Wednesday, August 10, 2011

Social Support Activities Lead to Better Quality of Life As One Ages

How important is social support as a person ages? This may seem like an easy question to answer. Most people would not choose isolation and loneliness versus spending time with companions. However, can lack of social support really hinder a person’s overall quality of life?

Lack of social support is related to negative impacts on health and well being, especially for older people. Having a variety of positive social supports can contribute to psychological and physical wellness of elderly individuals. Support from others can be important in reducing stress, increasing physical health and defeating psychological problems such as depression and anxiety.

When considering who provides social support for an elderly individual our first thoughts are of family members. While it is true that most support does come from family members, there are many circumstances in which family members cannot be supportive (stress due to responsibilities, illness, death, financial problems, job relocation). In the United States the fastest growing age group of individuals are those 85 years and older. Due to this fact, family supports will inevitable decrease for these older individuals. A need for community-based services is more important now then ever before.

Community-based services can be extremely useful for elderly individuals. Services for older persons can encompass many areas, but one of the most important areas as discussed previously is social support. Support for elderly persons can be found in many places including: senior centers, assisted living facilities, meal delivery, religious affiliations, adult day care centers, etc. These services can provide positive social supports that can help older persons defeat loneliness and isolation. However, social support must encompass more then physical presence or conversation. Studies have shown that social support services should contain quality activities. These activities should promote positive self-awareness.

Self-awareness is key to a person’s overall quality of life and satisfaction. Many leisure social activities can be used to help increase an individual’s self-awareness. Activities for elderly individuals may include reminiscence groups, journal writing, readings of favorite book passages, group exercise, singing groups, etc. Individuals may also feel more self-satisfied if they are part of the planning of social activities that take place.

Two of these community-based service centers that provide quality social support services for elderly individuals are discussed below.

Senior Citizen Centers

Today, there are estimated to be about 15,000 senior centers across the United States. Senior centers act as a focal point for older Americans to receive many aging services. The most common services offered at a senior center include health programs (including Zumba and Yoga), arts/humanities activities, intergenerational programs, employment assistance, community action opportunities, transportation services, volunteer opportunities, education opportunities, financial assistance, senior rights counseling/legal services, travel programs and meal programs. These programs and activities can help promote positive self-awareness.

Lori Beckle describes how participating in her local senior citizens center has given her the independence and life satisfaction she thought was lost when her husband died in 2009. “ I was devastated and so frightened for my future without Ed. He was my only friend and the one I turned to when I felt alone. My daughter invited me to attend our local senior center where a bereavement group was being held for those who had lost a loved one. I met Phyllis during the group and now I have a new friend I call when I become afraid. Phyllis has helped me develop the skills to get through the tough times and focus on my immediate happiness.”

Adult Day Care Centers

According to the National Adult Day Services Association (NADSA), there are currently more than 4,600 adult day care centers nationwide. Adult day care is a program in which activities are provided to promote social support and health services to an older adult during the daytime. Most centers operate Monday through Friday during daytime hours. Social support services at an adult day care can consist of musical entertainment and singing groups, group games such as cards, gentle exercise, discussion groups (books, films, current events), holiday/birthday celebrations and local outings. Not only are these social activities provided, but participants of the program can also develop lasting relationships with staff and other participants. Adult day care centers also provide meals and health services. Adult day care centers differ from other programs for elderly individuals, because they allow the participants to develop and increase self-awareness by encouraging independence.

Amanda describes her experience as a volunteer at her local adult day care center. She stated, “ I was involved in planning the activities for Thursday afternoons. I wasn’t sure what kind of activities my older friends would enjoy so I had them share their favorite activities they participated in when they were my age (23). I soon realized that I was hearing the most fascinating stories of hopping trains, college dances, swimming in the lake, etc We decided Thursday afternoons would be spotlights of each individuals’ lives as a twenty-something. One of the participants told me that Thursdays became a highlight for her week.”

