Mike Tomlinson - husband of Jane Tomlinson CBE backs free and flexible carers programme.
Caring with Confidence, a free Department of Health backed knowledge and skills based learning experience for carers in England, has today been launched - with the aim of helping carers make a positive difference to their life and that of the person they care for.
Around 4.91 million people are estimated to provide unpaid care in England and new research2 from Caring with Confidence has revealed as many as 62% - or more than three million do not view themselves as carers.
To address this major national issue, the programme will offer support and help to carers across England, with particular emphasis on the millions of people who provide care on a daily basis but don't know where to begin when it comes to accessing the services and benefits available to them.
The research also revealed that more than 60% of those people asked believed their caring role affected their health (16% a lot 46% a little). As a result the need to support people looking after loved ones in a flexible manner has never been greater.
This support is provided by Caring with Confidence through local sessions with groups of carers or from home using workbooks or the internet.
Stephen Jacobs, OBE, Caring with Confidence Project Board Chair, said: "The contribution made by carers is huge, but it is a role that is often taken on at short notice and without preparation, leaving carers to struggle with the vital responsibilities that they have assumed - this is where Caring with Confidence can help.
"The new programme will be free to carers, giving them a safe and supportive environment to explore the services available to them, look at the essentials of looking after someone and how to communicate effectively with other people to help support their needs - which will improve their own health and wellbeing and that of the person they care for."
Caring with Confidence is part of the Government's New Deal for Carers and the National Carers Strategy. It is aimed at helping carers build on their knowledge and strengths, sharing useful information and identifying the positive changes they can make in their own situations.
Today's launch marks the start of the programme across England for all carers over the age of 18.
Caring with Confidence is being supported by Mike Tomlinson, husband of the hugely inspirational athlete and fundraiser Jane Tomlinson CBE, who passed away in September 2007 after a long battle with cancer.
He said: "I have personal experience of caring for a loved one and it can often be an isolated and difficult experience as you struggle to balance the needs of the person you care for with your own and those of the wider family.
"Support was available but not in such a way that it could be accessed easily. The flexibility Caring with Confidence offers means that people across England will be able to access these vital support services and meet with other people in similar situations to exchange information and share knowledge."
The programme has been developed over the past 12 months with ongoing support from carers, which has highlighted the need for a recognised programme of this type.
Research conducted during the development also revealed one in five people caring 50 plus hours a week are also juggling a full-time job, and 23% of those people asked had been caring for at least 10 years.
It also showed that any support or provision should explain how to deal with the benefits and healthcare system (46% and 41% said these topics would be very or extremely useful) as well as providing practical information and advice about the condition they are dealing with (38% very or extremely useful).
The Caring with Confidence programme will run via a network of 32 providers3 throughout England. Carers will be encouraged to build on their own knowledge and skills based on a personal programme of development through both face to face sessions and distance learning.
By working with carers and experts within the carers' arena, Caring with Confidence has been designed to enhance and supplement existing provision rather than replace it. The provider organisations through which local sessions are being delivered have been carefully selected through their capacity to meet the needs of carers and recruit them to their sessions.
Source
Caring with Confidence
суббота, 14 мая 2011 г.
Memory Loss, Safety And Confusion Top Alzheimer's Caregivers' Concerns, National Survey Reveals
Caregivers and loved ones of individuals with Alzheimer's disease are most concerned about the patients personal safety, loss of memory and confusion - memory loss and confusion are examples of cognitive symptoms, which worried over two-thirds of caregivers the most, according to a national survey of non-professional caregivers involving 524 participants. The Harris Interactive Survey was carried out last month on behalf of AFA (Alzheimer's Foundation of America), Eisai Inc., and Pfizer (the last two being pharmaceutical companies).
Eric J. Hall, president and CEO of AFA, said:
These survey results reveal the changes in cognition as the disease progresses were an important concern among caregivers. We encourage caregivers and health care professionals to discuss these changes and any others during regular visits.
Alzheimer's disease is a progressive neurologic brain disease which eventually leads to permanent loss of neurons and cognitive/intellectual abilities, including reasoning and memory. As the disease progresses the patient's abilities to function socially or occupationally become so undermined that they need to be looked after. Typically, there are three stages to the disease - mild, moderate and severe. Caregivers and doctors often need to consult regarding the patient's lifestyle and treatment options.
The survey revealed that approximately three-quarters of caregivers are either "satisfied" or "very satisfied" with the therapy provided by health care professionals for their loved one. The rest of respondents who rated this as either "not at all satisfied" or "somewhat satisfied" reveal a need for improvement, the survey authors wrote.
Barry W. Rovner, M.D., director of the Division of Geriatric Psychiatry and professor in the departments of Neurology and Psychiatry at Thomas Jefferson University , Philadelphia, said:
AD (Alzheimer's disease) caregivers are typically the first to notice when their loved one's symptoms are becoming worse and whether the disease may be progressing to the next stage, which is why caregivers are essential partners in disease management discussions. In the face of this devastating chronic and progressive disease, it is important for AD caregivers to know about the available educational resources, support networks and treatments in order to enhance these discussions at all stages of the disease.
The survey revealed some of the problems caregivers have to cope with, as well as concerns and worries about how the disease progresses and is expected to progress, and discussions with health care professionals. 173 males and 351 female caregivers contributed towards the survey. There were some differences in priorities reported by male and female caregivers.
Highlighted below are some of the difficulties caregivers have to cope with:
55% say their caregiving duties have had a negative impact on their own health
13% of female caregivers tended to worry all the time, compared to just 3% of the male ones
60% of them said the whole thing was overwhelming
47% of female caregivers found maintaining relationships with friends and family "challenging", compared to 31% of men
67% of caregivers of mild AD patients found their duties often stopped them from taking part in activities they liked, compared to 68% of those with a moderate AD patient and 84% of those caring for a loved one with severe AD.
Highlighted below are some of the worries caregivers have about the progression of Alzheimer's disease:
Caregivers worried the most about: 41% memory loss, 33% personal safety, 27% confusion.
67% mentioned at least one cognitive ability loss as their main worry when thinking about AD's progression
50% of male caregivers were concerned and worried about memory loss, compare to 37% of the female ones
Highlighted below are some of the survey results regarding caregivers' dealings and discussions with health care professionals:
84% of male caregivers were satisfied with their health care professional communications versus 70% of the females ones
26% of males asked the doctor about support information, compared to 14% of females
53% of all caregivers who were not very involved in liaising with a health care professional were not satisfied with their loved one's treatment
31% of all caregivers who were very involved in liaising with a health care professional were not satisfied with their loved one's treatment
Eric J. Hall, president and CEO of AFA, said:
These survey results reveal the changes in cognition as the disease progresses were an important concern among caregivers. We encourage caregivers and health care professionals to discuss these changes and any others during regular visits.
Alzheimer's disease is a progressive neurologic brain disease which eventually leads to permanent loss of neurons and cognitive/intellectual abilities, including reasoning and memory. As the disease progresses the patient's abilities to function socially or occupationally become so undermined that they need to be looked after. Typically, there are three stages to the disease - mild, moderate and severe. Caregivers and doctors often need to consult regarding the patient's lifestyle and treatment options.
The survey revealed that approximately three-quarters of caregivers are either "satisfied" or "very satisfied" with the therapy provided by health care professionals for their loved one. The rest of respondents who rated this as either "not at all satisfied" or "somewhat satisfied" reveal a need for improvement, the survey authors wrote.
Barry W. Rovner, M.D., director of the Division of Geriatric Psychiatry and professor in the departments of Neurology and Psychiatry at Thomas Jefferson University , Philadelphia, said:
AD (Alzheimer's disease) caregivers are typically the first to notice when their loved one's symptoms are becoming worse and whether the disease may be progressing to the next stage, which is why caregivers are essential partners in disease management discussions. In the face of this devastating chronic and progressive disease, it is important for AD caregivers to know about the available educational resources, support networks and treatments in order to enhance these discussions at all stages of the disease.
The survey revealed some of the problems caregivers have to cope with, as well as concerns and worries about how the disease progresses and is expected to progress, and discussions with health care professionals. 173 males and 351 female caregivers contributed towards the survey. There were some differences in priorities reported by male and female caregivers.
Highlighted below are some of the difficulties caregivers have to cope with:
55% say their caregiving duties have had a negative impact on their own health
13% of female caregivers tended to worry all the time, compared to just 3% of the male ones
60% of them said the whole thing was overwhelming
47% of female caregivers found maintaining relationships with friends and family "challenging", compared to 31% of men
67% of caregivers of mild AD patients found their duties often stopped them from taking part in activities they liked, compared to 68% of those with a moderate AD patient and 84% of those caring for a loved one with severe AD.
Highlighted below are some of the worries caregivers have about the progression of Alzheimer's disease:
Caregivers worried the most about: 41% memory loss, 33% personal safety, 27% confusion.
67% mentioned at least one cognitive ability loss as their main worry when thinking about AD's progression
50% of male caregivers were concerned and worried about memory loss, compare to 37% of the female ones
Highlighted below are some of the survey results regarding caregivers' dealings and discussions with health care professionals:
84% of male caregivers were satisfied with their health care professional communications versus 70% of the females ones
26% of males asked the doctor about support information, compared to 14% of females
53% of all caregivers who were not very involved in liaising with a health care professional were not satisfied with their loved one's treatment
31% of all caregivers who were very involved in liaising with a health care professional were not satisfied with their loved one's treatment
Geriatric Mental Health Nursing Receives $1.2M Grant
The Hartford Center for Geriatric Nursing Excellence in the University of Iowa College of Nursing, and two other Hartford centers in the nation, have been funded for a four-year $1.2 million grant to ensure that nurses have the most recent evidence-based guidelines for caring for elders with mental health issues.
The three Hartford Centers of Geriatric Nursing Excellence, which will form the Geropsychiatric Nursing Collaborative, are in the UI College of Nursing, University of Pennsylvania School of Nursing, and University of Arkansas for Medical Sciences School of Nursing.
Researchers in the collaborative will focus on two areas that will affect the preparation of nurses for gerontologic mental health practice nationally, according to Kathleen Buckwalter, the Sally Mathis Hartwig Professor of Gerontological Nursing Excellence and director of the Hartford Center at the UI College of Nursing.
"In this four-year project, we will scan the existing geropsychiatric nursing curricula nationwide," Buckwalter said. "We will then work to include core geropsychiatric nursing competencies in nursing education programs and offer new geropsychiatric nursing curricula to nursing schools across the U.S. at no cost.
"Our aim is to ensure that nurses are exposed to the latest practices found to be effective through the most recent research concerning mental health care for older persons," Buckwalter added.
The grant is made possible by the John A. Hartford Foundation. The American Academy of Nursing will act as project manager, overseeing the use of the funds at each of the three Hartford centers.
"This collaborative has the potential for greatly improving the mental health care of America's older population," Buckwalter said.
Each of the centers has ongoing initiatives in geriatric mental health education and practice that can fuel the work of the proposed collaborative center.
The three Hartford Centers of Geriatric Nursing Excellence, which will form the Geropsychiatric Nursing Collaborative, are in the UI College of Nursing, University of Pennsylvania School of Nursing, and University of Arkansas for Medical Sciences School of Nursing.
Researchers in the collaborative will focus on two areas that will affect the preparation of nurses for gerontologic mental health practice nationally, according to Kathleen Buckwalter, the Sally Mathis Hartwig Professor of Gerontological Nursing Excellence and director of the Hartford Center at the UI College of Nursing.
"In this four-year project, we will scan the existing geropsychiatric nursing curricula nationwide," Buckwalter said. "We will then work to include core geropsychiatric nursing competencies in nursing education programs and offer new geropsychiatric nursing curricula to nursing schools across the U.S. at no cost.
"Our aim is to ensure that nurses are exposed to the latest practices found to be effective through the most recent research concerning mental health care for older persons," Buckwalter added.
The grant is made possible by the John A. Hartford Foundation. The American Academy of Nursing will act as project manager, overseeing the use of the funds at each of the three Hartford centers.
"This collaborative has the potential for greatly improving the mental health care of America's older population," Buckwalter said.
Each of the centers has ongoing initiatives in geriatric mental health education and practice that can fuel the work of the proposed collaborative center.
NCHICA Emphasizes Nurses' Role In Moving Health IT Initiatives Forward, USA
The North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA), a nonprofit consortium that aims to improve health and care in North Carolina through health information technology (HIT) initiatives, hosted "Improving Interoperability on Medical-Surgical Units," a workshop focused on how nurses can move HIT forward in patient settings efficiently and effectively.
As the largest single profession in the U.S. healthcare industry and the frontline of patient care, nursing is a critical component of successful HIT adoption. There are more than 2.4 million registered nurses practicing across the nation.
"Nurses are a key component of the brain trust in healthcare," said Holt Anderson, Executive Director of NCHICA. "NCHICA understands the necessity of having these individuals at the table when discussing HIT issues and strategy. Their collaboration is the key to understanding where technology solutions are needed-or in need of improvement-at the point of care. Our newly formed nursing workgroup provides an ongoing forum in which these objectives can be accomplished and educates nurses on how to integrate HIT in a manner that is the most beneficial to their patients and the least disruptive to workflow."
Marilyn Chow, DNSc, RN, FAAN, Vice President, Patient Care Services, Program Office, at Kaiser Permanente, provided an overview and preliminary findings of the American Academy of Nursing (AAN) Technology Targets Study, which is funded by the Robert Wood Johnson Foundation. The study aims to create an effective process for identifying technology solutions to medical-surgical unit workflow inefficiencies, and it will prompt organizations to develop technology that enhances workflow processes.
"Improving the practice environment is essential to retaining nurses, providing safe patient care and increasing the time nurses spend directly with patients," said Chow. "The Technology Targets Study is evaluating a 'Technology Drill Down' process at 25 acute care sites to determine the functional requirements needed to achieve these goals as well as the efficacy and reproducibility of the process itself."
Additionally, Joyce Sensmeier, MS, RN, BC, CPHIMS, FHIMSS, Vice President of Informatics for the Healthcare Information and Management Systems Society (HIMSS), shared information about interoperability, standards and Integrating the Healthcare Enterprise (IHE), an initiative that improves patient care by providing a common framework for implementing standards that harmonize healthcare information exchange.
"Working together, nurses can significantly impact the patient care agenda by getting involved in IHE and other standards efforts," said Sensmeier. "The presence of nurses in these processes has already produced results-the Clinical Care Classification System nursing terminology is a named standard within the Healthcare Information Technology Standards Panel Interoperability Specification for Electronic Health Records, Biosurveillance and Consumer Empowerment, which was recently accepted by U.S. Department of Health and Human Services Secretary Michael Leavitt. Continued, active involvement by nurses in standards processes such as Use Case development and public comment opportunities will ensure their voices are heard."
Collaboration during the workshop yielded the formalization of a workgroup to identify the collective actions nurses can take with respect to the use of HIT to improve the quality of health, care and the nursing experience in North Carolina. The first action taken by the workgroup was appointing Rebecca Kitzmiller, MHR, MSN, RN-C, Chair of the North Carolina Nurses Association (NCNA) Council on Nursing Informatics (CoNI), to the North Carolina Health Information Exchange Governance Council, which will develop policies and procedures that enable the timely and secure exchange of electronic health information among its authorized members.
"As a truly diverse profession, nurses meet the needs of patients across many different healthcare settings," said Kitzmiller. "Forming a nurse advisory group and collaborating with the Governance Council presents a tremendous opportunity to bring the diversity of nursing to strategic healthcare technology decision making, eventually improving the quality of care provided to the people of North Carolina."
NCHICA joined AAN, the Electronic Health Record Vendors Association, HIMSS, the North Carolina Center for Nursing and NCNA CoNI in sponsoring the workshop, which was held on July 30.
About NCHICA
The North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA) is a nationally recognized nonprofit consortium that serves as an open, effective and neutral forum for health information technology (HIT) initiatives that improve health and care in North Carolina. Members include leading organizations in healthcare, research and information technology.
Working closely with its members, NCHICA has the unique ability to convene and form partnerships to advance HIT adoption. NCHICA's leadership in conducting demonstration projects, hosting educational sessions and fostering collective efforts within North Carolina helps position the state at the vanguard of national HIT acceleration efforts. NCHICA is located in Research Triangle Park, NC.
NCHICA
As the largest single profession in the U.S. healthcare industry and the frontline of patient care, nursing is a critical component of successful HIT adoption. There are more than 2.4 million registered nurses practicing across the nation.
"Nurses are a key component of the brain trust in healthcare," said Holt Anderson, Executive Director of NCHICA. "NCHICA understands the necessity of having these individuals at the table when discussing HIT issues and strategy. Their collaboration is the key to understanding where technology solutions are needed-or in need of improvement-at the point of care. Our newly formed nursing workgroup provides an ongoing forum in which these objectives can be accomplished and educates nurses on how to integrate HIT in a manner that is the most beneficial to their patients and the least disruptive to workflow."
