Liberty Hospice delivered roses to all of its patients to honor them as part of Patient Recognition Week.

Here is patient Elizabeth Mason of Dunn, NC with Liberty nurse Sherri McNeil

Deliveries were made during scheduled nurse visits Feb. 1-7, as a thank you for those hospice patients and their families for utilizing hospice care with Liberty. The observance continues a commitment by Liberty Hospice, which in the past year has helped provide a new puppy, a final shopping trip, and specially-made Christmas ornaments to hospice patients.

Patient Recognition Week is a national celebration recognized by national healthcare providers as well as the U.S. Army as a way to honor patients.

“Our patients are truly special to us, and it is so rewarding to see the looks on our patients’ faces when they received our deliveries,” said Alanda McLeod, home care and hospice liaison with Liberty in Dunn. “This is just one way we can thank and honor our hospice patients and their families.”

Nurse Pat Young of Liberty Hospice prepares to make deliveries to Aiken patients

Hospice patients throughout the Carolinas and Virginia received the roses, which also included a note of thanks. Patients and their families stated how the deliveries helped brighten their days, and how it reflects the care and compassion that Liberty provides.

“Patient needs go beyond the technical aspects of medical care, and must include empathy and encouragement,” said Liberty HomeCare & Hospice Services President Tony Zizzamia. “By honoring our hospice patients for Patient Recognition Week, we want to show that hospice is not about death, it is about living life to the fullest. All of our patients exemplify that motto. We always try to go the extra mile for our patients, and this is just another way we want to thank them.”

“It has been a godsend,” he said from his home in Southern Pines, NC. “You don’t realize how much it can help until you start it.”

Jim and Norma Roberts with their dog Nubbin.

Jim Roberts said his wife Norma has been suffering from what doctors described as a hardening of the brain cells, and her condition had not improved. By September, the family knew there was little else they could do except to try to make her more comfortable.

A friend had recommended Liberty HomeCare & Hospice Services to Jim, to help provide the care that Norma needed, and assist Jim and his son Mark in her care. Jim Roberts made the call a few weeks later, and said it didn’t take long to see a difference.

“The next day I got a call from Liberty, and they had someone here by that Monday,” he said. “The nurses came out and really helped. They help Norma with her medication and bathing, and set up a comfortable bed for her.”

That provided Jim with peace of mind. Liberty’s nurses check on Norma at least once a week, and check her vital signs and help with pain management. When they first started hospice care, Norma’s condition had worsened to the point where she needed assistance getting in and out of a regular bed, but the hospital bed provided by Liberty gives Jim the chance to monitor her every night and check to see if she needs to go to the bathroom or has any other discomfort.

“That means so much,” said Jim, who has been married to Norma for 56 years. “I don’t have to worry about her. I know I can take care of her while she sleeps, and that she will be O.K. at night.”

Observing his wife – and the changes in her health – hasn’t been easy. Jim said that because of her condition, Norma sometimes forgets where she is, and doesn’t always recognize family members. Jim understands that those kinds of changes are to be expected, but said it is still difficult. He said the hospice care Liberty provides has allowed him time to himself, and to reflect on everything and prepare for what’s ahead.

“We have been so gratified with her care,” Jim said. “I don’t know what I would have done without it.”

The Center for Medicare and Medicaid Services (CMS) has promoted Hospice Services for the last two decades.  That growth could face challenges in the coming years as a result of the Affordable Care Act, which recommends changes to hospice payment authority and a new face-to-face requirement for Medicare hospice patients.

But the proposed HELP Hospice Act can help patients adjust to those changes, while making the transition easier. The HELP Hospice Act, which has already received bipartisan support in the U.S. House of Representatives, features three core segments.

• Any new payment methodology must first go through a two-year, 15-site demonstration program. This pilot program can help develop the reliable, evidence based, comprehensive data needed to determine which payment reform approach is best.
• The HELP Hospice Act would increase hospice survey frequency, on average, to once every three years. This increase from the current average of 6 to 8 years would provide a better certification process, and allow for improved and appropriate regulatory oversight.
• The HELP Hospice Act would modify the face-to-face encounter requirement by allowing clinical nurse specialists and physician assistants to also conduct the encounter, and allow hospice agencies seven days after the initial election of services to complete the requirement. These changes would help all agencies and particularly help small and rural hospices, which face operational constraints and may have to turn down patients who are most in need.

