Finding a Nursing Home - How to Deal With the Emotional Factor of Moving to a Care Home

In your senior years, one of your major tasks may be to find a nursing home. In fact, finding and moving into the right caring home is the key factor in determining the quality of your life. By choosing the right care home for your needs, you're entering an environment especially designed for people with your particular circumstances. Your new care home is a place where you can relax and not worry about the practicalities of daily life. You just need to focus on being as happy as possible. But this is not as simple as it sounds. For one thing, finding a nursing home and moving in is a very emotional experience.

So let's consider the emotional factors involved in moving into a caring home. Like all major life changes, it gives rise to a number of fears. These fears, which include fear of regimentation, of losing your identity and being institutionalized, can have profound emotional effects on the new arrival at a nursing home. The fact is that arriving at your new care home can be a daunting business and how you handle it will depend on your personality. If you're the resilient type, you can take it all in your stride. But most people experience a sense of anxiety, bewilderment and dislocation when first entering residential care.

So what can you do about this? One important way to do this is by finding a nursing home that you feel comfortable in. You shouldn't view a nursing home as just a building with a range of facilities and a collection of staff; you should view it as your new home, a place where you're going to spend most of your time in the future.

That's why it's important to visit every care home before deciding to move in. With luck, you'll find a place that feels just right but in any event, a detailed examination of potential nursing homes will mean that when you come to move in, it will be less of a surprise.

Other than visiting the homes and talking to residents, you should also ask questions about you potential new home. You need a find out to what extent you can maintain your independence. The fact is that caring homes vary considerably in their adherence to fixed routines.

So you need to find out answers to questions such as:

How much flexibility there is regarding meal times and bath times? Being able to follow your own routine as much as possible can help you feel more independent.

What are the visitor arrangements? In the early days, regular visits will help dispel in the initial sense of dislocation and loneliness. And are your pets allowed to visit?

What personal items can you bring with you? Obviously you'll probably have less room that your former home. But being able to bring your own small items of furniture and hang your favourite pictures will go a long way towards creating a homely atmosphere.

What organised activities are there? The best way to become part of a community is to be socially active. This way you'll feel a sense of belonging and quickly make new friends. Likewise, if you're used to being out and about, you should check if residents are encouraged to step outside the home.

Obviously living in a residential care home is regimented to some extent, and fixed routines have to be the order of the day. Flexibility varies from home to home and depends on such matters as budgets, staffing and facilities. But by creating your own personal routine and environment as much as possible, you can retain much of your own lifestyle and so avoid much of the emotional turmoil.

Failure to deal with the emotional consequences of moving into a care home can be serious and can have a profound effect on your emotional well-being and ability to adapt to life in your new home. So choose your new nursing home with care, make it your own special place, and join in the social life. In this way, your new nursing home will be not just a place to live and be taken care of, but a place where you can thrive and enjoy a whole new lease of life.

Elderly in Home Care Doesn't Mean a Lack of Socialization

While the vast majority of seniors prefer to age in one place, many seek assistance from home health companies and assistant living services because of an increased need for personal assistance or in home care. Numerous studies have been conducted that show that seniors having social connections through family members, friends, social organizations, even companion animals is directly linked with their overall good health, prolonged survival from serious illness, and longevity in general. As seniors age, the need for socialization is even more important to help maintain overall good health. Evidence of the connection between a strong social connection and good health include:

o Studies show that people who are able to get out and interact and spend more time with people during cold/flu season actually get fewer colds and illnesses than those who spend most of their time alone.

o People that have companion animals to interact have fewer illnesses that people who do not have a companion animal.

o People who use words such as "I', "mine", and "me" often during casual conversation are more susceptible to heart attacks than those whose conversations don't focus on themselves.

o Our immune system has natural killer cell activity that is negatively affected by a lack of social support.

o Our natural killer cells are more sluggish if we are lonely.

o Feeling grateful for what we have in life is associated with better physical and emotional health. The elderly can be at risk of isolation, which can directly affect overall health and longevity. If one spouse becomes ill, the other spouse tends to be the primary caregiver, which can consume much of their time. Caring for an ailing spouse can lead to isolation from the people and activities that were once enjoyed together on a regular basis. Seniors may also face the loss of a spouse. This event often further isolates you from some of the activities that you might have once enjoyed as a couple, as well as isolation from some of the friends that you interacted with together. Seniors are also at risk of decreased socialization as they age if they can no longer drive. Giving up driving for many means giving up on independence and access to the people and activities they rely on for social support. It's critical to take into account the importance of socialization as we age. Getting the personal care that is needed doesn't have to eliminate the opportunity to maintain social connections.

