One of the main topics in current hospital management is about risk management and specifically risks dedicated to infections.
The main point in managing this risk is that all employees have a stake in managing this risk. Secondly, systems or tools can help to reduce the risk, but a system can not eliminate the risk nor held responsible for the risk.
"Essential facts: 1. Infections contracted in hospitals are the fourth largest killer in America. Every year in this country, two million patients' contract infections in hospitals and an estimated 103,000 die as a result, as many deaths as from AIDS, breast cancer, and auto accidents combined. " (1)
The uniqueness of the hospital as a company unlike many others is of course the production process where patients are subject to a service often the operation) offered by a large number of medical professionals and cared by even more nursery professionals. It is this intervention process where the infection becomes a danger.
Another unique feature of hospitals is that it is open to the public. There is no one at the door who prevents people with flu to enter the area.
"The Major Problem: Poor Hygiene... ... physicians and other caregivers ("often") break the most fundamental rule of hygiene by failing to clean their hands before treating patients...
...
Cleaning hands is essential, but it's only the first step....("they") put on gloves, and then reach up and pull open the privacy curtain to see the next patient. That curtain is seldom changed, and it is frequently full of bacteria. The result? Caregivers' gloves are soiled again...
People management is the hardest job in overall business management. Especially if these "people" are highly qualified professionals that operate with a certain amount of autonomy... It is this autonomy that makes that the individual professional not easily accepts central rules and principles.
Yet as states in the beginning, all professionals have a stake in the risk and compliance to the central rules will determine the overall success of the hospital, which is in this case an infection free area. Solving an infection requires much more effort than preventing it to happen.
But there is more to a hospital than the professionals that cure and care patients...
Human resources make up the most significant part of a hospital and amongst them, the medical professionals dominate the number of employees.
Yet, a hospital is a more and more a capital intensive organization, where information systems, medical equipment and infrastructure determine the overall success of the company.
It is this combination of human resources and systems and its specific configuration that make a hospital both efficient and effective.
Sterilization is one of the most important central processes in a hospital. All tools and equipment must be sterilized before re-use. Then, the operating room is full of medical equipment.
Last but not least is an infrastructural element that is literally invisible: (clean) air. For this last there are new developments - like the virus buster (2) - that makes it possible to sterilize the air by using UV light.
This latter is an example where tools and systems may offer support in reducing the risk. The virus buster will clean (sterilize) the air and will help to reduce the chance on infections, but the system on itself will not solve the infection, nor will it be responsible. Responsibilities for risks are always assigned to employees or managers.
So in managing the risk the focus will be distributed on: measures and guidelines on human interaction (the organizational element), purchase and implementation of extra tools (the system element) and cleaning time (the business element).
Successful risk management is achieved by focusing on the organization; what's the follow-up rate on hygiene procedures and does the organization change to be more hygiene-conscious? It is partly achieved by investment in new tools and equipment (automatic doors and virus busters, etc). Yet while investing in these tools, there is a negative effect on the organizational awareness. Although systems cannot be held responsible, people imagine that with automatic doors the infection problem will be solved. Tools and equipment make the organization "lazy" which increases the risk.
Finally the business process is the part that can be measured by the risk manager. When cleaning times (to sterilize the operation rooms after an operation) decrease because of the pressure to increase the availability of operating space, the risk manager should ring a bell.
Bottom line: managing the risk of infections requires attention to people, procedures which can be summarized by: (more) discipline. The investment in tools and equipment will only give a one-time effect, similar like the "Da Vinci Inside (3):" having the latest robot technology doesn't automatically upgrade the hospital to one of the best. The same hospital may face the risk of an infection as any other. Only people (management) can prevent such a drama.
Wednesday, July 30, 2008
Fire These Nurses! Well, If Someone is Not Doing Their Job, Why Do You Need Them?
Let us say that you have someone in the nursing home or in a rehab and care center, and you have detected something incorrect or wrong or just something that needs to be changed. Your first instinct might be to tell the nurse or aid that is in the room or on duty right there. Most times, these workers will instruct you to go to the nurses station. And, since you are usually agreeing to almost anything that sounds reasonable, you go to the nurses station and you present your problem, question or critic right there at the nurses station.
Do not do it. You heard correct. When the aid, worker or doctor instructs you to go to the nurses station with the problem, do not do it. Well, you can go there, and find out which nurse or staff member is in charge of that particular issue or problem that you wish to speak about , for example, food, or clothing or medicine. Find out which worker is in that department. Once you are directed to the proper nurse, do not speak with her about the issue at the nurses station at all. Why ?
1. If the issue is something that is likely to annoy the nurses or make more work for nurses, then all the nurses or workers that are hanging out at the nurses station will have their ears open to what you are saying. So, instead of having your privacy and the resident's privacy, now every single person sitting or hanging out at the nurses station is now listening to what you are saying.
2. Since everyone is listening, and since the issue might be one that is annoying or probably to cause the nurses more work, most likely, some will interject with their own remarks, opinions or sly remarks regarding the issue EVEN though they have no authority to rectify or change the problem and even though it is not their department. They will feel free to enter into the conversation. This puts you at a loss. Have you ever tried to converse with five people who are disagreeing with you or who might be upset that your observation or problem might be causing them to have more work every day? Trust me with this one. Whenever you want to speak with staff, never speak with the nurse who is sitting behind the nurses station. Tell her that you need privacy in conversation and ask to speak with her aside somewhere. There is no reason why she should not oblige you. After all, the HEPA laws guarantee patient privacy do they not?
3. It is your right to refrain from discussing patient's, resident's or family members issues or problems or questions in the hallways of facilities or in any public areas of the nursing home. That is the law. And any employee, no matter what their job, who insists that you discuss private things in the public areas of the nursing home is breaking the law. But most employees will not tell you this. So, learn the laws yourself and save yourself lots of time and trouble.
4. Speaking with one staff member while five or six others are watching and listening protects the facility but does not protect you or the resident. Why? They are protected because they can back each other up and say what you said, even if you did not say it. This has happened many times in unscrupulous rehabilitation and care centers across America and across the world.
So, protect yourself and protect the family member, resident or patient by not discussing anything personal at all at any nurses station or in any public area of any nursing home, physical rehabilitation and care center or in any medical building, lab or hospital. Protect yourself from unscrupulous workers. If a worker is innocent and honest, that worker will want to talk with you in private, not in any public hallway and not in the public nurses station. So beware of ANY employees that wish to discuss personal things at the nurses station. Yes, they need to take a little time to come to the room or to bring you to an area of the place that is not public. But that they must do. They just will not tell you that.
One family member I know approached the nurses station to discuss a private matter and the matter --to be resolved--would mean extra and more work for the staff, so naturally, they did not want it resolved. The family member made the mistake of mentioning the problem at the nurses station. While five or six nurses were sitting around, seemingly doing nothing, their ears were spread wider than a happy face smile and they listened intentively. Then one by one, each interjected their own opinion, remarks and angry-looking expressions at the matter, even though they had no authority in the matter, no business in the matter and no power to resolve the problem. This family member learned the lesson the hard way. Then he had six nurses looking at him in disgust, just because they did not want to do their jobs, a little more work.
Moral of the experience, discuss everything in private, not in public, even if the staff wants to discuss it out in the open, never listen to the staff. They are out to protect themselves from more work and from other things. So protect yourself, and listen to your own inner instinct. Have private discussions in private.
FIRE THESE NURSES!
So, exactly which nurses are we talking about when we suggest, fire these nurses?
Okay, so that might be harsh. Instead of firing these nurses, let us just transfer them to different parts of the hospitals and nursing homes. Let us give them the harder jobs and then perhaps they will not be just hanging out at the nurses station minding everyone else's business.
Why do we say hanging out? This reason-- whenever you approach a nurse at a facility, most times they are busy , correct? Right. No problem. They are doing the job that they came there to do and they are doing the job they are being paid to do. However, there are some nurses that instead of doing the job that is their own assignment, will be listening with both ears to your conversation when you are obviously speaking to another nurse. As soon as they begin listening to you, instead of doing the job they are stationed there for, they are now hanging out instead of working. So you do not need them there.
You are speaking with one nurse, and that one nurse barely has time for you, so how in the world do you think that two or three or four nurses who just happen to be in the nurses station at the time, have time also--to listen to your conversation when you are not even speaking with them. They do not. So every moment they spend eavesdropping on your conversation with Nurse A, that nurse is not doing her own job since she is not Nurse A. Nurse B has stopped her own job and is now listening to you speaking to Nurse A , and then Nurse B enters her opinion when she is not being asked her opinion.
I say, transfer Nurse B to another part of the hospital where she will not have the opportunity to hang out and listen to other conversations that are not her business. Clear? Yes, clear. Transfer Nurse B--and problem solved.
So now you are informed! Keep your personal business private and keep it out of public areas in any facility.
Do not do it. You heard correct. When the aid, worker or doctor instructs you to go to the nurses station with the problem, do not do it. Well, you can go there, and find out which nurse or staff member is in charge of that particular issue or problem that you wish to speak about , for example, food, or clothing or medicine. Find out which worker is in that department. Once you are directed to the proper nurse, do not speak with her about the issue at the nurses station at all. Why ?
1. If the issue is something that is likely to annoy the nurses or make more work for nurses, then all the nurses or workers that are hanging out at the nurses station will have their ears open to what you are saying. So, instead of having your privacy and the resident's privacy, now every single person sitting or hanging out at the nurses station is now listening to what you are saying.
2. Since everyone is listening, and since the issue might be one that is annoying or probably to cause the nurses more work, most likely, some will interject with their own remarks, opinions or sly remarks regarding the issue EVEN though they have no authority to rectify or change the problem and even though it is not their department. They will feel free to enter into the conversation. This puts you at a loss. Have you ever tried to converse with five people who are disagreeing with you or who might be upset that your observation or problem might be causing them to have more work every day? Trust me with this one. Whenever you want to speak with staff, never speak with the nurse who is sitting behind the nurses station. Tell her that you need privacy in conversation and ask to speak with her aside somewhere. There is no reason why she should not oblige you. After all, the HEPA laws guarantee patient privacy do they not?
3. It is your right to refrain from discussing patient's, resident's or family members issues or problems or questions in the hallways of facilities or in any public areas of the nursing home. That is the law. And any employee, no matter what their job, who insists that you discuss private things in the public areas of the nursing home is breaking the law. But most employees will not tell you this. So, learn the laws yourself and save yourself lots of time and trouble.
4. Speaking with one staff member while five or six others are watching and listening protects the facility but does not protect you or the resident. Why? They are protected because they can back each other up and say what you said, even if you did not say it. This has happened many times in unscrupulous rehabilitation and care centers across America and across the world.
So, protect yourself and protect the family member, resident or patient by not discussing anything personal at all at any nurses station or in any public area of any nursing home, physical rehabilitation and care center or in any medical building, lab or hospital. Protect yourself from unscrupulous workers. If a worker is innocent and honest, that worker will want to talk with you in private, not in any public hallway and not in the public nurses station. So beware of ANY employees that wish to discuss personal things at the nurses station. Yes, they need to take a little time to come to the room or to bring you to an area of the place that is not public. But that they must do. They just will not tell you that.
One family member I know approached the nurses station to discuss a private matter and the matter --to be resolved--would mean extra and more work for the staff, so naturally, they did not want it resolved. The family member made the mistake of mentioning the problem at the nurses station. While five or six nurses were sitting around, seemingly doing nothing, their ears were spread wider than a happy face smile and they listened intentively. Then one by one, each interjected their own opinion, remarks and angry-looking expressions at the matter, even though they had no authority in the matter, no business in the matter and no power to resolve the problem. This family member learned the lesson the hard way. Then he had six nurses looking at him in disgust, just because they did not want to do their jobs, a little more work.
Moral of the experience, discuss everything in private, not in public, even if the staff wants to discuss it out in the open, never listen to the staff. They are out to protect themselves from more work and from other things. So protect yourself, and listen to your own inner instinct. Have private discussions in private.
FIRE THESE NURSES!
So, exactly which nurses are we talking about when we suggest, fire these nurses?
Okay, so that might be harsh. Instead of firing these nurses, let us just transfer them to different parts of the hospitals and nursing homes. Let us give them the harder jobs and then perhaps they will not be just hanging out at the nurses station minding everyone else's business.
Why do we say hanging out? This reason-- whenever you approach a nurse at a facility, most times they are busy , correct? Right. No problem. They are doing the job that they came there to do and they are doing the job they are being paid to do. However, there are some nurses that instead of doing the job that is their own assignment, will be listening with both ears to your conversation when you are obviously speaking to another nurse. As soon as they begin listening to you, instead of doing the job they are stationed there for, they are now hanging out instead of working. So you do not need them there.
You are speaking with one nurse, and that one nurse barely has time for you, so how in the world do you think that two or three or four nurses who just happen to be in the nurses station at the time, have time also--to listen to your conversation when you are not even speaking with them. They do not. So every moment they spend eavesdropping on your conversation with Nurse A, that nurse is not doing her own job since she is not Nurse A. Nurse B has stopped her own job and is now listening to you speaking to Nurse A , and then Nurse B enters her opinion when she is not being asked her opinion.
I say, transfer Nurse B to another part of the hospital where she will not have the opportunity to hang out and listen to other conversations that are not her business. Clear? Yes, clear. Transfer Nurse B--and problem solved.
So now you are informed! Keep your personal business private and keep it out of public areas in any facility.
Finding A Cheap And Affordable Healthcare Plan
Affordable health care is becoming a concern to many Americans nowadays. Many companies are now increasing the charges, for providing this service to their workers or cutting back on the level of cover. This situation happened to me not that long ago at the company I work for when every employee's health benefits were reduced. Last fall, out of the blue, we were informed that our health care provider was going to be switched to a cheaper alternative.
They said it was necessary if all their employees were to have the same level of health care. I suppose some people are better off and perhaps I shouldn't sound ungrateful. The new insurance company may be cheaper for the company but it isn't for me because to have my husband and daughter in the plan costs double what it did with the previous provider. This means, that for my company to provide a health plan to all of the employees, it is no longer affordable for us.
I suppose my health care plan is still good but this new company is not as good as the old one. Many workers saw their paychecks reduce when this new affordable health care scheme come into force. You see, four years ago, I gave birth to a little girl and of course my old insurance paid for the whole of my hospital stay. I sat and worked out the cost of this new plan and if I were to stay in hospital now and have a baby it would cost around 4,000 dollars out of my own pocket.
This figure does not take into account additional amounts I must pay out of my salary. Luckily there are more and more affordable health care programs being created to help those that do not have any coverage. Some people are even able to get free health care, also single mothers or families where an employment scheme isn't available are having the opportunity to join low cost plans. The problem is when a small number of people take advantage of a system that was designed for those that needed it most.
Those less well off are in need of these affordable health care schemes but they are also used by those who are intent on living of the state and do not actually contribute to society. We all have a responsibility to help those less fortunate but those who abuse the system put extra financial pressure on the rest of us. My employer definitely found advantages in finding a lower cost health plan provider for their employees! All too often this happens where the only one that really benefits is the company, who seem quite happy that many of their employees will take home less. In the long term we really need to do something in America to help those in need find affordable health care.
