KANSAS NURSING HOMES: FAR TOO DEPENDENT ON MIND-ALTERING MEDS TO CONTROL PATIENTS

File under Ghastly.

Kansas has always ranked at or near the top in percentage of medicated residents, suggesting there are thousands of residents in the state’s certified nursing facilities who have been given drugs that aren’t medically indicated for them, and could actually harm them.  

Then there is this: 

Kathy Greenlee, a former Kansas Secretary of Aging who was appointed to U.S. Assistant Secretary of Aging under President Barack Obama, said the overuse of anti-psychotics is an unintended consequence of removing physical restraints from nursing homes in the 1980s and 1990s.

Like I said, ghastly. 

I don't know why adult children put their parents in nursing homes.  Why not use that same money to buy or rent an apartment.  That way the other tenants will involve him or her in their social life.  I mean if the complex is 10% ethical.  Most people are neutral.  Hopefully, there will be a 10% ethical influence among the tenants, which is enough to move things in the right direction.  Hopefully, people will do the neighborly thing.  As to regular meds, why rely on sedatives for your mom, dad, husband, or wife?  Don't you want your loved to thrive in all that he does? One neighbor I had was an older gentleman whose family lived back in Chicago.  He had emphasema but he still got around, drove around town, in fact, quite a bit with this portable oxygen tank.  Great guy.  But he left a pan with boiling water on the stove too long.  The water evaporated and the heat turned his pan into a conductor and smoke began filling his apartment house.  I smelled the smoke as it billowed out his window, so I stepped over to his apartment and knocked but his door was locked.  He was asleep and couldn't hear me knocking and pounding on his door or my screams of "Bob!"  I phoned the fire department and they broke into his kitchen window, woke him up, and extinguished the smoke.  I apologized for making a big to do about it, but he was grateful.  Somebody was looking out for him.

Red and brown onions, garlic, shallots, and leeks contain Benfotiamine.

Also, there are alternatives to dementia.  Ignore that information at your peril.  See at the bottom of this post for THE key ingredient to stave off dementia.  Understand that nutritional compounds, for them to work, require several weeks at resetting your biology, one that perhaps has been undernourished for years if not decades.  Too many folks expects miracles over night.  And still some vitamins actually do produce immediate miracles depending on your level of deficiency through diet, conditions, and lifestyle.  There is a lot to correct.  With Benfotiamine, you have to be on this B1 compound for 18 months for it to produce benefits.  Lots of folks will simply wax cynical, "Oh, yeah, of course, manufacturers [or nutritional reviewers] are going to say that so they can keep you on the product for months and years and profit from your desperation."  Not if it's noted up front.  If you didn't know that Benfotiamine requires 18 months to be effective, what would happen is that you would try it for a few weeks and give up, exclaiming "that stuff is not worth it."  Read that article.  It is the only effective B1 compound that protects nerves from dementia.  So there's that.

Leeks

For foods that contain Benfotiamine, you're already familiar with: onions, garlic, shallots, leeks, and other members of the allium family of vegetables.

In the interview seen here, Charlene Wagner explains that the St. John's nursing home was giving her husband, who was diagnosed with Lewy Body Dementia, sedatives Seroquel and Adol, saying that the nursing homes use these meds to sedate her husband, not cure, relieve, or heal her husband's condition.  Or, she says, "I would rather say that they use the meds to control them."  Yeah, that's about right.  Read what Seroquel is typically used for:

Seroquel is the brand name of the generic drug quetiapine, used to treat schizophrenia and bipolar disorder (formerly known as manic-depression).

Seroquel changes the levels of neurotransmitters (naturally occurring brain substances) including serotonin and dopamine.

Seroquel belongs to a class of medications called atypical antipsychotics.

Here is the article.

Kansas nursing homes have 'become far too dependent' on mind-altering meds.

  by Andy Marso and Kelsey Ryan.  

Allen Wagner used to light up when his granddaughter entered the room, but when she visits him at his nursing home in Overland Park now, he hardly reacts. He’s sleepy and uncommunicative.

He’s sedated.

Wagner, 78, has Lewy Body Dementia and Parkinson’s disease. But his wife, Charlene, said it’s hard to tell how much of his lethargy is due to that and how much is due to the anti-psychotic medications he was first given during an extended hospital stay and has continued taking in nursing homes.

“I’ve seen a change since he went to the nursing homes,” Charlene Wagner said. “Not because of the care. The care is good. I believe it’s the medicines.”

Anti-psychotics are contraindicated for people with dementia and include a U.S. Food and Drug Administration warning that they increase the risk of falls, stroke and other potentially fatal side effects.

The federal government started tracking the off-label use of such medications in nursing homes in 2011. Since then, Kansas has always ranked at or near the top in percentage of medicated residents, suggesting there are thousands of residents in the state’s certified nursing facilities who have been given drugs that aren’t medically indicated for them, and could actually harm them.

