Running head: COMMUNITY HEALTH PROJECT 1 COMMUNITY HEALTH PROJECT 9 Community Health Advocacy Project – Part FourJeanette WalkerNur/544 September 01, 2013 Amy Negovan Community Health Advocacy Project – Part Four 1. Do patients possess somebody who will help them once they have got queries concerning his or her own medicines? The goal of home based care is to enable patients to have functional independence and to help patients stay at home. The question of whether the patients will have somebody who will help them when they have queries concerning their medication becomes vital. Home care providers may not be available full time to assist the patient with necessary guidance and if available they may not have the necessary skill to provide such guidance and thus creating the need to consult the physician or other healthcare providers in a central office. Data reveals that: A. The number of home healthcare visits per 1,000 Medicare enrollees increased from 3,822 in 1992 to 8,376 in 1996. Home healthcare visits increased because of a growth in the coverage criterion for the Medicare home healthcare benefit. In 2001, home health care visits declined after 1997 to 2,295 per 1,000 because of changes in Medicare payment policies for home healthcare resulting from implementation of the Balanced Budget Act of 1997. The rates increased thereafter to 3,409 per 1,000 in 2007 (Federal Interagency Forum on Aging related Statistics, 2010). B. “In the United States, the rate of home health care use for women aged 65 and over was 55% higher than the rate for men” (Jones, Harris-Kojetin, & Valverde, 2012) 2. What are the advantages of utilizing public health and home care regarding medication concerns or queries? Literature research done on medication management of residents receiving home healthcare revealed improvement of medication management. An advantage of using home based care such as nurses, pharmacists, and physicians regarding medication query is unnecessary and duplicate drugs (Ellenbecker, Samia, Cushman, & Alster, 2008). A. A study regarding elderly patients 2 days after hospital discharge found 64 percent were taking at least one drug that was not ordered, 73 percent failed to use the prescribed drug according to instructions, and 32 percent were not taking all medications transcribed at discharge. Another challenge in medication reconciliation is the determination of what medications elderly adults are taking at home. One study found 49 percent of community-based elderly adults are keeping storage of old prescribed drugs from the year before, and 6 percent admitted they self-prescribed medications (Hughes, 2008). B. The American Society of Health-System Pharmacists estimated that over 34% of older citizens are prescribed drugs by more than one doctor, and 72% use drugs they were prescribed over 6 months ago (Paley, 2011). 3. Are there any disadvantages of utilizing public health and home care? If so what are th ...

1. Running head: COMMUNITY HEALTH PROJECT
1
COMMUNITY HEALTH PROJECT 9
Community Health Advocacy Project – Part FourJeanette
WalkerNur/544
September 01, 2013
Amy Negovan
Community Health Advocacy Project – Part Four
1. Do patients possess somebody who will help them once they
have got queries concerning his or her own medicines? The goal
of home based care is to enable patients to have functional
independence and to help patients stay at home. The question of
whether the patients will have somebody who will help them
when they have queries concerning their medication becomes
vital. Home care providers may not be available full time to
assist the patient with necessary guidance and if available they
may not have the necessary skill to provide such guidance and
thus creating the need to consult the physician or other
healthcare providers in a central office. Data reveals that:
A. The number of home healthcare visits per 1,000 Medicare
enrollees increased from 3,822 in 1992 to 8,376 in 1996. Home
healthcare visits increased because of a growth in the coverage
criterion for the Medicare home healthcare benefit. In 2001,
home health care visits declined after 1997 to 2,295 per 1,000
because of changes in Medicare payment policies for home
healthcare resulting from implementation of the Balanced
Budget Act of 1997. The rates increased thereafter to 3,409 per
1,000 in 2007 (Federal Interagency Forum on Aging related

2. Statistics, 2010).
B. “In the United States, the rate of home health care use for
women aged 65 and over was 55% higher than the rate for men”
(Jones, Harris-Kojetin, & Valverde, 2012)
2. What are the advantages of utilizing public health and home
care regarding medication concerns or queries? Literature
research done on medication management of residents receiving
home healthcare revealed improvement of medication
management. An advantage of using home based care such as
nurses, pharmacists, and physicians regarding medication query
is unnecessary and duplicate drugs (Ellenbecker, Samia,
Cushman, & Alster, 2008).
A. A study regarding elderly patients 2 days after hospital
discharge found 64 percent were taking at least one drug that
was not ordered, 73 percent failed to use the prescribed drug
according to instructions, and 32 percent were not taking all
medications transcribed at discharge. Another challenge in
medication reconciliation is the determination of what
medications elderly adults are taking at home. One study found
49 percent of community-based elderly adults are keeping
storage of old prescribed drugs from the year before, and 6
percent admitted they self-prescribed medications (Hughes,
2008).
B. The American Society of Health-System Pharmacists
estimated that over 34% of older citizens are prescribed drugs
by more than one doctor, and 72% use drugs they were
prescribed over 6 months ago (Paley, 2011).
3. Are there any disadvantages of utilizing public health and
home care? If so what are the disadvantages? Public health and
home care has its own disadvantage. Practically one-third of
older home based residents have a probable medical problem,
thus leading to elderly taking unsuitable drugs (Ellenbecker et
al., 2008). Data reveals:
A. An adverse drug event (ADE) is described as harm
encountered by patients as a result of exposure to a medication,
and ADE accounts for virtually 700,000 emergency department

