Saturday, January 4, 2014

Questions and Answers on Assisted Living


When I meet with families who are in time sensitive situations relative to additional care for their parents or another loved one, there are many questions they ask in regards to assisted living. Most families do not prepare well when their loved ones need more assistance at home, assisted living or even nursing homes. Following are just some of the questions and answers.

Q - I am looking at assisted living for my parents, and someone mentioned to me I should look at a Board and Care. What exactly is this?

A - Board and Care is the name the Department of Social Services for the State of California gave to smaller Residential Care Facilities for the Elderly (RCFE's). These are licensed assisted living homes that are smaller than the larger facilities you may see on main roads, usually accommodating about 6 residents. Residents staying at this type of care home may need care with various activities of daily living (grooming, bathing, dressing, cooking, medication management, etc.).

Q - Is Assisted Living different than Retirement Homes?

A - Though there are many similarities, there is a difference. "Retirement Homes" is a generic term usually referring to independent or senior communities whose residents are at least 55-60 years of age and are in good overall health. Assisted living, on the other hand, may have many of the same activities but have caregivers on staff 24/7 to assist residents with various care needs. There are many options available in assisted living including a range from small, adult family homes to facilities with multiple levels of care.

Q - My father, who is a veteran, should be in assisted living, but it may not be affordable. At the same time, his assets appear to be too great for Medi-Cal eligibility. This doesn't seem fair. What suggestions do you have?

A - First of all, the fact that your father was a veteran during the time of war, there could very well be significant benefits to him. As far as Medi-Cal is concerned, the misconception is you have to spend all your money to qualify. This isn't always true. You may be able to protect your assets while qualifying for both Medi-Cal and Veteran's Aid and Attendance. Specialists in Medi-Cal planning and attorneys familiar with this can be well worth their fees.

Q - My mother needs to either get outside assistance in her home or possibly assisted living. Does Medicare cover any of this?

A - Medicare does pay for skilled care and home health aides in conjunction with skilled care. There are restrictions and care is performed by a licensed skilled care professional i.e. Nurse, Physical/Occupational Therapists, etc. Medicare does not pay for non-medical home care or assisted living which can includes Companion Care (Cooking, Cleaning, Shopping, Errands), Personal Care (Bathing, Dressing, Toileting, Transferring) and medication management (assisted living only). However, there are other options for paying.

Q - I am beginning to look into some locations for my mother, and I've been told to do research and ask a lot of questions. Can you provide some input?

A - Assisted Living and Residential Care Homes (Board & Care) are all licensed by the State of California. It's important to talk and meet with various people including those who run the location, as well as caregivers and residents. Also, it's imperative to review the State's facility evaluation reports to see if there have been any citations issued against the location, the severity of those citations and how they were remedied. The questions that need to be asked are too numerous for this article, but please call our office, and we would be happy to provide you guidance in all these areas.

A Few Tips Before Building Granny Flats


If you are thinking of not sending your folks out to a nursing home, then, it is a must to provide them with a decent flat to live in. It may be easier to just let them stay within your home, but this might not be the best option. Talking it over with your parents or grandparents can help you decide on whether or not to get them their very own granny flat. However, you need to know a few things even before you search for one.

First of all, you need to look at the available extra space within your residential lot. If you are eyeing your backyard, then, it is one are to consider. You must measure the dimensions and draft a sketch of your extra space in order to determine the ideal size and shape of the granny flat you will build within the area.

Next is to know the council policies in your area. The local government office is one place to check with such council regulations that are specific on building homes and similar constructions. You may need to talk to a city planner and building engineer in order to secure the proper documents needed for your granny flat.

The company where you'll get your kit can help you with the building permit and they may also have this service, so it's best to ask them right on before you purchase anything. The company may also provide you with the much-needed info and advice regarding securing permits.

The next thing to do next is to find a few granny flat options for your folks. Take note of their preferences, but also discuss with them the best possible options based on the measurements you took earlier. Some families go for the cabin type with a single story because most elderly folks find it difficult to climb up the stairs. Consider the safety and convenience of your parents or grannies first and foremost, so you'll end up with an ideal flat for them to enjoy and benefit from.

Ensuring the comfort and safety of your parents or grandparents should be your top priority when choosing a granny flat for them. You should also consider the possibility of hiring a nurse or caregiver in the future, so it is essential to look for a flat that can accommodate at least three people.

Involve your folks in the selection of the style of their future flat. Just remember all the necessary guidelines to ensure your folks' safety and comfort are always prioritized.

Affordable Care Act - What Does it Mean For Medicare Fraud Whistleblowers?


Love it or hate it, the Patient Protection and Affordable Care Act, H.R. 3590, was passed on March 21 by the 111th Congress and signed by President Obama yesterday to thunderous applause. The President called it "a new season for America." Opponents quickly began a campaign in opposition, and at least thirteen states, acting primarily through conservative attorneys general, joined in a lawsuit to block the new law.

Grandstanding might aptly describe such hyperbole on both sides of the debate. But amidst all the noise about healthcare reform, few are discussing or even aware of the details of the actual bill. As far as healthcare whistleblowers are concerned, these key changes among others written into the new law warrant mentioning:

For Healthcare Whistleblowers
Under Section 1558, workers who report healthcare violations to an employer, Federal Government, or a state Attorney General are protected from retaliation, including reporting violations of the new laws prohibiting denial of coverage based upon preexisting conditions. Such whistleblowers will receive remedies similar to those found in the federal False Claims Act, including among other things: reinstatement, back pay, special damages, and attorneys' fees.

Whistleblower Requirements for Long-Term Care Facilities
Officers, employees, managers, and contractors of long term-care facilities that receive more than $10,000 in federal funding annually are required to report reasonable suspicion of a crime to law enforcement and can be fined up to $200,000 for failure to do so. Retaliation against whistleblowers in such facilities is subject to a fine of up to $200,000 and exclusion from federal funds for up to two years.

Whistleblower Requirements for Nursing Homes
Under Section 6105, nursing homes are required to implement standardized complaint forms and each state is required to develop a complaint resolution process to track and investigate nursing home complaints and protect against whistleblower retaliation.

Whistleblowers Remain Most Powerful Tool in Fighting Medicare Fraud
While the debate rages on about the viability of healthcare reform, two things are certain: (1) Medicare and Medicaid have been and will continue to be fertile grounds for fraud; and (2) whistleblower suits are the most effective tools for ferreting out false claims and healthcare fraud.

Since 2009, nearly $6 billion has been recovered in state and federal false claims act cases (including criminal penalties). Under the federal and False Claims Act, whistleblowers may file actions on behalf of the federal government to recoup Medicare false claims. Likewise, many states have false claims act that permit whistleblower suits for Medicaid false claims.

With a few minor differences most state false claims acts operate like the federal False Claims Act, requiring that treble damages be paid for fraudulent billing and up to $11,000 per false bill be levied as a penalty. Actions brought by whistleblowers are known as qui tam lawsuits and by statute result in a whistleblower award of between 15-25% of any recovery based on credible, first-hand knowledge by the whistleblower. In cases where the whistleblower is permitted to proceed alone, he or she may receive up to 30% of the recovery based upon her efforts and involvement in the suit.

While the Affordable Care Act provides many new criminal and civil penalties and new tools for fighting healthcare fraud, it is the whistleblower protection provisions that are likely to be the most used - and most litigated. As word of enhanced whistleblower protection spreads, more and more individuals with knowledge of healthcare fraud are likely to come forward. No matter what you think about healthcare reform, that's a good thing.

穢 2010 James F. Barger, Jr.

Top Five Highest Paid Nursing Jobs


Did you know that in the health care allied industry, registered nurses form the largest in terms of numbers? Approximately sixty percent of RNs are working in hospitals. Though they are required to work for long hours on irregular shifting and may be called on a moment's notice, the position is still high in demand. According to the Bureau of Labor Statistics, the nursing career is projected to grow up to 22 percent from 2008 to 2018.

Moreover, the nursing profession offers a number of career advancement paths to higher-paying jobs. With the high demand for this profession, the roles and responsibilities of nurses are becoming more dynamic as well. Besides working in hospital institutions, they can choose to apply in different health care areas where nursing services are highly needed. The decision to choose the area of practice depends on several factors like professional expertise, work setting requirements, personal interest and compensation. Yes, compensation. Since, the nursing career is a very taxing job, nurses should be compensated properly. If you are like the many, who is aspiring to succeed in this career, following are the top nursing jobs today that are offering high pay and compensation to successful applicants:

Nursing Administrators/Directors
Nursing administrators and directors are the people responsible for supervising and managing not only the nursing department, but all the other allied health professionals employed by the health care institutions. The Chief Nursing develops and monitors the overall budget and expenditure, performance and conduct reviews or employees in line with the requirements set by state and federal regulators for patient care. Average salary of Nursing administrators and directors are $176,475 per year.

Certified Registered Nurse Anesthetist
In the past thirty years, this industry has dramatically grown, offering nurses a greater extent of autonomy and choice in their desired field. Today, Certified Registered Nurse Anesthetists is one of the highest paid nursing careers today. Their primary role is to administer anesthesia to patients. They also communicate with surgeons, dentists, anesthesiologists and podiatrists on whether the medications are safe for the patients or not. On average, the Certified Registered Nurse Anesthetist is earning $135,000 per year.

