Taking Responsibility for Reductions in Hospital Readmissions: Be Careful

Taking Responsibility for Reductions in Hospital Readmissions: Be Careful

 By: Elizabeth E. Houge, Esq.

Hospital administrators are increasingly focused on decreasing readmission as they continue to receive penalties in the form of reductions in reimbursement from the Medicare Program. Hospital staff appropriately seek assistance from post-acute providers in order to achieve reductions. There is no doubt that Medicare-certified home health agencies, HME suppliers, private duty home care agencies, hospices, skilled nursing facilities (SNFs), assisted living facilities (ALFs), outpatient therapists, etc. can assist hospitals to reduce readmissions. The post-acute industry generally welcomes the recognition that it has a crucial role to play in this regard.

BUT, BE CAREFUL! It appears that staff at some hospitals have only a superficial understanding of how reductions can be achieved. This is true, in part, because there is a general lack of evidence and data to show what activities contribute to reductions in readmissions. It remains unclear whether hospital discharge planning activities, for example, can have a substantial impact on reductions in readmissions.

There is a tendency on the part of hospitals, however, to put the entire responsibility for reductions on the shoulders of post-acute providers. This point of view may lead to some potentially harmful results, including failure to reduce readmissions. It may also support the argument that hospitals should be able to choose post-acute providers for patients since they suffer the financial consequences when patients are readmitted.

On the contrary, it seems likely that reductions in readmissions will be achieved only through partnerships between hospitals and post-acute providers of all kinds. The operative word is clearly “partnership.” This point of view is supported by Conditions of Participation (CoPs) of the Medicare Program for hospitals that govern discharge planning. Specifically, discharge planners/case managers at hospitals are required to:

  • Screen all inpatients soon after admission to determine which ones are at risk of adverse health consequences post-discharge if they lack discharge planning. Screening must include consideration of the following factors:
    • Patients’ functional status and cognitive ability
    • Type(s) of post-hospital care that patients require, such as:
      • Home Health, attendant care, and other community-based services
      • Hospice or palliative care
      • Respiratory therapy
      • Rehabilitation services (PT, OT, Speech, etc.)
      • End Stage Renal Dialysis services
      • Pharmaceuticals and related supplies
      • Nutritional consultation/supplemental diets
      • SNFs
      • ALFs
      • Medical equipment and related supplies
      • Home and physical environment modifications
      • Transportation services
      • Meal services
      • Household services, such as housekeeping, shopping, etc.
    • Whether the type(s) of post-hospital care require(s) the services of health care professionals or facilities
    • Availability of required post-hospital health care services to patients
    • Availability and capability of family and/or friends to provide follow-up care in the home
  • Evaluate post-discharge needs of inpatients identified in the first stage, or of inpatients who request an evaluation, or whose physician requests one. Evaluations must include the ability of patients to self-care post-discharge. An evaluation of the ability to self-care requires hospitals to actively solicit information regarding this issue not only from patients or their representatives, but also from family, friends, and support persons.
  • Develop a discharge plan, if indicated by the evaluation or at the request of the patient’s physician
  • Initiate implementation of the discharge plan prior to the discharge of inpatients. This requirement includes provision of inpatient education/training to patients for self-care, or to patients’ families or other support persons who will provide care in patients’ homes. It includes arrangements for:
    • Transfer to rehabilitation hospitals, long term care hospitals, or long term care facilities
    • Referrals to home health agencies or hospices
    • Referrals for follow-up with physicians and therapists
    • Referrals to pertinent community resources that may assist with financial, transportation, meal preparation or other post-discharge needs

Anecdotally, it appears that hospital discharge planners/case managers are not consistently engaging in these activities and others required by the CoPs. Compliance with the CoPs for discharge planning may have a significant impact on reductions in readmissions in partnership with post-acute providers of all types.

©2015 Elizabeth E. Hogue, Esq.  All rights reserved.

No portion of this material may be reproduced in any form without the advance written permission of the author.

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Do You Know The 4 Levels Of Care?

Do You Know The 4 Levels Of Care?
By Victor Montour

Most people are unaware there are four levels of care provided by all hospices in the United States. Every patient receiving hospice services in the United States will be on one of these four levels. A hospice patient can move from one level of care to another level of care and back, depending on the services required to fulfill his or her needs. The clinical needs of the patient will be used to determine if the patient meets the appropriate criteria for a higher level of care.

