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


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.

Lamson & Cutner, P.C.
9 East 40th Street
New York, New York 10016
 
Contact Information:
Phone: (888) 618-3701

Fax: (212) 486-1600 Web Site: www.elder-law-lawyer.com
    BLOG The Best Elder Law Blog
   


800AgeInfo - Information on Programs - Caregiver Support Page

800AgeInfo - Information on Programs - Caregiver Support Page

Caregiver Support


(caring for an individual)

The Massachusetts Family Caregiver Support Program (MFCSP) is
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:


  • 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.
Caring for a loved one can be overwhelming and at times stressful,
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)
  1. The Comfort Care DNR is designed to allow EMTs and first responders to honor a DNR order in an out-of-hospital setting.
  2. 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.
  3. The Comfort Care DNR protocol provides for a statewide, uniform DNR verification protocol.
  4. 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.
  5. Comfort Care DNR order verification forms must be completed and signed by the patient’s physician, authorized Physician’s Assistant or Nurse Practitioner.
  6. 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.
  7. 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


Comfort Care - Do Not Resuscitate
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

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. Code Comfort is for patients with a DNR order who desire comfort measures. Use of the order set will promote comfort for patients at risk for symptom crisis nearing end of life. Code Comfort Order Set Code Comfort Policy (draft)

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

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
May 21, 2014 by
May 21, 2014 by
 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 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?


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




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 disabilities
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.

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}

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

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

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

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


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

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

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

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



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

Questions to Ask About Medical Equipment and Supplies

Sample for disucssion:

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












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

Create A Better Day Café Marlborough , MA USA

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

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

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

There is no cost.

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

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


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

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



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



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

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

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

{end quote}

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

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

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

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

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

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

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






Alzheimer's Association list of safety services

stlreportsafetyservices.pdf





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


St. Louis Chapter
24/7 Helpline: 800.272.3900
www.alz.org/stl

VNSNY Professionals - Healthcare in Transformation

VNSNY Professionals - Healthcare in Transformation

 At VNSNY, we consider care coordination our core expertise, precisely because it is the one practice designed to overcome fragmentation. Patient-centered, evidence-based and protocol-driven, the VNSNY model of care replaces fragmentation with continuity.  It knits together the patient experience across the care continuum–from setting to setting, from provider to provider, from transition to transition.

That is why it is called VNSNY CO•CARE–comprehensive, continuous, collaborative and community-based. VNSNY CO•CARE means care we manage together:
- See more at: http://professionals.vnsny.org/why-vnsny/healthcare-in-transformation/#sthash.6OPe7DfF.dpuf

At
VNSNY, we consider care coordination our core expertise, precisely
because it is the one practice designed to overcome fragmentation.
Patient-centered, evidence-based and protocol-driven, the VNSNY model of
care replaces fragmentation with continuity.  It knits together the
patient experience across the care continuum–from setting to setting,
from provider to provider, from transition to transition.


That is why it is called VNSNY CO•CARE–comprehensive, continuous,
collaborative and community-based. VNSNY CO•CARE means care we manage
together:

- See more at: http://professionals.vnsny.org/why-vnsny/healthcare-in-transformation/#sthash.6OPe7DfF.dpuf
At
VNSNY, we consider care coordination our core expertise, precisely
because it is the one practice designed to overcome fragmentation.
Patient-centered, evidence-based and protocol-driven, the VNSNY model of
care replaces fragmentation with continuity.  It knits together the
patient experience across the care continuum–from setting to setting,
from provider to provider, from transition to transition.


That is why it is called VNSNY CO•CARE–comprehensive, continuous,
collaborative and community-based. VNSNY CO•CARE means care we manage
together:

- See more at: http://professionals.vnsny.org/why-vnsny/healthcare-in-transformation/#sthash.6OPe7DfF.dpuf


At
VNSNY, we consider care coordination our core expertise, precisely
because it is the one practice designed to overcome fragmentation.
Patient-centered, evidence-based and protocol-driven, the VNSNY model of
care replaces fragmentation with continuity.  It knits together the
patient experience across the care continuum–from setting to setting,
from provider to provider, from transition to transition.


