1 in 3 don't get potentially life-saving screening for colon cancer, second leading cause of cancer death in Ky. and U.S.

Federal officials said Tuesday that although detecting colon cancer early saves lives, only about two-thirds of Americans aged 50 to 75 have undergone recommended screening.

The U.S. Preventive Services Task Force recommends that men and women 50 and older get screened for colon caner, which is about 23 million Americans. However, only 28 percent of people who should be screened have ever done so and about 7 percent of people have received but are not up-to-date with their screening, says the federal Centers for Disease Control and Prevention.

Colon cancer is the second leading cause of cancer mortality in Kentucky and nationwide, and it affects men and women of all ethnicities. Kentuckians have a higher than average risk of colon cancer due to higher rates of obesity, diets high in fat, and lack of regular exercise.

"Despite research that shows colorectal cancer screening saves lives, screening rates remain far too low," CDC Director Dr. Tom Frieden said during a noon press briefing Tuesday. "Colon cancer is the second-leading cancer killer for both men and women. In fact, it's the leading killer of nonsmokers in this country, killing about 50,000 people a year," he said. The CDC report was published online Nov. 5 in its Morbidity and Mortality Weekly Report.

The number one reason people aren't being screened is because their doctor didn't recommend it, Frieden said, and the CDC is encouraging doctors to talk with their patients about screening. Certain preventive screening tests may be free under the Affordable Care Act, but be sure to check your individual policy.

"It is also important that individuals learn about testing options and get the test that's right for them," Frieden said. "But, we also know that not having health insurance greatly reduces the likelihood that someone will get tested and that's why increasing coverage is another way of saving lives."

MedLine Plus reports that several screening options can be used alone or in combination, including the following: Fecal occult blood test or fecal immunochemical test every year. These tests can be done at home; Flexible sigmoidoscopy, done every five years, with home fecal tests done every three years; Colonoscopy done every 10 years.

All these tests are effective and one is not necessarily better than another, Frieden said.  The CDC says that as many as 60 percent of deaths from colorectal cancer could be prevented if everyone age 50 and older were screened regularly.

"The best test is the one that gets done," he said. For some people, however, colonoscopy may be the best option, Frieden said. "These are people with a strong family history of colon cancer or an intestinal condition such as inflammatory bowel disease, or people who have had polyps removed in the past. But for everyone else, and that's the majority of people, there is no proven benefit to one versus another," Frieden said.

Kentucky nursing homes rank 40th in the nation in new survey; reformers ask governor to create special task force for action

Kentucky got a D grade and a rank of 40th among the states in a new national survey of nursing-home care, and reform advocates are calling on Gov. Steve Beshear and other policymakers to take corrective action.

The state ranks lowest in the Southeast, the lowest ranked region, in nursing home care quality; one in five Kentucky nursing homes were cited as having a severe deficiency, "indicating widespread abuse, neglect and mistreatment of residents," says the report of the survey, created by a Florida-based advocacy group Families for Better Care.

"The results of this first-ever survey sadly represent real people, human beings being abused and neglected every day," writes Bernie Vonderheide, president of the Kentuckians for Nursing Home Reform, the lobby that spearheaded the call for action. A representative of the Kentucky Association of Healthcare Facilities, the lobby for for-profit nursing homes in the state, was unavailable for comment.

The survey analyzed eight federal measures gauging nursing home care, and the state's nursing homes scored below average in five of the eight categories. For example, only a third of Kentucky facilities reported health inspections above average. Click here for more information or to see survey results.

In the letter to the governor, Vonderheide requested the creation of a special task force to address the issues, which they say affect thousands of Kentuckians, many who cannot speak up for themselves: "It’s time to stop this growing crisis in our state before it gets so big that we cannot manage it."

Study shows a 15-minute, moderate-speed walk a half-hour after eating can control older folks' spikes in blood sugar

It's no news that walking is good for your health or for preventing diabetes, but a new study published in Diabetes Care says a 15-minute, moderate-speed walk about 30 minutes after eating, which is when blood sugar spikes, is most beneficial for older individuals needing to control blood-sugar levels.