Marilyn Chow, DNSc, RN, FAAN, Vice President, Patient Care Services, Program Office, at Kaiser Permanente, provided an overview and preliminary findings of the American Academy of Nursing (AAN) Technology Targets Study, which is funded by the Robert Wood Johnson Foundation. The study aims to create an effective process for identifying technology solutions to medical-surgical unit workflow inefficiencies, and it will prompt organizations to develop technology that enhances workflow processes.
"Improving the practice environment is essential to retaining nurses, providing safe patient care and increasing the time nurses spend directly with patients," said Chow. "The Technology Targets Study is evaluating a 'Technology Drill Down' process at 25 acute care sites to determine the functional requirements needed to achieve these goals as well as the efficacy and reproducibility of the process itself."
Additionally, Joyce Sensmeier, MS, RN, BC, CPHIMS, FHIMSS, Vice President of Informatics for the Healthcare Information and Management Systems Society (HIMSS), shared information about interoperability, standards and Integrating the Healthcare Enterprise (IHE), an initiative that improves patient care by providing a common framework for implementing standards that harmonize healthcare information exchange.
"Working together, nurses can significantly impact the patient care agenda by getting involved in IHE and other standards efforts," said Sensmeier. "The presence of nurses in these processes has already produced results-the Clinical Care Classification System nursing terminology is a named standard within the Healthcare Information Technology Standards Panel Interoperability Specification for Electronic Health Records, Biosurveillance and Consumer Empowerment, which was recently accepted by U.S. Department of Health and Human Services Secretary Michael Leavitt. Continued, active involvement by nurses in standards processes such as Use Case development and public comment opportunities will ensure their voices are heard."
Collaboration during the workshop yielded the formalization of a workgroup to identify the collective actions nurses can take with respect to the use of HIT to improve the quality of health, care and the nursing experience in North Carolina. The first action taken by the workgroup was appointing Rebecca Kitzmiller, MHR, MSN, RN-C, Chair of the North Carolina Nurses Association (NCNA) Council on Nursing Informatics (CoNI), to the North Carolina Health Information Exchange Governance Council, which will develop policies and procedures that enable the timely and secure exchange of electronic health information among its authorized members.
"As a truly diverse profession, nurses meet the needs of patients across many different healthcare settings," said Kitzmiller. "Forming a nurse advisory group and collaborating with the Governance Council presents a tremendous opportunity to bring the diversity of nursing to strategic healthcare technology decision making, eventually improving the quality of care provided to the people of North Carolina."
NCHICA joined AAN, the Electronic Health Record Vendors Association, HIMSS, the North Carolina Center for Nursing and NCNA CoNI in sponsoring the workshop, which was held on July 30.
About NCHICA
The North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA) is a nationally recognized nonprofit consortium that serves as an open, effective and neutral forum for health information technology (HIT) initiatives that improve health and care in North Carolina. Members include leading organizations in healthcare, research and information technology.
Working closely with its members, NCHICA has the unique ability to convene and form partnerships to advance HIT adoption. NCHICA's leadership in conducting demonstration projects, hosting educational sessions and fostering collective efforts within North Carolina helps position the state at the vanguard of national HIT acceleration efforts. NCHICA is located in Research Triangle Park, NC.
NCHICA
Ground surface impacts wheelchair propulsion
Data from a manual wheelchair propulsion study indicate that different ground surfaces impact wheelchair propulsion ability, revealing conditions contributing to arm overuse in people who use wheelchairs.
Eleven manual wheelchair users were fitted with a SMARTWheel and pushed on a course consisting of high- and low- pile carpet, indoor tile, interlocking concrete pavers, smooth level concrete, grass, hardwood flooring, and a sidewalk with a five-degree grade.
Propulsive forces on grass, interlocking pavers, and ramp ascent were typically higher compared with tile, wood, smooth level concrete, and low- and high-pile carpeting.
Users adapted to more challenging surfaces by applying more force and increasing the number of times they struck the pushrim.
Journal of Rehabilitation Research & Development - pg 447
About the Journal
JRRD has been a leading research journal in the field of rehabilitation medicine and technology for more than 40 years. JRRD, a peer-reviewed, scientifically indexed journal, publishes original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers on all rehabilitation research disciplines. JRRD's mission is to responsibly evaluate and disseminate scientific research findings impacting the rehabilitative healthcare community. For more information about JRRD, visit vard.
Judith LaVoie
judithvard
VA Research Communications Service
vard
Eleven manual wheelchair users were fitted with a SMARTWheel and pushed on a course consisting of high- and low- pile carpet, indoor tile, interlocking concrete pavers, smooth level concrete, grass, hardwood flooring, and a sidewalk with a five-degree grade.
Propulsive forces on grass, interlocking pavers, and ramp ascent were typically higher compared with tile, wood, smooth level concrete, and low- and high-pile carpeting.
Users adapted to more challenging surfaces by applying more force and increasing the number of times they struck the pushrim.
Journal of Rehabilitation Research & Development - pg 447
About the Journal
JRRD has been a leading research journal in the field of rehabilitation medicine and technology for more than 40 years. JRRD, a peer-reviewed, scientifically indexed journal, publishes original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers on all rehabilitation research disciplines. JRRD's mission is to responsibly evaluate and disseminate scientific research findings impacting the rehabilitative healthcare community. For more information about JRRD, visit vard.
Judith LaVoie
judithvard
VA Research Communications Service
vard
Pennsylvania Law To End Mandatory Overtime For Some Health Care Workers
Pennsylvania Gov. Ed Rendell (D) on Thursday signed into law a bill that will prohibit health care facilities from requiring mandatory overtime of staff, the Philadelphia Inquirer reports. The law, set to take effect in July 2009, seeks to protect health care facilities from forcing nurses, technicians, technologists, certified nursing assistants and phlebotomists, and other caregivers from being disciplined or discriminated against for refusing to work overtime.
Mandatory overtime would be allowed in some cases, such as a natural disaster, but it could be used only as a last resort and employees would have to be given one hour to arrange for family care. Employers also are prohibited from using on-call time in place of mandatory overtime. Violators can be fined from $100 to $1,000 per violation. The state Department of Labor & Industry will enforce the law.
Supporters say the new rule will ensure patient safety. Rendell said, "There was a problem with nurses' being overworked and overtired and potentially error-prone in their jobs" (Couloumbis, Philadelphia Inquirer, 12/19).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Mandatory overtime would be allowed in some cases, such as a natural disaster, but it could be used only as a last resort and employees would have to be given one hour to arrange for family care. Employers also are prohibited from using on-call time in place of mandatory overtime. Violators can be fined from $100 to $1,000 per violation. The state Department of Labor & Industry will enforce the law.
Supporters say the new rule will ensure patient safety. Rendell said, "There was a problem with nurses' being overworked and overtired and potentially error-prone in their jobs" (Couloumbis, Philadelphia Inquirer, 12/19).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
NAMI Applauds New Report On Caregiving
The National Alliance on Mental Illness (NAMI) praises a new report, Caregiving in the U.S. 2009, which offers a revealing portrait of the nearly one-in-three American adults who serve as a family caregiver.
The study is based on interviews with 1,480 caregivers chosen at random and offers a national profile of people caring for adults, the elderly and children with special needs. It follows similar studies conducted in 2004 and 1997, but for the first time, caregivers for children, as well as those caring for adults over the age of 18, were surveyed.
The report echoes the findings of NAMI's own depression survey and schizophrenia survey, which include the perspective of caregivers for people living with these serious mental illnesses. All these reports suggest that caregivers face daily stresses that can impact their own health and other relationships. For example, NAMI's depression survey, released in November, found that while almost one-half (48 percent) of caregivers for people with depression have been diagnosed with depression themselves, only about 25 percent were engaged in treatment at the time of the survey.
"We know from our own studies that caregivers make significant sacrifices to care for their loved ones living with mental illness," said Michael Fitzpatrick, NAMI executive director. "The findings of this new report will help us anticipate the needs of caregivers so that we can improve NAMI's education and support programs."
NAMI offers a variety of peer education and support programs, including those specifically for caregivers.
Family-to-Family is a free, twelve-week course for family caregivers of individuals with severe mental illnesses. The course is taught by trained family members and more than 115,000 family members have graduated from this national program. The course is also available in Spanish.
NAMI Basics is an education program for parents and other caregivers of children and adolescents living with mental illnesses. The course is taught by trained teachers who are the parent or other caregivers of individuals who developed the symptoms of mental illness prior to the age of 13 years.
Source
National Alliance on Mental Illness
The study is based on interviews with 1,480 caregivers chosen at random and offers a national profile of people caring for adults, the elderly and children with special needs. It follows similar studies conducted in 2004 and 1997, but for the first time, caregivers for children, as well as those caring for adults over the age of 18, were surveyed.
The report echoes the findings of NAMI's own depression survey and schizophrenia survey, which include the perspective of caregivers for people living with these serious mental illnesses. All these reports suggest that caregivers face daily stresses that can impact their own health and other relationships. For example, NAMI's depression survey, released in November, found that while almost one-half (48 percent) of caregivers for people with depression have been diagnosed with depression themselves, only about 25 percent were engaged in treatment at the time of the survey.
"We know from our own studies that caregivers make significant sacrifices to care for their loved ones living with mental illness," said Michael Fitzpatrick, NAMI executive director. "The findings of this new report will help us anticipate the needs of caregivers so that we can improve NAMI's education and support programs."
NAMI offers a variety of peer education and support programs, including those specifically for caregivers.
Family-to-Family is a free, twelve-week course for family caregivers of individuals with severe mental illnesses. The course is taught by trained family members and more than 115,000 family members have graduated from this national program. The course is also available in Spanish.
NAMI Basics is an education program for parents and other caregivers of children and adolescents living with mental illnesses. The course is taught by trained teachers who are the parent or other caregivers of individuals who developed the symptoms of mental illness prior to the age of 13 years.
Source
National Alliance on Mental Illness
Lawmakers Introduce Bills To Delay Hospice Repayments To Medicare
Lawmakers earlier this month introduced bills in the House and Senate that would place a three-year moratorium on retroactive repayments from hospice providers to Medicare and authorize a comprehensive study of Medicare hospice benefits, Scripps Howard/Washington Times reports (Collins, Scripps Howard/Washington Times, 3/27).
The Medicare hospice program originally was designed for people with terminal illnesses who had less than six months to live, as certified by a physician. Nearly all of the patients had cancer and tended to die relatively quickly after health care providers halted curative efforts. However, in the last five years, the use of hospice by patients with less predictable life expectancies, such as those with Alzheimer's disease and dementia, has increased substantially.
According to the Medicare Payment Advisory Commission, the average stay for an Alzheimer's patient is 86 days, compared with 44 days for lung cancer patients. Congress in 1998 removed limits on how long a person could receive Medicare hospice services but did not remove a cap on the aggregate amount that hospices could be reimbursed each year. CMS has begun asking hospices for millions of dollars in repayments from facilities that exceed Medicare reimbursement limits. A recent MedPAC analysis projected that 220 hospices, or about one in every 13 providers, in 2005 received repayment demands totaling $166 million (Kaiser Daily Health Policy Report, 11/27/07).
The National Alliance for Hospice Access began lobbying for the moratorium after hospices began receiving repayment requests. According to Scripps Howard/Times, the repayment notices arrive one to two years after the funds have been used by the provider on salaries, medicines or other supplies, forcing hospices to determine other repayment methods or "face financial ruin" (Scripps Howard/Washington Times, 3/27).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
The Medicare hospice program originally was designed for people with terminal illnesses who had less than six months to live, as certified by a physician. Nearly all of the patients had cancer and tended to die relatively quickly after health care providers halted curative efforts. However, in the last five years, the use of hospice by patients with less predictable life expectancies, such as those with Alzheimer's disease and dementia, has increased substantially.
According to the Medicare Payment Advisory Commission, the average stay for an Alzheimer's patient is 86 days, compared with 44 days for lung cancer patients. Congress in 1998 removed limits on how long a person could receive Medicare hospice services but did not remove a cap on the aggregate amount that hospices could be reimbursed each year. CMS has begun asking hospices for millions of dollars in repayments from facilities that exceed Medicare reimbursement limits. A recent MedPAC analysis projected that 220 hospices, or about one in every 13 providers, in 2005 received repayment demands totaling $166 million (Kaiser Daily Health Policy Report, 11/27/07).
The National Alliance for Hospice Access began lobbying for the moratorium after hospices began receiving repayment requests. According to Scripps Howard/Times, the repayment notices arrive one to two years after the funds have been used by the provider on salaries, medicines or other supplies, forcing hospices to determine other repayment methods or "face financial ruin" (Scripps Howard/Washington Times, 3/27).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Who Is Responsible For Social Care Development For Older People In Residential Care?
With the number of people aged over 75 projected to nearly double from 4.8 to 8.7 million in England by 2033, experts from leading organisations dealing with the care of older people, are calling for positive change to training and development for managers and carers in residential homes.
The outcome from a high level debate, led by a group from the University of the West of England, (UWE), Bristol and Warwick Medical School, was consensus to lobby government to address the pressing need for future change to ensure the 500,000 people employed in the independent residential care sector have an appropriate training in basic nursing skills to offer the best care for our ageing population.
Those contributing included experts from the Royal College of Nursing (RCN), the Quality Care Commission, General Practice, National Skills Academy for Social Care, the British Geriatrics Society as well as lead independent, voluntary and public sector providers of long-term care. There was consensus that a nationally-recognised training and development programme for up-skilling care home staff with basic nursing skills needs to be implemented across the 18,000 care homes in England.
Professor Ala Szczepura from Warwick Medical School, said: "Our research indicates that increased training of social care workers in basic nursing skills can help prevent unnecessary hospital admissions, improve quality of care for older residents and reduce costs for the NHS."
Deidre Wild from the University of West of England, added: "The question is not whether social care staff can be trained to undertake a range of basic nursing skills we have seen that they are exceptionally responsive to learning new ways to provide a better quality of care. The real issue is who is going to take responsibility for consistency at a national level for such care improvements being implemented locally?"
Warwick Medical School and UWE confirmed there was consensus on three key recommendations:
Improve the abilities of home managers: by creating a national chartered professional management qualification building on the Registered Manager's Award. The National Skills Academy for Social Care is already well placed to respond to this development.
National registration of home managers and support workers: this should be competency-based, and derived from competencies already identified by providers at a local level.
A standardised induction with basic training for care home staff: this should be provided as low cost e-learning, to enable funds to be released for the more specialised training needed.
This debate comes at a time of increased demand upon public health and social services prompting the ad hoc growth of many projects aimed at up-skilling the social care worker. However, without a responsible professional framework we risk leaving vulnerable older people at increased risk from an unregulated system.
Sources: West of England University, AlphaGalileo Foundation.
The outcome from a high level debate, led by a group from the University of the West of England, (UWE), Bristol and Warwick Medical School, was consensus to lobby government to address the pressing need for future change to ensure the 500,000 people employed in the independent residential care sector have an appropriate training in basic nursing skills to offer the best care for our ageing population.
Those contributing included experts from the Royal College of Nursing (RCN), the Quality Care Commission, General Practice, National Skills Academy for Social Care, the British Geriatrics Society as well as lead independent, voluntary and public sector providers of long-term care. There was consensus that a nationally-recognised training and development programme for up-skilling care home staff with basic nursing skills needs to be implemented across the 18,000 care homes in England.
Professor Ala Szczepura from Warwick Medical School, said: "Our research indicates that increased training of social care workers in basic nursing skills can help prevent unnecessary hospital admissions, improve quality of care for older residents and reduce costs for the NHS."
Deidre Wild from the University of West of England, added: "The question is not whether social care staff can be trained to undertake a range of basic nursing skills we have seen that they are exceptionally responsive to learning new ways to provide a better quality of care. The real issue is who is going to take responsibility for consistency at a national level for such care improvements being implemented locally?"
Warwick Medical School and UWE confirmed there was consensus on three key recommendations:
Improve the abilities of home managers: by creating a national chartered professional management qualification building on the Registered Manager's Award. The National Skills Academy for Social Care is already well placed to respond to this development.
National registration of home managers and support workers: this should be competency-based, and derived from competencies already identified by providers at a local level.
A standardised induction with basic training for care home staff: this should be provided as low cost e-learning, to enable funds to be released for the more specialised training needed.
This debate comes at a time of increased demand upon public health and social services prompting the ad hoc growth of many projects aimed at up-skilling the social care worker. However, without a responsible professional framework we risk leaving vulnerable older people at increased risk from an unregulated system.
Sources: West of England University, AlphaGalileo Foundation.
National Grassroots Group Takes Up Dying Girl's Cause
Charlotte's "Web" of a Battle Escalates with Insurer Great-West Over Denial of Home Nursing Care -
A firestorm of media attention is building around a dying girl named Charlotte and her struggle to receive nursing care at
home rather than in the hospital. Today, following news coverage by local and regional television stations earlier this week,
a national grassroots organization has weighed in. It has launched an Internet campaign to increase pressure on Charlotte's
family's insurance company to "do the right thing."
