Hidden Costs of Assisted Living - AgingCare.com:
Carol Bradley Bursack, Expert
Author, speaker, columnist and eldercare consultant
The strong suit for in-home care agencies is their flexibility. During my years of caregiving for multiple elders, I used the services of two different in-home care agencies in the traditional manner, which was to fill the gaps in home care that I couldn't provide for my loved ones.
One of the reasons that assisted living centers are appealing to many people is that they offer a relatively high level of independence. If your parent is in good health and doesn't require much assistance with everyday tasks, assisted living is a terrific option. In fact, residing in an assisted living center is similar to having a private apartment, complete with private bathroom and kitchen, but you can rest easy with the knowledge that trained staff is on hand to help your loved one when necessary.
However, assisted living centers are not all cut out of the same mold. Depending on what part of the country you live in, what you get at assisted living may cost more.
Assisted living facilities provide a safe environment with convenient meals and social opportunities in their "base package." They are generally set up so that an elder can obtain help if he or she falls or has another emergency. Many also offer transportation by bus or other means for group outings or to specific locations.
But what about the basics of personal care: help with dressing, bathing, keeping track of prescription refills, setting up daily doses, injecting medications such as insulin, and a companion for trips to doctor appointments? Many assisted living facilities don't provide it in the "base" package. The services are add-on pricing.
So make sure you understand what services they do and don't offer per the contract, and what services may be available, but would cost extra. You might get some services you are expecting, but not all.
It works differently at different communities. At Emeritus Senior Living in Bonita Springs, FL the base rent is for what is called independent living. Any room could become an assisted room if the resident has a health care need. A caregiver goes to the room to help with showering, medication management and more. But, there's a fee for that.
Dave Mainwaring's Knowledge Network. Includes a more inclusive newsbasket: Mainzone Knowledge Network http://mainzoneknowledgenetwork.blogspot.com/
A newsbasket is on-line Internet publication containing comprehensive aggregated collections of information.
Confabulating and Confabulations
Everyone and particularly medical personnel and caregivers must understand!
Confabulating and ConfabulationsIn psychology, confabulation (verb: confabulate) is a memory disturbance, defined as the production of fabricated, distorted or misinterpreted memories about oneself or the world, without the conscious intention to deceive.
Key factors in confabulations are there is no intent to deceive, second the person being unaware that the information is blatantly false. Confabulating is distinct from lying because there is no intent to deceive, and the person being unaware that the information is blatantly false.
Carers challenge: is what they say true? Confabulations become a far greater concern in the later stages, because confabulations are much more likely to be acted upon.
It is difficult for everyone to accept a mind is damaged.
Not only is memory damaged their ability to process thoughts and conversations is impaired.
Confabulations are a major annoyance and can be dangerous- when we the take everything in a discussion at face value. Confabulating is very frequently observed in people with Alzheimer's.
We all Confabulate when we make..verbal statements and/or actions that inaccurately describe history, background and present situations unintentionally. We must be aware of information that is blatantly false yet are coherent, internally consistent, and appear relatively normal.
PRINT THIS OUT AND GIVE OUT
The Truth About Hospice | Author- Kathryn Watson
"Hospice is about living not about dying."
The Truth About Hospice- Kathryn Watson
Like many today, Kathryn Watson was thrust into the world of Eldercare with little knowledge or understanding of the industry.
Podcast- Listen to A Hospice Social Worker Explain “What is Hospice”
The challenges Kathryn Watson overcame led her to write Help! My Parents Are Aging Five steps to help you make the right decision regarding their care Paperback
and
Help! I Can’t Do This Alone When caring for your spouse becomes too hard Paperback
The Truth About Hospice
Like many today, Kathryn Watson was thrust into the world of Eldercare with little knowledge or understanding of the industry.
Podcast- Listen to A Hospice Social Worker Explain “What is Hospice”
The challenges Kathryn Watson overcame led her to write Help! My Parents Are Aging Five steps to help you make the right decision regarding their care Paperback
and
Help! I Can’t Do This Alone When caring for your spouse becomes too hard Paperback
3 Factors to Help You Compare Nursing Home Care - AgingCare.com
Ross Blair, Expert
President and CEO, eHealth Medicare
3 Factors to Help You Compare Nursing Home Care
Chances are, at some point you or a loved one may need to spend time in a nursing home.
In fact, about 70 percent of Americans will need a form of long-term care at some point in their lives. As more baby boomers continue to turn 65 — seniors are expected to comprise 19 percent of the population by 2030 — a growing number of people will be looking for the right place to receive the care and services they need.
3 Factors to Help You Compare Nursing Home Care - AgingCare.com:
President and CEO, eHealth Medicare
3 Factors to Help You Compare Nursing Home Care
Chances are, at some point you or a loved one may need to spend time in a nursing home.
In fact, about 70 percent of Americans will need a form of long-term care at some point in their lives. As more baby boomers continue to turn 65 — seniors are expected to comprise 19 percent of the population by 2030 — a growing number of people will be looking for the right place to receive the care and services they need.
3 Factors to Help You Compare Nursing Home Care - AgingCare.com:
Today's Geriatric Medicine - Alzheimer's/Dementia
Today's Geriatric Medicine - Alzheimer's/Dementia
Dementia and Inappropriate Sexual Behavior
Cognitive Evaluation for Memory Concerns
Lifestyle Influences Brain Health
Alzheimer's Research Comes of Age
Music and Art in Memory Care
Behavioral Expressions in Dementia Patients
Alzheimer's Diagnosis in Primary Care
Cognitive Decline Screening and Resources
Gait Speed Reflects Cognitive Function
Interventions Slow Brain Atrophy
Lighting Affects Dementia Patients’ Sleep
Therapeutic Options in Alzheimer’s Disease
Holistic and Creative Arts Therapies in Alzheimer’s Care
Fish Oils and Cognitive Function
Alzheimer’s Disease and the Blood-Brain Barrier
Evidence-Based Memory Preservation Nutrition
New Target for Therapy in AD Patients
Memory Maintenance
Pharmacological Prospects for Alzheimer’s Treatment
Medications Target Alzheimer’s Disease
What Should You Tell Patients About Alzheimer’s?
DBS to Treat Alzheimer’s Patients?
The Gait-Cognitive Decline Connection
Can You Recognize Lewy Body Dementia?
Recruiting Patients for Alzheimer’s Clinical Trials
Dementia and DSM-5: Changes, Cost, and Confusion
Alzheimer’s Staggering Financial Impact
12/15-Lipoxygenase’s Role in AD Prevention
New Technology to Detect, Diagnose AD
Dementia Care Model Facilitates Quality Outcomes
Integrating Palliative Medicine With Dementia Care
Dementia-Related Behavior Management
Combating Dementia With Infrared Light?
Deep Brain Stimulation
Becoming ADEPT at Predicting Mortality
New Biomarkers for Alzheimer’s Disease
MMSE vs. MoCA: What You Should Know
Vitamins and Dementia — Delaying Cognitive Decline?
Dealing With Dysphagia
New Molecular Tools Developed in Alzheimer’s Research
Hope for an Alzheimer’s Cure?
Alzheimer’s Cure on the Horizon?
Imaging Alzheimer’s Disease
Cognitive Camouflage — How Alzheimer’s Can Mask Mental Illness
Dementia and Inappropriate Sexual Behavior
Cognitive Evaluation for Memory Concerns
Lifestyle Influences Brain Health
Alzheimer's Research Comes of Age
Music and Art in Memory Care
Behavioral Expressions in Dementia Patients
Alzheimer's Diagnosis in Primary Care
Cognitive Decline Screening and Resources
Gait Speed Reflects Cognitive Function
Interventions Slow Brain Atrophy
Lighting Affects Dementia Patients’ Sleep
Therapeutic Options in Alzheimer’s Disease
Holistic and Creative Arts Therapies in Alzheimer’s Care
Fish Oils and Cognitive Function
Alzheimer’s Disease and the Blood-Brain Barrier
Evidence-Based Memory Preservation Nutrition
New Target for Therapy in AD Patients
Memory Maintenance
Pharmacological Prospects for Alzheimer’s Treatment
Medications Target Alzheimer’s Disease
What Should You Tell Patients About Alzheimer’s?
DBS to Treat Alzheimer’s Patients?
The Gait-Cognitive Decline Connection
Can You Recognize Lewy Body Dementia?
Recruiting Patients for Alzheimer’s Clinical Trials
Dementia and DSM-5: Changes, Cost, and Confusion
Alzheimer’s Staggering Financial Impact
12/15-Lipoxygenase’s Role in AD Prevention
New Technology to Detect, Diagnose AD
Dementia Care Model Facilitates Quality Outcomes
Integrating Palliative Medicine With Dementia Care
Dementia-Related Behavior Management
Combating Dementia With Infrared Light?
Deep Brain Stimulation
Becoming ADEPT at Predicting Mortality
New Biomarkers for Alzheimer’s Disease
MMSE vs. MoCA: What You Should Know
Vitamins and Dementia — Delaying Cognitive Decline?
Dealing With Dysphagia
New Molecular Tools Developed in Alzheimer’s Research
Hope for an Alzheimer’s Cure?
Alzheimer’s Cure on the Horizon?
Imaging Alzheimer’s Disease
Cognitive Camouflage — How Alzheimer’s Can Mask Mental Illness
How the Invention of Alzheimer's World Changed My Life Alzheimer's Reading Room
How the Invention of Alzheimer's World Changed My Life Alzheimer's Reading Room: How the Invention of Alzheimer's World Changed My Life
Alzheimer's Reading Room The best way to find Solutions to the Problems that Alzheimer's and dementia caregivers face each Day
The best way to find Solutions to the Problems that Alzheimer's and dementia caregivers face each Day
- See more at: http://www.alzheimersreadingroom.com/2011/07/why-i-invented-alzheimers-world-and.html#sthash.xGvr50v3.dpuf
The best way to find Solutions to the Problems that Alzheimer's and dementia caregivers face each Day
- See more at: http://www.alzheimersreadingroom.com/2011/07/why-i-invented-alzheimers-world-and.html#sthash.xGvr50v3.dpuf
Alzheimer's Reading Room The best way to find Solutions to the Problems that Alzheimer's and dementia caregivers face each Day
The best way to find Solutions to the Problems that Alzheimer's and dementia caregivers face each Day
The best way to find Solutions to the Problems that Alzheimer's and dementia caregivers face each Day
Dealing With Angry Seniors Under the Same Roof By Sarah Peterman on July 8, 2015
Angry & Elderly: Dealing With Angry Seniors Under the Same Roof http://tinyurl.com/oqc8g56
By Sarah Peterman on July 8, 2015 under Aging in Place as a Family, Process of Aging, Senior Care Advice
{QUOTE}
By Sarah Peterman on July 8, 2015 under Aging in Place as a Family, Process of Aging, Senior Care Advice
{QUOTE}
Every experienced family caregiver knows that seniors have their good days and bad days. Mood swings resulting from dissatisfaction, poor health, stress, pain, and a loss of dignity can easily lead to your loved one to lash out against you and others that they care about. Being a family caregiver under these conditions can be particularly stressful for the sandwich generation, who are “sandwiched” between living with an elderly parent and caring for their own children.
