Month: September 2016

Preventing Falls – New Tools and Resources

Posted on by Michelle Fritsch, Pharm.D.
fallenman
There are new tools to help you avoid falls.

Now that it is fall, let’s talk about falls. September 22 (or the first official day of fall each year) is national Falls Prevention Awareness Day. This year we have some new resources to learn about and to celebrate.

Every year very unintended falls, those slips that come out of nowhere, lead to deaths, fractures, hospitalizations, and need for assistive devices. In addition, fear of another fall leads to changes in day-to-day activities. One ‘little oops’ can take someone from doing all they want to do to needing assistance and having restrictions. No one wants that.

Falls Risk Factors

Besides snow, ice, and rickety steps there are so many things that can increase your risk for falling. Below are a few.

Medications

  • Those that make you sleepy
  • Those that relax you or change your mood
  • Those that make your blood pressure drop too low or too suddenly
  • Those that make your blood sugar dip too low
  • Many pain medicines
  • Any medicine that makes your mouth and eyes really dry
  • Most of the over-the-counter sleep aids

Medical conditions

  • Heart disease
  • Stroke
  • Anything that makes your legs hurt
  • Pain in general
  • Obesity
  • Incontinence

In your home

  • Rugs
  • Cords
  • Pets that get under your feet
  • Steps

Other

  • Vision problems or glasses that don’t fit or aren’t the right prescription
  • Hearing problems
  • Using a cane, crutches, or walker in the wrong way

Wow, and this is just a partial list!

New Falls Prevention Resources

That is why I am so excited to tell you about some new resources from the Centers for Disease Control (CDC). They released last summer the Stopping Elderly Accidents, Deaths & Injuries (STEADI) toolkit. The toolkit can be found here: http://www.cdc.gov/steadi/patient.html. You can find a checklist for your home. This will help you identify and fix any risks you might not have known about. There is a checklist to complete before you go to the doctor. It will help your doctor determine how much fall risk you have. The specific resources in the toolkit I encourage you to pull up are:

  • Stay Independent questionnaire
  • What Can You do to Prevent Falls brochure
  • Check for Safety home assessment guide

The STEADI toolkit has now been joined by a new toolkit that focuses more on the role of medications, medical conditions, and your physical function. This toolkit is the result of a collaboration between the American Society of Consultant Pharmacists and the National Council on Aging. This ASCP/NCOA resource was announced on National Falls Prevention Day. It will be first unveiled in a webinar for pharmacists on October 18. You can learn more at the ASCP website.

Also, on the 2016 National Falls Prevention Day, the CDC has released new statistics about the realities of falls in the US. You can learn more here.

Let us provide a comprehensive assessment of your falls risks today! Your preventative steps today can keep you active in the future. You can contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

Falling, especially after age 50 can change the course of the rest of your life. No wonder so much effort is put into preventing these falls.

What about falling away from what we’re called to do as Christians? Have you ever done something so terrible you feel like life will never be the same? Have you gotten caught up in activities that you later realize are not what God would want you to do? How far away did you fall?

How did you feel when you realized you had fallen away?

It’s often a big life event that reminds us that we fell away from God. Sometimes it’s an illness or birth of a child or death of a loved one. Sometimes it’s loss of a job or the end of a marriage.

How do you know if you have fallen too far? Could you fall so far that there is no return to God?

Ephesians 2:1-6 MSG

It wasn’t so long ago that you were mired in that old stagnant life of sin. You let the world, which doesn’t know the first thing about living, tell you how to live. You filled your lungs with polluted unbelief, and then exhaled disobedience. We all did it, all of us doing what we felt like doing, when we felt like doing it, all of us in the same boat. It’s a wonder God didn’t lose his temper and do away with the whole lot of us. Instead, immense in mercy and with an incredible love, he embraced us. He took our sin-dead lives and made us alive in Christ. He did all this on his own, with no help from us! Then he picked us up and set us down in highest heaven in company with Jesus, our Messiah.

Amazing news! You are saved through amazing grace! There is absolutely nothing you can do that can separate you from God.

2 Corinthians 5:17 ESV

Therefore, if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come.

Ephesians 2:8-9 ESV

For by grace you have been saved through faith. And this is not your own doing; it is the gift of God, not a result of works, so that no one may boast.

Romans 8:38-39 ESV

For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, 39 nor height nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.

So, you can fall and hurt your body in a way that can’t always be fixed. But, if you decide to come back, you CAN NOT fall so far away from God that you can’t return. We are so blessed! God is so good!

Blessings,

Michelle

Image source: National Library of Medicine, National Institutes of Health, United States Department of Health and Human Services

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Senior Service Providers – a huge network of resources

Posted on by Michelle Fritsch, Pharm.D.
occupational_therapist
There are many types of senior service providers for you to research in your area.

