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Palliative Care Consults in Nursing Homes Reduce Hospitalizations

Palliative Care for Seniors
Palliative Care can help seniors who would otherwise be depressed

Palliative care consults in nursing homes lead to fewer hospitalizations and less intensive treatment.

A study in the Journal of the American Geriatrics Society studied nursing home residents who died from 2006 to 2010 and found that hospitalization rates were the lowest when the initial palliative care consultation happened the furthest from death.

“These findings have never been shown in nursing homes,” author Susan Miller, PhD, MBA, a Brown University gerontologist and School of Public Health professor, said in a statement. “It’s important that we document this because essentially when people are in the nursing home for a long stay, that’s their final residence. These are people in need of supportive care and expertise in palliative care.”

The study found that for residents with initial consultations 8 to 30 days before death had a hospitalization rate in the last 7 days of life of 11.1% compared with a rate of 6.9% for patients with initial consultations 61 to 180 days before death.

Dr. Miller wasn’t surprised at the differences, but was surprised at how large the differences were.

Potentially burdensome transition rates were about 50% lower for residents with consults at 61 to 180 days before death compared with residents without consults. Transitions between settings can be physically and emotionally stressful for elderly, frail patients, and there is the risk of new medication side effects, exposure to resistant bacteria, and complications from procedures.

Palliative care consults are not used more frequently because unlike hospice care, palliative care consults are not a distinct benefit under Medicare. The payment for providers is usually not much.

Hospice care is used when the patient is likely to die within 6 months and many elderly people in nursing homes have serious illnesses that aren’t necessarily terminal. As a result, the hospice benefit may not be an option, but consults to access palliative care could benefit them.

“There are a lot of things that we need to consider,” Dr. Miller said. “If we had payment for this and there were more people providing it there would be greater access and maybe different people using it.”

Raising Awareness of Diabetes and Its Complications

Diabetes EquipmentEvery November is dedicated to diabetes awareness, which brings attention to the chronic disease and the millions of Americans who are impacted by it. Diabetes is a growing epidemic in the United States, with 29 million people currently diagnosed with the disease and another 86 million estimated to have prediabetes, which means they are at risk of developing diabetes.

Every National Diabetes Month has a new theme, and this year, the American Diabetes Association (ADA) settled on This Is Diabetes. The purpose of this year’s theme is to encourage people affected by diabetes to share their stories about what it means to live with diabetes.

“Too often, diabetes goes unnoticed in our society, but it’s a health care crisis that needs and deserves all of our attention,” Kevin L. Hagan, CEO of the ADA, said in a statement. “Through this year’s theme, This Is Diabetes, we want to bring more attention to this disease that affects our family members, friends, neighbors and colleagues and show how important it is to take urgent action to address diabetes and its devastating complications.”

The campaign is also highlighting the stories of 6 individuals affected by diabetes, including an entrepreneur trying to juggle her hectic career and manage her diabetes, a man who cares for his elderly mother with type 2 diabetes, and a woman who has lived with type 1 diabetes for 2 decades and spent 10 years looking for a physician who would help her have a healthy pregnancy.

While November is observed as National Diabetes Month in America, the disease is also recognized worldwide with World Diabetes Day, which falls on November 14 every year. This year’s theme was Eyes on Diabetes, which focused on improving the early diagnosis of type 2 diabetes and reducing the risk of severe complications, such as diabetic retinopathy, which can lead to vision impairment and blindness.

According to the International Diabetes Federation, it is estimated that 1 in 10 adults worldwide will have diabetes by 2040. Currently, half of the people with diabetes don’t know they have it, which makes them particularly susceptible to complications that arise from having untreated diabetes. In many countries, diabetes is the leading cause of blindness, cardiovascular disease, kidney failure, and lower-limb amputation.

Former Met’s first baseman Ed Kranepool has been diabetic for 40 years and had his big toe removed due to complications associated with his diabetes. Now he needs a kidney transplant. We wish him the best for a quick recovery.

To learn more about diabetes and to donate, contact the American Diabetes Association.