Most communities have resources for seniors to foster good health and social connections. Many towns offer a variety of activities through local seniors' centers, support groups, libraries,religious organizations and active retirement communities. For those unable live independently, assisted living communities and home care companies offer a variety of services. Seniors should be encouraged to participate in assisted living community activities and outings. Those living at home should be encouraged to look for the right home care company-one that recognizes the value of a support network and social connections. The elderly no longer need to sacrifice socialization for quality senior care.

Causes of Child Physical Abuse

Child physical abuse is unjustifiable under any guise; however because of its high prevalence in most cultures, studies have attributed some causes to it.

These causes are varied and can be classified into parental/caregiver causes, child with features that are provocative and environmental factors that promote violence against children. Below are some of the causes:

1. A parent/ caregiver who is short tempered would misconstrue a child's natural demand for attention as misconduct that should be punished.

2. A parent who feels the child came at the wrong time and so has feelings of resentment against the child is easily provoked by every innocent action of the child.

3. A child left in the care of baby sitter with abusive tendencies will be abused.

4. Caregivers who abuse alcohol and other substances have no inhibition in inflicting injuries on innocent children

5. Caregivers who are under stress at work place very often maltreat children.

6. Children with behavioral disorders have injuries inflicted on them in attempts to correct them.

7. Domestic violence raises the incidence of child physical abuse because victims of domestic violence vent their anger on hapless children. A study has found children whose mothers are battered to be 6 to 15 times more likely to be physically abused than children whose mothers are not physically abused.

8. A child with physical disability or who was born prematurely is also at risk for abuse by caregivers because of the extra demands such children make of caregivers.

9. Munchhausen syndrome is an abnormal situation where the caregiver makes the child sick and then derives pleasure from nursing the child.

10. Those who use corporal or physical force in disciplining children tend to gradually apply more force when the child fails to respond to milder force and this coupled with the angry state of mind of the caregiver can produce unintended injuries.

11. Socially isolated caregivers are more violent on the whole than caregivers who have a large network of friends.

12. Caregivers who do not have any religious affiliation do not have the benefit of restraint that religion puts on such aberrant behaviors like abusing a child. The Christian religion expressly teaches that children are a heritage of God and so must be handled with love and affection.

13. Children from single parent homes are more prone to abuse than children from two- parent home because the stress of caring for such children easily tips a parent into abuse at the slightest provocation. Some parents may inadvertently vent their anger on the child rather than on the offending spouse.

14. Caregivers who were abused in childhood tend to do same to their own child; a kind of transfer of aggression because of unresolved hurts and anger.

15. A child with poor bonding with caregiver will also be at risk for physical abuse.

16. Children from large families could be prone to abuse because demands on parents' resources could wear their patience thin and make them violent at the slightest provocation.

17. Low socioeconomic status and the attendant stress of daily living make parents resort to violent behaviors to correct children.

Elder Abuse by Family Members

The abuse of elders is, despite national hotlines, still the dirty little family secret. It takes many forms. Anything from the obvious -- hitting or physically abusing people -- to the more subtle. Shouting, screaming, threatening. Predating financial resources. Then there are the complex forms of abuse. One member of the family takes control of an elder and abducts that person away from the rest of the family. This usually happens between siblings and it tends to occur when only one parent is still alive.

However these adult children see it -- and they always say plenty to justify their actions -- it obviously is a failure of family relationship. It's usually one inadequate child's last opportunity to seize all the love, and all the attention finally. I most wonder just how the parent feels to be caught up in family war between their own children.

Then there are the abuses which everyone sees and no-one quite knows what to do about. Such as the age-disparate married couple. The husband significantly older than his wife. He treates her well, she makes publicly-demeaning remarks about her husband. Their friends are worried, but don't know what to do. In these cases. contacting the adult children can make a lot of sense. Children usually do know the state of relationship between their parents. They're often willing to take in the abused partner.

That's fine if the abused partner is willing to go. What about when either spouse is unwilling for this to happen? What can families do then? Often, alas, families will let the situation ride. Then it's neighbors who call the Elder Abuse Hotline. Verbal and emotional abuse is real abuse requiring action. However, in the current state of elder care, abuse is not uncommon and investigators few. This tends to mean that if there are no bruises to show, action will be slow to zero.

