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Hip Fractures in the Elderly

Friday, March 23rd, 2012 by Elizabeth

As the country continues to age, fractures will be a major cause of concern for healthcare professionals, patients and their families. According to the American Academy of Orthopaedic Surgeons, the number of hip fractures in 2050 will reach 650,000 annually or 1,080 hip fractures a day.

The Center for Health Statistics reported that there were 220,000 hip replacement surgeries in 2003. 25 of these patients were able to experience full recovery while 50 percent will require a cane or walker; 40 percent will need nursing home care and 24 percent of people age 50 and over will die within the next 12 months.

Hip Fractures – Risks and Causes

Image by JimScolman on Flickr

The risk for hip fractures is higher in the elderly. Different factors that are sometimes unique to seniors contribute in making them a high risk population for falls and injury. Advancing age brings so many physical changes that simple accidents that they were able to walk away from in the past could easily cause hip fractures in the elderly. Risks for hip fractures are highest for people age 50 and over. From there the rate of hip fractures doubles every five or six years.

Osteoporosis. A report made by the National Institutes of Health estimates that 40 million Americans are already suffering from Osteoporosis or at high risk due to poor bone mass. This medical condition is the leading cause of spine, wrists, and hip fractures in the elderly. Natural bone mass loss due to aging coupled with osteoporosis increases the possibility of hip fractures from simple falls or injury.

Nutrition. Calcium is the most abundant mineral in the body. It is needed for the growth and long-term health of the bones. But adequate calcium intake should not be our only concern.

Lifestyle. Smoking and excessive alcohol drinking interferes with the uptake of calcium and weakens the bones. Seniors confined for long periods of time in beds or are unable to exercise due to a debilitating illness are at high risk for hip fractures. Prolonged inactivity weakens bones.

Heredity. Asians and Caucasians with smaller bone densities have a higher risk for hip fractures. Seniors who have a family history of weak bones and poor bone mass are at risk for hip fractures.

Medications. Long-term used of glucocorticoids and some anticonvulsants leads to bone loss and weakening. Increasing calcium and Vitamin D intake could help decrease the effects of these medications.

Sex. Women are two or three times more likely to suffer from hip fractures compared to men. Numbers show that almost half of all women over the age of 90 have suffered from hip injury. Women who are 5’8” and over also have twice the chances for hip fractures compared to women who are 5’2” and below. Women are at higher risk for poor bone health due to decreasing levels of estrogen levels as they age.

Hormonal factors. Low estrogen levels and menopausal women weaken the bones. Abnormal levels of thyroid stimulating hormones and thyroid hormones affect the levels of calcium in the bones. Men like women also experience changing levels of sex hormones with aging. Decreasing levels of testosterone also contribute to bone weakening in men.

Preventing Hip Fractures in the Elderly

Hip fractures are the second leading cause of hospitalization in the elderly. Incidents of hip fracture increase directly with age. It is estimated that 23 per 100,000 adults age 50 are hospitalized for hip fractures. By the age of 80, this number increases to 630 for men and 1300 women per 100,000 of the population.

Serious and life-threatening injuries caused by a simple fall increases with age. While we were able to shrug off falls when we were younger, advancing age and deteriorating bone health makes it impossible for adults age 65 and older to ignore the danger of fall and accidents. Fortunately, falls are very preventable. Below are simple tips on how seniors could reduce the risk of falls and injury.

Check your medications – Consult with your physician regarding prescribed and over the counter medications that may cause drowsiness or dizziness. Any medication which may affect your mental state or sense of balance increases risk for falls. If there are no alternative medications, ask your physician about the drug’s side effects and how long before you could resume activities of daily living.

Exercise – Keeping our bodies active improves overall body strength. Simple exercises such as walking or flexing exercises are an excellent way of building inner body strength. Low impact exercises and Tai Chi programs, swimming and walking for example help seniors improve strength and flexibility without causing injury.

Proper Nutrition – Osteoporosis is a real concern among seniors. Weak bones increase the risk for falls and hip fractures. The National Institutes of Health Consensus Development Conference on Optimal Calcium Intake found that a large percentage of Americans failed to meet the recommended daily intake of calcium.

  • Men and women more than 65 – 1,500 mg per day
  • Men 25 to 65 – 1,000 mg per day
  • Postmenopausal women without estrogen therapy – 1,500 mg per day

Vitamin D helps the body absorb calcium, thus essential in building and maintaining strong bones. Inadequate amounts of Vitamin D in the body leads to calcium being taken out from the bones in an effort to maintain normal blood calcium levels.

