We've written about hospital infection rates before, indicating that sepsis and pneumonia killed 48,000 patients and added $8.1 billion to heath care costs in 2006 alone. And a current news story about famous 93-year-old Hungarian actress Zsa Zsa Gabor making headlines illustrates this tragic circumstance we see all too often, as she has developed an infection while in the hospital after having surgery on a broken hip.
Medicare data shows that nearly 1 in 5 patients who leave the hospital are re-admitted within the next month and that even more than 75% of these re-admissions are preventable. The top reasons for 30-day hospital re-admissions?
- 78% non-compliance with lifestyle recommendations
- 73% failure to take their medications correctly, given regimen changes
- 68% patient not properly directed to home health services
- 66% lack of follow-through on care/tests from shift to shift
- 57% failure of doctors to encourage home health
And while you can't always control whether or not you or your loved one must remain the hospital, there are things you can do to ensure hospital re-admittance is mitigated with these simple rules of thumb:
- Ensure that you or your loved one is following your medication plan
- Make transportation available so that you or your loved one is able to attend follow-up appointments, therapy, tests, etc.
- Make sure lifestyle changes are being reinforced
- 24/7 contact between physician, caregiver and patient
- Good communication - make sure your needs or the needs of your loved one are being met
If you're a parent, your children are your life. And if you're like most parents, you become an expert on anything relating to
childcare, your children's health and wellbeing, whether it's a tiny scrape or
special needs requiring skilled care. Sometimes this can be fairly simple, black and white almost. But what about gray area? When I talk about "gray area,"
autism stands out. Lately, it seems that there is so much published on this condition lately (still mostly speculative), it could make every parent's head spin.
One recent study published in the journal Autism Research suggests that an intricate equation may exist between the age of both the mother and father, as reported by Roni Caryn Rabin in the Times. Older mothers are more likely than younger ones to have a child with autism, and older fathers significantly contribute to the risk when their partners are under 30. Researchers analyzed almost five million births in California during the 1990s, and 12,159 autism cases were diagnosed in those children. This sample was large enough to examine how the risk of autism was affected when one parent was a specific age and the other was the same age or considerably older or younger.
Previous research found that the risk of autism grew with the age of the father. But the new study suggests that when the father was over 40 and the mother under 30, the increased risk was especially pronounced - 59 percent greater than for younger men. And every five-year increase in a mother's age raised her risk of having a child with autism by 18 percent.
We've all heard those sayings - "Home is where the heart is" and the like. Judy Garland even proclaimed this sentiment in the classic movie The Wizard of Oz ("There's no place like..." well, you know the rest). Despite these common adages, when something goes wrong with our health, there is something about hospitals that seems to make us feel safe and secure (and for good reason). Hospitals are often necessary when we face challenges with our health, but what does homecare potentially have on hospital stays?
According to a Wall Street Journal article, a recently published study indicates that sepsis and pneumonia, two infections that can often be prevented with tight infection control practices in hospitals, killed 48,000 patients and added $8.1 billion to heath care costs in 2006 alone. The article goes on to say that researchers analyzed 69 million discharge records from hospitals in 40 states between 1998 and 2006; the length of stay and mortality rates for the infections didn't change substantially over time, the study found, and high infection rates persist. Click here to read more.
One study by UCLA researcher Teresa E. Seeman, PhD, and colleagues, as reported on by WebMD, indicates a new trend among aging Baby Boomers: disability. The findings indicated that one in five 60-somethings need help with basic daily activities -- up from 13% just a decade ago. Various disabilities are up 40% to 70% in 60- to 69-year-olds.
"Our results have significant and sobering implications," Seeman and colleagues say. "To the extent that persons currently aged 60 to 69 years are harbingers of likely disability trends for the massive baby-boomer generation, the health care and assistance needs of disabled older Americans could, in the not so distant future, impose heavy burdens on families and society."
The article went on to say that, compared with those surveyed in 1988-1994, 60-somethings surveyed in 1999-2004 were:
- 70% more likely to have difficulty walking from room to room, getting in and out of bed, and/or eating and dressing.
- 70% more likely to have difficulty doing chores, preparing meals, and/or managing money
- 50% more likely to have difficulty walking a quarter mile and/or walking up 10 steps without rest
- 40% more likely to have difficulty stooping, crouching, or kneeling; lifting or carrying 10 pounds; and/or standing from an armless chair.
According to the National Family Caregivers Association, more than 50 million Americans provide care for a chronically ill, disabled or aged family member or friend during any given year, and that number is growing. Adult children are often first in line to care for their aging parents. Many of those adult children are still raising children of their own, making an entire "Sandwich Generation" of family caregivers. But given these new findings, is the sandwich generation already too stretched? What do you think?
We recently published the results of a survey conducted by BrightStar owner Lynn Berberich indicating that more than 40 percent of hospital case managers may only provide information regarding private duty in-home care services if it is requested by the patient at discharge. Now, two-thirds of seniors will need some form of long-term care at some point in their lives, according to this study, and in-home care is a viable option.
Elizabeth E. Hogue, attorney and author of a recent article, Private Duty Home Care Services and Patients' Right to Freedom of Choice of Providers, weighs in: "From a legal point of view, discharge planners/case managers must comply with Conditions of Participation (COP'S) that govern hospitals. Specifically, discharge planners/case managers are required to develop appropriate discharge plans, if necessary, for all patients. Development of appropriate discharge plans undoubtedly includes private duty home care services for patients who may benefit from them."
