Home Care Assistance of New Jersey: Caring for an Aging Loved One

Online Dementia and Driving Resource Center Helps Families Tackle a Difficult Topic

2012-01-11T21:34:00.000-05:00

Due to the progressive nature of Alzheimer’s, every person with the disease will eventually become unable to drive. Some people are able to continue driving in the early stages of Alzheimer’s disease, but it requires ongoing evaluation to ensure safety.

As hard as it is for people living with Alzheimer’s to give up driving, addressing the topic is often just as hard on caregivers. In response to this delicate topic and lack of resources to address it, the Alzheimer’s Association, with support from the National Highway Traffic Safety Administration, created a new Dementia and Driving Resource Center (DDRC) located online at alz.org/driving.

The DDRC was designed to inform and support the needs of both caregivers and people living with dementia in a compassionate manner. The site features four short videos depicting different scenarios for approaching driving and dementia. In addition, the DDRC has tips and strategies for planning ahead and handling resistance, common signs of unsafe driving, resources for alternative methods of transportation and additional information on driving and safety.

The Alzheimer’s Association recommends that families discuss driving, ideally while the person with Alzheimer’s is still able to participate in the conversation and decision-making process. The following are signs that it may be time for the person with dementia to stop driving:

Forgetting how to locate familiar places

Failing to observe traffic signs

Making slow or poor decisions in traffic

Driving at an inappropriate speed

Becoming angry or confused while driving

Hitting curbs

Using poor lane control

Making errors at intersections

Confusing the brake and gas pedals

Returning from a routine drive later than usual

Forgetting the destination you are driving to during the trip

If you are concerned that your loved one with Alzheimer's Disease or another related dementia may no longer be able to drive safely, then please visit the Alzheimer's Association's Dementia and Driving Resource Center.

Happy Veterans Day!

2011-11-10T20:53:00.000-05:00

As we observe Veterans Day on Friday, November 11, 2011, let’s take a minute to understand why this day is observed and who it is we are honoring.

A gentleman by the name of Raymond Weeks organized a parade in the city of Birmingham, Alabama to honor all American Veterans for their service. The parade was held on November 11, 1947. Later on, US Representative Edward H. Rees of Kansas proposed legislation that would change the name of Armistice Day to Veterans Day to honor all who have served in the United States Armed Forces.

In 1954, President Dwight D. Eisenhower signed a bill proclaiming that November 11th would be Veterans Day. He asked all Americans to rededicate themselves to the cause of peace. Issuing a presidential order, Eisenhower directed the Department of Veterans Affairs to form a Veterans Day National Committee to organize and oversee the national observance of Veterans Day.

In 1968, Congress moved Veterans Day to the fourth Monday in October. However, November 11th was historically significant to many Americans. Therefore, in 1978, Congress formally returned the observance to November 11th.

Every year on November 11th at 11am in Arlington National Cemetery, a color guard, which is comprised of a member from each branch of the military, renders honors to American’s who died in service during a tradition-rich ceremony at the Tomb of the Unknowns. Either the President or his representative places a wreath at the Tomb and a bugler plays “Taps”. The remainder of the ceremony takes place inside the Memorial Amphitheatre which is adjacent to the Tomb. Included in the ceremony is a parade of flags by members of various Veterans service organizations.

Some people ask what’s the difference between Memorial Day and Veterans Day? Memorial Day was set aside to honor those veterans who died in battle or as a result of battle-sustained injuries. Veterans Day is intended to thank and honor all who have served in the military, not only those who have died. Veterans Day aims to show appreciation to all veterans who have sacrificed and done their duty to their country.

Happy Veterans Day! Thank you, Veterans, for all that you have done for us!

Don't Ignore Signs of Caregiver Stress

2011-11-10T16:28:00.000-05:00

Caring for a person with Alzheimer's disease can cause depression, anger and irritability, in addition to taking a physical toll that results in exhaustion and sleeplessness. These are real issues caregivers shouldn't ignore.

November is National Alzheimer's Disease Awareness Month and National Family Caregivers Month. The Alzheimer's Association offers a number of resources to help caregivers manage stress:

The Alzheimer's Association Caregiver Notebook offers tips for care and planning for the future, as well as a list of resources to use when additional information is needed. To learn more or purchase the Caregiver Notebook, visit www.alz.org/caregivernotebook.
Caregiver Stress Check, an interactive quiz that helps caregivers to identify symptoms of stress and provides a tailored list of helpful referrals and other support. Take the quiz at www.alz.org/stresscheck.
Alzheimer's Association CareSource™, an easy-to-use, one-stop online portal for everything you need to widen your care options and plan for care for a person with Alzheimer's. Find out how CareSource can help at www.alz.org/caresource.

Learn more about Alzheimer's disease and caregiver stress by visiting http://www.alz.org/.

October is Breast Cancer Awareness Month

2011-10-11T21:35:00.000-04:00

Every October, people from across the United States and around the world come together to raise awareness about Breast Cancer. From the Breast Cancer walks to the NFL sporting the color pink, breast cancer awareness is on the rise, which should not come as a suprise. Breast cancer is the second most common cancer in women. According to the Susan G. Komen Breast Cancer Foundation, a woman dies from breast cancer every 69 seconds. But all is not doom and gloom. Between the years of 1999 and 2006, breast cancer rates decreased by 2% per year. Mortality rates between 1998 and 2006 decreased by 1.9% per year. It is thought that part of the decrease in prevalence can be attributed to the reduced number of women receiving hormone replacement therapy. Mortality rates are declining as a result of earlier detection and advances in treatment options.

While breast cancer is most prevalent in women, men are at risk for it also. According to the Centers for Disease Control for every 100 women diagnosed with the disease, one man will also be diagnosed. While a family history of breast cancer does increase one's risk of getting the disease , the majority of diagnosed women have no family history.

The best defense is a good offense. Therefore, it is important to start getting a mammogram yearly or every other year beginning with your 40th birthday. Monthly self-breast examinations are important as are yearly breast exams by your physician.

Raising Alzheimer’s Awareness Worldwide

2011-09-20T20:35:00.000-04:00

Alzheimer’s disease affects more than 35 million individuals worldwide and costs the global economy more than $600 billion. Alzheimer’s is an international health epidemic that impacts people from all racial and ethnic backgrounds.

September is World Alzheimer’s Month and an opportunity to raise awareness of this devastating disease on a global level. If you know an individual who is in need of information on Alzheimer’s, you can direct them to the following resources in multiple languages from the Alzheimer’s Association:

• Brain Tour – A virtual tour of the brain that helps to explain how the brain works and how Alzheimer’s disease affects it. It is currently available in 14 languages including German, Polish, French and Spanish at alz.org.

• Know the 10 Signs – An easy-to-read list describing the warning signs of Alzheimer’s disease. Available at alz.org in Spanish, Korean, Vietnamese and Chinese.

• 24/7 Helpline – A round-the-clock information and support helpline provided by education specialists and masters level counselors. Services include bilingual Spanish-speaking consultants and interpretation for more than 170 languages. Call 1.800.272.3900.

• Online portals – Fully translated microsites with an overview of Alzheimer's disease, signs and symptoms, caregiving tips and more. These sites are currently available in Chinese, Korean, Spanish and Japanese and can be accessed by visiting alz.org.

For those seeking information on Alzheimer’s in other languages, a local chapter of the Alzheimer’s Association may also be a good resource. To find the chapter nearest you, visit alz.org.

Maintaining Mental Health as We Age

2011-09-11T20:06:00.000-04:00

by Anne Pagnoni

Oh, to be young again! How many times have you heard yourself or someone else say this? As Home Care Assistance of New Jersey celebrates Health Aging Month, it's important to keep in mind that healthy aging encompasses more than just physical health. Mental health plays a big part in how well we age.

Many people are of the impression that memory loss is a product of normal aging. This is not true! However, as the saying goes, use it or lose it. Therefore, in order to maintain your mental and cognitive health, you have to make sure you're exercising your cognitive abilities. Here are some great brain exercises that you can do on a daily basis:

Play games that involve strategies, such as chess or bridge
Read newspapers, books, magazines and anything else that you find challenging
Try to learn new things such as games, driving routes, musical instruments, a foreign language, or a topic of interest
Do crossword and other word puzzles
Spend time regularly with others either by phone or in person
Volunteer your time at an organization that you believe in

While many people live in fear of losing their memory, the greatest enemy of mental health is depression. According to the National Institute of Mental Health, older adults are disproportionately likely to die as a result of suicide. Depression is one of the conditions most commonly associated with suicide. The risk of depression increases when someone begins to lose his or her physical function and when other illnesses are present. While feelings of sadness, grief, and blue mood are normal, persistent depression that interferes with someone's ability to function is not.

If you're depressed, you very well may want to lock the door to your home and not allow anyone in or venture out. You may allow yourself to sleep or watch television all day. These things will only make the depression worse. Instead, you need to make yourself more active and more socially involved. Research suggests that physical activity may be just as effective as antidepressants in treating depression. You don't need to hit the gym for two hours per day to reap the benefits of exercise. Instead, park a little farther from the store, do some light housework, or take a short walk. If you're physically disabled or frail, you can always participate in chair exercises to help boost your spirits and your muscle tone. Make sure you're enjoying the company of others. You need support to get through a depressive episode. Limit the time you spend alone. Keep in touch over the phone or email if you're unable to get out of the house regularly. Participate in activities that you enjoy. Get a pet to keep you company. Laugh! If you don't feel like you have anything to laugh about, then watch a comedy or read a funny book.

If you have made some lifestyle changes but are still experiencing depression, then seek help. Talk to your family physician about how you're feeling. Therapy, support groups, and medications are all effective treatments for depression. Don't go it alone.

The key to maintaining mental health as we age is to continue to find meaning in our lives. While we may no longer be working and our children may live further away, we can find other things that will give us a sense of purpose in our lives. Keep moving forward instead of focusing on the past.

As Mark Twain said, "Age is an issue of mind over matter. If you don't mind, it doesn't matter." Make sure you're giving your mental health as much attention as your physical health!

Keeping Yourself Safe at Home

2011-09-05T22:10:00.000-04:00

by Anne Pagnoni

Home is where the heart is. Most people want to stay in their homes for the duration of their lives. While it's inevitable that we'll experience physical changes as we age, there are some things that we can do to make sure that we're able to remain safely in the family home.

The biggest thing which forces an older adult from his or her home is a fall. According to the Centers for Disease Control, one out of three adults over age 65 falls each year and is the leading cause of injury death. Falls are also the most common cause of nonfatal injuries and hospital admissions due to trauma. Keep in mind that a fall can cause a hip fracture, pelvis fracture, or head injury all of which carry their own complications. All is not lost, however, as many falls do not "just happen" but can many times be avoided.

One of the most important things to do to ensure safety in the home is to make sure that your house is well-lit. If you have areas in your home that are dim, then consider adding additional lighting fixtures or table lamps. Have working light switches at the top and bottom of all stairs.

Stairs can be particularly hazardous. Make sure that all stairs are in good repair and clutter free. You should have handrails on both sides of the stairs. If you have wooden or concrete steps, then you may consider painting a strip of contrasting color on the edge of each step to guard against a misstep. Avoid carrying large items up or down the stairs. If you absolutely must carry something, then make sure you carry the item in one hand and hold onto the hand rail with the other. Never let the item that you're carrying block your view of the steps.

Throw rugs, pets, electric cords, coffee tables, and cluttered high-traffic areas all pose a tripping risk. All throw rugs should either be removed or tacked down. Pets have a tendency to get under foot. Make sure you always know where your pet is as you are walking around your home. Electric cords and telephone cords should all be taped down if they are crossing the floor in a traffic area. Coffee tables tend to be knee level as opposed to eye level. Make sure your coffee table is in an area that you don't frequently walk. Keep all walkways clutter free.

Avoid using waxy cleaners on hardwood, tile, or vinyl flooring as wax makes floors slippery. If you must use wax, then choose a non-skid formula. Do not walk on wet floors as they are slippery. Allow ample time to make sure that floors are dry before walking on them. During the winter months, make sure that you have salt or sand by any exterior doors that are used. Icy surfaces are slippery, too!

The bathroom is another room in the house that is full of fall hazards. To avoid falls in the shower, make sure that you have a non-skid surface in the tub/shower. If you have a bath rug or bath mat outside of the shower, make sure that it is secured to keep it from slipping when you step on it. Grab bars should be present and anchored securely to the inside of the tub or shower. If it is difficult for you to shower standing up, then consider purchasing a bath seat and a hand-held shower head. Both will allow you to continue tending to your personal care while reducing your risk of falling while showering. If you have difficulty getting on or off of the toilet, make sure that you have a toilet with a raised toilet seat and securely anchored grab bars near the toilet.

While a fall might not be the biggest concern to someone who is preparing a meal in the kitchen, there are a variety of other accidents waiting to happen. Keep your canned goods, other staple items, and pots and pans in an easy to reach location. Heavier items should be stored in lower cabinets while lighter items can be stored in higher cabinets. Make sure you have a stable step stool handy so that you can safely reach items that are outside of your reach. Keep a working fire extinguisher readily accessible to the kitchen. Avoid wearing loose fitting clothing while cooking on the stove top as they may catch fire.

For added security, have a telephone in all bedrooms, the living room, and kitchen. Make sure you have a list of emergency numbers next to each phone. If you have chronic health conditions or take medications that have a tendency to make you dizzy, then you may benefit from wearing an emergency call pendant. Should you happen to have a fall or another mishap in a part of the house where you aren't able to get to a phone, an emergency call pendant just may save your life. By pressing a button on a pendant that you wear either around your neck or on your wrist, you have access to an emergency response team 24 hours per day, 7 days per week.

By exercising caution and making some minor home improvements and changes to the way you do things, you will greatly reduce your risk of injury in the home.

Travel for Those with a Chronic Health Condition

2011-08-14T20:58:00.000-04:00

By Anne Pagnoni

As the end of summer nears, you may be considering a last minute vacation. If you or another member of your party has a chronic health condition, then there are some things that you may want to do before embarking on that fantastic voyage.

As soon as possible prior to your trip, arrange to meet with your physician to discuss any risks which may be involved with you traveling. This is especially important if you are traveling internationally as you may need immunizations or preventative medications prior to departure. Ask your physician for copies of recent EKG, laboratory, and x-ray results to take with you on your trip. If you are traveling to a country where English is not the primary language, then you may wish to have your medical records translated to the destination’s primary language. Keep in mind that while you may speak the language, if you are in a medically unstable condition, then you may not be able to communicate your health needs with the treating physician.

If you will be on an airplane or in a car for a long amount of time and have a history of circulatory problems, then you will want to take precautions to avoid swelling in the legs and developing blood clots. Make sure that you get up out of your seat or out of your car every hour or two and take a short walk; perform leg lifts several times per hour while sitting in your seat; and wear compression stockings.

Begin packing your luggage a week or two ahead of time to make the task more manageable. Pack all medications and medical supplies in your carry-on luggage. Bring extra medications in case you are delayed on your trip. Make sure your medications are in their original bottles to avoid any unnecessary delay at customs.

Contact your wireless cell phone provider to make sure that your phone can work internationally. Have the names, phone numbers, and fax numbers for all treating physicians and your pharmacy. Make sure you have the local numbers as 1-800 numbers typically do not work outside of the country. Have phone numbers of the local hospital in the country where you’ll be staying.

If you suffer from blood sugar issues or require food to take medications, then have a light snack on hand. This is especially important if you are traveling by plane as meals are no longer always served during a long flight.

Social Support Activities Lead to Better Quality of Life As One Ages

2011-08-09T22:09:00.000-04:00

by Anne Pagnomi

How important is social support as a person ages? This may seem like an easy question to answer. Most people would not choose isolation and loneliness versus spending time with companions. However, can lack of social support really hinder a person’s overall quality of life?

Lack of social support is related to negative impacts on health and well being, especially for older people. Having a variety of positive social supports can contribute to psychological and physical wellness of elderly individuals. Support from others can be important in reducing stress, increasing physical health and defeating psychological problems such as depression and anxiety.

When considering who provides social support for an elderly individual our first thoughts are of family members. While it is true that most support does come from family members, there are many circumstances in which family members cannot be supportive (stress due to responsibilities, illness, death, financial problems, job relocation). In the United States the fastest growing age group of individuals are those 85 years and older. Due to this fact, family supports will inevitable decrease for these older individuals. A need for community-based services is more important now then ever before.

Community-based services can be extremely useful for elderly individuals. Services for older persons can encompass many areas, but one of the most important areas as discussed previously is social support. Support for elderly persons can be found in many places including: senior centers, assisted living facilities, meal delivery, religious affiliations, adult day care centers, etc. These services can provide positive social supports that can help older persons defeat loneliness and isolation. However, social support must encompass more then physical presence or conversation. Studies have shown that social support services should contain quality activities. These activities should promote positive self-awareness.

Self-awareness is key to a person’s overall quality of life and satisfaction. Many leisure social activities can be used to help increase an individual’s self-awareness. Activities for elderly individuals may include reminiscence groups, journal writing, readings of favorite book passages, group exercise, singing groups, etc. Individuals may also feel more self-satisfied if they are part of the planning of social activities that take place.

Two of these community-based service centers that provide quality social support services for elderly individuals are discussed below.

