Earthbound Souls, Suicide, and the Problem With Reincarnation

It is one's state of evolution and consciousness that determines what sort of afterlife one finds one's self in after the crossing from this world into the realms beyond it. One's spiritual progress or development is largely dependent on the degree of one's personal illumination, love, understanding and forgiveness. We will explore what happens to souls who are overly steeped in materialism or dogmatic beliefs and to those that commit suicide. Also we will try to solve the problem of reincarnation.

Why Some Souls Start Out Earthbound

Search and rescue of earthbound souls is a common and very much needed occupation as many materialistic souls (not knowing anything about the astral planes or life after death) still cling to the earth for days, weeks, even months after they die simply because they know of nothing better and would often try to get the attention of their physical relatives and friends or take free rides up and down the streets on a bus! The only real problems encountered are those souls with very strong misconceptions (such as deep religious and old, life-long dogmatic convictions) about the afterlife. They are very hard to reach and often stay earthbound much longer than most souls and usually end up in a colony on one of the "belief system territories" of the lower astral worlds along with many other souls of that same very limiting religion or belief system. They are in most cases quite happy there, so might as well leave them well enough alone!

The Problem with Suicide

Well, after knowing just how wonderful death really is, why don't we all just kill ourselves and go back to paradise? One would think, especially if one is in a terrible predicament or suffering or pain or some other severe hardship that one might as well take one's own life and get it over with. After all, so many of the souls who come through can't help but say how extremely happy they are to be free from all the miseries and complexities of physical living and that death was the best thing that ever happened to them. However, the spirits warn that to go before one's time would be detrimental to spiritual wholeness.

Would suicide ever be justified? An assisted suicide might make sense for those patients who are on the life support, in intensive care, who are being forced to hang around in a "vegetable" state of total or extreme disability and/or who are only suffering and having no chance whatsoever of any future purpose, convalescence, joy, healing or happiness while still on Earth. If the physical body is very old, completely worn out, completely useless, in a coma, etc. then why on Earth prolong the suffering? Why not allow the soul its freedom of choice so that it can go on if it wants to? To deliberately force the soul to stay stuck in a painful, agonizing existence in a completely worn-out body and non-functioning brain would not make any sense whatsoever.

On the other hand, if one is still young, healthy, and can still in any way shape or form do some sort of good or service to humanity while still on Earth, it could be hazardous to one's spiritual progress or development to commit suicide, which would rather be like quitting school before one graduates or cutting "Earth" classes before the course is over. There is no such thing as a "shortcut" to paradise. To enter paradise, one's self-concept must be very upright or full of certainty or knowing that one has done only the best thing possible while on Earth with whatever hardship or seeming injustices thrown at one and has not overindulged in too much selfish behavior to the detriment of others. One must face one's self and that is the catch. Those who selfishly commit suicide will have to "live" with all the consequences of that decision, and face all the people hurt by or affected in any way by the taking of one's own life. It is universal law that when one causes pain in others, one never gets away with it.

Regarding life on Earth, no matter how difficult, suicide is never advisable, and death is not intended or designed to solve all one's problems, which are trying to teach one some very important lessons, not to mention all the very important reasons for being on Earth in the first place. Ask any soul who had committed suicide while still in the prime of life and they will lament at all the grief and sadness they had caused others to go through, lost opportunities to love, grow, experience and really become the person they always wanted to be. Every incarnated soul has a mission of some sort to accomplish, and from what I've learned, heard and read about suicide, to find one's self back "at home" without having first accomplished all that one has intended to do on Earth could result in having to go back to Earth and start all over again in a new body. Life, whether here or hereafter is a responsibility, and that responsibility can never be escaped from without great sacrifice to one's spiritual evolution and progress toward finer levels of happiness, fulfillment and salvation.

The Problem With Reincarnation (Not My Favorite Subject)

Very few souls ever want to go back to live (reincarnate) on Earth again. Some souls say reincarnation is possible, and there are many proven cases of reincarnation. According to a video of Betty Jean Eadie, author of Embraced by the Light there might be a form of reincarnation but nothing like what common eastern and popular western "New Age" concepts portray. According to the medium Robert James Lees (1849-1931), author of The Life Elysian, his spirit author (or ghost writer-ha! ha!), Aphraar states that the concept that one dies and reincarnates again and again is a distortion, in other words, there is usually no personal spirit that enters the body after its conception. He also states that there are many misled souls both on Earth and in the hereafter who will say that reincarnation is essential for spiritual and evolutionary progress, just as there are many who pass over still believing in old religious philosophies or dogmas, because no one suddenly becomes all-knowing wise and perfect just because they died.

William Charles Cadwell who is direct voice medium David Thompson's main spirit convener at the Circle of the Silver Cord, stated in one of the seances that half of the souls born onto the "Earth plane" have lived at least once before, while the other half are new souls with no past except as pure "God" energy. Getting exact, scientific knowledge of reincarnation even while in direct communication with spirits is still quite a challenge. Even though knowledge in the afterlife is so much easier to obtain and retain, the spirits can still carry with them many misconceptions and contradictions just as they had while on Earth. Other than for a great soul to come back as a teacher (like Yogananda or Jesus Christ), I would have to seriously question the reasoning of anyone who would want to come back and live on Earth again! My official view on reincarnation: it not only is possible, it is constantly occurring and is, unfortunately, essential for all souls who are still tied up with the Earth vibration. However, I personally dislike the idea of becoming physically restricted again after any period of heavenly freedom!

Anyway, I am still wondering about the sanity of those few souls on the other side who say they want to reincarnate! For example there is a Leslie Flint tape where the spirit of Annie Besant, a famous Theosophist talks for a while about reincarnation and spiritual development followed by an Italian lady named Estell (near end of tape) who wants to reincarnate so she could get married and have children which was not possible for her during her recent lifetime on Earth. (Why can't she do this on the astral plane where everyone's desire is provided for?) Annie Besant, who believed she herself would reincarnate right away (but speaking through Leslie Flint's ectoplasm 55 years after her death obviously did not!) states that there are group souls who reincarnate together to express truth and to uplift humanity. However I am a little uncomfortable and worried about what she says about reincarnation as if the time spent on Earth was so insignificant which may be true from the cosmic perspective, but from my viewpoint, just my present lifetime on Earth alone has been a rather traumatic, tiresome, unpleasant experience.

My concern with reincarnation is why do we souls seem to be such gluttons for punishment supposedly having had so many past lives many of which were quite tragic and then not even remembered by the vast majority? To willingly get reborn into a new body and forgetting everything previously learned to me is simply awful! Living lives on Earth compared to living lives in the heavenly spheres is usually much harder, often terrifying, and extremely frustrating!

At least it has been for me in both this lifetime in England and the U.S. and in previous lifetimes in Turkey and other parts of the Middle East where I was kidnapped, buried alive for several years, and then murdered while trying to escape, and in another life, I died by crashing through the top of a catacomb or abandoned well while riding a camel (along with several others in a caravan) over a desert hill which gave me nightmares for years while young and seemed to lead to severe problems in my present lifetime. I also remember a vivid nightmare where saw a man in very primitive clothing running across a barren, rocky plain so fast right in front of my range of vision that it made me laugh until the next thing I knew my head was being crushed within the mouth of a sabertooth tiger! Glad I woke up right away!

I would never, ever want to reincarnate ever again! I mean to go through all that forgetting who we really are, birthing trauma, diapers, growing up, learning how to communicate, making the same mistakes over and over, working hard for almost nothing, choking on physical food, hunger, searching for a mate, loneliness, uncertainty, suffering, disease, and dying etc. over and over again--who in their right mind would want to reincarnate?! It's a wonder I didn't crawl back inside whenever I was born! The frustrating and humiliating limitations and sufferings of physical living is this main concern that has driven me nearly insane and then to yoga, meditation and afterlife research in the first place--I really need to know for sure that I won't have to leave paradise and forget my true self again through another rudely disrupting reincarnation! This is the problem of reincarnation I have been concerned about and that has prompted much of my spiritual research in the hopes of finding a way out of this rather frightening cycle of birth, suffering and death.

Another serious problem regarding reincarnation one would have to acknowledge is the fact that with the ever growing population of the earth there could never be enough reincarnating human souls to occupy all those new bodies unless perhaps they come from either nature spirits (elemental thought forces or creations), fragments of one's Oversoul and/or animal spirits, Source Energy (as Abraham-Hicks would say) or simply nothing at all except some self-aware fragment of the Universal Spirit, Prana or Shakti. The recent massive surge to nearly seven billion people proves that there can't possibly be enough reincarnations from past human lives from past history to go around unless they came from some other source or even no source at all.

According to Robert A. Monroe's Ultimate Journey it is the numerous separate fragments of an Oversoul who reincarnate and never one soul reincarnating over and over. When tuning in through meditation or through dream states, these past lives of those fragments of one's Oversoul could easily be experienced or interpreted as one's own. These fragments often exist as members of like minded individuals living together in a group or community in the afterlife. I like that explanation and prefer to stick with it rather than feel I must go on and on reincarnating! This explanation is quite realistic because Robert actually met his other "soul fragments" quite frequently throughout his out-of-body adventures who were often in all sorts of states, stages and lifetimes. So have I experienced similar encounters in my dream states including fragmentary experiences of simultaneous lives in different planets, places and times as portrayed in Jane Robert's The Oversoul 7 Trilogy.

