2015-05-27
Clients With Overactive Bladder Can Reduce Risk of Falls
Joyce Apperson is a Registered Nurse and Geriatric Care Manager with 15 plus years of experience working with advocating for seniors. She is the founder and President of Caring Connection, Inc.
Quoting Joyce:
In addition to medication, doctors recommend several behavioral interventions to help seniors manage not only their overactive bladder symptoms, but also their risk of falling. These include:
Fluid Intake Schedule–When fluid is consumed on a regular schedule, bathroom breaks can be planned into the day with some certainty.
Double Voiding–Trying to void a second time after the bladder has been emptied can help prevent the immediate need to revisit the facilities.
Schedule Bathroom Breaks–Seniors should go to the bathroom on a schedule rather than waiting until they feel the urge.
Wear Absorbent Pads–Absorbent undergarments can help prevent the embarrassment of having an accident, especially in public places. It can also reduce any fears that may be associated with soiling clothes or furniture.
Quoting Joyce:
In addition to medication, doctors recommend several behavioral interventions to help seniors manage not only their overactive bladder symptoms, but also their risk of falling. These include:
Fluid Intake Schedule–When fluid is consumed on a regular schedule, bathroom breaks can be planned into the day with some certainty.
Double Voiding–Trying to void a second time after the bladder has been emptied can help prevent the immediate need to revisit the facilities.
Schedule Bathroom Breaks–Seniors should go to the bathroom on a schedule rather than waiting until they feel the urge.
Wear Absorbent Pads–Absorbent undergarments can help prevent the embarrassment of having an accident, especially in public places. It can also reduce any fears that may be associated with soiling clothes or furniture.
2015-05-23
The Tangle of Coordinated Health Care - NYTimes.com
Who coordinates the coordinators?
More specifically, who coordinates the proliferating number of health care helpers variously known as case managers, care managers, care coordinators, patient navigators or facilitators, health coaches or even — here’s a new one — “pathfinders”?
For Family Caregivers A Family Caregiver’s Guide to Care Coordination
{q}As a family caregiver, care coordination is something that you probably do often. This guide can help you to understand care coordination, the differences between care coordination by a family member and a professional care coordinator, and how to work together with professional care coordinators.
The guide also gives questions to ask a professional care coordinator, and tips on keeping your own care coordination organized - especially after the professional care coordinator's services end.{eq}
Professional Care Coordinators
Family Caregivers and Care Coordinators
Questions to Ask a Professional Care Coordinator
Tips for Staying Organized
More specifically, who coordinates the proliferating number of health care helpers variously known as case managers, care managers, care coordinators, patient navigators or facilitators, health coaches or even — here’s a new one — “pathfinders”?
Paula Span; The law of unintended consequences seems at work here“It’s not so much that there are too many cooks in the kitchen, it’s that the cooks are not always communicating,” Mr. Baker said. “We need to set up more rigorous protocols or structures, so we don’t have this who’s-on-first problem.” Perhaps, he suggested, a “dominant care manager” should guide the team.
Now, the Affordable Care Act and other attempts to make health care more effective and efficient (and less expensive) have created incentives and penalties that should, in theory, encourage one hand to know what the other is doing.
For Family Caregivers A Family Caregiver’s Guide to Care Coordination
{q}As a family caregiver, care coordination is something that you probably do often. This guide can help you to understand care coordination, the differences between care coordination by a family member and a professional care coordinator, and how to work together with professional care coordinators.
The guide also gives questions to ask a professional care coordinator, and tips on keeping your own care coordination organized - especially after the professional care coordinator's services end.{eq}
Professional Care Coordinators
Family Caregivers and Care Coordinators
Questions to Ask a Professional Care Coordinator
Tips for Staying Organized
2015-05-22
4 Reasons Care Transitions Can Keep Your Home Care Agency Competitive
The care coordination market is expected to grow at a compound annual growth rate (CAGR) of 26.1 percent between 2015 and 2020
An important driver in the care coordination market is the rapid adoption of new digital health solutions by payers and providers is the need to better track and manage patients across acute, ambulatory and home care settings.
To enable team-based care and ensure smooth care transitions and efficient use of healthcare resources, care coordination software should be flexible and extensible, with corresponding accountability, transparency of information, and ability to provide analysis and reporting among key stakeholders.
