What Is Long-Term Care?

Long-term care refers to a comprehensive range of medical, personal, and social services coordinated to meet the physical, social, and emotional needs of people who are chronically ill or disabled. A nursing home facility may be the best choice for people who require 24-hour medical care and supervision.

What Type of Care Do Nursing Homes Provide?

Nursing homes offer the most extensive care a person can get outside a hospital. Nursing homes offer help with custodial care -- like bathing, getting dressed, and eating -- as well as skilled care. Skilled nursing care is given by a registered nurse and includes medical monitoring and treatments.

How Can I Find the Right Nursing Home?

Finding the right nursing home takes time. It is important to begin the search for a suitable nursing home well in advance of seeking admission to the facility. There are often long waiting periods for available accommodations. Planning ahead also can make the transition of moving into a nursing home much easier.

About Nursing Homes

A nursing home, convalescent home, skilled nursing facility (SNF), care home, rest home or intermediate care provides a type of residential care. It is a place of residence for people who require continual nursing care and have significant difficulty coping with the required activities of daily living. Nursing aides and skilled nurses are usually available 24 hours a day.

Residents include the elderly and younger adults with physical or mental disabilities. Residents in a skilled nursing facility may also receive physical, occupational, and other rehabilitative therapies following an accident or illness. Some nursing homes assist people with special needs, such as Alzheimer patients.

Residents may have specific legal rights depending on the nation the facility is in.

Before the Industrial Revolution, elderly care was largely in the hands of the family who would support elderly relatives who could no longer do so themselves. Charitable institutions and parish poor relief were other sources of care.

Nursing homes offer the most extensive care a person can get outside a hospital. Nursing homes offer help with custodial care—like bathing, getting dressed, and eating—as well as skilled care given by a registered nurse and includes medical monitoring and treatments. Skilled care also includes services provided by specially trained professionals, such as physical, occupational, and respiratory therapists

Features included

  • 3 Chef-prepared meals daily and restaurant style dining
  • Dynamic calendar of activities, outings and Watercrest Institute classes
  • Salon and Spa Services on-site
  • Coastal Living design complete with pool, verandas, and outdoor living spaces
  • Spacious apartments with washer, dryer, and kitchenettes
  • 24-hour licensed staffing and world class personal care
  • Wellness programs
  • Pet friendly environment
  • A state-of-the-art wireless resident call system
  • Medication management available
  • Preventative health screenings
  • High apartment ceilings and spa showers
  • Transportation services seven days per week
  • Housekeeping services
  • Maintenance services
  • Utilities and cable included
  • Move-in coordination
  • Respite stay accommodations

Breast abnormalities: minimally invasive procedures should be sought––Midwest Breast Center

in Health & Fitness
Created: 01 June 2016
Breast abnormalities: minimally invasive procedures should be sought––Midwest Breast Center

Breast abnormalities: minimally invasive procedures should be sought

By Dr. Tim Goedde, Midwest Breast Center, Indianapolis North LIVING WELL Magazine

As a breast surgeon, I frequently see patients who have a breast problem, and their immediate concern is whether they have breast cancer, or even something that will lead to breast cancer.  These problems include things such as a palpable breast mass (one that can be felt), something that can’t be felt (found on mammogram and/or ultrasound or on MRI), nipple discharge or even breast pain.

For the patient, this is often a very anxiety-provoking time, leaving them vulnerable to their own misconceptions and incorrect ideas as to how to proceed. It’s common to meet a patient who “wants it out” usually implying they want surgery to have it removed. Most people remember family, friends, or even themselves who have had surgery to determine whether they have cancer or not.

 

Common misconceptions of having surgery to remove (excise) the abnormality include:

  1. Best way to find out is to remove in surgery
  2. Even if it isn’t cancer, get it removed surgically so it doesn’t turn into cancer
  3. Get it removed surgically so it doesn’t hide anything behind it in the future

These ideas are simple misunderstandings that get propagated by word of mouth, on blogs, even in some surgeons’ offices. These three misperceptions are all incorrect. Things that are NOT cancer rarely turn into cancer, and a well-trained breast surgeon readily recognizes those particular cases. Tumors, benign or malignant, do not hide other things in the breast with current mammography and ultrasound techniques. The best way to find out what an abnormality is, if necessary, is to do an image-guided breast biopsy using needle biopsy techniques.

A major goal of modern breast medicine is to reduce the number of surgeries required. Less invasive procedures use sophisticated needle biopsy techniques, usually guided by mammogram (stereotactic biopsy), ultrasound guidance, or MRI guidance. The vast majority of benign (not cancer) biopsies eliminate the need for surgery. If cancer is diagnosed WITHOUT surgery, then the cancer can usually be treated with one operation, optimally timed, with optimal cosmesis.  Surgical biopsy takes much longer, often requires insertion of wire into the breast prior to surgery, requires anesthesia with sedation, has increased pain, increased healing and recovery times, and is not more accurate.

I’ve performed over 5,000 stereotactic breast biopsies, and many more ultrasound guided breast biopsies. I’m on the American College of Surgeons National Faculty for Ultrasound and have trained many physicians in breast ultrasound; I’ve also trained many physicians how to do stereotactic biopsies at regional and national courses. As an expert in minimally invasive techniques, it makes sense that I would encourage patients to go this route, but this isn’t just my sole and biased opinion, nor is this a new revelation. The American Society of Breast Surgeons (ASBS) is the leading society in the education of breast surgeons with regards to our standards of care. ASBS, with the approval of its board of directors, published a position statement in June 2006 on its website for the benefit of its members, all physicians, and all patients regarding this very issue. This consensus statement, “Percutaneous Needle Biopsy for Image Detected Breast Abnormalities,” states that minimally invasive techniques “is the diagnostic procedure of choice for image-detected breast abnormalities.” This can be viewed at breastsurgeons.org

If patients are excellent candidates for these less invasive procedures, it’s inappropriate for a breast surgeon to even suggest that surgery is an option. Suggesting that surgery is an option when there is a better way just reinforces the misconceptions that patients have anyway, misconceptions that are then further propagated by word of mouth, blogs, etc.

While many breast surgeons and radiologist understand this, the experience of the doctor is vital to the success of the biopsy. Many cases are considered “too difficult” because the abnormality is too close to the skin, or too deep or too close to the nipple, making them technically more challenging to do than less invasive methods. In my experience, the more difficult cases are not a reason to revert to surgery without making an attempt at less invasive methods. I’ve been able to successfully biopsy virtually all abnormalities considered too difficult. This success was through experience, willingness to try new techniques that are more patient-focused and compassionate, and the trust of my patients.

Currently, it’s very uncommon that I must operate on a patient to make a diagnosis. In my latest analysis, I was able to perform less invasive needle biopsy techniques in 96% of my patients that required a biopsy. The ability to do less invasive techniques has become a quality measure used by the ASBS to track the quality of its members. This high rate (96%) represents a focus on less invasive, more compassionate technology for the patient.

To summarize, breast surgery used to make a diagnosis is almost never necessary anymore.   Less invasive methods are available with equal accuracy. If breast surgery is recommended to make a diagnosis, a second opinion should be sought.

Timothy A Goedde, MD, has been specializing in diseases of the breast for over 20 years. He’s pioneered new biopsy techniques and remains on the forefront of breast cancer treatment. He’s recognized as a leader and instructor in breast ultrasound and stereotactic biopsy methods  Dr. Goedde is affiliated with Community Hospital, St Vincent Hospital, and Hancock Regional Hospital. He is medical director of the Midwest Breast