* Source AARP
* While caregiving is traditionally associated with women, 45% percent of today's working caregivers are men.
* Nearly two-thirds or 63% of all caregivers ages 51-64 work, most full-time; 75% are primary caregivers.
* Up to 30% of employees have eldercare responsibilities, and 40% of those also have children at home.
* Eighty percent of older adult care is provided solely by family and friends.
* The average length of caregiving is eight years.
~Serena Brock
Monday, December 8, 2008
Friday, December 5, 2008
More Men Take the Lead Role in Caring for Elderly Parents
When Peter Nicholson’s mother suffered a series of strokes last winter, he did something women have done for generations: he quit his job and moved into her West Hollywood home to care for her full time.
Peter Nicholson quit a job and moved in to care for his mother, Bernice. He has lost 45 pounds and developed anemia in part because of the stress, and he is running out of money. But the hardest adjustment, Mr. Nicholson said, has been the emotional toll.
“The single toughest moment was when she said to me, ‘And now who are you?’ ” he said. “My whole world just dropped. That was the pinnacle of despair.”
Mr. Nicholson, 53, is part of a growing number of men who are providing primary care for their aging parents, usually their mothers.
The Alzheimer’s Association and the National Alliance for Caregiving estimate that men make up nearly 40 percent of family care providers now, up from 19 percent in a 1996 study by the Alzheimer’s Association. About 17 million men are caring for an adult.
“It used to be that when men said, ‘I’ll always take care of my mother,’ it meant, ‘My wife will always take care of my mother,’ ” said Carol Levine, director of the families and health care project at the United Hospital Fund. “But now, more and more men are doing it.”
Often they are overshadowed by their female counterparts and faced with employers, friends, support organizations and sometimes even parents who view caregiving as an essentially female role. Male caregivers are more likely to say they feel unprepared for the role and become socially isolated, and less likely to ask for help.
Women still provide the bulk of family care, especially intimate tasks like bathing and dressing. At support groups, which are predominantly made up of women, many women complain that their brothers are treated like heroes just for showing up.
But with smaller families and more women working full-time, many men have no choice but to take on roles that would have been alien to their fathers. Just as fatherhood became more hands-on in the baby boom generation, so has the role for many sons as their generation’s parents age.
Mr. Nicholson said his family had not discussed who would take care of his mother, Bernice, if she became frail. But as the unmarried child among his two siblings, and the one who was most readily available, he had spent increasing time with her as she aged.
Still, he was not prepared for the isolation of full-time care. “There’s absolutely no involvement in the outside world,” Mr. Nicholson said. “When I finally get out to a Dodgers game, walking to the car, I say, Oh, this is what life is about. I forgot about this. I can’t be doing myself any good by not getting out of here.”
Isolation affects women as well, but men tend to have fewer lifelines, said Donna Benton, an assistant research professor of gerontology at the University of Southern California and director of the Los Angeles Caregiver Resource Network. Men are less likely to have friends going through similar experiences, and depend more on their jobs for daily human contact.
“That’s the harder part for men, to find someone to talk to,” Dr. Benton said. “It’s the emotional side: the guilt, the sadness, the anger. For men it becomes more stressful because they can’t talk about it. They feel cut off.”
And then there is the inevitable question: What happens when I have to bathe her?
“That’s where the rubber meets the road,” said Donna Wagner, the director of gerontology at Towson University and one of the few researchers who has studied sons as caregivers.
For Mr. Nicholson, the whole experience has been a journey into the surreal, but especially at bath time.
Though he is not squeamish about it, he said: “The weirdness permeates our relationship. She doesn’t know if I’m her husband or her boyfriend or her neighbor. She knows she trusts me. But there are times when it’s very difficult. I need to keep her from embarrassing herself. She’ll say things like, ‘I adore you.’ I don’t know who she’s loving, because she doesn’t know who I am. Maybe I’m embarrassed about it — it’s my mom, for Christ sakes. But it’s weird how the oldest son becomes the spouse.”
Matt Kassin, 51, said he had no role model for male caregiver in his family. His father had been distant; he, in turn, had been the rebellious son. “I was the son who went through divorce, who needed to separate from my mom when I was teenager,” Mr. Kassin said. “I’m the son that wanted distance. Now I’m the son who hears every morning, ‘It’s so nice to hear your voice.’ ”
On a recent evening, Mr. Kassin visited his mother, Doris Golden, in her Manhattan apartment. Ms. Golden, 82, is in the early stages of Alzheimer’s and still lives independently, but relies on Mr. Kassin to arrange her schedule, pay her bills and make sure she remembers her daily tasks (his sister also helps).
His care has surprised his mother. “When he was young, I couldn’t get him to raise a finger,” Ms. Golden said. Her conversation looped repeatedly back to this point, and with each return, Mr. Kassin grew more irritated. That was when he was a teenager, he said, sharply; hadn’t he been more attentive since?
Finally she looked at him tenderly and asked, “When did I start relying on you?”
Interviewed apart from his mother, Mr. Kassin said: “It’s kind of like living my nightmare situation. But it’s a great opportunity here. Here’s the woman who nurtured me. She now is the child. You worry if you’re up for the challenge. If I don’t make this challenge, what kind of human being am I?”
In past generations, men might have answered this question by pointing to their accomplishments as breadwinners or fathers. Now, some men say they worry about the conflict between caring for their parents and these other roles.
In a 2003 study at three Fortune 500 companies, Dr. Wagner found that men were less likely to use employee-assistance programs for caregivers because they feared it would be held against them.
“Even though the company has endorsed the program, your supervisors may have a different opinion,” Dr. Wagner said. “I had a man who worked for a large company with very generous benefits, and he was told that if he took more time to go with his dad to chemotherapy, he was at risk of losing his job. He ended up not going with his father.”
Mr. Kassin said that although his employer had been understanding, he was reluctant to talk about his caregiving because “I think it would be looked at like, when they hire a male, they expect him to be 100-percent focused.”
“I don’t want to appear to be someone who has distractions that detract from performance,” he said.
For many men, the new role means giving up their self-image as experts, said Louis Colbert, director of the office of services for the aging in Delaware County, Pa., who has shared care of his 84-year-old mother with his siblings since her Alzheimer’s made it necessary.
“I’ve been a professional for 32 years,” Mr. Colbert said, “but yet I remember the first time I was driving to my mother’s house, being afraid because I didn’t know if I knew what to do.”
Once a year, Mr. Colbert organizes a get-together for male caregivers. The concerns they raise, he said, are different from those of women in support groups. “Very clearly, they said they wanted their role as caregiver validated, because in our society, as a whole, men as caregivers have been invisible,” he said.
This invisibility can extend to hospitals and nursing homes, said Amy Torres, helpline director at Fria, a national nonprofit organization based in New York that represents family members and residents in long-term care facilities.
“Nursing homes have a very difficult time dealing with male caregivers,” Ms. Torres said. “It’s unusual for them. The male caregiver is made to feel their interest in their relative is inappropriate. Our male callers say they’re made to feel what they’re doing is unusual, that it’s wrong.”
She gave the example of a son who was the health care agent for his mother and wanted to be in the room when the staff changed her diaper because he was concerned about her skin condition. “The staff refused to allow it,” Ms. Torres said. “They said the mother’s dignity was at risk.”
After two weeks of pressing, she said, he finally got his way. With a daughter, this would not have been an issue, Ms. Torres said.
And even when they are acknowledged, for many male caregivers, as for women, there is the lingering sense that whatever they do is not enough.
Mr. Nicholson said he knew this feeling too well. As a teacher, he could measure his contribution by the students’ progress. But with his mother, he can only watch her decline.
“I’m always asking myself, Am I even qualified for this?” he said. “Just because I love her a lot doesn’t mean that I have any idea if I’m doing the right thing, or doing what’s best for her.”
He sounded exhausted, rattled even.
“I don’t know if this is just the musings of someone who’s on the verge of tossing everything and putting her in a home,” he said. “But this is a very revealing journey about who I am to me and my family, and what’s important to me.”
New York Times 11/29/2008
Serena Brock
Peter Nicholson quit a job and moved in to care for his mother, Bernice. He has lost 45 pounds and developed anemia in part because of the stress, and he is running out of money. But the hardest adjustment, Mr. Nicholson said, has been the emotional toll.
“The single toughest moment was when she said to me, ‘And now who are you?’ ” he said. “My whole world just dropped. That was the pinnacle of despair.”
Mr. Nicholson, 53, is part of a growing number of men who are providing primary care for their aging parents, usually their mothers.
The Alzheimer’s Association and the National Alliance for Caregiving estimate that men make up nearly 40 percent of family care providers now, up from 19 percent in a 1996 study by the Alzheimer’s Association. About 17 million men are caring for an adult.
“It used to be that when men said, ‘I’ll always take care of my mother,’ it meant, ‘My wife will always take care of my mother,’ ” said Carol Levine, director of the families and health care project at the United Hospital Fund. “But now, more and more men are doing it.”
Often they are overshadowed by their female counterparts and faced with employers, friends, support organizations and sometimes even parents who view caregiving as an essentially female role. Male caregivers are more likely to say they feel unprepared for the role and become socially isolated, and less likely to ask for help.
Women still provide the bulk of family care, especially intimate tasks like bathing and dressing. At support groups, which are predominantly made up of women, many women complain that their brothers are treated like heroes just for showing up.
But with smaller families and more women working full-time, many men have no choice but to take on roles that would have been alien to their fathers. Just as fatherhood became more hands-on in the baby boom generation, so has the role for many sons as their generation’s parents age.
Mr. Nicholson said his family had not discussed who would take care of his mother, Bernice, if she became frail. But as the unmarried child among his two siblings, and the one who was most readily available, he had spent increasing time with her as she aged.
Still, he was not prepared for the isolation of full-time care. “There’s absolutely no involvement in the outside world,” Mr. Nicholson said. “When I finally get out to a Dodgers game, walking to the car, I say, Oh, this is what life is about. I forgot about this. I can’t be doing myself any good by not getting out of here.”
Isolation affects women as well, but men tend to have fewer lifelines, said Donna Benton, an assistant research professor of gerontology at the University of Southern California and director of the Los Angeles Caregiver Resource Network. Men are less likely to have friends going through similar experiences, and depend more on their jobs for daily human contact.
“That’s the harder part for men, to find someone to talk to,” Dr. Benton said. “It’s the emotional side: the guilt, the sadness, the anger. For men it becomes more stressful because they can’t talk about it. They feel cut off.”
And then there is the inevitable question: What happens when I have to bathe her?
“That’s where the rubber meets the road,” said Donna Wagner, the director of gerontology at Towson University and one of the few researchers who has studied sons as caregivers.
For Mr. Nicholson, the whole experience has been a journey into the surreal, but especially at bath time.
Though he is not squeamish about it, he said: “The weirdness permeates our relationship. She doesn’t know if I’m her husband or her boyfriend or her neighbor. She knows she trusts me. But there are times when it’s very difficult. I need to keep her from embarrassing herself. She’ll say things like, ‘I adore you.’ I don’t know who she’s loving, because she doesn’t know who I am. Maybe I’m embarrassed about it — it’s my mom, for Christ sakes. But it’s weird how the oldest son becomes the spouse.”
Matt Kassin, 51, said he had no role model for male caregiver in his family. His father had been distant; he, in turn, had been the rebellious son. “I was the son who went through divorce, who needed to separate from my mom when I was teenager,” Mr. Kassin said. “I’m the son that wanted distance. Now I’m the son who hears every morning, ‘It’s so nice to hear your voice.’ ”
On a recent evening, Mr. Kassin visited his mother, Doris Golden, in her Manhattan apartment. Ms. Golden, 82, is in the early stages of Alzheimer’s and still lives independently, but relies on Mr. Kassin to arrange her schedule, pay her bills and make sure she remembers her daily tasks (his sister also helps).
His care has surprised his mother. “When he was young, I couldn’t get him to raise a finger,” Ms. Golden said. Her conversation looped repeatedly back to this point, and with each return, Mr. Kassin grew more irritated. That was when he was a teenager, he said, sharply; hadn’t he been more attentive since?
Finally she looked at him tenderly and asked, “When did I start relying on you?”
Interviewed apart from his mother, Mr. Kassin said: “It’s kind of like living my nightmare situation. But it’s a great opportunity here. Here’s the woman who nurtured me. She now is the child. You worry if you’re up for the challenge. If I don’t make this challenge, what kind of human being am I?”
In past generations, men might have answered this question by pointing to their accomplishments as breadwinners or fathers. Now, some men say they worry about the conflict between caring for their parents and these other roles.
In a 2003 study at three Fortune 500 companies, Dr. Wagner found that men were less likely to use employee-assistance programs for caregivers because they feared it would be held against them.
“Even though the company has endorsed the program, your supervisors may have a different opinion,” Dr. Wagner said. “I had a man who worked for a large company with very generous benefits, and he was told that if he took more time to go with his dad to chemotherapy, he was at risk of losing his job. He ended up not going with his father.”
Mr. Kassin said that although his employer had been understanding, he was reluctant to talk about his caregiving because “I think it would be looked at like, when they hire a male, they expect him to be 100-percent focused.”
“I don’t want to appear to be someone who has distractions that detract from performance,” he said.
For many men, the new role means giving up their self-image as experts, said Louis Colbert, director of the office of services for the aging in Delaware County, Pa., who has shared care of his 84-year-old mother with his siblings since her Alzheimer’s made it necessary.
“I’ve been a professional for 32 years,” Mr. Colbert said, “but yet I remember the first time I was driving to my mother’s house, being afraid because I didn’t know if I knew what to do.”
Once a year, Mr. Colbert organizes a get-together for male caregivers. The concerns they raise, he said, are different from those of women in support groups. “Very clearly, they said they wanted their role as caregiver validated, because in our society, as a whole, men as caregivers have been invisible,” he said.
This invisibility can extend to hospitals and nursing homes, said Amy Torres, helpline director at Fria, a national nonprofit organization based in New York that represents family members and residents in long-term care facilities.
“Nursing homes have a very difficult time dealing with male caregivers,” Ms. Torres said. “It’s unusual for them. The male caregiver is made to feel their interest in their relative is inappropriate. Our male callers say they’re made to feel what they’re doing is unusual, that it’s wrong.”
She gave the example of a son who was the health care agent for his mother and wanted to be in the room when the staff changed her diaper because he was concerned about her skin condition. “The staff refused to allow it,” Ms. Torres said. “They said the mother’s dignity was at risk.”
After two weeks of pressing, she said, he finally got his way. With a daughter, this would not have been an issue, Ms. Torres said.
And even when they are acknowledged, for many male caregivers, as for women, there is the lingering sense that whatever they do is not enough.
Mr. Nicholson said he knew this feeling too well. As a teacher, he could measure his contribution by the students’ progress. But with his mother, he can only watch her decline.
“I’m always asking myself, Am I even qualified for this?” he said. “Just because I love her a lot doesn’t mean that I have any idea if I’m doing the right thing, or doing what’s best for her.”
He sounded exhausted, rattled even.
“I don’t know if this is just the musings of someone who’s on the verge of tossing everything and putting her in a home,” he said. “But this is a very revealing journey about who I am to me and my family, and what’s important to me.”
New York Times 11/29/2008
Serena Brock
Wednesday, December 3, 2008
Proactive Planning in a Time of Crisis AND to Avoid Crisis
We are faced with issues in our country many of us would never have imagined. We have lost, in one way or another and are concerned with how to protect ourselves from financial devastation and retirement protection. Who would have ever thought that their business would out live Wachovia or Lehman Brothers? Would you ever have thought that our government would have to bail out major car manufacturers? As strong as our country once was, would you have imagined this global financial crisis?
