Articles Posted in Home Care

With the nation fast graying, a long-term care crisis looms, and too many Americans may not realize that not only will nursing home care be tough to find and afford, it also may be less than ideal. But what happens if seniors themselves — especially the frail old — are asked how care-giving services might best serve them, so they not only can stay in their homes but also enjoy their lives more?

That’s the experimental approach taken by a health care team in Denver, working in the long-titled program, “Community Aging in Place — Advancing Better Living for Elders.” CAPABLE staff intervene with the aged, asking them how, even with disability and debilitation, to improve their lives. The program offers them six visits by an occupational therapist, four visits by a registered nurse, and home repair and modification services worth up to $1,300.

diabetesteststrips-300x200Doctors, hospitals, health officials, and disease advocacy groups race to warn about diabetes’ risks, harms, and increasing prevalence. But why, then, doesn’t modern medicine also do much more to help diabetics with the skyrocketing costs of their care, whether with insulin at excessive prices or with  expensive medical aids?

Ted Alcorn of the New York Times drilled down on one slice of diabetes care to capture how medical profiteering distorts what ought to be a more direct, simple, and less pricey treatment for a disease that afflicts as many as 100 million Americans in varying degree.

He reported on the “strange marketplace” for the chemical-imbued plastic strips diabetics use to test their blood sugar, inserting them into specialized meters for glucose readings. Before diabetics adjust their diet or take insulin, they may test themselves with strips and meters as many as 10 times a day. The costs add up. Diabetics can pay thousands of dollars annually to get test strips over the counter.

carehands-300x205Life can be hard, lonely, and difficult for adults who must become caregivers for their parents. If that sounds like the challenging story for tens of millions of millennials and Gen-Xers, yes, it’s true. But Judith Graham, in a column for the Kaiser Health News Service, describes what may be an even tougher role for startling numbers of seniors who find themselves solo caregivers for still older moms and dads.

Graham reported that a new analysis from the Center for Retirement Research at Boston College has found that 1 in 10 Americans between the ages 60 and 69 take care of parents in their 80s, 90s, and even older. For those 70 and older, the numbers increase, so 12 percent of these seniors care for even more elderly relatives. The research is based on data from 80,000 interviews (some people were interviewed multiple times) conducted from 1995 to 2010 for the Health and Retirement Study.

The analysis found that roughly “17 percent of adult children care for their parents at some point in their lives, and the likelihood of doing so rises with age. That’s because parents who’ve reached their 80s, 90s or higher are more likely to have chronic illnesses and related disabilities and to require assistance.”

asthma-300x123Even as they rake in big bucks and ride  a tsunami of mergers and consolidations sweeping the U.S. health care system, big hospitals and academic medical centers must step up on patients’ behalf, doing much more, for example, to battle America’s growing asthma woes and the opioid drug abuse epidemic.

Kaiser Health News, the Capital News Service, and the Washington Post deserve credit for their report on “Forgetabout Neighborhood,” the “worst asthma hot spot” in Baltimore. This part of the city is filled with “decrepit houses, rodents and bugs” that “trigger [asthma] and where few community doctors work to prevent asthma emergencies,” the news organizations have found. They say that residents of this neighborhood “visit hospitals for asthma flare-ups at more than four times the rate of people from the city’s wealthier neighborhoods.”

This area, zip code 21223, also sits in the shadow of not just one but two renowned medical centers, noted, among other things, for their respiratory expertise: Johns Hopkins, and the University of Maryland Medical Center. As the news organizations have reported:

srdrugs-300x178When families and friends visit Kansas nursing homes, they may be startled to see how listless and lethargic their elderly loved ones may be, especially if the facility residents suffer from dementia. There’s a sad, simple, and likely reason—the seniors may be drugged up with potent anti-psychotics.

