Choosing Care

Diagnoses: Getting a second opinion online

gokrex80 — Wed, 11 Nov 2009 10:07:50 GMT

Diagnoses: Getting a second opinion online

Past CNN articles address the subject of getting a second opinion online. Links can be found at
http://www.cellnetweb.com/SecondOpinion.htm

Article: A Place For Aunt Annie

Admin — Mon, 11 Feb 2008 00:56:38 GMT

A Place For Aunt Annie

For a lucky few, there was an adult—other than Mom and Dad—who made their childhood special. Perhaps it was a beloved teacher, or a grandparent, or an extended family member. But for Diane Ricciotti, her Aunt Anna Williams was that person. “It was always special when I got to spend time with Aunt Annie,” says Diane of her mother’s sister, who had no children of her own. “As a child, I would visit her on weekends sometimes, and we always had so much fun.”

This article continues at Elder Care Referral

Caregiver Practices - Recognizing Quality

GertrudeCNA — Wed, 26 Aug 2009 14:44:45 GMT

The Wisconsin technical colleges have a series of 80 training videos online (Lessons 1 - 80) that can be useful for caregivers. [http://deptets.fvtc.edu/nursing/ ]The series is geared towards training aides in hospitals and the like, but the techniques and precautions apply to home care as well.

These are classroom-type lessons, so the style might be a bit tedious for casual viewers. Even so, the lessons are organized well, and you can pick your subjects.

Several of the video lessons can be especially informative for those who have loved ones in care facilities. So often, I am discouraged by the actual practices in nursing homes or even hosptals that seem wonderful to the casual observer. They remind me of a friendly, personable mechanic who shouldn't be touching your car.

I'm not alone in this. This month's Consumer Report magazine includes a survey of patients in hospitals, and of nurses in those same hospitals. The survey highlighted the differences between what patients were concerned about - with the care level, facility, and all - compared to what their nurses thought they should have been concerned about. The nurses considered the lack of coordination among the providers (communication) and deficiencies in hand-washing discipline to be the two most significant things that the patients should have been worried about. Very few of the patients picked up on these, especially the hand-washing.

All this leads to a seemingly simple video topic - Lesson 22 Bed Making. [http://deptets.fvtc.edu/nursing/l22_Bedmaking.WMV] If you watch the video, at least the first half, you can't help but notice the emphasis on sanitary practices necessary for even this ordinary task. Next time you are in a hospital or long term care facility, observe the bed making. Watch the details. This is one, just one, small indication of the quality of care and attention to safe practices in the facility.

I'm impressed when I see tasks like this being done to proper standards. You should be, too. If you see that the staff attends to every detail, as these lessons will explain, compliment them and their supervisor. If you see short-cuts, however, be concerned. Friendly faces (at least in your presence) don't make up for lack of good practices.

Again, the Bed Making procedures are just an example. All the procedures laid out are important, of course. A carpenter friend once said that his boss had job applicants make a quick set of saw horses in the interview. The boss could tell all he needed to know from that. Bed making is something like that. Watch the video, and you'll see what I mean.

Gertrude

http://eldercarenotebook.blogspot.com/

Home Visits

Barbara Drum — Wed, 19 Aug 2009 23:55:20 GMT

You don't have to live with us in order for us to help. The Court at South Park an Emeritus Assisted Living for Memory Care Community in Charlotte NC, is offering a complimentary new service for seniors with Alzheimer's or dementia in our area. To help releive some stress, Emeritus offers a complimentary home visit. Wheather it's a listening ear, a safety check, a follow-up to hospitalization or just an enjoyable visit, we're here to help you and your loved one. Making home a little more comfortable. Our Family is Committed to Yours. Call today to learn more about our Home Visits program! (704)553-8700 website: www.emeritus.com email: courtatsouthpark-CRD@emeritus.com

Ventilator units

Randall H. Settle — Tue, 14 Jul 2009 21:36:06 GMT

How would I best go about finding a nursing home that provided Ventilator care for my mother?

Private Caregivers - Considerations

GertrudeCNA — Thu, 13 Aug 2009 09:25:03 GMT

Fortunately, with developments in licensing, insurance, and internet and related technology, identifying and researching qualified private caregivers isn't as daunting as it once might have been.

Licensing. Exams for CNA's have become standardized across many states. State licensing also includes law enforcement checks, including FBI checks as appropriate, and most states maintain databases of licensees that include any disciplinary information. Licensing also includes continuing education (CE) requirements, similar to other professions.

Consider using a licensed CNA. Ask for the caregiver's license number, and check it out with your state's Department of Health, either on-line or by phone.

Insurance. Professional liability insurance is now available for individual caregivers. It's affordable, provided of course that the caregiver is a good risk. Check that the person you engage has a professional liability policy.

If your favorite caregiver doesn't have a policy, you might suggest that they obtain one. Also, you might verify that any caregiver you obtain through an agency is individually qualified to obtain professional liability insurance (and not just that the agency is covered). It's another indication of quality.

Self-employed contractor. Much has been made about 'employer status' risk. To stay clear of problems, use a licensed professional who offers services to the general public.

As to work-place requirements, to quote the IRS: "the general rule is that an individual is an independent contractor if (the person for whom the services are performed) has the right to control or direct only the result of the work, and not what will be done and how it will be done or method of accomplishing the result." Again, the caution is to use a licensed professional who has the necessary training and experience to do the job - not someone you need to train and direct yourself.

Internet technology. Most states have on-line databases of licensed professionals, which provide the licensee's status. For those that want a more current background check than provided by the state licensing board, there are numerous on-line services. These typically charge nominal search fees.

Those providing long-distance care for their loved ones remotely through caregivers might consider a video camera - only if used appropriately, of course.

