Pilot Program for Colorado Spinal Cord Injury Patients

Posted by admin on December 1, 2012   |   No Comments

There may be a day in our not so distant future that Medicaid will pay for integrative therapies for individuals with a spinal cord injury. If so, a big thank you goes out to Chanda Hilton, founder of The Chanda Plan Foundation. Having a spinal cord injury herself and seeing firsthand the health benefits and cost savings to her insurance company from using integrative therapies, Chanda has advocated for a pilot program within the Colorado Medicaid system. The goal of this pilot program is to prove to legislatures that integrative therapies like acupuncture, massage, chiropractic care, and yoga make a significant difference in the lives of individuals living with a spinal cord injury and money will be saved in the Medicaid program.

The pilot has just started and only 67 Medicaid-eligible participants can be enrolled during this limited time period. To find out more information, talk with your Case Manager at the Single Entry Point agency assigned to assess your specific Medicaid services eligibility. You will then be given a Home and Community Based SCI Waiver to receive free integrative therapies. These treatments will be provided by Progressive Health Center.

To learn more about The Chanda Plan Foundation, visit http://www.thechandaplanfoundation.org/

 

Coping Techniques for Dementia During the Holidays

Posted by admin on November 22, 2012   |   No Comments

The 2012 holiday season is upon us. Many family members that you may not see on a regular basis are now in your home for an extended period to celebrate. A loved one may already have a dementia diagnosis which has noticeably progressed since a previous visit. Or, you may witness early warning signs of dementia which have gone undiagnosed. Dementia is a brain disease with the most common cause being Alzheimer’s disease.

November is recognized as National Alzheimer’s Disease Awareness Month. This is an appropriate month for bringing awareness to the disease since many families may initially recognize early symptoms during this holiday season. Symptoms may include: progressive forgetfulness, confusion, language difficulties, errors in judgment, and difficulty doing familiar tasks. Dementia is not part of our normal aging process as some may tell you.

Some dementias can be reversed if caused by depression, vitamin deficiency, thyroid malfunction, or hydrocephalus (water on the brain). The most common reason that you may have an irreversible dementia is if you have Alzheimer’s disease. Approximately 10 million baby boomers will develop what is now being called the defining disease of the baby boomer generation.

Here are some suggestions for coping with dementia during the holiday season.

  • Try to maintain the same daily routine as much as possible to reduce stress and anxiety.
  • Family holiday traditions are important. However, if a tradition is not practical for someone dealing with dementia, then substitute with a newly, created tradition.
  • A  holiday dinner may need to become a holiday lunch since many living with dementia perform better earlier in the day.
  • Use gift bags instead of wrapping paper. They can participate more easily in the gift wrapping/unwrapping process if bags are used.
  • Notify all holiday guests prior to their arrival that a loved one is dealing with dementia. Provide suggestions to guests on how to detect increased anxiety or frustration as well as tips for calming your loved one down.
  • Keep rooms well lit and turn off the TV. Make sure music is not too loud.
  • Identify yourself when greeting. If name recognition is a problem, make a game out of having everyone wear name tags.
  • Ask one question at a time.
  • Don’t argue. Be calm and supportive. Speak slowly and clearly.
  • Be patient and flexible.
  • Simplify your gatherings. Perhaps have several gatherings with fewer guests instead of one large gathering of family and friends.
  • Watch for signs of fatigue and provide a safe, quiet area to rest.
  • Gifts for the caregiver? Respite care! Offer your time to relieve the care partner from their daily duties. Even better, offer your time to stay a few hours with the individual living with dementia and provide a gift certificate to the care partner to receive a massage or go to a movie.

I wish for all a safe and loving holiday season with your family and friends! Treasure this precious time together.

 

 

Stem Cell Medicine Can Improve Lives and Reduce U.S. Health Costs

Posted by admin on October 30, 2012   |   No Comments

The 2012 presidential election process is soon coming to an end. Much time and rhetoric has been allocated to our country’s economic crisis and healthcare reform. Unfortunately, little time was spent discussing an investment in research that could greatly help reduce overall U.S.health care costs and improve the quality of life for many Americans.

