Warning: stay away from the hospital in July!

Are hospitals really more dangerous in July? Is there any truth to the rumor that there are more deaths and major complications in July? for years, there has been talk in the medical community about getting sick in July. One of the reasons that this is a concern is that U.S. doctors begin their residencies at teaching hospitals on July 1st.

July is when hospitals get their new groups of interns and resident physicians, and many believe a time when we see the most medical mistakes. It’s the so-called “July Effect”.

There has been some new research that deems that there is some truth to it.  Researchers from the University of California at San Diego investigated more than 62 million U.S. death certificates over a 27 year span. Nearly 250,000 of those deaths were caused by medication errors in a hospital. Research has shown that there is no spike in deaths or major complications in July or during full moons, Fridays or late afternoons. However, medication errors that result in death do increase by 10% at teaching hospitals during the month of July.

• Month to month, the statistics showed a relatively equal chance for a fatal medication error — except at teaching hospitals in the month of July.
• The study found that fatal medication errors spiked by 10 percent in July in counties with a high number of teaching hospitals, but stayed the same in areas without teaching hospitals.

“David Phillips, the lead author of the study, says “there’s something going on at teaching hospitals in July, and the most common thing people think of was residents starting.”

Phillips, a sociologist at the University of California-San Diego has reviewed 62 million deaths between 1979 and 2006 and focused on 244,388 fatal drug errors. The study found no spike in such deaths outside of hospitals or in counties without teaching hospitals.

And, Phillips says, he found no sign such deaths were decreasing amid rising concerns about patient safety and residents’ long work hours (which were cut in 2003). More study is needed, he says, to see if non-fatal drug errors also rise in July.”  USA Today

Hospitals in July are full of new people — not only doctors, but nurses, pharmacists and other caregivers fresh from graduation so it must be a pretty confusing place to be.

Summer travel tips – flying with an elderly person

If you have flown lately then you know how exacerbating it can be. Flight plans change for many reasons. Sometimes it is mechanical, often it is the weather. Lately it seems to be occurring more and more frequently. Traveling alone can be challenging so imagine traveling with someone has special considerations.

Airports can be daunting and confusing. It can be hard to hear the announcements, read the flight schedules and get to the correct terminal on time. Adding in the new security measures only causes more confusion to an already overwhelming experience.

The best advice is to plan ahead and address as many of the following issues as you can:

? Consider any health problems or issues Ask the elderly person’s physician just to address any concerns or recommendations.

? Because airlines do not offer meal options, it is wise to pack a light carry-on bag that contains a snack, a bottle of water and a two to three day supply of medication.

? Check for senior discounts with your travel agent or airline reservations.  If your travel companion is over the age of 65, they may qualify for a discounted ticket fare. Check the other fares as well, as the specials are sometimes cheaper than the senior discount.

? Ask in advance for any additional assistance that you may need such as a wheelchair or attendant.

? If your travel plans are flexible, consider traveling in mid-week or in the middle of the day when the airport is generally less crowded. Your elderly traveling companion may do better on a less crowded flight.

? Allow plenty of time for the arrival and check-in process. Many senior fares require check-in at the ticket counter to show proof of age. Keep the boarding pass and proof of identification handy for the security check points.

? Take a few extra minutes to eat something, take any medication and go to the restroom once you have passed through security.

? The airplane air exchange system causes dehydration.

? Stay hydrated by drinking plenty of water.

? Encourage your elderly companion to get up and move around especially on longer flights.

? The boarding process usually begins 30 minutes before scheduled take-off. Ask if the airline you are traveling on allows for early boarding.  Sometimes airlines will allow a passenger needing any special assistance to board the plane first which will help avoid standing in a long line to board and give you time to get comfortable before the plane is filled with other passengers.

Above all stay calm and reassure your traveling companion that getting upset will not change anything. Bring a book, magazine or just sit and talk about what is going on in the airport. Talk about obstacles that may occur before you book a flight so that there are no surprises. And remind them and yourself, no one gets in stuck in an airport forever, even though it may feel that way at the time.

