Best Area Nursing Homes?

Though pronounced dead at the hospital which provided her care Pearlie Mae actually died at the nursing home where she for hospice care. The facility did not receive a favorable rating during her "residency." We certainly felt the home was unacceptable for animal care let along the care of a human being. We don't have a high opinion of nursing homes in general. However the ones we do have neutral feelings toward actually didn't score very highly either.

One in five of the nation's 15,700 nursing homes have consistently received poor ratings for overall quality, a USA TODAY analysis of new government data finds. More than a quarter-million patients live in homes given another set of low scores within the past year, according to data released today by Medicare, which first released the star ratings of the nation's nursing homes in late 2008. The ratings are derived from inspections, complaint investigations and other data collected mostly in 2008 and 2009. (USA Today)

It's only because we have experience with many of these local facilities at the time of the ratings that we can support the findings of Medicare. We have from the Medicare site the list for our jurisdictions of the ONLY facilities that you should even consider for housing your recovering or discarded family members. Sorry! That was unnecessarily harsh and we apologize but the subject is still a sensitive one.

Former Frazier co-star David Hyde Pierce had a different opinion and take on the issue when interviewed for the for PBS Series Life (Part 2) stating:

"...[T]hey found a great assisted living place 7 miles from their house, moved him there. It turned out to be the best thing in the world. We usually think of that as a bad second choice. In this case, it was a wonderful choice because instead of being in a house where there were very few people around, 'cause people had to work or be in school, he was constantly surrounded by people. He flourished in a social environment. He was always a very social person. Because of the demographics, he was one of the few men among many women, so that was lovely. And he continued to decline. He never went as far as my grandfather did. My grandfather went the whole route of the disease. My dad was, as we think, mercifully, stricken with the flu and got very sick, and my brother called us all. We were all able to come up there and we were all with him and he still knew us when he passed away." (Science of Happiness, Episode 10)

It took us a few days to analysis the data and find the best of the "poor." These should be the only facilities that you'd even consider for care, however, knowing how a facility fails can help you in either your choice or your lawsuit. The choice to know the devil the government knows or to know what you need to watch out for can also be a great boon to their care.

The Five-Star Quality Rating System was created to help consumers, their families, and caregivers compare nursing homes more easily and help identify areas about which you may want to ask questions. This rating system is based on continued efforts as a result of the Omnibus Reconciliation Act of 1987 (OBRA '87), a nursing home reform law, and more recent quality improvement campaigns such as the Advancing Excellence in America’s Nursing Homes, a coalition of consumers, health care providers, and nursing home professionals. Nursing home ratings are taken from the following three sources of data: Health Inspections, Staffing and Quality Measures. We provide a star rating for each of these three sources, in case some areas are more important to you than others. Then, these three ratings are combined to calculate an overall rating. (MEDICARE)

DC 3 choices (though we only found two (2) worthy of use and our choices are below):

1.  Jeanne Jugan Residence, NE  Stars 5/5/5/2 Medicaid, Non Profit, (40)
2.  The Methodist Home, NW   Stars 5/5/4/4 Medicare and Medicaid, Non Profit, (50)

MD 36 choices (though we only found seven (7) worthy of use and our choices are below):

1. Maria Health Care Center, Baltimore  Stars 5/5/5/5 M and M, Non profit, (60)
2. Crawford Retreat, Baltimore  Stars 5/5/4/5 Medicaid, For Profit, (20)
3. Sacred Heart Home, Hyattsville, Stars 5/5/4/5 Medicaid, Non profit, (102)
4. St. Vincent Care Center, Emmitsburg, Stars 5/5/5/4 M and M, Non profit (46)
5. Garrett County Subacute Unit, Oakland, Stars 5/5/5/3 M and M, Government (10)
6. Hartley Hall Nursing Home, Pocomoke City, Stars 5/5/3/5 M and M, Non profit (70)
7. St. Joseph's Nursing Home, Catonsville, Stars 5/5/3/5 Medicaid, Non profit (44)

NC 47 choices (though we only found four (4) worthy of use and our choices are below):

