So what should you do with this new health system?

So what should you do with this new health system?

We are offering some general rules:

Understand what is happening in the health system now, so that you will better understand and know the procedures of the health firms that are constantly changing along with the pressures they are subject.
Know your condition so you can ask and focus on areas where you and your doctor should focus his attention and soon to seek help from a specialist-so you can control your diabetes.
Be your own lawyer. Meet the recommendations of the American Diabetes Association for preventive care and active search, and ask your doctor when it is time to follow those recommendations. Try to find a health care provider that supports (pay for) monitoring of these recommendations. Do not worry if you need to write a letter to your provider arguing why it is necessary that they will pay any procedure that you require and that they do not cubren- transfer to another physician or an educational program for example. Include in your argument any research that supports the need for the transfer, and be sure to mention that the insurance company will benefit if the referral to another doctor decrease your risk of developing medically more costly long-term problems.
Choose your doctor wisely. Find someone who is knowledgeable about diabetes and who are interested in working with you to control your disease.
Make sure your general practitioner is able to periodically refer you to a diabetes specialist or other specialist, or educational programs to help with more complicated problems.
If possible, be prepared to pay for some things out of pocket, particularly diabetes education, a second opinion given by a doctor who is not in the health system.
When possible, choose a health plan that allows greater freedom in choosing their doctors and to pay for the care you need.
Do not worry if you should express concern when he questions the quality of care offered.
The Changing physician performance:

Currently, the world of medicine is very specialized, however, efforts to keep prices are putting pressure on general practitioners - family physicians traditionally to provide the greatest care possible to patients because their care it is the least expensive. However, during the care of your diabetes may require medical needs a primary care physician and a group of professionals who work with their knowledge when needed. Dr. Richard S. Beaser and Joan VC Hill, RD, CDE described in the book " Joslin's Guide to Diabetes Care" "If possible, patients with diabetes should seek a medical environment where the disease is controlled by a professional team, including experts in important areas of their overall care. " This team should include a general physician, a diabetes expert who is usually an endocrinologist, a dietician, an expert nurse educator, an exercise physiologist and someone who will provide advice and psychological support when necessary. Other members may be added as necessary to treat or prevent complications.

His desire because diabetes is managed by a team of specialists-and the desire of his insurer, on many occasions, that most care is offered by the doctor generally can be contradictory. "Some believe that these needs are in conflict," describes Kenneth E. Quickel Jr., MD, president emeritus of Joslin in Boston. "But in fact, the patient with diabetes receive the best and most effective long-term care when the general practitioner and the team of specialists work as a team."

The doctor as traffic officer

Your general practitioner has been trained to treat you as a person of integrity and to treat a variety of medical problems such as colds, flus, monitoring cholesterol and control diabetes. This person works as a traffic officer, in many ways, coordinating their comprehensive medical treatment.

But besides acting as a traffic officer, this doctor also works in many health insurers as the gatekeeper, handling day to day health needs and regulating the flow of patients to the most expensive forms of care. In essence, the general practitioner works on his behalf and that of your insurance to ensure that you receive the best medical care in a way that does not lead to higher costs. Often, the insurance payment to general practitioners is limited to how effectively your doctor may reduce the use of expensive tests and services- and the doctor may be penalized for an abuse of specialists and effective testing.

"Elliott P. Joslin In 1916 wrote that" the number of cases of diabetes is so great that it is clear that their care rests in the hands of general practitioner. It is ridiculous to expect that treatment of diabetes is under the constant supervision of a specialist. Dr. Quickel. Notes, while the role of goalkeeper is a reality, has always been important that the general practitioner working closely with specialist diabetes. The selection of an excellent general practitioner is so important for a patient with diabetes as choosing a diabetologist or endocrinologist excellent addition to ensure that the two can work together.

Diabetologists and general practitioners

Diabetes programs of some health insurers, specialists are registering as general practitioners and diabetologists as to allow patients to choose a diabetologist as your general practitioner. This is due, in part, to the fact that most are trained diabetologists first general internal medicine or pediatrics before receiving their training in diabetes and endocrinology. Another reason I do this is because the dividing line between general medicine and diabetes is not clear. In medical practice in Boston, some of the Joslin diabetologists are recorded as general practitioners in some health plans for this very reason. "Physicians Joslin served as general practitioners for patients over the last 50 years or more, because diabetes is a disease that lasts a lifetime and it affects many aspects of a person's life," notes Dr. Quickel.

