A newsbasket is on-line Internet publication containing comprehensive aggregated collections of information.


Comfort Care Order (CCO-DNR) program Plus MOLST

EMS Comfort Care Order Do Not Resuscitate Program | doh


Comfort Care - Do Not Resuscitate
The
Emergency Medical Services (EMS) Comfort Care Order-Do Not Resuscitate
(CCO-DNR) program allows patients diagnosed with a specific medical or
terminal condition to express their wishes regarding end of life
resuscitation in the pre or post-hospital setting.


The program requires that a patient’s attending physician certify and sign a Comfort Care Order
(CCO) that states the patient (adult or child) has a specific medical
or terminal condition. The patient, or his or her authorized decision
maker or surrogate, must also consent and sign the CCO (verbal orders
are not valid). The physician then places a Comfort Care bracelet on the
patien

Resources | Novant Health | Choices and Champions

Resources | Novant Health | Choices and Champions
Novant Health is a integrated system of physician practices, hospitals, outpatient centers, and more – each element committed to delivering a remarkable healthcare experience for you and your family. Code Comfort is for patients with a DNR order who desire comfort measures. Use of the order set will promote comfort for patients at risk for symptom crisis nearing end of life. Code Comfort Order Set Code Comfort Policy (draft)

Code Comfort: A Code Blue Alternative for Patients with DNRs - HBR

Code Comfort: A Code Blue Alternative for Patients with DNRs - HBR



Code Comfort provides a response for patients whose code status is
DNR and who desire comfort measures only. It is a compassionate way to
manage pain and suffering — including emotional suffering — during an
acute crisis without providing unwanted care. Hospital staff responding
to a Code Comfort may include palliative care physicians, nurses,
respiratory therapists, chaplains and others who are prepared to rapidly
address the patient’s physical symptoms, as well as the suffering and
concerns of family members.




As is true for CPR efforts, we know teamwork matters to relieve the
suffering of dying patients. Code Comfort protocols include an
algorithm-driven method for assessing and addressing symptoms such as
pain, agitation and dyspnea. For example, a patient suffering from
severe, acute dyspnea would be given morphine and increased oxygen, her
head would be elevated, a fan might be used to provide a comforting
breeze, and she’d receive other measures to reduce anxiety. Importantly,
Code Comfort ensures that no patient or family suffers alone. Nurses
are present during the code, actively treating the patient’s symptoms
and calling in other team members as needed, all of which provides
essential emotional support and reassurance



 Code Comfort: A Code Blue Alternative for Patients with DNRs
Melissa P. Phipps, John D. Phipps; December 9, 2014

In the hospital? Are you a hospital inpatient or outpatient?

In the hospital? Are you a hospital inpatient or outpatient?     May 21, 2014 by Wendy Shane
May 21, 2014 by
May 21, 2014 by
 Why does this matter to patients?
When hospital patients are classified as outpatients on Observation Status, they may be charged for services that Medicare would have paid if they were properly admitted as inpatients (for example, medications, so you may want to bring medications with you). Most significantly, patients will not be able to obtain any Medicare coverage if they need nursing home care after their hospital stay. Medicare only covers nursing home care for patients who have a minimum 3-day inpatient hospital stay. Observation Status doesn’t count towards the 3-day stay.


Why does this matter to patients?




When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.

- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf


Why does this matter to patients?




When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.

- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf

Why does this matter to patients?




When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.

- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf

Why does this matter to patients?




When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.

- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf

Why are caregiver spouses so relectant to hire help? | LinkedIn

Brett Frankenberg Brett Frankenberg 2nd Founder at The Institute for Quality in Senior
Living, Greater San Diego Area participated in  an interesting discussion on
Home Care and Healthcare Advocacy  concerning "Why are caregiver spouses so
reluctant to hire help?

" I am paraphrasing from his discussion:”

One cannot stress enough the need for caregiver education. The problem
is many family members think they learn by watching caregivers in the
hospital.

Brett: Have you ever worked an overnight shift in a hospital with a
Senior who has dementia?

Brett If you have, I doubt you would assert that observing highly
trained professionals who care for patients in the hospital would
suffice as sufficient training.

Brett has managed home health and clinically based staff for years and
the amount of times needed to train caregivers on the most simple
activities - transfers, bathing, safety risks -blood glucose testing,
sliding scale insulin, specific diet instructions  such as chopped or
puree and you get an overwhelmed caregiver pretty darn quickly.

Brett believes the biggest mistake is assuming that a caregiver is
absorbing the necessary information simply by observing the clinical
activities that take place when the patient is an inpatient. Further,
we have no idea what the baseline of the caregiver is most of the
time.

Brett: Do they have some aspect of dementia themselves to the point
they can't learn?

Do they have physical limitations that would prevent them from
performing all the activities that daily caregiving demands?


Brett

Exploring the Potential of Digital Technology to link AHPs and People in Remote, Rural Hubs

Let's Talk about Dementia | Never in the history of mankind did not talking about something scary make it disappear.

Living it Up Creatively




Exploring the Potential of Digital Technology to link AHPs and People in Remote, Rural Hubs

 Background

Since June 2014, a group made up of people living with disabilities
and health problems, carers and Allied Health Professionals (AHP’s) have
been actively learning about the benefits of digital inclusion. In
August, we established a steering group to drive forward a Living it Up Creatively
digital project that links Helmsdale, a remote rural community in East
Sutherland, to New Craigs, the main Mental Health Hospital supporting
the Highlands from Inverness.



How will we use digital technology to connect professionals and people in the future?


For further information contact Sarah Muir (AHP Lead NHS Highlands) at sarah.muir2@nhs.net or Ann Pascoe (Dementia Friendly Communities, East Sutherland) on ann@dementia-friendly.com .


And follow us on twitter: @sarahahpmh and @a_carers_voice.

Addressing Unmet Palliative and Geriatric Needs of Zombies | GeriPal - Geriatrics and Palliative Care Blog

Addressing Unmet Palliative and Geriatric Needs of Zombies | GeriPal - Geriatrics and Palliative Care Blog
{Q{ Considerable evidence indicates that zombies do not receive optimal palliative or geriatric care.

Advance Care Planning 
The subject of advance care planning pertains to end-of-life decisions, which may seem unimportant for zombies as they are past the end of life. However, understanding the values and preferences of zombies around “dead-decisions” is just as important as asking the living about end-of-life decisions. Given the high rates of traumatic injuries, having stated values of what is most important to zombies in their deaths, what brings them enjoyment while being dead, and what are the biggest worries and concerns would appear to be just as important to the undead as to the living.

by: Eric Widera (@ewidera)  {EQ}

Quality of U.S. hospices varies, patients left in dark - The Washington Post

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.

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

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

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


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}