop diarrhea, abdominal pain, fevers, nausea, vomiting, whether they've recently gotten antibiotics or not, they should notify the provider, the nurse in charge immediately and then the patient should be checked with not only a stool sample to make sure C. diff isn't present, but also with laboratory to make sure that kidneys are not getting affected from the diarrhea in terms of dehydration, and check the white blood cell count to make sure it's not elevated due to the severe colitis. It's not something they should wait on, they should notify the providers immediately.
"Practice good hand hygiene because the alcohol based solution that you rub on your hands does not kill C. diff. You need to wash your hands with soap and water for two minutes and in fact, the soap and water does not kill the C. diff it’s the mechanical action that gets the spores off of the hands." — John Cascone
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Related Links:
https://www.todaysgeriatricmedicine.com/archive/012312p18.shtml
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About Bill Vigilante: Dr. Vigilante is a human factors and ergonomics consultant with experience researching topics related to pedestrian and premises safety, driver performance, roadway safety, lighting, night vision, the designing of warning and instructional information, risk perception, the effects of aging on performance, as well as safety and product design. Dr. Vigilante’s extensive resume includes the publication of dozens of scientific papers in the field of human factors and ergonomics. He has also testified as an expert witness in federal and state courthouses across the country. Dr. Vigilante’s expertise is in studying human performance issues and assessing how they should be used in the investigation to determine if and how they may have played a role in the outcome of an event. One issue includes aging.
In this episode, Steve and Bill discuss:
1. What are human factors and ergonomics?
- Human factors or ergonomics is the study of how people use all different types of products, how they interact with their environments, how they move about their environments, and essentially human factors and ergonomics is basically designing for peoples use.
2. Is your focus on how to make something safer for everyday people?
- Yes, there are three goals for human factors and ergonomics in design. To improve efficiency, user comfort, and the third pillar or goal of human factors, and ergonomics is safety.
3. Why should the senior and elderly community care about human factors and ergonomics? Is it because safety is such a big concern for them because of aging?
- It's certainly part of it and the other part of it is that from a human factors and ergonomics standpoint, because we're interested in the user, we want to be able to identify all the different potential characteristics of the users that are going to be involved with the product or the environment. If you're dealing with things that are more geared toward the elderly population, you want to make sure that those characteristics, abilities, and limitations are directly addressed.
4. Are products generally made with the aging population in mind?
- There are designers manufacturers of products specifically for those products geared to an older or elderly population. So for example, medications or medical devices that are geared towards elderly folks tend to take into consideration the abilities and limitations of older adults in their design whether it be the size of the product or the size of the print on the labeling, or it could be the strength required to to use the product. For example, Tylenol, ibuprofen, or another over the counter medication that is used for the general public typically come with childproof caps on them. Childproof caps are great to prevent young kids from getting into the medication, but they are an impediment to older adults using the medication. One of the characteristics and limitations you find is that they're more likely to have problems with strength and rotation of the hands and wrists. Childproof caps become problematic for an older adult.
5. In your opinion, are there product manufacturers that missed the boat and are actually a big problem for the senior and elder population?
- There are and that’s generally a big problem. When you go to a home improvement store, or a grocery store, the labeling on the product packaging is presented in font sizes, that is the size of the text in sizes that are too small or difficult for older adults to read. One of the issues that older people have or people encounter and becomes more problematic as the age is that some of their visual abilities decrease and are more likely to decrease. The ability to read small print on a packaging becomes more and more difficult as we progress past the age of approximately 40 with being really difficult when we get into our 70s and 80s. If the product manufacturer, the warning designer or the instructional material designer isn't keeping that into account, they can provide a very small text on their product labels. That creates problems for the elderly trying to figure out what the proper way to use the product is, and or what are the hazards and risks that they need to be aware of.
6. Is that a big problem with pharmaceutical companies or other businesses still today?
- It usually points back to a bad design? Because The designers are more worried about putting all the information into the smallest possible size on to the smallest possible label for various reasons. They're not recognizing that they’re making it difficult not just for elderly users, but for all users to be able to read and access that information.
7. Can you give an example of a danger that could be posed as a result of making the font or the print too small?
- Sure. So for example, if you go down to a home improvement store and you pick up a product that has flammable or has physical hazards associated with it, maybe it's combustible vapor that is the vapor can travel tuning to a to ignition source like a lit pilot light and travel back and explode the container. If the font size is too small or if the warnings printed on a small font size on the back of the can, an elderly user who's looking for information, may not be able to read that information and may not realize that risk is there and then potentially expose themselves to it.
8. Have you given your expert testimony to this type of situation in your capacity as a human factors expert?
- It does occur. Oftentimes the labeling is problematic because the information is presented in small text and the other problem I typically see is the information is presented in a condensed format. We found from testing both younger and older adults, that if you break that information up into a bulleted list, with white spacing, or more spacing between different topics, it's easier for the user to read. They can capture more information from reading the label. They're also a bit more willing to read the label because it's not difficult. So one of the things we know from a human factors and ergonomics standpoint is that if you make things difficult or uncomfortable for the user, they're not going to want to do it. This also has safety ramifications. If you make things too difficult, or increase the cost of compliance you're going to see reduction in people doing what is proper, what is necessary, or what is needed to be safe.
9. What are some of the problems from a human factors standpoint that you see that results in slip and falls, especially amongst elders and seniors?
- Older adults are more susceptible to other types of problems in the walkway for reasons associated with the deteriorating strength in the legs, in the core muscles, the balance, their ability to react fast, to take what we call a compensatory step, which is essentially basically like a stumble to regain your balance. These things will become more problematic for older adults. Consequently you see that they become more susceptible to other types of problems, other types of defects in the walkway. One big disadvantage for older adults tends to be that when they do fall or when they do lose their balance they can't recover. When they fall, they're more at risk for significant injury, particularly a hip fracture, or broken hip. Older adults are more likely not to recover and you see a higher mortality rate from that.
10. What can businesses or municipalities do better to take into consideration the challenges that the aging population has, when they're walking on walkways?
- There are walkway safety standards and building codes that focus on eliminating problematic conditions in the walkway for all users. Those codes prohibit changes in elevation over a quarter inch without having a beveled edge, a half an inch whether it's beveled or not. What they're doing is they're attempting to remove potential trip hazards from the environment. The billing codes and the safety standards look to limit potential hazards. Retail store managers or property owners want to make sure they're complying with building codes in prevalent walkways.
