AMNews: Aug. 31, 2009. Accountable care organizations: A new idea for managing Medicare ... American Medical News

 

….The accountable care organization is one of the latest designs for managing Medicare that is gaining traction among policymakers desperate to control costs and boost quality in the system. Proponents of the concept want to see it tested along with such alternatives as patient-centered medical homes, pay-for-performance and payment bundling.

A typical Medicare ACO would include a hospital, primary care physicians, specialists and potentially other medical professionals. Services would still be billed under fee-for-service, but the organization's members would coordinate care for their shared Medicare patients with the goal of meeting and improving on quality benchmarks. Because ACO members are held jointly accountable for this care, they would share in any cost savings that stem from the quality gains……

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AMNews: Aug. 31, 2009. Accountable care organizations: A new idea for managing Medicare ... American Medical News

Long Term Care Link - A Comprehensive Resource for Long Term Care

 

Welcome to the National Care Planning Council...

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and our web site "Long Term Care Link", a comprehensive
resource for long term care planning. The articles below will
help you learn about long term care planning and the providers
and services in the categories on the left and below under
"Find Eldercare Services" are here to help you with your
eldercare planning needs.

Long Term Care Link - A Comprehensive Resource for Long Term Care

Senior-proof your house now so you don't have to move later | News for Dallas, Texas | Dallas Morning News | Dallas Business News

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The Dallas couple, who are in their early 60s, have remodeled their 1980s-vintage master bathroom and kitchen so that they can use both more easily as they grow older. They replaced their tub with a step-in shower, and they enlarged the kitchen and installed pullout shelves….

Like the Exleys, nine of 10 people older than 50 plan to remain in their homes for as long as their health allows, an AARP survey has found. But most older homes weren't built to accommodate the frailties of old age.

The typical American home is still a "Peter Pan house," constructed for the young couple whom contractors think will never grow old, said Marty Bell, director of communications and marketing for the National Aging in Place Council, an advocacy organization….

Senior-proof your house now so you don't have to move later | News for Dallas, Texas | Dallas Morning News | Dallas Business News

Reminders From Intelligent System Increase The Independence Of Those With Special Needs

 

A team of researchers from the University of Granada (UGR) has created a system with Artificial Intelligence techniques which reminds elderly people or people with special needs of certain everyday tasks. This system uses sensors distributed in the environment in order to detect their actions and mobile devices which remind them, for example, to take their keys before they leave home……

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Reminders From Intelligent System Increase The Independence Of Those With Special Needs

"Dermastream" To Heal Bedsores And Chronic Ulcers

 

More than six million people in the U.S. suffer from persistent wounds - open sores that never seem to heal or, once apparently healed, return with a vengeance. Employing a special solution developed at Prof. Freeman's TAU laboratory, Dermastream offers a new approach to chronic wound care, a specialty known as "continuous streaming therapy." ……

"Our basic idea is simple," says Prof. Freeman. "We treat the wound by streaming a solution in a continuous manner. Traditional methods require wound scraping to remove necrotic tissue. That is expensive, painful and extremely uncomfortable to the patient. And while active ingredients applied with bandages on a wound may work for a couple of hours, after that the wound fights back. The bacteria build up again, creating a tedious and long battle……

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"Dermastream" To Heal Bedsores And Chronic Ulcers

Mind Book Throws Spotlight On Chemical Cosh

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Today leading mental health charity Mind has helped to redraw the boundaries in our understanding of psychiatric medication, with the launch of new book Psychiatric Drugs (1). Drawing heavily on individuals' experiences, it is the first book of its kind to explore what it is like to take antidepressants and other drugs from the viewpoint of the patient, and it contains new and provocative material about people's relationships with some of the most debated and controversial medications around……

Mind Book Throws Spotlight On Chemical Cosh

Families Say Healthsense's ENeighbor(R) Remote Monitoring System Helps Keep Relatives With Alzheimer's Safe At Home And Out Of Memory Care

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Families in Ohio and Pennsylvania who use Healthsense's state-of-the-art eNeighbor® remote monitoring to help care for elderly relatives with Alzheimer's disease or dementia say the technology has enabled them to keep their loved ones safe at home for longer and delay placing them permanently in secured memory care units. They also credit the Healthsense technology with improving their own quality of life by helping relieve the stress and strain of tending to seniors with Alzheimer's or dementia…….