They said it was necessary if all their employees were to have the same level of health care. I suppose some people are better off and perhaps I shouldn't sound ungrateful. The new insurance company may be cheaper for the company but it isn't for me because to have my husband and daughter in the plan costs double what it did with the previous provider. This means, that for my company to provide a health plan to all of the employees, it is no longer affordable for us.
I suppose my health care plan is still good but this new company is not as good as the old one. Many workers saw their paychecks reduce when this new affordable health care scheme come into force. You see, four years ago, I gave birth to a little girl and of course my old insurance paid for the whole of my hospital stay. I sat and worked out the cost of this new plan and if I were to stay in hospital now and have a baby it would cost around 4,000 dollars out of my own pocket.
This figure does not take into account additional amounts I must pay out of my salary. Luckily there are more and more affordable health care programs being created to help those that do not have any coverage. Some people are even able to get free health care, also single mothers or families where an employment scheme isn't available are having the opportunity to join low cost plans. The problem is when a small number of people take advantage of a system that was designed for those that needed it most.
Those less well off are in need of these affordable health care schemes but they are also used by those who are intent on living of the state and do not actually contribute to society. We all have a responsibility to help those less fortunate but those who abuse the system put extra financial pressure on the rest of us. My employer definitely found advantages in finding a lower cost health plan provider for their employees! All too often this happens where the only one that really benefits is the company, who seem quite happy that many of their employees will take home less. In the long term we really need to do something in America to help those in need find affordable health care.
Doctors & Nurses In Diapers, Picture That! Part Two
This article is about people who do not need to medically wear diapers. This is NOT about anyone who medically needs to wear diapers. Anyone who is incontinent and needs to wear diapers should wear diapers. But those adults who have been taught to be lazy and pee and poop in their diapers just because it is easier for nurses and doctors to handle that ---these are the patients that this article is addressed to. (See disclaimer at the end of this article).
All over the world, at this very moment, there are nurses, staff and attendants who are trying to convince fully healthy, continent individuals to wear diapers when they do not medically need to wear diapers. All over this is happening. And this is making the patient more and more unhealthy.
Here is why it is important that your family member or you do not wear diapers inside a nursing home or inside a physical rehabilitation and care center:
* Once you begin wearing diapers, you will become in the habit of just pooping and peeing whenever you want to simply because you have a diaper on and because your clothing will not get wet or soiled. The diaper will protect your clothing. You are told to go in your diaper because that is what they are for. So, you begin to get accustomed to pooping whenever you feel like it. Wow. Think about it. You do not even have to get out of bed. No more nighttime trips. You just poop and pee whenever you want to do so. But what is happening to your body while you do this? Here is what happens. Eventually, you will lose control of those muscles that you are not using and you will make yourself incontinent. Yes, you, yourself, with the help of nurses and staff who are being paid good money, are helping you lose your muscles. Soon you will not be able to control your muscles and then you will indeed be incontinent. If you do not use those muscles to hold it in, you will lose the power those muscles still have. So you are actually making yourself sick. You are making yourself to have signs of being an invalid, when you came into the place a healthier person who was fully able to urinate and defecate in a toilet bowl. But for the convenience of staff, imagine that, for the convenience of staff, you become more ill and more dependent on the staff in a nursing home or in a hospital.
* Now, if you are in such a mind that you think this is okay, think again. You are in the nursing home or in the rehab and care center --only temporarily. Yes, you are there temporarily, and after you leave there you will go home to your family. What happens when you get home? You will be there and you will be dependent on your family and also on temporary home care -to change your diapers. What if your family does not agree to changing diapers on you ---because you put yourself in diapers when it was not necessary? What happens if your family tells you that they will not change your diapers because you put yourself in that condition? (Of course this will be settled long before you leave the nursing home or rehab center). But I am trying to give you some ideas, some brainstorming of what your future might look like. Your future looks different if you are in or out of diapers, very different.
* Once you are at home now, and you are still in diapers, you will be sitting in soaked diapers for long times, just like in the nursing home. Since you are in diapers no one has to change you immediately. Get the picture? You wait. And yes, you wait. You might be under the impression that you will soil a diaper and wet a diaper and then someone will come immediately to change you --but you are mistaken. Once your family knows that you did this to yourself, once they know that you could have avoided being incontinent, do you think that they are going to drop everything they do and run to change your diaper? Do you think that you will have your diaper changed any quicker than the nurses will do it? Perhaps it will take longer, since there are many nurses and great number of staff but perhaps only one or two family members. Yes, you will wait. And you will wait in a soiled diaper or wet diaper, just the same way that you waited in the hospital . No one says that the minute you pee or poop that someone must or someone will imediately come running to change your diaper. Your family member might be in the tub or they might be out to work or to school or to a volunteer job, and if that is the case --that they are out, you will wait for them to return. And upon their return, they will have to catch their breath, sit a few minutes and then when they are able to change your diaper , then they will change it.
* So, you sit there smugly thinking that your home care attendant will change you promptly because that is what she is being paid for? Take the smug grin off your face and welcome yourself to reality and to the real world. When you have a home care attendant, you will have that person in your home only for short periods of time. You will not have someone there 24/7 . They work their own hours. So if they are there they can change your diaper. But what if you have a home-care attendant who hates her or his job? What if they are not happy people? What if they are not good workers? If this is the case, you can wait, yes , hours and hours to have your diaper changed, if at all. Your family member might say, that the attendant will be here soon to change the diaper and you might wait and then they might call in sick or not show up at all. And, there you sit in a messy, uncomfortable diaper until someone can change you. Remember, now, you put yourself in this position by volunteering to go in diapers when you did not need diapers. When I say volunteer, I mean that you did not insist that you be taken to the restroom but happily let the attendants put diapers on you when you were not medically incontinnet. You did this to yourself with the help of highly-paid staff at nursing homes and at physical rehabilitation and care centers.
* What about depression? If you are a patient who has ever been depressed in your lifetime, once you submit to wearing unnecessary diapers, your depression will come back to you and worsen. You are making yourself more unhealthy by submitting to unnecessary diapers. Depression is banished most times, by action. And when you sit all day in a diaper, to even a normal human being who has no depression that is depressing. There is no one that can honestly tell you that sitting in soiled diapers , soaked diapers, diapers with diareahh is not depressing. So by making yourself more physically unhealthy, you are also making yourself more emotionally unhealthy. Depression comes and comes back and worsens when a person is wearing diapers if they do not need to medically wear diapers.
Wearing diapers is a comfort ONLY to those who NEED to medically wear the diapers. They are not a comfort to continent people. Do not let any staff convince you otherwise. Do not let any staff scare you with the threat of falls or scare you with the threat of "accidents". Insist on your rights if you are not medically incontinent.
The bottom line is that once you PUT yourself in diapers when you are not medically incontinent, you are putting yourself in a world that you have never known and you are making more problems for yourself and even making more medical problems for yourself. How? Well, as you sit in dirty and soaked diapers, you might begin to develop rashes, or problems or sores, especially if you are diabetic or especially if you have a skin problem to begin with. Everyone knows that diapers bring rashes sometimes. And most likely you will have your share of diaper rashes in your lifetime when you choose to be in diapers.
Now all these things are only possibilities, that is all, but they are possibilities that you have not thought of, correct? But they are all possibilities, depending on the staff, home attendants and the families, and depending on their attentiveness and their availability. What I am trying to say to you is that your life will be so much easier for you if you just grow up and keep yourself out of diapers when you are medically able to not wear diapers.
When you put yourself in diapers and you do not medically need to be in diapers, you are killing a part of yourself, you are humiliating yourself for no good reason. If you are a person that is not incontinent, and if you are a person that does not medically need to wear diapers, then you should make the decision yourself and demand to be out of diapers immediately. If you do not medically need to wear diapers, there is no reason for you to wear diapers.
What about the doctors and nurses in diapers? Here is what about them. Think about this:
When a surgeon or nurse needs hospitalization, or when a lawyer or judge or someone of high importance needs hospitalization or a nursing home or rehab stay, do you think that these dignified people would allow anyone to put them in diapers for the convenience of the staff? Probably not. No lawyer, judge, or doctor or surgeon or nurse would permit themselves to poop and pee in a diaper for the mere convenience of the staff of a facility.
They would protest. They would demand that the staff do their job and they would insist that no one put a diaper on them. So that is why you will not see lawyers in diapers any more than you would see doctors, surgeons or nurses in diapers. Why? This is why:
* It is not medically necessary --in their cases.
* It is an embarrassment even though staff insists it is not embarrassing. Sure, it is not embarrassing to them because it is not their bare but that is being wiped of poop. It is only embarrassing to the patient that is all. And staff spends time to reassure the patient that this is not embarrassing. Lie!
* Lawyers, doctors and nurses have more recourse to argue the point and the staff knows that they had better not go against a surgeons words if that surgeon is insisting on NOT wearing diapers.
* The nurses know that it will come out to the public, if not to the news stations when a surgeon is put in diapers unnecessarily because that surgoen will do everythying in his power to stay out of diapers.
* That is why you do not see surgeons, doctors, lawyers or nurses in diapers. You will only see those patients who have been hoodwinked into thinking that they need diapers just in case or so they do not fall. It is all a lie. No healthy , continant patient needs diapers, EVER!
What about falls?
This is a big argument that staff has. Staff will insist that you have a diaper so you do not fall. Everyone knows that falls are dangerous. The fall is not the result of wearing a diaper or not wearing a diaper. You will not fall more if you do not wear diapers. You will only fall if you insist on net getting help to and from the bathroom. You will only fall if the staff is negligent and not paying attention and not coming when the bell rings. You will only fall if the staff ignores you.
So there you go, you have the fall situation solved. Your staff where you are should be attentive and should come when you call them. There is no excuse for negligence in any nursing home or rehab facilitiy. Do not worry about falling if you follow instructions.
To Avoid Falls do This:
Always ring the bell and do not get out of bed unatttended.
Always ask for help and get help.
This solves the fall problem.
And here is the biggy. If you are in a place where the staff is negligent and is not attending to you, you have many legal recourses and many organizations that will help you solve these problems. But the solution is not to wear a diaper for the convenience of the staff.
And yes, at this moment as I type and as you read this, hundreds if not thousands of patients are being forced into diapers just for the convenience of the staff. I wish Geraldo Rivera would do some kind of investigation into this diaper mess because it is a really big diaper mess. What are your thoughts?
I created this article on May 25, 2008. DISCLAIMER: I am not a doctor, nurse or any other type of medical practitioner. If you need medical advice or professional advice you should call your own doctor, lawyer or other professional for that advice. This article is for basic social information and for basic behind-the-scenes information that the public should be aware of. Do not do anything that is not safe for you to do and before making any medical or professional changes,consult your doctors, lawyers or professionals. Never ask your attending nurse/ or attendant if you should be in diapers because most will tell you yes, and most times they are saying that for their own convenience. Consult your medical doctors, lawyers and other professionals.
All over the world, at this very moment, there are nurses, staff and attendants who are trying to convince fully healthy, continent individuals to wear diapers when they do not medically need to wear diapers. All over this is happening. And this is making the patient more and more unhealthy.
Here is why it is important that your family member or you do not wear diapers inside a nursing home or inside a physical rehabilitation and care center:
* Once you begin wearing diapers, you will become in the habit of just pooping and peeing whenever you want to simply because you have a diaper on and because your clothing will not get wet or soiled. The diaper will protect your clothing. You are told to go in your diaper because that is what they are for. So, you begin to get accustomed to pooping whenever you feel like it. Wow. Think about it. You do not even have to get out of bed. No more nighttime trips. You just poop and pee whenever you want to do so. But what is happening to your body while you do this? Here is what happens. Eventually, you will lose control of those muscles that you are not using and you will make yourself incontinent. Yes, you, yourself, with the help of nurses and staff who are being paid good money, are helping you lose your muscles. Soon you will not be able to control your muscles and then you will indeed be incontinent. If you do not use those muscles to hold it in, you will lose the power those muscles still have. So you are actually making yourself sick. You are making yourself to have signs of being an invalid, when you came into the place a healthier person who was fully able to urinate and defecate in a toilet bowl. But for the convenience of staff, imagine that, for the convenience of staff, you become more ill and more dependent on the staff in a nursing home or in a hospital.
* Now, if you are in such a mind that you think this is okay, think again. You are in the nursing home or in the rehab and care center --only temporarily. Yes, you are there temporarily, and after you leave there you will go home to your family. What happens when you get home? You will be there and you will be dependent on your family and also on temporary home care -to change your diapers. What if your family does not agree to changing diapers on you ---because you put yourself in diapers when it was not necessary? What happens if your family tells you that they will not change your diapers because you put yourself in that condition? (Of course this will be settled long before you leave the nursing home or rehab center). But I am trying to give you some ideas, some brainstorming of what your future might look like. Your future looks different if you are in or out of diapers, very different.
* Once you are at home now, and you are still in diapers, you will be sitting in soaked diapers for long times, just like in the nursing home. Since you are in diapers no one has to change you immediately. Get the picture? You wait. And yes, you wait. You might be under the impression that you will soil a diaper and wet a diaper and then someone will come immediately to change you --but you are mistaken. Once your family knows that you did this to yourself, once they know that you could have avoided being incontinent, do you think that they are going to drop everything they do and run to change your diaper? Do you think that you will have your diaper changed any quicker than the nurses will do it? Perhaps it will take longer, since there are many nurses and great number of staff but perhaps only one or two family members. Yes, you will wait. And you will wait in a soiled diaper or wet diaper, just the same way that you waited in the hospital . No one says that the minute you pee or poop that someone must or someone will imediately come running to change your diaper. Your family member might be in the tub or they might be out to work or to school or to a volunteer job, and if that is the case --that they are out, you will wait for them to return. And upon their return, they will have to catch their breath, sit a few minutes and then when they are able to change your diaper , then they will change it.
* So, you sit there smugly thinking that your home care attendant will change you promptly because that is what she is being paid for? Take the smug grin off your face and welcome yourself to reality and to the real world. When you have a home care attendant, you will have that person in your home only for short periods of time. You will not have someone there 24/7 . They work their own hours. So if they are there they can change your diaper. But what if you have a home-care attendant who hates her or his job? What if they are not happy people? What if they are not good workers? If this is the case, you can wait, yes , hours and hours to have your diaper changed, if at all. Your family member might say, that the attendant will be here soon to change the diaper and you might wait and then they might call in sick or not show up at all. And, there you sit in a messy, uncomfortable diaper until someone can change you. Remember, now, you put yourself in this position by volunteering to go in diapers when you did not need diapers. When I say volunteer, I mean that you did not insist that you be taken to the restroom but happily let the attendants put diapers on you when you were not medically incontinnet. You did this to yourself with the help of highly-paid staff at nursing homes and at physical rehabilitation and care centers.
* What about depression? If you are a patient who has ever been depressed in your lifetime, once you submit to wearing unnecessary diapers, your depression will come back to you and worsen. You are making yourself more unhealthy by submitting to unnecessary diapers. Depression is banished most times, by action. And when you sit all day in a diaper, to even a normal human being who has no depression that is depressing. There is no one that can honestly tell you that sitting in soiled diapers , soaked diapers, diapers with diareahh is not depressing. So by making yourself more physically unhealthy, you are also making yourself more emotionally unhealthy. Depression comes and comes back and worsens when a person is wearing diapers if they do not need to medically wear diapers.
