Carol Harnett in Part II of "Small Changes Make a Big Difference" discusses the following: Step 3-Just because they show it doesn't mean they are committed. Step 4-Bend your knee, lean forward, and enjoy the ride. Carol's words of wisdom are as follows: "The most effective incentives are those that are important to the employee, are given frequently and are seen by the employee as generous." Carol's sign off is: "So we've ended where we began." Read this article to the end and see if you agree.

Thomas Felicetti, PhD, calls to the reader's attention that falling is a major concern for the elderly and disabled population. He continues for caregivers to define the area of "frequent fallers" by age group and sex. Dr. Felicetti shares methods for caregivers to implement to prevent and limit the occurrence of falls. He emphasizes that "attention" to the possibility of falling has, in fact, provided reduction in falling. Improve attention to falling situations may be key to prevention of falling.

Nancy Lewis reviews for us the criteria established by the Official Disability Guidelines and the Medical Disability Advisor. Their purpose is to assist in keeping treatment protocols and return-to-work timetables within industry-acceptable standards. In working within these stated standards, Nancy cautions, "Be sure you understand the term disability." Nancy takes us through the hoops of the various types of disabilities and defines a help tool, "listening with a third ear." Using this tool, you should become more attuned to a client's emotional state. On the basis of these tips, your interactions with your client will result in favorable and timely case management outcomes.

Frances Snowden, BS, RN, CRRN, CCM

Contributing Editor