State Medicaid Hospice Services - Hospice Patients Alliance: Hospice Patients Alliance: Consumer Advocates
Medicaid Reimbursed Hospice Services
Health Care Financing Administration website's public information on state Medicaid hospice services.
www.hcfa.gov/medicaid/ltc2.htm but HCFA is now Centers for Medicare Services.
See Hospice Medicaid regulation information at:
http://www.cms.hhs.gov/CFCsAndCoPs/05_Hospice.asp
or http://www.access.gpo.gov/nara/cfr/waisidx_04/42cfr418_04.html
Permission was granted to share these articles with others, to print them, or post them on other websites so long as credit is given to the author and Hospice Patients Alliance with a link to this original page.
Back to Articles by Ron Panzer
Welcome to the I CAN! I WILL! Library | Alzheimer's Disease International
Welcome to the I CAN! I WILL! Library | Alzheimer's Disease International
Welcome to the I CAN! I WILL! Library
I CAN! I WILL! is a library of ideas to help people around the world stand up and speak out about Alzheimer’s disease and related disorders.
These ideas, which raise awareness about dementia and help to erase the stigma, have been contributed by people just like you - people with dementia, care partners, medical professionals, volunteers and advocates - so that you can learn from their experiences and they can learn from you.
The Association of Directors of Adult Social Services (ADASS) UK
The Association of Directors of Adult Social Services (ADASS): Welcome
Welcome to the ADASS Website - the home of the Association of Directors of Adult Social Services, and the voice of adult social care. The site contains the whole range of policy initiatives, press releases and consultation responses that constitute so much of the daily activity of the Association's members, and is regularly updated.
The main contact details of the Association can be found at the foot of every page. Please post comments about this site - we value your views.
Welcome to the ADASS Website - the home of the Association of Directors of Adult Social Services, and the voice of adult social care. The site contains the whole range of policy initiatives, press releases and consultation responses that constitute so much of the daily activity of the Association's members, and is regularly updated.
The main contact details of the Association can be found at the foot of every page. Please post comments about this site - we value your views.
Retrofitting or Assisted Living | The BMA Blog
Retrofitting or Assisted Living | The BMA Blog: Retrofitting or Assisted Living
By Rick Banas of senior living and assisted living provider BMA Management, Ltd.
Neighborhood houses
Which might better? Retrofitting the house to accommodate aging in place or moving into a senior living or assisted living community?
Here are things to consider.
By Rick Banas of senior living and assisted living provider BMA Management, Ltd.
Neighborhood houses
Which might better? Retrofitting the house to accommodate aging in place or moving into a senior living or assisted living community?
Here are things to consider.
Please read: Talking Point updates
Please read: Talking Point updates
The main changes are outlined in the following posts, but if you have any questions or there is anything you’re not sure about, please post below or email talkingpoint@alzheimers.org.uk, and a member of the Talking Point team will get back to you as soon as possible.
1. New sub-forums
2. New drop-down menus and links to Alzheimer's Society resources
3. Members' personal menu options have moved
4. Moved buttons
5. Re-worded commands
The main changes are outlined in the following posts, but if you have any questions or there is anything you’re not sure about, please post below or email talkingpoint@alzheimers.org.uk, and a member of the Talking Point team will get back to you as soon as possible.
1. New sub-forums
2. New drop-down menus and links to Alzheimer's Society resources
3. Members' personal menu options have moved
4. Moved buttons
5. Re-worded commands
Grief for Spouse with Dementia | Lesley Postle Sydney Area, Australia
Grief for Spouse with Dementia or Alzheimer's
Lesley Postle wrote:
"Grief and loss can occur when the loved one is still alive, yet their personality and individuality has gone. Your spouse with dementia or Alzheimer's is gradually changing before your eyes and is becoming more and more dependent. You grieve for the loved one you had, whilst caring for the totally dependent person they have become."
"This long, slow loss of a loved one is a painful, difficult time for those coping with their home care. The husband who used to do all the DIY, gardening and deal with the household finances becomes like a child who has to be told what to wear and when to eat. The wife who used to be a great cook and homemaker becomes the child again. She has to be given food to eat, she can’t shop anymore as she comes home with pounds of tomatoes and nothing else. They are still with you, they have the same smile, they may appear outwardly normal, but the ability to cope alone is gone and they become totally dependent. Grief for Spouse with Dementia:"
Websites include www.pumpkinlicious.com - Owner
Lesley Postle wrote:
"Grief and loss can occur when the loved one is still alive, yet their personality and individuality has gone. Your spouse with dementia or Alzheimer's is gradually changing before your eyes and is becoming more and more dependent. You grieve for the loved one you had, whilst caring for the totally dependent person they have become."
"This long, slow loss of a loved one is a painful, difficult time for those coping with their home care. The husband who used to do all the DIY, gardening and deal with the household finances becomes like a child who has to be told what to wear and when to eat. The wife who used to be a great cook and homemaker becomes the child again. She has to be given food to eat, she can’t shop anymore as she comes home with pounds of tomatoes and nothing else. They are still with you, they have the same smile, they may appear outwardly normal, but the ability to cope alone is gone and they become totally dependent. Grief for Spouse with Dementia:"
Lesley Postle
Sydney Area, Australia
Websites include www.pumpkinlicious.com - Owner
www.griefandsympathy.com - Owner
www.sarahkeyphysiotherapy.com - builder
www.simplebackpain.com - builder
Her contact page on www.decolish.com
This Caring Home
This Caring Home
Rosemary Bakker is the creator and director of ThisCaringHome.org. She is also an interior designer, gerontologist, keynote speaker, and former caregiver to a mother with Alzheimer’s disease. She understands first-hand how difficult and rewarding caregiving can be. Most importantly, she learned how a dementia-friendly environment can make caregiving less difficult and more fulfilling. Rosemary is the recipient of many awards for her innovative education and has authored two books on interior design and aging, including Lark Books: The AARP Guide to Revitalizing Your Home: Beautiful Living for the Second Half of Life (2010). Rosemary is available for 1) Training and Speaking Engagements and 2) Design Consultations.
1) Training and Speaking Engagements
Rosemary brings a fresh innovative approach to dementia care training. Her lively presentations give professional and family caregivers the tips and tools they need to transform an ordinary dwelling into a dementia-friendly home. Learn about inspiring and practical solutions to everyday caregiving problems that enhance safety and well-being and help the person with dementia live a fuller, more meaningful life.
Keynote speeches, workshops, and lunchtime presentations can be customized to fit the needs of the audience, including healthcare providers, human resources, and family caregivers. Training on how to use ThisCaringHome as a vital resource can also be provided for service professionals.
Presentation Topics
Presentations cover a wide array of home safety and caregiving topics, including:
Rosemary Bakker is the creator and director of ThisCaringHome.org. She is also an interior designer, gerontologist, keynote speaker, and former caregiver to a mother with Alzheimer’s disease. She understands first-hand how difficult and rewarding caregiving can be. Most importantly, she learned how a dementia-friendly environment can make caregiving less difficult and more fulfilling. Rosemary is the recipient of many awards for her innovative education and has authored two books on interior design and aging, including Lark Books: The AARP Guide to Revitalizing Your Home: Beautiful Living for the Second Half of Life (2010). Rosemary is available for 1) Training and Speaking Engagements and 2) Design Consultations.
Rosemary brings a fresh innovative approach to dementia care training. Her lively presentations give professional and family caregivers the tips and tools they need to transform an ordinary dwelling into a dementia-friendly home. Learn about inspiring and practical solutions to everyday caregiving problems that enhance safety and well-being and help the person with dementia live a fuller, more meaningful life.
Keynote speeches, workshops, and lunchtime presentations can be customized to fit the needs of the audience, including healthcare providers, human resources, and family caregivers. Training on how to use ThisCaringHome as a vital resource can also be provided for service professionals.
Presentations cover a wide array of home safety and caregiving topics, including:
- Memory Aides
- 7 Steps to Better Bathing
- Cooking Safety
- Better Mealtimes
- Smart Home Devices
- Wandering Technologies
- Therapeutic & Fun Activities
- Dementia-Friendly Interior Design
- A Calmer Day: Reducing Agitation
Senior Housing Forum exists to address issues and ideas that directly relate to the senior housing industry. It is published by Steve Moran a 30+ year senior housing veteran.
The following article was authored by Karen Austin
While teaching college English for 30 years, I thought I knew a great deal about the human mind. After all, I was teaching critical thinking. Entering the field of gerontology has brought me to a greater awareness of how the brain works. As people experience changes based on trauma, disease or even just the passing of time, we can see brain functions that we take for granted.
Because of my area of research and my blog, I frequently have friends and acquaintances ask me if a parent’s changing cognition is a sign of dementia, specifically Alzheimer’s disease. I am not a neurologist, so I am not qualified to assess. I ask them to schedule an appointment with their parent’s general practitioner.
Nevertheless, I provide an overview of some of the many reasons why an aging parent might demonstrate a change in cognition.
Age-related Cognitive Changes. By the time people reach their 40s, they usually notice it’s harder to retrieve names with ease. As we age, we experience cognitive slowing. This makes it harder to multi-task, and it takes longer to retrieve information. We also think better with fewer distractions.
Mild Cognitive Impairment. This diagnosis emerged in the 1990s as a midpoint between normal age-related changes and dementia. People with MCI experience cognitive changes greater than their age and educational level; however, they can still perform day-to-day functions. Only 30% will progress to dementia over 10 years. The rest hold steady or return to former cognitive levels.
Delirium. Often rapid change in cognition is due to delirium, brought on by dehydration, infection, sleep deprivation or incorrect use of prescription medication. It’s important to get immediate medical attention to treat the underlying problem causing the mental confusion.
Hospital-induced psychosis. Many people suffering from the shock of a medical problem will have a dramatic change in cognition affecting memory. Infection or pain medication can cause or contribute to an altered mental state. The effects sometimes extend beyond the hospital stay, morphing into post-traumatic stress disorder.
Psychological Disorders. Depression, post-traumatic stress disorder, and obsessive-compulsive disorder are just a few of the psychological disorders that can affect a person’s attention, concentration, executive function and memory. Depression is particularly under diagnosed and under-treated among older adults.
