Pure Home Care Services

Planning for Retirement

You’ve reached age 60, but are you financially ready to retire in the next 2 to 6 years? If not, you are not alone. A growing number of people will work well beyond retirement age, not
because they want to, but because they have to in order to meet living expenses. Even though most people are saving, they are not saving enough. If you are discouraged about what you have not done to prepare for retirement, there are still things that you can do now to secure your financial outlook for the future.

Plan
Never before have so many people lived so long and enjoyed such active lives. Plan to have a long, active and healthy life. Start considering your lifestyle options today and identify resources available to help you
maintain your independence. Consider these life events:

• Changing work and retirement patterns

• Changes in your health or that of loved ones

• Family transitions

• Aging parents

• Long-term care

• End of life issues

Your local Area Agency on Aging is an excellent source for information about retirement planning, financial assistance, legal services, employment and other community resources for older adults.

Contact Pure Home Care Services at (586) 293-2457 today!  If you live in Macomb County or the surrounding area, we can help you care for your loved ones.

Study shows lifting weights just once a week helps keep your brain sharp

For older women, the type of exercise you do may be more important than how often you do it.

That’s the message of a surprising new study by Canadian researchers that found that women who started a once-a-week strength-training program were more likely to stick with it — and reap the physical and mental benefits — than those who started a twice-a-week program.

More importantly, older women who built muscle strength through biceps curls, leg lifts, squats and the like showed much greater improvement in mental focus and ability to make decisions and resolve conflicts than women who did only balance and toning exercises.

Published this month in theArchives of Internal Medicine, the study is a one-year follow-up of 155 women ages 65 to 75 who participated in an earlier strength-training exercise program in 2007-2008.

Weight training and the brain

The women in that program were randomly divided into once-weekly and twice-weekly regimens that used dumbbells, weight machines and free-form exercises like squats and lunges to build muscle strength. A control group performed twice-weekly balancing and toning exercises, but no weight lifting. At the end of the 12-month program, both the weight-training groups showed sharply improved mental focus. In the control group, mental function slightly declined.

A year later, researchers again tested the women to determine who had maintained their physical activity level as well as the mental boost they had gotten from exercising during the original program.

“We were very surprised to discover the group that sustained cognitive benefits was the once-weekly strength-training group rather than the twice-weekly training group,” says lead author Teresa Liu-Ambrose of the Centre for Hip Health and Mobility at Vancouver Coastal Health and the University of British Columbia.

Is once a week enough?

Although the twice-weekly group was exercising less a year later, the once-weekly group was still active and showed a 15 percent improvement on their mental skills test as compared with the balance-and-toning group, the researchers found.

Liu-Ambrose believes it’s because the once-weekly group found it easier than the twice-weekly group to maintain the same level of physical activity of the original study. “Those who start a once-weekly strength-training program are more likely to stick with it,” she says.

In other words, while exercising more often may ideally be better for you, ultimately the best exercise program is one that you actually will keep doing.

Source: AARP.org

Contact Pure Home Care Services at (586) 293-2457 today!  If you live in Macomb County or the surrounding area, we can help you care for your loved ones.

Debate Over Statins Heats Up as Lipitor Heads Toward a Generic Form

Is a statin the answer to everyone’s high cholesterol?

You think of yourself as reasonably healthy, but your doctor has told you that your cholesterol is too high. Should you be taking a cholesterol-lowing drug called a statin to ward off heart disease?

It sounds like a simple question, but getting a straight answer could prove surprisingly elusive.

Doctors usually urge patients to first try to lower their cholesterol by eating better, losing weight andgetting more exercise. But lifestyle changes such as those may not be enough, so statins likeLipitor, Crestor, Zocor andPravachol — proven lifesavers for those who have already suffered a heart attack — are often prescribed for millions of otherwise healthy people with high cholesterol. It’s a practice called primary prevention.

Although a large new British study released yesterday seems to indicate that statins are safe for long-term use, some medical experts question whether the practice really saves lives. And they point out that statins, while generally well tolerated, are not without risks.

The debate over statins is bound to intensify in the coming months. The biggest-selling statin — Lipitor, made by Pfizer — which has been prescribed to more than 17 million people and made more than $100 billion in sales over the past decade, is scheduled to come off patent Nov. 30. Over the next year prices are expected to drop gradually as generic forms of Lipitor become available, which could encourage many more people to use them.