Senior Citizen Centers
Today, there are estimated to be about 15,000 senior centers across the United States. Senior centers act as a focal point for older Americans to receive many aging services. The most common services offered at a senior center include health programs (including Zumba and Yoga), arts/humanities activities, intergenerational programs, employment assistance, community action opportunities, transportation services, volunteer opportunities, education opportunities, financial assistance, senior rights counseling/legal services, travel programs and meal programs. These programs and activities can help promote positive self-awareness.

Lori Beckle describes how participating in her local senior citizens center has given her the independence and life satisfaction she thought was lost when her husband died in 2009. “ I was devastated and so frightened for my future without Ed. He was my only friend and the one I turned to when I felt alone. My daughter invited me to attend our local senior center where a bereavement group was being held for those who had lost a loved one. I met Phyllis during the group and now I have a new friend I call when I become afraid. Phyllis has helped me develop the skills to get through the tough times and focus on my immediate happiness.”

Adult Day Care Centers
According to the National Adult Day Services Association (NADSA), there are currently more than 4,600 adult day care centers nationwide. Adult day care is a program in which activities are provided to promote social support and health services to an older adult during the daytime. Most centers operate Monday through Friday during daytime hours. Social support services at an adult day care can consist of musical entertainment and singing groups, group games such as cards, gentle exercise, discussion groups (books, films, current events), holiday/birthday celebrations and local outings. Not only are these social activities provided, but participants of the program can also develop lasting relationships with staff and other participants. Adult day care centers also provide meals and health services. Adult day care centers differ from other programs for elderly individuals, because they allow the participants to develop and increase self-awareness by encouraging independence.

Amanda describes her experience as a volunteer at her local adult day care center. She stated, “ I was involved in planning the activities for Thursday afternoons. I wasn’t sure what kind of activities my older friends would enjoy so I had them share their favorite activities they participated in when they were my age (23). I soon realized that I was hearing the most fascinating stories of hopping trains, college dances, swimming in the lake, etc We decided Thursday afternoons would be spotlights of each individuals’ lives as a twenty-something. One of the participants told me that Thursdays became a highlight for her week.”

Adult Day Care Centers and Senior Citizen Centers help to provide an elderly individual the opportunity to participate in social support activities. Social support activities found in these programs can be beneficial to a person’s quality of life and overall satisfaction. With a higher self-awareness and quality of life an individual can reduce the risks of mental and physical health problems as they age.

Safer Travel for Those with Dementia

2011-07-13T21:41:00.001-04:00

Summer is the time of year when many Americans plan summer and holiday travel. Whether you’re considering a weekend getaway or an extended stay, traveling with an individual who has Alzheimer’s requires additional thought and preparation.

People with Alzheimer’s and their caregivers need to be prepared for a change in schedule and environment. Even if it is a trip you have taken before, it may feel new for the person with the disease.

Additionally, as Alzheimer’s progresses, negotiating changes in environment will become increasingly challenging. Be prepared for the individual with the disease to experience some confusion or disorientation. Exercise caution, as wandering and getting lost are more likely during transitional times. The checklist below will help you plan for the trip and make it successful and safe.
Before going

• Call the Alzheimer’s Association chapter in the area you will be visiting. Let them know you will be staying in the area and ask about available resources. You can locate any chapter by calling 1.800.272.3900 or visiting www.alz.org/apps/findus.asp.

• Enroll the person in MedicAlert® + Alzheimer’s Association Safe Return®, a 24-hour nationwide emergency response service for individuals with Alzheimer’s or a related dementia who wander or have a medical emergency. You may also want to consider the Alzheimer’s Association Comfort Zone®, powered by Omnilink, a Web-based GPS location management service or Alzheimer’s Association Comfort Zone Check-InTM.

• If you are already enrolled in MedicAlert, update your records with temporary contact information (call 1.888.572.8566).

Upon arrival

• Let neighbors know a person with Alzheimer’s is staying next door and ask them to keep their eye out for wandering or other unsafe behavior.

• During the first few days after arrival, keep your schedule light with lots of down time.

• Create opportunities to re-acclimate the person to the new environment.

• Keep familiar things around.

• Limit access to money and credit cards.

• Limit access to driving.

• Be aware that the change can be chaotic for the person.

• Recognize the warning signs of anxiety and agitation.

For more tips on safety for people living with Alzheimer’s disease and related dementias, including concerns about wandering, disaster preparedness, home and medication safety, visit the Alzheimer’s Association Safety Center at www.alz.org/safetycenter or call 1.800.272.3900 to find the Alzheimer’s Association chapter closest to you.

Choosing Home Care Services that Meet Your Needs

2011-07-10T21:30:00.000-04:00

by Anne Pagnoni

Making the decision to hire a home care service to provide care for your loved one is an important decision and can, at the same time, be very difficult. If an illness or recovery from surgery requires nursing care or physical therapy, a physician may order skilled home care services that provide both skilled providers and personal aides. Your decision is then based on the obvious medical determinations made by the doctor. But what if you as the family caregiver must determine the extent of care needed without the help of a doctor?

Each home care situation is unique. In the beginning, family or friends step in to help with simple tasks and support for aging seniors who want to stay in their homes. As long term care needs progress, more time is required to manage those needs. Physical and mental conditions change with aging making usually routine hygiene and daily living activities difficult for an aging individual. Even with the healthiest of seniors, the ability to drive a car, shop for groceries or do general housekeeping eventually needs to be relinquished to the responsibility of another person.

In one example, Karen, would stop by her parents' home on her way to work every morning and again on her way home from work in the evening. She checked in the morning to see that they were up and ready for the day and Karen would take a shopping list for things they needed. In the evening she delivered the needed items she had purchased during her lunch break and sometimes she fixed a meal when one was not prepared by her mother. This worked well until Karen began to notice her father did not shave or dress during the day and both parents were forgetting their medications. Karen felt more time and supervision was needed in their care but with her own family and job, she could not do it. Non-medical or personal home care services would be a good option for Karen to consider.

Before starting your search for a non-medical or personal home care company, determine what the care needs are and how much time each week will be required for assistance from the company. You may want to consult with the family physician and other family members as well as experienced social workers or care managers to determine needs. Most home care companies, as well, will help you do an assessment at no charge. With your care needs in hand, you are ready to begin your search.

The National Association for Home Care & Hospice (http://www.nahc.org/home.html) gives the following guidelines and checklist in searching for a home care company.

•How long has this provider been serving the community?

•Does this provider supply literature explaining its services, eligibility requirements, fees, and funding sources? Many providers furnish their home care clients with a detailed "Patient Bill of Rights" that outlines the rights and responsibilities of the providers, clients, and family caregivers alike.

•How does this provider select and train its employees? Does it protect its workers with written personnel policies and malpractice insurance? Does it protect clients from theft or abuse by bonding its employees?

•Does this provider assign supervisors to oversee the quality of care clients are receiving in their homes? If so, how often do these individuals make visits? Who can the client and his or her family members call with questions or complaints? How does the company follow up on and resolve problems?

•What are the financial procedures of this provider? Does the provider furnish written statements explaining all of the costs and payment plan options associated with home care?

•What procedures does this provider have in place to handle emergencies? Are its caregivers available on notice?

•How does this provider ensure client confidentiality?

If a home care company has not previously been recommended to you, ask for a list of previous clients and call for their experience with this provider.

Following up on these guidelines can help you determine the quality of personal care that is given. Many states license non-medical home care companies and require both legal and health standards to be maintained.

Read about individual home care companies in your area on the National Care Planning Council's website www.longtermcarelink.net.

Downsizing, Organizing, Handicap Remodeling, or Relocating

2011-06-26T21:28:00.000-04:00

by Anne Pagnoni

When Robert and Anne bought their family home thirty years ago, their plan was to live through retirement in this home. They had furnished their home with refurbished antiques acquired from their many trips together. It was one of their cherished antique coffee tables that Robert tripped over, breaking his hip. Now with his return from the hospital in a wheelchair, the overwhelming task of making their home accessible for Robert’s wheelchair and safe for both of them faced Anne.

Remodeling for wheelchair access, organizing home furnishings and daily living items or downsizing and relocating to a smaller living area are monumental tasks that are many times thrust on senior home owners. Sometimes the need to do this is brought on by injury or age related illness. Home and yard maintenance can become a daunting chore for even the healthiest of seniors, requiring them to make a downsizing decision.

There is a large and growing industry of specialists who understand these challenges of elderly homeowners and are ready and willing to help with remodeling, organizing or the sale of the home and with the move to a new location.

A professional organizer provides skills in making the home safe and manageable. Relocating furniture, removing hazards such as electrical cords, throw rugs, heavy objects on shelves that might fall are some of the ways they make a home more senior friendly. They specialize in helping seniors part with items that clutter or have no valued use, so to make rooms less crowded or to make ready for a move to a smaller living space.

Handicap remodeling services and senior safety services offer help in adding wheelchair ramps and widening doorways. Bathrooms are made more accessible and safe, with hand rails, walk-in bath facilities and easier access to toilets.

If moving to a smaller retirement home or care facility is the best solution there is another senior specialty provider to call on called a Seniors Real Estate Specialist.

The Senior Real Estate Specialist concentrates more on a complete service package for the sale of the property and/or the purchase of a new living arrangement. The specialist also arranges for the services of a relocation specialist or Senior Move Manager to provide a complete, stress-free package for the elderly homeowner.

A move often requires downsizing and getting rid of a tremendous number of acquired possessions. The relocation specialist or Senior Move Manager, as they are often called, will typically provide a turnkey operation that includes assessing and identifying items to keep, arranging for auction or other disposal, cleaning the home, moving the belongings and setting up the new residence. The manager may also work closely with a real estate agent to arrange for the sale of the home and may also be involved in the financial transactions necessary to move into a new living arrangement.

All the help available to seniors may in itself be overwhelming. How do seniors choose the right service provider for their needs? How do they know they will hire someone qualified, responsible and honest? Area Agencies on Aging and State Better Business Bureaus are good resources to check out available service providers.

Family, friends and religious leaders can be valuable resources to seniors in referring service providers and helping to manage the hiring and supervision.

The National Care Planning Council’s website http://www.longtermcarelink.net/ provides educational articles and information on eldercare providers throughout the nation.

The Dangers of Osteoporosis

2011-06-13T21:10:00.000-04:00

by Anne Pagnoni

Osteoporosis, which is a disease in which the bones become weak and brittle, is a condition affecting almost 10 million Americans with another 34 million being at risk for the condition. Of these almost 20% are men. While osteoporosis may not sound like a devastating disease, consider the fact that bones can become so weak and brittle that even mild stressors such as bending over, sneezing, or coughing can cause a bone fracture.

When we're younger, breaking a bone isn't necessarily a serious condition. Think of the young child who falls and breaks an arm while bike riding. He often returns to school with a cast on his arm and a marker so that all of his friends can sign it. Breaking a bone when we're older, however, is a serious condition. Broken bones due to osteoporosis most likely occur in the spine or hip both of which directly support our weight. Hip fractures in older adults can lead to disability and even death due to postoperative complications.

Some people with osteoporosis find themselves with spinal fractures even though they haven't fallen or otherwise injured themselves. This is a result of the bones in the back becoming so brittle that they begin to compress on each other. Compression fractures tend to be very painful and require a long recovery.

There are a variety of risk factors for osteoporosis - some we can change and some we can't. Risk factors that we can change include maintaining an adequate amount of calcium in our diets; stopping smoking; getting regular exercise; avoiding excessive alcohol consumption; and, if possible, avoiding the long-term use of corticosteroid medications. Risk factors that can't be changed include being a woman; increasing age; being either white or of Asian descent; having a family history of osteoporosis; being of a small body frame; possessing too much of the thyroid hormone; or having certain medical conditions including celiac disease and Crohn's Disease.

Certain medications can be prescribed to help slow bone loss and maintain bone mass. Hormone therapy, particularly estrogen, can help maintain bone density if started shortly after menopause; however, this can increase the risk of developing a plethora of other ailments including blood clots, breast cancer, and even heart disease. Physical therapy is another option which can be helpful in improving bone strength.

If you find yourself diagnosed with Osteoporosis, there are a few things that you can do to work to maintain your independence. Maintain good posture as this can help alleviate stress on your spine. If you need to lift something, make sure that you bend at your knees and not your waist, and lift with your legs. Wear low-heeled shoes with nonslip soles. Make sure that you don't have any tripping or fall hazards at home including electrical cords, throw rugs, and slippery surfaces. Keep your home brightly lit and install grab bars both inside and outside of your shower door. If you are in chronic pain, then discuss this with your doctor. Chronic pain can begin to limit your mobility, which will result in even more pain.

When it comes to osteoporosis, prevention truly is the best medicine. Make sure that you're getting adequate amounts of calcium and vitamin D in your diet. If you aren't sure that you're getting enough, then talk to your doctor about supplements that you can take. Exercise regularly. While you don't have to be a body builder, make sure that you're incorporating strength training with weight bearing exercises.

Be Aware of High Blood Pressure

2011-06-08T17:24:00.000-04:00

by Anne Pagnoni

According to the CDC, almost 68 million people are living with high blood pressure, which is also known as hypertension. High blood pressure increases the risk for heart disease and stroke, which are the first and third leading causes of death, respectively.

Blood pressure is the force of blood against your artery walls as the heart pumps your blood throughout your body. If your blood pressure rises and stays high for a long period of time, then it can damage the body in a variety of ways. Blood pressure is measured in two numbers. The systolic number, which is the "top" number, refers to blood pressure when the heart is beating. The diastolic number, which is the "bottom" number, refers to blood pressure when the heart is resting between beats. A normal blood pressure reading is any reading when the systolic number is less than 120 and the diastolic number is less than 80.

Blood pressure varies during the day. It tends to increase when you're excited, nervous, or active. It tends to decrease when you are sleeping. It's important to keep in mind that if your blood pressure stays above the normal reading for the majority of the time, then you are at risk for hypertension and other health problems.

In addition to sleep, excitement, and activity, there are many other factors that impact blood pressure. The amount of water and salt that you have in your body; the condition of your kidneys, nervous system, and blood vessels; health conditions including thyroid disease and sleep apnea; and the varying levels of hormones in your body impact blood pressure. Age impacts blood pressure as blood pressure tends to increase as we get older simply because our blood vessels become stiffer as we age.

Hypertension has been shown to cause the arteries throughout the body to narrow in some places. As a result, blood flow is limited to various body parts which can lead to heart attack, stroke, or kidney failure. Aneurysms, which are abnormal bulges in artery walls, can form in blood vessels as a result of high blood pressure. Blood vessels in the eyes can burst or begin to bleed. This can lead to changes in vision or even blindness.

There are a variety of medications that can be used to treat hypertension. These vary from medications that help remove water and salt from the body to medications that slow down the heart or relax and widen blood vessels. Some individuals benefit from having two or more medications.

In addition to prescription medications, there are a variety of lifestyle changes that one can make to help decrease blood pressure. Eating a diet low in fat, cholesterol, and salt can help reduce blood pressure as well as limiting the consumption of alcoholic beverages. Men should have no more than two alcoholic drinks per day while women should have no more than one alcoholic drink per day. Physical activity is another way to manage high blood pressure. It's important to speak with your physician prior to starting any physical exercise regiment in order to learn what is safe for you to do. Maintaining a healthy weight can do wonders in the fight against high blood pressure. If you are a smoker, then quit smoking. There are products that can help you quit. Talk to your doctor for more information about these. Learn how to manage stress and relax. Some people choose physical activity while others opt for meditation or listening to music. Find out what works for you.

While high blood pressure cannot be cured, it can be controlled. Make sure that you work closely with your doctor to make sure that your hypertension is being properly managed. Managing your high blood pressure will allow you to live a long life.

For more information, please visit the Centers for Disease Control and Prevention or the National Heart Lung and Blood Institute.

Living with Arthritis

2011-05-09T22:15:00.000-04:00

By Anne Pagnoni

According to the CDC, over 50 million Americans are living with the pain and discomfort of arthritis. Of these, 21 million are experiencing physical limitations due to the disease. While arthritis is a word that most of us have heard, did you know that arthritis is actually a general term used to describe joint inflammation and that the term arthritis is used to describe over 100 different conditions impacting the joints? While osteoarthritis is the most common type of arthritis, rheumatoid arthritis, fibromyalgia, lupus, and gout are other frequently occurring forms of arthritis. Arthritis is seen more commonly in adults over age 65, but it can impact anyone including children.

Arthritis is seen as a public health problem as it impacts such a large number of people. As our population continues to age, the number of people living with arthritis is going to increase. It is predicted that the number of adults living with arthritis will increase to 67 million by the year 2030 with at least one third being impacted with limited activity as a result.

There are a variety of factors that have been shown to increase a person’s risk for arthritis. The risk of developing arthritis increases with age. Women are at a greater chance of developing arthritis than men. Almost 60% of all people with arthritis are women. Certain genes can increase a person’s chance of developing certain types of arthritis including rheumatoid arthritis and systemic lupus. Excess weight can lead someone developing osteoarthritis of the knees. If someone has a job that involves them repeatedly bending and squatting, then they are at an increased risk of developing arthritis.

There are things that you can do to protect your joints and help prevent osteoarthritis in particular. Maintain your ideal body weight. The more you weigh the more stress you’re putting on your knee, back, hip, and feet joints. Exercise regularly. Exercise protects joints by strengthening the muscles around them. Strong muscles keep joints from rubbing on each other. When lifting or carrying items, use your largest and strongest joints and muscles. This helps alleviate stress and prevent injury to smaller joints. Listen to your body. If you’re in pain, then you probably overstressed your joints.

