Men account for almost 40% of the caregiver population. In order for male caregivers to properly care for their loved ones, they must remember to care for themselves. Here are seven emotional and physical tips for male caregivers:
1. Participate in a support group.
2. Vary the caregiving responsibilities amongst family members or friends.
3. Exercise on the average of three times per week and maintain a healthy diet.
4. Establish time for meditation.
5. Practice time management.
6. Prepare all necessary documents, i.e.: insurance policies, deeds, loans and funeral arrangements.
7. Stay involved in hobbies.
http://www.caregiver.com/articles/general/7_tips_for_male.htm
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
Sunday, June 24, 2012
Monday, June 18, 2012
23 Tips for Keeping the House Cool
a Care2 favorite by Annie B. Bond
Puzzling out how to keep your house as cool as possible during these hot summer months? Trying to remember the conventional wisdom but not quite sure how it goes? Those window fans, for example, should they be placed to draw air in or out? Upwind or downwind of the dwelling? And what about windows, shades, and awnings? Are windows on the North side of the house better left closed or open during the day? Are awnings better than shades?
Find out the answers to these questions and more, right here:
The recent heat spell on the East Coast dredged these questions up for me, and I am sure these questions are seasonal for many of us. Efficient cooling saves money, energy, and the quality of our lives.
Turning to Consumer Guide to Home Energy Savings by Alex Wilson, Jennifer Thorne, and John Morrill of the American Council for an Energy-Efficient Economy has provided a wealth of answers to just these questions and more. I've compiled 23 tricks about how to keep a house cool to reduce the need for air conditioning from this book, as well as a few from The Real Goods Solar Living Sourcebook. These tips are really useful.
1. Reduce the cooling load by employing cost-effective conservation measures. Provide effective shade for east and west windows. When possible, delay heat-generating activities such as dishwashing until evening on hot days.
2. Over most of the cooling season, keep the house closed tight during the day. Don't let in unwanted heat and humidity. Ventilate at night either naturally or with fans.
3. You can help get rid of unwanted heat through ventilation if the temperature of the incoming air is 77 F or lower. (This strategy works most effectively at night and on cooler days.) Window fans for ventilation are a good option if used properly. They should be located on the downwind side of the house facing out. A window should be open in each room. Interior doors must remain open to allow air flow.
4. Use ceiling fans to increase comfort levels at higher thermostat settings. The standard human comfort range for light clothing in the summer is between 72 F and 78 F. To extend the comfort range to 82 F, you need a breeze of about 2.5 ft/sec or 1.7 mph. A sow-turning ceiling-mounted paddle fan can easily provide this air flow.
5. In hot climates, plant shade trees around the house. Don't plant trees on the South if you want to benefit from passive solar heating in the winter.
6. If you have an older central air conditioner, consider replacing the outdoor compressor with a modern, high-efficiency unit. Make sure that it is properly matched to the indoor unit.
7. If buying a new air conditioner, be sure that it is properly sized. Get assistance from an energy auditor or air conditioning contractor.
8. Buy a high-efficiency air conditioner: for room air conditioners, the energy efficiency ratio (EER) rating should be above 10; for central air conditioners, look for a seasonal energy efficiency ratio (SEER) rating above 12.
9. In hot, humid climates, make sure that the air conditioner you buy will adequately get rid of high humidity. Models with variable or multi-speed blowers are generally best. Try to keep moisture sources out of the house.
10. Try not to use a dehumidifier at the same time your air conditioner is operating. The dehumidifier will increase the cooling load and force the air conditioner to work harder.
11. Seal all air conditioner ducts, and insulate ducts that run through unheated basements, crawl spaces, and attics.
12. Keep the thermostat set at 78 degrees F or higher if using ceiling fans. Don't air-condition unused rooms.
13. Maintain your air conditioners properly to maximize efficiency.
Additional tips from the Real Goods Solar Living Sourcebook, edited by Doug Pratt and the Real Goods staff.
