INTERVIEW - Nathan & Dylan: Relationship is Heart of Quality Care (part two)

From PHI:

This is the second story in a two-part series about the unique relationship shared between a young man and his young caregiver (go to part one).

NOTE:  Nathan/Dylan slideshow at bottom.

Meaningful work

Nathan has never walked and cannot use his arms. He must be bathed, fed, and lifted from couch to chair to bed. In his own words, the overall physical effect of his disease is that “movement basically dies off.” When asked to describe his body to someone who can’t meet him or see him, Nathan says, “I would say it’s a brain and a jaw. The rest is just useless, there to support my brain.”

But he says that growing up in a small town and going to public school where you knew everybody made him feel less different. He doesn’t identify with others who share his disabilities and doesn’t feel terribly sorry for himself.

“I was born this way and it’s just this subtle thing I’ve dealt with my whole life. It’s hard, but I guess there’s a lot worse things to be afflicted with,” he says. “At least I can still speak and communicate with the world.”

Just as Nathan doesn’t like to be identified as disabled or as an inspiration to others for living beyond his doctors’ predictions, his caregiver doesn’t like to be told that he’s making a huge difference in the world with his job...

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Technology for Long-Term Care: Scaling Elder Care to the Next Billion

From University of Washington:

Video:

Long-term care helps the elderly perform key day-to-day tasks such as eating, personal care and medication. Today, such care is overwhelmingly manual. However, the cost of manual care is unsustainable in the face of demographic trends. Without dramatic breakthroughs in the cost of care, over half of all elders are expected to be without adequate care within a generation.

This talk describes a series of studies performed at Intel (in collaboration with several major partner organizations including the University of Washington) over the past six years towards understanding how technology may substantially reduce the manual burden of care...

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Person-Centred Care Reduces Agitation In People With Dementia And Should Be Considered As Standard Practice In Care Homes

From Medical News Today:

Both person-centred care and dementia-care mapping* reduce agitation in people with dementia in residential care. In addition, person-centred approaches can be taught quickly and should be introduced as standard practice in residential care homes. These are the conclusions of an Article to be published Online First and in the April edition of The Lancet Neurology...

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Imprisoning the Aged in Long Term Care Settings

From AssociatedContent:

After 20 years of working in long term care facilities as a Certified Activity Director, I have become disenchanted and frustrated with the lack of respect for the democratic resident rights of our ill and aging senior citizens. Where I once believed that it was possible to meet the needs of our aging population by developing high quality long term care facilities, I am no longer inclined to believe that is the norm in most of our nursing facilities. Instead, from my own personal observations and work with seniors and institutions, I believe we have a collusion that has developed between Medicare providers and long term care providers....

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Proper use of Medicaid stimulus funds still unclear

From McKnight's:

A fierce debate has erupted over how best to use the $87 billion in Medicaid money included in the recently passed economic stimulus bill, according to news analyses.

On one side of the issue are providers and patient advocacy goups, who would like to see the new money used to expand services, broaden eligibility requirements and increase reimbursements for providers, The Washington Post notes. Some in state governments, however, want to use the money to even out state budgets as a whole and prevent layoffs and cutbacks in areas other than just healthcare...

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Arbitration, Community-Based Spending Are Key Issues For Long-Term Care

From Medical News Today:

Summaries of recent developments related to long-term care issues in Congress appear below.

    * Arbitration: Rep. Linda Sanchez (D-Calif.) has introduced the Fairness in Nursing Home Arbitration Act (HR 1237), which would make arbitration prior to court disputes between long-term care facilities and residents invalid and unenforceable, CQ HealthBeat reports. According to Sanchez's office, the bill would not prohibit arbitration, but would give people the option to choose whether they arbitrate conflicts. Sanchez in a statement said, "Arbitration agreements are often buried in overly complicated contracts, and many consumers do not realize they are waiving their legal options." The American Health Care Association and the National Center for Assisted Living oppose the legislation, saying that pre-disputed agreements foster timely, easier settlements, curb rising lawsuit costs and allow staff to focus on patient care (Kim, CQ HealthBeat, 3/3).

    * Home and community-based spending: Of the $113 billion Medicaid spent on long-term care in 2007, 53% went to nursing homes and 47% went to care in home and community-based programs, according to testimony given by Thomas Hamilton, director of the survey and certification group at the Center for Medicaid and State Operations of CMS, at a Senate Special Committee on Aging hearing on Wednesday, CQ HealthBeat reports. Hamilton said the almost even split "reflects the progress of the rebalancing efforts in the growing community-based initiatives." The ratio of institutional to community-based spending has been as high as 80 to 20, according to Hamilton. He also said that home and community-based services "actually contained institutional costs and helped states moderate the growth of Medicaid spending overall" (Reichard, CQ HealthBeat, 3/3)....

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ALFA Commends Senator Bill Nelson's Commitment To Co-Pay Equity For Home And Community Based Seniors

From Medical News Today:

The Assisted Living Federation of America (ALFA) today praised Senator Bill Nelson (D-FL) and his leading bipartisan co-sponsors Sen. Jeff Bingaman (D-NM) and Sen. Susan Collins (R-ME) for their introduction of the Home and Community Services Co-payment Equity Act of 2009. This legislation will provide nearly one million dually eligible individuals (those receiving Medicare and Medicaid services) across the nation living in home and community based settings, such as assisted living communities, with the same prescription drug benefits under the Medicare Part D Prescription Drug Program (Part D) as those living in institutional settings such as nursing homes...

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