Have you ever had the difficult task of convincing your senior person they need assistance with their daily life.  Typically these conversations don’t go over very well.  It is a difficult decision to make when a family member is no longer able to live alone without assistance in order to ensure safety and maintain quality of life.  In my family full of stubborn folks, (see, I get it honestly) I have seen first hand the resistance in bringing in a home health aide. When my grandmother finally agreed, several persons were brought in, but she disliked each one.  She found fault in what was done, and even accused one aide of stealing things she herself misplaced. Worrying about a senior loved one can take a toll on everyone. 

Take responsibility by looking out for the signs that can help indicate it is time to bring in a trained certified home health aide either part time or for more severe cases full time.   For example, does your family member:

1. Gets lost while driving their car in their community
2. Misplace or continue to lose things
3. Require frequent hospitalizations
4. Mix up medications
5. Battle with depression
6. Isolate themselves from friends and family
7. Fall and hurt themselves
8. Have a fear of being robbed when they are not
9. Have difficulty with travel
10. Have trouble preparing their own food
11. Becoming confined to a wheelchair or walker
12. Failure to properly care for their own personal/ hygiene needs
13. Wander

A certified home health aide can provide companionship for your senior loved one, assist in daily activities such as cooking, dressing, bathing, cleaning, bathroom, administering the proper medication, as well as accompanying or driving a senior person to a doctor, and laundry.   The ideal way to attain a home health care aide is to contact an accredited and insured agency.  Do your research and make sure the agency is accredited and insured.  Check to see what training the employees providing care for your loved ones have had as well as what type of background checks were completed. 

There is no easy way to tell your senior loved one that they require a home health aide, though you can make it as painless as possible by working with a patient advocate.  Case Managers can act as a third party and mediator to  determine when they might require some extra help.  Losing your independence is difficult.  With a caring family and a well trained and insured aide the transition can help prolong a senior person’s quality of life.

*adapted from American Care Manager

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These folks were apparently using the government contracts to provide reporting on these monitoring devices as a means to practically print money.  They had a number of tricks up their respective sleeves, including unbundling items so that certain parts of a device could be double billed, providing false information from the results, and repeatedly billing for services for the same patient.  This went on for several years before they got the whistle blown on them.

An interesting point is that this seems to be quite the family affair.  In addition to the husband and wife team mentioned in the article, their grown sons served time in a related criminal case. Robert Parsons and Matthew Parsons both pleaded guilty in 2006 to federal health care fraud charges for using their respective cardiac laboratories, and the Holter monitoring technology developed by their grandfather, Bruce Del Mar, to defraud federal insurance programs. Both were sentenced to one year in prison.

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Nurses Week is celebrated each year from May 6^th til May 12^th, which is the birthday date of Florence Nightingale.

We all know that nursing today is nothing like it was 100 years ago, right?  Just for fun, there is a link to a graduating class from 1910 .  The truth is, I did start this post thinking about how incredibly different the profession is compared to 100 years ago.  Of course, it has been a little while since I took “History of Nursing 101”.  Plus, I had a bit different perspective back then.

When I was doing a little research to write this, it struck me as an older, wiser head now, that while things indeed have changed radically, with technology, education, new opportunities in the field and more, there are many aspects to nursing that really haven’t changed much at all.

If you go to the link http://www.nurseweek.com/features/99-12/workhist.html and read the article, there is a certain sense of how things never change so much as they stay the same.

Here are some items I thought bear reflection:

• No antibiotics, so nurses were in near constant danger of contracting a serious infection from their patients and environment.

• Long hours, tough jobs

• What we call home health care today was huge “back in the day” and called private duty nursing

• You had to love hard work to enjoy being a nurse

• Attention to detail and follow up was a big part of the nurses’ role

• Scientific knowledge (as far as it went) was a requirement

• Knowledge and practice of good hygiene was paramount

• Compassion, empathy and a commitment to service was part of the nurse’s stock in trade

When you look at today’s environment:

• Home health care is back on the rise due to “new” models in medicine

• We do have treatments for the infectious diseases that our foremothers (and fathers) didn’t have, but today we face other, difficult to treat infections, such as MRSA and C-Diff

• You still gotta love the job, at the end of the day!

• Scientific training and education is still the backbone of nursing education

• Hygiene, infection control are still vital

• Long hours, tough jobs

• Compassion, empathy and a commitment to service remain some of the primary characteristics of today’s nurse

So, while we have “come a long way, baby”, our core values as nursing professionals remain the same.  And that’s a good thing!  Here’s to you…Happy Nurse’s Week!

How Nursing was in the 1900′s

Basic information about Nurse’s Week for 2010

Nursing World Organization

Sen. Pat Roberts (R.-Kan.) sponsored an amendment to the health-care reconciliation bill that would have repealed the new tax on medical devices included in the health care law signed by President Obama.

(CNSNews.com) - The Senate defeated three separate amendments offered to the health-care reconciliation bill on Wednesday night that would have abolished or limited the impact of a new tax on medical devices—including prosthetics, such as artificial limbs—that was enacted in the new health-care law President Barack Obama signed.
Sen. Pat Roberts (R.-Kan.),“People with disabilities, diabetics, amputees, people with cancer, just to name some of the people—and more—who will see their costs go up because of this tax. We do not want to do this. Why would we want to do this on those who are most vulnerable?”