Warm Weather Window Solutions
14. Install white window shades or mini-blinds. Mini-blinds can reduce solar heat gain by 40-50 percent.
15. Close south and west-facing curtains during the day for any window that gets direct sunlight. Keep these windows closed, too.
16. Install awnings on south-facing windows, where there's insufficient roof overhang to provide shade.
17. Hang tightly woven screens or bamboo shades outside the window during the summer to stop 60 to 80 percent of the sun's heat from getting to the windows.
18. Apply low-e films.
19. Consider exotic infills in your windows, a new technology that fills the space between panes with krypton or argon, gasses that have lower conductivity than air, and which boost R-values.
Tips for your A/C
19. Provide shade for your room A/C, or the outside half of your central A/C if at all possible. This will increase the unit's efficiency by 5 percent to 10 percent.
20. Clean your A/C's air filter every month during cooling season. Normal dust build-up can reduce air flow by 1 percent per week.
22. Turn off your A/C when you leave for more than an hour.
23. Several studies have found that most central air conditioning systems are oversized by 50 percent or more.
Read more: Home, Reduce, Recycle & Reuse
Adapted from Consumer Guide to Home Energy Savings, by by Alex Wilson, Jennifer Thorne, and John Morrill. Copyright (c) 2000 by the American Council for an Energy-Efficient Economy . Reprinted by permission of Chelsea Green Publishing Company.
Adapted from Consumer Guide to Home Energy Savings, by Alex Wilson, Jennifer Thorne, and John Morrill.
http://www.care2.com/greenliving/keep-house-cool-23-tips.html#ixzz1yCEJFSYG
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
Puzzling out how to keep your house as cool as possible during these hot summer months? Trying to remember the conventional wisdom but not quite sure how it goes? Those window fans, for example, should they be placed to draw air in or out? Upwind or downwind of the dwelling? And what about windows, shades, and awnings? Are windows on the North side of the house better left closed or open during the day? Are awnings better than shades?
Find out the answers to these questions and more, right here:
The recent heat spell on the East Coast dredged these questions up for me, and I am sure these questions are seasonal for many of us. Efficient cooling saves money, energy, and the quality of our lives.
Turning to Consumer Guide to Home Energy Savings by Alex Wilson, Jennifer Thorne, and John Morrill of the American Council for an Energy-Efficient Economy has provided a wealth of answers to just these questions and more. I've compiled 23 tricks about how to keep a house cool to reduce the need for air conditioning from this book, as well as a few from The Real Goods Solar Living Sourcebook. These tips are really useful.
1. Reduce the cooling load by employing cost-effective conservation measures. Provide effective shade for east and west windows. When possible, delay heat-generating activities such as dishwashing until evening on hot days.
2. Over most of the cooling season, keep the house closed tight during the day. Don't let in unwanted heat and humidity. Ventilate at night either naturally or with fans.
3. You can help get rid of unwanted heat through ventilation if the temperature of the incoming air is 77 F or lower. (This strategy works most effectively at night and on cooler days.) Window fans for ventilation are a good option if used properly. They should be located on the downwind side of the house facing out. A window should be open in each room. Interior doors must remain open to allow air flow.
4. Use ceiling fans to increase comfort levels at higher thermostat settings. The standard human comfort range for light clothing in the summer is between 72 F and 78 F. To extend the comfort range to 82 F, you need a breeze of about 2.5 ft/sec or 1.7 mph. A sow-turning ceiling-mounted paddle fan can easily provide this air flow.
5. In hot climates, plant shade trees around the house. Don't plant trees on the South if you want to benefit from passive solar heating in the winter.
6. If you have an older central air conditioner, consider replacing the outdoor compressor with a modern, high-efficiency unit. Make sure that it is properly matched to the indoor unit.
7. If buying a new air conditioner, be sure that it is properly sized. Get assistance from an energy auditor or air conditioning contractor.