The solutions will enable care teams to implement and track care plans, engage patients in self-management, as well as provide closed-loop, 24/7 communication among all stakeholders, including patients and their families.
An important driver in the care coordination market is the rapid adoption of new digital health solutions by payers and providers is the need to better track and manage patients across acute, ambulatory and home care settings.
To enable team-based care and ensure smooth care transitions and efficient use of healthcare resources, care coordination software should be flexible and extensible, with corresponding accountability, transparency of information, and ability to provide analysis and reporting among key stakeholders.
The solutions will enable care teams to implement and track care plans, engage patients in self-management, as well as provide closed-loop, 24/7 communication among all stakeholders, including patients and their families.
2015-05-19
Getting the Right Care After a Hospital Discharge
In-Home Care
Most people do not understand the difference between home health and home care workers.
Essentially, home health services are provided by licensed medical professionals who come to the home to do a specific task that has been ordered by a physician and is paid for by Medicare or insurance.
Home care is classified as non-medical support, typically is not paid for by Medicare, and is for the time and duration that you specify. Some rehabilitation services can be carried out in the home through home health agencies. Visiting therapists or health care workers come once or twice a week to monitor health, administer injections, provide wound care, strength training and physical therapy exercises.
Typically, rehabilitation therapy provided by home health can only be offered a few times a week. For some patients to have a successful outcome, seniors must be motivated to exercise when the therapist is not present. In-home therapies also lack the peer support and socialization that can be provided in skilled nursing facilities and assisted living communities. That support and socialization often gives seniors the extra motivation as they recuperate.
............
Questions to Ask for Your Hospital Discharge Plan
Here are some questions to ask your hospital discharge planner or primary care doctor before your loved one leaves the hospital:
Sarah
Mitchell, MSW, has experience in hospital social work and geriatric
outpatient care. As an administrator in Assisted Living and Memory Care
with one of the top 20 assisted living companies, she acquired an
awareness and knowledge of the industry that she found valuable in her
role as a Senior Living Advisor at A Place for Mom. Since 2004, Mitchell
has used her education as a social worker and experience in senior
living to help over 14,000 families find the right senior care.
Getting the Right Care After a Hospital Discharge:
Most people do not understand the difference between home health and home care workers.
Essentially, home health services are provided by licensed medical professionals who come to the home to do a specific task that has been ordered by a physician and is paid for by Medicare or insurance.
Home care is classified as non-medical support, typically is not paid for by Medicare, and is for the time and duration that you specify. Some rehabilitation services can be carried out in the home through home health agencies. Visiting therapists or health care workers come once or twice a week to monitor health, administer injections, provide wound care, strength training and physical therapy exercises.
Typically, rehabilitation therapy provided by home health can only be offered a few times a week. For some patients to have a successful outcome, seniors must be motivated to exercise when the therapist is not present. In-home therapies also lack the peer support and socialization that can be provided in skilled nursing facilities and assisted living communities. That support and socialization often gives seniors the extra motivation as they recuperate.
............
Questions to Ask for Your Hospital Discharge Plan
Here are some questions to ask your hospital discharge planner or primary care doctor before your loved one leaves the hospital:
- What therapies will be required?
- What services will health insurance or Medicare pay for?
- Will we need help with dressing or bathing?
- Will we need help with cooking and housework?
- Will my loved one be safe at home upon discharge or will someone need to be with them 24 hours a day?
- What is the average length of recovery time?
- What problems, symptoms and side effects should we watch for?
- What should we do about any potential side effects or problems?
- Who do we call for emergencies and problems?
- What does each medicine do and why is it needed?
- What are the medication dosages, conflicts and side effects?
- Who do we call if we have questions about medical equipment such as oxygen or a walker?
Sarah
Mitchell, MSW, has experience in hospital social work and geriatric
outpatient care. As an administrator in Assisted Living and Memory Care
with one of the top 20 assisted living companies, she acquired an
awareness and knowledge of the industry that she found valuable in her
role as a Senior Living Advisor at A Place for Mom. Since 2004, Mitchell
has used her education as a social worker and experience in senior
living to help over 14,000 families find the right senior care.
