Nursing Home Or Assisted Living Residence - The Difference

We have become all too familiar with nursing homes. Families in the United States usually move their elderly loved ones to a nursing home for a long-term or permanent rehabilitation service. However, in 1990s, assisted living facilities were born giving the elderly and their families a better option. Assisted living facility is referred to different names in different states. It is also known as senior housing in Colorado while other states refer to it as retirement living home, adult living facility, elderly care housing, among others.

Nursing home is a skilled care facility for senior citizens who need 24-hour medical attention. This is for elderly with chronic medical conditions who needs and requires round-the-clock skilled care, long-term attention, and also for short-term recovering patients after being discharged from the hospital.

On the other hand, assisted living residence is for seniors who cannot independently live in their homes, who need assistance in their daily living activities and would want to grow old in an environment that provides a warm, peaceful, and safe home environment with new and balanced lifestyle and socialization, thus, allowing them to nurture new friendships with other residents and subsequently improve their physical, mental and emotional condition.

Nursing homes typically provide room and board, meals, skilled nursing and personal care, and medication management services, and social and recreational activities for their residents. While senior housing offers long term elderly care and assisted living guidelines which includes the following services: Care management and monitoring, help with activities of daily living, housekeeping and laundry, medication management, recreational activities, security, transportation, and two or more meals per day.

Nursing home long-term patients are being assisted in multiple daily activities such as bathing, dressing, eating, toileting, transferring in and out of chairs or bed, and the like. These also include residents with cognitive impairment due to Alzheimer's disease or another form of dementia. Nursing homes provide a secure environment and an array of services to meet the physical, medical, and social needs of their residents.

Assisted living residents only needs assistance with meal preparation, activities of daily living (ADL), medication support and household chores, and/or require supervision due to a cognitive impairment related to disorders such as mild Alzheimer's.

More than 50% of the nursing home residents were women, and 14% were under 65 years old. The average age of a nursing home resident is 86 years old (Source: US Census Bureau 2007). While more than 900,000 Americans live in approximately 39,500 senior care in the country. The average age of a senior living care resident is 85 years old and the average length of stay is roughly 27 months.

Lastly, the average daily cost for assisted living is still less than half the average daily cost for a private room in a nursing home. The average rate for a semi-private room has increased by 1.1% from $189 daily (in 2007) to $191 daily (in 2008) while the average assisted living rate has increased by 2.1% from $2,969 monthly (or approximately $98 daily in 2007) to $3,031 monthly (or approximately $101 daily in 2008). The average rate for a private room in an Alzheimer's wing is $219 and $198 for a semi-private room in the same wing. Rates vary by region and depending on the number of services included.

Quality of Life - the key difference between living at home and living in an assisted living home.

Elder Abuse - The Hidden Crime

The facts about Elder Abuse

Elder abuse has often been called the hidden crime -- it can be difficult to recognize, nursing home staff know how to conceal the evidence and victims are often too frightened or incapacitated to communicate the abuse. In fact, 84% of abuse cases go unreported. What's even more frightening? Nursing home deaths are rarely detected by government inspectors, or even investigated by medical examiners or law enforcement.

There are federal and state laws designed to protect residents of nursing homes and other assisted living facilities from what is known as "institutional abuse." But victims must be able to report incidents in order to make sure those laws are enforced. This can be difficult when you consider that abusers may be staff members, other patients or even visitors.

What are the types of abuse?

Elder "institutional" abuse generally falls into seven categories:

1. Physical abuse -- infliction of pain or injury, including sexual abuse.

2. Misuse of restraints -- restraining a resident with either physical restraints or medicine (i.e., overmedicating a resident so that he or she will be "less trouble") that falls outside any doctor's orders or accepted medical practice.

3. Verbal/emotional abuse -- demeaning statements, harassment, threats, humiliation or intimidation.

4. Physical neglect -- disregard for the necessities of daily living such as food, water, bathing and basic care.

5. Medical neglect - failing to provide medical care, such as ignoring a necessary medical diet, neglecting to call a physician when necessary, or not paying attention to the potential side effects of a patient's medication.

6. Verbal/emotional neglect -- failing to meet the patients' verbal/emotional needs including disregarding patients' wishes, or restricting contact with family and friends.

7. Personal property abuse - illegal or improper use of a resident's property (funds, property, assets).

What are the signs of abuse?