Adult Day Care Centers and Senior Citizen Centers help to provide an elderly individual the opportunity to participate in social support activities. Social support activities found in these programs can be beneficial to a person’s quality of life and overall satisfaction. With a higher self-awareness and quality of life an individual can reduce the risks of mental and physical health problems as they age.





Friday, July 01, 2011

Why are we never “ready for that” product or service until it’s too late? Start conversations BEFORE a need is apparent. What questions are you going to ask today?

Susan Estrada sells tech items. She shares her real-time experience at the San Diego Country Fair. She sells products that are meant for both the young and old which accomodate for a special need. For example, she had a med-e-lert medication dispenser, a talking clock, an ezRead Visual Aide Magnifier as well as less techie items like a spork at her booth.


After seeing literally thousands of people pass the booth, she made some interesting observations. Thirty-five to 59 year-old men were interested in anything techie. Women controlled the money, so if these men wanted to buy anything, they went looking for the female with the pocketbook. Multi-generational family groups with a physically-impaired elder family member didn’t even stop to look. The identified caregiver of the family didn’t stop even though she looked interested. These observations are right in line with market analyses of sales trends.

Why are we never “ready for that” product or service until it’s too late?

Families are afraid of upsetting the apple cart. Dr. Linda Rhodes, gerontologist and author of Should Mom Be Left Home Alone? Should Dad Be Driving? suggests starting conversations much earlier, long before a need is apparent.

Some "What if Scenarios" to review with a loved one to plan ahead include:

• IF you have a stroke or break a hip, what rehab or nursing home facility would you like to go to for recuperation?

• IF you're sick and need home health care, what agency should be called?

• IF it's not safe for you to live alone, what assisted living facility should we visit?

• IF you can't get around and do for yourself but can still stay at home, what kind of services do you want to help you with daily living?

Some TO DO suggestions include:

• Create a "Rainy Day Folder" that places all of your directives in one place and share a copy with family members.

• Fill out a Living Will so everyone will know what you want regarding any end-of-life decisions

• Make a list of all your physicians and identify the hospital of your choice in the event of an emergency

• Choose a Durable Health Care Power of Attorney so a trusted loved one can make health care decisions when you're too sick to make them

Dr. Rhodes warns, "Plan for the unexpected and share your plans with family members, NOW. Unplanned decisions are uninformed decisions, and in the heat of a crisis, they are rarely in anyone's best interest."

What questions are you going to ask today?

Wednesday, June 08, 2011

Heat-related Illnesses: What You Need to Know Now

Have you been outside today? The summer days are upon us, and as the days get hotter it is important to remember the risks heat exposure poses to some of the most vulnerable members of our community: infants and seniors. Seniors, in particular, are at a risk for heat exhaustion and heat stroke, two related but very different illnesses that can develop from exposure to high temperatures and lack of fluids.

A Look at Heat Exhaustion
Heat exhaustion is a milder form of heat stroke, and though not as fatal it can easily lead to heat stroke if not treated immediately. Those who are at most risk for heat exhaustion are seniors, people with high blood pressure, and those who work outdoors or exercise in the heat. It is important to stay hydrated and out of the heat in these months of the year, and symptoms can be hard to notice at first.

Symptoms of heat exhaustion include:
• Heavy sweating
• Pale skin
• Muscle cramps
• Tiredness
• Weak
• Dizzy
• Headache
• Nausea/vomiting
• Fainting
• Skin that is cool and moist to the touch
• Fast and shallow breathing
• Drowsiness

What To Do If You See the Signs
If you or someone you are with is suffering from any of the symptoms of heat exhaustion it is critical to begin treatment immediately so it does not progress to heat stroke, a true medical emergency. To begin treatment, immediately begin to cool the victim down using any combination of these methods provided by the Centers for Disease Control:
• Cool shower or bath, even spray with a garden hose if you are outdoors and cannot make it inside.
• Rest in an air conditioned environment.
• Lightweight clothing.
• Cool, nonalcoholic and non-caffeinated beverages (alcohol and caffeine can promote dehydration). If the symptoms get worse, or last longer than one hour, it is essential that you seek medical attention.

