A Simple Apron Helps Maintain Elderly Independence

Yes, it is true, as an elder home caregiver you will find yourself scouring the discount stores for aprons for Mom or Dad. Aprons are kind of a non-gender item that both women and men accept wearing as almost a badge of honor. That's why you will become an apron shopaholic to keep Mom or Dad looking spiffy and preserving his or her dignity as well as helping them maintain their independence. It is important for your senior to continue doing as much for him/herself for as long as possible. An elderly person who can still function to feed himself maintains his dignity and will go to great lengths to use good table manners.

The quilted apron solves a lot of problems for the senior. His clothing is covered, even over the knees, so if food cascades down the front, it rolls onto the floor or clings to the apron, not his clothes. The apron saves you; the elder home caregiver, major laundry time and Mom or Dad always looks spiffy. They do not have food stains on their clothes and so they feel good about themselves knowing their clothing is clean. So many elderly people look sad and forlorn just because their clothing is stained. They do not feel good about themselves. Even the elderly want to look their best and when they look good, they are in better spirits. Better spirits means an easier day for the caregiver.

As a caregiver, shop for an apron that is quilted, has a bib, and has a thick density or is laminated. Of course look for manly type aprons for Dad and some cute feminine ones for Mom. I have had the best luck finding the quilted aprons at discount stores for a very reasonable price around $7.00. I have searched online and most websites start around $20 for a simple unquilted apron. An unquilted apron will be better than nothing, but will not be dense enough to catch liquids. Obviously if a glass of water is spilled it will soak through, but a drop of gravy or sauce will remain on the top layer and not soak through to the clothing.

As an elder home caregiver you can join Mom or Dad by wearing an apron while preparing meals, working on hobbies, or doing housework. I know aprons are somewhat old-fashioned by today's living, but you will truly be amazed to see the amount of laundry the apron will save you from doing.

Many nursing homes and rehab centers provide bibs for their elderly charges, but the bibs are very undignified towels that only cover the chest area.

So make wearing an apron a family affair, make it fun, encourage your friends and family to join the "apron club", become a trendsetter.

Verbal Abuse Disguised As A Joke

Abuse disguised as a joke is a form of verbal abuse. This kind of abuse is not done in jest. It cuts to the quick, touches the most sensitive areas, and leaves the abuser with a look of triumph. The abuse never seems funny because it isn't funny.

Example 1:

Jack: "Gee Jill, you're getting fatter every day, ha ha ha!"

Jill: "I didn't think that was funny."

Jack: "You just can't take a joke!"

Example 2:

Jack: "Boy! You watch some stupid movies."

Jill: "I don't like it when you refer to the movies I watch as stupid."

Jack: "You're just trying to start an argument."

Just because your mate responds with anger, do not believe that "you took it wrong." Don't waste your time wondering if there is something wrong with your sense of humor. There isn't anything wrong with your sense of humor or with you. The brainwashing effects of verbal abuse cannot be over-emphasized.

Following are comments which a verbal abuser will describe as a joke:

- You need a keeper!

- Boy! Are you easily entertained!

- What else can you expect from a woman?

- You couldn't find your head if wasn't attached.

An abuser may also startle or frighten his partner, after which he will laugh as if it were a joke.

In order to respond to this form of abuse, it is helpful to know that he has put you down because he thinks doing so will put him up so to speak.

Don't try to explain to him what wasn't funny about the joke. Don't try to explain to him the kinds of jokes that you find humorous. Don't try to explain to him the kinds of jokes that you don't find humorous and would like him not to say to you. Don't ask him what he meant or why he said it. Don't spend time wondering if he understood how it sounded even if he's acting like it sounded funny to him. Don't spend time wondering why you can't laugh at the wit, or lack of wit.

Any time you are put down, disparged, denigrated, or ridiculed, or just don't like what you're hearing try responding emphatically with "Now that you have said that (put me down) (interrupted me) (laughed at me), do you feel more important?"

Then disengage. Leave the room so he can think about it. Don't carry on any discussion. You might say, "I don't want to talk about it." or "I'll get back to you later" if he continues to challenge you.

