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Hospice is likely to be the most important health care decision we make. by Joy Loverde

Hospice: I had no idea | Eldercare Blog: Families have a choice in hospice programs.
Hospice is likely to be the most important health care decision we make. For a long time, we could assume that every hospice provided high-quality care. That assumption is no longer safe. Families must shop around. To start the process, request a home visit for patient assessment and a customized Q & A. How receptive a hospice is to the following questions is an indicator of the quality of their program:

What do others say about your organization? Get references.
How long has the hospice been in operation?
Is the hospice Medicare-certified?
What is the expectation regarding the family’s role in caregiving?
Is there anything currently being done for the patient that you would not do?
(Make a list of specific family needs.) How will you address these needs?
What extra services are offered?
Is your availability 24/7?
How rapid is crisis response?
Do patients ever get transferred to inpatient care? Under what circumstances? And where do they go?
Is family respite care available? What kind? Under what circumstances?
Are your MDs/RNs certified in palliative care?
How are family complaints handled?
What kind of emotional support do you provide – now and after?

This is just brilliant! It can help so many people..

This is just brilliant! It can help so many people....Please SHARE, let's make this available for everybody! :)

Posted by Motivational and Inspirational Quotes on Thursday, August 20, 2015

New techniques to move patients safely



 Patient transfer

medicaresystem.net/company/distributors

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 InnoCare Health Corporation is a leading supplier of AEDs and related products and accessories across the United States. We are a family-owned and operated company and we pride ourselves on our ability to combine the most competitive pricing with outstanding customer service.

The Top Two Misconceptions about ADA Compliance at Your Senior Community | Senior Housing Forum

The Top Two Misconceptions about ADA Compliance at Your Senior Community | Senior Housing Forum: “But our resident units are accessible.”

While your resident units are accessible, you must remember that ADA accessibility is also about accommodating the general public and your employees.

This means all public accommodations at your senior care community, inside and out, should be in compliance.

“What often gets reported are violations that occur outside of the resident dwelling units, such as the lobby, public restrooms or parking lots,” said Greg. “Many senior care providers often forget that these areas need to be compliant, and since they have never received a complaint or violation, they continue to operate under the assumption that nothing needs to be changed.”

And don’t forget, you should also be cognizant of your employees’ work areas, such as the staff break rooms and bathrooms, which also need to be accessible.

How loved ones can help prevent patients developing delirium in hospital | Liz Charalambous | Society | The Guardian

 Health
John's Campaign
How loved ones can help prevent patients developing delirium in hospital
In the first of a series by health professionals on the importance of family and volunteers helping with a condition in hospital, we hear from a nurse at Nottingham University Hospital Ward B48



 How loved ones can help prevent patients developing delirium in hospital | Liz Charalambous | Society | The Guardian

What to Do When You Suspect Abuse in Your Parent's Retirement Home - AgingCare.com

What to Do When You Suspect Abuse in Your Parent's Retirement Home - AgingCare.com: What to Do If You Suspect Abuse in Your Parent's Retirement Home

I think most of us approach the idea of sharing the care of an elder with a lot of trepidation. We have cared for them with one-on-one loving attention. We know their history, their preferences, their tempers and their needs. Bringing others, no matter how experienced, into the equation is counter-intuitive.
, Expert
Author, speaker, columnist and eldercare consultant

  1. If
    possible, talk nicely with the CNA or hands-on person you think may
    need some direction. Talk kindly, and take some of the load off by
    saying, "Mom can be sensitive, and I know that. Is there a better way we
    can handle this?"
  2. If you don't get
    anywhere with that (all of this advice only applies if there isn't
    obvious abuse – if that is so, skip to the last step), talk with the
    floor supervisor, often a nurse.
  3. If
    that still doesn't get you a listening ear and some change – and if you
    are being realistic about your requests – then talk with the home
    administrator.
  4. If talking doesn't get you anywhere, write a letter and state the complaint and say that you will be contacting your state ombudsman.
    An ombudsman is an independent advocate who handles consumer complaints
    about government-regulated agencies. Since nursing homes are
    government-regulated agencies, they qualify. Assisted living centers may
    not, but it's worth a try. Then
    do so. You can go online to your state's website and look up aging
    services or you can go to the national site and find the National Long
    Term Care Ombudsman Resource Center at
    www.ltcombudsman.org.
    You will then type in the location of the home and you will find
    contact information. Carry through, and this person will investigate.
Don't ever be afraid to involve the ombudsman.

