Factors to Consider When Choosing Nursing Homes

There may be a time when you grow old and would need to acquire some professional care to help you live. When that time comes, nursing homes may become one of your top services to consider. If that is the case, here are some factors you should consider when choosing nursing homes, whether they are private nursing homes or not. Observe well and evaluate if they are up to par with the standards of these factors.

The first thing to consider would be the location of the home. You might want to look for a home that is located near your family, friends, or doctor. This allows them to easily pay a visit to you, or vice versa. You could also choose one that is situated at an appealing area to you, if you have always dreamed to stay in certain places. Regardless, the home should be located nearby a hospital in case of emergency. Do ask about visiting hours too because you would want people to find it convenient to visit you.

In the meantime, you should pay attention to the size of the home. There are typically more activities one can do at larger ones because they would need to serve the interest of many of their residents. However, there are people who prefer something smaller and personal. Decide on which would suit you better.

Of course, money is a very important issue to consider. You can check with the home to see what Medicaid or Medicare can cover to ease your costs. Check out how the different rooms cost differently, as you may prefer having smaller rooms, or do not mind sharing with others. Additional services such as helping with your daily tasks like bathing or eating would definitely incur additional costs, so if you do need such services, do ask because their rates can be significantly higher. Do note that private nursing homes would be more costly than non-private ones as well. There is another concern which is in the situation where you are hospitalized, will there be a bed reserved for you. Medicaid will pay for 7 days of the bedhold, but Medicare and private-pay residents will need to pay for each day of use of the bed, but their rates would not be more expensive than a regular daily rate on bedhold.

As you will be living in the home, you will definitely need to eat. Check what type of food is served and how often. One thing you can do is to visit during their meal ties to see if the food looks appealing or not, and if the residents there actually enjoy the food. You would not have a choice but to eat what is given if you start living at a home, so make sure you find one that is bearable to live with.

Lastly, find out how valuables are kept or protected. Theft does happen at nursing homes, so it is best to choose one that ensures most protection.

An Elder Abuse Advocate

Ila Swan is a dedicated patient advocate who has worked for many years to protect vulnerable nursing home patients in the California area, and other areas of the United States. Working on her own, and with other advocates, she has learned about "the system" which is supposed to protect the patients, but often is a web of continuous "runaround' where families plead for help and get nothing! Government agencies have often failed to protect the patients they are responsible to protect. Corporations that own and administer nursing homes often make large donations to political candidates and officials seeking re-election.

Ila has done the research, inspected the nursing homes on her own when the State would not, and discovered the truth about most nursing homes: the quality of care in most nursing homes is abominably low and the level of staffing is inadequate for even good health care professionals to do a decent job. When understaffing and "corner-cutting" remain the norm in the nursing home industry, placing your loved one in any nursing home is making a leap of faith that no family should have to make. Ila has lobbied the state and federal representatives to improve standards of care for nursing homes and has exposed the conflict of interest of those who accept industry money, while publicly professing to "care" about the patients.

If you have ever wondered why nothing seems to change in the nursing homes you have seen, take a look at Ila's information here, information at the A.P.E. website and your questions will be answered. If you need help resolving problems in a nursing home, contact Ila for information and assistance.

Nursing home patients are dying daily due to abuse and neglect. That is a fact. When a person is killed in a violent attack, the police are quick to arrest the guilty perpetrators. However, when our loved ones are killed in a nursing home, the police and district attorneys almost always do nothing! They, by their inaction, encourage the nursing home administrators and owners to continue to abuse and neglect patiens while increasing profit for their chief executives and stockholders. Just because patients have entered into a nursing home for assistance does not mean that they cease to have rights as human beings and citizens of the United States. Our loved ones deserve decent care, adequate staffing, and humane treatment wherever they reside. Ila Swan is working toward that goal.

Medicaid - Should We Just Go Ahead and Sell the House?

"My mother, who is a widow, has no savings but owns a home, valued at $200,000, and just entered a nursing home. The cost is $6,000 a month! The only way she can afford that is if we sell her house...If we don't sell her house, the state will take it anyway when she dies, right? So what difference does it make?"

My client was in a panic, and while selling the home seemed like the only solution, I suggested the following alternative: Don't sell the house, but instead apply for Medicaid immediately. If mom's only asset is her home, she will definitely qualify (assuming her income isn't unusually high).

"But if the state will take her home after her death, why not just sell it now?" my client persisted.

First of all, the state doesn't "take" a person's home, either during their lifetime or following their death. What happens, as a general rule, is that following the Medicaid recipient's death, the state will make a claim against the estate of the deceased recipient, for the total amount of Medicaid benefits paid out for their care, during their lifetime. (Note that a couple of states still do not seek reimbursement following a recipient's death, even though federal law requires it.)

Thus, if mom only lives for one year after being in the nursing home, and the Medicaid "bill" for her stay in the nursing home for that one year is, say, $50,000, then the family has a choice: keep the house and come up with the $50,000 themselves, or sell the house, pay the state the $50,000, and then divide up the balance of the sale proceeds among the family members, as provided by mom's will.

What if mom lives for many years in the nursing home, so that the bill from Medicaid exceeds the value of the house? In that case, the state is stuck---the most it can get is the net sales proceeds from the sale of the house. It can't go after the children for the balance.

Another reason not to sell the house: If mom applies for Medicaid now, and qualifies, the nursing home will be paid the state "Medicaid reimbursement" rate, which is always a good bit lower than the private pay rate. The actual amount the nursing home must accept varies from nursing home to nursing home, so there is no general guideline. However, assume the Medicaid rate is only $4,500/month, instead of $6,000/month. If mom dies after one year, the family may indeed have to sell the house to raise the money to reimburse the state, but it will only owe 12 x $4,500 ($54,000) vs. what it would have paid had it sold the house and paid the nursing home privately, i.e., 12 x $6,000 ($72,000). Thus, the family saved $18,000 by NOT selling the house! And that savings would increase for every additional month mom lives.

So the longer mom lives in the nursing home, the more the family will save by doing this. However, there is an upper limit: If mom lives long enough, so that the Medicaid bill exceeds the full value of the house, then in effect it will have made no difference whether the house was sold and she paid privately, or kept the house and got on Medicaid. In either case the house will have to be sold to pay for her care, leaving nothing for the family. So her age, health, and life expectancy enter into the equation.

As you can see, some careful thought must be given to this decision. What I did not discuss is the possibility of selling the house, gifting a portion of the proceeds, purchasing an annuity with some of the proceeds, adding a child's name to the deed, transferring a remainder interest in the house to a child, transferring the house (or a remainder interest in the house) to an irrevocable trust, the interaction of the spousal protection rules if mom is married, the limitation on the amount of equity mom can protect in her house, etc., etc. To explore these possibilities, consult an experienced elder law attorney in your locale. To get a running start, however, see my book, "How to Protect Your Family's Assets from Devastating Nursing Home Costs: Medicaid Secrets," which discusses all of these issues and more.

Abuse in the Nursing Home

In the U.S. there are over 16,000 nursing homes caring for the elderly citizens of the country. Some older individuals may choose to live with their family members who will watch over them and provide what care they can. Others may move in to senior housing where they can maintain much of their independent living. Nursing homes on the other hand offer a closer eye as well as other benefits for those that are aging and no longer able to sufficiently care for themselves alone. They provide live in facilities for their patients, including basic housing amenities and prepared meals. One of the greatest benefits of a nursing home for many is the medical attention and treatment that is on hand at the location. Nurses and other medical staff are either their daily or are called in to treat the needs of the patients living in the home. While these facilities can be a great blessing to the elderly and their families that cannot meet the level of care that they need, there can also be downfalls to them. Reports of nursing home abuse occur every year with estimates ranging between one and two million. While many accounts go unnoticed and unresolved, many are brought to the attention of authorities to handle legally.

Abuse suffered by nursing home patients can be physical abuse. Slapping, hitting, shoving, blocking and restraining are all examples of what can occur. In some cases the physical harm may be so severe that it leads to a personal injury. It can also be comprised of neglecting the patient. When staff leaves a person in their bed that cannot move about on their own, they may harm themselves trying to get up or they may be forced to remain in their bed, unable to go to the bathroom or feed themselves. Neglect can also involve not treating a person that is in need of medical attention and even ignoring their basic hygiene. Psychological or emotional abuse is also a common problem. It can incorporate yelling, threatening or humiliating them, as well as belittling or ignoring them. Others may suffer from workers that take advantage of their finances, stealing money, overcharging them or providing healthcare measures they did not actually need. One other appalling form of abuse is sexual abuse. It can include actual sexual acts, forcing them to view pornographic material, forcing them to undress and more. If the elderly person was against any of the actions or they were not in the right mind to express their opinion it is considered abuse.

The reasons for elder abuse will never all be known. Each case has its own circumstances that lead to the outcome. In many instances a nursing home worker may have a shorter tolerance for the people they are working with. The elderly person may not be as quick or capable as they would like. As an outlet of their frustration, they take it out on their patient, failing to provide the quality care they are meant to. This can include harsh treatment physically, when they are moving them about or talking down to them when they are explaining something to them. Other times it may be that the staff was not properly trained in techniques to deal with the patient both physically or in their bedside manner. Without knowing the correct procedure, they are more likely to make errors. Many nursing homes are understaffed and as a result the caretakers that are there cannot handle the overload of patients to the sufficient standards. They may be unable to turn them as often as they should, increasing the number of decubitus ulcers. They may not have the time required to properly asses their needs as well as carrying out those necessities. As a result of the lack of staff, the patients and the home will suffer.

