News Roundup: March 24, 2014
Trend in health care focuses on the home
Published by NWI Times
March 17, 2014
Parts of the Affordable Care Act focus on keeping people out of hospitals as a way to cut costs and to focus on patient care. That shift is putting more emphasis on areas like home-based care and transitional care.
"The main goal is to have people prepared when they go home," said Lisa Hopp, professor of nursing at Purdue University Calumet in Hammond and director of the Indiana Center for Evidence Based Nursing Practice.
Before, some patients sought hospitals for revolving door care. But that is costly.
"Hospitals are very expensive to operate," said Pat Bankston, associate dean at Indiana University School of Medicine Northwest and dean of the College of Health and Human Services at Indiana University Northwest in Gary.
If home health care providers can do the work instead, it cuts down on the expense, he said.
A large degree of pressure on hospitals now comes from the Affordable Care Act, demanding them to do better, Hopp said.
"Besides getting people insured, the Affordable Care Act has a legislative focus on patient-centeredness," she said. "Nurses have always felt that's what we do. We're patient-centered. It's written in our code of ethics."
Because of that, the Patient-Centered Outcomes Research Institute, or PCORI, has been welcomed as a huge resource, Hopp said.
"In the brouhaha when legislation (for the Affordable Care Act) was being debated, PCORI was what the strident people were calling the death panel," she said.
In reality, the institute focuses on patient-centered care. Its mission statement states the organization, "helps people make informed health care decisions and improves health care delivery and outcomes by producing and promoting high integrity, evidence-based information that comes from research guided by patients, caregivers and the broader health care community."
It emphasizes the role of patients in their own health.
"They have to be integrated from the very beginning," Hopp said.
With lengths of hospital stays being appropriately shortened, people go home with their illnesses, such as heart failure and pulmonary disease. They need to know how to manage their health, and that often means relying on people who specialize in transitional care, Hopp said.
"You need a team of people," she said.
Home health care agencies are playing a bigger role, especially with technology allowing care that can be provided in home instead of in a hospital setting, said Linda Delunas, associate dean in the College of Health and Human Services at IUN, associate professor in the School of Nursing and adjunct associate professor of medicine at the IU School of Medicine-Northwest.
One example is hospice care.
"Given the choice, people would rather die in their own home," Delunas said. "Hospice care provides support to do that."
And, it is a much less expensive option for patients who do not require high-tech hospital equipment, she said.
Hopp said many families who have used hospice for their dying loved ones are grateful.
"Hospice continues to be one of our bright spots in the health care system," she said. "Most people say, 'We should have done it earlier.'"
Another emphasis is on palliative care, which is different than hospice, Hopp said.
Palliative care is for patients who are seriously ill. The care uses a team approach to focus on relieving patients of symptoms and pain of serious illness.
Getting care and staying at home
Published by The News Leader
March 16, 2014
Lucille Vanfossen is a determined woman.
“I do all my work,” Vanfossen, 91, said. “I do my cleaning and my laundry.”
But for Vanfossen of Staunton, a caring web of support means that people are never too far away.
She illustrates just how independently people can live, into their 80s and 90s, so long as a nourishing community surrounds them. One of the people who supports her is Dottie Tarullo, RN. She helps Vanfossen and other telehealth patients in Home Health Services at Augusta Health.
Tarullo visits Vanfossen to check weight, blood pressure, oxygen level and pulse. And Vanfossen, with the help of her son, lets Tarullo know the results on the days when Tarullo does not visit.
Tarullo said that the equipment may take some getting used to, but that patients generally adjust.
“They usually manage pretty well,” she said. “Sometimes they need the help of a family member.”
Vanfossen said the one-on-one care is especially welcome.
“It makes you feel good that somebody’s interested in trying to help you,” she said. “I have to give it to Home Health. They are a very, very caring group of people.”
Vanfossen also gets help from her son Allan, for instance, who lives close by.
“Allan is so good to me,” she said.
Vanfossen said bathing is the toughest task for her, but she enjoys cooking. She mentioned baking bread and cooking other meals, such as macaroni and cheese, and she said she especially likes making meals from scratch.
“I don’t want to get a box and dump them in there and just put a little water with them,” she said.
Vanfossen does face physical challenges that affect even her favorite activities. She said she’s broken both hips within the past two years. She also has macular degeneration, which impedes her vision — especially when it comes to objects in front of her.
But she said her peripheral vision still functions, and she’s also learned to rely in creative ways on her other senses.
“I can’t see to measure, but I feel to see when I’ve got my measuring cup full,” she said. “Or when something is liquid, I pour until I hear it running over. I can’t see good, but the Lord gave me good hearing.”
Vanfossen said she moved to the house in 1955, and she’s been by herself for 29 years. She said that’s when her husband, Francis, died.
Vanfossen said nieces also come see her, and she mentioned friends from the neighborhood and from her church, Marquis Memorial United Methodist Church, who see her, too.
“They call me,” she said, noting that they’ve helped her to keep food in the house, especially after a hospital visit.
One friend from church, Phyllis Wiseman, called Vanfossen an inspiration — and also extremely likeable.
“She’s a very determined person,” Wiseman added. “She’s determined that she’s going to ... do things on her own.”