New Nursing Home Philosophy: Limit Time in Wheelchairs

RALEIGH, N.C. (AP) -- You can see it at most long-term care centers -- residents in wheelchairs lining hallways, just sitting or rolling slowly down the hall.

But a health service director at a Durham center says it's time to stop parking older people in wheelchairs.

Leslie Jarema of The Forest at Duke says in the old-school nursing homes, people are sitting around the nurses' station and asking for help because they are uncomfortable.

The Midwest-based group called GROW, or Get Residents Out of Wheelchairs, has taken up the cause on a national level. The nonprofit urges nursing homes to help residents use regular chairs, couches, recliners. The group, which has asked Jarema to speak about her approach at The Forest at Duke, also tries to get residents to be as active as possible, encouraging walking to meals, going on foot to the bathroom or shower and taking outside walks with family and friends when possible.

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Caregivers Find Unexpected Emotional Rewards in Tending for Family Members

Nearly 80% of family caregivers are finding the caregiving experience emotionally rewarding, despite initial negative perceptions of caregiving, according to a nationwide survey by Caring Today magazine.

Published in conjunction with National Family Caregivers Month this past November, the Caring Today survey shows that caregivers have distinctly more positive feelings after caring for a family member than they did as they were about to take on the responsibility. The number of caregivers finding the experience highly rewarding jumped by 50% following the caregiving experience.

White Nursing Home Residents Less Likely Than Blacks To Be Hospitalized, Study Finds

Black nursing home residents are more likely than their white counterparts to be hospitalized for conditions such as dehydration, poor nutrition and bedsores, according to a study to be published in the June issue of the journal Health Services Research, the Washington Post reports. Lead study author Andrea Gruneir and other researchers affiliated with the Brown University Albert Medical School examined data from 2000 on more than 500,000 nursing home residents in 9,000 facilities across the U.S. (Spinner, Washington Post, 1/15).

CMS Proposes Cash Allowance To Let Beneficiaries Hire Personal Care Workers

MS on Monday announced it will accept public comment on a proposal to provide some Medicaid beneficiaries with a cash allowance to hire personal care workers, CQ HealthBeat reports. If their home states elect to adopt a self-directed personal assistance services option in their state plan, beneficiaries would be able to hire and train their own qualified caregiver -- who could be a family member -- to assist with daily activities but not direct medical care.

Democrats seek release of the names of more bad nursing homes

Knowing which nursing homes are bad can be valuable information for a family seeking long-term care for an elderly loved one but concerned about issues like nursing home abuse and neglect. Recently, the Centers for Medicare and Medicaid Services announced the names of 54 nursing homes that had ranked as one of the worst in their state. Proper administration of medication to patients, appropriate assistance with activities of daily life and concern for the prevention of malnutrition and dehydration are examples of what inspectors look for in nursing homes. Inspectors also look for signs of nursing home abuse and neglect such as failure to maintain resident safety and prevent accidents, such as falls, infections, bed sores and other problems elderly people are susceptible to.

The list published by CMS containing the names of 54 nursing homes is actually a sample of 128 "special focus facilities", or homes that were identified as in need of more oversight. CMS says that the rest of the facilities were not identified because during the six months after being titled a "focus facility" they showed improvement. Democratic legislators, however, are demanding that all of the names be released in order to protect nursing home residents. Most nursing homes have around 6-7 deficiencies identified during inspection, but the ones on the list had twice as many or more. Unfortunately, no national standard has been set for the investigations so each state has its own parameters. An Illinois nursing home can be considered in terrible condition, but would not qualify in another state. A bill was recently introduced in the legislature to make it mandatory for CMS to publish all of the names, but the issue of discrepancies between states' standards is an issue that should be addressed by congress.

Waking the Unconscious

A 38 year old male had suffered severe brain damage, slipped into in a deep coma, and a year after receded into a minimally conscious state. The patient was non verbal, was fed and kept alive through tubes in a long term care facility. Six years later, despite the large amount of damage to the cortex, imaging results showed that some parts of the brain were still functioning. This led a team of neurosurgeons to believe that they would be able to improve the patient’s state through manual stimulation of those undamaged parts of his brain. Upon examination at the time of enrollment, the patient was able to move his eyes sideways (but not up and down), and the rest of his body was out of conscious control.

The results were dramatic – within 48 hours post surgery the patient was able to respond to noise stimuli by turning his head towards the source of the voice. Further, he was able to keep his eyes open for a sustained period of time on his own, as well as move his limbs. Within 50 days with continued stimulation, he was able to bring a cup to his mouth, swallow food, thus becoming independent of his feeding tube.

The patient continued to improve after the experimental phase was over, and eventually was able to put together up to six words to express himself vocally. The cost of care for this patient has since reduced significantly, since he is no longer on a feeding tube and can feed himself manually three times a day.

CMS Issues Proposed Rule To Empower Medicaid Beneficiaries To Direct Personal Assistance Services, USA

A proposed rule that would allow more Medicaid beneficiaries to be in charge of their own personal assistance services, including personal care services, instead of having those services delivered by an agency, was announced by the Centers for Medicare & Medicaid Services (CMS).

Through the rule on display today at the Federal Register, CMS requests public comment on how states could allow Medicaid beneficiaries who need help with the activities of daily living to hire, direct, train or fire their own personal care workers rather than working with personnel employed by an agency. Beneficiaries could even hire qualified family members who may already be familiar with the individual's needs to perform personal assistance (not medical) services.

COMMISSION MAKES RECOMMENDATIONS TO IMPROVE LONG-TERM CARE

Old story. but the picture and the site are interesting:

A report issued by the National Commission for Quality Long-Term Care warns of a coming long-term care crisis and includes recommendations to advance long-term care reform in four areas: quality, workforce, technology and finance.

As Home Instead’s The BUZZ continues its look at this report, entitled “Isolation to Integration: Recommendations to Improve Quality in Long-Term Care,” today’s article details recommendations regarding quality. Highlights of the commission’s 26 recommendations include:

· A critical part of long-term care quality is the individual’s quality of life. Giving individuals more choice and control over the services they receive in the settings of their choice will enhance their quality of life;