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Hospital Readmissions FAQs

What is Hospital Readmission?

Hospital Readmission is the term used in a section of the Patient Protection and Affordable Care Act (PPACA) which states that in October of 2012, the government will begin to penalize hospitals for avoidable hospital readmissions by reducing their Medicare reimbursements by a designated percentage.

The penalty is expected to be as follows: 1% in 2012, 2% in 2013 and 3% in 2014.

What is the time frame that the Center for Medicare and Medicaid Services (CMS) defines as an avoidable readmission?

CMS defines the time period for avoidable readmissions as 30 days from the date of discharge. Under the law, if a patient returns to the hospital within these 30 days, the hospital will be penalized. After 30 days, the penalty will not apply. Therefore, most hospitals testing formal readmission plans will be interested in patients not returning for a minimum period of 30 days.

What are the conditions that are primarily considered an issue for avoidable readmissions?

According to www.CMS.gov:

• CHF (Congestive Heart Failure),

• AMI (Acute Myocardial Infarction) – heart attack,

• Pneumonia, and Secondary causes: diabetes and co-morbidity or multiple conditions.

The top three causes are consistently stated in research; the secondary causes fluctuate based on the research conducted.

What are the main issues that CMS has stated are the reasons for high avoidable readmission rates?

• Medication mis-management or non-compliance

• Failure to make follow up doctor appointments

• Nutrition mis-management

• Safety Issues

Aren’t these issues that the Home Instead Senior Care® network can assist with?

Yes! These are all services that local Home Instead Senior Care offices can offer. We can join the conversation with traditional RPN’s who are discharging patients to support them in getting a patient home safely and let RPNs know that we can provide services to help support these individuals when they return home.

What is the Home Instead Senior Care network doing around readmissions?

We are pursuing a partnership with a national hospital system to conduct a pilot program. This is a 6 month test to:

• Gain empirical data that demonstrates the network’s care will lower readmission rates.

• Gain knowledge on what plan of care (number of hours/services) is optimal to reduce readmission rates.
We are attending several national conferences centered on this issue to insert ourselves in the conversation and raise awareness of the network’s services.

We are creating materials related to a new program called Returning Home. These materials will be rolled out in phases so that they can be used at first to sell the network’s traditional services without a formal readmissions program (30 day/tracked plan of care). In later phases, once data is collected, additional materials will be created to include data from the pilot we plan to conduct (lessons learned from the pilot program).

If your loved one needs help at home post hospital visit, please call us at 925-280-9688.

Home Care Walnut Creek, CA delivering home care and elderly services to seniors in the Contra Costa area including Concord. Call us 925-280-9688.

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Clutter Checklist for Senior’s Home Safety

The Easter holidays are a good time for family caregivers to notice signs that an older adult may need assistance.

Learn what clutter signs to look out for by reading this list and checking off twice!

Kitchen

Cabinets with unused pots and pans.
Problem: A senior can fall trying to get to them.

Freezer and refrigerator with expired and old food
Problem: A senior can suffer food poisoning or malnutrition.

Bills on the counter and kitchen table.
Problem: Unpaid bills.

Bathroom

Expired medications in the medicine cabinets and old make-up.
Problem: Missed medications and accidental overdosing; skin infections and irritations from expired make-up.

Cluttered shelves.
Problem: Inability to locate necessities.

Using the bathtub to store papers.
Problem: Hygiene.

Bedroom

Papers and magazines on and under beds.
Problem: Fire hazard.

Too much clothing and shoes in the closet.
Problem: Confusion and disorganization.

Stairways

Magazines and shoes on the steps.
Problem: Tripping hazard.

Basements

A catch-all for everything.
Problem: Rodents, mold and mildew.

Download: A Caregiver’s Guide to Spot Clutter Creep

Home Care Walnut Creek, CA delivering home care and elderly services to seniors in the Contra Costa area including Concord. Call us at 925-280-9688.

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Caregiver, A Job with a Purpose

Be a Home Instead Senior Caregiver

The Home Instead Senior Care network is expanding its workforce of compassionate and capable CAREGivers to meet the needs of this growing senior population worldwide. Meeting those needs begins in your community, between one CAREGiver and one senior.

The Seniors You Serve

Nothing is more important in this job than the relationships you develop with your clients and their family members. Those relationships enable you to provide the best care possible and find true fulfillment in your work.

