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RWJ Study Supportive of Home Care


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Many patients leave the hospital requiring care at home that ranges from complex medical issues to simply picking up the mail. According to a study supported by a grant from the Robert Wood Johnson Foundation and published in Nursing Economics, caregivers were helping with medical tasks that would be performed by a nurse or aide in the hospital as well as administrative tasks that would be handled by other hospital staff.


Findings in this study include the following:


* Closer coordination at discharge with home care agencies is essential.


* Medicaid covers many more home health services than Medicare, increasing problems for caregivers of the elderly related to financial issues.


* Many services required in the posthospitalization period are not covered by third-party payers.


* Most care recipients did not live with their caregivers, which made the caregivers ineligible for tax credits that could ease their financial crunch.



The biggest finding from this study:Medicare does not adequately cover the services needed by the posthospitalized elderly patient. Only changes in legislation can increase revenue available for these individuals.


Nursing Econonics. 2002. 20(5), 216-221.


Changes From OSHA on TB Testing

The Joint Commission home care surveyors will begin making recommendations regarding tuberculosis testing for home care workers according to state law and regulations or a home care organization's own policy. According to the Occupational Safety and Health Administration:


"OSHA would not cite home health care employers for not conducting TB testing. However, the Centers for Disease Control and Prevention's Guidelines for preventing the transmission of Mycobacterium tuberculosis in health care facilities, 1994, does recommend several measures for health care workers who perform home health care to patients who have suspected or confirmed infectious TB."


For more information, visit the CDC Web site at


or the OSHA Web site at


New Diagnostic Aid for Alzheimer's?


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New research has suggested that people with Alzheimer's also show an accumulation of proteins in the lens of the eye, resulting in a rare form of cataract. This cataract (equatorial supranuclear cataract) is made of the same proteins that aggregate abnormally in the patients' brains to form plaques, suggesting that the same factor is causing both.


The benefit of knowing this? If these rare cataracts precede memory-robbing symptoms of Alzheimer's a new type of eye exam could one day be used to diagnose patients at an early stage of illness, when treatment is most successful.


The Lancet. 2003. 361,1258-1265.


Shall I Supersize That?

Every day we hear that our diets are horrible, that we eat too much, and that as a nation we are getting fatter. Contributing are the larger portions that restaurants are serving. Can your eyes tell the difference in portion sizes? How much exercise is required to burn off those extra calories?


To test your knowledge and for a fun activity for you and your family and to teach patients and caregivers, visit: and try the interactive game yourself!


Another Reason to Have Children


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Women who never have children may be more likely to break a hip later in life. U.S. researchers found that women who had never given birth were 44% more likely to break a hip during a 10-year period, starting when they were at least age 65.


For many elderly people a hip fracture can mean more than a broken bone because up to 33% of patients who break a hip will die within 1 year and many others are left severely disabled. Although the reasons why childbirth may reduce the risk of hip fracture are unclear, the possibility exists that changes in the alignment of the hip and pelvis during pregnancy and childbirth could protect women from later fractures.


Journal of Bone and Mineral Research. 2003. 18(4), 784-787.


Winter Blues or Summer Sadness?


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Although reports of "winter blues" which appear to lift with the first signs of spring are common, new findings reveal that suicides are more frequent during warmer months. In an Australian study, researchers found that over a 10-year period the rate of suicide peaked in spring and summer and fell to its lowest level during winter months. Suicide rates appear to increase with increasing hours of daylight.


Although suicide results from a multitude of factors including physical, mental, and social issues, the presence of bright light by virtue of its impact on brain serotonin may be one piece of this complex puzzle. Increased light may decrease depression and enable an individual to have the energy to commit suicide. While the study was conducted in Australia there may be implications for citizens in other countries including the United States.


American Journal of Psychiatry. 2003. 160, 793-795.