Infected Mosquitos to Fight Zika

A new plan to fight the spread of Zika in Brazil was announced this week. The plan will take mosquitoes infected with the Wolbachia bacteria and release them into areas where Zika is present. Smaller test trials and recent studies using these infected mosquitoes in areas with Zika were successful and showed that Wolbachia infected mosquitoes were unable to transmit Zika virus.  

This innovative idea came from the Grand Challenges program that was started by the Gates Foundation. Each year, the program asks scientists to bid for funds with their creative and new ideas to solve some of the world’s most urgent health problems. In 2005, Professor O’Neill’s team from Monash University in Melbourne, Australia proposed infecting mosquitoes with the Wolbachia bacteria to help stop the dengue epidemic. The dengue virus belongs to the same family of viruses as Zika which makes it an excellent candidate for decreasing Zika carrying mosquito populations.

Following the success of small scale Wolbachia control method trails in Australia, Indonesia, Vietnam and Latin America, both Rio de Janeiro in Brazil and Antioquia in Colombia will see Wolbachia mosquitoes released early next year. The infected mosquitoes are expected to breed with local mosquitoes and pass the bacteria to their offspring. The project is not only self-sustaining and proven to drastically eradicate Zika carrying mosquitoes but it is also affordable and can help stop the spread of other viruses as well such as yellow fever. Wolbachia bacteria itself is benign, completely safe and found in 25% to 70% of all insects. Hopes are high for this newly developed method to end the Zika epidemic once and for all!

The Science of Zika: New Insights

Zika is a relatively new virus. It was accidentally discovered in the Zika forest in Uganda. Scientists from the Yellow Fever Research Institute discovered the virus during a routine surveillance check for yellow fever. The name of the virus comes from the word “ziika” which means “overgrown” in Luganda. Zika is now found around the world and has been a growing concern since the outbreak in Brazil started to spread rapidly around South America in 2015.         
New research is shining a light on the virus’s evolutionary development leading to new insight on how the virus spreads.

The virus belongs to a long list of viruses in the genus known as flavivirus. The name originated from the word “flavus” which is Latin for yellow. Yellow fever was the first virus in this family that also includes West Nile, dengue, chikungunya and tick-borne encephalitis viruses.

A team of scientists from Rome, Italy, have created a model that shows Zika’s diversity and how the virus has evolved. The study of the Zika virus was led by Dr. Ciccozzi and Dr. Angeletti from the University Campus Bio-Medico. An evolutionary analysis of the virus showed two types of genotypes, African and Asiatic, and two separate clades. The first clade represents African gene sequences and the second clade represents sequences of Asiatic and Brazilian origin. The Brazilian sequences are closely related to a French Polynesian sequence, supporting the  hypothesis of how the Zika virus showed up in Brazil. During the Va’a World Sprint Canoeing Championship in Rio de Janeiro, Brazil, in 2014, a team from French Polynesia participated. This supports the hypothesis that Zika virus was introduced during this time and not during the World Cup where no teams from French Polynesia or other Pacific countries participated.

“Understanding the differences and similarities between Zika and other flaviviruses is essential if effective drugs, vaccines and Zika-specific immunological tests for large population screening are to be designed,” the authors of the study say. This new research will help to understand how the infection spreads and how the immune system reacts to the virus.

Research Finds Fungus Associated With Crohn’s Disease

Researchers have a new understanding of why some people develop Crohn’s disease: fungi.

A study led by researchers from Case Western Reserve University School of Medicine has found that fungus is a key factor in the development of Crohn’s disease. Previous studies have shown that bacteria, genes, and diet all play factors in causing Crohn’s disease. The findings were published in mBio.

“Essentially, patients with Crohn’s have abnormal immune responses to these bacteria, which inhabit the intestines of all people,” senior author Mahmoud A Ghannoum, PhD, professor and director of the Center for Medical Mycology at Case Western Reserve and University Hospitals Cleveland Medical Center, said in a statement. “While most researchers focus their investigations on these bacteria, few have examined the role of fungi, which are also present in everyone’s intestines.”

The researchers studied the mycobiome and bacteriome of patients with Crohn’s and in their first-degree relatives who did not have Crohn’s, plus families in the area that did not have Crohn’s. The researchers found strong fungal-bacterial interactions in those with Crohn’s disease. The 2 bacteria and 1 fungus found worked together to produce a biofilm that can cause the inflammation the leads to Crohn’s symptoms.