Nurse Researcher
Their average salary is $95,000 per year. They work as analysts. They may be hired by private companies or nonprofits organization. They are responsible for publishing research studies based on collected data on health care products, services and practices.

Psychiatric Nurse Practitioners
Like the nurse researchers, they are receiving an average pay of $95,000 per year. They are the ones who provide immediate care and consultation to patients suffering from mental health disorders.

Travel Nurse
Travel nurses receive one of the most competitive pay and benefits in the industry, sometimes much better than nurses who are working in full-time and permanent positions. They normally garner between $30 and $50 per hour while on assignment. Many companies allow their nurse travelers to join in their 401(k) plans as well.

Truly, the nursing career is very promising in terms of career advancement and monetary pay and benefits. According to the U.S. Bureau of Labor Statistics (BLS), the mean nursing salary in the United States in March 2008 was $65,130. Specialists earn more. Then again, since not all nurses have 4-year degrees, the highest paid nursing jobs are those which require staff to have bachelor's degrees, graduate degrees and special training. When looking for a nursing specialty, consider the above posts and see if you fit in the requirements before you apply.

Assisted Living Statistics Are an Economic Pointer


Assisted living statistics helps understand how things are changing with regards to senior citizen assisted care. The change is something to look into as it does not merely give figures on this niche area but also gives us a peek into the changed environment that senior citizens today live in.

In the 1990s, when this concept began there was just a handful of these emerging service providers in the market. And the rules were yet to be laid. Today, however one of the studies show that capital invested in this sector in 2030 will be around USD490 billion. Compared to a mere USD 86 billion that was invested in 1996.

Increasingly people, entrepreneurs and speculators are looking closely at these assisted living statistics because they see growth beyond just senior care. It is a growth that is also economical.

Today, it is being seen as an industry that needs a lot of attention.

The Benefits

The upside of this changed perception is two-fold. One with people treating it as a full fledged industry there will be an inevitable rise in the standard of service provided. Better services, more organized efforts and consensus will do wonder for this sector. At least that is what the assisted living statistics tell us now.

The other factor is an economic one. A current estimate of target people is about 1.78 million which is projected to double to 3.7 million by 2030. This is significant because with increased demand will be greater spread of these assisted living facilities. In 2002 alone, American Housing Association gave us a figure of 7150 assisted facilities that were home to 500,000 seniors in the United States. That works out at an average of 74 residents per facility. Being labor intensive, just imagine the huge employment potential.

These assisted living statistics also help us understand how much we can expect out of this niche segment in terms of employment. In times of economic uncertainty, those working in the assisted living segment have observed that there were only minor changes to their income and prospects.

In 2003, State Senior's Housing report also put forth a median figure of USD 2050 per month as service fee paid by seniors. This clearly states that there is spending power and so it as an industry is actually waiting to be tapped. What we now need is a better understanding of how to stream line our efforts to optimize economic benefits. It is only right to note that in such a line of work EQ will be as critical as IQ and professional skills. Else the whole concept will collapse if people do not love what they do and use it merely as a stop gap solution.

Imagine an elderly person being pushed around on a daily basis. It would be the end of the industry even before we started making sense of these assisted living statistics.

Choosing the Right Nursing Job - Nurses Have Many Career Paths In Medical Industry


If you've already decided that nursing job is what you want, you've made a fantastic decision. You should know that there are plenty of different nursing specialties, and that there's a tremendous nursing shortage in the U.S. Just like there are different types of doctors, there are different types of nurses. And that is why nursing is such an exciting field. If you get tired of one area, there's always another.

Below are several different directions your new career in nursing could take you...

Certified Nurse Aides - As an important member of the health care team, CNAs are the "eyes and ears" of nurses. They observe patients, administer medications, develop care plans, prepare operating rooms, bathe patients, and much more. They average $25,000 a year, and it only takes 120 hours of work, 16 hours of supervision, and 12 hours of annual training.

Licensed Practical Nurse - The step before RN is an exciting opportunity. LPNs can give basic care like take samples, measure vitals, monitor patients, and other similar work. They must work under the supervision of an RN at all times. They average around $35,000 a year.

Registered Nurse - The backbone of the health care industry is as a registered nurse. RNs must obtain an associate degree, Bachelor degree, or diploma program, plus have hands on experience. This process can take between 2 and 4 years, but you will make approximately $50,000 per year. It is the largest healthcare profession, with over 2.5 million RNs nationwide.

Nursing Home Nurse - As the baby boomers come of age, nursing homes are popping up across the country and all nursing homes are required by law to have a registered nurse on duty 24 hours a day. This is a big market.

Home Health Nurse - These are usually RNs that do house calls to care for people that are house bound. There is a high level of responsibility, but also you control your own hours to some extent.

Head Nurse/ Nurse Supervisor - A position that is earned after hard work in the nursing field. This lucrative position brings in over $75,000 annually, but comes with the responsibility of supervision and experience.

Travel Nurse - This may be the best of both worlds - nurse and traveler. With this job, you are able to travel the country and work at hospitals that need temporary help - usually with nice perks like free housing. You may spend the winter in a skiing winter wonderland and your summer at an island resort. This is a great way to see the world and get paid well.

If you choose to get a master's degree in nursing, you could become...

Nurse Practitioner - After becoming a registered nurse, further education and training bring you to the next level of nursing - nurse practitioner. NPs can write prescriptions, order tests, do physicals, and much more. They can work with a doctor's office, hospital, or independently. The average salary is $75,000.

Nurse Anesthetist - After nursing school, add approximately 24 to 36 months of further education to become a CRNA. CRNAs are nationally certified nurses that provide anesthesia care. An average CRNA salary ranges upwards of $125,000. Not too shabby.

There are many other nursing professions that are not listed in detail here. You may want to be school nurse and deal with cuts and bruises from recess accidents... Or your passion may be to help with psychiatric patients... Or you may be a full time provider for an elderly relative... Or even a nursing school teacher...

Whatever path you choose, you will find work. Nurses are in extremely high demand across the globe! When you are a qualified nurse, be ready to pick where you want to work, what hours you want to work, and what type of nurse you want to become.

Friday, January 3, 2014

Norovirus Breakout in RI Nursing Homes


We recently have learned that a norovirus is in 9 to 11 nursing homes in Rhode Island. We are sure the outbreaks are more widespread than they are being reported. This virus has essentially shut down all visitors and new admissions to all the homes that are affected by it.

The norovirus is not spread through the air but through touch. It can survive on a piece of equipment, a piece of clothing and any surface at all for up to 2 weeks. There have been many reports of the norovirus on cruise ships through the years whereas the cruise ships needs to be completely de-contaminated for 2 weeks and cannot go into service until a month afterward with approval of the FDA.

The norovirus symptoms are vomiting, diarrhea, dehydration and pose a serious health threat to the patients, employees and anyone who tries to visit a loved one in a nursing home. Nursing homes are scrambling to sanitize all surfaces with any disinfectant that they individually choose. Bleach seems to be the disinfectant of choice and is rumored to have dried out the skin of numerous health care workers.

The norovirus usually lasts for 2 or 3 days but can be reacquired by a resident for a second or third or even fourth time if the surfaces are not properly sanitized. This translates into more safety conditions inside of health care facilities. The vast majority of health care operations have gloves available all over their floors. Gloves are used throughout all health care facilities today along with alcohol foams and gels at virtually every nursing station and also throughout the corridors.

There is technology today that can protect someone more than wearing gloves and/or using a sanitizing agent to protect one from bodily fluids and repel this awful virus. These medical uniforms today contain a nano-acrylic copolymer dispersion that makes garments naturally self-cleaning. Fluids literally bead up and fall off the garments.

Last year we lost our mother in a nursing home. Not because of this virus but she was terminal with leukemia. But we cannot imagine her having been on a lock down situation where she could not have seen visitors because someone else brought in the norovirus.

Our connections indicate to us that the norovirus in question could have come from a single person coming out of the hospital and then CNA's, who have multiple jobs in this industry, may have spread it between themselves and the numerous nursing homes in question.

In our personal opinion the health care industry needs to be protecting its patients and themselves at a much higher level. They can't utilize the cheapest medical uniforms, nursing scrubs or lab coats that they can purchase. They need to step up and buy protective uniforms for their loving professional staff.

This also would eliminate lost time of employees being out sick. You don't have to call in sick or take a vacation day in order to take care of your friends and patients, because we know personally that you do become the friends of patients.

Many Roles of Nurse Practitioners


Nurse Practitioners begin as registered nurses and obtain additional education and certifications. The qualifications for certification vary by state. Nurse Practitioners must first gain experience as a registered nurse, while working with patients along side an experienced Nursing Practitioner or physician. They may then apply to nursing schools that offer advanced practice programs.

Nurse Practitioner jobs are available in a wide variety of clinical settings such as hospitals, private physician offices, schools, county health clinics, home health care agencies, nursing homes, and even prisons.

A Nursing Practitioner is allowed to exercise a great deal of autonomy and independent judgment in her practice. Most provide basic care focused on common illnesses and injuries and in many states are authorized to write prescriptions. Nursing Practitioners offer greater access to primary health care at reduced costs. Some Nurse Practitioners specialize in treating patients long-term with common chronic conditions including, high blood pressure, diabetes, and asthma. A Nurse Practitioner has a strong focus on disease prevention and patient education.

