Health and Fitness

Training By Experience For Medical Students Involved In Nursing Home Program

A geriatric training method pioneered by Marilyn R. Gugliucci, PhD, president of the Association for Gerontology in Higher Education (the educational branch of The Gerontological Society of America) has proved successful enough that she plans to implement it on a national level. This project, called Learning by Living, involves students residing in a nursing home for two weeks to better understand the experience of aging in a long-term care setting. Gugliucci started this type of training four years ago with students at the University of New England College of Osteopathic Medicine, where she serves as director of geriatrics education and research. "By living the life of an elder resident these students have learned to open their hearts to older adults and as a result have created meaningful friendships, " Gugliucci said. "Prior to this experience they only considered the disease or frailty rather than seeing the person." Last year, an Institute of Medicine report, "Retooling for an Aging America: Building the Health Care Workforce, " indicated that America's aging citizens are facing a health care workforce too small and unprepared to meet their needs.

NMC Response To The CQC Report On Care Homes In England

In response to the report by the Care Quality Commission that one in four care homes in England are providing a poor service to older people, NMC Chief Executive and Registrar Dickon Weir-Hughes said: "Poor care is never acceptable and nurses working in care homes have a responsibility within the NMC code: Standards of conduct, performance and ethics for nurses and midwives (2008) to act without delay if they believe they, a colleague or anyone else may be putting someone at risk. This includes issues relating to the environment of care. "We know that we need to do more to help safeguard the health and wellbeing of patients and the public. These issues are being addressed through projects like our review of pre-registration nursing education which will set new standards for future nursing students. There is a particular emphasis on the fundamentals of care, such as compassion, nutrition, dignity and hygiene. "We are doing more to support nurses and midwives with their duty to raise and escalate concerns, and will be consulting on new guidance in January.

Study Finds One Third Of American Adults Serves As A Caregiver

"A new study says almost one out of three adults in the U.S. currently serves as a caregiver, " NPR reports. "The time and energy they put into caregiving becomes like an unpaid job. On average, they spend about 19 hours a week providing care, doing everything from bathing and dressing an elderly parent or loved one to balancing a checkbook or doing household chores." The survey was sponsored by AARP and the National Alliance for Caregiving, with funding from the MetLife Foundation. Many results "are similar to those from earlier versions in 2004 and 1999. Two-thirds of caregivers are women. The average age is about 48. Almost all -- 86 percent -- care for a relative. Most often, 36 percent of the time, it's for a parent. On average, caregivers have been providing care for 4.6 years, and three in ten report doing so for five years or more" (Shapiro, 12/8). This information was reprinted from 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.

At-Home Care May Be An Alternative To Hospital Care For Elderly Patients With Chronic Heart Failure

Hospital-at-home care may be a practical alternative to traditional hospital inpatient care for patients with acutely decompensated (suddenly worsening) chronic heart failure, according to a report in the September 28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. Nearly 7 million Europeans and 5 million North Americans are affected by chronic heart failure, a progressive and disabling syndrome, according to background information in the article. Hospitalization for chronic heart failure for older patients has increased and occurs in 2 percent to 3 percent of patients over age 85 every year. In the United States, decompensation (worsening) of chronic heart failure leads to more than 1 million hospital admissions per year and a 50 percent risk of subsequent hospitalization within six months of discharge. "Although the hospital is the standard venue for providing acute medical care, it may be hazardous for older persons, who commonly experience iatrogenic illness [complications due to treatment], functional decline and other adverse events.

GAO Finds That A Federal Program Is Missing Problem Nursing Homes

The Associated Press reports: Federal investigators report that a government-run program designed to bring "extra scrutiny to poorly performing nursing homes" is missing "hundreds of troubled facilities" that could qualify the closer look. "The Centers for Medicare and Medicaid Services identifies up to 136 nursing homes as 'special focus facilities' subject to more frequent inspections because of their living conditions. In every state except for Alaska, there are between one and six such facilities. But investigators said four times as many homes, or 580, could be considered among the nation's worst." Sen. Herb Kohl, D-Wis., the chairman of the Senate Aging Committee, said the new investigation by the Government Accountability Office indicated that the government's "special focus" is too limited. The GAO recommended expanding the program two years ago. The AP notes: "Federal officials agreed with the concept, but said they didn't have the resources to do so. The report being released Monday also suggests adjusting the methods used to identify the worst performing nursing homes" (Freking, 9/27).

