Thursday, March 26, 2015

Medication Management

Typically at some point in our lives we are given some form of medication that we must take in order to resolve whatever condition that is compromising our health. It is important to strictly adhere to the medication regimen in order to gain the full therapeutic effects. Medication is involved greatly when treating an individual’s condition(s) and will have an impact on their life. Following a daily medication regimen can prove to cause a burden in someone’s life; from the strict directions, to remembering to take your medication each day. This is where Total Home Health will step in. Our skilled and passionate professionals will provide you with resources and tips to improve your quality of life while managing your medication.

Commonly you will find that when patients are required to follow a strict medication routine that they will require additional drug therapy at some point for their condition, whether it be for prevention, synergistic (working together), or palliative (comfort) care. Plus, with some medications such as Coumadin, the dosage will need to be titrated frequently in order to maintain a safe therapeutic level to reach its intended goal. When medications require titration, this requires tasks such as frequent lab draws in order to maintain the drug at the correct dosage. With Total Home Health you can sit back and enjoy the convenience we have to offer you. Our skilled professionals can perform your blood draws in the comfort of your home so you do not have to frequently travel, which could prove to impose extra danger and costs to you.

Polypharmacy is a word that you most likely do not hear much. This term refers to the use of four or more medications by a patient; this is generally found in patients over 65 years old. Therefore, polypharmacy is most common in the elderly which encompasses almost half of older adults that live in their own home. This issue makes it more difficult to manage medication, even more so in the home environment.

Keeping track of your medications is very important. Making sure they are properly stored and have not passed their expiration dates are crucial points to take into consideration. If a medication is not properly stored or expired, this could result in it not exerting the fullest therapeutic effects, or it could even pose adverse reactions. Plus, it can be hard for an individual to remember what each drug is for, when it should be taken, and how it should be taken; this becomes at an increased risk for those with memory problems. Total Home Health will lead you onto the right path with some simple strategies that you can implement to help you or your loved one to manage your medications.

  • Keep a list. Try to keep a list of all the medications you take. Include in this list what the medication is, when it should be taken, and how it should be taken (some medications do better with food, juice, etc.)
  • Review Your Record. During your doctor visit at regular intervals, you should review your current medication list with your provider. This will allow you to make sure your list is up to date, and it will provide them with the opportunity to let you in on any new information or instructions about any of the medications.
  • Medication Advice. Always keep your medication in its original container. Never put more than one type of medication in the same container. A good piece of advice is to use a weekly medication organizer so you can place pills in the correct spot according to the day and time that they are to be taken.
  • Medication Storage. Always make sure to ask your provider or pharmacist where the best place to store your medication is. Plus, read the label because it will usually provide you with this information too. Remember that the bathroom cabinet may not be the best place to store medication after all, because of the frequent warm and moist conditions.
  • Do Not Abruptly Stop. You should never just immediately stop taking a medication. Always check with your provider beforehand because this could pose serious health risks. Remember that you should always take the full course of antibiotic therapy to gain the full therapeutic effect, just because you feel better does not mean that you should quit taking the antibiotic.
  • Refill Accordingly. Remember to frequently check expiration dates and do not allow yourself to run out of medications. Keep in mind how many pills that remain in your bottles so that you can reorder them in enough time so that you do not run out.
  • Keep in a Safe Place. Always keep medications out of the sight and reach of children and away from pets. Remember that children do climb, so place your medication strategically. Have the poison control center number available just in case.

Keep in mind that along with the advice mentioned above that your pharmacist is a great resource to turn to if you ever have any questions at all regarding your medications. Your pharmacist will keep records of all the medications you get filled at their store, so it is a good idea to always refill at the same place if at all possible.

Ultimately, managing your medications can prove to be very stressful and even dangerous to your health if not done correctly. Allow Total Home Health to assist you in making this process as easy as we possibly can. Our main focus is you and your well-being. We are eager to begin this journey with you!

Medicare Home Health

First of all you or your loved one may be new to the world of Medicare, so what is it? Medicare is the federal health insurance program for people who are 65 years or older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD – permanent kidney failure requiring dialysis or a transplant). There are four different parts of Medicare: Part A, Part B, Part C, and Part D. The different parts of Medicare help to cover specific services.

  • Medicare Part A (Hospital Insurance)
    • This part will cover inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Medicare Part B (Medical Insurance)
    • This part covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
  • Medicare Part C (Medicare Advantage Plans)
    • This part is a type of health plan that is offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. These plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. Most of these plans offer prescription drug coverage.
  • Medicare Part D (Prescription Drug Coverage)
    • This part adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare.