Wearing diapers is a comfort ONLY to those who NEED to medically wear the diapers. They are not a comfort to continent people. Do not let any staff convince you otherwise. Do not let any staff scare you with the threat of falls or scare you with the threat of "accidents". Insist on your rights if you are not medically incontinent.
The bottom line is that once you PUT yourself in diapers when you are not medically incontinent, you are putting yourself in a world that you have never known and you are making more problems for yourself and even making more medical problems for yourself. How? Well, as you sit in dirty and soaked diapers, you might begin to develop rashes, or problems or sores, especially if you are diabetic or especially if you have a skin problem to begin with. Everyone knows that diapers bring rashes sometimes. And most likely you will have your share of diaper rashes in your lifetime when you choose to be in diapers.
Now all these things are only possibilities, that is all, but they are possibilities that you have not thought of, correct? But they are all possibilities, depending on the staff, home attendants and the families, and depending on their attentiveness and their availability. What I am trying to say to you is that your life will be so much easier for you if you just grow up and keep yourself out of diapers when you are medically able to not wear diapers.
When you put yourself in diapers and you do not medically need to be in diapers, you are killing a part of yourself, you are humiliating yourself for no good reason. If you are a person that is not incontinent, and if you are a person that does not medically need to wear diapers, then you should make the decision yourself and demand to be out of diapers immediately. If you do not medically need to wear diapers, there is no reason for you to wear diapers.
What about the doctors and nurses in diapers? Here is what about them. Think about this:
When a surgeon or nurse needs hospitalization, or when a lawyer or judge or someone of high importance needs hospitalization or a nursing home or rehab stay, do you think that these dignified people would allow anyone to put them in diapers for the convenience of the staff? Probably not. No lawyer, judge, or doctor or surgeon or nurse would permit themselves to poop and pee in a diaper for the mere convenience of the staff of a facility.
They would protest. They would demand that the staff do their job and they would insist that no one put a diaper on them. So that is why you will not see lawyers in diapers any more than you would see doctors, surgeons or nurses in diapers. Why? This is why:
* It is not medically necessary --in their cases.
* It is an embarrassment even though staff insists it is not embarrassing. Sure, it is not embarrassing to them because it is not their bare but that is being wiped of poop. It is only embarrassing to the patient that is all. And staff spends time to reassure the patient that this is not embarrassing. Lie!
* Lawyers, doctors and nurses have more recourse to argue the point and the staff knows that they had better not go against a surgeons words if that surgeon is insisting on NOT wearing diapers.
* The nurses know that it will come out to the public, if not to the news stations when a surgeon is put in diapers unnecessarily because that surgoen will do everythying in his power to stay out of diapers.
* That is why you do not see surgeons, doctors, lawyers or nurses in diapers. You will only see those patients who have been hoodwinked into thinking that they need diapers just in case or so they do not fall. It is all a lie. No healthy , continant patient needs diapers, EVER!
What about falls?
This is a big argument that staff has. Staff will insist that you have a diaper so you do not fall. Everyone knows that falls are dangerous. The fall is not the result of wearing a diaper or not wearing a diaper. You will not fall more if you do not wear diapers. You will only fall if you insist on net getting help to and from the bathroom. You will only fall if the staff is negligent and not paying attention and not coming when the bell rings. You will only fall if the staff ignores you.
So there you go, you have the fall situation solved. Your staff where you are should be attentive and should come when you call them. There is no excuse for negligence in any nursing home or rehab facilitiy. Do not worry about falling if you follow instructions.
To Avoid Falls do This:
Always ring the bell and do not get out of bed unatttended.
Always ask for help and get help.
This solves the fall problem.
And here is the biggy. If you are in a place where the staff is negligent and is not attending to you, you have many legal recourses and many organizations that will help you solve these problems. But the solution is not to wear a diaper for the convenience of the staff.
And yes, at this moment as I type and as you read this, hundreds if not thousands of patients are being forced into diapers just for the convenience of the staff. I wish Geraldo Rivera would do some kind of investigation into this diaper mess because it is a really big diaper mess. What are your thoughts?
I created this article on May 25, 2008. DISCLAIMER: I am not a doctor, nurse or any other type of medical practitioner. If you need medical advice or professional advice you should call your own doctor, lawyer or other professional for that advice. This article is for basic social information and for basic behind-the-scenes information that the public should be aware of. Do not do anything that is not safe for you to do and before making any medical or professional changes,consult your doctors, lawyers or professionals. Never ask your attending nurse/ or attendant if you should be in diapers because most will tell you yes, and most times they are saying that for their own convenience. Consult your medical doctors, lawyers and other professionals.
Doctors & Nurses In Diapers! Picture That!
It is a myth that it is easier for nurses to bring someone to the restroom than it is for them to change messy diapers on grown adults. Most people figure that it would be less work for them and much easier to bring someone to the rest room than to clean up a person and change a diaper on a person.
Reality is this--nurses, cna, any person who is responsible for cleaning a person or bringing a person to the restroom has an EASIER time just changing that person's diaper. That is why there are some attendants or nurses aids' who prefer to have their patients in diapers even when the patient does not medically need to be in a diaper. The diaper is to save the staff time and work and effort. Here are the fact and the reasons why.
Staff Want Continent Patients To Wear Diapers When the Resident Does Not Medically Need to Wear Diapers Because:
1. When a person is wearing a diaper, they do not have to attend to that person immediately because the person is wearing a diaper. They know and tell the person to just "go in the diaper; that is what the diaper is for". So they tell people --who are not incontinent to begin just peeing and pooping in the diaper instead of calling them to bring that person to the restroom.
2. When a person in a diaper does call for the staff, they do NOT come right away because they know the person is wearing a diaper and they know that if the person can not hold it in, only the diaper will be messed, not the sheets and not the clothing. So staff is very comfortable letting diapered patients wait and wait and wait till they finally just give up and poop and pee in the diapers. Then they do not need to be taken to the restroom.
3. Patients can sit in wet diapers and dirty diapers for hours and the staff does not have to come to them immediately since -- resident is wearing a diaper.
4. So, a patient wearing a diaper might need only to be attended to once a day or twice a day, whereas a patient not wearing a diaper might ask to go to the restroom six or seven times a day or eight, depending on the person. (Sometimes a person thinks they need to go and then gets to the restroom and does not have to go to the restroom. So that makes a few extra trips sometimes).
5. Staff feels that when a patient wears diapers that lessons falls in the facility. This is not a good reason to have a person wear a diaper but staff convinces residents and families that this is a good reason. It is not a good reason and not a valid reason for someone to be in diapers when they are not medically needing diapers. Falls can be prevented OTHER ways besides keeping residents in diapers.
Reasons Why Staff Wants Healthy, Continent People Wear Diapers:
1. When the patient is not wearing a diaper, the staff must and should come immediately when the patient rings the bell for help. They must come immediately; they cannot tell the patient, wait a half-hour , or wait an hour , or wait four hours, like they do and have done when the patient is in diapers. They must attend and help that patient transport to the restroom.
2. They must wait there for some patients while they go. If the patient is not allowed to be left in the restroom by themselves, they must wait there for them until they are finished going. They must see that the patient washes their hands afterwards --to prevent infection. All of this takes time, lots of time out of the staff's schedule. And time, to any staff is very precious. If they do not wait with the patient, they have to come back immediately to get the patient out of the restroom. (Why must they go immediately? If they hesitate too much or make the patient wait, the patient might decide to help him or herself back and they might have a horrible fall that can cause injury or even death. That staff member will be responsible for that accident if they are not there with the patient.
3. They must spend time --and sometimes this takes lots of time-- helping the patient in and out of the bed just to get to the restroom. So when the patient is finally done,they must help them back.
4. After going to the restroom, any patient can ask to go again, maybe hour or so later or even sooner and the staff has to do this all over again. All of this takes up time. And the staff feels they do not have this kind of time. This is why staff sometimes puts people in diapers even though they are not incontinent and even though they do not need to medically be in diapers. Fully continent patients are kept in diapers when the staff wants this to happen.
Now after reading this you might thing it is good for a patient to be in diapers but that is the furthest thing from the truth. It is horrible for healthy, continent people to lay in diapers in nursing homes and in physical rehabilitation centers. It is a most horrible, horrible thing that affects their life in a very embarrassing, negative and life-changing way. I will write about all the downfalls of keeping patients in diapers --patients who are not medically needing diapers-- in another article.
Reality is this--nurses, cna, any person who is responsible for cleaning a person or bringing a person to the restroom has an EASIER time just changing that person's diaper. That is why there are some attendants or nurses aids' who prefer to have their patients in diapers even when the patient does not medically need to be in a diaper. The diaper is to save the staff time and work and effort. Here are the fact and the reasons why.
Staff Want Continent Patients To Wear Diapers When the Resident Does Not Medically Need to Wear Diapers Because:
1. When a person is wearing a diaper, they do not have to attend to that person immediately because the person is wearing a diaper. They know and tell the person to just "go in the diaper; that is what the diaper is for". So they tell people --who are not incontinent to begin just peeing and pooping in the diaper instead of calling them to bring that person to the restroom.
2. When a person in a diaper does call for the staff, they do NOT come right away because they know the person is wearing a diaper and they know that if the person can not hold it in, only the diaper will be messed, not the sheets and not the clothing. So staff is very comfortable letting diapered patients wait and wait and wait till they finally just give up and poop and pee in the diapers. Then they do not need to be taken to the restroom.
3. Patients can sit in wet diapers and dirty diapers for hours and the staff does not have to come to them immediately since -- resident is wearing a diaper.
4. So, a patient wearing a diaper might need only to be attended to once a day or twice a day, whereas a patient not wearing a diaper might ask to go to the restroom six or seven times a day or eight, depending on the person. (Sometimes a person thinks they need to go and then gets to the restroom and does not have to go to the restroom. So that makes a few extra trips sometimes).
5. Staff feels that when a patient wears diapers that lessons falls in the facility. This is not a good reason to have a person wear a diaper but staff convinces residents and families that this is a good reason. It is not a good reason and not a valid reason for someone to be in diapers when they are not medically needing diapers. Falls can be prevented OTHER ways besides keeping residents in diapers.
Reasons Why Staff Wants Healthy, Continent People Wear Diapers:
1. When the patient is not wearing a diaper, the staff must and should come immediately when the patient rings the bell for help. They must come immediately; they cannot tell the patient, wait a half-hour , or wait an hour , or wait four hours, like they do and have done when the patient is in diapers. They must attend and help that patient transport to the restroom.
2. They must wait there for some patients while they go. If the patient is not allowed to be left in the restroom by themselves, they must wait there for them until they are finished going. They must see that the patient washes their hands afterwards --to prevent infection. All of this takes time, lots of time out of the staff's schedule. And time, to any staff is very precious. If they do not wait with the patient, they have to come back immediately to get the patient out of the restroom. (Why must they go immediately? If they hesitate too much or make the patient wait, the patient might decide to help him or herself back and they might have a horrible fall that can cause injury or even death. That staff member will be responsible for that accident if they are not there with the patient.
3. They must spend time --and sometimes this takes lots of time-- helping the patient in and out of the bed just to get to the restroom. So when the patient is finally done,they must help them back.
4. After going to the restroom, any patient can ask to go again, maybe hour or so later or even sooner and the staff has to do this all over again. All of this takes up time. And the staff feels they do not have this kind of time. This is why staff sometimes puts people in diapers even though they are not incontinent and even though they do not need to medically be in diapers. Fully continent patients are kept in diapers when the staff wants this to happen.
Now after reading this you might thing it is good for a patient to be in diapers but that is the furthest thing from the truth. It is horrible for healthy, continent people to lay in diapers in nursing homes and in physical rehabilitation centers. It is a most horrible, horrible thing that affects their life in a very embarrassing, negative and life-changing way. I will write about all the downfalls of keeping patients in diapers --patients who are not medically needing diapers-- in another article.
Saturday, July 26, 2008
Prudent Design Of Health Savings Accounts (HSA) For Self Employed Health Insurance
One of the most underutilized tools in the insurance world for self employed premium victims is the modern Health Savings Account or HSA.
I find in my work that most of the issues can be tied to either having a lazy health insurance agent who is not well studied, or a customer who makes too many assumptions on what is and what is not included in the benefits. My hope is to clarify the process in which a consumer or agent should utilize to put together a smart and prudent HSA for themselves, and reap the tax advantaged benefits in the process.
HSA plans are designed to have a higher than normal deductible, and as a beneficial result, a much lower monthly premium to be paid. The deductibles are either for a single person (which can run up to $5,000) and family (up to $10,000) but when the deductibles are covered, the procedure expenses are paid 100%. The money which a person SAVES on monthly premium is supposed to be invested in to the Health Savings Account, which can take the form of a separate bank account at most major banks, or an investment fund approved for HSA deposits typically paying more interest benefit. A debit card is issued for the account chosen, and all prescriptions, medical procedures, dental, vision, and any other health related bill is paid from the account. As long as the account is used properly for medical expenses, the money invested into the account is tax advantaged: Up to $2850 for singles, $5650 for families, and is arguably the thrilling part of having one.
So what can possibly go wrong with the mathematics?
The obvious answer is more of a question, which is what happens if somebody needs major surgery (or these days, even simple outpatient surgery) before the HSA savings account has had enough time to build up to enough to cover deductibles and medications? Therefore, self-employed families should be especially careful with their cash flow ability when choosing the maximum deductible in the first place,
Having said that, another approach to policy design is to add enough ancillary and separate accident and critical care coverage to off-set a major shock, such as cancer, loss of limbs, any accident, and the most expensive surprises. This enables a person or family to keep the premiums somewhat at bay, but covers the very real possibility of needing $10,000 or $20,000 cash immediately to pay for an emergency room, or other catastrophe. There is no better policy combination that I know of than a federally mandated (standards) HSA Major Medical Plan combined with the correct ancillary items, when taken in to proportion of monthly premium benefit and overall safety from unexpected events.
The key to all of this for the self employed health insurance buyer is to work with a health agent who cares enough to dig in to the details of what ancillary policies would be best, covering everything from accidents and the top illnesses, to which discount program to use for dental and vision. If you do not have guarantees in all of these areas, coming up with large amounts of cash or credit for a surgery or other event could be horrible.
The HSA is one of the best weapons for the highest payers of health insurance, which are self employed individuals with no group plan to cover them. Take advantage of any of the top company plans, and choose your agent carefully. There are plenty of reliable health insurance companies out there. Find an agent that knows what ancillary tools to put in to perfect your HSA, and reap the premium and tax advantaged savings for you and yours.
I find in my work that most of the issues can be tied to either having a lazy health insurance agent who is not well studied, or a customer who makes too many assumptions on what is and what is not included in the benefits. My hope is to clarify the process in which a consumer or agent should utilize to put together a smart and prudent HSA for themselves, and reap the tax advantaged benefits in the process.
