February 14, 2020 / By Medlogic
Manual de Terapêutica Segura no Idoso
We will start a Special Series on the Book: Safe Therapeutic Manual for the Elderly, written by Dr. Edgar Nunes de Moraes, Flávia Lanna de Moraes and Adriano Max Moreira Reis, distributed in 08 weekly posts that gather all the information necessary for a good prescription of medications for the elderly, from issues related to the disease for which the drug is being used, to therapeutic goals according to the degree of vitality of the elderly.
There is also the Safe Therapeutic APP with selected and judicious information on your smartphone, such as: Classification of medicines by color; Patient Guidelines, Second medical opinion on the safe use of medication for the elderly.
POST 1: Why the elaboration of a Manual of Safe Therapy for the Elderly?
As the aging of the population in Brazil has progressed, every year the need to observe the practice of medicine becomes visible, with a special focus on safe therapy in the care of the elderly. In this context, the preparation of a manual was a fundamental instrument for the action of professionals, providing security, comfort for the elderly and, consequently, the quality of life in all phases of life.
This manual presents the information contained in the Drug Lists. Potentially Inappropriate (MPI). Often, the drug is not used according to the clinical indication and sometimes leads to a therapeutic duality. Therefore, the functional clinical stratification of the elderly is important, since it facilitates the definition of the objectives to be achieved in each elderly person, individualizing the therapeutic objectives.
The construction of this manual was based on the scientific literature and the appreciation of the experiences of the team involved in the preparation of content in safe therapies for the elderly. This work collects essential information for the preparation of appropriate recipes and provides a substrate for health professionals to make decisions based on evidence and scientific data.
CORONAVIRUS GLOBAL DISEASE
January 29, 2020 / By Medlogic
New disease in the world
Coronavirus is a disease that affects all ages. In the elderly it is serious due to low immunity.
How it started:
A group of scientists believe that the coronavirus originated from animals sold in the market in Wouhan, China.
It is transmitted through the respiratory tract: secretions, saliva, cough, sneezing.
The symptoms are: fever, prostration, severe dry cough and progression of shortness of breath with compromised airways and complicated pneumonia.
In the hospital area, due to the need for isolation, medication and the indication of some cases of oxygen therapy.Several scientists are investigating the mutation of the virus.
Surveillance at airports of people coming from China to control the disease has intensified. Due to the low immunity in the elderly
drink natural juices using raw yams.
Universal care: always wash your hands
protect yourself from coughing or sneezing, use a tissue
separate the towel from the face of the sick,
avoid crowded places.
Always seek medical evaluation.
Longevity Congress 2019
September 18, 2019 / By Medlogic
Longevity Congress 2019 in São Paulo is arriving!!!!
And Medlogic will be there!
Dr. Edgar Nunes, Member of the Senior Health Advisory Committee of the Ministry of Health. Consultant to the National Council of Health Secretaries (CONASS), Medlogic Professor of Medicine, and Co Founder will be speaking at the October 1st event at the Panel 2!
Medlogic will have a stand in RUA H.
Here, event map:
September 10, 2019 / By Medlogic
LONGEVITY CONGRESS IS HERE AND MEDLOGIC WILL ASSIST!!!
São Paulo will organize a professional event on quality of life and longevity, aimed at a growing market: the segment of more than 50 consumers.
The rapid aging of the Brazilian population is generating new needs and different consumption habits.
MORE INFORMATION OF LONGEVITY CONGRESS!
CONGRESS MAP HERE!!
10th Congress of Geriatrics and Gerontology of Minas Gerais
September 03, 2019 / By Medlogic
Medlogic participated in the 10th Congress of Geriatrics and Gerontology of Minas Gerais, held at the Hotel Ouro Miinas, on August 30, 2019.
The event presented the release of the Terapêutica Segura Book, launched by Dr. Edgar Nunes de Moraes, founding partner of MedLogic.
Visit our site and know a little more!
MedLogic in: Red CeMAIS 3i!
August 21, 2019 / By Medlogic
On wednsday, august 14, MedLogic assisted to an event organized by the CeMAIS i3 Network, an event which was attended by international entities expert in the care of the elderly, personalities such as: Peter Lloyd-Sherlock, professor and member of welfare research groups in old age; Nélida Redondo, a researcher specializing in aging, Karla Giacomin, a geriatrician, a consultant to the WHO, among others.
The exhibitors showed relevant data about the quality of Long Term institutions, some indicators that are being worked on to improve the stay of the elderly in these institutions, some statistics, personal experiences and so moche more.
Some pictures of the event:
From left to right, Professor Peter Lloyd-Sherlock, researcher Nélida Redondo, Geriatra Karla Cristina Giacomin.
Researcher Nélida Redondo
Professor Peter Lloyd-Sherlock
Here is the link for more information!
What are the effects of aging on the cognition of the elderly
August 5, 2019 / By Medlogic
Cognition refers to the range of intellectual functioning of the human being, which includes: perception, attention, memory, reasoning, decision making, problem solving and formation of complex knowledge sturctures. And over the years, some cognitive skills of the elderly are changing.
Some skills remain unchanged ability, and most language skills. The ones that suffer decline are working memory, speed of thought ans visual and spatial skills.
Crystallized intelligence, which is the ability to remember and use lifelong knowledge, tends to remain stable, while fluid intelligence, which is the ability to solve new problems that require little or no prior knowledge,tends to decline gradually. It is necessary for the elderly to remain active at all times so as not to spoil the reserves and acquire other possibilities.
Below are some suggestions to help your cognitive performance:
Physical activity: bodybuilding, dancing, water aerobics and swimming.
Music activities, such as attending a choir.
People's cognitive impairment can be related to several dactors, including lack of use. Some actions to keep the brain of the elderly working can be donde through cognitive training in order to maintain and expand this reserve capacity, thus preventing cognitive decline, so stay tuned and stay active!
Does sleeping well mean getting old well?
