Domnick & Shevin

Tips for Managing Distractions While Driving

Thu, 30 May 2013 14:41:00 -0400

According to the National Highway Traffic Safety Administration (NHTSA), 5,474 people were killed in 2009 in crashes involving driver distraction, and an estimated 448,000 were injured. Looking at the big picture, that means 16 percent of all fatal crashes and 20 percent of all accidents across the country in 2009 involved distracted drivers.

Here are 10 tips from the Governors Highway Safety Association (GHSA) for managing some of the most common distractions while driving:

Turn It Off - Either turn off your phone or switch it to silent mode before you get in the car.
Spread The Word - Set up a special message that tells callers you’re driving and will respond as soon as you can. You can enable some phones to do this automatically when you get in the car.
Pull Over - If you need to make a call, pull over and stop in a safe area first.
Deputize Your Passangers - Ask your passengers t answer or make calls for you. Conversely, if you are a passenger, offer to answer the driver’s phone.
X the Text - Don’t ever text and drive, surf the web, or check email. It is dangerous and against the law in most states.
Know the Law - Familiarize yourself with state and local laws before you start driving. Some prohibit the use of handheld cell phones in addition to texting. The GHSA offers this useful chart.
Prepare - Review maps and direction before you start to drive. If you need help when you are on the road, ask a passenger or pull over to review your directions again.
Secure Your Pets - Pets can be a big distraction in the car. Always secure your pets properly before you start to drive.
Keep the Kids Safe - Pull over if you need to address situations with your children in the car.
Focus on the Task at Hand - Avoid smoking, eating, drinking, reading, and any other activity that takes your eyes off the road, hands off the wheel, or mind off your driving.

Patient Safety

Tue, 30 Apr 2013 16:25:57 -0400

Introduction

This article looks at medical errors and steps you can take to protect yourself. A medical error is when a mistake is made tat can negatively affect the patient. Examples include errors in diagnosis or in surgical procedure, mistake in giving medications or in the use of medical equipment, misinterpretation of a test or lab results, and others. A medical error can involve the failure to carry out a plan of action or use of the wrong plan. An individual can cause the error or it might happen because of a failure in the system.

Medical errors can take place in health care facilities, pharmacies, your doctor’s office, and even in your home. The can involve complex systems like how a hospital tracks the medical services given to patients, or common tasks like giving food high in salt to a patient who needs a salt-free diet.

While advances have improved medical care and extended the lives of many people, the complexity of the American health care system also contributes to medical errors. Poor communication between patients and their health care providers can lead to mistakes as well.

Topics Include:

Health Care Team

Medicine Safety

Safety in Health Care Facilities and in Home Care

Prevention of Infections

Prevention of Falls

Health Care Team

Most people no longer have one physician who takes care of them throughout their lives and knows their entire history. You might change primary care physicians, visit various specialists, or find yourself in a hospital emergency department. At your doctor’s office you might see the doctor, nurse practitioner, or another professional. You might receive your care through a clinic where you see a different provider each time you visit.

The one constant in this care is you. You are an important member of your health care team. You know your history, medications, allergies, illnesses, and surgeries. Part of your responsibility is to educate yourself about your conditions and treatments and to share important information about your health with your health care providers.

Communication between you and your health care providers is an important part of patient safety. You have the right to ask questions and to have matters explained to you in a way you understand. You have the right to know what treatment choices are available for your care.

In addition you may find yourself being an advocate for loved ones because they are unable to make health care decisions, or a loved one may need to represent your if you are unable to speak for yourself.

Tips for Being a Part of Your Health Care Team

Inform all your health care providers of your medical history including any treatments, surgeries, medications, allergies, or medical conditions.
Tell all of your providers about every medication you take, including prescriptions, over-the-counter medicines, vitamins, and herbal supplements.
Write down questions and take them to your appointment. You might want take notes during the visit or take someone with you as your advocate. They can help you speak up, ask questions, and write notes. Later you can talk with this person about your situation and choices.
If you need to have medical care, ask what treatment choices you have.
If something is said that you don’t understand, ask for a clearer explanation.
If tests are performed and you don’t receive results, call the office and ask for them. You can also request a copy of the results.
If you want another opinion about a diagnosis or treatment, request one from another doctor. Ask if your health insurance will pay for a second opinion.
If you’re no satisfied with your health care provider you may want to choose another one.
If you have a medical condition, are getting a certain treatment, or are taking medications, educate yourself in these matters. Ask your health care provider for educational materials and use your local library or the internet to learn more.

Health Care Surrogate Designation

If you’re unable to be active in your health care due to physical or mental incapacity (like being in a coma or developing dementia) and if you don’t have a health care advance directive, health care decisions may be made for you by a guardian appointed by the courts, your spouse, adult child, parent, adult sibling or, under certain circumstances, another adult relative or close friend.

If you would like someone to represent you if your are unable to make decisions yourself you can designate a health care surrogate. Further information can be found in the pamphlet Health Care Advance Directives.

Medicine Safety

Actively managing and learning about your medications is an important part of patient safety. Following are suggestions to better protect yourself and your loved ones when taking medications.

Do your health care providers know all of the medications you take?

Some medicines and supplements may cause harm if used together. Learn about the medications ad supplements you take and any interactions the may have. At least once a year review all of your medicines (prescription and non-prescription) and supplements (vitamins and herbs) with your health care providers.

Whenever you are prescribed medication ask if the new medicine will interact with other medications or supplements you currently take.

Can you read your prescription?

If you can’t read your prescription the pharmacist may misread it and give you the wrong medicine. Florida law requires that the prescription be written clearly, so make sure you ask for a clearly written prescription. However, many doctors now use electronic prescribing so your prescription may be sent to the pharmacy through a secure internet connection.

Before leaving the pharmacy check the medication label to see that it is written to you and it’s the same name and strength as written on the prescription.

Be familiar with how your medicine looks. If it looks different than what you took before talk with your pharmacist before taking it.

Do you read your medication label and insert?

The label will tell you how much to take, when and how long to take it, and if there are restrictions. For example, the label might say you shouldn’t drink alcohol while taking the medication, stay out of the sun, or avoid certain foods or other medications. The insert will include information about safety precautions and side effects.

Is there a danger of buying medication that has been altered or that isn’t what the label says it is?

A good way to protect yourself is to confirm that the pharmacy where you buy your medication is licensed by the State of Florida. Each pharmacy is required to post the company’s license as well as the license of the pharmacy manager.

If you buy prescription medication online, or by mail order, it is important to be a wise shopper. First see your own health care provider for a prescription. Check to see of the company is licensed in the state in which it operates or if the National Association of Boards of Pharmacy (NABP) certifies the company through its VIPPS program.

Be cautious buying medications over the interne or by mail order. If the company is not legitimate, you may end up with fake, altered, or expired medication that will not help you and may cause harm. In addition, the website or mail order company may appear to be based in the United States, but actually be operating outside of the U.S. where quality and safety controls may not be available.

Is there danger in taking over-the-counter (OTC) medications?

Some OTC medications should not be used with prescription drugs. read your medication label and insert, and talk with your pharmacist if you have questions.

Also compare active ingredients before taking more than one medication at the same time. Many OTC and prescription medications contain the same active ingredient, which means you could take more than the recommended dose. For example, if you take pain medications along with cough, allergy, or sleep medicine, they may contain the same drug and the combination may be more than is safe to take at one time.

While your health care provider or pharmacist can alert you to unsafe combinations o drugs, you can also watch for the following two common ingredients:

Acetaminophen is used in over 600 products, especially headache and cold medicines. Taking more than is recommended can lead to liver damage or failure.
NSAIDs (nonsteroidal anti-inflammatory drugs) are common pain relievers. Overuse, or when used in combination with some drugs, can lead to stomach bleeding or kidney damage.

OTC medications are meant for temporary relief. If you need to use a medication longer than it says on he label, see your health care provider. You may have a serious medical condition or your provider may recommend another form of treatment.

Why is it important to know the correct dosage to take?

Medications can make you sick, injure you, or sometimes cause death when taken incorrectly. Do not take more of the medication than is recommended. Some things to watch out for:

OTC medications come in a variety of strengths. For example, pain relief medication may be regular, extra strength, or time-release; they may be pills, liquid, or capsules. Follow package directions for dosage.
Some people mistakenly think taking three pain reliefs at one time will relieve the pain more quickly. Or they take too many pills within a 24-hour time or for too many days. Taking more than the recommended dose can be dangerous.
If you take prescription medication do not change the dosage before discussing it with your health care provider.
An adult dosage of medication should not b given to children. Follow directions prescribed by your child’s doctor and for OTC medications buy the children’s strength and follow the directions. An incorrect dosage can quickly have a dangerous effect on children because of their smaller size.
Some seemingly harmless OTC medications may not be appropriate for children. For example, the American College of Pediatrics recommends that aspirin not be given to children.
The elderly can also be more sensitive to medications and their side effects. Check with your physician if you become drowsy, confused, dizzy, or have other side effects, as your physician may be able to adjust or change your medication.

Tips on Safe Handling of Medications:

Put medications in a safe place away from children (and animals) and keep them in childproof bottles.
If there is an adult who has difficulty reading labels or in knowing when to take medications, have another adult oversee the medication.
If medication poisoning occurs call your doctor or the Poison Information Center at (800) 222-1222 or, if life threatening, call for emergency assistance which in most areas is 911.
Do not store medications in our bathroom as the moisture and heat could change or destroy their effectiveness. If you store medication in the kitchen protect it from heat and moisture. Find out if your medication should or should not be stored in the refrigerator.
At least once a year review all of your prescription and over-the-counter medications, as well as vitamins and supplements. Do not continue to use medications that have changed color, consistency, or odor. Safely throw away any that have expired, that you no longer use, or whose labels you can’t read.
Throw out old medicine in a sealed, outdoor trash can in a manner that children, animals, or other adults cannot take it. Used syringes and needles should be placed in a hard contained (like a used laundry soap bottle) with a tight lid and then thrown into the trash. To dispose of controlled substances, like narcotics, you may want to ask your pharmacist or health care provider for advice.
If you take several medications you may want to keep a list and schedule of when you take each one. Some people keep track of their medications by using a pill organizer they fill once a week. Ask your pharmacist about pill organizers or other tracking aids.
If your medications are delivered by mail or another delivery service make sure they don’t sit outside your home for a lengthy period of time, they’re not exposed to heat or cold, and they won’t be tampered with or stolen.

Safety Tips on Taking Medications

If you have an allergic reaction call your health care provider, or if the life threatening, call for emergency assistance which in most areas is 911.
Learn about possible side effects of your medication, what you can do about them, and when they might be dangerous or life threatening.
If you forget to take your medicines, immediately taking the missed dose may not be the best thing to do. Read the package insert or call your pharmacist for advice.
Some people do not take their prescribed medications because they can’t afford them. If you do not take your medications or you skip doses, you may be able to get less expensive drugs by comparing the pharmacy prices in your area. View the State of Florida Prescription Drug Price website. This site has price information on the top most commonly used prescription drugs in Florida.
If you cannot afford your medications talk with your health care provider as he or she may recommend a less expensive medicine or may have free samples. Also, you may be eligible for prescription assistance programs.
Some medications should not be cut in half, chewed, or have the capsules opened as this will affect the medication and could cause harm or even result in death. Read the insert or ask your pharmacist if you have questions.
If you arrange for your child to be given medication at day car or school, ask about the procedures for storage, administration, and record keeping. Every so often confirm that your child is being given the medication correctly.
Do not take medication for recreational use or use medication prescribed to a friend or family member, even if you have the same illness or symptoms as that person. Doing so is illegal and can be dangerous or deadly.
Because older established drugs have been on the market longer more is known about their effectiveness and side effects. When you’re prescribed a medications ask your physician how long it’s been on the market. If there are medication choices ask which will best serve your needs.

