How Do You Qualify for Home Care?

As you may have surmised from the title of this post, today, I will be talking to you about how you qualify for home care. The source I'm using is from the Centers for Medicare & Medicaid Services website, a .pdf file called "Medicare and Home Health Care". I'll be paraphrasing most of this, as it's pretty basic already, but at least you can use this blog as a one-stop-shop for medical news and information.

Here are the requirements:

1. You must be under care of a doctor, and the services you get must be under a plan of care established and reviewed regularly by this doctor.

2. A doctor must certify that you need at least one of:

• Intermittent skilled nursing care
• Physical therapy
• Continued occupational therapy
• speech-language pathology services

3. The home health care agency taking care of you must be Medicare-certified, which, luckily, we are!

4. A doctor must certify that you are homebound, which means:

• Leaving home takes "a considerable and taxing effort," and therefore leaving home isn't recommended because of your condition.
• Your condition doesn't let you leave home without help from another person, a wheelchair or walker or other form of special transportation.

As for exceptions, you can leave for medical treatment or non-medical reasons, like religious services, so long as they are infrequent. Adult day care is allowed, but you still get the home care services in your home.

So long as your doctor doesn't discontinue your certification for services, and so long as the care is needed less than 7 days per week or less than 8 hours a day for 21 days. Some exceptions are made under special circumstances, but they don't detail those here.

Just so you know, Medicare will cover nearly everything, so don't feel afraid of the cost of letting us help. There are only a few things Medicare doesn't cover:

• Medical services or supplies that you agree to pay out of pocket for. Before you agree on this, we (or any other home care agency) would give you a Home Health Advance Beneficiary Notice.
• 20% of the Medicare-approved amount for Medicare-covered medical equipment like oxygen equipment, walkers, and wheelchairs.
• Private duty care(which we offer, Medicare just doesn't pay for it), like:
• 24-hour-a-day care at home
• Care (like bathing, dressing and using the bathroom) given by home health aides when this is the only care you need
• Services not outlined by your plan of care, like housemaking services (shopping, laundry, cleaning) when this is the only care you need
• Meal delivery

That should cover everything! As always, feel free to visit the Reliance Home Health Care of South Florida website if you have anymore questions or want more information about us. Thanks for reading, and have a fantastic day!

Reprint of a NAHC article

From www.NAHC.org


Most Seniors Open to Technology Use in Their Homes
Numbers of Seniors Now Using Wellness Technology Still Low, However
Seniors would be willing to use personal health and wellness technology -- even at a cost of some personal privacy -- if it will help allow them to live in their homes for as long as possible, according to a new study released by AARP. In the study, "Healthy @ Home 2.0," seniors said they would use technology such as a remote monitoring device or medication monitor/planner to remain independent in their homes.
The report is a follow-up to AARP's 2007 study analyzing factors that influence technology use among seniors (persons age 65 and older) and their caregivers that would help them live independently.
The report found that approximately two-thirds of seniors currently use personal computers to communicate with family and friends, while half use their personal computers to search for health information online. Seniors reported that they use their personal computers because it saves time and also helps give their family and friends peace of mind.
Among the study's findings:

• 20 percent of seniors reported that they'd be willing to use an electronic pill box that shares medication compliance information with their health care provider;
• 25 percent said they'd be willing to use a system that lets them send info to their provider and have a video conference;
• 34 percent said they'd be willing to use a system that lets them send their health information to their provider; and
• 54 percent are willing to use a personal emergency response system.

