Video Decision Support Tool For Advance Care Planning In Dementia: Randomised Controlled Trial, UK

Video images of advanced dementia can help patients choose the type of care they want in the future, finds a study published on bmj.com today. The images also led to more stable treatment preferences over time.

 
Respecting patients' preferences for treatment is a key component of high quality end of life care. Traditionally, doctors help patients engage in advance care planning by describing hypothetical situations, such as advanced dementia, and exploring possible goals of care, but this approach is limited.

Visual images have been shown to improve communication of complex health information and inform end of life decision-making. So a research team, led by Angelo Volandes at Massachusetts General Hospital, examined whether a video of a patient with advanced dementia could shape the choices made by patients about the kind of care they would want in the future.

Video Decision Support Tool For Advance Care Planning In Dementia: Randomised Controlled Trial, UK

Kaiser Annouces New Health Reform Gateway at Health Care for Health Care Workers

 

The Kaiser Family Foundation has launched a new health care reform gateway page which features numerous resources in one central location.

As part of the gateway page, the Foundation unveiled some new resources:

• An interactive tool for comparing major health care reform proposals,……
• A new interactive Web-based timeline that chronicles key events……
• A series of Explaining Health Care Reform Briefs…..
• A glossary…………….

Kaiser Annouces New Health Reform Gateway at Health Care for Health Care Workers

States To Pursue New Integrated Care Approaches For Dual Eligibles

 

As the nation debates health reform options, the Center for Health Care Strategies (CHCS) is launching Transforming Care for Dual Eligibles , a state initiative to test innovative care models for people who are dually eligible for Medicare and Medicaid ("dual eligibles"). Colorado, Maryland, Massachusetts, Michigan, Pennsylvania, Texas, and Vermont will implement strategies to improve care and control costs for dual eligibles, a high-need population with health care costs nearly five times those of other Medicare beneficiaries. The program is made possible through support from The Commonwealth Fund.

States To Pursue New Integrated Care Approaches For Dual Eligibles

Report: Chronic Diseases Take Heavy Toll on Health System, Economy at PHInational.org

The 2009 edition of the Almanac of Chronic Disease (pdf), subtitled “The Impact of Chronic Disease on U.S. Health and Prosperity,” has been released by The Partnership to Fight Chronic Disease (PFCD).

The report combines peer-reviewed data with commentary from national health care leaders and policy experts to provide a comprehensive collection of current information as well as guidance for making improvements through changes in individual, community, and national action.

A few notable facts from the ninety-two page report include:

• More than 133 million Americans, or 45 percent of the population, have at least one chronic condition.
• Of each dollar we spend on health care nationwide more than 75 cents – or about $1.7 trillion annually – goes toward the treatment of chronic illness.
• Treatment of patients with one or more chronic diseases now accounts for the vast majority of spending in both Medicare (96 percent) and Medicaid (83 percent).

Report: Chronic Diseases Take Heavy Toll on Health System, Economy at PHInational.org

Chairman Baucus, what’s on your political palate? : Center for Disability Rights : Free Our People

……………….

For three hours, a variety of Senators and healthcare experts discussed options.  And for three hours, not one person said anything about long term services and supports (long term care, by another name).

Sadly, the closest that the hearing came to a mention of long term services and supports (LTSS) was when they engaged in a discussion of “the high cost of dying.”

Yup, the Senate, in all its gentle wisdom, is showing more interest in how much it costs for seniors and others to stay alive at the very end than they have shown in how seniors and people with disabilities live for the DECADES before we get around to dying…………………

Chairman Baucus, what’s on your political palate? : Center for Disability Rights : Free Our People

Ari Ne'eman: Health Care Reform and the Disability Community

 

As we speak, Congress is deliberating on vast and important changes to the system of health care in the United States. This issue is one of crucial importance to all Americans, but of particular interest to those Americans who interact with public health insurance more than almost any other group -- people with disabilities. Ranging from veterans with disabilities who receive care through the Veteran's Administration health care system to the many low-income disabled adults who are eligible for Medicaid, the disability community interacts with the public health care infrastructure in the United States in a wide variety of ways. As we consider how to reform, streamline and expand that infrastructure through any of a variety of means, it is incumbent upon us to remember the key issues for making sure that health care reform doesn't leave disabled adults and youth behind……..