Prescription Assistance Programs
The following programs may offer assistance if you meet their eligibility requirements.

Medicare Part D Prescription Drug Assistance
Sunshine for Seniors. Call (800) 963-5337.
BenefitsCheckUp.org
More programs can be found at Medical Help Resources

Safety in Health Care Facilities and in Home Care
As a patient or resident in a facility or a person receiving home care services it might be challenging to be an active member of your health care team. You may not feel well. You may be given medication that makes you drowsy. You may be frail and find it difficult to speak up for yourself. But even with these challenges you still play a very important part in your health care team and you have the right to be involved in your care.

It’s important to have clear communication with your health care providers. If you think you may not be able to be clear, due to a temporary condition or long term declining health, you may want to have a loved one be your advocate and speak up for you. You may also want to designate someone as your health care surrogate as mentioned earlier.

Before entering a health care facility or receiving services from a home care provider you may want to learn more about the choices you have and the following resources can provide helpful information:

Learn about nursing homes through the Florida Nursing Home Guide
You can read consumer guides: Assisted Living in Florida, Home Health Care in Florida, Nursing Home Care in Florida, and Long-Term Care.
Compare Florida hospitals and ambulatory surgery centers, emergency rooms, hospice providers, and health plans. You can also find a list of facilities and home care providers here.
Medicare.gov

While Receiving Care

You have the right to review records related to your care. If you’re receiving medical care under a physician’s orders you will have a plan of care that describes your treatment. If a plan of care is not required other kinds of records may be kept.
When you are admitted, transferred, or discharged from a health care facility review your medications with your physician. Find out if there were medications changed and if you need to throw away any unused medicine that was replaced by a different drug or dosage.
If you’re in a facility where you have an ID bracelet, check that it can be read and correctly identifies you. If your ID bracelet doesn’t have the correct information, if it comes undone or if it can’t be read ask that it be replaced.
When you’re given medication, ask the person to check the medication, the order, and your ID so you receive the correct medicine and dosage at the correct time.
Be familiar with your how your medicine looks and if it looks different than what you were given before, talk with the nurse or aide before taking it.
Ask what hours you are scheduled for medications. Tell the nurse or aide if a medication time passes and no one has brought your medication.
Before a medical test or procedure is done, ask the person to check the order and your identification. Ask what is to be done and why.
Tell your nurse or physician if you have a reaction to you your treatment or if your symptoms get worse.
If you are bed bound ask what safeguards are in place to prevent blood clots and skin ulcers.
While staying in a hospital or ambulatory surgery center, try to have a family member or friend with you at all times, if possible.

While Receiving Care in a Health Care Facility

If you have a loved one with Alzheimer’s disease or dementia in a health care or long-term care facility, ask what safety precautions are in place for patients who wander.
Ask the facility what procedures are in place should the facility need to be evacuated due to an emergency or natural disaster, like a fire or hurricane.
Ask the facility what their policies are concerning restraints and seclusion of patients or residents.

While Receiving Care In Your Home

When receiving services in your home try to have a backup plan if the caregiver does not show up for the scheduled appointment. A home health care provider is required to provide all scheduled visits, so tell the agency’s director of nursing or administrator if someone doesn’t show. If the problem continues you may want to change agencies.
If you need medical equipment and supplies, your home care provider is required to train you and your loved ones in the correct use of the equipment. Keep written instructions and the company’s phone number nearby. Call them if you have questions or problems. If the equipment has alarms or error messages learn what these mean and what you need to do.
The home care provider is required to give a you phone number to call when you have questions or problem. If you’re receiving nursing or therapeutic services or if you’re on life-support equipment the company must be on-call 24-hours a day, 7 days a week.
If you have a physical or mental condition that will require help with evacuation and sheltering during a disaster, like a hurricane, the home care provider must help you register with the Florida Division of Emergency Management.

Safety Tips for Surgery & Medical Procedures:

If you have a choice, pick a health care provider and facility that have experience with surgery/procedure you are having. By using the hospitals and ambulatory surgery centers comparison tool you can view the number of visits and range of charges on over 150 medical conditions and procedures performed at ambulatory surgery centers and the number of hospitalizations and range of charges for hospitals. Additional information hospitals includes average length of stay as well as rates for readmissions, complications and infections, and mortality. The hospital comparison tool provides comparison of pediatric care as well as adult care, and a patient satisfaction survey.
Carefully follow directions about what you need to do prior to the surgery procedure. If you don’t understand the directions ask them to be explained to you.
Ask your health care provider if you need to stop any of your medications prior to the surgery/procedure, plus ask what you can eat or drink.
Make sure it is clear who will perform the surgery/procedure, what exactly will be done, and what to expect during and after the surgery/procedure.
Ask what safeguards are in place to ensure the correct surgery/procedure is done at the correct site on the correct patient.
Ask if you will need a blood transfusion and what safety precautions are in place to assure you receive the correct blood type. If possible, you may want to donate your own blood prior to the surgery/procedure. Tell your doctor if you have ever had a reaction to a blood transfusion.
Ask if there’s a risk of complications after your surgery/procedure and what symptoms you should watch for.
Have a loved one available during your surgery/procedure to be your advocate. Tell your physician if you want your loved one consulted, if needed, and to report to them once the surgery/procedure is complete.
Learn about your follow-up care including healing of the surgery site; how much rest you will need; what medications, food, and activities to avoid; and when you can return to work and other activities.
Make sure your health care provider answers all your questions and concerns.

Safety Tips for Anesthesia:

When preparing for a surgery or procedure you will also want to learn about anesthesia. Anesthesia is medication that keeps you from feeling pain and sensations during a surgery/procedure. Ask exactly who will give you anesthesia and monitor your vital signs.

Tell your doctor and the anesthesiologist if you have ever had a reaction to anesthesia. Tell them all the medications you take and any allergies you have. Also, let them know if you have any medical problems and, though this may feel personal, if you have a drinking problem or use drugs recreationally. This information is very important for safe anesthesia care.

Ask about restrictions on medications, food, and alcohol before and after the use of anesthesia.

After surgery under general anesthesia you may continue to feel drowsy, tired, or weak for a few days and you may have problems with coordination and thinking clearly. For at least 24 hours after receiving general anesthesia don’t drive, use machines, or do things that could be dangerous if you are not alert.

If You Have a Complaint:
If you have a complaint about your health care provider or health care facility talk with them first to see if the matter can be resolved. If you are still not satisfied and want to file a complaint with the State of Florida call the toll-free number (888) 419-3456.

Prevention of Infections
The Centers for Disease Control (CDC) states that about two million people a year get an infection during their stay in a hospital in the United States. A person can also get an infection in non-hospital settings like nursing home, dialysis centers, physicians’ offices, or in their own home.

Data is available on infections rates at Florida hospitals. If you are going to receive care or treatment in a hospital you may want to check your hospital’s infection rates or compare several hospitals in your area. You can find infection rates here.

Tips on Infection Prevention:

A patient can be at risk of getting an infection, so if you are ill do not visit a person who is sick at home or in the hospital. If a patient has an infection, he or she may transfer it to others, so take precautions to protect yourself.
The CDC states that clean hands are the most important part in preventing the spread of infection.
If you are giving care be sure to wash your hands before and after, and if you are receiving care don’t be afraid to ask your health care providers if they washed their hands.
As a patient it’s also important to keep your hands clean, particularly after handling soiled items or after using the bathroom.
If you are visiting an ill person, was your hands before and after the visit.
Gloves should be worn if coming into contact with body fluid, soiled items, or when inserting any invasive devices. Hands should be washed before and after using gloves. The gloves should be thrown out after caring for a patient.
If you have a drainage tube or catheter that comes lose,immediately tell your caregiver or health care provider. A drainage tube might be inserted to drain a wound; a catheter might be a Foley catheter (a thin tube inserted to remove urine from the bladder) or an intravenous line (IV) that is inserted into a vein to give fluids.
If you have either a catheter or a wound, keep the skin clean and dry around your IV catheter dressing or wound dressing. If the dressing gets wet or comes loose tell your caregiver or health care provider.
Long nails and artificial nails can continue to hold infectious germs even after a good hand washing. If a patient is at risk of getting an infection the CDC states caregivers should keep their nail tips to 1/4 inch in length and should not wear artificial nails.
Other ways germs can spread are through droplets (from an infected person coughing, sneezing, or talking, etc); airborne transmission (which may require special air handling and ventilation for treatment); items that have picked up germs like medical equipment or any item that can then spread infection; or when animals or bugs transmit infection (like mosquitoes, flies, or rats).
Sometimes it may be necessary for the patient, staff, or visitors to wear protective masks or gowns.
Under certain circumstances a patient may be placed in isolation in a hospital to protect the patient and to prevent the spread of infection. Patients placed in isolation will have signs posted outside their hospital doors. Before entering the room ask the hospital staff about about visiting restrictions and any protective requirements for the patient, staff, or visitors.
Some medical equipment and items may require special handling during and after use, for example, needles, catheters, or items soiled with body fluid, etc. Some items can be thrown in the regular trash, but others may need to be placed in a bio hazard waste container. Other items may be able to be sterilized or disinfected for future use.
Ask your health care provider about proper use and disposal of gloves, gowns, masks, medical equipment, and supplies.
The patient’s bed linens and clothing should be changed and washed regularly or if they become soiled. The patient’s surroundings should be kept clean.
Tell your health care provider if you show signs of a possible infection, like a fever, chills, pain, redness, swelling, a discharge, or other symptoms.
If you are diabetic you have a higher risk of developing an infection. Be careful about controlling your blood sugar and especially talk with your health care provider about your diabetic care needs if you have surgery, need wound care, will be bedridden, or other situations that might lead to infection.
If you are given antibiotics for an infection, use all the medication until it is finished. Even if you feel better do not stop taking the antibiotic.

Prevention of Falls
Injuries from falls are of particular concern for the elderly and for patients who might be frail or disoriented from illness, recovering from surgery, or on medication. Whether you’re in a health care facility or your own home, check for the following to help prevent falls:

If you’re in a hospital bed the side rails may need to be kept up. Ask your caregiver to lock the brakes on your bed. And, if needed, call for help to get out of bed.
Make sure throw rugs and floors aren’t slippery. Keep the floor clear of clutter.
Use shoes that give good support and are not slippery.
Use a walker, cane, or wheelchair if needed and learn how to use them correctly.
Eyeglasses or a change in eyeglasses may help as poor vision can contribute to falls.
Make sure there is good lighting.
Consider a bedside commode if walking to the bathroom in the middle of the night is difficult.
Use chairs and a bed that are easy to get in and out of.
Grab bars in the bathroom, a raised toilet seat, shower chair, and non-slip mat in the tub or shower are good safety features.
Stairs should have handrails on both sides, have good lighting, and be clear of objects.
Ask your physician if an adjustment in your medications could improve coordination.
An exercise program, even, for the frail elderly, can help improve balance and strength and help prevent falls. You may want to consult an exercise trainer or participate in an exercise program geared towards your skill level.

Review your surroundings and see what other actions can be taken to help prevent falls.

You Should Know Newsletter - Ruling May Leave You Vulnerable to Unsafe Generic Drugs

Wed, 17 Apr 2013 16:41:48 -0400

You Should Know Newsletter - Ruling May Leave You Vulnerable to Unsafe Generic Drugs:

Kira Gilbert, a college student from Cincinnati, took generic Darvocet that her doctor prescribed for pain in advance of knee surgery. She never woke up. it should have been a routine surgery, but at age 22 the accomplished young woman was dead. She’d taken just six pills spread over eight days. The FDA later pulled Darvocet and the generic from the market after linking them to sometimes fatal heart abnormalities. Hundreds of lawsuits have since flooded the courts handling the matter.