As you age, the process in which insulin converts sugar and glucose from your food into muscle cells, and the liver where it's stored for energy, doesn't work as well as it did when you were younger. Leaving too much glucose in the blood can lead to Type 2 diabetes and cardiovascular damage.

Exercise has long been known to helps prevent these effects. And while many individuals may not be able to get the recommended 45 minutes of exercise most days of the week, the study shows how you can be smart and get the most out of your exercising time. Compared to 45-minute walks in the morning and afternoon, the study says that only the 15-minute, post-meal walks managed to significantly reduce blood sugar spikes during the important three-hour post-meal window, reports Brian Alexander of NBC News.

This is the first controlled experiments of its kind and could be useful for pregnant women at risk for gestational diabetes who may not be able to exercise for 45 minutes,” the study’s leader, Loretta DiPietro of the Department of Exercise Science at The George Washington University, told NBC.

“This is not for weight loss, and it’s not going to increase your cardiovascular fitness very much,” DiPietro said. “It’s very specifically for glycemic control with older age.” But the study's findings benefit everyone because we all experience glucose spikes after eating, said DiPietro.

Remember to take precautions when walking at night, especially considering less than half of Kentucky adults live in communities with elements such as sidewalks or shoulders that allow for safe walking or bicycling.

Nursing homes push for lawsuit protection with fast-moving bill and broadcast ads; newspaper editorials excoriate sponsor, industry

A state Senate committee has approved a bill that would require lawsuits against nursing homes to clear a review panel before going to court, a move that has drawn very sharp criticism from the editorial pages of the state's two largest newspapers. Meanwhile, the nursing-home industry is running television and radio ads urging calls to legislators in favor of the measure, which the Senate Health and Welfare Committee approved 7-4 last Wednesday without hearing from its opponents.

"Slimy action on questionable bill" read the headline over Tuesday's Lexington Herald-Leader's editorial, which began, "Good ideas can withstand criticism. So, when lawmakers move a piece of legislation without hearing from any of its opponents, you have to wonder whether they're sneaking through a stinker."

The chairman of the committee and the bill's sponsor, Sen. Julie Denton, R-Louisville, said some members had to leave for other meetings. "But somehow they had time to listen to industry spokesmen before voting," the Herald-Leader noted. "The nursing home industry claims that it is under siege from frivolous lawsuits drummed up by attorneys advertising for clients and that this legal threat pushes up nursing homes' insurance and legal costs, taking money that otherwise could go into patient care." (Read more)

The Courier-Journal editorial, which first reported the committee's action, accused Denton of "a brazen abuse of her power as committee chairman" and said sarcastically that she was "humane" to spare members of he committee "the ugly details of nursing home neglect and abuse. . . . Why should members, before lunch, have to consider graphic testimony about bedsores, near-starvation, dehydration and bowel obstructions suffered by elderly, helpless people? But for members of the General Assembly who are interested in the facts, here are some:

• Kentucky currently has about 23,000, mostly frail, elderly people who are residents in about 280 nursing homes. About half the homes have been cited by federal inspectors for a serious deficiency since 2009.
• 40 percent of the homes are rated at below average by the U.S. Center for Medicare and Medicaid Services when it comes to basic health and safety.
• In 2012, Kentucky ranked first in overall federal fines for violations and one Kentucky nursing home racked up the nation’s highest fines for the year.
• Kentucky ranks first in serious nursing home deficiencies that threaten the safety of residents. (Read more)

Sen. Ray Jones, D-Pikeville, who called Denton's move "blatantly wrong." has filed several floor amendments to the bill, which remained in the Senate Rules Committee Monday.

The Kentucky Association of Health Care Facilities is pushing the bill with TV and radio commercials urging calls to legislators. It placed $9,464 worth of ads on Lexington TV stations through Feb. 14.

