See You Next Year!

ProMed's offices will be closed on Thursday and Friday in observance of the New Year holiday. We wish you and yours a wonderful New Year and we look forward to continuing to grow together in health care in 2010!

Excellent End-of-the-Year News: Drugs Found to Slow MRSA's Resistance to Treatment

It used to be that Staphylococcus aureus could easily be treated with penicillin. Then it developed a resistance to that, and then to methicillin and other antibiotics. Eventually, it became the often-feared methicillin-resistant Staphylococcus aureus, or MRSA.

Recently, MRSA has been moving out of the hospital setting and into the community, raising new concerns about antibiotic resistance.

But there's good news: A new study conducted by pharmacy researchers at Oregon State University has identified two antibiotics that appear to be less likely to cause future antibiotic resistance: linezolid and moxifloxacin. On the flip side, doxycycline and clindamycin are likely to cause rapid development of resistance against community-associated MRSA.

Researchers were especially intrigued by the discovery that moxifloxacin might be effective against the new strain of community-associated MRSA. Moxifloxacin, and other antibiotics in its class, had not previously been thought of as an appropriate agent against MRSA because resistance to it often develops rapidly.

The researchers' analysis was published in the International Journal of Antimicrobial Agents.

An Early Christmas Gift for ProMed's Dave Welch

ProMed Territory Manager Dave Welch got the best Christmas gift anyone could ask for - a new granddaughter!

Alyvia Louise was born on December 19 and 3:54 a.m. She weighed in at 8 pounds, 3 ounces and was 21 inches in length. Her proud parents are Amanda and Ted.

Congratulations to Dave and his family on their precious new addition!

Happy Holidays from ProMed

From our team to yours - ProMed wishes you a safe and happy holiday!

New Fall Prevention Strategy is "Out of This World"

A new study at the National Space Biomedical Research Institute is suggesting that technology created to help astronauts might be helpful to seniors with balance issues.

The Adaptability Training System (ATS) was developed to help astronauts overcome the dizziness, disorientation, motion sickness and lack of a sense of direction they often feel while experiencing weightlessness. When they return to Earth, ATS can help them readjust to gravity.

During ATS use, a treadmill is mounted to a moveable platform and placed in front of a large projection screen. Images of streets, hallways and rooms are shown on the screen. As the person walks, the image moves along with the platform, simulating balance disturbances.

The people behind ATS say that it could have enormous benefits for seniors and other people with balance problems. Forty percent of nursing home admissions are due to injuries caused by falls, and falling is the leading cause of accidental death for people over 75.

Celebrity Recall Might Hold Key to Alzheimer's Risk

Do you remember who starred in True Grit? How about the names of the two men who dressed as women in Some Like It Hot? It turns out this knowledge might come in handy for more than trivia games. New research suggests that knowledge about celebrities might hold a clue in the early detection of Alzheimer's disease.

Researchers at the University of Montreal showed a group of 117 healthy seniors (aged 60 to 91) pictures of 30 celebrities and asked them to recall information about the celebrities, such as name, profession, nationality and biographical information. With the healthy seniors, researchers found that the ability to recall a subject's name decreased over time, but the ability to recall details about a celebrity is less affected.

The same researchers then performed a similar test on seniors who had mild cognitive impairment or the early stages of Alzheimer's disease. In this group, the seniors had an easier time recalling celebrities' names, but they were less able to recall details.

The researchers think that this type of semantic memory test might prove useful in assessing those at risk for dementia and Alzheimer's. Semantic memory is the information that we gather throughout our lives to help us remember and recognize other people.

Hospira Announces Urgent Device Recall

Hospira, Inc. has issued an Urgent Device Recall for certain IV gravity and pump administration sets with CAIR Roller Clamps. The company is voluntarily recalling specific lot numbers of the products, manufactured by Borla S.P.A. of Italy.

If you have purchased ProMed item number 001-11540-58, lot number 600-194W, IV Sets w/Y Injection Site Primary 80" Disp ST (48/cs), during the time period of the recall (since December of 2006), please do a facility-wide search for the product - check every storage room, med room, resident cabinet, etc.