Many of the HELP Hospice Act’s principles do not cost any additional money, while still making a big difference for hospice organizations and their patients. All hospice patients and their families deserve the opportunity for the best care possible, and the HELP Hospice Act is a major step in that direction.

Tony Zizzamia

President, Liberty HomeCare & Hospice Services

But how does home care get started? Here’s a step-by-step guide to establishing home care for yourself or a loved one:

1. Set up an appointment with the primary care physician - Home care is typically established through a doctor’s referral. Doctors can refer a patient for reasons including a new diagnosis or condition, exacerbation of a previous diagnosis or condition, or a recent fall.
2. Ask for a referral to Liberty HomeCare & Hospice Services - Liberty HomeCare & Hospice Services has existing relationships with medical professionals throughout the Carolinas and Virginia, but any primary care physician can set up a referral by phone or through our online form. This referral form is the beginning of the home care process, and is often completed within 24 hours of your visit with the physician.
3. Attend an in-home evaluation – A Liberty staff member (typically a nurse, physical therapist, or speech therapist depending on the diagnosis) will visit your home and determine the frequency of home care visits. Those visits can be weekly or more often, depending on the needs of the patient.
4. Finalize your schedule with Liberty HomeCare & Hospice Services – Liberty personnel will arrange the schedule of home care visits, and will ensure that you or your loved one gets the attention that is needed and deserved.

This process can be completed with little paperwork, and visits can often be done for little cost to the patient. For more information, please contact Liberty HomeCare & Hospice Services, and we will be happy to answer any questions about getting home care started.

Congress’s “super committee” has been meeting for weeks to determine ways to address the federal deficit, and health care leaders, including the American Medical Association, had hoped that Medicare reduction would be taken out of budget revisions. But so far, nothing has been accomplished.

That could mean that doctors will refuse to see new Medicare patients after the New Year. A recent article stated that more than half of the physicians in Texas would likely stop seeing patients if the cuts take place.

Unfortunately, those kinds of tough choices were already happening locally, even before the latest round of cuts. WRAL-TV in Raleigh, NC reported that in 2010 more than 80 physicians in N.C. stopped seeing Medicare patients, and more than 100 stopped in 2009.

The cost for physicians is often more than the payment that they receive from Medicare, and that is even before this latest cut was proposed. So, it is understandable why a doctor might want to stop seeing those patients.

These latest cuts could trigger an even bigger decline in available physicians for local seniors. All patients need proper care, and these cuts will affect millions of seniors both locally and nationwide. AMA President Peter W. Carmel, MD, said this in regards to the budget stalemate:

“The deficit committee had a unique opportunity to stabilize the Medicare program for America’s seniors now and for generations to come,” he said. “Once again, Congress failed to stop the annual charade of scheduled Medicare physician payment cuts and short-term patches, which spends more taxpayer money to perpetuate a policy everyone agrees is fatally flawed.”

As Dr. Carmel mentioned, these cuts have been pushed off before. Delaying cuts isn’t the answer, finding a better solution is. Congressional leaders still have time, although the window is closing, to do just that. Let’s hope they can come up with a plan that serves everyone.

Tony Zizzamia

President, Liberty HomeCare & Hospice Services

Think about your last trip on an airplane. Flight attendants remind passengers to put on their own oxygen masks before helping others. That’s not selfish, that’s smart. By helping yourself, you are better prepared to help others around you.

Caregivers should help themselves by allowing time to recharge, rejuvenate and relax. Caregiver respite has been cited as a vital part of the process and not taking sufficient time for yourself to recharge your batteries can lead to caregiver burnout. Once that happens, the whole care system can crumble.

The physical, emotional and financial demands of caregiving can seem overwhelming and exhausting, but there’s a way to get the relief you need and break you deserve. Private care services are available by Liberty in the Pinehurst, Wilmington and Greensboro (NC) area, allowing you the comfort and peace of mind that comes with knowing loved ones are receiving proper care in the comfort of their own homes.

Private care services—often referred to as personal care—can lend a helping hand, whether for a few hours a day or seven days a week. Liberty Private Care Services offers personal care assistance, provides medication reminders, and helps with meals and household chores in the home. Maybe your mother needs help getting into the shower or your father needs help getting dressed and preparing dinner. Private care services offer caregivers an opportunity to give their loved ones proper care, while giving themselves an opportunity to do the things they have had to put off.

