Friday, June 29, 2012
Palliative Care and Hospice Care: The benefits for end of life care
Effective end-of-life care includes both palliative and hospice care. The term palliative care is a broad concept, since it includes the management of the physical, psychological, social, spiritual, and existential needs of individuals with advanced disease without reference to a specified life expectancy of the patient. Palliative care is focused on treatment of conditions that are life limiting or refractory to disease-modifying treatment. The term hospice care usually refers to a special type of comprehensive palliative care provided during the last 6 months of life, and is often linked to the specific programs offered under the Medicare hospice benefit. Both palliative care and hospice emphasize the importance of addressing the needs of both these persons and their families (National Hospice Organization Standard and Accreditation Committee, 1997, Task Force on Palliative Care, 1998).
This holistic approach to care required by hospice and palliative care, which recognizes the complex and multidimensional needs of patients and families, calls for an interdisciplinary team. Team members typically include nurses, physicians, and social workers, though others may be present, including psychologists, chaplains, pharmacists, dietitians, occupational or physical therapists, and volunteers. Conditions for which hospice and palliative care are appropriate include cancer, AIDS, congestive heart failure, chronic obstructive pulmonary disease, end-stage organ disease, and dementia and other progressive neurological diseases.
The goal of hospice and palliative care is to achieve the best possible quality of life for patients and their families. This goal is achieved through relief of suffering, pain and symptom management, psychosocial support, optimization of functional capacity, and respect for autonomy and the appropriate role of family and legal surrogates. While palliative care does not require the exclusion of all aggressive or curative therapies, hospice patients typically must agree to fore go aggressive or curative treatments (though some interventions may be performed to maximize quality of life, such as blood transfusions to maintain energy level in leukemia patients). Specific goals of hospice include self-determined life closure, safe and comfortable dying, and effective grieving (National Hospice Organization Standard and Accreditation Committee, 1997).
Wednesday, May 16, 2012
Sunday, April 29, 2012
Saturday, April 7, 2012
Great Learning Experience for Leadership
Everyone missed a good leadership opportunity this last week in Vegas. Learned so much that it will take me days to sort through it all! Families, here is a wonderful chance to understand how to relate to everyone within the family when making decisions about mom or dad. Better make your reservations now for next year, they have limited space left! See y'all there next year! Who's coming with me?
Leadership Reality Adventure presented by http://www.successcommunicationsinc.com
Leadership Reality Adventure presented by http://www.successcommunicationsinc.com
Thursday, March 15, 2012
Wednesday, March 14, 2012
Friday, March 9, 2012
Aging Impact
I wrote this in 2008. Seems like this still applies. What is your opinion?
The aging population will exacerbate the fiscal pressures on health care costs due to the longevity and increase of those in need of acute care. According to Orszag (2007), demographic changes will increase Social Security in 30 years from 4% to 6% before stabilizing. This increase will create outsized budget deficits that would raise the government debt to unprecedented levels. Although the effects of retirement of boomers and the social Security imbalance needs addressed, there is a greater need to examining health care costs that exert the dominant influence on the budget.
Hochhauser (2005) examines the Medicare benefits (currently collected by seniors for at least 10 to 15 years) changing with the increase in a healthier aging population living to approximately 100 years. Most Medicare payments do not cover all health care costs and seniors to pay for non-coverage services rely upon supplemental insurance. Hochhauser asks the questions, if retirement extends to 70 would Medicare not pay until people reached 100, moreover, what about Social Security? Efforts are currently being made to move the working age to 70 before collecting Social Security benefits. This then affects the HMO’s and managed care plans and eventually LTC.
Services will be in great demand; joint replacements, organ transplants, knee/hip replacement are just a few that will increase and place this great demand on the health care organizations. The demand on HMO’s and Medicare will increase and according to Hochhauser, there will be some kind of health care rationing, or triage, or frequency limit, or co-payment system that will be needed to help health plans finically survive. He poses on more question. What type of care can be provided for the aged with dementia and an extended lifespan? Who is going to pay for this care?(Hochhauser, 2005).
Not only do families, nursing facilities (long-term care providers) have these questions, but also the public is now examining the role of HMOs and MCOs as well as PPOs in long-term care. The impact of consumerisms on managed health care presents its own issues toward the transformation of managed health care plans and long-term care. Consumers are looking into new ways to save costs and pick a plan that offers different levels of health care services. These programs need to follow them into later life and long-term care. In response, health care plans are in a transformation process and the consumer is left with the question what is the best system for the long run?
Caregivers and health care professionals have a large impact on the health of the resident and the outcome of quality of care. Medicare and Medicaid are the most drawn on insurance providers for Long Term Care Facilities. These programs have strict limited requirements to be met by the facility to provide for the cost of care to the resident. HMOs and PPOs are not commonplace in Long Term Care, however, this may change with the pressures place on these plans from the new older generation,
Reference:
Orszag, Peter R. (2007). The Biggest Budget Buster. Wall Street Journal.(Eastern ed.) New York, N.Y. p A 19
Hochhauser, Mark.(2005). Living to 120: What Will it Mean toManaged Care?Managed Care Quarterly 13(1) 13–15
The aging population will exacerbate the fiscal pressures on health care costs due to the longevity and increase of those in need of acute care. According to Orszag (2007), demographic changes will increase Social Security in 30 years from 4% to 6% before stabilizing. This increase will create outsized budget deficits that would raise the government debt to unprecedented levels. Although the effects of retirement of boomers and the social Security imbalance needs addressed, there is a greater need to examining health care costs that exert the dominant influence on the budget.