One of my clients had a motion-sensor video security system installed in the foyer. If desired, comings and goings could be monitored, spot-checked, or even communicated by email The security service cost was quite reasonable. The added advantage of that system was that, combined with cell-phones, it could be an entertaining form of communication. Of course this is only appropriate if used with discretion - not obsession. Everyone involved needs to have good sense, and preferably a sense of humor.

Affiliations. If you are planning to use a CNA extensively, check that she has back-up resources available. Many independent CNA's have good networks, especially those with prior hospital or other institutional experience. For example, I sometimes use a former hospital co-worker as a substitute, after advance introductions to, and clearance from, the client. Some private caregivers have close affiliations with RN's. This can be especially helpful in complex cases.

Long Term Care insurance eligibility. Licensed caregivers are eligible providers under many LTC policies.Check with you agent or refer to your policy. You may be able to get more 'bang for your buck' hiring directly.

Financial & Quality advantage. By engaging a caregiver directly you can sometimes get professionals of caliber that you might not have access to through an agency, and at significantly lower cost.

For example, in South Florida, a caregiver through an agency might cost $17 to $20 per hour. That caregiver typically would be making $9 to $10 per hour. Although you may be paying top dollar, you are getting a $9 or $10 an hour person for the money. A private caregiver with the certifications and insurance discussed above will often gladly work for $15 per hour, and sometimes less (especially for long-hour schedules).

There's a similar range with live-ins. A 24/7 live-in is typically about $200/day through an agency. That agency caregiver is likely making $110 per day. A well-qualified licensed and insured private caregiver would be somewhere between those rates. The point again is that you can get high quality care with the better pay, and it can cost less.

The result. For short-term needs (including Medicare reimbursement situations), or in transitional situations, obtaining caregivers through agencies makes perfect sense. For longer-term situations, the key relationship is between caregiver herself and the care recipient. You can often get a more highly qualified individual, at more reasonable cost, directly than through other channels. With the developments in licensing, professional insurance availability, and technologies, private hiring is a more viable - and reassurring and affordable - option than ever before.

Gertrude

http://eldercarenotebook.blogspot.com/

how does live in care work?

kashmirsrider — Wed, 29 Oct 2008 15:18:03 GMT

My family is trying to determine if a live in is an option for our parents. My mother has dementia, and at the moment we have 3 caregivers doing shifts, but the cost is too great. What kind of additional coverage would be needed? Right now, the family is covering 8 am to 8 pm Saturday and Sunday, and this is a strain. How many hours per week would a live-in have off? How many hours in a 24 hour period? Do live-ins typically get vacation?

In home care

care giving mom x3 — Wed, 08 Jul 2009 16:48:25 GMT

I'll tell you a life saver for me is Comfort Keepers they are so good I would recomend them to any one!!!

Choosing a Nurse Call System For Your Senior Living Facility - Basic to Advanced

JDondero — Tue, 07 Jul 2009 15:50:07 GMT

By [http://ezinearticles.com/?expert=John_Dondero]John Dondero

There are approximately 16,000 Nursing homes or Skilled Nursing Facilities (SNF'S) and over 33,000 Assisted Living Communities (ALC's) in the United States today. The number of Independent Living Communities (IL's) is hard to determine because they are largely unregulated. In most cases these buildings have a facility wide nurse call system so a resident can notify staff by pressing a button or a pendant that they are in duress. The level of care may determine what the system is called. In SNF's they are almost always called a nurse call system. In ALC's they tend to be called emergency call systems or call systems. Residents in this level of care don't like the negative connotations when the term nurse is added. In IL's they are generally called PERS (Personal Emergency Response Systems.) In independent living they even get confused with Individual subscription systems like Life Alert or Philips Lifeline which residents add to their phone line, pay a monthly fee and it will dial an outside line to check on the person. Nurse Call Systems are required in SNF's but requirements in ALC's vary from state to state. Since Independent living is not regulated there is generally not a nurse call requirement unless the project has Federal dollars involved and has been required by HUD to install one. This article deals with choosing and implementing a call system in your facility.

As an owner or an operator of a senior living facility you should be making an informed choice about the call system you will be installing in your building. Many owner operators seem misinformed that all call systems are alike and base the purchase almost solely on the initial front-end costs. In my experience with new facility construction or remodels, many times the choice of the call system is left to the architect, electrical engineer, low voltage contractor or general contractor. The problem with this approach is architects and engineers don't have expertise in the all the different systems. They tend to recommend systems they have used in the past based on brand recognition without regard to actual customization. Low voltage or electrical contractors generally pick systems they get financial incentives for by becoming part of the call systems manufacturer's dealer network. General contractors choose the lowest cost alternative that will work. As an owner or operator choosing the lowest initial cost system can haunt you years down the road.

Basic Reasons for Implementing a new Emergency Call System

Skilled Nursing

They are mandatory and may give you efficiency gains requiring less staffing.
A more advanced system may be a marketing tool.
Reporting capabilities for families peace of mind.
You may have other areas of care like assisted or independent living where it would make more sense to have a campus wide system.

Assisted Living

It may be mandatory
You have to have one for marketing purposes because your competition has one.
Risk Management what are the effects to your bottom line or reputation if an emergency happens and a resident cannot get help in a timely manner.
Reporting capabilities.

Independent Living

Marketing
Incremental Revenue, your residents may be using a fee per month telephone service that typically calls your staff anyway. In this case you case you purchase a system ,charge them the monthly fee and create a new revenue stream. I have done multiple proformas on this. Typically the breakeven point be between thirteen to thirty months not taking depreciation into consideration. Your census is the biggest variable in this scenario.

