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....