Health and Disability

Home Guardian, LLC has announced the release of a suite of sensors that non-intrusively monitor the health status of seniors in their homes while enabling professional caregivers to focus on providing needed care. This includes the detection of falls, which constitute the largest cause of injuries for people over age 65 in the United States.

The systems were developed by a team of researchers originally from the University of Virginia's Medical Automation Research Center (MARC) in partnership with two nationally recognized not-for-profit senior care and service providers, The Evangelical Lutheran Good Samaritan Society (Sioux Falls, SD) and the Volunteers of America (VOA) National Services (Alexandria, VA).

Immediate benefits of the sensor systems-as shown in carefully controlled studies done by The Evangelical Lutheran Good Samaritan Society and the Volunteers of America National Services-include:

-- A reduction of the cost of care of nearly 75 percent
-- Increased feelings of safety and security in participants
-- Less job-related stress for caregivers

Providing health insurance makes consumer-directed home care workers more likely to stay, both on the job and in the field as a whole, according to a study from Washington state.

Evaluation of Interventions to Improve Recruitment and Retention (pdf) reports on a survey to evaluate a series of initiatives instituted by the Home Care Quality Authority (HCQA). The changes were aimed at improving recruitment and retention of the so-called individual providers (IPs) who participate in the state's consumer-directed home care program, many of whom are related to the people they care for.

The most expensive initiative - and the one the researchers expected would have the greatest effect - was subsidized health insurance. To qualify for the insurance, IPs had to have been working for the program at least 86 hours a month for at least three months. In general, though some exceptions were made, they also had to be ineligible for health insurance from any other source.

Researchers at Washington State University surveyed IPs and the consumers who employed them about their experiences from 2004, when the program began, to 2006. Among their findings:

* Average monthly turnover declined a statistically significant amount (from 1.53 percent to 1.27 percent);

Results from the third annual Alzheimer's Foundation of America (AFA) ICAN: Investigating Caregivers' Attitudes and Needs Survey suggest that Alzheimer's disease care is a family affair. Most "sandwich caregivers" - the parents or guardians of children under 21 who also care for an aging parent, other relative or friend with Alzheimer's disease - say their children are assisting with caregiving responsibilities that range from attending doctors' appointments to feeding and dressing their loved ones.

Survey results ound that about three in five caregivers say their children aged 8 to 21 are involved in caring for a loved one with Alzheimer's disease. Of the caregivers who feel they do a good job balancing the care of their loved ones with Alzheimer's disease and children under 21, more than one-third (36%) specifically cited support from children as a contributor to their success.

Among children, ages 8-21, who are involved in caregiving, many are reported as taking on significant tasks:

* About one-third of young adults (ages 18-21) assist with doctors' appointments;

* 42% of young adults assist with transporting loved ones with Alzheimer's disease;

* About one-quarter of young adults and teens (ages 13-17) assist with activities of daily living, such as feeding and dressing;

* Nearly 90% of pre-teens (ages 8-12) visit and entertain a loved one with Alzheimer's disease (please use caution when interpreting results due to small base size);

* Approximately 85% of teens pay visits to the person with the disease.

JACKSON, Missouri (CNN) -- Debbie Shank breaks down in tears every time she's told that her 18-year-old son, Jeremy, was killed in Iraq.

Even though the 52-year-old mother of three attended her son's funeral -- she continues to ask how he's doing. When her family reminds her that he's dead -- she weeps as if hearing the news for the first time.

Shank suffered severe brain damage after a traffic accident nearly eight years ago that robbed her of much of her short-term memory and left her in a wheelchair and living in a nursing home.

It was the beginning of a series of battles -- both personal and legal -- that loomed for Shank and her family. One of their biggest was with Wal-Mart's health plan.

education and collaboration to keep your loved ones safe and in their own homes

House Energy and Commerce Committee Chair John Dingell (D-Mich.) on Thursday introduced a bill (HR 5613) that would postpone seven new Medicaid regulations for one year -- "potentially killing them, depending on who is president by then," CQ Today reports (Wayne, CQ Today, 3/14). The regulations, proposed by the Bush administration, would prohibit states from using federal Medicaid funds to help pay for physician training, place new limits on Medicaid payments to hospitals and nursing homes operated by state and local government, and limit coverage of rehabilitation services for people with disabilities, including those with mental illnesses (Kaiser Daily Health Policy Report, 3/4).

Dingell in a statement said, "The restrictions the administration is imposing on Medicaid are harmful and will undoubtedly put the health of thousands of our most vulnerable children at unnecessary, indefensible risk." Dennis Smith, director of the Center for Medicaid and State Operations at CMS, said the Bush administration does not plan to delay the regulations because of congressional concerns.

Nursing Home Quality, the national leader in Quality Indicator Survey (QIS) based quality assurance solutions for long-term care providers, announced the release of the latest version of abaqisTM, a web-based quality assurance system designed for use by nursing home providers to identify quality concerns and focus quality improvement efforts.

The QIS is a revised long-term care survey process utilized by the Centers for Medicare & Medicaid Services (CMS) that involves two stages of review. In Stage I, preliminary investigations are conducted through structured resident, family, and staff interviews, resident observations, record reviews, and analysis of Minimum Data Set (MDS) data.

These tasks, in combination with structured facility reviews, yield 162 Quality of Care and Quality of Life Indicators (QCIs) that are compared with defined thresholds to identify Care Areas for further investigation in Stage II of the QIS. The second stage involves in-depth quality investigations using Critical Element Pathways that address assessment, care planning, care provision, and reassessment.

The latest release of the abaqis TM system encompasses all six assessments conducted on site during Stage I of the QIS, with modules for family, staff, and resident interviews, resident observations, and census and admission record reviews. The system comprehensively guides the quality assurance efforts based on QIS concepts and processes, electronically manages the resident file, and even provides analysis of facility data based on national thresholds.

"I believe that the QIS has rendered the survey process more objective and more resident-centered," says Andrew Kramer, M.D., CEO of Nursing Home Quality. "However, the QIS software used in the survey process was developed solely for government surveyor use. The abaqis TM system is an affordable, user-friendly tool designed specifically for nursing home providers, allowing them to replicate the QIS for quality improvement purposes. At the end of the day, this system enables nursing homes to provide better care and quality of life to their residents."

A recently released study of Medicaid-financed nursing home use over 18 months in 2001 and 2002 finds that in states such as Oregon that have extensive community based long-term care services, Medicaid-covered nursing home stays were shorter than the national average. The numbers suggest that where seniors have alternatives, their nursing home stays are more likely to be for acute care following a hospitalization or for a shorter period at the end of life.

The study, "Medicaid-Financed Nursing Home Services: Characteristics of People Served and Their Patters of Care, 2001-2002," conducted by Matehematica Policy Research for the Office of Disability, Aging and Long-Term Care Policy for the U.S. Department of Health and Human Services, reports that over half of Medicaid-covered nursing home residents do not become eligible for benefits until after they move to a nursing home, with 29 percent obtaining coverage within six months of moving to the nursing home, 5 percent between six and 12 months, 7 percent between one and two years, and 9 percent after more than two years.