Making an Informed Decision
If your facility is large enough, you should at a minimum have a team with representatives of your administrative, clinical, maintenance, training, construction, operations, marketing and IT departments. The representatives should all have input on which system to proceed with. Administrative members will generally give input on financial considerations like total cost of ownership. Clinical and operations members will be concerned with the reporting and functionality of the system. They may even give you insight to where you will gain dollars back from efficiency gains. Training representatives will give you insight into the ease of use and along with the maintenance team your ongoing operating costs. Marketing gives you insight into census gains you can make against your competition. Finally, IT will be able to determine your networking and integration capabilities.

Consider at least three to five manufacturers of call systems in your initial search and try to answer some of these questions:

Does the manufacturer sell direct or use dealers. Who services the equipment the manufacturer or dealers?
How many systems have they installed? How long have they been selling this equipment? Will the dealer or manufacturer likely be around five years from now with support? If a manufacturer or dealer has less than 500 installations are they really a player in this market considering the total population of facilities out there? Do they manufacture the equipment or do they buy it and label it with their brand, are they an integrator or just a reseller. Are we buying old current or groundbreaking Technology. Once you have answered these questions you can then begin to look at the options that are available.

Call System History

Basic operation
A call system works like this, a resident presses a device that alarms and notifies staff to attend to that particular resident. Some smaller ALC's use a cow bell system, because residents literally have a cow bell. The bell is rung and the staff responds. Small facilities put these in because they are not required to have a call system and these cost nothing. The next type of system is a visual call system. A pull cord is usually hung in bathroom and other rooms in the living quarters of a resident. These cords are wired back to a light display at a monitored central location using a standard pair of wire. When a light goes off on the board staff knows what room to respond to. The upgraded version of this system will add corridor lights outside the residents room. This is style of nurse call that has been around for fifty years. These systems tend to be the cheapest option during new construction but do nothing more than turn a light on or off. Since wired call systems may be over thirty years old, cost issues arise when the wiring fails, the facility wants to remodel or expand, or a facility wants to add reporting capabilities.

Wireless Call System Operation
Newer technologies using wireless call systems are now available. Wireless call systems add the added benefit of mobile devices such as pendants or the ability to connect bed or chair alarms and have the ability to have the alarms work in covered areas of the building or grounds. The term covered areas of the building is used because back of the store areas generally do not need coverage unless a facility is concerned about security. Some facilities are campuses on large acres of land so they may only choose to have coverage on outdoor patios, gardens or walking trails. Wireless call systems are easily scalable to suit the small building to the large campus. Wireless call systems use a network of antenna devices that send the signal back to the head end equipment. Wireless call systems usually have the benefit of being supervised, which means the facility is alerted if any of the devices fails. They will also usually have battery backups for devices that are plugged in so they can still operate if the power fails. Wireless systems are also let a facility add devices at anytime. In addition the devices can be easily moved in case the furniture is moved in a room.

Today, a legitimate call system, whether wired or wireless should require staff members to physically go to the device and reset the emergency call device. This ensures staff does not reset an alarm remotely without checking on a resident.

Infrastructure

UL 1069
Wired systems are almost always UL 1069 compliant which is the regulatory standard for almost all systems in hospitals or SNF's. There is a new UL 1069 standard for wireless call systems in the seventh edition. In the sixth edition to be UL 1069 compliant it meant adding a redundant wireless call system to a wired call system. The new standard basically calls for system that supervises the devices every ninety seconds. This means the device tells the computer I'm here and working every ninety seconds. If not, a device fault would be sent to notify your staff.

Basic Infrastructure
Wired system infrastructure is pretty straight forward two lead wire is run back to the annunciator panel
from each device. Some newer systems will use category 5 computer networking cable but those are usually found in hospital environments.

Today there are three major types wireless infrastructure 900 MHz, WIFI or ZigBee although WIFI and ZigBee are really cousins.

900 MHz systems use a network of one way antennas that blast the signal back to the head end. Most systems. While these systems tend to be reliable, if one of the antennas go down in this scenario you could possibly lose part of your coverage. In the majority of cases 900 MHz systems are made offshore by a company called Inovonics. Other dealers and manufacturers either private label or remanufacture this product. It is unclear this time if this product will be able to get to the UL 1069 seventh edition ninety second supervision requirement. You may want too ask if you are required to have UL 1069 if a wired call system is necessary as part of the system. Location capabilities for pendants usually works in two ways for these systems. You have to buy additional locators. However the locator is not a point, it is a sphere. You can get bleed through exteriors and other floors meaning a resident could be on the second floor but get picked up by a locator on the first floor. The second way is using transceivers or repeater/locators a computer algorithm tries to triangulate the nearest device to give location. Windows, wall construction, and RF noise can give you false readings. For instance I was once at a facility where the signal went out a window across the pool through another window in the opposite wing and would report their even though there was a locator in a nearby hallway closer. Neither choice helps with staff efficiency.

The latest systems designs are using WIFI or ZigBee infrastructures. You are probably familiar with WIFI from your wireless network at home. With a call system a network of routers is set up in your building to allow for communication. ZigBee systems are set up the same way but ZigBee was built for building infrastructure. Many building automation, lighting or security systems are set to come out using the ZigBee standard. WIFI is built to have enough bandwidth for voice, data and multimedia. ZigBee is only concerned with small amounts of data. Basically am I on or off. It consumes less power and should be cheaper than a WIFI system.

