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Senior Living

Shanna ParrishTaylor

2012-04-20 11:11:38

Q: My stepfather, who handled all of his and my mother’s affairs, recently passed away. She has no idea of her financial picture or anything else. Can you give me some steps to help get this on track?

A: Absolutely. Your mom is in a situation that is very common. In many households, one person handles all of the financial affairs. Here is a checklist that will help you get things in a better place. 1. Find debt and assets Make a master list of significant assets like bank and brokerage accounts, retirement plans, insurance policies, real estate, items in safe deposit boxes and debts like credit card accounts and loans. 2. Collect insurance If your mom is the beneficiary of a life insurance policy, file a claim for benefits. Do this as soon as possible as the process may take time and you will want to make sure that she has enough cash on hand to handle immediate needs. 3. Apply for benefits Also at the top of the to-do list is helping your parent apply for Social Security benefits. Contact the Social Security Administration for information about survivor’s benefits. Investigate other benefits to which she may be entitled, including pension, veterans, or employment-related payouts. 4. Change title to jointly owned assets If your parents owned property together, she should change the title document to show that he or she now owns the property alone. This will make it easier to manage the property and for you to wrap up your surviving parent’s affairs when the time comes. Check title documents for real estate, vehicles, bank accounts, and other significant assets to see whether you need to update ownership records. 5. Update will and trusts If your mom has a will or living trust, she should review it and change it, if necessary, to reflect her current life circumstances and wishes. 6. Take steps to avoid probate court Evaluate whether any part of the estate will be subject to probate when she dies. Simple probate avoidance methods could save a bundle of time and money -- for example, your mom might name pay-on-death beneficiaries for a bank or brokerage accounts that were jointly owned. 7. Update insurance policies If your father is still named as a beneficiary on insurance policies, those policies will need to be modified, cashed out, or canceled, depending on your parent’s current needs and wishes. 8. Make a health care directive Now is the time to prepare a living will and a durable power of attorney for health care. These documents set out health care wishes and name a trusted person to oversee her care and make medical decisions, if that becomes necessary. 9. Make a financial power of attorney This document lets your parent name someone to handle financial matters if he or she ever becomes incapacitated and unable to take care of things alone. Without this, loved ones would most likely have to go to court to get the authority. 10. Organize Do what you can to help your mom set up a good filing system to keep track of all the information mentioned above and other related information.

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Senior Living

Kevin Knaup

2012-04-20 09:47:21

Q: My mother-in-law is saving money by getting her prescriptions filled online with various internet pharmacies both here and outside the United States. Last week she mentioned that one prescription used to be a particular color and now it is not. I am concerned that it is fake, while she believes it is just a dosage change. How can I help her be sure that the medications are correct and safe?

A: First, I highly recommend using extreme caution when buying medications online. Suggest that she not purchase medications from unlicensed online distributors or those who sell medications without a prescription. Reputable online pharmacies will have a seal of approval called the Verified Internet Pharmacy Practice Site (VIPPS), provided by the Association of Boards of Pharmacy in the United States. I would not buy medications from outside the US, as the regulations may not be as stringent or laws obeyed strictly concerning the manufacture of the drug. Additionally, if a drug was proven defective or harmful, you may not have the same legal recourse. Always be mindful of the appearance of each medication. Closely examine the packaging and lot numbers of prescription drugs and be alert to any changes from one prescription to the next. If you find it difficult to remember what each one should look like, take a digital picture and compare to the correct prescription with every refill. If you notice a change in how they look or if they cause any adverse or unexpected side effects, talk to your doctor or pharmacist immediately. Taking them may cause as much damage as not taking them, or even prove fatal. Remember, even reputable looking sites may be a scam. Look for product promotions and “special deals” on medications commonly used to treat conditions most suffered by seniors. This may be associated with counterfeit product promotion. If your mother-in-law is trusting and reluctant to believe that anyone would instigate medication fraud, you might print out the information on the topic provided at Federal Bureau of Investigation website, www.fbi.gov. The site is filled with useful information on how seniors can avoid medical fraud.

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Senior Living

Kevin Knaup

2012-03-27 10:14:33

Q: I am new to being in the caregiving role and I am finding that there are numerous things for which I am not prepared. The recent storms for example, made me realize that I do not have a clue about keeping my grandfather safe in an emergency. I am frustrated that I do not know even the basics and feel like I am behind the learning curve on this. Can you give me some tips please?

A: First, thank you for taking on the role as caregiver. The task is a monumental one and you will find that there is always more to learn. Go easy on yourself though. Even people that have been involved in providing care for some time still find that every day is a new adventure. Next, I appreciate you asking such an important and timely question. Including seniors in disaster plans is something that deserves much more attention. And it is not a topic for caregivers alone— a recent report issued by Hardford Financial Services Group, an insurance company that funds research on aging, notes that most older adults have not discussed disaster plans with their loved ones and do not have a disaster plan in place. While it is nearly impossible to plan for every eventuality, you can take steps to incorporate valuable precautions. Here is a list to get you started: • Start talking. Incorporate your loved one in the planning of a disaster plan. The conversation may lead to understanding their needs better and the most comprehensive plan possible. • Talk to their physician and find out what medications you can get for an emergency preparedness kit and what other things you ought to know if emergency services are not available. • Take first aid and CPR and arm yourself with knowledge that could prove useful to your loved one and neighbors. • Prepare a kit that includes everyday essentials that your loved one may need, remembering that the pressures of the circumstance may demand additional needs or extra supplies. For example, in an emergency your diet may change because of loss of power or reduced resources which could be very hard on the sensitive digestive system of an older adult so extra toiletries would be very beneficial. • Remember to pack back-up of important items such as glasses, hearing aids, hearing aid batteries, collapsible walking aids. • Include items that would bring comfort and entertain your loved one such as a bible, novels, crosswords, or crafts. • Talk to neighbors and include them in your plan. If you are at work part of the day, ask neighbors to assist in case of an emergency. Make sure they know where to find all of your supplies and have all contact numbers. • When creating an emergency food supply, consider special diets, hard candy for diabetic lows, and foods the loved one would normally be able to eat. Also, consider joining a caregiver support group where you will gain a wealth of information from people in the midst of providing care. I wish you the very best of luck.

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Senior Living

Shanna ParrishTaylor

2012-03-23 10:14:17

Q: My siblings and I are sharing the responsibility of caring for our mother. This was working well until she started to get very paranoid about things. Lately she has been making wild accusations and pitting us against each other. What can I do to help get this on track and all of us on the same page?

A: Paranoia, delusions, and hallucinations are all very common problems in dementia, and whether you are providing care at home or your loved one is in an assisted living or nursing facility, paranoia causes a lot of disturbance for caregivers and loved ones. The first step in dealing with paranoia is understanding what is really happening. Dementia can cause sufferers to develop strange ideas about what is actually happening and may come to believe that other people want to harm them, are plotting against them, or have stolen something from them. These symptoms are not caused by mental illness, as some mistakenly believe, but are a result of the brain’s miscommunication. Unfortunately, these delusions can wreck havoc in a family. Very often, the sufferer will become confused when family starts to handle more of their affairs and accuse caretakers of stealing money from their account or items from the home, or even accuse those around them of abusing them in some way. Dealing with these issues requires your efforts in several areas: •Do not take these things personally. It is not something the sufferer can control and is not a reflection on you. •Deal with the issues directly with your mother but do not try to correct her no matter how irrational the thoughts. If she thinks something has been stolen, assure her that you will find it. If she believes she has been abused, assure her that you will keep her safe. •Talk with your siblings and discuss a plan of handling the problems. Make sure that the lines of communication are always open and that all activities are documented and free for all to see. Finances tend to cause the most problems, so provide a detailed accounting to avoid any problems or hurt feelings later. •Talk to your mother’s physician about the problem and ask whether medications may help lessen the severity of the symptoms. •Give yourself a break. Enlist the help of a skilled caregiver or facility for daytime services, or when the care becomes too much, find a skilled nursing facility that can handle dementia care. •Find a support group. Dealing with caregiving is difficult at best and even more difficult when paranoia is a part of the equation. Dealing with paranoia is emotional and exhausting. Talking with your siblings directly, openly, and honestly can help you all move forward in a positive way.

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Senior Living

Kevin Knaup

2012-02-28 10:55:26

Q: We plan to check out several nursing facilities for my mom over the next several weeks. Since my mom is rather shy and tends not to seek out social events, she would lean toward a smaller quiet arrangement. However, I would like to steer her to options that tend to have more activities. Is it best to cater to her natural leanings, or try to keep her engaged?

A: The good news is that it is possible to satisfy both the need for solitude while incorporating the benefits of social activity by finding a facility that incorporates and respects the value of both aspects. My mother-in-law is a great example of socializing. She lives in a local housing center with other seniors her age and they have regular social events like weekly breakfasts and lunches along with bingo and other games. She is one of those who enjoys the socialization. Not everyone has a social bent, however, and some people actually find socializing to be very stressful. Others warm up to the idea with some encouragement. For those who prefer the quiet life, it is always good to find options that will respect the need for quiet spaces and provide plenty of opportunity to unwind. That said, studies show that there is a real value to regular social interaction, particularly for those 65 and older. In fact, a recent Gallup poll found that seniors report higher levels of lasting happiness and satisfaction following socializing than any other adult age group. Amazingly, the study showed that younger people receive far less enjoyment from social activities as do seniors 65 and older. The results also showed that seniors not only receive more pleasure from interaction, it takes far less of it to achieve happiness, and the effects last much longer. Research found that the feeling of emotional wellbeing rises sharply after age 60. This increases not a result of retirement as you might expect. Both those 60 and older working full time and those out of the workforce, reported similar levels of happiness. The study concluded that the perception of happiness was directly affected by the amount of social interaction. About 72 percent of participants aged 65 and older who reported engaging in social activity six hours a day described a high level of enjoyment and happiness. Only 44 percent of those 65 and older who reported zero hours of social time described the same emotional wellbeing. While it is great to respect your mom’s private time, choosing an environment that has an emphasis on facilitating fun might prove very valuable in giving her options in expanding her social horizons.

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Senior Living

Shanna ParrishTaylor

2012-02-28 09:56:12

Q: I have a family member who has Alzheimer’s as well as other health issues. The level of difficulty is increasing, partly due to the other health concerns, and resulted in several hospital stays over the last 18 months. Although I have always thought the home environment is best, I am beginning to wonder if this is true. What things should I factor in as we decide the best options?

A: One of the most important things to remember while you sort out your options is that you are not alone in making hard choices. Many things factor in to whether or not the home environment is still suitable, or when it is time to consider other options. One of the most significant things loved ones giving care to those with Alzheimer’s encounter is the difficulty in managing co-existing health concerns. With or without any form of dementia, we encounter more health issues as we age. However, dementia compounds the problems of even common medical problems in several ways. For example, many health issues such as heart disease, high blood pressure and diabetes, which are all very common in senior citizens, frequently require medicine and dietary restrictions in their management. These can be difficult to mange under the best of circumstances, but add in difficulty in remembering to take medicine, or forgetting to eat meals, and suddenly you have a serious medical emergency. Even something as simple as having trouble with hygiene can lead to serious urinary track infections and extended hospital stays. This is in fact, one of the factors that weighs most heavily for those in the place of deciding whether or not it is time to consider other care options. Depending upon the availability of family caregivers, getting an in-home aid to help might be an option in assuring your loved one’s wellbeing, until such time that because of the disease progression that becomes impossible. Another option in helping to avoid hospitalizations and assuring the health and safety of your loved one is an assisted living facility that specializes in the care of those with Alzheimer’s. Assisted living facilities offer the care and routines helpful in avoiding things that lead to frequent hospitalizations in dementia patients, such as memory stimulating activities, well-balanced meals at the same time every day, safety rails, and limited obstructions.

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Senior Living

Shanna ParrishTaylor

2012-01-26 16:41:48

Q: Can you tell me about hospice care? We have a family member that is quite ill, who has for some time lived in an assisted living facility. We are considering the options of moving him in with us, but he considers the assisted living home. We definitely need support, but are unsure of what options are available in hospice care, or what it is exactly.

A: Hospice care is end of life care. Patients receive comfort care, such as medications to ease pain, but (in most cases) do not receive aggressive therapies to combat diseases such as cancer. Hospice patients are expected to live six moths or less, although care continues, should the patient live longer and continue to decline? Getting to the point of needing hospice care for a loved one involves many emotions. It also involves many choices to make the remaining days comfortable and filled with love. One of those choices is where the patient will reside while receiving care. Hospice care can take place in the home, at a hospice center, or in a hospital or skilled nursing facility. Some facilities have different levels of care or have developed a special relationship with facilities providing the necessary care, such as in an assisted living and hospice facility relationship. In this situation, the needed support system is already in place or readily available. While many people are reluctant to consider hospice care at first, studies show that most wish they had considered adding that element of support sooner. Not only does hospice care provide support for the patient, they also provide support for the family in coping with end of life issues and in helping set goals to make the remaining days fulfilling. In your situation, those involved in providing care can help in meeting his needs and help you sort out your options in whether bringing him into your home is the best option, or if there are others to be considered. The most important things to remember is that you do not have to manage this alone, and with support, you can make these days rich and full.

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Senior Living

Kevin Knaup

2012-01-26 15:49:47

Q: I am really thankful for this kind of community forum as I have a question that I am a little embarrassed, and really kind of ashamed to take anywhere else. I am in the situation of caring for my elderly mother who is in declining health. The only thing is, everything about it frightens me. Everything from taking her to the doctors and having to deal with bad news to dressing her, terrifies me. I am not sure what I should do, or if this is how I should feel? Any advice would be appreciated.

A: First, understand that most people experience fear in dealing with care giving. I would be lying if I said that I do not feel fear when dealing with any new challenge to a loved one’s health and well-being, and so would anyone else if they said it. In many cases, it makes sense to feel fear. I would never advise people to ignore their fears or hide from them, rather understand that some fear is useful and unhealthy fear can be overcome with knowledge and support. Have you ever wondered what a pilot feels before taking a mass of metal safely into the air? I guarantee you that before they took the controls for the first time, they were plenty scared. The thing that helped them was the knowledge that they could deal with most anything that was thrown at them since they had hundreds of hours of practice before entering the cockpit of a plane loaded with passengers. Knowledge helps create sense of fearlessness—not a lack of fear, but a better understanding of the issues they may be facing when flying a plane. As a family caregiver, you unfortunately do not always have that luxury of advanced preparation; our battle generally starts with a phone call in the middle of the night or a diagnostic visit to the doctor’s office. What you do have is the fact that there are so many other family and professional caregivers who each possess one small piece of the puzzle you need as a family caregiver. All you need to do is put those pieces in place by getting help and getting informed. The best thing to do is dive in to your resources and become acutely aware of topics on aging and care giving. Join forums, support groups and research online. One of the best ways to overcome the fear is to become an advocate. Fearless care giving is informed care giving and it is a process, not a destination. Once you are on your way, you will recognize how to use fear as a motivator, as opposed to a roadblock, to help find the answers and solutions you need as you care for your loved one.

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Senior Living

Shanna ParrishTaylor

2011-12-27 13:39:30

Q: We are anticipating caring for my parents in the near future, I am not sure what to expect or how to prepare. Can you give me some ideas on what to consider?

A: While most people anticipate caring for aging parents sometime in their life, most are concerned about their ability to do so. Here are some important areas where you can start planning now: Start Talking The sooner you begin conversations about the future, the better for all involved. Creating an ongoing open dialog about the future will allow you to work thorough changes productively. If your senior parent ever becomes incapacitated, everyone will know his or her wishes. Financial Considerations 61% of caregivers are women and in most cases, those women have a regular job. Many people do not anticipate the hours care giving requires, and fail to factor in reduced work hours and benefits into their budget. Caregivers also spend an additional $2,500 on average in care costs per year. A safe course of action might be setting aside money now to help offset the changes. Medical Considerations Become familiar with your parent’s medical history. Have them fill out an emergency kit containing the name of their doctors, medications, insurance information, allergies, and how to access advanced health care directives. Insurance Issues The decisions your parent makes now about insurance can make a huge difference in care later. Consider the value of things like long-term-care insurance. Get to know the complexity of Medicare and what it will and will not cover. Make Your Home Ready If your parent will move in with you, start making changes to your home, or consider relocating to a home that will make care giving as comfortable as possible for the parent, and as accommodating as possible for you. Things to consider might be ground floor bedrooms, room for medical equipment, private spaces for yourself, and easy access to the garage or driveway. If you feel unprepared to care for your aging parents, you are not alone. However, any effort you put in now is highly beneficial in the care giving process.

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Senior Living

Kevin Knaup

2011-12-27 11:43:55

Q: I have an elderly neighbor that I have noticed does not get out often and seems to be quite frail. We do not know her well, as we recently moved next door, but we believe she is not getting enough to eat. We do not want to insult her by asking, and so far, she has refused our invitations to diner. We are nearly certain that there are others in our neighborhood in the same situation. Do you have any suggestions?

A: It is good that you are taking a concern for your senior neighbors. Nutrition is an important issue for the senior population as they are most vulnerable to economics and likely have medical conditions that require special diets. Food insecurity, or not having food, whether because of lack of funds or means to attain it because of mobility issues, is a serious problem nationwide that largely goes unnoticed. Here are some startling facts about hunger and citizens over 65: • An estimated 1.2 million households have a person 65 or older facing food insecurity. • Many seniors use senior nutrition sites as their one meal a day. • 30% of households with seniors say they have had to choose between food and medication or paying utility bills. I would suggest that you keep trying to assist your neighbor. Ask if she would like to accompany you to town or offer to take her the store if lack of transportation is a problem. If she is reluctant to come to diner by herself, help her warm up by having an outdoor barbecue and invite other neighbors as well, so she sees it as a gesture of friendship, rather than charity. Ask her for her help first to help break the ice by keeping an eye on the house while you are away for the day, for example. Also, be sure your neighbors know about valuable programs like Meals on Wheels, which delivers nutritious meals right to their door. Chances are, the more you reach out, the more you will help her and perhaps others like her, accept your help.

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Senior Living

Kevin Knaup

2011-11-21 10:47:42

Q: My father who is already in a nursing facility was just diagnosed with Alzheimer’s. Can you touch on dementia as it relates to those in nursing facilities?

A: There’s hope on the horizon for people with Alzheimer’s disease, not to mention their families and professional caregivers. But the horizon is never as close as it looks. There’s a report out on a vaccine to delay or prevent Alzheimer’s by keeping plaques from forming in the brain. However, some scientists think these plaques - masses of protein found in the brains of all people with Alzheimer’s - are a result of the disease, not a cause. If that’s so, cleaning them up probably wouldn’t help at all. But that’s only part of the story. While scientist struggle to find causes and cures, providers and researchers are making strides in how we understand and interact with people with dementia. Design, programming, staff ratios and training, family relations and technology. There’s no shortage of things to consider if you’re providing dementia care. But probably the single most crucial element is that elusive one we call the human touch. Hire the right people in the right numbers and give them the training and support they need and you’ve gone a long way toward assuring good care. “There are a lot of things we do in dementia care that cost a lot but are relatively worthless. There are other things that are hard to cost out but that are priceless.” The bottom line, unless and until we find a universal cure for this disease, what happens in our nursing facilities is at least as important as what happens in the research lab.

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Senior Living

Shanna ParrishTaylor

2011-11-17 16:42:44

Q: We have my mother, who is in a care facility, come home with us during the holidays while my wife is on vacation from work. We would like to make the time special but find that she is resistant to joining in on the festivities. Can you recommend any ways to help her?

A: First, it is important to remember that while the holidays are a wonderful time for most people, for seniors everything about them can be a reminder of times and people that they miss. This may make them want to isolate, and reluctant to join the family for the celebration. It is difficult to know what to do but your best bet is to take cues from your mom. If she seems to be encouraged by talking about the holidays when the kids were little, spend time concentrating on those special memories. For some, recounting the past can cause some pain. In that case, try to involve her in a new tradition. Another way to encourage her may be to involve her in the planning stages, rather than expect her to manage her feelings with a house full of guests. Ask for her help in decorating, taking care not to have her do anything that would endanger her, such as climbing ladders. Ask for her advice in preparing the meal or any other activity she normally enjoys. When possible, arrange an outing to visit her friends, go shopping or enjoy any other activity that she prefers. Finally, remember that noise and commotion can be difficult for seniors to manage and that facet of the holidays alone may make your mom want to isolate. Be sure to have a quiet place ready where kids and other family do not intrude if she chooses to take time out to be alone. Managing the holidays is hard for everyone, but especially so for those who have lost loved ones. Take time to watch for her cues and she will likely come around to enjoying time with the family during the holiday gatherings.

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Senior Living

Kevin Knaup

2011-10-20 12:22:58

Q: My husband and I would like to travel during the holidays and take my mother with us to see family. My mother, whose health and clarity has declined drastically in the last few years, has lived in an assisted living facility for the last year and we are not sure how to plan or what to expect. Do you have any practical tips to make this something we can handle?

A: The first and most important tip is to remember that no matter how hard you try, expect to hit some difficult points. We all want the holidays to be “ideal” but when we expect that there will be places that are harder than others, we are free to enjoy the moments that are ideal. Prior to leaving on your trip, contact healthcare providers and ask if they have any recommendations such as a pre-travel check-up. Make a list of all providers with contact information, list of medications, and collect insurance paperwork. Be sure to have enough of all of your mother’s medications and medical supplies available to last the length of the trip. When packing for her, keep the weather in mind but also remember that the older we are the more difficult it is to stay warm. Make sure the clothes are comfortable and are easy to get on and off. Pack extra toiletries such as incontinence products and absorbent pads to help avoid embarrassment. Next, whether you are traveling by plane or car, plan for your parent’s comfort and plan ahead. • Arrange prior to departure to have a wheelchair available in airports. • Keep a folding cane or walker available. • If driving long distances, plan stops for bathroom breaks and to stretch the legs. • Keep the temperature warm enough and jackets handy. • If she has medical issues, such as an ostomy, discretely mention it to applicable airline personnel such as those conducting pat down searches to avoid any possible problems. There are also things you can do while visiting to help make the trip comfortable, pleasurable, and memorable. Look for more tips next month.

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Senior Living

Shanna ParrishTaylor

2011-10-20 11:24:41

Q: This will be our first year with two aging parents in the home for the holidays. Any tips for trying to manage the work while still having time to celebrate?

A: The holiday season is busy and sometimes stressful, even under the easiest of circumstances. When caring for adults, the tasks and stresses mount even more quickly. However, rather than make the holiday season something you “survive,” there are things you can do to make the holidays joyful and memorable and reduce some of the stress associated with them. Here are some tips for making the holidays manageable for caregivers. 1. Schedule regular doctor appointments early in the month and try to fit in several in a day if possible. Use down time to accomplish associated tasks like buying any necessary medical supplies and picking up prescriptions. 2. Don’t wait until you are overwhelmed to ask for help. Be deliberate in planning to have others incorporated into the care and oversight of your parents, if even for a few hours or few moments. Call family members and ask if they can come over for the day so you can get away to accomplish tasks or just take in the season. Also, use little moments as they come. For example, take your mother-in-law to get her hair and nails done as a special gift and slip away for a cup of coffee while she is being pampered, or enjoy some pampering with her! 3. Enlist the help of adult care facilities offering drop in or day services when appropriate. 4. Get shopping done early. Shopping online also helps to reduce some of the stress of the season. 5. Delegate tasks. You do not have to do everything. As a caregiver, there are many tasks that cannot be delayed. Hygiene and health care tasks never take a break, even for the holidays so get help when and where you can. Have someone come in to do housework or laundry, hire or have another family member act as a home healthcare relief aid. Use a gift wrapping service to manage making the gifts beautiful. 6. Choose an easy menu. Have family help cook. Cook ahead. Do not be afraid to incorporate some store bought goodies. While there are many jobs associated with care giving, remember not to treat your family members as a job to be accomplished. Invite them to participate in the preparations by helping decorate, sign cards, prepare foods and entertain guests. Find out what they would most like to do and try to accommodate them with quick shopping trips or by incorporating what makes it special for them too. Keeping them involved will keep their spirits high and make the holidays something very special.