July 5, 2019 / By Medlogic
We all feel the need to ret. After all, the human body, despite all its complexity, is not a machine and needs to replenish its energies through food and sleep. But can sleep only makes us relax?
Decreased rest time is common nowadays and so people are used to having an intense and restless routine. However, at some point the body will begin to show signs of exhaustion and everyday illness and difficulties may appear. Sleep deprivation impairs learning, memory consolidation, productivity, and school and work performance. In addition, tiredness can make a person angry and moody, negatively interfering with interpersonal relationships.
A rested body promotes better balance of hormones, which is essential in preventing diseases such as hypertension and diabetes. This is because satiety hormone leptin is secreted during slepp, preventing overeating. The same goes for insulin, a hormone that acts to control blood sugar. This is why people with insomnia are more likely to have diabetes.
Lack of sleep, for example: insomnia, has a major impact on morbidity and mortality. In the elderly, severe insomnia increases the probability of of mortality in three and a half years by three times. The risk of developing depression is much higher in older people with insomnia.
For optimal wakefulness, the adult requires an average of 7-8 hours of sleep over a 24 hour period, with night time awakenings representing up to 5% of total bedtime. Sleep cycles Message Faisal age is characterized by a pattern in which the individual spends 30% dreaming, 20% deep sleep and 50% light sleep.
Sleeping conditions should always involve concern for a comfortable and safe physical environment. The comfortable comes from tango furniture and mattress in good condition, as well as soft and fold - free sheets, use of light and good heating covers, controlled ambient temperature, absence or reduction of noise.
Safety an be provided by low intensity indirect lighting, which allows the elderly to get up at night without danger of falls or accidents. The prevention and treatment of sleep disorders in the elderly can be done through non-drug therapeutic measures aimed at improving the elderly's quality of sleep. However, its effectiveness decreases with age, suggesting a permanent monitoring of effects to assess the need to combine non-pharmacological strategies with drug therapy. (GIEB et al, 2003), after all, sleep and rest are restorative functions necessary for the preservation of life.
“IVCF, coupled with Medlogic technology, enables information to be gathered and passed on faster and more assertively, and can correctly guide a better Patient Care Plan.”
Dr. Edgar Nunes de Moraes.
It is important to remember that we always hear that the ideal is to sleep eight hours a day and this is no exaggeration.
During sleep, in addition to resting, our body works to maintain the balance of the immune, endocrine, neurological and other functions. This is why sleep is so essential to our health.
To sleep is to live longer and better, take care!!
And how to know some of the symptoms of the process of dementia in the elderly ??
July 1, 2019 / By Medlogic
Dementia is a disease of unknown cause characterized by the rapid death of many brain cells, the neurons, within the brain degenerate and the connections between the neurons are broken. Dementias can occur from head trauma injuries, alcohol abuse, degenerative diseases, brain tumors, infections, and inappropriate medication use.
The person with dementia is losing the ability and ability to do simple things. Dementia causes memory loss, confusion, strange behaviors and personality changes. There is still no cure for dementia, however there is treatment that relieves the signs and symptoms of the disease. Alzheimer's disease accounts for 45% of all dementias, vascular and neurological diseases.
Signs and symptoms of a person with dementia:
Failure in memory, one remembers perfectly, events that happened many years ago, but forgets what just happened:
Disorientation, such as difficulties in locating time, day and place, getting lost in familiar places;
Forgets the name of things, and to overcome this flaw, describes the object by function. Ex.: to ask for a pen, asks for "the thing thats writes".
Difficulty understanding what they tell you, performing household chores and doing your personal hygiene
It behaves inappropriately by evading social rules such as going out in pijamas, walking naked, etc.
Hide or loss things and the accuse people of stealing them
Hallucinate, see images, hear voices and noises that don't exist.
As the disease progresses, the signs and symptoms become more marked and disabling. So, attention!!! It is always important to emphasize that medical evaluation is required for diagnosis and treatment.
Fragil elderly and an integral health management focused on the elderly and family.
June 26, 2019 / By Medlogic
The rapid aging of the Brazilian population, coupled with increased longevity, has profound consequences on the structuring of health care networks, with a higher burden of chronic deseases and, particularly, functional disabilities.
Unfortunately, the current care offered to frail older people, those with multiple chronic health conditions, poly-disabilities or complex needs is often fragmented, inefficient, ineffective and discontinuous, futher aggravating their health. The hospital -centered health system of the 19th and 20th centuries, designed to deal with acute and especially infectious diseases, is inadequate to meet the long-term continuing treatment nned of the chronically ill. The response of the health system to the new demands makes it essential to use a set of management techonologies capable of ensuring optimal standards of health care, in a resolute, efficent, scientific evidence-based, patient and patient-safe manner. Health professionals, timely, equitable, offered in a humane and sustainable manner. The triple objective of better care experience, coupled with better population health and reduced care costos, developed bu the Institute of Healthcare Improvement (Triple Aim) is the best strategy for reorganizing and oprimizing health system performance. Providing the best care experience means knowing the health particularities of the elderly.
The use of parameters based on risk factors, deseases and/or age is inappropriate and associated with the high risk of iatrogenic disease. Vitality is extremely heterogeneous among the elderly, and chronological age is a poor metric in assessing an individual's homeostatic reserve. Similarly, aging without any chronic illness is more an exception than the rule. Thus, knowing only the age of individuals and their diseases does not add posibilities for greater understanding of the health situation.
