The Many Health Benefits of Walking

Walking isn’t just about keeping those few stubborn pounds at bay. There are far more advantages to walking than you may realize. It is known that blockages and general malfunction of our major internal organs can be attributed to a a stagnant lifestyle.

Looking at this more closely, we see that from simply taking a short walk, a series of miraculous events are occurring in our bodies.

the heart rate is a more healthy pace

more blood is delivered throughout the body including the muscles and the brain

oxygen is dispersed throughout the body more efficiently

our muscles burn fat

our immune system is enhanced

essential nutrients are being delivered to the brain

our lung capacity is increased

blood pressure is reduced

bone health is promoted

depression and anxiety are alleviated or can disappear altogether!

Of course there are far more advantages, too numerous to list. But looking at this short list of benefits relevant to each of the major systems of the body, we can readily see a cause and effect factor in play.

The High Cost Of Health Insurance:

If your insurance company called later today and bumped your premiums $100 per month, it is fair to assume you would be less than amused.

Yet people who don’t incorporate some physical component into their lifestyles are more destined to become ill from countless numbers of conditions which are 100% preventable simply by getting 30 minutes of daily exercise. If you are confined to a wheelchair, similar alternatives are available, but get moving the best way you can.

The choice is yours, higher medical insurance payments, doctor bills and medication, illness and feeling bad, or a free 30 minutes excercise each day.

Every benefit walking can give you will greatly reduce the need for frequent doctor visits. If you pay out monthly for medication to maintain healthy blood pressure, reduce cholesterol, or any anti depressants, you will already know the pain that is associated with delving into your pocket book. Now, try it again without prescription benefits and watch the cost soar to where you simply cannot afford to buy it. Will you survive or become another statistic? The number of people without health care in this country alone is at almost epidemic proportion. At the time of this writing, an estimated 47 million Americans do not have any health insurance whatsoever. With the cost of an unplanned trip to the emergency room at an approximate $700 to $1000, depending on the nature of the visit and an added X-Ray, followed by a prescribed medication and you will understand at least the financial necessity of taking care of yourself.

The Mayo Clinic offers a great 10 week walking planner which starts off at just 30 minutes per day. I recommend visiting their site to see how it works.

http://www.mayoclinic.com/health/walking/SM00060

If you’d like to get a free pedometer, take the pledge to be healthier. You’ll also get some healthy recipes and even coupons to use when making your new healthier food choices.

http://www.eatjustonemore.com/pledge.aspx

*I am not a licensed medical physician, please consult your Doctor before embarking on any new exercise routine.

Walking for Good Health

Walking for good health

Walking daily has a lot of benefits. It helps you get in control of yourself. It reduces the chances of diabetes, cancer and heart attack. It helps to keep them in check should you already be suffering from any of these. Yes, even those who have had heart attack before can take up walking.

In fact, doctors allow the heart patients to slow walk before getting discharged. Walking helps to dissolve fats, improve the circulation of blood and gives a boost to your sexual life. Walking helps improve our moods and suppress anxiety and fear. And above all, its free. Moreover, It improves the overall lifestyle.

Walk regularly, preferable at the same time everyday. Pick a time to walk. Preferably mornings. Our body is stiff early in the morning. A walk would loosen it up and allows allow fresh oxygen to flow which lifts our health. Be disciplined and wake up 30 minutes early to accommodate this new sport. If mornings are a hassle, pick any time that is suitable for you. However, make sure you get 20-30 minutes of uninterrupted walk.

Walk in a pollution free environment. Parks are ideal. Beaches are also welcome. If you prefer walking on a thread mill, make sure the air con is turned off.

Warm up. It is important to tell your body what you are up to. This would signal to get ready for the rush. Start with rolling your hands forward and backward. Move your head from side to side. Take deep breaths. Otherwise, start with a slow walk, gradually increasing speed. Exercise every prts of your body. Swing your arms from side to side while walking. Vary the steps you take. Long strides, short strides, 2 lefts 1 right etc. Smile. Work your jaws.:D.

Always follow up the walk with a relaxing exercise. Deep breathing exercises are the best. Remove all air, exhaling from our body followed by inhaling and holding. Repeat for a few times. 5-10 minutes are ideal for a relaxation.

Never strain yourself. Always start slow, allow your body to adjust and gradually increase the speed. Never wear heals or slippers when you go walking.Invest in a good walking or jogging shoes. It is very important to protect your feet. The strain on your legs are immense as you work out. Hence, do not let up on this one.