8. Buy a high-efficiency air conditioner: for room air conditioners, the energy efficiency ratio (EER) rating should be above 10; for central air conditioners, look for a seasonal energy efficiency ratio (SEER) rating above 12.
9. In hot, humid climates, make sure that the air conditioner you buy will adequately get rid of high humidity. Models with variable or multi-speed blowers are generally best. Try to keep moisture sources out of the house.
10. Try not to use a dehumidifier at the same time your air conditioner is operating. The dehumidifier will increase the cooling load and force the air conditioner to work harder.
11. Seal all air conditioner ducts, and insulate ducts that run through unheated basements, crawl spaces, and attics.
12. Keep the thermostat set at 78 degrees F or higher if using ceiling fans. Don't air-condition unused rooms.
13. Maintain your air conditioners properly to maximize efficiency.
Additional tips from the Real Goods Solar Living Sourcebook, edited by Doug Pratt and the Real Goods staff.
Warm Weather Window Solutions
14. Install white window shades or mini-blinds. Mini-blinds can reduce solar heat gain by 40-50 percent.
15. Close south and west-facing curtains during the day for any window that gets direct sunlight. Keep these windows closed, too.
16. Install awnings on south-facing windows, where there's insufficient roof overhang to provide shade.
17. Hang tightly woven screens or bamboo shades outside the window during the summer to stop 60 to 80 percent of the sun's heat from getting to the windows.
18. Apply low-e films.
19. Consider exotic infills in your windows, a new technology that fills the space between panes with krypton or argon, gasses that have lower conductivity than air, and which boost R-values.
Tips for your A/C
19. Provide shade for your room A/C, or the outside half of your central A/C if at all possible. This will increase the unit's efficiency by 5 percent to 10 percent.
20. Clean your A/C's air filter every month during cooling season. Normal dust build-up can reduce air flow by 1 percent per week.
22. Turn off your A/C when you leave for more than an hour.
23. Several studies have found that most central air conditioning systems are oversized by 50 percent or more.
Read more: Home, Reduce, Recycle & Reuse
Adapted from Consumer Guide to Home Energy Savings, by by Alex Wilson, Jennifer Thorne, and John Morrill. Copyright (c) 2000 by the American Council for an Energy-Efficient Economy . Reprinted by permission of Chelsea Green Publishing Company.
Adapted from Consumer Guide to Home Energy Savings, by Alex Wilson, Jennifer Thorne, and John Morrill.
http://www.care2.com/greenliving/keep-house-cool-23-tips.html#ixzz1yCEJFSYG
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
Sunday, June 10, 2012
Personality Secrets to a Long Life
Researchers Find Centenarians Optimistic, Extroverted, Positive; Some Became That Way Later in Life
By Kathleen Doheny Reviewed by Laura J. Martin, MD
WebMD Health News
May 30, 2012 -- A new study may offer some tips to help you stick around for your 100th birthday.
Try to be optimistic, easygoing, sociable, and conscientious. Don't bottle up your feelings. Suppress the urge to talk ill of others, the new research suggests.
That combination of personality factors seems to describe the secrets of living to 100, says researcher Nir Barzilai, PhD, director of the Institute for Aging Research at Albert Einstein College of Medicine in the Bronx, N.Y.
Those findings are among the latest from Barzilai's ongoing Longevity Genes Project.
While Barzilai found that those personality factors offer more clues to longevity, he has a caveat: "Still the No. 1 predictor for being a centenarian is if you have parents who are centenarians."
Even so, he is trying to answer the question: "Are the genes that are longevity genes also personality genes?"
The new research is published in the journal Aging.
And that has captured his research interest and that of others around the country. "There are several groups doing studies on centenarians," Barzilai says.
Some research has already suggested that centenarians share particular personality traits.
Among them: being extroverted and agreeable.
Barzilai decided to look more closely at genetically based personality characteristics.
