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How Corporate Health Care Leaders Maintain Their Impunity: The Case of Purdue Pharma's Funding of the Washington Legal Foundation to Attempt to Weaken the Responsible Corporate Officer Doctrine

The ongoing epidemic of narcotic (opioid) abuse, and the resulting rise in the deaths due to overdoses, has focused attention on pharmaceutical companies' aggressive promotion of these drugs which minimized their substantial risk. A recent article in the Intercept showed how the leadership of one such company tried to insulate itself from responsibility for such actions even while such promotions were continuing. Background: Impunity of Top Leaders of Big Health Care Organizations For years, we have railed against the impunity of top leaders of health care organizations.  We have noted that despite numerous legal settlements made by health care organizations of alllegations like fraud , bribery , and kickbacks , almost never do top leaders who presided over these actions face any negative consequences.  Lack of deterrence caused by such impunity appears to be a major cause of  the epidemic of continuing unethical behavior, crime and corruption on the part of large health car

Health Care and Senior Wellness

Most senior citizens typically have at least one health care issue that they deal with on a daily basis, whether it’s either physical or mental difficulty. Possibly it is both in many cases. As you age, staying active mentally is just as important as staying physically active. Now more than ever, seniors are leading active lifestyles, traveling, and trying new activities. However, older adults that could use a little support and assistance in their daily lives often are not sure how to accomplish those tasks.

There are many available resources that provide the human connection needed to enhance a senior’s quality of life, also to help reduce loneliness and provide information on available senior support services, including caring volunteers who provide support with errands such as transportation for grocery shopping, short medical appointments, errands and social outings. Seniors in many cases need assistance, depending on age and physical and mental capabilities.

Providing coordinated care with specific attention to most common problems within the senior population is important for a well rounded senior wellness regimen. Some of the more critical areas of care and support should include the following steps:

Basic Physical Assessments:
·         Intellectual impairment
·         Immobility
·         Instability
·         Incontinence
·         Iatrogenic (inadvertently induced) disorders

Geriatric Assessments
·         Clinical history
·         Nutritional assessment
·         Social evaluation
·         Neuropsychiatric evaluation
·         Physical examination
·         Functional examination

Support services and educational classes:
·         Nutrition
·         Diabetes
·         Independent living
·         Memory and healthy brain function
·         Fall prevention
·         Exercise
·         Caregiver support

Both seniors and caregivers should understand the importance of preventive healthcare and be involved withsenior wellness programs that focus on prevention, detection, education and follow-up in order to achieve and maintain productive, high-quality lives.  Whether you live independently at home or in a senior living facility, you may benefit from occasional visits by a registered nurse to ensure you are maintaining a healthy lifestyle. At your first visit, a complete medical assessment should be provided by a registered nurse for the following areas:
  • Physical
  • Emotional
  • Psychosocial
    Another consideration for seniors is prescription adherence. According to the Institute of Medicine, over 1.5 million people each year have adverse reactions due to medication errors or interactions. Caregivers and medical professionals, such as a doctor, nurse or physician assistant, should come to your senior center, group residence, or home and perform a complete medication review, to help you with the following needs:

    ·         Understand what medications you are taking and why
    ·         Learn how to properly take your medication and at what times for optimal results
    ·         Develop a medication chart that is easy to follow
    ·         Separate medication into daily/weekly containers
    ·         Create a telephone list of contact numbers or medication record in the case of an emergency to keep in a convenient location

    For seniors to stay their healthiest and enjoy life to the fullest, it's important to have regular health checkups by a medical professional. Assessments can include:
    ·         Physical
    ·         Emotional
    ·         Psychosocial
    ·         Neurological
    ·         Chronic illness such as diabetes, cholesterol, hypertension and asthma
    ·         Hearing
    ·         Medication review

    An indepth health program for seniors may provide more detailed provision for the following needs for wellness that focus on helping them strengthen and maintain the skills that other workouts often overlook:

    Gross motor skills—including balance and proprioception to keep you on your feet and active. Proprioception is the ability to innately sense your body’s position, movement, and spatial orientation, even when you are not looking. Examples of this are walking up and down steps without looking at each step, catching a fly ball, or closing the eyes and touching the nose.

    Mental processing, motor planning, and motor sequencing—the ability to take information, process it, plan next actions, and implement those actions. The goal is to keep the senior’s mind and body working together.

    Visual motor skills—like peripheral vision and efficient visual information processing—to maintain and enhance the mental connection between what seniors see and how their bodies reacts to it.

    Personal Training--fitness specialists work with seniors one-on-one—at their comfort level—to develop a customized fitness plan that focuses on the areas and skills they wish to target.

    Bone & Joint Health Program--uses state-of-the-art technology to help seniors safely and comfortably build bone, muscle, and joint strength and counteract the effects of osteoporosis and osteopenia.

    Accessible health, nutrition, exercise, and insurance information is increasingly important to older adults, seniors, and members of their families, who are often their part-time caregivers. Yet information about providers, programs, services, resources, and preventive care is overwhelming, confusing, and fairly inaccessible. Because many federal, state, and city programs overlap, older adults and seniors need help understanding what services are available and whether they qualify.

    A good senior wellness program engages both English- and Spanish-speaking seniors to help them understand the information, services, benefits, and programs that exist to help them maintain and improve their physical health and emotional well-being. Senior wellness program benefits may also include:

    ·         Insurance counseling, including Medicare and Medicaid
    ·         Benefit Access Program
    ·         Energy assistance
    ·         Senior companion program
    ·         Pet companion service

    Educational classes may include:
    ·         Aging well and diseases related to aging
    ·         Medical management for physical health and mental health
    ·         Crime prevention
    ·         Senior resources, including government benefits and housing information

    Here are a few websites that have senior friendly information: https://www.agingcare.com/Articles/Home-Modification-for-Senior-Friendly-Living-104573.htm ; http://www.everydayhealth.com/bipolar-disorder/bipolar-disorder-in-seniors.aspx ; http://www.assistedlivingct.com/wp-content/uploads/2013/01/RT-Aging-in-Place-Safe-at-Home-Checklist.pdf ; http://www.aplaceformom.com/senior-care-resources/articles/elderly-depression .

    Senior wellness programs can be very basic, such as just providing an exercise program or minimal social services at a local senior daycare center, to as inclusive as providing most of the services described in this story. Depending on the financial capabilities of how seniors can most afford those programs, it is in the best interest of caregivers and those seniors they are assisting to help those senior adults in navigating their pending wellness needs.


    Until next time.

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