The best marker of vitality in the elderly is their functional capacity, measured by activities of daily living (ADL). It represents autonomy (individual decision-making ability) and independence (execution capacity), allowing the individual to take care of himself and his life. Thus, health in the elderly can be defined as the individual capacity to satisfy biopsychosocial needs, regardless of age or the presence of diseases. The decline in vitality is known as frailty, frankly associated with the development of disability, functional dependence, hospitalization and death. Therefore, the presence of functional decline in activities of daily living should never be attributed to aging per se and should always trigger a broad investigation of the elderly. This research should address the performance of functional systems (cognition, mood/behavior, mobility and communication) and physiological systems (sleep, nutrition, oral health, skin and attachments, cardiovascular, respiratory, digestive, genitourinary, musculoskeletal, nervous and endocrine systems). -metabolic), allied to the evaluation of the medicines in use, past history and contextual factors, constituted by the socio-family evaluation, caregiver evaluation and environmental evaluation. This Multidimensional Evaluation of the Elderly is fundamental for the construction of the Personalized Care Plan (PCP), which is the set of biopsychosocial and functional diagnoses of the individual, associated with promotional, preventive, curative, palliative and / or rehabilitative interventions capable of maintaining or recovering. your health. PCP is, therefore, the guiding strategy of the healthcare team to meet the specific short, medium and long term patient health needs, which must also be strongly anchored in the principles of Patient-Centered Medical Home. This should be the logic that directs the team to seek the appropriate resources and required treatments, serving as the guiding axis of the entire care process. Proposed interventions should also be applied according to the vitality of the elderly, who may be robust, at risk of fragility or fragile.
The frail elderly is the largest consumer of procedures in any health system and most are asociated with iatrogenic illness and therapeutic futility. Health promotion strategy and primary and secondary prevention measurs should be applied very carefully, as the impact of such measures requires behavioral and lifestyle changes, as well as investments in diagnostic and therapeutic interventions that take too long to obtain positive results. This type of frail elderly person does not have a long enough life expectancy to benefit from such interventions. Morever, such interventions also present risks and may have negative repercussions for your health.
Tertiary prevention, which onsists in recognizing disabilities and interdisciplinary intervention aimed at rehabilitation, demands time, qualified professional care and patient and family adherence, factors associated with high cost. Recently, the concept of quaternary prevention has been incorporated, which consists of detecting individuals at risk of overtreatment to protect them from inappropriate new medical interventions and to suggest ethically acceptable alternatives. Quaternary prevention is about protecting health care users from excessive disease screening interventions, medicalization of risk factors, over-testing, overdiagnosis, futile drug use, or potentially inappropriate and defensive medicine. Its main objective is not to harm the patient (“primum non nocere”). These concepts of health micromanagement are fundamental for the maintenance and / or recovery of the independence and autonomy of the elderly, and also for the sustainability of public or private health care systems (health macromanagement).
In this perspective, the main interventions capable of improving the health of the frail elderly are, in order of importance:
a) Suspension of inadequate diagnostic and/ or therapeutic interventions, with emphasis on the safe prescription of inappropiate medications
b) Definition of individualized therapeutic goals shared with the elderly and their families, respecting the clinical-functional stratum of the patient.
c) Appropiate treatment of underdiagnostic conditions and, consequently undertreated, commonly atributed to "age" or "senillity"
d) Rehabilitation, according to the patient's rehabilitation prognosis
e) Secondary prevention, when life expectancy i slong enough for the expected benefit and there are no contraindications to drug, dietary or lifestyle changes.
f) Primary prevention, only when the elderly are robust and the cost-benefit-risk ratio is quite satisfactory, due to the scarcity of intervention studies in very elderly and especially in frail elderly.
All of these assumptions were grouped into the proposed Comprehensive Elderly and Family-Centered Health Management (GISCI) model, which is able to reconcile health micromanagement technologies and the most modern, fully integrated clinical management assumptions. Both technologies must be applied simultaneously to ensure the effectiveness and sustainability of the model. GISCI is being progressively implemented in SUS, through the experience of the Senior Reference Center of the Hospital das Clínicas of UFMG and Supplementary Health, with the Usifamília program of the São Francisco Xavier Foundation, both with very promising results.
By Edgar Nunes de Moraes
Professor at the Federal University of Minas Gerais
World Bank Consultant (Aging and Health in Brazil, 2017)
Rev. Bras. Geriatr. Gerontol., Rio de Janeiro, 2017; 20 (3): 307-308
How to manage the routine of the elderly with transparency and effectiveness
June 7, 2019 / By Medlogic
Finding the best way to demonstrate, transparency and competence for family members is not an easy task for long-term care institutions. So here are some items that will help you understand how important it is to incorporate technology into your institution's processes.
One of the biggest fears on the part of family members when choosing a geriatric place or a long stay institution is transparency, institutions that show the metodology, care plan, management and how the treatment applied to the guests, is the easiest way to gain family confidence at the time of choice.
Good management is the intial step in rising the standard of an LSIE, and having tools that make the process easier ir a great choice. In the market there are already softwares that contribute to the these activities, but other imporvments can be adopted.
Transparency of information regarding the treatment methodology applied to each host, times of external activities, prior medication control, among other information is very important. Facilitating family acess to the elderly's routine contributes to greater safety and reliability in the institution.
The technology provided by MedLogic is nothing more than a module among its processes that creats an individualized Care Plan for each host, Through the provision of information for each senior in the system. Once fed, the software generates a Care Plan with recommended activities and treatments for each elderly person.
Having targeted amd individualized routines allows special and differentiatied care.
Dementias will put in check health system
June 3, 2019 / By Medlogic
Dementia is a disease of unknown cause characterized by the rapid death of many brain cells. The nerve cells, the neurons, within the brain degenerate and the connections between the neurons are broken. Dementias can occur from head trauma injuries, alcohol abuse, degenerative diseases, brain tumors, infections, and inappropriate medication use.
There is no cure for dementia yet, but there is a treatment that relieves the signs and symptoms of the disease. Alzheimer's disease accounts for 40% to 45% of all dementias and vascular and neurological diseases, etc.
According to Argentine doctor Rubén Torres, dean of the Argentine ISalud University and former consultant to the Pan American Health Organization (PAHO), the phenomenon is frightening because it is occurring much faster in Latin American countries. But this is not the only problem facing the governments of the region.