Learn what it takes to become a CAREGiver

The Heart of a CAREGiver    info@homeinsteadinc.com

Caring for seniors is a labor of love that requires a special person with just the right touch.

The Home Instead Senior Care® network is looking for dedicated CAREGiversSM who share its passion for caregiving to provide non-medical in-home care assistance to seniors.

 http://caregiversnewsbasket.blogspot.com/ 

Senior Fall Prevention: Help for Caregivers

Senior Fall Prevention: Help for Caregivers: Caregivers can help seniors reduce their risk of falling and remain independent in several proven ways.

Regular exercise is essential in helping seniors improve balance and gain strength. Check in with local senior centers and community groups to find out about fitness classes, such as Tai Chi, for older adults. Even seniors with limited physical fitness can increase their abilities over time.

It's important for caregivers to offer gentle support if seniors push back against a new exercise regimen. One way to get your aging loved one on board while also deriving benefits for yourself? Join in their routine.

Also, take time to fall-proof your aging loved one's home. Cords, wiring, newspapers, and other debris are hazardous when underfoot. Living spaces should be free of clutter with clear, well-lit pathways between rooms. Grab bars, railings, and other assistive devices further protect seniors against falls.

Event - healing heart houspitality house

Event - healing heart houspitality house: Healing Heart Hospitality House sponsors a Caregiver’s Support Group every third Thursday of the month.

Graciously hosted at Dodge Park Rest Home, 101 Randolph Rd., Worcester, MA from 6:00 p.m. to 8:00 p.m.

A Guide to Coping with Alzheimer's Disease - Harvard Health

A Guide to Coping with Alzheimer's Disease - Harvard Health

 This Special Health Report includes in-depth information on diagnosing
Alzheimer’s and treating its symptoms. Because caring for someone with
Alzheimer’s continues to be one of the toughest jobs in the world, the
report includes help for family members and caregivers, as well as for
the individuals with Alzheimer’s.

Prepared by the editors of Harvard Health Publications in collaboration with John H. Growdon, M.D., Professor of Neurology, Harvard Medical School, and Director, Memory and Movement Disorders Unit, Massachusetts General Hospital. 53 pages. (2015)

Wheelchair to Car Transfers - Getting your patient AND the wheelchair in the car

home-health-care-physical-therapy.com/our-mission.html

Wheelchair to Car Transfers - Getting your patient AND the wheelchair in the car: Wheelchair to car transfers and wheelchair management is not exactly what most people think of when they think of home safety or independence ... but...

One of the toughest obstacles patients and caregivers alike face is that of getting in and out of a vehicle and accomplishing this safely for both patient and caregiver. No doubt this IS part of a wise home safety checklist. If attempted without any forethought, disaster can lurk at any point in this sometimes tricky transfer.

Yet, mastering this wheelchair to car transfer can spell freedom and excitement for years to come for those otherwise "stuck" at home. It is my theory that those disabled by stroke or any any other means live longer lives when they can go out with a caregiver. And getting out means getting in the car, going, and getting back out of the car.

Of great importance next to seat belt use and the like is your planning for this essential ability.

You may master the car transfers without a hitch until you turn and see that ole wheelchair. Unless it's truly a window shopping ride, that wheelchair needs to come along too. With so many moving parts, though, it can be tougher than getting mom or dad to get in the car!

Do-It-Yourself Home Health Physical Therapy is a free e-zine that is sent to you when something happens here worth notifying you about. In the future, we will be sending this out on a monthly (and possible weekly) basis. Either way, your Do-It-Yourself Home Health Physical Therapy newsletter keeps you up to date on hot home health care topics that affect your rehabilitation at home.

Beoynd the Video: Home Care—Lifting and Moving Your Loved One

Beoynd the Video: Home Care—Lifting and Moving Your Loved One: beyond the video
Home Care—Lifting and Moving Your Loved One

Video summary
This video demonstrates basic techniques for moving a person with limited mobility, such as after a stroke, from bed to wheelchair and back again.

