Research and Markets: Neurology and Neurosurgery: Clinical & Review Criteria Guidelines for Managing Care
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As millions of baby boomers reach retirement age and U.S. health care costs soar, Mexican nursing home managers expect more American seniors to head south in coming years.
Mexico’s proximity to the USA, low labor costs and warm climate make it attractive, although residents caution that quality of care varies greatly in an industry that is just getting off the ground there.
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After Jean Douglas turned 70, she realized she couldn’t take care of herself anymore. Her knees were giving out, and winters in Bandon, Oregon, were getting harder to bear alone. Douglas was shocked by the high cost and impersonal care at assisted living facilities near her home. After searching the Internet for other options, she joined a small but steadily growing number of Americans who are moving across the border to nursing homes in Mexico, where the sun is bright and the living is cheap.
For $1,300 a month–a quarter of what an average nursing home costs in Oregon–Douglas gets a studio apartment, three meals a day, laundry and cleaning service, and 24-hour care from an attentive staff, many of whom speak English. She wakes up every morning next to a glimmering mountain lake, and the average annual high temperature is a toasty 79 degrees. "It is paradise," says Douglas, 74. "If you need help living or coping, this is the place to be. I don’t know that there is such a thing back (in the USA), and certainly not for this amount of money."
An estimated 40,000 to 80,000 American retirees already live in Mexico, many of them in enclaves such as San Miguel de Allende or the Chapala area, says David Warner, a University of Texas public affairs professor who has studied the phenomenon. There are no reliable data on how many are living in nursing homes, but at least five such facilities are on Lake Chapala.
"You can barely afford to live in the United States anymore," said Harry Kislevitz, 78, of New York City. A stroke victim, he moved to a convalescent home on the lake’s shore two years ago and credits the staff with helping him recover his speech and ability to walk. "Here you see the birds, you smell the air, and it’s delicious," Kislevitz said. "You feel like living."
Many expatriates are Americans or Europeans who retired here years ago and are now becoming more frail. Others are not quite ready for a nursing home but are exploring options such as in-home health care services, which can provide Mexican nurses at a fraction of U.S. prices.
Retirement homes are relatively new in Mexico, where the aging seniors usually live with family. There is little government regulation. Some places have suddenly gone bankrupt, forcing American residents to move. Some Mexican homes have rough edges, such as peeling paint or frayed sofas, that would turn off many Americans.
"I don’t think they’re for everyone," said Thomas Kessler, whose mother suffers from manic depression and lives at a home in Ajijic. "But basically, they’ve kept our family finances from falling off a cliff."
Residents such as Richard Slater say they are happy in Mexico. Slater came to Lake Chapala four years ago and now lives in his own cottage at the Casa de Ancianos, surrounded by purple bougainvillea and pomegranate trees.
He has plenty of room for his two dogs and has a little patio that he shares with three other American residents. He gets 24-hour nursing care and three meals a day, cooked in a homey kitchen and served in a sun-washed dining room. His cottage has a living room, bedroom, kitchenette, bathroom and a walk-in closet.
For this Slater pays $550 a month, less than one-tenth of the going rate back home in Las Vegas. For another $140 a year, he gets full medical coverage from the Mexican government, including all his medicine and insulin for diabetes.
"This would all cost me a fortune in the United States," said Slater, a 65-year-old retired headwaiter.
On a recent afternoon, lunch at the Casa de Ancianos consisted of vegetable soup, beet salad, Spanish rice, baked dogfish stuffed with peppers, garlic bread and a choice of four cakes and two Jell-O salads. Slater’s neighbor doesn’t like Mexican food, so a nursing home employee cooks whatever she wants on a stove beside her bed.
Like many retirees, Slater has satellite television, so he doesn’t miss any American news or programs. When he wants to see a movie or go shopping downtown, the taxi ride is only $2 or $3. Guadalajara, a culturally rich city of four million people, is just 30 miles away.