We hear so much about pre-planning, asset protection, financial advisors, estate planning and healthcare planning. Do you really understand what it means to you and your family? Do you think it is only for those who are wealthy?
Proactive planning is important in all aspects of our lives from long term wishes to short- term daily goals. There is good reason for statements such as plan your work and work your plan. Having a strategic life plan is even more critical today than ever.
I know, who needs it, too young to consider it, mom and dad have already taken care of it, no time for it, etc., etc. I used to think the same, until I learned of real situations. Cases where a car accident took the lives of a married couple leaving their children in the hands of the state. Where adult children gave up their careers to move back home to care for mom, putting their career and family plans on hold. Or how about the situation where the healthy spouse takes a turn for the worst, goes into a nursing home and depletes the savings of the couple just before the ill spouse needs it?
Before and even more today, the thought of having to hire an attorney or utilize the services of a financial advisor seemed expensive and to some extent, unnecessary for so many of us. Why, we want to save our money – hold on to as much as we can, not spend it on services like financial or legal advice, right? Why do we need to consider or engage in home care services when the boy down the street can help out or the adult children can find time in their lives to support the parents?
As a home care agency owner and a national speaker on the importance of pre-planning, I have had first hand knowledge and experience of what can happen without a plan.
Here is how you can help your friends, colleagues and loved ones consider the importance of planning:
Family Matters – with the holidays quickly approaching, there is no better time to “have those uncomfortable discussions”. Take a proactive approach to ensuring that the financial and health related areas are observed and planned for. Make sure that your mom and dad have their protection plan in place and updated. Never assume that it is. Protect your own family and assets. Take the time, yes and the costs associated with obtaining professional advice from an estate planning or elder law attorney, financial advisor and a healthcare professional. Protection and planning includes preparation for aging, changes in medical condition as well as the preferred primary residence. Aging in place with in home care assistance verses a stay in a nursing home will vary in costs and in the life plan.
Wealth Management - is for all of us, regardless of Net worth. This is estate planning and what that means is ensuring that the disposition of your assets during life and after death is handled in the manner in which you want it to be. Of course, proper planning will help you avoid complicated and unnecessary tax implications, lost value in securities, real estate and other assets. Gifting and transferring your assets is not as simple as it once was or may seem. Professional advice from an estate planning or elder law attorney can save you and your family from losing the assets you have worked so hard to achieve.
Health Care Planning – It is no secret that there will not be government funds to support our aging and sandwich generation. It is up to each one of us, as individuals to plan for and protect our needs for health care. What that means to you is purchasing and/or reviewing your current medical and supplemental insurance plans. Don’t assume that a long-term care insurance plan purchased years ago will cover your aging needs of care. Review the particulars of the policy – does it illustrate home care? What level of service? For what duration? Daily, Monthly? Is there a maximum? If your wish is to age in place, take the appropriate steps to consider your aging needs such as assistance with your activities of daily living, financial management of regular tasks such as bill paying and considerations of facing a decline in health such as needs for nursing care. An attorney can explain and help you with your living will, power of attorney and healthcare directives. It is an important step that must be considered.
Alternative Options and Resources – Depending on your situation, there may be assistance available for you. Benefits such as the Veterans Aide and Attendance Special Benefit which provides a monthly amount to cover home care. Without knowing what resources are available, you may be missing out on key financial and caring support.
Don’t allow our current economic instability to cloud your better judgment. You can protect yourself, your loved ones and your hard earned assets. With the proper planning you will benefit from immediate relief and the peace of mind you deserve.
~Serena Brock
We hear so much about pre-planning, asset protection, financial advisors, estate planning and healthcare planning. Do you really understand what it means to you and your family? Do you think it is only for those who are wealthy?
Proactive planning is important in all aspects of our lives from long term wishes to short- term daily goals. There is good reason for statements such as plan your work and work your plan. Having a strategic life plan is even more critical today than ever.
I know, who needs it, too young to consider it, mom and dad have already taken care of it, no time for it, etc., etc. I used to think the same, until I learned of real situations. Cases where a car accident took the lives of a married couple leaving their children in the hands of the state. Where adult children gave up their careers to move back home to care for mom, putting their career and family plans on hold. Or how about the situation where the healthy spouse takes a turn for the worst, goes into a nursing home and depletes the savings of the couple just before the ill spouse needs it?
Before and even more today, the thought of having to hire an attorney or utilize the services of a financial advisor seemed expensive and to some extent, unnecessary for so many of us. Why, we want to save our money – hold on to as much as we can, not spend it on services like financial or legal advice, right? Why do we need to consider or engage in home care services when the boy down the street can help out or the adult children can find time in their lives to support the parents?
As a home care agency owner and a national speaker on the importance of pre-planning, I have had first hand knowledge and experience of what can happen without a plan.
Here is how you can help your friends, colleagues and loved ones consider the importance of planning:
Family Matters – with the holidays quickly approaching, there is no better time to “have those uncomfortable discussions”. Take a proactive approach to ensuring that the financial and health related areas are observed and planned for. Make sure that your mom and dad have their protection plan in place and updated. Never assume that it is. Protect your own family and assets. Take the time, yes and the costs associated with obtaining professional advice from an estate planning or elder law attorney, financial advisor and a healthcare professional. Protection and planning includes preparation for aging, changes in medical condition as well as the preferred primary residence. Aging in place with in home care assistance verses a stay in a nursing home will vary in costs and in the life plan.
Wealth Management - is for all of us, regardless of Net worth. This is estate planning and what that means is ensuring that the disposition of your assets during life and after death is handled in the manner in which you want it to be. Of course, proper planning will help you avoid complicated and unnecessary tax implications, lost value in securities, real estate and other assets. Gifting and transferring your assets is not as simple as it once was or may seem. Professional advice from an estate planning or elder law attorney can save you and your family from losing the assets you have worked so hard to achieve.
Health Care Planning – It is no secret that there will not be government funds to support our aging and sandwich generation. It is up to each one of us, as individuals to plan for and protect our needs for health care. What that means to you is purchasing and/or reviewing your current medical and supplemental insurance plans. Don’t assume that a long-term care insurance plan purchased years ago will cover your aging needs of care. Review the particulars of the policy – does it illustrate home care? What level of service? For what duration? Daily, Monthly? Is there a maximum? If your wish is to age in place, take the appropriate steps to consider your aging needs such as assistance with your activities of daily living, financial management of regular tasks such as bill paying and considerations of facing a decline in health such as needs for nursing care. An attorney can explain and help you with your living will, power of attorney and healthcare directives. It is an important step that must be considered.
Alternative Options and Resources – Depending on your situation, there may be assistance available for you. Benefits such as the Veterans Aide and Attendance Special Benefit which provides a monthly amount to cover home care. Without knowing what resources are available, you may be missing out on key financial and caring support.
Don’t allow our current economic instability to cloud your better judgment. You can protect yourself, your loved ones and your hard earned assets. With the proper planning you will benefit from immediate relief and the peace of mind you deserve.
~Serena Brock
Monday, December 1, 2008
Recognizing Caregiver Burnout
Web MD defines caregiver burnout as a state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude -- from positive and caring to negative and unconcerned. Burnout can occur when caregivers don't get the help they need, or if they try to do more than they are able -- either physically or financially. Caregivers who are "burned out" may experience fatigue, stress, anxiety, and depression. Many caregivers also feel guilty if they spend time on themselves rather than on their ill or elderly loved ones.
Caregivers often are so busy caring for others that they tend to neglect their own emotional, physical, and spiritual health. The demands on a caregiver's body, mind, and emotions can easily seem overwhelming, leading to fatigue and hopelessness -- and, ultimately, burnout.
The follwoing is a list of the symptoms of caregiver burnout:
Withdrawal from friends, family and other loved ones.
Loss of interest in activities previously enjoyed.
Feeling blue, irritable, hopeless, and helpless.
Changes in appetite, weight, or both.
Changes in sleep patterns.
Getting sick more often.
Feelings of wanting to hurt yourself or the person for whom you are caring.
Emotional and physical exhaustion.
Irritability.
~Serena Brock
Caregivers often are so busy caring for others that they tend to neglect their own emotional, physical, and spiritual health. The demands on a caregiver's body, mind, and emotions can easily seem overwhelming, leading to fatigue and hopelessness -- and, ultimately, burnout.
The follwoing is a list of the symptoms of caregiver burnout:
Withdrawal from friends, family and other loved ones.
Loss of interest in activities previously enjoyed.
Feeling blue, irritable, hopeless, and helpless.
Changes in appetite, weight, or both.
Changes in sleep patterns.
Getting sick more often.
Feelings of wanting to hurt yourself or the person for whom you are caring.
Emotional and physical exhaustion.
Irritability.
~Serena Brock
Friday, November 28, 2008
Elderly Financial Abuse
It is estimated that over 80% of incidents affecting millions of seniors who are the victims of financial exploitation each year go unreported. Seventeen states and Washington, D.C. have passed laws that require bank personnel to report suspected cases of elder financial abuse and hold banks liable should they fail to report suspicions of elder financial abuse. Another 33 states recommend that bank personnel report those suspected cases.
~Serena Brock
~Serena Brock
Wednesday, November 26, 2008
HAPPY THANKSGIVING
Avenue Homecare would like to wish our family, friends, and clients a Happy Thanksgiving.
Tuesday, November 25, 2008
The Key to Alzheimer's: Recognizing Symptoms and Seeking Early Detection
In a new online survey conducted by Harris Interactive and commissioned by the Alzheimer's Disease Screening Discussion Group (ADSDG) titled, "Alzheimer's Disease: Current Attitudes, Perceptions and Knowledge," it is reported that nearly 95% of the survey participants agreed they would encourage a loved one to seek early diagnosis if they suspected signs of Alzheimer's disease (AD).
However, the report goes on to state that of the 34% who previously thought a loved one had the disease, only about one-quarter prompted that person to take an AD screener test, and less than 40% encouraged initiating a conversation with his or her doctor.
Given the rise of AD as the baby boomer population ages - up to 16 million are estimated to have the disease by 2050 - these new survey results are particularly important. The ADSDG encourages everyone with a loved one age 55 and over to visit http://www.seethesigns.com if symptoms are suspected. The link has resources to learn more about the disease, its signs and symptoms, and has an online memory screener one can complete on behalf of a loved one.
~Serena Brock
However, the report goes on to state that of the 34% who previously thought a loved one had the disease, only about one-quarter prompted that person to take an AD screener test, and less than 40% encouraged initiating a conversation with his or her doctor.
Given the rise of AD as the baby boomer population ages - up to 16 million are estimated to have the disease by 2050 - these new survey results are particularly important. The ADSDG encourages everyone with a loved one age 55 and over to visit http://www.seethesigns.com if symptoms are suspected. The link has resources to learn more about the disease, its signs and symptoms, and has an online memory screener one can complete on behalf of a loved one.
~Serena Brock
Wednesday, November 19, 2008
What is a Do-Not-Resuscitate order?
A do-not-resuscitate (DNR) order is an instruction, issued for a specific person, by a physician providing treatment for that person; the instruction advises that the person has indicated that he or she does not want cardiopulmonary resuscitation (CPR) in the event that his or her heart stops beating or he or she stops breathing. A DNR order in a person's clinical record instructs agency or facility staff, emergency medical services personnel (including ambulance personnel), hospital staff and physicians not to initiate CPR.
~Serena Brock
~Serena Brock
Monday, November 17, 2008
WHAT IS A HEALTH CARE PROXY?
A health care proxy is a document created by a person (the principal) that names another person as his or her health care agent to have the authority to make decisions if and when the principal is determined to be incapable of making medical care decisions for himself or herself.
~Serena Brock
~Serena Brock
Friday, November 14, 2008
Being a Health Care Agent for a loved one
Advocating for your loved one can be a difficult task. You should ensure that you are comfortable taking on this responsibility and have ongoing conversations with your loved ones about their wishes for end-of-life care. One of your most important responsibilities will be to communicate with your loved ones healthcare providers to ensure your loved ones wishes are honored.
How to talk with a doctor if you are a healthcare agent:
Establish open communication with the doctor.
Make an appointment to speak about your loved one's care.
Be assertive in expressing your wishes. Clearly state the reasons behind your requests without being hostile.
Ask questions. To be effective and to make informed decisions, learn as much as possible about your loved one's condition and prognosis.
Ask about the goals of the treatment plan - often. A physician's definition of recovery can be different from what is acceptable to you or your loved one. Seek the assistance of a social worker or patient representative if necessary. Such professionals can help improve communication between you and the physician.
Don't be afraid to speak to the facility's administration. If the physician is unresponsive, go directly to his or her superiors, including the chief of medicine, risk manager, hospital lawyer or administrator.
~Serena Brock
How to talk with a doctor if you are a healthcare agent:
Establish open communication with the doctor.
Make an appointment to speak about your loved one's care.
Be assertive in expressing your wishes. Clearly state the reasons behind your requests without being hostile.
Ask questions. To be effective and to make informed decisions, learn as much as possible about your loved one's condition and prognosis.
Ask about the goals of the treatment plan - often. A physician's definition of recovery can be different from what is acceptable to you or your loved one. Seek the assistance of a social worker or patient representative if necessary. Such professionals can help improve communication between you and the physician.
Don't be afraid to speak to the facility's administration. If the physician is unresponsive, go directly to his or her superiors, including the chief of medicine, risk manager, hospital lawyer or administrator.
~Serena Brock
Wednesday, November 12, 2008
Family tug of war - how to make sure it doesn't pull you - or your finances - apart
You're rushing to drop the kids at school, fumbling with coats and lunch boxes, when you get the call. Dad has fallen down the stairs, is in the ER and your mom is panicking. She needs you to come home, now.
You want to drop everything. Your heart is racing and you can barely hold back your tears, because "home" is 2,000 miles away, and the last-minute flight, plus the home health aide you'll have to hire, will set you back $1,500 at least. Not to mention that you have a huge presentation to your biggest client this afternoon. All of the sudden, your anxiety level has gone through the roof and you can’t figure out how you will get home, get your kids, not lose your biggest client and manage to pay for the last minute details as a result of the situation.
All I can say, is, welcome, boomer. You're not just part of the sandwich generation - you're part of a triple-decker club with all the trimmings.
And if you feel trapped in the middle, you've got company: According to the Pew Research Center reports, Nearly 10 million boomers are now raising kids or supporting an adult child while giving a financial hand to an aging parent.
We can all relate to this situation and only hope that we are prepared. So let’s consider our own retirement and our own family preparation and protection.
There are so many resources available today, from local programs to national organizations, from books to Web sites, a veritable cottage industry has sprung up to assist you in juggling the demands of raising kids while also caring for aging parents.
Some of these services are a direct response by the government to meet the needs of the country's burgeoning senior ranks - with you, the taxpayer, footing the bill.
Others are the work of smart entrepreneurs who spy a business opportunity. Still others come from fellow boomers wanting to share what they've learned as they've grappled with these issues.
It is important that you consider your choices carefully. Although the situation may have come on suddenly and you feel overwhelmed and uncertain of how you will manage it all, take a deep breath, sit down and review your options.
1. If you have not had these conversations with your parents, now is the time. How are they doing financially and what plans have they made to protect them should be become ill or incapacitated?
2. How is your own personal financial situation? Now is a good time to make certain that your own family is protected, too.
3. Do you have POA? If an emergency situation arises, you will need to have the legal authority to act on your parents behalf. Talk to an attorney about a durable power of attorney, which will authorize you to sign checks, pay bills and make financial decisions on their behalf. You will need a durable power of attorney for health care (healthcare proxy), authorizing you or someone to make medical decisions and also ask about a living will, which will outline their wishes should their be a life-sustaining medical situation. An attorney will also further direct you and your parents with the appropriate planning options.
