Health and Disability

President Barack Obama told the National Governors Association in February, “we know that over half of all Medicaid costs come from just 5 percent of enrollees.”

Many of these patients are known as “dual eligibles,” poor elderly or disabled individuals who qualify for Medicare as well as Medicaid.

They are among the patients with the severest need for care and the fewest resources to get it. According to the Kaiser Family Foundation, 66 percent of dual eligibles have three or more chronic conditions, 61 percent are cognitively or mentally impaired and 22 percent require assistance with two or more daily tasks, such as getting dressed and bathing. Almost nine out of 10 live below 150 percent of the federal poverty level.

The devices in the room allow residents to make simple choices with immediate consequences. Press a blue button and the water in the bubble tube turns blue. Press another button and the patterns on a light board change. People can braid long fiber-optic strands attached to the wall, and stroke them or just feel their weight.

Robbins thinks it's calming to have some power over your environment. "It gives people that sense of efficacy that I can touch this and get involved with this and no one's yelling at me to stop and I can have some effect on my environment."

Two Dutch therapists came up with the idea of Snoezelen (pronounced snooze lin) in the late 1970s. It's a combination of the Dutch verbs snuffelen, which is to seek out and explore, and doezelen, which is to relax. They experimented with simple environments that stimulated the senses of clients with intellectual disabilities. At first, things were pretty low tech: scent bottles, musical instruments, a fan blowing pieces of paper. Modern Snoezelen rooms have more bells and whistles, including the light devices and massage chairs with built-in speakers, projectors that display moving images on walls, and aromatherapy dispensers.

How the Affordable Care Act Can Help

The Affordable Care Act offers states several incentives and programs to help reach these goals, including: 

• the Community First Choice option, which increases the federal share of Medicaid costs for states that offer person-centered home and community-based services;
• Money Follows the Person grants, which help people move out of institutions or avoid unwanted institutionalizations;
• the “no wrong door” policy, which creates a single point of entry for services and eligibility; and
• a new Medicaid option, featuring enhanced federal matching payments, to establish health homes (medical homes) for beneficiaries with chronic conditions.

The device will also help with fall prevention by working on balance and quadriceps strengthening exercises," said Burbank. "Simple exercises, such as leg lifts and standing on one leg with support as needed, can help reduce the risk of falling.

A further observation concerns the appropriateness of prescribed drugs to a potentially vulnerable group such as the elderly. The majority of prescriptions were made by primary care physicians. This may partly explain the somewhat unusual increase in prescriptions for antipsychotic medications. It has been reported that antipsychotic medications are disproportionately prescribed to elderly subjects and need further regulation. This is particularly true in emergency and disaster situations.

Welcome to the latest research blog from The Patient Experience.

In this blog we are interested in finding out a bit more about how you manage pain both acute and chronic (long term).
We see this blog as being a useful way in which you can share you experiences of managing pain and to give advice to others

There are a number of different ways of managing pain:-
a) Medications. These can vary from aspirin and paracetamol through NSAIDs to various different opioid products.
b) Physical approaches. These can include spinal cord stimulation, TENS machines, acupuncture or even low level laser therapy.
c) Physiological methods such as biofeedback, hypnosis and behavioural therapy.

In particular we are interested to how the answers to the following questions:-
• What are the medical conditions for which you need pain management?
• What kind of treatments have you used and how effective were those pain management treatments?
• How did you get information about pain management and how useful was this information?
• What advice would you give to somebody who is about to start a course of pain management?

"Thousands of people suffer debilitating brain injuries every year, and there is a clear ethical imperative to learn as much as possible about their ability to communicate," says the study's lead author, Jonathan Bardin, a third-year neuroscience graduate student at Weill Cornell Medical College.

"These findings caution us against giving too much weight to negative results and open our eyes to the diversity of responses one might expect from the wide-ranging group of severely brain-injured people," he says.

The potential implications of these kinds of consciousness studies are significant, says co-author Dr. Joseph Fins, the E. William Davis, Jr., M.D. Professor of Medical Ethics, chief of the Division of Medical Ethics, and professor of medicine, professor of public health, and professor of medicine in psychiatry at Weill Cornell Medical College. "Beyond facilitating communication with these patients, these studies should communicate to society at large this population is worthy of our collective attention.

"A vast majority of severely brain injured patients around the country are receiving substandard care because they are improperly diagnosed, not given adequate rehabilitation, and often end up in nursing homes. We all want this to change," adds Dr. Fins, who is also director of medical ethics and chairman of the ethics committee at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

The report showcases how three innovative programs are working to reduce re-hospitalization rates and improve care transitions: North Carolina’s Community Connections project in Chapel Hill; Vermont’s Seniors Aging Safely at Home in Burlington; and Michigan’s Detroit Community Action to Reduce Hospitalizations in Farmington.

Most "locked-in syndrome" patients say they are happy, and many of the factors reported by those who say they are unhappy can be improved, suggest the results of the largest survey of its kind, published in the launch issue of the new online journal BMJ Open.

The findings are likely to challenge the perception that these patients can no longer enjoy quality of life and are candidates for euthanasia or assisted suicide, say the authors.

The research team quizzed 168 members of the French Association for Locked in Syndrome on their medical history and emotional state, and their views on end of life issues, using validated questionnaires.

Locked-in syndrome describes a condition in which a person is fully conscious, but cannot move or communicate, save through eye movements or blinking. The syndrome is caused by brain stem injury, and those affected can survive for decades.

AARP HomeFit: Do you want to stay in your own home as you age? The AARP HomeFit program will show you how. The program will be offered at Plymouth Church, Friday, March 25, 1-3pm. To register call: 1.877.926.8300. Walk-ins welcome however registration is preferred. Learn how to evaluate your current home; identify areas of your home that can be changed; overcome obstacles to remaining independent; plan for independence, choice and dignity as you age.

Thanks and a hat tip to Aimee.