Other insurers do not allow diabetologists -a despite having certification to practice general internal medicine register as general practitioners. In some cases, they insiten that specialists associated with a medical school are classified as "tertiary care physicians," which limits patient referrals. Insurers perceive that these specialists and institutions where they hospitalize patients are expensive. Thus a physician at Joslin be classified as a general practitioner in a plan and as a specialist third level on another system.

"In a perfect world, our primary function is to serve as experts in diabetes and leave the primary care general practitioners," said Dr. Richard Jackson, a senior physician at Joslin. "But because patients demand and need sometimes more of us than insurers provide them if we only we affiliate specialists, we also we affiliate as general physicians."

The ideal

The ideal scenario is that you identify a general practitioner who knows the management of diabetes, is interested in sickness and knowing their limitations refer you to other experts to receive additional care when needed, despite the penalties that this will Truck with the insurer when the doctor made the reference. "Most doctors will not allow insurers to interfere when a patient needs to be referred only because they offer a small monetary reward, says Dr. Quickel. "But the general practitioner should know a lot about a no-number of diseases and different conditions. He or she can not be updated with the most recent management protocols as can be, the diabetologist, because their role is to know much about this disease and its complications. This means that the general practitioner can handle most of your medical problem - including many of those around the diabetes-. But at one point the general practitioner should seek help from a diabetologist if management has not been efficient as it should be.

"What we're looking for is a holistic approach, focused on preventing problems" says Dr. Jakson. "If we focus on preventing problems rather than acting on them when they occur, we can really lower the cost of health care by limiting the amount of money that patients need to spend in specialists who must treat costly complications such as arterial disease, heart attack, a stroke or other problems. "

Understanding Your Disease

How do you know that your diabetes is being managed properly by your doctor? "Knowing their disease," says Dr. Hill, who is the director of educational services at Joslin.

Here we present a number of important questions you should answer when you are evaluating the management of their diabetes in general and as has been the interaction between general practitioner and specialist in diabetes in managing their disease team. "If you do not know the answers to these questions, ask the person providing him with most managing your diabetes (either your general practitioner, a specialist at Joslin, a nurse practitioner , or ólogo diabetes another EU institution) the next time you have medical control, "says Hill.

Also provided are good questions to discuss with your general practitioner or the New diabetologist if you are going to change doctors because of changes in your health plan says Jackson.

Be your own lawyer

If you do not know the answers to all these questions, discuss them with the clinician more involved in the care of their diabetes during future visits. Then ask yourself how you felt when I was asking these questions. If you felt comfortable as the conversation continued, this may suggest that the doctor was listening to their concerns and not let him know he was upset because he was being questioned about his medical practice. If, on the other hand, felt he should stop asking as soon as it started, it was because the doctor either openly or secretly - he was sending messages because suddenly he felt uncomfortable when questioned about his knowledge about diabetes? or because it bothers you question a traditional figure of authority?

When shopping for health-insurance "make sure you receive the services for which they are paying" - says Dr. Jackson.

What to do if you feel uncomfortable?

Many people feel uncomfortable when they have to discuss this with your doctor. "Many of us have been brought up to believe that we can not ask the pastor or doctor, they take care of us and it is better not to ask a lot," says Hill. "But studies such as the Diabetes Control Test and show its complications (DCCT) results that careful control of blood glucose levels reduces the risk of complications. At this point it is very important to ensure that members of the diabetes management team know what they are doing-and that includes you. You, the patient, is the most important team member handling your illness. As a result, you have a right to know that the other team members are working with you, and who have the skills to make your life with diabetes is manageable and is free of risks as much as possible ".

What to do if you feel unhappy with your health care provider, and your options are limited to physicians associated with your insurance company?

"Ask," recommends Hill. "Attend association meetings local diabetes and try to find other patients with diabetes who may have found a good general practitioner and / or a good diabetologist that may be covered by your insurance. Interview general practitioners of his friends They do not have diabetes but said that their doctor is accessible and seems to have knowledge of a number of medical institutions. it is possible that such a doctor is knowledgeable about diabetes- or has- not be willing to refer you to a specialty was, and will continue to give general care unrelated to diabetes "

How can you help your employer?

