Nursing home rule decried

From Press-Telegram:

...a recent Bush administration change in
federal rules on nursing home inspections makes it nearly impossible
for others to do the same, say opponents of the federal action.

Put into effect in October with little notice and without a
public comment period, the federal move is getting sharp criticism for
closing off what advocates call crucial information....

Officials at the Department of Health and Human
Services said employees have been too burdened by requests for
information. Under the rule change, state employees who inspect nursing
homes for the federal government are reclassified as federal employees
who aren't allowed to provide "privileged" information or documents to
the public without approval from the head of the Centers for Medicare and Medicaid Services....

For More....

Associations among nurse and certified nursing assistant hours per resident per day and adherence to guidelines for treating nursing home-acquired pneumonia

From PHI:

This study finds that certified nursing assistant (CNA) hours per day
were significantly associated with better pneumococcal and influenza
vaccination rates and that a greater than 70 percent turnover was
inversely related to timely physician notification. The authors
conclude that a nursing home's ability to implement evidence-based care
may depend on adequate staffing ratios and stability.

For More....

Dementia Caregiver Gifts - Five Different Ideas

From The Dementia Caregiver's Toolbox:

Dementia caregivers may seem to be difficult people to shop for because
their lives are so tied up in caregiving responsibilities.  Yet this
characteristic gives you many great gift ideas to help them balance
their caregiving with some needed attention to themselves.  Here are a
few simple ideas:

For More....

Senator Tom Daschle - What's He Said About Long Term Care by Steve Gold

From Justice for All blog:

President-elect
Barack Obama has nominated former Senator Tom Daschle to be Secretary
of the U.S. Department of Health and Human Services.  His book
"CRITICAL - What We Can Do About the Health-Care Crisis," (Thomas Dunne
Books, St. Martin's Press, 2008) is quite important for advocates of
the disability and elderly communities.  Below are some relevant portions of the book.....

Here's what he writes about "long-term care," which he recognizes as a "troubling area - and the only one in which we spend less compared to peer nations." 
Medicaid "is fundamentally geared toward institutional care, even
though most elderly people prefer to receive care at home or in more
personalized community settings."

Daschle quotes Professor David Mechanic who calls "long-term
care' the stepchild of our health-care system'," which "vividly
exhibits our system's inability to deal with chronic conditions in an
integrated way."

For More...

New national nursing home rating system compares care

From Freep:

More than one in five of Michigan's 417 nursing homes
received failing grades for good care, staffing and deficiencies cited
in state inspections, according to a groundbreaking new system unveiled
today by the federal government's Medicare agency.The www.medicare.gov/nhcompare site will be updated four times a year.....

Sixteen nursing homes in tri-county metro Detroit received top
grades. Marywood Nursing Care Center, a small, nonprofit Livonia
nursing home and assisted living center with 117 beds, got the highest
scores in the tri-county area.

For a complete list of Michigan facilities and their scores, go to www.freep.com/data.cq-anstett
Thirty-three other nursing homes in tri-county metro Detroit got the
lowest scores, including five Heartland facilities in Bloomfield Hills,
Grosse Pointe Woods, Dearborn Heights and Livonia that are part of HCR
ManorCare of Toledo. Livonia has two Heartland facilities....

For More.....

New Bill Strengthens Workforce Training

From PHI:

New legislation introduced by the U.S. Senate Special Committee on
Aging looks to strengthen the direct-care workforce in preparation for
an older America. It joins several other bills likely to be
reintroduced early next year for consideration by

the incoming Congress, including the Empowered at Home Act that seeks to increase access to home and community based services, the Caring for an Aging America Act that would expand career ladder programs for direct-care workers and other caregivers, and the Promoting Small House Nursing Homes Act.

For More.....

Link Between Interruptions In Medicaid Coverage And Increased Hospitalization

From Medical News Today:

Interruptions in Medicaid coverage are associated with a higher rate of
hospitalization for conditions that can often be treated in an
ambulatory care setting, including asthma, diabetes, and hypertension,
according to a new study in today's issue of the Annals of Internal Medicine.
The analysis, which examines interrupted Medicaid coverage and
hospitalization rates, finds that increased risk for hospitalization is
highest in the first three months after an interruption in Medicaid
coverage.


The study suggests that when states require enrollees to demonstrate
eligibility on a more frequent basis, they may see an increase in
hospitalizations for common health conditions: lacking insurance to
cover the costs of primary care, many former Medicaid enrollees end up
in hospitals and are then re-enrolled in Medicaid.

For More.....

Dynamic Electronic Tracking And Care Coordination Tools Save Lives Of Seniors, Study Finds

From Medical News Today:

Can a patient-centered, care management program utilizing nurse care
managers and interdisciplinary teams, supported by electronic tracking
and care coordination systems reduce the rate of deaths and
hospitalizations among chronically ill older adults? The answer - based on a three-year study involving more than 3,400
chronically ill seniors led by Oregon Health & Science University
researcher David A. Dorr, M.D. - appears to be "yes."


For More.....

The Future of Elder Care: Part 1: Elder Cohousing

From The Senior List:

In my work with families who are placing a loved one in a care
community, I am often asked about the future of long term care. Many
people I talk with are uncomfortable with the concept of long term care
for themselves but think it’s adequate for their parents. I have good
news and bad news: There is an alternative to long term care options
known as Elder cohousing, but don’t expect it to show up in your
neighborhood anytime soon...

There are three
elder cohousing projects that have been completed in the US. The three
lucky states are Virginia, California, and Colorado. To date, there are
eight elder cohousing projects actively underway according to
Eldercohousing.org. Some communities are spearheaded by a group of
friends or neighbors; others are formed by a few members who then
recruit other future “neighbors” for investment and participation.

For More....

Parkinson's Patients Deserve Choice in Their Healthcare

From Care2:

Many Americans diagnosed with Parkinson's disease or other chronic
illnesses are able to stay at home for years with support before they
have to go into personal care or nursing homes. They simply need help
in housekeeping, shopping or gardening services....

The Community Choice Act of 2007 will fix this broken system
and give victims of chronic illness, like Parkinson's, more choice and
independence. Americans should have choices when it comes to long-term care. Urge your representatives to co-sponsor the Act today!

For More....

NATIONAL WAITING LIST INFORMATION for Medicaid 1915 ( c ) HCBS Waivers

From Kaiser:

By State and by Enrollment Group, 2007

        (SUMMARY
of Kaiser Commission and UCSF Information)

 

Total # of Waivers –
277         1,239,939 Enrollment Slots

Total # of Waivers with
Waiting Lists - 106

Total # of People
Waiting – 331,689

 

   MR/DD                                100 Waivers

                         
                          508,031 people on the waivers

                           
                         52 waivers have Waiting Lists
- (224,147 people)

 

   AGED                                      21 Waivers

                                                 
    155,642 people
on the waivers

                                                    
  3 waivers have Waiting Lists - (6,343
people)

 

  AGED/DISABLED                 62
Waivers

                                               463,726 people on the waivers

                                                     
 22 waivers have Waiting Lists - (80,995
people)

 

PHYSICALLY DISABLED     28
Waivers

                                                        60,736
people on the waivers

                                                       
11 waivers have Waiting Lists - (2,600 people)

 

CHILDREN                                
27 Waivers

                                       
                 16,735 people on the
waivers

                                                          
9 waivers have Waiting Lists - (16,099 people)

 

HIV/AIDS                                   
15 Waivers

                                                         
20,419 people on the waivers

                                                         
-0- Waiting Lists

 

MENTAL HEALTH                   
1 Waiver

                                                          
1,900 waivers on the waivers

                           
                               -0- Waiting
Lists

 

TBI/SCI                                         
23 Waivers

                                                         
12,750 people on the waivers

                                                          
  9 waivers have Waiting Lists - (1,505
people)

 

PHI Issue Brief: Invest in LTC Workforce to Boost Economy

From PHI:

PHI has released an issue brief called Direct-Care Jobs & Long-Term Care: Untapped Engine for Job Creation & Economic Growth that outlines how direct-care jobs are uniquely positioned to help repair and stabilize America’s economy.