But while the lawsuits involving name-brands move forward, cases involving those who took generics - like Kira Gilbert - were dismissed. Why? Because generic drug manufacturers won a ruling before the U.S. Supreme Court in 2011 saying they don’t need to warn patients when they learn of a new and dangerous side effect.

Karen Bartlett, of Plaistow, N.H., was prescribed a drug for shoulder pain that was filed with generic sulindac. Soon after, two-thirds of Karen’s skin began shedding off from a hellish condition called Stevens-Johnson syndrome (SJS). She spent months in a burn unit in a medically induces coma, covered in gauze. Karen enured 13 eye surgeries and numerous implants. She now has trouble walking, is legally blind and will need care for the rest of her life.

Karen was awarded significant damages after her legal team successfully argues that the drug’s design was dangerous and defective. But Karen won’t receive a dime unless the U.S. Supreme Court, which agreed to hear her case in Mutual Pharmaceutical Co. vs. Bartlett, reverses its 2011 ruling.

Understanding Prescription Drug Costs

Fri, 05 Apr 2013 10:34:34 -0400

Introduction

Prescription drugs are important in the treatment of many diseases and health conditions. At the same time the cost of prescription medications is a concern for many consumers. This article can help you better understand the pricing of drugs, ways in which you can possibly save money, and programs that might offer assistance. The article also includes questions you might want to ask your health insurance plan, health care provider, or pharmacist.

Topics in this article include:

The Prescription Drug Market
Compare Drug Prices
Talking to Your Health Insurance Plan
Talking to Your Health Care Provider
Talking to Your Pharmacist
Programs to Help with Drug Costs
Annual Review of Medications and Supplements
Does Your Doctor e-Presribe?

The Prescription Drug Market

Prescription drug prices are not regulated in this country. Often there are several choices of drugs available to treat a disease or health condition and some of these drugs may be more expensive, others less expensive.

Why would some drugs cost more? Prices of new drugs are not affected by competition from other companies. When a company creates a new drug it is placed under patent protection. By law, other companies cannot make and market the same drug during the years the U.S. patent protection is in effect, which can last 10 years or longer.

The purpose of patents for new drugs is to encourage research to develop more effective drugs. Drug testing is very expensive. The patent allows the drug developer to recover these research costs by passing the costs along to consumers.

New Drugs and Established Drugs

New drugs are developed to provide new treatments or to improve drugs that are already available. The developer of a new drug has to present evidence to the U.S. Food and Drug Administration (FDA) that the new drug is safe and effective and then receive FDA approval.

If the new drug is similar to other drugs already being sold, the developer will try to show that the new drug works better or has fewer side effects than other drugs already on the market used for the same disease or health condition.

A new drug may offer better treatment than an established, older drug. However, more is known about an older drug that has been on the market for years, where the health care providers and patients have gained experience in using the drug. Until a drug has been in use for many years it is not possible to know about all of its side effects or how effective the drug is with continued use.

If your health care provider wants you to take a drug that is new on the market, you may want to ask if there are benefits in taking this new drug instead of an established drug.

When a new drug comes on the market, the drug manufacturer usually advertises the drug in magazines, newspapers, and one television. Drug salespeople also promote the new drug to physicians and sometime provide free samples. Because older or established drugs have been available for years and have proven their ability, free samples often are not available.

If your health care provider offers you free samples of a drug, it can help you save money by not have to pay for a prescription. However, if you need to fill a prescription later for this same drug, you may find the cost is higher than other available drugs. If you are offered free sampled of a drug that you will later have to pay for yourself, ask your health care provider about the cost of the medication and other choices that might be available.

Generic Drugs:

Once the patent protection of a new drug expires, other companies can seek permission from the U.S. Food and Drug Administration to make and sell the drug. The drug can then be sold as generic.

Generic drugs are usually less expensive. The company that maker the generic drug does not need to recover the costs of development and advertising, unlike the company that first developed and marketed the drug.

Generic drugs must meet the same standards of quality control as new drugs. However, generic drugs do not need to be extensively tested because their safety and effectiveness have already been proven.

Compare Drug Prices

Drug prices vary between pharmacies. You might be able to save money by comparing the different pharmacies in your community and the prices they charge for the drugs you take.

The State of Florida provides the Florida Prescription Drug Price website with pricing information for the top most commonly used prescription drugs in Florida. This website can help you compare prices of drugs sold at the pharmacies in your area.

The prices are the “usual and customary prices,” also know as retail prices, reported monthly by pharmacies. This is what an uninsured consumer, with no discount or drug coverage, would pay. The prices can change throughout the month, so after viewing the prices you may want to double check with the pharmacy at MyFloridaRX.com.

Internet and Mail Order Pharmacies:

Some people try to save money by buying their medications through an Internet company or by mail order. If you buy prescription medication over the Internet, or by mail order, it is important to be a wise shopper. First see your own health care provider for a prescription. Check to see if the company is licensed in the state in which it operates or if the National Association of Boards of Pharmacy (NABP) certifies the company through its VIPPS program at nabp.net.

Be cautious buying medications over the Internet or by mail order. If the company is not legitimate, you may end up with fake, altered, or expired medication that will not help you and may cause harm. In addition, the website or mail order company may appear to be based in the United Sates, but actually be operating outside of the U.S., where quality and safety controls may not be available.

Talking to Your Health Insurance Plan

Your health insurance plan’s customer service office can provide useful information to help you save money on prescription drug costs. Sometimes health insurers or employers contract with a specialized firm to manage pharmacy insurance benefits. Your health insurance plan or your employee benefits office might refer you to a pharmacy benefits manager.

You can find the following types of information from your health insurance provider:

What your drug benefit covers
The amount of co-payment required and if drugs are assigned to various levels that require different amounts of co-payment
What drugs are included on each level of the preferred drug list
Whether there is a cap or limit on your drug benefits and the amount
Whether the medicines you are taking are included in the preferred drug list
Which pharmacies can fill your prescriptions
Tips on how to use your insurance coverage wisely and minimize your costs
Your rights and steps to take if affected by changes in benefits or if you are otherwise dissatisfied.

When you first sign up for health insurance coverage you should receive written material that explains your benefits. Changes to your benefits should also be in writing. Contact your health insurance provider if you have questions about your coverage or need written materials that explain coverage. Your health insurance provider may also have a website that can be a source of information.

Preferred Drug List:

A preferred drug list is a list of drugs that are accepted for payment by your health insurance plan. Drugs outside of the list may not be covered by your insurance or you may need to make a special request to see if your insurance will cover the medication even though it’s not on the list.

Some health insurers may have different levels of co-payments for prescription drugs. Members of the health plan are charged lower or higher co-payment amounts depending on whether the drug is generic, a brand-name drug included on the preferred drug list, or a drug not included on the list.

The preferred drug list may be revise from time to time to add new drugs or delete others. Be sure you know what your health plan’s policy is regarding notice of changes that affect you.

Talking to Your Health Care Provider

Questions to ask your health care provider about your prescribed medication might include:

What will this drug do for me?
Why did you choose this particular drug over others?
How long has this drug been on the market?
What is known about side effects from this medication?
Are there any special precautions I need to take?
Of the dosage range recommended by the drug company, will I be taking the lowest dose, highest dose, or in between?
Might I develop a tolerance to the drug requiring higher doses and costs?
Can this drug affect my other medications?
What happens if I stop taking the drug? Is there any immediate danger?
Would there be problems if I start this drug and then later change to another type of drug?

A good time to ask about drug costs is the first time the drug is prescribed and before you start taking it. You can also review these questions at any time you visit your health care provider. Following are other questions you might want to ask your health care provider:

How much does this drug cost?
Are there less expensive drugs that might work for me?
Is this drug available as a generic?
Are there other choices if this drug is not covered by my insurance?
Are there other drugs that will work for me and reduce my co-payments?

If your health care provider isn’t familiar with the costs, you can ask your pharmacist.

Talking to Your Pharmacist

Your pharmacist can answer many of the same questions you would ask your health care provider. If you would like to talk with your pharmacist you may wan to review the questions in the previous section.

Changing from a brand-name drug to a less-costly generic of the same drug can be done at the pharmacy. Usually the pharmacist can fill your prescription with a generic drug at your request or, if necessary, the pharmacist may ask you to first discuss this with your health care provider in order to get a new prescription.

Pharmacy Dispensing Fees:

Each time you buy a prescription drug, you are charged for the cost of the medicine and the dispensing fee. Sometimes you can save money on the dispensing fee if, for example, you are able to buy a three month supply of the medication at one time. Check with your pharmacist to see if you can receive a larger quantity and save money on the dispensing fee.

Programs to Help with Drug Costs

Following are programs that help with the cost of medications. You may need to meet an age or income requirement to qualify for some of these programs. Each program has its own application process and qualification requirements so you will need to contact a program to se if you qualify.

Medicare Part D Prescription Drug Benefit:

Medicare Part D is an insurance benefit to help people with Medicare pay for prescription drugs and is provided through Medicare approved private health plans.

If you have Medicare, but not Medicaid, you can enroll in a Medicare Part D drug plan, but you are not required to do so. However, if you are in a Medicare health plan for your medical coverage you will be dropped from the health plan if you enroll n a Medicare Part D drug plan. Be sure to speak with your health plan provider about this before making a decision.

You will want to compare these drug plans before you choose one - to see which ones cover the prescription medicines you take; how much coverage they offer; the cost of deductibles, co-payments and the monthly premium; and which pharmacies you can use with each plan.

For more information and to receive help with enrollment visit Medicare.gov.

People with limited income and resources may qualify for extra help with prescription drug costs under the Medicare Prescription Drug Benefit. To see if you qualify for this assistance visit ssa.gov/prescriptionhelp. If you are covered by Medicaid, you automatically qualify for the extra help.

Prescription Discounts for Some Florida Medicare Beneficiaries:

Medicare beneficiaries who choose not to enroll in the Medicare Part D Prescription Drug Benefit and who pay for their medications with private funds may be able to receive some discounts on their medications. By law, pharmacies that participate in the Florida Medicaid program must offer Medicare beneficiaries, who otherwise have no insurance coverage for prescription drugs, a discount on their prescription drugs. To obtain the discount, you must show your Medicare card when you present the prescription.

Florida Medicaid:

The Florida Medicaid programs pays the cost of prescription drugs for those who qualify for this coverage. However, if you covered by bot Medicaid and Medicare, most of your prescription drugs may be provided under the Medicare Part D Prescription Drug benefit or by a combination of Medicare and Medicaid.

Applications for Medicaid are made through the Florida Department of Children and Families. For further information call (866) 762-2237 or visit myflfamilies.com.

Sunshine for Seniors:

If you are 60 years or older and your insurance does not cover prescription drugs, call the Sunshine for Seniors program at the Florida Department of Elder Affairs at (800) 963-5337. They can help you apply for programs that might help with the cost of medications.

Florida Discount Drug Card:

The Florida Discount Drug Card can help people save money on prescription drugs. The program is for people 60 years or older who do not have drug coverage, those covered by the Medicare Prescription Drug Benefit who have reached a certain spending limit, or those under age 60 who meet the income requirements. To learn more go to FloridaDiscountDrugCard.com.

National Council on Aging:

For people 55 years or older, the National Council on Aging has website with referrals to programs that offer assistance with the cost of medications as well as other needs. Visit BenefitsCheckUp.org.

Pharmaceutical Patient Assistance Programs:

Many companies that make prescription drugs have programs to help some low-income individuals buy certain medications. Ask your pharmacist or health provider if they know of programs to help with drug costs. You can also do a search on the internet for the drug companies that make your medications to see if they offer such programs.

Community Health Centers:

Community health centers are federally funded to provide health care in medically under served areas. To see if there is a center in your area, visit hrsa.gov/GetHealthCare. If you meet income guidelines you may be able to receive prescription medication, if that service is provided at the center.

Phone 211:

Call the phone number 211. This is a service that offers referrals to various programs that help people in need. They may know of programs in your community that help with the cost of medications.

