“Avoidable” and “Unavoidable” Pressure Sores

The development of pressure sores on a client can easily go unnoticed to the untrained eye. They can cause serious infections, some of which can be lethal. Pressure sores are a major concern for any home care company.

The Center for Medicare & Medicaid Services (CMS) categorizes pressure sores under both “Avoidable” and “Unavoidable”. These definitions serve as a map for potential malpractice situations, and need to be understood by all home care companies.

“Unavoidable” pressure sores are defined as when the client developed a pressure ulcer even though the team had evaluated the client’s clinical condition and pressure ulcer risk factors; defined and implemented interventions that are consistent with client needs, goals, and recognized standards of practice; monitored and evaluated the impact of the interventions; and revised the approaches as appropriate.

“Avoidable” pressures sores are termed so because the clinical team was at fault because the process above was not implemented.

Pressure sores will be an unfortunate reality for many of your clients that are at high risk, such as those that use a wheelchair or are bed bound. You can use the CMS definitions as a starting point “checklist” to make sure that your company does everything possible to prevent, address and document pressure sore issues.

It is a good idea to assess each client for pressure sore risks at their first caregiver visit. Provide all of your caregivers with basic training about signs of pressure sores and sore prevention. A handy one page checklist tucked in a client journal can keep caregivers refreshed to this often overlooked, but serious issue.

Future Technology May Help Keep Seniors Safe

Check out the newest post on Private Duty Today for an insight on new robotic research projects aimed to keep seniors safe.

M.M.S. Study on Home Health Care from a Doctor's Viewpoint

A recent research collaboration between the Massachusetts Medical Society and Home Care Alliance of Massachusetts found that doctors supported the benefits of home health care, but found that there were problems within the medical system for wide spread referrals.

From a randomized sample of 3,000 Massachusetts licensed doctors, there were 248 responses from 12 specialties. Over half of the responses were from primary care physicians.

The majority agreed that these services allowed them to better manage their patients’ care, prevented emergency room visits, and reduced family stress.

Around half of the doctors said that paperwork, payment, and access problems interfered with home health services for their patients. Half stated that they had to keep patients in the hospital for a longer period simply because there was difficulty finding home health services.

I would like to thank The Boston Globe for providing much of the information. You can read their article here.

North Carolina Nurses Educate Legistlators About Effects of Medicaid Cuts

The state senate has recently approved a $55 million dollar budget cut to the Medicaid Personal Care Services (PCS) program. More than 36,000 elderly and children with mental/physical disabilities in North Carolina rely on these services as a part of their daily lives.

The North Carolina Association for Home and Hospice Care (AHHC) and its 900 agency membership have made efforts to educate the state legislators and communities about the devastating effects. The team points out a significant economic loss if the state forces many of these elderly patients into nursing homes, where care costs can nearly quadruple.

Encouraging Communication with Alzheimer's Patients

Caregivers need to understand how to listen to and communicate with their Alzheimer’s patients. This is essential for understanding their needs and developing a friendly relationship between caregiver and client. Make your caregivers aware of these simple steps.

• Be Patient. Alzheimer’s patients may have difficulty finding the right words to describe what they are thinking. They may stay silent when they are trying to organize the words in their head.
• Eliminate Distractions. The tv, phone, magazines, etc. may be inappropriate to use when conversing with your client. If your client is talking during a movie, turn the volume down. If you are on the phone, tell the person to hold for a couple of minutes.
• Agree to Disagree. Expect that the opinions, habits, and interests of your client will be vastly different from yourself.
• Be Reassuring. Alzheimer’s patients may be tempted to give up on communicating because of frustration or anxiety. Encourage your clients to speak their mind in their own words and that what they have to say is important to you.
• Be Positive. Remember to smile when you listen to your clients! Expand on positive statements that your clients bring up.
• Take Interest in Feelings. Emotions may be some of the easiest subjects for a client to express because they experience them daily. Highlight a good day or when you catch your client smiling or laughing.

Boomers May Face Bankruptcy and Long-Term Care Collapse

Check out a related article, posted on Private Duty Today, that explains more.