A newsbasket is on-line Internet publication containing comprehensive aggregated collections of information.

Quality of U.S. hospices varies, patients left in dark - The Washington Post

Quality of U.S. hospices varies, patients left in dark - The Washington Post

{Q}A boom in the industry allows patients to choose from an array of
hospice outfits, some of them excellent. More than a thousand new
hospices have opened in the United States in the past decade. But the
absence of public information about their quality, a void that is
unusual even within the health-care industry, leaves consumers at a loss
to distinguish the good from the bad.

Though the federal government publishes consumer data about the quality of other
health-care companies, including hospitals, nursing homes and home
health agencies, it provides no such information about hospices.

 The reasons that some hospices stint on care may be at least partly
financial. Medicare, the chief source of industry revenue, pays hospice
companies per day of care — about $155 for a “routine” day — regardless
of how much care is actually provided. That means that the less a
hospice spends on nursing and other services, the more it can profit.

 http://www.washingtonpost.com/wp-srv/special/business/hospice-quality  This database shows, among other things, whether the hospice has provided more intense levels of care for patients suffering a crisis; how much it spends on nursing visits per patient; and whether it has won approval from one of three outside accrediting agencies, the Joint Commission, the Accreditation Commission for Health Care and Community Health Accreditation Program, or CHAP

A Guide to Durable Medical Equipment And Medical Supplies - AgingCare.com

A Guide to Durable Medical Equipment And Medical Supplies - AgingCare.com

{Q}First, the basic needs of elderly or ill people must be addressed before they or their family members can think about more abstract or long-term issues.
Second, it is very difficult to obtain information about meeting these basic needs, especially when it comes to finding the right products or supplies. The policies and practices of third-party payers - whether private insurance, Medicare or Medicaid - are often confusing and inconsistent. 

Nevertheless, with a little persistence and some basic information, you can become a more  knowledgeable and satisfied consumer. The reward will be an improved  quality of life for both the elderly person and the caregiver. {EQ}

Read the article from end to end.Good information for caregivers, seniors, and families.

Questions to Ask About Durable Medical Equipment and Medical Supplies - AgingCare.com

Questions to Ask About Durable Medical Equipment and Medical Supplies - AgingCare.com

 An article full of very helpful advice and information. A long article and you need to read from end to end to get full benefit

Questions to Ask About Medical Equipment and Supplies

Sample for disucssion:

  • Are the senior's needs and comfort periodically assessed?
  • Handling a dispute with the insurer or vendor:
  • Has the caregiver made frequent and careful inquiries?
  • Has all communication (in person, phone, mail, email) been well documented?
  • If the insurer disputes the need for particular equipment or
    supplies or rejects a claim for a more costly but medically justified
    item, will an appeal be necessary?
  • Does the caregiver know how to file an appeal? 

Developed by, and made available with the permission of John J.
Connolly, Ed.D., President and CEO of Castle Connolly Medical Ltd.,
America's "trusted" source for information on top doctors and quality



6 Questions To Ask Before Hiring An In-Home Caregiver

 What is the cost, and how will the bills be paid? “Be certain to understand the whole payment package,” McVicker advises. For example, does the agency tack on extra charges for billing, taxes and worker’s compensation or include them in a single fee for services? Some agencies will send you a bill that includes the hourly rate for services plus additional itemized charges for taxes and administrative costs. Other agencies will simply charge you an hourly amount that encompasses all costs.

Code of Federal Regulations Resident rights (§483.10) Admission, transfer, and discharge rights (§483.12) Resident behavior and facility practices (§483.13) Quality of life (§483.15) Quality of care (§483.25)

Quoted from:http://tinyurl.com/pmmrher December 14, 2013 Long Term Care Facilities: Are You Being Treated Right? By CzepigaDalyPope LLC

The Code of Federal Regulations (herein either “the Code” or “CFR”) is a codification of rules published in the Federal Register by the departments and agencies of the Federal Government. Title 42 of the Code, Part 483, addresses public health requirements for long term care facilities.

Part 483 specifically addresses, among many other issues, the following:

Resident rights (§483.10) Admission, transfer, and discharge rights (§483.12) Resident behavior and facility practices (§483.13) Quality of life (§483.15) Quality of care (§483.25)

Most of the fundamental questions you have will be addressed, at least in part, in the sections cited above. Section 483.10, as one example, addresses resident rights and specifically provides for what a facility must do regarding issues that range from providing, for inspection, a resident with his or her medical records within twenty four hours of request, to prominently displaying information about how to apply for and use Medicare and Medicaid benefits.

