Tuesday, June 18th, 2013
When Nintendo came out with the Wii, one surprising benefit of the video game console was to provide exercise with for the elderly and physical rehabilitation for the injured. The Wii showed us the possibility of gaming as a source of low impact, physical activity. The highly anticipated release of the Xbox One carries the potential for home health monitoring as reported in the Home Health Care News. To view the original article, click here.
Xbox Gaming Carries Potential for Home Health Care
Microsoft’s Xbox gaming console could extend its scope into home health care, especially as health monitoring technologies continue making advancements.
The next generation of Xbox console and Kinect device may be opening the door to health monitoring territory, reports HIT Consultant, and the broader spectrum of healthcare.
FItness games made available through Xbox Kinect allow users to work out in the comforts of their own homes, some even calculating how many calories are burned in a session.
Xbox One, Microsoft’s newest gaming endeavor, looks to up the health monitoring ante by introducing a new version of the Kinect that can read a user’s heartbeat.
Tools for tracking one’s personal health has grown and has the potential to gain even more significance with increases in home health care.
Between 2010 and 2020, the demand for home health care professionals is projected to increase by 70%, according to the Bureau of Labor Statistics.
“Having the ability to better monitor health metrics could help these home care specialists provide service to their patients, and collaborate with doctors in the event of a crisis,” writes the article.
The possibility that video game consoles could empower people of all ages to take control of their personal health.
“With this innovation, consoles could potentially become as integral for older generations as they have become for the younger ones,” writes the article.
Tuesday, June 4th, 2013
Steven Dashiell, in his article Fighting Common Misconceptions about ER “Super-Users”, dissects the fallacies surrounding ER usage and the reason for overcrowding. According to Dashiell, though many may see healthcare reform as an opportunity to shorter ER lines and wait times, recent studies show that other factors come into play.
To view original article, click here.
Fighting Common Misconceptions About ER ‘Super-Users’
By Steven Dashiell May 28, 2013
Frequent use of the emergency department (ED) by patients who do not require urgent care is often cited as a major factor in crowded emergency rooms, long wait times and high costs within the ED.
Many see healthcare reform as an opportunity to provide primary and specialist care to these same patients, and to reduce the overall number of visits to the ED, ameliorating the problems of crowding and costs. Recent research, however, suggests that heavy ED usage by certain individuals will not significantly decrease with health reform; and, in fact, there are a number of misconceptions about frequent usage of the ED.
These frequent visitors to the ED, known as “super-users” or “frequent users,” make up a large percentage of overall ED usage. In a study by Robert Wood Johnson Foundation (RWJF), headed by U.S. Department of Veterans Affairs Clinical Scholar Kelly Doran, researchers found that roughly 92 percent of the Veterans Health Administration’s patients had one or no visits to the ED over the period of a year. The remaining eight percent accounted for 75 percent of ED use, with 6.4 percent visiting two to four times, 1.3 percent visiting five to 10 times, 0.2 percent visiting 11 to 25 times, and 0.01 percent visiting more than 25 times in the year.
This data does not necessarily indicate that these patients are abusing their right to visit the ED, notes Doran. “One common myth is that these patients just aren’t that sick, so they don’t really need to be in the ED. But what we find in our study is that, in fact, they’re the sickest patients; they’re among those with the greatest medical problems.”
Misconceptions in the Emergency Department
A recent research brief by the Center for Studying Health System Change addressed a number of myths regarding ED use. Among them:
- Most crowding results from emergency patients admitted to hospital who are waiting for an inpatient bed, not nonurgent ED visits.
- People with private insurance account for most ED use, and people with higher incomes and private physicians are driving increases in use over time. This is contrary to the thought that most ED users have Medicaid or are uninsured.
The brief notes that such misconceptions are driving policy, with some Medicaid programs denying payment for emergency care deemed unnecessary or penalizing patients for too many ED visits in response to state budget crises. Media coverage focusing on “super-users” has also reinforced notions of Medicaid and uninsured patients being the most frequent users of the ED.
The research team at RWJF found that rather than a lack of insurance, a variety of health factors, such as homelessness, heart failure, opiate prescriptions, pain diagnoses and schizophrenia, contributed to frequent ED usage.
“So, for example, homelessness increased one’s odds of being in the most frequent use group more than six-fold,” said Doran. “Just 1.7 percent of VHA patients who didn’t use the VHA’s emergency department during the year were homeless, but 45 percent who had 25-plus visits were homeless.”