To help set you up for success, staff coordinators at your local Home Instead Senior Care® office take the following factors into consideration when matching you with a client:

  • Personality and interest compatibility
  • Level of training and type of care required
  • Your schedule and availability
  • Your proximity to the client’s house

Staff at your local franchise office will provide you with an overview of the client before your first shift. To start your relationship with the client off on the right foot, a member of the office staff may accompany you to the client’s home and introduce you.

A client’s home may be a private residence or within a care facility. Schedule permitting, you may have more than one client.

There are seniors in your neighborhood who need help right now. Call the local Walnut Creek and Concord Home Instead Senior Care office to find out how you can join our CAREGiving team – 925-280-9688.

APPLY NOW

Home Care Walnut Creek, CA delivering home care and elderly services to seniors in the Contra Costa area including Concord. Call us at 925-280-9688.

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Recovery Services at Home from Hospital

Our short-term recovery services are an outstanding solution that allows seniors to recover at home following surgery, an illness or an accident. Home Instead Senior Care services in Indianapolis can mean a shorter stay in a rehabilitation facility, and it’s proven that people rebound more quickly in the comfort of their own home.

How we help:

Assist with household tasks

  • Help with laundry and ironing
  • Take out garbage
  • Make beds
  • Change linens
  • Dust furniture
  • Organize and clean closets

Plan, prepare and clean up meals

  • Shop for groceries and supplies
  • Prepare future meals
  • Help with errands
  • Drop off and pick up dry cleaning
  • Pick up prescriptions

Assist with pet care

Escort to appointments and events

  • Accompany to lunch or dinner
  • Escort for shopping and errands
  • Attend plays and concerts
  • Escort to religious services
  • Attend club meetings and sporting events
  • Aid with airport tasks

For immediate assistance with a loved one transitioning home, or if you simply want to learn more about the Home Instead Senior Care network’s “Returning Home” program, please contact us at 925-280-9688.

Home Care Walnut Creek, CA delivering home care and elderly services to seniors in the Contra Costa area including Concord. Call us at 925-280-9688.

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Avoid Multiple Hospital Visits

While not all hospitalizations due to chronic conditions in older patients are avoidable, a number of interventions such as patient and family education, proactive warning sign monitoring and additional care support can go a long way to help patients better manage their chronic conditions and avoid costly hospital visits and readmissions.

Here are a number of tips and resources to reduce hospitalization risk for three of the most common chronic conditions affecting seniors: arthritis, congestive heart failure and diabetes.

Arthritis

Osteoarthritis and rheumatoid arthritis, the two most common forms of arthritis in older adults, account for a large number of hospitalizations each year, according to the Centers for Disease Control and Prevention.

In addition to prescribed medications to help treat the symptoms of arthritis, your patients should know about the lifestyle modifications recommended by the Arthritis Foundation® to help manage their symptoms and avoid complications that may require more advanced care.

Someone living with arthritis may also benefit from additional in-home care support to help effectively manage their symptoms and complete their tasks of daily living. Patients and their families may find these lists helpful helpful.

Congestive Heart Failure

In adults over 60, congestive heart failure is the leading cause of hospitalization and death, according to Johns Hopkins Medicine (JHM). While congestive heart failure is a serious health risk, it’s possible for patients to manage many symptoms effectively if they adhere to prescribed regimens, and can recognize warning signs that require medical attention, according to JMH.

For symptom information sheets and other helpful resources related to congestive heart failure to share with your senior patients and their families, visit:

Diabetes

Having diabetes increases older adult’s risk of many serious health problems that often lead to hospitalizations, including nerve damage, poor circulation, foot ulcers, high blood pressure, and kidney failure, according to the Centers for Disease Control and Prevention. However, with treatment, certain recommended for lifestyle changes, and access to support resources, your elderly patients with diabetes may be able to properly manage their condition to prevent or delay the onset of complications.

Learn more about these common seniors conditions and others that contribute to a senior’s risk of hospitalization and readmission.

For more information about reducing seniors’ risk of hospital readmissions, visit www.returninghomecare.com.

Home Care Walnut Creek, CA delivering home care and elderly services to seniors in the Contra Costa area including Concord. Call us at 925-280-9688.

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4 Self-Care Tips for Caregivers of Cancer Patients

Exhausted. Anxious. Overwhelmed.

If you are the caregiver of a loved one with cancer, it is likely that you relate to all of these emotions expressed by Cat Koehler in the above excerpt of her caregiving journal.

Transportation to and from appointments, frequent hospital stays, and the sheer scope and duration of the illness are challenges many caregivers of cancer patients face. What is a caregiver to do when caring for another leaves little room for caring for oneself?