Regular Eye checkups – Failing or poor eyesight increases the chance for falls. Regular eye checkups prevent further eyesight deterioration and maintain proper eye health. Good chances are that poor eyesight might be caused by improper eyeglasses.

Fall-proof your Home

  • Proper lighting
  • Install rails, grab bars on walls and stairs
  • Place rugs and carpets on slippery surfaces
  • Place the senior’s bedroom on the first floor and near the bathroom
  • Position frequently used objects within easy reach
  • Ensure that all furniture, chairs and tables are stable
  • Wear low, non-slip shoes and slippers

Signs of Hip Fracture in the Elderly

Hip fractures can occur at any stage of life but a majority of injuries occur for seniors age 65 and older. Injuries from falls are more serious due to lower bone density or weaker bones. The signs of a hip fracture are immediately felt and visible after a fall. Pain radiates from the hip area and the senior is unable to move or standup.

Swelling, redness and bruising in the hip area are also tell-tale signs that a hip fracture has occurred. Stiffness, contusions and unequal leg length indicate that a senior has experienced hip fracture or trauma. However, there are some hip fractures where the head of the hip bone has impacted into the neck of the hip bone. This produces less pain which may mislead the senior or care provider that no serious injury has happened.

Any accident or fall where a senior clearly verbalizes pain in the hip area should not be taken lightly. Calling emergency services and preventing movement to avoid further injury are the first steps in emergency care. Doctors can confirm hip fractures through identification of symptoms or an MRI and x-ray is done to positively verify hip fracture has occurred.

Emergency Care and First Aid Treatment

If you suspect that a senior has suffered from a hip fracture, prevent movement unless necessary to avoid further injury. Hip fractures require immediate medical attention, call 911 or your local emergency number to report the injury.

Emergency care for seniors with hip fractures includes immediately stopping any bleeding arising from injury. This is done by applying direct pressure to the wound with a clean cloth and sterile bandage. After stopping the bleeding, immobilize the injured area. Only those medically trained to apply splints are advised to perform emergency care.

Placing pads or positioning the elderly in a more comfortable position is recommended to reduce stress and discomfort while waiting for professional medical help. If the senior appears to be in shock or shows short, rapid breathing position the head lower than the body and elevate the legs if possible. This is to improve blood flow to the head area and help the patient maintain consciousness.

Treating Hip Fractures in the Elderly

Treatment immediately starts by ensuring that the senior is medically stable. Once stable, the doctor assesses the best treatment available for the patient. Fractures are rarely stable and any movement could cause further injury in the patient.

Non-surgical treatment for hip fractures is possible if the fracture seems stable. Some hip fractures actually heal without surgery. This would require patients to be confined to bed for eight to twelve weeks. But doctors have found that placing seniors in bed for prolonged periods of time could cause serious medical complications than having the patient undergo surgical treatment for a hip fracture.

Almost all of hip fractures in the elderly are treated by surgery within 24 hours of hospital admission. The goal of surgery is to stabilize the fractured hip and help the senior recover from injury in the shortest possible time.

Metal Pins. Fractures that happen in the neck of the femur if still positioned correctly may only require the placement of two or three metal pins to stabilize the fracture. Also called hip pinning, it is a simple surgical procedure that allows patients to place weight down immediately after surgery.

Metal Plate and Screws. Hip fractures that are located below the femoral neck or in the intertrochanteric region are treated by the use of metal plate and screws. This type of fracture is usually the result of a fall that results to multiple breaks. It is one of the hardest fractures to treat requiring several pieces of bones to be joined together. Intertrochanteric fractures are treated by placing a metal plate and compression hip screw that aligns the bones and uses the muscles to compress fractured bones together.

Artificial Replacement of the Femoral Head. When hip fracture occurs at the neck of the femur and results to the ball being completely displaced, replacement of the femoral head is recommended. A fracture of this kind often results to disruption or blood supply to the femoral head. The femoral head collapses and dies a few weeks later.

The chances of the femoral head dying from this type of fracture are so high that a surgeon often recommend femoral head replacement immediately. Only half of the joint is replaced while the socket of the hip joint is untouched.

Recovering from a Hip Fracture

Image by TomD. on Flickr

The goal of treatment for seniors with a hip fracture is to help them recover as quickly as possible. This is to avoid serious medical complication that can result to long-term inactivity that includes blood clots, joint stiffness, chronic pain and pneumonia in the elderly.