While dealing with these feelings and the emotional strain they cause can require a considerable amount of patience and empathy, there’s much more you can do than simply hope for more good days than bad ones. Below you can learn about several simple steps you can take to help those you look after to be less cranky, and help preserve your own wellbeing as a family caregiver in the process.
Download A Free Guide to Dealing with Elderly Anger
Emotional Turmoil in the Elderly
Getting older can magnify our character traits, often in undesirable ways. Someone who was crabby in their younger days may be prone to full-on bouts of rage in old age. Unfortunately, caregivers are often the target of these outbursts, and it may seem at times as though there may be no simple solution to deal with this type of behavior. After all, when outbursts are not caused by serious problems like chronic pain or difficulties in memory, they’re often the result of serious illnesses like Alzheimer’s or dementia, over which your loved one has no control.
How to Handle Anger
The first step to dealing with these problems is to understand that you shouldn’t take these negative emotions and their associated behavior personally. Pain and disease can cause us to act in very inappropriate ways, and it’s important to take any opportunity for a break from your caregiving duties that you can get. In the long term, you’ll likely want to spread caregiving amongst as many friends and family members as you can to make the possibility of these breaks more frequent.
The best solution to dealing with difficult elderly parents is almost always communication. Unfortunately, parents can be generally uneasy talking with their children about fears of the future, finances, and their mortality. If your loved one seems increasingly frustrated, anxious, or otherwise emotionally disturbed, it’s your responsibility to find out why if you want to help fix the problem. The next time both of you are in a pleasant mood, try warming them up to the conversation, and be ready to try several times before you’re successful.{END QUOTE}
Read more: http://www.griswoldhomecare.com/blog/dealing-with-elderly-anger/#ixzz3fUK21wz9
Legal Issues – Revoking prior Powers of Attorney
From Jim Koewler's The Koewler Law Firm website
The agent named in a now-revoked POA may not be happy about being
replaced. That deposed agent may use the authority in the old POA to
take actions with the principal’s assets. The bank or investment office
or real estate agent (or anyone else, for that matter) has no way to
know that the POA has been revoked. (Not many former agents would act
out in this manner, but those few that would certainly can hurt their
principals.)
To avoid an old POA being accepted as current, there are practical steps (in addition to the legal steps) to revoke an old POA.
The principal should try to retrieve all of the copies of the prior
POAs. Retrieving all of them can be a daunting task if there are a
number of copies. (Most POAs have a statement that a copy is to be
honored just like an original, so retrieval of copies is important.)
For advice, representation and peace of mind through these difficult issues, contact Jim Koewler of The Koewler Law Firm. Legal Issues when someone has Dementia – Revoke prior Powers of Attorney |
The agent named in a now-revoked POA may not be happy about being
replaced. That deposed agent may use the authority in the old POA to
take actions with the principal’s assets. The bank or investment office
or real estate agent (or anyone else, for that matter) has no way to
know that the POA has been revoked. (Not many former agents would act
out in this manner, but those few that would certainly can hurt their
principals.)
To avoid an old POA being accepted as current, there are practical steps (in addition to the legal steps) to revoke an old POA.
The principal should try to retrieve all of the copies of the prior
POAs. Retrieving all of them can be a daunting task if there are a
number of copies. (Most POAs have a statement that a copy is to be
honored just like an original, so retrieval of copies is important.)
For advice, representation and peace of mind through these difficult issues, contact Jim Koewler of The Koewler Law Firm. Legal Issues when someone has Dementia – Revoke prior Powers of Attorney |
CMS will modify—not scrap—two-midnight' rule - Modern Healthcare
Under the two-midnight rule, the CMS directs its payment contractors to assume a hospital admission was appropriate if a patient's stay spanned two midnights and otherwise should have been billed as an outpatient observation visit.
The rule was conceived to address a spike in observation stays attributed to hospitals' fear that Medicare audit contractors would challenge their admissions.
Many patients, as a result, found themselves ineligible for skilled nursing after spending days in the hospital because their stay had been billed as observation.
CMS will modify—not scrap—two-midnight' rule - Modern Healthcare
The rule was conceived to address a spike in observation stays attributed to hospitals' fear that Medicare audit contractors would challenge their admissions.
Many patients, as a result, found themselves ineligible for skilled nursing after spending days in the hospital because their stay had been billed as observation.
CMS will modify—not scrap—two-midnight' rule - Modern Healthcare
5 Steps for Dealing with Anticipatory Grief - Visiting Nurse Service of New York
5 Steps for Dealing with Anticipatory Grief - Visiting Nurse Service of New York: It might be the hardest part of caregiving: Watching your loved one slip away step by terrible step, knowing you can’t stop the decline and grieving the loss of the person you once knew, long before they’re actually gone. Psychologists call this process anticipatory grief, and it’s very common among caregivers and family members of those suffering from Alzheimer’s disease, cancer and other terminal illnesses.
“As a disease progresses, there is so much frustration and sadness associated with watching the person you once knew go away,” says Vince Corso, M.Div, LCSW, CT, Manager of Hospice Psychosocial Services, VNSNY. “It can be overwhelming.”
“As a disease progresses, there is so much frustration and sadness associated with watching the person you once knew go away,” says Vince Corso, M.Div, LCSW, CT, Manager of Hospice Psychosocial Services, VNSNY. “It can be overwhelming.”
What Goes Into a Life Care Plan? | Hill Law Group, PA
Data gathering Forms | Hill Law Group, PA
These planning questionnaires are worth their weight in gold! Everyone should, IMCO, have a family records notebook built from these forms.
Dave M.
These planning questionnaires are worth their weight in gold! Everyone should, IMCO, have a family records notebook built from these forms.
Dave M.
Observation Status Bills Reintroduced in Both the House and the Senate (H.R. 1571/S. 843) || CMA
Federal Bill Would “Fix” Problem Related to Medicare and Hospital “Observation Days
Observation Status Bills Reintroduced in Both the House and the Senate (H.R. 1571/S. 843) || CMA
Observation Status Bills Reintroduced in Both the House and the Senate (H.R. 1571/S. 843) || CMA
Personal Support Workers, or PSWs, are starting to fight back, but their wage increases equate to worry for clients, families and service provider agencies.
THE CAREGIVERS' LIVING ROOM A Blog by Donna Thomson: A Fight Between PSWs, Clients and Agency Service Providers Spells Trouble For All
an article by always erudite Howard Gleckman He wrote in Forbes:
Should the aides who provide home care for frail elders and younger people with disabilities receive a living wage and decent benefits? If they do, how can families, who often are unable to afford care today, be expected to pay those higher wages and benefits? Should the market be allowed to set these prices, or should government intervene through minimum wage and mandatory overtime laws? …. These questions have set off an enormous, but largely unnoticed, political firestorm. In some states, they have pit states against the federal government, people receiving care against their aides, and large home care agencies against independent direct care workers.
In Ontario, exactly the same questions are being asked. This time last year, the then Ontario Liberal Health Minister Deb Matthews and Finance Minister Charles Sousa announced an election promise of an increase in the minimum wage for 34,000 publicly paid Personal Support Workers to $16.50 an hour by April 1, 2016, up 32 per cent from the current rate of $12.50. Implementation of that promise hasn’t been easy. According to the Canadian Union of PublicEmployees (CUPE), some home and community care agencies have chosen not to implement the wage increase or they exclude sick leave, vacation and training hours in the new hourly wages. The sum total effect, says a CUPE spokesperson, is that most Ontario PSWs have yet to receive a wage increase.
The real lives of personal care workers are documented in a new film titled CARE, due for release later this year. The trailer is riveting and I recommend watching it HERE for a clear picture of the human side of our crisis in home and community care.
The care workers depicted in the film are all women. They are mothers and daughters who have left their own families behind in more impoverished countries in order to care for more affluent strangers in the United States.
Many care workers in Canada, the UK, Australia and New Zealand match this description. Eva Kittay drills down into the issues surrounding immigrant care workers and the role they play in a larger, profit driven dynamic.
The migration of care workers is caused both by a pull, the need for care workers, and a push, the need of these women to provide for their families.
Eva Feder Kittay‘From the Ethics of Care to Global Justice
The truth is that people need care and care workers must be able to earn a living wage.
New LinkedIn Group
Canadian Caregivers United is a new group on LinkedIn.
an article by always erudite Howard Gleckman He wrote in Forbes:
Should the aides who provide home care for frail elders and younger people with disabilities receive a living wage and decent benefits? If they do, how can families, who often are unable to afford care today, be expected to pay those higher wages and benefits? Should the market be allowed to set these prices, or should government intervene through minimum wage and mandatory overtime laws? …. These questions have set off an enormous, but largely unnoticed, political firestorm. In some states, they have pit states against the federal government, people receiving care against their aides, and large home care agencies against independent direct care workers.
In Ontario, exactly the same questions are being asked. This time last year, the then Ontario Liberal Health Minister Deb Matthews and Finance Minister Charles Sousa announced an election promise of an increase in the minimum wage for 34,000 publicly paid Personal Support Workers to $16.50 an hour by April 1, 2016, up 32 per cent from the current rate of $12.50. Implementation of that promise hasn’t been easy. According to the Canadian Union of PublicEmployees (CUPE), some home and community care agencies have chosen not to implement the wage increase or they exclude sick leave, vacation and training hours in the new hourly wages. The sum total effect, says a CUPE spokesperson, is that most Ontario PSWs have yet to receive a wage increase.