Lame-duck Congress could cut funding for critical access hospitals; more than two dozen in Kentucky

Critical access hospitals, which in most states are rural facilities with fewer than 25 beds, may be under attack in the lame-duck session of Congress, former national rural-health director Wayne Myers writes for the Daily Yonder. President Obama's "budget proposes to revoke CAH status and special payments for any such hospital within 10 miles of another hospital, and to cut the extra 1 percent payment for all of the critical access hospitals," Myers writes. (Census Bureau map of CAH locations)

This would "have enormous consequences," Myers writes. "Of the hospitals that lose CAH designation probably most will close or merge with another hospital. I've seen no estimates of numbers. There are more than a few congressional budget hawks in both parties who would like to eliminate the special payments to Critical Access Hospitals entirely. If these small hospitals dodge the bullet during the lame duck session, they'll continue to be targets in the next Congress. If they are successful in reducing payments to CAHs, the net effect will be to move health care capacity and jobs from smaller to larger towns."

The issue is complex. Rural areas have less political clout than ever, because of declining population, and many rural people use urban hospitals over CAHs, even for ordinary care. "Those who do use CAHs say their experience there is just as good as that in urban hospitals, even if the quality of care isn't as good as in larger facilities," Myers writes. "Elderly patients stay at CAHs because they know the nurses and doctors and their families live close by."

Issues for CAHs arise out of how Medicare payments are made to them, Myers writes. "A long list of arcane, special funding arrangements has accumulated to try to fit small rural hospitals into a Medicare payment system designed for large city hospitals." The largest program is the "Disproportionate Share Program," or DISH, which gives $15 billion a year to states to hand out to CAHs. The program is being phased out between 2014 and 2020, along with several other programs, as part of the Patient Protection and Affordable Care Act. (Read more)

Some strategies for seniors as Kentucky observes Fall Prevention Awareness Day Saturday, Sept. 22

Kentucky has joined 45 other states in proclaiming Saturday, Sept. 22 as Fall Prevention Awareness Day. In 2011, fall-related injuries among the elderly in the Bluegrass were associated with $266 million in hospital charges, according to Julie Lasslo, Kentucky Safe Aging Coalition coordinator at the Kentucky Injury Prevention and Research Center.

"Falls come at an immeasurable impact on the quality of life for many seniors," Lasslo writes in the Lexington Herald-Leader, noting that the Centers for Disease Control and Prevention estimate that one-third of Americans are hospitalized due to falls. She says such falls are not an inherent part of the aging process and some simple strategies can prevent them:

# Engage in a physical activity regime that includes balance, strength training, and flexibility.
# Consult with a health professional about getting a falls risk assessment.
# Have medications periodically reviewed.
# Get an annual eye exam.
# Store frequently used items at waist level.
# Remove clutter from stairwells, hallways and walking paths.
# Install and use handrails in stairwells and bathrooms.
# Remove throw rugs.
# Place double-sided tape under area rugs and loose carpet.
# Keep your home well-lit and consider using a night light.

For more information, go to Nofalls.org.

New tool allows analysis of nursing-home deficiencies across the country; Kentucky seems to rank high in serious problems

Reporters now have a tool at their fingertips that will allow them to find nursing home problems in facilities across Kentucky, which appears to ranks high in serious problems.(iStock photo)

The tool was launched this week by ProPublica, a nonprofit, investigative news group, and allows "anyone to easily search and analyze the details of recent nursing home inspections, most completed since January 2011," report Charles Ornstein and Lena Groeger.

The tool has features that the federal government's Nursing Home Compare doesn't have, including the ability to search using any keyword. Results can also be sorted according to the severity of the violation and by state.

About 1.5 million people still live in nursing homes nationwide, though more seniors are living at home or in assisted-living facilities. The reports show there were almost 118,000 deficiencies cited against 14,565 homes. According to the Centers for Medicare and Medicaid Services, the average number of deficiencies for a nursing home inspected in the U.S. is eight and the average in Kentucky is seven.

ProPublica's analysis shows Kentucky ranked fourth nationwide for the most "K" and "L" deficiencies, considered the most serious kind. The state had 45 in the analysis, as did South Carolina. Texas had the most in the country by far, however, with 183. 