Patients who are physically able to undergo recovery treatment are usually assigned with a physical therapist. Exercises start by helping seniors move from their beds to a chair several times daily. All these exercises are designed to help seniors regain independence and return to their normal daily activities. Simple exercises are done to strengthen leg muscles and prevent blood clot formation. Walkers and crutches are assigned to free them from the confines of their beds.

The amount of weight that can be placed on the injured leg depends on the type of surgical treatment done. Most patients are able to place weight a few days after surgery. Those who have undergone artificial replacement of the femoral head however, are required to follow stricter guidelines or hip precautions.

Patients who have undergone femoral head replacements are advised to follow these guidelines for at least six weeks after surgery. This provides time for delicate tissues to recover enough strength to prevent the joint from dislocating. Precautions include limiting the amount of weight placed on the leg and using walkers or crutches.

Doctors may recommend elders recovering from a hip fracture to work with a physical therapist to assist the patient in transitioning safely to a home environment. These include instructing the patient on how to avoid placing too much weight on the injured leg and how to use crawlers and crutches when moving inside the home.

The goal of treatment is to help seniors slowly regain hip strength and resume their normal activities without aggravating the injury. Doctors and physical therapists could only do so much in helping senior recover from a hip fracture. The success of treatment ultimately lies in the hands of long-term care provider, family and patient.

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Posted in Home Care, Long Term Care | 1 Comment »

Pneumonia in the Elderly

Saturday, March 17th, 2012 by Elizabeth

According to the Centers for Disease Control and Prevention, 2009 saw more than 1 million Americans being hospitalized with cases of pneumonia. Of this number, 350,000 to 620,000 were those involving the elderly. The disease continues to be one of the leading causes of death among seniors.

Pneumonia, especially if diagnosed early responds well to treatment. But even with the best health care services, pneumonia continues to kill 40,000 to 70,000 Americans each year. The chances of older adults fully recovering from pneumonia is lower compared to the younger population. Even seniors who were able to recover have a higher chance of dying over the next several years.

Image by Wanderlinse on Flickr

Pneumonia Risk Factors in the Elderly

Age is a major risk factor for developing pneumonia. Adults age 65 and older continues to be one of the hardest hit sectors of the population. It is the most common infectious cause of death and responsible for millions of hospitalizations yearly. Numbers coming from the National Hospital Discharge Survey in the US has placed the number of hospitalizations for age 65 or older at 21.4 million between 1990 and 2002. More alarming is the fact that 70 percent of those hospitalized for pneumonia are from the senior population.

Age – Seniors age 65 or older are at high risk for acquiring pneumonia. A weaker immune system and especially those suffering from medical conditions are at great risk developing pneumonia.

Diseases – Diseases that compromise or weaken the immune system such as HIV/ AIDS and chronic illnesses such as lung disease, emphysema and heart disease increases the risk for developing pneumonia.

Immune System Weakening Treatments – People undergoing chemotherapy or any treatment that negatively affects the immune system such as immune suppressant drugs are at high risk for developing the disease.

Exposure to Chemicals and Pollutants – seniors who are constantly exposed to chemicals at home or in the workplace are in danger of acquiring uncommon types of pneumonia. The risk is particularly high for seniors who work with chemicals and fertilizers in their gardens.

Unhealthy Lifestyle Habits – Smoking exposes your body to harmful chemicals and diseases causing toxins. It weakens the immune system especially on seniors who are already suffering from compromised immune systems. Seniors who live more active lifestyles are also at less risk for developing pneumonia.

Pneumonia by Origin of Infection

Pneumonia may be classified according to where the infection was acquired or its causative agent. Doctors often classify pneumonia based on its origin of infection. This makes it easier for them to identify the likely cause of infection and symptoms associated with the disease.

Community-Acquired Pneumonia (CAP) – The American Academy of Family Physicians defines CAP as a pneumonia not acquired in a hospital or long-term care facility. This usually follows a viral infection such as flu. This makes treatment of common colds and flu important to prevent its progression towards pneumonia.

Pneumonia Acquired from an Institutional Setting – This includes pneumonia acquired from a hospital or long-term setting. Senior living assisted facilities, long-term care or senior homes are also included in this category. Seniors are in great risk for acquiring pneumonia through this setting due to a weaker immune system. Infecting agents are also more virulent compared to those found in the community setting.

Compared to community-acquired pneumonia, hospital-acquired and healthcare-acquired pneumonia are controllable. Medical and long-term care personnel are in a better position to control healthcare settings thereby reducing the risk for infection.