For medical care, Slater relies on the Mexican Social Security Institute, or IMSS, which runs clinics and hospitals nationwide and allows foreigners to enroll in its program even if they never worked in Mexico or paid taxes to support the system. He recently had gallbladder surgery in an IMSS hospital in Guadalajara, and he paid nothing.
Many of the nursing home employees speak English, and so does Slater’s doctor.
The Casa de Ancianos began accepting foreigners in 2000 as part of an effort to raise extra money, director Marlene Dunham said. It built the cottages especially for the Americans and uses the income received from them to subsidize the costs of the 20 Mexican residents at the home.
The program was so successful that the nursing home has plans for 12 more cottages, a swimming pool, a Jacuzzi and a gazebo with picnic area. The nursing home now advertises on the Internet and through pamphlets distributed in town. Some U.S. companies have also begun investing in assisted living facilities in Mexico, said Larry Minnix, president of the American Association of Homes and Services for the Aging, which represents 5,800 nursing homes and related services.
However, Minnix cautioned that lax government regulation poses dangers at smaller homes.
"It’s the same danger you have of going across the border looking for cheap medications," Minnix said. "If you don’t know what you’re getting, and you’re not getting it from people you trust, then you’ve got an accident waiting to happen."
Since many nursing homes are run out of private homes, regulation by state health departments is often spotty. Managers such as Beverly Ward of Casa Nostra and Maura Funes of El Paraiso, both in Ajijic, said that Mexican officials inspect them only once a year, unlike U.S. inspectors, who may visit a home several times a year.
The U.S. Embassy said it had no record of complaints against Mexican nursing homes, but some residents in the Lake Chapala area reported bad experiences at now-defunct homes.
The first home that Jean Douglas lived in after she moved from Oregon was staffed by "gossips and thieves," she said. It went out of business. Irene Chiara of Los Angeles also lived in a home that was shut down by Jalisco state authorities.
"It was filthy, and the food was very bad. It was all made in the microwave," she said.
Some Mexican managers also underestimate the costs and difficulty of running a retirement home. Two hotels turned into assisted living facilities, The Spa in San Miguel de Allende and The Melville in the Pacific Coast city of Mazatlán, recently abandoned the business, their managers said.
"It was very expensive to run it," said Luis Terán, manager of The Melville. Some managers said they were especially selective when admitting foreign residents, to make sure they’ll be able to pay. Medicare, Medicaid, the Department of Veterans Affairs and most U.S. insurance companies will not cover care or medicine as long as patients are outside the USA.
Some American residents said they had doubts about the quality of Mexican medical facilities and would go back to the USA if they became seriously ill. Jim May, 74, a resident of the Casa de Ancianos, said he recently decided to move to Texas to be closer to Veterans Affairs hospitals.
The language barrier can be daunting, and Mexican food can be very different, some residents said.
Some residents said they miss home and find it hard to make friends with Mexican residents. "It’s a very nice place, but it’s lonesome," said Polly Coull, 99, of Seminole, Fla., a resident at Alicia’s Convalescent Nursing Home in Ajijic.
Mexican entrepreneurs are doing their best to prepare for a tide of Americans. In the Baja Peninsula town of Ensenada, the Residencia Lourdes opened in 2003, offering care for patients with Alzheimer’s disease and senile dementia. The towns around Lake Chapala have at least five small retirement homes. Most of them opened in the last five years and house from one to 25 foreigners. The largest, Alicia’s Convalescent Nursing Home, consists of four renovated homes, one of them specializing in stroke victims and another for Alzheimer’s patients. Prices range from $1,000 to $1,500 a month and include everything except medicine and adult diapers. The rooms are outfitted in Mexican style, with murals, hand-carved beds, arched ceilings lined with brick and individual patios.
In other American enclaves, in-home healthcare services have sprung up to serve the retirees. In Rosarito, just south of the U.S. border, INCARE provides nursing aides to retirees starting at $8.33 an hour, less than half the cost of the same service in nearby San Diego.