The physical reality is really only a very tiny, rather backwards and insignificant part of the "rainbow universe." In the higher levels of the vibrational spheres or universal spectrum of existence, most souls seem to enjoy centuries and centuries of very idealistic living while gradually evolving into ever higher and higher spheres and expanding into ever new dimensions of great love, understanding, experience, creativity and beauty indefinitely.

The spirits say that salvation should come naturally, and to never expect it to come from some other "God," guru, or person, but only through the direct experience of their teachings, and through one's own inner growth, meditation and evolution of the soul. Just as one can never reach the horizon, absolute perfection can never be reached, only approached. One can never actually become God, one can and does however get ever closer and closer to becoming like God (perfect love, freedom, joy and wholeness).

From the Leslie Flint tapes, it is now confirmed that souls on the lowest level of development either come back to reincarnate right away after passing over or remain in either an unconscious (sleep) state, or are earthbound (shadow being), or remain stuck in an inferior low astral vibration or state. However, most souls, and those who are more spiritually advanced live more consciously, much more pleasantly and much longer on the astral spheres before returning to Earth again. The great Christ-like yogi, Sri Yukteswar said in Chapter 43 "The Resurrection of Sri Yukteswar" of Autobiography of a Yogi by Paramhansa Yogananda that the average soul, after some 150 to 600 years of astral living must either move on to higher planes (spheres) of consciousness beyond the astral plane (the causal and celestial planes or spheres which are said to be the real heavens) or if not evolved enough to remain conscious in such a refined state of being, must return back to Earth or some other sphere, and repeat this cycle until the soul is in fact advanced enough to consciously exist on the causal plane after which point it will simply manifest back and forth between the causal and astral spheres until it remains permanently on the causal and finally celestial levels of consciousness as a "freed soul."

Here again is more confirmation of why it is so essential to dedicate one's life to the search for truth, meditate on Spirit for long hours, evolve spiritually, become as selfless as possible, and to free one's self from all material (earthly) desires and attachments forever. From all of the most authoritative material that I have read and listened to so far, most of us will have to come back again and again to reincarnate many more lifetimes on Earth! Even Jesus (according to Dr. Marshall as "Lucillius") will reincarnate eventually but only as an extremely advanced "helper" of humanity and only as a "freed soul" or "avatar" as described in Autobiography of a Yogi by Paramhansa Yogananda.

An alternative to reincarnation on Earth is the possibility of reincarnation on a much "easier" sphere such as Bashar's world, Essassani mentioned in some of my other articles. A very physical reincarnation can be experienced on that planet, except it is still subtle enough to not be such a traumatic limitation to the soul nor have to force one to go through any other sort of unpleasantness so often typical of life's struggles on Earth.

Interesting to see in many instances how the system of yogic knowledge and experienced astral travelers confirm all that has come through Leslie Flint and how all the more important it is to evolve spiritually or remain stuck in the quandary of spiritual ignorance and suffering of reincarnation!

Nursing Homes Lack Expertise in Recommending Hospice Care Placing Your Family Member at Risk

Your family member, sick and in pain, is in a hospital or nursing home and no one is available to help because the person is the next room is in critical condition and the entire floor staff is rushing around to help this person. You empathize thinking that if you were in a similar situation you would want everyone rushing around to save you. What you really do not know is that this emergency is due in some cases to financial self interest or lack of staff education regarding critical or end of life care. Most individuals do not fear death as much as the experience of a painful death and many nursing homes and assisted living facility staff do not have the training or desire to educate family members about hospice and palliative care services.

How can we make the stress of having a sick loved one, piled on top of daily stress easier for all involved when hospitals, nursing homes and assisted living locations often provide end of life care? Whether you recently experienced the loss of someone you know or are currently experiencing the decline of a loved one there are steps that can be taken to ease the journey but you must be the one to ask questions because many facility staff lack training in hospice and palliative care.

According to research by Lisa Welch, Ph.D. few nursing homes or assisted living facilities have written procedures for regularly assessing residents' terminal disease status or eligibility for hospice care. Instead, many staff members base their timing and referral of hospice based on their ability to recognize decline, their personal beliefs about hospice services and their initiative in raising hospice as an option. What happens when facility staffs have little or no education relative to palliative or hospice care and family members rely on their level of experience to help their loved ones? The result is often family frustration, little or no pain assessment or management for the loved one and a painful death.

In my work, I have been personally told by facility staff that their administration does not want them recommending outside hospice services because that means that money leaves the building. Or, as the research mentions, if there is no family requiring support, hospice is not recommended and is instead provided by their own staff, lacking hospice background. In these cases, offering hospice becomes a territorial issue founded by concerns over money and staffing. How can family members trust health care providers when the concern for money and self interest overrides the care needs of their family members at an especially critical time of life? This choice should not be a decision made by facility staff but the decision of the individual or family member involved.

"Additionally, timing of hospice referrals is often delayed because staff members believe that hospice is appropriate only for the very end of life. There was often a discrepancy of weeks or months between when staff reported recognizing terminal decline and when referral to hospice occurred." It is clear that training needs exist for staff relative to recognizing declines and understanding the benefits of hospice services. In defense of facility staff, I have experienced instances where fear of breaking rules or regulations or chastisement by a superior prevents staff from doing the right thing. However in these cases mysteriously a phone call or recommendation is made and I become involved to help families navigate the situation.

Until the level of palliative and hospice care education catches up with the need, family members will have a greater level of responsibility navigating the care of loved ones experiencing declines in health. It's never too early to ask about palliative or hospice care; however it can be too late. Too late is when a loved one is days away from passing and has already likely experienced a high degree of pain and discomfort. In the instance you ask and it is not quite time for palliative or hospice care, at least you have been proactive in your own education and when the time does come you'll be more prepared and less reliant on others to recognize the signs or request assistance.

Welch, Lisa C. Ph.D. et. al. Referral and Timing of Referral to Hospice Care in Nursing Homes: The Significant Role of Staff Members. The Gerontologist. Vol 48, No. 4, 477-484.

Elder Care - Dealing With Difficult Siblings

One of life's biggest challenges, I think, is providing care for our elderly parents. As more and more people become care-givers for their parents we see more and more arguments erupting between siblings with different ideas about how their parents should be cared for.

Some may wish the elderly parent be placed in a nursing facility as they do not have the time to give the necessary care. This is often a choice that is not palatable for other siblings. Yes, we all have busy lives, especially if we are still raising our own children, but finding a suitable nursing home for your parent may be more time-consuming than you realize. After all, and this is not to demean the health care facilities in general, but we see stories daily about the unsatisfactory care many elderly receive at the hands of inexperienced or uncaring professionals.

Keep in mind that no matter how caring and respected a hospital or nursing facility is, they are in business. Your parent is a stranger. NO ONE will give the quality of care a family member will simply because they do not have a personal connection.

That said, however, there are some good quality nursing facilities available and if you are dealing with a parent or other elderly person with advanced dementia or Alzheimer, you may wish to consider this as an option. But, your siblings may not agree.

When Siblings Disagree on Elder Care - Find a Compromise

In my family there are five daughters. Each of us has varied ideas about how our mother should be cared for. When mom first fell ill is was fairly simple for my sister, whom she lived with, to offer the limited care she needed. She was not working and was able to take mom to doctors and outings with little difficulty. But things soon got worse for mom and then the arguments began.

I quickly recognized that mom's appetite was failing her. She just didn't want to eat. No wonder when many of her medications came with side effects that were unpleasant, to say the least. When I would visit mom I would take her special 'goodies'. These were usually fruit and other things I knew she liked but did not get regularly. My sister doesn't cook. Period. They go out to eat and would bring mom a meal from their favorite restaurants, usually fast food. Bless her, but my sister had no concept of the fact that it was perhaps the food offerings that turned mom off.

Not the time to fight. After talking to my sister and discussing this with her she was quite upset. She had no idea how to cook the foods mom needed, BUT, she was adamant about mom staying with her. So, a creative solution. I cook every night so I would make something for mom and take it to her daily. At least she got one good nutritional meal a day. Not the best solution, but a compromise.

Later as mom's mental health declined it became clear that my sister could no longer handle her. Other sisters wanted to put her in a facility as they were out-of-town and busy with their own lives. I do not condemn them. But I could not see doing leaving our mother in the hands of strangers. It just didn't sit right with me and I was not happy with the facilities available to us.

While this is not the best solution for many, for us it worked out. At the time I was in college and able to rearrange my schedule so that I could be home with mom a lot. My husband was also able to help out and I was able to enlist the other two sisters who lived locally to give one day a week to being with her. This allowed us to juggle her care in such a way as to allow each of us to offer what we were best at. I cooked and made sure she ate well. Another sister brought the laughter and was very good at getting mom laughing. They had great visits.

The second sister was the one she had previously lived with. She brought the news and gossip that mom loved. She also brought encouragement, over and above what we offered, and was able to keep mother's mood positive. Difficult sometimes, but she knew what buttons to push to get mom to stop feeling sorry for herself.

By finding ways to compromise we were able to give mom home care until her passing. This was important to us. After all, she gave everything to us when we needed it; we wanted to give back to her.