The real lives of personal care workers are documented in a new film titled CARE, due for release later this year. The trailer is riveting and I recommend watching it HERE for a clear picture of the human side of our crisis in home and community care.
The care workers depicted in the film are all women. They are mothers and daughters who have left their own families behind in more impoverished countries in order to care for more affluent strangers in the United States.
Many care workers in Canada, the UK, Australia and New Zealand match this description. Eva Kittay drills down into the issues surrounding immigrant care workers and the role they play in a larger, profit driven dynamic.
The migration of care workers is caused both by a pull, the need for care workers, and a push, the need of these women to provide for their families.
Eva Feder Kittay‘From the Ethics of Care to Global Justice
The truth is that people need care and care workers must be able to earn a living wage.
New LinkedIn Group
Canadian Caregivers United is a new group on LinkedIn.
Palliative Care for Caregivers | Get Palliative Care
Palliative Care for Caregivers | Get Palliative Care
Today, family caregivers provide about 80 percent of elder care, delivering meals, taking loved ones to doctor’s visits and managing medications and family conflicts. This results in lost work hours or lost jobs, high stress and serious declines in physical and mental health. Palliative care is a solution.
Mayo Clinic
Top 10 Things Palliative Care Clinicians Wished Everyone Knew About Palliative CareAugust, 2013 By Jacob J. Strand, MD, Mihir M. Kamdar, MD , Elise C. Carey, MD |
Today, family caregivers provide about 80 percent of elder care, delivering meals, taking loved ones to doctor’s visits and managing medications and family conflicts. This results in lost work hours or lost jobs, high stress and serious declines in physical and mental health. Palliative care is a solution.
Get Palliative Care
Get Palliative Care
What Is Palliative Care
Learn more about adult and pediatric palliative care, refer to the glossary and get answers to some frequently asked questions.
How to Get Palliative Care
Talk to your doctor, find a hospital and meet with your palliative care team. Just two simple steps to get palliative care.
Is Palliative Care Right for You
Take a quiz to determine if palliative care is right for you or a loved one.
What Is Palliative Care
Learn more about adult and pediatric palliative care, refer to the glossary and get answers to some frequently asked questions.
How to Get Palliative Care
Talk to your doctor, find a hospital and meet with your palliative care team. Just two simple steps to get palliative care.
Is Palliative Care Right for You
Take a quiz to determine if palliative care is right for you or a loved one.
Home Health Aide Certification and Certificate Programs
Home Health Aide Certification and Certificate Programs
Each state has its own requirements for home health aide certification. Some states only require that the employing agency be certified, while others require home health aides to pass a certification exam following completion of an educational program. Besides a skills assessment examination, certification may also require a state administered criminal background check. Some states maintain a registry database of certified home health aides that can be accessed by the public
===============
Each state has its own requirements for home health aide certification. Some states only require that the employing agency be certified, while others require home health aides to pass a certification exam following completion of an educational program. Besides a skills assessment examination, certification may also require a state administered criminal background check. Some states maintain a registry database of certified home health aides that can be accessed by the public
===============
Home Health Aide Training Requirements in MA
Massachusetts does not require a State issued certification, nor is there a State exam required to be eligible to work as a Home Health Aide. Instead the State recommends national certification through the National Association for Home Care and Hospice. The NAHC requires a 75 hour training course and a competency test before you are eligible to apply for their certification.Caregiving Criticism and Unsolicited Advice From Family - AARP
AARP Home » Home & Family » Caregiving »How to Handle Criticis...
How to Handle Criticism While Caregiving
Well-meaning advisers try to help but some can cause hurt
by Barry J. Jacobs, PsyD., AARP, December 29, 2014
just react to the message being given but to consider the background and
intentions of the messenger. Advisers often have a sincere desire to
help, because they truly are caring and invested. They just don't have
enough information and understanding to know how to actually be helpful.
They are also unaware that their good ideas may come across as
critical. If you express appreciation for their caring, they will
usually feel satisfied that they are making a difference and stop
pressing specific recommendations.
Some people, though, use pieces of advice as thinly veiled barbs. Out
of competitiveness or their own misery, they consciously or
unconsciously mean to take caregivers down a peg. They should be kept at
arm's length. It is seldom worth debating them or giving them the
satisfaction of having caused hurt.
Caregiving Criticism and Unsolicited Advice From Family - AARP
How to Handle Criticism While Caregiving
Well-meaning advisers try to help but some can cause hurt
by Barry J. Jacobs, PsyD., AARP, December 29, 2014
Take it from whence it comes
Caregivers would be well-advised (there's that word again) to notjust react to the message being given but to consider the background and
intentions of the messenger. Advisers often have a sincere desire to
help, because they truly are caring and invested. They just don't have
enough information and understanding to know how to actually be helpful.
They are also unaware that their good ideas may come across as
critical. If you express appreciation for their caring, they will
usually feel satisfied that they are making a difference and stop
pressing specific recommendations.
Some people, though, use pieces of advice as thinly veiled barbs. Out
of competitiveness or their own misery, they consciously or
unconsciously mean to take caregivers down a peg. They should be kept at
arm's length. It is seldom worth debating them or giving them the
satisfaction of having caused hurt.
Caregiving Criticism and Unsolicited Advice From Family - AARP
staff scheduling and labor management
OnShift provides staff scheduling and labor management software
They are focused entirely on the long-term care and senior living industry, software and services are built upon an in-depth understanding of how providers work day-in and day-out, and how industry regulations and issues affect their every move.
{ staff scheduling and labor management is of interest to the world of Caregiving}
Jan 26, 2015 Mark Woodka posted the following to their Long Term Care & Senior Living Blog
For some strange reason we encourage ourselves to prognosticate about the future annually as one year recedes and another begins. These projections might not always be correct, but I think they nicely balance out our attempts at New Year’s resolutions and give us something to aim for. (I hope this list goes more smoothly than those resolutions usually do…)
I’d like to outline my predictions for long-term care and senior living in 2015 – the big things that may change how you run your communities and provide care for your residents. So without further ado, here we go:
Affordable Care Act Penalties: The Employer Mandate began January 1 after two years of delays, and we must now be very, very cautious in managing our workforces to ensure we do not get penalized. There was a bill proposed to exclude certain industries from having to participate due to large populations of lower-wage hourly workers and low margins. Guess what? One of the original intents of the ACA was to get these very workers healthcare benefits. Therefore, this bill is a non-starter, and we will not see our industry excluded. The Affordable Care Act will remain the law of the land until and unless we have a new party in the White House in 2016, so tracking employee hours will be key.
More Doc Fix Activity: The game of kick-the-can that has been the Doc Fix for the past decade will continue. However, in an effort to kick the can as far as possible, Adam Vinatieri will be the kicker, and he will kick it 21 months into the future. This will nicely coincide with the new administration taking office in January of 2017. (I don’t think Congress will want to deal with this again in 12 months.) Ideally, our friends at AHCA will be able to focus the pay-fors to other segments or maybe even help them find a permanent solution if in fact there is an appetite for one.
- See more at: http://www.onshift.com/blog/5-game-changing-predictions-senior-care-2015#sthash.36ZATwXG.dpuf
==
You may want to Visit >>
Next Generation Educators blog
They are focused entirely on the long-term care and senior living industry, software and services are built upon an in-depth understanding of how providers work day-in and day-out, and how industry regulations and issues affect their every move.
{ staff scheduling and labor management is of interest to the world of Caregiving}
Jan 26, 2015 Mark Woodka posted the following to their Long Term Care & Senior Living Blog
For some strange reason we encourage ourselves to prognosticate about the future annually as one year recedes and another begins. These projections might not always be correct, but I think they nicely balance out our attempts at New Year’s resolutions and give us something to aim for. (I hope this list goes more smoothly than those resolutions usually do…)
I’d like to outline my predictions for long-term care and senior living in 2015 – the big things that may change how you run your communities and provide care for your residents. So without further ado, here we go:
Affordable Care Act Penalties: The Employer Mandate began January 1 after two years of delays, and we must now be very, very cautious in managing our workforces to ensure we do not get penalized. There was a bill proposed to exclude certain industries from having to participate due to large populations of lower-wage hourly workers and low margins. Guess what? One of the original intents of the ACA was to get these very workers healthcare benefits. Therefore, this bill is a non-starter, and we will not see our industry excluded. The Affordable Care Act will remain the law of the land until and unless we have a new party in the White House in 2016, so tracking employee hours will be key.
More Doc Fix Activity: The game of kick-the-can that has been the Doc Fix for the past decade will continue. However, in an effort to kick the can as far as possible, Adam Vinatieri will be the kicker, and he will kick it 21 months into the future. This will nicely coincide with the new administration taking office in January of 2017. (I don’t think Congress will want to deal with this again in 12 months.) Ideally, our friends at AHCA will be able to focus the pay-fors to other segments or maybe even help them find a permanent solution if in fact there is an appetite for one.
- See more at: http://www.onshift.com/blog/5-game-changing-predictions-senior-care-2015#sthash.36ZATwXG.dpuf
==
You may want to Visit >>
Next Generation Educators blog
Dealing with a “Code Brown”
Dealing with a “Code Brown” | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles
by Ani Burr, RN • October 22, 2010
When you are doing your best to get your client cleaned up, there is still that smell issue that can get in the way of your ability to focus and get in and out of there quickly! While it’s not guaranteed, you can try these tricks to protector your olfactory senses:
by Ani Burr, RN • October 22, 2010
When you are doing your best to get your client cleaned up, there is still that smell issue that can get in the way of your ability to focus and get in and out of there quickly! While it’s not guaranteed, you can try these tricks to protector your olfactory senses:
Caregiving MetroWest a program of BayPath Elder Services, Inc
Caregiving MetroWest –is a program of BayPath Elder Services, Inc. for MetroWest caregivers.
The site offers Information on all aspects of caregiving; "Caregiving is a complex and demanding undertaking. There are many elements involved in the caregiving role, and we’ve assembled some helpful information on a variety of areas of importance to caregivers.