In fact, Crestor at about $5 a pill, soon will be the only remaining statin still under patent. But even if you take cost out of the picture, says Mark Hlatky, M.D., a cardiologist and professor at Stanford University School of Medicine, “you could still have questions about” the use of statins.

“The first question is, ‘Does it work and how do the risks and benefits balance out for individual people?’ ” he says.

Dangers of high doses

That question was highlighted in June, when the Food and Drug Administration (FDA) warned that no new patients should start taking an80 mg dose of simvastatin — the generic name for Zocor — because it carries a higher risk of serious muscle damage that could lead to kidney failure and death. Meanwhile, a review of five major drug trials showed that high-dose statin users were slightly more likely to develop diabetesthan those on a lower dose.

Still, many researchers see statins, which have other effects besides lowering cholesterol, as miracle drugs. Intriguing studies have linked statins to a lower risk of colorectal cancer, rheumatoid arthritis,cataracts and multiple sclerosis. Statin users see fewer kidney complications after serious surgery and have better recovery from brain injury. They also are 60 percent less likely to develop high-gradeprostate cancer. Overall, their risk of dying is reduced, largely because of fewer deaths from infection and respiratory illness.

How to calculate your risk

A set of guidelines issued by the National Heart, Lung and Blood Institute (NHLBI) helps doctors decide when to prescribe statins, which provide much of their benefit by lowering LDL, the so-called “bad” cholesterol, Hlatky says.

They factor in LDL levels, signs of coronary disease and risk factors such as smoking, diabetes, high blood pressure and too little HDL, the “good” cholesterol. They also use a risk calculator — based on the findings of the huge, multigenerational Framingham Heart Study — to calculate a patient’s likelihood of dying from heart disease within the next 10 years.

Statins should be considered for patients with elevated LDL, two or more risk factors and a heightened 10-year risk of dying, the guidelines say.

Can an Aspirin a Day Do More Harm Than Good?

Experts are re-evaluating who should take a daily dose

Some 43 million Americans do it every day: take a tiny aspirin to help prevent heart attacks and strokes. In fact, doctors have been routinely recommending the practice to older adults for years.

But recently, experts have been questioning the aspirin-a-day regimen, concerned that this everyday miracle drug can pose serious risks, including bleeding in the brain and stomach.

The aspirin-a-day controversy erupted publicly in March when a 10-year study of nearly 30,000 adults ages 50 to 75 without known heart disease found that a daily aspirin didn’t offer any discernible protection.

The group taking aspirin had cardiovascular disease at the same rate as those taking a placebo. Moreover, the study—published in the Journal of the American Medical Association—reported thattaking a daily aspirin (100 mg) almost doubled the risk of dangerous internal bleeding.

And last year the U.S. Preventive Services Task Force — a panel of medical experts — issued new guidelines for patients, recommending only those at risk for heart attacks or strokes should take a daily aspirin. Risk factors include having high blood pressure, high cholesterol and diabetes, as well as being overweight.

The panel also recommended that people over 80 not take aspirin at all because of bleeding risk.

For the first time, the panel also broke down its advice by gender, recommending against daily aspirin use in women under 55 and men under 45.

So, should you take a daily aspirin or not? The answer is not quite as simple as doctors previously thought. Aspirin, they say, can still be a lifesaving drug, but it’s not for everyone.

Source: AARP.org

Contact Pure Home Care Services at (586) 293-2457 today!  If you live in Macomb County or the surrounding area, we can help you care for your loved ones.

10 Warning Signs

Your Older Family Member May Need Help

For many Americans, the Holiday season is one of the few times during the year that adults and their older loved ones spend quality time together. The Holidays may be a time when families face and discuss the difficult decisions about finding care for their older relative. The Eldercare Locator has produced a guide of “10 warning signs” to help families and older Americans determine if help is needed. Any one of the behaviors listed may or may not indicate that an action should be taken and your family member’s physician should be kept informed of physical or psychological behavior changes.