1.  Chowan Hosp-Snf, Edenton, Stars 5/5/5/5 M and M, Non Profit (40)
2.  Mayview Convalescent Center, Raleigh, Stars 5/5/5/5 M and M, For Profit (51)
3.  Pungo District Hosp Ventilator Unit, Belhaven, Stars 5/5/5/U M and M, For Profit (10)
4.  Wakemed Fuquay Varina Outpatient & Snf, Fuquay Varina, Stars 5/5/5/3 M and M, Non Profit (36)

VA 35 choices (though we only found seven (7) worthy of use and our choices are below):

1. Central Virginia Training Cent, Lynchburg, Stars 5/5/5/5 M and M, Government (104)
2. Little Sisters Of The Poor, Richmond, Stars 5/5/5/5 Medicaid, Non Profit (22)
3. Shenandoah Vly Westminster-Canterbury, Stars 5/5/5/5 M and M, Non Profit (40) 
4. Snyder Nursing Home, Salem, Stars 5/5/5/4 Medicaid, Non Profit (45)
5. Summit Square, Waynesboro, Stars 5/5/5/4 Medicaid, Non Profit (18)
6. Lake Prince Woods, Sufflok, Stars 5/4/5/5 Medicare, Non Profit (40) 
7. Southside Regional Medical Ctr, Petersburg, Stars 5/4/5/5 M and M, For Profit (20) 

• Stars (Overall / Inspections / Staff / Quality Measures) (# of Beds in the facility)

The best nursing home in the District of Columbia can't equal the best Maryland, North Carolina or Virginia facilities according to the Medicare government data. In choosing a better nursing home in the area size matters and the smaller the better - however smaller means fewer available beds. When your loved ones are in need the need from a hospital is immediate. Like David Hyde Pierce whose family interred their Grandfather and then their father in a nursing home while proclaiming the sites good for their relatives. You know if you're a nursing home person.

For us the question is would we want this for ourselves. We certainly wouldn't want to be burden on our families nor bankrupt them financially either. But to quote Mr. Pierce, speaking about his grandfather, on the PBS Series Life (Part 2) episode 10 entitled "Seeking Happiness:"

"The last time I saw him he was in a nursing home in New York State. He was in a wheelchair with his arms tied with straps to the arms of the wheelchair looking at cutout pictures in a construction paper book that some helpful volunteer had put together of flowers. Just sort of happily staring kind of blankly at this thing." (VIEW)

That's not the kind of life or death we'd like for ourselves but that's just us! We say live the kind of life you'd like to die living. For us it's not something we'd like to do alone with strangers but that's how we were raised. If you're raised differently stay in contact with the best places which can transport your loved ones to a facility for specialized care and then return them to the home to convalesce. Beds are few are far between - people are dying to get in.

Fat Happy and Seventy

If we're any indication Pearlie Mae did NOT live longer than her twin sister Mamie nor her older sister Alice. Alice was less mobile than either younger sisters but what she did have they didn't was weight. Not just the weight of her wisdom and memories of older children long since passed but size. In her final days the family had to assist in her hourly care which we did grateful though not tirelessly. It wore us out. Her son traveled by plane weekly to assist in her care. Her daughter maintain primary and overall care of Mother Alice.

Currently the "study published today in the Journal of The American Geriatrics Society (AGS). Researchers looked at data taken over a decade among more than 9,200 Australian men and women aged between 70 and 75 at the beginning of the study, who were assessed for their health and lifestyle as part of a study into healthy aging. The paper sheds light on the situation in Australia, which is ranked the third most obese country, behind the United States and the United Kingdom."

The results are in and though not an American study only one conclusion can be reached and that is - the couch wins! While it might be true for the US there are other research studies that point in a different direction for other nationalities. Specifically, "Lean Mass Index: A Better Predictor of Mortality than Body Mass Index in Elderly Asians" from the same Journal of The American Geriatrics Society (AGS).