This is why it is so important for family members to be willing to intervene. That requires some courage. An abuser is often likely to have been that person throughout family life. That means there may be a pattern of intimidation that carries through into adult life. The kids won't stand up against Dad.

One way that this situation can be brought under better control is for both parents to move into assisted living. That creates a watchful community around them that can intervene or limit any abusive speech and can call in the police for abusive action. Most adult children can work together to make this happen, especially if they see it as a solution to the parental problems.

Often, a parent-abuser can be someone who seems perfectly nice. You can have good friends and a good reputation and still be guilty of abusing a parent. Of course there are usually reasons -- poor family relationships, alcoholism or drug abuse, greed for the parent's wealth.

If you think an old person is being abused in any way, report it. No one need ever know it was you. But do not leave an elder at the mercy of abuse.

The Pricing Problem - Game Theory Used to Determine Optimal Rates For Assisted Living Facilities

When aging seniors begin to need basic assistance with daily living, they can essentially choose from one of the following to get the long-term care they need:

(1) receiving assistance at home from a loved one;
(2) hiring a caregiver from a homecare agency; or
(3) moving into an assisted living facility. While approximately 70% of seniors over 75 years of age obtain help from a loved one in the US, home care agencies (HC) and assisted living facilities (ALF) are growing, lucrative industries. ALFs and HC services provide quality senior care and assistance for those in the aging elderly US population who have the ability to lessen the burden on their children by paying for expert long-term care services with their home equity, pensions, retirement savings, and/or government funding.

ALFs naturally compete with HC agencies for seniors and it is typically the adult daughter who decides if her aging parent will either move into an ALF or hire an in-home caregiver. Presumably, an adult daughter will choose the option that cultivates the most health and happiness to her aging parent at the lowest cost (especially in the current economic climate), and the goal of an ALF is to maximize revenue while keeping occupancy rates high by not losing seniors to HC companies. However, ALFs (known in signaling games as the sender (Source 1), since they send a price signal to the adult daughter) can vary greatly in quality (i.e. 'good' or 'bad') and HC quality is more stable (See Note). Ideally, operators of 'good' ALFs would signal their high quality to adult daughters with high prices, but because HC is a valuable alternative and there are 'bad' ALF that could raise their prices to falsely signal quality, the 'good' ALF operator has to carefully set its rates. This uncertain price-quality signaling between high revenue for the ALF and optimal benefit to the senior resident can be analyzed using game theory, particularly an extensive form signaling model, to help owners and operators of ALFs answer the question:

How should I price my assisted living facility to profit and show high quality, while still attracting residents?

As with any theoretical model, many assumptions about the 'game' must be made in order to solve. First, we will presume that there is uncertainty for the adult daughter regarding the quality of ALFs and a facility can be either 'good' (G) (higher benefit), with a probability of (p), or 'bad' (B) (lower benefit), with probability (1-p). Moreover, the benefit a senior receives from an in-home caregiver is more constant and simply provides a benefit of (HC). Second, ALFs can charge a high monthly rate (H) or a low monthly rate (L) and HC companies charge a constant amount, (K). The following values will be used as a numerical example to represent the costs and benefits of various senior living choices:

(G) = 6 (arbitrary benefit value of a 'good' ALF)
(B)= 3 (half of the benefit value of a 'good' ALF because of lower quality care levels)
(HC)=6.5 (highest benefit value option, assuming seniors would rather stay at home at receive care)
(H)= goal to solve for (H); typical high priced ALFs in the US charge $3,000-$6,000/month)
(L)= 1.5 (represents the cost of typical low priced ALFs charging $1,500/ month)
(K)= 5.5 (represents typical monthly caregiver costs charged by HC companies of $5,500/month)
(p)= 0.5 (assume that 1/2 of ALF are 'good' regarding the health and happiness provided to the senior)

Consequently, a set of parameters and a graphical representation of this game can be created from these assumptions. Therefore, the adult daughter who wishes to maximize her aging parents utility (benefit minus cost) would order her preferences for care options (highest to lowest utility) as follows:

(G - L) > (G - H) > (B - L) > (HC - K) > (B - H)

Thus, the adult daughter would first like a 'good' ALF at a low cost, second, a 'good' ALF at a high cost, third, a 'bad' ALF at a low cost, fourth a HC agency at the typical cost (K), and lastly, a 'bad' facility at a high cost.

