Intestinal Superbug: A Serious Health Care Threat

In recent years, healthcare-associated infections—illnesses you acquire during a stay in a hospital or long-term care facility—have reached epidemic proportions. One of the most widespread and potentially serious of these illnesses is caused by the bacterium Clostridium difficile, often simply called C. diff, which is responsible for tens of thousands of cases of diarrhea and at least 5,000 deaths in the United States each year. And the problem is getting worse. According to a new study, the number of people hospitalized with this intestinal superbug has been growing by more than 10,000 cases a year.

Dr. L. Clifford McDonald, a CDC expert said, "The nature of this infection is changing; it's more severe."

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
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LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Older Adults More Likely To Go Into A Nursing Home Just After Death Of Spouse

The chances of older adults being institutionalized, for instance in a nursing home, go up significantly immediately after the death of a spouse, according to new research from Finland.

The study was conducted by Elina Nihtila and Pekka Martikainen, sociology researchers at the University of Helsinki in Finland and was published online in the American Journal of Public Health yesterday, May 29th.

The researchers investigated the risk of an older adult entering long-term institutional care after the death of their spouse, compared with how long they lived after their loss. They also looked at whether level of education or household income had an effect.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Free Dementia Care Guide Now Better than Ever

A dementia care guide that has been helping direct-care workers since 2006 is now better than ever.

Knowledge and Skills Needed for Dementia Care: A Guide for Direct Care Workers in Everyday Language helps direct-care workers determine whether they have the skills they need to deliver person-centered dementia care — and where to go for assistance if they need training. It also helps supervisors, policymakers, and others evaluate dementia care training programs. It was developed by a team of experts and reviewed by many more, including more than 60 home health aides and CNAs.

“Most people who provide hands-on care for individuals with dementia have big, warm, caring hearts,” says Dementia Project Coordinator Micki Horst. ”They want to learn all they can about how best to care for and interact with someone with dementia. We developed this guide to give them a tool for assessing their own competencies.”

The updated version includes useful additions:

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Voices Institute Graduates - May the Root Thrive!

We just completed another historic and successful step forward for the movement to empower direct care workers and to fix our broken long-term care system!

It is clear that Direct Care Workers want a voice and to have their voices heard to improve the profession and the quality of care and services. It was fitting that direct care workers from 12 states met at a place whose motto is: May the Root Thrive! The 25 leaders from 12 states gathered at the DeKoven Center are the roots of our growing movement! I have no doubt that each and every one of the attendees will ensure that the long-term care care-gap is avoided and direct care workers are empowered by applying the powerful tools we all learned at our five day training program.

The events I witnessed at the Voices Institute Inaugural class reminded me of the gracious, generous and powerful nature of direct care workers and their ability to meet any challenge and thrive: flexibility, ability to solve problems, address crisis situations, balance challenging schedules are the stuff that the daily care-giving experience is made of. And so, all the Voices Institutes leaders gathered and we learned speech making, fundraising, organizational and self empowerment strategies and we all thrived in the intense and challenging environment Bob Hudek designed for us. Thank you Bob Hudek for locating the perfect learning environment and for designing a curriculum that gave us comfort, hope and thought us powerful tools that along with Vera’s empowerment tools will lead us to success.


Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

My Caregiver Magazine

The National Association of Health Care Assistants- NAHCA- used to have a magazine for CNA’s called “CNA TODAY”- it ceased publication a couple years ago. NOW, they introduce a new magazine for ALL direct care workers in the nursing field, titled, “MY CAREGIVER”.

From the MY CAREGIVER web site:

My Caregiver is a quarterly magazine published by the Academy of Certified Health Professionals (ACHP) for and about health care assistants and their role in long term care. It is a special magazine, a publication virtually every person in the long term care industry will want to read.

With a circulation of 10,000, we reach nursing assistants, Directors of Nursing, facility Administrators, nursing home residents, and their families, product manufacturers, policy makers, and other health care associations.

