Winter Safety Tips

iStock_000022958229_Double-e1453831265599Be aware of ice. With a few simple adjustments, you can dramatically reduce your chance for falls. When you venture out as the mercury drops, stay alert for hard-to-see patches of ice on sidewalks and parking lots. Go slow, and if you’re using a cane, use it to explore before stepping off curbs and ramps. In fact, a new cane tip can be one of your first lines of defense. Shoes with non-slip soles and high traction bottoms should go without saying, but do you take them off as soon as you’re in the house? You should, so snow and ice remnants don’t melt and create new hazards.

Prepare for power outages. The Boy Scouts have it right – be ready for anything. This is especially important with winter’s dropping temperatures and blustery weather conditions. Make sure candles and flashlights are on hand – and that the latter have fresh batteries. Speaking of, lay in a supply of batteries in all sizes too, so you can power any backup. Invest in a battery powered radio to keep connected if necessary, and consider a NOAA (National Oceanic and Atmospheric Administration) weather radio – local TV or radio stations often program them for free, so you have the most up to date info immediately. Also, don’t forget today’s communications – if you have a cell phone, have a portable charger and extra batteries on hand.

Ask for help. Dropping temperatures and potential precipitation create dangerous conditions that may make venturing out alone treacherous. Ice patches on parking lots and sidewalks can be hard to see; gusting winds can quickly snatch or slam doors, doing damage of their own. Doing it yourself isn’t worth a fall – and it may have the opposite effect, sacrificing independence for injury. Whether for rides to doctor’s appointments or the grocery store, or help shoveling or scraping, a quick call can save a winter of suffering.

Keep your chin up. Long, dreary days plus piled on precipitation wear on the youngest, healthiest, most active individuals. So don’t fret if cabin fever sets in quickly thanks to Old Man Winter’s ice blasts. But do make every effort to stave off more serious situations than a bout of the blues. Depression and anxiety are more common than you think, especially when you have less contact and outside activity than normal. Check in regularly with family, and keep in touch with friends. Aim for a daily phone date with someone, and if you have e-mail, that’s great way to stay connected too.

Decoding Winter Weather Warnings

iStock_000003102814_LargeWinter storm alerts come out with regularity once the mercury starts dropping. But what do they mean, and when should you worry? Here’s what NOAA says:

Winter Weather Advisory: For accumulations of snow, freezing rain, freezing drizzle and sleet that will cause significant inconveniences.

Wind Chill Warning: When wind chill temperatures are expected to be hazardous to life within several minutes of exposure.

Wind Chill Advisory: When wind chill temperatures are expected to be a significant inconvenience.

Winter Storm Watch: A storm is likely – stay alert. Usually issued 12-48 hours ahead.

Winter Storm Warning: A storm is in your area – take action. Usually issued 12-24 hours ahead.

Blizzard Warning: Take shelter immediately. Sustained or gusty winds of 35 mph or more. Falling or blowing snow creating visibilities at or below 1/4 mile. Life-threatening wind chills. Conditions persist for at least three hours.

Comprehensive prevention program effectively reduces falls among older people

Families and physicians have a new tool in the fight against falls- a comprehensive prevention program developed by the U.S. Department of Health and Human Services that reduces both falls and resulting use of long-term care such as nursing homes.

The prevention program, which includes clinical in-home assessments of health, physical functioning, falls history, home environment, and medications to create customized recommendations, was developed by HHS based on the research evidence on risk factors and interventions. Using a randomized control trial, the program was tested among long-term care insurance policy holders age 75 and older to determine whether the intervention was effective and, if so, the impact on long-term care utilization.

The study found that the program led to significantly lower rates of falls over a one-year study period. Those who received the intervention had a 13 percent lower rate of falls, and an 11 percent reduction in risk of falling compared to the control group. Participants also had a significantly lower rate of injurious falls. Long-term care insurance claims were 33 percent lower over a three-year period. The intervention, which cost $500 per person to administer, saved $838 per person.

Falls- which happen to 1 in 3 people age 65 and over every year– can cause pain, suffering, and death, and cost an estimated $35 billion in health care spending in 2014. They are a leading risk factor for needing long-term care at home or in a nursing facility. Given the impact of falls, findings from the HHS-funded study give hope for reducing the rate of falls among the growing population of older adults.

