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Posts from the ‘Home Health Nursing’ Category


What Pfizer Approval Means for us.

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Tis the Season

80 percent of depression in the elderly is treatable. Take action and help your patients feel better for the holiday season and all of 2021.

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Less Than a Week…

My blog post today was supposed to be an essential piece regarding hearing loss in our patient population and what you can do to help your patients.  It will have to wait.  For now, just realize that lots of our patients don’t hear so well and it seems like you can’t do about it because Medicare doesn’t cover hearing aids. More about that later.  Email me if you admit a very hard of hearing patient. I do not intend to diminish the significance of hearing loss, but we aren’t voting on it next week.

Today, I’m going to do something I try very hard not to do.  With only a few days left until the election, I’m going to write a political post.  I try to avoid this because in my Pollyannaish heart, I believe we all want the same thing – a country that is safe, fair taxes and equal opportunities to make the American Dream come alive for each of us.  Obviously, we differ on how to get there.  And as far as unsolicited advice goes, I will limit it to my strong insistence that you vote. 

But I am spitting nails and losing my religion all at the same time this week because the president has accused pretty much the entire healthcare industry of colluding and conspiring to commit fraud.  He said that other countries stated that patients who died ‘with’ covid were not coded as Covid deaths but American doctors and hospitals just put Covid down for everything.

What does this all mean?  If the president knows what he is talking about and he does have an uncle who was a professor at MIT so he must know more than us, we have just been told:

  • Pretty much everyone in the healthcare industry deserves prison time. 
  • We apparently do not code as well as other countries.
  • We are all greedy and willing to compromise care for cash.

Healthcare professionals have gone from being heroes to criminals and for no purpose other than votes. Does the president not know how many registered voters work in healthcare?  This comes on the tail of insulting Dr. Fauci (or Tony as the president calls him).

The same people who would believe this are the same who believe Covid is a hoax but in the event they catch it, they can always self-inject bleach so why does it matter?

Unlike bleach recommendations and the prediction that warm weather will chase the virus away, this particular misinformation harms patients.  Patients who do not trust their physicians because they are criminals tend to be non-compliant. 

Can you imagine being told that a painful surgery or chemotherapy with a plethora of side effects is your best chance for living a long and healthy life by someone who merely wants to pay for a summer home?  Is there anyone in the world worse than a sleaze bucket who would lie about a diagnosis for a few extra dollars?   How about those patients on the ventilator in ICU’s?  Is all that expensive care really needed? 

What about the nurses, therapists, coders and billers who facilitate this fraud on the US government?  Fraud of this magnitude cannot be accomplished independent of the entire system.

I don’t often give advice on how to commit fraud, but I will offer one tidbit.  Do not have a lot of co-conspirators if you steal from the government.  It never works out. 

I may be wrong. My uncles never attended MIT. I am not on the cutting edge of bleached science. Doctors aren’t nice to me because they have to be and I don’t suffer if I disagree with the president. I am not important enough to be silenced by the white house.

I am not going to tell you how to vote but good information is required to make good decisions.  You decide how important it is to have the White House respect healthcare workers.  I know that I will do my best regardless of who is in office.  I also know that Covid isn’t a hoax treated with bleach.

For your Friday, enjoy two surgeons in the midst of the first surge of Covid singing Imagine on the front steps of the hospital. We all need a little hope.

A Long Summer

There are a lot of jokes about 2020 not being such a good year. For me, it is the year that I lost my mother at the tender age of 89 just weeks before her 90th birthday. To be honest, my math skills led me to believe she was 90 and on her way to her 91st birthday. Oh well.

Throughout this long summer while hanging out with Mama, I realized that we were living through history. Like the 1918 Spanish Flu, the Covid pandemic is an event that will continue to influence history for decades. I knew I should be writing about it but honestly, is there anything left to write? Maybe.