Getting the Right Care After a Hospital Discharge:
2015-05-15
2015-05-13
Fujitsu pushes wearable IoT tags that detect falls, heat stress | PCWorld
Tim Hornyak
IDG News Service
Fujitsu has developed stamp-sized wearable sensor tags that can detect whether users have changed their location or posture, fallen down or are experiencing high heat.
The tags transmit data via Bluetooth Low Energy and can be worn as wristbands or location badges on lapels or breast pockets. They could be used by people including hospital patients and infrastructure workers to relay data to supervisors.
The tags can also be attached to objects such as shopping carts or walkers for the elderly. They’re part of a cloud-based Internet of Things (IoT) platform from Fujitsu called Ubiquitousware that’s aimed at making IoT applications easier for businesses.
At a Fujitsu technology expo in Tokyo this week the company is showing off the prototype tags. They contain various sensors commonly found in smartphones such as accelerometers, barometers, gyroscopes and microphones. They can also house heart rate sensors and GPS modules.
The sensors are being housed in stand-alone tags to better promote IoT apps, according to Fujitsu.
IDG News Service
Fujitsu has developed stamp-sized wearable sensor tags that can detect whether users have changed their location or posture, fallen down or are experiencing high heat.
The tags transmit data via Bluetooth Low Energy and can be worn as wristbands or location badges on lapels or breast pockets. They could be used by people including hospital patients and infrastructure workers to relay data to supervisors.
The tags can also be attached to objects such as shopping carts or walkers for the elderly. They’re part of a cloud-based Internet of Things (IoT) platform from Fujitsu called Ubiquitousware that’s aimed at making IoT applications easier for businesses.
At a Fujitsu technology expo in Tokyo this week the company is showing off the prototype tags. They contain various sensors commonly found in smartphones such as accelerometers, barometers, gyroscopes and microphones. They can also house heart rate sensors and GPS modules.
The sensors are being housed in stand-alone tags to better promote IoT apps, according to Fujitsu.
2015-05-11
If You Had Dementia What Kind of Call System Would You Want? | Senior Housing Forum
Jacquie Brennan, Vice President, Marketing and Corporate Development for Vigil Health Solutions,
a Senior Housing Forum partner. She said, “In the industry, I think we
all agree that traditional emergency call systems – with pull strings or
call cords – don’t work very well for residents who have dementia,
right?
Vigil’s system uses intelligent software and passive sensors that
continually monitor resident rooms for unexpected behavior – for
example, agitation or restlessness, extended time in the bathroom,
getting out of bed when they’re typically asleep, or leaving their room.
When unanticipated conduct is detected that information is reported to
appropriate caregivers via silent pager, wireless phone, or email
enabled smart phones. Caregivers check in with residents to see what is
going on.
There are no audible alarms or flashing lights, instead a calm
homelike environment is maintained. Use of these unobtrusive systems for
monitoring residents helps maintain their privacy while safeguarding
their well being. And the data from the sensors is also directed to a
central computer where all alarm activity, sensor activity, and summons
are recorded for further analysis.
Clipped from:
Senior Housing Forum
a Senior Housing Forum partner. She said, “In the industry, I think we
all agree that traditional emergency call systems – with pull strings or
call cords – don’t work very well for residents who have dementia,
right?
“Dementia care residents may forget what the pull cords--
are for and pull them when there’s no emergency. This sets off loud
alarms that frighten and disturb other residents. And, if a resident
doesn’t know to use the cord in an emergency, they are useless anyway.
So why, in new communities or renovations are senior living developers
continuing to put them in dementia care buildings or units?”
Vigil’s system uses intelligent software and passive sensors that
continually monitor resident rooms for unexpected behavior – for
example, agitation or restlessness, extended time in the bathroom,
getting out of bed when they’re typically asleep, or leaving their room.
When unanticipated conduct is detected that information is reported to
appropriate caregivers via silent pager, wireless phone, or email
enabled smart phones. Caregivers check in with residents to see what is
going on.
There are no audible alarms or flashing lights, instead a calm
homelike environment is maintained. Use of these unobtrusive systems for
monitoring residents helps maintain their privacy while safeguarding
their well being. And the data from the sensors is also directed to a
central computer where all alarm activity, sensor activity, and summons
are recorded for further analysis.