Investigating Heat Stroke
Heat stroke is the next progression in heat exhaustion if it is left untreated, and requires emergency medical attention. In its worst cases, the victim can suffer from permanent organ damage or even death. It is a form of hyperthermia, which is a raised body temperature that can severely impact your health permanently. Though our bodies generally can dissipate heat by radiation through the skin, or sweating, when extreme heat conditions occur, the body may not be able to cool itself down well enough or fast enough causing the stroke. Additionally, someone who is dehydrated may not be able to sweat fast enough or cool down quickly, which can cause their body temperature to rise too high as well. Those with heart, lung and kidney disease, as well as those taking medications that can cause them to be vulnerable to heat strokes, are at a greater risk.

Symptoms of heat stroke, though similar to heat exhaustion, are more severe, and are both physical and neurological. Physically, the victim can suffer symptoms similar to a heart attack, and typically the following are noticed: nausea, vomiting, fatigue, weakness, headache, muscle cramps, difficulty breathing, absence of sweating-hot red or flushed dry skin, and rapid pulse. Neurological signs include: confusion, agitation, hallucinations, and strange behaviors.

If you notice someone exhibiting these signs, immediately call 911 and begin to cool the victim down. Many of the same cooling methods for heat exhaustion work well, in addition to fanning the victim to promote sweating, and monitoring their body temperature with a thermometer until the body temperature drops to 101-102 degrees and use any and all cooling methods until medical help has arrived. Always remember that prevention is the key.

Avoiding heat exhaustion and heat stroke is crucial when temperatures rise.
• The most important measures to prevent heat strokes are to avoid becoming dehydrated and to avoid vigorous physical activities in hot and humid weather.
• If you have to perform physical activities in hot weather, drink plenty of fluids (such as water and sports drinks), but avoid alcohol, caffeine and tea, which may lead to dehydration.
• Your body will need to replace important chemicals (such as sodium) as well as fluids if you sweat excessively or perform vigorous activity in the sunlight for prolonged periods.
• Take frequent breaks to hydrate yourself. Wear hats and light-colored, lightweight, loose clothes.

Friday, June 03, 2011

Know Your Rights About Health Care

Did you know there is a Patient Bill of Rights? The Patient Bill of Rights that was adopted by the U.S. Advisory Commission on Consumer Protection and Quality in the Health Care Industry in 1998. Virtually any organization that provide services and bill Medicare and Medical Assistance are required to inform patients of these rights when they start providing services to the individual.

So what does the Patient Bill of Rights say?

Information Disclosure: You have the right to accurate and easily-understood information about your health plan, health care professionals, and health care facilities. If you speak another language, have a physical or mental disability, or just don’t understand something, help should be provided so you can make informed health care decisions.

Choice of Providers and Plans: You have the right to a choice of health care providers who can give you high-quality health care when you need it.

Access to Emergency Services: If you have severe pain, an injury, or sudden illness that makes you believe that your health is in serious danger, you have the right to be screened and stabilized using emergency services. These services should be provided whenever and wherever you need them, without the need to wait for authorization and without any financial penalty.

Participation in Treatment Decisions: You have the right to know your treatment options and to take part in decisions about your care. Parents, guardians, family members, or others that you select can represent you if you cannot make your own decisions.

Respect and Non-discrimination: You have a right to considerate, respectful care from your doctors, health plan representatives, and other health care providers that does not discriminate against you.

Confidentiality of Health Information: You have the right to talk privately with health care providers and to have your health care information protected. You also have the right to read and copy your own medical record. You have the right to ask that your doctor change your record if it is not accurate, relevant, or complete.

Complaints and Appeals: You have the right to a fair, fast, and objective review of any complaint you have against your health plan, doctors, hospitals or other health care personnel. This includes complaints about waiting times, operating hours, the actions of health care personnel, and the adequacy of health care facilities.

