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[Need for nursing care--severely disabled patients. Problems in determining disability prerequisites in legal health insurance].

The report describes the legal and administrative regulations concerning the medical examination of the new Leistungstatbestand "Schwerpflegebedürftigkeit" (i.e. a situation characterized by "urgent need of nursing care"). The numbers of applicants and the results of the medical examinations during the period 1989-1992 are also reported. The main difficulties consist in clarifying the meaning of some important legal terms and the relatively vague formulations of the administrative guidelines. Another important aspect is seen in the fact that the result of the medical examination is largely dependent on the informations supplied by the patients or their relatives. Two case reports are presented for the purpose of demonstrating these difficulties. Finally short reports of the first few judgements regarding the definition of situations with "urgent need of care" by different social-courts of appeal are presented.

Aged↗

Disability in US presidents report. Recommendations and commentaries by the Working Group. The Working Group on Presidential Disability.

If the president of the United States must decide within minutes how to respond to a dire emergency, its citizens expect him or her to be mentally competent and to act wisely. Because the presidency of the United States is now the world's most powerful office, should its incumbent become even temporarily unable to exercise good judgment, the consequences for the world could be unimaginably far-reaching.

Persons with Disabilities↗

Disability: how successful are we in determining disability?

Individuals who have severe back pain have trouble bending, may not be able to put on their shoes, have difficulty in ambulation, and may not be able to clean their own houses. What distinguishes these individuals with low back pain from those afflicted with other conditions (i.e., congestive heart failure, metastatic cancer, symptomatic acquired immune deficiency syndrome) is prognosis. Back pain essentially never shortens life. Acute back pain has a very benign prognosis, with more than 90% of the individuals returning to functional status equivalent to their baseline status within 3 months of the onset of pain. Patients who have chronic back pain have a significantly worse prognosis, but most cohort studies show that substantial numbers of chronic back pain patients improve over time with supportive therapy.

Disability Evaluation↗