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The Challenging Behaviour Foundation's At-a-glance guides for carers

View topic - The Challenging Behaviour Foundation's At-a-glance guides for carers | The Princess Royal Trust for Carers
Online support team at Wed Jun 29, 2011 2:34 pm
Hi everyone,

We thought some of you might be interested in this link to The Challenging Behaviour Foundation Website where there are three new ‘At a glance’ guides aimed at family carers supporting people whose behaviour is described as challenging. The guides have been developed in collaboration with the Social Care Institute for Excellence and there are separate guides for adults, teenagers and children. You can find out more information here:

http://www.challengingbehaviour.org.uk/ - there is a link in the New Resources section on the left-hand side to ‘Challenging behaviour at-a-glance’ where the guides can be found.

We hope some of you find this helpful :)

Online Support Team,
Carers.org


UK Care Quality Commission

Care Quality Commission
CQC

The independent regulator of health and social care in England.

We regulate care provided by the NHS, local authorities, private companies and voluntary organisations. We aim to make sure better care is provided for everyone - in hospitals, care homes and people's own homes. We also seek to protect the interests of people whose rights are restricted under the Mental Health A


Alzheimer Research Forum EADC

EADC
Alzheimer Research Forum is a nonprofit organization that seeks to advance Alzheimer’s disease research by improving scientists’ access to information and research resources. The forum maintains an extensive web-based metajournal of scientific research, discussion forums, resource indexes, grant/conferences/job opportunities, researcher, lab and institute profiles, and sponsors programs and workshops to address impediments to research.


Alzheimer Europe Organization website

Alzheimer Europe
Alzheimer Europe website. We are a non-governmental organisation aimed at raising awareness of all forms of dementia by creating a common European platform through co-ordination and co-operation between Alzheimer organisations throughout Europe. Alzheimer Europe is also a source of information on all aspects of dementia.


Maximizing communication with the Alzheimer's patient by Martin D. Shulman, Ellen Mandel

Maximizing communication with the Alzheimer's patient | Nursing Homes | Find Articles at BNET

"Those who interact with individuals with a diagnosis of dementia of the Alzheimer's type know the difficulties in communicating with these patients. Their communicative deficits have been well documented and may include poor memory, poor judgement, poor word finding skills, poor comprehension of spoken and written material, poor expressive language skills, verbal perseverations of words and ideas, poor topic maintenance, poor turn taking, poor discourse skills, and general disorientation or confusion. While these patients may be able to speak clearly, they have difficulty in communicating their thoughts, needs and ideas."

"While certainly devastating to the individual, these deficits can have an equally negative impact on the communication partner. Anyone who needs to converse with an Alzheimer's patient faces a variety of potential difficulties which may set the stage for communicative breakdown and frustration. The authors have been involved in training programs designed to maximize communicating with the Alzheimer's patient. It is our feeling that family, friends, physicians, nurses, aides, orderlies, volunteers, and staff members of long-term care facilities can learn some strategies to make conversing with Alzheimer's patients more effective, efficient and, hopefully, less frustrating."


Alzheimer’s Drugs — Fact and Fiction | Alzheimer's Compendium

There are two main categories of drugs for treating Alzheimer’s, i.e.:
These drugs do not cure Alzheimer’s, and there is scant evidence that they slow down the damage that is being done. What they can do, however, is help the damaged regions of the brain function better, which in turn slows down the emergence of symptoms and improves your loved one’s quality of life.

(1) Cholinesterase inhibitors
These include the prescription drugs Aricept/donepezil, Razadyne/galantamine, and Exelon/rivastigmine, and the over-the-counter “supplement” huperzine A.

(2) NMDA antagonists
So far, there is only one drug in this category, i.e., Namenda/memantine.



Alzheimer’s Drugs — Fact and Fiction » Alzheimer's Compendium

Alzheimer’s is a multidomain disorder

Confabulation: Honest Lying » Alzheimer's Compendium
Alzheimer’s is a multidomain disorder, including not only memory loss, but also executive dysfunction (e.g., impaired ability to plan ahead, prioritize, stop and start activities, shift from one activity to another activity, and to monitor one’s own behavior) and varying degrees of visuospatial and language deficits.


What is a Carers; Centre? | Carers in UK

Carers' Centres are independent charities that deliver a wide range of local support services to meet the needs of carers in their own communities.

All Carers' Centres provide, either by telephone, drop-in or outreach surgeries, the following core services: Information and advice - about all issues affecting carers, including benefits, breaks, respite and support services, carer assessment procedures, aids and adaptations Emotional support - by providing opportunities for carers to talk through their concerns, both individually and in group sessions, with staff, trained volunteers and other carers who understand their situation, thus helping to alleviate isolation and stress.

Community consultation - carers need a unified voice in any locality to ensure that they have an impact on decision-making.
By working with other agencies and consulting carers, Carers' Centres can have a strong influence on local policy, planning procedures and outcomes. They can also ensure that the local carers' voice can be linked in to the regional and national decision-making bodies.

