The Future of Healthcare for Seniors

Now that the so-called "age wave" has begun crashing on society's shores we are all re-examining the implications this demographic shift will have on the provision of healthcare, particularly with respect to senior citizens. Given that public healthcare in more and more jurisdictions is beginning to hit a wall that no amount of funding will breach, it is incumbent on us to come up with alternatives to public healthcare in the provision of long-term care for seniors.

It is clear that long-term care for seniors is not a real priority to most governments, given the resources that are allocated to this sector versus, say, resources allocated to prisons. For instance, in the province of Ontario, government-subsidization of care for seniors in long term care facilities appears to be a mere afterthought. The province recently raised the daily food subsidy for seniors from $7.15 to $7.31 per day. This amount is intended to cover breakfast, lunch, dinner, snacks and all beverages for the residents of such facilities. By comparison, the food allowance for a prisoner at an Ontario penitentiary is currently more than double that. In addition, the province has managed to find money to pay drug-addicted inmates to attend rehabilitation sessions.

The number of seniors in society is increasing dramatically for two reasons. The first is that baby-boomers, which comprise the largest single demographic in our society, are beginning to reach their 60s. Gradually, this demographic will account for close to 50% of the entire population within the next two decades. In addition, improvements in healthcare and the choice of a healthier lifestyle will ensure that people live longer. The average age of residents in most long-term care facilities right now is at about 87. Given the above advances in healthcare and lifestyle, there is little doubt that this average will increase by a good 10 years, if not more.

So what are the alternatives? There really isn't an easy answer to this question, as the thinking behind the policies that have created this dilemma really hasn't changed over the past decades, nor does it appear too many policy makers are even aware that there is a looming problem. But let's say that meaningful solutions will be found when we view the problem through a different paradigm. Jim Scott, the visionary developer of Serenity Care for Seniors, Inc. has looked at the problem through a different paradigm and devised an elegant solution with the concept of foster care for seniors. I met and wrote about Jim back in the fall of 2008, as I was greatly impressed by his concept.

Other concepts could include family cooperatives that work in association with government agencies to provide long-term care for small groups of seniors living in regular homes. The idea being that family members of the residents as well as individuals within the community volunteer on a rotating basis to care for the aged residents. The up side of such a plan would be that seniors would not be stigmatized with having to be institutionalized and would enjoy a higher level of care than that provided in a long term care facility. The down side, of course would be increased cost and a limitation of access to qualified nursing staff. But even that down side isn't insurmountable as most jurisdictions have a community care organization already in place to provide some level of care to those in need.

I believe that the best solution doesn't necessarily entail any one answer, but a melding of a number of different concepts. It's clear to me that larger and ever more extensive nursing homes are not the answer, given that these tend to breed blind and unbending bureaucracies exacerbated by employees that fall under the auspices of public sector unions. That's why long-term care has become so prohibitively expensive over the past decades and has yielded less than stellar outcomes.

If we are going to meet the challenges this demographic shift will pose, it's important that we look beyond what we currently know and explore options that focus on the health and wellness of those being served, rather than looking for the most expedient way to make the problem go away.

An Overview on LPN to BSN Program

If you are working as a licensed practical nurse (LPN) or licensed vocational nurse (LVN), it is a very natural progression to move from LPN or LVN to registered nurse (RN). Today if we carefully look at the present scenario, turning from LPN to RN is considered as the next and major step in nursing career. No doubt, licensed practical nurse is an excellent starting point for you in the nursing profession, but on the other hand, advancement and income prospects significantly gets enhanced by becoming a registered nurse, which actually requires a bachelor's degree. Attaining a BSN degree can offer numerous nursing opportunities for you such as Nurse Practitioner, CRNA, Nurse Administrator, and many more. So, whether your aim is to boost your salary, increase your role and responsibilities as a nurse, or both, getting a BSN degree can help you achieve these goals.