Multiple television news stories about Charlotte's family and their predicament aired throughout Washington, Oregon, Idaho,
western Montana, northern California and Alaska on stations KING-5, KONG 6/16 and the regional Northwest Cable News channel
on February 1. The Colorado-based insurer, Great-West Life & Annuity, has taken the unusual step of denying home nursing care
to three year-old Charlotte. In nearly all similar cases, according to Children's Hospital and Regional Medical Center in
Seattle, insurers will convert benefits to allow terminally ill children to spend their final weeks and months at home rather
than in a hospital.
"It's heartless," observed Kathleen O'Connor, founder and CEO of CodeBlueNow!, the national grassroots organization that has
taken up Charlotte's cause. "Great-West will pay for hospital care but not less costly care at home," she said. "Where other
insurers almost always convert benefits to allow for home nursing care, Great-West has abandoned Charlotte's family when they
needed coverage the most. Ironically, they would provide home care if she were not dying. That's simply un-American."
CodeBlueNow!, with members in 46 states, is a nonprofit, nonpartisan group that uses the Internet to advocate for fundamental
health care reform. To help Charlotte's family pressure Great-West, the organization has begun a "viral marketing" campaign,
sending e-mail to thousands of supporters nationwide. The e-mail urges recipients to take action and tell a friend. It
directs them to a website (codebluenow/charlotte) to
write, fax or e-mail Great-West's CEO, calling on the company to let Charlotte receive nursing care at home. The e-mail also
includes a 60-second video with shots of Charlotte and her family.
Despite onslaught of negative attention, Great-West has so far refused to budge. In a statement to KING-5, a company
spokesperson claimed that Charlotte's family has been told "three times" that home nursing care is not covered by their
policy. Great-West has avoided responding directly to reports that other insurers would convert benefits under similar
circumstances.
"Charlotte's situation is emblematic of a larger national crisis facing American families and their employers," remarked
O'Connor, who is also publisher of The O'ConnorReport, author of The Buck Stops Nowhere: Why America's Health Care is all
Dollars and No Sense, and 26-year veteran of health care analysis. "This could happen to anyone in America. With half of all
bankruptcies due to medical bills, our flawed health care system is driving Americans out of house and home. Just this year,
Tennessee cut 323,000 from its health care rolls." O'Connor argues that CodeBlueNow!'s nonpartisan efforts to reform the
system are more needed now than ever.
Charlotte is fortunate in one respect. The State of Washington's Department of Developmental Disabilities was able to provide
a special one-time exemption that allows 16 hours per day of home nursing care through a Medicaid-funded program. However,
her family must augment this care with costly high-risk insurance on top of their monthly premiums to Great-West.
As the e-mails and letters continue to pile up at Great-West's headquarters, CodeBlueNow! vows to "turn up the heat" until
the company agrees to cover Charlotte's home nursing care. "They don't know what's about to hit them," says O'Connor. "You
don't mess with a dying three year old girl. And you don't mess with a family that simply wants to spend time with their
child, instead of filing insurance appeals. Great-West is about to learn this lesson the hard way."
About CodeBlueNow!
CodeBlueNow! is a non-partisan, national 501(c)3 non-profit organization that is mobilizing grassroots efforts to transform
the financing, delivery and management of the American health care system, by assuring that the public has a voice in shaping
health care policy. The organization has grown from 30 people in October 2003 to having thousands of supporters in 46 states
and an online radio show. More information is online at: codebluenow.
For More Information Contact:
Kathleen O'Connor, 206-650-2750, kathleencodebluenow
Matt Eldridge, 206-331-2868, mattcodebluenow
codebluenow
A firestorm of media attention is building around a dying girl named Charlotte and her struggle to receive nursing care at
home rather than in the hospital. Today, following news coverage by local and regional television stations earlier this week,
a national grassroots organization has weighed in. It has launched an Internet campaign to increase pressure on Charlotte's
family's insurance company to "do the right thing."
Multiple television news stories about Charlotte's family and their predicament aired throughout Washington, Oregon, Idaho,
western Montana, northern California and Alaska on stations KING-5, KONG 6/16 and the regional Northwest Cable News channel
on February 1. The Colorado-based insurer, Great-West Life & Annuity, has taken the unusual step of denying home nursing care
to three year-old Charlotte. In nearly all similar cases, according to Children's Hospital and Regional Medical Center in
Seattle, insurers will convert benefits to allow terminally ill children to spend their final weeks and months at home rather
than in a hospital.
"It's heartless," observed Kathleen O'Connor, founder and CEO of CodeBlueNow!, the national grassroots organization that has
taken up Charlotte's cause. "Great-West will pay for hospital care but not less costly care at home," she said. "Where other
insurers almost always convert benefits to allow for home nursing care, Great-West has abandoned Charlotte's family when they
needed coverage the most. Ironically, they would provide home care if she were not dying. That's simply un-American."
CodeBlueNow!, with members in 46 states, is a nonprofit, nonpartisan group that uses the Internet to advocate for fundamental
health care reform. To help Charlotte's family pressure Great-West, the organization has begun a "viral marketing" campaign,
sending e-mail to thousands of supporters nationwide. The e-mail urges recipients to take action and tell a friend. It
directs them to a website (codebluenow/charlotte) to
write, fax or e-mail Great-West's CEO, calling on the company to let Charlotte receive nursing care at home. The e-mail also
includes a 60-second video with shots of Charlotte and her family.
Despite onslaught of negative attention, Great-West has so far refused to budge. In a statement to KING-5, a company
spokesperson claimed that Charlotte's family has been told "three times" that home nursing care is not covered by their
policy. Great-West has avoided responding directly to reports that other insurers would convert benefits under similar
circumstances.
"Charlotte's situation is emblematic of a larger national crisis facing American families and their employers," remarked
O'Connor, who is also publisher of The O'ConnorReport, author of The Buck Stops Nowhere: Why America's Health Care is all
Dollars and No Sense, and 26-year veteran of health care analysis. "This could happen to anyone in America. With half of all
bankruptcies due to medical bills, our flawed health care system is driving Americans out of house and home. Just this year,
Tennessee cut 323,000 from its health care rolls." O'Connor argues that CodeBlueNow!'s nonpartisan efforts to reform the
system are more needed now than ever.
Charlotte is fortunate in one respect. The State of Washington's Department of Developmental Disabilities was able to provide
a special one-time exemption that allows 16 hours per day of home nursing care through a Medicaid-funded program. However,
her family must augment this care with costly high-risk insurance on top of their monthly premiums to Great-West.
As the e-mails and letters continue to pile up at Great-West's headquarters, CodeBlueNow! vows to "turn up the heat" until
the company agrees to cover Charlotte's home nursing care. "They don't know what's about to hit them," says O'Connor. "You
don't mess with a dying three year old girl. And you don't mess with a family that simply wants to spend time with their
child, instead of filing insurance appeals. Great-West is about to learn this lesson the hard way."
About CodeBlueNow!
CodeBlueNow! is a non-partisan, national 501(c)3 non-profit organization that is mobilizing grassroots efforts to transform
the financing, delivery and management of the American health care system, by assuring that the public has a voice in shaping
health care policy. The organization has grown from 30 people in October 2003 to having thousands of supporters in 46 states
and an online radio show. More information is online at: codebluenow.
For More Information Contact:
Kathleen O'Connor, 206-650-2750, kathleencodebluenow
Matt Eldridge, 206-331-2868, mattcodebluenow
codebluenow
Medtronic Launches Large-Scale Clinical Trial To Examine Impact Of Implantable Device-Based Monitoring Technology On Heart Failure Patient Care
Medtronic, Inc. (NYSE: MDT) today announced the start of a nationwide trial to examine the relationship between the company's OptiVol® Fluid Status Monitoring technology and the ability to predict worsening heart failure, a leading cause of hospitalizations worldwide. The trial will assess whether more frequent (monthly vs. quarterly) review of patient data results in earlier clinical intervention.
"Medtronic has been the pioneer in the development of tools to aid in the early detection of worsening heart failure. The goal of this new trial, called OptiVol Care Pathway, is to provide physicians with clinical evidence to understand the role and application of comprehensive diagnostics, including fluid status monitoring, in managing heart failure patients," said Marshall S. Stanton, M.D., vice president of clinical research for the Cardiac Rhythm Disease Management business at Medtronic. "Monitoring fluid trends via OptiVol can help physicians identify patients who are at risk of experiencing worsening heart failure events, but who may not experience symptoms."
Previous studies have demonstrated that monitoring fluid trends in the chest cavity using OptiVol identified patients more likely to have subsequent heart failure events, such as shortness of breath, fatigue, tissue swelling due to fluid build up, and decompensation or deterioration of heart function leading to hospitalizations. However, most physicians today rely on non-specific measures such as patient weight in an effort to detect worsening heart failure.
The commencement of the OptiVol Care Pathway trial complements a data analysis that will be presented during Heart Rhythm 2009, the annual scientific sessions of the Heart Rhythm Society, which utilized de-identified data aggregated in the Medtronic Discovery™ Hub on more than 43,000 ICDs and CRT-Ds. The analysis examined the association between worsening heart failure as indexed by OptiVol and atrial and ventricular tachyarrhythmias (AT and VT). Results from the analysis will be presented at the session, "Decreases in Intrathoracic Impedance Are Associated with Atrial and Ventricular Tachyarrhythmias: An Analysis of 43,356 CRT-D and ICD Devices," at 10:45 a.m. Friday, May 15, in Room 255 at the Boston Convention and Exhibition Center.
About OptiVol Care Pathway
OptiVol Care Pathway is a prospective, randomized, multicenter, clinical trial that will assess the impact of monthly vs. quarterly review of OptiVol with Cardiac Compass™ Trend information on patient care. The study is expected to enroll approximately 1,500 patients at up to 200 sites; patients will be followed for 12 months. Principal investigator is W.H. Wilson Tang, M.D., assistant professor of medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. First enrollments in the OptiVol Care Pathway trial took place at Metropolitan Cardiology Consultants (Coon Rapids, Minn.) by Amin Rahmatullah, M.D., and Carolina Heart Specialists (Gastonia, N.C.) by Mark Thompson, M.D.; enrollments continue at centers nationwide.
About OptiVol Fluid Status Monitoring
OptiVol is found on Medtronic's latest wireless defibrillators (Consulta™ and Concerto® CRT-Ds, Secura™ and Virtuoso® ICDs), and has been available on Medtronic devices since U.S. Food and Drug Administration approval in 2004. OptiVol fluid status monitoring uses low-level electrical pulses that travel across the thoracic cavity (the chest area encompassing the lungs and heart) to measure the level of resistance, indicating fluid in the chest - a common sign of heart failure. Since normal fluid levels vary from patient to patient, and fluid accumulation can be either slow or rapid, OptiVol's ability to measure fluid status trends over time in conjunction with other key device trends and physiologic measures available in Medtronic's proprietary Cardiac Compass Reports can provide the opportunity to intervene before patient symptoms develop. As of Jan. 1, 2009, the U.S. Centers for Medicare and Medicaid Services have begun reimbursing physicians for their time spent monitoring heart failure patients using fluid trend data obtained from Medtronic implantable cardiac devices via CareLink® Network remote transmission.
About Heart Failure1
An estimated 5.7 million Americans have heart failure, and new cases are diagnosed in this country at a rate of another 670,000 annually. Each year, heart failure accounts for more than 1 million hospitalizations, is associated with nearly 300,000 deaths, and costs more than $37 billion. Most of the hospitalizations are characterized by excessive fluid accumulation in the chest cavity.
1 Heart Disease and Stroke Statistics 2009 Update. A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, published online Dec 15, 2008
Source
Medtronic, Inc.
"Medtronic has been the pioneer in the development of tools to aid in the early detection of worsening heart failure. The goal of this new trial, called OptiVol Care Pathway, is to provide physicians with clinical evidence to understand the role and application of comprehensive diagnostics, including fluid status monitoring, in managing heart failure patients," said Marshall S. Stanton, M.D., vice president of clinical research for the Cardiac Rhythm Disease Management business at Medtronic. "Monitoring fluid trends via OptiVol can help physicians identify patients who are at risk of experiencing worsening heart failure events, but who may not experience symptoms."
Previous studies have demonstrated that monitoring fluid trends in the chest cavity using OptiVol identified patients more likely to have subsequent heart failure events, such as shortness of breath, fatigue, tissue swelling due to fluid build up, and decompensation or deterioration of heart function leading to hospitalizations. However, most physicians today rely on non-specific measures such as patient weight in an effort to detect worsening heart failure.
The commencement of the OptiVol Care Pathway trial complements a data analysis that will be presented during Heart Rhythm 2009, the annual scientific sessions of the Heart Rhythm Society, which utilized de-identified data aggregated in the Medtronic Discovery™ Hub on more than 43,000 ICDs and CRT-Ds. The analysis examined the association between worsening heart failure as indexed by OptiVol and atrial and ventricular tachyarrhythmias (AT and VT). Results from the analysis will be presented at the session, "Decreases in Intrathoracic Impedance Are Associated with Atrial and Ventricular Tachyarrhythmias: An Analysis of 43,356 CRT-D and ICD Devices," at 10:45 a.m. Friday, May 15, in Room 255 at the Boston Convention and Exhibition Center.
About OptiVol Care Pathway
OptiVol Care Pathway is a prospective, randomized, multicenter, clinical trial that will assess the impact of monthly vs. quarterly review of OptiVol with Cardiac Compass™ Trend information on patient care. The study is expected to enroll approximately 1,500 patients at up to 200 sites; patients will be followed for 12 months. Principal investigator is W.H. Wilson Tang, M.D., assistant professor of medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. First enrollments in the OptiVol Care Pathway trial took place at Metropolitan Cardiology Consultants (Coon Rapids, Minn.) by Amin Rahmatullah, M.D., and Carolina Heart Specialists (Gastonia, N.C.) by Mark Thompson, M.D.; enrollments continue at centers nationwide.
About OptiVol Fluid Status Monitoring
OptiVol is found on Medtronic's latest wireless defibrillators (Consulta™ and Concerto® CRT-Ds, Secura™ and Virtuoso® ICDs), and has been available on Medtronic devices since U.S. Food and Drug Administration approval in 2004. OptiVol fluid status monitoring uses low-level electrical pulses that travel across the thoracic cavity (the chest area encompassing the lungs and heart) to measure the level of resistance, indicating fluid in the chest - a common sign of heart failure. Since normal fluid levels vary from patient to patient, and fluid accumulation can be either slow or rapid, OptiVol's ability to measure fluid status trends over time in conjunction with other key device trends and physiologic measures available in Medtronic's proprietary Cardiac Compass Reports can provide the opportunity to intervene before patient symptoms develop. As of Jan. 1, 2009, the U.S. Centers for Medicare and Medicaid Services have begun reimbursing physicians for their time spent monitoring heart failure patients using fluid trend data obtained from Medtronic implantable cardiac devices via CareLink® Network remote transmission.
About Heart Failure1
An estimated 5.7 million Americans have heart failure, and new cases are diagnosed in this country at a rate of another 670,000 annually. Each year, heart failure accounts for more than 1 million hospitalizations, is associated with nearly 300,000 deaths, and costs more than $37 billion. Most of the hospitalizations are characterized by excessive fluid accumulation in the chest cavity.
1 Heart Disease and Stroke Statistics 2009 Update. A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, published online Dec 15, 2008
Source
Medtronic, Inc.
Fla.'s Jackson Health System Struggles With Nursing Home And Hospital Losses; Advocates Push Marijuana Cultivation In Calif.
The Miami Herald: As the Jackson Health System's "governing board prepares to vote Monday on a proposed budget for 2011, its two money-losing nursing homes stand as a symbol for the challenges the system faces as it attempts to cut losses. Almost 100 of the 289 nursing home patients in the Jackson Health System are uninsured. Half of those are undocumented immigrants under age 50. Many are quadriplegic, on ventilators -- hugely expensive patients who can cost up to three times as much as regular nursing home residents. Despite these and other challenges, Jackson must present a balanced budget to the Miami-Dade County Commission" (Dorschner, 8/23).
Politico: "The nerve center for this year's highly publicized movement [in California] to legalize marijuana is in a neighborhood known as Oaksterdam. ... A group of 20-somethings, many of them on summer break, spend their days calling voters around the state to explain the virtues of ending the 73-year marijuana prohibition from cannabis campaign headquarters. ... Proposition 19 ... would allow anyone older than 21 to cultivate a small amount of marijuana for personal use. Cities would be able to regulate and tax sales. California is the first state to make such a bold push for decriminalizing the leafy drug, and it's a test case closely watched by states - including New York and Colorado - that also are eyeing more lenient stances on marijuana, in part to bring much-needed tax revenue to ease crushing deficits" (Hart, 8/21).
