Phil Chuang, PhD, FHIMSS is the CIO for Sutter VNA and Hospice, a Northern California not-for-profit affiliated with Sutter Health System. Edward Elliott is the agency’s Technical Services Manager. Like many in their positions, they learned more than they thought they would during the process of implementing a clinical point-of-care system across multiple branches. The duo shared those real-world insights with a SRO audience at this week’s HIMSS meeting in a presentation entitled “EHR To Go: Opportunities and Challenges of Mobile EHR Deployment.” (more…)
Like many in their age group, my parents, at 91 and 87, still live in the house they bought shortly after they married. Though the fact of that is not constantly front and center in my awareness, its significance hit me squarely between the eyes earlier this year when I visited my childhood home for a few days to give my mother, Dad’s primary caregiver, a few days off.
As I helped Dad navigate his morning routine — bed to walker to bathroom to walker to the table in the extended kitchen he built with his own hands — the bathroom, admittedly an odd place for deep meaning to present itself, spoke to me. Modern cabinets and fixtures faded from my view as 50s-era linoleum and sinks took their place and the shadowy figure of a very familiar-looking little boy appeared, perched on an antique training seat atop the toilet.
Shaking off the vision, I removed a soiled pair of the “special pants” we had to force on Dad last year and replaced them with clean ones. As I guided his halting footsteps toward the commode, the boy said, “He used to do the exact same thing for you in this very room.”
The realization transcended mere memories of the days when Dad was big and I was small. It was more important than that. Here I was, caring for my frail, incontinent father, not just in any bathroom but in sacred space, the very room where he had cared for me, given me baths, bandaged my knees and taught me to shave.
Dad does not often speak today and, this time, it was just as well. If he noticed the redness that was surely visible in my eyes, the redness that returns as I write this, he did not mention it.
Dad’s legs barely hold him up today, partly from age, partly from living 68 years with some kind of primitive cement-based compound that was inserted in his right shin in 1943 to replace a 4-inch piece of bone that had been shattered by a sniper’s tracer bullet. According to a hometown Pennsylvania newspaper at the time, he had apparently run screaming and waving his arms down a Belgian hillside to draw the sniper from his nest, where the sniper was holding a company of G.I.s at bay. The small band of brothers did finally take the town; one small, forgotten component of the Allies’ victory at the Battle of the Bulge. “My buddy got the guy who shot me,” was the legend I grew up with.
His actual brothers once pointed out to me a three-story Pennsylvania house where they had lived, three-to-a-bed, during the Great Depression, apparently anxious to ensure I knew my heritage fell somewhere between courageous and nuts. “Your father used to do handstands on the top of that chimney,” they claimed. It was not fraternal joking. The story turned out to be true; they just couldn’t remember the name of the girl he was trying to impress.
These are the kinds of memories that make tolerable the work of the family caregiver, a person continually aware, “This is a human being who, though approaching the end, was once young and self-sufficient, a breadwinner and parent, who coached Little League and met his life partner at a square dance, who was capable only a couple years ago of cradling his great-grandchild in his arms.”
Certainly, family caregivers work hard and grow weary, sometimes short-tempered. Yes, they often compromise their own health by putting someone else’s health needs first. Of course, they save the Medicare Trust Fund millions, perhaps billions, of dollars every year. I have written about the financial boon family caregivers offer the U.S. taxpayer as a news item in the pages of this publication but, I have learned through experience, saving Medicare money is secondary to the family caregiver’s experience.
What is primary is that ever-present awareness, “This shrinking body and slowing mind are not the full story of who this person is.” It would be a great gift if family caregivers could put across the full story to those who meet him at age 90 for the first time, people such as home health nurses, therapists and aides.
Family caregivers do not see a 90-pound 90-year-old, they see the soldier, the square dancer, the Little League coach. Whether dressing him or cleaning him or reminding him of his grandchildren’s names, there is no moment when the feats and legends of his youth are not vividly present, living not only in what is left of him but in the people who inhabited the house he built and made sacred by more than 60 years of memory-making.
Every time I walk him from the bathroom to the kitchen, I steal a look over my shoulder at the otherwise ordinary suburban bathroom. A little boy smiles up from his comic book at me and says, “Take good care of him. He’s my Daddy.”
Tim Rowan
December 7, 2011
Jan Erickson was a volunteer caregiver. Answering her church’s call to be of service to the elderly and infirm, she worked with a number of women, one of whom broke her heart before inspiring her to dream, literally. That dream became a specialty clothing company with which home health care and hospice nurses and therapists need to be acquainted. (more…)
by Trisha Tulloch, RN, BSN, MSN, HCS-D
TRISH TULLOCH
In the summer of 2008, we at RBC Limited were privileged to work with two home health demonstration agencies participating with the Centers for Medicare and Medicaid Services (CMS) and Abt Associates to field test the revised OASIS-C. Since that time we have supported dozens of agencies in their transition planning to OASIS-C through leadership, staff education and competencies. To help you plan and refine your agency’s transition processes to ensure success in 2010, this column shares some “Lessons Learned” from those experiences. (more…)
by Trisha Tulloch, RN, BSN, MSN, HCS-D
TRISH TULLOCH
With less than three months until OASIS changes again, home health providers are proactively organizing and finalizing OASIS-C training initiatives to provide up-to-date information on critical new and revised assessment items based on the Centers for Medicare and Medicaid Services (CMS) Guidance. Additionally, agency leadership is assessing the impact of these changes to OASIS and revising agency processes to accommodate those requirements.