Other areas of advanced practice nursing available in Nurse Practitioner jobs:

Certified Nurse Midwives (CNM) - provide prenatal care, deliver babies, and provide post-partum care to normal healthy women. A CNM must graduate from a state-approved school of nursing and pass a national licensing exam. A CNM must also hold at least a Master's of Nursing or higher degree.

Certified Registered Nurse Anesthetists (CRNA) - administer anesthesia to keep patients pain free for all types of surgery in hospitals, doctor's offices, and dental practices. A CRNA is a registered nurse that holds at least a master's degree and must also pass a national certification examination.

Clinical Nurse Specialists (CNS) - deliver specialty care in a number of areas including: cardiology, oncology, neonatology, OB/GYN, pediatrics, neurology, and mental health. The expertise of a CNS elevates the quality of patient care. She anticipates and troubleshoots problems and complications with an emphasis on prevention.

Sub-specialty Areas of Nursing

Certified Wound and Ostomy Nurse (CWON) - provide expertise for patients and staff nurses in the area of wound, ostomy and continence care.

Certified Pediatric Nurse Practitioner (CPNP) Otorhinolaryngology (ENT) commonly known as ear, nose and throat - provide care and consultation for children with tracheotomies. This type of CPNP coach staff nurses who are novices and provides education for parents, when their children will be discharged from the hospital. They may also participate in programs designed to educate school personal such as teachers, principals, and school bus drivers in the basic care of children with tracheotomies.

International Board Certified Lactation Consultant (IBCLC) - These healthcare professionals are dedicated to promoting, protecting and supporting breastfeeding worldwide. They possess credentialed knowledge and experience to manage maternal-child breastfeeding success.

Rehabilitation Nurse Specialist - focuses on getting patients back to normal daily activities following serious injuries and strokes. They practice in hospitals, nursing homes, and home health care settings.

3 Tested Ways to Choose a Good Personal Injury Lawyer


Work-related injury cases are never to be taken lightly. They often involve devastating injuries, permanent deformities and in grave cases, death. A life with so much promise could be cut short in an instant because of a personal injury. Individuals once appreciated as lead providers in their households, easily turning dependants as means to eke a livelihood. The only hopeful lining in the cloud to compensate for the suffering, trauma and medical treatments is the hiring of good work injury lawyer. It is only a good lawyer that can stake a credible injury claim for fair compensation. If you are a victim of injury in the workplace, here are 3 tested ways to choose a good personal injury lawyer.

Handling Insurance Companies

It is important to choose a personal injury lawyer, who is deft and experienced with insurance companies. Insurance lawyers always seek for a minimum payment. An inexperienced lawyer could be easy fodder and fall short in negotiations. An experienced lawyer with an enviable track record who knows how to play hardball will almost always get a good compensation before the injury claim can make court.

Trial Experience

Most claims are settled outside court. But it is important for the work injury lawyer to have tasted court room experience. Some defendants prefer going to court, risking more money and bad publicity rather. What they are saying is that they could care less about the consequences. Experience plays a critical factor in determining a claimant's case. If your work injury lawyer is still wet behind the ears and has not won too many courtroom cases, the defendants in your lawsuit might sense the pendulum swinging in their favour.

Gun for Only for Expertise

It is not enough to just go for any lawyer with personal injury experience. The lawyer must be able to accurately assess your injury claim, estimate the monetary compensation and the best way to realize it. He or she must have a wide-ranging expertise with different injuries types. And must be in sync with up-to-date developments in personal injury law in order not to be caught napping by the legal opposition.

Work injury cases must be evidentiary and not sympathetic in the eyes of the law. Your legal counsel must be able to prove that your injury claim stems from gross negligence or recklessness and needs to be compensated for the damages or injuries incurred. Compensation is granted on the basis of evidence strength, extent of injury and the competence of the work injury lawyer, you hire.

Home Health Care Vs Facility Placement - Options in Elder Care


It always makes me sad to hear the families of an elder say "Mom made me promise to never put her in a nursing home". That is simply a promise that most families today cannot keep. If a caring son or daughter finds that they have to break that promise, they may feel guilty for the rest of their lives. Mom probably asked for that promise because the nursing homes she remembers were dark, institutional places which would be considered substandard in America today. Today's family structure and the financial challenges of elder care, make facility living a very common choice. When an elder shows signs of not being able to perform the basic activities of daily living, families or concerned professionals must step in. It is actually against most state laws for a professional to be aware of an elder in trouble without taking some reasonable action to secure their safety. There are many indicators that an elder is no longer safe at home alone. The basic litmus test is to ask yourself is: "Could this person save him or herself if their home were on fire? Would they be able to call 911 and communicate their exact location? If left alone for any period of time are they at risk for physical abuse or financial exploitation? Do they have the skills and resources to meet their daily hygiene and nutritional needs? The answer is "NO" for many American elders who live home alone.

Independence vs. Isolation

Many of my elderly clients who were trying so hard to maintain their independence by living alone at home actually maintained nothing more than an isolated existence punctuated by the occasionally call or visit from friends and family. This type of isolation was also coupled with medication errors or abuse, self neglect and unsanitary housekeeping. A person living in this situation will often "bloom like a flower" in the right retirement facility environment. It is amazing what three hot meals a days, social interaction, clean sheets and regular administration of medications can do for a person's mind, body and spirit. A person who lives alone is more likely to fall and lay alone on the floor for days without being found. A person, who lives alone may make poor choices such as keeping, (or worse,) spoiled food in the refrigerator. If a person lives alone, there are many signs of illness that no one will notice during sporadic short visits. Medical appointments may be missed and prescriptions left unfilled. Many people feel that they are honoring their aging loved one by letting them live alone, even though all the tell tale signs of self neglect are apparent. There is no honor or dignity in being found on the floor after one has laid in their own excrement for three days. Unfortunately, many families will wait for this type of incident before insisting on either home health care or facility placement. If an elder is physically or verbally abusive to family and care givers, they are much more likely to be left alone to make their own decisions, regardless of how dysfunctional their situation may be. Elders with difficult personalities are many times more likely to be abused by caregivers. They need more supervision, not less.

American Family Dynamics and the Pressures of Today's World

I hear people say "Americans don't take care of their elders like other countries do". Well that is not my experience. The adult children who consult with Geriatric Care Manager or other eldercare professionals are very concerned about their parents. They love them and they want the best care their money can buy. That's the clincher: what their money can buy. In America, caregivers, maids, etc,, are expensive. Perhaps in another country where slave labor is commonplace, people can afford plenty of care. But in this country it costs $12.00 per hour (or more) for a home health aide. At eight hours per day, that is $96.00 per day. That is $2,880 per month or $34,560 per year - more than the average working American earns per year. The average woman gets a social security check of less than $500.00 per month. Do the math and you will soon see that unless you are wealthy, many people cannot afford to keep their elders in their own home with a part time caregiver or even in their children's home with a caregiver.

Now couple this financial problem with another very real problem. Most middle income women in their fifties, who are caring for their elderly parents, are also trying to hold down a job, help their young-adult children and maintain a marriage. If a middle income woman stops working to care for her parents, she and her husband either cannot pay their bills or they must significantly reduce their standard of living. I know a few husbands who are fifty-something and feel they have worked too hard and too long to have their dreams of retirement evaporate because someone else's needs are suddenly more important than their own. Now that Americans have come to grips with the concept that it takes two incomes to live well in this country, they are more determined than ever to have a retirement. Paying $35,000 per year for a caregiver can take a huge chunk out of the retirement savings. Frankly, most people couldn't afford to do it even if they wanted to. Because most Americans' net worth is in the equity of their home, selling the family home is the most common way to finance elder care services. If the family home sells for $100,000.00 and the average cost of an Assisted Living Residence is $36,000.00 per year, an elder can afford to live in that Assisted Living for 2.7 years. Coincidently, the average amount of time a person lives in an Assisted Living before moving on to a nursing home is 2.5 years.

Many adult children, who do have the desire and financial means to bring their elders to live with them, still cannot. They cannot because the medical or psychological needs of the elder are beyond their capacity to manage. For example, if Grandma is sweet and docile by day, but "sundowns" or grows agitated as evening falls, this poses a difficult problem for the caring family. When some people experience dementia or other medical issues, they may stay awake all night. They sometimes wander out of doors or rummage through drawers and closets. This behavior will keep the whole family awake at night. If a working family cannot sleep at night, this situation will become intolerable very quickly. Some adult children have been raised by violent, aggressive parents who are now violent aggressive elders. Children who have been raised under these conditions need not feel obligated to bring their parents to live with them, despite the pressure they may get from outsiders who do not know the real story.

Elders and their families who are trying to make difficult choices about elder care benefit from a professional assessment from a geriatric specialist. Professional care managers can offer an objective opinion based on a clinical evaluation of the physical and cognitive status of the elder. Physicians, hospital case managers, facility admissions coordinators and social workers can also offer advice about appropriate placement of an elder or even suggest how to set up services in the home to best meet the elder's needs.

Home Health Care - Stay Home without Being Alone

At the very least, any elder living alone should have a medical alert system. This is a necklace or wrist band with a panic button that can be pushed in case of emergency. If the button is pushed a dispatch center receives the signal and makes and attempt to communicate with the elder through a speaker placed in the home. If the elder needs help or does not respond to attempts to communicate, emergency services will be dispatched to the home. Many services will also contact friends and family to notify them that assistance is needed. A good candidate for this device is one WHO DOES NOT have memory loss as memory loss makes it difficult to learn to operate new appliances.