Pneumonia in the Elderly

The difficulty with diagnosing pneumonia is that many of its early symptoms can be mistaken for the common cold or flu. According to an Oxford Journal on Aging and infectious diseases, pneumonia in the elderly may present itself with few respiratory symptoms and signs and instead may be manifest as delirium, worsening of chronic confusion, and falls. Delirium or acute confusion was also found in 44 percent of those suffering from pneumonia. Falls may also indicate that a person is ill or severely weakened.

Symptoms

Older adults with pneumonia may not show traditional symptoms of pneumonia. Symptoms might be milder, different or fewer. Seniors with pneumonia may not suffer from fevers or have nonproductive cough (coughing without sputum).  Symptoms that are commonly seen in seniors include confusion or delirium. Chronic illnesses or a lingering cough are also clear indications that the elderly is already suffering from pneumonia.

  • Cough – yellowish, greenish or bloody mucus
  • Mild or high fevers
  • Chills
  • Shortness of breath especially when performing strenuous activities
  • Sharp stabbing pain when coughing or breathing deeply
  • Headaches and migraines
  • Excessive sweating
  • Loss of appetite
  • General body weakness
  • Confusion especially in the elderly

Symptoms may vary according to the type of infection. Pneumonia caused by bacteria may cause high fevers (as high as 105 degrees F). Other symptoms may include rapid and shallow breathing. Poor blood circulation can cause bluish lips and nail beds, a clear indication that oxygen is not reaching these areas. Bacterial pneumonia may also affect the person’s mental status causing confusion or delirium.

Initial symptoms of viral pneumonia are similar to influenza. Symptoms include fever, headaches, dry cough, weakness and muscle pain. The next 12 to 36 hours shows difficulty in breathing, worsening cough with small amounts mucus. Blood circulation is also impaired with bluishness seen in the lips and nail beds of the patient.

Diagnosis of Pneumonia in the Elderly

Chronic illnesses such as colds and flu in the elderly are tell-tale symptoms that the individual might be suffering from a major disease. Common colds should be treated immediately to prevent it from developing into pneumonia.

Seniors suspected of suffering from pneumonia are advised to consult with their doctors and discouraged from self medicating. Simple diagnosis is done by first letting the doctor listen to the senior’s lungs. An infection is suspected when the doctors hear rales, rattling or bubbling sounds. This is a clear indication of infection and additional tests are advised to identify the illness.

When infection is suspected, pulse oximetry tests are used to compute blood oxygen levels to determine lung functioning. CT scans or chest x-rays are then recommended to determine the area of infection and degree of illness. A blood or sputum test is used to determine the specific agent responsible for infection.

Preventing Pneumonia in the Elderly

Pneumonia’s main mode of transmission is through direct contact with people who are ill. It could also be transmitted through respiratory droplets from the nose or mouth. Preventing the spread of infection could easily be done by being proactive and ensuring that seniors are not exposed to the illness. This is especially true for seniors who are at long-term care and hospital settings where the medical team exercises full control over the environment.

Eating healthy and living an active lifestyle goes a long way in helping seniors boost their natural immune system. Exposure to pneumonia infective agents could not be totally eliminated but ensuring that seniors are at their optimum health is an achievable goal.

Seniors are at high risk for developing pneumonia. Underlying medical conditions and a weak immune system makes them susceptible to infection. Simple antiseptic techniques such as washing your hands before handling a senior’s personal things dramatically reduce the spread of infection. Good oral hygiene should also be practiced to prevent infection.

Senior Pneumonia Vaccinations – A Quick Look into the Numbers

Image by Lance McCord on Flickr

Almost 65 percent of Americans age 65 and older have been vaccinated against pneumonia. According to the Agency for Healthcare Research and Quality, 2000 to 2008 saw the numbers of seniors vaccinated against pneumonia increase from 53 to 60 percent. The 2010 National Healthcare quality Report which examines the nation’s access to and quality of healthcare showed that:

  • 65 percent or two thirds of high-income seniors have been vaccinated against pneumonia while 46 percent or less than half of poor seniors have received similar treatment.
  • Seniors living in a large inner-city area where a majority of the population were low-income and minorities only had 52 percent vaccinated against pneumonia. However, seniors living in medium-size cities reported that 64 percent of them had undergone vaccination.
  • 65 percent of white seniors were vaccinated against pneumonia compare to 45 percent for Asian and Black seniors. Hispanic seniors were at the bottom of the list with only 37 percent of them vaccinated against pneumonia.