The Associated Press/MSN Money: "Legislation [in New York] that would require health insurers to cover screening, diagnosis and lifetime treatment of autism spectrum disorders has reached Gov. David Paterson's desk, but it falls short with some advocacy groups. The bill, approved unanimously by the Senate and Assembly, would require the state Department of Health to identify treatment and therapy options that are evidence-based, peer-reviewed and clinically proven. Regulations specifying what will be covered would have to be drafted within a year, in consultation with insurance companies and mental health and disabilities experts. Insurers could review individual coverage to confirm it's medically necessary" (Virtanen, 8/22).
Insurance Journal: "A new regulation that makes it harder for health insurance companies to drop individual policyholders in California is being challenged in court by an industry trade group. The California Department of Insurance's new regulations require insurers to investigate the medical histories of those seeking individual policies before accepting any premiums. About 1.1 million individual health policies are regulated by the department. The Association of California Life and Health Insurance Companies sued to stop the rules on Monday, accusing the state of acting 'in excess of its jurisdiction and authority' by creating regulation that conflicts with the state's insurance code" (Mohajer, 8/23).
The Associated Press/(N.J.) Star-Ledger: "Just two people in New Jersey will begin receiving coverage today under new plans created by federal health care reforms. NJ Protect plans are available to those who have been without insurance for at least six months and submit evidence of pre-existing health conditions. The state will receive $141 million in federal subsidies to cover claims that exceed the premiums paid by the beneficiaries" (8/23).
Albany (N.Y.) Times Union: "A growing insolvency crisis in workers' compensation insurance, born from years of lax oversight by state regulators, is threatening to leave thousands of small businesses owing $600 million or more to New York insurance pools they trusted to pay claims from workplace death and injury. Already, the little-publicized crisis has forced otherwise stable companies to lay off workers and curtail hiring plans during a critical point in the state's economic recovery. And at some point, taxpayers could be forced to pick up the tab for whatever can't be recovered through lawsuits or other means" (Anderson, 8/23).
Politico: "The nerve center for this year's highly publicized movement [in California] to legalize marijuana is in a neighborhood known as Oaksterdam. ... A group of 20-somethings, many of them on summer break, spend their days calling voters around the state to explain the virtues of ending the 73-year marijuana prohibition from cannabis campaign headquarters. ... Proposition 19 ... would allow anyone older than 21 to cultivate a small amount of marijuana for personal use. Cities would be able to regulate and tax sales. California is the first state to make such a bold push for decriminalizing the leafy drug, and it's a test case closely watched by states - including New York and Colorado - that also are eyeing more lenient stances on marijuana, in part to bring much-needed tax revenue to ease crushing deficits" (Hart, 8/21).
The Associated Press/MSN Money: "Legislation [in New York] that would require health insurers to cover screening, diagnosis and lifetime treatment of autism spectrum disorders has reached Gov. David Paterson's desk, but it falls short with some advocacy groups. The bill, approved unanimously by the Senate and Assembly, would require the state Department of Health to identify treatment and therapy options that are evidence-based, peer-reviewed and clinically proven. Regulations specifying what will be covered would have to be drafted within a year, in consultation with insurance companies and mental health and disabilities experts. Insurers could review individual coverage to confirm it's medically necessary" (Virtanen, 8/22).
Insurance Journal: "A new regulation that makes it harder for health insurance companies to drop individual policyholders in California is being challenged in court by an industry trade group. The California Department of Insurance's new regulations require insurers to investigate the medical histories of those seeking individual policies before accepting any premiums. About 1.1 million individual health policies are regulated by the department. The Association of California Life and Health Insurance Companies sued to stop the rules on Monday, accusing the state of acting 'in excess of its jurisdiction and authority' by creating regulation that conflicts with the state's insurance code" (Mohajer, 8/23).
The Associated Press/(N.J.) Star-Ledger: "Just two people in New Jersey will begin receiving coverage today under new plans created by federal health care reforms. NJ Protect plans are available to those who have been without insurance for at least six months and submit evidence of pre-existing health conditions. The state will receive $141 million in federal subsidies to cover claims that exceed the premiums paid by the beneficiaries" (8/23).
Albany (N.Y.) Times Union: "A growing insolvency crisis in workers' compensation insurance, born from years of lax oversight by state regulators, is threatening to leave thousands of small businesses owing $600 million or more to New York insurance pools they trusted to pay claims from workplace death and injury. Already, the little-publicized crisis has forced otherwise stable companies to lay off workers and curtail hiring plans during a critical point in the state's economic recovery. And at some point, taxpayers could be forced to pick up the tab for whatever can't be recovered through lawsuits or other means" (Anderson, 8/23).
This information was reprinted from kaiserhealthnews with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.
© Henry J. Kaiser Family Foundation. All rights reserved.
Access To Primary Healthcare Improves Quality Of Life In Care Homes, UK
Help the Aged responded to a new evaluation study published by the Joseph Rowntree Foundation which found that bringing a community nursing and physiotherapy team into residential care homes for older people improved quality of life and reduced hospital admissions.
The two-year pilot scheme, set up in a group of local authority residential homes caring for 131 long-term residents, found that a dedicated 'in-reach team' was able to detect and deal with undiagnosed illnesses, producing long-term benefits for residents' health and quality of life.
Elizabeth McLennan, Policy Officer at Help the Aged, commented:
"This report highlights the importance of access to primary healthcare services for people staying in care homes. The value of preventing hospital admissions cannot be underestimated, both in terms of maintaining quality of life of older people, along with the cost to the NHS.
"Many older people lose links with their local healthcare services on entering a care home.
"It's vital that along with the rest of the population, care home residents have access to free primary healthcare. Often, access to GPs is not free.
"Failure to give care home residents the same medical priority as people living in their own homes means forcing thousands of older people to endure lives of avoidable pain and suffering, with an increased chance of hospital admission.
"This isn't just a case of poor standards on the part of the NHS, it is a breach of human rights."
Notes
Help the Aged is currently campaigning to secure a change in the law to outlaw age discrimination in the provision of goods, facilities and services. Please visit helptheaged.uk/en-gb/Campaigns/ for information about 'Just Equal Treatment'.
Right care, Right deal' is the new national campaign launched to build public awareness and support for the need for brave and innovative solutions for the social care system. With the Government indicating that social care is an urgent political priority, and in advance of the expected green paper later in 2008, the campaign combines three of the UK's largest charities working with and for older people and their families and carers, and will urge the government to renew its vision for the future of social care in England. Visit rightcare.uk
Help the Aged is the charity fighting to free disadvantaged older people in the UK and overseas from poverty, isolation, neglect and ageism. It campaigns to raise public awareness of the issues affecting older people and to bring about policy change. The Charity delivers a range of services: information and advice, home support and community living, including international development work. These are supported by its paid-for services and fundraising activities - which aim to increase funding in the future to respond to the growing unmet needs of disadvantaged older people. Help the Aged also funds vital research into the health issues and experiences of older people to improve the quality of later life.
Help the Aged urgently needs donations and support to help it in the increasingly challenging fight to free disadvantaged older people from poverty, isolation and neglect.
Help the Aged
The two-year pilot scheme, set up in a group of local authority residential homes caring for 131 long-term residents, found that a dedicated 'in-reach team' was able to detect and deal with undiagnosed illnesses, producing long-term benefits for residents' health and quality of life.
Elizabeth McLennan, Policy Officer at Help the Aged, commented:
"This report highlights the importance of access to primary healthcare services for people staying in care homes. The value of preventing hospital admissions cannot be underestimated, both in terms of maintaining quality of life of older people, along with the cost to the NHS.
"Many older people lose links with their local healthcare services on entering a care home.
"It's vital that along with the rest of the population, care home residents have access to free primary healthcare. Often, access to GPs is not free.
"Failure to give care home residents the same medical priority as people living in their own homes means forcing thousands of older people to endure lives of avoidable pain and suffering, with an increased chance of hospital admission.
"This isn't just a case of poor standards on the part of the NHS, it is a breach of human rights."
Notes
Help the Aged is currently campaigning to secure a change in the law to outlaw age discrimination in the provision of goods, facilities and services. Please visit helptheaged.uk/en-gb/Campaigns/ for information about 'Just Equal Treatment'.
Right care, Right deal' is the new national campaign launched to build public awareness and support for the need for brave and innovative solutions for the social care system. With the Government indicating that social care is an urgent political priority, and in advance of the expected green paper later in 2008, the campaign combines three of the UK's largest charities working with and for older people and their families and carers, and will urge the government to renew its vision for the future of social care in England. Visit rightcare.uk
Help the Aged is the charity fighting to free disadvantaged older people in the UK and overseas from poverty, isolation, neglect and ageism. It campaigns to raise public awareness of the issues affecting older people and to bring about policy change. The Charity delivers a range of services: information and advice, home support and community living, including international development work. These are supported by its paid-for services and fundraising activities - which aim to increase funding in the future to respond to the growing unmet needs of disadvantaged older people. Help the Aged also funds vital research into the health issues and experiences of older people to improve the quality of later life.
Help the Aged urgently needs donations and support to help it in the increasingly challenging fight to free disadvantaged older people from poverty, isolation and neglect.
Help the Aged
Patients Endorse Home Oxygen Servicem UK
95% of patients in England and Wales are happy with the service they
receive from the Home Oxygen Service, the Department of Health
announced today.
The first annual National Patient Satisfaction Survey of the Home
Oxygen Service, published today, was commissioned jointly by the
Department of Health and oxygen suppliers and is an important measure
of the quality of care patients receive to show satisfaction with the
service.
The Home Oxygen Service supplies oxygen delivered directly to the
home of over 90,000 patients in England and Wales who suffer a range
of conditions including Chronic Obstructive Pulmonary Disease, lung
cancer and supporting the discharge of premature babies. It provides
equipment and oxygen as well as education and training and 24/7
support for patients.
The survey results show:
- 88% of patients believe that their quality of life has improved
since receiving the service;
- 75% of patients say they speak highly about the service; and
- The helpline provided by oxygen suppliers is the greatest factor in
driving patient satisfaction
Commenting on the results Health Minister Ben Bradshaw said:
"The Home Oxygen Service plays an important role in improving quality
of life for thousands of patients with a wide range of conditions. I
am very pleased to see such high levels of patient satisfaction and
we will use this data to continue to improve the service patients
receive."
The National Patient Satisfaction Survey is the first measure of
patient satisfaction since the service was modernised in February
2006. The new integrated service means that all patients' needs are
met by one supplier in each area to provide better support at home.
It also offers greater access to the latest equipment and expert
knowledge of latest oxygen technologies.
Patients who have been receiving the oxygen since before February
2006 also have similar or higher levels of satisfaction than newer
patients, reflecting the success of the new service.
The Department of Health will continue to work together with oxygen
suppliers to improve satisfaction with regards to the convenience of
oxygen deliveries and confidence that oxygen will be delivered on
time.
1. The full results of the Home Oxygen Service National Patient
Satisfaction Survey can be found at homeoxygen.nhs.uk
2. A postal survey was sent to a representative sample of 4,800
patients from over 80,000 service users. A total of 3,065
questionnaires were returned representing a response rate of 66%. The
represent a very high response rate for a survey of this kind. The
profile of respondents closely matches the patient population, giving
confidence that the attitudes expressed in the survey are
representative
3. All patient needs are met by a single supplier in each service
area, providing an integrated service to patients and clinicians. The
home oxygen service is provided through eleven regional contracts in
England and Wales, and is delivered by three suppliers:
- Air Products: North West, Yorkshire and Humber, East Midlands, West
Midlands, North London, Wales
- BOC: Eastern England and South West
- Air Liquide : North East, South London, South East
Department of Health
, UK
receive from the Home Oxygen Service, the Department of Health
announced today.
The first annual National Patient Satisfaction Survey of the Home
Oxygen Service, published today, was commissioned jointly by the
Department of Health and oxygen suppliers and is an important measure
of the quality of care patients receive to show satisfaction with the
service.
The Home Oxygen Service supplies oxygen delivered directly to the
home of over 90,000 patients in England and Wales who suffer a range
of conditions including Chronic Obstructive Pulmonary Disease, lung
cancer and supporting the discharge of premature babies. It provides
equipment and oxygen as well as education and training and 24/7
support for patients.
The survey results show:
- 88% of patients believe that their quality of life has improved
since receiving the service;
- 75% of patients say they speak highly about the service; and
- The helpline provided by oxygen suppliers is the greatest factor in
driving patient satisfaction
Commenting on the results Health Minister Ben Bradshaw said:
"The Home Oxygen Service plays an important role in improving quality
of life for thousands of patients with a wide range of conditions. I
am very pleased to see such high levels of patient satisfaction and
we will use this data to continue to improve the service patients
receive."
The National Patient Satisfaction Survey is the first measure of
patient satisfaction since the service was modernised in February
2006. The new integrated service means that all patients' needs are
met by one supplier in each area to provide better support at home.
It also offers greater access to the latest equipment and expert
knowledge of latest oxygen technologies.
Patients who have been receiving the oxygen since before February
2006 also have similar or higher levels of satisfaction than newer
patients, reflecting the success of the new service.
The Department of Health will continue to work together with oxygen
suppliers to improve satisfaction with regards to the convenience of
oxygen deliveries and confidence that oxygen will be delivered on
time.
1. The full results of the Home Oxygen Service National Patient
Satisfaction Survey can be found at homeoxygen.nhs.uk
2. A postal survey was sent to a representative sample of 4,800
patients from over 80,000 service users. A total of 3,065
questionnaires were returned representing a response rate of 66%. The
represent a very high response rate for a survey of this kind. The
profile of respondents closely matches the patient population, giving
confidence that the attitudes expressed in the survey are
representative
3. All patient needs are met by a single supplier in each service
area, providing an integrated service to patients and clinicians. The
home oxygen service is provided through eleven regional contracts in
England and Wales, and is delivered by three suppliers:
- Air Products: North West, Yorkshire and Humber, East Midlands, West
Midlands, North London, Wales
- BOC: Eastern England and South West
- Air Liquide : North East, South London, South East
Department of Health
, UK
Care In First 6 Months Post Stroke Soars To More Than $2.5 Billion Annually
Health-care costs for patients in just the first six months after they have a stroke is more than $2.5 billion a year in Canada, according to a study presented at the Canadian Stroke Congress.
The Canadian Stroke Network's Burden of Ischemic Stroke (BURST) study found that the direct and indirect health-care costs for new stroke patients tally an average $50,000 in the six-month period following a new stroke. There are about 50,000 new strokes in Canada each year.
Earlier and widely quoted estimates, based on the most recent data from Health Canada's Economic Burden of Illness (1998), indicated that the total cost of stroke in Canada was $2.4 billion a year for both new stroke patients and long-term survivors. There are 300,000 people living with stroke in Canada.
"Our old estimates of how much stroke costs the economy are way off base," says Dr. Mike Sharma, who together with Dr. Nicole Mittmann of Sunnybrook Health Sciences Centre, led the BURST study, which is the first prospective national economic analysis on stroke costs.
"The cost of stroke is far more than we expected - at least double previous estimates."
BURST researchers examined the health-care costs of 232 hospitalized stroke patients in 12 sites across Canada at discharge, three months, six months, and one year. The study looked at both disabling and non-disabling stroke.
Hospitalization, medication, physician services, diagnostic imaging, homecare and rehabilitation all contribute to the bill. There are also indirect costs, including disability leave, lost wages, assisted devices, caregivers, and out-of-pocket expenses for families such as personal assistance products or changes to homes to accommodate disabilities.
While costs are much higher than expected, "the idea is to make initial investments in prevention and acute treatment to prevent these costs down the road," says Dr. Sharma.
For example, health-care costs fall sharply when people get access to the clot-busting drug tPA, which can significantly reduce post-stroke disability, as well as treatment in a specialized stroke unit.
Prevention is the biggest factor in reducing health-care spending overall, Dr. Sharma says. If people maintain a healthy blood pressure, maintain a healthy weight, reduce sodium intake, and exercise, the impact on stroke costs would be dramatic.
While at least 80 per cent of costs during the first six months post-stroke are health-system costs, families take on a greater proportion of stroke-related expenses, including those associated with caregiving, transportation, and lost income, beginning at the seventh month post-stroke and beyond.
Costs rise dramatically as levels of disability increase. People with non-disabling strokes - about 25 per cent of patients - personally expended about $2,000 in costs during the first six months. The costs for families increased from there to as much as $200,000 for the most severely affected.
"The difference between merely having symptoms to requiring even minimal at-home assistance from others can mean a significant cost difference," says Dr. Sharma. "The need to have someone drive you around and help with shopping can double personal costs - as well as costs incurred by the person helping you."
Dr. Sharma, who is director of the Ottawa Hospital's regional stroke program, says that personal costs for stroke survivors continue through their lifetimes. "It's a burden on individuals, their families, and communities."
"A stroke doesn't just affect one person - it has a ripple effect," says Heart and Stroke Foundation spokesperson Dr. Michael Hill. "It can challenge families, overburden caregivers, and have a tremendous toll on our healthcare system."
Stroke is the third leading cause of death and a leading cause of disability. The situation may get worse, with aging baby boomers entering their at-risk years.