Carers' Centres develop other services in response to identified local needs.
These might include: Advocacy - at tribunals, assessments, case reviews, assistance to access funds and services, or whenever a carer needs a friend or supporter Practical help - befriending, breaks, transport, benefits advice Training and education - in skills often needed by carers, such as moving and handling, first aid, and care giving; personal development; stress reduction through reflexology and aromatherapy; and training and education for professionals on carer-related issues Fun - time out, breaks, the opportunity to enjoy a social life, taking into account carers' special needs and sense of isolation The aim of our work is to help ensure that no carer has to reach crisis point before they get the support they need. In short, to make it easier for carers to cope.
--
The Princess Royal Trust for Carers works to reach carers and develop services for carers across the country through The Nationwide Network of 144 Carers' Centres.

Caregiver Resource Directory: Online Version from Net of care

Caregiver Resource Directory (Online Version) - NetofCare
The Caregiver Resource Directory is a practical guide that includes much of the information available on this site, while also offering a way to organize materials and information.

The Princess Royal Trust for Carers | UK

One in 10 people in the UK are carers - looking after a loved-one who is sick, disabled, suffering from a mental health problem or an addiction - some carers are as young as five years old. What carers have in common is the selflessness to put their family members needs before their own, but they face an on-going life of isolation, ill-health and poverty.

A lifeline for hundreds of thousands of carers across the UK.
http://www.carers.org/

For 20 years, The Princess Royal Trust for Carers has been fighting to provide carers with the support they so desperately need. The Trust understands that few of us plan to become carers, so when a caring role starts, every carer needs an expert to guide them through the maze of services, rules and entitlements. For a carer, this can make the difference between keeping and losing their job, or between staying healthy and collapsing under the stress.

At the heart of The Trust is a unique network of 144 independently-managed Carers' Centres, 89 young carers' services and interactive websites (www.carers.org and www.youngcarers.net) which deliver around the clock support to over 424,000 carers and approximately 25,000 young carers. Today we are the largest provider of carer support in the UK offering unique and innovative services.
--

Media clip:
BBC - BBC One Programmes - Lifeline, The Princess Royal Trust for Carers

E-learning: The Open Dementia Programme

SCIE e-learning: Fair Access to Care Services (FACS) 2010 training module
E-learning: The Open Dementia Programme

Published: 2009

The Open Dementia e-Learning Programme is aimed at anyone who comes into contact with someone with dementia and provides a general introduction to the disease and the experience of living with dementia. This programme is designed to be accessible to a wide audience and to make learning as enjoyable as possible and so allows users to fully interact with the content and includes video, audio and graphics to make the content come alive. In particular the programme includes a considerable amount of new video footage shot by both the Alzheimer’s Society and SCIE where people with dementia and their carers share their views and feelings on camera.

Top tips for carers - Alzheimer's Society UK

Top tips for carers - Alzheimer's Society
Top tips for carers
Man smiling with woman
When your loved one is being cared for in hospital

There are many things you can do to check your loved one is receiving good care in hospital. Working with the care home is the best place to start.

We have put together our ten top tips for carers whose loved one are now being cared for in a care home/hospital:

Helping the person with financial issues | moneymatters article by Alzheimer s Association,

© 2010 Alzheimer s Association. All rights reserved. This is a  official publication of the Alzheimer s Association but may be distributed by unaffiliated organizations and individuals. Such distribution does not constitute an endorsement of these parties or their activities by the Alzheimer s Association.

Helping the person with dementia settle financial issues Putting financial plans in place is important for everyone, but understanding money matters is especially vital for the person with dementia.

Dementia is a general term for the loss of memory, decision-making and other intellectual abilities serious enough to interfere with daily life. Alzheimer’s disease is the most common form of dementia.

Once a person is diagnosed, family and friends should help the person make financial plans.The sooner plans can begin, the more the person with dementia may be able to participate.

The Alzheimer’s Association has identified costs you may face as your loved one lives
with dementia. Inside, you’ll also find different ways to help cover those costs.

1 Getting started Gather financial and legal documents Discuss financial needs and goals
Get professional assistance Look at factors that affect income Costs you may
face

How to cover the costs Insurance Work-related and personal resources Government assistance Financial help that you provide Support services in your community

Money matters is meant to provide general financial information, not to take the place of professional financial or legal advice. New developments – such as legislative and regulatory changes – may affect its accuracy. Consult a professional before making decisions.

Getting started

Begin putting financial plans in place as soon as the diagnosis has been made. Careful planning can help you secure a healthy financial future.

In addition to planning for the cost of care, there are many ongoing financial duties, including:
• Paying bills
• Arranging for benefit claims
• Making investment decisions
• Preparing tax returns

Get started by putting in place all of the information, resources and support you’ll need.

Gather financial and legal documents

Carefully go over all financial and legal documents, even if you’re already familiar with them.