Some practical advice to assure that you are adequately informed:

Speak up if you have questions or concerns, ot if you don't understand information provided to you. It's your or your loved one's body and you have a right to know.

Pay attention to the care you or your loved one is receiving. Makre sure you/they are getting the right treatments and medications. Don't assume anything.

Make sure staff providing care are introducing themselves and you know what their credentials are.

Notice whether or not the staff is washing their hands. Hand washing is the most important way to prevent the spread of infections. Don't be afraid to gently remind the caregiver.

Makre sure the health care professional confirms your/ your loved one's identity before giving medications or treatments.

Educate yourself about the diagnosis, services provided and the care plan. Gather information. Write down important information the doctor tells you and ask if the doctor has any written information you can take with you to look at later.

Thoruoghly read all forms and make sure you understand them before you sign anything. If you don't understand something, ask for a better explanation.

Make sure you understand how to use any equipment that is being used.

Know the medications and why they are prescribed. Ask about the purpose and ask for written information which can be provided by the pharmacy. Know both the brand and generic names of the medications. Know the possible side effects to watch out for.

Whenever a new medication is prescribed, tell the doctor about any allergies and other medications prescribed to be sure that it is safe to also take the new medication.

Ask for a list of providers for services recommended. The hospital or nursing facility should not automatically assign providers for on-going care. You get to choose who you want for continuing care needs.

Friday, May 27, 2011

TRANSITIONS Reduces Re-hospitalization

Hospitals are dangerous places for patients due to frequent medical errors. Almost 25% of all patients have an adverse event related to processes typically used to discharge a person home. A new program is helping avoid problems associated with discharge. This innovative program includes a predischarge history and physical tailored to the special needs of geriatric patients, with emphasis placed on communication and teamwork among providers from different disciplines, a detailed medication review with a pharmacist, and a predischarge meeting among the patient, the patient's caregiver, and a clinician. The program was tested in general medicine wards run by hospitalists at 3 hospital centers in different states. At 3 days postdischarge, 88% of the study group described their health as better than it was before their hospital stay compared with 79% of those who did not have this process used as part of the discharge planning process. Improving the transition from hospital to home with more information and better communication about care needs after discharge to home improves overall health. While this process is not used in all facilities at this time, Health Calls is implementing these services to assist patients In the transition to home. There are things that you can do to help your loved one in the hospital:
  • Visit frequently and ask questions about your loved one's progress.
  • Keep notes about what is discussed.
  • Provide the doctor and staff with a list of the medications he/she was taking prior to hospitalization.
  • Review your loved one's medical history with the clinical team. Ask about the current status of each medical condition.
  • Ask questions about signs or symptoms your loved one is experiencing in the hospital.
  • If you ask to speak to someone and no one comes to address your concerns within one hour, assertively ask to speak to someone again. If the doctor is unavailable ask to speak to the nursing supervisor or RN assigned to your loved one's care.
  • Before discharge, ask for a printout of the list of medications that your loved one will be taking at home. Compare it with your list and determine any changes in the schedule. Ask questions about anything you do not understand.
  • Ask about any changes needed in your loved one's diet, activity, or treatments.
  • Ask about your loved one's ability to care for him or herself. Does he or she need help with walking or dressing, bathing safely? Medication management?
  • Request home therapy and nursing visits if there are any changes in his or her ability to care for self.
  • If he or she is unable to walk safely without help, consider a rehabilitation hospital or skilled nursing facility stay before returning home with home services.
  • Ask about follow-up care needed after discharge.
  • Ask for Health Calls Home Health Agency to reduce the risk for re-hospitalization. Health Calls Home Health Agency's re-hospitalization rate is below the national average, ranking in the top 25 percent of all home health agency's nationally.

Thursday, May 19, 2011

Reducing Medical Stroke Risks

May is National Stroke Awareness Month. The National Stroke Organizations has published the following guidelines.