Has your family member:

1. Changed eating habits within the last year resulting in weight loss, having no appetite, or missed meals?
2. Neglected personal hygiene resulting in wearing dirty clothes, body odor, bad breath, neglected nails and teeth, sores on the skin?
3. Neglected their home so it is not as clean or sanitary as you remember growing up?
4. Exhibited inappropriate behavior by being unusually loud or quiet, paranoid, agitated, making phone calls at all hours?
5. Changed relationship patterns such that friends and neighbors have expressed concerns?
6. Had physical problems such as burns or injury marks resulting from general weakness, forgetfulness, or possible misuse of alcohol or prescribed medications?
7. Decreased or stopped participating in activities that were previously important to them such as bridge or a book club, dining with friends, or attending religious services?
8. Exhibited forgetfulness resulting in unopened mail, piling newspapers, not filling their prescriptions, or missed appointments?
9. Mishandled finances such as not paying bills, losing money, paying bills twice or more, or hiding money?
10. Made unusual purchases such as buying more than one magazine subscription of the same magazine, entered an unusual amount of contests, increased usage of purchasing from television advertisements?

Source: Eldercare.gov

Contact Pure Home Care Services at (586) 293-2457 today!  If you live in Macomb County or the surrounding area, we can help you care for your loved ones.

What are Home Modifications?

Home modifications are changes made to adapt living spaces to meet the needs of people with physical limitations so that they can continue to live independently and safely. These modifications may include adding assistive technology or making structural changes to a home. Modifications can range from something as simple as replacing cabinet doorknobs with pull handles to full-scale construction projects that require installing wheelchair ramps and widening doorways.

Why Do Seniors Need Home Modifications?

The main benefit of making home modifications is that they promote independence and prevent accidents. According to a recent AARP housing survey, “83% of older Americans want to stay in their current homes for the rest of their lives,” but other studies show that most homes are not designed to accommodate the needs of people over age 65. Most older people live in homes that are more than 20 years old. As these buildings get older along with their residents, they may become harder to live in or maintain. A house that was perfectly suitable for a senior at age 55, for example, may have too many stairs or slippery surfaces for a person who is 70 or 80. According to the National Centers for Disease Control and Prevention, each year thousands of older Americans fall at home.

Where Do You Begin?

Before you make home modifications, you should evaluate your current and future needs by going through your home room by room and answering a series of questions to highlight where changes might be made.

You can begin your survey by examining each area of your home and asking the following questions:

Appliances, Kitchen, Bathroom

• Are cabinet doorknobs easy to use?
• Are stove controls easy to use and clearly marked?
• Are faucets easy to use?
• Are there grab bars where needed?
• Are all appliances and utensils conveniently and safely located?
• Can the oven and refrigerator be opened easily?
• Can you sit down while working?
• Can you get into and out of the bathtub or shower easily?
• Is the kitchen counter height and depth comfortable for you?
• Is the water temperature regulated to prevent scalding or burning?

Closets, Storage Spaces

• Are your closets and storage areas conveniently located?
• Can you reach items in the closet easily?
• Do you have enough storage space?

Doors, Windows

• Are your doors and windows easy to open and close?
• Are your door locks sturdy and easy to operate?
• Are your doors wide enough to accommodate a walker or wheelchair?
• Do your doors have peepholes or viewing?

Driveway, Garage

• Does your garage door have an automatic opener?
• Is your parking space always available?
• Is your parking space close to the entrance of your home?

Electrical Outlets, Switches, Safety Devices

• Are light or power switches easy to turn on and off?
• Are electrical outlets easy to reach?
• Are the electrical outlets properly grounded to prevent shocks?
• Are your extension cords in good condition?
• Can you hear the doorbell in every part of the house?
• Do you have smoke detectors throughout your home?
• Is the telephone readily available for emergencies?
• Would you benefit from having an assistive device to make it easier to hear and talk on the telephone?

Floors

• Are all of the floors in your home on the same level?
• Are steps up and down marked in some way?
• Are all floor surfaces safe and covered with non-slip or non-skid materials?
• Do you have scatter rugs or doormats that could be hazardous?

Hallways, Steps, Stairways

• Are hallways and stairs in good condition?
• Do all of your hallways and stairs have smooth, safe surfaces?
• Do your stairs have steps that are big enough for your whole foot?
• Do you have handrails on both sides of the stairway?
• Are your stair rails wide enough for you to grasp them securely?
• Would you benefit from building a ramp to replace the stairs or steps inside or outside of your home?