Our top picks for senior blogging sites

Adults over 50 make up 29% or 47.27 million adults. More and more they are becoming tech savvy and looking to the internet for their information. Here’s how the Harris Poll demographics break down for adults over 50 who use the Internet:

• All adults over 50 who use the Internet: 29 percent, or approximately 47.27 million. Adults over 50 comprise about 37 percent of the overall U.S. adult population.
• Adults age 50-64 who use the Internet: 29 percent, or approximately 47. 27 million. Adults age 50-64 make up approximately 22 percent of the total U.S. adult population.
• Adults age 65 and over who use the Internet: 8 percent, or a little more than 13 million. Adults age 65 and over comprise about 15 percent of the total U.S. adult population.

Harris poll online http://www.harrispollonline.com/

Seniors and their families are blogging, researching and playing games via the computer. We have researched some blogs that contain interesting information about the following topics:

Humor

http://www.mamaflosatx.com/

Technology

http://www.thesavvyboomer.com/

Health

http://www.webmd.com/healthy-aging/default.htm

Money and retirement

http://blogs.consumerreports.org/money/2008/05/retire_optimism.html

Employment

http://www.nowwhatjobs.net/web_village/index.php

Travel

http://in-search-of-nirvana.blogspot.com/

Senior Housing

http://www.seniorsforliving.com/assisted-living/

AARP

http://www.seniorsforliving.com/assisted-living/

If you find any blogs that are of interest, please send them along to us. Happy blogging!

Tips to help ease the transition to an assisted living facility

Transitioning to an assisted living facility can be upsetting. Most people will be leaving the homes that they lived in for years, leaving their neighborhood friends and losing their independence.  The caregiver or family member can make the transition easier by following the tips:

Remind those around you to practice patience. There is almost always resistance from the person moving. It’s an upsetting time and losing your temper will not help matters. Walk away for  a few minutes until you gather your thoughts.

Help the elder with privacy concerns. Yes, there will be other people under the same roof but the elder will still have the choice of who can visit and when, especially if they are in an assisted living facility.

There will be both positive and negative expectations. Some ideas will come from knowledge and some will come from rumor. The elder will need some assistance coping with expectations. Don’t embellish or overreact about how wonderful the place is.

It is okay to admit that this is a trying time. Talk about and acknowledge feelings that are rising to the surface.

Do’s

• Call and visit often. Keep your promise and show up when you say you will unless there is a dire emergency.
• If asked, help with packing, and moving.
• Listen as your loved one talks about what they left behind.
• Recognize that moving  represents a major life change.
• Be positive.

Don’ts

• Be negative
• Take over the decisions about what stays and goes.
• Focus on your loss. This is not about you.
• Criticize the decisions your loved ones have made even if you don’t agree with it.
• Immediately talk about selling their house.

Assisted Living “No, I WON’T go!”

Assisted living is often cheaper than nursing home care and still allows residents independence along with support services. When the time comes to look for alternative housing and care for your parents or loved ones, look for an assisted living facility that cares for physical, social and intellectual needs.

Ideally, it will offer the following:

? Highly functional, independently mobile residents
? Intellectually interesting activities such as aerobics and classes like history and foreign language
? Internet capability in each room with tech support
? Quality meals
? Comprehensive house cleaning
? Life alert safety systems
? Covered parking or garages
? Storage units on site

Many seniors end up very satisfied with assisted living; it offers the best of both worlds in providing residents with the opportunity to spend time alone in their own apartments as well as to socialize daily.

Once you find what you believe to be the right place, introduce it to your parent in a positive light. The first impression is vital. Many adult children make the mistake of dropping by the facility unannounced in the middle of the day. It may be more beneficial to stop by during a planned event.

Here are tips for introducing and elderly parent to an assisted living facility:

? Plan your visit.
? Consider attending a cheery event to present the prospective new home in a positive way.
? Try to find friends or colleagues who can introduce your parent to existing residents.
? Visit when the most active residents will be around.
? Take in a meal in order to participate in the biggest daily social event.
? Consider going for a day or half day to get a better feel for the residents and staff.
? Talk to the resident association president. Ask whether management is responsive, how much rent increases, about the personalities of the other residents and who might make good companions for your parent.

For more information about long term care options and the Administration on Aging (A0A) http://www.aoa.gov/AoARoot/AoA_Programs/HCLTC/index.aspx

The Older American Act and other legislation, supports programs that help older adults maintain their independence and dignity in their homes and communities. In addition AoA provides funding for a range of supports to family caregivers.

