Geriatric Care

Virginia Loses Wellness Facility

Jennifer

The only medical eldercare facility in East Virginia – SeniorCare Geriatric Medical Center – is set to close next month due to lack of interest from the elderly and their caretakers.  It was run by majority owner Dantra Healthcare and Mary Washington Healthcare. When it began in May 2011, the hope was that it would fill a gap in senior services while offering services to the continually growing population of elderly – around 32,000 individuals according to the US Census Bureau.  In addition, it is expected that this will increase with the aging of the baby boom generation.

What is most unfortunate about the upcoming closure of the facility is that it really was the only one of its kind, since it offered services both in-house (at its office in Spotsylvania County) and outside, caring for the elderly in their homes.  There were five members of staff including a board-certified geriatrician and a nurse practitioner. The home visits were very popular, but the elderly did not generally tend to come into the office, so that part of the business was very slow. The anticipated need of seeing patients in the clinic just didn’t happen.

Once it closes, a nurse practitioner will continue to see the patients who are unable to leave their homes, at home.  And it is hoped that this change will not cause any disturbance in patient care.

Louisville: Global Leader in Aging Care Innovation

Jennifer

What happens when business, technology and healthcare for the elderly are combined?  Innovate LTC.  In 2006, a study that was undertaken on Louisville’s healthcare system found that it was very productive in eldercare.   Since then it has been working hard on further developing this factor along with long-term wellness care.  In addition, various organizations have relocated their headquarters to Louisville, such as Kindred and Signature HealthCARE, rendering the city “the world leader in aging care innovation.”

Since the baby boomers are aging, there is an escalating demand for in-home care. Thankfully, due to major innovations in technology, it is becoming much more affordable. Rest Assured – developed by Louisville-based ResCare (America’s largest home care service provider) – offers video and sensor monitoring; reminders to take medication; and telecaregivers.

Given that Louisville is at the head of aging care innovation and wants to remain there, it established America’s first aging care accelerator – Innovate LTC. (the International Center for Long Term Care Innovation). This was set up between the University of Louisville and Signature. The project seeks to amass investment capital for new technology and products, connecting entrepreneurs with organizations that can financially make these ideas become a reality, such as aging-friendly products.

One such idea in the pipeline is an idea Innovate LTC is working on with Vita Care, to give the non-mobile elderly the opportunity to sit in a chair connected to a TV showing people dancing, swimming, etc.  The chair moves with the screen action and thus engages the elderly cognitively and physically so that on some level they can “participate” in these activities.

Unsettling Silver Tsunami Threatens Baby Boomers

Jennifer

Are Nurses the Solution?

A recent report put out by the Institute of Medicine (IOM) – the research of which was led by Dr. Dan G. Blazer, psychiatric and behavioral science professor at Duke University Medical Center – has found that care providers are simply ill-prepared for an aging population it failed to anticipate.  The amount of people who are now living longer, requiring substantially more healthcare – both physical and mental – has been termed a “silver tsunami.”  In addition, it seems like the mental wellbeing of these individuals is gaining even less attention than the already inadequate physical healthcare.

Almost 20 percent of Americans who are 65-years and up, suffer from a variety of mental health issues.  Substance abuse is also an issue, often to do with a declining mental capacity, or the fact that as people age, they cannot tolerate the same kind of medications prescribed to their younger counterparts.  In addition, since there is such a lack of geriatricians in America (see Dealing with an Aging Population) – only one geriatrician for every 2,500 Americans – it is not surprising this is becoming such a widespread problematic phenomenon, especially since the aging population is likely to increase more than double in the next 20 years.

Medicare and Medicaid to Step Up?

So what’s the solution?  Already there is too much pressure on America’s health care systems to further extend themselves to help the aging population and baby boomers.  Yet still, the IOM’s study findings is pointing the finger.  It is calling for these health care programs to “overhaul payment rules” and prioritize care, counseling and other services the aging population they serve, needs.  Currently, this is not the case at all. Indeed, both Medicare and Medicaid do not cover such treatments.  This exacerbates the problem.