A caregiver’s health and happiness are equally as important as those that they care for. Yet while putting their needs behind others, caregivers miss out on opportunities to enjoy life. See a movie you’ve been hearing about for weeks, play a relaxing round of golf, plan the dinner date you’ve been postponing for months or simply spend valuable time with your children. Your enjoyment may seem like a necessary sacrifice, but it doesn’t have to be. Private care services offer caregivers the chance to live their own lives while loved ones remain safe, secure and independent in the home.

Of course, leaving a loved one, even for a few hours, can be difficult. Fortunately, private care is flexible, often allowing you to schedule as few or as many hours as you need. The type of private care also varies. Some companies provide only companion care, which includes light housekeeping and friendship, but no assistance with activities of daily living. Liberty Private Care Services offers the safest alternative outside of providing the care yourself.Liberty employs only certified nursing aides with medical training, so they know what to look for while a caregiver is away. Plus, certified nursing aides understand the importance of medication reminders, are well-trained for special circumstances such as dementia and are supervised by registered nurses.

It can be difficult to step aside and let someone else take care of your loved one, even if that person is highly qualified. We want to be able to care for our loved ones ourselves. It’s a natural inclination to “take care of your own.” Consequently, caregivers often forget to take care of another very important person—herself. Taking that step might seem like a luxury, but in many ways it’s a necessity.

You cannot put a price on your health and peace of mind. Even the most loving and patient caregiver has a breaking point and caregivers owe it to themselves to get help before that happens. Letting go is never easy, but caregivers often forget that they face additional challenges that didn’t exist for previous caregivers 10 or 20 years ago. Nowadays, caregivers can tend to loved ones for years. That kind of extended care did not happen in previous generations. Caregivers like your parents didn’t have to juggle other responsibilities such as a career or older children living in the home. It all creates added stress that previous caregivers did not face.

That stress can be the root of even more serious problems for a caregiver. Their own health and well-being often suffer from the responsibility of taking care of loved ones. Too many times, a caregiver will wait until they need professional care before deciding to seek help from others. Caregivers have to remember that they are just as important as the person they are caring for.

With that in mind, private care can be a lifesaver for a lot less than you might think. Yet caregivers can’t put a price on how much better their lives and overall health would be with a few hours of respite. Use the time wisely and provide much-needed care for yourself.

To contact Liberty about private care services, click here.

That kind of discord is also evident in the health care system, as skyrocketing costs continue to sap consumers and have detrimental effects on the economy. The new Affordable Care Act was signed as a way to curtail that, but no one can guarantee that it will stop the surge of health care expenses.

One thing we must curtail now is the rehospitalization of patients. Readmissions are a major drain on our economic system. The Wall Street Journal reports that 4.4 million hospital stays are from potentially preventable readmissions. Those readmissions are costing $30 billion a year, or roughly 10 percent of all money spent on hospital care.

One in five Medicare patients will be readmitted within 30 days after an initial visit, and in many instances, those repeat visits can be avoided.

In half of those cases, patients did not see a doctor before being readmitted. Many patients don’t follow up with a doctor once they leave a hospital because they are fearful of ending up readmitted again or don’t understand the risks of missing a follow-up appointment. Patricia Rutherford, vice president of the Institute for Healthcare Improvement, acknowledged the problem to the Washington Post earlier this year.

“We don’t do a good job of coordinating care,” Rutherford said. “For very sick patients being discharged, 30 days is way too late to see a doctor.”

Home care agencies such as Liberty HomeCare & Hospice Services can help better coordinate care for discharged patients and ease their concerns. Home care offers patients the option to be treated in the comfort of their own home. Home care saves millions of dollars each year, and can create faster recovery times for patients.

Recovery time at home increases even more with proper planning of care. Follow-up with patients is vital, including self-management programs, counseling and developing exercise programs for recovery.

November is National Home Care Month, giving us all an opportunity to appreciate the valuable services that home care provides. But the benefits of home care aren’t just reserved for one month – home care can make a big difference year round.

That’s the message that patients, and everyone else, need to understand. No one wants them to return to hospital rooms. Instead, those patients can get the care they need in the place they want – their home. Let’s get that movement started now.

Tony Zizzamia

President, Liberty HomeCare & Hospice Services

According to the American Physical Therapy Association, the benefits of physical therapy include:

-          Improving mobility and motion.

-          Reducing the risk of injury.

-          Improving balance and preventing falls.

-          Aiding recovery from stroke.

