ADVANCE Perspective: LTC

Social Networking

Liz Rosto — Tue, 22 Jul 2008 17:59:00 GMT

For those of us who are 10 years or more out of college, we are just getting used to terms like "blogs," "Web 2.0," "MySpace" and "Facebook." But once you start "social networking," it can be addictive and contagious.

I joined Facebook about two years ago, not really having any clue about what it was or its potential. For months, I had nothing posted on my page except some contact info. I think I only had two friends (one of whom was a cousin!). But in the last six months, my Facebook activity has really taken off. I'm up to 82 friends and counting. I've reconnected with high school classmates and college roommates I haven't seen or talked to in years.

And now, Facebook is also being used by businesses and professional associations (including AAHSA), which is why we at ADVANCE for Long-Term Care Management launched a page last week. It's a great place for professionals in the industry to network with each other, so if you're already on Facebook, become a fan of our page. And if you're not yet on board, check it out here!

How are your employees weathering the economic storm?

Carrie Adkins-Ali — Fri, 11 Jul 2008 16:20:00 GMT

A recent Reuters article blames rising fuel costs and a lower standard of living for an increase in worker hostility. The article even reports that "2 percent to 3 percent of people admit to pushing, slapping or hitting someone at work."

Current economic woes hurt everyone, but they disproportionately affect those on the lower end of the income scale, such as CNAs. Have you noticed that your employees' behaviors have changed in light of economic woes? If so, what are you doing to address it?

Gas Prices Cutting Elderly Assistance

Maureen McAndrews — Thu, 10 Jul 2008 16:38:00 GMT

According to a recent article in the New York Times, rising gas prices are forcing cutbacks on aid services for the elderly. Programs that offer Meal on Wheels, transportation assistance and home care are being scaled back due to the increasing price of gas. Volunteers who live in rural areas are being hit especially hard by soaring costs. In fact, more than half said they had already cut back on programs because of gas costs, and 90 percent said they expected to make cuts in the 2009 fiscal year, according to a recent survey by the National Association of Area Agencies on Aging.

DON Salary Results Revealed

Carrie Adkins-Ali — Tue, 08 Jul 2008 17:46:00 GMT

The national average salary of directors of nursing in CCRCs increased 4.07 percent in 2008, according to the AAHSA Continuing Care Retirement Community Salary and Benefits Report, published by Hospital & Healthcare Compensation Services.

Nationally, the average salary of DONs in CCRCs with a revenue size up to $14,999,999 was $72,666, compared with a national average salary of $81,632 in CCRCs with a revenue greater than $15,000.

Is Your LTC Team is the Best?

Liz Rosto — Tue, 01 Jul 2008 19:42:00 GMT

It's that time of year again for our annual Best Long-Term Care Team Contest 2008. Tell us how your staff works together to achieve the best possible outcomes. We encourage all those facilities out there doing wonderful things to tell us your story. The winner will receive recognition in the magazine, a commemorative plaque, and a $500 prize.!

Click here to enter today!

Falls Cause More Than Broken Hips

Maureen McAndrews — Thu, 26 Jun 2008 20:00:00 GMT

Fall-induced traumatic brain injuries caused almost 8,000 deaths and 56,000 hospitalizations in 2005 among Americans 65 and older, reports the Centers for Disease Control and Prevention in the June issue of the Journal of Safety Research.

In 2005, TBIs were responsible for 50 percent of unintentional fall deaths and 8 percent of nonfatal fall-related hospitalizations among older adults.

"Most people think older adults may only break their hip when they fall, but our research shows that traumatic brain injuries can also be a serious consequence," Dr. Ileana Arias, director of CDC's National Center for Injury Prevention and Control, said in a press release.

This study analyzed 2005 data from the National Center for Health Statistics' National Vital Statistics System and the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample.

HHS to Help Medicare Beneficiaries and Providers in Iowa and Indiana

Maureen McAndrews — Mon, 16 Jun 2008 18:36:00 GMT

Acting under his authority in the Public Health Service Act, HHS Secretary Mike Leavitt today declared a public health emergency in the flood-stricken states of Iowa and Indiana. The action gives CMS Medicare beneficiaries and their health care providers greater flexibility in meeting emergency health needs, according to an HHS news release.

Because of flood damage to local health care facilities, many beneficiaries have been evacuated to neighboring communities, where receiving hospitals and nursing homes may have no health care records, information on current health status or even verification of the person's status as a Medicare beneficiary.

CMS is assuring those facilities that in this circumstance, the normal burden of documentation will be waived and that they can act under a presumption of eligibility.

CMS will make certain that health care providers that provide items and services in good faith are exempt from sanctions from noncompliance with otherwise applicable requirements, provided there is no fraud or abuse.

For more information ,visit CMS online.

A Safehaven for Abused Seniors

Liz Rosto — Tue, 10 Jun 2008 12:54:00 GMT

Long-term care facilities are respected for their role in caring for seniors when they (and their families) are no longer able to provide for themselves at home. Some facilities across the country are providing another refuge for seniors who have been abused.

Reports of elder abuse have reached 472,813 in 2000, the latest number available, according to the National Center on Elder Abuse, a research group financed by the United States Administration on Aging. Officials believe this number is probably low because not all abuse is reported. There is a tremendous need for domestic violence shelters suited to the continuum of needs of elder victims, including geriatric care, physical therapy and peer counseling.

