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Home Health for Parkinson’s Disease

April 17, 2014

By, Jessy Draka, Communications Intern

April is Parkinson’s Awareness Month. Muhammad Ali and Michael J. Fox may be familiar people, but how familiar are you with their disease? Many people have misconceptions about Parkinson’s Disease (PD) and education can change that.

Parkinson’s Disease is a neurodegenerative brain disorder, or motor system disorder, that can make walking, talking, and other everyday tasks difficult to complete. Between 50 and 60 thousand Americans are diagnosed with PD each year.

How would you know if you have Parkinson’s disease? The National Parkinson Foundation (NPF) lists ten early warning signs of PD.

Home health is an option for patients with Parkinson’s disease. Support and guidance is important when making this decision and throughout the journey of care. Living at home can be comfortable and safe if certain precautions and preventative steps are taken. Most falls take place in the bathroom. This is an important room to survey and make sure it is safe. Watch our video about the importance of bathroom safety. The kitchen is also a difficult room to navigate and manage, so some reorganization may be helpful to make living at home easier. For more home safety tips, visit the National Parkinson Foundation home safety page.

Kindred at Home provides home health to patients with many diseases, PD included. Physical, speech, and occupational therapies are offered to enhance the patient’s quality of life. Constant exercise and a well-balanced diet can help improve the patient’s health and disease management.

Caring for someone with PD can be accompanied by special challenges and questions. Being educated about the disease and adapting to challenges as the disease progresses can make caregiving easier and less stressful. Due to the multiple symptoms of PD and the side effects of medications that may be prescribed, time and patience is needed to learn how to provide the best care.

Kindred’s Subacute Units: When You’re Out of the Hospital But Not Well Enough to Go Home

April 15, 2014

The typical stay at a traditional hospital is five days. At Kindred Transitional Care Hospitals, the length of stay may be measured in weeks, not days. Why? Because we know that not all patients can recover in five days or less. Some have underlying conditions that make illnesses or other conditions harder to treat. Others are still too ill to return home.

At Kindred Hospitals, we offer a range of services to help patients who need additional time to recover, and the length of the stay depends on the needs of the patient. This includes the specialized services of our Subacute Units, where we work with patients who have an acute illness or injury or worsening of a disease but no longer need the aggressive level of care provided in a hospital. We offer short-term comprehensive inpatient medical care and rehabilitation that is designed to get the patient home or to a facility such as a skilled nursing center.

In a Kindred Subacute Unit, every patient has a team of healthcare professionals with a personalized treatment plan and one goal: To restore health and help the patient achieve maximum independence. We provide care to patients who need between 45 minutes and 12 hours of therapy per week and those who need wound care, IV therapy management, tube feeding and other specialized care. Depending on the patient’s condition, a patient’s team may include rehab therapists, dietitians and respiratory therapists, in addition to physicians, nurses, case management and social workers.

If your hosts asked you about your plans to leave as soon as you arrived at their house, you might be offended. But if you’re a patient in a Kindred Subacute Unit, we’re going to bring it up early and often. The medical term is discharge planning, and it begins on admission. Your care will focus on what you need to get better now and how to care for yourself after you leave. We will teach you and your family members to successfully manage a daily routine after discharge.

Our subacute services include:
• a comprehensive rehabilitation program
• pulmonary and respiratory care
• advanced wound care
• IV antibiotic therapy
• pain management
• cardiac care
• dialysis
• post-surgical care

Learn more about all of the services offered at Kindred Hospitals, or visit our Family Education center for more family resources.

Healthcare Headlines Week of April 7, 2014

April 11, 2014

Healthcare_Headlines_4.7.14Controversial Cuts Rolled Back

The Obama Administration has rolled back proposed cuts to Medicare Advantage, a potential provision of the Affordable Care Act. Reimbursement is now expected to rise 0.4 percent instead of the 1.9 percent reduction that had been talked about before. Read the story

Type of Insurance Affects Access to Primary Care Providers, Study

A new study has found that callers claiming to have private insurance had greater success in securing an appointment with a primary care provider than did their counterparts claiming to be covered by Medicaid — 85 percent to 58 percent to be exact. Read the story

For the new study, the researchers called doctors’ offices in 10 U.S. states to ask about making an appointment as a new patient. The team made about 13,000 calls to almost 8,000 doctors’ offices between November 2012 and April 2013.

