Friday, July 31, 2009
Thursday, July 30, 2009
Tuesday, July 28, 2009
What do a long term care facility and a fire house have in common? A lot actually. Dirty jobs, life and death, dark moments and light yet the firefighters culture thrives with little burnout and low attrition. Why is that? Firefighters create a supportive and celebratory culture that acknowledges the heartache (death around the corner) while celebrating joy. Long term care workers are confronted with their mortality every day but have little support to help them relieve fear, grief and sadness. When they are burned out they leave.
Friday, July 24, 2009
Wednesday, July 22, 2009
AAHSA has a unique way to involve people at a grassroots level in the health reform debate as it pertains to long term care.
You can do your part by throwing a Party with a Purpose. These community gatherings will serve as a platform for conversation and action around long-term services and supports.
Tuesday, July 21, 2009
In the past five years more than 40 Web sites have begun reviewing physicians. Questions about their usefulness have fueled debate. As a defensive measure, some physicians are requiring patients to sign broad agreements that prohibit online postings or commentary in any media outlet. Medical Justice, a company that for a fee starting at $495 provides sample privacy agreements and monitors online comments for its 2,000 physician members.
Read more in this Washington Post article. Suffice it to say there are arguments on both sides of this thorny issue.
Freedom of speech probably trumps the “for” arguments. Word of mouth is here to stay. It can happen in a real conversation face to face or online. No real difference. The same useful or trivial information will be shared.
And that points to just how useful any of this is at the end of the day for your actual health, the “against” argument.
Hospitals spend millions advertising their quality ratings and positioning themselves to be featured in the U.S. News and World Report Best hospitals. Yet no one really understands an iota about the ratings and the criteria. Yet it forms a perception, maybe a wrong one. Same with physician ratings that paint a picture of a doctor more from the office experience than clinical ability. I rather know a primary care physician’s rate of correct diagnosis if you could measure it. Or tell me how many procedures of x y or z you have performed so I get a comfort level of your real expertise. Oh yeah how many people died under your watch? But that is not what these sites are touting.
They are touting in the physician’s case the experience and that is something that physicians need to pay attention to or they will lose patients to a practice that may be clinically equivalent but offer more in terms of a pleasing experience. John Swapceinski, a founder of RateMDs.com, says waiting time is a "huge issue" mentioned often, as are statements such as the doctor "never made eye contact and was out in 30 seconds."
I left a competent physician and now drive 40 miles out of my way for the experience of my primary care physician. Why? Well let’s start with he actually returns phone calls and spends time with you. This is simple people.
The public should take most of the information with a grain of salt. Unfortunately providers have to assess the damage to their reputations. "I'd love to have a Web site where I could complain about patients," one doctor said. Yeah, that’s the answer. For me it comes down to the experience. And that can be subjective.
It’s about how you would like to feel when the visit is said and done and how much you are willing to tolerate. Were you harried, worried, discomforted or were you assured, confident and bolstered. You may have a clinically fine doctor that offers the former experience and decide to put up with it. That is your decision. Or you may decide that feeling confident and supported in your healing journey is just as important as the practitioner’s clinical expertise. Then you might walk.
Monday, July 20, 2009
The findings suggest that this may be in part because their remaining brain cells become extra large to compensate. According to scientists, people's brains can adapt and change -- a phenomenon known as plasticity -- well into an individual's 80s and 90s. It's possible that neurons get bigger to compensate for damage done by the toxic proteins produced in Alzheimer's disease.
The results were published in the journal Neurology.
Scientists have wondered why some people with plaques and tangles in their brains characteristic of Alzheimer's have intact mental faculties their whole lives. Rush University conducted similar studies and found that people with the tangles and plaques in their brains that did not show symptoms were those who had broad social networks.
So this is making sense. Develop your language skills and use them to cultivate meaningful relationships.
Friday, July 17, 2009
Person Centered Care. Culture Change. A lot of jargon is being spewed in the continuum of aging services. What I have noticed though is that while the talk is good, the underlying tone is somewhat defeatist and negative and that can only spell doom for the industry.
While embracing the Eden Alternative or building Green Houses is great, there is something more fundamental that needs to take place - not hammers and nails but a shift in hearts and minds. When the shift occurs, natural positive movement occurs. What is that shift? Take a look.
Thursday, July 16, 2009
However to imply cheesy and amateur to some of the music offerings in the continuum of aging services is to suggest that not a single one of those residents has sophisticated tastes and appreciates good music and performing when they hear and see it.
After all these are the same people that went to opera or went to see Sinatra. Yet cheesy and amateur is all they deserve I guess.
I know what I offer in these facilities is of a caliber they would have paid to see in their life outside the facilities they live. And there are many other fine entertainers (yes some cheesy and not talented as well.).
So Ms. Osbourne, why don't you join me in Philadelphia the week of August 10 during my 15 nursing and assisted living facilities and see what life and activities are really like in a place you have probably rarely if ever stepped into.
Tuesday, July 14, 2009
Wednesday, July 8, 2009
I have witnessed hundreds of times in nursing homes how a seemingly incoherent person can come alive during a performance. Anecdotal and observational evidence of the healing power of music abound. But now science is catching up. (Check this article at CNN about music’s therapeutic value.)
Researchers in Finland have demonstrated that listening to music for several hours a day can enhance the rehabilitation of stroke patients.
At Colorado State University, researchers have used musical and rhythmic cues as a tool to improve the movement and balance of Parkinson's disease sufferers.
Not too long ago at a performance, a resident told me he recently had head and neck surgery and was ordered not to participate in activities. He wanted to be at my performance. I was touched and also told him I believed that the music was part of his healing. He agreed.
So what's my point? Tune in here.
Tuesday, July 7, 2009
Thursday, July 2, 2009
Reporting in the June 10 issue of BMJ, researchers have developed a new self-administered cognitive test that is quick to use, examines 10 skills, and reportedly detects 93% of cases of Alzheimer's disease. Lead researcher and neurologist Jeremy Brown, MD, from
Investigators evaluated subjects from three hospitals including a memory clinic. They looked at 540 control participants and 139 patients with dementia or amnesic mild cognitive impairment. Of the 139 patients with dementia or mild cognitive impairment, 108 had Alzheimer's disease and 31 had degenerative dementias.
The test requires participants to write 10 answers on a double-sided card. The requested tasks evaluate a range of areas, including the patient's semantic knowledge, ability to calculate and name objects, and recall. A Web site is being developed for clinicians to download the new test, scoring sheets, and further instructions.
Globally approximately 24 million people have dementia, and it is estimated that the prevalence will double every 20 years. Cognitive tests are useful to diagnose dementia and to evaluate functional ability. Currently available cognitive tests do not satisfy criteria for widespread use by non-specialists.
Wednesday, July 1, 2009
In this blog, the author makes a great case for the importance of technology to the patient experience. In this case telemonitoring. To quote:
"Telemonitoring, in and of itself, doesn’t change lives. Telemonitoring is really just a 21st century biofeedback service. Remote monitoring combined with the “just in time” teaching provided by our telemonitoring nurses give our patients the information they need to decide if they want to change their lives. Increasingly, our patients decide whether their chronic illness controls them or whether they, as much as possible, control it. Telemonitoring doesn’t cure disease, but it gives them another way to understand the information that we, the healthcare clinicians, have been giving them for weeks, months, and sometimes, years. "
So telemonitoring influences behavior far more than verbal and written instructions seem to provide. Sure we know the regimens and instinctively know what we should be doing but when your compliance is demonstrated it puts it in a different perspective.
Lesson for readers, our caregivers and elderly - embrace technology.