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Senior Living

Kevin Knaup

2011-09-29 15:17:16

Q: I have an incredibly independent and stubborn great-aunt who is, as far as I can tell quite healthy. I am the only relative that lives in the area and I am trying to look after her as best I can. However, we cannot seem to get her to go for regular medical care and she is convinced she only needs to go when she is sick, which is seldom.

A: Your great-aunt is in a very common group of people. Unfortunately, many older Americans do not seek out or receive the preventative care such as vaccinations and screenings recommended by physicians. The reasons for this are many and complex. One reason is that older Americans feel as if they visit the doctor frequently enough, not realizing that physicians within certain specialties would not order many of the screenings. Another is having a sort of apathy, and not wanting to preserve their health. Of course, there are many more reasons so a number of things may be at the core of why your great-aunt resists getting preventative care. However, there are some great reasons she may want to start thinking about getting regular screenings. These important services help detect many diseases, delay their onset, or identify them early in their most treatable stages to ensure healthier, longer, and more productive lives for older adults. Staying healthy longer may mean staying in their own homes, or retaining the ability to enjoy community events or hobbies. Staying healthy means keeping your independence longer, this is something that may appeal to your aunt. The Centers for Disease Control recently issued a report on enhancing the use of clinical preventative medicine in older adults and identified key indicators for monitoring the use of clinical preventive services among adults 65 and older: • Two vaccinations that protect against influenza and pneumococcal disease • Five screenings for early detection of breast cancer, colorectal cancer, diabetes, lipid disorders, and osteoporosis • Counseling service for smoking cessation • Alcohol misuse screening and counseling • Aspirin use • Blood pressure screening • Cervical cancer screening • Depression screening • Obesity screening and counseling • Zoster vaccination The fall is a great time of year to broach the subject of health screenings as it is more frequently in the news. Chances are that when she realizes that she can play a role in staying independent longer, she will get the care she needs.

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Senior Living

Kevin Knaup

2011-07-01 10:51:00

Question: Recently, I took my elderly mother. who suffers from several chronic diseases, to her doctor. The doctor said that she would likely need to move from self-sufficiency to an informal caregiver situation soon and to skilled care sometime after that. What exactly is an informal caregiver?

Answer: Simply put, an informal caregiver is a caregiver without formal medical training who is participating in the care of that person. Most often, this is referring to family members of sick or incapacitated who are providing help in bathing, medicines and meals. Informal caregivers are really the unsung heroes of our society. It is estimated that over 50 million people are providing care to someone who is chronically sick or disabled. With an aging population and better healthcare, that number is on the rise. It sounds as if you want to be a help and support to your mother and no doubt, the doctor realized this. Since your mom is independent, the physician may be easing her in to the idea that she needs to allow her family to help in her daily life and figure more prominently as informal caregivers. For many people, receiving care is very difficult and may only feel ready for care provided by ones that they love.

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Senior Living

Lynn Spragg

2011-07-01 08:19:00

Question: We recently placed my mom in a care facility that specializes in dementia care. Right now, we are having difficulty visiting her because every time we go, she thinks that she is being checked in for the first time and becomes unsettled event to the point of becoming violent, each time. Are there ways that we can help this? Will it settle down in time? Is it better to visit more, or less?

Answer: I understand the heartache and frustration you must feel. One of the most difficult parts of Alzheimer’s is that it robs the patient’s ability to enjoy the company of their family in so many different ways. One of the first things you need to realize when you visit is that you will need to expect changes in your mom in many areas. In addition to lapses in memory, which alone can be profound, she may also have changes in personality. Commonly, people with Alzheimers have become very suspicious and view everyone as a threat. If you expect that there will be changes, you will not be as put off by them when dealing with her. Next, try to visit soon after breakfast. Studies show that patients with dementia become more confused and agitated later in the day. A morning or early afternoon visit may result in a more positive experience for you both. Finally, go with the flow. Since you cannot undo the damage the disease has caused, you can choose to join them in their journey and make the best of a difficult situation. Try not to frustrate her with questions about the past or take it personally if she thinks you are someone else that day. Simply announce yourself and your relationship upon entering her room. If she does not recall who you are, or where she is, it will be evident very quickly. You cannot force her into your reality, but you can take time to visit her in hers. It is hard to tell if things will calm down for your mom. Perhaps adjusting these things will help in some measure. Above all, remember that there will be good days, and bad days. As hard as it is to see the toll the disease takes, do not let it rob you and your mom of the pleasure that can still be had in frequent visits.

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Senior Living

Kevin Knaup

2011-06-01 12:22:00

Question: Can you tell me what I should know about the admissions process? Is the admission process the same or similar for most skilled nursing facilities? What can we do to make the process, and transition simpler?

Answer: When you ask about the admission process, I assume you mean more than the paperwork involved, so let’s talk about it from that aspect. Prior to beginning the admission process, you may want to make a call to the facility or facilities which are under consideration. A brief conversation with the Admissions coordinator or Social Worker will help you know if you or the person for whom you are searching is eligible for residency at that facility. Once that is determined, a quick tour may help rule in, or out, a facility from consideration. All nursing facilities will have basic admission criteria. Assuming those basic requirements are met, the next step for consideration may be the completion of a Resident Review Instrument, or RRI. Once completed the RRI acts as an assessment tool and is forwarded to our Admissions Department for review. Referrals may be initiated by hospital discharge planners, other nursing facilities or family members. Once it is determined that the person is eligible, then further plans are made including organizing Medicaid and insurance coverage and signing admission papers. The Kansas Area Agency on Aging will need to complete a Care Assessment before admission. After all the paperwork is in place, you will likely be given a list of what to bring such as clothing, and decorations for the room, pictures, chair, television, etc. You will also be informed of what personal hygiene supplies are provided and what you will need to bring. From there the actual move in process is very simple and just a matter of organizing personal belongings and getting settled in. The staff at most facilities understands that this transition can be difficult and are very sensitive to the needs of residents.

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Senior Living

Shanna ParrishTaylor

2011-06-01 12:22:00

Question: My aunt is really struggling with depression and loneliness. I try to visit her as much as possible but it is really not enough. I try to help encourage her, but all she really does is watch television or talk about how alone she feels. Please tell me how I can help her.

Answer: As we’ve discussed in the previous two articles of this series, seniors often face the reality of outliving friends and even family. Eventually, the social group narrows and they may find it difficult to establish new friends and new habits. Unfortunately, this can lead to feelings of isolation and loneliness, a huge concern for senior adults. Not only can loneliness rob the joy in life, long term depression can lead to other serious health issues. It is great that you visit your aunt often, and I would certainly continue that practice. Since you can not be with her always, I would try to help by giving her some tips to combat those feelings. Here are some important ways to fight loneliness, no matter what your age. •Keeping busy is key in fighting off loneliness If you fill your time with activities, it gives your brain positive stimulation. Often when we are feeling down, we withdraw from normal activities. Choose to add one additional activity a day, whether it is caring for a garden, doing a puzzle, or going for a walk. •Get around people! If you find that your social group has changed or dwindled, grow it by getting involved in church, support groups, clubs or initiating contact with neighbors that you may not know. •Find a new hobby Everyone needs to be passionate about something, and there is never a bad time to learn a new skill. Choose a hobby that will get you outdoors and around people that enjoy the same thing. Or try a hobby that you have always wanted to do but have put off. Things like gardening, metal detecting, and walking will not only give you a brighter look on life, but can put you in a place to meet wonderful new friends. •Choose to have a positive outlook on life If you are missing family, choose to spend time with people that need your attention and carving out your own place of making a difference. Keeping your mind focused on what is good will force out negative thoughts. •Avoid mental escapes Constantly thinking about what has changed or what once was is good only if it does not bring you down. When you think about those you have lost, try to make it positive and in the present, like thinking about how proud they would be to know that you are tutoring neighborhood children or have taken up another new activity. Focus on what the past has given you that enables you to make something wonderful out of today.

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Senior Living

Shanna ParrishTaylor

2011-05-01 11:25:00

Question: I am my mother’s only living relative and only support. Since I work, the time I have with her is limited and she is starting to get depressed and lonely. Do you have any ideas how I can help her?

Answer: One of the best ways to combat loneliness in seniors is by getting out and helping others. In fact, volunteering has many surprising advantages that can help your mother in her overall health and well being. Here are just a few: •Provides additional exercise •Expands social networks •Shifts focus to positive thoughts •Provides worthwhile and valued service •Aids in feeling useful to society •Provides something for which to look forward •Fulfills needs within the community Over the past two decades, growing body of research that indicates volunteering provides individual health benefits in addition to social benefits. Studies show it benefits health in these ways: •Improves and maintains mobility •Fights depression •Boosts immunity •Lower rates of mortality While you did not mention if your mother was mobile, there are likely many opportunities right at her footstep. Here are a few suggestions and areas of opportunity you might want to help her pursue: •Libraries •Thrift Stores •Literacy programs •Mentoring/Tutoring •Living History •Classroom Aid for the Disabled •Support for Military Personnel •Outreach for Homebound Adults The local senior center or library will also have information for those wishing to share their talents. Volunteering will not only allow your mother the platform to share her talents, it will give her a new group of friends and interesting activities that will fight off feelings of depression and loneliness.

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Senior Living

Kevin Knaup

2011-05-01 10:46:00

Question: What exactly is long term care insurance and what does it cover that health insurance does not? Would I be doubling up on coverage? Is it worth the investment?

Answer: If you are an adult in your 40’s or older, there is no better time to consider the value of long term care insurance. Long term care insurance is not health insurance. It is designed to cover related health expenses which health insurance does not, such as in-home help, assisted living services, adult day care, visiting nurses and depending on the level of insurance, care in a nursing home. Unfortunately, long term care is costly but is something that all of us will likely need at some point in our life. While we all realize this, a recent study by Prudential Insurance Company showed that most of us fail to prepare for that eventuality, mostly due to lack of knowledge. A full one third of respondents believed that Medicare or Medicaid would cover any extended care costs. In reality, long term care is expensive and can quickly exhaust resources. Medicare does not cover long term care and Medicaid will, but only after all other resources are exhausted, leaving very little to live on. This can leave the person needing care, and their family, in a difficult place. Long term care insurance can help provide the assistance needed, filling the gap left by what health insurance does not cover. However, it is best to consider buying it well before an anticipated need. Those purchasing it at age 70 or older will likely be deemed high risk and have high premiums if they are able to obtain coverage at all. As in any type of insurance coverage, be sure to go over the policy and to see exactly what it covers. Some of the most important concerns would be: •Does not require hospital stay before receiving benefits •Cannot be cancelled if you pay the premium •Covers pre-existing conditions •Inflation protection •Allows a downgrade in coverage if you cannot afford premiums •Covers dementia care The cost of individual policies can vary significantly, so it is important to shop around until you find one that meets you needs and your budget.

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Senior Living

Shanna ParrishTaylor

2011-04-01 13:55:00

Question: What are the symptoms of loneliness in the elderly?

Answer: Many people think that you must be alone to feel lonely. Simply put, feeling lonely is an emotional state of mind that includes feeling as if you do not belong or do not have anyone with whom you can associate. Even in a social setting, it is possible to feel alone. Loneliness can manifest with both physical and emotional symptoms. While it is different than, and can be confused with depression, if overlooked, it can lead to depression and other serious health issues. Here are some of the most common symptoms of loneliness: • Homesickness • Shyness • Self-consciousness • Dissatisfaction with social or family relationships • Lethargy • Lack of direction • Sadness • Fatigue • Weight loss • Increased use of alcohol • Fixation on death • Memory problems Often, senior life includes regular major life changes such as the loss of a spouse or friends, moves and heath problems. Any of these can add to feelings of loneliness. If your family member is exhibiting any of these symptoms, it is important to get a full medical evaluation to see if any other conditions may be causing the problem. Sometimes, something as simple as a change in medication can make a huge difference. If the feelings of loneliness are circumstantial, it may be wise to help the senior ease in to new situations. For example, if they have recently moved into your home, or into another, spend extra time socializing with them in their new community. Being a catalyst to new experiences can help them get over the fear of having to “start over” or help them identify new activities that would interest them. Feelings of loneliness are normal and common, but should never be ignored.

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Senior Living

Murl Webster

2011-04-01 13:55:00

Question: What is the difference between senior housing, assisted living, nursing facilities and skilled nursing facilities?

Answer: The difference between them is great, as are the needs of those who inhabit them. Generally, each type of senior housing is developed for people with different needs. Independent housing, Sr. Apartments, Adult Housing are all euphemisms for age restricted housing. Only persons who have reached a specific age are allowed to live in these homes. Age restricted, i.e. elderly housing was the only definition or separate group that was allowed to survive when HUD went on a “discrimination” busting rampage in the housing market about 30-years-ago. During that time, the powers that be decreed that no one had the right to decide they wanted to live with any selected group. Individual housing developments as well as apartment complexes were declared in violation of federal anti-discrimination laws if they chose to rent to any specific group. At the time, developers and apartment owners all catered to the wants of the marketplace. Many complexes were “adult only” for those who didn’t want to contend with children in their busy lives. Often, apartment complexes were divided into “adult” and ”family” divisions, where children were excluded from the “adult” divisions. The two divisions usually had their own amenities with separate pools, playgrounds in the family area and “adult only” fitness centers. Most people found the arrangement to their liking. At the time, I had a pre-teen in the house and the arrangement worked well. While we often availed ourselves of the “adults only” fitness center, we were quite happy that our youngster went to the “family” pool and was not privy to some of the more adult shenanigans that went on at the “adult” pool. However, there were a group of women, with children, who filed suit claiming they were being discriminated against, and not allowed to live where they liked with their children. With the very liberal court make-up at the time and HUD’s government-paid attorneys, they prevailed and another freedom of choice fell. However, the separation of senior adults, who at the time were considered a minority, into their own children-less housing was allowed. From time to time, that right has been challenged but survived due to case-law precedents. Basically, the only difference in Senior Housing, and any other is just the restriction on the age of those who are allowed to live there. Senior housing can be independent houses, townhouses, condos, duplexes or apartments or any other configuration you can think of in housing. The only real division in senior housing is that some of them are also income restricted. In an income restricted complex, (usually built with a government subsidy) only those who receive less than a certain income each year, are allowed to live there. The income restrictions usually allow differing amounts for individuals or couples and are adjusted up each year to allow for inflation. Usually, the qualification is judged only on “income” and not assets. For instance, a couple could be millionaires in the value of their stocks, but if the income they received each year was under the limit, they could live in “income-restricted” housing. There are several examples in the Greater Wichita Area of “income-restricted” housing. Assisted Living Facilities (ALF’s) is another form of senior housing, but is designed for those who are not able to care for themselves, and perhaps need differing levels of oversight. Those admitted to “assisted living”, or “residential care” may need something as simple as help taking their medications to stay well or other more advanced levels of care. However, to be able to live in residential care, one must be able to perform most of their own activities of daily living, defined as eating, dressing, toileting and walking. In assisted living, bathing help is available. Residents in “assisted living” often still have their own cars and can come and go as they please. Others have chosen assisted living when they were no longer able to drive and/or wanted the convenience of someone taking care of housekeeping and meal preparation for them. Residential care also allows for couples to share their accommodations if they choose. In some cases, a spouse, who is unable to help their partner as much as needed will choose residential care so they can continue life together in a much less stressful environment, where the chores are taken care of for them, and they can sit back and enjoy life. In an assisted living environment, the majority of the “help staff” usually are certified medication aides who are trained in the dispensing of medications and have previously qualified as certified nursing aides. Due to their training, they are able to watch for health indicators and to alert the licensed nurse when she comes in. They also are able to summon assistance when needs are beyond their training. Sometimes only a door separates the residential care complex from the skilled nursing facility which has licensed nurses on duty, and available for immediate care, 24 hours a day. Nursing Facilities and Skilled Nursing Facilities or nursing homes as they are more commonly called are definitely a step up in care over assisted living. Once a person no longer meets the State mandated criteria for assisted living, they are no longer allowed to live there. An assisted living provider can be seriously penalized for allowing persons who no longer meet state guidelines to continue living in an assisted living facility. Once a person no longer meets assisted living guidelines according to their “care assessment,” they are appropriate for care in a nursing home. The “care assessment” is a state test, performed by persons specifically trained in that test, to determine the level of care they need and whether they are qualified for nursing home care. One of the qualifiers is whether the person is capable of performing for themselves their normal “Activities of Daily Living” (ADL’s) as mentioned earlier when we were discussing the qualifications for Residential Care. Nursing home care is much more intense and can vary from helping one with two or three ADL’s to total care. Elderly persons with dementia, who are unable to manage their lives are appropriate for a nursing home, even though they might be perfectly capable of performing all their own ADL’s. They receive the level of care they need, however, intense it may be. It is in the intensity of care that Skilled Nursing Facilities (SNF) commonly referred to as “sniffs” differ from Nursing Facilities (NF) “niffs”. A SNF has the staffing and expertise, as well as regulatory certification to provide the higher level of care required by Medicare. A person who has undergone the requisite three-day stay in an acute care hospital and is released needing “skilled nursing” can only receive Medicare benefits from a SNF. Sometimes the ‘skilled nursing” is a form of physical, occupational or speech therapy. It may also include constant monitoring by licensed nurses, or special care that can only be provided by an adequate licensed staff. Nursing facilities, (NF) have licensed nursing staff, and in some cases meet the requirements of Medicare, but have just not been certified. Other times, they are located in more rural areas where adequate licensed staff is difficult to hire and they provide care for those who need a less intense regimen. It is not unusual for a certified Skilled Nursing Facility, to receive a resident from another nursing home which is a NF after that resident has been hospitalized. They provide the Medicare required services, before transferring them back to their original nursing facility when they are appropriately improved. “Rehab to Home” is a favorite expression for those who have completed their hospitalization and need more care, and usually therapies, before being released back home. Much of the Medicare services are directed at getting persons back to their homes in a healthy condition where they can continue to live a more normal life. Whereas, nursing homes used to be a place where persons unable to care for themselves were “warehoused” until released by death, the whole purpose has changed. Today, a nursing home is expected to provide fun exciting activities, appropriate for all of their residents and maintain the highest and best functioning possible. To that end, they provide multiple activity programs, of all types, and exercise programs, which are both fun and effective in maintaining, or improving physical strength and stamina. It is important to try to get residents to a level of functioning where they can return to their homes if possible. I personally became a Nursing Home Administrator after watching my father lie, for his final six months of life in one of the old style, what I called a “Boot camp Nursing Home.” I could not stand the lack of care and the demands made of the residents by the staff. They were told when to eat, when to bathe, when to go to the bathroom, (and ignored if they couldn’t wait). They were given one unappetizing choice of food, and almost forced to eat it. (At an even earlier time, residents had their mouths forced open and food forced down their throats). Today, we send a staff member around daily with a menu to let the residents choose their meals and they have a salad or fruit bar. Not only is it looked down upon and a bad business model to operate homes the old way, it is thankfully also illegal. “Culture change” is the watch word now, both in the nursing home and with the State regulatory agencies who oversee them. When I first started what we called person-centered care in 2002, my new staff looked at me as if I was crazy when I told them our residents would be choosing what they wanted to eat, and when they wanted to eat. That they would tell us when they wanted to bathe and whether it would be a shower or bath. They began to like it better when I told them of the choices of activities i.e. recreation that we would be having for our residents, and as caregivers they would be “required” to participate! I remember one staff member in particular that liked the idea of being paid to go fishing and to the casino with residents. Today’s nursing home is where one goes to improve the quality of life, not end it.

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Senior Living

Kevin Knaup

2011-04-01 10:42:00

Question: What are some symptoms of Alzheimer’s disease? And how do you know the difference between normal aging?

Answer: Although some memory loss is expected as part of the aging process, Alzheimer’s is a brain disease that causes serious problems with memory, thinking and behavior well beyond normal age related memory loss. Alzheimer’s disease (AD) is a slowly progressive disease of the brain that is characterized by impairment of memory and eventually by disturbances in reasoning, planning, language and perception. The disease is typically categorized into three stages, mild moderate and severe. Symptoms of Mild Alzheimer’s Disease •Noticeable memory loss •Decrease in cognitive functions which may be seen in getting lost, problems handling money, poor judgment and problems managing normal tasks. •Mood changes Symptoms of Moderate Alzheimer’s Disease •Memory loss •Confusion •Problems recognizing friends and family •Unable to learn new skills •Difficulty in tasks that have multiple steps •Mood swings Paranoia Symptoms of Severe Alzheimer’s Disease •Inability to communicate •Dependent on others for care Alzheimer’s is a common disease and is generally discovered around age 60. An estimated 5.3 million Americans of all ages have Alzheimer’s disease. If you suspect your loved one has AD, contact their physician. A physician can help manage the disease and recommend ways to help manage the care of the patient thereafter.

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Senior Living

Murl Webster

2011-03-01 11:31:00

Question: What is life like in a nursing home?

Answer: Well, I can’t really answer that exactly because it’s a little different for each person and nursing homes vary also. However, let’s just follow a fictitious person through their choices for the day in a nursing home. To make it easier, let’s assume you are in the nursing home and choose to get up about 6:45 am. (Some choose to sleep in until 11 am). At 6:45 am a Certified Nurse Aide (CNA) would lightly knock on your door, announce themselves and step into your room. They would then come to your bed to help you wake up. Depending on your needs, they would assist you in getting ready for the day. Perhaps you would need help with oral care, hair care or dressing. Perhaps a little assistance would be needed getting to the toilet. Once you were ready, they would either let you head down the hall to the dining room, or assist you. Arriving in the dining room you would be asked what you were ordering for breakfast. Then you would make choices from the breakfast bar, and have them brought to you, while you were waiting for your order to be ready. You would be talking with other residents, who had become your friends and chose to get up the same time of day as you. Perhaps this morning, you wanted donuts and coffee as you wait for your breakfast to be ready. Drinks would be brought to your table according to your preferences. You might end up with water, milk, a juice and your coffee. Periodically you would be checked to see if you needed a refill. Your breakfast, that you chose off the menu would arrive. Today you chose scrambled eggs, breakfast sausage and biscuits. The CNA bringing them would inquire if you needed any assistance with your food, even though she knows you very well and knows you are self sufficient.. After breakfast is over you go back to your room, where an aide greets you and reminds you to get ready for your whirlpool bath that you chose over a shower. Whirlpools are so much nicer than showers you think. As your bath finishes, you think about what you want to do for today. There are many things to choose from. Perhaps you will choose to spend a half-hour with Bible study this morning. It’s a great way to start a day. Especially after your invigorating whirlpool bath. Then it’s decision time. Do you want to go with the guys to play poker, or join the music makers group this morning? Poker sounds like fun you think. The conversations are always fun and you like the camaraderie of the group. Perhaps you’ll do music tomorrow. The game lasts a little long, (you were winning), so you then slip into the exercise class a little late. Today, there’s new music and a whole new fitness routine that you can do. A couple of the exercises are a bit too strenuous for you so you just do what you can, but it really feels good after sitting at that poker table for so long. With exercise over, you and a couple of friends opt for some relaxation in the TV room until lunch time. You look forward to choosing your lunch. The food is always so good that sometimes it’s hard to choose what you want. A great hot lunch really hits the spot as you sit in the dining room, looking out at the snow blowing by the windows. You talk with your table mates about the times you have had to work out in the cold white stuff and are thankful that today you can stay warm. The live piano music makes a nice background for your conversations. Warm and snug, with a full tummy, you decide a nap would be good before you begin activities for the afternoon. As you head for your bed, you ask that you be awakened in time for Bingo at 2 pm. It seems your head just hit the pillow when you hear the voice of the activities person coaxing you from sleep, reminding you that you wanted to get up for bingo. Getting to the bingo game, you find the caller on your side and you win three games. In a celebratory mood, you join other residents at the monthly birthday party with the obligatory cake, ice cream and drinks. Then its off to a session of Wii bowling. They’re talking about setting up a Wii tennis tournament. You think you might do better at that. Bowling is fun, but the strikes seem to be just a hard to get as on a real alley. Tired and hungry you’re ready for your dinner when you finish the games. You put in your order, eat and head for your room. As you arrive in your room, you notice on the activity schedule, there’s a movie and popcorn in the TV room this evening. You’ll have time for a quick nap before you go check out the movie. The thought of that fresh popcorn and how good it smells makes your mouth water. You know that after a busy day and evening movie, you’ll be tired and ready for bed. But the staff here is always so helpful that you know if you need assistance getting ready for bed, or even just someone to untie your shoes, they’re always ready. As your head sinks into the pillow, you think it’s really nice to be here. It’s home.