If your family member lives in a nursing home or assisted living facility, don't assume that abuse isn't taking place. Even when the staff and care are of the highest caliber, you remain your loved one's best advocate, so look out for the following signs of potential abuse:

1. Mysterious bruises or lacerations that cannot be explained by a reasonable medical cause.

2. Lack of cleanliness -- in your loved one's appearance, the condition of his or her room and the facility overall.

3. A change in demeanor that isn't the result of failing health or mental state - does your loved one exhibit fear of certain staff members or other patients?

4. Failure to notice medical issues -- if your relative becomes ill, does the staff notice and take immediate action to summon the doctor?

What are the responsibilities of a nursing home?

In order to receive reimbursement from Medicare and Medicaid, nursing homes must meet certain requirements for quality care as stipulated by the Nursing Home Reform Act (NHRA). The NHRA states that a participating nursing home "must provide services and activities to attain and maintain the highest practicable physical, mental and psychosocial well-being of each resident in accordance with a written plan of care..."

Most states also have laws requiring doctors, nurses and other health care professionals to report suspected neglect -- and the law requires nursing homes to investigate and report any abuse incidents that occur within their facility. Physicians, hospitals, nurses, therapists, aides, orderlies and administrators all bear the responsibility to provide adequate care, medical treatment and protection to the residents and patients in their facility.

However -- the truth is that many institutions fail to meet these requirements, regardless of what the law mandates. A recent California study revealed that only 23% of nursing homes in the state met federal regulations for care.

What can I do if I suspect nursing home abuse?

Your family member may be vulnerable and unable to speak out - but you have the ability to take action on his or her behalf. There are several steps you can take if you suspect that elder abuse is taking place.

1. Be vigilant -- if you have even the slightest suspicion of abuse, pay attention and demand answers of the staff or administration. It's easy not to notice the symptoms of abuse -- but nothing is more difficult than knowing that the suffering of a loved one could have been prevented.

2. Document everything -- note the dates and names of people with whom you spoke regarding any incidents. This information will prove to be invaluable if legal action is necessary.

3. Take your concerns to the highest authority -- if you don't feel the staff members you have spoken to are addressing the issues, do not hesitate to contact their superiors. Find out who is in charge of the home and communicate with them directly.

4. Get legal help -- consult with an experienced nursing home abuse attorney. A lawyer with experience in elder abuse can make sure that any institution guilty of abuse is held accountable. The nursing home abuse attorneys at Epperly & Follis, P.C know the law, the legal system and victim rights -- and they can help take action against those who abuse the elderly.

Information Regarding Slip, Trip and Fall Accidents

The legal term "slip and fall" refers to any accidents that happen in someone else's property. Any hazardous conditions inside or outside a property, either it is a residential or commercial area, can result to any person slipping, tripping and falling. Premises liability is commonly the form of liability in such an accident, due to the fact that owners and occupiers of a property are held legally responsible for any mishaps that happen in a certain property.

Slip and fall accidents in residential and commercial properties account to one million injuries among Americans according to the Centers for Disease Control and Prevention (CDC). Though this kind of accident is not that severe as a car accident, it has already claimed 17,000 lives in a yearly basis. Slip and fall accidents account to 15 percent of all work-related injuries, while the elderly aged 65 and older are the most common victims of such mishaps.

There are two forms of slip and fall accidents: elevated falls and same-level falls. Same-level falls are the most frequent form of accidents within the property, and the damage to the body ranges from mild to severe. Elevated falls, however, are even more severe despite this being less frequent among the two. Here is some information regarding these classifications:

• Same-level falls are falls in which the person either slips or trips and then falls to the ground. There are three forms of same-level falls, namely slip and fall, trip and fall, and step and fall.

• Slipping and falling is caused by a slippery surface coupled with wrong footwear. The person may either slip forward and fall backward, or may slip and then fall front first.

• Tripping and falling happens when the person's foot strikes an object on the floor, causing him or her to fall on his or her front. This kind of fall happens most frequently on a flight of stairs.

• Stepping and falling usually occur when a person steps on an uneven walking surface and then falls to the ground. Although falling may not happen, he or she may experience pain on the affected foot, resulting to a sprain.

• Elevated falls are falls that occur when a person is atop an elevated surface, such as ladders, stools, scaffolding, vehicles and equipment, and stairs.

Property owners are tasked to establish policies and practices that will alleviate the number of injuries and deaths because of slip and fall accidents. They must be committed enough to prevent these forms of accidents by inspecting the whole property, especially walking and working areas, paying attention to the lighting, stairways and walkways. They must also be keen in installing proper warning signs, especially on certain locations within the property.