You may consider express the human resources department where he works on his disagreement with the medical care they are receiving under the health plan offered, particularly if the health coverage has recently been changed and you feel that your care is suffering from this reason. While insurers, on average, have a customer enrolled for three years before this individual change insurer or change jobs, statistics show that your employer will use it for much longer. Poor delivery of health services results in the impoverishment of their job performance, absenteeism and low productivity, not to mention the high costs for the insurance if you develop complications. Your employer will probably be interested to know if you are concerned about the quality of your medical care as a result of changes in health delivery. And the insurance will be more interested in hearing the voice of a quiene employer is paying for health insurance for hundreds or thousands of workers, rather than listen to you, who represents one person.

More importantly, your employer may be interested to know how they can continue to offer health plans at low cost that meet the needs of most of its employees, while offering additional programs at work, which will help meet the needs of workers with diabetes, or other problems such as obesity, high blood pressure, high blood lipids, etc. You can propose to the human resources department to organize days of nutrition in the workplace and free of charge to people with such problems; or to offer weight loss programs or exercise in addition to the basic health program, which will help you develop an exercise program or weight loss at low cost and it will help you manage your diabetes; or even better a stress management program to help workers to lower blood pressure.

Be prepared to pay out of pocket

People should know know what, having health insurance does not involve a complete health service free. Patients with diabetes must always pay for their education in diabetes-and in some cases they end up frustrated at the end. "An important component to be an educated consumer is to have a good education in diabetes," says Hill. "While insurers have increased coverage of educational programs in diabetes, you probably have to pay some of the cost."

Also, if insurance should be changed, this change in the provision of health may make you want to have the management team their previous diabetes. Surprisingly, you may be at a crossroads where you do not get the transfer you want to see again the diabetes management team you prefer. Or the effort involved in managing your diabetes and all the other things that are happening in your life leave you without enough energy to make all the necessary search for that transfer. Or, admit it, some people feel uncomfortable when they complain in their own name. Or your work environment can make you feel uncomfortable about having to mention the health service that receives the human resources department of your employer.

If you are in any of these situations, then you should, if possible, set aside an amount of money once a year for a good specific medical evaluation of your diabetes- medical examination, laboratory tests, diabetes education, exam vision) with specialists of their choice, even if they do not belong to your health plan. Think of it as increasing the care you receive through your insurer. "After all, to make sure your car always works well you should invest $ 500- $ 1000 a year in oil changes and basic maintenance that exceed the guarantee of their car," says Dr. Jackson. "Why not do the same for your own body?"

This can help you in two ways: first, it can help to reaffirm that diabetes care is where it should be, and can provide information on how you can improve your diabetes care. Second, if problems are discovered even with your current insurance, you can use this information to call attention to your doctor and insurance to improve the service. "Maybe you can parlay the information the information into an out-of-plan referral to the physician team you wanted to see in the first place, or some additional action (ie specialty referrals) Within the plan to physicians WHO May be categorized as Super specialists, only to be Referred to in The most dire of Circumstances. "

Choosing your insurer?

Despite the changes in the market, most patients insured through an employer think they have options to choose their health coverage. What should evaluate the health insurance plans when to make the annual selection? What should be evaluated in a health plan if you are going to change jobs and one of their insured relatives have diabetes? How minimizes agitation discomformidad in its health insurance? We offer below a series of questions to ensure that you know the answers when evaluating health insurance plans:

Doctors who are managing my disease are included in the health plan?
If they are, it will be easy or difficult to obtain transfers to these specialists? How easy, in general, you can get a transfer ?.

Seeing the name of your doctor on the list of providers may suggest you podráverlos whenever you want, as used to be in the past. This can not happen now. Some plans, for example, publish lists with names of doctors who belong to its health network. But they are providers of tertiary level, which means that you can only see them if and only if recommended by your general practitioner and director of the health plan approves. "Getting this approval is a lengthy process and your request may be denied after all. Instead, the plan will provide coverage locales- an endocrinologist specialists in their community not associated with the doctor you want to see, although the doctor you want to see this in the area.