• Download the issue brief (pdf)
• View the press release
• Listen to the podcast

For More....

Worker-owned Home Care Business Featured in Philly

From PHI:

They call it “heartwork,” because “if you don’t do it from the heart, it makes it hard to do,” Terrell Cannon recently told a Philadelphia Inquirer columnist about the role of a direct-care worker.

Cannon was featured in a recent column called “While helping others, investing in themselves,”
which examined the recent bailout of U.S. automakers in contrast to
Home Care Associates, a Philly-based employee-owned cooperative and
affiliate of PHI....

For More...

Cholinesterase inhibitors reduce aggression, wandering and paranoia in Alzheimer's disease

From Caring Kay b.:

Cholinesterase inhibitors, used to treat cognitive
symptoms of Alzheimer's disease, are also a safe and effective
alternative therapy for the behavioral and psychological symptoms of
dementia, according to a study that appears in the December 2008
edition of Clinical Interventions in Aging.

Investigators
from the Indiana University School of Medicine, the Regenstrief
Institute and Wishard Health Services reviewed nine randomized,
double-blind, placebo-controlled clinical trials evaluating the
effectiveness of three popular cholinesterase inhibitors in managing
behavioral and psychological symptoms displayed by patients with
Alzheimer's disease.

The researchers
report that the trial results indicate cholinesterase inhibitors led to
a statistically significant reduction in behavioral and psychological
symptoms such as aggression, wandering or paranoia when using the same
dosage as administered for improving cognitive impairment.

EurekAlert > full article

Process will allow review of rejected long-term care claims

From Desmoines Register:

If an elderly Iowan can no longer feed or dress herself, but her
insurance company rejects her claim for long-term care benefits, there
will soon be a new way to fight that decision.

A new independent review process kicks in Jan. 1.

The
process is considered a national model by advocates elsewhere, and an
Iowa lawmaker hailed it Tuesday as a victory for consumers.

Iowans
will pay only $25 to have an independent reviewer with medical
expertise examine their cases. If the reviewer sides with the consumer,
that decision is final...

For More...

Boone says nearly all nursing home deaths probed

from The State Journal-Register:

Sangamon County Coroner Susan Boone says she and her staff investigate
virtually all of the deaths of nursing home residents in the county,
there are indications that some deaths may have escaped Boone’s
scrutiny.



Illinois doesn’t require all nursing home deaths to be investigated by coroners or anyone else.



Boone, who has been coroner since 1996, said her office receives notification from nursing homes of 90 to 200 deaths per year....

For More....

Arkansas coroner sees ‘deterrent effect’ at nursing homes

from The State Journal-Register:

A 1999 state law that requires all Arkansas nursing homes to notify the
local coroner whenever a resident dies has reduced the number of
bedsores and accidental deaths in the facilities, according to the
coroner in Arkansas’ largest county.



The investigations are having a “deterrent effect,” said Garland
Camper, coroner in Pulaski County, which includes the city of Little
Rock.



However, Camper said his view of the law’s effect is based on anecdotal reports. No comprehensive studies have been done.....

For More....

Panel Urges More Screening of Brain Injury in Troops

From NY Times:

A long-awaited government report is calling on the military to test all
new recruits for cognitive skills and then do large-scale studies of
returning combat veterans to better evaluate and respond to traumatic brain injury, the signature wound of the Iraq war.

For years, veterans’ advocates and researchers have called for more
careful investigation of head injuries — not just severe wounds but
also “closed head” injuries, which do not produce visible damage and do
not show up on CT scans.

Some doctors and veterans say the high
blast impact of I.E.D.’s, the roadside explosives that have accounted
for most head injuries to troops in Iraq, may be creating symptoms that
differ from the sort of concussions suffered in sports or car accidents. Many veterans have complained of persistent, sometimes disabling symptoms like sleeplessness, dizziness and confusion that can resemble disorders like post-traumatic stress and can complicate disability assessments....

For More...

Crimes by Elders Linked to LTC in Japan

from PHI:

Japan is now where the US is heading in terms of a significant
shortage of long-term care workers. A recent highly publicized elder
crime spree in Japan provides a shocking example of what can happen
when governments don’t pay enough attention to social infrastructure.

Several news agencies, looking at Japanese government statistics
released last month, have reported that while the 65-and-older
population in Japan has doubled in the past two decades, crime among
the elderly has increased fivefold in a country long considered to be
safe....

For More...

Bob Kerrey’s Op-Ed on Boomer Care

from PHI:

This year the first Baby Boomers started receiving Social Security
benefits. In 2011, they  will become eligible for Medicare — a system
most believe will pay for their long-term care needs.

This is false hope, says Bob Kerrey, a former Nebraska Senator and president of The New School in New York City, who recently wrote a Chicago Tribune opinion piece on the long-term care crisis facing the Baby Boomer generation.

“They are wrong. Just as they were wrong to believe they had plenty
of savings tucked away in the value of their homes and 401(k)
accounts,” he writes.....

For More....

Is Your Long-Term Care Policy Safe?

From US news & World Report:

Conseco's move earlier this month to shift roughly 150,000 of its
older long-term care policies to a trust overseen by Pennsylvania
insurance regulators is a shocker.

Notwithstanding a comforting letter to affected policyholders from
C. Everett Koop, former U.S. surgeon general, the jettisoning by
Conseco of a longtime money-losing book of business means that the
policies are now self-funding and can no longer look to Conseco to
provide financial support.....

Older LTC policies have been an industry problem. Many were sold years
ago when the concept of long-term care insurance was relatively new.
With scant actuarial evidence about ultimate policy costs, the industry
in general badly underpriced the early policies. Over time, LTC
policyholders have exhibited sustained longevity gains, meaning
policyholders are living longer than expected and posting
correspondingly higher claims for their LTC policies....

For More...

Vets' Brain Injuries Linked To Long Term Health Problems

from Medical news Today:

A report by a non-profit US medical organization suggests that military
personnel who suffer severe or moderate traumatic brain injury (TBI)
are at greater risk of long term health problems including
Alzheimer's-like dementia, aggression, symptoms similar to Parkinson's
disease, depression, and memory loss.


Titled "Gulf War and Health: Volume 7: Long-Term Consequences of
Traumatic Brain Injury", the report is published by the National
Academies press and compiled by a committee of experts working under
the auspices of the Institute of Medicine. The study was funded by the
US Department of Veteran Affairs....

For More...

Expert: Long-term care health coverage a hidden casualty of economic slide

From physorg.com:

Many Americans have lost more than just retirement savings amid a
year-long economic meltdown that has sliced the U.S. stock market's
value by nearly half in a little over a year, a University of Illinois
elder law expert says....