He recruited 243 centenarians. He gave them and their family members questionnaires that asked if they had characteristics such as optimism.
He gauged how easygoing they were, how outgoing, and how much they laughed. He looked at how freely they expressed emotions.
He looked at characteristics like conscientiousness, such as a tendency to be self-disciplined.
He looked at neuroticism, a tendency to express negatives emotions such as anxiety, anger, or guilt.
He compared their scores to averages found in the U.S. population.
He also did a validation study to reduce the impact of any mental impairment. Nineteen centenarians and 26 of their children participated in the validation study.
In general, he found those who live to 100:
The link he found is just that, Barzilai says. "It doesn't mean there is a cause-and-effect relationship."
One problem, he says, is they don't have -- and can't have -- a comparison group. "Their friends died years ago, and younger people won't work [as a comparison group]," he says.
One surprise? Some of the 100-year-olds, he found out, were not always easygoing and agreeable, he says. He found that out while talking to some of the centenarians' children.
"There is some adaptation with age," he says. "You try to focus on the good things and not on the bad."
"If they are getting hit [with problems]," he says of his centenarians, "they roll with the punches and they smile. When they are healthy and they get to 100, they are very agreeable.''
The easygoing personalities didn't hold across the board. He tells of one woman's daughter who confided that her mother was mean.
Later, her siblings declined to even talk to Barzilai for the study because they had nothing to do with their mother.
Her own research on centenarians has found some similar links. She reviewed the study findings.
"We know personality has a strong genetic background," she says. Those who live to 100, Jopp says, "seem to have a very special psychological makeup."
Those who age successfully adjust their expectations about health, she has found. They accept a few aches and pains, she says. They don't focus on complaints, such as having trouble sleeping.
Based on her work and that of others, Jopp says for now she can give this advice to those who want to make it to 100: "Don't get too stressed out," she says.
"People who are optimistic and look positively into the future have not only a better time, but it may help them live longer," she says.
In her research, she finds those living to 100 tend to be well aware of their limited life expectancy, but to continue to make plans anyway.
http://www.webmd.com/healthy-aging/news/20120530/personality-secrets-to-long-life
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
By Kathleen Doheny Reviewed by Laura J. Martin, MD
WebMD Health News
May 30, 2012 -- A new study may offer some tips to help you stick around for your 100th birthday.
Try to be optimistic, easygoing, sociable, and conscientious. Don't bottle up your feelings. Suppress the urge to talk ill of others, the new research suggests.
That combination of personality factors seems to describe the secrets of living to 100, says researcher Nir Barzilai, PhD, director of the Institute for Aging Research at Albert Einstein College of Medicine in the Bronx, N.Y.
Those findings are among the latest from Barzilai's ongoing Longevity Genes Project.
While Barzilai found that those personality factors offer more clues to longevity, he has a caveat: "Still the No. 1 predictor for being a centenarian is if you have parents who are centenarians."
Even so, he is trying to answer the question: "Are the genes that are longevity genes also personality genes?"
The new research is published in the journal Aging.
Longevity & Personality Study
Living to 100 years old is still rare. About 53,000 people in the U.S., or 0.2% of the population, are 100-plus. However, the number of centenarians has been increasing about 8% a year, Barzilai says.And that has captured his research interest and that of others around the country. "There are several groups doing studies on centenarians," Barzilai says.
Some research has already suggested that centenarians share particular personality traits.
Among them: being extroverted and agreeable.
Barzilai decided to look more closely at genetically based personality characteristics.
He recruited 243 centenarians. He gave them and their family members questionnaires that asked if they had characteristics such as optimism.
He gauged how easygoing they were, how outgoing, and how much they laughed. He looked at how freely they expressed emotions.
He looked at characteristics like conscientiousness, such as a tendency to be self-disciplined.
He looked at neuroticism, a tendency to express negatives emotions such as anxiety, anger, or guilt.
He compared their scores to averages found in the U.S. population.