While ProPublica does rank the states, nursing home industry officials say "inspectors in different regions of the country have different thresholds for issuing a citation, and that could unfairly make one state's homes appear worse than another's," Ornstein and Groeger report. (Read more)

CDC: Ten swine flu cases reported last week were linked to Ohio's Butler County Fair; warns nation's fairgoers to be cautious

Centers for Disease Control officials in Atlanta say 29 human cases of the new strain of the H3N2 swine flu have been confirmed in the last year, including 12 last week. Ten of the new cases were linked to the Butler County Fair in southwest Ohio. Butler County is just north of Cincinnati's Hamilton County. The fair ended last weekend. None of the cases have been tied to human-to-human transmission and all 12 of the new patients had close contact with swine prior to getting sick. The two other new cases occurred in Hawaii and Indiana. (CBS News photo)

Health official told CBS News that because county and state fair season in full swing, attendees should avoid taking food and drinks into barns and to wash their hands after they have been near animals. Pregnant women, young children, the elderly and people with weakened immune systems are especially at risk for developing the flu strain. So far, the strain hasn't spread easily, and recent cases have been mild. (Read more)

Most Ky. nursing homes give more antipsychotic drugs to non-psychotic patients than U.S. median, but get little attention so far

Most Kentucky nursing homes exceeded the national average of the share of residents without psychosis or a related condition who nevertheless received antipsychotic drugs, according to federal data gathered by The Boston Globe and distributed by Kentuckians for Nursing Home Reform.

The data from the Centers for Medicare and Medicaid Services showed that 16.7 percent of patients fell into that category, and that 161 of the 280 Kentucky nursing facilities for which data were available exceeded the national average. Twenty had percentages more than double the national average, and three were more than triple: the Glasgow State Nursing Facility, at 62 percent; Arbor Place of Clinton, 61 percent; and the nursing home at Western State Hospital in Hopkinsville, 60 percent.

The data are for 2010. Nursing homes were not included if there were no data on antipsychotic drug use. Some data were taken from 2009 because no 2010 data were available. The Globe put the data into an easily reviewable database, available here, the Kentucky reform group issued a press release about it on June 14, and Kentucky Health News reported it on June 22.

However, only two Kentucky newspapers have reported on the survey and a local facility that exceeded the national average, according to our limited subscriptions and the news-clipping service subscribed to by the Foundation for a Healthy Kentucky and shared with Kentucky Health News. Those were the Kentucky New Era in Hopkinsville, which mentioned several facilities in its area (Western State's director said state policy prevented him from commenting), and The Anderson News of Lawrenceburg. Its June 20 edition had a story focusing on Heritage Hall in Lawrenceburg, where 20 percent of non-psychotic patients received antipsychotic drugs.

A spokesman for Heritage Hall's operator, Elmcroft Senior Living and Memory Care of Louisville, told Anderson News Editor Ben Carlson that physicians "may choose to prescribe a medication such as antipsychotics without a diagnosis of psychosis or related condition such as controlling a patient's anxiety over a specific disease process."

Bernie Vonderheide, spokesman for the reform group, told Carlson that it suspects that many nursing homes use the drugs to keep patients under control and to avoid hiring more staff. "That is the single biggest problem in nursing homes, the lack of caregivers." (Read more; the New Era's story is behind a pay wall.)

Besides the Glasgow, Clinton and Hopkinsville facilities, the following had a percentage of non-psychotic patients receiving antipsychotic drugs that was more than double the national average:

Dawson Pointe, Dawson Springs 49%
Dover Manor, Georgetown, 49%
Edgemont Health Care, Cythiana, 46%
Pineville Community Hospital, Pineville, 44%
Edgewood Estates, Frenchburg, 42%
Wesley Manor Nursing Center, Louisville, 42%
Wellington Parc of Owensboro, 42%
Stanton Nursing Center, Stanton, 41%
Shady Lawn Nursing Home, Cadiz, 41%
Charleston Health Care Center, Danville, 37.5%
Breckinridge Memorial Nursing Facility, Hardinsburg, 37%
Cedar Ridge Health Campus, Cynthiana, 37%
Brighton Cornerstone Health Care, Madisonville, 36%
Carmel Home, Owensboro, 36%
Ridgeway Nursing and Rehabilitation Facility, Owingsville, 36%
J.J. Jordan Geriatric Center, Louisa, 35%
Medco Center of Henderson, 35%
Wolfe County Health and Rehabilitation Center, Campton, 34%
(Figures are rounded to the nearest percentage unless .5)

Large percentage of patients with dementia given drugs they don't need; see how your nursing home is doing

Kentucky reporters can now see how the nursing homes in their area are treating patients with dementia. The Boston Globe has published a list of all the nursing homes in the country that shows the percentage of residents without psychosis or a related condition but who are being given antipsychotic drugs. The data came from the federal Centers for Medicare & Medicaid Services.

Almost 40 percent of nursing home residents with dementia are on powerful antipsychotic drugs though they don't have psychosis or a related condition, federal regulators announced at the end of May. Their aim is to cut the use of these drugs on these patients by 15 percent by the end of this year.

The median use nationwide for patients being given antipsychotic drugs but who don't have psychosis is 16.7 percent. In Kentucky, 161 of 280 nursing homes surveyed were over the median number, according to the nonprofit advocacy group Kentuckians for Nursing Home Reform.

To see how your nursing home is doing, click here. (Read more)

Health-care system not ready to deal with baby boomers as they get old, expert says at seminar on aging

When it comes to dealing with aging baby boomers, the nation's health-care system isn't ready to deal with them, Dr. Gregg Warshaw, left, said at the University of Kentucky's Summer Series on Aging in Lexington yesterday. "We've made progress," he said, but "We have a lot more to do, and we are running out of time." (Photo by Jonathan Palmer)

Warshaw's figures show "patients with five or more chronic conditions account for about 68 percent of spending on Medicare," Mike Wynn reports for The Courier-Journal. "Around 141 million people suffered with chronic conditions in 2010, and that number is expected to jump by 30 million in the next two decades."

The shift from primary-care doctors to specialists is another big, expensive problem that is hurting the quality of health care for seniors, Warshaw argued. Ageism and frustrations over health networks are also challenges. "Like a lot of things in American medicine right now, we know the answers to those questions," he said. "We just don't know how to get from here to there."

Warshaw, who is the director of the Geriatric Medicine Program at the University of Cincinnati College of Medicine, was one of more than 350 professionals who attended the seminar, hosted by the UK College of Public Health. (Read more)

Louisville has highest concentration of nursing-home and extended-care companies in U.S.

Louisville has the largest concentration of nursing-home and extended-care companies in the country. Of the 570,000 people who call Louisville home, 4,000 work in the industry and produce $28 billion in revenue, reports Frank Browning for Kaiser Health News. (Kaiser photo illustration)

Though the city didn't intend to become the leader in the long-term care industry, companies opted to cluster around each other, with Humana the nucleus of the movement. "As its influence grew, the health insurance giant created spinoffs and attracted like-minded businesses, including a growing number of companies dealing with long-term care," Browning writes, without noting that Humana itself began as a nursing-home company, Extendicare, then evolved into a hospital firm and an insurance company.

There are seven key players in theindustry who have headquarters in the city: Kindred Healthcare, Trilogy Health Services, Atria Senior Living Group, Elmcroft Senior Living, ResCare, and Signature Health Care. Those companies then attracted firms such as RecoverCare and PharMerica. "It's been an evolution," Christian Furman, a gerontologist at the University of Louisville medical school, told Browning.

One of the key moves was attracting Signature, which has 73 long-term care facilities in seven states, from Florida to Kentucky. A promise of up to $4 million of corporate income tax credits in 10 years helped, but "access to talent was most important. There's an incredible amount of expertise here," said CEO Joe Steier.