“While falls are preventable, we need to intervene at the right time in a way that is comprehensive and yet individually tailored,” said Richard Frank, Ph.D., the assistant secretary for planning and evaluation at HHS, whose office funded the study. “Preventing falls helps everyone: the older person, their family, and the health and long-term care systems. And this study shows that by investing in falls prevention, we can reduce long-term care use and spending.”

The risk factors for a fall include fear of falling, gait and balance problems, certain medications, clutter in the home, and some health conditions. Few interventions have taken a comprehensive approach to address all of the risk factors through one program.

Although this study focused on the rate of falls and long-term care utilization and costs, future research will examine the impact of the intervention on health care utilization and costs.

“We expect to see a similar or greater return on investment in terms of health care costs,” added Richard Frank.

The 2015 White House Conference on Aging, in partnership with the National Council on Aging, recently convened a Falls Prevention Summit to call attention to the critical role of falls prevention in healthy aging and to provide opportunities for older Americans and stakeholders to share their views and ideas on this important issue. More information about the intervention and the study design are available athttp://aspe.hhs.gov/daltcp/reports/fallexpfr.htm.

The study appears online and in print in the June issue of Health Affairs.

From HHS.gov

Readmission by the Numbers

Readmission by the NumbersReadmission initiatives and efforts toward prevention are capturing center stage in healthcare across the country. Have you stopped to think what readmissions are really costing you, and what you could gain by cutting them?

  • Readmissions cost the US $25 billion
  • Studies show patients remember less than half of what they hear from providers in the hospital
  • One in every five Medicare patients is readmitted within 30 days
  • Many readmissions are preventable—as much as 13 percent
  • Readmissions could be reduced by as much as 12 percent by:
    • Improving admission and discharge procedures
    • Enhancing follow-up care
    • Using technology

The New England Healthcare Institute found that healthcare information technology is a vital component of any readmission program. Telehealth technologies automatically track patient data and send it to providers. This allows for in-home monitoring as well as more accurate, reliable information and follow-up during care transitions.

Patients often place independence above all else, and telehealth systems empower them and increase their ability to do so. They can be better informed about their health, and with the right information, be motivated to take steps of their own to prevent readmission.

Does it work for every patient? Telehealth technology has been studied extensively in cardiac patients, but its effectiveness is also being documented in chronic diseases like diabetes. And its impact stretches across a huge continuum of care and conditions.

One place where the numbers aren’t a factor is cost: A Pennsylvania health system reports that it not only reduced readmissions across 26 facilities, but also paid for the system in just two months. Return on investment is not a problem when it comes to telehealth technology.

But engagement makes a huge difference in telehealth success, as many early adopters have discovered. When their hospital introduces or suggests the technology, patients are much more responsive and adoptive than when telehealth comes about after discharge.

One of the most significant examples of telehealth success comes from the Veterans Health Administration Care Coordination/Home Telepath Program, which reports a 40 percent reduction in overnight stays. In turn, patient satisfaction rates are at 85 percent.

Those numbers add up to fewer readmissions. How about yours?

5 Ways Technology Can Improve Care Transitions

 

