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


Memory loss from cholesterol drugs real:

Memory loss from cholesterol drugs real: How it might happen: Statins effect on the brain is real

Researchers from University of Arizona discovered brain cells treated with statins swell, causing a sort of traffic jam in signaling cells of the brain known as neurons; revealed in lab studies. The result could explain why some people taking cholesterol lowering drugs report difficulty thinking and memory loss.

The scientists have dubbed what they saw in the lab as the "beads-on-a-string" effect that is probably more severe than what really happens to people sensitive to statins who suffer memory problems. The study authors say the swelling seen in the brain’s neuron was significant.

 There is also still a lot we don’t know about how they affect behavior and cognition. Another side effect reported by patients who take the drugs is muscle pain

Getting Good Information: Caregivers, Sundowners Syndrome, Dementia

from Aging Wisely Blog

Getting Good Information: Caregivers, Sundowners Syndrome, Dementia: We read a lot of forums, websites, books and articles about all matter of topics related to aging and elder care. With the explosion of information available on the web and, in particular, social media and forums for comments and feedback, there are many caregivers benefiting from sharing information and connecting with others in similar circumstances.

However, the downside to the information superhighway is that it can take you on a lot of wrong turns. We all know the stories of ways the internet has been used by con artists for scams, but another less obvious concern is filtering through information to ensure you are getting accurate information or advice.


Both online and offline, we see a lot of misinformation about dementia and related terms like sundowners syndrome, Alzheimer's disease and memory loss.  It is not uncommon when a family comes to see us to hear that they have not been able to get specific answers about what is going on with a loved one who is having cognitive issues.  Sometimes this is due to fear and no one wanting to seek a specific diagnosis, other times certain assumptions have been made (the symptoms are just "old age") and occasionally the family has gotten blatently incorrect information.
Here are some words of advice for seeking information as a caregiver, whether on issues like sundowners syndrome, dementia, caregiving or preparing for eldercare:
  1. Seek expert sites on the specific topic.  Start with sites such as disease-specific organizations and trusted resources with long histories. 
  2. Find out who is providing the information and review their "about us" closely.  What are the academic backgrounds and qualifications of the people writing the information?  If you cannot locate an "about us" page, you should probably seek information elsewhere.
  3. The best information to get from other caregivers is support and ideas on how they have handled situations.  When it comes to diagnoses, care planning and choosing specific resources, a professional opinion usually serves you better.  Here are some areas where we see particularly bad (or just misguided) information being shared: legal advice, qualifying for benefits/programs and how to do so, diagnosis and treatment information, terminology and resources.  Many times it is not that the information is purposely harmful, it just doesn't necessarily apply to your situation.
  4. Stay away from judgmental or negative commentary.  It is the last thing you need as a caregiver.  If you review a Facebook group or forum site and notice people sharing strong opinions of what a caregiver should or should not do, this may not be a supportive atmosphere for you.  Negativity (and even things like political ranting) can cause you greater anxiety.
  5. Just like with other aspects of caregiving, strategize which ways the internet and technology can help you most.  For example, reading too much about a relative's diagnosis might be scary at first.  Instead, seek information on which physicians or hospitals specialize in treatment or who offers local support groups.  Setting up an online personal health record or using a communications system/online community can be very helpful to caregivers.
  6. Use a combination of information sources to seek resources/care providers.  When you are trying to find options such as in-home care, assisted living, and benefit programs, you may be best served by having professional help in pulling together a care plan.  This can save you a lot of hours of research and heading down the wrong roads

FirstHealth dementia care

Richmond County Daily Journal - Caregivers Family Night to focus on FirstHealth dementia care: FirstHealth dementia care

Melanie Bunn; geriatric nurse practitioner, a dementia training specialist with Alzheimers North Carolina and an instructor of nurses with Duke University’s School of Nursing, .... her life’s work, ... involves the care and concerns of people with dementia.

Bunn’s role with the Moore Regional nursing staff has focused on building a “care-giving team” with the appropriate tools and knowledge for the individualized care of individuals with “altered mental status.” That can mean the temporary confusion that can accompany an acute illness or the vast mental and physical losses of advanced dementia.

The hospital’s revised protocols on these patients with altered mental status begin at admission during the routine medical assessment that is required of every patient. Patients with an appropriate diagnosis get a gray armband that identifies their altered mental status to the entire care-giving team, and the information is documented in their patient record.

Additional hospital protocols for patients with altered mental status focus on individualized care approaches and specified methods of communication. They also include environmental suggestions for maintaining a “safe, calm, non-threatening environment” such as encouraging frequent family/familiar caregiver visits and avoiding visual and/or auditory elements that could disturb the patient even more.

According to Cheryl Batchelor, R.N., Moore Regional’s executive director of clinical operations, the protocol revisions followed a study of the hospital’s dementia care-giving practices after the husband of an Alzheimer’s patient had raised some concerns.

“He felt we needed to acknowledge the special needs of people with dementia,” Batchelor said. “We thought we were doing a good job, but we were not looking at individualized needs.”
After hearing examples to the contrary during a meeting with the patient’s husband and two other relatives of patients with dementia,

Batchelor, physician champion Jenifir Bruno, M.D., of Hospitalist Services and other members of the FirstHealth nursing staff formed a task force with “cross representation” from all three FirstHealth hospitals.

“We involved as many (disciplines) as possible,” said Tabitha Stewart, R.N., a nurse clinician with Moore Regional Clinical Practice/Professional Development.

Team members reviewed medical literature and contacted other hospitals and various specialists in the area of dementia care. Results included revised educational materials and protocols that were approved by FirstHealth’s Nurse Practice Council.

The admissions database was revised to improve the screening of dementia patients, and the Information Technology department developed a special music-only TV channel for patients who don’t cope well with noise. In addition to Bunn, expert contacts included Dr. Eleanor McConnell of Duke’s Center of Excellence in Geriatric Nursing Education, and Alice Watkins, executive director of Alzheimers North Carolina.

As the various initiatives were rolled out, family caregivers continued to be involved and are pleased with the results. In a recent email, the family member who raised the initial concerns shared the following story about another family:

“At a Dementia Caregiver’s Support Group meeting this week, a participant shared a story about a recent MRH ED visit with her loved one who has dementia. The visit was precipitated by a fall, which resulted in a nasty cut on the forehead. She indicted that he was given a gray wristband. But, more importantly to her, she said the staff seemed much more empathetic to his dementia and accommodating to her than during her previous ED visits, the most recent being about six months ago.
“She additionally noted that upon asking she was allowed to accompany him to imaging where they provided a chair for her while he was given a CT scan.