HSA plans are designed to have a higher than normal deductible, and as a beneficial result, a much lower monthly premium to be paid. The deductibles are either for a single person (which can run up to $5,000) and family (up to $10,000) but when the deductibles are covered, the procedure expenses are paid 100%. The money which a person SAVES on monthly premium is supposed to be invested in to the Health Savings Account, which can take the form of a separate bank account at most major banks, or an investment fund approved for HSA deposits typically paying more interest benefit. A debit card is issued for the account chosen, and all prescriptions, medical procedures, dental, vision, and any other health related bill is paid from the account. As long as the account is used properly for medical expenses, the money invested into the account is tax advantaged: Up to $2850 for singles, $5650 for families, and is arguably the thrilling part of having one.
So what can possibly go wrong with the mathematics?
The obvious answer is more of a question, which is what happens if somebody needs major surgery (or these days, even simple outpatient surgery) before the HSA savings account has had enough time to build up to enough to cover deductibles and medications? Therefore, self-employed families should be especially careful with their cash flow ability when choosing the maximum deductible in the first place,
Having said that, another approach to policy design is to add enough ancillary and separate accident and critical care coverage to off-set a major shock, such as cancer, loss of limbs, any accident, and the most expensive surprises. This enables a person or family to keep the premiums somewhat at bay, but covers the very real possibility of needing $10,000 or $20,000 cash immediately to pay for an emergency room, or other catastrophe. There is no better policy combination that I know of than a federally mandated (standards) HSA Major Medical Plan combined with the correct ancillary items, when taken in to proportion of monthly premium benefit and overall safety from unexpected events.
The key to all of this for the self employed health insurance buyer is to work with a health agent who cares enough to dig in to the details of what ancillary policies would be best, covering everything from accidents and the top illnesses, to which discount program to use for dental and vision. If you do not have guarantees in all of these areas, coming up with large amounts of cash or credit for a surgery or other event could be horrible.
The HSA is one of the best weapons for the highest payers of health insurance, which are self employed individuals with no group plan to cover them. Take advantage of any of the top company plans, and choose your agent carefully. There are plenty of reliable health insurance companies out there. Find an agent that knows what ancillary tools to put in to perfect your HSA, and reap the premium and tax advantaged savings for you and yours.
When Health Care Workers Get Sick
Absenteeism in the health care work place has a problematic rippling effect on the other workers and patients. In hospitals and nursing homes, keeping each shift "comfortably" covered is no easy task. Because hospitals and nursing homes must function under a unique and high-pressured clinical setting, a specialized employee wellness program is needed to keep both health care workers and their patients healthy.
What happens when health care workers get sick? They don't show up for work leaving a strain on the remaining workers. Patient care is often prioritized so the most critical services are maintained while less necessary care can be postponed. Emergency procedures, medication and meals cannot wait. What other tasks can be put off? Showers, completing forms, answering questions and checking in on patients are temporarily put on the back burner. It is a difficult scenario for dedicated workers who hate to decline a patient's request when circumstances are beyond their control.
What happens when sick health care workers come back to work? Are they really better? Will they relapse and call in sick again? Are there factors in the work place contributing to their poor health? Do they have adequate health care as an employee of a health care institution? Is there a way to assist them without infringing on their privacy rights? Can health care administrators prevent the burnout that leads to high turnover rates in hospitals and nursing homes?
Health care workers also have a significant number of health problems. There is a high rate of smoking and obesity in nurses. The British Medical Journal has reported medical doctors die from suicide, poisonings and cirrhosis of the liver. In 2003, The Journal of the American Medical Association touched on the subject of sick doctors in the article, "Care of the Dying Doctor." An unhealthy staff is an overlooked epidemic that mirrors the rest of society.
Getting health care workers well and keeping them well takes the same effort that their patients have to take. They need to follow the same advice: healthy diet, physical fitness, and stress management. It is not easy in general, but the health care worker sees the tragic results of other people's stress: trauma, disease, suffering and death. Their continual exposure to other people's ill health forces them to carry the extra burden of caring for others as well as themselves.
Health care workers must not set their well being aside. A specialized health care worker wellness program can be implemented to reinforce healthy habits so they can inspire their patients to do the same. It requires an honest look at working conditions, and introducing positive incentives. Employee wellness programs have statistically shown positive benefits to a corporation's bottom line as well as employee morale.
Health care workers may have better knowledge of what it takes to promote health and it should be encouraged at work as well as home. This "bridging" allows the health care worker to remain consistent in their efforts all the time. Hospitals and nursing homes have the opportunity to invest in their health care workers with a unique wellness program that will help their workers and benefit the public.
What happens when health care workers get sick? They don't show up for work leaving a strain on the remaining workers. Patient care is often prioritized so the most critical services are maintained while less necessary care can be postponed. Emergency procedures, medication and meals cannot wait. What other tasks can be put off? Showers, completing forms, answering questions and checking in on patients are temporarily put on the back burner. It is a difficult scenario for dedicated workers who hate to decline a patient's request when circumstances are beyond their control.
What happens when sick health care workers come back to work? Are they really better? Will they relapse and call in sick again? Are there factors in the work place contributing to their poor health? Do they have adequate health care as an employee of a health care institution? Is there a way to assist them without infringing on their privacy rights? Can health care administrators prevent the burnout that leads to high turnover rates in hospitals and nursing homes?
Health care workers also have a significant number of health problems. There is a high rate of smoking and obesity in nurses. The British Medical Journal has reported medical doctors die from suicide, poisonings and cirrhosis of the liver. In 2003, The Journal of the American Medical Association touched on the subject of sick doctors in the article, "Care of the Dying Doctor." An unhealthy staff is an overlooked epidemic that mirrors the rest of society.
Getting health care workers well and keeping them well takes the same effort that their patients have to take. They need to follow the same advice: healthy diet, physical fitness, and stress management. It is not easy in general, but the health care worker sees the tragic results of other people's stress: trauma, disease, suffering and death. Their continual exposure to other people's ill health forces them to carry the extra burden of caring for others as well as themselves.
Health care workers must not set their well being aside. A specialized health care worker wellness program can be implemented to reinforce healthy habits so they can inspire their patients to do the same. It requires an honest look at working conditions, and introducing positive incentives. Employee wellness programs have statistically shown positive benefits to a corporation's bottom line as well as employee morale.
Health care workers may have better knowledge of what it takes to promote health and it should be encouraged at work as well as home. This "bridging" allows the health care worker to remain consistent in their efforts all the time. Hospitals and nursing homes have the opportunity to invest in their health care workers with a unique wellness program that will help their workers and benefit the public.
Important Reasons For Having Medical Records
Medical records are the documentation of the medical histories of patients. They includes the following information: demographics and personal circumstances of the patient, such as the name, birth date, age, civil status, etc. They also list the diseases, sickness and growth landmarks of the patient, as well as his allergies and preferences.
Hospitals and health care service providers compile and store medical records of the patients for safekeeping, but it would be better for each patient to maintain and compile their own. Doing this will make them aware of their own health while at the same time become more interested and learning more about how their body reacts to certain diseases and external stimuli. This has been especially true for allergic reactions. A person with allergies should know what causes them and know how to deal with them properly.
Hospitals and health care providers, on the other hand, need the medical information so they can give continuous care to the patient. This continuity of care should not stop in case the patient transfers to another hospital or chooses another doctor. The previous hospital or doctor is required to turnover the medical records of the patient, so the new hospital or doctor can continue monitoring his health.
Doctors depend on this to come-up with better diagnostics of a sickness or disease. They need these records to avoid prescribing medications that can otherwise produce ill-effects to the patient instead of being a cure for the sickness. They also need it to give advice to patients with a weak disposition, so they can avoid possible contraction of diseases or illness he is vulnerable from. In times of emergency, for example, if the patient is unconscious, his medical records are all that the hospital or doctor can use as reference.
As already explained, medical records are very important and because personal information is stored in medical records. Indeed, there are legal and ethical rules that must be followed. Simply put, hospitals and doctors are required to keep patient information confidential and secure from unauthorized third parties. Also, patient records will be used solely for the continuous care of the health of the patient.
Hospitals and health care service providers compile and store medical records of the patients for safekeeping, but it would be better for each patient to maintain and compile their own. Doing this will make them aware of their own health while at the same time become more interested and learning more about how their body reacts to certain diseases and external stimuli. This has been especially true for allergic reactions. A person with allergies should know what causes them and know how to deal with them properly.
Hospitals and health care providers, on the other hand, need the medical information so they can give continuous care to the patient. This continuity of care should not stop in case the patient transfers to another hospital or chooses another doctor. The previous hospital or doctor is required to turnover the medical records of the patient, so the new hospital or doctor can continue monitoring his health.
Doctors depend on this to come-up with better diagnostics of a sickness or disease. They need these records to avoid prescribing medications that can otherwise produce ill-effects to the patient instead of being a cure for the sickness. They also need it to give advice to patients with a weak disposition, so they can avoid possible contraction of diseases or illness he is vulnerable from. In times of emergency, for example, if the patient is unconscious, his medical records are all that the hospital or doctor can use as reference.
As already explained, medical records are very important and because personal information is stored in medical records. Indeed, there are legal and ethical rules that must be followed. Simply put, hospitals and doctors are required to keep patient information confidential and secure from unauthorized third parties. Also, patient records will be used solely for the continuous care of the health of the patient.
Thursday, July 24, 2008
The Basics Of Qualifying For Colorado Medicaid - What You Can And Cannot Keep
In order to understand the process of Medicaid qualification in Colorado, you first need to know how Medicaid treats your assets.
Basically, Medicaid breaks your assets down into two separate categories. The first are those assets which are "exempt" and the second are those assets which are "non-exempt" or countable.
Exempt assets are those which Medicaid will not take into account (at least for the time being). Generally the following assets are exempt:
* The home, up to $500,000 in equity. The home must be the principal place of residence. The nursing home resident may be required to show some "intent to return home," even if this never actually takes place.
* Household and personal belongings, such as furniture, appliances,jewelry and clothing.
* One vehicle of any value.
* Prepaid funeral plans and burial plots.
* Cash value of life insurance policies, as long as the face value of all policies added together does not exceed $1,500. If it does exceed $1,500 in total face amount, then the cash value in these policies is countable. Also, term life insurance is exempt.
* Cash (e.g. a small checking or savings account) not to exceed$2,000.
These are basically the assets which Medicaid will ignore, at least for now. Keep in mind, however, that the estate recovery unit may come back to recoup payments made to a Medicaid recipient after the death of the recipient and the recipient's spouse.All other assets which are not exempt (i.e. the ones not listed earlier) are countable. This includes checking accounts, savings accounts, certificates of deposit, money market accounts, stocks,mutual funds, bonds, IRAs, pensions, second cars and so on. While there are some minor exceptions to these rules, for the most part,all money and property, as well as any item that can be valued and turned into cash, is a countable asset, unless it is one of those listed earlier as exempt.
While the Medicaid rules themselves are complicated and somewhat tricky, for a single person it's safe to say that you will qualify for Medicaid so long as you have only exempt assets plus a small amount of cash.
For a married couple, the community spouse (i.e., the one not needing nursing home care) can generally keep $104,400. Of course,this does not mean there are not things which can be done to protect assets beyond these levels. Instead, this information is designed to review the basics in a way which a caseworker from Medicaid would do so.
Basically, Medicaid breaks your assets down into two separate categories. The first are those assets which are "exempt" and the second are those assets which are "non-exempt" or countable.
Exempt assets are those which Medicaid will not take into account (at least for the time being). Generally the following assets are exempt:
* The home, up to $500,000 in equity. The home must be the principal place of residence. The nursing home resident may be required to show some "intent to return home," even if this never actually takes place.
* Household and personal belongings, such as furniture, appliances,jewelry and clothing.
* One vehicle of any value.
* Prepaid funeral plans and burial plots.
* Cash value of life insurance policies, as long as the face value of all policies added together does not exceed $1,500. If it does exceed $1,500 in total face amount, then the cash value in these policies is countable. Also, term life insurance is exempt.
* Cash (e.g. a small checking or savings account) not to exceed$2,000.
These are basically the assets which Medicaid will ignore, at least for now. Keep in mind, however, that the estate recovery unit may come back to recoup payments made to a Medicaid recipient after the death of the recipient and the recipient's spouse.All other assets which are not exempt (i.e. the ones not listed earlier) are countable. This includes checking accounts, savings accounts, certificates of deposit, money market accounts, stocks,mutual funds, bonds, IRAs, pensions, second cars and so on. While there are some minor exceptions to these rules, for the most part,all money and property, as well as any item that can be valued and turned into cash, is a countable asset, unless it is one of those listed earlier as exempt.
While the Medicaid rules themselves are complicated and somewhat tricky, for a single person it's safe to say that you will qualify for Medicaid so long as you have only exempt assets plus a small amount of cash.
For a married couple, the community spouse (i.e., the one not needing nursing home care) can generally keep $104,400. Of course,this does not mean there are not things which can be done to protect assets beyond these levels. Instead, this information is designed to review the basics in a way which a caseworker from Medicaid would do so.
Residents Call For Help - No One Hears Their Calls
Today I present to you a different kind of article. Today, instead of just putting facts across the page, I want to inject a little of creative writing, various ideas into my usual way of presenting information here. Bear with me, hoping you understand the message here. Yes, sometimes I can write words that might be a little confusing but that is not a problem on your end but here. I will explain that at a later date.
Some creative writing ventures in here, here on this white space, here in this computer space. Well, honesty be told, all of my writing is creative in one way or another, even my factual stories are presented in a very creative way to keep your interest, to keep my interest. After all, how much can you write about apples and not be bored of apples or any other topic for that matter?
So my story begins here,
Meanwhile, I went to look into my journal yesterday and was not surprised to find the writing, writings that came from my mind, heart, soul and spirit. These were writings of my thoughts, ideas and suggestions that flooded through, begging to come out onto paper. And yet day after day passed and not one word dared venture out onto the paper. After all,once the ideas or thoughts are on paper, it is so easy for people to steal or borrow them. So for years, I kept the journal private and now soon this year I will reveal it to the public.
Yesterday I visited again. Without too much hope in my heart, I entered the parking lot to this nursing home. Funny thing, this nursing home has had the reputation of being very good. That being very good, that is what interested me in it in the first place. Who would not be relieved to hear that a nursing home is very good? And indeed, this one was classified as being very good. I walked from the parking lot to the walkway of the building. It was a crystal clear day, and the weather was just begging people to come out and sit by the ocean. The invitation was nice and very timely but the smarter part of me kept saying, no, today is not the day for the ocean. Today is your visiting day. Do that first. Uhhghhg, the feelings I got after that order. Suddenly, I felt depressed, sad, and seemingly overwhelmed. I feel sad and overwhelmed every single time that I visit there. And now just the thought of going into another nursing home, another hospital or another medical center make me sick to my stomach. Perhaps I have too many memories of the extremely bad facilities. Perhaps I just did not read enough. Perhaps, perhaps and perhaps, these are the important bits of my description . Perhaps is a very prevalent word when it comes to talking with someone who is in a medical center or nursing home.
I creeped up the walk. Turned into the curve, yes, it was a driveway from the parking lot. There at the ocean you would prepare to visit and then go up at exactly visitors' time. I think things over and I remember the things that bothered me, even about the good place. Yes , even about the good nursing home. This is what people do not realize. They do not realize that even the good nursing homes are bad. Why are they bad? They are bad because their first priority is getting paid and making more money and filling beds and making sure that each and every thing is paid for immediately and as quick as possible. Even the good ones have billing problems. In some of the good ones, what happens is that when the patient is alone in the facility --perhaps he or she has no visitors for an hour or so, while that patient is alone, there can be one or two or three specialists sent in to examine the patient even when the patient does not want the examination, even when the patient or family never asked for these extra examinations. The patient and family just have t o put up with this because they are unaware that it is happening.
