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


A Dementia Book Every Family & Professional Needs

A Dementia Book Every Family & Professional Needs | Alzheimer's Speaks Blog: A Dementia Book
Every Family & Professional Needs


This book shows and explains to the reader what is happening and why. It answers the questions of what do we do now? It shows the reader how to interact with someone who has been diagnosed in a loving and respectful fashion. It teaches us not to loose our relationship to illness, but to adapt life to the imperfections we all have. Lori La Bey

Top Ten caregiver.com Articles of June 2013

Top Ten Articles of June 2013:
 Here are the top ten articles you read in June

Which one was your favorite?

Avoiding Mistakes when Buying a Power Lift Chair Recliner

Emotional First Aid

10 Tips to Protect a Wandering Loved One

Heat Stress in the Elderly

Arthritis Tips

Ten Tips for Ensuring Medication Safety

Nine Ways to Get Someone to Eat

A Caregiver's Bill of Rights

Parkinson's Disease: Tips for Caregivers

Bipolar Disorder: Preventing Manic Episodes



Read them now!

PioneerNetwork : Conference Schedule at a Glance

PioneerNetwork : Conference Schedule at a Glance: Conference Schedule at a Glance

 Pioneer Network was formed in 1997 by a small group of prominent professionals in long-term care to advocate for person-directed care. This group called for a radical change in the culture of aging so that when our grandparents, parents — and ultimately ourselves — go to a nursing home or other community-based setting it is to thrive, not to decline.  This movement, away from institutional provider-driven models to more humane consumer-driven models that embrace flexibility and self-determination, has come to be known as the long-term care culture change movement.  Our partners and audience are primarily engaged in some aspect of long-term care including long-term care CEOs and administrators, consumers and family caregivers, doctors and nurses, direct care providers, and others who care about, and care for, the aging.

Pioneer Network is a center for all stakeholders in the field of aging and long term care whose focus is on providing home and community for elders. We believe that the quality of life and living for America's elders is rooted in a supportive community and cemented by relationships that respect each of us as individuals regardless of age, medical condition or limitations.


  from  Jytte Fogh Lokvig, Ph.D.

Create A Better Day Café Grand Opening... Sunday, June 23rd 1:00pm to 3:00pm | Create A Better Day Café will be held the 4th Sunday of each month from 1:00pm to 3:00pm

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.

Grand Opening...

Sunday, June 23rd 
1:00pm to 3:00pm
 

Create A Better Day Café will be held the 4th Sunday of each month from 1:00pm to 3:00pm
at Pleasantries Adult Day Services 195 Reservoir Street
 Marlborough, MA. 
Call Tammy for more information at 508-335-1968

- Smart911 data etc

What is Smart911? - Smart911: What is Smart911?

Smart911 is a free service that allows citizens across the U.S. to create a Safety Profile for their household that includes any information they want 9-1-1 to have in the event of an emergency. Then, when anyone in that household dials 9-1-1 from a phone associated with their Safety Profile, their profile is immediately displayed to the 9-1-1 call taker providing additional information that can be used to facilitate the proper response to the proper location. At a time when seconds count, being about to provide 9-1-1 with all details that could impact response the second an emergency call is placed could be the difference between life and death.
Be Smart About Safety. Sign Up Today.

Give 9-1-1 the information they need to better help you and your family in the event of an emergency.

Disability Indicator Program

Disability Indicator Program: Disability Indicator Program
Disability Indicator Form


The disability indicator program is voluntary for both the community and it's residents. The disability indicator form pdf format of disability_info_and_form.pdf was created by a group of several different organizations representing the mobility, hearing, speech and sight impaired communities.

*PLEASE NOTE: IT IS IMPORTANT TO SUBMIT A NEW DISABILITY INDICATOR FORM UPON CHANGE OF SERVICE PROVIDER, TELEPHONE NUMBER, OR ADDRESS*

The information provided on the disability indicator form enables a special code to appear on the 911 call takers screen which alerts the call taker that a person residing at that address may require special assistance during an emergency.


It is a standardized form created to encourage participation from all persons with disabilities. As you are aware, there are an extensive range of disabilities and medical conditions. The disability indicator categories listed on the form may be considered too broad for some; when you consider the extensive range of disabilities. However, information requested on the form must remain sensitive to those who may not wish to provide detailed information.
Always remember information on the disability indicator form is confidential.