So before signing up for a new health plan, not just check the book of medical providers to see if their specialists belong to this network service. Also ask specialists directly how difficult it is to get a referral using the health plan you are considering choosing.

Other questions you should know the answer:

How much you must pay copayment and how much is the deductible health plan that will choose? What is the difference when I see a doctor outside the network?
The insurance covers things like diabetes education? Programs for weight loss? Exercise programs? Individual consultations with dietitians, diabetes educators or certified? The deductible includes the cost of these services? The insurance plan includes costs associated with these programs at any institution, or only in certain places?
The plan covers the costs incurred for purchase of equipment for monitoring, lancets, controls, etc.? Which includes drug insurance? Covers insulin and syringes?
Provides support mental health? It will cover things like diabetes support groups or individual counseling? How easy is it to get a referral to one of these programs through this health program?
If the patient with diabetes to be affiliated presents a complication associated with the disease, the rules governing the pre-existence of certain diseases can limit coverage by the insurer in such complications or care of the disease itself.
The patient with diabetes consider the possibility of pregnancy while in this health plan? If so, the health plan will cover the most common tests and medical visits required? Who are gestational diabetes specialists affiliated with this health plan? That clinic is expected that the baby will be born? And what neonatology services are available there ?.
Remember that every insurance plan has a no n umber of sub-plans that sells insured employer groups. The only way you'll know for sure if their care at Joslin obtained will be covered, for example, is asking the insurer directly.

"The search for a health plan is not like it used to be," said Hill. "Patients should be more aggressive consumers so they can get the care that previously was obtained by fee based health insurance and accounts their doctors. This represents a lot of work. But now, more than ever, only the intelligent and informed consumer who decides to be a little aggressive get the best health service ".

By Tonywankha

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Floods - Healthcare

Floods - Healthcare

Flooding in natural and human causes are combined. Among natural factors include geographic and weather. The increased precipitation is another natural factor that makes subsurface reservoirs are saturated and thus raise the water table, causing major flooding. On the other hand, the lower height of the right bank of the Parana and Paraguay rivers, allows the overflow of water to the provinces of Formosa, Chaco and Santa Fe. The Sudestada, with its strong winds, preventing the drain of the rivers Parana Uruguay and causing flooding in the Delta area.

Among the causes of human action, floods occur before the uncontrolled growth of cities, to the inadequate and poor maintenance of storm drainage system, filling and occupation of coastal areas that hinder even more drainage, among others.

Prepare to raise those furniture, appliances, mattresses or clothing that may be affected by water.

Pick up litter, debris, branches and leaves his house and street to avoid during a storm, flood or heavy rains, drains and other water escape routes from your home clogged.

If possible, seal leaks possible that you already know with some waterproof material.

Make sure all family members know how to cut water services, electricity and gas.

If there declared ALERT: Stay informed of warning notices, instructions disseminate forecasts or municipal or provincial authorities through the media. Further:

Prepare a waterproof bag containing essential items for family use (warm clothing, rain boots, stockings, a small portable radio, etc.) and count with first aid kit with essential medicines for family members.

Have a supply of drinking water and nonperishable food. Store food in high places to prevent water from the scope and ruin.

Prevent children, the elderly or illness or disabilities are home alone.

Cutting water services, electricity and gas.

Identify the high places of the area as well as temporary shelters and routes to reach them.

You should try to stay away from rivers and streams already see overwhelmed or are at risk of overflowing.

Please get phone Fire, Civil Defense, Red Cross and Hospitals.

Recommendations during the event
In enclosed spaces (home, work, other): Evacuate area and position yourself in critical areas or high roof or upper floor of the house. If there is no possibility to access higher ground in the home, do not risk and evacuated to a temporary shelter.

For health care in public: stay away from low areas or flood-prone areas and walk up and free of water. Otherwise, wait for lower the water level to mobilize. Never attempt to walk across a stream of water that exceeds its knees. It is important to prevent electrocutions, so stay away from power lines, poles or downed power lines.

For health care at school: if evaluation in school (or work), do it in an orderly manner. Always follow directives of those designated to coordinate emergency situations.