These are just a couple of examples of how we five were able to reach solutions for our mother's care. Your situation is quite different, I am sure. But the bottom lime is that someone needs to recognize the problems and seek a solution that can satisfy everyone. Often that is the eldest sibling, but not always. Communication with your siblings is the vital key. Don't ever feel that you have to take the first solution that presents itself, and if you are certain you do not want your parent to go to a facility, then talk to your siblings and try to work something out.

If you cannot reach a solution, then work together to find the best possible facility. Be sure to verify any and all recommendations. Go for an unannounced visit when you can. Is all as you expected it to be? If not, tell your siblings of your concerns. You can always open a new discussion and make changes.

Finally and perhaps most importantly

Never criticize your siblings on how the may be caring for an elderly parent or family member. When you criticize the defenses go up. Try to find ways to encourage the sibling for the things they are doing that is helping and play down the things that do not. Be ready to offer your help. While the primary caregiver may tell you they are find, truth be known they can certainly use help. Be open to opportunities to talk to your siblings, express your concerns in a positive way, and offer suggestions or solutions that are considerate of your siblings feelings and current efforts.

When I offered to help my sister by providing fully cooked meals for mom it took a lot of the stress from her. I also provided frozen meals that could quickly be heated and served if I could not deliver something fresh for some reason.

Some times it is the little things that are overlooked when you are dealing with an elderly person. Things like what are they actually eating, setting a table and sitting with them for a meal, or taking time to talk to them.

Communication is one of the vital keys that is often abandoned in the heat of family arguments. While siblings may have the same parents and similar values, they certainly will have developed their own ideals. Your idea of care may not be the same as your sibling. Who is right and who is wrong is not the issue here. There really is no right or wrong answer. You must work together to find a solution that works for you, your family, and your elderly family member.

We lost our mother a few years ago, but working together to care for her as her health declined brought us closer and allowed us to grieve together rather that begin blaming each other for contributing to her failing condition. It was well worth the effort.

DISCLAIMER: I am not now, nor have I ever been a medical professional. I have supplied this example from my own life experience and offer it only as encouragement. Please discuss any necessary care options with the patient's doctor.

The Ever Increasing Demand For Healthcare Workers

The need for healthcare encompasses the need for professionals in their field, as well as people who can provide administrative support. There are thousands of healthcare practitioners in Western countries and other parts of the globe. But the need to fill in their staff and experts seem endless.

One of the main reasons why healthcare jobs are still on the rise is because the number of patients is also rising. The need for nurses, doctors, medical technologists, and other professionals are always high due to the number of patients contracting diseases from various sources. The number of aging individuals is also another concern for institutions such as nursing homes.

Lifestyle change is another major factor that affects the demand for healthcare practitioners. To put it simply, many people are suffering diseases and ailments caused by poor diet, bad habits, and lack of physical activity. If you'll look at the rise of people with hypertension, diabetes, cancer, and obesity, you will understand why more and more healthcare jobs are being opened across the globe.

As much as possible, there should be only one person per patient or elderly individual in order for the healthcare provider to give quality care and assistance. In reality, this can be achieved but with consequences such as working long hours or doing part-time jobs in other institutions, hospitals, or private homes.

What positions are in demand?

Nurses, physicians, and surgeons are highly in demand in various hospitals. And as the healthcare sector grows, the demand for it will also increase.

Medical technologists [in various fields] are also on the rise due to the demands in many institutions such as hospitals. These specialists are also needed in homes and private clinics especially if they know how to administer EEG, ECG, lab testing, and many others.

Nutritionists and dieticians are highly in demand because of the rise in health problems connected to food intake and poor diet. These experts are always searching for ways and strategies to improve the health and diet of those inflicted with diseases caused by poor nutrition.

Technical tasks such as those required in hospitals will definitely need the expertise of such staff. Dental, ophthalmic, and clinical laboratory techs are sought-after for their skill and experience.

Therapists, psychologists, and health insurance experts are also needed badly in many major hospitals around the world. They provide specialized services typical of their fields of study. In the case of health care insurance experts, their jobs require medical billing, claims analysis, and reimbursement.

Chemists and pharmacists are also in demand these days due to the same reasons. The need to properly schedule, maintain, and dispense medicines are all part of the daily routines in hospitals, clinics, and similar institutions.

Nursing Home Management And Leadership Tips

The true benefit of a properly managed nursing facility or any establishment cannot be truly measured. It is the total outcome of the business' profitability, customer satisfaction and employee retention. Properly and conscientiously managed businesses thrive no matter what type of economy the world may be facing. When everyone who matters in your business (clients, customers, employees, investors and stakeholders) is happy and contented then there is no reason for your business to go under no matter what.

As Nursing Home Administrator, you are the center of everything that happens in and out of your nursing facility. You are handling patients, employees both health professionals and management support. That is why your management and leadership skills should be broad and diverse. These are the very reasons why the role of Nursing Home Administrator is always challenging.

Here are some tips that will help you in managing you facility effectively and efficiently. These tips also aim to improve your leadership style that is effective according to the diversity of your role.

A Small Amount Of Care Goes A Long Way

It is not a sign of weakness if you show that you care. Gone are the days of strict to the core management and leadership style. Care and concern for your employees is more rewarding than to ignore the human consideration that they need. Small details could be a big deal for them so make sure nothing is overlooked. Examples of this aspect are:

Make sure that each employee schedule and shifts are respected. Should there be some changes always inform them ahead of time with a brief description or comment as to why their schedule is going to change. Welcome any feedback and always anticipate that there will be some objections. Make sure you have a back-up plan.

Always make sure that employee evaluation is regularly administered. Employees look forward to this date because it is their opportunity to be evaluated on their performance that could lead to promotions and pay increase.

If possible set-up an emergency loan program of certain amount that your employees could avail of in case they will be in a financial crisis. This program should be interest free and can be availed of by employees at any time without any hassle.

Above are just some examples that you can do for your employees for you to let them know that you, as part of management care for them.

Listen and Take Action

It is one thing to listen and another thing to take action on what you have learned. In all relationship, listening is an active aspect that should be given consideration at all times. In your case, here are some examples that you can do in order to show that you are listening or willing to listen to whatever they have to say about their work and workplace.

Satisfaction surveys should always be conducted regularly. Results of this should be discussed among your employees so that they know you take this survey seriously

If possible and if you have a large facility then having a newsletter or facility magazine will also help them voice out their how they feel about their work and ideas on how to further improve the process in the facility

Empathize

This very powerful word if handled properly can take you a long way in your management and leadership abilities. Learn how to put yourself in their shoes. Learn how to truly feel what they feel about certain issues. Empathy is a powerful human tool that is now being used in different aspects of practically all businesses today. This should make you all soft and vulnerable but it should make you see different situations in different perspective allowing you to draw several courses of actions and take the best out of them.

These are just some of the tips that can help you improve your management and leadership style and abilities. Remember to care, listen and empathize with your employees. These tips will help you build a strong relationship with them. These will help you put their minds at ease with management and earn their trust and confidence. The result will be productivity and hassle free work place.

Great Gifts For Grandma - The Top 10 Best Gifts For Seniors in Assisted Living Care

What do you get the woman who has everything? For the first 40 or 50 years, you were probably able to come up with great, personal, gift ideas that your Mom truly treasured. But let's face it; times and needs change. Mom may now be in a nursing home or assisted living facility. After a while we run out of good gift ideas find ourselves to be gift-giving challenged!

Just as you might recall the holiday you really wanted "Abby Road", and instead you got your very own fruit cake, it's your turn to rethink gift-giving for "Gram".

It's likely Grandma deals with chronic in pain, has lost a lot of physical flexibility, and can't see well. Opt for resents that provide comfort, simplicity, and independence; ten thoughtful suggestions sure to be well received.

Gift ideas for that special elder:

1. Back Scratcher: Seniors can't bend, twist, and stretch like they could when they were younger. Back scratchers offer welcome relief for those hard-to-reach areas that itch and when there's no one around to offer to "scratch their back."

2. Shoe Horn: Eliminate Gram's need to bend over to get her heels completely inside her shoes or slippers with a good metal shoe horn. Look for one with a long 8-10" reach.

3. Walker Basket Attachment: It's impossible to carry anything while using a walker. Attaching a pouch or basket, specially designed for walkers, frees up hands. It's practical and a boost to feelings of independence and self-sufficiency.

4. Smart Night Lights: Falling is a serious matter when it happens to a senior. Bones become brittle, break easily and heal slowly. Motion detector lights aren't just for outdoor use; they can safely light the way when Grandma gets up in the middle of the night, greatly reducing the likelihood of tripping and falling.

5. Telephones with Sound Amplification: Telephones with cords often provide better sound than cordless. They also operate during power outages, while cordless phones only work with electricity. Cordless phones offer the safety and convenience of access throughout the house. Look for cordless phones with outstanding amplification features "Sound amplified" or "extra amplification"will be listed as a key feature in the on-line description, or on the box or display feature list. Phones with those features are becoming much more widely available; consider one of each, for the best of both.

6. Big Button Telephone: Large, easy-to-read buttons make dialing easier for arthritic fingers or for anyone who can't see quite as well as they used to.

7. Slipper Bottom Socks: People with cold feet often like to wear socks to bed. Yet socks can be a slippery safety hazard when stepping out of bed, especially on uncarpeted surfaces. The solution? Warm socks with sticky bumps on the bottom keep Grandma's feet warm in bed and also prevent falls by grabbing the floor surface when they get out of bed.