Safety and home accessibility for elders

Every home should be a safe place to live but extra thought and care should be given to those with challenges, whether it be an elder person or someone who is disabled. Falls can be detrimental to elders in a number of ways. It can make them fearful, less independent if they need care while recuperating and limit their confidence and ability to live independently. The following are tips to help prevent falls, not just for elders but for the whole family.

From the Center for Disease Control and Prevention (CDC)

• More than one third of adults 65 and older fall each year in the United States (Hornbrook et al. 1994; Hausdorff et al. 2001).
• Among older adults, falls are the leading cause of injury deaths. They are also the most common cause of nonfatal injuries and hospital admissions for trauma (CDC 2005).
• In 2005, 15,800 people 65 and older died from injuries related to unintentional falls; about 1.8 million people 65 and older were treated in emergency departments for nonfatal injuries from falls, and more than 433,000 of these patients were hospitalized (CDC 2005).
• The rates of fall-related deaths among older adults rose significantly over the past decade (Stevens 2006).

Carpeting

• Navigating a wheelchair or  walker can be difficult if carpet is too thick. Carpeting in the home should be low profile with padding no more than 3/8 inch thick.
• Do not use throw rugs if the room has hardwood floors.

Doors

• Doors should be wide enough for a wheelchair or walker. Whenever possible, doors should swing out and away from the frame.

Stairs should have:

• Handrails
• No carpet
• Non-skid treads
• Adequate lighting
• Chair lift

Shower

• Walk in shower with non-skid surface and grab bars, shower seat and long handle shower extension.

Bath tubs

• Attach a secure tub bar clamp to the side of the tub
• Install a tub transfer bench
• Install grab bars that are secured to studs. Do not use grab bars with suction cups.

Toilets

Various toilet seat risers are one option for low toilets, but these are sometimes less convenient than replacing them with the ADA standard 17-19 inch seat height toilet commonly available.

Shelves

Shelves can be out of reach in some homes so look for storage space and cabinets that are more easily accessible. Lazy Susan are built into some corner cabinets. Another resource would be a suction tip reacher to retrieve items that are out of reach.

Refrigerator

A side-by-side refrigerator is more convenient to  use for someone who has a walker, cane or wheelchair. Attach a basket to the walker for an extra precaution.

Stoves

Electric stoves are safer for people who are aging. They often lose their sense of smell or lean into the stove and catch their clothes on fire.

Smoke detectors and Carbon Monoxide detectors on every level of the home. Preference given to wired in to avoid having to rely on batteries.

Phones in both kitchen and bedroom.

GFCI ground fault electrical outlets in bathrooms, kitchen, outdoor areas to prevent electrical shock.

Ramps

A 1:12 incline is preferred, but 1:10 incline is acceptable in some instances. (Every one inch of height requires 10 or 12 inches of length.) The steeper pitch of 1:10 makes it more difficult to go up quickly and down slowly, and is more effort for the person who has to push the wheelchair.

What is Adult Foster Care?

Many of us are familiar with foster care for children but not familiar with foster care for adults. Often times families cannot take care of the older family members and look for other options besides a nursing home or Assistive Living institution. Placing an elderly loved one in a foster family setting may be an option for your loved one.

Adult Foster Care homes provide room, board and general supervision of personal care services in a family home. Adult Foster Care often meet the needs of adults who require periodic or regular assistance with activities of daily living, but do not require nursing services. Examples of “activities of daily living” include: dressing, bathing, eating, brushing teeth, or combing hair.

Adult Foster Care homes may serve both private-pay and state-pay individuals. The Department of Social Services is responsible for case management services to individuals age 60 and over and receiving state payment. If the individual is under the age of 60, the Department of Human Services’ Division of Developmental Disabilities is responsible for payment and case management.

Residents are determined eligible for a state Adult Foster Care payment under the same process used for Long-Term Care assistance. Prospective state pay for Adult Foster Care residents must obtain an application from a benefits specialist, through the Division of Economic Assistance, responsible for nursing facility application and must meet the financial requirements.

Individuals who are appropriate for Adult Foster Care homes:

• Oriented to time, person and place and not a danger to themselves or others in the adult foster care home.
• Unable to live independently.
• Require minimal supervision and/or assistance in completing one or more of the following: dressing, personal hygiene, transportation, ambulation, nutrition, health supervision.
• Capable of taking action for self-preservation in case of fire or storm with direction.
• Usually has control of bowel and bladder, but may have stress incontinence and/or capable of meeting their own needs when incontinent.