4. You need to know about your options should a nursing home stay come into the future. Bills for a nursing home, assisted living or in home care are very costly.
5. Before you do see an attorney, gather all of the policies that your parents may have as it relates to insurance. Do they have long term care insurance?
6. Talk to your parents about all of their issues, concerns, wishes. What do they want to happen? Faced with reality, where do they want to live? How do they wish to be cared for? Are there things that they wish to happen? What do they want to avoid?
7. Plan to protect them, and your own family. This is a great time to ensure that you do not leave your own children in a similar position. Planning in advance is the best option.
Serena Brock
You want to drop everything. Your heart is racing and you can barely hold back your tears, because "home" is 2,000 miles away, and the last-minute flight, plus the home health aide you'll have to hire, will set you back $1,500 at least. Not to mention that you have a huge presentation to your biggest client this afternoon. All of the sudden, your anxiety level has gone through the roof and you can’t figure out how you will get home, get your kids, not lose your biggest client and manage to pay for the last minute details as a result of the situation.
All I can say, is, welcome, boomer. You're not just part of the sandwich generation - you're part of a triple-decker club with all the trimmings.
And if you feel trapped in the middle, you've got company: According to the Pew Research Center reports, Nearly 10 million boomers are now raising kids or supporting an adult child while giving a financial hand to an aging parent.
We can all relate to this situation and only hope that we are prepared. So let’s consider our own retirement and our own family preparation and protection.
There are so many resources available today, from local programs to national organizations, from books to Web sites, a veritable cottage industry has sprung up to assist you in juggling the demands of raising kids while also caring for aging parents.
Some of these services are a direct response by the government to meet the needs of the country's burgeoning senior ranks - with you, the taxpayer, footing the bill.
Others are the work of smart entrepreneurs who spy a business opportunity. Still others come from fellow boomers wanting to share what they've learned as they've grappled with these issues.
It is important that you consider your choices carefully. Although the situation may have come on suddenly and you feel overwhelmed and uncertain of how you will manage it all, take a deep breath, sit down and review your options.
1. If you have not had these conversations with your parents, now is the time. How are they doing financially and what plans have they made to protect them should be become ill or incapacitated?
2. How is your own personal financial situation? Now is a good time to make certain that your own family is protected, too.
3. Do you have POA? If an emergency situation arises, you will need to have the legal authority to act on your parents behalf. Talk to an attorney about a durable power of attorney, which will authorize you to sign checks, pay bills and make financial decisions on their behalf. You will need a durable power of attorney for health care (healthcare proxy), authorizing you or someone to make medical decisions and also ask about a living will, which will outline their wishes should their be a life-sustaining medical situation. An attorney will also further direct you and your parents with the appropriate planning options.
4. You need to know about your options should a nursing home stay come into the future. Bills for a nursing home, assisted living or in home care are very costly.
5. Before you do see an attorney, gather all of the policies that your parents may have as it relates to insurance. Do they have long term care insurance?
6. Talk to your parents about all of their issues, concerns, wishes. What do they want to happen? Faced with reality, where do they want to live? How do they wish to be cared for? Are there things that they wish to happen? What do they want to avoid?
7. Plan to protect them, and your own family. This is a great time to ensure that you do not leave your own children in a similar position. Planning in advance is the best option.
Serena Brock
Tuesday, November 11, 2008
Monday, November 10, 2008
Aging with Dignity: Help is in place for our diverse, aging population
In June of 2007, Aging with Dignity, a non-profit organization launched a campaign to support our diverse aging population with the importance of end-of –life decisions, including using advance directives.
Five Wishes is a planning tool that helps individuals express how they want to be treated if they become seriously ill and unable to speak for themselves. It is an Advance Directive, or living will, that helps people make important end-of-life-care decisions that address their medical, personal, emotional and spiritual needs before a health crisis. Five Wishes helps answer the following questions:
Who will make decisions for you when you can’t make them yourself?
What kind of medical treatment do you/don’t you want?
How comfortable would you like to be?
How do you want people to treat you?
What do you want your loved ones to know?
Five Wishes meets the legal requirements in 40 states and is used as a model to prepare Advanced Care Directives in the remaining 10. It is now available in Albanian, Bengali, Arabic, Chinese (traditional and simplified), Croatian, French, Gujarati, Haitian Creole, Hindi, Hmong, Japanese, Korean, Polish, Portuguese, Russian, Somali, Spanish, Urdu and Vietnamese, in addition to English.
The 500,000 Wishes Campaign is a nationwide “call to action” from leading organizations that are committed to focusing attention on the importance of end-of-life-care decisions and communicating those decisions to caregivers and family members. Additionally, the campaign is a response to the increasing number of people who require assistance in communicating their wishes in languages other than English. It has received much support and endorsement from many people including U.S. Assistant Secretary for Aging, Josefina G. Carbonell, who joined the launch of the 500,000 Wishes Campaign.
For more information on this program, please visit www.agingwithdignity.org
~Serena Brock
Five Wishes is a planning tool that helps individuals express how they want to be treated if they become seriously ill and unable to speak for themselves. It is an Advance Directive, or living will, that helps people make important end-of-life-care decisions that address their medical, personal, emotional and spiritual needs before a health crisis. Five Wishes helps answer the following questions:
Who will make decisions for you when you can’t make them yourself?
What kind of medical treatment do you/don’t you want?
How comfortable would you like to be?
How do you want people to treat you?
What do you want your loved ones to know?
Five Wishes meets the legal requirements in 40 states and is used as a model to prepare Advanced Care Directives in the remaining 10. It is now available in Albanian, Bengali, Arabic, Chinese (traditional and simplified), Croatian, French, Gujarati, Haitian Creole, Hindi, Hmong, Japanese, Korean, Polish, Portuguese, Russian, Somali, Spanish, Urdu and Vietnamese, in addition to English.
The 500,000 Wishes Campaign is a nationwide “call to action” from leading organizations that are committed to focusing attention on the importance of end-of-life-care decisions and communicating those decisions to caregivers and family members. Additionally, the campaign is a response to the increasing number of people who require assistance in communicating their wishes in languages other than English. It has received much support and endorsement from many people including U.S. Assistant Secretary for Aging, Josefina G. Carbonell, who joined the launch of the 500,000 Wishes Campaign.
For more information on this program, please visit www.agingwithdignity.org
~Serena Brock
Thursday, November 6, 2008
Personal Emergency Readiness
The unfortunate disasters that we have all been witness to, victimized by or known someone involved in has made us more aware of how quickly our lives can change. In fact, these recent disasters remind us that personal emergency readiness needs to be a priority for everyone, including older adults and caregivers.
AoA recommends a simple, three-step approach:
Step 1: Know the basics . Learn about the risks your particular community faces; know how to do things like turning off your gas and electricity; get to know your neighbors.
Step 2: Have emergency supplies ready . This includes items you would need to survive in your home until help arrives; it should also include a personal evacuation bag, partially packed and ready to go.
Step 3: Make a personal plan. Many older persons have special needs relating to medications, medical equipment, mobility, and support services; making a personal emergency readiness plan increases the likelihood that essential needs will still be met, even in an emergency situation.
For more information about AoA 's Emergency Preparedness and Response efforts, visit the Administration on Aging website at www.AoA.gov
~Serena Brock
AoA recommends a simple, three-step approach:
Step 1: Know the basics . Learn about the risks your particular community faces; know how to do things like turning off your gas and electricity; get to know your neighbors.
Step 2: Have emergency supplies ready . This includes items you would need to survive in your home until help arrives; it should also include a personal evacuation bag, partially packed and ready to go.
Step 3: Make a personal plan. Many older persons have special needs relating to medications, medical equipment, mobility, and support services; making a personal emergency readiness plan increases the likelihood that essential needs will still be met, even in an emergency situation.
For more information about AoA 's Emergency Preparedness and Response efforts, visit the Administration on Aging website at www.AoA.gov
~Serena Brock
Wednesday, November 5, 2008
Sandwiched?
The Sandwich Generation is a generation of people who care for their aging parents while supporting their own children. Merriam-Webster officially added the term to its dictionary in July 2006.
For Example:
Thomas and Liz are a couple in their 40s. They are busy raising a family of three children. They also spend much time each week at their parents' homes doing yard maintenance and running errands for their parents. Thomas and Liz are members of the Sandwich Generation.
In the United States, Sandwich Generation Month is a month of awareness to commemorate and celebrate the dedication, patience and caring of adults who are part of the Sandwich Generation - those caring for their children as well as their own aging parents. Sandwich Generation is officially registered within the National Special Events Registry as an annual national observation, occurring each July 1-31. Events are held throughout the United States in annual commemoration of the national observation. Sandwich Generation Month brings the community and families together to heighten understanding of the special needs of the Sandwich Generation. It also spotlights community support available to those working hard to maintain multi-generational families.. According to the Pew Research Center, just over 1 of every 8 Americans aged 40 to 60 is both raising a child and caring for a parent, in addition to between 7 to 10 million adults caring for their aging parents from a long distance. US Census Bureau statistics indicate that the number of older Americans aged 65 or older will double by the year 2030, to over 70 million.
Source: Wikipedia.com
~Serena Brock
For Example:
Thomas and Liz are a couple in their 40s. They are busy raising a family of three children. They also spend much time each week at their parents' homes doing yard maintenance and running errands for their parents. Thomas and Liz are members of the Sandwich Generation.
In the United States, Sandwich Generation Month is a month of awareness to commemorate and celebrate the dedication, patience and caring of adults who are part of the Sandwich Generation - those caring for their children as well as their own aging parents. Sandwich Generation is officially registered within the National Special Events Registry as an annual national observation, occurring each July 1-31. Events are held throughout the United States in annual commemoration of the national observation. Sandwich Generation Month brings the community and families together to heighten understanding of the special needs of the Sandwich Generation. It also spotlights community support available to those working hard to maintain multi-generational families.. According to the Pew Research Center, just over 1 of every 8 Americans aged 40 to 60 is both raising a child and caring for a parent, in addition to between 7 to 10 million adults caring for their aging parents from a long distance. US Census Bureau statistics indicate that the number of older Americans aged 65 or older will double by the year 2030, to over 70 million.
Source: Wikipedia.com
~Serena Brock
Tuesday, November 4, 2008
Important Medicaid Notice
The requirement for submission of a signed Letter of Attestation for Federal Fiscal Year 2007 has passed. Letters of Attestation have not been received from many provider types. This includes individual and group physicians, adult care homes, home health agencies, skilled nursing facilities, etc. Claims will begin denying early November 2008.
Please visit our False Claims Act web page for more information at http://www.ncdhhs.gov/dma/fca/falseclaimsact.html . There you may access a searchable database to see if a provider must attest this year.
For additional questions contact EDS Provider Services at 1-800-688-6696 or 919-851-8888 option 3
~Serena Brock
Please visit our False Claims Act web page for more information at http://www.ncdhhs.gov/dma/fca/falseclaimsact.html . There you may access a searchable database to see if a provider must attest this year.
For additional questions contact EDS Provider Services at 1-800-688-6696 or 919-851-8888 option 3
~Serena Brock
Monday, November 3, 2008
There are good agencies and not so good agencies!
This is a venting blog. I absolutely love my role in home care. In fact, I think that those of us who provide home care today are some of the most compassionate, caring individuals. Then, there are those who are clearly only in the business for business.
Tonight, I had the privilege of meeting one of the sweetest ladies I have ever met. Her son, now 5, still requires 24/7 nursing care and will for the rest of his life. I can handle that part, as sad as it is, some of these moms that I meet are truly the strongest women on the planet. So, having the ability to truly help these women – these families and provide them with comfort and relief, is more satisfaction than you can imagine.
As home care providers we are charged with a very critical mission: quality, ethical care that ensures the safety and well being of the client. For my team, it goes further than that – eliminate the headaches, stress and undue emotional pressures that families face when caring for a sick loved one. Now, imagine for just a moment being new to this country, learning the language AND having a child who requires round the clock nursing care. Thankfully, the Medicaid program provides this invaluable service that permits licensed agencies to send nurses into a home, thus eliminating the need for families to be without their children – having to deal with only visiting them in a home similar to a nursing home. It is a great program – but sadly abused by some agencies out there.
I am sickened, no, repulsed by the mere fact that there are agencies out there who are more concerned with the bottom dollar than the families. This mom was petrified that if she switched agencies (she is only receiving nursing care 50% of the time) that she would be harassed by the current agency manager, should she leave. In fact, on several occasions she has tried to leave and received continuous phone calls and even unannounced visits by the manager telling her to stay. She claimed that he would call her home, her cell phone and continue to beg her to stay.
What gives you the right to harass a family? The fact that your commission depends on it? Trust me, this is just ONE issue we have in home care today and it is ONE that will not be forgotten. So, to all of you out there who diligently follow my blog – to all of my competitors, those whom we support and those of you who read it merely to follow what we are doing... I will caution you. Treat your patients and their families with the respect they deserve. Home care is a service to assist them, not create more stress and headaches. If you are only in this business to make a living, find a new career. We are not checking out groceries – we are caring for people. If you are not sincere about their well being – do us all a favor and get out.
Tonight, I had the privilege of meeting one of the sweetest ladies I have ever met. Her son, now 5, still requires 24/7 nursing care and will for the rest of his life. I can handle that part, as sad as it is, some of these moms that I meet are truly the strongest women on the planet. So, having the ability to truly help these women – these families and provide them with comfort and relief, is more satisfaction than you can imagine.
As home care providers we are charged with a very critical mission: quality, ethical care that ensures the safety and well being of the client. For my team, it goes further than that – eliminate the headaches, stress and undue emotional pressures that families face when caring for a sick loved one. Now, imagine for just a moment being new to this country, learning the language AND having a child who requires round the clock nursing care. Thankfully, the Medicaid program provides this invaluable service that permits licensed agencies to send nurses into a home, thus eliminating the need for families to be without their children – having to deal with only visiting them in a home similar to a nursing home. It is a great program – but sadly abused by some agencies out there.
I am sickened, no, repulsed by the mere fact that there are agencies out there who are more concerned with the bottom dollar than the families. This mom was petrified that if she switched agencies (she is only receiving nursing care 50% of the time) that she would be harassed by the current agency manager, should she leave. In fact, on several occasions she has tried to leave and received continuous phone calls and even unannounced visits by the manager telling her to stay. She claimed that he would call her home, her cell phone and continue to beg her to stay.
What gives you the right to harass a family? The fact that your commission depends on it? Trust me, this is just ONE issue we have in home care today and it is ONE that will not be forgotten. So, to all of you out there who diligently follow my blog – to all of my competitors, those whom we support and those of you who read it merely to follow what we are doing... I will caution you. Treat your patients and their families with the respect they deserve. Home care is a service to assist them, not create more stress and headaches. If you are only in this business to make a living, find a new career. We are not checking out groceries – we are caring for people. If you are not sincere about their well being – do us all a favor and get out.
Friday, October 31, 2008
LONG TERM CARE COSTS
Long term care can be expensive.
Long-term care is the kind of help you may need if you have a prolonged physical illness, disability, or severe cognitive impairment (such as Alzheimer’s disease) that keeps you from living an independent lifestyle.
Most Americans are unprepared. Learn about expected costs and make sure long term care is part of your overall retirement plan.
Be Prepared! Check out the following website in order to identify long term care costs in your state.
Genworth also released a 2008 Cost of Care Study that revealed the cost of long-term care in U.S. nursing homes, assisted living facilities and in the home increased for a fifth consecutive year.
Long-term care is the kind of help you may need if you have a prolonged physical illness, disability, or severe cognitive impairment (such as Alzheimer’s disease) that keeps you from living an independent lifestyle.