But Blazer is insisting that somehow the problem be solved now, or else, the “older population and their extended families will suffer the consequences.”  At the end of the day, the report has called on policymakers to step up and sort everything out.  It was argued that Congress has to provide extra funding to “evaluate, coordinate and facilitate the efforts of health care workers taking on these enormous challenges.”

NICHE to Help Baby Boomers?

A nurse-led program seeking to improve healthcare quality could possibly provide some relief to this issue.  A study – undertaken at Johns Hopkins University School of Medicine – indicated that the Nurses Improving Care to Healthsystem Elders (NICHE) program “could be an effective model for improving hospital quality and safety for older adults.”

Right now, six systems are being investigated by Medicare Innovations Collaborative to test out potential new programs whose goal it is to improve the care for Medicare patients who suffer multiple chronic conditions.  This study would suggest that Medicare is trying to look at how it can help the elderly population more, at least in hospitals, but that is a start.

So what does NICHE actually do?  It offers a variety of tools that can be used to improve hospital care specifically for the elderly population which is much more prone to picking up infections, etc., while they are being treated in these facilities.  It seeks to increase the availability in hospitals of equipment used specifically for the elderly, as well as other resources needed by nurses for treatment.

One of the main priorities of the program is to improve the knowledge base for nurses while encouraging leadership skills.  Hospitals working with NICHE, appoint a Geriatric Resource Nurse (GRN) who leads other nurses on the unit.  The GRNs are given a specialized-education course on how to nurse adults, along with consistent mentorship and support from a full interdisciplinary team.

The Future of Geriatric Care

While indeed this NICHE program is certainly not a solution to the issue discussed above and still much needs to be done, it is certainly a step in the right direction and is indicative of the fact that Medicare is at least on board vis-à-vis the recognition of eldercare in hospitals.

Are Healthcare Apps Good for Seniors?

Jennifer

 

Technology is supposed to be helping people improve their health and enhance their quality of life.  But are they?  An argument can be made that the more that can be done virtually, the better off many otherwise housebound seniors should be.

Today, it seems like the healthcare app market for the senior community is growing.  Indeed, the availability of mobile devices has escalated to a value of $150m in 2011, according to Kalorama Information. As well, the medical community is using Smartphones and their apps for basics, and indicating that Smartphones are doing some of the work that used to be undertaken through the computer.  This has led the Food and Drug Administration to provide more supervision.

According to the report’s author, Melissa Elder, the medical app market is growing faster than the entire app market and is being used by professionals in the healthcare industry as a positive, productive tool.

So how can these apps help?  Well, one of them – the Viary app – was created to battle depression, which is more common as people age and become increasingly housebound. How can this work in practice though?  Well, according to a study published by BioMedCentral.com, close to three-quarters of participants who used the application were considered “no longer depressed” once they had completed the study protocol.  The app was set up to do this through behavior activation, through which the patient – with the therapist – is able to identify activities he or she finds positive and thereafter set up a matrix within which he or she will be motivated to engage in them more often.

So ultimately yes, it seems that apps can be helpful to everyone who wishes to improve the health. But it should not negate the fact that it is still equally crucial to make regular contact with one’s health care physician, one-on-one.

Senior Health and Fitness Day

Jennifer

Next week, more than a thousand organizations nationwide will be celebrating the 19th annual Senior Health & Fitness Day.  According to president of Firstat Nursing Services in San Diego, Linnea Goodrich, “National Senior Health & Fitness Day reminds us of the importance of staying active later in life.”  This annual day is a great way for all those seniors who get in-house care to learn healthy nutrition and fitness techniques. They learn how to set up a safe environment and how to easily incorporate exercise into their everyday lives.  Home caregivers help motivate and reassure these elderly people that they can do it and that by adding exercise to their lives they will feel better and have a greater chance of living better quality lives.