Legal documents include:

• Living wills
• Medical and durable powers of attorney
• Wills Financial documents
include:
• Bank and brokerage account information
• Deeds, mortgage papers or ownership
statements
• Insurance policies
• Monthly or outstanding bills
• Pension and other
retirement benefit summaries
• Rental income paperwork
• Social Security payment
information
• Stock and bond certificates
At this point, it may also be helpful to
identify which necessary documents are not in place.

Professional financial and legal advisers can assist you with this task.
Discuss financial needs and goals

After the diagnosis, determine financial needs and goals. Discussing these early on
enables the person to still understand the issues and to talk about what his or her
wishes are.

Involve all other people concerned as much as possible. Talk about putting financial and care plans in place. If others are available to help, encourage the sharing of caregiving duties. Discuss how finances might be pooled to provide necessary care.

Get professional assistance

Now is also a good time to find the professionals you will need. They will be valuable sources of information and assistance.

Start by contacting your local Alzheimer’s Association office. Our staff can match you with the right professional services, including qualified attorneys, financial planners and accountants.

Financial advisers

Professional financial advisers, such as financial planners and estate planning
attorneys, can help you:

• Identify potential financial resources • Identify tax deductions • Avoid bad
investment decisions that could deplete your finances

When selecting a financial adviser, check qualifications such as:

• Professional credentials
• Work experience
• Educational background
• Membership in professional associations
• Areas of specialty Also, ask the financial adviser if he or she is familiar with elder care or long-term care planning.

Legal advisers

Seek an experienced elder law attorney to help:

• Address estate planning issues • Prepare legal documents If you cannot afford legal
assistance, find out if pro bono (no cost) legal aid is available in your community.

Look at factors that affect income

When making financial plans for the person with dementia, be sure to consider his or her:

• Age
• Types of assets
• Types of insurance
• Tax issues • Long-term health outlook

Costs you may face

Begin planning a long-term budget now. Consider all the costs you might face, now and in the future.

Keep in mind that Alzheimer’s is a progressive disease, and the person’s needs will
change over time.

Costs may include:

• Ongoing medical treatment for Alzheimer’s, including diagnosis and follow-up visits

• Treatment for other medical conditions
• Prescription drugs • Personal care supplies •
Adult day care services
• In-home care services
• Full-time residential care services

These costs vary depending upon where you live.

To learn about care options in your area, contact your local Alzheimer's Association office or visit the Alzheimer's Association CareSource™ at www.alz.org/caresource.There you’ll find a set of online tools and services that will help you coordinate and plan to pay for care. A financial adviser can help design a plan that’s unique to the person’s financial needs – both immediate and long-term.

How to cover the costs A number of financial resources may be available to help cover the costs throughout the course of the disease. Some may apply now, others in the future.

Insurance

Health-care coverage

If you are 65 or older, the primary source of health care coverage is usually Medicare.

However, private insurance, a group employee plan or retiree health coverage may also be in effect. No matter what the age of the person with dementia, it’s vital to keep active any existing health care plans that meet his or her needs.

Medicare covers inpatient hospital care and some of the doctors’ fees and other medical items for people with Alzheimer’s who are age 65 or older. Medicare also covers outpatient prescription drugs.


If the person with dementia is younger than 65, Medicare can provide coverage if he or she has been on Social Security disability for at least 24 months.

Medicare provides some home health care, including skilled nursing care and
rehabilitation therapy, under certain conditions.

Custodial long-term nursing home care is not covered by Medicare. Medicare will only pay for up to 100 days of skilled nursing home care under limited circumstances.
Medicare will pay for home or inpatient hospice care for qualified people who are terminally ill.

You may be able to choose a “managed care” form of Medicare, such as:
• Medicare health maintenance organization (HMO)
• Preferred provider organization (PPO)
• Point of service (POS) plan

These options may provide services not covered by traditional Medicare. But these forms of Medicare usually have limits on which hospitals,doctors and other health care providers you can use.

To learn about the many Medicare options, and whether they are right for the person with dementia, read each plan carefully. You can also contact your State Health Insurance Assistance Program (SHIP) for free one-on-one help and publications. Call us at 1.800.272.3900, and ask for the SHIP location nearest you.

You also may be able to supplement the person’s Medicare coverage with Medigap insurance, which fills gaps in Medicare coverage, such as paying for coinsurance.The more expensive Medigap policies may cover additional items.

Learn more about Medicare Call 1.800.633.4227 Visit www.medicare.gov or find your state’s SHIP at www.medicare.gov/contacts/static/allStateContacts.asp If the person with dementia is younger than 65 years old (considered younger-onset Alzheimer’s), he or she may have private insurance, a group employee health plan or perhaps retiree medical coverage.

If he or she changes policies, check how soon expenses from Alzheimer’s disease will be covered under the new policy.

Most policies do not cover “pre-existing conditions” for up to a year. However, these exclusion periods (when coverage is not provided) don’t apply in all cases.