Most Americans are unprepared. Learn about expected costs and make sure long term care is part of your overall retirement plan.
Be Prepared! Check out the following website in order to identify long term care costs in your state.
Genworth also released a 2008 Cost of Care Study that revealed the cost of long-term care in U.S. nursing homes, assisted living facilities and in the home increased for a fifth consecutive year.
Thursday, October 30, 2008
Presidential Candidates view as it applies to healthcare/homecare:
Today we received this break down from home care industry expert, Stephen Tweed. Thought I would share:
Let's take a quick look at the candidates, their position on healthcare, and how their approach to the presidency might affect your business, and your ability to care for patients. Then you can go to the polls and make the decision that is right for you.
Senator John McCain:
Supports home care as an alternative to institutional care
Believes in a free market approach to solving the health care problem
Proposes a move away from employer-sponsored health insurance
Proposes a $5,000 tax credit for families to purchase their own health insurance
Encourages incentives to use home health care as opposed to long term care in a facility
Acknowledges the massive costs of chronic disease on his web site
Calls for greater emphasis on preventive care
Calls for more use of health savings accounts
Supports association health plans and allowing purchases of health insurance across state lines
Advocates giving chronically-ill seniors and disabled persons cash to pay for their home care
Senator Barack Obama:
Believes in universal health care coverage like Federal government employees receive
Favors bigger government and higher taxes for the wealthy, including those home care business owners who make more than $250,000
Supports greater use of disease management for chronic illnesses
Favors mandating coverage only for children
Would offer employer reinsurance for catastrophic coverage
Would require employers that do not offer or contribute to employee health coverage to contribute a percentage of payroll to a fund for the national health insurance program
Endorsed the "Fostering Independence Through Technology Act" to establish demonstration projects supporting home health telemonitoring
Pledged to ensure that seniors have choices in their health care
Supports the expansion of government centered health programs
Favors more government regulation of many industries
~Serena Brock
Let's take a quick look at the candidates, their position on healthcare, and how their approach to the presidency might affect your business, and your ability to care for patients. Then you can go to the polls and make the decision that is right for you.
Senator John McCain:
Supports home care as an alternative to institutional care
Believes in a free market approach to solving the health care problem
Proposes a move away from employer-sponsored health insurance
Proposes a $5,000 tax credit for families to purchase their own health insurance
Encourages incentives to use home health care as opposed to long term care in a facility
Acknowledges the massive costs of chronic disease on his web site
Calls for greater emphasis on preventive care
Calls for more use of health savings accounts
Supports association health plans and allowing purchases of health insurance across state lines
Advocates giving chronically-ill seniors and disabled persons cash to pay for their home care
Senator Barack Obama:
Believes in universal health care coverage like Federal government employees receive
Favors bigger government and higher taxes for the wealthy, including those home care business owners who make more than $250,000
Supports greater use of disease management for chronic illnesses
Favors mandating coverage only for children
Would offer employer reinsurance for catastrophic coverage
Would require employers that do not offer or contribute to employee health coverage to contribute a percentage of payroll to a fund for the national health insurance program
Endorsed the "Fostering Independence Through Technology Act" to establish demonstration projects supporting home health telemonitoring
Pledged to ensure that seniors have choices in their health care
Supports the expansion of government centered health programs
Favors more government regulation of many industries
~Serena Brock
Wednesday, October 29, 2008
False Claims Act Education
Section 6023 of the Deficit Reduction Act (DRA) of 2005 requires providers receiving annual Medicaid payments of $5 million or more to educate employees, contractors, and agents about Federal and State fraud and false claims laws and the whistleblower protections available under those laws.
Beginning September 2007 and annually thereafter, DMA will notify providers that they received a minimum of five million dollars in Medicaid payments during the last federal fiscal year and that they must submit a Letter of Attestation to show that they are in compliance with the DRA. This minimum amount may have been paid to one North Carolina Medicaid provider number or to multiple provider numbers associated with the same tax identification number. Each Medicaid provider who receives a notification must sign and submit the Letter of Attestation to EDS within 30 days of the date of notification. Additional copies of the Letter of Attestation may be printed from this web page. A separate Letter of Attestation must be submitted for each Medicaid provider number.
Compliance with Section 6023 of the DRA is a condition of receiving Medicaid payments. Medicaid payments will be denied for providers that do not submit a signed Letter of Attestation within 30 days of the date of notification. Denied claims may be resubmitted by the provider once Medicaid has received the Letter of Attestation. DMA will publish information on the status of receipt of providers' Letters of Attestation on this web page.
For more information please visit the web page at: http://www.ncdhhs.gov/dma/fca/falseclaimsact.html
~Serena Brock
Beginning September 2007 and annually thereafter, DMA will notify providers that they received a minimum of five million dollars in Medicaid payments during the last federal fiscal year and that they must submit a Letter of Attestation to show that they are in compliance with the DRA. This minimum amount may have been paid to one North Carolina Medicaid provider number or to multiple provider numbers associated with the same tax identification number. Each Medicaid provider who receives a notification must sign and submit the Letter of Attestation to EDS within 30 days of the date of notification. Additional copies of the Letter of Attestation may be printed from this web page. A separate Letter of Attestation must be submitted for each Medicaid provider number.
Compliance with Section 6023 of the DRA is a condition of receiving Medicaid payments. Medicaid payments will be denied for providers that do not submit a signed Letter of Attestation within 30 days of the date of notification. Denied claims may be resubmitted by the provider once Medicaid has received the Letter of Attestation. DMA will publish information on the status of receipt of providers' Letters of Attestation on this web page.
For more information please visit the web page at: http://www.ncdhhs.gov/dma/fca/falseclaimsact.html
~Serena Brock
Tuesday, October 28, 2008
READ THAT LABEL
Advice on the Importance of Drug Compliance By: Eric Feil- Caring Today Magazine LLC
According to a new report, roughly 1.5 million Americans are injured every year by drug errors in hospitals, nursing homes and doctor’s offices—a number that does not include an estimate of mistakes patients themselves make! In hospitals alone, an average of one medication error per patient per day occurs.
Michael Cohen, president of the Institute for Safe Medication Practices and co-author of the study, offers patients and caregivers the following key recommendations:
Before leaving your doctor's office, know the name of each new prescription medication, how to take it, the side effects and potential adverse effects, and why it’s being taken.
Seek out doctors who prescribe by computer. Computers can alert doctors to the thousands of possible drug interaction concerns and also take into account a patient’s personal information (allergies, for example) to help screen out drugs and doses that might cause adverse effects.
Talk directly to your pharmacist before leaving the pharmacy with a new prescription. Obtain important information about the medication and, to avoid errors, make sure the information from the pharmacist matches what the doctor said.
Share important clinical information (allergies, chronic diseases, problems with liver or kidney, pregnancy status, whether you are breastfeeding, etc.) in confidence with your pharmacist. He or she can serve as an important double-check to make sure nothing is overlooked regarding you or your care recipient.
Maintain an up-to-date list of all medications, nonprescription drugs, herbal remedies, vitamins, etc. It is critically important that caregivers have this information about their care recipients before treatment begins. Patients often overlook the importance of having this kind of list or do not consider certain items important enough to include.
~Serena Brock
According to a new report, roughly 1.5 million Americans are injured every year by drug errors in hospitals, nursing homes and doctor’s offices—a number that does not include an estimate of mistakes patients themselves make! In hospitals alone, an average of one medication error per patient per day occurs.
Michael Cohen, president of the Institute for Safe Medication Practices and co-author of the study, offers patients and caregivers the following key recommendations:
Before leaving your doctor's office, know the name of each new prescription medication, how to take it, the side effects and potential adverse effects, and why it’s being taken.
Seek out doctors who prescribe by computer. Computers can alert doctors to the thousands of possible drug interaction concerns and also take into account a patient’s personal information (allergies, for example) to help screen out drugs and doses that might cause adverse effects.
Talk directly to your pharmacist before leaving the pharmacy with a new prescription. Obtain important information about the medication and, to avoid errors, make sure the information from the pharmacist matches what the doctor said.
Share important clinical information (allergies, chronic diseases, problems with liver or kidney, pregnancy status, whether you are breastfeeding, etc.) in confidence with your pharmacist. He or she can serve as an important double-check to make sure nothing is overlooked regarding you or your care recipient.
Maintain an up-to-date list of all medications, nonprescription drugs, herbal remedies, vitamins, etc. It is critically important that caregivers have this information about their care recipients before treatment begins. Patients often overlook the importance of having this kind of list or do not consider certain items important enough to include.
~Serena Brock
Monday, October 27, 2008
ALZHEIMER'S: CAREGIVING 101
By: Beth Polazzo-Caring Today Magazine LLC
Caring for a person with Alzheimer's disease (AD) at home is a difficult task and can become overwhelming as well as heartbreaking at times. Research has shown that caregivers themselves often are at increased risk for depression and illness, especially if they do not receive adequate support from family, friends, and the community.
When the patient is first diagnosed, they are often reluctant to admit even having the disease — it's easier to blame forgetfulness and other strange behaviors on aging, stress or anything else besides AD. For the caregiver, the job goes from normal day-to-day living to watching and helping a loved one become someone they never married or even knew. One of the biggest struggles caregivers face is dealing with the difficult behaviors of the person they are caring for. Dressing, bathing, eating-basic activities of daily living-often become difficult to manage for both the person with AD and the caregiver.
Dealing with the Diagnosis
According to the Alzheimer's Disease Education and Referral Center, finding out that a loved one has AD can be stressful, frightening, and overwhelming. As you begin to take stock of the situation, here are some tips that may help:
Ask the doctor any questions you have and discuss what treatments might work best to alleviate symptoms or address behavior problems.
Contact organizations such as the Alzheimer's Association and the Alzheimer's Disease Education and Referral (ADEAR) Center for more information about the disease, treatment options, and caregiving resources. Find a support group where you can share your feelings and concerns.
Consider using adult day care or respite services to ease the day-to-day demands of caregiving.
Begin to plan for the future. This may include getting financial and legal documents in order, investigating long-term care options, and determining what services are covered by health insurance and Medicare.
You will find that as the disease progresses, you and your loved one must find new ways to do the things that you have long taken for granted. Everything from communicating, bathing, dressing, eating, day-to-day activities and exercise become increasingly more difficult. Some of the most stressful times for the caregiver arise when the patient has to surrender the car keys, experiences incontinence, has trouble sleeping (when you are ready to fall over in exhaustion), suffers from hallucinations or delusions, wanders away from home or, like a youngster, has no regard for home safety.
Although getting there might prove to be a monumental effort, it is important that the person with AD receive regular medical care since some symptoms or behaviors may be due to an illness that is not related to AD.
Not to be overlooked is your health and well-being. The mental, physical and emotional demands that you face on a daily basis are daunting. There is help available—and it comes in many different ways but you need to accept the fact that you are only one person and there are only 24-hours in a 7-day week. Just the pressure of knowing that "you can't get sick" can make you a nervous wreck. It is NOT a sign of weakness, incompetence or negligence to cry "uncle." In fact, it's normal to be overwhelmed.
What should you do for yourself?
When someone offers help, take it.
When you need a break, ask someone to step in.
Take time for you and your needs—go for a walk, go to a concert, play cards or just get a massage. The world will go on and nothing will happen if you plan a little bit ahead. Line up a few volunteer caregivers; you'll be surprised at how willing people really are to lend you a hand.
Think about adult day care offerings.
Consider community resources that can range from financial to emotional support.
Talk to a therapist—or a friend who makes you laugh.
If you aren't physically strong enough to lift your patient or even the groceries, try asking a neighbor or neighbor's son for help. And if it's really an emergency, the police or fire departments will be more than willing to literally lend a helping hand.
When you are feeling so frustrated that you want to scream, walk out the door and yell or pound your fist into something soft (walls are not soft!).
Don't ignore your physical ailments hoping that they'll go away. They won't. See a healthcare professional and stop diagnosing your aches and pains.
If you can afford it, pay for a professional caregiver. They are angels disguised as mere mortals.
When your patient seems to be close to death, call for hospice help. You have no idea how comforting it can be to put some of your concerns in their more-than-capable hands.
And don't forget about those "little" things, like eating and sleeping!
~Serena Brock
Caring for a person with Alzheimer's disease (AD) at home is a difficult task and can become overwhelming as well as heartbreaking at times. Research has shown that caregivers themselves often are at increased risk for depression and illness, especially if they do not receive adequate support from family, friends, and the community.
When the patient is first diagnosed, they are often reluctant to admit even having the disease — it's easier to blame forgetfulness and other strange behaviors on aging, stress or anything else besides AD. For the caregiver, the job goes from normal day-to-day living to watching and helping a loved one become someone they never married or even knew. One of the biggest struggles caregivers face is dealing with the difficult behaviors of the person they are caring for. Dressing, bathing, eating-basic activities of daily living-often become difficult to manage for both the person with AD and the caregiver.
Dealing with the Diagnosis
According to the Alzheimer's Disease Education and Referral Center, finding out that a loved one has AD can be stressful, frightening, and overwhelming. As you begin to take stock of the situation, here are some tips that may help:
Ask the doctor any questions you have and discuss what treatments might work best to alleviate symptoms or address behavior problems.
Contact organizations such as the Alzheimer's Association and the Alzheimer's Disease Education and Referral (ADEAR) Center for more information about the disease, treatment options, and caregiving resources. Find a support group where you can share your feelings and concerns.
Consider using adult day care or respite services to ease the day-to-day demands of caregiving.
Begin to plan for the future. This may include getting financial and legal documents in order, investigating long-term care options, and determining what services are covered by health insurance and Medicare.
You will find that as the disease progresses, you and your loved one must find new ways to do the things that you have long taken for granted. Everything from communicating, bathing, dressing, eating, day-to-day activities and exercise become increasingly more difficult. Some of the most stressful times for the caregiver arise when the patient has to surrender the car keys, experiences incontinence, has trouble sleeping (when you are ready to fall over in exhaustion), suffers from hallucinations or delusions, wanders away from home or, like a youngster, has no regard for home safety.
Although getting there might prove to be a monumental effort, it is important that the person with AD receive regular medical care since some symptoms or behaviors may be due to an illness that is not related to AD.
Not to be overlooked is your health and well-being. The mental, physical and emotional demands that you face on a daily basis are daunting. There is help available—and it comes in many different ways but you need to accept the fact that you are only one person and there are only 24-hours in a 7-day week. Just the pressure of knowing that "you can't get sick" can make you a nervous wreck. It is NOT a sign of weakness, incompetence or negligence to cry "uncle." In fact, it's normal to be overwhelmed.
What should you do for yourself?
When someone offers help, take it.
When you need a break, ask someone to step in.
Take time for you and your needs—go for a walk, go to a concert, play cards or just get a massage. The world will go on and nothing will happen if you plan a little bit ahead. Line up a few volunteer caregivers; you'll be surprised at how willing people really are to lend you a hand.
Think about adult day care offerings.
Consider community resources that can range from financial to emotional support.
Talk to a therapist—or a friend who makes you laugh.
If you aren't physically strong enough to lift your patient or even the groceries, try asking a neighbor or neighbor's son for help. And if it's really an emergency, the police or fire departments will be more than willing to literally lend a helping hand.
When you are feeling so frustrated that you want to scream, walk out the door and yell or pound your fist into something soft (walls are not soft!).
Don't ignore your physical ailments hoping that they'll go away. They won't. See a healthcare professional and stop diagnosing your aches and pains.
If you can afford it, pay for a professional caregiver. They are angels disguised as mere mortals.
When your patient seems to be close to death, call for hospice help. You have no idea how comforting it can be to put some of your concerns in their more-than-capable hands.
And don't forget about those "little" things, like eating and sleeping!