That is why it is called VNSNY CO•CARE–comprehensive, continuous,
collaborative and community-based. VNSNY CO•CARE means care we manage
together:

- See more at: http://professionals.vnsny.org/why-vnsny/healthcare-in-transformation/#sthash.6OPe7DfF.dpuf
At
VNSNY, we consider care coordination our core expertise, precisely
because it is the one practice designed to overcome fragmentation.
Patient-centered, evidence-based and protocol-driven, the VNSNY model of
care replaces fragmentation with continuity.  It knits together the
patient experience across the care continuum–from setting to setting,
from provider to provider, from transition to transition.


That is why it is called VNSNY CO•CARE–comprehensive, continuous,
collaborative and community-based. VNSNY CO•CARE means care we manage
together:

- See more at: http://professionals.vnsny.org/why-vnsny/healthcare-in-transformation/#sthash.6OPe7DfF.dpuf

myhomehelper - award winning memory aid

myhomehelper - award winning memory aid


what is myhomehelper?

myhomehelper is the innovative new memory aid developed from the personal experience of assisting a family member living with dementia.

It is a 9.7 inch on-line digital display, specifically designed to support people living with memory impairment and learning difficulties in their own homes. myhomehelper helps to reduce anxiety and isolation and gives peace of mind, reassurance and confidence to family and carers.

    Features
    Calendar Clock
    Diary
    Timed and Random Reminders
    Photos
    News Headlines
    Auto answer Skype Video Calling
    Facebook Messages
    Night Mode
    Multi User Access
    SMS and e-mail system to carers
    Multi Language

Developed from ideas and feedback given from service users and carers in trials of the system over the last 3 years, the user centred design ensures that it is ideal for people with no computer or IT experience and requires no interaction from the user for it to work.
how does it work?

myhomehelper comes pre-installed on a tablet computer that has been configured to run the system optimally from the moment that you turn it on.

A simple set-up system can be accessed by family, friends and carers to tailor the system to suit individual needs via the myhomehelper website, from anywhere that has access to an internet connection - be that at home, work or even on holiday.

It has been designed as an "always on" system and once set-up only needs to be maintained when new activities, appointments or photos etc need adding. The end user does not have to do anything but look at the display occasionally to benefit from it - there is no other interaction required.

--


how much does it cost?

myhomehelper costs £333.33 (ex VAT) for the first year and then either £7.49 per month or £77.88 per year thereafter to continue using the on-line features.

The price includes:

    a tablet computer configured for myhomehelper
    12 month myhomehelper subscription
    tablet stand
    18 month warranty
    on-line technical support


New US Goverment organization, the Administration for Community Living (ACL). WE should be able to live at home

About ACL

All Americans—including people with disabilities and older adults—should be able to live at home with the supports they need, participating in communities that value their contributions. To help meet these needs, the U.S. Department of Health and Human Services (HHS) created a new organization, the Administration for Community Living (ACL).
ACL brings together the efforts and achievements of the Administration on Aging, the Administration on Intellectual and Developmental Disabilities, and the HHS Office on Disability to serve as the Federal agency responsible for increasing access to community supports, while focusing attention and resources on the unique needs of older Americans and people with disabilities across the lifespan.

Caregivers
A caregiver is anyone who provides help to another person in need. In this section, we provide links to a wealth of information on the Internet designed to assist family members and caregivers.
  • Alzheimers.gov
    This site is the government’s resource for Alzheimer&rsqup;s and related dementias.
  • Alzheimer’s & Dementia Caregiver Center External Web Site Policy
    This site provides information about day-to-day help and services in your community; getting support; or preparing for the future.
  • ARCH National Respite Network External Web Site Policy
    The ARCH National Respite Network and Resource Center provides resources to help families locate respite and crisis care services.
  • Family Caregiver Alliance External Web Site Policy
    The site contains a wide array of publications and services based on caregiver needs, including a Family Care Navigator.
  • National Alliance for Caregiving External Web Site Policy
    The site contains publications and resources for caregivers, including the Family Care Resource Connection, where you can find reviews and ratings on over 1,000 books, videos, Web sites, and other materials on caregiving.
  • Caregiver Action Network External Web Site Policy
    The site offers a virtual library of information and educational materials for family caregivers.
  • eXtension External Web Site Policy
    This website was created by the United States Department of Agriculture (USDA), Cooperative Extension System. Here, caregivers and advocates can access a wide range of information and materials designed to help them learn about and provide supportive services to family and relative caregivers. Topics include disaster preparedness, military families, grandparents raising grandchildren, housing, and nutrition.
  • HHS Office of Women’s Health (OWH)
    The OWH website provides an extensive list of links of interest to caregivers.