I f you or someone you know has been diagnosed with arthritis, there are things that you can do to continue to live a relatively pain-free life. While there are medications that can help alleviate joint pain and swelling, there are many things that can be done that don’t involve medications. Physical and occupational therapy, splints or assistive devices, and weight loss can all help control pain and maintain function. For more suggestions on how to “do it easier” with arthritis, please visit Arthritis Today.

For more detailed information about arthritis, please visit the Arthritis Foundation and Centers for Disease Control and Prevention.

MyCareCommunity Hosts a Free Webinar for New Jersey Caregivers

2011-04-25T20:53:00.000-04:00

by Anne Pagnoni

According to the National Alliance for Caregiving, there are more than 65 million Americans spending an average of 20 hours per week providing care for a loved one. The value of these caregiving services is estimated to be $375 billion a year. This is almost double the amount spent on home care and nursing home services combined. As a service to these caregivers, MyCareCommunity of New Jersey is hosting an educational web conference entitled, "For Those in Transition…A Community Behind You". The program will address which community support services are available, should you or your loved one choose to remain at home. Also discussed in the program will be variety of senior healthcare and housing options that are available should you or your loved one choose to move from your home.

Kevin McClarren, president and care manager of Home Care Assistance in Warren Township, has partnered with MyCareCommunity both to promote the resources that it offers to caregivers and to pull together a local panel of experts, who will be present on the webinar. “This webinar is an excellent one-stop shop for caregivers to gain insight into the variety of care options that are available to their loved ones both in the home and in other care settings. Caregivers will have the ability to ask questions and interact directly with the panel, which includes experts in the field of home care, independent living, and assisted living.”

This live and interactive consumer-oriented event will be offered April 28, 2011, at 12:00 PM EST. The hour long program will explore options regarding utilizing the services of a Senior Real Estate Specialist; Assisted Living; Independent Living; Home Care; and Geriatric Care Management.

Preregistration for the event is required. Sign up today by visiting http://www.mycarecommunitynj.org/ and clicking on the registration link. Caregivers who are unable to attend the live webinar will be able to view a playback of the presentation provided that they are preregistered for the event.

About MyCareCommunity

MyCareCommunity is a free, online caregiver support program providing caregivers and their families the support and information they need to manage their many caregiving responsibilities. For more information, please visit http://www.mycarecommunitynj.org/.

Using Your Home Equity for Long Term Care

2011-04-18T21:55:00.000-04:00

by Anne Pagnoni
For many seniors the equity in their home is their largest single asset, yet it is unavailable to use unless they use a home equity loan. But a conventional loan really doesn't free up the equity because the money has to be paid back with interest.

A reverse mortgage is a risk-free way of tapping into home equity without creating monthly payments and without requiring the money to be paid back during a person's lifetime. Instead of making payments the cash flow is reversed and the senior receives payments from the bank. Thus the title "reverse mortgage".

Many seniors are finding they can use a reverse mortgage to pay off an existing conventional mortgage, to create money to pay off debt, make home repairs, or for remodeling.

For those seniors who are in need of long term care and want to stay in their home, a reverse mortgage can create the money needed to pay for in-home personal and medical care. They can also pay for needed medical equipment and handicap adaptation to their home.

There are no income, asset or credit requirements. It is the easiest loan to qualify for.

A reverse mortgage is similar to a conventional mortgage. As an example:

•The bank does not own the home but owns a lien on the property just as with any other mortgage

•You continue to hold title to the property as with any other mortgage

•The bank has no recourse to demand payment from any family member if there is not enough equity to cover paying off the loan

•There is no penalty to pay off the mortgage early

•The proceeds from a reverse mortgage are tax-free and can be used for any legal purpose you wish

False Beliefs Regarding Reverse Mortgages

•"The lender could take my house." The homeowner retains full ownership. The Reverse Mortgage is just like any other mortgage; you own the title and the bank holds a lien. You can pay it off anytime you like.

•"I can be thrown out of my own home." Homeowners can stay in the home as long as they live, with no payment requirement.

•"I could end up owing more than my house is worth." The homeowner can never owe more than the value of the home at the time the loan is due.

•"My heirs will be against it." Experience demonstrates heirs are in favor of Reverse Mortgages.

Virtually anyone can qualify. You must be at least 62, own and live in, as a primary residence, a home [1-4 family residence, condominium, co-op, permanent mobile home, or manufactured home] in order to qualify for a reverse mortgage.

The amount of reverse mortgage benefit for which you may qualify, will depend on

•your age at the time you apply for the loan

•the reverse mortgage program you choose

•the value of your home

•current interest rates

•and for some products, where you live

As a general rule, the older you are and the greater your equity, the larger the reverse mortgage benefit will be (up to certain limits, in some cases). The reverse mortgage must pay off any outstanding liens against your property before you can withdraw additional funds.

The loan is not due and payable until the borrower or borrowers no longer occupy the home as a principal residence (i.e. the borrower sells, moves out permanently or passes away). At that time, the balance of borrowed funds is due and payable, all additional equity in the property belongs to the owners or their beneficiaries.

The most popular reverse mortgages are the so-called HECM loans. HECM loans require that the applicant meet with a government approved counseling agency to be sure the applicant understands the reverse mortgage process.

The Federal Trade Commission states:

“Before applying for a HECM, you must meet with a counselor from an independent government-approved housing counseling agency. Some lenders offering proprietary reverse mortgages also require counseling. The counselor is required to explain the loan’s costs and financial implications, and possible alternatives to a HECM, like government and nonprofit programs or a single-purpose or proprietary reverse mortgage. The counselor also should be able to help you compare the costs of different types of reverse mortgages and tell you how different payment options, fees, and other costs affect the total cost of the loan over time. Most counseling agencies charge around $125 for their services. The fee can be paid from the loan proceeds, but you cannot be turned away if you can’t afford the fee.”

A Reverse Mortgage Specialist in your area can answer your questions, calculate the amount of loan you can receive and advise the type of loan for your needs.

The National Care Planning Council (http://longtermcarelink.net/a7reversemortgage.htm) has a list of Reverse Mortgage Specialists in your area.

New Report Reveals Nearly 15 Million Alzheimer's Caregivers

2011-03-30T15:06:00.000-04:00

According to the 2011 Alzheimer's Disease Facts and Figures released March 15 by the Alzheimer's Association, there are nearly 15 million Alzheimer's and dementia caregivers in the United States - 37 percent more than reported last year. In 2010, these individuals provided 17 billion hours of unpaid care valued at $202.6 billion.

The rising prevalence of Alzheimer's places increasingly intense demands - emotional, physical and financial -on the millions of family members and friends who care for those with Alzheimer's. "Alzheimer's disease doesn't just affect those with it. It invades families and the lives of everyone around them," said Harry Johns, president and CEO of the Alzheimer's Association.

As the Alzheimer's epidemic continues to escalate, more and more Americans will experience the strain of this disease. Today, an estimated 5.4 million individuals are living with Alzheimer's. It is the sixth-leading cause of death in the country and the only cause of death among the top 10 in the United States that cannot be prevented, cured or even slowed.

2011 Facts and Figures also includes a special report focusing on early detection and diagnosis. Increasing evidence suggests that early diagnosis of Alzheimer's and timely intervention is beneficial both for people with the disease and their caregivers. Experts believe that early detection of Alzheimer's disease and early interventions with improved therapies provide the greatest hope to delay or stop additional damage to the brain.

To help, learn the 10 Warning Signs of Alzheimer's Disease© and be aware of them in yourself and others. The signs are a key tool in increasing recognition of changes that indicate Alzheimer's or another dementia.

10 Warning Signs of Alzheimer's Disease

• Memory changes that disrupt daily life

• Challenges in planning or solving problems

• Difficulty completing familiar tasks

• Confusion with time or place

• Trouble understanding visual images and spatial relationships

• New problems with words in speaking or writing

• Misplacing things and losing the ability to retrace steps

• Decreased or poor judgment

• Withdrawal from work or social activities

• Changes in mood and personality

If you or someone you care about is experiencing any of the 10 warning signs, please see a doctor to find the cause. For more information about the signs, early detection and diagnosis or the Facts and Figures report, contact the Alzheimer's Association via the web or 1.800.272.3900.

A Local Hometown Hero

2011-03-20T21:08:00.000-04:00

This month’s Caregiver Spotlight honors Barbara Bryson from Home Care Assistance of Southern New Jersey for her professionalism, compassion and dedication to her client. Barb has been in the health care field for over 20 years and she has been a Certified Home Health Aide for over 16 years.

Barb’s stays with her client Nancy five days a week. Nancy is unable to effectively verbalize her thoughts and ideas due to the effects of a brain tumor and stroke. The two have built such a strong bond that Barb is now able to anticipate most of Nancy’s needs before they arise. Speaking on behalf of the family, Nancy’s daughter Jane says:

"Barb is an absolute gem. Not only is she reliable, caring and compassionate, but she is truly a wonderful person. She is very respectful of my home which is very important when you have someone in your home every day. Barb has become as close to a family member as we could hope for."

Barb provides daily companionship to Nancy and accompanies her on appointments and other trips outside the home. She has happily agreed to stay overnight at the home when Jane needs to travel for business. In addition to the great bond Barb has formed with Nancy and her family, she has also found a new friend in their dog Petey!

Thank you, Barbara, for all your hard work! You are an inspiration to us all.

Choosing Home Care Services that Meet Your Needs

2011-03-10T21:07:00.000-05:00

How long has this provider been serving the community?
Does this provider supply literature explaining its services, eligibility requirements, fees, and funding sources? Many providers furnish their home care clients with a detailed "Patient Bill of Rights" that outlines the rights and responsibilities of the providers, clients, and family caregivers alike.
How does this provider select and train its employees? Does it protect its workers with written personnel policies and malpractice insurance? Does it protect clients from theft or abuse by bonding its employees?
Does this provider assign supervisors to oversee the quality of care clients are receiving in their homes? If so, how often do these individuals make visits? Who can the client and his or her family members call with questions or complaints? How does the company follow up on and resolve problems?
What are the financial procedures of this provider? Does the provider furnish written statements explaining all of the costs and payment plan options associated with home care?
What procedures does this provider have in place to handle emergencies? Are its caregivers available on notice?
How does this provider ensure client confidentiality?

If a home care company has not previously been recommended to you, ask for a list of previous clients and call for their experience with this provider.

Following up on these guidelines can help you determine the quality of personal care that is given. Many states license non-medical home care companies and require both legal and health standards to be maintained.

Read about individual home care companies in your area on the National Care Planning Council's website http://www.longtermcarelink.net/.

Who is Home Care Assistance?

2011-02-27T20:28:00.000-05:00

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!

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

2011-02-23T22:00:00.000-05:00

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.

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

2011-02-12T22:09:00.001-05:00

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

2011-02-12T21:36:00.000-05:00

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.

How to Choose Homecare

2011-02-02T16:58:00.000-05:00

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.

Take Care of Your Eyes: They're the Only Two You've Got!

2011-01-24T21:04:00.000-05:00

January is National Glaucoma Awareness Month. Glaucoma is a word that we hear often, but what is it and how can we prevent it? If you or someone you know has been diagnosed with glaucoma, then what should you expect?

Glaucoma is an eye disease affecting nearly 2.2 million people aged 40 and older. If left untreated, then it can lead to blindness. The eye produces a watery substance that easily drains out of the eye and into the bloodstream. However, in someone with glaucoma, the fluid isn't able to properly drain out of the eye, which results in an increase of pressure inside the eye. Doctors believe that this increase in eye pressure results in damage to the optic nerve, which can inevitably lead to blindness.

Treatment for glaucoma can range from medications to surgery. Medication is typically the first line of defense and can consist of either drops, pills, or ointments. Prescription drugs can either work to reduce the amount of fluid that is produced by the eye or to improve the drainage system in the eye. Laser surgery is another option whereby a doctor uses a laser to make anywhere from 50-100 tiny burns in the eye to open up the drainage system, which reduces pressure inside the eye. In some cases, glaucoma surgery, which is more intense than laser surgery, becomes necessary. In glaucoma surgery, the surgeon either makes a small opening in the white part of the eye to create a new path for the fluid to flow out or inserts an implant to serve as the eye's new drainage system.

If you have been diagnosed with glaucoma, it is important to keep an optimistic outlook. Treatment can allow you to live a normal life. If, however, you are experiencing low vision as a result of glaucoma, there are some things that you can do to make things easier for you. Read large-print books. Use a computer with a large screen. Maintain a well-lit environment. Invest in magnifying lenses.

Most of the risk factors (i.e. age, race, and family history) for glaucoma are outside of your control. However, yearly eye exams are important. For high risk individuals, glaucoma screenings are covered at 80% by Medicare. If you are unable to afford a vision screening, there are a number of organizations that can assist you in getting the eye care that you need. Please visit The Glaucoma Learning Center for available resources.

For more information about glaucoma and other eye diseases, please visit Prevent Blindness America or the Glaucoma Research Foundation.

We’re Making Progress in the Fight Against Alzheimer’s Disease

2011-01-06T21:36:00.001-05:00

By Anne Pagnoni

On January 4, 2011, President Obama signed the National Alzheimer's Project Act (NAPA) in to law making this the largest legislative victory in the fight against Alzheimer's. The passing of the bill will lead to the creation of the National Alzheimer's Project within the Department of Health and Human Services. The overall goal of NAPA is to create a national strategic plan to improve treatments, prevent, and ultimately find a cure for Alzheimer's Disease. What a giant step in the battle against Alzheimer's!

For more information, please visit the Alzheimer's Association at www.alz.org.

The Weather Outside is Frightful!

2010-12-29T22:19:00.003-05:00

By Anne Pagnoni
The winter is upon us, fellow New Jerseyans. If you don't believe me, then just look out your window. How many inches – or feet – of snow are still on your sidewalk or driveway? How long did it take for your street to be plowed? How long were you held up in your home with no way to get out? How much worrying did you do about your mother or father being home alone without any way of getting to them? How many phone calls did you place to your mother reminding her to take her medicine and to make sure that she hadn't left the house? These are the times when having a loved one with dementia really takes its toll on the family caregiver. Now is the time to consider a live-in caregiver from Home Care Assistance of New Jersey.

Home Care Assistance is a full service home care agency offering hourly services but with a specialty in live-in caregivers. Our caregivers are specifically trained in our exclusive Balanced Care Method^TM . Focusing on lifestyle and dietary choices, the Balanced Care Method^TMpromotes healthy activity, stress reduction, and social interaction to help seniors live their best possible lives – in the comfort of home. But, what exactly does this mean for your mother or father?

When it comes to physical hygiene, our caregivers are able to provide assistance with bathing, dressing, and grooming. A little help here can go a long way in improving your loved one's willingness to interact with others.
From planning the menu to preparing the meal, the caregiver will ensure that your loved one is eating three, well balanced meals per day. If your mother or father has food preferences or enjoys cooking, then she or he and the caregiver will enjoy doing this together.
Exercise. Not a word that most of us like to think about, but it's a necessity nonetheless. Your loved one isn't going to be training for a marathon by any stretch, but the caregiver will work to improve physical stamina. From simply doing stretches and chair exercises to walking to the mailbox or around the block, your mother or father won't be sitting in a favorite chair all day long anymore!
You know the old saying, use it or lose it. It applies to short term memory, too! While our caregivers can't reverse memory loss associated with dementia and Alzheimer's Disease, they can provide social interaction, which has been shown to improve cognitive function. A game of cards, anyone?

Don't keep playing the waiting game. None of us can predict when Mother Nature is going to send another Nor'easter our way. Now is the time to take the necessary steps to safeguard your loved one's future. When it comes to caring for your aging loved one, accept help from the live-in professionals. For more information about Home Care Assistance, please visit our website at http://www.homecareassistance.com/. To be directed to your local Home Care Assistance office, please call 1-866-4-LIVEIN.

National Alzheimer's Project Act (NAPA): Take Action!

2010-12-26T15:17:00.003-05:00

The Alzheimer's Association reports that there are currently 5.3 million people living with Alzheimer's Disease and that every 70 seconds another person is diagnosed with this terminal disease. It is predicted that up to 16 million Americans will have Alzheimer's Disease by the year 2050 and that someone will be diagnosed with the Disease every 33 seconds. Alzheimer's Disease is the 7th leading cause of death in the United States with mortality rates on the rise. The yearly price tag of Alzheimer's Disease? $172 billion per year.

Over the past several years, organizations have been encouraging Congress to take action in the fight against Alzheimer's Disease. Congress has voted, unanimously, to pass the National Alzheimer's Project Act, which creates a plan to combat Alzheimer's Disease with the same intensity as the attacks on cancer and AIDS. The goal of the project is to create a national strategic plan to improve treatments, prevent, and ultimately find a cure for Alzheimer's Disease.

If signed in to law by President Obama., the bill would create the National Alzheimer's Project within the Department of Health and Human Services. There would be a plethora of organizations represented on the Project's adisory council as well as health care professionals and family caregivers of those with Alzheimer's Disease.

Your help is needed to have this bill signed in to law by year's end. Please visit the Alzheimer's Association for information on how you can send a message to President Obama.