Today there are many leading nursing schools in the United States offering special online LPN to BSN programs. (cont) The best advantage of this degree program is that it can help you as a student to learn more about nursing professional foundations and other important elements of nursing like nursing competency coursework, nursing research coursework with informatics, nursing situation analysis, leadership and resource management courses as well as additional study. This degree program is the next step to earn a new level of competency. It offers quick completion of BSN along with RN training in short duration.

Apart from all this, the key benefits of selecting LPN to BSN program is this degree program typically takes 2-3 years to finish in contrast to the four years of a usual bachelor's degree in a nursing program. Adding to this, once you complete the program, you also become entitled to appear for the (NCLEX-RN) National Council Licensure Examination. It prepares you for licensure exams and requirements that are specific to the state that they generally practice. Moreover, as you are already LPN, you get the benefit of course credit for your LPN training, which in turn help you complete the program more easily. You may do not require taking same nursing courses, which might cover material that you already know.

In terms of curriculum, generally the LPN to BSN program includes topics in direct patient care, legal and ethical issues in treating patients, subjects in relation to record keeping and data collection in health care settings, clinical and patient management. Apart from this, the course even lets you earn specializations in different fields such as surgical, clinical and organizational administration, inventory management of medicines along with different topics related to hospital and health care structure and organization. This can be very beneficial for you as a nurse to learn about the latest in technology used in hospitals and health care facilities. Today it is one of the few programs that introduce you to the practical and theoretical facets of nursing and prepare you in making effective decisions usually required in the registered nursing.

Benefits of Cherokee Nursing Scrubs

One of the leading nursing scrub manufacturers is Cherokee. Though there are other fine medical uniform suppliers including Dickies and Skechers, Cherokee is widely regarded as the most comfortable and stylish of all the brands available. Started in 1972, Cherokee has devoted its business to the healthcare industry and designs stylish and practical nursing uniforms for men and women that offer the comfort and flexibility they need to do their jobs effectively. While many scrub uniforms can offer fashionable designs, not everyone has the special fabrics and unique designs that allow nurses and healthcare professionals to move about freely and comfortably throughout their shifts.

Consider the Cherokee fold over waist pant. Unlike other nursing scrubs that have drawstrings that can be a pain to keep tied or may come undone at inopportune moments, the Cherokee waist pant features a soft and stretch contract knit that enfolds the waistband. With this feature you can fold down the waist to any position that's comfortable and the center back waist tack will keep it in place. These nursing uniform pants also include a handy cargo pocket with convenient flap that lets nurses carry important instruments such as scalpels, pen flashlights and medications.

In addition to the wide range of nursing pants, Cherokee also offers a wide variety of nursing tops including mock wrap tunics and v-neck, square neck and split neck tops to provide nurses with the breathable fabrics and flexible designs they need to perform multiple functions. For nurses who are very active during their shifts, the Cherokee split neck crossover top has two patch pockets and an additional contract angled pocket for plenty of space to hold medical instruments, medications, phones and other necessary nursing tools. With a center back elastic, stitching detail and side vents this nursing top is sporty, flexible and capable of holding up under intense pressure.

Cherokee nursing scrubs also benefit from having an amazing selection of colors, designs and patterns that can match the fashion taste of all nurses. These scrubs also come at a very affordable price so nurses who are on a budget while they finish a residency or start a full-time job while paying back school loans can outfit their entire nursing wardrobe without going further into debt. The flexibility and fashion choices of the Cherokee brand of medical uniforms and nursing scrubs make their selection one of the most popular for nurses in hospitals, assisted living centers, healthcare management facilities and other medical offices.

Assisted Living Options Available to Seniors

For those that are unable to totally care for themselves in their own homes, there are assisted living options available to provide the care that they need. It can be very difficult for some to adjust to not being able to live alone. Due to baby-boomers retiring and getting old in age, senior care facilities are popping up everywhere.