Developed with grants from the National Institutes of Aging (NIA) and the Defense Advanced Research Projects Agency (DARPA), the eNeighbor system is built around a set of battery-operated Wi-Fi sensors placed in private homes or senior living residences to monitor residents' daily living activities and wellness. These sensors include pressure sensors in beds to detect when a resident gets in or out of bed; motion detectors on walls to detect movement or inactivity; toilet sensors to monitor toilet usage; contact sensors on kitchen cupboards and refrigerator doors to monitor whether the resident is eating regularly; and door sensors that alert when the resident tries to leave the residence or enter potentially hazardous areas, such as stairways. eNeighbor's "smart" operating system uses algorithms to analyze the sensor data and determine whether the resident requires assistance. The system automatically issues assistive prompts or alerts via any phone when the data indicate help is needed. Information and reports can also be accessed from a secure web portal……

Technorati Tags: dementia,emonitor

Families Say Healthsense's ENeighbor(R) Remote Monitoring System Helps Keep Relatives With Alzheimer's Safe At Home And Out Of Memory Care

Payment Options for Elder Care and Assisted Living

 

Our goal is to help aging Americans and their families understand their long term care options and connect with the best resources to pay for at-home care, assisted living, Alzheimer's and nursing home care.   We provide benefits and eligibility information on many resources including federal programs such as Medicare or Medicaid and outside financial resources such as veterans’ pensions or reverse mortgages.

Many care and financial options exist, but differing eligibility requirements can make sorting through them a challenge.  To help visitors with this task, we provide two methods to access this site’s content. Use the Eldercare Resource Locator Tool to search for senior care resources based on your current situation or Browse by Resource Category & Name……

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Payment Options for Elder Care and Assisted Living

Alzheimer's Reading Room: Wii a Useful Tool for Alzheimer's Caregivers

 

Back in May I wrote about Wii Fit suggesting it would be an excellent tool for older people and those suffering from Alzheimer's disease.
The game satisfies two needs: social interaction and exercise.
Recently, I am reading articles about how Wii is being adopted by Senior centers and assisted living facilities all across the country. The game of choice seems to be bowling. Wii bowling provides moderate exercise and allows groups to get together much like they would at a bowling alley……

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Alzheimer's Reading Room: Wii a Useful Tool for Alzheimer's Caregivers

Treatment For Chronic Illness Must Be Less Disruptive In The Daily Lives Of Patients

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A paper published today on bmj.com reports that many patients with complex chronic illnesses are overwhelmed by their treatment.
The authors explain that the burden is caused by the healthcare systems themselves. In order to be effective, care must be less disturbing in the daily lives of patients……

Treatment For Chronic Illness Must Be Less Disruptive In The Daily Lives Of Patients

Veteran, Caregiver Bill Passes House at PHInational.org

Technorati Tags: LTC,veterans,pay family caregivers

Why is such a simple approach so lacking in so many parts of the Medicaid LTC system?

On July 28 the U.S. House of Representatives passed what the Military Times described as “landmark legislation to train family members to provide care for severely wounded veterans — and pay them for it” (”House passes bill to train, help caregivers,” July 28).

HR 3155, the Caregiver Assistance and Resource Enhancement Act, or CARE Act, received vocal support from families of wounded war veterans after being introduced into the House in July. CNN reported that supporters and members of the Wounded Warrior Project, an advocacy group and provider of services for injured soldiers, gathered along with politicians on Capitol Hill on July 21 to urge Congress to pass the bill (”Wounded Warrior Program urges funding for war vet caregivers,” July 21)…..

Veteran, Caregiver Bill Passes House at PHInational.org

Report: Make Olmstead Principles Part of Health Reform at PHInational.org

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Includes Video and Report Link: 

A full implementation of the home and community-based care principles embodied in the landmark Olmstead Supreme Court decision will achieve two of the chief goals being pursued in the current push for national health reform, namely, saving money and improving health care outcomes. This is the claim advanced in “Still Waiting: The Unfulfilled Promise of Olmstead” (June 24, 2009, pdf), a recent report from the Washington, D.C.-based Bazelon Center for Mental Health Law.

Main points in the report include:…….

