Quality of U.S. hospices varies, patients left in dark - The Washington Post
{Q}A boom in the industry allows patients to choose from an array of
hospice outfits, some of them excellent. More than a thousand new
hospices have opened in the United States in the past decade. But the
absence of public information about their quality, a void that is
unusual even within the health-care industry, leaves consumers at a loss
to distinguish the good from the bad.
Though the federal government publishes consumer data about the quality of other
health-care companies, including hospitals, nursing homes and home
health agencies, it provides no such information about hospices.
The reasons that some hospices stint on care may be at least partly
financial. Medicare, the chief source of industry revenue, pays hospice
companies per day of care — about $155 for a “routine” day — regardless
of how much care is actually provided. That means that the less a
hospice spends on nursing and other services, the more it can profit.
{EQ}
http://www.washingtonpost.com/wp-srv/special/business/hospice-quality This database shows, among other things, whether the hospice has provided
more intense levels of care for patients suffering a crisis; how much
it spends on nursing visits per patient; and whether it has won approval
from one of three outside accrediting agencies, the Joint Commission, the Accreditation Commission for Health Care and Community Health Accreditation Program, or CHAP
A Guide to Durable Medical Equipment And Medical Supplies - AgingCare.com
A Guide to Durable Medical Equipment And Medical Supplies - AgingCare.com
{Q}First, the basic needs of elderly or ill people must be addressed before they or their family members can think about more abstract or long-term issues.
Second, it is very difficult to obtain information about meeting these basic needs, especially when it comes to finding the right products or supplies. The policies and practices of third-party payers - whether private insurance, Medicare or Medicaid - are often confusing and inconsistent.
Nevertheless, with a little persistence and some basic information, you can become a more knowledgeable and satisfied consumer. The reward will be an improved quality of life for both the elderly person and the caregiver. {EQ}
Read the article from end to end.Good information for caregivers, seniors, and families.
{Q}First, the basic needs of elderly or ill people must be addressed before they or their family members can think about more abstract or long-term issues.
Second, it is very difficult to obtain information about meeting these basic needs, especially when it comes to finding the right products or supplies. The policies and practices of third-party payers - whether private insurance, Medicare or Medicaid - are often confusing and inconsistent.
Nevertheless, with a little persistence and some basic information, you can become a more knowledgeable and satisfied consumer. The reward will be an improved quality of life for both the elderly person and the caregiver. {EQ}
Read the article from end to end.Good information for caregivers, seniors, and families.
Questions to Ask About Durable Medical Equipment and Medical Supplies - AgingCare.com
Questions to Ask About Durable Medical Equipment and Medical Supplies - AgingCare.com
An article full of very helpful advice and information. A long article and you need to read from end to end to get full benefit
Developed by, and made available with the permission of John J.
Connolly, Ed.D., President and CEO of Castle Connolly Medical Ltd.,
America's "trusted" source for information on top doctors and quality
healthcare.
An article full of very helpful advice and information. A long article and you need to read from end to end to get full benefit
Questions to Ask About Medical Equipment and Supplies
Sample for disucssion:
- Are the senior's needs and comfort periodically assessed?
- Handling a dispute with the insurer or vendor:
- Has the caregiver made frequent and careful inquiries?
- Has all communication (in person, phone, mail, email) been well documented?
- If the insurer disputes the need for particular equipment or
supplies or rejects a claim for a more costly but medically justified
item, will an appeal be necessary? - Does the caregiver know how to file an appeal?
Developed by, and made available with the permission of John J.
Connolly, Ed.D., President and CEO of Castle Connolly Medical Ltd.,
America's "trusted" source for information on top doctors and quality
healthcare.
6 Questions To Ask Before Hiring An In-Home Caregiver
What is the cost, and how will the bills be paid? “Be
certain to understand the whole payment package,” McVicker advises. For
example, does the agency tack on extra charges for billing, taxes and
worker’s compensation or include them in a single fee for services? Some
agencies will send you a bill that includes the hourly rate for
services plus additional itemized charges for taxes and administrative
costs. Other agencies will simply charge you an hourly amount that
encompasses all costs.
Code of Federal Regulations Resident rights (§483.10) Admission, transfer, and discharge rights (§483.12) Resident behavior and facility practices (§483.13) Quality of life (§483.15) Quality of care (§483.25)
Quoted from:http://tinyurl.com/pmmrher December 14, 2013
Long Term Care Facilities: Are You Being Treated Right?
By CzepigaDalyPope LLC
The Code of Federal Regulations (herein either “the Code” or “CFR”) is a codification of rules published in the Federal Register by the departments and agencies of the Federal Government. Title 42 of the Code, Part 483, addresses public health requirements for long term care facilities.