There are 4 criteria an individual must meet in order for Medicare to help cover costs of your home care services:

  1. You must be considered homebound. This means that you either require the assistance of another person or device (walker) to leave your home, your provider believes that if you leave your home it would be harmful to your health, and it is difficult for you to leave your home and you generally are not able to do so.
  2. You require skilled care.
  3. Your doctor signs a home health certification stating that you qualify for Medicare home care due to being homebound and in need of intermittent skilled care. The certification must also say that a plan of care has been made for you, and that a doctor regularly will review and evaluate it.
  4. You receive your care from a Medicare-certified home health agency (HHA).

Following the brief explanation of Medicare above, you or your loved one should now have a better understanding of how it works and what services are covered. As far as home health services go, Medicare will cover specific types of care. The programs offered by Total Home Health will be specific to you not only regarding your situation, but also your Medicare benefits. If you qualify for the home health benefit, you will find that Medicare covers the following types of care:

  • Skilled nursing services and home health services provided up to 7 days a week for up to 8 hours per day or up to 28 hours per week. In the event of an unusual case, Medicare can cover up to 35 hours (an unusual case will be determined by other rules and regulations).

  • Medicare will pay in full for skilled nursing care. This includes services and care that can only be performed safely and effectively by a licensed nurse. Such as injections, tube feedings, catheter changes, observation and assessment of a patient’s condition, management and evaluation of a patient’s care plan, and wound care.

  • Medicare will pay in full for a home health aide if you require skilled services. This aide will provide personal care services including help with bathing, using the bathroom, and dressing. If you only require this type of personal care, you indeed do not qualify for the Medicare home care benefits.

  • Skilled therapy services. Physical therapy (PT), speech therapy (ST) and occupational therapy (OT) services that can only be performed safely by or under the supervision of a licensed therapist, and that are reasonable and necessary for treating your illness or injury. PT includes gait training and supervision of and training for exercises to regain movement and strength to a body area(s). ST services include exercises to regain and strengthen speech and language skills. OT helps you regain the ability to do usual daily activities by yourself, such as eating and dressing yourself. Medicare should pay for therapy services to maintain your condition and prevent you from worsening as long as these services require the skill or supervision of a licensed therapist, regardless of your potential to improve. *There may be additional stipulations if you only require OT, Medicare benefits will be determined based on your specific condition.

  • More skilled therapy services such as medical social services. Medicare will pay in full for services ordered by your provider to reach out and help you with any social and emotional concerns that you may have related to your illness. This could include counseling or help with finding resources within your community.

  • Medical supplies. Medicare will pay in full for certain medical supplies provided by the Medicare-certified home health agency. This could include things such as wound dressings and catheters that may be needed for your care.

  • Durable medical equipment. Medicare pays 80 percent of its approved amount for certain pieces of medical equipment, such as a walker or wheelchair.
Get busy! Do some research to see what your benefits qualify you for and enroll in Total Home Health today! Our professionals are eager to come to you and become involved in your treatment to maintain your optimal health status.

Complicated Wound Care

Having a wound can be a big deal that requires extensive and time-consuming treatment on a daily basis. There are various types of wounds and their causes are unique to the person who is affected. It is important that you strictly adhere to the treatment regimen prescribed for you so that your wound can resolve correctly and so that you may avoid infection and long-term complications as best as possible.

Complicated wounds are the most severe that you or your loved one may experience. You will find that it requires more skill and advanced treatment than a simple wound. Complicated wounds may generally require surgery, more intricate treatment, and often multiple procedures in order for the wound to resolve efficiently. With Total Home Health, we have highly-skilled, specially trained staff that is ready to take on your wound treatment regimen.

You may wonder, “How do I know if my wound is complicated or not?” Typically if your wound is the result of a bed sore, second or third-degree burn, an ulcer that has been drained or if your wound requires packing gauze and extra medication, then it would be considered complicated. If four weeks have passed and your wound is still being treated, it will then also be classified as chronic. Visible bone, nerves, and other soft internal tissues also constitute a complicated wound. Also, if you have other health conditions such as diabetes mellitus or an autoimmune disease, your wound has an increased risk of becoming complicated due to the decrease in immune system functioning. The decrease in your immune system will delay the healing process, making the wound a more complicated process to resolve. Generally wounds heal within a matter of four phases: inflammatory, epithelialization, proliferative, and remodeling. If a wound becomes complicated, any or all of these processes will be delayed.