Lighting, Ventilation

• Do you have night lights where they are needed?
• Is the lighting in each room sufficient for the use of the room?
• Is the lighting bright enough to ensure safety?
• Is each room well-ventilated with good air circulation?

Once you have explored all the areas of your home that could benefit from remodeling, you might make a list of potential problems and possible solutions.

If you live in Macomb or the surrounding area, contact Pure Home Care Services at (586) 293-2457 today to see what we can do for you!

Source:  Eldercare.gov

Federal law requires that all individuals receiving home care services be informed of their rights as a patient. Following is a model patient bill of rights the National Association for Home Care (NAHC) has developed, based on the patient rights currently enforced by law.

Home care patients have the right to:

• be fully informed of all his or her rights and responsibilities by the home care agency;
• choose care providers;
• appropriate and professional care in accordance with physician orders;
• receive a timely response from the agency to his or her request for service;
• be admitted for service only if the agency has the ability to provide safe, professional care at the level of intensity needed;
• receive reasonable continuity of care;
• receive information necessary to give informed consent prior to the start of any treatment or procedure;
• be advised of any change in the plan of care, before the change is made;
• refuse treatment within the confines of the law and to be informed of the consequences of his or her action;
• be informed of his or her rights under state law to formulate advanced directives;
• have health care providers comply with advance directives in accordance with state law requirements;
• be informed within reasonable time of anticipated termination of service or plans for transfer to another agency;
• be fully informed of agency policies and charges for services, including eligibility for third-party reimbursements;
• be referred elsewhere, if denied service solely on his or her inability to pay;
• voice grievances and suggest changes in service or staff without fear of restraint or discrimination;
• a fair hearing for any individual to whom any service has been denied, reduced, or terminated, or who is otherwise aggrieved by agency action. The fair hearing procedure shall be set forth by each agency as appropriate to the unique patient situation (i.e., funding source, level of care, diagnosis);
• be informed of what to do in the event of an emergency; and
• be advised of the telephone number and hours of operation of the state’s home health hot line, which receives questions and complaints about Medicare-certified and state-licensed home care agencies.
• NAHC’s affiliate, the Hospice Association of America, has developed the following model bill of rights for all individuals receiving hospice care. It also is based on the patient rights currently enforced by law.

Source: NAHC

If you have any questions about the rights of a home care patient or need additional information about home care services in Macomb County, MI and surrounding areas, call Pure Home Care Services today at (586) 293-2457 today!

With the life expectancy of Americans now over 78 years, demand for long term care facilities is strong and future prospects continue to look positive for services such as assisted living, nursing homes and home care, according to Kalorama Information. The healthcare market research publisher estimated the long term care market in the U.S. to be $258 billion in 2010. The findings were included in their report on the industry, “Long Term Care Market: Nursing Homes, Home Care, Hospice Care, and Assisted Living.”

In 1900, U.S. life expectancy was 47 years and it rose to 76 years in the 20th century. Now the Centers for Disease Control Vital Signs puts life expectancy at over 78.2 years of age. But Kalorama notes that this high life expectancy statistic could be misleading, especially where gender is considered.

“Life expectancy is an averaged statistic and thus it doesn’t tell the full story,” said Carlson. “For men the average age is 76, but for women, it’s over 80 years of age. Elderly women thus have a higher chance of being widowed and, absent another caregiver, may require outside care.”

According to Kalorama, home care and assisted living services have experienced the highest rate of growth and will continue to do so as the elderly population increases. Overall the market is expected to grow an average of 5-6% annually for the next five years.

A key driver for sales of long term care services is the offering of a continuum of care. The average patient may start with some home care assistance. At a certain point, however, the elderly require a level of care that exceeds what can be comfortably met through home care. As this occurs, residential assisted living may be considered as an option to provide care, ensure safety and improve quality of life. The last step in this progression represents the move from assisted living or a family member’s home to a residential nursing facility. It usually occurs when the individual’s degree of impairment becomes such that he or she needs continuous supervision and/or help with a large number of activities of daily living. Many assisted living companies have nursing care facilities attached so that they can offer all services.

“In long term care, demand is not a problem, so the revenue will go to whoever can provide the service most efficiently and it will hinge on the ability of the industry and patients to maintain the commitment of payors to reimburse costs,” Carlson said.

