The ACO playbook you need today. This is the title of the panel discussion I served on at the recent Senior Living 100 Leadership Conference. Senior Living 100 is the annual destination for the nation’s most progressive senior living organizations, and it was a privilege to represent HSL.
Joining me on the panel were a trio of senior living leaders, who, like us are charged with addressing the monumental changes being fostered by health care and payment reform. We each shared and discussed our respective health care environments, goals, approaches and challenges in creating meaningful relationships with Accountable Care Organizations, or ACOs for short.
As dementia progresses, brain cells are damaged, causing cognitive symptoms to worsen. While current medications cannot stop disease progression, they may help lessen or stabilize symptoms for a time by boosting certain chemicals involved in carrying messages among the brain's nerve cells. However, these drugs have unwanted side effects, or have little effect in some individuals. Given no cure and limited treatment available, it is no surprise that there is high public interest in complementary and alternative therapies when it comes to treating dementia.
Nearly one in five Americans over the age of 65 struggles with depression, which can be a debilitating and life-threatening condition. Social isolation, illness and the loss of loved ones can all trigger or worsen depression, as can certain medications.
Center Communities of Brookline, one of HSL’s supportive housing communities, recently implemented a depression management program that delivers treatment, support and hope to seniors. The program, developed by Baylor College of Medicine, has been shown to reduce the severity of depression symptoms in older adults.
Following a hospital stay, it’s not uncommon to need additional care before going home. A stay in a rehabilitation facility is often recommended for patients recovering from a range of medical and surgical conditions, including joint replacement and stroke.
Whatever the reason for rehabilitation, the main goal of treatment is the same: Preparing the patient to return home and live as independently and safely as possible. Our approach is patient-centered and driven by each patient's goals. His or her impairments, prior level of function, and home and social environments all play a critical role in determining the treatment plan.
I just finished reading Being Mortal: Medicine and What Matters in the End by Atul Gawande, MD, MPH. In his book, Dr. Gawande, a nationally known surgeon, writer, and public health researcher, discusses end-of-life care, the many issues with traditional nursing home care in this country and the ways in which long-term care should be re-imagined.
A 2009 study found that more than half of Americans over the age of 65 take 5 or more prescription drugs regularly and one in 4 seniors takes between 10 and 19 pills per day. And that the more medications a senior takes, the more room there is for error.
When medications are taken incorrectly, serious, life-threatening harm may result. In medical terms, this would be described as an “adverse medical event.” The Centers for Disease Control and Prevention (CDC) reports that older adults are twice as likely as others to visit the emergency room due to an adverse drug event – over 177,000 visits per year. Reasons for these visits may include dizziness, falls, delirium and changes in vital signs.
More than 70% of health care dollars in this country are spent on chronic conditions. Two out of three older Americans have multiple chronic conditions, and 95% of health care spending for older adults is attributed to chronic disease. As Baby Boomers live longer than the generations that came before them, research into conditions that are common in old age – like osteoporosis, fractures, falls, dementia, and delirium – is becoming more and more critical.
When I was in nursing school in the mid eighties, I had not yet attained influenza vaccination enlightenment, and in the middle of that winter season, I got the flu. What ensued was a week of being bedridden. I was unable to eat, drink or move. I was helpless. I had a high fever, body aches and the whole week was a complete blur, except for the one thing I remember very clearly. I was so sick, I came very close to asking my roommate to give me a Tylenol suppository. I was too embarrassed, so I suffered through it. I will never forget it. I will never forget that feeling.
Almost all of my hearing aid patients ask me “what’s new” in the world of hearing aids when they come in for their check ups.
Like all technology, there is almost always something new! I generally tell my patients that each hearing aid manufacturer will roll out a new product 1-2 times a year. Does this make their current product obsolete? No. But, for those who might be in the market for new hearing aids, or, those who always seek the latest products, asking about the new developments is wise.
I have devoted my research career to advancing the understanding of a serious condition called delirium and the impact it has on clinical outcomes. As a medical resident, I observed symptoms of confusion and disorientation in many of the seniors I cared for during my hospital rotations. These symptoms were generally shrugged off as just something that sometimes happens to older patients. Little, if anything was done to prevent or treat it despite its devastating effects.