Independent Living Skills - Essential Skills All Seniors Need to Know

No one likes the thought of getting older. Many people associate aging with the loss of independence. In most cases, elderly people and nursing homes are thoughts that walk hand in hand in one's mind. However, aging does not mean that you must give up your home and your freedom to live by yourself. With the right independent living skills, an aging person can extend the time that they have in the comfort of their own home.

One major skill that is needed to live successfully on your own is self-care. In order to remain independent, a person must be able to take care of bodily needs such as hygiene and using the restroom, including being aware of the need to use the restroom. It is important for at-home seniors to know how to properly and safely bathe.

Another of the very important independent living skills deals with money. It takes money to properly keep a home. A senior must be able to budget finances to accommodate power, water, medical, and grocery needs. He or she should be knowledgeable in keeping a check register and writing checks. It is important for elderly persons living alone to understand their savings, retirement, and social security income.

Home management is another essential element for independent living. These tasks include cooking, cleaning, and laundry. While some hire help for these chores, it is still important that a senior recognize the need for them to be completed. When cooking, it is critical that aging persons be aware of safety precautions to take. They must be careful about remembering to carry out functions such as turning off the stove.

Taking care of health is one of the independent living skills that should not be neglected. Those living by themselves must be able to recognize the need for a doctor's appointment. He or she should be accurate in taking medications. Knowledge of doctor appointments is important. It is also helpful for seniors to be aware of medical insurance issues.

Community skills are important for anyone living on their own. A senior needs to understand the risks involved in dealing with strangers. He or she should be able to appropriately locate help from the community such as firemen and policemen. Knowledge of public transportation should also be on the list.
A senior living on his or her own should have the independent living skills to carry out shopping needs. He or she should be competent to create a shopping list, understand the process of purchasing the needed items, and paying for the items.

Remaining in your own home for as long as possible is a desire of most everyone. The feeling of being able to care for yourself is priceless when it comes to adding happiness and length to your life. Achieving the independent living skills that are needed to successful manage your own home and care for your own needs are the key to maintaining your freedom in your senior years.

Nursing Homes Suicides - They Happen, Or Do They?

You would never think it but there are many people inside of nursing homes who want to die. Yes, you hear correctly. They want to die. And most times, the reason they want to die is because they feel that they have no freedom, no life and no control over their life.

How do I come to this conclusion? Well, peer into any bad rehabilitation and care center or into any bad nursing home and check out the conditions and atmosphere inside there. Look at the people who line the hallways in wheelchairs and look at their faces. Are they smiling? Probably not. Most of the time that people spend inside of bad rehab centers is the time of waiting. Yes. They wait. On most visits to these places, a visitor can see the patients and residents waiting for something. Some wait for their breakfast, while others wait for their medication. Others wait to be taken to the rest room and still others wait to have their diapers changed. Then there are those who just want to go downstairs to the lobby or to another floor and they cannot go without an escort, so they wait for an escort.

And they wait and wait and wait and wait. And one would figure that after working hard their whole lives they would probably want to reach a point where they do not have to be dependent on someone else's time schedule and they probably would want a time in their lives when they could be free to do what they want. But no, not when one resides inside a bad rehabilitation and care center and not when one resides inside of a bad nursing home. (No need for comments, I am not stating that they are all bad; I am writing this article about the bad ones only).

So, during all this process of waiting, some do want to die. Some actually express this in words, like let me die. So there are people inside of these horrible places that wish to die and they feel that will relieve them of the pain that they are experiencing. Yet, nothing is done about this waiting and this pain and this atmosphere. Instead of hiring more workers so that the patients do not have to wait the last years of their lives away, the places hire psychiatrists to find out what the problem is. The problem is the bad places are understaffed or they have staff that is not doing its job.

No mystery, problem solved. So by looking around we see the need for more nurses, more nurses aids, more health care workers and less psychiatrists inside of the bad nursing homes and inside of the bad rehabilitation and care centers. What is actually happening is that the atmosphere and the lack of the proper number of workers is actually making patients depressed. And then some, being depressed wish to die.

This past year, one resident was found on the grounds of a nursing home. The police stated that this was a probable suicide. This resident, according to the news had jumped out of the sixth floor window and thus was killed. To date, no one has heard an update on this probable suicide. And this happened in a nursing home in Staten Island, New York.