BayPath Elder Services, Inc
BayPath Elder Services, Inc. administers programs offering home care and related services enabling people to live independently and comfortably in their homes while promoting their well-being and dignity.
Many BayPath services are free, others are based on one's ability to pay, and some are offered on a fee-for-service basis.
“This non-profitcorporation is organized to plan, develop and implement the coordination and delivery of services and supportive programs for persons sixty years of age and over unless otherwise restricted by conditions of grants or contracts, in the City of Marlborough, and the townships of Ashland, Holliston, Hopkinton, Dover, Sherborn, Natick, Framingham, Wayland, Sudbury, Hudson, Northborough , Southboro ugh and Westboro ugh , Massachusetts. The corporation shall endeavor to assist older persons to obtain services including but not limited to information and referral, homemaker and chore assistance, housing services, health maintenance and rehabilitation, nutritional services, legal and advocacy assistance, transportation, emergency assistance, and whatever medical or supportive services may be needed to prolong the life and well - being of older persons in the community and to prevent premature institutionalization."
The site offers Information on all aspects of caregiving; "Caregiving is a complex and demanding undertaking. There are many elements involved in the caregiving role, and we’ve assembled some helpful information on a variety of areas of importance to caregivers.
BayPath Elder Services, Inc
BayPath Elder Services, Inc. administers programs offering home care and related services enabling people to live independently and comfortably in their homes while promoting their well-being and dignity.
Many BayPath services are free, others are based on one's ability to pay, and some are offered on a fee-for-service basis.
“This non-profitcorporation is organized to plan, develop and implement the coordination and delivery of services and supportive programs for persons sixty years of age and over unless otherwise restricted by conditions of grants or contracts, in the City of Marlborough, and the townships of Ashland, Holliston, Hopkinton, Dover, Sherborn, Natick, Framingham, Wayland, Sudbury, Hudson, Northborough , Southboro ugh and Westboro ugh , Massachusetts. The corporation shall endeavor to assist older persons to obtain services including but not limited to information and referral, homemaker and chore assistance, housing services, health maintenance and rehabilitation, nutritional services, legal and advocacy assistance, transportation, emergency assistance, and whatever medical or supportive services may be needed to prolong the life and well - being of older persons in the community and to prevent premature institutionalization."
Talking with a person with Alzheimer's guidelines: five basic ones
Marie Marley is the award-winning author of Come Back Early Today: A Memoir of Love, Alzheimer's and Joy. Her website contains a wealth of information for Alzheimer's caregivers.
www.ComeBackEarlyToday.com
When relating to a person with Alzheimer's there are many guidelines to follow.
five basic ones:
1) Don't tell them they are wrong about something,
2) Don't argue with them,
3) Don't ask if they remember something,
4) Don't remind them that their spouse, parent or other loved one is dead
5) Don't bring up topics that may upset them.
Dementia and Cognitive Impairment Diagnosis and Treatment Guideline
Dementia and Cognitive Impairment Diagnosis and ...
www.ghc.org/all-sites/guidelines/dementia.pdf
Dementia and Cognitive Impairment Diagnosis and Treatment Guideline. 1 ..... Guidelines are systematically developed statements to assist patients and providers in .... new and challenging mental activities, such as a language or musical instrument. .... Many different tools are available for assessing cognitive function.
Group Health Cooperative
About Group Health
Group
Health Cooperative is a member-governed, nonprofit health care system
that coordinates care and coverage. Founded in 1947 and based in
Seattle, Wash., Group Health and its subsidiary health carriers, Group
Health Options, Inc. and KPS Health Plans, serve more than 600,000
residents of Washington and North Idaho.
"Care Transitions for the Home Care Industry." Ankota software
Chronic Care Management Services:
Here's the deal... Physicians are starting to be incentivized (and penalized) for their performance with respect to their chronic patients, but there's a reimbursement associated with it. The reimbursement is for patients with two or more chronic conditions in a practice with a certified EMR (Electronic Medical Record) system. The reimbursement has two levels. The first level, reimbursed at $42/month, requires a 20 minute check-in (e.g., on the phone) with the patient. The second, reimbursed at almost $100, requires telehealth.
Home care agencies can put a program in place where your best aides are paid $10 for a 20 minute check-in call. If you charge $32 for this service (leaving a $10 margin for the referring practice) and allocate some of the revenue to your staff nurses and for software, you can provide a great service and make a reasonable margin. Care Transitions Services: You can provide services to help transition patients from hospital to home. Most hospitals are now being penalized for excessive readmissions These hospitals can use your help and there are many benefits to your agency. We have a new white paper to teach you about the numerous benefits that your home care agency can achieve.
At Ankota, we love providing home care software, telephony, care plans, scheduling, billing, payroll and all the other basics, but we really love that we can enable your agency to play a broader role in the future oh health care. We can make a difference together. Please download our newest free white paper "Why Care Transitions is the Next Big Thing for the Home Care Industry."
About Ankota Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination.
Here's the deal... Physicians are starting to be incentivized (and penalized) for their performance with respect to their chronic patients, but there's a reimbursement associated with it. The reimbursement is for patients with two or more chronic conditions in a practice with a certified EMR (Electronic Medical Record) system. The reimbursement has two levels. The first level, reimbursed at $42/month, requires a 20 minute check-in (e.g., on the phone) with the patient. The second, reimbursed at almost $100, requires telehealth.
Home care agencies can put a program in place where your best aides are paid $10 for a 20 minute check-in call. If you charge $32 for this service (leaving a $10 margin for the referring practice) and allocate some of the revenue to your staff nurses and for software, you can provide a great service and make a reasonable margin. Care Transitions Services: You can provide services to help transition patients from hospital to home. Most hospitals are now being penalized for excessive readmissions These hospitals can use your help and there are many benefits to your agency. We have a new white paper to teach you about the numerous benefits that your home care agency can achieve.
At Ankota, we love providing home care software, telephony, care plans, scheduling, billing, payroll and all the other basics, but we really love that we can enable your agency to play a broader role in the future oh health care. We can make a difference together. Please download our newest free white paper "Why Care Transitions is the Next Big Thing for the Home Care Industry."
About Ankota Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination.
Hiring Home Care Workers: Why Work through an Agency? By Rona S. Bartelstone,
Hiring Private Duty Home Care Workers: Why Work through an Agency
Quoted:
One of the greatest long-term needs of older adults and those with
chronic illnesses is for in-home, custodial care services. These
workers are often referred to as home health aides, certified nursing
assistants and custodial care workers. These in-home workers make it
possible for people with functional limitations to remain at home in a
comfortable, familiar environment. Home health aides (as we will refer
to this class of workers) provide a wide range of assistance with
activities of daily living (ADLs), such as bathing, dressing, grooming,
assisting with ambulation or transferring, toileting, feeding and
providing medication reminders. In addition, home health aides help
with what professionals call, instrumental activities of daily living
(IADLs), such as shopping, meal preparation, making medical
appointments, transportation, laundry and companionship.
While it is true that most people would prefer to remain in their
own homes, there are circumstances in which care in a residential or
nursing facility is more appropriate and more cost-effective. For
example, the individual who needs round the clock care because of
treatments or behavioral issues will find a nursing facility or
residential setting likely to be more affordable.
The biggest proportion of people who utilize home health aide services are those
who need several hours per day of assistance, as opposed to those who need full-time care.
Due to the cost and the increasing shortage of home health
aides, many families seeking to hire in-home staff turn to private
individuals rather than working through an agency. While at first
glance this seems reasonable, it can also cause numerous problems and create unexpected liabilities for the family, who becomes the employer.
Quoted:
One of the greatest long-term needs of older adults and those with
chronic illnesses is for in-home, custodial care services. These
workers are often referred to as home health aides, certified nursing
assistants and custodial care workers. These in-home workers make it
possible for people with functional limitations to remain at home in a
comfortable, familiar environment. Home health aides (as we will refer
to this class of workers) provide a wide range of assistance with
activities of daily living (ADLs), such as bathing, dressing, grooming,
assisting with ambulation or transferring, toileting, feeding and
providing medication reminders. In addition, home health aides help
with what professionals call, instrumental activities of daily living
(IADLs), such as shopping, meal preparation, making medical
appointments, transportation, laundry and companionship.
While it is true that most people would prefer to remain in their
own homes, there are circumstances in which care in a residential or
nursing facility is more appropriate and more cost-effective. For
example, the individual who needs round the clock care because of
treatments or behavioral issues will find a nursing facility or
residential setting likely to be more affordable.
The biggest proportion of people who utilize home health aide services are those
who need several hours per day of assistance, as opposed to those who need full-time care.
Due to the cost and the increasing shortage of home health
aides, many families seeking to hire in-home staff turn to private
individuals rather than working through an agency. While at first
glance this seems reasonable, it can also cause numerous problems and create unexpected liabilities for the family, who becomes the employer.
Great Big List of Caregiver Blogs | Caregiver's Corner July 14, 2010
Great Big List of Caregiver Blogs
One of the best ways for a caregiver to find answers, reassurance,
and understanding is to connect with other caregivers. To help with
that, here is a list of blogs run by caregivers. If you know of any
blogs that should be added to this list, let us know!
One of the best ways for a caregiver to find answers, reassurance,
and understanding is to connect with other caregivers. To help with
that, here is a list of blogs run by caregivers. If you know of any
blogs that should be added to this list, let us know!
Top 10 Codes You Aren’t Meant To Know - Listverse
Top 10 Codes You Aren’t Meant To Know - Listverse
Stores, hospitals, entertainment venues, and other places where the public are together in large numbers, use secret codes to pass information between store employees. These are meant to be a secret as they don’t want to alarm the non-staff members or alert someone (like a thief) to the fact that they have been noticed. Many stores have their own codes – for example WalMart, but there are a number that are nearly universal in application. This is a list of ten secret codes that may prove useful to you in future, or at least dispel any curiosity you may have if you hear them.
Stores, hospitals, entertainment venues, and other places where the public are together in large numbers, use secret codes to pass information between store employees. These are meant to be a secret as they don’t want to alarm the non-staff members or alert someone (like a thief) to the fact that they have been noticed. Many stores have their own codes – for example WalMart, but there are a number that are nearly universal in application. This is a list of ten secret codes that may prove useful to you in future, or at least dispel any curiosity you may have if you hear them.
