FCA releases two new reports on important role of family caregivers in reducing negative outcomes for patients

Increased training, support and recognition are needed by families as healthcare increasingly moves into home settings

SAN FRANCISCO, Dec. 20, 2012 /PRNewswire-USNewswire/ – The National Center on Caregiving at Family Caregiver Alliance has released two new reports that shine a light on the important roles of family caregivers in U.S. healthcare—and how those caregivers are often unrecognized and unsupported within medical and long-term service systems.

Family Caregiving and Transitional Care: A Critical Review is an examination of the often ignored — yet absolutely essential — role of caregiving families as patients transition from one healthcare setting to another, for example discharge from hospital to home or hospital to rehab facility.

The report notes that although family caregivers are usually the individuals who will actually implement care plans following release from the hospital, they are rarely actively included in discharge planning; worse, their training, even for complex medical procedures, is often insufficient. The all-too-common result: preventable negative outcomes for patients.

The report looks at ways family caregivers characterize their experiences when a transition occurs and they are expected to take on challenging care tasks such as direct medical treatments (e.g., monitoring ventilators or home dialysis), managing medications, and coordinating essential medical services. Transition decisions made hurriedly at the point of discharge can change patient outcomes, and can be implicated in costly hospital readmissions, serious medication errors and omissions in follow-up treatment.

The authors state, “As the US continues its pressing search for ways to contain healthcare costs and improve quality, the one group whose role has been largely ignored is the nation’s 41 million family caregivers… Family caregivers are a critical missing link in improving transitional care for frail older adults with disabilities.”

The report also examines the relatively few model transitional care programs that do support family caregivers, and concludes with recommendations on improvements needed for practice, research and public policy.

Authors: Mary Jo Gibson, MA, whose career spans 30 years of work on family caregiving, health and long-term services and supports (LTSS) policy; Kathleen Kelly, MPA, Executive Director of Family Caregiver Alliance, the National Center on Caregiving and the Bay Area Caregiver Resource Center; and Alan K. Kaplan, MSc, JD, who has more than 30 years of experience on patients’ rights, medical peer review and Medicare quality assurance issues. The report is available at: http://caregiver.org/caregiver/jsp/content/pdfs/FamCGing_TransCare_CritRvw_FINAL10.31.2012.pdf

A second report, Selected Caregiver Assessment Measures: A Resource Inventory for Practitioners, was developed for researchers and program developers to accurately assess the knowledge and well-being of family caregivers as they perform the tasks necessary to maintain the health of their ill or elderly relatives. It is the second edition and follow-up for the first Resource Inventory, published by Family Caregiver Alliance’s National Center on Caregiving in 2002.

Many family caregivers have multiple, varied and serious unmet financial, physical, emotional and social needs which require attention. As healthcare continues to move into home settings, it is important not only to assess the skills and capacity of caregivers to provide care, but also to address caregiver well-being and health in order to prevent more serious health problems for families in the long-term. Valid, reliable assessment tools are necessary to gauge families’ abilities to continue providing care.

The Resource Inventory provides a compendium of caregiver assessment measures that are practice-oriented, practical and applicable, and which address the multidimensional aspects of the caregiving experience.

“As the population ages and caregiving needs increase throughout the country, the essential role families play in the healthcare system is undeniable,” said FCA’s Kathleen Kelly. “At the same time, healthcare budgets are severely stressed and resources strained. Whether family caregivers provide transportation, food preparation, help with personal care or complex medical care such as dealing with wound care or feeding tubes, they are involved at every level. Unfortunately, caregivers’ needs are often unassessed, unrecognized, or even worse, ignored.”