"[T]he researchers concluded that the type of disease which caused their death, for example heart disease or cancer, did not affect the level of protection being overweight had. To remove any risk of bias in participants with illnesses which caused them to lose weight, and also increased their risk of dying, the researchers contrasted subjects who were relatively healthy compared with those who had major chronic diseases or smoked and found no apparent differences in the BMI: mortality relationship."

But we're neither asian nor concerned about negative news. We'll listen here and just think of us ourselves as Aussies! Of course you've got to get to seventy (70) years of age before you can really derive any benefits from being fat and happy! From other studies we know if we want to live to sit on our butts to old age that that extra spare tire or chin and a half can protect you against heart disease or cancer rather than be a source of heart disease or cancer. We're not sure why this is we're just glad it's so. Maybe its more of that everything in moderation we've heard so much about.

Pearlie Mae, Mamie and Alice all lived beyond seventy (70) years of age. First there were five (5) including Buddy and Nellie when there were just the few. Nellie was the baby and Buddy the baby boy. The baby Nellie went first and then Buddy - both big fat and happy. Buddy more than Nellie though his respiratory strength was the worst. In their cases Nellie only left to go to church and Buddy needed full time nursing care when sitting up became too much for his lungs. One by one and then there were gone.

Running Bare

Every country boy knows that shoes aren't good for you feet and every city boy knows that you can judge a man by his footwear. When we're at home we take our shoes off, cause we're country, but we do put on slipper cause our feet get cold. While the current study in NATURE magazine says when it comes to running, bare is better. It's not the soil that makes treading better it's the way we put our foot down! We thought it was minerals in ground that leeches into your skin and we were sooooo wrong!

“People who don’t wear shoes when they run have an astonishingly different strike,” said Daniel E. Lieberman, professor of human evolutionary biology at Harvard University and co-author of a paper appearing this week in the journal Nature. “By landing on the middle or front of the foot, barefoot runners have almost no impact collision, much less than most shod runners generate when they heel-strike. (Harvard University)

Sometimes initially we're wrong. Sometimes we'll be totally wrong - we allow for that possibility. Always we'll point to other wrong points that help us comprise our incorrect point of view. So when we're wrong we'll show you how we got that way and we'll learn from our mistakes so that we'll try to be less so in the future.

We, the city among us, think the solution to running bare or shod is FiveFinger running shoes or you could just run properly by putting your front or middle part of your foot down first and don't stretch your stride. The choice is yours a seventy-five ($75) dollar purchase or change the way you run.

Low Carb Blood Pressure

It hasn't worked for us but it might work for you. The headlines and stories all tout: "A low-carbohydrate diet like Atkins is better at cutting blood pressure than weight-loss pills, say US doctors." BBC News, LA Times, and Reuters.

Called a low-carbohydrate, ketogenic diet (LCKD) the results were especially pronounced for individuals with combination symptoms, high blood pressure and diabetes. For those of us with just high blood pressure the weight went down but not pressure. Nor was our results a part of a scientific study and we don't number one hundred and forty-six (146). We're what you would call real world experience. The study said:

(t)he mean age was 52 years and mean body mass index was 39.3 (calculated as weight in kilograms divided by height in meters squared); 72% were men, 55% were black, and 32% had type 2 diabetes mellitus. (Archives of Internal Medicine)

We love the Atkins logo and it probably should be noted that Atkins doesn't obviously appear to be funding the study by the Durham VA Medical Center. But we do love the logo, or rather someone of us do. It says: "Sweet, sexy science." Oh, yeah! If science is going to be anything we think it should be sweet and sexy. Unfortunately it's anything but sweet or sexy. We just like where their head is, well some of us do anyway!

Death By Couch

An editorial putting forth the argument that exercise is beneficial which on its face appears to be an accepted premise. Hopefully the actual research will offer a bit more detail and specifics. When we tried to verify the claim that couching can kill you.

We found this information at University of Kansas Medical Center (UKMC) Exercise and the Brain: KU Medical Center Collaborating with the YMCA in Innovative Study, the results of which should be available in about a year.