5 Reasons for your Long Permanent Institution for Elderly to Adheres to Aged Clinical Management Software
May 31, 2019 / By Medlogic
Having management software is essential for any business. Increasingly competitive markets require companies from different segments to be simpler, more collaborative and more connected, and the insertion of technological solutions that help improve and innovate their processes and results is essential.
The healthcare industry with an emphasis on homes or longterm care facilities has sought to update itself more and more. This segment grows considerably every year, and residents family members in turn, are demanding differentiated service when they need to choose which geriatric institution their loved one will receive the best care.
A managament software can optimize almost 90% of the processes of long Term Institutions that want to innovate and enhance their overall functioning. These same processes can become very time consuming and sometimes quite costly due to the adhered methods.
That's why we have separated 5 reasons that will make your LPIE stand out from the rest, through the use of specialized management software.
1) FINANCIAL CONTROL
Tight control of accounts and receivable, expense development through spreadsheets, inventory notices, replenishment and purchase of missing drugs are some of the software's uses in the financial area. This control is essential for LPIE that want growth and full administrative control, avoiding waste and unnecessary purchases.
2) CAREER TEAM MANAGEMENT
There is already in the market a software that aggregates all administrative/financial functions and has a multidisciplinary team management module. Medlogic has a function that tracks the daily tasks of caregivers, has activity alerts and even measures results through completed activities. Caregivers can access daily generated activities from any device connected to the internet.
3) TRNASPARENCY FOR FAMILIES
For LPIE who always want to keep family members aware of all care and treatment provided to the elderly, MedLogic software has on its platform the tool that generates Individualized Care Plans. This care plan is automatically generated for each senior through the software and is prepared according to the information provided by each resident. Later, if requested or required, family members may also have access to the Plan.
4) EASY TO IMPLEMENT AND USE
MedLogic is a pioneer system in the field of clinical management of the elderly and was developed to make its handling as easy as friendly as possible. It's 100% cloud software, so it's simple and light to install, meaning no servers or memory! Backups are made entirely online and data and information are saved with full anti-tempering security.
5) RESULT IN LITTLE TIME OF USE AND ECONOMY
By using this software your LPIE will see results in a short time: Time savings, less time spent on time consuming processes, fully monitored staff performance, savings on expendable materials, fewer errors in organizational and administrative activities. In addition, a visible growth in excellence in service and family satisfaction.
Learn more about MedLogic and have in your Retirement Home or Long Satr Instituion a system that maximizes care for the elderly and management.
What you should know about Alzheimer's, May 24 2019 / By Medlogic
The official name of Alzheimer's refers to physician Alois Alzheimer, the first to describe the disease in 1906. He studied and published the case of his patient Auguste Deter, where he studied his brain and described the changes that are now known as features of the disease.
Alzheimer's occurs due to the reduction in the production of cerebral acetylcholine (neurotransmitter), causing a deterioration in the performance of cholinergic circuits of the brain systems. It is difficult to determine who will develop Alzheimer's disease as it is a complex disorder of unknown cause that apparently has multiple factores involved.
Alzheimer's disease is divided into thee stages. The early stage is difficult to notice due to the normal aging process.
The person can:
Have language problems
Have significant memory loss particularly from the things that just happened.
Not knowing the time or day of the week.
Get lost in well known places.
Having difficulties in making decisions.
Be inactive or unmotivated.
Show mood swings, depression or anxiety.
React with unsual or aggresive anger on certaing occasions.
Have a loss of interest in hobbies and other activities.
As the disease is progressive, in the intermediate stage, the person with dementia has difficulty with daily life:
It can get very demoralized, especially with recent events and people's names.
Can no longer manage to live alone without problems.
Unable to cook, clean or shop.
Being extremely dependant on a family member and the caregiver.
Needs for help with personal hygiene, for example, washing and dressing.
Difficulty with speech advances.
Presents problems with repeating questions, shouting, clinging and sleeping disorder.
Getting lost both at home and away from home.
Hallucinations: Seeing and hearing things that don't exist.
The advanced stage is the closest to total dependence and inactivity, where the person can:
Having trouble eating.
Being unable to communicate.
Not recognizing relatives, friends and family objetcs.
Having difficulty understanding what happens around you.
Unable to find its way back home.
Having difficulty in swallowing.
Having urinary and fecal incontinence.
Manifesting inappropiate behavior in public.
Staying confined to a wheelchair or bed.
That is why detailed attention is indicated and doing everything with love. A correct diagnosis at an early stage can be crucial for a good quality of ife.
Geriatric Syndromes and Elderly Frailty
May 20, 2019 / By Medlogic
Contrary to common sense, a healthy elderly person is not an elderly person who has no disease at all. A healthy elderly person is someone who is able to manage his own life and take care of himself. Thus, the concept of health established by the World Health Organization can be considered as the most complete biopsychosocial-cultural-spiritual well-being. Most elderly people have diseases and they are rarely associated with activity limitation or social participation restriction.
There is proportionality between welfare and funcionality of the elderly. Autonomy and independence derived from functional capacity are, in fact, the best indications of health. Morever, both are closely related to the integrated and harmonious functioning of the following functional systems:
Cognition and Humor - Linked directly to autonomy and refer, respectively, to the ability to understand and solve everyday problems and the motivation to perform activities and socialize.
Movility and Communication - Linked directly to independence and refer, respectively, to the ability to move around and manage the space around them and the ability to exchange information and express wishes, ideas and so on.
The daily tasks necessary for a person to take care of himself and his own life are called: activities of daily living (ADL) and are fundamentally related to the satisfactory performance of the functional systems already mentioned. They can be classified according to the degree of complexity into: basic, instrumental and advanced.
Elderly people with more severe dependence and denoting impairment of some or all of the ADL are generally more fragile elderly people who need differentiated attention. Thus, the isolated, discontinuous and emergency care model are capable of further aggravating their health conditions.
Recent foundations show that health care for the most fragile elderly, with quality, resoluteness and cost-effectiveness, must be associated with four basic presmises, which go beyond the mere diagnosis and treatment of individual diseases:
-Multidimensional assessment able to recognize all biopsychosocial demands of the patient: their values, beliefs, feelings and preferences for care.
