ADVANCE Perspective: LTC : News

AAHSA's Chef Challenge & Last Designer Standing

Liz Rosto — Thu, 12 Nov 2009 17:01:00 GMT

My favorite part of the conference came to a dramatic finish yesterday afternoon, as the winners of the food and design challenges were announced on the exhibit hall floor.

After very competitive opening rounds, Team Aramark and Team Mather faced off in the Chef Challenge finals on Wednesday, having to work with the secret ingredient chocolate. In the end, Chefs Chip Fegert and Chivo Montero from Team Mather emerged victorious.

Over at Last Designer Standing, two teams of interior design students from Harrington College of Design in Chicago had 48 hours and $2,000 to create a 550-square foot room for a local long-term care resident. Team 1's design, "Intersections," got the most votes and a $1,000 prize from AAHSA.

Here are some photo highlights from the conference on AAHSA's Flickr page

AAHSA Awards

Liz Rosto — Tue, 10 Nov 2009 21:23:00 GMT

AAHSA honored several individuals and LTC communities in this morning's general session. It's always important to take time out to recognize those who go the extra mile in caring for seniors.

Award of Honor: David Ferguson, President and CEO, American Baptists Homes of the West, Pleasanton, Calif.

Excellence in Leadership: Gary Puma, President and CEO, PHS Senior Living, Princeton, N.J.

Leading Edge Care and Services: Broadway House for Continuing Care, Newark, N.J.

Excellence in the Workplace: ACTS Retirement-Life Communities, West Point, Pa.

Excellence in Research and Education: Jewish Home Life Care, New York, N.Y.

Hobart Jackson Cultural Diversity Award: The Hebrew Home at Riverdale/Project HOPE, Riverdale, N.Y.

Dr. herbert Shore Outstanding Mentor Award: Darren Trisel, Asian Community Center Nursing Home, Sacramento, Calif.

Public Trust Award: Kendal at Oberlin, Oberlin, Ohio

Outstanding Advocacy Award: David Bannerman, CEO, The Ohio Masonic Home, Springfield, Ohio

The AAHSA 2009 conference is being held Nov 8-11 in Chicago.

AAHSA in the Windy City

Liz Rosto — Mon, 09 Nov 2009 22:10:00 GMT

My first day at AAHSA has been a whirlwind, with so much to see and do in the lecture halls and on the exhibit hall floor! A big hit last year, the Chef Challenge and Last Designer Standing competitions are in full swing. New this year is the AAHSA Idea House, which showcases aging-in-place technology and sustainability.

Stay tuned for a slide show of photos coming soon!

AARP Endorses House Health Care Reform Bill

Maureen Salera — Fri, 06 Nov 2009 01:54:00 GMT

At a press briefing today at AARP's Washington headquarters, AARP Chief Executive A. Barry Rand said AARP supports the House health care reform bill over other proposals because this plan does more to lower drug costs for Medicare beneficiaries, strengthen Medicare and bar insurance companies from denying people coverage because of their health or age. The bill also would lower premiums for Americans ages 50 to 64 who have to buy private insurance and would create a voluntary long-term care insurance program.

To read more, click here for the AARP Bulletin and video on the announcement.

Caught in the Middle

Liz Rosto — Fri, 30 Oct 2009 13:11:00 GMT

A new study from PHI, a national non-profit organization working to strengthen the health care services workforce, reveals that less than one-fifth of Massachusetts direct-care workers (nursing home assistants, home health care aides and personal care attendants) are enrolled in employer-sponsored health insurance plans.

The primarily reason for the lapse in coverage is that it's too costly. The study found that most employers in this sector offered insurance but their direct-care employees did not enroll.

The reason: many workers are caught in a bind. If they are offered employer-sponsored health coverage, direct-care workers, whose wages primarily come from public programs such as Medicare and Medicaid, cannot access Massachusetts' less-expensive subsidized health insurance programs.

This scenario is all too common for low income workers. They don't make enough money to afford health insurance, but they make too much to qualify for public assistance. We all know that a strong work ethic is valued in American society, so why are these workers being left behind adn what can we do to change it?

"While considering proposals to expand access to health care coverage, Congress must heed what we learned from the Massachusetts model: it has done nothing to lower the cost of employer-sponsored health coverage, making it prohibitive for low-wage, direct-care workers and their employers," PHI government affairs director Carol Regan said in a press release.

Nationally, there are 3 million direct-care workers and the number is projected to grow to 4 million by 2016, becoming thenation's single largest occupational group.

In Coverage for Caregivers: Lessons from Massachusetts Health Reform, researchers recommend the following provisions should be included in health reform legislation:

Support the inclusion of a national, publicly operated health insurance option.
Allow all eldercare/disability service employers access to the proposed insurance "exchanges" or "gateways" regardless of size.
Ensure adequate federal subsidies to low- and moderate-income workers and their families.
Expand Medicaid to include all individuals earning up to at least 133 percent of the federal poverty level.