Strategies to Protect Your Money from Medicaid - AgingCare.com
AgingCare.com is not simply a website, but a community of caregivers facing the challenge of caring for an elderly loved one.
They provide a comfortable meeting place for the free exchange of ideas with knowledgeable professionals, responsive experts, and people just like you. They provide an excellent knowledge network, use it.
The following is extracted from AgingCare.com
{quote}
Too few older adults know and understand their rights and options regarding health care, particularly long-term care, which, to quote the New York Court of Appeals, is "ruinously expensive."
A Caregiver Agreement is an excellent strategy in many cases where extra services are needed or desired that would not be covered by Medicaid, and are outside the scope of what a nursing facility or home care attendants would provide.
The caregiver can be a son, a daughter or other family member, a friend, a geriatric care manager or a home care agency. The services can be paid for in advance, and the payment will then reduce countable resources, helping the person in need of care gain Medicaid eligibility. A family member can render these services, providing income for that person (who may have given up a job or taken time off from work), and reducing conflict with other family members who are unable or unwilling to help out.
If the caregiver is to be paid in advance, the keys to creating an agreement that will be accepted by Medicaid are:
The contract must specifically define the services provided and hours to be worked by the caregiver.
The lump sum payment must be calculated using a reasonable life expectancy and legitimate market rates for the services.
A daily log of actual services rendered and hours worked must be maintained, along with written invoices.
Upon the death of the patient, any unearned amounts must be paid to Medicaid, up to the amount that Medicaid paid on behalf of the patient.
Spousal Transfers and Spousal Refusal
An important feature of the Medicaid laws is that transfers between spouses are permitted, are not subject to the "look back," and thus do not result in any penalty. In the case of a married couple, one of the basic strategies is to transfer any assets that are in the name of the spouse who needs care to the name of the well spouse (also called the "community spouse" where the spouse who needs care is in a nursing home).
New York and some other states permit something called "spousal refusal." In these scenarios, the well (or community) spouse will refuse to provide support for the spouse who needs care.As a result, the spouse who needs care will be immediately eligible for Medicaid, and will receive services.
Once Medicaid provides services, it has the right to seek contribution from the well spouse. In some cases, however, Medicaid does not pursue its rights, and in other cases it is willing to settle at a discount. At a minimum, the well spouse will receive a significant benefit because any reimbursement to Medicaid will be at Medicaid's discounted rates, rather than at the private pay rates that the providers would have charged.
Unfortunately, the majority of states are "spousal share" states that do not permit spousal refusal. In these states, the resources of both spouses are counted towards the Medicaid eligibility amount, and the above strategy is therefore ineffective.
Elder Law attorneys are able to work within the Medicaid laws to produce favorable outcomes for their clients. Bear in mind that every case has its unique facts, and these strategies might or might not be the top five for you, given your circumstances. In any case, it's hardly ever too late to develop an effective strategy to obtain benefits, and protect at least some of your assets or income at the same time.
David Cutner is a former family caregiver and co-founder of Lamson & Cutner, a boutique elder law firm in Manhattan, known for its successful strategic planning and insights into the issues of today's elder law maze.
{End of Quoting}
I have no connection with David Cutner the following contact information is my thanks to him.
They provide a comfortable meeting place for the free exchange of ideas with knowledgeable professionals, responsive experts, and people just like you. They provide an excellent knowledge network, use it.
The following is extracted from AgingCare.com
{quote}
Too few older adults know and understand their rights and options regarding health care, particularly long-term care, which, to quote the New York Court of Appeals, is "ruinously expensive."
A Caregiver Agreement is an excellent strategy in many cases where extra services are needed or desired that would not be covered by Medicaid, and are outside the scope of what a nursing facility or home care attendants would provide.
The caregiver can be a son, a daughter or other family member, a friend, a geriatric care manager or a home care agency. The services can be paid for in advance, and the payment will then reduce countable resources, helping the person in need of care gain Medicaid eligibility. A family member can render these services, providing income for that person (who may have given up a job or taken time off from work), and reducing conflict with other family members who are unable or unwilling to help out.
If the caregiver is to be paid in advance, the keys to creating an agreement that will be accepted by Medicaid are:
The contract must specifically define the services provided and hours to be worked by the caregiver.
The lump sum payment must be calculated using a reasonable life expectancy and legitimate market rates for the services.
A daily log of actual services rendered and hours worked must be maintained, along with written invoices.
Upon the death of the patient, any unearned amounts must be paid to Medicaid, up to the amount that Medicaid paid on behalf of the patient.
Spousal Transfers and Spousal Refusal
An important feature of the Medicaid laws is that transfers between spouses are permitted, are not subject to the "look back," and thus do not result in any penalty. In the case of a married couple, one of the basic strategies is to transfer any assets that are in the name of the spouse who needs care to the name of the well spouse (also called the "community spouse" where the spouse who needs care is in a nursing home).
New York and some other states permit something called "spousal refusal." In these scenarios, the well (or community) spouse will refuse to provide support for the spouse who needs care.As a result, the spouse who needs care will be immediately eligible for Medicaid, and will receive services.
Once Medicaid provides services, it has the right to seek contribution from the well spouse. In some cases, however, Medicaid does not pursue its rights, and in other cases it is willing to settle at a discount. At a minimum, the well spouse will receive a significant benefit because any reimbursement to Medicaid will be at Medicaid's discounted rates, rather than at the private pay rates that the providers would have charged.
Unfortunately, the majority of states are "spousal share" states that do not permit spousal refusal. In these states, the resources of both spouses are counted towards the Medicaid eligibility amount, and the above strategy is therefore ineffective.
Elder Law attorneys are able to work within the Medicaid laws to produce favorable outcomes for their clients. Bear in mind that every case has its unique facts, and these strategies might or might not be the top five for you, given your circumstances. In any case, it's hardly ever too late to develop an effective strategy to obtain benefits, and protect at least some of your assets or income at the same time.
David Cutner is a former family caregiver and co-founder of Lamson & Cutner, a boutique elder law firm in Manhattan, known for its successful strategic planning and insights into the issues of today's elder law maze.
{End of Quoting}
I have no connection with David Cutner the following contact information is my thanks to him.
Lamson & Cutner, P.C. | ||||||||||||||||||||
9 East 40th Street | ||||||||||||||||||||
New York, New York 10016 | ||||||||||||||||||||
|
800AgeInfo - Information on Programs - Caregiver Support Page
800AgeInfo - Information on Programs - Caregiver Support Page
Caregiver Support
administered through a partnership with local Area Agencies on Aging
(AAAs) and Aging Service Access Points (ASAPs). MFCSP provides family
caregivers guidance, support, and attention that often is unavailable or
overlooked. Caregivers receive individual attention to:
even isolating; yet it can be meaningful and rewarding as well. It is
critical that caregivers are aware of available services. Through the
MFCSP compassionate and knowledgeable professionals work directly with
caregivers offering a range of services that may include:
Caregiver Support
(caring for an individual)
The Massachusetts Family Caregiver Support Program (MFCSP) isadministered through a partnership with local Area Agencies on Aging
(AAAs) and Aging Service Access Points (ASAPs). MFCSP provides family
caregivers guidance, support, and attention that often is unavailable or
overlooked. Caregivers receive individual attention to:
- discuss their caregiving situation
- increase knowledge of and access to resources
- make informed decisions and solve problems related to their caregiver role
- increase their own personal well-being including reduced stress
Family caregivers are individuals who:
- Care for a spouse, parent, other relative or friend who is age 60 or older, or who has Alzheimer’s disease.
- Are grandparents age 55 or older who are caring for grandchildren who are 18 years of age or younger, or who are disabled.
- Are over the age of 55 and caring for a disabled individual who is not their child.
even isolating; yet it can be meaningful and rewarding as well. It is
critical that caregivers are aware of available services. Through the
MFCSP compassionate and knowledgeable professionals work directly with
caregivers offering a range of services that may include:
- One-on-one Counseling
- Family Meeting
- In-home Assessment
- In-home Services
- Respite (a break for caregivers)
- Nutrition Services
- Transportation Services
- Caregiver Training
- Support Groups
- Supplemental Services (such as assistive devices, emergency response system)
- Financial Counseling
- Legal Referral
Comfort Care DNR protocol
When a patient is in a non-hospital setting, Emergency Medical
Technicians (EMTs) are required to provide emergency medical care and to
transport patients to appropriate health care facilities. Emergency
Medical Services (EMS) personnel are required by law to provide
treatment to the fullest extent possible, subject to their level of
training.
Comfort Care DNR Order Verification Protocol (Comfort and Care DNR)
- The Comfort Care DNR is designed to allow EMTs and first responders to honor a DNR order in an out-of-hospital setting.
- Before 1999, when Massachusetts implemented its Comfort Care DNR protocol, there was no mechanism to enable EMT’s and other first responders to recognize DNR orders in a non-hospital setting. So EMT personnel were always obligated to perform full resuscitation measures when they encountered a patient unable to convey directions regarding medical treatment.
- The Comfort Care DNR protocol provides for a statewide, uniform DNR verification protocol.
- The purpose of the Comfort Care DNR is to: (a) provide a verification of DNR orders to enable EMTs and first responders to honor DNR orders, (b) clarify the role and responsibilities of EMTs and first responders at the scene and/or during transport of patients who have a valid current DNR order, (c) avoid resuscitation of patients who have a current and valid DNR, (d) provide for palliative/comfort care measures for patients with a current Comfort Care DNR order verification form.
- Comfort Care DNR order verification forms must be completed and signed by the patient’s physician, authorized Physician’s Assistant or Nurse Practitioner.
- The patient must post the Comfort Care DNR where any EMT or first responder can easily find it. (Usually the patient’s refrigerator, or taped to the patients bedroom door. The Department of Public Health stopped issuing Comfort Care DNR bracelets in 2007, but the Department’s approved form contains bracelet inserts that can be used in generic wrist bracelets.
- The Comfort Care DNR Order Verification form can be accessed by anyone, in downloadable format from the Massachusetts Department of Public Health/Office of Emergency Medical Services website, at: http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/oems/comfort-care/public-health-oems-comfort-care-verification.html. But the form must be fully completed and signed by the attending physician, authorized nurse practitioner or authorized physician assistant as proscribed by the regulations.