Developers of independent living facilities for seniors are also beginning to look to Mexico. A Spanish-U.S. venture is building Sensara Vallarta, a 250-unit condominium complex aimed at Americans age 50 and older in the Pacific Coast resort of Puerto Vallarta. And in the northern city of Monterrey, El Legado is marketing itself as a "home resort" for seniors.
Academics and government officials are beginning to take notice. In March, the University of Texas at Austin held a forum for developers, hospital officials, insurance companies and policymakers to discuss health care for retirees in Mexico.
"With the right facilities in place, Mexico could give (American retirees) a better quality of life at a better price than they could find in the United States," says Flavio Olivieri, a member of Tijuana’s Economic Development Council, which is seeking funding from Mexico’s federal government to build more retirement homes, including senior apartments. "We think this could be a very good business as these baby boomers reach retirement age," he says.
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When the topic of women’s health care is raised, the first disease that comes to mind is probably breast cancer. But surprisingly, that’s not the number one health care issue confronting women today. In fact, heart disease kills more women each year than all forms of cancer combined. By knowing the most significant risks in women’s health care and what you can do to combat these health care issues, women of all ages can take a proactive approach to leading healthier lives.
The #1 Women’s Health Care Issue: Heart Disease More than 489,000 American women lose their lives each year as a result of heart attacks, strokes, and other cardiovascular diseases. In fact, more women than men die from heart disease each year. Until recently, little research focused on women and heart disease, but the good news is that’s no longer the case. From research into the effects of hormone replacement therapy on heart health to studies of how cholesterol-lowering medications work in women, there’s an unprecedented increase in the amount of information available to women working to live with and ward off heart disease.
Experts at the Mayo Clinic offer simple common sense advice to women (and men) in the fight against heart disease: don’t smoke, eat a diet low in fat and rich in fruits, vegetables, whole grains, and low-fat dairy products, exercise at least 30 to 60 minutes a week, and maintain a healthy weight.
In addition, they encourage women to see their family doctor each year for a physical which includes blood pressure and cholesterol screenings. Studies indicate that there is a 46% increase in stroke risk for women for each 7.5 mm HG increase in their diastolic blood pressure, so monitoring blood pressure and controlling hypertension are vital.
Women who suffer migraines, are pregnant, have atrial fibrillation and those with the auto-immune disease Lupus also appear to run a greater stroke risk. Diabetes is another women’s health care issue with a direct impact on heart health. The American Heart Association notes women with diabetes have a two to six times greater risk of heart disease and heart attack and are at a significantly greater risk of suffering a stroke. All of these risk factors make an annual visit with your doctor one of the best ways women can manage and improve the health of their hearts.
Cancer Concerns: The Second Deadliest Health Care Issue Women Face While breast cancer is often at the top of the list of health care issues for women, several other types of cancers also pose a significant threat to women’s health. In this country, one in eight women will be diagnosed with breast cancer during her lifetime according to current data which means that a little more than 2 million women are currently living with breast cancer in the U.S. But melanoma, a form of skin cancer, actually kills more young women than any other cancer according to statistics provided by the Skin Cancer Foundation. In fact, melanoma is the most common form of cancer in women between the ages of 25 and 29 and its incidence has tripled in women under 40 in the last thirty years.
Ovarian cancer is another women’s health care concern. Usually symptomless until it is widespread, this disease is the fourth most frequent cause of death for American women. The American Cancer Society estimates 26,000 new cases of ovarian cancer diagnosed each year. Unfortunately, there are few definitive screening tests that detect this disease, but experts advise a thorough annual gynecological exam and for women to be alert to pelvic pain and pressure, low back discomfort, mild nausea, and an increase in constipation or gas. A serum CA-125 blood test can detect certain forms of ovarian cancer, but the test is not accurate enough to be used as a routine screening tool.
The rate of women suffering from cervical cancer has dropped a great deal over the years, thanks in part to the increase in the number of women who get an annual Pap smear which can indicate the presence of abnormal cells on the cervix. It’s a strong argument for making sure you never skip your Pap smear. Women who have had Human Papillomaviruses (HPVs), herpes simplex virus, those with suppressed immune systems, and those who have had multiple sexual partners run a greater risk of cervical cancer. On the prevention front, a recent trial of a vaccine against cervical cancer was 100% effective in the short term at blocking the disease.