The Resource Inventory was developed by Family Caregiver Alliance’s National Center on Caregiving in collaboration with the Margaret Blenkner Research Institute of the Benjamin Rose Institute on Aging. It was compiled by Sarah Schwartz, MSSA and Laura Darlak, BA, under supervision of Carol J. Whitlatch, PhD, with oversight by Kathleen Kelly, MPA. David M. Bass, PhD, was the reviewer. The report is available at: http://caregiver.org/caregiver/jsp/content/pdfs/SelCGAssmtMeas_ResInv_FINAL_12.10.12.pdf

Family Caregiver Alliance and its National Center on Caregiving offer local and national programs to support and sustain the important work of families and friends caring for loved ones with chronic, disabling health conditions. A wealth of caregiving advice, resource listings, newsletters, fact sheets, research reports, policy updates, discussion groups, and the Family Care Navigator are available free on the FCA website. Visit http://www.caregiver.org or call (800) 445-8106 for more information.

SOURCE Family Caregiver Alliance

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Daily funerals now routine in Newtown

NEWTOWN, Conn. (AP) — A season that should be a time of joy has been marked by heart-wrenching loss in Newtown, as more victims from the massacre of 20 children and six adults are laid to rest.

At least nine funerals and wakes were held Wednesday for those who died when gunman Adam Lanza, armed with a military-style assault rifle, broke into Sandy Hook Elementary School Friday and opened fire. Lanza killed his mother at her home before the attack and committed suicide at the school as police closed in.

On Thursday, five funerals and six wakes were planned, and more tributes were scheduled for Friday and Saturday.

"The first few days, all you heard were helicopters," said Dr. Joseph Young, an optometrist who attended one funeral and would go to several more. "Now at my office all I hear is the rumble of motorcycle escorts and funeral processions going back and forth throughout the day."

At St. Rose of Lima Catholic Church on Wednesday, mourners arrived for Caroline Previdi, an auburn-haired 6-year-old with an impish smile, before the service had even ended for Daniel Barden, a 7-year-old who dreamed of being a firefighter.

"It's sad to see the little coffins," said the Rev. John Inserra, a Catholic priest who worked at St. Rose for years before transferring to a church in Greenwich.

"It's always hard to bury a child," Inserra said of the seemingly unrelenting cycle of sorrow and loss. "God didn't do this. God didn't allow this. We allowed it. He said, 'Send the little children to me.' But he didn't mean it this way."

Hundreds of firefighters formed a long blue line outside the church for Daniel's funeral. Two of his relatives work at the Fire Department of New York, and the gap-toothed redhead had wanted to join their ranks one day.

At Caroline's funeral, mourners wore pink ties and scarves — her favorite color — and remembered her as a New York Yankees fan who liked to kid around. "Silly Caroline" was how she was known to neighbor Karen Dryer.

"She's just a girl that was always smiling, always wanting others to smile," Dryer said.

Across town, at Christ the King Lutheran Church, hundreds gathered for the funeral of Charlotte Helen Bacon, many wearing buttons picturing the 6-year-old redhead. Speakers, including her grandfather, told of her love of wild animals, the family's golden retriever and the color pink.

She was "a beautiful little girl who could be a bit stubborn at times, just like all children," said Danbury resident Linda Clark as she left the service.

And in nearby Stratford, family and friends gathered to say goodbye to Victoria Soto, a first-grade teacher hailed as a hero for trying to shield her students, some of whom escaped. Musician Paul Simon, a family friend, performed "The Sound of Silence" at the service.

"She had the perfect job. She loved her job," said Vicky Ruiz, a friend since first grade.

In Woodbury, a line of colleagues, students and friends of slain Sandy Hook Principal Dawn Hochsprung, 47, wrapped around the block to pay their respects to the administrator, who rushed the gunman in an effort to stop him and paid with her life. U.S. Secretary of Education Arne Duncan attended the service.

"She loved kids. She'd do anything to help them and protect them," said Joann Opulski, of Roxbury.

The symbol of Christmas took on a new meaning in Newtown, where one memorial featured 26 Christmas trees — one for each victim at the school.

Edward Kish said he bought a Christmas tree two days before the shooting but hasn't had the heart to put it up or decorate it.