11. Are you seeing compliance or a lack of compliance with these retail establishments?
- For the most part generally speaking, property owners and retailers do a good job of eliminating trip and slip hazards in their stores. I typically get involved in cases where there is a violation. None of these standards, codes, and hazards are allowed to exist in the walkway. So if you're dealing with an environment in which you have a large population of older adults this is something you may want to keep in mind and consider. You can't just be relying upon the minimum codes you should be going above and making sure that you have no height differentials or height differentials less than a quarter inch.
12. What challenges are senior and elderly drivers facing in the evening with the different lighting? Is it safe for seniors and elders to go out in the evening?
- Our visual abilities start to decrease as we age. Vision is dependent upon light so younger folks are going to have an easier time seeing than older adults. In the driving environment or even in the walking environment typically we're identifying hazards that have potential, significant and severe consequences to our health and well being are detected visually. So you can imagine whether it's in the driving environment or the walking environment, low light becomes problematic. It increases the risk of encountering a hazard and not avoiding it in time. So typically in the driving environment, we are dependent upon our headlights, street lighting, and to a lesser extent lighting from nearby businesses or homes. In good lighting situations, a relatively high level of street lighting, elderly drivers benefit greatly. When there's no street lighting and when there's no lighting from ambient buildings and so forth older drivers have a harder time at night. That puts them at greater risk of encountering roadway hazards.
"If you make things difficult or uncomfortable for the user, they're not going to want to do it and this does have the safety ramifications." — Bill Vigilante
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Bill Vigilante:
Website: Vigilante Forensic.com
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
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Show notes by Podcastologist: Kristen Braun
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About Stan Andrzejewski: Stan is the founder of Greater Baltimore Yoga. He was certified in the Iyengar tradition in 1988 while a student of John Schumacher, but now considers Victor van Kooten as his main inspiration. He integrates 45 years of experience as a physical therapist into his 33 years of teaching yoga. He works with people with orthopedic and neurologic problems in his private practice. He has trained many yoga teachers through his apprenticeship program. He has taught a series of continuing education courses for physical therapists entitled Hatha Yoga as Physical Therapy.
In this episode, Steve and Stan discuss:
1. What is a neurological physical therapist?
- Working with and treating people with neurological issues. Working with children with cerebral palsy, muscular dystrophy, and adults with multiple sclerosis, and parkinsons.
2. How did you get involved in Yoga?
- I went to a Hatha Yoga conference in 1980 and then ended up taking a yoga class at college. I fell in love with yoga. When something just feels right, intuitively, it’s something that I know that I need to pursue.
3. Is it an accurate portrayal of yoga to say that yoga is only for people who are double jointed, who have been gymnasts, or people who can put their legs behind their neck?
- Not at all yoga is really for everyone. It can be used to help with basic balance issues and relief of pain. The way we move we can hurt ourselves and perpetuate certain kinds of issues, pains, by the way we stand, sit, and move. Most people don't even realize that they're actually causing themselves physical pain, by the way they move or don't move.
4. Why should seniors and our elderly community be interested in doing and performing yoga?
- Well, basically to stay independent and to stay out of pain. We perpetuate our pain and can get very sensitive to certain kinds of mechanical stress just by standing.
5. What is mechanical stress?
- Gravity weight bearing pressure stress on the joints.
6. Does yoga and movement therapy train one’s nervous system, condition the cardiovascular system, and protect the body from the accumulated mechanical and stresses of aging?
- It does! Training is retraining our nervous system through repetition.
7. I have a history of bad posture, are you saying that I learned that from a young age?
- Yes, it's learned, and it can be unlearned, we have to pay attention to what we're doing that's creating pain. Pain is a great reminder that we're doing something wrong. Through the skills of grounding, centering and lifting we're paying attention to the sensations of the body, and then we can create the intentional movement.
8. So, are you saying that when the elderly and senior population get to their 60s or 70s, that there's going to be problems because they have developed these habits and these postures and weight bearing issues over years and years and years?
- Yes, most people do. It’s the idea of being able to start at any time to head in the right direction. We're either heading in the wrong direction, or we're heading in the right direction. We can lament we didn't start earlier that we created this thing called arthritis, but we can actually work on our independence and our confidence in moving and have ways to relieve the pains that may happen.
9. Can yoga or movement therapy also help people who have experienced injuries that cause them to have all different types of aches, pains, fractures, surgeries, and the like?
- Whenever someone is injured it's a sudden, very acute assault on their physical body and every other aspect of them as well. There's recovery, there is the ability for our bones to mend and our bruises to resolve but our movements become compensatory, because we're learning a way to avoid something when it's an acute situation. Then we have to unlearn that. So we're always trying to move in the right direction, but the art is to do it gently, gradually, and precisely enough that we don't reinjure ourselves, or cause other kinds of issues. Most yoga classes are way too aggressive for seniors, and we need to slow it down, be very gradual and very attentive to exactly what they're doing in each moment.
10. What are some exercises or movements that someone waking up with arthritis, or all stiff, achy, and unable to move well, can do that can help them to not experience the stiffness and the pain?
- Lying on their back, bring their knees to chest, and just gently exhale as they pull with their hands, their legs, their shins into them to press their low back into the mattress. Then sit up on the side of the bed, and I lean over with your legs spread wide with your feet well established on the floor, and you simply bend over. Slowly and gradually is the key. Lean in and try to bring their hands closer to the floor and drop their head. Slowly, what they have to do is calm their head last and their belly first. They put the weight in their legs, their feet and lift their toes. It wakes up their feet to start to be able to feel the floor, and then they stand up belly first, and still keep their chin tucked. They may have to walk their hands up their legs or press into a nightstand or something, because that helps the belly. Finally, after they're still lifting their toes, work in their legs and take their belly back. I ask them to lift their heart, their chest And the last moment if that's all working really well enough finally their head, so they slowly stand up.
11. If people have a weight bearing problem, wouldn't standing up cause a problem?
- With people with low back joint problems bending forward, knees to chest is relieving. When they extend or stand up straight and when their bones and their joints are straight and standing up tall, they're in what I call a provocative position, meaning that you can either provoke yourself into joint pressure and pain.
12. So yoga, movement therapy, is going to help seniors and elderly individuals be able to get out of bed without falling and be able to get out of bed without having a lot of aches and pains, if they do some of the exercises that you were talking about, correct?
- Yes.
