A study was published in the journal JAMA last week that showed “no reduction in urinary tract infections for female nursing home patients who took standardized, high-dose cranberry capsules — the equivalent of 20 ounces of juice daily — for a year.”
A link to an article from last week’s New York Times about the study is here:
www.nytimes.com/2016/10/28/
Health | Misconceptions
The Cure for UTIs? It’s Not Cranberries
New York Times
By Jan Hoffman
Oct. 27, 2016
Robin
The ICU can be a dangerous place for neurologically normal people. Imagine how much worse it is for our loved ones who are neurologically impaired!
Here’s an excerpt from a recent article in STAT (statnews.com):
“Anywhere from a third to more than 80 percent of ICU patients suffer from delirium during their hospital stay. And one-quarter of all ICU patients suffer from post-traumatic stress disorder once they leave, a rate that’s comparable to PTSD diagnoses among combat veterans and rape victims. Patients with ICU delirium are less likely to survive and more likely to suffer long-term cognitive damage if they do.”
One critical care physician quoted in the article calls ICU delirium a “massive, massive public health problem.”
Read the full article here:
www.statnews.com/2016/10/14/icu-delirium-hospitals/
Hospitals struggle to address terrifying and long-lasting ‘ICU delirium’
By Usha Lee McFarling
STAT
October 14, 2016
Robin
“Endnotes” is a regular section of STAT, a website focused on the “frontiers of health and medicine.” Someone on an online frontotemporal dementia support group recently shared an article on STATnews.com so I started digging around on the website. There are lots of good articles.
This article — titled “Making a living will is a good idea. Telling people about it is even better” — makes an excellent point. Many of us have prepared a living will or advance care directives but few of us have shared them with our primary and secondary healthcare agents. And few of us have had conversations about our wishes with our healthcare agents.
The author notes that “spouses often grant power of attorney to one another or complete living wills, but they find it too painful to talk openly about each other’s death.”
Also, some patients are “reluctant to thoroughly advocate for their end-of-life preferences” as they are worried about hurting the feelings of their loved ones.
When a healthcare agent doesn’t know the person’s end-of-life wishes for treatment, this can backfire because usually uninformed healthcare agents opt for aggressive treatment.
Here’s a link to the article:
www.statnews.com/2015/12/04/living-will-important-steps/
Endnotes
Making a living will is a good idea. Telling people about it is even better
STAT
By Bob Tedeschi
December 4, 2015
Robin
This post may be of interest to those who have family members on Medicare, and probably of most interest to adult children who are new caregivers to parents as this audience probably has little awareness of the ins-and-outs of Medicare.
We are in the midst of National Medicare Education Week (ends on Wed., Sept. 21st), and Medicare Open Enrollment starts on Oct. 15th.
Besides a short article in Huffington Post that offers a quick overview of Medicare Parts A-D, there are two other good sources of Medicare info:
1- MedicareMadeClear.com, a website
2- HICAP (Health Insurance Counseling and Advocacy Program), a terrific resource for Medicare and MediCal (what Medicaid is called in California) info. In California, you can find HICAP resources by county. Start here and then click on “Services by County”:
In other states, HICAP might be called SHIP (State Health Insurance Assistance Program). You can likely find contact info on SHIP resources by contacting the local area agency on aging.
Here’s a link to the short article on the “ABCs of Medicare”:
www.huffingtonpost.com/entry/abcs-of-medicare-for-caregivers_us_57d6d1abe4b0273330ac46f3?
Voices | Health Post 50
The ABCs Of Medicare For Caregivers
Huffington Post
Dr. Efrem Castillo, Chief Medical Officer, UnitedHealthcare Medicare & Retirement
09/12/2016 12:17 pm
Happy reading!
Robin
This post may be of interest to those on Medicare.
This New York Times article is about the fact that skilled nursing facilities, home health agencies, and outpatient therapists deny continued therapy or treatment for Medicare beneficiaries with the rationale that the patients are “not improving” or “have reached a plateau.”
This issue was supposedly settled in a 2013 lawsuit. According to the settlement, Medicare must cover skilled care and therapy when they are “necessary to maintain the patient’s current condition or prevent or slow further deterioration.” The judge required CMS (Centers for Medicare and Medicaid Services) change its policy manuals and “begin an educational campaign to publicize the change.”
According to the article: “By early this year, however, the Center for Medicare Advocacy [one of the plaintiffs in the 2013 case] was hearing from many sources that despite the settlement, providers and the contractors reviewing Medicare claims were still denying coverage when beneficiaries didn’t demonstrate improvement.”
So the plaintiffs in the 2013 case went back to court. The judge has given CMS until early October to come up with a plan as to how it with launch an educational campaign.
As the article points out, there is an appeals process if Medicare denies therapy or skilled care but most patients don’t appeal. The authors notes:
“Of course, patients and families have the same right to appeal coverage denials that they’ve always had. (A notice to this effect is buried somewhere in the paperwork they sign.) They also have the same odds of prevailing they’ve always had: very low, said Judith Stein, the executive director of the Center for Medicare Advocacy. Patients generally have 72 hours to appeal, a process that involves seeking a ‘redetermination’ and then, if that fails, a ‘reconsideration.’ If families go all the way to a hearing before an administrative law judge, Ms. Stein said, they have a good shot. But most families don’t persevere, in part because they can’t afford to pay for care while the appeal proceeds. (If they do spend their own money, though, they can appeal for reimbursement.)”
Here’s a link to the full article:
www.nytimes.com/2016/09/13/health/medicare-coverage-denial-improvement.html
The New Old Age
Failure to Improve Is Still Being Used, Wrongly, to Deny Medicare Coverage
The New York Times
Paula Span
September 12, 2016
Robin