Team Care Appeals to Many Seniors

The new model of care that encompasses mid-level clinicians and a team approach is just fine with many Medicare beneficiaries, and they believe it will improve their overall health, according to a new survey. Read the story

Advance Directives Up, But Not Hospice Use

A new study has found that more and more people are using advance directives to instruct doctors and loved ones about their wishes for care should they become incapacitated, but this has not translated into greater use of hospice services. Read the story

Information About Medicare Payments to Doctors Released

The Centers for Medicare and Medicaid Services is making public data that details how Medicare payments are divided up among doctors in various specialties, with ophthalmologists taking in the biggest piece of the pie, particularly when they perform a common treatment for age-related macular degeneration. Read the story

Solutions to Long-Term Care Needs Sought

The Bipartisan Policy Center announced an initiative looking into how to solve the growing long-term care needs in the United States, with an estimated 27 million Americans expected to need long-term care by 2050. Read the story

Moderation May be Key in Running

A new study has found that people who run over 20 miles a week don’t live much longer than those who don’t run much at all, and that running about 1.5 hours per week seems to provide the most benefit to health. Read the story

Citizens’ Roundtable Weighs in on the Affordable Care Act

A USA Today reporter sat down with a group of Coloradans before and after the rollout of the Affordable Care Act and got their viewpoints on the challenges and promise of the new legislation. Read the story

Their stories reflect the promise and the problems of the biggest expansion of health care in America in a half-century. Four are delighted and relieved to finally have health insurance. Three made at least some efforts to sign up but found the process too complicated or confusing to complete. And the final four decided they’d rather take their chances and pay the fine.

Is There a Secret Sauce When it Comes to Living to Age 100?

Researchers have looked into the factors that come into play allowing some people to live decades longer than the average — not surprisingly, abstaining from drinking and smoking is important, but could having a fall birthday increase your chances of making it to the century mark? Read the story

Tips for Eating Healthy in an Airport

Dietitian/nutritionist Keri Gans gives readers some tips on eating healthfully in an airport, and not surprisingly, those delicious-smelling cinnamon buns don’t make the cut. Read the story

Opinions expressed in any of the included stories or their publications do not necessarily reflect the opinions of Kindred Healthcare and this blog post is a compilation of news stories from other sources that have appeared during the past week.

New Law Includes a Hospital Admissions Reduction Program for Skilled Nursing Facilities

April 10, 2014

On April 1, 2014, the Protecting Access to Medicare Act of 2014 was signed into law by President Obama. Most commonly, this legislation is known for providing a one-year patch to the physician Medicare sustainable growth rate – otherwise known as the ‘doc fix’ – but it also includes other important provisions including the extension of the Part B Therapy Cap exceptions process and the establishment of a value-based purchasing (VBP) program for skilled nursing facilities.

In more common terms, the legislation creates hospital readmission reduction program for all patients cared for in nursing centers nationwide. In order to incentivize improvement in preventable admissions to short term hospitals, the legislation establishes an incentive pool for high performers.

In crafting the legislation, policy makers recognized that it will take time for the Department of Health and Human Services (HHS) to identify the most appropriate hospital readmission and for nursing facility providers to prepare for the new policy.

Source: American Health Care Association

Source: American Health Care Association

How will this all work?

After the Secretary of HHS identifies the readmission measure – prior to October 2015 – the Secretary will then establish a performance standard that identifies achievement of a low readmission rates as compared to all SNFs and a performance standard that recognizes individual facility improvement in readmission rates. Based on both standards, the Secretary will then develop a scoring methodology in order to create an annual ranking system.

In order to fund the incentive pool based on performance, beginning on October 1, 2018, two percent of the SNF Medicare payment will be withheld. Of the incentive pool, the law dictates that 50-70 percent of the funds collected are used to reward the highest performers.

