Diabetes and Home Care


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Home care and diabetes

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Diabetes and Home Care

  1. 1. Diabetes and Home Care A Good Fit for the Diabetic
  2. 2. Diabetic Problems <ul><li>A recent epidemiological study found that 42% of the diabetic population in the United States is 65 years or older. </li></ul><ul><li>This proportion is projected to increase to 53% by 2025 and to 58% by 2050. </li></ul>
  3. 3. Why is this increase a concern? <ul><li>People with diabetes and hyperglycemia face a greater risk of major cognitive decline or physical disability than do those without diabetes. </li></ul>
  4. 4. Why is this increase a concern? <ul><li>Hyperglycemia in the elderly can cause </li></ul><ul><ul><li>Poor sleep </li></ul></ul><ul><ul><li>Incontinence </li></ul></ul><ul><ul><li>Dehydration </li></ul></ul><ul><ul><li>Impaired mobility </li></ul></ul><ul><ul><li>Falls </li></ul></ul><ul><ul><li>Visual disturbances that interfere with self administration of insulin </li></ul></ul>
  5. 5. American Diabetes Association reports: Diabetes causes more deaths a year than breast cancer and AIDS combined. Two out of three people with diabetes die from heart disease or stroke.
  6. 6. STILL… diabetes is often put on the back burner of elderly patient care. Case in point: Many patients never achieve glycemic control in the hospital and are found on admission to home care to have blood glucose levels well over 200 mg/dl. This toxic level: • Impairs leukocyte function • Predisposes infection
  7. 7. Diabetic Solutions… Optimizing diabetic health and wellbeing
  8. 8. Communicate <ul><li>Specifically refer patients to home health diabetic care. Patients are commonly only referred for whatever co-morbid condition led to their hospitalization. </li></ul><ul><li>If diabetes is not identified as a home care concern, blood glucose measurement may not be included in initial or ongoing patient assessments. </li></ul>
  9. 9. Communicate <ul><li>Home health care is increasingly relied upon to address the needs of patients as hospitals: </li></ul><ul><ul><li>Shorten patients’ lengths of stay </li></ul></ul><ul><ul><li>Become mindful of the Diagnostic Related Groupings reimbursement criteria </li></ul></ul><ul><li>Health care in the home environment: </li></ul><ul><ul><li>Is more comfortable for patients </li></ul></ul><ul><ul><li>Offers less risk of infection </li></ul></ul><ul><ul><li>Saves health care dollars </li></ul></ul><ul><ul><li>Promotes ongoing strategies to improve patients’ quality of life </li></ul></ul>
  10. 10. Telecare <ul><li>Studies demonstrate that home telecare (sometimes called telemedicine or telehealth) appears to improve outcomes among patients with chronic diseases, such as heart failure, diabetes, and chronic wounds. </li></ul>
  11. 11. Telecare <ul><li>There is also evidence that home telecare coordination strategies improved functional independence in veterans with chronic diseases and produced a significant reduction in the proportion of diabetic patients who were hospitalized (50% reduction). </li></ul>
  12. 12. Telecare <ul><li>When monitored and educated via telecommunication devices, elderly patients with diabetes had: </li></ul><ul><ul><li>Reduced HbA1c (glycated hemoglobin) values </li></ul></ul><ul><ul><li>Reduced blood pressure </li></ul></ul><ul><ul><li>Reduced LDL cholesterol </li></ul></ul><ul><ul><li>Reduced clinic visits </li></ul></ul><ul><li>Users felt that on many occasions home telecare led to reduction in costs due to: </li></ul><ul><ul><li>Time savings </li></ul></ul><ul><ul><li>Avoidance of traveling </li></ul></ul>
  13. 13. Educate <ul><li>When elderly patients were similarly educated regarding diet, symptoms, management of hyperglycemia, foot care, and exercise, they had a better understanding of their status. </li></ul><ul><li>This led to: </li></ul><ul><ul><li>Better self-care </li></ul></ul><ul><ul><li>Lower health risk </li></ul></ul>
