The US health system focuses an enormous amount of money and attention on post-acute care—the medical treatment patients receive after they have been discharged from a hospital. But it would more cost effective, and far better for patients, to refocus on what you might call pre-acute care: What the US can do to prevent those hospitalizations in the first place. [...]
As the Covid-19 public health emergency ends, many older adults who need a post-hospital stay in a skilled nursing facility (SNF) will be in for an unpleasant surprise: Traditional Medicare may not pay. The change, one among dozens that affect older adults, restores rules from before the pandemic. But they are complicated and will shock many patients and their families, [...]
President Biden’s announcement that the Covid-19 public health emergency (PHE) will end on May 11 will have a significant impact on older adults. Some changes will be immediate, others won’t occur for nearly two years. Some may improve care for older adults, others could cost seniors more money and end some important benefits they received during the pandemic. Biden’s decision [...]
I’ve recently spent more time as a hospital visitor than at any time since the pandemic began. A lot has changed since Covid-19, but my experiences confirm some good advice for older patients, their families, and the medical staff that cares for them. Here are a few ideas for patients and staff. While they focus on hospitals, many apply to [...]
More than ever, family members are required to play a major role in caring for their loved ones. But they are being asked to do increasingly complex medical tasks with little or no training. The result: Greater risk to patients and enormous avoidable stress for those family caregivers. A new study attempts to identify the barriers to good caregiver training. [...]
By now, you’ve probably heard about the desperate shortage of nurses and aides in nursing homes and long-term care facilities. This workforce crisis not only hurts their residents, it also is creating severe backups in hospitals, putting both patients and the facilities themselves at risk and increasing health care costs. As those staffing shortages course through the entire health care [...]
Last week, I suggested that in the wake of the coronavirus pandemic, nursing homes may need to take patients from over-burdened hospitals. At the same time, care settings such as assisted living facilities (ALFs) might have to accept nursing home residents who must be relocated to make room for those post-acute patients. Now, it looks like that is beginning to [...]
Family members and friends are the bedrock of our system of personal care for frail older adults and younger people with disabilities. Without their support, the nation’s hospitals and nursing homes would be filled to the rafters with very sick, frail seniors. And many of those older adults would die before their time. Those family caregivers often provide assistance with [...]
The influential National Academies of Sciences, Engineering and Medicine (NAS) has called for a major initiative to better integrate heath care and social supports. The group, formerly known as the Institute of Medicine, has published a white paper on the subject that should encourage both policymakers and medical practitioners to pay more attention to the importance of social supports to [...]
No issue generates more anger and confusion among Medicare recipients than observation status—that hospital stay that really isn’t a hospital stay. Over the holidays, I got an earful from three people who had been treated at a hospital by hospital staff yet not admitted to the hospital. A typical case goes like this: A person comes to a hospital emergency [...]