13. What's another exercise that people could utilize or they could do that could help them with the low back pain?
- Well, there are variations of knees to chest. Flexion is a relieving position. So from knees to chest, some people can from all fours rock back, we call it Child's Pose where they set down their butt back towards their feet, if your knees allow. Another great pose is to lay down on your back and prop your legs way up. If you can get down on the floor, you would prop your calves up on a coffee table, a seat of a chair, or up the wall. If you can't get on the floor, you would put something higher, like a chair on your couch or something to raise your legs up to bend your hips.
14. What about senior or elderly individuals who have rotator cuff, shoulder injuries, they have problems lifting their arm, or just mobility with their extremity? What would you recommend for those individuals?
- Shoulders and necks are some of the more difficult things to work on with anybody. If you think of movement like to look up or raise your arm over your head, it's the end of a chain of events that started with your feet on the floor standing or your sit bones on a chair sitting, and then you move. To be able to move your head, neck, your arm, or your shoulder you need a great foundation, the foundation of your spine, the foundation of your pelvis. If you're sitting, the foundation of your legs pressing into the floor. If that all were to collapse, there's no foundation for you then to move your arm and that's where rotator cuff problems come into play.
15. What’s an exercise that people with knee or hip replacements can do?
- Activate your legs by lifting your toes. Pressing your heels, the four corners of the feet into the floor, lifting your toes will support your knee and your hip instead of collapsing into it, and putting all the torques and rotations, twists and stresses on those joints.
16. What’s an exercise or something that our audience can do that can make them healthier and a little more flexible?
- Pay attention to your breathing. Breathe through your nose, in breath and out breath through the nose and feel the gentle movements and sensations that you make in your belly, ribs, or in your nostrils. Pay attention to your breath. It is critical for you to be able to pay attention to the body's sensations. Pay attention to your body, not just the emotions and thoughts that you have, but to the sensations of your body.
"Pay attention to your body, not just the emotions and thoughts that you have, but to the sensations of your body." — Stan Andrzejewski
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Stan Andrzejewski:
Website: Maryland Yoga.com
Email: Stan@marylandyoga.com
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About John Cascone: Dr. Cascone, is a Board Certified Internal Medicine and Infectious Disease Physician. His internal medicine residency was done at the University of Kansas and infectious disease follow up at the University of Missouri, Columbia. He is the Medical Director of nursing homes in southwest Missouri. His medical practice includes the care of residents in long term care facilities, infectious disease consultations and telemedicine and infectious disease services to rural facilities. He has a special interest in the diagnosis and treatment of sepsis, C diff, colitis, staphylococcus aureus, antimicrobial stewardship, and pressure ulcers. He lives in Joplin, Missouri with his family.
In this episode, Steve and John Cascone discuss:
1. What is Sepsis?
- Sepsis is the body's, often deadly, response to infection.
2. What kind of infection does this include?
- These infections could be bacterial, viral, or fungal.
3. What are some common types of infections that you see in an elderly and senior population?
- In elderly individuals the most common types of infections that lead to sepsis are urinary tract infections, pneumonia, bacteremia, infections that involve artificial knees or hips, skin infections, pressure ulcers, skin tears, and even the use of antibiotics can cause a certain type of diarrhea that is infectious.
4. What exactly would constitute an infection and are there other types of infections which aren't exactly clear or that don't come out and appear as an infection initially?
- Infections present differently in different people. In the elderly population, infections don't present the way they do in younger or middle age groups of people. For instance, a young healthy woman may have a urinary tract infection, and that manifests itself as difficulty or pain with urination, maybe back pain and a low grade fever. In the elderly population, a urinary tract infection may manifest itself simply as confusion or a change in mental status.
5. What are some other types of symptoms that the injured senior community should be on the lookout for?
- The most common signs or symptoms of sepsis in the elderly is a change in mental status, feeling under the weather, poor appetite, increased confusion, fatigue, and lightheadedness.
6. What should be done if we notice those symptoms with a loved one?
- Take your loved one to the hospital and have them evaluated in the emergency room. Time is of critical importance in the survival of sepsis. The longer we wait, the mortality or the or the risk of death starts to climb. The sooner sepsis is recognized and treated, the likelihood of survival and getting through it is much improved.
7. When someone has dementia or Alzheimer's, how do you distinguish between regular signs of Alzheimer's or dementia as opposed to them having mental confusion that is indicative of an infection? Are there other symptoms that we should be looking for?
- Dementia is a risk factor and contributes to the atypical presentation of sepsis. Patients are sleeping more, they don't want to eat, they're not interacting at all. Their skin may feel warm or it's flush. They have some sweating, their mucous membranes or their tongue is dry, changes in their bowel movements, or not making urine. These are all things we must look for in patients who are not able to tell us they are not feeling well.
8. How do you differentiate between just regular symptoms of Alzheimer's as opposed to septic confusion?
- If there's an Alzheimer's patient who doesn't typically have behaviors, and now they're having behaviors that could change a condition that needs to be evaluated. If they typically had behaviors and the behaviors are worse, or they're not occurring anymore because the patient is not interacting as much. That's also a changing condition. When in doubt, the loved one or caregiver at home should always bring the patient to the ER.
9. If your elderly loved one is showing signs of mental confusion, are you losing time if you don’t have them seen immediately?
- That is correct. In the case of sepsis, for every hour that passes, that a patient does not get appropriate antibiotic therapy, the mortality goes up by 7.8%. Time is critical to survival.
10. What is the mortality rate for the aging senior population when they're coming in with sepsis? Is it higher than the rest of the population?
- Yes, it is. It's much higher.
11. What are some tests that the medical professionals do in the ER or at a medical facility that they do to determine whether or not you have sepsis?
- Ask loved ones about changing conditions. How's the person been acting? We check vital signs. What's the blood pressure, is the heart rate fast? What's the respiratory rate?
12. When you say respiratory rate do you mean how many breaths per minute they're taking?
- Exactly. Normal breaths per minute, is approximately 14 to 20 above 20 breaths per minute is considered a warning sign, and a pulse above 90 beats per minute, is considered a warning sign.
13. Do Doctors start treatment right away without even waiting for the lab tests to come back, because if you wait, that person could go into septic shock?
- Doctors make an educated assessment, a clinical diagnosis of what we think is going on. We get antibiotics on board, we get fluids running, and then as the data starts coming in, we can start pulling back but we don't want to miss that. opportunity to treat our patients. If we don't give them antibiotics, we don't provide fluid resuscitation with IV fluids, then we have a high risk of a poor outcome.
14. What is a blood pressure that someone should be concerned about as far as sepsis?
- If the systolic or top number is below 100 and or the bottom number is under 60 or 65. It's a concern and they should be evaluated emergently.