"This is a wake-up call for
people who were willing to use their own resources for long-term care
expenses, figuring that they'd never outlive their savings," he said.
"The point is that now, after a 45 percent drop in the stock market,
they just might."



With the market-driven decline in the value of retirement assets,
many older Americans may be taking a second look at long-term-care
insurance, Kaplan said.



"But that insurance is a risky product that has only gotten riskier
in the last few months," said Kaplan, who wrote a 2007 paper that
appeared in the Lewis & Clark Law Review calling long-term health-care needs the greatest gap in retirement planning.



"Nothing has happened since then to make people more comfortable
with this product," he said. "What has changed is that people may need
to consider it because their other investments have declined in value.
But long-term-care insurance is even riskier today than it was just a
year ago."



Hefty premium increases for existing policyholders that have long
been charged by smaller insurers are now surfacing among the industry's
very largest companies, he said. Three leading insurers – Genworth
Financial, John Hancock and MetLife – had never before raised premiums
for existing policyholders, but recently bumped rates by as much as 18
percent, he said.



Those rate increases come as policyholders grow older and may have
no realistic alternative to paying higher rates, said Kaplan, a member
of the National Academy of Social Insurance.


For More...

Pressure Ulcers Increasing Among Hospital Patients, AHRQ, USA

from Medical News Today:

Hospitalizations involving patients with pressure ulcers- either
developed before or after admission - increased by nearly 80 percent
between 1993 and 2006, according to the latest News and Numbers from
the Agency for Healthcare Research and Quality.

For More...

CMS reminds Part D providers of obligations to nursing home residents

From McKnight's:

The Centers for Medicare & Medicaid Services recently reminded
Medicare Part D plan providers of their duty to provide convenient
access to network pharmacies for long-term care residents.

For More....

Insurer Casts Off Long-Term-Care Policies

From The Wall Street Journal:

A major insurer has dumped a chunk of its long-term-care policies
into an independent trust, putting tens of thousands of policyholders
at risk of reduced benefits or big premium increases.

Conseco
Inc. officials have said the transfer of many of the insurers'
long-term care policies to a new state-supervised nonprofit trust,
Senior Health Insurance Co. of Pennsylvania, allows it to concentrate
on its core businesses. The policies were a drag on the company's
earnings because they were underpriced and required continuing capital
infusions to meet the long-term needs of policyholders.

For More....

AHCA to Congress: More long-term care nurses needed

from McKnight's:

Congress should enact reforms that bolster the long-term care workforce
and help address the nursing shortage, the American Health Care
Association told lawmakers Monday.

For More....

Autonomy among physically frail older people in nursing home settings: a study protocol for an intervention study.

from 7th Space Interactive:

Experiencing autonomy is recognized to promote health and well-being
for all age groups. Perceived lack of control has been found to be
detrimental to physical and mental health......

DUH!

For More.....

Social Security Holds Third Disability Hearing on Compassionate Allowances

from The Military Family Network:

Experts Provide Testimony on Traumatic Brain Injuries and Stroke

The Social Security Administration, in conjunction with the United
States Department of Defense, held a public hearing on Compassionate
Allowances today at Ft. Myer in Arlington, VA. Senior executives from
the Department of Defense and the National Institutes of Health joined
Michael J. Astrue, Commissioner of Social Security, to hear testimony
from some of the nation’s leading experts on traumatic brain injury,
the signature injury of the conflicts in Iraq and Afghanistan, and
stroke.

“Compassionate Allowances, which we launched last month with an
initial list of 50 conditions, allows us to make disability decisions
on certain categories of cases in a matter of days, rather than months
or years,” said Commissioner Astrue. “Today’s hearing gives us
additional insight into how we might better recognize and fast-track
the disability applications of veterans and others dealing with the
effects of traumatic brain injuries and strokes.”

Compassionate Allowances are a way of quickly identifying
diseases and other medical conditions that invariably qualify under
Social Security’s disability standards based on minimal objective
medical information. Today’s hearing is the third of four public
hearings Social Security plans to hold.

Previous hearings dealt with cancers and rare diseases and
resulted in the nationwide launch of the Compassionate Allowances
initiative in October 2008. See the press release at: http://www.socialsecurity.gov/pressoffice/pr/compassionate-allowances-1008-pr.htm

For More....

Wisconsin A Leader In Pressure Ulcer Initiatives

from Medical news Today:

The Wisconsin Department of Health Services announces that health care
leaders from across the state have formed the Wisconsin Pressure Ulcer
Coalition to help reduce pressure ulcers in Wisconsin's health care
industry, including nursing homes and hospitals.....

The goals of the Wisconsin Pressure Ulcer Coalition are to:


- Decrease the incidence of pressure ulcers in our health care settings

- Continue to educate caregivers and leaders about effective preventive measures

- Improve assessment when an individual is admitted to a health care facility, as well as continue to monitor appropriately

- Develop appropriate prevention strategies within 24 hours if
individual identified to be at risk of developing pressure ulcers

- Improve communication between providers to provide a better continuity of care

for More...

Newspaper Explores LTC Crisis in own Backyard

from PHI:

As the challenge of caring for America’s aging population
intensifies, the issue is beginning to get the increased newspaper
coverage it deserves. Case in point: an in-depth series that has been
offered up from a small daily paper out of Utah (hat tip to The New Old Age).

Gray Area: Utah As It Ages
features sparsely written vignettes examining the lives of elderly
people in Utah when they were young and their current challenges with
aging. Accompanying each story are intimate black and white photos of
wrinkles, smiles, and struggles.

For More...

LETTER OF SUPPORT FOR UNITED CAREGIVERS OF AMERICA

from Gather:

As I write these words thousands upon thousands of elderly people
are being cared for at home, in hospitals, and nursing homes. The
problem is most caregivers lack the proper amount of training and
education to deliver or administer top of the line quality care and
treatment. The nurse aide, home health aide, and family member
caregiver need to be recognized as the most important component in the
long term health care system. They are the ones who make or break the
system. They are the ones who deliver the majority of care to the
patient. Yet they are the ones least recognized and in some cases even
disrespected.

At some point in time all of you reading these
words will be face to face with a basic caregiver. And you better hope,
for your sake, they know what they are doing. For they are the ones who
hold the key to your survival. They are the ones in control of your
care. And in many cases they will be the ones fighting for your life
(or not). How do you know a good caregiver from a bad caregiver? You
don't.

For More......

Care and support - a community responsibility?

from Joseph Rowntree Foundation:

Any new settlement on long-term care and support must address the apportionment of responsibility for its delivery as well as its funding. With the state's capacity limited and family input likely to decline, the wider community must expect to play a growing role. This offers an opportunity to end social care's marginalisation, argues David Brindle.

Author
David Brindle, The Guardian
Key points

    * Social care has become isolated from mainstream society and its recipients are cut off from their neighbourhoods and from each other.

For More......

Disabled people 'bullied at work'

from guardian.co.uk:

Disabled people are much more likely than the able-bodied to be hit,
injured, bullied and humiliated at work, groundbreaking research for
the Equality and Human Rights Commission will reveal today.

In
the first comprehensive survey of discrimination in the workplace, the
commission found 11.6% of employees with a disability or long-term
illness experienced physical violence at work, compared with 5.5% of
other employees.

