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April 2009 Your Partners in Home Care Volume 2, Issue 1
In This Issue HCP Update Fall Prevention
HCP Profile Elizabeth Stellema RN
Article of the Month Spirituality and the Work of the Spiritual Care Team
Mental Health Brain Games Keep the "Boring" Out of Board Games
A Note from Melanie West MBA, MT (ASCP)
Administrator/COO
Quality Assurance
The Perils of Emphysema
Suggested Reading Thank You Quick Links Contact Us!
Email us
Linda Jones, RN
CEOJulianne Stroud
Director of EducationMedical Social Work Manager
Medical Director
Dear Friends & Relations,
Welcome to another edition of Health Care Partners, Inc. e-news. In this issue we talk about Fall Prevention and the importance of safety in your home followed by the latest study in research from the American Geriatric Society, a study that profoundly emphasizes the seriousness and compassion in our work with seniors in the home and why choosing a quality compassionate home care agency is so vital. I want you to meet Tom Barbas and read his thoughts on Spiritual Care. Brain Games That Aren't Boring is a reminder for us to always exercise our brains, daily! A Note From Melanie West introduces you to our exceptional and committed Quality Assurance Team. Learn about the normal aging process of the lungs in The Perils of Emphysema by our Medical Director, Dr. Pedro Caing. Our employee profile is on Elizabeth Stellema, RN. I have known Liz since 2000 when she joined us at Health Care Partners. I hope you enjoy this edition and please visit the Quick Links to learn about other great people and services. One last very important thing, please read all the way to the bottom. My latest fundraiser for the Hope and Healing Foundation is taking place on Sunday, June 7th. I realize there are graduations and other family events taking place. If you, your family and/or friends cannot partake in this event with us, please consider sponsoring a team for $100. The proceeds benefit the scholarship fund to provide aid to a low income seriously minded student for a degree in Nursing. Thank you and I hope you can join us for family fun on a warm afternoon in June!
Joyfully,
Linda Jones, RN
Owner, Health Care Partners, Inc.
HCP Update:
by Julianne Stroud, RN, Director of Education More than 1/3 of adults 65 and older fall each year in the United States. More than 30% of community-dwelling older adults fall at least once each year; of the 30%, half do so repeatedly. Of those who fall, one in forty will be hospitalized. Of those hospitalized, only half will be alive at the year’s end. Health Care Partners is aware of these facts and the consequences of not practicing fall prevention. Fall Risk Assessments and fall prevention are practiced diligently by all staff.
To prevent falls:
1. Begin a regular exercise program.
- Exercise strengthens, improves balance and coordination.
2. Review medications, including over the counter medicines.
- Some medicines or combinations cause sleepiness, dizziness and falls.
3. Get up slowly after sitting or lying down.
4. Have regular eye exams.
- Poor vision increases the chance of falling; wearing the wrong glasses, glaucoma or cataracts limit vision.
5. Make the home safer.
- Remove obstructions (papers, books, clothes, shoes, rugs) from stairs, floors, hallways and walking places. Use double-sided tape on rugs to prevent slipping.
- Coil or tape cords and wires to the wall, put in another outlet if necessary.
- Fix loose or uneven steps.
- Paint a contrasting color on the top edge of the staircase to see stairs better.
- Use glow in the dark light switches at the top and bottom of stairs.
- Make sure the carpet is firmly attached to every step.
- Fix loose hand rails. Make sure they are as long as the stairs on both sides.
- Place a lamp on both sides of the bed within easy reach.
- Use night lights that go on by themselves after dark for walking to the bathroom.
- Keep often used items within easy reach in cabinets. If you must use a step stool, get one with a bar to hold on to. Never use a chair as a step stool.
- Install grab bars next to the toilet and in tub and shower. Use non-slip mats in tub.
- Improve lighting with fluorescent lights and reduce glare with shades.
- Wear shoes indoors and outdoors, avoid walking barefoot or slippers.
- Keep emergency numbers in large print near each phone.
- Put a phone near the floor in case of a fall.
- Wear a Lifeline or Medic Alert.
Home Based Program Extends Seniors' Lives: by Jane Cortez
A home-based program for seniors that includes occupational and physical therapy, as well as some minor home modifications, can help people live longer gaining a 3.5 year of lifespan according to researchers at Thomas Jefferson University in Philadelphia, says study author Laura Gitlin, Director of the Jefferson Center for Applied Research on Aging and Health and a professor in the department of Occupational Therapy at the university. The work was funded by the U.S. National Institute on Aging, and the results were published in the March issue of the Journal of the American Geriatrics Society. The intervention group met with an occupational therapist five times, including at home and by telephone. The therapist taught the seniors how to do tasks differently and ways they could conserve energy during tasks. Everyone in the intervention group also had at least one visit with a physical therapist to evaluate their balance and their fear of falling. All were taught how to fall safely, and how to recover from a fall. Those in the intervention group had fewer troubles with daily living activities and reported a higher quality of life.