Psychological Well-being: A Growing Health Care Issue for Women In the field of women’s health care, psychological problems, which include eating disorders, depression, and anxiety disorders, affect millions of American women. From coping skills to medications to alternative and complementary medical approaches, there is a growing body of knowledge being brought to bear on this important health care issue.
More than 19 million people in the United States, the greatest percentage being women, live with anxiety disorders that disrupt their lives. The different types of disorders within this group include generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and phobias. Treatment options include talk therapy and a wide range of medications that can quell the symptoms of the condition. Many women also combine alternative approaches to treatment such as acupuncture, meditation, and diet modification with traditional forms of treatment.
According to the American Psychological Association, women are almost twice as likely to suffer from major depression as men. In fact, some experts in the field have called depression the most significant mental health risk for women, especially those in their childbearing and rearing years. Studies have found that married women and mothers are especially vulnerable to depression. It’s important for a woman who feels she may be suffering from depression to be carefully evaluated by a physician because the source of the depressive symptoms could be birth control pills, hormone replacement therapy, or thyroid disease. Treatment for depression, like most other psychological conditions, includes talk therapy and medications. Some women also find relief in alternative medicine with herbal supplements, meditation, and other complementary techniques.
Though many of the women who struggle with eating disorders are in their teens and twenties, these conditions also affect women at other stages in their lives. Anorexia, bulimia, and binge eating are the most well-known forms of eating disorders. Statistics show that one out of every one hundred girls between the ages of 10 and 20 is anorexic, 4% of college-aged women are bulimic, and 1% of women are binge eaters. The root causes of these diseases include stress at home and at school or work, depression and anxiety, major life changes like a divorce or death, and physical and sexual abuse. Breaking out of the cycle of eating disorders requires a combined approach to this health care issue including psychological treatment, nutrition counseling, and in some cases, hospitalization.
A Holistic Approach to Women’s Health Care As women become more proactive about their health, many seek a holistic approach to improving their well-being and fighting disease. But coordinating information among several health care providers, keeping on top of the latest breakthroughs in health, and finding the United States’ best doctors is a daunting task for any women.
Some are turning to private professional health care advocates, like those available at PinnacleCare, to help them achieve their goal of a whole-woman centered approach to health care issues. From compiling and electronically storing comprehensive medical records to researching treatment options and providing accelerated access to the United States’ top doctors, PinnacleCare’s health advocates make a holistic approach to health care possible.
"I passionately believe that what our PinnacleCare Members experience is the way healthcare ought to be delivered," explains John Hutchins, PinnacleCare’s Managing Director. "The healthcare system has gotten so complex that most people are at a loss to find their way through it without professional guidance and objective counsel."
R.Gitcher
http://www.articlesbase.com/health-articles/womens-health-care-742933.html
Cardiovascular care in America is spiraling out of control. We are now spending more than one hundred billion dollars a year for treatment and management of cardiovascular catastrophes (heart attack, stroke and diseases of the vascular system). This extraordinary amount of money is spent on victims of a disease that is largely preventable.
In The Great American Heart Hoax I have outlined the problems of cardiovascular care in America that is draining our healthcare dollars and contributing to our financial collapse. In addition, I point out key areas of wasteful spending on expensive and risky diagnostic studies as well as procedures that are of no benefit to the millions of Americans who fall prey to the cardiovascular intervention industry. What may surprise you is what you believed to be the ultimate of cardiac care in this country is often unnecessary and dangerous.
Examples of inappropriate cardiovascular care are summarized below:
The Solution
There is a better road we can walk down that will provide us with a lifetime of heart health. This road is called progress road and it costs a fraction of the journey down the dead-end road, with excessive interventions and diagnostic studies that don’t improve clinical outcome. Progress road is truly the biggest bang for the buck!