Drug or Alcohol Abuse. If a younger person behaves oddly, people will too often assume drug or alcohol abuse when it could be something else. Too often older people are pronounced “senile” when the cause for their cognitive disorder could be substance abuse.
Strokes or TIAs. If the cognitive change is sudden, the underlying cause could be a stroke or a transient ischemic attack (TIA). The person needs immediate medical attention.
Concussion or Traumatic Brain Injury. If a person has suffered a blow to the head from a fall or another type of accident, they might have a concussion. Or the injury could result in a traumatic brain injury, which is more serious.
Dementia. Yes, sometimes cognitive changes to signal the early stages of dementia from Alzheimer’s Disease, vascular dementia, Parkinson’s Disease, Huntington Disease or another disease. It’s vital to get an assessment with a cognitive tool such as the Wechsler Adult Intelligence Scale (WAIS). A doctor might first administer a shorter test in the office before referring to a neurologist or another specialist for more extensive testing.
Most often, cognitive changes are age-related, and the adult child is overly concerned. Nevertheless, sometimes a more serious problem causes the change in mental functioning, which requires attention from a medical professional. Learn more about the causes listed above by consulting qualified sources on the Internet, in print or in person.
When you are dealing with family members of residents who have cognitive changes, how do you help them with this painful reality?
Karen Austin blogs about aging at The Generation Above Me
Presented with permission from Steve Moran -
Steve's Bio
I am the publisher of Senior Housing Forum. In the early 80's shortly after graduating from college I stumbled into the senior housing industry. I started by operating and later developing a number of small 15 bed buildings (I was young, foolish and not terribly successful). For the next 20 or so years I worked in and around the senior housing developing and operating CCRC's and freestanding single level of care communities.
I took a 10 year detour into high tech but found that senior housing was my first love.
I am currently an account manager for Vigil Health Solutions where we provide the finest emergency call systems for independent living, assisted living, skilled living and dementia units. (www.vigil.com)
Steve
smoran@seniorhousingforum.net
Better Day Café Next Café is Sunday, July 28th, 2013 1:00pm to 3:00pm
Better Day Café
Next Café is
Sunday, July 28th, 2013
1:00pm to 3:00pm
Create A Better Day Café will be held the 4th Sunday of each month from 1:00pm to 3:00pm at Pleasantries Adult Day Services 195 Reservoir Street Marlborough, MA.
Call Tammy for more information at 508-335-1968
---
http://alzheimercafes.blogspot.com/
Alzheimer's Cafes Worldwide
Cafes come by a number of names, Memory Cafes, Alzheimer's Cafes, Dementia Cafes. In the UK many have been in existence for several years. Currently the concept is gaining momentum and hundreds of memory cafes sprouting up everywhere. The concept is to provide a social occasion, a meetup, for anyone with dementia / Alzheimer's, their care givers and family. They are informal and generally free. Activities vary. Support and funding depends on the host-provider and contributions. Ish's, Ishmael's, Knowledge Network blogs, web sites, groups
TaskRabbit Support : About TaskRabbit
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Ten Questions To Ask When Choosing A Home Care Provider | Area Agency on Aging of Pasco-Pinellas, Inc.Area Agency on Aging of Pasco-Pinellas, Inc.
What is the background of your company?
Search out the history and ownership of the company. What type of license do they have? Find out who owns the company and weigh how the ownership affects the company’s service and reliability. Is this agency backed by a nationally strong firm? Is it reputable and in good standing? Is it involved in professional organizations?
2. How long has your company been in business?
The number of years an agency has been in business is not always pertinent to the quality of care given, but it does reflect on the stability and success of the company.
3. What qualifications, certifications, experience and training do you require of your workers?
read more
from
Area Agency on Aging of Pasco-Pinellas, Inc.
Serving as a designated Aging and Disability Resource Center (ADRC)
Main Office – Pinellas County, Florida20130221 DSC_0054 for web
9549 Koger Blvd.
Gadsden Building, Suite 100
St Petersburg, FL 33702
Phone: (727) 570-9696
Helpline 1-800-963-5337
For inquiries from outside of the area call
(727) 217-8111
Search out the history and ownership of the company. What type of license do they have? Find out who owns the company and weigh how the ownership affects the company’s service and reliability. Is this agency backed by a nationally strong firm? Is it reputable and in good standing? Is it involved in professional organizations?
2. How long has your company been in business?
The number of years an agency has been in business is not always pertinent to the quality of care given, but it does reflect on the stability and success of the company.
3. What qualifications, certifications, experience and training do you require of your workers?
read more
from
Tender Book Teaches Children about Alzheimer’s Disease | Alzheimer's Speaks Blog
Alzheimer's Speaks Blog
Trailblazing Teen Researcher
Wins Accolades for Best-Seller
Tender Book Teaches Children
about Alzheimer’s Disease
July 18, 2013, Boston, MA– At age five, Max Wallack learned to cope with his great-grandmother’s Alzheimer’s symptoms. Forgetfulness was the least of her problems: Max experienced her fears, episodes of irrational behavior, incontinence – even escape attempts. But Wallack didn’t just cope. He devoted himself to easing her suffering. By second grade, he had invented adaptive equipment to help her with mobility, and at age 12 he founded www.PuzzlesToRemember.org, a non-profit charity that distributes therapeutic puzzles at no cost to Alzheimer’s facilities worldwide.
Wins Accolades for Best-Seller
Tender Book Teaches Children
about Alzheimer’s Disease
July 18, 2013, Boston, MA– At age five, Max Wallack learned to cope with his great-grandmother’s Alzheimer’s symptoms. Forgetfulness was the least of her problems: Max experienced her fears, episodes of irrational behavior, incontinence – even escape attempts. But Wallack didn’t just cope. He devoted himself to easing her suffering. By second grade, he had invented adaptive equipment to help her with mobility, and at age 12 he founded www.PuzzlesToRemember.org, a non-profit charity that distributes therapeutic puzzles at no cost to Alzheimer’s facilities worldwide.
Caregiver Partnership Agreement Program™ to organizations and care facilities that provide specialized care for individuals living with Alzheimer’s and other dementias.
Home - Remembering4you - Alzheimer’s Coaching:
Dr. Ethelle Lord, Remembering 4 You P. O. Box 193 Mapleton, ME 04757 Phone: (207) 764-1214
a unique Caregiver Partnership Agreement Program™ to organizations and care facilities that provide specialized care for individuals living with Alzheimer’s and other dementias. In this program physicians, administrators, social workers, nursing staff, and families are trained and certified to work as a cohesive team known as Care Partners™ in a number of important areas such as instituting a care model versus the medical model to save about 50% in costs, speaking Alzheimer’s, adopting a seamless transfer method from home to long-term care, improved family communications, and many more.
Our perspective is that the medical model of care for Alzheimer’s and many dementias is not appropriate. Healthcare systems cannot continue to sustain in this way and change must begin with top decision makers. We must educate both family caregivers and professional caregivers in ways that will improve careDisclaimer: Remembering4You.com is NOT a medical website. It was developed to provide useful information for individuals and facilities who give care to individuals with Alzheimer's and other forms of dementia. We do not have medical personnel on staff or on retainer to answer your questions. We do not make any medical referrals or offer a second opinion to an existing medical condition such as Alzheimer's, and we cannot offer replies to any specific case because every case is different. Instead, we hope that you will use the many links offered throughout the website to locate other sites of interest; utilize our contact page to share ideas and ask questions; send us your personal story for publication on our Stories section; and to sign up for our class offerings if you feel those classes are of interest to you or to your organization. Remembering 4 You reserves the right to refuse to post any story that may be objectionable and if photos are mailed to us, we are unable to return them to you.
The information on the World Wide Web comes from many sources and changes on a daily basis. Please note that it is possible to find errors and omissions in such information. To the best of its knowledge Remembering 4 You, contributors and sponsors to this website believe the information presented on this website is accurate and complete.
The goal at Remembering4You.com is to support and encourage caregivers all over the world, family caregivers and professional caregivers, in their quest to provide care for individuals with Alzheimer's and other forms of dementia. It is our intent to create a safe place to meet and retreat together. We do not endorse any miracle cure or easy way to provide the care, but we do encourage visitors to our site to explore and challenge themselves whether it be through gathering information or taking a class. A link to an outside product or site should never be viewed as a recommendation or an endorsement of a particular product. Always consult your doctor first.
Note: Remembering 4 You believes you should always direct medical or health questions to your medical provider. and lower costs.
We can all learn something from your personal story. Please send your 1-2 pages personal story (with or without pictures) to: Dr. Ethelle Lord, P. O. Box 193, Mapleton, Me 04757 ---
Dr. Ethelle Lord, Remembering 4 You P. O. Box 193 Mapleton, ME 04757 Phone: (207) 764-1214
Our perspective is that the medical model of care for Alzheimer’s and many dementias is not appropriate. Healthcare systems cannot continue to sustain in this way and change must begin with top decision makers. We must educate both family caregivers and professional caregivers in ways that will improve careDisclaimer: Remembering4You.com is NOT a medical website. It was developed to provide useful information for individuals and facilities who give care to individuals with Alzheimer's and other forms of dementia. We do not have medical personnel on staff or on retainer to answer your questions. We do not make any medical referrals or offer a second opinion to an existing medical condition such as Alzheimer's, and we cannot offer replies to any specific case because every case is different. Instead, we hope that you will use the many links offered throughout the website to locate other sites of interest; utilize our contact page to share ideas and ask questions; send us your personal story for publication on our Stories section; and to sign up for our class offerings if you feel those classes are of interest to you or to your organization. Remembering 4 You reserves the right to refuse to post any story that may be objectionable and if photos are mailed to us, we are unable to return them to you.
The information on the World Wide Web comes from many sources and changes on a daily basis. Please note that it is possible to find errors and omissions in such information. To the best of its knowledge Remembering 4 You, contributors and sponsors to this website believe the information presented on this website is accurate and complete.
The goal at Remembering4You.com is to support and encourage caregivers all over the world, family caregivers and professional caregivers, in their quest to provide care for individuals with Alzheimer's and other forms of dementia. It is our intent to create a safe place to meet and retreat together. We do not endorse any miracle cure or easy way to provide the care, but we do encourage visitors to our site to explore and challenge themselves whether it be through gathering information or taking a class. A link to an outside product or site should never be viewed as a recommendation or an endorsement of a particular product. Always consult your doctor first.