-Preparation, implementation and monitoring of the care plan, consisting of all preventive, curative, palliative and rehabilitative interventions, defined in a shared way.
-Communication and coordination with all professionals and services needed to implement the care plan, with emphasis on transitional care.
-Promoting the active engagement of patients and their families in caring for their health.
Clinical information systems integrated with well-established guidelines are critical to good health care, especially for the frail elderly. Such systems, however, are scarce for health professiionals and users. Even so, these professionals recognize that the use of specific systems should be treated as a priority for the elaboration and monitoring of each user's care plan and the production of indicators of clinical effectiveness of the health system.
MedLogic, a software developed especially to assist in the health management of the elderly, is a complete system that has some tools that streamline and optimize the necessary care processes mentioned in the text above. Learn more at our website: http://www.medlogic.com.br
Which are the costs that long-term care Institutions have to face?
MAY 8, 2019 / By Medlogic
The growing aging of the brazilian population together with the increase in life-expectancy brings profound consequences for the healthcare network of the elderly, given that a fragmented assistance can lead to an inefficient and discontinuous care and therefore, to the worsening of the elderlies health.
Coordination between the different care teams incharge of the elderlies health is necessary to ensure minimum assistance patterns in a resolute, efficient, structured, humane and scientifically based manner. Consequently an improved population health and a reduction in assistance-related costs will be achieved.
The knowledge of both the particularities and the parameters of the elderly health, based on risk factors, medical conditions and iatrogenesis risk are of utmost necessity to ensure a proper and quality care for the elderly.
Do you know the frailty grade of your elderly patient?
Access the link and complete the test to find out: http://www.medlogic.com.br/ivcf-20
The accompaniment of the elderly by the caring team as well as a continuous supervision (both at home and at the institution) is of utmost importance to avoid unnecessary tests and procedures and, in that way be able to provide a close understanding of the environment where he/she lives as well as to avoid domestic accidents, therefore incentivize the elderly’s autonomy.
Which are the costs that long-term care Institutions have to face?
APRIL 18, 2019 / By Medlogic
This is one of the most debated topics among managers of long-term institutions. One of the great challenges of these companies, public or private, is to how understand the costs of a residence, as often, the pricing processes of the operations are complicated.
Brazil, nowadays, has a deficiency of over 17.000 long-term care facilities for the elderly. It is important to understand that a good standard of care in these kind of institutions is extremely expensive, which makes an efficient and proper management of costs and revenues, including all donations received, of utmost necessity.
We must realize that a good pricing is essential for any decision-making process within a institution, for it represents the beginning of the transaction process, as it allows the managers of the Institutions to prioritize the types of services they want to offer, as well as realizing which classes of elderlies represent a higher cost concentration, and how to reduce and/or minimize such costs.
It is important to remember that all pricing must be done taking into consideration the particularities of each long-term care Institution. Some costs they face, include:
Rent (if applicable)
Cleaning and office supplies
Maintenance and renovation
Apparel (shoes, clothing, all necessary accessories)
It's important to point out that the support staff in these kind of institutions is highly specialized, for they perform activities ranging from a those of a hotel with restaurant service to the all the processes of medical attention / welfare care. For this reason these is one of the main costs to consider and requires a continuous process of management and attention.
In order to assist in the pricing process of a long-term care institution, or any of their services, a number of tools and processes can be implemented, yet then comes the question: How do I classify my patients?
The IVCF-20 is a methodology of Comprehensive Geriatric Assessment, resulting of over 20 years of scientific research, which helps the institution or any person to quickly identify the frailty grade of the elderly. When it comes to finantial management, the classification of the patients is essential, especially considering that a frail patient have caring costs around 70% higher than a robust one., considering the usage of all resources such medic material, medicines, treatments, odontology, physiotherapy, among others.
It is essential that classification of the resident, when it comes to financial management, as studies indicate that a frail elderly, can cost approximately 70% higher than a robust elderly, considering beyond the amounts spent by the entity, all related costs the consumption of materials, food, medicine, medical, dental and physiotherapy treatments, spending on leisure, among others.
MEDLOGIC is a Brazilian software platform, pioneer in the Multidimensional Assessment of the elderly and able to assist in the Institutions management process by assisting in controlling all care-related costs. An advantage of the software is the ability to integrate all medical and assistance informations to the financial records and processes of the Institution. This allows the managers and decision makers full view of all the information in one place, facilitating their decision making and team integration. (Learn more in http://www.medlogic.com.br)
A good administrator can achieve success in meeting budget targets, if they’re based on a good financial management through the optimization of the institution's resources, with constant and efficient management tools applied by a committed team.
Do you know how to calculate the cost that one elderly represents for your Institution?
APRIL 4, 2019 / By Medlogic
A good planification is essential for any decision-making process within a company, since it allows managers to prioritize the types of services to offer. For nursing homes and geriatrics, it is necessary to classify their residents in order to understand which classes of elderlies represents a greater percentage of costs and which costs can be eliminated or minimized.
But then one question arises: How do I classify my residents?
The IVCF-20 is a methodology of Comprehensive Geriatric Assessment, with more than 20 years of scientific research, which serves as a tool in the rapid identification of the frail adult. This condition of the resident is essential, in regard of the institution financial management, since studies indicate that a frail elderly person can have a cost, approximately, 70% higher than a robust adult.
And how can I do it?
Next, we relate a step-by-step that can guide you in the identification and classification of costs/resident. Yet it’s important to emphasize that the assessment must always be done, based on the informations of the Institution, regarding the particularities of each one.
1) Perform the IVCF-20 of all the residents: the first step is to classify the elderly who are now staying in the residential. For this we suggest the use of IVCF-20 in the following link:
2) Take a measure of work hours, or have a meeting with the care team to calculate the number of hours dedicated to the care of each of the residents, separated by their degree of vulnerability.