About 1 out of every 14 cases of domestic elder abuse is reported to police, while one out of every five cases of all types of elder abuse is never brought to their attention. Various circumstances may be the reasons why no one ever notices an elderly person is being abused or the individual themselves does not call attention to it. There may be a fear of the consequences if they do or they may worry that no one will believe them. Those that interact with them should always take notice of any changes to see if there is an issue of abuse they are just not willing to mention. To detect elder abuse, be on the lookout for any physical warning signs. If there is bruising or other personal injuries, inquire as to how they sustained them. Also take note of their behavior. While some may conclude that unusual behavior of the elderly person is a case of dementia or just getting older, it could also be the effects of the abuse they are sustaining. If there are any changes in their actions or personality, question to see if there is something more extensive going on. Notice how they interact with their caregivers; if it is in a gentle loving manner or if there is clear friction between the two.

Nursing home abuse can lead to effects that are physical as well as emotional. The victim may be emotionally damaged by the terrible acts that were committed against them. They may suffer through a change in their personality; becoming quitter or more easily agitated. They may also have to deal with a personal injury. As a result of negligence they may have had a slip and fall accident. For the elderly, injuries and falls can have a much greater effect. They may have broken a bone or ruined a hip replacement. Since the immune system of older citizens becomes compromised the older they get, any illnesses or injuries may not heal as they otherwise would. An injury to them can shorten their life span or hinder their quality of life. In no way should this atrocious treatment ever be tolerated. Those that are injured should speak to an attorney who can defend them; fighting to secure the financial earnings they need to pay for medical expenses and live the best life possible they can in spite of their emotional and physical grievances.

How To Stay Cool But Caring

Caring for others is always stressful. For those caring for elderly parents or for children with disabilities, there will come times when the strain seems to become unbearable. When this happens, not only are you putting your own physical and mental health at risk, but in your stress and fatigue, you may drop your guard and say or do things you might later regret. Here are seven steps or suggestions for dealing with your stress.

1. Walk Away

Know your triggers. If a conversation about global warming, consumerism, or the trash crisis in the U.S. is overwhelming you, simply excuse yourself. If you're noise-sensitive and the scene at your local mega-mart makes you want to throw bags of frozen food and cans of Ensure across the store, tell your companions you need a time-out. (Bring along your husband or a friend so you can leave your elderly parent safely, if need be.) My wife knows her trigger points, and if a conversation or setting is getting close to her, she simply puts one foot in front of another, and departs. This is much better than my usual response, which is to put my mouth in gear.

2. Close Your Eyes

Gently let the world disappear, and go within to regain your equilibrium. Ever since my long stay in intensive care several years ago, with all of their machines, tubes and monitors, I've become aware of how important shutting our eyes is to the health of the nervous system. Sometimes, it just helps to close out the world for a few minutes. Just make sure you aren't driving or otherwise need to be aware of what is going on around you.

Also, be aware of who is watching as some dementia suffers are triggered into rage when they believe they are being ignored. You want to know when a fist may be coming your way.

3. Find Some Solitude

This can be challenging if you are at work, or at home with kids as creative and energetic as mine. However, we all need some private time to let the nervous system regenerate. My fishing is my solitude. My autistic son loves to go with me and I enjoy his company. However, there are just some times when a guy needs to be alone, just me and the fish! Thankfully, my wife understands this and can explain it to our son.

Be creative. Find your space. Any way you can. You may want to create a "retreat" space in your own home. One friend caring for a demanding parent put a chair in her laundry room and would retreat there and shut the door. I have no info on whether she packed a lunch or not.

4. Go Outside

This is a true lifesaver for me. I need to be outside for at least an hour every day to get my sanity fix. Granted, I am fortunate to have a career that allows for some flexibility. However, there are ways to cope. Again, my wife, that wise, beautiful woman, has created a space on the deck where she can enjoy her morning coffee, read her Bible and pray. I suspect she is praying that grumpy will sleep late that morning, but that is her secret. I know this was a secret to her sanity when she had the double chore of raising our autistic son and meeting the demands of her father when he lived with us.

Even if I'm not fishing or gardening, being outside calms me in a way that hardly anything else can. With an hour of nature, I go from being a bossy, opinionated, angry, cynical, uptight person into a bossy, opinionated, cynical, relaxed person.

5. Find Some Water

The mood effects of water are universal, and how somehow, very healing. "Water helps in many ways," writes Elaine Aron. "When over aroused, keep drinking it--a big glass of it once an hour. Walk beside some water, look at it, and listen to it. Get into some if you can, for a bath or a swim. Hot tubs and hot springs are popular for good reasons."

My son experiences periods of moodiness and irritability related to his disabilities. We noticed in middle childhood how his mood and affect changed through the course of a shower. We have grown to love his off-key and often inventive singing while he showers. We have also learned to live with high water bills and lots of dirty towels, but it helps him and us. No wonder the phrase "hit the showers" is so popular in athletics. Have you thought about why one of the most sought-after amenities in a new home is a garden or Jacuzzi tub?

6. Breathe Deeply

Breathing is the foundation of sanity. Respiration (breathing to you non-medical types) is the way we provide our brain and every other vital organ in our body with the oxygen needed us to survive. Breathing also eliminates toxins from our systems.

Dr. Andrew Weil, a University of Arizona physician and popular natural-medicine author, has long advocated a "four-square" breathing exercise that instructs patients to inhale for a four-count, then hold the breath for four, exhale for four and hold again for four. Learning the "Four Square" method of breathing may help you to reduce anxiety and frustrations when caring for children and the elderly.

1. Breathe in slowly to a count of four.

2. Hold the breath for a count of four.

3. Exhale slowly through pursed lips to a count of four.

4. Rest for a count of four (without taking any breaths).

5. Take two normal breaths.

6. Start over again with number one.

7. Listen to Music

Research has shown that music with a strong beat can stimulate brainwaves to resonate in sync with the beat, with faster beats bringing sharper concentration and more alert thinking, and a slower tempo promoting a calm, meditative state. Moreover, research has also found that the change in brainwave activity levels that music can bring can also enable the brain to shift speeds more easily on its own as needed, which means that music can bring lasting benefits to your state of mind, even after you've stopped listening.

One of our favorite stories is of our son, then 10, running through the house dripping wet and stark naked singing at the top of his lungs, "What A Mighty God We Serve!" Another true story is the success we had in helping him to focus on his homework and other tasks by playing Beethoven in the background. My wife, the music major and my son's best advocate, says there is something to the "four beats per measure" common to Ludwig von B's music.

Whatever works for you, take care of yourself. You have been given a gift in the responsibility of caring for someone else. Cherish it, but prepare yourself and be aware of what and when your buttons are being pushed. Blessings.

Making the Transition to a Senior Care Facility: Convincing Mom and Dad to Move

The discussion about making the transition to a senior care facility is a delicate and difficult subject to bring up to aging parents. Stella Henry, R.N., author of The Eldercare Handbook, advises that the best way to avoid the awkwardness and possible conflict is by talking about the future, and what the future holds.

According to Henry, shaping the discussion around the future and what it holds takes the pressure away from aging parents, by making the issue seem like it is your problem, rather than your parents'. Expressing sincere concern for your parents' health and well-being, as well as stating that it worries you to see them not get the assistance they may need is better than flat out telling your parents that they have to move. Most seniors do not want to burden or scare their children, which is why many aging parents avoid initiating the conversation. Henry advises that showing the elderly parents that you care and want to be their advocate will take the pressure off and make the subject much easier to discuss.

Many retirement homes and other senior living facilities welcome their potential residents to come and stay for up to a week, to try the facility for free, to get a feel of what the environment is like before making a commitment. Barry Jacobs PhD, counsellor and author of The Emotional Survival Guide for Caregivers states that most of people are more likely to change their mind about a situation when it's their own choice to do so; but should one be feel under pressure to make a major life change, the move seems scary and dangerous, so one is likely to resist regardless of how good the idea may appear to someone else.

Should the senior parent flat out refuse to move, it's best to temporarily back off, but not give up completely. The subject should be brought up again, gently, when a good opportunity arises. If the parents is now more receptive - or curious - about the idea, don't wait to arrange a few visits to assisted living facilities or senior homes, and - if need be - suggest to your parents that it would mean a lot if they would simply 'humor' you by visiting together.

Care giving is a family affair, argues Henry, and for this reason it's important to discuss this issue as a whole family, but in absence of the aging parent, at first. Financial and power of attorney issues should be resolved, the family needs to pick a member responsible for making medical decisions, as well as the advocate for the elderly parent. Experts agree that all family members should be in agreement on care giving decisions for the elderly, and that all support should be provided from a united standpoint.

In some cases, a single uncooperative family member can make the whole process very difficult, even more so if the elderly parent picks up their negative vibe. There are counselling sessions available for families who want to overcome these issues; psychologists help families to leave old hurts aside and to focus on coming together in order to make the best possible decision for their elderly. In all cases, it's the well-being and health of the aging parent that should be the priority at this important and difficult time of transition.