5 Ways Technology Can Improve Care Transitions Moving from one healthcare setting to another presents one of the biggest challenges in a patient’s treatment plan. Here the possibilities for medication errors, setbacks and readmissions skyrocket, unless an effective care transition plan is part of the care continuum. The most common issues with care transition revolve around communication, patient education and accountability. Leveraging some of the latest telehealth technology can have a surprisingly significant impact on care transition – some say reducing readmissions by almost 50 percent. How?  Faster response to rising health concerns. A patient with diabetes is discharged after a cardiac event. Though he’s following his doctor’s discharge orders related to his heart, repeated blood glucose spikes land him back in the hospital. If remote vital signs monitoring like wireless blood glucose and blood pressure devices were part of the care transition plan, caregivers and providers would automatically receive alerts when readings were off, enabling them to quickly and proactively address any rising health issues.  Built-in timely follow up. You undoubtedly have a skilled staff – with a large workload. Telehealth technology makes it easier for them to do their jobs, and easier to know when a patient’s condition has changed. Today’s technology comes with benefits like setting daily weekly notifications, adding in immediate alerts for key changes, setting alarms for unauthorized medication attempts, for faster intervention, fewer ER visits and fewer readmissions. For medications, for vital signs, for falls, you can design an online, wireless monitoring and reporting system that improves your level of care, creates better outcomes and enhances the care transition.  Better patient engagement. Today’s advanced health monitoring technologies take little effort from the patient – key to encouraging compliance with discharge plans. Single button operation, wireless designs and readings within minutes mean patients can take key metrics like blood pressure, pulse oximetry, blood glucose and weight with little disruption to their daily routines. Immediate data transmission ensures you have good data to easily track trends and changes to client conditions.  Continued care even with new or unknown issues. Let’s say a patient understands and even repeats all instructions during discharge, but at home, doesn’t follow the treatment plan. Repeated efforts fail and readmission is unavoidable. Two months later, dementia is diagnosed. With telehealth technologies like remote patient monitoring, medication management systems and medical alert systems, both the patient and caregivers would have received reminders, and notifications when key metrics were off, potentially avoiding readmission.  Less stress on patients and caregivers. One of telehealth’s biggest appeals for caregivers and patients alike is the option of transferring some of the load. Remembering medication times and dosages, taking consistent health metric readings, plus worrying about safety and fall prevention can take a toll on even the strongest, most proficient among us. Wireless vital signs monitoring, medication organizers with auto alerts and notifications and medical alert systems with unlimited access to registered nurses provide not just tools but invaluable peace of mind that increases the odds of successful care transition.  Find the patients at risk for readmission faster, improve the continuity of care and increase patient satisfaction – telehealth technology can do all that and more.Moving from one healthcare setting to another presents one of the biggest challenges in a patient’s treatment plan. Here the possibilities for medication errors, setbacks and readmissions skyrocket, unless an effective care transition plan is part of the care continuum. The most common issues with care transition revolve around communication, patient education and accountability. Leveraging some of the latest telehealth technology can have a surprisingly significant impact on care transition – some say reducing readmissions by almost 50 percent. How?

Faster response to rising health concerns. A patient with diabetes is discharged after a cardiac event. Though he’s following his doctor’s discharge orders related to his heart, repeated blood glucose spikes land him back in the hospital. If remote vital signs monitoring like wireless blood glucose and blood pressure devices were part of the care transition plan, caregivers and providers would automatically receive alerts when readings were off, enabling them to quickly and proactively address any rising health issues.

Built-in timely follow up. You undoubtedly have a skilled staff – with a large workload. Telehealth technology makes it easier for them to do their jobs, and easier to know when a patient’s condition has changed. Today’s technology comes with benefits like setting daily weekly notifications, adding in immediate alerts for key changes, setting alarms for unauthorized medication attempts, for faster intervention, fewer ER visits and fewer readmissions. For medications, for vital signs, for falls, you can design an online, wireless monitoring and reporting system that improves your level of care, creates better outcomes and enhances the care transition.

Better patient engagement. Today’s advanced health monitoring technologies take little effort from the patient – key to encouraging compliance with discharge plans. Single button operation, wireless designs and readings within minutes mean patients can take key metrics like blood pressure, pulse oximetry, blood glucose and weight with little disruption to their daily routines. Immediate data transmission ensures you have good data to easily track trends and changes to client conditions.

Continued care even with new or unknown issues. Let’s say a patient understands and even repeats all instructions during discharge, but at home, doesn’t follow the treatment plan. Repeated efforts fail and readmission is unavoidable. Two months later, dementia is diagnosed. With telehealth technologies like remote patient monitoring, medication management systems and medical alert systems, both the patient and caregivers would have received reminders, and notifications when key metrics were off, potentially avoiding readmission.

Less stress on patients and caregivers. One of telehealth’s biggest appeals for caregivers and patients alike is the option of transferring some of the load. Remembering medication times and dosages, taking consistent health metric readings, plus worrying about safety and fall prevention can take a toll on even the strongest, most proficient among us. Wireless vital signs monitoring, medication organizers with auto alerts and notifications and medical alert systems with unlimited access to registered nurses provide not just tools but invaluable peace of mind that increases the odds of successful care transition.

Find the patients at risk for readmission faster, improve the continuity of care and increase patient satisfaction – telehealth technology can do all that and more.

When Aging Is Something More: 10 Red Flags

iStock_000019498110XLargeEditAs we’re aging, we all experience bouts of memory lapse or wondering if we’re going to “lose it”—who hasn’t walked into a room, only to wonder why you went in there? But when it’s impacting daily life, or when it puts life at risk, that’s the time for concern. It’s even harder when it’s not you, but your parents experiencing memory issues. How do you know when forgetting medication is human error or a sign of something bigger?