For example, figure this one out. Patient has ulcers that came from bedsores. Patient had quite a few here and there. Patient was admitted to the hosital for heart failure and then sent to another nursing home, a good one. At this nursing home, instead of asking the family or patient where these sores were from or how he or she got them, they automatically sent a plastic surgeon to check the patient's sores and ulcers. When the family asked why that doctor had come for a consultation, the doctor replied that the patient had sores and they had to find out why he had sores and why so many. That is odd. The odd thing is that the sores were from a previous nursing home. And both the family and the patient knew this. Yet they had a consultation with a plastic surgeon to see why the patient had these sores. Now, of course the family wanted the patient to see a doctor, of course. But would it not make more sense for a skin specialist to be brought in, and would it make more sense to bring in an infections specialist ? Would it not made more sense to contact the family first and let them in on what was happening to the patient at that time when they were not in the nursing home? No skin specialist was brought in; no infections specialist was brought in. Even no heart specialist was brought in even though this patient had a history of heart disease, heart problems, heart stents, heart murmer and past congestive heart failure, this nursing home did not send a heart specialist but sent a plastic surgeon. Interesting? Yet, it is typical of what happens in the better nursing homes. There is not enough of the correct examinations and too much of the examinations that are not necessary.
And, that incident was a minor matter, not a major matter. But it was not a major matter because this was one of the better nursing homes. So what happens in one of the rehabiliation and care centers? What if you live in Staten Island and need to go to a rehabilitation and care center? Which one do you choose? Do you dare choose? In the past, I have visited many nursing homes and also some rehabilitation and care centers. And what I have found is that these things are synonmous with almost all nursing homes and especially with bad nursing homes. These things happen and these things exist:
1. Staff has no time for residents and patients. She seem to be busy running back and forth but it appears that the bulk of their time is spent filling out reports, conversing amongst each other and talking to doctors and filling out more reports.
2. When staff does have any time for residents, the staff seems impatient, and in a hurry. The residents wait and wait and wait for service here and there and when the service finally comes, the aids and staff are in too much of a hurry to give good, friendly service.
3. There is rampant kinds of different neglect and abuse in the bad rehabiliation and care centers to the point of the administrators and seniors and supervisors seemingly doing things that might be illegal, yet no one stops them and no one knows because these senior staff have so much power.
4. Everything is a secret. You will find out later. No one has the answers to the questions you ask and you just get pushed from one place to another.
5. Residents are basically prisoners. They have schedules that they do not want. They can not eat, or sleep when they want to. Most cannot go outside the place if they want to and there is everything else wrapped up in red tape.
6. Humans sit in urine and in feces in diapers for hours at a time. Humans beg to be brought to the bathroom but no one hears their cries.
7. Humans sit in hallways begging to get out of these places. And then more happens.
Is that the kind of place you want to visit in or live in ? And that is just a sample, a small sample of what is happening in those places.
Some creative writing ventures in here, here on this white space, here in this computer space. Well, honesty be told, all of my writing is creative in one way or another, even my factual stories are presented in a very creative way to keep your interest, to keep my interest. After all, how much can you write about apples and not be bored of apples or any other topic for that matter?
So my story begins here,
Meanwhile, I went to look into my journal yesterday and was not surprised to find the writing, writings that came from my mind, heart, soul and spirit. These were writings of my thoughts, ideas and suggestions that flooded through, begging to come out onto paper. And yet day after day passed and not one word dared venture out onto the paper. After all,once the ideas or thoughts are on paper, it is so easy for people to steal or borrow them. So for years, I kept the journal private and now soon this year I will reveal it to the public.
Yesterday I visited again. Without too much hope in my heart, I entered the parking lot to this nursing home. Funny thing, this nursing home has had the reputation of being very good. That being very good, that is what interested me in it in the first place. Who would not be relieved to hear that a nursing home is very good? And indeed, this one was classified as being very good. I walked from the parking lot to the walkway of the building. It was a crystal clear day, and the weather was just begging people to come out and sit by the ocean. The invitation was nice and very timely but the smarter part of me kept saying, no, today is not the day for the ocean. Today is your visiting day. Do that first. Uhhghhg, the feelings I got after that order. Suddenly, I felt depressed, sad, and seemingly overwhelmed. I feel sad and overwhelmed every single time that I visit there. And now just the thought of going into another nursing home, another hospital or another medical center make me sick to my stomach. Perhaps I have too many memories of the extremely bad facilities. Perhaps I just did not read enough. Perhaps, perhaps and perhaps, these are the important bits of my description . Perhaps is a very prevalent word when it comes to talking with someone who is in a medical center or nursing home.
I creeped up the walk. Turned into the curve, yes, it was a driveway from the parking lot. There at the ocean you would prepare to visit and then go up at exactly visitors' time. I think things over and I remember the things that bothered me, even about the good place. Yes , even about the good nursing home. This is what people do not realize. They do not realize that even the good nursing homes are bad. Why are they bad? They are bad because their first priority is getting paid and making more money and filling beds and making sure that each and every thing is paid for immediately and as quick as possible. Even the good ones have billing problems. In some of the good ones, what happens is that when the patient is alone in the facility --perhaps he or she has no visitors for an hour or so, while that patient is alone, there can be one or two or three specialists sent in to examine the patient even when the patient does not want the examination, even when the patient or family never asked for these extra examinations. The patient and family just have t o put up with this because they are unaware that it is happening.
For example, figure this one out. Patient has ulcers that came from bedsores. Patient had quite a few here and there. Patient was admitted to the hosital for heart failure and then sent to another nursing home, a good one. At this nursing home, instead of asking the family or patient where these sores were from or how he or she got them, they automatically sent a plastic surgeon to check the patient's sores and ulcers. When the family asked why that doctor had come for a consultation, the doctor replied that the patient had sores and they had to find out why he had sores and why so many. That is odd. The odd thing is that the sores were from a previous nursing home. And both the family and the patient knew this. Yet they had a consultation with a plastic surgeon to see why the patient had these sores. Now, of course the family wanted the patient to see a doctor, of course. But would it not make more sense for a skin specialist to be brought in, and would it make more sense to bring in an infections specialist ? Would it not made more sense to contact the family first and let them in on what was happening to the patient at that time when they were not in the nursing home? No skin specialist was brought in; no infections specialist was brought in. Even no heart specialist was brought in even though this patient had a history of heart disease, heart problems, heart stents, heart murmer and past congestive heart failure, this nursing home did not send a heart specialist but sent a plastic surgeon. Interesting? Yet, it is typical of what happens in the better nursing homes. There is not enough of the correct examinations and too much of the examinations that are not necessary.
And, that incident was a minor matter, not a major matter. But it was not a major matter because this was one of the better nursing homes. So what happens in one of the rehabiliation and care centers? What if you live in Staten Island and need to go to a rehabilitation and care center? Which one do you choose? Do you dare choose? In the past, I have visited many nursing homes and also some rehabilitation and care centers. And what I have found is that these things are synonmous with almost all nursing homes and especially with bad nursing homes. These things happen and these things exist:
1. Staff has no time for residents and patients. She seem to be busy running back and forth but it appears that the bulk of their time is spent filling out reports, conversing amongst each other and talking to doctors and filling out more reports.
2. When staff does have any time for residents, the staff seems impatient, and in a hurry. The residents wait and wait and wait for service here and there and when the service finally comes, the aids and staff are in too much of a hurry to give good, friendly service.
3. There is rampant kinds of different neglect and abuse in the bad rehabiliation and care centers to the point of the administrators and seniors and supervisors seemingly doing things that might be illegal, yet no one stops them and no one knows because these senior staff have so much power.
4. Everything is a secret. You will find out later. No one has the answers to the questions you ask and you just get pushed from one place to another.
5. Residents are basically prisoners. They have schedules that they do not want. They can not eat, or sleep when they want to. Most cannot go outside the place if they want to and there is everything else wrapped up in red tape.
6. Humans sit in urine and in feces in diapers for hours at a time. Humans beg to be brought to the bathroom but no one hears their cries.
7. Humans sit in hallways begging to get out of these places. And then more happens.
Is that the kind of place you want to visit in or live in ? And that is just a sample, a small sample of what is happening in those places.
An Effective Visit To Your Doctor
Maintaining good health involves a good partnership between you and your health care team. It is important that you can communicate well with your doctors, your nurses and other health professionals so that you can make smart decisions.
You should also have one personal doctor who will do all the coordination with other medical practitioners for your medical care.
He or she will help you to understand any procedures of your health plan and recommend you the best care available for you.
When you make an appointment with your doctor or nurse practitioner, remember that it is very important to show up on time for. But if for any reasons that you cannot make it on time, do call the office any inform them. This will help your doctor's office to be more efficient for everyone.
Giving your doctor a concise and organized description of your illness is the very first most important information that your doctor needs. This has to come from you and definitely is your responsibility to do so to show that you care and want to participate in your health matter.
Your doctor will most probably continue to probe further into the illness by asking more questions. Responding and expressing clearly will help your doctor to a more accurate diagnosis to your illness.
Giving your doctor complete information about medications you have taken before or during the illness will be most helpful. Any allergies you may have should also be told to your doctor.
Other information that your doctor may want to know is about your social life and your work. Many a time illnesses are related to your job, family, drinking habits, sexual activity or even exposure to chemical or toxic substances. Thus you need to be as truthful as possible in your answers as they do play an important part in your diagnosis and treatment.
You too need to participate by asking your doctor questions. This will give you a better understanding of the condition of your health and the treatment that you may be receiving. Never worry about making a pest of yourself by asking questions. All good health professionals encourage their patients to ask questions and take an active role in their own health care. You may want to prepare yourself with a list of questions before going to see your doctor. This will ensure that you have all the questions in hand.
Last but most importantly you need to ask if your aren't absolutely sure about the doctor's advice, or medication instructions given to you. It would be wise to write down all instructions given. Don't depend on your memory. Call back if you are still not sure. But don't ever guess. It is your health that matters.
You should also have one personal doctor who will do all the coordination with other medical practitioners for your medical care.
He or she will help you to understand any procedures of your health plan and recommend you the best care available for you.
When you make an appointment with your doctor or nurse practitioner, remember that it is very important to show up on time for. But if for any reasons that you cannot make it on time, do call the office any inform them. This will help your doctor's office to be more efficient for everyone.
Giving your doctor a concise and organized description of your illness is the very first most important information that your doctor needs. This has to come from you and definitely is your responsibility to do so to show that you care and want to participate in your health matter.
Your doctor will most probably continue to probe further into the illness by asking more questions. Responding and expressing clearly will help your doctor to a more accurate diagnosis to your illness.
Giving your doctor complete information about medications you have taken before or during the illness will be most helpful. Any allergies you may have should also be told to your doctor.
Other information that your doctor may want to know is about your social life and your work. Many a time illnesses are related to your job, family, drinking habits, sexual activity or even exposure to chemical or toxic substances. Thus you need to be as truthful as possible in your answers as they do play an important part in your diagnosis and treatment.
You too need to participate by asking your doctor questions. This will give you a better understanding of the condition of your health and the treatment that you may be receiving. Never worry about making a pest of yourself by asking questions. All good health professionals encourage their patients to ask questions and take an active role in their own health care. You may want to prepare yourself with a list of questions before going to see your doctor. This will ensure that you have all the questions in hand.
Last but most importantly you need to ask if your aren't absolutely sure about the doctor's advice, or medication instructions given to you. It would be wise to write down all instructions given. Don't depend on your memory. Call back if you are still not sure. But don't ever guess. It is your health that matters.
Help! I Am Locked In A Bad Rehabilitation And Care Center Formerly Known As A Nursing Home
This article might be a little shock to you. After you are shocked, the best thing that you can do for you and for your family is to prepare them and prepare yourself for the future and cover any what ifs that could or might happen.
After doing extensive research on the topic and after being a somewhat-constant visitor to many hospitals, medical centers, nursing homes and a rehabilitation and care center, I have come to the conclusion that nursing homes are not meant for human beings. The only human beings that most nursing homes can benefit are those humans that have absolutely no family, friends, co-workers or connections. And even then, those patients are not helped either but might be the ones that are most taken advantage of.
These are statements in general about various things that can, did and will happen in your local nursing homes, rehab centers and medical centers and hospitals.
1. Nursing homes and rehab centers and some hospitals will insist that patients wear diapers --even when they do not medically need diapers.
2. Nursing homes and rehab centers will present some patients with contracts/policy admissions or enrollment papers that gives the facility practically complete control over all the assets, money an d real estate of the patient. The documents will give mass permission to the facility to investigage into the patient's entire life, financial, social, psychiatric, medical and more circumstances without even asking the patients' permission again. (They get the signature when the patient enrolls and most time the patient has no clue what the enrollment agreement /contract is.
3. Nursing homes and rehab centers, in some and lots of cases, will try to isolate the family members and co workers and friends from their relatives, patients so that the family members and friends are not witnesses to the nursing home lacks and neglects. The really bad nursing homes are those that want the patient to be separate from their immediate family members even from those family members that have been helpful, beneficial and good towards the patient or family member.
4. Nursing Homes and rehab centers, once they get your signature on Medicaid or Medicare applications, and once they get your application almost processed will ignore your requests to go home, to visit out of the nursing homes and your requests to be connected with people.
5. Rehabilitation and care centers that are bad or going bad will keep their public phones -- on the long term floors -- broken or out of order most times. THey know that is the connection with family members, yet the phones are always either busy, broken or both.
6. They will let patients sit for hours and hours in their own urine and excrement, ignoring their pleas for help and assistance.
7. They will let patients wait for hours on toilet bowls, having them wait to have assistance to come off the toilet bowl.
8. They will medicate patients that are witnesses and medicate patients who complain about conditions.
9. They will lie to families consistently and continuously. There was one case where they told the family member that a patient could walk 90 feet, yet when the family member went to watch the patient, the patient could walk only a few feet at one time and no where near 90 feet. They have lied to other patients about whether patients came out of the bed. For example, a nurse will say, yes she had breakfast in the dining room, but the truth is that she had breakfast in bed in her own room, still isolated from the rest of the population in the facility.
10. They will consistently lose patients' clothing, all the time. There are patients wearing other patients' clothing and there are tons of clothing lost for each year.
11. They will ignore your requests for help. They will make fun of patients, mimicking them when they want to do so.
12. They will take money from residents so that they can purchase cigarettes and other health-harming items for patients who are on oxygen, patients who are sick, and for patients who are not allowed out of the building.
13. Some will take your clothing and not issue any receipts.
14. Some will lose ALL the pants and some of the clothing. The method to their madness about them losing the pants, is this: If the resident has many pairs of pants then the resident can tell the place that he does not want to wear diapers. So, those facilities that want to keep residents isolated, will lose the residents pants so that the resident cannot leave his room. YOu are not permitted to leave your room without pants, of course, and it the place consistently loses their pants, the resident becomes more isolated and more unhappy.
