Wednesday is the 6-month anniversary of the Illinois Caregiver, Advise, Record, Enable (CARE) Act.  This law recognizes the important role that family members and friends (Lay Caregivers) play in post-hospitalization patient recovery.
 
The CARE Act is more than a nice idea.  Research shows that informed Lay Caregivers contribute to improved post-hospitalization health outcomes.   One study found that patients with trained Lay Caregivers were over 5 times more likely to complete recommended post-hospital procedures than patients without similar support, a major factor in decreasing the chance of re-admission.
 
Though AARP is the national sponsor of the CARE Act, the act applies to patients of all ages.  Versions vary slightly from state to state, but basic requirements are the same: 

• Identification: Each patient (or legal representative) must be given the opportunity to name a family/friend caregiver.
• Notification: Family member/friend caregiver is to be notified ASAP of their loved one's forthcoming discharge.
• Training: Hospital must provide explanation and instruction in after-care medical tasks that a designated family member or friend would perform at home.  (NOTE: "After-care" can include a wide range of tasks such as bathing, wound treatment, medication management, and operation of medical equipment.)

Some Illinois hospitals, like Advocate Sherman in Elgin and OSF Healthcare, are very much on board.  If you or your loved one is a patient at one of these hospitals, chances are that the lay caregiver will be more involved in discharge planning.  
 
Other hospitals, however, are still working to put the new procedures in place.  If you and/or your loved one feel that your post-hospital planning is not receiving the time and attention that it deserves,

• Inform hospital staff that your needs are not being met; most hospitals will work with you to resolve your concerns.  For a guide to help you ask questions that you don't know you should ask, click here to download this guidebook from the Agency for Healthcare Research & Quality.
• If hospital staff cannot satisfy your concerns, call the Illinois State Department of Health:  800 252-4343.
• If you are on Medicare, contact KEPRO, the Medicare Quality Improvement Organization for the State of Illinois:  844-430-9504.

Hospitalization can be a scary time... for patients and for their loved ones.  Post-discharge can be scary too, especially when Lay Caregivers are left out of the discharge planning process.  Don't yield to external pressure; understand and advocate for your rights.  Your health may depend on it.
 
PS:  Enhance your advocacy skills by attending CareSmart's Advocacy program, Thursday, August 4.  Click here for additional information.

NOTE:  Gina Kolata is a science reporter for the New York Times.  I ran across her article on Medical Mysteries this week and was fascinated by her observations.  I think you will be too. 
 
Despite the abundance of data that's collected and analyzed by medical scientists, they still can't explain the huge declines in disease that are occurring in the United States and other well-to-do countries.  For example,

• Colon cancer deaths have declined nearly 50% since the early 1990s.  Improvement can be tied to better screening, treatment, and ????

• Heart disease deaths have fallen 60% from their peak in 1950.  The decrease appears to be related to better control of blood pressure, cholesterol levels... and something else.

• Hip fractures have declined 15-20% over the last 30 years.  Some of the drop may be due to medications... but only 10% of women over the age of 65 take them.  Some experts speculate that the improvement may be related to increased weight which is related to stronger bones... but no one knows for sure.

• Dementia rates have also been falling... at a rate of 20% per decade since 1977.  The decline has been linked to improved cardiovascular health and education level (completion of a high school diploma).  Exact reasons are unknown.  NOTE:  Dementia is a group of symptoms related to Alzheimer's disease and many other brain disorders.  

Of course, many people still suffer and die from these diseases.  The good news is, however, that prevention, treatment, lifestyle changes... and a mysterious "something else"... appear to be, for many, delaying them until later in life.
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A few weeks ago, our Smart Tech posting offered a range of techologies that can help us age better. Here are a few strategies to help you select the "right" tools for the job...
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How much time have you spent trying to select the right cell phone, computer, or TV?  Fortunately (or unfortunately), we have SO many options. 
 
Most people start with the technology itself... a new cell phone, tablet, or big-screen TV.  This approach can work, but sorting through the options can be confusing... and we sometimes end up with a tool that's not really what we want. 
 
The challenge can be more daunting when we're trying to select a technology for someone else.  Applying the PETT Framework can help us make smarter selections.  An acronym, PETT stands for Person, Environment, Tasks, and Tools, and it works like this.
 
Person:  Who's the technology for?  What are the personal and technological capabilities of the person/s who will be using it?  Does s/he have hearing or vision challenges or arthritis?  Fear technology or love it?  Are there cognitive challenges?
 
Environment:  Where will the technology be used?  If thinking about a new phone, for instance, is it mainly for home, away-from-home, or everywhere use?
 
Tasks:  What task/s should the technology accomplish or enhance?  Maybe the main focus is communication so the desired tool should be for talking, texting, emailing, Facebooking, etc.  Tool options are different if the primary focus is entertainment or safety.
 
Tools:  Given what is known about the person, the environment, and task/s, which tools best match the person's needs?  At one extreme, the best communication device might be a "bells and whistles" cell; on the other, it might be a CapTel captioned phone for a homebody with hearing challenges.
 
Once the list is pared down, consider cost, reliability, and privacy.  We often don't think about this last factor but when considering technologies like tracking devices and home monitoring systems, it's important (and very often necessary) to have the "beneficiary's" buy in.
 
For more information on the selection of technologies that can increase, maintain, or improve function, see the Center for Aging Services or Assistive Technology Industry Association websites.  Happy shopping!!
 
*The PETT Framework is based on Joy Zebala's SETT Framework, created to help schools select appropriate assistive technologies for students.