The first issue of My Caregiver debuted March 2008. It evolved from the original CNA Today magazine to focus on health care assistants from diverse settings in long term care. The original magazine, CNA Today, launched June 2001 and was unveiled at the NAGNA National Convention.

Now My Caregiver will prove to be a remarkable resource for information on long term care for all who perform the role or duties of a nursing assistant, regardless of title.

The magazine is published quarterly and costs $15.00/year for non NAHCA members; $10.00/year for members.

NAHCA’s main web site is HERE.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

The Health Coverage Crisis in Direct-Care

Download the report (pdf 1.9MB)

Report Shows High Rates of Injury, Inadequate Health Coverage May Result in Caregiver Shortage

As part of National Women’s Health Week, PHI’ Health Care for Health Care Workers Campaign will deliver a sobering report -– Invisible Care Gap: Caregivers without Health Coverage — on the health insurance status of our nation’s caregiving workforce, 90% of which is female. Based on the most recent data from the U.S. Bureau of the Census and Bureau of Labor Statistics, the report reveals that:

  • Nurse aides have the highest rates of workplace injuries and illnesses in the country, making it America’s most dangerous job.
  • Nearly 30% of direct-care workers have no health insurance coverage, twice the rate of the general population.
  • The country’s fastest-growing workforce—jobs providing in-home personal care services—is the least likely to have health coverage.
  • Direct-care wages are so low (median hourly wage of $9.56/hr) that nearly 30% live in or near poverty and few can afford high cost of insurance premiums.
Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Antipsychotics In Older Adults With Dementia Associated With Serious Adverse Events And Death

Short term courses of antipsychotic medications, when given to older adults with dimentia, are associated with a greater risk of hospitalization and death, according to a report released on May 26, 2008 in the Archives of Internal Medicine, one of the JAMA/Archives journals.

Antipsychotic drugs are used to treat various psychotic disorders -- some conventional examples include haloperidol or loxaprine. The authors point out that a new generation of these drugs has been released, but the effects of short term prescription have not yet been ascertained. "Newer antipsychotic drugs (olanzapine, quetiapine fumarate and risperidone) have been on the market for more than a decade and are commonly used to treat the behavioral and psychological symptoms of dementia," they say. "Antipsychotic drugs are often used for short periods to treat agitation in clinical practice. They are frequently prescribed around the time of nursing home admission." Approximately 17% of nursing home admission begin a regimen of antipsychotic medications, with only 10% on a single prescription. Given this information, they say, it is important to evaluate the effects of short term regimens on patients.

To investigate this issue, Paula A. Rochon, M.D., M.P.H., F.R.C.P.C., of the Institute for Clinical Evaluative Sciences (ICES), Ontario, and colleagues examined older adults living with dementia in the community and in nursing homes between 1997 and 2004. In each setting, three separate groups of equal size were identified, each differing only in their exposure to antipsychotic medications. One group had not received antipsychcotics, one group had been prescribed atypical or newer antipsychotics, and the last group was prescribed conventional psychotics. For older adults in the community, 6,894 were in each group for a total or 20,682 patients. In the older adults with dementia living in nursing homes, each group had 6,853 for a total of 20,559 subjects.

The medical records of each participant were examined, and hospital admissions and death within 30 days of the initiation of therapy were noted as serious adverse events. The team found that, in the general community, those prescribed with nonconventional antipsychotic drugs were more likely to experience adverse events, while those on conventional antipsychotic drugs were even more likely. "Relative to community-dwelling older adults with dementia who did not receive a prescription for antipsychotic drugs, similar older adults who did receive atypical antipsychotic drugs were three times more likely and those who received a conventional antipsychotic drug were almost four times more likely to experience a serious adverse event within 30 days of starting therapy." The authors continue, noting a similar but less pronounced trend in the nursing room group: "Relative to nursing home residents in the control group, individuals in the conventional antipsychotic therapy group were 2.4 times more likely to experience a serious adverse event leading to an acute care hospital admission or death. Those in the atypical antipsychotic group were 1.9 times more likely to experience a serious adverse event during 30 days of follow-up."


Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

CMS Places Three-Year Moratorium On Construction Of New Long-Term Care Hospitals

CMS officials this week announced a regulation that places a three-year moratorium on the construction of new long-term care hospitals and limits the effects of payment reductions to existing facilities, CQ HealthBeat reports. According to CQ HealthBeat, admissions criteria among long-term care hospitals and the industry’s “Medicare-fueled growth” had “raised eyebrows among policy makers.”

As a result, several regulatory provisions, including a proposal to reduce base rates and the extension of the so-called 25% rule, were “putting the hurt” on the long-term care hospital industry. The 25% rule reduced payments for care of each patient from a single referring facility above one-quarter of a long-term care hospital’s patient load. According to CQ HealthBeat, the 25% rule addressed hospitals building long-term care facilities within their own facilities to capture higher revenues associated with long-term care. The new regulation implements provisions of a measure signed by President Bush last year regarding Medicare and Medicaid payments and an extension of SCHIP.

The new revisions “ease the impact” of the 25% rule and block the base rate reduction, according to CQ HealthBeat. In addition, the regulation sets policies for implementing the moratorium and determines which facilities will be prohibited from new construction. CMS will be evaluating exemptions on a case-by-case basis, according to Alec Vachon, a Washington, D.C. consultant and former Senate Finance Committee staffer. The regulation will be published in the Federal Register on Thursday (Reichard, CQ HealthBeat, 5/21).

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Statement By Mike Leavitt Secretary Of Health And Human Services On Two Medicaid Rules, USA

The Administration has been asked several times the impact of implementing two Medicaid rules when an existing moratorium expires May 25, 2008.

1. Graduate Medical Education -- CMS 2279 -- proposed rule published on May 23, 2007; and

2. Cost limit for Providers Operated by Units of Government and Provisions to Ensure the Integrity of Federal-State Financial Partnership -- CMS 2259-FC -- final rule with comment period, published on May 29, 2007.

In response, Secretary Michael O. Leavitt released the following statement today:

"I reiterate the Administration's willingness to work with Congress and Governors to discuss their concerns before the rules go into effect," Secretary Leavitt said. "We will voluntarily refrain from making these rules effective until August 1, 2008, more than 60 days after the moratorium expires. I invite interested parties to sit down with me and my staff in the coming weeks to ensure that we meet our mutual commitments to protect health care for low-income individuals."

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Caregivers For Alzheimer's Patients Record Life Stories With Project StoryKeeper

Project StoryKeeper, a non-profit organization dedicated to preserving family heritage and announced that new findings by the Alzheimer's Association are increasing the need to document the life stories of patients. Caregivers of Alzheimer's patients can get access to Project StoryKeeper's interviewing technology by visiting http://www.storykeeper.org.

"The Alzheimer's Association just announced that one in eight Baby Boomers can expect to develop the disease," said Dennis Stack, Founder of Project StoryKeeper. "That means that more and more family histories - and the richness they hold - will be slipping away if we don't do something now to preserve them. We think Project StoryKeeper is a great way for families and caregivers of all ages to use the latest technology to keep family legacies going strong."

Targeted towards caregivers, Project StoryKeeper's online training program includes questions, interviewing techniques, and recording tips to be used in drawing out the personal histories of senior citizens at home or within elder care settings such as hospices, assisted living facilities, and home care agencies.

Capturing life stories - through technology.

Captured stories can be posted and archived on a private family web page on http://www.lifelenz.com. LifeLenz is a family-centric social network designed to enable families to easily preserve their legacy, stay in touch and communicate in ways not possible before. The tools LifeLenz provides allow for caregivers and family members to share in each other's lives through text, audio, video and photographs.

Easy-to-use online communication tool.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/