Read more: Richmond County Daily Journal - Caregivers Family Night to focus on FirstHealth dementia care

Primary Phone: 910-997-3111
Primary Fax: 910-997-4321
John Charles Robbins
Editor
910.997.3111
jrobbins@civitasmedia.com



 


http://en.wikipedia.org/wiki/Nursing_home | nursing home, convalescent home, skilled nursing facility

Canada
Quebec

Long-term care facilities exist under three types, public, subsidized and private. Public and subsidized differ only in their ownership, all other aspects of funding, admission criteria, cost to the individuals are all regulated by the Quebec Ministry of Health and Social Services.[3] Private facilities are completely independent from government ownership and funding, they have their own admission criteria. They must maintain certain provincial[clarification needed] standards and require licensing from the ministry.


--------------

United Kingdom

In 2002 nursing homes became known as care homes with nursing, and residential homes became known as care homes.[4]


In the United Kingdom care homes and care homes with nursing are regulated by different organisations in England, Scotland, Wales and Northern Ireland. To enter a care home, a candidate patient needs an assessment of needs and of their financial condition from their local council. The candidate may also have an assessment by a nurse, should the patient require nursing care. The cost of a care home is means tested in England.


As of April 2009 in England, the lower capital limit is £13,500. At this level, all income from pensions, savings, benefits and other sources, except a "personal expenses allowance" (currently £21.90), will go to paying the care home fees. The local council pays the remaining contribution provided the room occupied is not more expensive than the local council's normal rate, currently £364.48 for Hampshire for example. If the resident is paying more than this the council will not pay anything and contributions from a third party or charity must be found or the resident move to a cheaper care home. Between the lower and the upper capital limits, the resident pays their income less personal expenses allowance + £1/week for every £250 capital between lower and higher limit. The council pays the rest, subject to the same conditions as before. It is therefore preferable to find a home within the council's limit if council funding is likely to be required to avoid a forced move later. Patients with capital over more than £23,000 pay the full cost of the care home, until the total value of their assets fall below the threshold.[5] Patients who require additional nursing care are assessed for this.[6] and receive additional financial support (£103.80 weekly) through the National Health Service (NHS). This is known as Funded Nursing Care.


The NHS has full responsibility for funding the whole placement if the resident in a care home with nursing meets the criteria for NHS continuing Health Care. This is identified by a multidisciplinary assessment process.[7]


Care homes for adults in England are regulated by Care Quality Commission, which replaced the Commission for Social Care Inspection, and each care home is inspected at least every three years. In Wales the Care Standards Inspectorate for Wales has responsibility for oversight, In Scotland Social Care and Social Work Improvement Scotland otherwise known as the Care Inspectorate, and in Northern Ireland the Regulation and Quality Improvement Authority in Northern Ireland.


In May 2010, the Coalition Government announced the formation of an independent commission on the funding of long-term care, which was due to report within a 12-month time frame on the financing of care for an Ageing population. It delivered its recommendations on Monday 4 July 2011. The Care Quality Commission have themselves implemented a re-registration process, completed in October 2010, which will result in a new form of regulation being outlined in April 2011. [8]
--------------------

United States

In the United States, there are three main types of nursing facilities (NFs).


Intermediate care facility (ICF)


An intermediate care facility (ICF) is a health care facility for individuals who are disabled, elderly, or non-acutely ill, usually providing less intensive care than that offered at a hospital or skilled nursing facility. Typically ICF is privately paid by the individual or by the individual's family. An individual's private health insurance and/or a third party service like a hospice company may cover the cost.
Assisted living facility (ALF)

----------

Rest home for seniors in Ceský Tešín, Czech Republic


Assisted living residences or assisted living facilities (ALFs) are housing facilities for people with disabilities. These facilities provide supervision or assistance with activities of daily living (ADLs); ALFs are an eldercare alternative on the continuum of care for people, for whom independent living is not appropriate but who do not need the 24-hour medical care provided by a nursing home and are too young to live in a retirement home. Assisted living is a philosophy of care and services promoting independence and dignity.[9]
Skilled nursing facility (SNF)



A skilled nursing facility (SNF) is a nursing home certified to participate in, and be reimbursed by Medicare. Medicare is the federal program primarily for the aged (65+) who contributed to Social Security and Medicare while they were employed. Medicaid is the federal program implemented with each state to provide health care and related services to those who are below the poverty line. Each state defines poverty and, therefore, Medicaid eligibility. Those eligible for Medicaid maybe low-income parents, children, including State Children's Health Insurance Programs (SCHIPs) and maternal-child wellness and food programs.[citation needed] seniors, and people with disabilities.


The Centers for Medicare and Medicaid Services (CMS) is the component of the U.S. Department of Health and Human Services (DHHS) that oversees Medicare and Medicaid. A large portion of Medicare and Medicaid dollars is used each year to cover nursing home care and services for the elderly and disabled. State governments oversee the licensing of nursing homes. In addition, States have a contract with CMS to monitor those nursing homes that want to be eligible to provide care to Medicare and Medicaid beneficiaries. Congress established minimum requirements for nursing homes that want to provide services under Medicare and Medicaid. These requirements are broadly outlined in the Social Security Act, which also entrusts the Secretary of Health and Human Services with the responsibility of monitoring and enforcing these requirements. The Centers for Medicare and Medicaid Services is also charged with the responsibility of working out the details of the law and how it will be implemented, which it does by writing regulations and manuals.[10]

-------

Typical nursing home staff


Administration

Once a patient has moved into the nursing home, their relatives may not have significant contact with the administration team, unless there are specific concerns that arise. Depending on the size of the nursing home, the administration staff may be very small, consisting of only a handful or people, or it may have dozens of staff responsible for individual departments (i.e., accounting, human resources, etc). Most states require nursing home administrators to have a license to run a facility.


Support personnel

Some staff members focus solely on caring for the buildings and grounds. Custodians, maintenance staff, and groundskeepers, for example, keep the inside and outside of the building in clean, working order.


