Friday, December 18, 2009
I am not going to debate the medicine and science behind VBAC's (vaginal birth after C-Section) but I will say that this shows that if people do not like the experience at one health care entity they will travel for a better experience elsewhere, in this case six hours away.
As reform rolls out and more people flood the system, patients need to be more conscious and demanding of their health care experiences and employers need to respond in kind.
Thursday, December 17, 2009
A recent Career Builder survey reveals that 20% of healthcare workers have low morale; 38% lack motivation; and 25% have no loyalty. Why is that important to providers, consumers, boomers and seniors? Take a look.
Astronauts experiencing weightlessness often suffer from disorientation, motion sickness and a loss of sense of direction because their bodies try to adapt to the conditions of microgravity. Back on Earth, they must readjust to gravity and can experience problems standing up, stabilizing their gaze, walking and turning.
The Sensorimotor Adaptation Team ( I kid you not. That is their name.) is developing pre-flight and in-flight training countermeasures, so that astronauts can adjust more rapidly to weightlessness, to other gravitational environments and upon return to Earth.
An Adaptability Training System (ATS), that they hope will help astronauts overcome these problems more quickly is being developed. A treadmill is mounted on a moveable platform in front of a large projection screen showing images of streets or hallways or a room. As the person walks, the image moves—along with the platform, simulating balance disturbances. Though developed for astronauts, researchers say the system could have enormous benefit for seniors and those with balance issues.
Studies will provide basic knowledge relating to dizziness and balance problems affecting more than 90 million Americans, particularly the elderly. Forty percent of nursing home admissions are due to injuries caused by falls. Falling is the leading cause of accidental death for persons over age 75.
Wednesday, December 16, 2009
Trust for America''s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released a public opinion survey that finds that 71 percent of Americans favor an increased investment in disease prevention and that disease prevention is one of the most popular components of health reform. Disease prevention receives majority support from across the political spectrum (85 percent of Democrats, 59 percent of Republicans, and 68 percent of Independents) and across the country (72 percent in the Northeast, 73 percent in the South, 71 percent in the West, and 69 percent in the Midwest).
People also think prevention will save money rather than cost money. Prevention was the second highest proposal tested, after prohibiting insurance companies from denying coverage because of age, medical history, or pre-existing conditions.
58 percent of Americans favor a proposal to create a National Prevention and Wellness Strategy to coordinate efforts by assessing the health of our country, establishing priorities, and setting health goals.The poll, which reflects the responses from 1,008 registered voters, was conducted by Greenberg Quinlan Rosner Research and Public Opinion Strategies from November 2 to 5, 2009. The margin of error was +/- 3.1 percent.
Someone should devise a poll gauging individual health behaviors and how they intend to change them. All this poll seems to indicate is that their should be some "body" that establishes and dictates actions but does not even hint as to whether the public would actually follow any recommendations put forth.
And anyway none of this is being addressed in "reform." Reform in its current state is nothing more than the granting of access to the system. It does not necessarily mean lower costs or that you will get into the system in a timely fashion and have a good experience. And it still gives insurers the option to deny coverage as they scrutinize care. So please just call it what it is - granting access to people who are uninsured - nothing more. Yes it is morally correct but it in no way reforms healthcare.
Tuesday, December 15, 2009
The Beaumont Rehabilitation and Skilled Nursing Center started fantasy football to liven up ho-hum Sunday afternoons for its elderly residents. Now, more than halfway through the season, the league is more successful than Beaumont’s recreation assistant Lindsay Benedetto ever thought possible. In just two months, attendance at televised Sunday afternoon games in the third-floor common room has doubled, and about a dozen seniors between the ages of 77 and 93 earn points weekly depending on the performance of their NFL teams.Active, engaged seniors who can yes actually still think, function, root for their teams and have fun. Go figure. Read the Boston Globe story.
Monday, December 14, 2009
According to a recent study by researchers at the University of Colorado nearly 9 in 10 hospitalized seniors could not name a single take-as-needed medication prescribed during a hospital stay. 88% of hospitalized seniors could not recall any medications they had been prescribed. Patients were given a list of medications and asked to check which ones had been prescribed. That list was then compared to actual prescription records.
Reesearchers concluded that more patient involvement in medication is needed to prevent adverse reactions. I would take it two steps further. Hospital discharge planning must be more aggressive in their discharge instructions and in follow up after discharge. Diligent hospitals will call patients after discharge and check on them and re-review instructions. But this is also a warning for caregivers and family members to pay attention and be involved in your loved ones care. If you are too far away then consider hiring a patient advocate to work with your loved one and assure they are advocating for everything they need and educating the patient on what they need to do as well.
The study appears in the Dec. 10 edition of the Journal of Hospital Medicine.
Thursday, December 10, 2009
Here are some additional holiday tips when visiting elders this holiday season. If you have not seen a loved one in a while, don't be alarmed and panicked at their condition as it could simply be that they are aging naturally and appropriately. But do pay attention. And do stay in contact when you are not there physically. More...
A recent trip to the American College of Healthcare Administrators conference where person-centered care was conspicuously absent from the agenda and a recent study that revealed that hospital boards may not be paying as much attention to quality as they should has me worried. Because inherent in both is the assumption that quality of care and quality of life are good.
Sort of like Robert DeNiro's latest movie Everybody's Fine. His character Frank Goode looks forward to a reunion with his four adult children. When all of them cancel their visits at the last minute, Frank, against the advice of his doctor, sets out on a road trip to reconnect. As he visits each one in turn, Frank finds that his children's lives are not quite as picture-perfect as they've made them out to be.