Six-year-old girl faces eviction from retirement community

Maureen Salera — Thu, 22 Oct 2009 16:52:00 GMT

There's a debate raging in a Florida retirement community over evicting a six-year-old girl who lives there with her grandparents.

Kimberly Broffman is the little girl at the center of it all. She lives in the retirement community with grandparents Jimmy and Judie Stottler because they are her legal guardians.

The community's homeowner's association wants Broffman out because the bylaws of the community clearly state that residents must be 55 years or older. Apparently the Stottlers were willing to leave: They've been trying to sell their home, but the housing crisis has prevented them doing so, even after they decreased the asking price by almost $100,000.

Pretty soon, a judge will have to decide whether Broffman can stay or if she must go.

Click here to see the Today's show coverage of the story.

What do you think of this debate?

Futile end-of-life care

Maureen Salera — Fri, 16 Oct 2009 17:42:00 GMT

Two new studies from The New England Journal of Medicine indicate that nursing home residents may be receiving futile care measures at the end of their lives.

In one study, doctors examined health records of 3,702 nursing-home residents across the nation who started dialysis between 1998 and 2000. While the average age was 73, many had other health problems, including diabetes, heart disease and cancer. Within the first year, 58 percent died and 29 percent declined in their ADL ability.

The second study followed 323 people with advanced dementia from nursing homes in the Boston area. Their average age was 85 and they could not recognize loved ones or walk or talk. One out of four died within six months and half died during the 18 months they were followed.

As this article points out, experts agree that these two studies point back to the need for more palliative care in nursing homes.

Proper Handwashing Technique

Liz Rosto — Fri, 16 Oct 2009 14:44:00 GMT

With the H1N1 virus lurking in our office (so far, one confirmed case), experts agree that aside from vaccination, the best defense is thorough handwashing. Check out this video from the Washington Post that shows proper handwashing technique.

We hear these messages all the time, but truthfully, we could all probably do a better job following through. In fact, a recent Australian study found that three out of ten men and one out of ten women didn;t wash their hands after using the restroom.

On a related note, did you know yesterday (October 15) was Global Handwashing Day? www.globalhandwashingday.org

Dialysis May Do More Harm Than Good

Heather Simons — Thu, 15 Oct 2009 20:34:00 GMT

A study published in The New England Journal of Medicine questions whether dialysis is the best treatment for nursing home patients. As reported by USA Today, more than half of older nursing home residents die within a year of starting dialysis and "nearly another third experience a significant decline in their ability to perform simple tasks, such as feeding themselves."

Study authors said they hope the results will encourage health care professionals to engage in "open and honest discussions" with residents about the risks of the treatment.

For frail elderly nursing home patients, permanent kidney failure "is like metastatic cancer with rapid deterioration and short life expectancy," [says Peter Aronson, Yale University nephrologist]. "The results of this study should inform end-of-life planning for such patients and encourage consideration of alternatives to dialysis, such as palliative care" to relieve symptoms.

Read the full article here.

H1N1 Vaccination: My Experience

Adkins-Ali Carrie — Wed, 07 Oct 2009 19:34:00 GMT

This morning, two of my three children got their first H1N1 vaccinations. Now that it's available to high-risk groups, I thought I'd give my doctor's office a call about getting mine. (I have asthma, so I'm in the high risk group.)

Not only does my doctor's office not have any, but they don't even know if they'll get any at all. Off I went to the Dept. of Health to investigate.

Each provider must put in a request to the state and wait to hear if they're approved. The state is looking for risk groups as well as the ability to house the vaccine with sufficient refrigeration, and distribute it efficiently. Here in Pennsylvania, all vaccine is going to pediatricians right now, and the priority is five to nine year olds. Though my kids got it even though they're only 3 and 4. There's no word on when my baby can get one-she needs the shot and only the mist is currently available.

Every week, the state will distribute a group of doses with instructions on who is to be prioritized. But no one knows who will be next in the priority list. The person I spoke to at the health department-who was suprisingly unfrazzled-said that the only thing for people to do it watch the Web site (http://www.h1n1inpa.com/ for local folks) and call in a few weeks. She also reminded me that the flu is being a bit overblown.

What has your experience been?

Strange Research

Adkins-Ali Carrie — Wed, 07 Oct 2009 14:51:00 GMT

I recently discovered a rather interesting awards ceremony, the IG Nobels. Hosted by the Harvard-based journal Annals of Improbable Research , the awards honor less-than-traditional research and are handed out by real Nobel laureates.