Note: Remembering 4 You believes you should always direct medical or health questions to your medical provider. and lower costs.
We can all learn something from your personal story. Please send your 1-2 pages personal story (with or without pictures) to: Dr. Ethelle Lord, P. O. Box 193, Mapleton, Me 04757 ---
These 4 Things Happen Right Before a Heart Attack
These 4 Things Happen Right Before a Heart Attack
For a limited time, Newsmax Health is making Silent Heart Attacks: A Special Newsmax Heart Health Report available at no charge. Click here to see the 4 things that happen before a heart attack.
http://tinyurl.com/odgjw2m
For a limited time, Newsmax Health is making Silent Heart Attacks: A Special Newsmax Heart Health Report available at no charge. Click here to see the 4 things that happen before a heart attack.
http://tinyurl.com/odgjw2m
Hospices Directory | Best Hospices | Caring.com
Hospices Directory | Best Hospices | Caring.com
Questions to Ask When Choosing a Hospice Program There are more than 3,100 hospices in this country and the hospice in your community can provide information and help you answer some of the difficult decisions that accomp...
Questions to Ask When Choosing a Hospice Program There are more than 3,100 hospices in this country and the hospice in your community can provide information and help you answer some of the difficult decisions that accomp...
What is Dementia? News-Medical.net article
What is Dementia?: Types of dementia
Dementia may be of 100 different types. Some of them include:
Alzheimer’s disease is where small clumps of protein, known as plaques, begin to develop around brain cells. This may lead to severe loss of memory over time.
Another type is vascular dementia where there are problems in the blood supply to the brain. The brain does not receive adequate oxygen.
Dementia with Lewy bodies is another form of dementia where small abnormal structures, known as Lewy bodies, develop inside the brain.
Frontotemporal dementia is said to occur when frontal and temporal lobes (two parts of the brain) start shrinking. This may occur in individuals under 65 years of age. It is much rarer than other types of dementia.
Dementia and other disorders
Sometimes dementia may be accompanied by other mental disorders like mood swings, anxiety and depression and confusion.
Many other illnesses can cause dementia. These may include viral infections such as HIV, Creutzfeldt-Jacob disease, chronic heavy alcohol intake, Huntington's disease, progressive supranuclear palsy and normal pressure hydrocephalus, Multiple sclerosis and Motor neurone disease.
Prognosis or outlook of dementia
There is no cure for dementia. In most patients the symptoms worsen over time.
http://www.youtube.com/watch?feature=player_embedded&v=6q-H1-XwCZA
Dementia may be of 100 different types. Some of them include:
Alzheimer’s disease is where small clumps of protein, known as plaques, begin to develop around brain cells. This may lead to severe loss of memory over time.
Another type is vascular dementia where there are problems in the blood supply to the brain. The brain does not receive adequate oxygen.
Dementia with Lewy bodies is another form of dementia where small abnormal structures, known as Lewy bodies, develop inside the brain.
Frontotemporal dementia is said to occur when frontal and temporal lobes (two parts of the brain) start shrinking. This may occur in individuals under 65 years of age. It is much rarer than other types of dementia.
Dementia and other disorders
Sometimes dementia may be accompanied by other mental disorders like mood swings, anxiety and depression and confusion.
Many other illnesses can cause dementia. These may include viral infections such as HIV, Creutzfeldt-Jacob disease, chronic heavy alcohol intake, Huntington's disease, progressive supranuclear palsy and normal pressure hydrocephalus, Multiple sclerosis and Motor neurone disease.
Prognosis or outlook of dementia
There is no cure for dementia. In most patients the symptoms worsen over time.
http://www.youtube.com/watch?feature=player_embedded&v=6q-H1-XwCZA
What is an Elder Law Attorney? | Area Agency on Aging of Pasco-Pinellas, Inc.Area Agency on Aging of Pasco-Pinellas, Inc.
What is an Elder Law Attorney? | Area Agency on Aging of Pasco-Pinellas, Inc.Area Agency on Aging of Pasco-Pinellas, Inc.: What is an Elder Law Attorney?
shutterstock_108635621
Attorneys who work in the field of elder law bring more to their practice than an expertise in the appropriate area of law. They also have knowledge of the senior population and their unique needs as well as the myths related to competence and aging. They are aware of the physical and mental difficulties that often accompany the aging process. Because of their broad knowledge base they are able to more thoroughly address the legal needs of their clients.
For example, when planning an estate, an elder law attorney would take into consideration the health of the person or couple, the potential for nursing home care and the wishes and concerns of the person or couple if that event were to occur. If need arises, the elder law attorney will associate other legal experts.
shutterstock_108635621
Attorneys who work in the field of elder law bring more to their practice than an expertise in the appropriate area of law. They also have knowledge of the senior population and their unique needs as well as the myths related to competence and aging. They are aware of the physical and mental difficulties that often accompany the aging process. Because of their broad knowledge base they are able to more thoroughly address the legal needs of their clients.
For example, when planning an estate, an elder law attorney would take into consideration the health of the person or couple, the potential for nursing home care and the wishes and concerns of the person or couple if that event were to occur. If need arises, the elder law attorney will associate other legal experts.
Alzheimer's World Bang Your Head Against the Wall | Alzheimer's Reading Room
Alzheimer's World Bang Your Head Against the Wall | Alzheimer's Reading Room: By +Bob DeMarco
+Alzheimer's Reading Room
Alzheimer's World Bang Your Head Against the Wall
Print and tape to the wall. Follow the directions in the circle.
If you are like me, you probably felt like you could put everything you knew about Alzheimer's disease in a thimble the day you received the diagnosis.
And, if you are like me, you probably realized over time that you developed some skills over the course of your life that would help you to deal with a person suffering from Alzheimer's disease.
With this in mind, you will need to learn how to engage in new and different kinds of communication while interacting with someone suffering from Alzheimer's disease in order to remain sane.
You can use some of the communication tools you developed over the course of your life that work; and then, you develop new communication tools that you use only while in Alzheimer's World.
+Alzheimer's Reading Room
Alzheimer's World Bang Your Head Against the Wall
Print and tape to the wall. Follow the directions in the circle.
If you are like me, you probably felt like you could put everything you knew about Alzheimer's disease in a thimble the day you received the diagnosis.
And, if you are like me, you probably realized over time that you developed some skills over the course of your life that would help you to deal with a person suffering from Alzheimer's disease.
With this in mind, you will need to learn how to engage in new and different kinds of communication while interacting with someone suffering from Alzheimer's disease in order to remain sane.
You can use some of the communication tools you developed over the course of your life that work; and then, you develop new communication tools that you use only while in Alzheimer's World.
A Dementia Book Every Family & Professional Needs
A Dementia Book Every Family & Professional Needs | Alzheimer's Speaks Blog: A Dementia Book
Every Family & Professional Needs
This book shows and explains to the reader what is happening and why. It answers the questions of what do we do now? It shows the reader how to interact with someone who has been diagnosed in a loving and respectful fashion. It teaches us not to loose our relationship to illness, but to adapt life to the imperfections we all have. Lori La Bey
Every Family & Professional Needs
This book shows and explains to the reader what is happening and why. It answers the questions of what do we do now? It shows the reader how to interact with someone who has been diagnosed in a loving and respectful fashion. It teaches us not to loose our relationship to illness, but to adapt life to the imperfections we all have. Lori La Bey
Top Ten caregiver.com Articles of June 2013
Top Ten Articles of June 2013:
Here are the top ten articles you read in June
Which one was your favorite?
Avoiding Mistakes when Buying a Power Lift Chair Recliner
Emotional First Aid
10 Tips to Protect a Wandering Loved One
Heat Stress in the Elderly
Arthritis Tips
Ten Tips for Ensuring Medication Safety
Nine Ways to Get Someone to Eat
A Caregiver's Bill of Rights
Parkinson's Disease: Tips for Caregivers
Bipolar Disorder: Preventing Manic Episodes
Read them now!
Here are the top ten articles you read in June
Which one was your favorite?
Avoiding Mistakes when Buying a Power Lift Chair Recliner
Emotional First Aid
10 Tips to Protect a Wandering Loved One
Heat Stress in the Elderly
Arthritis Tips
Ten Tips for Ensuring Medication Safety
Nine Ways to Get Someone to Eat
A Caregiver's Bill of Rights
Parkinson's Disease: Tips for Caregivers
Bipolar Disorder: Preventing Manic Episodes
Read them now!
PioneerNetwork : Conference Schedule at a Glance
PioneerNetwork : Conference Schedule at a Glance: Conference Schedule at a Glance
Pioneer Network was formed in 1997 by a small group of prominent professionals in long-term care to advocate for person-directed care. This group called for a radical change in the culture of aging so that when our grandparents, parents — and ultimately ourselves — go to a nursing home or other community-based setting it is to thrive, not to decline. This movement, away from institutional provider-driven models to more humane consumer-driven models that embrace flexibility and self-determination, has come to be known as the long-term care culture change movement. Our partners and audience are primarily engaged in some aspect of long-term care including long-term care CEOs and administrators, consumers and family caregivers, doctors and nurses, direct care providers, and others who care about, and care for, the aging.
Pioneer Network is a center for all stakeholders in the field of aging and long term care whose focus is on providing home and community for elders. We believe that the quality of life and living for America's elders is rooted in a supportive community and cemented by relationships that respect each of us as individuals regardless of age, medical condition or limitations.
from Jytte Fogh Lokvig, Ph.D.
Pioneer Network was formed in 1997 by a small group of prominent professionals in long-term care to advocate for person-directed care. This group called for a radical change in the culture of aging so that when our grandparents, parents — and ultimately ourselves — go to a nursing home or other community-based setting it is to thrive, not to decline. This movement, away from institutional provider-driven models to more humane consumer-driven models that embrace flexibility and self-determination, has come to be known as the long-term care culture change movement. Our partners and audience are primarily engaged in some aspect of long-term care including long-term care CEOs and administrators, consumers and family caregivers, doctors and nurses, direct care providers, and others who care about, and care for, the aging.