"I'll still put it up, probably," he said. "It doesn't seem right, and it doesn't seem like Christmas."

___

Contributing to this report were Associated Press writers Allen G. Breed, Helen O'Neill, John Christoffersen, Katie Zezima and Pat Eaton-Robb in Newtown; Michael Melia in Hartford; and Larry Margasak in Washington and AP Business Writer Joshua Freed in Minneapolis.

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Canada serial killer inquiry finds “systemic bias” by police

(Reuters) – Police made critical errors in pursuing Canadian serial killer Robert Pickton partly because of “systemic bias” against his victims, sex trade workers from a rough Vancouver neighborhood, according to the final report from a public inquiry released on Monday.

Commissioner Wally Oppal was asked by the British Columbia government to investigate, in effect, why Pickton was not caught sooner. Women disappeared from the Downtown Eastside neighborhood for more than a decade before the pig farmer’s 2002 arrest.

“The investigations of missing and murdered women were characterized by blatant police failures, and by public indifference,” Oppal said at a press conference in Vancouver that was frequently interrupted by protesters.

Pickton was convicted of six murders, but prosecutors believe he killed many more – 20 other charges were stayed after he received the maximum possible sentence.

Oppal outlined a string of police errors, from failing to take proper reports when women went missing and communicate adequately with families, to ineffective coordination across jurisdictions. He called his more than 1,200-page report, which is based on eight months of hearings, “Forsaken”.

“After reviewing the evidence of the investigations, I have come to the conclusion that there was systemic bias by the police,” he said.

Oppal recommended that the provincial government establish a compensation fund for the children of the victims and consider creating a regional police force for Vancouver, instead of the patchwork of jurisdictions currently in place.

After Oppal’s announcement, B.C. Minister of Justice Shirley Bond wiped away tears as she spoke to victims’ families.

“I want you to know that, however inadequate these words sound, we are sorry for your loss,” she said. “We will work hard to prevent these circumstances from being repeated in our province.”

She announced the appointment of a former lieutenant governor, Steven Point, to serve as the report’s “champion”, guiding implementation. Bond said the government would immediately give new funding to WISH, a drop-in center for women who work in the Downtown Eastside’s sex trade.

POLICE RESPOND

The Vancouver Police Department said in a short statement that it is committed to learning from its mistakes and will study the report.

“We know that nothing can ever truly heal the wounds of grief and loss but if we can, we want to assure the families that the Vancouver Police Department deeply regrets anything we did that may have delayed the eventual solving of these murders,” it said.

Deputy Commissioner Craig Callens, who commands the Royal Canadian Mounted Police in British Columbia, said in a statement that his force will review the report.

Oppal said many individual police officers were diligent, and he commended several by name. But he said that as a system, the authorities failed because of bias against Pickton’s victims, many of whom were poor and addicted to drugs.

“Would the reaction of the police and the public have been any different if the missing women had come from Vancouver’s (more affluent) west side? The answer is obvious,” he said.

Aboriginal women were overrepresented among the victims, and Oppal repeatedly referred to the broader “marginalization” of aboriginal people in Canada.

“There has to be community responsibility for what has taken place,” he said, highlighting poverty and the conditions on the Downtown Eastside. “The social reality is that racism and gender bias are prevalent within Canadian society, and we must do something to eradicate those.”

Victims’ families and activists were on hand for Oppal’s press conference, and he stopped speaking several times as audience members shouted criticism, chanted and played drums.

The provincial government did not offer funding to a number of community organizations that said they needed support to participate in the lengthy and complex inquiry. In protest, other groups boycotted the process.

In November, several organizations, including the B.C. Civil Liberties Association, released their own report, criticizing the inquiry for, among other things, excluding too many aboriginal women, sex trade workers and drug users.