Nursing Schools Dirty Little Secret - A Students Experience

Are you thinking about applying to a nursing school? After all you have a high GPA and have always dreamed of being a nurse. Your heart is in the right place because you are a moral person and know that you will make a difference in a person's life. You are a kind and caring soul who believes in doing things right. Hold that thought right there.

What you don't know about nursing school now may cause you to have a moral dilemma and make you rethink if nursing is the right field for you later on. Did you know that nursing schools have a dirty little secret that you will only find out once you are in the program? That secret is that some of the instructors are bullies. You read right-bullies.

The nursing profession is full of bullies both in nursing programs and in the workplace. One reason for this is that nursing schools allow the instructors to teach however they please. The instructors themselves learned how to bully from their bully nursing program instructors and when they entered the workplace they saw bullying as the status quo of normalcy.

Even though bullying, harassment and horizontal hostility is legally wrong and if done in the workplace opens the door to a lawsuit by the victim; it is not that way in university and college nursing schools. Nursing schools are not held to the same legal standards as an employer. Even though the student is paying tuition to learn and gain a degree, it is not a contract situation. Therefore if a student is harassed and or bullied and the student complains, the nursing department can retaliate and not give the student their degree. The student can appeal through the proper administrative steps, but unfortunately, the student usually is stonewalled and still will not receive their degree.

The goal of nursing school departments is to make money for the college. The unwritten rule that the nursing student finds out once they are in the program is "You will sit down, shut up, take what we dish out, and if you question how we teach or complain you will not pass". A student can and will be subjected to intimidation, verbal abuse and harassment from some of the instructors because that is currently an acceptable behavior in all aspects of nursing.

The following are examples of the bullying that I endured while in the nursing program I went through. I had a 3.54 GPA, passed all the lecture courses with a B+ average and passed all clinicals until I reached the last one.

I was in a first semester nursing lab class and the instructor was talking about an assessment procedure that I wanted clarification on. I raised my hand and asked a question. The instructor lashed out and stated, "Do you know how silly you sound, Laura, even your classmates are rolling their eyes".

In one lecture class I received a B+ on a test and during a class break I went up to ask the instructor about a question on the test. The instructor's face became angry and she snapped back at me, "If you would have listened better and not asked so many questions you would have gotten a better score!" My classmates in the front row stopped talking and their mouths were hanging open. I walked back to my seat sad and about ready to cry.

In another lecture class I raised my hand when the instructor was taking questions and she answered everyone else's questions but not mine.

In the last clinical class I had, the instructor had a narcissistic personality and it was all about her. She regularly cussed, degraded and embarrassed us in front of each other in every post clinical conference because we had made her look bad that day.

In a closed door meeting this instructor tried to find out what other clinical instructors had said about me so she could help me pass. When I did not disclose the information she put me on a work plan as punishment. The week before the instructor had given me permission to give the hospital floor manager my resume. After I did not disclose what other instructors had said about my performance, she said "how do you expect to be hired when you can't perform the job, which makes me look bad".

This instructor constantly would correct us in front of patients. If we were late in giving reports to the instructor because we were taking care of a patient situation, she would get angry and blame us for delaying her from doing what she had to do. She would never ask what was wrong with the patient.

I and another student at different times finally complained to the nursing department about the bullying we were receiving in the last clinical. We both were pulled out of that clinical and put into other secondary separate clinicals. However, the instructors were also bullies whose goal was to find as many errors as they could to fail us both as retaliation for reporting the bullying.

In that clinical, the instructor was one who had passed me in a previous clinical and interacted with me in all aspects of patient care. The second time around she only interacted with me when I had to pass medications and she always found errors. Even when I did it correctly and she gave me the okay to give the medications to the patient, she then would come into the room and ask me a question she knew I could not answer. She then said it was a med error in front of the patient. This left the patient uneasy and I had to reassure the patient that the instructor was just being safe. She in turn said the patient's uneasiness was due to my lack of knowledge and created a safety hazard for the patient. I observed that when she was doing medications with my classmates, if they did not do something correct she never said that was a med error and taught them about the medication.

In her quest to prove I was an unsafe practitioner, she one time said she would wait by the patients open wall computer chart and medication bin while I administered the medications. This open bin had two vials of heparin and a needle package in it. When I came out into the hallway after I was finished, the chart and medication bin was unattended. She knew that anyone could have come down that hall and seen the open chart and taken the bin. I felt this was a set up because according to school policy, this situation would have been an automatic student failure. However, I caught it before a staff member did and I said nothing and I heard nothing further on it.

Every clinical day she told me I was an unsafe practitioner, unintelligent sounding and was not critically thinking. She would write out weekly error sheets for our group. Mine was always a page and a half, while my classmates were a half page even though she spent more time with my classmates teaching, talking about sports and her social life.

By the fourth week she said "If I had to today, Laura, I would have to fail you". By the fifth week I was put on a work plan and told me I had to be perfect and by the sixth week, two weeks before I was to graduate, she said she was failing me. However, I withdrew before that grade went onto my transcripts.

The other student was told by her instructor that the student had deeper issues and she needed to be evaluated by a mental health professional before continuing. However, she was not allowed to return for missing too much time and was failed two weeks before graduation.

Bottom line is when considering nursing school; find out if the school has a history of bullying. This may require talking to past alumni who in all likelihood will be honest because they are graduated. Do not be lulled into thinking that you will have no problem kow-towing down to the instructor so you can get through. If you are a moral, honest and God fearing person your resolve will be tested. You may face the moral dilemma of "do I risk losing my chances of passing by reporting the bullying or do I keep quiet". Remember, if your moral self wins out and you report it-you will lose just as I did. And if you think you have legal recourse-you don't.

There are attorneys that will take on your case but for a hefty fee. Most attorneys charge $250.00 an hour. The reason that attorneys do not work on contingent is because the client usually does not win money. And because schools know this and have expensive attorneys who will protect the school's reputation at any cost, hence, that is why the student loses and nursing school bullying continues.

It is recommended that all nursing students please read Kathleen Bartholomew's book, Ending Nurse to Nurse Hostility; Why Nurses Eat Their Young.

How to Decide on a Nursing Home For Your Loved One

Choosing a nursing home for a loved one can be one of the most stressful things you will ever have to do. Your support and care are important to help the person adjust to having to move into a long term care facility. Include the person you are helping in the decision making process whenever possible. If they feel decisions are being made with their needs and preferences in mind, it will make the process easier for everyone involved.   

Paying for nursing home care is the first consideration to be made. It's important to know that Medicare does not cover long-term care in a nursing home. Short-term rehabilitative care after a hospital stay is covered by Medicare, but not nursing home residency. Room and board in a nursing facility is paid from personal resources, long-term insurance, state government or Medicaid if the person is eligible. Check with the U.S. Centers for Medicare & Medicaid Services (CMS) for more information on paying for nursing facilities. If the elderly person has a Medicare health plan, coverage will continue for doctor visits, hospital care, and prescription drugs while living in a nursing home.

The Centers for Medicare & Medicaid recommends the following guidelines for choosing a nursing home:

• Make sure the nursing home is Medicare- or Medicaid-certified, and that it provides the level of care you need, either skilled or custodial. Also make certain the facility has necessary services available in case of dementia, or for rehabilitation. Choose a nursing home that is located near friends and family. 
  


• Visit the facility on separate occasions and note if the residents are clean, well groomed and appropriately dressed. The facility itself should be clean, well maintained and free from unpleasant odors. The air temperature should be comfortable; all areas should be well lit, and noise levels in common areas like the dining room should be pleasant. Smoking should be limited to specific areas.  Furnishings should be attractive and comfortable. 
  


• Note the relationship of the staff to residents; is the atmosphere warm and polite? The staff should wear name tags and be courteous at all times, address residents by their names and knock before entering a person's room. Nursing staff should be on duty 24 hours a day, 7 days a week. A registered nurse (RN) should be on call at least 8 hours every day, along with a full-time social worker, and a licensed medical doctor who can be reached around the clock. Ask if the nursing home does background checks on all staff, including maintenance workers. 
  


• Residents should be able to keep personal belongings, including furniture, in their rooms. Closet and dresser should provide ample storage space. Every bedroom should have a window. Residents should be able to choose their roommates and have access to a personal telephone and television. 
  


• There should be a choice of food at each meal, and snacks should be available when desired. If help is needed at mealtime, staff should assist with eating and drinking. 
  


• A variety of activities should be provided on a daily basis, even for those who are unable to leave their rooms. Outdoor areas for fresh-air activities should be available year-round and staff should be on hand to help residents go outside. 
  


• Make sure residents get preventive care such as a yearly flu shot and dental visits. Residents should be able to see their private physician and the nursing home should provide transportation. Ask what arrangements the nursing home has with a nearby hospital in case of an emergency.  
  


• Arrange regular meetings with staff to discuss your relative's needs and care. Make sure friends and family members can visit frequently and unexpectedly. There should be regular and frequent communication between staff and family of the resident.   
  