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Senior Living

Shanna ParrishTaylor

2011-03-01 10:26:00

Question: Lately, every time I visit my aging parents I notice signs of decline in the ability to care for themselves. Since I live quite a distance and am unable to move at this time, I am very concerned that they are not eating properly and taking care of themselves sufficiently. I spoke to them about assisted living, but they took it as a personal assault to their freedom and dignity. Is there a way I can help ease them into the idea?

Answer: It is very normal to be resistant to the idea of assisted living when the idea is first broached with a loved one. Part of that resistance may be caused by a reluctance to leave a special and familiar place, feeling too old for something new or the fear of being forgotten. Other people are resistant to the idea of assisted living because they have a perception of it having an institutional feel and restricting their freedom. There are several ways to help your parent consider assisted living in a new light. Here are a few things to help make that transition: •They could choose an assisted living facility closer to where you live and would therefore have much more time with them. •Visit the several facilities and arrange before hand to be able to participate in some of the day’s activities. •Be honest and upfront about your concerns. Let them know that they raised you to honor them and protect their wellbeing, a job that you want to do well by assuring that they are in safe surroundings with people to care for their needs. •Explain that knowing that they are safe is a gift to you throughout the day. •Explain the real situation. Autonomy now could lead to injuries from falls, which would necessitate an extended time away from one another and greater reduction in freedoms. •Place the decision in their hands when possible. Most family members given enough time to decide and exposure to quality assisted living facilities will make the decision to protect their health. Making the transition to an assisted living facility can be difficult. In most cases, having enough exposure to what an assisted living facility is really like can make all the difference.

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Senior Living

Kevin Knaup

2011-03-01 10:05:00

Question: What is the difference between Medicare and Medicaid? Are the eligibility requirements different? I hear people using the term interchangeably and wonder for what my mom, who was recently diagnosed with early onset Alzheimer’s, might be qualified. I’m new to this and it is all pretty confusing.

Answer: Although they are two entirely different programs, many people get confused when it comes to the differences between Medicare and Medicaid. To help clear up the difference, let’s begin with how the U.S. Department of Health and Human Services defines each: “Medicare is an insurance program. Medical bills are paid from trust funds which those covered have paid into. It serves people over 65 primarily, whatever their income; and serves younger disabled people and dialysis patients. Patients pay part of costs through deductibles for hospital and other costs. Small monthly premiums are required for non-hospital coverage. Medicare is a federal program. It is basically the same everywhere in the United States and is run by the Centers for Medicare & Medicaid Services, an agency of the federal government.” While Medicaid is defined: “Medicaid is an assistance program. Medical bills are paid from federal, state and local tax funds. It serves low-income people of every age. Patients usually pay no part of costs for covered medical expenses. A small co-payment is sometimes required. Medicaid is a federal-state program. It varies from state to state. It is run by state and local governments within federal guidelines.” The eligibility requirements for Medicare are much the same all over the country, covering seniors over 65. Medicaid is state run and each state has separate, but similar guidelines for eligibility. For those receiving Medicare, it is also helpful to know about Medigap insurance. Many companies offer insurance policies that cover out of pocket cost not covered by Medicare. Each company may offer the insurance at different rates, so it helps to shop around for the best prices.

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Senior Living

Shanna ParrishTaylor

2011-02-01 14:24:00

Question: I have been calling around looking for an assisted living home for my father who is unable to live alone any longer. However, I am finding that the pricing structures vary, and frankly, a bit confusing. This makes it difficult to plan finances accordingly, or even know if the ones that seem to be what we can manage actually are in a reasonable price range. Can you give me an idea of how the pricing structures work and what is actually included?

Answer: I understand your confusion! The different pricing options do make it very difficult to compare costs or be certain what is included in the fees. I will try to help clear things up as much as possible. Some assisted living facilities offer an “all inclusive” or a bundled rate that includes all of the major points of service that a facility offers, such as room, food, utilities (excluding phone services), and housekeeping. Others break out the pricing based on the service and level of care. Additional Charges: Ask each facility how additional charges are incurred under their quoted price to you, and ask for a price list of those charges and services. Generally, additional charges are incurred for levels of care. A resident that needs help bathing might be a level one, where a resident with Alzheimer’s would require much more care and therefore, on a higher fee structure. What’s Not Included: Always ask what is not included, even and perhaps especially in all-inclusive rates. All-inclusive for one facility may mean room, food, utilities, and personal assistance, but only includes two meals a day. In others, transportation to doctor’s appointments may be an additional charge. In the majority of cases, the family provides the resident with necessary toiletry supplies and they are not included in the price. Once you have the actual figures on what a facility charges, then you can estimate any additional charges, if the facility charges for levels of care, based on the needs of your loved one.

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Senior Living

Lynn Spragg

2011-01-01 11:24:00

Question: My husband’s mom is in an assisted living facility. Since we have some time off, we thought it might be nice to bring her home for a mini-vacation. We were wondering, if the resident is away for a week and obviously not receiving care, is that a billable week? How does this work?

Answer: Thank you so much for your question. This comes up very frequently in an assisted living situation. Sometimes it is because, like in your case, you would like to have some time with your family member. This same situation might also arise if the resident becomes ill and requires an extended stay in the hospital. Most generally, there are three options that apply to this situation. •The monthly cost is prorated •The facility does not charge for that period •The facility charges a room on hold charge (which generally applies to residents away for an extended time, such as for a hospital stay) If, in the case of a resident that is going to visit family, is not excessive, the facility may not charge. However, if it were to become too regular, it would begin to impact the facility’s ability to operate effectively. Most assisted living agreements will have a provision for residents that become ill and require an extended stay in a hospital. Understanding that this is a consideration, especially for elderly adults, some facilities will charge a reduced “room on hold charge” which holds the room open for that resident and allows the facility to continue to run optimally. Each facility is likely to have a different protocol for these situations which is generally fond in the original agreement. However, there are many facilities that will consider adapting that agreement on a case by case basis.

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Senior Living

Murl Webster

2011-01-01 10:18:00

Question: I’ve heard you mention several times “It’s not your Grandmother’s Nursing Home” What do you mean by that?

Answer: Nursing home’s, during their inception, back in Grandma’s time were basically modeled after acute care hospitals. In that kind of environment, everyone must be told what to do and unquestioningly do it, since the emergency nature of the hospital is to save lives which are immediately at risk. In that scenario, quality of life stepped aside for the saving of life. Unfortunately, as they evolved in the early days, they tended to become warehouses for those waiting to die. It wasn’t a pretty picture, and most of our current regulations were developed to protect persons who lived in that kind of environment. Today’s nursing home is anything but a warehouse for the elderly. Home is the operative word and the culture is constantly changing to make nursing homes more responsive to the wants and needs of the residents, rather than just dealing with their clinical needs. In other words, we want to make it home, not an institution. Many persons, who come to a nursing home today, come for short-term nursing and rehabilitation therapies. It is often a halfway house between the acute hospital stay and returning to a normal life at home. Skilled nursing homes today offer Physical, Occupational and Speech therapies to their residents. In many cases, they are offered to get the resident in shape to go home and live their own life. In other instances, they are given to get the resident in the best shape they can be to live as normally as possible. Most all of us want to be able to do things for ourselves. We Americans are an independent lot. We don’t want someone choosing our clothes and taking care of our normal activities. We want to brush our own teeth, comb our own hair and put on our own clothes. However, often people coming into the nursing home, for whatever reason are unable to accomplish all that for them. Therapies are designed to give us back as much of our independence as possible. It is not all that unusual for someone coming into a nursing home to find that with the excellent care they receive, many of their abilities are restored and they are able to go to a less restrictive environment, whether that is to independent or assisted living. Nursing homes are more homes than nursing now. Of course, the nurses and care staff are still there to provide for your medical/clinical needs, but the focus is on quality of life now, not just what medicines the doctor ordered. That’s the way it should be. It wasn’t all that long ago that I sat in my living room talking with a friend about the treatment my father was receiving in a nursing home in another town. We were appalled. We considered whether we should join an advocacy group, try to get together a group of our own, or what we could do to change the situation. After a lot of prayer, we decided that the only way to make a real change was to get in and do the work ourselves. As my friend said, “You’re just not a toe-in-the-water kind of guy.” I decided to bite the bullet and began my training as nursing home administrator. Nursing Homes are in a constant state of change, and I should say, thankfully in a state of change. I didn’t like what Dad had to go through. I love the way we take care of residents now. I also love the way we are changing the way we take care of them. When we began a program of “Whole Person Care” back in 2003, we were among the leaders in the field of change that would later be labeled “Culture Change” Today, I was in meetings dealing with restaurant style menus,, open meal times, so residents can eat whenever they want, not just at scheduled times,, resident choices for when they get up and go to bed, We were forming committees so the caregivers who know what the residents want most, could tell us what changes we need to make for them. When I began as a nursing home administrator, we didn’t allow pets into the building because animals were “unsanitary”. Today we have our own dog roaming the halls and giving love to the residents. The Social Services person and I were discussing the other day, what we would have to do to be able to safely take residents to the casino. We think they’d like that even more than the two slot machines (tokens only!) that we already have in the facility, courtesy of one of our staff members. We’re also planning picnics and fishing trips to the lake, even though we now in the winter months I was talking with an amazing friend the other day. She is 87-years-old and each Thursday evening she has a dance at her local American Legion Hall. She doesn’t dance as much as she used to, but she still won’t miss a fast polka. When someone laughingly suggested that she should be picking out a nursing home her answer was “They’re not going to tie me in a wheelchair, drug me up and put me in a corner...” That’s the nursing home of our grandmothers. Many of our elderly, just like my friend, fear it. But it’s not the nursing home of your grandmother anymore. It’s a real home , where people go to live and if possible, get well enough to return to their other home. And if they can’t go back, then this is where they have friends and fun. A few years ago, I had a resident come to me and say, “If I’d known it was this much fun here, I’d have moved in years ago.”

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Senior Living

Murl Webster

2011-01-01 10:18:00

Question: I’m watching the aging of my parents and know the day is coming soon that they will need a nursing home. What do I do to find a good one?

Answer: Part of the selection process involves determining if the resident and the nursing home fit. In other words, will the needs of the resident be met there? Nursing homes vary widely in their culture and in the services they offer. When searching for a nursing home for a loved one, we always want to find out if the services and the needs meet. We don’t want to just check that they have a comfortable bed and someone to give their medications on time. We also want to know if the wants, as well as the needs will be met. For instance, we regularly admit residents who have Alzheimer’s disease. However, there are person with Alzheimer’s who we recommend to other facilities which are better able to meet that person’s particular needs. While some Alzheimer’s residents progress through their disease easily, others fight it constantly and aggressively. They are combative and inventive in trying to leave the home where they reside. They become a risk both to others and themselves. Some homes are especially equipped to provide quality care for that particular type of resident. For the less aggressive Alzheimer’s resident, our home works very well as it is a calm, quiet, family atmosphere with electronically secured doors, but not the hardened security of a “Locked Unit.” So – the first thing to do is consider what the needs of your loved one are, or are likely to be when you need nursing home living for them. Will they need dementia care? Will they need therapies, such as physical therapy or occupational therapy to help them back up to a prior level of functioning? Perhaps they will need therapies to help them adjust to some of the limitations that age has brought with it. When checking for therapy provisions at a nursing home, it is usually good to determine if they have therapists on-site or if they have traveling therapists who come in at certain times. On-site therapies are of course more dependable. However, I know some traveling therapists who are absolutely wonderful. For the most part however, I would probably opt for on-site therapists if the home is large enough to support them. If possible, check with someone who has experienced the therapies at the home you are considering. Personal experience is always the best. If possible, check with several people so you can get a well-rounded overview of the program. One should also see if the home has an active restorative program. This is a less intensive program with trained restorative aides, to assist residents in maintaining or improving their level of functioning, even though they may not be candidates for the programs run by licensed therapists. Never, place your loved one in home just because someone recommended it, unless you have no other choice. Always visit the home you are considering if possible. First, I would suggest you make an appointment for a guided tour. This way, you will be shown all the features of the home and won’t miss anything. However, if I was considering a home, I probably would go back on my own at another time just to check it out, and I would ask lots of questions. Just make certain you are asking the questions of someone who should know the answers. There are a lot of employees in a nursing home and because so many wear scrubs, it is sometimes hard to tell who does what, without asking. When doing the guided tour, I would ask about mealtimes and what I would have to do to sample the meals the residents eat. Food is such an important part of a resident’s social life and wellness program that I wouldn’t leave it to chance. Check out the menu and find out if the residents have choices in the food they eat or do they just have the required main meal and one alternate. Obviously, the more choices they have the happier they will be. Happy eaters usually eat better and are healthier. And while we’re on the subject of choices, what activities are offered? A wide selection of activities helps the days go by pleasantly and with increased socialization, wellness also statistically improves. Religion also plays a large part in our lives, so you will want to know if spiritual needs will be met for your loved one. If you have questions about how the costs of the nursing home will be met, ask. Most homes will help you with the necessary questions, and some of the answers, so you can plan for the financial needs. Check out whether your primary care physician, will continue to care for your loved one in the nursing home and if they will make visits to the nursing home. Sometimes it is better to change to another physician, who will make nursing home calls if yours won’t. Other times, residents who can, leave the nursing home for visits to their physician. Ask who the Medical Director is, and while you are at it, find out if the home can take Medicare A residents, or if your loved one would have to go somewhere else for skilled care following a hospital stay. It’s always comforting if one can return to the familiarity of their own bed following the stress of hospitalization, rather than having to go somewhere else first. Those facilities who can take Medicare A residents are considered “Skilled” and are able to give a higher level of care than those who are not “skilled.” Of course, I am always ready to help anyone considering nursing home placement for a loved one. It is always a stressful time for families and it helps to have a guide who is sympathetic and familiar with the process.

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Senior Living

Lynn Spragg

2010-12-01 14:26:00

Question: Next week we have to move my mother out of the home she has lived in for 48 years and into an assisted living facility. Although she is willing, she says that since it does not feel like home, it makes the family seem distant. Are there ways we can help make her feel more comfortable and connected?

Answer: I am so glad you asked! Many small things can make a big difference in helping your mom feel connected to her family. Some of these things may be obvious, but because they are so common, they are frequently overlooked. Think about the needs that have necessitated the move, and remember to think of things that you can do to help make that better. Is your mom hearing or visually impaired? Many times, families will call daily, but because their loved one has hearing loss, they are not sure what they said or sometimes even which relative called. Pride frequently will prevent them from saying that they cannot hear you. If they have vision loss, they may not be able to see the phone well enough to call as often as they like. The result is that they feel very isolated even though you are doing your best to keep close. Take an inventory of your mother’s conditions and address those needs. Simple things like amplified listening devises, phones with your number saved or larger, lit buttons are simple things that make staying connected possible. Another thing that people often over look are family photographs. Having current pictures of family means everything to someone in assisted living. However, something even more helpful is scheduling regular appointments to take family pictures which include them. A room filled with pictures of the family together reminds assisted living residents that they are not tucked away to be forgotten. It also gives them ample opportunity to talk about the family to other residents and staff, which also reminds them that they are still an important part of the family. Lastly, remember to need your mom. Call her up and ask for advice regularly. Ask her opinion on the things going on in your life. Often, leaving a home behind also represents leaving behind a time when you felt useful. Schedule time to have your mom teach something she enjoys at the assisted living facility, or to the family at home. Being needed in the most effective tool helping people feel connected, valued and useful.

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Senior Living

Murl Webster

2010-12-01 11:33:00

Question: My friend’s mother doesn’t have enough money to pay for nursing home care and yet he was told that Medicare won’t pay for her. Why not?

Answer: Well, I don’t know your particular case, but I would suspect he may be getting Medicare and Medicaid mixed up. Medicare as used in a nursing home is only for someone who qualifies because they have been in a hospital for the required days and must have what is referred to as skilled nursing care. They must also have Medicare A insurance, which they have to pay for, and either enough money to cover the co-pay or a “medi-gap” insurance policy, which covers the difference between what Medicare pays and the balance of the bill or they must have what is known as a Medicare Advantage Plan. Medicare can seem real complicated. It can get very complicated when a Medicare Advantage plan is used instead of a Medicare, medi-gap policy combination, only because each plan is different. The simplest form of Medicare, at least for us in the nursing home profession to deal with, is the government issued Medicare A policy and a privately issued medi-gap policy. In that case, the government i.e. the Medicare program pays for required “skilled” care for the first twenty days of a nursing home stay and them requires co-pay for the next 80 days. However, to get that payment, the resident must “qualify” for Medicare A payments. They must also not have used up some of those days previously within the same qualification period or their benefit will be decreased by that many days. Remember, this is a government program! We are only going to talk about the use of Medicare A in nursing homes here, and then only touch on it lightly. To deal with it in detail would require a very thick book. The first qualification for Medicare A in a nursing home is the resident must have had a three night qualifying stay in a hospital. That means they must have been admitted to the hospital for a reason that will require “skilled” follow-up care in a nursing home. One of the problems we are seeing with the use of Med A for residents is that many times hospitals bring a person in for “observation” rather than “admitting” them. That precludes the use of Med A in the nursing home. If the resident is admitted to the hospital for the required three-night stay, then it must be determined if they require “skilled” services in the nursing home. While it can be complicated on what the requirements are, basically, it means that if the resident requires therapies or specialized nursing services, because of the hospital stay, then they can qualify for Medicare A in the nursing home While Medicare A, will pay for up to 100 days, they seldom do because the specialized services usually aren’t needed that long. When the resident no longer needs the “skilled” services, whatever they were, then Medicare A will cease payments. The resident then must pay for their stay out of their own pocket, unless they have long term care insurance or they previously have been admitted to the Medicaid program which provides financial assistance for nursing home care to those who are unable to pay for it themselves.. The real issue here is that you must fill out an extensive application for Medicaid and be found in need. The folks at SRS, who receive these applications, are very very busy trying to take care of everyone. Oftentimes there is a wait, not because they don’t want to help you, but they are just so overburdened with applications. Even if you are admitted to the Medicaid program, it does not mean that all of your nursing home care will be paid for. The program will assist in the payment of the costs, but in many cases there is a “resident liability” based on the resident’s assets. Medicaid takes into account all income and assets while calculating how much they will assist in the payments for nursing home care. If the original question was: Will Medicare pay for my mothers nursing home care and if she wasn’t in the hospital? The answer was probably a no. However, many people get Medicare and Medicaid mixed up. Maybe your friend should have been asking if Medicaid would help pay for his mother’s care. To find out if Medicaid can assist in his mother’s care he should contact SRS at 316-337-7000.

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Senior Living

Lynn Spragg

2010-11-01 13:31:00

Question: My mother is 82-years-old, are there any resources of financial services available to help pay for her assisted living room? Say I have $1,200 a month, and assisted living typically costs $2,500 - 3K a month. Please help!

Answer: This is one of the most common problems facing older Americans and their families. In fact, only those with expert retirement planning or long-term care insurance are truly able to pay the full rates in most cases. Although it seems costly, assisted living care is tailored to meet the needs of the residents and the cost is comparatively low for other long term care options. Still, affording a long term care facility can be difficult. Most often, it is necessary to pool resources from several places. I will try to offer a few ideas to get you started. Medicaid is a government program which may be able to assist in paying for a portion of the rates. Program eligibility is based on income and personal resources. Some people have long term care insurance as part of an insurance package. If your mom has been keeping insurance, find out exactly what is covered. Even if it is clear that she has long term care insurance, it is still necessary to find out what is included. If your mom owns a home, a reverse mortgage is another option. This is a special type of loan which allows the homeowner to convert a portion of the equity in their home into cash. The Department of Housing and Urban Development or HUD also offers federally insured reverse mortgages to those 62 and older and meet financial requirements. Wartime veterans and their spouses may also be eligible for Aid and Attendance Pension benefit through the VA. Senior living line of credit is a financing option that allows someone to move into an assisted living community before other funds kick in. Pooling family resources is another way families fund the care of a loved one. Often, loved ones find that they have assets they can liquidate in order to make up a portion of the bill. Some of these programs have a lengthy process of application and approval, so keep that in mind as you find the best options for you and your family.

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Senior Living

Murl Webster

2010-11-01 13:31:00

Question: I hear you’ve acquired a new staff member at your nursing home. What’s her name?

Answer: Yes we do have a special new staff member at Medicalodges in Goddard, and her name is Marlie. Marlie is a 3-year-old, female, Golden Retriever. She came to us when her owners were no longer able to keep her. She was originally saved by family, when the dog was owned as a puppy by a man who drove a truck and could not take care of a puppy while he drove across the country. A mother and her 12-year-old daughter agreed to take care of Marlie and she become a member of their family for three years. She was an inside dog, but was also often taken to the country where she could run and play. The 12-year-old and Marlie became inseparable companions. Mom would often find her daughter and Marlie lying on the floor, cuddled up and fast asleep. There were a few times when Marlie was found to have been invited into the girl’s bed to sleep beside her without Mom’s knowledge. It was a great start for a great dog. Marlie learned to love people. As 12-year-olds are prone to do, the daughter was growing up. The day came, that her prowess as a volleyball player dictated a move to the Goddard School District. The family had to move and as they sought housing, they found that Marlie could no longer be accommodated in their home. They tearfully decided to find a new home for the beautiful dog who had become such a beloved member of their family. It was while discussing the need for a home for Marlie with a staff member that Medicalodges Regional Vice President, Marla Nispel suggested that Marlie make her home at Medicalodges, Goddard. Family members brought Marlie to the home, to check out the reaction of the dog , the residents and the staff. The delight taken in the dog’s visit, by both staff and residents reassured the family she would be well taken care of. Marlie was delighted with all the attention and seemed to sense when a resident was concerned. Some folks she went to immediately, others she waited until invited. A staff “Marlie Committee” was formed to consider the entrance of a new four-footed staff member and to make plans for her integration into the community. Places to sleep, beds, water bowls, food schedules, potty schedules and responsibilities had to be considered. Residents had to be talked to and surveyed on whether they wanted to have Marlie in their home. Result of the resident survey was a resounding “Yes.” Marlie was wanted and welcome! August 15th, Marlie moved into her hew home, on probation for thirty days, but welcomed. She would sleep in the basement and be allowed on the main floor either leashed or supervised for the next 30 days until it was determined that she was a safe member of the community. Thirty days passed and Marlie was allowed off her leash and the freedom of the facility. She quickly learned which residents had doggy treats in their rooms for her. Some residents had family pick up doggy toys for her. She loved it. And the residents loved her. Oh there were issues, like the night she decided to bark in the basement. But for the most part, things went smoothly. The “Marlie Committee” met again and it was decided that Marlie had passed her test and would be allowed to stay on the main floor continuously, except for the early morning hours when she would be taken downstairs so she could eat undisturbed. It is not unusual for residents to be asking “where’s my dog?” As they go looking for the fluffy golden retriever. She seems to be especially gentle and accepting of those residents who are cognitively impaired. With them, she responds just as well to the name of their deceased pet’s name as she does to her own. Ambulatory residents are able to take Marlie out for walks giving both the exercise they need. Several requests have been received to have Marlie sleep in resident’s rooms. One even asked that she be allowed to sleep on the bed with her. In the interest of safety and sanitation however, those requests have had to be denied. Marlie is free to go to residents rooms however. She even was invited to one family gathering in a resident room and spent several hours with them. Some family members have even offered to provide obedience classes at discount for her. The comment that came with the offer however, was, “She could probably qualify as a therapy dog quickly as she is already so gentle and loving, and obeys so well.” Yes, we have a few staff/family members at Medicalodges Goddard and she’s making a lot of people very happy. Please stop by and say Hello to her. She may even give you a kiss!

