Sunday, February 27, 2011

Who is Home Care Assistance?

This is who we are. The security guard. The friend. The caregiver.

“No way, I’ll throw her out of the house – I don’t need and I don’t want a caregiver,” Ed yelled at his daughter.

Linda knew her Father needed help — his Alzheimer’s was progressing and he was getting very forgetful of important things – like turning off the stove.

But he was adamant about not having help. Linda was getting desperate, afraid for her Father’s safety and health since he lived alone in a home that he didn’t want to leave.

Fortunately, Linda called Home Care Assistance and talked with a Case Manager familiar with the problem. They discussed her Father’s habits and enjoyments and found that Ed liked going out to lunch every day and occasionally, to a nearby Indian casino to play the slot machines.

OK, said the Case Manger – Ed doesn’t want a caregiver, but how about a security guard, would he accept that?

Together, daughter and our Home Care Assistance Case Manager convinced Ed that he would be a lot safer with a security guard – and he agreed.

One of Home Care Assistance best male caregivers (aka Security Guard Jim), took care of Ed in his home – and made sure that he was safe when they went out to lunch – and occasionally, to play the slots at the nearby casino!

Wednesday, February 23, 2011

Caregiver Interventions Can Help Treat Those With Alzheimer’s and Dementia

With a new year, comes new innovations in the healthcare industry. The New York Times reports that recent research is stressing the importance of caregiving to those with Alzheimer’s. With no effective treatment for Alzheimer’s, dementia therapy is the caregiving performed by families, agencies or at assisted living facilities.

“There’s actually better evidence and more significant results in caregiver interventions than there is in anything to treat this disease so far,” says Lisa P. Gwyther, Education Director for the Bryan Alzheimer’s Disease Research Center at Duke University.

Research suggests that creating positive emotional experiences for Alzheimer’s patients reduces distress and behavior problems. Emotions exist even after cognition deteriorates, so changing things like food, art, exercise, or the aesthetics of a room can generate positive emotions. The Journal of the American Medical Association found that brightening lights in dementia facilities decreased depression and cognitive deterioration.

Additionally, the research is stressing the importance of a caregiver’s emotional state, so much that agencies are developing programs to provide caregivers with education and emotional support. This type of support is not only beneficial to the caregivers themselves, but to their patients as well.

Home Care Assistance similarly stresses the importance of emotional support to both the patient and the caregiver. This type of innovative research is an exciting start to 2011. Hopefully we will continue to see even greater breakthroughs in the treatment of those with Alzheimer’s and dementia.

Saturday, February 12, 2011

Report Calls Alzheimer's the Defining Disease of Baby Boomer Generation

According to Generation Alzheimer’s, a new report released by the Alzheimer’s Association on Jan. 27, one in eight baby boomers will develop Alzheimer’s, a devastating, heartbreaking, costly disease. It’s no longer their grandparents and parents who have Alzheimer’s – it’s the baby boomers themselves.

A rapidly aging population and dramatic increases in the number of Alzheimer cases in the coming years underscores the urgency in dealing with a crisis that is no longer emerging, but here.

Generation Alzheimer’s also describes the effect Alzheimer’s has on families and friends. Beyond the 10 million baby boomers who will either die with or from Alzheimer’s, millions of caregivers will be devastated, not only by the progressive loss of their loved one, but also by the care they will provide – care that could negatively affect their health, financial security and their future.

Most people survive an average of four to six years after a diagnosis of Alzheimer’s, but many live for as long as 20 years with the disease. This often long duration places increasingly intensive care demands on Alzheimer and dementia caregivers – as many as 11 million nationwide.

Alzheimer’s disease will also have a profound effect on our nation, killing more than diabetes and more than breast cancer and prostate cancer combined. According to preliminary data from National Center for Health Statistics, the number of Americans that die each year from Alzheimer’s disease has risen 66 percent since 2000. In 2010, Alzheimer’s and other dementias cost American society – families, insurers and the government - $172 billion; during the next 40 years it will cost more than $20 trillion, enough to pay of the national debt today and still send a $20,000 check to every man, woman and child in America.

Generation Alzheimer’s calls for a federal government committed to a thorough, aggressive and innovative approach to ending Alzheimer’s.

For more information about Generation Alzheimer’s, Alzheimer’s disease or resources to help, visit the Alzheimer’s Association at alz.org.  To read the report, please click here:  Generation Alzheimer's

Somebody's Sweetheart

by Anne Pagnoni

The month of February and Valentine’s Day brings a celebration of love and stirs couples to rekindle feelings of romance and devotion. Not so different from young couples are aging seniors, celebrating memories of sweethearts and romance in days gone by. Sit a while with a senior couple and they will soon be telling you their romance story or listen to a widow or widower as they sing their favorite love song from their youth.

Dementia and Alzheimer’s can rob senior minds of many of these treasured memories, changing their personality and life style. Because of these and other illnesses, many seniors end up in nursing homes or care facilities where only their basic physical needs are cared for by the facility staff. To these seniors, Valentine’s Day becomes no different from every other day. They often find it difficult to relive memories of the past. In one care facility a sign placed lovingly over a patient’s bed reads, “I Am Somebody’s Sweetheart,” as if to say I once dreamed, lived and loved, please treat me kindly.

When asked how she relates to those she cares for, nurse assistant Karen W. replies that most of the time it's those patients who are causing a disturbance or may be in danger of harming themselves who are the ones that get her attention. Even then she can only take care of the immediate problem. Very seldom has she time to personally get to know well all the elderly people she cares for.