Finally, trust your instincts. If you didn't like what you saw on a visit, say, the facility wasn't clean or you were uncomfortable talking to the staff, you might want to consider another nursing home. Take time to find the right facility for your loved one and your own peace of mind.

Elder Care Laws - Can My Children Force Me to Live in a Nursing Home?

There are laws to protect all of us - be it laws for children rights, laws for adults rights or even animal rights. Laws are put into place and kept updated so that no-one has the right to abuse a person and get away with it. Even the Elderly people have protection and laws put into place so that no one is able to mis-treat them.

Elder Care Laws

There are Civil Rights laws put into place where the rights to shelter, food, health and freedom is allowed. For the Elderly its the right to freedom of movement, freedom of choice, freedom of speech and the right to equal treatment under the law. If those rights are taken away from the Elderly person then they have the right to seek help. So under those Civil Rights no one is allowed to force you into living in nursing home.

Elder Care Laws - Can My Children Force Me to Live in a Nursing Home?

When you reach a certain age you will need some help with your ADL's (assistance with Daily Living) and basic health care needs. You may no longer be as quick on your feet as you were when you were younger, and you may be losing your eye sight/ hearing. Yet you have the right as a human being to decide if you need to live in a Nursing Home. There will come a time in your life that as you age you will not accept the help, nor would you want to admit that you need the help but you are still awarded the Civil Rights law like any other human being.

When Family Step In

As an aged Care Nurse I have seen family step in and force their Mother/Father into a Nursing Home. Usually it is when a family member has Enduring Power of Attorney and believes that the Elderly person is no longer safe/nor able to look after themselves at home. Then it becomes an issue of yes the Children Can force a parent to live in a Nursing Home... but that usually means that the Elderly Person is no longer able to make their own decisions - financially or personally. If an aged care person reaches that stage then they are not fully aware of where they are (as in place) or why they are there.

Elder Care Rights

Each Elderly person is still allowed their basic human rights, their rights to health care, and their right to live. If those rights are being abused by an Enduring power of Attorney (EPOA) then the Adult Guardian will step in to protect and promote the rights of the person who is cognitive impaired (ie can not speak for themselves). No matter what age a person is, what is their reason for needing a nursing home - they deserve the basic care and needs that is their right.

Supporting Elderly People

If you are concerned about your Children admitting you to an Nursing Home without your consent then you need to find the answers to your questions. Confide in either a great friend, or family member or seek out an advocate who can support you without being personally involved.

There are laws for all and everyone. They are put into place to protect a person... so if you are an elderly person and you are wondering about, elder care laws? ... then ask for help and reassurance. There will be a time when you will need a Nursing Home if there is no-one at home able to care for you. There is also home care - where a team of Nurses can give visits to your home depending on your needs and what you can apply for. So check out all your options before you are forced into any situation that you do not feel comfortable with. Elderly People deserve the best care possible.

To see more about Nursing Issues within Nursing Homes, and how an aged Care Nurse deals with Elderly People jump over to Nursing Issues.

Home Medical Monitoring Technology Priceless for Seniors

Senior medical alert systems offer a line of defense to elderly individuals who may have health problems, and to those who are simply growing more fragile with age. Many elderly home alarm systems also offer services that notify elderly patients when they need to take their medication.

Taking that a step further, medical response system outfits can even provide seniors with a medication organizer that is set up to ensure medications are taken in a timely, orderly fashion, virtually eliminating the possibility of a senior double-dosing.

One of the most appreciated benefits of senior alarm systems is the peace of mind they offer family and friends of the senior. Just because a person is elderly and may need some occasional assistance doesn't mean they no longer desire their independence. A multitude of seniors live in their own homes or apartments for many years with the comfortable of knowing the push of a button on a medical alert bracelet or necklace will trigger a quick reaction from medical alarm responders.

Services and Technology Always Evolving

Until recently, senior medical alert systems required a telephone landline to operate. These types of systems function through the use of a phone line that plugs into a medical monitoring box or panel to establish communication between the senior and the monitoring station. In situations where trouble arises, the monitoring box acts as a "receiver," allowing the elderly adult to initiate two-way communication by pressing the alert button on their bracelet or necklace.

The range on these units is typically around 300 feet. The higher-end units can reach as far as 600 feet. And while typical battery backups on these units last between 12 to 24 hours, the monitoring center for most of these systems will be alerted if a battery is running low or expires.

These units have a number of safeguards in case of issues such as power outages arise. Many of these systems will also override a phone call if the senior is on the phone at the time of an emergency. For an additional fee, an add-on can be installed, which guarantees an emergency transmission will take precedence over a phone call.

In addition to recent upgrades in medication alerts and distribution is the introduction of more sensitive fall detector equipment. Fall and motion sensor technology continues to advance. Not long ago, seniors would have to take a rather significant tumble to trigger a fall sensor. Today, these sensors can detect slighter and less aggressive movements, resulting in fewer incidents from slipping through the cracks.

Senior medical alert systems operating through landlines remain popular as they continue to save lives and offer comfort to seniors and their loved ones. But the new wave of home medical monitoring and alert systems are slated to open up a whole new world to seniors.

Also known as "remote" units, these systems will eliminate some of the limitations of landline-based systems by allowing seniors to travel further from their homes and still be within range of monitors. These systems are also expected to feature enhanced monitoring and tracking capabilities that allow a senior's vital signs to be monitored from a remote location.

While there are costs associated with having a home medical monitoring system in place, they pale in comparison to the expense of a nursing home or assisted living facility. All in all, the freedom and independence these systems offer to our seniors is worth every cent.

All About Cardiac Care Nursing

With nearly eighty million Americans now suffering from some form of heart disease, and almost a million and a half heart attacks occurring each year, nurses who specialize in cardiac care have seen an ever-increasing demand for their services. Early and comprehensive care of such ailments as high blood pressure, stroke, and coronary disease are essential elements of life-saving medical treatment, and cardiac care nursing plays a critical role in providing that treatment.

In many hospitals, the cardiac care nursing staff is a part of the intensive care staff. Their training and experience places these nurses on the front lines of response to cardiac emergencies, as well as in the development of long-term cardiac care treatment plans. They are also responsible for much of the interaction that takes place with the families of cardiac patients, as well as providing care information to the patients in their charge. Their assistance in the early detection and treatment management of cardiac conditions has a direct impact on the high survivability rates of cardiac patients in the United States.

Most cardiac nursing care is performed within a hospital setting, where patients with life-threatening cardiac conditions undergo surgery and intensive levels of care. There are, however, other environments in which these professionals provide critical services as well. One such environment is a rehabilitation facility. Cardiac care nursing is vital in these facilities to assist patients in making the transition of lifestyle necessary to ensure improvement in their conditions. Nursing homes with residents who have a history of heart problems often receive regular visits from cardiac care nurses who monitor the health of the facility's residents, and assist in treatment needs. There are also cardiac nursing personnel who provide in-home visits to patients who require frequent monitoring.

Cardiac care nursing is a specialty that requires the basic registered nurse (RN) degree, and sometimes requires the four year bachelor's degree in nursing as well. Before being recognized as a cardiac specialist, many nurses pursue additional accreditation in more advanced cardiac techniques, and also receive extensive hands-on training in a critical care ward. In addition, this field of nursing requires advanced communication abilities to ensure that written and spoken directives are properly delivered and understood by patients and families. In the care of people with heart conditions, even the slightest miscommunication can have disastrous consequences.

These communication skills also come in handy as cardiac care nursing skills are used on a daily basis. Due to the amount of interaction between the care nurse and the patient, the nurse is often the first health care providers to recognize that a patient is demonstrating signs of depression. Due to their training, those in the cardiac care nursing field are well-equipped to not only recognize these signs - common in those who have suffered a heart attack or stroke, but to discuss the problem with the patient and contact the necessary psychological staff when necessary. In this way, cardiac care nursing specialists provide care that goes well beyond the basic physical treatments, as their broad base of expertise assists patients in achieving recovery in every area of their lives.

Decorating a Living Room Requires the Right Ideas and Concepts

Ideas for decorating are available in plenty, but the most important thing to remember when you start out on a project to do up your living room is to appreciate the fact that this is the area where you would spend most of your waking hours when you are at home. A living room is a common room for all the members of the family and so any ideas of decorating or furnishing it must include the needs of everyone in the family.

The interiors of the room must be pleasing to the eye and the design and d矇cor must be such that it fits a particular theme. This may be in the colors, the materials used or even a recurring motif that is not too jarring or obvious. Themes can be traditional like plants, flowers, and animals or modern with abstract designs.

Living room decoration ideas must include furniture which fits in with the overall theme. Modern furniture with clean straight lines would in turn influence the choice of furnishings and color to see that the consonance is not broken. Traditional furniture of deep sofas and the like call for warmer paint colors.

Lighting in a living room is one aspect of decoration that cannot be neglected. The lighting should be such that the highlights or central theme of the d矇cor is given prominence. While this is being done, the comfort level of the users of the living room must be taken into consideration. Lighting should be such that the normal activities in a living room like reading or just relaxing are assisted.

While decorating a living room, the cost aspect has to be kept in mind depending on the funds available and a total estimate must be worked out before even starting on the decoration. This will allow all the various areas like furniture, fixtures, furnishing, paints and lighting to get equal importance. All the styles need to be balanced so that one does not look out of place when compared to the other.