The Rise of the ED
While many would like to see less activity within the ED, research suggests that the ED plays an important role for many Americans who seek care, and it continues to rise in importance within the healthcare arena.
Another study by RAND Corporation notes that EDs are responsible for roughly half of all hospital admissions in the United States, which accounts for nearly all of the growth in hospital admissions experienced between 2003 and 2009. Furthermore, while those with chronic conditions are visiting EDs more often, hospital readmissions for such conditions remain flat, which suggests that ED visits may help prevent avoidable hospital admissions, RAND researchers suggest.
“Use of hospital emergency departments is growing faster than the use of other parts of the American medical system,” said Art Kellermann, the study’s senior author and a senior researcher at RAND, in a statement. “While more can be done to reduce the number of unnecessary visits to emergency rooms, our research suggests emergency rooms can play a key role in limiting growth of preventable hospital readmissions.”
RAND researchers’ data also suggests that many office-based physicians are directing some patients to EDs that they previously would have admitted to hospitals themselves. Emergency departments are also shown to be increasingly supportive of primary care providers, performing complex diagnostic workups that cannot be done in physician offices, as well as handling overflow, after-hours cases and weekend demand for medical care.
Lowering Emergency Department Usage
In the RWJF and RAND studies, both conclude that in order to obtain lower numbers of ED visits, efforts should be made to improve social services for the patient, improving the underlying factors that drive them to the ED.
“The strong association between psychosocial needs and ED use suggests that interventions aimed at reducing ED will not be successful unless they address these needs in addition to medical problems,” wrote researchers at RWJF. “On a societal level, our findings support recent research suggesting that improved health outcomes may be realized through increasing expenditures for social services such as housing subsidies and income supplements.”
Researchers at RAND also suggest a greater integration of operations and practices into inpatient and outpatient care systems. Suggested practices include greater use of interconnected health information technology, better coordination of care and case management, and more collaborative approaches to medical practice. These aims and practices suggested by RWJF and RAND coincide with the medical home’s vision for healthcare best practices and serve as an excellent reinforcement of the effectiveness of patient-centered healthcare both for patients and healthcare moving forward.
Access the full RWJF and RAND studies
Saturday, June 1st, 2013
In an enlightening article by Children’s Hospitals and Clinics of Minnesota, entitled How to Talk to your Children about Death, Dr. Michael F. Troy, their resident medical director of behavioral health services, attempts to answer questions such as how do I explain death to my child in an age-appropriate way, and why death takes away loved one. To view the original text, visit http://www.healthcarecommunication.com/Main/Articles/10948.aspx .
HOW TO TALK TO YOUR CHILDREN ABOUT DEATH
by Children’s Hospital and Clinics of Minnesota
Editor’s note: We had this post scheduled on our editorial calendar before the tornadoes hit Oklahoma City on Monday afternoon. In light of the tragedy there, its message is especially timely. Our thoughts are with all whose lives are touched by the devastation.
During the past 12 months, we’ve been rattled by the tragedies we’ve read and heard about in the news.
In July 2012, 12 people were killed and 58 others were injured in an attack in an Aurora, Colo., movie theater shooting.
Twenty children and six adult staff members were shot to death in December 2012 at Sandy Hook Elementary School in Newtown, Conn.
Closer to home, an insanity trial is underway for a man who admitted to murdering his three daughters this past summer. Recently, a woman and her two children were found dead in their home after authorities say she drowned them and then committed suicide.
And of course, Boston.
As parents, we want to protect our children from these horrors. It’s hard to comprehend discussing the unthinkable—a mother or father taking the life of their child—with our own kids. Do we bring it up? How do we respond when they come to us looking for answers?
We spoke with Dr. Michael F. Troy, Ph.D., L.P., our medical director of behavioral health services, in an attempt to answer some of those questions:
How do I explain death to my child in an age-appropriate way?
There are important differences between explaining the death of an important person in your child’s life and talking about a tragic death in the news. The former is likely to be a challenging, but near universal, role for a parent. Eventually, all families will face the loss of a loved one requiring parents to share sad news with their child. While it is typical for parents to find these junctures difficult, this does not mean that they are unable to do so with skill and sensitivity. Parents are used to explaining things to children in developmentally appropriate ways. Whether it’s why they have to have a shot at a doctor’s office or why they need to move to a new community, parents generally know—by instinct and knowledge—how to do this. Talking about death, while less common and inherently sad, is not an entirely different kind of task. Parents should think of it as being like other kinds of sad or disappointing news they might have to discuss with their child. The specifics, for example, the closeness of the person who died, whether it was an expected loss, and the age of the child, will determine what is communicated. But the general point, that parents actually do have experience in talking about difficult things and that they should rely on that experience, is most important.
