15
Mar

Rehabilitation For Alcoholics

Chronic drinking is associated with neurocognitive deficits due to neuropathological changes in the structure, metabolism, and function of the brain. One of the consequences of neuropathological brain abnormalities in the cerebellum of alcoholics has been impairment of motor functioning. A new study using functional magnetic resonance imaging (fMRI) during a finger-tapping exercise has found a weakened relationship between frontal lobe and cerebellar activity in alcoholic individuals.

Chronic alcohol exposure most commonly causes deficits in visuospatial skills and problem solving, while problems with learning and memory can also be observed. A commonly unappreciated deficit is in motor functions: for instance, balance when standing can be affected by dysfunction of the cerebellum as can the ability to perform rhythmic movements.

Researchers used fMRI to examine 10 uncomplicated chronic alcoholic patients after five to seven days of abstinence and once signs of withdrawal had lessened, as well as 10 matched healthy controls.   The method helped researchers examine functional connectivity between cerebellar and cortical brain regions.

Although it may seem an unsophisticated movement, finger tapping is a simple, rhythmic movement that can be used to study the function of the parts of the brain that are often damaged by chronic drinking, such as the cerebellum and the frontal lobes.

Weaker relationships between these regions in alcoholics might reflect direct injury to one or both of these parts of the brain, disruption of frontal-cerebellar neural pathways that connect these regions, or some sort of compensation for injuries elsewhere in the brain

Researchers explained that while they found that the alcoholic patients could produce the same number of finger taps per minute as did the normal controls, they employed different parts of the brain to do so. This suggested that alcoholics needed to compensate for their brain injury. However, if the task becomes more complex, performance may break down and alcoholics may seem impaired when tested. This is the big advantage of studying simple tasks that alcoholics can perform at normal levels.

While this study supports other research showing problems in the frontal-cerebellar brain circuits in alcoholic patients, Rogers said its major contribution is related to studying the simple tasks that

Now that researchers have fMRI available to help determine the areas of the brain that are activated in the performance of tasks, the study of simple tasks may also be very informative. Complex tasks clearly show abnormalities in fMRI, but it becomes impossible to determine whether the fMRI differences observed are due to the impaired performance or brain differences that account for the impaired performance.

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23
Jan

Therapy Cap Exceptions Extension Helps Long-Term Care Facilities

The Temporary Extension Act of 2010 (H.R. 4691) that aims to help unemployed Americans, including extending unemployment insurance and premium assistance for COBRA benefits, also extends the exceptions process for Medicare therapy caps to March 31, 2010.

The therapy caps were designed to put a limit on Medicare Part B reimbursement for therapy services. In 2010, this limit is $1,860 for physical therapy (PT) and speech language pathology (SLP) combined and $1,860 for occupational therapy (OT). Under the exceptions process, which was enacted in 2006, Medicare will continue to pay for therapy services in excess of the cap if the services are deemed to be medically necessary.

H.R. 4691 extends the therapy cap exceptions process through March 31, 2010, retroactive to January 1, 2010. Some nursing homes have been holding claims for therapy services provided on or after January 1 for residents who exceeded the cap, but qualified for an exception under previous law. These facilities may now submit those claims to Medicare.

Nursing homes who have submitted these claims before now and had them denied should ask their Medicare contractor to adjust the claims to add the KX modifier and ensure the appropriate exception applies.

Although the extension of the therapy cap exception process is good for providers, it is only temporary. If the process is not extended beyond March, many facilities will see declines in revenue.

If a resident goes over the cap, the facility can bill privately. But if the resident has Medicaid, this may hurt the SNF for reimbursement purposes.

In a statement released Wednesday, Larry Minnix, president and CEO of the American Association of Homes and Services for the Aging, commended Congress and President Obama for extending the therapy cap exceptions process and also called attention to the need for a permanent solution.

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18
Jan

Seniors With Disabilities Struggle

California’s low-income seniors with disabilities are struggling to remain in their homes as public funding for long-term care services shrinks and may be slashed even further, according to a new study by the UCLA Center for Health Policy Research conducted with support from The SCAN Foundation.

Should as much as $100 million in additional cuts be made to In-Home Supportive Services (IHSS) on Dec. 15, as proposed by the state Legislature, seniors with disabilities will lose crucial support systems that allow them to remain safely in their homes and out of nursing homes. This vulnerable group could face a 20 percent loss in the number of paid caregiver hours they receive, on top of cuts already enacted earlier this year.