Both WIFI and ZigBee systems have two way communication between devices meaning you can now get location down to room level if you want for pendant or mobile devices. The devices are lower power and typically there are more of them. The pendants look for the nearest router to tell them where they are and passed from one router to another as you move through the building. It might be comparable to cell towers making handoffs as you drive down the highway. If you want location capabilities the best choice today is a networked system It is a byproduct of the two way communication built into the system. The networks are also self healing so you shouldn't lose part of your coverage area in an emergency. The systems may be able to integrate with other systems using the same standards. They both appear to be able to designed to get the UL 1069 rating. Make sure you check with your vendor to be sure on these last two items.

Types of Call Devices

Most types of call devices are standardized across the industry.

Bed Cord - a cord plugged into a wall plate, the cord reaches to the bed and has a thumb button a resident can push. Many systems have an option for touch pads, blow tubes or other assistive technologies for residents that cannot use a thumb button.

Pull Cord - mounted to a wall with a cord hanging to the floor the device is easily activated by pulling on the cord.

Wireless Pendant - a small mobile device usually worn with a neck lanyard, a belt clip or a wrist strap. Residents can press the button and are not limited to the placement of bed cords or pull cords. If a resident is mobile pendants generally provide the best safety option for residents providing they will wear it. Many residents in independent living do not like the idea of wearing these devices.
Call Buttons - manufacturers have various types of buttons. Buttons are usually used in independent living to conceal the fact there is a call system which helps with resident dignity. They also are helpful in areas where a staff member might be the most likely person to be calling for assistance. Such as a beauty parlor. They may also be used as a concierge non-emergency device.

Reporting

When choosing a call system, whether wired or wireless should either have a computer included or the ability to easily add a computer without having to reconfigure your entire call system infrastructure. A computer allows a facility reporting capabilities. Reporting capabilities vary from manufacturer as the reporting capability is largely software driven.

Basic reporting allows senior living operators to:
See which residents are calling for help the most. See how fast your staff is responding to the calls.

Advanced reporting adds
What are the reasons residents are calling? What staff members are responding to the most calls? How much time does it take your staff member to give the appropriate care for the incident?

Corporate Reporting
Does the system have dashboard capability if you own multiple housing facilities? Can you easily compare your different operations and use the information to determine best practices. Can you view the reports from your corporate office.

Care Management Integration
Some systems are now able to directly integrate to care management programs so no double information entry is needed. However, since there is currently no standard for EHR, EMR, PHR or in call system reporting there is no way to guarantee compatibility. This feature is currently a little head of the curve.
Advanced Options to consider

Voice to Voice (VTV)
VTV allows caregivers to talk to residents through various intercom devices depending on the manufacturer. VTV lowers a resident's stress level about staff responsiveness or worrying if they got the message. VTV also allows staff to triage care based on what the resident verbally reports the problem is. VTV should allow an open channel to the resident to be activated by the staff in the event of an emergency. The resident should be able to communicate by voice hands free in this situation. The speaker in the residents room should also have an indicator light to avoid the worry of eavesdropping. VTV is great for assisted and independent living situations if you would like to add a concierge service or are worried that residents will abuse the emergency nature of the system. Some facilities add a separate b

Aesthetics, durability, and ease of use should always be a consideration when considering a new emergency call system. Industrial and institutional are the two looks to avoid. Once you have decided on the devices you want to use you should then consider how you would like this to report the information to your staff.

Call Notification
As I mentioned before the most simple way to notify staff is with a bell but this also includes products that chime or ring. The next is to have a light panel at a central or multiple locations can warn your staff of an emergency call. These systems usually have corridor lights outside a resident room. The problem with these systems today, as resort or home style living is the new paradigms, your competitors are removing the extraneous alarm noises and lights. This helps to make the building a more comfortable less institutional feel. In skilled nursing some states may still require corridor lights or large LED signs in the hallways as an alternative. To get around these requirements you can only ask for a waiver or lobby the appropriate governmental authority.

Modern and cutting edge operators are employing alerting devices that let their staff become more efficient a mobile. The most basic device is a pager it simply alarms the appropriate staff with a simple vibration that a resident has need that needs to be taken care of. Based on my experience, this probably accounts for over eighty percent of the facilities using mobile alerting devices. The pagers can be custom set to escalate paging to other staff members if no one can respond to a call. Two way pagers are close at hand that will allow reporting back to a computer or allow caregivers to call for assistance.

Handheld radios are the next choice of facilities. They are great for allowing staff to communicate with each other but they have the annoying chirps and squawks associated with CB radios. To combat this some facilities will instead send the alarm to a cell phone or PDA through email or text messaging. This is a great alternative but can usually involve monthly fees. Camera capabilities because of HIPAA and some administrators don't trust giving their staff members a phone the are charged $70 a month for.

`A wireless in house phone system is a great alternative to these problems. They generally bolt right on to your existing phone system. The usually use WIFI so if you add them you can then offer wireless internet service to your residents as an amenity. Nurses are no longer tied to a desk Assisted Living and Independent Living buildings can have their staff on the move which means you may not need a full time receptionist anymore or less caregivers per shift.

While none of these notification choices may be perfect most vendors can help you pick and choose a system that works for you.

Response
There is certainly no boilerplate for responsiveness except to say every call is an emergency. Your staff needs to respond quickly whether its all hands on deck or designated caregivers. You need to make sure your vendor has enough experience to work with you and set up the system to work best for your needs. They should also be able to make changes as time goes on.

Integration
Some facilities are now asking for reporting of all life safety equipment through their call system. Systems like fire alarm panels, wander management systems and fall alarms can now all report through the call system. The extent of reporting and messaging you are looking for will determine how elaborate the integration will be.

Service
The final variable to look at is service and support. Does your vendor service the equipment or was he just an installer. Do they have phones support and if they do is it free or do they charge for it. Do they offer support via the internet for patches. Can they eliminate service calls via the internet. Can they help your staff add pagers or devices. In most cases with a wireless system your staff should be able to do this. IO have heard many stories of dealers that require a trip charge for this. Do they offer service agreements? How vast is their service network are they factory trained technicians.