Here are a few suggestions that may provide relief.

1. Invite others in.
As the primary caregiver, no one knows your loved one’s situation as intimately as you do. You may find it hard to break away or trust others to take your place, even in the simplest of tasks, but this is exactly why you should. Inviting a friend or family member to pitch in can be a breath of fresh air for all involved, and it gives you a much-needed break.

2. Delegate transportation.
Consider allowing a friend or family member to serve as taxi on appointment days. Between treatments, doctor visits and follow-ups, a cancer patient’s calendar can be grueling to maintain alongside your other day-to-day responsibilities. Delegating your loved one’s transportation to and from appointments to a trusted third party may bring some relief to your strained schedule. If family and friends are not available, consider contacting your local Home Instead Senior Care® franchise office to inquire about transportation services as a convenient alternative.

3. Take a coffee break.
Or, take a walk, do some yoga, or just do a little bit of nothing at all. No matter how busy and stress-filled the days get, taking quiet moments for yourself is essential to your wellbeing. As a caregiver, what is essential to your wellbeing is essential to your loved one’s wellbeing. Be intentional about carving out a few minutes several times a day to do something that refreshes you, however simple that something might be.

4. Remember.
The work you are doing is hard work, but it is also good work. Yes, caring for a cancer patient can be physically, mentally and emotionally draining, but your efforts are vitally important. You are making a real, tangible difference in the life of someone you love. Don’t give up, but do take care of yourself.

For more self-care tips, read Caregivers Need Care Too: Tips on Managing Caregiver Stress.

Call us at 925-280-9688 for additional information and resources to share with your senior family members living with Alzheimer’s Disease.

Home Care Walnut Creek, CA delivering home care and elderly services to seniors in the Contra Costa area including Concord. Call us at 925-280-9688.

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How to Prepare Mom for Home Care Help

This Alzheimer’s Care information is brought to you by Home Instead Senior Care, a family network of locally owned franchise offices striving to be your trusted in-home care agency, to help keep your aging loved ones in their home as they grow older.

We present David Troxel, an internationally known expert in Alzheimer’s disease and memory care. David has worked for over 25 years in the Alzheimer’s care field developing and teaching care techniques as a consultant, writer and speaker.

Question: My brother and I both live out of state. We have attempted to get help into the home to help my elderly father with my mother who has dementia. She is adamant that she does not want anyone coming into the home to help out, that she can take care of things and he doesn’t need a break. She makes it so uncomfortable for everyone we had to let the aide go. Is there a way to make this process easier so that Dad can get a break and some much needed time to himself?

David Troxel: This is always a tough one – your mother has dementia but she is still able to make her preferences known. She may not have the self-awareness to know that she (and your dad) needs help.

A few ideas:

Give the caregiver a “job.” Perhaps your new in-home worker can be there to help cook and clean, garden or organize so that your mother sees she has a purpose other than just taking care of her.

Be sure you let the caregiver know your mom’s life story. Help the new in-home worker make a better connection by telling her lots about your mother’s history and preferences.

Keep trying
– Sometimes you have to wait for a (hopefully small) emergency like your mom or dad getting ill, a fall or other circumstance to introduce the new in-home worker.

Be ready to move fast if an opening happens
. The short term “helper” can hopefully build a connection with your mother that will stick.

Coach the caregiver – Provide the caregiver with some coaching about what to do when your mother is mean or challenging (e.g. take a break, offer some ice-cream, call an adult child, etc.). Finding a caregiver with confidence who won’t take your mom’s negativity personally can help.

Call us at 925-280-9688 for additional information and resources to share with your senior family members living with Alzheimer’s Disease.

Home Care Walnut Creek, CA delivering home care and elderly services to seniors in the Contra Costa area including Concord. Call us at 925-280-9688.

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How to Encourage a Parent to Eat

This information is brought to you by Home Instead Senior Care, a family network of locally owned franchise offices striving to be your trusted in-home care agency, to help keep your aging loved ones in their home as they grow older.

We are so pleased to have Molly Carpenter, author, speaker, trainer and family caregiver. In her current role, she works with a team responsible for ensuring that the Home Instead Senior Care® network’s 60,000 caregivers worldwide have the resources necessary to effectively provide quality care in the home and understand the importance of their work enhancing the lives of those they serve.

A family caregiver, Teri, asks Molly:

We are really concerned about my Mother-in-law’s lack of appetite and protein deficiency? When she does have an appetite it is for only sweet things.