Ari Ne'eman: Health Care Reform and the Disability Community

Two-thirds Of Publicly-insured Adults Have One Or More Chronic Conditions

 

Nearly two of every three adult Americans under age 65 who were covered by public insurance from 2005 to 2006 had at least one chronic illness, such as diabetes, heart disease, and kidney disease, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.
-- About 57 percent of people with private insurance and 36 percent of the uninsured had one or more chronic ailments, such as diabetes, heart disease, and kidney disease
-- People who had two or more chronic illnesses accounted for 45 percent of the publicly insured, 32 percent of the privately insured and 17 percent of the uninsured.
-- Health expenditures for treatment of chronic conditions for adults with two or more such conditions averaged $6,455 for people who only had public insurance compared with $1,987 for the uninsured and $3,598 for people with private insurance.
-- However, a publicly insured person with two or more chronic illnesses had lower average annual out-of-pocket expenses than a similar uninsured person ($708 vs. $1,040).
-- Chronic diseases accounted for 57 percent of medical care spending for adults who only had public insurance, 46 percent for the privately insured, and 47 percent for the uninsured.

Two-thirds Of Publicly-insured Adults Have One Or More Chronic Conditions

Massachusetts Health Reform: The Myth of Uncontrollable Costs | Massachusetts Taxpayers Foundation

Full report link is on the page through the link at bottom. 

Despite a public perception that the state's landmark health care reform law has turned out to be unaffordable, a new analysis by the Massachusetts Taxpayers Foundation finds that the cost to taxpayers of achieving near universal coverage has been relatively modest and well within initial projections of how much the state would have to spend to implement reform, in part because many of the newly insured have enrolled in employer-sponsored plans at no public expense. 

The Foundation report concludes that state spending on the reform has increased by $350 million between fiscal 2006, the last year before reform, and fiscal 2010 - an average annual increase of only $88 million.

Massachusetts Health Reform: The Myth of Uncontrollable Costs | Massachusetts Taxpayers Foundation

safepatientproject.org-ToDelayIsDeadly.pdf (application/pdf Object)

This is a pdf from Consumers Union about medical Errors and the 1 million people that have died from them in the last decade.

safepatientproject.org-ToDelayIsDeadly.pdf (application/pdf Object)

Die_Charta_in_Englisch.pdf (application/pdf Object)

All human beings have an unqualified entitlement to respect for their dignity and uniqueness.
People needing assistance and long-term care have the same rights as everybody else and
should in no way be disadvantaged as a result of their special circumstances. The state and
society have a special responsibility to protect the human dignity of those in need of longterm
care and assistance since this group is often not in a position to represent its own interests.
The aim of this Charter is to strengthen the role and the legal position of people in need of
long-term care and assistance by summarising the basic and indisputable rights of those
people in need of assistance, support and care. These rights are an expression of respect for
human dignity and are thus also anchored in numerous national and international legal texts1.
They are elaborated on in the explanatory notes to the articles in relation to various key aspects
and situations in the lives of those needing long-term care and assistance. The Charter
also formulates quality criteria and objectives which should be the goals of all good long-term
care and support.

and much more……..

Die_Charta_in_Englisch.pdf (application/pdf Object)

051809 Health Care Description of Policy Options.pdf (application/pdf Object)

Financing Comprehensive Health Care Reform:
Proposed Health System Savings and Revenue Options
The U.S. health care system is in crisis. This crisis is not limited to the 46 million who lack
health insurance – it extends to those who have health coverage but are worried about increasing
costs. Rising health care costs affect families and American businesses, as health insurance
premiums continue to outpace wages and inflation. Between 1999 and 2008, premiums for
employer-sponsored health benefits increased 117 percent for families and individuals and 119
percent for employers. And annual health spending growth is expected to outpace average annual
growth in the overall economy by 2.1 percentage points in each of the next ten years. In 2009 alone,
health spending will increase 5.5 percent while gross domestic product (GDP) is expected to decrease
0.2 percent.
Rising health care costs also have a significant impact on federal and state health care programs.
Last week’s release of the 2009 Medicare Trustees Report indicates that the Medicare Hospital
Insurance (HI) Trust Fund will be exhausted in 2017, two years earlier than last year’s report.
Spending for Medicare and Medicaid is projected to increase by 114 percent in ten years. Over
the same period, the GDP is projected to grow by just 64 percent. Last year, health spending in
the U.S. represented 16.6 percent of our gross domestic product (GDP) – a much greater share
than any other industrialized country. And according to the most recent National Health
Expenditure estimates, health care expenditures will consume over 20 percent of the GDP by
2018, an amount representing $4.4 trillion in annual spending.

and much more……..