The approach your provider will take regarding closure of your complicated wound will be specific to the cause, location, physical characteristics, and the healing potential of the wound. There are several other factors that play a role in your treatment regimen such as, your age, co-morbidities, nutritional status, if you are a smoker, etc. All in all, your complicated wound treatment will require a long-term multidisciplinary plan that will work to address all factors involved to promote healing of your complicated wound. The ultimate goal of managing complicated wounds is for the individual affected to return to a normal level of functioning.

Total Home Health has a program specialized for you regarding treatment of your wound. Enroll today and allow us to address all of your needs so that you may resume functioning at your most optimal levels.

Thursday, March 19, 2015

Gait and Balance Education

 Falls can occur no matter how old you are or what condition you are in.  However, the risk of falling increases with compromised health and as we age.  At Total Home Health Inc. our goal is to maintain your safety in your home to prevent falls at all costs, because they can prove to be very debilitating.  An important aspect to maintain your safety is continued education regarding your gait and balance for you and your loved ones.

Gait, the process of walking, and balance are intricate movements that occur with each and every step.  These movements rely on proper functioning from several areas of the body that work together to ensure you are able to walk without difficulty.  These areas that work together include the ears, eyes, brain, muscles.  Problems may arise with these areas and it could lead to walking difficulties, falls or injuries if the situation is not properly addressed.  The problems may just be short-term or become persistent and end up being long-term; it will all depend on the cause.  Our professional staff will provide continued evaluation of your functional status with each visit.  Interventions will be implemented whenever we anticipate a problem in order to best maintain your functional status and prevent injury.

Potential causes of temporary gait or balance problems include injury, trauma, inflammation or increase in pain.  Whereas potential causes of long-term difficulty often result from muscular and neurological issues.  You and your loved ones will be educated on what to look-out for that may end up compromising your gait and balance.  If any of these causes arise do not hesitate to contact our staff at Total Home Health Inc. or your provider.  The longer the problem goes without being addressed, the more extensive the gait and balance difficulties will become.

The following list is of specific conditions that may pose an impact on your gait, balance, and coordination:

·      Joint pain, such as from arthritis
·      Multiple sclerosis
·      Brain tumor
·      Parkinson’s disease
·      Guillain Barre Syndrome
·      Peripheral neuropathy; diabetics are at an increased risk for this
·      Cerebral palsy
·      Gout; can occur suddenly and be very painful
·      Muscular dystrophy; causes muscle atropy
·      Alzheimer’s disease; affects neurological functioning

You will also find that obesity, chronic abuse of alcohol, and stroke are other causes that may impair gait and balance.  Certain medications, especially anti-hypertensives may result in sudden drop in the blood pressure from lying, to sitting, to standing that may cause an individual to fall.  Gait and balance problems can be a direct result of pain, weakness, loss of balance, impaired vision, etc.  One may also have problems walking if they are extremely fatigued or tire easily with minimal exertion.  Numbness in the lower extremities can also lead to poor gait and balance, with numbness it may be difficult to know where the feet are in relation to the floor.  The list goes on and it is our priority to provide you with education regarding these facts so that falls will be prevented in your home.

To diagnose a gait and balance problem your provider will perform a physical examination and possibly a neurological examination to determine the cause(s).  The treatment of this condition depends on the cause and may include medication or therapy services to compensate for the area that is lacking, such as a decline in balance.  The prognosis of your treatment also depends on the underlying conditions that are present and also how motivated you are to participate in your treatment. 

Total Home Health Inc. will provide you with all the education you and your loved one needs related to maintaining your gait and balance.  Our professionals will never fail to provide you with holistic care to maintain your well-being and functional status. 

Kinnser Physician Access

With your enrollment in Total Home Health Inc. the possibilities are endless.  Our company is modernized and with continued advances, we are ready to serve you in the most efficient ways possible.  A part of our modern technology includes the Kinnser Physician Access.  For those of you that do not really consider yourself tech savvy, no worries because our staff will direct you along the way if the need ever would arise. 

The physician access service we offer is 100 percent HIPPA compliant.  What is HIPPA?  HIPPA is the federal Health Insurance Portability and Accountability Act of 1996.  The goal of this law is to make it easier for individuals to keep their health insurance and to protect the confidentiality and security of the healthcare information.  Therefore, all information will be secured and protected while in our hands.  Our physician access service is also a free online service provided to you.  It is designed specifically to streamline the process of ordering and billing of Home Health services from physicians.  It is easy to enroll by just visiting our website. 

