Recently in Primary Medical Care Category

The Green House nursing care center for seniors is a relatively new concept in "home-like" care for seniors requiring nursing care. Traditional nursing homes are based on a medical model. The Green House projects are based on a home model -- with a smaller, more homelike building with private space and shared community facilities.

Staffing is also different. Each project is based on 24/7 care, but the duties have shifted from highly specialized care to more family-like care provided by a core team, and supplemented with appropriate medical teams from outside.

Clinical Support Team

The clinical support team is comprised of a Medical Director, Director of Nursing, nurses, therapists, social workers, dietician, and activities coordinator to provide skilled care for the residents as required in the care plan. The Shahbazim are certified nursing assistants with additional Green House training) by developing close relationships with the elders, provide the Clinical Support Team with valuable information to assist in developing the care plan.

Licensed nurses are available to and responsible for clinical care in Green House homes on a 24-hour basis. If the nurse is not in the home and is needed, is available to the Shahbazim and elders via pager and other communication technologies. The Shahbaz

The Shahbaz (plural: Shahbazim) is a universal worker who provides personal care, meal planning and preparation, light housekeeping, and laundry for 7-10 elders. Shahbazim core training as Certified Nursing Assistants receive about 120 additional hours of specialized training to cover The Green House philosophy of care, person-directed care for persons with demenia, household operations, building self-managed work teams, policies and procedures for their project, communication skills, culinary training, safe food handling, and certification in first aid and CPR.

The Guide

The Green House Guide serves as coach and supervisor the the Shahbazim, and is responsible for the overall operations and quality of services in the home. The Guide may be responsible for more than one home, depending on the size of the community.

The Sage

The Green House Sage is a resident elder who acts as a coach or mentor, assists facilitating the development and continued growth of the self-managed work team and to serve as a trusted advisor to the Shahbazim. This is a volunteer position.

Extended Nursing Care Residents

Residents in the Green House are encouraged to participate in shared home activities such as cooking, self care and cleaning, as well as hobby activities and participation in the surrounding community.

Family

Family participation is encouraged and welcomed in The Green House home, from sharing meals to participating in activities and volunteering time and services to help their loved one decorate personal space. Well-behaved family pets are also welcome visitors!

Only projects accepted through the application process and developed in cooperation with The Green House Project team are authorized to provide long-term care services under the licenses service mark: THE GREEN HOUSE®.

A five year pilot project ending in 2010 is reaching its goal of 50 projects across the country. Check the website for locations in your region. These nursing care facilities are often developed by nonprofit groups, churches and even municipalities.

Data from a new Mayo Clinic (http://mayoclinic.edu) study suggest that dietary therapy using flaxseed can decrease hot flashes in postmenopausal women who do not take estrogen.

A hot flash is often described as a flush of intense warmth across much of the body that may be accompanied by sweating, reddening of the skin, or, occasionally, cold shivers. Hot flashes occur in varying frequency and duration, even during sleep, and often cause or accompany sleep deprivation, anxiety and irritability.

Although until recently hormone replacement therapy was the most commonly prescribed treatment for hot flashes, unwanted side effects have led to the search for nonhormonal solutions. Several effective nonhormonal drug therapies have been identified, but they are not always effective, and not all women can use them because of side effects. These limitations have led researchers to explore non-drug agents. They have studied a variety of herbal and dietary supplements in randomized, placebo-controlled trials, including vitamin E, black cohosh and soy, but none has shown to produce any significant reduction in frequency or severity of hot flashes.

Participants were asked questions that the researchers translated into a hot flash score -- a combined measure of frequency and severity. The frequency of hot flashes decreased 50 percent over six weeks, and the overall hot flash score decreased an average 57 percent for the women who completed the trial. Participants also reported improvements in mood, joint or muscle pain, chills and sweating; which significantly improved their health-related quality of life.

"We are quite pleased with the improvements noted by these women in their quality of life," says Dr. Pruthi. "Not only does flaxseed seem to alleviate hot flashes, but it appears to have overall health and psychological benefits as well."