Pneumonia continues to be one of the leading causes of hospitalization and death in the elderly. Preventing pneumonia in the elderly should always be a priority among family members and long term care providers. So the next time you suspect your love one is suffering from the early symptoms of pneumonia, consulting with a medical professional gives your love ones the best chance of full recovery.

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Posted in Home Care, Long Term Care | 4 Comments »

Staff Turnover Closely Tied to Quality Care

Tuesday, March 13th, 2012 by Angela Stringfellow

Research from the Institute for the Future of Aging Services indicates that annual staff turnover levels in home health care companies can vary between 60 and 100 percent across the nation. An article appearing in USA Today last week reflects on the issue, pointing out that turnover can have a significant impact on the quality of care received by clients. It’s these hands-on caregivers who are interacting with patients day in and day out, learning specific wants and needs and forming relationships.

So when these front-line staff are like a revolving door, seniors lose the feeling of security that comes with consistency. High turnover rates also impact the frequency of errors, as it often takes several months on the job to get a firm grasp on daily routines and procedures.

Home health care agencies face high turnover

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Is pay the problem?

Part of the problem, according to some, is the low pay common to home health aides in these settings. In December, the U.S. Department of Labor issued new rules requiring home health care agencies to pay their employees minimum wage and overtime. Currently, the federal minimum wage is just $7.25 an hour.

Still, some employees are making less than $7.25 per hour. Twenty-one states have regulated the industry requiring agencies to comply with the minimum wage, yet those who have not still frequently encounter pay less than the federal minimum wage. Further, the concept of time-and-a-half for hours worked over 40 per week causes further complications. According to Catherine Ruckelshaus of the National Employment Law Project, agencies will typically enlist several workers to fulfill client needs when they exceed the 40-hour threshold. This avoids the necessity of paying overtime, yet creates inconsistency for the seniors being cared for.

The Center for Business and Economic Research at Ball State University found that since 2000, employment in the home health care sector has increased 23 percent, yet salaries have remained stagnant. Another study conducted by the Carey Institute at the University of New Hampshire finds that the average hourly wage for home health care workers in New Hampshire is $10 per hour. More shocking is that 70 percent receive no paid leave and a mere 20 percent receive healthcare through their employers.

Better pay for better care

Kristin Smith, a University of New Hampshire family demographer, notes that research has shown a clear link to higher wages and higher quality of care. Yet agencies fight against regulations requiring overtime and other benefits, pointing out that those increased costs would have to be passed on to seniors, making home health care considerably more expensive.

So what’s the solution? An already struggling healthcare system can’t realistically alleviate more of the cost burden than it currently does through programs such as the Medicaid Waiver. Yet as more seniors require in-home care, the industry must adapt to changing economic demands to hire qualified caregivers.

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Posted in Home Care, Senior Living News | No Comments »

Find a Job as a Caregiver Today

Friday, October 28th, 2011 by mackenzie

At Seniorhomes.com we are consistently getting inquires about jobs at the communities we feature on our site.  We are not able to tell the person if the community is hiring, but we try to help them anyways by offering resources that can help.

But, Caregiverlist has taken the next step and created a easy to use widget that can direct you straight to a caregiver job in your area.  Once you find a job you can also use their site to help you build you resume or brush up on your caregiver knowledge with a certification course.

Providers please let us know what you look for in a caregiver and we will share it with our readers!

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Posted in Caregiver Tips, Health News, Home Care | 2 Comments »

Looking for New Traditions? 6 Ways to Celebrate Halloween with Your Aging Loved One!

Thursday, October 20th, 2011 by mackenzie

Image courtesy of Stef on Stock.xchng

When asked about their favorite seasons, most people would talk about summer, fall or maybe winter. But for me, the best season will always be that two month period between Halloween and New Year’s Eve.  Yes, it can be a very hectic, cold, and stressful time of year, yet it is also the time of year that reminds us of what is really  important.   Presents are great, but this time of year is my favorite because I get to make new memories and celebrate old traditions with my family and friends.

Though I love this time of year, the holidays can also serve as an acute reminder that as our families and friends age, many of our old traditions must change. The holiday activities my 93 year old grandmother is able to participate in is ever evolving and many activities she could do last year are no longer possible for her.

So from now until the New Year, I am going to write about the activities I am planning on doing with my grandmother to get in the festive spirit. Below are my top six ideas of Halloween traditions you can still enjoy with your aging loved one. Please feel free to try one of my Halloween traditions and tell me what your favorite ones are!