Annual Review of Medications and Supplements

At lease one a year review all your medications and supplements with your health care provider. This review will help to make sure your drug combinations are safe and that you’re taking only needed medications. It may also help you save money by adjusting your medication use.

You and your health care provider can discuss:

What each drug does for you
When you should take your drugs each day
If you can stop taking any drug that is no longer necessary
If you need to increase or decrease doses
Any problems with drowsiness, dizziness, or any other side effects

If you don’t buy the medications you need or skip doses because you cannot afford to buy all of your drugs each month, let your health care provider know. He or she may know of programs that can help with the cost or may suggest a less costly treatment.

Does Your Doctor e-Prescribe?

More and more doctors are starting to e-prescribe which offers convenience and safety. E-prescribing is the use of a computer system and a secure network to send prescriptions over the internet from your doctor to you pharmacy.

The system allows your doctor to keep accurate medication history and gives the pharmacist a computer order instead of a handwritten one, helping to eliminate errors due to poor handwriting. Your doctor can also easily view your prescription drug benefits, helping the doctor to prescribe the most effective medication based on your health insurance.

Prescriptions are sent through a private and secure network and the prescription arrives at the pharmacy before you leave your doctor’s office, making it easy to pick up on the way home.

Check the website LearnAboutPrescriptions.com to see if your doctor and pharmacy e-prescribe. Or just ask your doctor or pharmacist the next time you visit. To learn more about e-prescribing and electronic health records visit the Agency for Health Care Administration website at fhin.net.

How To Handle Bullying

Wed, 03 Apr 2013 13:24:00 -0400

The APA defines bullying as “aggressive physical contact, words or actions to cause another person injury or discomfort.” Psychology Today goes further, describing it as a “pattern of deliberately harming and humiliating others”. And Stopbullying.gov ads that it “involves a real or perceived power imbalance.”

In our popular consciousness, bullying used to mean Nelson and his gang of thugs on The Simpsons rolling Bart home in a trashcan. Or the countless incarnations most of us have seen in movies and television of anyone small being closed inside their locker. Almost always, the bullying was done by a single individual or a small group (typically male), and as bad as it was, the victim could escape his or her tormentors by running home or at least getting away from school.

Real kids in today’s world, though, don’t have the same luxury. With the technological advancements of the last 20 years, bullies are able to continue harassing their prey 24/7. Kids are bullied via text message and through nasty posts on their social media profiles. Bullies can send emails and harass them in chat rooms. Some even go so far as to upload embarrassing photos or videos or create entire websites devoted to making fun of someone.

It’s important to know how far-reaching bullying can become because far too often adults can feel like kids are “safe” when they’re home or engaged in certain activities, but it’s just not true. Severe instances of bullying touch practically every part of a victim’s life, and he or she can end up feeling like there’s no escape.

Types of Bullying
Experts at bullying organizations divide bullying into four different types: physical bullying, verbal bullying, covert or social bullying, and cyber bullying.

Physical bullying is exactly what it sounds like, and it’s probably the type that we’re most familiar with. It involves any kind of aggressive contact, including hitting, kicking, pushing, and pinching, as well as property damage and stealing personal items from another person.
Verbal bullying, too, is fairly self-explanatory. Taunting, name-calling, threatening, and just generally using words to make someone else feel bad are all ways that someone can be verbally abused. Racial slurs and homophobic remarks are also included under this type of bullying.
Covert or social bullying. This kind of bullying occurs when a group of people work together to make someone feel like an outsider. They might be made the butt of an unflattering rumors, feel like everyone is deliberately ignoring them, laughing at them, or making rude or menacing gestures, or find themselves excluded from games and other important events. Bullying such as this is sometime called covert because the person or people instigating the behavior won’t necessarily harass their victim directly, but instead encourage others to engage in ostracizing behavior.
Cyber bullying has already largely been defined above, and depends more on the medium than the specific kinds of actions taken against a victim. It involves any kind of harassment or bullying that takes place using digital technologies such as mobile phones or the internet, and can be overt, covert, social, verbal, written, and more. Probably the worst thing about cyber bullying is that it can feel like there is nowhere to go to escape it, and if someone posts something embarrassing about to the world, there’s little you can do to get rid of it. Read more about how educators can handle cyber bullying here.

How to Handle Being Bullied

The National Education Association’s website has a number of horrifying statistics about bullying in America, including the fact that 79 percent of boys and 83 percent of girls say that they’ve had to deal with harassment in school, and 60 percent of teens report that they see some kind of bullying going on at least once a day.

Bullied kids say that they’re afraid of riding the bus, going to the bathroom, and even going to school at all. In fact, the National PTA website says that every day 160,000 children are so afraid of going to school that they stay home. It’s the kind of fear that causes physical distress and hampers kids’ ability to learn in class. On the one hand, it’s terrible that so many kids out there are suffering. But if you’re the victim of bullying yourself, all of this information should mean two important things: bullying is a serious problem that needs to be dealt with and you are not alone.

So how do you deal with being bullied? You may not feel like it but you have a number of options available to you depending on the nature of the bullying and your own personality.

Avoid them. This isn’t a suggestion to skip class or stay home from school entirely but if you know your bully takes a specific route or eats in a certain place, do what you can to keep from running into them.
Stand up for yourself. A bully’s power is in making you feel small and bad about yourself, but many times they don’t know how to react when their victims actually stand their ground and refuse to be cowed. Be careful before taking this action, though, because it can cause some bullies to redouble their efforts to “break you” if you embarrass them by not backing down.
Ignore them. In the same way that bullies can be surprised when you stand for yourself, many are just as confused when you don’t give them the reaction they want. Pretending that their actions have no effect on you whatsoever - that they don’t matter - is a great way to stop teasing in its tracks.
Use the buddy system. Bullies are far less likely to harass people traveling in groups, so try to come up with a schedule to make sure that you’re always around a few friends.
Talk to someone. Most kids don’t want to tell adults when they are being bullied but this is a mistake. In fact, bullies count on victims not telling adults as part of their strategy. As long as no one with more power than them is involved, they can keep doing what they’re doing. Don’t feel bad for the bully. What they are doing is serious and wrong, and getting an adult to stop their behavior may even help them in the long run.
Start an anti-bullying program. If you don’t want to talk to an adult and “out” a bully directly, talk to someone about starting an anti-bullying program. Some schools have eliminated or greatly minimized the culture of bullying by creating “bully-free zones” and working to educate teachers and students about the dangers of bullying so that they’re more willing to get involved when they see harassing behavior.

How to Help If Your Child is Being Bullied

Different parents have different reactions to learning that their child might be experiencing bullying. Some may believe that the bullying is a way to “toughen them up” and “show them how it is in the real world”. Others might become so enraged that they want to confront the bullies themselves or may push their children to fight back.

These options are rarely the right way to handle bullying. It’s much better to try to calm yourself down and take the middle ground - show concern but try to find ways to solve the problem that don’t involve physical or verbal altercations. Here are some suggestions that experts recommend.

Talk about bullying. One of he best ways to help your bullied child is to simply talk about bullying. Not about their bully specifically or the trouble they’re going through, but why bullying happens, how bullies typically work, and what they can do to make it stop and help others. They also need to understand that victims are never to blame for bullying because far too many of them can feel guilt and even become depressed. Educating your child in this way arms them with information that they can use to solve their problem.
Make yourself available to your child. A lot of kids won’t be comfortable coming to their parents for help for a variety of reasons, so it’s important that you do everything you can to show them that talking to you about a problem is something safe. Make sure they know that you care and that you’re willing to listen no matter what, but don’t press them for information or they might retreat further into themselves.
Document everything. If there are records of your child being bullied, as is often the case with cyber bullying, holding on to the evidence is vital. School authorities will often want proof if you go to them with accusations, and the court will certainly need it if it gets to the point that you need to make it a legal matter. Just as importantly, hanging on to things like emails can really help if your son or daughter is being targeted by anonymous bullies, because authorities sometimes use that information to track down the culprit.
Go to officials. Letting bullying go too far can lead to all kinds of potential physical and psychological damage, and sometimes you have little recourse other than to go on to school officials to get it stopped. Meetings like this can go one of two ways - you can focus solely on the problem your child is having and demand that action is taken against the bullies, or you can work with them to start programs that educate the student body about bullying and seek to curb it in the school.

What Teachers Can Do About Bullying

Experts have found that comprehensive programs in the school are the most effective and efficient way to change the culture of bullying. Teachers and administrators, obviously, play a key role in this process because they are on the front lines just as much as parents are - if not more. Which strategies are known to work?

Raise awareness. When teachers notice that bullying is a problem, one of the best things they can do to solve the problem is to use their platform to talk about it and educate students. All too often, bullied kids feel like they’re alone and that no one will be willing to help them, but talking about it can change that. Encourage bullied students to seek help, and for those who witness bullying to speak out about it. Let them know that bullies can’t intimidate everybody if they work together against them.
Keep an eye out. Sometimes teachers can ignore signs of bullying because they’re too caught up in their own classes or simply trying to make it through the day. Unfortunately, this kind of “blind-eye” attitude is exactly what allows bullying to continue. If you want to stop bullying, you need to pay attention to how your students are treating each other and watch for students who seem to need help. Talk to other teachers and administrators, too, so that everyone is on the same page and knows where potential problems may come from.
Assert your authority. It’s one thing to watch for trouble, but another to actively step in and stop it. Most bullies are smart enough not to do their worst in front of authority figures, but if you see bullying going on, it’s important that you keep it from happening and punish the bully. They need to know that what they’re doing is unacceptable and that you’re not going to let them get away with it. When the situation calls for it, bullies should be made to go through counseling to better manage their anger and other emotions.

Above all, the best way to put a stop to bullying is to let it be known that it won’t be tolerated and then follow those words up with actions that prove them. The only real way to stamp out bullying is with a concerted effort that changes the culture and gets everyone involved - teachers, parents, and students.

Watch the video to see Michael Lawley explain why he’s...

Tue, 12 Mar 2013 12:20:00 -0400

Watch the video to see Michael Lawley explain why he’s fighting against expanding Florida’s medical malpractice laws.

A year ago this month, Michael Lawley of Melbourne disconnected the respirator that was keeping his brain-damaged daughter alive.

Shannon Lawley had entered a Brevard County emergency room suffering from what an autopsy would later determine was acute pancreatitis. She waited five hours as the understaffed team failed to monitor her vital signs or transfer her to intensive care, her father told the House Subcommittee on Civil Justice last week.

Doctors eventually administered heart medicine without realizing Shannon’s heart was functioning properly, he recalled. She went into cardiac arrest. Her lung collapsed as the medical team attempted resuscitation and her brain was deprived of oxygen for seven minuted, causing irreversible brain damage and gangrene, he said.

“After multiple tests and second opinions, I took her off the respirator and died two days later,” Lawley told the panel. “My daughter deserved better. She didn’t get it. The health care system in Florida failed her.”

Read more

Nursing Home Care in Florida

Fri, 04 Jan 2013 14:45:11 -0500

This article provides information to help you choose a nursing home for yourself or a loved one. Nursing homes serve both long-term residents and people who come for a short period for rehabilitative care. Some also provide respite care, which is when a person comes for a short stay to give relief to a primary caregiver.

A nursing home can be a freestanding facility or it can be part of a continuing care retirement community (CCRC). A CCRC allows residents to move from one level of care to another, as needed, and can include independent living, an assisted living facility, and/or a nursing home. Additionally a hospital can have a skilled nursing unit which includes designated beds within the hospital that serve patients who need short-term care and rehabilitation services.

