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Archive for August, 2009

The Centers for Medicare & Medicaid Services (CMS) is part of the federal government’s Department of Health and Human Services. Because many Medicare and Medicaid recipients are elderly, much of the funding goes to nursing homes or eldercare services. Home health agencies that receive certifications from Medicare undergo an assessment every three years. CMS always checks these home health care agencies via quality measures and publishes each agency’s results.

CMS & Home Health

CMS also provides scoring for all Medicare certified home health services via the Home Health Compare. The quality measures take into account: (1) the patient’s improvement in performing a variety of activities of daily living (ADLs), and (2) whether the patient’s health condition improves or stabilizes within time.   It is important to note that the quality measures should only be used as a general guide. Always remember that the recipients in the home health care are elderly and each of them have different needs. Some patients are recovering from surgery or a medical emergency. Others have chronic and worsening medical conditions. Therefore, it is understandable that the lack of improvement in some home health care recipients is not due to poor standards or substandard care, but rather due to declining health. In addition, Medicare’s quality measures for home care are fairly recent and are still being refined. Currently, the quality measures provide a baseline to help consumers see how a local agency compares to both state and national averages.

CMS Quality Measures

The CMS quality measures are used in Medicare certified home health care agencies in order to come up with the final scoring. Medicare details the following quality measures:  Three measures related to improvement in getting around:   The percentage of patients who get better at moving or walking around   Percentage of patients who get better at getting in and out of bed   Percentage of patients who have less pain when moving around    Four measures related to meeting the patient’s activities of daily living:   The percentage of patients whose bladder control improves   Percentage of patients who get better at bathing   Percentage of patients who get better at taking their medicines correctly (by mouth)   Percentage of patients who are short of breath less often  Two measures about how home health care ends:   Percentage of patients who stay at home after an episode of home health care ends   Percentage of patients whose wounds improved or healed after an operation    Three measures related to patient medical emergencies:    Percentage of patients who had to be admitted to the hospital   Percentage of patients who need urgent, unplanned medical care   Percentage of patients who need unplanned medical care related to a wound that is new, is worse, or has become infected

If you happen to be under homecare and if you have to lie immobile for long periods of time, you should pay special attention to the health of your skin, to prevent skin breakdown. Proper skin care helps in preventing pressure sores (bedsores) and will help you feel generally refreshed. Weight loss and the side effects of radiation or chemotherapy can lower your resistance to infections; and since infections are very difficult to treat, the only way is to prevent them. Skin is your body’s first line of defense against infection, and a rupture of the skin exposes you to infections. Germs can enter the body through a cut, an open bedsore, or raw, chafed skin.  Bedsores are caused when an area of skin loses its blood supply for an extended period of time, e.g., when a bony area of the body lies against a surface like a mattress, and nutrients and oxygen are unable to reach the skin cells. The area then begins to break down and the skin cells slowly and eventually die. Parts of your body which are particularly susceptible are the coccyx or tailbone, the hip bones, the spine, elbows, heels and ankles, and the shoulder blades.  If redness doesn’t go away from these bony areas a short time after the pressure is removed, the skin is probably not receiving adequate bloodflow. You may have to tell your senior care caregiver, if you happen to have one

You can always prevent bedsores by changing your bed position frequently, at least every two hours. In addition, placing a cushion on the bony parts of your body is a good way to reduce pressure on the skin. An “egg crate” mattress, or a foam or sheepskin pad will cushion you, as well as providing better air circulation for the skin. You can also use pillows or any other props that can help reducing the pressure on those areas.

Heat and massage are additional means of increasing the blood supply to the skin. Whirlpool baths are ideal for this purpose. Although you can use heat lamps or heating pads, you must take care not to burn your skin, which is already tender. First check with your doctor or nurse to make sure a lamp or heating pad would be helpful to you; and if you do use a pad, keep it turned on “low,” and keep a protective pad or towel between it and your body to avoid skin burns. A warm pair of socks, an extra blanket at the foot of the bed, or fleece-lined booties are often more helpful than heating appliances. (See: Massage Therapy Techniques that will also increase bloodflow to your skin.)

Chafed or irritated skin is caused by a combination of moisture, heat and friction. It occurs most often where skin folds over itself as in the groin area, under the breasts, or in the abdominal area of heavier people. For chafed skin, you want to keep the area clean and dry. Cornstarch applied after bathing or a small amount of talcum powder will help keep the area dry and free of bacteria. Exposing chafed skin to the air for a few minutes twice a day will also help keep it dry.