It said 8.8% of disabled people sustained an
injury as a result of violence or aggression at work, compared with
4.7% of able-bodied people.

For More.....

Nursing Home Litigation

from InjuryBoard.com:

My, My!!

Nursing home cases in Arkansas present unique problems. Many nursing
homes no longer carry liability insurance and have mortgages and liens
against their assets, making collection of any judgment next to
impossible. After a series of large verdicts here in Arkansas the homes
could no longer afford to carry liability insurance.

My advice in selecting a nursing home for your loved one is to inquire
about their history of lawsuits in the past. One good source is the
Medicare website, Nursing Homes Compare.

New Internet Service Delivers Relief to Families of Those in Long-Term Care

from International Business Times:

COLUMBUS,
Ohio and PHOENIX, Nov. 25 /PRNewswire/ -- There is a newInternet
service available that changes the communication paradigm inlong-term
care. Addressing the family's basic need to stay informed, it
allowslong-term care providers to give them regular proactive wellness
updatesthrough a secure web page, by email and text message without
families havingto call, no matter where they are.

Too much to do and too little time. It's a common problem that takes
onspecial significance for the families of the more than 3.8 million
people inthe U.S. living in Nursing Homes, Assisted Living Facilities
or receiving HomeCare as they struggle to stay up-to-date with the
well-being and needs oftheir loved ones.



"As one of the millions of people in the U.S. with family in
long-termcare," said Neil Moore, founder and chief executive officer
ofConnect4Healthcare, the company that developed the service, "I was
shocked tofind that with all of the technology available to us today,
the only way wecould find out how our loved-ones were doing was to
visit or call the careprovider. Most of us can't do that as often as we
want; our lives are just toohectic."



After spending almost 20 years in the healthcare IT business, Moore
knewhe could do better. "That's why we created Connect for
Healthcare(TM). It'sbecome my personal mission. We (families) want and
need the information; carefor our loved ones is better when we are
better informed, and good careproviders want to communicate with us. It
helps everybody involved."



The Connect for Healthcare(TM) service was developed by the company
withinput from families and care providers. "Although our primary
objective is tohelp families and their loved ones," says Moore, "the
role of the long-termcare provider in our process is critical. Staff
time and money continue to betheir key challenges. The simplicity of
our software and our unique businessmodel address them both."



Today, the company is introducing their service to long-term
careproviders but plans to begin marketing directly to consumers early
next year."In the meantime," says Moore, "families that want the
service should call thecare provider and ask for it. Send them to our
website or have them contactus. We can have them ready to start sending
you updates in less than a day."

Nursing home suicide rates have not improved in 15 years

from McKnight's:

While instances of suicide among community-dwelling seniors have fallen
in recent years,the same has not been true for long-term care
residents, according to a recent study.



University of Michigan researchers studied the rate of suicide among
seniors aged 60 and over in New York City between 1990 and 2005. During
that time, the relative rate of nursing home suicides did not decline.
The most at-risk cohort were men between the ages of 60 and 69.

Storytelling in Long Term Care Facilities

from Novice to Expert:

This article really resonated with me. I truly believe in the value of
storytelling and if stories carried actual physical weight, I would
weigh a lot more than I did when I first started in nursing because of
the patients' stories I carry with me.

This article from Provider Magazine, Creative Tasks Spark Imagination,
outlines three techniques used in a long term care facility for
residents along the continuum of memory impairments (from none to
late-stage Alzheimer's or dementia). The first technique is based on Timeslips, which promotes social interaction. It helps to reduce the isolation that many persons with dementia may experience.

The second technique involves storyboarding which can be done by the resident or by the family, if the resident is not able to participate. Upon completion of the storyboard, a celebration is held to celebrate the individual's life.

In the third technique, individuals write their life stories in a 6-10 week storytelling workshop.

Disabled couple see independence intertwined with will to live

from The Sacramento Bee:

Kevin Terrell and Beverly Evans-Terrell are married. They live in an
apartment in the Country Club neighborhood of suburban Sacramento. They
have both been disabled since birth and depend on services provided
through the state to remain independent and live outside of nursing
homes.

Kevin Terrel

I grew up in a nursing home in Southern California. Nursing homes are a zoo.

You live with at least 50 other people and you have 50 people working
in various positions. I don't like them. I am the king of
claustrophobia. I need my space. I need my privacy. I will not go back
to a nursing home without a fight. It's not going to happen.

If nursing homes cost so much, why is California trying to cut these
programs that do their best to keep us out of nursing homes? That is
what I would like to know.

Beverly Evans-Terrel

I was born with spina bifida. I was raised at home until I was 13 and
then I lived in Sonoma State Hospital. When I was 24 I asked to be
placed in a place where they would teach us to be somewhat independent.
Now I live on my own, with Kevin.

If we have to go back to nursing homes we will lose the will to live.
Living on my own I have the responsibility to take care of myself. I'm
free from dictators. I can go anywhere I want to go. I can go to bed
when I want to.

In Housing Slump, Elderly Forgo Assisted Living

from The New York Times:

Maybe a reason for more in-home supports!

The housing crisis has kept thousands of older Americans who need
support and care from moving into retirement communities or
assisted-living centers, effectively stranding them in their own homes.

Without selling their houses or condominiums, many cannot buy into
retirement homes that require a payment of $100,000 to $500,000 just to
move in. So they are scratching themselves off waiting lists, canceling
plans with packing services and staying put, in houses that fit well 30
years ago, but over the years have become lonely, too large or too
treacherous to navigate.

National Senior and Disability Advocates Agree on Principles for Financing Long-Term Services and Supports

from MarketWatch:

WASHINGTON, Nov 20, 2008 /PRNewswire-USNewswire via COMTEX/ --
In a historic step toward a healthier, more equitable and affordable
system for financing long-term services and supports, the Leadership
Council of Aging Organizations (LCAO) and the Consortium for Citizens
with Disabilities (CCD) have agreed on a set of joint principles for
reform.

The principles are:

    1. National Problem, National Solution -- Recognize that although states,<br />       communities, families, and individuals have important roles to play,<br />       financing for long-term services and supports is a national problem that<br />       requires a national solution.<br />    2. Universality with Limited Opt-Out -- Create a public program that allows<br />       all people, including individuals with disabilities and those near<br />       retirement, the opportunity to contribute to and prepare for the costs of<br />       long-term services and supports.  Make participation as convenient as<br />       possible but give people the limited choice to opt out.<br />    3. Public/Private Partnership -- Provide a strong foundation of protection<br />       while providing opportunities for personal planning that include a role<br />       for private sector options.<br />    4. Affordability and Risk Pooling -- Provide for broad pooling of risk and<br />       appropriate low-income subsidies to make premiums affordable enough so<br />       that all people, regardless of income and health status, can participate.<br />       Ensure that a new program does not force people to impoverish themselves<br />       to qualify.<br />    5. Fiscal Responsibility -- Provide actuarially sound funding, such as<br />       through voluntary premiums that build reserves over time sufficient to<br />       pay for future needs in a way that is affordable to individuals and to<br />       society as a whole.<br />    6. Relieve Pressure on Medicaid -- Provide additional long-term services and<br />       supports funding mechanisms that will help take the pressure off of<br />       future Medicaid expenditures, while preserving the guaranteed safety net.<br />    7. Consumer Choice and Control -- Promote independence and dignity across<br />       the broad continuum of services and supports by ensuring beneficiaries<br />       the right to control and choose what services they receive, how and where<br />       they are delivered and who provides them.<br />    8. Support Family Caregivers -- Recognize and support the central role<br />       families and other informal caregivers play in planning for and providing<br />       long-term services and supports, including developing strategies to<br />       support working caregivers to maintain their financial security.<br />    9. Invest in Quality Care and Quality of Life -- Target additional funding<br />       to ensure sufficient training and compensation for the workforce and to<br />       strengthen oversight, enforcement, and advocacy programs that improve<br />       quality of life and quality of care in all settings.<br /><br /><br /></pre>
        <div class="p">
            About CCD ( <a class="lk001" target="_blank" href="http://www.c-c-d.org/">http://www.c-c-d.org</a>)