So for this Senior Health & Fitness Day, a list of three main points were compiled that should be very helpful to the elderly:  first, they need to ensure their home space is safe as they probably spend a lot of time at home and will be likely engaging in their exercise routines there too.  One slight fall can often be the beginning of the end for the elderly, so doing all they can to avoid that is commendable.  A home caregiver is usually able to set this up for them and help them build up their confidence and their skills.  Second, reintroduce exercise into the lives of the elderly, many of whom have not engaged in exercise for many years and, as now elderly people, do not know how to start.  Perhaps they were pretty active as youngsters, but over the years this has gone awry and now they need assistance in reintroducing it in a fun and safe way.  Third, a qualified caregiver can help the elderly stay motivated.  Everyone can benefit from exercise and the elderly are no exception; they just need to be motivated and find the exercise that works for them.

Ultimately, the main aim of this day is to keep elderly Americans fit, healthy and moving.  The day – that began in 1963 – is always the last Wednesday in May (May being Older Americans Month) and marks the country’s biggest annual health promotion event for the elderly.  It is a time of pride, during which it shows the commitment and recognition of the country of its elderly citizens.  It is a public-private partnership organized by the Mature Market Resource Center.  According to the program manager for NSHFD, Patricia Henze, “our goals for senior day are to make exercise fun, to increase awareness of the benefits of a regular exercise program for older adults, and to encourage all older adults to take advantage of the may health and fitness programs offered in their communities.”

New Jersey: Seniors Mental Health Problems

Jennifer

 

In New Jersey, a project is being undertaken to help seniors dealing with different types of mental health issues.  The city’s Healthcare Foundation has recently made it financially viable to hire four part-time elder-life specialists (ELS) to work with the delirium program at the Overlook Medical Center.

The task of an ELS is to work with: the patient, their families, nursing staff and anyone else involved in the case.  The healthcare plan is discussed amongst all the involved parties.  These specialists are able to provide support that other healthcare individuals simply do not have the time or resources to undertake. For example, they can facilitate the process for the patient’s carers to access alternative treatments, that are not so readily available, as well as ensure proper management of the patient’s sensory impairment, providing for as much mobility as possible. 

In addition, ELS’s relieve the strain on nurses, taking over some of their tasks, such as visiting the patients on a daily basis.  It’s a huge support for everyone. 

HELP: Hospital Elder Life Programs

Hospital Elder Life Programs (HELP) are a superb invention for geriatric care.  Set up to boost the development of interdisciplinary clinical geriatric expertise in all fields, hospitals become recognized as centers for excellence in geriatric care.  It is geriatric professionals – which are often lacking in many states – that form the basis of the HELP program. 

Indeed, as noted in a previous post, as it is, in Canada for example, there are a mere 420 geriatricians available to serve 4.2 million seniors.  So at least if there are more ELS’s and HELP programs, that’s a step in the right direction.  Those professionals who form the HELP team include:  Elder Life Nurse Specialists (nurses with experience in geriatrics), Elder-Life Specialists, Geriatricians, Program Directors (a role that can be undertaken by geriatricians or elder life nurse specialists); interdisciplinary support staff and volunteers.

While there are not nearly enough geriatricians in New Jersey (a mere 298 in Morristown), the increase in elder-life specialists and other workers in the HELP program, will definitely be of assistance.  Just looking at the statistics nationwide, it seems that according to Care Family there is an estimated increase for the next two decades of 13 to 20 percent in the senior population.  Morristown, NJ will follow suit.  Thus more carers – in all professional capacities – for the elderly, are required.  Further, 13.5 percent of the population of NJ is over-65 right now, which is slightly higher than the 13 percent nationwide average.

It is hoped that geriatric care and special assistance for those elderly battling mental health issues will improve in New Jersey as well as nationwide.

Geriatric Issues in India

Jennifer

There are many health issues impacting the elderly everywhere in the world.  A new study however, found that a staggering 25 percent of the seniors in India are suffering from depression; a third has arthritis and a fifth is unable to hear. In addition, it seems this problem is only going to get worse since it is estimated that by next year, there will be 100 million people in the 60+ age group and by 2030, that figure will almost double to 198 million.

So how is India planning on dealing with this phenomenon?  There has been a revision of the National Programme for the Healthcare of the Elderly (NPHCE) which is now planning on establishing 20 institutions that can turn out 40 post-graduates in MD in geriatric medicine annually.  As well, it will have another 6,400 beds in district hospitals and 1,000 beds in medical colleges for the elderly by 2017.