There are two basic types of home health care services: Medicare and Private Duty:

Medicare Home Health is free but can only be accessed if ordered a physician. Medicare will only authorize the free home health services if specific events have happened such as a recent hospitalization lasting three or more days, or a recent change in health status, etc. Medicare will send a Registered Nurse to evaluate the elder and that nurse decides if other professionals such as physical therapists, social workers, dieticians, etc. should perform evaluations. Each professional will determine what services they will render and for how long. Medicare services are temporary in nature and are not offered on a full time basis. The average visit by the nurse, aide and therapist is less than one hour each. Even Medicare home health aides only stay long enough to bathe and dress the patient.

Private Duty Home Health can be arranged on a full time, part time or live- in basis. Many Long Term Care Insurance policies will pay for home health care. The amount of care one can get and the duration of the services varies depending upon which policy they purchased. If someone does not have insurance, they must pay out of pocket (or private pay) for any services. Typically a private home care agency will offer services at a minimum of four hours per day. Typical eight hour shifts are 7am-3pm, 3pm-11pm and 11pm - 7am. Many elders complain that an agency sends them a different caregiver each day. In order to avoid having the same aide, that as much as possible, order care every day for at least eight hours. This will allow the agency to schedule the same person for all your shifts. Because labor laws do apply and the agency would have to pay overtime for time which exceeds 40 hours per week, you will most likely have at least two to three caregivers on a full time case. The average hourly rate is $14.00 per hour. A live-in will cost about $150.00 per day. A live-in lives in your home and drives your car (or theirs for a mileage fee) and you are expected to feed them as well, even if you go out to dinner. By law, a live- in is entitled to two hours per day of free time. They can do what ever they like, including leaving the house during their break. If this arrangement will not work for your situation, consider hiring an aide around the clock. Around the clock care is typically delivered in two twelve hour shifts which are done by two different caregivers.

One aide comes to the home from 8am until 8pm and is relieved by the second caregiver at 8pm until 8am. Around the clock care can be delivered in many schedule formats. A live- in is expected to have their own private bedroom and bathroom although many agencies are flexible on this issue. The live- in is expected to be awake all day and have at least 7 hours of sleep at night. If the elder does not sleep at night, a live- in arrangement will not work. One option is to have the live in ($150/day) plus hire a caregiver to come to the house and stay up all night with the elder ($14.00. hour for eight nighttime hours). This costs $112 + $150= $262.00 per day. The only other alternative is to have around- the- clock care which will cost $14.00/hr X 24 hr=$336/day. Adding the eight hour night shift to the live in, saves about $3,000 per month. The Veterans Aid and Attendance Pension is available to qualified veterans who need a caregiver in their home on a regular basis.

Types of Adult Housing and Facilities:

Independent Living Facilities usually offer small apartments with some meals included in the price. A person who lives in an Independent Living Facility is expected to manage their daily care needs on their own, but the staff would readily recognize if needs increased and assist the resident in obtaining the needed help. Some facilities have extra care services available for additional charge to help the resident "age in place." Others may ask a resident to move out if their needs exceed the scope of that particular facility. Limited transportation is usually provided although many residents are still driving when they enter an Independent Living Facility. These facilities may cost anywhere from less than $1,000 per month to over $5,000 per month depending upon the luxury amenities and location.

Assisted Living Facilities usually offer hotel size rooms with the option to share a room or pay extra for a private room. Three meals and snacks are usually provided as part of the price. Residents are expected to need some assistance with their daily care needs. Medication administration is strictly supervised. The State laws dictate who can live in an Assisted Living. The State does not want Assisted Living facilities to house nursing home candidates or Nursing Homes to admit people who could function just as well in an Assisted Living Facility. Assisted Living residents must be able to walk and transfer ( from bed to chair or chair to standing) with the assistance of only one other person. An Assisted Living resident can be left alone in their room for two hours or more. Nurses aides are on duty around the clock. Registered nurses or Licensed Practical Nurses are on duty at least during the daytime. Many medical services may make rounds and visit residents at least monthly. It is not uncommon for an Assisted Living resident to never have to leave the building for a medical or beauty appointment. Prices may range from under $1200/month to over $8,000/ month, once again depending upon the amenities. Medicaid has a program called the Medicaid Waiver which can pay part of the cost of the Assisted Living. However, funds have been historically limited and waiting lists can be long. The Veteran Aide and Attendance Pension is designed to financially assist qualified veterans who need the services of an Assisted Living facility

Dementia Specific Facilities are designed especially for the memory impaired resident. The building, floorplan, furnishings, décor, activity program and even the lighting have been scientifically engineered to enhance the lifestyle of residents with dementia. Many Assisted Living Facilities and Nursing Homes offer a dementia program or dementia unit, but there are entire facilities which specialize in this unique population. Dementia Specific Facilities can be either Assisted Living Facilities or Nursing Homes. They are secure in order to prevent residents from wandering off the property and getting hurt or lost. The price for this extra level of care is usually about $1,000 to $2,000 more per month than a non-specialty building.

Nursing Homes are State regulated and are inspected at least annually. A person who needs a nursing home generally cannot live safely in an Assisted Living environment. A typical resident is either wheelchair bound or bed bound. Those who can walk around freely may need the nursing home environment because they need constant medical supervision. The medical component of this environment is similar to a hospital or hospice setting. The emphasis is on rehabilitation or custodial care rather than socialization and activities. The ICP Medicaid Program (institutional care program) will pay for the room, board and medical costs of those residents who meet the financial and medical criteria. It is possible to plan in advance to help an elder meet these strict criterion.

Financial Realities

Keeping an elder at home with a caregiver can be the most expensive option of all. Many families feel keeping their loved one in the comfort of their own home is priceless. If a paid caregiver cost $14.00/hour, eight hours per day is equal to $2,880.00 per month. Around the clock care exceeds $10,000 per month. Independent Living Facilities cost an average of $2,300.00/ month and provide no personal assistance. Assisted Living Facilities range from about $2,500/month to $5,000/month and provide limited care. A Nursing Home (without ICP Medicaid assistance) can cost from 5,000.00 to $7,000.00 per month and will provide total care.

Anyone considering hiring home health or moving an elder into a care facility of any type should have their elder's current needs assessed by a qualified professional who can ascertain the elder's current medical/psychological and financial needs and anticipate future needs/solutions. With careful, realistic planning, caring for an elder does not have to be a financial or emotional nightmare. Making the right choices for you and the elder you care about is easier when you enlist the help of people who know the eldercare community and all that it has to offer.

Whiplash Injury Claims Advice


Whiplash injuries can be sustained as a result of road traffic accidents, falls from heights and sporting accidents. In most cases, they can give rise to whiplash injury claims if the injury occurred due to the negligence of another person. If you have sustained whiplash injuries following a no fault accident, it is important that you seek legal advice and consider making a whiplash injury claim.

Whiplash injuries can be minor or serious. A person suffering from whiplash can recover from the injuries within a matter of weeks or months. In the severe cases, it may take years to make full recovery. Whiplash injuries can also result in permanent disabilities. The amount of compensation that is payable usually depends on the severity of the injury sustained, time it takes to recover, any ongoing symptoms and other losses that you experienced as a result of the injury.

Whiplash injuries can cause a great deal of pain and discomfort. This means that you not be able to carry out work as normal for a period of time or until the injury is healed. If you take considerable time off work, you may have to suffer loss of earnings. This may have an effect on you as well as on your family. For this reason, it is advisable to seek compensation for loss of earnings and other financial losses when you make a whiplash injury claim.

It is quite common that a third party insurer will try to do everything possible to settle a whiplash claim quickly and with minimum compensation. Insurance companies don't really care that you have been hurt or how the injury is affecting your life. They will always try to save as much money as possible. As an injury victim, you have the legal right to recover fair compensation. So don't be fooled when the third party insurers come up to you and make a pre-medical offer.

In most whiplash injury cases, insurance companies offer 瞿1,000.00 to settle the claim. This offer is made before you obtain medical evidence. Insurance companies know very well that you need medical evidence to get your claim valued. Medical reports outline the extent of your injuries, symptoms that you are experiencing and how long you may be suffering from the injury. This evidence is vital when it comes to estimating the value of a whiplash claim. Before you accept any pre-medical offer, it is advisable to seek legal advice and find out how much your claim is likely to be worth. If you don't take this step, you could be obtaining far less compensation than you actually deserve.

How to Write Computer Programmer Cover Letter


As far as the computer programmers are concerned, they are definitely in great demand. You will find out that the computer programmers are in great demand. You can look at any one company and you will find thousands of the programming jobs. Each of them comes out of the specific technology. This does mean that with each and every technology you will have some type of job. For example if you know about UNIX then you can become the UNIX programmer or the administrator. But you will at first have to apply for the post. For this purpose you will have to prepare curriculum vitae. However you will have to enclose the cover letter as well. Let us see that how the cover letter is being prepared.

Some of the tips regarding the computer programmer's cover letter are as follows:

1. The first thing which you will have to keep in mind is related to the format. You will have to be formal and this is definitely an issue. Do not try to be personal for even one line. You should become personal only when the recruiters start knowing about you in detail. Thus formal format is to be used. You need to realize that it is better to be formal.

2. The second point which you will have to understand is that how you are going to tackle with the problem. This is certainly very important. You will have to prove that you are going to be very handy for the company. It will require you to explain the talent which you possess. You should make sure that the recruiters come to know about your talent after reading the cover letter itself. This is definitely very important. For this purpose you should try to use standard terms since the recruiters will then be able to catch the fact quite easily.