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Senior Living

Lynn Spragg

2010-10-01 11:22:00

Question: What is the difference between senior housing, assisted living, nursing facilities and skilled nursing facilities?

Answer: There are some very basic differences in senior housing, assisted living, nursing facilities and skilled nursing facilities, mostly centered on levels of care. Determining which one is the right choice depends greatly on the ability of the senior, and which one best meets their medical needs. Senior Housing is housing situations with an age restriction requirement. In Senior housing, residents must be 55 to 62 or older, depending on the community. Senior housing can be independent houses, townhouses, condos, duplexes or apartments, or any other configuration you can think of in housing. The only real division in senior housing is that some of them are also income restricted. In an income restricted complex, (usually built with a government subsidy) only those who receive less than a certain income each year, are allowed to live there. The income restrictions usually allow differing amounts for individuals or couples and are adjusted up each year to allow for inflation. Usually the qualification is judged only on “income” and not assets. For instance, a couple could be millionaires in the value of their stocks, but if the income they received each year was under the limit, they could live in “income-restricted” housing. There are several examples in the Greater Wichita Area of “income-restricted” housing. Assisted Living Facilities (ALF’s) is another form of senior housing, but is designed for those who are not able to care for themselves, and perhaps need differing levels of oversight. Those admitted to “assisted living”, or “residential care” may need something as simple as help taking their medications to stay well or other more advanced levels of care. However, to be able to live in residential care, one must be able to perform most of their own activities of daily living, defined as eating, dressing, toileting and walking. In assisted living, bathing help is available. Residents in “assisted living” often still have their own cars and can come and go as they please. Others have chosen assisted living when they were no longer able to drive and/or wanted the convenience of someone taking care of housekeeping and meal preparation for them. Residential care also allows for couples to share their accommodations if they choose. In some cases, a spouse, who is unable to help their partner as much as needed will choose residential care so they can continue life together in a much less stressful environment, where the chores are taken care of for them, and they can sit back and enjoy life. In an assisted living environment, the majority of the “help staff” usually are certified medication aides who are trained in the dispensing of medications and have previously qualified as certified nursing aides. Due to their training, they are able to watch for health indicators and to alert the licensed nurse when she comes in. They also are able to summon assistance when needs are beyond their training. Sometimes only a door separates the residential care complex from the skilled nursing facility which has licensed nurses on duty, and available for immediate care, 24 hours a day. Nursing Facilities and Skilled Nursing Facilities or nursing homes as they are more commonly called are definitely a step up in care over assisted living. Once a person no longer meets the State mandated criteria for assisted living, they are no longer allowed to live there. An assisted living provider can be seriously penalized for allowing persons who no longer meet state guidelines to continue living in an assisted living facility. Once a person no longer meets assisted living guidelines according to their “care assessment” they are appropriate for care in a nursing home. The “care assessment” is a state test, performed by persons specifically trained in that test, to determine the level of care they need and whether they are qualified for nursing home care. One of the qualifiers is whether the person is capable of performing for themselves their normal “Activities of Daily Living” (ADL’s) as mentioned earlier when we were discussing the qualifications for Residential Care. Nursing home care is much more intense and can vary from helping one with two or three ADL’s to total care. Elderly persons with dementia, who are unable to manage their lives are appropriate for a nursing home, even though they might be perfectly capable of performing all their own ADL’s. They receive the level of care they need, however intense it may be. Skilled Nursing Facilities (SNF) commonly referred to as “sniffs” differ from Nursing Facilities (NF) “niffs”. A SNF has the staffing and expertise, as well as regulatory certification to provide the higher level of care required by Medicare. A person who has undergone the requisite three-day stay in an acute care hospital and is released needing “skilled nursing” can only receive Medicare benefits from a SNF. Sometimes the ‘skilled nursing” is a form of physical, occupational or speech therapy. It may also include constant monitoring by licensed nurses, or special care that can only be provided by an adequate licensed staff. Nursing facilities, (NF) have licensed nursing staff, and in some cases meet the requirements of Medicare, but have just not been certified. Other times, they are located in more rural areas where adequate licensed staff is difficult to hire and they provide care for those who need a less intense regimen. It is not unusual for a certified Skilled Nursing Facility, to receive a resident from another nursing home which is a NF after that resident has been hospitalized. They provide the Medicare required services, before transferring them back to their original nursing facility when they are appropriately improved. “Rehab to Home” is a favorite expression for those who have completed their hospitalization and need more care, and usually therapies, before being released back home.

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Senior Living

Murl Webster

2010-10-01 10:11:00

Question: I just passed a survey party at a construction site and was reminded of a friend saying that nursing homes are surveyed annually. Why do they do that?

Answer: It’s a different kind of survey than you are familiar with. You probably are more familiar with the term audit and that is really what a nursing home survey is. It’s not because they don’t know where they are. All nursing homes who participate in either or both, Medicare and Medicaid are required to be surveyed, or audited, by a team of Nurses who are a part of the state survey agency. State agencies are contracted by the Centers for Medicare, Medicaid Services, ( CMS) to survey nursing homes annually. If CMS is a new term for you, it used to be called the Health Care Financing Administration, (HCFA), or HickFa for short. The purpose of annual nursing home surveys is to ensure the residents of those homes receive quality care. Surveys were actually started to alleviate abuse of nursing home residents, following the reporting of several high profile cases. The survey process originally was to check to see if abuse was occurring and to stop it if so. It was also to prevent abusive practices. The surveyors would enter a nursing home unannounced ( they still do today) and observe care practices, as well as sanitation, nutrition, and environmental conditions. Surveyors at that time contained both Registered Nurses and persons who were well-versed in other than clinical areas, such as maintenance. However, over the years, that has changed and only Registered Nurses are on the teams. Each one is widely trained in care home issues, including such areas as maintenance. Originally surveyors or team members had wide discretionary powers and were able to assist the care homes in correcting deficient practices. In many cases errors were found, but they weren’t intentional. Along with the birth of the survey, was the idea of consequences and ways of measuring how good the care was in a particular nursing home. The scope and severity matrix was an answer to that issue. Scope in a nursing home survey, is designed to indicate whether the instance is isolated, whether there is a pattern of errors, or whether they are widespread. Severity is pretty well self explanatory. Any time surveyors find an error, whether it is in resident care or paper documents, it is cited as a deficiency, or deficient practice and is assigned a letter for location within the matrix. Over the years, as laws and regulations have changed so have the methods and requirements for the surveyors. However, their professional opinion always was a large part of the survey and how deficiencies were cited. Each state had its own team requirements as well as individual surveyors opinions. Many organizations have condemned the wide differences in the way each survey team worked. Complaints were made that due to the large variation in the survey system, the system was not fair. Many new laws were enacted, trying to create a more equitable survey system. The laws proliferated to the point where there were more regulations for nursing homes than there were for the nuclear power industry! And there were still inequities. Finally, it was decided to use the power of the computer and data banks to develop a totally new way of surveying nursing homes in an effort to treat all homes equally. The new survey system is called the QIS (Quality Indicator Survey). Using the new system, surveys are more uniform and the new system is more fair. But I’m not really certain I’m glad about that. Having looked at nursing homes in several states, and actually been an Administrator in two states, I think I’m disappointed. I was proud to be from Kansas, which has had some of the toughest surveys in the nation. I believe they also are the best surveyors in the country. From the first survey I went through as an Administrator-in-Training, to the last one I just went through a few weeks ago, I have always considered surveyors my friends and partners in caring for God’s frail elderly. Staff and surveyors work as a team to ensure the very best care and quality of life for those who are living in nursing homes. Each day, as I watch our staff members take care of the residents I am in awe. The love they lavish upon the residents is beautiful to behold. It is obviously much more than a job to them. It is a calling, a mission they live each day as they care for God’s frail elderly. Perhaps that is why Medicalodges Goddard had such an exemplary survey.

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Senior Living

Murl Webster

2010-09-01 13:38:00

How did you become a hypnotist?

Answer: Honestly I was practicing simple hypnosis before I ever knew what it was. As a brash, arrogant young reporter for the Capital-Journal, in Topeka, smelling an expose’, I got involved with a metaphysical group who did meditation as part of their meetings. In 1973, meditation was written in quotes and people who did it were only one step removed from the “hippie” label. Getting bored one night when it was my time to keep the time for the meditation, I started making suggestions for good experiences the participants would have during the next week. At the next meeting, they all reported back on the good things that had happened to them during the week – just like in meditation. And they wanted me to be the timekeeper/suggestor again. Of course, the results were hit-or-miss because I really didn’t know what I was doing, or how to actually formulate effective suggestions. A few years later, while attending a national conference of the Association for Past Life Regression Therapies , I decided to take a beginning course in hypnosis. The course was taught by a member of The Rose Institute in Ft. Lauderdale, FL. I was totally shocked to be “learning” techniques that I had stumbled upon and was using in my “Guided Meditations” I’ll admit, when I see some one advertising they do “guided meditation” I chuckle a little bit, realizing that they, like I was, probably are not really very well trained in the art and science of hypnosis, which is what they are really doing. At the time I took The Rose Institute course, it was owned by Dr. Brian Weiss, MD, Chief of Psycho-pharmacology at Cedars of Sinai Hospital in Miami Beach, FL. Dr. Weiss was the darling of the conference in that he, a devoted scientist, had just “come out” about the efficacy of past life regression therapy and the evidence for the credibility of past life memories. Dr. Weiss’s new book, detailing his first experiences with past life therapy, “Many Lives, Many Masters” was on sale at the conference. Hypnosis is such an evolving art and science, that one who aspires to be one of the best in hypnosis must constantly study to stay up with the latest developments, and progress on his own I have studied hypnosis since the very first experience with The Rose Institute. There were times that I tried other interesting careers – and enjoyed them all. However, hypnosis has never lost it’s luster of attractiveness for me. After years of education and study with some of the great masters of hypnotism like Donald Kahl, Steven LaVelle, Ormond MacGill, Allen Chips and Gerald Kein I have learned some very powerful techniques. However, there was one common thread that I learned from all the greats. Each of them said, “ If you don’t try to do it better than what you have been taught, don’t call yourself a hypnotist. You’re just a robot.” With years of hypnosis practice and years of education, I have been lucky enough to be able to combine those wonderful techniques and distill from them an even more powerful form which we call “Energy Hypnosis” As you read this, I will have just concluded teaching my first class of Energy Hypnosis, giving to others, this wonderful way of helping others, quickly and permanently to change their lives for the better. If one wants to become a hypnotist, I would recommend getting a course from someone who has the experience to be able to teach from. There are a lot of schools out there which claim to teach “Hypnotism.” Honestly, they all do. The only concern is, the quality and effectiveness of the techniques they teach, as well as who is actually doing the teaching. A few years ago, I referred a protégé to a school that I had attended earlier, thinking she was going to get an excellent hypnosis education. However, the man who owned the school, had turned most of the teaching over to a student of his, due to health issues. The protégé returned with a minimal amount of the education I had expected her to receive. That experience was one of the things that told me, I had to start teaching new hypnotists and new techniques. One thing I would caution anyone interested in learning hypnotism about. Beware of the weekend hypnotism school. Yes you can become a certified hypnotist, but I can guarantee you, you won’t be very good. You will have only gotten your feet wet. Hypnotism degrees are also a warning sign. They just aren’t real yet. However, with the academic community beginning to recognize the efficacy of this profession, I have hopes that a school will soon give courses leading to a degree in hypnotism. Right now, most schools have degrees in psychology with minor courses in hypnotism, and many of those are so old-fashioned as to be ludicrous. I split my school in two sets of two weekends each. Then we teach single technique courses on a continuing basis so those people have completed our Beginner to Intermediate and Intermediate to Advanced classes, can continue to hone their skills. Hypnotism is a hands-on technique and can’t be learned only from books or lecturers. It must be practiced. Students along with their certifications, at whatever level, also receive homework in the form of practical assignments. That is the only way they can possibly reach the levels of expertise that are needed. How did I become a hypnotist? I studied in many schools and with many masters. And also with many people who obviously weren’t masters. However, it is a labor of love. I’m always available to talk about hypnosis and/or learning it. It’s been one of my favorite subjects for many years.

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Senior Living

Lynn Spragg

2010-09-01 10:09:00

Question: My mother is elderly and lives alone. My sister and I both know that she is not taking proper care of herself. Any time we approach the subject of placing her in an assisted living, she begins to cry and questions our love for her. We immediately quit talking about it and feel guilty for even bringing the subject up. We both have full time jobs and are not able to spend the time with her, making sure that she is cared for. We have tried home health, but she needs more than they offer. Where do we go from here?

Answer: First of all, let me begin by saying that you are not alone. Many families have come to me with the same scenario. It is very difficult for anyone to give up their home and their life as they know it. Change is not easy for most of us. Perhaps your mother is also fearful that she will be giving up her independence as well. Fear of being accepted by the other residents is another concern for many. Whenever we admit a new resident, I try to remember how scared I was my first day of high school. It is the fear of the unknown that typically scares us. Those are undoubtedly some of the same feelings your mother is experiencing too. Assisted livings are the answer for many because they are able to give as much or as little assistance as needed, yet still allow residents to maintain their independence. Residents furnish their apartments with their personal belongings; continue seeing their own primary care physicians and family and friends visit, just as before. The added benefits of choosing the right assisted living is that you will have peace of mind knowing that your mother has twenty four hour assistance, if needed. In addition, she will be assessed by a competent nursing staff that will alert both you and her physician if any changes in her medical condition should arise. One of the greatest benefits that I see in facilities is the socialization aspect. You have seniors who spend most of their day watching television and never interact with other people. Then when they come to assisted living, they start participating in activities, dining with other seniors, forming new relationships, and their outlook on life takes on a new meaning. Placing a loved one in a facility is an agonizing decision. However, it is also one of the most courageous and selflessness acts that you can do for a loved one needing more assistance with the activities of daily living. Making the decision to move your mother into an assisted living is actually the easy part. Choosing the right assisted living takes time and effort. My suggestion would be to start out by bringing in brochures and information about assisted livings in your area. Perhaps your primary care physician or minister would also assist you in approaching this subject. There is strength in numbers. You could start by touring assisted livings with your mother. Call ahead and ask to share a meal with the residents and staff. Watch and see how your mother reacts to the different facilities. Is the staff friendly and helpful? Is the Administrator or Director available to answer any questions? Is there a beauty shop in the facility? What activities are offered? Talk to the other residents. Ask them if they are happy living there. If your mother still refuses to move and her safety is of concern, then I would try a compromise. Ask her if she would be willing to “try out” an assisted living on a trial basis. Many assisted livings also have furnished apartments available with short term stay rates. Good luck in finding the best assisted living that meets your mother’s needs.

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Senior Living

Murl Webster

2010-08-01 12:54:00

Question: What is the most important element for a successful hypnosis session?

Answer: I would have to say it would be desire or maybe belief. Actually, when it comes to achieving anything in this life, those two, very closely allied mind sets, are of utmost importance. You know, many years ago, I read a book by Napoleon Hill entitled “Think and Grow Rich” I really didn’t understand it at all then, but one thing did stick in my mind. In that little book, which holds the key to achievement, was a statement that I never forgot. “Anything the mind of man can conceive and believe it can achieve.” Mr. Hill summed up the whole book in those few words. The rest was mostly, “how to...”, explanations. When a person comes in for a hypnosis session, we talk about their desires, and whether they really want what they are asking for, or whether they just think it might be “nice” to have it. We talk about why and how hypnosis works, so they have the opportunity to believe that it will work. The mindset, or attitude of the person who is seeking to change their life by hypnosis, is critical to the success of the session and their achieving the goals they seek. We discuss the various mindsets and what happens with them. For instance, the person who comes in saying, “I’ll give it a try, but I know it won’t work” ….. is absolutely right. They desire failure and an excuse for it. Some people come in with the attitude, “I hope this works.” It is guaranteed not to. Because hope, is a failure word. It ranks right in there with “Ill try this and see if it works” Again it won’t because both “hope” and “try” presuppose failure. Have you ever known someone who was really in trouble and they were praying for God to come help them out? They maybe were feeling a little guilty about some of the things they had done so they prayed, “God if you’ll just do this …… for me I’ll try to do better.” Why did they tell God they would “try” to do better? Because they intended to fail and they didn’t want to get caught lying to God. “Try” is a failure word. We also see clients come in with the attitude, of “OK, I’ll do this and see if it works” and it won’t! The only way hypnosis will work is if the person seeking to change their life has the attitude, of “I like this and I know it’s going to work. I want this to work” If they have a strong desire and the belief that it will work. Of course, sometimes people want something to work but they are afraid it won’t or afraid they will be manipulated by the hypnotist. Sometime, the client is mostly afraid the session will work and of achieving the goal they set for themselves. If that were to happen, then they would be accountable for what they did with the change, and that can be downright scary. As I’ve heard since I was a child, “Better the devil you know than the devil you don’t” Many of us cling to the familiar, and often painful, because the new, or change is so very frightening. We’re afraid we can’t handle it. However, there is another fear that I believe many of us carry. It was described so beautifully by Marianne Williamson a few years ago when she said: “Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness, that most frightens us. We ask ourselves, who am I to be brilliant, gorgeous, talented and fabulous? Actually, who are you not to be? You are a Child of God. Your playing small doesn’t serve the world. There’s nothing enlightened about shrinking so that other people won’t feel insecure around you. We were born to make manifest the glory of God that is within us. It’s not just in some of us; it’s in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our fear, our presence automatically liberates others.” So many times, I find clients who come to me, wanting to change their lives. They come to me, hating what their lives are, but so very fearful of what will happen to them if they are successful in achieving their hypnosis goal. Often times, I have a spouse who comes to me, wanting to change, seeking happiness, but so very fearful of what will happen to their marriage partner, and to them, if they suddenly change into something better than they have been. Sometimes the mother fears what will happen with her children if she suddenly changes into the person she so longs to be. She fears to lose their love. And yet, when I see them change, and heal, I also see the changes that occur with family members who are able to be around this new, wonderful, positive person. It is such a testimony to the wisdom of Ms. Williamson. Napoleon Hill in his books focused on the fact that to achieve great things, one must have a great desire for them. His term was a “burning desire”. When one has a want, of desires something, but the want or desire is weak, it is usually a product of a lack of belief that they can have what they want, or a lack of belief in themselves and the ability to achieve their goal. However, there are ways of creating the “burning desire” of belief in achieving. If you are willing to do the work, you can work on visualizing what you want as actually being real. You can imagine that you already have it. You can imagine what it feels like to have it. Imagine what you can do when you have it. You can work with your imagination until you get very emotional about having it, and then it can happen. As you imagine, you can create the emotional state that is so very powerful. Albert Einstein once said,” Imagination is more powerful than knowledge.” Napoleon Hill called his book “Think and grow Rich”, but if you read the book, thinking is only the first step. Hill talks about imagining and feeling what it is like to have what you want too much. He also says that before you can get to that step, you must decide what you want. Be very specific. Once you have a desire, go to work on it, create that burning desire for it. Imagine that you already have it. Don’t do like I did so many years ago, when I first read this gem of a book. I wanted several things, but not a whole lot. I gave myself permission to fail by asking, “but what if what I want isn’t the right thing to want?” If you have several wants, pick one and focus on it. Go through the steps to get it, and you just might find that by doing the exercise to achieve that want the most, you also get all the others. You don’t have to start out, with a burning desire and fantastic emotions about it. But you can work on it. So what if you don’t get what you want immediately? If it is worth having, it is worth expending a little energy and time to achieve it. Anyone, no matter what their circumstances, if they will work on their goal can achieve it. Of course, if you’re like me and “want it now” you can use some of the tools I do. Hypnosis helps me to reach the more powerful levels of achieving so much faster, than doing it the hard way. Hypnosis let’s me leapfrog over many of the beginning, slower steps and get right to the “good” parts. Years ago, as a young man in my twenties, I went to Eureka Springs, AR to a folk festival. While there I wandered into a “String Shop” which was mostly guitars. I walked around, dreaming about being able to play, as other folks walked in and began taking guitars off the walls and jamming. It was a folk festival so there were lots of folk songs. I thought it would be lots of fun to be able to do that too. But during a break in the jamming, an older gent reached up and took a guitar off the wall and began playing it in the classical style. Everyone in the store went silent as we listened to the beauty of the music flowing from his fingertips. It made my soul soar. I didn’t sleep well that night, tossing and turning and thinking about the beauty of that music and how much I wanted to be able to play like that. The next morning, about 10 am, the “wanting” had turned to “burning desire” and I went back to the store, bought a guitar and a classical guitar instruction book. I wanted that so bad, I decided that I would never let a day go by without practicing on that guitar for at least 5 minutes. A year later, I gave an impromptu concert of classical guitar music to my friends at a party. Burning desire and the belief that I could achieve that skill made it happen. Anyone can do the same thing, with anything they desire enough. Desire and belief are the two most important elements of a successful hypnosis session. Desire and belief are two of the most important elements of success in life. And of course, hypnosis to make it all happen faster. Murl Webster, LNHA, BCH has been helping his fellow man with hypnosis for more than 30 years. He has appeared on television and has given hypnosis advice over radio in 14 countries. He is the founder of Lifemasters llc where he gives classes in hypnosis and provides clients with personal hypnosis sessions. He is an ordained minister and a spiritual healer. You may e-mail him at Lifemastersllc@yahoo.com

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Senior Living

Murl Webster

2010-07-01 12:50:00

Answer: As Charlie would say, I’m glad you asked that. Actually we have much more control over what we think, than most of us realize. In reality, we control every thought. Consciously though it is impossible for us to monitor every thought we have and to therefore control it because there are too many to think about.