Report: Make Olmstead Principles Part of Health Reform at PHInational.org

TheHill.com - Health reform, long-term

 

Though unnerved by uncertainties about what Washington is offering, Americans are still demanding healthcare reform.
If one little-discussed element of reform is missing, however, Americans will be surprised, and even distraught, while the country will be ensnared in another kind of healthcare crisis in the near future.

Most Americans believe healthcare reform will provide coverage for a variety of long-term care services. In a survey we conducted for the American Associating of Homes and Services for the Aging, majorities expected that care for people with Alzheimer’s disease (61 percent), in assisted living (57 percent) and assistance for an older or disabled person in taking their medications (64 percent) will all be covered when healthcare reform is enacted.

If the Senate HELP Committee’s bill, or that reported out by the House’s Energy and Commerce Committee, reflect the ultimate shape of what is passed into law, voters’ expectations will be met. Those versions of healthcare reform create a voluntary insurance program where, for premium payments of just a couple of dollars a day, the elderly, the disabled or anyone who needs assistance caring for themselves will receive a benefit of up to about $37,000 a year.

Constituents are expecting reform to provide some mechanism for long-term care, and they will be sorely disappointed if healthcare reform fails to deliver in this arena. More important, the country will be far worse off for having squandered the opportunity to avert an impending crisis.

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TheHill.com - Health reform, long-term

Study Shows That Competitive Bidding Benefits Insurance Companies And Forces Many Seniors To Use Out-of-State Providers

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The American Association for Homecare hosted a media conference call yesterday, unveiling a new economic study that exposes severe flaws in the Medicare competitive bidding program for durable medical equipment and services. The bidding program is set to re-start this October. The study, released today by Brian O'Roark, PhD, of Robert Morris University, found that the federal Centers for Medicare and Medicaid Services drastically misread the marketplace and that the current competitive bidding program reduces overall competition and hurts the quality of patient care.
The full report and a summary of findings are available at http://www.aahomecare.org.

Study Shows That Competitive Bidding Benefits Insurance Companies And Forces Many Seniors To Use Out-of-State Providers

Research Activities, July 2009: Elderly/Long-Term Care: Dramatic changes in family structure have altered the care of disabled elderly parents

 

Since the 1970s there have been profound changes in family structure in the United States that have the potential to alter the care received by disabled elderly parents from their children, according to a new study by Barbara Steinberg Schone, Ph.D., of the Agency for Healthcare Research and Quality, and colleagues. They used data from the Asset and Health Dynamics Among the Oldest Old survey to estimate the joint probabilities that an adult child provides time and/or cash transfers to a parent.

The estimates suggest significant detrimental effects of parental divorce and step relationships on support of disabled elderly parents. For example, children were significantly less likely to provide care to their disabled parent if the parent was divorced versus widowed. Children of divorced parents were about half as likely as children of widowed parents to co-reside with a parent and their parents were more likely to live alone or in a nursing home. Children with parents who remarried were less likely to provide cash transfers and more likely to have a parent who was in a nursing home…..

Technorati Tags: family support,LTC

Research Activities, July 2009: Elderly/Long-Term Care: Dramatic changes in family structure have altered the care of disabled elderly parents

Thousands of California Elders Losing Long-Term Care - NAM

 

Thousands of California Elders Losing Long-Term Care

New America Media, News Report , Paul Kleyman, Sidebar by Justine Drennan, Posted: Aug 10, 2009

Thousands of California Elders Losing Long-Term Care

New America Media, News Report , Paul Kleyman, Sidebar by Justine Drennan, Posted: Aug 10, 2009

Ortiz & Carol Walton from Paul Billingsley on Vimeo.

Renowned bassist Ortiz Walton was once the youngest person and first African American to play in the Boston Symphony.

But at 75, not only can’t Walton play his bass, but he cannot bathe, dress, eat or move in his wheelchair without the help of his wife, Carol, and assistance from state-subsidized services designed to keep him in their Berkeley, Calif., home and out of a nursing institution.

Those services, were line-vetoed entirely last week by Gov. Arnold Schwarzenegger. The governor terminated $489 million in additional spending over and above reductions already agreed on by California legislators..…..

We must pass CCA!

