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Medicare Costs Grow Due to Aggressive Care in End-Stage Dementia

October 12, 2011 By Leave a Comment

Medicare Costs Grow Due to Aggressive Care in End-Stage Dementia

Article by Georges Baxter









A new study dealt with nursing home residents with advanced dementia. The study claims that a large part of Medicare expenditures for these patients is spent on aggressive treatments that may be of little clinical benefit. Roughly one-third of all Medicare costs for dementia were for hospitalizations.

“It can be difficult making choices about the type of care someone should receive during this difficult time in their life,” suggests Alan Weinstock, an insurance broker at MedicareSupplementPlans.com. “But what this study demonstrates is that some Medicare expenditures in advanced dementia cases may be avoidable and may not improve outcomes.”

Debate over End-Stage Dementia Care

The study reviewed Medicare expenditures for 323 nursing home residents with advanced dementia. The findings indicated that expenditures for hospitalizations was 30.2% and for hospice 45.6%. In addition, Medicare costs rose by 65% in each of the last four quarters before death.

Another study also an affiliate of Harvard Medical School, indicated the clinical course of advanced dementia is similar to what other patients with other terminal conditions experience. This includes symptoms such as pain, pressure ulcers and high mortality.

The suggestion is that there is a need to improve the quality of palliative care in nursing homes to reduce the physical suffering of patients with advanced dementia. This strategy could shift Medicare expenditures away from aggressive treatments, which may be less beneficial for end-stage dementia patients, toward a more comfort care approach.

Focusing on Comfort Care and Advanced Care Planning

Hospice and palliative care focus on quality of life. This “comfort care” includes active pain management and the management of other symptoms. In addition, it includes dealing with the psychological, social and spiritual issues that come with the end-of-life experience. However, unlike hospice care, palliative care is sometimes used in conjunction with curative treatment.

Many believe that advance care planning may be a key step toward preventing unneeded or unwanted aggressive end-of-life care. Here are some tips on how to work through the advanced care planning process.

1. First, consider your values, beliefs and preferences and make sure to communicate this information to your family and health care practitioner.

2. Get help with planning and choose someone to be your health care proxy. Make sure this person is available and comfortable with this role.

3. Develop any legal documents such as a living will, medical power of attorney and a “do not resuscitate” (DNR) order. Be sure to consult with an attorney. Be sure to keep your advanced care planning documents easily accessible.

4. Review your plans periodically. Be sure your health care proxy is still available and willing to carry out your plans.



About the Author

The best Medicare Supplemental Insurance is one that provides full security to the people and hence is called Medigap; Medicare supplemental plans should be beneficial for the people.










Filed Under: Dementia Communication Strategies Tagged With: , , , , , ,

Hearing loss may be an early sign of dementia

September 23, 2011 By Leave a Comment

Hearing loss may be an early sign of dementia

In some people, gradual hearing loss may also be an early sign of types of dementia. We listen with our ears but hear with our brains. Gradual hearing loss is a common symptom of aging, but in some people it may also be an early sign of Alzheimer’s disease

Gradual hearing loss is a common symptom of aging, but in some people it may also be an early sign of Alzheimer’s disease or other types of dementia, a new study suggests.

The risk of dementia appears to rise as hearing declines. Older people with mild hearing impairment — those who have difficulty following a conversation in a crowded restaurant, say — were nearly twice as likely as those with normal hearing to develop dementia, the study found. Severe hearing loss nearly quintupled the risk of dementia.

It’s unclear why the loss of hearing and mental function might go hand in hand. Brain abnormalities may contribute independently to both conditions, but it’s also possible that hearing problems can help bring on dementia, the researchers say. Hearing loss may lead to social isolation (which itself has been linked to dementia), for instance, or it may interfere with the brain’s division of labor.

“The brain might have to reallocate resources to help with hearing at the expense of cognition,” says the lead researcher, Frank R. Lin, M.D., an ear surgeon at Johns Hopkins Hospital in Baltimore. That may explain in part why straining to hear conversations over background noise in a loud restaurant can be mentally exhausting for anyone, hard of hearing or not, he adds.

The findings suggest that poor hearing is a “harbinger of impending dementia,” says George Gates, M.D., a hearing expert at the University of Washington in Seattle, who was not involved in the new study but whose own research has demonstrated a link between the two conditions.

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“We listen with our ears but hear with our brains,” Gates says. “It is simply not possible to separate audition and cognition.”

In the study, which appears in the Archives of Neurology, Lin and his colleagues followed more than 600 dementia-free adults between the ages of 36 and 90 for an average of 12 years. A little less than 30 percent of the study participants had some hearing loss at the start of the study.

Overall, 9 percent of the participants went on to develop Alzheimer’s disease or another form of dementia. Mild, moderate, and severe hearing loss were associated with a two-fold, three-fold, and five-fold higher risk of later dementia, respectively, in comparison to normal hearing.

People with moderate hearing loss generally struggle to communicate even in quiet settings, and those with severe hearing loss are near deaf.

Lin says that hearing loss has an enormous impact on the lives of his patients and their family members. “Yet because it is such a slow and insidious process, it is often left ignored and untreated.”

Whether hearing aids or other treatments (such as cochlear implants) can help stave off dementia is the “50 billion dollar question,” Lin adds. Thirty million Americans currently have impaired hearing and 1 in 30 are predicted to suffer from dementia by 2050, so if those treatments prove to be helpful, their impact would be felt widely.