The steps for each maneuver are simply stated, but these are the things you need to know first:

Help the person to work with you by placing yourself so that his stronger side is on the edge closest to the bed or chair.
Tell the person what you are going to do and that the move will take place when you say "Now" so that he is prepared and can work with you.
Always bend your knees and keep your feet spread about shoulder-width apart so that you can lift with your legs, not your back.
Use a transfer belt that is fastened around the person's waist with room for you to get your fingers underneath it for each lift. You will be reaching both arms around his waist (closer to his back) and putting your fingers underneath the bottom of the belt, with your thumbs at the top of the belt. This makes the transfer easier for you and also helps the person feel more secure.

How To Get Up After a Fall – A Short Video from Learn Not to Fall

How To Get Up After a Fall – A Short Video from Learn Not to Fall: LEARN HOW TO GET UP
Review Your Risk Now
How to get up
How to call for help



In this short video, Dr. Dorothy Baker, RN PhD, explains the importance of knowing how to get up if you fall, and shows a senior demonstrating these techniques.A  printable copy (PDF) of illustrated instructions on how to get up is available

 
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----
Alzheimer's Safety Proofing Households, Devices and Equipment
http://dandyfunk4.blogspot.com/

Follow : Dave's Knowledge Networks  http://tinyurl.com/ny62zh3
“The beautiful thing about learning is nobody can take it away from you.”   B.B. King

Hidden Costs of Assisted Living - AgingCare.com

Hidden Costs of Assisted Living - AgingCare.com:

, Expert
Author, speaker, columnist and eldercare consultant

The strong suit for in-home care agencies is their flexibility. During my years of caregiving for multiple elders, I used the services of two different in-home care agencies in the traditional manner, which was to fill the gaps in home care that I couldn't provide for my loved ones.

One of the reasons that assisted living centers are appealing to many people is that they offer a relatively high level of independence. If your parent is in good health and doesn't require much assistance with everyday tasks, assisted living is a terrific option. In fact, residing in an assisted living center is similar to having a private apartment, complete with private bathroom and kitchen, but you can rest easy with the knowledge that trained staff is on hand to help your loved one when necessary.

However, assisted living centers are not all cut out of the same mold. Depending on what part of the country you live in, what you get at assisted living may cost more.

Assisted living facilities provide a safe environment with convenient meals and social opportunities in their "base package." They are generally set up so that an elder can obtain help if he or she falls or has another emergency. Many also offer transportation by bus or other means for group outings or to specific locations.

But what about the basics of personal care: help with dressing, bathing, keeping track of prescription refills, setting up daily doses, injecting medications such as insulin, and a companion for trips to doctor appointments? Many assisted living facilities don't provide it in the "base" package. The services are add-on pricing.

So make sure you understand what services they do and don't offer per the contract, and what services may be available, but would cost extra. You might get some services you are expecting, but not all.

It works differently at different communities. At Emeritus Senior Living in Bonita Springs, FL the base rent is for what is called independent living. Any room could become an assisted room if the resident has a health care need. A caregiver goes to the room to help with showering, medication management and more. But, there's a fee for that.

Confabulating and Confabulations


Everyone and particularly medical personnel and caregivers must understand!
Confabulating and Confabulations

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.
Not only is memory damaged their ability to process thoughts and conversations is impaired.

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

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

PRINT THIS OUT AND GIVE OUT

The Truth About Hospice | Author- Kathryn Watson

"Hospice is about living not about dying."

The Truth About Hospice - Kathryn Watson

Independent Elder Care Consultant-Kathryn WatsonLike many today, Kathryn Watson was thrust into the world of Eldercare with little knowledge or understanding of the industry.

  Podcast- Listen to A Hospice Social Worker Explain  “What is Hospice” 

 The challenges Kathryn Watson overcame led her to write Help! My Parents Are Aging  Five steps to help you make the right decision regarding their care Paperback
      and
Help! I Can’t Do This Alone   When caring for your spouse becomes too hard Paperback


3 Factors to Help You Compare Nursing Home Care - AgingCare.com

, Expert
President and CEO, eHealth Medicare
 3 Factors to Help You Compare Nursing Home Care

Chances are, at some point you or a loved one may need to spend time in a nursing home.

 In fact, about 70 percent of Americans will need a form of long-term care at some point in their lives. As more baby boomers continue to turn 65 — seniors are expected to comprise 19 percent of the population by 2030 — a growing number of people will be looking for the right place to receive the care and services they need.