Bond, the justice minister, said she did not regret the decision not to fund those groups, but said she saw them participating in the future. “I think going forward this is room for us to include other voices.” (Reporting by Allison Martell; Editing by Eric Beech)

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“Best Funeral Ever” premiere delayed after Newtown school shootings

LOS ANGELES (TheWrap.com) – Fans of death-centric reality TV will have to wait a little longer to dig into TLC‘s “Best Funeral Ever.”

TLC has pushed back the premiere of the special to January 6 at 10/9c in light of the school shootings in Newtown, Conn. last week.

“Best Funeral Ever” was initially scheduled to premiere on December 26 at 8/7c.

“Best Funeral Ever” centers around the Golden Gate Funeral Home in Dallas, which specializes in elaborate specialty funerals catering to the deceased’s interest. In the special, a doo-wop singer famous for his rib-sauce jingle receives a barbecue-themed sendoff, while a disabled man who was unable to ride roller coasters in mortal life receives a State Fair-themed funeral.

Since last Friday’s horrific shootings, a number of programs and other entertainment-related events have been moved out of sensitivity. Syfy, for one, decided not to air its scheduled episode of “Haven” on Friday night, because it contained elements of fictionalized school violence.

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Canada wins $28.3 billion case on pension fund payments

OTTAWA (Reuters) – The Canadian government won a far-reaching case at the Supreme Court of Canada on Wednesday when judges ruled Ottawa did not have to return more than C$ 28 billion ($ 28.3 billion) to civil servant union pension plans.

The unions said the federal government had improperly taken the money out of their plans, largely through withdrawal of surpluses. Ottawa said it had followed laws governing the pensions and that, in any case, it would meet its obligation to pay union members the defined benefits they were owed.

In a unanimous 9-0 ruling, the Supreme Court said the unions did not have a legal interest in the pension plan‘s surpluses.

“The plan members‘ interests are limited to their interest in the defined benefits to which they are entitled under the plans,” the court said in its judgment.

“The government was not under a fiduciary obligation to the plan members, nor was it unjustly enriched by the amortization and removal of the pension surpluses.”

The judgment was not a surprise, since the unions had lost in two lower courts. A law passed in 2000 gave the government the right to remove surpluses from the pension funds and use the money for whatever purpose it saw fit.

The Canadian Association of Professional Employees said the ruling meant union members would have to pay larger contributions over longer periods of time.

“A portion of the accumulated funds to ensure the continued viability of their pension plans was used for other purposes by their employer,” it said in a statement.

The federal government was not immediately available for comment.

(Reporting by David Ljunggren; Editing by Lisa Von Ahn)

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Gun deaths set to outpace car fatalities

Twenty-seven wooden angels stand in a yard down the street from the Sandy Hook School in Newtown, Conn. (Spencer …

Deaths from firearms are set to outstrip car fatalities for the first time, according to data from the Centers for Disease Control and reported by Bloomberg News.

The CDC estimates that auto-related deaths--long on the decline as more motorists wear seat-belts and face harsher penalties for drunk driving--will fall to 32,000 in 2015. Deaths from firearms, which include suicides and accidents, are estimated to rise to 33,000 over the same period.

Every day, 85 Americans are shot dead, about 53 of them in suicides. This figure is still lower than 1993's peak in gun deaths (37,666), but has risen significantly since firearm deaths reached a low  in 2000 (28,393). The data goes back to 1979.

Meanwhile, USA Today, which looked at FBI figures, reports that 774 people were killed between 2006 and 2010 by a mass killer, defined as a person who kills four or more people in one incident. The figures show that mass killers strike on average once every two weeks. A third of the 156 mass killings did not involve firearms, but rather fire, knife or other weapon. Almost all of the mass killers in those years were men, and their average age was 32. The dozens of deaths caused by mass killers represented about 1 percent of all homicides between 2006 and 2010.

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Syrian rebels take control of Damascus Palestinian camp

BEIRUT (Reuters) – Syrian rebels took full control of the Yarmouk Palestinian refugee camp on Monday after fighting raged for days in the district on the southern edge of President Bashar al-Assad‘s Damascus powerbase, rebel and Palestinian sources said.