The Kansas City Star deserves credit for providing a powerful reminder that nursing homes, not just in the Heartland but nationwide, persist in over-relying on off-label dosing of their sometimes difficult to handle patients with drugs such as olanzapine (more commonly known by the branded product Zyprexa), aripiprazole (Abilify), risperidone (Risperdal), or quetiapine (Seroquel).

As the newspaper reported:

caregiver-300x200Pick up that phone. Dash off a text or an email. Issue a dinner invitation or make a date for a casual lunch. Or just drop by to see that friend or loved one who struggles with the burdens of caring for someone in poor physical or mental health.

Why now? Why not? Paula Spann deserves credit for her latest New York Times column highlighting the “unbearable” loneliness and isolation that caregivers confront as, other experts estimate,  43.5 million Americans provide $470 billion in tough, unstinting, and unpaid work for loved ones.

Even as they do so, however, they often must abandon their own careers and chunks of their own lives, watching with sadness as their social contacts and intellectual interests narrow, especially as their worlds become consumed with washing, feeding, entertaining, and keeping safe a spouse, grandparent, uncle, aunt, or other loved one. Their woes can be especially great if they’re caring for loved ones with the increasingly common and hugely demanding conditions of dementia and Alzheimer’s.

Dr. Bruce Leff explains why geriatric healthcare is best practiced out of the hospital

It wasn’t that long ago — see those classic black-and-white movies — when hospitals commonly cared for many different kinds of patients in large open wards. Young volunteers, women known as “candy stripers,” could be seen rolling carts down the aisles between the many rows of beds, selling cigarettes. Families might pop in for a visit, carrying for their sick kin a chicken dinner on a plate covered by a white napkin.

With the huge changes that the Affordable Care Act has brought to hospitals and American health care, and with the shifts that are yet to come if Obamacare gets repealed and replaced, it’s easy to forget how significantly and rapidly medical services continue to transform.

The events of recent days ─in Texas, Louisiana, and Minnesota─ have been so tragic that it’s easy to despair. Here are four health-related people stories worth reading to remind us of humanity’s enduring better side:

  • In the horrors of Syrian combat, medical Samaritans strive to maintain some kind of care

syriaFirst, let’s stipulate that there’s almost as much barbarous conduct as can be imagined in this recent New Yorker report about the struggle to maintain medical care in combat-ravaged Syria. President Assad’s predation on his own people has become an international abomination, including his forces unleashing snipers to maim emergency medical personnel, and their dropping barrel bombs, laden with lacerating shrapnel, on hospitals or known care-giving sites (February, 2016, photo of a bombed hospital from Doctors Without Borders/Medicins san Frontieres).

Flag_of_South_Dakota.svgSevere diabetics, the blind, and the mentally ill all too often get sent to sterile and restrictive group or nursing homes by South Dakota officials who can’t seem to find other care options because they discriminate against thousands of the disabled, the federal government says.

The Justice Department is investigating the state under federal laws affirmed by the U.S. Supreme Court. As the New York Times reports, the feds aim to protect the disabled from needless confinement in highly regimented group or nursing homes because:

[A] 1999 Supreme Court decision, Olmstead v. L.C. [held] that, unless a nursing home is medically necessary, people have a right under the Americans With Disabilities Act to receive care without being segregated from society. Advocates for the disabled have compared that ruling to Brown v. Board of Education, which declared racial segregation in schools unconstitutional.

An elderly couple wait to cross the road
With the United States getting grayer by the day and a national crisis looming in dementia- and senior-care, new information from one of the larger, longer running, and more significant health studies has offered a glimmer of optimism. Experts say dementia risks are showing a  decline─by as much as 20 percent. They’re uncertain exactly why. But increased education and individuals’ improved overall health, especially their cardiovascular wellness, may be helping.

An elderly couple wait to cross the road (Photo by Garry Knight/ Creative Commons)

The surprising dementia trend emerges from the legendary Framingham Heart Study, which has monitored and detailed the health of thousands of Americans for decades. Framingham research led to greatly improved heart and lung care with information on such issues as high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity.

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