As Congress considers a proposed long-term care insurance program as part of health overhaul plans, nursing homes costs are going up. The Washington Post reports on the Community Living Services and Support (CLASS) Act, which would create a government insurance program for long-term care: "The idea has been around for years, and the late Sen. Edward M. Kennedy (D-Mass.) pushed to have the measure included in the health-care overhaul package that passed the Senate health committee in July. A similar measure was also adopted by voice vote in one of the three House committees handling health care. ... The idea is to create long-term care insurance that would be available to anyone, including those who are already disabled. People would be automatically enrolled, unless they chose to opt out, and would pay a premium in exchange for the opportunity to receive cash benefits to cover the cost of home care, adult day programs, assisted living or nursing homes after they had been enrolled for at least five years.
Illinois nursing home patients often receive psychotropic drugs without cause, which poses various health dangers and even death, the Chicago Tribune reports as part of its Compromised Care series. "Frail and vulnerable residents of nursing homes throughout Illinois are being dosed with powerful psychotropic drugs, leading to tremors, dangerous lethargy and a higher risk of harmful falls or even death, a Tribune investigation has found. Thousands of elderly and disabled people have been affected, many of them drugged without their consent or without a legitimate psychiatric diagnosis that would justify treatment, state and federal inspection reports show." The Tribune identified about 1, 200 such violations at Illinois nursing homes since 2001. The newspaper's "unprecedented review of more than 40, 000 state and federal inspection reports found that nursing homes ranging from 'five-star' establishments on the North Shore to run-down facilities in urban neighborhoods have been cited for improperly administering psychotropic drugs.
New Study Reports Three Times More People Receiving Health Care Support At Home Rather Than In Nursing Homes Or Assisted-Living Facilities
American Association for Long-Term Care Insurance and Homewatch CareGivers, the largest, most experienced international provider of home care for people of all ages, teamed up to conduct a study examining trends in long-term health care and the utilization of associated support services. Among the conclusions of the study is the dramatic growth of people receiving support care at home and the significantly greater percentage of those with long-term care insurance who are able to receive home-based care and stay in the their homes longer. According to the American Association for Long-Term Care Insurance, approximately 7.5 million individuals currently receive long-term care at home because of an acute illness, long-term health condition, a permanent disability, or terminal illness. That compares to only 1.5 million in nursing homes and 1.1 million in assisted-living facilities who receive similar care for the same types of conditions. That means nearly three times more people are receiving care at home rather than in a residential facility.
Minister Brady welcomed the launch of a report of the National Economic and Social Forum (NESF) entitled "Implementation of the Home Care Package Scheme". The Minister highlighted that "a main feature of Government policy in recent years has been to develop services to allow older people to remain living at home and in their communities for as long as possible". Where this is not feasible Older People should have access to quality, affordable long-term residential care. The Minister pointed out that, "unprecedented levels of investment had been provided to develop community based provision for older people over 2006-8, with just over Euro 200m additional base funding made available to the HSE to develop such services nationally. These included the new Home Care Package (HCP) Initiative introduced in 2006, and the expansion of existing Home-Help, Meals-on-Wheels and Day/Respite services around the country". The Minister noted that the NESF report on the Euro 120 million a year Home Care Package programme, which focused on this initiative primarily from a policy point of view, acknowledges that this was a well thought out policy and that many older people in receipt of the packages are happy with the service.
ProPublica / The Chicago Tribune examine the case of a controversial psychiatrist who delivered an anti-psychotic medication to thousands of Medicaid patients in Chicago's nursing homes. "Dr. Michael Reinstein is one of the most prolific providers of psychiatric care in Chicago-area nursing homes and mental health facilities. But he is trailed by lawsuits and complaints while getting government reimbursement for seeing a large number of patients." Reinstein received payments totalling nearly $500, 000 over 10 years from the drugmaker AstraZeneca, and published several studies promoting its drug Seroquel. "During that period, Reinstein also faced accusations that he overmedicated and neglected patients who took a variety of drugs. But his research and promotional work went on, including studies and presentations examining many of the antipsychotics he prescribed on his daily rounds." According to ProPublica/Tribune, several physicians have questioned the results of Reinstein's studies.