It is evident that you will feel pain the first time and subsequent walks. However, this is your body getting used to the routine. Should you let up at the first pain, you will never be able to religiously follow it through and take walking up as a regular exercise. Endurance is the key. Even after a month of regular walking you feel the pain, do consult your doctor.

Do not wear clothes that hinder movement. Wear comfortable and preferably, cotton clothing. This helps the body to breathe and helps with the sweat.

Don’t drink water or health drinks immediately after a workout. Allow yourself to relax first. Give yourself 10-15 minutes. Wait till you unwind and do your deep breathing exercise before quenching your thirst.

As with any other form of exercises, care should be taken. If you feel nauseated, giddy, heart ache or temporary blindness, stop walking. Consult your doctor immediately to diagnose the symptoms. Get a go-ahead from the doctor before continuing with the walk.

Patients who have suffered heart attacks should take extra precaution. Never walk on inclines or steps. Always walk on flat surface. Monitor your speed. Should you feel that you are unwell (breathlessness) during or after walk, place a Sorbitrate pill under your tongue for immediate relief and consult your doctor immediately.

There you have. After a 30 minute walk, and the 10 minute deep breathing exercise, a new you, ready to face the day, confidently.

Health, Happiness, and Stress Relieving Tips from Ireland

The Irish have long been known for their happiness, optimism, beauty, etc.. They have always ranked near the top in studies that Gage happiness and overall satisfaction with life. This article will reveal some of their secrets passed on from generation to generation. Secrets that keep them strong, happy, and healthy, and now they are available to you too.

Let’s start with the Irish secret for good cheer. Some people think that the fresh sea air might have a lot to do with it because it is charged with negative ions that are proven to make you feel energized and alert. Negative ions not only clear the air of dust so you can get more invigorating oxygen they also help combat depression. In fact exposure to negative ions proved to be just as effective as antidepressants like prozac and zoloft, and without the side effects. So what can we do if we are far from the shore? You can get a dose of negative ions just by taking a shower or get yourself a bubbling mini fountain. The mini fountains are very popular in home decor and can be found almost anywhere.

Next, and one of my favorites, what is the Irish secret for that radiant skin? Apparently the Irish drink more tea than any other country per capita. So why does this help the skin? Well, all tea is full of polyphenols, antioxidants that destroy wrinkle-causing free radicals. Antioxidants also boost blood flow to the skin and keep it hydrated, giving it a gorgeous glow.

The Irish secret for a slim figure is Irish moss, which I had previously never even heard of. It is now being called a miracle diet food. It is a mild seaweed that expands in the stomach so that you feel full fast and it also gives your a thyroid a boost. You can buy dried moss at www.kalyx.com. You can try putting a tbs. into soup or just 1-2 capsules of the herbal supplement a day with meals.

Total well being would seem like the ultimate goal for many of us. The Irish say that natural foods are the secret to this! Meats in Ireland are free of hormones that have been linked to certain cancers, and the fish comes from clean off-water shores. Irish folks also tend to buy things from a farmers market and eat them the same day. This is another reason the Irish are so healthy: since refrigerated produce loses half of their vitamins within one week. Basically fresher foods are tastier and healthier for you also.

The Irish have very strong resilience. What is their secret to this? It may sound silly to us but looking for rainbows and silver linings apparently is the key. Historically Ireland has had its share of troubles, and the weather there can often be rainy and gray. But you can also see rainbows everyday and the clouds are gorgeous. The sky Will be dark and ominous one minute and the next there will literally be a silver lining. And the Irish make a point of being thankful for bright spots and this helps them boost optimism and be able to bounce back quickly from anything.

And finally the Irish secret that I was most curious about. Stress relief! When looking for some stress relief the folks in Ireland turn to animals. Ireland is largely rural and the people there still have plenty of contact with animals. There are horses, cows, and lots of other critters that they credit as a real plus for their mental health. Research shows that just being in the presence of an animal or petting one, a rhythmic , meditative activity, reduces blood pressure and heart rate.

We may not all be able to have the luck of the Irish but thanks to these tips maybe we can enjoy some of the other great aspects of the way they live. For more information on Ireland and the Irish people visit www.irishcultureandcustoms.com .

Review of Quaker Mini Delights Caramel Drizzle

The newest movement is attempting to eat healthy to loose weight or the extreme measure of Gastric Bypass Surgery or Lap Band to reduce body mass. Myself personally, I am not real sure of altering the body I was given, not to say I’m excited about the way I look. But let’s face it we all can’t look like Barbie®.