Care when driving: do not drive the car through a flooded area or try out once the water is already at a high level. If a power line falls on your car while you are driving, stay inside the vehicle and continue to drive away the cable. If the engine stops, turn off your car by turning the ignition key and off.

Warn others not to touch the vehicle and call your local power company and emergency services.

Water care: potabilice water, boiling for three minutes or by placing two drops of bleach per liter of water and let stand for 30 minutes before use.

Recommendations on vaccination against floods - download

Recommendations after the event
Care for the return home had to be evacuated if: check if the house is ready to be inhabited again. To prevent electrical accidents, try to go home to daylight for not using electricity. From the first entry into the housing, it is desirable that the electricity and gas are turned off to avoid fire, electrocution or explosions. Also, make sure that facilities, all electrical equipment and appliances are completely dry before putting them to work.

Household hygiene and disinfection: After the flood, make sure you dry and well ventilated rooms. Clean and disinfect with bleach walls, floors and other household surfaces such as countertops, cabinets, refrigerator, children's toys, etc. Use a cup of bleach (about the size of a cup of coffee) every 10 liters of water (1 bucket).

Upholstered furniture spray some disinfectant and let dry in the sun.

Wash with hot water and detergent all clothes worn during the cleanup. These clothes should be washed separately from uncontaminated clothes and linens. Wash with hot water and detergent clothing that has been in contact with contaminated water or flood.

After completing the cleanup, wash your hands with soap and safe water.

What to do with food and water: if water supply is affected by the effects of the flood, or take mineral water from a safe source. You can also become safe water that comes from other sources (well, network, etc.).

Place 2 drops of bleach per liter of water, and let stand 30 minutes before using. You can also boil for 3 minutes and wait for it to cool to consume.

Reinforce basic hygiene habits. Always wash your hands with soap and water that has been boiled, disinfected or known to be safe: before preparing food; after going to the bathroom; after performing cleaning activities at home; after touching things around the house that have been hit by flood water or sewage.

Check out all food that has been in your home and remove those whose containers have been badly damaged by water. Throw away food that have lost the cold chain due to cuts in electricity supply.

It is important that baby bottles and pacifiers replace baby. If you are breastfeeding your child, keep doing it. Breast milk helps build defenses in children. Wash new safe water bottles.

Also wash fruits and vegetables with safe water.

In order to reuse them, wash the glasses, dishes and other kitchen items with plenty of detergent and, if possible, rub all over with a brush to avoid waste. Discard wooden utensils and plastic. To disinfect metal pots and utensils, boil them for 10 minutes.

If there is any particular health risk: it is important to be aware of snakebites and contact with other vermin. Snakes usually appear during floods when transported by aquatic vegetation. If you can not get away in time, refrain from sudden movements. Do not touch in any way a snake.

By Suradiwat

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What is health care at home?

What is health care at home?

Many people receive home care because of illness, recovering from surgery, disability and other disorders. This guide examines the work with assistants for health care at home, personal caregivers and others who provide personal care.

Services health care at home can offer you and your family a trained medical and personal care assistant. Note, however, that health care at home is limited to specific tasks.
For information about the types of agencies health care at home, insurance coverage, choosing an agency and the referral process, we recommend you read the guide for companion care home health: a guide for the family caregiver .

What are the types of personal care?

Many different people provide direct care at home. Between them:

Attendees for health care at home and the personal care attendants primarily provide personal care, including care for feeding, bathing, walking and dressing, as well as activities related to independent living, such as shopping, preparing food and go to the laundry.

Attendees for health care at home are allowed to do certain tasks relating to health and personal care. They can take the temperature of the patient and control blood pressure. They can change a dry dressing (no one with blood or pus), move your arms and legs and help the patient exercises to expand the range of motion, as simple stretches. In general, they are not allowed to give medication to the patient; each state has different rules regarding what can and can not do.

Note that an assistant care home health in general is at home only to provide patient services, and are not supposed to provide services to the spouse or other household inhabitants. If you pay from your own pocket, you can assign tasks to include other household members. (Some managed care companies include a child care if the patient is the family head.)

Personal care assistants share many of the same tasks as assistants for health care at home. The differences between the assistants for health care in the home and personal care attendants depend on the requirements of each state in terms of training.