He also did a validation study to reduce the impact of any mental impairment. Nineteen centenarians and 26 of their children participated in the validation study.
In general, he found those who live to 100:
- Are outgoing
- Are positive -- not the type to talk ill of others
- Laugh often
- Express emotions
- Are conscientious
- Are not neurotic
The link he found is just that, Barzilai says. "It doesn't mean there is a cause-and-effect relationship."
One problem, he says, is they don't have -- and can't have -- a comparison group. "Their friends died years ago, and younger people won't work [as a comparison group]," he says.
One surprise? Some of the 100-year-olds, he found out, were not always easygoing and agreeable, he says. He found that out while talking to some of the centenarians' children.
"There is some adaptation with age," he says. "You try to focus on the good things and not on the bad."
"If they are getting hit [with problems]," he says of his centenarians, "they roll with the punches and they smile. When they are healthy and they get to 100, they are very agreeable.''
The easygoing personalities didn't hold across the board. He tells of one woman's daughter who confided that her mother was mean.
Later, her siblings declined to even talk to Barzilai for the study because they had nothing to do with their mother.
Personality & Longevity: Perspective
"I really believe these are some of the mechanisms [of longevity]," says Daniela Jopp, PhD, assistant professor of psychology at Fordham University.Her own research on centenarians has found some similar links. She reviewed the study findings.
"We know personality has a strong genetic background," she says. Those who live to 100, Jopp says, "seem to have a very special psychological makeup."
Those who age successfully adjust their expectations about health, she has found. They accept a few aches and pains, she says. They don't focus on complaints, such as having trouble sleeping.
Based on her work and that of others, Jopp says for now she can give this advice to those who want to make it to 100: "Don't get too stressed out," she says.
"People who are optimistic and look positively into the future have not only a better time, but it may help them live longer," she says.
In her research, she finds those living to 100 tend to be well aware of their limited life expectancy, but to continue to make plans anyway.
http://www.webmd.com/healthy-aging/news/20120530/personality-secrets-to-long-life
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
Sunday, June 3, 2012
Some Patients Can Choose To Be Hospitalized At Home
By Judith Graham
May 29, 2012
This story was produced in collaboration with
ALBUQUERQUE -- The man's face was pasty, his eyes closed as he lay back in bed waiting for a wave of nausea to pass. Dr. Elizabeth Ward bent over him after checking his temperature, blood pressure, and oxygen levels and finding that all were normal.
Physician Elizabeth Ward, a provider with Presbyterian Health Care System's Hospital at Home program in Albuquerque, N.M., follows up with Pamela Blondin, whose husband is being treated daily for colitis. (Photo by Rick M. Scibelli for USA Today)
"Would you rather stay home or go to the hospital?" she asked Frank Blondin, 52, who suffers from severe rheumatoid arthritis and heart disease, and had a nasty diarrhea-inducing bacterial infection.
"Home," Blondin responded, without hesitation.
Soon, the doctor was managing a "hospital at home" admission for Blondin -- an arrangement allowing him to receive intensive care and medical monitoring in the quiet of his own bedroom. Medical supplies and medications would be delivered as soon as possible, she told Blondin's wife, Pamela. A nurse would come within the hour, take laboratory samples, and return later that afternoon and in the days to come. Ward would check in by phone, visit daily, and help would be available 24/7 if required.
"Hospital at home" programs fundamentally refashion care for chronically ill patients who have acute medical problems -- testing traditional notions of how services should be delivered when people become seriously ill. Only a handful of such initiatives exist, including the Albuquerque program, run by Presbyterian Healthcare Services, and programs in Portland, Ore., Honolulu, Boise, Idaho, and New Orleans offered through the Veterans Health Administration.
But the concept – which has been adopted in Australia, England, Israel and Canada -- is getting attention here with increased pressure from the national health overhaul to improve the quality of medical care and lower costs. Hospital at home programs do both, according to research led by Dr. Bruce Leff, the director of geriatric health services research at Johns Hopkins School of Medicine in Baltimore who pioneered the concept.