Routine Home Care – Patient at home with symptoms controlled

Routine level of care is the level of care most patients will be placed in at the time of admission. This level of care can be provided to patients while they reside at home (or a long-term care facility) and does not have symptoms which are out of control. These symptoms could include—but aren’t limited to—severe pain, continuous nausea and vomiting, bleeding, acute respiratory distress, and unbearable restlessness or agitation. A patient at this level may have access to the following services:

  • Registered Nurse Visits
  • Social Worker Visits
  • Chaplain Visits
  • Home Health Aide Services
  • Counselors
  • Medications
  • Equipment

The needs of the patient determine the number of visits from hospice staff members. These needs are established and outlined in a plan of care formed by the patient or Medical Power of Attorney, the hospice team and the patient’s physician. The care plan serves as a guideline to assist all those serving the patient with care. At this level of care the patient also has access to an on-call hospice nurse twenty-four hours a day seven days a week.

Respite Care – Patient at facility with symptoms controlled

A patient may be moved to respite care when the caregiver needs a break. Many hospice patients live at home, with their family providing most of the care, sometimes around the clock. Caring for their loved one can be exhausting and very stressful. The family members and/or caregivers need time to themselves and it’s important that they take that time. Respite care allows a patient to be temporarily placed in a facility with 24-hour care so the family can rest. If the patient is willing and the family requests it, hospice must provide placement in a facility or a hospice home for the patient. The patient will be transferred to the facility, and according to Medicare regulations, can stay for up to five days before being transferred back home. A patient at this level may have access to the following services:

  • Registered Nurse Visits
  • Social Worker Visits
  • Chaplain Visits
  • Home Health Aide Services
  • Counselors
  • Medications
  • Equipment

Continuous Nursing Care – Patient at home with uncontrolled symptoms

A patient would receive continuous nursing care if he or she has symptoms that are out of control and choose to stay at home. This is similar to inpatient care, except that the patient remains in his or her home instead of being placed in a facility. A hospice nurse is required to provide continuous around-the-clock nursing care if the symptoms cannot be controlled while on routine home care. Hospices are required to provide this level of care if it is needed. This level of care requires certain criteria be met to be placed under this level of care. This level of care is a short lived benefit. Patients in this level of care must have their symptoms under control within 72 hours. Once symptoms are under control the patient must be moved back to the routine level of care. A patient at this level may have access to the following services:

  • Registered Nurse Visits
  • Social Worker Visits
  • Chaplain Visits
  • Home Health Aide Services
  • Counselors
  • Medications
  • Equipment

Inpatient Care – Patient at home or in a facility with uncontrolled symptoms

A hospice patient may require inpatient care when his or her symptoms have gotten out of hand and can no longer be managed at home. When these symptoms cannot be controlled on routine home care, then the patient requires extra attention until these symptoms subside. Hospices take aggressive actions to control the symptoms and make the patient comfortable. In order to do this, the patient may be temporarily placed in a hospice home, skilled nursing facility or an acute care hospital. At this level of care, a moment-to-moment assessment of what’s happening and what needs to be done takes place. The hospice team and the patient’s physician work together to ensure the patient obtain and maintain a tolerable comfort level. Once this has been achieved, the patient will return home and back to routine home care. Again certain criteria must be met to be placed in this level of care. The only physician who can determine a patient meets criteria is the hospice physician or hospice medical director. This level of care is a short lived benefit. Patients in this level of care must have their symptoms under control within 72 hours. A patient at this level may have access to the following services:

  • Registered Nurse Visits
  • Social Worker Visits
  • Chaplain Visits
  • Home Health Aide Services
  • Counselors
  • Medications
  • Equipment

If you would like more information about Front Range Hospice or the 4 levels of care call 303-957-3101 or 970-776-8080 or email us at info@frhospice.com

Watch out for our next blog: Taking Responsibility for Reductions in Hospital Readmissions: Be Careful

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The Truth About Hospice – Our Response to The Washington Post

The Truth About Hospice – Our Response to The Washington Post

By Victor Montour

The Washington Post published an article on December 27, 2014 that may cause confusion for the public who are seeking end of life care. As a leader in end of life care we feel the right thing to do is provide you the truth about hospice and the hospice industry.

