Health care has grown into a colossal tapeworm in the bowels of the Ontario government, devouring cash as quickly as it gets shoveled down the taxman’s maw.
They have thrown significant cash at health care’s many woes. However, the need is for the creation of an integrated health care system where electronic records safeguard against prescription errors, where patients are proactively tested for disease and where doctors and nurses counsel patients throughout their life to guide them to better health. We are nowhere near that and progress to restructure health care to prepare for imminent need has focused on political priorities and acute care needs. One day, and soon, we’ll all pay a price for that. James Wallace is the Queen’s Park bureau chief for Osprey News Network.
Contact the writer at www.ospreymedia.ca.
Thursday, May 17, 2007
Tips to Avoid falls for the elders
No More Dangerous Falls
Sometimes a fall is just a minor annoyance, resulting in minor abrasions -- but not always. Falls break bones and tear tendons. Even more worrisome, statistics show that falls are the leading cause of injury-related death among people age 65 and over. This unhappy statistic is partly because older people often have changes in muscle strength, reflexes and coordination. In addition, those with chronic conditions are more susceptible to falling because those conditions may affect balance and certain medications for those conditions can affect balance. But plenty of healthy folks fall as well, including a very good friend of mine who is very active and athletic. If she could fall, anyone can. So, how can you "fall-proof" yourself?
RECENT RESEARCH
In my research, I came across a recent study from the University of Michigan in Ann Arbor about a program called Combined Balance and Step Training (CBST). For this study researchers gathered results from 162 people age 65 and older who were divided into two groups. One group was in a tai chi program, the ancient Chinese mind-body practice... and the other group took CBST. Both groups practiced their particular method three times a week in one-hour sessions over a period of 10 weeks. Interestingly, in spite of tai chi's well established reputation for helping practitioners avoid falls, the CBST group performed slightly better in tests that measured specific abilities that promote fall avoidance. The senior author of the study was Neil B. Alexander, MD, director of the Mobility Research Center at the University of Michigan Geriatrics Center. I called him to find out more about CBST and how it helps people develop fall resistance.
Dr. Alexander first explained that falls generally occur because of a confluence of factors, both internal and external. To explain: You are talking on your cell phone having a heated debate about something and you cross a busy street. You are watching the traffic, but fail to notice the cracked cement on the other side of the street and over you go. A young healthy person might be able to right himself before falling, but that ability decreases with age and not just because of slowed reflexes, says Dr. Alexander. Falling often has to do with not just what you see, but also how you process what you see.
Cognitive decline -- even if mild -- can interfere with visual processing, but so can everyday stress and fatigue whatever your age. The reason: When stressed, your brain may fail to process visual cues, such as something in your peripheral vision that ordinarily you would take note of. Adding to the problem, 9% of people over age 65 have a balance problem that makes them more apt to tip. Dr. Alexander says this is often because of medicine side effects or conditions such as peripheral nerve problems or silent strokes that cause no immediate noticeable symptoms but affect the nervous system over time.
WALK RIGHT
The way people walk -- their gait -- has a great deal to do with how stable they are in motion too. With age, many people start to take shorter and slower steps. (This is also true of people affected by certain disorders such as Parkinson's or osteoarthritis.) But slower steps that are not long enough can make people more vulnerable to falling, says Dr. Alexander. Furthermore, one of the best ways to overcome an imminent fall is to make a rapid step of sufficient length in the direction of the fall, an ability many people lose. Consequently, CBST focuses on teaching participants to take longer steps at a faster speed, exactly the opposite of the shuffle walk associated with some older adults. It's also worth noting that long, fast steps require lifting the feet slightly higher, which provides better toe clearance, which in turn helps prevent a trip over small near-to-the-ground bumps and curbs.
BALANCE RESPONSES
Fall prevention also includes having good balance responses, which means being able to right yourself quickly when you are thrown off balance. To develop these responses, the CBST study group practiced a series of exercises to train them in what Dr. Alexander calls dynamic balance. The following are some examples... a.. Responding to a balance challenge while standing -- for instance, moving the upper body while bouncing and catching a ball. b.. Changing direction while walking, such as walking backward or laterally. c.. Moving from a symmetrical (side by side) to asymmetrical (one foot in front of the other) stance. d.. Maintaining balance while walking on a reduced base of support, such as on a narrowing plank. e.. Braiding/grapevine stepping -- foot in front, foot in back while going sideways. f.. Stepping over small hurdles the height of an average step (about six inches).The group also did modest exercises to increase ankle, knee and hip strength.
