Delirium is a challenging, underappreciated problem in the home care setting. When it is not detected early and managed effectively, delirium adversely affects outcomes and quality of life. Home healthcare nurses play a key role in the assessment, early identification, and management of delirium and in the support and education of patients and their family caregivers. This article reviews delirium and describes strategies for detecting and managing delirium in the home care setting.
Stewart M. Bond, PhD, RN, AOCN, is Research Associate in Nursing and John A. Hartford Foundation Claire M. Fagin Fellow at Vanderbilt University School of Nursing, Nashville, Tennessee.
Address correspondence to: Stewart M. Bond, PhD, RN, AOCN, Vanderbilt University School of Nursing, 505 Godchaux Hall 207, 461 21st Ave South, Nashville, TN 37240 (firstname.lastname@example.org).
The author of this article has no significant ties, financial or otherwise, to any company that might have an interest in the publication of this educational activity.
Reprinted with permission from Bond, SM. Delirium at Home: Strategies for Home Health Clinicians. Home Healthc Nurse. 2009;27:24–34.
15 Chronic Conditions for Medicare Special Needs Plans
Beginning in 2010, Medicare Advantage Special Needs Plans (SNPs) that serve Medicare beneficiaries with chronic conditions must meet new guidelines recently issued by the Centers for Medicare & Medicaid Services (CMS).
Special needs plans are a type of Medicare Advantage plan that serve only beneficiaries living in institutions, eligible for both Medicare and Medicaid, or living with severe or disabling chronic conditions. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) directed CMS to convene a panel of clinical advisors to determine the specific chronic conditions that met the MIPAA statutory definition of a severe or disabling chronic condition in regard to SNPs.
The panel's recommendations were based on public input and panelists' clinical experience, as well as the prevalence of these conditions among people with Medicare. The report can be found at www.cms.hhs.gov/SpecialNeedsPlans/.