Decorating ideas for a living room can be taken from magazines, books or even the internet. A number of firms that sell paint, lighting fixtures or furniture are very keen to sell their products and can also be a good source of some designs. Decide on a theme once you have an idea of what you want the interiors to look like, and then make all your designs for furniture, paint and lighting to suit that theme.

Elder Care Law - What is Life Care Planning? Part 2

Preparing for the possible costs of future impairment and long-term care is, regrettably, a task that everyone faces as they age. You may never need long-term care. This year, about 9 million men and women over age 65 will need long-term care. By 2020, 12 million older Americans will need long-term care. Four out of five older adults have a chronic condition. Losses in a person's ability to function day to day are a natural part of the aging process, and those losses become more severe as people get older.

When the elder's needs for long-term care can no longer be met either inside the home or without the intervention of paid providers, the elder enters what I call the long-term care maze. The elder, and the elder's family, are now embarking on an arduous journey through murky waters. The journey begins with the observation that the current system in our country for addressing long-term care is a non-system, a hodgepodge of services that fails to meet the needs of the elderly and disabled in the variety of long-term care settings. It is economically inefficient and it fails to assure the quality of services that are provided.

Currently, elderly people finance long-term care services from a variety of sources, including private resources, like personal savings, care donated by friends and family, and long-term care insurance and public programs, including Medicaid and Medicare. Medicare pays for health care, such as the Part A hospital benefit and the Part B physician's benefit. Many of our clients begin their initiation in the long-term care maze with a stay in the hospital, which Medicare pays for. Hospitals are under increasing pressure to shorten inpatient stays. Patients who are not ready to go home may instead be discharged to skilled nursing facilities, under Medicare's limited skilled nursing facility benefit. As a result, most people either stay for a short period of time in Medicare skilled nursing care or exhaust the benefit during the course of their stay. Many of our clients and their families believe that Medicare pays for all long-term care. Medicare pays for health care, not personal or custodial care and it is strictly limited in duration. Medicaid pays for intermediate care in a nursing home provided that the individual meets certain income and asset levels and exemptions. Veteran's benefits pays for health care and some long-term care costs depending upon the facility and the status of the veteran or the veteran's spouse.

A person preparing for possible long-term care needs has several options from which to choose. One option is to self insure by setting aside personal savings and assets and then supplementing those personal resources with the donated, or free care of family and friends. In fact, the majority of impaired seniors rely solely on donated care and their own savings. An individual who self insures retains maximum flexibility and control over his or her savings and assets, but must bear the full financial risk of impairment, which will depend on the extent and duration of functional losses. According to the Congressional Budget Office, seniors in general are not well prepared to pay for their long-term care needs.

Although long-term care insurance can be available to pay for long-term care, spending from long-term care insurance accounts for only about 4% of total long-term care expenditures. When it comes to paying the cost of long-term care - whether in a nursing home, assisted living facility, or community home based care - there are really only two choices for most people, private wealth or public benefits. These are not mutually exclusive. Seldom will the public pay all of the costs of someone's care, at least not for an extended period of time. In fact, most public benefits programs in the United States have a cost sharing or co-payment component. For example, Medicare's skilled nursing facility benefit pays all of the costs for the first 20 days; for the 21st to 100th day, the patient pays a co-payment that changes annually and in 2008 is $128 a day. In 2009 it will increase to $133.50 a day. Medicaid requires that the nursing home resident pay all of their monthly income to the nursing home, less certain allowable deductions, such as the personal needs allowance.

Most health care systems are ill-equipped to address the needs of the aging populations they are meant to serve. Modern health care systems were founded on the principles of acute care and are dominated by a focus of growing specialization, efficiency, and expediency. It is a system that is focused on curing the patient's immediate illness and reacting to health care crises. Yet older patients presenting with chronic illness and comorbidities require continuity of care that bridges across traditional medical boundaries and care settings. Three basic flaws exist in the acute care model of health care. First, it does not support people in the day-to-day self management of their chronic illness. Second, it does not coordinate or advocate for good chronic illness care. Third, it does not provide the necessary support and financing for other than acute care or nursing home care.

Life Care Planning is an innovative approach to elder law that helps families respond to all of the challenges presented by long life, illness and disability. Peace of mind for the elderly and their families is the goal of every Life Care Plan.

Why Should You Keep A Diary?

Do you ever feel like your life is whizzing by you to little consequence? Do you ever feel like you can't even remember what you did last weekend let alone last year? Do you every worry that your life is moving along - and that nobody, not even you, is really noticing?

I picture myself at the end of my life, living at an assisted living home or with one of my yet-to-be-born adult children, and long after the talking heads and soap operas on television have lost their allure, I picture myself in the emptiness of those moments. What I would most like to remember and reflect on in those hours - in that final twilight of my life - is how much fun I had, who mattered to me and why. I want to remember all the things I did and places I went - I want to feel that my life mattered.

Enter the diary or journal - a great way to keep track of your life now at the midsummer of your life. It's a terrific way to record the little occasions, the anniversaries, the weddings and the kids' birthday parties.

Diaries are a terrific way to record today the things that will matter to you tomorrow as you look back and reflect on the special moments that have been part of your unique and special life.

Diaries and journals across the ages have been used for various purposes from simply recording what happened over the course of a day to a form of therapy where people write their deeper reflections on their spirituality, marriage, family relationships, job aspirations and so on.

Personal journals or diaries have played important roles in human existence from the earliest days of recorded history. The earliest record of personal diaries date back over two thousand years - the pillowbooks of Japanese court ladies and Asian travel journals are some of the earliest surviving examples of this kind of writing. The 9th century scholar Li Ao, for example, kept a diary of his journey through southern China. In more modern times, Lewis and Clark kept a detailed account of their travels across the United States and Charles Darwin's "Beagle Diary" recounts his travels over the course of 5 years around the world. And of course, I would be remiss not to mention the bestselling and ever-popular "Diary of Anne Frank" - the diary of a young Jewish girl whose family was forced to hide from the Nazis in the attic of an Amsterdam apartment.

These important works and many others like them have taught us a great deal about the experiences and struggles of a variety of people across the ages but a personal diary doesn't - and shouldn't - speak to a future generation or an entire society. The greatest value a diary can offer is what it offers to us personally. For more the most important legacy we leave behind is the legacy we leave for ourselves.

Over the months and years, the endless parade of activities, events, parties, conversations, vacations, and news both national and personal can quickly become overwhelming. As such, we really need one place where we can keep track of it all and simultaneously process how we feel about it at the same time. We all need a place to record the significant - and mundane - happenings in our life so that when we look back in one, ten or fifty years, in the haze of our later years, we will have some comfort in knowing that it all did really happen. And that it was amazing.

Senior Safety Issues - The Dangers of Living Alone

There are roughly 37 million people over age 65 living in America today. The growing number of seniors of this age is due to advances in medical care, which have increased life expectancies. Many seniors live alone in homes or apartments. This poses a great risk to seniors-one which can be remedied by knowing your limitations and capabilities. According to experts at the Centers for Disease Control and Prevention (CDC), falls are one of the leading causes of injury and death among the elderly today. Many seniors make mistakes in taking their medications, which can lead to illness and other health complications.

Falls

Falls are one of the biggest senior safety issues out there. They affect scores of seniors every year, and in many cases, no one comes to the rescue. One of the best ways to avoid falling is to have adaptive equipment in your home. Place guard rails in the bathroom. Put rubber grips on slick, slippery surfaces. Also be sure to space your furniture evenly, leaving a lot of walking room. That way, you're not as likely to fall as you would be in a cluttered living space.

Medication Mistakes

Sometimes it is hard to remember when to take your medication and how much to take. Hectic schedules and keeping track of doctor's appointments often leave little time to make sure you have the correct dosage of your medication. To avoid making mistakes, it may be helpful to make a chart of what times you should take your medications, along with the dosage amount.

Another way to keep track of your medications is to have a weekly pill holder with separate pill bottles for each day. Set aside one day each week to fill each bottle to last the next seven days. Each pill bottle is removable, so it may help to and set a pill bottle on your night stand or a table every night. Put the correct dosage of pills in each pill bottle and make sure that you are not taking any more or any less than you are supposed to.

Dangers of living alone

Living alone is a great thing for many people. It gives them a sense of independence and the freedom to do want they want when they please. But for seniors this comes with risks. Living alone increases your chances of getting injured. This is especially dangerous when there is no one there to help you.

For seniors suffering from dementia or the early stages of Alzheimer's disease, living alone is especially dangerous. People with dementia may wander off and leave their dwelling place, thus opening the potential for further injury and confusion.

To decrease your chances of getting hurt, it may be helpful to look into different living options, such as assisted living or residential care. Residential care homes offer 24-hour care and assistance for seniors in need of extra help with medications, fall prevention and activities of daily living (ADLs).

Healthcare Management Advice for New Graduates

The healthcare administration degree is just one of the best degree programs to choose from for a future full time job or career. Having said that, in many cases this certification is confused with other degree programs. These degree or graduate programs can include the MPH or MA degree. Whereas a few do look comparable, the aim of these graduate university programs are drastically different than the MHA or Master of Healthcare Administration Degree. As you will likely understand, it is imperative to gather the accurate facts when looking for a future career or occupation.