Additional support personnel also include people who may have some contact with the patient in the nursing home, but it may not be daily or even regularly. For example, nursing homes may have an activities director who is responsible for planning and implementing holiday events, daily and weekly educational and social activities, coordinating special visitors and religious services. Larger facilities may have multiple staff members, such as chaplains or activity assistants, who take on some of those roles. Physical therapy staff may also be available, depending on the home.

Direct care staff

Nurse at a nursing home in Norway


The direct care staff have direct, daily contact with the patient. The following are types of direct care staff included in all nursing homes:


    Registered nurse (RN)
    Licensed practical nurse (LPN) or licensed vocational nurse (LVN)
    Certified nursing assistant (CNA)

   
Staffing requirements


Federal law requires all nursing homes to provide enough staff to adequately care for residents. There is no current federal standard for optimal nursing home staffing levels. The nursing home must have at least one RN for at least 8 straight hours a day, 7 days a week, and either an RN or LPN/LVN on duty 24 hours per day. Certain states may have additional staffing requirements. CNAs provide care to nursing home residents twenty four hours per day, seven days a week.


Services

Nursing homes offer the most extensive care a person can get outside a hospital. Nursing homes offer help with custodial care—like bathing, getting dressed, and eating—as well as skilled care given by a registered nurse and includes medical monitoring and treatments. Skilled care also includes services provided by specially trained professionals, such as physical, occupational, and respiratory therapists.



The services nursing homes offer vary from facility to facility. Services include:


    Room and board
    Monitoring of medication
    Personal care (including dressing, bathing, and toilet assistance)
    24-hour emergency care
    Social and recreational activities

   
Occupational Therapy


Some of the individuals that are housed in a nursing home need ongoing occupational therapy. Occupational Therapists (OTs) and Occupational Therapy Assistants (OTAs) “promote the health and participation of people, organizations, and populations through engagement in occupation” (American Occupational Therapy Association [AOTA], 2008). OTs and OTAs provide intervention in areas of occupation such as: activities of daily living (ADLs) including bathing, dressing, grooming; instrumental activities of daily living (IADLs) including home and financial management, rest and sleep, education, work, play, leisure, and social participation (AOTA, 2008). They also develop and implement health and wellness programs to prevent injuries, maintain function, and improve safety of residents. For example, OTs and OTAs can take a leadership role in developing and implementing programs to educate clients on compensatory techniques for low vision, customized exercise programs, or strategies to prevent falls. Occupational therapy practitioners may also consult with other staff within the facility or in the community on a variety of topics related to increasing safe engagement in activities. Occupational therapy practitioners can provide a variety of services to short- and long-term residents of a SNF. Based on a client-centered evaluation, the occupational therapist, the client, caregivers, and/or significant others develop collaborative goals to identify strengths and deficits and address barriers that hinder occupational performance in multiple areas. The intervention plan is designed to promote a client’s optimal function for transition to home, another facility, or long-term care.


Physical therapy


Some of the individuals that are housed in a nursing home need ongoing physical therapy. This can be for any number of reasons. Perhaps a person has motor skills that never fully developed or have stopped functioning for some reason. Perhaps an individual has undergone a surgery or medical procedure that requires some manner of physical restitution on a personal level. Nursing homes offer specialists that are well versed in the field of rebuilding muscle or helping one regain their confidence when it comes to doing something physical. This is one of the most common therapies that are done in these nursing homes.


Medical needs



Nearly all residents in a nursing home have the need for some type of medical need. It can be anything from basic care of a medical inadequacy to something more specialized such as someone that is missing an appendage. These nursing facilities can take care of just about any medical need that needs to be taken care of. Most of the staff at these nursing homes has ample training in how to deal with patients that have some manner of specialized need. In fact, the staff that interacts with the patients the most are normally registered nurses that have spent years training for any situation that they may encounter during a patients stay at one of these nursing homes.


Companionship


Payment for nursing home care can be made through Medicare, Medicaid, private insurance, and personal funds.



    Medicare is a federal health insurance program providing health care benefits to all Americans age 65 and over. Insurance protection intended to cover major hospital care is provided without regard to income. Medicare will only provide 100 days of nursing care, and only if a person requires skilled care and is referred by a doctor when discharged from the hospital. If a person needs custodial care alone, Medicare will not cover it. Medicare only pays for skilled care in a nursing facility that has a Medicare license.
   
   
    Medicaid is a joint federal/state health insurance program providing medical care benefits to low income Americans who meet certain requirements. Nursing home care is covered through Medicaid, but the requirements and covered services vary widely from state to state. To become eligible for Medicaid coverage, people usually have to spend all of their assets first. This means that they might pay for nursing home care out of pocket initially. Once their money runs out, Medicaid would kick in. It's a good idea to work with a lawyer who specializes in elder law when determining Medicaid eligibility.
   
   
    Private long-term care insurance is a health insurance option that, if purchased, supplements Medicare coverage. Private long-term care insurance policies vary greatly. Each policy has its own eligibility requirements, restrictions, costs, and benefits.

Alzheimer's Disease Medications Fact Sheet | National Institute on Aging

Alzheimer's Disease Medications Fact Sheet | National Institute on Aging
Alzheimer's Disease Medications Fact Sheet

Several prescription drugs are currently approved by the U.S. Food and Drug Administration (FDA) to treat people who have been diagnosed with Alzheimer’s disease. Treating the symptoms of Alzheimer’s can provide patients with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well.

It is important to understand that none of these medications stops the disease itself.

For information about managing medicines for people with Alzheimer's disease, read the tip sheet Managing Medicines (PDF, 625K).
Volunteers—people with Alzheimer's or mild cognitive impairment and healthy individuals—are needed to participate in Alzheimer's clinical research. Learn more about participating in clinical trials.

Treatment for Mild to Moderate Alzheimer’s

Medications called cholinesterase inhibitors are prescribed for mild to moderate Alzheimer’s disease. These drugs may help delay or prevent symptoms from becoming worse for a limited time and may help control some behavioral symptoms. The medications include: Razadyne® (galantamine), Exelon® (rivastigmine), and Aricept® (donepezil). Another drug, Cognex® (tacrine), was the first approved cholinesterase inhibitor but is rarely prescribed today due to safety concerns.

Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimer’s disease, but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimer’s progresses, the brain produces less and less acetylcholine; therefore, cholinesterase inhibitors may eventually lose their effect.

