Prove the statement below. Use only the definitions of the terms and the assumptions listed on page 146 of the textbook, not any previously established properties of odd and even integers. Follow the directions given in this section for writing proofs of universal statements. 

If x is any even integer and y is any odd integer, then 3x + y – 1 is even 

1. Use page 146 of the textbook. 

300 Words. APA format

 

Watch the following videos featuring two different portrayals of older adults suffering from Alzheimer’s disease. Address the questions listed below:

• HBO: The Alzheimer’s Project, Grandpa Do You Know Who I Am? (part 3/3) Click here to access.
• Gladys Wilson and Naomi Feil. Click here to access.

1. What symptoms of cognitive decline did you notice being displayed by the Alzheimer’s patients portrayed in the two videos? What behaviors did they exhibit? How can you connect the cognitive decline with the behaviors you witnessed? How are these cognitive symptoms and behaviors different from the normal age-related changes you learned about from the concepts studied in your textbook? (Be specific; provide examples and a rationale).

2. What strategies did the caregivers portrayed in the videos utilize to form a connection with their loved one? Why were these strategies successful?

3. If you had to create an educational pamphlet teaching caregivers how to successfully interact with their loved ones suffering with Alzheimer’s, what recommendations would you include? What evidence-based rationale would you provide for your recommendations?  

4. Explain what connections you have been able to make between the concepts studied in this week’s assigned readings and the content presented in these video clips. 

Read and follow the Discussion Board Post Grading Rubric to ensure your post and follow up comments meet all of the requirements noted there.

First, explain in 150 words why a site significant to you would be an appropriate topic for a cultural report (be sure to read the guidelines). For instance, why would the Japanese Gardens at Herman Park be compelling and vivid? Well, mostly because the park represents many issues, including a distinct view into Japanese gardening traditions, an aesthetic that allows for peaceful meditation and reflection, and an appreciation of diversity and multiculturalism in a thriving metropolis.

2. Write a 150 word response to one of the following discussion topics.

A. How does Marge Piercy provide symbols of war of conflict, how does the readers understand she is trying to appeal to many different types of women, and why is her discussion of dinner preparation a convenient, commonplace way to probe issues of feminism?

B. “Night Waitress” explores the tough job of working a third shift in a working class community. How does Hull convey the notion that the poem’s subject, the waitress, feels a sense of conflict in her life, a sense of isolation and loneliness, and various forms of desire? What does the frail machinery signify, as well as the Cadillac, plus the cross tattooed on the cook’s forehead too?

C. How does Marge Piercy illuminate the conflicts between the colonizing of the West and the history of Native Americans? Does she employ irony — a sense of contrast — to do this (like using the Pontiac car, rather than  a Chrysler … as well as incense vs. mosquitos), and why do you think she uses the actor John Wayne as the subject — does it have to do with his many roles as an Anglo actor expressing much anger, valor, and violence?

 

Each paragraph must contain 5 or more sentences.  Please read the rubric. Do not cite the Internet, only cite from the textbook. You must cite the text at least 3 times for your entire post in MLA style (see Announcements). Respond to 2 or more classmates with 3 or more sentences. Failure to follow these instructions will result in deduction of points. Remember that you will obtain a failing score for the entire DB post if you first submit a blank post first, for I consider it cheating. Along the lines of cheating, submitting a partial DB post first and an additional one to complete the DB will also result in only the first (partial) post being graded. In other words, keep all answers on one post. 

For more info on grading policy for Discussion Boards see the grading rubric located in the syllabus and other docs tab. Lastly, all citations must contain page numbers or else you will lose 10 points. 

Chapters 7-9

In one full page explain the following: What important cultural differences between Mexican Americans and the dominant society shaped the relationships between the two groups?

In half of a page explain the following: In what ways are the experiences of Puerto Ricans and Cuban Americans unique compared with those of other minority groups? How do these differences reflect other differences, such as differences in contact situation?

In a third full page explain the following: Describe the cultural characteristics of Asian American groups. How did these characteristics shape relationships with the larger society? Did they contribute to the perception of Asian Americans as “successful”? How?

In the same third explain the following: Compare and contrast the contact situations for Chinese Americans, Japanese Americans, and Cuban Americans. What common characteristics led to the construction of ethnic enclaves for all three groups? How and why did these enclaves vary from one another?

In two different paragraph with no less than 75 words  give your personal opinion to Lakita Boykin  and Heather Schlegelmilch 

Heather Schlegelmilch 

HMS Home Care is a Medicare certified home health agency that offers nursing, physical therapy, occupational therapy, and speech-language therapy. All Medicare-certified Home Health Agencies have to participate in the Home Health Quality Reporting Program (QRP) (CMS, 2019). HHA’s submit quality measures for patient quality of care (OASIS) and patient survey results (HHCAHPS) to Medicare which factors into the HHA’s Medicare star rating (CMS, 2019). Due to the importance of this data I decided to start an Efficiency Review Committee, which will be a standing committee.  The main purpose of this committee is to improve our quality of care in the most efficient way possible by identifying opportunities for improvement.