The Kinnser Physician Access program has various features and benefits for your practice.  Within the program we have more effective Care Plan Oversight (CPO) billing which will prove to maximize your practice revenue by thousands of dollars, making sure nothing is missed.  Our physician access program also automatically generates all necessary claim forms for the Care Plan Oversight.  This way no claims will be missed and the process will occur as smoothly and quickly as possible.  Another feature is the reduction of time providers will observe if this program is utilized.  Signing home health orders, carrying out the billing process and managing the documentation regarding your visits can be a burden sometimes.  However, with our program you will find that the time you spend on that aspect of your job will be decreased, allowing more time for other productive tasks.  This modernized technological service will enable providers to digitally sign all home health orders all from one screen, how convenient! 

Patients will need to be referred at some point in their care usually in order to receive specific treatment and evaluation in other areas to increase their well-being, such as participation in therapy services.  With the Kinnser Physician Access program, providers can easily refer patients with a simple online form which makes it easy for everyone.  You will never have to worry about where your documentation is, because our program allows you to automatically manage and store all home health related documentation in one place that is easily accessible at any time. 

The best benefit of this program is that there is absolutely no cost to physicians for this powerful service.  This is a great incentive and will help you to demonstrate meaningful use in your practice, which is the process of using certified electronic health record (EHR) technology to improve the quality and efficiency of healthcare services, while decreasing the costs.  Plus, there is nothing at all to download or install that will take up space on your system.  All you need to start is a Web browser and a connection to the internet and you are ready to go.

Ultimately, the Kinnser Physician Access service provides huge benefits for all involved with the goal of improving the quality of healthcare provided to patients and their families while reducing costs wherever possible along the way.  With Total Home Health Inc. you will find that we strive to put your needs at the center of our attention and want to provide you with the most efficient care we possibly can.  Our professional team is ready whenever you are, enroll today!

Low Vision Impairment

Our senses are very important related to our well-being and how we function on a daily basis.  Vision is extremely important to how we function on a daily basis.  It can be very frustrating and even go as far as to cause depression if your vision becomes even the slight bit impaired.  As we age our vision seems to decline, we end up having to get glasses just to be able to continue to do things we like to do.  Low vision impairment, especially in the elderly is a big deal because it could result in debilitating injuries that otherwise could have been prevented with a simple eye exam. 

If you or your loved one has low vision impairment having glasses, contact lenses, taking medications, or having surgery performed may not help.  Activities you find enjoyable such as reading, shopping, writing, watching television, and driving may be more difficult to do.  The leading causes of low vision impairment and even blindness tend to be age-related diseases such as macular degeneration, cataracts, and glaucoma.  To be considered low vision impairment visual acuity will measure 20/70 or poorer up to 20/160 in the better-seeing eye.  A visual acuity of 20/70 means that the person with 20/70 vision who is 20 feet from the eye chart sees what a person with 20/20 vision can see from 70 feet away.  

Of course other disorders of the eye, injuries to the eye, and even birth defects can result in vision impairment.  There are various common types of low vision such as loss of central vision, loss of peripheral vision, blurred vision, generalized haze, extreme light sensitivity, and night blindness.  Your eye doctor will determine the type of low vision impairment upon your assessment and will discuss with you treatment options.

Your provider will do their best to determine the cause(s) of your vision loss.  However, whatever the cause may be, vision that is lost cannot be restored, it can only be managed.  An impairment or loss of vision may result in having to totally reorganize your lifestyle and adapt to new ways of doing the things you love.  There are several visual aids out there that can make life easier for you such as special glasses, large print books, special phones, special remote controls, etc. 

As always with any health condition, the quicker vision impairment is observed and treated, the better your chances of keeping and maintaining what vision you have left.  A good point to remember is that visual impairment can take on many forms and exist in varying degrees unique to the person.  Some individuals may function better than others with the same condition.  When you become enrolled in Total Home Health Inc., our professional staff will be sure that you have the opportunity to schedule regular comprehensive exams to maintain your eye health.

Some signs that you or your loved one may be experiencing low vision impairment include things such as difficulty recognizing a familiar face, difficulty reading, and difficulty seeing objects that may be potentially hazardous (uneven surfaces, steps, curbs, etc.).  Each type of low vision impairment will require a different therapeutic approach for rehabilitation.  After completion of a thorough examination your provider will develop a treatment plan for you to deal with your condition to enhance what visual acuity that remains. 