Older Adults

  • Alzheimers.gov – This site is the government's resource for Alzheimer's and related dementias.
  • Eldercare Locator – The ACL Eldercare Locator is a website and call center that links you to state and local agencies on aging and community-based organizations that serve older adults and their caregivers.
  • Check for Benefits External Web Site Policy – The BenefitsCheckUp Website helps consumers find benefits programs that help them pay for prescription drugs, health care, rent, utilities, and other needs. The BenefitsCheckUp Website includes information from more than 1,650 public and private benefits programs from all 50 states and DC.
  • Find Helpful Publications and Website Resources – A part of the Eldercare Locator Website, here you will find useful topic-specific resources for older adults, caregivers and aging professionals.
  • Long-Term Care Planning – Long-term care includes a variety of services and supports to meet health or personal care needs over an extended period of time. The National Clearinghouse for Long-Term Care Information Website provides information and resources to help individuals plan for future long-term care.

Understanding theDementia Experience

by Jennifer Ghent-Fuller, B.A., R.N., M.Sc.N.

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
Thoughtful Dementia Care TM
ISBN: 978-0-9881678-2-7

Coach Broyle's Playbook alzheimersplaybook.pdf

alzheimersplaybook.pdf

Loads PDF file for reading on your browser now:
This “Playbook for Alzheimer’s Caregivers”
is a social model, not a medical model (doing things with
her, not for her). It was written to give you practical tips
to help guide you in taking care of your loved one with Alzheimer’s disease


Frank Broyles
University of Arkansas,
Razorback Athletic Director Emeritus

Available from Amazon | Coach Broyles' Playbook for Alzheimer's Caregivers: A Practical Tips Guide

Alzheimer's and Dementia: Global Resources

Alzheimer's and Dementia: Global Resources: Worldwide, at least 44 million people are living with dementia. To serve this global population, as well as their families and caregivers, the Alzheimer's Association has translated its most popular and unique online resources and tools.

Jean Dickinson
Vice President of Marketing & Communications at Alzheimer's Association, California Southland Chapter
 
 
It's time to celebrate. Our group is now 20,000 members strong. This includes many members from around the world. It's also indicative of the growing interest in Alzheimer's disease and related dementias and the increasing number of people affected each day.

The Alzheimer's Association has "gone global," too. Please take a moment to visit our new Web portal at http://www.alz.org/global/ It has information in many languages along with in-country resources. We encourage you to link to us!

Alzheimer's & Dementia: Global Resources
    Country-specific Alzheimer's statistics, research plans and local support services.
    Educational content covering risk factors, symptoms, diagnosis and treatment.
    An overview of the Alzheimer's Association role in funding critical dementia research.
    An interactive brain tour.
    A call to action for the global community to join the cause.

Content can be accessed by country or language.

Gina Shaw, It Takes a Team: How to coordinate your loved one's care—and take care of yourself in the process. -- American Academy of Neurology

It Takes a Team: How to coordinate your loved one's care—and take care of yourself in the process. -- American Academy of Neurology
 You may have been thrust into the role of caregiver for a loved one with a neurologic condition suddenly—perhaps as the result of a traumatic brain injury or stroke. Or it may have happened more slowly, with the progression of multiple sclerosis, Alzheimer's disease, or Parkinson's disease. Either way, you will need a team of experts to help you coordinate your loved one's care. These professionals can be of enormous help, but sometimes just figuring out who is involved in your loved one's care, and what they do, can seem insurmountable.

To help you, we've identified some of the key healthcare professionals involved in caring for someone with a serious...... condition. Here's how you can work with them.