Hochhauser (2005) examines the Medicare benefits (currently collected by seniors for at least 10 to 15 years) changing with the increase in a healthier aging population living to approximately 100 years. Most Medicare payments do not cover all health care costs and seniors to pay for non-coverage services rely upon supplemental insurance. Hochhauser asks the questions, if retirement extends to 70 would Medicare not pay until people reached 100, moreover, what about Social Security? Efforts are currently being made to move the working age to 70 before collecting Social Security benefits. This then affects the HMO’s and managed care plans and eventually LTC.
Services will be in great demand; joint replacements, organ transplants, knee/hip replacement are just a few that will increase and place this great demand on the health care organizations. The demand on HMO’s and Medicare will increase and according to Hochhauser, there will be some kind of health care rationing, or triage, or frequency limit, or co-payment system that will be needed to help health plans finically survive. He poses on more question. What type of care can be provided for the aged with dementia and an extended lifespan? Who is going to pay for this care?(Hochhauser, 2005).
Not only do families, nursing facilities (long-term care providers) have these questions, but also the public is now examining the role of HMOs and MCOs as well as PPOs in long-term care. The impact of consumerisms on managed health care presents its own issues toward the transformation of managed health care plans and long-term care. Consumers are looking into new ways to save costs and pick a plan that offers different levels of health care services. These programs need to follow them into later life and long-term care. In response, health care plans are in a transformation process and the consumer is left with the question what is the best system for the long run?
Caregivers and health care professionals have a large impact on the health of the resident and the outcome of quality of care. Medicare and Medicaid are the most drawn on insurance providers for Long Term Care Facilities. These programs have strict limited requirements to be met by the facility to provide for the cost of care to the resident. HMOs and PPOs are not commonplace in Long Term Care, however, this may change with the pressures place on these plans from the new older generation,
Reference:
Orszag, Peter R. (2007). The Biggest Budget Buster. Wall Street Journal.(Eastern ed.) New York, N.Y. p A 19
Hochhauser, Mark.(2005). Living to 120: What Will it Mean toManaged Care?Managed Care Quarterly 13(1) 13–15
Thursday, March 8, 2012
Monday, March 5, 2012
Changing the way we think.
With the population changing to an over-whelming elderly group, it is important for everyone to understand the impact this age group will have on future technologies and programs affecting the community and society as a whole. We have had many challenges over the years and had to adjust our values, beliefs, and morals in reaction to our judgments of these events and challenges.
Our ability to discard outdated judgments and values, proves that individuals are active constructive thinkers. We hold the future in our hands. What we do with it is totally up to our own reactions to our life history. I have changed how I react to the environment around me. My decisions to continue my education and work in patient advocacy comes directly from the formulations made with the stored information collected over the years. If I can change my reactions to the events presented to me in a positive direction, then I believe I can help others in their choice of reacting in a more comforting and peaceful way to conflicting stresses and the complexion of health issues.
Our ability to discard outdated judgments and values, proves that individuals are active constructive thinkers. We hold the future in our hands. What we do with it is totally up to our own reactions to our life history. I have changed how I react to the environment around me. My decisions to continue my education and work in patient advocacy comes directly from the formulations made with the stored information collected over the years. If I can change my reactions to the events presented to me in a positive direction, then I believe I can help others in their choice of reacting in a more comforting and peaceful way to conflicting stresses and the complexion of health issues.
The Spiritual Life Review
Spiritual Life Review by Mary Miller Lewis (2001) discusses the opportunities the older adult receives through the review process. Spirituality has been linked to positive physical health and inversely related to physical illness. Two spiritual needs are seen across all lists, and seem to be important for counselors to discuss with adults who identify as spiritual or religious or both: (1) dealing with death, and (2) discussing meaning and purpose.
Older adults face many adjustments as they approach death. Robert N. Butler’s (1971) opinion is that life review is an important element in an individual’s overall adjustment to death, a continuation of personality development right to the very end of life (Vander Zanden, 2003).
The life review process enhances an elders self-understanding, personal meaning, self-esteem and the meaning of life. This has a positive effect on the health of the elderly according to Mary Miller Lewis. The use of spirituality in counseling is an option to help resolve issues and adjust to a treatment plan.
References:
Vander Zanden, J. W. (2003). Human Development. NY: McGraw Hill
Lewis, M. M., (2001). Spirituality, counseling, and elderly: An introduction to the spiritual life review. Journal of Adult Development, 8(4), 231-240.
Older adults face many adjustments as they approach death. Robert N. Butler’s (1971) opinion is that life review is an important element in an individual’s overall adjustment to death, a continuation of personality development right to the very end of life (Vander Zanden, 2003).