The exclusion period won’t apply if the person:
• Has been covered for the past 12 or 18 months, depending on the policy,
• Has already met an exclusion period, and • Has not been without health coverage for more than 62 days

COBRA may be another option for a person younger than age 65. COBRA stands for the Consolidated Omnibus Budget Reconciliation Act of 1985. COBRA applies to employers with 20 or more employees. Under COBRA, an employee may continue group plan coverage for up to 18, 29 or 36 months,depending on the circumstances, if he or she:
• Leaves the employer
• Has his or her hours reduced to the point that he or she nolonger qualifies for the health plan
The insured employee must pay the full cost of coverage, plus up to 2 percent more to cover administrative costs. COBRA can be especially helpful until the person with dementia:
• Gets new coverage through an employer, or
• Becomes eligible for Medicare You must activate the COBRA option within 60 days of when the person with dementia leaves work or has work hours reduced. Some private health care plans will extend coverage under a disability extension of benefits. In other words, even though the medical plan may lapse, an insured’s disability (in this case, Alzheimer’s disease) remains covered.

Disability insurance

Disability insurance provides income for a worker who can no longer work due to illness or injury. With an employer-paid disability policy, 60 to 70 percent of a person’s gross (overall total) income is usually provided. Benefits paid out of an employer-paid plan are taxed as income.

If the person with dementia bought a personal disability policy, then the benefits paid will be the amount he or she chose.The benefits from a personal disability policy are not taxed as income.

Long-term care insurance

If long-term care insurance is in place, carefully review the policy to find out:
• Is Alzheimer’s disease covered? Most policies say they cover Alzheimer’s disease, but take a closer look to be sure.
• When can the person with dementia begin to collect benefits? Most policies require a defined level of physical or cognitive impairment.
• What is the daily benefit, and is it adjusted annually for inflation?
• How long will benefits be paid?
• Is there a maximum lifetime payout?
• What kind of care will the policy cover? Examples include skilled nursing home, assisted living, custodial care and licensed home care.
• How long after diagnosis will the policy begin to pay? This is often called the
elimination period.
• Are there tax implications for getting this money? Unfortunately, after symptoms of Alzheimer’s disease appear, it is usually no longer possible to purchase many types of insurance, like disability and long-term care insurance.

Life insurance

Life insurance can be a source of cash. You may be able to borrow from a life insurance policy’s cash value. Or the person with dementia may be able to receive a part of the policy’s face value as a loan. This is called a viatical loan and is paid off upon the person’s death.

Some life insurance policies may offer accelerated death benefits. This means that some of the insurance benefits can be paid if the insured person is not expected to live beyond the next six to 12 months because of a terminal illness. The payout may run as high as 90 to 95 percent of the policy’s face value and will not be taxed as income. See if any policies contain a waiver of premium rider. That means that the insured,if disabled,does not have to pay premiums to continue coverage.

Work-related and personal resources

Employment

In the early stages of dementia it’s often possible that a person will continue
working. This may mean adapting job duties to fit the current level of ability.

The Americans with Disabilities Act (ADA) offers limited protection to those with
Alzheimer’s. The ADA requires that companies with at least 15 or more employees make “reasonable” accommodations for job applicants and employees with physical or mental disabilities. For example, an employer may switch the worker to a less demanding job or reduce work hours.

Be sure the employer is educated about Alzheimer’s disease and its symptoms.

If you think the person with dementia has been treated unfairly at work, first try to resolve the issue with the employer. If that doesn’t work, you can file a claim under the ADA through the federal Equal Employment Opportunity Commission or under your state’s disability law.

Employee benefits

If the person with dementia continues to work:
• Review the employer’s benefits handbook. • Ask the benefits specialist what benefits may be available. For example, the employer may provide paid sick leave or other short-term disability benefits (usually for one year or less).
• Keep written confirmation of all benefits. The employee may be able to convert an
employer-provided life insurance policy to an individual plan. If the person with
dementia is still working, he or she may have available a flexible spending account. This allows payment for out-of-pocket medical expenses with pretax dollars, for potential savings of about 20 to 30 percent.

Retirement benefits

Retirement plans include:
• Individual retirement accounts (IRAs)
• Annuities Benefits from retirement plans can
provide critical financial resources, even if the person with dementia hasn’t reached retirement age.

Pension plans typically pay benefits before retirement age to a worker defined as
disabled under the plan’s guidelines.

The person with dementia may also be able to withdraw money from his or her IRA or
employee-funded retirement plan before age 59 1/2 without paying the typical 10 percent early withdrawal penalty. This money usually will be considered regular income, and taxes will have to be paid on the amount withdrawn.

In that case, if withdrawals can be delayed until after the person leaves work, income taxes due will likely be less because he or she will probably fall into a lower income-tax bracket.

Social Security benefits are also available before retirement age if Social Security disability requirements are met.

Personal savings, investments and personal property

Investment assets like these can be sources of income:
• Stocks
• Bonds
• Savings accounts
• Real estate
• Personal property, such as jewelry or artwork For example, the equity in a home could be converted into income, a process called a reverse mortgage. This is a type of home equity loan that allows a person age 62 or older to convert some of the equity in his or her home into cash while remaining the homeowner. The amount the person is eligible to borrow is generally based on the:
• Person’s age • Home’s equity • Lender’s interest rate Reverse mortgages do not have an impact on Social Security or Medicare benefits, but they may affect qualifying for other government programs.