Pioneer Network is a center for all stakeholders in the field of aging and long term care whose focus is on providing home and community for elders. We believe that the quality of life and living for America's elders is rooted in a supportive community and cemented by relationships that respect each of us as individuals regardless of age, medical condition or limitations.
from Jytte Fogh Lokvig, Ph.D.
Create A Better Day Café Grand Opening... Sunday, June 23rd 1:00pm to 3:00pm | Create A Better Day Café will be held the 4th Sunday of each month from 1:00pm to 3:00pm
Create A Better Day Café
Are
you caring for someone with Alzheimer's or other dementia? Create A
Better Day Café encourages socialization with other caregivers and loved
ones where you can just be yourself. This is a wonderful opportunity to
get out with your loved one and have an enjoyable afternoon. It's a
time to step out of the daily routine, leave the disease at the door,
and enjoy a positive experience in a supportive environment. The
afternoon will consist of conversation, music, arts, games,
refreshments, and most importantly, laughter. There is no cost. It is
open to anyone at any stage of the disease process accompanied by
friends, family, and loved ones.
Grand Opening...
Sunday, June 23rd
1:00pm to 3:00pm
Create A Better Day Café will be held the 4th Sunday of each month from 1:00pm to 3:00pm
at Pleasantries Adult Day Services 195 Reservoir Street
Marlborough, MA.
at Pleasantries Adult Day Services 195 Reservoir Street
Marlborough, MA.
Call Tammy for more information at 508-335-1968
- Smart911 data etc
What is Smart911? - Smart911: What is Smart911?
Smart911 is a free service that allows citizens across the U.S. to create a Safety Profile for their household that includes any information they want 9-1-1 to have in the event of an emergency. Then, when anyone in that household dials 9-1-1 from a phone associated with their Safety Profile, their profile is immediately displayed to the 9-1-1 call taker providing additional information that can be used to facilitate the proper response to the proper location. At a time when seconds count, being about to provide 9-1-1 with all details that could impact response the second an emergency call is placed could be the difference between life and death.
Be Smart About Safety. Sign Up Today.
Give 9-1-1 the information they need to better help you and your family in the event of an emergency.
Smart911 is a free service that allows citizens across the U.S. to create a Safety Profile for their household that includes any information they want 9-1-1 to have in the event of an emergency. Then, when anyone in that household dials 9-1-1 from a phone associated with their Safety Profile, their profile is immediately displayed to the 9-1-1 call taker providing additional information that can be used to facilitate the proper response to the proper location. At a time when seconds count, being about to provide 9-1-1 with all details that could impact response the second an emergency call is placed could be the difference between life and death.
Be Smart About Safety. Sign Up Today.
Give 9-1-1 the information they need to better help you and your family in the event of an emergency.
Disability Indicator Program
Disability Indicator Program: Disability Indicator Program
Disability Indicator Form
The disability indicator program is voluntary for both the community and it's residents. The disability indicator form pdf format of disability_info_and_form.pdf was created by a group of several different organizations representing the mobility, hearing, speech and sight impaired communities.
*PLEASE NOTE: IT IS IMPORTANT TO SUBMIT A NEW DISABILITY INDICATOR FORM UPON CHANGE OF SERVICE PROVIDER, TELEPHONE NUMBER, OR ADDRESS*
The information provided on the disability indicator form enables a special code to appear on the 911 call takers screen which alerts the call taker that a person residing at that address may require special assistance during an emergency.
It is a standardized form created to encourage participation from all persons with disabilities. As you are aware, there are an extensive range of disabilities and medical conditions. The disability indicator categories listed on the form may be considered too broad for some; when you consider the extensive range of disabilities. However, information requested on the form must remain sensitive to those who may not wish to provide detailed information.
Always remember information on the disability indicator form is confidential.
The disability indicator form is available through the State 911 Department or it can be downloaded from this website. Originally, the form had to be filled out in triplicate. The new disability indicator procedure form only requires that when a person in your community submits a signed disability indicator form, the 911 Municipal Coordinator signs the form and faxes it to the Verizon Database Center at 1-800-839-6020 for entry into the 911 Verizon database. It is no longer necessary to mail your original. You retain that original copy as part of your permanent records to be used later for the annual verification of your database. Remember these are important confidential documents and should be stored in the same manner as all municipal records.
Annually, Verizon will send the Municipal Coordinator a current listing of those persons in their community who are enrolled in the disability indicator program for updating. Verizon enters the new information into the 911 database. A new Disability Indicator Form should be submitted for the following:
1. a person moves or no longer resides at that address
2. the apartment number changes
3. the telephone number changes
4. to add or delete a disability
Remember to review the lists carefully to maintain accurate records which will ensure the proper response in the event of an emergency.
Disability Indicator Form
The disability indicator program is voluntary for both the community and it's residents. The disability indicator form pdf format of disability_info_and_form.pdf was created by a group of several different organizations representing the mobility, hearing, speech and sight impaired communities.
*PLEASE NOTE: IT IS IMPORTANT TO SUBMIT A NEW DISABILITY INDICATOR FORM UPON CHANGE OF SERVICE PROVIDER, TELEPHONE NUMBER, OR ADDRESS*
The information provided on the disability indicator form enables a special code to appear on the 911 call takers screen which alerts the call taker that a person residing at that address may require special assistance during an emergency.
It is a standardized form created to encourage participation from all persons with disabilities. As you are aware, there are an extensive range of disabilities and medical conditions. The disability indicator categories listed on the form may be considered too broad for some; when you consider the extensive range of disabilities. However, information requested on the form must remain sensitive to those who may not wish to provide detailed information.
Always remember information on the disability indicator form is confidential.
The disability indicator form is available through the State 911 Department or it can be downloaded from this website. Originally, the form had to be filled out in triplicate. The new disability indicator procedure form only requires that when a person in your community submits a signed disability indicator form, the 911 Municipal Coordinator signs the form and faxes it to the Verizon Database Center at 1-800-839-6020 for entry into the 911 Verizon database. It is no longer necessary to mail your original. You retain that original copy as part of your permanent records to be used later for the annual verification of your database. Remember these are important confidential documents and should be stored in the same manner as all municipal records.
Annually, Verizon will send the Municipal Coordinator a current listing of those persons in their community who are enrolled in the disability indicator program for updating. Verizon enters the new information into the 911 database. A new Disability Indicator Form should be submitted for the following:
1. a person moves or no longer resides at that address
2. the apartment number changes
3. the telephone number changes
4. to add or delete a disability
Remember to review the lists carefully to maintain accurate records which will ensure the proper response in the event of an emergency.
Complementary Content
Your 3M Resident Monitoring (RM) system will no longer operate properly. | Senior Housing Forum
Misplaced Trust: 3M adds insult to injury . . . | Senior Housing Forum: “ in the absence of qualified maintenance and support. Specifically, in the absence of regular database maintenance the system will stop sending alert messages to your employees and to the central monitoring station. This is likely to mean that your staff will not know based on the system when a resident has exited your facility or is in need of assistance.”
“FOR THIS REASON, YOU MUST REPLACE OR DISABLE YOUR 3M RESIDENT MONITORING SYSTEM ON OR BEFORE DECEMBER 31, 2013”
“If you choose to continue to operate the 3M Resident Monitoring system or any of its components or software after December 31, 2013, you do so at your own risk, and neither 3M Resident Monitoring Inc., 3M company, nor any of their affiliates shall assume any liability for the outcome.”
“FOR THIS REASON, YOU MUST REPLACE OR DISABLE YOUR 3M RESIDENT MONITORING SYSTEM ON OR BEFORE DECEMBER 31, 2013”
“If you choose to continue to operate the 3M Resident Monitoring system or any of its components or software after December 31, 2013, you do so at your own risk, and neither 3M Resident Monitoring Inc., 3M company, nor any of their affiliates shall assume any liability for the outcome.”
20-Common-Problems-Nov-2010-Final.pdf
20-Common-Problems-Nov-2010-Final.pdf
NSCLC provides education and counseling to local legal services advocates, but does not educate or provide advice or counsel to individuals. If you are looking for legal advice, you can find local resources by clicking here.
1444 Eye Street, NW Suite 1100
Washington, DC 20005
202-289-6976
3701 Wilshire Boulevard, Suite 750
Los Angeles, CA 90010
213-639-0930
1330 Broadway, Suite 525
Oakland, CA 94612
510-663-1055
20 Common Nursing Home Problems and
How to Resolve Them
Copyright ©2010 by the
National Senior Citizens Law Center.
read their pdf
How to Resolve Them
Copyright ©2010 by the
National Senior Citizens Law Center.
read their pdf
NSCLC provides education and counseling to local legal services advocates, but does not educate or provide advice or counsel to individuals. If you are looking for legal advice, you can find local resources by clicking here.
1444 Eye Street, NW Suite 1100
Washington, DC 20005
202-289-6976
3701 Wilshire Boulevard, Suite 750
Los Angeles, CA 90010
213-639-0930
1330 Broadway, Suite 525
Oakland, CA 94612
510-663-1055
Partners All | http://www.caregiver.com/
Partners All: Once we have succeeded in finding our physicians, personal support staff, physical therapists and even pharmacists, then it’s time to find the partners we need as we choose the products and equipment that our loved ones require. And frankly, with the Internet, these choices have become exponentially more difficult. I think the way you choose such a partner successfully is similar to how you choose your other care professionals. Certainly, in this case, price is an extremely important element, but there’s a lot more involved. Will they become a trusted resource for information and training? Will they be there when you have questions? Have they created an easy system to navigate? Are they accessible by phone or is it a Web-only wall that you cannot seem to climb over in order to find any human support? And (of course) do they stand by their products?
Heat Stress in the Elderly
(read orginal three pages) Heat Stress in the Elderly
Elderly people (that is, people aged 65 years and older) are more prone to heat stress than younger people for several reasons:
Elderly people do not adjust as well as young people to sudden changes in temperature.
They are more likely to have a chronic medical condition that changes normal body responses to heat.
They are more likely to take prescription medicines that impair the body's ability to regulate its temperature or that inhibit perspiration.
Elderly people (that is, people aged 65 years and older) are more prone to heat stress than younger people for several reasons:
Elderly people do not adjust as well as young people to sudden changes in temperature.
They are more likely to have a chronic medical condition that changes normal body responses to heat.
They are more likely to take prescription medicines that impair the body's ability to regulate its temperature or that inhibit perspiration.