In 2011 the baby boom generation will enter the period of increasing risk for stroke. "After age 55, the stroke risk doubles every 10 years," says Dr. Hill. "This will increase the strain on our healthcare services."
Over the next two decades, the number of Canadians who are age 65 and over will grow from roughly 4.3 million today to 8 million. Their share of the population will rise from about 13 per cent today to more than 20 per cent, says Dr. Hill.
"We have to learn - and learn fast - how to respond to this situation," says Dr. Antoine Hakim, Canadian Stroke Network spokesperson.
Coordination is key. "Our objective for the study was to identify the cost drivers so decision makers can make informed choices," Dr. Sharma says.
The Canadian Stroke Network's Burden of Ischemic Stroke (BURST) study found that the direct and indirect health-care costs for new stroke patients tally an average $50,000 in the six-month period following a new stroke. There are about 50,000 new strokes in Canada each year.
Earlier and widely quoted estimates, based on the most recent data from Health Canada's Economic Burden of Illness (1998), indicated that the total cost of stroke in Canada was $2.4 billion a year for both new stroke patients and long-term survivors. There are 300,000 people living with stroke in Canada.
"Our old estimates of how much stroke costs the economy are way off base," says Dr. Mike Sharma, who together with Dr. Nicole Mittmann of Sunnybrook Health Sciences Centre, led the BURST study, which is the first prospective national economic analysis on stroke costs.
"The cost of stroke is far more than we expected - at least double previous estimates."
BURST researchers examined the health-care costs of 232 hospitalized stroke patients in 12 sites across Canada at discharge, three months, six months, and one year. The study looked at both disabling and non-disabling stroke.
Hospitalization, medication, physician services, diagnostic imaging, homecare and rehabilitation all contribute to the bill. There are also indirect costs, including disability leave, lost wages, assisted devices, caregivers, and out-of-pocket expenses for families such as personal assistance products or changes to homes to accommodate disabilities.
While costs are much higher than expected, "the idea is to make initial investments in prevention and acute treatment to prevent these costs down the road," says Dr. Sharma.
For example, health-care costs fall sharply when people get access to the clot-busting drug tPA, which can significantly reduce post-stroke disability, as well as treatment in a specialized stroke unit.
Prevention is the biggest factor in reducing health-care spending overall, Dr. Sharma says. If people maintain a healthy blood pressure, maintain a healthy weight, reduce sodium intake, and exercise, the impact on stroke costs would be dramatic.
While at least 80 per cent of costs during the first six months post-stroke are health-system costs, families take on a greater proportion of stroke-related expenses, including those associated with caregiving, transportation, and lost income, beginning at the seventh month post-stroke and beyond.
Costs rise dramatically as levels of disability increase. People with non-disabling strokes - about 25 per cent of patients - personally expended about $2,000 in costs during the first six months. The costs for families increased from there to as much as $200,000 for the most severely affected.
"The difference between merely having symptoms to requiring even minimal at-home assistance from others can mean a significant cost difference," says Dr. Sharma. "The need to have someone drive you around and help with shopping can double personal costs - as well as costs incurred by the person helping you."
Dr. Sharma, who is director of the Ottawa Hospital's regional stroke program, says that personal costs for stroke survivors continue through their lifetimes. "It's a burden on individuals, their families, and communities."
"A stroke doesn't just affect one person - it has a ripple effect," says Heart and Stroke Foundation spokesperson Dr. Michael Hill. "It can challenge families, overburden caregivers, and have a tremendous toll on our healthcare system."
Stroke is the third leading cause of death and a leading cause of disability. The situation may get worse, with aging baby boomers entering their at-risk years.
In 2011 the baby boom generation will enter the period of increasing risk for stroke. "After age 55, the stroke risk doubles every 10 years," says Dr. Hill. "This will increase the strain on our healthcare services."
Over the next two decades, the number of Canadians who are age 65 and over will grow from roughly 4.3 million today to 8 million. Their share of the population will rise from about 13 per cent today to more than 20 per cent, says Dr. Hill.
"We have to learn - and learn fast - how to respond to this situation," says Dr. Antoine Hakim, Canadian Stroke Network spokesperson.
Coordination is key. "Our objective for the study was to identify the cost drivers so decision makers can make informed choices," Dr. Sharma says.
Surrogate parenting may help undo damage of prenatal cocaine exposure
Babies born to cocaine users fared better socially, emotionally and intellectually if they were cared for during their first two years by people who were not their parents, says a new study.
"Many of the negative outcomes observed in children of drug users can be attributed to care-giving factors," not biology, according to Roger Bakeman, Ph.D., of Georgia State University and colleagues.
Their work appears in the journal Child Development.
The researchers compared 83 children exposed to cocaine in the womb to 63 nonexposed children. Cocaine-using mothers had given birth to more previous babies, were less likely to have graduated high school or have had prenatal care early in pregnancy.
As Bakeman expected, the study found no differences in mental and language skills or in physical growth between children of using and nonusing mothers.
Children of addicted mothers were once written off as permanently damaged "crack babies," but recent research refutes that assumption, says Bakeman. He cautions against attributing differences in cocaine-exposed children to unchangeable physical characteristics developed in the womb.
"These results suggest that in fact, many of the negative outcomes observed in children of drug users can be ameliorated," he says. He found that who raised the child had an important influence.
Some cocaine-exposed children in the study continued to be cared for by their mothers after birth. But 41 percent of the cocaine-using mothers gave up care of their children, compared to 3 percent of the nonusing mothers, Bakeman says.
About 49 percent of the cocaine-exposed children, but only 6 percent of the nonexposed children, were involved with child protective services by 24 months. Slightly more than half these nonparental caregivers were grandmothers or other relatives, while the rest were unrelated to the child.
Nonparental caregivers were older, had higher incomes and were more likely to be married than cocaine-using birth parents who cared for their children.
The cocaine-exposed 2-year-olds scored better on a battery of tests the further they got from their parents. Children in nonparental care scored better than those in a parent's household, but children overseen by unrelated caregivers did even better than those in related, nonparent care.
Part of that result may be due to the fact that using cocaine in any environment doesn't make for good parenting, Bakeman says.
Children of cocaine-using mothers could better achieve their potential by helping them directly, by helping women recover from drug abuse and by teaching the mothers better parenting skills.
This study was funded by a grant from the National Institute on Drug abuse.
FOR MORE INFORMATION:
Health Behavior News Service: (202) 387-2829 or hbns.
Interviews: Contact Claire D. Coles, (404) 712-9814 or E-mail: ccolesemory
Child Development: Contact Stephanie J. Somerville at (734) 998-7310 or somersjumich.
Center for the Advancement of Health
Contact: Ira R. Allen
Director of Public Affairs
202.387.2829
presscfah
"Many of the negative outcomes observed in children of drug users can be attributed to care-giving factors," not biology, according to Roger Bakeman, Ph.D., of Georgia State University and colleagues.
Their work appears in the journal Child Development.
The researchers compared 83 children exposed to cocaine in the womb to 63 nonexposed children. Cocaine-using mothers had given birth to more previous babies, were less likely to have graduated high school or have had prenatal care early in pregnancy.
As Bakeman expected, the study found no differences in mental and language skills or in physical growth between children of using and nonusing mothers.
Children of addicted mothers were once written off as permanently damaged "crack babies," but recent research refutes that assumption, says Bakeman. He cautions against attributing differences in cocaine-exposed children to unchangeable physical characteristics developed in the womb.
"These results suggest that in fact, many of the negative outcomes observed in children of drug users can be ameliorated," he says. He found that who raised the child had an important influence.
Some cocaine-exposed children in the study continued to be cared for by their mothers after birth. But 41 percent of the cocaine-using mothers gave up care of their children, compared to 3 percent of the nonusing mothers, Bakeman says.
About 49 percent of the cocaine-exposed children, but only 6 percent of the nonexposed children, were involved with child protective services by 24 months. Slightly more than half these nonparental caregivers were grandmothers or other relatives, while the rest were unrelated to the child.
Nonparental caregivers were older, had higher incomes and were more likely to be married than cocaine-using birth parents who cared for their children.
The cocaine-exposed 2-year-olds scored better on a battery of tests the further they got from their parents. Children in nonparental care scored better than those in a parent's household, but children overseen by unrelated caregivers did even better than those in related, nonparent care.
Part of that result may be due to the fact that using cocaine in any environment doesn't make for good parenting, Bakeman says.
Children of cocaine-using mothers could better achieve their potential by helping them directly, by helping women recover from drug abuse and by teaching the mothers better parenting skills.
This study was funded by a grant from the National Institute on Drug abuse.
FOR MORE INFORMATION:
Health Behavior News Service: (202) 387-2829 or hbns.
Interviews: Contact Claire D. Coles, (404) 712-9814 or E-mail: ccolesemory
Child Development: Contact Stephanie J. Somerville at (734) 998-7310 or somersjumich.
Center for the Advancement of Health
Contact: Ira R. Allen
Director of Public Affairs
202.387.2829
presscfah
The Phenomenon Of Women Caring For Ex-Husbands
The aging population, 65 years and older, includes nearly 3.8 million divorced men and women, according to the U.S. Census Bureau. Illnesses and end-of-life issues can be particularly difficult for singles without spouses or designated caregivers. A new study from the University of Missouri provides insight into the experiences of exes who care for their former spouses, offering support, assistance with daily tasks and management of health needs.
"The concept of women as caregivers for their ex-husbands is largely unexplored," said Teresa Cooney, associate professor in the College of Human Environmental Sciences. "To date, our study is the first to examine this form of caregiving. Initial findings suggest that it is more common than expected and that the experience is highly variable for caregivers."
Cooney and Christine Proulx, MU researchers in the MU Department of Human Development and Family Studies, are examining the experiences of women who provide care for their ex-husbands. In the study, the researchers conducted a series of telephone interviews with caregivers throughout the U.S. and identified unique characteristics and motivations of these women and how caregiving affected their relationships.
"Compared to traditional caregiving, there are unique issues involved with providing care for former spouses," Proulx said. "A surprising number of the women reported continued involvement with their ex-husbands post-divorce. A strong motivator for women to become caregivers is related to their desire to maintain relationships, not with ex-husbands, but typically with their children. It appears that having shared children with an ex might facilitate emotional attachment. Women also might try to shield their children from the demands of caregiving."
Emotional attachments among women and their exes, including post-divorce relations or positive feelings toward former spouses, facilitated their caregiving relationships. Additionally, the study revealed that some women experience "uplifts" or emotional rewards for caregiving.
"Some women reported caregiving as a turning point in relationships with their ex-husbands," Cooney said. "These women experienced positive interactions as they helped their former husbands, which seemed to buffer the challenges of caregiving. Although pleasant interactions are common among more traditional caregivers and their recipients, we didn't expect to find this in a study of ex-wife caregivers. Several women noted that their ex-husbands had 'softened' during illness and there was less conflict."
Continued exploration to determine why and how former spouses become caregivers will expand current ideas about families and relationships, Cooney said. Cooney and Proulx will further examine relational changes, support for caregivers of former spouses and males as caregivers.
"The concept of women as caregivers for their ex-husbands is largely unexplored," said Teresa Cooney, associate professor in the College of Human Environmental Sciences. "To date, our study is the first to examine this form of caregiving. Initial findings suggest that it is more common than expected and that the experience is highly variable for caregivers."
Cooney and Christine Proulx, MU researchers in the MU Department of Human Development and Family Studies, are examining the experiences of women who provide care for their ex-husbands. In the study, the researchers conducted a series of telephone interviews with caregivers throughout the U.S. and identified unique characteristics and motivations of these women and how caregiving affected their relationships.
"Compared to traditional caregiving, there are unique issues involved with providing care for former spouses," Proulx said. "A surprising number of the women reported continued involvement with their ex-husbands post-divorce. A strong motivator for women to become caregivers is related to their desire to maintain relationships, not with ex-husbands, but typically with their children. It appears that having shared children with an ex might facilitate emotional attachment. Women also might try to shield their children from the demands of caregiving."
Emotional attachments among women and their exes, including post-divorce relations or positive feelings toward former spouses, facilitated their caregiving relationships. Additionally, the study revealed that some women experience "uplifts" or emotional rewards for caregiving.
"Some women reported caregiving as a turning point in relationships with their ex-husbands," Cooney said. "These women experienced positive interactions as they helped their former husbands, which seemed to buffer the challenges of caregiving. Although pleasant interactions are common among more traditional caregivers and their recipients, we didn't expect to find this in a study of ex-wife caregivers. Several women noted that their ex-husbands had 'softened' during illness and there was less conflict."
Continued exploration to determine why and how former spouses become caregivers will expand current ideas about families and relationships, Cooney said. Cooney and Proulx will further examine relational changes, support for caregivers of former spouses and males as caregivers.
Greater Attention Should Be Shown To Spiritual Needs Of People With Advanced Cancer
People with advanced cancer felt they received little or no spiritual support from religious communities and the medical system, according to a new survey. However, those who did receive such support reported a better quality of life.
The study, led by researchers at Dana-Farber Cancer Institute and Harvard Medical School and published in the Journal of Clinical Oncology, drew on data from the Coping With Cancer study, a multi-institutional investigation of advanced cancer patients and their main caregivers. Of 230 patients surveyed, the vast majority - 88 percent - considered religion to be at least somewhat important. But nearly half said their spiritual needs were largely or entirely unmet by a religious community, and 72 percent felt those needs were similarly unaddressed by the medical system.
The findings also indicated that greater spiritual support from religious organizations and medical service providers was strongly linked to better quality of life for patients, even after other factors were taken into account. Intriguingly, patients who considered themselves religious were more likely to want all possible measures taken to extend their lives.
"This study examined how much spiritual support advanced cancer patients received from religious organizations, as well as hospital-based doctors, nurses, and chaplains," said the study's lead author, Tracy Balboni, MD, a senior resident in the Harvard Radiation Oncology Program. "Our findings suggest that such support can help improve patients' quality of life at the end of life."
The infrequent recognition of the spiritual components of illness on the part of many hospitals may reflect a debate over the medical system's proper role in this area, the authors stated. Numerous barriers deter physicians from helping procure spiritual support services for patients at the end of life. Among these is a separation of the realms of medical science and religion that exists within many hospital cultures. Another is concern that physicians might try to impose a specific set of religious beliefs on patients.
Given religious faith's ability to help people cope with illness, physicians' reluctance to inquire about spiritual issues may deprive patients of an important force for healing and wholeness, the authors asserted. This does not mean that physicians should be spiritual counselors, "but they can participate appropriately in spiritual care ??¦ by recognizing spiritual needs and advocating for attention to them," the authors wrote.
They advocate making a "spiritual history" - an account of a patient's religious upbringing and evolution - a routine part of patient care. "It's a way of saying to patients that we acknowledge their illness may have a spiritual dimension for them," Balboni stated. "It may make it easier for patients to bring up spiritual issues later in the course of their illness and may cue doctors and nurses into special concerns that may arise."
The study also tracked how patients' religious observances changed as a result of disease. In general, there was a shift from public to more private forms of spirituality, possibly because people with advanced illness are less able to attend services in a house of worship.
The finding that highly religious patients were the most likely to desire life-extending measures came as something of a surprise, said Balboni. Such individuals might be expected to submit to the natural unfolding of a divine plan, rather than want heroic measures. But, the authors suggested, "Religious individuals may feel that because their illness is in divine hands, there is always hope for a miraculous intervention. Religious individuals also may place a value on life that supersedes potential harms of aggressive attempts to sustain life."
In addition to recommending that spiritual histories be a routine part of care for patients with advanced illness, the authors offered other ways that caregivers can demonstrate concern for patients' spiritual well-being. These include training of non-pastoral medical staff to identify spiritual needs and improve patients' awareness of resources in this area. Integrating pastoral staff into the medical team is another suggestion, as is improving connections between the medical system and outside religious communities.
The research was funded in part by grants from the National Institutes of Health.
The study's senior author is Holly Prigerson, PhD, of Dana-Farber. Co-authors are Susan Block, MD, Christopher Lathan, MD, and John Peteet, MD, and Lauren Vanderwerker, PhD, of Dana-Farber, and Elizabeth Paulk of University of Texas Southwestern Medical Center.
Dana-Farber Cancer Institute (danafarber/) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.
Contact: Bill Schaller
Dana-Farber Cancer Institute
The study, led by researchers at Dana-Farber Cancer Institute and Harvard Medical School and published in the Journal of Clinical Oncology, drew on data from the Coping With Cancer study, a multi-institutional investigation of advanced cancer patients and their main caregivers. Of 230 patients surveyed, the vast majority - 88 percent - considered religion to be at least somewhat important. But nearly half said their spiritual needs were largely or entirely unmet by a religious community, and 72 percent felt those needs were similarly unaddressed by the medical system.
The findings also indicated that greater spiritual support from religious organizations and medical service providers was strongly linked to better quality of life for patients, even after other factors were taken into account. Intriguingly, patients who considered themselves religious were more likely to want all possible measures taken to extend their lives.