051809 Health Care Description of Policy Options.pdf (application/pdf Object)

Coalition to Protect Senior Care Applauds Inclusion of Long Term Care in Senate Finance Committee Roundtable Discussion on Health Care Delivery System - Yahoo! News

 

The Coalition to Protect Senior Care (CPSC) -- a national coalition of frontline clinician and caregiver groups providing quality skilled nursing care -- commended the U.S. Senate Finance Committee for including long term care considerations in their roundtable discussion on Reforming America's Health Care Delivery System. The discussion was the leading session in a series of roundtables on the financial aspects of health care reform as Congress considers comprehensive health care reform legislation this year.

"Speaking on behalf of the hundreds of thousands of dedicated front-line caregivers in America's skilled nursing facilities, we commend Chairman Baucus, Ranking Member Grassley and the Committee for recognizing the vital role long term care plays within the spectrum of health care delivery by including eldercare as part of this important policy roundtable," said Lori Porter, co-founder of the National Association of Health Care Assistants (NAHCA) and CPSC. "As-is, direct care workers in skilled nursing facilities are already challenged with funding issues and staffing shortages, estimated at 110,000 nationwide; we particularly hope to work with Congress to stimulate job growth in long term care in order to not only improve patient care, but also help stimulate critical economic recovery efforts."……

Coalition to Protect Senior Care Applauds Inclusion of Long Term Care in Senate Finance Committee Roundtable Discussion on Health Care Delivery System - Yahoo! News

H.R.1441: Ryan Dant Health Care Opportunity Act... OpenCongress

 

To amend title XIX of the Social Security Act to allow States to permit certain Medicaid eligible individuals who have extremely high annual lifelong orphan drug costs to continue on Medicaid notwithstanding increased income.

H.R.1441: Ryan Dant Health Care Opportunity Act... OpenCongress

Examining Medicaid as an Option for Health Reform at Health Care for Health Care Workers

 

…….A briefing held at the Kaiser Foundation yesterday discussed the issues that must be addressed as congressional leaders work on proposals for universal coverage that might include the expansion of Medicaid.  Some of those  issues included:

• Cost at the state and federal level
• Variance in federal match rate for states
• Eligibility in terms of income and health status
• Provider payment rates
• Balance between public programs and private insurance

The briefing is available via webcast.

Examining Medicaid as an Option for Health Reform at Health Care for Health Care Workers

Impact Of Informal Caregiving On Work Productivity

As the population ages, more working adults are be providing informal care to a chronically ill older relative, however this informal care-giving may result in a 20% loss of work productivity for each employed caregiver…….

http://www.medicalnewstoday.com/articles/149886.php

Quality Of Life Survey Highlights Need For Holistic Approach In Elderly Residential Care

Choice, privacy and a sense of identity are just some of the things that older people living in residential care need to maintain a good quality of life, according to research in the May issue of the Journal of Advanced Nursing……Medical News Today

CMS releases draft version of MDS 3.0 for nursing homes

A draft version of the new MDS 3.0 for nursing homes and long-term care facilities was posted Monday on the Centers for Medicare & Medicaid Services' Web site.
The MDS 3.0 draft version is not the final version, CMS warns, and should not be used for training purposes. The final version is slated for release in October of this year, and will include the item set, data specifications and RAI manual. Any questions or comments on the draft version should be directed to MDS30Comments@cms.hhs.gov.
The draft version of the MDS 3.0 and a timeline for its implementation can be found by searching for "MDS 3.0" on the CMS Web site, or by visiting the following Web address: http://www.cms.hhs.gov/NursingHomeQualityInits/25_NHQIMDS30.asp.

