As a Pennsylvania nursing home lawyer, I was interested to see a study saying unnecessary treatments may be one reason for the growing cost of caring for the elderly. As the New York Times New Old Age blog reported Jan. 21, a study published in the Archives of Internal Medicine found that some of the most expensive treatments for late-stage dementia patients are also the most unnecessary ones. These included hospitalization and related after-care. In fact, author Dr. Susan Mitchell said in addition to being avoidable, these hospitalizations can be traumatic and confusing for dementia patients and may make them uncomfortable when antibiotics are used.
Mitchell and her colleagues at the Hebrew Senior Life Institute for Aging Research studied Medicare spending for 300 patients in greater Boston over 18 months. The largest share of the spending, 30 percent, went to hospitalization; 10 percent more went to skilled nursing administered after the hospital. Many hospitalizations were for pneumonia or related respiratory problems, which are common problems for dementia patients. However, Mitchell said, about 75 percent of the hospitalizations were for ailments that could have been treated just as well in the nursing home. In addition to being less expensive, leaving the patient in the home could also avoid the emotional trauma to patients who don't understand why they're being moved. And in patients near the end of their lives, palliative care may be preferred by some, the post said. Mitchell added that nursing homes may hospitalize patients they can treat on-site to shift costs from Medicaid to Medicare, which pays higher rates.
Any unnecessary medical treatment is a bad sign to me, as a Philadelphia medical malpractice lawyer. In addition to being expensive and traumatic, sending patients to the hospital unnecessarily puts them at risk of infection, medication mistakes and other problems that can arise from a change in caregivers. Even the emotional trauma can have significant effects on a patient with already compromised health, and physical injuries could send that patient into a health decline that could even end in death. If Mitchell is right that nursing homes do this to make a bit of extra money, that's even worse -- because it explicitly puts the nursing home's profits ahead of the best interests of the patients, their families and the taxpayers. Patients who believe their loved ones have been used as pawns in this way should talk to a Philadelphia injury lawyer right away.