“There’s something about that dementia coupled with the anti-psychotics,” said Margaret Farley, a board member for Kansas Advocates for Better Care, a group that represents nursing home residents. “This is not just us saying, ‘Gee, that’s not very good, you’re robbing them of their personality, they won’t talk, they’re not active, etc, etc.’ This is hardcore. This is a 1.6 to 1.7 times increase in deaths that most of the time is related to cardiovascular changes or it’s related to the development of pneumonia.”

Kansas also led the nation last year in percentage of skilled nursing facilities cited by the federal government for a broad slate of medication-related violations, some of which relate to anti-psychotic use.

Kathy Greenlee, a former Kansas Secretary of Aging who was appointed to U.S. Assistant Secretary of Aging under President Barack Obama, said the overuse of anti-psychotics is an unintended consequence of removing physical restraints from nursing homes in the 1980s and 1990s.

Now when people visit nursing homes they’ll no longer see residents strapped to beds and wheelchairs. But they will likely see some under “chemical restraint,” through the use of anti-psychotic medications like Haldol and Seroquel, which Charlene Wagner said have caused her husband to deteriorate.

Greenlee said she knows Kansas nursing homes are not the worst in the nation overall. But the rate at which they use anti-psychotics should cause some soul-searching about how they deal with difficult or disruptive behavior of residents with dementia.

“They can be overprescribed to sedate people and then mask the need to deal with these underlying causes (of disruptive behavior),” said Greenlee, who is now vice president of aging and health policy for the Center for Practical Bioethics in Kansas City, Mo.

Groups that represent Kansas nursing homes say the state’s anti-psychotic use ranking is unfairly skewed by a handful of homes that specialize in mental illness and that they face a number of challenges that are outside their control.

It’s hard to find enough qualified staff in many parts of the state. Some facilities rely heavily on Kansas Medicaid and payments under that program have been delayed for years due to bureaucratic changes. There’s also a shortage of psychiatrists in Kansas, especially those who specialize in treating older people.

“All of those I believe do factor into our ability to continue to really tackle this issue,” said Debra Zehr, the president and CEO of LeadingAge Kansas.

Cindy Luxem, the president and CEO of the Kansas Health Care Association, said Kansas homes have brought rates down, but they need help to reduce them further.

“We’re going to take a lot of responsibility on this topic, but at the same time we look at it as something where we really better start getting family members involved,” Luxem said. “Physicians, pharmacists, you name it.”

Zehr said that when doctors and nursing home workers use anti-psychotics on people who don’t have a mental illness, it’s not ideal, but it’s done with good intentions.

“Anybody who’s spent time with people in the throes of dementia and has seen the kind of internal anguish and volatile behaviors of people with dementia at certain stages, they’re trying to help,” Zehr said.

But some facilities have found better ways to handle those behaviors. Farley said more should follow their example.

“It’s not an easy thing to be able to take care of bad behaviors without these medications, but we’ve become far too dependent upon them,” Farley said.

The fight over the rankings

On average, 20 percent of all Kansas long-term nursing home residents received an anti-psychotic medication at some point in 2016, tying it for the highest rate in the country with Oklahoma and Mississippi. The national average is 16 percent. Missouri ranked near the top at about 19 percent.

Kansas has dropped from a high of about 26 percent in 2011, but other states’ rates have fallen more since then.

SUPPLEMENTAL MAGNESIUM IS CRITICAL FOR DIABETICS

Here I review Bill Sardi's article, "On Controlling Diabetes Free of Prescription Drugs."

It is amazing to me how helpless those with diabetes talk about their condition.  It used to be called a disease.  Now it's just a metabolic condition. 

Herbal supplements, like cinnamon, are touted for their ability to control

blood sugar levels.

It can certainly become a disease.  But without a glitch each person I know who has it treats it as though it is a life sentence handed down to them from their genetic make-up by claiming that "My mother had it, my father had it, and my grandmother had it."  No doubt.  

So what I hear is a surrender to a condition that they believe the primary cause is genetic and not food or diet related.  And it certainly is difficult to see the faults in eating habits when you've lived those habits your whole life.  I should know . . . though thankfully I've not yet been diagnosed with diabetes.  By the time we're adults, I would think that most people should the know the error of their ways and jettison breakfast cereals and soda pop.  Many adults who survived the onslaught of a sugary diet from childhood celebrate the survival of childhood excesses by announcing "Oh, I ate four bowls of Captain Crunch" or "I downed 5 bowls of Coco Puffs before I drank a 6 pack of Cherry Cola.  Just the thought now of those soda binges wears me out.  Two, high-energy adults I've worked with have both been addicted to Diet-Pepsi.  I mean a 6-pack a day.  I could only shake my head at what that HFCS was doing to their hormones.  iSe la vie! 