Avalere Shows Home Health Interventions Associated With Lower Medicare Spending And Re-Hospitalizations For Patients With Chronic Illness

 

Medicare patients with diabetes, chronic obstructive pulmonary disease, or congestive heart failure that used home healthcare within 3 months of being discharged from a hospital cost the program $1.71 billion less and had 24,000 fewer re-hospitalizations than similar patients that used other forms of post-acute care over a two-year period. The analysis, released by Avalere Health, also found that if cumulated to the full set of Medicare beneficiaries in the study group that utilized other forms of post-acute care, the program would have saved an additional $1.77 billion.

Avalere Shows Home Health Interventions Associated With Lower Medicare Spending And Re-Hospitalizations For Patients With Chronic Illness

Long-term care premiums to jump up to 25% | mySBX

 

As many as 155,000 civilian and military employees and retirees enrolled in the federal long-term care insurance program can expect their premiums to increase by as much as 25 percent later this year or early next year.
The increases will affect most of those who are enrolled in the program’s “automatic compound inflation protection” option. Under this option, enrollees’ benefit payments increase 5 percent annually, but premiums do not regularly increase. Under the new policy, however, a range of premium increases will go into effect, depending on the age at which an enrollee first signed up for coverage. Enrollees who first purchased coverage at age 65 or younger face a premium increase of 25 percent. Those who purchased coverage between the ages of 65 and 70 face smaller increases. Those who purchased at age 70 or older face no increase.

Long-term care premiums to jump up to 25% | mySBX

Transforming Activities in Long Term Care « FORGET MEMORY

 

……………….

I’m neck deep in thinking about “activities” now as I prepare for the Center on  Age & Community’s (which I direct) Next Step Think Tank.

Artist David Greenberger and musician Paul Cebar

This year, we’re gathering leaders in the arts, education, aging services, and media and technology, as well as students and family caregivers to think about “How can we radically transform activities in long term care?”

Over the two days, we aim to 1) describe what we’d like activities to be like – for those living in individual homes or in group settings; 2) enchant or enliven a dozen or more “recommended” activities according to our own description of what activities should be like; 3) identify why activities aren’t working or aren’t accessible now; 4) imagine ways to help them work.

And dare we imagine a better word than “Activity?”…….

Transforming Activities in Long Term Care « FORGET MEMORY

Post Magazine: The Growing Need for Home-Care Aides - washingtonpost.com

 

America is increasingly

relying on home-care aides to keep the elderly out of nursing homes. Yet we barely pay them a living wage.

Paula Span explored the work of a home-care aide in her Post Magazine cover story, "Marilyn Daniel's Reward." Span is a contributing writer for the Magazine and author of "When the Time Comes: Families with Aging Parents Share Their Struggles and Solutions," to be published in June by Grand Central Publishing.

Span and Marla Lahat, executive director of Home Care Partners, were online Monday, May 11 to take questions from readers.

The transcript is below.

____________________

Paula Span: Greetings, everyone and thanks for joining us. Marla Lahat, executive director of Home Care Partners, a venerable nonprofit home care agency in DC, is here as well to answer questions about finding home care for elderly relatives. Let's begin.

_______________________

Washington, D.C.: I was floored by the story in the photo gallery about the 104-year-old caring for her 92-year-old sister. A sad and beautiful story of devotion.

Post Magazine: The Growing Need for Home-Care Aides - washingtonpost.com

New Survey: Economic Conditions Taking Toll On Family Caregivers And Their Ability To Provide Care

Image by Dare*2*Dream via Flickr

 

The Evercare® Survey of The Economic Downturn and Its Impact on Family Caregiving, released today, finds that during the past 12 months, almost 20 percent of caregivers report a decline in the quality of care their loved ones receive as a direct result of the recession, and 14 percent say the amount of care they have been able to provide for others during this time period has decreased. The survey is published by Evercare by UnitedHealthcare and the National Alliance on Caregiving……

New Survey: Economic Conditions Taking Toll On Family Caregivers And Their Ability To Provide Care

ADAPT and SEIU Rally in D.C. for Home Care at PHInational.org

Image via Wikipedia

 

Members of ADAPT, the United States’ largest grassroots advocacy organization for people with disabilities, and SEIU, the nation’s largest union for home care workers, created a stir in the nation’s capitol last week when they gathered to protest the Obama administration’s perceived lack of support for the Community Choice Act (CCA).