~Serena Brock
Friday, October 24, 2008
Should You Get a Flu Shot? What You Need to Know
By Jeff Levine - October 10, 2008 - AARP Bulletin Today
Since the flu is nothing to sneeze at, experts are making their annual plea for people 50-plus and other at-risk groups to get their shots.
Public health officials say a new vaccine from five different manufacturers has been shipped to clinics and doctors’ offices around the country. There should be enough to go around. According to Julie Gerberding, M.D., director of the U.S. Centers for Disease Control and Prevention (CDC), between 143 million and 146 million doses are available, ruling out any shortage like the one that occurred in 2004, when the vaccine supply was cut in half.
Influenza—the fancy word for the flu—is an infectious respiratory disease, caused by a virus, that can be really dangerous to at-risk groups, including the older people, infants and people with chronic diseases. Flu and bacterial pneumonia—a common complication of flu—each year send 200,000 people to hospitals in the United States and cause on average 36,000 deaths.
Immunizations usually help individuals avoid the flu, but public health officials are concerned that this season, people may be reluctant to be inoculated. That’s because last year’s circulating virus strains did not match up with the vaccine, so more people came down with the flu.
Vaccine formulations are determined each year by scientists who look at the dominant strains in the Southern Hemisphere. In February they recommend the three viruses that are most likely to strike the United States in the next flu season. Usually one or two strains are used from the previous year’s vaccine. But this year’s formulation is “unprecedented,” says Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), because the vaccine has been manufactured with three new strains.
In 16 of the last 19 years, the vaccine has been a good match with prevailing viruses, says Joe Bresee, M.D., head of the CDC’s flu prevention effort. Normally, a shot works for 70 to 90 percent of those immunized, he says, but last year only 44 percent were protected.
Betty, an 81-year-old Fairfax, Va., resident who doesn’t wish to be identified, was one person for whom last year’s vaccine failed. She got her regular flu shot in October 2007 and thought she was protected. A month later she became severely ill.
“One day out of the blue, I just got a real high temperature and almost blacked out and started sweating,” Betty says. She went to the emergency room, where she was diagnosed with the flu and spent four days in the isolation ward. Despite her experience, she says she’ll get another flu shot this fall.
Betty’s gerontologist, Joanne Crantz, M.D., was also disappointed with last year’s vaccine. “It’s always disconcerting when you give someone a shot that you think is going to be protective, and it’s not,” she says. She saw 20 cases of flu last year in patients, some of whom had been vaccinated.
The vaccine has come under scrutiny from other sources as well. In fact, some doctors don’t think it prevents disease in the older population. They point to a study published in the British medical journal the Lancet on Aug. 2, which found that the vaccine didn’t lower the risk of pneumonia. Researchers at the Group Health Center for Health Studies in Seattle found that older people who are the most likely to get a flu shot are generally healthy and the least likely to get pneumonia, while those too weak or frail to get to the doctor’s office for a vaccination are the most vulnerable. Factoring in the variations in health status, the vaccine appeared to make little difference in pneumonia risk. The findings were based on a review of thousands of medical charts of older members of a Seattle HMO.
Still, many health experts remained unconvinced. Crantz, despite her disappointment over the vaccine’s effectiveness last year, says she doesn’t agree with the study’s conclusions. “Some very hardy people get the flu,” she says. And even the study’s lead author, Michael L. Jackson, said in a press report that he “still wants my grandmother to keep getting the flu vaccine ... even if it might lower the risk of pneumonia and death only slightly.”
“People may question whether the vaccine is effective,” adds the CDC’s Bresee, “but they need to remember it’s still the best protection we have year in and year out.”
Walter Orenstein, M.D., the former head of the CDC’s national immunization effort, says flu “has emerged as a health security issue because of its huge medical and economic toll.” Despite this, he says, warnings about the flu are too often ignored.
A new CDC report shows that in 2006, 72 percent of those older than 65 were vaccinated, but only 42 percent of individuals ages 50 to 64 and 35 percent of 18- to 49-year-olds were immunized. Just 42 percent of health workers got the shots. And a new consumer survey commissioned by the National Foundation for Infectious Diseases (NFID) shows that four in 10 patients say they’ve never even talked with their doctors about being vaccinated.
What’s likely to get more people to roll up their sleeves is a longer-lasting vaccine that confers immunity from year to year. “I think that’s the ultimate endgame and endpoint, but we’re not there yet, obviously,” says Fauci. Currently, NIAID is spending about $94 million on developing vaccines for different types of flu, up from just $3.6 million in 2000, before the 9/11 attacks, the anthrax scare and worries about avian flu.
In the meantime, AARP board member Cora Christian, M.D., said at an NFID press briefing, “Get the flu shot—it’s a powerful preventive weapon.”
Who should get immunized?
• People age 50 and older
• Nursing home residents
• Health care workers
• People with chronic diseases that weaken their immune systems
• People who are in contact with those at high risk for flu
• Children and teens, from six months to 18 years old
• Pregnant women
Types of vaccines
• Traditional flu shot consisting of a “killed” virus for healthy people older than six months
• Nose spray consisting of a weakened live virus for healthy people ages 2 to 49 years (but not pregnant women)
• A one-time vaccination against bacterial pneumonia, a common complication of flu, for those 65 and older and nursing home residents
Clinics and Costs
• Flu shots generally cost between $15 and $30, but check hospitals, senior centers, pharmacies and public clinics in your community for free or low-cost shots.
• Some polling places are offering flu shots on Election Day through the Vote and Vax program.
• Medicare pays for the total cost of flu and pneumonia vaccinations, and so do many private health plans.
Helpful Websites:
• AARP offers tips on protecting yourself from the flu.
• The Centers for Disease Control and Prevention offers information on everything from prevention to flu symptoms to treatment.
• The American Lung Association provides information on pneumonia associated with the flu and a site to help you find a flu clinic in your area.
• Medicare’s site focuses on flu and people 65-plus.
Since the flu is nothing to sneeze at, experts are making their annual plea for people 50-plus and other at-risk groups to get their shots.
Public health officials say a new vaccine from five different manufacturers has been shipped to clinics and doctors’ offices around the country. There should be enough to go around. According to Julie Gerberding, M.D., director of the U.S. Centers for Disease Control and Prevention (CDC), between 143 million and 146 million doses are available, ruling out any shortage like the one that occurred in 2004, when the vaccine supply was cut in half.
Influenza—the fancy word for the flu—is an infectious respiratory disease, caused by a virus, that can be really dangerous to at-risk groups, including the older people, infants and people with chronic diseases. Flu and bacterial pneumonia—a common complication of flu—each year send 200,000 people to hospitals in the United States and cause on average 36,000 deaths.
Immunizations usually help individuals avoid the flu, but public health officials are concerned that this season, people may be reluctant to be inoculated. That’s because last year’s circulating virus strains did not match up with the vaccine, so more people came down with the flu.
Vaccine formulations are determined each year by scientists who look at the dominant strains in the Southern Hemisphere. In February they recommend the three viruses that are most likely to strike the United States in the next flu season. Usually one or two strains are used from the previous year’s vaccine. But this year’s formulation is “unprecedented,” says Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), because the vaccine has been manufactured with three new strains.
In 16 of the last 19 years, the vaccine has been a good match with prevailing viruses, says Joe Bresee, M.D., head of the CDC’s flu prevention effort. Normally, a shot works for 70 to 90 percent of those immunized, he says, but last year only 44 percent were protected.
Betty, an 81-year-old Fairfax, Va., resident who doesn’t wish to be identified, was one person for whom last year’s vaccine failed. She got her regular flu shot in October 2007 and thought she was protected. A month later she became severely ill.
“One day out of the blue, I just got a real high temperature and almost blacked out and started sweating,” Betty says. She went to the emergency room, where she was diagnosed with the flu and spent four days in the isolation ward. Despite her experience, she says she’ll get another flu shot this fall.
Betty’s gerontologist, Joanne Crantz, M.D., was also disappointed with last year’s vaccine. “It’s always disconcerting when you give someone a shot that you think is going to be protective, and it’s not,” she says. She saw 20 cases of flu last year in patients, some of whom had been vaccinated.
The vaccine has come under scrutiny from other sources as well. In fact, some doctors don’t think it prevents disease in the older population. They point to a study published in the British medical journal the Lancet on Aug. 2, which found that the vaccine didn’t lower the risk of pneumonia. Researchers at the Group Health Center for Health Studies in Seattle found that older people who are the most likely to get a flu shot are generally healthy and the least likely to get pneumonia, while those too weak or frail to get to the doctor’s office for a vaccination are the most vulnerable. Factoring in the variations in health status, the vaccine appeared to make little difference in pneumonia risk. The findings were based on a review of thousands of medical charts of older members of a Seattle HMO.
Still, many health experts remained unconvinced. Crantz, despite her disappointment over the vaccine’s effectiveness last year, says she doesn’t agree with the study’s conclusions. “Some very hardy people get the flu,” she says. And even the study’s lead author, Michael L. Jackson, said in a press report that he “still wants my grandmother to keep getting the flu vaccine ... even if it might lower the risk of pneumonia and death only slightly.”
“People may question whether the vaccine is effective,” adds the CDC’s Bresee, “but they need to remember it’s still the best protection we have year in and year out.”
Walter Orenstein, M.D., the former head of the CDC’s national immunization effort, says flu “has emerged as a health security issue because of its huge medical and economic toll.” Despite this, he says, warnings about the flu are too often ignored.
A new CDC report shows that in 2006, 72 percent of those older than 65 were vaccinated, but only 42 percent of individuals ages 50 to 64 and 35 percent of 18- to 49-year-olds were immunized. Just 42 percent of health workers got the shots. And a new consumer survey commissioned by the National Foundation for Infectious Diseases (NFID) shows that four in 10 patients say they’ve never even talked with their doctors about being vaccinated.
What’s likely to get more people to roll up their sleeves is a longer-lasting vaccine that confers immunity from year to year. “I think that’s the ultimate endgame and endpoint, but we’re not there yet, obviously,” says Fauci. Currently, NIAID is spending about $94 million on developing vaccines for different types of flu, up from just $3.6 million in 2000, before the 9/11 attacks, the anthrax scare and worries about avian flu.
In the meantime, AARP board member Cora Christian, M.D., said at an NFID press briefing, “Get the flu shot—it’s a powerful preventive weapon.”
Who should get immunized?
• People age 50 and older
• Nursing home residents
• Health care workers
• People with chronic diseases that weaken their immune systems
• People who are in contact with those at high risk for flu
• Children and teens, from six months to 18 years old
• Pregnant women
Types of vaccines
• Traditional flu shot consisting of a “killed” virus for healthy people older than six months
• Nose spray consisting of a weakened live virus for healthy people ages 2 to 49 years (but not pregnant women)
• A one-time vaccination against bacterial pneumonia, a common complication of flu, for those 65 and older and nursing home residents
Clinics and Costs
• Flu shots generally cost between $15 and $30, but check hospitals, senior centers, pharmacies and public clinics in your community for free or low-cost shots.
• Some polling places are offering flu shots on Election Day through the Vote and Vax program.
• Medicare pays for the total cost of flu and pneumonia vaccinations, and so do many private health plans.
Helpful Websites:
• AARP offers tips on protecting yourself from the flu.
• The Centers for Disease Control and Prevention offers information on everything from prevention to flu symptoms to treatment.
• The American Lung Association provides information on pneumonia associated with the flu and a site to help you find a flu clinic in your area.
• Medicare’s site focuses on flu and people 65-plus.
Thursday, October 23, 2008
Medicare Critical to Long-Term Care for Senior Citizens
Elderly Americans most frequently turn to Medicaid for long-term care, as the cost of nursing homes and other intensive care quickly diminishes the financial resources of many families.
Among the different types of health care services, Medicaid plays the largest role in the funding of long-term care. According to the 2006 National Health Expenditure data, Medicaid is estimated to have paid for 34 percent of all home health care and 43 percent of all nursing home care in the U.S.
Medicaid has a major responsibility for providing long-term care because the program covers some aged and many disabled persons, who tend to be the most frequent and most costly users of it, and because private health insurance and Medicare often furnish only limited coverage for such care, particularly for nursing homes.
Many people who pay for nursing home care privately become impoverished because nursing home care is very expensive; as a result, these people eventually become eligible for Medicaid.
Medicaid spent $99.9 billion on long-term care and $66.6 billion on managed care and other premiums in FY 2007.
During FY 2000 through FY 2005, Medicaid growth was faster than in the previous 6 years, with spending increasing an average of 8.9 percent per year over the 6-year period.
Several trends contributed to this acceleration. First, Medicaid enrollment increased at an average rate of 6.4 percent per year between FY 2000 and FY 2005. It grew fastest between FY 2000 and FY 2002, coinciding with the 2001economic recession, and reached a peak of 9.3 percent in FY 2002.
While blind or disabled enrollees and aged enrollees are the smallest enrollment groups in Medicaid, they are projected to account for the majority of spending. As indicated in the table below, for FY 2007, estimated benefit spending was $126.7 billion for blind or disabled enrollees and $70.9 billion for aged enrollees.
Combined, spending on these two groups constituted 67 percent of Medicaid expenditures (excluding DSH, territory expenditures, and adjustments which cannot be allocated by eligibility group). Medicaid spending on non-disabled children was about 19 percent of total Medicaid benefit expenditures, and spending on non-disabled and non-aged adults was about 13 percent.
~Serena Brock
Among the different types of health care services, Medicaid plays the largest role in the funding of long-term care. According to the 2006 National Health Expenditure data, Medicaid is estimated to have paid for 34 percent of all home health care and 43 percent of all nursing home care in the U.S.
Medicaid has a major responsibility for providing long-term care because the program covers some aged and many disabled persons, who tend to be the most frequent and most costly users of it, and because private health insurance and Medicare often furnish only limited coverage for such care, particularly for nursing homes.
Many people who pay for nursing home care privately become impoverished because nursing home care is very expensive; as a result, these people eventually become eligible for Medicaid.
Medicaid spent $99.9 billion on long-term care and $66.6 billion on managed care and other premiums in FY 2007.
During FY 2000 through FY 2005, Medicaid growth was faster than in the previous 6 years, with spending increasing an average of 8.9 percent per year over the 6-year period.
Several trends contributed to this acceleration. First, Medicaid enrollment increased at an average rate of 6.4 percent per year between FY 2000 and FY 2005. It grew fastest between FY 2000 and FY 2002, coinciding with the 2001economic recession, and reached a peak of 9.3 percent in FY 2002.
While blind or disabled enrollees and aged enrollees are the smallest enrollment groups in Medicaid, they are projected to account for the majority of spending. As indicated in the table below, for FY 2007, estimated benefit spending was $126.7 billion for blind or disabled enrollees and $70.9 billion for aged enrollees.
Combined, spending on these two groups constituted 67 percent of Medicaid expenditures (excluding DSH, territory expenditures, and adjustments which cannot be allocated by eligibility group). Medicaid spending on non-disabled children was about 19 percent of total Medicaid benefit expenditures, and spending on non-disabled and non-aged adults was about 13 percent.
~Serena Brock
Medicaid Spending Will Join Medicare in Out Running the Economy in Years Ahead
Long-term care for low-income senior citizens will help drive cost to $4.9 trillion in 10 years.
Oct. 19, 2008 - Under current law, spending on Medicaid is expected to substantially outpace the rate of growth in the U.S. economy over the next decade, according to a new annual report released Friday by the Centers for Medicare & Medicaid Services (CMS). This is the first time the government has spotlighted Medicaid spending as it does annually with Medicare and Social Security all three critical programs to millions of senior citizens. For a copy of the full CMS report, please email serena@avenuehomecare.com or visit the CMS website.