No published study directly compares these drugs. Because they work in a similar way, switching from one of these drugs to another probably will not produce significantly different results. However, an Alzheimer’s patient may respond better to one drug than another.

Treatment for Moderate to Severe Alzheimer’s

A medication known as Namenda® (memantine), an N-methyl D-aspartate (NMDA) antagonist, is prescribed to treat moderate to severe Alzheimer’s disease. This drug’s main effect is to delay progression of some of the symptoms of moderate to severe Alzheimer’s.

It may allow patients to maintain certain daily functions a little longer than they would without the medication. For example, Namenda® may help a patient in the later stages of the disease maintain his or her ability to use the bathroom independently for several more months, a benefit for both patients and caregivers.

Namenda® is believed to work by regulating glutamate, an important brain chemical. When produced in excessive amounts, glutamate may lead to brain cell death. Because NMDA antagonists work very differently from cholinesterase inhibitors, the two types of drugs can be prescribed in combination.
The FDA has also approved Aricept® for the treatment of moderate to severe Alzheimer’s disease.

Dosage and Side Effects

Doctors usually start patients at low drug doses and gradually increase the dosage based on how well a patient tolerates the drug. There is some evidence that certain patients may benefit from higher doses of the cholinesterase inhibitors. However, the higher the dose, the more likely are side effects. The recommended effective dosages of drugs prescribed to treat the symptoms of Alzheimer’s and the drugs’ possible side effects are summarized in the table (see below).
Patients should be monitored when a drug is started. Report any unusual symptoms to the prescribing doctor right away. It is important to follow the doctor’s instructions when taking any medication, including vitamins and herbal supplements. Also, let the doctor know before adding or changing any medications.


Alzheimer's Disease Education and Referral (ADEAR) Center
A Service of the National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services
November 2008
Publication Date: July 2010
Page Last Updated: March 22, 2013

National Family Caregiver Support Program (NFCSP)

The Purpose of the Program and How it Works

The National Family Caregiver Support Program (NFCSP), established in 2000, provides grants to States and Territories, based on their share of the population aged 70 and over, to fund a range of supports that assist family and informal caregivers to care for their loved ones at home for as long as possible.

Families are the major provider of long-term care, but research has shown that caregiving exacts a heavy emotional, physical and financial toll. Many caregivers who work and provide care experience conflicts between these responsibilities. Twenty two percent of caregivers are assisting two individuals, while eight percent are caring for three or more. Almost half of all caregivers are over age 50, making them more vulnerable to a decline in their own health, and one-third describe their own health as fair to poor.

The NFCSP offers a range of services to support family caregivers. Under this program, States shall provide five types of services:

information to caregivers about available services,
assistance to caregivers in gaining access to the services,
individual counseling, organization of support groups, and caregiver training,
respite care, and
supplemental services, on a limited basis

Alzheimer's Day Care at Night guide to establishing Evening-Daycare.

Carers often experience chronic sleep deprivation 
There may be (i.e. can be, should be) relief for caregivers and families.

Comments regarding evening-day-care {and daycare-at-night}

Find a comment link at the bottom where you can reply with a comment. You can also reply to the comments as well. We encourage you to do so! You’ll just need to enter your name and email.

Please ask questions, post thoughts or even write your own mini-blog entry (in the form of a comment).

To submit a post for this blog – please contact admin daycareatnight @ gmail.com

Because a lot of caring is done by family members, it's assumed anyone can do it. | Carers Chill4us

Because a lot of caring is done by family members, it's assumed anyone can do it. | Carers Chill4us

 http://observer.guardian.co.uk/


Carers come in all shapes and sizes, and as more and more of us fail to die on time, the demand for them is going to increase. But according to a survey, only a third of those working in the NHS believe they are properly supervised, and nine out of 10 want to be registered, as nurses are. Which might be a step in the right direction, but doesn’t address the basic trouble: that caring has no real status.

Some carers are little short of saints, but because a lot of caring is inevitably done by family members, it’s assumed anyone can do it, and too many are simply doing it because it’s the only job going, with no sense of vocation, precious little pay, and too often expected to fit half an hour’s care into 20 minutes. They are, in terms of status, about where nursing was pre-Florence Nightingale: in a job that very few would choose above all other occupations.

The Skills Academy for Social Care is recruiting graduates to be fast-tracked into management, but caring won’t improve until carers themselves, and not just well-educated outsiders, can aim for a real career structure and proper recognition in terms of pay.

Carers get a hairdresser at the new dementia cafe opened in Norwich | Carers Chill4us

Carers get a hairdresser at the new dementia cafe opened in Norwich | Carers Chill4us: dementia café has been opened in the Norwich area.

Age UK Norfolk’s drop in cafe initiative taking place at Hammerton Court, Norwich. Getting to know one another in during an introduction to Cognititve Stimulation Therapy.

The café, at the Hammerton Court dementia care unit in Bowthorpe Road, follows similar initiatives in Costessey, Diss and Horstead.

The Pabulum Cafe opens will run on the third Wednesday of every month from 10.30am to 12.30pm.

The café offers people the chance to drop in and stay for as long as they wish.
A hairdresser is also available, providing an opportunity for carers attending the café to have their hair cut without having to arrange care cover.
Age UK Norfolk’s drop in cafe initiative taking place at Hammerton Court, Norwich. Getting to know one another in during an introduction to Cognititve Stimulation Therapy.

For more information about the café, call 01603 785241 or see www.ageuknorfolk.org.uk

DayCare at Night programs serving Alzheimer's Caregivers

Night Care Registry: DayCare listing Night programs serving Alzheimer's Caregivers
Carers often experience chronic sleep deprivation. At the onset of nighttime. The demons of anxiety, anger, fear, hallucinations and paranoia come out. Night time can be unpredictable, up and down cycles.

Please email "daycareatnight at gmail.com" to add programs.

UKGeriActive catalogue of activity ideas

UKGeriActive

A-Z of Activity

Ideas In the following pages you will find a catalogue of activity ideas for you to use just click on the image and away you go

The Caregiver’s Bill of Rights | Alzheimer's Reading Room

The Caregiver’s Bill of Rights | Alzheimer's Reading Room: Whether they realize it or not caregivers do have rights – lots of them.

This list has been circulating on the internet for a long time and is attributed to various persons.

This version was taken from www.caregivers.utah.gov, where it is attributed to Jo Horne.

