Saturday, March 23, 2013

MSN (Master of Science in Nursing) Salary Range


The Master of Science in Nursing (MSN) is one of the few degrees that offer nurses further specialization in a specific field. As a graduate holding a master degree in nursing you may be well qualified to serve in a leadership role at a health-care facility or as a member of a university faculty. The degree even allows you to advance your career in the nursing field.

Once you complete your MSN program or earn a MSN degree, you may advance your healthcare career and become an administrator or supervisor. Adding to this, you may also work as a clinical nurse specialist (CNS), a nurse midwife, a certified registered nurse anesthetist (CRNA), a nurse practitioner, or a nurse psychotherapist, among others. These days, many MSN graduates act as specialists in areas that include community health, management and geriatrics.

Apart from all this, earning a master's degree in nursing allows you to focus and widen your opportunities for having bigger responsibilities and even earn more money. In fact, in terms of salary, the nurse who holds a MSN degree enjoys a decent income. Though working as a MSN graduate may have its own share of challenges and responsibilities, but it even offers tremendous rewards along with salary range that can be beyond any evaluation to any other profession.

Although it is easy to generalize what a nurse with a master's degree may earn, but generally salaries greatly differ when specialties are concerned. Nurse with a master's degree in ambulatory care can earn an average yearly income of $44,000. Adding to this, a nurse with a degree in nurse management can have the potential to earn an average of $65,000 a year in that field. The highest earning nurse in the health care industry is often the nurse practitioner.

The working location also plays a very major role for a nurse who holds a MSN degree, even when it comes to overtime. Certain medical facilities or centers compensate overtime by paying a high hourly rate, while others pay off the time by increasing time off. If the reimbursement comes as an hourly pay, in that situation the pay rate usually differs from one specialty to another. Nurses may acquire their hourly pay by the number of beds or by the size of the supervised staff.

In next few years the employment opportunities for nurses having master's degree is expected to grow at an average rate. Tough the opportunities may differ by region of the United States, but with the increase in job opportunities the salary range is expected to boost in next few years in the United States.

Nursing Home Administrator - Roles and Responsibilities


Nowadays, nursing homes not only provide care for the aged people but also with younger patients as well. This is true for patients who are physically and mentally impaired. At times, even healthy adults enter these care facilities because of the physical, occupational, and rehabilitation services that these facilities provide. That is why the need for nursing home administrators is really in demand. There are two main tasks in this kind of career. First is to manage clinical and administrative relationships and second is to ensure that the other related services are on the right track.

Typically, the responsibilities of a Nursing Home Administrator is supervising staff and employees, handling financial issues, medical care, medical supplies, facilities and added tasks as demanded. In pursuing this kind of career, good skills in managing people, nursing, financial and medical concerns of the nursing home are vital. Moreover, having people management skills, as well as enough understanding about finances, nursing, and medical skills would be essential for an assisted living facility. Additionally, the responsibilities run from patients and staff counselling, supervision of budgetary limits of the organization, managing training of staff and welfare programs for patients, and accomplishing the role as a supervisor in the facility. To have a successful career as an administrator, consider the following guidelines:

Education Requirements

As a Nursing Home Administrator, you need to complete no less than 4-year, bachelor's degree in the field of health services administration, public administration, or long-term care administration. An administrator is dedicated in both medical and health services management. Comparable to any other application for a job, requirements may differ by place of employment or state. If aspiring for a higher place to work in large institution, an extra 2-year or masters' degree in related field would be required. Some of the usual courses in these kinds of programs are working in fundamental skills and practices, the science of aging and long-term care, gerontology, and health behaviour. Once you completed the state-approved program, the next thing to do is to pass the licensing examination for the Nursing Home Administrators.

Important Skills Requirements

To be a successful administrator and to excel in this kind of profession you should have great skills and understanding in health care and business fields. If you want an effective career as a Nursing Home Administrator, an utmost ability in understanding complex and inconsistent information would be very helpful, as well as promising and key leader with great communication skills would be very essential.

Employment And Economic Outlook

After completing all the qualifications, the next step is to post your resume on the internet and register in several job advertisements. The help of the internet is very important in your career search to find out the different job openings both locally and internationally.

Based on the United State Bureau of Labor Statistics (BLS), the Nursing Home Administrators fall into the bigger group of medical and health services managers, wherein a 16% growth in employment in this field. It will continue to prosper up to 2016. In 2006, the median earnings for this career are around $73,340.

Finally, in any health care profession it is important to practice patience and discipline. If you are lucky to get shortlisted, prepare for a background check performed by every management on any applicant before finally qualifying them for the job. You will definitely land the job if you have varied work experience in a hospital environment or related facility and if you have all the needed skills, certification, and education.

Farewell My Migrant Healthcare Worker


What follows below is a slightly edited transcript of an interview with a young woman named "Jiang" (alias) which occurred in Beijing, Chaoyang District at a Starbucks coffee shop on December 1, 2011. All edits are primarily due to issues of translation, my imperfect "on the run" typing effort and a very uncomfortable seat at Starbucks. Otherwise, her responses are reported below in as true a form as possible. The purpose of the interview is to shed light on the single most critical issue within the burgeoning geriatric care industry in China: namely, the absolute dearth of properly trained human resources and consequently the use of inadequately trained personnel to administer care to the elderly Chinese. A read through the interview illuminates other social concerns, and while I am sympathetic to these, my focus here is senior care.

Jiang is a young lady of 36 years who is a migrant healthcare worker in Beijing. She is perfectly average for her social cohort in nearly every respect: neither pretty nor ugly, simply dressed, with serious tooth decay and a limited world view. She is a contract employee at a state run nursing facility and has no professional education in nursing other than what she has learned over the past few years. Jiang, and many of the people with whom she works are known as "Bao Mu", or migrant workers. Being Bao Mu carries a stigma and it is not a pleasant one; they are viewed as wholly inferior, as a lower caste, dirty and unworthy. In reality, I found in Jiang bucolic charm and a meek honesty which set her in sharp contradiction to her current urban existence; indeed, her life in Beijing could not be more uncomfortably foreign.

As we moved through the discussion, Jiang became more relaxed and began to open up. I did not intend to enter the realm of her private life but as the interview progressed, it became obvious that her past has had profound influence on her current situation. Some of her answers are startling and painful; they paint a vivid picture of not only her job but of her life as well. Lastly, you will notice that the conversation is occasionally peppered with anecdotal comments, either before or after a question, in << >> brackets. I added these notes after a final proof read as I found a simple rote reproduction of the interview resulted in a hollowness which failed to convey the emotional environment.

Jiang arrived at Starbucks prior to the translator and me. She was sitting at a small table in the back of the room waiting patiently with her coat and gloves on, giving a guarded impression and that she considered us a potential no-show. As we approached the table she stood, smiled and said hello. After a brief introduction by the translator and some explanation, I began the interview:

***

Bromme: Hello, Jiang

Jiang:Hello Sir

Bromme: Hi, my name is (Ke Bo Ming) and I have a business here in China. I help Chinese businesses build private nursing homes and senior living facilities. I have explained to you that I want to ask you a number of questions about the work you do, how you came to do it, what you think about it and generally about what you want to do in the future. Is this ok? You understand?

Jiang: Yes Sir

Bromme: Also, I am asking you these questions because I intend to publish your answers in a blog I write. You will remain anonymous, but your responses will be reproduced, after translation and small edits, in their entirety. This is OK for you?

Jiang: Yes Sir

<<Jiang nods in approval>>

Bromme: Ok, let's get started. Where were you born and where did you grow up?

Jiang: I was born in Bishan; I grew up there too; my entire life.

<<Bishan is a rural town near Chongqing. Jiang, obedient and dutiful, asks if she can take her coat off.>>

Bromme: How old are you?

Jiang: 36

Bromme: How many years of education do you have? And what have you studied?

Jiang: I studied the basic curriculum

<<This means that Jiang spent nine years in school>>

Bromme: Jiang, I understand that you work in a nursing home, how long have you worked there?

Jiang: About three years

Bromme: What do you like most about it?

Jiang: The money, but I do not get paid much.

Bromme: How much are you paid?

<<Jiang was not eager to discuss her salary and I think she found this a little intrusive. There was some conversation between them about my question between the time I asked it and her final response. It was awkward for her and, I sensed a little painful. But I believe she was truthful.>>

Jiang: They pay me 1,500 rmb per month. I also get a bed and some food.

<<This equates to roughly USD235 plus the food and bed.>>

Bromme: What do you like least about it?

Jiang: I do not like taking care of old people; I am a young person. The old people yell at me and sometimes try and hit me when I have to touch them.

Bromme: Do you get hit a lot? Why do you have to touch them? What do you mean?

Jiang: Sometimes I get hit but often they miss me because they are slow. The nurses tell me I have to clean them when they shit in the bed. Or sometimes I have to help them go to the bathroom by inserting my finger into their anus. Also, sometimes the families blame us when the old people die.

<<Jiang tried to release this bit of information as if she were sorting laundry, but she could not contain the anguish; it was embarrassing for her.>>

Bromme: Does anyone else hit you? Have the nurses ever hit you? The boss?

Jiang: No. My father used to hit me but not the nurses.

<<Obviously, this was unexpected and the result of a miscue in translation. It made both the translator and me a little uncomfortable, and I decided to ignore it for the time being. After a breath, I continued.>>

Bromme: How did you find your job here at the nursing home?

Jiang: My friends told me.

Bromme: How did they find this job?

Jiang: I don't know

Bromme: What did you do before you worked at the nursing home?

Jiang: I was a food worker. I prepared food in a factory.

<<Her answers here were robotic and truly conveyed that she was disconnected to her job; it was merely a means to an end.>>

Bromme: Jiang, when you left the factory (Where was the factory?) and came here to Beijing to work at the nursing home, what training did they give you?

Jiang: I worked in Wenzhou. When I was contracted, the nurses told me what to do and after a few weeks I was able to do most of the work alone.

<<Wenzhou is located on the coast of China, not far south of Shanghai. Wenzhou is the crucible of Chinese entrepreneurship.>>

Bromme: Other than clean the patients, what else are your duties?