I lived through one aspect of Covid that isn’t getting as much attention as the number of cases and the mortality rate. My mother was ill since February and it had nothing to do with Covid. How she was treated and if she was treated had everything to do with Covid. In the end, I wonder if Covid will totally transform our healthcare industry.

My mother, always social, had very few visitors in the months prior to her death. I did not encourage visitors and when people asked if they could visit, I usually refused. I had two parents and my Dad, with Dementia, simply can’t remember to wear a mask correctly. It was uncomfortable for him and also, Mama. Covid would have been a death sentence for either of them. Even after it became clear that my mother was terminal, I would not have wished a Covid death on her. And who would have cared for her and my Dad if my son or I became sick?

Hiring help was similarly difficult. We got very lucky when an aide who is otherwise unemployed became available. She is sitting out the semester in college due to the pandemic and we are learning from the news that she may have made the very best decision. Agency help would have meant an aide that possibly went to different homes and it would be unfair to limit someone’s ability to work. Covid has changed the economic status of many Americans.

At times, I received a lot of encouragement to send Mama to the hospital. Each time her condition exacerbated, I called the local ERs and learned that nobody was allowed to stay with her in the Emergency room and if admitted, only one person who tested negative for Covid could stay with her. This person was not interchangeable. That meant my Dad who would forget rules about leaving the room would not be able to visit and either me or my son would not be able to see her.

Chances are we would have dropped her off at the ER like so much dry cleaning that got lost and we would have never seen her again. I could not do that and I had her written power of attorney for healthcare so it did not happen.

But there were friends and relatives who made life easier. I have a cousin who is a physician who visited. His approach to Mom’s care was like mine – as long as something was not painful or invasive, Mama got it. No extensive treatment or ‘heroics’ (as she called them) were attempted. If Mama were around or if she is reading this blog post, she would tell me to add to it that there is nothing heroic about shoving a tube down the throat of a senior octogenarian simply to prolong a heartbeat. And Mama is always right.

A cousin who is a nurse along with her daughter provided the very best palliative care – chocolate peanut butter cookies from the Snoop Dogg and Martha Stewart collaboration cookbook aptly named From Crook to Cook.

Another local cousin dropped off meals. It was gourmet meals on wheels. Like kids playing a joke on neighbors, the doorbell would ring and nobody would be at the door but when I would look down, there was dinner. There are no words to express how grateful we were for the care packages.

Cards were also delightful especially to mother. The beauty of cards is that they can be set aside when appropriate and read repeatedly when someone is awake.

I tell you all of this because unless a treatment is found for Covid very soon, everyone will have a friend or relative with Covid or another illness that prevents visits. You can still let them know that you care. Snoop, Martha and Cousin Tillie would want you to find a way to bring chocolate comfort.

Still, I would have hired help earlier had it not been for Covid. I would have maybe, just maybe, taken Mom to the hospital when she first had a GI bleed just to see if the problem was easily correctable. I would have had hospice come in earlier. As it was, I had access to a hospice client who gives excellent care and they were on call for me whether they knew it or not. Thanks Audubon.

Humana saved a ton of money on my mother without changing the outcome of her illness. I realize this a luxury because not everyone can take a break from life to provide total care to an elderly patient but I wonder how many people are not accessing healthcare because of the pandemic. Are outcomes in general significantly changed?

But that’s just my story of how Mama saw a return on investment on my nursing school tuition.

Covid has affected every aspect of our lives from how we work and shop to how we educate our children, socialize and even experience illnesses. Politics has played an inappropriate role in determining our response to Covid.

I hope you’re keeping some sort of record. 102 years after the Spanish Flu, it is the personal accounts of the patients and the healthcare workers, and even the San Francisco Anti-Mask league of 1919 that tell the story of the Spanish flu. Some numbers are just too high to comprehend.

If you are keeping some sort of record, please consider sharing all or part of it with us. You can email me here.

COVID-19 for Visiting Nurses

How should home health and hospice visiting employees address Covid19 and protect staff and patients?

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