Michigan Disability Resistance

U.S. nursing homes have significantly reduced the use of powerful antipsychotic drugs among their elderly residents, responding to pressure from many directions. Yet advocacy groups insist that overmedication remains a major problem, and want the pressure to intensify.

According to the latest data from the federal Centers for Medicare & Medicaid Services, known as CMS, the percentage of long-term nursing home residents being given antipsychotic drugs dropped from about 24 percent in late 2011 to under 16 percent last year. Decreases were reported in all 50 states, with the biggest in Tennessee, California and Arkansas.

Dr. Jerry Gurwitz, chief of geriatric medicine at the University of Massachusetts Medical School, depicts the overall decrease as "one of the most dramatic changes I've seen in my career." He wonders, however, if some nursing homes might be finding other medications that sedate their patients into passivity without drawing the same level of scrutiny as antipsychotics.

Advocacy groups — including the Washington-based Center for Medicare Advocacy and AARP Foundation Litigation — say even the lower rate of antipsychotic usage is excessive, given federal warnings that elderly people with dementia face a higher risk of death when treated with such drugs.

"Given the dire consequences, it should be zero," said attorney Kelly Bagby of the AARP foundation, which has engaged in several court cases challenging nursing home medication practices. Bagby contends that the drugs are frequently used for their sedative effect, not because they have any benefit to the recipients.

The advocacy groups' long-running campaign was reinforced Monday with the release of a detailed report by Human Rights Watch urging federal and state authorities to take tougher measures against improper use of antipsychotic drugs.

"On paper, nursing home residents have strong legal protections of their rights, but in practice, enforcement is often lacking," said the report, based on interviews with more than 300 people and visits to 109 nursing homes in six states.

Ten years ago, according to the Department of Health and Human Services, roughly 270,000 nursing home residents suffering from dementia were receiving antipsychotic drugs even though such medications are not approved to treat that condition. The powerful class of drugs is intended, instead, to treat serious mental illnesses such as schizophrenia and bipolar disorder.

This is one of those things where everyone knew the apparent rates were low, but it was hard to fund research to find out....

https://goo.gl/UXScQM

Fetal alcohol spectrum disorders may be more widespread in U.S. communities than previously thought, an observational study of 6,600 first-graders suggests.

The active-case ascertainment study, online in JAMA, estimates the prevalence of fetal alcohol spectrum disorders at 1.1% to 5%, reported Christina Chambers, PhD, MPH, of the University of California San Diego, and coauthors.

Weighted, those numbers jump to a range of 3.1-9.8% -- considerably higher than previous prevalence estimates of about 1%.

"We've had spotty estimates of the prevalence of fetal alcohol spectrum disorders in the U.S.," Chambers told MedPage Today. "It is difficult to recognize, so it can be hidden. There may be a stigma associated with it and reluctance on the part of mothers to be forthcoming about alcohol exposure, and on the part of physicians to ask about it."

Fetal alcohol spectrum disorders involve central nervous system damage and physical deficits that stem from prenatal alcohol exposure. The previously accepted prevalence estimate was derived largely from clinic-based studies and passive record surveillance.

Active-case ascertainment -- in which investigators pull data from many sources including site visits -- has been used in other countries and has led to higher prevalence estimates, Chambers explained.

Her group's study evaluated children at four sites in Midwest, Southeast, Pacific Southwest, and Rocky Mountain communities where primary investigators had developed trust. The researchers sampled first-grade students in public and private schools for 2 academic years from 2010 to 2016. Sampling methods and consenting processes varied across sites.

Assisted Living Services are often ignored when it comes to rights.....

https://goo.gl/x9YV1h

Older people and people with disabilities receiving Medicaid assisted living services—over 330,000 in 2014—can be vulnerable to abuse, neglect or exploitation. The Centers for Medicare & Medicaid Services oversees how states monitor such incidents, but its guidance has been unclear.

More than half of the 48 states providing these services couldn’t tell us the number or nature of critical incidents in assisted living facilities. In addition, states may not be monitoring things you might expect them to. For example, 3 states don’t monitor unexpected or unexplained deaths.

Ever had your wheelchair or personal equipment screwed up by airline staff? TAKE THIS  SURVEY!!!

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Please help us by answering a few questions about your experiences with air travel.

The following advocacy organizations and consumer and caregiver representatives are all members of the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) Standards Committee on Air Travel and are working together by way of survey data and meetings throughout the year to provide input and concerns to the committee, from the disability, veterans and caregiver communities regarding the problems with air travel for passengers with disabilities in order to set revised and updated standards for wheelchair handling, labeling, storage, airline and airline contractor training: All Wheels Up, Christopher & Dana Reeve Foundation, Muscular Dystrophy Association, National Disability Rights Network, National Council on Independent Living, Open Doors Organization, Paralyzed Veterans of America, University of Illinois at Chicago.