Start the Year Off Right with Home Care Assistance of New Jersey

2010-12-26T15:11:00.001-05:00

Getting together and celebrating a special occasion with the family can be a wonderful time. It can also be a time when you begin noticing changes in your aging loved one. Perhaps as you celebrated the recent holidays, you noticed that your mother’s hygiene isn’t what it used to be. You may have noticed that her short term memory is declining or that she has been losing weight. Perhaps she mentioned being lonely during the day but being unable to get out of the house on her own due to physical ailments. You are working and taking care of your own busy family and can’t imagine taking on additional caregiving responsibilities even though you want to. So what do you do? Now is the time to call Home Care Assistance.

Home Care Assistance is a full service home care agency offering hourly services but with a specialty in live-in caregivers. Our caregivers are specifically trained in our exclusive Balanced Care MethodTM . Focusing on lifestyle and dietary choices, the Balanced Care MethodTM promotes healthy activity, stress reduction, and social interaction to help seniors live their best possible lives – in the comfort of home. But, what exactly does this mean for your mother?

1. When it comes to physical hygiene, our caregivers are able to provide assistance with bathing, dressing, and grooming. A little help here can go a long way in improving your mom’s willingness to interact with others and her own self-image.

2. From planning the menu to preparing the meal, the caregiver will ensure that your mother is eating three, well balanced meals per day. If your mother has food preferences or enjoys cooking, then she and her caregiver will enjoy doing this together.

3. Exercise. Not a word that most of us like to think about, but it’s a necessity nonetheless. Your mom isn’t going to be training for a marathon by any stretch, but the caregiver will work to improve her physical stamina. From simply doing stretches and chair exercises to walking to the mailbox or around the block, she won’t be sitting in her favorite chair all day long anymore!

4. You know the old saying, use it or lose it. It applies to short term memory, too! While our caregivers can’t reverse memory loss associated with dementia and Alzheimer’s Disease, they can provide social interaction, which has been shown to improve cognitive function. A game of cards, anyone?

When it comes to caring for your aging loved one, accept help from the professionals. While this is new to you, it isn’t new to us. For more information about Home Care Assistance, please visit our website at www.homecareassistance.com. To be directed to your local Home Care Assistance office, please call 1-866-4-LIVEIN.

Using the Holidays to Your Advantage

2010-12-22T22:16:00.000-05:00

The holidays are the time of year when even far away family members travel in order to gather together. This makes the holidays the perfect time to do some planning for the future. With parents aging and their health and lifestyles changing, children need to discuss some changes and decisions that will be needed in the near future. Parents should take the time to tell their children where important documents are kept and what their wishes are in the event of needing health care directives or experiencing long term care needs.

For those children who live away, the change they see in their parent's health and mental capacity may be alarming -- whereas siblings that have daily contact are working with these issues constantly. Here is the chance to compare notes and work together as a complete family in the long term care planning process.

For you parents who are well and active, this is a good time to hold a family meeting and share with your children your plan for long term care. Tell them where financial and legal documents are located. Review health care directives, living wills and long term care alternatives.

Experience has shown that even families that are close can quickly grow angry, jealous and hostile towards each other when an aging parent begins to need long term care. If a sibling moves into the parent's home, others can easily be suspicious of ulterior motives and fear losing their inheritance. On the other hand, the child who assumes the role of caregiver becomes bitter and feels there is no support or help from siblings. Meetings for the purpose of making a plan, before eldercare becomes imminent, avoids these types of conflicts.

In its book, The 4 Steps of Long Term Care Planning, the National Care Planning Council provides guidelines and checklists for family planning meetings. Here are some suggestions as taken from the book:

Get all interested persons together in one place at one time. Taking advantage of the holidays or another special event can be a great way to get everyone together. If this isn't conducive, then perhaps a special dinner might be an incentive.
Depending on the circumstances surrounding the meeting, the facilitator can be the parent, caregiver, family friend, or a professional advisor.
The agenda can be formal or informal. If you want a formal agenda, then a care plan should be prepared prior to the meeting and presented to all attendees. The facilitator should work to encourage input from everyone involved through active discussion.
After a thorough discussion of the issues and the presentation of the solutions to the problems that will be encountered, there should be a consensus of all attending to support the plan. It is not always possible to please everyone so there must sometimes be compromise.
The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. GET IT IN WRITING! All good intentions seem to be forgotten with time. It may be years after this meeting before the long term care plan begins.

The U.S Department of Health and Human Services states: "No one wants to think about a time when they might need long-term care. So planning ahead for this possibility often gets put off. Most people first learn about long-term care when they or a loved one need care. Then their options are often limited by lack of information, the immediate need for services, and insufficient resources to pay for preferred services. Planning ahead allows you to have more control over your future."

Whether you plan a formal meeting with an agenda or informally gather for a discussion, when the family is together make it a point to start the long term care planning process. There is a lot to learn and many decisions to make concerning finances, health issues and legal work. It may take research and a lot of time to put a plan together, but if everyone is involved it will work, and be worth it.

For more information, please visit Home Care Assistance or the National Care Planning Council.

Make the Holidays Brighter

2010-12-22T22:07:00.000-05:00

The holidays are a busy but wonderful time of the year for most of us. However, for an older adult who has physical and/or cognitive limitations, the holidays can be a confusing, depressing, and very stressful time of year. Here are a few tips for how you can make the holidays more enjoyable for the older adults in your life:

Reminisce: older adults with memory impairment have difficulty recalling recent events, but often times remember past events clearly. Allow them the opportunity to share their favorite memories. You might just learn something!
Plan accordingly: some older adults tire quickly or respond poorly to over stimulation. Avoid cramming too many activities in to one day. Allow the time for a nap if necessary. If your loved one becomes easily confused or agitated by noise, then set aside a quiet area for him or her to relax. Instead of having the entire family over for one visit, consider having a couple of holiday gatherings over a few days.
Physical environment: if older adults are visiting outside of their home, then ensure that the physical environment is a safe environment. Eliminate throw rugs and other tripping hazards. If visiting in the older adult's home, do not rearrange furniture as this can increase confusion.
Avoid embarrassment: an older adult with early memory impairment may embarrass easily if unable to remember an earlier conversation or the name of a rarely seen family member. Avoid adding to their embarrassment by saying, "Don't you remember?" They don't remember and no amount of prodding will make them remember.
Involve your loved one: invite them to help make cookies, wrap gifts, or set the dinner table. Involve them in the conversation at the holiday meal.

By making a few small adjustments, you'll guarantee a happier holiday season for all involved!

The Perfect Holiday Caregiver: It’s All a State of Mind

2010-12-13T21:48:00.000-05:00

by Anne Pagnoni

The holidays are always a wonderful time of year for family gatherings, reflection on what we have and the spirit of giving. The television is packed with specials showing relationships and families coming together for the holidays. But the holidays can also be a time of stress and sadness for those who are caring for family members that are struggling with health problems, frailty, dementia and loss. Those who care for these individuals may feel overwhelmed, frustrated, depressed or resentful as they watch “perfect” families enjoying the holidays. There are many surveys and documents that show that caregivers are highly susceptible to these feelings. If you are a caregiver, there are measures you can take to avoid this.

First: you are not alone.

If you are new to caregiving or have been caring for someone for a very long time, remember that the perfect family on television is not reality for many Americans. You are not the only one with these challenges. A recent study by the National Alliance for Caregiving and AARP found that 44.4 million Americans age 18 or older are providing unpaid care to an adult. In fact according to the survey provided by the National Family Caregivers Association:

• The typical caregiver is a 46-year-old Baby Boomer woman with some college education who works and spends more than 20 hours per week caring for her mother who lives nearby.

• Female caregivers provide more hours of care and provide a higher level of care than male caregivers.

• Almost seven in ten 69%) caregivers say they help one person.

• The average length of caregiving is 4.3 years.

• Many caregivers fulfill multiple roles. Most caregivers are married or living with a partner (62%), and most have worked and managed caregiving responsibilities at the same time (74%).

Second: find help.

There are many resources available to a caregiver. Some of these include family members, friends, a local religious group, elder care agencies and homecare providers. The internet provides many great resources and help. The National Care Planning Council offers many articles, brochures and local referrals to help caregivers find the help that they need.

“When my husband’s stepfather was released from the hospital in December of 2009, he called us to give him a ride home. Once he was home, we quickly realized that he was not able to care for himself at all. He lived alone and we found ourselves driving back and forth three or four times a day to assist all of his needs. It was overwhelming and frightening to suddenly become a caregiver to a man we weren’t even that close to. With my husband working full time days, I became his primary caregiver. I would pack up my two little girls every day to come with me to take him to the doctor, do his laundry and feed him his meals, do his grocery shopping and help him with his bills. I had no idea what his finances were like or how to pay his medical bills. He was too sick to care or even understand what I was saying to him. I quickly realized I was going to have to find help. First I called his children. They were sympathetic, but gave all kinds of excuses as to why they could not help. Next, I went to the internet. I went to the website for National Care Planning Council www.longtermcarelink.net and found and contacted a Care planner in my area. The Care Planner came to my stepfather’s house and met with the two of us. They helped me get organized and set up time to meet with someone to explain his Medicare services and what my next steps would be. It was such a relief to have a plan and to know what to do.” MH- Salt Lake City, Utah

Most family members are willing to help, but just don’t know what to do. Many caregivers feel that they are the only one who can give the best care. It is important to communicate with other family members about what kind of help you need and let them know specifically what they can do.

A number of organizations and private companies will give you advice and guidance -- many for free. If your care recipient has a very low income, you might get free help from your local Area Agency on Aging. A lot depends on available funds. Click here for a nationwide list of agencies.

A good source for professional advice is the rapidly growing business of non-medical home care companies. Most will offer free consultations and will provide paid aides to help you with your loved-one with such things as bathing, dressing, shopping, household chores, transportation, companionship and much more. These people may also help you coordinate adult day care or other community services.

You may wish to pay for a formal assessment and care plan from a professional geriatric care manager. Even though it may cost you a little money to hire a care manager, this could be the best money you will ever spend. Care managers are valuable in helping find supporting resources, providing respite, saving money from care providers, finding money to pay for care, making arrangements with family or government providers and providing advice on issues that you may be struggling with.

Lastly: it is important to take care of yourself first in order to give effective and loving care.

Stephen Covey tells a story in his book The Seven Habits of Highly Effective People about a man who is sawing a tree. A woman approaches and asks the obviously exhausted man how long he has been sawing the tree. He tells her that he has been there for hours.

She says “Well, I see that your saw is dull, if you would just sharpen your saw you would be able to saw it much faster and with less effort.”

He replies, “I don’t have time to stop and sharpen my saw, I need to chop this tree down now!”

It seems pretty silly that the man just doesn’t stop for a few minutes to make the work easier. It is common for caregivers to do the same thing. They focus on caring for their loved one and run themselves down instead of stopping to “sharpen their saw”.

Covey states that “sharpening the saw” is to take care of yourself by keeping your physical, mental, emotional and spiritual self balanced. There is joy and respite in balancing all of these areas in our life. This is what makes us efficient and happy. Here are some ways for you as a caregiver to sharpen your own saw:

• Maintain a positive attitude. Take time to be grateful for everything that is good in your life. There is always something. Adjust your expectations for the holiday season. If you aren’t expecting that perfect holiday family picture, then you won’t be angry and frustrated that it isn’t something you have right now. It is always possible to change your attitude and perceptions, but it is not always possible to change your circumstances.

• Eat healthy food and be sure to get some exercise. Do this in small increments if it is too overwhelming to plan menus. Drink more water, cut down on sugary snacks, pick up some vegetables and fruit to grab. Walk or do marching in place. Run or walk up and down stairs if that is all the time you have right now.

• Forgive and let go of frustrations, anger, resentment and guilt. These are common feelings for caregivers. The best thing a caregiver can do for their own emotional health is to clear out these negative thoughts and feelings. Get counseling, talk to a friend or family member or simply write down the negative feelings to get them out of your system. Never take your anger and frustrations out on those you care for.

• Take time to do something you enjoy and give yourself a little bit of rejuvenation everyday. Laughter is a great stress reliever. Find something funny to read or get on the internet and find a funny video to watch.

• During the holidays, be easy on yourself. If you enjoy holiday activities, then get out there and do them. Ask someone to help with your caregiving duties even if it is just for an hour or two to shop or to see a concert or movie. There are day care facilities or home care services available for short term care. See www.longtermcarelink.net for a service in your area.

Being a “perfect” caregiver during the holidays does not have to look like the perfect on-screen holiday family. How you handle your circumstance will be the key to creating your own peace, happiness and cheer during the holiday season. The holidays can be a time of reflection on good things. Your attitude and a little care for yourself can make a big difference in the care that you give in the coming year.

Safer Travel for Those with Dementia

2010-12-05T21:30:00.005-05:00

December is a time when many families are planning to travel to visit family and friends. Whether you're considering a weekend getaway or an extended stay, traveling with an individual who has Alzheimer's requires additional thought and preparation.

Additionally, as Alzheimer's progresses, negotiating changes in environment will become increasingly challenging. Be prepared for the individual with the disease to experience some confusion or disorientation. Exercise caution, as wandering and getting lost are more likely during transitional times. The checklist below will help you plan for the trip and make it successful and safe.

Before going persons with Alzheimer's and their caregivers need to be prepared for a change in schedule and environment. Even if it is a trip you have taken before, it may feel new for the person with the disease.

Call the Alzheimer's Association chapter in the area you will be visiting. Let them know you will be staying in the area and ask about available resources. You can locate any chapter by calling 1.800.272.3900 or visiting www.alz.org/apps/findus.asp.
Enroll the person in MedicAlert^® + Alzheimer's Association Safe Return^®, a 24-hour nationwide emergency response service for individuals with Alzheimer's or a related dementia who wander or have a medical emergency. You may also want to consider the Alzheimer's Association Comfort Zone^TM, powered by Omnilink, a Web-based GPS location management service.
If you are already enrolled in MedicAlert, update your records with temporary contact information (call 1.888.572.8566).

Upon arrival

Let the neighbors know a person with Alzheimer's is staying next door and ask them to keep their eye out for wandering or other unsafe behavior.
During the first few days after arrival, keep your schedule light with lots of down time.
Create opportunities to re-acclimate the person to the new environment.
Keep familiar things around.
Limit access to money and credit cards.
Limit access to driving.
Be aware that the change can be chaotic for the person.
Recognize the warning signs of anxiety and agitation.

For more tips on safety for people living with Alzheimer's disease and related dementias, including concerns about wandering, disaster preparedness, home and medication safety, visit the Alzheimer's Association Safety Center at www.alz.org/safetycenter or call 1.800.272.3900 to find the Alzheimer's Association chapter closest to you.

FDA Passes New Food Safety Bill

2010-12-02T21:55:00.000-05:00

A new food safety bill passed by the Senate on Tuesday is going to give the U.S. Food and Drug Administration higher authority to stop contaminated food from getting onto our plates.

An estimated 76 million Americans get food poisoning every year, resulting in more than 300,000 hospitalizations and 5,000 deaths, according to the Centers for Disease Control and Prevention. Food poisoning mainly affects seniors, small children and anyone with a weak immune system.

The last time the FDA’s food regulations were updated was in 1938—before penicillin use was widespread. The passage of this bill will benefit everyone and hopefully the number of hospitalizations and deaths as a result of food borne illnesses will go down drastically.

Don’t Ignore Signs of Caregiver Stress

2010-11-14T16:43:00.001-05:00

November is National Alzheimer's Disease Awareness Month and National Family Caregivers Month. The Alzheimer's Association offers a number of resources to help caregivers manage stress:

The Alzheimer's Association Caregiver Notebook offers tips for care and planning for the future, as well as a list of resources to use when additional information is needed. To learn more or purchase the Caregiver Notebook, visit www.alz.org/caregivernotebook.
Caregiver Stress Check, an interactive quiz that helps caregivers to identify symptoms of stress and provides a tailored list of helpful referrals and other support. Take the quiz at www.alz.org/stresscheck.
Alzheimer's Association CareSource™, an easy-to-use, one-stop online portal for everything you need to widen your care options and plan for care for a person with Alzheimer's. Find out how CareSource can help at www.alz.org/caresource.

Learn more about Alzheimer's disease and caregiver stress by visiting www.alz.org.

Great Program for Caregivers

2010-11-07T21:25:00.003-05:00

Caring for an aging loved one has its fair share of challenges. For the caregiver who is caring for someone with Alzheimer's Disease or another related dementia, these challenges are compounded by difficult behaviors that many times accompany Alzheimer's Disease, i.e. agitation, repetition, hallucinations, and sundowning. The caregiver in this situation is also grieving the loss of the person that they once knew.

On November 16, 2010 at 6:00PM (EDT) the National Private Duty Association is presenting a web conference for family caregivers, who are caring for someone with Alzheimer's Disease. The 45 minute web conference will discuss patient assessment, care plans, caregiver education, safety, and other issues related to caring for someone with Alzheimer's.

While the program is free of charge, pre-registration is required. To register and for more information, please visit the NPDA at http://www.privatedutyhomecare.org/.

Alzheimer's Disease Awareness Day

2010-10-31T16:06:00.004-04:00

In 2007 the State of New Jersey passed legislation designating the first Monday in November as "Alzheimer's Disease Awareness Day". This year we observe this day on Monday, November 1st.