My husband and I decided right after the first of the year that we needed to find a way to get the pounds off. I started by cutting back on the amount of food that I serve at our meals and choosing the healthier options that are available. I rinse the hamburger before finishing any dish to remove the excess fat from the meat. I measure portions and insure every meal has a vegetable and cut out all most all desserts. This is great but it left my husband with a strong feeling of being hungry every night after getting up from the table. Enter here the need for a low fat healthy snack that tastes good.

Now I don’t know about anyone else but we tried the weight loss shakes, or meal replacement shakes and those things are just nasty. The only thing they could effectively do is turn you against eating all together. So I started purchasing these new 90 Calorie Packs from the Quaker Company®. These things are great, a little small but that’s because they are portioned to help you loose weight and gain control of eating habits. I purchased the Caramel Drizzle, Bit Sized Light Crispy Multigrain Cakes, now my first thought was multigrain cakes yuck, but I was very pleasantly surprised. They have just the right amount sweetness and don’t taste like you are chewing on a Styrofoam cup. The next test, the kid test, they love them. They ask for more everyday and eat them quicker than we do. I found I really enjoy this healthy snack alternative. This product comes in many flavors in addition to the Caramel Drizzle and is very reasonably priced.

During the same visit to the grocery, I purchased the Quaker Rice Cakes® in Chocolate and Caramel flavors. Now while not intended to be eaten as a meal I enjoyed them for breakfast and snacking throughout the day. They are a wonderful product that I would highly recommend and plan on purchasing again. You can find all the information you need at www.Quakeroats.com .

Why We Should All Drink Less Water and More Coffee

If you believe some people, I should have shriveled up long ago.

That’s because instead of drinking the supposedly necessary 8 glasses of water per day, I probably drink one or two, if that. On top of that, I drink at least four cups of coffee and I used to drink a couple glasses of soda, as well. According to the water-obsessed, not only does the water in coffee and soda not “count”, but it also dehydrates you – basically, it works like “negative water”. So if you add it all up, I must be getting a bit more dried up every day, and should probably be dead by now.

I always wondered whether the 8 glasses a day rule was some kind of myth, perhaps fueled by the multi-billion dollar bottled water industry. Recently, when embarking on my quest to lose a tiny bit of weight, I had the chance to do some research. That’s because all the weight loss information you can find anywhere urges you to increase your water intake. Some sources suggest not 8 glasses, but something more like 12-16 glasses a day. The idea is that not only is all this extra water somehow “good for you” (though nobody ever seems to explain how exactly), but also magically “melts away” or “flushes away” or “dissolves” fats and “toxins”. Weight loss gurus also claim that drinking extra water can make you feel fuller – for example, you are supposed to drink a full glass before sitting down to a meal, hopefully to ensure that you eat a bit less. This last factoid I could sort of get behind (it didn’t sound so pseudoscientific as the others), so I did make a bit of an effort to increase my water intake up to around 6-8 glasses per day.

It didn’t seem to make me feel any fuller, but it did make me pee constantly, which was pretty irritating. So I figured maybe I should look into this water thing a bit more.

Here’s what I found out: there is no reason that a healthy person should ever drink 8 or more glasses of water per day. Most people can drink perfectly adequate amounts of water by just letting their thirst guide them. In fact, the larger ranges of suggested water consumption (14 glasses or more) can be a bit dangerous for some people, because it puts stress on the kidneys and forces them to output huge quantities of dilute urine. Another potential danger is the increasing amounts of toxins in our water supply – not a big deal for most people drinking a reasonable amount of water, but if a lot of the populace is drinking 14+ glasses of water per day, one might wonder whether things like cancer rates could show an increase on average.

It turns out that the myth of 8 glasses of water per day came from an old, misinterpreted report (you can read about it here) that stated that most people need the equivalent of 8 glasses per day from all food and drink they consume. Most of this water, in fact, probably comes from our food intake (yes, food has a lot of water in it!). The remainder can come from plain water, flavored drinks, coffee, tea, soda, or whatever else you like. In actuality, caffeine-containing drinks do not significantly dehydrate the body (you can read about it in this recent NYT article).

There is no evidence that water “flushes out” or “melts” anything in our body, including fat or woo-woo “toxins”. There is also no mechanism by which this kind of “melting” action could possibly occur. Finally, the theory that I briefly ascribed to – that water might “fill you up” is also pretty suspect. Food scientists think that the human body is actually not capable of interpreting water consumption as “filling” (for sound evolutionary reasons). However, when extra water is mixed with our food (such as in soup), we can interpret water consumption as filling to some degree (I love soup, so this is good news!).