The three-day rally held April 27-29 drew considerable media attention when many of the 400 ADAPT members in attendance blocked Independence and Constitution Avenues, crawled up the steps of the Capitol Building, and chained themselves to the White House fence. Nearly a hundred, many of them using wheel chairs, were arrested by Washington, D.C. police for exceeding the size limit for protesting without a permit outside the White House (“More Than 100 Arrested in Series of Protests,” The Washington Post, April 28)……

ADAPT and SEIU Rally in D.C. for Home Care at PHInational.org

AAHSA Releases Culture Change “Toolkit” for States at PHInational.org

 

Last week PHI reported on the publication of a practical guidebook from the Advancing Excellence in America’s Nursing Homes campaign that helps nursing home staff to prepare, implement, and sustain culture change initiatives (see “Manual Offers Guidance for Culture Change in LTC,” April 30).

Now the American Association of Homes and Services for the Aging (AASHA) has provided a similar resource for U.S. states, to help them “initiate or expand culture change efforts in nursing homes.”

The State Investment in Culture Change Toolkit (pdf) describes programs and activities drawn from case studies of seven different states — Georgia, Kansas, Massachusetts, Michigan, North Carolina, Oregon, and Vermont — that have supported culture change activities. It was created by the Institute for the Future of Aging Services, AASHA’s research arm, and supported by The Commonwealth Fund….

AAHSA Releases Culture Change “Toolkit” for States at PHInational.org

http://ping.fm/kxVkD - May is "Protest the Mental Health System" Month - MindFreedom Live Web Radio - Free � MFI Portal

New blog post: http://ping.fm/Py3IS - Charge news from Gerald Butler

Info Long-Term Care: "Current Perspectives" Update: Managing Pain in Long-Term Care

 

Managing Pain in Long-Term Care in the J. W. Crane Memorial Library’s "Current Perspectives" series has been newly updated. The "Current Perspectives Series" from the J. W. Crane Memorial Library, highlights current articles, books and Internet resources on specific topics of interest to long-term care professionals.
To access Managing Pain and other topics in the series, go to: http://umanitoba.ca/libraries/units/health/links/aging.html#currentpers

 

Info Long-Term Care: "Current Perspectives" Update: Managing Pain in Long-Term Care

May 13: Mark Your Calendars for Another Long-Term Care Financing Call to Congress » Changing Aging - Ecumen

 

Please join us on May 13th for our next call-in to Congress re: making long-term care services and supports part of health care reform.  Last time you helped generate 5,000 calls to Congress.  We can do even better on May 13th. . .

Congressional committees are drafting health care reform legislation, and we expect to see their proposals over the next month. In order to ensure long-term services and supports are included in these proposals, we are inviting you to join us in a Congressional Call-In Day on May 13, 2009.

Beginning at 8 a.m. Eastern time, please call toll-free to (800) 687-3813. Tell your legislators why long-term services and supports are a must for both you and the people you serve.

May 13: Mark Your Calendars for Another Long-Term Care Financing Call to Congress » Changing Aging - Ecumen

Experts Set New Home Care Goals For Older Americans

 

U.S. home health care leaders and geriatrics experts have established the first national framework to define home care excellence and shape the future of home health services for older people."The Framework Initiative is the first comprehensive effort to synthesize a large body of geriatric and chronic care research and distill its application to the home health setting. Building on this evidence base, we drew on the knowledge and experience of experts in home care and geriatrics to chart the first national course toward home care quality improvement for older adults."
The Framework Initiative calls for the recognition by home care providers that truly outstanding home care must focus on older people and their well being not simply on their problem or disease. Home care providers must embrace foundational values that:
- Maximize older persons' quality of life
- Honor their preferences and provide genuine choices
- Optimize their health and ability to function
- Help them cope both physically and emotionally with decline and end of life
More information is available at http://www.champ-program.org/framework/.