Good hygiene is the foundation of skin care. If you can, take a daily bath or shower. Even if you are not confined to bed, bathing may be a chore because of the difficulty of climbing in and out of tubs and showers. Try sponging your body at the sink while sitting in a chair. Aids such as bath seats, grab bars, and long-nozzled showerheads make tub or shower bathing much easier. If you are confined to your bed, take a daily sponge bath. Ask your family or you home health care nurses to assist you with the areas which you cannot reach by yourself. There is no one “right” way to give a bedbath. Common sense will dictate the most comfortable and thorough method for you. Don’t forget bath oils if your skin tends to dryness. Massaging body areas with a little lotion after a bath stimulates circulation and prevents skin breakdown.

As an author and business motivational speaker, I have seen the effect on an audience of a well-told story many times. Here’s a short story which, if you live in the US, you will already know. After weighing in a 425 pounds, Jared Fogle decided to go on a ‘Subway Diet’. And, over a period of time, dropped to 180 pounds. An amazing feat!

And an equally amazing response by Subway’s marketplace. On January 1st 2000, Subway introduced Jared in a regional ad campaign. On January 3rd, the chat-show superstar Opera Winfrey called, wanting to interview Jared. And, over the next two years, Subway profits leapt a whopping 34 percent! Wow!

As all business motivational speakers know – like in the impressive Subway ad – the right story can bring outstanding results. And that’s why it’s worth telling stories in a corporate presentation. And so, as you look for suitable stories to tell your business colleagues and/or prospects, here are a couple of pieces of advice to bear in mind.

Get Clear About The Aim Of Your Presentation

Has your speech been written to inspire your team to greater effort? Or is your presentation focused on persuading a prospect to buy your product? A business motivational speaker knows the objective of her speech. As a result, suitable stories readily come to mind.

Fact is, industry speakers rarely have this kind of clarity around their business speeches. And one of the ways an inexperienced speaker can tell that he or she lacks clarity around a topic is that relevant stories are tough to find. However, once you’re  really clear on the point you want to make, you’ll find stories pop-up everywhere you look. Key Point: Don’t forget to write down the story immediately. Otherwise, I swear, you’ll forget it.

The Best Motivational Business Speakers Make Someone Else The Rock Star

Fact: In a business setting, most audiences don’t care about you at all. And so, if all your stories revolve around how clever you are, don’t expect your audience to be impressed. However, make it about them and they will love you for it.

One final (and important) point: inspirational stories don’t need to be long. A brief story is often more than enough to achieve your objective. When you have complete clarity around the goal of your speech, a short (less than ten sentences) story is often more than enough to get your point across.

If you follow these simple pieces of advice your stories will make you sound like a true business motivational speaker. The best of luck for your next speech.

In my first article, I have talked about what a geriatric care manager like me does and when exactly to consider getting a care manager.  My following missives will be guided by your feedback, so please be in touch! Caring for an elderly loved one can be confusing, frustrating and overwhelming. There are many emotional pulls and no single easy solution to any situation you may be facing. Even if one feels that he or she is moving in the right direction, other family members and/or friends may disagree on a route or decision even as a situation moves into a crisis mode.  Ask Yourself: How do you choose the best form of long-term care, the right living situation?  How would you find the time to make phone calls, contact government agencies and visit alternative living facilities?  How do you know which local facilities have a good reputation and whether they might be a good match for your loved one?

We have all been newbies in learning a new skill or a new job, or in moving into a new phase of our lives. Just like those skills, the many aspects of caring for an elderly relative can always be learned. You may be thinking, ” Well, I am learning how and feel fine making decisions, and I am coping. ” Should that be the case, great and congratulate yourself then. Others of you read the above questions and think, ;Yikes! Help me, and fast!;  Or, ” I could figure this all out, but I would rather not. Let someone else give me a hand. “  If all these responses sound just like you, consider calling in a geriatric care manager to work with and guide you.  Those who belong to the first group might want to consider a consultation to help determine if there are other angles or aspects of the situation you are involved in that could be considered.

A helpful care manager will act as a consultant, advocate and problem-solver. She will meet with you and your loved one and sensitively and thoroughly assess his or her overall situation. She will look at the whole person, addressing quality-of-life concerns as well as practical considerations. She will then develop a plan that will enable you to choose the optimal form of senior care, and make the necessary contacts for you. She can usually arrange for care at homes or accompany you as you visit nursing homes and assisted living facilities and arrange for placement. An excellent care manager will talk and coordinate your loved one’s care and act as a liaison with family, friends and health care providers, now and in the future. She also provides counseling and support for you and the family, as well as for your loved one, as you deal with these difficult and stressful transitions. A good geriatric care manager will be there for you and your loved one every step of the way, helping to make your lives as stress-free as possible, while ensuring the best and highest quality of life possible at all times. It is my pleasure to meet each and every one of you. I look forward to getting to know each other through our struggles and triumphs.