8. Soap for Sensitive Skin: Older skin is often dry, fragile, and sensitive. Look for soap that is free of irritating additives and designed for very sensitive skin. Health food and medical dermatology stores are a good resource. Consult your local pharmacist for any special order items.

9. Silky Nightwear: Fleece-lined silk is warm and cozy for the wearer. And for caregivers, silk makes it easier to roll over or reposition someone in bed. But there is a downside to watch out for. Beware that Grandma and Grandpa don't slide right off the bed and get hurt, seriously, this is true!

10. Easy Remote Control: For seniors who can't or don't want to fumble with multiple, microscopic-size buttons, go for the specially designed three-button TV remotes. Make TV-watching simple and pleasurable with a large, easy to use 3-button remote control device.

Where to Look:

Out and about shopping: Most of these gifts are readily available in your local hardware store, local pharmacy, health food, home health division of your local hospital store, specialty shoe stores, better department stores. Radio Shack

is a great source for affordable items for seniors.

On-line: The Alzheimer's Store, Maxi Aids, Walgreens and other stores that sell independent living aids

Before You Buy:

It's always a good idea to discuss products with Grandma's caregivers to be sure they're safe for her particular situation.

The Best Gift of All:

More than anything, most of us want to be loved and remembered. If you can, give your gift in person. If you can't, then call, write an easy to read personal note, check in. Even if your gifts may sometimes initially be an unwanted reminder of the consequences of aging, letting your Mom know you care and are doing your best to promote her independence and keep in touch, will go a long way in helping maker her golden years just that. PS., all of these ideas can be enjoyed by Grandpa too!

Financing Your Franchise

Franchise businesses are a great way for would-be entrepreneurs to easily and quickly enter the business world and secure their financial future.

First, franchises usually provide a proven business model meaning that many franchisees do not have to struggle during a start up period in ensuring the feasibility of their products, their market and their processes.

Second, brand. Many established franchisors have already spent the time and effort in educating the consuming public or your potential target market to the benefits of the products and services the franchise offers.

And, lastly, economies of scale. One issue that almost every new business owner faces is the ability or power to negotiate price reductions with suppliers or vendors. But, with the buying power of an entire franchise system (compared to a single business unit) franchisees are able to realize huge purchasing discounts from the very day they open their doors.

Over the last two years, many franchise concepts have struggled in this economy just as other traditional, stand alone businesses have. However, not all franchises are made the same and, as a result, not all have suffered the same. In fact, according to an October 2009 press release from FRANdata, the world's largest repository of franchise information and data, "The home health care industry is rapidly growing... What's more, demand for in-home care service is only expected to grow over the next decade as baby boomers continue to age and require assisted living services."

The bottom line is that while many franchise concepts have felt the same economic pinch that nearly all other businesses have, overall, as an industry, it seems that many franchises found it easier to weather the storm based on some of the particulars outlined above. In fact, according to Jason Daley (an Entrepreneur Magazine Contributor) 2010 and beyond is expected to see a modest recovery in franchise businesses such as fast food, tax prep and home repair not to mention the staples in the industry like pet care and products related to children.

But, while purchasing a franchise may be the best path for many would-be entrepreneurs, actually finding the financing for that purchase still remains a very high hurdle to overcome.

Many well known franchisors relied on preferred lender programs with national or international financial institutions. Here, the franchisor would essentially pre-sale its business model to banks and other national lenders. Thus, when a strong prospect for a new franchise appeared, the franchisor would simply send that person to their preferred lender or lenders.

However, many of these same preferred lender partners were the ones that got hit hardest during the financial crisis and as a result have either pulled back or stopped these preferred lending relationships.

Today, just like any business owner seeking financing, the capital or credit pool for franchises remains very shallow but it has not completely dried up.

Here are five potential avenues when seeking the financing to purchase or grow a franchise business:

1) Always start with the franchisor. Your franchisor only succeeds as the number of units they sell increase. And, if financing is a common problem, look to the franchisor to help you (the franchisee) solve that problem. There are still a few preferred lending programs with some of the largest, most well known franchise concepts. And, while these relationships have tighten, your franchisor will be a great source in helping you determine if you are a strong candidate for these programs - before you waste any time and effort in applying directly.

Moreover, many franchisors that have lost their preferred lender partners have turned to in-house financing programs - making approvals much easier as your lender (the franchisor) already understand the overall benefit and potential of the business as well as its long-term revenue generation ability.

2) SBA loans. The SBA loves franchises. First, they understand that the model is proven to work, second, that you, the franchisee, are not alone in business and have tons of resources at your disposal and third, the SBA knows that many franchisors will step in and either help the franchisee or take over the franchise should the individual business owner not be able to overcome its own obstacles.

When seeking either SBA or conventional loans, contact community or region banks first. Many of these financial institutions were not hurt by the financial market break down as they just simply did not have large amounts of toxic home mortgage loans in their portfolio. But, these same organizations, not having a lot of experience in funding franchise businesses, will need to be educated about your particular franchise and its potential in paying back a loan. This means more time and effort on your part in selling these lenders the business's ability to service the requested loan.

3) Franchise loan brokers. Brokers can be a great method in securing funding for your franchise. They understand the market and keep up with the latest trends; who's lending and who is not. Further, they can pre-approve you under certain programs as they understand both your situation and which program would serve your business best; saving you both time and trouble. Look at brokers like FranFund, Franchise Direct or FranChoice Inc.

4) Non-bank lenders. Most non-bank lenders receive their capital pools (the money they in turn lend out) from private investors. And, while these investors did pull back a bit during the recession, non-banks lenders seem to be recovering much faster than their traditional counterparts. Companies to look at are WingFinance, CIT or Diamond Financial Services.

5) Bootstrapping. A common practice of finding any way possible to scrap together the funding you need to either purchase or grow your franchise. Possible bootstrapping techniques could be loans from friends or family, finding local, private investors (think local Doctors, Lawyers, CPAs or other business owners who want to invest in their own communities), or using personal assets like home equity or the sale of a second home to get the financing you need.

In general, while franchises are great ways to jump right into business quickly and easily with proven products and tons of potential customers, franchisees are still facing the same financing hurdles as every other business. But, by knowing which avenues to approach for a franchise or business loan will not only save you time and money but may just get you that elusive 'Yes' approval; moving you one step closer to your dreams.

Recognizing Abuse in Nursing Homes

The choice to put your parent or elderly family member in a nursing home is never an easy one. These facilities may provide the care your loved one needs, but the nursing home environment can be less than inviting. Regular visitation and communication with your family member is a crucial step for his or her health and continued wellbeing.

Unfortunately, nursing homes can be the sites of a wide range of elderly abuses. These adults, who are often vulnerable to such abuse, may not be entirely aware of their circumstances. It is important to protect your family member from abuse and respond appropriately if you believe they have become a victim.

Nursing home abuse happens in a number of different ways. Physical abuse cases may result from negligent care on the part of a caregiver. Caring for a large number of adults can be a stressful position at times, but it is never reason for abusive or harmful behavior. If you see signs of physical abuse, like bruising or burns, it is important to take proper action.

Emotional or psychological abuse can also occur in these facilities. The manner in which caregivers interact with the residents of a facility plays an important part in their health. Emotional abuse can affect an elderly adult's wellbeing and have real, physical results. Yelling, name calling, or demeaning language does not promote a healthy or comfortable environment.

Finally, sexual abuse is a serious concern in elderly care facilities as well. Sexual assaults between residents or between a caregiver and resident can take a toll on a vulnerable older adult. The embarrassment and physical injuries that can result from this behavior must be addressed to the full extent of the law.

Nursing Tips - How to Organize and Prioritize Your Shift

To successfully and efficiently complete your daily tasks in your nursing shift, it is essential to organize and prioritize every time. The first thing that you have to understand is that things do not always go as planned. Rather, it is the exception when everything falls right into schedule. Because you are always expecting the unexpected, it will be easier for you to readjust your plans and not panic and get stressed out at the slightest changes. You will feel cooler and lighter in your discount landau scrubs. You should always have a Plan B even if it is just a vague plan.

Organizational and time management skills are invaluable skills for nurses and yet there are a lot of nursing schools that do not include these essential tools in their required courses, and only offer it as extension courses. Below are some ways to develop good organizational and time management skills.

Preparing at home

Being in the comfort of your home and away from the high intensity of your work environment, you will be able to think more clearly and objectively. While at home, you should already start organizing the basics of your shift. What you can do is try to map out a day in your life as a nurse. In a paper or word processor divide your shift into two hour increments and fill up the projected patient meal times, AM care, HS care, and so on. Include medication schedules such as ac, pc, and hs medications if there are any. Also put in when your patients are likely to go for therapy or tests and when MDs make their rounds. Also consider when new admits and discharges are likely to surge during the shift and what part of visiting hours gives you some time to catch up on tasks you left behind. The goal is to know when you will be busiest and when the tasks slow down so that you know how to readjust in any situation or circumstance.