I hope I have helped you learn the essentials of picking out a call system for your building and why you shouldn't let others do it for you. I believe unless you have already standardized on a call system for multi facility operators, call systems should be taken off the bid specifications and be provided by the owner when construction is involved. If you have standardized on a system put a real lockout specification in where only that vendor or their dealers will participate. If you can try to deal with the manufacturer most sell directly and they will give you a better price.

John Dondero has spent ten years in the medical equipment industry. He holds an MBA in Technology Management with a Specialty in Healthcare Management. He is currently selling RFID devices and Senior Safety equipment to Senior Livng facilities.

To find more information on senior or family safety and security issues, please visit [http://www.silverlifechoices.com]http://www.silverlifechoices.com.

Article Source: http://EzineArticles.com/?expert=John_Dondero http://EzineArticles.com/?Choosing-a-Nurse-Call-System-For-Your-Senior-Living-Facility---Basic-to-Advanced&id=2481106

Looking for a well established Nursing Home Group in the Philidelphia , PA Area for a good friend

Binyamin — Tue, 09 Jun 2009 01:23:58 GMT

My friends asked me to post a specific request .She would like to find a Nursing Home that has at least 4- 5 branches to chose from experiences to share..

That way they have a track record and have had successes .

Thank you,

Binyamin

benyamintripp@gmail.com

Any opinions/experiences regarding "Emeritus" facilities in Loma Linda, Grand Terrace CA?

Carol Smith — Tue, 26 May 2009 00:41:58 GMT

I am trying to relocate my mother to this facility. It appears to be a very lovely place, and the staff is extremely helpful and wonderfully concerned. Any opinions or experiences would be greatly appreciated.

Insider secrets for securing an in-home caregiver

kgbkind — Wed, 13 May 2009 22:03:22 GMT

“I used to pride myself on being a do-it-yourselfer,” says Martin Greensboro. “But thinking that I alone could take care of my mom with Alzheimer’s was the dumbest decision of my life.”
    A 56 year-old, married member of the burgeoning sandwich generation that’s caring for both children and parents, Greensboro had met his match. Going it alone started as a noble cause. “Who could I trust better than myself to know how to deal with my own mother?” But like tens of thousands of adult children of Alzheimer’s sufferers, he soon realized he needed help—but didn’t know where to turn.
    Hospitalizing his mother wasn’t an option, since doctors aren’t in the business of housing the chronically ill. And like nine out of ten seniors and their families, a nursing home was out of the question. His mom’s home was the only choice that both of them could live with. If only Alzheimer’s disease care could make house calls.
    Fortunately for Greensboro and those like him, the in-home care industry has already been thriving for about twenty years. Of the $3.5 billion in benefits paid out to individuals through long-term insurance claims last year, 43 percent was attributed to home care. That’s higher than what assisted living facilities received, and much higher than nursing home care.
Why home is the best place for Alzheimer’s care
    In-home care for Alzheimer’s disease has been gaining popularity for a number of reasons.

1.    89 percent of seniors would rather live at home than anywhere else. Senior citizens fear moving into a nursing home and losing their independence more than they fear death, according to a study reported in The Wall Street Journal. 82 percent of baby boomers fear their parents will be mistreated in a nursing home.
2.    Staying at home causes less disruption and agitation. Even under the best conditions, any move is stressful, even for healthy individuals. Simply moving in with a relative poses a huge threat to the delicate balance in the mind of a person with AD. Abandoning the familiarity ingrained over decades living in his or her home can be traumatic. In-home care provides stability, allowing people with AD to remain more grounded, even when the world and people around them seem to be changing.
3.    Home care is safer. Institutionalized residents are at higher risk for developing acute illnesses such as pneumonia, dehydration and even antibiotic-resistant infections. The one-on-one personal attention by an in-home caregiver greatly lowers the risk of such illnesses, especially cross-contamination. Falls—which are often fatal to elderly adults—are twice as common in facilities than in private homes, according to the Annals of Internal Medicine. The close, individualized care and familiar surroundings made possible by in-home care significantly reduce the risk of falling, accidents and wandering.
4.    Home care reduces stress and depression for the whole family. Twenty percent of family caregivers suffer from depression, twice the rate of the general population. The “role reversal” of family caregiving is equally stressful on the relative giving and the one receiving care. Even people with AD remain keenly aware of the increasing physical and mental losses they are suffering. Plus they may feel embarrassed to require a family member (especially their child) to help them with certain issues such as gong to the bathroom. Transitioning to an institution can be even more depressing. An in-home caregiver not only provides respite for the caregiving relative, it requires the minimum stress-inducing change for the loved one who needs the care.
5.    Home care prevents institutionalization. Alzheimer’s disease can quickly render people to care for themselves. Simple tasks like bathing, using the toilet, and preparing meals become difficult ordeals. An in-home caregiver helps AD sufferers accomplish these activities of daily living, right in the comfort and familiarity of their own homes.
How to find a caregiver
    Once you’ve come to the decision that you’d like to hire an in-home caregiver, where do you look for one? Your parent’s doctor or discharge planner may be able to refer you to a list of caregivers, in-home care agencies, referral agencies or geriatric care managers. Friends, senior centers, benevolent or religious organizations and even long-term care insurance providers are also useful sources for caregiver suggestions.