Topics in this article include:

Nursing Home Services
Find and Choosing a Nursing Home
Questions You May Want to Ask
Checklist for Visiting a Nursing Home
Financial Resources
Prior to Admission
Moving into a Nursing Home
Nursing Home Admission
Important Phone Numbers and Websites
Alternatives to Nursing Home Care

Nursing Home Services

A nursing home provides 24-hour nursing and personal care to residents. Nursing care is provided by licensed practical nurses and registered nurses. Personal care is given by certified nursing assistants and can include help with bathing, dressing, eating, walking, and physical transfer. Nursing home services include, as needed:

Nursing care 24-hours a day
Help with personal care
Nutritional meals and special diets
Physical, occupational, speech, and respiratory therapy
Case management, health monitoring, and supervision
Social and creative activities
Respite care

When you visit a nursing home, be sure to ask about all of the services that are available and think about the services you need now as well as those you might need in the future.

What services will you need?

When you (or your loved one) first arrive in the nursing home the staff will do an assessment of your condition. A registered nurse, along with other staff, will use the doctor’s order and assessment to develop a care plan. The care plan will state what services you need; what health care professionals should provide this care and how often; what kind of medical equipment, supplies, or medicine you might need; and your health care goals.

Finding and Choosing a Nursing Home

How will you find the nursing home that offers the services you need and where you feel comfortable, that provides quality care and is in a location convenient for visitors and for your needs outside of the nursing home? The following resources can help you begin to review and compare nursing homes:

Facility Locator: You can use this to find a list of nursing homes in your area. Clicking on a facility will give you the address, phone number, and driving directions. This profile page also includes links to inspection reports, the Federal Nursing Home Compare website, current daily room rates, special programs and services, and more.

The following resources also provide more information:

Florida Nursing Home Guide

Florida Department of Elder Affairs (800) 963-5337

Continuing Care Retirement Communities: FLOIR.com/CompanySearch

Questions You May Want to Ask

When you visit a nursing home you may want to ask some of the following questions:

What are the fees and what services are provided?
Ask if there have been fee increases. How often and how much of an increase?
What types of payment are accepted?
What paperwork will I need to complete?
What activities are offered?
What meals and snack are provided? Are special diets available?
Will the nursing home help make appointments for medical care and arrange transportation to the appointment?
Are special services offered for persons with dementia?
What is the facility’s bed hold policy?
Is there a resident council and/or family council? How often do they meet and what kinds of things do they do?

After your first visit:

After you’ve met with staff at the nursing home and have had a tour, you may want to return again unannounced and at a different time of the day to get a feel for the place. Take time to talk with residents and staff. How does it compare to when you had an appointment and the staff knew you were coming? You can visit a variety of times if you wish and be sure to make an appointment with the administrator or director to discuss any additional questions you may have.

Checklist for Visiting a Nursing Home

Residents:

Are residents appropriately dressed and well-groomed?
Are residents alert and up and about or are they sitting in chairs for long periods or lying in bed?
Are there organized activities and are residents participating?
Is privacy respected? Do you see staff knock on doors before entering a resident’s room? If there are privacy curtains, are they drawn while care is given?

Staff:

Does the staff interact with residents? Are they friendly and respectful?
Are the administrator, director of nursing, and other staff friendly and willing to answer your questions?

Residents Rooms:

Are the rooms pleasant, with good lighting, a window, and enough space?
Do the rooms have storage space for each resident?
Are rooms private or shared? How many residents are in each room?
How many residents share a bathroom?
Are there handrails and a call button in the bathrooms?
Where does the resident shower or bather?

Common Space

Is the facility clean and free of strong odors?
Are rooms and hallways neat, free of clutter, and easy to walk through?
Are there handrails in the hallways?
Is the temperature comfortable throughout?
Are there common areas available for residents and their visitors?
Are there outside areas for use by residents and visitors? Are they being used?
Is furniture sturdy, comfortable, and clean?
Is the kitchen clean and well-organized? Is the dining area clean and comfortable?

Meals:

Ask to see a menu. Is there variety and do residents have choices?
Are nutritious snacks provided between meals and/or upon request?
Visit during a meal. Does the food appear and smell appetizing? Does it include fresh foods or mostly canned or frozen? Do residents enjoy the meal?
If staff are assisting some residents with eating, are the patient and attentive to the resident?

Financial Resources

Residency in a nursing home can be paid with private funds, long-term care insurance, or a person might qualify for help from government programs.

Often people do not know that Medicare does not pay for long-term residency in a nursing home. Medicare may cover a limited number of days, but only if you require some form of skilled care , only afters you have had at least a three day hospital stay, and other requirements. Depending on your length of stay you may be responsible for a co-payment. Speak with Medicare or the nursing home concerning these requirements. Additionally, if you are in a Medicare health plan you need to ask the health plan which nursing homes are in the plan and if you need to notify the health plan prior to admission. The nursing home has to be certified for Medicare and have Medicare beds available.

The Florida Medicaid Program does cover nursing home care for those who qualify for Medicaid coverage and who meet the criteria for nursing home care. A person may initially need to pay with their own funds if the person does not qualify for Medicaid when they first enter a nursing a home or if they exhaust their coverage under Medicare or another form of insurance. When the person has spent down their own funds or no longer has another type of coverage, they might then qualify for Medicaid. The nursing home has to be certified for Medicaid and have Medicaid beds available.

The following contacts can help you learn more about Medicare, Medicaid, and other possible financial resources:

Medicaid: Call (866) 762-2237 or visit MyFlorida.com/accessflorida

Medicare: Call (800) 633-4227 or visit Medicare.gov

Long-term Care Insurance: Call (877) 693-5236 or visit MyFloridaCFO.com

Department of Veterans Affairs: Call (727) 319-7400 or visit FloridaVets.org or VA.gov

Worker’s Compensation: Call (877) 693-5236 or visit MyFloridaCFO.com/WC

SHINE Program: Call (800) 963-5337 or visit FloridaShine.org

Prior to Admission

If you are a Medicaid recipient or have just applied for Medicaid and need care in a nursing home, you will receive an assessment from the CARES program. CARES provides assessments fro persons 21 years of age and older and evaluates a person’s ability to perform personal care as well as their emotional, cognitive, medical, and psychosocial state. The program is assure the person received an appropriate placement and the level of care that is needed. Individuals not covered by Medicaid can request a CARES assessment at no charge.

If you are moving into a nursing home that is Medicaid certified you will go through a Pre-Admissions Screening and Resident Review (PASRR). This is a federally required screening performer prior to admission to a Medicaid certified nursing home. The screening is to check for mental illness and mental retardation to ensure appropriate placement in the least restrictive environment and to see if special services are needed. This screening is usually done by discharge planners and hospital staff prior to discharge from a hospital.

To learn more about the PASSR and CARES programs, call the Florida Department of Elder Affairs (800) 963-5337 or visit ElderAffairs.state.fl.us/doea/cares.php.

Moving into a Nursing Home

When you move into your new home you will be leaving behind the familiar and adjusting to new surroundings, new people, and new routines. You will also receive supportive services and care and have the opportunity to have daily contact with other residents and employees at the facility and to participate in activities.

You will need to make decisions about what to bring with you. If you have a favorite chair, lamp, TV, radio, or other items, ask the staff what you can bring with you. Before bringing items that are valuable, ask the staff how your personal belongings will be safeguarded. Ask if you can decorate your room.

If possible, take time to carefully go through your personal belongings. Decide what you want to take with you and if you want to store, sell, or give away anything. It may be helpful to temporarily store some of your personal belongings with a loved one or in a storage unit. Once you have moved in, you may want to bring additional things from storage or exchange items.

Nursing Home Admission

At the time of admission the nursing home is required to provide you with a copy of the residents’ bill of rights, the nursing home’s admission and discharge policies, and information on health care advance directives. You will also sign a contract with the nursing home and may want to request a copy of it prior to admission to take home for careful review. The contract should also include a list of services and supplies not covered by the daily charge, but available to the resident along with the charges for those extra services.

If you are helping a loved one with admission into a nursing home, and if the person gives you permission, you can participate throughout the process. If your loved one is unable to make decisions or to understand the process, or they need a lot of help to do so, you may want to consider becoming the person’s health care surrogate or durable power of attorney.

Discharge or transfer: If you are a resident in a Medicaid or Medicare certified nursing home you may challenge a decision by the facility to discharge or transfer you. The nursing home is required to give a 30 day written notice prior to discharge or transfer. If you or a loved one receives such a notice, you can contact the Long-Term Car Ombudsman Council to request a review and hearing.

Important Phone Numbers and Websites

Agency for Health Care Administration - The Agency licenses and regulates nursing homes in Florida. To file a complaint against a nursing home call the toll-free number (888) 419-3456 or find a complaint form at AHCA.MyFlorida.com/contact/what_happens.shtml.

Disability Rights Florida - To report a heath care facility that has not made reasonable accommodations to meet your needs or has discriminated against you due to a disability, call the Disability Rights Florida toll-free number (800) 342-0823 or view DisabilityRightsFlorida.org.

Florida Abuse Hotline - To report abuse, neglect, or exploitation call the toll-free number (800) 962-2873 or view www.myflfamilies.com/service-programs/abuse-hotline.

Long-Term Care Ombudsman Council - To get help with concerns about your stay in a nursing home, with discrimination in a nursing home, or for what might be an inappropriate transfer or discharge, call the toll-free number (888) 832-0404 or view Ombudsman.MyFlorida.com.

skank0saurus: This is in memory of the 27 people who lost their...

Fri, 14 Dec 2012 15:30:50 -0500

skank0saurus:

This is in memory of the 27 people who lost their lives today in Newtown, Connecticut. You are forever in our hearts.

End-of-Life Issues: A Practical Planning Guide

Fri, 14 Dec 2012 14:08:15 -0500

Introduction:

Many people are uncomfortable thinking about or talking with others about the end of their lives. However, learning about end-of-life arrangements and talking in advance with your loved ones and your health care provider can help lessen fears. Such preparation can also let those close to you know how you would like matters to be handled, making it more likely that your wishes will be carried out.

This article looks at various choices available to you, whether you are preparing in advance or if you are a patient, family member, or friend already dealing with a terminal illness or with a sudden death.

You have the right to decide what king of care you want or do not want, to chose where you spend the last days of your life, and to make clear what you would like from people close to you. You have the right to choose how you want matters to be handled after your death. We plan for other life events, like birthdays, graduations, and weddings, but often we leave preparation for the end of our lives until the very end.

At some point each of us will come to the end of our life. Thinking and talking about it can make the experience less difficult for ourselves and for those we leave behind. Being open can help us break through isolation, give us comfort and a chance to live our lives fully even as we face our mortality.

Topics in this Article Include: Facing Death, Medical Concerns, Legal and Practical Concerns, Grief and Loss, and Final Arrangements.

Facing Death

When we face the end of our own life, or that of a loved one, we bring to the experience all of our values, traditions, emotions, and knowledge, all the parts that make up who we are. In some cultures death is accepted as part of life, while in others there is a fear to talk openly about it.

In facing your own terminal illness, or the death of loved one, you may want to seek the advice and support of family members, friends, religious or spiritual advisors, or get counseling or support from others who have had a similar experience. Also, hospice programs, described later on in this article, specialize in caring for terminally ill paiets and their loved ones.

When a Patient has a Terminal Illness

When a patient is told he or she has a terminal illness it can be frightening and overwhelming. The patient may feel there is nothing more to do, but there are still choices to be made.

It is important to have a partnership with your health care provider, as he or she can provide needed care and can educate you on what to expect. Even though your illness may not be curable, there is care that can provide comfort.

Tell your health care provider what is important to you and how you want to be treated through each stage of illness. Make a list of questions and concerns and have a friend or family member go to appointments with you. Having another person can help in asking questions and in understanding what is being said. If there is something you do not understand, as that it be explained more clearly.

Along with medical care you may want to seek emotional, physical, and spiritual care. Other professionals that can be of help are listed under the “Home Care Programs”.