ALZ Connected - Alzheimer's Association

ALZ Connected - Alzheimer's Association
Here's a
PDF brochure from the Alzheimer's Association that describes/discusses
legal planning and documents for the care of persons with AD/dementia.
It includes discussions on POAs and guardianships.

http://www.alz.org/national/documents/brochure_legalplans.pdf

The Validity of Online Contracts

The Validity of Online Contracts      



 It is basic, black letter, first week in law school law
that in order to have a valid contract, there must be at least 3
essential elements.   These elements are an offer, acceptance and
consideration.




        The concept of “offer” is simple: a web site offers goods,
services, software, membership in the site etc. etc. and that offer is
contained, for the sake of this article, in some sort of agreement
posted on the site.




        “Consideration” for the sake of extreme simplicity and
because it is not germane to this article, involves something of value
being exchanged between the parties.  Let’s just leave it at that.




        This article deals with how, in the context of the
Internet, the element of “acceptance” can be satisfied so that, assuming
the validity of a given offer and a valid consideration, a binding
obligation can be created.




Family Caregiver Stress Relief | Caregiver Stress

Family Caregiver Stress Relief | Caregiver Stress



 There are ways to make personal care tasks easier, though. As a senior
care professional, you’ve likely learned to overcome those awkward
situations with your patients as well. Here are seven suggestions you
can recommend to family caregivers. {end quote}



Ask Dr. Amy



Dr. Amy D'Aprix, MSW, PhD, CSA, is  Executive Director of the DAI Foundation on Caregiving.

Dr. D'Aprix's focus on providing service for seniors and their caregivers started at the State University of New York at Albany, where she concentrated on Aging Studies in both her BS and MSW programs. During her doctorial program at Case Western Reserve University in Cleveland Ohio, Dr. D'Aprix received a Doctoral Fellowship from the Mandel Alzheimer's Caregiving Institute. In addition to her university degrees, Dr. D'Aprix holds the designation of Certified Senior Advisor and is currently on the International Faculty for the Society of Certified Senior Advisors and the Canadian Academy of Senior Advisors.




Ten Things to Think About: Lawsuits - FindLaw

Ten Things to Think About: Lawsuits - FindLaw



Lawsuits
are serious business, requiring plenty of time, energy, and money. Here
are some things to consider if you are involved in litigation - See
more at:
http://litigation.findlaw.com/filing-a-lawsuit/ten-things-to-think-about-lawsuits.html#sthash.tWbzQLv0.dpuf
Lawsuits
are serious business, requiring plenty of time, energy, and money. Here
are some things to consider if you are involved in litigation - See
more at:
http://litigation.findlaw.com/filing-a-lawsuit/ten-things-to-think-about-lawsuits.html#sthash.tWbzQLv0.dpuf


Lawsuits
are serious business, requiring plenty of time, energy, and money. Here
are some things to consider if you are involved in litigation. - See
more at:
http://litigation.findlaw.com/filing-a-lawsuit/ten-things-to-think-about-lawsuits.html#sthash.tWbzQLv0.dpuf
Lawsuits
are serious business, requiring plenty of time, energy, and money. Here
are some things to consider if you are involved in litigation. - See
more at:
http://litigation.findlaw.com/filing-a-lawsuit/ten-things-to-think-about-lawsuits.html#sthash.tWbzQLv0.dpuf
Lawsuits
are serious business, requiring plenty of time, energy, and money. Here
are some things to consider if you are involved in litigation. - See
more at:
http://litigation.findlaw.com/filing-a-lawsuit/ten-things-to-think-about-lawsuits.html#sthash.tWbzQLv0.dpuf
Lawsuits
are serious business, requiring plenty of time, energy, and money. Here
are some things to consider if you are involved in litigation. - See
more at:
http://litigation.findlaw.com/filing-a-lawsuit/ten-things-to-think-about-lawsuits.html#sthash.tWbzQLv0.dpuf
Lawsuits
are serious business, requiring plenty of time, energy, and money. Here
are some things to consider if you are involved in litigation. - See
more at:
http://litigation.findlaw.com/filing-a-lawsuit/ten-things-to-think-about-lawsuits.html#sthash.tWbzQLv0.dpuf
Lawsuits
are serious business, requiring plenty of time, energy, and money. Here
are some things to consider if you are involved in litigation - See
more at:
http://litigation.findlaw.com/filing-a-lawsuit/ten-things-to-think-about-lawsuits.html#sthash.tWbzQLv0.dpuf
Lawsuits
are serious business, requiring plenty of time, energy, and money. Here
are some things to consider if you are involved in litigation - See
more at:
http://litigation.findlaw.com/filing-a-lawsuit/ten-things-to-think-about-lawsuits.html#sthash.tWbzQLv0.dpuf

