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Medicare subsidizes Alzheimer's home care
DRUG
NEWS
CONSULT
WATCH
conthmed from page 44
conthmed from page 6
teach him about the danger and discuss the risks with the physician.
Financing Administration (HCFA), take effect November 1991. Plus, the legislation spells out the rights of residents to refuse an intrafacility transfer if its main purpose is to remove the person from a part of the building reserved for skilled nursing care. By September 1991, the Secretary of H e a l t h and H u m a n Services (HHS) is to propose a plan to replace the current reimbursement scheme for nursing facilities with a prospective payment system (PPS). This plan is to take into account such variables in facilities as the number of low-income senior citizens, the case mix and volume, and patient characteristics (e.g., functional disability or cognitive impairments). Finally, the bill requires states to help pay the private insurance premiums for an adult child if the child's health insurance plan will cover parents and at a lower cost than covering a parent under Medicaid.
A Final Word o f Advice About many drugs, the literature is not clear. But the drugs described here--alcohol, anesthetics, barbiturates, benzodiazepines, antidepressants, phenothiazines, salicylates, nonsteroidal anti-inflammatory agents, diuretics, antihistamines , anticholinergics, beta blockers, and thyroid hormones---have been definitively linked to body temperature problems. Be sure to look for these drugs in your overall assessment of older adults and warn of the risks. By identifying the risks, you may prevbnt drug-related problems and detect alterations in thermoregulation at ,an early stage. :REFERF~NCES 1. Navari, FLM., and Sheehy T. Xt,:H)potherm~a. [s The Practice of Geriatrics, ed. by E. Calkins, and others. Philadelphia, W. B. Saunders Co., 19~ pp. 291-301. 2. Kallman, H. Protecting your elderly patient from ~mter "scold. Geriatrics 40:.69--72,77, g I, Dee. 19S5. 3. Finch, C. E., and Landfield. R W. Neuroendocrine and a u t o n o m i c functions in aging mammals. In:Handbook of the Biology of Aghzg. 2nd edition, edited by C. E. Finch and E. L Schneider. New York, Van Nostrand Reinhold Co., 1985, pp. 567-587. 4. Smith, I. M. Prevalence, diagnosis, and treatment of infectious diseases. IN The Practice ofGerlatrics, ed. by E. Calkins, and others. Philadelphia, W. B. Saundcrs Co., 19S6,pp. 5-a0--554. 9 5. Olson, K. R., and Benowitz, N. L. Environmental and drug-induced hyperthermia. Pathophysiology recognition, and management.Emerg.Med.Clin. A'onh An~ 2:459--474, Aug. 1984.
MOVING? GIVE US YOURNEW ADDRESSSIX WEEKSAHEAD To ensure prompt service when you change your
address o- whenever you write to us about your GERIAtRIC NURS!NG subscription, please include your address label from a recent issue of GERIATRIC NURSING. Address your correspondence to GERtAT. RIC NURSING Subscription Change of Address Dept., P.O. Box 1730, Riverton, NJ 08077-7330. I Afftx acldless laOel here "~hen send~ng aOaress] change. Clearly print NEW address The expire I lion dave of your subscription is toward the r=ght| end el the upper portion of the label, l
/
Naive
.................................................
A d d r e s s ............................................. City .................................................... State ............... Zip ...........................
48 GeriatdcNursing Januar)/Fcbruary1991
Medicare Subsidizes Alzheimer's Home Care NEW YORK, N y I A three-year research and demonstration program into the effectiveness of Medicaresubsidized home care for Alzheimer's patients has been started by the HCFA. In the Medicare AlzheimerX Project (MAP), Medicare, for the first time, will pay 100 percent of the cost for case management, caregiver support, training, and education, and 80 percent of the cost of other direct services. The project will take place at eight sites nationwide: in Miami, Florida; Urbana, Illinois; Portland, Oregon; Memphis, Tennessee; Cincinnati, Ohio; Rochester, New York; St. Paul, Minnesota; and Parkersburg, West Virginia. Patients must be 65 or older, have Medicare Parts A and B, and be willing to make a 20 percent copayment. For more information on the program, call the Aizhcimer's CARE LINE: (305)576-5533.
New 1)rugs Combat Prostate Enlargement NEW YORK, NY--Alpha-1 blockers can relieve the signs of an enlarged prostate gland by relaxing the smooth muscles of the prostate, reported Herbert Leper, MD, at The National Kidney Foundation's briefing for science writers. A blocker called terazosin has been especially effective because it is long acting. Nearly 70 percent of the men treated with this drug showed clear improvement. A second drug being investigated, called MK906, shrinks prostate tissue by lowering levels of dihydrotestosterone. But only a third of the men using this drug for prostatic hypertrophy showed improvement. Other nonsurgical treatments being tried to treat the disease include balloon catheters to stretch the prostatic urethra. Prostatic stents involve placing a wire-like mesh into the prostatic urethra. This stent is then expanding, which forces the prostatic urethra open, thereby unblocking the urine flow.
Can Premarin Prevent Heart Disease .,Mad Hot Flashes? WASHINGTON, D C - - The FDA has recommended that more tests be conducted on Premarin, an estrogenreplacement d~ug made by WyethAyerst. C u r r e n t l y . m a r k e t e d to treat menopause-related symptoms such as osteoporosis, night sweats, and hot flashes, it has been suggested for possible heart-disease prevention in postmenopausal women. Studies presented by the manufacturer show that Premarin raises highd e n s i t y l i p o p r o t e i n and r e d u c e low-density lipoprotein, thereby lowering the risk of heart disease. But the FDA is worded because the drug is also known to cause uterine cancer, b r e a s t cancer, and g a l l - b l a d d e r disease.].