The assisted living options that are available at these facilities include cooking, cleaning, shopping and assistance with other daily activities. They can also provide supervision ans administration of medicines for those that required it. Some even offer medical support that is on standby 24/7.

Facilities that offer assisted living options understand that most elder people have a hard time adjusting to having to depend on others for help with their daily tasks. They try their best to promote independence to their residents and help them as much as possible in the areas that they need help.

There are many, many different types of senior care facilities and visiting all of them that are in your area can be a daunting task. It is best to have someone that specializes in the research of these facilities to give you a helping hand. The will give you a list of the facilities along with the options that each offers.

By law, each facility has to be licensed and everyone caring for patients has to be certified to do so. Some assisted living facilities are like retirement communities. Some may do better than others at catering to individuals and make them feel comfortable and at home.

Elder Abuse - Role of Victims and The Government

This is the second part of a series of four articles on Elder Abuse: Role of Civil Society and Government. We saw earlier an overview of Elder Abuse and various parties associated with it. We shall now talk about the victims per se and what they can do. Role of State and Central Government is also discussed briefly.

Victims of Elder Abuse - What they can do

Senior citizens should empower themselves with facts, information and data required to face and tackle abuse. They should have phone numbers and addresses of lawyers, doctors, police, pressure groups, counseling centers and the like. Ignorance of rights and the law in particular is harmful and places the senior citizen in a vulnerable position. Senior citizens should join several associations and peer groups like walkers clubs, prayer groups, Day Care Centers etc. When abuse occurs they should openly discuss it with others without feeling shy or ashamed. Senior Citizens must make themselves financially sound and independent.

They should never give away their property to their wards or disclose all their assets to everyone. Where feasible they should not hesitate to take Reverse Mortgage Loan and ensure a steady flow on income. Taking recourse to legal provisions should be the last resort. Having anger alone or standing on one's prestige alone is not enough. Civil Suits take years to get decided and lot of time & time are wasted.

Pointers to the State and Central Governments:

Central Government: Present MWPSCA 2007 does not talk about softer issues of Elder Abuse. Provisions must be made in this to render it a comprehensive piece of legislation. Presently it is an act to tell the World Bodies like the UN: "Look Here, We also have a law on Senior Citizens". The subject of Elder Abuse relates more to HRD (Human Rights protection) and MOSJE should liaise with HRD and promote meaningful program to handle EA issues. Standards for OAH should cover EA prevention and reporting also.

State governments must adopt the Central law. Rules framed there under must include EA in Old Age Homes, Nursing Homes, Senior Facilities or Assisted living centers or Hospices. Tribunals set up under the MWPSCA need to liaise with SCAs or Resident Welfare Associations for solving EA cases.

The Basics Of Nursing Entrepreneurship

Those certified nurses who are enthusiastic about pushing forward with some nursing entrepreneurship ideas will likely have a lot to be excited about. Because nurses have been through rigorous academic training and have assuredly earned their degrees, they will have much to offer the world. By setting up their own businesses, they can strike out independently and, in a sense, be their own bosses. Most nurses who try this should at least pick up some basics in business management so they know how to go about the process. They will also need to begin finding clients, which can be done rather easily with some tips and guidelines.

There are several ways in which nurses can use their skills to help patients. First off, they may very well find that some men and women have just recently arrived back from the hospital and need some sort of at-home care. Men and women can provide this kind of care, sometimes around the clock. If they will be caring for younger children, then they will need to have a formal discussion with the parents so that everyone knows what to expect out of the situation. If the young patients are not in immediate medical danger, then this might be the perfect nursing job.

Likewise, some senior citizens may have an acute illness but may wish to stay in their own homes. To avoid going to a nursing home or some other similarly themed retirement community, they will need nursing help. Some people may wish to build their nursing businesses on patients who are in this type of situation. If nurses can develop an outstanding reputation within the community, then they may make quite rapid progress in bringing new patients on board. Keeping files on the special needs of each particular patient is a good idea.