If you locate this product in your facility, it needs to be returned to ProMed immediately. We appreciate your cooperation!

Still Looking for That Perfect Gift for Your Elderly Loved One? Try a Wii!

If you have a Wii on your "to-buy" list for the holidays, you might want to add another one - for your elderly loved ones.

While video game sales plummeted overall in 2009, sales are actually increasing in an unexpected demographic - senior citizens. According to an article posted on The Atlantic's Web site, Boomers who are edging into their golden years are far more likely than their predecessors to embrace video games.

The Wii has several features that make it a good fit for the older population. For starters, its games focus more on simple visuals than complex narratives, making it ideal for first-time gamers or those who are nostalgic for Atari, Sega or even arcade games.

Wii also has a surprising number of health benefits. The physical exertion it requires is fairly light, but still beneficial for anyone stuck in a sedentary lifestyle. Physical therapists have also been using "Wiihibilitation" to help motivate patients recovering from strokes, broken bones or other injuries that affect balance, coordination or circulation.

Facilities are also seeing the social benefits that the Wii can bring, according to an article in USA Today. Erickson Retirement Communities in Chicago has been organizing Wii bowling tournaments that have resulted in people who hardly knew each other cheering and hugging in the span of a few hours.

Seniors aren't the only group seeing unexpected benefits from the Wii. NPR's health blog noted that the popular gaming console is also being used to train students in CPR, help with physical therapy and even demonstrate virtual surgery.

Barnes Foundation Presents $30K Donation to American Cancer Society

During ProMed's annual holiday party, held on December 18, the Barnes Foundation presented a check for $30,000 to the American Cancer Society. (The Barnes Foundation was established by ProMed's president, Terry Barnes.) The funds were raised during the first annual Barnes Foundation Walk for Life, which was held on October 4. The proceeds will benefit the ACS's Illinois Patient Navigation Services, which provides a full spectrum of hands-on cancer support to residents of Illinois. The donation will be matched in full by the Duchossois Family Foundation's Campaign of Hope.

Tips for Keeping the Holidays Jolly at Your Facility

'Tis the season for gifts and sweets and gathering together...but for many elderly Americans, the holidays can also bring depression and sadness. According to Mental Health America, the holidays can trigger self-evaluation, loneliness, reflection on past failures and anxiety about an uncertain future.

The American Geriatrics Society Foundation for Health in Aging recently shared "Tips for Beating the Holiday Blues." They recommend the following strategies for lightening the sadness and depression many older people feel during the holidays.

• Invite them to get-togethers (take into account their needs for transportation or special diets).
• Offer to help them with shopping and preparations for the holidays.
• Encourage them to talk about how they are feeling. Acknowledge the difficulty they might be having, including a sense of loss they might have if family or friends have died or moved away.
• Encourage them to talk to a healthcare provider. Many older people don't realize when they're depressed. Let them know that depression is a medical illness and nothing to be ashamed of.

The Mayo Clinic recommends being proactive in recognizing known triggers that can lead to stress and depression during the holiday season. If you see them, you might be able to defuse them before they worsen.
Common triggers include:

• Relationships: Facing the holidays alone can make people feel lonely and sad.
• Finances: The holidays can put a strain on your budget that can last for months.
• Physical demands: The events that pop up during the holiday season can leave people feeling wiped out. In addition, burning the wick at both ends can make people more susceptible to colds and other bugs.

What do you think? Do you have any additional strategies for helping residents enjoy the holiday season?

Is Cinnamon "Spicing Up" Glucose Regulation?

At a time of year when cinnamon is popping up in everything from coffee to candles, we thought we'd take a look at the current debate over whether the spice can regulate glucose levels for people with type 2 diabetes.

A 2003 study generated interest in the possibility that cinnamon could mimic insulin and be effective in the treatment of insulin resistance. The authors of the study found that people who consumed between one and six grams of cinnamon each day had a reduction in their serum glucose, trigylceride, LDL cholesterol and total cholesterol.