Talking about deaths reported in the news is a different situation. While there are always exceptional circumstances, it is generally best to wait and see if your child raises the issue. Whether they are aware of a news story is likely to depend on factors such as their age, how routinely they are exposed to the news, and how direct the event in the news is to their day-to-day lives. If they don’t have knowledge of the story, raising the issue with them is unlikely to be a helpful. If they do raise the issue, it’s important to first find out what they have learned and what specific questions they have (there is no need to respond with answers to questions they don’t have). Additionally, it is important to keep your feelings and thoughts about the news story separate from the actual, specific concerns your child has. Your job as a parent is to help your child understand the event in a way that’s consistent with their developmental level, as well as to reassure and comfort them as necessary.
How do I explain why a parent killed his or her child?
You can’t really explain what you may not understand yourself. If you find the news of a parent killing her children and then herself perplexing and distressing, then it is OK to say that you are confused and upset by it. At the same time, you can also provide reassurance of your child’s safety and, if necessary, of your own ability to take care of them. If you feel you have some understanding of the event, for example, if it was the result of the mother’s severe mental illness, do your best to explain this briefly and in developmentally appropriate ways and with an emphasis on how rare such events are. You might also want to communicate empathy for those most affected by the loss.
Should I talk about the mental health of the parent? How do I do that?
You should talk about the mental health of the parent if your child asks about it, or if you feel that it’s important and appropriate for you to include in your response to the specific questions your child has asked. It’s unlikely that we would actually know the mental health status of a parent taking the violent and tragic actions reported in these recent cases, especially in the immediate aftermath of the tragedy when it is most likely to be in the news. Consequently, you might note that questions regarding mental health issues have been raised—and what this might mean—without suggesting that you know for certain what led to act of violence. It may also be important for you to note that while mental health issues are sometimes linked to violent acts, the vast majority of people with a mental health diagnosis are not violent.
At what age is it appropriate to approach my kids about this topic? Should I always wait for him/her to bring it up?
Unless you have specific reason to anticipate your child encountering discussion of these issues, it is generally better to wait and see if your child raises such concerns with you. Of course, the older children are, the more likely they are to both hear about and initiate questions about news of a tragic event. Similarly, the older your child is, the more reasonable it likely is to bring up the issue.
Are there things I can say or do to make my child feel safe and at ease?
First, it’s worth remembering that our goal as adults caring for children is to help them feel safe without needing frequent reassurance. If such reassurance is necessary, then the most important thing to emphasize is just how incredibly rare these types of events (school shootings, parents killing their children) are. They are extremely upsetting to hear about, and terribly tragic for the families affected, but also quite unlikely to happen. Because they are so rare and so dramatic, they tend to receive intense media coverage. But it also this pervasive media coverage that can make it seem as if these tragedies are more common than they really are. Consequently, it is almost always reasonable to reassure children that they are safe and that there are many adults in their lives looking out for their wellbeing. Some children will have specific concerns requiring specific reassurance. Younger children are likely to need you to talk about the ways in which their own home and school are safe places, while older children might need help understanding the rarity of these events through comparison to other types of risks. For example, you might point out that while there are people struck by lightning every year, the odds of any given individual beings struck is exceedingly low.
You can read more here.
Monday, May 13th, 2013
Tuesday, May 7th, 2013
This week, let’s show our appreciation to all the nurses for their hard work and dedication. In recognition of their service, here’s a brief history of the nursing profession:
National Nurses Week History (view source: http://nursingworld.org/FunctionalMenuCategories/AboutANA/NationalNursesWeek/MediaKit/NNWHistory.html)
National Nurses Week begins each year on May 6th and ends on May 12th, Florence Nightingale’s birthday. These permanent dates enhance planning and position National Nurses Week as an established recognition event. As of 1998, May 8 was designated as National Student Nurses Day, to be celebrated annually. And as of 2003, National School Nurse Day is celebrated on the Wednesday within National Nurses Week (May 6-12) each year.
The nursing profession has been supported and promoted by the American Nurses Association (ANA) since 1896. Each of ANA’s state and territorial nurses associations promotes the nursing profession at the state and regional levels. Each conducts celebrations on these dates to recognize the contributions that nurses and nursing make to the community.