Dr. Pruthi's team chose to research flaxseed because it is a phytoestrogen (plant-based estrogen source). Flaxseed contains lignans and omega-3 fatty acids. Lignans are antioxidants with weak estrogen-emulating characteristics, and have some anti-cancer effects. Flaxseed also appears to have anti-estrogen properties and has been shown in some recent research trials to decrease breast cancer risk. The researchers hypothesized that patients taking flaxseed might gain some relief for hot flashes.

This pilot trial was designed to determine the effectiveness of flaxseed in alleviating hot flashes and identify possible side effects. Dr. Pruthi cautions that the results are preliminary and taking flaxseed may not give relief to every woman suffering hot flashes.

The 29 participants in Mayo's clinical trial were women with bothersome hot flashes who did not want to take estrogen because of a perceived increased risk of breast cancer.

The findings from the pilot study are published in the summer 2007 issue of the Journal of the Society for Integrative Oncology.

Sandhya Pruthi, M.D., (http://mayoresearch.mayo.edu/mayo/research/staff/pruthi_s.cfm) Mayo Clinic breast health (http://cancercenter.mayo.edu/) specialist and the study's primary investigator.

Other Mayo Clinic researchers included Charles Loprinzi, M.D.; Susan Thompson; Paul Novotny; Debra Barton, Ph.D.; Lisa Kottschade; Angelina Tan; and Jeff Sloan, Ph.D. The flaxseed study was supported in part by the Susan G. Komen Breast Cancer Foundation.

For more information on clinical trials available at Mayo Clinic, please visit http://clinicaltrials.mayo.edu.

The Green House Project is a radically new and innovative approach to long-term, skilled nursing care.

Caring for our seniors, our parents, aunts, uncles and neighbors weighs heavily on our society. While medical breakthroughs extend the years of life, social breakthroughs have been sparse to make those years meaningful and fruitful...and affordable for our loved ones. The Green House Project offers a model and hope. Here are details about this new concept in skilled nursing home care that can be applied to a wide variety of cooperative living arrangements for seniors.

Green House Homes for Skilled Nursing Care

Green House® homes are residences for 6 to 10 elders who require skilled nursing care and want to live a rich life. They are a radical departure from traditional skilled nursing homes and assisted living facilities, altering size, design, and organization to create a warm community. Their innovative architecture and services offer privacy, autonomy, support, enjoyment and a place to call home. Green House® homes are developed and operated by long-term care organizations in partnership with The Green House Project and NCB Capital Impact.

Read the details about this model for senior living and nursing care.

These new tips and information can help seniors and Medicare beneficiaries deter, detect and defend against Medical identity theft.

Medical identity theft occurs when someone steals a patient's personal information, such as his or her name and Medicare number, and uses the information to obtain medical care, to buy drugs or supplies, or to fraudulently bill Medicare using that patient's stolen identity.

"When criminals steal from Medicare, they are stealing from all of us," said Secretary Sebelius. "Preventing medical identify theft is an important part of our work to stop Medicare fraud, and these tools will give seniors important information about how to deter, detect and defend against ID theft and fraud."

The Department of Justice (DOJ), in collaboration with the Department of Health and Human Services (HHS), will continue to protect the integrity of the nation's public health programs and vigorously pursue those who seek to take advantage of our most vulnerable citizens.

"Medical identity theft can disrupt your life, damage your credit rating, and threaten your health if inaccurate information ends up in your medical records," added HHS Inspector General Daniel R. Levinson.

OIG's agents frequently uncover fraud schemes that involve the sale and use of stolen Medicare identification numbers. 

• Medicare beneficiaries are reminded to beware of offers of free medical equipment, services, or goods in exchange for their Medicare numbers. 

• Beneficiaries are also encouraged to regularly review their Medicare Summary Notices, Explanations of Benefits statements, and medical bills for suspicious charges and to report suspected problems.

The effort to help prevent medical identity theft is one part of the Obama Administration's work to crack down on Medicare fraud. In May, Attorney General Eric Holder and Secretary Sebelius announced the creation of a new interagency effort, the Health Care Fraud Prevention and Enforcement Action Team (HEAT), to combat Medicare fraud.  