3) Take the times raised for each resident in their respective groups:
Group 1: Robust older adults: IVCF of 0 - 6;
Group 2: Older adults at risk of embrittlement IVCF: from 7 to 15;
Group 3: Frail older adults: IVCF above 15.
The result will be, for example:
• XX Daily work hours of the nursery technician / group
• XX Daily work hours of the Nurse / group
• XX Daily work hours of the cleaning technician/ group
• XX Daily work hours of the pharmacy technician / group
• XX Daily work hours of the kitchen staff / group
4) Multiply the number of work hours of each professional by the hourly cost of each of them. In this way, you will have the total cost of direct labor for each degree of fragility.
5) To have the total cost of a resident, it is necessary to calculate the the indirect costs. To do this, take the total fixed cost divided by the total number of residents, regardless of the degree of fragility. This way we will have the "overhead"costs, which are the part of the indirect costs that falls to each resident.
6) Take this "overhead" costs, and calculate them for each degree of fragility, then add the direct costs, and so the total cost of the residents will be calculated according to their specific level of frailty and not by only a generic average.
A good administrator can achieve success in meeting budget targets, if they’re based on a good financial management through the optimization of the institution's resources, with constant and efficient management tools applied by a committed team.
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How to create a safe home environment for the elderly
MARCH 27, 2019 / By Medlogic
Currently, the care of the autonomy of the elderly has become an important topic in the global discussions between countries. It is well known that the health of the elderly depends on their comfort and autonomy, that's why when we speak of comfort it is necessary to adapt the spaces of the home in a safe and effective way for the elderly family member, turning this space in a comfortable environment that adapts to his/her needs.
One of the first steps to care for the elderly´s autonomy is to know the degree of frailty, since this will determine both the type of care that must be performed as well its activities. Besides, elderlies have a much greater risk of suffering falls and injuries in their homes, since the aging process produces physical changes that contribute to increase possible accidents. That is why we must follow some advices that will help us properly care and protect the elderly.
For safety at home we suggest:
• Suitable furniture:
Buy suitable furniture to make it easy and safe to lean on them and in the same way to support the balance of the adult person. The furniture should not have sharp corners or be made of very rigid materials, the excess of furniture in the home can also obstruct the passage of the relative.
• Grab bars in the bathroom:
The use of grab bars in the bathroom is a common help for adult autonomy since they use it as support on different occasions on everyday activities. It is necessary to acquire handles that contain anti-slip materials so that the hands won't slip, as added safety.
Sometimes it is difficult for the elderly to realize the risks they face and most of the time it's because they don't see the risk, that is the reason why signaling strategic points of the house is important, such as: stairs from its beginning to end, possible rungs or shelves even unevenness in the garden or entrances.
• Use of carpets:
Avoid the use of carpets in the passage of the elderly, most are not fixed in place, and it is possible for those who walk on top of them, to slip and fall.
Tips to overcome of hidden dangers in the home:
• Adequate lighting:
In-home lighting must be bright and well-placed for the most common places, as well as for those dark corners, in order to achieve a clear vision, specifically during important activities such as the taking of medicines.
• Electric devices:
It is necessary to keep the electrical appliances always in good condition and verify that they are well connected, look at their cables and plugs and make use of insulating cables. It is important to secure and check the spaces where there is running water, all humid environments , locks and bathtubs.
• Cell phones and emergency numbers:
Place emergency numbers in writing and digitally form in the room of the elderly, in the livingroom and the kitchen (In all strategic places).
• Floor maintenance:
Homes that have a garden or green areas, are more likely to have holes, unevenness or objects that can obstruct the passage and/or may cause accidents, that`s the reason why the maintenance of them is vital for the older adult ability to walk with freedom and safety.
The number of long-term care institutions is growing
MARCH 6, 2019 / By Medlogic
The aging of the population is an complex process that involves biological, psychological and sociocultural dimensions that affect the life-style and the aging process of the person. With the increased lifespan of the world population it is of utmost importance to be aware of the special needs of the elderlies, who are one of the most vulnerable sociographic and need support, either temporary or permanent in their everyday activities.
In order to help and serve the elderlies in this stage of life providing them with the best life quality and attention, there are specialized institutions who provide such care, this are what in Brazil are known as ILPI (Institução de Longa Permanência do Idoso), for the rest of the world they´re all the institutions who provide long-term care and living grounds for the elderlies. The attention and care provided must be integral and involve all the different types of care, such as hospitalization, specialized ambulatory care, day hospital and home-care among others. The law dictates and support the care of the institutionalized elderly citizen, holder of rights, for them to be respected and receive a good quality care and attention in all dimensions.
So, ¿What is an ILPI? For ANVISA (Agência Nacional de Vigilância Sanitaria), the brazilian national sanitary agency, they are all residential-related governmental and nongovernmental institutions dedicated to persons with over 60 years of age, with or without family support and who have conditions of freedom, dignity and citizenship.
To regulate ILPI´s a number of documents guidelines must be followed, regarding structure and the way the care is provided to each patient. Now, we are going to see a little of what is needed.
So, ¿How does it work?
The CDC (Código Brasileiro de Defesa do Consumidor), the brazilian consumer protection agency conducts an inspection of the ILPI, in order to assure a minimum level of functionality, habitability, accessibility and safety. The permit provided by ANVISA is an obligatory document and will only be issued if the ILPI complies with all criteria.
The sanitary inspections refers to the safety and care provided to all institutionalized patients. Each ILPI must have a firefighting and prevention mechanism and programs approved by the local fire department in order to avoid possible accidents, train the institution staff in case of a fire and guarantee the quick elimination of safety hazards for the patients in case of emergency.
According to the law, all constructions intended for collective use, whether they are residential, commercial, industrial, etc, must have an inspection by the Fire Department and an permit issue by them declaring that the building indeed have all the safety conditions for evacuation in case of panic, easy access for the Fire Department as well as all the necessary fire extinguishing equipment.