Comfort Care Order (CCO-DNR) program Plus MOLST
EMS Comfort Care Order Do Not Resuscitate Program | doh
The
Emergency Medical Services (EMS) Comfort Care Order-Do Not Resuscitate
(CCO-DNR) program allows patients diagnosed with a specific medical or
terminal condition to express their wishes regarding end of life
resuscitation in the pre or post-hospital setting.
The program requires that a patient’s attending physician certify and sign a Comfort Care Order
(CCO) that states the patient (adult or child) has a specific medical
or terminal condition. The patient, or his or her authorized decision
maker or surrogate, must also consent and sign the CCO (verbal orders
are not valid). The physician then places a Comfort Care bracelet on the
patien
Emergency Medical Services (EMS) Comfort Care Order-Do Not Resuscitate
(CCO-DNR) program allows patients diagnosed with a specific medical or
terminal condition to express their wishes regarding end of life
resuscitation in the pre or post-hospital setting.
The program requires that a patient’s attending physician certify and sign a Comfort Care Order
(CCO) that states the patient (adult or child) has a specific medical
or terminal condition. The patient, or his or her authorized decision
maker or surrogate, must also consent and sign the CCO (verbal orders
are not valid). The physician then places a Comfort Care bracelet on the
patien
Resources | Novant Health | Choices and Champions
Resources | Novant Health | Choices and Champions
Novant Health is a integrated system of physician practices, hospitals, outpatient centers, and more – each element committed to delivering a remarkable healthcare experience for you and your family.
Novant Health is a integrated system of physician practices, hospitals, outpatient centers, and more – each element committed to delivering a remarkable healthcare experience for you and your family.
- Aging with Dignity
- American Bar Association Consumer’s Toolkit for Healthcare Advance Planning
- American Bar Association: Myths and Facts about Health Care Advance Directives
- American Bar Association smartphone app for advance directives
- BeginTheConversation.org
- Caring Connections
- The Conversation Project
- Donate Life America
- Engage with Grace
- Get Palliative Care
- A Gift to Your Family
- The Go Wish game
- It's OK to Die When You Are Prepared
- MedlinePlus
- Moments of Life
- N.C. Partnership for Compassionate Care
- OrganDonor.gov
- South Carolina Advance Care Planning: Isn’t It Time We Talked?
Code Comfort: A Code Blue Alternative for Patients with DNRs - HBR
Code Comfort: A Code Blue Alternative for Patients with DNRs - HBR
Code Comfort provides a response for patients whose code status is
DNR and who desire comfort measures only. It is a compassionate way to
manage pain and suffering — including emotional suffering — during an
acute crisis without providing unwanted care. Hospital staff responding
to a Code Comfort may include palliative care physicians, nurses,
respiratory therapists, chaplains and others who are prepared to rapidly
address the patient’s physical symptoms, as well as the suffering and
concerns of family members.
As is true for CPR efforts, we know teamwork matters to relieve the
suffering of dying patients. Code Comfort protocols include an
algorithm-driven method for assessing and addressing symptoms such as
pain, agitation and dyspnea. For example, a patient suffering from
severe, acute dyspnea would be given morphine and increased oxygen, her
head would be elevated, a fan might be used to provide a comforting
breeze, and she’d receive other measures to reduce anxiety. Importantly,
Code Comfort ensures that no patient or family suffers alone. Nurses
are present during the code, actively treating the patient’s symptoms
and calling in other team members as needed, all of which provides
essential emotional support and reassurance
Code Comfort: A Code Blue Alternative for Patients with DNRs
Melissa P. Phipps, John D. Phipps; December 9, 2014
Code Comfort provides a response for patients whose code status is
DNR and who desire comfort measures only. It is a compassionate way to
manage pain and suffering — including emotional suffering — during an
acute crisis without providing unwanted care. Hospital staff responding
to a Code Comfort may include palliative care physicians, nurses,
respiratory therapists, chaplains and others who are prepared to rapidly
address the patient’s physical symptoms, as well as the suffering and
concerns of family members.
As is true for CPR efforts, we know teamwork matters to relieve the
suffering of dying patients. Code Comfort protocols include an
algorithm-driven method for assessing and addressing symptoms such as
pain, agitation and dyspnea. For example, a patient suffering from
severe, acute dyspnea would be given morphine and increased oxygen, her
head would be elevated, a fan might be used to provide a comforting
breeze, and she’d receive other measures to reduce anxiety. Importantly,
Code Comfort ensures that no patient or family suffers alone. Nurses
are present during the code, actively treating the patient’s symptoms
and calling in other team members as needed, all of which provides
essential emotional support and reassurance
Code Comfort: A Code Blue Alternative for Patients with DNRs
Melissa P. Phipps, John D. Phipps; December 9, 2014
In the hospital? Are you a hospital inpatient or outpatient?
In the hospital? Are you a hospital inpatient or outpatient? May 21, 2014 by Wendy Shane
When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.
- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf
When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.
- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf
When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.
- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf
When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.
- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf
May 21, 2014 by Wendy Shane
May 21, 2014 by Wendy Shane
Why does this matter to patients?
When hospital patients are classified as outpatients on Observation Status, they may be charged for services that Medicare would have paid if they were properly admitted as inpatients (for example, medications, so you may want to bring medications with you). Most significantly, patients will not be able to obtain any Medicare coverage if they need nursing home care after their hospital stay. Medicare only covers nursing home care for patients who have a minimum 3-day inpatient hospital stay. Observation Status doesn’t count towards the 3-day stay.Why does this matter to patients?
When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.
- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf
Why does this matter to patients?
When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.
- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf
Why does this matter to patients?
When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.
- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf
Why does this matter to patients?
When hospital patients are classified as outpatients on Observation
Status, they may be charged for services that Medicare would have paid
if they were properly admitted as inpatients (for example, medications,
so you may want to bring medications with you). Most significantly,
patients will not be able to obtain any Medicare coverage if they need
nursing home care after their hospital stay. Medicare only covers
nursing home care for patients who have a minimum 3-day inpatient
hospital stay. Observation Status doesn’t count towards the 3-day stay.
- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf
Why are caregiver spouses so relectant to hire help? | LinkedIn
Brett Frankenberg 2nd Founder at The Institute for Quality in Senior
Living, Greater San Diego Area participated in an interesting discussion on
Home Care and Healthcare Advocacy concerning "Why are caregiver spouses so
reluctant to hire help?
" I am paraphrasing from his discussion:”
One cannot stress enough the need for caregiver education. The problem
is many family members think they learn by watching caregivers in the
hospital.
Brett: Have you ever worked an overnight shift in a hospital with a
Senior who has dementia?
Brett If you have, I doubt you would assert that observing highly
trained professionals who care for patients in the hospital would
suffice as sufficient training.
Brett has managed home health and clinically based staff for years and
the amount of times needed to train caregivers on the most simple
activities - transfers, bathing, safety risks -blood glucose testing,
sliding scale insulin, specific diet instructions such as chopped or
puree and you get an overwhelmed caregiver pretty darn quickly.
Brett believes the biggest mistake is assuming that a caregiver is
absorbing the necessary information simply by observing the clinical
activities that take place when the patient is an inpatient. Further,
we have no idea what the baseline of the caregiver is most of the
time.
Brett: Do they have some aspect of dementia themselves to the point
they can't learn?
Do they have physical limitations that would prevent them from
performing all the activities that daily caregiving demands?
Living, Greater San Diego Area participated in an interesting discussion on
Home Care and Healthcare Advocacy concerning "Why are caregiver spouses so
reluctant to hire help?
" I am paraphrasing from his discussion:”
One cannot stress enough the need for caregiver education. The problem
is many family members think they learn by watching caregivers in the
hospital.
Brett: Have you ever worked an overnight shift in a hospital with a
Senior who has dementia?
Brett If you have, I doubt you would assert that observing highly
trained professionals who care for patients in the hospital would
suffice as sufficient training.
Brett has managed home health and clinically based staff for years and
the amount of times needed to train caregivers on the most simple
activities - transfers, bathing, safety risks -blood glucose testing,
sliding scale insulin, specific diet instructions such as chopped or
puree and you get an overwhelmed caregiver pretty darn quickly.
Brett believes the biggest mistake is assuming that a caregiver is
absorbing the necessary information simply by observing the clinical
activities that take place when the patient is an inpatient. Further,
we have no idea what the baseline of the caregiver is most of the
time.
Brett: Do they have some aspect of dementia themselves to the point
they can't learn?
Do they have physical limitations that would prevent them from
performing all the activities that daily caregiving demands?
Brett
Exploring the Potential of Digital Technology to link AHPs and People in Remote, Rural Hubs
Let's Talk about Dementia | Never in the history of mankind did not talking about something scary make it disappear.
Living it Up Creatively by talkingdementia
and health problems, carers and Allied Health Professionals (AHP’s) have
been actively learning about the benefits of digital inclusion. In
August, we established a steering group to drive forward a Living it Up Creatively
digital project that links Helmsdale, a remote rural community in East
Sutherland, to New Craigs, the main Mental Health Hospital supporting
the Highlands from Inverness.
How will we use digital technology to connect professionals and people in the future?
For further information contact Sarah Muir (AHP Lead NHS Highlands) at sarah.muir2@nhs.net or Ann Pascoe (Dementia Friendly Communities, East Sutherland) on ann@dementia-friendly.com .
And follow us on twitter: @sarahahpmh and @a_carers_voice.
Living it Up Creatively by talkingdementia
Exploring the Potential of Digital Technology to link AHPs and People in Remote, Rural Hubs
Background
Since June 2014, a group made up of people living with disabilitiesand health problems, carers and Allied Health Professionals (AHP’s) have
been actively learning about the benefits of digital inclusion. In
August, we established a steering group to drive forward a Living it Up Creatively
digital project that links Helmsdale, a remote rural community in East
Sutherland, to New Craigs, the main Mental Health Hospital supporting
the Highlands from Inverness.
How will we use digital technology to connect professionals and people in the future?
For further information contact Sarah Muir (AHP Lead NHS Highlands) at sarah.muir2@nhs.net or Ann Pascoe (Dementia Friendly Communities, East Sutherland) on ann@dementia-friendly.com .