After doing extensive research on the topic and after being a somewhat-constant visitor to many hospitals, medical centers, nursing homes and a rehabilitation and care center, I have come to the conclusion that nursing homes are not meant for human beings. The only human beings that most nursing homes can benefit are those humans that have absolutely no family, friends, co-workers or connections. And even then, those patients are not helped either but might be the ones that are most taken advantage of.
These are statements in general about various things that can, did and will happen in your local nursing homes, rehab centers and medical centers and hospitals.
1. Nursing homes and rehab centers and some hospitals will insist that patients wear diapers --even when they do not medically need diapers.
2. Nursing homes and rehab centers will present some patients with contracts/policy admissions or enrollment papers that gives the facility practically complete control over all the assets, money an d real estate of the patient. The documents will give mass permission to the facility to investigage into the patient's entire life, financial, social, psychiatric, medical and more circumstances without even asking the patients' permission again. (They get the signature when the patient enrolls and most time the patient has no clue what the enrollment agreement /contract is.
3. Nursing homes and rehab centers, in some and lots of cases, will try to isolate the family members and co workers and friends from their relatives, patients so that the family members and friends are not witnesses to the nursing home lacks and neglects. The really bad nursing homes are those that want the patient to be separate from their immediate family members even from those family members that have been helpful, beneficial and good towards the patient or family member.
4. Nursing Homes and rehab centers, once they get your signature on Medicaid or Medicare applications, and once they get your application almost processed will ignore your requests to go home, to visit out of the nursing homes and your requests to be connected with people.
5. Rehabilitation and care centers that are bad or going bad will keep their public phones -- on the long term floors -- broken or out of order most times. THey know that is the connection with family members, yet the phones are always either busy, broken or both.
6. They will let patients sit for hours and hours in their own urine and excrement, ignoring their pleas for help and assistance.
7. They will let patients wait for hours on toilet bowls, having them wait to have assistance to come off the toilet bowl.
8. They will medicate patients that are witnesses and medicate patients who complain about conditions.
9. They will lie to families consistently and continuously. There was one case where they told the family member that a patient could walk 90 feet, yet when the family member went to watch the patient, the patient could walk only a few feet at one time and no where near 90 feet. They have lied to other patients about whether patients came out of the bed. For example, a nurse will say, yes she had breakfast in the dining room, but the truth is that she had breakfast in bed in her own room, still isolated from the rest of the population in the facility.
10. They will consistently lose patients' clothing, all the time. There are patients wearing other patients' clothing and there are tons of clothing lost for each year.
11. They will ignore your requests for help. They will make fun of patients, mimicking them when they want to do so.
12. They will take money from residents so that they can purchase cigarettes and other health-harming items for patients who are on oxygen, patients who are sick, and for patients who are not allowed out of the building.
13. Some will take your clothing and not issue any receipts.
14. Some will lose ALL the pants and some of the clothing. The method to their madness about them losing the pants, is this: If the resident has many pairs of pants then the resident can tell the place that he does not want to wear diapers. So, those facilities that want to keep residents isolated, will lose the residents pants so that the resident cannot leave his room. YOu are not permitted to leave your room without pants, of course, and it the place consistently loses their pants, the resident becomes more isolated and more unhappy.
Wednesday, July 23, 2008
Is It Effective Medicaid Planning In Colorado To Add Someone's Name To Your Bank Account?
Many people believe that adding someone's name to your bank account can be an effective strategy for protection of assets when attempting to qualify for Colorado Medicaid. This is actually not the case, however. Consider the following situation:
Mrs. Jones' husband was diagnosed with Alzheimer's Disease three years ago and the disease has progressed to the point where he needs long-term nursing home care.
At the time of the diagnosis, she talked to some friends of the family who told her to go ahead and add the kids names to her bank accounts and mutual funds as a way to protect those assets from Medicaid. Now that her husband is in the nursing home she wonders
whether she did the right thing.
Adding someone else's name to a bank account or mutual fund does NOT transfer the ownership on that account. If Mrs. Jones had a bank account with $20,000 and she added her daughter's name to the account, the state would say that her daughter's name was added for convenience purposes only. In other words, the entire account still belongs to Mrs. Jones. So even though the child's name has been added, the practical effect, from a Colorado Medicaid standpoint, is that there has been no gift and the entire account still belongs to Mrs. Jones.
This is true whether we are talking about bank accounts, certificates of deposit, savings bonds, mutual funds or any other liquid asset. The law says there is no gift until the child actually takes the money out of the account. In other words, using this same example, if Mrs. Jones added her daughter's name to the account three years ago, there has been no gift made. If her daughter later takes some money out of the account and moves it into her own name, then the gift is made at the time the daughter takes the money out of the account.
This general rule is not true where real estate is concerned. That's because if someone's name is added to real estate, at the time the deed is signed and recorded, then a completed gift has been made.
Whether or not it makes sense to add someone's name to real estate or financial assets depends upon the facts and circumstances of each particular case, and laws can vary from state to state. Be sure to seek the advice of a competent professional before proceeding.
Mrs. Jones' husband was diagnosed with Alzheimer's Disease three years ago and the disease has progressed to the point where he needs long-term nursing home care.
At the time of the diagnosis, she talked to some friends of the family who told her to go ahead and add the kids names to her bank accounts and mutual funds as a way to protect those assets from Medicaid. Now that her husband is in the nursing home she wonders
whether she did the right thing.
Adding someone else's name to a bank account or mutual fund does NOT transfer the ownership on that account. If Mrs. Jones had a bank account with $20,000 and she added her daughter's name to the account, the state would say that her daughter's name was added for convenience purposes only. In other words, the entire account still belongs to Mrs. Jones. So even though the child's name has been added, the practical effect, from a Colorado Medicaid standpoint, is that there has been no gift and the entire account still belongs to Mrs. Jones.
This is true whether we are talking about bank accounts, certificates of deposit, savings bonds, mutual funds or any other liquid asset. The law says there is no gift until the child actually takes the money out of the account. In other words, using this same example, if Mrs. Jones added her daughter's name to the account three years ago, there has been no gift made. If her daughter later takes some money out of the account and moves it into her own name, then the gift is made at the time the daughter takes the money out of the account.
This general rule is not true where real estate is concerned. That's because if someone's name is added to real estate, at the time the deed is signed and recorded, then a completed gift has been made.
Whether or not it makes sense to add someone's name to real estate or financial assets depends upon the facts and circumstances of each particular case, and laws can vary from state to state. Be sure to seek the advice of a competent professional before proceeding.
Prison 101 - Part One In A Serious Series About Rehabilitation Centers And Nursing Homes
The woman looked at me and said, This place is like a prison; I am not coming back here. I looked at the place and from the outside and sometimes from the inside, the place looked pretty inviting, not homey but inviting. I knew that most of the staff was pleasant, friendly and somewhat professional. Though I was not affiliated with the place, I did have the opportunity to see inside the building and to notice what happens inside. I really wondered why she thought it was like a prison but I did not want to talk it over for hours as I was planning to have a pleasant day, peaceful, thinking on beautiful, serene things. Yet, her words kept haunting me. Why should those words haunt me and you? They should haunt us because with one stroke of fate, you or I or both of us can land in that place accidentally and then we two will discover what the place is really like inside, when the visitors leave, when the witnesses leave. What is a nursing home like when you have to live there as opposed to being there only as a visitor?
Well, here are some things that make residents and patients feel like they are in prison:
* Most of the residents, if they are wheelchair-bound, are literally bound from going where they want to go, when they want to go. They have so many time restrictions due to that there are not enough staff members to take them where they want to go to.
* This particular place even has restrictions on their clothing; prisoners do also. Prisoners have to wear the clothing that is given to them by the state or federal government. Residents in nursing homes are restricted to wear the clothing that the facility does not lose or to clothing that people from the outside bring to them because most of them cannot go shopping on their own. They need to get special passes to go out of the building.
* They are not free to come and go as they please, even though that might be their permanent home. Can you imagine being a grown person and needing to ask if you want to go outdoors and then when you ask you are told you need a pass, a special pass that needs to be signed by the nurses or social workers?
* In some facilities, the residents cannot even go from one floor to the next floor without an aide or person accompanying them. If they want to use the vending machines or if they want to go to the auditorium or go to activities, there is one rehab and care center that has elevators that are not wheelchair accessible in the fact that people in wheelchairs cannot reach the elevator buttons. They need someone to be in the elevator to press the buttons for them. So even if a resident does not need an aid because they are physically independent but need the wheelchair to help, this resident cannot be free to go to the lobby or other floors without asking an aide to help them.
* When they ask for help or an aid to accompany them somewhere in or out of the building, most times, the staff is never available. The residents have to wait and wait and wait and wait until finally, maybe, someone might be able to help them, maybe. And that is a very big maybe, because most times, they just wait and wait and then give up on going where they want to go.
* Everything they want to do is accompanied by a pass or written instructions or special rules. That is not a home, that is more like a prison. Residents need to get approval for practically anything and everything, including going to the restroom. Imagine really having to go to a restroom and needing to wait and wait and wait till someone comes to get you?
There are two million ways that bad rehab centers and nursing homes and EVEN good nursing homes are so much like prisons. They are more like prisons than prisons are. There are some prisons where the inmates have so much more freedom than nursing home residents have and that is the absolute truth. Do not doubt that for one moment. So could you even imagine, working your whole life so that you can have a good retirement life and then ending up in a place that has less freedom than your average prison has? No. You probably could not even imagine that , correct?
You can help.
Write here and leave your comments, ideas, suggestions and complaints. You can help. Write to me today to share your ideas, your hope, your understanding, your knowledge, your inside information and everything else you can share to make these prisons better today.
Well, here are some things that make residents and patients feel like they are in prison:
* Most of the residents, if they are wheelchair-bound, are literally bound from going where they want to go, when they want to go. They have so many time restrictions due to that there are not enough staff members to take them where they want to go to.
* This particular place even has restrictions on their clothing; prisoners do also. Prisoners have to wear the clothing that is given to them by the state or federal government. Residents in nursing homes are restricted to wear the clothing that the facility does not lose or to clothing that people from the outside bring to them because most of them cannot go shopping on their own. They need to get special passes to go out of the building.
* They are not free to come and go as they please, even though that might be their permanent home. Can you imagine being a grown person and needing to ask if you want to go outdoors and then when you ask you are told you need a pass, a special pass that needs to be signed by the nurses or social workers?
* In some facilities, the residents cannot even go from one floor to the next floor without an aide or person accompanying them. If they want to use the vending machines or if they want to go to the auditorium or go to activities, there is one rehab and care center that has elevators that are not wheelchair accessible in the fact that people in wheelchairs cannot reach the elevator buttons. They need someone to be in the elevator to press the buttons for them. So even if a resident does not need an aid because they are physically independent but need the wheelchair to help, this resident cannot be free to go to the lobby or other floors without asking an aide to help them.
* When they ask for help or an aid to accompany them somewhere in or out of the building, most times, the staff is never available. The residents have to wait and wait and wait and wait until finally, maybe, someone might be able to help them, maybe. And that is a very big maybe, because most times, they just wait and wait and then give up on going where they want to go.
* Everything they want to do is accompanied by a pass or written instructions or special rules. That is not a home, that is more like a prison. Residents need to get approval for practically anything and everything, including going to the restroom. Imagine really having to go to a restroom and needing to wait and wait and wait till someone comes to get you?
There are two million ways that bad rehab centers and nursing homes and EVEN good nursing homes are so much like prisons. They are more like prisons than prisons are. There are some prisons where the inmates have so much more freedom than nursing home residents have and that is the absolute truth. Do not doubt that for one moment. So could you even imagine, working your whole life so that you can have a good retirement life and then ending up in a place that has less freedom than your average prison has? No. You probably could not even imagine that , correct?
You can help.
Write here and leave your comments, ideas, suggestions and complaints. You can help. Write to me today to share your ideas, your hope, your understanding, your knowledge, your inside information and everything else you can share to make these prisons better today.
The Basics Of Qualifying For Colorado Medicaid - What You Can And Cannot Keep
In order to understand the process of Medicaid qualification in Colorado, you first need to know how Medicaid treats your assets.
Basically, Medicaid breaks your assets down into two separate categories. The first are those assets which are "exempt" and the second are those assets which are "non-exempt" or countable.
Exempt assets are those which Medicaid will not take into account (at least for the time being). Generally the following assets are exempt:
* The home, up to $500,000 in equity. The home must be the principal place of residence. The nursing home resident may be required to show some "intent to return home," even if this never actually takes place.
* Household and personal belongings, such as furniture, appliances,jewelry and clothing.
* One vehicle of any value.
* Prepaid funeral plans and burial plots.
* Cash value of life insurance policies, as long as the face value of all policies added together does not exceed $1,500. If it does exceed $1,500 in total face amount, then the cash value in these policies is countable. Also, term life insurance is exempt.
* Cash (e.g. a small checking or savings account) not to exceed$2,000.
These are basically the assets which Medicaid will ignore, at least for now. Keep in mind, however, that the estate recovery unit may come back to recoup payments made to a Medicaid recipient after the death of the recipient and the recipient's spouse.All other assets which are not exempt (i.e. the ones not listed earlier) are countable. This includes checking accounts, savings accounts, certificates of deposit, money market accounts, stocks,mutual funds, bonds, IRAs, pensions, second cars and so on. While there are some minor exceptions to these rules, for the most part,all money and property, as well as any item that can be valued and turned into cash, is a countable asset, unless it is one of those listed earlier as exempt.
While the Medicaid rules themselves are complicated and somewhat tricky, for a single person it's safe to say that you will qualify for Medicaid so long as you have only exempt assets plus a small amount of cash.
For a married couple, the community spouse (i.e., the one not needing nursing home care) can generally keep $104,400. Of course,this does not mean there are not things which can be done to protect assets beyond these levels. Instead, this information is designed to review the basics in a way which a caseworker from Medicaid would do so.
Richard D. Hughes is a graduate of Indiana University and the University of Denver College of Law. He has hosted scores of seminars, workshops and panel discussions on a variety of topics including probate avoidance, tax savings, disability issues, asset protection strategies, Medicaid law and trust planning.
Basically, Medicaid breaks your assets down into two separate categories. The first are those assets which are "exempt" and the second are those assets which are "non-exempt" or countable.
Exempt assets are those which Medicaid will not take into account (at least for the time being). Generally the following assets are exempt:
* The home, up to $500,000 in equity. The home must be the principal place of residence. The nursing home resident may be required to show some "intent to return home," even if this never actually takes place.
* Household and personal belongings, such as furniture, appliances,jewelry and clothing.
* One vehicle of any value.
* Prepaid funeral plans and burial plots.
* Cash value of life insurance policies, as long as the face value of all policies added together does not exceed $1,500. If it does exceed $1,500 in total face amount, then the cash value in these policies is countable. Also, term life insurance is exempt.
* Cash (e.g. a small checking or savings account) not to exceed$2,000.
These are basically the assets which Medicaid will ignore, at least for now. Keep in mind, however, that the estate recovery unit may come back to recoup payments made to a Medicaid recipient after the death of the recipient and the recipient's spouse.All other assets which are not exempt (i.e. the ones not listed earlier) are countable. This includes checking accounts, savings accounts, certificates of deposit, money market accounts, stocks,mutual funds, bonds, IRAs, pensions, second cars and so on. While there are some minor exceptions to these rules, for the most part,all money and property, as well as any item that can be valued and turned into cash, is a countable asset, unless it is one of those listed earlier as exempt.