Kalorama Information’s report, “Long Term Care Market: Nursing Homes, Home Care, Hospice Care, and Assisted Living,” provides market data, forecasts, competitive analysis and trend information for the long term care market.

Source:
Kalorama Information

Pure Home Care Services, located in Macomb County, MI, specializes in home care services for you or your loved one.  Call us today at (586) 293-2457 for more information about how we can help you!

The American Association for Homecare supports tough anti-fraud measures for Medicare, and we hope that the Energy and Commerce subcommittee hearing on this issue this week will focus on effective measures to prevent theft of taxpayer dollars. The American Association for Homecare represents providers of durable medical, or home medical equipment and services.

We have zero tolerance for fraud and will continue to work to help federal officials more effectively regulate this sector.

Several years ago, the American Association for Homecare proposed to Congress a 13-point Medicare Anti-Fraud Legislative Action Plan that included tougher penalties for fraud, more site visits, and real-time claims audits to prevent fraud at the front-end of the process rather than relying on the ineffective pay-and-chase system. Parts of our 13-point plan have been proposed in several congressional bills and were adopted in the recent health reform law. However, we encourage Congress to adopt all of our proposals to ensure a comprehensive approach that shuts down avenues for Medicare fraud. Details of the 13-point plan can be viewed here.

It’s important to point out that providers of home medical equipment must now be accredited by a deemed accrediting organization and they must also post a surety bond. These two requirements took effect a year ago, October 2009, and fraud associated with the home medical equipment sector has likely declined since then. We encourage federal officials to assess and report the rate of fraud since those requirements took effect.

Spending in the home medical equipment sector represents less than two percent of total Medicare spending, and fraud associated with durable medical equipment represents a tiny fraction of total fraud in Medicare.

A number of important new anti-fraud measures are now in place, which were long overdue. But Congress, CMS, and the Office of Inspector General should not promote or impose unreasonable burdens on the existing, accredited home medical equipment providers.

Correcting the Record: Myths Associated with Fraud Debate

During discussions on the issue of fraud in the home medical equipment sector, policymakers frequently commingle issues that distort and misrepresent the homecare community.

Competitive Bidding Is a Payment Mechanism, Not an Anti-Fraud Measure

Competitive bidding is simply a payment mechanism-not an anti-fraud tool. When competitive bidding was enacted in 2003, Congress adopted a number of separate measures to address fraud and abuse through the establishment of quality standards and mandatory accreditation. CMS also has taken additional steps recently to prevent fraud through the implementation of surety bonds and more stringent supplier standards. Medicare has also issued enhanced provider enrollment rules and more stringent supplier standards.

Internet Pricing Is Not an Accurate Benchmark for Medicare Payment Levels

Several studies conducted by federal agencies such as the GAO and the OIG highlight the disparity between Internet prices and Medicare payments. This is not an accurate comparison. First, these studies clearly cite that the analyses did not look at service-related costs in the provision of home medical equipment. The studies also overlook overhead, staffing costs and mandatory accreditation, 24/7 emergency care, adherence to quality standards, and FDA’s home use requirements. There has been only one comprehensive study that has evaluated both service and equipment costs. This study found that in the oxygen arena, equipment costs only account for 28 percent of the Medicare payment rate. The remaining 72 percent is related to service and general and administrative costs.

Payment Rates that Differ from Internet Pricing Do Not Promote Fraud

Criminals out to defraud the Medicare program are intent on stealing. They do not provide equipment and services and they do not follow Medicare rules and regulations. However, recently, the OIG stated that because home medical equipment reimbursement rates are often higher than pricing for HME available on the Internet, it inherently leads to fraud and abuse. The OIG reasons that excess revenues attract criminals who intend to defraud the Medicare program and can be used to promote kick-back arrangements. This is an unsubstantiated assumption. AAHomecare is not aware of any federal study conducted by the OIG or the GAO that demonstrates that excessive payment promotes fraud. The real point is that criminals intent on defrauding Medicare are not suppliers and have no intention of providing items and services to Medicare beneficiaries regardless of the payment rate.