There is no cure for dementia, and there are no surefire ways of preventing it. Gates isn’t optimistic that restoring hearing can affect the course of dementia. However, if treatments and prevention strategies for dementia do become available in the future, he says, hearing loss could play an important role in early detection.

Lin and his colleagues have begun researching the effect of hearing aids on the risk of dementia. “Whether or not it can help dementia, we don’t know yet,” he says. “But in the meantime, there’s no reason not to take your hearing loss seriously and pursue some type of treatment.”

Welcome to Center for Hearing Aids

Center for Hearing Aids is the leader in the field of custom hearing aids, complete ear check up for proper audio perception, hearing aid accessories, all types of hearing aids services and fittings. We use state of the art hearing aid technologies and style to provide personalized and true High Definition hearing and comfort. We sell all major brands of hearing aids and their corresponding batteries and accessories, we have professional audiologists for checking your hearing loss and detecting early stages of hearing problems. We deal in all the types and major brands like Phonak, Siemens Widex, ReSound, Starkey, Barnafone, Oticon, Alps and Unitron.

Center for Hearing Aids provides care with hearing aids at retail outlet prices. We are proud to be one of the only companies to provide transparent pricing.

Contact Details:

Sandeep Malhautra

E-32, Hauz Khas Market

New Delhi – 110016, INDIA

Mobile : +91 9810074489

 

Center For Hearing Aids

 

E-32, Hauz Khas Market,
New Delhi-110016

E-mail : ramavisionhearing@gmail.com

Contact no: +91 – 9810074489

http://www.hearingaidsdelhi.com/


Filed Under: Dementia Communication Strategies Tagged With: , , , ,

Critical Communication For Caregivers, Dallas Texas

September 13, 2011 By Leave a Comment

Critical Communication For Caregivers, Dallas Texas

Article by Ruby Bhayani









What works for a spouse with dementia?

Alzheimer’s disease and other forms of dementia represent an exponentially growing social and health care challenge for American families – not only family members who face the progressive brain disease, but also those who love them.

Many spouses of those with dementia do more than watch as their partners deal with the disease’s effects on brain functioning, memory, motor skills and emotional health. They often assume round-the-clock caregiving responsibilities as their husband or wife of many years faces progressive decline. Communication can become a particularly difficult issue.

“We found that breakdowns in communication may trigger or deepen problem behaviors in family members with dementia,” says Marie Savundranayagam, assistant professor of social work at the University of Wisconsin-Milwaukee (UWM). “These problem behaviors by those with dementia, such as agitation and aggression, have consistently been linked with caregiver stress.”

Through a UWM Research Growth Initiative grant and an Alzheimer’s Association New Investigator Research Grant, Savundranayagam is working to identify communication strategies used by caregivers to resolve communication breakdowns.

Partners in long-lasting relationships are the focus of her research. “There’s something very special about these relationships,” she says. “These caregivers are less likely to place their spouses in a nursing home. They want to keep that family member at home as long as possible.”

New strategies can backfire

“Communication breakdowns can also result from caregivers’ use of ineffective communication strategies that they perceive to be helpful,” says Savundranayagam.

“Imagine the frustration that a wife, married to her husband for 40 years and now thrust into the role of caregiver, feels when their familiar conversational give-and-take no longer works,” she continues. “When the wife tries to communicate differently, that strategy may work – or it may create even more problems.

“For example, the wife may think that she can communicate better with her loved one by talking slower. But that’s actually the opposite of what should be done. A person with dementia will actually forget what was said in the first part of the sentence before the caregiver finishes talking.”

Insights from everyday interactions

Savundranayagam and co-investigator J.B. Orange, associate professor and director of the School of Communication Sciences & Disorders at the University of Western Ontario, are now analyzing everyday activities and communication patterns of persons affected by Alzheimer’s disease and other dementias.

Caregiver/care receiver couples completed questionnaires and were then video-recorded as they interacted in their homes – at the dinner table, for example. Communication Sciences and Disorders students from UWM’s College of Health Sciences, coached by Orange, are transcribing and coding these videos to help pinpoint the types of communication strategies the caregiver is using to resolve misunderstandings.

The next step, says Savundranayagam, is assessing the effectiveness of caregiver strategies. “Do their approaches exacerbate a communication problem or resolve it?” Savundranayagam’s work also will investigate the role of effective and ineffective communication strategies in predicting episodes of problem behaviors and caregiver stress.

The goal is to lay the foundation and justification for designing empirically derived communication interventions for family caregivers that target both problems.

“Sometimes a caregiver can deal with problem behaviors and it’s not that distressing for them,” says Savundranayagam. “But other times, the caregiver’s appraisal is incorrect, and a strategy that they think is good really isn’t. When we see that, we know that an intervention is necessary for a specific group of caregivers.

“That’s really where this project is going – to target the people who will really benefit from a communication intervention,” says Savundranayagam.

Visit us at www.seniorcarecompanion.com or www.seniorcaredallas.net for more assistance with your aging loved one.

Source: Marie Y. Savundranayagam University of Wisconsin – Milwaukee



About the Author

Rubyna Bhayani,Registered Nurse,Certified Case Manager with extensive clinical experience in the fields of Geriatric Case Management, Long Term Disability Management and Home Health Services. Proud owner and manager of Senior Care Companion, in-home Personal Care Assistance Provider.










Filed Under: Dementia Communication Strategies Tagged With: , , , ,

Teleworkshop: Communicating with a Person with Dementia

September 1, 2011 By Leave a Comment

This workshop for family caregivers offers insights about effective communication strategies, and ways of providing care that focuses on the needs of the person with the disease.
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