Whether you have seen it previously or not, it is always worth repeating and sharing


  • To take care of myself. Caregiving is not an act of selfishness. It will give me the capability of taking better care of my loved one.
  • To seek help from others even though my loved ones may object. Only I can recognize the limits of my endurance and strength.
  • To maintain facets of my life that do not include the person I care for, just as I would if he or she were healthy. I know that I do everything that I reasonably can for this person, and I have the right to do some things just for myself.
  • To get angry, be depressed, and express other difficult feelings occasionally.
  • To reject any attempts by my loved one (either conscious or unconscious) to manipulate me through guilt, and/or depression.
  • To receive consideration, affection, forgiveness, and acceptance for what I do, from my loved ones, for as long as I offer these qualities in return.
  • To take pride in what I am accomplishing and to applaud the courage it has sometimes taken to meet the needs of my loved one.
  • To protect my individuality and my right to make a life for myself that will sustain me in the time when my loved one no longer needs my full-time help.
  • To expect and demand that as new strides are made in finding resources to aid physically- and mentally-impaired persons in our country, similar strides will be made towards aiding and supporting caregivers.

Accepting Alzheimers, Coping in Alzheimers World | Alzheimer's Reading Room

Accepting Alzheimers, Coping in Alzheimers World | Alzheimer's Reading Room: Accepting Alzheimers, Coping in Alzheimers World

Did you ever wonder why most Alzheimer's patients stick like glue to their caregiver? Call out their name when they can't see them? Want to know where you are when they can't see you?

By Bob DeMarco
Alzheimer's Reading Room

Accepting Alzheimer's Coping
When a person has Alzheimer's disease or another type of dementia they are often difficult to understand. The behaviors they express are often difficult to accept.

It be be very hard to deal with a person suffering from Alzheimer's disease.

It is hard to understand that a person can't remember. Harder to accept that when they can't remember, they will do things that are completely foreign to your frame of reference.

Each of us has emotions and feelings. Alzheimer's has a way of bringing out the worst of these feelings and emotions.

The challenge -- learning to deal with a person living with Alzheimer's on their own terms. Learning to deal with Alzheimer's disease.

 http://tinyurl.com/buqqwxz 

Many caregivers come to the conclusion that the person living with Alzheimer's is not the person they knew. Knew most or all of their life.

Is it possible to deal with a stranger? Is this supposed stranger likable?

Can you like someone that continually makes you angry, frustrated and sad?

See what is happening? You make the situation about you. This is not the person I knew. I knew.

But Alzheimer's caregiving is not only about you. It is also about the person living with the disease.

The "live -R" cannot help or change the way they are acting. But, you can change the way you are acting or feeling.

Sooner or later you have to start by reminding yourself this is my Mom, this is my Dad, this is my Husband, this is my Wife.

Here is something I learned on the Alzheimer's Reading Room. Alzheimer's caregivers want, try hard, to give the person living with AD the highest quality of life possible.

Striving for this goal is difficult. Near the beginning, it seems impossible for most of us.

Carers to get a break as new service launched - Local Headlines - Deeside Piper and Herald

Carers to get a break as new service launched - Local Headlines - Deeside Piper and Herald: “Respite is essential. We recently got access to the Creative Breaks Fund through the Scottish Government and the Change Fund. It can be used flexibly to help carers have a short holiday, pay for leisure or gardening equipment or enjoy a bit of pampering. It can be a chance to have a break from their caring role or spend quality time with the person they care for. It means they can rest and recharge their batteries as well as trying a new skill or picking up an old hobby. I’d urge any local carers to get in touch as soon as possible to get support in applying for this funding.”

“For short-term respite we’re working in partnership with Alzheimer Scotland to offer relaxation sessions for carers at Victory Hall in Aboyne.”

Defining Non-Medical Home Care for Seniors | In Home Care for Elders

Defining Non-Medical Home Care for Seniors | In Home Care for Elders
Home Care is a service that assists those in need to continue living and celebrating life from the comfort of their own home. Home care is a model of care that includes both professional and informal support networks that include family, neighbors, and friends. To remain independent, these individuals construct your ‘Care Team’ which work together to meet your goals and expected outcomes. At some point, you may determine that a professional Home Care company is needed to join your Care Team.
Considering your options

When selecting a Home Care services company, you will have many questions. The first thing to understand is that Home Care services vary from facility-based options. Chances are if you’re researching senior care you’ve heard a lot about senior housing options such as a nursing home, assisted living community, adult day care, retirement community, or continuing care retirement community (or CCRC). These elderly care options all have unique benefits, however, at home care is often the preferred choice for seniors who wish to age in place at their own home. Your financial, social, and health situation will often determine which environment you choose.

Choosing the right care for loved ones is an important decision and it starts with knowing when to call. Professional care givers can assist your loved one in a number of important ways

Paying for In Home Care | Affordable Quality Home Care: Paying for Home CareWhen it comes time to find non-medical, in-home care for your loved ones, paying for this important service is probably the last thing on your mind.

Zip Door when all you need to seal is the doorway


 Zip Door is a great way when all you need to seal is the doorway. One person can install it in under a minute. It's also great for residential jobs like kitchen and bath remodeling, or where renovation will disturb lead paint.   
    For  doors up to 4' x 8'
    Flame retardant Made from 4 mil plastic sheeting
    Two heavy duty zippers pre-installed


Marie Marley: Alzheimer's and the Devil Called Denial

Marie Marley: Alzheimer's and the Devil Called Denial

But people noticing consistent signs of confusion and forgetfulness in a loved one should not wait for the 'defining incident.' One early action to take is to review the Alzheimer's Association's 10 Signs of Dementia and ask yourself whether your loved one is showing one or more of them:
1. Memory loss that disrupts daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks at home, at work and at leisure
4. Confusion with time or place
5. Difficulty understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Losing things and the inability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality
The Alzheimer's Association website has additional information about each of these items and explains how they differ from things 'normal people' do from time to time

Hiring an In-Home Caregiver

Hiring an In-Home Caregiver

(Page 1 of 4)
For older adults, in-home non-medical care might be the key to independence. However, the quality of care depends on the quality of the caregiver. When looking for in-home care, finding the best service can be a challenge. This article offers suggestions on what to look for when hiring a caregiver.
What is In-Home Care?
In-home caregivers provide assistance with activities of daily living (ADL) such as meal preparation, dressing, grooming, medication monitoring, transportation and light housekeeping. These services should not be mistaken for home health services, which offer skilled, medical services by licensed professionals such as nurses and therapists. While in-home caregivers may be trained and/ or certified, they focus mostly on activities of daily living and are not required to perform complex health care related tasks. Programs such as Medicare, or Medicaid (Medi-cal) cover Home Health Services, but do not usually cover non-medical services. There are some long-term care insurance policies that cover non-medical in-home care services. Review your policy to determine whether in-home care is covered by your insurance.