There Is Not an Excessive Number of HME Providers

Federal officials frequently point to the need to reduce the number of suppliers that participate with the Medicare program. What is overlooked is that there are only approximately 15,000 home medical equipment providers nationwide-or about one for every 2,500 Medicare beneficiaries. Even CMS cites the statistic that only 20 percent of suppliers in the round one areas of competitive bidding bill more than $10,000 to the Medicare program annually. The vast majority of entities that have supplier numbers are pharmacies like CVS or Rite Aid, physical therapists, physicians, ophthalmologists, prosthetists, neurosurgeons, dentists, and other similar providers. Moreover, some policymakers have stated that the DMEPOS fee schedule is outdated. This is incorrect as Congress and CMS have adjusted DME pricing multiple times over the past decade so that current Medicare payments are sometimes 50 percent less than they were a decade ago.

Improper Payments Should Not Be Confused with Fraud

There have been a number of audit samples of specific HME items such as oxygen therapy, power wheelchairs and continuous positive airway pressure (CPAP) devices that indicate a high improper payment rate. As the OIG correctly points out, the increase in the Medicare error rate in the home medical equipment sector is “not necessarily due to more fraud in the program. In fact, the error rate is not a measure of fraud.” In 2009, the OIG implemented a strict adherence to policy documentation requirements, retro application of rules, signature legibility requirements, and lack of physician documentation and the removal of claims history as a valid source for review information. In this latter example, in previous years, auditors could use clinical inference to determine if a claim was reasonable and necessary. Now, they cannot use their education and training to determine if a claim is appropriate.

However, when there is an error rate of 78 percent as was the case in a recent oxygen probe audit, this points to a larger problem with the overall system-not with HME providers. We maintain that CMS is not doing an adequate job of educating physicians and homecare providers and the policies have become so complex that the vast majority of HME providers are not able to reasonably comply. In this example and others, federal bureaucrats are overturning physician decision making and judgment in more than 3 out of every 4 cases. Upon appeal at the Administrative Law Judge (ALJ) level, the ALJs are reversing CMS’ decisions 3 out of 4 times suggesting that there is an institutional disconnect that is hurting legitimate providers of HME.

Homecare providers and the Medicare beneficiaries they serve require clear, reasonable, consistent, and unambiguous guidance that does not change from auditor to auditor.

CMS and Its Private Contractors Have Failed in their Oversight of Supplier Enrollment

A number of reports have pointed to the low barrier to entry that has made home medical equipment vulnerable to criminal activity and fraud. In south Florida, for example, the OIG conducted unannounced site visits to 1,581 providers and found that 31 percent of these providers did not maintain a physical facility or were not open and staffed during business hours. In another analysis, the GAO found that a supplier number was granted to a broom closet.

AAHomecare believes that CMS and its contractors have failed in their oversight responsibility. It is CMS’ responsibility to determine whether a supplier should be granted billing privileges. CMS is required to conduct a site visit for any new supplier and upon renewal of the supplier number every three years. If CMS were doing an adequate job, these egregious lapses would not have occurred. Congress has also addressed this vulnerability by requiring mandatory accreditation and quality standards for all home medical equipment providers. This should serve as a double check on CMS and raises the bar of entry and protect the Medicare program. Finally, policymakers and the media focus on fraudulent activity that occurred prior to the implementation of enhanced screening tools in 2009.

Source:
American Association for Homecare

Pure Home Care Services, located in Macomb County, MI, specializes in home care services for you or your loved one.  Call us today at (586) 293-2457 for more information about how we can help you!

There are nearly 15 million people caring for individuals with Alzheimer’s disease and dementia in the USA, the Alzheimer’s Association has revealed today. The number of caregivers is 37% higher than estimates published last year, according the 2011 Alzheimer’s Disease Facts and Figures.

The authors of the report found that American caregivers gave 17 billion hours of unpaid care, estimated at $202.6 billion. A state with a population of 15 million would be the 5th largest in the USA.

Most individuals over the age of 65 years survive for about four to eight years after they are diagnosed with Alzheimer’s disease, sometimes 20 years. Because of the debilitating effects of the disease and its long duration, family members and friends who care for patients are placed under increasingly intense demands.

Source: Alzheimer’s Association

If you have questions about home care services for your loved one suffering with Alzheimer’s or Dementia, please contact Pure Home Care Services, serving Macomb County, MI at (586) 293-2457 today.