Jiang: I feed them, give them medicine, help wash them, help them exercise if they want.

Bromme: Jiang, how long do you think you will work at the nursing home? Do you have other plans? What would you like to do with your life after the nursing home?

<<This question was either puzzling to Jiang or the translation was off. It took a few iterations to get it on target>>

Jiang: I have to work here because I need the money. Someday I might find another job but I don't know. I would like not to work here, but I don't know where to go. I would like to have a shop and sell things.

Bromme: What type of things would you like to sell?

Jiang: All sorts of things, cute little knickknacks, dolls, sweets!

<<Jiang turned into a little girl describing this. She was almost excited and literally disappeared into another world for a moment.>>

Bromme: So, Jiang, if I understand you correctly, you work at the nursing home for no other reason than you need the money? Right? You essentially hate the job, nothing about it interests you. In fact, caring for the old people disgusts you...they even hit you sometimes, right?

Jiang: Yes Sir

Bromme: Do you think you are good at your job? Are you proud to be a health care worker?

Jiang: Today I know my job and I do it, but I do not like it. I am not proud of being a health care worker.

<<The idea of being proud of her job was novel, but once she understood the question, she responded with little hesitation>>

Bromme: Do you think being a health care worker is an important job?

Jiang: It is not an important job, if it were I would be paid more money.

<<Jiang's logic was unassailable and her honesty was simple. I was beginning to sense that this idea of mine, that is to interview a migrant health care worker, needed something more. So I decided on a different track>>

Bromme: I want to ask you some questions not related to your job at the nursing home, ok?

Jiang: Yes

Bromme: Did you have a happy childhood and are your parents still alive?

<<I felt this was a reasonable subject to explore given her prior admission about her father.>>

Jiang: We are a very poor family. And when I was little my parents had to split up and work in different cities. I had to go and live with my relatives for a long time. One day my father came to get me and take me home. But he would beat me all day and tell me to call my mother and beg her to come home. I had a very bad relationship with my father. My parents are still alive.

<<Jiang opened up here in a way that I doubt she has in quite some time. She was almost eager to say these things. Her answer above is an abridged version of her entire response.>>

Bromme: If you could buy anything what would it be?

Jiang: A nice house for my mother and a shop for me!

<<Jiang smiled broadly. She missed her mother enormously>>

Bromme: Jiang, I have only a few more questions. When your mother is old and frail will you take care of her? Or would you consider a nursing home for her?

Jiang: Yes, I will care for her.

<<Jiang oozed empathy>>

Bromme: But you will have to work, right? How will you take care of her and work at the same time?

Jiang: I don't know.

<<And again, Jiang's honesty was never more apparent than in this answer. She paused for a while before answering, looked down at the floor hopelessly and responded without looking up. I think that this may have been the first time she ever considered the difficult situation of either caring for the mother she loves more than anything or supporting herself. I don't want to read too much into her answer but I suspect that she began to rethink her plight at this moment. Her answer in a way almost made me feel guilty about presenting her with this dilemma>>

Bromme: Jiang, do you have any questions for me?

Jiang: Sir, why do you want to work in nursing homes?

<<Clever girl, I thought>>

Bromme: I don't really work in them. I help people build them and operate them.

<<Jiang waited for the translation. It didn't appear that my response really answered her question.>>

Bromme: Thank you, Jiang. I have enjoyed speaking with you.

Jiang: Yes Sir, Did I do a good job?

Bromme: Yes, Jiang. You did a great job.

<<Jiang rose from the table and put her jacket back on. She thanked the translator, smiled and began to walk out, when I asked her one last question>>

Bromme: Jiang, have you ever seen the Chinese movie Farewell my concubine?

Jiang: Oh, no Sir, movies are too expensive. Goodbye

Bromme: Goodbye, Jiang.

***

In my two hours with her, I found Jiang to be much like Chen Dieyi in the film Farewell my concubine. Not on a superficial level, but in terms of how tortured she must be; caught in the middle of a miserable triangle with the angles of her life defined by a father who beat her as a child, the necessity of holding down a job she despises and a mother to whom she is fully devoted and loves dearly but cannot live with for financial reasons. Making this mosaic more complex, Jiang now knows that she, like millions of other poor and middle income Chinese, face a dreadful dilemma of ultimately having to care for their parents and lose a job or keep the job and turn their parents over to a nursing home.

Update: Last week I found myself in the vicinity of the nursing home where Jiang works. I stopped by to say hello and thank her again for her time. The manager of the facility seemed frustrated when I inquired about her; he told me she had quit her job three days ago and did not know where she went.

She just left he explained, raising his hands in exasperation, "Like all the Bao Mu, appear from nowhere and disappear into nowhere".

I turned and walked out of the nursing home, leaving behind the caustic tang of bleach and sour reek of dirty clothes. The cold air bit into my nose and cleared my lungs as I stepped outside. I walked down the street I thought about what the manager said regarding Bao Mu disappearing into nowhere. As I hailed a cab, I looked back at the nursing home and pictured Jiang, an apparition with suitcase in hand, furtively leaving her job, escaping under the cover of a foggy dawn.

Full of ephemeral sympathy for Jiang, I thought to myself as I got into the cab, "Indeed, has there ever been a more poignant, unknown destination?"

Interview Tips for Nurses


Whether you're an experienced nurse or just out of nursing school, interviewing for a job can be stressful. The best plan of attack, as with most anything, is to be prepared. The following are a few simple tips to prepare.

• Take a copy of you resume with you. Even if you have previously submitted a copy, whether in person, mail, email, or by fax, make sure you take a hard copy of your resume to the interview. Things can get lost in the shuffle, and just because the human resources department has a copy, does not necessarily mean the person interviewing you will have received a copy.

• Dress appropriately. This should go without saying, but I have been shocked, many times, by what I've seen nurses showing up in for a job interview. The best rule for most interviews is to show up in clothes similar to what you would be wearing on the job. With nursing, this is a little different. Unless you are coming to the interview right before or after a shift at your current job, and the interviewer already knows this, it is best not to wear scrubs. As a nurse, you want to present a professional appearance, so clothing appropriate for a professional office job would be best. No jeans, sweats, or sneakers please. And conservative is best. Nothing low cut, or too short.

• Never bring up salary at your initial interview unless is first brought up to you by the interviewer. In most nursing facilities, salary is not discussed until a job offer is made. But, be prepared ahead of time for questions regarding salary. It is fine to put negotiable on the application, but know ahead of time what you would actually expect, what the norm is for someone with your experience at this facility and the minimum you are willing to take.

• Practice your answers for the most frequently asked interview questions, such as: what is your biggest strength, your biggest weakness, (you want a weakness that can actually be a positive, such as caring too much, or working too hard, etc.), what would you do if you saw that a co-worker had a bad attitude, or wasn't carrying their weight.

• It should go without saying, but be on time for the interview. Allow yourself extra time for the little emergencies that might crop up such as traffic, detours, getting gas and having to stop at more than one station because one of them is out of fuel, (yes, it happens).

Being prepared for the interview is the biggest step towards getting your dream job, don't blow these simple measures.

Learn How to Cope With Placing Your Elderly Parent in a Nursing Home


Taking care of your elderly parent can be hard work mentally, emotionally, physically and spiritually. Many times roles are reversed and they become more childlike while you become more parent like. It's not an easy adjustment to make for your parent or yourself especially if he or she has been very independent all their life. Consequently, if you want to provide loving care for your parent and still take care of yourself there are many things you need to know.

TRANSITIONS

Acknowledging that this is a time of transition and knowing that things will not be as they once were is a good first step in care-taking. Because difficult and unsettling emotions surface keeping a journal to process them is helpful. Issues, disputes, and unsettled business can make for a heavy burden if you carry it alone. If you have a trusted friend, minister, rabbi or someone you deeply respect around you to discuss your feelings or simply listen without judgment your burden will be lighter. Your parent may also need a counselor or someone in which they can confide and share their feelings. Often the facility will make this service available.

In my own situation I needed to move my mother closer to my residence to manage her care in the assisted living facility. I could not give her the skilled care she needed. As I write this now it almost seems like moving her happened overnight without much forethought or concern. Indeed the opposite is true. I planned long and hard about it. Being the independent person she was, she resisted this move with all her might like your parent may do with you. She didn't want to go into a nursing home...period. Even though you may plan the move very carefully and with as much love as you can, be prepared for your parent to be angry, irritated, upset, resistant, and uncooperative. This was the case with my parent. Even though she traveled the 12-hour drive in a huge motor coach with 2 drivers she was very upset when she arrived. Be prepared. Even though you may put your heart and soul into making the transition as easy as possible it may be hard for your independent parent and you.

THE FIRST FEW DAYS AND AFTERWARD

The first few days can also be a trying time for both you and your parent. He or she is in a new place and has lost independence. They may lash out at you, the nurses, nurse aides, or other residents. For example, upon arriving in the nursing home my mom complained about everything including: her roommate's bathroom habits, the food, her inability to sleep on the bed, the aides checking her in "the middle of the night." But finally after several months she seemed like she had made the transition well. She and her roommate, "Ava", became great friends and she grew to like most of the staff. No matter how your situation unfolds this time may hold deeper meaning for you both. It can be looked at as an extraordinary journey into facing aging and possibly the death of your parent. Indeed it can be a time of facing your own fears about losing your parent and facing your own aging process.

BEING THEIR CHEERLEADER

Making major decisions for your parent may put you in the position of medical or financial advocate.. If your parent has a living will, and has named their durable power of medical attorney and durable power of financial attorney review those documents. If this is not set up you may want to consult a lawyer if you haven't done so already. Talk to your parent about this. Sure, these are difficult subjects but must be done! Parents may not be able to handle their own finances or medical treatments alone. You are there to assist and possibly take over when they need you to do so.