In 2004, another study found that the polyphenols in cinnamon bark mimic insulin and could potentially be used in some product form to reduce blood sugar levels. In 2007, researchers reviewed additional studies and reported that data from the studies suggested that cinnamon has a possible modest effect in lowering plasma glucose levels in patients with poorly controlled diabetes.

However, some members of the scientific community aren't quite ready to accept these findings. Maria Collazo-Clavell, a Mayo Clinic endocrinologist who addresses health issues on MayoClinic.com, cautions that most research suggests that cinnamon isn't an effective treatment for type 1 or type 2 diabetes. She urges diabetics to contact their doctors if they have questions or concerns about their diabetes treatment plans.

CMS Warns C. diff Can Stick Around for Six Months

C. difficile might be a tougher bug than we first gave it credit for.

CMS has just modified its infection control guidance regarding C. diff. They've upped the time that C. diff can survive in the environment (such as on or around toilet seats, bed rails and the floor) in its spore form from five to six months.

According to the revised guidance, “Rigorously cleaning the environment removes C. difficile spores, and can help prevent transmission of the organism. Cleaning equipment used for residents with C. difficile with a 1:10 dilution of sodium hypochlorite (nine parts water to one part bleach) will also reduce the spread of the organism. Once mixed, the solution is effective for 24 hours.”

To view the revised guidance in its entirety, click here.

Life Expectancies are Growing - and So are Medicare and Social Security Costs

Which would you like first - the good news or the bad news?

Okay, we'll start with the good news. A new study from the MacArthur Foundation reveals that by 2050, Americans may live 3.1-7.9 years longer than official government projections. For men, that means life expectancy would rise to 83.2-85.9 years, up from the current projection of 80.0-80.9 years. For women, the estimate of 89.2-93.3 years is up from 83.4-85.3 years.

Not only is this great for those of us who want to stick around as long as we can, it also means that American society can expect new and expanded markets in health care and leisure and an expanded work force.

By the middle of the next decade, researchers expect the United States to become an "aging society" in which people over the age of 60 outnumber people under the age of 15.

So what's the bad news, you ask? Well, as life expectancies go up, so do the costs for government programs that serve older citizens. The study's authors estimate that the cumulative outlays for Medicare and Social Security could rise by $3.2 to $8.3 trillion over current government projections by 2050.

Great News for a Monday Morning: Link Found Between Coffee and Prostate Cancer Prevention

Here's some news to savor as your sip your coffee this morning: Harvard researchers have found an intriguing link between coffee and the prevention of an aggressive type of prostate cancer.

The findings, which were presented at the Frontiers in Cancer Prevention Research Conference, revealed a strong inverse association between coffee consumption and the risk of lethal and advanced prostate cancers.

A press release on the study quoted Kathryn M. Wilson, Ph.D., a postdoctoral fellow at Harvard, as saying "Coffee has effects on insulin and glucose metabolism as well as sex hormone levels, all of which play a role in prostate cancer. It was plausible there may be an association between coffee and prostate cancer."

Interestingly, coffee's best-known ingredientt - caffeine - is not the key factor in this association. Researchers are unsure exactly which components are most important, as coffee contains many biologically active compounds, such as antioxidants and minerals.

The study found that men who drank the most coffee has a 60 percent lower risk of aggressive prostate cancer than men who did not drink any coffee at all.

It's Beginning to Look a Lot Like Christmas at ProMed

You can view even more pictures of our festive headquarters on our Facebook page!

Medicare to Cover HIV Screenings

On December 8, CMS announced that, effective immediately, it will begin covering HIV screenings for Medicare beneficiaries who are at an increased risk for the infection, including pregnant women and beneficiaries of any age who voluntarily request the screening. An estimated 19% of U.S. residents diagnosed with AIDS are age 50 or older.