Molly Carpenter replies: Teri- I think the first thing to figure out is why she isn’t interested in eating anymore.

1. Is there a chronic illness present where she takes medications that are possibly changing her taste buds or curbing her appetite?

2. Does she have any dental issues, dry mouth or chewing difficulties?

3. Has her activity level changed? Regular physical activity can help stimulate the appetite.

4. Has her mood changed? Depression and loneliness can affect a person’s desire to eat.

5. Can you suggest having friends over for a meal or taking her out for an occasional meal?

It’s also important to remember that taste and smell decline is a normal part of aging. Try to find foods you know she loved in the past, maybe even favorite family meals. Try adding some natural flavor enhancements to food such as olive oil, garlic, onions, spices, cinnamon, and ginger. Or even have breakfast for dinner-mixing up meals for a change.

There is a lot of protein in the breakfast foods. Greek yogurt is another great option for a high protein food choice as well as the different granola bars that have added protein.

You are going to have to try a few things and see what works. While shopping for groceries, keep the filter on for high protein options.

Home Care Walnut Creek, CA delivering home care and elderly services to seniors in the Contra Costa area including Concord. Call us 925-280-9688.

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How Loneliness Affects Senior’s Health

Loneliness — it’s one of the most serious obstacles to good nutrition that your senior loved one could face. Approximately 37 percent of Canada’s 75-plus population – 1.8 million people – lives alone, according to the 2006 Canadian Census. These seniors face significant socialization challenges, particularly when it comes to lack of shared mealtime experiences.

“There is no question that having meals with other people in a group setting is preferable to eating alone,” said Carol Greenwood, Ph.D., Professor in the Department of Nutritional Sciences at the University of Toronto, and Senior Scientist at Baycrest. “Seniors who eat alone often have an underlying isolation and depression and lack of social engagement. This leads to low quality of life and a more rapid decline as they age.”

The far-reaching impact of loneliness prompted the Home Instead Senior Care® network to conduct a first-of-its-kind study to measure mealtime routines, challenges and preferences of seniors age 75 plus who live by themselves in their own homes or apartments.

This comprehensive study, which involved 400 interviews, provides evidence that increased opportunities for seniors to share meals with others will promote nutritional and emotional well-being. Key findings include:

  • Nearly one-half of seniors who live alone have at least four warning signs of poor nutritional health.
  • One in five seniors says he or she sometimes or most of the time feels lonely when eating alone.
  • Seventy-six percent of these seniors eat alone most of the time.
  • One of the biggest mealtime challenges for older people who live alone is lack of the shared family experience, including lack of companionship.
  • Mealtimes last two-and-a-half times longer when seniors who live alone share meals with others compared with when they eat alone.
  • A majority of seniors who live alone say they eat more nutritiously and the food actually tastes better when eating with others.
  • Eighty-six percent of seniors who live alone say they wish their families shared more meals together.
  • The most common obstacles preventing these seniors from sharing more meals with others are that they don’t drive and that their family and friends don’t have enough time.

As a result of this study, the Home Instead Senior Care network has launched the Craving Companionship public education program to encourage extended families to bring back the family meal for the benefit of their seniors, especially those who live alone.

For more information, visit www.mealsandcompanionship.com. The program includes a variety of resources including recipes and tips to help family caregivers make the most of mealtimes.

Home Care Walnut Creek, CA delivering home care and elderly services to seniors in the Contra Costa area including Concord. Call us 925-280-9688.

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Build Senior Health with Nutrition

The importance of proper nutrition for seniors simply can’t be understated. Poor nutrition can affect the mind, the body, the immune system and energy levels in ways you may not be aware of. The more you know about the aging factors that can affect eating habits, the easier it will be to ensure the person you care for maintains a healthy diet.

We’ve collected a wide range of materials to help you recognize the warning signs of poor nutrition, understand the physical changes with age that affect appetite and digestion, and be aware of the lifestyle changes that can affect the way mealtimes are viewed. You’ll find nutrition guidelines for mature men and women, a list of food staples every senior should have, and suggestions for making shopping, meal preparation and dining more enjoyable. In addition, there are tips for food safety, recommendations for transportation and budget issues, as well as discussions about the role diet plays in patients with diabetes, cancer and Parkinson’s disease

If you need help with a loved one at home, please call:

Home Care Walnut Creek, CA delivering home care and elderly services to seniors in the Contra Costa area including Concord. Call us 925-280-9688.

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