  14. 14. Educate <ul><li>Home care organizations can provide: </li></ul><ul><ul><li>An extensive supply of disease-specific educational materials to help patients and their families get involved in care, better understand the condition, monitor the disease, and follow a prescribed plan of care. </li></ul></ul><ul><ul><li>Healthy and nutritious meals tailored to foster better health in diabetics. </li></ul></ul><ul><ul><li>24-hour response system for patient questions and needs. (Research reports that on-call coverage improves care and patient satisfaction.) </li></ul></ul>
  15. 15. Relieve Stress <ul><li>Home care organizations provide mental and physical stress relief for diabetics at home. </li></ul><ul><li>Stress can cause hormonal changes that result in elevated blood glucose levels. </li></ul><ul><li>The presence and care of a diabetic patient at home can help reduce stress responses. </li></ul>
  16. 16. Relieve Stress <ul><li>External environmental stressors can also be reduced by having a home care agency arrange for other services as needed, such as those provided by: </li></ul><ul><ul><li>A physical therapist </li></ul></ul><ul><ul><li>Social workers </li></ul></ul><ul><ul><li>Community programs </li></ul></ul>
  17. 17. Schedule Routine Checkups <ul><li>A diabetic person requires regular checkups and visits with specialists to address any diabetes-related complications he or she may have. </li></ul><ul><li>A home caregiver can assist with scheduling and transportation to and from the appointments. </li></ul>
  18. 18. Meeting Ongoing Care Needs <ul><li>Home health organizations can also help by monitoring: </li></ul><ul><ul><li>Blood sugar </li></ul></ul><ul><ul><li>Medications </li></ul></ul><ul><ul><li>Weight </li></ul></ul><ul><ul><li>Diet </li></ul></ul><ul><ul><li>Exercise </li></ul></ul><ul><ul><li>Diabetic-related complications </li></ul></ul><ul><ul><li>General patient health and functional status </li></ul></ul>
  19. 19. Differences in Home Care Options
  20. 20. Private Duty/Private Pay Services are usually paid directly by the patient or his or her family members.
  21. 21. Home Care Differences <ul><li>In some situations, private duty/private pay services can be paid by: </li></ul><ul><ul><li>Long-term care insurance </li></ul></ul><ul><ul><li>Workers’ compensation </li></ul></ul><ul><ul><li>Some armed services funding </li></ul></ul>
  22. 22. Home Care Differences <ul><li>Private duty/private pay includes a range of the following services: </li></ul><ul><ul><li>Companionship </li></ul></ul><ul><ul><li>Housekeeping </li></ul></ul><ul><ul><li>Meal planning and preparation </li></ul></ul><ul><ul><li>Medication reminders </li></ul></ul><ul><ul><li>Transportation </li></ul></ul><ul><ul><li>Personal care </li></ul></ul><ul><ul><li>Dementia care </li></ul></ul><ul><ul><li>24-hour or respite care </li></ul></ul>
  23. 23. Home Care Differences <ul><li>Full service agencies provide non-medical care by employees of the agency who are: </li></ul><ul><ul><li>Screened </li></ul></ul><ul><ul><li>Trained </li></ul></ul><ul><ul><li>Monitored </li></ul></ul><ul><ul><li>Usually bonded and insured </li></ul></ul>
  24. 24. Home Care Differences <ul><li>Full staff means: </li></ul><ul><ul><li>No lapses in care due to sick days and vacations </li></ul></ul><ul><ul><li>All staff are screened for skills and thoroughly vetted </li></ul></ul><ul><ul><li>Far more safety in this model versus a nursing registry </li></ul></ul><ul><ul><li>Far less potential liability for the care recipient than with a nursing registry </li></ul></ul>
  25. 25. Home Care Differences <ul><li>Home Health Care </li></ul><ul><li>Skilled nursing care and certain other health care services received in a home setting for the treatment of an illness or injury: </li></ul><ul><ul><li>Care for a wound (dressing changes) </li></ul></ul><ul><ul><li>Injections </li></ul></ul><ul><ul><li>Monitoring of health conditions like diabetes, blood pressure or heart disease </li></ul></ul><ul><ul><li>Assistance with medical equipment like dialysis, indwelling catheter, naso-gastric (NG) tube feeding, or a ventilator </li></ul></ul><ul><ul><li>Physical, respiratory, occupational or speech rehabilitation therapy </li></ul></ul>
