HealthBridge's In-Home Care Blog

Can where you live make you healthy?

When you bring your loved one to the doctor's office, you fill out lots of forms about his history, right?  In fact, you've probably filled the same forms with the same information dozens of times.  

Doctors are keenly interested in your loved one's health history.  Caregivers constantly fill out forms collecting his medical history, surgical history, and your family history. 

But, do they ever collect information about your loved one's place history?  

Bill Davenhall thinks they should.  In this TEDMED talk, he explains how geo-medicine can help our loved ones and us.  

I found the Jack Lord quote he included to be stunning, "Geography is destiny in medicine."  If that's so, why have I never been asked about my place history?  

How do you think your loved one's place history has affected his health?  How about yours?  

Like a West Texas wildfire, some ideas spread on their own.  They catch hold and take over our conscientiousness.  

Some ideas are slower to spread.  The slow ones are usually about things that are scary.  Alzheimer's Disease is an idea like that.  

But, fighting for a world without Alzheimer's is an idea worth spreading. 

I'm proud of the work the Alzheimer's Association does to spread this idea (disclosure: I'm on their board).  And, I'm proud of it's CEO, Mike Spencer, for his recent Op Ed piece in the Dallas Morning News.  I couldn't resist sharing it with you.  I hope you're as moved by it as I have been.  
 

The Silver Tsunami
I want you to think about something you do not want to think about—Alzheimer’s disease. When it struck my family, I was not prepared to think about it. If we do not demand that our legislators make this issue a national priority, we will not only be thinking about Alzheimer’s more than we want to—we will be living it in ever increasing numbers…as more than 10,000 Baby Boomers are turning 65 every day.

The Issue. One in eight people over 65 have Alzheimer’s. That translates to an estimated 5.4 million Americans living with Alzheimer’s, including as many as 340,000 here in Texas. This does not include the 1.2 million Texans providing unpaid care for a loved one with dementia.
For families that cannot afford to pay for home healthcare or an assisted-living facility, this is a grim reality, particularly, if they are still trying to work outside of the home: 66% took time off, 14% took a leave of absence, 10% reduced hours or take a less demanding job, and 10% quit working altogether.

The Problem. Alzheimer’s disease is moving in the wrong direction—increasing by 66% since 2000 when the other major diseases are decreasing.

Even though Alzheimer’s has surpassed diabetes to become the 6th leading cause of death in this country and is the only cause of death in the top ten that cannot be prevented, cured or even slowed, the government focus and dollars have not been allocated accordingly. The National Institutes of Health spends about $3 billion a year on HIV/AIDS research, while Alzheimer’s, with five times as many victims, receives a mere $480 million.

Retired Supreme Court Justice Sandra Day O’Connor had this to say in an article that she co-authored about a year ago: “OUR government is ignoring what is likely to become the single greatest threat to the health of Americans: Alzheimer’s disease, an illness that is 100% incurable and 100% fatal.”

For each penny the National Institutes of Health spends on Alzheimer’s research, we spend more than $3.50 on caring for people with the condition.

While a cure is the ultimate goal, even delaying the onset of the disease or slowing its progression by 5 years could result in dramatic savings and improved quality of life for millions.
Alzheimer’s costs the nation $183 billion now. By 2050, these costs will soar to $1 trillion, and Medicare costs will increase nearly 600 percent– if we do nothing.

The Hope. History has shown us that when the government will focus its attention and dollars on a health issue like this one, within a decade dramatically improved treatments or even a cure are possible. We’ve seen evidence of this with typhoid, polio, HIV/AIDS and some cancers.

Last January, Congress and President Obama responded to this public health crisis and their constituents by signing into law the National Alzheimer’s Project Act. The Department of Health and Human Services has created an advisory council charged with making recommendations to Congress on how to reduce the financial and human toll of this disease.

The Solution. We are at a critical moment where the creation of a strategic plan to address the escalating Alzheimer’s crisis is within our grasp, but we need the nation’s leaders to follow through and fulfill their commitment.