While we could not find the Swedish editorial in the British Journal of Sports Medicine (BJSM) we did find this article relating to exercise and Alzheimer. What do you do when you can't remember if you exercised or to exercise?

Exercise is beneficial for patients with Alzheimer's disease: A call to action - Alzheimer's disease (AD) is the most common neurological disorder associated with aging, and has a global prevalence of 6% in people over the age of 65.

1. It is also the most common cause of dementia, accounting for 50-60% of all cases.
2. The increase in life expectancy of the world population is expected to translate into many more cases of dementia – it is estimated that 1 in 85 persons worldwide will be affected by AD in 2050.
3. Clearly Alzheimer’s disease is a major public health problem. (BJSM)

"Long periods of sitting at desk can cost you your life," according to the Yahoo News Article. Writing in the British Journal of Sports Medicine (BJSM), Elin Ekblom-Bak and colleagues from the Swedish School of Sport and Health Sciences and the Karolinska Institute in Stockholm said that sitting still should be recognised as a risk to health, independently of taking too little exercise.

"One study compared two groups of sedentary office workers, one of whom had regular breaks to move around while the other remained sitting for up to eight hours a day. The group that had the breaks had better blood lipid levels and blood glucose and less obesity."

"Another study from Australia showed that for every extra hour women spent sitting, their risk of metabolic syndrome - a pre-cursor of diabetes and heart disease, rose by a quarter, regardless of how much exercise they took. Dr Ekblom-Bak said: "It is important to have a five minute break from desk work every 45 minutes. Don't email colleagues - walk across the office to give them the message. Take a coffee break or put the printer in the next room. I am a desk worker and I try to do it. It is not difficult but sometimes you get lost in your work and you forget about it."(ANI)

When the story appeared in Medical News Today (MNT) it includes a PDF from the British Journal of Sports Medicine that says - "We need to consider that we are dealing with two distinct behaviours and their effects:

1.  the benefits of regular moderate to vigorous-intensity physical exercise and
2.  the risks of too much sitting and limited non-exercise everyday life activity. If found to be true, the clinical importance and implication of this new paradigm is extensive. In the future, the focus in clinical practice and guidelines should not only be to promote and prescribe exercise, but also to encourage people to maintain their intermittent levels of non-exercise daily activities. Climbing stairs rather than using elevators and escalators, 5 minutes of break during sedentary work, or walking to the store rather than taking the car will be as important as exercise. In the demanding and stressful society of the present, to prescribe these low and minimally time-consuming efforts may encourage many people with problems in maintaining a sufficient level of exercise.

We found it. Thanks to the MNT we actually find the editorial though only in this PDF format.

If the goal of the father is to as, Chris Rock says to "If you can keep your son off the pipe and your daughter off the pole, you're ahead of the game." Then the goal for children and the married is too keep your parents and mate from being alone in old age.

"Elderly women are less likely than men to live in a family setting. After age 75, most women are widowed and live alone, while most men are married and live with their wives."

"Elderly women (16 percent) were more likely to be poor in 1992 than elderly men (9 percent). Of the 2.3 million elderly poor who lived alone in 1992, 2.0 million were women."

"In 1990, elderly with a self-care or mobility limitation were more likely to be poor (20 percent) than elderly without such limitations (11 percent)."

The Census article "65+ in the US 2005" (PDF)

Sitting Time and Mortality from All Causes, Cardiovascular Disease, and Cancer(ACSM) comparing the editorial to a twelve (12) year study of 17,013 Canadians 18-90 yr of age. Results: There were 1832 deaths (759 of cardiovascular disease (CVD) and 547 of cancer) consistent with our areas and the nation's causes of death.

We can agree with the Swedish School of Sport and Health Sciences in that we should get off the couch to use the bathroom every 45 minutes. We'd even go so far as to suggest we do so every half hour as long as we don't have to walk up stairs. After all - all that sitting isn't good for the gluteus maximus.