There exists a specific price at which the adult daughter may choose a high priced ALF in hopes that it is 'good' (G - H), in spite of the risk that the ALF is 'bad' (1 - p) and gets (B - H). Subsequently, the total utility is: (p)(G - H) + (1 - p)(B - H). The adult daughter will then only choose a high priced ALF if the utility is greater than the utility from a HC agency, illustrated by the equation:

(p)(G - H) + (1 - p)(B - H) > (HC - K)

For a numerical application, assume the values from above to solve for (H) (See Figure 2 for detailed calculations) and the resulting highest price an adult daughter is willing to pay for the potential benefit of a 'good' ALF at high price, with the risk of that the ALF could be 'bad' factored in, calculates to H

The Advantages of Home Care For the Elderly

Many seniors have trouble getting around their homes safely, leaving families with some tough decisions. Whether or not an elderly family member should move into an assisted living facility is often one of the key questions. However, home care is a viable option with many great benefits.

1. Homecare allows seniors to retain a sense of independence and freedom as they age. They can leave their home to go wherever they please whenever suits them best. Similarly, they can eat when they are hungry as opposed to when meals are served to them. Maintaining this sense of dignity is important, as it is something many seniors fear losing.

2. When the elderly live at home they are able to keep their physical possessions close at hand. The things they love do not have to be placed in storage as a result of moving into a smaller space. Many of these objects are tied to priceless memories, so it is understandable that a senior wouldn't want to part with them. Additionally, most retirement homes do not allow pets. At home, seniors can keep any pets they've grown attached to, which has been scientifically proven to reduce stress.

3. Those who live at home often have an easier time staying connected with friends and family. There aren't any visiting hours at home and the number of visitors allowed at any one time is not limited.

4. Living at home should help seniors stay healthier, as they won't be subjected to the all the germs that inevitably linger at a place where many people live. Those who are sick can simply be asked not visit until they are feeling better.

5. Home care allows the elderly to avoid the emotional stress of moving to a new place with new people and a new routine. Maintaining continuity leads to psychological wellbeing.

6. Assisted living facilities are costly and the location may be inconvenient, making it difficult for family members to visit. Many seniors have already paid off their mortgage, so moving to a retirement home is an added expense. With few exceptions, home care is a more fiscally responsible choice.

7. Finally, most seniors who live at home are far happier than they would be if they moved into an assisted living facility. The comforts of home are truly invaluable.

There are now many products and services that make living at home both feasible and affordable. Enhanced security systems, emergency panic buttons, and home delivered meals are just a few of the options to choose from. If your elderly family member wants to live at home, honoring that wish is now easier than ever before.

A Step-by-Step Guide to Starting an Assisted Living Business

Because of various reasons, the demand for assisted living facilities has been rapidly growing these days - probably mainly because of the very fact that the baby boomers are now getting close to the retirement age. Most of them have already retired. These facilities provide housing solutions and special need care for the elderly people and those who are physically disabled or have accessible problems. However, unlike nursing homes, these facilities do not provide round-the-clock assistance to their residents. The facilities they provide include a moderate level of assistance in things where the residents need special care. They also offer meals and private living areas for the residents. These facilities are best suited for those who are suffering from the pain of living alone. Following are some of the steps that you need to consider if you are planning to start an assisted living business.

Obtain License
As per the laws of the state, every such facility needs to obtain a license first. Therefore, you can start by applying for the license. The process can be a bit complicated and lengthy, but if you are genuine in your efforts and are well prepared, you should not find much difficulty. You will have to attend interviews with different authorities. Everything that you have mentioned in your application will be inspected thoroughly. In particular, the state will want to make sure that the kind of services you are promising are something that you are capable to provide. You can contact the Chamber of Commerce or the concerned State's department to get detailed information about the requirements to start an assisted living business in your area.

Type Of Facility
The next thing that you have to consider is the type of facility that you want to offer - whether you want to cater to a large number of residents or just a small number of people. You will have to choose the facility building accordingly. If it is a small scale business, you can probably go ahead with a single family home, but if you want to provide services to a large number of people, you will need a multi-story building.

Financing
If you are going to start your assisted living business on a small scale, you can probably go with self financing, but if it is a large project, you will have to look out for other financing options as well. You may like to take a business loan from a bank - for that purpose, you will need to show a very good project to the bank. The idea is to convince the bank that your business is going to be successful one and that you will repay the loan in a timely manner.

You will have to be very careful while choosing your staff members. Make sure that you hire only the certified medical staffs who can effectively handle administrative and operational tasks as well. Once you are through with everything, you will have to do effective marketing of your assisted living business.