As a case manager I see major problems with the new healthcare plan.  I personally think we would have done better with a plan which would have put the healthcare dollars in the hands of the patients in the form of Health Savings Accounts coupled with nurse case managers or primary care physicians as the educators to provide assistance in the decision making process.  This tax on health care devices, including prosthetics, limits innovation.

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Accredited hospitals in America have steadily improved the quality of patient care over a seven-year period, saving lives and improving the health of thousands of patients, according to The Joint Commission’s latest annual report. The report, Improving America’s Hospitals: The Joint Commission’s Report on Quality and Safety 2009, provides scientific evidence of improvements in the care of patients with heart attacks, heart failure, pneumonia, and surgical conditions.

The data shows:

• Hospital performance on two individual measures of quality relating to  inpatient care for childhood asthma is excellent after only one year of  measurement. Specifically, there was 99.8 percent performance on providing  “relievers” to childhood asthma inpatients and 99.1 percent performance on  providing systematic corticosteroids to childhood asthma inpatients.
• The overall heart attack care result improved to 96.7 percent in 2008 from  86.9 percent in 2002. (A 96.7 percent score means that hospitals provided an  evidence-based treatment 967 times for every 1,000 opportunities to do so.)
• The overall heart failure care result improved to 91.6 percent, up from  59.7 percent in 2002, an improvement of 31.9 percentage points.
• The overall 2008 pneumonia care result is 92.9 percent, up from 72.3  percent in 2002 – an improvement of 20.6 percentage points.

Quality, safety and patient satisfaction results for specific hospitals can be found at www.qualitycheck.org. For a complete copy of Improving America’s Hospitals: The Joint Commission’s Report on Quality and Safety 2009, please visit www.jointcommission.org.

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This year marks the centennial year of Florence Nightingale‘s death.  Florence Nightingale (1820-1910) is the founder of modern nursing.  Her contributions to nursing theory, education, practice, research, statistics, public health, and healthcare reform are foundational and inspirational and allow me to do what I do today.  She was a health care advocate to influenced leaders of her time.  She impacted public awareness and changed how people understood and valued health.

Not only was Florence Nightingale a patient advocate, she was also an advocate for nurses and nursing.  She asked that we continually be renewed to sustain our effective, compassionate, and caring practices (something I need to do more of).

This year a grassroots organization has come to honor nurses, our values and wisdom, and to act as catalysts for achieving a healthy world.  There are estimated to be more than 15 million of us.

International Year of the Nurse, has set out 8 goals.

1.  Eradicate extreme poverty and hunger

2. Achieve universal primary education

3. Promote gender equality and empower women

4. Reduce child mortality

5. Improve maternal health

6. Combat HIV, AIDS, malaria, and all communicable/noncommunicable diseases

7. Ensure environmental sustainability

8. Develop a global partnership for development

To learn more go to 2010iynurse.net

In November, there was a story of a young girl, 2 years of age, with major injuries to both of her hands.  She was taken to the local hospital for treatment.  Inadvertently, this young girl had both of her legs amputated, instead of her hands.  This is a headline we have seen too often from hospitals across the United States.  Except, this time, this took place in Africa.   This same story talks of the insensitive approach after the death of a new born baby and the family having to search through baby bodies to find their own child.   See the story here:  http://www.timeslive.co.za/news/article213483.ece

Healthcare has its own challenges regardless of where you may live.  All too often we will raise our voice in detest, complaining about the regulations that we have to follow in our profession and as an industry.  But these very same regulations are in place to prevent wrong site amputations, and prevent a parent from searching for their own dead child.  We could continue to complain about what we do and don’t have in our healthcare system, but it is our system and our responsibility to advocate for own care.  Learn to listen, and listen to question what you do not know or don’t understand.  Get involved in what is happening in the Senate and the House of Representatives.  Pick up the phone, send an email, or write a letter, anything, to become a part of a quickly changing industry that has a direct effect on each and every one of us.  Together, we can make sure that we move forward in our healthcare, and not backwards, like what occurs in other nations.

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October 11th, 2009 starts the weeklong celebration of case managers and the commitments and contributions we make in educating the public.  I have previously been employed with national case management firms who would honor us with activities such as lunches, continuing education seminars and gifts of appreciation.  As a business owner I no longer get to participate in such functions, but it certainly does not diminish my pride in what we offer to the community, our patients, and our fellow healthcare providers.

If you have a firm or facility are are looking for ways to recognize the work of your case management staff, consider suggestions made by CMSA (Case Management Society of America).  They have downloadable resources as well as promotional products that you might wish to use to make this year’s celebration the best ever.

Perhaps you could like to join this exciting field.  To learn more about becoming a certified nurse case manager, check out the Commission for Case Manager Certification.  Even before you become certified you can join CMSA for networking, educational opportunities and assistance in positively impacting and improving patient wellbeing and healthcare outcomes.

Happy Case Management Week!

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As a Nurse Life Care Planner, I often have to research various agencies to determine what resources exist when developing life plans for a catastrophically ill or injured patient.  For the past few years I have been collecting resource links.  For the last six months or so I have been sharing these resources with others in hopes of helping others locate this information in a convenient (and search-able) fashion.  In this edition I have posted some great links that are specific to Arkansas.  Check here for agencies and information regarding a variety of illnesses and conditions.

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