PRACTICING AT HOME
Although a CBST program is relatively simple, Dr. Alexander recommends starting such training following a screening by a professional, such as a physical therapist. (These professionals are trained to recognize weak spots and help people achieve their physical goals without causing themselves any injury in the process. He adds that everyone can and should integrate some balance training into an exercise regimen. These need to be more challenging than simply standing on one foot. He advises practicing doing two things at once (catching a ball as you move, for example), walking on something with decreasing support and teaching yourself to take longer, faster steps. Caution: Do not practice any of this without holding on to something stable for support. The idea is learning to prevent falls, not to promote them. Remember, too, that when you are tired, stressed or distracted, your ability to move properly may be hindered -- be especially careful at those times wherever you are. Even better: Be sure you get plenty of rest so your mind and bodily responses are fresh.
THE RIGHT SHOES
One last contributing factor -- what you wear on your feet plays a huge role in whether or not you are vulnerable to falls, says Dr. Alexander. Some soles, such as on sneakers, unfortunately, tend to grip, especially when you change surfaces, say from carpeting to linoleum, or when the surface rises slightly. Wearing sneakers, then, calls for extra awareness. Watch out for the lip (the tip of the shoe where the shoe front meets the sole) of the shoe, and how far it extends in front of your foot. An extended lip easily catches on steps or small hurdles along the way. The worst offenders in the shoe lip problem are sandals and some of the thick-soled shoes that are popular now. As for high heels, well, Dr. Alexander says, one error and you topple. The shoes to look for, then, are those without much lip but with a good fit to provide good support to the foot and ankle (making slippers a no-no). Soles should not be so thick it decreases the sensory input to your foot. If shoes have a slippery sole, scratch them up with a metal brush or the like before you wear them. Shoes without laces (fixation) or slip-ons without a back can also increase risk. Finding the right shoes takes some sleuthing, but fortunately there are many that fit the bill and are even fashionable enough to have you looking good while keeping you safe.
Sometimes a fall is just a minor annoyance, resulting in minor abrasions -- but not always. Falls break bones and tear tendons. Even more worrisome, statistics show that falls are the leading cause of injury-related death among people age 65 and over. This unhappy statistic is partly because older people often have changes in muscle strength, reflexes and coordination. In addition, those with chronic conditions are more susceptible to falling because those conditions may affect balance and certain medications for those conditions can affect balance. But plenty of healthy folks fall as well, including a very good friend of mine who is very active and athletic. If she could fall, anyone can. So, how can you "fall-proof" yourself?
RECENT RESEARCH
In my research, I came across a recent study from the University of Michigan in Ann Arbor about a program called Combined Balance and Step Training (CBST). For this study researchers gathered results from 162 people age 65 and older who were divided into two groups. One group was in a tai chi program, the ancient Chinese mind-body practice... and the other group took CBST. Both groups practiced their particular method three times a week in one-hour sessions over a period of 10 weeks. Interestingly, in spite of tai chi's well established reputation for helping practitioners avoid falls, the CBST group performed slightly better in tests that measured specific abilities that promote fall avoidance. The senior author of the study was Neil B. Alexander, MD, director of the Mobility Research Center at the University of Michigan Geriatrics Center. I called him to find out more about CBST and how it helps people develop fall resistance.
Dr. Alexander first explained that falls generally occur because of a confluence of factors, both internal and external. To explain: You are talking on your cell phone having a heated debate about something and you cross a busy street. You are watching the traffic, but fail to notice the cracked cement on the other side of the street and over you go. A young healthy person might be able to right himself before falling, but that ability decreases with age and not just because of slowed reflexes, says Dr. Alexander. Falling often has to do with not just what you see, but also how you process what you see.
Cognitive decline -- even if mild -- can interfere with visual processing, but so can everyday stress and fatigue whatever your age. The reason: When stressed, your brain may fail to process visual cues, such as something in your peripheral vision that ordinarily you would take note of. Adding to the problem, 9% of people over age 65 have a balance problem that makes them more apt to tip. Dr. Alexander says this is often because of medicine side effects or conditions such as peripheral nerve problems or silent strokes that cause no immediate noticeable symptoms but affect the nervous system over time.
WALK RIGHT
The way people walk -- their gait -- has a great deal to do with how stable they are in motion too. With age, many people start to take shorter and slower steps. (This is also true of people affected by certain disorders such as Parkinson's or osteoarthritis.) But slower steps that are not long enough can make people more vulnerable to falling, says Dr. Alexander. Furthermore, one of the best ways to overcome an imminent fall is to make a rapid step of sufficient length in the direction of the fall, an ability many people lose. Consequently, CBST focuses on teaching participants to take longer steps at a faster speed, exactly the opposite of the shuffle walk associated with some older adults. It's also worth noting that long, fast steps require lifting the feet slightly higher, which provides better toe clearance, which in turn helps prevent a trip over small near-to-the-ground bumps and curbs.