In March 2008 Australian researchers began testing a trial in Melbourne and Sweden called PBT2. Now there's been progress as the trials move to "a very preliminary stage of development, examples of new exciting drug therapies include: PBT2, which opposes A-beta production, and has been shown to improve the brain function of people in early stages, Rember, a drug which is showing an 81 per cent improvement in the rate of mental decline, and AL 108, a drug administered by way of nasal spray." The article refers to Alzheimer's Society of Canada but the research information is old and starting on its second year since its revision in 2008.

2010 - The Flu Is Still With Us - Week 2

May it not be with you. For us the choice was simple even though we followed the commercial to our area CVS for an H1N1 shot to discover you need to make an appointment prior to receiving a $15 inoculation. The twenty-four (24) hour pharmacy was quite willing to allow us to make an appointment for the following week to pay to receive a shot. Or we could as only a few others receive a free shot at a local church after service or for a few hours later.

Flu Deaths Week 2 2010 2009 2008 2007 District of Columbia Baltimore, MD Richmond / Norfolk, VA Charlotte, NC 3 34 12 26 3 29 6 U 1 20 5 7 1 19 9 7 TOTALS 75 38 33 36

Now we are all protected staff members. It's still out there - like the truth. The number of dying are still growing although there is protection and for many it's free. To choose between waiting and paying and waiting and receiving a free injection was no choice for us.

The number of deaths from accidents, cancer, heart disease, high blood pressure and strokes are greater we'll admit. Other than accidents all seem within our control and the Center for Disease Control and Prevention (CDC) suggests "washing your hands" often as well as a form of flu prevention for the H1N1 and seasonal flu as well as getting the shot. We do highly encourage everyone to get this form of protection being offered in our communities whether for pay or free. It really isn't over regardless of what the local and international critics might say. But it is really up to you!

Just Juicing

This is not a story about Mark Mcgwire and steroids. It's about the big blueberry story. We love the story because its a healthy way or getting and staying healthy by raising a glass and bending our elbow. Not just once but two or three times a day.

The reports say don't make a big deal out of it because it's sponsored by the wild blueberry association and it only involves a small sample of people so don't put a lot of stock into the news. All of which is true but missing is how the same researchers have been investigating the benefits of wild blueberries since 2002.

Mary Ann Hodorwicz, a dietician in private practice in Palos Heights, also touts the benefits of the blueberry. She cites the antioxidant properties as the reason for aiding memory and many other health benefits including fighting cancer, promoting healthy aging and reducing inflammation. “Generally speaking the darker the fruit, the higher the antioxidant properties,” Hodorwicz said. “Shoppers should look for deeply colored fruits.” (MEDILL REPORTS)

Time magazine had the most interesting take on the research and one of our favorite reports on the wild blueberry juice benefits.

While all participants experienced age-related cognitive problems, the blueberry-juice drinkers showed significantly better performance on two memory tests than a control group of seven participants who drank a sweet placebo beverage that contained no juice. What's more, the juice drinkers' test scores had improved by the end of the 12 weeks. In case you were wondering, all that juice also didn't make them fatter. 

One caveat: Although the study was conducted independently at the University of Cincinnati and received National Institutes of Health funding, it was also partly funded by the Wild Blueberry Association of North America, a trade group that no doubt would be very happy if you decided to buy blueberry juice as a result of the study. (TIME)

 Our caveat is one shared by a reader of the TIME blog who shares a study that we couldn't verify exists saying that you can fake any study and fool three (300) hundred first year psychology students. If we could verify the fake study where a fake website was created to fool three (300) hundred or more viewers we could quote it. You decide if the study is worth bending an elbow or two.

Blueberry Haze: The Jenn Slemmer Experience
“We had two groups of men with a moderate risk of heart disease and hypertension. One group drank a cup of blueberry juice every day for three weeks. We gave the other a placebo. In that short amount of time, the blueberry group showed trends towards improved metabolic parameters including insulin and glucose levels.” - Scientist Jenn Slemmer 

It Can't Hurt! We'll take our gym membership money and spend it on frozen wild blueberry juice anytime. How can that be a bad thing? Now if we could just do something about the high cost of frozen wild blueberry juice.