Section 483.12, as one other example, lists the six permissible reasons to discharge a resident from a long term care facility. It is important to note, there are no other reasons for discharge beyond these six, any other purported reason for discharge that is not listed in §483.12 (a)(2) is a violation of Federal law.

6 Reasons for Discharge

The transfer or discharge is necessary for the resident’s welfare and the resident’s needs cannot be met in the facility
the transfer or discharge is appropriate because the resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility
The safety of individuals in the facility is endangered
The health of individuals in the facility would otherwise be endangered
The resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the facility.
The facility ceases to operate

For those who live in long term care facilities, it is your home and you are entitled to certain rights within it. For those of you who visit a loved one in a long term care facility, if you begin to question whether your loved one is being treated appropriately, simply go online, type into Google “42 CFR 483,” and start getting your questions answered.

A trial attorney who handles these types of matters, can give you lots of help,
you would be surprised how effective Federal law is when properly cited during discussions with facility administrators and staff.

Posted in: Elder Law and Nursing Home Litigation

Create A Better Day Café Marlborough , MA USA

Create A Better Day Café Are you caring for someone with Alzheimer’s or other dementia? Create

A Better Day Café encourages socialization with other caregivers and loved ones where you can just be yourself. This is a wonderful opportunity to get out with your loved one and have an enjoyable afternoon.

It’s a time to step out of the daily routine, leave the disease at the door, and enjoy a positive experience in a supportive environment. The afternoon will consist of conversation, music, arts, games, refreshments, and most importantly, laughter.

There is no cost.

It is open to anyone at any stage of the disease process accompanied by friends, family, and loved ones. The café is held the 4th Sunday of each month Please attend our next Café on Sunday, October 26th 1:00pm to 3:00pm at Pleasantries Adult Day and Consulting Services 195 Reservoir Street, Marlborough

Please contact Tammy for more information at 508-481-0809 Due to the possibility of cancellation please call prior to attending and listen to voice message

Hospice and Nursing Homes Blog: Death Rattle, Families, Signs of Dying (Research, ...

Hospice and Nursing Homes Blog: Death Rattle, Families, Signs of Dying (Research, ...:

{quote}A crackling, gurgling sound emanating from a dying person’s throat can distress onlookers who have not been prepared for this  occurre...

  Caregivers and loved ones should be educated regarding the death rattle experience and reassured about the unlikelihood of patients’ pain.

Supporting this need for more education is additional death rattle family research focused on bereaved family members who had witnessed the anxiety of watching a death rattle experience. This study involved 663 questionnaire surveys conducted in 95 palliative care units, Among family members who participated, 46% of respondents had witnessed the death rattle. Of these participants, 66% reported high distress levels, and 53% perceived a strong need for improved death rattle care.

This research concluded that family distress could be reduced by having medical staff lessen patients' symptoms with comprehensive and supportive care strategies. These strategies would include decreasing secretions and uncomfortable smells along with alleviating torment of family members through education.

{end quote}

Some Basic basics for caregivers | Compiled from aggregated information on the Net

Learning about and accepting Confabulating and Confabulations is
essential and not easy to accept.

In psychology, confabulation (verb: confabulate) is a memory
disturbance, defined as the production of fabricated, distorted or
misinterpreted memories about oneself or the world, without the
conscious intention to deceive.

Key factors in confabulations are there is no intent to deceive,
second the person being unaware that the information is blatantly
false. Confabulating is distinct from lying because there is no intent
to deceive, and the person being unaware that the information is
blatantly false. Carers challenge: is what they say true?
Confabulations become a far greater concern in the later stages,
because confabulations are much more likely to be acted upon.

It is difficult for everyone to accept a mind is damaged by
Alzheimer's Disease. Not only is memory damaged their ability to
process thoughts and conversations is impaired.

Confabulations are a major annoyance and can be dangerous- when we take everything in a discussion at face value. Confabulating is very frequently observed in people with Alzheimer's.

We all Confabulate when we make..verbal statements and/or actions that
inaccurately describe history, background and present situations
unintentionally. We must be aware of information that is blatantly
false yet are coherent, internally consistent, and appear relatively

Understand the similarities between confabulation and delusions; e.g.,
both involve the production of unintentional false statements, both
are resistant to contradictory evidence.

Recognize Sunrise Syndrome delusions that are frequently observed in
Alzheimer's patients include beliefs about theft, the patient's house
not being his home, a spouse, is an impostor, belief an intruder is in
the house,abandonment, spousal infidelity, and paranoia.

It seems that Alzheimer's world is fraught with confabulation speak.
The general public doesn't understand Alzheimer's they certainly need
to be educated regarding Confabulation.