Our population is aging! And there is a rapidly growing network of Senior Service Providers to help promote healthy, safe aging. I was first introduced to this ever expanding network about a year and a half ago.

So I want to introduce you to the many resources available to you, to your aging loved ones, and to anyone you know who is anxious to stay as healthy as possible.

I don’t think it would be possible to make a list like this complete. So know if you have a specific need not listed, search for what you need. I’m fairly certain someone has thought of that need and designed a solution. At the end of this blog I’ll point you toward a think-tank of even more innovative solutions being pursued.

Senior Service Providers to seek in your area

  • Aging-in-Place/Home Safety
  • Assisted Living Placement Services
  • Assistive Technology Devices
  • Certified Care Management
  • Computer & Technology Services
  • Daily Money Management
  • Estate Liquidation & Cleanout
  • Financial Services & Insurance
  • Fitness and Balance Classes
  • Home Modification and Repairs
  • In-Home Primary Care Provider
  • Legal Services
  • Licensed Massage Therapy
  • Medicaid Planning
  • Medical Alert Systems
  • Medication Management
  • Mortgage & Reverse Mortgage
  • Move Coordination from your home
  • Nutrition
  • Occupational Therapy
  • Personal Historian
  • Physical Therapy
  • Private Duty & Home Care
  • Real Estate
  • Senior Living Communities
  • Transportation

Ways to find senior service providers

Again, this is not an exhaustive list. If you want to modify a home to make it safer, there are specialists that can help you. Look for the ‘Aging in Place’ certification. If you want to know what resources are available in your particular community, find a local Lifecare Manager at www.aginglifecare.org. If you are faced with downsizing, moving from home to assisted living or in with children, or arranging for someone to move in with you, there are a host of specialists to help. There are realtors specialized in homes designed for safe aging; mortgage and reverse mortgage specialists to help find the best rates, companies that specialize in helping you sort through your belongings and sell those you don’t plan to keep to convert them to cash; and companies that specialize in sorting through horded materials. There are companies that will pack you, move your belongings, and unpack them so that they are right where you want them.

There are lawyers specializing in the sensitive needs of older adults making financial and legal decisions. You can find specialists that will manage your bills and finances for you in your home – http://aadmm.com.

Note, some of these services are covered by insurance while others are out-of-pocket. Be sure to ask about costs as you research your options.

And, as promised, I want to tell you about Aging 2.0. This organization is pulling together innovative people with any kind of solution that will enhance healthy aging. It gives those innovators a platform to share their innovation, perhaps find funding, and network with other providers so they can collaborate and offer a more robust service. You can learn more at https://www.aging2.com/about-us/.

I have been amazed at all of the available resources. I hope you find hope in the many kinds of senior service providers that can help you in your quest for healthy aging. For more information about options, please contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

As Christians, we have a lot of resources at our disposal, too. Within the body of believers we have every kind of gift and skill. In Acts the believers supported each other and shared everything. We don’t do that, but we can use our gifts to help each other in whatever God is calling us to do.

Acts 4:32-37 ESV

Now the full number of those who believed were of one heart and soul, and no one said that any of the things that belonged to him was his own, but they had everything in common.  And with great power the apostles were giving their testimony to the resurrection of the Lord Jesus, and great grace was upon them all.  There was not a needy person among them, for as many as were owners of lands or houses sold them and brought the proceeds of what was sold and laid it at the apostles’ feet, and it was distributed to each as any had need.  Thus Joseph, who was also called by the apostles Barnabas (which means son of encouragement), a Levite, a native of Cyprus, sold a field that belonged to him and brought the money and laid it at the apostles’ feet.

The messages about helping each other are found in the New Testament and the Hebrew Bible.

Hebrews 13:16 ESV

Do not neglect to do good and to share what you have, for such sacrifices are pleasing to God.

Philippians 2:4 ESV

Let each of you look not only to his own interests, but also to the interests of others.

It is through going to Church, being part of small groups, participating in Bible studies, and other times of fellowship that we can find out about the needs. Then, as we consider our own gifts, we can align ourselves with the needs where we can be of assistance. We can also help connect those with needs to those with matching gifts among our Christian community. It is so beautiful when those matches come together!

Blessings,

Michelle

Image source: National Eye Institute, National Institutes of Health, U.S. Department of Health and Human Services

Gratitude and Satisfaction – Healthcare Perspective

Posted on by Michelle Fritsch, Pharm.D.
jamaica-group-wait
Have you expressed gratitude for your healthcare?

When was the last time you expressed gratitude for your healthcare? How often are you satisfied with the healthcare you receive? When do you suppose is the last time your doctor, nurse, pharmacist, medical assistant, intake/discharge specialist, or billing office received a ‘Thank you!’?

I encourage you to take a moment and list the last five benefits you received from your healthcare providers?