While the Medicaid rules themselves are complicated and somewhat tricky, for a single person it's safe to say that you will qualify for Medicaid so long as you have only exempt assets plus a small amount of cash.
For a married couple, the community spouse (i.e., the one not needing nursing home care) can generally keep $104,400. Of course,this does not mean there are not things which can be done to protect assets beyond these levels. Instead, this information is designed to review the basics in a way which a caseworker from Medicaid would do so.
Richard D. Hughes is a graduate of Indiana University and the University of Denver College of Law. He has hosted scores of seminars, workshops and panel discussions on a variety of topics including probate avoidance, tax savings, disability issues, asset protection strategies, Medicaid law and trust planning.
Monday, July 21, 2008
Global Medical Tourism
As you know, medical procedure prices are extremely high in the United States. As an alternative to high U.S. prices, we have medical and dental provider locations in India. Until the last few years, people looked at countries outside the U.S. and its hospitals as inferior imitations of those in developed countries. Western expatriates as well as wealthier Third World "natives", having very little trust in local hospitals or doctors, would fly to the United States for something as simple as an executive check-up.
In the past 30 years, the costs of health care have soared in developed countries, especially in the United States. Due to rapidly escalating health care costs, Americans, Europeans, Canadians and Australians in ever increasing numbers began to search for alternatives that could reduce their personal out of pocket medical expenses. In the last few years, millions of people from developed nations have chosen to become Medical Tourists.
Need a coronary bypass surgery that costs more than $150,000 in the U.S.? Simply pack your bags. Take a vacation, and pay $6,500. Need an elective Caesarean section? That's about $1,000 including a four day hospital stay in a private room. How about a breast augmentation with smooth saline implants? Breast implants will cost you $2,000. If you are willing to travel, the list of more affordable medical procedures is seemingly endless: cardiac surgery, orthopedic surgery, weight loss procedures, cancer treatments, cosmetic surgery, general surgery, medications, infertility treatments, dental, glasses, stress reduction programs, neurosurgery, laparoscopic procedures, sex reassignment surgery, experimental treatments and so much more.
International rates are very low compared to what is paid in the United States, Europe or Australia. In some cases, the savings from dental work alone can give people extra money for a luxury vacation. For example, a family can take an expensive, four-star, luxury vacation in a Mexican Oceanside Villa and pay for the trip with the savings they receive on getting their glasses, medications and dental work from local providers. Medical Tourism can certainly be a win-win proposition. While taking care of health needs at deep discounts, shopping excursions, river tours, sight-seeing, nature excursions, intellectual pursuits, religious pilgrimages, cruises, ancient site tours, safaris, hunting or fishing trips and trips to nearby beaches can all be arranged around a medical appointment schedule. Medical Tourism is a simple concept: people can combine medical treatments with vacations, and use the savings on the medical care to pay for the vacation.
As with everything, there is one major drawback. Although most Americans have gone to a physician in the U.S. with international training, the majority of Americans remain very skeptical about traveling to other countries for their medical care. Logic mandates that there are international hospitals and health care professionals that can match those in the United States. Thus, the key is weeding through thousands of potential sources for international medical care and finding the right clinical provider, location and overall travel package.
At Medical Discounts International (MDI), we help consumers find international sources of U.S. equivalent medical care at affordable prices. MDI evaluates health care providers on five criteria: (1) the locations current geo-political issues, safety, security and weather; (2) the cost of services performed including the cost of transportation, food and lodging; (3) the convenience for the patient; (4) the quality standards as set and evaluated by an objective third party, and finally, (5) the local tourist and vacation attractions.
Medical Tourism is not for everyone, but it is a viable option for people who can not afford the high costs of health care in the United States.
In the past 30 years, the costs of health care have soared in developed countries, especially in the United States. Due to rapidly escalating health care costs, Americans, Europeans, Canadians and Australians in ever increasing numbers began to search for alternatives that could reduce their personal out of pocket medical expenses. In the last few years, millions of people from developed nations have chosen to become Medical Tourists.
Need a coronary bypass surgery that costs more than $150,000 in the U.S.? Simply pack your bags. Take a vacation, and pay $6,500. Need an elective Caesarean section? That's about $1,000 including a four day hospital stay in a private room. How about a breast augmentation with smooth saline implants? Breast implants will cost you $2,000. If you are willing to travel, the list of more affordable medical procedures is seemingly endless: cardiac surgery, orthopedic surgery, weight loss procedures, cancer treatments, cosmetic surgery, general surgery, medications, infertility treatments, dental, glasses, stress reduction programs, neurosurgery, laparoscopic procedures, sex reassignment surgery, experimental treatments and so much more.
International rates are very low compared to what is paid in the United States, Europe or Australia. In some cases, the savings from dental work alone can give people extra money for a luxury vacation. For example, a family can take an expensive, four-star, luxury vacation in a Mexican Oceanside Villa and pay for the trip with the savings they receive on getting their glasses, medications and dental work from local providers. Medical Tourism can certainly be a win-win proposition. While taking care of health needs at deep discounts, shopping excursions, river tours, sight-seeing, nature excursions, intellectual pursuits, religious pilgrimages, cruises, ancient site tours, safaris, hunting or fishing trips and trips to nearby beaches can all be arranged around a medical appointment schedule. Medical Tourism is a simple concept: people can combine medical treatments with vacations, and use the savings on the medical care to pay for the vacation.
As with everything, there is one major drawback. Although most Americans have gone to a physician in the U.S. with international training, the majority of Americans remain very skeptical about traveling to other countries for their medical care. Logic mandates that there are international hospitals and health care professionals that can match those in the United States. Thus, the key is weeding through thousands of potential sources for international medical care and finding the right clinical provider, location and overall travel package.
At Medical Discounts International (MDI), we help consumers find international sources of U.S. equivalent medical care at affordable prices. MDI evaluates health care providers on five criteria: (1) the locations current geo-political issues, safety, security and weather; (2) the cost of services performed including the cost of transportation, food and lodging; (3) the convenience for the patient; (4) the quality standards as set and evaluated by an objective third party, and finally, (5) the local tourist and vacation attractions.
Medical Tourism is not for everyone, but it is a viable option for people who can not afford the high costs of health care in the United States.
Residents Call For Help - No One Hears Their Calls
Today I present to you a different kind of article. Today, instead of just putting facts across the page, I want to inject a little of creative writing, various ideas into my usual way of presenting information here. Bear with me, hoping you understand the message here. Yes, sometimes I can write words that might be a little confusing but that is not a problem on your end but here. I will explain that at a later date.
Some creative writing ventures in here, here on this white space, here in this computer space. Well, honesty be told, all of my writing is creative in one way or another, even my factual stories are presented in a very creative way to keep your interest, to keep my interest. After all, how much can you write about apples and not be bored of apples or any other topic for that matter?
So my story begins here,
Meanwhile, I went to look into my journal yesterday and was not surprised to find the writing, writings that came from my mind, heart, soul and spirit. These were writings of my thoughts, ideas and suggestions that flooded through, begging to come out onto paper. And yet day after day passed and not one word dared venture out onto the paper. After all,once the ideas or thoughts are on paper, it is so easy for people to steal or borrow them. So for years, I kept the journal private and now soon this year I will reveal it to the public.
Yesterday I visited again. Without too much hope in my heart, I entered the parking lot to this nursing home. Funny thing, this nursing home has had the reputation of being very good. That being very good, that is what interested me in it in the first place. Who would not be relieved to hear that a nursing home is very good? And indeed, this one was classified as being very good. I walked from the parking lot to the walkway of the building. It was a crystal clear day, and the weather was just begging people to come out and sit by the ocean. The invitation was nice and very timely but the smarter part of me kept saying, no, today is not the day for the ocean. Today is your visiting day. Do that first. Uhhghhg, the feelings I got after that order. Suddenly, I felt depressed, sad, and seemingly overwhelmed. I feel sad and overwhelmed every single time that I visit there. And now just the thought of going into another nursing home, another hospital or another medical center make me sick to my stomach. Perhaps I have too many memories of the extremely bad facilities. Perhaps I just did not read enough. Perhaps, perhaps and perhaps, these are the important bits of my description . Perhaps is a very prevalent word when it comes to talking with someone who is in a medical center or nursing home.
I creeped up the walk. Turned into the curve, yes, it was a driveway from the parking lot. There at the ocean you would prepare to visit and then go up at exactly visitors' time. I think things over and I remember the things that bothered me, even about the good place. Yes , even about the good nursing home. This is what people do not realize. They do not realize that even the good nursing homes are bad. Why are they bad? They are bad because their first priority is getting paid and making more money and filling beds and making sure that each and every thing is paid for immediately and as quick as possible. Even the good ones have billing problems. In some of the good ones, what happens is that when the patient is alone in the facility --perhaps he or she has no visitors for an hour or so, while that patient is alone, there can be one or two or three specialists sent in to examine the patient even when the patient does not want the examination, even when the patient or family never asked for these extra examinations. The patient and family just have t o put up with this because they are unaware that it is happening.
For example, figure this one out. Patient has ulcers that came from bedsores. Patient had quite a few here and there. Patient was admitted to the hosital for heart failure and then sent to another nursing home, a good one. At this nursing home, instead of asking the family or patient where these sores were from or how he or she got them, they automatically sent a plastic surgeon to check the patient's sores and ulcers. When the family asked why that doctor had come for a consultation, the doctor replied that the patient had sores and they had to find out why he had sores and why so many. That is odd. The odd thing is that the sores were from a previous nursing home. And both the family and the patient knew this. Yet they had a consultation with a plastic surgeon to see why the patient had these sores. Now, of course the family wanted the patient to see a doctor, of course. But would it not make more sense for a skin specialist to be brought in, and would it make more sense to bring in an infections specialist ? Would it not made more sense to contact the family first and let them in on what was happening to the patient at that time when they were not in the nursing home? No skin specialist was brought in; no infections specialist was brought in. Even no heart specialist was brought in even though this patient had a history of heart disease, heart problems, heart stents, heart murmer and past congestive heart failure, this nursing home did not send a heart specialist but sent a plastic surgeon. Interesting? Yet, it is typical of what happens in the better nursing homes. There is not enough of the correct examinations and too much of the examinations that are not necessary.
And, that incident was a minor matter, not a major matter. But it was not a major matter because this was one of the better nursing homes. So what happens in one of the rehabiliation and care centers? What if you live in Staten Island and need to go to a rehabilitation and care center? Which one do you choose? Do you dare choose? In the past, I have visited many nursing homes and also some rehabilitation and care centers. And what I have found is that these things are synonmous with almost all nursing homes and especially with bad nursing homes. These things happen and these things exist:
1. Staff has no time for residents and patients. She seem to be busy running back and forth but it appears that the bulk of their time is spent filling out reports, conversing amongst each other and talking to doctors and filling out more reports.
2. When staff does have any time for residents, the staff seems impatient, and in a hurry. The residents wait and wait and wait for service here and there and when the service finally comes, the aids and staff are in too much of a hurry to give good, friendly service.
3. There is rampant kinds of different neglect and abuse in the bad rehabiliation and care centers to the point of the administrators and seniors and supervisors seemingly doing things that might be illegal, yet no one stops them and no one knows because these senior staff have so much power.
4. Everything is a secret. You will find out later. No one has the answers to the questions you ask and you just get pushed from one place to another.
5. Residents are basically prisoners. They have schedules that they do not want. They can not eat, or sleep when they want to. Most cannot go outside the place if they want to and there is everything else wrapped up in red tape.
6. Humans sit in urine and in feces in diapers for hours at a time. Humans beg to be brought to the bathroom but no one hears their cries.
7. Humans sit in hallways begging to get out of these places. And then more happens.
Is that the kind of place you want to visit in or live in ? And that is just a sample, a small sample of what is happening in those places.
Some creative writing ventures in here, here on this white space, here in this computer space. Well, honesty be told, all of my writing is creative in one way or another, even my factual stories are presented in a very creative way to keep your interest, to keep my interest. After all, how much can you write about apples and not be bored of apples or any other topic for that matter?
So my story begins here,
Meanwhile, I went to look into my journal yesterday and was not surprised to find the writing, writings that came from my mind, heart, soul and spirit. These were writings of my thoughts, ideas and suggestions that flooded through, begging to come out onto paper. And yet day after day passed and not one word dared venture out onto the paper. After all,once the ideas or thoughts are on paper, it is so easy for people to steal or borrow them. So for years, I kept the journal private and now soon this year I will reveal it to the public.
Yesterday I visited again. Without too much hope in my heart, I entered the parking lot to this nursing home. Funny thing, this nursing home has had the reputation of being very good. That being very good, that is what interested me in it in the first place. Who would not be relieved to hear that a nursing home is very good? And indeed, this one was classified as being very good. I walked from the parking lot to the walkway of the building. It was a crystal clear day, and the weather was just begging people to come out and sit by the ocean. The invitation was nice and very timely but the smarter part of me kept saying, no, today is not the day for the ocean. Today is your visiting day. Do that first. Uhhghhg, the feelings I got after that order. Suddenly, I felt depressed, sad, and seemingly overwhelmed. I feel sad and overwhelmed every single time that I visit there. And now just the thought of going into another nursing home, another hospital or another medical center make me sick to my stomach. Perhaps I have too many memories of the extremely bad facilities. Perhaps I just did not read enough. Perhaps, perhaps and perhaps, these are the important bits of my description . Perhaps is a very prevalent word when it comes to talking with someone who is in a medical center or nursing home.
I creeped up the walk. Turned into the curve, yes, it was a driveway from the parking lot. There at the ocean you would prepare to visit and then go up at exactly visitors' time. I think things over and I remember the things that bothered me, even about the good place. Yes , even about the good nursing home. This is what people do not realize. They do not realize that even the good nursing homes are bad. Why are they bad? They are bad because their first priority is getting paid and making more money and filling beds and making sure that each and every thing is paid for immediately and as quick as possible. Even the good ones have billing problems. In some of the good ones, what happens is that when the patient is alone in the facility --perhaps he or she has no visitors for an hour or so, while that patient is alone, there can be one or two or three specialists sent in to examine the patient even when the patient does not want the examination, even when the patient or family never asked for these extra examinations. The patient and family just have t o put up with this because they are unaware that it is happening.
For example, figure this one out. Patient has ulcers that came from bedsores. Patient had quite a few here and there. Patient was admitted to the hosital for heart failure and then sent to another nursing home, a good one. At this nursing home, instead of asking the family or patient where these sores were from or how he or she got them, they automatically sent a plastic surgeon to check the patient's sores and ulcers. When the family asked why that doctor had come for a consultation, the doctor replied that the patient had sores and they had to find out why he had sores and why so many. That is odd. The odd thing is that the sores were from a previous nursing home. And both the family and the patient knew this. Yet they had a consultation with a plastic surgeon to see why the patient had these sores. Now, of course the family wanted the patient to see a doctor, of course. But would it not make more sense for a skin specialist to be brought in, and would it make more sense to bring in an infections specialist ? Would it not made more sense to contact the family first and let them in on what was happening to the patient at that time when they were not in the nursing home? No skin specialist was brought in; no infections specialist was brought in. Even no heart specialist was brought in even though this patient had a history of heart disease, heart problems, heart stents, heart murmer and past congestive heart failure, this nursing home did not send a heart specialist but sent a plastic surgeon. Interesting? Yet, it is typical of what happens in the better nursing homes. There is not enough of the correct examinations and too much of the examinations that are not necessary.