Organizing at work

It is best to arrive early for your shift so that you have the time to assess the intensity of the previous shift and prepare yourself accordingly, whether for chaos or for downtime. So that you can anticipate what will ensue more or less in your shift, listen during rounds and reports on how busy the staff is going to be, the general level of acuity of that day's patients, who might have time to help you should you get overwhelmed, patients who require more of your time, what assessments, treatments and procedures you could learn from if you had the time, new patients and their diagnosis and treatments that you need to look into, time specific events such as meetings, things that you want to put off until the end of the shift or hope you don't need to do, and things that can be delegated to an LPN or nursing aide. Prioritize things that are difficult or you dislike so that you can get them out of the way. The more you put them off, the more they will be a burden for you for the rest of the day. Once you're done with the hard tasks, things will be generally lighter from there.

Deficit Reduction Act Changes the Way We Think About Medicaid - Nursing Homes

I'm still dumbfounded that Congress determined it was necessary to take away much of the Medicaid Planning that was available to the public.

What is Medicaid you ask? Well, it's complicated.

This is a federal and state funded and state administered medical benefit program which can pay for the cost of the nursing home if certain asset and income tests are met.

There are basically four ways to pay for nursing home care:

1. Private Pay. This is the method many people are required to use at first. Quite simply, it means paying for the cost of a nursing home out of your own pocket. Unfortunately, with nursing home bills averaging between $4,000 and $4,500 per month in our area, few people can afford a long term stay in a nursing home.

2. Long Term Care Insurance. If you are fortunate enough to have this type of coverage, it may go a long way toward paying the cost of the nursing home. Unfortunately, long term care insurance has only started to become popular in the last few years and most people facing a nursing home stay do not have this coverage

The first two methods of private pay (i.e. using your own funds) and long term care insurance are self-explanatory, our discussion will concentrate on Medicare and Medicaid.

3. Medicare - This is the national health insurance program primarily for people 65 years of age and older, certain younger disabled people, and people with kidney failure. Medicare provides short term assistance with nursing home costs, but only if you meet the strict qualification rules.

4. Medicaid - This is a federal and state funded and state administered medical benefit program which can pay for the cost of the nursing home if certain asset and income tests are met. Since the first two methods of private pay (i.e. using your own funds) and long term care insurance are self-explanatory, our discussion will concentrate on Medicare and Medicaid.

Medicaid has traditionally been the way many people paid for long term stays in skilled nursing facilities. For instance, if a loved on is facing a nursing home stay due to an illness such as Alzheimer's, Medicaid may pay for these costs. But the rules are much tougher now than they have ever been, due to changes in the law that occurred in 2006 under the Deficit Reduction Act (DRA)

The main thing to note is that there are many ways to still qualify for Medicaid paid nursing home care, and many planning techniques that may still be available, even under these tough new laws. But you need a qualified Elder Law Attorney to help you navigate through the ever rising riptides.

Working With the Elderly

I work with elderly people in an assisted living facility. Each time I see a particular resident, the experience is new. I try to comprehend how it must feel to age, to change and become more and more dependent. The result is, I'm dumbfounded... I just don't understand.

I talk with residents who tell me about their former careers, amazing vacations they've been on, achievements throughout life, etc. They even relate to where I am at in my life right now. "When my first son was born, I was so terrified, yet excited," one resident recalled. "He wouldn't sleep until I bounced him so long I developed a constant twitch." That's right, I would think... That's what I have to do. Then ten minutes later, the resident would ask me how my baby was and recap her experience, "When my first son was born, I was so terrified, yet excited." My heart sinks each time. Will that be me when I get "OLD?"

Then I talk with another woman who just celebrated her 101st birthday! She tells me to come into her room where she is sitting with her newspaper sprawled out and her magnifying glass in hand. "Can you believe what a jerk that Madoff guy is? He deserves everything that's being handed to him," she states with a grimace. Then she talks about our current economy and the Great Depression and how our country is so mismanaged. "Will we ever get it right," she asks rhetorically as I look at her in amazement. How can a woman who is so old be so with it? Will THAT me be when I get "OLD?"

I then cross the hall where I see little Tracy trying to get out of bed with twisted hands and feet from years of arthritis eating at her joints. She looks at me with frustration and says, "It sucks being old. Don't ever do it!" I chuckle, yet empathetically also want to cry. Tracy's mind is as sharp as the 101 year-old, but her young, 74 year-old body is failing. Will that be me when I get OLD? "

Each day I am humbled and curious about life. If I eat right, will my body be healthy and strong when I'm 80? If I read a lot and do crossword puzzles, will I bypass Alzheimer's Disease? Who knows the answer to these questions, scientific experts? What "controlled" study will they come up next? Probably one that claims green tea and tomatoes are the cure all, oh wait, it's that little yellow pill passed down from Big Pharma.

The one point I am certain about that people can control is attitude. I see young, healthy individuals complaining about how life stinks and they've been handed the raw end of the deal. Then I see someone like Tracy struggling to get out of bed and making jokes about being old. She smiles everyday and has a little skip in her crippled, walker-aided step. Tracy loves life and makes the best of her situation. Hmm, why the difference in attitude? Is it experience or the understanding that life could be much worse? Or are the younger generations just spoiled with an overindulgent sense of entitlement? Just a little something to ponder.

I, personally, am humbled everyday by the elderly people of this community. They each have their own struggles and issues, but they are alive and continue to thrive. I just hope younger generations appreciate where they are at in life and realize that one day they, too, will be "OLD." No matter what body part fails or how bad the memory declines, it's attitude and relationships that are the difference and make life worth the struggle!

Trisha Kellogg

Caring For Aging Parents Without Guilt

Seniors who are able to age in place at home positively impact their general outlook and mental health. Being able to maintain their freedom and independence is a major factor for this. When asked, the vast majority of seniors would prefer to stay in their own home and live independently for as long as possible.

As living completely independent becomes more difficult, many children of seniors begin assisting by providing home health care to their aging parents. While this initially is a workable arrangement, there are limits to what family can provide ongoing. Baby Boomers' lives are so hectic that they eventually run out of hours in the day to juggle work, their own children, and now their parents' growing needs. What usually gets neglected are their own needs and health. As the children of seniors find themselves spread too thin, they tend to feel guilty that they aren't able to provide everything their aging parents need. Finding the right kind of assistance for aging parents doesn't need to leave you feeling guilty.

The idea of placing an aging parent in a nursing home, while sometimes necessary, tends to seem so "final" which only makes you feel guiltier. Assisted Living facilities offer the aging senior a safe place to reside while also offering assistance with personal care, access to medical care, prepared meals in a dining room setting, and a variety of social activities for residents to stay engaged throughout the day. But many seniors resist the idea of having to give up the home they have lived in for 40-50 years or more.

Home Care has become a popular option for many children when they can't provide all the care their parents need and they want to allow their aging parents the opportunity to remain in their own home. Home care workers generally provide personal care with activities of daily living (ADL) such as bathing, dressing, grooming, and toileting. But this option alone doesn't provide that socialization component that an assisted living facility offers to help seniors thrive versus merely existing.

Sometimes finding respite care a day or two per week is all you need. A respite caregiver is someone who comes in to assist a family, thereby allowing the primary caregiver(s) a break from the daily routine and stress. If you need more than respite care, but less than a nursing home, and you don't want to force your parents to move out the their home, home care that provides a component that focuses on enrichment activities may be the answer. Finally, a way to provide care for aging parents without the guilt.

For more information, visit http://www.assistedlivinginhomecare.com

Nursing Home Abuse and Neglect

Nursing home neglect and abuse is a national disgrace. In fact, this is a widespread -- and increasing -- problem in the United States. An analysis of the death certificates of persons who died in California nursing homes between 1986 and 1993 revealed that over 7%, or 1 in 15, of the deaths of seniors in nursing homes, resulted at least in part, to utter neglect, lack of food or water, untreated bedsores, or other generally preventable ailments. Since that study, this nation's nursing home population has risen sharply. If the 1.6 million Americans now in nursing homes are dying of questionable causes at the same rate, then every year about 35,000 elderly citizens die prematurely or in unnecessary pain, or both. According to a survey published in the Journal of the American Geriatrics Society, 30% of those polled said they would rather perish than live in a nursing home.

The U.S. Congress and state legislatures have taken steps to make nursing homes accountable. The federal Nursing Home Reform Act states that a nursing home must provide "services and activities to attain or maintain the highest practicable physical, mental, and psycho-social well-being of each resident in accordance with a written plan of care." However, you still need to be alert to your own loved one's needs, and if necessary, demand that the nursing home respect all of his or her legal rights. Listed below are examples of positive steps you can take to prevent problems and ensure proper treatment in a nursing home for your relative or friend.

Signs of Nursing Home Abuse

It is important to watch for signs that your loved one may be a victim of abuse or neglect. Most nursing home residents must depend on the staff for most or all of their daily needs, including food, water, medicine, toileting, grooming, stimulation and turning.

Although most facilities provide good care, some cause needless suffering and death. Sadly, many nursing home residents are starved, dehydrated, over-medicated, and suffer painful pressure sores. In addition, they may be isolated, ignored, and deprived of social contact and stimulation.