Things are not as picture perfect as we think in health care and boards need to be the overseers to reset the direction and make sure we are paying attention to quality of care (the clinical) and quality of life (the experience).
Wednesday, December 9, 2009
Total U.S. spending on health care was $7,290 a person in 2007, nearly two-and-a-half times the OECD average of $2,984. Spending on health care in the U.S. grew more quickly between 1997 and 2007 than in France, Italy, Germany and Spain, averaging 3.4 percent annually over the period. The U.S. also underperforms other rich countries in the health of its youngest. U.S. infant mortality, at 6.7 deaths per 1,000 , was well above the OECD average of 3.9 in 2007.The U.S. was the world's biggest spender on pharmaceuticals, spending $878 per person, with Canada next at $691 per person and the OECD average at $461.
Ironically health care "reform" will do nothing to curb costs or improve outcomes. It will in theory grant access to those who had none before and that is good but providers are ill equipped to handle the new onslaught that will result.
Bottom line - as a nation we need to take self responsibility for our health. There is an expectation, an entitlement attitude, that if we get sick there is a drug, a therapy, a procedure that will make it all better. In many cases all we are doing is maintaining control of chronic conditions that should have never surfaced if we took better care of ourselves. This only adds to the cost of healthcare and the expectation that I can let myself go and someone will take care of me.
Tuesday, December 8, 2009
As muscle strength decreases, chances of developing Alzheimer's disease increases, according to research by Rush University Medical Center.
970 adults with an average age of 80 engaged in a series of strength and cognition tests. The subjects' strength was rated in units, and ranged from -1.6 to 3.3. For each one-unit increase in strength measured at the beginning of the study, researchers found a corresponding 43% decrease in the likelihood of that subject developing Alzheimer's over the course of the roughly 3.6 year follow-up period. The strongest 10% were 61% less likely to develop Alzheimer's than the weakest 10%, according to the report.
The report appears in the November issue of the journal Archives of Neurology.
I lift weights 3x a week. So I am hopeful. You should start lifting if you don't already.
Monday, December 7, 2009
Nearly 98% of nurses and physicians report witnessing behavior problems between colleagues, according to the results of a recent survey by the American College of Physician Executives.
13,000 nurse and physician executives were surveyed nationally. Respondents indicated that degrading comments and insults, and yelling were the most common behavioral problems at their facilities. And 55% said these altercations happened either weekly or monthly, while nearly 10% witnessed bad behavior daily. The majority of respondents—67.2%—were nurse executives.
There is a fundamental lack of respect between doctors and nurses that affects every aspect of their jobs, according to the report. Many of the survey participants said that such behavioral problems could only be corrected through early education for both nurses and physicians. More information is available at www.acpe.org. The report appears in the November-December edition of the Physician Executive Journal.
Either hospitals do a good job of hiding it or their HCAHPS ratings are an aberation because statistically most people are satisfied with their healthcare providers. That is statistically. Talk to them face to face and you get another story. And guess what folks healthcare reform is not going to fix basic care. In fact care will get worse as more people tax the system. So choose carefully.
Thursday, December 3, 2009
Pharmacy giant Omnicare recently agreed to pay a $98 million settlement in connection with allegations it engaged in an illegal kickback scheme with drug maker Ivax. The same day, officials filed an additional complaint against Omnicare and nursing home giants Mariner and SavaSenior Care in relation to other alleged kickback schemes.
Omnicare, the nation's largest provider of nursing home pharmacy services, solicited and accepted $8 million from Ivax in exchange for ordering $50 million worth of drugs from it. Omnicare also allegedly received kickbacks from drug maker Johnson & Johnson in exchange for recommending that doctors prescribe J&J's antipsychotic drug Risperdal to nursing home residents.
The most recent complaint claims that Omnicare, Mariner, SavaSenior Care and their representatives conspired to have Omnicare pay $50 million in kickbacks to funnel nursing home chain business to the pharmacy provider.
I believe that caregivers and families evaluating nursing home care need to look at issues such as this, which while alleged, imply a lack of moral and ethical integrity. That could reflect itself in how facilities are managed and ultimately the care a loved one receive.
Tuesday, December 1, 2009
Alzheimer's Association to Offer Comfort Zone, a web-based application that tracks the position of Alzheimer's patients
One of the most widespread and potentially dangerous behaviors for persons with Alzheimer’s or other forms of dementia is the tendency to wander. As many as 60% of Americans affected by Alzheimer’s wander at some point, and are often unable to return safely without assistance. Nearly 70% of individuals that wander will do so repeatedly, and of those not found within 24 hours, up to half suffer serious injury or death.
The Alzheimer's Association is teaming with location-based technology vendor Omnilink to offer Comfort Zone, a web-based application that tracks and relays the position of Alzheimer's patients to prevent them from straying from familiar territory, unable to remember the way back.
With these technologies, caregivers can help ensure that persons with Alzheimer’s or other forms of dementia are easily located if they wander.Comfort Zone includes GPS tracking technology and a cellular link to a monitoring center. Caregivers can follow Alzheimer's patients online through a secure web portal and receive automatic email or text alerts if the patient strays from a predefined area. They also can access electronic medical records on the patients through the MedicAlert Foundation.
Service packages start at $42.99 per month, and there's a $45 activation fee.While this sounds like a commercial for Comfort Zone, I certainly think that it is worth checking out nonetheless. There have been increasing news reports of wandering incidents with often fatal consequences. Technology like this can help. Great name too don't you think? More here.