And, that incident was a minor matter, not a major matter. But it was not a major matter because this was one of the better nursing homes. So what happens in one of the rehabiliation and care centers? What if you live in Staten Island and need to go to a rehabilitation and care center? Which one do you choose? Do you dare choose? In the past, I have visited many nursing homes and also some rehabilitation and care centers. And what I have found is that these things are synonmous with almost all nursing homes and especially with bad nursing homes. These things happen and these things exist:
1. Staff has no time for residents and patients. She seem to be busy running back and forth but it appears that the bulk of their time is spent filling out reports, conversing amongst each other and talking to doctors and filling out more reports.
2. When staff does have any time for residents, the staff seems impatient, and in a hurry. The residents wait and wait and wait for service here and there and when the service finally comes, the aids and staff are in too much of a hurry to give good, friendly service.
3. There is rampant kinds of different neglect and abuse in the bad rehabiliation and care centers to the point of the administrators and seniors and supervisors seemingly doing things that might be illegal, yet no one stops them and no one knows because these senior staff have so much power.
4. Everything is a secret. You will find out later. No one has the answers to the questions you ask and you just get pushed from one place to another.
5. Residents are basically prisoners. They have schedules that they do not want. They can not eat, or sleep when they want to. Most cannot go outside the place if they want to and there is everything else wrapped up in red tape.
6. Humans sit in urine and in feces in diapers for hours at a time. Humans beg to be brought to the bathroom but no one hears their cries.
7. Humans sit in hallways begging to get out of these places. And then more happens.
Is that the kind of place you want to visit in or live in ? And that is just a sample, a small sample of what is happening in those places.
An Effective Visit To Your Doctor
Maintaining good health involves a good partnership between you and your health care team. It is important that you can communicate well with your doctors, your nurses and other health professionals so that you can make smart decisions.
You should also have one personal doctor who will do all the coordination with other medical practitioners for your medical care.
He or she will help you to understand any procedures of your health plan and recommend you the best care available for you.
When you make an appointment with your doctor or nurse practitioner, remember that it is very important to show up on time for. But if for any reasons that you cannot make it on time, do call the office any inform them. This will help your doctor's office to be more efficient for everyone.
Giving your doctor a concise and organized description of your illness is the very first most important information that your doctor needs. This has to come from you and definitely is your responsibility to do so to show that you care and want to participate in your health matter.
Your doctor will most probably continue to probe further into the illness by asking more questions. Responding and expressing clearly will help your doctor to a more accurate diagnosis to your illness.
Giving your doctor complete information about medications you have taken before or during the illness will be most helpful. Any allergies you may have should also be told to your doctor.
Other information that your doctor may want to know is about your social life and your work. Many a time illnesses are related to your job, family, drinking habits, sexual activity or even exposure to chemical or toxic substances. Thus you need to be as truthful as possible in your answers as they do play an important part in your diagnosis and treatment.
You too need to participate by asking your doctor questions. This will give you a better understanding of the condition of your health and the treatment that you may be receiving. Never worry about making a pest of yourself by asking questions. All good health professionals encourage their patients to ask questions and take an active role in their own health care. You may want to prepare yourself with a list of questions before going to see your doctor. This will ensure that you have all the questions in hand.
Last but most importantly you need to ask if your aren't absolutely sure about the doctor's advice, or medication instructions given to you. It would be wise to write down all instructions given. Don't depend on your memory. Call back if you are still not sure. But don't ever guess. It is your health that matters.
You should also have one personal doctor who will do all the coordination with other medical practitioners for your medical care.
He or she will help you to understand any procedures of your health plan and recommend you the best care available for you.
When you make an appointment with your doctor or nurse practitioner, remember that it is very important to show up on time for. But if for any reasons that you cannot make it on time, do call the office any inform them. This will help your doctor's office to be more efficient for everyone.
Giving your doctor a concise and organized description of your illness is the very first most important information that your doctor needs. This has to come from you and definitely is your responsibility to do so to show that you care and want to participate in your health matter.
Your doctor will most probably continue to probe further into the illness by asking more questions. Responding and expressing clearly will help your doctor to a more accurate diagnosis to your illness.
Giving your doctor complete information about medications you have taken before or during the illness will be most helpful. Any allergies you may have should also be told to your doctor.
Other information that your doctor may want to know is about your social life and your work. Many a time illnesses are related to your job, family, drinking habits, sexual activity or even exposure to chemical or toxic substances. Thus you need to be as truthful as possible in your answers as they do play an important part in your diagnosis and treatment.
You too need to participate by asking your doctor questions. This will give you a better understanding of the condition of your health and the treatment that you may be receiving. Never worry about making a pest of yourself by asking questions. All good health professionals encourage their patients to ask questions and take an active role in their own health care. You may want to prepare yourself with a list of questions before going to see your doctor. This will ensure that you have all the questions in hand.
Last but most importantly you need to ask if your aren't absolutely sure about the doctor's advice, or medication instructions given to you. It would be wise to write down all instructions given. Don't depend on your memory. Call back if you are still not sure. But don't ever guess. It is your health that matters.
Help! I Am Locked In A Bad Rehabilitation And Care Center Formerly Known As A Nursing Home
This article might be a little shock to you. After you are shocked, the best thing that you can do for you and for your family is to prepare them and prepare yourself for the future and cover any what ifs that could or might happen.
After doing extensive research on the topic and after being a somewhat-constant visitor to many hospitals, medical centers, nursing homes and a rehabilitation and care center, I have come to the conclusion that nursing homes are not meant for human beings. The only human beings that most nursing homes can benefit are those humans that have absolutely no family, friends, co-workers or connections. And even then, those patients are not helped either but might be the ones that are most taken advantage of.
These are statements in general about various things that can, did and will happen in your local nursing homes, rehab centers and medical centers and hospitals.
1. Nursing homes and rehab centers and some hospitals will insist that patients wear diapers --even when they do not medically need diapers.
2. Nursing homes and rehab centers will present some patients with contracts/policy admissions or enrollment papers that gives the facility practically complete control over all the assets, money an d real estate of the patient. The documents will give mass permission to the facility to investigage into the patient's entire life, financial, social, psychiatric, medical and more circumstances without even asking the patients' permission again. (They get the signature when the patient enrolls and most time the patient has no clue what the enrollment agreement /contract is.
3. Nursing homes and rehab centers, in some and lots of cases, will try to isolate the family members and co workers and friends from their relatives, patients so that the family members and friends are not witnesses to the nursing home lacks and neglects. The really bad nursing homes are those that want the patient to be separate from their immediate family members even from those family members that have been helpful, beneficial and good towards the patient or family member.
4. Nursing Homes and rehab centers, once they get your signature on Medicaid or Medicare applications, and once they get your application almost processed will ignore your requests to go home, to visit out of the nursing homes and your requests to be connected with people.
5. Rehabilitation and care centers that are bad or going bad will keep their public phones -- on the long term floors -- broken or out of order most times. THey know that is the connection with family members, yet the phones are always either busy, broken or both.
6. They will let patients sit for hours and hours in their own urine and excrement, ignoring their pleas for help and assistance.
7. They will let patients wait for hours on toilet bowls, having them wait to have assistance to come off the toilet bowl.
8. They will medicate patients that are witnesses and medicate patients who complain about conditions.
9. They will lie to families consistently and continuously. There was one case where they told the family member that a patient could walk 90 feet, yet when the family member went to watch the patient, the patient could walk only a few feet at one time and no where near 90 feet. They have lied to other patients about whether patients came out of the bed. For example, a nurse will say, yes she had breakfast in the dining room, but the truth is that she had breakfast in bed in her own room, still isolated from the rest of the population in the facility.
10. They will consistently lose patients' clothing, all the time. There are patients wearing other patients' clothing and there are tons of clothing lost for each year.
11. They will ignore your requests for help. They will make fun of patients, mimicking them when they want to do so.
12. They will take money from residents so that they can purchase cigarettes and other health-harming items for patients who are on oxygen, patients who are sick, and for patients who are not allowed out of the building.
13. Some will take your clothing and not issue any receipts.
14. Some will lose ALL the pants and some of the clothing. The method to their madness about them losing the pants, is this: If the resident has many pairs of pants then the resident can tell the place that he does not want to wear diapers. So, those facilities that want to keep residents isolated, will lose the residents pants so that the resident cannot leave his room. YOu are not permitted to leave your room without pants, of course, and it the place consistently loses their pants, the resident becomes more isolated and more unhappy.
After doing extensive research on the topic and after being a somewhat-constant visitor to many hospitals, medical centers, nursing homes and a rehabilitation and care center, I have come to the conclusion that nursing homes are not meant for human beings. The only human beings that most nursing homes can benefit are those humans that have absolutely no family, friends, co-workers or connections. And even then, those patients are not helped either but might be the ones that are most taken advantage of.
These are statements in general about various things that can, did and will happen in your local nursing homes, rehab centers and medical centers and hospitals.
1. Nursing homes and rehab centers and some hospitals will insist that patients wear diapers --even when they do not medically need diapers.
2. Nursing homes and rehab centers will present some patients with contracts/policy admissions or enrollment papers that gives the facility practically complete control over all the assets, money an d real estate of the patient. The documents will give mass permission to the facility to investigage into the patient's entire life, financial, social, psychiatric, medical and more circumstances without even asking the patients' permission again. (They get the signature when the patient enrolls and most time the patient has no clue what the enrollment agreement /contract is.
3. Nursing homes and rehab centers, in some and lots of cases, will try to isolate the family members and co workers and friends from their relatives, patients so that the family members and friends are not witnesses to the nursing home lacks and neglects. The really bad nursing homes are those that want the patient to be separate from their immediate family members even from those family members that have been helpful, beneficial and good towards the patient or family member.
4. Nursing Homes and rehab centers, once they get your signature on Medicaid or Medicare applications, and once they get your application almost processed will ignore your requests to go home, to visit out of the nursing homes and your requests to be connected with people.
5. Rehabilitation and care centers that are bad or going bad will keep their public phones -- on the long term floors -- broken or out of order most times. THey know that is the connection with family members, yet the phones are always either busy, broken or both.
6. They will let patients sit for hours and hours in their own urine and excrement, ignoring their pleas for help and assistance.
7. They will let patients wait for hours on toilet bowls, having them wait to have assistance to come off the toilet bowl.
8. They will medicate patients that are witnesses and medicate patients who complain about conditions.
9. They will lie to families consistently and continuously. There was one case where they told the family member that a patient could walk 90 feet, yet when the family member went to watch the patient, the patient could walk only a few feet at one time and no where near 90 feet. They have lied to other patients about whether patients came out of the bed. For example, a nurse will say, yes she had breakfast in the dining room, but the truth is that she had breakfast in bed in her own room, still isolated from the rest of the population in the facility.
10. They will consistently lose patients' clothing, all the time. There are patients wearing other patients' clothing and there are tons of clothing lost for each year.
11. They will ignore your requests for help. They will make fun of patients, mimicking them when they want to do so.
12. They will take money from residents so that they can purchase cigarettes and other health-harming items for patients who are on oxygen, patients who are sick, and for patients who are not allowed out of the building.
13. Some will take your clothing and not issue any receipts.
14. Some will lose ALL the pants and some of the clothing. The method to their madness about them losing the pants, is this: If the resident has many pairs of pants then the resident can tell the place that he does not want to wear diapers. So, those facilities that want to keep residents isolated, will lose the residents pants so that the resident cannot leave his room. YOu are not permitted to leave your room without pants, of course, and it the place consistently loses their pants, the resident becomes more isolated and more unhappy.
I Cry For You, Please Cry For Me - Part Two - Healthy Adults In Diapers
This next part of the series of articles is about questions. These are the questions that I need answered. And as I sit here, I wonder if anyone out there has the answers to these questions. Please contribute and please participate in this series of articles that was written with the intent to bring things out to the public, written with the intent to connect with readers, residents, patients and family members. It is written with the intent to break down the barriers of isolation that the system seemingly sets up to break down the connections that people have. The bottom line is that the first thing that happens inside of horrible nursing homes is that they isolate, medicate and then continue to take all of a person's freedom, assets, liberties. They begin by first putting the resident in diapers against their will. They convince the residents to wear diapers insinuating that if they do not wear diapers the resident will be made to sit in wet clothing for hours and hours. Most residents give up, give up their will to fight, to live and to have their dignity and most of them agree --against their will, to wear diapers even when the diapers are not medically necessary for the resident. I am not speaking about those residents who actually need diapers. I am speaking about those residents who do not medically need diapers but who are made to wear diapers just for the convenience of the staff and workers.
Help!
Thank you. I am trying to get your attention here and I hope that I got someone's attention. If you are sitting there wanting to go to another website now and not wanting to read any further, I beg you; I implore you to bear with me a little and please participate in this communication. Here are my questions:
* What would you do if a nurse insisted that you wear diapers but you know that you are not incontinent? How would you answer the nurse?
* Would you have any fear in saying --no, I do not need diapers?
* Have you been in that position in a nursing home or in a rehabilitation center?
* What would you do if you sat for hours pleading for help and yet no one helped you inside of that nursing home?
* What would you do if they insinuated that they would leave you for hours in wet and pooped clothing inside a nursing home if you did not agree to wear diapers?
* If they ask you to wear diapers, just in case you have an accident, and they keep repeating that to you even though you told them that you are not wearing diapers, isn't that some kind of problem for you? If you told them no once, shouldn't that one no be enough for them to understand that you are not incontinent?
These are some questions that some nursing home residents are asking us and they are needing our help to get answers for them. They need your help in seeing that they are not alone and in seeing that people are beginning to know what is happening inside those camps. I mean, inside those nursing homes and inside those rehabilitation and care centers.
Help!
Thank you. I am trying to get your attention here and I hope that I got someone's attention. If you are sitting there wanting to go to another website now and not wanting to read any further, I beg you; I implore you to bear with me a little and please participate in this communication. Here are my questions:
* What would you do if a nurse insisted that you wear diapers but you know that you are not incontinent? How would you answer the nurse?
* Would you have any fear in saying --no, I do not need diapers?
* Have you been in that position in a nursing home or in a rehabilitation center?
* What would you do if you sat for hours pleading for help and yet no one helped you inside of that nursing home?
* What would you do if they insinuated that they would leave you for hours in wet and pooped clothing inside a nursing home if you did not agree to wear diapers?
* If they ask you to wear diapers, just in case you have an accident, and they keep repeating that to you even though you told them that you are not wearing diapers, isn't that some kind of problem for you? If you told them no once, shouldn't that one no be enough for them to understand that you are not incontinent?
These are some questions that some nursing home residents are asking us and they are needing our help to get answers for them. They need your help in seeing that they are not alone and in seeing that people are beginning to know what is happening inside those camps. I mean, inside those nursing homes and inside those rehabilitation and care centers.
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