What documentation do I need to get?
Formal contract of provision of services with the elderlies, family our legal tutor, detailing the type of service to be provided as well as the rights and obligations of the entity and the patient in accordance to the 1st section of article 50 of the Law Nº 10.741 of the 1 of October, 2003 (Elderly Statute).
Admisión report of the general evaluation of the elerlies with the classification of the dependence grade of each, the grade of dependence must be updated whenever necessary or at a minimum of every 6 months.
Records of every elderly, each must obligatory contain: the admission medical tests, periodical medical tests, all interventions made by health professionals and all relevant data.
Dta of the elderly register, all personal data, situation of social security, family and/or responsables reference contacts, date of entry, exit or passing.
Individual caring plan of the elderlies.
Notification, in case of need, to all pertinent organization in reference to state of negligence, discrimination, violence, cruelty and oppression as well as the absence of ID information, according to the Federal Law Nº 10.741 / 2003.
Consolidated evaluation of the performance and operation of the institution, which must be completed and delivered on a monthly basis up to the 15th of January of the following year to the local sanitary agency
Manual of Norms and Routines elaborated and implemented to all sectors and activities in the institution. Each sector must have a register of operational proceedings (POP´s) located in an visible and easy-to-access place for the employees.
These are some of the informations and documents the institutions need to provide to the families or to any possible fiscalization. Having all these materials integrated and updated is essential to guarantee that the ILPI´s activities are being well conducted and, further that that, they are necessary to ensure a proper care to the elderlies guaranteeing a level of autonomy and independence.
Medlogic is an brazilian electronic platform, pioneer in the multidimensional evaluation of the elderly and is an indispensable tool for the “Improvement of the life-quality and attention coordination provided to the elderlies, from the entrance door all the way through their care” (ANS, 2016). With the use of the platform one can generate reports and have access to all information, updated in real-time and can be used to secure that all necessary documentation is always at hand.
Another of the advantages of the platform is the possibility of integrate the work of the caring staff, specific evaluations, nursery and care protocols, physical therapy, occupational therapy, phonoaudiology, nutrition, pharmacy, psychology, neuropsychology, social work and odontology. This ability to exchange virtual information is fundamental to and successful multidisciplinary work.
The elderly is more vulnerable to violence, given that he/she holds an increase physical or mental dependence. The caring of the elderly, specially in cases of partial or total dependency, is not an easy task. It can be exhausting, and requires a technical preparation, professionalism and love.
Alterations of body balance in the aging process
FEBRUARY 15, 2019 / By Medlogic
Alterations of body balance in aging
Alterations of the corporal balance, clinically characterized as dizziness, vertigo, imbalance and fall, are among the most common complaints of the elderly population and constitute a medical problem of great relevance.
It is estimated that the prevalence of complaints of balance in the population over 65 years reaches 85% being associated with several etiologies, and may be manifested as imbalance, gait deviation, instability, nausea and frequent falls. These alterations of postural control are associated, in the elderly population, the greater risk of falling and its consequent sequelae, which present high morbidity.
The difficulties with the control of the orthostatic posture and with the consequent falls constitute an important problem that gets worse during aging. Despite the apparent simplicity of the task, the control of posture is a great challenge for the human body, it must be able to regulate the balance in unstable situations (static balance) and at the same time be versatile enough to allow rapid initiation of movement, without losing stability (dynamic equilibrium).
According to the Global Report of the World Health Organization on the Prevention of Falls in Old Age, there is a considerable body of evidence indicating the effectiveness of various interventions in the prevention of falls. Such evidence includes, among others:
• Balance and walking training with the appropriate use of support devices;
• Evaluation of environmental risks and their modification;
• Review of medications and modification of what needs to be changed;
• Treatment of vision problems;
• Education and training offer;
• Treatment of foot and foot problems;
• treatment of orthostatic hypotension and other cardiovascular problems.
Given that the act of aging represents a triumph of social development and public health, all efforts to improve it will be welcome to collaborate with the best care and attention to the elderly.
The benefits of physical activity in the elderly
JANUARY 25, 2019 / By Medlogic
Sedentary lifestyle is one of the concepts that tends to lead aging, this has caused significant pressure within the technological advance occurred in recent decades.
A sedentary lifestyle is an important risk factor for chronic degenerative diseases, especially cardiovascular diseases, which is one of the main causes of death in the elderly. That is why the practice of physical exercise, in addition to combating sedentary lifestyle, contributes significantly to the maintenance of physical fitness, either in its health aspect, as well as in functional capacities. However, physical exercises may present some limitations for the elderly, due to the physiological modifications imposed with the aging process (ALVES teal, 2004).
On the other hand, the role of physical exercise, discussed in several reviews and well-controlled studies, which attribute the regular practice of physical activity even started after 65 years with a result towards greater longevity, reduction of the general mortality rates, was highlighted. The improvement of physiological capacity (aerobic capacity) in carriers of chronic diseases, reduction in the number of prescribed medications, prevention of cognitive decline, maintenance of higher functional status, reduction in the frequency of falls and incidence of fractures and psychological benefits, such as improvement of self-esteem (CHAIMOWICZ, 1997).
It is true that the practice of exercises also prevents or delays the intellectual decline through an improvement in mood, memory, psychological function and through a reduction in stress and depression, with the consequent maintenance of well-being. Other benefits of physical activity include decreased risk of falls from increased balance, muscle strength and flexibility.
However, to avoid the fall of physical fitness with aging it is necessary to be active, through walks, in a gym or accompanied by physiotherapy, in this way, the safety acquired with an exercise program makes the older adults perform their Daily Living Activity (ADL) satisfactorily. Considering that the improvement with the practice of physical activities will give autonomy and independence. Various institutions offer free spaces and activities for the best age, just look at the official sites of each city.
Taking care of health is taking care of the future, think about that 😊!
MedLogic at London TechWeek!