1. Pumpkin carving night. Invite all your family members and/or close friends to your house for a pumpkin carving party.  You can let people choose if they want to actually carve out their pumpkin or simply paint it.  Everyone can bring their favorite snack or Halloween drink.  Those that do not want to carve can still enjoy visiting with loved ones and reminiscing about their favorite Halloween memories.

2. Senior Center Halloween Party. In almost every community there is a senior center that throws a Halloween party.  Encourage your parent/grandparent/friend to attend.  If they are nervous or uncomfortable with attending alone, try to attend with them.  Not only are they likely to have a good time and meet other people in the community, but they may feel comfortable returning on a regular basis without you.

3. Night of old Halloween movies, and cocktails. There is nothing my grandma loves more than cozing up by the fire with a old movie on

5. Baking night. Bake or buy cookies and get simple supplies to decorate them.    Then you can  share them with family, friends and neighbors.  If your loved one is in a new community or neighborhood, this can be a great way for them to introduce themselves and meet new people. and a martini.  So put on the movie, mix some drinks and get comfortable for the evening.

4.  Trick or Treating at your local mall. If you still have young kids or grandchildren, why not take them trick or treating at the mall?  It is a warm, safe, and easy place to do an evening of trick or treating.  Plus your aging loved one will enjoy just sitting and watching all the kids trick or treating.  This type of trick or treating is easy, and stress free for both you and your aging loved one.

Grandma relaxing with a cocktail on a cruise in 2009.

6.  Invite them over for  Halloween night. Halloween night can be scary for aging adults home alone.  They may feel vulnerable with
strangers coming to the door.  Therefore, it is a perfect opportunity for you to to invite them over to your house.  You can give them a simple costume and they can help you give candy to the trick or tr eaters, drink spiced cider or simply enjoy each others company.

Bottom line, Halloween can be another holiday where aging loved ones feel lonely and nostalgic.  However, it can also be a great time to relive old memories together while creating new ones.

Pick an idea that sounds easy and fun to you, because ultimately the holidays are about enjoying yourself and being with the people you love.  Please share with me how you plan on celebrating Halloween, we would love to see pictures!

Posted in Caregiver Tips, Fun Caregiving Ideas, Holidays, Home Care | No Comments »

House Calls by Paramedics Aim to Reduce Emergencies, Assisted Living Admissions

Sunday, September 11th, 2011 by Angela Stringfellow

It used to be that if an ambulance was parked in front of someone’s home, there was likely a medical emergency.  Now, that’s not always the case.

With ever increasing budget cuts, a declining number of family practice physicians and the desire for many ailing seniors to stay out of traditional senior living centers like assisted living facilities and nursing homes, health systems are developing innovative ways to serve the patient base.  In several states, paramedics are now being used to provide non-emergency services to home-bound patients.

According to an Associated Press article posted on MSNBC, the paramedics are able to do such tasks as draw blood, check blood pressure, change bandages, and check medication compliance.  These are all basic tasks done by paramedics regularly in the field.  “Instead of taking out the blood and guts, this is a move into preventative care, so people don’t have to call 911,” reported Eagle County Colorado paramedic Kevin Creek.

The Colorado pilot-program is designed to see if there are financial and health benefits to using paramedics in this capacity.  With its 52,000 Medicare-eligible residents, officials are hoping to see savings at both the state and federal levels.  Currently, funding is being provided through a $700,000 grant, but the goal is to have Medicare and Medicaid eventually agree to cover the costs.

Doctor’s OrdersParamedics Giving Preventative Care

Paramedics working in this capacity are not making medical decisions independently; they are working under the supervision of participating physicians.  Medical information collected during visits is evaluated by the doctor who will ultimately decide the course of action.   “We’re the eyes and ears of the primary care physician in the home,” said Lisa Ward, program coordinator. “It’s out-of-the-box health care, and it’s the future.”

For many seniors who are foregoing skilled nursing care and assisted living homes, this can be a win-win situation.  The chronic diseases that often plague the elderly and lead to many hospital admissions like diabetes, congestive heart failure and COPD, can all be monitored by paramedics in this program without patients making the arduous trip to the doctor’s office or hospital.   It’s reminiscent of days gone by when house calls were common place.

For non-emergencies only?

But if paramedics are providing preventative care, who will be available in the event of a true emergency?  Dr. Jeffrey Beeson, past president of the American College of Emergency Physicians, believes such programs can, in fact, reduce the number of ambulance calls.  In a similar program in Fort Worth, Texas, paramedics have visited more than 200 patients when they would have otherwise been waiting for emergency calls.

