Problem about practicing medicine in nursing home is many medical problems which includes cognitive impairment.
The major challenge about nursing home is Medicare billing. The problematic was that in the nursing home environment, many of patients were demented and couldn’t possibly give a coherent history.
No wonder physicians often respond to a call from the nursing home about a sick patient with an order to send the patient to the hospital for assessment. Send a weak nursing home patient to the emergency room and he has so about a 90% chance of being admitted. So instead of paying a physician an appropriate amount for making a visit to the nursing home.
Image source: Nurse Practitioner | Family Practice | Gallup, NM
On Wednesday, July 23, Dr. Heidi Keeler, course faculty for Gero Nurse Prep, Dr. Catherine Bevil, Director of Continuing Nursing Education at UNMC, and Tim Gilbert, Office and Business Associate for Gero Nurse Prep, attended a workshop hosted by Vetter Health Services. The workshop’s target audience was long term care administrators and directors of nursing.
Dr. David Gifford, Senior Vice President, Quality & Regulatory Affairs for AHCA/NCAL
The guest speaker was Dr. David Gifford, Senior Vice President, Quality & Regulatory Affairs for AHCA/NCAL. Dr. Gifford conducted the 2 day workshop to forward the quality mission of the organization. Drs. Keeler and Bevil also presented at the meeting, and delivered a message concerning the benefits of certification and outlining how Gero Nurse Prep can help nurses achieve certification. The workshop was very effective at promoting and maintaining a culture of quality in long term care.
Urinary incontinence is a problem for a large proportion of older adults, regardless of their residence. It is important for Gero nurses to understand the complexity of the problem and also to be ready with information and patient education regarding possible treatment options and referrals.
2014 NNFA/NALA Fall Convention
September 16, 2014 | Booth #71
La Vista Conference Center
12520 Westport Parkway
I-80 Exit #442
La Vista, NE.
402-331-7400
Special Offer!
We are offering $100 off the course fee to people who will visit the GNP booth#71 and get the code at GNP booth#71 during the convention. The offer will be valid from September 16, 2014 and expires on December 31, 2014.
Some challenging news from top experts in elder care-see what they are saying about weight and health in older adults.
Diabetes appears to be loosening its awful grip on the elderly, and one leading geriatrician is hoping that caretakers will reassess their tactics in the battle of the bulge.
A report earlier this year found that the worst complications of elderly diabetes fell off dramatically between 1990 and 2010. Many factors might account for it, St. Louis University School of Medicine Professor John Morley says in a new editorial, but there is “one factor that can clearly be excluded”—obesity.
Geriatrician Urges ‘Rethinking’ of Elderly Obesity
“In addition, there is evidence in nondiabetic individuals that obesity may be slightly protective,” Morley writes. “There is also evidence that weight loss may accelerate mortality in older persons with diabetes mellitus. This has been termed the obesity paradox.”
The National Administration on Aging, through the National Center on Elder Abuse, has released a report on the Elder Justice Road map Project, aimed at preventing elder abuse. I highly recommend you read about this project, at the least look over the executive summary.
A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD
Image source : http://www.benefitspro.com
April 16 – It was officially the day Americans were made-up to remember to complete an advance directive.
Nobody put much consideration to National Healthcare Decision Day since it came just after the anniversary of Boston Marathon bombing or possibly Americans were overburdened by holiday work.
A new study published this month in the journal of the American Geriatrics Society the main focus was – how many people have an advance directive and how has this changed over the past 10 years? But this study has some major limitations-
Only includes people who died and relies on the testimony of relative or friend.
It was restricted to people over age 60.
Author of current study conclude that having an advance directive is correlated to one’s wishes for end-of-life care are followed. It was based on the report which states that the person who died had actually wanted. Also National Healthcare Decisions Day was ignored by media because it was surpassed by the other more exciting events or because it continues to pay attention on a form, on finalizing a legal document, rather than on addressing head on what is most important to us in the last year or two or five of life, on the decisions that will matter most in life’s last stage, however long that lasts.
Geriatrics would be a good deal easier if every older person suffered from just one medical condition. But most elderly people have more than one chronic disease and the older they are, the more chronic conditions they are likely to have. Since “multiple chronic conditions” is a mouthful, researchers coined the term “multimorbidity,” an only slightly less awkward way of expressing what is probably one of the most critical features of geriatric existence. It’s so critical because the best medical treatment, known as “evidence-based medicine,” is founded on studies of patients who don’t have multimorbidity at all. They are generally perfectly healthy except for the single disease being studied. So when we tell a patient that “studies show’ that blood pressure should be below 140 and that the best medication to take if the blood pressure is elevated is a diuretic, we mean that if the only problem is high blood pressure, then taking the diuretic is the best way to lower the risk of bad outcomes such as strokes and heart attacks. But if the patient also has another chronic condition, say Parkinson’s disease, which is being treated with the medication L-dopa (Sinemet), then giving that patient a diuretic to lower blood pressure could backfire—long before any heart attacks or strokes were prevented, the patient might fall down (both L-dopa and diuretics contribute to sudden falls in blood pressure when a person stands up) and break a hip. Simply assuming it makes sense to apply multiple guidelines to a patient with multiple problems can result in medication lists a mile long that cost a fortune and that cause more problems than they solve. So multimorbidity is a big deal in geriatrics. Now, for the first time, multimorbidity is getting the attention it deserves.
Image Source: Google Images
A couple of years ago, the American Geriatrics Society set up a task force to develop an approach to multimorbidity for physicians. This group generated a report that lays out the basic principles that should underlie care for a patient with multiple chronic conditions. And a recent symposium brought together physicians and researchers from a variety of backgrounds to come up with strategies for generating a better evidence base, for designing new guidelines, and for carrying out appropriate systematic reviews for patients with multimorbidity. The results of the symposium are published as 3 articles along with an editorial in the April issue of the Journal of General Internal Medicine.
According to WashingtonTimes.com- President Obama’s mendacious political promise, “If you like your health care plan, you can keep it,” continues to cast a long and disturbing shadow of doubt and confusion over millions of Americans who have lost coverage as a result of Obamacare. As 2014 unfolds, the most vulnerable senior citizens — those who receive home health care services — are about to learn they are out of luck. Obamacare opens a trap door under them, leaving this elderly population in freefall — with many citizens losing access to home health care.
Image source: Google Images
Add another compelling reason to reverse Obamacare. Whether by accident or intention, the “Affordable Care Act” empirically strips America’s oldest and poorest cohort, all part of the World War II generation, of this basic coverage. Here is how.