Some of the best nurses may go on to establish their own agencies after they graduate from school. Those who exhibit managerial skills may eventually find themselves overseeing a whole network of nurses. These nurses will be sent to the houses of different clients in the name of the agency. Assuming that excellent care is given, the agency will only continue to build itself up through the months and years. Some agencies will be in the business of making money while others will be non-profit in nature. There are advantages to each of these setups.

Developing skills in a broad array of areas will best prepare nurses to go into business for themselves. They will have to be eminently familiar with biology, anatomy, physiology, and a range of other sciences. It may even be best if nurses have a particular area of specialization that they can tout. Nurses will also have to be excellent communicators. Because they are often liaisons between patients and doctors, they will often be on call and may work long shifts. An attention to detail, especially on non-routine medical tasks, is also a must.

In short, when researching nursing entrepreneurship, men and women will have to take a number of things into consideration. As long as they set clear goals and have a plan for reaching those goals, they should be setting themselves up for success. As they begin to become more familiar with being self-employed, they should develop a method of completing tasks efficiently.

Copyright (c) 2012 Nurse Entrepreneur Network

How to Find the Best Nursing Home

Even at a well-known, fully licensed nursing home, there is the possibility of abuse or neglect. That is why you need to make sure that a facility will provide your loved one with quality care.

Touring a facility is only the first step, because a scheduled visit is unlikely to reveal everything that is happening beneath the surface or when no one is visiting. Certainly, your goal is to assure quality care for your loved one, as well as peace of mind for your family. To accomplish this, it's helpful for you to take the following steps before selecting a nursing home:

• Talk with other residents at the nursing home that you are considering. You can simply walk the corridors of the facility, and speak with residents, including those who are bedridden.



• In addition, your own physical observations are extremely important. Do the residents appear well groomed? Do any of them have visible wounds or sores? How is their oral care? If you find several residents who seem confused and disoriented, you may be witnessing signs of neglect.



• Federal regulations require that all nursing homes have the latest state survey of the facility readily available for review. Ask the management for this survey, read it carefully, and ask questions. Be on the lookout for signs of any problems with basic care.



• Ask questions about the staff at the facility. What is the size of the staff during the different hours of the day and night? How many staff members are nurses? How many are nursing assistants? Are there social workers and clergy on the staff? Consider how the staffing of that facility compares to other nursing homes with a similar number of patients.



• Speak with the relatives of other residents at the facility. Have they observed any problems? Do they have any issues with the management or staff at the facility? You may wish to find out whether any of the residents' families use of web cameras (sometimes called "granny cams"). Although this cyber visitation is a new practice, some families who cannot visit their loved ones every day are placing special internet cameras in relatives' rooms to allow them to see what is happening at any time. If you see a "granny cam" at a facility, ask to speak with the family of that resident, to learn what they have observed. If possible, inquire if the facility would mind if you used this kind of device.



• When walking the halls of the facility, use your senses. One of the most effective methods of inspecting a facility may be your sense of smell. A nursing home should not smell of urine or feces. If it does smell, residents may not be receiving adequate toileting care. Often, this basic care is essential to preventing life-threatening illnesses, like urinary tract infections or bedsores.



• Watch as residents are being fed. Do many residents look underweight? How much of the food are they eating? Is staff helping residents who have problems feeding themselves? Do the aides who assist with the food seem overwhelmed? Are the aides spending enough time working with each resident during mealtime?



• If at all possible, visit the potential nursing home more that once and plan your visits at different times of the day and week. If you can only visit the nursing home once, go at night or on a weekend afternoon. Staff levels may be lowest during these "off" times.



• Is water easily available to all residents at the facility? If some residents are incapable of helping themselves to a drink, is staff offering assistance at regular intervals?



• When you attempt to look at the facility, are you deliberately steered to certain rooms or residents? If you feel that you are being denied full access to the facility, you should find out if there is a good reason.