Clipped from:
Senior Housing Forum
A Place for Conversation & Collaboration
2015-05-01
Understanding Hallucinations, Delusions and Paranoia - AgingCare.com
Lori Johnston
Lori’s writing expertise includes personal finance, healthcare and small business. She was an Associated Press writer and an editor of Gulfshore Business, a magazine in Southwest Florida. In addition to AgingCare.com, her work has appeared in The Atlanta Journal-Constitution, People, Atlanta Homes & Lifestyles and Atlanta Business Chronicle.
Caregivers want to help loved ones know that these troubling behaviors are not real, but that natural instinct can be wrong.
Lori’s writing expertise includes personal finance, healthcare and small business. She was an Associated Press writer and an editor of Gulfshore Business, a magazine in Southwest Florida. In addition to AgingCare.com, her work has appeared in The Atlanta Journal-Constitution, People, Atlanta Homes & Lifestyles and Atlanta Business Chronicle.
Caregivers want to help loved ones know that these troubling behaviors are not real, but that natural instinct can be wrong.
2015-04-29
Getting Medicare to Pay for Nursing Home Care - AgingCare.com
Getting Medicare to Pay for Nursing Home Care - AgingCare.com: Getting Medicare to Pay for Nursing Home Care
Caregivers:
don't let the nursing home business office tell you that Medicare can no longer cover room and board for your loved one because he or she isn't "improving."
The Improvement Standard is not—and never has been—a valid reason for nursing homes to cut off Medicare nursing home days. Medicare's nursing home payment manual makes it clear that "[e]ven in situations where no improvement is expected, skilled care may nevertheless be needed." This manual was published in 2014, but some nursing homes haven't adapted to help chronic patients get access to the Medicare coverage they are eligible for. Many business offices rely on software programs to manage their billing, and those programs haven't caught up to the Jimmo v. Sebelius court decree that was issued on January 24, 2013.
Articles About Skilled Nursing Care
Who’s Who in Skilled Nursing: Staff Caregivers Should Get To Know
When a loved one moves into a skilled nursing facility the flurry of new faces can be confusing for seniors and their family members. Who on the staff should you get to know? Who's responsible for which aspects of your loved one's care?
Robin Maibach, Admissions and Social Services Director at Lourdes-Noreen McKeen, a retirement community in West Palm, FL, highlights the staff members that residents of skilled nursing facilities and their family members are most likely to interact with:
Charge nurse
Other names: head nurse, staff nurse
What they do: The charge nurse in a skilled nursing setting is there to oversee the nursing staff that helps senior residents with various health issues that may come up. These health care professionals generally work in eight-hour shifts to ensure that a senior has round-the-clock access to medical care. This means that, in any given 24-hour period, there may be three different people who take turns performing the role. Maibach advises caregivers to try and become familiar with the nurses assigned to the daytime shifts (generally 7:00 am-3:00 pm and 3:00 pm-11:00 pm)
When to go to them: An elderly resident should contact the charge nurse when they have a health concern that they wish to seek treatment for. A senior who is not feeling well, or who has a cut, blister, or pain that needs treatment and they don't know what to do, should seek out the charge nurse on duty or contact an available CAN (see below for description).
Social worker
Other names: case manager, gerontological social worker
What they do: Skilled nursing facilities generally have one social worker assigned to each individual unit. These staff members exist to handle the non-nursing related issues that can crop up.
When to go to them: If a senior is experiencing problems with unmet needs, or financial concerns, they should seek the help of their social worker to resolve the problem. Maibach says that a social worker can help an elderly resident with everything from getting broken hearing aid fixed, to helping a depressed resident gain access to a mental health professional. They also are trained to help residents navigate the complex processes underlying billing and financial aid.
Activities director
Other names: recreation director, lifestyle coordinator, social director, life enrichment director, activity program coordinator
What they do: An activities director is usually a full-time employee who is responsible for developing and implementing plans for various engagement activities and outings for senior residents.
When to go to them: A senior (or family member) who has questions regarding a particular activity or program offered by the facility—or an idea for one—should consult the activities director.
Medical director
Other names: N/A
What they do: The medical director is responsible for reviewing the care that a resident is currently receiving from their personal doctor and make sure that their medical needs are being met by the medical professionals in the assisted living community. They are constantly in contact with the community's nursing staff as well as an individual resident's primary care physician.