Part 483 specifically addresses, among many other issues, the following:
Resident rights (§483.10) Admission, transfer, and discharge rights (§483.12) Resident behavior and facility practices (§483.13) Quality of life (§483.15) Quality of care (§483.25)
Most of the fundamental questions you have will be addressed, at least in part, in the sections cited above. Section 483.10, as one example, addresses resident rights and specifically provides for what a facility must do regarding issues that range from providing, for inspection, a resident with his or her medical records within twenty four hours of request, to prominently displaying information about how to apply for and use Medicare and Medicaid benefits.
Section 483.12, as one other example, lists the six permissible reasons to discharge a resident from a long term care facility. It is important to note, there are no other reasons for discharge beyond these six, any other purported reason for discharge that is not listed in §483.12 (a)(2) is a violation of Federal law.
6 Reasons for Discharge
The transfer or discharge is necessary for the resident’s welfare and the resident’s needs cannot be met in the facility
the transfer or discharge is appropriate because the resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility
The safety of individuals in the facility is endangered
The health of individuals in the facility would otherwise be endangered
The resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the facility.
The facility ceases to operate
For those who live in long term care facilities, it is your home and you are entitled to certain rights within it. For those of you who visit a loved one in a long term care facility, if you begin to question whether your loved one is being treated appropriately, simply go online, type into Google “42 CFR 483,” and start getting your questions answered.
A trial attorney who handles these types of matters, can give you lots of help,
however,
you would be surprised how effective Federal law is when properly cited during discussions with facility administrators and staff.
Posted in: Elder Law and Nursing Home Litigation
The Code of Federal Regulations (herein either “the Code” or “CFR”) is a codification of rules published in the Federal Register by the departments and agencies of the Federal Government. Title 42 of the Code, Part 483, addresses public health requirements for long term care facilities.
Part 483 specifically addresses, among many other issues, the following:
Resident rights (§483.10) Admission, transfer, and discharge rights (§483.12) Resident behavior and facility practices (§483.13) Quality of life (§483.15) Quality of care (§483.25)
Most of the fundamental questions you have will be addressed, at least in part, in the sections cited above. Section 483.10, as one example, addresses resident rights and specifically provides for what a facility must do regarding issues that range from providing, for inspection, a resident with his or her medical records within twenty four hours of request, to prominently displaying information about how to apply for and use Medicare and Medicaid benefits.
Section 483.12, as one other example, lists the six permissible reasons to discharge a resident from a long term care facility. It is important to note, there are no other reasons for discharge beyond these six, any other purported reason for discharge that is not listed in §483.12 (a)(2) is a violation of Federal law.
6 Reasons for Discharge
The transfer or discharge is necessary for the resident’s welfare and the resident’s needs cannot be met in the facility
the transfer or discharge is appropriate because the resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility
The safety of individuals in the facility is endangered
The health of individuals in the facility would otherwise be endangered
The resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the facility.
The facility ceases to operate
For those who live in long term care facilities, it is your home and you are entitled to certain rights within it. For those of you who visit a loved one in a long term care facility, if you begin to question whether your loved one is being treated appropriately, simply go online, type into Google “42 CFR 483,” and start getting your questions answered.
A trial attorney who handles these types of matters, can give you lots of help,
however,
you would be surprised how effective Federal law is when properly cited during discussions with facility administrators and staff.
Posted in: Elder Law and Nursing Home Litigation
Create A Better Day Café Marlborough , MA USA
Create A Better Day Café Are you caring for someone with Alzheimer’s
or other dementia? Create
A Better Day Café encourages socialization with other caregivers and loved ones where you can just be yourself. This is a wonderful opportunity to get out with your loved one and have an enjoyable afternoon.
It’s a time to step out of the daily routine, leave the disease at the door, and enjoy a positive experience in a supportive environment. The afternoon will consist of conversation, music, arts, games, refreshments, and most importantly, laughter.
There is no cost.
It is open to anyone at any stage of the disease process accompanied by friends, family, and loved ones. The café is held the 4th Sunday of each month Please attend our next Café on Sunday, October 26th 1:00pm to 3:00pm at Pleasantries Adult Day and Consulting Services 195 Reservoir Street, Marlborough
Please contact Tammy for more information at 508-481-0809 Due to the possibility of cancellation please call prior to attending and listen to voice message
A Better Day Café encourages socialization with other caregivers and loved ones where you can just be yourself. This is a wonderful opportunity to get out with your loved one and have an enjoyable afternoon.
It’s a time to step out of the daily routine, leave the disease at the door, and enjoy a positive experience in a supportive environment. The afternoon will consist of conversation, music, arts, games, refreshments, and most importantly, laughter.