        </div>
    
        <div class="p">
The Consortium for Citizens with Disabilities is a coalition of
approximately 100 national disability organizations working together to
advocate for national public policy that ensures the self
determination, independence, empowerment, integration and inclusion of
children and adults with disabilities in all aspects of society </div>
    
        <div class="p">
            About LCAO ( <a class="lk001" target="_blank" href="http://www.lcao.org/">http://www.lcao.org</a>)

        </div>
    
        <div class="p">
The Leadership Council of Aging Organizations (LCAO) is a coalition of
national nonprofit organizations concerned with the well-being of
America's older population and committed to representing their interest
in the policy-making arena. The 56 members offer expertise and advocacy
on a broad range of issues affecting the elderly and those who care for
them. The coalition focuses on ensuring social justice and fiscal
responsibility for an aging society. </div>
    
        <div class="p">
            SOURCE  Consortium for Citizens with Disabilities

        </div>
    <pre> <a class="lk001" target="_blank" href="http://www.c-c-d.org/">http://www.c-c-d.org</a><br /><br />

Updated Nursing Home Care Resources Released by IQ Nursing Homes

from Transworld News:

IQ Nursing Homes has recently updated its
Nursing Home Resources and is now providing information about nursing
home admission, paying for long term care, and nursing home services.
The IQ Nursing Homes website has been created with the goal of
providing a comprehensive source of nursing home information, and this
recent update marks another step in our progress toward achieving this
goal.

 Visit http://www.iqnursinghomes.com/
to review these new resources. You can also find up-to-date nursing
home news and information about signs of elder abuse and nursing home
neglect on this site.  IQ Nursing Homes offers a free
nursing home abuse claim form, which will be reviewed by a qualified
nursing home attorney within 36 hours. Nursing home employees who have
witnessed neglect can report it anonymously.

John Hancock Announces Results of National Long-Term Care Cost of Care Study

from Virtualization:

BOSTON, Nov. 20 /PRNewswire-FirstCall/ -- John Hancock Life Insurance
Company (John Hancock) today announced the results of an in-depth study of the
2008 costs of long-term care (LTC), which found that LTC costs have been
increasing in line with inflation in recent years.

Including information from more than 11,000 care providers nationwide, the
study of national care costs conducted by CareScout, based in Wellesley, MA,
revealed average costs of care in the U.S. are roughly $75,000 annually for a
private room in a nursing home; $67,000 annually for a semi-private room in a
nursing home; and $35,000 annually for an assisted living facility, while the
average cost of home care was found to be about $19 per hour.

A comparison of the 2008 national averages to those of a similar study
conducted by Harris, Rothenberg International for John Hancock in 2002,
indicates that the increases in costs over the past six years appear to be
tracking inflation, as measured by the Consumer Price Index (CPI) during the
same time period. According to the study, the average annual increase in the
cost of long-term care is trending in line with the 3.3 percent average annual
increase in the CPI during the same time period as noted below.

PHI has supported such alternatives by developing training for staff who were moving from traditional nursing home environments to Green Houses®. THE GREEN HOUSE Project was initially developed by Dr. William Thomas, a professor at the University of Maryland’s Erickson School and leader in the elder culture change movement, who writes a blog called Changing Aging.org. The first Green Houses® opened in Tupelo, Miss., in 2003, to provide seniors of all incomes with more dignity, autonomy, and choice in long-term care. The name stems from the focus on encouraging personal growth among residents. The idea is that Green Houses® cost no more to run than traditional homes because they produce less waste and require less infrastructure.

from Wall Street Journal:

As Budget Shortfalls Force Reductions in Home Care, Low-Income People May Face Nursing Homes, Advocates Say

Faced with widening budget shortfalls, several states are rolling
back support services for the elderly and disabled. The move is making
it tougher for them to continue living on their own, advocates say.

At least 15 states, including Alabama, Virginia and Massachusetts,
are targeting such funding, mostly for programs that allow low-income
shut-ins to receive personal care -- like cooking, cleaning and basic
health services -- in their own homes, according to the Center on
Budget and Policy Priorities, a liberal-leaning Washington, D.C. think
tank that studies state budgets.

The cutbacks are exacerbating the already long waiting lists for
home-care support services in many states. That leaves the low-income
elderly and disabled to dip into their meager incomes to hire their own
help, reach out to family or charity, or seek more restrictive and
expensive care in a nursing home, advocates say.

"We are beginning to see serious cuts and we are expecting those
cuts to get worse," says JoAnn Lamphere, director of state government
relations at AARP, an advocacy group for the elderly.

As the economy falters, declining revenues and tax receipts have led
state agencies to cut spending, with 41 states facing current or
looming deficits, according to the Center on Budget and Policy
Priorities.

A burgeoning market for assisted living and senior living facilities in Mexico is drawing retirement-age baby boomers, according to The Dallas Morning News. Many factors contribute to the appeal of a Mexican retirement, including quality of care, climate and cost, the newspaper reports. A recent MetLife survey places the average cost of assisted care in the U.S. at just over $3,000 per month, while many facilities in Mexico can provide similar care for $1,100 per month, according to the newspaper. Also, many expect that Mexican culture—one that values taking care of the elderly at home—will be suited for the long-term care field. But precisely because of its home-care oriented culture, nursing homes in the country are sparse. The industry is almost entirely deregulated, leading some to question the safety of a Mexican retirement.

from PHI:

Pioneer Network,
a national organization leading the movement for radical change in the
culture of long-term care, is launching the Small House Online
Networking Initiative to bring together key stakeholders to explore the
idea of community-based “small houses” for older adults.

With the support of the Robert Wood Johnson Foundation, the new
initiative aims to enhance communication and shared learning among
those interested in the financing and delivery of person-directed
long-term care through small houses—an alternative to institutional
nursing homes. The virtual meeting place will also provide a forum for
providers who currently run small house initiatives to exchange
information.

PHI has supported such alternatives by
developing training for staff who were moving from traditional nursing
home environments to Green Houses®.

THE GREEN HOUSE Project was initially developed by Dr. William Thomas,
a professor at the University of Maryland’s Erickson School and leader
in the elder culture change movement, who writes a blog called Changing Aging.org.

The first Green Houses® opened in Tupelo, Miss., in 2003, to provide
seniors of all incomes with more dignity, autonomy, and choice in
long-term care. The name stems from the focus on encouraging personal
growth among residents. The idea is that Green Houses® cost no more to
run than traditional homes because they produce less waste and require
less infrastructure.