15. If you had to give two or three action steps if people are suspecting sepsis, what would those tips be?
- Get your vaccinations, your flu shot, and your pneumonia shot. Keep a list of all the medications you take in your wallet. If your loved one is not acting normally, or you just don't feel like things are right, take them to the hospital and have them evaluated urgently. Do not delay.
"Dad's not acting himself is analogous to having chest pain. The mortality from sepsis is equivalent, if not greater than the mortality from an acute myocardial infarction or heart attack. " — John Cascone
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH JOHN CASCONE:
Email: jcascone77@gmail.com
Phone: 816-277-8686
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Ellen: Ms. Platt is founder and owner of The Option Group, LLC. Her team conducts comprehensive evaluations, makes recommendations, implements a plan of care and coordinates resources to support it. They provide a thorough knowledge of the healthcare industry and can help families skillfully navigate the maze. Additionally, they provide advocacy services and can assist with care in the home or placement in a facility. Ongoing monitoring can also be set up so that the most appropriate plan of care can be implemented at all times and changes can be made to address changes in condition and avoid crises. The goal is to identify ways to enhance the quality of life for the clients she serves, in the safest, yet least restrictive environment possible, taking safety, independence, function, and comfort levels into consideration.
Ellen is both a Certified Rehabilitation Counselor, and a Certified Professional Geriatric/Aging LifeCare Manager, with a span of 30 years providing care management and case coordination services to those with catastrophic injury, chronic diseases and disabilities. Out of that experience, she created The Option Group to address similar needs and services specifically for seniors or those with special conditions and their family caregivers and guardians. Her primary practice focuses on working with caregivers and aging families and the large variety of issues and needs specific to that population.
In this episode, Steve and Ellen discuss:
1. Ellen, can you tell our listeners what a geriatric care manager does?
- Care managers cover a wide variety of tasks. We help people navigate longevity, whatever that means for them, we go to the person where they are in that stage of life, and we help them navigate the system. It's really a holistic, client centered approach of caring for people. We look out for people with a variety of health challenges. We'll do an assessment. We'll make recommendations for care and come up with an individualized care plan. Then we monitor it and tweak it to make sure that it's meeting their needs and we also do some health, education, advocacy, family coaching, and crisis intervention. So we cover a wide scope of variety of tasks and a variety of people in situations.
2. Would it be correct to say that you are geriatric care managers, more focused on seniors and the elderly?
- We do a lot of work with seniors in cognitive or physical decline but we also utilize our team to help younger people with M.S., mental health issues, traumatic brain injury, or catastrophic injury. People with these issues still need an advocate and someone to help them navigate the resources and their care.
3. What issues, would you say, are generally the most important to the senior and elderly community?
- One of the biggest things is that people want to know what their options are, understand the options, given their situation, and they want to understand why they might pick one over the other. We're able to educate them, give them ideas of what the options are, what the costs associated with those options are, and they know who is paying for it. Is it an insurance paid benefit, or is it something that they're paying out of pocket? We're helping them to pull together this holistic care plan and create a solution that's going to help them remain safe, as independent as possible, functioning as well as they can, and maintaining their dignity in the process.
4. What are some of the significant injuries that you deal with and see the most?
- With an aging population, we see all different types of dementia, Parkinson's, or stroke tend to happen more frequently with people who are advanced in age. We also deal with folks who have had traumatic brain injuries, concussions, a medical malpractice case, catastrophic injury that left them with significant residual disabilities, or they sustained a permanent injury of some type and now they need to reclaim their lives and have the best quality of life possible and function as well as they can give in their new circumstances. So they often need some help navigating that process.
5. At what point during the process does either a senior, an injured individual or their family contact a certified geriatric manager after a catastrophic injury?
- People are often contacting us when there's been a crisis and they don't know how to navigate the various systems involved. We often are able to jump in pretty quickly to do that assessment and come up with recommendations and stabilize the situation. First thing we address is safety issues. Then we also look short term, then ideally, long term. So that's where we come in with that full assessment, looking at the clinical picture, and figuring out what it is they need and care managers really have eight core areas of expertise that we work within. We navigate health care for people, look at the clinical picture of their health and disability, the financial picture, their housing situation, advocacy, and we look at their legal documents to make sure that they have their planning documents in place. We often do crisis intervention. Ideally, we'd like to be called before the crisis so that we can do some planning and they have some options in place.
6. What are some examples of crises that you see a lot?
- Often we'll see a husband and a wife living together and maybe one spouse has a lot of physical disability and there's another spouse that has the cognitive disability. And together they make one person but if something happens to one of them, things start unraveling quickly prior to that they were compensating for each other's difficulties and were able to maintain their living situation. But if something happens to that it topples pretty quickly. And families are looking to us to help. Right things.
7. If someone reached out to a geriatric care manager would they provide someone who would be able to step in and make sure that everything financially in a household is kept up to speed?
- Yes, exactly. We would be able to link them with somebody who would be able to step in quickly and be able to keep them fiscally organized, make sure that they're not receiving collections notices, or getting things ready for their accountant.
8. What's the important part of consulting with a geriatric care manager before a loved one is placed in a nursing home?
- Many times people say they want to stay at home. We're able to help them bring in resources and services and put in that infrastructure that allows someone to stay at home longer. Sometimes there are situations where it’s going to either make more financial sense, or they have certain needs that need a special level of care on a consistent basis that you're not able to establish in the home. We would then help them navigate to a facility. Working with a care manager, you have somebody who knows the systems, knows the local resources, and can look at the clinical picture and find a care facility that is going to support their particular needs. The care managers can help with all the paperwork and the legwork needed to be able to move into a facility. We also work to help set up the expectations with the care facility and how we expect the care to be provided to this individual.
9. What is the difference between what a geriatric care manager does as compared to a placement agency?
- The primary difference between us and a placement agency is our payment source. We don't get any payments whatsoever from our referral sources, whether we're referring them to facilities or home care agencies, or other senior services. So there's no temptation or no tendency to see things from a financial perspective of where that person is going to go for their care.
- Care managers also work across the continuum of care. It could be somebody who's independent, somebody who needs assisted living memory care, or skilled nursing so we can work in any level of care all the way through end of life. When you use a certified care manager, you're getting someone that has a master's level education and they're held to a code of ethics. They have ongoing peer review meetings and ongoing continuing educational requirements so that they're staying on top of the latest information. Care managers will work directly with the client and the family and are really their advocates. Our concern is the clients best interest.