The disability indicator form is available through the State 911 Department or it can be downloaded from this website. Originally, the form had to be filled out in triplicate. The new disability indicator procedure form only requires that when a person in your community submits a signed disability indicator form, the 911 Municipal Coordinator signs the form and faxes it to the Verizon Database Center at 1-800-839-6020 for entry into the 911 Verizon database. It is no longer necessary to mail your original. You retain that original copy as part of your permanent records to be used later for the annual verification of your database. Remember these are important confidential documents and should be stored in the same manner as all municipal records.

Annually, Verizon will send the Municipal Coordinator a current listing of those persons in their community who are enrolled in the disability indicator program for updating. Verizon enters the new information into the 911 database. A new Disability Indicator Form should be submitted for the following:

1. a person moves or no longer resides at that address
2. the apartment number changes
3. the telephone number changes
4. to add or delete a disability
Remember to review the lists carefully to maintain accurate records which will ensure the proper response in the event of an emergency.

Your 3M Resident Monitoring (RM) system will no longer operate properly. | Senior Housing Forum

Misplaced Trust: 3M adds insult to injury . . . | Senior Housing Forum: “ in the absence of qualified maintenance and support. Specifically, in the absence of regular database maintenance the system will stop sending alert messages to your employees and to the central monitoring station. This is likely to mean that your staff will not know based on the system when a resident has exited your facility or is in need of assistance.”

“FOR THIS REASON, YOU MUST REPLACE OR DISABLE YOUR 3M RESIDENT MONITORING SYSTEM ON OR BEFORE DECEMBER 31, 2013”

“If you choose to continue to operate the 3M Resident Monitoring system or any of its components or software after December 31, 2013, you do so at your own risk, and neither 3M Resident Monitoring Inc., 3M company, nor any of their affiliates shall assume any liability for the outcome.”

20-Common-Problems-Nov-2010-Final.pdf

20-Common-Problems-Nov-2010-Final.pdf
20 Common Nursing Home Problems and 
How to Resolve Them
Copyright ©2010 by the 
National Senior Citizens Law Center.
read their pdf

NSCLC provides education and counseling to local legal services advocates, but does not educate or provide advice or counsel to individuals. If you are looking for legal advice, you can find local resources by clicking here.
1444 Eye Street, NW Suite 1100
Washington, DC 20005
202-289-6976
3701 Wilshire Boulevard, Suite 750
Los Angeles, CA 90010
213-639-0930
1330 Broadway, Suite 525
Oakland, CA 94612
510-663-1055

Partners All | http://www.caregiver.com/

Partners All: Once we have succeeded in finding our physicians, personal support staff, physical therapists and even pharmacists, then it’s time to find the partners we need as we choose the products and equipment that our loved ones require. And frankly, with the Internet, these choices have become exponentially more difficult. I think the way you choose such a partner successfully is similar to how you choose your other care professionals. Certainly, in this case, price is an extremely important element, but there’s a lot more involved. Will they become a trusted resource for information and training? Will they be there when you have questions? Have they created an easy system to navigate? Are they accessible by phone or is it a Web-only wall that you cannot seem to climb over in order to find any human support? And (of course) do they stand by their products?

Heat Stress in the Elderly

 (read orginal three pages)  Heat Stress in the Elderly

Elderly people (that is, people aged 65 years and older) are more prone to heat stress than younger people for several reasons:

Elderly people do not adjust as well as young people to sudden changes in temperature.
They are more likely to have a chronic medical condition that changes normal body responses to heat.
They are more likely to take prescription medicines that impair the body's ability to regulate its temperature or that inhibit perspiration.

How to Apply For a Senior Care Job - Caregiverlist.com

How to Apply For a Senior Care Job - Caregiverlist.com

 List A:
  • U.S. Passport (expired or unexpired)
  • Permanent Resident Card or Alien Registration Receipt Card
  • Unexpired foreign passport with a temporary I-551 stamp
  • Unexpired Employment Authorization Document that contains a photograph
  • Unexpired foreign passport with unexpired Arrival-departure dates
  • Form I-94, bearing the same name as the passport and containing an endorsement of the alien's nonimmigrant status, if that status authorizes the alien to work for the employer
List B (Must also have an item from List C):
  • Driver's license or ID card issued by a state or outlying possession of the United States provided it contains a photograph or information such as name, date of birth, gender, height, eye color and address
  • School ID card with a photograph
  • Military dependent's ID card
  • U.S. Coast Guard Merchant Mariner Card
  • Native American tribal document
  • Driver's license issued by a Canadian government authority
List C (Must also have an item from List B):
  • U.S. Social Security card issued by the Social Security Administration (other than a card stating it is not valid for employment)
  • Certification of Birth Abroad issued by the Department of State (Form FS-545 or Form DS-1350)
  • Original or certified copy of a birth certificate issued by a state, county, municipal authority or outlying possession of the United States bearing an official seal
  • Native American tribal document
  • U.S. Citizen ID Card (Form I-197)
  • ID Card for use of Resident Citizen in the United States (Form I-179)
  • Unexpired employment authorization document issued by DHS (other than those listed under List A)