However, there are many ways to control our thoughts, and therefore our state of mind. Our state of mind is the real crux of the matter. Our state of mind can affect every part of our lives, whether it be relationships, job performance, health, or anything else. We as human beings are complex combinations of body, mind and soul. Anything off in one area is likely to affect the others. In some cases, I have seen people who let themselves get into a downward spiral because they felt helpless in changing one part of their lives. They began to experience problems on all levels and it continued to get worse. I’m certain that you too have met these people. I have heard, and read in many reports varying percentages quoted on how many physician visits are linked to stress. However, the number seems to be somewhere above 75% in all reports. The American Institute for Stress says somewhere between 75 % and 90 % of all visits are stress related. The Mayo Clinic says psychological stress is the best predictor of heart attacks. I don’t know about you, but to me that is downright scary. Stress is a thought process. Oh I know. A lot of people will laugh at that. They will tell you that stress is caused by outside forces like the economy, by the baby crying all night, by the bad weather that is ruining their crops, or by the kids who just won’t mind. Sorry, but that is just not true. Stress is caused by what you think about those occurrences, not by the occurrences themselves. For instance, how stressed do you think a businessman who earns millions of dollars each year would be if the weather was bad and he didn’t have a very good crop on his 40 acre hobby farm? He might consider buying an irrigation system for next year’s new toy but I doubt he would be very stressed about it. He would just think about all the fun he had with his machinery. However, the man farming a few thousand acres of dryland crops, might get pretty stressed out seeing the fields burn up during a drought. He would be thinking, "This is terrible. I don’t know if the bank will finance my operation next year and what am I going to feed my family with this year?" The difference in the stress is the thoughts they are thinking. How about two drivers, each on their way to the lake for a wonderful summer weekend. Traffic is bad and slow. One driver is thinking how bad the traffic is and how all those idiots on the road are keeping him from his fun at the lake. He gets angry, his blood pressure increases, as does his heart and respiration rates. The other driver, listens to his favorite music, thinks about what fun he will have at the lake and how lucky he is to be able to take the weekend off. Both are in the same traffic, moving at about the same speed, going to the same destination for the same reason. Yet one, because of how he thinks of if, is terribly stressed, the other because of his thoughts, is relaxed. Stress is a thought process. There are all types of stress, but we can basically divide them into good stress and bad stress. Good stress helps you, bad stress is unhealthy So how do we sort them? We look at the physiological changes they cause in our bodies. Good stress, might be the joy of playing basketball with your friends. Bad stress would be getting angry at other drivers on the way to the game. Good stress could happen if you fall in love. Stressful yes, but so much fun! In all cases, our thoughts are the stress, not the occurrences themselves. That is why we need to be able to change our thoughts. Changing our thoughts is extremely easy, once we accept that it is a natural thing to do. There are so many very good reasons for changing our thoughts to less stressful ones. Of course we feel better if we are not stressed, but there are great physical changes taking places also. Anger, along with feelings of depression, have been shown in healthy men to increase the levels of IL-6, a protein that causes inflammation, and may be a part of arterial thickening. In situations where people are angry and feel they have little control over their lives causing increases in cortisol and epinephrine resulting in higher cholesterol and blood sugar levels. Diverting those thoughts which harms us is essential if we want to live good, happy, healthy fulfilling lives. A good technique, which I used to use when I had a lot of anger in my life was really quite simple I don’t remember where I read about it, but I give thanks to the author. I thought about five things that made me happy when I thought of them. Then, when I began to feel angry and think angry thoughts, I would take three deep breaths, and then think of one of the things that brought me happiness for at least 10 seconds. Usually, I liked that good feeling so much better that I would think of it longer. As I worked with that technique, I noticed something interesting happening. I was getting angry less often. And when I did it wasn’t as intense as before, when the anger would really grow. I seldom do that technique now, because anger is not an important part of my life. If I do find anger starting to poke up it’s nasty little head, I have different, even more effective ways of dealing with it, i.e., of changing my thoughts. Another technique for changing your thoughts, or at least of knowing when to change your thoughts is almost as simple. I really believe that if we are thinking the right thoughts we will be happy. As we mentioned earlier, you have so many thoughts in your conscious mind that you cannot possibly monitor all of them. However, monitoring your emotions is pretty easy. It’s as simple as "Do I feel good, or do I feel bad?" If you are not feeling good, it is because you are thinking unhappy thoughts. You are thinking thoughts that make you unhappy. Use a part of the technique that I told you earlier and find five things that make you happy when you think about them. (As you do this exercise over time you will have many more happy things than five to think about.) When you feel yourself getting stressed, depressed or unhappy in any way, think about one of those five things, and notice how the happiness grows within you. Now I know that there are times when we have a challenge and we have to think about a solution. Sometimes thinking about those challenges is not something that makes you happy. However, to manage the stress of the challenge, take a short break to think happy and then go back to problem solving. You will probably find that you are much more able to deal with finding a solution if you first take a few seconds to de-stress. Sometimes, the stress is so strong, or has become such a habit that it behooves us to use the help of an expert in order to change the situation faster. In those cases, hypnosis can be a very effective means of not only dealing with current stressors, but negating those that might come in the future. It’s another way of changing your thoughts. An hour of deep relaxation focused on living, and thinking, better is a great way to change your life Happiness is always in style. Murl Webster, LNHA, BCH has been helping his fellow man with hypnosis for more than 30 years. He has appeared on television and has given hypnosis advice over radio in 14 countries. He is the founder of Lifemasters llc where he gives classes in hypnosis and provides clients with personal hypnosis sessions. He is an ordained minister and a spiritual healer. You may e-mail him at Lifemastersllc@yahoo.com

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Senior Living

Murl Webster

2010-05-01 14:25:00

It is through accessing the subconscious mind, utilizing methods that relax the conscious mind, a process we call hypnosis, that all types of seeming miraculous changes can take place. In reality, science and modern technology tell us that the process is actually changing our brain chemistry so we can achieve the goals we have set for ourselves. Contrary to myth, anyone with a normal intelligence can be hypnotized if they want to be. Other similar myths about hypnosis, such as you can get stuck in it, can be forced to do things you don’t want to or can be made to tell secrets are just as untrue. Your personal will always is in charge while in the hypnotic state. There also is no swinging watch. Modern hypnotic methods can have you deeply relaxed in three or four minutes using words alone.

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Senior Living

Murl Webster

2010-05-01 14:25:00

You often mention changing your brainwaves while talking about hypnosis. What are they and why would you want to change them?

Answer: Actually there are many ways of changing brainwaves. The easiest way to change your brainwaves is to change your thoughts. Brainwaves always respond to what you are, or are not, thinking about.

However, let’s talk about brainwaves themselves just a little bit. Brainwaves are regular electrical impulses from the brain and are basically lumped into four different groups, each of which encompasses a range of brainwave frequencies. If there are any brainwave hobbyists out there, they will tell you there are hundreds of brainwave groups. But let’s just stay with the simpler groupings for now. Brainwaves are grouped into Beta, Alpha, Theta and Delta, with Delta being the lowest or slowest frequency whereas Beta is on the high end and is where we spend a lot of our waking day. However, our brainwaves fluctuate constantly with what we are thinking, what we are doing, our level of activity, our levels of stress and on and on. Every stimulus affects brainwave frequency. By the same token, everything which reduces stimulation also tends to affect our brainwaves. As you might guess, as stimulation decreases, so do our brainwaves usually. As we relax we normally find our brainwave frequency decreasing. I say normally, because with hypnosis, it is possible to relax the body and stimulate the mind to do some pretty miraculous things in the realm of healing. The science of brainwaves has been around a long time. They were first discovered in 1929. Many have heard of EEG’s or electroencephalograms. Very simply, these are medical/scientific machines for measuring the rate, or frequency, of our brainwaves. To do this, electrical probes are fastened to our scalps to sense the electrical waves of our brain. In the early days, to get an EEG, they shaved a few spots on your scalp and attached wires. Today, with modern technology you put on a rubber cap with the wires attached and they take many readings of the different frequencies within your brain at any one time. Medical doctors use the EEG for diagnosis. Others use it to better understand how the brain works or how to use the brain to affect the body. Which brings up another point. Different parts of the brain operate at different frequencies. For instance, the left brain can be operating at one frequency, the right one at another, and where the two frequencies hit each other, or "beat" a third frequency crops up. So why do we care? Because if we can control our brain; if we can control our thoughts, and if we know what the results are of doing it, we can cause healing, we can obtain a better life, more calm, or change our lives. As many have said – We are the product of our thoughts. Quantum physicists tell us that our thoughts affect everything about us. Brainwaves are part of the evidence they use. As we desire to change our brainwaves, we can use the conscious method of relaxation, and consciously controlling our thoughts. We can, with practice and understanding, put our brain into any brainwave area we want. We call that self-hypnosis. Many people don’t want to take the time to learn or to practice. They want it now! There is a way of doing that. Scientists, studying primitive cultures and cultural drumming, began to find some interesting results. Depending on the rate of the drumming, the people listening reacted differently. Slower drumbeats could literally lead a group of people into a trancelike state, whereas faster drumming could create a frenzy, a knowledge the witch doctors or shamans used often. The scientists began to study the causes of the reaction and with the help of EEGs were able to discover that the brainwave frequencies locked onto the drumbeats. The scientists however, reported "brainwave entrainment in the subjects." The brainwaves entrained with the frequency of the outside stimulus. They actually were able to prove brainwave entrainment scientifically in 1934. So began the scientific study of brainwave entrainment and its effects on humans. Today, we can use software programs (I have one on my computer in the office), to change our brainwaves, and to in effect, massage different areas of the brain to help us in many ways. Brainwave entrainment can be used to vary the brainwaves down in delta and thereby cause the body to deploy extra human growth hormone ( HGH) to speed healing. It can be used for the lazy man’s meditation, or relaxation. Programs are available to deal with ADHD, improve cognition and memory, enhance athletic performance, aid in study, reduce anxiety, enhance creativity, decrease blood pressure, help depression etc. The uses of brainwave entrainment are apparently endless as studies continue in the research universities. In the field of hypnosis, many of us, knowing we cannot personally work with all the people who need our services, create hypnotic CD’s which people can listen to and receive beneficial suggestions. They are very efficacious for some of the changes that people need. With brainwave entrainment, we often add a background brainwave track which makes reaching the hypnotic state much easier and quicker, for the listener, thus ensuring a higher rate of success for them. I use a brainwave track when I need to increase my creativity. I am consciously aware of the increase in speed of what I am doing, as well as the fact that ideas seem to come easier. I use them in conjunction with self-hypnosis suggestions to cut the time I need to spend in making desired changes. How can you change your brainwaves? Well you can just change your thoughts, get hypnotized, you can buy a software program, or you can kill a deer, tan its hide and stretch it over a barrel. Then let your neighbor pound on it while you sit eyes closed and cross legged beside it! All four methods will work. Some are better than others. C. Murl Webster, LNHA, BCH, has been serving his fellow man with hypnosis since 1973. He is the founder of Lifemasters llc where he provides hypnosis sessions and classes. He has been heard on radio in 14 countries giving advice and has given many speeches and seminars on hypnosis. He is an ordained minister and spiritual healer. He can be reached at sourceco@earthlink.net or you can leave him a voicemail at 316-617-1836.

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Senior Living

Murl Webster

2010-03-01 08:47:00

Question: How does hypnotism actually work? What does it do that makes it work?

Answer: I don’t know. As a matter of fact, no one really knows how hypnotism works. With the advent of new technologies, we can see some of the effects it has on the brain, scientifically, but no one really knows how it creates those effects.We can theorize as to what is going on. That is probably the best explanation we can get right now, and will probably be proved out over the years as new technologies increase our scientific knowledge of what now are those most intriguing mysteries of how our brain works, and how our body works. In fact, there are many studies being done today, that will help us to more than theorize about what is going on. I fully believe that many of the "scientific facts" we now have about such things will be totally disproved as we learn to delve into those areas of knowledge that are now considered "fringe." It wasn’t too many years ago that scientists were able to prove the rotation of electrons around a nucleus, in a little thing they called "an atom, the smallest particle of matter that can exist" We all know what happened to that "fact" We now know there are much smaller particles than this and that while measuring their movement, the thoughts of the scientist affect their paths. In some cases, the thoughts of the observer can cause the particles to appear or disappear. Most any intelligent person now accepts that everything is vibration and frequencies of vibrations have affects. In many cases we’re not aware of how or what those frequencies affect, but we are pretty sure they do. Good Vibrations is no longer just a "groovy" song from the sixties. Anyone with mechanical experience knows that bad vibrations can tear apart a machine. Maybe they can also tear apart thoughts, bodies and minds. Or maybe good vibrations can mend them, or cause them to run more smoothly or improve health. One of those absolutes of knowledge that we all learned in school, and most of us have believed all our lives is that the brain controls the body and everything we do. Right? I’ve just completed a book written by an MD , called "The Heart Speaks." In that book, she talks about the power of the heart. She quantifies it as a transmitter of about 3 watts power (way more than your cell phone). In fact, years ago, Ham radio operators were known to talk thousands of miles using three watts of power. The author also says that research being done today indicates the heart may be the control center and give commands to the brain! It may be that they talk back and forth in a symbiotic decision-making relationship. It has long been known that the cells of the body communicate so it should come as no surprise that two major organs could communicate. One of the facts that she mentioned in the book really caught my eye, as a hypnotist. The author stated that because of the power transmitted by the heart, the heartbeat of one person, can be read in the body of another person if the distance is not too great. She was not talking about being inches away, but feet away. A person on one side of the room, can be the measuring station for the heartbeat of someone on the other side of the room!If, with the very little we know, the heart can affect the body of another so completely, couldn’t a similar effect be what causes hypnosis to work. Could it be that the power of the hypnotist’s transmitter is received by the person hypnotized and acted upon, in a manner of communication that we really know nothing about? Well, in reality, that is going on! We really don’t know how hypnotism works. About the only things we do know is that it accesses the power and information in the subconscious mind and causes chemical changes in the brain, and in the functioning of the brain. That change is what causes, we think, the wonderful effects of hypnotism, either on the body or its thought processes. In our "normal" way of viewing things, we have assumed that it was the meaning of the words spoken by the hypnotist that caused the changes to take place. We know that words are vibrations (there’s that word vibration again) in the air. What if it is the effects of those vibrations, or the frequencies of the vibrations that are interacting with the vibrations of the client, causing the changes to take place. We know that most hypnosis takes place most easily when the frequency of the brain waves is down in the lower realms of Alpha, Theta, or Delta. Interestingly, hypnotists often find a lowering of their brain wave frequencies in sympathy with those of the client while working with them. It is called brain wave entrainment, and is a whole field of study now. Most hypnotists learn to control their brain wave frequencies while working with clients so they can be most efficient and effective. In hypnotism, we basically lump all mind definitions into the "subconscious" category for ease of explanation. However, we know that beyond the conscious mind is the subconscious, unconscious, and super conscious, or the collective unconscious. How it all works together we don’t know. But we are getting some delightful glimpses which tease us with the possibilities of wonderful things and realms to come. How does hypnotism work? We really don’t know, but there are some delightful suggestions which are raising their most intriguing heads. Do you think it might actually all come from the heart?

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Senior Living

Murl Webster

2010-02-01 08:42:00

Question: You’re a nursing home administrator. What do you think is going to happen with the State of Kansas cutting Medicaid payments by 10%?

Answer: I think we’re all going to suffer because of it. However, there is a solution. Hopefully, the Legislature will act fast to ameliorate the situation. The reason given for the cut was that the state general fund was depleted due to decreased tax collections because of the bad economy. By cutting Medicaid reimbursement by 10% they would save millions of dollars in payments to nursing homes. On the surface, it looks like a reasonable and necessary action. However, the long term and short term ramifications of this action, do not bode well for our state, our local economies, job availability or the care of our seniors. At the same time state officials were considering this 10 % cut to the Medicaid program, some state employees were being given 10% raises. In nursing homes I haven’t seen a raise for anyone above 2% annually in the last seven years. In some instances, I have seen companies actually CUTTING pay rates by 2%, just so they could keep the home open and the residents cared for. The 2009 Legislature froze Medicaid rates at the then current level, for 2010. Now they want to cut back the payments for the frozen rates by 10%. When the state perennially pays $14.00 per day less than the costs of care for Medicaid residents, homes which are willing to take care of these frail elderly persons, are in a constant state of scrambling for ways to cut costs and survive. Approximately 70% of operating costs of a nursing home are labor-related. It’s an easily understood statistic when you realize they have to keep nursing staff working 24 hours per day to provide the needed care. In reality, the first casualty when there is a high percentage of Medicaid residents in a home and not enough money to continue, is staff-to-resident ratios. Once staff (i.e. labor costs) are cut then one has to overwork the staff you do have, to keep the bankruptcy wolf from the door. When jobs are cut, not only care, but the local economy suffers. When small homes, in areas which have high percentages of Medicaid residents, have to sustain a 10% cut in reimbursement, we will see closures. Those closures come with resulting job losses and the local economies take a major hit. In many small communities, the nursing home is the largest employer and purchaser of items and services. A closure would be devastating. Many small rural communities in Kansas are already struggling to survive. Closing their largest employer/purchaser could sound their death knell. That would result in widespread unemployment, and greater losses to the state through unemployment payments Typically, every dollar paid out in salaries in a local economy is spent, (and taxed), seven times before leaving the area. If those taxes are not collected, it will result in an even greater shortfall in the state tax coffers. I hate to be talking only about dollars, because the effects of home closures would be devastating to the residents and their families socially and psychologically also. Many residents would have to be moved to other homes, far from families and friends. In some cases they would be unable to find a home at all, leaving them with families who are unable and/or ill-equipped to care for them. In other cases, nursing homes would be unable to admit new residents on Medicaid, because they couldn’t sustain the additional losses. There is a Bright Spot on the Horizon. Currently, the Kansas Health Care Association, and many providers are encouraging the legislature to pass a “bed tax” or “provider tax/assessment” It’s not often that we see a group asking to have a new tax imposed on them. The reason they are asking to be taxed is simple. Under the federal guidelines for Medicaid the state furnishes 30% of the cost of Medicaid, and the Federal Government pays 70%. The way it actually works, is Kansas pays the federal government, the 30 % of the costs of Medicaid in Kansas. The feds then add the 70% they pay ( all out of our tax dollars I might add) and then returns the whole 100% to Kansas. ( At this point we won’t get into the size of the bureaucracy needed to accomplish this.) If Kansas passed a provider tax and then sent that money to the feds, they would receive back about $3.34 for every $1.00 sent to the feds in provider taxes. The Kansas Health Care Association says that 91% of Kansas nursing homes would benefit from such a tax. That 91% are those who are taking the biggest hit from the reduced payments, because they have the most Medicaid residents. This tax, with the increased return, could save our nursing homes, our local economies and our jobs and ensure that our elderly are cared for. BUT! It needs to be done quickly. That means the legislature needs to act on this as soon as possible after their opening date so the assessment plan and state plan amendment proposal can be submitted by March 1, 2010. If submitted by that date then it could become effective by July 1, 2010, hopefully in time to save those homes which would have closed, and the jobs which would have been lost Actually, it is possible that some homes will not be able to weather the 6 months of reduced payments and will have to close their doors. This will throw their communities into chaos as families seek a new place of residence, out of the area, for their frail elderly, and as the jobless seek new employment, again probably out of the area. This tax plan was presented to the Kansas Health Policy Authority Board at their Nov. 17, 2009 meeting but they deferred action until 2010. We now have no time to lose. If interested persons will contact their legislators and tell them they want this provider assessment approved, it stands a much better chance of passing in the required time frame. It is essential for our communities and our honored elderly, the ones who provided for us as we were growing up, that state legislators step up to the plate quickly to correct this dire situation. As our representatives they are expected to follow our wishes. They can only do that if we make our wishes known to them, in a timely manner, so they can act accordingly. A simple e-mail to your legislator is very powerful If you don’t know who your legislator is, or want assistance in contacting them, please call me and I will help you in anyway I can.

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Senior Living

Murl Webster

2010-02-01 08:42:00

Question: I’ve been reading about long distance healing, and doctors who work over the internet. Can you do hypnosis that way?

Answer: Short answer: Yes, I can. Let me talk a little about what you have been reading about. I’ve been quite interested myself in the “distance healing” that you mention. Anyone who works with hypnosis, is aware that there are many mind-body connections of which we are minimally aware. Many of those connections were well-known previously, but as “Western Medicine” took over, they were discarded as old-fashioned, and not nearly so easy as “poppin a pill.’ Distance healing is also referred to often as “energy healing”. Churches have known about this for a long time. They just use different terms, like prayer. Now I don’t know about your personal spiritual practices, but I have found very few folks who don’t believe in some way that there is a power beyond our understanding. And that it can affect our lives. Personally, I am a Christian, and before every hypnosis session, I ask for help from that power that I call God. I believe that in every case of healing I do, there is other power working through me; That I am just the tool. Many of those who are involved in energy healing have the same belief systems that I do. They use a different vocabulary sometimes, but we all believe in that higher power which assists us in our work. Dr. Albert Einstein often rocked the thoughts of others when he uttered one of his many philosophical pronouncements, which seemed to be totally devoid of the math for which he was known. At one point he was said to have proclaimed that if one “followed physics far enough he would be in metaphysics”. He also proclaimed that everything is vibration. And my favorite, “imagination is more powerful than knowledge” Hang in there with me for a minute. There really is a reason for me quoting the great Dr. Energy healing has been labeled as metaphysical by many, because it doesn’t use something you can see. It doesn’t use solid objects, like pills to heal. Well, I guess I’d have to agree – it probably is metaphysics in Dr. Einstein’s terms. If we believe that he was right, that all is vibration, and energy healers work at changing sick vibrations to well ones it seems to make a lot of sense. Of course, if we progress beyond Einstein into what is now called Quantum physics, we find ourselves working with many of the laws and ideas that used to be in the realm of metaphysics. Quantum physics shows up right where Dr. Einstein said metaphysics would be. Hypnosis works in changing the brain wave frequencies i.e. vibrations, so that what we refer to as the subconscious, unconscious or super-conscious mind can affect both psychological and physical changes within our mind/body. Most of us believe we have a soul, which cannot be seen or measured by normal means. There are methods available now though which can measure a radiant energy in the live body, but which no longer exists when the body dies. Could be that energy is the soul that we believe in and talk about. Most of the hypnotists that I know and respect also believe in the soul and that often we work at a soul level, rather than a mind level. When we see the miracles happen in our offices, knowing that something way more powerful than we are is effecting the cures, we are almost forced to believe in “soul work” So, it comes as no surprise to us, when we are able to pick up a telephone and talk to someone miles and miles away, helping them into a deep hypnotic state and talking them through a cure for whatever is bothering them. We can do the same thing over the internet. Internet is more fun, because we can use a webcam there and see the person we are working with. There are many other distance types of healings that we can get involved in. Almost all religions recognize that sometimes there are “spirits” which are without bodies and sometimes attach themselves to living persons, causing them physical or psychological problems. Most of those same religions have ways of getting rid of the unwanted spirits. Jesus was known to cast out spirits and demons to allow persons to heal. Most religions have persons who are trained in these techniques. The Catholic Church for one, has their own trained personnel who do demon exorcisms, or depossessions. Interestingly, some of the early pioneers of hypnosis, worked in the same field and have passed their knowledge down to us who work in hypnosis today. With hypnosis, the term is “remote depossession” since it is accomplished by a hypnotist and another person who works, while hypnotized, as the intermediary. All they need to do is to have a name, and a time the person was at a specific address to be able to do their work. The intermediary on a soul level, asks the person to be scanned for attachments, if they have permission to do so.. Once permission is given, the hypnotist asks the intermediary to look for dark places on the person being scanned,. When they are found the hypnotist, through the intermediary talks to the spirit attachment and convinces it to “ go into the light”, a place that many of us happily call heaven. Persons who have had these remote depossessions, have reported the easing of physical and psychological symptoms at exactly the time the hypnotist and intermediary wee working with them. They also report that the attachments, as reported by the intermediary, were in exactly the places on their bodies that they had been experiencing discomfort.. Yes, hypnosis can be used at a distance. Sometimes, it seems a little far out, but as in everything, the proof is in the results.