Here are some true stories according to the news articles:

Staten Island suicide at nursing home suicide is here : http://www.idph.state.il.us/public/press01/elmhurst.htm

And this one, an added horror - a murder-suicide at another nursing home

This past year, at least ONE resident at a Staten Island nursing home supposedly jumped out of a six floor window. I say supposedly because to this date, there has been no news of whether an official investigation was done or not.

Do you have the updated story? My readers would love to hear it. So message me or leave a note. Thank you. (Be sure to leave your source also).

I created this article on June 1, 2008.

Caregivers: Ten Important Questions to Ask Before a Hospital Discharge

Do you have a loved one, parent, child, friend or even yourself who is about to be discharged from a hospital stay?

Read before you proceed. Ten important questions to ask before you take your loved one home that could be a life saver.

1. What is the Prospective Discharge Date?

When a loved one is admitted to the hospital, the last thing on the mind of a caregiver or family member are concerns about them being discharged. Initially, all of the caregiver's or family's concerns are focused on the present. For example, concerns of what is wrong with the patient, what kinds of treatment the patient will undergo, and whether or not they will be fine are all commonplace during this time. The caregiver and family members of the patient realize that, unless the untimely happens, the patient will be discharged from the hospital at some point. The discharge most likely will happen sooner than expected. Based on today's statistics, the average hospital stay for a non-complicated patient is 1.5 days. Due to Medicare, Medicaid and private insurance regulations, hospitals and institutions are discharging their patients sooner than expected and utilizing other available resources such as rehabilitation centers, assisted living facilities, nursing homes, and course, the patient's family.

Technically, the discharge planning for the patient starts at the time of admission. As soon as a patient is registered into the hospital system, a team is ready to plan the discharge. The caregiver and family of the loved one are part of the discharge planning team that includes the physicians, nurses, social workers, case managers, and all other medical personnel involved in the patient's care. With this information on hand, the caregiver and or family of the patient must understand that they are an important part of the discharge planning team. Therefore, they must be informed, assertive, and proactive to obtain the best possible outcome for their loved one.

2. Who are Your Teammates?

It is imperative that the patient's caregiver or family meet with the discharge planning team, in order to understand their role and what to expect from them. Know them on a first name basis, meet with them, and collect their phone numbers.

a) The Patient

The patient is the most important member of the discharge planning team. It is easy for all those involved with the patient's care, as well as the patient's family, to assume that once a person is lying on a hospital bed all decisions are made by somebody else. However, it will ultimately be the patient, depending on their age and condition, who will make the decision of their care following discharge.

b) All Physicians and Specialists Involved

Keep in mind that the physician that provided care during the patient's hospital stay is not necessarily the one that will continue care after discharge. Today, more and more, hospitals have what is called a Hospitalist. A Hospitalist's involvement with the patient is limited to treatment and care required while in the hospital. Upon discharge, the patient must follow-up with their primary care physician. In other words, after discharge you may not be able to contact the discharging physician or Hospitalist for follow-up orders, refills or consultations. It will be very difficult and frustrating for you to try to contact him or her and ultimately they will refer you to the primary care physician. Obtain all prescriptions and services that the patient needs to continue after discharge. This includes equipment such as a hospital bed, wheelchair, oxygen, supplies, and home care services. Ask for these orders/prescriptions before the patient is discharged. If your loved one received care from any kind of Specialist, make sure that you have their names, specialty, addresses, phone numbers and their office manager's name. Ask if your patient must follow-up with them and make an appointment as soon as possible.

c) Clinical Personnel

This includes nurses, therapists, clinical managers and others involved in the patient's care. As well as the other team members, know them by name and obtain phone numbers where they could be contacted in case of questions or concerns. Learn what their responsibilities are when the patient is admitted and how you could get in contact with them if needed after discharge. Make sure that you get the name and phone number of the Nurse Manager of the unit where your patient was admitted.

d) Case Manager

Every patient admitted in a hospital or institution is assigned a case manager. This person plays a key role in the discharge planning process. Get to know her or him well. This individual is your line to sanity during the first few hours after discharge. The Case Manager is the one that coordinates the whole process. When a strong, positive relation is developed between the patient, caregiver, family, and case manager, the process is usually easier and less stressful for all those involved. The case manager will arrange for the equipment needed after discharge, home care services or hospice, referrals or placement to other health care facilities such as assisted living facilities, nursing homes or rehabilitation centers and transportation if needed.