The survival benefits kicked in at one year. At two years, the mortality rate in the intervention group was 5.6 percent versus 13.2 percent for the control group. The benefit continued for 3.5 years, but wasn't statistically significant after three years, according to the study.
People say the program "gave them back their life and made them feel they had a sense of control."
HCP Profile: Ms. Elizabeth Stellema, RN Name: Elizabeth Stellema, RN
Born: Garden City, Michigan
Childhood Dream: To get married and have a family.
Graduated: 2000, Associates Degree in Nursing from Schoolcraft College.
Joined HCP: 2000
Passion: My family, tennis, animals, helping people.
Greatest job demand: Nursing can be demanding when many patients at one time are very sick, it's difficult. Luckily this doesn't happen very often.
Greatest impact in your life: My faith, it guides me and made me who I am. My family has had a big influence on who I am, I have a great family.
Greatest invention ever: Cell phone. It's made my life easier!
What makes your heart soar? My 2 little doggies, to wake up in the morning to have them there and when I come home they are so happy, it's so special.
Email rnliz247@aol.com
by Tom Barbas
SPIRITUALITY AND THE WORK OF THE SPIRITUAL CARE TEAM
Every person is a spiritual human being, no matter what his or her faith tradition. An atheist is no less so than the most devout Buddhist monk. That's because the spirit in all of us is the spark of life or what many of us call the soul. As thinking people, we can't deny that. It's true, though, that many people don't recognize or understand their own spirit.
But life and spirituality, as given to us, are quite simple. It's we who tend to complicate things, isn't it? One way of looking at spirituality is this: The work of the spirit is to love. But that love is so puny unless and until it is shared. That's it. Simple, direct and easy to understand. Love in Action is spirituality.
I meet with people to help them grow in their own spirituality. However, I don't preach at them nor try to change their beliefs. Instead, I share my own spiritual journey with them as a way to encourage them to do the same with me.
By talking with me, many of them are able to voluntarily bring up and face long-time hard feelings, hurt, guilt, worry about their physical condition, fears for their families and other problems that may be weighing them down.
Of course, what they tell me, I hold in great confidence, unless their health and well-being is in danger. When I sense that they need counseling and help outside the scope of our work, I have been trained to know when and how to call the HCP Social Work Team and get their advice and guidance.
The Spiritual Care Team is available to all HCP patients by contacting our nurses, therapists, social workers, community outreach staff and admissions office.
Email: tombarbas@aol.com
by Joanne Corbo Cruz, MSW, LMSW
Brain Games Keeps the “Boring” Out of Board Games
Health Care Partners is one of the first home health care agencies in the metropolitan area to provide practical education to local seniors about brain health.
Mental stimulation for brain health is not limited to doing puzzles or reading. Health Care Partners exercises all the senses (smell, taste, vision, touch and hearing) and our senior audience reports great satisfaction with these memory enhancement and brain sharpening education workshops. Seniors are experiencing a common side effect from participating—they socialize with their neighbors and learn basic practical information about their brain and have a great time. Seniors are also introduced to and partake in new activities while teaching their brain to do new things and keep it stimulated. Doing these exercises daily can only help, not harm!
Books, articles and studies have constantly highlighted and supported these 5 elements that contribute to brain health:
1. Socialization, people need to stay connected to their communities and get involved in meaningful ways.
2. Physical activity, the human brain demands 25% of the blood from each heartbeat. Walking daily, aerobic exercises and other physical activities promote blood flow necessary to the brain.
3. Nutrition, food rich in Omega-3 fatty acids is good, certain fish and antioxidants are beneficial while reducing processed foods and saturated fats.
4. Mental Stimulation, since birth the brain desires mental stimulation. Exercises such as learning a new language, dance step, writing, doing puzzles, computer-based cognitive exercises. This keeps the brain guessing!