In a new study, the amount of television viewed by many young children in child care settings doubles the previous estimates of early childhood screen time, with those in home-based settings watching significantly more on average than those in center-based daycares. This study is the first to examine screen time in child care settings in more than 20 years. The study looked at television use in 168 child care programs in four states, and was guided by lead researcher Dimitri A. Christakis, MD, MPH, director of the Center for Child Health, Behavior and Development at Seattle Children's Research Institute and professor of pediatrics at the University of Washington School of Medicine. "Preschool-Aged Children's Television Viewing in Child Care Settings" is published in the December 2009 issue of Pediatrics, appearing online November 23, 2009. Previous estimates of screen time for babies and pre-school children relied on parental reports of viewing in the home, yet the majority of pre-schoolers are now commonly cared for by someone other than a parent, away from home in a child care setting.
The Washington Times reports that an "insurance plan championed by Sen. Edward M. Kennedy that would help elderly or disabled people avoid nursing homes ironically adds yet another sticking point to the comprehensive health care reform plans" in Congress. Moderate Democrats and Republicans worry the Community Living Services and Support Act will increase the deficit and make the federal government responsible for another insurance program. "Under the proposal in the House-passed version of the overhaul, the CLASS Act fund would collect monthly premiums, estimated to be $65 in 2011, from the wages of all working Americans, unless they elect to opt out - a technique used to help drive participation. Once they pay premiums for five years, participants would be eligible for cash benefits to help them buy in-home care, if they can no longer care for themselves." Several senators have expressed concerns that purported savings on the plan don't start until 2016 and that benefits paid will outweigh premiums gathered (Haberkorn, 11/11).
Family caregivers can significantly reduce suffering in cancer patients at home through use of simple touch and massage techniques. These findings were recently reported at the 6th International Conference of the Society for Integrative Oncology. The study, sponsored by the National Cancer Institute, evaluated outcomes of a 78 minute DVD instructional program and illustrated manual in a sample of 97 patients and their caregivers. The multi-ethnic sample represented 21 types of cancer (nearly half with breast cancer ) and all stages of disease. Caregivers included spouses, adult children, parents, siblings and friends. The project was conducted in Boston, MA, Portland, ME, and Portland, OR using English, Spanish and Chinese languages. According to the principal investigator, William Collinge, PhD, president of Collinge and Associates states, "Touch and massage are among the most effective forms of supportive care in cancer, but most patients cannot access professional practitioners of these methods on a regular basis.
Alzheimer's Society has today welcomed the recognition of people with dementia in the Queen's speech and called for dementia to be a priority for all political parties. Responding to proposals to give people with the highest needs free personal care, Alzheimer's Society called for more detail and warned that both money and improved quality of home care was needed to make proposals a success. 'Free personal care at home for those with the highest needs is a welcome development but the challenge to implement this proposal will not be easy. Money is needed to make sure people with dementia aren't being pushed into full time care earlier than needed. Quality also needs to be driven up for people to see real benefit. 'Today's measures will not fix the crumbling system of funding for social care. Problems still loom as the number of people with dementia will double in the next generation and costs triple. We need a robust funding system that provides good care at a fair price for people at every stage of their condition.
Since Florence Nightingale worked to improve the medical conditions of soldiers, nursing has progressed into a duty of caregivers with both clinical knowledge and specialist expertise. Continually building on this proud tradition, nurses from The Cancer School of Cutting edge Woolly (CINJ) and throughout the country, will present their latest research findings at the Oncology Nursing Society's 34th Annual Congress career held this week in San Antonio, Texas. CINJ is a Centre of Excellence of UMDNJ-Robert Wood Johnson Medical School. The conference features presentations and poster sessions on site-specific cancers, prevention, detection, symptom management, treatment advances and other topics dedicated to oncology nursing. One such presentation features the employment of Meg Joyce, PhD(c), RN, AOCN, interim chief nursing officer at CINJ, and Linda Patrick-Miller, PhD, employer of the Division of Behavioral Sciences at CINJ and assistant professor of psychiatry at UMDNJ-Robert Wood Johnson Medical School, which highlights lung cancer in patients who background dyspnea, or difficult breathing.