~Serena Brock
Oct. 19, 2008 - Under current law, spending on Medicaid is expected to substantially outpace the rate of growth in the U.S. economy over the next decade, according to a new annual report released Friday by the Centers for Medicare & Medicaid Services (CMS). This is the first time the government has spotlighted Medicaid spending as it does annually with Medicare and Social Security all three critical programs to millions of senior citizens. For a copy of the full CMS report, please email serena@avenuehomecare.com or visit the CMS website.
~Serena Brock
Wednesday, October 22, 2008
Thank You To Our Road Warriors!
A recent study conducted by the National Association for Home Care and Hospice shows that nurses, therapists, home care aides, and others who serve elderly and disabled patients in their own homes drive nearly 5 billion miles each year. Caring for nearly 12 million patients annually with 428 million visits, the dedicated providers of home care and hospice services are health care's version of "road warriors."
~Serena Brock
~Serena Brock
Tuesday, October 21, 2008
McCain Medicare/Medicaid Changes Focus of Media Attention
The following blog is from the NAHC Report Article dated Tuesday, October 7, 2008.
WSJ Says Spending Reduction to Offset Tax Credit. Media reports in recent days have referenced comment by a “top aide” that Republican Presidential Candidate Sen. John McCain (R-AZ) would pay for his health care plan by making “major” reductions to Medicare and Medicaid. The Wall Street Journal carried the article Oct. 6. This cut, the Journal said, could amount to as much as $1.3 trillion over 10 years. The changes to health entitlement programs, according to the Journal, are needed to keep McCain’s health-care plan budget neutral as he has promised. The McCain campaign hasn't given a specific figure for the cuts, but didn't dispute the analysts' estimate, according to the Journal. Douglas Holtz-Eakin, McCain's senior policy adviser, was quoted as saying that the campaign has always planned to fund health care tax credits, in part, with savings from Medicare and Medicaid, and that the changes will improve the programs and eliminate fraud, but he didn't detail where the cuts would come from. “It's about giving them the benefit package that has been promised to them by law at lower cost,” he said. A Kaiser Family Foundation analysis of the candidates on Medicare provider payment reform indicates that McCain favors bundling of services related to a patient's disease instead of paying a separate fee for each service; Kaiser indicates that McCain’s contender for the presidency, Sen. Barack Obama (D-IL) supports bundling Medicare provider payments in certain circumstances but not as a requirement. McCain also believes Medicare should not pay for services resulting in, or related to, preventable errors or mismanagement. Both candidates support stepped-up prevention efforts. According to the Journal, in the months since Sen. McCain introduced his health plan, statements made by his campaign have implied that the new tax credits he is proposing to help Americans buy health insurance would be paid for with other tax increases. The nonpartisan Tax Policy Center, a Washington think tank, estimates that the McCain plan would cost the government $1.3 trillion over 10 years, the Journal reported. The plan would allow as many as five million more people to have insurance coverage, it estimates. The Journal quoted Holtz-Eakin as saying the plan is accurately described as budget neutral because it assumes enough savings in Medicare and Medicaid spending to make up the difference. He said the savings would come from eliminating Medicare fraud and by reforming payment policies to lower the overall cost of care. The new health insurance tax credits of $2,500 per person and $5,000 per family will help some low-income people avoid joining Medicaid and allow people to buy health coverage on the open market, where they may have more choices and might look for a better bargain. In exchange, the Journal explained, the government would begin taxing the value of health benefits people get through work. If an employer spends $10,000 to buy a worker health insurance, the worker would pay taxes on that money. The Journal noted that McCain's plan actually would lower taxes for most people. Obama also would rely on some Medicare savings to pay for his health care plan, which, according to the Journal, would offer subsidies to help consumers pay for premiums. The Tax Policy Center estimates that his plan would cost $1.6 trillion over 10 years and cover 34 million more people. The full Wall St. Journal story can be found here http://online.wsj.com/article/SB122315505846605217.html.
~Serena Brock
WSJ Says Spending Reduction to Offset Tax Credit. Media reports in recent days have referenced comment by a “top aide” that Republican Presidential Candidate Sen. John McCain (R-AZ) would pay for his health care plan by making “major” reductions to Medicare and Medicaid. The Wall Street Journal carried the article Oct. 6. This cut, the Journal said, could amount to as much as $1.3 trillion over 10 years. The changes to health entitlement programs, according to the Journal, are needed to keep McCain’s health-care plan budget neutral as he has promised. The McCain campaign hasn't given a specific figure for the cuts, but didn't dispute the analysts' estimate, according to the Journal. Douglas Holtz-Eakin, McCain's senior policy adviser, was quoted as saying that the campaign has always planned to fund health care tax credits, in part, with savings from Medicare and Medicaid, and that the changes will improve the programs and eliminate fraud, but he didn't detail where the cuts would come from. “It's about giving them the benefit package that has been promised to them by law at lower cost,” he said. A Kaiser Family Foundation analysis of the candidates on Medicare provider payment reform indicates that McCain favors bundling of services related to a patient's disease instead of paying a separate fee for each service; Kaiser indicates that McCain’s contender for the presidency, Sen. Barack Obama (D-IL) supports bundling Medicare provider payments in certain circumstances but not as a requirement. McCain also believes Medicare should not pay for services resulting in, or related to, preventable errors or mismanagement. Both candidates support stepped-up prevention efforts. According to the Journal, in the months since Sen. McCain introduced his health plan, statements made by his campaign have implied that the new tax credits he is proposing to help Americans buy health insurance would be paid for with other tax increases. The nonpartisan Tax Policy Center, a Washington think tank, estimates that the McCain plan would cost the government $1.3 trillion over 10 years, the Journal reported. The plan would allow as many as five million more people to have insurance coverage, it estimates. The Journal quoted Holtz-Eakin as saying the plan is accurately described as budget neutral because it assumes enough savings in Medicare and Medicaid spending to make up the difference. He said the savings would come from eliminating Medicare fraud and by reforming payment policies to lower the overall cost of care. The new health insurance tax credits of $2,500 per person and $5,000 per family will help some low-income people avoid joining Medicaid and allow people to buy health coverage on the open market, where they may have more choices and might look for a better bargain. In exchange, the Journal explained, the government would begin taxing the value of health benefits people get through work. If an employer spends $10,000 to buy a worker health insurance, the worker would pay taxes on that money. The Journal noted that McCain's plan actually would lower taxes for most people. Obama also would rely on some Medicare savings to pay for his health care plan, which, according to the Journal, would offer subsidies to help consumers pay for premiums. The Tax Policy Center estimates that his plan would cost $1.6 trillion over 10 years and cover 34 million more people. The full Wall St. Journal story can be found here http://online.wsj.com/article/SB122315505846605217.html.
~Serena Brock
Monday, October 20, 2008
Bush administration calls for nursing home ratings
In a recent article found in The Detroit News ( Follow this link to read the complete article from The Detroit News
http://www.detnews.com/apps/pbcs.dll/article?AID=/20080619/NATION/806190347/1020),
Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services, was quoted as commenting that, "The fact a home has a lower rating will likely put them on the path to improvement," said Kerry Weems, "I don't think we're going to see many people who are very anxious to put a loved one in a one-star home."
The good news for our aging citizens is that this rating system, that is said to be implemented by the end of the year, will offer a rating system designed to give consumers another tool to consider when shopping for a nursing home. These ratings would be placed on a government web site.
http://www.detnews.com/apps/pbcs.dll/article?AID=/20080619/NATION/806190347/1020),
Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services, was quoted as commenting that, "The fact a home has a lower rating will likely put them on the path to improvement," said Kerry Weems, "I don't think we're going to see many people who are very anxious to put a loved one in a one-star home."
The good news for our aging citizens is that this rating system, that is said to be implemented by the end of the year, will offer a rating system designed to give consumers another tool to consider when shopping for a nursing home. These ratings would be placed on a government web site.
Friday, October 17, 2008
Veterans and Veterans Benefits
We have all heard the statistics. Americans are living longer, and because of it are requiring more healthcare services. For those in the 65+ age group, which is currently the fastest growing segment of the American population, home healthcare services are in the greatest demand. With the home healthcare industry barely able to keep pace, it is expected that home healthcare costs will skyrocket. Who can afford to pay such costs? Not many! Unless a person has a long term care insurance policy, it is a well known fact that Medicare and Medicaid are not going to provide much assistance. Are we missing something? Is there another way to pay? The answer is, “yes”, and it relates to veterans and veteran’s benefits.
If they qualify, a veteran and/or his or her surviving spouse will be entitled to receive a monthly pension benefit, which is more commonly referred to as the “Aid and Attendance Benefit”. The Aid and Attendance benefit is designed to pay for home healthcare services. For 2008, the maximum monthly benefit to a veteran is $1,554, married veteran is $1,842, and surviving spouse of a veteran is $998. So do all veterans and or his or her spouse, who are 65 years of age or older, and need home healthcare services, qualify for the Aid and Attendance benefit? The answer is, “no”, but simple planning strategies, the majority can qualify for the benefit. To qualify, the veteran and/or his or her spouse must pass three tests, including a: (1) military service test, (2) healthcare necessities test, and (3) an asset and income test.
To pass the military services test, the veteran must have served at least 90 consecutive days of active duty, and one of the days occurring during a war-time period (WWI, WWII, and Korean War, Vietnam War), and received an honorable discharge. To pass the healthcare necessities test, the veteran and/or his or her surviving spouse must be able to prove that he or she is unable to dress or undress, attend to the wants of nature, and as a result of the physical or mental incapacity requires assistance on a regular basis in the home. In support of conditions, it is necessary to obtain a physician’s statement which substantiates the conditions, and specifies that there is a need for regular assistance to avoid daily environmental hazards. If the person is blind, and/or unable to drive, it is, without question, that the person will require daily assistance. Finally, to pass the asset and income test, the veteran and/or his or her surviving spouse must show that, excluding the value of the family home, the household furnishings, and one motor vehicle, their total assets are valued at $80,000, or less, and their monthly income is less than their unreimbursed medical expenses. Unreimbursed medical expenses, in a home healthcare setting include: the cost of home healthcare aides, doctor’s fees, dentist’s fees, prescription glasses, hearing aids, Medicare premiums, medical transportation costs, prescription drugs, and therapies.
The VA statistics currently show more than 23,816,000 veterans, of which 39.1% are 65 years of age or older. Are many veterans and/or his or she surviving spouses taking advantage of the Aid and Attendance Benefit Program? With the VA statistics also showing that only 317,439 veterans and/or their spouses are currently receiving on the program, the answer is, “no”. So where does the problem lie? The problem lies in the fact that most veterans are not aware of the Aid and Attendance Benefit Program.
However, with more and more seniors now using computers and researching on the web, along with attorneys now certified to work with veterans, the statistics are starting to change.
How do you find out about this benefit? How do you qualify? Are you or is your client a candidate? Is there in-home support?
As there is much information available online today regarding this benefit and the associated steps you must make to qualify, there is important consideration for an applicant’s situation as a whole. Do you/they currently have in-home care? Does the applicant meet the ADL minimum requirements? Is there a financial plan in place? Is the potential applicant working with an estate planning or elder law attorney? Does the overall plan blend well with possible Medicaid benefits?
It is important to understand the processing time involved with a VA A& A application, the consequences of an in complete or denied application. We invite you to post your questions and/or comments on this blog or email Dale M. Krause directly at dalekrause@medicaidannuity.com.
About the author, Guest Blogger:
Dale M. Krause, J.D., LL.M.
For more than 20 years, Dale M. Krause, J.D., LL.M., has provided Medicaid Compliant Annuities to elder law attorneys, and their clients, throughout the United States. As a result of his practice, Mr. Krause has been labeled "The Pioneer of Medicaid Compliant Annuities."
Mr. Krause is the CEO of Krause Financial Services, a business that designs, develops, markets, and distributes Medicaid compliant products. Mr. Krause earned his B.S. degree from the University of Wisconsin-Stevens Point, in 1981, his J.D. degree from Thomas Cooley Law School, of Lansing, Michigan, in 1985, and his LL.M. in Taxation from DePaul College of Law, of Chicago, Illinois, in 1990. He is a practicing member of the Wisconsin and Michigan Bars, and is an out-of-state member of the New York Bar Association. He is a licensed insurance agent, and is registered to sell stocks, bonds, and mutual funds.
~Serena Brock
If they qualify, a veteran and/or his or her surviving spouse will be entitled to receive a monthly pension benefit, which is more commonly referred to as the “Aid and Attendance Benefit”. The Aid and Attendance benefit is designed to pay for home healthcare services. For 2008, the maximum monthly benefit to a veteran is $1,554, married veteran is $1,842, and surviving spouse of a veteran is $998. So do all veterans and or his or her spouse, who are 65 years of age or older, and need home healthcare services, qualify for the Aid and Attendance benefit? The answer is, “no”, but simple planning strategies, the majority can qualify for the benefit. To qualify, the veteran and/or his or her spouse must pass three tests, including a: (1) military service test, (2) healthcare necessities test, and (3) an asset and income test.
To pass the military services test, the veteran must have served at least 90 consecutive days of active duty, and one of the days occurring during a war-time period (WWI, WWII, and Korean War, Vietnam War), and received an honorable discharge. To pass the healthcare necessities test, the veteran and/or his or her surviving spouse must be able to prove that he or she is unable to dress or undress, attend to the wants of nature, and as a result of the physical or mental incapacity requires assistance on a regular basis in the home. In support of conditions, it is necessary to obtain a physician’s statement which substantiates the conditions, and specifies that there is a need for regular assistance to avoid daily environmental hazards. If the person is blind, and/or unable to drive, it is, without question, that the person will require daily assistance. Finally, to pass the asset and income test, the veteran and/or his or her surviving spouse must show that, excluding the value of the family home, the household furnishings, and one motor vehicle, their total assets are valued at $80,000, or less, and their monthly income is less than their unreimbursed medical expenses. Unreimbursed medical expenses, in a home healthcare setting include: the cost of home healthcare aides, doctor’s fees, dentist’s fees, prescription glasses, hearing aids, Medicare premiums, medical transportation costs, prescription drugs, and therapies.
The VA statistics currently show more than 23,816,000 veterans, of which 39.1% are 65 years of age or older. Are many veterans and/or his or she surviving spouses taking advantage of the Aid and Attendance Benefit Program? With the VA statistics also showing that only 317,439 veterans and/or their spouses are currently receiving on the program, the answer is, “no”. So where does the problem lie? The problem lies in the fact that most veterans are not aware of the Aid and Attendance Benefit Program.
However, with more and more seniors now using computers and researching on the web, along with attorneys now certified to work with veterans, the statistics are starting to change.
How do you find out about this benefit? How do you qualify? Are you or is your client a candidate? Is there in-home support?
As there is much information available online today regarding this benefit and the associated steps you must make to qualify, there is important consideration for an applicant’s situation as a whole. Do you/they currently have in-home care? Does the applicant meet the ADL minimum requirements? Is there a financial plan in place? Is the potential applicant working with an estate planning or elder law attorney? Does the overall plan blend well with possible Medicaid benefits?
It is important to understand the processing time involved with a VA A& A application, the consequences of an in complete or denied application. We invite you to post your questions and/or comments on this blog or email Dale M. Krause directly at dalekrause@medicaidannuity.com.
About the author, Guest Blogger:
Dale M. Krause, J.D., LL.M.
For more than 20 years, Dale M. Krause, J.D., LL.M., has provided Medicaid Compliant Annuities to elder law attorneys, and their clients, throughout the United States. As a result of his practice, Mr. Krause has been labeled "The Pioneer of Medicaid Compliant Annuities."