This study represents the first time fungus has been linked to Crohn’s disease in humans. Dr. Ghannoum believes that the findings may lead to a new generation of treatments that can make a real difference in the lives of people with Crohn’s.

Less than a week after the findings were released, the Food and Drug Administration approved another treatment for Crohn’s disease: Stelara. The drug is approved to treat moderately to severely active Crohn’s disease in adults who failed or were intolerant to treatment with immunomodulators or corticosteroids.

“Because of the individual nature of these diseases, what works for one patient may not work for another. That is why it is so critical that our Crohn’s patients have many different treatment options available to them,” Michael Osso, president and CEO of the Crohn’s & Colitis Foundation of America, said in a statement.

He added that with Stelara approved, many patients with moderate-to-severe Crohn’s disease who have exhausted available treatments have another option to hopefully induce remission, help manage their disease, and improve their quality of life.

 

Acknowledging the Tireless Work of Physicians

Doctor taking child's temperature
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Every day of the year, physicians in the US work tirelessly to care for patients, and one day a year. The country recognizes the work of its doctors with National Doctors’ Day every March 30th.

The day has a long history, dating back to 1933, and was officially turned into a national holiday in 1990. And physicians need our acknowledgment perhaps more now than ever. Research has shown that physicians are facing an epidemic of burnout.

Physicians suffer burnout more than any other American worker, according to a 2012 report by the Annals of Internal Medicine. In 2015, Medscape found that nearly half (46%) of all physicians had burnout, up significantly from 2013, when less than 40% responded similarly.

Physician burnout can have far reaching effects. According to a commentary published in the September/October 2015 issue of Family Practice Management, burnout is directly linked to some undesirable consequences:

    • Lower patient satisfaction and care quality
    • Higher medical error rates and malpractice risk
    • Higher physician and staff turnover
    • Physician alcohol and drug abuse and addiction
    • Physician suicide

“For all of us who take care of patients in the course of our workday, we have been trained and conditioned by our educational process to continue to work despite the fact that our batteries are completely empty,” Dike Drummond, MD, explained.

Burnout rates vary by specialty, but those on the front line of care—primary care physicians and emergency physicians—have the highest reported burnout rates.

As for physician suicide, nearly 400 physicians take their lives each year. Not only is this likely an underestimate, but that makes it the highest suicide rate of any profession, The Advisory Board Company reported in 2014.

So this March 30, take the time to thank your doctor and acknowledge him or her for all the hard work and countless hours they put in to keep their patients healthy and treat them when they become ill. 

Visiting the Elderly – A Habit That Can Keep Them Young

Your beloved aunt is in a nursing home or your grandmother with whom you used to stay all the time or even the grandpa whom you visit; we often feel sympathetic towards our elders who are living in a nursing home but that is the only thing we do for them; thinking of them occasionally. How come we never consider visiting them?

Most of us have a perception of nursing homes being a depressing place or that visiting our elders is not just cool enough. We are hugely mistaken on both accounts. First-off, the nursing homes of today not only provide the most excellent care to their elders, but also have many activities and other things planned that keep the elders occupied. Moreover, the elders get to meet people like them and of their own age. The only thing lacking from their life is a visit from their loved ones.

There are many good reasons for you to visit your beloved elder. Here are some of them:

Keeping A Check On Their Health

They are your own flesh and blood and it is your responsibility to keep a check on their health. Visiting them once a week is good and visiting them every other day is even better. You’d know how they are doing, how they are being taken care of and would result in you being kept in the loop about their well-being. The elder person too feels secure and safe in the knowledge that someone is looking after them.

Mending Severed Ties

There is always someone in the family who we never liked much or we never had a good relation with. However, that doesn’t mean that we put them out of our lives forever. It’s a harsh reality but at any point of time, those elders could be taking their last breaths. You don’t want them to die without saying sorry to them or without actually getting on good terms with them. Visiting elders you never liked will not only be good for your conscience, but will also give you a sense of closure. You will be surprised to know how many people actually become good friends only after reaching a very old age. So, don’t put your non-favorite people off your visiting list.