The ANA supports and encourages National Nurses Week recognition programs through the state and district nurses associations, other specialty nursing organizations, educational facilities, and independent health care companies and institutions.
A Brief History of National Nurses Week
1953 Dorothy Sutherland of the U.S. Department of Health, Education, and Welfare sent a proposal to President Eisenhower to proclaim a “Nurse Day” in October of the following year. The proclamation was never made.
1954 National Nurse Week was observed from October 11 – 16. The year of the observance marked the 100th anniversary of Florence Nightingale’s mission to Crimea. Representative Frances P. Bolton sponsored the bill for a nurse week. Apparently, a bill for a National Nurse Week was introduced in the 1955 Congress, but no action was taken. Congress discontinued its practice of joint resolutions for national weeks of various kinds.
1972 Again a resolution was presented by the House of Representatives for the President to proclaim “National Registered Nurse Day.” It did not occur.
1974 In January of that year, the International Council of Nurses (ICN) proclaimed that May 12 would be “International Nurse Day.” (May 12 is the birthday of Florence Nightingale.) Since 1965, the ICN has celebrated “International Nurse Day.”
1974 In February of that year, a week was designated by the White House as National Nurse Week, and President Nixon issued a proclamation.
1978 New Jersey Governor Brendon Byrne declared May 6 as “Nurses Day.” Edward Scanlan, of Red Bank, N.J., took up the cause to perpetuate the recognition of nurses in his state. Mr. Scanlan had this date listed in Chase’s Calendar of Annual Events. He promoted the celebration on his own.
1981 ANA, along with various nursing organizations, rallied to support a resolution initiated by nurses in New Mexico, through their Congressman, Manuel Lujan, to have May 6, 1982, established as “National Recognition Day for Nurses.”
1982 In February, the ANA Board of Directors formally acknowledged May 6, 1982 as “National Nurses Day.” The action affirmed a joint resolution of the United States Congress designating May 6 as “National Recognition Day for Nurses.”
1982 President Ronald Reagan signed a proclamation on March 25, proclaiming “National Recognition Day for Nurses” to be May 6, 1982.
1990 The ANA Board of Directors expanded the recognition of nurses to a week-long celebration, declaring May 6 – 12, 1991, as National Nurses Week.
1993 The ANA Board of Directors designated May 6 – 12 as permanent dates to observe National Nurses Week in 1994 and in all subsequent years.
1996 The ANA initiated “National RN Recognition Day” on May 6, 1996, to honor the nation’s indispensable registered nurses for their tireless commitment 365 days a year. The ANA encourages its state and territorial nurses associations and other organizations to acknowledge May 6, 1996 as “National RN Recognition Day.”
1997 The ANA Board of Directors, at the request of the National Student Nurses Association, designated May 8 as National Student Nurses Day.
Friday, May 3rd, 2013
Every year since 1963, May has been the month to appreciate and celebrate the vitality and aspirations of older adults and their contributions and achievements. It is a proud tradition that shows our nation’s commitment to honor the value that elders continue to contribute to our communities.
This year’s Older Americans Month theme—”Unleash the Power of Age!”—emphasizes the important role of older adults. This May, communities across the nation will recognize older Americans as productive, active, and influential members of society.
Older Americans Month celebrations will acknowledge the value that older adults continue to bring to our communities by making an effort to applaud recent achievements of local elders and inviting them to share the activities they do to unleash the power of age.
The Accredited Family of Home Health Services encourages you to take part in the celebrations by sharing your Older Americans Month resolutions with the U.S. Administration on Aging. Post what you will do this May to unleash the power of age on the AoA Facebook Page, and follow up by sharing a picture or story about the experience later in the year.
While Accredited provides services, support, and resources to older adults year-round, Older Americans Month is a great opportunity to show special appreciation! We will continue to provide opportunities for elders to come together and share their experiences with one another, as well as with individuals of other generations.
To learn more about activities and events planned for Older Americans Month, or to find ideas about what you can do to unleash the power of age, contact your local Area Agency on Aging office by visiting www.eldercare.gov or calling 1 (800) 677-1116 to find ongoing opportunities to celebrate and support older Americans.
Saturday, April 27th, 2013
*For the original article, visit http://finance.yahoo.com/news/millions-cant-afford-doctor-041400851.html.
