Workers' Compensation: Old age

Showing posts with label Old age. Show all posts

Sunday, November 24, 2013

The ePrognosis App: How Calculating Life Expectancy Can Influence Healthcare Decision-Making

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com

By Leslie Kernisan, MD

Last month an intriguing new decision support app launched, created by experts in geriatrics and palliative care. It’s meant to help with an important primary care issue: cancer screening in older adults.
Have you ever asked yourself, when considering cancer screening for an older adult, whether the likely harms outweigh the likely benefits?
Maybe you have, maybe you haven’t. The sentence above, after all, is a bit of wonky formulation for the following underlying questions:

How long is this person likely to live, given age and health situation?
Given this person’s prognosis, does cancer screening make sense?

The first question seems like one that could easily occur to a person — whether that be a patient, a family member, or a clinician – although I suspect it doesn’t occur to people perhaps as often as it should.
As for the second question, I’m not sure how often it pops up in people’s minds, although it’s certainly very important to consider, given what we now know about the frequent harms of cancer screening in the elderly, and usually less frequent benefits.
Furthermore, there is abundant evidence that “inappropriate” cancer screening remains common. “Inappropriate” meaning the screening of people who are so unwell and/or old that they’re unlikely to live long enough to benefit from screening.
For instance, one astounding study found that 25% of physicians said...

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Wednesday, October 23, 2013

Questioning Statins for Older Patients

Limiting medication can reduce overall patient care costs. The efficacy of controlling cholesterol in the "very old" population is now being discussed. Today's post was shared from the NYTimes.com.

Should older adults take statins if they have elevated cholesterol but no evidence of heart disease? It’s a surprisingly controversial question, given the number of seniors taking statins.

Recently AMDA, a professional group representing physicians working in nursing homes, highlighted the issue in a list of five questionable medical tests and treatments. The list was drawn up as part of the national “Choosing Wisely” campaign, which alerts consumers to inappropriate or overused medical interventions, an effort that caregivers would do well to follow.

The standout item on the AMDA list: “Don’t routinely prescribe lipid-lowering medications in individuals with a limited life expectancy.” That means anyone older than 70, according to the medical society.

Dr. Hosam Kamel, an Arkansas geriatrician who is vice chair of AMDA’s clinical practice committee, said that there is scarce scientific evidence supporting the use of statins by 70- or 80-year-olds without pre-existing cardiovascular disease. Only a handful of studies have focused on outcomes (heart attacks, strokes, premature death) in this older population.

Most of the data on the benefits of statin use come from larger studies that looked at adults of varying ages. The results...

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Monday, October 14, 2013

California To Regulate New Home Care

Injured workers have been receiving home health care at increased rates as hospitals and rehabilitation cnters are releasing recuperating workers quickly under discharge protocols. Today's post is shared from the NY Times.

California has become the latest state to tighten oversight of home health agencies that provide custodial care — help with bathing, dressing, toileting and other basic tasks — to older adults and people with disabilities.

Gov. Jerry Brown on Sunday signed the Home Care Services Consumer Protection Act of 2013, which will require agencies to conduct background checks on workers, provide five hours of training, list aides in an online registry and obtain a license certifying their compliance with basic standards. Home health agencies had opposed the bill’s training and background check requirements.

The governor vetoed a similar bill last year; this year’s version dropped a requirement that aides hired from referral agencies or directly by seniors get background checks and be listed in the online registry. Mr. Brown also asked for a delay in putting the legislation in place until January 2016.

Critics have long argued that the home care industry has been too lightly regulated. According to a new study in the Journal of Applied Gerontology, only 15 states require training for home care workers or on-site supervision of their activities. Altogether, 29 states mandate that agencies be licensed.

The move to tighten industry...

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Thursday, September 12, 2013

Getting While the Getting Is Good

Preparing for disability can only go so far. Sometime pre-emptive action needs to be taken. This is an example of what aging workers need to consider. Today's post was shared by The New Old Age and comes from newoldage.blogs.nytimes.com

“Don’t wait for a crisis,” I told a friend whose elderly parents were struggling to care for themselves and a big Connecticut home.

“Don’t wait for a crisis,” I told another friend, his mother recently widowed, lonely and overwhelmed, rattling around in a family house that was now her solo responsibility.

“Don’t wait for a crisis,” I told a third friend, whose widowed father-in-law dropped his daily insulin regimen after his live-in girlfriend left him.

“Don’t wait for a crisis,” I’ve told readers of “The New Old Age,” no doubt ad nauseam.
As just about everyone who has cared for an aging parent knows, getting old is both an inexorable and maddeningly unpredictable forward march. Everything is OK. Then it’s not. Then it is again. What felt early on like a roller coaster becomes the new normal. In between swerves and plummets, it is almost possible to doze off.

And planning for all possible eventualities is useless — after the essential documents are in place, the family has talked openly and often about end-of-life wishes, they understand the difference between Medicare and Medicaid, they know how much money is available and that it is probably not going to be enough.

Caregivers and their elderly charges both know, in a spoken or unspoken way, that on the horizon is The Crisis. That’s the one that demarcates “before” and “after.” Your parents...

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Sunday, November 24, 2013

The ePrognosis App: How Calculating Life Expectancy Can Influence Healthcare Decision-Making