3. visits and 100,000 hospitalizations each year. ADEs affect
almost 5% of hospitalized individuals, making them one of the
most common types of inpatient errors (Agency for Healthcare
Research and Quality, 2005).
B. Studies suggest that practically 15% of individuals
discharged after hospitalization experience a medication
discrepancy. The five most common medication concerns were
anticoagulants, diuretics, angiotensin-converting enzyme
inhibitors, lipid-lowering agents, and proton pump inhibitors.
(Agency for Healthcare Research and Quality, 2005).
4. Has there ever been a time when an elderly person was
unable to get a prescription filled because of lack of funds or
resources? Elder Americans are accounted for approximately
one-third of medical spending in the United States. The cost of
medical expenses is four times the amount of money to treat a
65 year old for healthcare in annually than it does to treat a 40
year old. However, individuals age 65 and older have health
care insurance, such as Medicare, Medicare pays the expenses
and has not been aggressively involved in promoting a enhanced
delivery system for the elder (Day,2013). Data reveals:
A. “10.3 percent of the elderly population ages 65 and older
were unable to obtain or delayed in obtaining necessary
prescription medicines in 2010 on a national level” (Healthy
People, 2013).
B. Data gap: Only 25 states with the largest population in 2010–
2011 were collected and Mississippi was not included (Centers
for Disease Control and Prevention, 2012).
5. Do elderly patients abuse prescribed drugs? Statistics suggest
that drug abuse among older Americans is significant and
growing.
A. . A study in Annals of Epidemiology projected that the
number of individuals age 50 and older abusing prescription
medications may increase 190% over the next two decades from
911,000 in 2001 to almost 2.7 million by 2020 (John Hopkins
Medicine, 2010).
B. 6.1 percent of individuals aged 12 years and older reported

4. nonmedical exploit of any psychotherapeutic medications in
2008 (Substance Abuse and Mental Health Services
Administration, Center for Behavioral Health Statistics and
Quality, 2013).
Medication Questionnaire
Name____________________________
DOB______________________
Ethnicity____________________ Sex___________________
Age______
Education level_______________ City
____________________________
Medical
Diagnoses____________________________________________
__
_____________________________________________________
________
1. Are you taking any medications? Yes
No
2. If so, how many? ________
3. Are you allergic to any medications?
Yes No
4. Provide a list of allergies, if answered yes to above
question____________________

5. _____________________________________________________
_________
5. Do you know what the medications treat?
Yes No
6. Before the doctor prescribed you medication, did you try a
diet change? Yes No
7. Do you take any over the counter medicine?
Yes No
8. Do you take your medicine on a regular basis?
Yes No
9. How often do you visit the doctor?
Weekly
Biweekly
Monthly
Yearly
10. Do you see the same doctor?
Yes No
11. Do you take your medication with you on every visit?
Yes No
12. If the doctor prescribes you new medication, does he
explain it? Yes No
13. Does the doctor order any labs to monitor lab values of the
medication? Yes No
14. Have you experienced any side effects of your medication?
Yes No
15. If yes, provide a brief
explanation___________________________________________
_____________________________________________________
_____________________________________________________
__________________
16. Have you ever been prescribed the same medication twice?
Yes No
17. Have you ever ask the doctor to review your medication for
a decrease? Yes No
18. When you have questions regarding medication, who do you
contact? _____________

6. 19. Have the amount of medication you take increased within
the last year? Yes No
References
Agency for Healthcare Research and Quality. (2005).
Medication errors. Retrieved from
http://psnet.ahrq.gov
Agency for Healthcare Research and Quality (2005).
Posthospital medication
discrepancies: prevalence and contributing factors. Retrieved
from http://psnet.ahrq.gov
Centers for Disease Control and Prevention. (2012). National
health interview survey
2011. Retrieved from http://www.cdc.gov
Day, T. (2013). The American perspective on aging and health.
National Care Planning
Council. Retrieved from
http://www.longtermcarelink.netEllenbecker, C., Samia, L.,
Cushman, M., & Alster, K. (2008). Patient safety and quality in
home health care. Retrieved from http://www.ncbi.nlm.nih.gov
Federal Interagency Forum on Aging related Statistics (2010).