Although chugging extra water excessively is not really a great idea, it turns out that our liquid consumption can have a significant impact on weight in terms of the kinds of liquids we choose to consume. Drinking a couple of glasses of soda for example, adds a ton of calories to the diet. Even healthy beverages like milk or juice, if consumed in any significant quantities, are a pretty bad dietary decision, if you think about it. Add to this the fact that our bodies don’t really feel “full” after drinking these calorific drinks, and you could easily increase your calorie consumption by 1/10 to 1/3 per day without even noticing it.

So the moral of the story? Drink more coffee – it has only two calories per cup, contains tons of antioxidants, and is non-dehydrating!

Sources:

http://www.snopes.com/medical/myths/8glasses.asp
http://www.nytimes.com/2008/03/04/health/nutrition/04real.html?_r=2 scp;=1 sq;=dehydration st;=nyt oref;=slogin oref;=slogin
http://www.usatoday.com/news/health/2007-03-25-soda-drinkers_N.htm
http://ajpregu.physiology.org/cgi/content/full/283/5/R993

A Simple Solution to a Complex Problem

Consider the following hypothetical scenario: You have been experiencing annoying medical symptoms for a prolonged period of time now an have made the decision to seek medical attention not only for relief, but for reassurance and assessment or diagnosis which should explain these symptoms.

But at the same time, you are reluctant to do so.

Because you have a primary care doctor, and it’s an unpleasant experience each time you visit there. You call the office and, after waiting on the phone for a lengthy period of time, you finally find yourself having a dialogue with an employee there who appears apathetic and unpleasant, with a hint of joy when this person informs you that you will have to wait two weeks until an appt. with your doctor can be done. Does not matter, really, because you are reluctant to go to the doctor’s office anyway. Once you enter there, you’ll experience an over-crowded lobby that includes medical representatives who will take up even more of the time of your doctor, which means that your time will be stolen from you. Equally aggravating is that your doctor over-booked his clinic day with deliberate intent to correct a problem that does not exist yet, which is patients either not showing up or cancelling thier appointments with your doctor. Considering what has been said, can you blame such patients if they do this?

Your vexed and disappointed, yet somewhat desensitized due to experiencing this carelessness in the past. Alternative choices now regarding your symptoms are possibly urgent care or an emergency room- both of which are terribly expensive and ridiculously time-consuming. So get use to the mystery of your medical ailments and the discomfort, right?

Wrong. Enter convenience care clinics. Find one and go to it. You will be refreshed at what you experience because of the following:

1. Thier intrinsic drive begins with thier focus on you, and you never have to make an appointment at such clinics. Walk in, and let the examination begin.
2 You should feel amazingly comfortable as you begin your discussions with your health care provider, as you sense that this person truly does
believe he or sh is responsible for your medical care, and not you, as has been the case in the past. The provider examines you which, in your case, is an annoying case of a runny nose. Possibly, had I seen my primary care doctor for this, my symptoms would probably increase, involving maybe a headache, or anxiety, or both.

Since you have a history of seasonal allergies, this symptom has occured in the past with you. The provider informs you that your diagnosis is
called rhinorrhea, not to be confused wth diarrhea, and can treat you medicinally to provide relief with you. Now the provider does something
you have never experienced with your own doctor. This person actually provides you with counseling and recommendations to prevent this
ordeal in the future. A clinician who actually cares about my well-being. How unusual.

3. By the way, convenience care clinics usually have a nurse practitioner diagnosing and treating you. Thier title is irrelevant, as thier treatment
success is comparable with any doctor. At the same time, however, if this clinician suspects your medical issues are more severe than you
imagined, they are fully prepared to get you in front of one who can fully treat you quickly and thoroughly. This happens with about 10 percent of
patients seen at these types of clinics.

4. Statistically as well, the cost of your visit at a convenience care clinic is typically about 25 percent less than a primary care doctor visit, and the
clinics and NPs are not compelled like so many other doctors affiliated with some hospital to perform unnecessary testing on you or to over-
treat you, which ultimately not only restores your heath, but restores your faith in what is possible with health care, perhaps.

Finally, and in summary, the access and value at these clinics are great. More fufilling for many, I imagine, is the patient’s impression of thier provider
and thier thoroughness in treating you rapidly, which now is proven not to be all that difficult after all.