But here again, it's Bill Sardi who lays out a new way of seeing old problems.  He's not simply pulling these assessments out of a hat but he cites research after research, collating data to demonstrate that a lot of the medical assumptions that have reached the popular culture are just wrong.  With regards to diabetes, not completely wrong, but wrong as to the causes.  The cause is the overconsumption of sugar in all of its forms.  Bill Sardi takes it apart, starting with almost a comical scene--a meeting in which the nation's largest food companies were asked to "share" some of the responsibility.  I laugh because when I emailed Pederson's bacon about their use of soy as feed for the pigs, I got a reply that went like this "If we told you, we'd have to kill you."  That was their attempt at a joke, of course, a Customer Service joke.  Ha, ha.  But one has to ask--Should customer service be joking like that?  So, I turn to honest, direct and ethical men like Bill Sardi.  He starts

At a 1999 conclave, executives of the nation’s biggest food companies walked out on a meeting that attempted to get them to share some of the responsibility for the then growing diabesity epidemic.  [New York Times Feb 20, 2013]  With sugarized bacon, ketchup, peanut butter, wrapped meats, salad dressings and processed foods dominating grocery store shelves, shockingly half the nation now is diabetic or pre-diabetic.  [LA Times Sept 8, 2015; Journal American Medical Assn. Sept 8, 2015] 

That's about right.  I couldn't imagine anything good coming from this meeting either.  Absolutely--high blood sugar levels are the causes of diabetes.  The answer then is to bring down the high blood sugar levels by removing from one's diet those foods that cause it to soar, regardless if they are traditional foods of your culture.  

Pre-diabetes means that your blood sugar level is higher than normal but not high enough to be classified as adult-onset (type II) diabetes and you have not developed symptoms yet (eyes, kidneys, heart, pancreas).  You are more likely to develop full-blown diabetes within 2 to 10 years. [Mayo Clinic] 

What I find interesting is that the theory of a disease is driven in part, perhaps in large part, by a pharmaceutical monopoly on the medicines that treat specific diseases put forth by institutions funded by the companies providing the antidote.  Wow!  Does that ever sound conspiratorial.  But it is mainly just folks jimmying with the free market.  Instead of allowing the customer or patient to find his own cure, conglommerants put enough safeguards in place so as to ensure a higher percentage of patients purchasing their prescription.  And so the narrative that folks walk around with in their heads about a condition is an old one.  Hell, it's antique.  So as the profession has a lock on the narratives that filter down to us folks, we are left with antiquated knowledge that serves as a terrible guide for greater health.  

On the diabetic front, Sardi points out important feature of diabetic drugs--

It is common for diabetics to experience frequent urination.  Elevated blood sugar has diuretic action induces frequent urination which results in loss of nutrients.  Yet replacement of lost nutrients is not the mainstay of diabetic therapy.

I wonder how many diabetics know this.  What is astounding is that physicians are phyto-phobic and mineral phobic when it comes to diabetes.  Sardi explains that supplemental magnesium is critical for diabetics.  

More than 50% of diabetics take dietary supplements, but most are unguided.  [Diabetic Educator 2011]  Even dietitians look at dietary supplements with disdain when it comes to diabetes.  One prominent dietitian says she doesn’t recommend over-the-counter supplements for fear of possible drug contraindications. 

She says: “I’d never advise anyone to take extra magnesium or to use a supplement-level doses of herbal remedies that claim to lower blood sugar.”  [Todays Dietitian Nov 2011]  Yet, as you will learn below, supplemental magnesium is critical for diabetics. 

Phyto-phobic physicians themselves issue caution over dietary supplements interfering with anti-diabetic drugs even though vitamins and minerals are essential for life.  It may be the drugs that are interfering with nutrients. [Advances Clinical Experimental Medicine Nov 2014]

And people wonder why doctors are held in such contempt.  Perhaps they hold your health in contempt.  More importantly, it is vitamins and minerals that are the first line of defense.  This goes for any non-diabetic individuals as well. 

 In development of a list of supplemental nutrients for diabetics, essential vitamins and minerals such as vitamins C and D should be given priority over herbal or other supplements.  While there are many herbal supplements that are touted for sugar control (among them cinnamon, Gymnema sylvestre, and many others), it is important to first utilize essential nutrients (vitamins and minerals) in a daily dietary supplement regimen for diabetics. 

Could it be clearer?  If someone has diabetes, your first line of attack is a daily vitamin C and D supplement.  Commit to this regime for a few weeks first before you look for the long-term benefits from herbs, like cinnamon, to bring under control other symptoms associated with diabetes.  