5. Spirituality, daily prayer, meditation and relaxation help reduce stress which affects brain development.
by Melanie West, MBA, MT (ASCP)
Administrator/Chief Operating Officer
Our Quality Assurance Department
Quality is hard to measure. We send satisfaction surveys to our patients and receive a 100% rating of either excellent or good. We send satisfaction surveys to our referring physicians and receive a 98% rating when we ask the doctors if they are satisfied with the quality of care that their patients receive. Quarterly we tabulate “Outcome Based Quality Monitoring”. This data demonstrates Health Care Partners patient care results and compares our patient outcomes to state and national benchmarks. We continue to score very well. How do we do all this? A huge amount of the credit for the proven quality achieved by our professional clinical staff is due to the hard work by our Quality Assurance Department.
The QA nurses review the assessments made by the nurses and therapists who visit the patients in the home. They teach and oversee the treatment plan that is created and ensure that the frequencies of home visits are appropriate for the doctor’s diagnoses. These very talented nurses monitor the progress of the patients while they are being treated in the home and help the field staff to reach the best possible outcomes. Everyday we educate patients and their caregivers about their medical issues, we instruct them on how to better manage their medications, and we teach people how to administer their own insulin injections if they have diabetes. Thank you Sandy, Anne, Deb and Toni for helping us to take great care of the people we serve!!
Pay for Performance (P4P)
In 1965 Congress voted to implement the Medicare Program. In 1966 we started talking about ways to control the cost of health care and we have been talking about it ever since. The cost of a hospital stay was controlled during the 1980s by implementing a new way of reimbursing the hospital by Medicare called Diagnosis Related Group (DRG). The Balanced Budget Act of 1997 legislated more ways to control costs for nursing homes and home health agencies like ours. After 45 years of Medicare, we are still trying to control the costs of medical care in the United States.
Now comes P4P. Medicare intends to pay doctors and home health agencies based on the results they achieve with their patients. Currently doctors and home health agencies are paid an amount for the service they render, without any consideration for results. Because of all our computers we have such a capacity to measure and store data; they want to use the data as a basis for how they reimburse us. If a patient gets an infection after surgery and has to go back into the hospital, the doctor and the home health agency will not receive as much money as when the patient has a good outcome and the patient has no infection after surgery.
Ongoing demonstration projects around the country are showing that if provider reimbursement by Medicare is based on patient outcomes, the doctors will manage care to attain a better outcome. The incentive to coordinate care to achieve better results is compelling. This will be true for home health agencies as well. Will this new reimbursement methodology control health care costs? We will have to wait and see.
Tele Monitoring
Doctors may choose to use HCP’s Tele-health Program to monitor homebound patients with serious medical conditions on a daily basis. This program allows the patient to keep the tele-monitor in their home and transmit their vital signs: blood pressure, oxygen content of the blood and weight for review by a nurse. Providing care in this manner not only enables Health Care Partners, to improve the quality of clinical and humanistic outcomes, but also empowers the client to truly participate each day in the management of their own health care, optimizing their quality of life.
Requirements for the Patient
- Must be alert and oriented to their environment or have a caregiver assist them with vital sign prompts from the tele-monitor.
- Willing to send data daily.
Services to be Provided by Health Care Partners
- Installation and removal of monitor in the home.
- Daily review of vital signs transmitted to the office via the patient’s phone.
- Call to the patient, caregiver, or physician when data is outside programmed alert ranges. Notify emergency contact when an urgent medical situation is discovered.
This great program is helping HCP and the doctor to act in a timely manner to keep people out of the emergency room and decrease hospital admissions.
Electronic Medical Record
In September of 2008 HCP implemented an electronic medical record system for our Medicare certified home health agency. This computer software has modules for scheduling the appointments, documenting notes into the patient’s chart, and billing the insurance company electronically. The use of computers is improving productivity and efficiency for the agency. We also can print management reports to help us improve our internal processes and measure our patient outcomes.
Health Care Partners is known for “high touch” (compassionate care) and “high tech” (using technology). We provide a whole new approach to home health care.
From right to left: Anne Meloche, RN, Toni Keating, RN, Deborah Breitenbeck, RN
QA Director, Sandra Rosenick, RN, not shown
The Perils of Emphysema
by Pedro V. Caing, MD
Dr. Pedro V. Caing is the Medical Director of Health Care Partners, Inc. He is an active staff member of Oakwood Hospital in Dearborn, Michigan, maintains a private practice in Internal Medicine at 3735 Monroe Street, Dearborn, MI 48124. telephone: 313-277-6560, email caing62740@comcast.net.
The normal aging process takes its toll differently on every organ in the body. In the lungs, there is loss of elastic recoil resulting in collapsed airways during respiration. This is almost always associated with a loss in the number of air sacs (alveoli) resulting in reduced vital lung capacity. Furthermore, the age-weakened chest wall muscles add to a decrease in maximum voluntary respiration leading to a normal reduction in expiratory flow rate of 20-30 ml each year.
