Influenza: New CDC Recommendations

Although common, flu continues to rank as a serious health threat to Americans. From 2010 to 2013, influenza contributed to as many as 633,000 hospitalizations and 27,000 deaths per year.¹ Influenza causes the majority of these events among patients over the age of 65. Immunization remains the first line of defense, but earlier this year, the CDC updated their immunization recommendations. The CDC temporarily recommends against the use of live attenuated influenza vaccine due to its limited efficacy in the past two flu seasons. They continue to recommend vaccination of all people over age six months, with an age-appropriate vaccine, absent any contraindications. Additionally, the CDC has updated their recommendations related to egg allergies. The recommended time for clinical observation after vaccination of people with egg allergies has been reduced from 30 to 15 minutes. They additionally recommend that flu vaccinations of people with egg allergies should occur in a clinical setting prepared to respond to allergic reactions (e.g. a hospital or doctor’s office). The recommendations state that Flublock is the only vaccine considered egg-free.

When treating geriatric patients, prevention is only one-third of that for which the healthcare community should prepare. We must also consider treatment of illness in this especially vulnerable population and recovery. When elderly patients are sent home to recover from the flu, Five Star Home Health can provide a number of skilled services designed to increase your patients’ peace of mind, protect their health status, protect their caregivers, and prevent unnecessary hospitalization. An influenza care plan can include:

• Skilled observation and assessment to identify a worsening condition in a timely fashion – up to daily
• Training, observation, and direct care to ensure optimal at-home care
• Patient / caregiver training in warning signs
• Patient / caregiver training for preventing the spread of the flu in the home
• Activity consultation: Evidence suggests that elderly patients will spend more time than needed in bed or sitting when they are ill.² As with most remedies, bed rest is only useful in proper doses. Too much bed rest can lead to slower strength recovery, functional loss, and other complications.³ Five Star nurses and therapists can monitor patient recovery up to daily and advise your patient about optimal activity levels based on your patient’s current condition.
• Home care has the additional advantage of limiting community contact. 

Bed rest affects elderly patients more negatively than younger patients. Among a test sample of healthy subjects age 67 and older, 10 days of bed rest resulted in more lean tissue loss than 28 days of bed rest caused in younger test subjects.⁴ This observed loss of muscle at a rate 3 times greater than with younger patients was with healthy test subjects and did not take into account the additional effects that nutritional compromise, inflammation, and comorbidities could have during bed rest for flu. For patients over the age of 70, bed rest is associated with a major, new disability in 1/3 of prolonged cases.² For elderly patients who may have experienced a functional loss as the result of bed rest, order a physical therapy assessment from Five Star. Our qualified physical therapists specializing in elderly care can set your patient on the path to recovering from strength and functional losses.

Leading the Nation in Preventing Urgent Care

Medicare’s Home Health Compare shows that Five Star Home Health leads both state and nation in prevention of unplanned emergency room care during the home health episode. Compared to other home health agencies, the patients you refer to Five Star prove 22% less likely to require urgent care.

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References

1. Grohskopf L, Sokolow L, Broder K, et al. Prevention and control of seasonal influenza with vaccines recommendations of
   the Advisory Committee on Immunization Practices – United States, 2016-17 Influenza Season. MMWR Recomm Rep.
   2016; 65 (5): i-d56.
2. Viccaro L, Parera S, Studenski S. Is timed up and go better than gait speed in predicting health, function, and falls in older
   adults? J Am Geriatr Soc. 2011; 59 (5): 887-892.
3. Michael Y, Whitlock E, Lin J, et al. Primary care - relevant interventions to prevent falling in older adults: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2010; 153: 815-825.
4. Karinkanta S, Pirrtola M, Sievanen H, et al. Physical therapy approaches to reduce fall and fracture risk among older adults.
   Nat Rev Endocrinol. 2010; 6: 396-407.