Someone who gets injured in a slip and fall mishap can always consult an Orange County personal injury lawyer. The injured person can be entitled for compensation for the damages he or she sustained, which is why the legal expertise of the reputable personal injury lawyer is important.

Choose Dumpster Rental for Your Next Major Cleanup or Cleanout Project

Maybe you re moving cross-country and want to get rid of all the junk that s been cluttering your home. Maybe you re transitioning an elderly relative into an assisted living facility and need to clean out his or her space. Or maybe you re renovating your building and need help getting rid of the construction debris. In these and other scenarios, dumpster rental is the ideal solution.

Most dumpster services allow you to rent a certain size container for one or more days. The rental company will arrive at the specified time with the dumpster in tow and leave it for you to fill as needed. At the end of the rental period, the company will return to tow away the container and dispose of its contents.

What are the benefits of choosing dumpster rental over gathering and disposing of junk, trash, and other debris yourself? Renting a dumpster can:

• Save you time: Imagine driving back and forth to the dump or the local recycling center with load after load of unwanted materials and items. Now imagine staying on your property and being done with those items the moment you toss them into a dumpster. Dumpster rental saves you all of that driving time, which can speed up your cleanup or cleanout dramatically.


• Give you a central trash area: In the case of large-scale cleanouts and cleanup projects, it can help for everyone to know exactly where the garbage or junk goes once it s out of your building or the construction/demolition area. Rather than stacking up black garbage bags along the curb or filling your lawn with items to be carted off, one by one, with dumpster rental service, all the junk goes to the same place. This can further speed up your cleaning process, as well as minimize collateral damage to your property.


• Ensure proper disposal: Do you know the laws regarding disposal of appliances, furniture, construction debris, and garbage in your area? If you tackle trash removal yourself, you might unknowingly dispose of items incorrectly. Improper disposal can lead to fines plus the possible frustration of having to return to fetch those items and take them to their rightful resting place.

The cost of dumpster rental will vary based on the type of junk you have to get rid of, how much that garbage weighs, and how long you need the container on site. It might not be cheap, but if you consider that you re likely to finish the cleanup faster than with DIY disposal, spend less money on gasoline, and avoid fines, dumpster service can be well worth the cost. And don t underestimate the emotional benefits. When you call to schedule dumpster rental, you ll feel relief that a frustrating, overwhelming, or just plain long cleanup might be finished hours or even days sooner. As you watch the dumpster drive away, you ll have peace of mind that the junk is out of your hands and out of your life.

Great Activities for Seniors

When caring for senior citizens and the elderly, keeping their minds and bodies active is very important. Staying physically active can help prevent or maintain different chronic diseases like heart disease. Doing different mental activities can help with memory for seniors who suffer from Alzheimer's or dementia. The only thing is making sure the activities are fun and don't seem like a chore. Here are some fun activities for seniors.

Playing cards can be a great way to stimulate the mind. There are so many different card games that can work. Games like UNO or Dirty Neighbor can be fun and stimulating. Not only does the person need to remember the rules, but they have to plan and strategize what their next move will be. This helps the brain get a work out by triggering different parts of it. You could even play poker, with fake money, and whoever wins gets a prize. Poker will help when it comes to rationalizing as well as planning.

Arts and crafts can be very helpful when it comes to dexterity and hand eye coordination. For those who have arthritis, this can become difficult depending on when the activity is. These can be anything from sewing or cross stitching to painting or playing an instrument. Depending on whether or not the person has arthritis and/or how far advance it is, the crafts that require steadiness of the hand, or completing small details may be difficult. On the other hand this keeps the mind relaying messages to their hands.

Doing yoga or tai-chi can be a very helpful activity that doubles as exercise. These activities help keep joints healthy by stretching and working out different joints and muscle groups. As stated before, exercise can help prevent control different diseases that are common in senior citizens. Also, by making it a group activity, seniors can be more social while doing something good for their mind and body. Many people, not just the elderly, find activities like yoga and tai-chi to be very relaxing.

If the person is in a senior citizen care facility or a nursing home, having movie nights can be quite beneficial. Instead of serving snacks like pop corn, you can serve healthy alternatives like grapes, or carrots. Or, if they are on a good diet and can splurge, you can bring in nostalgic candy and then pop some popcorn as well. A movie night may not seem like exercise in any way, shape or form, but happiness is a major part of being healthy. As they say, laughter is the best medicine, and what is a better way to laugh than at a familiar movie with friends and/or family.