The assistance of friends and family members can be important not only for you, but also for your loved ones. People often want to help, but are uncertain how to ask or what to offer. You, or someone else close to you, can make a list of needs. These needs might include spending time with you or going to appointments, providing meals, assisting with legal and estate matters, gathering medical information, running errands, organizing bills and other paperwork, doing laundry or yard work, and arranging for home care services.

You may choose to face your illness with the help of only a few close loved ones or to involve a wider community of support. It is important to take part in deciding when and how you want help from others.

You might choose life-prolonging treatment or at some point you may decide to limit such treatment. You might choose to have medical care in a hospital or, if possible, you may want to remain in your home. Programs like hospice, home health agencies, or nurse registries can provide some medical and support services in the home.

Special Concerns

When Death is Sudden and Unexpected:

Whatever the cause, sudden death can leave survivors in shock, intensifying feelings of grief and loss. There is no time to say good-bye or to show the person how you feel. In addition, if the person who died did not prepare in advance, funeral services will have to be arranged quickly, maybe without knowing what the personal would have wanted. You may have to straighten out legal and financial matters requiring a lot of work and time.

When a Child Dies:

Parents, grandparents, brothers or sisters, and other relatives and friends can experience a wide range of intense emotions when a child dies. You may blame yourself or repeatedly replay the event in your mind in hopes of changing the outcome. It may help to talk with others who have lost a child.

Compassionate Friends is a national support organization that offers friendship and understanding to grieving family members who have lost a child. They have a national website and local support groups throughout the United States. For more information visit CompassionateFriends.org or call their toll-free number (877) 969-0010.

When Death is the Result of Suicide:

The grief that survivors of suicide feel can be overwhelming. You might wonder if you could have done something to prevent the suicide. For more information you may want to contact the following organizations: Survivors of Suicide (SurvivorsOfSuicide.com) or the National Hopeline Network (Hopeline.com, 800-784-4673). For possible support resources in your local community call the phone number 211 or visit Flairs.org.

When Death is the Result of Criminal Violence:

Dealing with the results of criminal violence can be an emotional and confusing experience. The person who brought on the violence may never be found or„ if the person is arrested, you might chose to participate in what is usually a long legal process. Many law enforcement departments and state attorney offices have a victim advocacy program that assists survivors of a murder victim.

The Division of Victim Services at the Florida Attorney General’s office has a fund for financial assistance to innocent victims of crime. If your loved one was a murder victim, his or her immediate family may be eligible for financial help for some lost income, mental health services, and funeral expenses. To learn more call the toll-free number (800) 226-6667, or in the Tallahassee area call (85) 414-3300, or visit MyFloridaLegal.com.

Medical Concerns

The medical needs and concerns of a terminally ill patient will likely change as the patient’s illness progresses. This section looks at medical concerns, including questions for your health care provider, pain management, and home care programs.

Questions for Your Health Care Provider

It is important to have open and comfortable communication with your health care provider. If you are direct about what you need you will more likely receive the kind of care you want. Questions to ask might include:

What is your experience in working with terminally ill patients?
Are you comfortable talking openly with me about death and dying.
What will happen to me as this illness progresses?
What are the benefits and difficulties of my care options?
What medications will I be taking and how will they affect me?
If i experience pain how will it be managed?
Will you keep me informed of changes in my care plan?
If I want aggressive, limited, or experimental treatment will you respect my wishes?
If I want only comfort care, such as provided through hospice, will you continue to serve as my health care provider?
What is the range of time I might be expected to live?
What can I expect during the last few weeks or months of my life.

You have the right to decide how much treatment you want. Do you want the medical staff to do everything medically possible to extend your life? Do you want care given only for comfort and to reduce pain? If you say you want a certain level of treatment, and even if you put those choices into writing, you still have the right to change your mind at any point.

Pain Management

If the illness is going to cause pain, it is very important that pain be talked about and managed as best as possible. According to various studies, patients often are under treated for pain. You can suffer unnecessarily when you or those providing your health care are uncertain about appropriate medication dosage or if they do not understand your level of pain.

Pain management needs to be responsive to the needs of each patient. It needs to include good communication between you and the medical staff involved in your care. Talk with your physician or nurse if you feel you are not receiving the best level of pain management. You can also request a second opinion on treatment options. Also, hospice programs have knowledgeable experience with pain management.

Home Care Programs

Hospice providers a coordinated program of professional and volunteer services for patients with a terminal illness. Staff members are specially trained to assist you and your loved ones in dealing with end-of-life issues. They offer palliative care, which provides comfort and relieved pain and other symptoms when there is no cure available. Hospice allows you to die with dignity, respecting your values and encouraging you and your loved ones to be involved in the decision making process all along the way. The goal is to provide a good quality of life while preparing for the the end of life.

To be eligible for hospice services a patient must have a prognosis of living six months or less and no longer want curative care. This means the patient is not looking for a cure, but wants palliative care. If a patient lives beyond six months after admission they can continue to receive services as long as the doctor continues to document the patient’s eligibility. Hospice services are often not fully used because most people turn to hospice only during the last two to six weeks of the patient’s life, though they could have the services for much longer. Hospice services can be provided at the following locations:

Your personal home
Nursing home
Assisted living facility
Group home
Foster care home
Freestanding hospice facility
Hospital

Services can include:

Nursing
Physician care
Social work
Pastoral Services
Nutritional counseling
Grief counseling for patients and their families
Physical, occupational, speech, and massage therapy
Music and art therapy
Home health aide and homemaker services
Home medical supplies and equipment
Respite services for caregivers

Grief counseling and support continue to be available to loved ones after the patient dies.

Employees in home health agencies and nurse registries can also provide some of the services listed above. However, their employees may not be specially trained to assist with end-of-life issues, like hospice. Home health agencies and nurse registries can provide services from a nurse, certified nursing assistant, home health aide, and homemaker. In addition, a home health agency can provide physical speech, occupational and respiratory therapy; home medical equipment; nutritional counseling; and social work services.

You can find a list of Florida hospice providers, home health agencies, and nurse registries on Facility Locator. After you have and agency or list of agencies click on a name to find the address, phone number, driving directions, the administrator and owner, emergency actions (where applicable), and a link to inspection reports.

The profile page also includes a “Compare Quality and/or Pricing” link for Medicare certified home health agencies that connects to Medicare’s Home Health Compare websites. The Compare Quality and Pricing link for hospice providers opens the Family Evaluation of Hospice Care survey. The results of this survey are based on the experience of families whose loved one received hospice care. It asks family members about their view on the care provided to the patient, as well as their own hospice experience and asks if the patient’s needs were met, including personal needs, respectful treatment, if the family was kept informed, and if evening and weekend needs were met.

Services through home care programs can be paid by private funds or by some insurance policies. In addition:

If you are eligible, Medicare or Medicaid can pay for hospice services
If you and the home health agency are eligible, Medicare or Medicaid may pay for home health services
If you and the nurse registry are eligible, one of the Medicaid Waiver Programs may pay for services arranged by a nurse registry

For more information visit Medicare.gov. To apply for Medicaid visit MyFLFamilies.com. Click here to read more about the Medicaid programs.

Legal and Practical Concerns

We all have the chance to make some plans in advance of a terminal illness or an unexpected death, and to discuss these matters with the significant persons in our lives, This section looks at health care advance directives, Do Not Resuscitate Orders, durable power of attorney, wills, and tips for getting organized.

Health Care Advance Directives

A health care advance directive is a paper that expresses a person’s wishes about his or her health care, or a written form directing an anatomical donation after death. Advance directives, as the term indicates, are written in advance. Some people write them when they are diagnosed with a life-threatening illness. Others put their wishes into writing while they are healthy, often as part of their estate planning, like writing a will or buying life insurance. Types of health care advance directives include:

Living Will - a written form that describes if you want certain life-prolonging medical care provided, withheld, or withdrawn if you are unable to make your own decisions and you have a terminal illness or are in a persistent vegetative state.
Health care surrogate designation - a written document naming another person as your representative to make medical decisions for you if you are unable to make them yourself. You can include instructions about any treatment you want or do not want, similar to a living will. You can also choose an alternate surrogate. If you choose a health care surrogate and alternate, be sure to ask them if they agree to take this responsibility, discuss how you would like matters handled, and give them a copy of the document.
Anatomical Gifts - a written document that indicates your wish to donate, at death, all or part of your body. This can be organ and tissue donation to persons in need, or donation of your body for training of physicians, dentists, physician assistants, and other health workers.

Other Forms:

A Do Not Resuscitate Order (DNRO) is a form to identify people who d not wish to be revived if they are not breathing or if their heat stops. It usually is for patients who are terminally ill or who are in a persistent vegetative state. The DNRO is a specific form from the Florida Department of Health. Your attorney, health care provider, or an ambulance service may have copies available for your use. The DNRO form is requested and signed by you, or your legal representative, and is signed by your doctor. For more information visit DOH.state.fl.us/demo/trauma/DNRO.html.
Durable power of attorney is a written document naming another person to act in your behalf. It is similar to a health care surrogate, but the person can be designated to perform a variety of activities (financial, legal, medical, etc.). If you choose someone as your durable power of attorney be sure to ask the person if he or she will agree to take this responsibility, discuss how you would like matters handled, and give the person a copy of the document.
A will tells others how you want your financial estate and possessions to be distributed after you die. It can also name someone to be the personal representative of your estate or to care for your dependent children, should that be necessary. A lawyer can write a will for you or you can write one yourself. There are books and internet resources that can guide you in writing your will.

Grief and Loss

You and your loved ones will probably go through a wide range of feelings. There is no right or wrong way to grieve, and each person will have his or her own way and time for grieving.

Grief and loss can begin before a patient dies and, for survivors, can continue long afterwards. Holidays, birthdays, anniversaries, certain activities or locations, even smell and taste can bring on a sudden sense of loss and grief. In our fast paced society other might expect we should move quickly through grief and put it behind us. But grieving can be a slow passage that moves through many changes.

You might choose to grieve alone or might want the support of loved ones. You might become active in your community or with hobbies, to help you through the grieving process. You may turn to your religious community or draw on your spirituality to help you through. Also, most hospice programs offer grief and loss services to anyone in the community, even if the patient did not receive hospice services. Other resources include books, support groups, or counseling.

Final Arrangements

Often people do not think about final arrangement until after a person has died. Then decisions are required to be made quickly during an emotional and stressful time. It is possible to plan ahead by discussing your wishes with the significant person (or persons) in your life and writing down how you would like things to be handled.

You can pay in advance for a burial site, cremation, and/or funeral services through a pre-need contract with a funeral home, crematory, or cemetery. Or you might decide in advance to donate your body to science. The information in this section can help you think about what you would like.

Funeral Services

People usually think of funeral services as the viewing at the funeral home and a graveside service. However, the services can include many choices.

Funeral costs include the basic services of the funeral director and staff. This covers funeral planning, getting necessary permits and the death certificate, sheltering the remains until the burial or cremation is completed, and coordinating with the cemetery, crematory, or other third parties.

Additional services include transporting the remains, embalming, use of the funeral home for viewing or memorial service, graveside service, use of a limousine, a casket, grave liner, and cremation or burial. These additional services can vary in price among funeral homes and not all of the services are required.

Additional Concerns

What is a person dies while away from home, in another city, state, or country? Contact a funeral in your town or city an they can make arrangements for the transfer of the deceased to the location of your choice. You can also arrange for cremation in the city where the person died and have the cremains sent to you or another location.
Who should be called when a person dies outside of a medical setting? If the person was receiving services from a hospice program contact the hospice. If the person did not have hospice services call for local law enforcement and an ambulance, which in most areas would be the phone number 911.
What happens to a person’s financial assets, possessions, and unpaid debts after death? If there is a will, the custodian of the will must deposit it with the Clerk of the court within 10 days of learning of the person’s death. You may want to consult with an attorney to find out whether a probate proceeding is required.
What else will need to be taken care of after death?