Based upon the ranking system, the highest performing centers will receive the highest incentive payments – potentially earning more than the two percent that had been withheld – and the lowest performers would receive no incentive payment.

The performance of all nursing facilities would be publicly reported on the Nursing Home Compare website.

The American Health Care Association has created an issue brief that provides greater detail of the new provision.

What does this mean for Kindred Nursing and Rehabilitation Centers?

Kindred has been committed to reducing unnecessary rehospitalizations for the past several years. As we reported in our 2013 Quality and Social Responsibility Report, from 2009 to 2013 our centers reduced rehospitalizations by 15 percent.

While the methodology and risk adjustment for the HHS rehospitalization measure still has to be determined, the American Health Care Association Quality Initiative uses national MDS 3.0 data from CMS, calculating the 30-day, risk-adjusted readmission rate for all nursing centers using the PointRight OnPoint 30™ rehospitalization measure. Kindred outperformed the national average in 2013 using this same measure.

Healthcare Headlines Week of March 31, 2014

April 4, 2014

Healthcare_Headlines_3.31.14Stroke Patients Have Great Palliative Care Needs, Says American Heart Association

Stroke survivors have an “enormous” need for palliative care that needs to be met by healthcare providers, The American Heart Association said in an issued statement. Read the story

More Than 7 Million Enrolled Under Affordable Care Act

The Obama administration announced that after Monday’s enrollment deadline, more than seven million people have signed up for health plans under the Affordable Care Act. The figure includes enrollees of the federal and state-run marketplaces. Read the story

Insurance Premiums Expected to Increase Next Month

Premiums are expected to rise next month on health plans bought through federal and state marketplaces. Questions remain about what cost increases consumers can expect in months to come. Read the story

Options Explored for Employer Support for Family Caregivers

The demanding nature of family caregiving often presents challenges in the workplace for caregivers. Some propose that employer elder care benefits and caregiver support services could help employees care for aging parents. Read the story

Eighty-percent of long-term care is provided by family caregivers. That translates to $450 billion of care,” said Jody Gastfriend, VP of Senior Care Services at “Employers are waking up to the reality that this is something that’s impacting productivity and engagement, and they’re looking for solutions.”

Diet Drinks Associated with Heart Problems in Women

Older women who frequently consume diet beverages like sodas are at an increased risk of diabetes, blood pressure and cardiovascular complications. Read the story

Chronic Heart Failure Patients Officially Covered by Medicare for Rehab Services

A 2009 study demonstrating the efficacy of exercise interventions for heart failure patients helped convince CMS to cover cardiac rehab services. The broadening of coverage is now official. Read the story

Cardiovascular Exercise During Youth Bodes Well for Cognition in Later Years

Regular exercise as a child may positively affect brain function later in middle age. Read the story

Thousands of Affordable Care Act Customers Given a Grace Period to Enroll

For those who were unable to complete enrollment in a marketplace by the April 1 deadline and were left in a queue, a grace period is instated. Read the story

Efficacy of Cognitive Screening Tools Called Into Question

A recent government report states there is no clear benefit to screening symptom-free adults for cognitive impairments. But The Alzheimer’s Association warns against discounting early detection tools. Read the story

“Early detection of Alzheimer’s disease can empower individuals and their families to take a more proactive approach to care planning and treatment and thus help improve quality of life,” said AFA [Alzheimer’s Foundation of America] CEO Charles J. Fuschillo Jr. in a foundation statement.

Beth Israel Deaconess Medical Center Addresses Hospital Readmissions

As part of the PACT (Post-Acute Care Transitions) Program, the hospital tracks Medicare patients at high-risk for readmission and follows through with patients after discharge. Beth Israel Deaconess Medical Center has reduced readmissions by 25%. Read the story

Opinions expressed in any of the included stories or their publications do not necessarily reflect the opinions of Kindred Healthcare and this blog post is a compilation of news stories from other sources that have appeared during the past week.

Health Essentials: A Good Night’s Sleep

April 3, 2014

Sometimes it seems you’re asleep as soon as your head hits the pillow, but nearly everyone has had nights where they just couldn’t get to sleep right away or they woke up after two or three hours and couldn’t go back to sleep. And most have felt the effects the next day.