The Hebrew Home at Riverdale is one such facility opening its doors to abused elders. The program provides not just shelter, but access to legal and financial services, social workers and other help for individuals who are being abused. The organization is now helping other nursing homes in Florida, New York, Connecticut and Rhode Island replicate the program.

Click here to read the New York Times article about this fascinating program.

Sleep Apnea Virtually Undocumented Among Nursing Home Residents

Maureen McAndrews — Fri, 30 May 2008 13:50:00 GMT

Sleep apnea is a virtually undocumented condition in America's nursing homes, according to new research report from the Institute for the Future of Aging Services (IFAS). The IFAS report is an analysis of data from the 2004 National Nursing Home Survey, which reviewed medical records of a representative sample of the 1.49 million nursing home residents in the U.S. Of these individuals, only half of one percent had sleep apnea documented on their medical records. The findings are in stark contrast to numerous, in-person studies of nursing home residents that clearly showed a high prevalence of sleep apnea in this population.

The research was presented at the American Thoracic Society's International Conference and is available in the May 2008 issue of the Journal of the American Medical Directors Association.

Older & Wiser Brains

Maureen McAndrews — Thu, 22 May 2008 21:57:00 GMT

According to a New York Times article, an increasing number of studies are finding that brain power doesn't decrease with aging. Rather, the aging brain takes in more information and attempts to filter through a clutter of information, often to its long-term benefit.

The studies are analyzed in a new edition of a neurology book, "Progress in Brain Research." While Alzheimer's disease and dementia do make some brains deteriorate with age, the authors say much of what occurs is a gradually widening focus of attention that makes it more difficult to latch onto just one fact, like a name or a telephone number.

For example, in studies where subjects are asked to read passages that are interrupted with unexpected words or phrases, adults 60 and older work much more slowly than college students. That indicates that they are not just stumbling over the extra information, but are taking it in and processing it.

Congress looking at nursing homes

Carrie Adkins-Ali — Fri, 16 May 2008 18:56:00 GMT

"Congress, apparently still with time left over after all those hearings dissing the drug industry, is beginning to turn up the heat on nursing homes," reports the Wall Street Journal. Read the grisly details here.

Education and Cognitive Loss

Carrie Adkins-Ali — Fri, 16 May 2008 18:52:00 GMT

Seniors with at least a high school education spend more of their older years without cognitive loss, including the effects of Alzheimer's, Parkinson's and dementia, but die sooner after the loss becomes apparent, reveals a new study appearing in the June 2008 issue of the Journal of Aging and Health.

Read a summary of the report at http://www.seniorjournal.com/NEWS/Alzheimers/2008/8-05-12-SenCitWithMost.htm.

Are Seniors Overmedicated?

Liz Rosto — Thu, 15 May 2008 14:16:00 GMT

A study conducted by the Wake Forest University School of Medicine found that many commonly administered drugs can hasten decline in the elderly. Elderly people who took drugs for incontinence, allergy or high blood pressure walked more slowly and were less able to take care of themselves than others not taking the drugs, researchers found.

The findings, presented at the American Geriatrics Society Meeting in Washington, add to a growing body of research that suggests that anticholinergic medications can hasten functional and cognitive declines in elderly people.

Head researcher Dr. Kaycee Sink explained that many useful drugs from many different classes of medications have anticholinergic properties. The researchers found that the more anticholinergic drugs people had in their systems, the worse their physical function. They also pointed out that in many cases, newer drugs are available that do not have these effects.

This is just one example of what makes medication management often difficult. Treating one symptom, can sometimes lead to several other detrimental side effects. Make sure your records keep track of these, so medications can be adjusted accordingly.

The Move to Retirement Living

Maureen McAndrews — Tue, 13 May 2008 16:35:00 GMT

The Washington Post puts an interesting spin on an article about the decision to move into a retirement community. Instead of telling the story from the oft-used angle of those who work in the retirement living industry, the article is written by a 79-year-old woman who recently made the move from her home into retirement living. She explores the way her and her husband came to terms with their idea of "aging in place." She concludes that this decision was best made on their own terms, when they were ready. She talks about timing being everything.

In an accompanying article, the writer's daughter shares her thoughts on coming to terms with her parents' move to a retirement community. While she originally felt some guilt, she says it was assuaged by witnessing her mother making many new friends and starting a new phase of life.

Is this general feeling shared by most people who move into retirement living? In your experiences of dealing with residents, what do you find? Are most ready? If they're not ready, are they glad once they've made the move? What role do adult children play in the process?

These two unique perspectives can give you some idea of just exactly what's going through the minds of your potential residents.

Earth Day 2008 - Encouraging Greener Living

Liz Rosto — Tue, 22 Apr 2008 14:31:00 GMT

Happy Earth Day 2008! As people all over the world are paying more attention to environmental issues, there are many things individuals can do close to home--even in long-term care facilities.

In our March-April issue, contributor Mike LePostollec wrote about incorporating elements of sustainable design into long-term care. Some of the most common sustainable features include:

improved insulation
solar hot water heating systems
daylighting (using natural light to illuminate building spaces, rather than relying solely on electric lighting during the day)
geothermal heating, which distributes natural heat from the earth throughout a building
green roofs, which reduce solar gain on buildings and lower cooling costs
heat recovery systems, which provide a counter-flow temperature exchange between inbound and outbound air. Warm air leaving the building heats the inbound air, and vice versa.

For more ideas on how we can conserve resources, read the New York Times' Green Issue.