To fulfill the main purpose of the committee the members will be responsible for reviewing the two categories of quality measures that are used in the Home Health Quality Reporting Program (HH QRP): Outcome measures; and Process measures. CMS classifies the four types of Outcome measures as the following: “Improvement measures (i.e., measures describing a patient’s ability to get around, perform activities of daily living, and general health); Measures of potentially avoidable events (i.e., markers for potential problems in care); Utilization of care measures (i.e., measures describing how often patients access other health care resources either while home health care is in progress or after home health care is completed); and Cost/Resource measures.” (CMS, 2019). Process measures evaluate the rate of home health agency use of specific evidence-based processes of care. They will also review patient survey results (HHCAHPS) and the measurements that the survey tool looks at.

The committee will look through current and past data to identify our quality problems and also identify other opportunities for improvement. Once quality problems have been identified the committee will be responsible for finding the root cause of the problem and to develop recommendations for improvement. In developing recommendations they will look at the current policies and procedures and staffing models to see if any changes need to be made.  The administrator who sits on the committee will bring recommendations to me.  With my approval of committee recommendations they will help disseminate any changes or new policies to their departments.  Feedback and monitoring these changes will be a part of their function as well to see if the changes generated the improvement they were hoping for.

Medicare no longer requires HHAs to have a Professional Advisory Committee (PAC) however I feel following the previous requirements regarding committee members will be beneficial for my agency’s Efficiency Review Committee. The PAC previously required the following members: “The agency’s Administrator, the agency’s medical director, at least one member who is neither an owner nor an employee, at least one registered nurse, appropriate representation of each discipline for which the agency provides service, at least one consumer representative and therapy and clinical supervisors can represent their multiple disciplines” (HCPRO, 2013). The external members will be an Administrator, Director of Nursing or a Physician that utilizes my agency the most and can provide feedback on our services and a previous patient who was on our services and would like to share their experiences with the committee. If I cannot find a past patient that wishes to be on the committee I will sub with the Director of Client Services.

All committee members will be appointment by me and the committee will vote on the Chair. Since this is a small, home health agency we currently only have one Medical Director and one Director of Nursing who is a RN so they along with the Administrator will be on the committee indefinitely or until census grows to the point where we can brings on an Assistant MD and Assistant Director of Nursing at which they can then rotate their committee memberships. Other members will have a two-year commitment.

Medicare never had a requirement for how often meetings should be held just that they should be held “frequently”. Since this committee is looking at quality and efficiency in patient care that can affect our Medicare rating I feel a monthly meeting would be of huge benefit in finding problems sooner.

References

Home Health Star Ratings. (2019). Retrieved from: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/HHQIHomeHealthStarRatings.html

Home Health Quality Measures (2019). Retrieved from: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/Home-Health-Quality-Measures.html

What are the requirements of an agency’s professional advisory committee (PAC)? (2013).  HCPRO Website. Retrieved from:  https://www.hcpro.com/HOM-289943-6962/Q-What-are-the-requirements-of-an-agencys-professional-advisory-committee-PAC.html

 

Lakita Boykin 

As the CEO for the local “Boykins Home Health Agency” among the community I have decided to set up a Department Efficiency Review Committee. This committee will be set in place to ensure the effectiveness of the agency. The Department Efficiency Review Committee will also ensure that the patients are receiving the complex care and also making sure the agency is performing at its anticipated levels of quality and financial performance satisfactions.  Our mission at the agency is to improve quality of life for those we serve through the delivery of clinical excellence, extraordinary service and compassionate care, while being recognized as the leader in home health services. Guaranteeing your stay with care is a part of the function of the agency.

There will be divisions among the various departments in the agency. Each division will have specific roles & responsibilities once leadership is chosen. The division leader will be reviewing the current issues and agency status at hand ongoing will adhere for changes, implementations, recommendations and findings. This advisory committee will report to myself with the findings and ongoing efforts for advancement among the agency once final decision has been reached. An outline of procedures and program processes will be administered among the meetings.

The selection process of the committee advisory board will be comprised of one member of seniority from each division and two field workers from the agency. The decisions among committee membership will be based upon length of service and experience. The members have to be knowledgeable of the services provided and departmental information/ functions. Collectively the committee will vote upon roles. Once roles are selected the members will serve a 1 year term.  The committee will meet once every month to ensure that the patients are receiving the complex care and also making sure the agency is performing at its anticipated levels of quality and financial performance satisfactions.

Among the agency will be suggestion boxes for client, volunteers and other employees to voice their opinions as we are providing services to fulfil our mission.  Also the agency unit meeting will also be a great time to discuss any issues, concerns or suggestions they may have. It will be the committee member’s job to relay the messages during the proper time frame.  If a decision is to be made, the committee will do so by voting. Most CEO’s are extremely busy; however, I will be very involved and present during the meetings outside of emergencies. It’s important to be in the know and not just made aware of situations by other leaders. Active participation, effective communication and respect for the agency/ employees is key to the Boykins Home Health Agency.  Committees are important as they allow you to see progress, stalls, issues and the need for improvements.

References:

Dunn, R. (2016). Dunn and Haimanns healthcare management. Chicago, IL: Health Administration Press.

Home Health Care Mission Statements

https://www.missionstatements.com/home_health_care_mission_statements.html