A retrospective chart review, including Falls Risk Assessment (FRA) performed at start of care, demographic information, specific physical therapy (PT) evaluation, and visit notes if necessary to determine if the fall met the inclusion criteria. Scores for each individual area of the assessment were collected for statistical analysis. Data were analyzed by a biostatistician using simple linear regression, t-tests, and regression of variable combinations.

The total score on the multifactorial risk assessment tool was shown to have a strong relationship with incidence of falls. The average scores of individuals who fell after assessment were significantly higher than those of individuals who did not fall. No single factors were found to be highly predictive. A single approach to decreasing falls is likely to be less effective than a multipronged approach. Caregivers and providers are advised to consider the entirety of the falls risk and direct comprehensive interventions to address the multiple factors that lead to falls.

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As the number of people with Type 2 diabetes mellitus has grown, so has the number of drugs to treat this chronic illness. T2DM is not a single defect of glucose metabolism rather it is a progressive metabolic disorder with defects in multiple systems (^{Unger et al., 2013}). As more is learned about its complexity, drug therapies in development focus on a multitude of systems and mechanisms. Treatment options have become more complex, it is important for care providers to understand the differences in the various drug classes and insulin preparations. T2DM treatment must also address healthy lifestyle and cardiovascular health; however, this review will focus on hyperglycemia treatment. As with any review, specific drug details are not included. Professionals are encouraged to seek out complete references related to any particular medication.

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A common observation when interacting with patients suffering from multiple chronic diseases is an extensive list of medications, which expands phenomenally as people age (^{Linjakumpu et al., 2002}). By definition, the use of five or more medications is considered polypharmacy (^{Hovstadius & Petersson, 2012}). This phenomenon is very common in older patients and has been associated with an increase in geriatric syndromes, decrease in functional outcomes, and increased mortality (^{Gnjidic et al., 2012}). These poor outcomes are related to adverse drug reactions, falls, and medication compliance (^{Sergi et al., 2011}). Several explanations can account for polypharmacy in the older adults; one such explanation is accumulation of comorbidities that results in consulting multiple providers each prescribing medications for a particular condition independent of other prescribers (^{Randall & Bruno, 2006}). The purpose of this paper is to discuss the issues surrounding polypharmacy in older adults and provide a case example to illustrate the significance of this problem.

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Home healthcare clinicians can improve skin health and well-being for older adults by incorporating simple but thorough systematic skin assessments at every visit. This includes identifying the patient’s personal skin care practices and preferences. Home healthcare clinicians can intervene and address excessive moisture or extreme dryness of skin, use available resources for best practices in wound care, and educate about sun protection.

Although the home care clinician’s role is often multifaceted, the primary reason for visiting the patient may not be related to their skin, yet many of these chronic conditions indirectly affect the skin’s surface. Thus, in order to provide the best evidence-based home healthcare to older patients, clinicians must adequately assess all skin surfaces, not just what is readily visible.

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However, current Medicare home health coverage guidelines have precluded treatment of patients with mental illness by home health agencies (HHAs). Conditions such as restrictive psychiatric clinician qualification requirements, restrictive homebound criteria relative to patients with mental illness, lack of an easily identifiable end point to the disease process of mental illness, and difficulty identifying a skill reimbursable by Medicare make treating this patient population difficult. More specifically, home care practitioners in general fail to recognize the effect of psychiatric conditions on how patients experience medical illness and how these comorbid psychiatric conditions affect patient functioning, engagement in treatment, treatment compliance, and recovery.

The post The Role of the Psychiatric Nurse in Home Care appeared first on Criminal Bar Association.

Because older adults are at increased risk for respiratory disease due to loss of elasticity and decreased ventilation of the lower lobes, specifically inquire about fatigue, weight change, dyspnea on exertion, flu and pneumonia vaccine status, and change in number of pillows used at night (^{Hogstel & Curry, 2005}).

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hysical exam and history taking are essential to evaluate patients with suspected or known heart disease, and to detect early symptoms of worsening heart failure. Home care clinicians have the opportunity to assess the patient in the home environment, identify significant changes in the patient’s status, and form a plan of care for effective intervention to prevent the need for emergency department care or rehospitalization. In this second article of a four-part series, the subjective and objective assessment of the cardiovascular system exam is reviewed.

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Approximately 4 million Americans undergo urinary catheterization annually, and more than 500,000 of these catheterizations involve indwelling catheters left in place for some period (^{Warren, 2001}). Between 15% and 25% of patients may receive indwelling catheters during hospitalization, and the prevalence of catheter use in residents of long-term care facilities is estimated between 7.5% and 10% (^{Saint et al., 2000}). One study found that of 4,010 individuals receiving home care services, 4.5% used an indwelling catheter (^{Sorbye et al., 2005}). Although the indications for catheterization have been extensively outlined, reports of the inappropriate use of catheters range from 21% to more than 50%

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While most Trusted Advisors have a degree of comfort when it comes to things such as estate planning and managing client portfolios, when it comes to making sure elderly clients are healthy and secure in their homes, it’s often a different story.

For nearly 50 years, the NanoCare franchise network has been providing home care services to assist seniors in maintaining or improving their quality of life. From an initial assessment to providing the highest quality of service, NanoCare professionals help you bring health, safety and quality of life information and services to your clients in a manner that protects you and optimizes your client resources.

We’ve prepared a handy discussion guide for Trusted Advisors to use in consulting with their clients. It’s designed to help Advisors identify issues of importance and compare the consequences of the different choices of care that are available at local NanoCare franchise locations.

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Companies seem to dislike the term ‘turnaround consulting’ because it represents failure. The truth is that turnaround consulting represents success at realizing the company is going in the wrong direction. The only time the company fails is when it is not possible to do a turnaround anymore. We help companies pivot into more profitable directions where they can expand and grow.

Companies seem to dislike the term ‘turnaround consulting’ because it represents failure. The truth is that turnaround consulting represents success at realizing the company is going in the wrong direction. The only time the company fails is when it is not possible to do a turnaround anymore. We help companies pivot into more profitable directions where they can expand and grow.

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