Stem cell medicine is proving to be a successful treatment for not just rare diseases that affect a minority of the population. Stem cell-based therapies have also shown positive results in dozens of chronic diseases like diabetes, cancer, kidney disease, liver failure, blindness, Parkinson’s, osteoporosis, multiple sclerosis, blood diseases, arthritis, traumatic brain injury, cardiac failure, spinal cord injuries and burns.

Stem cells are the foundation or building block of our body’s entire cell production. They naturally regenerate more cells to repair or replace damaged cells to heal. Depending on the type of stem cell, it makes more of the same cell to self-renew or more of other types of cells to differentiate. Since many debilitating medical conditions are caused by a malfunction during the cell division process, stem cell medicine development and progress holds significant promise.

Many in the medical community believe that every organ in our body has its own unique type of stem cells. The controversy that surrounds stem cells is the use of a specific type of stem cell called embryonic stem cells (ES). These cells come from human embryos and can be regenerated to create a large quantity of cells. This ability to create an unlimited amount of cells is important for stem cell transplants which require large amounts of stem cells to complete the procedure. However, due to the nature of this unlimited cell division, ES cells can also regenerate to form tumors. The excitement generated around ES cells is their ability to make many different types of cells for any organ type – blood, bone, skin, liver, kidney, brain, and heart among others.

Few people have an issue with tissue-derived stem cells (adult stem cells). These stem cells come from tissue in small quantities and they regenerate to become cells in the same tissue. Unlike ES cells, the ability for adult stem cells to divide in large numbers is limited. Since some stem cell treatments require large amounts of stem cells, there can ultimately be a supply and demand issue for adult stem cells. This has created the need for stem cell banking. There are companies that specialize in storing your own stem cells for a future medical crisis. Recently, Governor Rick Perry of Texas underwent an experimental stem cell procedure using his own adult stem cells to relieve back pain from an injury. 

A new type of stem cell has been identified called induced pluripotent stem cells or iPS cells. iPS cells are adult cells that have been reprogrammed to perform like an ES cell. iPS cells can originate from a patient’s own body and injected back into the same patient without the risk of the immune system rejecting the stem cells. Similar to ES cells, iPS  cells can be created to be any type of cell in the human body.

It has been determined that even cancer cells have their own stem cells. Many researchers believe that a cancer stem cell must be totally destroyed to ensure that there is not a recurrence of the cancer.

Pharmaceutical companies are buying stem cells to conduct research on new drugs in their pipeline to test for dangerous drug side effects.

FDA-approved clinical trials are necessary to ensure safety and effectiveness of stem cell treatments. To find current stem cell trials you can visit http://www.clinicaltrials.gov/.

Stem cell medicine can play a major role in our battle to reduce healthcare costs. In the U.S. we spend approximately $450 billion a year on health care for chronic diseases. Approximately $15 billion annually is spent solely on Type 1 diabetes care. The National Institute of Health (NIH), which is the official U.S.agency for medical research, has a total annual budget of approximately $30 billion for all medical research. A greater investment in stem cell medicine research may ultimately provide a better quality of life for individuals living with a chronic disease while also reducing our health care costs.

For more information about the advances of stem cell medicine you can review highlights from presentations delivered at the annual World Stem Cell Summit which will be held December 3-5 in West Palm Beach, Florida. International leaders in research, business and advocacy will focus on how to accelerate access to stem cell therapies.  http://www.worldstemcellsummit.com/

 

 

 

 

How to Select and Negotiate for Long Term Care

Posted by admin on August 26, 2012   |   No Comments

National Assisted Living Week will be recognized this year during September 9-15. I have received many inquiries from families in need seeking information to find the best long term care accommodation options. 1.5 million people are currently living in U.S. skilled nursing and assisted living communities. Due to Colorado’s scenic beauty and ample sunshine, the state is attracting a growing older adult population with diverse care needs.