Alzheimer’s Disease and Dementia Knows No Borders Video | Alzheimer's Speaks Blog

Alzheimer’s Speaks provides a variety of platforms and forums to educate and shift our dementia care culture for professional, family caregivers and the public at large. Alzheimer’s Speaks believes collaborative and alternative approaches push society forward in search for answers and that working together and sharing knowledge is the best way to win the battle against this disease. Alzheimer’s Speaks believes it is time to shift caregiving from crisis to comfort by removing the fear and providing economical services, tools, concepts and products to those in need. For more information please visit and learn about how you and your organization can become Dementia Friendly.

Patient Self-Determination Act - Wikipedia, the free encyclopedia

Patient Self-Determination Act - Wikipedia, the free encyclopedia

The requirements of the PSDA are as follows:
  • Patients are given written notice upon admission to the health care facility of their decision-making rights, and policies regarding advance health care directives in their state and in the institution to which they have been admitted. Patient rights include:
  1. The right to facilitate their own health care decisions
  2. The right to accept or refuse medical treatment
  3. The right to make an advance health care directive
  • Facilities must inquire as to the whether the patient already has an advance health care directive, and make note of this in their medical records.
  • Facilities must provide education to their staff and affiliates about advance health care directives.
  • Health care providers are not allowed to discriminately admit or treat patients based on whether or not they have an advance health care directive.

[edit] Purpose

The purpose of the Patient Self-Determination Act was to inform patients of their rights regarding decisions toward their own medical care, and ensure that these rights are communicated by the health care provider. Specifically, the rights ensured are those of the patient to dictate their future care (by means such as living will or power of attorney), should they become incapacitated.

[edit] References

  1. ^ Health Care Advance Directives - What is the Patient Self-Determination Act?. American Bar Association.
  2. ^ What is the Patient Self-Determination Act?. Legal HelpMate.
  3. ^ Advance Care Planning in Health Care Reform Legislation. National Hospice and Paliative Care Organization.
  4. ^ Robert Pear (December 25, 2010). "Obama Returns to End-of-Life Plan That Caused Stir". The New York Times.
  5. ^ Robert Pear (January 4, 2011). "U.S. Alters Rule on Paying for End-of-Life Planning". The New York Times.

[edit] Further reading

  • Yates JL, Glick HR (1997). "The failed Patient Self-Determination Act and policy alternatives for the right to die". J Aging Soc Policy 9 (4): 29–50. PMID 10186890.
  • Leahman D (2004). "Why the Patient Self-Determination Act has failed". N C Med J 65 (4): 249–51. PMID 15481498.

[edit] External links

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Article: OBRA regulations and chemical restraints. (Omnibus Budget ...

www.accessmylibrary.com › ... › November 1990 articlesCached - SimilarShare
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Nov 1, 1990 – Free article about 'OBRA regulations and chemical restraints. (Omnibus Budget Reconciliation Act of 1987)' at AccessMyLibrary.com. ... Nursing Homes and Senior Citizen Care articles > November 1990 articles.

Avoiding the Urinary Tract Infection | Alzheimer's Reading Room By Carole B. Larkin

Avoiding the Urinary Tract Infection | Alzheimer's Reading Room: Here are a few tips/tricks that may help you avoid the dreaded UTI -- Urinary Tract Infection.

By Carole B. Larkin
Alzheimer's Reading Room

First, I am not a doctor, nor am I a nurse. I am an experienced Geriatric Care Manager and a woman. Over the years, I had more conversations with urologists and their nurses about urinary tract infections (UTIs) than I care to remember.

<><><><>
The biggest cause of UTI’s is dehydration! It’s ironic, because the thought process of many older adults is,

“if I don’t drink much, then I won’t have to go to the bathroom very often, which is better because it’s a pain in the butt (sorry again!) to get up, get over to the bathroom, partially disrobe, and then go to the bathroom and then do it all in reverse, before I get to relax in my chair or bed again.”
So they don’t drink fluids, which of course leads to dehydration, the leading cause of UTI’s and incontinence (at least in early and midstage Alzheimer’s.) So to prevent UTI’s you must be persistent in having mom drink fluids. Water is best, but among one of the hardest things to get some people to drink, so flavor it with Kool-Aid or something similar. I can’t tell you how many times my clients have ended up with UTI’s just because no one insisted that they drink!

A Family Caregiver’s Elevator Speech

A Family Caregiver’s Elevator Speech: “I am Elizabeth Chomsky’s daughter. She is a person living with dementia, but loved to paint, ice skate and still can have a wicked sense of humor. I want to be informed of any change in her condition, medications or situation since I am her primary caregiver, loving daughter and fearless caregiver.” (Or something like that.)
 Gary Barg
Editor-in-Chief

gary@caregiver.com   

 Sign up for our FREE Fearless Caregiver Weekly Newsletter, your guide for the best caregiver support.

- Specialized Care Co, Inc.for individuals who need dental care

- Specialized Care Co, Inc.



Specialized Care Co, Inc. designs, markets and sells products that facilitate the delivery of oral health services. Our products include Rainbow Stabilizing Systems (some people refer to these generically as Papoose Boards), Airway Positioners and Cushions for knee-to-knee exams; Open Wide mouth props (bite blocks) and mouth rests; Stay N Place pillows for the dental chair, chair liners and booster seats; Surround 3-headed toothbrushes, and training DVDs for delivery of dental care to people with special needs.

Specialized Care Co, Inc. markets products that facilitate the delivery of oral health services. Our products assist dental professionals, nurses and at-home helpers as they provide care for individuals who need dental care, but who are unable to cooperate for safe and effective dental treatment. You may call us toll-free at 800/722-7375 (U.S. and Canada) if you'd like further assistance. For our international visitors, our phone number in the U.S. is 603/926-0071 and our fax number is 603/926-5905.

Stressed Anyone?