The nation needs the President to fulfill his promise and deliver a strong national plan as well as the necessary steps and resources to put the plan in motion.
I urge you to let our government know what you expect from them on this issue, because no matter who is in office this Fall, we cannot afford to wait…because Alzheimer’s will not wait.

Mike Spencer
President & CEO
Alzheimer’s Association of Greater Dallas

Thanks, Mike.  Please keep spreading this idea.  It's important.  

This simple bit of advice makes busy caregivers organized.

With it, you’re going to feel at ease. Without it, you’re stressed.

It’s deceptively plain and easily ignored.

We already know that it’s nearly impossible to collect and organize all of the important information about your loved one. The task of explaining who he is and why he needs care becomes an unravelling ball of yarn each time you take him to the doctor’s office.

So, what’s this really simple organization tip that will pull it all together?

Create a Face Sheet

Healthcare providers have been using face sheets for decades. That’s what they call the cover page of your loved one’s chart in the hospital. It’s the short, simple document that contains his essential information - the who, what, when, where, why and how document.

I know what you’re thinking - a face sheet will just get me started in getting my loved one’s info pulled together.

Yes. That’s the idea.

Once you’ve put this information on paper, you’ll feel a tremendous weight lifted off your shoulders. It’s simple information that you likely know off the top of your head, but the act of collecting it in one place is remarkable.

So, what should you include?

• Full Name
• Nickname
• Date of Birth
• Social Security Number
• Insurance / Medicare Number
• Supplemental Insurance Number
• Primary Contact’s Name
• Primary Contact’s Relationship to your loved one
• Primary Contact’s Phone Number
• Primary Physician’s Name
• Primary Physician’s Phone Number
• Current Diagnosis or Concerns
• Previous Diagnoses 
• Previous Hospitalizations
• Previous Surgeries
• Durable Power of Attorney Name & Contact Info
• Medical Power of Attorney Name & Contact Info
• Advance Directives to Physicians 
• Other critical information, like if an Out of Hospital Do Not Resuscitate Order is in place

The best thing is, all of that information will fit on one page (without having to use 8 point font).

Sure, there’s a ton more that defines your loved one. There’s even more that would aid a doctor or other healthcare provider.

But, this really simple organization tip is meant to be just that: a really simple way to make a big improvement to your own peace of mind.

Just think, after you’ve made this face sheet, even your spouse could take your loved one to the doctor and not be completely lost!

Have you made a face sheet for your loved one? Did you include anything else?

Image credit:  ~Brenda-Star~

I don't often share entire articles on our blog, but this breaking news must be spread.  From the AP:

WASHINGTON (AP) — The government is setting what it calls an ambitious goal for Alzheimer's disease: development of effective ways to treat and prevent the mind-destroying illness by 2025.

The Obama administration is developing the first National Alzheimer's Plan to find better treatments for the disease and offer better day-to-day care for those afflicted.

A newly released draft of the overall goals for that plan sets the 2025 deadline but doesn't provide details of how to fund the necessary research to meet that target date. Today's treatments only temporarily ease some dementia symptoms, and work to find better ones has been frustratingly slow.

A committee of Alzheimer's experts began a two-day meeting Tuesday to help advise the government on how the eventual plan, expected by spring, could meet those goals.

Families have been "reminding us of the enormity of our task, perhaps, most important, the meaningfulness of it," said Dr. Ron Petersen, an Alzheimer's specialist at the Mayo Clinic, who chairs the committee.

But hanging over the meeting is the reality of a budget crunch. It's not clear how much money the federal government will be able to devote to Alzheimer's, and states have seen their Alzheimer's budgets cut.

"We're not going to fix this without substantial resources," said David Hoffman of the New York State Department of Health, who oversees that state's Alzheimer's programs. "In New York, we're hanging on by our nails."