More U.S. seniors enjoying golden years south of border

from McKnight's:

A burgeoning market for assisted living and senior living facilities in
Mexico is drawing retirement-age baby boomers, according to The Dallas
Morning News.



Many factors contribute to the appeal of a Mexican retirement,
including quality of care, climate and cost, the newspaper reports. A
recent MetLife survey places the average cost of assisted care in the
U.S. at just over $3,000 per month, while many facilities in Mexico can
provide similar care for $1,100 per month, according to the newspaper.
Also, many expect that Mexican culture—one that values taking care of
the elderly at home—will be suited for the long-term care field.



But precisely because of its home-care oriented culture, nursing homes
in the country are sparse. The industry is almost entirely deregulated,
leading some to question the safety of a Mexican retirement.

Elderly People Requires Better Fire Prevention

from Medical news Today:

If you are over seventy years old, your chances of dying in a fire at
home are four times as high as they are for the rest of the population.
It is also a fact that half of all women who die in house fires are 70
or older.

These are among the results of a report from SINTEF
Norwegian Fire Laboratories, which also identifies measures that could
reduce the number of fires, particularly those of electrical origin or
that are due to the inappropriate use of electrical equipment. Taken
together, these are the most frequent causes of fires in Norway.

Elderly Cancer Survivors' Ability To Function Improved By Home-Based Interventions

from Medical News Today:

Climbing stairs, carrying groceries, taking a shower - these are
activities that we take for granted; however, after a cancer diagnosis,
many survivors are unable to function as they used to. Home-based diet
and exercise interventions may improve physical functioning in older,
long-term cancer survivors, according to data presented at the American
Association for Cancer Research's Seventh Annual International
Conference on Frontiers in Cancer Prevention Research.


Wendy Demark-Wahnefried, Ph.D., professor of behavioral
science at the University of Texas M. D. Anderson Cancer Center,
focused this study on survivors older than 65 years old. She said this
age group often suffers long-term side effects of cancer and its
treatment which could threaten the ability to live independently.
"Younger cancer patients are usually able to bounce back, but older
patients may need a structured program to stop functional decline and
retain independence," said Demark-Wahnefried.


Those in the intervention group received tailored mailed print
materials on diet and exercise, a pedometer and exercise bands. For the
first three weeks, participants received weekly phone calls, which
tapered off to every two weeks and then once a month until the end of
the study.


At the end of one year, researchers evaluated physical
function, diet quality and physical activity using standard measures.
Participants in the intervention group demonstrated significant
improvements in their diet and exercise behaviors, and their weight
status. What's more, according to the SF-36 physical function test,
participants in the intervention group had a 2.5 point decline compared
with a 5.3 point decline in the control group. Similar differences were
seen in measures of basic lower extremity and advanced lower extremity
functioning. Overall, the magnitude of effect was similar to preventing
physical function losses comparable to that imposed by ischemic heart
disease.

from Market Watch: LIFE Foundation Reviews Five Facts You May Not Know about Long-Term Care Insurance and Encourages Americans to Assess Their Needs With significant losses to their savings and investments, and economists warning of a prolonged recession, many Americans are feeling uncertain about their retirement security and their ability to pay for long-term care services. According to a new survey by the nonprofit LIFE Foundation, 64 percent of Americans age 45 and older say that the recent economic downturn has had a major negative impact on their ability to pay for long-term care services should they become unable to take care of themselves for an extended period of time. Considering that 70 percent of Americans who reach age 65 will need such care at some point in their lives, according to the U.S. Department of Health and Human Services, these findings show how financially vulnerable many people are without a long-term care plan. Released to coincide with Long-Term Care Awareness Month in November, the LIFE survey found that most adults recognize the reality of needing long-term care services:

from health Care for Health Care Workers:

A testimonial by Cheryl D., a home care consumer in Pennsylvania:

At the age of 14, a cardiac arrest left my son Renzo with a severe
anoxic brain injury. For the last seven years, he has been completely
dependent on the help of direct-care workers. I pay at the higher end
of the wage scale ($10.50 - $15 per hour), but I can’t afford health
benefits for his workers.

Over the years, Renzo has seen more than 40 workers come and go. His
short-term memory is challenged. It’s not until he has had somebody for
two to three months that he can remember their name. And it takes
workers at least a month to understand his patterns of speech.

For every aide that comes in, I am the trainer. I have to teach them
how to help him eat through a straw, how to manage his toileting needs,
and how to help him therapeutically regain limited skills. He has never
really learned to use the augmentative communication device because he
has not had a consistent person to work with him long enough.

Nursing-Home Sex Becoming More Acceptable

from Fox News:

Nursing-home
residents have sexual needs too. And now researchers are finding ways
to educate staff on the taboo topic and provide accommodations for the
elderly to shack up under some privacy.

"Most
staff have the same mindset many of us do, which is 'I don't want to
think about my parents having sex, let alone my grandparents,'" Gayle
Doll, who directs Kansas State University's Center on Aging, told
LiveScience.

The researchers suggest educating staff about sexuality and making sex in nursing homes less hush-hush.

In
the long run, they hope federal guidelines will help all nursing homes
deal with sexuality in a positive way, especially as baby boomers age
and bring their 1950s and 1960s attitudes about sex with them to the
facilities.

Survey Finds Economic Downturn Has Had a Major Negative Impact on Americans' Ability to Pay for Long-Term Care Services

from Market Watch:

LIFE Foundation Reviews Five Facts You May Not Know
about Long-Term Care Insurance and Encourages Americans to Assess Their
Needs

With significant losses
to their savings and investments, and economists warning of a prolonged
recession, many Americans are feeling uncertain about their retirement
security and their ability to pay for long-term care services.
According to a new survey by the nonprofit LIFE Foundation, 64 percent
of Americans age 45 and older say that the recent economic downturn has
had a major negative impact on their ability to pay for long-term care
services should they become unable to take care of themselves for an
extended period of time. Considering that 70 percent of Americans who
reach age 65 will need such care at some point in their lives,
according to the U.S. Department of Health and Human Services, these
findings show how financially vulnerable many people are without a
long-term care plan.

Released to coincide
with Long-Term Care Awareness Month in November, the LIFE survey found
that most adults recognize the reality of needing long-term care
services:

Brainline,org

from Brainline:

This site is supported by the Defense Centers of Excellence.  It is intended to support veterans and other people with brain injuries.  Lots of stuff!

2008 MetLife Assisted Living and Nursing Home Surveys

from Homewatch:

In October 2008, MetLife published their 2008 survey results of Nursing
Home and Assisted Living costs across the US. Nursing Home rates
essentially stayed the same from 2007 to 2008 at at an average of
$212/day for a private room or approx. $80,000/ year. Assisted Living
costs rose by 2% and averaged $3,031 per month or $36,500/year for the
"base rate" which doesn't include some "a la carte" services.
For the full MetLife survey,http://www.metlife.com/FileAssets/MMI/MMIStudies2008NHALCosts.pdf

Integrated Managed Long-Term Care forum

from Patti's Blog:

From the Michigan Department of Community Health:

INVITATION

The Long-Term Care Supports and Services
Advisory Commission
Finance Work Group

is hosting an:

INFORMATIONAL FORUM ON INTEGRATED MANAGED LONG-TERM CARE

December 11, 2008 from 2 to 4 PM
State of Michigan Library Auditorium
Click here for flyer for more info.