Experts Set New Home Care Goals For Older Americans

Future Technology Blog | Jump The Curve | Long-Term Care’s Robotic Future

 

Later this week, I will be giving a keynote presentation to the Wisconsin Association of Homes and Services for the Aging. In addition to these two trends which I discussed a few weeks ago, another big trend I will be highlighting is the growing popularity of robotic pets. This six-minute video from Japan offers a glimpse into the future…..

Future Technology Blog | Jump The Curve | Long-Term Care’s Robotic Future

New blog post: http://ping.fm/nmWvo - The Growing Push for "Mad Pride" | Newsweek Health | Newsweek.com

New blog post: http://ping.fm/Msnyl - Community Care Recovery Institute

New blog post: http://ping.fm/4PzHI - Medicaid Prescription Practices Linked To Worse Outcomes With Mental Illness

I'm at the DCH Access standards tng. ,No wifi so I'llblog later

Seniors at home in co-housing - USATODAY.com

 

Annie Russell lives alone but not in solitude.

While she was laid up for almost nine months by an injured knee, neighbors checked in on her regularly. They brought her ice packs, fetched water and did her grocery shopping.

Twice a week year-round, everyone in Russell's community is assured dinner with friends in the large common house of Silver Sage Village in Boulder, Colo. It's a potluck of sorts. Residents can cook the meal together in a communal gourmet kitchen.

"If somebody just wants a place to live and doesn't want to commune with their neighbors, this is not for them," says Russell, 68.

Seniors at home in co-housing - USATODAY.com

New blog post: http://ping.fm/WG5BX - NH operators howl as government proposes slashing Medicare payments by $1 billion

Nursing home operators howl as government proposes slashing Medicare payments by $1 billion - McKnight's Long Term Care News

 

The Centers for Medicare & Medicaid Services set off a backlash from nursing home operators late Friday afternoon when it proposed “adjustments” that would cut Medicare payments by $1.05 billion in fiscal 2010. The 3.3% reduction will “largely” be offset by a 2.1% market basket increase, officials said.
Regulators stressed they would be simply closing a four-year window in which providers were paid far more than originally forecasted after a 2006 payment adjustment for certain therapy groupings. Providers, however, claimed the cut would be working against the spirit of the recently passed economic stimulus bill, endangering resident care and causing thousands of caregiver job losses.

Nursing home operators howl as government proposes slashing Medicare payments by $1 billion - McKnight's Long Term Care News

169 Years Of The British Medical Journal Now Free Online

 

Every BMJ article published since the journal's first issue in October 1840 is now freely available online from bmj.com. Eighteen of the BMJ Group's specialist journals - including Heart, Gut, and Thorax - are also available…..

For an introduction to the archive, a series of specially commissioned videos focussing on some of the important issues and individuals that have appeared in the journal's pages are now available at http://podcasts.bmj.com/themes/bmj/mp3/archive_videos/BMJ_archive_the_stories.mp4

169 Years Of The British Medical Journal Now Free Online

New blog post: http://ping.fm/bYOty - 169 Years Of The British Medical Journal Now Free Online

New blog post: Cuts for nursing homes in Medicare this fall http://ping.fm/O29Gz - Article - WSJ.com

Article - WSJ.com

 

WASHINGTON (Dow Jones)--The federal government has proposed a 1.2% cut in payments to nursing homes from the Medicare program as part of regulations that would take effect this fall.

Centers for Medicare and Medicaid Services, or CMS, announced the proposed payment cut, which would amount to $390 million. The cut takes into account a 3.3% reduction in payments based on changes to CMS payments to skilled nursing facilities for "medically complex" patients and a 2.1% increase to account for inflation….

Article - WSJ.com

New blog post: http://ping.fm/yOD4z - CDC releases guidance for long-term care on swine flu infection - McKnight's Long Term Care News

CDC releases guidance for long-term care on swine flu infection - McKnight's Long Term Care News

 

The Centers for Disease Control and Prevention has released interim guidance for healthcare facilities, including long-term care, for care of residents with confirmed or suspected swine flu, also known as the H1N1 virus.
The guidance offers recommendations regarding patient placement, isolation, management of visitors, and surveillance of healthcare professionals, among other guidelines. To date, there have been 109 confirmed cases in the United States and one death….
See the swine flu guidelines from the CDC at http://www.cdc.gov/swineflu/guidelines_infection_control.htm.