Author’s note: I’ve been employed in a variety of medical settings that expands two decades. With all honesty, I respect and think highly of most doctors, who I believe truly care about thier patients, yet are coerced to be limited in thier actions and feelings towards thier patients because of the health care system’s toxic enviornment presently. Thank you for reading thisl

Weight Loss Through Monotonous Eating

What do you want for lunch today? You scour the office cafeteria, looking for the healthiest options. Unfortunately, the cook in the kitchen doesn’t seem to care that many of the office workers are on diets or are watching what they eat. On the table lay piles of grease-laden burgers and cheesy clumps of lasagna. Sighing, you give up as you walk out of the cafeteria, still hungry. Your office doesn’t even have a salad bar for crying out loud! What are you to do? Bring a lunch from home, you conclude.

Home lunch brings with it problems of its own, though. Do you really have time to pack a lunch in the morning. If you can manage that, what do you pack? Well, here’s a simple trick I have used in order to keep track of what I eat. It makes meals simple. For those on diets, this method of eating also helps control the amount you eat.

I call it monotonous eating. It involves eating the same foods in the same amounts everyday. Say that cheerios is your favorite breakfast food. If you are to follow the monotonous eating method, you would eat the same amount of cheerios every morning, day after day. One apple, a tuna sandwich, a bag of carrots, and a small carton of apple juice could be your lunch for weeks on end. This is how the monotonous eating method works. Eat the same foods everyday at about the same time. Why would you want to do this? Well, there are a few reasons.

First, your body will grow accustomed to the amount of food it knows it will receive at specific times throughout the day. It will adjust its hunger cues accordingly. The body will also send the its satisfied cues toward the end of your meal. It knows when the end is near, so it prepares for the wait to the next meal time. For those who count calories, this method of eating makes counting calories a snap. Since it’s the same food everyday, the calories remain the same. Very helpful for those who want to lose weight.

Second, it makes preparing a meal a snap. Since you don’t have to worry about what you’re going to eat, you can have breakfast, lunch, etc. already prepared at meal time. This saves on time, worry, and effort.

Does this style of eating sound kind of boring? Well, it can be, which is why I recommend that you follow the monotonous eating pattern for 1-2 meals a day. Maybe a monotonous snack can be thrown in as well. Your diet still needs a variety of foods, and monotonous eating often will not provide your body with all the nutrients it requires.

Here’s a suggestion. Make breakfast monotonous. Have the same meal every morning. Since most of us are in a rush in the morning to get to school or work, the time you will save on breakfast will be of great benefit. Even for those who want to lose weight, breakfast is the most important meal of the day.

Lunch is a little different. I would recommend that those who want to lose weight or those who have little time to pack a lunch go with a monotonous meal, eating the same lunch everyday as well. As stated above, your body will start to feel satiated towards the end of the meal, since it knows the end is near. For those who are simply trying to eat healthy, a menu of 2 or 3 different lunches, all with about the same amount of food, will suffice. Chances are, some people want a little variety, so lunch is your chance to mix things up a little.

Dinner should not be monotonous. At least one meal a day needs to follow the intuitive eating pattern. At dinner, mix it up. Have a different dinner everyday of the week. Listen to your bodies hunger signals and stop when you are satisfied, but not bursting full. Having a different meal at dinner everyday is important. If dinner becomes monotonous, and you eat the same breakfast and lunch everyday as well, it will leave you feeling unsatisfied, and food will no longer be enjoyed. Make sure that at least one meal a day is different, and you will be on your way to successful weight loss or a general feeling of good health.

On an ending note, make sure that, when you make up your meals, choose healthy foods, foods that are nutrient rich and not chocked full of saturated fats and calories. Monotonous eating will not work if you eat a Big Mac from McDonald’s every day. Choose wisely. Eat lean meats, plenty of fruits and vegetables, and all the other guidelines that have been preached for years on end. Make sure you get at least 30 minutes of cardiovascular exercise a day, as well. An hour is preferable. For further information on healthy diets, visit www.mypyramid.gov

Simple Ways to Reduce Health Care Costs for HMOs and Medicare

As the presidential campaign in the United States moves toward the various delegate conventions, it becomes clear that massive changes to health care delivery might once again be considered. Whether that only occurs in the Democratic Party or also among republicans, the success of Michael Moore’s recent documentary, Sicko, makes some kind of reform likely.