This article explains the leadership considerations that can have the biggest impact on home health providers and the decisions that need to be finalized to assure that OASIS-C staff training will enhance clinical practice consistency. (more…)
Congratulations to Ann McCaughan –
First Nurse to Win Frost & Sullivan Lifetime Achievement Award for
North American Remote Patient Monitoring
by Carolyn J. Humphrey, Editor
Ann McCaughan, Chief Operating Officer and Chief Technology Officer of Noninvasive Medical Technologies, Inc. (NMT) is the 2009 Frost & Sullivan Lifetime Achievement Award winner in the category “North American Remote Patient Monitoring.” (more…)
We confront home care and hospice’s toughest problems through five topical newsletters.
Home Health News hopes you will find our newsletters informative, sometimes even inspiring. Please know that your feedback is encouraged to all of our articles but especially our occasional opinion pieces. This will be a place where the home health care and hospice community can learn from each other.
Using Home Health News is easy. Most people select the title or titles at the right that interest them and subscribe to that newsletter. You can also sign up for our RSS feed so that you are notified when breaking news happens.
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When one of our newsletters with its own site, such as “Tim Rowan’s Home Care Technology Report” and “RAC Assistance for Hospice,” runs an especially important or controversial article, we will reproduce it here so that you can comment on it more easily.
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Wednesday, September 23, 2009
1:00 pm ET
During an influenza pandemic, home health care workers can expect to be called on to provide care for hospital patients who are well enough to be discharged but who still need care, as well as patients who need home health care services. On any given day, there are approximately 500,000 patients in home care—three times the number of patients in hospitals. In a pandemic influenza outbreak, the existing home health care population combined with new patients from hospitals is likely to exceed the industry’s current capacity to respond. (more…)
The U.S. Department of Health and Human Services will host a telephone conference on Thursday, August 20 to provide information for healthcare providers about the H1N1 Virus
Title: Information Exchange with HHS on H1N1 Healthcare System Preparedness and Response
Date: Thursday, August 20, 2009
Time: 1:30 -3:00 pm, EDT
Call-in Number: 800-837-1935
Conference ID: H1N1
Agenda
I. Opening Remarks
Chair: Dr. Nicole Lurie, Assistant Secretary for Preparedness and Response
Co-Chairs: Capt. Clare Helminiak, Dr. Sally Phillips, and R.Adm. Ann Knebel
Moderator: Susie Butler, CMS Office of External Affairs
II. Discussion
The purpose of the dialogue is to engage the provider community in a discussion of H1N1 preparedness and response issues. High priority will be put on a discussion of the value and contribution of the primary care
provider networks. We will discuss strategies for:
* reducing the burden on emergency departments
* early identification and intervention with high risk patients
* work force protection
In addition we will discuss emerging issues on the healthcare system surge capacity, critical care planning and home health care preparedness and planning issues as of interest to the participants.
III. Open Q&A
Submit questions and innovative solutions in advance at: H1N1.listening@hhs.gov.
Note: CMS emphasizes that submitting questions prior to the call will allow them to address as many questions
as possible. If you choose, you may wait to speak your question during the call.
The CMS Office of External Affairs would like to hear from you:
* What are your plans to protect high risk patients from H1N1 infection in your clinics/professional settings?
* Have you initiated any early intervention strategies with high risk patients (e.g. home antivirals)?
* What strategies are you planning to prevent unnecessary trips to the Emergency Department?
* How are you addressing an anticipated increased patient volume?
* Could telehealth play a role in surge?
* Could call centers support hospital decompression?
* What can PCP do to help the hospitals and vice versa?
Mark your calendar! A follow-up call on the same topic is scheduled for Monday, September 14, 2009.
Welcome to the industry’s newest news source and community dialog covering issues important to home care and hospice clinicians.
As this site develops over the summer of ’09, you will find here a wealth of information about the things that concern you most as a clinician. Longtime editor of the magazine Home Health Nurse, Carolyn Humphrey, RN, will research and report on OASIS, coding, regulatory issues and patient care.
From time to time, we will introduce other writers, either as a guest or regular columnist, to explore chart documentation questions, ICD-10 news, physical therapy procedures and a growing list of important clinical issues.
Your input will be a major part of this service. Commenting on articles is as easy as registering on the site and clicking on the “comment” tag at the end of every article. We hope that the resulting dialog will be helpful for everyone.
If you are a writer with something to say beyond the scope of a comment, we always welcome article submissions and will try to publish as many as we can. Send them to the editor, Tim Rowan, at editor@homecaretechreport.com.