Medical stroke risk factors include:
Previous stroke, previous episode of TIA or mini stroke, high cholesterol, high blood pressure, heart disease, atrial fibrillation and carotid artery disease. These medical risk factors can be controlled and managed even if you have already had issues with any of them in the past. Talk with your doctor about what will work best for you.
 
Lifestyle stroke risk factors include:
Smoking, being overweight and drinking too much alcohol. You can control these lifestyle risk factors by quitting smoking, exercising regularly, watching what and how much you eat and limiting alcohol consumption.
 
Public Stroke Prevention Guidelines
1. Know your blood pressure. If it is elevated, work with your doctor to keep it under control. High blood pressure is a leading cause of stroke. Have your blood pressure checked at least once each year—more often if you have a history of high blood pressure.  
 
2. Find out if you have atrial fibrillation (AF). If you have AF, work with your doctor to manage it. Atrial fibrillation can cause blood to collect in the chambers of your heart. This blood can form clots and cause a stroke. Your doctor can detect AF by carefully checking your pulse.
 
3. If you smoke, stop. Smoking doubles the risk for stroke. If you stop smoking today, your risk for stroke will begin to decrease.
 
4. If you drink alcohol, do so in moderation. Drinking a glass of wine or beer or one drink each day may lower your risk for stroke (provided that there is no other medical reason you should avoid alcohol).  Remember that alcohol is a drug - it can interact with other drugs you are taking, and alcohol is harmful if taken in large doses. If you don’t drink, don’t start.
 
5. Know your cholesterol number. If it is high, work with your doctor to control it. Lowering your cholesterol may reduce your stroke risk. High cholesterol can also indirectly increase stroke risk by putting you at greater risk of heart disease - an important stroke risk factor. Often times, high cholesterol can be controlled with diet and exercise; some individuals may require medication.
 
6. Control your diabetes. If you are diabetic, follow your doctor’s recommendations carefully because diabetes puts you at an increased risk for stroke. Your doctor can prescribe a nutrition program, lifestyle changes and medicine that can help control your diabetes.
 
7. Include exercise in the activities you enjoy in your daily routine. A brisk walk, swim or other exercise activity for as little as 30 minutes a day can improve your health in many ways, and may reduce your risk for stroke.
 
8. Enjoy a lower sodium (salt), lower fat diet. By cutting down on sodium and fat in your diet, you may be able to lower your blood pressure and, most importantly, lower your risk for stroke.
 
9. Ask your doctor if you have circulation problems. If so, work with your doctor to control them. Fatty deposits can block arteries that carry blood from your heart to your brain. Sickle cell disease, severe anemia, or other diseases can cause stroke if left untreated.
 
10.​If you have any stroke symptoms, seek immediate medical attention.

Monday, May 16, 2011

National Stroke Awareness Month: Guidelines to Recognize and Act Quickly Can Reduce Symptoms

 
May is Stroke Awareness Month. The following guidelines are Published by the National Stroke Association.

Stroke 101
• Stroke is a brain attack, cutting off vital blood flow and oxygen to the brain.
• In the United States, stroke is the third leading cause of death, killing about 137,000 people each year, and a leading cause of serious, long-term adult disability.
• From 1996 to 2006, the stroke death rate fell 33.5 percent and the actual number of stroke deaths fell by 18 percent.
• Approximately 795,000 strokes will occur this year.
• Stroke can happen to anyone at any time, regardless of race, sex or age.
• Approximately 55,000 more women than men have a stroke each year.
• Men’s stroke incidence rates are greater than women’s at younger ages, but not older ages.
• African Americans have almost twice the risk of first-ever stroke compared with whites.
• Types of Stroke:
o Ischemic stroke occurs when arteries are blocked by blood clots or by the gradual build-up of plaque and other fatty deposits. About 87 percent of all strokes are ischemic.
o Hemorrhagic stroke occurs when a blood vessel in the brain breaks leaking blood into the brain. Hemorrhagic strokes account for thirteen percent of all strokes, yet are responsible for more than thirty percent of all stroke deaths.
• Two million brain cells die every minute during stroke, increasing risk of permanent brain damage, disability or death. Recognizing symptoms and acting fast to get medical attention can save a life and limit disabilities.
• The prevalence of transient ischemic attacks (TIA) increases with age. Up to 40 percent of all people who suffer a TIA will go on to experience a stroke.
• The estimated direct and indirect cost of stroke for 2010 is $73.7 billion.
 