Many people believe that personal care does not require many skills. That is not like that. Some tasks can be very difficult, as bathe a person with dementia or move (move) to a heavy patient.

Home helpers can assist your family with light housework, laundry, small grocery shopping and food preparation and other household tasks that would allow the family to remain at home. House aides generally do not provide personal care such as bathing and dressing the patient, and are not housekeepers. Heavier tasks and complete housecleaning in general are not made ​​by the house helper.

For information about how to find and choose home care also read Care Home Health: A Guide for the family caregiver .

If you hire agency staff or paid to a worker of his own pocket, make sure in advance to understand the role of each person. Know what you can do and what each person can do.
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What should I know about working with an assistant for health care at home?

If you hire assistants through a private agency, make sure in advance which includes the role of each person. Know what can and can not do each person. Also you want to be clear on what you can and can not do. Each situation is different and will need to agree the details.

In general, participants spend more time with his family nurses or physical therapists. When an assistant for health care at home comes home for the first time, plan to spend some time together. Show him the house, and explain the routines that your family prefers. If you do not live in the same home as your family, you may want to call during the day to stay in touch and regularly go visit without calling first.

Other things to think about:

If you need the wizard can drive your car, check the history of your driving record and contact your insurance company to make sure your vehicle is covered in case of an accident. If the person drive your own car as part of the work, make sure the car is safe and secure check.
Terms and expectations: If you hire privately, be clear about your expectations. Write them in a simple arrangement. Include times and that have agreed to pay, if the schedules and the cost of food are included, including vacation time and an alternative plan if the wizard can not arrive on time or have to cancel. These situations arise, but if you have an alternative plan, will be better positioned to make other arrangements. If you are using the services of an agency, make sure you understand its terms.
Emergencies: Leave a list of emergency phone numbers, including your family doctor and all phone numbers where they can contact you. Place the list where anyone can find it easily. Develop an emergency plan, and make sure all know. If you are using the services of an agency, you should ask them about their policy emergencies. For example , is who should be called first in case of an emergency, and when an assistant is supposed to call 911?
Valuables: As you would with any foreign worker who enters your home, keep private papers, cash and valuables in a safe place.
Wizard relationships: They are not allowed to agency workers have visitors. If you hire your own, you should discuss whether or not he have visitors. Also talk about any other personal issue that could interfere with the care that will provide your family.
The relationship between you, the participants and their family is a relationship business. You and your family can take affection to attendees, and this is fine, but it's still a business relationship. attendees are hired to carry out a service. Do not expect to do more than they are allowed or what they are prepared to do. On the other hand, know when to set limits, even when that limit is not obvious. It needs to be clear about what behaviors you do not consider acceptable.

Should I hire someone who does not work for an agency?

You may need or want to hire more help for home care that will pay your insurance company. Or you may need help after exhausting insurance coverage. If your family still needs help from a health care home exhausted after coverage, you may want to continue using that agency and pay them directly. In these cases, you must pay with money from their own family.

Remember that when you hire someone on your own, also assumes the role of supervisor and financial manager. It could not have an alternative plan when the wizard report sick or have a personal emergency. If you will be notified, you can hire a replacement, but often these programming changes happen at the last minute. You can bring problems for you and your family routine. These issues can be resolved, but keep them in mind if you are considering hiring someone on their own.

You may know someone reliable who can do the job and already knows his family. Or you can place an advertisement in a neighborhood newspaper or an online service, or ask your friends and coworkers. Be sure to select all candidates by phone telling them about your family, the kind of help you need and basic job description. Then you can interview in person only who seems to be suitable for the job.

Have some identification and references. Be sure to call these references and ask about work habits, attitude and reliability of the person. If the person is an assistant for health care at home, check with the licensing authority of the state to ensure that It is certified. If the person is not an assistant for health care at home, then you can use terms like personal care attendant, home helper or companion. Some states have a certification for personal care assistants and home aide. The "companion" or other titles are simply personal choice; there are generally no accreditation, state licensing or certification.

Some states maintain a database or registry, which contains lists of nurses and assistants for health care at home. You can call these records and request a list for your location, or information may be available on the Internet. In some states, these records are regulated and licensed. By using these records, family caregivers should ask specific questions about the training and qualifications of the worker. Check the website of the Health Department of your state to see if there is a record.