For the study, researchers spent a year following and documenting the lives of a typical group of seniors with disabilities who are enrolled in Medicare and Medi-Cal and receive in-home and community care in Los Angeles, San Diego, San Francisco and Santa Clara counties. The seniors depend on fragile networks of paid public programs and unpaid help to live safely and independently at home in spite of already limited caregiving hours.

Aging safely and independently at home is not only a strongly held desire of most Americans; the U.S. Supreme Court’s decision in Olmstead v. L.C. and E.W. (1999) requires public programs to honor these desires when feasible, the study authors said.

The study found that the needs of seniors with disabilities are unstable and often unpredictable. The costs associated with these needs often become overwhelming for families. Older adults’ health and abilities change continually, sometimes unpredictably. Most of the respondents’ declines in health were slow to moderate, but for several, their health worsened dramatically in a short period.

For many seniors, their declining health and uncertain support also exacerbated existing mood disorders and other chronic mental health conditions.

Posted in Healthcare | 2 Comments
31
Dec

Understanding The Need For Physical Therapy

When a person is sick it is obvious and they know that they need to go to a doctor.  But there might be things wrong that they are not as aware of.  Perhaps a car accident has left them feeling less than perfect.  If so the doctor might recommend an appointment for physical therapy.

Choosing to visit a physical therapist could be the wisest course after an automobile accident or even surgery.  When our body is bounced around there can be damage that is not immediately noticeable.  Something that we put off as a minor inconvenience could result in long term damage.

Whether bones are broken or not you could have muscles pulled that may not clear up right away without assistance.  But accidents are not the only use we would have for a therapist.  There are many instances after surgery that physical therapy would be recommended.

Our daily life can also have an impact on our well being.  Overusing our hands can result in Carpal Tunnel Syndrome, requiring not only therapy but possibly surgery.  And we might tend to let exercising or playing get out of hand.  This could result in strains or more serious troubles with tendons and ligaments.

When this happens it might take more than a heating pad or ice pack to relieve the pain we are suffering.  With the right therapist you will begin a treatment plan based on your particular condition.  As your physical therapy progresses you will begin to understand how this is more beneficial than a pill or the cream you were applying would have been.

Another thing that will send a person to therapy is the natural aging process.  When we are less active things have a tendency to tighten up and stop working.  Exercising can restore the use of the areas that had become painful and allow full motion again.  There are many reasons to seek physical therapy.  The most important one is so you will feel better fast.

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28
Dec

Understanding And Changing The Therapy Cap

When laws are put into action it is done from a higher level.  The people on the lower rungs do not always have a chance to put in their point of view.  But in the end they will be the ones that will have to pay for it.  This includes the attempt to put a therapy cap in place.  

The way this will affect the common person is not only in how much they pay for a visit to a therapist but also how many times they will be allowed to see them.  To go see a therapist now you need to have a prescription from your primary care physician.  That doctor will decide if you need therapy and if so how many times you should be treated.  

Deciding to visit a therapist on your own is not an option.  You must first go to your doctor and describe your symptoms.  After his examination he might then authorize your treatment to a therapist of his recommendation.  Unfortunately, you do not even get to choose who you would see.

Under some cases the therapist will communicate the need for more visits.  Whether this actually happens or not is determined by your doctor, not you.  If, in his judgment, he decides that is not necessary it will not happen.  Instead of allowing you to receive the treatment to clear the problem completely he could prescribe an alternate method.

With a therapy cap in place there is the possibility that the six or eight visits that would be necessary could be reduced to three or four.  Or even less.  But one thing that could be increased would be the copay you are responsible for at each office visit.  And by increasing this, chances are a person would not be able to pay for all of the treatments that were prescribed.  

Therapists are generally placed in a specialist category which is what allows your insurance company to charge higher copays for their services and limit the visits.  And it is the reason that you can not access them directly.  This places the burden directly on the patient.

They are not able to gain treatment at a reasonable price for the type of therapy that would either alleviate or completely cure their condition.  By not granting them this, but placing a financial and health burden on them, they deny them the medical care that they need.  Instead they let them continue to suffer and tell them it is the way the insurance companies want it.

Posted in Advocacy | 1 Comment
26
Dec

Locating Jobs In Occupational Therapy

Choosing to work in Occupational Therapy is a major decision.  The job can be very demanding but will also be extremely rewarding.  You will be standing, bending, kneeling and lifting throughout your shift.  But while you are doing this you are helping another person regain their mobility.  

When a patient that you have been working with walks out of your facility feeling like a new person the satisfaction you receive is incomparable.  It might have been a hard struggle but you helped them through it.  They are now capable of resuming their life thanks to your assistance.

Before you look for the perfect job making sure you are prepared is a must.  Of course you have to pass your exams to be licensed.  And licensing regulations will vary from state to state so you will need to be aware of what is necessary where you live.  A master’s degree or higher in occupational therapy will also be required.  