Blogs Comment On Health Reform, Population Control, Provider Education, Other Topics

The following summarizes selected women's health-related blog entries. " Health Care Reform is a Woman's Issue, " Nancy Folbre, New York Times ' "Economix" : An exchange between Sen. Jon Kyl (R-Ariz.) and Sen. Debbie Stabenow (D-Mich.) at Friday's Senate Finance Committee hearing illustrates why health reform is such an integral issue for women, Folbre -- an economics professor at the University of Massachusetts-Amherst -- writes in the blog. In a discussion of what benefits private insurers should be required to offer, Kyl said he "'does not think he should be required to pay premiums to help finance maternity costs, since he has never needed maternity care, '" Folbre reports. However, she adds, "As Sen. Stabenow calmly observed, 'I think your mom did.'" Folbre notes that women will be especially affected by health reform because they face unique challenges when dealing with the existing health system. "Women need more health care than men because of the combined demands of pregnancy and family planning, " Folbre writes.

Homewatch CareGivers New, Expanded Pathways To Memory trade; Program To Help Enhance Cognitive Function For Patients With Memory Loss

Based on the ground-breaking program released in 2005, Homewatch CareGivers, the largest, most experienced international provider of full-service home care, announced the release of its newly expanded Pathways to Memory™ Program, a set of therapeutic activities delivered in a nurturing, failure-free environment that stimulates and enhances cognitive function for patients with early to mid stage dementia, Alzheimer's disease, and other memory loss conditions. Now with more than 100 memory-enhancing activities, Pathways to Memory has achieved from 50% to more than 200% improvement in memory screenings with clients. The program is available exclusively through Homewatch CareGivers-certified specialists. "As the first home care company to develop a memory care program, we recognize the importance of providing families with proactive intervention tools to help loved ones with memory loss, " said Leann Reynolds, president of Homewatch CareGivers. "With our years of experience in the practical application of cognitive-enhancing programs, we've seen the positive effects first hand.

Illinois Nursing Homes Mix Seniors And Mentally Ill Patients, Some Criminals

Some Illinois nursing homes create dangerous and unsafe environments by mixing seniors and younger mentally ill residents, the Chicago Tribune reports: "More than any other state, Illinois relies heavily on nursing homes to house mentally ill patients, including those who have committed crimes. But a Tribune investigation found that government, law enforcement and the industry have failed to adequately manage the resulting influx of younger residents who shuttle into nursing facilities from jail cells, shelters and psychiatric wards." Citing government records, the article reports that "mentally ill patients now constitute more than 15 percent of the state's total nursing home population of 92, 225, " and "the number of residents convicted of serious felonies has increased to 3, 000. Among them are 82 convicted murderers, 179 sex offenders and 185 armed robbers. Yet the state's background checks on new residents are riddled with errors and omissions that understate their criminal records, the Tribune found, and homes with the most felons are among those with the lowest nursing staff levels.

Sweeping Cuts To State Safety Net Affect Half-Million Low-Income Elderly

An 81-year-old San Francisco woman with dementia, little money and an equally aged caregiver sister who is suffering from cancer. A 72-year-old Riverside woman with Alzheimer's who cannot be left safely on her own, forcing her son to cut back his working hours to care for her. A 78-year-old Los Angeles man with Alzheimer's whose daughter will have to quit her job to take care of him if day care services are cut. These are some of the hundreds of thousands of low-income seniors who are likely to lose income - and some of the tens of thousands who will also lose some or all of the in-home and supportive care they rely on - as budget cuts resulting from California's 2009 fiscal crisis go into effect starting Oct. 1, according to a new study by the UCLA Center for Health Policy Research. Among the most vulnerable: seniors with Alzheimer's disease whose families rely on state-funded Alzheimer's centers that will soon lose all of their state funding. Also impacted are low-income seniors with disabilities, who often rely on a web of safety-net programs that both supplement their incomes and give them access to free or subsidized in-home care, say the authors of the new policy brief, "California Budget Cuts Fray the Long-Term Safety Net.

Nursing Home Industry: New Funding Reductions Will Force Closures

Industry leaders say the nursing home industry could be at a tipping point. "The nation's nursing homes are perilously close to laying off workers, cutting services - possibly even closing - because of a perfect storm wallop from the recession and deep federal and state government spending cuts, industry experts say, " The Associated Press reports. "A Medicare rate adjustment that cuts an estimated $16 billion in nursing home funding over the next 10 years was enacted at week's end by the federal Centers for Medicare and Medicaid Services." This move came in addition to state-level reductions or flat-funding "that already had the industry reeling. And Congress is debating slashing billions more in Medicare funding as part of health care reform." The crisis is compounded by an aging baby boomer population. "The nation's 16, 000 nursing homes housed 1.85 million people last year, up from 1.79 million in 2007, U.S. Census Bureau figures show. Already this year, 24 states have cut funding for nursing home care and other health services needed by low-income people who are elderly or disabled, according to the Center on Budget and Policy Priorities, a nonprofit research firm based in Washington, D.

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