Do you happen to have or have had those annoying red blisters on your lip that you can’t obviously hide? Well, then it is more likely that you have a cold sore. Cold sore first appears to be a small, hard spot on your lip that you still can’t see and would then evolve into red blisters after a day or two. Another common term for cold sores is fever blisters and it is primarily caused by several strains of the herpes virus. The certain strain of the virus that more frequently causes cold sores is the Herpes simplex virus type 1. Genital herpes on the other hand is primarily caused by the second strain which is the Herpes simplex virus type 2. But either way, the two strains of the virus are generally capable of causing both illnesses. Unhealthy practices such as sharing of razors, eating utensils, and towels can further spread the infection. Once you have the virus in you, you would be concerned about its being incurable. The virus is incurable and there’s no specific alternative to prevent any contractions of the Herpes virus, but then, there are known few steps to help you reduce the frequency of these cold sores and significantly decrease the duration of an occurrence.

Cold sores are not really that serious but they can be really painful and uncomfortable. A cold sore is quite simple to handle even without having to leave the comfort of your home. All you need is a reliable computer set with fast internet access and you are on your way with all the quick and simple remedies at home.

One initial step in treating your cold sores is by simply covering them with petroleum jelly. Petroleum jellies contain a significant element that help provide a much faster healing process and can also prevent more infection. Petroleum jellies contain a significant element that help provide a much faster healing process and can also prevent more infection. It is very much agreeable that having a red blister on your lips can be very discomforting and awkward to see. Some people might think of using a make-up to hide such an annoying red spot. This practice is highly discouraged as there are certain chemicals in your make-up that can irritate the blisters and even worsen the case. Another important reminder regarding make-up is to avoid sharing your lipstick as it can also help spread the infection.

A good dentist would say that it a healthy practice to change your toothbrush at least once a month. And if you happen to have a cold sore, it is also a perfect time to buy a new toothbrush for yourself. Furthermore, a new toothbrush is also needed right after you have completely healed from the infection as your previous toothbrush may still have the herpes virus and may cause early recurrence. As said earlier, the blisters on your cold sore can be very painful. In this case, it is a good idea to take some pain relievers such as paracetamol, ibuprofen, and aspirin.

Salty foods such as chips should be avoided when you have a cold sore as the salt can only irritate the blisters causing more pain. You also have to refrain from eating acidic foods like citrus fruits as they too can worsen the infection. These summer days, cold sores are more common as heat is a basic factor that enhances its recurrence. To help you effectively protect your lips from it, lip balms with sunscreens up to 15 or higher come very handy.

One important reminder whenever you have cold sore blister, avoid touching the infected area. Squeezing and pinching of the blisters should be avoided as it can make them more infected. To provide some relief, cold compresses as ice packs are perfect alternatives. When in agonizing pain and you seem to be out of paracetamols and ibuprofens, milk is a perfect alternative as pain reliever. All you got to do is soak a cotton ball into the milk and apply it on the sores.

Cold sores are a painful condition and a shameful one as well. With the aid of your computer and a fast and easy internet access, you can make your home into your own personal healing sanctuary with all the helpful cold sore home remedies online. These helpful and reliable tips are yours for the take in just a single click.   

It’s no surprise that with age, seniors often experience increased limitations, the loss of certain abilities and require more assistance with the activities of daily living. It is equally unsurprising that one;s finances  largely influence the types of services and long-term care available to that individual. An experienced financial planner for the elderly can provide the seniors and their families with invaluable advice on money issues and more,  to help seniors find the appropriate solution to their particular situation. Some of the questions a financial  planner can address include:  What type of long-term care can I afford? Will I outlive my assets? How much are all my assets worth? Can I make my assets create more income to meet growing expenses? What do I sell first? What are all my options? What is the cost of selling different assets? Do I have to sell my own house? Are there other financing alternatives? What impact will this have on my spouse and dependents? Is it too late to do any estate planning? What about inheritance issues?