Kathleen Sebelius, Secretary of the Department of Health and Human Services, was quoted as saying "Beginning with expanding coverage for HIV screening, we can now work proactively as a program to help keep Medicare beneficiaries healthy and take a more active role in evaluating the evidence for preventive services."

CMS has new flexibility in adding to Medicare's list of covered preventive services, thanks to the recently passed Medicare Improvements for Patients and Providers Act of 2008, or MIPPA. Before MIPPA, Medicare could only cover additional preventive screening tests when Congress authorized it to do so.

Of the more than one million people believed to have HIV, the CDC estimates that about one quarter do not realize they are infected. While there is currently no cure for HIV, screenings can help identify infected individuals so that they can begin receiving medical treatment that can help delay the onset the AIDS. Without treatment, AIDS usually develops within 8 to 10 years.

The final decision regarding HIV coverage can be found here.

Caring for an Elderly Loved One? You're Not Alone

"Caregiving in the U.S.," a new report from the AARP/National Alliance for Caregiving, reveals that nearly one-third of the population, or 65.7 million adults, provide some level of care.


About 70 percent of of those adults provide care to someone over the age of 50, usually a relative (86%) and often a parent (36%). The average caregiver spends about 20 hours a week providing care.

Additional findings:

• American caregivers are predominantly female (66%)
• The average caregiver is 48 years old
• One in seven caregivers provides care over and above traditional parenting to a child with special needs
• Caregiving lasts an average of 4.6 years

The top reasons cited for why people needed care included old age (12%), Alzheimer's disease (10%), mental/emotional illness (7%), cancer (7%), heart disease (5%) and stroke (5%).

The report also noted that both caregivers of adults and their care recipients are older than their counterparts were five years ago. For caregivers, the average age rose from 46 to 49. For those receiving care, the age shifted upward from 67 to 69.

To view the report, click here.

Nursing Homes Face $4.7 Billion Medicaid Shortfall in 2009

A new report is estimating that Medicaid will underpay nursing homes by $14.17 per patient day in 2009, for a total of $4.7 billion in unpaid Medicaid allowable costs. Researchers predict that this will only get worse in 2010 and 2011 due to unprecedented state budget deficits and the expiration of federal stimulus funds at the end of 2010.

The report also notes that states are continuing to redirect more of their long-term care budgets to non-institutional services, and that many states that use provider taxes to fund nursing home reimbursement chose to neither increase nursing home reimbursement nor lower provider tax rates.

To view the report in its entirety, click here.

Battling MRSA On a Cellular Level

A new study, highlighted in the journal Nature Chemical Biology and McKnight's Long-Term Care News, suggests that it might be possible to halt methicillin-resistant superbugs such as Staphylococcus aureus before they become harmful.

Researchers from the Jeff Brinker research group have discovered that the process of bacteria emitting toxins begins with a single cell that releases a peptide that "switches" bacteria from harmless to virulent. This is a stark contrast to current theory, which holds that staph infections develop when a large number of bacteria "signal" each other to start emitting toxins.

The researchers found that by introducing a lipoprotein, they were able to bind the peptide that triggers the switch from harmless to virulent to the cell, preventing bacteria from becoming harmful.

The researchers reason that this approach could make it easier to treat drug-resistant staph infections before they become life-threatening. It would also eliminate treating the infection with antibiotics, therefore preventing the good bacteria that live in the stomach and intestines from being affected.

CDC: Black Nursing Home Residents Need More Help with ADLs

A new data brief from the CDC titled "Racial Differences in Functioning Among Elderly Nursing Home Residents, 2004" reveals that black nursing home residents (who account for 11 percent of the 1.3 million nursing home residents aged 65 or older) typically have a lower functional status than residents of other races.

This determination was based on data gathered from the 2004 National Nursing Home Survey. The data showed that black residents:

• Are more likely to be totally dependent in both eating and toileting and as well as totally dependent in all five activities of daily living (bathing, dressing, eating, transferring and toileting)
• Are more likely to be incontinent of bowel, bladder or both
• Are less likely to have scheduled toileting plans when compared to bladder-incontinent residents of other races

In addition, the report notes that black nursing home residents are might be more likely to reside at facilities that have serious deficiencies, such as low staffing ratios and great financial vulnerability.