This is definitely a good start but there is still a long way to go until the issue of the elderly is solved in India.

Dealing With an Aging Population

Jennifer

It is the time of baby boomers throughout America, but in Kern County caretakers and physicians are looking to provide solutions to this problem.  A report from the area’s Aging and Adult Services Department has shown that the number of baby boomers is almost 178,000 across the nation. (Baby boomers are those aged 48 to 66).  As CAO of KMC Dr. Eric vanSonnenberg pointed out, “geriatrics is absolutely becoming a booming area.”  The problem is the healthcare workforce is just not equipped to deal with this, according to a report in 2008 from the Institute of Medicine.  Indeed, it found that there is only one geriatrician for every 2,500 seniors in America.   

What can be Done?

According to experts in the area from kern City, the way to deal with this is not by just training more doctors but for physicians across the board to “think differently and communicate more.” For example, if a patient comes in with various ailments including mental issues, the physician should be able to prescribe medications but it might end up too costly for the individual on a low (fixed) income.  Thus if there is a social worker on board, he/she can help with the financial issue and maybe find a generic pill that could reduce costs.

So basically, to improve the situation for the elderly, doctors and caretakers from different disciplines need to get together to discuss how best to proceed.

Plans for Improving Senior Healthcare

Jennifer

At the end of March, healthcare professionals will convene in Long Beach, CA to brainstorm on better ideas for caring for America’s “expanding senior population.”  Clearly the group is looking to the future, since, as Dan Osterweil, MD pointed out, in 20 years’ time, “one of every five Americans will be 65 or older.”  Thus these individuals will need the appropriate care.  Osterweil is the course chair of the Leadership and Management in Geriatrics (LMG) Conference.   The aim thus is to make eldercare more “efficient and less costly.”  For this to be achieved, those in the healthcare profession need to “hone their leadership and management skills,” which is what the conference is focusing on.  

The LMG Conference has been running for a decade in order to help fill the gap in geriatric care.  Sponsored by SCAN Health Plan, it is run in collaboration with the UCLA Academic Geriatric Resource Center and the California Geriatric Education Center.   It offers its participants (comprised of all sorts of health professionals) to brainstorm new ideas on geriatric care as well as giving them the opportunity to get help and guidance from leaders in the field.

The ultimate goal of course is, according to Osterweil, to “actually change behavior in ways that lead to a better patient experience.”

Caring for the Elderly from Afar

Jennifer

What do you do, when you are the sandwich generation and you are simply not living close enough to keep a close eye on your aging loved ones?  Well, first there is the Ideal Life monitoring devices that has been used recently; a wireless device fitted into the homes of your aging parents enabling faraway carers to keep a close eye on their loved ones.  As well, it provides caregivers who are in the vicinity with all the individual’s necessary information.

Vis-à-vis other technological devices, there are various products that can dispense the correct number of pills; track sleep patterns and bathroom activity and also monitor blood pressure.

There are other things one can do from faraway as well.  For example, keeping in close contact with the individual through video chats/Skype is recommended.  You – or someone near by – will probably need to set this up for them ahead of time and teach them how to use it.  Doing this, can give you an idea of their health, just by looking at them; if they are deteriorating you will probably be able to get some kind of sense of it by seeing how they look on a regular basis and noting any dramatic changes that might occur.  In this realm, you should also ensure your loved one is being regularly assessed and monitored by a geriatric care manager.  He or she will also be able to set up services at home and ensure other services are being offered to the patient should the need arise.

Also, it’s a good idea to ensure there is someone nearby in case of emergency, or just for company; keep in touch with that person. From where you are though, you can be sure to have all their medical records up-to-date and on-hand should you need them.

Watch out for small clues – perhaps they didn’t wash their hair or the house is unkempt; did they pay all their bills as they usually do? – this will give you a clue as to whether you need to pay a visit.

It can be done.  These days with the technology available, a lot can be achieved even when you are far away.