What works for a spouse with dementia? Alzheimer's disease and other forms of dementia represent an exponentially growing social and health care challenge for American families - not only family members who face the progressive brain disease, but also those who love them. Many spouses of those with dementia do more than watch as their partners deal with the disease's effects on brain functioning, memory, motor skills and emotional health. They often assume round-the-clock caregiving responsibilities as their husband or wife of many years faces progressive decline. Communication can become a particularly difficult issue. "We found that breakdowns in communication may trigger or deepen problem behaviors in family members with dementia, " says Marie Savundranayagam, assistant professor of social work at the University of Wisconsin-Milwaukee (UWM).
A large study of family child care providers shows that while nutrition standards are often met, most children ages 2 to 5 are not getting enough physical activity and are exposed to the television for most of the day. A study of about 300 home-based child care providers by Oregon State University's Stewart Trost, an internationally-recognized expert on childhood obesity issues, sheds light on both positive and negative aspects of family daycare providers. The findings are published in the December issue of the American Journal of Preventive Medicine. Trost, who directs the obesity prevention research core at the new Hallie Ford Center for Healthy Children at Oregon State, said a big concern was television exposure in such a young age group.
"Embedded in sweeping health legislation passed by the House and being debated on the Senate floor is a major new federal insurance program, " called the Community Living Assistance Services and Supports Act, or Class Act, The New York Times reports. The program, which is to be financed with premiums paid through voluntary payroll deductions, would provide cash benefits to people with cognitive impairments or those who could not perform two or three of the "activities of daily living, " such as eating, bathing or dressing. "Advocates for older Americans and people with disabilities see the program as a long-overdue effort to address needs that will explode as baby boomers age.
In his latest Kaiser Health News column, Howard Gleckman writes: "In the ongoing congressional debate over the CLASS Act - the proposed national long-term care insurance program - critics and supporters have been arguing over whether a benefit of $50- or even $75-a-day is worthwhile. Some in the insurance industry, for instance, assert that given the high cost of care in nursing facilities and even at home, a $75 benefit is hardly worth the premium cost" (12/14). Read entire column. 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.
Patients, discharged from hospitals on ventilator support and with cognitive impairments, fare poorly four months later. Researchers from the Frances Payne Bolton School of Nursing at Case Western Reserve University report these findings in American Journal of Critical Care. "Survival alone is not the only important outcome for patients, " says Barbara Daly, the lead researcher on the National Institutes of Health-funded study, "Composite Outcomes of Chronically Critically Ill Patients 4 Months after Hospital Discharge." She adds that having a better quality of life by living at home, breathing free from the ventilator and having normal cognitive function are also important factors constituting a positive outcome in the aftermath of a hospital stay.
Thirty percent of the home health care workers' compensation cases managed by Total Medical Solutions (TMS) were discharged prior to the "order-end date, " the last date the physician had anticipated that services would be required. The figure comes from an internal review of 250 cases with an intake date between March 1 and July 15, 2009. Of the early discharges, 27 involving RN or LPN services were discharged an average of nine days early. Twenty four of the cases involved physical therapy and were discharged an average of 10 days early and 10 cases involved home health care aides and nine involved intravenous or infusion services. "With home health care adding hundreds of dollars a day to a claim, earlier discharge represents significant savings for our clients, " said Cara Barde, president of TMS.