Here is my current list:

  1. Emergency services in the middle of a blizzard for a head injury for a child.
  2. A surgeon and many, many supportive people for a rotator cuff repair.
  3. A patient, engaging ophthalmologist helping a frustrated teen with vision-related headaches.
  4. Access to an annual mammogram with follow up ultrasound whenever something looks suspicious.
  5. Preventative vaccines and personalized guidance from my physician in preparation for third-world healthcare provision.

Healthcare gratitude I experienced in Jamaica

I can’t stop thinking about my week in Jamaica and the many insights I took away. I was honored to serve with a team of about 20 people caring for people in St. Mary Parish, an underserved portion of Jamaica. We had physicians, nurses, pharmacists, medical records, check-in, child-care, and spiritual support specialists. (Remember that spiritual health is a key aspect to overall health).

Two situations have especially stood out to me. One was a woman who was diagnosed with breast cancer in 2014. She was treated with a mastectomy. She did not have access to radiation or chemotherapy. Now, in 2016, she had a lump under her arm. The physician prescribed an antibiotic. We are all hoping and praying it is an infected cyst and not cancer. Guess what? She was grateful for the care and for the antibiotics! She did not demand other therapy. She was not disgruntled. [Maybe she doesn’t know how it would be treated in a developed country with insurance. Then again, her gratitude and lack of stress over options can actually be to her benefit.]

The other situation was a young boy with low hemoglobin, so he was anemic. Hemoglobin carries oxygen throughout the body. There are several possible causes of anemia in a child. We were able to give him multivitamins and iron supplements. His mother was surprised to hear he was anemic. He was outside playing with the other children as we talked about the medicine. When he came in she showed me how strong and healthy he looks. She was very satisfied with the vitamins and iron. I couldn’t help but think how differently that exchange would likely be here in the US. Parents would want a series of tests to rule out any obscure implication of the anemia. [Note, anemia in children is not uncommon in Jamaica. Children are breastfed for an extended period by mothers who do not have prenatal vitamins. Then, because meat is expensive, the diet has less iron in it.]

Health benefits of gratitude

It is so easy to find fault in other people and in systems. Add the element of fear that comes with medical diagnoses, and people often have very negative reactions in the healthcare setting. That increases stress for the patient, any caregivers with the patient, the physician, and all members of the healthcare team.

Consider the benefits of gratitude instead. Gratitude can:

  • Boost your spirits and sense of well-being
  • Boost your immune system making you less likely to get sick
  • Decrease your chances of heart disease
  • Improve your performance (job, concentration)
  • Bust your stress

By all means, when mistakes are made they need to be addressed. But mistakes are not the norm. People go to school for many, many years to be able to provide the best healthcare they can provide.

We saw hundreds of patients in very hot August in Jamaica in churches with no air conditioning and few fans. And I only heard one person complain over five very full days. That woman didn’t understand why the man next to her got more diabetes medication than she got. Once she understood it took more medicine to manage his sugar she was satisfied.

If you would like to hear more about my trip to Jamaica or about the health benefit of gratitude, contact me at www.medsmash.com/newsblog/.

BIBLICAL APPLICATION

Life feels so different when we live in gratitude rather than dissatisfaction. Negativity stresses us out and ultimately kills us.

1 Thessalonians 5:18 ESV

Give thanks in all circumstances; for this is the will of God in Christ Jesus for you.

I have a new source of gratitude this week.

Do you ever have a God moment when something becomes so clear? I received the best analogy this week. And I can’t wait to tell you about it!

It likens faith with a child going on vacation.

When a family is going on vacation, the child knows the mom or other adult will pack the clothes, the snacks, the sunscreen, the towels, and anything needed for that vacation. The child knows someone will take care of the directions, putting gas in the tank, making hotel reservations, and other travel details. The child knows there will be a safe place to sleep, some fun adventures along the way, food to eat, and all basic needs will be met. The child gets in the car when told it’s time and follows the lead of the adults who have planned the trip. The child is along for the fun with no stress and no second-guessing the plans.

Wow, isn’t that like faith? God’s got this! He has plans for your life. He has plans for each year, month, day, minute, … Faith is being the child with full faith in the adults who are in charge of the details.

Proverbs 3:5-6 ESV

Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways acknowledge him, and he will make straight your paths.

Isaiah 42:16 NIV

I will lead the blind by ways they have not known,

    along unfamiliar paths I will guide them;

I will turn the darkness into light before them

    and make the rough places smooth.

These are the things I will do;

    I will not forsake them.

I encourage you to spend less time on daily travel details and more time letting God take the lead this week.

Blessings,

Michelle

 

When the Rules Don’t Quite Make Sense

Posted on by Michelle Fritsch, Pharm.D.
Airplane ors.od.nih.gov
Interpretation of rules has created an airplane that has launched with no plans to build the runway in healthcare.