An estimated 5.4 million Americans have Alzheimer's or similar dementias. It's the sixth-leading killer and is growing steadily as the population rapidly ages. By 2050, 13 million to 16 million Americans are projected to have Alzheimer's, costing $1 trillion in medical and nursing home expenditures.

The national plan is supposed to tackle both the medical and social aspects of dementia, and advocacy groups had urged that it set a deadline for progress.

Among the draft's other goals:

• Improve timely diagnosis. A recent report found as many as half of today's Alzheimer's sufferers haven't been formally diagnosed, in part because of stigma and the belief that nothing can be done. Symptomatic treatment aside, a diagnosis lets families plan, and catching the disease earlier would be crucial if scientists ever found ways to slow the disease's progress.

To do that, the draft suggests starting with a national public awareness campaign so more people know the early warning signs of dementia — and to include memory assessment tools in the annual Medicare wellness visit.

• Improve support and training for families so they know what resources are available for patients and what to expect as dementia worsens.

A caregiver-training program in New York has shown that families taught how to handle common dementia problems, and given support, are able to keep their loved ones at home for longer. Mr. Hoffman said such training programs are far cheaper than nursing homes.

Alzheimer's sufferers gradually lose the ability to do the simplest activities of daily life and can survive that way for a decade or more. In meetings around the country last summer and fall, families urged federal health officials to make sure the national plan addresses how to help patients live their last years at home without ruining their caregivers' own health and finances.

“You don’t have to go home, but you can’t stay here.”

• have an acute disability that prevents them from returning home with family care
• medical or surgical conditions are sufficiently stable to allow participation in therapies
• demonstrate the ability to participate in at least 1 hour of therapy two times a day
• demonstrate the ability to make progress in the acute care therapies
• have a social support system that will allow them to return home after reasonable improvement of function
• receive financial clearance from their insurer.

• have an acute disability
• have  medical or surgical conditions that may not be sufficiently stable to allow full participation in therapies, but do not require inpatient hospitalization
• demonstrate the ability to participate in at least 1 hour of therapy a day
• acceptance of fiscal responsibility by insurer and/or patient

Funding
Most insurers have subacute rehabilitation benefits within a nursing home (skilled nursing facility or "SNF"), including non-managed care Medicaid, non-managed care Medicare Part A, and most private insurers.  Subacute rehabilitation in an acute rehabilitation unit or acute hospital is only occasionally covered by insurers.  Medicaid reimbursement for SNF level care specifically directed at rehabilitation (as opposed to medical) needs is rare. 

Have you had to navigate between hospitals, rehab hospitals, and skilled nursing facilities? 

Let me know if I can help you.  

How many times have you said that?  You’re a caregiver, so I’m sure you offer to help all the time.  

But, how many times has someone actually let you know that you can help them?  If you’re like most caregivers, it’s shockingly low.  

Caregivers want to help.  You’re full of empathy and experience, so you have tons of ideas that will make your loved one's life better.  

So, why don’t more people take caregivers up on their offers to help?

Because your offer lacks specificity.  

There are a couple of ways to add specificity to your offer.  One of the best is simply by giving a reason why.  The next time you offer to help your loved one, add the word because. 

Take a look at how that simple fix transforms the first line of this post:

Let me know if I can help you, because you’ve always been there to help me.

Much more compelling isn’t it?  

Another way to add specificity is to be specific.  You’re allowed to roll your eyes.  But, I’m not kidding.  Instead of saying, “let me know if I can help you,” try to propose something clear-cut.  

See how this fixes the first original offer:

Let me know if I can help you organize your medicine on Saturday at 2:30.  

There’s no chance your loved one will shrug off that offer as just being polite.  Instead, she’ll understand that you really want to help her.  You’ve even given her exactly how and when you’ll  help.  That’s a nicety she’ll appreciate.  

The next time you want to help your loved one, tell her why and be specific.  Then, drop me a note and let me know how it goes.

“Thanksgiving Day comes, by statute, once a year; to the honest man it comes as frequently as the heart of gratitude will allow.” 