Government assistance

In addition to Medicare, the person with dementia may qualify for a number of public programs. These programs provide income support or long-term care services to people who are eligible.

Social Security Disability Income (SSDI)

A worker who is younger than age 65 may qualify for Social Security disability payments. To qualify for SSDI, the person must meet the Social Security Administration’s definition of disability. Meeting the definition of disability generally means proving that:

• The person with dementia is unable to work in any occupation.
• The condition will last at least a year or is expected to result in death. Family
members also may be eligible to receive SSDI benefits. File for SSDI benefits as soon as possible:
• Benefits do not begin until the sixth full month of disability.
• The Social Security Administration often takes a long time to decide whether to
approve a claim.
• It’s not unusual for disability applicants to be rejected initially. Be prepared to appeal.Your professional advisers can assist in this process.

After receiving SSDI benefits for at least 24 months, the person with dementia will
qualify for Medicare benefits.

Supplemental Security Income (SSI)

SSI guarantees a minimum monthly income for people who:
• Are age 65 or older, • Are disabled or blind, and • Have very limited income and
assets – these asset and income levels vary from state to state To qualify for SSI
benefits, the person with dementia must meet the Social Security Administration’s
definition of disability.

If you think he or she qualifies for SSI benefits, begin the application process as
quickly as possible after the diagnosis. SSI payments begin upon approval of the
application.

Learn more about SSDI and SSI Call 1.800.772.1213 Visit www.ssa.gov

Medicaid

Medicaid is a program jointly funded by federal and state governments. It is
administered by each state. Medicaid pays for:
• Medical care for people with very low income and asset levels
• Long-term care for people who have used up most of their own money, under most circumstances Most Medicaid dollars go toward nursing home care, but most states have home- and community-care options for some people who qualify for nursing home care. (Not all nursing homes accept Medicaid, so choices are limited.)

In most states, Medicaid will pay for hospice care. If the person with dementia is
eligible for SSI, he or she usually is automatically eligible for Medicaid.

Those not on SSI must have minimal income and assets. The amount is determined by each state.

There are also specific guidelines about protecting spouses from impoverishment (the depleting of finances) in determining income and asset levels. The person with dementia should be very careful about giving away assets to family members to qualify for Medicaid. Strict laws govern this area. Be sure you are fully aware of the legal and financial results of transferring property and wealth. Check with your legal adviser before you proceed.

Learn more about Medicaid

•Your state’s Medicaid telephone number may be listed in the blue (government) pages of the telephone directory
• Call the general information telephone number for your state or county human services or social services department
• Visit www.cms.hhs.gov/medicaid Veterans benefits Veterans
may qualify for government benefits, including health and long-term care. These benefits often change, so call a Veterans Affairs benefits counselor or visit the VA Web site for the latest information. Learn more about veterans benefits Contact the Department of Veterans Affairs: Call 1.877.222.8387 for health care benefits Call 1.800.827.1000 for general benefits Visit www.va.gov

Other public programs

Many states have state-funded, long-term care, including: • Adult day care
•Respite care
Learn more about other public programs
•LocalAlzheimer’sAssociationoffice
•LocalAreaAgencyonAgingortheEldercareLocator: Call 1.800.677.1116
Visit www.eldercare.gov Tax benefits Some financial benefits are available
for the caregiver from the Internal Revenue Service (IRS): Income tax deductions
• Income tax credits The person with dementia is likely considered your dependent for tax purposes. If so, you may be allowed to itemize his or her medical costs. Keep careful records of all medical expenses.

You may be entitled to the Household and Dependent Care Credit if you need to pay someone to care for the person so you can work. This credit can be subtracted directly from the tax shown on your return. Learn more about tax issues
•Alzheimer’sAssociationpublication, Taxes and Alzheimer’s disease, available from your local chapteroratwww.alz.org
•Yourtaxadviser•InternalRevenueService(IRS): Call
1.800.829.1040 Visit www.irs.gov

Financial help that you provide

You may choose to pay out of your own pocket for some or most of the care. Review your own resources, such as savings and insurance policies.

Flexible spending account

If the person with dementia is a dependent under the tax rules, you might be able to use your own workplace flexible spending account. This money can cover the person’s out-of-pocket medical costs or dependent care expenses in some cases.

Family and Medical Leave Act

If you work for an employer with 50 or more employees, you may be able to use the
federal Family and Medical Leave Act (FMLA) to help balance your caregiving
responsibilities.

FMLA allows you to take off up to 12 weeks of unpaid leave each year to provide caregiving. Most workers are guaranteed to keep their jobs.

Paid time off

Some employers provided limited paid time off. You may be able to adjust your schedule or work fewer hours.

In-home care

If you hire a professional to work in your home to help with caregiving, you may be
responsible for paying his or her Social Security and unemployment taxes. Ask your
financial adviser to be sure.