Memory loss comes with age. It is true, but delaying diagnosis for Alzheimer’s or dementia can delay valuable treatments that can help your parents live independently longer. To distinguish, think of it this way: you may forget what day it is for a moment, but you’ll likely remember later. If your loved one doesn’t know the day or the season, that may be cause for concern. Forgetting to pay the water bill one month is a natural mistake. No longer being able to manage a budget should raise a flag. Trouble finding the right word in conversation? That happens to the best of us. Having trouble having a conversation at all? That may be cause for concern.

Learning to recognize the 10 early signs and symptoms of Alzheimer’s can help your loved one get help faster, before the disease takes more memory, thinking and reasoning skills away. The Alzheimer’s Association says these should always be red flags:

  1. Memory loss, especially forgetting recently learned information
  2. Challenges in solving or planning problems (following a recipe, taking longer to do things)
  3. Difficulty completing familiar tasks at home, work or leisure (trouble driving to work or playing a favorite game)
  4. Confusion with time or place (forgetting how they got somewhere)
  5. Trouble understanding visual images and spatial relationships (difficulty reading or judging distance)
  6. New problems with words in speaking or writing (stopping in the middle of a conversation, calling things by the wrong name)
  7. Misplacing things and losing the ability to retrace steps (also putting things in unusual places)
  8. Decreased or poor judgment (giving large amounts of money to telemarketers, lack of grooming)
  9. Withdrawal from work or social activities (physical changes make them uncomfortable)
  10. Changes in mood and personality (confused, easily upset, suspicious, fearful)

Someone may experience one of these symptoms or all of these symptoms. If you notice them, ask for a doctor’s input. Many effects can be helped with today’s telehealth technology, like medication management, remote monitoring and medical alert devices. Just as you’ll add these to your loved one’s home for added safety, asking the doctor to review concerning symptoms adds another layer of preventive health management.

Prescription for Success: Practical Tips for Managing Medications

MedMinderWhen you can’t be with your loved ones round the clock, medication management becomes a looming specter in daily life. The thought of mom forgetting her heart pill or dad taking too many blood thinners reads like a script from our worst nightmares. And being the pill police doesn’t put a positive spin on the narrative either. But with a few simple suggestions and changes, you can rewrite the story and set the stage for successful health management.

In sight it’s right. “Out of sight, out of mind” became a standard for a reason. Storing pills in medicine cabinets and clever baskets may keep things looking nice, but it’s not a recipe for remembering. Keep medications in plain sight, near a sink in the kitchen or bathroom as a daily reminder.

Make a list. Create a simple chart of all medications. Include both over-the-counter and prescription, and make a space for drug name, purpose, color and shape, how much and when to take it and special instructions like taking with food or not taking before bed. Set it up in a weekly or monthly format, whichever makes the most sense for the number and frequency of medications.

Phone a friend. Friends and family can be a great resource for remembering to take medications. It may only take a week or two of friendly reminders before you’re on schedule with just a few refreshers here and there to keep on track.

Get a pillbox organizer. The most low-tech of these are simple weekly plastic containers with a slot for the pills to take each day. When the Wednesday box is empty, the dose was taken. The best options come with alarms and timers for added reassurance and reminders. They’re secure and locked, provide auto alerts and notifications and even offer a flashing light in the appropriate compartment when it’s time for medication. Auditory prompts, automatic phone calls, text messages and emails can be enabled as reminders. Caregivers can also receive web-based and real-time reports.

10 Tough Questions to Ask Your Parents

As parents get older, and the slow but inevitable reversal of roles progresses, you’re placed in the unenviable position of shepherding decisions. Much as they used to do for you in youth and adolescence, you’re now responsible for guiding, but not always making for them, decisions on welfare, safety and independence.

Figuring out how to open the door on those conversations isn’t easy, but planning ahead with a prepared list of questions can help. Here’s a starting point:

  1. Is there anything about the house we could change to make it easier for you day to day?
  2. Are the stairs still doable, or would one level be better?
  3. How many prescriptions are you taking?
  4. Do you have any trouble reading your medication containers?
  5. Do you do OK remembering to take your medicine or could you use help?
  6. Has your doctor looked at your total medication list lately? With different specialists and doctors it’s important to have one person review for potential interactions.
  7. Would it be good to have help with chores like yardwork, cleaning or meals?
  8. Is there anything you’ve stopped doing because you can’t see as well or you’re concerned about falling?
  9. Have you ever fallen and didn’t think you’d be able to get up?
  10. What would happen if you fell while you were outside in the yard or garden?