The strength of family care at home can be for fear of losing independence.
Make a list of tasks you want to do the person, and make sure you have the training or experience necessary for such tasks. For example, if your family has memory problems or tends to ramble, you want to make sure that the person has training and experience working with people with similar needs. You also want to make sure that the person has patience and not be upset by the behavior of his family.

What kinds of problems can arise and how can I solve?

Regular meetings and open communication can help solve problems before they arise. If the situation can not be resolved, then you need a different worker.

Two of the most common problems are resistance to outsiders and cultural differences.

Resistance to strangers
Many older people resist the idea that they do not know people who come to your home and this may include attendees for health care at home. They may insist that they do not need such care, who can take care of themselves to perfection and that you, as your relative, is the only person I trust. If this problem is not resolved, your family may dismiss the worker or make it work so hard to give up.

Part of this resistance comes from fear of theft, abuse and other ills. Most, however, probably comes from the fear of losing their independence. This is common and there is no simple solution. However, you can talk to your family about the tasks for which no help is needed. Tell your family to have help actually allow you to do more things and can avoid health problems in the future.

Cultural respect is important for everyone. Be sure to discuss differences in language and food, among others, in advance.
You can also remind your family of your other responsibilities. Your job, your family and your children also need. Explain that attendees make it possible for you to be a good child and a good father (or whatever the combination of relations). You should not feel guilty if you can not provide all the care. And should not assume that it can provide all care for a long time, no matter how much you want or feel it should. You can not help your family if you are exhausted, anxious or overwhelmed.

Attendees for health care in the household experienced know how to handle patients who do not want their help. They do not take the rejection personally. Some will be strong, while others gently distract the patient. You may have to try several assistants until you find the one with a style that best suits your family. Sometimes what starts badly ends well when the family and the worker learn to understand and appreciate each other.

Cultural differences
Cultural respect between health care assistant in the home and family is really important. Start by names. Ask the assistant if you want to be called by his first name or his last name, "Mary" or "Ms. Jones ". At the same time, tell them how you want and your family to be called. Some people are quite informal at this point. Others, particularly the elderly, do not like being called by his first name. Also, many people do not like to be told "affection", "love", "Mom" or nicknames.

You can avoid many problems if cultural differences are addressed from the beginning. Often, however, they are only addressed once the problem occurred. Many attendees are women who belong to minority groups of immigrants.

Good nutrition is essential for good health. As people age, they may find that foods previously enjoyed no longer have the same taste. Or they may be sensitive to odors that are unfamiliar. If the health worker in the home kitchen spicy food or have a strong smell, your family may refuse to eat them. In this case, you should talk with the worker and his family to develop a food plan that you both agree.
So are many of the patients they care for. If your family does not speak English, ask an assistant who speaks the same language. Many attendees who speak different languages ​​at home, can speak and understand English well enough to communicate with his family.

Other differences may arise that are related to food, religious practices or daily routines. If you and your family follow certain religious practices and other practices, you should explain them to the audience. They may have care of other patients of their religion and may assume that their practices are the same when in fact they are not. At the same time, the worker should ask if there is something you should know about their culture and religious practices - things that can affect your ability to work. Have respect for mutual cultural differences can really create a link between the worker and his family.

By Rosaki

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What you can do to maintain your health

What you can do to maintain your health

The affected lot. All the major causes of death such as cancer, heart disease, stroke (stroke), lung cancer and injuries can be prevented by lifestyle and choices you make.

Do not smoke or use snuff derived products.
Smoking and use of snuff products are very dangerous habits. Smoking causes 440,000 deaths a year in the United States. There are more preventable diseases (such as emphysema, cancer of the mouth, throat and lung and heart disease) that are caused by the use of snuff more than anything else. The sooner you stop smoking the better.

Limit the amount of alcohol you drink.
This means no more than 2 alcoholic drinks per day in men and more than 1 drink per day for women. One drink is 1 can of beer (12 ounces), a glass of wine or a 4-ounce glass measuring liqueur 1 ounce.

Too much alcohol can damage the liver and contribute to the development of cancers such as throat and liver. Alcohol also contributes to deaths from car accidents, murders and suicides.