3 Factors to Help You Compare Nursing Home Care - AgingCare.com

Today's Geriatric Medicine - Alzheimer's/Dementia

Today's Geriatric Medicine - Alzheimer's/Dementia


    Dementia and Inappropriate Sexual Behavior
    Cognitive Evaluation for Memory Concerns
    Lifestyle Influences Brain Health
    Alzheimer's Research Comes of Age
    Music and Art in Memory Care
    Behavioral Expressions in Dementia Patients
    Alzheimer's Diagnosis in Primary Care
    Cognitive Decline Screening and Resources
    Gait Speed Reflects Cognitive Function
    Interventions Slow Brain Atrophy
    Lighting Affects Dementia Patients’ Sleep
    Therapeutic Options in Alzheimer’s Disease
    Holistic and Creative Arts Therapies in Alzheimer’s Care
    Fish Oils and Cognitive Function
    Alzheimer’s Disease and the Blood-Brain Barrier
    Evidence-Based Memory Preservation Nutrition
    New Target for Therapy in AD Patients
    Memory Maintenance
    Pharmacological Prospects for Alzheimer’s Treatment
    Medications Target Alzheimer’s Disease
    What Should You Tell Patients About Alzheimer’s?
    DBS to Treat Alzheimer’s Patients?
    The Gait-Cognitive Decline Connection
    Can You Recognize Lewy Body Dementia?
    Recruiting Patients for Alzheimer’s Clinical Trials
    Dementia and DSM-5: Changes, Cost, and Confusion
    Alzheimer’s Staggering Financial Impact
    12/15-Lipoxygenase’s Role in AD Prevention
    New Technology to Detect, Diagnose AD
    Dementia Care Model Facilitates Quality Outcomes
    Integrating Palliative Medicine With Dementia Care
    Dementia-Related Behavior Management
    Combating Dementia With Infrared Light?
    Deep Brain Stimulation
    Becoming ADEPT at Predicting Mortality
    New Biomarkers for Alzheimer’s Disease
    MMSE vs. MoCA: What You Should Know
    Vitamins and Dementia — Delaying Cognitive Decline?
    Dealing With Dysphagia
    New Molecular Tools Developed in Alzheimer’s Research
    Hope for an Alzheimer’s Cure?
    Alzheimer’s Cure on the Horizon?
    Imaging Alzheimer’s Disease
    Cognitive Camouflage — How Alzheimer’s Can Mask Mental Illness

How the Invention of Alzheimer's World Changed My Life Alzheimer's Reading Room

How the Invention of Alzheimer's World Changed My Life Alzheimer's Reading Room: How the Invention of Alzheimer's World Changed My Life

 Alzheimer's Reading Room    The best way to find Solutions to the Problems that Alzheimer's and dementia caregivers face each Day



The best way to find Solutions to the Problems that Alzheimer's and dementia caregivers face each Day
- See more at: http://www.alzheimersreadingroom.com/2011/07/why-i-invented-alzheimers-world-and.html#sthash.xGvr50v3.dpuf

The best way to find Solutions to the Problems that Alzheimer's and dementia caregivers face each Day
- See more at: http://www.alzheimersreadingroom.com/2011/07/why-i-invented-alzheimers-world-and.html#sthash.xGvr50v3.dpuf

Dealing With Angry Seniors Under the Same Roof By Sarah Peterman on July 8, 2015

Angry & Elderly: Dealing With Angry Seniors Under the Same Roof   http://tinyurl.com/oqc8g56

By on July 8, 2015 under Aging in Place as a Family, Process of Aging, Senior Care Advice
{QUOTE}
Every experienced family caregiver knows that seniors have their good days and bad days. Mood swings resulting from dissatisfaction, poor health, stress, pain, and a loss of dignity can easily lead to your loved one to lash out against you and others that they care about. Being a family caregiver under these conditions can be particularly stressful for the sandwich generation, who are “sandwiched” between living with an elderly parent and caring for their own children.

While dealing with these feelings and the emotional strain they cause can require a considerable amount of patience and empathy, there’s much more you can do than simply hope for more good days than bad ones. Below you can learn about several simple steps you can take to help those you look after to be less cranky, and help preserve your own wellbeing as a family caregiver in the process.

Download A Free Guide to Dealing with Elderly Anger

Emotional Turmoil in the Elderly

Getting older can magnify our character traits, often in undesirable ways. Someone who was crabby in their younger days may be prone to full-on bouts of rage in old age. Unfortunately, caregivers are often the target of these outbursts, and it may seem at times as though there may be no simple solution to deal with this type of behavior. After all, when outbursts are not caused by serious problems like chronic pain or difficulties in memory, they’re often the result of serious illnesses like Alzheimer’s or dementia, over which your loved one has no control.