And follow us on twitter: @sarahahpmh and @a_carers_voice.
Addressing Unmet Palliative and Geriatric Needs of Zombies | GeriPal - Geriatrics and Palliative Care Blog
Addressing Unmet Palliative and Geriatric Needs of Zombies | GeriPal - Geriatrics and Palliative Care Blog
{Q{ Considerable evidence indicates that zombies do not receive optimal palliative or geriatric care.
Advance Care Planning
The subject of advance care planning pertains to end-of-life decisions, which may seem unimportant for zombies as they are past the end of life. However, understanding the values and preferences of zombies around “dead-decisions” is just as important as asking the living about end-of-life decisions. Given the high rates of traumatic injuries, having stated values of what is most important to zombies in their deaths, what brings them enjoyment while being dead, and what are the biggest worries and concerns would appear to be just as important to the undead as to the living.
by: Eric Widera (@ewidera) {EQ}
{Q{ Considerable evidence indicates that zombies do not receive optimal palliative or geriatric care.
Advance Care Planning
The subject of advance care planning pertains to end-of-life decisions, which may seem unimportant for zombies as they are past the end of life. However, understanding the values and preferences of zombies around “dead-decisions” is just as important as asking the living about end-of-life decisions. Given the high rates of traumatic injuries, having stated values of what is most important to zombies in their deaths, what brings them enjoyment while being dead, and what are the biggest worries and concerns would appear to be just as important to the undead as to the living.
by: Eric Widera (@ewidera) {EQ}
Quality of U.S. hospices varies, patients left in dark - The Washington Post
Quality of U.S. hospices varies, patients left in dark - The Washington Post
{Q}A boom in the industry allows patients to choose from an array of
hospice outfits, some of them excellent. More than a thousand new
hospices have opened in the United States in the past decade. But the
absence of public information about their quality, a void that is
unusual even within the health-care industry, leaves consumers at a loss
to distinguish the good from the bad.
Though the federal government publishes consumer data about the quality of other
health-care companies, including hospitals, nursing homes and home
health agencies, it provides no such information about hospices.
The reasons that some hospices stint on care may be at least partly
financial. Medicare, the chief source of industry revenue, pays hospice
companies per day of care — about $155 for a “routine” day — regardless
of how much care is actually provided. That means that the less a
hospice spends on nursing and other services, the more it can profit.
{EQ}
http://www.washingtonpost.com/wp-srv/special/business/hospice-quality This database shows, among other things, whether the hospice has provided more intense levels of care for patients suffering a crisis; how much it spends on nursing visits per patient; and whether it has won approval from one of three outside accrediting agencies, the Joint Commission, the Accreditation Commission for Health Care and Community Health Accreditation Program, or CHAP
{Q}A boom in the industry allows patients to choose from an array of
hospice outfits, some of them excellent. More than a thousand new
hospices have opened in the United States in the past decade. But the
absence of public information about their quality, a void that is
unusual even within the health-care industry, leaves consumers at a loss
to distinguish the good from the bad.
Though the federal government publishes consumer data about the quality of other
health-care companies, including hospitals, nursing homes and home
health agencies, it provides no such information about hospices.
The reasons that some hospices stint on care may be at least partly
financial. Medicare, the chief source of industry revenue, pays hospice
companies per day of care — about $155 for a “routine” day — regardless
of how much care is actually provided. That means that the less a
hospice spends on nursing and other services, the more it can profit.
{EQ}
http://www.washingtonpost.com/wp-srv/special/business/hospice-quality This database shows, among other things, whether the hospice has provided more intense levels of care for patients suffering a crisis; how much it spends on nursing visits per patient; and whether it has won approval from one of three outside accrediting agencies, the Joint Commission, the Accreditation Commission for Health Care and Community Health Accreditation Program, or CHAP
A Guide to Durable Medical Equipment And Medical Supplies - AgingCare.com
A Guide to Durable Medical Equipment And Medical Supplies - AgingCare.com
{Q}First, the basic needs of elderly or ill people must be addressed before they or their family members can think about more abstract or long-term issues.
Second, it is very difficult to obtain information about meeting these basic needs, especially when it comes to finding the right products or supplies. The policies and practices of third-party payers - whether private insurance, Medicare or Medicaid - are often confusing and inconsistent.
Nevertheless, with a little persistence and some basic information, you can become a more knowledgeable and satisfied consumer. The reward will be an improved quality of life for both the elderly person and the caregiver. {EQ}
Read the article from end to end.Good information for caregivers, seniors, and families.
{Q}First, the basic needs of elderly or ill people must be addressed before they or their family members can think about more abstract or long-term issues.
Second, it is very difficult to obtain information about meeting these basic needs, especially when it comes to finding the right products or supplies. The policies and practices of third-party payers - whether private insurance, Medicare or Medicaid - are often confusing and inconsistent.
Nevertheless, with a little persistence and some basic information, you can become a more knowledgeable and satisfied consumer. The reward will be an improved quality of life for both the elderly person and the caregiver. {EQ}
Read the article from end to end.Good information for caregivers, seniors, and families.
Questions to Ask About Durable Medical Equipment and Medical Supplies - AgingCare.com
Questions to Ask About Durable Medical Equipment and Medical Supplies - AgingCare.com
An article full of very helpful advice and information. A long article and you need to read from end to end to get full benefit
Developed by, and made available with the permission of John J.
Connolly, Ed.D., President and CEO of Castle Connolly Medical Ltd.,
America's "trusted" source for information on top doctors and quality
healthcare.
An article full of very helpful advice and information. A long article and you need to read from end to end to get full benefit
Questions to Ask About Medical Equipment and Supplies
Sample for disucssion:
- Are the senior's needs and comfort periodically assessed?
- Handling a dispute with the insurer or vendor:
- Has the caregiver made frequent and careful inquiries?
- Has all communication (in person, phone, mail, email) been well documented?
- If the insurer disputes the need for particular equipment or
supplies or rejects a claim for a more costly but medically justified
item, will an appeal be necessary? - Does the caregiver know how to file an appeal?
Developed by, and made available with the permission of John J.
Connolly, Ed.D., President and CEO of Castle Connolly Medical Ltd.,
America's "trusted" source for information on top doctors and quality
healthcare.
6 Questions To Ask Before Hiring An In-Home Caregiver
What is the cost, and how will the bills be paid? “Be
certain to understand the whole payment package,” McVicker advises. For
example, does the agency tack on extra charges for billing, taxes and
worker’s compensation or include them in a single fee for services? Some
agencies will send you a bill that includes the hourly rate for
services plus additional itemized charges for taxes and administrative
costs. Other agencies will simply charge you an hourly amount that
encompasses all costs.
Code of Federal Regulations Resident rights (§483.10) Admission, transfer, and discharge rights (§483.12) Resident behavior and facility practices (§483.13) Quality of life (§483.15) Quality of care (§483.25)
Quoted from:http://tinyurl.com/pmmrher December 14, 2013
Long Term Care Facilities: Are You Being Treated Right?
By CzepigaDalyPope LLC
The Code of Federal Regulations (herein either “the Code” or “CFR”) is a codification of rules published in the Federal Register by the departments and agencies of the Federal Government. Title 42 of the Code, Part 483, addresses public health requirements for long term care facilities.
Part 483 specifically addresses, among many other issues, the following:
Resident rights (§483.10) Admission, transfer, and discharge rights (§483.12) Resident behavior and facility practices (§483.13) Quality of life (§483.15) Quality of care (§483.25)
Most of the fundamental questions you have will be addressed, at least in part, in the sections cited above. Section 483.10, as one example, addresses resident rights and specifically provides for what a facility must do regarding issues that range from providing, for inspection, a resident with his or her medical records within twenty four hours of request, to prominently displaying information about how to apply for and use Medicare and Medicaid benefits.
Section 483.12, as one other example, lists the six permissible reasons to discharge a resident from a long term care facility. It is important to note, there are no other reasons for discharge beyond these six, any other purported reason for discharge that is not listed in §483.12 (a)(2) is a violation of Federal law.
6 Reasons for Discharge
The transfer or discharge is necessary for the resident’s welfare and the resident’s needs cannot be met in the facility
the transfer or discharge is appropriate because the resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility
The safety of individuals in the facility is endangered
The health of individuals in the facility would otherwise be endangered
The resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the facility.
The facility ceases to operate
For those who live in long term care facilities, it is your home and you are entitled to certain rights within it. For those of you who visit a loved one in a long term care facility, if you begin to question whether your loved one is being treated appropriately, simply go online, type into Google “42 CFR 483,” and start getting your questions answered.
A trial attorney who handles these types of matters, can give you lots of help,
however,
you would be surprised how effective Federal law is when properly cited during discussions with facility administrators and staff.
Posted in: Elder Law and Nursing Home Litigation
The Code of Federal Regulations (herein either “the Code” or “CFR”) is a codification of rules published in the Federal Register by the departments and agencies of the Federal Government. Title 42 of the Code, Part 483, addresses public health requirements for long term care facilities.
Part 483 specifically addresses, among many other issues, the following:
Resident rights (§483.10) Admission, transfer, and discharge rights (§483.12) Resident behavior and facility practices (§483.13) Quality of life (§483.15) Quality of care (§483.25)
Most of the fundamental questions you have will be addressed, at least in part, in the sections cited above. Section 483.10, as one example, addresses resident rights and specifically provides for what a facility must do regarding issues that range from providing, for inspection, a resident with his or her medical records within twenty four hours of request, to prominently displaying information about how to apply for and use Medicare and Medicaid benefits.
Section 483.12, as one other example, lists the six permissible reasons to discharge a resident from a long term care facility. It is important to note, there are no other reasons for discharge beyond these six, any other purported reason for discharge that is not listed in §483.12 (a)(2) is a violation of Federal law.
6 Reasons for Discharge
The transfer or discharge is necessary for the resident’s welfare and the resident’s needs cannot be met in the facility
the transfer or discharge is appropriate because the resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility
The safety of individuals in the facility is endangered
The health of individuals in the facility would otherwise be endangered
The resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the facility.
The facility ceases to operate
For those who live in long term care facilities, it is your home and you are entitled to certain rights within it. For those of you who visit a loved one in a long term care facility, if you begin to question whether your loved one is being treated appropriately, simply go online, type into Google “42 CFR 483,” and start getting your questions answered.