To ensure that you are selecting a long term care community that meets the specific needs of your family it is worth the time to conduct due diligence on the community, its ownership, and care process. Basic reconnaissance can be accomplished by contacting the Ombudsman Office to talk with the local Ombudsman who is assigned to that specific residential community. In addition, there is a lot of fundamental information that can be obtained by visiting the community unannounced during different times of the day and week. This will allow you to see firsthand how the residents are being treated, quality and quantity of food available, cleanliness of the property, and staff interaction with residents and other staff members. You may even witness a specific behavior or a situation occurs that allows you to see how a staff member manages the issue.

Health facilities and residential care communities are regulated by the state and must meet minimum standards established by state and federal laws to receive licensing as well as federal funding if they are serving Medicare/Medicaid residents. The Colorado Department of Public Health and Environment has a web site that enables you to view inspection and occurrence reports. These reports can be quite revealing in terms of the quantity and type of incidents that have occurred at a property as well as how situations were handled by management. This web site also allows you to view training that staff completed which may be relevant to your selection process (i.e. dementia care certification). http://www.cdphe.state.co.us/hf/alr/index.html

Some families may opt to utilize the services of a referral agency to locate the most appropriate care community. Keep in mind that many of these agencies promote that they are a free service. They typically receive their payment directly from the residential care community as a referral fee/commission. Many times that fee equals one month of rent. As a family member, you want to ensure that you are not being steered toward a community that offers a higher referral payment.

Unfortunately, many times families do not have the luxury of time to conduct thorough research during the selection process due to a health crisis. During these situations, time is limited and stress levels are increased. Families may not completely read or understand all of the language contained in the admissions contract. It is critical to have proper time allocated to review the contract or have an advocate review and negotiate on your behalf. The admission process is when you have the most control over the type and quantity of care services and their corresponding cost for the individual you are seeking care. You should use this time period to your advantage during the admissions process.

Be aware of common language that may be included in your admissions contract but is prohibited by the federal Nursing Home Reform Law. For example, a family member or friend can not be personally liable for all nursing home charges. Financial guarantees are prohibited by law. Furthermore, most contracts state that all disputes will be handled through an arbitration process instead of the court system. The arbitration process may be in the favor of the long term care provider. It usually is in your best interest to negotiate removal of that clause from your admissions contract so that you will have the leverage of the court system if ever needed. Make sure you understand their eviction process and the language that is stated in your contract gives your family the flexibility you need. The excuse that a behavior is too difficult or care needs are too time-consuming may be improper reasons for evictions depending on the specific circumstances. By law, nursing homes are obligated to provide the level of care that the residents require. http://www.law.cornell.edu/uscode/pdf/uscode42/lii_usc_TI_42_CH_7_SC_XVIII_PA_A_SE_1395i-3.pdf

There are multiple checklists available to the public to assist in selecting the proper care community for your loved one. By spending the appropriate due diligence upfront, it will save you time, money and many hours of frustration in the future.

To read about the Evolution of Assisted Living, visit Colorado Health or click here. 

 

How Do You Prevent or Manage a Health Crisis?

Posted by admin on July 19, 2012   |   No Comments

Are you or someone you know the 1 out of the 3 people that research indicates are affected by hospital medical errors? Health care misdiagnoses, improper care and/or lack of priority for the best care available are common scenarios that can be managed.

Other problem areas that people in need of care experience:

  • Returning from a doctor’s appointment wishing they had asked more questions yet were overwhelmed with medical jargon or intimidated by the doctor‘s status during the appointment.
  • Not pursuing additional opinions on a recent diagnosis.
  • Receiving medical bills that are not only confusing but also incorrect for services performed.  
  • Insurance coverage denial for medical procedures or treatment plans that they need.

Unfortunately, these are very common situations in the current and foreseeable future of the stressed U.S.healthcare system. These overwhelming and frustrating encounters have created a demand in the healthcare industry for independent patient advocates. There is a growing need for people to be professionally represented and take a proactive role in managing their health to prevent incomplete or improper care, reduce denial of coverage and/or incorrect billings. Independent patient advocates or personal health advocates help to manage the health care process for individuals and families.