There is no cost.
It is open to anyone at any stage of the disease process accompanied by friends, family, and loved ones. The café is held the 4th Sunday of each month Please attend our next Café on Sunday, October 26th 1:00pm to 3:00pm at Pleasantries Adult Day and Consulting Services 195 Reservoir Street, Marlborough
Please contact Tammy for more information at 508-481-0809 Due to the possibility of cancellation please call prior to attending and listen to voice message
Hospice and Nursing Homes Blog: Death Rattle, Families, Signs of Dying (Research, ...
Hospice and Nursing Homes Blog: Death Rattle, Families, Signs of Dying (Research, ...:
{quote}A crackling, gurgling sound emanating from a dying person’s throat can distress onlookers who have not been prepared for this occurre...
Caregivers and loved ones should be educated regarding the death rattle experience and reassured about the unlikelihood of patients’ pain.
Supporting this need for more education is additional death rattle family research focused on bereaved family members who had witnessed the anxiety of watching a death rattle experience. This study involved 663 questionnaire surveys conducted in 95 palliative care units, Among family members who participated, 46% of respondents had witnessed the death rattle. Of these participants, 66% reported high distress levels, and 53% perceived a strong need for improved death rattle care.
This research concluded that family distress could be reduced by having medical staff lessen patients' symptoms with comprehensive and supportive care strategies. These strategies would include decreasing secretions and uncomfortable smells along with alleviating torment of family members through education.
{end quote}
{quote}A crackling, gurgling sound emanating from a dying person’s throat can distress onlookers who have not been prepared for this occurre...
Caregivers and loved ones should be educated regarding the death rattle experience and reassured about the unlikelihood of patients’ pain.
Supporting this need for more education is additional death rattle family research focused on bereaved family members who had witnessed the anxiety of watching a death rattle experience. This study involved 663 questionnaire surveys conducted in 95 palliative care units, Among family members who participated, 46% of respondents had witnessed the death rattle. Of these participants, 66% reported high distress levels, and 53% perceived a strong need for improved death rattle care.
This research concluded that family distress could be reduced by having medical staff lessen patients' symptoms with comprehensive and supportive care strategies. These strategies would include decreasing secretions and uncomfortable smells along with alleviating torment of family members through education.
{end quote}
Some Basic basics for caregivers | Compiled from aggregated information on the Net
Learning about and
accepting Confabulating and Confabulations is
essential and not easy to
accept.
In psychology,
confabulation (verb: confabulate) is a memory
disturbance, defined as
the production of fabricated, distorted or
misinterpreted memories
about oneself or the world, without the
conscious intention to
deceive.
Key factors in
confabulations are there is no intent to deceive,
second the person being
unaware that the information is blatantly
false. Confabulating is
distinct from lying because there is no intent
to deceive, and the person
being unaware that the information is
blatantly false. Carers
challenge: is what they say true?
Confabulations become a
far greater concern in the later stages,
because confabulations are
much more likely to be acted upon.
It is difficult for
everyone to accept a mind is damaged by
Alzheimer's Disease. Not
only is memory damaged their ability to
process thoughts and
conversations is impaired.
Confabulations are a major
annoyance and can be dangerous- when we take everything in a
discussion at face value. Confabulating is very frequently observed in
people with Alzheimer's.
We all Confabulate when we
make..verbal statements and/or actions that
inaccurately describe
history, background and present situations
unintentionally. We must
be aware of information that is blatantly
false yet are coherent,
internally consistent, and appear relatively
normal.
Understand the
similarities between confabulation and delusions; e.g.,
both involve the
production of unintentional false statements, both
are resistant to
contradictory evidence.
Recognize Sunrise Syndrome
delusions that are frequently observed in
Alzheimer's patients
include beliefs about theft, the patient's house
not being his home, a
spouse, is an impostor, belief an intruder is in
the house,abandonment,
spousal infidelity, and paranoia.
http://www.alzcompend.info/?p=293
It seems that Alzheimer's
world is fraught with confabulation speak.
The general public doesn't
understand Alzheimer's they certainly need
to be educated regarding
Confabulation.
{Quoting
http://tinyurl.com/qfutbn4 Nature Reviews Neuroscience }
"Most patients with
spontaneous confabulation eventually stop
confabulating."
"Confabulators may
occasionally act upon their confabulation."
("Occasionally"?
Later-stage Alzheimer's patients persistently and
repeatedly act upon the
belief their childhood memories are relevant
to their present
circumstances.)
"Confabulations are
usually limited in time; they relate to the recent
past, the present, and the
future."
{End Quoting
http://tinyurl.com/qfutbn4 Nature Reviews Neuroscience }
An aide/caregiver must
understand the individual has Alzheimer's
Disease, be aware of the
danger, and treat the person with patience.