3. Actually the above point is about the body. You will also have to provide the introduction. In the introduction you will have to write down that how you came to know about the job. This is certainly very important. The better will be the introduction; better will be your chances.

4. You will also have to keep in mind that the cover letters are the first thing which the recruiters will read. But they want to come to the conclusion within few seconds. This is certainly very important.

These are some of the points which you need to keep in mind. Only then you will be able to present yourself in better way.

Thursday, January 2, 2014

Integrating the Elderly and Disabled With Personal Support Worker Training and More


A very modern challenge is integrating the disabled and the elderly into daily life and helping them lead independent lives. While in the past, institutionalization and isolation was the norm, today it is considered to be healthier for society and for the individuals to be able to work, live in non-care home or alternatively structured care-home environments. There are many factors that have gone into this, from sociological research, medical break throughs and the rise of careers like community service worker or for people with personal support worker training.

Some of these concepts are not new. In the distant past, before there was anything close to modern hospital and social infrastructure, disabled people and other people who needed care and assistance were generally looked after by family. Institutions began as a mercy operation for the impoverished or people like veterans, who were being rewarded with care in exchange for their military service. Usually this was part of a religious organization's charitable mission. At this time, excepting nuns, professional nursing was not seen as a respectable profession. People with the resources could hire servants to look after their needs, but even the role of doctor or surgeon was on the cusp of respectability.

With the primitive medicine of the time, it took better results before healthcare became more respected. That was followed by a zealous trend towards institutionalization. Meanwhile alongside a growth in nursing there was also a growth in social work, from which we get the professional community service worker.

At this time, even in the home, there was still an unfortunate trend to hide away sick or disabled people. Disabled persons were seen as being better off in a structured environment where they could receive medical attention. But while this dealt with physical problems efficiently, it created emotional problems. Psychological and sociological research discovered better health results and quality of life. As treatments extended life and increased mobility, disabled and elderly patients became capable of functioning better without constant help.

Meanwhile social values shifted towards more respect for diversity. Simple adaptations like wheelchair ramps were added to many locations. It was discovered that with only a few hours a week from someone with personal support worker training, many of these people could stay in comfortable home networks. Employers are also encouraged to make allowances for disabled workers, increasing their efficacy.

On the other hand, institutions tried to become more like the world outside their walls. Today a retirement community encourages social involvement and resembles a luxury apartment complex more than a hospital. True there are plenty of healthcare workers, but also usually even small stores and hairdressing services. And people are brought in from outside the community for mutual benefit, from school kids to people there to learn from seniors.

Types of Buildings and Facilities That Require Handrails


Many of us are familiar about handrails being used primarily for stairs in the homes. But other than being installed in residential properties, handrails are also used in other buildings such as offices, bars, hospitals and facilities such as swimming pools and even parks. The main purpose of these rails is to act as a safety feature especially for people with disabilities and with health conditions that affect their sense of balance.

Handrails are integral part of any structure notably those that have slopes and stairs. They can be used indoor and outdoor to help people with difficulty walking or navigating around the place. Buildings that are friendly to people with physical disabilities and senior citizens provide handrails in specific areas. However, hospitals and nursing homes that accommodate people who walk with difficulty or may not be able to walk on their own will require additional rails in certain areas.

Recreational facilities such as parks and swimming pools normally have handrails installed. At parks, they can be found at the skating area and certain parts that have stairs and upper levels.

Handrails are also a staple at pool areas. They're very important so people using the swimming pools have something to hold on when they go down the water or when they go up and down the slide or diving board.

Contractors are skilled in determining the areas where handrails need to be installed and what types to use. They have to consider several factors as well such as the length, material and special features if appropriate.

Handrails are available in different materials. They can be made from wood or metal.

The wooden type is a cheaper option and can be customized. Most recommended for use indoor, this comes in different shapes such as the round, square and moulded. Decorative wooden handrails are commonly used in homes mostly because of the beauty they provide to staircases. And since they are customizable, they can be designed according to the preference of home owners. Most wooden handrails are sold by the foot.

The metal handrails are the more durable type and are ideal for use outdoors. They can be made from wrought iron, stainless steel and copper. The stainless steel tops the rest in terms of durability as it is weather and rust resistant. And while they're more known for their functionality, this type can also be decorative.

Other than the aesthetics, the best handrails to use are those that are not only durable but needs low maintenance. More importantly, contractors and homeowners should be aware of government requirements for installing this safety feature. The current building code specifies that handrails be installed at a height between 34 and 38 inches. For the circular type, the outside diameter should be a minimum of 1-1/4 inches and a maximum of two inches. For the non-circular type, the minimum perimeter dimension should be four inches and a maximum of 6-1/4 inches.

The existence of handrails only mean one thing - the place is safe for all types of people whether in normal condition or those with physical disabilities.

Nursing Home Choices


Selecting a nursing home is never easy, since there are many options for long term care for most seniors and many families are leery of placing an elder in an unknown professional care situation. While there is no cookie cutter approach which will guarantee that a family will make the right choice, there are certainly many considerations which should be weighed carefully when selecting any eldercare facility, including a nursing home, assisted living center or other type of senior residence.

First of all, it is crucial to understand the difference between the various types of senior housing and care centers which are available. Nursing homes are at the more comprehensive end of the care spectrum, as they provide around the clock services for elders who truly require assistance with all or most of their basic activities of daily living. This level of care far surpasses that found in domestic care situations, assisted living facilities and other general senior residences. To put it simply, nursing homes are for seniors who can not or will not take care of their basic necessities in life, including those who suffer from serious mental and physical health issues, such as Alzheimer's disease.

Once a family confirms that skilled nursing care is the best choice for their loved one, then it is time to go about finding the best facility for their individual circumstances. It is always best to place elders with special needs into a facility where those needs are commonplace and subjects of specialized care. Basically, for Alzheimer's sufferers, the facility should be noted for AD care and offer the best possible practices for these difficult cases. Similarly, for patients with other physical or mental impairments, the same rule applies, regardless of the whether the circumstances include physical disability, such as confinement to a wheelchair, the need for rehabilitative services for strokes or the individual attention demanded by cancer patients...

The family should always go to visit several of the best institutions in their area and consult with the home administrators for detailed information about care protocols, restraint usage, quality and variety of medical services provided, access to auxiliary services and many other pertinent factors which will help in choosing the best facility.

Once the field has been narrowed down to include only the best candidates that can provide the type of care demanded, then another lengthy list of ratings criteria comes into play... These include a great variety of considerations to take into account, ranging from the geographical location of the facility, to the visitation policy, to the menu offered, to the governmental rating enjoyed, to the forms of payment accepted... There are far too many variables to be detailed in a short article such as this one, but the full list of criteria used to choose the ideal nursing home for your needs can be found on the free website listed in the resource section of this page.

In summation, the process of attaining the need for nursing care takes a lifetime to achieve... The decision to place an elder in a nursing home is not easy and should never be made without careful consideration. However, when this is the right choice, the selection of the exact facility should also take time and effort. Rushing the process can have dire consequences for the senior, including being subjected to subpar living conditions and possibly even becoming victim to nursing home neglect, or the far worse, nursing home abuse...

How to Market Your Nursing Home With a Video


Are your customers thinking or feeling? Knowing whether they are thinking or feeling will determine your facility's success. Unlike any other medium, video has the ability to impact your audience on an emotional level. LTC marketing expert, Michael Larson, author of "Easy and Inexpensive Ideas for Increasing Census" recognizes the uniqueness of video.

"Video is an impressive communications tool. A professionally produced video seen by your target market can be gold. The key is producing the right video and getting it in front your customers. The sales potential of video is impressive when these two elements are strong."

A company that sets the benchmark for growing their business with video is Creative Solutions in Health Care. In the past, they used traditional marketing tools like brochures. During the first six years, their efforts produced little results. Then they decided to do something different, by using video to directly advertise to potential customers. Since then, they've expanded from six facilities to over forty in just four years. Gary Blake, the company owner explains why he continues to use video:

"Our company has experienced exponential growth in just a few years. The promotional videos have helped increase our census and total revenues. It's an investment I've learned to trust with each facility I acquire."

Too often, LTC marketing fails to connect with the customers. You have to realize that people tend to be emotional, not rational. Video not only raises awareness about your services, but it connects with your audience on an emotional level - and that is your key to successful marketing. "Video's creative and emotional elements are impressive, as they provide various opportunities for impacting potential customers. Unlike other mediums, video offers a rare blend of sight, sound, and motion. It's more life-like and captivating," says Larson.

Video is a product people like to share. With the popularity of social media, such as YouTube, Facebook and social blogs, distribution has become a lot easier and faster. Studies show that 90% of people who receive a video will watch it, and almost 50% will view it more than once. To be successful, you must become competition-oriented. A customer-oriented approach is simply inadequate. In today's competitive society customer service is a given, it's not what makes you different. Marketing guru, Al Reis, preached about the importance of positioning. If you want to stand out in the minds of your customers, you need to differentiate yourself from the competition. Video is a savvy way to position yourself in your market, express what makes you different and present the message of your facility.