How to Apply For a Senior Care Job - Caregiverlist.com
How to Apply For a Senior Care Job - Caregiverlist.com
List A:
List A:
- U.S. Passport (expired or unexpired)
- Permanent Resident Card or Alien Registration Receipt Card
- Unexpired foreign passport with a temporary I-551 stamp
- Unexpired Employment Authorization Document that contains a photograph
- Unexpired foreign passport with unexpired Arrival-departure dates
- Form I-94, bearing the same name as the passport and containing an endorsement of the alien's nonimmigrant status, if that status authorizes the alien to work for the employer
- Driver's license or ID card issued by a state or outlying possession of the United States provided it contains a photograph or information such as name, date of birth, gender, height, eye color and address
- School ID card with a photograph
- Military dependent's ID card
- U.S. Coast Guard Merchant Mariner Card
- Native American tribal document
- Driver's license issued by a Canadian government authority
- U.S. Social Security card issued by the Social Security Administration (other than a card stating it is not valid for employment)
- Certification of Birth Abroad issued by the Department of State (Form FS-545 or Form DS-1350)
- Original or certified copy of a birth certificate issued by a state, county, municipal authority or outlying possession of the United States bearing an official seal
- Native American tribal document
- U.S. Citizen ID Card (Form I-197)
- ID Card for use of Resident Citizen in the United States (Form I-179)
- Unexpired employment authorization document issued by DHS (other than those listed under List A)
Young Adult Carers blog | Carers Trust | The Princess Royal Trust for Carers and Crossroads Care are now Carers Trust. Action, help and advice for carers
Young Adult Carers blog | Carers Trust | The Princess Royal Trust for Carers and Crossroads Care are now Carers Trust. Action, help and advice for carers
the Young Adult Carers blog, a place for 14-25 year-old carers to share their stories, express their views and share valuable advice. As part of our Charity of the Year work with The Co-operative, Carers Trust is carrying out a range of
projects to support and raise awareness of young adult carers. Find out more on our Charity of the Year pages.
the Young Adult Carers blog, a place for 14-25 year-old carers to share their stories, express their views and share valuable advice. As part of our Charity of the Year work with The Co-operative, Carers Trust is carrying out a range of
Activities of Daily Living – Checklist, Definitions and Importance - Paying For Senior Care
Activities of Daily Living – Checklist, Definitions and Importance - Paying For Senior Care
What are the Activities of Daily Living (ADLs)?
What are the Activities of Daily Living (ADLs)?
The Activities of Daily Living are a series of basic activities performed by individuals on a daily basis necessary for independent living at home or in the community. There are many variations on the definition of the activities of daily living but most organizations agree there are 5 basic categories.
1. Personal hygiene such bathing, grooming and oral care
2. Dressing including the ability to make appropriate clothing decisions
3. Eating, the ability to feed oneself though not necessarily prepare food
4. Maintaining continence or the ability to use a restroom
5. Transferring oneself from seated to standing and get in and out of bed
Whether or not an individual is capable of performing these activities on their own or if they rely on a family caregiver to perform the ADLs serves a comparative measure of their independence.
What are the Instrumental Activities of Daily Living (IADLs)? 1. Personal hygiene such bathing, grooming and oral care
2. Dressing including the ability to make appropriate clothing decisions
3. Eating, the ability to feed oneself though not necessarily prepare food
4. Maintaining continence or the ability to use a restroom
5. Transferring oneself from seated to standing and get in and out of bed
Whether or not an individual is capable of performing these activities on their own or if they rely on a family caregiver to perform the ADLs serves a comparative measure of their independence.
IADLs are actions that are important to being able to live independently but are not necessarily required activities on a daily basis. The instrumental activities are more subtle and can help more finely determine the level of assistance required by the elderly or disabled. The IADLs include:
1. Basic communication such as using a telephone
2. Transportation, either by driving, arranging rides or the ability to use public transportation
3. Meal preparation and the ability to safely use kitchen equipment
4. Shopping and the ability to make appropriate food and clothing purchase decisions
5. Housework such as doing laundry and cleaning dishes
6. Managing medications such as taking accurate dosages at appropriate times and managing re-fills
7. Managing personal finances, operating within a budget, writing checks and paying bills
1. Basic communication such as using a telephone
2. Transportation, either by driving, arranging rides or the ability to use public transportation
3. Meal preparation and the ability to safely use kitchen equipment
4. Shopping and the ability to make appropriate food and clothing purchase decisions
5. Housework such as doing laundry and cleaning dishes
6. Managing medications such as taking accurate dosages at appropriate times and managing re-fills
7. Managing personal finances, operating within a budget, writing checks and paying bills
The American Elder Care Research Organization
736 Cole Street
San Francisco, California 94117
Telephone: 641-715-3900 Ext. 606151#
===========
Eldercare FAQs and Helpful Guides - Paying For Senior Care
736 Cole Street
San Francisco, California 94117
Telephone: 641-715-3900 Ext. 606151#
===========
Eldercare FAQs and Helpful Guides - Paying For Senior Care
Memory loss from cholesterol drugs real:
Memory loss from cholesterol drugs real: How it might happen: Statins effect on the brain is real
Researchers from University of Arizona discovered brain cells treated with statins swell, causing a sort of traffic jam in signaling cells of the brain known as neurons; revealed in lab studies. The result could explain why some people taking cholesterol lowering drugs report difficulty thinking and memory loss.
The scientists have dubbed what they saw in the lab as the "beads-on-a-string" effect that is probably more severe than what really happens to people sensitive to statins who suffer memory problems. The study authors say the swelling seen in the brain’s neuron was significant.
There is also still a lot we don’t know about how they affect behavior and cognition. Another side effect reported by patients who take the drugs is muscle pain
Researchers from University of Arizona discovered brain cells treated with statins swell, causing a sort of traffic jam in signaling cells of the brain known as neurons; revealed in lab studies. The result could explain why some people taking cholesterol lowering drugs report difficulty thinking and memory loss.
The scientists have dubbed what they saw in the lab as the "beads-on-a-string" effect that is probably more severe than what really happens to people sensitive to statins who suffer memory problems. The study authors say the swelling seen in the brain’s neuron was significant.
There is also still a lot we don’t know about how they affect behavior and cognition. Another side effect reported by patients who take the drugs is muscle pain
Getting Good Information: Caregivers, Sundowners Syndrome, Dementia
from Aging Wisely Blog
Getting Good Information: Caregivers, Sundowners Syndrome, Dementia: We read a lot of forums, websites, books and articles about all matter of topics related to aging and elder care. With the explosion of information available on the web and, in particular, social media and forums for comments and feedback, there are many caregivers benefiting from sharing information and connecting with others in similar circumstances.However, the downside to the information superhighway is that it can take you on a lot of wrong turns. We all know the stories of ways the internet has been used by con artists for scams, but another less obvious concern is filtering through information to ensure you are getting accurate information or advice.
Both online and offline, we see a lot of misinformation about dementia and related terms like sundowners syndrome, Alzheimer's disease and memory loss. It is not uncommon when a family comes to see us to hear that they have not been able to get specific answers about what is going on with a loved one who is having cognitive issues. Sometimes this is due to fear and no one wanting to seek a specific diagnosis, other times certain assumptions have been made (the symptoms are just "old age") and occasionally the family has gotten blatently incorrect information.
Here are some words of advice for seeking information as a caregiver, whether on issues like sundowners syndrome, dementia, caregiving or preparing for eldercare:
- Seek expert sites on the specific topic. Start with sites such as disease-specific organizations and trusted resources with long histories.
- Find out who is providing the information and review their "about us" closely. What are the academic backgrounds and qualifications of the people writing the information? If you cannot locate an "about us" page, you should probably seek information elsewhere.
- The best information to get from other caregivers is support and ideas on how they have handled situations. When it comes to diagnoses, care planning and choosing specific resources, a professional opinion usually serves you better. Here are some areas where we see particularly bad (or just misguided) information being shared: legal advice, qualifying for benefits/programs and how to do so, diagnosis and treatment information, terminology and resources. Many times it is not that the information is purposely harmful, it just doesn't necessarily apply to your situation.
- Stay away from judgmental or negative commentary. It is the last thing you need as a caregiver. If you review a Facebook group or forum site and notice people sharing strong opinions of what a caregiver should or should not do, this may not be a supportive atmosphere for you. Negativity (and even things like political ranting) can cause you greater anxiety.
- Just like with other aspects of caregiving, strategize which ways the internet and technology can help you most. For example, reading too much about a relative's diagnosis might be scary at first. Instead, seek information on which physicians or hospitals specialize in treatment or who offers local support groups. Setting up an online personal health record or using a communications system/online community can be very helpful to caregivers.
- Use a combination of information sources to seek resources/care providers. When you are trying to find options such as in-home care, assisted living, and benefit programs, you may be best served by having professional help in pulling together a care plan. This can save you a lot of hours of research and heading down the wrong roads
FirstHealth dementia care
Richmond County Daily Journal - Caregivers Family Night to focus on FirstHealth dementia care: FirstHealth dementia care
Melanie Bunn; geriatric nurse practitioner, a dementia training specialist with Alzheimers North Carolina and an instructor of nurses with Duke University’s School of Nursing, .... her life’s work, ... involves the care and concerns of people with dementia.
Bunn’s role with the Moore Regional nursing staff has focused on building a “care-giving team” with the appropriate tools and knowledge for the individualized care of individuals with “altered mental status.” That can mean the temporary confusion that can accompany an acute illness or the vast mental and physical losses of advanced dementia.
The hospital’s revised protocols on these patients with altered mental status begin at admission during the routine medical assessment that is required of every patient. Patients with an appropriate diagnosis get a gray armband that identifies their altered mental status to the entire care-giving team, and the information is documented in their patient record.
Additional hospital protocols for patients with altered mental status focus on individualized care approaches and specified methods of communication. They also include environmental suggestions for maintaining a “safe, calm, non-threatening environment” such as encouraging frequent family/familiar caregiver visits and avoiding visual and/or auditory elements that could disturb the patient even more.
According to Cheryl Batchelor, R.N., Moore Regional’s executive director of clinical operations, the protocol revisions followed a study of the hospital’s dementia care-giving practices after the husband of an Alzheimer’s patient had raised some concerns.