In a study of three experimental hospital at home programs published in 2005 in the Annals of Internal Medicine, Leff demonstrated that patient outcomes were similar or better, satisfaction was higher and costs were 32 percent less than for traditional hospitalizations.
The initial programs focused on people with four conditions -- chronic obstructive pulmonary disease, congestive heart failure, pneumonia and skin infections known as cellulitis. Presbyterian Healthcare has expanded the list to include patients with dehydration, nausea, urinary tract infections, blood clots, and some artery blockages in the lungs.
Excluded are patients who are medically unstable or who cannot be cared for adequately at home. "The patient, the family, the nurse, the doctor and the referring physician all need to feel if it's safe," said Dr. Scott Mader, clinical director of rehabilitation and long-term care at the Portland VA Medical Center, which recently treated its 1,000th hospital at home patient. If patients take a turn for the worse, for instance developing chest pain, an ambulance is summoned to take them to the hospital.
'It's Going To Be Very Common'
In most programs, doctors examine the patient daily and nurses and aides come up to three times a day, often for an extended period. Patients are admitted for three to five days after being seen in the emergency room, referred by a physician or discharged early from a hospital.
Last year, the Cochrane Collaboration, an international organization that evaluates the evidence supporting health care interventions, published a review of 10 randomized controlled studies on hospital at home programs; it found that 38 percent fewer patients in these programs had died after six months, compared to those who underwent traditional hospitalizations.
"Imagine if there was a pill that did that: everyone would want it," Leff said.
"It's a very successful model and in five years, I think it's going to be very common. But we're still in the early adoption phase," said Mark McClelland, an assistant professor at the Center for Health Care Quality at George Washington University.
Among current plans for hospital at home programs:
For physicians, "doing hospital-level services at home sounds scary" and "it's a big jump" that they haven't yet embraced, said McClelland. Starting a program requires a considerable up-front investment of time and money, and it's not a priority for many institutions distracted by the pressures of the national health overhaul, he said. Indeed, keeping beds full is a financial mandate for most hospitals.
That may change as hospitals and doctors form new structures known as "accountable care organizations (ACOs)" that are promoted in the health care overhaul. ACOs call for providers to restructure how medical care is delivered while participating in the financial rewards and risks of those changes.
Presbyterian Healthcare in Albuquerque is New Mexico's largest health care system, including eight hospitals, 36 clinics, a large physician group, five home health care agencies, and its own 413,000 member health plan.
Because Presbyterian has control over how that health plan pays for services, it was able to start a hospital at home program in 2008 with a reliable funding base. As for the motivation, "We are never going to build enough bricks and mortar (institutions) to provide care for all the baby boomers and the elderly who will need it by 2030," said Lesley Cryer, executive director of Presbyterian Home Healthcare. "So, we've got to find alternatives like this."
Patients Appreciate Being Home
On a recent morning in Albuquerque, Dr. Melanie Van Amsterdam, one of three doctors who provide hospital at home care for Presbyterian, stopped in to see Rosa Sota, 76, who had fallen on a doorstep, cut herself above her right eyebrow, and developed cellulitis.
Van Amsterdam set a chair in front of the older woman, who was lying on a couch in her small living room with a pinched expression. The doctor did a careful examination, then explained the course of treatment she was ordering.
"It's better in my house because if I need to eat, I don't have to push a button. I can go to the kitchen for myself," Sota said, as her husband Ruben nodded in agreement a few feet away. "And here I sleep better because you don't have all the people coming and going and I don't feel so nervous."
For Frank Blondin, care began with a call for help from a home health nurse. Within an hour, Ward arrived, performed a thorough evaluation, obtained the patient's consent for a hospital at home admission, and decided on a treatment for his main medical issues -- dehydration and the infection. Then, Ward sat down to carefully review Blondin's history and medications with his wife and explain that risks were slightly higher that complications would not be dealt with as quickly as in the hospital.
