Can monitoring patients at home avoid readmissions?

Monitoring Patients Can Help Med Adherance

A recent LA Times story quoted data from a study conducted by Kaiser Health News found that nearly half of patients misunderstood what it or other common label instructions meant on medicine bottles. Consequently, they are advocating that the Food and Drug Administration should aim to simplify, clarify and standardize the labels that are affixed to those drugs.

According to the LA Times, “Medication compliance, or ‘adherence,’ as it's called, is a big problem. Despite the fact that 87 percent of people in a recent survey said they thought prescription medicines were important to their health, only about half of those surveyed take their drugs as directed. People skip doses, take the wrong number of pills, and take pills at the wrong time of day, among many other problems. Poor adherence results in up to $290 billion in medical expenses each year, according to NEHI, a health research organization.”

The study found that in general, people are more compliant with drugs for acute conditions such as a bladder infection than for chronic problems like diabetes. But both are problematic, and the reasons people offer for not taking their drugs are as varied as the drugs they're not taking. In that patient survey, 59 percent said they stopped taking their medication because they were feeling better and didn't think it was necessary to continue, while 25 percent said they stopped because they weren't feeling any better. Thirty-seven percent were worried about side effects, while 24 percent said their drugs were too expensive.

“Simple forgetfulness may be the culprit in many cases of nonadherence, especially when a drug doesn't actually make people feel any different. Drugs to treat high cholesterol or high blood pressure fall into this category. Many researchers and others involved in medication adherence issues are excited about the potential of technology to both educate patients and provide a "tickler" system to remind them to take their drugs,” said the LA Times.

While no single strategy or technology will get everyone to take their medicine as directed, experts agree that clear instructions on the pill bottle are a basic requirement if that's to happen. Many of the USP recommendations seem commonsensical: place patient information and instructions at the top of the label in bigger type than the doctor or pharmacy name or information on refills and expiration; use everyday words like high blood pressure instead of hypertension; keep auxiliary information, such as warnings, simple and straightforward.

And to avoid confusion over things such as dosages and when to take the medication, the recommendations say, keep those instructions separate and simple, using numbers instead of words when appropriate. With those guidelines in mind, perhaps fewer people would be confused by the instruction that started this column. The new and improved pill bottle would read, "Take 2 tablets by mouth in the morning and 2 tablets by mouth in the evening."

Medication compliance is one of the major roles that home aides play when working with patients. They can monitor patients to ensure that the right doses of medications are being taken at the right times, and whether they should be taken with meals or not. Home aides also can determine if medications are being effective or if there are unanticipated side effects. Ask Assisting Hands® about their services or visit assistinghandschicago.com.

Senior Home Safety Blog: Are the Elderly prepared for Summer temperatures?

Senior Home Safety Blog: Are the Elderly prepared for Summer temperatures?: Summer temperatures can pose a danger to older adults. Working or playing in the sun, spending time in an unventilated home, or sitting i...

Are the Elderly prepared for Summer temperatures?

Summer temperatures can pose a danger to older adults. Working or playing in the sun, spending time in an unventilated home, or sitting in a closed vehicle can result in uncomfortable and even dangerous temperatures.
As we grow older, our bodies are less efficient at regulating temperature. Especially at risk are people with health problems such as cardiovascular disease, kidney or lung problems, unhealthy body weight, or those who take certain medications that interrupt the body's ability to protect itself by perspiring. Other risk factors include: age-related changes to the skin, including inefficient sweat glands; being substantially overweight or underweight; and dehydration.
Here are some tips for staying safe and comfortable during periods of higher heat:

• Drink plenty of fluids, even if you don't feel thirsty. On hot days, the body loses moisture more rapidly, so keep hydrated with water or fruit juice. Avoid caffeine and alcohol, which cause the body to lose more fluid. (If you are on a fluid-restricted diet, speak to your healthcare provider during periods of heat.)
• Keep your home comfortable by letting in cool air during the early morning and evening hours. Create cross-ventilation by opening windows on two sides of the building. Use fans to circulate cooler air. Close curtains and blinds during the warmest hours.
• Take a break at an air conditioned location during the hottest part of the day. Go to the mall, a movie, the library.
• Dress for the weather. Wear short-sleeve, loose-fitting garments. Natural fibers and light colors are cooler than synthetic materials and dark colors. And don't forget your sun hat!
• Exercise and work outside only during the cooler hours of the day, and pace your activities.
• Wear sunblock when you are outdoors. Sunburn reduces the body's ability to regulate heat.

Heat-Related Illness
Hyperthermia is the name for a variety of heat-related illnesses that can include:

• Heat cramps (a painful tightening of the muscles of the abdomen, arms or legs)
• Heat edema (swelling of the ankles and feet)
• Heat syncope (a sudden dizziness and rapid pulse that usually occurs when someone is exercising in the heat)

If ignored, these conditions can progress to a dangerous condition called heat stroke. The symptoms of heatstroke are:

o    Fainting
o    Body temperature over 104
o    Confusion, staggering
o    Dry, flushed skin with no sweating
o    Strong, rapid pulse
o    Headache
o    Unconsciousness

A person with heat stroke should be seen by a physician immediately!
The National Institute on Aging provides five tips on what to do if you suspect someone is suffering from a heat-related illness:

1. Get the person out of the sun and into an air-conditioned or other cool place.
2. Offer fluids such as water, fruit and vegetable juices, but avoid alcohol and caffeine.
3. Encourage the individual to shower, bathe or sponge off with cool water.
4. Apply a cold, wet cloth to the wrists and/or neck, places where arterial blood passes close to the surface and the cold cloths can help cool the blood.
5. Urge the person to lie down and rest, preferably in a cool place.

For More Information
The Centers for Disease Control and Prevention (CDC) offers information on staying safe during periods of extreme heat.
The Weather Channel website issues alerts for periods of high heat, and includes heat safety and preparedness resources.