10. Is a placement agency always going to place a patient in the best possible place for their needs?
- You want somebody with a minimum standard and code of ethics that really understands the resources and the various systems out there to be placing an individual into the proper facility for them.
11. What is the most important thing for a geriatric care manager to do for a senior or elderly individual who has just sustained a catastrophic spinal injury?
- In an incident like that, we would probably use a catastrophic case manager, a nurse case manager that we would have because they would be more in tune with the medical issues that are involved with a spinal cord injury.
- That case manager would be getting the information from the physicians, the hospital, discharge records, and health history information to really understand the injury itself and how any underlying conditions may impact that injury.
12. Would a nurse case manager go with the individual to their medical appointments, review records, and keep an eye on what's going on to make sure they're getting the best possible care?
- They do a lot of medical care coordination. They may even be doing things like scheduling appointments, requesting medical records, taking them to get imaging, coordinating surgery, and being there the day of surgery so we can do some really hands on stuff.
13. Do nurse case managers have a specialty like orthopedic injuries?
- Yes, that's possible.
14. Is it correct that another catastrophic injury that you might see a lot is traumatic brain injury?
- Yeah, especially when in a sports world. We do work with some professional sports teams that have issues with head injury and concussion, and then older sports retired players who need assistance with coordinating their care as maybe they have dementia developing or other medical conditions and they need they have special circumstances that we need to help navigate.
15. Can you work with older individuals who have had sports injuries earlier in their lives?
- Yes, and many of them need help navigating because they're no longer able to do it for themselves. If you think about it, whether it's football, rugby, soccer, ice hockey, boxing, there's all different sports, where people are sustaining head injuries and over time, they may have some special circumstances arise.
16. When are you brought in to handle care for a patient with dementia?
- In the instance of dementia, often people have symptoms or issues relating to dementia, possibly even 10 years before they actually get a diagnosis. It might be mild forgetfulness, it might be getting lost in a familiar area while they're driving their car, it might be starting to forget names, more than just the typical stuff you see with aging, it becomes problematic and that's when we get the call. It becomes problematic and difficult for somebody or the family to function given the person's new ability or declining ability to function independently. That's typically when we get the call and when services will be started because that's when they're really noticing it.
17. Are you brought in when you have individuals who might have gotten a clostridium difficile infection, pneumonia, or sepsis?
- We do, but that is generally secondary to something else going on. Or while we're managing their care, they get an infection. For instance, it may be because they have a catheter, they get a urinary tract infection, maybe pneumonia, maybe they have swallowing issues, and they have aspirated and it leads to pneumonia. So those are conditions that we're always keeping our antenna up on. That's not typically why we're called but it definitely is something that needs to be watched.
18. What other professionals would you make part of your team in a situation where you had a senior or elder with catastrophic injury or dementia?
- We could bring in a Certified Daily Money Manager to keep them fiscally organized on a day to day basis, a professional called a Senior Move Manager who can help coordinate and orchestrate a move from beginning to end, and a home care company to bring in all the hands on caregivers that are going to help with those activities of daily living. We also put into place systems for medication management, transportation, housekeeping, meal planning, and cooking.
"When you use a certified care manager, you're getting someone that has a master's level education and they're held to a code of ethics." — Ellen Platt
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Ellen Platt:
Website: Aging Lifecare Association
LinkedIn: Ellen Platt
Email: eplatt@theoptiongroup.net
Phone: 410-667-0266
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Show notes by Podcastologist: Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
About Rob Schenk: Rob Schenk is a lawyer with the law firm Schenk Smith Trial Attorneys based in Atlanta, Georgia. The Schenk Smith Law firm focuses exclusively on representing families with loved ones that have been seriously injured or killed in nursing homes.
In this episode, Steve and Rob Schenk discuss:
1. Why do nursing homes so greatly want residents to sign binding arbitration?
- Arbitration is an alternative to litigating a case in a court of law. By signing a binding arbitration you are forfeiting your right to litigate your case in a court of law. The nursing home benefits from this because it keeps the case out of the private eye. Everyone in the case will be held to a confidentiality agreement. Studies have also proven that companies which require arbitration will ultimately benefit from arbitration because they are the company that hires the arbitrators.
2. Alright, so what you're saying is that it's kind of like the employers, the nursing homes, they have relationships with the arbitration panels or, there's a friendly kind of, you watch our back, we'll watch your back kind of thing?
- I won’t say that’s explicitly what’s happening because that would be unethical, but the statistics show that arbitration awards compared to jury awards tend to favor the defendants, in this case meaning the nursing homes.
3. So if they come out with large verdicts, or awards against nursing homes, the nursing homes aren't going to pick that particular arbitrator again, right?
- That's right. It's the free market. They're aware of the fact that if the industry continues to get burned from one particular arbitration company, they can just choose another arbitration company.
4. The other option, if you don't sign an arbitration agreement, is that you have the right to take the case in front of a jury. Jurors deal with the case in front of them and they try to get it right and without bias, prejudice, or other types of conflicts that an arbitrator might have.
- That's the basis of the Seventh Amendment. You want your community to hear your case, and decide the outcome because theoretically, they are, they are the benefactors of whatever the decision is. The jurors are the gateway to protecting the community that that nursing home sits in. The jury can see this as their way to step in as the community and put a check on that system.
5. Are there any advantages to potential nursing home residents signing a binding arbitration agreement?
- None. You may be told up front that it is less expensive and faster than hiring and paying a lawyer. In many cases neither instance is true as you end up paying an arbitrator hourly to review your case when in court of law cases most of the same services are paid for with your filing expenses.
6. How is an arbitrator hearing a case different than when a jury hears a case?
- An arbitrator is expected to apply the law as applicable to their area but the information and judgements are ultimately under their discretion.
7. So if a nursing home resident signs a binding arbitration agreement are they allowed to be represented by an attorney?
- You can be represented by an attorney but some agreements word their agreement in a way that makes you believe you can represent yourself.
8. What are some of the best reasons to not sign a binding arbitration agreement?
- The best reason not to sign an arbitration agreement is because we live in a country that has a Constitution. The constitution allows civil trials with the jury to hear your claims. I believe that 12 community members can do a better job of understanding what's fair, and what's allowable and what's preferred in a particular community, versus an arbitrator that is employed by an arbitration company that is selected by an industry to hear claims.
9. It might take longer to get your day in court than with an arbitration. Is it worth waiting a little longer to get in front of a panel of jurors who are your peers, as opposed to an arbitrator, who may be prejudicial and biased in favor of the nursing home?
- Yes. I would agree with that.