The clincher was "the whole alignment of public and private support, including the University of Louisville, that has made the city into a national and international center for aging care companies," Steier said. (Read more)

National effort to combat Alzheimer's disease begins; as research continues, there are preventive steps you can take

Country singer Glen Campbell, who has Alzheimer's disease,
stands with wife Kim during a national conference Tuesday.
Associated Press photo by Charles Dharapak.

With numbers expected to jump to 16 million Americans by 2050, research is being conducted in earnest to find a way to ward off Alzheimer's disease.

One plan of attack is testing therapies before people show symptoms of memory loss, since the disease starts attacking the brain at least 10 years before memory problems appear. An international study will see if an experimental drug can halt the disease in "people who appear healthy but are genetically destined to get a type of Alzheimer's that runs in the family," reports Lauran Neergaard for The Associated Press. In another study, researchers will see if a nasal spray that shoots insulin to the brain can help patients with early memory problems.

Part of the challenge in combatting the disease is researchers are still not sure what causes it. "The chief suspects are a sticky gunk called bata-amyloid, which makes up the disease's hallmark brain plaques, and tangles of a protein named tau that clogs up dying brain cells. One theory: "Amyloid may kick off the disease while tau speeds up the brain destruction," Neergaard reports.

Given the expected increase in the number of people with Alzheimer's, the Obama administration has adopted a national strategy to fight the disease, part of which is a website that is a "one-stop shop for families" to offer information about dementia and links to community resources. Today, there are 5.4 Americans with Alzheimer's or related dementias.

There are steps people can take to protect their brains from the disease, including intellectual and social stimulation to help build "cognitive reserve." Doing crossword puzzles, for example, can help. So can physical activity. "Any time your heart is healthier, your brain is healthier," said Dr. Elizabeth head of the University of Kentucky. Diet is another consideration, since foods that are heart healthy are brain healthy, including omega-3 fatty acids found in fish. (Read more)

455 deficiencies found in 72 Kentucky nursing homes in fourth quarter of 2011

State inspectors found 455 deficiencies in 72 Kentucky nursing homes in the fourth quarter of 2011, with one facility accounting for 25 of them alone: Kindred Transitional Care & Rehab-Fountain Circle in Winchester.

The information was released by Kentuckians for Nursing Home Reform, a nonprofit organization that advocates for nursing home residents and obtains the data regularly through open-records requests to the Kentucky Cabinet for Health and Family Services and distributes it statewide. The information is posted as part of Medicare's nursing-home comparison data.

According to the Centers for Medicare and Medicaid Services, the average number of deficiencies for a nursing home inspected in the U.S. is eight and the average in Kentucky is seven. Inspections assess a facility on the care of residents and how that care is administered; on how staff and residents interact; and on its environment. Certified nursing homes must meet more than 180 regulatory standards. The state Office of Inspector General website has more data, such as the results of inspections and the ownership of each facility.

Nursing homes with 10 or more deficiencies in the fourth quarter of 2011 were:

• Bridge Point Care and Rehabilitation Center, Florence (22)

• Pineville Community Hospital (17)

• North Hardin Health & Rehabilitation Center, Radcliff (15)

• Richmond Place Rehabilitation and Health Center, Lexington (13)

• Hart County Health Care Center, Horse Cave (13)

• Parkview Nursing and Rehabilitation Center, Pikeville (13)

• West Liberty Nursing & Rehabilitation Center (13)

• Redbanks, Henderson (12)

• Knox County Hospital, Barbourville (11)

• The Forum at Brookside, Louisville (11)

• Bradford Square Care and Rehabilitation Center, Frankfort (10)

• Florence Park Care Center (10)

• Boyd Nursing and Rehabilitation Center, Ashland (10)

• Corbin Health & Rehabilitation Center (10)

For more information about Kentuckians for Nursing Home Reform, click here.

Free seminar on guardianship to be offered Feb. 26 in Lexington

Kentuckians for Nursing Home Reform will provide the opportunity to learn from experts about guardianship Feb. 26. More than 23,000 Kentuckians live in nursing homes.