The battle had pitted rebels, backed by some Palestinians, against Palestinian fighters of the pro-Assad Popular Front for the Liberation of Palestine-General Command (PFLP-GC). Many PFLP-GC fighters defected to the rebel side and their leader Ahmed Jibril left the camp two days ago, rebel sources said.

“All of the camp is under the control of the (rebel) Free Syrian Army,” said a Palestinian activist in Yarmouk. He said clashes had stopped and the remaining PFLP fighters retreated to join Assad‘s forces massed on the northern edge of the camp.

The battle in Yarmouk is one of a series of conflicts on the southern fringes of Assad’s capital, as rebels try to choke the power of the 47-year-old leader after a 21-month-old uprising in which 40,000 people have been killed.

Government forces have used jets and artillery to try to dislodge the fighters but the violence has crept into the heart of the city and activists say rebels overran three army stations in a new offensive in the central province of Hama on Monday.

On the border with Lebanon, hundreds of Palestinian families fled across the frontier following the weekend violence in Yarmouk, a Reuters witness said.

Syria hosts half a million Palestinian refugees, most living in Yarmouk, descendants of those admitted after the creation of Israel in 1948, and has always cast itself as a champion of the Palestinian struggle, sponsoring several guerrilla factions.

Both Assad’s government and the mainly Sunni Muslim Syrian rebels have enlisted and armed divided Palestinian factions as the uprising has developed into a civil war.

“NEITHER SIDE CAN WIN”

Syrian Vice President Farouq al-Sharaa said in a newspaper interview published on Monday that neither Assad’s forces nor rebels seeking to overthrow him can win the war.

Sharaa, a Sunni Muslim in a power structure dominated by Assad’s Alawite minority, has rarely been seen since the revolt erupted in March 2011 and is not part of the president’s inner circle directing the fight against Sunni rebels. But he is the most prominent figure to say in public that Assad will not win.

Sharaa said the situation in Syria was deteriorating and a “historic settlement” was needed to end the conflict, involving regional powers and the U.N. Security Council and the formation of a national unity government “with broad powers”.

“With every passing day the political and military solutions are becoming more distant. We should be in a position defending the existence of Syria. We are not in a battle for an individual or a regime,” Sharaa was quoted as telling Al-Akhbar newspaper.

“The opposition cannot decisively settle the battle and what the security forces and army units are doing will not achieve a decisive settlement,” he said, adding that insurgents fighting to topple Syria’s leadership could plunge it into “anarchy and an unending spiral of violence”.

Sources close to the Syrian government say Sharaa had pushed for dialogue with the opposition and objected to the military response to an uprising that began peacefully.

In a veiled criticism of the crackdown, he said there was a difference between the state’s duty to provide security to its citizens, and “pursuing a security solution to the crisis”.

He said even Assad could not be certain where events in Syria were leading, but that anyone who met him would hear that “this is a long struggle…and he does not hide his desire to settle matters militarily to reach a final solution.”

In Hama province, rebels and the army clashed in a new campaign launched on Sunday by rebels to block off the country’s north, activists said.

The Syrian Observatory for Human Rights, an opposition-linked violence monitor, said fighting raged through the provincial towns of Karnaz, Kafar Weeta, Halfayeh and Mahardeh.

It said there were no clashes reported in Hama city, which lies on the main north-south highway connecting the capital with Aleppo, Syria’s second city.

Qassem Saadeddine, a member of the newly established rebel military command, said on Sunday fighters had been ordered to surround and attack army positions across the province. He said Assad’s forces were given 48 hours to surrender or be killed.

In 1982 Hafez al-Assad, father of the current ruler, crushed an uprising in Hama city, killing up to 30,000 civilians.

Qatiba al-Naasan, a rebel from Hama, said the offensive would bring retaliatory air strikes from the government but that the situation is “already getting miserable”.