Stroke Strikes Fast. You Should Too. Call 9-1-1.
Few Americans know the symptoms of stroke. Learning them—and acting FAST when they occur—could save your life or the life of a loved one. Remember that: Stroke Strikes Fast. You Should too. Call 9-1-1.
 
Common stroke symptoms include
:
• Sudden numbness or weakness of the face, arm or leg – especially on one side of the body,
• Sudden confusion, trouble speaking or understanding,
• Sudden trouble seeing in one or both eyes,
• Sudden trouble walking, dizziness, loss of balance or coordination,
• Sudden severe headache with no known cause.
 
Use the F.A.S.T. test for recognizing and responding to stroke symptoms:
 
F = FACE​ Ask the person to smile. Does one side of the face droop?
 
A = ARMS​ Ask the person to raise both arms. Does one arm drift downward?
 
S = SPEECH ​Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?
 
T = TIME ​If you observe any of these signs, it’s time to call 9-1-1 or get to the nearest stroke center or hospital.
 

Friday, May 13, 2011

Regional Philly Forum Offers Straight Talk on Lupus - May 17

Lupus is a challenging disease that often leaves patients feeling alone and misunderstood, challenging to recognize, diagnose and treat. This chronic autoimmune disorder can affect many organs, including the skin, brain, joints, and other internal organs. Symptoms vary widely, wax and wane and often mimic other conditions. Since the disease manifests itself in numerous different ways, patients often are misunderstood at home and in the workplace.

While many patients might not “look” sick, they may be silently managing the debilitating pain, fatigue and other symptoms associated with lupus. This can lead to a lack of understanding from friends, family members and even physicians. Lupus can be challenging to recognize, diagnose and treat. The chronic autoimmune disorder can affect many organs, including the skin, brain, joints, and other internal organs. Symptoms vary widely, wax and wane and often mimic other conditions. Background materials about the disease are available on the recently launched “the us in lupus” website at www.usinlupus.com.

Doctors and patient ambassadors from “the us in lupus” community at www.usinlupus.com are traveling to cities across the country to offer support, information, and tips for people living with the chronic autoimmune disorder and their caregivers, family and friends.

Two such advocates, Dr. Daniel Kirby and Rena Baldwin, will visit Philadelphia during Lupus Awareness Month in May to help lupus patients discuss their challenging disease – and to help forge new understanding among patients and their caregivers, family and friends.

WHEN
Tuesday, May 17, 2011
Registration: 6:30 p.m.
Program start: 7:00 p.m.

WHERE
Crowne Plaza Philadelphia/ Valley Forge
260 Mall Boulevard
King of Prussia, PA 19406

INFORMATION
To register or learn more about this event log on to www.usinlupus.com or call 1-855-874-6587 to register.

These forums are sponsored by Human Genome Sciences and GlaxoSmithKline.

Tuesday, May 10, 2011

Ways You Can Help Your Family Prevent Medical Errors

About one in three people in the United States will encounter some kind of mistake during a hospital stay, according to a recent study reported in April. This finding is about 10 times higher than estimates using older methods. Adverse reactions to medications account for nearly 1.1 million emergency department visits annually by elderly patients alone. 33% of these patients end up being hospitalized for further treatment.

Much more work is needed to improve health care quality. Medical errors are mistakes, when something happens with your health care that doesn't work out or when the wrong plan was used. Medical errors can hurt or even kill people. Many, including doctors, hospitals, nurses, and others are working hard on initiatives to prevent medical errors. These can be medicine errors, mistakes with surgery, tests, diagnosis, equipment, lab reports and other aspects of health care delivery. They can happen during even the most routine tasks such as when a hospital patient on a salt free diet is given an high-salt meal.