So, is it time to think outside of the box? According to Larson it is: "You can't hide ineffective marketing; it shows in the census and profits. The old adage, "you get what you pay for", is especially true in LTC marketing today. Facilities focused on cutting costs will likely find fewer customers. New strategies and marketing investments are needed to sustain growth in today's LTC market. Tools like professional video and new marketing ideas will play a significant role in positioning facilities for long-term success."

Living Arrangements and Accommodations - Assisted Living Homes


Living arrangements and accommodations in assisted living homes will vary. They can be very opulent and resort like or more family oriented. There is literally an arrangement for everyone. There are several different models that assisted living homes can be set up under. From the very small intimate model to those that are like living in an opulent hotel community.

Actual Homes

Many adult group homes are set up in actual homes. Usually these homes are four or more bedrooms with central living areas. Each resident has their own space in the form of a bedroom and may or may not have their own bathroom. The bathrooms might be shared. In homes that are set up in this arrangement the kitchen, living room and dining room are community areas. Meals are served family style and there is a sense of an intimate family setting.

In all of these homes there is twenty four hour staff. The staff is there to supervise activities including dispensing medications, handling personal care needs, and transporting residents for shopping, doctor's appointments, and errands. This is a warm intimate setting, where fast friends are made. It is like having a community of folks living together that shares a common bond, are from the same generation in most cases, and can relate to one another extremely well. One of the greatest benefits of adult group homes is that it allows people who would ordinarily be alone most of the day to socialize with others and participate in activities that they enjoy.

Facilities and Communities

There are some assisted living homes that are set up in apartment buildings or in large communities. The assisted living homes that are set up in apartment buildings usually are set up with centralized areas that are used for organized games. They may contain a restaurant style dining room and other facilities to include gyms and pools. Each resident has their own apartment which is typically a one bedroom, living room and eat-in kitchen with a private bath. Usually these apartments are set up with call buttons in each room and an intercom system. The same services are provided that are provided in smaller assisted living homes just on a larger scale.

There are some adult group homes that are actual communities. The communities are typically divided into different levels. There are almost completely independent living opportunities as the first level, than an intermediate part of the community where the folks that need a bit more help may live than finally an area where the living is very dependent on the staff for care. These types of assisted living homes provide the same services as the smaller homes do but on a much grander scale.

Adult group homes come in a variety of sizes and a full range of accommodations, it is entirely up to the individual and their family as to what type is right for them.

Single Parent Families and Child Abuse - The Best Way to Prevent It


Parenting runs along two continuums: abusive and nurturing. One can equate higher incidence of nurturing with less incidence of abuse because the two behaviors are mutually exclusive. In nurturing single parent families, children receive support, have clear boundaries, and live under appropriate expectations. In abusive single parent families, too much may be expected from the children. Empathy for the children is lacking, physical punishment is prominent, and lack of awareness of the children's developmental levels is evident.

It is clear, however, that many single parents who become involved in the child welfare system did not intentionally harm their children; rather their lack of knowledge, skills, or resources led them to harm their children.

The best way to then to prevent child abuse is to help single parents, through effective parent training, to develop their skills and identify resources they need to understand and meet their children's needs and protect them from harm.

Moreover, research has shown that increasing positive parent interactions and emotional communications; and, requiring parents to practice new skills during and away from the training provides for the intended outcome of improving parenting skills and decreasing the children's externalizing behaviors. Furthermore, the long range consequence of child abuse is that children who experience such maltreatment are at greater risk for adverse health effects and risky health behaviors when they reach adulthood.

Some worthwhile goals for an effective parent training program then should include: helping parents to learn ways to discipline their children other than by yelling and hitting, such as redirection (trying to shift a child's attention from something dangerous, such as jumping off a chair to something harmless, such as doing a puzzle.); helping parents learn to teach their children how to control their anger as well as to manage their own angry feelings and stress; helping parents to learn stages of child development and to acquire realistic expectations; making available to parents in-home one on one parent coaching and support groups, and finally, helping parents to learn job hunting and life management strategies. In addition, the program should have a problem-solving focus, provide for active participation, involve the whole family, and target individually identified needs.

Several different types of parent training exist, such as models designed for parents who just want additional information to be sure they are doing the best job they can, and models that address specific needs, such as families experiencing child behavior problems or families in which child maltreatment is a concern. The program described above emphasizes the latter.

Wednesday, January 1, 2014

Dignified Living - Assisted Living Facilities


Assisted living is a term usually used in conjunction with senior citizen homes. It includes assistance with the daily activities of life, helping residents with administration of medication or personal care by trained staff, and monitoring of activities to make sure that the residents are safe and taken care of. This can be true for anyone who is not able to do his or her daily life activities but it is usually the provided for - senior citizens, mentally and physically challenged, and the people who are suffering from a chronic disease that make them dependent on others. It is actually a philosophy of provision of care and services in order to enable them to lead a dignified life.

Assisted, living facilities are licensed at the state level. Assisted care living facility, Personal care homes, and Old people's homes are some of the names used for such facilities. Such facilities are a way to make sure that a standard of care and concern will be provided to the people who cannot do so for themselves.

Assisted living facilities cannot be compared or equated with Nursing Homes for there are mark differences between the two.

o Nursing homes employ licensed medical professionals such as nurses, doctors and paramedical staff, who provide medical services to its residents. Non-medical staff usually provides assisted-living facilities and if they have licensed medical practitioners on their staff, then their responsibilities are usually limited to providing routine medical services.
o There is greater preference over privacy and personal care in assisted living facilities.

There are about one million Americans staying in assisted, living facilities. Thereby, much emphasis is on such assisted-living facilities rather than Nursing Homes.

A typical assisted living facility is usually a renovated Victorian house or school that has large and spacious areas where all residents can dine together, have a recreational and social activity that helps in bonding everyone as one big family and not feel the absence of their loved ones.

Some of the services provided in assisted, living facilities are preparation and serving of timely meals, laundry and ironing of personal clothing and linens, administration of medication, supervision of outdoor and indoor activities, reading and engaging in hobbies that interest the residents so as to keep the zeal for living ignited in them.

While looking for an assisted-living facility, one should consider what would be best for their particular circumstances. For most people, cost and location are the number one deciding factors. Second comes the reputation of the place. Is the staff well trained? Is it a licensed facility and is it safe?

Most of the assisted, living facilities are opened both for monitory and non-monitory means. A few are opened in order to make profits while others are opened as a social services or a charity that works for a cause. Before the legalization of such facilities, they were all privately owned. But, fortunately the requirement of licensure have regularized and improved the quality of services provided in most assisted living facilities.

No one wants to be dependent on others for the basic and everyday activities of life. Life circumstances beyond one's control can force one to lead a dependent life. However, one still has the ability to choose a dignified assisted life over a completely dependent and disgraceful living.

Assisted living facilities provide one with this choice - a choice to be able to do what one can and at the same time get assistance for what one must.

Why Are Nursing Homes Buying the Nintendo Wii For Their Patients?


One of the many goals of a nursing home is to keep their patients as active as possible. It may not be possible for them to get out as much as they once did but they can still take part in many activities. It may surprise you to find out that many nursing homes are buying the Nintendo Wii for their patients.

This is due to the many interactive games they can play. For example the interactive bowling game allows even those in their wheelchairs to follow through the process of rolling an imaginary ball. Then they watch on the screen as the pins fall down. They can be seen being very competitive with each other and having a great time with the games.

Tennis is another interactive Nintendo Wii game that the older patients really seem to enjoy. Many of them will tell you stories about playing such sports in their youth as well. This can bring back wonderful memories that they may not have thought about for a while. Even if they have never played a real game of tennis in their life they are having a great time playing it now.

There is also golf and fishing which seem to be quite popular with the men at these nursing home facilities. In addition to them working their muscles, hand and eye coordination is continuing to take place. They also have a great time interacting with the staff and with each other. This type of fun and laugher can certainly help them to feel younger inside and out.

The market for the Nintendo Wii is amazing when you consider the range of people it appeals to. They younger generations are certainly interested in the many features and newer games it offers. Even very young children who are just learning about video games are able to enjoy a variety of games. Parents are playing many of the interactive games with their children. They love that everyone isn't just sitting around.

As you can see from some of the examples here, even the elderly are able to enjoy the various Nintendo Wii games. They allow them to regain some of their youth and vibrance. At the same time they get to have some fun on a level that they can relate to. They are even getting some low impact exercise that really makes them feel good.

As the benefits of these games for the elderly continue to be exposed, you can be sure more adult communities are going to start offering them. When you consider that the gaming console and these games can be purchased for less than $500 it is really a very good investment. In fact, some of the residents at these facilities are even asking for such activities to be offered for their entertainment.

Many doctors are even encouraging this type of activity for therapy. Tournaments for various types of games are becoming popular in these nursing homes as well. Even though these individuals are older, their spunk and their competitive nature is still there. They can have great fun trying to do better than their opponents. In the end though there is a lot of support and cheering going on in the background. This type of encouragement is really needed in such an environment.

Caring For an Elderly Relative Versus Nursing Home Care


There may come a time when it becomes necessary to think about the future life of an elderly relative when it becomes obvious that they are no longer able to live independently or provide for all of their own care needs. There are a number of options including bringing in home care services through agencies in their local community. These may include visiting companions, home duties services and nursing services. There are services that provide transporting and shopping services to help your elderly relative remain living independently however, there may come a time when this is no longer viable.

If an elderly relative experiences frequent physical or mental difficulties they may require ongoing full time support. It's decision time. Before you make the decision about how to manage this situation you need to consider many factors.