Technorati Tags: LTC,HCBS,California

 

Thousands of California Elders Losing Long-Term Care - NAM

Avoid conservatorship; opt for power of attorney | jacksonsun.com |

 

She has never signed a power of attorney, legally designating you as the person she wants to make decisions and transactions for her if she is incapacitated.

Is it too late? Is the only option an expensive trip to court to invoke a conservatorship?

Maybe not, says elder-law attorney Tim Takacs of Hendersonville. He stresses that, if possible, you avoid conservatorship, which is a legal right given to a person to be responsible for the assets and finances of a person who is incapacitated. A judge oversees decisions the conservator makes.

Takacs argues that just because there is a diagnosis of Alzheimer's or dementia, it doesn't mean the person can't sign a power of attorney.

"The law says there is a presumption of competency," Takacs said. "Merely because you have a diagnosis does not change the presumption. It doesn't matter if you have had Alzheimer's disease for eight years. You are still presumed to have full competency. Mental capacity is not an all or nothing thing."……

Technorati Tags: LTC,dementia,conservatorship

Avoid conservatorship; opt for power of attorney | jacksonsun.com |

National Survey: Caregivers Find Unexpected Emotional Rewards in Tending for Family Members

 

Nearly 80% of family caregivers are finding the caregiving experience emotionally rewarding, despite initial negative perceptions of caregiving, according to a nationwide survey by Caring Today magazine.
Published in conjunction with National Family Caregivers Month this November, the Caring Today survey shows that caregivers have distinctly more positive feelings after caring for a family member than they did as they were about to take on the responsibility. The number of caregivers finding the experience highly rewarding jumped by 50% following the caregiving experience…..

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National Survey: Caregivers Find Unexpected Emotional Rewards in Tending for Family Members

The Dementia Caregiver's Toolbox : Dementia Caregiving: When A Loved One Is NOT Loved

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I had a recent email from a reader who asked a critical question that I have heard before:  How do you care for someone with dementia when they are not a "loved one"?  Isn't caregiving hard enough even when the person IS loved?

We take for granted that we are thrown into dementia caregiving situations by our roles and relationships:  a husband who cares for his loving wife of 45 years or an only child who brings her mom to live with her, without reservation.  Yet a minority of the many dementia caregivers out there are caring for those with dementia who wouldn't fall into the category of even "liked one", let alone "loved one".  These are persons who now have dementia who may have been abusive parents, unfaithful husbands or in general, led a life that made people run from them, not care for them.

The Dementia Caregiver's Toolbox : Dementia Caregiving: When A Loved One Is NOT Loved

Amazon, Kindle, boomers and seniors -- they get it | Aging In Place Technology Watch

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Image via CrunchBase

 

So it's not the first time I have had the Kindle presented as a technology for seniors -- in a recent overview I did for a senior center, one of the attendees observed that I had left the product out. Two days ago as I walked past two elderly individuals seated on motorized scooters in the back of an ampitheater in Chautauqua NY, a family member poked me as we walked by -- they were listening to music side-by-side AND reading books on their Kindles -- which they might have learned about at the Amazon product forum for seniors. I think they were friends.

Kindle is a device for downloading books -- up to 1500 of them. It's not cheap -- at $299 -- or upwards of $359 and beyond for latest models..……

Amazon, Kindle, boomers and seniors -- they get it | Aging In Place Technology Watch

Google Voice -- Compelling phone service trumps Skype for Boomers and Seniors | Aging In Place Technology Watch

 

Yeah, yeah, Skype is cool for boomers and seniors -- especially grandparents. Free video conferencing with the grandkids and free long-distance calls -- even if some of them are a bit flaky in quality, probably due to a poor Internet connection. And the teaser (of course) is to upgrade you to their low, low international long distance phone plans. Okay, sounds good -- and I know folks love it -- "Do you Skype?" is a frequent starter for planning a meeting. But let's just forget Skype for a minute -- a jaw-dropping service may be around the corner -- Google Voice.

Google has snuck up on the long distance world -- and said 'Boo'. Google grabbed a million phone numbers from Level 3, according to NetworkWorld, and in the past few weeks has enabled users to sign up online and be 'invited' to select one of those numbers, which can be in your standard local area code, selected by you from a displayed list. What can you do with that number? Well that's the game changer, as they like to say in the tech world……

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Google Voice -- Compelling phone service trumps Skype for Boomers and Seniors | Aging In Place Technology Watch

How Choose an Emergency Alert System

 

More than 33 percent of accidents and falls involving people over age 65 occur at home, according to the CDC. A caregiver’s worries never end, particularly when the elderly parent wants to remain living in their own home – which most seniors would prefer to do for as long as possible. But what if an elderly mother falls, or dad has heart attack, stroke or any medical emergency? What if they are home alone? What if they can’t get to a telephone to dial for help?…….