7. 2010 Older Americans:
Key indicators of well-being. Retrieved from
http://www.agingstats.gov
Healthy People. (2013). Healthy people 2020 objective topic
area. Retrieved from
http://www.healthypeople.gov
Hughes, R. (2008). Medication management of the community-
dwelling older adult.
Retrieved from http://www.ncbi.nlm.nih.gov
John Hopkins Medicine. (2010). Drug abuse and the elderly.
Retrieved from
http://www.johnshopkinshealthalerts.com
Jones, A., Harris-Kojetin, L., & Valverde, R. (2012).
Characteristics and use of home
health care by men and women aged 65 and over. National
Health Statistics Report, 52(), 12.
Paley, A. (2011). Managing medications for elderly patients.
Retrieved from
http://www.pharmacytimes.com
Substance Abuse and Mental Health Services Administration,
Center for Behavioral
Health Statistics and Quality. (2013). The NSDUH report:
Nonmedical Use of prescription-type drugs. Retrieved from
http://www.samhsa.gov
Discussion Board #4
Format of DB Responses [ Click here for detailed Grading
Rubric for DB responses. ]
In these essay-style responses, express a point of view and
support your view with good reasons, evidence, examples,
expert opinion, etc. High marks will not be achieved by simply
reporting back information from the text or other sources.
Philosophical thinking and writing involves more than
presenting information; beyond doing this, you must also

8. critically assess the issue in question—this involves original
thinking and analysis. Moreover, you should attempt to come to
some final position in response to the question and include
evaluation of other possible positions or views on the issues.
Work for originality and development of critical analyses and
evaluations.
In responding to the questions for each discussion board, you
are encouraged cite specific examples from the course text (or
other sources) to illustrate and support your points. If you copy
or paraphrase word or ideas from the text or other sources,
make sure that you follow appropriate procedures for crediting
those sources with quotation marks and citations.
If you want to "go the extra mile" on this assignment, bring in
some discussion of your peers' responses to the DB questions;
showing that you have read through and thought critically about
how the other students in the class answered the questions will
raise your score on this assignment.
Question 1: What Is Art?
What qualifies something to be counted as a work of art?
Explain what you understand Arthur Danto's theory of art to be
saying in response to this question and compare and contrast
what he says about art with Plato's conception of art
as mimesis (copy, imitation, simulacrum). Be sure to give an
account of what Danto means by "the is of artistic
identification."
What is your own view about art?
If you say that it is all a matter of subjective taste (that "art or
beauty is in the eye of the beholder"), then what can be
said about the fact that some artworks are worth millions (or
hundreds of millions) of dollars, displayed with utmost
reverence in museums, galleries and other public venues, while
others have little if any monetary value?

9. Why should the opinions of art critics, art historians,
philosophers of art, art collectors and art dealers, and even
artists themselves matter more than the opinions of those of us
who make up the public at large?
Maybe you think that they should not matter more, but they do!
Question 2: The God Question
Kierkegaard waged a mighty battle with his own will and
conscience not just about the existence of God, but, more
importantly, about having faith in the promise of Christianity--
that God actually became Man in the form of Jesus Christ, who
died for the sins of all men, in order to renew His promise of
eternal salvation and everlasting life in God's paradise
(heaven).
Wolff characterizes Kierkegaard's existential dilemma: "But just
because I need so desperately to know that Jesus really lived, I
am hopelessly at a loss for evidence or argument sufficient to
my need. Can I rest comfortably in the belief that I have been
promised eternal life when the evidence for my belief is merely
probable, merely the sort of evidence that a historian or
philosopher can produce? No, too much is at stake: Salvation is
everything; it is eternity of life rather than death. I am reduced
by my terror and my need to infinite concern for something that
defies rational grounding. In short, I am reduced to an
absolute leap of faith" (p. 310).
Explain in your own words what you think Kierkegaard is trying
to solve or establish here; specifically, explain what he means
by saying that one must make a "leap of faith" in order to truly
realize the promise of Christianity. Be sure to discuss how
Kierkegaard's approach to religious faith differs radically from
that of his family and the society of his time, including his
claim that faith is irrational and that "truth is subjectivity."