“He felt we needed to acknowledge the special needs of people with dementia,” Batchelor said. “We thought we were doing a good job, but we were not looking at individualized needs.”
After hearing examples to the contrary during a meeting with the patient’s husband and two other relatives of patients with dementia,
Batchelor, physician champion Jenifir Bruno, M.D., of Hospitalist Services and other members of the FirstHealth nursing staff formed a task force with “cross representation” from all three FirstHealth hospitals.
“We involved as many (disciplines) as possible,” said Tabitha Stewart, R.N., a nurse clinician with Moore Regional Clinical Practice/Professional Development.
Team members reviewed medical literature and contacted other hospitals and various specialists in the area of dementia care. Results included revised educational materials and protocols that were approved by FirstHealth’s Nurse Practice Council.
The admissions database was revised to improve the screening of dementia patients, and the Information Technology department developed a special music-only TV channel for patients who don’t cope well with noise. In addition to Bunn, expert contacts included Dr. Eleanor McConnell of Duke’s Center of Excellence in Geriatric Nursing Education, and Alice Watkins, executive director of Alzheimers North Carolina.
As the various initiatives were rolled out, family caregivers continued to be involved and are pleased with the results. In a recent email, the family member who raised the initial concerns shared the following story about another family:
“At a Dementia Caregiver’s Support Group meeting this week, a participant shared a story about a recent MRH ED visit with her loved one who has dementia. The visit was precipitated by a fall, which resulted in a nasty cut on the forehead. She indicted that he was given a gray wristband. But, more importantly to her, she said the staff seemed much more empathetic to his dementia and accommodating to her than during her previous ED visits, the most recent being about six months ago.
“She additionally noted that upon asking she was allowed to accompany him to imaging where they provided a chair for her while he was given a CT scan.
Read more: Richmond County Daily Journal - Caregivers Family Night to focus on FirstHealth dementia care
Melanie Bunn; geriatric nurse practitioner, a dementia training specialist with Alzheimers North Carolina and an instructor of nurses with Duke University’s School of Nursing, .... her life’s work, ... involves the care and concerns of people with dementia.
Bunn’s role with the Moore Regional nursing staff has focused on building a “care-giving team” with the appropriate tools and knowledge for the individualized care of individuals with “altered mental status.” That can mean the temporary confusion that can accompany an acute illness or the vast mental and physical losses of advanced dementia.
The hospital’s revised protocols on these patients with altered mental status begin at admission during the routine medical assessment that is required of every patient. Patients with an appropriate diagnosis get a gray armband that identifies their altered mental status to the entire care-giving team, and the information is documented in their patient record.
Additional hospital protocols for patients with altered mental status focus on individualized care approaches and specified methods of communication. They also include environmental suggestions for maintaining a “safe, calm, non-threatening environment” such as encouraging frequent family/familiar caregiver visits and avoiding visual and/or auditory elements that could disturb the patient even more.
According to Cheryl Batchelor, R.N., Moore Regional’s executive director of clinical operations, the protocol revisions followed a study of the hospital’s dementia care-giving practices after the husband of an Alzheimer’s patient had raised some concerns.
“He felt we needed to acknowledge the special needs of people with dementia,” Batchelor said. “We thought we were doing a good job, but we were not looking at individualized needs.”
After hearing examples to the contrary during a meeting with the patient’s husband and two other relatives of patients with dementia,
Batchelor, physician champion Jenifir Bruno, M.D., of Hospitalist Services and other members of the FirstHealth nursing staff formed a task force with “cross representation” from all three FirstHealth hospitals.
“We involved as many (disciplines) as possible,” said Tabitha Stewart, R.N., a nurse clinician with Moore Regional Clinical Practice/Professional Development.
Team members reviewed medical literature and contacted other hospitals and various specialists in the area of dementia care. Results included revised educational materials and protocols that were approved by FirstHealth’s Nurse Practice Council.
The admissions database was revised to improve the screening of dementia patients, and the Information Technology department developed a special music-only TV channel for patients who don’t cope well with noise. In addition to Bunn, expert contacts included Dr. Eleanor McConnell of Duke’s Center of Excellence in Geriatric Nursing Education, and Alice Watkins, executive director of Alzheimers North Carolina.
As the various initiatives were rolled out, family caregivers continued to be involved and are pleased with the results. In a recent email, the family member who raised the initial concerns shared the following story about another family:
“At a Dementia Caregiver’s Support Group meeting this week, a participant shared a story about a recent MRH ED visit with her loved one who has dementia. The visit was precipitated by a fall, which resulted in a nasty cut on the forehead. She indicted that he was given a gray wristband. But, more importantly to her, she said the staff seemed much more empathetic to his dementia and accommodating to her than during her previous ED visits, the most recent being about six months ago.
“She additionally noted that upon asking she was allowed to accompany him to imaging where they provided a chair for her while he was given a CT scan.
Read more: Richmond County Daily Journal - Caregivers Family Night to focus on FirstHealth dementia care
Primary Phone: 910-997-3111
Primary Fax: 910-997-4321
John Charles Robbins
Editor
910.997.3111
jrobbins@civitasmedia.com
http://en.wikipedia.org/wiki/Nursing_home | nursing home, convalescent home, skilled nursing facility
Canada
Quebec
Long-term care facilities exist under three types, public, subsidized and private. Public and subsidized differ only in their ownership, all other aspects of funding, admission criteria, cost to the individuals are all regulated by the Quebec Ministry of Health and Social Services.[3] Private facilities are completely independent from government ownership and funding, they have their own admission criteria. They must maintain certain provincial[clarification needed] standards and require licensing from the ministry.
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United Kingdom
In 2002 nursing homes became known as care homes with nursing, and residential homes became known as care homes.[4]
In the United Kingdom care homes and care homes with nursing are regulated by different organisations in England, Scotland, Wales and Northern Ireland. To enter a care home, a candidate patient needs an assessment of needs and of their financial condition from their local council. The candidate may also have an assessment by a nurse, should the patient require nursing care. The cost of a care home is means tested in England.
As of April 2009 in England, the lower capital limit is £13,500. At this level, all income from pensions, savings, benefits and other sources, except a "personal expenses allowance" (currently £21.90), will go to paying the care home fees. The local council pays the remaining contribution provided the room occupied is not more expensive than the local council's normal rate, currently £364.48 for Hampshire for example. If the resident is paying more than this the council will not pay anything and contributions from a third party or charity must be found or the resident move to a cheaper care home. Between the lower and the upper capital limits, the resident pays their income less personal expenses allowance + £1/week for every £250 capital between lower and higher limit. The council pays the rest, subject to the same conditions as before. It is therefore preferable to find a home within the council's limit if council funding is likely to be required to avoid a forced move later. Patients with capital over more than £23,000 pay the full cost of the care home, until the total value of their assets fall below the threshold.[5] Patients who require additional nursing care are assessed for this.[6] and receive additional financial support (£103.80 weekly) through the National Health Service (NHS). This is known as Funded Nursing Care.
The NHS has full responsibility for funding the whole placement if the resident in a care home with nursing meets the criteria for NHS continuing Health Care. This is identified by a multidisciplinary assessment process.[7]
Care homes for adults in England are regulated by Care Quality Commission, which replaced the Commission for Social Care Inspection, and each care home is inspected at least every three years. In Wales the Care Standards Inspectorate for Wales has responsibility for oversight, In Scotland Social Care and Social Work Improvement Scotland otherwise known as the Care Inspectorate, and in Northern Ireland the Regulation and Quality Improvement Authority in Northern Ireland.
In May 2010, the Coalition Government announced the formation of an independent commission on the funding of long-term care, which was due to report within a 12-month time frame on the financing of care for an Ageing population. It delivered its recommendations on Monday 4 July 2011. The Care Quality Commission have themselves implemented a re-registration process, completed in October 2010, which will result in a new form of regulation being outlined in April 2011. [8]
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United States
In the United States, there are three main types of nursing facilities (NFs).
Intermediate care facility (ICF)
An intermediate care facility (ICF) is a health care facility for individuals who are disabled, elderly, or non-acutely ill, usually providing less intensive care than that offered at a hospital or skilled nursing facility. Typically ICF is privately paid by the individual or by the individual's family. An individual's private health insurance and/or a third party service like a hospice company may cover the cost.
Assisted living facility (ALF)
----------
Rest home for seniors in Ceský Tešín, Czech Republic
Assisted living residences or assisted living facilities (ALFs) are housing facilities for people with disabilities. These facilities provide supervision or assistance with activities of daily living (ADLs); ALFs are an eldercare alternative on the continuum of care for people, for whom independent living is not appropriate but who do not need the 24-hour medical care provided by a nursing home and are too young to live in a retirement home. Assisted living is a philosophy of care and services promoting independence and dignity.[9]
Skilled nursing facility (SNF)
A skilled nursing facility (SNF) is a nursing home certified to participate in, and be reimbursed by Medicare. Medicare is the federal program primarily for the aged (65+) who contributed to Social Security and Medicare while they were employed. Medicaid is the federal program implemented with each state to provide health care and related services to those who are below the poverty line. Each state defines poverty and, therefore, Medicaid eligibility. Those eligible for Medicaid maybe low-income parents, children, including State Children's Health Insurance Programs (SCHIPs) and maternal-child wellness and food programs.[citation needed] seniors, and people with disabilities.
The Centers for Medicare and Medicaid Services (CMS) is the component of the U.S. Department of Health and Human Services (DHHS) that oversees Medicare and Medicaid. A large portion of Medicare and Medicaid dollars is used each year to cover nursing home care and services for the elderly and disabled. State governments oversee the licensing of nursing homes. In addition, States have a contract with CMS to monitor those nursing homes that want to be eligible to provide care to Medicare and Medicaid beneficiaries. Congress established minimum requirements for nursing homes that want to provide services under Medicare and Medicaid. These requirements are broadly outlined in the Social Security Act, which also entrusts the Secretary of Health and Human Services with the responsibility of monitoring and enforcing these requirements. The Centers for Medicare and Medicaid Services is also charged with the responsibility of working out the details of the law and how it will be implemented, which it does by writing regulations and manuals.[10]
-------
Typical nursing home staff
Administration
Once a patient has moved into the nursing home, their relatives may not have significant contact with the administration team, unless there are specific concerns that arise. Depending on the size of the nursing home, the administration staff may be very small, consisting of only a handful or people, or it may have dozens of staff responsible for individual departments (i.e., accounting, human resources, etc). Most states require nursing home administrators to have a license to run a facility.