You can protect yourself and your family from medical errors.
1. The single most important way you can help to prevent errors is to be an active member of your health care team. Talk to you doctor, nurse and other health care workers. Tell them important information about your health. Ask them questions. Make decisions about your health care with them.
2. Make sure that you receive the right medicine. Bring your medicines with you to all doctor appointments or at least a correct current list of your medicines which includes the dose and frequency that you take them. Include on your list medicines that you may buy over the counter including aspirin, cold medicine, vitamins, and herbs. This will help your doctor make sure that your new medicine does not cause problems with the ones that you are already taking. Tell your doctor if you have any allergies. Also tell about any problems your medicines have caused, such as a rash or a stomach ache. When your doctor gives you a prescription, look at the writing. Is it easy to read? If you can't make out the letters, the drugstore may not be able to either. When you pick up your medicine at the drugstore, make sure it is what the doctor ordered. Ask questions before you leave the drugstore. If you receive the wrong medicine from the drugstore, ask about it.
3. Make sure you follow the right schedule and take the right amount of medicine. Ask your doctor: "What time of day should I take this medicine?"; "do I need to take this medicine with food?'; "How much should I take each time?". Make sure you know how to measure your liquid medicine. The label may say teaspoon but do not use the teaspoon you eat with to measure your medicine. These do not hold the right amount. Use a special measuring tool designed to accurately measure the amount. These are available for purchase at the pharmacy.
4. Errors made in procedures performed by health care workers can make you sick. Illness can spread when health care workers don't wash their hands and apply gloves. It is okay to ask anyone who touches you whether they have washed their hands. Some foods can make you ill. Know what foods your doctor doesn't want you to eat.For example, people with heart failure can not have salt in their food, and diabetics receiving a meal with lots of carbohydrates or sugar can become sicker.
5. Make sure that your doctor operates on the right part of your body. Talk to your doctor about the surgery. Ask what will be done. Be sure your surgeon makes a mark with a pen before the surgery on the part of your body where the surgery will happen just prior to the surgery, while you are still awake.
6. When you are discharged from the hospital, ask your doctor to explain the treatment plan you will use at home. This includes learning about your medicines and finding out when you can go back to your regular activities. Research shows that doctors think their patients understand more than they really do about what they should or should not do when they return home.
7. Make sure that those caring for you have all the important health information about you. Do not assume that everyone knows everything they need to know.
8. Ask a family member or friend to be there for you and to be your advocate. Having someone who can help get things done and speak up for you if you can't is important. Even if you think you don't need help now, you might need it later when you are groggy and sedated after surgery, or not able to think clearly if you aren't feeling well.
9. Know that more is not always better. It is a good idea to find out why a test or treatment is needed and how it can help you. You could be better off without it.
10. If you have a test, don't assume that no news is good news. Ask about the results.

Doctors and nurses, other healthcare providers want to offer safe care. They learned to do "no harm" in their training. In spite of that, defects in the health care delivery system result in errors. Teamwork among everyone, including patients, is essential.