"This study examined how much spiritual support advanced cancer patients received from religious organizations, as well as hospital-based doctors, nurses, and chaplains," said the study's lead author, Tracy Balboni, MD, a senior resident in the Harvard Radiation Oncology Program. "Our findings suggest that such support can help improve patients' quality of life at the end of life."
The infrequent recognition of the spiritual components of illness on the part of many hospitals may reflect a debate over the medical system's proper role in this area, the authors stated. Numerous barriers deter physicians from helping procure spiritual support services for patients at the end of life. Among these is a separation of the realms of medical science and religion that exists within many hospital cultures. Another is concern that physicians might try to impose a specific set of religious beliefs on patients.
Given religious faith's ability to help people cope with illness, physicians' reluctance to inquire about spiritual issues may deprive patients of an important force for healing and wholeness, the authors asserted. This does not mean that physicians should be spiritual counselors, "but they can participate appropriately in spiritual care ??¦ by recognizing spiritual needs and advocating for attention to them," the authors wrote.
They advocate making a "spiritual history" - an account of a patient's religious upbringing and evolution - a routine part of patient care. "It's a way of saying to patients that we acknowledge their illness may have a spiritual dimension for them," Balboni stated. "It may make it easier for patients to bring up spiritual issues later in the course of their illness and may cue doctors and nurses into special concerns that may arise."
The study also tracked how patients' religious observances changed as a result of disease. In general, there was a shift from public to more private forms of spirituality, possibly because people with advanced illness are less able to attend services in a house of worship.
The finding that highly religious patients were the most likely to desire life-extending measures came as something of a surprise, said Balboni. Such individuals might be expected to submit to the natural unfolding of a divine plan, rather than want heroic measures. But, the authors suggested, "Religious individuals may feel that because their illness is in divine hands, there is always hope for a miraculous intervention. Religious individuals also may place a value on life that supersedes potential harms of aggressive attempts to sustain life."
In addition to recommending that spiritual histories be a routine part of care for patients with advanced illness, the authors offered other ways that caregivers can demonstrate concern for patients' spiritual well-being. These include training of non-pastoral medical staff to identify spiritual needs and improve patients' awareness of resources in this area. Integrating pastoral staff into the medical team is another suggestion, as is improving connections between the medical system and outside religious communities.
The research was funded in part by grants from the National Institutes of Health.
The study's senior author is Holly Prigerson, PhD, of Dana-Farber. Co-authors are Susan Block, MD, Christopher Lathan, MD, and John Peteet, MD, and Lauren Vanderwerker, PhD, of Dana-Farber, and Elizabeth Paulk of University of Texas Southwestern Medical Center.
Dana-Farber Cancer Institute (danafarber/) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.
Contact: Bill Schaller
Dana-Farber Cancer Institute
Three New Resources Available To Individuals Providing Care To Chronically Ill Patients
The Wall Street Journal on Tuesday examined three new resources available for the almost 34 million U.S. residents who care for chronically ill patients ages 50 and older. The resources include:
Alzheimer's disease Web site: The Web site, launched earlier this month by the Alzheimer's Association, provides caregivers with information on care plans, care options, care coordination and support and resources. In addition, an interactive tool on the Web site recommends care options and automatically develops questions to ask to help select care providers and facilities.
Caregiver booklet: The 20-page booklet -- recently published by the Mature Market Institute, a resource center and part of MetLife -- provides caregivers with advice and a list of resources for those who must meet with physicians, health insurers and other providers on behalf of patients.
Nursing homes booklet: The 34-page booklet, written by Eric Carlson and titled "Twenty Common Nursing Home Problems -- and How To Resolve Them," highlights "standard operating procedures" at many facilities that violate federal rules. For example, according to Carlson, an attorney who has worked as an advocate for nursing home residents for more than 15 years, many nursing homes fail to adhere to federal rules that require them to meet at least once annually with residents and their representatives to establish or update individualized care plans (Greene, Wall Street Journal, 6/27).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Alzheimer's disease Web site: The Web site, launched earlier this month by the Alzheimer's Association, provides caregivers with information on care plans, care options, care coordination and support and resources. In addition, an interactive tool on the Web site recommends care options and automatically develops questions to ask to help select care providers and facilities.
Caregiver booklet: The 20-page booklet -- recently published by the Mature Market Institute, a resource center and part of MetLife -- provides caregivers with advice and a list of resources for those who must meet with physicians, health insurers and other providers on behalf of patients.
Nursing homes booklet: The 34-page booklet, written by Eric Carlson and titled "Twenty Common Nursing Home Problems -- and How To Resolve Them," highlights "standard operating procedures" at many facilities that violate federal rules. For example, according to Carlson, an attorney who has worked as an advocate for nursing home residents for more than 15 years, many nursing homes fail to adhere to federal rules that require them to meet at least once annually with residents and their representatives to establish or update individualized care plans (Greene, Wall Street Journal, 6/27).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Family And Friends May Cause Most Tension For Caregivers
The biggest cause of stress for people who care for loved ones after a stroke may not be worrying about the affected family member.
Rather, surprising new research from Northwestern Medicine shows that a lack of understanding and help from friends and relatives causes the most stress and the greatest threat to a caregiver's own health and well-being.
These and other stressors, like simply trying to take care of themselves and their families along with the demands of caregiving can cause caregivers to report signs of anxiety and depression.
The findings were presented at the Association of Rehabilitation Nurses annual educational conference Sept. 29 to Oct. 2 in Orlando, FL.
The study of 58 caregivers of stroke survivors, identified 15 types of common problems caregivers face. The most stressful problems concerned friends and family who criticize, ignore or don't help caregivers.
"Often families aren't really understanding, or families might blame a caregiver for not doing more than they're doing," said Rosemarie King, the study's lead investigator and research professor in physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine. "We had one caregiver in our study ask if we could send her a write-up that she could just hand to family members to explain how harassed and stressed caregivers are."
The next most stressful problem category was the difficulty caregivers experienced in trying to sustain themselves and their families. Social isolation and changes in their relationship with the stroke survivor also top caregivers' concerns.
"Caregivers face much anxiety about managing their own finances and taking care of their own emotions during such a difficult time," King said. "The least stressful area was patient-related problems. Not that those problems aren't stressful, they were just not as stressful for this group of caregivers."
The study suggests that these often-overlooked concerns for caregivers are a major source of stress. The results are critical, King noted, because other studies, mostly of Alzheimer's caregivers, show stress and depression seem to be associated with increased mortality.
King offers a few tips for friends and family that may ease caregiver stress:
Encourage online or in-person caregiver support groups.
Invite the caregiver to join you at a social event.
Ask the caregiver how she is doing and express concern for her well-being.
Be a sounding board; let the caregiver bounce ideas off of you.
Stay with the patient for a few hours, so the caregiver can get out of the house.
Offer to help with specific everyday tasks, such as shopping for groceries for the caregiver or bringing prepared meals to the home.
Rather, surprising new research from Northwestern Medicine shows that a lack of understanding and help from friends and relatives causes the most stress and the greatest threat to a caregiver's own health and well-being.
These and other stressors, like simply trying to take care of themselves and their families along with the demands of caregiving can cause caregivers to report signs of anxiety and depression.
The findings were presented at the Association of Rehabilitation Nurses annual educational conference Sept. 29 to Oct. 2 in Orlando, FL.
The study of 58 caregivers of stroke survivors, identified 15 types of common problems caregivers face. The most stressful problems concerned friends and family who criticize, ignore or don't help caregivers.
"Often families aren't really understanding, or families might blame a caregiver for not doing more than they're doing," said Rosemarie King, the study's lead investigator and research professor in physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine. "We had one caregiver in our study ask if we could send her a write-up that she could just hand to family members to explain how harassed and stressed caregivers are."
The next most stressful problem category was the difficulty caregivers experienced in trying to sustain themselves and their families. Social isolation and changes in their relationship with the stroke survivor also top caregivers' concerns.
"Caregivers face much anxiety about managing their own finances and taking care of their own emotions during such a difficult time," King said. "The least stressful area was patient-related problems. Not that those problems aren't stressful, they were just not as stressful for this group of caregivers."
The study suggests that these often-overlooked concerns for caregivers are a major source of stress. The results are critical, King noted, because other studies, mostly of Alzheimer's caregivers, show stress and depression seem to be associated with increased mortality.
King offers a few tips for friends and family that may ease caregiver stress:
Encourage online or in-person caregiver support groups.
Invite the caregiver to join you at a social event.
Ask the caregiver how she is doing and express concern for her well-being.
Be a sounding board; let the caregiver bounce ideas off of you.
Stay with the patient for a few hours, so the caregiver can get out of the house.
Offer to help with specific everyday tasks, such as shopping for groceries for the caregiver or bringing prepared meals to the home.
Researchers Study Best Way To Help African-American Dementia Caregivers
With a rapidly expanding population of elders, the number of dementia caregivers in Florida is increasing exponentially. According to the Alzheimer's Association, nearly 10 million caregivers provide unpaid care to people with Alzheimer's disease. Finding the best way to support caregivers, especially with fewer state resources available, is one focus of ongoing research at Mayo Clinic in Florida.
The study to date includes 75 adult African-American caregivers and involves researchers from Mayo Clinic in Florida and Florida State University (FSU), as well as Tallahassee Memorial HealthCare, and James Madison University in Virginia.
The African-American Alzheimer's Caregiver Training and Support (ACTS) project at Mayo Clinic involves a 12-week program that provides skills training and support to African-American dementia caregivers with depression, and is conducted either by phone or face to- face.
Led by Floyd Willis, M.D., chair of Mayo Clinic's Department of Family Medicine, in conjunction with Robert Glueckauf, Ph.D., a professor of medical humanities and social sciences at Florida State University, ACTS helps caregivers find creative ways to improve difficult care giving problems and, at the same time, enhance their own emotional well-being and physical health. The primary purpose of this study is to compare the effects of telephone-based versus face-to-face cognitive-behavioral therapy (CBT), an evidence-based, skills-building support program. Early participants' outcomes, says Willis, indicate that both modes of therapy are equally effective and have led to substantial reduction in caregivers' depression and anxiety, as well as improvement in their physical health.
"The pilot study results already look promising," Willis said, "but we really want to enlarge the number of participants so we can complete the study to validate our pilot data." To complete their study, researchers are looking for an additional 40 to 45 African-American individuals. For their participation, caregivers will receive up to $100 and, judging from the early results, they also will benefit psychologically, physically and spiritually, says Willis.
The study to date includes 75 adult African-American caregivers and involves researchers from Mayo Clinic in Florida and Florida State University (FSU), as well as Tallahassee Memorial HealthCare, and James Madison University in Virginia.
The African-American Alzheimer's Caregiver Training and Support (ACTS) project at Mayo Clinic involves a 12-week program that provides skills training and support to African-American dementia caregivers with depression, and is conducted either by phone or face to- face.
Led by Floyd Willis, M.D., chair of Mayo Clinic's Department of Family Medicine, in conjunction with Robert Glueckauf, Ph.D., a professor of medical humanities and social sciences at Florida State University, ACTS helps caregivers find creative ways to improve difficult care giving problems and, at the same time, enhance their own emotional well-being and physical health. The primary purpose of this study is to compare the effects of telephone-based versus face-to-face cognitive-behavioral therapy (CBT), an evidence-based, skills-building support program. Early participants' outcomes, says Willis, indicate that both modes of therapy are equally effective and have led to substantial reduction in caregivers' depression and anxiety, as well as improvement in their physical health.
"The pilot study results already look promising," Willis said, "but we really want to enlarge the number of participants so we can complete the study to validate our pilot data." To complete their study, researchers are looking for an additional 40 to 45 African-American individuals. For their participation, caregivers will receive up to $100 and, judging from the early results, they also will benefit psychologically, physically and spiritually, says Willis.
Home-Based Child Care Is Meeting Nutritional Standards Although Widespread Use Of TV Is A Concern
A large study of family child care providers shows that while nutrition standards are often met, most children ages 2 to 5 are not getting enough physical activity and are exposed to the television for most of the day.
A study of about 300 home-based child care providers by Oregon State University's Stewart Trost, an internationally-recognized expert on childhood obesity issues, sheds light on both positive and negative aspects of family daycare providers. The findings are published in the December issue of the American Journal of Preventive Medicine.
Trost, who directs the obesity prevention research core at the new Hallie Ford Center for Healthy Children at Oregon State, said a big concern was television exposure in such a young age group. The providers surveyed were caring for young children up to age 5, and two-thirds of providers said they had the TV on most of the day. The American Academy of Pediatrics recommends no more than two hours of television per day for children between the ages of 2 and 5, and discourages any television viewing for children younger than 2.
In addition, while many providers (78 percent) reported offering more than an hour of time for active play daily, 41 percent said children sat for extended parts of the day. Also of concern to the researchers: A majority (63 percent) restricted active play or exercise as punishment for kids.
"Would you withhold fruits and vegetables for kids who misbehave and negatively affect their health?" Trost said. "All the research shows that restricting physical activity makes children more, not less, likely to misbehave. So it's not even an effective means of punishment."
Trost said the most eye-opening result of the study was that less than half of the providers had received any training in physical activity. Trost's past research has shown that children in family daycare get an average of only seven minutes of physical activity per hour. Group this with the 114 percent rise in childhood obesity in the last 30 years, and Trost said it is time to act on this crisis facing American children.
He said providers did "pretty well" in supporting healthy eating habits. Very few reported serving fried foods or high-fat foods, and a low percentage of providers served sweets or chips as snacks.
One area of nutritional concern was the use of whole milk and an over-reliance on fruit juice. More than 50 percent of providers reported serving juice every day, and less than 14 percent served low-fat milk regularly.
"There is a misconception that whole milk is what should be served to youngsters," Trost said. "Low-fat or skim milk has just as much vitamins, and is much healthier. And fruit juice, even 100 percent juice, is mainly sugar and is not what we recommend."
Trost said weaning American children off juice is not an easy task, and child care providers are probably doing what they think is best for kids.
"Juice boxes are part of the culture, and it is hard to break those habits and the heavy influence of marketing, on both parents and child care providers," he said.
Trost and colleagues at OSU Extension Service, in response, have begun a four-year intervention study called the Healthy Home Child Care Project with family daycare providers in a five-county area from Portland to Eugene. The largest intervention of its kind, this $1.2 million project is funded by the U.S. Department of Agriculture. It will collect data on what Oregon family care providers are doing, as well as seek to improve nutritional and physical activity standards through Extension-based training.
"We've got an epidemic that affects the future of our children, and we need to act," Trost said. "We need to put the research into the hands of the people caring for our youth and start getting results."
A study of about 300 home-based child care providers by Oregon State University's Stewart Trost, an internationally-recognized expert on childhood obesity issues, sheds light on both positive and negative aspects of family daycare providers. The findings are published in the December issue of the American Journal of Preventive Medicine.
Trost, who directs the obesity prevention research core at the new Hallie Ford Center for Healthy Children at Oregon State, said a big concern was television exposure in such a young age group. The providers surveyed were caring for young children up to age 5, and two-thirds of providers said they had the TV on most of the day. The American Academy of Pediatrics recommends no more than two hours of television per day for children between the ages of 2 and 5, and discourages any television viewing for children younger than 2.
In addition, while many providers (78 percent) reported offering more than an hour of time for active play daily, 41 percent said children sat for extended parts of the day. Also of concern to the researchers: A majority (63 percent) restricted active play or exercise as punishment for kids.
"Would you withhold fruits and vegetables for kids who misbehave and negatively affect their health?" Trost said. "All the research shows that restricting physical activity makes children more, not less, likely to misbehave. So it's not even an effective means of punishment."
Trost said the most eye-opening result of the study was that less than half of the providers had received any training in physical activity. Trost's past research has shown that children in family daycare get an average of only seven minutes of physical activity per hour. Group this with the 114 percent rise in childhood obesity in the last 30 years, and Trost said it is time to act on this crisis facing American children.
He said providers did "pretty well" in supporting healthy eating habits. Very few reported serving fried foods or high-fat foods, and a low percentage of providers served sweets or chips as snacks.
One area of nutritional concern was the use of whole milk and an over-reliance on fruit juice. More than 50 percent of providers reported serving juice every day, and less than 14 percent served low-fat milk regularly.
"There is a misconception that whole milk is what should be served to youngsters," Trost said. "Low-fat or skim milk has just as much vitamins, and is much healthier. And fruit juice, even 100 percent juice, is mainly sugar and is not what we recommend."
Trost said weaning American children off juice is not an easy task, and child care providers are probably doing what they think is best for kids.
"Juice boxes are part of the culture, and it is hard to break those habits and the heavy influence of marketing, on both parents and child care providers," he said.
Trost and colleagues at OSU Extension Service, in response, have begun a four-year intervention study called the Healthy Home Child Care Project with family daycare providers in a five-county area from Portland to Eugene. The largest intervention of its kind, this $1.2 million project is funded by the U.S. Department of Agriculture. It will collect data on what Oregon family care providers are doing, as well as seek to improve nutritional and physical activity standards through Extension-based training.