File any life insurance claims
Contact the deceased’s place of employment to ask about any possible benefits
Contact Social Security, Veterans Affairs, and other organizations that may provide benefits or that need to be informed of the death
Notify banks about accounts, companies about loans, and change property titles
Obtain copies of the death certificate to be used in making these types of notifications and claims
Close out accounts, as needed, like utilities, cable services, services that deduct payment directly from a bank account, etc.

A will or a probate hearing may affect some of these tasks. You may decide to carry out these kinds of task yourself or hire and attorney to do them.

A Patient's Guide to a Hospital Stay

Thu, 08 Nov 2012 13:57:06 -0500

If your doctor decides you need medical treatment that will require a stay in the hospital, this article provides information and questions to help you prepare.

Before going into the hospital ask your doctor to explain your condition and the treatment you will receive. Ask if there are other choices of treatment available. You can also request a second opinion from another doctor, or you may be referred to a specialist.

Ask the doctor for written material about your condition and treatment that can help you know what to expect and how best to help in your healing. You might also find information on the internet.

Topics in this article include:

Before You Go Into the Hospital
Questions You May Want to Ask the Doctor
Consumer Tips
A Child’s Hospital Stay
Questions for the Doctor
FloridaHealthFinder.gov - Information at Your Fingertips
Patient’s Bill of Rights and Responsibilities
If You Have a Complaint

Before You Go Into the Hospital

Visit FloridaHealthFinder.gov to find information on your medical condition or procedure.
When you meet with the doctor, if possible take a friend or loved on with you. They can help you ask questions and take notes, if necessary.
If there is more than one hospital you can choose from, talk with your doctor about this choice. You can also view the hospital comparison tool to compare hospitals on health outcomes and performances.
Ask your insurance company if they will pay for the treatment, if they cover this doctor, and if you need approval from them before going into the hospital. Ask which hospitals are covered by your insurance. If they do not approve coverage, ask how you can appeal the decision.
Ask your insurance company about coverage limits and if there is a deductible and/or co-payment. If you are covered by a health plan, you might like to review your plan for member satisfaction and quality measures. These can be found through the health plan comparison tool.
Be sure to give the doctor a complete medical history, including medical conditions, past surgeries, and allergies. Provide a full list of the medications you take (prescription, over-the-counter, vitamins, and herbal supplements), including the names and dosages. You can either make a list or bring the medicine containers with you.
An anesthesiologist is the person who will give you medication in order to block pain and/or put you to sleep during the procedure or surgery. be sure this person has your medical history, including any allergies, your medications, and if you have had reactions to medicine.
If you have a health care advance directive, make sure your doctor and the hospital have a copy. An advance directive states how you want medical decisions made should you not be able to make them yourself. More information can be found in the article Health Care Advance Directives.
Plan for your hospital stay and recovery before you go into by arranging for childcare, pets, plants, transportation home, and, if needed, home health care or rehabilitation.
Following are personal items you may want to bring with you to the hospital: toiletries (hairbrush, toothbrush and toothpaste, deodorant, etc.); a robe, nightgown, and slippers; reading material; TV listings; and other things to occupy your time. Some of these items may be provided by the hospital, but are often costly and may not be paid for by your health insurance.
Do not take jewelry, cash, or other valuables.

Questions You May Want to Ask the Doctor
About the Procedure/Surgery

Why do I need the procedure/surgery and what are the risks?
Are there alternative treatments?
Will you or someone else perform the procedure/surgery? If it’s someone else, ask to meet with that person.
What is your experience with this procedure/surgery?
When will I meet with the anesthesiologist?

About the Hospital Stay

Is there preparation I need to do before coming to the hospital?
Do I need to stop or change any of my medications before this procedure/surgery?
What can I expect once I arrive at the hospital?
How long will the procedure/surgery take?
How long do you think I will be in the hospital?

About Recovery

Will I have any restrictions on walking, eating, drinking, bathing, lifting, etc., while in the hospital or once I return home?
What signs or symptoms should I watch for that might show I am not healing well, am having a poor reaction, or developing an infection?
Will I need home health care, special medical equipment or rehabilitation when I leave the hospital? Will you or hospital staff help me arrange for this care?
Will there be any changes in my medications after this procedure/surgery?
How do I take care of my incision?
How soon can I drive, exercise, resume sexual activity, return to work, etc?

Consumer Tips

If you need more time to think about your choices, talk with you doctor about your concerns. You can also ask for a second opinion from another doctor. Ask if your health insurance will cover a second opinion.
If you do not understand something when talking with your doctor or the hospital staff, ask that it be more clearly explained to you.
You may be able to save money or a hospital day by having routine tests before going into the hospital. Discuss this with your doctor.
If you prefer privacy, you might want to compare the cost of private and semi-private rooms and ask your insurance company how much they would pay for the room. If you want a private room you can pay the additional charge above what your insurance company will pay.
If possible have a friend or loved one at the hospital and ask the doctor to speak with them after your procedure/surgery. If someone is unable to be with you at the hospital, provide the names and telephone numbers of people to contact in case of a medical emergency or a change in your condition. Due to federal law, hospitals and medical staff are not allowed to share medical information unless you give them permission to do so.
Make sure your hospital wristband has your correct information.
Before you are given medication or other treatments, ask that the order be checked to make sure if it is the correct medication or treatment.
Be aware of the medicines you are given, what they are for, and what side effects they may cause. If you think they are late giving you medicine or you think they have missed a dose, speak with a nurse.
Find out when your doctor plans to visit you so you will not be asleep or of you want to have a loved one with you during the visit.
Have paper and pen to write down questions for you doctor or nurse. You or a loved one can also take notes on information given to you.
If you are in pain, speak with your doctor or nurse to see if your pain medication can be adjusted.
If your condition changes and you begin to feel worse or have symptoms that concern you, speak with your doctor or nurse.

A Child’s Hospital Stay

Being in a hospital can be frightening for children since they may not know what to expect and may not be able to easily express their concerns. The more a child and the parents can learn will help the child be better prepared.

Before the Hospital Stay

Have the doctor describe the procedure or surgery to your child, in an age appropriate way, describing what your child can expect during the hospital stay. You may want to meet separately with the doctor to get more details.
Ask your child if he or she has any questions or concerns. Give a truthful and clear response to each concern, providing information appropriate for the child’s age. Reassure your child you will be there to give help and comfort.
If possible, take your child for a visit to the hospital before they are admitted, as this can make them feel more familiar and comfortable.
Have your child choose a favorite book, game, stuffed animal, blanker, and similar items which will give comfort and entertain them. Ask them to help pack a suitcase for their stay, so they are part of the preparation.
Inform your child’s school of his or her upcoming absence and, if appropriate, ask how your child can keep up with school work, arranging for assignments and books.

Questions for the Doctor

Is this procedure/surgery commonly performed on children?
How have other children reacted to this procedure/surgery?
If my child is going to be taking medicine, is it commonly given to children?
Is there a Child Specialist on staff to help prepare my child for the visit?
Can I stay overnight in my child’s room?
Is there a children’s area or a program to provide arts and crafts, children’s videos, or other types of activities?
When can my child return to school and normal activities?

Helpful Tips for Kids & Parents

Have a family member or friend with your child as much as possible. If you need to leave, show your child how to operate the nurse call button and let the staff know the child will be alone.
Introduce hospital staff to your child when they enter the room and ask the staff to explain what they are doing.
Encourage your child to talk about their experiences and feelings. let them know it’s okay to be afraid, to cry, and to ask questions.
Assure your child that the visit to the hospital does not mean he or she has done something wrong. Remind them why they are there and what is going to happen.
Remind your child to tell you, the nurse, or doctor if something hurts or if they start to feel worse. Watch your child for changes in mood, behavior, temperature, upset stomach, and other things that might show they are not healing well, are having a poor reaction, or developing an infection.
Allow your child to make decisions (about food, TV programs, and what to play or read). This will help them feel some control in an unfamiliar situation.
Your child may begin acting younger than his or her age, by clinging or whining, wetting the bed, sucking their thumb, wanting to sleep with the light on. These can be normal reactions to the stress and change of being in a hospital. Such behaviors will likely begin to disappear when your child returns home to a more normal routine. However, if such behavior continues for a long period of time, you may want to talk with your child’s doctor.

FloridaHealthFinder.gov - Information at Your Fingertips

The Agency for Health Care Administration created the FloridaHealthFinder.gov website yo provide comparison tools and information to help the public become better informed health care consumers and to assist researchers in the study of Florida’s health care trends. The website includes a Multimedia Health Encyclopedia, a Symptom Navigator, a hospital and ambulatory surgery comparison tool, and other comparison tools.

Patient’s Bill of Rights and Responsibilities

A patient has the right to:

Be treated with courtesy and respect, with appreciation of his or her dignity, and with protection of privacy.
A prompt and reasonable response to questions and requests.
Know who is providing medical services and is responsible for his or her care.
Know what patient support services are available, including if an interpreter is available if the patient does not speak English.
Know what rules and regulations apply to his or her conduct.
Be given by the health care provider information such as diagnosis, planned course of treatment, alternatives, risks, and prognosis.
Refuse any treatment, except as otherwise provided by law.
Be given full information and necessary counseling on the availability of known financial resources for care,
Know whether the health care provider or facility accepts the Medicare assignment rate, if the patient is covered by Medicare.
Receive prior to treatment, a reasonable estimate of charges for medical care.
Receive a copy of an understandable itemized bill, and, if requested, to have the charges explained.
Medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.
Treatment for any emergency medical condition that will deteriorate from failure to provide treatment.
Know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such research.
Express complaints regarding any violation of his or her rights.

A patient is responsible for:

Giving the health care provider accurate information about present complaints, past illnesses, hospitalizations, medications, and any other information about his or her health.
Reporting unexpected changes in his or her conditions to the health care provider.
Reporting to the health care provider whether he or she understands a planned course of action and what is expected of him or her.
Following the treatment plan recommended by the health care provider.
Keeping appointments and, when unable to do so, notifying the health care provider or facility.
His or her actions if treatment is refused or if the patient does not follow the health care provider’s instructions.
Making sure financial responsibilities are carried out.
Following health care facility contact rules and regulations.

If You Have a Complaint

If you are not satisfied with the service you are receiving while in the hospital speak with your doctor, the director of nursing, the patient advocate, or ask the staff who you can talk to about your concern.

If you think the hospital may have violated the law relating to your care, you can file a complaint with the Agency for Health Care Administration, while you are in the hospital or after your discharge. To file a complaint call the toll-free number (888)-419-3456 or file it online here.

To file a complaint against a doctor, or other health care professional, call the Department of Health’s toll-free number (877)-425-8852 or visit FLHealthSource.com.

Shocking hidden camera footage at a nursing home reveals...

Thu, 13 Sep 2012 16:14:23 -0400

Shocking hidden camera footage at a nursing home reveals physical abuse from staff. This kind of nursing home abuse is illegal and an egregious crime against humanity. Our most vulnerable citizens reside in nursing homes and they deserve to be treated and respected like human beings.

If you or a loved one has been the victim of nursing home abuse (physical abuse, developing pressure sores, or suffering falls), make a call for justice and contact Nursing Home Abuse Lawyer Michael Brevda.

First 10 Minutes, First 10 Hours After a Road Accident

Thu, 13 Sep 2012 13:54:46 -0400

First 10 minutes after a car accident:

Stay calm- assess the health and safety of your passengers before you do anything else.
Call 911 immediately if you or anyone else in your car is injured.
Get out of harm’s way- if property damage is minor and you can do so safely, move cars and people out of traffic.
Turn hazard lights on to warn other drivers.
Exit your vehicle safely and check on the drivers and passengers in other vehicles for injuries. Make sure help is on the way, if necessary.
Call police even if the accident is minor and there are no injuries. Don’t leave until they arrive.
Be polite, don’t blame others, and don’t admit fault.
Take pictures if you have a camera and if it’s safe to do so.
Exchange information with other drivers: name, address, phone number, licnse plate number, driver’s license number and insurance company details.
Ask witnesses for names, phone numbers and addresses.