A significant majority of seniors participating in the study, 70 percent, said they would be willing to have their doctors diagnose their conditions using technology that receives their health information from another doctor. Slightly less, 68 percent, said they'd be willing to have their doctors diagnose their conditions using technology that receives their health information directly from their homes, and slightly more, 73 percent, said they'd be willing to have their doctors provide follow-up care while sharing health information received from other doctors remotely monitoring their conditions. And 68 percent said they would be willing to have their doctors provide follow-up care while using telemedicine technology that receives their health information from remote monitoring devices directly in their homes.
Although the number of seniors who indicated willingness to use technology for health and wellness, the actual number of those currently using it remains low, according to the study. Less than one in 10 seniors currently uses a personal emergency response system such as a medical alert, bracelet, or necklace, or the devices that automatically contact first responders. Even fewer are using technologies that enable them to share their health information with their providers. These technologies would include a personal health record (PHR) or telehealth solutions like a remote monitoring device which would allow the patient and doctor to communicate remotely using a video connection or would allow certain clinical data to be collected through a device and shared with the provider remotely.
Comparably, 81 percent of caregivers ages 45 to 75 report that they communicate with family and friends using a personal computer, and 71 percent said they search for health information online. Caregivers reported they believe personal computers are reliable, could save them money, give them peace of mind, and make the person they care for feel safe.
Caregivers attribute some of these same benefits to using personal health and wellness devices, yet 67 percent believe these solutions costs too much to install and maintain. Half of caregivers reported that they do not believe these technologies are available to the person they help; 48 percent said they believe that the technologies would be difficult to learn how to use; and 42 percent said they believe the technologies are an invasion of privacy.
NAHC and its Home Care Technology Association of America (HCTAA) affiliate believe these trends are additional clear indicators that more resources are needed to support education and adoption of health IT in the home. NAHC and HCTAA are calling on members to urge their senators to cosponsor the Fostering Independence Through Technology (FITT) Act (NAHC Report, 3/11/11). The FITT bill would create pilot projects within Medicare that would provide incentives to home health agencies for the adoption and use of remote monitoring and other communication technologies.

Reliance News - Accountable Care Organizations

Reliance is looking to partner with health care organizations to form an Accountable Care Organization (also known as an ACO) to work towards managing patients’ health care and outcomes. Reliance’s outcomes for patients are incredible – better than state and national averages. When providers partner up, they should always look towards those providers that are delivering high quality health care while minimizing costs. Part of our success comes from educating patients, empowering them to work toward independence from health care, and teaching them that dialing 911 doesn't have to be their first route of action in every circumstance. Rather, through this education and our own telehealth technologies (as mentioned in an earlier blog), we make sure that patients don't pay a dime for health care (especially emergency health care) until it is absolutely necessary and appropriate. While this alone can save hundreds of thousands just for our local partners, we can never look to risking health at the cost of saving a few bucks. 

Speaking of telehealth, Reliance is partnering with an electronic monitoring company to carry out many of their programs. We are using telehealth for safe remote care and support, so patients can easily contact us, sometimes by just a single push of a button, and let us know if you think you may need to go to the hospital, or ask us if you need to spend such large amounts of money on those expensive medications if you don't have to. That's why we're called Reliance: you can rely on us to keep you safe and comfortable, but you can also know that you can turn to us with any questions you may have as well.

For questions about ACOs, the NPR website has a great Q&A page.

For anything else, there's always us: Reliance Home Health Care 

Aging in Place

Aging in place

I mentioned in an earlier blog that Aging in Place is one of the myriad services we offer, since our very own Liz Ligeti and Rosie Castro are trained in helping you "age in place".

Now, if you haven't heard of Aging in Place before, you probably don't know that it is a way of making sure you can live in your home comfortably and safely for as long as possible. Often times, this may consist of remodeling your home to include things like bars in hallways for you to hold to maintain your balance, or making sure appliances and cupboards are lower and every room is accessible to you if you happen to need a wheelchair. Other scenarios may include taking things away, rather than installing them, so that your movement throughout each room isn't impeded by potentially treacherous corners or installments.

We are all getting older. We all age differently. Aging in Place ensures your safety and comfort while you do. For more information, visit http://aginginplace.com/.

Or contact Liz Ligeti at: http://reliancehomehealthcare.com/contactus.html

MS Causes & Treatments

Special thanks to Andy Primm for the first request for an informational blog! While you can find lots of information at The National MS Society's website, I will do my best to tell you all about the causes and treatments of Multiple Sclerosis (MS).