In my case, I drove my mother to many doctor's appointments, answered calls from the facility, and discussed her care with all of her doctors. I was her cheerleader too, encouraging her when she was down or depressed. This took enormous strength on my part because even though I loved my mother very much she was not a cheerleader for me as I was growing up. When I was five she began full-time "shift work" in a factory. Although I had wonderful grandparents caring for me they couldn't fill the void that mom created when she was gone. I had questions, concerns and problems as any kid does and they only multiplied throughout my teenage years. She wasn't a cheerleader for me when I needed her but now she needed me to act as hers.

Old wounds may open up. Processing them is significant to the care you can offer your parent and taking care of yourself. Strive to talk with your trusted friends, minister or rabbi. They are there for you. Encourage your parent to utilize the counseling services at the facility.

UNUSUAL BEHAVIORS

Don't be surprised if your parent displays unusual behaviors. They may be forgetful, may display dementia and get upset. He or she may have medical problems that color their day. At times it may be all you can do to visit or advocate.

Sometimes advocating proved to be more than I could give. My mother resented me for moving her and putting her in the "old age home." She had dementia and would say the most bizarre things. Once evening my mother called me a total of 15 times wanting me to help her locate my brother. You see if she didn't talk to him everyday this unwarranted fear set in and she imagined that he was lying dead in a ditch somewhere.

This type of behavior began to happen daily until the social worker of the facility called a "team meeting." My brother and I were present along with the head nurse, the physical therapist and social worker. They suggested that arranging a phone call between my brother and her at a specified time everyday might alleviate mom's anxiety. That time was 9:30 am. Then, she would call me around 5:00 PM daily. Everyone on the floor knew of this arrangement and helped mom make the calls. It worked out very well.

Don't hesitate to seek the help of the professionals at the facility. They have lots of experience and can often offer many suggestions that make life more pleasant for everyone involved.

DIFFICULT TIMES

There are going to be some difficult days. Your parent may not be feeling well, may be depressed or feel as it they have nothing to live for. You may have to dig deep inside yourself to find the compassion and strength to companion them.

In my own situation, there were days when I'd walk into my mother's room and she'd be lying on her bed with the shades drawn down. She had osteoarthritis in her left hip, which caused severe pain. On these days it was all I could do to comfort her. Providing energy therapy gave her some relief, which would enable her to get up off the bed, walk to dinner and the library. The hip pain was like fighting an old but familiar enemy because she was also fighting depression. She often spoke about how she wanted to die and go to her "permanent home." When I heard this repeatedly it began to affect me adversely. On one hand I listened with compassion for a time but I also had to detach lest I became depressed myself.

You will find that you can only do so much. You cannot stop the aging process but you can be there to listen, to advocate and to make like bearable for your aging parent.

MAKING GOOD MEMORIES

You and your parent can make good memories during this stage of their life. If you participate in the activities that the facility offers with your parent many times you will find that you actually enjoy yourself. If they are able to leave for outings encourage them to do so. There's nothing better than a ride on a lovely summer day, visiting family in their homes or lunch out. Do it as often as they are willing and able. You won't regret it. In fact these memories will be some of the one you treasure the most.

In my case, sometimes when I came to visit my mother was fully engaged in circle ball and chair exercises or playing a game of bingo. These were fun times and I would often participate. It was fun encouraging all of the residents to do their best to hit the ball. They enjoyed it too and often there would be plenty of smiles. On some afternoons, we sat outside on the benches under the awning of the building. These were among my favorite times as the trees and flowers were in full bloom. Other residents would come out too and we'd have lively conversations albeit loud ones as most of them were hard of hearing. Sometimes it would just be mom and I talking about our happy memories or retracing our family tree.

Again, help them get out and enjoy life as often as possible. The nursing home may have a van that takes residents out for activities. Help your parent find the activities they like encourage them to join in.

SELF CARE

Self care is a must for anyone that is a caretaker. Often care-takers don't want to take out time for themselves. This is not good thinking. In order to take care of others you must first practice self-care! What good can you possibly to your elderly parent or anyone else if you are emotionally, mentally, physically and spiritually depleted? The answer is: you cannot.

What brings you joy? What brings a smile to your lips? Is it a walk in nature? Time alone in meditation? Exercise? Reading a book quietly? Vacationing? Listening to good music? Gardening? Baking? Meeting up with friends? Playing with your pet? Enjoying time with children? Whatever fills you up do it! I created a comfortable chair in my home where I would meditate. I had a candle, prayer beads, scripture and other inspirational books on the side table. An iPod with meditation music and headphones were there too. Feeling God's presence with me on this journey sustained me through it all.

Those times when I visited my children and granddaughter were happy times that lifted me out of the caretaker-problem solver role. To see new life and the excitement it brings warmed my heart like nothing else.

I exercised by riding my bicycle when the weather was good. I promised myself that I would not take my cell phone on the ride and for that hour no one could contact me. It was I riding in nature. I'd ride out to my favorite spot on the trail and feel re-energized by the beauty surrounding me. Most of the time I felt as if I could face anything when I returned. I knew I had to do what was life-giving for me so I could be there for her. This and the support of friends, my spiritual director, good books and faith was what helped me through this time of my life.

FINAL PASSAGE

It is very hard to witness your parent weakening and becoming frail. Not many of us want to face losing a parent no matter how ill they are. You may bargain with God, deny the situation, become angry or very sad. This is a time of life that all of us face someday. But your parent may be looking toward the next life and being out of pain. When thinking of them instead of yourself you may be able to accept their impending death.

"She had been in the emergency rooms of local hospitals over 25 times in the year and a half that she was here," I reasoned. At 92 she was tired of fighting this hard battle with the arsenal of drugs and invasive procedures. She was ready to go home. But was I ready to let go? Well, whether I was ready or not, it was going to happen.

You may think of how you could have or should have done things better or differently. You may think about how you could have been kinder, gentler or a better problem solver. All these thoughts may go through your mind. If you've done the best you could do and were there for your parent, then you should have no regrets. Sure, it's still hard and you may be grieving but time does help. Also, to honor the memory of your parent you may consider donating to a charity, planting a tree in your yard, or spending time volunteering in your community. These activities help others but they do help you as well. Above all, know that you have walked a difficult journey and give yourself time to heal.

A very good website to visit for further information on care-taking is http://www.agingcare.com

Hidden Spy Camera - Preventing Nursing Home Elder Abuse


For millions of Americans the issue of aging parents and where and how to house them has become huge. And the bad news is it is only going to get worse. With more baby boomers getting to retirement age, a big demand is being placed on nursing home and assisted care facilities and especially their staff personnel. So far the existing system is strained to say the least.

What this leads to is nursing homes, assisted care and long term facilities sometimes making compromises when it comes to hiring staff. A missed background check, a missed reference check and worse add up to unqualified personnel being employed there. And home care caregivers and domestic help-OMG!

Even if you use an employment agency, there is no guarantee the person they send you is qualified-maybe just a warm body!

What can you do to protect your senior loved ones? Over one out of three assisted care facilities report some form of abuse or theft from patients. Seniors with dementia and Alzheimer's are particularly vulnerable.

In a home care situation the figures largely are undocumented so we really have no idea. I get anecdotal evidence from customers that are scary to say the least. I hear stories of trusted housekeepers stealing from the home; stories of new caregivers who are incompetent and are in the U.S. illegally; theft, elder abuse and more.

One way to prevent or catch the bad guys is to install a hidden spy camera. That is a small hidden camera with built in DVR that records images on an 8 GB SD card for easy retrieval and play back. Just remove the card and plug it into your computer and see what happened when you weren't there.

These new hidden spy cameras are disguised as everyday household items like an air freshener, alarm clock, wall clock and more-14 in all. No one would ever suspect that inside these working products is a camera and DVR to record video too.

Some new models are considered body worn applications making audio recording legal. They are disguised as a car key remote, wristwatch, ball point pen and stick mini camera. They all have a camera, microphone and DVR just less memory on the SD card. Of course these are less likely to be of assistance in a nursing home or for in-home surveillance but they do have their place.

When you need to keep an eye on a caregiver at a nursing home or caregiver and domestic help at your home to prevent nursing home elder abuse this is the best way to do it.

Friday, March 22, 2013

How to Detect & Prevent Nursing Home Abuse With a Hidden Spy Camera


Millions and millions of the baby boom generation are becoming parents to our aging parents. As our parents get older, it is possible that they require a lot of care. Thus the proliferation of assisted care and long term care facilities. And it will grow quickly as the population ages.

Even though our parents may live longer than ever it is not necessarily better. These facilities house 2.6 million residents. Abuse happens in 44% of nursing homes according to one study. Elder abuse is an under recognized problem with life threatening consequences.

Every day, headlines throughout the U.S. show seniors who have been abused, neglected, and exploited, by people they trust the most. Abusers may be spouses, family members, personal acquaintances, professionals in positions of trust or opportunistic strangers who prey on the vulnerable.

That is only one part of the problem. The other is the millions of seniors live at home by themselves who have home health care and domestic assistance. Many of these folks have dementia and are targets of unscrupulous caregivers and domestics.

Back to the issue at hand: how to detect/prevent nursing home abuse with a hidden spy camera. If you suspect exploitation, verbal, emotional or physical abuse, neglect or even abandonment make sure you make your suspicions known immediately and demand that the issue be investigated.

No one really knows for sure how big the problem actually is because relatively few cases are identified since elders often are reluctant to report the mistreatment. Based on available information, women and "older" elders are more likely to be victimized. Dementia is a significant risk factor. Mental health and substance abuse issues - of both abusers and victims - are risk factors too as well as isolation.

One way to keep an eye on things when you can't be there is to install a hidden camera with built in DVR in their room. There are many hidden cameras with camera and DVR all in one neat looking package. Aim it in the direction you want, set the recording speed and record.

They are disguised as common devices like wall clocks, boom boxes, alarm clocks, tower fans, et. al. The camera is motion activated so a minimum of down time. When you are ready to playback remove the SD card and insert it into your computer or alternatively use the RCA cable to your TV for easy no brainer playback.

It may not be a perfect solution to all situations but it can offer a viable way to keep an eye on aging parents and others to keep them safe.