Your body needs sleep and not just so you don’t nod off at your desk in the afternoon. How well you sleep impacts your overall health.

Even a short run of sleepless nights can hurt your immune system. In a Mayo Clinic FAQ, Timothy Morgenthaler, MD, explains that “your body needs sleep to fight infectious diseases.” Not only does a lack of sleep make you more vulnerable to viruses, but, “Lack of sleep can also affect how fast you recover if you do get sick,” he says.

The effect is worse when it’s long-term, when it increases the “risk of obesity, diabetes, and heart and blood vessel (cardiovascular) disease,” Dr. Morgenthaler says.

The occasional sleepless night may not be cause for concern, but Cleveland Clinic’s Sleep Disorders Center website notes that around 70 million Americans have a sleep disorder. The good news is that most disorders are treatable with an accurate diagnosis. And Cleveland Clinic, Mayo Clinic and other top medical organizations have programs, research and resources dedicated to furthering our understanding of sleep and helping to treat sleep disorders. Whether you’re a medical professional or you just need help getting a better night’s sleep, resources are readily available.

General resources

Sleep AwarenessA National Sleep Foundation infographic clearly outlines how much sleep we need by age, and illustrates the benefits of sleep and how to improve sleep quality. Cleveland Clinic offers the Go! to Sleep app, designed to “improve your sleep habits,” which will help you rate your sleep quality. For those who want a less technical approach, the Mayo Clinic has a straightforward article: “Sleep tips: 7 steps to better sleep.”

Clinical resources

For the latest research updates, clinicians can access Mayo Clinic sleep articles, and Cleveland Clinic’s Sleep Disorders Center research and clinical trials section. The National Sleep Foundation has patient education information and other resources for medical professionals.

Take some time to focus on the quality of your sleep. A good night’s sleep can also help speed your recovery from a serious injury or illness.

Supporting the Patient and Family: The Role of the Social Worker

April 1, 2014

Terah Hatter can sum up her job in one word – amazing. Her job, she says, “is about caring.”

“It’s an honor to walk beside the patient and family to help them through a difficult time,” says Hatter, LMSW, a social worker for IntegraCare, which is an affiliate of Kindred at Home and an agency that provides home health, hospice and private duty nursing care in Texas.

It’s not so easy to describe a typical day for Hatter, if only because each one presents new challenges.

Each day she reviews referrals, which may come from the patient, family or the healthcare team. Patients may need to have meals delivered to their home or the patient’s primary family caregiver may need someone to stay with the patient while they run errands or even just take a break.

Hatter has a list of community resources but says she also relies on other social workers and agencies to help locate the right resources for each patient and family.

Kindred at HomeOne way Hatter and other IntegraCare social workers help determine those needs is through a “life review.” She describes this review as very “conversational.” The goal, she says, is “to help shine a light on how the patient or family member coped with adversity in the past.” In understanding how people have dealt with other difficult situations, social workers at IntegraCare can help devise the most effective support plans for helping them cope with their illness or the illness of a family member.

In Hatter’s experience, the patient’s family may not all be on the same page, especially with patients in hospice care. She recalls a situation in which one family member continued to believe that the patient would recover, a belief that wasn’t shared by the medical experts or the rest of the family. While it’s a normal part of the grieving process to experience denial, Hatter says that the social worker “is likely to be the person who gives a reality check on the patient’s medical condition and progress.”

It’s a tough job, but Hatter has seen firsthand the rewards of helping families get to a place where they can focus on spending time together and working together to support the patient.

For her patients, too, she knows how beneficial it can be for them to adjust to and face their situation. In some instances, for patients in hospice care, that transition may provide an opportunity for them to accomplish a life goal, which she is happy to help make a reality. For both the patients and their families, Hatter helps pull together all the resources they will need to cope with what could be the most devastating situation they’ve encountered in their lives.

While there are social workers in many areas, including healthcare, the National Association of Social Workers (NASW) describes the general role that every social worker has: “Social workers help individuals, families and groups restore or enhance their capacity for social functioning, and work to create societal conditions that support communities in need.”


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