Lexington attorneys Carolyn Kenton and Robert McClelland will speak, along with Virgiel Clayton, director of the Division of Guardianship in the Department of Aging and Independent Living.

The seminar, which is free and open to the public, will begin at 2 p.m. Feb. 26 at the Tates Creek Branch of the Lexington Public Library. For more information, click here.

Nursing home ombudsman program at risk because of 'callous and apparenly clueless' move by feds, advocate writes

The Kentucky long-term care ombudsman program is at risk in Kentucky due to a change in federal policy. The Centers of Medicare and Medicaid Services is "quietly telling some state aging leaders that by Jan. 1 they will no longer be allowed to use civil monetary penalty funds to help pay for the nursing home ombudsman program in their states," Bernie Vonderheide, president and founder of Kentuckians for Nursing Home Reform, writes an op-ed piece in The Courier-Journal.

The civil penalties are assessed for violations in nursing homes. In Kentucky, the fund contains about $15 million. But if the move by CMS goes through, Kentucky "stands to lose more than a half million dollars a year from the CMP fund that has gone into supporting full-time ombudsmen in all of the 15 area development districts in the state," Vonderheide writes. "We are concerned about the callous and apparently clueless action by the federal Centers for Medicare and Medicaid Services. It is obvious that the Washington bureaucrats who make decisions like this have never been in a nursing home and are oblivious to the needs of the people."

Nursing-home ombudsmen investigate alleged abuse and neglect in facilities, and visit residents. "In the average nursing home, surveys show that more than half the residents never have a visitor — family member or friend — except for one, and that's the ombudman," Vonderheide writes. "We can't lose our nursing home residents' best friends — those angels of mercy, the ombudsmen." (Read more)

Jury tells nursing home to pay $1 million to former resident

A Fayette County jury has decided that Lexington's Cambridge Place Nursing Home will have to pay more than $1 million in damages to a former resident who fell and was found in an equipment storage room with broken bones in her face.

In January 2009, Irene Hendrix, who has Alzheimer's disease, was reportedly walking up and down a hall using a Merry Walker, which is a walker that has a seat. At some point, Hendrix, right, fell and was found with bleeding in her brain, a 4-centimeter cut on her forehead and the broken bones, the Lexington Herald-Leader's Valarie Honeycutt Spears reports. Hendrix's daughter and guardian filed a lawsuit against the facility later that year, alleging negligence.

After two hours of deliberation, the jury awarded Hendrix $1 million for physical pain, suffering and mental anguish. It also awarded Hendrix more than $27,000 for her medical bills. "A jury spoke today regarding the level of care they expect for their loved ones in nursing homes in Fayette County," plaintiff's lawyer Scott Owens said.

The Cabinet for Health and Family Services and the Office of the Kentucky Attorney General previously investigated Hendrix's case and a state adult-protection worker "determined that Hendrix was a victim of caretaker neglect and had been exposed to an extreme safety risk," Spears reports. "The protection worker told the attorney general's office that she thought Hendrix's injuries were the result of an accident." The attorney general's office closed the case in March 2009. (Read more)

Free conference on Alzheimer's in Louisville Sept. 17

A Washington-based geriatric researcher will join University of Louisville researchers and clinicians a free conference examining Alzheimer’s disease from 9 a.m. to 3 p.m., Saturday, Sept. 17, at the Crowne Plaza Louisville Airport Hotel, 830 Phillips Lane, near the state fairgrounds.

“The Journey: Alzheimer’s Disease and Caregiving” will provide information on the risk factors for Alzheimer’s disease, the reasons why certain populations are at greater risk for developing it, and current practices in caregiving. Admission, parking and lunch are free to participants at but pre-registration is required by Sept. 15 to info@alz.org or 1-800-272-3900.

Thomas Obisesan, M.D., chief of geriatrics at Howard University Hospital, will open the meeting. His research is focused on finding a cure for Alzheimer’s and "disentangling the overlap of cardiovascular disease with Alzheimer’s disease risk," a U of L release says. The conference is supported with grants from Eisai Co. Ltd. and the Signature Research Institute. It is co-sponsored by the university and the Greater Kentucky and Southern Indiana Chapter of the Alzheimer’s Association.