The following is a list of some forms of nursing home abuse:

• Assault and battery


• Sexual assault and battery


• Rape


• Unreasonable physical constraint


• Prolonged deprivation of food or water


• Use of physical restraints, like straps or bels


• Use of chemical restraints, like sedatives or sleeping medications


• Use of psychotropic or other medications for any purpose not authorized by a physician


• Excessive dosages of medication


• Withholding needed medication


• Confinement to a room or fixed location

Nursing home abuse victimizes the most vulnerable individuals. Although many residents can report mistreatment, some cannot even describe what happened. If your relative or friend is a nursing home resident, you can help by watching out for signs of abuse, including:

• Unexplained injuries


• Inability of nursing home staff to give an adequate explanation of a resident's condition


• Open wounds, cuts, bruises, welts, or bedsores


• Slapping, pushing, shaking or beating


• Non-verbal signs from the nursing home resident that something is wrong, such as:
  • Unusual emotional outbursts or agitation
  
  
  
  
  • Extreme withdrawal or lack of communication
  
  
  • Unusual behavior, like sucking, biting, rocking, etc.
  
  
  • Humiliating, insulting, frightening, threatening or ignoring behavior towards family and friends
  
  
  • Desire to be isolated from other people
  
  
  
  

Signs of Nursing Home Neglect

Neglect means the negligent failure by any person with care or custody of an elderly or a dependent adult to exercise that degree of care that a reasonable person in a similar position would exercise.

Neglect includes, but is not limited to:

• Failure to provide food, clothing, shelter, or help with personal hygiene


• Failure to provide medical care for physical and mental health needs


• Failure to protect from health and safety hazards


• Failure to prevent malnutrition or dehydration


• Failure to provide the necessities of daily living


• Failure to prevent bed sores


• Failure to provide sanitary conditions


• Failure to prevent infections

Specific Examples of Common Nursing Home Abuse or Neglect Injuries

Bedsores

Bedsores are also known as pressure ulcers, pressure sores, and decubitus ulcers. The primary cause of bedsores is unrelieved pressure to a particular part of the body. They also may result from friction, like rubbing against something like a bed sheet, cast, brace, etc., or from prolonged exposure to cold.

Any area of skin tissue directly over a bone is a potential site for a bedsore. These areas include the spine, coccyx or "tailbone," hips, heels, and elbows. The factors that contribute to formation of a bedsore include poor nutrition, poor hygiene, weight loss, diabetes, and dehydration. The least serious kind of bedsore looks like skin discoloration, and may disappear within a few hours after relieving pressure on that area. However, more severe bedsores are profound wounds, which can extend through skin tissue into internal organs or bones.

Medical professionals have identified similarities between bedsores and burns. Like a first-degree burn, a mild bedsore may involve mild redness of the skin and/or blisters. A third-degree or fourth-degree burn, or severe bedsore, may have a deep open wound with a lot of blackened tissue, which is called "eschar." The primary treatment for bedsores starts with removing all pressure from the affected area, to prevent further tissue decay and promote healing. The victim must be turned or repositioned frequently and get enriched nutrition. The affected area must be kept clean, and dead or necrotic tissue should be removed to minimize the risk of infection. The worst bedsores often require a surgical procedure, known as debridement of dead tissue.

If you suspect that a relative or friend is suffering from a bedsore, you need to get immediate medical attention for that individual. In addition, help your loved one get legal assistance. Very frequently, severe bedsores result from abuse and neglect. Federal regulations confirm that there rarely is a valid medical reason for a bedsore to develop into a massive deep wound, which is known as the stage 4 level.

Suffocation and Strangulation

A frail nursing home resident can suffocate or strangle to death in a hospital bed, if ignored or neglected by nursing home staff. Between 1993 and 1996, there were 74 of these cases reported, and probably many more went unreported.

The design of the side rails on a nursing home bed may contribute to the danger. Often side rails have slats that are spaced six or more inches apart. That space may trap an elderly person's head, causing him or her to strangle, or allow a thin individual to squeeze between the rails and fall to the floor. If the mattress on a nursing home bed does not fit properly in the bed frame, a patient may be trapped and strangle in a gap between the mattress and side-rails.

Broken Bones or Fractures

For the elderly, falling is the most frequent cause of fractures. Nursing home staff must regularly evaluate each patient; determine his or her risk for falling, and provide safety devices and services that each individual needs to minimize the risk of injury. Some of the risk factors for harmful falls include:

• Previous falls


• Cardiac arrhythmias (irregular heartbeat)


• Stroke


• Central nervous system disorders, such as Alzheimer's disease, Parkinson's disease, or dementia


• Problems with mobility and gait


• Low blood pressure (orthostatic hypotension) when trying to stand up


• Bowel or bladder incontinence


• Dizziness


• Dehydration


• Visual impairment (i.e. macular degeneration, cataracts, etc.)


• Use of restraints


• Medication side effects


• Slipping or tripping hazards, like torn or loose rugs or mats

The Cost of Nursing Home Abuse or Neglect

The cost can be quite high for the treatment of a victim of nursing home abuse or neglect. Often the resulting injuries are permanent, and may require hospitalization or a higher level of medical treatment and nursing care than your loved one previously needed. This can be an extreme hardship for the victim and his or her family. If the injuries are the fault of a nursing home, then it should have insurance to pay for those substantial bills, other expenses, and damages for pain and suffering. Proving a nursing home abuse or neglect case is a complex process. To succeed, you need a lawyer who is well versed in the complicated laws that govern these legal actions.

How to Become a CNA: Start a New Career in the Medical Field

What is a CNA?

CNA can stand for 'Certified Nurse Aide' or 'Certified Nursing Assistant'. In some states they even have different initials like in Ohio they use 'STNA' and in Vermont 'LNA'.

So what does it all really mean? The basic idea is that a CNA is a healthcare professional that has had some official training or testing and is registered or certified by the state to provide care and assistance to patients within the state's rules.

Who hires CNAs?

Nurse aides work in all kinds of healthcare settings. You will find CNAs working in hospitals, clinics, home health, and rehab centers. The most demand for CNAs is in long-term care facilities like nursing homes and assisted living facilities. There is so much need with the aging population that you can often get a job at a nursing home and they will pay for your CNA education and all of your training.

What do CNA do? What is the work like?

What the job includes will vary a lot depending on what type of facility you are working in. The general job of Nursing Assistants is to help ill, disabled, elderly or weak people do the things they can't do for themselves without help.

CNAs help people with their basic needs called 'Activities of Daily Living' (ADLs). You might assist people to get out of bed, to walk, to shower and to get dressed. CNAs also perform basic nursing procedures like taking vital signs such as blood pressure, pulse and temperature.

In some states and on some jobs you can get further education and training and be able to perform more complex nursing skills like doing EKGs, drawing blood for lab samples, giving patients medication and more.

How do you become a CNA?

Every state has their own specific requirements for becoming certified or registered as a CNA; however they have a lot a common.

Most states require you to take a CNA training program that is approved by the state. The training program must include classroom training as well as supervised clinical practice. Each state has a minimum number of hours required for CNA training, usually at least 75 and some require as high as 180 hours.

After you complete your CNA education you will have to take the state's competency exam. Every state's test includes a written exam as well as a skills examination where you will have to show your ability to perform some CNA tasks safely.

Many states, and some employers will also require some type of criminal background check or fingerprinting before you will be listed with the state's registry.

How does the job market look for CNAs?

The short answer is 'excellent'. The US Department of Labor says there are "numerous job openings and excellent job opportunities are expected".

In their report they also say that job growth is higher than the average for all other jobs. The US has an aging population which means more need for retirement homes, assisted living facilities and other long-term care options all requiring more CNAs.

The need for CNAs is so great that you can often have your CNA training and testing paid for by your employer. If you pay for own training and then get a CNA job, some states even require the company to reimburse you for your CNA education.

Becoming a CNA is a great way to get into an entry level position in the healthcare field without going to college. You can find a job and start getting paid quickly. Another benefit if being a CNA is that many employers will pay for you to continue your education if you are interested in advancing your career even more. Many CNAs go on to become LPNs or Registered Nurses.

Warehousing Our Elderly

It is a national shame that in our culture we stick our elderly in warehouses called nursing homes, or assisted living or rehabilitation facilities. About twenty years big corporation recognized the huge money profits by exploiting end of life care. Many churches had not-for-profit homes to care for older people who could no longer live independently. But one by one they were bought up by for profit corporations.

In the United States older persons are invisible, not valued or respected in general. We put those who have outlived their usefulness in institutions. Out of sight ---out of mind. Some fortunate older people have family members who live close and can act as advocates when they can't act on their own behalf. But more and more families are spread out in different states, even different countries, and the elderly person is alone

If the person has a stroke, ALS, terminal cancer or other life threatening illness and cannot speak for himself or herself, they are often neglected, dehydrated even abused.

I recently spent five days in a nursing home tagged as a rehabilitation facility. It was an eye opener. The nursing home collected big bucks from my health care provider and was determined to keep me there as long as my insurance company paid. They got more for rehabilitation patients than regular "residents."

The care was abominable. My bed sheets weren't changed for the entire time; I didn't receive a bath or even given a basin of warm water to sponge bath myself. I had ankle reconstruction and was in a cast and in severe pain. Medication was withheld or errors were made. The staff was overworked and underpaid. When I was assertive in requesting necessary care some staff embers were passive aggressive and I was either neglected or punished in some way like leaving me on a bedpan for over two hours, or spilling urine as the bedpan was removed then leaving me in a urine soaked bed and refusing to change my bed. One staff member refused closing the door at night to shut out the noise in the hall or loud conversations of the night staff. Turning overhead bright lights on in the room at 3:00 AM to take my blood pressure because the nursing assistant forgot to take it at bedtime wakened me. These are just a few of the infractions I received.