NEWS
CONSULT
WATCH
conthmed from page 44
conthmed from page 6
teach him about the danger and discuss the risks with the physician.
Financing Administration (HCFA), take effect November 1991. Plus, the legislation spells out the rights of residents to refuse an intrafacility transfer if its main purpose is to remove the person from a part of the building reserved for skilled nursing care. By September 1991, the Secretary of H e a l t h and H u m a n Services (HHS) is to propose a plan to replace the current reimbursement scheme for nursing facilities with a prospective payment system (PPS). This plan is to take into account such variables in facilities as the number of low-income senior citizens, the case mix and volume, and patient characteristics (e.g., functional disability or cognitive impairments). Finally, the bill requires states to help pay the private insurance premiums for an adult child if the child's health insurance plan will cover parents and at a lower cost than covering a parent under Medicaid.
A Final Word o f Advice About many drugs, the literature is not clear. But the drugs described here--alcohol, anesthetics, barbiturates, benzodiazepines, antidepressants, phenothiazines, salicylates, nonsteroidal anti-inflammatory agents, diuretics, antihistamines , anticholinergics, beta blockers, and thyroid hormones---have been definitively linked to body temperature problems. Be sure to look for these drugs in your overall assessment of older adults and warn of the risks. By identifying the risks, you may prevbnt drug-related problems and detect alterations in thermoregulation at ,an early stage. :REFERF~NCES 1. Navari, FLM., and Sheehy T. Xt,:H)potherm~a. [s The Practice of Geriatrics, ed. by E. Calkins, and others. Philadelphia, W. B. Saunders Co., 19~ pp. 291-301. 2. Kallman, H. Protecting your elderly patient from ~mter "scold. Geriatrics 40:.69--72,77, g I, Dee. 19S5. 3. Finch, C. E., and Landfield. R W. Neuroendocrine and a u t o n o m i c functions in aging mammals. In:Handbook of the Biology of Aghzg. 2nd edition, edited by C. E. Finch and E. L Schneider. New York, Van Nostrand Reinhold Co., 1985, pp. 567-587. 4. Smith, I. M. Prevalence, diagnosis, and treatment of infectious diseases. IN The Practice ofGerlatrics, ed. by E. Calkins, and others. Philadelphia, W. B. Saundcrs Co., 19S6,pp. 5-a0--554. 9 5. Olson, K. R., and Benowitz, N. L. Environmental and drug-induced hyperthermia. Pathophysiology recognition, and management.Emerg.Med.Clin. A'onh An~ 2:459--474, Aug. 1984.
MOVING? GIVE US YOURNEW ADDRESSSIX WEEKSAHEAD To ensure prompt service when you change your
address o- whenever you write to us about your GERIAtRIC NURS!NG subscription, please include your address label from a recent issue of GERIATRIC NURSING. Address your correspondence to GERtAT. RIC NURSING Subscription Change of Address Dept., P.O. Box 1730, Riverton, NJ 08077-7330. I Afftx acldless laOel here "~hen send~ng aOaress] change. Clearly print NEW address The expire I lion dave of your subscription is toward the r=ght| end el the upper portion of the label, l
/
Naive
.................................................
A d d r e s s ............................................. City .................................................... State ............... Zip ...........................
48 GeriatdcNursing Januar)/Fcbruary1991
Medicare Subsidizes Alzheimer's Home Care NEW YORK, N y I A three-year research and demonstration program into the effectiveness of Medicaresubsidized home care for Alzheimer's patients has been started by the HCFA. In the Medicare AlzheimerX Project (MAP), Medicare, for the first time, will pay 100 percent of the cost for case management, caregiver support, training, and education, and 80 percent of the cost of other direct services. The project will take place at eight sites nationwide: in Miami, Florida; Urbana, Illinois; Portland, Oregon; Memphis, Tennessee; Cincinnati, Ohio; Rochester, New York; St. Paul, Minnesota; and Parkersburg, West Virginia. Patients must be 65 or older, have Medicare Parts A and B, and be willing to make a 20 percent copayment. For more information on the program, call the Aizhcimer's CARE LINE: (305)576-5533.
New 1)rugs Combat Prostate Enlargement NEW YORK, NY--Alpha-1 blockers can relieve the signs of an enlarged prostate gland by relaxing the smooth muscles of the prostate, reported Herbert Leper, MD, at The National Kidney Foundation's briefing for science writers. A blocker called terazosin has been especially effective because it is long acting. Nearly 70 percent of the men treated with this drug showed clear improvement. A second drug being investigated, called MK906, shrinks prostate tissue by lowering levels of dihydrotestosterone. But only a third of the men using this drug for prostatic hypertrophy showed improvement. Other nonsurgical treatments being tried to treat the disease include balloon catheters to stretch the prostatic urethra. Prostatic stents involve placing a wire-like mesh into the prostatic urethra. This stent is then expanding, which forces the prostatic urethra open, thereby unblocking the urine flow.
Can Premarin Prevent Heart Disease .,Mad Hot Flashes? WASHINGTON, D C - - The FDA has recommended that more tests be conducted on Premarin, an estrogenreplacement d~ug made by WyethAyerst. C u r r e n t l y . m a r k e t e d to treat menopause-related symptoms such as osteoporosis, night sweats, and hot flashes, it has been suggested for possible heart-disease prevention in postmenopausal women. Studies presented by the manufacturer show that Premarin raises highd e n s i t y l i p o p r o t e i n and r e d u c e low-density lipoprotein, thereby lowering the risk of heart disease. But the FDA is worded because the drug is also known to cause uterine cancer, b r e a s t cancer, and g a l l - b l a d d e r disease.].