This nation is in the midst of a financial crisis that all of the candidates seem to be ignoring, so the purpose of this book is to make suggestions about actions that might be taken by medical doctors and administrators to bring down those costs now. To that end, we will look first at all of the fraud by medical doctors pertaining to Medicare and the Health Care Maintenance Organizations (HMO’s.)

The first step that can be implemented right away, without any oversight legislation is for doctors to voluntarily stop charging insurance companies their full hourly rate even though they usually only see each patient for ten to twelve minutes per visit. That’s a neat way to avoid salary controls and to also evade taxes, isn’t it? And Medicare and the HMOs must know this since they all have medical personnel on their staff to try to find ways to avoid paying for necessary procedures.

If that could happen, I think legislation should be proposed stating that no HMO administrator above middle management shall take a salary in excess of one hundred and fifty times that of any registered nurse, with no further college specialty. No one is worth the kind of salaries most of them are paid. It is to sooth their egos when they compare their employment to that of comparable positions in private industry. But HMOs were created in an attempt to get health care costs under control in the first place, so their purpose makes it impossible to compare their responsibilities with that of any other upper level business position. We must now ask ourselves to what extent does the profit motive belong in the health care industry.

Taking these three steps immediately would cause an instant decrease in costs of common surgeries and preventive care. Its hard to estimate how quickly costs would drop, but an immediate change would be dramatic. Such common procedures as seeing five patients per hour and not pro-rating charges are but one example. Later on we’ll also talk about how much a band aid costs in the Medicare system.

Another way in which doctors routinely pad the accounts is sending a medical student in for a visit twice a day or more when a patient is recovering from some serious surgery. The doctor then charges Medicare and/or HMOs the full doctor fee for each visit by medical students. They don’t earn a penny for providing interim care. In fact, they pay tuition.

Do Health Surveys Actually Improve Nursing Homes?

With a tip of the hat to Charles Dickens, it was a very bad day, and then it became the unimaginably worst day ever. It was the day I went to work and saw the sign on the door announcing “Facility Being Surveyed by the Department of Health.” I was a social service director at a large nursing home and this was the signal that our annual survey had begun. I was not looking forward to it.

As I was settling in, getting my mind prepared for what was sure to be a grueling week, a co-worker came into my office and asked, “Have you heard the news?”

I sighed, “Yes, we are in survey.” Looking puzzled he replied, “No, the World Trade Center has been hit by terrorists.” Now I was puzzled, as I hadn’t listened to the news that morning. He re-iterated the bad news, and then I realized that not only were surveyors in the building, but our country had just been attacked. Yes, the date was 9-11-2001.

Thus began a horrible week, both for the nursing home staff and for the country as a whole. Although the surveyors were employees with the State of California, and all state employees had been ordered to go home, these inspectors did not. They chose to continue with their surveying tasks, and were with us for the entire week.

This created an almost impossible situation. The staff had to attend to the needs of the surveyors, which involved finding the documentation they requested, answering questions about the care the residents received, and monitoring the facility to ensure all staff were following protocol. In addition we were trying to deal with our own feelings and grief issues, especially as several of the staff knew people who worked in the World Trade Center. At the same time we were trying to keep the residents calm, and assist them with processing their feelings. Some of the WW II veterans were trying to figure out how they could re-enlist!

The Purpose of Inspections
Skilled nursing homes that accept Medicare and Medicaid funds are inspected at least yearly to ensure that the facility is compliant with regulatory codes. The Center for Medicare amp; Medicaid Services (CMS) is the part of the US Department of Health and Human Services that oversees the Medicare and Medicaid programs. CMS then contracts with each state to provide the on-site inspections. The inspections are usually unannounced, although most nursing homes know when they are due, and have been gearing up for months in order to be ready. Inspections can also occur randomly, especially if a nursing home has a history of poor inspections. The state inspectors also respond to complaints.

The survey team usually consists of 4-5 inspectors, usually registered nurses, but may also include a dietician, social worker, or pharmacist. A fire safety specialist also conducts an inspection, although this may occur at a different time.

What is the Process?
Upon arriving at the facility, the survey team will post signs around the building to inform the public that a survey is in process. Family members or residents are encouraged to report any concerns they may have. It was this sign that tipped me off that my nursing home had started the process. The first task of the inspectors is to do a walk-through of the facility. This involves walking from room to room, gathering information about each resident. They also look for any obvious problems.

After the walk-through, the surveyors will retire to a designated room to prepare their approach. Each nursing home is required to submit quarterly documentation electronically to the state, called a Minimum Data Set. The team has already reviewed these reports and has identified the residents that they want to review. They have also targeted major concerns, i.e. the facility has a high rate of falls.