Stressed Anyone?
 Home > Other Diseases > Stressed Anyone?

Stressed Anyone?

Beat stress with our simple S.T.R.E.S.S. management Tips Stressed-Anyone A flat tyre when you are already running 20 minutes late for office – stress; not able to meet deadlines – more stress; pile-on friends coming over on weekdays – stress + grump…. there couldn’t be enough reasons to avoid this unwanted condition of getting stressed every now and then. To be honest, no one can control the “causes” of stress but yes, can learn to deal with the metal exhaustion it creates.
Try to follow the simple things, make certain lifestyle changes, and be a happy person all along!!

S.T.R.E.S.S. Management Tips

S – Sleep: In today’s time, getting enough sleep is not an easy and simple thing to find. A peaceful eight hours sleep is something a lot of people crave for and can be a cause of impending stress. Caffeine, alcohol, heavy and greasy food causes indigestion and interfere with sound sleep. Setting a routine bed time, a glass of warm milk, no television in bedroom, and washing your feet just before getting in the bed will definitely aid in a blissful slumber.
T – Time Management: A planned and organised day well in advance saves a lot of stress. Maintain an organiser to avoid forgetting important things and stuff to do. Priorities your daily chores, do first things first. Keep time slots for the day’s work and stick to it.
R – Rest and relax: Incorporate some relaxation ideas into your day. Watching your favourite TV show or reading a book, even listening to music helps in a big way. Take up a hobby or just sit by the window chatting with friends. Anything that you like doing will do the trick and ease off the mental pressure.
E – Exercise: Nothing can beat exercising in relieving stress. A good work out session post office hours will take away all the gloom and stress by surging the adrenaline rush which will make you feel good and happy. And with all that working out, the compliments that you receive will add to your de-stressing.
S – Smile more: Smiling always makes things easier in life and comes for free too!! When you smile often, you see more faces around you smiling back in response. That definitely feels great and you feel little less stressed.
S – Simplify life: Make life simple. Don’t complicate it by trying to do everything all by yourself.


Indus Health Plus (P) Ltd.
'INDUS HOUSE', Pride Port,
Model Colony,
Pune- 411 016
Maharashtra, India
 



Chris Cooper and Company - Managing the Cost of Terminal Illness, Part 3: Consider Palliative Care

Chris Cooper and Company - Managing the Cost of Terminal Illness, Part 3: Consider Palliative Care:

What Is Palliative Care? Written by Chris Cooper, CFP® | 18 March 2013

Palliative care is an approach to medical treatment that involves taking steps to relieve pain and improve quality of life for people with serious illnesses (such as AIDS, cancer, Alzheimer's disease or Parkinson's disease). Unlike hospice care, which is specifically for people who are close to death, palliative care is for anyone with a serious illness. And it doesn't take the place of more traditional treatments—it simply offers additional services (such as help with pain, insomnia, nausea or other symptoms) in coordination with traditional care. Typically, it involves a team approach, with doctors, nurses, social workers/counselors, and perhaps even clergy members and nutritionists working together to help the patient. Palliative care considers a patient's physical health along with their emotional and spiritual needs.

While the term palliative care is relatively new, this approach to treatment has actually been around for decades and is offered by many hospitals. And there's evidence that patients who receive this type of care enjoy better quality of life. One study found that people who had advanced lung cancer and received palliative care lived longer and required less chemotherapy and hospitalization.

How To Use the Alzheimer's Reading Room Knowledge Base | Alzheimer's Reading Room

How To Use the Alzheimer's Reading Room Knowledge Base | Alzheimer's Reading Room: How To Use the Alzheimer's Reading Room Knowledge Base

The Alzheimer's Reading Room Knowledge Base contains more than 4,000 articles. In the Alzheimer's Reading Room (ARR), we offer "real life" solutions to problems that Alzheimer's caregivers and their families encounter each day.

By Bob DeMarco
Alzheimer's Reading Room

How To Use the Alzheimer's Reading Room Knowledge Base
The goal of the Alzheimer's Reading Room is to Educate, Empower, and sometimes Entertain Alzheimer's caregivers, their families, and the entire Alzheimer's community.

At its core the Alzheimer's Reading Room is about helping members of the Alzheimer's and Dementia Community understand, cope, and communicate with persons living with Alzheimer's and Dementia.

The Alzheimer's Reading Room is currently the number one source of information for Alzheimer's, dementia, memory loss, and related health and life news on the Internet.

Subscribe to the Alzheimer's Reading Room
Email:

You can access the Alzheimer's Reading Room Knowledge Base by using the search box that is available on every page on this website.

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Bob DeMarco

Founder, Alzheimer's Reading Room

From Grief Comes A Mission To Make Estate Planning Less Daunting : NPR

From Grief Comes A Mission To Make Estate Planning Less Daunting : NPR:

Estate planning may seem like a pain, but imagine the mess you leave to those managing your affairs if you don't draw up a will or get life insurance.

"It takes really just a few hours now, rather than a pile of hours and thousands of dollars to do it later when you really need it done," says Chanel Reynolds, who created a website geared to help people get their affairs in order.

Her site — which is a NSFW riff on "get your stuff together" — features a checklist and templates for some key documents, including a will, living will and power of attorney. It also suggests compiling online account usernames and passwords and putting these key documents in a safe or scanning and uploading them to a password-protected site.

Reynolds also suggests setting aside emotional items like photos of yourself, "so that when you're gone people can touch them and hold them and feel them and remember you as well."

For wills, Reynolds notes that lawyers can help, but there are also affordable online software options. "I didn't realize that creating a will, you don't need a lawyer to do it for you," she says. "In most states you need two witnesses and/or someone to notarize it. And it can save your family weeks and weeks and hundreds of hours of pain and confusion and legal costs that you probably can't afford."


ADvancing Care Newsletter | alz.org/nyc

ADvancing Care Newsletter | alz.org/nyc:

 Alzheimer's Association, New York City Chapter
360 Lexington Avenue., Fl. 4, New York, NY 10017

Alzheimer's Association is a not-for-profit 501(c)(3) organization.

Culture change towards person-centred care in Canada

Culture change towards person-centred care: Culture change towards person-centred care in Canada


Person-centred care of people with dementia living in care homes: Executive summary

The Alzheimer Society believes that people with dementia have the right to enjoy the highest possible quality of life and quality of care. The Society believes that each person with dementia is an individual, regardless of the stage of the disease, and that care should be individually tailored to their unique needs, interests, habits and desires.