When to go to them: According to Maibach, medical directors don't often interact directly with seniors and their caregivers. Questions regarding an elder's health are generally fielded by either the community's nursing staff or their personal doctor, not the medical director.
Certified nursing assistant (CNA)
Other names: nursing aide, care manager, licensed practical nurse
What they do: According to Maibach, CNAs provide the bulk of hands-on care for seniors in skilled nursing facilities. They can assist an elder in performing activities of daily living, including: bathing, grooming, eating, toileting, etc.
When to go to them: A senior should seek the services of a CNA if they require help with tasks relating to personal hygiene, eating or incontinence.
Dietary coordinator
Other names: dietary assistant, food service coordinator, clinical nutrition manager
What they do: Depending on the facility, a dietary professional may or may not be involved in the day-to-day preparation and serving of food to senior residents. Sometimes they will act in a strictly advisory capacity, helping design menus and meals to fit a senior resident's specific requirements.
When to go to them: Typically, the family members of seniors living in skilled nursing facilities will play a significant role in helping a senior communicate their menu preferences to the dietary coordinator. If a senior has particular dietary restrictions or questions regarding the preparation or serving of food, they should solicit the help of the dietary coordinator or an available CNA.
Housekeeper
Other names: custodial service, maintenance staff
What they do: Senior residents in a skilled nursing facility are not responsible for cleaning their own rooms or doing their own laundry. Room cleaning and linen changes are the daily responsibility of the housekeeping staff.
When to go to them: A senior who has an accident or needs something in their room cleaned should contact the housekeeping staff for assistance.
What’s the Difference Between Skilled Nursing and a Nursing Home?
When it comes to senior living, many terms get thrown around: skilled nursing and nursing homes are two examples. Oftentimes, the terms are used interchangeably. The confusion leaves many caregivers asking, “is there a difference?"
Tracking Alzheimer's or Dementia in Senior Living Communities
Staff at assisted living and skilled nursing facilities is prepared to monitor your parents' well-being as dementia progresses. You should expect them to track your parent's condition in a variety of ways.
Caregivers:
don't let the nursing home business office tell you that Medicare can no longer cover room and board for your loved one because he or she isn't "improving."
The Improvement Standard is not—and never has been—a valid reason for nursing homes to cut off Medicare nursing home days. Medicare's nursing home payment manual makes it clear that "[e]ven in situations where no improvement is expected, skilled care may nevertheless be needed." This manual was published in 2014, but some nursing homes haven't adapted to help chronic patients get access to the Medicare coverage they are eligible for. Many business offices rely on software programs to manage their billing, and those programs haven't caught up to the Jimmo v. Sebelius court decree that was issued on January 24, 2013.
Articles About Skilled Nursing Care
Who’s Who in Skilled Nursing: Staff Caregivers Should Get To Know
When a loved one moves into a skilled nursing facility the flurry of new faces can be confusing for seniors and their family members. Who on the staff should you get to know? Who's responsible for which aspects of your loved one's care?
Robin Maibach, Admissions and Social Services Director at Lourdes-Noreen McKeen, a retirement community in West Palm, FL, highlights the staff members that residents of skilled nursing facilities and their family members are most likely to interact with:
Charge nurse
Other names: head nurse, staff nurse
What they do: The charge nurse in a skilled nursing setting is there to oversee the nursing staff that helps senior residents with various health issues that may come up. These health care professionals generally work in eight-hour shifts to ensure that a senior has round-the-clock access to medical care. This means that, in any given 24-hour period, there may be three different people who take turns performing the role. Maibach advises caregivers to try and become familiar with the nurses assigned to the daytime shifts (generally 7:00 am-3:00 pm and 3:00 pm-11:00 pm)
When to go to them: An elderly resident should contact the charge nurse when they have a health concern that they wish to seek treatment for. A senior who is not feeling well, or who has a cut, blister, or pain that needs treatment and they don't know what to do, should seek out the charge nurse on duty or contact an available CAN (see below for description).
Social worker
Other names: case manager, gerontological social worker
What they do: Skilled nursing facilities generally have one social worker assigned to each individual unit. These staff members exist to handle the non-nursing related issues that can crop up.