• Ask to meet all of the key executive personnel at the facility. Speak with the administrative head, the medical staff administrator, and the nursing staff administrator. Ask how often physicians actually examine residents. Find out about the facility's staff turnover rate, including the average length of employment for nursing assistants and other primary caregivers.

Nursing Home Evaluation Checklist

You should be alert whenever you visit your loved one's nursing home. The following are questions to ask yourself during each visit:

• Do you notice signs that your loved one is suffering from dehydration (lack of water) or malnutrition (lack of food)?


• Have you noticed the resident is less active or less able to move about?


• Have you noticed emotional changes, mood swings, withdrawal, anxiety, or other fears?


• Are residents dressed appropriately for the season and time of day?


• Are the resident's living quarters clean?


• Are the resident's medical conditions being treated in a timely manner?


• Does the resident seem to suffer from chronic viruses and/or infections?


• Are all medications administered in a timely and appropriate fashion?


• Has the nursing home staff delayed reporting an injury or incident to a doctor or to the resident's family or guardian?


• Has the resident suffered frequent falls or broken bones?


• Does there seem to be adequate staff and supervision?


• Are the caregivers ignoring the resident or describing him or her as a burden?


• Does any caregiver react defensively to routine questions about the resident's care?

Nursing homes must provide good nutrition and hydration to residents. Poor diet and lack of water are among the most common forms of nursing home abuse and neglect. Some of the health problems associated with malnutrition and/or dehydration include:

• Increased risk of infections


• Confusion


• Muscle weakness (possible immobility and increased risk of falls)


• Pressure ulcers or bedsores


• Pneumonia


• Increased risk of becoming ill from exposure to bacteria or viruses

The Importance of Proper Nutrition and Hydration

Nursing homes should conduct regular nutritional assessments and provide residents with well-balanced, palatable meals. When you consider a nursing home for a loved one, you may wish to ask to sample a random meal at the facility. Also, ask to speak to the staff dietitian about the factors they use to develop meal plans for the facility. The following is a list of reasons why an individual may suffer from malnutrition and/or dehydration:

Personal causes of malnutrition:

• Illness


• Adverse drug effects such as nausea, vomiting, diarrhea, cognitive disturbances, or sleepiness


• Food and drug interactions that decrease the ability of the body to absorb vitamins and minerals


• Depression


• Swallowing disorders


• Mouth problems such as tooth loss, dentures that do not fit properly, mouth sores, and mouth pain


• Tremors or shakiness, which affect residents' ability to feed themselves

Environmental causes of malnutrition:

• Inadequate staff attention for residents who need help to eat


• Staff who lack training about malnutrition and the proper ways to feed residents who need help


• Reliance on liquid supplements


• Special diets

Signs that a resident is malnourished:

• Clothes fitting more loosely than usual


• Cracks around the mouth


• Pale looking lips or mouth


• Dentures that no longer fit


• Hair thinning or getting sparser


• Wounds that take longer to heal


• Confusion (which is unusual for that individual)


• Skin breaking down


• Sunken eyes


• Weight loss

The following questions may help you pinpoint the reason for a particular person's problems with nutrition or hydration:

• Can the resident feed him/herself?


• What is the resident's favorite meal of the day


• When and where does the resident prefer to have meals serve


• Does it take a long time for the resident to eat?


• Is the resident rushed through meals?


• Is the resident unable to finish meals?


• Does the resident seem to eat more when someone is there to help with the meal?


• Does the resident seem uninterested in food?


• Has the resident lost his/her appetite?


• Does the resident like the food at the facility?


• Can the resident choose from a menu?


• Are snacks readily available to the resident?


• Is the resident on a special diet?


• Has the resident started taking any new medications?


• Is the resident's weight monitored on a regular basis?


• Has the staff informed family members of weight loss?


• Has staff asked family members for assistance?