Young Adult Carers blog | Carers Trust | The Princess Royal Trust for Carers and Crossroads Care are now Carers Trust. Action, help and advice for carers

Young Adult Carers blog | Carers Trust | The Princess Royal Trust for Carers and Crossroads Care are now Carers Trust. Action, help and advice for carers

 the Young Adult Carers blog, a place for 14-25 year-old carers to share their stories, express their views and share valuable advice. As part of our Charity of the Year work with The Co-operative, Carers Trust is carrying out a range of
projects to support and raise awareness of young adult carers. Find out more on our Charity of the Year pages.

Activities of Daily Living – Checklist, Definitions and Importance - Paying For Senior Care

Activities of Daily Living – Checklist, Definitions and Importance - Paying For Senior Care


What are the Activities of Daily Living (ADLs)?

The Activities of Daily Living are a series of basic activities performed by individuals on a daily basis necessary for independent living at home or in the community.  There are many variations on the definition of the activities of daily living but most organizations agree there are 5 basic categories.

1. Personal hygiene such bathing, grooming and oral care
2. Dressing including the ability to make appropriate clothing decisions
3. Eating, the ability to feed oneself though not necessarily prepare food
4. Maintaining continence or the ability to use a restroom
5. Transferring oneself from seated to standing and get in and out of bed

Whether or not an individual is capable of performing these activities on their own or if they rely on a family caregiver to perform the ADLs serves a comparative measure of their independence. 
What are the Instrumental Activities of Daily Living (IADLs)?
IADLs are actions that are important to being able to live independently but are not necessarily required activities on a daily basis.  The instrumental activities are more subtle and can help more finely determine the level of assistance required by the elderly or disabled.  The IADLs include:

1. Basic communication such as using a telephone
2. Transportation, either by driving, arranging rides or the ability to use public transportation
3. Meal preparation and the ability to safely use kitchen equipment
4. Shopping and the ability to make appropriate food and clothing purchase decisions
5. Housework such as doing laundry and cleaning dishes
6. Managing medications such as taking accurate dosages at appropriate times and managing re-fills
7. Managing personal finances, operating within a budget, writing checks and paying bills
 The American Elder Care Research Organization
736 Cole Street
San Francisco, California 94117
Telephone: 641-715-3900 Ext. 606151#
===========

 Eldercare FAQs and Helpful Guides - Paying For Senior Care

Let's Look Together | by Rae-Lynn Cebul Ziegler

Let's Look Together | by Rae-Lynn Cebul Ziegler


Let's Look Together: An Interactive Picture Book for People with Alzheimer's and Other Forms of Memory Loss (A Dementia Activity Book) [Paperback]

October 1, 2009 1932529519 978-1932529517 1
NOW WITH FREE USER'S GUIDE!! VISIT HEALTH PROFESSIONS PRESS WEBSITE TO GET YOURS TODAY. Wake up someone's brain with every turn of the page in this delightfully engaging resource. Featuring evocative images of children, this picture book for adults is to be shared between a family (or professional) caregiver and a person with memory loss to encourage meaningful emotional connections and conversations through therapeutic brain stimulation.

Users of Let's Look Together are encouraged to
Relate to the feelings suggested by the photos, Reminisce about situations triggered in the person's memory, Describe what might precede or follow the photo's action, Tell a story about the child or image, and Find pleasure in sharing the book together.

Twenty-nine full-color photographs portray an array of easily recognized emotions and activities. Joy, tears, surprise, contentment and stubbornness are interspersed with edible delights, unexpected encounters, nurturing family interactions, and more. Simple conversation starters are provided for each image. It all comes together to create a new visual and emotional journey for each person every time the book is opened.

Let's Look Together is for use one-on-one or in groups at home or in formal care settings ranging from adult day services to hospitals and nursing homes.


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 ...

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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.