JUNE 7,2018 / By Medlogic
Next week MedLogic CEO, Daniel C. Melo will be in London on a DIT (British government department) mission to promote the internationalization of companies. This participation is a very important step for the internationalization plan that MedLogic initiated last year.
One the occasion, Daniel will also meet with the British partners of the CityZen project, the result of a partnership between the governments of Brazil and United Kingdom, which will involve artificial intelligence technologies to assist in the care of the elderly.
Londres TechWeek (June 11 - 17/ 2018)
MedLogic is chosen as one of the most relevant companies to mold the future of Latin America
MARCH 8,2018 / By Medlogic
The World Economic Forum, the International Finance Corporation (IFC), a member of the World Bank Group, and some of the leading Latin American authorities in the entrepreneurship ecosystem, chose MedLogic as one of the 50 most relevant undertakings for building the future of society, Latin America.
According to Jeremy Jurgens, director and head of Knowledge and Digital Engagement at the World Economic Forum, “startups in Latin America are using creative solutions to address not only local but also global problems”. “This new initiative will integrate Latin American startups leaders into national and regional dialogues related to the region's main challenges”, he concludes.
MedLogic responds to one of the greatest global concerns of today's world, the aging of the population, offering management software for nursing houses, clinics, health care operators and hospitals, with state-of-the-art technology combined with solid scientific knowledge, eith the aim of caring for the health of the elderly in a consistent and multidimensional manner and also to reduce the waste of resources and healthcare costs.
The selected startups will join the UpLink Global community as regional representatives and, as a first step, will be invited to participate in a tailor-made programme during the World Economic Forum on Latin America, to be held on 15 March in São Paulo. This is WEF initiative the seeks to accelerate and achieve the success of startups and offer entrepreneurs the opportunity to interact with politicians from the region and executive leaders. In due course, they will have access to the Forum's network of members, with whom they will be able to form alliances for future projects in the region.
“Innovative business models are already helping to raise the level of competitiveness of Latin America and the Caribbean. The exchange of ideas among the startups will help accelerate their contribution to some of the region's major development challenges”, said Hector Gomez Ang, IFC's Country Head in Brazil. “This is part of a broader IFC initiative to support entrepreneurship and capacity building in Latin America and the Caribbean”, he added.
The World Forum on Latin America is expected to bring together more than 800 government, business and civil society leaders from more than 50 countries. The objective is to discuss and promote the adoption of technology and innovation as key factors in modernizing economies, improving productivity and accelerating economic progress.
For more information, visit: https://toplink-v1.weforum.org/
Prescriptions that do more harm than good
FEBRUARY 8,2018 / Por Otávio Nóbrega y Margõ Karnikowski
The number of elderly people in the Brazilian population has been growing a lot in the last decades. Between the 1940s and 1970s, there was a large increase in the life expectancy of the population, mainly due to public health actions, such as vaccination and basic sanitation; and due to medical-technological advances. In addition, the processes of urbanization and family planning that market the 1960s led to a significant reduction in fertility, resulting in a population increase of 65 years of age or more (Fonseca & Carmo, 2000; Chaimowicz, 1997). It is estimated that by 2025, the Brazilian population will have increased fivefold over that of 1950, while the number of people over 60 will have increase nearly 15-fold. This increase will place Brazil as the sixth largest carrier of the world's elderly population I absolute terms (Fonseca & Carmo, 2000), which will require improvements in the health care model provided to the country, especially with regard to the deficiencies in pharmaceutical assistance provided to the population (Karnikowski et al, 2004).
The aging process is accompanied by increased demand for health services and medicines, which greatly predisposes he geriatric population to the risks of polypharmacy practice and the adverse effects of medicines (Anderson and Kerluke, 1997). However, attention should be paid to the fact that an elderly person's body shows changes in its physiological functions that should not be overlooked, as they can lead to differentiated pharmacokinetics and increased sensitivity to both the therapeutic and adverse effects of medications.
Change in pharmacological parameters in the elderly organism
Of all the pharmacological parameters, distribution and metabolization may be the most affected by aging. The bioavailability of water-soluble medicines administered orally, for example, may be increased, taking into account that the elderly person has a lower water content in the body, leading to a reduction in their volume of distribution (Beyth RJ & Shorr RI, 2002). In addition, hepatic blood flow is usually reduced, sometimes by almost half, with consequent reduction in the first step metabolism of medication (Fonseca & Carmo, 2000; Beyth RJ & Shorr RI, 2002; Thorn Burg, 1997).
Liposoluble drugs, such as diazepam, for example, have a higher volume of distribution in the elderly, as the proportion of adipose tissue in these individuals is higher (Beers et al, 1991). Two other conditions that frequently occur in the elderly can contribute to an irregular distribution of medication:
The plasma concentration of albumin tends to be lower, which means that the binding of drugs to these proteins is also reduced, resulting in a higher free fraction of the drug in the plasma and a higher volume of distribution.
Renal elimination may be impaired, prolonging the plasma half-life of drugs and increasing the likelihood of toxic effects (Beyth & Shorr, 2002; Thorn Burg, 19997; Beers et al., 1991). In this context, some categories of medicines were considered inappropriate for the elderly, either because of a lack of therapeutic efficacy or because of an increased risk of adverse effects that outweighs their benefits compared to other categories of medicines, and their use should be avoided. In 1991, Beers et al (1991) inappropriate nursing home medications.
Although these criteria were initially developed for the weaker and sicker elderly in nursing homes, many authors went on to use them with adaptations to assess prescriptions made for the non-institutionalized elderly (Stuck et al., 1994, Willcox et al., 1994). With the advent of a greater number of therapeutic alternatives and the publication of studies agreed upon by specialist in geriatrics and pharmacology (Beers, 1997, Pollow et al., 1994), it became possible to generalize certain criteria to the entire elderly population, despite the level of fragility.
The rational use of medicines by the elderly is essential to avoid excessive spending on multiple medicines and to prevent unnecessary hospitalizations and disrupt the public health system, as well as to ensure a good quality of life for these individuals.
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