CDC releases guidance for long-term care on swine flu infection - McKnight's Long Term Care News

Off to the Arc Michigan Straegic Planning Session

Disableism Day Blog Post http://bit.ly/Tb6Yq

Worries About Losing Her Caregivers at Health Care for Health Care Workers

 

My name is Eunice Spooner, I’m a member of First Congregational Church in Waterville, and I live in Sidney. I was a school teacher until a car crash left me a quadriplegic and confined to a wheelchair over 20 years ago. Since then, I have had many blessings in my life – wonderful family, friends, and caregivers, the chance to be a deacon at church, a volunteer at the Atwood Elementary School, and a member of the SAD #47 School Board. Still, the fact is that I cannot get through my day without a lot of assistance throughout the day, from getting up, doing light housework, driving to appointments, going me to bed and even using the bathroom…….

Worries About Losing Her Caregivers at Health Care for Health Care Workers

The Age of What? on Disableism Day 2009

Culture is Frozen Struggle.
                     -after Roberto Unger

In our fight against ableism/disableism, we have passed through a legislative age (peaking with the passage of the ADA), and we are now  in an operational age, in which building support systems and creating communities that are accessible are the focus, whether through policy change, legislation, or community organizing.

What might the future hold?

• Collaboration with other communities for change that includes our issues, in a broader context of struggle

We remain isolated from the community of psychiatric survivors and that of people with developmental and cognitive disabilities.  The joke still is, “I may be _____, but I’m not ______!” (replace with your favorite vulnerable and oppressed communities). There is still no usable consensus on how to make the web accessible to people with low literacy, and the web as a whole is still growing faster than the accessible web. Driving change through peer relationships and peer organizations is still at its very beginning in both of these communities.

But Michigan has 500 peers working in the mental health system, a group of adults with DD is developing a model of peers, and I saw a nice article about an anarchist conference where safe spaces for recovery was a break out session.

• The oppression of people with disabilities still remains a cultural and ethical “right”.

While there is a lot more going on internationally than even a couple of years ago, people with psychiatric labels and persons with developmental disabilities still wallow in hideous institutions, not to mention nursing homes,  both here and everywhere.

Medicine is finding (even developing standards for), killing us before we would die on  our own, not treating us, and consigning us to ethical limbos based on our “inferiority”.  Sterilization of people with DD still goes on in hospitals everywhere. Stephen Drake and Not Dead Yet still have way too much to do.

But, institutions are being challenged internationally, families are finding the courage to challenge their members oppression, and multi-ethnic culturally focused collaborations are fighting against the assumption of cultural “rights” to oppress.

I think these two arenas are the grounds upon which our struggles will take place for the next generation.

And we need to start working on prisons and disability and post-incarceration peer support.

Struggles they will be…….

Technorati Tags: disableism day

A Little-Known VA Benefit: Long-Term Care Aid for Vets and Surviving Spouses : Veterans Today - News for U.S. Military Veterans Jobs, VA Benefits, Home Loans, Hospitals & Administration

 

There’s actually a little-known veterans’ benefit that helps wartime veterans and their surviving spouses pay for a variety of medical and long-term care costs. Here’s what you should know.

The VA benefit that may help your dad is called “Aid and Attendance,” a special pension benefit established in 1952 that provides a tax-free monthly income up to $1,644 for a veteran; $1,056 for a surviving spouse; or $1,949 for a veteran and one dependent. The money can be used to pay for in-home care, assisted living and nursing home care as well medical expenses, prescription drugs and more.

Today, around 150,000 veterans and surviving spouses receive this benefit, but hundreds of thousands more are eligible and either don’t know about it, or don’t think they can qualify for it.