During this initial phase, the staff are busy gathering documents that the surveyors require, such as suspected abuse logs, staffing schedules, demographic reports with the ages of residents, how many wear hearing aids, glasses, etc. While trying to complete this task, we tried to ignore the news reports of the tragedy that the residents had playing on the televisions in their rooms.

There are over 150 regulatory standards that nursing homes must meet, which cover all aspects of resident life. They include but are not limited to: safe storage and preparation of food, medication administration, resident rights, nursing care, clean environment, activities, and social services. In addition to reviewing the clinical record, the inspectors will interview family and residents, observe nursing care being provided, meals being fed, and on-going activities. They will watch to see if call lights are being answered in a timely manner, often timing them with a stopwatch.

They will also look for discrepancies or omissions in the written documentation. A plan of care might state that a resident will be bathed twice a week. The inspectors check the nursing flow sheets to see if this is documented. If there is no documentation, it is considered to have never happened, even if the resident states, “I always get my bath.” On the other hand, a resident may claim they never get a bath, yet the documentation can indicate that showers are given as scheduled. In this case, the surveyor might consider that the documentation has been falsified.

Upon completion of the survey, the facility is notified of any problems, or deficiencies. Most nursing homes have at least a few deficiencies, although a few nursing homes can brag about a zero deficiency survey. The nursing home then must prepare a plan of correction to ensure that all of these problems are corrected, and take steps ensure it does not happen again.

You can find out how a facility did on their last survey by going to Medicare.gov, Nursing Home Compare. This will bring up a list of the deficiencies of any facility you are interested in. When I checked my previous facility, they had 13 health deficiencies and 4 safety deficiencies in the last survey. This was about average for the state.

This information must be viewed selectively, however. Unless you are privy to the details of the situation, it can be difficult to determine just how serious it is. Yes, there are bad nursing homes out there, and they do tend to score very poorly on a survey. But most nursing home administrators and staff genuinely care about the quality of care they provide, and try every day to do their best. Mistakes do happen, and staffing can often be a challenge, but my experience is that for the most part, residents of nursing homes get very good care.

Do Surveys Help Improve Nursing Homes?
Which leads me back to the title of this article. Do health surveys contribute to the improvement of the nursing home, or do they actually make it harder to do a good job? From the point of view of the caregivers, too much time is spent documenting what we were doing, and too little time actually doing it. In other words, the volume of documentation required to ensure a successful survey has become so cumbersome, it actually adversely affects the quality of the care.

Let me give you an example. As a social worker, I was expected to visit residents who, for one reason or another, seldom left their rooms. The care plan might indicate that this was to be done 2-3 times a week. The purpose was to provide socialization, and to ensure that their psychosocial needs were being met. Let’s say that I visited Mrs. Brown who was bed-ridden. She complained to me that the nurses were not giving her the pain medication that had been ordered. Mrs. Brown would also call a family member and complain and he would call me. I would then check with the charge nurse who stated that the medication was given as ordered by the doctor, but that Mrs. Brown would often forget that she had received it.

The total time to visit this resident and talk to her family member might be 15-30 minutes. Follow-up time with the nurse could add another 5-10 minutes, more if I checked the medication record myself. To ensure that this information was communicated to a surveyor, I would make a note in the chart about the room visit and my follow-up. I would also indicate that this resident had a history of claiming she didn’t get her medication. I might choose to administer a mini-mental exam to document that she did indeed demonstrate short-term memory loss. This assessment tool could take up to 30-45 minutes. I would update the plan of care, identifying the psychosocial issue and provide interventions. One example could be providing a notepad for resident to sign when she received her medication, both to remind her it was given, and to provide further documentation to the family member.

Multiply this scenario times 100, depending on the size of the nursing home, and you can see how documenting can quickly eat up your time. Yet without this on-going record, it would be difficult to show an inspector that the facility was aware of the resident’s concerns and had intervened. In addition to the social services intervention, nursing would document that they had reported to complaint to the doctor, in case he wanted to change medication. They would do a pain assessment, and indicate on the nursing care plans what comfort measures had been tried. The activity staff would also document their room visits as well and possibly provide music therapy to distract the resident from her pain.

