Medical Students' Perspectives On Dementia Altered By Storytelling Program

http://goo.gl/a3DHR

Medical students commonly perceive persons with dementia as being challenging to work with.

"We currently lack effective drugs for dementia, and there's a sense that these are cases where students can't do much to benefit the patient," George said. "The perception is that they're hard to extract information from, you don't know if that information is reliable, and there are often other complicated medical issues to deal with." 

TimeSlips is a non-pharmacological approach to dementia care that uses creative storytelling in a group setting and encourages participants to use their imagination rather than focusing on their inability to remember chronologically. Pictures with a staged, surreal image - for example, an elephant sitting on a park bench - are shared with all participants, who are encouraged to share their impressions of what is happening in the picture. As part of George's elective, medical students spent one month facilitating TimeSlips with groups of five to 10 residents and helping the residents build stories in poem form during their interactions. 

One In Four Adults In The US Is A Family Caregiver

http://goo.gl/FqaJi

One in four American adults is caring for an elderly or sick family member as more people develop chronic diseases and the population as a whole becomes older, new research finds.

Caregivers are using every resource available to obtain the information and support they need to care for their family members.

Among caregivers, 39% took charge of medications for a loved one, like checking to make sure pills are taken at the right time or refilling prescriptions. Approximately 7% of caregivers use online or mobile tools like apps or websites to do so.

Eighty-seven percent of caregivers own a cell phone and 37% of those say they used their cell to search for medical or health information online. This is much higher than the rate of mobile health searches among non-caregivers; 84% of non-caregivers have a cell phone and 27% have used their phone to search for online health information.

1 in 4 Stroke Survivors Develops PTSD

http://goo.gl/az5LJ

One in every four survivors of stroke or TIA (transient ischemic attack) develops PTSD (post-traumatic stress disorder) within twelve months, while 1 in 9 has chronic PTSD for longer than a 12 months, researchers from Columbia University Medical Center reported in the journal PLoS ONE.

This means that almost 300,000 survivors of stroke or TIA develop PTSD symptoms each year in the USA as a result of their traumatic experience.

Learning to Speak Alzheimer's: A Groundbreaking Approach for Everyone Dealing with the Disease

http://goo.gl/wkW3y

Revolutionizing the way we perceive and live with Alzheimer’s, Joanne Koenig Coste offers a practical approach to the emotional well-being of both patients and caregivers that emphasizes relating to patients in their own reality. Her accessible and comprehensive method, which she calls habilitation, works to enhance communication between carepartners and patients and has proven successful with thousands of people living with dementia. Learning to Speak Alzheimer’s also offers hundreds of practical tips, including how to · cope with the diagnosis and adjust to the disease’s progression · help the patient talk about the illness · face the issue of driving · make meals and bath times as pleasant as possible · adjust room design for the patient’s comfort · deal with wandering, paranoia, and aggression.

Subsidy Calculator: Premium Assistance for Coverage in Exchanges

http://goo.gl/sIOD2

This tool illustrates health insurance premiums and subsidies for people purchasing insurance on their own in new health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). Beginning in October 2013, middle-income people under age 65, who are not eligible for coverage through their employer, Medicaid, or Medicare, can apply for tax credit subsidies available through state-based exchanges.

Additionally, states have the option to expand their Medicaid programs to cover all people making up to 138% of the federal poverty level (which is about $33,000 for a family of four). In states that opt out of expanding Medicaid, some people making below this amount will still be eligible for Medicaid, some will be eligible for subsidized coverage through Marketplaces, and others will not be eligible for subsidies.

With this calculator, you can enter different income levels, ages, and family sizes to get an estimate of your eligibility for subsidies and how much you could spend on health insurance. As premiums and eligibility requirements may vary, contact your state’s Medicaid office or exchange with enrollment questions.

Appearances can be deceiving: aging, homelessness, and acute care

http://goo.gl/RP3Pg

here’s the catch: the odds are very good that you've met someone (maybe even provided clinical care for someone) who was without a home but you didn't know it because they didn't “look homeless.” In a study published this month in the Journal of Healthcare for the Poor and Underserved (JHCPU), my colleagues and I described the experience of acute care from the perspective of 100 homeless individuals seen in the ED or hospitalized over a 1 year period in New Haven, CT. We found that only 2 in 5 were ever asked about their housing status during the course of their care at the hospital. Not surprisingly, those who were asked were several times more likely to receive high-quality discharge planning based on their needs (e.g. discussions about costs of medications and transportation). Compounding the problem of using the “eyeball test” to determine who has unstable housing, many patients are hesitant to disclose their need for fear of discriminatory care or simply from embarrassment – this may be particularly true for older adults.

Free phone for seniors

http://goo.gl/Jq7RR

The federal program called “Lifeline” was created to provide cell phones or free home phone service for anyone for emergencies; this is especially important for seniors. The Lifeline program provides a free cell phone and free minutes every month.

Anyone who is eligible can apply for the program. If you already receive assistance from the federal government or if your income is equal to or less than 135% of the federal poverty guidelines, you can qualify for the program. This program provides a free phone for seniors or anyone else meeting these requirements.
The Lifeline program has many different carriers, which will offer different phones and monthly plans for seniors.

Hospice and the Transgendered

http://goo.gl/oUC5y

An elderly female (MTF) transgendered patient had developed metastatic cancer.  Chemotherapy had failed and had left her profoundly weak and infirmed.  Estranged from her family, she had only a few friends to rely on but then only intermittently so.  Hospice admitted her to their IPU and, with supportive care, her overall status did improve.  However, now she was in a dilemma.  She was well enough to leave the unit but not well enough to go home.  Too poor to afford a single room, the patient was unable to be placed.  Chronic care facilities viewed her as if she were both male AND female.  This  prohibited her placement with a roommate.  As she was physically  female she wished to have a female roommate; the facilities saw her as originally 'male' and either could not or would not comply.  In the end, she remained at the hospice center for the remainder of her life.  While the hospice provided her with exemplary care, the obstacle of society's views on gender prevented her from ever leaving the unit.

Poor integration between hospital EHRs and NICUs

A technical issue but important for infants with disabilities:

http://goo.gl/78VjB

The limits of meaningful use for HITECH also exclude all of my patients – newborns and young children (age 2 or less). These children, especially those managed in neonatal intensive care units, comprise a significant portion of the pediatric population dependent upon medical technology – even upon their discharge home – and are affected by complex and sometimes chronic diseases of childhood (pulmonary, cardiac, gastrointestinal and neurologic). Neonatal ICUs have long utilized EHRs, but often this occurred in large hospitals that either didn’t develop or adapt EHRs system-wide, or had a different system for other units of care. Today, many hospitals are hampered by EHR adoption, and many NICUs by having to integrate a smoothly operating NICU-oriented EHR system into the new broader hospital EHR, or totally refit or rebuild the NICU system and lose years of meaningful and accessible data.

Family Caregiver Stress Relief

http://goo.gl/SbNz0

The responsibilities and challenges of caring for a loved one can place significant stress on the family caregiver. In fact, this stress can build up to actually cause caregiver distress—a situation where the caregiver may become more susceptible to other health risks such as high blood pressure, diabetes, and increased risk of stroke.

To help family caregivers combat this potential for caregiver distress, Home Instead, Inc., franchisor of the Home Instead Senior Care®network, has developed this Family Caregiver Stress ReliefSM education program. Here you’ll find helpful resources to identify if you are at potential risk for caregiver distress and lists of reliable resources to get help.