A quality hospice is not defined by whether a hospice is non-profit, for-profit or by looking at any single statistic. The tax status of a hospice does not influence the quality of care a hospice provides to patients and families. To learn more about this check out our blog post on September 17, 2014 “For-Profit and Non-Profit Hospices”.

From the time hospice was introduced in America in 1963 by Dame Cicely Saunders the hospice community has evolved over the years keeping patients and families the primary focus. As the need for hospice, the awareness and understanding of hospice services has increased, so has the mix of corporate and non-corporate or for-profit and not-for-profit structures. This structure is reflected in the entire U.S. healthcare sector from hospitals to nursing homes to doctor and dental offices. The hospice sector is no exception to this type of structure.

I ask you to ask the question; what makes hospice so unique then traditional healthcare? The answer; hospice provides care not by a single person but by an interdisciplinary team of specially trained individuals who can address the medical, psycho-social, and spiritual needs of the patient and families served.

Hospice is not about looking at just a disease process, but looking at the whole person and supporting that individual as a whole, along with the family caregivers. Focusing on just the medical care ignores the holistic approach that is the center piece of hospice care. An individualized care plan is created with the patient, family and hospice team for every patient that receives end of life care.

The Medicare hospice benefit is designed as a risk based model of care. It has been this way for the last 40 years. What does this mean? It means that some patients need a larger amount of services and others not as much. The payment at roughly $150 per day (this will vary depending on the county you live in) is spread out to take into account both the more expensive and the less expensive. So a hospice does not make more or less money based on the acuity of the patients they serve.

All hospices regardless of for-profit or not-for-profit must submit to the regulations and standards placed on them by the Centers for Medicare and Medicaid (CMS). The National Hospice and Palliative Care Organization (NHPCO) has been pushing for additional oversight and more frequent surveys of hospice providers to ensure the care you receive from any hospice will be at or above the standards set by CMS. New legislation is now in place that will increase survey frequency beginning in 2015. This will help create greater oversight and increase transparency with the hospice community. The law will mandate surveys of Medicare certified hospice providers at least every three years.

Front Range Hospice has a long standing commitment in strengthening the hospice community. We do this by having quality measures in place to share with the community and our referral sources. Our transparency is key to our success. We establish quality partnerships within the communities we serve to provide our families alternative options for care settings and the ongoing work to improve the delivery of care to patients at end of life.

Millions of families have benefited from hospice care over the years because the hospice community is dedicated to providing the highest quality of care. Data from the Family Evaluation of Hospice Care, a post-death survey sent to families who have had a loved one in hospice care, shows that family satisfaction has remained high and consistent. The survey shows that 93.5% of the 228,000 respondents rated the care the patient received as “excellent” or “very good” and 97.3% of respondents indicated that they would recommend their hospice to others. If you’re interested in seeing the most current post death survey results for Front Range Hospice check our blog post  “Hospice Survey – Previously Known As The Hospice Experience Of Care Survey” Posted December 16 2014.

“Focusing solely on the tax status of providers is an affront to every hospice professional working as a nurse, social worker, physician, hospice aide, allied therapist, bereavement or spiritual counselor, volunteer, administrator or other hospice team member. Hospice professionals are dedicated to providing compassionate care, whoever their employer might be. The Washington post article does state “The quality of individual hospices varies widely. In some cases, for-profit hospices provide service at levels comparable to nonprofits, according to the review.”

A number of statements are made in the Washington post article that needs further attention. The best way to do this in this blog is to list the statement from the Post and then provide you, our readers a response to such statements.

The Washington Post States the following;

The Typical for-profit hospice;