"Is that OK by you?" the doctor asked.
"I'm a little apprehensive because I've had to call 911 so many times for Frank," Pamela Blondin admitted. "But he really wants to be home and I'd much rather have him here. Even though there's a bit of a fear factor, I have to tell you, I appreciate having the choice."
This article was produced by Kaiser Health News with support from The SCAN Foundation.
http://www.kaiserhealthnews.org/Stories/2012/May/30/Graham-Hospital-At-Home.aspx
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
May 29, 2012
This story was produced in collaboration with
ALBUQUERQUE -- The man's face was pasty, his eyes closed as he lay back in bed waiting for a wave of nausea to pass. Dr. Elizabeth Ward bent over him after checking his temperature, blood pressure, and oxygen levels and finding that all were normal.
Physician Elizabeth Ward, a provider with Presbyterian Health Care System's Hospital at Home program in Albuquerque, N.M., follows up with Pamela Blondin, whose husband is being treated daily for colitis. (Photo by Rick M. Scibelli for USA Today)
"Would you rather stay home or go to the hospital?" she asked Frank Blondin, 52, who suffers from severe rheumatoid arthritis and heart disease, and had a nasty diarrhea-inducing bacterial infection.
"Home," Blondin responded, without hesitation.
Soon, the doctor was managing a "hospital at home" admission for Blondin -- an arrangement allowing him to receive intensive care and medical monitoring in the quiet of his own bedroom. Medical supplies and medications would be delivered as soon as possible, she told Blondin's wife, Pamela. A nurse would come within the hour, take laboratory samples, and return later that afternoon and in the days to come. Ward would check in by phone, visit daily, and help would be available 24/7 if required.
"Hospital at home" programs fundamentally refashion care for chronically ill patients who have acute medical problems -- testing traditional notions of how services should be delivered when people become seriously ill. Only a handful of such initiatives exist, including the Albuquerque program, run by Presbyterian Healthcare Services, and programs in Portland, Ore., Honolulu, Boise, Idaho, and New Orleans offered through the Veterans Health Administration.
But the concept – which has been adopted in Australia, England, Israel and Canada -- is getting attention here with increased pressure from the national health overhaul to improve the quality of medical care and lower costs. Hospital at home programs do both, according to research led by Dr. Bruce Leff, the director of geriatric health services research at Johns Hopkins School of Medicine in Baltimore who pioneered the concept.
In a study of three experimental hospital at home programs published in 2005 in the Annals of Internal Medicine, Leff demonstrated that patient outcomes were similar or better, satisfaction was higher and costs were 32 percent less than for traditional hospitalizations.
The initial programs focused on people with four conditions -- chronic obstructive pulmonary disease, congestive heart failure, pneumonia and skin infections known as cellulitis. Presbyterian Healthcare has expanded the list to include patients with dehydration, nausea, urinary tract infections, blood clots, and some artery blockages in the lungs.
Excluded are patients who are medically unstable or who cannot be cared for adequately at home. "The patient, the family, the nurse, the doctor and the referring physician all need to feel if it's safe," said Dr. Scott Mader, clinical director of rehabilitation and long-term care at the Portland VA Medical Center, which recently treated its 1,000th hospital at home patient. If patients take a turn for the worse, for instance developing chest pain, an ambulance is summoned to take them to the hospital.
'It's Going To Be Very Common'
In most programs, doctors examine the patient daily and nurses and aides come up to three times a day, often for an extended period. Patients are admitted for three to five days after being seen in the emergency room, referred by a physician or discharged early from a hospital.
Last year, the Cochrane Collaboration, an international organization that evaluates the evidence supporting health care interventions, published a review of 10 randomized controlled studies on hospital at home programs; it found that 38 percent fewer patients in these programs had died after six months, compared to those who underwent traditional hospitalizations.