Currently, there are several hundred private patient advocates in the U.S. and the number is growing to ramp up to demand. Unlike professionals who are termed as patient advocates on staff at a hospital or insurance company, an independent and private patient advocate is not affiliated with or paid by a potential conflict of interest organization. A private patient advocate is typically paid directly by the individual or the family to help find and decide on the best options to prevent a crisis and/or manage a care situation with their client’s interest as the priority.

When someone is hospitalized there are many serious and sometimes fatal situations that can arise if a patient does not at least have a dedicated and qualified friend or family member carefully managing their care. Many families do not have this and the differences in diagnoses, treatments and care can be significant. Some examples of this: 

  • Incorrect medications/dosages cause 7,000 deaths annually.
  • Hospital-acquired infections affect 1 out of every 10 patients.
  • Unnecessary falls in the hospital occur frequently.
  • Transitioning from a hospital to a residential setting introduces another level of complications that can be avoided with effective communication during the discharge process. 

What are some specific tasks that you may want to hire a patient advocate to do for you or your family?

  • Help you prepare for a doctor’s appointment and/or participate with you during the appointment.
  • Provide care coordination between your multiple providers during your illness.
  • Help you find experts in your area of need.
  • Help you identify and prioritize your care options.
  • Advise you on treatment options, home care services and insurance issues.
  • Improve communication between medical providers and family members to ensure that appropriate actions are being taken in a timely manner.
  • Assist you in deciphering and negotiating your medical bills.
  • Research new drugs, treatments and clinical trials.
  • Provide hospital bedside companion service.
  • Assist you in hiring and managing in-home caregivers.

Patient advocates at their best are problem solvers and project managers who strive to provide their clients with the knowledge they need to make timely, informed decisions. Many advocates have backgrounds as individuals who have learned about the problems of the system through personal experience, are experts in facilitation/management and can think outside the current system’s issues.

Highlights from the Annual Cancer Conference

Posted by admin on June 6, 2012   |   No Comments

The premier oncology conference just concluded their 2012 annual meeting for cancer health professionals. The American Society of Clinical Oncology (ASCO) hosts this conference where all disciplines of oncology are represented by the ACSO’s 30,000+ membership. This includes medical, surgical and radiation oncologists.

ASCO is a not-for-profit organization dedicated to conquering cancer through research, education, prevention and delivery of patient care. The term ‘cancer’ includes over 200 dissimilar diagnoses. If you or a loved one are dealing with a cancer diagnosis, knowledge that is disseminated from ASCO is current on research and scientific studies that affect new drugs and treatment options. Hopefully, your oncologist will access this information in a timely manner and discuss with you if applicable for your situation. However, your oncologist may have limited time and access to ASCO’s resources may be less frequent than desired. That is where YOU – the empowered, informed patient or family advocate can access scientific data as soon as it is released to medical professionals. Read what your doctors are reading….maybe even before them!

The annual conference is a platform for announcing new findings from cancer clinical trials. Highlights from this year’s conference can be found on their site at http://chicago2012.asco.org/

The Journal of Clinical Oncology is an authoritative cancer resource published by the organization and read by many oncology professionals. http://jco.ascopubs.org/

Another outlet that the ASCO utilizes to distribute their information is Cancer.net. http://www.cancer.net/  This is a website developed specifically for cancer patients. In addition to up-to-date treatment options, Cancer.net allows you to locate an oncologist based on your specific cancer diagnosis. That is the most important decision you will make during your road to recovery. You need to select an oncologist that is an expert in YOUR specific cancer diagnoses. You don’t want the leader of your ‘team’ to have experience with a small number of similar cases as yours. You want an oncologist who primarily or solely works with your cancer type.

A major initiative that ASCO is undertaking is called CancerLinQ. This is a central knowledge base that will aggregate information from patients’ electronic health records, clinical trials and published reports. It is a real-time decision support tool for oncologists to use with their patients based on shared data from other patients, researchers and oncologists. The first assessment phase prototype will be conducted on breast cancer.

Once CancerLinQ is ready for oncologists to apply to their practice, you should ask members of your oncology team if they are utilizing this tool to help formulate a personalized treatment plan for you.