How to Handle Anger

The first step to dealing with these problems is to understand that you shouldn’t take these negative emotions and their associated behavior personally. Pain and disease can cause us to act in very inappropriate ways, and it’s important to take any opportunity for a break from your caregiving duties that you can get. In the long term, you’ll likely want to spread caregiving amongst as many friends and family members as you can to make the possibility of these breaks more frequent.

The best solution to dealing with difficult elderly parents is almost always communication. Unfortunately, parents can be generally uneasy talking with their children about fears of the future, finances, and their mortality. If your loved one seems increasingly frustrated, anxious, or otherwise emotionally disturbed, it’s your responsibility to find out why if you want to help fix the problem. The next time both of you are in a pleasant mood, try warming them up to the conversation, and be ready to try several times before you’re successful.{END QUOTE}

Read more: http://www.griswoldhomecare.com/blog/dealing-with-elderly-anger/#ixzz3fUK21wz9

Legal Issues – Revoking prior Powers of Attorney

From Jim Koewler's The Koewler Law Firm website
The agent named in a now-revoked POA may not be happy about being
replaced.  That deposed agent may use the authority in the old POA to
take actions with the principal’s assets.  The bank or investment office
or real estate agent (or anyone else, for that matter) has no way to
know that the POA has been revoked.  (Not many former agents would act
out in this manner, but those few that would certainly can hurt their
principals.)

To avoid an old POA being accepted as current, there are practical steps (in addition to the legal steps) to revoke an old POA.


The principal should try to retrieve all of the copies of the prior
POAs.  Retrieving all of them can be a daunting task if there are a
number of copies.  (Most POAs have a statement that a copy is to be
honored just like an original, so retrieval of copies is important.)

For advice, representation and peace of mind through these difficult issues, contact Jim Koewler of The Koewler Law Firm. Legal Issues when someone has Dementia – Revoke prior Powers of Attorney |

CMS will modify—not scrap—two-midnight' rule - Modern Healthcare

 Under the two-midnight rule, the CMS directs its payment contractors to assume a hospital admission was appropriate if a patient's stay spanned two midnights and otherwise should have been billed as an outpatient observation visit.

 The rule was conceived to address a spike in observation stays attributed to hospitals' fear that Medicare audit contractors would challenge their admissions.

 Many patients, as a result, found themselves ineligible for skilled nursing after spending days in the hospital because their stay had been billed as observation.

 CMS will modify—not scrap—two-midnight' rule - Modern Healthcare

5 Steps for Dealing with Anticipatory Grief - Visiting Nurse Service of New York

5 Steps for Dealing with Anticipatory Grief - Visiting Nurse Service of New York: It might be the hardest part of caregiving: Watching your loved one slip away step by terrible step, knowing you can’t stop the decline and grieving the loss of the person you once knew, long before they’re actually gone. Psychologists call this process anticipatory grief, and it’s very common among caregivers and family members of those suffering from Alzheimer’s disease, cancer and other terminal illnesses.

“As a disease progresses, there is so much frustration and sadness associated with watching the person you once knew go away,” says Vince Corso, M.Div, LCSW, CT, Manager of Hospice Psychosocial Services, VNSNY. “It can be overwhelming.”

What Goes Into a Life Care Plan? | Hill Law Group, PA

Data gathering Forms  | Hill Law Group, PA

 These  planning questionnaires are worth their weight in gold! Everyone should, IMCO, have a family records notebook built from these forms.

Dave M.



Personal Support Workers, or PSWs, are starting to fight back, but their wage increases equate to worry for clients, families and service provider agencies.

THE CAREGIVERS' LIVING ROOM A Blog by Donna Thomson: A Fight Between PSWs, Clients and Agency Service Providers Spells Trouble For All
an article by always erudite Howard Gleckman  He wrote in Forbes:

Should the aides who provide home care for frail elders and younger people with disabilities receive a living wage and decent benefits?  If they do, how can families, who often are unable to afford care today, be expected to pay those higher wages and benefits?  Should the market be allowed to set these prices, or should government intervene through minimum wage and mandatory overtime laws? …. These questions have set off an enormous, but largely unnoticed, political firestorm.  In some states, they have pit states against the federal government, people receiving care against their aides, and large home care agencies against independent direct care workers.