If you have finished schooling and you meet all of the requirements you can proceed to look for a position.  This could be a very simple process once you have settled on the type of position you want.  And what kind of facility you would prefer to work in.

Hospitals post bulletin boards with openings.  This is updated as spots become available so routinely checking these would give you ideas of what they are offering.  Postings are placed in the local newspapers as well. 

Great ideas are also available on the internet.  You will find listings that are readily open or you could choose to work with an agency.  With this option you would also be able to choose staying close to your home or working in travel occupational therapy.  This would give you the advantage of a more varied resume offering more experience to the next position you apply for.  

While you are on the internet you can compare the many choices that are open to you.  When you see the type of salary you could make traveling it might affect your decisions.  Or you would have a better idea of what is open in the treatment facilities or extended care centers that you have thought about applying to.  

The more you know about the facility you would like to work in the better your bargaining point will be at your interview.  Learn as much as you can not only about the facility but about the level of work that will be required.  Find out if your education will meet all of their needs or if more classes might be required.  Be as prepared as you can be before you get called for the interview.

Posted in Job Tips | 1 Comment
23
Dec

Choosing Speech Therapy As A Profession

When people consider a medical career there are many different fields that can be chosen.  Not everyone has a desire to be a brain surgeon or even a doctor.  But they still have a dream of helping people.  After spending time going through the options presented to them speech therapy was settled on as the first choice.

 Maybe other forms of therapy were considered.  And they are all noble choices but for the most part they do not offer the level of treatment that you are interested in providing.  The thought of helping someone with a major condition is your prime motivator.  

This is an area that will give a lot of variety in the daily job.  And it is a field that can cover many different issues.  For some specialties you will deal with the same illnesses and treatments.  In this instance that is not the case.  The need for treatment may not even be the result of an illness.  

 A particular patient may need to see a therapist because of an injury to the throat that has damaged the voice box.  Or in the case of musicians they could have strained vocal cords while singing.  There are also certain surgeries that could be the cause of the distress.  

 Speech therapy could also be advised for learning disabilities that need to be treated so a patient can lead a normal life.  This could be a terrible lisp or stutter that would affect the way a patient relates to other people. It would be something that would also affect their self esteem.  You might also be required to teach a person to cope with swallowing conditions.

 As you learn the different facets to your new job you might become fascinated with what you have selected.  Understanding the difference between phonation and intonation is only going to be the beginning.  There is also resonance and respiration involved.  The decision that you made involves so much that you had never even dreamed of.

 But the most important part of this choice is how it affects the people that you will be helping.  For some you might help them clean up a bad speech impediment.  For others you might need to teach them to speak all over again.  And there will never be a moment that you regret your career choice.

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21
Dec

Choosing To Travel Or Stay At Home While You Work In Physical Therapy

There are advantages to staying in one place for your full career. When you work in the same facility you become accustomed to the tasks that you do. Many of them are repetitive, done on a daily basis. The physical therapy that you do consists mainly of the same type of treatments every day.

And you have worked with the same people for a long time. You are comfortable with them and you all work well together. Most of the patients that you treat are also regulars. They know you and you are aware of their condition and what will be expected when they come in.

But circumstances like this can also allow boredom to set in. You have settled into a comfortable rut. There are no challenges and there is nothing new on the horizon.  Occasionally you wish for a change but you do not want to leave your work. This type of work is very rewarding to you when you see someone begin to make progress.

You do not need to give up physical therapy to get a change or variety into your life. Do the same thing but take it into a new arena. By traveling you could meet new colleagues and even see a new type of patient. In different regions you could see many different needs for therapists.

Travel is an experience you might have thought about. Hearing of  jobs on cruise ships has had you wondering if that is something you would be qualified for. Or maybe you would prefer working at a resort in a tropical paradise. You could easily see yourself relaxing on the beach after a day of work and marvel at a beautiful sunset.

At your home facility you know all about your job. You also know what your advancement possibilities and financial gains are going to be. In two years time you have an idea of what you will be making if you stay where you are.

Traveling therapists are in high demand.  With options of short or long term contracts they are among the largest growing field in the profession.  The largest salaries can also be a result of this demand.  In addition to the salaries many bonuses are offered for various conditions.  Referrals, contract completions and even travel expenses could be paid for the right job.

All that is required is the incentive to make a change.  For those who work in physical therapy that occasionally desire a change.  Perhaps it is time to consider giving up the comfortable rut and branch out in your career.

Posted in Staying At Home Versus Travel | Leave a comment