Planned merger of Louisville hospitals grows more controversial; C-J devotes considerable space to it and Beshear steps in

UPDATE, July 27, 3:43 p.m.: Gov. Steve Beshear issued a statement saying "It is clear there are growing concerns within the community about issues related to the hospital’s future level of access to medical services, and those concerns need to be fully vetted before the Commonwealth takes the legal steps required to approve this merger," such as changes in leases of public property and agreements on operation of the hospital. Just as important as the legal issues, Beshear said, is "the public policy of how the University of Louisville Hospital will continue to honor its mission as a public teaching hospital that provides access and care to citizens, especially those who are indigent." The governor said his administration "will hold a series of conversations with the principals in the proposed merger and other interested parties," starting with a meeting among four of his cabinet secretaries, Mayor Greg Fischer, state Auditor Crit Luallen and Attorney General Jack Conway.

The merger that would put a Catholic health group in charge of the University of Louisville's hospital is growing ever more controversial, as demonstrated by today's edition of The Courier-Journal. The top story was about U of L President Jim Ramsey's uncertain response to a request by state legislators to answer questions of a legislative committee, accompanied online by a photograph of a somewhat sheepish-looking Ramsey, left. UPDATE, July 28: Ramsey says he will appear before the panel Aug. 17.

The paper's editorial page was mainly about the issue. The top editorial was headlined "Ramsey's silence," and it referred to the second 'editorial' on the page, actually a recitation of email correspondence between Ramsey and one of his Fern Creek High School classmates and her husband, who oppose the merger and questioned Ramsey's charcterization of an earlier C-J editorial as "not based on complete and factual information."

Next to that piece was a letter from the lawmakers: Rep. Tom Burch, chairman of the House Health and Welfare Committee and a Catholic who opposes the merger because of its implications for reproductive and end-of-life procedures; and Reps. Mary Lou Marzian and Joni Jenkins of Louisville. It was illustrated by a photo of Ramsey looking thoughtful. Above it was a letter, illustrated by a photo of Pope Benedict XVI, from Eugenia K. Potter, former executive director of the Kentucky Commission on Women, headined "Is it dogma or discrimination?" Conservative commentator Martin Cothran has a contrary view on his blog.

UPDATE, July 27, 8 a.m.: The C-J editorial page is again mainly about the issue, with an editorial urging the state auditor, governor and attorney general "to thoroughly scour and bring transparency to the negotiations with Catholic Health Initiatives;" an article by former University Hospital nurse Beverly Glasscock saying that the hospital wouldn't be able to perform emergcy abortions needed to save a woman's life; and a letter from former university trustee Bill Stone defending Ramsey from what he calls an "over the top" attack by the paper's editorial board.

Louisville hospital merger could thwart some patients' final wishes

More concerns are being raised about the merger that would put a Catholic hospital group in charge of the University of Louisville's hospital. First, it was the prospect that women getting Caesarean sections would not be able to get their tubes tied at the same time. Now, "A growing chorus of protest from local residents, doctors and others has erupted over the fact that Catholic doctrine could override patients' end-of-life wishes," Laura Ungar and Patrick Howington report for The Courier-Journal.

"While many wealthier patients could simply choose a different hospital, indigent patients have little choice but University Hospital for treatment, including end-of-life care," the reporters note. "That has left some worried about how end-of-life decisions will be affected if living wills and decisions to remove a feeding tube, for example, will not be honored if they are 'contrary to Catholic teaching'."

Denver-based Catholic Health Initiatives told the newspaper that advance directives such as living wills would be honored “in the vast majority of cases” but “There may be the rare situation, such as a patient in a persistent vegetative state who is not in the dying process, when what the patient is requesting through his or her advance directive is not consistent with the moral teaching of the Church. In those few cases, a Catholic health care facility would not be able to comply, and with the family's guidance, the patient would be transferred to another facility, or to their home under hospice and family care.” (Read more)