10. Have you ever seen cases where the nursing homes actually trick or deceive a resident into signing an agreement requiring a binding arbitration?
- If there's any trick, it’s that there is no one competent enough to explain what arbitration is. The family members will usually just sign whatever documentation it takes to get their family member in, never understanding what they are signing.
11. Are there situations where the residents actually are signing the paperwork on when they're getting admitted?
- Yes. For arbitration to take place the person who has signed the document must be deemed to a have sound mind. In my experience the resident should usually not be the one signing anything. However, there are sometimes exceptions.
12. Have you ever seen situations when an arbitration agreement was overturned because a potential resident signed, who was not of sound mind or didn't have the requisite capacity?
- Yes. In the instance of people who sign their own documents to get themselves into nursing homes,or you have the nursing home saying that this resident was of sound mind. Those facilities, within 14 days of admission, are required to complete a comprehensive assessment of every resident if that nursing home was taking Medicare, Medicaid, which 95% of them do. They need to do an assessment of the cognitive capacity of the residents. So sometimes we see a nursing home argument that the person was able to sign themselves in and the next day, 24 hours later, 48 hours later Two weeks later says they were not of right or sound mind.
13. Have you seen instances when a nursing home is saying that this person has the capacity to sign this arbitration agreement, but then two weeks later you said the person is not of sound mind. So, which is it?
- There are instances where this does happen. More likely though is not the argument of capacity but, authority. No one is allowed to sign away the rights of another person unless there is some sort of written authority given. In most cases for a binding arbitration to be lawful the person signing the agreement has been lawfully recognized as being guardian or given authority over the resident going into the nursing home.
14. So there has to be their power of attorney, a directive, or a guardianship in order to be able to sign the arbitration agreement?
- That’s correct and even in those instances, this is state specific, but a healthcare power of attorney might not grant you the authority to sign the arbitration agreement.So even within the written authorities, sometimes the scope is not broad enough to allow the arbitration agreement and it is not enforceable.
15. If you're a caregiver or a loved one and your loved one signed the arbitration agreement, or you signed the arbitration agreement, not really knowing what you did. Are there different ways that you can look at it where it may be able to be voided, or overturned?
- The best advice is that you should seek out the advice of an attorney in your state if you've signed one of these and you might not want to arbitrate. A Lawyer will advise you on the best way to move forward and have your case heard in court.
16. What would be some questions that people or loved ones should be asking about arbitration agreement paperwork?
- I would recommend asking if they have an arbitration agreement? Ask to see it, strike through it, and initial it. Make sure to note that you do not agree with those terms. Nursing homes cannot make the signing of an arbitration agreement mandatory for being admitted.
17. Would the patient or family be able to take the agreement and have it looked at by an attorney?
- There are different laws for different states, but you would be within your right to ask for an attorney to go over it. Make sure that you know how many days you have before a decision needs to be made about signing the document. Additionally, I would recommend whatever you do try to get it in writing as best you can.
18. Do they have the right to bring in an attorney or bring in an ombudsman when they're right there in the nursing home office?
- Yes. You have the right you have the right to do all those things. Many of these documents encourage the resident or the residents family to get legal counsel. Many of these forms have language that states you've had the opportunity to review this with your attorney. So having an attorney there or having an attorney review the information is well within your rights.
- An ombudsman is just the Swedish word for advocate. A long term care ombudsman is actually an advocate on behalf of residents of nursing homes. The Ombudsman is your tool for when your rights as a resident have been infringed upon. If there's been some type of physical injury or improper discharge from the facility. That's when you need to contact a lawyer.
19. Would it be accurate to say that the verdicts or decisions from arbitrators, as opposed to verdicts from juries, in the court system are lower than in the court system?
- I have not conducted the studies but the statistics that I've seen would reflect that. Yes.
20. If you are admitting your parent or a loved one, and something really bad happens to that person. You may need additional medical treatment for them, or need money to pay the medical bills for the damage that was done in the nursing home. Are those things that you can get from a jury trial?
- The issue is that the process, the fairness is not the same as in a jury trial, although the measure of damages is probably going to be the same.
"Within 14 days of admission, there must be a comprehensive assessment of every resident if that nursing home was taking Medicare, Medicaid, which 95% of them do, and they need to do an assessment of the cognitive capacity of the residents." — Rob Schenk
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Rob Schenk:
Twitter: @Schenk Smith
Facebook: Rob Schenk
Instagram: @Schenk_Smith
Website: Schenk Smith Trial Attorneys
Show: The Nursing Home Abuse Podcast
LinkedIn: Rob Schenk
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Show notes by Podcastologist Kristen Braun
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
In this episode, Steve and Paul discuss:
1. How did you go from an attorney in England to a district attorney in San Diego?
- I came to the US in 1970 after seeing Easy Rider, traveled the country, met a girl and fell in love.
2. How did you come to specialize in elder abuse prosecution?
- One day the San Diego D.A. says “Adult Protective Services tells me we have an elder abuse problem” and I didn’t even know what that was at the time, so he made me the head of Elder Abuse Prosecution and I learned from there.
3. Why was it that nobody knew about this problem?
- It's the same parallel that we had with domestic violence about 40 years ago, nobody wanted to talk about it because it was a private family affair, yet look at how far we've come. Now, recognizing domestic violence.
4. What are the various forms of elder abuse?
- There is no uniform definition of elder abuse because in fact, some states don't even recognize as a category. When I use the term elder abuse. I'm actually also encompassing what I would also call dependent adults, people with disabilities, people with physical or mental challenges who could be of any age because the same elements of the crime apply to that category as much as it does older adults. It covers physical abuse, slapping, hitting, pushing, homicides, sexual assaults, fear, mental abuse, neglect, and financial exploitation. Even though you can't photograph the injuries of mental abuse there, they're out there.
5. Is there one particular form of elder abuse that you saw as a district attorney that is more prevalent?
- Physical abuse by a son. He's typically aged between 35 and 55, he lives at home with his widowed mother and he is in every pretty much every single case. I've prosecuted. He’s lazy, unemployed, and often has an addiction and/or a gambling problem.
6. Did you find the same thing with the mother whose son was abusing her but just didn't want to speak out because she might have been scared or ashamed?
- Yes, and often they would not want to prosecute to try to protect their son. Sometimes I would have to go out on a limb and say “I am going to prosecute your son whether you want me to or not because your son has an addiction” then we would pursue the case with or without the victim's blessing, but sometimes it was challenging.