Progress road utilizes clinically proven prevention rather than needless intervention to keep us healthy and lowers our health care costs that cripple the financial health of America thereby impeding our ability to compete in a global economy.
It consists of:
At this critical juncture, we have to decide what is best for the health and wealth of the citizens of this country. Will it be business as usual with indiscriminate utilization of diagnostic and interventional procedures that cost billions and don’t improve the overall health of Americans or do we want a health care system that is affordable and delivers preventive care that gives us the biggest bang for our buck? I think the answer is clear. The Great American Heart Hoax chronicles all that is wrong with our current health care system for cardiovascular treatment and it also delivers a concise, practical and clinically proven 10- step approach that can lead us to the promise land of affordable health care, fewer heart attacks and strokes and freedom from a misguided cardiovascular intervention industry that is sabotaging our financial and medical well-being.
Copyright © 2009 Michael Ozner, M.D., author of The Great American Heart Hoax: Lifesaving Advice Your Doctor Should Tell You About Heart Disease Prevention (But Probably Never Will)
Author Bio
Michael Ozner, MD, FACC, FAHA, author of The Great American Heart Hoax: Lifesaving Advice Your Doctor Should Tell You About Heart Disease Prevention (But Probably Never Will), is one of America’s leading advocates for heart disease prevention. Dr. Ozner is a board-certified cardiologist, a Fellow of the American College of Cardiology and of the American Heart Association, medical director of Wellness & Prevention at Baptist Health South Florida and a well-known regional and national speaker in the field of preventive cardiology. He is the medical director of the Cardiovascular Prevention Institute of South Florida and symposium director for “Cardiovascular Disease Prevention,” an annual international meeting highlighting advances in preventive cardiology. He was the recipient of the 2008 American Heart Association Humanitarian Award. Dr. Ozner is also the author of the BenBella Books title The Miami Mediterranean Diet.
Michael Ozner, Md, Facc, Faha
http://www.articlesbase.com/health-articles/the-great-american-heart-hoax-economic-and-political-implications-738679.html
Revised Standards Of Care Call For Changing How Gestational Diabetes Should Be Diagnosed
The American Diabetes Association is recommending changes in the way pregnant women are tested for gestational diabetes, which will likely result in a doubling of the number of women diagnosed, but should also reduce the health risks to mother and baby. The new testing guidelines will be published in a special supplement to the January issue of Diabetes Care as part of the Association’s revised …
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New research finds physicians not following standard care guidelines for OA
New research found clinicians who care for patients with osteoarthritis are likely not following standard care guidelines that are based on current medical evidence.
Read more on News-Medical-Net
Roundup: 2010 Advances in Heart Disease and Stroke Care
TUESDAY, Dec. 28 (HealthDay News) — 2010 was a year that enjoyed continued advances in the treatment of heart disease and stroke, according to the American Heart Association/American Stroke Association.
Read more on HealthDay via Yahoo! News
Diabetes care raises alarm
This year’s fatal outbreak of hepatitis B in a North Carolina assisted-living home unfolded like a singular nightmare, but state and national experts predict such events will grow more common in years to come.
Read more on The News & Observer
Finding the concession diet for diabetic patient management is an important side during the control of diabetes. A heap of diabetics, particularly sort 2 diabetics, don’t take their condition seriously, and thus place themselves at excellent risk since they are continuously disobeying the diabetes guidelines outlined by their doctors.
It’s price asking the question, is the diet for diabetic patient care excessive, or is there a firm medical basis for this diet? Unfortunately, the diet for diabetic patient care is, favor loads of diets, a difficult issue to adhere to over an extended period of time. Yet the finish goal of here guidelines is just not to search best, or feel additional attractive. It’s to safeguard the life, health and lifestyle of the diabetes sufferer.