In Ontario, exactly the same questions are being asked. This time last year, the then Ontario Liberal Health Minister Deb Matthews and Finance Minister Charles Sousa announced an election promise of an increase in the minimum wage for 34,000 publicly paid Personal Support Workers to $16.50 an hour by April 1, 2016, up 32 per cent from the current rate of $12.50.  Implementation of that promise hasn’t been easy.   According to the Canadian Union of PublicEmployees (CUPE), some home and community care agencies have chosen not to implement the wage increase or they exclude sick leave, vacation and training hours in the new hourly wages.  The sum total effect, says a CUPE spokesperson, is that most Ontario PSWs have yet to receive a wage increase.

The real lives of personal care workers are documented in a new film titled CARE, due for release later this year.   The trailer is riveting and I recommend watching it HERE for a clear picture of the human side of our crisis in home and community care.

The care workers depicted in the film are all women.  They are mothers and daughters who have left their own families behind in more impoverished countries in order to care for more affluent strangers in the United States. 

Many care workers in Canada, the UK, Australia and New Zealand match this description.  Eva Kittay drills down into the issues surrounding immigrant care workers and the role they play in a larger, profit driven dynamic.

The migration of care workers is caused both by a pull, the need for care workers, and a push, the need of these women to provide for their families.


Eva Feder Kittay‘From the Ethics of Care to Global Justice

The truth is that people need care and care workers must be able to earn a living wage. 

New LinkedIn Group
Canadian Caregivers United is a new group on LinkedIn.

Palliative Care for Caregivers | Get Palliative Care

Palliative Care for Caregivers | Get Palliative Care
Mayo Clinic

Top 10 Things Palliative Care Clinicians Wished Everyone Knew About Palliative Care

August, 2013   By Jacob J. Strand, MD, Mihir M. Kamdar, MD , Elise C. Carey, MD

 Today, family caregivers provide about 80 percent of elder care, delivering meals, taking loved ones to doctor’s visits and managing medications and family conflicts. This results in lost work hours or lost jobs, high stress and serious declines in physical and mental health. Palliative care is a solution.

Get Palliative Care

Get Palliative Care


What Is Palliative Care

Learn more about adult and pediatric palliative care, refer to the glossary and get answers to some frequently asked questions.
How to Get Palliative Care

Talk to your doctor, find a hospital and meet with your palliative care team. Just two simple steps to get palliative care.
Is Palliative Care Right for You

Take a quiz to determine if palliative care is right for you or a loved one.

Home Health Aide Certification and Certificate Programs

Home Health Aide Certification and Certificate Programs

 Each state has its own requirements for home health aide certification. Some states only require that the employing agency be certified, while others require home health aides to pass a certification exam following completion of an educational program. Besides a skills assessment examination, certification may also require a state administered criminal background check. Some states maintain a registry database of certified home health aides that can be accessed by the public

===============

Home Health Aide Training Requirements in MA

Massachusetts does not require a State issued certification, nor is there a State exam required to be eligible to work as a Home Health Aide.  Instead the State recommends national certification through the National Association for Home Care and Hospice. The NAHC requires a 75 hour training course and a competency test before you are eligible to apply for their certification.

Caregiving Criticism and Unsolicited Advice From Family - AARP

AARP Home » Home & Family » Caregiving »How to Handle Criticis...
How to Handle Criticism While Caregiving
Well-meaning advisers try to help but some can cause hurt
by Barry J. Jacobs, PsyD., AARP, December 29, 2014

Take it from whence it comes

Caregivers would be well-advised (there's that word again) to not
just react to the message being given but to consider the background and
intentions of the messenger. Advisers often have a sincere desire to
help, because they truly are caring and invested. They just don't have
enough information and understanding to know how to actually be helpful.
They are also unaware that their good ideas may come across as
critical. If you express appreciation for their caring, they will
usually feel satisfied that they are making a difference and stop
pressing specific recommendations.


Some people, though, use pieces of advice as thinly veiled barbs. Out
of competitiveness or their own misery, they consciously or
unconsciously mean to take caregivers down a peg. They should be kept at
arm's length. It is seldom worth debating them or giving them the
satisfaction of having caused hurt.

 Caregiving Criticism and Unsolicited Advice From Family - AARP

staff scheduling and labor management

OnShift  provides staff scheduling and labor management software

They are focused entirely on the long-term care and senior living industry, software and services are built upon an in-depth understanding of how providers work day-in and day-out, and how industry regulations and issues affect their every move.