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Senior Living

Murl Webster

2009-12-01 08:24:00

Question: Are all hypnosis sessions the same except for different suggestions?

Answer: Oh my goodness no! Hypnosis sessions are as varied as the client to a well-trained, modern hypnotist. The session changes to meet the client’s needs. For instance, let us look at the older, more traditional hypnosis session where the hypnotist helps the client into a hypnotic state and then gives direct suggestions for change. While this type of hypnosis has been effective for centuries, and still is, there are new methods of using hypnotism to change people’s lives. These new methods are so much more powerful, and can help in areas where direct suggestion just could not reach. The art/science of hypnotism has made such great strides in the last few years that in many cases, it hardly seems the same thing. During my seminars, I often tell people we have learned more about how efficacious hypnosis can be in the last year than we have learned in the last 30 years. Modern technology has been able to show the skeptical scientist that hypnosis is actually making changes in the brain chemistry of the hypnotized person rather than the old “It’s just mind over matter” adage. Interestingly enough, while that saying was used to denigrate the practice of hypnosis, new machines like the fMRI, and yes it really is spelled that way with a little “f”, have been able to prove that the mind is changing the matter, i.e. chemistry of the brain. While I love the simplicity of the standard Direct Suggestion techniques that have been around for so long, we are constantly learning of new ways to use hypnosis and also, new techniques for achieving off times, spectacular results. One of the techniques that I really love is one in which the body and brain are relaxed down in the traditional manner. However, once the state of deep relaxation is achieved, the body is allowed to further relax, but the mind is brought up, up, up to a very high state of focus and awareness. This technique is known by several names. One of the early experimenters with this state called it “hyper-imperium” The man who, I believe, has developed it the most, and copyrighted his name for it is Jerry Kein of DeLand, Florida. Jerry was one of my early teachers and of all the masters I have studied with, I hold him the highest, both as an effective, practicing hypnotist and the best of teachers. Unfortunately, Jerry has had to deal with some serious physical conditions the last few years and does very little teaching. Most of his classes are now given over to others They’re good teachers, but they just can’t achieve the heights of the master. One of the reasons that I now teach classes, is because I want students to have the opportunity to get the teachings as Jerry would have presented them. He always challenged his students to do more and better things instead of just performing the things they were taught, by rote. “Ultra-Height” is the copyrighted name Kein gave to his version of this very effective technique which seems to work for most issues. UH, as most of us refer to it, is one of those techniques where the client gets a wonderful experience of healing, or changing their life almost instantly. In many cases, once the client emerges from their hypnosis, they find their life changed. In some cases, the client gets information on things that they need to change in their lives to achieve their goals. Interestingly enough, they sometimes also communicate to the hypnotist, techniques to use with the client at a later time. . Again, as with many of the things that happen in hypnosis, it is not a scientifically quantifiable healing technique, but the anecdotal evidence is overpowering. While to many, the healings and experience during this type of session appear to be in the metaphysical realm, the healings and changes come to everyone, no matter what their belief system. I have had people describe their experiences to me immediately following the session and then ask “ Was that real?” I can only ask, “ Did it seem real to you? Do you feel better now?” When they answer yes I can only answer that if the results are real, that is all that really matters. Recently a lady with fibromyalgia went to a hypnotist friend for some help. She is an awesome conservative Christian who regularly takes a lunch hour for “fasting prayer” each week. She has an absolutely beautiful relationship with her God. She was guided into UH with the instructions that there was something in her body that needed healing, and she would find it there. She described to me the sublime joy of being so deeply relaxed physically and yet her mind was soaring. She described it as a “heavenly” feeling and “ then it was like I was on a jet-ski zooming from nerve to nerve, healing and calming them.” Needless to say, most of the painful trigger points of fibromyalgia are gone and her life has changed dramatically. Her legs, which have been grotesquely swollen for years were noticeably smaller following the session. She describes herself as “a new woman”. With changes in her “fibro” she has decided to change much in the rest of her life. She came to me a week ago and said, “I want to lose weight, but I don’t want to lose my figure”. She meant that she didn’t want to lose the weight from her upper body, where most women begin to lose weight first on traditional diets In the last eight days she has lost 5 pounds with no indications of her figure fading. Ultra Height (copyrighted) or Hyper-Imperium both use the powers that are hidden within us, as all hypnosis does. It seems however, to tap more powerful sources of change than are traditionally used. Often we find the client later reporting they heard the answers to questions, or what they needed to do. Others explain they read it, or sometimes they just suddenly “know” or “feel”. Whatever their experience, positive changes result. Sometimes, the client keeps the very private information or healing to themselves, not explaining it to the hypnotist at all, as is their right. Other times they can’t wait to share the wonderful thing that has happened to them. These techniques work not only for physical healing but for changing lives in any way needed. It has been used to help business persons to understand issues that were crippling them and consequently their business. It has helped in interpersonal relationships, addictions and many other needs. As always however, it has to be the trained hypnotist who chooses the specific technique which is best for the client’s needs. When choosing a hypnotist always feel free to “interview” them before working with them. Check their credentials, and their experience. Many hypnotists have been trained in out of date techniques that work. I found an old CD the other day, that I made for relaxation about 10 years ago. It worked, but I would be embarrassed to use it now. Today the techniques available to the modern hypnotist are so much more powerful and faster than ever before. Probably the best test of your hypnotist is whether you “feel good” with them. If you don’t feel comfortable with the hypnotist (not the technique), then it’s probably a good idea to get up and leave. Don’t be embarrassed to take action. A good hypnotist will understand, and you don’t want to waste your time with the other kind. Mayo College of Medicine calls hypnosis a “benign” or safe therapy. So give it a try. Change your Mind – Change your Life.

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Senior Living

2009-12-01 08:24:00

Question: Recently you finished a series on loneliness in seniors. The entire series was most informing. One of the most lonely times of the year seems to be the holidays. Do you have some additional information on ways to make these more manageable.

Answer: Thank you for the question. You’re right…talking about this subject as it relates to the holidays is not only timely, but it is also a perfect way to sort of “cap off” the series. Although the winter holiday season is supposed to be a time of sharing joy and good tidings, oftentimes seniors - find that, as the season unfolds they experience deep sadness and loneliness. . There are many influencing factors that can contribute to seniors being at particular risk of suffering from the “holiday blues”, including: Reminders of loved ones lost - For many seniors the holidays bring back memories of better, happier times. Many seniors have survived a number of their cherished family members and friends. Nostalgic memories of past holiday celebrations can lead to present cases of melancholy. These losses often take on greater significance during the holidays. The holidays are not what they used to be - For many older people, the memories of holidays past so outshine present day celebrations they feel unable to focus on or experience pleasure in the “now.” Unrealistic expectations - the holidays can bring a host of expectations, such as family togetherness, festive events and feelings of expanded happiness. Seniors can often feel lonely even at large family gatherings. The increase in the noise levels and the crowded activity can lead to a feeling of isolation for a senior who has suffered hearing loss. Reality too often falls short of these expectations, which can cause an individual to plummet to new lows of sadness, feelings of loneliness and despair. Spending the holidays alone - Some seniors live by themselves and/or at a distance from friends and family and spend much, if not all, of the holidays alone. Grown children often become busy with their own social obligations and may not realize how much their parents or grandparents look forward to sharing time during the holidays with them. Coping with failing health - The holidays can often serve to underscore the limitations failing health imposes on the ability to participate in once-enjoyed activities. Many older people face the reality of not being able to get around as easily as they once did. The stress and fear of being home bound adds to their disappointment. They find themselves unable to get out and shop. Small tasks as getting to the Post Office for stamps and to mail presents can seem overwhelming. The “let down’ after - While the holidays often bring more family and friends interaction they also can accentuate the loneliness afterwards. Many seniors who are busy with family and friend events over the holiday once again find themselves alone. Now the loneliness seems worse when compared to the flurry of activity over the holidays. What Can You Do? The following strategies can be useful in helping anyone not just seniors to get around potential sources of the “holiday blues”: Adjust the expectations - Include your loved ones in the planning and preparation of the events for the season. They will feel involved and really “planning” is half the fun. For example, if you think the perfect family get-together won’t be a part of this year’s holidays, keeping this realistic assumption in mind can help avoid frustration and disappointment. Limit predictable sources of stress - If the annual trappings of shopping, decorating, cooking and attending social events risks becoming overwhelming and stressful, limit these activities. Get together with friends and family members - As much as possible, share the holidays with friends and family members in person, as well as by phone, e-mail, and mail. The holiday season is also a good time to contact someone you have not heard from for awhile. For those who have recently suffered the loss of someone especially close, spend time with special friends and family with whom you can reminisce and share stories and cherished memories about your loved one. REMINDER: for seniors suffering from hearing loss, mobility problems, or minor dementia limit the number of guests at one time; instead ask family to make special one to one visits. This will eliminate the stress of a crowd and create a more special remembrance Attend holiday community events - Most communities offer special events during the holidays, such as theatrical and orchestral performances, that can be enjoyable to look forward to and to attend. Join a social group - Feelings of loneliness and isolation can often be remedied by participating in activities with others. This can also help in opening up the potential for making new friends. You might consider looking into groups affiliated with your local church, museum, library or community center. Engage in volunteer activity - Helping others is a pretty foolproof method of making the holidays feel more meaningful. There are many volunteer organizations that need extra help during this time of year. Enjoy activities that are free - Financial strain can be the cause of added stress during the holidays; however, there are many ways of enjoying the season that are free, including driving or walking around to admire holiday decorations, going window shopping without buying, making a snowman with children, and attending free concerts. Don’t drink too much - Many of the season’s parties and social gatherings include alcohol. Be aware that excessive drinking will only increase feelings of overwhelm or depression. Alcohol is NOT an antidepressant and, in fact, often worsens mood. Seek new, enjoyable ways of getting physical exercise - Exercising, for example, aerobics, walking, skiing, hiking, yoga, or swimming can help burn away a lot of stress as well as the extra calories of holiday meals. Adopt a pet - Many have found that assuming the responsibility of caring for and loving a pet brings new joy and companionship into their lives. Remember that life brings changes - As families change and grow, traditions often need to adapt to the new configurations. While you can hold onto certain family rituals, for instance, a certain holiday activity or preparing a long-cherished family recipe, some traditions, such as everyone gathering at your house, may not be possible this year. Each holiday season is different and can be enjoyed in its own way. Don’t set yourself up for disappointment by comparing this year’s holiday season with the “good ol’ days.” Spend time with supporting people - In all of the ways listed above - as well as any other opportunities you can think of that specifically apply to your life or an older person in your life - this holiday season when searching for a meaningful gift for an older family member or friend consider the “Gift of your Time”. It cannot be emphasized enough how important it can be to spend the holiday season in the company of supportive and caring people. You will receive a precious gift in return!

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Senior Living

2009-11-01 15:55:00

Question: Last month you ended your article series on loneliness in seniors with, “I will be back next month to explore volunteerism, a cure for loneliness.” We are going through a bout of what we think is “loneliness” with Mom, yet she is in good health and can be as active as she wants. Volunteerism may just be the “ticket.”

Answer: It may very well be. Over the past few weeks we have researched together the effects of loneliness on the elderly. We have discovered that loneliness can be stressful, debilitating and painful. We have discovered that loneliness is both social and emotional. As your “circle of friends” get smaller due to illness, moves to be closer to friends, lack of transportation or death an active social life can dwindle. Where do you go to find this group of friends to “hang out” with? As I began my research I quickly realized that I have many “older” friends and acquaintances who already found this answer and were actively practicing Volunteerism. What better way to discover where to go to get the “cure” and the effects of the cure on their lives than to hear directly from individuals who have experienced a positive impact on their lives through volunteering. I was privileged to interview several of these folks about their volunteer experiences and the effects it has on their lives. I asked all of them the same questions. Before I share the answers with you I want to introduce you to just two of the many individuals I interviewed this past week. Galen Quakenbush lives at ParkWest Plaza Retirement Community. You might have read about Galen in the spring 2007 issue of Health Matters magazine when he was featured in an article about Volunteerism. Galen has been an American Red Cross volunteer for 19 years. He coordinates transportation for seniors to and from medical appointments. Galen said two years ago when interviewed, “Volunteering gives me something to look forward to; it is good to know you have helped someone who needs it! “I look forward to getting out every week.” Two years have passed since Galen gave those quotes, he is still volunteering at the same position and his quotes were the same this week when April Leason from Park West Plaza discussed volunteering with him! Lois Cool who I am proud to say is my MOM, is an 82 year old female, married, still living in her personal home and still drives. Her social network has dwindled some due to age but she still socializes with my Dad and their friends, bowls, plays golf and is active in her church. Sounds like she is a busy lady and she is but she was looking for something more – something to allow her to give back to her community. She is a “pink” lady in the surgery center at a local hospital. Her primary role is to be a support person for family in the waiting room. She visits, holds hands, navigates the communication process for families, serves refreshments, and in general is a support person. She loves it!!! She is busy giving of herself to those in need. Is she is nurse? No – she is a caring individual who has been a caregiver all her life – for family and friends and now she is giving support and care to those she has only just met!! In our interview she said at least 3 times – “I just love this job! “ “I know you do MOM; I can see it in your face every time we talk about your volunteer position. Following is the list of questions about Volunteerism that I asked my volunteer friends and the answers they gave to me. Q. Why do you volunteer? 1. I enjoy being needed and I love knowing I can still help others 2. I was looking for friends 3. I wanted to be useful to someone 4. I retired but missed working Q. What benefits do you get from volunteering? 1. I don’t have time to worry about myself, volunteers are much in demand 2. I realized I have a lot of valuable talent I can share 3. I feel needed and useful 4. I have found a whole new group of friends 5. I realized even at my age I can still learn new things. 6. On the days I am busy volunteering the time just flies by, I am tired but it is a good tired. 7. I have something to look forward to and to plan for, I have a schedule Q How did you find the right volunteer positions for you? 1. “I looked for a volunteer opportunity where I could use my skills I practiced for 40 years at my job. You would be surprised how many youth groups, churches, and community organizations need my engineering and carpentry skills and knowledge, I am in demand!” 2. I love helping others and I am a good coordinator. My position at the hospital allows me to help and provide support for others. 3. I asked our lifestyles coordinator for suggestions. I found I could volunteer in helping others here in my community. I thoroughly enjoyed my conversations with these Active Volunteers. As I read the answers and reviewed my notes I discovered some commonality about these individuals. All talked about the benefits they received from their volunteer positions, they all expressed their desire to help others and not one mentioned being lonely!

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Senior Living

Murl Webster

2009-11-01 15:55:00

Question: Can hypnosis help my athletic performance?

Answer: From High School on up to the Olympics and professional sports, hypnosis is being used to improve athletic performance around the world. I don’t know of a single sport, with human contestants, where hypnosis can’t help the participant to perform at a higher, more perfect level. Golfers regularly use hypnosis session to lower their scores through more accurate and longer drives, putts etc.. They also are calmer and more exacting with their swing because of the work they do while in that wonderful, relaxing state called hypnosis. The story is that Tiger Woods’ father hired a hypnotist to go to every game with Tiger when he was 13 years old. I can’t confirm the story, but when I watch Tiger get ready for a drive, he certainly appears to be using self-hypnosis to concentrate and calm himself. But then when you really watch, almost all of the professional golfers are using hypnotic technique to improve their game. Olympians in all sports use self-hypnosis techniques to improve their performance. They call it “getting in the zone.” Most teams have a professional hypnotist available, if not as a regular member of the team support staff. I remember being in Danbury, Connecticut a few years ago, doing a seminar for group hypnosis to lose weight and stop smoking. My seminars consisted of three parts, with the first being a description of hypnosis, what to expect during the actual hypnosis sessions and some demonstrations of how effective hypnosis was with volunteers. During the break, a young man, who looked like a barrel of muscle came up to me and said “ You’re right about hypnosis to get in the zone, but I’ve lost it. I can’t get it back” Since he seemed a bit disturbed I asked him what he had lost.. He told me that he had been an Olympic wrestling medalist, but he was working in Connecticut at the time and had “lost the zone”. He again became a little agitated as he told me how he used to be able to get in the zone, but now was unable to. He had forgotten how. I reminded him of how I had explained earlier that the subconscious mind remembered everything that had ever happened to us. I explained that he hadn’t lost the zone, but instead has just lost the way to it. He had the zone still in his subconscious. I did a quick technique with him and helped him find the zone again. He was a grateful young man, and I was proud to have helped one of our country’s champions. I was blown away the next morning as we opened a new seminar about a hundred miles away, and the same young man walked in, this time with a strong tall girl in tow. He explained that she was his fiancé, and as an Olympic karate champ, she also needed help getting back to the zone. I was glad to oblige. There have been quite a few scientific studies done to determine if hypnosis actually was helping or if it was just that people thought they were better. In the studies, performances were quantified, and averaged, for groups of participants prior to being hypnotized. Then a portion of the group were given hypnosis sessions for improvement, while the other portion received only instructions to relax. The group which had received hypnosis showed a marked improvement over a long period of time as compared to those which only received relaxation instructions. Hypnosis can help in both team or individual sports. I always wanted to get my hands on Shaquille O Neal to improve his free throws, but could never get through the security ring to reach him. The uses of hypnosis to improve performance is almost limitless. In fact it may be limitless, because we keep finding ways to use it. For instance, a policeman, who is having trouble qualifying on the pistol range can improve his score dramatically and quickly with just one hypnosis session. Likewise the archer, hunter, skeet shooter, can improve their game. Long distance runners, or swimmers, usually go into an altered ( read that hypnotic) state to stave off fatigue. Lance Armstrong once was quoted as explaining that he went off into his imagination during a race, so he felt good and didn’t concentrate on the fatigue and pain. It is quite common, during contact sports for a player to be injured, but to play on without pain until later, because the subconscious mind understands the desire of the player to keep on with the game. It’s not that the player ignores the pain, but that in reality, the pain is removed, much as we do in the surgical suite. It is a form of self-hypnosis. Dancers use self-hypnosis techniques to perfect their moves, their concentration and to calm their nerves. Calming techniques result in softer, more pliable, stronger muscles which respond better to the controlling thoughts. Relaxed muscles are less likely to be injured. It also means without the muscle constriction of nervousness, there is more energy available for dancing. Whatever the sport, one of the techniques often used is for the athlete to go into a hypnotic state and imagine they are playing their sport perfectly. They are almost as if they are actually doing the sport as they practice in their minds. It has been noticed in some athletes that they begin to sweat after a period of imagined perfect play while in the hypnotic state. After working in this perfection of the mind, the athlete takes to the field, or floor expecting to do everything right. This is where the first law of the mind takes affect. The first law of the mind is “ That which is expected, tends to be realized.” I know many of you have heard a person say, “ I can’t do that” and then prove themselves right. And right after them, comes a person who really shouldn’t be able to do it, but believes they can. That person succeeds. Hypnosis can create those positive beliefs and implant them strongly in the subconscious mind of accomplishment. It can also remove negative beliefs, and replace them with positive thoughts. If you want to improve your game, hypnosis can help. Of course, when we talk about sports improvement, someone always asks about bedroom sports, Yes it can help there too.

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Senior Living

Larry Nanny

2009-10-01 15:50:00

Question: How do I know if my loved one needs a skilled nursing facility?

Answer: There are some instances when an individual needs skilled nursing care for a short term stay. This could be following a fall and broken hip, mild stroke, knee replacement, etc. These acute conditions usually require a brief hospitalization followed by rehabilitation to get the individual strong enough to return to their previous living arrangement. Other people have more long term needs possibly due to Alzheimer’s, extreme frailty, or major stroke. In this case, care is necessary on an ongoing basis. A person in need of a skilled nursing facility on a long term basis normally falls into one of the following categories: 1) An individual may not be able to care for themselves due to a physical, emotional or mental problem. 2) Some can no longer take care of their own Activities of Daily Living. This would be things like bathing, eating, dressing, toileting, or medication management. 3) An individual may need more care than can be provided by a care-giver at home. 4) Some individuals may have wandering tendencies to the point that they are no longer safe to be alone. 5) Some individuals may have extreme medical needs that makes it necessary to be under the care of a licensed RN 24 hours per day, such as tube feeding, IV treatments, dialysis management, tracheotomy care, etc. 6) Some individuals may need short term skilled care or nursing and therapy to regain prior level of functioning so they can return home. 7) Some individuals may have a drastic enough general decline that a physician will suggest an admission to a nursing facility.

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Senior Living

Murl Webster

2009-10-01 15:50:00

Question: What is hypnotic regression really? Isn’t it just someone who wants to pretend they were Cleopatra or something?

