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|A Newsletter of FCA's National Center on Caregiving|
July 6, 2011
Volume XI, Number 12
State Legislation, Policy & Reports
- FL: Rejects $ 2 Million Planning Grant For Money Follows The Person More...
- OH: Report Addresses Evolving Medicaid Long-Term Care Programs More...
- IN: Privatization Of Medicaid And Food Stamps Programs Falls Short More...
- NRCPDS: New Web Site, Including State-Level Participant-Direction Map More...
- IA: State Senator Participates In "Come Care With Me Days" More...
- Technical Assistance Provided To 10 States To Improve Medicaid LTSS More...
Federal Legislation, Policy & Reports
- FCA Innovations Clearinghouse Tracks Legislation Affecting Caregivers More...
- Budget Showdown Continues With August 2nd Deadline More...
- Report Profiles 16 Medicare Beneficiaries, Most Are Close To Financial Edge More...
- Direct Care Job Quality Improvement Act Introduced More...
- 12th Anniversary Of Olmstead Decision, Plaintiff Meets President Obama More...
- International Treaty Focuses On Protections For Domestic Workers More...
- Lawmakers Urge UN To Include Alzheimer's Disease In Sept. Health Conference More...
- Thailand: Political Parties Need To Focus On Long-Term Care More...
Research Reports & Journal Articles
- Study: Multidisciplinary, Integrated Care Approach Improves Care More...
- CDC Releases Data Snapshot: ADL's For People Aged 80 And Older More...
- Conference Focuses On Research Linking PTSD With Dementia, Heart Disease More...
- Report: Shift From "Long-Term Care" To "Active Ageing" More...
- Report: Aging Tsunami Or Opportunity To Try New Strategies? More...
Conferences & Trainings
- Webinar: NASW Standards for Social Work Practice with Family Caregivers of Older Adults, July 29th More...
- Care Congress Will Focus On Quality Jobs And Quality Long-Term Care July 12 More...
- Webinar: Senior Center Strategies for Sustainability August 18th, 1:30-2:30PM (ET) More...
- Conference: National Home and Community-Based Services Conference Sept. 11-14 More...
Funding, Media & Miscellaneous
- Rosalinde Gilbert Innovations in Alzheimer's Disease Caregiving Legacy Awards More...
- HHS Announces Up To $500 Million In Funding Through Partnership For Patients More...
- Family Caregiver Advocates For Advanced Health Care Proxy Legislation More...
- Twin Cities Adopt Wisconsin's Advanced Health Care Directives Effort More...
- Consumer Voice Interview Provides Suggestions For Choosing Nursing Homes More...
- Technology Pilot Programs Could Promote Aging In Place, But Expense Is A Barrier More...
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A legislative panel in Florida rejected a $2.1 million federal grant that would have started the process for Florida to receive an additional $35.7 million in federal Medicaid funding as part of the Money Follows the Person demonstration program. The five-year program is designed to shift Medicaid beneficiaries out of nursing homes and into home and community based settings. While Governor Rick Scott recommended accepting the grant, the GOP-majority commission rejected it. The program was expected to result in approximately 1,700 people transferring from nursing homes back into their homes with supportive services. Florida has also held several meetings recently to gather input about the state Medicaid program's possible transition to a managed care system. The plan, which still needs approval from CMS, would require most of the state's three million Medicaid enrollees (including seniors in nursing homes) to join private health plans after July 1, 2012. The shift is seen as a way to better manage costs, with enrollment growth increasing 50% in the past four years with a cost that now exceeds the education budget at more than $20 billion. However, patients and advocates are skeptical, and a participant from a pilot of the managed care plan discussed her experience with doctors leaving the system, prescriptions not being filled by plans, and her having to change plans repeatedly. For more information, visit:
Bradenton.com "Florida panel rejects federal funds for elderly"
Palm Beach Post: "Lawyers warn of "granny dumping" at Medicaid hearing in West Palm Beach"