{ staff scheduling and labor management is of interest to the world of Caregiving}

Jan 26, 2015 Mark Woodka posted the following to their  Long Term Care & Senior Living Blog

For some strange reason we encourage ourselves to prognosticate about the future annually as one year recedes and another begins.  These projections might not always be correct, but I think they nicely balance out our attempts at New Year’s resolutions and give us something to aim for. (I hope this list goes more smoothly than those resolutions usually do…)

I’d like to outline my predictions for long-term care and senior living in 2015 – the big things that may change how you run your communities and provide care for your residents.  So without further ado, here we go:

    Affordable Care Act Penalties: The Employer Mandate began January 1 after two years of delays, and we must now be very, very cautious in managing our workforces to ensure we do not get penalized.  There was a bill proposed to exclude certain industries from having to participate due to large populations of lower-wage hourly workers and low margins.  Guess what?  One of the original intents of the ACA was to get these very workers healthcare benefits.   Therefore, this bill is a non-starter, and we will not see our industry excluded.   The Affordable Care Act will remain the law of the land until and unless we have a new party in the White House in 2016, so tracking employee hours will be key.
    
    More Doc Fix Activity: The game of kick-the-can that has been the Doc Fix for the past decade will continue.  However, in an effort to kick the can as far as possible, Adam Vinatieri will be the kicker, and he will kick it 21 months into the future.  This will nicely coincide with the new administration taking office in January of 2017.  (I don’t think Congress will want to deal with this again in 12 months.)  Ideally, our friends at AHCA will be able to focus the pay-fors to other segments or maybe even help them find a permanent solution if in fact there is an appetite for one.

- See more at: http://www.onshift.com/blog/5-game-changing-predictions-senior-care-2015#sthash.36ZATwXG.dpuf



==

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Next Generation Educators blog




Dealing with a “Code Brown”

Dealing with a “Code Brown” | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles
by Ani Burr, RN • October 22, 2010
When you are doing your best to get your client cleaned up, there is still that smell issue that can get in the way of your ability to focus and get in and out of there quickly! While it’s not guaranteed, you can try these tricks to protector your olfactory senses:

Caregiving MetroWest a program of BayPath Elder Services, Inc

Caregiving MetroWest is a program of BayPath Elder Services, Inc. for MetroWest caregivers.
The site offers Information on all aspects of caregiving; "Caregiving is a complex and demanding undertaking. There are many elements involved in the caregiving role, and we’ve assembled some helpful information on a variety of areas of importance to caregivers.

BayPath Elder Services, Inc
BayPath Elder Services, Inc. administers programs offering  home care and related services enabling people to live independently and comfortably in their homes while promoting their well-being and dignity.
Many BayPath services are free, others are based on one's ability to pay, and some are offered on a fee-for-service basis.

 “This non-profitcorporation is organized to plan, develop and implement the coordination and delivery of services and supportive programs   for persons sixty years of age and over unless otherwise restricted by conditions of grants or contracts, in the City of Marlborough, and the townships of Ashland, Holliston, Hopkinton, Dover, Sherborn, Natick, Framingham, Wayland, Sudbury, Hudson, Northborough , Southboro ugh and Westboro ugh , Massachusetts. The corporation shall endeavor to assist older persons to obtain services including but not limited to information and referral, homemaker and chore assistance, housing services, health maintenance and rehabilitation, nutritional services, legal and advocacy assistance, transportation, emergency assistance, and whatever medical or supportive services may be needed to prolong the life and well - being of older persons in the community and to prevent premature institutionalization."

Talking with a person with Alzheimer's guidelines: five basic ones


Marie Marley is the award-winning author of Come Back Early Today: A Memoir of Love, Alzheimer's and Joy. Her website  contains a wealth of information for Alzheimer's caregivers.
www.ComeBackEarlyToday.com

When relating to a person with Alzheimer's there are many guidelines to follow. 

five basic ones:
1) Don't tell them they are wrong about something,
2) Don't argue with them,
3) Don't ask if they remember something,
4) Don't remind them that their spouse, parent or other loved one is dead 
5) Don't bring up topics that may upset them.