Edward Sandford Martin  
Happy Thanksgiving!  

November 1, 1848 - The first medical school for women opened in Boston. The Boston Female Medical School was founded by Samuel Gregory with just twelve students. In 1874, the school merged with the Boston University School of Medicine, becoming one of the first co-ed medical schools

November 2, 1947 - The first and only flight of Howard Hughes' "Spruce Goose" flying boat occurred in Long Beach Harbor, California. It flew about a mile at an altitude of 70 feet. Costing $25 million, the 200-ton plywood eight-engine Hercules was the world's largest airplane, designed, built and flown by Hughes. It later became a tourist attraction alongside the Queen Mary ship at Long Beach and has since been moved to Oregon.

November 2, 1734 - American frontiersman Daniel Boone (1734-1820) was born in Berks County, near Reading, Pennsylvania.

November 4, 1922 - King Tut's tomb was discovered at Luxor, Egypt, by British archaeologist Howard Carter after several years of searching. The child-King Tutankhamen became pharaoh at age nine and died around 1352 B.C. at age 19. The tomb was found mostly intact, containing numerous priceless items now exhibited in Egypt's National Museum in Cairo.

November 5, 1911 - Aviator C.P. Snow completed the first transcontinental flight across America, landing at Pasadena, California. He had taken off from Sheepshead Bay, New York, on September 17th and flew a distance of 3,417 miles.

November 6, 1860 - Abraham Lincoln was elected as the 16th U.S. President and the first Republican. He received 180 of 303 possible electoral votes and 40 percent of the popular vote.

November 7, 1989 - L. Douglas Wilder became the first African American governor in U.S. history, elected governor of Virginia.

November 8, 1895 - X-rays (electromagnetic rays) were discovered by Wilhelm Roentgen at the University of Wuerzburg in Germany.

November 9, 1872 - The Great Boston Fire started in a dry-goods warehouse then spread rapidly in windy weather, destroying nearly 800 buildings. Damage was estimated at more than $75 million. The fire's bright red glare could be seen in the sky for nearly 100 miles.

November 9, 1965 - At 5:16 p.m., the Great Blackout of the Northeast began as a tripped circuit breaker at a power plant on the Niagara River caused a chain reaction sending power surges knocking out interconnected power companies down the East Coast. The blackout affected over 30 million persons, one-sixth of the entire U.S. population. Electricity also failed in Ontario and Quebec.

November 11th - Celebrated in the U.S. as Veterans Day (formerly called Armistice Day) with parades and military memorial ceremonies

November 13, 1956 - The U.S. Supreme Court ruled that racial segregation on public buses was unconstitutional.  

November 15, 1969 - The largest antiwar rally in U.S. History occurred as 250,000 persons gathered in Washington, D.C., to protest the Vietnam War.

November 17, 1869 - The Suez Canal was formally opened after more than 10 years of construction.

November 19, 1863 - President Abraham Lincoln delivered the Gettysburg Address during ceremonies dedicating 17 acres of the Gettysburg Battlefield as a National Cemetery. Famed orator Edward Everett of Massachusetts preceded Lincoln and spoke for two hours. Lincoln then delivered his address in less than two minutes. Although many in attendance were at first unimpressed, Lincoln's words have come to symbolize the definition of democracy itself.

November 19, 1998 - The U.S. House of Representatives began an impeachment inquiry of President Bill Clinton, only the third presidential impeachment inquiry in U.S. History - the other two being of President Andrew Johnson in 1868 and President Richard Nixon in 1974.

November 22, 1963 - At 12:30 p.m., on Elm Street in downtown Dallas, President John F. Kennedy's motorcade slowly approached a triple underpass. Shots rang out. The President was struck in the back, then in the head. He was rushed to Parkland Memorial Hospital where fifteen doctors tried to save him. At 1 p.m., John Fitzgerald Kennedy, 35th President of the United States, was pronounced dead. On board Air Force One, at 2:38 p.m., Lyndon B. Johnson was sworn in as the 36th President.  