CMS issues new guidelines for Medicare Advantage Special Needs Plans

from McKnight's:

The Centers for Medicare & Medicaid Services last Thursday laid out
new guidelines governing Medicare Advantage Special Needs Plans that
serve Medicare beneficiaries with chronic conditions.  



"Based on the panel's recommendations, we are defining the chronic
conditions that certain Medicare special needs plans must use to
identify the beneficiary populations eligible for enrollment," said CMS
Acting Administrator Kerry Weems.



Special needs plans are a type of Medicare Advantage plan that serve
only beneficiaries living in institutions, eligible for both Medicare
and Medicaid, or living with severe or disabling chronic conditions.
The new guidelines, which are based on recommendations from the Special
Needs Plan Chronic Condition Panel, will take effect in 2010. They
identify 15 chronic conditions that will dictate eligibility for a
Chronic Care Medicare Advantage Special Needs Plan. The 15 chronic
conditions include dementia, chronic heart failure, diabetes mellitus,
and stroke.



To view the panel's full report, go to www.cms.hhs.gov/SpecialNeedsPlans.

Another Extendicare Class Action Lawsuit Filed over Nursing Home Neglect in Wisconsin

from Aboutlawsuits.com:

Nursing home operator Extendicare faces a third class action suit,
this time filed on behalf of all residents of their nursing homes in
Wisconsin. Similar Extendicare class action lawsuits
have been filed in Washington and Minnesota, with all of the cases
alleging that the company places profits over patient care by admitting
residents that they are not properly equipped to handle.

The Wisconsin Extendicare lawsuit was filed Friday in the Circuit
Court for Milwaukee County by one resident, but seeks class action
status on behalf of all residents who have been treated at 26 different
nursing homes operated by Extendicare in the state.

Extendicare is one of the largest nursing home operators in the
United States and Canada, with as many as 226 homes in North America
and over 30,000 beds.

The lawsuit alleges that Extendicare fraudulently advertises
services that they are not capable of performing and admits ill
residents without hiring the necessary staff to provide even adequate
care.

New Comprehensive Study of Hispanic Family Caregivers

from Market Watch:

A study released today from UnitedHealth Group's
Evercare(R) organization and the National
Alliance for Caregiving (NAC) finds that more than one third of Hispanic
households (36 percent) have at least one family member caring for an
older loved one --a larger percentage than all
U.S. caregiving households which is 21 percent (one in five), according
to the Evercare Study of Hispanic Caregiving in the U.S. The
study, the largest comprehensive look at Hispanic caregivers, also
revealed that caregiving caused a major change to the working situation
of Hispanics, which could have dramatic personal implications as the
current fiscal crisis continues to unfold in the United States.
Additionally, the emotional and physical tolls of caregiving might also
impact the local and national economies, given that more than eight
million Hispanics provide care to older loved ones nationwide.

Curious Consent Standards in Nursing Home Admissions

from Nursing Home Administrator's Blog:

Nursing home administrators face an unexpected ethical (and legal)
dilemma when admitting new residents to skilled nursing care. The
Nursing Home Care Act undercuts a traditional notion of informed
consent in such a way that many residents may be admitted to a nursing
home without ever consenting to treatment, or having a meaningful
surrogate consent to their treatment. This is clearly an issue of
nursing/medical ethics, as well as a font of potential legal liability
for providing unauthorized care.

American health care law is predicated on the notion of patient
autonomous-direction. Within this notion exist a number of inter-linked
rights: the right to self-determination, the right to give consent
before treatment, the right to information forming the basis of consent
and many others. Curiously, in senior care, as in perhaps no other
major area of American health care law, the status of patient
autonomous direction, especially with respect to consent before
treatment, is less sacrosanct, the exceptions more numerous. This is
especially true in the legal quagmire of involuntarily placing adults
in nursing homes.

I am most familiar with the Illinois Nursing Home Care Act and it
will thus form the background of this discussion, but the Illinois Act
is not dissimilar to Nursing Home Care Acts in many other states, at
least inasmuch as the acts address the issue of involuntary admission.
Clearly involuntary admission of a resident to a nursing home presents
moral and ethical issues most families are not experienced in dealing
with, not to mention attendant feelings of guilt for the family members
and likely betrayal for the patient herself. However, for the health
care provider, the nursing home, the struggle is a balance between
determining the self-interest rights of the resident and the interests
in rendering care.

Better LTC jobs will boost economy, says Kuttner

from PHI:

Economics writer Robert Kuttner has some advice for President-Elect Barack Obama in his new book Obama’s Challenge: America’s Economic Crisis and the Power of a Transformative Presidency.

Kuttner makes a strong case for professionalizing the human services
sector – jobs which are harder to outsource – to boost the U.S. economy.

Last week, he told NPR’s Fresh Air,
“All jobs taking care of America’s children and taking care of
America’s old people and taking care of America’s sick people, by
definition, these are jobs that have to be close to home.”

Scholars Delve Into How Money, Family Structure, and Culture Influence Care of the Elderly

from the Urban Institute:

Who cares for the elderly and at what cost concern policymakers and
laypeople alike, for the Census Bureau predicts that more than 20
percent of the U.S. population will be older than 65 by 2050, compared
to just 12 percent in 2000. Intergenerational Caregiving, a
new book from the Urban Institute Press, reveals how social, cultural,
demographic, and financial circumstances shape care and support
arrangements for Americans as they age, as well as for family members
of all ages facing disability and special needs.

Editors Alan Booth, Ann C. Crouter, Suzanne M. Bianchi, and Judith
A. Seltzer collect the insights of more than a dozen economists and
sociologists, whose detailed essays highlight the issues that
legislators, program managers, and advocates must consider as America
grays. The book cites evidence that the advent of Social Security in
the 20th century improved the financial position of the elderly, whose
higher retirement incomes led to a sharp decline in the proportion of
aged parents living with their adult children. Income and housing
decisions likely would change again if, as one author speculates,
future adjustments to Social Security shrink benefits for retirees or
raise taxes on their adult children.

Class-action suit filed against Extendicare nursing homes

from JSonline:

A Milwaukee attorney filed a class-action lawsuit Friday against
Extendicare Homes that alleges the nursing home chain fraudulently
advertised its services and deliberately admitted more acutely ill
residents without hiring enough staff to properly care for them.

The
lawsuit alleges Extendicare violated the state's Consumer Protection
Act through false advertising that lured residents into believing they
would receive good care at nursing homes that were cited for health
violations by state regulators.

The
complaint also contends the company's "24/7 Extendicare Admission
Policy" was designed to automatically admit patients who have acute
medical conditions such as hepatitis B or who require dialysis or
therapy. Nursing homes are reimbursed at higher rates for more acutely
ill residents.

The
goal of this policy, also known as the "Green Flag" policy, is to admit
the sickest patients regardless of a nursing home's staffing level,
alleged Jay Urban of the Milwaukee law firm Urban & Taylor, who
filed the suit. The Madison law firm Boller & Vaughan are
co-counsel in the lawsuit.

"They
are putting profits ahead of people," Urban said. "You can't take in
higher acuity people unless you provide higher acuity care."