Although this is true with many facilities, the need for more personalized care is, in some cases, being recognized. Assisted living facilities with specialized memory care programs -- some using art, music and dance or physical activities -- are finding great success with increasing the quality of life for those suffering from dementia and Alzheimer’s. Many care facilities across the nation are adding these programs to better serve their residents.

If you cannot find a facility in your area that provides this special attention, home care may be a better option. Consider this real experience. When Nora would visit her father in the nursing home she would find him sitting, slumped over and disinterested in his surroundings. By the time she and her young children finished their visit, he was alert and talking to them. Feeling he would do better in her home environment, Nora enlisted the services of a Geriatric Care Manager to evaluate her father and determine what would be needed for his care at home so that he could get the social stimulation that he needed.

A Geriatric Care Manager can be a valuable asset to family members when it becomes necessary to look at alternatives for their loved one's long term care. They work with all members of the family in educating about resources and making decisions. Some services provided are:
  •  Make an assessment about the type of care need
  •  Develop a care plan for care both current and future care 
  •  Work with physicians in getting medical support
  •  Find home care services that work with the families’ needs
  •  Provide assistance with legal and financial issues
Home care services vary, depending on what is needed, and may change as caregiving requirements change in regards to the physical or mental health of the elderly person. Types of Home Care are:

  • Home health care companies: provide nurses, physical therapists, social workers and aides that assist with basic health care such as changing bandages, taking vital signs and helping with medication as well as a host of other skilled needs. 
  • Non-medical home providers: help with bathing, dressing, meals, ambulating, chores, errands, housekeeping and much, much more.
Home care personnel are skilled in working with the spouse and extended family members of their ailing loved one to provide needed services and support in the home. They add consistency in the care and are available in time of crisis or need to add additional services.

With help from her Geriatric Care Manager, Nora brought her father to her home for his care. The care manager worked with her father’s doctor, prescribing a physical therapist and nurse's aide to come to the home. A non-medical home care company was employed to help with daily bathing and dressing.

Another resource available to families, which is not used as often as it should be, is hospice. Hospice care is provided in the home or in a hospice facility, hospital or nursing home. When illness is terminal, hospice service is provided by a team which includes doctors, nurses, grief counselors, aides and social workers as needed. These services can be provided at no out-of-pocket cost by Medicare.

In her internet article Naomi Naierman, President and CEO of the American Hospice Foundation states: “As a Medicare beneficiary, you are entitled to the Medicare Hospice Benefit without additional premiums. If you are enrolled in a managed care organization (MCO) you have access to this benefit, even if the MCO does not cover hospice services. The Medicare Hospice Benefit covers the following hospice services in full:
  • Skilled nursing services
  • Volunteer Services
  • Physician visits
  • Skilled therapy
  • Home health aide visits
  • Medical social services
  • Spiritual counseling
  • Nutrition counseling
  • Bereavement support for the family”
There is a growing market for care providers throughout the nation to fill the need of senior care services. Assisted living, home care and hospice care, geriatric care managers and geriatric clinics are all just part of these services. The National Care Planning Council supports family caregivers with information and resources of all types of long term care services on its website: http://www.longtermcarelink.net/.

"Somebody’s Sweetheart" may be in need of your loving care someday and help is available to reduce your burden and ease the journey.

 

Wednesday, February 2, 2011

How to Choose Homecare

By Kathryn Zakskorn

One of most difficult decisions adult children make when caring for aging parents is where to turn for in-home care. The myriad of choices can be overwhelming. Essentially, there are three choices: private hire, Domestic Referral Agencies and full service companies.

With a private hire caregiver, the family or older adult becomes responsible for all steps of the hiring process. They must advertise, interview, and conduct background checks. Once a caregiver is selected, the older adult or family member must negotiate schedule, salary and benefits. A written contract, signed by both parties, clearly outlining all of the duties and expectations, is imperative. Liability normally falls on the client’s lap when it comes to payroll taxes, social security, unemployment taxes and workers compensation cost. It is imperative to get a rider on your homeowners insurance policy to protect your assets if anything should happen to the private hire in your home. Even though a private hire may be cost effective, the safety risk is the greatest especially when the older adult lives alone without supportive family available or there is impaired judgment on the part of the older adult. The risk is greatly reduced when a family member is able to supervise the caregiver. Professional geriatric care managers are also excellent supervisors when family is not available (more on that next issue).

Domestic referral agencies are essentially registries. A client calls for service and a caregiver is placed in a home for a placement fee and sometimes an ongoing management fee. The referral agencies do not employ the caregiver. The client becomes the employer, and similar to a private hire is responsible for payroll taxes, social security, and unemployment insurance and workers compensation. Some referral agencies have trust accounts where the client pays the agency and the agency then pays the caregiver, and sometimes sets up a tax service for the client, but the client is still considered the employer. Since referral agencies are not employers, they do not supervise the caregiver. This increases the safety risk. Like a private hire, it is important that a family members or geriatric care manager supervise and oversee the care.

Full service agencies employ the caregivers. They hire, screen, train and supervise the employees and place them in the older adult’s home. As the employer, the full service agency is responsible for all payroll taxes, social security, worker compensation, and unemployment insurance. A good full service agency should be able to produce a copy of their liability insurance and carry some sort of bond. Supervision is done by the agency, with some agencies providing care managers who directly oversee client cases, thereby lowering the risk to the consumer. The cost of a full service agency is normally higher than a private duty hire or a domestic referral agency due to these factors, however the risk is essentially lower.

When choosing homecare for yourself or an older adult, remember to take into consideration the risk level of the older adult and the familial involvement. Educate yourself on what service is best for your situation and then interview several potential individuals or agencies. Finally, think ahead. Don’t wait for a crisis to begin searching for the best care for you or your loved one.