Teams that have been successfully fighting fraud in South Florida, Los Angeles, Detroit and Houston.  Established in 2007, these teams have a proven record of success using data analysis techniques and community policing to identify, investigate and prosecute on-going fraud.

The Centers for Medicare & Medicaid Services (CMS) has undertaken other steps to fight fraud and protect beneficiaries who buy durable medical equipment or rely on home health services.

• On October 1, all durable medical equipment suppliers across the nation, except for pharmacies, must be certified by Medicare, a requirement that assures beneficiaries that their suppliers are valid businesses and meet Medicare's financial and quality standards.

Senior Medicare Patrol programs

The SMP programs are funded by HHS' Administration on Aging and help Medicare and Medicaid beneficiaries prevent, detect, and report health care fraud. Because this work often requires face-to-face contact to be most effective, SMPs nationwide recruit and train nearly 5,000 volunteers every year to help in this effort. Most SMP volunteers are both retired and Medicare beneficiaries and thus well-positioned to assist their peers.

To learn more about stopping Medicare fraud, visit www.StopMedicareFraud.gov. To report suspected Medicare fraud call the Inspector General's toll-free Hotline at 800-447-8477 (800-HHS-TIPS). The toll-free TTY number is 800-377-4950.

Having just tried to find more cost effective health insurance and long term care insurance, I can tell you how frustrating it is to get good data. 

The Dartmouth Atlas Project has documented glaring variations in how medical resources are distributed and used in the United States. 

This interactive US Atlas of Health Care shows you various information by local areas... the best, the growth, by hospital referral region.

As you can see, the Los Angeles region has a bit of a difference in prices and cost increases than counties north and south of it.  Hmmmm....

The cost of providing health care to seniors is rising more than twice as fast in Dallas as in San Diego, and Medicare now spends nearly three times more to care for its enrollees in Miami than it does in Honolulu.

Nationally, Medicare spent an average of $8,304 per enrollee in 2006, and national spending grew at a rate of 3.5 percent annually from 1992 to 2006. Among states, New York was tops in spending per enrollee, at $9,564. Hawaii was lowest, at $5,311.

Where Medicare spending per enrollee grew at an annual rate of 5 percent in Miami, the rate was less than half, at 2.4 percent, in San Francisco. Medicare spent $16,351 per enrollee in Miami in 2006, almost twice the spending of $8,331 in San Francisco.

The researchers project that, at current spending rates, Medicare will be $660 billion in the red by 2023.

But by reducing the annual growth in per capita spending from 3.5 percent, the national average, to 2.4 percent, the rate in San Francisco, Medicare could save $1.42 trillion and turn the deficit into a healthy surplus.

Small Differences Make a Huge Savings

Small differences, because of compounding, can make an enormous difference.

The authors call on physicians to lead an effort to reform how the U.S. delivers and pays for health care to bring spending under control.

Systems of Quality Care

They write: "Payment systems could then shift from purely volume-based payments to systems ... that foster accountability for the overall costs and quality of care, allowing physicians to align their work more closely with the values that brought them to health care. "

Read more at:  SolutionsForYourHealthCare.com 

First, primary care is the logical basis of an effective health care system.
 
Second, primary care is essential to reaching the objectives that constitute value in health care: high quality care (including achieving desired outcomes), good patient satisfaction, and efficient use of resources.

Primary care is valuable to individuals in at least the five ways listed below:

1. It provides a place to which patients can bring a wide range of health problems for appropriate attention--a place in which patients can expect, in most instances, that their problems will be resolved without referral.
2. It guides patients through the health system, including appropriate referrals for services from other health professionals.
3. It facilitates an ongoing relationship between patients and clinicians and fosters participation by patients in decisionmaking about their health and their own care.
4. It provides opportunities for disease prevention and health promotion as well as early detection of problems.
5. It helps build bridges between personal health care services and patients' families and communities that can assist in meeting the health needs of the patient.

Seemingly routine or simple problems may be embedded in a patient's conditions that could have serious consequences for his or her health. Excellent primary care training provides  clinicians with the ability to distinguish among simple, serious, and complex conditions and to provide care for all.