7. On the financial abuse is it mostly stealing or is it a little more sophisticated?
- The son, the grandson, the granddaughter, the nephew or the niece who's down on their luck or who's addicted, they will use any method they can to steal from the elderly person in the home. You've got the paid caregiver coming in from an outside agency, they come into the house, and they see an easy opportunity to steal from the vulnerable elderly person. The third type of category is the rogue tradesperson, the plumber, the electrician, the roofer who sees a golden opportunity to overcharge to upsell to to convince the elderly person that the house is about to collapse and they need all these repairs done on the house. You've then got the internet scammer, you've got the romance scammer who pretends to be somebody who's fallen in love with the elderly widow or divorcee, the sweepstakes scammer, the IRS scam and many others.
8. The Coronavirus is such a tragic situation but I'm sure a lot of scammers that can really take advantage of vulnerable people like elderly right now?
- They really do, using the stimulus check as an opportunity to send emails to make phone calls pretending to be from the government, or we need this information before we can send out your money. So you get a call, as a say, a 75 year old who's been using the internet and you get a call saying, Oh, this is Microsoft. There's something that there's a virus on your computer, we need to fix it. And then they get remote control of your computer. And then they download all your banking information. And from that, I mean, this is happening every single day.
9. What are some of the ways, in your opinion, to reduce the risk of becoming a victim of elder abuse?
- We need to stay in touch with an aging parent. I can't tell you how many times I would get a call at my office, from an angry child of an aging parent, “I've just discovered that my 86 year old mother has been ripped off by her caregiver and I want you to prosecute to the max” and when I find out it’s been going on for a long time, I would hear every excuse as to why they had not been involved in their parent’s life during that time.
10. {See the quote below regarding contacting your parent’s bank}- Do banks step up and actually pay attention, and do you have a template letter for this?
- California passed a law several years ago requiring every bank teller to be a mandated reporter of suspected elder financial abuse. That is a powerful weapon to remind the bank in the letter. Find out in the state where your parents reside if the financial institution is mandated to report suspected financial elder abuse.
There's a lot of older adults who are very loyal to their place of worship, and if you've got parishioners who've sat in the same Pew for the last 40 years and you see that that person is no longer attending your services, that should create a red flag, because one of the first indicators of elder abuse is that the perpetrator will make sure that the older adult stops doing their regular socializing. It takes the whole community to be part of this- banks, clergy, doctors, nurses, CPAs, elder law attorneys, civil attorneys, mail carriers, Meals on Wheels, we all need to be on the lookout for any sign that an older person is not showing the same kind of consistency that they showed in the past.
“Many older families have to have a caregiver come in to the home and I have this conversation with adult children. Write a letter to your parent’s bank branch. And it's got to be a letter, not a phone call, not an email, a letter, good old fashioned letter and say, dear sir, or Madam, I understand that my parents have been with your bank for the last 55 years. They are loyal customers. I want you to be loyal to them. I want you to keep a special eye on my parents’ account because things have changed over the last few weeks. My parents now have a caregiver coming into the house. I want you to scrutinize their accounts. I know you're not going to tell me because it's confidential. But if you see a fluctuation in any pattern of their normal financial behavior, I want you to pay special attention to that. And the moment you suspect that somebody is taking advantage of my parents’ accounts, I want you to call the local Adult Protective Services and make them aware’ and I think if more people did that letter, we could stop a lot of financial exploitation of older adults within the first week of a suspicious withdrawal from an ATM machine. " — Paul Greenwood
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Paul Greenwood:
Twitter: https://twitter.com/pgreendda
LinkedIn: https://www.linkedin.com/in/paul-greenwood-14841a5/
Email: pgreendda@gmail.com
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
1. Your website http://www.thedisabilitydigest.com/ It has nearly 200,000 people who have maximized their disability benefits or income opportunities. Can you tell my listeners what exactly is the disability digest?
- The disability digest is a free resource where you sign up, fill out a profile that helps us understand if you're going through the approval process or if you've been through it, then we help you either get your disability benefits or maximize your disability benefits and some of the common things that we help with our disability approval assistance.
2. How are you able to do that for free?
- We have over 50 contributors to the Disability Digest that have donated their time and have provided a lot of the content.
3. If you're a senior, and you've got heart disease, diabetes, cancer or mental health disorders, but you are disabled, how do you actually become eligible to receive Social Security Disability?
- If somebody cannot work because of a condition or conditions, and as a general rule, they've worked 50% or more of the last 10 years and pay their taxes, then the Social Security system operates like an insurance policy, and if you prove that you're not able to work and you're successful, then you can get a disability check, which is, in essence, the same benefits package that you would get at the full retirement age of 66 ½, which is your check and your Medicare.
4. If you live to 100, but you began receiving disability before you would have qualified for retirement, do they penalize you for that?
- No, it's kind of like “Passing go and collecting $200” you just advance to that benefits package. So when you turn full retirement age at 66 and a half, your check amount stays the same. You have Medicare, all that is just the same.
6. So if somebody is disabled, and you know, they qualify for benefits, and they applied to the Social Security Administration, do they automatically get the benefits? what is required for them to do to at least get started? And what do they have to prove to qualify?
- “Automatic” and “Social Security” are not really synonymous. There's a lot of people that are legitimately disabled medically, that unfortunately, don't get approved. It's really evidence-based and what I encourage people to think about is not what they may feel that they're entitled to, but what evidence do they have to support it.
7. What if someone has medical documentation, are there certain factors that they look at when determining whether or not a person is going to get the benefits?
- If you're under 50 years old, then you need to prove that you are not able to do any job in the US economic system, regardless of what you're currently doing.
8. Do most seniors beginning in the early 50s who have a legitimate disability get approved initially?
- 32% nationally get denied initially, but if you don't get approved there, you can appeal it. There’s a reconsideration phase 11.9% of the cases get approved there, then cases go to hearing and 60-70% of those are approved.
9. If you have to appeal, you may have to wait a couple of years until your legitimate case is actually approved and they start getting benefits?
- Yes, it could take 2-3 years to get approved on appeal. They may get back pay to the original date, but only if the judge agrees on the date of the diagnosis and start of treatment.
10. What about the person who is diagnosed with stage four cancer, is that person most likely going to get approved or there's some process that expedites their approval because of this catastrophic problem?
- There's major categories of listings for major ailments including heart attacks, autoimmune, bad backs, cancer being one of them, and they should be approved right away.
11. Do most seniors eventually get approved?
- Yes, if they have all the key ingredients for a good case for sure.
12. If somebody has been approved, and they are getting benefits, can they still work part-time and get their benefits?
- Yes, you can earn up to $910 a month without having any impact on your benefits.