BALANCE RESPONSES
Fall prevention also includes having good balance responses, which means being able to right yourself quickly when you are thrown off balance. To develop these responses, the CBST study group practiced a series of exercises to train them in what Dr. Alexander calls dynamic balance. The following are some examples... a.. Responding to a balance challenge while standing -- for instance, moving the upper body while bouncing and catching a ball. b.. Changing direction while walking, such as walking backward or laterally. c.. Moving from a symmetrical (side by side) to asymmetrical (one foot in front of the other) stance. d.. Maintaining balance while walking on a reduced base of support, such as on a narrowing plank. e.. Braiding/grapevine stepping -- foot in front, foot in back while going sideways. f.. Stepping over small hurdles the height of an average step (about six inches).The group also did modest exercises to increase ankle, knee and hip strength.
PRACTICING AT HOME
Although a CBST program is relatively simple, Dr. Alexander recommends starting such training following a screening by a professional, such as a physical therapist. (These professionals are trained to recognize weak spots and help people achieve their physical goals without causing themselves any injury in the process. He adds that everyone can and should integrate some balance training into an exercise regimen. These need to be more challenging than simply standing on one foot. He advises practicing doing two things at once (catching a ball as you move, for example), walking on something with decreasing support and teaching yourself to take longer, faster steps. Caution: Do not practice any of this without holding on to something stable for support. The idea is learning to prevent falls, not to promote them. Remember, too, that when you are tired, stressed or distracted, your ability to move properly may be hindered -- be especially careful at those times wherever you are. Even better: Be sure you get plenty of rest so your mind and bodily responses are fresh.
THE RIGHT SHOES
One last contributing factor -- what you wear on your feet plays a huge role in whether or not you are vulnerable to falls, says Dr. Alexander. Some soles, such as on sneakers, unfortunately, tend to grip, especially when you change surfaces, say from carpeting to linoleum, or when the surface rises slightly. Wearing sneakers, then, calls for extra awareness. Watch out for the lip (the tip of the shoe where the shoe front meets the sole) of the shoe, and how far it extends in front of your foot. An extended lip easily catches on steps or small hurdles along the way. The worst offenders in the shoe lip problem are sandals and some of the thick-soled shoes that are popular now. As for high heels, well, Dr. Alexander says, one error and you topple. The shoes to look for, then, are those without much lip but with a good fit to provide good support to the foot and ankle (making slippers a no-no). Soles should not be so thick it decreases the sensory input to your foot. If shoes have a slippery sole, scratch them up with a metal brush or the like before you wear them. Shoes without laces (fixation) or slip-ons without a back can also increase risk. Finding the right shoes takes some sleuthing, but fortunately there are many that fit the bill and are even fashionable enough to have you looking good while keeping you safe.
Wednesday, May 16, 2007
New Horizons for Seniors
Any worthhile seniors or challenge projects out there? qj
New Horizons for Seniors: "New Horizons for Seniors
Call for Applications
New Horizons for Seniors is now accepting applications for funding. View the Call for Applications for your province or territory.
This program provides funding for community-based projects across Canada. Projects encourage seniors to continue to play an important role in their community by:
helping those in need;
providing leadership; and
sharing their knowledge and skills with others.
Calls for Applications are issued once or twice a year. Application deadlines may vary for each province and territory."
New Horizons for Seniors: "New Horizons for Seniors
Call for Applications
New Horizons for Seniors is now accepting applications for funding. View the Call for Applications for your province or territory.
This program provides funding for community-based projects across Canada. Projects encourage seniors to continue to play an important role in their community by:
helping those in need;
providing leadership; and
sharing their knowledge and skills with others.
Calls for Applications are issued once or twice a year. Application deadlines may vary for each province and territory."