Answer: Sigmund Freud, at the peak of his career, said that the answer to all psychosis would be found by going back to the initial cause of it, with a technique as yet undiscovered ( at that time). Dr. Freud, didn’t know it, but he was very close to that technique at the time, having been experimenting with hypnosis. However, the eye fixation i.e. pendulum, technique, used to induce hypnosis at the time was extremely slow to use, and for many people didn’t work at all. Freund also said that hypnosis held great promise due to the immediacy of the results, if a way could be found to make it useful in more cases. The “Undiscovered Technique” that Dr. Freud was hypothesizing about is now termed “regression” A very effective technique for finding the initial sensitizing event that is causing one discomfort. Once the ISE “Initial Sensitizing Event” is discovered, various ways of defusing its’ effect on ones’ life can be used. As for “people who want to imagine they were Cleopatra” I’m certain there are some out there. This particular statement however deals with a certain type of regression which is known as “Past Life Regression” which has proven also to be an effective way of dealing with difficulties. So let’s define a little more clearly what we are talking about here. All of us know that progress is to go forward. To regress is to go backward. A hypnotic regression takes us back in time to when an event occurred that is now affecting our life. If it was helping us, we wouldn’t want to get rid of it, so we’ll assume for the present that all regressions are going to be done to help us deal with something negative in our present life. In this case, present means today, not 10 years ago. We will deal with the subject of past lives, whether they exist or not, a little later. Hypnosis, of course, as we’ve discussed before, is not a matter of the hypnotist controlling the client, but instead a team effort between them to achieve a stated goal, whether it is to stop smoking, relieve pain, improve test taking ability, eliminate fear, have easy, painless childbirth or any of the thousand other things it can help with.. Once the client enters into the highly focused state of hypnosis, working with their powerful subconscious mind the trained hypnotist then determines the direction to go, as any good coach does, to reach the goal. In many cases, the hypnotist uses positive suggestions and/or imagination to help the client make the changes desired in the super powerful subconscious mind. Often this is all that is required to make the desired changes. However, sometimes it becomes obvious to the trained hypnotist that some experience is causing the unwanted behavior. For instance, a disabling fear which is constantly getting worse almost always has its cause in something that was experienced prior to the experience of the conscious fear. To shield personal identities, I am going to give you an example which combines several cases. A client came in who couldn’t drive over a bridge without extreme fear, not only of the bridge, but he also feared it would cause him to faint and wreck his car, possibly driving off the bridge. He believed it stemmed from a time when he and a brother were swimming in the creek near a bridge and he had difficulties and almost drowned. Since his work required him to drive, and cross many bridges, it was creating extreme difficulties for him and his family. In his case, knowing that he had to start functioning, his first hypnosis session dealt with direct positive suggestions, that he would be able to control his fear and breathing, so he could drive across bridges. However, that was not taking care of the problem. It was at best a band-aid on the wound. He was scheduled for a second appointment, when he had more time for his session.. During that appointment, using a technique known as an “Affect Bridge” for regression, we went back to the initial event which started the fear to building within him. During his boyhood, he had been climbing on a slate roof and his mother had yelled at him to get off that roof before he fell and killed himself. The boy agreed to do so and his mother went back inside. While working his way back to the tree he had used to climb onto the roof, he slipped and only avoided a deadly fall, when his belt caught on a roof projection as he went over the edge. As young boys are able to do, he twisted around and got back on the roof, making his way safely down. However, he had been scared and that fear lay in his subconscious for years. A ride in a glass-walled elevator in a hotel, also built on the fear, as did several other experiences until suddenly, he began to fear going over high bridges and each time he did so, the fear grew until he was almost totally disabled by it. After using time-tested techniques during the session., he was able to drive over bridges and deal with heights with no difficulties. The fear was gone. Incidentally, one of the reasons regression is so powerful, is because during a regression, the person actually relives the occurrence as if they were back there again. Regression is not remembering, instead it is re-living. The experience is thus so much more powerful than it would be if it was just a conscious mind memory. Sometimes regression leads us back to adult years, or to childhood years. Sometimes, we find it was only a word or sentence, which began a waterfall of growing experiences which cropped up negatively at a later time, and maybe was only distantly related to the issue. Regression is not something that you decide that you need. Just like the young man thought his fear of bridges stemmed from almost drowning, the conscious mind usually leads us astray on what the cause, or treatment is. Only a trained hypnotist, in the session, can make the decision on what technique to use. Often clients are referred in from mental health professionals who feel their client needs to discover causes of current discomfort. In most cases of such referrals, the referring mental health professional is invited to sit in on the session with their client. We have had such referrals in which the client had “missing years” or could not remember a portion of their life. Regression is almost always the way those times are accessed. Usually, the person cannot remember, because something traumatic occurred which would be too painful to remember, or which they could not deal with by themselves. In a hypnosis session, with trained professionals, those occurrences can be accessed and the client helped to deal with the trauma in a healthy way. Now, the issue of past lives. Most people want to know if it’s real or if past lives really exist. I really can’t answer that. We don’t have scientific evidence proving the existence of past lives. We do have a preponderance of evidence that something is there, but whether it is a past life, a scenario dreamed up by the subconscious for healing, a memory from the superconscious, or a glimpse of a parallel universe, or one of the hundreds of theories advanced, we just don’t know. What we do know, unequivocally, is that regressions which lead to the experience of “past lives” are healing. For me, that is all I need to know. My job is to help people live better lives. Whatever helps them is fine with me. However, let’s talk about an experience I had while touring the U.S. putting on hypnosis seminars. While I worked coast-to-coast, I also had a circuit where I re-visited certain venues in the southeast every 6 to 8 weeks. One of those was a hotel on International Drive in Orlando, FL. Since I lived in hotels I had the accumulated many “points” and received priority treatment there, always getting the same suite,(at singe room rates) on the 12th floor. This particular hotel was built around a large patio area, and we walked along an open balcony from the elevator to our suite. On one trip, I noticed a marked uneasiness while walking along the balcony, which i ascribed to fatigue. However, the next trip, the fear was so great I hugged the inside wall, almost unable to walk. I was sweating and nauseous. Realizing, that I had an increasing fear, and that it had to come from somewhere, I called a fellow hypnotist, described what I was experiencing and said, “Let’s go get it” About 45 minutes into the session the hypnotist asked me, “ Where are you now?” I replied, “In the crow’s nest … on the ship” While I was hypnotized, and talking to him, I was also experiencing being in the crow’s nest, feeling the wind, the rails and seeing the ocean. “What happened there” he asked. “I died”, I replied as tears began flooding down both sides of my face. There was no sobbing, only the tears for about 20 seconds, and then it was over. At that point I was aware the fear had gone. A few weeks later, as I again visited my hotel in Orlando, I was leaning over the twelfth floor balcony railing looking down at the people crossing the patio, and feeling no fear at all. Was I experiencing a past Life? Well, it felt like it, but I’ve been to movies where I thought the bad guys were about to get me too. I just don’t know. What I do know, is that unexpected fear of heights, which barged into my life is totally gone. And when you come right down to it, that’s all that really matters. Yes regression is real. As for the reality of past lives, the scientific jury is still out. Oh, and by the way, in all the regressions I have done that ended up in past lives, I’ve never met a person who appeared to be anything more than ordinary. I really would like to meet Cleo though!

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Senior Living

2009-10-01 09:07:00

A few weeks ago, I was asked to provide information on the topic of “Loneliness in seniors.” For the past few issues we have been doing just that. Here is an article that deals with this subject on a different perspective. It was taken from http://seniors-site.com/widowm/lonely.html, written by William J. Diehm. Sometimes, it is best to answer a question by using a third party. I felt his article goes well with what we have already discussed, yet covers some new areas. The elderly population is large and growing. In 1987, 8.5 million elderly lived alone; by 2020, 13.3 million elderly will live alone. More than 6.5 million, or 77%, of all elderly living alone are women. The percentage of older women living alone exceeds that of men in each age group, but women become progressively more likely than men to live alone with age. Among those over 85, 52% of women live alone compared to 29% for men. Widowhood is by far the most common situation for older women who live alone. Between the ages of 65 and 74, 77% of women living alone are widows, as are 88% of those over 75. Men who live alone are far more likely to be divorced or never to have married. This phenomenon occurs because women tend to marry men older than themselves, and because women live longer than men. I will never forget the time that I walked into a hospital and heard the unhappy cry of an old man, “Nurse, I’m lonely.” Over and over again he expressed his need in heart-rending sobs that touched my soul in a unforgettable way. I asked the nurse on duty, “What’s wrong with the old man?” She replied, “He has outlived all his relatives and no one comes to see him anymore; and I can’t spend all day holding his hand.” Over the years, I have visited hundreds of retirement homes. Some are very well-run, caring organizations, handling older people effectively who are in every state of functioning. We who are advanced in years must take the time to consider where we will live, if we live too long to take care of ourselves. If we wisely prepare in advance, we can select a home that does have some people who can take the time to hold our hand. When I first started visiting retirement and full-care homes, I considered them to be awful places and one day I said to a son: “Son, before you put me in one of these homes, shoot me.” Of course I was kidding; but, you can see how terrible I thought the homes were. Since that time, I have seen dozens of beautiful caring places. So, if you find a care facility that cares, you will not need to worry about the frightening conditions of loneliness. Today, social services, churches, lodges, schools, and institutions are dedicated to the proposition that many people need to be cared for. If you are one of those people, relax and let other people cure their loneliness by curing yours. Loneliness comes to people who do not prepare for a good retirement. I have met young people who said they were never going to retire; but when the time comes, almost everyone has to drop the old loads and pick up new ones. We must all carry some type of burden or occupy ourselves with something of interest. The saddest tale ever told concerns the person who never made any provision to retire or change occupations. Here are eight sure-fired cures for such loneliness: 1. Keep busy -- If you are lonely, do with eagerness whatever is in front of you to do: write letters, visit people, fix something that needs to be fixed, take up a hobby, start collecting something of value, become amazed and fascinated by everything around you. Keep busily involved in everything that gets your attention--every little thing and every middle-sized thing can soon grow into big significant projects. The happiest person I ever met and the busiest person I ever met are one and the same. Cure loneliness by keeping busy. 2. Involve yourself -- If you are lonely, involve yourself in community affairs. Many times when people retire they find themselves in a burned-out condition. Some folks have told me, all I want to do is just sit in a chair, pet my dog, stare out the window, or watch TV. This kind of mental attitude sets a person up to be lonely. And, if a person continues to be a hermit, there will come a time when an incurable loneliness will be the order of the day. 3. Help others -- If you are lonely, look for and strive to cure the loneliness of someone else--it will cure your own. How about holding the hand of some of those people who made no provisions for old age. There are myriads of people who need help--find them and help them. 4. Avoid escapes -- If you are lonely, avoid day dreaming, sleeping too much, and watching too much TV. When you do dream dreams, make them possible, obtainable, and something you can work on. Dream magnificent goals for the future and start to bring them about. TV can be a life-saver on occasions; but to mesmerize your brain in a constant dose of radiation from the idiot box is a sure-fire way of becoming depressed and lonely. Too much sleep can be a powerful escape mechanism. We can find ourselves fleeing from guilt, responsibility, failure, and hopelessness. To run away through sleep is just like running away with alcohol--it only makes matters worse. Fight the tendency to sleep too much as if it were a demon from hell--it is. 5. Choose to be happy -- If you are lonely, you are probably depressed and unhappy. Fight unhappiness with a direct attack of the will--choose to be happy in spite of the circumstances. Ask yourself the question, “How does my unhappiness change my situation?” The answer will be, “It doesn’t, it just makes it worse.” So make things better for yourself by choosing to be happy. Fight depression by talking out your problems. If alcoholics can join a group and get control of their drinking, you can join a group and get control of your depression. Talk to friends, a counselor, or your pastor, and keep talking until you find yourself maintaining an attitude of optimism. 6. Collect good thoughts -- If you are lonely, collect inspirational thoughts, good jokes, meaningful poems, and literary masterpieces. Read lots of good books, if you can; if you can’t, have someone read to you. Make a list of good things that you read about and then try to memorize some inspirational quotation and share it with whoever comes your way. Collect good thoughts to share with those people who come your way, and soon others will search for your companionship like the proverbial guru of the mountain. 7. Join a social group -- If you are lonely, join one of the many social groups in your community. See that you visit the Senior Center regularly and meet new people. You will find many individuals there that are involved in social gatherings of various types. Commit yourself to one or more groups that you find of interest. 8. Go to church -- If you are lonely, go to church. How do I have the nerve to tell people to go to church when I am writing a secular work? I do for the following reason: There is a lot of criticism of the church, but no substitute for it. Most churches care for their people and treat everyone who attends like family. If we cut the church out of the community there would be tens of thousands of more lonely people. I have heard some people say, I went to church and the people were unfriendly. If we are friendly, the church will be friendly. If we are unfriendly, more than 75% of the time, the church will still be friendly. Loneliness is often caused by wanting people to do something for us. When we do things for other people, we are never lonely. Think up, think out, toward people, think around, toward all the exciting things of life; and avoid thinking too much about yourself, and the problem of loneliness will disappear. Test yourself – Where do you fit on the loneliness scale? Ask yourself the following questions: Do I like my life the way it is? Do I have a network of friends I can count on? Do I have someone who I feel close to other than my children? Do I have someone I can easily talk to about my life and theirs? Do I have someone who understands me? If you answered no to one or more of these, loneliness may be affecting your life. I will be back next month to explore “volunteerism, a cure for loneliness”.

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Senior Living

Murl Webster

2009-09-01 14:47:00

Answer: The difference between them is great, as are the needs of those who inhabit them. Generally, each type of senior housing is developed for people with different needs. Independent housing, Sr. Apartments, Adult Housing are all euphemisms for age restricted housing. Only persons who have reached a specific age are allowed to live in these homes. Age restricted, i.e. elderly housing was the only definition or separate group that was allowed to survive when HUD went on a “discrimination” busting rampage in the housing market about 30 years ago. During that time the powers that be decreed that no one had the right to decide they wanted to live with any selected group. Individual housing developments as well as apartment complexes were declared in violation of federal anti-discrimination laws if they chose to rent to any specific group. At the time, developers and apartment owners all catered to the wants of the marketplace. Many complexes were “adult only” for those who didn’t want to contend with children in their busy lives. Often apartment complexes were divided into “adult” and ”family” divisions, where children were excluded from the “adult” divisions. The two divisions usually had their own amenities with separate pools, playgrounds in the family area and “adult only” fitness centers. Most people found the arrangement to their liking. At the time, I had a pre-teen in the house and the arrangement worked well. While we often availed ourselves of the “adults only” fitness center, we were quite happy that our youngster went to the “family” pool and was not privy to some of the more adult shenanigans that went on at the “adult” pool. However, there were a group of women, with children, who filed suit claiming they were being discriminated against, and not allowed to live where they liked with their children. With the very liberal court make-up at the time and HUD’s government-paid attorneys, they prevailed and another freedom of choice fell. However, the separation of senior adults, who at the time were considered a minority, into their own children-less housing was allowed. From time to time, that right has been challenged but survived due to case-law precedents. Basically, the only difference in Senior Housing, and any other is just the restriction on the age of those who are allowed to live there. Senior housing can be independent houses, townhouses, condos, duplexes or apartments, or any other configuration you can think of in housing. The only real division in senior housing is that some of them are also income restricted. In an income restricted complex, (usually built with a government subsidy) only those who receive less than a certain income each year, are allowed to live there. The income restrictions usually allow differing amounts for individuals or couples and are adjusted up each year to allow for inflation. Usually the qualification is judged only on “income” and not assets. For instance, a couple could be millionaires in the value of their stocks, but if the income they received each year was under the limit, they could live in “income-restricted” housing. There are several examples in the Greater Wichita Area of “income-restricted” housing. Assisted Living Facilities (ALF’s) is another form of senior housing, but is designed for those who are not able to care for themselves, and perhaps need differing levels of oversight. Those admitted to “assisted living”, or “residential care” may need something as simple as help taking their medications to stay well or other more advanced levels of care. However, to be able to live in residential care, one must be able to perform most of their own activities of daily living, defined as eating, dressing, toileting and walking. In assisted living, bathing help is available. Residents in “assisted living” often still have their own cars and can come and go as they please. Others have chosen assisted living when they were no longer able to drive and/or wanted the convenience of someone taking care of housekeeping and meal preparation for them. Residential care also allows for couples to share their accommodations if they choose. In some cases, a spouse, who is unable to help their partner as much as needed will choose residential care so they can continue life together in a much less stressful environment, where the chores are taken care of for them, and they can sit back and enjoy life. In an assisted living environment, the majority of the “help staff” usually are certified medication aides who are trained in the dispensing of medications and have previously qualified as certified nursing aides. Due to their training, they are able to watch for health indicators and to alert the licensed nurse when she comes in. They also are able to summon assistance when needs are beyond their training. Sometimes only a door separates the residential care complex from the skilled nursing facility which has licensed nurses on duty, and available for immediate care, 24 hours a day. Nursing Facilities and Skilled Nursing Facilities or nursing homes as they are more commonly called are definitely a step up in care over assisted living. Once a person no longer meets the State mandated criteria for assisted living, they are no longer allowed to live there. An assisted living provider can be seriously penalized for allowing persons who no longer meet state guidelines to continue living in an assisted living facility. Once a person no longer meets assisted living guidelines according to their “care assessment” they are appropriate for care in a nursing home. The “care assessment” is a state test, performed by persons specifically trained in that test, to determine the level of care they need and whether they are qualified for nursing home care. One of the qualifiers is whether the person is capable of performing for themselves their normal “Activities of Daily Living” (ADL’s) as mentioned earlier when we were discussing the qualifications for Residential Care. Nursing home care is much more intense and can vary from helping one with two or three ADL’s to total care. Elderly persons with dementia, who are unable to manage their lives are appropriate for a nursing home, even though they might be perfectly capable of performing all their own ADL’s. They receive the level of care they need, however intense it may be. It is in the intensity of care that Skilled Nursing Facilities (SNF) commonly referred to as “sniffs” differ from Nursing Facilities (NF) “niffs”. A SNF has the staffing and expertise, as well as regulatory certification to provide the higher level of care required by Medicare. A person who has undergone the requisite three-day stay in an acute care hospital and is released needing “skilled nursing” can only receive Medicare benefits from a SNF. Sometimes the ‘skilled nursing” is a form of physical, occupational or speech therapy. It may also include constant monitoring by licensed nurses, or special care that can only be provided by an adequate licensed staff. Nursing facilities, (NF) have licensed nursing staff, and in some cases meet the requirements of Medicare, but have just not been certified. Other times, they are located in more rural areas where adequate licensed staff is difficult to hire and they provide care for those who need a less intense regimen. It is not unusual for a certified Skilled Nursing Facility, to receive a resident from another nursing home which is a NF after that resident has been hospitalized. They provide the Medicare required services, before transferring them back to their original nursing facility when they are appropriately improved. “Rehab to Home” is a favorite expression for those who have completed their hospitalization and need more care, and usually therapies, before being released back home. Much of the Medicare services are directed at getting persons back to their homes in a healthy condition where they can continue to live a more normal life. Whereas, nursing homes used to be a place where persons unable to care for themselves were “warehoused” until released by death, the whole purpose has changed. Today, a nursing home is expected to provide fun exciting activities, appropriate for all of their residents and maintain the highest and best functioning possible. To that end, they provide multiple activity programs, of all types, and exercise programs, which are both fun and effective in maintaining, or improving physical strength and stamina. It is important to try to get residents to a level of functioning where they can return to their homes if possible. I personally became a Nursing Home Administrator after watching my father lie, for his final six months of life in one of the old style, what I called a “Boot camp Nursing Home”. I could not stand the lack of care and the demands made of the residents by the staff. They were told when to eat, when to bathe, when to go to the bathroom, (and ignored if they couldn’t wait). They were given one unappetizing choice of food, and almost forced to eat it. (At an even earlier time, residents had their mouths forced open and food forced down their throats). Today we send a staff member around daily with a menu to let the residents choose their meals and they have a salad or fruit bar. Not only is it looked down upon and a bad business model to operate homes the old way, it is thankfully also illegal. “Culture change” is the watch word now, both in the nursing home and with the State regulatory agencies who oversee them. When I first started what we called person-centered care in 2002, my new staff looked at me as if I was crazy when I told them our residents would be choosing what they wanted to eat, and when they wanted to eat. That they would tell us when they wanted to bathe and whether it would be a shower or bath. They began to like it better when I told them of the choices of activities i.e. recreation that we would be having for our residents, and as caregivers they would be “required” to participate! I remember one staff member in particular that liked the idea of being paid to go fishing, and to the casino with residents. Today’s nursing home is where one goes to improve the quality of life, not end it. At Medicalodges Goddard they work every day to make that day just a little bit better for residents than the day before.

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Senior Living

Larry Nanny

2009-09-01 14:37:00

Question: What factors should one consider when choosing a nursing home?

Answer: Nursing facilities today are providing a wider range of services than ever before, from sub-acute care to rehabilitative care, to their more traditional role of long-term care for the chronically ill. Some people are admitted to a nursing home following a serious injury or accident for a short period of rehabilitative service and then are able to return home. In other cases, families seek nursing facility care when an elderly or disabled relative’s condition declines to the point that they can no longer safely care for that person at home. Choosing a nursing home is a very difficult endeavor for most people. This usually comes at a time when a parent has had a debilitating injury or their long term illness has gotten to the point that they can not manage it in the home any longer. Here are a few tips to consider if you are ever burdened with this responsibility. The first thing to do is find out what nursing homes are in your area. You can get this information from your case manager at the hospital, Department of Aging, Area Agency on Aging, phone book and other senior resources. After you have this information you want to decide what location you may want. For example, if you live on the west side of Wichita and are not willing to drive to the east side to visit mom, you would probably pick west side facilities, to make it easier to visit her. After deciding on a general location that would be acceptable, you need to start gathering information about these homes. I would start with a phone call to the facilities to get information as to the services that they offer to ensure they will be able to meet mom’s medical needs. After getting this information I would narrow it down to about 3-5 homes to gather specific information and take tours. You should start by checking annual survey results. Nursing homes get an annual survey once per year and have to meet standard requirements to maintain licenses. You can get information from the latest survey at cms.gov. Go to nursing home compare and search by individual home or by zip code. The next thing you should do is take a tour of the facilities you are interested in. You should take a tour during the day when the administrative staff is available, and I would also suggest going in unannounced on an evening or weekend to ensure the same care is provided when the supervision is not in the building. Here are some things to look for: 1) Are the staff friendly to residents and guests? 2) Do the residents look cared for? Are they clean? Are the men shaved? Are their teeth brushed and hair combed? 3) Talk to residents and other family members that may be in the facility during your visit to see how happy they are. 4) Ask about fall programs or skin programs that may be in place to prevent accidents and skin break down. 5) What does it smell like? Does the facility look clean? 6) Ask other residents how the food tastes. Eat a meal yourself, as most facilities will invite you to eat a meal if you are there during meal time. 7) Are there any activities going on? Look at the monthly activity schedule. 8) Talk to someone about rates. What are the costs? Does the facility accept Medicare or Medicaid? Ensure there are no hidden costs that show up on a bill 30 days after admission that you were not prepared for. Choosing the right place for mom is not an easy task. Most folks usually do not know where to start because it is not something we have to do every day. Hopefully some of these tips will get you started in the right direction. Ensuring that mom ends up in a place where she will be happy and receive quality care is a very important decision and should not be made without having adequate knowledge.

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Senior Living

2009-08-01 13:52:00

Question: Last month you answered a question regarding a person’s mother and the things she was doing, in respect to her being lonely. Can you provide more information on this and what one might do to counter such feelings?

Answer: Sure - upon doing some research, the following article was as good as I have seen recently on the subject. It was taken from http://www.ahealthyme.com/topic/srfriends. It is written by Chris Woolston – Health After 60, Seniors and Friendship. The key concept in his article is that loneliness can have a negative impact on one’s life and socializing can extend your life. What more can we ask for – permission to become a social butterfly! In this day and age retirement communities and aging services abound, making it even easier to extend your social network. Below: Socializing extends your life by Chris Woolston When Marge Burger’s husband died of a heart attack seven years ago, she made a sad discovery: Widows don’t get invited to many dances…or card games…or dinners. “I still had loyal friends, but I just didn’t seem to fit in,” she says. Like many seniors her age, the 74-year-old resident of Portland, Oregon, slipped into a quiet, lonely rut. She enjoyed time with her children and grandchildren, but she spent most of her time sitting around her house, trying not to miss a minute of her favorite soap operas. It was a comfortable life, and she hated it. “Living alone is the pits,” she says. “When you enjoy a conversation with a cat, things are pretty bad.” Nobody in her situation would disagree: At any age, loneliness is a curse. And for older people, a lack of a social life can even be hazardous to their health. People who don’t get out much often succumb to depression, a condition that in turn makes them vulnerable to many illnesses, including heart disease, alcoholism, diabetes and perhaps…cancer. Socializing extends your life But just as loneliness can destroy a person’s life, socializing can save it. In a 13 year study published in 1999 of almost 3,000 senior citizens, Harvard researchers found that social activities such as playing bingo or attending church were as important to survival as regular exercise. That’s right: When it comes to adding years to one’s life, looking for bingo’s O-62 is right up there with jogging. Seniors get more out of socializing than just a few extra years of life. Friendships and activities reduce stress, help people feel worthy and needed, and stimulate the mind. According to a recent report in the Annals of Internal Medicine, strong social contacts offer powerful protection against the mental declines that often go along with aging. And, having strong friendships can also add years to one’s life. A Spanish study published in the journal BMC Geriatrics in 2007 found that having a confidant was linked to a 25 percent less risk of dying prematurely than an elderly person without a strong friendship As Marge Burger found, it just takes a little effort to cash in on the benefits of friendships. A few months after her husband’s death, she got involved in programs at the Elks’ Club. She joined a bowling team for the first time in 40 years. She soon made friends with another woman stuck alone at home, and the two started attending symphonies and church services together. Going back to church made the biggest difference in her life, she says. “I feel very secure there,” she says. “There’s always somebody who wants to reach out to you.” Now 81, she appreciates her friends, family and her social life more than ever. “When I get chances to laugh, reminisce and share, I’m not thinking about how much my back aches or how much my feet hurt,” she says. “Any situation improves when you have people around you.”