Homes are required to meet the following criteria. Each state may have their own unique requirements.

AFC providers must:

• Be able to read and write
• Be 18 years of age or older
• Have a valid driver’s license and liability insurance
• Have another source of income
• Have telephone access
• Have adequate space for the client
• Have a substitute care provider
• Undergo training

Individuals that may not be appropriate for Adult Foster Care:

• Consistently not oriented to time, person and place to such a degree they pose a danger to themselves or others in the home.
• Unable or unwilling to meet own personal hygiene needs under minimal supervision.
• Has a communicable disease or infectious condition which pose a threat to the health or safety of other residents of the home.
• Chronically disruptive and unable or unwilling to comply with adult foster care rules.
• Behavior poses a threat to other residents.
• Unable to self-medicate on one’s own or with the assistance of supervision or monitoring.
• Require a complex, therapeutic diet.
• Require any other type of care which can only be provided safely by or under the supervision of a licensed practical nurse or a registered nurse.

Adult Foster Care providers must provide the following services and items:

? Shelter
? At least three meals a day
? Assistance with personal care
? Companionship
? Assistance with activities of daily living

• Expendable items used by the clients in small quantities such as facial and toilet tissue and personal items such as towels and soap, laundry services, non-medical transportation and socialization.

In addition, the Department of Social Services Medical Review Team must determine an individual is in need of Adult Foster Care Level of Care.

Resource to help you decide what type of elder care would be appropriate for you and your family can be found at:  AdultCare.org is a consumer based source for adult care facilities.

Program of All-Inclusive Care for the Elderly (PACE)

What is PACE?

PACE is an optional benefit under both Medicaid and Medicare that focuses entirely on older people who meet their state’s standards for nursing care. Each state chooses to offer PACE under Medicaid.

Comprehensive social and medical services can be provided in a home, inpatient facilities or in an adult day health center.  A team of health professionals assess the participants needs, develops a  plan and then services are delivered and integrated into a complete health care plan.

Eligibility

To be eligible one must be:

• At least 55 years of age
• Live in a PACE service area
• At time of enrollment, be able to safely live in a community setting
• Meet State’s nursing facility level of care

Services

Generally services are provided in an adult day health center setting but can also include in-home.  PACE’s mission is to maintain or restore independence to the elderly by offering and managing medical, rehabilitative and social services. This in turn will allow them to remain in their communities, in their homes and maintain a quality of life. Services are available 365 days a year, 7 days a week and 24 hours a day.  Minimum services such as primary care, social, personal care and nutritional counseling must be provided in PACE center. Other services include, meals, recreational therapy and restorative therapies.

Medical team

The PACE team has constant contact with the enrollee in order to be able to adjust services that may be needed. A team may consist of the following:

? Drivers

? Dietitians

? Personal care attendants

? Social workers

? Primary care physicians and nurses

? Occupational, recreational and physical therapists

Payment

Each contract year a fixed monthly payment is  paid to PACE regardless of the services an enrollee may have.  There may be a monthly premium depending on eligibility for Medicare and Medicaid.

Listing of nationwide organizations that support PACE

http://www.cms.hhs.gov/pace/pacesite.asp

The Official U.S. Government Site for Medicare

http://www.medicare.gov/Nursing/Alternatives/Pace.asp

What is Home Sharing?

Home sharing is an arrangement where two or more unrelated people share a home. Each person has their own private space and common living spaces. Often elders are not ready for assisted living or a nursing home but are in need of assistance with day to day living or companionship.

The process begins when one person is looking for a place to live and another is looking for someone to live with them. People are then matched by filling out an application and answering many questions about their abilities, disabilities and likes and dislikes. An in-depth interview of each person is held with family members being encouraged to participate in this process.

Typically, a student or person working outside the home is matched with a Home Provider and brings the comforting assurance of having someone in the house at night.  This person will either work 12-15 hours a week doing household chores such as cooking or shopping, in exchange for free room or do less service and make a small contribution to household expenses or do no services and pay rent in the range of $250-$300 per month.

• References are checked
• A meeting between applicants is set up and each decides if they would like to meet again or match up
• Written agreement is created
• Follow ups take place during the match

How long does it take?
Time to make a match varies and can take up to several months. One of the challenges in finding matches is to make sure people are compatible.

More information on home sharing:
Homeshare International