The Impact of Assistive Technology on Quality of Life of Home-Dwelling People with Parkinson's Disease.

Parkinson's disease (PD) is the fastest growing neurological disease worldwide with more than 8.5 million people diagnosed. Assistive technologies for people with PD support the user to maximize independence. The purpose of this integrative literature review was to critique and synthesize the literature on the impact of assistive technologies on quality of life of home-dwelling individuals with PD. A literature search for studies on assistive technologies for people with PD with a primary outcome measure of quality of life was conducted. Of 156 articles screened for eligibility, 6 met selection criteria, including 4 quantitative studies, 1 qualitative study, and 1 mixed-method. Levels of evidence were scored as a percentage of quality criteria met, from 60% to 100% using the Mixed Methods Appraisal Tool. Using home monitoring devices was associated with significant improvements in walking, especially during freezing of gait. Evidence supports the use of assistive technologies including voice-activated technology, home automation, and home monitoring devices. Further research is needed to determine the effect of assistive technology on quality of life.

The Value of Home Health Physical Therapy.

The purpose of the Triple Aim is to improve population health, reduce healthcare costs, and improve the patient experience. These goals-to reduce cost while improving health outcomes and patient experiences have shifted utilization of services from other postacute care settings to the home. The purpose of this perspective article is to discuss how home healthcare services, and home physical therapy (PT) specifically, provide value to patients, caregivers, and payers to meet the goals of the Triple Aim. This article will substantiate the value of home PT and provide healthcare professionals with evidence-based information on the value of home PT.

Creating regional consensus for starting school later: a physician-driven approach in southern Maine.

In April 2016, several contiguous school districts and an independent high school academy in southern Maine voted simultaneously to start school later, beginning with the 2016-17 academic year. They became Maine's first school districts to implement the American Academy of Pediatrics'1 and the American Medical Association's2 health policy recommendations that middle and high schools should not start before 8:30 AM. Local physicians' presentations to school staff and parents on the medical evidence of the health benefits of a later start solidified early consensus. The action required special permission from the Maine Municipal Association to hold a joint school board vote, impacted approximately 6500 students across the region, resulted in no increase in busing costs, and took 8 months to implement after the first formal school board discussions.

Reflections of a hospice physical therapist: patient-centered care bringing quality toward end of life.

When discussing hospice care with physical therapy (PT) students, other healthcare professionals, patients, and families, they often ask: What do you do with a hospice patient? What goals can they actually achieve? What rehab potential do they actually have? My answer is: What does the patient want to be able to do? How does he or she want to improve his or her mobility? Hospice PT is all about the quality of the end of a patient's life.

Characteristics of the home health practice setting that attract and retain physical therapists: results of a survey and implications for home health.

An electronic survey of the home health (HH) section members of the American Physical Therapy Association (APTA) found that physical therapists (PTs) are attracted to HH for flexible work hours, the ability to work one on one with a patient, the functional setting, and salary, in that order. They continue to practice in HH because they take pride in their work, the relationships they have with their patients/caregivers, their ability to make autonomous work decisions, their control over their schedule, the relationships they have within the home health agency (HHA), salary, the relationships they have with peers, their benefits, and their ability to handle documentation demands, in that order.

Contacting bereaved relatives: the views and practices of palliative care and oncology health care professionals.

There are few data on the interactions of health care professionals with bereaved relatives. The objective of this study was to explore the current practice of health care professionals in oncology and palliative care in contacting bereaved relatives, and to elicit their views regarding the purpose, the optimal means, the format, timing, and content of these contacts. We conducted 28 in-depth, semi-structured interviews with health care professionals in Australia working in palliative care and oncology. The interviews were audiotaped and transcribed. Further interviews were conducted until no additional themes were raised. The narratives were analyzed using qualitative methodology. Most participants were in favor of contacting bereaved relatives after the death of a patient they had cared for. Some barriers to implementing these contacts were identified, including time constraints, institutional factors, and personal barriers. Contacts ranged from a personal phone call to a standardized letter. Timing of contacts varied from immediately after the death of the patient to several weeks later. Participants used words and phrases in these contacts that ranged from personal and individualized messages to standard phrases. Health care professionals emphasized the importance of contacting bereaved relatives after the death of a patient for whom they had cared. The format and content of current contacts vary widely, and there does not seem to be a gold standard approach. This area has been relatively unexplored and lacks adequate models for health care professionals. This study provides some insight into current practice and hopes to facilitate further discussion of this topic.

Medicare prospective payment before and after implementation: a review of visits and physical performance among Medicare home health patients after total knee replacements.

This retrospective case study examined whether the Medicare Prospective Payment System affected the number of visits and physical performance among Medicare home health patients after total knee replacements. Post-Prospective Payment System significant results included fewer visits, less improvement in knee extension range of motion, and increased ambulation distances at discharge.