Health and Disability

A COLLEAGUE RECENTLY introduced me to a young physician, noting that her research interest was difficult patients. "Really," I responded. "I’m a difficult patient, and it’s served me well." I assumed that she considered being a difficult patient a good thing, but her pained expression suggested otherwise. We shared an awkward moment before parting, and I walked away considering the plight of the "difficult" patient.

In the clinical world, the term difficult is applied to a variety of patients: the noncompliant; the rude, abusive, and manipulative; the malingering; the mentally ill; the skeptical. In my case, I too frequently challenged my doctors with questions and too often chose a treatment that differed from what they’d recommended. I consider myself to be an assertive patient, but it was clear on many occasions that some providers thought I deserved the "difficult" label.

How did I earn this distinction? Surely some of it was genetic predisposition; I was born with a feisty personality that compensates for my diminutive stature. But mostly it was born of necessity, a survival instinct that involved both fight and flight.

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/

Both the connection to health care and its affordability worsened for many nonelderly U.S. adults living with chronic conditions between 1997 and 2006. This erosion varied by health insurance coverage, fundamental as it is to securing health services. Access to care among uninsured adults with chronic conditions deteriorated on all of our basic measures between 1997 and 2006. In addition, more of both the privately and publicly insured with chronic conditions went without health care because of its cost over this ten-year span, even while they were just as likely as or more likely than others to have a usual source of care over time.

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/

WHAT:        

Genworth Financial’s third annual National Long Term Care Symposium will spotlight the Presidential candidates’ views on LTC policy for the mature market and an aging nation.

WHEN:        

TUESDAY, SEPTEMBER 9, 2008
 9:00 – 11:30 a.m.  (Breakfast will be served)

WHERE:                

SENATE BUILDING DIRKSEN, Room G-50
200 Second Street NE, Washington, DC
(Northeast of the Capitol, adjoining the Hart Senate Office Building)

WHO:          

DEB WHITMAN: Staff Director, Senate Special Committee on Aging and advisor to Obama for President campaign

JAY KHOSLA: Healthcare Policy Advisor, John McCain for President

BUCK STINSON: President, Genworth Financial Long-term Care Division

SUSAN DENTZER, Editor-in-Chief, Health Affairs, will serve as moderator

The event will also include a second panel discussion with members of congress and speakers from policy institutions including The CATO Institute, Third Way, Heritage Foundation and The Center for American Progress

WHY:          

With nearly 80 million Americans approaching retirement age, and one-half of seniors likely to require long term care at some point in their lives, the discussion on how to pay for that care is becoming increasingly urgent.

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/

An article by Allison Rupp from the Jackson Hole Star Tribune discusses one alternative model for long-term care facilities that provide care for Alzheimer’s patients.

Mary Hein, along with a group of community members, wants to build several “pod-type nursing homes” for people with dementia where residents eat home-cooked meals at a dining room table and have their own room and bathroom.

Residents would see the same staff members every day and feel more comfortable and less confused in the home-like environment.

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/

Welcome to the National Clearinghouse for Long-Term Care Information. This web site was developed by the U.S. Department of Health and Human Services to provide information and resources to help you and your family plan for future long-term care (LTC) needs.

Why should you plan?
Because, at least 70 percent of people over age 65 will require some long-term care services at some point in their lives.  And, contrary to what many people believe, Medicare and private health insurance programs do not pay for the majority of long-term care services that most people need - help with personal care such as dressing or using the bathroom independently.  Planning is essential for you to be able to get the care you might need.

This site provides a wide range of information and options to help you plan for future long-term care needs, but it can't tell you which ones will work best for you. Everyone's situation is different. Carefully review these options and your unique situation before making your planning decisions.

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/

A Long Term Care Ombudsman is an advocate for residents of nursing homes, board and care homes, and assisted living facilities. Ombudsmen provide information about how to find a facility and what to do to get quality care. They are trained to resolve problems. If you want, the ombudsman can assist you with complaints. However, unless you give the ombudsman permission to share your concerns, these matters are kept confidential. Under the federal Older Americans Act, every state is required to have an Ombudsman Program that addresses complaints and advocates for improvements in the long term care system. To find the ombudsman in your state, click here.

Administered by the Administration on Aging (AoA), the ombudsman network has 8,400 volunteers certified to handle complaints and over 1,000 paid staff. Most State Ombudsman Programs are housed in their State Unit on Aging. (See exceptions here.) Nationally, the ombudsman program handles over 264,000 complaints annually and provides information, referrals and consultation to more than 260,000 people. To learn more about the ombudsman program, go to the AoA website.

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 Medicare Payment Advisory Commission (MedPAC) may take another look at Medicare reimbursements for durable medical equipment (DME). Its consideration follows lawmakers' decision to temporarily delay implementation of the competitive bidding program.

The Medicare Improvements for Patients and Providers Act (MIPPA) halted the controversial bidding process, which began on July 1 in 10 metropolitan statistical areas. In exchange for the delay, reimbursements for items and services that were selected for the bidding program were cut by nearly 10%, and contracts that had been awarded to 325 suppliers through the bidding program were terminated.

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/

It doesn't matter if you have a formal religion you choose to follow or you just feel there is a higher power, dementia caregivers need to embrace their spiritual side as a way of keeping their balance as a caregiver.

Dementia caregiving brings out all sorts of emotions that have to be dealt with; both by you as the caregiver and by the person with dementia.  One easy way to cope is to fall back on old routines.  If you have found comfort in formal religion from your past, practice the rituals with your loved one with dementia.  You may be surprised to find that many of the songs or prayers from religious practice are part of long-term memories and can often be accessed again.  This activity also gives you a way to communicate and connect with each other, when other methods might be difficult.

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/