MAGNESIUM for DIABETIC CONDITIONS

Low magnesium blood levels are common among adults with diabetes. [Journal College Physicians Surgery Pakistan Nov 2014]

Low dietary intake of magnesium or increased excretion of magnesium due to diuretic use, are the most common causes of magnesium deficiency.  [World Journal Diabetes Aug 2015; Journal Renal Injury Prevention 2014]

Blood serum magnesium levels decline as blood sugar levels rise.  The hemoglobin A1c blood test, a measure of long-term blood sugar status, rises as serum magnesium levels decline.  [Diabetes Metabolism Syndrome Jan 2015]

In another study, 382 mg of supplemental magnesium taken over a 4-month period resulted in 50.8% of supplemented patients improving their blood glucose levels compared to just 7.0% taking an inactive placebo.  [Diabetic Metabolism June 2015]

One of the biological actions of metformin, a commonly prescribed anti-diabetic drug, is it raises magnesium levels. [Biology Trace Element Research July 2011]

Magnesium has been proposed as a public health strategy against diabetes.  Diabetics are commonly deficient in magnesium.  Insulin and glucose regulate magnesium and visa versa. 

There is considerable evidence that diligent magnesium supplementation may delay the progression from impaired blood sugar (glucose) regulation to adult-onset diabetes.  [Diabetes Obesity Metabolism Sept 2015]

In one study, just 100 mg increase of supplemental or dietary magnesium was associated with a 16% risk reduction for diabetes.  [Biomedical Environmental Science July 2015]

In one study of 54 diabetic patients, 300 milligrams of supplemental daily magnesium improved blood sugar (glucose) levels. [Medical Journal Islam Republic Iran July 2014]

How many diabetics have ever heard of an iron overload as one of the causes for insulin resistance?  That's what I thought.

An overlooked fact is that iron overload induces insulin resistance, that is, the inability of insulin to get into cells and generate energy. 

So how do you know if you have too much iron?  Get a blood test.  Sardi identifies that test.  It's called a ferritin test.  

There is a blood test that is not part of a regular blood panel that measures iron load in the body.  It is called a ferritin test.  Transferrin is another test that measures iron transport.  Elevated transferrin and ferritin are believed to be underlying causes of high blood sugar (glucose) and insulin resistance. [European Journal Endocrinology Aug 20, 2015]

Very few diabetics are aware of the need to measure iron storage in the body.  Men begin to accumulate iron in their body earlier than females who control iron load by monthly menstruation. 

I wonder if this is why men tend to get Diabetes II at a later age than women do.  

Men tend to have a greater risk to develop diabetes as indicated by a high ferritin level.  [British Journal Nutrition Dec 14, 2014]

Males accumulate 1 milligram of excess iron per day of life after they are fully grown.  By middle age, around age 40 years, males will have double the iron load of an equally-aged female and experience double the risk for diabetes. 

I thought that this was the most interesting point about iron accumulattion.  "Iron from plant foods is absorbed on an as needed basis.  Iron from meat is absorbed whether it is needed or not."  Ouch!

Iron from plant foods is absorbed on an as needed basis.  Iron from meat is absorbed whether it is needed or not.  The consumption of red meat, which provides the most easily absorbed iron of any food source, is associated with adult-onset diabetes. [American Journal Clinical Nutrition June 2015]  High ferritin levels, as determined by a blood test for the amount of iron stored in the body, correlates with the onset of diabetes.  [Advances Biomedical Research March 2015]  Insulin resistance occurs when ferritin (iron storage) levels rise. [Journal Pakistan Medical Assn. Dec 2014; Diabetologia March 2015]  In fact, elevated ferritin levels predict future onset of insulin resistance. [Diabetes Research Clinical Practice Jan 2015; Acta Diabetology April 2015] 

Note that the quotation above says "Iron from meat . . . ," and not "iron from red meat."  So any meat--chicken, beef, pork, etc.

FOOD SOURCES of MAGNESIUM
from Healthline

Cooked spinach, one cup, 157 mgs of magnesium.

Pumpkin seeds, 150 mgs of magnesium in a one-ounce serving.

Cooked black beans, a one-cup serving, contain 120 mgs of magnesium.

Cashews, a one-ounce serving, contain 82 mgs of magnesium.

Buckwheat, one-ounce serving, contains 65 mgs of magnesium.

Dark chocolate, a one-ounce bar, contains 64 mgs of magnesium.

Avocado, one medium avocado, contains 58 mgs of magnesium.

Tofu, 53 mgs of magnesium in a 3.5 ounce serving.

Salmon, half of fillet, contains 53 mgs of magnesium.

Bananas, 37 mgs of magnesium.  

In addition to the benefits for diabetics, magnesium is also an important bone mineral.  From Bill Sardi's book, The New Truth About Vitamins and Minerals, he writes comparing the virtues of calcium to magnesium  

Magnesium interferes with crystalization and produces flexible bones that can withstand physical stress.  Boron, a trace mineral, enhances bone hardness.  

So there's that.