Important Steps in Filing a Personal Injury Claim


Getting hurt by someone else is never a situation that anyone wants to be in. Unfortunately, there are many laws revolving around protecting someone who has been injured and numerous guidelines that must be followed in obtaining the protection that is due to an injured person. Personal injury accidents can affect your life, monetary situations and overall happiness. If you are potentially due a monetary settlement, it would make sense to seek out professionals who have dealt with these types of situations before, like a competent personal injury attorney.

There are many types of personal injury accidents, including the following:
• Premises liability (such as slip and fall)
• Animal attacks (like a dog attack)
• Product liability (such as the product breaks and causes injury during normal usage)
• Drug defect (like carcinogenic ingredients)
• Medical malpractice (such as surgery-related negligence)
• Wrongful death (like workplace negligence)
• Auto accidents (such as at fault)
• Pedestrian accidents (such as hit by bicycle, car, or motorcycle, etc.)
• Swimming pool accidents (such as drowning, injury)
• Assaults (like a personal assault)
• Nursing home abuse (like neglect of patient)
• Trucking accidents (side-swiped)

These cases have different rules for establishing liability for a responsible party and may also have different timelines for filing a claim. For example, you have two years to bring a personal injury action in Las Vegas and specifically in Nevada, but a medical malpractice claim can be brought within three years of the date of the negligent act, or within one year if the injury should reasonably have been discovered earlier. Product liability suits can be brought within four years. There are even different rules depending on your age and mental competence.

Different filing procedures and timelines exist if a city or municipality is involved. Be sure to seek out the rules and regulations regarding your municipality to ensure that you stay within the guidelines. Your local county website and/or municipality can help direct you in these cases.

Proving Your Case

It can also be a mistake if you attempt to handle your injury claim alone. Even in the simplest of accidents where liability may not be disputed, an insurance adjuster or defense lawyer can easily raise certain defenses and allege that you may have contributed to the accident and that your injury was minimal or your treatment unreasonable, thus diminishing your claim's value. There are certain steps that should be taken in ensuring that you are maximizing your potential for receiving the proper claim due.

One is that after an accident, sometimes people feel that they do not need to see a Doctor, even if their neck hurts just a little bit. The problem is, if your injury develops into something worse down the road and you did not have proper medical documentation of the incident, along with either an accident report or a police report, then this greatly diminishes your chances of being successful in your claim. So if you are in a car accident, be sure to do the following things to maximize your potential for being successful in your claim for the accident:

1. Be sure to get all of the other driver's information immediately after the accident. Get their insurance card information, car registration information as well as their all of their license information and car make, model and year. If you are near somewhere that can get access to a copier, make a photocopy of all of this associated information in case you make a mistake in copying.

2. Take pictures of any damage to both vehicles after the accident. Also take pictures of any injuries that have occurred due to the accident. Most of us have camera phones and can very easily take pictures to better document the event and any associated damage. If the personal injury is severe enough, be sure to call 911.

3. Call your insurance company and file a claim with them right away. They will help you in any other requirements that might need to be taken.

4. Depending on the severity of the accident, call the police to report the accident. If the police are not going to be called, be sure to go to the DMV and file an accident report. This will be critical if your case ever goes to court. If you do not have proper filings of the accident, then it can be one person's word against the other.

These are the steps that you can take immediately after an accident to improve the likelihood of you being successful in your case. From this, you can determine if utilizing a personal injury attorney will help you further.

In a personal injury claim, you have the burden of proving that the responsible party was negligent in causing your injury. For example, anyone who drives a motor vehicle has a duty to operate their care safely according to the existing conditions. The maker of a product similarly must design a product that is safe to use or issue detailed warnings about possible complications or risks that are reasonably foreseeable.

You must also establish a link between the negligent act and your injury, show that you were injured, and offer evidence that your damages are reasonable and are related to the negligent conduct. This often requires a comprehensive investigation of your accident, the obtaining of medical documents and other records, the retaining of experts in certain specialties and the filing of motions to force a party to release certain evidence.

You are also entitled to certain damages, including past and future wage loss; past and future medical costs; property damage; damages for lost working capacity and the need for rehabilitation; and pain and suffering. The latter is determined by the nature and extent of your injuries, including any permanent disability and how the accident has affected your life. There are different damages that can be awarded in wrongful death cases. These include, but are not limited to: driving while using a cell phone, drunk driving, and death caused by work conditions, or perhaps medical malpractice.

Although the majority of personal injury cases settle before trial, only a meticulously organized and professionally presented claim can convince an insurance company or defense attorney to resolve your case on satisfactory terms. Studies have shown that being represented by a competent attorney in personal injury cases overwhelmingly result in more compensation to the victim, even taking attorney's fees into account.

If you are in an accident, be sure to call and file a police report right away. This documents the accident report with the authorities, even if it is minor. Take as many pictures as you can as well. Also, make sure that you receive all of the other party's license, registration and insurance information. Forgetting any of this will make it tougher for you to deal with adjusters down the road.

A personal injury can seriously affect your life. Trusting it to anyone is not an option. Find and retain a Las Vegas personal injury lawyer whom you can trust to vigorously prosecute your injury claim and obtain the compensation you deserve.

Hire an Attorney for Nursing Home Abuse


An attorney is one of the most important people to talk with if you or your loved one is facing nursing home abuse. As one of the most commonly hidden tragedies, it can be hard to determine if someone you care about is facing these types of problems. Yet, if you know it is happening, it is a good idea to discuss your case with your doctor right away. Doing so can help to prevent further problems from happening. Your lawyer can help you to know what your options are, too.

Reporting Is Not Enough

Your attorney may tell you that reporting such problems and concerns to the facility is rarely enough to get anything done about them. If you notice sores or bruises on your loved one, for example, you may first feel like you need to talk to the nurses or staff to find out what happened. However, reporting this type of concern to them may not be enough to get change to happen. Rather, it may be necessary for you to discuss the case with a legal professional that can help you to settle the matter.

Dealing with Medicare

One of the problems many people have in situations of nursing home abuse is getting Medicare or other health care providers to agree that there is a problem so that your loved one can be moved to another facility and still receive the supplemental care needed. This is when a lawyer can help as well. He or she can help you to prove that there is a problem and that the location needs to be changed in order to protect your loved one from further abuse. This is not something you can battle yourself.

Getting a Settlement

Perhaps your loved one was significant injured and you are angry about it. They may have even died because of the actions or inactions of someone on the staff. If this is a case, you may be entitled to a settlement if you have proof of your claim. It is a good idea to work with a lawyer to discuss this as an option. In some cases, the funds from such a settlement can help to pay for the costs of moving a loved one or providing that person with better accommodations for the rest of their life.

You do have options. An attorney can help you when you are dealing with nursing home abuse. This is not something that you want to battle on your own, but there is help available in nearly all situations. Talk to your attorneys to find out what your options are. Stand up for those who are suffering so others do not have to keep suffering.

Caring - The Top Prerequisite For Working in Senior Care


When trying to decide which line of work will be best for you, it helps to find out what the most important skill, requirement or prerequisite is needed to succeed at it. Senior care is a popular option these days, especially since it isn't affected too much by tough economic times; after all, people age and need extra care, even during a recession. If you're interested in pursuing a career in senior care, there's one skill that is absolutely mandatory if you want to succeed: caring.

Caring People Apply Within

There's no question that the typical nursing home job involves and requires many different skills. However, caring is the one that matters the most, since it has such a major impact on how you conduct all of your work. People who excel at assisted living jobs care passionately about what they do - and about helping the patients and clients who they work with every day. In other words, a genuine desire to help and take care of other people is imperative when it comes to senior care jobs. If you're only interested in looking out for yourself, then you should probably pursue work in a different field.

Why Caring Counts

The assisted living industry revolves around patient care. If the people living in a nursing home aren't taken care of, then the entire operation is going to fail. The staff of any given assisted living facility is its backbone; each employee is an important piece of the puzzle. If you decide to pursue assisted living jobs or a nursing home job, you need to make sure that you're going to fit in well and that you're going to be an asset to the team as a whole. Above all else, you have to have an authentic desire to help and take care of the people who the facility revolves around.

Do You Have What it Takes?

It's easy to qualify for a nursing home job on paper; it's what's inside that will determine whether or not you succeed in your chosen field. Whether you're interested in hospice jobs, nursing home administrator jobs or an RN job in a nursing home, the overarching and most important quality that you should have is caring. That caring not only pays off well for the patients who will be in your charge, but it will pay off enormously for you. As you help make patients' lives better on a daily basis, you will be rewarded with the knowledge that your caring is making a real difference in their lives.

Long Term Care Issues Facing Baby Boomers Today


Millions of baby boomers in the United States are not fully aware of the importance of insuring their health. Many of them do things to protect their assets, but they fail to realize the fact that long-term care is the biggest financial risk of their lives. They also don't know exactly how to deal with the expenses of long term care they will incur in the future.

A large percentage of baby boomers may need extended care when they hit their retirement years. Yet, fewer than half of them have taken measures to prepare for it. This lack of preparation can lead to financial disasters. For one thing, the expenses needed to support baby boomers are expensive. On average, nursing home care amounts to US$74,600 per year. With nursing home stays averaging 2.4 years, the overall amount of extended care is expected to reach $8.88 trillion over the next 19 years.

At present, there are estimated 78.2 million baby boomers in the USA. These are the people who were born during the post-World War II era, from 1946 to 1964. Annually, Americans spend about US$200 billion on long term care services. 51% of this amount is paid by individual policy holders and private LTCi providers. The remaining percentage is paid by Medicaid. However, we can expect a sudden change in these percentages when the baby boomers reach their golden years. There is also a great deal of speculation about whether or not Medicaid will be able to support the increasing number of seniors needing care in the coming decades.

The baby boom generation faces various issues today. One of them is the escalating costs of living and medical expenditures. Amidst the advancements in medical technology, the expenses of health care for senior citizens continue to rise. Baby boomers who don't plan their post-retirement care costs are at risk of a financial crisis.