Listening to Your Needs – Financial planners can assist you in understanding and evaluating your decisions,  which will help you avoid confusion, frustration, major errors and family dissension. Financial decisions are more  than about just money, I know from experience how difficult it is for everyone involved. Making major financial  decisions can be even more daunting when you don;t have the detailed knowledge, time, experience or ability. What are the potential impacts and benefits of making one decision over another? So what are the requirements to execute such decisions? Financial planning for senior care begins with acknowledging and considering all present and  possible future situations you might encounter. This can be very difficult as it requires both forward thinking as  well as transitional realism. By ” transitional realism, ” I mean about being realistic about your changing needs, and the impact of those needs on your life as well as the lives of  your loved ones. When evaluating your needs, a financial planner should consider:

Personal care, do you need assistance with activities of daily living? Services, what types of long-term care services do you require? Are there any specific concerns with regards to safety? Transportation;are there physical or financial considerations? Priorities, what are your desires and limitations? Interpersonal relationships;how will financial decisions affect your loved ones? Following is a list that comprises the elements you should consider in identifying  and evaluating your needs. You may want to think about these things before talking to a financial planner to ensure  the time you spend in conversation is well spent. If you happen to have questions about any of these elements, a financial planner  who works with the elderly will be well versed in all of these issues and should be able to address any concerns.  Financial needs Insurance coverage and limitations Income sourcesExpenses (present and future) Assets availabilityReal estate needs Human resources: home health care, personal and quality-of-life issues After you have indentified all of your needs, think about the resources that you will need, and  the ones that you already have at your disposal.

This can help you in developing a plan of action.  Make a list of the following  resources that you might need: Public resources like prepared food services, community activities, religious and charitable assistance/support, etc.Private resources, including family members and/or homecare caregivers. Planning can make a huge difference in finding the best solutions. Knowing all of your needs and resources is paramount before making any major financial changes. Financial decisions should be holistic in nature, therefore recognizing that everyone, seniors and caregivers, all have   different needs and resources, unique to their particular situation. Making financial decisions based only   on your present situation, without full consideration of everything, can have disastrous results.

Misty mountain wilderness is one of the chosen holiday and retreat destination of Australia, preferably sited in between the foremost cities of Sydney and Brisbane and present the paramount calm and serene atmosphere to retreat your stressful mind and body. Many top executives from the corporate sectors are often paying a visit here to get the flawless nutrition to their boiling nerves, disturbed minds and exhausted bodies.

The land of Australia is surrounded by natural wilderness and charming locals and the calamities are also supremely apposite for the health retreat. Moreover, everyone requires a revitalizing atmosphere to refresh their minds and bodies from the hectic schedules of the city in order to value a more calm atmosphere which provides the very required heavenly solitude. The Detox health retreat, health resorts, health retreat NSW, etc. are a few of the most recognized health retreats for incredible spa treatments and a list of appetizing vegetarian food. These retreats offer a wide range of nourishing and stimulating body massage treatments with the assist of the best aromatic oil extracts from the natural flowers, grape seeds, etc.

Thus, people can pick the best suitable massage therapies for their body based on their needs from the variety of offerings. Massage is the most soothing body therapy that promotes the tired cells of the body and revitalizes the body energy. Massages done with the facilitate of therapeutic drug and other proven medicated ointments are also highly helpful in providing the most tranquil effects to the body and offer you a nice tense free deep sleep. You can advantage the most energizing facilities like the sauna bath, in order to acquire relief from tension and thus acquire a god health. It largely facilitates to revitalizes your skin and body cells and give you soothing comforts.

Apart from the retreat services, they offer you the paramount chance to interact with other people and you can discuss freely with them about your custom problems. Here, you can also organize the seminars on topics like, how to escape the mental stress and also relax oneself in the situation of life. Moreover they also have researching facility that is bent on to find the top natural herbs existing from the natural wilderness. Also, for the well being of the people, they sell their herbal medications which prove to be useful for the body. However, their most imperative element is their noble offerings of affordable tariff. They provide the comfy accommodation in the lap of mountains to offer you the total still environment to retreat your mind and body.

Moving a long distance has a whole different set of issues than moving locally and a lot of people find the process unsettling. It can become very difficult to keep track of all that’s going on when you move a long distance. Fortunately, there are methods that can help you maintain control of the situation. One is to use a one-way truck rental, which I will discuss more later.

Local movers can make all the difference, no matter how far you move. That’s because a professional moving company can load your belongings into the truck, so you don’t have to take responsibility for the process. And if you also allow the moving company to do the packing for you, your work will be minimal. Using a professional moving service, however, usually means that you have to allow them to control how your belongings are treated and which packing materials are used.