•    Private hire caregivers can be found advertising in the classifieds section of your local newspapers or online, on such sites as www.craigslist.org. Many are found by word of mouth, through friends, senior centers or your place of worship.
•    Referral agencies can be found by searching “senior care referral agencies” online or in the yellow pages. Referral agencies provide suggestions for private hire caregivers and other senior living options. While such agencies handle selection, prescreening for criminal backgrounds and checking references, their responsibility over the caregivers ends there.
•    Professional Geriatric Care Managers can also act as excellent referral sources. You can locate those nearest you (or your parent) through the National Association of Professional Geriatric Care Managers home page at www.caremanager.org. In addition to referrals to private hire and full-service agency caregivers, geriatric care managers offer the added advantage of being trained specialists who can assess and oversee the care of your loved one. However, this service comes at an additional cost.
•    Full-service home care agencies are plentiful and can also be located and researched online using terms like “home care” or “senior care.” Many senior centers, hospital discharge planners and other professional organizations also maintain lists of home care agencies. However, such referral lists may not be as current or informative as what you can find yourself during an Internet search. The same shortcomings may be true for phone book yellow pages listings. If you have long-term care insurance, your provider can also help you by providing an excellent list of reputable home care agencies that accept coverage.

    Your best approach is to use more than one of the above listed sources to develop a pool of caregivers you can interview and find the ones who best match your needs and means.
Comparing private or agency caregivers
    The caregiver recommendations you get will most likely fall into one of two categories: private hire or full-service agency. Each has its advantages and considerations that need to be weighed.
Private-hired care: a good deal but you’re the boss
    Privately hired caregivers are naturally the more inexpensive option. They are especially advantageous if they come referred to you directly by a friend, coworker or other associate. Nothing beats the first-hand personal reference of someone you know. Many private caregivers come highly experienced, with backgrounds in nursing or social work, and choose to work independently to make higher wages. Such caregivers know the importance of word-of-mouth referrals, an added incentive to maintaining great attitude and conscientiousness.
    The primary trouble with hiring a private caregiver is that it forces you into the role of an employer rather than a client. The responsibilities fall upon you to conduct their background checks, ensure they are legal to work, pay their wages, report their taxes and cover them with your insurance. You also face the nightmare of having to find a last-minute replacement in case your caregiver calls in sick—or doesn’t call in at all. Also, firing a caregiver, should the need arise, is never a pleasant task.
    “We were very lucky we found a long-time family friend who was a nursing assistant. I can’t imagine hiring a stranger off the online classifieds to come into our home,” said Janine Meyers, daughter of a Lewy body disease patient. “I don’t know the first thing about doing a background check, and I wouldn’t want my Mom to become another tragic news story or a statistic!”

Are the risks worth the savings?
    While cost is a consideration for some families, the hourly savings of hiring an independent caregiver come at a price. “I tell people that when you hire privately, you are not being a wise consumer, says Kathy Johnson, PhD, a geriatric care manager in Palo Alto, CA. “You cannot protect your loved one against caregiver theft or misuse of personal property, until it's too late.”
    There are plenty of horror stories in geriatric care industry about families who have hired unqualified, untrustworthy or even inhumane caregivers. Excessive
long-distance phone bills, missing cash or jewelry, extra miles on the family car, are just a few of the scenarios that are all too common when a private caregiver is on a job. “I've seen it myself,” says Dr. Johnson. “I know it is something most people who are considering a private hire don't think about.”
    Even worse, you can’t protect loved ones against abuse from private caregivers, which is often subtle. “I’ve seen so-called caregivers leave diapers on until soaking, bring their relatives into the house to take over while they do errands, or spend hours on their cell phones while the client sits in front of a TV,” she notes.
    Unless you intend to visit your loved one every day, you have no guarantee that the private caregiver is doing the right things. A good agency, on the other hand, will conduct surprise visits, ongoing supervision, preparation and review of a Plan of Care. Thorough follow-through and follow-up on the Plan of Care by agency personnel is your guarantee your loved one is receiving superior, consistent care.
    When families seek a nanny or baby sitter for their children, they always want the very best they can afford. However, when it comes to care for their aging parents, some people consider price-shopping as an acceptable behavior. Is the bargain worth the cost of your peace of mind?
Agency-provided care: getting more for what you pay for
    While less than the cost of most institutionalized care, full-service home care agencies may charge double the cost of an independent caregiver. However, agencies handle the major aspects of hiring a caregiver for you and eliminate the headaches of management and scheduling.
    Agencies know their business reputation depends on assuring their caregivers are experienced, competent, professional and safe. Therefore their services normally include:
•    Conducting thorough checks of employees’ criminal backgrounds, DMV records and legal work authorizations
•    Checking multiple references and work experience
•    Providing worker's compensation insurance
•    Bonding or maintaining liability insurance
•    Handling collection or reporting of all payroll taxes
    “To protect our clients, we go the additional step of checking multi-state criminal records, including reports of elder abuse,” Chris Ensmann, president of Home Care Assistance of Dallas/Fort Worth. “We also require all of our caregivers to pass a unique psychological exam, written and assessed by PhD psychologists at our corporate headquarters, to verify honesty and conscientiousness.”
    One of the greatest advantages of working with an agency is that they handle the challenge of supervising caregivers, replacing a caregiver who isn’t a good fit and supplying a substitute caregiver when a hired one will be absent. “We chose Home Care Assistance because we know we can call them for anything, 24/7, “ says Ken Bailey, of Houston. “They’ve even managed an emergency scheduling request we made within a hour!”
    With a privately-hired caregiver, you’re on your own. Hiring a caregiver from an agency also reduces the risk of contagious disease infection by making it possible for a caregiver who is ill to call in sick, knowing his or her shift can be quickly covered with the help of the agency’s staffing coordinator.
What to look for in a caregiver or home care provider
    Finding the caregiver who is right for your loved one requires some research. Following is a checklist of questions to ask potential caregivers or providers, to help you determine which is best for you.
1.    How experienced is the caregiver, and/or how long has this provider been in operation?
2.    What references come on behalf of the caregiver or this provider?
3.    What is the caregiver’s criminal background, driving and work legality, or how does this agency screen caregivers?
4.    What are the services offered and their associated fees? Is there a minimum charge or long-term contact required? Does the caregiver or this provider furnish written statements explaining all of the costs and payment options associated with home care? Do they accept long-term care insurance? Do they take credit cards?
5.    What special training does the caregiver have? Does this provider train its employees?
6.    Is the caregiver insured ad bonded? Does this agency cover employees with liability insurance against client injury or loss of property?
7.    Would the caregiver be comfortable with surprise visits, or does this agency conduct unannounced visits periodically to evaluate the client’s quality of care and re-evaluate home care needs?
8.    How does the agency follow up on and resolve problems? Do case managers consult the client’s family members, geriatric care managers and other care professionals related to the case?
9.    Is the client’s course of care documented, detailing the specific tasks to be carried out by the caregiver? Does this provider take time to educate family members on the care being administered to the client?
10.    What procedures do the caregiver or this provider have in place to handle emergencies? Are caregivers available 24 hours a day, seven days a week? Will the agency guarantee the caregiver will show up, or at least work to immediate replace a caregiver who is unable to arrive for an assigned shift do to illness or other issue?
11.    Will the home care provider to supply you with a list of references, such as GCMs, discharge planners, clients or their family members, and community leaders who are familiar with the provider’s quality of service? Is the home care provider accredited by the Better Business Bureau?
12.    Does this provider offer to let you meet with a number of potential caregivers, to see which seem most compatible with our loved one and you?
    The ideal home care agency for you should be able to answer all the above questions with a “Yes.”