To achieve this goal, the Alzheimer Society of Canada looked for evidence-based research that shows how to successfully implement person-centred programs and practices in long-term care homes. The result of this research is the Guidelines for care: Person-centred care of people with dementia living in care homes framework, which includes the input of peop

Guidelines for care

The Guidelines for care framework consists of the following sections:
  • What does a person-centred philosophy mean?
Our most important objective is to ensure that a person-centred philosophy of care is well understood and put into practice in care homes to improve the quality of care and quality of life for people with dementia. Dignified care must become part of the inherent culture of every long-term care home.
  • What does person-centred care look like in a care home?
Person-centred care is a philosophy that recognizes that individuals have unique values, personal history and personality and that each person has an equal right to dignity, respect, and to participate fully in his environment. Person-centred care should be incorporated into all aspects of care, regardless of the resident’s condition or stage of the disease. A person-centred care home values partnerships among care home staff, people with dementia, and family members that will lead to the best outcomes and enhance the quality of life and quality of care of people with the disease. Services and supports are designed and delivered in a way that is integrated, collaborative, and mutually respectful of all persons involved, including the person with dementia, family members, caregivers and staff.
le with dementia, family caregivers, researchers, educators, long-term care home staff, and various stakeholders.
---

Alzheimer Society of Canada
20 Eglinton Avenue West, 16th Floor,
Toronto, Ontario, M4R 1K8
Tel: 416-488-8772 Fax: 416-322-6656
Toll-free: 1-800-616-8816
Email: info@alzheimer.ca

Massachusetts | Consumer and Provider Service Organizations

Resource List

The Official Website of the Executive Office of Health and Human Services (EOHHS)








Resource List



This is a partial listing of frequently used resources. When contacting any of the organizations listed below, be sure to ask if they have suggestions about additional resources you may want to contact.

Government Agencies

Massachusetts Department of Public Health
Division of Health Care Quality
Telephone: (617) 753-8000
Survey Tool Information: (617) 753-8000
Web Site: http://www.mass.gov/dph/dhcq

Massachusetts Executive Office of Elder Affairs
General Information & Referral Assistance (9am-5pm)
Telephone: (617) 727-7750 or 1-800-882-2003
(24 hours) 1-800-882-2275
Web Site: http://www.mass.gov/elder

The Massachusetts Commission on End of Life Care
250 Washington St
4th Floor
Boston, MA 02108
Phone:617-624-5437
Fax: 617-624-5075
Web Site: http://www.endoflifecommission.org

MassHealth
Client Services, Medicaid Eligibility
Telephone: (617) 210-5000
Web Site: http://www.mass.gov/masshealth

Massachusetts Division of Insurance
Consumer Services Section
Information on Long-Term Care Insurance
Telephone: (617) 521-7777
Web Site: http://www.mass.gov/doi/

Massachusetts Office of the Attorney General
Consumer Protection Division
Telephone: (617) 727-8400
Web Site: http://www.mass.gov/ago

Consumer and Provider Service Organizations

Alzheimer's Association of Eastern Massachusetts
Telephone: (617) 494-5150
Helpline: 1-800-548-2111

Massachusetts Aging Services Association, Inc.
Telephone: (617) 739-3235
Web Site: http://www.massaging.org/

Living is for the Elderly (LIFE) Nursing Home Resident Advocacy Group
Telephone: (781) 646-1000 ext. 4733

Massachusetts Senior Care Association
Telephone: (617) 558-0202
Web Site: www.maseniorcare.org

Massachusetts Elderline
General Consumer Information on Free Prescription Drug Program and
Services for the Elderly
Telephone: 1-800-AGE-INFO

Hospice Federation of Massachusetts
Telephone: (781) 225-7077
Web Site: http://www.hospicefed.org

This information is provided by the Division of Health Care Quality within the Department of Public Health.








Massachusetts Home Care Program | Executive office of Elder Affairs in coordination with Aging Services Access Points (ASAPs),

Home Care Program Overview

Home Care Program Overview

The Massachusetts Home Care Program provides support services to elders with daily living needs to help maintain independent community living. Services are designed to encourage independence and ensure dignity. The program also supports families caring for elders in order to encourage and relieve ongoing care giving responsibilities. The Home Care Program is administered by the Executive office of Elder Affairs in coordination with Aging Services Access Points (ASAPs), located in communities throughout the Commonwealth of Massachusetts. The program provides homemaker, personal care, day care, home delivered meals, transportation, and an array of other community support services to help elders remain in their homes. The ASAP conducts comprehensive needs assessments to determine eligibility for the Home Care Program as well as other programs and services as appropriate. An individualized service plan is developed with the elder and his/her family. On an ongoing basis, the ASAP conducts reassessments and monitors services for quality.
Eligibility for the Home Care Program is based on age (60 years or older or under 60 with a diagnosis of Alzheimer's disease and in need or respite services), financial status, and ability to carry out daily tasks such as bathing, dressing, and meal preparation.

Eligibility for the Home Care Program


Age

60 years or older or under 60 with a diagnosis of Alzheimer's disease and in need of respite services

Codes

Functional Impairment Levels (FIL) - Activities of Daily Living (ADLs) - Instrumental Activities of Daily Living (IADLs)

Uniform Intake

Functional Impairment Level (FIL) 1-3, with critical unmet needs

Functional Impairment Levels

FIL 1 4-7 ADL impairments
FIL 2 2-3 ADL impairments
FIL 3 6-10 ADL/IADL impairments
  • Activities of Daily Living (ADLs) include bathing, dressing, eating, toileting, continence, transferring, and mobility
  • Instrumental Activities of Daily Living (IADLs) include meal preparation, shopping, laundry, managing money, housework, transportation, use of telephone, outdoor mobility, and taking medicine
  • Critical Unmet Needs include ADLs, meal preparation, shopping, medical transportation, and need for home health services or respite care

Financial

MassHealth members are financially eligible. Income guidelines require Annual Gross Income less than $24,838/single and 35,145/couple.

Monthly Co-Payments

  • $9-$130 for individuals with incomes that range from $10,924-$24,837
  • $17-$140 for couples with incomes that range from $14,646-$35,144

Respite Over-Income Scale

  • 50%-100% of cost of services