First 10 hours after a car accident:

Secure vehicle for transport; remove valuables or other personal items.
Seek medical attentions as soon as possible if you were injured, even if you think your injuries are minor.
Write notes for your records on everything about the accident, including weather, time, location, statements made, etc.
Contact your insurance agent.
Revisit the accident scene and take photos. Look for skid marks or anything else that seems important.
Photograph your injuries if they are visible.
Obtain police reports as soon as they are available.
Evaluate damage to your car and get repair estimates.
Contact your employer if you cannot work.
Contact your attorney:

If you are injured and.or there is extensive property damage.
Before providing any information to an adjustor from another driver’s insurance company.
If anyone is pressuring you into a quick settlement.
Before the time period allowed for filing a claim expires.

Read the full article here.

Trial opens in case of West Palm Beach widow accusing tobacco company in husband's death.

Wed, 05 Sep 2012 12:35:27 -0400

For years, Shirley Baker implored her husband to quit smoking.

She nagged. She cajoled. When warning labels were put on cigarette packs, she held one up to his face and demanded he read it. In the words of their son, Richard, who also urged his father to give up the deadly habit, “she rode him like an older Harley.”

But despite their efforts, Elmer “Perry” Baker didn’t quit. In 1993, months after being diagnosed with lung cancer, he died. He was 65.

To Shirley Baker and her attorneys, Perry Baker’s inability to quit is a testament to an addiction that was fueled by decades of lies and deception from tobacco companies.

“This is a case about greed, about money, about how the defendant R.J. Reynolds put sales over safety and profit over people,” her attorney Harry Shevin told a Palm Beach County jury Tuesday.

To attorneys representing R.J. Reynolds, which produced the Lucky Strikes, Winstons and Pall Malls that ultimately produced a tumor in Baker’s chest, the longtime ambulance company owner didn’t quit simply because he didn’t want to.

“Mr. Baker was a willing smoker who chose to smoke because he enjoyed it,” attorney Mark Belasic, who represents the tobacco giant, said. “He knew the risks and he chose to smoke anyway.”

The case is one of about 8,000 that were spawned statewide when the Florida Supreme Court in 2006 threw out the $145 billion a jury awarded smokers in a class-action suit. While upholding the jury’s findings that the cigarette-makers lied about the dangers of smoking, the high court ruled that each smoker had to prove how he or she was uniquely harmed.

By the end of May, when a Broward County jury ordered four tobacco companies to pay $75.35 million to the family of a Lauderhill smoker, 65 cases had gone to trial. Of those, 43 were won by smokers or their families. In the three cases tried in Palm Beach County, two ended with multi-million-dollar verdicts for smokers while one resulted in a win for cigarette-makers

The companies have appealed all of the unfavorable verdicts. In a handful of cases, the decisions have been upheld and the victims compensated.

Like the other cases, Shevin said he will be seeking millions for Bakers, 84, who ran Love’s Flower Shop in West Palm Beach for years before turning it over to one of her sons.

Attorney Sean Domnick, who also represents Baker, told the eight-person jury that when the trial concludes next week, they will have a rare opportunity to tell corporate America that it will pay dearly for putting defective products on the market.

There is no doubt tobacco executives knew cigarettes were dangerous, Shevin said. Internal documents dating to the 1950s show cigarette-companies joined hands, in violation of anti-trust laws, to conceal the dangers of smoking. As late as 1994, tobacco executives assured Congress that cigarettes were neither harmful nor addictive. Their testimony came a year after Baker’s death.

However, Belasic said, the public was well aware of the risks of smoking. In 1899, Florida lawmakers decreed that selling or manufacturing cigarettes was a crime punishable by a maximum six months in jail and a $500 fine. While the law was ultimately repealed, in 1918 state officials required that Florida school children be taught about the dangers of smoking. As a Lake Worth native, Baker learned that lesson in school, he said.

Further, even before the landmark 1964 U.S. Surgeon General report that found the smoking-cancer link, numerous national and local publications warned that cigarettes kill.

“He was a human being who made his own decision,” Belasic said. “He heard the warnings and he told people to shut up, (that) it’s my life.”

Florida's Schools Get Low Grade for Dealing With Poor Students

Thu, 30 Aug 2012 13:34:28 -0400

Florida's Schools Get Low Grade for Dealing With Poor Students:

For 14 years the Republicans have controlled all aspects of Florida state politics: The governor, the house and the senate. This is what we get. It’s time to change.

Florida is one of the three worst states in the nation for school funding equity.

That ranking comes from the Educational Law Center and Rutgers University.

The inequities are mostly connected to concentrated poverty.

Those high poverty areas in Florida, Missouri and North Carolina simply do not receive the resources they need.

The report identified four metrics that have to do with total school funding combined with equity measures.

So a state with good equity but low overall funding still would shortchange its students.

“Sufficient school funding, fairly distributed to districts to address concentrated poverty, is an essential precondition for the delivery of a high quality education through the states,” the report stated.

Unfortunately, Florida rated low on all four measures with data through 2009. It’s fair to say that Florida’s overall school funding levels haven’t improved much since 2009.

The national child poverty rate in U.S. schools is 16 percent, but that is deceptive, since many of the low-income students are concentrated in schools with large numbers of them.

In counties like Duval where large proportions of students attend private schools, the poverty rate in the public schools has an even larger impact.

Notably, only a few states have even itemized the costs associated with providing equitable funding to high poverty areas.

So while states like Florida have set standards for high quality education, they have not adequately figured out the funding needed to meet those standards.

A high income family has a whole host of advantages, many of them difficult to quantify, over a high poverty family.

How do you quantify the impact of a two-parent family, both spouses with college educations, where the parents have time to volunteer at school?

It’s real and it’s an advantage.

Six states do well on all four metrics: Iowa, Kansas, Massachusetts, New Jersey, New Mexico, and Vermont.

Kansas is the most meaningful state here because leaders purposely began addressing equity issues recently.

Florida is new to the bottom group, having seen substantial drops in funding levels.

For instance, Florida’s effort grade was an F while Georgia received a B and South Carolina and A.

The point of equity ratings is that funding should increase based on the need of the students. So students from high poverty areas have greater needs and thus require more funding.

Student poverty is simply the easiest way to measure many related factors, such as race, English language learners, and student mobility.

“Most states continue to neglect growing student poverty by failing to direct resources to the students and schools most in need,” said David Sciarra, executive director of the Education Law Center.

“In some states and regions, the shortfalls in school funding are reaching crisis levels.”

Students living in poverty are going to need more support to they are able to learn.

Florida should look at the states making big strides, such as Kansas and South Carolina, an move to an A grade.

The future demands it.

Tort Reform Reduces Your Insurance Premium? Think Again...

Tue, 28 Aug 2012 14:06:55 -0400

Florida CFO Jeff Atwater released a letter claiming that recent changes to the state’s Personal Injury Protection laws will reduce consumer premiums 14 percent to 24.6 percent. Almost immediately, insurers and regulators cautioned “other costs” could offset these savings. Florida’s Office of Insurance Regulation warns, “These projected savings may actually mitigate premium increases, not reduce premiums.” Translation: rates probably aren’t going to drop at all. This is the typical pitch we hear from corporation-backed tort reform lobby. We will save you on your insurance premium through tort reform. But when it is time to prove that tort reform actually lowers premiums, we see that there are always “other costs” that offset the “savings”.

Corporate wrongdoing is rampant in our society. Personal accountability through injury lawsuits are one of the few incentives big corporations have to play by the rules. Domnick and Shevin prides itself on protecting injured individuals rights against powerful insurance companies, nursing homes and corporations. If you or a loved on have been injured by someone else’s actions, make a call for justice at 561-630-5363. If you have not been injured, be thankful. But don’t block someone else’s constitutional right to seek justice because the insurance lobby sold you the illusion of “tort reform savings”.

A doctor who treated teen beating victim Josie Ratley testified...

Tue, 17 Jul 2012 14:14:15 -0400

A doctor who treated teen beating victim Josie Ratley testified Tuesday at the trial of the boy accused of the attack. Dr. Randall Powell testified how close Ratley came to dying on the operating table. Wayne Treacy, 17, has been charged as an adult with attempted murder in the March 17, 2010 attack on Ratley at a bus stop outside Deerfield Beach Middle School.

The Care Quandary

Sat, 23 Jun 2012 18:48:33 -0400

The Care Quandary:

Nursing homes need to maintain an elderly person’s dignity while they are residents. If you or a loved one has developed a bedsore while in a nursing home, make a call for justice.

Video surveillance is everywhere nowadays. Obtaining video...

Sat, 23 Jun 2012 18:45:39 -0400

Video surveillance is everywhere nowadays. Obtaining video surveillance of your injury occurring in real time can make your case.

The way people are treated in nursing homes is a crying shame!

Sat, 23 Jun 2012 18:43:12 -0400

So many people have come to me complaining about how the old ones are being treated in nursing homes.

I was compelled to write this because the old and the disabled have no voice. It seems like no one cares about them, but I care because I am disabled and this is a crying shame the way they are being treated in these nursing homes.

Abuse and neglect is unacceptable. We are supposed to live in country of compassion, love, and respect for our elderly for they are the ones that built this foundation for us to follow. I don’t see how anyone could abuse, neglect and take advantage of the older ones knowing that they can’t help themselves. It’s got to be a change done quickly because I don’t like the way they are being treated.

I have visited a couple of nursing homes to visit a friend. I have seen so many people lying in their own feces. Do you know how long it took for someone to come and assist them? It took hours; Do you know how that feels? It takes away one’s pride, dignity, and self-respect and it’s a crying shame.

I don’t understand why Florida Governor Rick Scott fired the inspector, because he cared about what was really happening and what was going on in these facilities. It hurts me to my heart to know that people don’t care about another human being’s feelings or well-being. It makes me and angry and very upset because I am disabled and when this affects them, it affects me.

Someone has got to step up to the plate and be held accountable.

KNOW YOUR RIGHTS & RESPONSIBILITIES AS A PATIENT Patient...

Thu, 31 May 2012 14:21:00 -0400

KNOW YOUR RIGHTS & RESPONSIBILITIES AS A PATIENT

Patient Rights:

Patients have the right to be told about their illness; to have their medical records explained.
Patients should be explained about whatever treatment/medicines are prescribed to them. They should be made aware of the risks and side effects, if any. They have the right to ask questions and clarify their doubts about the treatment
Patients have the right to know a doctor’s qualifications.
Patients have the right to be handled with consideration and due regard for their modesty when being physically examined by the doctor.
Patients have the right to maintain confidentiality regarding their illness and can expect the same from the doctors.
Patients have the right to a second opinion if they are doubtful about the medicines or treatment suggested.
Patients have the right to know what a suggested operation/surgery is for and the possible risks involved. If he/she is unconscious or unable to make the decision due to other reasons, informed consent needs to be taken from their nearest relatives.
Patients have the right to get their medical records/case papers on request from the doctor/hospital.
If the patient needs to be moved to another hospital, he/she has the right to know the reason for it and also has the right to make their own choice in consultation with the doctor.
Patients have the right to get details of the bills they have paid for.

Patient Responsibilities:

The patient should undergo the treatment as prescribed by the doctor faithfully and follow his/her instructions diligently.
If the doctor has prescribed certain preventive measures in case of infections, the patient should follow the same.
The patients need to be punctual for the treatments and follow-ups.
Patients should maintain all the medical records and prescriptions.
If the patient wants to take a second opinion, consult with your doctor about the same.
Patients should pay for their treatment as applicable to the doctors and hospitals promptly.