Helping them Feel Loved

Blood relations can never be replaced by anyone or anything else in life and that is why most elders become very lonely, despite being surrounded by many others. Visits from you can change their life. They begin to show positive behavior, smile more and they wait for your visits every day. Most elders who are left by their family get very quiet and their health deteriorates quicker than the others. Visiting family and friends keep them young, healthy and happy. So, even when their time is up, they leave the world with a smile on their face. Imagine you being the reason for that smile!

If you have any elder in a nursing home right now, then make it a point to visit them as regularly as possible. They don’t need much and just your presence is enough to add life to their numbered days.

Five Reasons to Volunteer in a Nursing Home

Are you at that phase of your life where you have nothing but time on your hands? If so, then you can only belong to one of the two kinds; you either want to spend all your time lounging around the house or you want to experience something new and different that you haven’t had a chance of doing before. Needless to say, the latter is always a good idea. So, while you search long and hard about some life-shattering and eye-opening experience, let us advise you to look a little closer and maybe think about the nearest nursing home in your vicinity.

There are many good reasons to spend your free time with the elderly but most importantly, it can also be as life-changing as you want it to be. It will just happen a lot subtly. Still not convinced? Allow us to do the honors:

Become a Better Person:

Could there be a better goal in life than that of becoming a good person? No, there isn’t. Fortunately, it is a goal that doesn’t require money or fame. Doing small things for others can make you a hero; whether it is pushing someone’s wheelchair, reading stories to someone or just listening to what they have to say. Little acts of kindness can become a big sea of good deeds.

Elders Have a Lot To Tell:

If you are ever feeling down or are caught in some dilemma of life, then who do you think would be better company? Your best friend who is almost as confused as you are or the elders who have already been through this thing in which you are drowning in? Spending some meaningful time with them can not only help them stay young but will also help you become wiser.

The Fear of Death Will Recede:

Old age and death is something that we think about as little as we can. However, not planning or not thinking won’t change the fact that one day, we’ll all grow old and we’ll all die, not exactly in that order. Spending more time with the elderly will help you appreciate old age too and after remaining in the company of brave old souls, you will realize that death isn’t that scary anymore. Most people are absolutely ready when their time comes.

You’ll feel Appreciated:

A large number of us rarely feel appreciated. That’s just how the world is. Parents are always asking us to be one thing or the other, siblings are usually just annoyed by our presence and it’s impossible to even think that our existence is appreciated by anyone, except a select few. But, if you pay attention to the faces of the elderly people you meet every day, you’ll notice how they smile as soon as they see you, how they have been waiting for you all day long and how they are genuinely smiles to have you with them. The old people sure know how to make us feel appreciated.

You Get to Learn:

By watching nurses roam around and taking care of the old, you are certain to learn a few things. If not a proper profession, then at least you’ll know how to take care of old people much better than most other people.
We usually believe that nursing homes need volunteers like us. However, what we don’t realize is how much we need to have them around us.

Drug Usage Continues to Climb Amongst Teenagers

Although not a disease, we thought it important to talk about this subject, since is is so prevalent in our society. The use of drugs has increased over all in our society, but the prevalence among teenagers is alarming. The teenagers have no need to indulge in these activities, yet they somehow end up being a part of this act and often get addicted to drugs at a very young age. The most common reasons why teenagers use drugs include:

  • Peer Pressure

One of the most common reasons why teenagers firstly try and then get hooked to drugs is due to peer pressure. The constant pressure from their friends, seniors, and other people of their age often leads many teenagers to try drugs just so that they can feel included. Many times bullies involve younger teenagers at schools to try out drugs as a challenge. Out of the fear of being left out and ridiculed, teenagers try drugs out. And this develops into a continuous habit in many cases.

  • Seeing Others

Teenagers often see other adults trying out a drug which gives them a feeling of thrill or excitement and they want to try it on their own. Many times, this is done out of curiosity as well. If parents openly smoke, drink alcohol, or abuse other drugs in front of their children, the children eventually follow the footsteps as observed in many research studies as well. The influence of the social circle and neighborhood that the teenagers are a part of also plays a very important role.