When to go to them: If a senior is experiencing problems with unmet needs, or financial concerns, they should seek the help of their social worker to resolve the problem. Maibach says that a social worker can help an elderly resident with everything from getting broken hearing aid fixed, to helping a depressed resident gain access to a mental health professional. They also are trained to help residents navigate the complex processes underlying billing and financial aid.
Activities director
Other names: recreation director, lifestyle coordinator, social director, life enrichment director, activity program coordinator
What they do: An activities director is usually a full-time employee who is responsible for developing and implementing plans for various engagement activities and outings for senior residents.
When to go to them: A senior (or family member) who has questions regarding a particular activity or program offered by the facility—or an idea for one—should consult the activities director.
Medical director
Other names: N/A
What they do: The medical director is responsible for reviewing the care that a resident is currently receiving from their personal doctor and make sure that their medical needs are being met by the medical professionals in the assisted living community. They are constantly in contact with the community's nursing staff as well as an individual resident's primary care physician.
When to go to them: According to Maibach, medical directors don't often interact directly with seniors and their caregivers. Questions regarding an elder's health are generally fielded by either the community's nursing staff or their personal doctor, not the medical director.
Certified nursing assistant (CNA)
Other names: nursing aide, care manager, licensed practical nurse
What they do: According to Maibach, CNAs provide the bulk of hands-on care for seniors in skilled nursing facilities. They can assist an elder in performing activities of daily living, including: bathing, grooming, eating, toileting, etc.
When to go to them: A senior should seek the services of a CNA if they require help with tasks relating to personal hygiene, eating or incontinence.
Dietary coordinator
Other names: dietary assistant, food service coordinator, clinical nutrition manager
What they do: Depending on the facility, a dietary professional may or may not be involved in the day-to-day preparation and serving of food to senior residents. Sometimes they will act in a strictly advisory capacity, helping design menus and meals to fit a senior resident's specific requirements.
When to go to them: Typically, the family members of seniors living in skilled nursing facilities will play a significant role in helping a senior communicate their menu preferences to the dietary coordinator. If a senior has particular dietary restrictions or questions regarding the preparation or serving of food, they should solicit the help of the dietary coordinator or an available CNA.
Housekeeper
Other names: custodial service, maintenance staff
What they do: Senior residents in a skilled nursing facility are not responsible for cleaning their own rooms or doing their own laundry. Room cleaning and linen changes are the daily responsibility of the housekeeping staff.
When to go to them: A senior who has an accident or needs something in their room cleaned should contact the housekeeping staff for assistance.
What’s the Difference Between Skilled Nursing and a Nursing Home?
When it comes to senior living, many terms get thrown around: skilled nursing and nursing homes are two examples. Oftentimes, the terms are used interchangeably. The confusion leaves many caregivers asking, “is there a difference?"
Tracking Alzheimer's or Dementia in Senior Living Communities
Staff at assisted living and skilled nursing facilities is prepared to monitor your parents' well-being as dementia progresses. You should expect them to track your parent's condition in a variety of ways.
2015-04-26
Dying from Dementia -- Dementia Suffering Often Unnecessary | Alzheimer's Reading Room
Original content +Bob DeMarco , the Alzheimer's Reading Room
Posted by Bob DeMarco at Wednesday, February 11, 2015
Dying from Dementia -- Dementia Suffering Often Unnecessary | Alzheimer's Reading Room: The "Choices, Attitudes and Strategies for Care of Advanced Dementia at the End-of-Life," or CASCADE, study prospectively followed the clinical course of 323 nursing home residents with advanced dementia living in 22 Boston-area nursing homes for up to 18 months.
At the final stage of the disease, patients had profound memory deficits such that they could not recognize close family members, spoke fewer than six words, and were non-ambulatory and incontinent.
Over the course of the study, 177 patients died.
The researchers found that the most common complications were pneumonia, fevers and eating problems, and that these complications were associated with high six-month mortality rates. Uncomfortable symptoms, including pain, pressure ulcers, shortness of breath, and aspiration, were also common and increased as the end of life approached.
