On Monday, the Prime Minister gave a speech in which he called for more people to be treated in their own homes by the NHS in future. As a partner to the NHS, in providing healthcare in their own homes to 14, 000 patients, many with complex conditions, Bupa the leading international healthcare company, strongly supports his comments. Steve Flanagan, managing director of Bupa Home Healthcare said: "We agree with the Prime Minister's views that it is better for patients to be treated in their own homes. "Our experience of caring for 14, 500 NHS patients in their own homes shows it can be more cost-effective, helps avoid hospital-acquired infections, and produces higher levels of patient satisfaction. "This is a key way for the NHS to meet its goals of improving its services against the background of the current economic climate and pressure on public spending." Source Bupa Home Healthcare
Intensive care unit patients are not the only ones likely to be severely depressed in the aftermath of hospitalization. Family and friends who care for them often suffer emotional and social hardship, too, according to a prospective study from the University of Pittsburgh School of Medicine that is the first to monitor patients and caregivers during a one-year period for predictors of depression and lifestyle disruption. The findings, published this month in Chest, indicate that the informal caregivers of ICU survivors endure even more stress than those caring for Alzheimer's disease patients, noted senior author Michael R. Pinsky, M.D., professor and vice chair for academic affairs, Department of Critical Care Medicine. "Caregiver depression is the collateral damage of these stressful ICU admissions, " he noted. "This research reveals that loved ones of critically ill patients have profound and unmet needs for assistance even after hospital discharge. The emotional and economic burden is enormous, and these issues must be addressed.
The Seattle Times investigates Washington's practice of relocating some Medicaid patients from nursing homes to adult family homes. "Jeri Ringseth had no business being in an adult family home. Her physical and mental disabilities are so significant that she's spent most of her adult life in nursing homes or state hospitals. ... Ringseth is just one of thousands of Medicaid recipients who have been steered by the state from expensive nursing homes into adult family homes, which cost the state one-third as much. These homes are a growing, little-regulated housing option for the state's aged - as well as for the poor and frail, such as Ringseth, who cannot care for themselves alone. ... In hundreds of cases, a Seattle Times investigation has found, medically fragile adults such as Ringseth are handed over to amateur caregivers who are inadequately trained to keep them safe" (Berens, 2/1). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J.
Aine Brady T.D., Minister for Older People and Health Promotion, noted a report 'Analysis of Irish Home Care Market' by the Irish Private Home Care Association (IPHCA) on home care services in Ireland together with the response by the Health Service Executive (HSE). The Minister said "maintaining older people at home with appropriate support has been the thrust of Government policy in recent years and has been significantly developed by the HSE through a number of community based supports such as Home Help, Home Care Packages and Day/Respite care." In 2010, the HSE will invest in the region of 210m euros for Home Help services, and 130m euros in Home Care Packages. The Government's commitment to this important area is reflected by the fact that, notwithstanding the current difficult economic circumstances, an additional 10m euros was provided in the recent Budget to expand the Home Care Package programme to concentrate on reducing inappropriate admissions by older people to the acute hospital and long-term residential care systems.
Giving people living in nursing facilities vitamin D can reduce the rate of falls, according to a new Cochrane Review. This finding comes from a study of many different interventions used in different situations. In hospitals, multifactorial interventions and supervised exercise programs also showed benefit. Older people living in nursing facilities or who have been admitted to hospital are much more likely to suffer a fall than those living in the community. In these settings, falls fairly often result in head injuries and fractures, with rates of hip fracture more than ten times higher in nursing facilities than in the community. It is important to try to prevent falls to avoid unnecessary stress for older people and their families, and to reduce pressure on staff and resources. However, prevention is complicated as falls usually happen for several or many different reasons. "Many of the preventive measures used to avoid falls in older people are combined in what are called multifactorial interventions, so it can be very difficult to separate out the effects of all the different measures, " said lead researcher Ian Cameron, who is based at Sydney Medical School at the University of Sydney in Ryde, Australia.
A new study of children in Ukraine has found that for the growing number of HIV-infected children, the quality of care and the relationship between children and their caregivers play an important role in their development. Based on their findings, the researchers highlight the importance of comprehensive but focused intervention efforts to improve these relationships by changing caregivers' working schedules and providing training to enhance the stability and sensitivity of care. Published in the January/February 2010 issue of the journal Child Development, the study was conducted by scientists at Leiden University in the Netherlands. One of the researchers, doctoral student Natasha Dobrova-Krol, is of Ukrainian origin. The researchers sought to examine the effects of HIV infection and being raised in institutions on the development of 58 infected and uninfected Ukrainian 4-year-olds. Some of the children lived in institutions from shortly after birth, while others lived with their biological families.
A new study of young children in orphanages in Bucharest, Romania, has found that children placed in foster care before age 2 were more apt to develop secure attachments to their foster parents than those who entered foster care after age 2. The study is based on data from the Bucharest Early Intervention Project, the first randomized controlled trial of foster care as an alternative to institutional care. It was carried out by researchers at Tulane University School of Medicine, the University of Maryland, Harvard Medical School/Children's Hospital Boston, and the University of California, Los Angeles, and appears in the January/February 2010 issue of Child Development. The study's goal was to determine whether a family-based intervention such as foster care could improve the quality of attachments between Romanian 3-year-olds and their caregivers. The researchers studied 169 children: Some had been in institutions from birth, some were institutionalized at birth and later placed in foster care, and some were raised by their families at home.
Caregivers of severely injured veterans and their families face emotional and financial pressures and difficulty accessing military medical care. USA Today reports on the "thousands of unpaid caregivers - parents, spouses, siblings and war buddies - helping veterans injured in the Iraq and Afghanistan wars get through each day. [Barbara Cohoon, deputy director of government relations for the non-profit National Military Family Association] says the caregivers are a vulnerable group, often under-recognized, and in need of help to navigate the military's medical system. Cohoon says not all caregivers receive military benefits, even though many have quit jobs, moved out of their homes and drained their savings to care for their loved ones." Two bills are currently being debated in Congress to help caregivers of veterans to receive "financial support, including health insurance" (Marcus, 1/26). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J.
USA Today : "One in five of the nation's 15, 700 nursing homes have consistently received poor ratings for overall quality, a USA Today analysis of new government data finds. More than a quarter-million patients live in homes given another set of low scores within the past year, according to data released today by Medicare, which first released the star ratings of the nation's nursing homes in late 2008. The ratings are derived from inspections, complaint investigations and other data collected mostly in 2008 and 2009. ... nearly all homes that repeatedly received few overall stars - one or two stars - were owned by for-profit corporations, the data show." USA Today also includes a searchable database of homes (Gillum, 1/28). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.
The amount of time children spend in institutional care may affect how their brains develop. That's the conclusion of a new study carried out by researchers at the University of Wisconsin, Harvard Medical School/Children's Hospital Boston, and the University of Minnesota. The study is published in Child Development in the journal's January/February 2010 issue. To learn how the deprivation and neglect that institutionalized children often experience affect brain development, the researchers looked at 132 8- and 9-year-olds. Some of the children were adopted into U.S. homes after spending at least a year and three-quarters of their lives in institutions in Asia, Latin America, Russia and Eastern Europe, and Africa. Others were adopted by the time they were 8 months old into U.S. homes from foster care in Asia and Latin America; most of these children had spent no time in institutional care, while some had spent a month or two in institutions prior to foster placement. On average, the internationally adopted children had been living with their families for more than 6 years.