A recent report on Ohio's long-term care system used 16 years of program data to examine how the state's system has evolved. PASSPORT, one of Ohio's Medicaid waiver programs highlighted in the report, allows consumers to receive in-home services within the community instead of institutional care. The cost of PASSPORT per month is $1,067, while nursing homes are $4,281, and PACE is $2,643. The authors note that the average monthly caseload for PASSPORT has grown from 15,000 in 1995 to 30,000 in 2010, placing Ohio in third place for largest waivers for older adults, behind Washington and Texas. Policy recommendations include increasing prevention and self-sufficiency (about 49% of the 146,000 older adults with severe disability rely on Medicaid), using technology, increasing effectiveness and efficiency in service delivery, better support for the growing number of family caregivers and better data collection to improve policymaking. A family caregiver provided her perspective of the PASSPORT program in a follow-up newspaper column and explained how the program supports her and her brother and allows her mother to age in her home. Governor Kasich indicted that he wants to expand PASSPORT to serve an additional 4,800 seniors. For more information, visit:
The Los Angeles Times recently analyzed Indiana's experience with privatizing its Medicaid and Food Stamp programs- a move that California is slated to start with its Medicaid program in the fall of 2011 with over seven million Medicaid beneficiaries. In Indiana, the state hired an IBM-led consortium of companies, including a company called ACS that has been heavily involved in providing out-sourced services in other states. Among other changes, under the privatized system, Medicaid and Food Stamp beneficiaries had to apply for benefits online or through call centers, instead of waiting to see caseworkers. According to advocates, the transition led to disrupted benefits for recipients, and the Times profiles an 80-year woman whose Medicaid payments were cut off because she hadn't called into an eligibility hot line in 2008 on the same day she was hospitalized for congestive heart failure. The state's negative error rate (a measurement of how often cases are incorrectly closed or denied) was below the national average from 2001 to 2007, however, it more than doubled to over 13% one year after the firms took over- the largest rate increase in the nation. For the 80-year old woman, the state/contractors eventually restored the benefits under pressure from Legal Services attorneys. In October of 2009, Governor Mitch Daniels acknowledged that replacing caseworkers with centralized call centers "just didn't work," and canceled the 10-year contract with IBM, while giving ACS an eight-year contract worth $638 million. The state's lawsuit against IBM is slated to begin next February, and the state cites problems in its lawsuit including lost documents, piled up cases, and workers routinely denying applications to reduce backlogs. For more information, visit:
The National Resource Center for Participant Directed Services launched a new Web site in June with new tools and resources about participant direction. An interactive map allows users to view participant-directed programs in their state by clicking on the map. The new site also includes a searchable database of resources including readiness reviews, presentations, issue briefs, and video shorts with personal stories of participant direction. For more information, visit:
Iowa State Senator Jeff Danielson recently participated in a PHI "Come Care With Me" day where he trailed Kelly Stokes, who is a CNA at a long-term care facility in Waterloo, IA. Despite being a firefighter, Senator Danielson expressed surprise at the physical toll of the direct care work. He explained that he thinks the public may underestimate the importance of direct care workers, and suggested that direct care workers need to be paid well and receive health care benefits. For more information, or to view a video of the "Come Care with Me" day, visit:
The Center for Health Care Strategies, Inc. recently announced that it will provide technical assistance to ten states to improve their Medicaid long-term services and support (LTSS) programs. The ten states include Arizona, Georgia, New Jersey, Nevada, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Virginia, and Washington. The grant is supported by the Scan Foundation, and will allow states to focus on rebalancing their LTSS system to more home and community-based settings and/or focus on managed LTSS. The Affordable Care Act includes incentives for states to improve LTSS, and it is expected that these grants will assist states in improving health care quality, controlling costs, and enhancing quality of life for beneficiaries. For more information, visit:
FCA Innovations Clearinghouse Tracks Legislation Affecting Caregivers
The Innovations Clearinghouse, administered by the National Center on Caregiving at Family Caregiver Alliance, monitors legislation introduced at state and federal levels that is especially relevant to family caregivers and has been recently updated. Alzheimer's laws were the most frequently introduced type of legislation at the state level in 2011, with focuses on state plans and task forces as well as long-term care facilities that advertise being specially equipped for patients with dementia. Staff levels as well as background checks for nursing homes and home care agencies were introduced in 12 bills, while elder abuse (financial and otherwise) was the focus of seven bills. Changes to Medicaid and HCBS programs were introduced through seven bills, and long-term care insurance rate increases and other issues were addressed by six bills. Family leave was introduced in several bills, and legislation around advanced directives and other types of end-of-life care preferences were included in five bills. For more information, visit
FCA Innovations Clearinghouse
Budget Showdown Continues With August 2nd Deadline
Discussions over the federal deficit and a looming deadline to raise the debt limit by August 3rd continue to dominate the political discourse in Washington DC. Changes to Medicaid and Medicare have been discussed as possible strategies, however, a Kaiser poll conducted in June found that while 45% of Americans would support minor reductions to current levels of Medicare spending, less than one in five (18%) would support major reductions. A report by the Lewin Group analyzed a bill introduced by Senator Corker (R-TN) and Senator McCaskill (D-MO) and co-sponsored by seven Republican senators to cut federal spending. The Commitment to American Prosperity Act would limit federal spending to about 20.8% of GDP and automatically cut across all federal programs for any year when spending is projected to go higher than 20.8%. The Lewin analysis found that if enacted, the legislation would cut $4.2 trillion out of the federal budget between 2013 and 2021, with $1.3 trillion cut from Social Security, $859 billion from Medicare, and $575 billion less in federal Medicaid funding to the states. The authors estimate the cuts would force 3.8 million people into poverty, of which 2.1 million are seniors, representing a 44% increase for this age group. For more information, visit:
Kaiser Health Tracking Poll -- June 2011
Salt Lake Tribune: "Report: Proposed federal cuts proposal would harm elderly, children, poor"
Report Profiles 16 Medicare Beneficiaries, Most Are Close To Financial Edge
A recent report from the Kaiser Foundation profiled 16 Medicare beneficiaries and their financial situations. The authors explain that the detailed profiles may be helpful for policymakers in Washington, DC who are considering possible changes to Medicare and Medicaid that could increase costs to enrollees. Half of the individuals/couples profiled have incomes below twice the poverty level (under $22,000 for an individual), which is the same proportion of the total Medicare population. The people interviewed use a variety of strategies to make ends meet with limited or fixed incomes, including incurring credit card debt for regular expenses, prematurely dipping into nest eggs, and relying on money from adult children. Several themes emerged, including barely making ends meet, Medicare playing an important role in ensuring access to health care yet people still postponing medical care, especially if there are out-of-pocket costs, and debt, minimal savings, and concerns about the future as the norm for most of the couples profiled. In addition to the report, there is a 10 minute documentary, as well as an archive of a webcast from June that examined current policy options being considered for Medicare. The Agency for Healthcare Research and Quality (AHRQ) released data in June that roughly one of every six Americans aged 18 to 64 report using more than 10% of their total family income to pay for health insurance premiums and out-of-pocket medical expenses in 2007. For more information, visit:
Kaiser "Living Close to the Edge: Financial Challenges and Tradeoffs for People on Medicare"
Kaiser Video "Making Ends Meet: The Medicare Generation"
Kaiser Briefing "The Role of Medicare and Beneficiaries in the Deficit-Reduction Debate"
AHRQ "Who Paid More Than 10 Percent of Their Family Income for Medical Expenses?"