The healthcare administration degree permits someone to specialize in medical care management. This does not just simply involve hospitals or clinics, but also whatever type of firm in the healthcare industry. Illustrations of jobs can include administrators, executives, or marketing positions. Having said that, the principal intent of this degree is to help you to grasp ways to run healthcare companies. Many other graduate university programs provide an ordinary or general knowledge of medical care small businesses, but this degree genuinely provides you with in depth understand of the healthcare industry.

Several other degree programs present you with understanding in medical care but do not go into the management of these organizations. You will take a variety of diverse courses in these programs that are limited to medical organization supervision. These programs include stats, management, finance, and leadership. Additionally, a person's degree courses will very likely involve a place of employment or traineeship. These positions are already presented for you via your college. Many online schools offer this, having said that typically it is on campus programs that will have this requirement.

These programs do have specifications for admission though. These requisites require an examination and a college education. Your field doesn't matter though. Truly make certain that you perform well and have a very good GPA. Similarly, work knowledge in your school will aid you to form your abilities as a future leader in the market place. It may also guide you into being admitted into Health Care Management Degree Programs.

As soon as you have applied to a Healthcare Management Degree Program, you will see what is sincerely being presented. You will definitely match up with a number of diverse people in the market place who can help you to get a place of employment or an understanding of how the marketplace works. Additionally, you will meet different lecturers from distinctive backgrounds. This tends to permit you to increase your net work in hopes of uncovering an occupation after you conclude. During the very first year you need to search into volunteer programs to obtain knowledge and experience in the healthcare industry. A certification could help you, however know-how will just add to that.

Soon after you have concluded the program you are likely to expect a bunch of diverse opportunities. These options range from different management roles in quite a few sectors. Soon after you have shown that you can be a success, you could have the prospect to achieve the management level. These placements are extremely rewarding and pleasing. Also, you will be able to impact people young and old on a daily basis by way of health and healthcare.

At Home Care Services for Bedridden Seniors

Caring for a bedridden loved one can be both physically, mentally, and emotionally exhausting for families. Fortunately, the personal and professional care they need can be provided by an at home care services agency with the experience and expertise for caring for a bedridden senior.

Homecare services are often the ideal answer when care has become too taxing on the family and moving their loved one to a sterile nursing home isn't an option. At home care services provide bedridden seniors with a higher level of care and comfort in a familiar setting to minimize the depression that often accompanies a sudden lack of mobility.

Of course, seniors who are confined to their bed pose significant challenges as well. In addition to other non-medical at home care services, such as bathing, cooking, managing medications, and running errands, caregivers must be even more diligent to prevent bedsores. Since bedsores form easily on the body's pressure points, such as the spine, buttocks, hips, and elbows, it's important for caregivers to frequently change the senior's position in bed. An at home care services agency can also assist with stretching and moving joints to decrease the possibility of bedsores, prevent joint stiffness, and promote circulation.

There are several factors to consider when caring for seniors who are confined to their beds, including hygiene, comfort, and keeping the bed clean.

Hygiene:
Hygiene is an important part of at home care services for bedridden seniors. They should be given a bed bath every day to clean, refresh, and relax. Baths also improve circulation, which is a vital component of preventing bedsores. In addition to assisting with brushing their teeth or cleaning their dentures, at home care services also include brushing their hair, shaving them, and clipping their fingernails and toenails. Paying attention to bedridden seniors' hygiene and appearance improves morale because they typically feel better when they look better.

Comfort:
When seniors are confined to their bed, ensuring comfort is job number one for an at home care services agency. It provides support for seniors' back and joints to avoid straining, and their arms and legs are comfortably positioned in the bed as well. Several pillows support their head, neck, and back and, if necessary, a brace is installed at their feet so they don't slide down the bed. When changing positions, the caregiver carefully guides their movements to comfortably resituate them.

Bed Maintenance:
Maintaining the bed is another critical part of at home care services for bedridden seniors. Bed linen should be changed regularly to prevent germs and, of course, whenever linens become soiled. Home caregivers ensure that the mattress is firm and protected with a waterproof cover, and they turn the mattress over on a weekly basis to prevent premature wear on one side.

Meals and Activities:
An at home care services agency makes mealtime social and ensures the senior stays engaged. In addition to adhering to the senior's specialized diet, caregivers keep him or her occupied with conversation, reading materials, television, radio, card games, puzzles, and visitors.

If your senior loved one is bedridden but can still stay in the comfort of his or her own home with some professional assistance, homecare services can provide the care he or she needs and allow you to rest easier. Learn more about at home care services by visiting http://www.CambrianHomecare.com or calling 877.422.2270.

5 Signs It's Time to Move Your Loved One Into Assisted Living

While assisted living homes can be comfortable, beautiful, and enjoyable places to live, many adults are not sure they are ready to make that transition. For these individuals and the people who care about them, determining when it is time to move into an assisted living home is a question that weighs heavily on their minds. Consider the following as you make this decision:

1. Is safety an issue?

If your loved one is putting themselves in danger in the normal course of their lives, it is probably a sign that they need to move somewhere safer. Potential hazards include falling down stairs, leaving the stove on, falling in the bathroom, and similar issues.

2. Is he or she able to perform the activities necessary for daily life?

As we age, some of the things that we took for granted when we were younger become much more difficult. Getting groceries, showering, getting dressed, and even using the toilet can become too challenging. If it is difficult to attend to these matters, then it is time to move to an assisted living home where you can get help to make your life easier.

3. Are family helpers or in-home care giving viable options?

In some cases, the problems that an elderly person is having can be fixed with some help from family members and in-home help. However, in many cases, the problems go beyond this scope, and it is time to move out of one's home and into an assisted living residence. For example, while family members are happy to help with groceries or cooking, it can be more difficult emotionally and physically to help with issues such as incontinence or getting up and down the stairs.

4. Is he or she handling medication properly?

If your loved one is not taking their medication as it is prescribed, is forgetting to refill prescriptions, or has expired medication around the house, it is time to get them help and consider moving into an assisted living home where their medication will be controlled an dispensed safely. This is of particular concern to those in the early stages of Alzheimer's Disease, when medication is helpful but often forgotten or taken too often.

5. Are there physical signs of poor health?

If you have not noticed any of the specific issues listed above, you may have noticed other signs of poor health that can indicate that it is time to move. For example, if you see signs of dramatic weight loss or significant mood swings, these can be signs of larger health problems that will be addressed in an assisted living home.

The most important thing you can do for someone who is considering this type of move is to be aware of the signs and symptoms that indicate the time has come to move. Waiting too long can result in injuries or serious complications that would have been avoided had the individual been residing where the care was more attentive.

Different Types of Lawyers

Nearly everyone is going to need to hire a lawyer at some stage in their life. There are many kinds of lawyers available, and it is often quite difficult for people with no experience to know what kind of lawyer they are actually looking for. Each lawyer has a field that they specialise in. It is important that you know what each kind of lawyer specializes in, and what they can do for you.

Lawyers can be basically separated into two categories. Civil and criminal. Civil lawyers generally deal with issues such as adoption and divorce, domestic issues, and criminal lawyers deal with personal injury, crime, and corporate law. Although here you will find a list of the main types of lawyers that are available, be aware that there are many other smaller specialties within each specialisation. Therefore you need to ask a lot of questions to find out which lawyer is actually right for you.

o    Divorce Lawyers specialise in divorce and annulment. They can provide many services during these hard times. There are many issues that you may not even know about that a divorce lawyer can help you with. These include, mediation, financial planning, avoiding going to court, visitation and custody.

o    Civil Lawyers deal with individuals and businesses, organizations between individuals. For example they may handle marriage and divorce, property disputes, malpractice and wrongful death.

o    Bankruptcy Lawyers help individuals and businesses file for bankruptcy and work to help them get the best possible terms for their situation. They maybe be able to help them keep their homes and cars, or avoid personal items being repossessed.

o    Family lawyers cover quite a wide range of services. All issues that relate to families. There are many family related problems that can occur that a family lawyer can help you with. Domestic violence, child visitation rights, paternity, divorce and adoption.

o    Criminal Lawyers work with criminal offenses. Often people need someone to defend them, as they have been charged, this may be in or out of the court, it simply depends on the crime. The range of crimes that criminal lawyers defend is large, ranging from murder to sexual assault to fraud.

o    Accident Lawyers help people that are victims of injury or accidents in order to get compensation.

o    Malpractice Lawyers help people that have suffered from medical malpractice. Often, medical professionals don't do the job they are supposed too, for whatever reason, however the results can be disastrous. Problems that can occur are health and personal problems and can often affect an individual or their families greatly.

o    Immigration Lawyers provide assistance regarding any immigration issue. They often work with government agencies.

o    Personal Injury Lawyers help get compensation for many different kinds of accidents. Construction site accidents, automobile accidents, and things such as even nursing home abuse.

o    Tax Lawyers help people do their tax returns and basically deal with all issues of tax.

There are a large variety of lawyers available to help in any situation, and it is wise to know what kind of lawyer you need for your specific case.

What Is a Negligent Security Case (Also Known As Inadequate Security or Premises Liability Case)?