Many of them think that regular health insurance would be enough to address their care needs, but they are absolutely wrong in this assumption. Long term care costs will not be covered by medical insurance and social security benefits. Long term care insurance for baby boomers is the only type of policy that would cover the expenses for caregiving services and activities of daily living (ADLs). LTCi is designed to provide coverage for various services for the elderly and disabled who requires care and assistance at home, nursing institution or assisted living facility.

As a matter of fact, combined health care plans and Medicare benefits pay only about 3% of extended care expenditures. Also, an individual can only be eligible to government-funded Medicaid benefits if he or she lives below the poverty level or has low-income and limited assets. To confront such issues, the baby boom generation should plan their future care needs by getting long term care insurance for baby boomers. Understanding the costs of LTCi plans will help a baby boomer in making the right choice to ensure a quality long-term care.

Thursday, March 21, 2013

The Importance of Nursing Home Activities


Many people think a nursing home is a nasty, soul-less place where residents either lie in bed or sit endlessly in a rocking chair, waiting out their days until the inevitable happens. The reality - at least in a good nursing home - is far from that. Many people enter a nursing facility when they have lots of life in them yet, and look forward to years of fun and companionship, with daily activities to keep both their bodies and brains active.

In fact, studies have shown that regular stimulating activities help half a decline in depression among nursing home residents, staving off dementia and keeping their spirits as well as their bodies alive. Activities are vital to keeping up residents' mental and physical well-being, and even staff and visiting family and friends can take part - willingly - in the activities a good nursing home provides.

If you are looking to find a nursing home for a loved one who's still capable of loving life, it's important that you discover what types of activities are on offer - and how often they are available. In fact, nursing homes that take Medicare or Medicaid patients have to have a designated activities director to get the proper funding. But how well they carry out their job is something you will have to assess yourself...

"I think the residents I talk to who tell me there is nothing for them to do but sleep, eat and read the paper are looking for purpose to get up every morning," writes Vicki30CNA on the allnurses.com website. "They do not look forward to the next day as they all run together. And our residents that are not as able get little to no stimulation besides toileting and shower. A few fold bibs every AM and see it as their 'job', but that job takes them a half hour. Then what, they tell me. I hate to see their last years months days so empty and without purpose. "

If you want to avoid this from happening to someone you love, read on. A wide variety of activities should be on offer at every nursing home, so make sure this is the case when considering a nursing home. Some residents may enjoy going out for lunch several times a week, shopping or visiting the local art gallery or cinema. Others will prefer on-site activities that stimulate their hearts and minds.

It might be a good idea to have a chat with the nursing home activities director to see what's available. Here is just a handful of activities that a good nursing home should willingly provide...

Self-Starting Activities

Great as they require little preparation and can be planned by the residents themselves. They include:

Gardening. Depending on residents' scope of mobility and interest, gardening can be as rigorous or as gentle as they want it to be. If there is a real garden that's fantastic, if not then hanging baskets, small pots of herbs and indoor cactus or orchid collections can still keep the interest going.

Arts and crafts. Even older residents enjoy making something - especially when they feel it's going to a good cause. Knitting blankets, making baby clothes or entering art or photographic contests can keep people busy and help them make a contribution to society at the same time.

Games. You might think bingo is the most popular nursing home game - and you're right. But there's more to competitive games than just bingo. How about bridge, mah-jong, canasta or chess - the sky's the limit. One-on-one games are great for encouraging closer relationships among residents, and group games are also good for fostering a sense of community.

Musical-based activities. Don't limit the fun to sing-alongs - you may even have professional musicians among the residents, or you may discover some hidden talents.

Volunteer-led Activities

Nail care, Bible study, hair salon day - all you need is a volunteer with a skill - and the time to make a difference in someone's life.

School groups. It may sound cliched, but young people have a lot to learn from oldsters. This can take the form of Granny teaching little Albertine to knit, or visiting a school once a week and reading to the little ones. Many schools, in fact, encourage people from the outside - assuming they have been police-checked - to help kids who need a little bit extra with one-to-one reading or math exercises.

Local community groups. People who have a special talent often enjoy visiting nursing homes on a regular basis and sharing their skills. This can be giving residents massages or reflexology sessions, teaching them a special aspect about gardening, or giving a talk about growing orchids.

Scout groups. Often, scout troops visit nursing homes - gathering together to do something fun such as bake chocolate-chop cookies or build a birdhouse. The two groups can learn from each other and make use of each other's skills and talents.

Local charities. People from charities often give their time to older people, whether that means preparing outings or having a Pet Therapy day when the local vet or employees from the animal shelter bring animals to visit.

Nursing Home-Led Activities

Themed events, such as birthdays or religious celebrations. Some creative residents get together with staff to plan events such as Hawaiian nights, Chinese New Year celebrations or Halloween or Thanksgiving festivities. Friends and family can be invited to join in - perhaps even residents of neighboring nursing homes as well.

Outdoor activities such as barbecues, picnics or a stroll through a park or garden center. In some cases volunteers may be called on to help residents with mobility issues.

A bit of culture. Going to the theatre, opera, museum or cinema can take some planning, but its worth it. Again, volunteer helpers and drivers may be necessary.

Alternative therapies. Everyone can benefit - as long as they're not too invasive. Massage, yoga or Tai Chi can help residents have fun, get fit and relax.

Keeping people as happy and healthy as possible for as long as possible. both physically and mentally, should be the goal of every nursing home. Activities should be varied and interesting, suited to the different abilities, needs and interests of the residents. They should be not only fun but worthwhile, enabling residents to form new relationships, develop new skills, and keep up their fitness levels.

"We have a 'senior prom' in May, where the local single Marines escort our residents (wheelchairs and all) for dancing and food, writes CoachCathy on the allnurses.com site. "We have gowns and suits donated by the local thrift stores. Local hair parlors come and do the hair and nails. Everyone has a blast.

"And we had a Winter wonderland theme last December - we made snowmen with diaper boxes painted white - and had a snowman decorating contest. The residents had an indoor snowball fight (with cotton balls). It was so much fun!"

Assisted Living Facility - Taking Care of Your Special Needs


A lot of help may be required when a person grows old, and this can make it tough for families to take care of the person. Nowadays, families prefer to help elderly people move into assisted living facilities. As elderly people start needing more extra care, they can continue living a relaxed and happy life. Growing old is not a bad thing as long as there is extra care, which is what every aged person wants. The best way to offer this care is to look for a senior apartment. Considering the growing demand of these senior citizen homes, a number of facilities have been built, and each of them caters to the different needs of the elderly people. These days, families cannot take care of senior members at home because it requires a lot of time and patience. People who move into independent senior living can live their lives peacefully. The level of services offered in senior apartments varies from one facility to the next and should be chosen according to the needs of the individual.

For many people who are nearing retirement age or have already retired, choosing the best independent senior living is the biggest task. It depends on the individual whether or not to choose a regular senior apartment or assisted living, as the kind of services offered in both of these facilities varies. Special needs arise with age and it is at this time that an assisted living facility can serve all of your individual needs. Special programs are designed for people with their own specific needs. Apart from regular services like laundry or healthcare services, other personal care services are also offered in these facilities, which makes life for the elderly more relaxed and enjoyable. When people get older, they run the risk of developing any kind of physical problem, and it's at those times that a senior apartment offering special services is the ideal choice for families.

Most elderly people don't look forward to going into nursing homes, and for them the best alternative is an assisted living facility. In these facilities, recreational activities are also there to keep the elderly person involved and to maintain the quality of life of the senior citizens. Even if you opt for a senior apartment, make sure it caters to your special needs because only then the elderly person can enjoy staying in the facility. The main goal of any aged person is to live a peaceful and relaxed life, and for that the needs of the aging person need to be met. In these seniors, sometimes independent senior living can also be a good option. However, for this the person needs to be physically fit and active. So, if the senior citizen is looking to have a secure old age with special needs being taken care of and recreational activities on a regular basis, then an assisted living facility is the best choice.

Moving Mom Or Dad - Senior Care Options


As an empowered generation, the baby boomers are known for having enjoyed the 1960's to their fullest extent and are often defined as trail-blazers of radical social change around the world. As the Baby Boomers age however, they are finding themselves faced with an entirely new struggle. As medical care has improved over the years and individuals are living significantly longer, this generation is finding themselves in a complex and demanding situation of trying to provide care for both aging parents and their own children. Due to the economy, many boomers are finding themselves having to provide housing for their post-college graduate children who have moved back home as they search for jobs, while at the same time many are being faced with the scenario of having to move elderly parents in with them to provide them with sufficient care. As these circumstances arise, the Baby Boomer generation has found themselves re-branded as the "Sandwich Generation", stuck in between their aging parents and children who both require a considerable amount of care, time and energy.

As this generation watches as their parents grow older and more frail, the difficult decision looms of whether or not to move aging parents into their own homes or to a care facility. This is probably one of the most difficult decisions any child will ever have to make. Many seniors unrealistically believe that they can successfully care for themselves for the rest of their lives, and understandably so as no one wants to willingly give up their independence after a long life of independence and self-sufficiency. For this reason, many children find it difficult to approach this sensitive subject and suggest that change is needed. This hesitancy can often have negative consequences for your loved ones however, and the last thing you want to do is to have to make this decision in a crisis situation.

This is why it is important that you open up the lines of communication with aging parents early on, before the need for immediate care is staring you directly in the face. Regular conversations with an elderly parent in regards to what will need to be done should they no longer be able to provide care for themselves will prepare the both of you and will lessen the sting of words like "nursing home" and "assisted living".

Many aging parents will be resistant to the idea of leaving their own home for an assisted care facility or nursing home. When approaching this topic you should make it your problem. Stress to your aging mom or dad that is worries you to see them like this and that you are concerned for their health and safety. Few elderly parents wish to burden their children, and will often be more open to the idea of moving if they know that you are seriously concerned. You need to have the support of other family members and siblings and everyone needs to be on the same page when this subject is addressed.

An alternative to moving seniors to a new a residence is to enlist the services of a professional senior caregiver. Most adult children are too busy with work and their own family lives to provide their aging parents with the adequate care they need. A senior caregiver can help lessen this burden by taking over many of the daily care responsibilities your elderly loved one needs, therefore allowing you to enjoy your free-time with your parent rather than be stressed out and exhausted from it. Hiring a senior home care agency will also allow your loved one to remain in their own home and will save you the stress of relocating your senior loved one. Elder Caregivers can provide their services anywhere from a couple hours a day to round the clock, depending on your aging parent's needs.