IKOR of Greater Columbus: How to choose an aide/caregiver/unlicensed personnel

ABOUT NON-AGENCY CAREGIVERS
  • Who will be providing oversight? 
  • Who will conduct the background search to make sure this person does not have a criminal past? 
  • What happens if this person gets injured on the job? Are YOU willing
    to pay for workers comp insurance so the person does not try to sue you
    or your loved one if injured while caregiving? 
  • Will you document the care for tax reasons? Bills can add up quickly
    and can make a big difference during tax time if you can write off the
    expenses, or not write them off if you are not tracking expenses. 
  • What about other insurance and bonds to protect your loved one that is provided by reputable agencies. 
  • Again- not all agencies have these protections in place, make sure you do your due diligence!

Seniors staying in their homes more instead of moving to assisted living centers

Seniors staying in their homes more instead of moving to assisted living centers



"Samah Assad/SAssad@MorningJournal.com

 Samah covers Oberlin, Westlake, Sheffield, and crime and cops. She loves all things Cleveland. Reach the author at sassad@morningjournal.com
or follow Samah on Twitter: @SAssadMJ.




John Schlotterer, left, of Elyria has been the full-time primary
caregiver for his 85-year-old mother Helen. They have recently begun
utilizing the Home Instead Senior Care office that serves Lorain County"





 Karin Wolff, a registered nurse and owner of the Home Instead Senior
Care office, which helps seniors and their caregivers in Lorain County
prepare older adults for aging, said 85 percent of seniors have not
educated themselves as to dangers they could face in the home. The
center’s caregivers primarily visit homes and provide transportation,
housekeeping and personal care for seniors.





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

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

Caregiver Resilience: What It Is and Why It Matters for Family Caregivers | Griswold

Caregiver Resilience: What It Is and Why It Matters for Family Caregivers | Griswold

In Resilience, Steven Southwick and Dennis Charney (2012) outline ten ways that resilient people tend to cope with stress.  The good news is that these can be learned and developed.
1.      Realistic Optimism: Viewing life in a hopeful,
confident way. Anticipating a bright future.  Believing that good things
are coming and hard work will yield success.  Realistic optimism is the
foundation of resilience, and fuels each of the following resilience
factors.
2.    Social Support: Connecting with other people by
seeking out and accepting help that is offered, and also by giving help
to those in need.
3.   Facing Fear: Using thoughts and behaviors to triumph
over fear.  Acting in spite of fear to accomplish goals and become
stronger.
4.   Religion and Spirituality: Turning to God, or a Higher
Power.  Engaging in formal religious services or private spiritual
practices.  Finding inspiration in nature or the arts.
5.   Meaning, Purpose and Growth:  Finding strength and
courage by pursuing an inspiring goal.  Using adversity as a catalyst
for growth.  Actively serving a purpose that is greater than
self-interest.  Transcending traumatic experiences by helping others who
have been traumatized.  Choosing to be a victor, rather than a victim.  
6.  Moral compass/Altruism: Engaging in right actions and avoiding doing wrong. Thinking of and serving others.
7.   Role models: Imitating people who demonstrate positive
ways of handling adversity.  Identifying real people, living or dead;
fictional characters, famous individuals or historic figures.
 Replicating small aspects of their behavior that have led to positive,
desired outcomes.
8.  Training: Improve physical health and preventing or
diminishing the effects of chronic illnesses by keeping the body fit.
 Mastering physical challenges to also improve mental health and
emotional regulation.   
9.  Brain fitness: Focusing thoughts, and challenging the
mind so the intellect is sharp and continues to grow.  Regulating
emotions to eliminate feelings that undermine effective coping.
10.  Flexibility: Employing a variety of mental and
emotional strategies to handle adversity; accept what can’t be changed;
learn from failure; transform negative energy into positive energy; and
find opportunity and meaning in adversity.