  • Spends less on nursing per patient.
    • Front Range Hospice has one of the best nurse to patient ratios in the state. Our nurses carry smaller case loads so they can spend the time needed with patients and not feel like they are being rushed out the door. Our nurses are available to our patients 24 hours a day 7 days a week. Our Administrators at Front Range Hospice are also available 24 hours a day 7 days a week to assist our patients with any needs, concerns suggestions and after hour admissions. Front Range Hospice has a three tier on call structure staffed with a nurse, a psycho-social member and an administrator. When you call Front Range Hospice after hours and you want to talk to a person, you get a person.
  • Is less likely to have sent a nurse to a patient’s home in the last days of life.
    • The Front Range Hospice nurses and administration team work hard to provide additional support to our patients and families as death draws near. Front Range Hospice will never keep our nurses from meeting the needs of our patients and families. We will send nursing support out as often as the patient and family is in need.
  • Is less likely to provide more intense levels of care for patients undergoing a crisis in their symptoms.
    • Front Range Hospice knows and understands the regulations placed upon us to meet the needs of our patients. Front Range Hospice has used and will continue to use the 4 levels of care that are available to patients while in hospice. Front Range Hospice firmly believes our patients have the right to die where they choose. Most wish to die at home. To keep our patients at home Front Range Hospice uses the Continuous Care benefit available to patients in our service when they are undergoing a crisis in symptoms and the patient meets criteria for this benefit. Front Range Hospice also understands that dying is a natural process. Through education with the family and the care givers about the anticipated trajectory of the patient’s disease process and having the appropriate medication at hand, dying is not a crisis and patients are able to remain in their home environment.
  • Nursing staff at for-profit hospices had a smaller proportion of registered nurses.
    • Front Range Hospice staffs every patient with a registered nurse case manager who is the primary nurse that case manages all aspects of care for our patients.

Again the important message for you is that for-profit and not-for-profit hospice are the same. The hospice professionals and volunteers are dedicated to caring for the 1.56 million dying Americans and their families every year and dedicated to providing compassionate care to the dying. To be with patients and families at such a sacred time is a blessing and we do not enter into it lightly.

The holistic care that is delivered at the bedside in every corner of our nation is guided by the hospice philosophy of care developed in 1963. Front Range Hospice is committed to educating the communities we serve and the public at large about the truth in hospice.

If you would like more information about Front Range Hospice call 303-957-3101 or 970-776-8080 or email us at info@frhospice.com

Watch out for our next blog: Do you know the 4 Levels of Hospice Care?

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What is the Norovirus?

What is the Norovirus?

By Victor Montour

The Norovirus is a very contagious virus you can get from an infected person, contaminated food, water, or by touching contaminated surfaces. The norovirus can cause your stomach, intestines or both to get inflamed which we call (acute gastroenteritis). This leads you to have stomach pain, nausea, vomiting and diarrhea.

Anyone can be infected with norovirus and get sick. You can also get the norovirus illness many times in your life. The reason for this is that there are many different types of noroviruses. Being infected with one type of norovirus may not protect you against other types. Norovirus illness can be serious, especially for young children and older adults.

The norovirus is the most common cause of acute gastroenteritis in the United States. Each year, it causes 19-21 million illnesses and contributes to 56,000-71,000 hospitalizations and 570-800 deaths. The norovirus is also the most common cause of food borne-disease outbreaks in the United States. The norovirus can spread very quickly in closed well populated places like daycare centers, nursing homes, schools, and cruise ships. Most norovirus outbreaks happen in one of these settings with a peak season from November to April in the United States.

The most common symptoms associated with the norovirus are;

  • Diarrhea
  • throwing up
  • nausea
  • stomach pain
  • fever
  • headache
  • body aches

If you think you have norovirus illness, you can feel extremely ill and throw up or have diarrhea many times a day. This can lead to dehydration, especially in young children, older adults, and people with other illnesses. Most people with norovirus illness get better within 1 to 3 days. The symptoms of dehydration are;

  • decrease in urination
  • dry mouth and throat
  • feeling dizzy when standing up
  • Children who are dehydrated may cry with few or no tears and be unusually sleepy or fussy.

The norovirus can be found in your stool (feces) even before you start feeling sick. The virus can stay in your stool for 2 weeks or more after you feel better. You are most contagious with the norovirus when you are sick with norovirus illness, and during the first few days after you recover from norovirus illness.You can become infected with norovirus by accidentally getting stool or vomit from infected people in your mouth. This usually happens by;

  • eating food or drinking liquids that are contaminated with norovirus,
  • touching surfaces or objects contaminated with norovirus then putting your fingers in your mouth.
  • having contact with someone who is infected with norovirus (for example, caring for or sharing food or eating utensils with someone with norovirus illness).

There is no specific medicine to treat people with norovirus illness. Norovirus infection cannot be treated with antibiotics because it is a viral (not a bacterial) infection.