Support services in your community

Many community organizations provide low-cost or even free services, including:
• Respite care
• Support groups
• Transportation to social events
• Meals delivered to the home Learn more about support services
• Your local Alzheimer’s Association office
• Eldercare Locator: Call 1.800.677.1116 Visit www.eldercare.gov
• Your local religious organization •Hospital social worker or discharge
planner

Learn more about financial issues and planning by visiting your local Alzheimer's
Association or one of the following resources:

Alzheimer's Association CareSource™
www.alz.org/caresource


BenefitsCheckUp
www.benefitscheckup.org

Eldercare Locator
www.eldercare.gov 1.800.677.1116

Financial Planning Association
www.fpanet.org 1.800.322.4237

Internal Revenue Service
www.irs.gov 1.800.829.1040

National Academy of Elder Law Attorneys
www.naela.com

Money matters was developed from source material created in a collaboration with the
National Endowment for Financial Education® (NEFE®).To learn more about the NEFE, visit
www.nefe.org.


10 quick tips Money matters

1 Don’t put off talking about finances and future care wishes

2 Organize and review important documents

3 Get help from well qualified financial and legal advisers

4 Estimate possible costs for the entire disease process

5 Look at all of your insurance options

6 Work-related salary/benefits and personal property should be considered as potential income

7 Find out for which government programs you are eligible

8 Learn about income tax breaks for which you may qualify

9 Explore financial assistance you can personally provide

10 Take advantage of low-cost and free community services

The Alzheimer s Association is the leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer s disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health.

For reliable information and support, contact the Alzheimer’s Association:
1.800.272.3900 www.alz.org

© 2010 Alzheimer s Association. All rights reserved. This is an official publication of the Alzheimer s Association but may be distributed by unaffiliated organizations and individuals. Such distribution does not constitute an endorsement of these parties or their activities by the Alzheimer s Association.


Johns Hopkins Prescription Drugs Special Report Ordering Your Drugs Online

Johns Hopkins: Prescription Drugs on buying medications from Canada: Johns Hopkins Special Reports

Johns Hopkins Health Alerts Prescription Drugs Ordering Your Drugs Online

Ordering medications from Canada? Here’s a guide to help you play it safe.

"How to buy less expensive medications is one of the top questions I get from my patients," says Johns Hopkins lung specialist Peter B. Terry, M.D. One way to purchase medications at a reduced cost is to buy them online or by phone from Canadian pharmacies. The U.S. Food and Drug Administration (FDA) opposes foreign drug purchases, warning that these sales pose serious safety problems. While importing Canadian medications is against U.S. policy, the FDA has said that it will not prosecute individuals who import small amounts (three months or less) for personal use. If you are considering ordering medications from Canada, remember that the FDA cannot guarantee the safety of those medications. The FDA’s concerns include:

AARP has come up with guidelines to help consumers minimize their risk and ensure that the medications they receive are the ones their doctors have prescribed. AARP recommends that you pick a pharmacy that:

Provides its license number on its website and the name of the Canadian regulatory agency that granted the license so that you can check the pharmacy’s authenticity.

Displays the seals of the Canadian International Pharmacy Association (CIPA; see www.ciparx.ca/) or Internet and Mail-Order Pharmacy Accreditation Commission (IMPAC; see www.impacsurvey.org/). These organizations set standards for safety and service among Canadian mail-order pharmacies that sell to Americans. Those that meet the standards receive accreditation.

Requires a prescription for medication from your doctor. Reputable pharmacies may allow you to fax in a prescription but will then either confirm the prescription by a phone call to your doctor’s office or wait until they receive the original one in the mail before filling your order.

Requires you to submit details of your medical history and clearly states the pharmacy’s policies for ensuring medical and personal privacy.

Requires you to have taken a medication for at least one month before you order by mail so that you and your doctor know the medication is working and is safe for you.

Provides a full mailing address and a toll-free phone number on its website so that you can call a pharmacist to ask any questions you may have.

Explains differences between American and Canadian drug names and labeling and why the pharmacy does not sell some medications.

Normally sends medications in the manufacturer’s original container, with seals intact. An exception to this rule occurs when the quantity of pills in the manufacturer’s own container exceeds a 90-day supply. In these cases, medications may arrive in ordinary pharmacy bottles.

Sends medications with labeling that includes strength, dosing directions, expiration date, appropriate warnings, and a Drug Identification Number (DIN) that shows the drug has been approved by the Canadian government health authorities.

Displays on its website full information about shipping fees, payment policies, and refunds. Reputable pharmacies offer secure (encrypted) online payment for credit cards, alternative options for payment (such as electronic fund transfers and regular checks), and do not charge any separate fees except for shipping.

Charges the cost of the medications to your credit card only when the drugs are shipped, not when the order is first placed.

Refunds your money or reships medications immediately if your order does not arrive.