The Alzheimer's Association reports that there are currently 5.3 million people living with Alzheimer's Disease and that every 70 seconds another person is diagnosed with this terminal disease. It is predicted that up to 16 million Americans will have Alzheimer's Disease by the year 2050 and that someone will be diagnosed with the Disease every 33 seconds.

Alzheimer's Disease is the 7th leading cause of death in the United States with mortality rates on the rise. The yearly price tag of Alzheimer's Disease? $172 billion per year.

Please join Home Care Assistance of New Jersey as we honor the victims of Alzheimer's Disease and their loved ones by observing Alzheimer's Disease Awareness Day. Wear purple to show your support. Together we can turn New Jersey in to a sea of purple on Monday, November 1st!

Breast Cancer Awareness Month

2010-10-17T22:32:00.000-04:00

If you are looking for resources regarding breast cancer awareness or breast health, then please visit the following websites:

Five Risk Factors for Breast Cancer -- And Five Ways You Can Fight Back
http://www.seattlepi.com/sound/428481_sound104971549.html

Breast Cancer Information with Content Provided by the MayoClinic
http://www.bing.com/health/article/mayo-125861/Breast-cancer?q=breast+cancer&qpvt=Breast+Cancer

Nonprofit organization providing current information on breast cancer and treatments
http://www.breastcancer.org/

American Cancer Society
http://www.cancer.org/cancer/breastcancer/index

National Cancer Institute
http://www.cancer.gov/cancertopics/types/breast

Legal Issues with Veterans Benefits

2010-10-10T19:50:00.002-04:00

by Anne Pagnoni
Accreditation
Federal law dictates that no one may help a veteran in the preparation, presentation and prosecution of an initial claim for VA benefits unless that person is accredited. The only exception to this law is that any one person can help any veteran -- one-time only -- with a claim. To help any veteran a second time requires accreditation.
VA recognizes 3 types of individuals for purposes of accreditation.
(1) Accredited attorneys
(2) Accredited agents and
(3) Accredited representatives of service organizations. (Veterans Service Officers)
In order to be accredited to help veterans with new claims, an individual desiring this certification from VA must submit a formal application, must meet certain character requirements and work history requirements and -- except for attorneys -- must pass a comprehensive test relating to veterans claims and benefits. There are also requirements for ongoing continuing education.
Without accreditation no one may help a veteran with a claim more than one time.
What Does It Mean to Help a Veteran with a Claim?
VA interprets its prohibition on preparing, presenting and prosecuting a claim to mean that talking to a veteran or a veteran's qualifying spouse or dependent after that person has indicated an intent to file a specific claim for benefits requires accreditation. Anyone can talk about veterans benefits in general with any veteran and need not be accredited. The point at which discussion narrows down to specific information about the veteran's service record, medical conditions, financial situation including income and assets and other issues relating to a claim specific to a veteran or dependent triggers accreditation. According to VA, discussing the specifics of the claim means that the veteran has expressed an intent to file an application for veterans benefits, and at this point, the consultant helping the veteran must be accredited.
Stated again: An individual cannot advise a veteran or other eligible beneficiary about that person's specific claim for VA benefits unless that individual is accredited.
It does not matter whether physical help with filing the claim is provided or not. The need for accreditation occurs at a much earlier stage than becoming physically involved in the claim. For a better understanding of how VA General Counsel interprets the need for accreditation please go to the VA Office of General Counsel Website -- Frequently Asked Questions about Accreditation at http://www4.va.gov/ogc/accred_faqs.asp
Working under the Umbrella of an Accredited Attorney or Accredited Claims Agent
Many individuals or organizations who are not accredited and who are promoting and helping veterans obtain their benefits are often attempting to work under someone who is accredited. Most of these individuals are doing it wrong and not complying with the law.
These individuals make sure that the application is done by an accredited attorney or an accredited agent. In some cases, non-accredited individuals will refer veteran households to a local veterans service officer (an accredited representative of a service organization).
Unfortunately, most individuals who are not accredited and who are operating with someone who is accredited are still illegal. This is because the non-accredited individuals become involved in the claim by providing advice after an intent to file and in many cases they help gather documents and other pertinent information. As mentioned above, these activities require accreditation. The only way that a non-accredited individual can operate legally to assist someone who is accredited is to immediately refer a veteran or dependent to an accredited person when first understanding an intent to file a claim. No additional help or advice may be given after the intent to file has been recognized.
Many accredited attorneys are also not operating legally. Only an accredited attorney -- one-on-one with the client -- may be involved with a claim. Anyone else, inside or outside of the office, cannot assist with the claim except under certain limiting conditions. Specifically, in order to work under an attorney, a non-accredited assistant must either be another attorney in the office, a certified paralegal in the attorney's office or an office law student or an intern. The client must also sign a consent letter allowing this arrangement. This consent must be filed with the original application. No other arrangement is allowed. Please see 38 CFR § 14.629 for an explanation of this requirement.
Charging a Fee for Help with Filing a Claim
Generally, no individual or organization may charge a fee for help with filing an initial application for benefits. There is only one exception to this rule and that is under the third-party exemption in 38 CFR § 14.636 (d). The requirements under this exception are very specific. In our opinion, no one that we know of, who is charging a fee, thinking he or she is operating under this exception, is doing it legally. Here are the ways these people are violating this law. (In most cases those who are operating illegally are engaging in all 4 of these unlawful activities.)
(1) The person paying the fee is not a disinterested third party as required by law.
(2) The person filing the claim is not submitting the fee agreement to VA general counsel as required.
(3) The person filing the claim is not submitting the disclaimer to General Counsel as required.
(4) The fee is contingent upon a percentage of the amount of the approved benefit.
We are seeing various financial arrangements for filing claims that are disguised fees in one way or another. As a general rule, anyone who would directly benefit financially from helping a veteran file a claim -- whether a direct fee is charged or not -- is in essence charging a fee. We know from numerous discussions with representatives, this is the way VA General Counsel treats these arrangements.
If you are working with someone who is not operating legally as outlined above, you should stop using that person's services. If you yourself are operating in a manner that is not in accord with the conditions outlined above, you must stop doing that. You're not legal. Not only could unauthorized individuals get a notice to cease and desist but in some cases there could be fines or legal action involved as well. It's not worth it. For help with accreditation issues you can contact the National Care Planning Council at info@longtermcarelink.net.

Good vs. Bad Cholesterol

2010-09-19T20:50:00.001-04:00

Here are some great additional resources to check out regarding cholesterol:

Good vs. Bad Cholesterol

National Cholesterol Education Month

High Cholesterol Foods

Low Cholesterol Foods

Eldercare...Planning for Baby Boomers, Providing the Answers You Need

2010-09-19T16:47:00.000-04:00

Zarephath Christian Church invites the public to their upcoming panel presentation on Saturday, October 16th at 9:00 a.m. at the church. This valuable program entitled “Eldercare Planning for Baby Boomers– Providing the Answers you need” addresses caregivers who share the common issues of being overwhelmed and under informed when an older adult needs their help. The panel presentation will be moderated by Maryann Porosky, LCSW, Care Management Specialist of Caring Choices and will feature four experts: Michelle Bucci, Outreach Director at the Chelsea of Warren, Kevin McClarren, President, Home Care Assistance; Jeff Knapp, Eldercare Law Attorney of Knapp Law Firm, and Terri Erbacher, LPN, Elder Care Advocate.

The panel of speakers will explain ways to avoid costly mistakes, both emotional and financial by planning now rather than facing a crisis unprepared. They will discuss choosing the right venue for care, whether it be your home, an assisted living facility or a nursing home and minimizing the financial impact it can have on your family and loved ones. You will also have an opportunity to participate in a Q&A session after the presentation.

There is no charge for this invaluable presentation and a nice continental breakfast will be served. Advance reservations are requested by confirming your attendance by calling Terri Erbacher at 908-526-5279. Zarephath Christian is located at 14 Chapel Drive in Zarephath, NJ.

Home Care Assistance of Greater New Jersey Delivers Cost-Free Caregiver Support

2010-09-13T22:17:00.010-04:00

By Anne Pagnoni

Being a primary caregiver for another individual is a daunting experience. In addition to making sure that the individual's personal care needs are met, the caregiver is responsible for making financial and health care decisions, managing doctors' appointments, and maintaining a safe living environment for the care recipient. The caregiver needs support, too, during this tumultuous time. Where can the caregiver turn for help? Home Care Assistance of New Jersey is excited to announce its partnership with a free, online, caregiver support program called MyCareCommunity.

Studies show that caregivers find stress-relief in three ways: access to information and tools, support from other caregivers, and the ability to share caregiving responsibilities with family and friends. MyCareCommunity allows caregivers to do just that, by providing a convenient, easy-to-use website that offers:

Practical advice and expert information
Caregiver blogs, discussion forums and sharing of real-life stories and experiences
Ability to get answers from local NJ professionals on a variety of health and elderly care issues
Search features for care services, care providers and community resources
Access to a private webpage that is focused on the care of a loved one

MyCareCommunity has a true Ask the Expert feature. Experts in the field of aging from all over New Jersey have availed themselves to caregivers. Each expert is listed with a short biography which allows caregivers the opportunity to direct their questions to the expert best able to answer their questions.

One of the greatest features of MyCareCommunity is the Personal Communities, which enable users to create a webpage for their loved one and then invite other family members or friends to view it. The caregiver is able to provide updates about their loved one via the personal community, which alleviates the need for the caregiver to make numerous phone calls or send multiple emails with notifications. There is a care scheduler feature, which allows the caregiver to enter appointments into a calendar. All other personal community members are able to see the appointments and offer assistance to the caregiver accordingly.

If you're a caregiver, then take a few minutes and check out all of the features of MyCareCommunity. It's an invaluable resource that will make your caregiving responsibilities easier. By visiting www.mycarecommunityNJ.org, caregivers will find the support and information that they need to assist them in managing their caregiving journey.

Support Groups for Caregivers

2010-08-29T17:08:00.002-04:00

By Anne Pagnoni

Being a caregiver for a loved one is an overwhelming responsibility. Many caregivers hold full time jobs; juggle children with their many extracurricular activities; and maintain their own household with laundry, bill paying, meal preparation, grocery shopping, yard work, cleaning, etc. In addition to their own familial responsibilities, they are responsible for the care of another adult individual, who typically has multiple physical and cognitive limitations. While initially the caregiving responsibilities may not be too taxing, as the aging loved one's limitations increase so does the time that the caregiver needs to spend caregiving. Overtime the caregiver will become overwhelmed and will need a support system in place to help him or her through the rough times.

Professionally run support groups are an excellent resource for the caregiver. Caregivers have the opportunity to talk with each other and share tips on things that have and haven't worked. Professional facilitators are available to provide useful information on relevant caregiving topics and to steer caregivers in the right direction when looking for additional services. Support groups usually meet for a couple of hours either weekly or biweekly. But what about the caregivers who aren't able to make the meetings or caregivers who need support between meetings? How do they get the help that they need?

Home Care Assistance of New Jersey has teamed up with an online caregiver support group designed to provide resources to caregivers and link them with professionals, who can share insight on particular caregiving issues. On Wednesday, September 1^st Home Care Assistance will be making an announcement regarding this partnership with information on how individuals can begin utilizing the site. Stay tuned for more information!

New Study States that Home Care Following Hip Surgery May Aid Survival

2010-08-19T20:52:00.002-04:00

Great article detailing a new study, which found that older adults who utilized home care services following hip surgery had a greater survival rate than those who did not.

Getting Your Affairs in Order

2010-08-16T21:43:00.001-04:00

By Anne Pagnoni

If we had a crystal ball and could see into the future, we would not need to prepare ahead for end of life decisions.

James was 62 years old when a stroke made it impossible for him to communicate with his family. Neither his wife nor children knew anything about his financial or medical information. James had always taken care of things himself and left no written directives in his behalf. Besides having to locate important documents, the family was left to make their own decisions about James long term care.

The National Institute on Aging gives three simple, but important steps to putting your affairs in order:

"Put your important papers and copies of legal documents in one place. You could set up a file, put everything in a desk or dresser drawer, or just list the information and location of papers in a notebook. If your papers are in a bank safe deposit box, keep copies in a file at home. Check each year to see if there's anything new to add.
Tell a trusted family member or friend where you put all your important papers. You don't need to tell this friend or family member about your personal affairs, but someone should know where you keep your papers in case of emergency. If you don't have a relative or friend you trust, ask a lawyer to help.
Give consent in advance for your doctor or lawyer to talk with your caregiver as needed. There may be questions about your care, a bill, or a health insurance claim. Without your consent, your caregiver may not be able to get needed information. You can give your okay in advance to Medicare, a credit card company, your bank, or your doctor. You may need to sign and return a form." National Institute on Aging http://www.nia.nih.gov

Preparing Advance Directives or Living Will

Advance directives are legal documents that state the kind of medical care or end of life decisions you want made in your behalf. It is a way for you to communicate your wishes to family or health care professionals. Emergency response medical personnel cannot honor Advance directives or living wills. They are required to save and stabilize a person for transfer to a hospital or emergency facility. Once at the facility a physician will honor the directives.

The Living Will as part of your directives gives your consent or refusal for sustained medical treatment when you are not able to give it yourself. If this document is not in place then a family member or physician will decide such things as:

Resuscitation if breathing or heartbeat stops
Use of breathing machines
Use of feeding tubes
Medications or medical procedures

Advance Directives and Living Wills are legal throughout the United States; however, some states may not honor other states' directive documents. Be sure to check with the state you live in for their requirements.

Review your directives periodically. They do not expire, but your wishes may change.
A new or revised Advanced Directive invalidates the old one. Be sure your family member or healthcare proxy has a current copy.

Choosing a Power of Attorney

General Power of Attorney - authorizes someone to handle your financial, banking and possibly real estate and government affairs as long as you remain competent.

Special Power of Attorney - authorizes someone you designate to handle certain things you cannot do yourself for a period of time.

Durable" Power of Attorney -The general, special and health care powers of attorney can all be made "durable" by adding certain text to the document. This means that the document will remain in effect or take effect if you become mentally incompetent.

Many people do not know the difference between a general and a durable power of attorney. A general power of attorney is a document by which you appoint a person to act as your agent.

Agents are authorized to make decisions for you, sign legal documents, etc. Many people are unaware that a General Power of Attorney is revoked when the person granting that power becomes incompetent or incapacitated.

It is the "Durable" Power of Attorney that allows for an agent to continue making decisions on your behalf no matter what happens to you. A responsible adult child of an aging parent would be given a "durable power of attorney" to act on behalf of the parent. This provides broader authority than just adding the child's name to bank accounts and documents.

You may choose to produce notarized power of attorney documents on your own. If your estate is large and real estate or business is included it is advised to secure a reliable attorney.

National Care Planning Council http://www.longtermcarelink.net/a2cfindattorney.htm

5 Steps To Protect Against Extreme Heat’s Effects On Seniors

2010-08-08T17:21:00.001-04:00

Article written by the Co-Founder of Home Care Assistance. Great tips to consider especially during the dog days of summer, which are upon us!

5 Steps To Protect Against Extreme Heat’s Effects On Seniors

Applying for the Veteran’s Aid and Attendance Pension: My Personal Experience

2010-07-29T20:03:00.003-04:00

My previous blog entry was about this exact government program – Veteran's Aid and Attendance. Read on to learn more about the application process for one family. Please keep in mind that this pension program also exists for a Veteran, who wishes to remain in his or her home with home care services. –Anne Pagnoni

Applying for the Veteran's Aid and Attendance Pension
My Personal Experience
By Melissa Howell

12:20 a.m. The clock was blurry as I rubbed the sleep from my eyes to answer the phone.
"Hello", I said. A weak and frightened voice on the other end pleaded, "Melissa? Is Bryan there? I can't get out of my chair. Could you or Bryan come over?"

I sighed as I handed the phone to my husband and heard him say, "I'll be right over, Dad."
When Bryan left, I pondered on my father-in-law, John, and his situation. John had just come out of the hospital after a serious illness and although the doctor had assured us he would be fine, we quickly learned that he was not able to care for himself. He lived alone in a small apartment and had in-home health care assistance through his Medicare plan. They came once a day to help him with a shower and to aid him with incontinence. Bryan and I came over three times a day to help him with changing his clothes and to make his meals. In addition, we helped him with his bills and took him to his frequent doctor appointments. Tonight was the first time he had called to ask for help in the middle of the night. We needed to do something different. We were both exhausted between working our jobs and caring for our four young children and constantly running out to take care of John's needs. It was becoming more than we could handle. We realized we really needed to get him into assisted living.

John lived comfortably on an income consisting of social security and a retirement pension, but as we visited different assisted living homes in our immediate area, we quickly realized that this income was not enough. Assisted living was really expensive!

John had served in the Navy during the Korean conflict and we had heard through a friend that veterans could receive assistance through the Department of Veteran's affairs for health care. The catch was doing it correctly. Our friend referred us to a Veteran's Consultant from the National Care Planning Council to provide information for the challenging task of filling out the paperwork to receive this benefit. A Veteran's Consultant can provide general information on how a claim is filed. Our consultant told us about all of the necessary supporting documents we would need to make sure it was approved. The paper work was pretty daunting, but we worked through each form thoroughly to be sure that we were providing all the information Veterans Affairs (VA) would need in order to expedite John's payments.