The caregiver interview
    When selecting a home care agency or a caregiver, you should ask open-ended questions that will prompt more than a simple “yes or no” response. Ask for previous, real-life examples of problem-solving with other clients similar to your parent. Look for a caregiver who communicates well. Caregivers should be good listeners and should be able to repeat instructions back to you. Make sure the caregiver is compatible with you or your parent, so time together can be enjoyable. Discuss with the caregiver some appropriate actions to common situations that may arise with your loved one.
    Remember that a home care provider and caregivers strive to ensure your loved one not only survives, but also thrives with the highest possible quality of life. Their purpose is to enable your elder relative—and you—continue to live the healthy and independent life you both deserve.

Article: Myths of Senior Assisted Living

Admin — Wed, 13 Feb 2008 19:26:08 GMT

Myths of Senior Assisted Living

Senior assisted living communities are designed to empower individuals to maintain the independence they have come to enjoy. At the same time, community living provides friendship and companionship. Senior assisted living communities provide seniors with many options to make sure they feel right at home.

Despite the great advantages of community living, making the decision to move is a difficult one for many seniors and their families. Listed below are some common myths about senior assisted living that may help you understand the benefits of this wonderful living option.

Myth: I don't want to give up my independence!

Truth: Your own space without the hassles

This article continues at Senior Assisted Living.

Where is Home Care Provided?

michelle.json — Tue, 24 Mar 2009 06:36:29 GMT

Home care is provided in a place or residence including but not limited to the following: single family home, apartment, assisted living, adult foster home, adult day care, relative's home, or congregate housing residence. Home care is not usually provided in an institutional setting such as a long-term care facility or hospital, unless an arrangement has been made for private duty nursing by the client or family.

Mom and/or Dad - Invest in yourself, please!

Oak_tree_village — Fri, 20 Mar 2009 03:34:32 GMT

So often lately, we hear about someone taking a hit to their investments. Often times this is the reason given for not wanting to put out the money for senior housing - in our case, independent senior living. I wish more seniors would see this as an investment in themselves. They have worked so hard at jobs, fought in wars, raised families, and now at the time of their lives when they should be relaxing, they are stressing over lost investments and portfolios.

While these things are indeed important and can be worrisome, mom and dad are top priority, as is their well-being, health and safety.

Investing in themselves by leaving the stresses of home upkeep, cleaning, the majority of the cooking, as well as driving is a wonderful way to live out your days...surrounded by friends in the same boat. All of whom deserve the best.

Making the transition to a retirement community benefits not only mom and dad, but we the children as well. Knowing our parents are surrounded by friends and 24 hour staff helps us sleep better at night. Plus, mom and dad have so many opportunities for fun!

I hope more people will focus on themselves and live the life they deserve. Happliy ever after.

Article: Retirement Living In Today’s Senior Communities

Admin — Wed, 13 Feb 2008 22:06:56 GMT

Retirement Living In Today's Senior Communities

Retirement communities are no longer just destinations for those seniors looking to slow down. In fact, current trends suggest exactly the opposite to be true. As more than 77 million baby boomers reach retirement age, people are heading to senior communities well stocked with outdoor clubs more typical of the college than the traditional senior campus. People over 60 are also choosing to move earlier than ever to senior communities for security, personal safety, transportation, services, and to be closer to peers who share their passion for life.

"Seniors are more actively engaged in life," says Tim Burris, A Place For Mom's Market Development Coach for the Southeast region. "The clubs are responding by supplementing their staffs with independent activity directors to keep this new wave of seniors satisfied."

This article continues at Senior Communities.

Searching in Stockton

ShanT — Mon, 19 Jan 2009 06:09:34 GMT

Hello,

Can anyone recomend safe, caring, trustworthy in home care for an elderly emphysema patient in Stockton?