(Additional reporting by Oliver Holmes, Erika Solomon and Dominic Evans in Beirut, Afif Diab at Masnaa, Lebanon; editing by Philippa Fletcher)

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Xbox SmartGlass updated with second-screen ESPN and NBA Game Time app experiences

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Florida man sentenced to 10 years in “hackerazzi” case

LOS ANGELES (Reuters) – A Florida man who pleaded guilty to hacking into the email accounts of celebrities to gain access to nude photos and private information was sentenced to 10 years in prison by a federal judge in Los Angeles on Monday.

Former office clerk Christopher Chaney, 36, said before the trial that he hacked into the accounts of film star Scarlett Johansson and other celebrities because he was addicted to spying on their personal lives.

Prosecutors said Chaney illegally gained access to email accounts of more than 50 people in the entertainment industry, including Johansson, actress Mila Kunis, and singers Christina Aguilera and Renee Olstead from November 2010 to October 2011.

Chaney, who was initially charged with 28 counts related to hacking, struck a plea deal with prosecutors in March to nine felony counts, including wiretapping and unauthorized access to protected computers.

“I don’t know what else to say except I’m sorry,” Chaney said during his sentencing. “This will never happen again.”

Chaney was ordered to pay $ 66,179 in restitution to victims.

Prosecutors recommended a 71-month prison for Chaney, who faced a maximum sentence of 60 years.

TEARFUL JOHANSSON

Prosecutors said Chaney leaked some of the private photos to two celebrity gossip websites and a hacker.

Johansson said the photos, which show her topless, were taken for her then-husband, actor Ryan Reynolds.

In a video statement shown in U.S. District Court in Los Angeles, a tearful Johansson said she was “truly humiliated and embarrassed” when the photos appeared online, asking Judge S. James Otero to come down hard on Chaney.

Prosecutors said Chaney also stalked two unnamed Florida women online, one since 1999 when she was 13 years old.

Chaney, a native of Jacksonville, Florida, was arrested in October 2011 after an 11-month FBI investigation dubbed “Operation Hackerazzi” and he continued hacking after investigators initially seized his personal computers.

Shortly after his arrest, Chaney told a Florida television station that his hacking of celebrity email accounts started as curiosity and later he became “addicted.”

“I was almost relieved months ago when they came in and took my computer … because I didn’t know how to stop,” he said.

(Reporting by Eric Kelsey; Editing by Jill Serjeant and Andrew Hay)

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House Republicans eye limited fiscal cliff bill

WASHINGTON (Reuters) – With time running short before a Dec. 31 deadline, House of Representatives Speaker John Boehner will begin work on legislation that simply would extend current low income tax rates for all families with incomes below $ 1 million a year, according to an aide.

Negotiations will continue with the White House on a broader tax and spending deal, the Boehner aide said.

Boehner is presenting the plan to rank-and-file Republicans in a closed-door session.

On January 1, income tax increases for most Americans will begin unless Congress acts.

Last July, the Democratic-controlled Senate passed a bill to extend the current low rates for all families with net incomes below $ 250,000 a year. The House Republican proposal, if passed by the House, would require agreement by the Senate or force a round of negotiations on a compromise between the two chambers.

In excerpts of remarks Boehner was delivering to his Republican members Tuesday morning, the speaker complained that “the White House just can’t seem to bring itself to agree to a ‘balanced’ approach” to deficit-reduction in negotiations. At the same time, Boehner said Republicans were “leaving the door wide open for something better” than just the limited extension of current low tax rates for most Americans.

“Current law has tax rates going up on everyone January 1. The question for us is real simple: How do we stop as many of those rate hikes as possible?” Boehner said.

For months, Democrats have been urging House Republicans to pass a bill protecting middle-class taxpayers from a January 1 rate increase.

(Reporting By Richard Cowan; Editing by Doina Chiacu)

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