Also, Confabulation is
common. Conversing with someone who has
Alzheimer's is often like
talking with your cat.
Acknowledge, respond, be
affectionate, develop boundless patience.
Forget about rational
responses. Show respect, your therapeutic
fictional responses are
allowed. ~{quoting}DLMifm}
To cope with spontaneous
confabulation, and ease the confusion,
frustration, and fear for
the loved one, use resources such as:
By far, the most serious
danger posed by Alzheimer's disease is when
the individual may decide
they want to go for a walk, go searching for
"home," or maybe
just walk outside to get the paper. In a restaurant
they may go to a
rest-room. When they turn around, the place they
expect to see is gone.
Their assurance they are Ok and can go on their
own ?. may be a example of
confabulation.
----
Alzheimer Society of
Canada, http://tinyurl.com/oujghvy Toronto,
Ontario, M4R 1K8
Hallucinations and
delusions are symptoms of Alzheimer's disease and
other dementias. With
hallucinations or delusions, people do not
experience things as they
really are.
Delusions are false
beliefs. Even if you give evidence about something
to the person with
dementia, she will not change her belief. For
example, a person with
dementia may have a delusion in which she
believes someone else is
living in her house when she actually lives
alone. Delusions can also
be experienced in the form of paranoid
beliefs, or accusing
others for things that have not happened. For
example, the person with
dementia may misplace an item and blame
others for stealing it.
Some people with dementia may have the
delusion that others are
"out to get them." For example, he
may believe that his food
is being poisoned.
Hallucinations are
incorrect perceptions of objects or events
involving the senses. They
seem real to the person experiencing them
but cannot be verified by
anyone else. Hallucinations are a false
perception that can result
in either positive or negative experiences.
Hallucinations experienced
by people with dementia can involve any of
the senses, but are most
often either visual (seeing something that
isn't really there) or
auditory (hearing noises or voices that do not
actually exist). For
example, a visual hallucination could be seeing
bugs crawling over the bed
that aren't actually there. Of course,
people also make “visual
mistakes,� mistaking a housecoat hanging
up for a person, for
example, because they can’t see the object
clearly. This can happen
to anyone, and is not considered a
hallucination.
-----
Definition of Alzheimer's
Sunrise Syndrome
Internet description:
cognitive instability on arising from sleep.
Sunrise Syndrome,(sun?riz)
a condition in which a person with
Alzheimer's wakes up
rising in the morning and their mind is filled
with delusions which
include include beliefs about theft, the
patient's house not being
their home, a spouse is an impostor, belief
an intruder is in the
house, abandonment, spousal and paranoia, people
eavesdropping. Sometimes
the person may carry over content of a dream.
One observation is that
Sunrise Syndrome is different from Sundowning
because the person may
wake up in a confabulation mind set. During a
Sunrise Syndrome
conversation with the content may filled with
confabulations; verbal
statements and/or actions that inaccurately
describe history,
background and present situations.
Sundowning in contrast
displays as confusion, disorientation,
wandering, searching,
escape behaviors, tapping or banging,
vocalization,
combativeness; the demons of anxiety, anger, fear,
hallucinations and
paranoia come out.
===
When I became a caregiver
for my wife with Alzheimer's I had no
clue to the tasks ahead. I
started to read and search the Internet for
information.
Now retired I enjoy
blogging and networking. I am an Aggregator to
Ishmael's Knowledge
Network, I frequently collect content from various
Internet sources and
consolidate it on Ish's Knowledge Network
http://tinyurl.com/4qqekc6
Knowledge networking is a
pastime / hobby. BTW I have no
commercial ties to the
linked information.
Suggested reading Jennifer
Ghent-Fuller's article,
"Understanding the
Dementia Experience"
http://tinyurl.com/pzof7an
--
I really need to say this: The blog is for informational purposes only. I assume no responsibility for its accuracy. The information is subject to change without notice. Any actions you take based on information from the podcast or from this website are entirely at your own risk. Products and services are mentioned for informational purposes only and their various trademarks and service marks are the property of their respective owners. Fair Use: is not an infringement of copyright
Alzheimer's Association list of safety services
stlreportsafetyservices.pdf
The information is based on the
provider’s description of their own services
provider’s description of their own services
.
We cannot guarantee, endorse,
or recommend any provider listed and the information may change
without notice. This is an informational list only and we update it
regularly. Through our 24-hour Helpline
or recommend any provider listed and the information may change
without notice. This is an informational list only and we update it
regularly. Through our 24-hour Helpline
St. Louis Chapter
24/7 Helpline: 800.272.3900
www.alz.org/stl
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