To qualify, your dad must have served at least 90 days of active military service with at least one day of service during a period of war (stateside or overseas), and was not dishonorably discharged. (Single surviving spouses of war time vets are also eligible if their marriage ended due to death.) Your dad will also have to meet certain physical and financial requirements to be eligible……

A Little-Known VA Benefit: Long-Term Care Aid for Vets and Surviving Spouses : Veterans Today - News for U.S. Military Veterans Jobs, VA Benefits, Home Loans, Hospitals & Administration

Baucus, Grassley propose 'bundling' of post-acute payments; nursing home groups object - McKnight's Long Term Care News

Image by Getty Images via Daylife

 

Sens. Max Baucus (D-MT) and Charles Grassley (R-IA) this week released several policy ideas for revamping America's healthcare delivery system. Many of these would affect the long-term care and post-acute care fields.
Under their proposal, a Medicare value-based purchasing plan would be implemented for skilled nursing facilities by 2012. Baucus and Grassley also suggest bundling payments for post-acute care services occurring or initiated within 30 days of hospital discharge. These would include skilled nursing facilities…..

Baucus, Grassley propose 'bundling' of post-acute payments; nursing home groups object - McKnight's Long Term Care News

Community Approach Necessary For Affordable Long-Term Care, Says NCB Capital Impact

Image via Wikipedia

 

In light of protests in Washington urging inclusion of the Community Choice Act in health care reform efforts, NCB Capital Impact points to the success of existing community-based, affordable long-term supports models as examples of what is possible.

The number of those who need more intense health care support is at an all-time high. Among the 54 million people with disabilities in the U.S., there is a growing population seeking affordable and accessible living alternatives that allow them to stay connected to their communities. Additionally, the projected growth of the elderly population, which currently includes more than 37 million people age 65 or older in the U.S., highlights the need for health care reform that supports consumer preference and choice.

NCB Capital Impact and its partners nationwide have established community-based long-term supports models that can provide affordable access to services for people in their homes and communities. The Village-to-Village approach establishes membership-driven organizations run by small staffs and volunteers who coordinate affordable services including transportation, in-home medical care, home repairs and other day-to-day needs enabling individuals to receive care at home. Another example, the Green House Project(R), transforms institutional long-term care by altering facility size, interior design, staffing patterns and methods of delivering skilled professional services in a way that creates communities for individuals and staff that emphasize social networks……

Community Approach Necessary For Affordable Long-Term Care, Says NCB Capital Impact

Study: Long-term care costs on the rise - South Florida Business Journal:

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The high cost of long-term care and the economic downturn are creating significant financial planning challenges for Florida’s elderly population, according to a newly released study by Genworth Financial.

Nationwide, the annual cost of a private nursing home room is $74,208, or $203 a day, up 4 percent a year since 2005, according to the study……

Study: Long-term care costs on the rise - South Florida Business Journal:

Care Coordination for Seriously Injured Veterans Improving -- House Committee on Veterans' Affairs Press Release from VA Watchdog dot Org - 04-30-2009

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On Tuesday, April 28, 2009, the House Veterans’ Affairs Oversight and Investigations Subcommittee, led by Chairman Harry Mitchell (D-AZ), conducted a hearing to evaluate the newly implemented Federal Recovery Coordination Program (FRCP). The Subcommittee examined the effectiveness of the FRCP which was established in October 2007 and went into operation in January 2008. The Subcommittee also assessed if outreach efforts by the Department of Veterans Affairs (VA) has succeeded in bringing coordinated care to veterans who were injured prior to the launch of the FRCP….

Care Coordination for Seriously Injured Veterans Improving -- House Committee on Veterans' Affairs Press Release from VA Watchdog dot Org - 04-30-2009

Manual Offers Guidance for Culture Change in LTC at PHInational.org

 

A new manual from the Advancing Excellence in America’s Nursing Homes campaign created with support from the Commonwealth Fund seeks to address this issue by offering nursing home staff an evidence-based guide to preparing, implementing, and sustaining clinical and cultural changes.

Implementing Change in Long-Term Care: A Practical Guide for Transformation (pdf) is a 134-page manual written by Barbara Bowers, Ph.D., R.N., Kim Nolet, B.S., Tonya Roberts, B.S., R.N., and Sarah Esmond, M.S., of the University Wisconsin–Madison School of Nursing, and published in April 2009.

In its introduction, eight chapters, and four appendices, the manual offers various strategies for developing:

• person-centered care and culture change models
• strong leadership
• effective teams
• skilled staff
• preparation activities and organizational assessments
• accountability systems

Manual Offers Guidance for Culture Change in LTC at PHInational.org