Mr. Krause is the CEO of Krause Financial Services, a business that designs, develops, markets, and distributes Medicaid compliant products. Mr. Krause earned his B.S. degree from the University of Wisconsin-Stevens Point, in 1981, his J.D. degree from Thomas Cooley Law School, of Lansing, Michigan, in 1985, and his LL.M. in Taxation from DePaul College of Law, of Chicago, Illinois, in 1990. He is a practicing member of the Wisconsin and Michigan Bars, and is an out-of-state member of the New York Bar Association. He is a licensed insurance agent, and is registered to sell stocks, bonds, and mutual funds.
~Serena Brock
Thursday, October 16, 2008
Interesting Statistics
According to AARP, 59 percent of people older than 65 are living on a fixed income.
Roughly 7 out of 10 people living with Alzheimer's disease are living at home and receiving 75% of their care from informal care partners.
Roughly 7 out of 10 people living with Alzheimer's disease are living at home and receiving 75% of their care from informal care partners.
Wednesday, October 15, 2008
DID YOU KNOW?
Aging seniors and the disabled have a right, spelled out in the U.S. Supreme Court's Olmstead decision of 1999, to enjoy care services in the least-restrictive environment possible. Oftentimes, that means at home rather than in a nursing home.
Monday, October 13, 2008
Retirement is not etched in stone...
Well, with all of what is going on in our country today...most of us have first hand experience of how quickly our "plans" for retirement can change. In fact, it is just like any other part of our lives, change happens when you least expect it.
One thing that we do know, is that based on numerous studies, it is those people who will and are experiencing the most enjoyable retirements are the ones who have planned appropriately for them.
Although our country is in an economic down turn and many have lost their savings as a result of the stock market plunge, there is no time better than now to protect those assets that you worked so hard to earn.
Planning for your future is much more than just financial considerations. It includes protecting your assets from family changes such as divorce, second marriages, children who are incapable of managing money and considering how you will carry out your years physically, emotionally and geographically.
Who and how you will be cared for in the event of a health crisis. Do you want your spouse to care for you at home? What about when you are unable to perform the activities of daily living such as bathing, toileting and dressing? Do you want your spouse, children or other family members to assist you? Would you prefer that your dignity is not compromised and allow a professional caregiver to help? I know that it is not a conversation that is welcomed, but it is ever so important to address these issues before a crisis hits.
Will you remain at home? Move in with your adult children? Assisted living center? Long term care? How your surviving family will carry on after you are gone.
Now, I am not an attorney but I have had the pleasure of working with and learning how invaluable an estate planning attorney or one who specializes in elder law is. In fact, over the past several years, I have become a huge advocate of the importance of engaging in their services.
So I urge you - learn more about the importance of protection such as wills, healthcare directives, guardianships, trusts (including special needs trusts), estate planning and Medicaid planning. Isn't it worth it to learn how you can protect yourself, your family and everything you have worked so hard for?
~Serena L. Brock
One thing that we do know, is that based on numerous studies, it is those people who will and are experiencing the most enjoyable retirements are the ones who have planned appropriately for them.
Although our country is in an economic down turn and many have lost their savings as a result of the stock market plunge, there is no time better than now to protect those assets that you worked so hard to earn.
Planning for your future is much more than just financial considerations. It includes protecting your assets from family changes such as divorce, second marriages, children who are incapable of managing money and considering how you will carry out your years physically, emotionally and geographically.
Who and how you will be cared for in the event of a health crisis. Do you want your spouse to care for you at home? What about when you are unable to perform the activities of daily living such as bathing, toileting and dressing? Do you want your spouse, children or other family members to assist you? Would you prefer that your dignity is not compromised and allow a professional caregiver to help? I know that it is not a conversation that is welcomed, but it is ever so important to address these issues before a crisis hits.
Will you remain at home? Move in with your adult children? Assisted living center? Long term care? How your surviving family will carry on after you are gone.
Now, I am not an attorney but I have had the pleasure of working with and learning how invaluable an estate planning attorney or one who specializes in elder law is. In fact, over the past several years, I have become a huge advocate of the importance of engaging in their services.
So I urge you - learn more about the importance of protection such as wills, healthcare directives, guardianships, trusts (including special needs trusts), estate planning and Medicaid planning. Isn't it worth it to learn how you can protect yourself, your family and everything you have worked so hard for?
~Serena L. Brock
Thursday, October 2, 2008
Social Security
According to the AARP, 3.1 million Americans depend on social security as their main source of income.
Monday, September 29, 2008
Long-term care protest planned -- 'What's happening is wrong'
Posted By CAROL MULLIGAN, THE SUDBURY STAR
A Sudbury woman with 27 years in the long-term care sector says workers in the system are so stressed, the rates of violence and abuse in nursing homes are "astronomical."
Staff charged with caring for 10 to 16 adults in a single shift are cutting corners and "care is not getting done," said Anne Marie MacInnis at a news conference Tuesday.
MacInnis is a Sudbury representative on the Ontario Health Coalition and an organizer of the All Out Mass Protest scheduled in several Ontario cities, including Sudbury, on Saturday.
The Sudbury rally is being sponsored by the coalition and the Sudbury and District Labour Council.
MacInnis, who is an organizer for Mine Mill Local 598/CAW, said the rallies are targeted at Premier Dalton McGuinty, and will call on him to keep his election promises to support public health care.
"Alarming rates" of violence, injury, accidents and neglect are occurring in long-term care homes where employees don't have the time to care for the number of residents they are responsible for every day.
Organizers are calling on the McGuinty government to stop the cuts to hospital services, stop funding private-public partnerships in health care, end competitive bidding in home care and regulate a minimum standard of care in long-term care residences.
A core group of employees in the home care, long-term care and hospital sectors will participate in the rallies.
Sudbury's All Out Mass Protest is scheduled from 11 a. m.-3 p. m. at Tom Davies Square.
Starting at 8 a. m., workers will present street theatre presentations to "engage" the public in the discussion, said MacInnis.
Thousands of people are expected to participate in rallies in Toronto, Windsor, Kingston, Thunder Bay and Sudbury.
"What's happening is wrong," said MacInnis, and the purpose of the All Out Mass Protests is to "tap into social awareness" about that.
John Closs, president of the Sudbury and District Labour Council, stressed the protest is not a labour event although OPSEU, CUPE, Mine Mill/CAW and Steelworkers members will participate.
These issues "affect everybody," said Closs.
~Serena L. Brock
A Sudbury woman with 27 years in the long-term care sector says workers in the system are so stressed, the rates of violence and abuse in nursing homes are "astronomical."
Staff charged with caring for 10 to 16 adults in a single shift are cutting corners and "care is not getting done," said Anne Marie MacInnis at a news conference Tuesday.
MacInnis is a Sudbury representative on the Ontario Health Coalition and an organizer of the All Out Mass Protest scheduled in several Ontario cities, including Sudbury, on Saturday.
The Sudbury rally is being sponsored by the coalition and the Sudbury and District Labour Council.
MacInnis, who is an organizer for Mine Mill Local 598/CAW, said the rallies are targeted at Premier Dalton McGuinty, and will call on him to keep his election promises to support public health care.
"Alarming rates" of violence, injury, accidents and neglect are occurring in long-term care homes where employees don't have the time to care for the number of residents they are responsible for every day.
Organizers are calling on the McGuinty government to stop the cuts to hospital services, stop funding private-public partnerships in health care, end competitive bidding in home care and regulate a minimum standard of care in long-term care residences.
A core group of employees in the home care, long-term care and hospital sectors will participate in the rallies.
Sudbury's All Out Mass Protest is scheduled from 11 a. m.-3 p. m. at Tom Davies Square.
Starting at 8 a. m., workers will present street theatre presentations to "engage" the public in the discussion, said MacInnis.
Thousands of people are expected to participate in rallies in Toronto, Windsor, Kingston, Thunder Bay and Sudbury.
"What's happening is wrong," said MacInnis, and the purpose of the All Out Mass Protests is to "tap into social awareness" about that.
John Closs, president of the Sudbury and District Labour Council, stressed the protest is not a labour event although OPSEU, CUPE, Mine Mill/CAW and Steelworkers members will participate.
These issues "affect everybody," said Closs.
~Serena L. Brock
Wednesday, September 24, 2008
Home Care Today– Growing Options and Risks
As published in:
Simply the Best Barbara McKay Magazine Spring/Summer 2008
Home Care Today– Growing Options and Risks
With an estimated 4.2 million Americans currently over age 85, an expected 78 million baby boomers to reach age 65 by 2030; almost 25% of Americans are in the process of dealing with elder/care issues, it is no surprise that the home care industry is exploding.
Growing Options
It's not easy to become elderly or a parent to your parent(s). The “Sandwich Generation”, those sandwiched between aging parents and their own children, face a number of key areas critical to elder care; aging, legal, medical, financial and living arrangement issues. Support from an in home caregiver can help to assist with the activities of daily living, while providing companionship, whether it is your own child, spouse, sibling or an aging parent.
The type of home care service needed depends on several factors: mental/ physical health condition, support from family or friends, residential location, availability of finances. Financing may be long term care policies, money from a trust, state funded programs, insurance, Veterans aid and attendance benefit or private pay. Licensed home care agencies provide qualified caregivers such as companions, certified nursing assistants, nurses and rehabilitation therapists. Their services cover: activities of daily living, nursing/wound care; rehabilitation, case management, pre/post operative care, errands, etc. In addition to elder care, services can include pre/post operative care, new moms and multiples support, short term disability and illness. For employers, some agencies offer packages to help save on lost time/revenue as a result of employees forced to miss work to care for sick parents and/or their own children. Imagine the comfort and peace of mind knowing your loved one is in good hands whether you live near, with or far from your loved one.
Risks
With many home care agencies choices, all making the same promises, it is critical to carefully select your agency. Unfortunately, not all are honest and ethical. We recommend you ask to see the agency’s policy on orientation, screening, testing and supervision. The National Association for Home Care and Hospice, NAHC, is a great resource in each state.
A Question of Quality and Ethics
Home care is a very personal choice and can be an invaluable service. Too often, we are witness to heart wrenching cases where neglect, abuse, theft and lawsuits have occurred as a result of families trying to save money by privately hiring their own caregivers. Like any other service, you pay for what you receive. In addition, if someone is offering to buy items to gain or keep your business, question their ethics. Peace of mind is worth the price. Call and interview agencies. Ask for references. Take your time and be sure that you feel a connection with them. Visit their office. Trust and confidence in your agency, its internal staff and its caregivers is critical. Make informed decisions based on your own research. After all, they spend a great deal of time in the home, and truly become an extension of your family!
Leading Education & Ethics in Charlotte and Across the Country
Serena Brock - nationally recognized entrepreneur/speaker and focuses on the importance of the synergistic relationship between attorney’s, financial planner’s and home care owner’s supporting the fast growing baby boomer population. An advocate for children/seniors, she currently is a member of the North Carolina Association for Home and Hospice Government Affairs Committee, the North Carolina Guardian ad Litem Foundation and the World Orphans Day, Global Click Campaign. Brock lends her expertise to several national organizations including the National Private Duty Home Care Association, Medicaid Practice Systems, Elder Law Answers and The National Network for Estate Planning Attorneys.
Simply the Best Barbara McKay Magazine Spring/Summer 2008
Home Care Today– Growing Options and Risks
With an estimated 4.2 million Americans currently over age 85, an expected 78 million baby boomers to reach age 65 by 2030; almost 25% of Americans are in the process of dealing with elder/care issues, it is no surprise that the home care industry is exploding.
Growing Options
It's not easy to become elderly or a parent to your parent(s). The “Sandwich Generation”, those sandwiched between aging parents and their own children, face a number of key areas critical to elder care; aging, legal, medical, financial and living arrangement issues. Support from an in home caregiver can help to assist with the activities of daily living, while providing companionship, whether it is your own child, spouse, sibling or an aging parent.
The type of home care service needed depends on several factors: mental/ physical health condition, support from family or friends, residential location, availability of finances. Financing may be long term care policies, money from a trust, state funded programs, insurance, Veterans aid and attendance benefit or private pay. Licensed home care agencies provide qualified caregivers such as companions, certified nursing assistants, nurses and rehabilitation therapists. Their services cover: activities of daily living, nursing/wound care; rehabilitation, case management, pre/post operative care, errands, etc. In addition to elder care, services can include pre/post operative care, new moms and multiples support, short term disability and illness. For employers, some agencies offer packages to help save on lost time/revenue as a result of employees forced to miss work to care for sick parents and/or their own children. Imagine the comfort and peace of mind knowing your loved one is in good hands whether you live near, with or far from your loved one.
Risks
With many home care agencies choices, all making the same promises, it is critical to carefully select your agency. Unfortunately, not all are honest and ethical. We recommend you ask to see the agency’s policy on orientation, screening, testing and supervision. The National Association for Home Care and Hospice, NAHC, is a great resource in each state.
A Question of Quality and Ethics
Home care is a very personal choice and can be an invaluable service. Too often, we are witness to heart wrenching cases where neglect, abuse, theft and lawsuits have occurred as a result of families trying to save money by privately hiring their own caregivers. Like any other service, you pay for what you receive. In addition, if someone is offering to buy items to gain or keep your business, question their ethics. Peace of mind is worth the price. Call and interview agencies. Ask for references. Take your time and be sure that you feel a connection with them. Visit their office. Trust and confidence in your agency, its internal staff and its caregivers is critical. Make informed decisions based on your own research. After all, they spend a great deal of time in the home, and truly become an extension of your family!
Leading Education & Ethics in Charlotte and Across the Country
Serena Brock - nationally recognized entrepreneur/speaker and focuses on the importance of the synergistic relationship between attorney’s, financial planner’s and home care owner’s supporting the fast growing baby boomer population. An advocate for children/seniors, she currently is a member of the North Carolina Association for Home and Hospice Government Affairs Committee, the North Carolina Guardian ad Litem Foundation and the World Orphans Day, Global Click Campaign. Brock lends her expertise to several national organizations including the National Private Duty Home Care Association, Medicaid Practice Systems, Elder Law Answers and The National Network for Estate Planning Attorneys.
Tuesday, September 2, 2008
13% of Seniors Report Being Mistreated
THURSDAY, Aug. 28 (HealthDay News) -- A new study says that 13 percent of American seniors suffer mistreatment from various forms of abuse.
The University of Chicago researchers said the chief forms were verbal abuse (9 percent), being taken advantage of financially (3.5 percent), and physical abuse (0.2 percent). The team also found that seniors with physical impairments were most likely to suffer verbal abuse.
"Older people with any physical vulnerability are about 13 percent more likely than those without one to report verbal mistreatment, but are not more likely to report financial mistreatment," study co-author Linda Waite, a professor of sociology, said in a university news release.
The analysis of national survey data from 3,005 community-dwelling adults, ages 57 to 85, also found that adults in their late 50s and 60s are more likely to report verbal or financial mistreatment than those who are older.
"Perhaps the respondents are including fairly routine arguments, perhaps about money, with their spouse, sibling or child in their reports, or perhaps older adults are more reticent to report negative behavior," lead author Edward Laumann, a professor of sociology, said in the news release.
Women were twice as likely as men to report verbal abuse; Hispanics were about half as likely as whites to report verbal abuse and 78 percent less likely to report financial mistreatment; and blacks were 77 percent more likely than whites to report financial mistreatment.
Of those who reported verbal abuse, 26 percent said their spouse or romantic partner was responsible, 15 percent said it was their children, and the remainder of respondents said friends, neighbors, co-workers or bosses were responsible. Of the respondents who reported financial abuse, 57 percent said a relative other than a spouse, parent or child was taking advantage of them.
The study was published in the Journal of Gerontology: Social Sciences.