Total Home Health Inc. has a program just for you if you or a loved one is affected by low vision impairment.  Our professional staff possesses keen observation skills used to assess for any visual impairment or decline in functional status with each visit.  We are eager to begin caring for you, enroll today!

Friday, March 6, 2015

Surgical Wounds

The word “surgery” is just plain scary.  When we hear this we automatically think about being put to sleep and find ourselves thinking of the worst that may happen.  Surgery may be necessary for you or your loved one someday, and it is important that you understand some key points.  Simply put, in any surgical procedure, a surgical wound will be created in order to open the layers of tissue necessary to access the source of disease or injury.

Surgery generally involves blood loss resulting in a surgical wound afterwards that will need strict care provided until it resolves to prevent infection from setting in.  Any opening in the body is a possible growth medium for an infectious process to begin.  Surgical wounds are made for a number of reasons by a highly trained health care professional with use of a sterilized cutting instrument, such as a scalpel, during a procedure in a sterile environment.  Many variables can be controlled in the sterile environment such as bacteria, size, location and the nature of the wound itself.  Surgery may be required in some cases of disease or injury to treat or further investigate what is going on with the specific condition.

Be advised that there are four classes of surgical wound types based on the wound’s level of contamination: clean, clean-contaminated, contaminated and dirty-infected.  Once your wound is evaluated and its type is determined, this will allow health care professionals to better predict the risk of infections and wound healing outcomes to include in your plan of care, thereby allowing optimal treatment for each type of surgical wound.

·        Class I – This class refers to clean surgical wounds that show no apparent signs of inflammation and do not involve the respiratory, gastrointestinal (GI), or genitourinary (GU) tracts.  An example of this would be a skin biopsy.

·        Class II – Surgical wounds in this class are considered clean-contaminated; meaning they are clean, but with a higher risk of infection, such as those surgeries that involve the GI, GU or respiratory tracts.  The surgery must be uncomplicated, meaning there was a purpose to open a wound.  An example of this would be if a wound is opened to remove pins.  Be advised though, the opening of the wound allows for entrance of infection.

·        Class III – These are contaminated wounds.  They occur when an outside object comes into contact with the wound itself.  This could be things from the outside including bullets, knife blades, etc.  Or the contamination could be caused by spillage from the GI tract into the wound during the procedure.  If the tissue surrounding the surgical wound is highly inflamed or infected, the wound will be determined as a Class III, contaminated wound.

·        Class IV- If your wound falls into this class it is considered a dirty-infected surgical wound.  This occurs if a foreign body is lodged in the wound, such as debris from an accident or a bullet.  Also, your wound could be a Class IV if it occurred from a traumatic injury from a dirty source and you waited to seek treatment.  Or, this class includes surgical wounds that are infected, and/or have been exposed to pus or fecal matter.

Signs of infection are another area you should be familiar with if ever you experience a surgical wound.  Never hesitate to seek out medical attention.  These signs include but are not limited to: increased redness around the wound, increased warmth noted in the skin around the wound, swelling, fever, drainage from the wound that is foul-smelling or discolored, increase in pain at the wound area, or if the wound continues to get larger or deeper even with strict treatment.  Those with a decreased in immune function will generally have a longer recovery time with an increase risk of developing an infection, such as those with diabetes or the elderly.  Obviously too, if your wound treatments are completed poorly causing contamination, this could result in worsening of your condition.  Individuals must pay close attention to the location of the wound, if it is near a place that is contaminated often such as the groin; it will need maintained a lot more frequently than a wound that is say, on your leg.

The treatment plan will be specific to your type of surgical wound.  The provider will develop a plan of care for you that our professionals at Total Home Health will follow to ensure your best recovery time.  As always though, ensure that you maintain proper nutrition and hydration during your recovery period, as this will promote your wound to heal along with helping to prevent infection. 

All in all, if there is one thing you should have learned from this is that from the classes of wounds mentioned above, you definitely want yours to be classified as a Class I.  However, once you are stabilized and are able to receive care in your home our professional staff at Total Home Health will provide you with the best wound treatment by strictly adhering to the regimen stated by your provider.  Our goal will always be to prevent infection of your wound and to make your recovery time as easy as possible so that you can begin functioning at your normal level once again.