Marie Marley author of Come Back Early Today


Dementia and Cognitive Impairment Diagnosis and Treatment Guideline

Dementia and Cognitive Impairment Diagnosis and ...
www.ghc.org/all-sites/guidelines/dementia.pdf
Group Health Cooperative
Dementia and Cognitive Impairment Diagnosis and Treatment Guideline. 1 ..... Guidelines are systematically developed statements to assist patients and providers in .... new and challenging mental activities, such as a language or musical instrument. .... Many different tools are available for assessing cognitive function.
 
 About Group Health
Group Health Cooperative is a member-governed, nonprofit health care system that coordinates care and coverage. Founded in 1947 and based in Seattle, Wash., Group Health and its subsidiary health carriers, Group Health Options, Inc. and KPS Health Plans, serve more than 600,000 residents of Washington and North Idaho.

"Care Transitions for the Home Care Industry." Ankota software

Chronic Care Management Services:
Here's the deal...  Physicians are starting to be incentivized (and penalized) for their performance with respect to their chronic patients, but there's a reimbursement associated with it. The reimbursement is for patients with two or more chronic conditions in a practice with a certified EMR (Electronic Medical Record) system.  The reimbursement has two levels. The first level, reimbursed at $42/month, requires a 20 minute check-in (e.g., on the phone) with the patient.  The second, reimbursed at almost $100, requires telehealth.

Home care agencies can put a program in place where your best aides are paid $10 for a 20 minute check-in call. If you charge $32 for this service (leaving a $10 margin for the referring practice) and allocate some of the revenue to your staff nurses and for software, you can provide a great service  and make a reasonable margin. Care Transitions Services: You can provide services to help transition patients from hospital to home.  Most hospitals are now being penalized for excessive readmissions   These hospitals can use your help and there are many benefits to your agency.  We have a new white paper  to teach you about the numerous benefits that your home care agency can achieve.
 At Ankota, we love providing home care software, telephony, care plans, scheduling, billing, payroll and all the other basics, but we really love that we can enable your agency to play a broader role in the future oh health care.  We can make a difference together.  Please download our newest free white paper "Why Care Transitions is the Next Big Thing for the Home Care Industry."
About Ankota Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination.

Hiring Home Care Workers: Why Work through an Agency? By Rona S. Bartelstone,

Hiring Private Duty Home Care Workers: Why Work through an Agency

Quoted:
One of the greatest long-term needs of older adults and those with
chronic illnesses is for in-home, custodial care services. These
workers are often referred to as home health aides, certified nursing
assistants and custodial care workers. These in-home workers make it
possible for people with functional limitations to remain at home in a
comfortable, familiar environment. Home health aides (as we will refer
to this class of workers) provide a wide range of assistance with
activities of daily living (ADLs), such as bathing, dressing, grooming,
assisting with ambulation or transferring, toileting, feeding and
providing medication reminders. In addition, home health aides help
with what professionals call, instrumental activities of daily living
(IADLs), such as shopping, meal preparation, making medical
appointments, transportation, laundry and companionship.

While it is true that most people would prefer to remain in their
own homes, there are circumstances in which care in a residential or
nursing facility is more appropriate and more cost-effective. For
example, the individual who needs round the clock care because of
treatments or behavioral issues will find a nursing facility or
residential setting likely to be more affordable.

The biggest proportion of people who utilize home health aide services are those
who need several hours per day of assistance, as opposed to those who need full-time care.

Due to the cost and the increasing shortage of home health
aides, many families seeking to hire in-home staff turn to private
individuals rather than working through an agency. While at first
glance this seems reasonable, it can also cause numerous problems and create unexpected liabilities for the family, who becomes the employer.

Great Big List of Caregiver Blogs | Caregiver's Corner July 14, 2010

Great Big List of Caregiver Blogs    

One of the best ways for a caregiver to find answers, reassurance,
and understanding is to connect with other caregivers. To help with
that, here is a list of blogs run by caregivers. If you know of any
blogs that should be added to this list, let us know!

Top 10 Codes You Aren’t Meant To Know - Listverse

Top 10 Codes You Aren’t Meant To Know - Listverse
Stores, hospitals, entertainment venues, and other places where the public are together in large numbers, use secret codes to pass information between store employees. These are meant to be a secret as they don’t want to alarm the non-staff members or alert someone (like a thief) to the fact that they have been noticed. Many stores have their own codes – for example WalMart, but there are a number that are nearly universal in application. This is a list of ten secret codes that may prove useful to you in future, or at least dispel any curiosity you may have if you hear them.

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