Direct Care Job Quality Improvement Act Introduced
Representative Linda T. Sanchez (D-CA) introduced legislation (HR 2341) on June 24th to provide additional employment protections for home care workers. One of the most visible provisions of the bill would eliminate the "companionship exemption" in the Fair Labor Standards Act that exempts home care workers from receiving a guaranteed minimum wage and overtime. If enacted, the legislation would improve federal and state data collection and oversight of the direct care workforce and would establish grant programs for states to improve data collection as well as recruitment, retention, and training of workers. The Department of Labor announced in 2010 that it intends to review the companionship exemption and would issue a proposed rule in October 2011. For more information, visit:
Press release: "Linda S?nchez Stands Up For Home Care Workers"
12th Anniversary Of Olmstead Decision, Plaintiff Meets President Obama
Last month, Lois Curtis, one of the original plaintiffs in the Olmstead case, met with President Barack Obama in commemoration of this landmark Supreme Court Decision. The court ruled in 1999 that under the Americans with Disabilities Act, Americans with disabilities had the right to live in communities when it can be reasonably accommodated. The Obama administration noted its commitment to the Olmstead decision, citing a recent settlement agreement with Georgia's mental health and developmental disability system, and the Department of Justice's participation or initiation in over 25 cases in 17 states. The administration also started "The Year of Community Living" in 2009 and noted that the Money Follows the Person Demonstration has helped almost 12,000 individuals move from institutions to the community. For more information, visit:
White House: "On Anniversary of Olmstead, Obama Administration Recommits to Assist Americans with Disabilities"
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|International Treaty Focuses On Protections For Domestic Workers
Human Rights Watch (HRW) announced in June that a new international treaty focused on extending domestic rights to all domestic workers, including caregivers, nannies, and housekeepers has been approved by International Labor Organization (ILO) members. HRW lobbied the ILO, which began considering international standards on domestic workers three years ago, and the ILO agreed to create a legally binding convention. During the voting on the treaty, 396 delegates voted for the convention that would extend basic labor rights to all domestic workers, requires governments to set a minimum age for domestic work, and would provide girls with access to education. HRW said it will press governments to ratify the treaty and bring their national laws in line with it. For more information, visit:
HRW "A Victory for Domestic Workers"
Lawmakers Urge UN To Include Alzheimer's Disease In Sept. Health Conference
At a recent hearing of the House Foreign Affairs Subcommittee on Africa, Global Health, and Human Rights, witnesses testified about the global impact of Alzheimer's Disease. The disease currently affects 24-37 million people throughout the world, a number that could increase to 115 million by 2050. Representative Christopher Smith (R-NJ), the Chair of the subcommittee, agreed with advocates that Alzheimer's should be included at an upcoming United Nations summit in September on non-communicable diseases, and sent a letter along with Representative Edward Markey (D-MA), signed by 28 other lawmakers requesting that the UN add the disease to the conference agenda. For more information, visit:
Kaiser Foundation: "Experts Discuss Global Threat Of Alzheimer's Disease At House Subcommittee Hearing" Kaiser Family Foundation
Thailand: Political Parties Need To Focus On Long-Term Care
A recent article focused on Thailand's shifting demographics and the government's need to start planning. Of the 40 political parties in Thailand, only 12 have issued policies for the elderly, and the policies are focused on monthly allowances. A professor from the College of Population Studies suggested at a recent seminar that elderly people will need assistance beyond just economic security. Of Thailand's seven million elderly people, only 15% have saved money for retirement, while about 30% lack health insurance. The population is expected to increase to 20 million in the next 40 years. For more information, visit:
The Nation: "Govt must face up to coming society of elders"
Study: Multidisciplinary, Integrated Care Approach Improves Care
A recent study in the Netherlands used a multidisciplinary integrated care approach for 340 residents with physical or cognitive disabilities living in 10 residential care facilities near Amsterdam. About 10% of seniors aged 75 or older live in residential care facilities in the Netherlands, and more than 70% of residents have multiple chronic diseases and related disabilities. As part of the study, trained nurse-assistants conducted functional assessments every three months; discussion of priorities and outcomes with the family physician, patient and family members were held, and monthly meetings with the patient's health care team (including nurse assistant, family physician, psychologist and geriatrician) were conducted. The authors report that while functional ability, number of hospital admissions and health-related quality of life remained comparable (between the control group and study group), the model "resulted in substantially higher quality of care for elderly people in residential care facilities," mortality decreased, and patients were more positive about the quality of their care. For more information, visit:
EurekAlert: "Multidisciplinary integrated care for seniors gives better quality care"
CDC Releases Data Snapshot: ADL's For People Aged 80 And Older
The Center for Disease Control Morbidity and Mortality Weekly Report recently featured data on the percentages of people aged 80 and older who need assistance with activities of daily living (ADL's). Women were more likely than men to need assistance with personal care activities (14.8% vs. 10.2%). Of these activities, women were more likely than men to need assistance with bathing/showering (12.1% vs. 8.1%), dressing (9.1% vs. 7%), and eating (3.9% vs. 2.4%). The estimates are based on household interviews from a sample of the non-institutionalized U.S. population, and therefore excludes adults living in assisted living facilities, nursing homes for the elderly, hospitals for the chronically ill, or correctional facilities. For more information, visit:
CDC: "QuickStats: Percentage of Noninstitutionalized Adults Aged ≥80 Years Who Need Help with Personal Care, by Sex --- United States, 2008-2009"
Conference Focuses On Research Linking PTSD With Dementia, Heart Disease
Research conducted at the San Francisco Veterans Affairs Medical Center was presented in June at the fourth annual "Brain at War" conference. Researchers have found that combat veterans with post-traumatic stress disorder (PTSD) are twice as likely to have dementia and two to three times as likely to develop cardiac problems as compared to veterans without PTSD. Dr. Michael Weiner, director of the Center for Imaging of Neurodegenerative Diseases at the Veterans Affairs Medical Center, explained that this could lead to a large increase in the number of veterans who develop Alzheimer's disease in the next 10 to 20 years. While there isn't a cure for Alzheimer's, researchers hope that by understanding how combat affects the brain, they can work towards improvements. For example, the hippocampus, devoted to short-term memory and learning new things, is significantly smaller in veterans with PTSD and researchers want to determine if this smaller section can grow as a result of therapy and treatment for stress. It is estimated that as high as 20% (about 400,000) of the two million soldiers who served in Iraq and Afghanistan have developed or are at risk of developing PTSD. A Veterans Administration Web Site features a searchable map of PTSD programs throughout the country, and the National Center for PTSD, administered by the VA, is working to advance the clinical care and social welfare for American's Veterans through research on PTSD. The Center also co-designed a downloadable Phone App, "PTSD Coach" to connect veterans with information, resources, and tools to use to manage living with PTSD. For more information, visit:
San Francisco Chronicle: "Brains of vets with PTSD can change as they age"
VA PTSD Program Locator
National Center for PTSD
Report: Shift From "Long-Term Care" To "Active Ageing"
A recent report from the European Centre for Social Welfare Policy and Research analyzes shifting from a passive approach of "long-term care" and "prevention" to a more empowering approach of "Active Ageing." The authors focus on Austria and note that long-term care is increasing being recognized as a central social and health policy field of action in Europe. Successful development of the approach will require better integration between health and social systems, more coordination between formal and informal care sectors, and the development of "harmonized and transparent quality standards, funding flows and management structures." The author analyzes Austria and its approach to improving long-term care, including the introduction of a non-means tested long-term care allowance in 1993. While Austria has made considerable progress, similar to other countries, the "coordination cooperation between the social and acute medical care sector remains a problem area..." Citing data that 80 to 85% of vulnerable older adults are currently cared for at home by a family member, the author cautions that surveys show the majority of Austrians do not want to be live-in caregivers, but also suggests that "frequent decisions for permanent nursing home admission" are problematic. Report recommendations include a stronger focus on supporting older caregivers who face higher health risks because of their caregiving, better coordinated networks of appropriate care at the right time and in the right setting, and overall better coordination among supportive systems. For more information, visit:
European Centre: "Active Ageing and Prevention in the Context of Long-Term Care"
Report: Aging Tsunami Or Opportunity To Try New Strategies?