Support personnel
Some staff members focus solely on caring for the buildings and grounds. Custodians, maintenance staff, and groundskeepers, for example, keep the inside and outside of the building in clean, working order.
Additional support personnel also include people who may have some contact with the patient in the nursing home, but it may not be daily or even regularly. For example, nursing homes may have an activities director who is responsible for planning and implementing holiday events, daily and weekly educational and social activities, coordinating special visitors and religious services. Larger facilities may have multiple staff members, such as chaplains or activity assistants, who take on some of those roles. Physical therapy staff may also be available, depending on the home.
Direct care staff
Nurse at a nursing home in Norway
The direct care staff have direct, daily contact with the patient. The following are types of direct care staff included in all nursing homes:
Registered nurse (RN)
Licensed practical nurse (LPN) or licensed vocational nurse (LVN)
Certified nursing assistant (CNA)
Staffing requirements
Federal law requires all nursing homes to provide enough staff to adequately care for residents. There is no current federal standard for optimal nursing home staffing levels. The nursing home must have at least one RN for at least 8 straight hours a day, 7 days a week, and either an RN or LPN/LVN on duty 24 hours per day. Certain states may have additional staffing requirements. CNAs provide care to nursing home residents twenty four hours per day, seven days a week.
Services
Nursing homes offer the most extensive care a person can get outside a hospital. Nursing homes offer help with custodial care—like bathing, getting dressed, and eating—as well as skilled care given by a registered nurse and includes medical monitoring and treatments. Skilled care also includes services provided by specially trained professionals, such as physical, occupational, and respiratory therapists.
The services nursing homes offer vary from facility to facility. Services include:
Room and board
Monitoring of medication
Personal care (including dressing, bathing, and toilet assistance)
24-hour emergency care
Social and recreational activities
Occupational Therapy
Some of the individuals that are housed in a nursing home need ongoing occupational therapy. Occupational Therapists (OTs) and Occupational Therapy Assistants (OTAs) “promote the health and participation of people, organizations, and populations through engagement in occupation” (American Occupational Therapy Association [AOTA], 2008). OTs and OTAs provide intervention in areas of occupation such as: activities of daily living (ADLs) including bathing, dressing, grooming; instrumental activities of daily living (IADLs) including home and financial management, rest and sleep, education, work, play, leisure, and social participation (AOTA, 2008). They also develop and implement health and wellness programs to prevent injuries, maintain function, and improve safety of residents. For example, OTs and OTAs can take a leadership role in developing and implementing programs to educate clients on compensatory techniques for low vision, customized exercise programs, or strategies to prevent falls. Occupational therapy practitioners may also consult with other staff within the facility or in the community on a variety of topics related to increasing safe engagement in activities. Occupational therapy practitioners can provide a variety of services to short- and long-term residents of a SNF. Based on a client-centered evaluation, the occupational therapist, the client, caregivers, and/or significant others develop collaborative goals to identify strengths and deficits and address barriers that hinder occupational performance in multiple areas. The intervention plan is designed to promote a client’s optimal function for transition to home, another facility, or long-term care.
Physical therapy
Some of the individuals that are housed in a nursing home need ongoing physical therapy. This can be for any number of reasons. Perhaps a person has motor skills that never fully developed or have stopped functioning for some reason. Perhaps an individual has undergone a surgery or medical procedure that requires some manner of physical restitution on a personal level. Nursing homes offer specialists that are well versed in the field of rebuilding muscle or helping one regain their confidence when it comes to doing something physical. This is one of the most common therapies that are done in these nursing homes.
Medical needs
Nearly all residents in a nursing home have the need for some type of medical need. It can be anything from basic care of a medical inadequacy to something more specialized such as someone that is missing an appendage. These nursing facilities can take care of just about any medical need that needs to be taken care of. Most of the staff at these nursing homes has ample training in how to deal with patients that have some manner of specialized need. In fact, the staff that interacts with the patients the most are normally registered nurses that have spent years training for any situation that they may encounter during a patients stay at one of these nursing homes.
Companionship
Payment for nursing home care can be made through Medicare, Medicaid, private insurance, and personal funds.
Medicare is a federal health insurance program providing health care benefits to all Americans age 65 and over. Insurance protection intended to cover major hospital care is provided without regard to income. Medicare will only provide 100 days of nursing care, and only if a person requires skilled care and is referred by a doctor when discharged from the hospital. If a person needs custodial care alone, Medicare will not cover it. Medicare only pays for skilled care in a nursing facility that has a Medicare license.
Medicaid is a joint federal/state health insurance program providing medical care benefits to low income Americans who meet certain requirements. Nursing home care is covered through Medicaid, but the requirements and covered services vary widely from state to state. To become eligible for Medicaid coverage, people usually have to spend all of their assets first. This means that they might pay for nursing home care out of pocket initially. Once their money runs out, Medicaid would kick in. It's a good idea to work with a lawyer who specializes in elder law when determining Medicaid eligibility.
Private long-term care insurance is a health insurance option that, if purchased, supplements Medicare coverage. Private long-term care insurance policies vary greatly. Each policy has its own eligibility requirements, restrictions, costs, and benefits.
Quebec
Long-term care facilities exist under three types, public, subsidized and private. Public and subsidized differ only in their ownership, all other aspects of funding, admission criteria, cost to the individuals are all regulated by the Quebec Ministry of Health and Social Services.[3] Private facilities are completely independent from government ownership and funding, they have their own admission criteria. They must maintain certain provincial[clarification needed] standards and require licensing from the ministry.
--------------
United Kingdom
In 2002 nursing homes became known as care homes with nursing, and residential homes became known as care homes.[4]
In the United Kingdom care homes and care homes with nursing are regulated by different organisations in England, Scotland, Wales and Northern Ireland. To enter a care home, a candidate patient needs an assessment of needs and of their financial condition from their local council. The candidate may also have an assessment by a nurse, should the patient require nursing care. The cost of a care home is means tested in England.
As of April 2009 in England, the lower capital limit is £13,500. At this level, all income from pensions, savings, benefits and other sources, except a "personal expenses allowance" (currently £21.90), will go to paying the care home fees. The local council pays the remaining contribution provided the room occupied is not more expensive than the local council's normal rate, currently £364.48 for Hampshire for example. If the resident is paying more than this the council will not pay anything and contributions from a third party or charity must be found or the resident move to a cheaper care home. Between the lower and the upper capital limits, the resident pays their income less personal expenses allowance + £1/week for every £250 capital between lower and higher limit. The council pays the rest, subject to the same conditions as before. It is therefore preferable to find a home within the council's limit if council funding is likely to be required to avoid a forced move later. Patients with capital over more than £23,000 pay the full cost of the care home, until the total value of their assets fall below the threshold.[5] Patients who require additional nursing care are assessed for this.[6] and receive additional financial support (£103.80 weekly) through the National Health Service (NHS). This is known as Funded Nursing Care.
The NHS has full responsibility for funding the whole placement if the resident in a care home with nursing meets the criteria for NHS continuing Health Care. This is identified by a multidisciplinary assessment process.[7]
Care homes for adults in England are regulated by Care Quality Commission, which replaced the Commission for Social Care Inspection, and each care home is inspected at least every three years. In Wales the Care Standards Inspectorate for Wales has responsibility for oversight, In Scotland Social Care and Social Work Improvement Scotland otherwise known as the Care Inspectorate, and in Northern Ireland the Regulation and Quality Improvement Authority in Northern Ireland.
In May 2010, the Coalition Government announced the formation of an independent commission on the funding of long-term care, which was due to report within a 12-month time frame on the financing of care for an Ageing population. It delivered its recommendations on Monday 4 July 2011. The Care Quality Commission have themselves implemented a re-registration process, completed in October 2010, which will result in a new form of regulation being outlined in April 2011. [8]
--------------------
United States
In the United States, there are three main types of nursing facilities (NFs).
Intermediate care facility (ICF)
An intermediate care facility (ICF) is a health care facility for individuals who are disabled, elderly, or non-acutely ill, usually providing less intensive care than that offered at a hospital or skilled nursing facility. Typically ICF is privately paid by the individual or by the individual's family. An individual's private health insurance and/or a third party service like a hospice company may cover the cost.
Assisted living facility (ALF)
----------
Rest home for seniors in Ceský Tešín, Czech Republic
Assisted living residences or assisted living facilities (ALFs) are housing facilities for people with disabilities. These facilities provide supervision or assistance with activities of daily living (ADLs); ALFs are an eldercare alternative on the continuum of care for people, for whom independent living is not appropriate but who do not need the 24-hour medical care provided by a nursing home and are too young to live in a retirement home. Assisted living is a philosophy of care and services promoting independence and dignity.[9]
Skilled nursing facility (SNF)
A skilled nursing facility (SNF) is a nursing home certified to participate in, and be reimbursed by Medicare. Medicare is the federal program primarily for the aged (65+) who contributed to Social Security and Medicare while they were employed. Medicaid is the federal program implemented with each state to provide health care and related services to those who are below the poverty line. Each state defines poverty and, therefore, Medicaid eligibility. Those eligible for Medicaid maybe low-income parents, children, including State Children's Health Insurance Programs (SCHIPs) and maternal-child wellness and food programs.[citation needed] seniors, and people with disabilities.
The Centers for Medicare and Medicaid Services (CMS) is the component of the U.S. Department of Health and Human Services (DHHS) that oversees Medicare and Medicaid. A large portion of Medicare and Medicaid dollars is used each year to cover nursing home care and services for the elderly and disabled. State governments oversee the licensing of nursing homes. In addition, States have a contract with CMS to monitor those nursing homes that want to be eligible to provide care to Medicare and Medicaid beneficiaries. Congress established minimum requirements for nursing homes that want to provide services under Medicare and Medicaid. These requirements are broadly outlined in the Social Security Act, which also entrusts the Secretary of Health and Human Services with the responsibility of monitoring and enforcing these requirements. The Centers for Medicare and Medicaid Services is also charged with the responsibility of working out the details of the law and how it will be implemented, which it does by writing regulations and manuals.[10]
-------
Typical nursing home staff
Administration
Once a patient has moved into the nursing home, their relatives may not have significant contact with the administration team, unless there are specific concerns that arise. Depending on the size of the nursing home, the administration staff may be very small, consisting of only a handful or people, or it may have dozens of staff responsible for individual departments (i.e., accounting, human resources, etc). Most states require nursing home administrators to have a license to run a facility.