"The population of this country is aging, and people now live with chronic diseases longer. So, it's important to understand, from a health perspective, how people are being treated as they age," Laumann said.
~Serena L. Brock
The University of Chicago researchers said the chief forms were verbal abuse (9 percent), being taken advantage of financially (3.5 percent), and physical abuse (0.2 percent). The team also found that seniors with physical impairments were most likely to suffer verbal abuse.
"Older people with any physical vulnerability are about 13 percent more likely than those without one to report verbal mistreatment, but are not more likely to report financial mistreatment," study co-author Linda Waite, a professor of sociology, said in a university news release.
The analysis of national survey data from 3,005 community-dwelling adults, ages 57 to 85, also found that adults in their late 50s and 60s are more likely to report verbal or financial mistreatment than those who are older.
"Perhaps the respondents are including fairly routine arguments, perhaps about money, with their spouse, sibling or child in their reports, or perhaps older adults are more reticent to report negative behavior," lead author Edward Laumann, a professor of sociology, said in the news release.
Women were twice as likely as men to report verbal abuse; Hispanics were about half as likely as whites to report verbal abuse and 78 percent less likely to report financial mistreatment; and blacks were 77 percent more likely than whites to report financial mistreatment.
Of those who reported verbal abuse, 26 percent said their spouse or romantic partner was responsible, 15 percent said it was their children, and the remainder of respondents said friends, neighbors, co-workers or bosses were responsible. Of the respondents who reported financial abuse, 57 percent said a relative other than a spouse, parent or child was taking advantage of them.
The study was published in the Journal of Gerontology: Social Sciences.
"The population of this country is aging, and people now live with chronic diseases longer. So, it's important to understand, from a health perspective, how people are being treated as they age," Laumann said.
~Serena L. Brock
Saturday, August 23, 2008
Senate Bill Seeks to Expand Medicaid Coverage of Home and Community-based Care
Prior to leaving for the August Congressional recess, Senators John Kerry (D-MA) and Charles Grassley (R-IA) introduced the “Empowered at Home Act” (S. 3327 http://thomas.loc.gov/cgi-bin/bdquery/z?d110:s.03327), a bill that seeks to increase access to home and community based services by giving states new tools and incentives to make these services more available to those in need.
In a statement upon introduction of the bill, Kerry said, “Far too many elderly or disabled Americans can’t get the help they need in their home and community. Home- and community-based services are high-quality, cost-effective, and help many people live independent lives, but Medicaid continues to favor nursing homes. It’s a problem when the nation’s largest purchaser of long-term care services is tilted towards nursing homes rather than home and community based services. This bill will level the playing field and give families real choices to care for their loved ones, and give cash-strapped states new tools to provide cost-effective long-term care options to the most vulnerable.”
“Being able to live at home greatly improves quality of life because people can be with loved ones and have the dignity that goes with greater independence,” said Grassley. “This bill encourages states to help make that possible, which is also fiscally smart because institutional care is the most expensive form of long-term care that Medicaid pays for. This bill also empowers individuals to manage the financial burdens that come with caregiving needs.”
The bill has four basic parts:
1. It seeks to improve the Medicaid Home and Community-based Services (HCBS) State Plan Amendment Option by giving states more flexibility in determining eligibility for which services they can offer under the program, creating greater options for individuals in need of home and community-based services, and providing some additional funding to assist states in making the transition. It would establish parity in income eligibility standards for home and community based services and institutional care at 300 percent of the Supplemental Security Income (SSI) level ($22,932/year). In return states could no longer cap enrollment and would have to offer services throughout the entire state.
2. It would require that the same spousal impoverishment protections offered for new nursing home beneficiaries be in place for those opting for home and community based services. In addition, low-income recipients of home and community based services would be able to keep more of their assets when they become eligible for Medicaid, allowing them to stay in their community longer.
3. It would offer tax-related provisions to support family caregivers and promote the purchase of private long-term care insurance.
4. It would provide grants for states to invest in organizations and systems to help ensure a sufficient supply of high quality workers, promote health, and transform home and community based care to be more consumer-centered.
Section 201 of the bill would provide grants that states could use to create one or more statewide or regional public entities or non-profit organizations to address workforce issues, including training, screening, and taking on many of the responsibilities of the employer of home care workers. Although the legislation does recognize “the multiple delivery options that take into account differing needs of individuals” and ensures that consumers would not be restricted to hiring workers from such entities, the creation of these entities (sometimes referred to as public authorities) would be a cause for concern by many home and community-based providers and consumers. Such public authorities can result in discouraging home care aides from working for home care agencies or consumers from obtaining home care aides services through agencies. In its Legislative Blueprint for Action, the National Association for Home Care & Hospice (NAHC) maintains that consumers should have the right to choose to receive home care aide services according to the delivery model that they are most comfortable with. In addition, home care aides should have the opportunity to choose their employer. Home care agencies are better equipped than public authorities to provide worker training, screening, and oversight.
~Serena L. Brock
In a statement upon introduction of the bill, Kerry said, “Far too many elderly or disabled Americans can’t get the help they need in their home and community. Home- and community-based services are high-quality, cost-effective, and help many people live independent lives, but Medicaid continues to favor nursing homes. It’s a problem when the nation’s largest purchaser of long-term care services is tilted towards nursing homes rather than home and community based services. This bill will level the playing field and give families real choices to care for their loved ones, and give cash-strapped states new tools to provide cost-effective long-term care options to the most vulnerable.”
“Being able to live at home greatly improves quality of life because people can be with loved ones and have the dignity that goes with greater independence,” said Grassley. “This bill encourages states to help make that possible, which is also fiscally smart because institutional care is the most expensive form of long-term care that Medicaid pays for. This bill also empowers individuals to manage the financial burdens that come with caregiving needs.”
The bill has four basic parts:
1. It seeks to improve the Medicaid Home and Community-based Services (HCBS) State Plan Amendment Option by giving states more flexibility in determining eligibility for which services they can offer under the program, creating greater options for individuals in need of home and community-based services, and providing some additional funding to assist states in making the transition. It would establish parity in income eligibility standards for home and community based services and institutional care at 300 percent of the Supplemental Security Income (SSI) level ($22,932/year). In return states could no longer cap enrollment and would have to offer services throughout the entire state.
2. It would require that the same spousal impoverishment protections offered for new nursing home beneficiaries be in place for those opting for home and community based services. In addition, low-income recipients of home and community based services would be able to keep more of their assets when they become eligible for Medicaid, allowing them to stay in their community longer.
3. It would offer tax-related provisions to support family caregivers and promote the purchase of private long-term care insurance.
4. It would provide grants for states to invest in organizations and systems to help ensure a sufficient supply of high quality workers, promote health, and transform home and community based care to be more consumer-centered.
Section 201 of the bill would provide grants that states could use to create one or more statewide or regional public entities or non-profit organizations to address workforce issues, including training, screening, and taking on many of the responsibilities of the employer of home care workers. Although the legislation does recognize “the multiple delivery options that take into account differing needs of individuals” and ensures that consumers would not be restricted to hiring workers from such entities, the creation of these entities (sometimes referred to as public authorities) would be a cause for concern by many home and community-based providers and consumers. Such public authorities can result in discouraging home care aides from working for home care agencies or consumers from obtaining home care aides services through agencies. In its Legislative Blueprint for Action, the National Association for Home Care & Hospice (NAHC) maintains that consumers should have the right to choose to receive home care aide services according to the delivery model that they are most comfortable with. In addition, home care aides should have the opportunity to choose their employer. Home care agencies are better equipped than public authorities to provide worker training, screening, and oversight.
~Serena L. Brock
Wednesday, July 30, 2008
The Power of Gratitude
Caregivers -- Ask your loved one, "What are you thankful for today?" It may be the gift of love, how blessed the person feels to have someone who cares for him, or that he's in his own home. If the person's in a facility, maybe it's the lady who comes by to give her a little smile or stroke on the cheek.
And when you write it down, what a great thing. So get a dry-erase board, put it within eyesight for the person and write "Today's Thank You" across the Top. Maybe it's just one thing: "Tell me something that good today. Oh, it's beautiful outside. Let me turn you so that you can see the gorgeous sun!" Then write, "Today's a beautiful sunny day." Add the date, and maybe a pretty picture.
Before you change it, write it in a notebook. Then when your loved one is having a particularly blue day, you can say, "You know, I know today's not a good day, but remember last week when the Girl Scouts came and sang..." Revisiting a positive memory may make a day that isn't such a great day, a better one!
~Serena L. Brock
And when you write it down, what a great thing. So get a dry-erase board, put it within eyesight for the person and write "Today's Thank You" across the Top. Maybe it's just one thing: "Tell me something that good today. Oh, it's beautiful outside. Let me turn you so that you can see the gorgeous sun!" Then write, "Today's a beautiful sunny day." Add the date, and maybe a pretty picture.
Before you change it, write it in a notebook. Then when your loved one is having a particularly blue day, you can say, "You know, I know today's not a good day, but remember last week when the Girl Scouts came and sang..." Revisiting a positive memory may make a day that isn't such a great day, a better one!
~Serena L. Brock
Monday, January 28, 2008
Wife, Mom, Career Woman and Caregiver?
For those of us that are referred to as the “sandwich generation”, we never imagined that during the heart of our career we would be faced with caregiving challenges. As a child, it is hard to picture your parents getting “old” and as a grown up, it is heart wrenching to watch them age.
So many of us feel as though we are not doing enough and become frustrated that we can’t do more. It is difficult to watch parents age – to observe the slow or fast decline in their overall health. But, unfortunately, it is a fact of life and the best course of action is to find support and manage.
1. Remember, you are not alone. Don’t be afraid to talk to friends and other family members. The stress of caregiving can be very serious and the first thing you need to avoid is allowing the situation to have a negative impact on your own health. A sick you cannot care for an aging parent.
2. Involve others – children, family, friends. Delegate jobs and responsibilities. If you do not have help – you may want to consider hiring a home health aide. You could consider even just one day a week to assist with household chores and companionship for your parent(s). You will need the personal time away.
3. Don’t lose sight of your personal life. Your family: husband and children – your friends. Having the responsibility to care for an aging parent can be a 24/7 job, especially if they are non-ambulatory. For the sake of your relationships, be careful not be become consumed with your new caregiving responsibilities. Block quality time with all of those who support and love you.
4. Seek resources: a licensed home care agency; an elder law attorney or trusted advisor; a senior center; on line support; your church; your employer (flex time options); books and others also caring for their parents.
It is one job to be a parent, but when you are faced with caring for your own parents as well, it is often an uncomfortable and stressful time. It is important to care for yourself. Be sure to monitor your own stress level and involve any and all resources that are available. In the long run – everyone will be much happier and most importantly, safe.
~Serena L. Brock
So many of us feel as though we are not doing enough and become frustrated that we can’t do more. It is difficult to watch parents age – to observe the slow or fast decline in their overall health. But, unfortunately, it is a fact of life and the best course of action is to find support and manage.
1. Remember, you are not alone. Don’t be afraid to talk to friends and other family members. The stress of caregiving can be very serious and the first thing you need to avoid is allowing the situation to have a negative impact on your own health. A sick you cannot care for an aging parent.
2. Involve others – children, family, friends. Delegate jobs and responsibilities. If you do not have help – you may want to consider hiring a home health aide. You could consider even just one day a week to assist with household chores and companionship for your parent(s). You will need the personal time away.
3. Don’t lose sight of your personal life. Your family: husband and children – your friends. Having the responsibility to care for an aging parent can be a 24/7 job, especially if they are non-ambulatory. For the sake of your relationships, be careful not be become consumed with your new caregiving responsibilities. Block quality time with all of those who support and love you.
4. Seek resources: a licensed home care agency; an elder law attorney or trusted advisor; a senior center; on line support; your church; your employer (flex time options); books and others also caring for their parents.
It is one job to be a parent, but when you are faced with caring for your own parents as well, it is often an uncomfortable and stressful time. It is important to care for yourself. Be sure to monitor your own stress level and involve any and all resources that are available. In the long run – everyone will be much happier and most importantly, safe.
~Serena L. Brock
Sunday, January 27, 2008
What is a home health agency?
A home health agency is an organization that provides caregivers to assist those in need of help.
There are several types of agencies. Here are some examples for you:
1. Licensed and Non-licensed. There are strict guidelines that are governed by the state. In order to become a state licensed agency, the owner must comply with the rules and regulations and be able to produce materials including policies and procedures, in order to pass the state audit. In my personal opinion, I am a strong advocate for licensure. This only helps to regulate agencies and more importantly, helps to ensure quality patient care. If the agency you are considering is not a state licensed agency, you have no way of knowing how they screen their employees, nor what guidelines they follow in their operations (policies and procedures).
2. Medical or non medical agencies. Those agencies who provide non medical care offer companions, home health aides and personal care givers. Most of the care delivered will include errand running, transportation and assistance with ADL’s (activities of daily living). There are some very reputable agencies who offer caregivers that are trained, skilled and very qualified to provide non medical care.
3. Skilled or medical care agencies. These agencies, although most are Medicare certified (able to accept funds through Medicare) provide skilled nurses and therapists.
If you are considering hiring a home care agency to provide care for you or a loved one, I would recommend that you review the document on our website “How to Hire a Home Care Agency”, provided by the National Home and Hospice Association.
~Serena L. Brock
There are several types of agencies. Here are some examples for you:
1. Licensed and Non-licensed. There are strict guidelines that are governed by the state. In order to become a state licensed agency, the owner must comply with the rules and regulations and be able to produce materials including policies and procedures, in order to pass the state audit. In my personal opinion, I am a strong advocate for licensure. This only helps to regulate agencies and more importantly, helps to ensure quality patient care. If the agency you are considering is not a state licensed agency, you have no way of knowing how they screen their employees, nor what guidelines they follow in their operations (policies and procedures).
2. Medical or non medical agencies. Those agencies who provide non medical care offer companions, home health aides and personal care givers. Most of the care delivered will include errand running, transportation and assistance with ADL’s (activities of daily living). There are some very reputable agencies who offer caregivers that are trained, skilled and very qualified to provide non medical care.
3. Skilled or medical care agencies. These agencies, although most are Medicare certified (able to accept funds through Medicare) provide skilled nurses and therapists.
If you are considering hiring a home care agency to provide care for you or a loved one, I would recommend that you review the document on our website “How to Hire a Home Care Agency”, provided by the National Home and Hospice Association.
~Serena L. Brock
Friday, January 25, 2008
Welcome To The Avenue
Our competent and sensitive caregivers ease the difficulties brought on by advanced age while allowing seniors the space and independence they require, while cultivating a harmonious, long-term relationship. The bond between a caregiver and a person requiring care to be able to stay in their home or place of residence, can be a beautiful relationship. It allows a precious measure of independence and autonomy for the senior. It can also relieve an elderly person of their concerns about burdening his or her own children/family with the infirmities of aging.
Our caregivers are dedicated professionals selected for their suitability for the rewarding yet highly demanding work of in-home care. Because most persons requiring care cannot be left alone for any period of time, it can be confining. It also requires enormous patience, repsect and a high-level of attention to detail and accountability. Our high caliber caregivers are skilled and loving individuals who have chosen to dedicate their career to helping and caring for others. They have a strong commitment to their work and exude a passion for caring for those who require some level of care.
~Serena L. Brock
Our caregivers are dedicated professionals selected for their suitability for the rewarding yet highly demanding work of in-home care. Because most persons requiring care cannot be left alone for any period of time, it can be confining. It also requires enormous patience, repsect and a high-level of attention to detail and accountability. Our high caliber caregivers are skilled and loving individuals who have chosen to dedicate their career to helping and caring for others. They have a strong commitment to their work and exude a passion for caring for those who require some level of care.
~Serena L. Brock
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