e) Caregiver and Family Members of the Patient

Another extremely important team member in the discharge planning process, and most of the time the most difficult to coordinate, is the caregiver and family. It is important to identify, without a doubt, exactly who is in charge. Call for a family meeting and designate who will be taking the responsibility of coordinating the patient's care after discharge. Keep clear in mind that the caregiver position cannot be an assumed or imposed one. There are options available to be considered before making this decision. Caregiving - whether at home or outside the home - is one of the most stressful, life disturbing experiences anyone could ever live. I recommend that the person that is considering taking this responsibility take the Caregiver Assessment Test. This will provided some insight of the potential caregiver's strengths and weaknesses before undertaking the task.

3. What are the Patient's Diagnosis or Diagnoses, Prognosis and Life Expectancy?

Be very clear and specific about this. Ask for the specific name of the diagnosis or diagnoses. If unknown or difficult to understand, ask the person providing the information to explain it in simple words or to write it down for you. Research and educate yourself on the matter. The caregiver and/or family must be fully aware on what to expect after the patient is discharged. Ask about prognosis and life expectancy. This will be a difficult subject to deal with. Healthcare professionals sometimes have difficulty dealing with this topic themselves, and could be very evasive about it. The caregiver has the right to know, contingent with privacy regulations, the patient's condition to be able to make the best decision regarding the patient's after care.

4. What are the Best Options for After Discharge Care?

There are as many answers to this question as there are patients, diagnosis and conditions. It all depends on the patient's specific condition, prognosis, life expectancy, age, availability of caregiver and family support system. The options include but are not limited to; the patient's own home, family and friend's homes, nursing home facilities, rehabilitation centers and assisted living facilities. The caregiver or family must make a self-assessment to determine the best options for their loved, as well as themselves. If you, a family member or friend decides to undertake this task, I have created a simple tool that the caregiver could use to determine if care giving at home is an option. Take this simple test before you make any decision.

Talk with the patient's physician, case manager and other members of the discharge planning team, including other family members. Reach out! This will be your salvation once you start this journey of caring for someone at home.

5. What Treatments and Procedures will have to be Continued After Discharge?

Now more and more it happens that patients are being discharged from the hospital in need of continued care such as therapy, treatment or procedures. Even if the patient will receive home care services, usually these services are provided for a limited amount of time and the caregiver is expected to continue to perform them after the services are terminated. From insulin injections, tracheostomy care, colostomy care, wound care or dressing changes and everything in between. Many of these procedures do not require a professional to perform them but the caregiver must be instructed on how to perform them. Educate yourself, observe the healthcare provider performing these procedures while in the hospital, request a one on one, hands on instruction session. Plain and simple, get ready! It is up to the caregiver to get ready for the task. Clinical personnel will not volunteer to instruct the caregiver on certain procedures unless the caregiver demonstrates an interest in learning or it is specifically ordered by the physician.

6. Will My Patient Continue the Same Medications and Treatments Before They Were Admitted?

I wanted to list this question as a serious issue that needs to be addressed independently. In my experience as a nurse and caregiver, medication non-compliance is one of the most frequent reasons for the patient to be readmitted to the hospital. Most of the time, the patient and/or caregiver assume that a medication or medications are to be continued or discontinued without understanding the consequences. It is standard practice that when a patient is admitted into the hospital all of the medications that are taken at home are reconciled. The same procedure applies at discharge time. Make sure that a list of medications taken at home is brought in upon admission of the patient or shortly after. At the time of discharge, request to speak with the clinician in charge of your patient's care. Go over each one of the medications in the patient medication profile. Ask for indications, dosages, frequency and route as well as possible side effects and or allergic reactions. If a new medication has been indicated during the hospital stay, ask if it is to be continued after discharge. Be certain to request prescriptions for all those new medications. You do not want to find yourself in the situation of needing a medication, not having a prescription from discharge and it is a holiday. Good luck!