Many adult children who find themselves faced with making a decision regarding their senior parent's care will often find themselves overwhelmed with feelings of guilt. They must remember however that they are doing what is in the best interest of their parent's health and safety. Knowing your elderly loved one is safe and well cared for will provide you with great peace of mind.

Baby Boomers' Addiction & Alcoholism May Take Down Medicare & Social Security Programs


There is a relatively new group to be treated for addiction and alcoholism that is growing very quickly, and which is causing some in the field great concern: It is the retiring "baby-boomer" population.

There are several reasons that the "boomer" generation may potentially be home to many more addicts and alcoholics than the rest of the population. Some of these reasons are that the boomers were (1) the first generation to engage in wide-spread recreational use of a variety of addictive drugs (including cocaine, marijuana, and methamphetamines); (2) the first generation for which a wide variety of prescription medications and painkillers were readily available; and (3) the last generation for which treatment and recovery were not culturally acceptable. For these and other reasons, some are calling it, " America's hidden epidemic". [1]

According to some studies, it is expected that, by 2020, the number of seniors with alcohol and other drug problems will leap 150 percent to 4.4 million older people - up from only 1.7 million in 2001. [2]

Deborah Trunzo, research coordinator for the SAMHSA (Substance Abuse and Mental Health Services Administration), has said that, by 2020, the number of older people who will have drug problems, and be seeking treatment, will be "likely to swamp the system".

It is the baby-boomer generation, or the "young old" - those born between 1946 and 1964 - that are at the heart of this possible epidemic. Unlike their predecessors, those in the baby-boom generation are more comfortable taking medications for a wide range of problems, including pain, insomnia, depression, and anxiety.

In addition, the baby boomers are the first generation to widely experiment with recreational drug use. Yet along with all of these "firsts", they are also the last group born before it became somewhat permissible to admit to addiction or alcoholism, or to seek help or treatment.

One of the big concerns is that the boomers are much more vulnerable to late-life manifestation of alcoholism, addiction, and drug abuse.

In addition, in more recent years, this group has been prescribed with far more painkillers, as well as newer "designer drugs" including potentially addictive psychotropics.

A. Rush Limbaugh: The Poster-Child for Late-Onset Addiction

For example, in October 2003, at the age of 55, well-known political talk-show host, Rush Limbaugh, was charged with prescription drug fraud, and admitted to being addicted to painkillers - primarily oxycodone. With Mr. Limbaugh's admission to his addiction, he became the poster child (or poster "senior") of the new type of patient showing up in treatment centers, and emergency rooms. [3]

This "late onset" substance abuse is often linked to other medical problems, and the emotional traumas that can accompany old age, which arise from isolation, injuries and accidents, the death of friends and family, and the natural aging and dysfunction of the body.

As the boomers move into retirement, and leave the work force, they may find it more difficult to maintain their drug supply of choice: On the one hand, those who obtain drugs through legal means will have less medical coverage and less money to spend on prescription drugs. On the other hand, those who rely upon illegal drugs will no longer have as much money to pay for those drugs after retirement, and many will lose "access" to those drugs from their professional vocation (think of the dentist, nurse, or paramedic, for example, who has easy access during work). Retirement may simply mean a loss of supply, the attendant consequences of withdrawal, and the need for medical treatment.

A new legion of addicts is coming, and they require a far different approach to treatment, as well as a much higher level of medical intervention and support.

B. The Need for Greater and More Specialized Treatment

In general, older adults have different needs than younger adults; and, when it comes to the treatment of addiction and alcoholism in older adults, these differences are magnified.

Typically, younger adults are more resilient, and have abused themselves for a shorter period of time, and therefore, have a much better chance of living in recovery. On the other hand, senior citizens are much more likely to drop into a long decline toward death following any significant medical event (such as detoxification).

The aged are a very vulnerable group, and are noted to have the highest rate of suicide and other complications in relation to alcoholism. [4] Older adults are also showing an increase in seeking treatment for methamphetamine use. These are just some examples of the differences and trends which make the boomers such a widely diverse group, with different histories and backgrounds, giving the group the need for a wider variety of treatment plans and responses. [5]

Also, boomers are more likely to have dual diagnosis, with untreated long-standing co-morbid mental health problems, such as ADHD, anxiety disorder, and other personality disorders, that were simply not recognized by the medical community back in the day when the boomers were younger.

Finally, the aging abused human body in retirement will require more medical attention, more care-giving, more nursing homes, more medications, and more money, on average, than one who has led a relatively healthy life.

Macroeconomics: Medicare and Social Security Programs

The greater monetary and social costs associated with older adult treatment, recovery, and medical support could be substantial. If we significantly under-estimate the number of baby-boomers that are or will be addicts and alcoholics in their retirement years, we may have greatly misjudged the overall costs to our healthcare systems.

The Social Security and Medicare Boards of Trustees just this week released the 2008 Annual Report on the Status of the Social Security and Medicare Programs. [6]

The Summary Report begins as follows:

"A MESSAGE TO THE PUBLIC:

Each year the Trustees of the Social Security and Medicare trust funds report on the current and projected financial status of the two programs. This message summarizes our 2008 Annual Reports.

"The financial condition of the Social Security and Medicare programs remains problematic. Projected long run program costs are not sustainable under current financing arrangements. Social Security's current annual surpluses of tax income over expenditures will begin to decline in 2011 and then turn into rapidly growing deficits as the baby boom generation retires. Medicare's financial status is even worse. This year Medicare's Hospital Insurance (HI) Trust Fund is expected to pay out more in hospital benefits and other expenditures than it receives in taxes and other dedicated revenues. The difference will be made up from general revenues which pay for interest credits to the Trust Fund. Growing annual deficits are projected to exhaust HI reserves in 2019 and Social Security reserves in 2041. In addition, the Medicare Supplementary Medical Insurance (SMI) Trust Fund that pays for physician services and the prescription drug benefit will continue to require general revenue financing and charges on beneficiaries that grow substantially faster than the economy and beneficiary incomes over time.

"The drawdown of Social Security and HI Trust Fund reserves and the general revenue transfers into SMI will result in mounting pressure on the Federal budget. In fact, pressure is already evident. For the second consecutive year, a "Medicare funding warning" is being triggered, signaling that non-dedicated sources of revenues-primarily general revenues-will soon account for more than 45 percent of Medicare's outlays. The President recently proposed remedial action pursuant to the warning in last year's report and, in accordance with Medicare statute, a Presidential proposal will be needed in response to the latest warning.

We are increasingly concerned about inaction on the financial challenges facing the Social Security and Medicare programs. The longer action is delayed, the greater will be the required adjustments, the larger the burden on future generations, and the more severe the detrimental economic impact on our nation."

The actuarial assumptions underlying the Annual Report are based upon the intermediate range of projected costs. As also stated in the Summary Report:

"How Are Estimates of the Trust Funds' Future Status Made? Short-range (10-year) and long-range (75-year) projections are reported for all funds. Estimates are based on current law and assumptions about factors that affect the income and outgo of each trust fund. Assumptions include economic growth, wage growth, inflation, unemployment, fertility, immigration, and mortality, as well as factors relating to disability incidence and the cost of hospital, medical, and prescription drug services. [Emphasis added.]

Because the future is inherently uncertain, three alternative sets of economic, demographic, and programmatic assumptions are used to show a range of possibilities. The intermediate assumptions (alternative II) reflect the Trustees' best estimate of future experience. The low-cost alternative I is more optimistic for trust fund financing, and the high-cost alternative III is more pessimistic; they show trust fund projections for more and less favorable conditions for trust fund financing than the best estimate. The assumptions are reexamined each year in light of recent experience and new information about future trends, and are revised as warranted. In general, greater confidence can be placed in the assumptions and estimates for earlier projection years than for later years. The statistics and analysis presented in this Summary are based on the intermediate assumptions." [Emphasis added.]

Therefore, it is possible that the current Reports significantly under-estimate the number of addicts and alcoholics in the boomer generation, the wide diversity of addiction types, and the overall health problems and medical needs of the boomers as they enter the Social Security and Medicare systems in the years ahead.

If so, the impact on the financial outlook of the systems could be catastrophic:

"What is the Long-Range (2008-2082) Outlook for Social Security and Medicare Costs? An instructive way to view the projected cost of Social Security and Medicare is to compare the financing required to pay all scheduled benefits for the two programs with the gross domestic product (GDP), the most frequently used measure of the total output of the U.S. economy. Costs for both programs rise steeply between 2010 and 2030 because the number of people receiving benefits will increase rapidly as the large baby-boom generation retires (Chart B). During those years, cost growth for Medicare is higher than for Social Security because of the rising cost of health services, increasing utilization rates, and anticipated increases in the complexity of services. [Emphasis added.]

The potential for amplified costs of treatment for a much larger population of addicts and alcoholics would rest upon the shoulders of an already absurdly large set of projected healthcare costs.

C. Conclusion

In conclusion, if the actual addiction and alcoholism rates of the retiring baby-boomers is significantly higher that our current estimate of those rates, then the overall medical and related costs to be borne by the Medicare and Social Security Programs could be substantially higher than our current predictions. This, in addition to the already high projected costs of healthcare for that group, could, in turn, impact all of us by way of the significant long-term financial impact on the United States Government.

As the Summary Report concludes:

"The combined difference grows each year, so that by 2017, net revenue flows from the general fund will total $449 billion (2.0 percent of GDP). The positive amounts that begin in 2017 for OASDI, and in 2008 for HI, initially represent payments the Treasury must make to the trust funds when assets are redeemed to help pay benefits in years prior to exhaustion of the funds. Note that neither the redemption of trust fund bonds, nor interest paid on those bonds, provides any new net income to the Treasury, which must finance redemptions and interest payments through some combination of increased taxation, reductions in other government spending, or additional borrowing from the public.