First, let's talk about what MS is. According to the website above, "Multiple sclerosis (or MS) is a chronic, often disabling disease that attacks the central nervous system (CNS), which is made up of the brain, spinal cord, and optic nerves. Symptoms may be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision. The progress, severity, and specific symptoms of MS are unpredictable and vary from one person to another." There are four different courses that people with MS may experience, ranging from mild to severe.

1. Relapsing-Remitting: With this kind of MS, people find that they will have "clearly defined attacks of worsening neurologic function." The attacks are usually called relapses, and are followed either by patial recovery periods or complete remission. About 85% of MS patients are intially diagnosed with this type.
2. Primary-Progressive: Without any notable remissions, this type is characterized by slowly worsening function from the beginning. While rates of progression might vary from person to person, the disease may plateau or improve occasionally.
3. Secondary-Progressive: This type starts with the Relapsing-Remitting type, but a secondary disease type develops which worsens progressively. Without medication, about half of the first type develop Secondary-Progressive MS.
4. Progressive-Relapsing: This one is pretty rare (only 5% of MS patients have this). It steadily worsens and has attacks of worsening neurological function. Unfortunately, there are no remissions.

Apparently, there is no known cause for MS, although scientists are working on it. That's why donations and grants to research are so important, so scientists can prevent, treat, and possibly even cure it. Factors/Causes being studied include:

• Immunologic: MS involves an autoimmune process, in which research is being done to find ways of preventing this progress, although researchers and scientists don't yet have the entire picture figured out.
• Environmental: Studies show that MS occurs in places further from the equator, according to the website (which neglects to say exactly how far one has to be from the equator for this to be likely). Strangely enough, the website says "Studies of migration patterns have shown that people born in an area of the world with a high risk of MS who then move to an area with a lower risk before the age of 15, acquire the risk of their new area. Such data suggest that exposure to some environmental agent that occurs before puberty may predispose a person to develop MS later on." Some scientists think sunlight helps prevent MS, as it helps produce vitamin D, which in turn benefits a person's autoimmune function. Other scientists study clusters of above-average numbers of people with MS that live near each other in an attempt to see if there are any environmental factors that may contribute to the disease.
• Infectious: Some viruses and bacteria cause effects similar to MS, so it's possible that these disease may trigger MS.
• Genetic: Apparently, "MS is not hereditary in a strict sense, having a first-degree relative such as a parent or sibling with MS increases an individual's risk of developing the disease several-fold above the risk for the general population." This goes into genetic studies and predisposition to environmental triggers to MS, though more research into genetics is the only way to know for sure.

Disproven causes include: aspartame (the artificial sweetener in many diet sodas), allergies, physical trauma, exposure to heavy metals, and small animals.

Like I mentioned earlier, there is no cure yet for MS, though there are now ways to modify the type (or "course") of MS mentioned above, manage symptoms, improve function and safety, and treat the attacks and relapses. Medication, combined with therapy, assistive devices, and the person caring for his- or herself, can go a long way in fighting MS.

For a more information, along with a full list of disease-modifying agents, click here. If you or a loved one are looking for an MS support group, visit this website.

If you have anymore questions, please feel free to ask. Or, if you would like me to write a blog about anything else health-related, please leave a comment, and I will do my best to blog about it in a timely manner. Thank you, Andy & the rest of my readers. Have a great rest of your day!

Private Duty

Did you know that Reliance also offers private care? That's right! Whether it's for just a few hours a day, or 24/7, we can take care of you. Here are some of the private care services we offer at Reliance Home Health Care in South Florida:

Bathing & Dressing
Light housekeeping
Laundry
Meal Preparation
Caring Companionship
Bathing & Dressing
Walking Assistance
Transferring
Errands & Transportation

Grocery Shopping/Errands
Medication Reminder
Doctor Appointments
Alzheimer's & Dementia Care
Fall Prevention
Change Linens & Bed Making
Play Games or Cards
Attending an Event
Home Safety Evaluation

We have certified home health aides and registered nurses that can attend to any of these needs. We have done background checks on ever aide and nurse in our employ, so you know you're in good hands with Reliance. Our services - which include respite care - can be at your home, in a hospital setting, or an assisted living facility (ALF). Lastly, we also do short-term post-op care for those of you who have recently undergone surgery, including plastic surgery.