Final word of advice: If you’re wondering where to start looking for pharmacies online, visit www.pharmacychecker.com, a website run by an independent American consumer research group that provides ratings and price comparisons for more than 40 online pharmacies based mainly in the United States and Canada. This site rates them on a scale of 1–5 and notes whether a pharmacy is licensed, requires a prescription, provides its address and phone number, and offers personal privacy and payment security. The site compares prices for more than 1,000 drugs at these pharmacies and gives details on shipping fees and delivery times.

For more Prescription Drugs articles, please visit the Prescription Drugs Topic Page

Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer

Posted in Prescription Drugs on February 13, 2007

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Understanding the Dementia Experience

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

Smashwords Edition 2012
This ebook is licensed for your personal enjoyment. This free ebook may be given away to other people. If you would like to share this book with another person, please send the entire book only, not a partial sampling. This book may not be sold except if printed on paper in its entirety and only for the exact cost of the materials only. Thank you for respecting the hard work of this author. Further information about sharing is in 'Note Written in 2002.'
Copyright Jennifer Ghent-Fuller 2002


Causes of Memory Loss That Aren't Alzheimer's | Caring.com

Causes of Memory Loss That Aren't Alzheimer's | Caring.com
Memory-loss cause #1: Chronic stress

Why it happens: When the body goes on hyperalert to face a crisis, a series of biochemical changes takes place that fuels the fight-or-flight response system. The chemical cortisol increases in the brain, for example, to mobilize energy and alertness. That's great when a saber-toothed tiger is chasing you. But when tension and anxiety become chronic, as with work or family problems, the system is overloaded with substances that are intended for emergency use only.

Cognitive Dysfunction in Multiple Sclerosis

Cognitive Dysfunction in Multiple Sclerosis - Other Rare Causes of Dementia - Other forms of dementia - Dementia - Alzheimer Europe

Other Rare Causes of Dementia
by Clive Ever

There has been a lot of recent research into changes in cognition due to MS and it is now evident that such changes do occur and that they are more common than was previously thought. Cognition is about our abilities in thinking things through and how well our memory works.

Cognition is also about how to focus and to maintain our attention; the way we learn and remember new things; how we think reason and solve problems. It also concerns how we plan and carry out our activities; the way we understand and use language and how well we recognise objects, assemble things together and judge distances.

The brain damage in MS is different to that in e.g. Alzheimer’s type dementia and so the problems shown are different. Although the problems may not amount to full dementia they can cause significant disruption to the lives of patients. In studies of MS patients with and without cognitive dysfunction, those with have been shown to be more significantly impaired with respect to work, sexual and social functioning and basic activities of daily living.

Cognitive Dysfunction is one of the more scary symptoms of Multiple Sclerosis.

Cognitive Dysfunction - multiple sclerosis encyclopaedia
Cognitive Dysfunction is one of the more scary symptoms of Multiple Sclerosis. It used to be thought that cognitive dysfunction was relatively rare symptom of the disease but it is now understood to be quite a common feature.

Among the reasons that it's frequency was formerly underestimated is that the dysfunction is often mild, cognition is a very complex subject and, in the past, physicians have felt more comfortable denying its existence to their patients. Things have changed over the past few years. Rather than lumping cognitive dysfunction in the same bracket as fatigue and depression, it is now studied on its own. Cognitive evaluation techniques have also improved greatly and now proper studies into cognitive dysfunction in MS are beginning to be done.


Hiring an Overseas Caregiver, proceed with caution

Hiring an Overseas Caregiver to work in the US Page - Nannies and nanny services for 20 years in Canada and the US, OptiMum Childcare and Nannies Ltd.

An American family may legally hire a US citizen, someone who has been lawfully admitted for permanent residence, or someone with a valid work permit.

Eligibility for lawful employment must be verified by the employer using form I-9 form.

http://www.state.gov/r/pa/ei/rls/dos/1718.htm


Confabulation: Honest Lying paper on The Alzheimer's Compendium

Confabulation: Honest Lying » Alzheimer's Compendium
[QUOTE]
spontaneous confabulation in the Alzheimer’s patient … that is exactly what our loved ones do, more and more, as the disease progresses and they live more and more in the past. And while provoked confabulations are a major annoyance in the early stages — when friends, family, and the medical community take everything our loved ones say at face value, no matter how false we know their statements to be — spontaneous confabulations become a far greater concern in the later stages, because spontaneous confabulations are much more likely to be acted upon by the loved one."