Highlights from this year include:

The veterinary medicine prize went Catherine Douglas and Peter Rowlinson at Newcastle University's school of agriculture for discovering that cows with names give more milk.
The peace prize went to Stephan Bolliger and colleagues at the University of Bern in Switzerland, who found that empty beer bottles are sturdier than full ones, but either can fracture the human neurocranium.
The medicine prize-my personal favorite as a knuckle cracker, went to Donald Unger, a doctor in Thousand Oaks, Calif. He cracked the knuckles of his left hand, but never those on his right, every day for 60 years to investigate whether it caused arthritis. (He concluded that it does not.)
The chemistry prize was awarded to Javier Morales who heated 80-proof tequila blanco in a pressure vessel to create diamonds.

Recession May Spur Longevity

Maureen Salera — Fri, 02 Oct 2009 18:36:00 GMT

Longevity actually flourishes in times of economic hardship, and that may be true for the current recession as well, according to research that appears in the Proceedings of the National Academy of Sciences.

After examining life expectancy and mortality data from 1920 to 1940, University of Michigan researchers José Tapia Granados and Ana Diez Roux found a surprising boost. Over that time, they found U.S. life expectancy increased by 6.2 years during the Great Depression-from 57.1 years in 1929 to 63.3 years in 1933, according to this article posted on MSNBC.com.

In fact, the researchers found that while overall population health (as measured by life expectancy) rose during the Great Depression and other recessions between 1921 and 1938, mortality increased during periods of strong economic expansion, such as 1923, 1926, 1929 and 1936-37.

The researchers looked at mortality rates for specific age groups and as a result of six specific causes that accounted for about two-thirds of total mortality in the 1930s: cardiovascular and renal diseases, cancer, influenza and pneumonia, tuberculosis, motor vehicle traffic injuries and suicide. Mortality for all ages due to all the causes declined in periods of economic downturn, except for suicide.

The researchers acknowledge these findings seem counterintuitive, but they still say they may apply to the current recession. Still, there are significant economic and societal differences between now and the 1930s, Granados told LiveScience. While overall population health and life expectancy may improve during down times, that might not be the case for any particular person, especially someone who is unemployed or worried about getting laid off and suffering attendant stress, he noted.

The overall rise persists, though despite potential health declines in those who have lost their jobs, because the majority of the work force is still employed (or retired and receiving benefits), he explained.

Reliable Nursing Home Information Lacking

Heather Simons — Tue, 29 Sep 2009 15:52:00 GMT

Reliable information on the quality of nursing homes is hard to come by these days, according to an article in the Los Angeles Times.

Currently, a Web site called Nursing Home Compare, which was created by the Centers for Medicare and Medicaid Services in 1998, provides information on nursing homes, from characteristics of residents to staffing and quality. But the Web site has been criticized since its inception over a decade ago.

Legislation included in a health care reform bill could revamp the site, making it more accurate and comprehensive:

That legislation, the Nursing Home Transparency and Improvement Act, would require the site to provide more precise data on staffing ratios and facility ownership, and improve and accelerate the complaint process. It would also require the Department of Health and Human Services to scrutinize the site to ensure the information provided is clear to consumers.

The bill has long been awaited by advocates of nursing home reform.

To read the full article, including shortcomings and assets of the government-run Web site, click here.

Salsa at 3 a.m.?

Maureen Salera — Thu, 24 Sep 2009 14:23:00 GMT

This morning, Good Morning America ran a segment about a program that allows patients with Alzheimer's or dementia to stay active all night long.

The program, which is billed as the first of its kind, takes place in the Hebrew Home for the Aged, Riverdale, N.Y. It addresses the insomnia that often occurs with Alzheimer's or dementia and old age, according to the article on ABCNews.com.

The 11-year-old program offers various activities--from salsa dancing to art class and even field trips to restaurants and movie theaters--for patients with dementia every night of the week, from 7 p.m. to 7 a.m. The program also provides van service to pick up patients and bring them to the facility.

Because Medicare and Medicaid cover the program, it can help alleviate the financial burden that families can incur from providing nightly nursing supervision to patients.

While the program is widely supported by the state of New York, people all around the world are taking notice. In fact, representatives from senior centers in Ireland, Canada and Great Britain have sought recommendations from the Hebrew Home, and are hoping to replicate the nightly program.

Caring for Seniors in Rural Areas

Liz Rosto — Thu, 24 Sep 2009 13:31:00 GMT

Providing quality health care to people in remote and rural areas is a challenge. Fortunately for some seniors, a new study shows that cognitive testing by telephone is generally as effective as in-person testing.

The study, which will appear in the International Journal of Geriatric Psychiatry, is the first to evaluate the effectiveness of telephone assessment in an elderly group using established neuropsychological tests. Fifty-four healthy women with an average age of 79 were divided into two groups and subjected to a series of standard neuropsychological tests that are typically used in clinical trials of Alzheimer's Disease. Both groups received in-person assessment of cognition as well as assessment by telephone.

The results suggest that telephone assessment may be a useful, cost-effective and time efficient alternative to in-person assessment of cognition in the elderly.

With new technologies that allow for free live video chatting (like Skype), telemedicine equipment might not even be required, and those in underserved areas will have more opportunities for care.