To finish a thought from last week’s blog, sometimes the rules create their own problems. The Centers for Medicare and Medicaid (CMS) created a new risk-sharing payment strategy with hospitals. If someone has health insurance through Medicare, and if they are readmitted to the hospital for the same condition within 30 days, then the hospital will not be paid for the second admission. (Of course it’s a bit more complex than that, but this is the gist).

This ruling has created a whole new ‘market’. A group of very smart technology experts and entrepreneurs have identified this as a place to create new ways to keep people healthy at home. Tools and solutions are created that help people be successful at home after being in the hospital.

  • Patients benefits by having new resources to help them maneuver their care at home and stay at home.
  • The hospital benefits by losing less money on readmissions within 30 days.
  • The new companies, technology gurus, and entrepreneurs make money by being paid through the hospital’s cost savings.

Rules (and solutions) – make sense?

These are the parts that are missing, in my opinion.

  1. Once we determine how to keep people home safely for 30 days, I anticipate CMS will expand the time window to 60, 90, or more days. So short–sighted solutions will not survive.
  2. What happens after 30 days? Many of these new solutions involve technology. Who pays for the technology and the monitoring after the 30 days? Will it just be removed from the person’s home? Then what happens? Is that cost effective? Does it even make sense?
  3. What about people who are fearful of technology? Again, most of the solutions I’m hearing and reading about are based on technology. What if the person doesn’t have internet access or land-line phone access? What if the person has no interest in learning how to use the technology? What if the person just can’t get the hang of the technology?
  4. As I mentioned last week, I am finding very little data on what users/people with chronic medication conditions want. Solutions are being developed with little to no input about whether people will actually want or use the solutions.

For some of these issues the answers I’ve received are that there will always be exceptions. Those will be dealt with one by one. The goal is to find solutions for the majority.

It was funny, in one of these conversations we likened the current technology solutions boom to the airplane that’s in the air but no one has thought yet about the runway. That seems like a fitting analogy to me right now.

Hope

There is hope. I talked yesterday to a company taking a MUCH broader view of helping people stay healthy in their homes. They are not even thinking about the 30 day readmission rules. They are looking at long-term solutions that are created and maintained around the person that is using them. I know that company is not alone. I’ll put my hope in these types of companies!

For more information about new technologies in healthcare, please contact us at www.medsmash/contact.

BIBLICAL APPLICATION

Do you ever feel like the ‘rules’ of Christianity don’t make sense? Are you left wondering why the Christians around you are doing things a particular way? Have you been instructed to do something that doesn’t make sense?

In these instances, I encourage your FIRST question to be, ‘Is it Biblical’?

1 John 4:1 ESV

Beloved, do not believe every spirit, but test the spirits to see whether they are from God, for many false prophets have gone out into the world.

2 Peter 2:1 ESV

But false prophets also arose among the people, just as there will be false teachers among you, who will secretly bring in destructive heresies, even denying the Master who bought them, bringing upon themselves swift destruction.

I’m not saying every pastor or spiritual leader who says something that is not Biblical is a false prophet. People, even pastors, do make mistakes. But we have A LOT of examples of people adding rules to what is in the Bible. These ‘human’ rules are just that. Each denomination has their ‘way of doing things’. Even these are often the result of people trying their best to understand and interpret the scriptures. So see if the item that you question is from people or from God.

Your SECOND question should be, ‘Did I understand correctly’? Never hesitate to ask clarifying questions. We are all guilty of making assumptions about the other person’s knowledge when we answer a question. This often leads to complete misunderstanding.

Proverbs 18:13 MSG

Answering before listening

    is both stupid and rude. 

1 Timothy 6:20-21 MSG

And oh, my dear Timothy, guard the treasure you were given! Guard it with your life. Avoid the talk-show religion and the practiced confusion of the so-called experts. People caught up in a lot of talk can miss the whole point of faith.

I encourage your THIRD question to be, ‘Does it glorify God?’ By this I mean, does it promote the type of life and interaction we are called to live?

James 3:17-18 MSG

Real wisdom, God’s wisdom, begins with a holy life and is characterized by getting along with others. It is gentle and reasonable, overflowing with mercy and blessings, not hot one day and cold the next, not two-faced. You can develop a healthy, robust community that lives right with God and enjoy its results only if you do the hard work of getting along with each other, treating each other with dignity and honor.

The real ‘rules’ and instructions are in the Bible. The rest are interpretations, good/spot on and sometimes misguided. So discernment helps us sort them out. I know I have trouble sorting through it all on my own. Bible reading, study, trusted people to talk with, and prayer help me through.

Blessings,

Michelle

Image source: Office of Research Support; National Institutes of Health; U.S. Department of Health and Human Services.