The answer to this question may lie in Eagle County’s pilot program. The grant, which is provided by the Colorado Department of Health, two private health organizations and the ambulance district, has provided opportunity for Creek and a colleague to be assigned to providing these services to its residents.  This way, there is no shortage of emergency personnel.

So, don’t be surprised if in the near future your doctor decides to make a house call. Only, it most likely will be the local paramedic who comes knocking instead of the doc himself.  Would  you be comfortable with a paramedic performing basic, non-emergent care for your loved one?

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Posted in Health News, Home Care, Senior Living News | 2 Comments »

Home Care Gets a Boost from Housing Slump

Friday, May 13th, 2011 by Angela Stringfellow

Home care providers may be benefiting from the slow economic recovery, according to a May 8, 2011 article in The Milford Daily News. According to the article, more seniors residing in the Milford, MA area have delayed moving to independent living or assisted living communities, instead opting to wait out the housing slump. With real estate prices down, many seniors would be faced with selling their homes for less value or have difficulty selling at all. Those who are still independent enough to care for themselves are choosing to wait it out, hoping for a housing rebound before they’re in a position that they have to move immediately. Seniors choosing to delay moving to long-term care due to housing slump

Betsy Willard, director of community relations for Sunrise Senior Living in Milford, tells the Daily News she’s noticed a decline in referrals for assisted living, but notes that referrals for their memory care facility have remained consistent. Willard believes that’s because memory impairment often becomes a safety issue, so families are more likely to take action to keep their aging loved ones safe, even if it means financial sacrifice.

Seniors who are able to remain at home often do so with the help of home care services, which tends to be more flexible. Assisted living is essentially an all-or-nothing choice; you’re paying for 24-hour care right off the bat, while home care can range from just a few hours per week to round-the-clock care. For this reason, home care is often viewed as a more affordable option. Likewise, McKnight’s Long Term Care News reported yesterday that Genworth Financial’s cost of care survey finds that home care and adult day care costs have remained flat, while the cost of assisted living and skilled nursing facilities has gone up.

Still, consumers should evaluate their options carefully. If a loved one requires care for just a few hours each day, home care or adult day care makes sense. But families reaching a point at which they’re continuously adding hours with a home senior care provider, it might be time to re-evaluate. Home care, at an average cost of $19 per hour, can easily exceed the costs of assisted living and nursing home care if you’re approaching 10 hours per day or more. If your loved one requires 24-hour care, assisted living is a more cost-effective solution.

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Posted in Aging, Home Care, Long Term Care, Memory Care, Senior Living News | 1 Comment »

Home Care Alleviates Caregiver Stress, Reduces Medical Costs

Wednesday, March 9th, 2011 by Angela Stringfellow

Home Instead Senior Care, a national network of locally-owned, in-home, non-medical care providers, recently commissioned a study gauging the role home care services play in the overall continuum of long-term senior care. The study, entitled “The Value of Caregiving at Home,” enlisted a panel of unbiased advisors, including medical professionals, members of academia, researchers and senior care experts to ensure the integrity of the research and methodology.  Home care services help reduce medical costs

The research finds that those receiving home senior care report less frequent physician visits, home care recipients average more than twice as many hours of care per week than those not paying for care, and caregivers provide higher ratings for the quality of care received when paid in-home care services are part of a loved one’s care.

Prior research shows that non-medical home care reduces medical costs by about $25 billion in the U.S. each year, primarily by reducing the number of hospital visits. It’s not clear whether that figure calculates the medical costs saved by caregivers, but Home Instead’s study indicates that caregivers report better health when a loved one is receiving paid home care, likely due to decreased responsibilities and stress, allowing caregivers to pay more attention to their own health needs.

Specifically, caregivers of loved ones with dementia report fewer hospital visits when paid home care is involved–18 percent report visiting the hospital as an outpatient wtihin the last year among those whose loved ones were receiving home care, compared to 40 percent when home care services were not involved.

CaregiverStress.com reports that 83 percent of caregivers say the task is “very demanding,” and 77 percent describe their loved one’s care needs as “overwhelming.” Home care services support not only the patient, but family caregivers as well by alleviating some of the pressure and providing an additional support system, and it’s an alternative for families who aren’t yet ready to place their loved ones in assisted living or nursing homes.