"Chart E shows that the difference between outgo and dedicated payroll tax and premium income will grow rapidly in the 2010-30 period as the baby-boom generation reaches retirement age. Beyond 2030, the difference continues to increase nearly as rapidly due primarily to health care costs that grow faster than GDP. After the trust fund exhaustion dates (2041 for OASDI, 2019 for HI), the increasing positive amounts for OASDI and HI depict the excess of scheduled benefits over projected program income. When the statutory SMI general fund revenue requirements are added in, the projected combined Social Security and Medicare deficits and statutory general fund revenues in 2082 equal 9.3 percent of GDP, indicating the magnitude of the potential effect on the Federal budget if general revenues were used to ensure payment of all scheduled program benefits. A similar burden today would require nearly 80 percent of all Federal income tax revenues, which amounted to 11.7 percent of GDP in 2007.

"To put these magnitudes into historical perspective, in 2007 the combined annual cost of HI, SMI, and OASDI amounted to 38 percent of total Federal revenues, or about 7 percent of GDP. That cost (as a percentage of GDP) is projected to double by 2060, and then to increase further to nearly 17 percent of GDP in 2082. It is noteworthy that over the past four decades, the average amount of total Federal revenue as a percentage of GDP has been 18 percent, and has not exceeded 21 percent in a given year. Assuming the continued need to fund a wide range of other government functions, the projected growth in Social Security and Medicare costs would require that the total Federal revenue share of GDP increase to wholly unprecedented levels."

While the financial outlook for the Programs is bleak, the failure to address a potentially larger problem of addiction and alcoholism in the next generation to retire could have amplified consequences for everyone.

References

(1) Jointogether.org; "Addiction Among Seniors Called 'Hidden Epidemic'; News Summary, July 21, 2003.

(2) The New York Times; "Addicts of A Certain Age: Baby Boomers Need Help." March 6, 2008.

(3) CNN.Com; "Limbaugh admits addiction to pain medication"; Oct. 10, 2003.

(4) National Institute on Alcohol Abuse and Alcoholism. Alcohol Alert. Alcohol and Aging.

(5) Hughes, Mary Elizabeth; O'Rand, Angela; "The Lives and Times of the Baby Boomers", part of "The American People" series. http://www.aginghipsters.com/blog/archives/1/000346.php; 12/16/04.

(6) Actuarial Publications; "Status of the Social Security and Medicare Programs/Summary of the 2008 Annual Reports"; Social Security and Medicare Boards of Trustees; http://www.ssa.gov/OACT/TRSUM/trsummary.html

An Old Coach Offers a Simple Solution to Childhood Obesity


Obesity is a huge and growing problem in America and around the world. And the childhood edition of this problem is a 21st century tragedy that's not only costing our nation billions of dollars, but it's costing millions of kids their confidence, their self esteem, their willingness to try something new in public for fear of failure, and consequently their capacity to live full and productive lives.

While scientists are busy studying body chemistry, body composition, nutrition, and exercise physiology, pharmaceutical companies are busy developing the latest weight loss pill, the diet industry is designing a new diet strategies, infomercials are crowing about new exercise devices, health clubs are hustling fitness, insurance companies are cutting benefits, and McDonald's is pushing salads, all in an effort to commercially take part in the multi billion dollar obesity industry. In the mean time, the problem continues to grow unabated, like a forest fire raging out of control.

An Old Coach's Reaction

In light of that raging forest fire I'd like to introduce you to the wisdom of a retired coach who I've known for over three decades. In the words of this old coach (he prefers to remain anonymous, and back in the shadows), "I taught physical education for most of my adult life and during that time I made the following observation. I noticed that kids who could perform pull-ups were never obese," he said. "And kids who were obese could never perform pull-ups. Pull-ups and obesity are mutually exclusive, and are never found in the same kids," he added.

Without Pills, Shots, or Magic Diets

The old coach's conclusion was that if you start 'em young, before they've had a chance to pick up much weight, teach them the ability to perform pull-ups, and teach them to never lose that ability, you can immunize kids against obesity for a lifetime, without pills, shots, magic diets, or much in the way of expense. "The more kids you can teach to physically pull their own weight," he said, "the closer you'll come to whipping the childhood obesity epidemic."

But Kids Hate Pull-Ups

I told the coach that I thought his logic was impeccable, but in my view he had one problem. According to my recollection, most kids hated pull-ups with a passion. And if they hate doing it, how can you teach them to perform pull-ups? They'll drag their feet all the way to the gym, won't they?

Using A Height Adjustable Pull-Up Bar

"Kids hate doing anything where they fail in public," the coach replied. "The trick is to start them young before they learned to fail on the pull-up bar. Start them out on a height adjustable bar that allows them all to succeed immediately with leg- assisted pull-ups, jumping and pulling at the same time. With this inexpensive tool you'll eliminate failure, and build regular success into the experience for all participants."

How High Do You Set The Bar

A couple of more questions popped into my mind immediately. First, how high do you set the bar when you're starting a youngster out? And secondly, how do you adjust the level of difficulty in order to insure progress? I could tell however, the wise old coach had an answer on the tip of his tongue.

The Progression

"You start the bar out low enough that the child can do at least 8 leg assisted pull-ups, but no more than 12. You allow them to work out twice a week and expect them to improve every time for a number of weeks, consecutively. In other words, in the second workout they should do 9, in the third 10, in the fourth 11, and in the fifth 12 leg assisted pull-ups. When they hit 12 repetitions you raise the bar one inch and they begin the 8-12 process all over again. This strategy allows a child to make a little progress every time he or she works out, and after several weeks they learn to EXPECT TO SUCCEED IN PUBLIC, which in turn teaches them to love instead of hate pull-ups."

They've Immunized Themselves Naturally

So if I understand it right Coach, the kids literally inch their way upward until they eventually run out of leg assistance, at which point they've not only learned to perform pull-ups, but they've also learned to love doing them, and in the process they've immunized themselves naturally against obesity for a lifetime as long as they maintain the ability. Does that sound about right, I asked?

They May Want To Be Bad, But

"Mechanically speaking that's correct," the coach said. But there are a few other things that go into the strategy that you need to understand. One thing is that you're tapping into a child's natural desire to be strong and not weak. In my years of teaching I met lots of kids who wanted to be bad, but I never met a kid who wants to be weak. And that goes for the boys as well as the girls. We all want to be strong. All kids know that the ability to do pull-ups requires you to be strong. And when you work in a group, they're getting stronger in public, and kids love to succeed in public," he said. "They inevitably finish off by giving each other high fives, and they love every second of it."

I asked the coach what other things are built into his strategy. He said kids learn that three things make them strong, including regular work, good eating habits, and getting enough rest at night and in between workouts. They also learn that fooling around with tobacco, alcohol, and drugs makes them weak. And no kid ever wants to be weak. "They also learn these concepts in a very hands-on, and concrete way," he said.

Taking Responsibility For Yourself

I knew the coach could have talked on this subject all day but I wanted to finish on one other related point. The phrase pull your own weight has responsibility taking connotations that are very appealing to most people these days. What role does taking responsibility for oneself play in this childhood obesity prevention strategy?

After congratulating me on all the good questions the old coach said, "One of the big lessons that kids learn from working on the pull-up bar is that nobody else can do it for you," he said. "I mean in reading, writing, and arithmetic you may get away with having somebody else do your homework for awhile. But the pull-up bar knows immediately if you've done the work, it knows if you're eating right, it knows if you got enough rest recently, and it pays you for doing these things with additional success.

On the other hand, it also knows if you fail to do these things, and it can just as easily deny the public success that all kids crave. So this strategy absolutely encourages kids to take responsibility for themselves in all kinds of ways," the coach said.

A Web Site Dedicated to The Old Coach's Strategy

I confessed that he'd sold me. I agreed that teaching kids to pull their own weight would go a long ways towards solving the childhood obesity epidemic, it could save our nation billions of dollars, and do all kinds of wonderful things for the individuals who learned the lessons that are built into this simple, practical, affordable, and infinitely measurable strategy. In fact I was so impressed that I offered to build an informational web site dedicated to the old coach's naturalistic vision. He took me up on the offer, and as I write this sentence you can now check out "pull your own weight dot net" if you'd like to learn more about the old coach's simple childhood obesity prevention strategy.

One Final Question

My final question to parents and educators (or anyone who works with kids) is, why wait for the experts to come up with a high tech solution when you can turn the tide naturally with your own kids right now by simply teaching them to pull their own weight? As they always say, there's no time like the present. Carpe diem.

The Medical House Assisted Living Model Can Rewrite Long-Term Care As America Knows It


The "Medical House" Assisted Living Model Can Rewrite Long-Term Care as America Knows It - It Deserves Public Funding

Angela did not really realize what she was in for when she set out to house people with certain medical issues in her Midwest assisted living residence. As a nurse she focused on the non-behavioral populations who were managing issues with pulmonary concerns, diabetes, obesity and hypertension, including survivors of stroke.

She disdained the atmosphere surrounding funds that reimbursed homes which served the mentally ill, labeling the systems that oversees these funds as laced with improper politics and the kind of constant budget cuts that made quality care impossible. Without knowing it, Angela was onto something big, and she spent $30,000.00 on television advertisement to tell the world about it. She had developed the small-scale "Medical House", an assisted living revolution still in short supply in comparison to what is really needed throughout America.

Charging from $3,000.00 to $6,000.00 per month depending upon the needs of the prospective resident after a thorough assessment, Angela's Medical House still costs much less than the average monthly fee in a nursing home for the same patient which ranges $8000.00 to $10,000.00 per month. The routine in the home is an impressive one.

Each resident receives what is called the "morning quarter", which is 15 minutes per morning devoted to nothing but observation of a resident's mood and behavior in comparison to the day before or multiple previous days which helps staff to better plan a routine for the day. Often a specific 3 questions are asked of each resident.

The "morning quarter" is then used to help plan a more person-centered and meaningful regimen that considers energy levels, response to new medications, mood swings, sorrows, sleeplessness, new personal events, appetite changes and much more.