Support personnel
Some staff members focus solely on caring for the buildings and grounds. Custodians, maintenance staff, and groundskeepers, for example, keep the inside and outside of the building in clean, working order.
Additional support personnel also include people who may have some contact with the patient in the nursing home, but it may not be daily or even regularly. For example, nursing homes may have an activities director who is responsible for planning and implementing holiday events, daily and weekly educational and social activities, coordinating special visitors and religious services. Larger facilities may have multiple staff members, such as chaplains or activity assistants, who take on some of those roles. Physical therapy staff may also be available, depending on the home.
Direct care staff
Nurse at a nursing home in Norway
The direct care staff have direct, daily contact with the patient. The following are types of direct care staff included in all nursing homes:
Registered nurse (RN)
Licensed practical nurse (LPN) or licensed vocational nurse (LVN)
Certified nursing assistant (CNA)
Staffing requirements
Federal law requires all nursing homes to provide enough staff to adequately care for residents. There is no current federal standard for optimal nursing home staffing levels. The nursing home must have at least one RN for at least 8 straight hours a day, 7 days a week, and either an RN or LPN/LVN on duty 24 hours per day. Certain states may have additional staffing requirements. CNAs provide care to nursing home residents twenty four hours per day, seven days a week.
Services
Nursing homes offer the most extensive care a person can get outside a hospital. Nursing homes offer help with custodial care—like bathing, getting dressed, and eating—as well as skilled care given by a registered nurse and includes medical monitoring and treatments. Skilled care also includes services provided by specially trained professionals, such as physical, occupational, and respiratory therapists.
The services nursing homes offer vary from facility to facility. Services include:
Room and board
Monitoring of medication
Personal care (including dressing, bathing, and toilet assistance)
24-hour emergency care
Social and recreational activities
Occupational Therapy
Some of the individuals that are housed in a nursing home need ongoing occupational therapy. Occupational Therapists (OTs) and Occupational Therapy Assistants (OTAs) “promote the health and participation of people, organizations, and populations through engagement in occupation” (American Occupational Therapy Association [AOTA], 2008). OTs and OTAs provide intervention in areas of occupation such as: activities of daily living (ADLs) including bathing, dressing, grooming; instrumental activities of daily living (IADLs) including home and financial management, rest and sleep, education, work, play, leisure, and social participation (AOTA, 2008). They also develop and implement health and wellness programs to prevent injuries, maintain function, and improve safety of residents. For example, OTs and OTAs can take a leadership role in developing and implementing programs to educate clients on compensatory techniques for low vision, customized exercise programs, or strategies to prevent falls. Occupational therapy practitioners may also consult with other staff within the facility or in the community on a variety of topics related to increasing safe engagement in activities. Occupational therapy practitioners can provide a variety of services to short- and long-term residents of a SNF. Based on a client-centered evaluation, the occupational therapist, the client, caregivers, and/or significant others develop collaborative goals to identify strengths and deficits and address barriers that hinder occupational performance in multiple areas. The intervention plan is designed to promote a client’s optimal function for transition to home, another facility, or long-term care.
Physical therapy
Some of the individuals that are housed in a nursing home need ongoing physical therapy. This can be for any number of reasons. Perhaps a person has motor skills that never fully developed or have stopped functioning for some reason. Perhaps an individual has undergone a surgery or medical procedure that requires some manner of physical restitution on a personal level. Nursing homes offer specialists that are well versed in the field of rebuilding muscle or helping one regain their confidence when it comes to doing something physical. This is one of the most common therapies that are done in these nursing homes.
Medical needs
Nearly all residents in a nursing home have the need for some type of medical need. It can be anything from basic care of a medical inadequacy to something more specialized such as someone that is missing an appendage. These nursing facilities can take care of just about any medical need that needs to be taken care of. Most of the staff at these nursing homes has ample training in how to deal with patients that have some manner of specialized need. In fact, the staff that interacts with the patients the most are normally registered nurses that have spent years training for any situation that they may encounter during a patients stay at one of these nursing homes.
Companionship
Payment for nursing home care can be made through Medicare, Medicaid, private insurance, and personal funds.
Medicare is a federal health insurance program providing health care benefits to all Americans age 65 and over. Insurance protection intended to cover major hospital care is provided without regard to income. Medicare will only provide 100 days of nursing care, and only if a person requires skilled care and is referred by a doctor when discharged from the hospital. If a person needs custodial care alone, Medicare will not cover it. Medicare only pays for skilled care in a nursing facility that has a Medicare license.
Medicaid is a joint federal/state health insurance program providing medical care benefits to low income Americans who meet certain requirements. Nursing home care is covered through Medicaid, but the requirements and covered services vary widely from state to state. To become eligible for Medicaid coverage, people usually have to spend all of their assets first. This means that they might pay for nursing home care out of pocket initially. Once their money runs out, Medicaid would kick in. It's a good idea to work with a lawyer who specializes in elder law when determining Medicaid eligibility.
Private long-term care insurance is a health insurance option that, if purchased, supplements Medicare coverage. Private long-term care insurance policies vary greatly. Each policy has its own eligibility requirements, restrictions, costs, and benefits.
Alzheimer's Disease Medications Fact Sheet | National Institute on Aging
Alzheimer's Disease Medications Fact Sheet | National Institute on Aging
Alzheimer's Disease Medications Fact Sheet
Alzheimer's Disease Medications Fact Sheet
Several prescription drugs are currently approved by the U.S. Food and Drug Administration (FDA) to treat people who have been diagnosed with Alzheimer’s disease. Treating the symptoms of Alzheimer’s can provide patients with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well.
It is important to understand that none of these medications stops the disease itself.
For information about managing medicines for people with Alzheimer's disease, read the tip sheet Managing Medicines (PDF, 625K).
Volunteers—people with Alzheimer's or mild cognitive impairment and healthy individuals—are needed to participate in Alzheimer's clinical research. Learn more about participating in clinical trials.
Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimer’s disease, but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimer’s progresses, the brain produces less and less acetylcholine; therefore, cholinesterase inhibitors may eventually lose their effect.
No published study directly compares these drugs. Because they work in a similar way, switching from one of these drugs to another probably will not produce significantly different results. However, an Alzheimer’s patient may respond better to one drug than another.
It may allow patients to maintain certain daily functions a little longer than they would without the medication. For example, Namenda® may help a patient in the later stages of the disease maintain his or her ability to use the bathroom independently for several more months, a benefit for both patients and caregivers.
Namenda® is believed to work by regulating glutamate, an important brain chemical. When produced in excessive amounts, glutamate may lead to brain cell death. Because NMDA antagonists work very differently from cholinesterase inhibitors, the two types of drugs can be prescribed in combination.
The FDA has also approved Aricept® for the treatment of moderate to severe Alzheimer’s disease.
Patients should be monitored when a drug is started. Report any unusual symptoms to the prescribing doctor right away. It is important to follow the doctor’s instructions when taking any medication, including vitamins and herbal supplements. Also, let the doctor know before adding or changing any medications.
It is important to understand that none of these medications stops the disease itself.
For information about managing medicines for people with Alzheimer's disease, read the tip sheet Managing Medicines (PDF, 625K).
Volunteers—people with Alzheimer's or mild cognitive impairment and healthy individuals—are needed to participate in Alzheimer's clinical research. Learn more about participating in clinical trials.
Treatment for Mild to Moderate Alzheimer’s
Medications called cholinesterase inhibitors are prescribed for mild to moderate Alzheimer’s disease. These drugs may help delay or prevent symptoms from becoming worse for a limited time and may help control some behavioral symptoms. The medications include: Razadyne® (galantamine), Exelon® (rivastigmine), and Aricept® (donepezil). Another drug, Cognex® (tacrine), was the first approved cholinesterase inhibitor but is rarely prescribed today due to safety concerns.Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimer’s disease, but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimer’s progresses, the brain produces less and less acetylcholine; therefore, cholinesterase inhibitors may eventually lose their effect.
No published study directly compares these drugs. Because they work in a similar way, switching from one of these drugs to another probably will not produce significantly different results. However, an Alzheimer’s patient may respond better to one drug than another.
Treatment for Moderate to Severe Alzheimer’s
A medication known as Namenda® (memantine), an N-methyl D-aspartate (NMDA) antagonist, is prescribed to treat moderate to severe Alzheimer’s disease. This drug’s main effect is to delay progression of some of the symptoms of moderate to severe Alzheimer’s.It may allow patients to maintain certain daily functions a little longer than they would without the medication. For example, Namenda® may help a patient in the later stages of the disease maintain his or her ability to use the bathroom independently for several more months, a benefit for both patients and caregivers.
Namenda® is believed to work by regulating glutamate, an important brain chemical. When produced in excessive amounts, glutamate may lead to brain cell death. Because NMDA antagonists work very differently from cholinesterase inhibitors, the two types of drugs can be prescribed in combination.
The FDA has also approved Aricept® for the treatment of moderate to severe Alzheimer’s disease.
Dosage and Side Effects
Doctors usually start patients at low drug doses and gradually increase the dosage based on how well a patient tolerates the drug. There is some evidence that certain patients may benefit from higher doses of the cholinesterase inhibitors. However, the higher the dose, the more likely are side effects. The recommended effective dosages of drugs prescribed to treat the symptoms of Alzheimer’s and the drugs’ possible side effects are summarized in the table (see below).Patients should be monitored when a drug is started. Report any unusual symptoms to the prescribing doctor right away. It is important to follow the doctor’s instructions when taking any medication, including vitamins and herbal supplements. Also, let the doctor know before adding or changing any medications.
Alzheimer's Disease Education and Referral (ADEAR) Center
A Service of the National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services
November 2008
A Service of the National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services
November 2008
Publication Date: July 2010
Page Last Updated: March 22, 2013
Page Last Updated: March 22, 2013
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