  • To End Boredom or To Express Rebellion

Many teenagers adopt drugs as a sign of rebellion against their lifestyle, family life, social norms, or environment in general. Being considered a taboo, drugs are prohibited in such a young age. As they say that “forbidden fruit is the sweetest”, hence, teenagers often try drugs to stand against the general norms. In some cases, teenage try drugs out of boredom or just for the sake of trying. This turns into drug abuse in most of the cases.

  • Repetitive Promotion in Media

Drugs are portrayed as attractive substances and often deemed to be cool in various media channels, especially music. Many Rap songs are actually promoting the use of drugs, and this is establishing a drug culture in a way. Young minds, without understanding the consequences and only blinded by the pseudo attractions, end up using drugs.

  • To Boost Self-Esteem

As we just mentioned, drugs are often perceived to be ‘cool’ by many teenagers. The ones who have low self esteem or do not have much confidence, they use drugs to feel good and improve their perception about themselves. This also gives them an excuse or safe way out in case they do something to embarrass themselves.

There are many more reasons that add up to the list. Many of them can be addressed through better research and proper educative awareness programs, especially in school.

Why the Healthcare System Should Embrace Telemedicine

The 21st century is experiencing marvels in technological advancements and the medical industry is no exception. To date, one of the most promising advances is telemedicine.

Telemedicine or Telehealth refers to the process of health care experts being able to perform diagnosis and/or treatments of patients who are not physically located at the medical facility’s office. Rather, it is done through the use of remote communication. The process involves a connection from a physician or medical professional to a patient via a secure video feed over the Internet. The patient may be a few blocks away, a few miles away or even hundreds of miles away. 

If managed correctly, the benefits can be plentiful; such as a patient doesn’t have to travel to the doctor’s office, which can be advantageous when the individual is not feeling well enough to travel. The person can be provided with a much quicker diagnosis and at times, a life-saving suggestion from the other side of the world may need to be provided. 

Telemedicine allows for one of the most apt responses and attention a patient can get, especially when there are fewer medical practitioners at hand or no medical team within reach. Sometimes, it is also referred to as absentia care and in a recent survey by the Medical Society of the State of New York on telemedicine, the results were significant. Over 78% of doctors surveyed said they are interested in pursuing this technology. Let’s delve in more detail about how the advantages of telemedicine can bring a revolution in the healthcare industry:

Telemedicine Reduces Expenses:

Health is important and cannot be ignored in any case; however, it is the expensive medicines and other health care expenses that make people hesitate in paying attention to their health. Telemedicine acknowledges this issue and in a way, provides a solution by being able to provide better and quality healthcare. Telemedicine also reduces expenses by eliminating the transport expenses associated with doctors, urgent care and hospital visits, as well as avoiding whole workdays off from work.

Telemedicine Consultant
Telemedicine can be advantageous in many ways

Brings Healthcare to the Rural Areas Around the World:

Remote places around the world are not so fortunate to have the luxury of excellent medical care that the people of urban areas have. Telemedicine is beneficial because it is making it possible for the rural population to have the same level of expertise in medical care as that of an urban area.

Progress in Medical Researches:

When great minds come together, they create something magical. Telemedicine is making this possible too. When the best and most expert practitioners from around the world communicate more frequently, take suggestions, give advice and see results, it allows them to establish better ways of providing health care.

An Option for All:

A majority of working-class people or sometimes, even the most career-oriented people, find it difficult to miss a workday or two or to wait for hours in the doctor’s office while their children are with a babysitter. Telemedicine allows people to have their independence. People can deal with their health and care without making them appear to be a glitch in their everyday routines. Sometimes, a health problem even forces families to move to a different state, whether they like it or not. However, with Telemedicine, such an inconvenience can be avoided.

Better Chances of Recovery:

It’s one thing when only doctors and parents are worried about someone’s health care and an entirely different matter when a person is too invested in their own proper health-related issues. It increases the chances of recovery and lowers the cost. With telemedicine, a patient him/herself has to take care of their virtual appointments and has to contact their doctors or nurses at times of a sudden emergency. With more patient engagement, the chances of healing increase tenfold. 

So, now that we know how telemedicine can bring a revolutionary change in the world of medical care, the only thing preventing it is a lack of awareness and the establishment of proper systems in place.