There are so many different activities that senior citizens can get involved that will be beneficial in more ways than you may think. Many nursing homes and elderly care facilities already have activity schedules set in place, but if there is something else that you think of, ask and see if it can be put on your activity list. Living happy and healthy doesn't have to be a chore, simply get involved in some of your favorite activities and you will be well on your way.

Duties of a Certified Nursing Assistant CNA

The duties of a certified nursing assistant (CNA) include a wide range of responsibilities depending where you work and in which state you reside. These tasks vary with the job and facility and also vary somewhat from state to state. There are many laws of responsibility and liability that cover the exact duties of a CNA.

As you go through your formal education and training you will learn more about the law of your state and how it applies to your role as a certified nursing assistant. Your first obligation will be the client or the patient. You will often be responsible for the daily management and routine of your patient. This is especially true for the care of elderly people in nursing home and extended care facilities.

Most likely your second obligation will be to carry out the mission, goals, and objectives of the facility where you are working. Many places today offer intense training and an orientation program to carefully go over the expectation of their workers.

Your third obligation will be to carry out the duties of a certified nursing assistant as you were trained and educated to do and perform. This becomes your major obligation and you will find it very rewarding and satisfying.

One of the specific responsibility of a CNA include making sure the rights of the patient are always protected. This includes the right of privacy, the right to be informed of their health care program and treatment, their right to accept or reject treatment, and the right to be included in their health care plan information.

Because nurses do not spend a lot of time in direct contact with the patient the certified nursing assistant becomes the "eyes and the ears" of the nurse. Your duties will include to keep close watch over your patient or client and be familiar with emergency responses in case of need. In most situations the duties of a certified nursing assistant also include the monitoring of vital signs for your client or patient.

Of course this will involve you taking temperature, respiration, pulse, blood pressure, and level of pain. These are common duties that you will perform everyday on all of your patients. Most likely your responsibilities will also include helping with the feeding process to ensure that patients are eating. You may also be assigned the task of bed-making, hair care, and bed-bath responsibilities.

There are many duties of a certified nursing assistant and the responsibility is enormous and challenging. The reward will also be exciting and very satisfying.

Louis Zhang, Certifiednursingassistantonline dot com

Taking Disciplinary Actions in Nursing Home Abuse Cases

Nursing homes in the United States are doing great service to families of elderly people. It's a pity that some families do not have the time and patience to take care of their elderly members such as their parents and grandparents. But thankfully, there are nursing homes that can do the job for them from bathing the old folks, changing their clothes, feeding them, to entertaining them and putting them to sleep.

Senior citizens aged 65 and above account for most of the residents in nursing home facilities. As of 2004, there were 16,100 nursing homes with 1.5 million residents or 86 percent occupancy rate in the U.S. based on the National Nursing Home Survey.

Sadly, abuses have been found to be increasing in these facilities for elderly folks. Nursing home abuse cases vary from one facility to another with some initiated by staff members and the others caused by the residents. Cases may involve from as simple as neglect to worse cases such as physical injury, emotional, verbal and sexual abuse. What's unfortunate is that many of these cases were not reported leaving the victims still fearful.

The management of the nursing home facility is responsible for taking the necessary disciplinary actions immediately after an abuse is reported. If a staff is the one involved, it's the nurse executive's responsibility to protect the resident and immediately transfer the alleged wrongdoer to another area with no access to residents notably during the investigation proceedings.

The standard procedure is for the head of the facility to immediately conduct an investigation on the abuse issue. Should the nurse executive is not available, the nurse in charge or supervisor present during the incident can start the investigation. Normally, an incident report has to be made. This needs to provide information on the activities taking place at the time, names and statements of staff on duty, details of the resident abused (physical assessment) as well as statements from witnesses, the violator and other residents.

However, while it may be alright to just move the wrongdoer to the kitchen or laundry area of the facility when the matter is looked into, there are still risks involved. If the person alleged to have initiated the abuse remains in the facility, the risk remains and is even greater when there's less supervision in new area where that staff is assigned.

A Federal regulation calls on all nursing home facilities to ensure that violations including neglect, mistreatment and abuse are reported right away to the administrator and other officials. Reporting of violations to the facility's management should be done foremost prior to investigating the issue. Only when criminal cases such as rape occur should the police be notified although some organizations say this should not be so.

Nursing home lawyers also exist to help families who may have complaints regarding their elder's facility and nursing care. They can provide professional advice on what steps to take should families wish to pursue a legal case against the facility or a staff member who initiated the abuse to their loved ones.