"We've got an epidemic that affects the future of our children, and we need to act," Trost said. "We need to put the research into the hands of the people caring for our youth and start getting results."
Residential Home Nurse Receives 5 Year Caution For Care Failures, UK
A 50 year old registered nurse from Herne Bay, Kent has received a 5 year caution order from the Nursing & Midwifery Council following a string of incidents in which he failed to ensure that a patient received the appropriate standard of care.
Takoorparsad Kanayalall Ghowry was the owner and Registered Manager of St Stephens Residential Home when between January 2004 and February 2004 three charges were brought against him for misconduct.
The independent Conduct and Competence Committee panel of the NMC heard that when Patient A, an elderly female resident, was at risk of developing, and subsequently did develop, pressure sores Ghowry -
- failed to ensure that a risk assessment was completed in respect of Patient A's deteriorating skin condition;
- failed to ensure that advice in respect of Patient A's deteriorating skin condition was obtained from visiting medical practitioners;
- failed to ensure that a pressure relief mattress was requested for Patient A;
- failed to ensure that appropriate medical assistance was requested from a District Nurse from when the pressure area became an open wound
- inappropriately allowed Carers to perform nursing duties when they cleaned and dressed Patient A's open pressure areas
In finding the 5 year caution order, the panel considered that the allegations concern the registrant's failure as the owner of the home and as a Registered Nurse in relation to the pressure area care, nutrition, weight and comfort of patient A - a frail, elderly and confused patient. This resulted in Patient A's pressure areas breaking down, in her becoming painfully emaciated and in her having been left immobile in a room with an open window.
Commenting on the panel's decision, NMC spokesperson Sarah Connolly said:
"The committee noted the registrant's acknowledgement now of how wrong it was not to supervise his staff more closely and that he stated that he used his experiences of 2004 since to the benefit of clients in his care. The committee therefore determined that the public would not be at risk and the public interest would be best served if a caution order were imposed in this case"
The Nursing and Midwifery Council (NMC) is the UK regulator for two professions, nursing and midwifery. The primary purpose of the NMC is protection of the public. It does this through maintaining a register of all nurses, midwives and specialist community public health nurses eligible to practice within the UK and by setting standards for their education, training and conduct. Currently the number of registrants exceeds 674,000. The Nursing and Midwifery Order 2001 (The Order), sets out the NMC's role and responsibilities.
Nursing and Midwifery Council
Takoorparsad Kanayalall Ghowry was the owner and Registered Manager of St Stephens Residential Home when between January 2004 and February 2004 three charges were brought against him for misconduct.
The independent Conduct and Competence Committee panel of the NMC heard that when Patient A, an elderly female resident, was at risk of developing, and subsequently did develop, pressure sores Ghowry -
- failed to ensure that a risk assessment was completed in respect of Patient A's deteriorating skin condition;
- failed to ensure that advice in respect of Patient A's deteriorating skin condition was obtained from visiting medical practitioners;
- failed to ensure that a pressure relief mattress was requested for Patient A;
- failed to ensure that appropriate medical assistance was requested from a District Nurse from when the pressure area became an open wound
- inappropriately allowed Carers to perform nursing duties when they cleaned and dressed Patient A's open pressure areas
In finding the 5 year caution order, the panel considered that the allegations concern the registrant's failure as the owner of the home and as a Registered Nurse in relation to the pressure area care, nutrition, weight and comfort of patient A - a frail, elderly and confused patient. This resulted in Patient A's pressure areas breaking down, in her becoming painfully emaciated and in her having been left immobile in a room with an open window.
Commenting on the panel's decision, NMC spokesperson Sarah Connolly said:
"The committee noted the registrant's acknowledgement now of how wrong it was not to supervise his staff more closely and that he stated that he used his experiences of 2004 since to the benefit of clients in his care. The committee therefore determined that the public would not be at risk and the public interest would be best served if a caution order were imposed in this case"
The Nursing and Midwifery Council (NMC) is the UK regulator for two professions, nursing and midwifery. The primary purpose of the NMC is protection of the public. It does this through maintaining a register of all nurses, midwives and specialist community public health nurses eligible to practice within the UK and by setting standards for their education, training and conduct. Currently the number of registrants exceeds 674,000. The Nursing and Midwifery Order 2001 (The Order), sets out the NMC's role and responsibilities.
Nursing and Midwifery Council
American Association For Homecare Registers Strong Opposition To Medicare Cuts In Proposed '08 Budget
Hours after the President's proposed 2008 budget was released on Monday, the American Association for Homecare (AAHomecare) expressed strong opposition to several provisions of the budget that would weaken access to homecare for millions of older and disabled Americans. The President's proposal would heap new cuts on the nation's homecare sector by requiring reductions to payments for homecare equipment, therapies, and visits from home health agencies. The proposed budget includes particularly severe cuts to home oxygen therapy. These homecare reductions come on top of numerous other cuts and freezes mandated by Congress in recent years.
"Homecare provides a clear path to more cost-effective care in Medicare and Medicaid," stated Tyler Wilson, President and CEO of the American Association for Homecare. "Homecare delivers value for every healthcare dollar and is clinically effective and preferred by patients and families. These proposed cuts serve only to hobble the homecare infrastructure that this nation desperately needs."
"Over the coming days and weeks, AAHomecare will mobilize to fight these draconian cuts that simply undermine access to and quality of homecare," said Walt Gorski, AAHomecare vice president for government affairs.
Specifically, AAHomecare commented on the following points, which it will address with Members of Congress and in congressional testimony later this week:
Cuts to Home Oxygen Therapy
The American Association for Homecare opposes the proposal in the President's budget that would force Medicare patients to assume the burden of owning and managing medical oxygen equipment in their homes after only 13 months of rental. The Association issued a statement objecting to the 13-month provision along with the National Home Oxygen Patients Association and the National Association for Medical Direction of Respiratory Care, a physicians' group. The statement said, "We believe the proposed change in payment methodology places an unfair, unsafe, and unrealistic burden on the beneficiary." The organizations are concerned that Medicare policy is increasingly at odds with the clinical needs of home oxygen therapy patients, as well as with physicians' and home oxygen providers' ability to deliver optimal home respiratory care. (See full statement at aahomecare.)
The typical Medicare home oxygen beneficiary is a woman in her seventies who suffers from late-stage chronic obstructive pulmonary disease (COPD) with associated severe low levels of oxygen in her blood (hypoxemia). Approximately 15 million Americans have been diagnosed with COPD, and an estimated 12 to 15 million more remain undiagnosed. Medical oxygen is a highly regulated prescription drug. Because of services required for providing oxygen therapy, it is best suited to a continuing, uninterrupted relationship with a qualified home oxygen provider. Prior to the Deficit Reduction Act of 2005 (DRA), the home oxygen benefit in Medicare provided for rental as long as the prescribed oxygen therapy was medically required by the patient. Home oxygen has been the target of budget cuts for many years: Congress has reduced Medicare reimbursement for oxygen therapy by nearly 50 percent over the past 10 years.
Budget Proposal Would Reduce Access to Power Mobility for Disabled Americans
The Association also opposes a provision in the President's budget that would "establish a 13 month rental period for power wheelchairs." The association believes that this change would reduce beneficiary access and increase costs to Medicare. Currently, Medicare permits a beneficiary to choose to purchase a power wheelchair when it is prescribed by a physician. When the beneficiary chooses to purchase a power mobility device, Medicare payment is made on a lump sum-basis. In October 2005, the Senate debated a provision to eliminate the first-month purchase option for power wheelchairs and decided to reject this policy change from the budget reconciliation package. The amendment was defeated based on the following reasons:
-- Beneficiaries in need of power mobility devices suffer from long-term debilitating conditions that are not short-term in nature.
-- Many power wheelchairs are custom-configured and individualized for the patient. These are not commodity items.
-- Eliminating the first-month purchase option would severely curtail beneficiary access as the supplier will be unable to cover the significant up-front service costs that go into the provision of the most appropriate power mobility device to accommodate the beneficiary's needs.
-- More than 95 percent of all power wheelchairs are purchased in the first month because beneficiaries who meet the coverage criteria have long-term life needs.
Payment Freeze Hurts Home Health Agencies
The Association opposes the proposed five-year freeze (from 2008 to 2012) to the Medicare market basket payment update for home health agencies and the proposed market basket reduction of .65 percent for each year thereafter. While the consumer price index, a general measure of cost of goods, has increased annually at more than 3 percent, home health agencies have sustained a number of reimbursement cuts in recent years that have hurt their ability to integrate new technologies, hire and retain staff, and initiate advanced clinical protocols. Medicare home health providers are currently participating in a one-year collaboration with the Centers for Medicare and Medicaid services to reduce the rate of hospitalization for Medicare patients. A reimbursement cut will reduce resources required to invest in telehealth and other health information technology to achieve transformational change in the quality of care and avoid unnecessary institution costs for Medicare. In addition, the dramatic rise in fuel costs over the last two years has had a particularly negative impact on home health providers, whose nurses, therapists, and aides often have to drive great distances to provide health care services to patients in their homes.
American Association for Homecare
2011 Crystal Drive, Suite 725
Arlington, VA 22202
aahomecare
"Homecare provides a clear path to more cost-effective care in Medicare and Medicaid," stated Tyler Wilson, President and CEO of the American Association for Homecare. "Homecare delivers value for every healthcare dollar and is clinically effective and preferred by patients and families. These proposed cuts serve only to hobble the homecare infrastructure that this nation desperately needs."
"Over the coming days and weeks, AAHomecare will mobilize to fight these draconian cuts that simply undermine access to and quality of homecare," said Walt Gorski, AAHomecare vice president for government affairs.
Specifically, AAHomecare commented on the following points, which it will address with Members of Congress and in congressional testimony later this week:
Cuts to Home Oxygen Therapy
The American Association for Homecare opposes the proposal in the President's budget that would force Medicare patients to assume the burden of owning and managing medical oxygen equipment in their homes after only 13 months of rental. The Association issued a statement objecting to the 13-month provision along with the National Home Oxygen Patients Association and the National Association for Medical Direction of Respiratory Care, a physicians' group. The statement said, "We believe the proposed change in payment methodology places an unfair, unsafe, and unrealistic burden on the beneficiary." The organizations are concerned that Medicare policy is increasingly at odds with the clinical needs of home oxygen therapy patients, as well as with physicians' and home oxygen providers' ability to deliver optimal home respiratory care. (See full statement at aahomecare.)
The typical Medicare home oxygen beneficiary is a woman in her seventies who suffers from late-stage chronic obstructive pulmonary disease (COPD) with associated severe low levels of oxygen in her blood (hypoxemia). Approximately 15 million Americans have been diagnosed with COPD, and an estimated 12 to 15 million more remain undiagnosed. Medical oxygen is a highly regulated prescription drug. Because of services required for providing oxygen therapy, it is best suited to a continuing, uninterrupted relationship with a qualified home oxygen provider. Prior to the Deficit Reduction Act of 2005 (DRA), the home oxygen benefit in Medicare provided for rental as long as the prescribed oxygen therapy was medically required by the patient. Home oxygen has been the target of budget cuts for many years: Congress has reduced Medicare reimbursement for oxygen therapy by nearly 50 percent over the past 10 years.
Budget Proposal Would Reduce Access to Power Mobility for Disabled Americans
The Association also opposes a provision in the President's budget that would "establish a 13 month rental period for power wheelchairs." The association believes that this change would reduce beneficiary access and increase costs to Medicare. Currently, Medicare permits a beneficiary to choose to purchase a power wheelchair when it is prescribed by a physician. When the beneficiary chooses to purchase a power mobility device, Medicare payment is made on a lump sum-basis. In October 2005, the Senate debated a provision to eliminate the first-month purchase option for power wheelchairs and decided to reject this policy change from the budget reconciliation package. The amendment was defeated based on the following reasons:
-- Beneficiaries in need of power mobility devices suffer from long-term debilitating conditions that are not short-term in nature.
-- Many power wheelchairs are custom-configured and individualized for the patient. These are not commodity items.
-- Eliminating the first-month purchase option would severely curtail beneficiary access as the supplier will be unable to cover the significant up-front service costs that go into the provision of the most appropriate power mobility device to accommodate the beneficiary's needs.
-- More than 95 percent of all power wheelchairs are purchased in the first month because beneficiaries who meet the coverage criteria have long-term life needs.
Payment Freeze Hurts Home Health Agencies
The Association opposes the proposed five-year freeze (from 2008 to 2012) to the Medicare market basket payment update for home health agencies and the proposed market basket reduction of .65 percent for each year thereafter. While the consumer price index, a general measure of cost of goods, has increased annually at more than 3 percent, home health agencies have sustained a number of reimbursement cuts in recent years that have hurt their ability to integrate new technologies, hire and retain staff, and initiate advanced clinical protocols. Medicare home health providers are currently participating in a one-year collaboration with the Centers for Medicare and Medicaid services to reduce the rate of hospitalization for Medicare patients. A reimbursement cut will reduce resources required to invest in telehealth and other health information technology to achieve transformational change in the quality of care and avoid unnecessary institution costs for Medicare. In addition, the dramatic rise in fuel costs over the last two years has had a particularly negative impact on home health providers, whose nurses, therapists, and aides often have to drive great distances to provide health care services to patients in their homes.
American Association for Homecare
2011 Crystal Drive, Suite 725
Arlington, VA 22202
aahomecare
Emeritus Senior Living Provides Holiday Tips To Alzheimer's Caregivers
The holidays are a time for families to gather and celebrate generations coming together to enjoy each other's company. Though for those caring for loved ones with Alzheimer's or dementia, this time of year can bring increased anxiety as they strive to create a calm holiday environment while keeping family traditions alive. For that reason, Emeritus Senior Living, a national provider of assisted living and Alzheimer's and related dementia care services to seniors, has put together helpful guidelines and suggestions to make this holiday season a memorable one for the whole family.
"The holidays are an important time of year for families to come together, and keeping our loved ones who are suffering from Alzheimer's involved in family traditions continues to be critically important," commented Crystal Scott, Director of Memory Care for Emeritus Senior Living. "By incorporating our loved ones in their favorite activities and by taking steps to prepare both the senior and other family members for celebratory events, families can create new memories while fostering a connection with seniors on a deeper level."
Emeritus Senior Living encourages Caregivers to take the following steps in order to prepare the person who is living with Alzheimer's:
- Talk about and show pictures of the people who are coming to visit.
- Play familiar holiday music and serve favorite traditional holiday foods.
- Have loved one watch or help with decorations.
- People with Alzheimer's may recognize faces of family members and friends but may be unable to recall names. Name tags are helpful.
- Have a "quiet" room for if things get too hectic, and have a familiar person stay with them so they don't feel isolated or left out.
- Prepare for distractions beforehand to divert attention if problem behavior occurs.
- Incorporate favorite traditions from the past. If the activity is first introduced and there is no interest, try again later.
- Slow the pace of the activities to allow the person with Alzheimer's to comprehend as well as enjoy the sensory pleasure from the activity.
Caregivers are also encouraged to:
- Plan ahead.
- Take a break regularly; try some extra day care or in-home care.
- Cut out the unnecessary - don't be afraid to say no!
- Ask for and accept help from family and friends.
- Set limits as to what you are able to do and make sure the family understands your needs and wishes.
- Create a clear pathway for walking; avoid wires, cords, and throw rugs.
- Use ribbon or yarn instead of sharp hooks to hang ornaments and decorations.
- Serve non-alcoholic beer, wine, or sparkling cider.
- Avoid decorating with items that look edible.
- Use plastic or silk mistletoe rather than real - it's toxic if eaten.
- Avoid confusing, blinking lights.
- Do not leave lighted candles or fireplaces unattended.
Additional tips for preparing those who will be visiting a loved one with Alzheimer's this holiday season are available on the Emeritus website.
Source
Emeritus Senior Living
"The holidays are an important time of year for families to come together, and keeping our loved ones who are suffering from Alzheimer's involved in family traditions continues to be critically important," commented Crystal Scott, Director of Memory Care for Emeritus Senior Living. "By incorporating our loved ones in their favorite activities and by taking steps to prepare both the senior and other family members for celebratory events, families can create new memories while fostering a connection with seniors on a deeper level."
Emeritus Senior Living encourages Caregivers to take the following steps in order to prepare the person who is living with Alzheimer's:
- Talk about and show pictures of the people who are coming to visit.
- Play familiar holiday music and serve favorite traditional holiday foods.
- Have loved one watch or help with decorations.
- People with Alzheimer's may recognize faces of family members and friends but may be unable to recall names. Name tags are helpful.
- Have a "quiet" room for if things get too hectic, and have a familiar person stay with them so they don't feel isolated or left out.
- Prepare for distractions beforehand to divert attention if problem behavior occurs.
- Incorporate favorite traditions from the past. If the activity is first introduced and there is no interest, try again later.
- Slow the pace of the activities to allow the person with Alzheimer's to comprehend as well as enjoy the sensory pleasure from the activity.