"Approaches that can be used to cope with spontaneous confabulation, and ease the confusion, frustration, and fear for the loved one, can be found in resources such as:

Jennifer Ghent-Fuller’s paper “Understanding the Dementia Experience”

Jolene Brackey’s book, Creating Moments of Joy

Naomi Feil’s “validation therapy”

The Savvy Caregiver training program

___

Alzheimer’s

Layers of memories separated in time Photographic double exposures

You are you but also a long dead sister or a half-remembered husband maybe partially a grandkid

Or maybe you are mostly the long dead sister.
She is at home or maybe in another place –Her last home or one from many years ago

She is a child or there are children to be taken care of, One of them may be you

A Kaleidoscope of images from whole lives Jumbled together

~ Anonymous Caregiver
[/QUOTE]

Physicians Healthcare

Care for Elderly in Massachusetts - Find Local Elder Care Services at ElderCareLink.com
Physicians Healthcare – Quincy, Massachusetts

At Physicians Healthcare we provide your loved ones with first-rate health care in the comfortable and secure surroundings of their own home. Our specially designed clinical programs use nurses, doctors, and rehabilitation therapists to accommodate your specific needs

nationwide network of Physicians

Physicians and Other Health Professionals Who Make Housecalls Nationwide
Dochousecall.US/MDonhousecall.net is a nationwide network of Physicians & Health Care professionals with various specialties dedicated to contribute further to a better quality of life of patients by making house calls to your home and your home away from home in the old tradition using up to date evidence-based medical therapeutics.

House Calls to the Elderly -- A Vanishing Practice

physicians house calls Massachusetts - Google Search
[PDF]
121897 House Calls to the Elderly -- A Vanishing Practice Among ...
File Format: PDF/Adobe Acrobat - Quick View
by GS MEYER - 1997 - Cited by 79 - Related articles
Copyright © 1997 Massachusetts Medical Society. All rights reserved. .... scale, the reimbursement for a physician's house call ... Specialties of Physicians Making House Calls to Elderly Medicare Beneficiaries. Because 1683 house calls ...
tommorrione.com/.../House%20Calls%20to%20the%20Elderly%20-%20Vanishing%20Practice%20Among%20Physicians.pdf

Bing Search for Doctors making House Calls in USA

MD at Home

Inn House DoctorMD at Home - Services
Our Services

Physician Home Visits
Full mobile lab
Physical Examinations
Wound care/lacerations
Decubitus wound care
Consultative Examinations
Mental Status opinions and Affidavits
Pulmonary Function Testing
Tracheostomy tube changes



Gastrostomy tube changes
Echocardiogram
Ultrasound
EKG
X-Ray
Oximetry
Fracture care
Customized Services



Copyright MD at Home™ 2006

Inn House Doctor

Inn-House Doctor Home Page
Hotel Room/ Home Visits
Diagnosis & Treatment
No Forms to Fill Out
24/ 7 Service
Pediatrics
No Crowded E.R. Rooms
No Waiting
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24-Hour Dental (Boston)
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In home doctors

Lincona Medical Associates, LTD.
Lincona Medical Associates, LTD.

Chicago Area Mobile Urgent Care

Mobile Doctors, Chicago Doctor House Calls in Chicago, IL
Our mobile doctors make house calls in Chicago and the suburbs. We offer pediatric medical services and urgent medical care throughout Chicago and outlying suburbs. If you are in need of child or adult medical care and treatment, express house calls, or urgent care please contact us right away.

Visiting Physicians Association®

SERVICES
Our services include but are not limited to:

Comprehensive review of your medical history, physical examinations and ongoing treatment of your medical condition
Medication management and medication refills
State-of-the-art laboratory services and portable diagnostic testing performed in the comfort of your home
Referral to physical therapy and specialized rehabilitation services
Coordination of all home care services and medical equipment
Community placement consultations
Physician review for authorizations:
Home health authorizations
Medical equipment authorizations
Diagnostic testing authorizations

Impaired Hearing Resouurces

Guardian vs. Conservator: What’s the Difference? - Robert J. Kulas, P.A.

Guardian vs. Conservator: What’s the Difference? - Robert J. Kulas, P.A.


Quoted for your discussion from web site of Robert J. Kulas, Attorney, East Lake Professional Center, 2100 SE Hillmoor Drive, Suite 105, Port St. Lucie, FL 34952, Phone: (772) 398-0720
information@kulaslaw.com
--
Guardian vs. Conservator: What’s the Difference?
Sep 8, 2010

When it comes to estate planning, the terms “guardian” and “conservator” tend to come up often. There’s sometimes confusion about what a guardian does as opposed to what a conservator does. The two roles are similar but distinct.

A guardian is a court-appointed fiduciary who is responsible for ensuring that the personal, day-to-day needs of a child or incapacitated adult are taken care of. The person whose well-being the guardian is responsible for is called a “ward”. In the case of a child, often the guardian is the primary caregiver, living with the child and fulfilling a parental role. This is not always the case with an incapacitated adult. The guardian of an incapacitated adult is usually in charge of making sure that the ward gets adequate medical treatment and that the ward’s caregivers are doing an adequate job of meeting his or her personal needs.

A conservator, or guardian of the property, on the other hand, is a court-appointed fiduciary who is responsible for managing the financial affairs of a child or an incapacitated adult. The conservator takes care of real estate, manages bank accounts, and handles investments. His or her duties can range from paying bills to buying and selling stocks and bonds to managing rental property on behalf of the ward.

The main benefit of having a guardian or conservator is that the fiduciary is subject to court oversight in fulfilling his or her duties. The disadvantages to this arrangement include that, because of court involvement, guardianship or conservatorship can be an expensive and time-consuming process, and that it is a public process.

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