How Much is Enough?
When I left the industry in August of 2006, CMS had just initiated a new Psychosocial Severity Guide. This new guideline focuses on the decline in a resident’s psychosocial well-being due to the facility’s non-compliance of any regulation. The result was a flurry of new assessments tools mandated by the corporate office to counteract any claims by inspectors that these issues were not being addressed. I estimated that implementing the new paperwork for a new admission would take a minimum of 1-½ hours, and we had an average of 20 admissions a week. At the time, I had one full-time assistant.

Those of us who went into the helping professions, such as nurses, social workers, activity professionals, and dieticians, did so with the expectation that we would be helping people. We believed in the importance of personal contact and providing support to people in need. People who are admitted to nursing homes are often at a stage of life where they have lost family, friends, belongings, and are now moving from a home environment to an institution. This transition often is difficult and people need a lot of one-on-one attention.

But with the requirements placed upon facilities to comply with Federal regulations, more and more time is spent on documentation, planning and preparing for survey, doing chart reviews to ensure that all the components have been entered into the medical record, and doing walk-arounds to make sure other people are doing their jobs. There is very little chance of actually spending any quality time with a resident. This creates a rebound effect, for the less one-on-one time a resident receives, the greater the chance that it will adversely affect their psychosocial well-being, which in turn leads to survey deficiencies.

There is a place for Health Department surveys, especially to weed out the very poorly run homes that never seem to improve. But the current process subjects even well run nursing homes to a meaningless and overly subjective scrutiny. It forces a company to develop an even longer paperwork trail to meet these requirements. In the final analysis, it is a disservice to the people we are trying to serve, the nursing home resident.

Sources:

Website: Medicare.gov, Nursing Home Compare
http://www.medicare.gov/NHCompare

Website: The American Medical Directors Association
http://www.amda.com/publications/hpa/june2006/Psychosocial_Outcome.cfm

Website: US Dept of Health and Human Services
The Official US Government Site for People with Medicare
http://www.medicare.gov/nursing/aboutinspections.asp

Website: Center for Medicare and Medicaid Services, US Dept of Health and Human Services
http://www.cms.hhs.gov/CertificationandComplianc/12_NHs.asp

The Best Mental Health Blogs

Blogs are becoming a valuable source of information on the Internet. Mental health blogs are a great way to attain information on mental health concerns, mental illness, and research being done in the field of psychology. The blogs I list in this article are the ones I believe to be the best mental health blogs on the Internet today.

The Wall Street Journal’s Mental Health Blog: The Wall Street Journal’s mental health blog is a great source of information on the most up-to-date research being done in the field of psychology. The author of this journal describes psych studies and news very well. However, this journal lacks information about mental illnesses.

You can visit the Wall Street Journal’s Mental Health Blog by clicking on this link: http://blogs.wsj.com/health/category/mental-health/.

Dr. Deb: Psychological Perspectives: Dr. Deb is an active psychologist who shares interesting tidbits about psychology in her blog. She not only covers current research, but she also informs her readers of mental health awareness days and posts fun psych activities for her readers to do, such as sharing what they see in a homemade ink blot.

To see Dr. Deb’s blog, please visit: http://drdeborahserani.blogspot.com/.

Mental Health Manual: I must admit I am a little bias about this blog, as it is my own. In my blog, I discuss the signs and symptoms of different mental illnesses, review recent research, and offer resources to individuals struggling with mental illness. I also discuss issues such as abuse and trauma. Additionally, I provide information for families and friends of those suffering with mental illness, so that they may be able to help their loved ones in the most effective way possible.

To view Mental Health Manual, please visit: http://mentalhealthmanual.blogspot.com.

Mind Hacks: Mind Hacks is another great blog that reviews psychological research. Mind Hacks is a well-established blog, and is updated daily.

To view Mind Hacks, please visit: http://www.mindhacks.com/.

Anxiety, Addiction, and Depression Treatment: This blog not only focuses on reviewing studies that deal with anxiety, depression, and addiction, but it also reviews studies that focus on other mental illnesses. This blog provides detailed summaries of studies and news stories in psychology.

You can access this blog by visiting: http://www.treatmentonline.com/treatments.php.

EnteruptingMind: EnteruptingMind is a blog that offers practical advice for self-improvement. The site offers self-improvement articles on subjects such as creativity, dealing and interacting with other people, fear, setting goals, sleep, living mindfully, self-esteem, accepting yourself, and conflict resolution.

To access this blog, please visit: http://www.eruptingmind.com/.

Mental health blogs are a viable source of mental health information on the web. These blogs will help you keep up-to-date on mental health research, news, mental illness information, and resources.