Monday, May 14, 2007
Health Telemointoring
Innovations with technology
2. Study: Telemonitoring seems promising
Home-based telemonitoring of patients with chronic diseases has a great deal of potential, according to a new study published this month in a high-profile health IT journal. To conduct the research, which appeared in the Journal of the American Medical Informatics Association, Canadian researchers reviewed more than 65 studies published in the U.S. and Europe. The studies looked at home-based management of chronic pulmonary conditions, cardiac diseases, diabetes and hypertension using remote monitoring technology. While it wasn't clear how large the effect was, home telemonitoring did seem to cut ED visits, hospital admissions and average length of hospital stays, authors said. Telemonitoring seemed to have more impact on pulmonary and cardiac cases than diabetes and hypertension.To get more information on the study:- read this Healthcare IT News articleRelated Articles:USDA offers $128M for rural telemedicine. ReportPartners Healthcare tests remote blood pressure monitoring. ReportFirm offers mobile disease management platform. ReportVendor trials mobile phone-based diabetes monitoring. Report
2. Study: Telemonitoring seems promising
Home-based telemonitoring of patients with chronic diseases has a great deal of potential, according to a new study published this month in a high-profile health IT journal. To conduct the research, which appeared in the Journal of the American Medical Informatics Association, Canadian researchers reviewed more than 65 studies published in the U.S. and Europe. The studies looked at home-based management of chronic pulmonary conditions, cardiac diseases, diabetes and hypertension using remote monitoring technology. While it wasn't clear how large the effect was, home telemonitoring did seem to cut ED visits, hospital admissions and average length of hospital stays, authors said. Telemonitoring seemed to have more impact on pulmonary and cardiac cases than diabetes and hypertension.To get more information on the study:- read this Healthcare IT News articleRelated Articles:USDA offers $128M for rural telemedicine. ReportPartners Healthcare tests remote blood pressure monitoring. ReportFirm offers mobile disease management platform. ReportVendor trials mobile phone-based diabetes monitoring. Report
Saturday, May 12, 2007
More help from the the government needed?
Beware the artificial government crisis at hand -QJ
For the past decade, the province has increasingly moved residents out of provincial institutions and into community facilities. Just 500 adult residents remain in three institutions – in Orillia, Smiths Falls and Chatham – and those are being closed by March 2009. More than 40,000 adults with developmental disabilities are now in some form of community care, ranging from help to live on their own or with roommates to group homes and long-term care homes. Approximately 7,000 unionized workers are employed in those community facilities and half, at some 70 locations, are working under contracts that expired March 31.
Labor woes trouble homes for developmentally disabled James Wallace Queens Park - Wednesday, May 09, 2007 By James Wallace Osprey News Network A looming, province-wide labour dispute at agencies that serve developmentally disabled adults could see care jeopardized for thousands of Ontario’s most vulnerable adults, union officials in the sector say. Meanwhile, the $200 million government bailout intended to stave off strikes or lock-outs at group homes, agencies and other community facilities that provide care for adults with developmental disabilities may be fatally flawed, said Sid Ryan, president of CUPE Ontario. Workers in the sector have been frustrated for years over chronically low wages, Ryan said. And despite the recent funding announcement, both CUPE and Ontario Public Service Employees Union locals representing some 3,500 workers report recent strike votes of 95 per cent and higher. “We’re trying to head off labour unrest,” Ryan said. “These are of course, we all know, the most vulnerable of people; people with mental disabilities other disabilities that need a lot of help.” People who work with the developmentally handicapped may typically earn $35,000 or less annually and 25 per cent less than workers doing similar jobs in hospitals, the union maintains. Meanwhile, there is a $10-an-hour gap between the wages for not-for-profit and government staff that do the same work. Ryan said unions and the agencies that provide care urged the government during pre-budget discussions to find the $200 million needed to address wage disparities in the sector.
For the past decade, the province has increasingly moved residents out of provincial institutions and into community facilities. Just 500 adult residents remain in three institutions – in Orillia, Smiths Falls and Chatham – and those are being closed by March 2009. More than 40,000 adults with developmental disabilities are now in some form of community care, ranging from help to live on their own or with roommates to group homes and long-term care homes. Approximately 7,000 unionized workers are employed in those community facilities and half, at some 70 locations, are working under contracts that expired March 31.
Labor woes trouble homes for developmentally disabled James Wallace Queens Park - Wednesday, May 09, 2007 By James Wallace Osprey News Network A looming, province-wide labour dispute at agencies that serve developmentally disabled adults could see care jeopardized for thousands of Ontario’s most vulnerable adults, union officials in the sector say. Meanwhile, the $200 million government bailout intended to stave off strikes or lock-outs at group homes, agencies and other community facilities that provide care for adults with developmental disabilities may be fatally flawed, said Sid Ryan, president of CUPE Ontario. Workers in the sector have been frustrated for years over chronically low wages, Ryan said. And despite the recent funding announcement, both CUPE and Ontario Public Service Employees Union locals representing some 3,500 workers report recent strike votes of 95 per cent and higher. “We’re trying to head off labour unrest,” Ryan said. “These are of course, we all know, the most vulnerable of people; people with mental disabilities other disabilities that need a lot of help.” People who work with the developmentally handicapped may typically earn $35,000 or less annually and 25 per cent less than workers doing similar jobs in hospitals, the union maintains. Meanwhile, there is a $10-an-hour gap between the wages for not-for-profit and government staff that do the same work. Ryan said unions and the agencies that provide care urged the government during pre-budget discussions to find the $200 million needed to address wage disparities in the sector.
Subscribe to:
Posts (Atom)