Dr. Mitchell, an Associate Professor of Medicine at Harvard Medical School, said that she and her team found that while 96 percent of the patients' health-care proxies believed that comfort care was the primary goal of care for their loved one, nearly 41 percent of patients who died during the study underwent at least one intervention, including hospitalization, an emergency room visit, intravenous therapy, or tube feeding, in the last three months of life. However, patients whose health-care proxies understood the clinical course of the disease were less likely to receive aggressive treatment near the end of life.
"Many of the patients in our study underwent interventions of questionable benefit in the last three months of life," says Dr. Mitchell. "However, when their health-care proxies were aware of the poor prognosis and expected clinical complications in advanced dementia, patients were less likely to undergo these interventions and more likely to receive palliative care in their final days of life."
At the beginning of the study, 81 percent of the proxies felt they understood which clinical complications to expect in advanced dementia, yet only one third said that a physician had counseled them about these complications.
Currently, more than 5 million Americans suffer from dementia, a number that is expected to increase by almost three-fold in the next 40 years. A recent study by Alzheimer's Disease International estimates that the number of people with dementia worldwide will exceed 35 million by 2050. Dementia is a group of symptoms severe enough to interfere with daily functioning, including memory loss, difficulty communicating, personality change, and an inability to reason. Alzheimer's disease is the most common form of dementia.
"A better understanding of the clinical trajectory of end-stage dementia is a critical step toward improving the care of patients with this condition," says Dr. Mitchell. "This knowledge will help to give health-care providers, patients and families more realistic expectations about what they will confront as the disease progresses and the end of life approaches."
__________
The CASCADE study was funded by the National Institutes of Health.
Scientists at the Institute for Aging Research conduct rigorous medical and social studies, leading the way in developing strategies for maximizing individuals' strength, vigor and physical well-being, as well as their cognitive and functional independence, in late life. Hebrew SeniorLife, an affiliate of Harvard Medical School, is a 106-year-old organization committed to maximizing the quality of life of seniors through an integrated network of research and teaching, housing and health care.
How Alzheimer's Spreads Throughout the Brain | Alzheimer's Reading Room
How Alzheimer's Spreads Throughout the Brain | Alzheimer's Reading Room:
Title: How Alzheimer's Spreads Throughout the Brain
What is the Difference Between Alzheimer's and Dementia?
Title: How Alzheimer's Spreads Throughout the Brain
What is the Difference Between Alzheimer's and Dementia?
2015-04-25
Certified Nursing Assistant (CNA): End-of-Life Care in Long-Term Care (Research, Video 1:51)
Hospice and Nursing Homes Blog Frances Shani Parker, writes this blog.
Research on the CNA preparedness role included in-person interviews with 140 CNAs about their experiences regarding residents' deaths. These experiences included characteristics such as care preferences, status perceptions of residents, and the caregiving context with emotional and informational preparedness.
These were the results:
1) CNAs who reported that residents were "aware of dying" or "in pain" expressed higher levels of both emotional and informational preparedness.
2) CNAs who endorsed an end-of-life care preference of wanting all possible treatments regardless of chances for recovery were likely to report lower emotional preparedness.
3) More senior CNAs, both in regard to age and tenure, reported higher preparedness levels.
4) Greater support from coworkers and hospice involvement were associated with higher levels of both facets of preparedness, the latter in particular when hospice care was viewed positively by the CNAs.
This research concludes that more information about the status of residents and more exchange opportunities within the care team around end-of-life care-related challenges may help CNAs feel more prepared for residents' deaths and strengthen their ability to provide good end-of-life care. Creating this kind of context requires ongoing commitment, implementation, and monitoring.
These were the results:
1) CNAs who reported that residents were "aware of dying" or "in pain" expressed higher levels of both emotional and informational preparedness.
2) CNAs who endorsed an end-of-life care preference of wanting all possible treatments regardless of chances for recovery were likely to report lower emotional preparedness.
3) More senior CNAs, both in regard to age and tenure, reported higher preparedness levels.
4) Greater support from coworkers and hospice involvement were associated with higher levels of both facets of preparedness, the latter in particular when hospice care was viewed positively by the CNAs.
This research concludes that more information about the status of residents and more exchange opportunities within the care team around end-of-life care-related challenges may help CNAs feel more prepared for residents' deaths and strengthen their ability to provide good end-of-life care. Creating this kind of context requires ongoing commitment, implementation, and monitoring.
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