And many patients are benefiting from them. U.S and World Report indicates that an estimated five million North Americans suffer from the heart disease. According to a recent study, given they are seeking the appropriate treatment for their condition, patients with chronic heart disease fare better in the home. Remaining in the comfort and familiarity of your own home can also help to alleviate stress and loneliness that can occur when moving to a new environment.
Adults, seniors, men, women - patients from just about every walk of life can and do develop chronic heart disease, a condition in which it is increasingly difficult for the heart to pump oxygen-rich blood throughout the body. In fact, cardiovascular disease is the leading killer of U.S. women, and there's a growing recognition that heart attack risk increases after menopause. Some say that we aought to pay more attention to heart attack risk for younger women as well.
According to the WSJ Health Blog, in recent decades, heart-attack risk rose for women aged 35 to 54, even as it fell for men in the same age group (Archives of Internal Medicine). Prevalence is still much higher for men in that age group than in women, but this change, many say, is cause for concern. Read more here.
So what is the answer - what can be done to prevent the onset of heart disease? Is legislation to tax fattening foods the solution? Or do we take our health into our own hands and live healthy lifestyles? Weigh in now!
According to AARP, 82% of people would like to remain in the comfort and familiarity of their own homes for as long as they are able. But according to a recent survey, more than 40 percent of hospital case managers may only provide information regarding private duty in-home care services if it is requested by the patient at discharge. The results of this survey indicate that more Mid-Atlantic residents should be provided with in-home care information in order to fully recover from their hospital stay.
The survey was completed by hospital case managers in attendance at 7th Annual ACMA Maryland Chapter of Hospital Case Management Conference, held on September 26, 2009 in Columbia, Maryland. The survey found that 54 percent of Mid-Atlantic hospital case managers discharge 6-25 patients per week. While the majority of survey participants responded that they do not provide their patients with information on in-home and follow-up care, 24 percent always provide information to their patients upon discharge, regardless if they know that the patient can afford such care. Sixteen percent of the survey respondents stated that they only provide referrals if they know that the patient can afford this care.
When selecting which private duty homecare agency to refer a patient to, hospital case managers ranked the following criteria from most to least importance:
1. Ability to provide a caregiver on short notice
2. Feedback from the patient or family on the last referral
3. Ability to always provide the entire referral list to the patient
4. RN on staff to supervise and develop the plan of in-home care
5. Ability to coordinate with Medicare agencies
6. Availability when called
Lynn Berberich, BrightStar Baltimore homecare provider, who provides homecare and medical staffing in Baltimore County, was surprised by the survey results. "A very large portion of private duty in-home care is not paid for by the patient," Berberich stated. "It is the family members who individually or as a group pay for the care of their loved one and it is important for all patients who are discharged from the hospital to consider continued in-home care."
According to a Rand Corporation study released in 2005, patients who underwent hip and knee replacements were less likely to end up in more costly institutions when they were discharged directly from the hospital to homecare after surgery. The study also revealed that home-based rehabilitation saved patients $3,500 to $8,000 per episode over similar treatment provided by skilled nursing or inpatient rehab. "The results of the BrightStar survey show that more patients who have been hospitalized... may not be receiving the proper information about in-home care services to fully recover," stated Barnett Lloyd, BrightStar Rockville homecare provider.
A recent study, reported on by TechXav, indicated that spending time on the Internet can help slow the effects of dementia by boosting the brain activity of the elderly. Using brain scans, a team at the University of California, Los Angeles (UCLA) found that using the Internet stimulated the mind more strongly than reading, with effects that continued long after an Internet session had ended.
So what was going on here? For seniors who did not usually surf the Web, the use of the Internet was found to change brain activity patterns and enhance function. We all know that the Internet can be a helpful resource, but that there are mental benefits is such a compelling finding. So what else can the Internet and modern technology do for the aging population?
- Blogtastic goodness. Socializing is so important as we grow older. So much, in fact, that some studies have even indicated that there is a direct correlation between strong social ties and lifespan. Blogging and social media tools like Facebook are helping seniors to connect with others and express themselves from the comfort of their own home.
- "Visiting" loved ones (without the travel). Technology is making the world smaller by the day, making keeping in touch with family and friends who live far away simple. Tools like Skype and webcams are helping to bring people together from afar through video, while photo sharing sites like Facebook and Flickr have the same effect but with photos.
- Accessible fitness. Put down those dumbells, folks - with the advent of tools like Wii, technology has made personal fitness more accessible and, quite frankly, more fun and engaging.
- Virtual insanity... but in a good way. Talking walking frames, robopets and interactive coffee tables are some of the technologies that could keep older people living at home for longer. Some of these may seem strange now, but think about it: years ago, did you ever imagine seniors using video games for fitness and blogging on the Internet?
There are so many ways that technology is helping seniors to live healthy, social lives and remain independent longer. Are we missing something that you or someone you know is using? Share your stories!
Adults, seniors, men, women - patients from just about every walk of life can and do develop chronic heart disease, a condition in which it is increasingly difficult for the heart to pump oxygen-rich blood throughout the body. A new study has indicated what we've seen for years - given they are seeking the appropriate treatment for their condition, patients with chronic heart disease fare better at home versus the hospital.
According to U.S and World Report, an estimated five million North Americans suffer from the disease, and this number is undoubtedly to the growing prevalence of obesity and diabetes. In the United States, worsening chronic heart failure is the cause of more than one million hospital admissions a year, and patients have a 50 percent risk of readmission within six months of discharge, according to the authors of a study published in the Sept. 28 issue of the Archives of Internal Medicine.
We want to hear from you! What are the greatest factors contributing this finding? Why do heart disease patients benefit from being treated in their homes rather than the hospital?