"Imagine if there was a pill that did that: everyone would want it," Leff said.
"It's a very successful model and in five years, I think it's going to be very common. But we're still in the early adoption phase," said Mark McClelland, an assistant professor at the Center for Health Care Quality at George Washington University.
Among current plans for hospital at home programs:
- Presbyterian Healthcare and McClelland's center have applied for a Medicare "innovation" grant to bring hospital at home programs to sites in Illinois, Rhode Island, New York, Florida and Minnesota.
- This summer, Centura Health, Colorado's largest hospital system, plans to launch a hospital at home experiment in Colorado Springs, with United HealthCare's Secure Horizons Medicare managed care plan as a partner.
- The Veterans Health Administration has approved funding for a new hospital at home program in Philadelphia and an expanded program in Honolulu, said Kenneth Shay, director of geriatric programs for the VHA. "This is a very patient-centered model of care that also has the potential to reduce rates of hospital-related complications" such as infections, medication mix-ups, and delirium, Shay said.
- Clinically Home, a commercial venture, has developed a hospital at home model that involves caring for patients over 35 days, combining acute and post-acute care. Kaleida Health, the largest health care system in western New York, wants to sign on to start a program later this year – if it can convince local insurers to come on board, said Donald Boyd, senior vice president.
For physicians, "doing hospital-level services at home sounds scary" and "it's a big jump" that they haven't yet embraced, said McClelland. Starting a program requires a considerable up-front investment of time and money, and it's not a priority for many institutions distracted by the pressures of the national health overhaul, he said. Indeed, keeping beds full is a financial mandate for most hospitals.
That may change as hospitals and doctors form new structures known as "accountable care organizations (ACOs)" that are promoted in the health care overhaul. ACOs call for providers to restructure how medical care is delivered while participating in the financial rewards and risks of those changes.
Presbyterian Healthcare in Albuquerque is New Mexico's largest health care system, including eight hospitals, 36 clinics, a large physician group, five home health care agencies, and its own 413,000 member health plan.
Because Presbyterian has control over how that health plan pays for services, it was able to start a hospital at home program in 2008 with a reliable funding base. As for the motivation, "We are never going to build enough bricks and mortar (institutions) to provide care for all the baby boomers and the elderly who will need it by 2030," said Lesley Cryer, executive director of Presbyterian Home Healthcare. "So, we've got to find alternatives like this."
Patients Appreciate Being Home
On a recent morning in Albuquerque, Dr. Melanie Van Amsterdam, one of three doctors who provide hospital at home care for Presbyterian, stopped in to see Rosa Sota, 76, who had fallen on a doorstep, cut herself above her right eyebrow, and developed cellulitis.
Van Amsterdam set a chair in front of the older woman, who was lying on a couch in her small living room with a pinched expression. The doctor did a careful examination, then explained the course of treatment she was ordering.
"It's better in my house because if I need to eat, I don't have to push a button. I can go to the kitchen for myself," Sota said, as her husband Ruben nodded in agreement a few feet away. "And here I sleep better because you don't have all the people coming and going and I don't feel so nervous."
For Frank Blondin, care began with a call for help from a home health nurse. Within an hour, Ward arrived, performed a thorough evaluation, obtained the patient's consent for a hospital at home admission, and decided on a treatment for his main medical issues -- dehydration and the infection. Then, Ward sat down to carefully review Blondin's history and medications with his wife and explain that risks were slightly higher that complications would not be dealt with as quickly as in the hospital.
"Is that OK by you?" the doctor asked.
"I'm a little apprehensive because I've had to call 911 so many times for Frank," Pamela Blondin admitted. "But he really wants to be home and I'd much rather have him here. Even though there's a bit of a fear factor, I have to tell you, I appreciate having the choice."
This article was produced by Kaiser Health News with support from The SCAN Foundation.
http://www.kaiserhealthnews.org/Stories/2012/May/30/Graham-Hospital-At-Home.aspx
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