Physical therapy was ordered but I didn't receive any, yet my insurance company was charged for this service. I requested a bedside commode and never got one. The staff said none were available.

I was fortunate because I wasn't there permanently but my roommate was, and she was reduced to a passive compliant wimp. Prior to her stroke she was a Unitarian Minister a successful assertive woman. On one occasion after she had been given a suppository and was having severe abdominal cramps and she needed a bedpan during the night a nursing assistant threatened her if she turned on her call light again and refused to give her a bedpan. She cried in pain.

Greedy corporate elderly care owners cut back on quality care by hiring staff with little or no training, pay minimum wages, cut back of food, have insufficient equipment available. They do little or no staff in-service training or offer staff incentives to reduce the difficult and depressing job. These administrators are so far removed from the recipients of their services they have no idea nor do they care about quality of life issues, including attractive and tasteful healthy food, well trained staff, hydration, cleanliness, comfort, recreation therapy as appropriate, regular medical visits and supervision, not to mention respect and kindness.

Care of the elderly is at the bottom of the priority list in the delivery of health care services, is poorly monitored or regulated and it is a national shame.

Launching An Adult Day Health Care Center In Chicago

Chicago is acknowledged as the cultural, industrial, financial, and economic capital of the Midwest. It has a population that exceeds 2,873,790, of which 8.7% were single senior citizens above 65 who lived alone. With two-income families on the rise, care and supervision of a loved senior has become an increasing concern. Adult care centers are thus gaining popularity, as not only are their aged loved ones under supervision, they also have the chance to mingle with their peers.

Tips for Starting an Adult Day Care Center:
Adult day health care centers are for senior citizens who need skilled nursing and rehabilitative therapy services in addition to providing excellent personal care services. These registered nurses and rehabilitative therapists always act under the supervision of the senior citizen's physician.

It can be a great idea to start an adult day health care center, but first be realistic and conduct a detailed analysis of the demographics of your area to find out if there are any senior citizens who can afford a day care service. You could visit your competitors and find out the range of services they offer and the prices to give you an idea of how to price your services and offer a little extra in the beginning to capture the market. Adult day health care services usually charge $10 to $15 per hour.

Lease an appropriate place with easy access to health care facilities, having proximity to a health care practitioner in case of an emergency. It has to be conveniently located with easy accessibility and meet all the required state regulatory factors.

Buy the necessary furniture and other equipment and materials that are necessary and decorate the interior in such a way that the senior citizens will not have much trouble in moving around. Keep the interior pleasing and attractive.

There are certain minimum staffing requirements for adult day health care centers. There has to be an administrator, a registered nurse, a rehabilitative therapist, a program director, an activity coordinator, and a social worker. Make sure the staff is qualified and experienced and able to handle emergencies if necessary without panicking. Ensure that the staff is checked periodically and their performance assessed.

You could advertise your services in the local newspaper and on radio and cable TV. You could leave your fliers in hospitals and pharmacies, making sure that people are aware of your center. If you provide quality service and manage to satisfy the clients, clients will return and you will thereby profit.

There are numerous services and products available that you may make use of to run your new business successfully. If you are dedicated, service-oriented, and really want to give back something to the community, start an adult day health care center.

General Scope of Health Care Administration

It will not be wrong if we say that this is challenging time for health care administration. Increase in world's population, high rate of diseases and increased pollution has over loaded the facilities and it is a real test of administrators.

To cater for such a rush there is a terrible need of professional administration staff, who can handle the ongoing situation efficiently. This high demand of professionals has made this filed a lucrative one; therefore more people are rushing towards institutes in order to gain knowledge and degrees related to health care management or administration.

MBA in Health Care Administration is the most popular masters degree program these days. An effective MBA program in this field should offer following training parameters.

• How and where it is to be delivered?
• Who can provide these services?
• How it is financed?

The above mentioned parameters are the basics upon which the complete MBA in Health Care Administration is normally planned.

With a rapid increase in health facilities all around the globe, administrators are required in following setups.

• Hospitals and Clinics
• Mental Hospitals
• Public Health Organization
• Rehabilitation Centers
• Health Consulting Facilities
• Nursing Homes
• Children Hospitals
• Pharmacies

MBA in Health Administration is a full of opportunities degree. According to a careful survey more than 1 million people are connected to this profession all around the United States of America. They are serving as department heads and chief executives of several health organizations.

In fact, health care organizations are in need of dedicated, professional and effective administrators who can understand their problems and concerns as a doctor. Keeping this particular point of view this special MBA program has been designed.

RN to MSN - What You Need to Know

RN to MSN is classified as a nursing bridge program which enables Registered Nurses to obtain their MSN (Masters Degree in Nursing) immediately after earning their BSN. The classes are tailored to meet the specific needs of each student; therefore, nurses are able to eliminate any overlap between MSN and BSN courses, as they receive the maximum amount of advanced placement credit for their BSN work as possible.

RN to MSN Overview

Admissions Requirements

While schools tend to vary in the requirements they are looking for, the following things are typically required:

-A valid RN license

-An overall GPA of 3.0

-A Graduate from an accredited diploma program/associate degree

-BLS Certification

-Diversity of experience, e.g. fluent in other languages, knowledge of other cultures, study abroad

-Personal Goal Statement

-A transcript (official) of all schools attended

-3 Reference Letters

-Work Experience

-Non-Academic Considerations

-Extracurricular Activities

-General education requirements for the BSN completed (55-58 credits)

How Much is Tuition for RN to MSN Programs?

Just as programs differ in admission requirements and content, they also differ in cost. While a state school is substantially cheaper ($12,000) than a private school ($60,000), the quality of education will not compare to what you would receive at a private school. These fees exclude books, lab fees and registration, so make sure you include these costs when budgeting for your education.

For those who may need financial aid, scholarships, loans and grants are often available.

How Important is Accreditation?

Enrolling in a program which has been accredited is a must. Accreditation proves that the education you will receive will adequately prepare you to enter the workforce.

Career Advancement

An RN to MSN program opens up many doors for registered nurses. However, career advancement depends on the specialization chosen. This includes:

-Clinical Nurse Specialist

-Certified Nurse Midwife

-Nurse Administrator

- Nurse Anaesthetist

-Nurse Educator

-Nurse Executive

-Nurse Practitioner

-Nurse Researcher

Nurses who hold a MSN degree have greater career opportunities available to them than nurses who hold an RN diploma or a BSN degree. Some opportunities which are available are in executive or teaching positions; these are very well paid in demand positions with very attractive benefits. If a nurse decides against an executive or teaching role, he/she can choose to go down the clinical path route, with pay being substantially higher than a Clinical Nurse Specialist, Nurse Practitioner, Registered Nurse, and in fact higher than the vast majority of positions in the field of nursing.

MSN degree holders can also practice under the supervision of a physician - this type of role is called a "Physician Extender," as nurses are able to offer care to patients, and increase the productivity of the physician's office, all without compromising patient care.

How Can I Choose the Best RN to MSN Program?

Accreditation

As mentioned, accreditation is very important. Therefore, narrow your selections to only those schools which have been fully accredited. If you don't, you can waste your time, money and energy on a degree which is often regarded as worthless.

Specialization

To ensure you choose the right specialization, ask yourself what your goals are. Do you want to pursue a career in education or administration, stay in clinical nursing, or become a Nurse Anaesthetist etc? This is a vital step, as not only will it affect the position you will be able to hold, but also because not all programs offer the same specializations.

One more thing to keep in mind is whether you prefer a classroom based program, or an online program.

Cost

As mentioned, the cost of an this type of bridge program varies significantly for a state school compared to a private school. You must find out which type of school you can afford, and then discover and apply for any financial aid/or and scholarships which may be available. It is also worth seeing whether a tuition reimbursement program is offered by your employer.

Work Experience Credit

One last thing to consider is whether the program you are planning to apply to will give you credit for the work experience, or any course you may have already taken. If the answer is yes, the cost of the program may be lower, and you may be able to complete a RN to MSN program in a shorter amount of time. As each school has their own specific policy regarding credit, you should ask the school what their policy is.

At times, nursing can be a challenging career, but with the satisfaction of knowing that you can make a difference to peoples' lives, it all becomes worth it. Anyone who wants to evolve beyond the position of a RN and/or wants to earn more money should seriously consider enrolling in an RN to MSN program

Differences Between Nursing Homes, Assisted Living & Continuing Care Retirement Communities

Benjamin Franklin said it best - “nothing in life is certain except death and taxes” but with daily advancements in science, technology and health care, Americans are living longer than ever before*. This blessing however, has created a unique dilemma for modern American families: How to plan for and prepare for one's retirement years.

Have you taken a road-trip lately? Almost every highway is graced with large bill-boards providing the locations of new planned communities where couples can spend their retirement years dedicated to recreational pursuits. I doubt you will find a local newspaper that doesn’t have at least one ad promoting the amenities found at a local assisted living facility. Try to search for “nursing homes in Virginia” on the Internet and thousands of web pages will appear. Each and every day new facilities offering different programs are being built and marketed across the state.

