Wheelchair Users: People who Take Action

Crystal Evans seeks a new image for wheelchair users. This is a story from Boston about a woman living with a neuromuscular disease who figures out a way to use her power wheelchair to shovel snow, helping not just herself but her neighbors too!

http://www.wcvb.com/news/braintree-woman-shovels-town-sidewalks-from-wheelchair/31435238

Finally, Home Health Aide recognized as a member of the Patient's TEAM!

In a 2013 agreement reached with CMS in NYS, policy wonks saw the benefits of including home health aides in the Interdiscipinary Teams (IRTs) required by the Fully Integrated Duals Advantage (FIDA) program. Designed to provide Medicare-Medicaid enrollees with a more coordinated, person-centered care experience, this is the latest attempt to bring the costs of people who are dually eligible for both Medicare and Medicaid, traditionally a high cost population.

In addition to the Participant (or designee), each IRT will be comprised of a Primary Care Physician, a Care Manager, Behavioral Health Professional,the patient's home health aide,and other providers as requested by the participant.

Finally, policies are reflecting the reality of the caregiving experience: it is about supporting a patient's ability to function in their own home, optimizing their health status to the best of everyone's ability.

See: http://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialAlignmentInitiative/New-York.html

NPR: Zwerdling highlights the physical burden of lift-transfer

On February 4th and again on February 10th, Daniel Zwerdling (renowned investigative reporter for NPR's "All Things Considered" afternoon segment) covered the physical demands caused by lifting and transferring patients. His sources are hospital-based nursing staff, but the stories and observations can apply to both unpaid family caregivers and paid home health workers as well.

We would urge Daniel to include the patient's point of view in his coverage. Though ceiling lifts may address a "pain point" for the caregiver, the care recipient still has to wait, gets hoisted through the air (my mother used to think of this as being treated like cattle), and in general is subjected to a dehumanizing interaction with equipment. They have no control or say in the process.

Contrast that with putting the toileting assistance equipment in the hands of the patients. They control the height of the bedside commode, they are able to manage the transfer board so that they feel fully supported, and they get themselves on and off without having to wait for someone to help. While this may not be the answer for everyone, a substantial proportion of those needing toileting assistance will benefit from a solution that incorporates their needs as well as those of the caregiver.

AND, it removes a source of injury from the caregiving experience, while generally enhancing the quality of caregiving for all involved. We understand that a third segment will air next Thursday, 2/18 in the afternoon "All Things Considered."

http://www.npr.org/2015/02/04/382639199/hospitals-fail-to-protect-nursing-staff-from-becoming-patients

Taking a risk on SMART Home Med Equipment

In the sleep therapy market, one company that invested in embedded patient monitoring data found that the risk was rewarded: "... a 25% increase over the same period last year. Driving the popularity of the AirSense 10, Farrell said: the Air Solutions platform, which includes, among other things, a monitoring and compliance management system.

Healthcare informatics is now a core competency for our company,” he said. “It is a major area for investment that we are using to drive customer value. We are leading the digitization of medicine in the respiratory space, and we are just getting started.”

Home Med Equipment Providers, Not Just a Business

"As an HME provider, you don’t just sell products. You help people feel better. You help people feel whole. You help people feel self-reliant and self-confident again." - See more at: http://www.medtrade.com/news/legislative-advocacy/Empowering-Customers-with-Instant-Connections-2260.shtml?utm_source=Silverpop&utm_medium=email&utm_campaign=47884296&utm_term=8333315&utm_content=#sthash.OjLXxwPB.dpuf

"You May Be Uncomfortable Providing This Type of Care"

There are many Caregiver manuals available on the internet that offer guidance on providing assistance with activities of daily living. For example, see "Family Caregiver Handbook," State of Washington, http://www.dshs.wa.gov/pdf/Publications/22-277.pdf.

It is not uncommon to find this phrase, "You may be uncomfortable providing this type of care" only in the section addressing toileting assistance. Speaks volumes about the "yuk" factor associated with toileting? Yet another indication that improvements in toileting caregiving/carereceiving are long past due.

Unique Collaborations Needed to Improve Home Med Equipment

Seeking Alpha (seekingalpha.com) reports on July 29th: Novartis (Pharma), Medtronic (Med Device), Oracle (Software) and Kaiser Permanente (Health System) among those providing Proteus Digital Health with $172M to develop "a 'smart pill' that a patient swallows. It records data on the internal milieu and transmits it externally via a patch on the abdomen. Reactions with stomach juices provide the power."

Hopefully, companies will grow in their willingness "to play with others" to get cross-cutting improvements in healthcare interventions to market. No longer do the solutions sit within the domain of any one sector!