In 2008, in an effort to provide helpful information to consumers and improve provider quality, the Centers for Medicare & Medicaid Services (CMS) developed and implemented the Five-Star Quality Rating System (Five-Star System). The Five-Star System assigns each nursing home an overall rating and three component ratingshealth inspections, staffing, and quality measuresbased on the extent to which the nursing home meets CMSs quality standards and other measures. The rating scale ranges from one to five stars, with more stars indicating higher quality. This book examines how CMS developed and implemented the Five-Star System and what key methodological decisions were made during development; the circumstances under which CMS considers modifying the Five-Star System; and the extent to which CMS has established plans to help ensure it achieves its goals for the Five-Star System.

Solution Focused Brief Therapy (SFBT) promotes collaborative work and positive outcomes. It is an approach that can be used with individuals, families and groups in acute hospitals as well as with clients who are seen as outpatients or in the community. Written in an accessible style with over seventy case examples, this new edition of 'Focus on Solutions' shows how SFBT can help people who are suffering from voice or memory difficulties, a stammer, a stroke, HIV, traumatic brain injury or illness such as cancer or Parkinson's disease. Two new full session transcripts show clients beginning to shift from focusing on the problems in their lives towards a clear description of how they want their lives to be different. Recent outcomes are included on solution focused supervision within the NHS and examples of ways to help clients monitor progress and give feedback. 'Focus on Solutions' contains many useful ideas for experienced practitioners and those new to solution focused work, which is of growing importance in the health service as well as business and education. Therapists, doctors, nurses and psychologists will find this book an invaluable contribution to the field of reflective practice. 'Focus on Solutions' is a clear and inspiring application of the solution-focused approach in a medical and community setting . . . Bonus content includes how to be solution-focused in supervision, training new practitioners and measuring client outcomes. The varying and updated case examples brings the approach to life, demonstrates its practical nature and how it can be incorporated into existing speech and language therapy frameworks.

Well child care is designed to promote optimal health status for children, including school and life success. This preventive care includes anticipatory guidance; continuity of care; assessment of growth and development; screening procedures for vision, hearing, dental, and cognitive development; and immunizations. Anticipatory guidance provides parental health education, counseling, and reassurance. The vast majority of Medicaid-insured children receive fewer than the American Academy of Pediatrics (AAP) recommended number of well child visits in the preschool years, and a disproportionate number of children have poor health and lack school readiness. With little empirical data available indicating clinical effectiveness other than for immunizations, the AAP recommendations for well child care were originally based on consensus expert opinion, and more than three decades later, documentation of effectiveness remained unavailable. This information gap led policymakers to question the value of well child care and limited incentive to correct its underuse. Only in the last five years have experimental findings indicated an association between well child care and both more cost efficient health care and increased school readiness. Awareness of these findings by insurance company and Medicaid administrators is limited. The purpose for this book is to increase awareness by all stakeholders of the empirically determined clinical effectiveness of well child care. The short-term goal is to facilitate increased utilization of well child care, with a longer term goal of improved child health and life success.

Hospice Palliative Care in Nepal is written in clear easy to understand language, with the Nepal Caregivers in mind. It guides you through best practices for providing care for the dying, adapting caregiving practices and includes caregiving stories from Nepal to meet the unique culture and expectations of Nepali society. Practical ways for managing common physical symptoms of the dying are explained, including: causes of common symptoms, palliative (medical) measures for treating symptoms, and comfort measures. Using this book will teach you about psychosocial issues that affect dying people and their family as well as ways to help people communicate in difficult situations.

Hospices have played a critical role in transforming ideas about death and dying. Viewing death as a natural event, hospices seek to enable people approaching mortality to live as fully and painlessly as possible. Award-winning medical historian Emily K. Abel provides insight into several important issues surrounding the growth of hospice care. Using a unique set of records, Prelude to Hospice expands our understanding of the history of U.S. hospices. Compiled largely by Florence Wald, the founder of the first U.S. hospice, the records provide a detailed account of her experiences studying and caring for dying people and their families in the late 1960s and early 1970s. Although Wald never published a report of her findings, she often presented her material informally. Like many others seeking to found new institutions, she believed she could garner support only by demonstrating that her facility would be superior in every respect to what currently existed. As a result, she generated inflated expectations about what a hospice could accomplish. Wald's records enable us to glimpse the complexities of the work of tending to dying people.

Die meisten Menschen in Deutschland sterben in Institutionen wie Krankenhausern oder Pflegeheimen, wo die Personalsituation oft angespannt ist. Damit Patienten und Bewohner in Wurde und Geborgenheit ihr Lebensende erleben konnen, unterstutzen zahlreiche ehrenamtliche Sterbebegleiter/-innen die hauptamtlich Tatigen. Die Ehrenamtlichen bringen durch ihre Zeit, Zuwendung, Aufmerksamkeit, Ruhe, Gelassenheit und Offenheit Erleichterung in den Alltag und speziell in die Situation Sterbender.Dieses Handbuch bereitet auf die ehrenamtliche Sterbebegleitung professionell vor. Dabei steht die Entwicklung einer inneren Haltung der Achtsamkeit und Wertschatzung sterbenden Menschen und ihren Angehorigen gegenuber im Mittelpunkt. In der Auseinandersetzung mit eigenen Verlusten und dem Sterben lernen die Kursteilnehmerinnen und -teilnehmer, die Bedurfnisse von Menschen in ihrer letzten Lebensphase sensibel wahrzunehmen und die Beziehung zu ihnen individuell und angemessen zu gestalten. Themen sind: eigene Abschieds- und Grenzerfahrungen, Schulung der Wahrnehmung, Kommunikation mit schwersterkrankten Menschen/Gesprachsfuhrung, Trauer, eigene Motivation fur den Dienst, Psychohygiene. Dieses Handbuch Ehrenamtliche Sterbebegleitung umfasst neben einer Einfuhrung in die einzelnen thematischen Bereiche zahlreiche Ubungsmodule mit genauen Beschreibungen.