weekly blog--one for the ages
Medicare Payment Squabble
Increasingly, hospitals have chosen to keep some patients under observation instead of formally admitting them to avoid the heightened attention that inpatient admissions can bring from private auditors hired by Medicare to root out what they consider excessive spending.
At issue...hours spent under observation do not count toward the three days of care needed to trigger Medicare coverage for post-hospitalization nursing home care. A federal law scheduled to be implemented later this year is intended to minimize the financial shock some Medicare patients suffer. The law, known as the Notice Act, mandates that Medicare patients treated under observation status for more than 24 hours be formally told that they may be responsible for their hospital care, prescription drug costs and any follow-up treatment. Boston Globe
Retirement Dilemma, Japanese Style
At 82, Japan’s Emperor Akihito would like to retire. However, Japanese law states that the emperor must serve until death and makes no provision for abdication. In order for Akihito to step down, Japan’s parliament would have to change the law, a move that could redefine the country's royal family and open the debate over allowing a woman to occupy the throne which has been held by the Akihito family for nearly 2,700 years. NY Times
Retirement Dilemma, American Style
A survey by the T. Rowe Price Group, a Baltimore-based financial firm, concluded that three-quarters of parents of children aged 8 to 14 were willing to postpone retirement to pay for their children's college costs. About 68 percent said they were willing to get a second job, while 69 percent said they favor putting aside money for their kids' college before their own retirement, which is not recommended. Nearly 42 percent said they were losing sleep worrying about future college costs, and 63 percent felt guilty that they would not be able to pay more. Bloomberg News
Caregiver Healthcare Checklist
A recent study by the Harvard Medical School found that caregivers who utilize a short checklist about their patients’ conditions were able to report a number of changes that could result in more serious care interventions if left untreated. Caregivers were required to clock-in and clock-out of a web-based software platform that operates for visit scheduling, integrated telephony for point-of-care reporting, two-way caregiver messaging and other managerial functions. The check-in moments, which were designated at the beginning and end of a shift for payroll purposes, also included a checklist about their patients. Senior Housing News
Canoodles…A recent study by the Gerontology Institute at Georgia State University found that residents at many assisted-living facilities are often denied their rights to sexual freedom because of a lack of policies and the attitudes of staff and administrators. Among the chief concerns: safety and security.
However, the issue of nursing home sex is not new. RiverSpring Health, the Hebrew Home in Riverdale, New York, has had a sexual expression policy in place since 1995. They didn’t respond to my request for demographic information, however, their website says that consensual, intimate relationships among residents should be celebrated and encouraged instead of being forbidden and frowned upon.
Employees are taught not to be judgmental or to bring religious, cultural and personal beliefs to work with them. They are instructed on how to help residents’ consummate relationships in a safe, private setting. Rooms are arranged to accommodate sexually active residents, and staff sometimes do things like put a “do not disturb” sign on the door.
Cuddles…For those who don’t have someone to cuddle-up with, consider hiring a certified professional. You can book a one hour session for $80 at http://cuddlist.com.
Medical Marijuana…In states that allow it, more and more assisted living communities are treating patients who have Alzheimer’s or other types of dementia with medical marijuana. Behavior management is one reason to do so. The other…there is preliminary evidence tetrahydrocannabinol (THC) and additional compounds present in marijuana can promote the cellular removal of amyloid beta, a toxic protein linked to Alzheimer’s disease.
Researchers have found that high levels of amyloid beta were linked to cellular inflammation and increased rates of neuron death. Exposing the cells to THC decreased amyloid beta protein levels and eliminated the inflammatory response from the nerve cells caused by the protein, permitting the nerve cells to survive.
Security experts say cyber criminals are increasingly targeting the $3 trillion U.S. healthcare industry to obtain large amounts of personal data found in medical records. The data for sale includes names, birth dates, policy numbers, diagnosis codes and billing information, and it may be up to 10 times more valuable than credit cards, which tend to be quickly canceled by banks once fraud is detected.
Fraudsters use this data to create fake IDs to buy medical equipment or drugs that can be resold, or they combine a patient number with a false provider number and file made-up claims with insurers. Adding to the problem, medical identity theft is often not immediately identified by a patient or their provider, enabling criminals to use the data for years.
My father wore a hearing aid. So did his older brother and son. If hereditary holds, at some point soon I will probably be wearing one too. Hearing loss is one of the most common conditions affecting people of age. Approximately one in three people between the ages of 65 and 74, and nearly half of people older than 75 have difficulty hearing.
Hearing loss caused merely by aging is called presbycusis. Doctors do not know why presbycusis affects some people more than others, but it seems to run in families. Another reason for hearing loss may be years of exposure to loud noise. This condition is known as noise-induced hearing loss. Hearing loss can also be caused by viral or bacterial infections, heart conditions or stroke, head injuries, tumors, and certain medicines.
There are a number of devices that can improve hearing loss. The most common are hearing aids, cochlear implants, and assistive listening or amplifying devices. Lip or speech reading has also proven to be an effective aid. The first drugs to protect and repair some types of hearing conditions could be available within the next 5 years.
Scientists are also working on a new gene therapy treatment. One study involves injecting patients’ inner ears with a harmless virus. The virus is stocked with a gene essential to the development of sound-sensing “hair cells” in the cochlea. The hope is that the introduced gene will stimulate the growth of new hair cells and restore some hearing capacity.