7. What are Possible Signs and Symptoms I should be Aware of?

It is here where the absolute understanding of the patient's diagnosis and prognosis comes into play. Signs, symptoms and actions to take depend on the patient's condition and vary with them. Request a conference with all those involved in the patient's care i.e. physicians, specialists, clinical personnel, and case manager or social worker. Ask all the questions that you think are pertinent to your patient's condition and prognosis. The ideal situation will be that the conference is held with all participants at once; however, most likely that will not be the situation. One thing is certain; you must have a face-to-face conversation with all the disciplines mentioned if you want to survive the first 24 hours after discharge. Get educated, be assertive and proactive, request, demand and expect. Most hospital personnel welcome the caregiver interested on a fast recovery or the best outcome possible of their loved one, but in today's fast environment the caregiver should assume a very assertive position.

8. Who is Responsible for the Patient's Financial Obligations?

This should be asked right up front. Do not assume that the caregiver is responsible for this obligation. Have an honest talk with the patient, if possible, on how he or she plans to meet their financial obligation with the hospital or institution. Request an appointment with the office of financial affairs at the hospital or institution to discuss the patient's bill status. Familiarize yourself with all medical insurance policies that the patient might have. Bring with you all of the identification cards, copies of insurance policies including any supplemental health insurance policies. Request an itemized bill. Obtain the name and phone number of the person you are dealing with. You will need to call back regarding this issue and you need a person that knows you. This will prevent the aggravation of having to tell your story to several people repeatedly.

9. What do I do During the Days Just Before Discharge?

The panic is overtaking you. Reality is sinking in. Your loved one is coming home tomorrow. You have accepted the responsibility of taking care of him or her at home. Welcome to the club. There are millions of members in this club. Hopefully, you took the Caregiver Assessment Tool Test before you assumed this responsibility.

Today you will collect the patient's belongings that will not be needed for the rest of the hospital stay. Make sure you go over every item that was brought with the patient at the time of admission. This includes eyeglasses, dentures, any equipment such as wheelchairs or walkers. If possible, ask the patient if there is anything else that was brought in that you are not aware of. If anything is missing, this is the time to speak with the personnel that took care of the patient and start a search. Do not wait until the day of discharge.

Make sure that before discharge, care is already coordinated and in place. This is equipment, supplies and services such as home care. Contact the home care agency that is supposed to service your loved one and inform them of the prospective discharge date. Get a contact person's name and phone number. Contact the case manager and inform him or her of any discrepancies in the coordination of services.

10. Today is the Day, What do I do?

Today is the day. Discharge day. Emotions are running high. Make sure that you are available at the time of discharge. It is imperative that you are there during this process. On this day, you will take last inventory of the patient's belongings. Get prescriptions from the hospitalist. Talk with the nurse that is in charge of the patient's care and request all medications that remained unused. Ensure these medications are on the list of medications that the patient is supposed to continue after discharge, as well as all supplies. These medications and supplies were already charged to the patient. Request a last-minute conference with the hospitalist to be clear on instructions that were already discussed. Clarify any doubts and ask questions. Avoid the feeling that you are taking their time or interfering with their schedule. They are there for you and your patient. Now, it is time to go home.

Welcome aboard.

The journey has begun.

Choosing the Best Nursing Facility For Your Loved One

There are three basic steps you must take in order to find the best nursing facility for your loved one. First, you must create a list of nursing facilities that you are interested in. You may choose to do this by asking friends and family for recommendations, talking to your doctor, or by researching facilities in your area. Next, you'll begin comparing the nursing facilities on your list. Some of these options will likely drop off the list as you delve deeper into your research. Finally, when you have a shortlist of nursing facilities that you are most interested in, arrange a visit to each one to help you make your final determination.

Nursing Home Compare

Nursing Home Compare is an online tool that helps you find and compare nursing facilities. It has a comprehensive database of all Medicare- and Medicaid-certified nursing homes in the U.S. You can search by name (if someone you know gave you a personal recommendation, for example) or geographic location.

Nursing Home Compare also enables you to compare the quality of individual nursing facilities. The tool details: how each nursing home scored on its most recent health inspection; nursing home staffing data; quality measures; and fire safety inspection results. Regular nursing facility inspections measure how a facility scores across many different areas, including nursing care. Understanding the inspection results can be confusing if you are not familiar with how nursing facility operate.

