CRITICAL NEW INFORMATION ADDED TO NURSING HOME COMPARE WEB SITE
April 24, 2008 -- CMS -- For the first time, the Centers for Medicare & Medicaid Services (CMS) Nursing Home Compare Web site will list whether a home is or has been on CMS’ special focus facility (SFF) list. The agency’s SFF initiative gives heightened scrutiny to nursing homes that have a history of poor performance or repeated violations of state and federal health and safety rules. Read more >>
TIP OF THE WEEK
Resident Safety in the Great Outdoors
The sun is shining and the birds are singing. Everyone is just itching to get outside and enjoy the blue skies and warm breezes. Nursing facility residents who want to join in the fun should be encouraged do so, but they need to venture outside safely. The basic outdoor hazards apply to everyone from child to elder, with specific considerations for our unique population.
PROTECTING AGAINST SUNBURN
The greatest sun damage occurs between 10 a.m. and 4 p.m. This is when the sun’s ultraviolet rays (UVA and UVB) are at their strongest. However, these rays are always present, so damage can result even on cloudy days or outside of the peak hours. Protect residents’ skin when they go outside with an SPF 15 or higher sunscreen. Sunscreen, even water resistant types, must be reapplied every two hours to be effective.
Also consider the type of clothing residents are wearing. A typical white tee shirt has a three SPF, so it does not offer much protection from damaging rays. Wearing long sleeves, long pants, and a hat are recommended. Remaining in shady areas will also help to protect residents from the sun. [1]
There are many common medications that cause photosensitivity. Examples include Zoloft, Paxil, Zyrtec, Cipro, Levaquin, Zyprexa, Risperdal, Cardizem, Zocor, Lasix, Glucotrol, Motrin, and Depakote. [2] Special attention to sunscreen and protection against UVA and UVB rays should be paid to residents who are taking these medications.
HEAT EXHAUSTION
According to the National Oceanic and Atmospheric Administration (NOAA), there were 253 deaths in 2006 caused by heat with 58 percent of them occurring in people over the age of 60. Heat is the number one killer among weather-related fatalities. [3] Certain factors can compromise the human body’s ability to cool itself including illnesses, medications (beta blockers, diuretics, antihistamines, tranquilizers, and neuroleptics), or compromised ability to perspire. Obesity also impedes internal temperature regulation and causes retention of more heat.
Consider the following steps to prevent heat exhaustion:
- Wear loose fitting, lightweight, light-colored clothing
- Avoid sunburn
- Drink plenty of fluids avoiding caffeine
- Avoid hot spots like a car
- Rest frequently if walking in heat
- Remain in air conditioning
The signs and symptoms of heat exhaustion are heavy sweating (often not seen in the elderly); faintness, weak, and rapid pulse; low blood pressure; nausea; low-grade fever; headache; and dark urine. To reverse heat exhaustion, help the resident get to a cool place, loosen clothing, offer cool water, and apply moist, cool towels to the skin. If these are ineffective, contact the resident’s physician immediately. [4]
HEAT STROKE
If left unchecked, heat exhaustion can develop into a life-threatening situation, often referred to as heat stroke. The medical indicators of heat stroke are:
- Body temperature 104 degrees or higher
- Cessation of sweating (not a good indicator in the elderly)
- Hyperventilation
- Rapid heart rate and pulse
- Neurological symptoms like seizures, hallucinations, confusion, and coma
- Muscle cramps, muscle rigidity, or weakness
Until emergency medical assistance arrives, immediate cooling of your resident may prevent brain damage and/or death. [5]
INSECTS
Aside from being a terrible annoyance, mosquitoes and ticks can also cause serious disease. Mosquito-borne West Nile Virus has already been reported this year in Arizona, Mississippi, and Tennessee. To prevent mosquito and tick bites, follow these precautions:
- Use insect repellent
- Eliminate standing water that can be a mosquito breeding site
- Repair any holes in window or door screens
- Avoid outdoor activity during peak hours – dusk to dawn
- Control ticks in wooded areas around the facility
- If exposed to wooded areas, check your residents for ticks
West Nile Virus and tick-borne Lyme disease both have similar presentations: fever, headache, body aches, and fatigue. Additionally, Lyme disease causes a characteristic rash (erythema migrans) in 80 percent of the cases. Lyme disease, if treated early, generally has a short course of a few weeks but can linger for months if left untreated. [6] West Nile Virus is the less serious, more common form of the disease, which usually presents as unexplained encephalitis or meningitis. Surprisingly, 80 percent of people infected with West Nile Virus never show any symptoms. [7]
Remind family members and volunteers assisting you with outdoor activities of these and other hazards such as wandering, falls, and wheelchair safety. For everyone to truly enjoy the great outdoors, it is important to respect each resident’s individual preferences and abilities, and to assist those who need help with curbs, stairs, and wheelchair locks.
