Older women with low bone density have a greater risk of breaking a hip if they fall. Unfortunately, fall-related fractures are terribly debilitating, resulting in long-term pain, trouble walking, and difficulty doing even simple daily chores. All too often, a simple broken hip leads to life in a nursing home or other long-term care facility.

A new study published in the latest issue of the Archives of Internal Medicine (September 27, 2010) shows that women may be able to prevent falls if they follow a simple program of home-based exercises.

The researchers followed women over age 70, all of whom had osteopenia (pre-osteoporosis) for an average of about 7 years. Even though bone density did not improve, women who exercised had fewer overall fractures and no hip fractures. They also had better balance, faster walking speed, and improved ability to do daily chores.

The women in the study learned the exercise routine from a physiotherapist, but then were asked to continue to train 20 minutes a day at home. Just 20 minutes a day could make the difference between independence and a life in a nursing home.

Anyone who wants to start an exercise program should talk with a doctor first. Once you are cleared, the types of exercises used in this study are the kind most people can do at home. (If you do any of these on your own, be sure to do them at your own pace, and on a stable surface. Hold onto chairs, walls, railings, or anything else to keep your balance.) The exercises include:

• Walking
• Rapid walking
• Walking with arm movements
• Knee bends
• Leg lifts
• Heel rises and drops
• Dancing
• Stamping
• Stepping sideways, forward, backward
• Stair climbing
• Jumping

The overall goal is to start slowly, but keep a regular routine of balancing and strengthening exercises. Better yet, find a partner to exercise with you—there is strength in numbers. You can encourage each other, and even provide balance for each other if necessary.

But remember…talk with your doctor, and stay safe. Then, get strong!

Resources

“Long-term Outcomes of Exercise: Follow-up of a Randomized Trial in Older Women with Osteopenia.” Archive of Internal Medicine; Sept 27, 2010; pages1548-1556.

“Effect of Exercise on Extraskeletal Risk Factors for Hip Fractures in Elderly Women with Low BMD: A Population-Based Randomized Controlled Trial.” Journal of Bone and Mineral Research; Jan 23, 2006; pages 772-779. (http://onlinelibrary.wiley.com/doi/10.1359/jbmr.060116/pdf)

Patients and their families won a class action lawsuit against Skilled Healthcare Group Inc., which operates 22 assisted living facilities in California. Although the jury originally awarded $670 million, the case was settled for $50 million. Yes, it’s much less, but it also means that the patients will actually get compensation now, while they are still alive.

Skilled Healthcare Group Inc. was found liable for understaffing at its nursing homes–patients didn’t receive the minimum amount of nursing care required under California state law. Although the group did not admit doing anything wrong, it agreed to the settlement dollars.

The lawyers of HensonFuerst are heartened by the original verdict. Nursing home residents are routinely neglected and often abused, and we are happy to see that the good guys sometimes win. The only sour notes in this story are that the settlement ended up being only about 7% of the original verdict…and that Skilled Healthcare didn’t have to admit that it had done anything wrong.

We hope that this verdict serves as a caution to other nursing home operators—follow regulations, take care of residents, and put their health above the quest for money. Everyday, HensonFuerst Attorneys fight for the rights of abused and neglected elderly nursing home residents. We will continue to speak for them and, when necessary, to see that justice prevails.

To read more about this story, see the full article here:  Los Angeles Times nursing home verdict story

Many people who wind up in a nursing home are transferred there after a hospital stay. But an article in today’s The Washington Post points out a technicality that could block your ability to have Medicare cover the cost of  your nursing home stay.

Basically, everyone in the hospital is categorized as being in either “for observation” or as a regular “inpatient.” Here’s the tricky part:

Even if you are admitted as an inpatient, the hospital can switch you to observation status; in that case, the hospital is required to notify you.

If you do not have three consecutive days of hospitalization as an inpatient — excluding the day of discharge — Medicare will not cover a subsequent stay in a nursing home. For those who do qualify, Medicare pays for up to 100 days of rehabilitation or skilled nursing care.    [from The Washington Post article, emphasis added]

Although you can’t force the hospital to change your status from “observation” to “inpatient,” you can ask what your status is, and why. You can also talk with your personal physician, who can request (but not force) a status change.

If you are admitted to a nursing home without the required three days as an inpatient, there are still steps you can take to try to get Medicare to cover your costs.

1. When you enter the nursing home, ask to have them bill Medicare for your care.  If Medicare denies the claim, you can appeal the decision.
2. If the nursing home won’t bill Medicare, then you can complete a form called a “Notice of Exclusions from Medicare Benefits: Skilled Nursing Facility” (click the form name for an online copy of the form). The nursing home won’t bill you while you wait for a response from the government (and you know how long it can take to hear from a government agency).

If Medicare does not pay for your costs, you will be responsible, so know your rights…and continue to appeal any denial until you have no more options. If you need help, contact a local Estate/Medicare lawyer, who can usually provide technical assistance in these types of matters.

Sources of Information

The Washington Post

www.medicare.gov

HensonFuerst attorneys (www.lawmed.com)

In Scotland, the Inchmarlo Continuing Care Retirement Community has a new therapist:  Humphrey, a 12-week-old bulldog puppy. He takes his job so seriously that he has his own blog, where he (or his ghostwriter) chronicles his adventures. Recent entries include an account of his visit to meet the Queen of England, watching a rugby match, check-up visits to the veterinarian, and his “work” at the facility.

According to Deadline Scotland blog, Professor Charles Skene, the chairman of the Skene Group who run the care home, is “delighted” the pooch is joining his team. Professor Skene said:

“He’s already proving popular with residents and staff and I think he will be a great addition to the Community. It’s important that people who are living in care have access to animals, as that is very therapeutic. However, as many older people aren’t able to keep pets themselves, having a therapy assistant like Humphrey is a great way of bringing animals into their lives. His job will be to visit residents across the Inchmarlo estate, providing comfort and cheering them up. For those who are feeling lonely or vulnerable, this can be important contact for them.

Judging by the response from our residents so far, it’s clear that Humphrey is a big hit.”

If you would like to follow Humphrey’s blog (and see more cute pictures), follow the link: http://inchmarlo.wordpress.com/