Home care can also enable family caregivers to continue working, something that many give up (either by choice or lack of choice) to care for their loved ones. This is often the case when adult children are providing care for elderly parents and must continue to work to provide for their own families. Seventy-one percent of family caregivers utilizing home care services are employed, and 51 percent maintain part-time employment.

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Passive Monitoring May Reduce Patient Care Costs in Assisted Living, Home Health

Wednesday, March 2nd, 2011 by Angela Stringfellow

Wellness technology, such as digital blood pressure monitors and electronic emergency alert systems, has been around for many years. But even with these advances that make caring for elderly and disabled persons simpler, the cost of monitoring and caring for patients in assisted living facilities and home care settings steadily increases. A new wave of technology may soon be entering the market that has proven to reduce care costs and promote aging in place: Think underwear equipped with blood pressure monitors and pills and capsules with microchips that send a message to indicate whether a patient has taken a medication. Wellness technology improves patient monitoring

Robin Felder, associate director of clinical chemistry and toxicology at the University of Virginia, advocates for the use of what she has dubbed “passive” technology for patient monitoring, citing a 2007 publication in the Journal of Telemedicine and e-Health which showed a staggering 74 percent reduction in the cost of caring for assisted living residents with the use of these devices. According to Felder, the key to the success of passive monitoring devices is that unlike current mainstream gadgets, such as automatic blood pressure monitors, passive devices don’t require any thought or effort on behalf of the patient or caregiver.

Felder says that the majority of blood pressure monitors (95 percent) go unused and stashed away in a drawer or closet. The reason, notes Felder, is that while they’re simpler to use, patients still have to interrupt their activities to use them. Felder spoke during a “Views from the Top” session at last week’s HIMSS conference, where she introduced a number of innovative technologies and products that will make wireless patient wellness monitoring (which Felder calls “wellness support”) a  more realistic possibility:

  • Everyday garments–yes, even your underwear–could function as blood pressure monitors and pulse sensors.
  • Digestible microchips in tablets and pills (that will cost pharmaceutical companies about one cent each) to indicate whether a patient has taken the medication as well as provide data such as stomach pH and other vitals. If that’s not enough, this little chip will transmit the readings to a cell phone using Blueooth technology.
  • Contact lenses and other eye inserts will have the capability to monitor glucose levels in tears in diabetic patients. These gadgets cost about a dime each.
  • Everyday bathroom fixtures will measure your weight, body temperature and other vital signs. No more hiding from the scale!

All of the information gathered through these various devices will be integrated into a patient’s health and wellness records, providing a basis for targeted information to help patients lead healthy lifestyles. Felder terms this the “Medical Cloud,” or the concept of integrating multiple sources of data for multiple clinicians to collectively manage and monitor patients aging  at home, in assisted living facilities or other community-based long-term care facilities.

Read the related article at MobiHealthNews.

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Senior Home Health Care: 60% of Paid Caregivers Make Medication Errors

Monday, February 28th, 2011 by Angela Stringfellow

Researchers from Northwestern University surveyed 98 paid caregivers recruited from physicians’ offices, caregiver agencies, independent living facilities and senior shopping areas to gauge the health literacy of caregivers who serve in a paid capacity for non-family members. To determine the level of health literacy, face-to-face interviews were conducted using The Test for Functional Health Literacy (TOFHLA). Medication aptitude was tested by having participants sort medications into pill boxes by following the directions supplied on the medication bottles. Senior caregivers may make medication errors

More than 60% of participants made errors dispensing the medications into the appropriate containers, indicating difficulties following medication instructions. This finding is significant, because many seniors rely on paid, non-family caregivers for assistance with activities of daily living, which may include medication management. Among the participants, 35.7% were found to have inadequate health literacy, and 85.7% performed health-related tasks, such as medication reminders, sorting or dispensing medications, or accompanying patients to medical appointments.

Seniors who don’t reside in assisted living facilities, independent living or nursing homes and don’t have family nearby capable of managing their care often hire outside caregivers from home care agencies to help manage their activities of daily living. Dr. Lee Lindquist, lead author of the study, says improper medication administration could result in adverse drug reactions or interactions, which could lead to hospitalization. Lindquist says that in some cases, caregivers are genuinely trying to help their clients by taking on additional health-related tasks, but inadequate eduction could make these circumstances dangerous.

When choosing a home care provider, it’s important to check the agency’s reputation and request verification that the caregivers employed by the agency have training in medication management and have clear criminal history and background checks. You can learn more about home care in our home care center.

Read a related article on Dalje.com and the abstract from the Journal of General Internal Medicine.

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