Support staff who may work partial shifts during the day then utilize the notes made by the early morning staffer allowing all to come together until bedtime to enhance the assisted living experience on each and every day. During this process an on-line case management system is updated and messages sent to applicable nurses, pharmacists, physicians including psychiatrists, guardians and other interested parties who can receive this information without privacy violations in real-time. There are two, (2) staff on duty during the morning quarters so that one can focus on observation, documentation and reporting while the other tends to morning personal care, medications and housekeeping.

The result? Even people with special needs which includes the medically fragile elderly and those with catastrophic injuries can live in their own communities in more dignified, non-institutional settings and avoid the stigma and depersonalization which can often come with the nursing home environment.

These 6-bed environments require the right staffing, ownership that is open-minded to change and innovation, professional relationships with a competent, experienced nurse and the regular involvement of a visiting physician whose practice is aimed at the population being served including a physical medicine and rehabilitation and wound care focused doctor.

The "Medical House" would typically be licensed based upon the requirements of your state of operation. They serve a valuable purpose and provide a meaningful, effective alternative to nursing home care for many and can spare lots of pain from Medicaid budgets once bureaucrats accept with action the need to develop a national standard and provide a fee for service system for this clinically competent assisted living model.

Such a reimbursement model must be a direct bill type system without the requirements associated with contracting with an agent of Medicaid waivers. Accreditation bodies must be involved and while these businesses cannot be skilled settings along the lines of a nursing home, they can be a close cousin in terms of quality medical oversight with lots more personal attention.

How urgent that America come together so thousands more neighborhoods develop and take pride in a real family booster, ""The Medical House" for those who need someone else to be their keeper.

Thanks for allowing us to share.

Retirement In Diaspora: Are You Preparing For It? Feedback From Nigerians - Part 2


The feedback received provided insight you might find useful. The reader must know that this information is not scientific and has not been put through in-depth statistical models or evaluations. Please do your own research before adopting any of these suggestions from fellow Nigerians.

In the previous Ezine article fellow Nigerians were asked to share their plans and preparations for "The Big R," retirement. Many responded, and thanks to everyone who took the time to write.

James (last name withheld) wrote: While we struggle to live up to expectation, (Not that I know who's expectation) a lot is wasted on things without tangible future value. I have often seen that mansion in the village as a waste of valuable money but we did not grow up with the culture of investing for the future." Children are often our retirement. We need education if we don't want to become a burden to the kids or start packing in preparation for a final trip to the village as we head towards retirement.

Some Nigerians who implied or expressed that they are domiciled in Europe took the stance that the governments there will take care of their retirement, and therefore they did not have to worry about saving additional funds. "Those in Europe and Scandinavia may not have much to share, as their retirements are relatively better secured as long as they have had active working lives and have paid into the better managed retirement purse - unlike the American 401K," remarked a reader called Ayookun.

While some readers who responded have totally lost faith in Nigeria for various reasons, there are more people whose belief in Nigeria is rock solid. Those who have written Nigeria off as a place to retire or invest for retirement cite common complaints of Nigerians overseas: swindling by family and once-trusted friends in Nigeria; and terrible governance. In their experience, they have been pitched great investment ideas, only to be taken to the cleaners once their hard earned money is sent to Nigeria. Jabolondon wrote this about an uncle who was duped when he invested for retirement in Nigeria: "He appointed his brother as "Project Manager" and, since 1994, has diligently repatriated funds for the project. Fast forward to today. His house is one level of concrete blocks in a rubbish-strewn site. His brother, meanwhile, is the proud owner-landlord of a block of 4 x 4 plush apartments."

This has been a serious and perennial compliant of many Nigerians working overseas. It is quite detrimental to all parties in obvious ways: the person who is cheated not only loses his scarce retirement investment, but may inadvertently ignite eternal family feuds that do no good. Those overseas who hear these (often exaggerated) stories are dissuaded from investing or planning to retire in Nigeria. The person doing the cheating loses too, because ori otu mgba a bughi ezi - he who eats all the food at once starves once the food in his stomach digests.

However, for every five respondents who have had enough of Nigeria and don't intend to retire there, there are eleven that urge a second look. The latter group espouses the benefits of investing in Nigeria as a retirement vehicle. One prolific commentator named Patcho made a point that is very appealing to most Nigerians in Diaspora. He stated, "Eventually when retirement age comes, I'll like to retreat to my village because I want to walk around, feeling the soil barefooted in my compound and welcoming visitors who did not need to call or write me before they knocked."

Using the money Patcho said he sent home over the years, his relatives in Nigeria have helped him amass real estate holdings around his home town. Wouldn't it be great for most of us, both in Nigeria and overseas, to have the realistic option of retiring in our villages in peace and security; bringing our retirement funds to enjoy and to help further develop Nigeria?

Cajetan Nwagbara has this edited recommendation: "Go to any city in Nigeria, and buy a parcel of land. Develop it, build at least 12 flats, and rent them for N25,000 each flat per month. One can conveniently live on N300,000 income, if one has a personal house and a decent car." It is a good idea. Frankly, a retiree in a medium- to low-cost part of America can survive on $2,000 (plus Social Security income) if the Nigerian funds can be religiously sent here and the person is in relatively good health and has no mortgage on the home in the States.

Valteena summed it up this way: "Haba!!! onyeije Naija can't be that bad for you to want to erase it off completely. I beg no erase. Nigeria may yet go better." That was in response to Onyeije who wrote as if Nigeria should be wiped off the map. He said " I am just waiting for my parents to join their ancestors, then I [will] erase and obliterate that name NIGERIA from all available lexicon."

Those are heartfelt words from someone who obviously loves Nigeria but is deeply disappointed in what Nigeria has become. It is a sentiment discreetly shared by many Nigerians, especially those in Diaspora. These Nigerians resent the leadership at home who fostered the conditions that forced them to abandon their familiar environment and reside overseas, even as many who wish to leave Nigeria look up to those abroad as the lucky ones.

The mention of retirement homes in the previous article sent shockwaves to most readers. Studies show there are many great retirement homes all over the western world, but most of them also come with hefty price tags. From the feedback, it was obvious that the prospect of going to any nursing home is too hot or raw for most Nigerians abroad to deal with. Truth be told, many of us have to get serious with retirement and estate planning and funding if we are to avoid the dreaded poor nursing home dilemma.

The original article was written to awaken and bring to forefront the importance of retiring with dignity, and the need to save the necessary funds to achieve this golden age goal. You need quite a lot of money to do that, so stop wasting and start saving as if your life depends on it - because it just might.

Many of us have children, and children everywhere love their parents as much as children anywhere. Let's not lose that point in this whole healthy discussion. However, we have not come this far, worked this hard, and weathered so many storms to depend on anyone else, including our wonderful and loving children. We should spare them the worry of our finances. We should be leaving estates for them to cushion their lives, not saddling them with the financial hardship of caring for us in our old age.

Rokijola has an outside-the-box, albeit utopian, solution: "One option will be to have retirement homes in America that cater to Nigerians, and have sister retirements homes in Nigeria. These retirement homes can be operated something similar to time-share holiday homes. The greatest challenge will be managing healthcare needs, which is a given with old age."

That is one great idea, especially if restaurants serving authentic Nigerian foods are located on the premises like those near Highway 59 and Bissonnette in Houston, Texas. That area is the closest you can be to Aba, Calabar, Benin, Owerri, Jos, or Lagos without leaving America. The only food better or even close would be home cooked meal prepared by one's spouse. Sorry to digress, I just want to give a shoutout to those Houston restaurateurs; none of whom I know personally.

F. Scopion made elaborate and logical points, taking into account inflation, deflation (which is more serious), low interest income, American 401K plans, and Roth IRAs, as well as global and long-term (30-year) views. F. Scopion wrote: "Best bang for your buck, and almost the only sane option left, is to invest in an emerging economy. A lot of savvy middle class Americans are already investing in BRIC [Brazil, Russia, India, and China] countries using financial instruments. Some even travel there to buy real estate. Nigeria isn't on the list yet, because its financial system is still too opaque. My point? Investing in property in Nigeria is more than just a good idea: there is no earthly reason why you shouldn't do it, if you can. I can assure you that well-to-do Americans would jump at that chance".

Idi-ogi made a rather extreme appeal against retiring overseas but softened it by suggesting investment in Nigerian real estate. He wrote this: "Retiring abroad is not as rosy as it may first appear. When I lived in England, my wife carried out a survey involving old retired people. She met an elderly Nigerian whose wife had returned to Nigeria while he stayed in Manchester. This gentleman was unkempt and disheveled. He was malnourished because his meals were pushed over the door with no opportunity for him to make his choice known. Same for his other supplies. The workers simply left things at the door and notified him by knocking on the door. By the time he opened the door, they have disappeared into thin air."

"Investing in real estate is the way to go. The return on investment is far better in places such as Lagos and Port-Harcourt. The drawback is that there is very little opportunity to finance the huge amount of money needed. A similar investment in the US will yield minimal returns at this time, but may be easier to finance with good credit rating," he concluded,

I also receive responses that were either too personal to publish or the emailer did not want me to quote them or use their names. Those responses made me think this topic has deeper roots than I first thought. Brothers and sisters, retiring in poverty is hellish. Retirement planning and funding is neither a husband's thing or a wife's thing; it is a family jewel. One has to think about one's self and spouse first. When you REALLY need them, you cannot Western-Union back the funds you should have saved and invested in your working years.

It might be prudent to diversify and not put all your retirement eggs in one basket by investing only in Nigeria or solely in your base overseas, or in emerging markets. Those governing Nigeria should capitalize on the pull of funds held overseas by both Nigerians inside and outside the country by making conditions more attractive for these Nigerians and their funds to come home to roost.

Finally, retirement is something positive to look forward to. While it will take a long time planning and acting to achieve good results, excessive stress over saving for tomorrow could rob you of the joy and blessing of treasuring today. And too much stress might cause an untimely end that makes retirement a moot point! So thanks again to those whose responses made this article possible, and I wish all of us success as we continue preparing for retirement in prosperity, not in abject poverty.