For more information about the American Society of Clinical Oncology, you can visit http://www.asco.org/

 

 

 

 

Preserve the Rights of Those Living With Alzheimer’s

Posted by admin on April 26, 2012   |   No Comments

We continue to hear in the media the devastating statistics about Alzheimer’s disease.

 #1 –  It is currently the 6th leading cause of death in the U.S. and the only cause of death in the top 10 that cannot be prevented, cured or slowed down.

#2 – Every 68 seconds someone develops Alzheimer’s disease.

#3 – Over 5 million people are affected now by Alzheimer’s and it’s anticipated that 16 million will be living with the disease by 2050. 

#4– Currently, 15 million people are unpaid caregivers and that number will rise to 45 million by 2050. 

Fortunately there are more organizations specializing in training and support for the disease that is currently affecting 1 of every 8 Americans.

The Best Friends Approach™ to Alzheimer’s and dementia care offers a proven philosophy of care for caregivers and any person interacting with someone affected by Alzheimer’s and other related brain disorders. This organization conducts training for assisted living communities, local chapters of the Alzheimer’s Association and adult day centers. The basis of their approach focuses on socialization as the primary treatment of Alzheimer’s. They provide simple techniques for caregivers that can be incorporated every day to ensure that dignity and independence is the cornerstone of all care provided. 

The Best Friends Bill of Rights has been created to guide caregivers on how to be sensitive to the needs of those living with Alzheimer’s and dementia. This document should be a guide to care for individuals living at home as well as assisted living communities. If you are looking for a residential community for your loved one, you should ask if they promote the   Best Friends Approach™ to Alzheimer’s and dementia.

An Alzheimer’s Disease Bill of Rights

Every person diagnosed with Alzheimer’s disease or a related disorder

deserves the following rights:

  • To be informed of one’s diagnosis
  • To have appropriate, ongoing medical care
  • To have expressed feelings taken seriously
  • To be free from psychotropic medications, if possible
  • To live in a safe, structure, and predictable environment
  • To enjoy meaningful activities that fill each day and to be outdoors on a regular basis
  • To have physical contact, including hugging, caressing, and hand-holding
  • To be with individuals who know one’s life story, including cultural and religious traditions
  • To be productive in work and play for as long as possible
  • To be treated like an adult, not like a child
  • To be cared for by individuals who are well trained in dementia care

 

Private Patient Advocates Are On The Rise

Posted by admin on March 6, 2012   |   No Comments

The second annual Private Professional Patient Advocates Week is March 11-17th, 2012. Private or independent patient advocates are filling a critical need in our healthcare system that families are embracing. Patient advocates help families to professionally manage the care process. Private patient advocates do not work for hospitals, insurance companies or other health organizations. They are hired directly by an individual or family member to work solely on your behalf.   

Some services provided by patient advocates include,

  • Help you prepare for and participate with you during a doctor’s appointment
  • Provide care coordination between your multiple health providers during your illness
  • Assist in researching top physicians, Centers of Excellence, and treatment options for your illness
  • Ensure that you are receiving health care and financial assistance benefits as well as support services that you are eligible to receive
  • Improve communication with your medical providers and family members to ensure that appropriate actions are being taken in a timely manner

Ken Schueler, who was considered the Father of Private Patient Advocacy, once said that cancer is like entering a foreign land. I agree with Ken that cancer, as well as other life-threatening diseases, is unfamiliar territory with its own language and protocols. As an advocate, it is my role to make the journey less intimidating and empower individuals and their families to take control instead of allowing a serious health condition to control them. I feel blessed to have the opportunity to utilize my strengths in helping people navigate to a better place. 

Click below to find more information about Private Professional Patient Advocates Week http://pppadvocatesweek.com/

 

 

 

Hospital Discharge Planning is Critical for Recovery

Posted by admin on February 4, 2012   |   No Comments

Why is hospital discharge planning so important for a successful recovery? The following example is one of many that happen frequently in hospitals.