U.S. Residents With Chronic Illnesses More Likely To Experience Medical Errors, Forgo Medical Care Because Of Cost

from medical news Today:

U.S. residents with chronic diseases are more likely to forgo medical
care because of high costs and experience medical errors than residents
of other nations with such conditions, according to a study published
on Thursday in the journal Health Affairs, Reuters/Boston Globe reports. For the study, conducted by the Commonwealth Fund,
researchers surveyed 7,500 adults, each of whom had at least one of
seven chronic diseases -- high blood pressure, heart disease, lung
disease, diabetes, cancer, arthritis and depression. Participants
included residents of Australia, Canada, France, Germany, the
Netherlands, New Zealand, Britain and the U.S.

Okla. To Build Sex Offender Nursing Home

from KOCO.com:

A nonprofit group, A Perfect Cause, said there are currently 30 sex
offenders living in Oklahoma nursing homes. The group hopes that moving
offenders out of those facilities will make them safer for other
residents."The Department of Corrections talked about there
being thousands of people moving from the criminal justice system who
are 65 or older in the coming years," said Wes Bledsoe, of A Perfect
Cause.

Gov. Brad Henry signed a bill into law last July that required the
state to build a separate nursing home for sex offenders. The Oklahoma
Health Department is preparing to seek bids to run the facility, but
also wants to know how those bidders would plan to operate it."The
proposal will include provisions for heightened, 24-hour security to
protect the residents and the public," said Henry Hartsell, of
Protective Health Services.

The Business Innovation Factory’s Nursing Home of the Future: A Place to Design, Test and Learn.

from Nursing Home of the Future:

Overview

The NHoF lab has created a platform to test new ideas in a real world
environment in partnership with designers, clinicians, service
providers, product manufacturers and elder care experts.

Phase I: Understanding the Current Elder Experience

In Phase I, the NHoF team created a detailed description of the
current experience of nursing home and assisted-living residents to
reveal areas most in need of redesign and opportunities ripe for
intervention.

Multimedia

The NHoF team has synthesized phase I work into a series of videos,
vignettes and pictorial displays that make it easier for everyone to
understand the elder care experience see opportunities for improving
it.

After Financial Bailout, a Long Term Care Bailout? No, Industry Expert Says, Pointing to Recent Congressional Action

from MarketWatch:

KIRKLAND, Wash., Nov 12, 2008 /PRNewswire via COMTEX/ --
Will Long Term Care Awareness Week (November 16-22) Help Avert New Economic Tsunami?

Following the $700-billion-plus economic bailout and stimulus program,
"Congress does not relish another big bailout," says Cameron Truesdell,
CEO of LTC Financial Partners LLC (LTCFP), one of the nation's largest
and most experienced long term care insurance agencies. "But they see
another tsunami coming." That's the message Truesdell gets from the
September 25 introduction of House Resolution 431, "Supporting the
goals and ideals of a Long-Term Care Awareness Week."

Consumer Direction in Medicaid and Opportunities for States

from The Heritage Foundation:

The Center for Medicare
and Medicaid Services (CMS) published a final Medicaid rule that
permits Medicaid recipients to self–direct their own health care and
supportive services. The rule, Self–Directed Personal Assistance Services Program State Plan Option (Cash and Counseling),
is a great victory for persons with disabilities. Medicaid recipients
in need of long–term care have been given the freedom to control their
own destiny. If states take advantage of it, this change has the
potential to revolutionize the $100 billion long–term care delivery
system under Medicaid.

Self–direction, with the
benefit of counseling, is a dramatic reversal of the traditional model
of long–term care that is based on dependency. Self–direction puts the
individual back in control. This raises expectations and demands
greater personal responsibility on the part of the Medicaid recipient.
But properly understood, that in itself adds value and quality as well
as expands access to services.

John Kemp, an expert on
disability issues, has explained that "control and choice is not just a
theme; they are a tenet of the disability movement."[2]
Experience shows, moreover, that putting the consumer rather than the
provider in control is also cost effective as well as personally
liberating. Says Kemp: "We have been trying to save our government
money for a long time."[3]

Use of advance directives increases among nursing home residents

from McKnight's:

Advance directive documentation is sharply on the rise in the nation's
nursing homes, according to a recent report from the Institute for the
Future of Aging Services, a research arm of the American Association of
Homes and Services for the Aging.



Nearly 70% of all nursing home residents over the age of 65 have at
least one advance directive document in their records. That is up from
53% in 1996, according to the report.

Crossing The Digital Divide For The Elderly, Chronically Ill And Medically Undeserved

from Medical News Today:

What will motivate the elderly, the chronically ill and the medically underserved to use interactive information technology systems to actively help manage their own health problems? What barriers have prevented people in these groups from using such systems more widely than they have?

The U.S. Agency for Healthcare Research and Quality's (AHRQ) Oregon Evidence-based Practice Center (EPC) at Oregon Health & Science University searched the scientific literature for answers. The EPC's report is the first to identify and catalog the factors that influence the use of home computer-based health IT systems by the most at-risk subgroups of the population and to review the evidence on health outcomes attributable to the use of these technologies. "This report will help us make health information technology more available and accessible to consumers as they use it to become more active in their care," said AHRQ Director Carolyn M. Clancy, M.D. "I hope the report will be useful to clinicians, policymakers, patient advocates and others who are working to integrate health IT solutions that improve the quality and safety of health care for all Americans."

Among the study's findings:

- The most effective systems are those that provide routine and timely tailored clinical feedback and advice. Patients prefer systems that provide them with information that is specifically tailored for them and is not general in nature.

- Patients prefer systems that send them information on devices that fit into their normal daily routine, such as cell phones.

- The lack of a perceived benefit is the primary barrier to wider use by patients of interactive IT technologies. When patients did not perceive a potential health benefit or did not trust the advice they were given they were less likely to use the technology.

- Issues of access, ease of use, and convenience of technology systems were also found to be key barriers to wider use.

- The most frequently used health IT functions are online peer group support bulletin boards and disease self-management tools.

- Patients value the anonymity and nonjudgmental nature of interacting with a computer system, especially those with HIV/AIDS or mental disorders.

Because Of Homecare, Millions Will Share Thanksgiving At Home With Family - November Is National Homecare Month

from Medical news Today:

Thanks to home medical equipment providers, millions of seniors and people with disabilities will share Thanksgiving and other holidays in the comfort of their homes. During November, which is National Homecare Month, the American Association for Homecare celebrates the thousands of dedicated professionals who provide cost-effective and consumer-preferred homecare.

Five Facts about Homecare

1) Among the eight million Americans who depend on homecare for medically required services or equipment are people with chronic obstructive pulmonary disease (COPD), multiple sclerosis, Lou Gehrig's disease, spinal cord injuries, congestive heart failure, diabetes, and other conditions.

2) Virtually every type of healthcare short of surgery can be performed in the home. Today Americans benefit from oxygen therapy, wheelchairs, skilled nursing, sleep therapy, infusion therapy, diabetes supplies, hospice, and other medical services, supplies, and equipment at home.

3) The home is the most cost-effective setting for medical care. Home-based care is a key part of the solution to the severe fiscal challenges facing Medicare and Medicaid and should be an essential part of healthcare reform discussions for federal and state policymakers.

4) Advances in technology for home medical equipment and telemedicine are expanding the clinical effectiveness of homecare.

5) In the event of a pandemic flu, homecare will play a large role in treating the millions of Americans who will require care.

For consumer information and links about homecare, visit www.aahomecare.org/athome.