The perfect diet for diabetic patient management should involve recent root plus vegetables, lean cuts of meat, and the decrease or avoidance of alcohol consumption, particularly full strength beer plus spirits. It is commonly this last purpose that is a the majority of complicated one for a diabetic patient to confront, since they feel which a doctor is attempting to ruin a part of their life and enjoy. The truth is which, in a fair diet for diabetic patient care, your doctor is not asking you to absolutely impart up alcohol consumption, but consume alcohol during a moderate plus responsible fashion.
The identical applies to countless of the sweet things which are mostly excluded from a diet for diabetic patient management. Countless diabetics get pleasure from high sugar foods, such as cream cakes, chocolate plus ice cream. What many doctors are suggesting is just not that you simply absolutely cut these of the your diet, for diabetic patient willpower is usually not robust adequate to carry out this, but moderating and controlling the number which you can eat of these. This depends, after all, on the extent of your diabetes, plus on the recommendation of your medical doctor, who after each one purely has your good plus your health in mind!
You may similarly attain low sugar alternatives to a number of the sweet foods that you simply enjoy. In the same way, unsweetened chocolate can facilitate to satisfy some of the cravings you’ll experience as a diabetic.
During the end, the ideal diet for diabetic patient management is the legal 1 which you can stick to! It is useless having a extremely strict diet that you ignore, therefore work along with your doctor not against your doctor, plus try and get a diet that you are able adhere to, even in festive times. Together you should be able to find the concession diet for diabetic patient care that works for everybody.
Diabetes does not have to be the harmful, devastating disease most people believe it is. You are able learn to respect your health, live a tedious plus prosperous life and do it every one the natural way. For numerous FREE data and numerous answers, take a look at Best Diet For A Diabetic
Diabetes Guidelines Mellitus is a medical condition wherein there is increased glucose in the blood due to the problem of the pancreas of the body to produce insulin that helps trigger the liver and the cells to take up increased levels of glucose in the blood. With increased concentration of glucose in the blood, it will have the characteristic of being viscous. This leads to poor circulation of blood throughout the body. When the body is not able to circulate properly, there is poor nutrition and oxygenation to the cells and when there is the presence of wound, it will not heal properly which can lead to infection and gangrene.
In diabetic patients, this poor circulation is evident mostly on the feet. That is why management of this condition involves foot care. According to diabetes news, there are a lot of patients who have undergone amputation due to neglect on the care of the feet. Even a small wound can become complicated because of the slow wound healing that occurs in diabetic patients. That is why it is very important to teach the patient about the facts about diabetes and how to take care of the extremities to prevent complications.
Diabetes Guidelines care of the feet involves the examination and taking not of certain indications of infection daily. You must check your foot carefully from top to bottom. If it is very hard for you to do it, have someone check your feet for certain signs of impending infection. You must check whether there is a break in the skin or dryness that can lead to breakage. Feel for warmth and tenderness and see whether you can see any redness on a specific portion of your skin. If you can notice any blisters, just cover it up so that it will not be infected.
Included in the diabetes guidelines in taking care of your feet is to wash and clean them with warm water regularly. It helps take away any bacteria that are harbored. Make sure that you will not rub it to prevent any break in the skin caused by friction. Just pat it until it is dry. After that, apply moisturizers or lotions to prevent any cracks.
When you cut your nails, you must be very cautious not to include the skin of your feet. Make sure that you cut it straight across and use a nail file. However, if you are unsure of what you are doing, ask someone to do it for you or to be sure, seek the services of a foot doctor. Lastly, wear shoes and socks that are comfortable for you. You must not wear tight fitting shoes or those with heels. Make sure that you do not walk around barefooted.
These are the diabetes guidelines that you must follow in order to prevent any complications especially foot ulcer that can lead to a gangrenous foot when not taken cared for immediately. Management of the effects of diabetes on circulation includes proper foot care. It is your responsibility as a well informed patient to do what you need to do.
Diabetes news includes the growing number of diabetics around the globe who undergo amputation of a part of the extremities due to poor management of wounds. With a medical condition that involves poor blood circulation, foot care is very important. Learn more about other important things to remember for diabetics at http://diabetesguidelines.org/.
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