If you are a victim of violence in a parking garage, in the parking lot of a shopping center, or in a friend's housing/apartment complex, could the commercial owner of these types of properties be liable for your injuries? The answer, as is so often the case in a legal context, is maybe.

These types of cases are referred to as negligent security, premises liability, or inadequate security cases and will require the hiring of a negligent security attorney.

The analysis a personal injury / negligent security attorney performs in deciding whether or not to take this kind of case involves answering two questions: was the incident reasonably foreseeable or was the incident reasonably preventable by the owner of the premises? And of course, should they have taken action if the violent incident in question was, in fact, reasonably foreseeable or preventable.

(1) Was the Violent Crime Foreseeable?

While not all inadequate security offenses can be reasonably be anticipated, many can and are. The police record of a particular location can be an amazingly precise forecaster of upcoming illegal activity in that same place. A corollary to this idea is that criminal/security-related activities that happen in one type of real estate asset (based on a wide range of circumstances) may be more likely to happen in similar demographic areas with similar qualities - but in different places. For example, one developer/owner may own several condominium complexes situated in different geographical areas, but the condos are often the same or identical style, have identical safety measures in place, and that attract people with similar incomes. This is because, many developers like to specialize - if they have had great success with luxury condominiums, the developer is likely to focus on building high-end condos. On the other hand, the same can be said for developing mobile-home parks.

If there is a pattern of security breaches (break ins, violence) happening in one place, it would be irresponsible and reckless for the owner/developer not to take precautions to prevent identical violence or theft-activity happening in their other properties with similar qualities.

An often quoted study conducted by Spelman et al, called "Crime Analysis" concludes that police-calls-for-service reports are a highly precise forecasters of future criminal activity. A personal injury attorney familiar with inadequate security cases will dig deeper and pull crime grids, call reports, incident reports, and local ordinance violations. Such a firm would also be able to subpoena security/maintenance records, video footage, and property management reports. Police records that report similar crimes will allow the lawyer to attempt to interview prior victims and witnesses to prior crimes in the same or nearby property. As you would probably guess, prior victims will have an interest in talking to the plaintiff/victim's attorney if for no other reason than to finally get the negligent property owner to take corrective action.

(2) Was the Violent Crime Preventable?

A negligent security attorney will likely hire an expert who will explain to a jury the Rational Choice Theory of crime prevention or the Routine Activity Theory of Crime Prevention.

Rational Choice. This theory proposes that when the apparent risks involved in committing a crime are outweighed by the apparent benefits of committing that same crime, logically (and statistically) the crime is more likely to occur. Therefore, a property owner should always try to heighten the potential risk and minimize the potential reward involved with committing a violent crime on that particular property. This is done by manipulating the environment (installing or improving barriers such as fences, gates, locks, and hedges/landscaping. This might include hiring roving patrols, setting up readily-visible security cameras, etc...

Routine Activity. When someone looking to commit a crime comes across a target with a lack of deterrents, that crime is more likely to occur. Manipulating elements such as those listed above, in addition to ensuring there is plenty of lighting to enhance visibility serves to signal a potential criminal that an area has or lacks control and security.

The criminal-prevention expert will be familiar with ASIS - the industry-leading security organization that publishes General Security Risk Guidelines relating to: security officer training, security officer and property employee background-screening guidelines; violence-deterrent guidelines. This will be in addition to being familiar with the Illuminating Engineering Society's lighting-standard guidelines for a variety of commercial and residential properties.

5 Major Mistakes New Entrepreneurs in Assisted Living Make - And How They Can Be Avoided

Some of the most well meaning professionals contact our offices or one of our affiliates wanting to increase their personal income and serve society by entering into the assisted living business - sometimes on a small-scale (6-12 beds) and often much larger. These special programs provide clinical competence, quality shelter and personal care assistance for some of the most vulnerable among us including the catastrophically injured and the medically fragile elderly who do not belong in a nursing home.

Those who contact us seek direction on program models and types or they look for valuable information from our paid webinar or conference call sessions (which are conducted early mornings and late evenings for the convenience of busy professionals). Some of you look to engage others in your business plans, i.e. relatives or existing business partners and would like direction on how to do it.

Having assisted in the establishment of or the refining of more than 200 programs, we delight to help people enter the business correctly. After all, America was built on entrepreneurism.

However, there are even more people who enter the business having made some critical, avoidable mistakes and end up having to pay us to clean it up. We are happy to do it, but it makes our job harder. So let us discuss some key ingredients associated with a pattern of success by enumerating those five, (5) most commonly made mistakes:

I. Wrong Real Estate

Those who engage the technical advisor/consultant early in the process have quality direction in advance of purchasing real estate. Since real estate should be selected based upon how best it can serve the needs of the intended population and not just due to its reasonable price, professional insight in this area is meaningful.

II. Wrong Interim and Initial Personnel

New entrepreneurs are quick to align themselves with people who have worked in care. Often these are individuals who have provided direct care to a population with grave illnesses. Perhaps they have performed well in the clinical end of care. For some, thanks to meeting the requirements of one, (1) year of experience and completion of high school, they qualify to act as the administrator of record for the newly licensed program based upon currently published licensing guidelines.

Problem: This same person, while a high quality direct care deliverer, is not a trained, effective or savvy marketer. Their contacts with referral sources may leave them feeling as though they are completely out of their league. As a result this new entrepreneur in the business of care has set-up a good person to fail as a result of asking them to perform tasks they are not qualified to undertake and the initial impression to the long-term community at large may be a bad one to start.

This same person - on whom the new entrepreneur in care has latched - is not a technical writer. They may also not be trained in the professional development of plans of care, contract negotiation with community mental health agencies, responding to insurance issues affecting payments from no-fault insurers for a catastrophically injured person or the management of a clinically competent care environment. All of this underscores the need to be discerning in the selection of this initial staff member, especially management.

Ask yourself: Are they a certified brain injury specialist? Do they have clock hours learning what is involved in plan of care development? Do they have an advanced degree? Is their experience limited to simple, small-scale home management and direct care delivery or have they successfully swam with the sharks of long-term care?

Sentimentality cannot be allowed to override good judgment in this process. You need the right people.

III. Ignoring Regulatory Requirements

Every state of the union has clear, concise guidelines for determining what program models require licensure. Some attempt to render services without adhering to these guidelines resulting in licensing authorities seeking injunctions in circuit courts and even worse. Often a cursory review of licensing guidelines is not enough to consider oneself literate in this process.

Refusal to accept the value of regulatory compliance can be a fatal mistake on multiple levels.

IV. Refusal to Accept the Necessity of Effective Marketing

Many feel they have entered the business once they have a house. This is far from the truth. That house has to be converted into a workable, marketable, community responsive and clinically competent program with expert management. Holding title to the structure is by far not enough.

A similar situation would be present if this line of thinking existed as often occurs when you have the wrong personnel. Nice house - but no long-term profitability.

V. Absence of Operational Protocol

A business needs clear, enforceable guidelines to govern the work of its employees. An assisted living business needs routine and general policies and procedures to ensure there is a daily protocol that is not abandoned in the execution of services to residents. Staff must be trained in wound prevention and management, medication administration guidelines and so much more. Without it, no business can exist and thrive.

Want to avoid these pitfalls? Employ the right technical advisor/program manager who will hold your hand every step of the way. After all, a little leadership can be the recipe for avoiding tons of headaches down the road.

I am hopeful all of this will be extremely helpful to you and I thank you for allowing me to share.

MRSA in Nursing Homes

Nursing Homes have long had a MRSA (Methicillin resistant Staphylococcus aureus) problem that is very close to the well documented hospital acquired MRSA challenges. This problem also extends to any residential facility that provides health care. Here is a short list of some of these types of facilities outside the traditional hospital that may be contributing to the MRSA problem:

• skilled nursing facility


• rehabilitation centers


• long term care facilities


• retirement centers


• assisted living centers


• group homes


• senior care


• residential homes


• home care services

A common misconception is that these facilities primarily provide care to the aged population. This type of medical facility can be a place of residence for anyone who requires constant nursing care and have significant deficiencies with activities of daily living. Residents include the elderly and younger adults with physical disabilities. Unfortunately, a patient may enter a center for care after an illness or accident and contract MRSA through no fault of their own.

Nursing homes and other extended care facilities have long known about and monitored the resistance patterns of infection causing organisms. This is important information for them to know because the "hospital acquired" or nosocomial infection rate is something they must control. Choices of antibiotics for these health care facilities are greatly influenced by this data. Just like other medical facilities, MRSA in nursing homes is caused by person to person contact, contaminated equipment and the environment. With the smaller staff at these facilities, attention to sanitation procedures can be a real problem.

These facilities generally have a sicker patient population with many health issues requiring diligent care. Long term care patients may have had multiple infections with a greater probability of the development of resistance because of repeated exposure to antibiotic treatments. This patient population routinely undergoes catheterization, ventilation, central lines and intubation - all invasive procedures which can create additional opportunities for MRSA infection. Bed ridden patients are also highly susceptible to the development of bed sores (also called decubitus ulcers). Multiple hospitalizations may contribute to the problem in the long term care facility or vice versa - the nursing home admissions may contribute to the resistance seen in hospitals. Hospitals are beginning to swab patients as they are admitted from nursing homes.