When a nursing facility does not meet one of the more than 150 regulatory standards set forth by Congress, the inspection team issues a deficiency citation. These regulations cover extensive ground ranging from food safety, to fire safety to nursing care practices. Deficiencies are not all equal. They are measured in terms of scope and severity-that is, how many residents were affected, and how great the harm was on a scale of one to four. Keep in mind that most nursing facilities receive deficiencies from time to time-the important things to know are whether the deficiency was egregious, causing harm or the potential for harm to residents, and how responsive the facility was in correcting the problem.

Medicare's 5-Star Quality Rating System

In 2008, in response to complaints that Nursing Home Compare was too technical for most consumers, Medicare instituted the 5-Star Quality Rating System to provide an "at-a-glance" feature designed to make the inspection results easier for consumers to understand. However, critics of the 5-Star Rating System say that it leans too far in the opposite direction, oversimplifying the nuanced inspection results. Here is how it works. On a scale of one to five, Medicare assigns stars to represent the facility's score across each category of inspection results. Sometimes the star ratings can be deceiving, as some deficiencies are minor and pose no risk to residents. Nevertheless, any deficiency can affect the facility's overall star ratings. So when you use Nursing Home Compare, be sure to read the entire inspection results for the nursing homes on your shortlist.

Visiting the Nursing Home & Making Your Decision

Your initial research will answer a lot of questions and help you narrow your nursing facility search significantly. However, it is imperative that you visit these facilities in person before making your decision. Visiting in person will answer a lot of questions, too. But before you go, make sure you know what to look for. Read Checklist for Visiting a Senior Care Home and Long-Term Care Facilities: How to Choose the Right One for more information.

If you are able to whittle your list down to a few choices and are still having trouble making a decision, it's not necessarily a bad thing. You might choose to make a list of pros and cons for each remaining option to move your decision forward. Talk to people whom you trust, such as family, friends, or your doctor, about your choices. Your local long-term care ombudsman is another great source for information on local nursing facilities.

CNA Certification Classes and Benefits

Nowadays, people opt for careers that do not only provide emotional fulfillment but also financial security. And among the jobs that meet these requirements is a career as a Certified Nursing Assistant (CNA). In fact, there is currently a huge demand for CNAs in major cities in the United States, such as New York, Houston, Philadelphia, Chicago, Los Angeles, Baltimore, Boston, and St. Louis. What's more, according to the United States Department of Health and Human Services, this demand is expected to increase by 40% over the next 20 years. CNAs are expected to earn almost $30,000 per year, depending on experience, location, etc.

CNAs, as their name implies, provides support to nurses in providing basic patient care. Other functions of a CNA include maintaining medical equipment, checking patient's vital signs, providing both social and emotional support to patients and their families, stocking supplies which are used by nurses, helping patients move around and/or exercise, recording patient's progress, charting body functions, performing emergency procedures, etc. They are also known in the following titles: geriatric aides, unlicensed assistive personnel, orderlies, or hospital attendants.A career as a CNA can also serve as a stepping stone to bigger careers, like becoming a Registered Nurse (RN) or a Licensed Practical Nurse (LPN).

Also, CNAs get to work not only in hospitals but also in other settings, such as nursing care facilities, community care facilities for the elderly, home health agencies, assisted living facilities, hospice nursing, sub-acute care facilities, doctor's offices, etc.

The good thing about becoming a CNA is that it does not require a college degree. Minimum requirements consist of only a high school diploma or a General Equivalency Diploma (GED), a clean criminal record, fluency in English, plus the completion of a CNA certification program, which usually takes 6 to 12 weeks or up to 120 hours in total.

Conducted by either Registered Nurses or Licensed Practical Nurses in community colleges or medical facilities, CNA certification classes involve topics like basic nursing skills, infection control, proper body mechanics, nutrition, anatomy, and physiology. Aside from this, it is mandatory that you also acquire a 75-hour clinical training. The American Red Cross also offers CNA courses, which are at much lower costs (and sometimes free) compared to those offered in community colleges, which usually cost $300 to $2,000, depending on the region. Other facilities that offer free CNA training courses are senior homes and state nurse aid training. These courses are also available online.

After completing the CNA training, you will need to take a state certification exam, admitted by your State's Board of Nursing. Upon passing the exam, your name will now be included in the registry of nursing aides, wherein you will already be allowed to perform CNA duties.