Physical therapists can also help reduce the risk of additional surgeries, and eliminate pain without medication. There are more than 40 different health conditions that can be improved through physical therapy, and the need for physical therapists continues to grow. Physical therapists are one of the most in-demand professions in health care, and the need for physical therapists is expected to surge 26 percent in the next six years.

Physical therapists are available to discuss any home care needs, and can also do an in-home needs assessment. You can see some of the exercises they can perform with you here.

Before visiting with a physical therapist, a patient should:

-          Make a list of questions.

-          Write down any symptoms.

-          Make a list of all medications you are currently taking.

-          Write down key information about your medical history.

-          Consider taking a family member or trusted friend.

Physical therapy can make a big difference. In fact, 88 percent of physical therapy recipients say the care they received was beneficial to helping them return to normal activity.

Liberty HomeCare & Hospice Services can help you or a loved one get started. Please contact us for more information.

     All of those benefits have a direct, positive effect on our healthcare system, yet new guidelines being discussed inNorth Carolinawould dramatically limit the amount of physical therapy that would be available to Medicaid recipients.

     According to the latest proposal by the North Carolina Department of Health and Human Services, Medicaid recipients would only be eligible for a total of three home health therapy visits per year. This includes physical therapy, speech therapy, and occupational therapy combined.

     That is a dramatic decrease from current standards. Right now, patients receive physician ordered therapy according to the patient’s individual needs.  Giving them the opportunity to achieve optimal outcomes and avoid the costly complication of re-hospitalization.

     There are also several serious issues that need to be addressed about the proposal. How will a doctor know whether a patient has used up their three visits for the year (no such database currently exists for them), and how will the new limitations affect physicians’ recommendations? Limiting the patient to only three visits would dramatically reduce any benefit they can receive from such services. In fact, allowing only three visits is not much better than eliminating their availability entirely.

     All of that is potentially bad news for Medicaid patients for North Carolina.  This was the result when the legislature passed the new State budget.  This reduction doesn’t benefit anyone.  This new policy doesn’t help the patient, and it doesn’t help the Medicaid system, because less therapy will create more re-hospitalizations. That will further strain the system and keep costs going higher and higher.

     Why push for a plan where nobody wins? There has to be a better way.

      Tony Zizzamia

      President, Liberty HomeCare & Hospice Services

Specifically, red fruits (such as strawberries, tomatoes, watermelon, apples, and cherries) contain nutrients such as lycopene and ellagic acid and have been shown to help arthritis, lower cholesterol and improve blood pressure.

Yellow-Orange fruits and vegetables have beta-carotene, flavonoids, lycopene, and vitamin C.  These foods help promote healthy joints, help prevent prostate cancer, lower cholesterol and blood pressure as well.  The fruits in this group include delicious foods such as oranges, mangos, pineapples, carrots, apricots, and peaches.

Green veggies (i.e. leafy greens, celery, peas, limes, cabbage, honey dew, etc…) have chlorophyll, vitamin C, Beta-carotene, calcium, and folic acid.  These nutrients have been found to improve vision, help with digestion, improve cholesterol and blood pressure, as well as boost the immune system. 

White Fruits and vegetables (such as bananas, white corn, onions, ginger, cauliflower) contain beta-glucans and lignans which improve the immune system, assist in balancing hormone levels and help decrease the risk of certain cancers such as prostate cancer, colon cancer, and breast cancer.

Dark fruits and vegetables (Blue and Purple) contain lutein, vitamin C, flavonoids, and fiber.  They also help with vision, improve digestion, enhance calcium absorption, contain anti-inflammation properties, and reduce cancer risks.  Foods in this group include: grapes, eggplant, plums, prunes, raisins, and figs.

Unfortunately, potatoes are very starchy and not considered a vegetable according to the food pyramid and should be eaten in moderation.

It is generally suggested that we eat at least five servings of fruits and vegetables per day. Consider getting organic or locally grown vegetables.  According to organic food producers, organic food is higher in vitamins, minerals, and fiber and contains no pesticides unlike nonorganic foods.  A possible day could contain: a pear with breakfast, lettuce and tomatoes on a sandwich at lunch, a banana as a daytime snack, a cup of leafy veggies at dinner, and a half cup of fruit with yogurt or low fat whipped cream for dessert. 

Remember… have fun, be healthy, remember to exercise, and EAT THE RAINBOW!!!

Lumberton Health Center is an affiliate of Robeson Health Corporation. This article is courtesy of Dr. Donee Thomas-Patterson, a friend of the practice who is a board certified family physician in Philadelphia, Pennsylvania.