First, I obtained a medical report from John's doctor -- the most crucial step in the process. This form would prove that John needed aid and attendance. In our case, the doctor described his medical condition and then noted specifically his need for help with incontinence and showers, his lack of motivation to make meals for himself and his inability to leave the house alone. It was, however; important to us that the doctor wrote that John was mentally capable of making his own decisions, because we did not want to go through a delaying process of having VA assign somebody who would need to pay his bills for him (VA calls this person a fiduciary).

Another key thing was that John had to show evidence to VA that his care costs were close to or exceeded his income. Fortunately, John had a small amount of savings and he was able to pay in full for the first month's payment to his assisted living home. This was important, because the statement showing this payment was important evidence needed to present to VA. Since his assisted living cost exceeded his income by $1,000 per month, we arranged with the director, to pay what John could afford until the benefit from VA came in and then the director agreed to pay the remaining debt balance on the account at that time.

An important form was John's original DD-214, which was the official record showing that he had been honorably discharged from the military. I quickly found a certificate of honorable discharge (DD-256) but this was not the correct form. We searched through all of his files and boxes and couldn't find the DD-214. So I got on the Internet and found a website for the National repository where the official forms can be obtained. It appeared that it could take up to 6 weeks to receive an official copy. Fortunately, we found the original document folded in his wallet and we did not have to delay our process.

One of the forms my Consultant made me aware of was a VA power of attorney form (VA form 21-22a) that gave me the authority to fill out and submit the forms to VA on behalf of John. Although John was mentally sound, he was weak and tired and didn't really want to do anything but watch television and eat. With this form, I was able to communicate with VA in his behalf.
There were several other forms to fill out and after all the paperwork was finished, my Veteran's consultant gave us the address of where to send all of them. Our particular VA processing office was located in St. Paul, Minnesota.

After about two weeks, John and I each received a letter stating that VA was working on his case and they assigned him a case file number. After another two weeks, we received a letter stating that we needed to fill out some other paper work. I showed these to my consultant, who assured me, in our case, that it was standard procedure and that the paper work I had originally filed was sufficient. Within another two weeks, John received his first payment.
Because his care cost exceeded his income, he was awarded the full $1644.00 per month. VA sent another payment from the date that they had first issued his case number. So in the first month, we received two payments. These were sufficient to catch up the debt he owed to his assisted living and to continue with full payments each month.

Applying for the VA Aid and Attendance Pension was detailed, but it was not terribly frustrating because of the general information on the application process I received from my consultant. It did require extra work on my part, but it was well worth the end result of getting the care that John needed and the relief that Bryan and I needed in the end. I am grateful that we had such a wonderful resource in National Care Planning Council to help us find a capable and informative Veteran's Consultant.

Bryan and I now see John twice a week and visit with his assisted living staff often to help him have a comfortable and enjoyable life in his new home. He is able to enjoy activities and meals with other people, have quality personal care and have the peace of mind that someone is always there to help him. I now sleep at ease through the night, knowing that his needs are taken care of and that there won't be any middle of the night calls asking for help.

The National Care Planning Council wishes to thank Melissa for providing her experience. We maintain a list of consultants across the country which can be found at the following address: www.veteranslisting.com. We also provide a book with instructions to help people who want to file an application by themselves. This book can be purchased online at http://www.longtermcarelink.net/a16books.htm.

Little-Known Government Program Pays the Cost of Elder Care

2010-07-25T20:49:00.003-04:00

By Anne Pagnoni
WHAT IF 33% OF ALL SENIORS IN THIS COUNTRY could receive up to $1,949 a month in additional income from the government to help cover their elder care costs? THEY CAN!
Under the right circumstances, a little-known federal program will pay additional income to cover long term care costs for at least 1/3 of all US senior households -- that's how many war veterans or their surviving spouses there are in this country. But the provisions of this program are such a well-kept secret that only 4.7% of US seniors are actually receiving the benefit. The great news about this program is the Department of Veterans Affairs will pay you to hire your family, friends or just about anyone to take care of you (Caregiving spouses can't be paid under this program). The program is called "Veterans Pension."
Most people who have heard about Pension know that it will cover the costs of assisted living and, in some cases, cover nursing home costs as well. But the majority of those receiving long term care in this country are in their homes. Estimates are that approximately 70% to 80% of all long term care is being provided in the home. All of the information available about Pension overlooks the fact that this benefit can also be used to pay for home care.
It also comes as a surprise to most people that the Department of Veterans Affairs will allow veterans' households to include the annual cost of paying any person such as family members, friends or hired help for care when calculating the Pension benefit. This annual cost is deducted from household income and used to calculate a lower "countable income" which in turn enables families to receive this disability income from VA. Even though VA claims the benefit is for low income families, because of the special provision in the regulations -- allowing for deduction for care costs -- households earning between $3,000 to $6,000 a month or more can still qualify for Pension under the right conditions.
This extra income can be a welcome benefit for families struggling to provide eldercare for loved ones at home. Under the right circumstances, this annualized medical expense for the cost of family members, friends or any other person providing care, could create an additional household income of up to $1,056 a month for a single surviving spouse of a veteran, up to $1,644 a month for a single veteran or up to $1,949 a month for a couple.
If the disabled care recipient has been rated "housebound" or in need of "aid and attendance" by VA, all fees paid to an in-home attendant will be allowed as long as the attendant provides some medical or nursing services for the disabled person. The attendant does not have to be a licensed health professional. There is also no need to distinguish between medical and nonmedical services -- all are deductible.
For a disabled person who has been rated "in need of aid and attendance" or "housebound", a family member will be considered an in-home attendant, but that family member has to be paid for services duly rendered. There is potential for fraud here where a family member may move into the home and ostensibly receive payment as a caregiver but not actually provide the level of care paid for. Documentation for this care must be provided to VA, and it is reasonable for VA to question whether the services being purchased from a family member living in the household are legitimate. Such arrangements should be extensively documented and completely arm's-length.
The care arrangements and payment for home care must be made prior to application and there must be evidence that this care is needed on an ongoing and regular basis. We recommend a formal care contract and weekly invoice billing for services. Money must exchange hands and federal law requires employment taxes must be withheld and there must be evidence of this. All of this documentation must be provided as proof to VA when making application for the pension benefit. Costs for these services must be unreimbursed; meaning these costs are not paid by insurance, by contributions from the family or from other sources. VA will allow, however, family caregivers being paid by their loved ones, to turn around and pay the household bills for their loved ones to help defray the cost of the care.
Due to the need for a rating, documentation for annualizing care costs and the extensive proof needed to show the caregiver is indeed an employee of the care recipient, most people should not try this on their own. An expert in this area should be sought to help with the application in order to avoid lengthy delays in awarding a benefit or a possible denial of benefits. For a list of individuals or companies in your area who understand how to get this benefit go to http://www.longtermcarelink.net/ref_veterans_consultants.htm

Aftercare Tips for Elderly Patients Checking Out of the Hospital

2010-06-21T21:49:00.000-04:00

Readmission into the hospital after surgery or another procedure is extremely common, costly and time consuming. Since it is one of our main priorities to keep our clients healthy and living at home rather than in the hospital, I wanted to share this article from The New York Times as it provides great tips for hospital checkout and avoiding readmission.
In 2009,The New England Journal of Medicine reported “one in five Medicare patients returns to the hospital within 30 days of being discharged.” Dr. Mark V. Williams, who worked on this study, suggests that part of the issue is due to the fact that doctors place much of their focus on the admission process, when the patient is most sick. When the patient leaves the hospital, they often have more medications and treatments to worry about than when they first entered. Some doctors suggest that this problem may also occur because it may benefit the hospital financially for patients to be readmitted.
Dr. Eric A. Coleman, professor of medicine at the University of Colorado Denver, has developed a program called Care Transitions Intervention to help seniors take initiative in their care after leaving the hospital. The steps of the program include taking charge of your care, checking the medication list for errors, making a comprehendible discharge plan and contacting your primary physician if you have any questions or concerns. To further help the cause, some medical centers are providing financial incentives for lowering readmission rates and are providing guidance for improving the discharge process.

Recognizing Symptoms of Dementia

2010-06-13T22:27:00.003-04:00

By Anne Pagnoni

The Brown family reunion has always been an event everyone looks forward to. Family visits, games, stories and everyone's favorite foods are always on the agenda. On the top of the menu is Grandma's Lemon Coconut Cake. Grandma always makes the traditional cake from her old family recipe. This year, however, the cake tasted a little on the salty side - perhaps a half cupful of salty.

Though the family was disappointed over the cake, of more concern was Grandma's confusion with the recipe and her similar confusion about the loved ones around her. Could something be wrong with grandma's mental state?

One might say that for an older adult a little forgetfulness or confusion is normal, but when do you know if there is a serious problem, such as dementia? An online article from FamilyDoctor.org outlines some common symptoms in recognizing dementia:

"Dementia causes many problems for the person who has it and for the person's family. Many of the problems are caused by memory loss. Some common symptoms of dementia are listed below. Not everyone who has dementia will experience all of these symptoms.

Recent memory loss. All of us forget things for a while and then remember them later. People who have dementia often forget things, but they never remember them. They might ask you the same question over and over, each time forgetting that you've already given them the answer. They won't even remember that they already asked the question.
Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it.
Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want.
Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home.
Poor judgment. Even a person who doesn't have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather.
Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them.
Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can't find these things later.
Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes.
Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful.
Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people."

Dementia is caused by change or destruction of brain cells. Often this change is a result of small strokes or blockage of blood cells, severe hypothyroidism or Alzheimer's disease. There is a continuous decline in ability to perform normal daily activities. Personal care including dressing, bathing, preparing meals and even eating a meal eventually becomes impossible.

What can family members do if they suspect dementia? An appointment with the doctor or geriatric clinic is the first step to take. Depending on the cause and severity of the problem there are some medications that may help slow the process. Your doctor may recommend a care facility that specializes in dementia and Alzheimer's. These facilities offer a variety of care options from day care with stimulating activities to part or full-time live-in options. Sometimes if patients tend to wander off, a locked facility is needed.

In the beginning family members find part time caregivers for their loved one. At first, loved ones need only a little help with remembering to do daily activities or prepare meals. As dementia progresses, caregiving demands often progress to 24 hour care. Night and day become confused and normal routines of sleeping, eating and functioning become more difficult for the patient. The demented person feels frustrated and may lash out in anger or fear. It is not uncommon for a child or spouse giving the care to quickly become overwhelmed and discouraged.

Family gatherings provide an excellent opportunity to discuss caregiving plans and whole family support. It is most helpful if everyone in the family is united in supporting a family caregiver in some meaningful way. "The first step to holding a family meeting, and perhaps the most difficult one, is to get all interested persons together in one place at one time. If it's a family gathering, perhaps a birthday, an anniversary or another special event could be used as a way to get all to meet. Or maybe even a special dinner might be an incentive. The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. This might just simply be moral support and agreement to abide by the provisions or it is hoped that those attending will volunteer to do something constructive. This might mean commitments to providing care, transportation, financial support, making legal arrangements or some other tangible support." The Four Steps of Long Term Care Planning

Professional home care services are an option to help families in the home. These providers are trained and skilled to help with dementia patients.

The National Care Planning Council supports caregiving services throughout the country. Visit www.longtermcarelink.net for more information.

Why Any and All Activity Matters

2010-06-02T20:54:00.002-04:00

By Anne Pagnoni

The health benefits of exercise are extraordinarily well documented. Regular exercise lowers your risk of a stroke by 27%, reduces instances of both high blood pressure and Alzheimer's disease by 40%, cuts your chance of developing diabetes by 50%, and lowers your risk of developing colon cancer by a whopping 60%. As well, it obviously helps maintain a healthy weight. Plus, exercise has been shown to be just as effective at fighting depression as both SSRIs (like Prozac) and therapy.

A recent study from the Appalachian State University's Human Performance Lab even showed that people who took a brisk walk five days a week had fewer and less severe colds and flus than sedentary control subjects. So it's not just long-term chronic and fatal conditions that being fit staves off – regular exercise actually helps you battle the common cold, too!

Beyond full-on exercise, however, a recent study out of Australia also shows the health risk of being inactive. The study from the physical activity lab at the Baker IDI Heart and Diabetes Institute in Victoria, Australia found that the more television its subjects watched, the greater risk they had of dying at a younger age, particularly from heart disease.

Subjects in the study who watched four hours or more of television per day were 80% more likely to die from heart disease and 46% more likely to die from all causes, even when factors such as: education levels, overall health, age, past smoking, waist circumference, cholesterol levels, and blood pressure of the subjects was taken into account.

The study concluded that the real problem with television watching is that it is done while sitting, and sitting with extraordinarily little muscle movement. Such "extreme" inactivity affects metabolism overall, not just during the time spent inactive. A study from July 2008 showed that standing engages muscles and promotes the distribution of lipase, a fat-absorbing enzyme that triggers the body to process fat and cholesterol. Most important, the benefits of this regular, unremarkable movement are independent from the amount of time subjects spent exercising.

That same study found that the health consequences that develop from too much sitting are very different and independent from those that result from too little exercise. Along with the recent Australian study, it found that the negative health consequences of prolonged periods of sitting – larger waistlines, higher bad cholesterol levels, lower good cholesterol levels, heart disease risks – were not fully counteracted by regular exercise.

In other words, regular exercise – beneficial as it is – doesn't counteract the negative effects of long periods of inactivity.

Part of the issue is that television watching is fundamentally inactive. Harvard Health Publications estimates that, when it comes to calories burned, watching television (56 calories per hour) is closer to sleeping (46 calories per hour) than it is to sitting and reading (84 calories per hour), which itself is more akin to standing in line (94 calories per hour) than it is to watching television. (Note: calorie counts are for a 155-pound person.) In other words, watching television is an inactive as a person can get without sleeping.

Along with limiting television watching, these studies point to the importance of remaining active throughout the day. The good news is that it ends up that the simple physical movements of standing and moving between rooms has significant health benefits. When watching television, standing up during commercial breaks, going to get a glass of water, or even putting down the remote control and getting up to change channels and adjust volume the old-fashioned way can help people from staying in one extremely inactive position for extended periods of time.

Light household tasks and self-care – activities encouraged by the Balanced Care Method™ whenever clients are physically able – can help keep people moving. Not only does such daily activity help keep people physically active longer, we now know it also can help fight heart disease and other health risks.

Caregiver Stress: Hazardous to Your Health

2010-05-17T21:32:00.003-04:00

By Anne Pagnoni
UNDERSTANDING CAREGIVER STRESS
A 2003 study of caregivers by a research team at Ohio State University has proven the off-repeated adage "stress can kill you" is true. The focus of the investigation was the effect the stress of caregiving had on caregivers. The team, led by Dr. Janice Kiecolt-Glaser, reports on a 6-year study of elderly people caring for spouses with Alzheimer's Disease. The study not only found a significant deterioration in the health of caregivers when compared to a similar group of non-caregivers but also found the caregivers had a 63% higher death rate than the control group.
The demands on a caregiver result in a great deal of stress. It is often observed in aging publications that stress can induce illness and depression. The resulting poor health can further decrease the effectiveness of the caregiver and in some cases, as proven by the study mentioned above, even cause premature death.
Stress can be defined as a physiological reaction to a threat. The greater the threat -- the greater the level of stress. A threat is a real or perceived action against our person. Threats may include the anticipated possibility of death or injury but may also include challenges to our self-esteem, social standing or relationships to others or a threat may simply be a potential or real disruption of our established routines. What is stressful to one person may not be to another. For example, bumper-to-bumper traffic might be stressful to the woman executive who is late for an important meeting but to the delivery man who has no deadline and is being paid by the hour, it may be a welcome respite to relax and listen to the radio.
Stress produces real physical changes. In some unknown way the fears in our mind, both conscious and unconscious, cause the hypothalamus and pituitary glands, deep in our brain, to initiate a cascade of hormones and immune system proteins that temporarily alter our physical body. This is a normal human physiological response inherent to the human body when a threat is perceived--real or not. It is often called the "fight-or-flight response" or the "stress response". The purpose is to give us clearer thought and increased strength as well as to activate the immune system to deal with potential injury and to repair potential wounds. When the perceived threat is removed, assuming no damage is done, the body returns to normal.
A team of researchers at Ohio State University Medical Center has found a chemical marker in the blood that shows a significant increase under chronic stress and is linked to an impaired immune system response in aging adults. The team, led by Dr. Janice Kiecolt-Glaser, reports in the June 30, 2003 issue of Proceedings of the National Academy of Sciences on a 6-year study of elderly people caring for spouses with Alzheimer's Disease. With the caregivers, the team found a four-fold increase in an immune system protein -- interleukin 6 (IL-6) -- as compared to an identically matched control group of non-caregivers. Only the stress of caregiving correlated to the marked increase of IL-6 in the caregiver group. All other factors, including age, were not significant to the outcome. Even the younger caregivers saw an increase in IL-6.
The study also found that the caregivers had a 63% higher death rate than the control group. About 70% of the caregivers died before the end of the study and had to be replaced by new subjects. Another surprising result was that high levels of IL-6 continued even three years after the caregiving stopped. Dr. Glaser proposes the prolonged stress may have triggered a permanent abnormality of the immune system.
IL-6 is only one cytokine--an immune system mediator protein--in a cascade of endocrine hormones and cytokines that are released when the brain signals a person is threatened with harm, injury, undue mental or physical stress or death. The hormones prepare the body to react quickly by increasing heart rate, making muscles more reactive, stimulating thought, altering sugar metabolism and producing many more changes that result in the "rush" people experience when they think they may be harmed.
The cytokine release is mediated by IL-6, which takes the role of directing the immune system to gear up to prevent infection, promote wound healing and repair organs and muscles from any injury that may result from the imminent danger. The release of cytokines such as IL-1, IL-6, IL-8, TNF and other proteins such as CRP (C reactive protein) also promote development of inflammation, which is essential for blood cells to home in on injury or infection. In addition, these chemicals promote development of various types of immune system blood cells in bone marrow. This response to harm -- either real or perceived -- is an important and beneficial life-saving activity of a normally functioning body.
The problem is if this response is initiated over and over again, frequently, and over a long period; it can have a dangerous effect on the body. This constant initiation of the stress response is common among caregivers -- especially those caring for loved ones with dementia. Providing supervision or physical assistance many hours a week and over a period of years turns out to be extremely stressful. This type of stress is often unrelenting, occurring day after day and week after week. And the long-term effects of this stress are more pronounced in middle-aged and older people who are precisely the group most likely offering long term care to loved ones.