Caregivers are also encouraged to:
- Plan ahead.
- Take a break regularly; try some extra day care or in-home care.
- Cut out the unnecessary - don't be afraid to say no!
- Ask for and accept help from family and friends.
- Set limits as to what you are able to do and make sure the family understands your needs and wishes.
- Create a clear pathway for walking; avoid wires, cords, and throw rugs.
- Use ribbon or yarn instead of sharp hooks to hang ornaments and decorations.
- Serve non-alcoholic beer, wine, or sparkling cider.
- Avoid decorating with items that look edible.
- Use plastic or silk mistletoe rather than real - it's toxic if eaten.
- Avoid confusing, blinking lights.
- Do not leave lighted candles or fireplaces unattended.
Additional tips for preparing those who will be visiting a loved one with Alzheimer's this holiday season are available on the Emeritus website.
Source
Emeritus Senior Living
Confusion Surrounds Medicare Wheelchair Policies; AAHomecare Sponsors Workshop And Webinar To Find Answers
Even though the Medicare National Coverage Determination for Mobility Related Equipment was revamped in 2005, many providers and suppliers continue to be perplexed by complex policy requirements and strict protocols for physician and clinician documentation using the algorithmic approach to qualify the appropriate level of Mobility Assistive Equipment (MAE). Additionally, recent audit outcomes in Jurisdiction A and B highlight the need for targeted education to insure future provider and supplier compliance.
The American Association for Homecare is jointly sponsoring a workshop and online webinar with the University of Pittsburgh Medical Center called "Best Practices and Clinical Documentation for Mobility Assistive Equipment" on May 29, 2008 from 1:00 p.m. to 5:00 p.m. The workshop will take place at the University of Pittsburgh in Pittsburgh, Pa.
"This is the first national program on MAE documentation to take participants through a virtual physician evaluation and clinical assessment documentation process," said Tyler J. Wilson, president of the American Association for Homecare.
Dr. Paul Hughes, medical director for Region A of the National Health Information Center, will present, along with Dr. Brad Dicianno, medical director of the Center for Assistive Technology and assistant professor in the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh Medical Center. Other speakers include Mark Schmeler, Ph.D., OTR/L, ATP, instructor and director of the Continuing Education Program in the Department of Rehabilitation Science & Technology at the University of Pittsburgh, as well as Georgie Blackburn, vice president of government relations and legislative affairs for BLACKBURN'S and rehab team leader for the Jurisdiction A durable medical equipment Medicare administrative contractor Advisory Council to Dr. Paul Hughes.
The registration fee of $250 per person includes CME or CEU credits. For further information please contact Kim Kianka at 703-535-1887 or visit aahomecare.
The American Association for Homecare (AAHomecare) represents providers of durable medical equipment and related services and supplies as well as equipment manufacturers. AAHomecare members serve the medical needs of millions of Americans who require home oxygen equipment, wheelchairs and other mobility products, hospital beds, medical supplies, inhalation drug therapy, home infusion, and other medical equipment, therapies, services, and supplies delivered in the patient's home. AAHomecare's provider members operate more than 3,000 home care locations in all 50 states.
American Association for Homecare
The American Association for Homecare is jointly sponsoring a workshop and online webinar with the University of Pittsburgh Medical Center called "Best Practices and Clinical Documentation for Mobility Assistive Equipment" on May 29, 2008 from 1:00 p.m. to 5:00 p.m. The workshop will take place at the University of Pittsburgh in Pittsburgh, Pa.
"This is the first national program on MAE documentation to take participants through a virtual physician evaluation and clinical assessment documentation process," said Tyler J. Wilson, president of the American Association for Homecare.
Dr. Paul Hughes, medical director for Region A of the National Health Information Center, will present, along with Dr. Brad Dicianno, medical director of the Center for Assistive Technology and assistant professor in the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh Medical Center. Other speakers include Mark Schmeler, Ph.D., OTR/L, ATP, instructor and director of the Continuing Education Program in the Department of Rehabilitation Science & Technology at the University of Pittsburgh, as well as Georgie Blackburn, vice president of government relations and legislative affairs for BLACKBURN'S and rehab team leader for the Jurisdiction A durable medical equipment Medicare administrative contractor Advisory Council to Dr. Paul Hughes.
The registration fee of $250 per person includes CME or CEU credits. For further information please contact Kim Kianka at 703-535-1887 or visit aahomecare.
The American Association for Homecare (AAHomecare) represents providers of durable medical equipment and related services and supplies as well as equipment manufacturers. AAHomecare members serve the medical needs of millions of Americans who require home oxygen equipment, wheelchairs and other mobility products, hospital beds, medical supplies, inhalation drug therapy, home infusion, and other medical equipment, therapies, services, and supplies delivered in the patient's home. AAHomecare's provider members operate more than 3,000 home care locations in all 50 states.
American Association for Homecare
Gerontological Society Of America Awards New Hartford Doctoral Fellowships
Eight outstanding doctoral students have been chosen as the newest recipients of the prestigious Hartford Doctoral Fellowship in geriatric social work. The program is funded by the John A. Hartford Foundation, administered by The Gerontological Society of America, and directed by Dr. James Lubben.
Each of the Hartford Doctoral Fellows receive a $50,000 dissertation grant plus $20,000 in matching support from their home institutions, which enables recipients to more fully concentrate on their dissertation research projects over the next two years. Fellows also receive supplemental academic career guidance and mentoring, as well as professional development enabling them to more successfully launch an academic career in gerontology and social work.
Elana Buch
University of Michigan
Joint Program in Social Work & Social Sciences
Dissertation Topic: "Home care quality in practice: A comparison of publicly and privately funded home care"
Avani Shah
The University of Alabama
Psychology Department
Dissertation Topic: "Efficacy of an audio-based cognitive behavioral treatment for depression in older adults"
Kimberly McClure Cassie
University of Tennessee
College of Social Work
Dissertation Topic: "The organizational culture & climate of nursing homes"
Mary Lindsey Smith
University of Pittsburgh
School of Social Work
Dissertation Topic: "Just one more: An examination of the prevalence, correlates, and consequences of concurrent alcohol and medication use in older adults"
Leslie K. Hasche
Washington University in St. Louis
GWB School of Social Work
Dissertation Topic: "Exploring the potential of aging network services to improve depression care for older adults"
Mei Kit Tang
The University of Alabama
School of Social Work
Dissertation Topic: "Cultural values, informal support, and caregiving outcomes among Chinese American caregivers"
Katherina Nikzad
University of Kentucky
Graduate Center for Geronology and the College of Social Work
Dissertation Topic: "Dementia caregiving outcomes: The impact of caregiving onset, role occupancy, and care-recipient decline"
Wanda White
University of California, Los Angeles
Social Welfare
Dissertation Topic: "The intersection of religion, aging, and sexual orientation from the perspective of lesbian older adults
This fellowship program is a component of the nationwide Geriatric Social Work Initiative, which seeks to expand the training of social workers in order to improve the health and well being of older persons and their families. It was created to help social work doctoral students overcome their greatest obstacles, such as limited teacher training and career guidance. These fellowships cultivate the next generation of geriatric social work faculty as teachers, role models and mentors for future generations of geriatric social workers.
Dr. Lubben holds the Louise McMahon Ahearn University Chair at Boston College and is Professor Emeritus at UCLA. A national program advisory committee plays a central role in selecting the Fellows. This year's committee consists of Iris Chi of the University of Southern California, Namkee Choi of the University of Texas at Austin, Ruth Dunkle of the University of Michigan, Jan Greenberg of the University of Wisconsin, Jeanne Marsh of the University of Chicago, Nancy Morrow-Howell of Washington University in St. Louis, and Deborah Waldrop of the State University of New York at Buffalo. Ad hoc members include Barbara Berkman of the Hartford Faculty Scholars Program and Carmen Morano of the Hartford Pre-Dissertation Award Program.
The Gerontological Society of America (GSA), founded in 1945, is the oldest and largest national multidisciplinary scientific organization devoted to the advancement of gerontological research. Its membership includes some 5,000+ researchers, educators, practitioners, and other professionals in the field of aging. The Society's principal missions are to promote research and education in aging and to encourage the dissemination of research results to other scientists, decision makers, and practitioners.
Contact: Todd Kluss
The Gerontological Society of America
Each of the Hartford Doctoral Fellows receive a $50,000 dissertation grant plus $20,000 in matching support from their home institutions, which enables recipients to more fully concentrate on their dissertation research projects over the next two years. Fellows also receive supplemental academic career guidance and mentoring, as well as professional development enabling them to more successfully launch an academic career in gerontology and social work.
Elana Buch
University of Michigan
Joint Program in Social Work & Social Sciences
Dissertation Topic: "Home care quality in practice: A comparison of publicly and privately funded home care"
Avani Shah
The University of Alabama
Psychology Department
Dissertation Topic: "Efficacy of an audio-based cognitive behavioral treatment for depression in older adults"
Kimberly McClure Cassie
University of Tennessee
College of Social Work
Dissertation Topic: "The organizational culture & climate of nursing homes"
Mary Lindsey Smith
University of Pittsburgh
School of Social Work
Dissertation Topic: "Just one more: An examination of the prevalence, correlates, and consequences of concurrent alcohol and medication use in older adults"
Leslie K. Hasche
Washington University in St. Louis
GWB School of Social Work
Dissertation Topic: "Exploring the potential of aging network services to improve depression care for older adults"
Mei Kit Tang
The University of Alabama
School of Social Work
Dissertation Topic: "Cultural values, informal support, and caregiving outcomes among Chinese American caregivers"
Katherina Nikzad
University of Kentucky
Graduate Center for Geronology and the College of Social Work
Dissertation Topic: "Dementia caregiving outcomes: The impact of caregiving onset, role occupancy, and care-recipient decline"
Wanda White
University of California, Los Angeles
Social Welfare
Dissertation Topic: "The intersection of religion, aging, and sexual orientation from the perspective of lesbian older adults
This fellowship program is a component of the nationwide Geriatric Social Work Initiative, which seeks to expand the training of social workers in order to improve the health and well being of older persons and their families. It was created to help social work doctoral students overcome their greatest obstacles, such as limited teacher training and career guidance. These fellowships cultivate the next generation of geriatric social work faculty as teachers, role models and mentors for future generations of geriatric social workers.
Dr. Lubben holds the Louise McMahon Ahearn University Chair at Boston College and is Professor Emeritus at UCLA. A national program advisory committee plays a central role in selecting the Fellows. This year's committee consists of Iris Chi of the University of Southern California, Namkee Choi of the University of Texas at Austin, Ruth Dunkle of the University of Michigan, Jan Greenberg of the University of Wisconsin, Jeanne Marsh of the University of Chicago, Nancy Morrow-Howell of Washington University in St. Louis, and Deborah Waldrop of the State University of New York at Buffalo. Ad hoc members include Barbara Berkman of the Hartford Faculty Scholars Program and Carmen Morano of the Hartford Pre-Dissertation Award Program.
The Gerontological Society of America (GSA), founded in 1945, is the oldest and largest national multidisciplinary scientific organization devoted to the advancement of gerontological research. Its membership includes some 5,000+ researchers, educators, practitioners, and other professionals in the field of aging. The Society's principal missions are to promote research and education in aging and to encourage the dissemination of research results to other scientists, decision makers, and practitioners.
Contact: Todd Kluss
The Gerontological Society of America
Health Net Shares Tips For Family Caregivers In Honor Of National Family Caregivers Month
The beginning of November marks the start of National Family Caregivers Month, which is sponsored by the National Family Caregivers Association. In support of this annual awareness effort, Health Net, Inc. (NYSE: HNT) is sharing tips to help caregivers take care of themselves so they better help the ones they love.
Approximately 15 million Americans provide care for others. They spend at least part of their day - before or after work - assisting parents, family members or friends who need help in order to remain living in their own homes. It can be a difficult task. It's even harder if you are one of the "Sandwich Generation" - caring for your parents while caring for your children, too.
If you feel stuck in the middle of caregiving, the U.S. Administration on Aging (AOA) offers the following suggestions:
1. Ask for help. Siblings, cousins and other family members can help share the load. You don't have to go it alone. Neighbors and friends may be willing to provide transportation or respite care or take on shopping duties.
2. Tap existing resources. Ask about resources in your company that provide caregiving assistance. Many companies offer free or low-cost assistance programs to help ease the burden. Visit your local area's Agency on Aging. They often have services that can help with everything from transportation to legal assistance. Also, Eldercare Locator helps track down resources. The AOA also has a helpful web page aoa/AoARoot/Elders_Families/.
3. Talk to Other Caregivers. Do you want to share ideas and strategies? Ask for support during a difficult moment? Help someone solve a problem? Then check out Family Caregiver Alliance's Online Caregiver Support Group. It might fit your needs. Visit Caregiver.
4. Empower the person you care for to be independent. Understand that caregiving does not mean doing everything for someone. Letting care recipients help themselves boosts self-worth. Many new technologies are available to support mobility needs.
5. Know your options for home health care. Churches, temples, senior employment services, senior centers and other agencies often coordinate care options and volunteer workers. Ask about the resources that may be available.
6. Take care of yourself, too. Studies show that caregivers who take care of their own needs are happier and healthier, and so are their charges. Treat yourself right. Give yourself quality time apart from caregiving.
"With the 2010 Medicare Annual Election period beginning November 15, 2009, your elderly friends or parents may ask for help in deciding which Medicare plan to choose," said Scott Kelly, chief Medicare officer of Health Net, Inc. "Having the right information on the 'four Cs' - cost, convenience, customer service and coverage - makes the decision making process easier and less stressful."
Caregivers are constantly dealing with stress, not only because of new demands in their day-to-day lives but also because of the increased sense of responsibility in caring for older family members.
"Helping aging parents make important financial and health care decisions creates much pressure and stress. The decisions we might make for ourselves may not be the ones our parents would make, and the differences need to be reconciled," said Dr. Ian Shaffer, chief medical officer of MHN, the behavioral health subsidiary of Health Net, Inc. "It's essential that caregivers attend to their own well-being, because ongoing stress can lead to depression, caregiver burnout and physical health problems."
For more information on Health Net's Medicare Advantage plans, visit abetterdecision. You also can visit medicare for information Medicare plans. Don't forget to get ideas and support from other caregivers. For more information on caregiving, go to aoaor eldercare.
Source
Health Net, Inc.
Approximately 15 million Americans provide care for others. They spend at least part of their day - before or after work - assisting parents, family members or friends who need help in order to remain living in their own homes. It can be a difficult task. It's even harder if you are one of the "Sandwich Generation" - caring for your parents while caring for your children, too.
If you feel stuck in the middle of caregiving, the U.S. Administration on Aging (AOA) offers the following suggestions:
1. Ask for help. Siblings, cousins and other family members can help share the load. You don't have to go it alone. Neighbors and friends may be willing to provide transportation or respite care or take on shopping duties.
2. Tap existing resources. Ask about resources in your company that provide caregiving assistance. Many companies offer free or low-cost assistance programs to help ease the burden. Visit your local area's Agency on Aging. They often have services that can help with everything from transportation to legal assistance. Also, Eldercare Locator helps track down resources. The AOA also has a helpful web page aoa/AoARoot/Elders_Families/.
3. Talk to Other Caregivers. Do you want to share ideas and strategies? Ask for support during a difficult moment? Help someone solve a problem? Then check out Family Caregiver Alliance's Online Caregiver Support Group. It might fit your needs. Visit Caregiver.
4. Empower the person you care for to be independent. Understand that caregiving does not mean doing everything for someone. Letting care recipients help themselves boosts self-worth. Many new technologies are available to support mobility needs.
5. Know your options for home health care. Churches, temples, senior employment services, senior centers and other agencies often coordinate care options and volunteer workers. Ask about the resources that may be available.
6. Take care of yourself, too. Studies show that caregivers who take care of their own needs are happier and healthier, and so are their charges. Treat yourself right. Give yourself quality time apart from caregiving.
"With the 2010 Medicare Annual Election period beginning November 15, 2009, your elderly friends or parents may ask for help in deciding which Medicare plan to choose," said Scott Kelly, chief Medicare officer of Health Net, Inc. "Having the right information on the 'four Cs' - cost, convenience, customer service and coverage - makes the decision making process easier and less stressful."
Caregivers are constantly dealing with stress, not only because of new demands in their day-to-day lives but also because of the increased sense of responsibility in caring for older family members.
"Helping aging parents make important financial and health care decisions creates much pressure and stress. The decisions we might make for ourselves may not be the ones our parents would make, and the differences need to be reconciled," said Dr. Ian Shaffer, chief medical officer of MHN, the behavioral health subsidiary of Health Net, Inc. "It's essential that caregivers attend to their own well-being, because ongoing stress can lead to depression, caregiver burnout and physical health problems."
For more information on Health Net's Medicare Advantage plans, visit abetterdecision. You also can visit medicare for information Medicare plans. Don't forget to get ideas and support from other caregivers. For more information on caregiving, go to aoaor eldercare.
Source
Health Net, Inc.
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