According to the report, these findings "identify important differences in the needs and care of black nursing home residents nationally."

Medical Alert Jewelry Gets a Makeover

Traditional but clunky medical alert jewelry is starting to give way to styles that are both information-loaded and stylish. According to McKnight's, USB jewelry has begun to enter the marketplace. These pieces contain a memory key that stores a resident's medical data, such as allergies, special needs or prescription information. In the event of an emergency, the information can easily be accessed on a computer.

The bracelet shown above is available from Amazon. Click here to learn more.

Inconsistencies Unearthed in Five-Star Quality Rating System

A Scripps Howard analysis of the CMS Nursing Home Compare system uncovered an uneven level of quality of the country, spotlighting just how complicated it can be to find a good nursing home.

Some of the findings include:

• Institutions run by for-profit corporations (about two-thirds of all nursing facilities) generally receive lower scores than those run by nonprofits.
• Homes with more nursing staff per resident (typically nonprofits) generally fare better in ratings.
• Ratings are lowest in the Southern states and highest in Northeast states.
• Homes that have more than 100 beds tend to have lower ratings in all categories.
• A little more than 20 percent of nursing homes regularly receive the lowest ratings, while 12 to 13 percent have received the top rating.

The study also noted that while about 500,000 residents die each year in nursing homes, more than 2 million return home after a stay of less than three months.

These are just a few highlights of the study. To view it in its entirety, complete with recommendations on how to use the ratings most effectively, click here.

Tips for Safe Shoveling

Snow is in the forecast today here in New Lenox, Illinois, so we thought this was a perfect time to revisit safe shoveling tips (even though we hope we won't have to use them any time soon).

The AARP has assembled a list of pointers to help ensure that you'll be able to stand back and admire your work without huffing and puffing or nursing your strained back.

1. Make sure you have clearance from your doctor to be shoveling. People who smoke or have a history of heart trouble, pain, back problems or other ongoing health concerns need to be careful. Shoveling is more vigorous than you might think!
2. Warm up your back before you head outside.
3. Dress properly for the weather. Try layers that you can peel off when you start to work up a sweat.
4. Stay hydrated! Dehydration is just as big a problem during winter as it is during summer. Drink plenty of water.
5. Get a good shovel. It's tempting to get the biggest shovel out there because you think you'll get the area cleared faster, but you're more likely to hurt yourself. Get a smaller shovel that suits your size, and get one with a bend in it if possible. These are better for your lower back.
6. Pace yourself. Start out slow to avoid putting too much stress on your heart.
7. Use your legs rather than your back.
8. Push, don't lift, snow when possible to avoid straining or twisting your back.
9. Be on the lookout for ice that could cause you to fall. Black ice is especially dangerous!
10. Ask for help if you need it.
11. Listen to your body. If you feel any tightness in your chest, stop shoveling and call your doctor right away. If you're sore, take a hot shower, get a massage or take a pain reliever. If the pain persists, see your doctor.

A Few Extra Tips for Fighting H1N1 in LTC

By now, we all know the basics of H1N1 prevention. Here are a few additional tips geared specifically toward long-term care facilities.

1. Keep your building as clean as possible to help control the spread of the virus once it gets inside (at this point, it's practically inevitable that H1N1 will find its way in).
2. Observe people as they enter your facility to see if they exhibit signs of infection. If they do, politely ask them to leave until they recover.
3. Create a quarantine area to isolate residents with H1N1 from the healthier population.
4. Make sure you have a coordinated effort in place to keep surfaces clean. To clean surfaces, use antibacterial, alcohol-based sprays.
5. Don't forget the air! Use an industrial air purifier in areas where people congregate, such as dining rooms and social rooms.

If you start using best practices now, you'll be ready when H1N1 eventually creeps through the doors to your facility!