Sunday, May 01, 2011

5 Tips for Getting the Most of Your Doctor’s Visits When You or a Loved One Is A Patient in the Hospital

You may recognize this common scene that occurs in room after room on any floor in any hospital. A patient has had tests or is waiting to have tests. A doctor has been in to review the findings and has a plan. Or the patient is waiting to see the doctor. In either case, once the doctor leaves, the patient and their loved ones don’t always have a clear sense of what the next step or plan is. I have seen families write notes on the back side of a discarded breakfast menu so that they can be sure that they ask a follow-up question of the doctor the next time he or she visits. Then of course, the family waits until the next visit which may be 24 hours later.
I have been on both sides of this scene. I have been there as a clinician coaching the family to help them understand and interpret what they have heard and then as a daughter anxiously waiting to hear the results of the test and waiting all day with the hope of getting a 2 minute conversation with the doctor.
I recently read an observation that people ask more questions when buying a cell phone than they ask their doctors. Your health and your loved one’s health are more valuable then any cell phone! Use these tips to get the most information to make an impact on the quality of the care your loved one receives in the hospital.
1. Get a spiral bound notebook. Family members are often at a loss as to what to bring in as a gift for someone in the hospital. Use a spiral bound notebook to jot notes down listing details from the hospital staff providing information.
2. Ask more questions, get involved. When you ask questions you get answers that can help you make better decisions and get better quality care. Read that last part again: better quality care. People who are more involved in their health care management receive better quality care. Questions usually don’t appear to you until after the doctor has left the room. Write down all your questions. Remember, there is no dumb question, especially when it comes to your health. Write down the answers offered to you by the doctor to help you remember and sift the information as you think about it later.
3. Ask what all the options are for treatment. There are at least three treatment options for most conditions: a conservative approach, the usual treatment, and more aggressive treatments. Not all treatments may be available to you in the current hospital setting. It’s good to ask anyway. Newer or more aggressive treatment options may not be available in the hospital you are in. Find out where you may go to receive more aggressive treatment if needed.
4. Ask what would happen if you don’t follow the recommended treatment. There are many people who don’t agree with the treatment approach that the doctor has recommended but never tell him/her. Treatment may be started in the hospital, but most often, treatment needs to continue after you leave the hospital. Are you going to realistically follow through with the treatment plan? If you don’t think that is possible, or you know that your loved one will forget or won’t have ability to leave home to get treatment, discuss that with the doctor now so an alternative can be arranged. For example, if the patient is going to need to have therapy and the doctor wants the patient to go to an outpatient clinic but you need to return to work and the patient cannot drive, explain this. Home Health Care is a possible solution in this case. Most of the time, alternatives are available.
5. Ask what follow-up will be required. Follow-up doctor visits, lab work, additional tests, treatments often follow after a hospital stay. Unfortunately, 1 in 5 patients end up being re-hospitalized within thirty days of a hospital stay. Why? Lack of follow-up with a timely doctor office visit and medication confusion and/or mismanagement are the most frequent causes. Leaving the hospital is often a flurry of activity and a lot can get lost or missed in the confusion. Pay attention to discharge instructions provided both verbally and written prior to leaving the hospital. Keep the instructions in a safe, deliberate place, like the spiral bound notebook until you get home and settled. Then, pull out the instructions again and read them carefully. Most of the time, the medications have been listed, follow-up treatments or tests and instructions to call the doctor’s office have been listed. Now is the time to follow through with the instructions. Getting settled can be difficult and these details are often overlooked and result in deteriorating health and re-hospitalization if not promptly taken care of.

Friday, April 22, 2011

Difficulty Understanding Basic Health Information May Lead to Higher Risk For Death

Health literacy is a person's ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor's directions and consent forms, and the ability to negotiate complex health care systems. Health literacy is not simply the ability to read. It requires a complex group of skills including reading, writing, and reasoning to understand concepts inorder to make health behavior decisions.

Medication bottles collected in medicine cabinets across the country simply read: "Take as directed". For those adults who have limited health literacy, or are limited in their ability to make sound health care decisions, this has little meaning. Take Charlie, for example,who has bronchitis and has been taking a swig from that cough medicine the doctor prescribed that has codeine in it. His caregiver discovered he was drinking from the bottle after she found him on the floor in his kitchen. He had been drinking the medicine staight from the bottle without measuring the amount every 2 or 3 hours. If a little is good for you, more is better, right?

More than 75 million English-speaking Americans have limitations in their ability to make health care decisions. Health literacy can be improved. Patient teaching handouts, medical forms, and health web sites make it easier to understand and improve patient-provider communication.However, the most important strategy for people with limited health literacy is to have a person with them to advocate for them at doctor appointments, during short procedures and especially while in the hospital.

What is your biggest concern for someone you love with limited health care literacy who requires health care?