Is such a facility right for you and your family? If so, which facility? We often hear the terms “retirement community,” “nursing home,” and “assisted living facility” but rarely consider what these terms actually mean. The differences however, are striking and it is imperative to understand these differences when making choices for yourself or your loved ones.

NURSING HOMES

In Virginia, a nursing home means any facility with the primary function of providing long-term nursing care, nursing services and health-related services on a continuing basis, for the treatment and inpatient care of two or more non-related individuals**. Put simply, a nursing home is a facility designed for someone who needs less care than a hospital, but requires daily health care assistance.

The Virginia Department of Health licenses such facilities and has established guidelines regulating various aspects of their operations, programs, and staffing needs, etc***. For example, a nursing home must: (a) have written policies and procedures regarding the treatment of residents and the management of resident care which are available to residents and their families (12VAC5-360-20); (b) provide emergency medical services within 15 minutes, under normal conditions (12VAC5-360-50); (c) be subject to unannounced on-site inspections of the nursing facility by State employees (12VAC5-371-60); (d) have a written agreement with one or more physicians licensed by the Virginia Board of Medicine to serve as medical director (12VAC5-371-230); and (e) each resident shall be under the care of a physician licensed by the Virginia Board of Medicine (12VAC5-371-240).

In addition, residents of nursing homes are also given certain rights as defined by Virginia Code §32.1-138. See http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+32.1-138. Nursing homes are the most regulated and structured residential options for our Seniors requiring some level of daily health care. If the facility provides care through Medicare and Medicaid programs, it is deemed a "Certified nursing facility" (Virginia Code §32.1-123; Virginia Code §32.1-127) and must be in compliance with both federal and state laws.

Of course, the more rules and regulations that define and control the daily operations of a nursing home, the greater the responsibility of the staff. These are the people who will be charged with the daily task of caring for your loved one, and making sure they are in compliance with state and federal laws. No matter how nice and or attractive the facility might be, the staff will make the difference between your loved one being cared for and encouraged, or not.

A nursing home is best suited for someone:

• Who requires daily health care – such as assistance getting in and out of bed; taking medicine; or using the restroom.


• Who may have dementia or Alzheimer’s and as a result, is unable to eat and or bathe daily without reminder or assistance;


• Who is recovering from a fall or accident and is therefore unable to walk, dress and or eat without assistance

ASSISTED LIVING FACILITY

“Assisted living facility” means an adult care residence which has been licensed by the Virginia Department of Social Services to provide a level of service for adults who may have physical or mental impairments and require at least moderate assistance with the activities of daily living. Within assisted living, there are two types: regular assisted living for those seniors (typically) who need assistance with one or more daily activity; and intensive assisted living for someone who may be incapable of performing activities due to mental and/or severe physical impairment (12VAC30-120-450).

The Virginia Department of Social Services licenses assisted living facilities but does not regulate in the way the Department of Health regulates nursing homes. While there are Virginia guidelines regulating aspects of assisted living facilities, they are limited: An assisted living facility must: (a) provide or coordinate personal and health care services; and (b) provide 24-hour supervision.

As reflected in the table below, assisted living facilities have no obligation to provide health care and/or have health care staff available to assist your loved one. In addition, with no obligation to provide such services, there is the question as to whether or not they owe a duty to warn or treat residents with illnesses or diseases that could be transmitted from other residents.

While a nursing home will have many nurses on staff and doctors hired to monitor the residents, assisted living is more analogous to an apartment building or college dorm where laundry and food services are provided and residents are on their own for the rest of the day.

An assisted living Facility is best suited for someone:

• Who is basically independent but may not be able or willing to prepare their own food or drive to doctors’ appointments;


• Someone who wants to scale back and anticipates needing assistance with laundry, cooking, etc. in the near future.


• A couple where one spouse is independent but may need assistance in feeding and or providing for needs of other spouse.

CONTINUING CARE RETIREMENT COMMUNITY

In Virginia you may also see advertisements for a retirement community. They are popping up all around our favorite College Towns and Tourist destinations.

A Continuing Care Retirement Community provides care depending on your current needs. Like an insurance policy, the resident pays an entrance fee and periodic adjustable payments, which in turn gives the resident a package of residential and healthcare services that the CCRC is obligated to provide at the time these residential and health care services are required. For example, if upon entering, all you want is help with your meals, that is the only service which will be provided. If you require intensive physical therapy or God forbid, daily assistance for a Dementia patient, the CCRC has assisted living services or nursing home services available under your contract. Continuing care contracts are regulated by the Virginia Bureau of Insurance of the Virginia State Corporation Commission.

Many CCRCs can have nursing home services available either on-site, or at licensed facilities off-site (12VAC5-360-10). While you may be entering the Retirement Community as a very healthy independent and capable resident, as your needs change, so will your contract with the Community and in turn, the facility’s obligations to you.

A Continuing Care Retirement Community Facility is best suited for someone:

• Who is basically independent but anticipates the need for daily health care for themselves or a spouse in the near future;


• Someone who is physically disabled and would be unable to care for themselves or a spouse if the disability grew worse.

With at least three very different choices, it is very important to do your research:

To research assisted living facilities in Virginia, go to Department of Social Services website: http://www.dss.state.va.us/facility/search/alf.cgi.

To research nursing homes, go to Medicare’s website: http://www.medicare.gov

AND LAST BUT NOT LEAST

It is always best to speak to a family member of a current resident and spend time getting to know the staff, no matter what type of facility you are looking into. If looking and researching is not enough, then consider the chart below – a comparison of the legal duties of a nursing home compared to the legal duties of an assisted living facility in Virginia.

DUTY or REQUIREMENT

NURSING HOME

ASSISTED LIVING

Duty to provide nursing care and or monitor resident’s health?

YES

NO

Doctor required to supervise residents?

YES

NO

Each resident shall be under the care of a physician licensed by the Virginia Board of Medicine?

YES

NO

Must have nurses on staff?

YES

NO

Must offer rehabilitative services?

YES

NO

Must have ongoing consultation from a registered dietitian or dietitian on staff?

YES

NO

24 Hour Supervision required?

YES

YES

Must develop a written plan upon admission of resident?

YES

YES

Staff must undergo criminal background check?

YES

YES

Monitored by Virginia Center for Quality Health Care Services and Consumer Protection

YES

NO

Monitored by Department of Social Services

NO

YES

*Life expectancy increased dramatically during the past century, from 47 years for Americans born in 1900 to 77 years for those born in 2001. These same factors—improved medical care and prevention efforts— that are partly responsible for the dramatic increases in life expectancy have also produced a major shift in the leading causes of death in the United States in the past century, from infectious diseases and acute illnesses to chronic diseases and degenerative illnesses.” The State of Aging and Health in America 2004, published by the Center for Disease Control, available at http://www.cdc.gov/aging/pdf/State_of_Aging_and_Health_in_America_2004.pdf.

**See generally, Virginia Code §32.1-123, as amended and Virginia Administrative Code § 12VAC5-360-10.

***It is a Felony under Virginia law to operate a nursing facility without a license. See generally, 12VAC5-371-30.

What Should I Look for in an Alzheimer's Care Facility?

Families of persons who have been diagnosed with Alzheimer's disease or a related dementia will be somewhat relieved to learn that more and more assisted living for memory care facilities have become available in recent years. For so long, the illness was simply diagnosed as senile dementia in seniors and left to progress as a natural part of aging. Today, many seniors are able to live in assisted living facilities specifically designed for those with memory impairment. For many, caring for a loved one with progressed dementia is not a viable option in the home setting and a good alternative is an Alzheimer's care facility.

Alzheimer's care facilities

Similar to an assisted living community, a legitimate dementia facility will have the same or expanded licensing requirements through their state governing body. Full-time, 24-hour staff of dementia specifically trained care givers is required in the facility. Some also have the oversight of licensed nurses and visiting physicians. Many contract services for an added medical benefit from home health and/or hospice companies. It is advisable to research the licensure requirements of each state to confirm that a facility meets these requirements. With licensing requirements have been established, several facilities located near the family should be reviewed and visited to find the best community meeting the families needs.

Staffing, services and amenities

With an understanding of staffing requirements, know that some states will structure personnel requirements based on the number of patients residing in the facility. The staff should have the states required training in caring for Alzheimer's patients. An attitude of compassion and kindness should be present amongst all of the staff. Because some Alzheimer's patients can display episodes of frustration, the staff should also know how to redirect to change the current behavior. Many times the family has experienced behavioral challenges with their loved one and they begin to realize that their family member would be better cared for in a dementia facility, where staff is trained to handle difficult situations.

Services will include personal care, assistance with activities of daily living - bathing, dressing, grooming, toileting, continence management, medication management and more. 24-hour staff is on site to provide such supervision. Patients are also offered 3 meals per day, snacks and hydration. Housekeeping, laundry and maintenance services are provided. Daily programming through a scheduled activities program helps to manage behaviors and offer a daily routine, enhancing quality of life.

It is vital that a robust and diverse social program be in place to help patients retain as much social contact and busy activity as possible. Entertainment, games and exercise should be part of the social programming. Along with these activities, visits and continued relationships from family members are important to the Alzheimer's patient.

With this information, the preference for selection will be a family decision after visits to qualified Alzheimer's care facilities have been accomplished. You should also engage your physician in the decision making process.