There are basically two choices, your elderly relative co-habits with you or they go in to a nursing home facility. A care assessment of the needs of an elderly relative will need to be done and will dictate if the co-habitation option is appropriate. It is important that there is a care assessment completed before any decision is reached. Their doctor is the best person to speak to about how to get a care assessment done. The assessment will determine the level of care that is required for your elderly relative. If your elderly relative is assessed as high level care needs that the decision will be taken out of your hands, it may be that your relative will not be permitted to live with you because it is assessed as medically unsafe.

If the assessment comes back with a low level of care needs there are further considerations. Could you manage caring for an elderly person 24/7? Where are they going to live, in their home or in yours? Most elderly people go to live with their adult children so there are a number of questions about this.

Is there physically enough room at your home? Will your elderly relative have their own room? Most elderly people are used to having their own place and own space, it is therefore important that they have their own bedroom at minimum. This is somewhere they can spend time or retreat to where their right to privacy is ensured. You will also need to consider the impact on others in your home, how will they feel about an elderly relative competing with them for your time.

Time factor is another consideration. Do you have time to provided care and support to your elderly relative in the way they deserve? If you are employed full time or have other major commitments on your time think about what it is you can offer. Would your elderly relative be safe if they are left alone for long periods of time? This will need to be thought about and discussed.

Is there enough room in bathroom facilities so they can get in and out with ease? Does railing need to be installed to ensure their safety? You will need to measure the bathroom facilities to ensure that there is room to install railing when the time comes. This will improve your elderly relative's sense of independence for bathing and toileting.

There will be a number of decisions about your elderly relative's home if they come to live with you. If they own the property decision will need to be made about whether to keep the property or sell it. If the property is kept, there will need to be planning around maintaining the property, decisions about which person will be responsible for looking after the home. There are benefits and pitfalls to this option. There is another option of renting the home; this also has benefits and pitfalls. Get well informed about all of these options to save problems in the future.

Another consideration is the cost factor. It may not seem to be appropriate to bring up money as you feel this is something that you want to do for your loved one however it is extremely important that your elderly relative does not become a financial burden. This can be a major deciding factor. Caring for people is expensive and as time goes on your elderly relative may require many medications, physical aides and your home may also require further modification or remodeling.

Even after all this is decided there needs to be other plans in place. What happens when your elderly relative becomes too frail or ill for you to continue care? Then the nursing home option will need to be considered.

There are many considerations in choosing a nursing home for your elderly relative. Location is high on the list. They have been living with you for some time, and will initially miss the close contact you had with them. If they are close by you will be able to visit frequently to assist in their settling in to a nursing home. Other important considerations will come under cost and level of care provided.

It is always an excellent idea to visit all of the reputable nursing homes in your area. Make appointments and see for yourself what the facility has to offer. Meet with management and employees and obtain information that is important to you. For example ask about daily activities, menu, medical care, emergency care, palliative care and how complaints are managed. Observe the residents in the facility, do they look well cared for and how do the employees address them? It is important that you feel the residents are respected by the nursing home employees. It is also important that the nursing home's visiting hours are not too restricted. This will allow you to visit when it suits you. As a general rule there should be some visiting hours available in the morning and afternoon of each day.

There are many considerations to be taken into account; after all, this is a big decision. It may be one of the biggest decisions you will ever make. Everyone feels some obligation to provide care to and elderly relative, however this is not always possible or appropriate. There will be many impacts to your life, elderly relative's life and the entire family's lives. There are practicalities that need to be assessed and thought through carefully. Thorough planning is essential to decide on the best care options for your elderly relative.

Respecting The Rights Of Senior Citizens - 4 Factors To Pick The Right Care Facility For The Elderly


There is no formal 'Senior Citizens Bill of Rights', but as individuals, senior citizens are entitled to their rights. However, the senior citizens have little energy left in them in their old age to fight for their rights and therefore, it is the duty of the children to see that their elderly parents are getting what they are rightfully entitled to.

Every right must be claimed to be deemed as a right. There are laws in existence for the running of nursing homes for the elderly and retirement communities. Even if your elderly mom or dad is in an assisted care facility, there are certain laws that are fundamental and expected to be followed by these care facilities too. It is your duty as a caregiver to see that they are following the laws and living up to the expectations.

There are some factors that you must verify before selecting a facility for your elderly parents:

- Ensure that the facility will provide the basic cleanliness and safety. Check out the evacuation plans in place, in case of an emergency situation. Verify whether the evacuation plan is a workable one, considering the fact that the facility may be full of elderly and invalids who may be slow in moving out of the building in case of a fire. Find out if there is emergency power available to operate the automatic doors and elevators so that everyone can get out safely.

- If food is provided by the facility, ensure that meals will be provided three times a day. The meals should be healthy and the food should be delivered to the room if your parent is disabled or injured. There should be some variety in the diet and since there is a separate charge for the food, it is not wrong to expect some quality and variety in the food.

- If your parent has moved to an assisted care facility, they have every right to live as they wish in that apartment, since they have paid for it. However, they have to observe certain restrictions because they are living in a community setting. They should be able to live without any interference from the staff of the facility and have the freedom to select the décor of the apartment or have family and friends to visit.

- Another fundamental right of a senior citizen is to be treated with compassion, respect and dignity. Although this is not a tangible right, how the staff at the facility treats the elderly is an important aspect in the selection of a facility for your parents. The staff of the facility must be respectful and pleasant in their dealings with your parents. If your parent complains of any emotional or verbal abuse, you must investigate and hold the facility accountable for it.

As a primary caregiver, responsible for the well being of your elderly parents, you have the right to remind the assisted care facility of their responsibilities. Ensure that your parents are getting the service and care that they paid for and that they are comfortable in their living quarters and enjoying their stay there.

Should You Get Nursing Home Insurance at a Young Age?


Thinking that you are too young, can mean you avoid getting the protection provided by nursing home insurance policies. Some may think that it is only for retirement-age people and that less mature adults shouldn't worry about buying this important coverage.

There are several advantages to purchasing long term care insurance at an early age. You may need to be in a long term care facility long before you reach normal retirement age. You may develop a health condition later in life that will keep you from buying a nursing home insurance policy in the future. You be able to lock in a lower monthly premium if you purchase a long term care policy at a younger age.

Planning ahead and buying a long term care policy can mean that not only are you prepared for your golden years, you are better protected today. Skilled care in a custodial facility is needed by both the old and the young who are unable to live in at home due to a sickness or injury that causes disability.

Although it is true that one is more likely to need nursing home insurance (long term care insurance) the older one gets. Not everyone in a nursing home is elderly. Eighty-eight percent of the people in a nursing home are over age 65. This means that twelve percent of nursing home residents are not of retirement age.

Other types of policies will not cover a nursing home stay or won't cover it well. Health insurance and disability insurance plans can provide some coverage, but the coverage can be quite limited.

A medical insurance policy may cover you well in the hospital and the doctor's office. However your policy probably only covers the expenses of the first one hundred days in a skilled care nursing home. Most residents are in custodial care facilities or intermediate care facilities.

A disability income policy may pay you a percentage of your lost wages when you are disabled. Even if this does provide you with enough income to cover the cost of your care, you will have less income left over to cover your mortgage or any other expenses that you may have.

Long term care insurance requires applicants to be medically underwritten. This means that if you have a medical condition you may not qualify or you may be charged a higher insurance premium. This means that if you are healthy today, you may qualify for a low cost long term care insurance policy. However, since you cannot guarantee that you will just as healthy a year from now procrastination can mean that you will be unable to own this important protection.

The prices for nursing home insurance policies tend to be based on the age you purchased your policy. This means that you can pay the price only forty-year-old applicants qualify for when you are in your sixties and seventies. This can mean a huge cost savings when your income is more limited.

If you add an inflation rider to your coverage, you may only not even need to supplement your coverage as you get older. An inflation rider is recommended for any long term care insurance purchase.

Buying long-term care insurance at as as a younger man or woman has significant advantages. You get insurance protection right away. You are more likely to medically qualify for a policy. You will probably be able to lock in much lower insurance premium than you would if you waited, since rates go up as you age.

Spring is Recognition Time For Volunteers, Teachers, Nurses & Other Key Staff Members


Spring is a busy season for showing appreciation. Three nationally recognized events stand out, but there are many celebrations for the dedicated professionals who service schools, hospitals, nursing homes and general business and government. These events are held to let hardworking staff members know their efforts are recognized.

Department heads, administrators or event coordinators are responsible for decorating their facilities, lounges, hallways and work stations with themed items to proclaim their recognition and appreciation. Balloons, banners and posters help to make the workplace festive. Breakfasts, luncheons and ice cream socials are often held during short break periods.

Gifts are usually given out with the organization's name and a brief message imprinted on them. When you put your logo and a sentiment of thanks on a mug, shirt, tote bag, mouse pad or any other useful item, you are creating a keepsake that will be carried or worn with pride.

Here are some of the most notable recognition events:

National Volunteer Week April 18 - 24, 2010

Volunteers are almost everywhere and you may never know it. Sometimes hospitals, schools, nursing homes, senior centers and even businesses thrive by the unrewarded acts of some very generous people. National Volunteer Week allows everyone a chance to give a small reward to those who ask for nothing in return for their acts of kindness.

A small token of appreciation such as a coffee travel mug or a decorated chocolate bar will let the volunteers in your organization or community know that their time and efforts are cherished.