If you have the norovirus illness, you should minimize contact with other people, drink plenty of liquids to replace fluid lost from throwing up and diarrhea. This will help prevent dehydration. Sports drinks and other drinks without caffeine or alcohol can help with mild dehydration. But, these drinks may not replace important nutrients and minerals. Oral rehydration fluids that you can get over the counter are most helpful for mild dehydration.

Dehydration can lead to serious problems. Severe dehydration may require further medical attention or hospitalization for treatment with fluids given through your vein (intravenous or IV fluids). If you think you or someone you are caring for is severely dehydrated, call for medical attention.

Preventing the spread of the norovirus

The best way to help prevent spreading the norovirus is to practice proper hand washing and general cleanliness. Wash your hands carefully with soap and water—

  • After using the toilet and changing diapers
  • Always before eating, preparing, or handling food.
  • Disinfect surfaces that may have become contaminated
  • Isolate yourself from others till symptoms have resolved for24 hours
  • Do not share eating utensils or beverage containers

Remember the Noroviruses can be found in your vomit or stool even before you start feeling sick. The virus can stay in your stool for 2 weeks or more after you feel better. So, it is important to continue washing your hands often during this time.

Alcohol-based hand sanitizers can be used in addition to hand washing. But, they should not be used as a substitute for washing with soap and water.

If you would like more information about Front Range Hospice or The Norovirus call 303-957-3101 or 970-776-8080 or email us at info@frhospice.com.

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What is influenza (also called the flu)?

By Victor Montour

The flu is a contagious respiratory illness caused by the influenza viruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and at times can lead to death. Flu like symptoms are picking up steam and we have yet to hit the peak of flu season. The U.S. Centers for Disease Control and Prevention reports widespread flu activity in 29 states, primarily in the South and Midwest. That’s twice as many states as the previous week. Thirteen states reported high levels of influenza-like illnesses, while another six states saw moderate activity.

FRH Flu

Most of the patients who have been hospitalized with severe cases of the flu are either very young or the very old.

Health experts say part of the problem is that this year’s vaccine doesn’t provide protection for the H3N2, the strain of the influenza that’s currently making the rounds. This year’s vaccine does help protect against H1N1 and one or two strains of influenza B.

Because the H3N2 is dominating this flu season, we should expect more people to come down with the flu. There might be reduced protection as opposed to zero protection from the flu vaccine. However, the CDC and other health experts still recommend people go for the vaccine. At a minimum, the vaccine may prevent a more severe case of the flu if you happen to be one of the unlucky people this season who develop flu or flu like symptoms. Remember the vaccine will also protect against other strains of the flu that are still floating around.

The CDC says anyone who develops symptoms of the flu should contact their doctor immediately. Tamiflu (oseltamivir) and Relenza (zanamivir) are two prescription antiviral drugs currently on the market that can actually lessen the time of acute illness by two days if taken early on in the flu illness.

Signs and symptoms of flu

People who have the flu often feel some or all of these signs and symptoms:

  • Fever* or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (very tired)
  • Some people may have vomiting and diarrhea, though this is more common in children than adults.

*It’s important to note that not everyone with flu will have a fever.

How the flu spreads

Most experts believe that flu viruses spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or possibly their nose.

Period of contagiousness

You may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Some people, especially young children and people with weakened immune systems, might be able to infect others for an even longer time.

How serious is the flu

The Flu is unpredictable and how severe it is can vary widely from one season to the next depending on many things, including:

  • what flu viruses are spreading,
  • how much flu vaccine is available
  • when vaccine is available
  • how many people get vaccinated, and
  • How well the flu vaccine is matched to flu viruses that are causing illness.

Complications of flu

Certain people are at greater risk for serious complications if they get the flu. This includes older people, young children, pregnant women; people with asthma, diabetes, or heart disease are all so at greater risk. Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

To learn more about your risk go to:                         http://www.cdc.gov/flu/about/disease/high_risk.htm 

Health habits can help stop the flu

Practicing good health habits like covering your cough and washing your hands often can help stop the spread of germs and prevent respiratory illnesses like the flu. Below is a small list to help guide you in preventing the spread of this year’s Influenza.

  1. Avoid close contact

Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.

  1. Stay home when you are sick

If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.

  1. Cover your mouth and nose

Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.

  1. Clean your hands

Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub.

  1. Avoid touching your eyes, nose or mouth

Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

  1. Practice other good health habits

Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

This year 100% of the clinical team at Front Range Hospice has received the influenza vaccine. We will always do our part to protect our patients, staff and the communities we serve.