  26. 26. Home Care Differences <ul><li>Home Health Care </li></ul><ul><li>Medicare pays for some of the care in a patient’s home only if all four of the following conditions are met: </li></ul><ul><ul><li>The patient must need intermittent (and not full time) skilled nursing care, physical therapy, speech/language pathology, or continuing occupational therapy. </li></ul></ul><ul><ul><li>The patient is homebound. </li></ul></ul><ul><ul><li>The care is referred by a doctor and is medically reasonable and necessary, related to the problems encountered, and addresses realistic outcomes. </li></ul></ul><ul><ul><li>The home health agency caring for the patient is approved by the Medicare program. </li></ul></ul>
  27. 27. Home Care Differences <ul><li>Home Health Care </li></ul><ul><li>If the conditions for eligibility are met, Medicare will pay for the following services in the patient’s home when they are medically reasonable and necessary. </li></ul><ul><ul><li>Intermittent skilled nursing and home health aide services </li></ul></ul><ul><ul><li>Physical therapy/speech therapy/occupational therapy </li></ul></ul><ul><ul><li>Medical social services </li></ul></ul><ul><ul><li>Medical supplies </li></ul></ul><ul><ul><li>Durable medical equipment, such as wheelchairs, hospital beds, oxygen and walkers </li></ul></ul>
  28. 28. Home Care Differences <ul><li>Hospice Care </li></ul><ul><ul><li>Provides end-of-life care in a home or a hospital setting </li></ul></ul><ul><ul><li>Ensures someone is with the dying patient at all times </li></ul></ul><ul><ul><li>Provides services ranging from nurses and mental health professionals to spiritual advisors </li></ul></ul><ul><ul><li>Is covered by most private insurance providers, through Medicare nationwide, and as an optional Medicare service covered by most states </li></ul></ul><ul><ul><li>Will likely provide for anyone who cannot pay using money raised from the community or from memorial or foundation gifts </li></ul></ul>
  29. 29. For More Information <ul><li>With the number of aging diabetics on the rise and hospital costs and readmissions being scrutinized, creating a seamless continuum of care for diabetic patients is of great importance. For any further questions on the services a home care or a home health care agency can provide, please contact Heartwarming Care at (253) 460-1574 or (360) 754-3995. </li></ul><ul><li>Also visit www.heartwarmingcare.com for free downloadable patient educational materials. </li></ul>
  30. 30. For More Information <ul><li>Heartwarming Care Servicing Pierce, Thurston and South King Counties </li></ul><ul><ul><li>7610 40 th Street West Suite 100 University Place, WA 98466 </li></ul></ul><ul><ul><li>(253) 460-1574 • (253) 460-1579 </li></ul></ul><ul><ul><li>[email_address] </li></ul></ul><ul><ul><li>www.heartwarmingcare.com </li></ul></ul><ul><ul><li>www.facebook.com/heartwarmingcare   </li></ul></ul>
  31. 31. Works Cited <ul><li>www.Caring.com/articles/coping-with-type-2-diabetes </li></ul><ul><li>www.Caring.com/articles/chronic-diabetes-complications </li></ul><ul><li>www.Diabetes.org/diabetes-basics/diabetes-myths </li></ul><ul><li>www.Diabetes.org/diabetes-basics/diabetes-statistics </li></ul><ul><li>www.Diabetes.org/living-with-diabetes/complications/mens-health/diet-and-exercise </li></ul><ul><li>www.Diabetes.org/living-with-diabetes/planning-for-a-healthy-life/diabetes-and-how-it-affects.html </li></ul><ul><li>ePodiatry.com/diabetic-foot.htm </li></ul><ul><li>www.geriatria.unimo.it/PDF/Zanasi%20tele%20cron%20dis.pdf </li></ul><ul><li>www.MayoClinic.com/health/diabetic-coma/DS00656/DSECTION=symptoms </li></ul><ul><li>www.medicinenet.com/diabetic_home_care_and_monitoring/page9.htm </li></ul><ul><li>spectrum.diabetesjournals.org/content/16/4/217.full </li></ul><ul><li>International Diabetes Foundation, Diabetes Atlas, 4 th edition </li></ul>