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How Choose an Emergency Alert System

Senior Helpers National In Home Care Talks About Home Safety and Security for Seniors « Senior Helpers National In Home Care

Cover via Amazon

Technorati Tags: LTC,home safety

Did you know that of the three million Americans age 65 and older who are involved in accidents every year, a majority were injured right in their own homes?

The good news is that many of these accidents can be prevented. With a small investment of time and effort, you can help protect yourself or your loved one from dangers in the home.

A Five Step Plan for Protecting Against Accidents

There is no magic formula for avoiding mishaps in the home. But advanced planning and taking proactive steps can lower the risk. Here is a simple plan to follow for making safety a greater priority:

Good stuff worth looking at…..

Senior Helpers National In Home Care Talks About Home Safety and Security for Seniors « Senior Helpers National In Home Care

JULY09-Gazette.pdf

From the National Consumer Voice for Quality Long-Term Care:

Articles on Ombudsman programs, awards, and lots of other stuff.

Technorati Tags: NCVQLTC,LTC

JULY09-Gazette.pdf (application/pdf Object)

Do Not-For-Profit Nursing Homes Provide Better Quality Care?

 

On average, not-for-profit nursing homes deliver higher quality care than do for-profit nursing homes, according to a study published on bmj.com today……

Technorati Tags: LTC,nonprofit vs. forprofit,nursing homes

Do Not-For-Profit Nursing Homes Provide Better Quality Care?

Healthcare Intelligence Network-Story of the Week: Long Term Care

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Technorati Tags: LTC,global aging

The average age of the world’s population is increasing at an unprecedented rate. The number of people worldwide 65 and older is estimated at 506 million as of midyear 2008; by 2040, that number will hit 1.3 billion. Thus, in just over 30 years, the proportion of older people will double from 7 percent to 14 percent of the total world population, according to a new report, An Aging World: 2008. The report examines the demographic and socioeconomic trends accompanying this phenomenon. It was commissioned by the National Institute on Aging (NIA), part of the National Institutes of Health and produced by the U.S. Census Bureau.

Healthcare Intelligence Network-Story of the Week: Long Term Care

Democrats Ignoring Long-Term Care, Activists Respond. LET MY PEOPLE GO! – Nick's Crusade

 

44 years ago, Congress passed several historic amendments to the Social Security Act, the Medicare and Medicaid programs. Back then, there were no home ventilators, there were few medications for managing disease, there were no home Hoyer lifts, and Congress couldn’t imagine the elderly and disabled living at home successfully and independently. The technology and possibilities for independent living have been available for over three decades now, but the law has not changed. The feds only mandate that state Medicaid agencies cover long-term care in nursing homes and other institutions. Basically, Pharaoh will only allow you care in a prison-like setting. People with disabilities are forced every day to leave their taxpaying jobs and families behind to go into these prisons. It’s the only way they can get the care needed to stay alive. “Give up your freedom or give up your life,” is no choice at all.

The Pharaoh is now drafting his plan to reform America’s insane health care system, but has said that long-term care, which Medicaid is the number one provider of, will not be reformed in this package. How can they reform health care without addressing long-term care, one of the biggest expenses straining state budgets and bankrupting American families? It is bizarre that legislators and voters could ever see this as a separate issue, when it is one of the worst examples of how badly the system is broken. Institutions cost the most of any long-term care option, but are enshrined in law as mandatory, while home care services, the least expensive option, are slashed to the bone by states because they are “optional.” States are still forcing people with disabilities into institutions, the most costly option, because of the antiquated and discriminatory institutional bias in federal Medicaid law that both parties continue to choose to ignore…..

More, including a video…

Democrats Ignoring Long-Term Care, Activists Respond. LET MY PEOPLE GO! – Nick's Crusade

Ask Medicare

This site has lots of info for caregivers on the ins and outs of Medicare.

Medicare.gov - Caregiver