A patient had parathyroid surgery. The parathyroid gland regulates calcium in the blood. A known side effect of this surgery is hypocalcemia, low calcium level in the blood.
The patient was discharged from the hospital without calcium supplements or instructions on potential complications and symptoms if a low calcium level develops. She returned to the hospital emergency room when her calcium level caused severe hypocalcemia symptoms. She was given excessive daily dosages of calcium and remained in the hospital until her condition stabilized. She was discharged from the hospital. Similar to her first hospital discharge, she was not given instructions on potential side effects. More importantly, her increased daily dosage of calcium was not reduced upon discharge. She went home continuing to take excessive amounts of calcium for many weeks. She returned to the hospital again when the increased calcium levels caused hypercalcemia symptoms which included kidney damage and several of her teeth fell out!

75% of hospital readmissions are preventable. Most of these are drug events which are preventable. Unfortunately, there is a breakdown of communication between medical providers, home health staff, nursing homes, family members and the patient. Medicine reconciliation is critical when you are discharged from the hospital. Typically, when you are admitted to the hospital your prescription drugs will change based on what the hospital uses. It is important for your health safety to reconcile your medications upon discharge to ensure that duplication and adverse side effects do not occur.

The Agency for Healthcare Research and Quality (AHRQ) recognizes this serious, yet common problem in hospitals and has addressed it by funding Project RED, Re-Engineered Discharge. Currently, approximately 250 hospitals are participating with more to follow. The program helps hospitals to educate patients on self-care and to improve hospital discharge communication to reduce overall hospital readmission. The program was initially developed by Boston University Medical Center to help solve their own discharge planning problems.

Common questions addressed in successful discharge planning include:

What should I eat?
What activities or foods should I avoid?
Where is my pharmacy?
What is my medical problem?
What are my medication allergies?
What medicines do I need to take? Why am I taking them? How much do I take?
How do I take this medicine?
When are my next appointments?
Questions for my next appointments

Remember, if you are a Medicare beneficiary and you do not feel that you are ready to be discharged or the post-discharge planning is not acceptable to you, you can appeal the decision. http://www.lifelongwellnessadvocates.com/are-you-being-discharged-from-the-hospital-too-soon/


Embrace Self-Care for the New Year

Posted by admin on January 14, 2012   |   No Comments

Americans will continue to hear more about self-care for prevention and management of chronic illness as health care reform dominates our media. The National Committee for Quality Assurance is a not-for-profit organization that provides accreditation and certification to U.S. health plans to ensure that they are following standards to improve health care quality http://www.ncqa.org/. Self-care management tools are an important component of new health care delivery models offered by Accountable Care Organizations. These organizations will benefit financially from shared savings to Medicare by having healthy patients who will not burden our acute hospital services. In the same manner, they will be held financially accountable to losses that affect Medicare. The success of these organizations is based on improved coordination and communication between patients and their medical providers.

Currently, Medicare patients have five or more chronic conditions. 75% of healthcare expenditures are for chronic care. Patients are going to be required to take an active role in managing their chronic illnesses. Many European countries have successfully implemented telehealth programs. Over the past two decades Denmark has been a leader in providing care at a distance to its citizens. In the U.S., the Veterans Administration has the most robust and well-received telehealth program currently available to address the needs of veterans, especially those located in rural areas. This has reduced travel time and emergency visits to medical facilities as well as loss of time from work. Monitoring of vital signs, blood pressure readings, glucose monitoring, pulse rate, and haemodialysis can all be conducted at home with results being delivered via text, email, videoconferencing and phone to medical personnel for review. An ePatch offers a revolutionary approach to obtain body measurements wirelessly. In-home rehabilitation therapy devices provide remote monitoring for therapists to evaluate progress and customize a home therapy program accordingly. Emerging technologies like mobile health apps will also play a major role as telehealth programs continue to rollout.    

You will see more companies providing diagnostic services to individuals for preventative health. This helps expedite the identification of areas of concern before a health crisis occurs. WellnessFX is one of these companies that are giving individuals the tools to help manage and control their own health with consultations from medical professionals. http://www.wellnessfx.com/

You should consider embracing self-care in 2012 because the best person to take care of you is YOU!


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