You don’t have to stick to this list, but sometimes it helps to have a starting point. You may also need to ask more difficult questions about sensitive topics like driving and finances. But if you can think ahead, go in with solutions and suggestions such as medication management and reminders, and medical alert devices, and even rehearse your approach, you can make a hard conversation easier for all of you.

Is Patient Monitoring Just Another Bell and Whistle?

jpg of bp deviceEvery day healthcare tabloids and pundits tout the benefits of in-home patient monitoring. Is this really a true need, or another bell or whistle? Let’s take a look at the facts.

A Boston hospital adopted a heart failure telemonitoring program with powerful results. The program has produced a 50 percent decrease in all-cause readmissions and has also positively impacted patient mortality.

Patient monitoring can also impact medication management and reduce medication errors, a huge expense for healthcare today. A Minnesota hospital that implemented remote monitoring saw their medication take rates climb to 50-70 percent for heart failure patients.

And by starting remote monitoring for patients with chronic diseases, a Colorado hospital dropped their all-cause readmission rate to just 7.3 percent—two thirds lower than the national average.

So why do patient monitoring systems make a difference?

No patient intervention

So much of healthcare relies on patient participation, from medication management to follow-up strategies. Telehealth devices collect the data without waiting for patients. Data is transmitted any time a reading is taken.

Data preservation

Mention the term “data loss,” and you’ll strike fear in the hearts of healthcare IT managers everywhere. Patient data losses can not only be catastrophic; they can set up high liability situations that may take years to reveal their consequences. Wireless monitoring devices use, store and forward technology to increase reliability.

No phone required

In today’s world there’s no guarantee every patient will have a phone, which can significantly up the complications in follow-up and monitoring. New technology offers connections via cellular networks – the perfect solution for two-way communication and accurate, reliable monitoring.

Fast connection

Automatic updates keep providers constantly connected with their patients, so instead of waiting to hear about a problem when a patient reports it, they’re learning about it in real time. Providers are better equipped to address issues quickly, before they escalate and risk readmission.

Better outcomes

Let’s say you have a particularly compliant recovering cardiac patient who regularly monitors blood pressure, heart rate and other vitals. But she inevitably forgets the final step of reporting it to the provider. Even the most consistent numbers are meaningless unless a physician sees them. Monitoring devices take human error out of the equation, automatically uploading and allowing physicians access at their convenience.

Whether you’re a telemarketing devotee or a devoted skeptic, the evidence bears out that the concept deserves consideration. Your patients deserve it.

Anatomy of a Fall: What Really Happens

We hear a lot about how dangerous falls are for older Americans, especially those living alone. The numbers are particularly harsh when it comes to hip fractures – 90 percent are caused by falls, and 250,000 Americans suffer one each year. They’re the leading fall-related injury causing hospitalization, and recovery is long and costly. But do we really understand the true ramifications of falls, and what they mean for their victims? To get an idea, let’s take a look at what happens in the minutes, hours, days and even months after a fall.

Minutes Later

  • Within 30 to 60 minutes, muscle cell breakdown begins

Days Later

  • 5 percent muscle strength is lost every day
  • Bed rest causes lower blood oxygen and plasma, in turn leading to dizziness
  • Muscle spasms and pain, especially with spine injuries

Months Later

  • 25 percent of elderly people with a hip fracture die six months after the injury
  • One in four people with a hip fracture must live in a nursing home for a year
  • Balance and stability is often permanently affected
  • Depression and dementia can result
  • May need a wheelchair or walker permanently
  • Fear of falling makes them more prone to repeats – half will fall again within a year

Falls are scary, but prevention is real. You can take steps to prevent yourself or a loved one from taking a fall that could change your life. Falls are the #1 reason for emergency room visits among those 65 and over – and there is no need to be a statistic. Fall-proof the home, consider a monitoring device, carefully manage medications to prevent side effects, and exercise to improve strength and balance. Studies show that older adults who exercise are nearly 40 percent less likely to be injured in a fall compared to elderly people who do not get exercise. Any movement helps – start small and build up! And if you do fall, know what to do to stay safe and minimize injury. Be smart, and take control of your health to maintain your independence.