The life review process enhances an elders self-understanding, personal meaning, self-esteem and the meaning of life. This has a positive effect on the health of the elderly according to Mary Miller Lewis. The use of spirituality in counseling is an option to help resolve issues and adjust to a treatment plan.
References:
Vander Zanden, J. W. (2003). Human Development. NY: McGraw Hill
Lewis, M. M., (2001). Spirituality, counseling, and elderly: An introduction to the spiritual life review. Journal of Adult Development, 8(4), 231-240.
Sunday, February 5, 2012
Nurses
Nurses are being scorned for being late with medicine, and yet they are holding their bladder because they don't have time to use the restroom, and starving because they missed lunch. They're being peed on, puked on, pooped on, bled on, bitten, hit, yelled at and are missing their family while taking care of yours. They may even be crying for you. The minute you read this, nurses all over the world are saving lives. Re-post if you love a nurse, are a nurse, or appreciate a nurse. Anonymous.
Friday, February 3, 2012
Caregivers compassion
The human capacity to care for others isn’t something trivial or something to be taken for granted. Rather, it is something we should cherish. Compassion is a marvel of human nature, a precious inner resource, and the foundation of our well-being and the harmony of our societies. If we seek happiness for ourselves, we should practice compassion: and if we seek happiness for others, we should also practice compassion.
http://www.facebook.com/DalaiLama
http://www.facebook.com/DalaiLama
Tuesday, January 24, 2012
Friday, January 6, 2012
Add Suggestions to improve this blog
I look forward to any suggestions you may have to improve this blog and help meet your needs. Please email me and let me know what you think.
Sunday, January 1, 2012
2012 is here!
Take this time to reflect on your past and look towards the future with promise and success. Happy New Year to Everyone!
Monday, December 19, 2011
Not forgetting loved ones during the holidays.
This holiday season is all about being with family. Take the time to include your elderly loved ones in the festivities. Depression is a large part of the holiday season, and this is especially true for the elderly.
During this time of the year, I am reminded of the many sad faces of residents in long term care facilities (nursing homes) who's family did not show up for a visit or share the holiday with them. The elderly sits and waits for family to arrive for a visit every day. The holidays intensifies the anxiousness they feel while waiting. Even after a few minutes, they can become anxious worrying if the family will show up.
To help, be sure to call a head and let the staff know you are coming and when, so they may help mom or dad be ready and prepared. Don't forget to let them know how many are coming as the facility can help with arrangements for a private meeting room or setting up refreshments and providing a comfortable chair for mom or dad while unwrapping their many gifts.
By including your elderly loved ones in the holidays at home or at the long term care facility, goes such a long way in their mental well being.
Happy Holidays to you and your loved ones!
During this time of the year, I am reminded of the many sad faces of residents in long term care facilities (nursing homes) who's family did not show up for a visit or share the holiday with them. The elderly sits and waits for family to arrive for a visit every day. The holidays intensifies the anxiousness they feel while waiting. Even after a few minutes, they can become anxious worrying if the family will show up.
To help, be sure to call a head and let the staff know you are coming and when, so they may help mom or dad be ready and prepared. Don't forget to let them know how many are coming as the facility can help with arrangements for a private meeting room or setting up refreshments and providing a comfortable chair for mom or dad while unwrapping their many gifts.
By including your elderly loved ones in the holidays at home or at the long term care facility, goes such a long way in their mental well being.
Happy Holidays to you and your loved ones!
Saturday, December 10, 2011
Knowledge Acquisition
Working as a Patient Advocate/Navigator and Program Director in the geriatric profession within the field of home health care and long-term care conducting assessment evaluations for placement is a rewarding position in helping the elderly population and their families with acute care, chronic illnesses and Alzheimer disorder. Families come for help with managing and/or placing their parents in the proper type of care environment.
Intuition plays an important part of the Advocate's role in determining the complex needs of the aging and ailing adult. Observations over the years are valuable when added to empirical data, which allows the advocate to apply his/her knowledge in the best interest of the client’s situation. The elderly come with many complex issues and need to be understood individually according to their own personal stories and idea of self.
Care plans designed by the care manager are to help the client live a meaningful and productive life within the means of the new restrictions placed on this person physically, mentally, and emotionally. The care plan is a plan of trust; the nurse trusts the caregivers and client to carry out their part of the plan, and the latter two trust the nurse to provide a professional support system.
We use our self-awareness to understand the situations with which our clients are dealing with and we are working to relieve their stress and anxiety.
Intuition plays an important part of the Advocate's role in determining the complex needs of the aging and ailing adult. Observations over the years are valuable when added to empirical data, which allows the advocate to apply his/her knowledge in the best interest of the client’s situation. The elderly come with many complex issues and need to be understood individually according to their own personal stories and idea of self.
Care plans designed by the care manager are to help the client live a meaningful and productive life within the means of the new restrictions placed on this person physically, mentally, and emotionally. The care plan is a plan of trust; the nurse trusts the caregivers and client to carry out their part of the plan, and the latter two trust the nurse to provide a professional support system.
We use our self-awareness to understand the situations with which our clients are dealing with and we are working to relieve their stress and anxiety.
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