Convincing a Sibling That Mom Needs Assisted Living

Bonnie Wahiba — Fri, 24 Oct 2008 21:02:13 GMT

My youngest sister has assumed primary care for my 83-year-old mother. She is her executrix and handles all of my Mom's finances. We have an older sister in the same town, but she is not as involved in Mom's care for a variety of reasons. Both my brother and I live quite far away (400 miles) from my mom. While my brother seems content to let my sister care for my Mom, I try to stay very involved and fly down to see her about once every two months. When my Dad died about 2 1/2 years ago, my older sister and I thought assisted living would be the best option for Mom. But my youngest sister refused - and still refuses - to even consider it. She has only been to one assisted living facility in her city and will not visit any others. Her husband, I believe, has been a big influence on her, urging her not to put my Mom in a "home." (Clearly they both have very outdated ideas of what is considered elder care these days.) Mom broke her leg two weeks ago when she was alone in her apartment and is now in rehab. I found out one of the assisted living near my sister will take a resident on a month-to-month basis. The administrator said this would be a perfect chance for my Mom to rehab where help is right near her and it's a chance for her to check out assisted living.

HOW CAN I CONVINCE MY SISTER TO AT LEAST CONSIDER THIS??

Thanks for all your help.

Article: Finding Respect At The End of the Rainbow: LGBT Retirement Communities

Admin — Wed, 13 Feb 2008 18:38:49 GMT

Finding Respect At The End of the Rainbow: LGBT Retirement Communities

"It's Not A Lifestyle-It's Your Life," proclaims the Santa Fe-based RainbowVision. The property management and development group was co-founded by Joy Silver, its president and CEO, to create and operate welcoming and fun retirement communities for ***, gay, bisexual, and transgender elders. The company just celebrated the one-year birthday of its first fully operational LGBT retirement community, RainbowVision Santa Fe. According to co-founder and senior vice president Joyce Bogosian, three more properties are planned for the future: Palm Springs, San Francisco, and Vancouver, British Columbia.

"If I planted you at the doorway and you walked in you would never say this is a retirement community," says Bogosian. "It feels more like a boutique hotel."

This article continues at LGBT Retirement Communities.

trying to find a home near mulvane kansas

jeff — Thu, 22 May 2008 00:15:07 GMT

I'm trying to find a nursing home in or around mulvane kansas for my mother.

Geriatric Care Manager

Linda Temple — Tue, 11 Dec 2007 20:35:38 GMT

We have a geriatric care manager for my husbands grandmother. We have found this extremely beneficial, as her adult children live out of state. The geriatric care manager keeps an eye on the care she receives at the assisted living community. Also, she takes grandma to all of her doctor appointments and communicates to the doctor and reports back to the family after the visit. I think a good geriatric care manager is worth their weight in gold in many cases!

Your Spouse and picking the right caregiver

belinda b — Fri, 28 Mar 2008 03:29:26 GMT

Many of the families I speak with are dealing with a spouse who is ill with chronic or terminal diseases. The guilt of placing their loved one in a community or residential care home eats away at the spouse. A great resource I mention to families is WELL SPOUSE ASSOCIATION 1-800-838-0879- the group and network offers support to the spouses and partners of the chronically ill or disabled. www.wellspouse.org check it out sometime!

Belinda Battistelli

Eldercare Advisor

Honest Feelings of an Eldercare Advisor with A Place for Mom

mariab — Fri, 28 Mar 2008 02:04:35 GMT

As an advisor I am faced every day with new situations and challenges to help our families and seniors find the best communites or services....sometimes it is hard to tell the families that I am helping how I really feel about helping them...

The lyrics of this song truly tell how I really feel when I am trying to help a family....I don't know the author of the song....but I know I heard it sung by Kimberly Locke from American Idol. It touched my heart and I felt that I needed to share with the world that when an advisor from A Place for Mom is helping your family...this is what they really want to say....read and know that we are with you all the way.....just let go and fall.....

Some of the lyrics of the song "FALL"

Oh look there you go again

Putting on that smile again

Even though I know you’ve had a bad day

Doing this and doing that

Always putting yourself last

A whole lot of give and not enough take

But you can only be strong, so long before you break

So fall

Go on and fall apart

Fall into these arms of mine I’ll catch you every time you

Fall

Go on and loose it all

Every doubt, every fear, every worry, every tear, I’m right here.

Baby fall

Forget about the world tonight

All that’s wrong and all that’s right

Lay your head on my shoulder, let it fade away.

And if you want to let go baby its ok

Fall

Go on and fall apart

Fall into these arms of mine I’ll catch you every time you

Fall go on and loose it all

Every doubt, every fear, every worry, every tear, I’m right here

Baby fall

Article: Choosing Residential Care Facilities: What to Look For

Admin — Tue, 12 Feb 2008 18:51:39 GMT

Choosing Residential Care Facilities: What to Look For

Driving by residential care facilities only gives us a glimpse of its environment. Before stepping inside potential custodial care homes, think about the needs of your loved one, and prepare a list of questions and concerns. Since there are no federal standards for these small care homes, it's vital to thoroughly research each potential residence. States with licensing regulations provide surveys on each residential care home, so start by contacting your state's department of aging for information, or ask each residential care home for its survey.

This article continues at Choosing Residential Care Facilities.

Article: Tips For When You Tour Nursing Homes And Assisted Living

Admin — Wed, 19 Mar 2008 03:51:25 GMT

Tips For When You Tour Nursing Homes And Assisted Living

Choosing the right home for an elderly loved one is the most important elder care decision a family can make. Be sure to schedule visits to several different communities so you have options before deciding. Here are some helpful “tips on touring” about what to look for when you tour nursing homes, assisted living homes, or other senior housing communities.

Remember that it is not the decor that counts, but the quality of care your loved one will receive that’s most important.

This article continues at Tour Nursing Homes and Assisted Living.