Emphysema, also called chronic obstructive pulmonary disease or COPD is a disease state that results from the destruction of the air spaces distal to the terminal bronchioles or small airways. These small airways undergo an inflammatory remodeling process from long-term exposure to cigarette smoke in 90% of cases. Occupational and urban pollutants, asthma and chronic childhood infection leads to airway narrowing. There is a genetic abnormality known as alpha1 antitrypsin deficiency (AAT) that accounts as the cause in less than 1% of COPD. As the disease process worsens, less oxygen reaches the air sacs while more trapped carbon dioxide is retained.
COPD is manifested clinically by cough, sputum production, wheezing and shortness of breath. Symptoms are worst when acute bronchial infection develops. It is the second leading cause of disability, after heart disease and the 4th leading cause of death.
In the final stages, the patient develops a barrel chest as wheezing, chest congestion and shortness of breath become severe. They eventually become dependent on supplemental oxygen to survive. Heart failure is a common complication. In addition, there is an added risk of developing lung cancer.
Asthma may have similar symptoms but the airway narrowing is a result of exaggerated lung response (allergy) to various irritating stimuli. It is usually reversible and responds to bronchodilators and or steroids.
Diagnosis and disease severity is best established by spirometry or pulmonary function studies. Chest x-ray showing over expanded lung will confirm its presence. Your doctor after a thorough physical examination will assess the severity of COPD.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) set the goals of management as follows:
· Prevention of disease progression best achieved by cessation of
cigarette smoking.
· Relief of symptoms with optimum use of medications.
· Improvement of exercise tolerance.
· Improvement of health status and quality of life.
· Prevention and treatment of complications.
· Prevention and treatment of acute symptoms flare-ups.
· Reduce mortality. In some cases, there is a surgical option that includes lung transplantation.
If you are a cigarette smoker, make a commitment to kick the habit now before COPD breathing problem develops. And if you already have it, make a serious effort to be compliant with the treatment your doctor has given you.
Health Care Partners, Inc. team of professional nurses and caregivers will work closely with you and your doctor by providing comprehensive home equipment needs along with a multidisciplinary approach to help attain your goal towards a good quality of life.
"How to Get the Health Care You Want,
the Savvy Consumers Guide to Navigating the Health Care System"
by Laura Casey
Whether you are in the midst of a health crisis, caring for a sick loved one, or healthy but feeling frustrated by everyday issues and wellness exams, this book will help you to make confident, informed choices about health care and its costs.
Written by a patient, patient advocate and tenured professional in the business of health care, Laura Casey offers straightforward and immediately applicable advice on how to communicate with your caregivers, create long-term, mutually beneficial care relationships and tailor your health care to your personal values, standards and budget.
"To be the recognized standard home health care organization that exceeds the expectations of our patients and clients, by utilizing skill, knowledge and expert resources; to provide homecare that is meaningful, safe and respectful."
Thank You... to all of our referring physicians, nurses, social workers, rehab staff and office staff for providing excellent care to our patients! The staff at Health Care Partners continues to provide quality care to our patients and communicates their progress to all of our referring physicians!
Health Care Partners tracks our outcome-based quality improvement measures on a monthly basis. Our scores for the last quarter were above the national average on 4 of the 7 measures!
At Health Care Partners, we care and it shows!!!
Quick Links www.healthcarepartnersinc.com www.professionalparentcare.com www.thefamilycaregiver.org www.healingdoc.com www.senioroptionsmi.com www.banananose.com
Contact Us For more helpful information, contact Health Care Partners, Inc.
Health Care Partners, Inc.
18000 W. Nine Mile Rd. Suite 400
Southfield, MI 48075
Phone: 248-358-1186
Fax: 248-784-3919
Don't forget to add us to your address book!
Your comments or suggestions for future issues are always welcome; or if you would like your name removed from this email please contact Jane Cortez.
For back issues of e-news, visit our website and click on the Contacts page at www.healthcarepartnersinc.com
The Health Care Partners e-news team Douglas Jones Jane Cortez Arnel Doreza email Doug email Jane email Arnel
Join the fun!
Sunday, June 7, 2009
Bowl for the Hope & Healing Foundation!
Help alleviate the nursing shortage, support HHF's scholarship fund!
check in: 1:00 p.m.
Begin: 1:30 p.m.
2 games of bowling, 2 pieces of pizza, 1 beverage - all for $20
or sponsor a team for $100
50/50 Raffle
Glow Bowling
Smoke free environment
Super Bowl
located at
45100 Ford Road
Canton, MI