Millions Can’t Afford to Go to the Doctor
by Tami Luhby
A growing number of Americans are skipping needed medical care because they can’t afford it.
Some 80 million people, around 43% of America’s working-age adults, didn’t go to the doctor or access other medical services last year because of the cost, according to the Commonwealth Fund’s Biennial Health Insurance Survey, released Friday. That’s up from 75 million people two years ago and 63 million in 2003.
Not surprisingly, those who were uninsured or had inadequate health insurance were most likely to have trouble affording care. But 28% of working-age adults with good insurance also had to forgo treatment because of the price.
Nearly three in 10 adults said they did not visit a doctor or clinic when they had a medical problem, while more than a quarter did not fill a prescription or skipped recommended tests, treatment or follow-up visits. One in five said they did not get needed specialist care.
And 28% of those with a chronic condition like hypertension, diabetes, heart disease and asthma who needed medication for it reported they did not fill prescriptions or skipped doses because they couldn’t afford to pay for the drugs.
Even those with coverage find themselves shelling out more for deductibles and co-payments. The share of Americans with deductibles greater than $1,000 more than tripled between 2003 and 2012, reaching 25%.
“Costs of health care have gone up faster than wages,” said David Blumenthal, president of The Commonwealth Fund.
The survey also found that 84 million people, nearly half of all working-age adults, went without health insurance for a time last year or had such high out-of-pocket expenses relative to their income that they were considered under-insured. That’s up from 81 million in 2010 and 61 million in 2003.
One bright spot in the report is that fewer young adults, those ages 19 to 25, were uninsured. The share fell to 41% in 2012, down from 48% two years earlier. That’s due in large part to the Affordable Care Act, which allows young adults to stay on their parents insurance until age 26.
All of those numbers should improve going forward as more health reform provisions take effect in 2014 — primarily the state-based insurance exchanges, which are intended to offer affordable plans to those without work-based coverage.
The Affordable Care Act, better known as Obamacare, will provide more coverage and cost protections, said Sara Collins, the study’s lead author. Insurance plans offered through the state exchanges have to cover a suite of “essential” benefits, including maternity care and mental health services. They also limit the insured’s out-of-pocket payments to no more than 40% of expenses.
Tuesday, April 23rd, 2013
In the article, “Home Health Medicare Co-Pay: A Study in Unintended Consequences” written for Forbes yesterday, Robert A. Book and Doug Holtz-Eakin tackle the issues regarding a $1.4B increase in discretionary spending for administrative expenses related to the implementation of the Affordable Care Act. The article brings to the forefront a proposed co-payment for Medicare patients in relation to the utilization of home health care services.
Book and Holtz-Eaton examines the pit falls of this proposal and factors that are not taken into consideration. For the full article, visit http://www.forbes.com/sites/aroy/2013/04/19/home-health-medicare-co-pay-a-study-in-unintended-consequences.
Monday, March 18th, 2013
We live in an age where technology truly enables us to provide a higher quality of life for the elderly of our population. On February 19, 2013, Gizmag.com featured the “wonderwall system”. The system is based aroubd a tablet computer mounted on a wall in the home. It monitors everything from vitals such as blood sugar levels and blood pressure to climate control within an individuals living space. It’s also outfitted with an “indoor positioning system” that keeps track of misplaced items such as keys, glasses, etc.
Below is the link to the full article:
With this technology, keeping our elderly safe and independent in their own homes while giving family members some peace of mind is now possible.
Thursday, February 14th, 2013
If you are:
- A woman of age 55 or older
- A man of age 45 or older
- A person with a family history of early heart disease
- An individual who is beyond their ideal body weight
…then you are at a higher risk of heart disease.
Heart disease is a broad term used to describe a range of diseases affecting your heart. Coronary artery disease, arrhythmias, heart infections, atrial fibrillation, and birth heart defects fall under this umbrella of heart diseases. Often interchangeable with “cardiovascular disease”, it refers to conditions involving narrowed or blocked blood vessels that can lead to a heart attack, chest pain, or stroke. Many forms of heart disease can be prevented or treated with healthy lifestyle choices.
To keep your heart healthy:
- Watch your weight.
- Quit smoking and stay away from secondhand smoke.
- Control your cholesterol and blood pressure.
- If you drink alcohol, drink only in moderation.
- Get active and eat healthy.
- Talk to your doctor about taking aspirin everyday if you are a man over the age of 45 ir a woman over 55.
- Manage stress.