In most younger people, when the threat lessens or disappears, the body reacts fairly quickly to shut down the stress response and return things to normal. But numerous studies have shown, as people age, the chemical cascade from stress lingers. Over a period of time, this constant chemical stimulus impairs the immune system and results in early aging, development of debilitating disease and early death. In this altered state, the body maintains high, potentially harmful levels of IL-6. The body does not return to normal without intervention.
Prolonged high levels of IL-6 and the accompanying hormones and cytokines have been linked to: cardiovascular disease, type II diabetes, frequent viral infections, intestinal, stomach and colon disorders, osteoporosis, periodontal disease, various cancers and auto immune disorders such as lupus, rheumatoid arthritis and multiple sclerosis. Alzheimer's, dementia, nerve damage and mental problems are also linked to high IL-6. Wounds heal slower, vaccinations are less likely to take and recovery from infectious disease is impaired. People who have depression also have high levels of IL-6. Depression in caregivers is about 8 times higher than the non-cargiving population.
This debilitating response to chronic stress is not unique to humans. Animals are affected as well. A 2004 PBS Scientific American Frontiers Special entitled "Worried Sick", explored the effect of chronic stress on animals. Observations in the field and experiments on animals exposed to chronic stress, uncovered the same phenomenon of debilitating disease and early death found in humans. Blood tests on the affected animals confirmed high levels of IL-6. The work of Dr. Janice Kiecolt-Glaser's team was also followed in the Special.

STRATEGIES TO REDUCE CAREGIVER STRESS
Ask for help.
Most caregivers are reluctantly thrust into their role without preparation because the need for care usually comes with little warning. Caregivers end up operating in a "crisis" mode--arranging medical care and living arrangements, scheduling care time, providing meals and household chores and so forth. Because they are so stressed and burdened, they rarely take time to find out what resources are available to help them. Ironically, caregivers often sever ties with family, friends and support groups about this time just when help from these people is most needed.
As a caregiver you must ask for help. The stress of going it alone is dangerous to your health. If it's difficult to ask for yourself, use an advocate--a sibling, friend or professional care manager --to arrange a meeting and get formal, written commitments from those people who are willing to help you. The extra help will give you breathing room to find all those resources that are there to help you.
Seek care management advice.
A number of organizations and private companies will give you advice and guidance -- many for free. If your care recipient has a very low income, you might get free help from your local Area Agency on Aging. A lot depends on available funds. Go to http://www.longtermcarelink.net/eldercare/ref_state_aging_services.htm for statewide lists of agencies.
A good source of free professional advice is the rapidly growing business of non-medical home care companies. Most will offer free consultations and these companies will also provide paid aides to help you with your loved-one…such things as bathing, dressing, shopping, household chores, transportation, companionship and much more. These people may also help you coordinate adult daycare or other community services. Go to http://www.longtermcarelink.net/a7homecare.htm for a nationwide list.

You may wish to pay for a formal assessment and care plan from a professional geriatric care manager. Go to http://www.longtermcarelink.net/a2bfindmanager.htm for a nationwide list of these valuable care specialists. Even though it may cost you a little money to hire a care manager, this could be the best money you will ever spend. Care managers are valuable in helping find supporting resources, providing respite, saving money from care providers, finding money to pay for care, making arrangements with family or government providers and providing advice on issues that you may be struggling with.
Take time off--find temporary substitutes.
Taking a break from caregiving is just as important as taking a break at work or taking that long-awaited vacation. A care manager may be of help in selecting the best temporary help to give you a break. Or you may make arrangements with family or friends to give you a break from caregiving.
Make plans for funding future care arrangements for you or for a healthy parent.
The analysis of data from three national surveys (Mature Market Institute, National Alliance for Caregiving and LifePlans, Inc) points out that employees caring for disabled elders who have long term care insurance (LTCI) are nearly two times more likely to be able to continue working than those caring for non-insured relatives. In addition, working caregivers of those with long term care insurance said that they were less likely to experience some type of stress, such as having to give constant attention to the care recipient or having to provide care while not feeling well themselves. Also, the group with insurance devoted more "quality time"--more companionship and less hands-on assistance--than the group without.
See if your healthy parent can still buy insurance. If he or she can't afford it, see if other family members might contribute to premiums. There are also useful strategies using a reverse mortgage to buy long-term care insurance and life insurance for your loved ones. You should also consider insurance for yourself so when you need care someday, it won't be so stressful on your caregivers. To learn all about long term care insurance and reverse mortgages go to www.longtermcarelink.net.
Use assistive technology.
There are a number of technologies to make sure your loved-ones are safe while you're away. Such things as emergency alert bracelets and pendants, GPS tracking for wandering, remote video surveillance, telehomecare, sensory augmentation and all sorts of assistive devices to help disabled people cope on their own. Go to www.longtermcarelink.net for more information.
FINDING RESOURCES FOR CAREGIVERS
The free resources of www.longtermcarelink.net are designed to provide you with government provider lists, free care assessments, information and care provider lists for reducing your eldercare burden and the attending stress. The site is a non-commercial source of help. It is the largest and most comprehensive free source of long term care information on the Internet. There are no ads or solicitations or pop-ups. A related site for the veterans aid and attendance benefit is found at www.veteransaidbenefit.org. This is a benefit that could be available to up to one third of all US residents over the age of 65 under certain conditions. It could provide an additional monthly income of up to $1,843 a month for qualifying veterans households.
Stay tuned for additional options that are available to managing caregiver stress!

Happy Holidays?

2010-05-13T12:00:00.001-04:00

By Anne Pagnoni

Home Care Assistance is a full service home care agency offering hourly services but with a specialty in live-in caregivers. Our caregivers are specifically trained in our exclusive Balanced Care Method^TM . Focusing on lifestyle and dietary choices, the Balanced Care Method^TMpromotes healthy activity, stress reduction, and social interaction to help seniors live their best possible lives – in the comfort of home. But, what exactly does this mean for your mother?

When it comes to physical hygiene, our caregivers are able to provide assistance with bathing, dressing, and grooming. A little help here can go a long way in improving your mom's willingness to interact with others and her own self-image.
From planning the menu to preparing the meal, the caregiver will ensure that your mother is eating three, well balanced meals per day. If your mother has food preferences or enjoys cooking, then she and her caregiver will enjoy doing this together.
Exercise. Not a word that most of us like to think about, but it's a necessity nonetheless. Your mom isn't going to be training for a marathon by any stretch, but the caregiver will work to improve her physical stamina. From simply doing stretches and chair exercises to walking to the mailbox or around the block, she won't be sitting in her favorite chair all day long anymore!
You know the old saying, use it or lose it. It applies to short term memory, too! While our caregivers can't reverse memory loss associated with dementia and Alzheimer's Disease, they can provide social interaction, which has been shown to improve cognitive function. A game of cards, anyone?

When it comes to caring for your aging loved one, accept help from the professionals. While this is new to you, it isn't new to us. For more information about Home Care Assistance, please visit our website at www.homecareassistance.com. To be directed to your local Home Care Assistance office, please call 1-866-4-LIVEIN.

Difficulties Facing Stressed & Overwhelmed Family Caregivers

2010-05-02T20:40:00.003-04:00

by Anne Pagnoni

Many family caregivers find themselves unprepared for the physical and emotional demands of caring for a loved one and quickly become stressed and overloaded. When this occurs many caregivers find themselves unable to provide the level of care necessary to nurture their loved one at home.

Situation One: The care receiver lives with the care provider

If the caregiver is working outside of the home or has a very active social calendar, then the care receiver often finds him or herself at home alone for the greater part of the day. As a result the care receiver quite often becomes imprisoned by the home environment due to functional limitation. Receiving little or no social stimulus, the care recipient spends day after day sleeping and watching television. Physical exercise consists of moving to or from the bathroom. The care receiver typically will not prepare a meal. Many times drinking and eating are deliberately avoided to lessen trips to the bathroom. When the care receiver lacks adequate food and fluid intake the result is malnutrition and dehydration both of which result in poor mental reasoning and stupor; hence, the cycle of sleeping and television watching continues.

Solution: A home health aide is a great option if you wish to have your loved one remain in your home while being properly care for during your daily absences. In addition to a home health aide, consider having your loved one attend an adult day care center either daily or several times per week. An assisted living community is another viable option if you feel that your home is no longer an appropriate setting for your loved one.

Situation Two: The care receiver lives alone

Care recipients who live alone can be guilty of self-neglect. Self-neglect is when the care recipient is not interested or is incapable of taking care of his or her own needs. Examples of self-neglect include not eating or drinking enough; not tending to personal hygiene including bathing and grooming; allowing garbage to accumulate within the home; having unattended pets, which urinate and defecate in living spaces; and refusing assistance. When a caregiver is providing care to a care recipient who lives alone, it is imperative that the caregiver work to provide a stimulating environment for the care receiver. Self-neglect with or without a caregiver is a form of elder abuse and in some states it is required by law that its existence be reported. A caregiver allowing self-neglect to happen could be criminally charged.

Solution: A home health aide can assist your loved one with meal preparation, bathing, dressing, grooming, and housekeeping. Many live-in caregivers will tend to family pets. For social interaction have your loved one attend an adult day care center or senior center. Seek out the services of a Geriatric Care Manager for guidance on how to make your loved one safe at home.

Situation Three: Failure to bring in outside help

The biggest mistake made by caregivers is not asking for help. The reasons for this vary. Sometimes the caregiver is a child, who is a long distance caregiver, and doesn't fully appreciate the severity of the situation. Other times money can be the big motivator. Stressed and overwhelmed caregivers become so involved with their loved one that they isolate themselves from others. This isolation makes them reluctant to contact those who can help. Regardless of the cause, failure to ask for help or to hire help can have dire consequences on the welfare of the care recipient and the caregiver.

Solution: Ask for help!! Talk to a local home care agency about available options. While you may think that home care services aren't affordable, you may find yourself pleasantly surprised. Contact your local area agency on aging. If you are a long distance caregiver, then enlist the services of a Geriatric Care Manager so that there is someone locally managing your loved one's care.

If you are the primary caregiver for another individual, then please do not allow yourself and your loved one to fall into one of the situations described above. Ask for help. Be involved. Know your options.

Please direct comments or questions on this post to apagnoni@homecareassistance.com. For more information on Home Care Assistance, please visit us at http://www.homecareassistance.com/ or call 1-866-4-LIVEIN.

Travel Tips for Seniors on the Go!

2010-04-04T15:35:00.000-04:00

by Dr. Kathy Johnson, PhD, CMC

Going on a trip? Are you traveling by plane, train or bus and you want to pack light? Here are some great travel suggestions for Seniors Citizens who plan to travel for a one week stay to almost anywhere for two:

» If you have to take shampoos, lotions, tooth paste, mouth wash, etc. either buy the small traveler sizes or, if small bottles are available, transfer liquids to these.
» Pack only cotton underwear (3) and cotton socks (men 3 pr.- women one pr. panty-hose, one pr. knee-highs one pr. cotton socks), and roll these to save space (they can be placed into shoes). Note: you can wash these items while there.
» Pack items of clothing to ‘layer’, i.e. one light-weight cotton knit cardigan to wear over two or three different cotton knit shirts or blouses (NO bulky sweaters).
» No more than TWO pairs of shoes (one pr. comfortable walking and one pr. dress), the comfortable clothes will probably be worn in travel.
» Two pairs slacks (you'll be wearing the third pair) or skirts (if preferred). Choose items that can mix/match with everything packed.
» Pack medicines, book/magazine, snack, flat slippers (in case the feet swell) and only other necessary items in the carry-on tote. If there is a necessity for dress clothes, pack these in the fold-up hanging bag; shoes can fit in these, also, along with odd/end items.
» Don’t carry on board anything but the tote and a jacket/coat (when necessary-but don’t pack them); leave the ‘handling’ to others. If going to visit friends/family, and want to take gifts, box them and mail ahead of time; let the postal dept. help! Pack your needs, but pack them wisely! Happy traveling!

Airport Security Measures
Before you go on that senior travel tour make sure to check security measures and what you can and cannot take on board with you. Go to www.tsa.gov and click on “travel and consumers.” You will find a list of prohibited and permitted items for checked and carry-on luggage.

Invest in Portable Luggage
How many of us are still dragging around those heavy pieces of luggage? Well, it’s time for some new pieces! You know the kind that has the expandable tote-handle and wheels! Ah, what relief for our backs! I found these sizes to be so handy: 21″/22″ Carry-on (but don’t carry on :o) 27″ Upright, then add the 15″ Tote (to carry with you containing your medications and other absolute senior travel necessities), and the hang-up/zip-close ’suitor’ that has great extra compartments. These latter two MUST have handles, so you can lap these over either the Upright or Carry-on extended handles, and shuffle along your way! Don’t throw out the old luggage, however; use to store old keepsakes, clothing, books, whatever, and place in the attic to one day give to your grandchildren!

Traveling Off Season, The Senior Way!
Remember when we were younger and took the kids on vacation? And how crowded places of interest were? We had to make reservations far in advance to get a motel room. I’ve enjoyed a much slower pace of senior citizen travel and find it not hard to get reservation when traveling in the ‘off-season’; that is, when kids are back in school! We’ll also be giving families a break by not competing with their ‘time’. So try to plan your trips around this time of year (school summer vacations); you’ll find your trips more relaxing and easier to make plans.

How to Improve Senior Sleep Patterns

2010-03-13T21:49:00.000-05:00

How to improve senior sleep patterns.
-Dr. Kathy Johnson, PhD CMC

Naps and medication are two of the most frequently cited ways seniors and their caregivers try to solve their sleep problems. Either (or both) may be appropriate, but each carries its own ability to disrupt sleep further. Each must be used carefully and purposefully, and in conjunction with healthy sleep habits (a.k.a. “sleep hygiene”) as outlined below.

Naps can be either the cause or the cure, depending on how and when they happen. For seniors who struggle to stay alert all day, a short nap may be the bridge they need to get them from a convenient waking time to a reasonable bedtime. Good, healthy, restorative naps are short – just 15 to 30 minutes – since longer naps can lead to drowiness and an inability to fall asleep at bedtime, relatively early in the afternoon so they don’t conflict with bedtime, and physically comfortable in a quiet and dimly lit place.

Many seniors turn to the ever-growing numbers of sleep aids – both prescription and over-the-counter – that are available. One of the potential problems with this route is that sleep aids can interact negatively with a range of medications the senior may already be taking and/or they can cause drowsiness that itself leads to accidents and falls. Worse, many sleep aids can cause confusion and disorientation even in younger, healthier people. For seniors with any level of dementia, this potential side effect must be closely monitored and avoided since it can lead to night fears, heightened anxiety, and even worse: sleep problems.

For seniors having trouble getting to sleep and staying asleep long enough to feel rested and refreshed in the morning, these “sleep hygiene” tips and habits are the first steps to take:

Gradually eliminate caffeine from your diet, or at least limit caffeine intake to one caffeinated beverage in the morning. Avoid all caffeine after lunch.

1.Eat a big meal at lunchtime, and have a lighter dinner.
2.Avoid alcohol, or at least limit alcohol consumption to one drink, preferably with a meal and not right before bedtime.
3.Do some sort of physical activity every day, preferably outside where you can get direct daylight. Exercise early in the day since physical exertion too close to bedtime can be stimulating.
4.Establish and maintain a set bedtime and waking time. If you choose to take a nap (see guidelines above), do so at a regular, set time.
5.Establish a pre-bedtime calming routine. This may include a warm bath, reading, or listening to restful music.
6.Avoid television right before bed.
7.Write down or simply state aloud any fears, worries, or concerns that are on your mind as part of your bedtime routine – giving voice to such concerns can help reduce their ability to negatively impact sleep.
8.Use your bed (and preferably the whole bedroom) only for sleeping, do not read or watch television in bed.

If you don’t fall asleep after 15 – 20 minutes, get out of bed and do something quiet and calm, read or listen to restful music or a book on tape. Serious or long-term sleep disorders should always, of course, be brought to the attention of a health care provider.

The Need for Outside Help in Family Caregiving

2010-02-28T19:51:00.000-05:00

by Anne Pagnoni

Being a family caregiver for a loved one makes for a very stressful situation especially in the long-term. After a prolonged period of time, caregiving can become too difficult to endure any longer, and the caregiver reaches a crisis point. At this point outside help is typically needed.