November 25, 1783 - At the end of the Revolutionary War, the last British troops left New York City.

November 26, 1789 - The first American holiday occurred, proclaimed by President George Washington to be Thanksgiving Day, a day of prayer and public thanksgiving in gratitude for the successful establishment of the new American republic.

November 26, 1832 - The first horse-drawn streetcar carried passengers in New York City along Fourth Avenue between Prince Street and 14th Street.

November 28, 1934 - FBI agents killed bank robber George "Baby Face" Nelson near Barrington, Illinois.

November 30, 1782 - A provisional peace treaty was signed between Great Britain and the United States heralding the end of America's War of Independence. The final treaty was signed in Paris on September 3, 1783. It declared the U.S. "...to be free, sovereign and independent states..." and that the British Crown "...relinquishes all claims to the government, propriety and territorial rights of the same, and every part thereof."      

October 1, 1908 - Henry Ford's Model T went on sale for the first time.

October 3, 1863 - President Abraham Lincoln issued a proclamation designating the last Thursday in November as Thanksgiving Day.

October 4, 1957 - The Space Age began as the Russians launched the first satellite into orbit. Sputnik I weighed just 184 lbs. and transmitted a beeping radio signal for 21 days.

October 6, 1927 - The first "talkie" opened in New York. The Jazz Singer starring Al Jolson was the first full-length feature film using spoken dialogue.

October 9, 1940- John Lennon (1940-1980) was born in Liverpool, England. He was a member of The Beatles. He was murdered in New York City on December 8, 1980.

October 13, 1884 - Greenwich was established as the universal time from which standard times throughout the world are calculated.

October 14, 1964 - Civil Rights leader Martin Luther King, Jr., became the youngest recipient of the Nobel Peace Prize. He donated the $54,000 in prize money to the Civil Rights movement.

October 20, 1968 - Jacqueline Kennedy married multi-millionaire Greek businessman Aristotle Onassis, ending nearly five years of widowhood following the assassination of her first husband, President John F. Kennedy.

October 21, 1879 - Thomas Edison successfully tested an electric incandescent lamp with a carbonized filament at his laboratory in Menlo Park, New Jersey, keeping it lit for over 13 hours.

October 21, 1915 - The first transatlantic radio voice message was made by the American Telephone and Telegraph Company from Virginia to Paris.

October 24, 1861 - The first transcontinental telegram in America was sent from San Francisco to Washington, addressed to President Abraham Lincoln from the Chief Justice of California.

October 24, 1945 - The United Nations was founded.

October 26, 1825 - The Erie Canal opened as the first major man-made waterway in America, linking Lake Erie with the Hudson River, bypassing the British-controlled lower St. Lawrence. The canal cost over $7 million and took eight years to complete.

October 27, 1904 - The New York City subway began operating, running from City Hall to West 145th Street, the first underground and underwater rail system in the world.

October 28, 1886 - The Statue of Liberty was dedicated on Bedloe's Island in New York Harbor. The pedestal contains the words: "Give me your tired, your poor, your huddled masses yearning to breathe free, the wretched refuse of your teeming shore. Send these, the homeless, tempest-tost to me, I lift my lamp beside the golden door!"

October 28, 1919 - Prohibition began in the U.S. with the passage of the National Prohibition (Volstead) Act by Congress. Sales of drinks containing more than one half of one percent of alcohol became illegal. Called a "noble experiment" by Herbert Hoover, prohibition last nearly 14 years and became highly profitable for organized crime which manufactured and sold liquor in saloons called speakeasies.

October 29, 1929 - The stock market crashed as over 16 million shares were dumped amid tumbling prices. The Great Depression followed in America, lasting until the outbreak of World War II.

October 31, 1941 - Mount Rushmore National Memorial was completed after 14 years of work. The memorial contains 60-foot-tall sculptures of the heads of Presidents George Washington, Thomas Jefferson, Abraham Lincoln and Theodore Roosevelt.