Teacher Appreciation Week May 3-9, 2010

Teachers spend as much and sometimes more time with children then parents. Young minds are molded by these dedicated professionals and sometimes their time and preparation is taken for granted. There are plenty of items that teachers will enjoy from brief bags and desk accessories to symbolic apple shaped novelties.

Superintendents, Principals, PTA/PTO and other parent group leaders and even students should organize a super celebration throughout their schools to let teacher and every other school staff member know how much they mean to the families in your community. Honor not only teachers, but valuable teacher assistants, secretaries, guidance counselors and maintenance staff members.

National Nurses Week May 6-12, 2010

Often overworked and underpaid, these healthcare professionals meet a demanding workload and schedule as they are responsible for the health and comfort of their patients. Hand out tote bags or backpacks with a sentiment of appreciation so they can carry books and a change of clothes home with pride. Massagers and stress balls with your imprinted logo will also be met with a sense of well deserved appreciation.

Honor not only the Nurses at your hospital, nursing home or facility, but supporting staff members and technicians who make your facility run. And Nursing assistants have their own event if you choose not to hold one blanket event (Nursing Assistant Week is held June 10-17).

Here are some other recognition events held this spring:

National Library Week - April 11-17, 2010
National Medical Lab Week - April 18-24,
National Hospital Week - May 10-16, 2010
National Nursing Home Week - May 9-15, 2010
National EMS Week - May 16-22, 2010

The price is small, but the rewards are great when you let caring individuals know they are appreciated.

Tuesday, December 31, 2013

Overcome Mental Abuse


You have most probably encountered the subject of mental abuse many times and you may have even read a thing or two concerning the subject. If you are someone that has personal experience with mental abuse or any sort of abuse for that matter, then you most certainly have reason more to set aside some time and open yourself to the possibility of having a life that is absolutely free from this often well hidden secret that constantly haunts your being.

In order to be trustworthy in the matter, I shall only say for now, that I have personally experienced the excruciating pain of being mistreated and the utter degradation of surrendering before the administrator of such pain and giving them complete control over thoughts and feelings.

Depending on the severity and length of subjection to abuse, you may or may not have the much needed willpower to distance yourself from people that cause you to punish yourself. Often times, it is hard for people that are not familiar with this problem, to understand, just why does a person choose to stick with the punishment. If you take any bad habit, like smoking, alcohol and drug abuse, in each case, the person is most likely aware that indulging the habit, is indeed harmful and a unnecessary or useless part of life.

Thinking along these lines, reveals a pattern of behavior that defies rationality and that is seemingly illogical for most human beings. However, there are many smokers, drug addicts and people that are constantly abused in the world today, so where does it all begin to make sense? In order to really understand, you need to give the pattern of behavior the attention it deserves, do not undermine the power it wields and the powerful effect it has on living.

I believe that habits are one of the essential building blocks of daily life, in other words, we create habits to automate life and to put routines into blocks that the brain categorizes in order not to get bogged down with a thousand and one little details. There is some absurdity in this because if you look at it from the top, you realize that all these habits make up the largest habit of all, which is staying alive.

I am sure there are behavioral specialists who could write many books on the subject but in my effort to stay close to the subject at hand, I will only say that habits form an integral part of our life and as such, the brain by means of evolution and programming, gives them a superior level of importance, thus allowing them many times to slip the radar, even when there are clear signals of danger.

To further understand why a person tolerates mental abuse, it is key to go back to the moment where it first started. By far, the worst cases of mental abuse are those in which it starts from a young age and for a number of reasons. Children are in a phase of constant growth and their brain is in the delicate phase of laying the foundation of thought that will help them get through adulthood, not that abuse should ever be accepted but in children the consequences are more likely to be life long and devastating. Children are also less able to escape from it where as the adult will more often have a choice, even though it is quite common for many adults and especially women, to become addicted to the abuse and in turn unable to flee from it.

There are a many reasons why a a grown person may feel unable to let go and seek shelter from abuse, most certainly where there are dependencies involved. A housewife that has no personal income may allow herself to be constantly abused in order to escape the responsibility of taking complete responsibility for her life, thus being forced to earn her own living. It may be fear based, often abusive spouses will threaten with physical abuse in order to keep their stronghold of control over the other person. In such cases, the person being abused may be overcome with such fear and refuse to take a leap towards regaining control of their life.

If any of this strikes a chord with you or someone that is close to you, know that this is for the reason mentioned above, I am actually speaking this from personal experience and an understanding which I have gained through the desire to claim my own life.

Ultimately, it is a psychological problem which you need to acknowledge, pretending it is something else will not diminish its capacity or duration. There are no new methods to combat this but there are many choices, even though it may seem like there are none. The first and most obvious choice is to formally recognize that it is a real problem. You may indeed always be aware of the abuse but you may not really target it specifically, again a force of habit which creates a invisible layer that protects the habit from direct and targeted attack. I am not sure why or how but habits definitely have qualities of living things, they have life, longevity, a defense mechanism and a number of other qualities that are only visible once you begin to actively combat them.

One of the most important messages I wish to convey to you is that, if you are unable or feel drained by the lifelong effects of mental abuse, humiliation and the fear involved, begin by seeking professional help. Seek help from groups, institutions, law, family or friends. No matter how alone you may feel, know that there are always fine human beings that will hear you out and not turn away from a desperate plea. Unless you are sure to have the will to break free from an abusive person, you must seek help, no matter how difficult or embarrassing it may feel to talk to others, trust me, they will not judge, ridicule or blame you.

What to Look For in Nursing Home For an Alzheimer's Patient


At some point, most Alzheimer's patients will spend time in a nursing home or assisted living facility. Whether, the stay is a temporary or permanent in nature, the special needs of Alzheimer's patients must be recognized and evaluated before the person is placed into a nursing home environment. There are no specific nursing home regulations in place for people with Alzheimer's and dementia.

Consequently, the burden of selecting an appropriate facility falls squarely on the shoulders of the family or close friends. The following is general 'game plan' that can be used by families of people with Alzheimer's, dementia or traumatic brain injury to aid in the selection of a temporary or permanent nursing home.

Before any change in living arrangements is contemplated, a complete physical and mental assessment of you loved one should be completed. A candid discussion of the individuals needs should be done in the presence of the family and caregivers. Try to decide what the person is really capable of an in what areas the person needs assistance. Honesty is crucial. An open and honest discussion will help with the selection of a facility, but will also help the staff at the facility a baseline get an idea of your loved one's needs.

Initial selection of a nursing home or long-term care facility for an Alzheimer's patient is no different from the selection of a nursing home for a non-Alzheimer's patient. The first step is to do some research about the facilities via friends or on the internet. I suggest the Medicare website as a starting point. You can see on-line where the facilities are located and what services they offer.

After conducting some initial fact gathering about the facilities, a visit to the facility is a must. Do not risk the safety and happiness of your loved one at a facility without physically visiting the facility. Before deciding on a facility at least two visits are in order. The first visit should be a scheduled visit to get a tour from the staff. If the initial visit passes muster, a second unannounced visit should be made. The second visit will likely be more telling than a carefully coordinately tour. Do not hesitate to talk with the staff during your visits. You can learn a lot about the facility depending on their attitude and demeanor. Unhappy staff is usually indicative of unhappy residents.

Unlike most nursing homes that care for the elderly, nursing homes that care for Alzheimer's patients and those suffering from a brain injury needs to take precaution to reduce the risk of residents harming themselves and others. Nursing homes for Alzheimer's patients should have specialized design considerations to help ensure the individual's safety and happiness. Facilities should:

- Place restrictions on in-and-out privileges for residents. Safeguards to prevent elopement and wandering --common sources of injury to Alzheimer's residents.

- Require each visitor to sign in. Mentally impaired residents are disproportionately physically and sexually abused compared with the general nursing home population.

- Bracelets and alarms. Does the facility have a tracking system or alarm for residents who have a tendency to wander? Depending on the mobility of the individual, a surveillance bracelet should be used to keep track of the person.

- The facility should have clearly marked walkways inside and outsides the facilities. The walkways should be well lit, have directional signage with diagrams as opposed to written diagrams.

- Have a circular configuration. Alzheimer's patients get particularly frustrated when encountered by dead-ends and right angles.

Staffing Is The #1 Consideration

'Does the facility regularly handle people with Alzheimer's?' This is an important question to ask, because the most important factor in your loved ones happiness and safety will be dependent on how much experience the facility has in dealing with Alzheimer's patients. Seek out a facility that focuses exclusively on Alzheimer's care or has a specialized unit for residents with Alzheimer's. If the facility houses both Alzheimer's and non-Alzheimer's patients, precautions should be in place to control both groups access to the other. Though it may seem segregationalist, depending on the level of functionality, most Alzheimer's patients should be kept together for their own safety.

Most incidents involving nursing home injury occur due to staffing problems. Don't be afraid to ask some or all of the following:

- Does the facility require / provide any specialized Alzheimer's training for the staff?
- Does the facility do backgrounds checks on all employees?
- What is the policy for alerting a family member to an incident?
- What is the policy for physical and / or drug restraints?
- What is the facilities toileting policy? Are diapers changed regularly or does the facility only change on a schedule?
- How does the facility ensure that resident's eat? Do they have staff to monitor what is and is not eaten?
- What is the resident / staff ratio? A general rule is 1:6 for staffing during the day.