When someone initially takes on the role of caregiver, he or she is confident and has everything under control. The caregiver is coping well with the situation. However, as time continues and the care recipient begins needing more help, the caregiver may begin to isolate from family and friends. The caregiver starts to feel alone and helpless. If the caregiver doesn’t look for outside help at this point, then the caregiver may begin to find his or her physical health deteriorating. Once the physical health of the caregiver is compromised, the caregiver loses focus and extreme fatigue will cloud judgment resulting in the caregiver being unable to make rational decisions or ask for help. Without intervention, the caregiver may find him or herself requiring care.

When assuming the responsibility of a family caregiver, it is important to enlist the help of outside professionals. A financial planner or reverse mortgage specialist may find funds to pay for professional in-home care services. An elder law attorney can help stave off future legal issues. A geriatric care manager can be a guide through the maze of long-term care issues. A home care agency can provide care services to allow the primary caregiver to take a much-needed break. Having a strong support system in place at the beginning will often make the difference between allowing a loved one to remain at home and needing to relocate to a nursing facility.

Family caregivers need the support of family, friends, and professionals. Doing it alone almost never works. If you find yourself in the position of being a family caregiver for a loved one, take the necessary steps at the beginning to get a support system in place. In the long run you’ll be happy that you did!

The Benefits of Elderly Home Care

2010-02-22T18:02:00.000-05:00

The Benefits of Elderly Home Care
by Suzan Love

As your parents and grandparents grow older, you may become concerned about their safety at home. Placing them in an assisted living facility is often considered as an option. However, homecare is an alternative that has many benefits.

1. Seniors who live at home are able to maintain a level of freedom that would not be possible at an assisted living residence. For many, this freedom is synonymous with maintaining dignity, which is something many individuals fear loosing as they age. Similarly, those who receive homecare can come and go as they please-for whatever reason. They can also choose their own meal times.
2. Elderly individuals do not have to part with any of their beloved possessions if they continue to live at home. Having the things they love physically close at hand can help keep stress levels to a minimum, as those possessions are tied to invaluable memories. Seniors can also keep their pets when living at home, and caring for an animal has been scientifically proven to have positive health benefits.

3. Those who live at home can have visitors whenever they please and are not restricted by visiting hours. This can lead to more fulfilling relationships with friends and family, as they are able to visit more frequently.

4. Living at home has physical health benefits, as it is easier to avoid those who are sick. When living in a place with many people, such as an assisted living facility, one person’s illness spreads like wildfire. At home it is also possible to request that sick people visit only after they are fully recovered.

5. Home care allows the elderly to avoid the emotional stress of moving to a new place with new people and a new routine. Maintaining continuity leads to psychological wellbeing.

6. Assisted living facilities can be very expensive and, in some cases, far away from other family members’ homes, especially in less populated areas. In many cases, seniors have already completely paid off their off mortgage, which can substantially reduce the costs of caregiving at home. The stressors related to the actual moving process are also eliminated.

7. As a final point, those who live at home are often happier than they would be living at a retirement home. The familiarity and comforts of home are irreplaceable.

There are now many products and services that make living at home both feasible and affordable. Enhanced security systems, emergency panic buttons, and home delivered meals are just a few of the options to choose from. If your elderly family member wants to live at home, honoring that wish is now easier than ever before.

Elderly Home Care Service Can Help Your Loved One Maintain Independence

2010-02-15T16:31:00.000-05:00

Elderly Home Care Service Can Help Your Loved One Maintain Independence
by: Thao Nguyan

Elderly home care services are growing at an accelerated rate, and this particular industry is only poised to continue to grow as the population of the United States ages. The number of people of retirement age and older is expected to double by the year 2030, and by the middle of this century, there will be more elderly people in this country than any other age group.

While a few people are lucky and stay healthy enough to be able to take care of themselves without help for their entire lives, others are not so fortunate. With advances in preventive medicine and anti-aging technologies, the number of elderly who live alone will rise, but there will always be a need for help for those who have difficulties maintaining their independence. Family members are not always able to attend to every need of the aging parent or grandparent, especially if that person needs frequent assistance. No one wants to go the nursing home route if other alternatives are available, and that is the reason why elderly home care companies provide such an essential service.

The elderly home care agency you choose can usually help with a variety of personal care services and chores around the house. Depending on the needs and wants of your elderly relative, you can find elderly home care services that can send people out to check on him or her once a day, once a week, round the clock or however often is required. These elderly care assistants can do minor household chores, help with bathing and dressing, and administer medications. Having such a service available and on call can make the difference between your relative remaining in his or her own home and having to go into an assisted living or nursing facility.

If you decide to use elderly home care services, help your loved one interview and select the paid caregiver. Have the agency send someone over to spend some time with your relative, so they can see if the match is a good one. Not every match is right and you might have to through many different elderly care assistants before finding the right person. The whole experience of using an elderly home care service will be much more successful for everyone if you determine the needs and wants of your loved one and involve him or her in the process of finding the most suitable elderly care assistant.

Article Source: http://EzineArticles.com/?expert=Thao_Nguyen

Keep an Eye on the Family Caregiver - Part III

2010-01-24T19:19:00.000-05:00

Keep an Eye on the Family Caregiver – Part III
Posted on Jan. 14th, 2010
by Joy Loverde

In Part I & II of Keep an Eye on the Family Caregiver, we discussed that there are no blueprints in caregiving and we each must find our way. We also looked at the importance of keeping a realistic view of our demands to make sure we don’t sabotage the caregiving process. Let’s continue taking a look at caregiving and make sure we are taking care of ourselves to better help others.

Are you a walking time bomb?

Is your life already filled to capacity? Are you currently handling major, time-consuming obligations between parenting, your own career, and other commitments? How much time can you afford to devote to your elders? Eldercare requires patience, and tolerance for this kind of work may not be part of your emotional makeup. For example, if you’ve never assisted an older adult with bathing and dressing for the day, you may not realize that this seemingly simple activity could eat up the better part of the morning. What might be your reaction to an elder who asks you the same question over and over again in a matter of minutes?

Are you thick-skinned?

Disappointment, loneliness and frustration come with the job of caregiving. Your circle of friends may start to shrink; siblings and relatives will find excuses to keep their distance from you and your elders. Are you good at deflecting criticism? Can you bounce back after a hard day’s work? Can you forgive others for their shortcomings? Are you willing to get help if you suspect that you are becoming increasingly depressed?

Are you an effective money manager?

Eldercare is a bottomless pit of ongoing expenses. Beyond health care, there are other eldercare-related costs that will quickly drain the money supply: senior housing, special diets, medications, transportation, and more. Are you proactive rather than reactive when it comes to managing money? Will you seek financial advice? Will you stick to a budget in order to avoid a family financial crisis? Are you willing to talk to other family members about paying for long-term care?

Is it possible that you will have to quit your job to perform eldercare duties?

Most people cannot afford to give up their own primary means of support. Are you willing to research your company’s work-life eldercare programs? Will you be risking your job security by being candid with your boss about your eldercare situation? If your employer offers work-life benefits are you making good use of them now?

Once you know where the caregiving roller coaster is going, are you still in for the ride? Millions of us are facing this question. We all have limitations — getting help is the smart thing to do. Sometimes love is best served when we do not place ourselves in a position of resentment

Keep an Eye on the Family Caregiver - Part II

2010-01-17T17:52:00.000-05:00

Keep an Eye on the Family Caregiver – Part II
by Joy Loverde

There are no blueprints in caregiving. Each of us will carve our own path. The following self-assessment questionnaire is meant to help guide you to better choices. If anything else, the answers to these questions and the questions in Keep an Eye on the Family Caregiver – Part III will reveal when it’s time for you to supplement your care plans.

Do you get along with your elders, and have a fair amount of influence over them?

Perhaps at times your sister gets along with Mom better than you do. People outside the family circle or an “authority figure” may be more influential and able to accomplish what you cannot – it might be a doctor, a member of the clergy, a geriatric case manager or an attorney who may be able to step in on your behalf.

Do you live far away?

Be realistic about your ability to handle all of the eldercare details from a distance. Are there some things you simply cannot accomplish from far away? Is it realistic right now for you to pick up and move or ask your elder to do the same? Can you share duties with someone who lives closer?

Are you willing to ask for and accept help?

There is no getting around this one. If you have trouble delegating tasks or accepting help from others, then it’s simply a matter of time before the quality of your own life will begin to crumble.

Do you have strong problem-solving abilities?

Day-to-day eldercare problems are complex, multi-dimensional and sure to challenge the brightest of minds. If your confidence in researching options and making difficult decisions is low, you are better off surrounding yourself with professional advisors and, in some cases, letting geriatric case managers assess the situation and supplement the care and decision-making process.

Are you good at learning new things and taking advice?

Everybody — from health care professionals to the neighbor down the street — will have a strong opinion on how your elder should be cared for. While some of their suggestions may be off target, others may be worth considering. How flexible and open-minded are you? Are you will to make changes in mid-stream?

2010-01-10T20:10:00.000-05:00

Keep an Eye on the Family Caregiver – Part I

by Joy Loverde

If I had to create a “Help Wanted” ad as a way to hire a family caregiver, this is how the advertisement would read:

HELP WANTED
Person available and on-call seven days a week, twenty-four hours a day with no days off and little or no financial compensation. Qualifications:

Can speak medical, insurance, and legalese
Financial planning and bookkeeping
Juggle multiple scheduling systems
Car with valid driver’s license
Heavy lifting
Expertise in home maintenance and repairs
Dietician, meal planning, and chef
Medication management
Limitless patience
Ability to change plans in mid-stream
Social worker and spiritual director
Willingness to sacrifice personal time and put career plans on hold
Can withstand criticism and ongoing feelings of isolation
Loves surprises

Seasoned family caregivers know all too well about the stresses of eldercare even under the best of circumstances, and family caregiving is not necessarily a short-term commitment. Responsibilities very often last for decades.

If you are not acknowledging how family caregiving may be affecting he quality of your own life, and you do not recognize yourself in the “Help Wanted” ad above, then I beg you to ask people you trust if they think you are taking on way too much by yourself.

Too often, family caregivers have rigid beliefs on who does the care and how it should be implemented. Making hasty statements like, “My mother will never go to a nursing home!” and taking pride in not asking others to pitch in will surely get the best of you.

Unrealistic goals and unhealthy attitudes can sabotage the caregiving process. When we come face-to-face with our own limitations and can’t provide the kind of care we wish we could, we feel it’s our own fault. The truth is we may not be the most qualified person to take on all of the caregiving responsibilities all of the time. Limitations of relationships, time, stamina, and skill dictate how much help we can realistically offer.

Keep an Eye on the Family Caregiver – Part II and Part III will offer a self-assessment questionnaire.

Leisure Activities Help the Brain Stay Sharp | HealthandAge – Medical Articles and News for Health in Aging > Live Well, Live Longer

2010-01-03T20:56:00.001-05:00

Leisure Activities Help the Brain Stay Sharp | HealthandAge – Medical Articles and News for Health in Aging > Live Well, Live Longer

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How to Hire a Home Health Aide & Keep Future Medicaid Eligibility

2009-12-22T21:29:00.001-05:00

Spotlight on Elder Law: How to Hire a Home Health Aide and Keep Future Medicaid Eligibility

As long term care needs increase, hiring home health aides often becomes necessary. Paying an aide, however, if not done correctly, can cause Medicaid ineligibility years later, after funds run out.

Qualifying for Medicaid requires spending down assets below $2000. Transferring assets may cause Medicaid ineligibility if you do not receive something of equal value back. Medicaid calls this a "penalty". However, and this is key, you must prove to Medicaid that assets transferred are not subject to a penalty. If you pay the aide cash (or check) but don't keep proper records Medicaid will assess a penalty. The aide may be reluctant to give you anything in writing, either because of immigration or income tax issues.

The penalty is calculated by dividing the transferred amount by the average cost of nursing home care. When one applies for Medicaid there is now a 5 year lookback period, meaning Medicaid will look back 5 years from the date of the application to find transfers. They will add together all the transfers made during that time. The penalty will begin when all other assets have been spent down and the individual enters a nursing home and applies for Medicaid.

Let's say Jane hires a home health aide at $700 per week cash, or $3000 per month. She keeps the aide 3 years until her funds run out and now needs round the clock care. A nursing home becomes the only option. She applies for Medicaid but is told, "Sorry, you're not eligible for 16.2 months. You'll have to private pay until then." Of course, Jane has no more money. She'll have to come up with the funds some other way, perhaps from family members. But at $8500 per month or more that may not be possible.

How did Jane get into this mess? Because Medicaid treated her payments to the aide ($108,000) as transfers subject to a penalty. How can you avoid Jane's problem? By keeping records to prove the payments were not gifts, which probably means paying withholding taxes and workers compensation insurance. Another, perhaps better, solution is to hire a home health agency that will supply the aide. Your contract with the agency will satisfy Medicaid that no gift is involved.
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Tune in to Yale Hauptman's monthly audio podcast on elder law issues at www.elderlawtodaypodcast.com.If you're not yet on our mailing list go to http://hauptmanlaw.com/requestinfo.asp to sign up.

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Spotlight on Elder Law is distributed for informational purposes only and does not constitute legal advice. For more information or to receive future mailings contact Yale S. Hauptman at Hauptman & Hauptman, P.C.

Time is Not On Your Caregiving Side

2009-12-16T22:05:00.000-05:00

Time is not on your caregiving side

by Joy Loverde

If you don’t make good use of your time when you are gathered together as family during this holiday season, you will never ever get that kind of quality time to make plans for the future with your aging parents. In the eldercare world, change happens quickly. If you choose to say and do nothing this time of year, you lose. There is a reason why my book, The Complete Eldercare Planner is over 350 pages long. THERE’S A LOT OF STUFF TO PLAN FOR AND TALK ABOUT right now.

The possibility that your parents may need the family’s help down the road is real. And while it may be difficult to think about the day you hope will never come, doing nothing to plan for family caregiving responsibilities will leave the entire family in even worse shape — emotionally, financially and otherwise.

As a rule, family holiday gatherings are not the ideal time to discuss parent-care issues or to resolve them. Besides, who wants to spoil the festive atmosphere by talking about a potential hotbed of depressing emotional issues such as eldercare?

Instead of trying to talk to your parents about their future well being during family holiday visits, try these three tips instead:

1. Before the holiday family visit – pick up the phone and call your siblings. Tell them of any present and future concerns you may have about your parents. Let them know how you feel about the importance of planning ahead should anything happen to Mom or Dad. Make a specific request that when everybody is together in person that they join you in looking and listening for clues that your parents may need help sooner rather than later.

2. During holiday family visits – the most efficient use of physically being together is watching for tell-tale signs that problems may exist. Are your parents walking slower or having difficulty climbing stairs? Are you sensing they are becoming more forgetful? Do you suspect they are having trouble making ends meet financially?

3. After the holidays – Arrange a family meeting – over the phone or in-person, and discuss your observations with your siblings; then make a date to talk with your parents about your concerns.

Elderly and depression: How to understand Depression in the elderly 1/4 | HealthandAge – Medical Articles and News for Health in Aging > Live Well, Live Longer

2009-12-10T22:15:00.001-05:00

Elderly and depression: How to understand Depression in the elderly 1/4 | HealthandAge – Medical Articles and News for Health in Aging > Live Well, Live Longer

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Holidays with Alzheimer's Disease

2009-12-07T18:04:00.000-05:00

Holidays with Alzheimer’s Disease
Posted on Dec. 6th, 2009

By Jo Nelson

Holiday time is coming up, and for caregivers of loved ones with Alzheimer’s disease, it can be a very challenging time of the year. Here are some suggestions to help you and your loved one to have a safe and happy season together in spite of the obstacles.

In the midst of putting up decorations, rearranging furniture and putting up Christmas trees, the person with Alzheimer’s will do better in an environment that is as consistent as possible. Try not to move the furniture more than absolutely necessary, and watch for danger spots, like electrical cords or throw rugs that could cause a fall. Don’t have candles burning in places that could easily be brushed up against with clothing. Avoid using blinking lights or decorations that look edible. Use your loved one’s best-loved decorations to spark memories and increase their ability to enjoy the festivities. Play familiar Christmas songs, and fix traditional foods that they will enjoy.

Have young children play in a separate room to keep noise levels down and avoid causing your loved one to feel panicked or agitated. Alzheimer’s patients pick up on the moods of others around them, and the atmosphere needs to feel serene and peaceful for them to enjoy visitors. Have just a few guests at one time, and avoid large crowds of people. Name tags are very helpful and will keep your loved one from feeling frustrated and embarrassed when they can’t remember people they should know. Have a quiet room that the Alzheimer patient is accustomed to in case they feel overwhelmed by too much noisy activity. If you notice signs of increased confusion or agitation, assist them to their quiet place to rest for a while.

Christmas stories from years gone by will help draw your loved one in and keep them involved in the celebration. It’s much easier for people with Alzheimer’s Disease to remember things that happened long ago than something that happened yesterday, so reminisce! Try simple tasks to occupy the time, like frosting cookies, stamping envelopes for cards, or making simple ornaments. Look at catalogs together and help your special one to order gifts for people they care about. Take time to look at photo albums and talk about happy holiday times together. This could be just what they need to reconnect and appreciate the holidays, creating more memories that you will hold dear for years to come.

Jo Nelson, RN is the owner of Servant’s Heart Homemaker Services, a personal care assistance company located in North Central Indiana.

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