{Quoting http://tinyurl.com/qfutbn4 Nature Reviews Neuroscience }

"Most patients with spontaneous confabulation eventually stop

"Confabulators may occasionally act upon their confabulation."
("Occasionally"? Later-stage Alzheimer's patients persistently and
repeatedly act upon the belief their childhood memories are relevant
to their present circumstances.)

"Confabulations are usually limited in time; they relate to the recent
past, the present, and the future."

{End Quoting http://tinyurl.com/qfutbn4 Nature Reviews Neuroscience }

An aide/caregiver must understand the individual has Alzheimer's
Disease, be aware of the danger, and treat the person with patience.
Also, Confabulation is common. Conversing with someone who has
Alzheimer's is often like talking with your cat.

Acknowledge, respond, be affectionate, develop boundless patience.
Forget about rational responses. Show respect, your therapeutic
fictional responses are allowed. ~{quoting}DLMifm}

To cope with spontaneous confabulation, and ease the confusion,
frustration, and fear for the loved one, use resources such as:

By far, the most serious danger posed by Alzheimer's disease is when
the individual may decide they want to go for a walk, go searching for
"home," or maybe just walk outside to get the paper. In a restaurant
they may go to a rest-room. When they turn around, the place they
expect to see is gone. Their assurance they are Ok and can go on their
own ?. may be a example of confabulation.


Alzheimer Society of Canada, http://tinyurl.com/oujghvy Toronto,
Ontario, M4R 1K8

Hallucinations and delusions are symptoms of Alzheimer's disease and
other dementias. With hallucinations or delusions, people do not
experience things as they really are.

Delusions are false beliefs. Even if you give evidence about something
to the person with dementia, she will not change her belief. For
example, a person with dementia may have a delusion in which she
believes someone else is living in her house when she actually lives
alone. Delusions can also be experienced in the form of paranoid
beliefs, or accusing others for things that have not happened. For
example, the person with dementia may misplace an item and blame
others for stealing it. Some people with dementia may have the
delusion that others are "out to get them." For example, he
may believe that his food is being poisoned.

Hallucinations are incorrect perceptions of objects or events
involving the senses. They seem real to the person experiencing them
but cannot be verified by anyone else. Hallucinations are a false
perception that can result in either positive or negative experiences.
Hallucinations experienced by people with dementia can involve any of
the senses, but are most often either visual (seeing something that
isn't really there) or auditory (hearing noises or voices that do not
actually exist). For example, a visual hallucination could be seeing
bugs crawling over the bed that aren't actually there. Of course,
people also make “visual mistakes,� mistaking a housecoat hanging
up for a person, for example, because they can’t see the object
clearly. This can happen to anyone, and is not considered a


Definition of Alzheimer's Sunrise Syndrome

Internet description: cognitive instability on arising from sleep.

Sunrise Syndrome,(sun?riz) a condition in which a person with
Alzheimer's wakes up rising in the morning and their mind is filled
with delusions which include include beliefs about theft, the
patient's house not being their home, a spouse is an impostor, belief
an intruder is in the house, abandonment, spousal and paranoia, people
eavesdropping. Sometimes the person may carry over content of a dream.

One observation is that Sunrise Syndrome is different from Sundowning
because the person may wake up in a confabulation mind set. During a
Sunrise Syndrome conversation with the content may filled with
confabulations; verbal statements and/or actions that inaccurately
describe history, background and present situations.

Sundowning in contrast displays as confusion, disorientation,
wandering, searching, escape behaviors, tapping or banging,
vocalization, combativeness; the demons of anxiety, anger, fear,
hallucinations and paranoia come out.

When I became a caregiver for my wife with Alzheimer's I had no
clue to the tasks ahead. I started to read and search the Internet for

Now retired I enjoy blogging and networking. I am an Aggregator to
Ishmael's Knowledge Network, I frequently collect content from various
Internet sources and consolidate it on Ish's Knowledge Network
Knowledge networking is a pastime / hobby. BTW I have no
commercial ties to the linked information.

Suggested reading Jennifer Ghent-Fuller's article,
"Understanding the Dementia Experience"

I really need to say this: The blog is for informational purposes only. I assume no responsibility for its accuracy. The information is subject to change without notice. Any actions you take based on information from the podcast or from this website are entirely at your own risk. Products and services are mentioned for informational purposes only and their various trademarks and service marks are the property of their respective owners. Fair Use:  is not an infringement of copyright

Alzheimer's Association list of safety services


The information is based on the
provider’s description of their own services
We cannot guarantee, endorse,
or recommend any provider listed and the information may change
without notice. This is an informational list only and we update it
regularly. Through our 24-hour Helpline

St. Louis Chapter
24/7 Helpline: 800.272.3900