13. So if a senior is listening right now, and they're disabled, how do they apply for social security?
- The best way that I encourage them to do it to go to http://www.thedisabilitydigest.com/, register and go through our process.
14. If someone's gone to your website, applies, and is still denied, and they have to appeal before and go before an administrative law judge. Could they also get an attorney through the disability digest?
- Yes, many of the contributors at http://www.thedisabilitydigest.com/ would be glad to help people get approved, and they can certainly do the selection on their own.
15. What are the top one or two tips that a senior should take away from this podcast?
- Don't have an entitlement attitude, and don’t have an “autopilot approval” mentality where you just apply and wait to see what happens. You need to take ownership and if your condition doesn't allow you to, get somebody to advocate for you.
"The most common thing that I see that is problematic in the system is people wait too long before they apply. And these benefits do expire. If you take a look at somebody in their early 50s and they get injured when they're 50, for example, but they choose not to address anything until they're 56. So those benefits have likely expired." — Brian Therrien
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
Connect with Brian Therrien:
Website: http://www.thedisabilitydigest.com/
Facebook: https://www.facebook.com/TheDisabilityDigest
LinkedIn:https://www.linkedin.com/in/brian-therrien-44998b17/
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: info@injuredseniorhotline.com
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
In this episode, Steve discusses:
- Occupational diseases can be any chronic ailment that occurs as a result of working conditions or occupational activity, even long term
- These do not occur overnight, they can take years to develop over a sustained period of time
- An employer can be responsible for medical treatment, lost wages, permanent disability compensation, prescriptions, and even vocational rehabilitation to get you retrained and back in the workforce if working conditions caused your injury
Key Takeaways:
- There are currently hundreds of thousands of seniors who are suffering from occupational diseases and may not be aware of it
- 30% of COPD (Chronic Obstructive Pulmonary Disease) and adult asthma cases may be attributed to occupational exposure.
- 8 out of 10 long-term manufacturing workers have noise-related hearing loss
- Employers can be held responsible for
"Occupational diseases could [be caused by] coal dust from the mines, grain dust from farming, cotton dust. The nurse or nursing assistant who is allergic to latex, the bartender or waitress who inhale secondhand smoke, the housekeeper or janitor who was exposed to the noxious chemicals from cleaning supplies. The factory worker who inhales metals and foundries, silica or fine sand.” — Steve Heisler
To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/pages/category/Lawyer---Law-Firm/National-Injured-Senior-Law-Center-102270204804871/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
Steve and Martha Discuss:
1. What is a pressure ulcer or bedsore?
- “All bedsores are pressure ulcers but not all pressure ulcers are bedsores.”
- Many of these types of wounds develop from the inside out; the factors contributing to tissue breakdown go further than simply laying in the same position for too long.
2. How serious can a bedsore be?
- A bedsore can become very serious if not treated properly and can lead to as serious of a health condition as sepsis or death.
3. Do the senior and elderly come along with comorbidities which make them more susceptible to bedsores and pressure ulcers?
- Yes, usually there is more than one health or dietary issue contributing to the tissue breakdown, medications can also make someone more susceptible to getting bedsores or pressure ulcers. Some health issues that can make a senior more likely to get a bedsore are smoking, diabetes, thyroid issues, etc.
4. In nursing home and assisted living facility settings is it a fair assumption to say you’ll see a lot of bedsores and/or pressure wounds?
- Yes, but it also has to be acknowledged that these populations are more susceptible to these types of wounds in the first place and possibly that these types of wounds are inevitable at some point in their stay/housing time.
5. What would be protocols these facilities should have in place to deal with these issues?
- Utilize the staff members that you don’t usually use to provide overall healthcare such as the pharmacology doctor or the dieticians on staff for preventative care. Keeping track of nutrition plans and minor wounds as they occur will also help prevent major sores. Further, having protocols for when new patients enter to ensure they do not already have wounds that require care from the beginning.
6. Are we taking for granted that nursing homes and facilities are doing everything they need to for wound care?
- We assume that doctors and nurses learn about wound care in school but they often do not and many of the treatments recommended now are very outdated.
7. What can families and loved ones do to advocate or help if their loved one has a sore/wound that requires care?
- Ask for updates on wound care including pictures and reports when a loved one has such an issue, don’t be afraid to look at the wound yourself, and don’t be afraid to advocate and ask questions.
Main Takeaways
- Pressure ulcers and bedsores are not simply from laying in the same position for too long; there are many other contributing factors to the breakdown of tissue and subsequent wounds.
- There are also many strategies to treat and prevent these types of wounds from developing for at risk individuals.
Martha’s Kelso’s checklist “Comprehensive Alternative Risk Factor Form”
https://mywoundcareplus.com/online-library
Connect with Martha Kelso and Wound Care Plus:
Twitter: https://twitter.com/mywoundcareplus
Instagram: https://www.instagram.com/woundcareplus/
Facebook: https://www.facebook.com/woundcareplusllc/
Website: https://mywoundcareplus.com/
LinkedIn: https://www.linkedin.com/in/martha-r-kelso-5209741/
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/attorneysteveheisler/
LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.
We are all living longer, which means we may need to rely on others to help us or our parents. Thus, like it or not, the Senior and Elderly population is vulnerable to negligence committed by medical professionals, Nursing Home and assisted living facilities, pharmaceutical and medical device companies, insurance companies and everyday individuals and businesses. Do you know who to trust? The Injured Senior Podcast will educate and inform you about legal issues of importance to the injured Senior and Elderly population such as medical malpractice, Nursing home and assisted living abuse and neglect, defective drugs and medical devices, age discrimination, on the job injuries, and personal injuries such as motor vehicle injuries and slip and fall. Your Host Steve H. Heisler is a lawyer and creator of the National Injured Senior Law Center and has been advocating for seniors’ rights for over 30 years. He is also a senior. The show will include many interviews with experts in the aforementioned areas of law as well as advice from Steve's personal experiences and past cases. Tune in each week to learn what you may not have even known to ask before. Welcome to The Injured Senior Podcast.
To find out more about the National Injured Senior Law Center or to set up a free consultation go to www.injuredseniorhotline.com or call 855-622-6530.
CONNECT WITH STEVE H. HEISLER:
Website: www.injuredseniorhotline.com
Facebook: https://www.facebook.com/pages/category/Lawyer---Law-Firm/National-Injured-Senior-Law-Center-102270204804871/
LinkedIn: www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/
Email: info@injuredseniorhotline.com
Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.