A trial attorney who handles these types of matters, can give you lots of help,
however,
you would be surprised how effective Federal law is when properly cited during discussions with facility administrators and staff.
Posted in: Elder Law and Nursing Home Litigation
Create A Better Day Café Marlborough , MA USA
Create A Better Day Café Are you caring for someone with Alzheimer’s
or other dementia? Create
A Better Day Café encourages socialization with other caregivers and loved ones where you can just be yourself. This is a wonderful opportunity to get out with your loved one and have an enjoyable afternoon.
It’s a time to step out of the daily routine, leave the disease at the door, and enjoy a positive experience in a supportive environment. The afternoon will consist of conversation, music, arts, games, refreshments, and most importantly, laughter.
There is no cost.
It is open to anyone at any stage of the disease process accompanied by friends, family, and loved ones. The café is held the 4th Sunday of each month Please attend our next Café on Sunday, October 26th 1:00pm to 3:00pm at Pleasantries Adult Day and Consulting Services 195 Reservoir Street, Marlborough
Please contact Tammy for more information at 508-481-0809 Due to the possibility of cancellation please call prior to attending and listen to voice message
A Better Day Café encourages socialization with other caregivers and loved ones where you can just be yourself. This is a wonderful opportunity to get out with your loved one and have an enjoyable afternoon.
It’s a time to step out of the daily routine, leave the disease at the door, and enjoy a positive experience in a supportive environment. The afternoon will consist of conversation, music, arts, games, refreshments, and most importantly, laughter.
There is no cost.
It is open to anyone at any stage of the disease process accompanied by friends, family, and loved ones. The café is held the 4th Sunday of each month Please attend our next Café on Sunday, October 26th 1:00pm to 3:00pm at Pleasantries Adult Day and Consulting Services 195 Reservoir Street, Marlborough
Please contact Tammy for more information at 508-481-0809 Due to the possibility of cancellation please call prior to attending and listen to voice message
Hospice and Nursing Homes Blog: Death Rattle, Families, Signs of Dying (Research, ...
Hospice and Nursing Homes Blog: Death Rattle, Families, Signs of Dying (Research, ...:
{quote}A crackling, gurgling sound emanating from a dying person’s throat can distress onlookers who have not been prepared for this occurre...
Caregivers and loved ones should be educated regarding the death rattle experience and reassured about the unlikelihood of patients’ pain.
Supporting this need for more education is additional death rattle family research focused on bereaved family members who had witnessed the anxiety of watching a death rattle experience. This study involved 663 questionnaire surveys conducted in 95 palliative care units, Among family members who participated, 46% of respondents had witnessed the death rattle. Of these participants, 66% reported high distress levels, and 53% perceived a strong need for improved death rattle care.
This research concluded that family distress could be reduced by having medical staff lessen patients' symptoms with comprehensive and supportive care strategies. These strategies would include decreasing secretions and uncomfortable smells along with alleviating torment of family members through education.
{end quote}
{quote}A crackling, gurgling sound emanating from a dying person’s throat can distress onlookers who have not been prepared for this occurre...
Caregivers and loved ones should be educated regarding the death rattle experience and reassured about the unlikelihood of patients’ pain.
Supporting this need for more education is additional death rattle family research focused on bereaved family members who had witnessed the anxiety of watching a death rattle experience. This study involved 663 questionnaire surveys conducted in 95 palliative care units, Among family members who participated, 46% of respondents had witnessed the death rattle. Of these participants, 66% reported high distress levels, and 53% perceived a strong need for improved death rattle care.
This research concluded that family distress could be reduced by having medical staff lessen patients' symptoms with comprehensive and supportive care strategies. These strategies would include decreasing secretions and uncomfortable smells along with alleviating torment of family members through education.
{end quote}
Some Basic basics for caregivers | Compiled from aggregated information on the Net
Learning about and
accepting Confabulating and Confabulations is
essential and not easy to
accept.
In psychology,
confabulation (verb: confabulate) is a memory
disturbance, defined as
the production of fabricated, distorted or
misinterpreted memories
about oneself or the world, without the
conscious intention to
deceive.
Key factors in
confabulations are there is no intent to deceive,
second the person being
unaware that the information is blatantly
false. Confabulating is
distinct from lying because there is no intent
to deceive, and the person
being unaware that the information is
blatantly false. Carers
challenge: is what they say true?
Confabulations become a
far greater concern in the later stages,
because confabulations are
much more likely to be acted upon.
It is difficult for
everyone to accept a mind is damaged by
Alzheimer's Disease. Not
only is memory damaged their ability to
process thoughts and
conversations is impaired.
Confabulations are a major
annoyance and can be dangerous- when we take everything in a
discussion at face value. Confabulating is very frequently observed in
people with Alzheimer's.
We all Confabulate when we
make..verbal statements and/or actions that
inaccurately describe
history, background and present situations
unintentionally. We must
be aware of information that is blatantly
false yet are coherent,
internally consistent, and appear relatively
normal.
Understand the
similarities between confabulation and delusions; e.g.,
both involve the
production of unintentional false statements, both
are resistant to
contradictory evidence.
Recognize Sunrise Syndrome
delusions that are frequently observed in
Alzheimer's patients
include beliefs about theft, the patient's house
not being his home, a
spouse, is an impostor, belief an intruder is in
the house,abandonment,
spousal infidelity, and paranoia.
http://www.alzcompend.info/?p=293
It seems that Alzheimer's
world is fraught with confabulation speak.
The general public doesn't
understand Alzheimer's they certainly need
to be educated regarding
Confabulation.
{Quoting
http://tinyurl.com/qfutbn4 Nature Reviews Neuroscience }
"Most patients with
spontaneous confabulation eventually stop
confabulating."
"Confabulators may
occasionally act upon their confabulation."
("Occasionally"?
Later-stage Alzheimer's patients persistently and
repeatedly act upon the
belief their childhood memories are relevant
to their present
circumstances.)
"Confabulations are
usually limited in time; they relate to the recent
past, the present, and the
future."
{End Quoting
http://tinyurl.com/qfutbn4 Nature Reviews Neuroscience }
An aide/caregiver must
understand the individual has Alzheimer's
Disease, be aware of the
danger, and treat the person with patience.
Also, Confabulation is
common. Conversing with someone who has
Alzheimer's is often like
talking with your cat.
Acknowledge, respond, be
affectionate, develop boundless patience.
Forget about rational
responses. Show respect, your therapeutic
fictional responses are
allowed. ~{quoting}DLMifm}
To cope with spontaneous
confabulation, and ease the confusion,
frustration, and fear for
the loved one, use resources such as:
By far, the most serious
danger posed by Alzheimer's disease is when
the individual may decide
they want to go for a walk, go searching for
"home," or maybe
just walk outside to get the paper. In a restaurant
they may go to a
rest-room. When they turn around, the place they
expect to see is gone.
Their assurance they are Ok and can go on their
own ?. may be a example of
confabulation.
----
Alzheimer Society of
Canada, http://tinyurl.com/oujghvy Toronto,
Ontario, M4R 1K8
Hallucinations and
delusions are symptoms of Alzheimer's disease and
other dementias. With
hallucinations or delusions, people do not
experience things as they
really are.
Delusions are false
beliefs. Even if you give evidence about something
to the person with
dementia, she will not change her belief. For
example, a person with
dementia may have a delusion in which she
believes someone else is
living in her house when she actually lives
alone. Delusions can also
be experienced in the form of paranoid
beliefs, or accusing
others for things that have not happened. For
example, the person with
dementia may misplace an item and blame
others for stealing it.
Some people with dementia may have the
delusion that others are
"out to get them." For example, he
may believe that his food
is being poisoned.
Hallucinations are
incorrect perceptions of objects or events
involving the senses. They
seem real to the person experiencing them
but cannot be verified by
anyone else. Hallucinations are a false
perception that can result
in either positive or negative experiences.
Hallucinations experienced
by people with dementia can involve any of
the senses, but are most
often either visual (seeing something that
isn't really there) or
auditory (hearing noises or voices that do not
actually exist). For
example, a visual hallucination could be seeing
bugs crawling over the bed
that aren't actually there. Of course,
people also make â€Å“visual
mistakes,� mistaking a housecoat hanging
up for a person, for
example, because they can̢۪t see the object
clearly. This can happen
to anyone, and is not considered a
hallucination.
-----
Definition of Alzheimer's
Sunrise Syndrome
Internet description:
cognitive instability on arising from sleep.
Sunrise Syndrome,(sun?riz)
a condition in which a person with
Alzheimer's wakes up
rising in the morning and their mind is filled
with delusions which
include include beliefs about theft, the
patient's house not being
their home, a spouse is an impostor, belief
an intruder is in the
house, abandonment, spousal and paranoia, people
eavesdropping. Sometimes
the person may carry over content of a dream.
One observation is that
Sunrise Syndrome is different from Sundowning
because the person may
wake up in a confabulation mind set. During a
Sunrise Syndrome
conversation with the content may filled with
confabulations; verbal
statements and/or actions that inaccurately
describe history,
background and present situations.
Sundowning in contrast
displays as confusion, disorientation,
wandering, searching,
escape behaviors, tapping or banging,
vocalization,
combativeness; the demons of anxiety, anger, fear,
hallucinations and
paranoia come out.
===
When I became a caregiver
for my wife with Alzheimer's I had no
clue to the tasks ahead. I
started to read and search the Internet for
information.
Now retired I enjoy
blogging and networking. I am an Aggregator to
Ishmael's Knowledge
Network, I frequently collect content from various
Internet sources and
consolidate it on Ish's Knowledge Network
http://tinyurl.com/4qqekc6
Knowledge networking is a
pastime / hobby. BTW I have no
commercial ties to the
linked information.
Suggested reading Jennifer
Ghent-Fuller's article,
"Understanding the
Dementia Experience"
http://tinyurl.com/pzof7an
--
I really need to say this: The blog is for informational purposes only. I assume no responsibility for its accuracy. The information is subject to change without notice. Any actions you take based on information from the podcast or from this website are entirely at your own risk. Products and services are mentioned for informational purposes only and their various trademarks and service marks are the property of their respective owners. Fair Use: is not an infringement of copyright
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