If you would like more information about Front Range Hospice or Influenza call 303-957-3101 or 970-776-8080 or email us at info@frhospice.com

Watch out for our next blog on the Norovirus

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Hospice Survey – Previously known as the Hospice Experience of Care Survey

Hospice Survey – Previously known as the Hospice Experience of Care Survey

By Victor Montour

Front Range Hospice, your leader in providing Legendary End of Life Care once again comes out on top. This year the Centers of Medicare and Medicaid Services (CMS) will be implementing a post death family caregiver survey. This survey will systematically assess patient and family experiences with hospice care.

Front Range Hospice has been conducting post death family experience satisfaction surveys for years. (see the image below for the most recent month’s available data) The implementation of the new survey by CMS will have very little to no impact on how we do business at Front Range Hospice. However, this change will have a large impact on you as a consumer. You will be able to look at any hospice and compare the exact same data being measured the exact same way. You will get to see who is above or below the national average in quality service. This information will help you choose the best hospice for you or your loved one.

Once the survey goes live you can expect that the survey will be available in English and Spanish. The survey responses will be used to calculate quality measures in 8 distinctive categories which I have listed for you. Failing to meet CMS standards in the following 8 areas may result in a decrease of reimbursement to the hospice provider from Medicare and Medicaid.

    • Hospice Team Communication
    • Getting Timely Care
    • Treating Family Member with Respect
    • Providing Emotional Support
    • Getting Help for Symptoms
    • Information Continuity
    • Understanding the Side Effects of Pain Medication
    • Getting Hospice Care Training (Home Setting of Care Only) 

The survey will be administered by an outside vendor on behalf of the hospice care provider. The Hospices will be required to contract with an approved CMS survey vendor and to provide caregiver contact information to the vendor on a monthly basis. Again, Front Range Hospice has been doing this for years; we contract with one of the leaders in hospice data collection.

Something to note is any Hospice with fewer than 50 decedents during the prior calendar year are exempt from the data collection and reporting requirements for payment determination.

If you would like more information about Front Range Hospice or if you would like to see our current Family Experience Satisfaction Survey Results on an ongoing basis please call 303-957-3101 or 970-776-8080 or email us at info@frhospice.com

Wishing all of you a safe and Happy Holiday Season and a Very Merry New Year!

Hospice Survey

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Alzheimer’s Dementia – Music and the Mind

Alzheimer’s Dementia – Music and the Mind

By Victor Montour

For centuries, music has been known to calm people down and provide relief from stress and tension. Neuroscientists, now equipped with brain scanning technology, have a renewed interest in finding how music affects our neural circuits.

Researchers in Finland using magnetic resonance imaging (fMRI) found that music listening recruits not only the auditory areas of the brain, but also employs large-scale neural networks. For instance, they discovered that the processing of musical pulses recruits motor areas in the brain, supporting the idea that music and movement are closely intertwined.

Limbic areas of the brain, known to be associated with emotions, were found to be involved in rhythm and tonality processing. Music can be powerful in many ways, like reducing agitation and improve behavioral issues that are common in the middle-stages of Alzheimer’s.

In the late-stages of Alzheimer’s, a person may be able to tap a beat or sing lyrics to a song from childhood. Researchers have found that music provides a way to connect, even after verbal communication has become difficult or absent.

A few tips when selecting music for a person with Alzheimer’s /dementia:

  • Identify music that’s familiar and enjoyable to the person. If possible, let the person choose the music.
  • Choose a source of music that isn’t interrupted by commercials, which can cause confusion.
  • Use music to create the mood you want. For example, a tranquil piece of music can help create a calm environment, while a faster paced song from someone’s childhood may boost spirit and evoke happy memories.
  • Encourage movement (clapping, dancing) to add to the enjoyment.
  • Avoid sensory overload; eliminate competing noises by shutting windows and doors and by turning off the television. Make sure the volume of the music is not too loud
  • Think ahead: make playlists of different kinds of songs for different kinds of mood.

If you would like more information about Front Range Hospice and how we use music therapy, call 303-957-3101 or 970-776-8080 or email us at info@frhospice.com

Watch out for our next blog on Hospice Survey’s.

Posted in alzheimers, dementia, hospice, mind, music | Leave a comment