To gain complete control over the entire move, you’re left with only one real option: renting a truck yourself. That would literally put you in the driver’s seat. At a minimum, you’d have full knowledge of how your items are packed and handled. You’d know that your fragile items would be in good hands because you’d be the one overseeing their care. Saving money is another perk that comes from controlling your own move. And by moving your own things you won’t be forced to use expensive packing materials and can then use less expensive alternatives, such as used boxes you find at your local grocery store. You can also use old linens and towels to wrap your valuables. By taking control of the situation, you would no longer be forced to use expensive materials that a professional moving company use by default.

So if you’re curious about the best way to move or even thinking about moving companies Connecticut, a one-way truck rental might be the best option for you. Depending on how busy you are, you might find that controlling your own move is actually easier than hiring a moving company. People are pretty used to thinking that moving has to be hard or stressful but it doesn’t necessarily have to be that way. Just remember to plan wisely, though, because if you want to reach the end of the move with a smile on your face, you need to make the right decisions from the beginning.

A major fear people have of dying is that they’ll be in pain. Hospice eases that fear by providing palliative care with an emphasis on pain control. The main objective is to relieve symptoms that interfere with one’s quality of life.. Hospice manages emotional and spiritual pain in addition to physical pain. By using a combination of counseling, medication and therapy, hospice care has a very high success rate of easing a patient’s pain. Some families are worried about the thought of their loved ones being so drugged that they are unable to communicate or are unaware of what’s happening. Although this can happen, it’s rare. Fortunately, hospice nurses are capable of providing strong medications and high dosages that will provide comfort without impairing the patient;s alertness.

Hospice supports the Pain Care Bill of Rights, which states that as a person with pain, you have a right to:

Have your report of pain taken seriously and to be treated with dignity and respect by doctors, nurses, pharmacists, and other health care professionals.

Have your pain thoroughly assessed and promptly treated.

Remember to be kept informed by your health provider about what may be causing your pain, possible treatments, and the benefits, risks, and cost of each.

Participate actively in decisions about how to manage your pain.

Have your pain reassessed regularly and your treatment adjusted if your pain hasn;t been eased.

Be referred to a pain specialist if your pain persists.

Get clear and prompt answers to your questions, take time to make decisions, and refuse a particular type of treatment if you choose. CCRCs are living communities for seniors. Most have three levels of residence: independent living, assisted living and skilled nursing. Each level of residence is tied to the level of care that the resident requires. The primary concept behind a CCRC is that it offers a wider spectrum of assisted care, so that once a senior moves into the community, he or she will be able to receive the appropriate care as his or her needs change.

If you think you need a hearing aid, or your family members are constantly at you to get one, the first thing you need to do is get your ears and hearing checked to confirm that you have a hearing loss.Your hearing difficulty may have a simple medical cause unrelated to age or other factors and it’s possible that medical treatment alone will solve the problem.  However, if your GP advises you to, then think about buying a hearing aid. Modern hearing aids cost between £700 and £3,000 each, depending on the model type and technology. So they should definitely go on your contents insurance policy!
Hearing aids are available in different shapes, sizes and types and can be purchased privately.

Hearing aids employ either analogue or digital technology to processes sounds.Some are worn just behind the ear while others fit right inside the ear. Note though that because a hearing aid is digital doesn’t mean it will always be compact and unobtrusive.However, with digital hearing aids it is possible to customise sounds very precisely to suit your hearing loss.   Many digital aids can be programmed with different settings for different sound environments that you can select at the touch of a button.Some digital hearing aids adjust themselves automatically with directional microphones and very good feedback filters so you can pick out individual voices even in a crowded and noisy space.

If you find small or fiddly controls awkward, you may prefer to use the larger type of aids. However, some people find it more convenient to use an in-the-ear type of aid. Behind-the-ear (BTE) hearing aids have an ear mould, which sits right inside your ear. In this model, the hearing aid rests behind your ear and a plastic tube connects it to the ear mould. This is the most common type of hearing aid supplied via the NHS. In-the-ear (ITE) and in-the-canal (ITC) aids have their working parts in the ear mould so the whole aid fits into your ear and is virtually invisible, but if you have severe hearing loss, these aids are not really suitable.

Bone conduction hearing aids (BAHA) are for people with conductive hearing loss or those who cannot wear a conventional hearing aid. They deliver sound through the skull and one type requires a small operation behind the ear to fit.CROS or BiCROS hearing aids are for people with hearing in one ear only. CROS hearing aids pick up sound from the side with no hearing and feed it to your better ear. BiCROS aids amplify sound from both sides and feed it into the ear that has some hearing.

Which type of hearing aid you choose will also depend on how much you’re willing to spend and which technology best suits your hearing loss.  Any decent supplier should be able to provide hearing aid services that will assist you in your choice.