A recent report focused on member countries of the Organization for Economic Co-Operation and Development (the U.S. is a member) suggests that while changing demographics have the potential to strain healthcare and social service programs, this shift can also be seen as an opportunity to adapt programs and policies and try new approaches. The authors explain that the first approach views the growing elder population as a burden that will lead to higher costs and potential conflicts between generations about spending priorities. The alternative approach, which the authors advocate for, is to acknowledge the challenges of the demographic shift while also recognizing that longer life spans could mean more people who can work and volunteer in ways that will benefit the rest of society. They also advocate for a "life course" approach that focuses on prevention and a stronger focus on healthy lifestyles. The authors suggest that flexible workplace policies, gradual retirement, improved housing options, new methods of providing health care and social programs and new technologies can all contribute to longer, healthier lives while delaying the need for costly, intensive institutional care. For more information, visit:
The International Longevity Centre - UK (ILC-UK): "Aging, Health and Innovation: Policy Reforms to Facilitate Healthy and Active Ageing in OECD Countries"
The Technical Assistance Centers for Caregiver Programs & Lifespan Respite at Family Caregiver Alliance is sponsoring a webinar on July 29th with Dr. Sandra Edmonds Crew, who will review the 12 standards that were released in 2010. The standards were designed by the National Association of Social Workers in partnership with the AARP Foundation, the Administration on Aging, and Family Caregiver Alliance with funding from the John A. Hartford Foundation. Dr. Crew, who helped create the standards, will review each of the 12 standards and discuss the significance of each standard through case studies and discuss how social workers will utilize the standards when working with family caregivers of older adults. Dr. Crewe, a professor at Howard University, is the Associate Dean for Academic and Student Advancement and is also the Director of the Multidisciplinary Center for Gerontology at Howard. For more information or to register, visit:
Webinar: NASW Standards for Social Work Practice with Family Caregivers of Older Adults
A national coalition of advocates is organizing a "Care Congress" on July 12 in Washington DC as part of a four-pronged strategy to improve the quality of direct-care jobs, provide better training/career ladders for home care workers, create a citizenship path for immigrant workers who want to work in eldercare, and support families who are burdened by the costs of caregiving. Organizes expect 700 participants and the U.S. Secretary of Labor, Hilda Solis, will address the Congress. After this national event, local care congresses will be held in more than a dozen cities. For more information, visit:
PHI: "National Care Congress to Be Held in July"
Webinar: Senior Center Strategies for Sustainability August 18th, 1:30-2:30PM (ET)
A webinar sponsored by the National Council on Aging on Thursday, August 18th will focus on strategies for seniors centers to create sustainable fundraising through partnerships, endowment funds, large scale fundraising, and innovative programming. Pat Branson, the Executive Director of Senior Citizens of Kodiak, Inc, in Kodiak, Alaska, will present about their program that is a full service-multi purpose agency that serves Kodiak and six island villages. Branson serves on the AK Commission of Aging, the Governor's Coordinated Transportation Task Force, Providence Health Services Region Board and the Kodiak City Council. For more information, or to register, visit:
NCOA: Senior Center Strategies for Sustainability
Conference: National Home and Community-Based Services Conference Sept. 11-14
The National HCBS conference will take place on September 11-14th, in Washington DC. The agenda is now available and the conference contains a number of workshops on programs serving aging and disabled communities. Topics include collaborations between the aging and disabled systems, prioritizing access when demand exceeds capacity, best practices in family caregiving, Money Follows the Person, and many more. For more information or to register, visit:
National Association of States United for Aging and Disabilities HCBS Conference
Rosalinde Gilbert Innovations in Alzheimer's Disease Caregiving Legacy Awards
Applications are now available for the fourth annual Rosalinde Gilbert Innovations in Alzheimer's Disease Caregiving Legacy Awards. The awards are given in three categories, Creative Expression, Diverse & Multicultural Communities, and Policy & Advocacy. Each of the three award recipients receive a $20,000 award, and applications are invited from non-profits, government agencies, and universities. The application deadline is August 15th, 2011. For more information or to view the application, visit:
FCA: "Rosalinde Gilbert Awards Application"
HHS Announces Up To $500 Million In Funding Through Partnership For Patients
The U.S. Department of Health and Human Services recently announced that the CMS Innovation Center will make available up to $500 million in funding to help hospitals, health care provider organizations and others stop preventable injuries and complications due to health care acquired conditions and unnecessary readmissions. The Partnership for Patients was announced earlier this year as a public-private initiative aimed at reducing harm in hospital settings by 40% while reducing hospital readmissions by 20% over a three year period. To achieve these goals, the funding will pay for "Hospital Engagement Contractors" to design programs to teach and support hospitals in making care safe, conduct trainings for hospitals and care providers, provide technical assistance, and establish and track systems to monitor hospital progress in improving quality. For more information, visit:
HHS: "Up to $500 million in Affordable Care Act funding will help health providers improve care"
Family Caregiver Advocates For Advanced Health Care Proxy Legislation
A recent blog posting on The New Old Age discussed one family caregiver's challenge in navigating the health care system on behalf of her mother and her potential solution- an advanced health care proxy. Donaa Appell is a registered nurse and is also the primary caregiver for her mother. Appell cited a phone call in which her mother's mail order pharmacy refused to speak with her without her mother's permission as the inspiration for a law she has been trying to have enacted in New York State for three years. Advanced health directives only take effect when the person becomes incapacitated, thus limiting their effectiveness for caregivers like Appell whose mother has capacity. The advanced health care proxy would allow a patient to designate a friend, family member or a doctor to assist with health care decisions even when the patient is still legally competent. Maine, Maryland, New Mexico and Wisconsin have similar laws that allow agents to take over for the patient when they become incapacitated or sooner if specified in the document and North Dakota and Vermont both allow advance directives to become effective while the patient is capable. For more information, visit:
New York Times This New Old Age: "A Better Way to Help with Medical Decisions"
Twin Cities Adopt Wisconsin's Advanced Health Care Directives Effort
A highly successful initiative in La Crosse, Wisconsin to increase the number of people completing advanced health care directives is now being duplicated in the Twin Cities in Minnesota and is called "Honoring Choices Minnesota." The program is three years old and includes every health provider and health system in the metro area. In La Crosse, more than 90% of adults who die have filled out a living will, the highest rate of any city in the U.S. In the Minneapolis-based Allina Hospitals, the number of patients filling out advanced care directives has more than doubled as a result of the program, from 16% to 39%. For more information, visit:
Minnesota Public Radio "Twin Cities program helps patients discuss end-of-life planning"
FCA Fact Sheet: "End-of-Life Decision Making"
Consumer Voice Interview Provides Suggestions For Choosing Nursing Homes
In a recent interview with the "You Should Know" program, Janet Wells, the director of public policy for Consumer Voice, provided suggestions for family members in researching nursing homes. Prior to placing a family member, Wells suggests visiting several nursing homes, and observing the treatment of residents- for example, are they in restraints, what are the interactions like between staff and residents, and do residents receive adequate attention? Wells recommends trying the food at the facility and reviewing the inspection reports that nursing homes are required to provide. Another place to check is the state long-term care ombudsman office to see the number and nature of complaints and the state-level licensing agency. In about half of the states, there are coalitions formed by consumers and their family members who can assist with learning about nursing home options. Wells explained that Consumer Voice has advocated for mandatory minimum staffing levels at nursing homes but has not yet succeeded. If family members have complaints, she suggested trying the state long-term care ombudsman as a first step, and explained that legal avenues should be seen as a last step, especially since mandatory arbitration clauses and tort reform have limited the effectiveness of suing for negligent care. She concluded the interview by cautioning that current proposals to block-grant Medicaid could result in federal protections for nursing home residents being eliminated. Consumer Voice is also accepting nominations for six awards related to long-term care advocacy, applications are due July 15th. To listen to the interview, visit:
"You Should Know: Nursing Home Safety"
FCA Fact Sheet: Residential Care Options
Consumer Voice "Call For Nominations for 2011 Leadership Awards"
Technology Pilot Programs Could Promote Aging In Place, But Expense Is A Barrier
The Oregon Center for Aging & Technology at Oregon Health & Science University is conducting several studies to test new technologies to allow older people to age in their homes. One of the study participants, profiled by the Los Angeles Times has agreed to have her condominium outfitted, and it includes motion sensors to record her gait and walking speed, a door sensor that senses when she is leaving the house, and a refrigerator sensor to monitor her eating. She has also shared her home with a 4-foot tall robot that her relatives could control remotely and that includes a video monitor. A video game she plays on her computer monitors her results to detect any abnormalities. The equipment in her home is monitored by researchers at the Oregon lab, which also has a model home to test new gadgets, including a bed with sensors that assess breathing patterns, heart rate, and sleep quality. Other technologies include an electronic pill box that monitors when medication is taken, and a Wii video game system that measures weight and balance. Future possibilities include software to assist people with dementia find their way home, devices that can interpret facial expressions to detect depression, and robotic "pets" for seniors. While the devices could prove helpful, expense is a large obstacle, including monthly monitoring bills, and a researcher acknowledged that technology could also allow people to become more isolated, though she also suggested that it could help caregivers focus on larger issues than whether or not somebody took their medicine. For more information, visit:
Los Angeles Times "Elder care goes high tech"
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