Eat healthily.
A healthy diet has many health benefits. Heart disease, certain cancers, stroke, diabetes and damage to the arteries may be associated with what you eat. By choosing healthier food options you can also lower your cholesterol and lose weight.

Lose weight if you're overweight.
Many Americans are overweight. Being overweight increases your risk of high blood pressure, high cholesterol, diabetes, heart disease, stroke, some cancers, gallbladder disease and arthritis in weight - bearing joints such as the spine, hips or knees. The high-fiber diet low in fat and doing regular exercise can help you lose weight and keep it off.
Workout.
Exercise can help prevent heart disease, high blood pressure, diabetes, osteoporosis and depression. You can also help prevent colon elcácner. the derrae and back injuries. If you exercise regularly you will feel better and keep your weight under control. Try to exercise for 30 to 60 minutes 4 to six times a week, but remember that any amount is better than nothing.

Do not use: sun or tanning booths.
Exposure to sunlight is associated with skin cancer is the most common cancer in the United States type. It is best to limit sun exposure and wearing clothing and hats for sun protection when exposed to the sun. The sunscreen is also very important. This protects your skin and helps prevent skin cancer. Be sure to use sunscreen throughout the year on skin that is exposed as the face and hands. Use a sunscreen with broad spectrum at least sun protection factor, SPF (SPF) of 15 and one that blocks both ultraviolet A and B.

Practice safe sex.
The safest sex is between 2 people who are only having sex with each other and do not have any infection that is sexually transmitted (STI) or share needles to inject drugs.

Use latex condoms and spermicidal cream (a product that kills sperm) or a spermicide gel. Talk to your doctor about getting tested for STIs every year.
Control your cholesterol level.
If your cholesterol level is high, keep on eating well and exercising. You can also lower your cholesterol level by limiting the amount of cholesterol you eat and quitting smoking.
Control high blood pressure.
High blood pressure can increase your risk of heart disease, stroke and kidney disease. To control it, lose weight, exercise, eat less salt, drink less alcohol, smoke and take medicine if your doctor prescribes it.

Stay informed with their shots.
Adults need a booster shot for tetanus and diphtheria every 10 years. Your doctor may also replace a Td booster DTaP that protects against whooping cough. You should also get a flu shot (influenza) every year. Ask your doctor if you need other vaccines.

Make time for breast health
Breast cancer is the second most common cause of death in women. Between 50 and 74 years, women have a mammogram every 2 years should get tested for breast cancer. Women who have risk factors for breast cancer such as family history of breast cancer may need to have mammograms more often or start hacérselas before.

Perform Pap tests regularly
Cervical cancer in women can be detected by performing Pap tests regularly. their first Pap test should be done at the end of three years they started having sex. a Pap test should be performed at least once every 3 years, unless your doctor suggests that you need to do it more often.
Ask your doctor about other tests to detect cancer.
Adults over age 50 should ask their doctor about a screening for colorectal cancer. Men over age 50 should talk to their doctor about the risks and benefits of being screened for prostate cancer.

I should get a complete physical exam every year?
Tests to determine the health are replacing annual physical exam. Instead of each person make you the same examinations and tests, you will only make those that are appropriate. Talk to your family doctor about your risk factors and what examinations and tests are appropriate for you.
Have essential health benefits and preventive care services work for you.
The essential health benefits are a group of service categories of health care that should be covered by certain plans, from 2014.

If you buy a plan through the health insurance market, your insurance will cover prevention services and at least 10 essential health benefits that the law requires health care at low prices (Affordable Care Act, ACA). All plans private health insurance offered in the markets provided federally offer the following 10 essential health benefits: Outpatient services (outpatient care you get without being admitted to a hospital) Hospital emergency services (such as surgery) Maternity and newborn care (care before and after your baby is born) mental health services and use disorder chemicals, including behavioral health treatment (this includes counseling and psychotherapy) Devices and habilitation and rehabilitation of drug prescription (services and devices that help people with injuries, disabilities or chronic conditions to gain or regain mental and physical skills) laboratory services prevention and wellness and chronic disease management pediatric services state markets will also be required to provide 10 EHB, but the list of benefits may differ.

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