Whatever the source, MRSA infection In the elderly and immunocompromised patient can have devastating consequences. MRSA infects wounds, the respiratory system, or the urinary tract. A symptomatic resident in these facilities, who has methicillin resistant staph aureus isolated from the urine, should even be evaluated for the possibility of sepsis.

As our population ages, we need to be concerned about MRSA in the long term care facility. This could prove to have major implications on how well our loved ones live out their later years. Families should be on the watch out for MRSA outbreaks in the long term care facility and be an advocate for the inpatient who may not be able to speak for themselves.

I Am A Dog Bite Victim: Should I Sue Or Settle?

Dog Bite Incidents and how the law can protect you.

If you have been bitten by a dog you may be able to sue the dog owner in a personal injury lawsuit. Different states may have different laws and the amount of money you can get can vary. Therefore consider hiring a local attorney who is familiar with the state laws.

The dog owner may be liable for almost any injury their dog was involved in. There could be exceptions, however. If the victim was on private property trespassing or caused a dog to upset into attacking, then the dog owner might not be at fault.

You may be able to file a lawsuit for negligence if dog owners actions caused the accident. For example if the owner was aware of the fact that the dog was dangerous and did not take appropriate steps to prevent the dog bite accident.

Another example of negligence could be for example, if the dog's owner disregards public safety and leaves the fence door, gate, or door open or does not use leash where required by law.

If you have been injured, you may need to consult a personal injury attorney who is experienced in your state laws and has experience representing other victims of dog bite incident.

After you hire a lawyer, he or she will gather all the facts, any evidence and will draft a demand letter. The demand letter includes details of your dog bite injuries. It will also include a state that you intend to file a lawsuit. Your lawyer can write up arguments as to why the lawsuit is justified. He or she can also specify any settlement amount you may be requesting from the other party in order to avoid a trial in the court. It is probably best to avoid trial and settle for an agreed upon amount for a dog bite incident if this is acceptable by the victim. A lawsuit can be a very expensive, lengthy, and stressful endeavor.

If the dog owner agrees and accepts the settlement figure offer without further negotiation, it may be a good idea to not to proceed further to the trial and take the settlement if that is what the dog bite victim wants. If the dog owner offers a counter-offer then options are to litigate, negotiate further, or accept the counter offer.

If the settlement negotiations fail, it may be necessary to go to trial.

5 Industries That Will Hire Freelance Writers

Freelance writers who want to grow their freelance writing business will be excited to know that in 2011, certain industries will be growing and hiring. These industries will need web content writing, copywriting, blogs, article writing, newsletters, and other writing. It's up to you to take advantage of the opportunity to market you and your writing services.

5 Industries That Will Hire Freelance Writers

Travel. You may not believe that tourism is increasing but it is thanks to baby boomers. This group won't give up travel. They have the funds to travel wherever and whenever and like to get a good deal. If you're interested in travel writing, now is the time to get started. If you have prior experience as a travel writer, start marketing your writing services to travel agencies and your local tourism office. You could find fun writing opportunities such as adventure travel, food and wine writing, and other niches.

Doctors. The health care industry will experience growth because baby boomers are getting older and will require more medical attention. This means doctors will expand their offices move to new and additional locations. They'll need to market their new (or improved) offices and freelance writers can help them do this through copywriting and web content writing.

Nursing homes and assisted living facilities. Believe or not, some baby boomers will be entering nursing homes and assisted living facilities. More and more of these facilities will be built now and in the future. They'll need freelance writers to help them market these businesses.

Education. Colleges and universities are not going away. In fact, they're adding more teachers as are public school systems. Schools wanting to attract students will need help with this. Freelance writers can write the copy for brochures, newsletters, and websites. Freelance writers, who love education, take advantage of this area.

Staffing and recruiting. Many businesses will be employing more office workers and need help finding intelligent office workers. Businesses will turn to staffing and recruiting companies to help them find the employees. Freelance writers can help staffing and recruiting agencies by writing copy for brochures, print and radio ads, and web content.

Freelance writers who want to grow their writing businesses will take advantage of the growth within the industries listed above. If you want to become wealthy freelance writers, you must get out of your comfort zone. Start approaching medium and large businesses and stop looking on certain job boards that post low paying writing opportunities. Make a commitment to work with clients that understand business and will pay your writing fees. You'll have to occasionally negotiate your rates, but it's not a good idea to accept assignments just for the money. You won't be happy and it will show in your work. If must make ends meet, you may consider getting a 'temporary' job that will pay the bills while you build your freelance writing business. Remember, "Rome wasn't built in a day." Don't get discourage if you don't make $10,000 or more a month straight-away. It will happen if this is what you truly desire.

Feelings of Guilt When Our Parents Go Into an Assisted Living Facility

When my mother began having falls and was having difficulty remembering to take her numerous medications three times a day, we discussed the idea of an assisted living facility. My mother and I spent several days checking out various places and she was put on a list for three of the ones she liked the best. And then she settled back and thought she probably had about two years before she'd have to leave her home. But the call came in just three months time.

My mother was strong-willed and extremely independent. She dug in her heels and decided that it was too soon. But it was her favorite place because it was less than one year old and offered an on-the-premise grocery store. We went to visit it again and after meeting some of the people who lived there and the staff, she agreed. Until it came time to pack up her things and then she dug in her heels again.

And that's when guilt came again to weigh heavily on my shoulders. My feelings of ambivalence jumped to the fore. Was it really for the best? Was she going to feel abandoned? When our elderly parents are least able to do things for themselves, they are expected to meet new people, make new friends, get used to a new environment and become accustomed to new ways of doing things. Admittedly, it is a difficult challenge for them but there are often few other viable options available.

On the one hand we know that it is the best solution because they will get better medical care, there are more social opportunities, they are closely monitored and the facility has the means to take better care of your elderly loved one than you can. And also when we remember that the decision-making abilities of the elderly are not as good as they once were, we know it is the best thing to do.

But knowing that doesn't stop us from feeling we're not doing as much as we should be doing. We suffer with feelings of inadequacy, guilt over not making as many phone calls as they would like us to make, trying to get them to do what they don't want to do, i.e.: drink more fluids or eat more fruit, or things like doing chores for my mother while on a visit. She did not consider it a visit even when I had spent several hours chatting with her while I was working.

As the only daughter and the one who took her to her appointments, did her chores and looked after her, I was also the one who bore the brunt of her anger. Her anger and frustration always left me feeling as if I hadn't done enough for her. This led to extreme feelings of guilt. Could I do more? But often I wasn't sure what was expected of me.

Added to that was my mother's fear of dementia which led to more anger when her memory failed. But when I took her to a Gerontologist doctor who suggested medication, it just fueled her anger. The burden seemed to be on me to help her feel better but I didn't know how because I agreed with the doctor that she should have medication.

My mother has since passed away. With much soul searching I have decided that I had done the best I could with what I had available to me. I do believe the assisted living facility was good for her. And on her good days, she loved it there and was very happy with the staff and her surroundings.

For those who are going through this difficult situation and have feelings of guilt riding on their shoulders, it is very helpful to talk to others who are dealing with the same situation. I believe there are few of us who do not at some time or another feel guilty with decisions that have been forced upon us when caring for our elderly parents. If we know that we are doing the best we can, we can do no more.

Assisted Living - What Can You Expect?

In today's world, finding suitable care for our elderly loved ones is becoming a complicated choice. It's hard enough deciding what type of care makes the most sense from both a practical and financial standpoint. And even then you still have to sort through all the jargon to choose between various levels of in home care as well as the many different types of facilities that may advertise senior care, senior living, independent living and even Alzheimer's care.

But perhaps the biggest factor in deciding what type of care to choose for an elderly parent or loved one should be made in consideration of what type of lifestyle they currently have and are trying to maintain. And if your senior is somewhat independent and wants to stay that way as long as possible, assisted living might be just what they need.

A look at daily life

Housing - Each resident or couple will usually have their own apartment or living space to themselves. These housing units will include standard furniture such as beds and dressers, private bath facilities and may potentially include full kitchen accessories such as a stove and refrigerator. They can come and go as they please, although most facilities will encourage residents to check in for their own safety.

Daily Living - Each resident may have different needs for what services they need depending on their level of lifestyle and mobility. Daily living services can including anything from housekeeping services like cleaning and laundry to more personal services such as help with bathing and dressing. As an individual or couple's situation changes, the services provided can also be altered to meet their new needs.

Common Areas - Common areas will typically include a restaurant style area for serving meals, as well as areas for games, activities and social gatherings. Some facilities may even include things like a library, movie theater, fitness center and a pool. It is also common to find quiet areas for reading as well as a chapel of some sort.

Meals - Many senior apartments will come equipped with a basic kitchen, but meals are typically provided at set times in a common area. However, the quality and types of meals may vary widely.

Medicine - Getting help administering and managing daily medication is one of the primary functions at an assisted living facility.

Activities - No discussion of senior living would be complete without at least a mention of activities which rival cruise lines when it comes to fun.

The bottom line is that a facility that describes itself as assisted living is more than likely best suited for a relatively mobile and independent senior. For example, the facility staff will help seniors manage their medication and other important daily activities; but it would not be suitable for seniors that need close supervision or help.