The beautiful weather of spring and summer is here – enjoy it!
RESOURCE SPOTLIGHT
Look at Me Video
This video depicts an elderly man reflecting on a life well-lived, and offers a touching perspective of the elderly. It describes the goals and responsibilities of the VA Medical Centers, recounting the needs of elderly veterans. This video has implications for the care of all elderly in the long-term care continuum.
IN THE NEWS
FDA CLEARS GLOVE MADE FROM NEW TYPE OF LATEX
April 23, 2008 -- FDA -- The U.S. Food and Drug Administration has cleared for marketing the first device made from a new form of natural rubber latex, guayule latex. The product is derived from the guayule bush, a desert plant native to the Southwestern United States. Read more >>
$300 FEDERAL REBATE IS OPEN TO NURSING-HOME RESIDENTS
April 22, 2008 -- Cleveland Plain Dealer -- With a pen and a 1040A form from the Internal Revenue Service, you can help nursing home residents on Medicaid to get $300 of spending money with the federal tax rebate. Read more >>
SENIORS NO STRANGERS TO HAPPINESS
April 22, 2008 -- HealthDay -- Older Americans are quite satisfied, while Baby Boomers are the least content, survey shows. Surveys of Americans taken since 1972 suggest that plenty of older people are quite happy, with more than half of black men and women over the age of 80 saying they're "very happy," with older white men and women following suit. Read more >>
CMS PROPOSES MORE ACCURATE PAYMENTS FOR INPATIENT REHABILITATION SERVICES IN FY 2009
April 21, 2008 -- CMS -- Due to statutory requirements in the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), the Centers for Medicare & Medicaid Services (CMS) will apply a zero percent increase factor for Inpatient Rehabilitation Services (IRF) payment rates for FY 2009. As a result, CMS expects to spend roughly $5.6 billion in FY 2009 and approximately $30 billion in the next five years for IRF services. Read more >>
CMS RELEASES NEW QUALITY REPORTING OPTIONS FOR PHYSICIANS
April 17, 2008 -- CMS -- CMS released new reporting options, including registry-based reporting, to make it easier for physicians to participate in the Physician Quality Reporting Initiative (PQRI). Read more >>
INDUSTRY EVENTS
NAVIGATING THE MDS THROUGH THE OHIO MEDICAID REIMBURSEMENT SYSTEM
May 1, 2008, 8:30 a.m. to 4:45 p.m. ET
Speakers: Claire Spellmire, RN, BSN, and Karen Jennings, LNHA, MHA, from the Case Mix Section, Bureau of Long Term Care Facilities, Office of Ohio Health Plans.
Cost: Free
For more information or to register, call Cheryl Robertson at (614) 466-9088.
Space is limited to two per facility.
Cuyahoga Community College Spring ’08 Continuing Education
Schedule for Gerontology Professionals
Health Policy Institute of Ohio: Regional Meetings on the Ohio Family Violence Prevention Project
Consistent Assignment – The Practice and the Experience
June 3, 2008, 2:00 to 3:30 PM. Register now. (registration closes May 29, 2008)
Dial in to this teleconference hosted by the Advancing Excellence in America’s Nursing Home Campaign to learn what consistent assignment really is, why it works, and how to do it! We’ll also hear from several nursing homes that have done it and been successful at it.
Handouts will be available after May 29, 2008 on www.nhqualitycampaign.org.
Medicare Learning Network: Learning resources and products for the healthcare professional.
Alzheimer’s Association Training Events
Case Western Reserve University School of Medicine Courses
Ohio Department of Health, Technical Assistance Program – New Programs
Ohio Health Care Association Events
An archive of The Nursing Home Weekly Update is available on our Web site. Click here >>
Clinically driven. Client focused. Value based.