Thanks for reading!

Telehealth

Good morning, everyone! I hope you all had a good Cinco de Mayo. Today, we'll be talking about telehealth, another service we're beginning to offer here at Reliance.

Most of my information comes from this website: www.hrsa.gov

So, what is telehealth? Basically, it's a way of using new information and telecommunication technologies to aid in long-distance health care. We can contact patients using video streaming, the internet, wireless communications, and video to ensure all your needs are met without disrupting your routine or otherwise interrupting your time.

If you've ever seen the Lifeline commercials (think "I've fallen and I can't get up!"), then you have already seen an example of this. With the press of a button, you can inform those on the other end of your communications device that you need assistance, cutting down on some of the worry you may be facing and the possibility of having to pay huge hospital bills for something we could have resolved for you. Also, we can send you messages, such as reminders to take your medication, or just a simple check-in message to make sure you are doing all right. These are just a few examples of "remote coaching," another perk of telehealth.

Equipped with your Personal Emergency Response System (or PERS), you will both feel and be safer in our hands.

PERS is also just one aspect of the Aging in Place program, which I will explain in a future blog.

Thanks for reading, everyone, and have a happy Mother's Day this weekend!

Vestibular Rehabilitation Therapy

Since the previous post was so short, I figured we'd tell you about another service we at Reliance Home Health Care now take part in for our clients in the South Florida area.

For those of us who learn best when pictures are involved, the vestibular nerve is #16 in the diagram above.

Now, Vestibular Rehabilitation Therapy, which we'll just refer to as "VRT" in the future, is a way to compensate for loss of balance due to problems in your inner ear. It can help for certain kinds of vertigo and reduced inner ear function in one or both ears, which may be due to a number of issues.

So, why is VRT important? Well, those tiny vestibular organs can get injured or may not work well due to an illness. Once that happens, you may start to feel dizzy, experience vertigo, or lose your balance easily. Oftentimes, even people who balance with the help of a walker, for example, fall and injure themselves because of this. Sometimes, people want to cut corners and decide not to use their walker to reach something just a few feet away. But those few feet can be deadly to someone with osteoporosis and little to no balance. This is merely one example of many for why VRT is so important. Without the treatment, if your body doesn't heal normally, of course, your body will try to develop other methods of balancing, but these can be ineffective and can also lead to issues of their own. VRT trains the brain to process signals from other areas of your body in order to maintain balance.

Here's how VRT works: first, a physical or occupational therapist (PT and OT, respectively) take your medical history, and test your balance. They may also do some hand-eye coordination tests. They may also ask you some questions based on your lifestyle changes or the severity of your symptoms. The results from these tests and questionnaires get made into a treatment plan of how best to retrain your brain to help you regain your balance. Don't be alarmed if your symptoms get worse briefly after you begin VRT -- this can happen, but if you stick with the exercises, you will most likely be far better off than you were before. Sometimes, you may get sick and the symptoms can return, but simply returning to the exercises should bring you back to normal, so long as no additional vestibular damage has been done.

This information was taken from this website. If you have anymore questions, post them here or visit us at our website, which I linked to above!

Transitional Care Management

So, we're changing things up a bit here at the Reliance HHC blog. We'll now begin telling you about the vast array of services we provide. Let's start with our transitional care management program.

Transitional care management (or TCM, for short) refers to the care given during the time between health care practitioners and settings change, depending on their chronic or acute illness. This time is important for the patient undergoing the transition. For example, if a person is discharged from the hospital, but suffers an accident at their home within the next 30 days, they are re-admitted. This increases the risk to that person's health, costs money and manpower, and takes up a much needed hospital bed for something that very well could have been prevented. And that's exactly what we do; we prevent accidents and injuries that shouldn't happen in the first place, but invariably do to many thousands of people every year.

For the original care transitions program set in place by Dr. Eric Coleman, visit his website.