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Senior Living

Murl Webster

2009-08-01 12:16:00

Answer: Don’t laugh! It is quickly gaining the respect of physicians and scholars across the country who are researching the newly re-discovered benefits of this ancient, but effective means of pain relief. It is being used for everything from headaches to surgical pain. It has long been known to be effective in helping persons to quit smoking, and was even featured in “O” Magazine as one of the most effective ways to lose weight and keep it off. The hypnosis being used daily in major medical institutions is a far cry from the comedy shows at the State Fair or Las Vegas. But it’s still hypnosis, even if the intent is to cure rather than entertain. Today, hypnosis is being used as anesthetic for surgeries, to increase fertility, manage or entirely remove chronic pain, and help patients through the discomfort of cancer. The hypnotist usually starts by guiding their client into a state of deep concentration by using words that help them relax and focus. If you’ve ever wondered just what hypnosis is like, think back to a time when you were so engrossed in a book, movie or TV show that you didn’t even know when someone walked into the room. That is the state of hypnosis or the trance state as it is sometimes called. While in this state you are totally focused and aware of everything the hypnotist says. You also are totally in charge and if you chose, could get up and walk out of the room with no ill effects. However, most people find the “trance” state to be so relaxed they love the feeling. The most common request of first-timers after hypnosis is “that was great – can I go back?” Some hypnotists provide their clients with a technique so they can easily reach a very relaxed state anytime they choose. While in the trance state, you can experience or visualize anything suggested more vividly and intensely. It is this highly focused state that allows one to create the changes in the subconscious mind, where all habits and automatic reactions are stored. It is also the location where you have the most mind power. Dr. Albert Einstein said the subconscious mind is where you have at least 90 percent of your mind power. The conscious mind, the mind you think with and which you commonly refer to as your mind, has only 10 percent or less of your real ability to change. That is why so often, when we “decide” or “think about” making a change we are unsuccessful It is through accessing the subconscious mind, utilizing methods that relax the conscious mind, a process we call hypnosis, that all types of seeming miraculous changes can take place. In reality, science and modern technology tell us that the process is actually changing our brain chemistry so we can achieve the goals we have set for ourselves. Contrary to myth, anyone with a normal intelligence can be hypnotized if they want to be. Other similar myths about hypnosis, such as you can get stuck in it, can be forced to do things you don’t want to or can be made to tell secrets, are just as untrue. Your personal will always is in charge while in the hypnotic state. There also is no swinging watch. Modern hypnotic methods can have you deeply relaxed in three or four minutes using words alone. In the wonderfully relaxed state that we call hypnosis we can change our habits, our attitudes, our sensations, our beliefs, and our physical state. Of course, to make those changes successfully does take someone adequately trained in the field of hypnosis as a primary therapy. Hypnosis is commonly used to lose weight, stop smoking, alleviate fears, reduce anxiousness, relieve pain, contour the body, increase circulation, increase healing, prevent pain during or after surgeries, relieve the nausea of cancer treatments, increase fertility, and mitigate the effects of hot flashes, among the hundreds of uses that it is used for daily. Students are finding the use of hypnosis enables them to retain information from their studies better, as well as recall it during tests. They also use it to eliminate pre-test jitters, resulting in better test results. Business persons, who have to absorb and retain large amounts of information, can use it for that purpose also. It’s a great solution to the fear of public speaking, which has been found to be greater than the fear of death in most people. At Lifemasters Hypnosis, we use hypnosis to benefit people to make the changes they wish to make in their lives. We use both direct suggestion (traditional hypnosis) and regression techniques to achieve the desired changes. Direct suggestion is the method suggesting positive changes once a person has reached an adequate level of focus, or hypnosis. Those can be as simple as suggesting that they no longer wish to smoke and therefore have become a non-smoker. It can also be as demanding of the subconscious mind as inducing it to begin healing and reducing the inflammation of a damaged nerve or growing new tissue. Regression techniques are different. Regression is used to return the client to an incident that happened previously, which is impacting their current life. The client does not remember the incident, but instead experiences it again, almost as if they were re-living it. At that point, the hypnotist can help them deal with the ramifications of the incident, effectively removing it from further impact on their lives. While we work in all areas to help people improve their lives, we specialize in pain management/relief. We often are contacted as a last resort in pain management after all other methods have failed. We have used hypnosis for surgical patients who needed no pain medications after surgery, and from hip replacements to radical mastectomies. Colonoscopies, normally a painful procedure requiring medications to make one forget the pain are performed using hypnosis with the patient conscious and comfortable all the time. Many instances of pain, are either little understood or considered untreatable by the normal medical methods available today. Hypnosis can be very effective for chronic pain, acute pain or cancer pain. Many times, the normal healing process occurs, but for some unknown reason the pain remains, long after healing is completed. That kind of pain is the most difficult to treat by normal means. However, using the relaxation and focus of hypnosis, it can be relieved or usually completely eradicated. Diabetes has reached epidemic proportions in the U.S. today and chemical medicines often cannot adequately treat the pain of neuropathy or the lack of circulation. However, we have used hypnosis very effectively to treat the pain and increase circulation in the affected areas. RSD/CRPS, reflex sympathetic dystrophy/complex regional pain syndrome is a little understood and almost impossible to treat pain that in many cases disables the sufferer, often making them feel like the affected parts are being immersed in boiling water. It can also cause extreme discoloration in the areas of greatest pain. It is so disabling Social Security has provided a specific benefit for sufferers of this malady. Hypnosis has proven very effective in treating and relieving the discomfort in the patients who have come to my practice. While hypnosis for many years was often dismissed as “mind over matter,” recent advances in technology such as the FMRI, and PET scanning have brought understanding to scientists who are able to actually see the changes occurring in brain chemistrywhile subjects are being hypnotized. Studies on the efficacy of using hypnosis for pain relief were done in a joint study by the University of Iowa School of Medicine and the University of Aachen, Germany, using a source producing painful heat. It was noted that areas of the brain associated with pain actually changed chemically when hypnosis was present and suggestions for feeling pain were given. They also saw the brain change to a non-pain state, under hypnosis even though painful stimuli were being given to the volunteers. “It definitely does something to reduce the pain signal input into the cortical structure” said Sebastian Schulz-Stubner, M. D., Ph.D., UI assistant professor (clinical) of anesthesia. The National Institute of Health, and the National Institute of Mental Health are actively engaged in research projects to further the understanding and effective use of hypnosis in the medical community. The Mayo College of Medicine called Hypnosis, “effective” and a “benign therapy” in a 21-page report of accumulated studies on the benefits of Hypnosis in 2005. They also said “patients treated with hypnosis experienced substantial benefits for many different medical conditions. An expanded role for hypnosis (in medicine) and a larger study of techniques appears to be indicated.”

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Senior Living

2009-08-01 12:16:00

Question: My elderly mother lives alone and does not appear to be taking care of herself. My sister and I both work and are unable to spend much time with her. Every time we approach the subject of placing her in a retirement community or assisted living residence she begins to cry and questions our love for her. Could these be symptoms of loneliness. Where do we go from here?

Answer: Understanding why their mother may be acting this way is the key to enhancing the her overall health and wellness. “Living alone” are the key words in this question. “How does Mom spend her time each day?” Loneliness can be a distressing and debilitating condition, and can often have an adverse impact on overall health. With age comes losses the loss of a spouse, loss of our social and professional network, loss of the ability to drive, loss of energy levels and the loss of overall good health. Seniors often find themselves more and more homebound, bored and alone alone with aches, pains, and worries. The stress related to loneliness begins to impact their physical wellbeing, they become depressed. They may begin to ignore personal hygiene and appearance, stop cooking and settle for whatever is in the refrigerator, or just skip a meal. Like any living thing without attention, seniors can wither away. Children often wrongly assume that their parents “cannot” take care of themselves, when in fact they may be lonely or depressed. The need for socialization is important at all ages but even more so in life’s later journey. Finding opportunities for continuing lifestyles and interests is essential to maintaining physical and emotional wellbeing, maintaining mental alertness, and avoiding the impact of loneliness on health issues. For elderly parents and loved ones, interaction with peers and opportunities to socialize may take some planning. There are many senior service organizations and centers that offer meals, transportation and social events. For some, these services may be the answer. Your local Department on Aging will have information on these organization and services. Others may want to change their environment entirely. For those, opportunities for socialization abound in retirement communities and assisted living residences. As you explore retirement communities or assisted living residences for your parent or loved one, personally visit those which provide opportunities for seniors to take part in social, cultural, and spiritual activities. Look for a retirement community or assisted living residence that offers a variety of educational classes, health seminars, religious services, wellness assessments and fitness classes along with transportation services. Check out the dining programs – look for choices in menu selections and a positive dining environment. Most communities will be happy to invite you and your parent to an event in the residence or to enjoy a sampling of the meal service. Look for community gathering areas in the residence that support one on one interaction such as conversation nooks, hobby learning centers, theaters and musical venues, etc. While there watch residents interact with one another and the staff, look for respect, smiles, support and laughter!!! You may find that once your loved one finds outlets for socialization again and begins to interact with their peers regularly whether it is through supportive services or a move to a retirement community or assisted living residence, their overall health will improve, and the person they once where will resurface - smiles and joy will become more evident once again. As a family member once told me, “I used to get a call from Mom every morning, noon, and night – now she is never in her apartment and the only reason she calls is to check on the grandkids and to tell me about the adventures of her day!” Socialization and personal interaction with peers will help to maintain the highest possible level of functioning and quality of life for everyone as we age, but most of all for our seniors.

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Senior Living

2009-06-01 10:29:00

Question: My father passed away recently. My mother lives by herself. My other siblings live out of town. I would like to see her move into her own apartment in a community if possible, but I would want to know that if she needs help later on with things like dressing and bathing, would she be able to these support service in her own apartment without having to move again to another facility with more services?

Answer: Many children have found themselves in your shoes and have felt the same way – their Mom living alone, other siblings out of town and not available on a daily basis, a loved one who is basically independent now but may need some assistance with activities of daily living at some point in the future. For whatever reason - a health related wake-up call, difficulty maintaining a private residence or a desire to be closer to the children - you or your elderly loved one may have recognized a need for a change in lifestyle and housing. Once the realization is made that a change of lifestyle is probably a change of address, many questions and concerns become apparent. What are the housing options available in my immediate area? What services are offered by these providers? How long can my loved one live there? Are support services such as bathing and dressing available in a retirement apartment community? A majority of retirement communities consist of apartment homes but that is where the similarity usually ends. Today’s new and innovative communities offer an even wider range of specialty features and supportive services. It is important that consumers investigate all the options and understand all of the support services available in each community prior to making a decision. The newer free-standing rental retirement communities are essentially an independent living community with a more user-friendly and supportive environment. In these brand new purposefully designed communities, residents will find a wide range of state-of-the-art building designs and services available to enhance or support their desire to be independent in daily lives. These features and the benefits of these features not only add to the resident’s ability to maintain independence longer but also provide peace of mind for their families. The common areas inside and outside enhance the resident’s opportunities to continue his or her social and cultural lifestyles. Unique state-of-the-art design elements such as special positioning of electrical outlets, light switches and thermostats, provide ease of access for residents who experience mobility challenges. The design and location of windows and the special hall lighting provide additional light for seniors with vision disabilities. Optional emergency response systems provide residents with a 24 hour on-call responder. Many of today’s newest independent retirement communities partner with home health agencies that can provide services for residents who need assistance with bathing, dressing or medication management. Others may combine this service with a unique concierge or companion service option that offers assistance with everyday lifestyle activities such as “pet care”, additional maid and housekeeping services, party and event planning, gift wrapping, catering services and more. Remember when looking at senior housing options – don’t wait until you have to make a change. The key to staying independent, healthy and in charge of your life is to make the investment in time and research sooner rather than later.

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Senior Living

Joe Benter

2009-05-01 11:45:00

Question: Do all nursing homes operate the same?

Answer: Many do similar things like having an activities’ program to help residents stay active, socialize and improve quality of life. They may also have things like regular activities such as bingo, arts & crafts and baking. But some nursing homes do things others don’t do, like host a “Gone Fishing” program. About every other week, weather permitting, some nursing homes have had the privilege of taking a number of residents to the lake to do some fishing. Now this may not seem like a big deal, but to nursing home’ residents, this is an activity that is greatly anticipated and talked about for days both before and after. On fishing day the gear is gathered, the kitchen puts together some lunch and off go the residents and the supervisory staff for an afternoon of fun. Once at the lake, some residents quickly get to the task at hand, while others prefer to paint or just observe the activities. It doesn’t take long before the fish start biting and the proud smiles start showing on the residents’ faces. Lots of photos are taken of the prize catches of the day and posted back at the residence by the nurse’s station. Maybe the biggest problem the residence has is keeping the pictures up on the wall because every wants to show off their catches. Fish stories of that day and others from years ago abound, from all of the ones that got away. The residents of these types of nursing homes are having fun, they’re happy, entertained and full. But what they don’t know is that it is also good for them. The doctor who heads the therapy department will state that in addition to the fun, socialization and great outdoors, he has ulterior motives for the fishing trips. These benefits include: range of motion exercises, practicing dexterity, fine motor skills, standing and balancing as well as just the joy of being outdoors. Isn’t that just like a therapist to sneak in some exercise when people are trying to have fun? So the next time you stop by a nursing home on a sunny day and it seems like no one is around, check for the “Gone Fishing” sign and head down to the lake where you will probably find residents and staff laughing, telling stories, and having a good time. Not bad for a day at the office!

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Senior Living

Joe Benter

2009-04-01 14:39:00

Question: How do I pick a nursing home for my loved one?

Answer: Picking a nursing home for a family member is both a daunting and emotional task to say the least. First, you have to admit that your family member needs more help than you can provide. This in itself is often one of the biggest hurdles to placing a loved one in a nursing home. The important thing here is to remember that placing someone in the nursing home doesn’t mean you have failed as a caregiver. What it does mean is that you care enough to get them the help that they need. Talk to anyone who works in a nursing home and they will tell you that it’s hard some days even with a team of people. So you’ve made the decision. Now it’s time to decide where. How do you go about narrowing your choices? A good place to start is the Centers for Medicare & Medicaid Services website at www.cms.gov. This website will allow you to compare the ratings of all the nursing homes in a designated area and allow you to get the basic facts about each facility. Keep in mind though that this information will only give you part of what you need to make your decision and may not reflect the current level of care provided by that facility. However, no amount of information can replace the need for a visit to the facility. Location is always a major consideration. Something close is usually preferred, but is not always available. Each facility tends to have its strengths and weaknesses when it comes to the type of resident they can provide the best quality of care for. Next, plan on taking a tour of the facility. Whether you drop by or make an appointment, it doesn’t really matter that much because the things you want to look for can’t really be hidden. Smell is always one of the first things visitors will notice. Does it smell like urine or feces? What time of day is it? I can almost guarantee that no matter how good the home is there are certain times of day that there will be smells. Here are some other things to look for. Does the staff look happy? Is the place clean? Are they friendly? Can the facility meet the needs of your loved one or do they take anyone so they can just fill the beds? Ask questions. And not just to the person giving the tour. Here is a biggie. Don’t base your judgment on the looks of the building. The quality of care provided to your family member has nothing to do with the esthetics of the building. The quality of care comes from the people who work there. And that folks is what it comes down to. Does the staff of the facility see their position as a job or a calling? The bottom line is this, listen to your gut. Find a place where the staff has a passion for what they do and you will have found the right place.

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Senior Living

Joe Benter

2009-04-01 14:39:00

Question: When should I worry about advance directives for my parents and myself?

Answer: In short the answer is “NOW”. End of discussion! First though, let’s step back for a minute. Just what exactly are advance directives? How do they affect me? Will they cost me money? Will I be giving up control of my life and/or estate? Advance directives are legal documents that allow a designated person to carry out our wishes when we are no longer able to do so ourselves. Advance directives consist of Living Wills, Durable Power of Attorney (DPOA) for Health care, Financial Durable Power of Attorney, and Do-Not-Resuscitate (DNR). These documents will allow someone else to make their decision for you, but only when you are not able to make these on your own. They can be drawn up by an attorney and be very complicated or you can fill out a basic form and that can be very simple. Either way, they are crucial to have done before something happens. Advance Directives are less effective if you wait until you need them. Oftentimes people wait too long and then the courts have to get involved. The key is that the person making the advance directives must be of sound mind when they put them in place. Let’s discuss briefly what each of these are. A Living Will is a document that states your wishes about whether or not you would like to be kept on life support, feeding tubes, IV’s etc. Simply put, to what measures do I wish to be kept alive should something happen to me. A Do-Not-Resuscitate (DNR) is a document that states if I die, do I want extraordinary measures done to bring me back. For example CPR. A Durable Power of Attorney for Health Care and Financial Durable Power of Attorney are simply documents that allow someone else to act on your behalf when you can no longer do so yourself. The point I want to emphasize here is that even though you may have these documents, it is extremely important that you actually talk about what those wishes are while you can. The DPOA only gives you the authority to act on someone else’s behalf. What you really need to know is what that person would want if they were not able to make those decisions themselves. The one thing I have learned over the years is that it is very easy to tell whether a family has had these discussions about end-of-life. It’s the difference between doing what your loved one wanted and doing what makes you feel better. They are not always the same thing. To summarize. Now is the time to make your Advance Directives. Now is the time to have that uncomfortable discussion about what if. Don’t wait until it’s too late.

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Senior Living

Joe Benter

2009-02-01 14:22:00

Question: What can you expect to happen as a person enters the late state of Alzheimer’s Disease?

Answer: Late stage Alzheimer’s Disease can last anywhere from 1 to 3 years. In the late stage giving care is mostly about meeting the needs that your loved one can no longer do for themselves. This is where their brain will cause them to not know who you are or who they are. They won’t be able to eat without help, control their bowels or bladder and walk or sit without the aid of someone. This will be the time to make hard choices about the care of your loved one. Care giving will become a 24-hour a day job if you decide to keep them at home. Programs from your local Area Agency on Aging, home health agencies or private nursing assistants will be critical to the well being of both your loved one and yourself. Many caregivers make the choice to move their loved ones into a nursing home in this stage. Often there are multiple chronic illnesses that are best cared for by trained personnel. More importantly, this will allow you to spend what time is left letting them know how much they are loved. Please keep in mind that if this is your choice, it doesn’t mean you have failed. If you chose to keep your loved one at home you will need to learn some new skills. As time passes they won’t be able to eat or drink without the possibility of choking. You will need to make a choice about whether to use a feeding tube or not. Here are some things to know before you decide. They will not feel hunger or thirst as they approach death. Lack of food and fluids can reduce pain. A feeding tube may not prevent weight loss and may make them more uncomfortable. Hopefully this is something you have already talked about in the early stage. Communication will also be different. You will need to learn how to tell what they need by looking at them as their communication will be limited to grunts and moans. The muscles in their face no longer work. They have little or no control over their bodies and will fall over if not propped up. Muscles that bend their arms and legs will no longer work and often they will lay in the fetal positions when in bed. Joints will stiffen and eventually they will forget how to sit up. Their skin will change and lose its ability to stretch. The skin will bruise and tear easily. Sores may appear on their elbows, hips, heels and bottom. Keeping their mouth clean and lips moist becomes very important. Weight loss will happen because their body can no longer get the nourishment it needs from the food they eat. Right now you may feel too tired to think about what you need. However, your years of care giving are coming to an end. This is a sad time and you will grieve as death slowly approaches. Take comfort in your family and friends. Finally, be proud of the job you have done as a caregiver! To obtain a free copy of “Coach Broyles’ Playbook for the Alzheimer’s Caregiver” call the Alzheimer’s Association at 800-272-3990.

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Senior Living

Joe Benter

2008-12-31 10:43:00

Question: How can someone determine if a person may be in the early stages of Alzheimer’s, and is there an overview of what one can expect?

Answer: Middle stage Alzheimer’s Disease (AD) can last anywhere from 2 to 10 years and is when changes in behavior become most prominent. Safety becomes your top concern as memory loss increases and the interventions used in earlier stages don’t work anymore. The damage to the brain begins to affect things like the way the patient acts, walks, sits down and gets up, goes to the bathroom, find their way around the house, gets dressed and deals with noise and light. In early stage AD you could leave notes, call on the phone and leave them alone for periods of time. In middle stage AD they are no longer able to make sense of phone messages, take baths or brush their teeth without help. They need cues from you to eat and can no longer put thoughts into words. And most importantly, they cannot be left alone. They may tend to fidget and act nervous late in the day. They become easily upset and are hard to calm down. What they are experiencing is called “sundowning” because it happens late in the day. Often they may say over and over that they want to go home. To them the idea of “going home” is not what you may think. “Home” is often not the place they live or the place where they grew up. To them “home” means feeling safe and may not be a place at all. “Home” is more like a feeling. It’s important to remember that changes in how people with AD act are caused by the brain damage and is not something they can control. It’s part of the disease process. If one haven’t done it already, now is the time to get a support team together. Talk to the doctor, the family and the friends. Talk about what services are available to them in they’re town. And as I have said before and will say again, “Take care of yourself!” It’s going to get tough and the need for support is critical at this time. Here are some tips on home safety. Make their world simple. Use plain-colored tablecloths, bath towels and sheets. Block off stairs so they don’t fall up or down. Have all your house locks keyed to the same key. Have them wear an ID bracelet. Use locked cabinets for soaps, cleaners, poisons and medicines. Communications will change as well. Break tasks down into one step at a time and wait until they finish the first before you go onto the next. Be patient and calm. Touch (holding hands) is very important. Don’t use baby talk. Stop what you are doing and listen to the feelings behind the words. Treat them with dignity and respect. Say exactly what you want them to do and use ordinary words. Eventually you will find that your loved one may just sit or walk around the room and say nothing. Talk to them first, they may not remember how to start a conversation. I’ve covered just a few of the changes that will occur in middle stage Alzheimer’s Disease with some tips on how to cope with them. Once again I would suggest getting “Coach Broyles’ Playbook for Alzheimer’s Caregivers”. It is informational, easy to read, full of great information and can be obtained for free by calling 800-272-3990.

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Senior Living

Joe Benter

2008-12-31 09:59:00

Question: What are some obvious signs that will help recognize Dementia?

Answer: As a Nursing home administrator, dealing with residents with Dementia can be a daily event. Dementia is a medical term used when damage in the brain causes at least four changes. These are: memory loss, changes in how people talk, changes in how people act and changes in the ability to do simple things like getting dressed or bathing. Alzheimer’s disease is just one of many diseases that can cause Dementia. Over the next few editions of this article, we will take a journey through the early, middle and late stages of Alzheimer’s and look at some practical tips about the disease process. Please keep in mind that by no means am I an expert in dealing with Alzheimer’s patients. In fact, much of what you will read here comes from a great resource called “Coach Broyles Playbook for Alzheimer’s Caregivers”. This is a free resource from the Alzheimer’s Association and can be obtained by calling 800-272-3900. Early stage Alzheimer’s disease can last anywhere from two to four years. The first signs of Alzheimer’s are things like having trouble with numbers, forgetting to mail bills, not signing checks and stopping activities that were once always enjoyed. This is one of the most important times to see a doctor. Your doctor can prescribe medicine that can slow down the damage Alzheimer’s causes in the brain. Remember, Alzheimer’s is a disease of the brain and there is no reason for shame or to hide away. During this early stage, it’s also a good time to take care of practical matters. Locate personal papers like birth records, social security cards, medical cards and insurance papers. Also, you will want to get three important legal documents: a Living Will, a Durable Power of Attorney for Health Care, and a Durable Power of Attorney for Financial Matters. It’s also a good idea to have a backup plan incase something happens to you. Alzheimer’s affects the entire family, not just the person with the disease. It’s important to remember that when dealing with someone with Alzheimer’s, it is just as critical to take care of your self as it is to meet the needs of the person with the disease. As a caregiver, you must get into the habit of making time for yourself each day. Don’t give up on the things you love to do. Exercise, eat right, get enough rest and spend time with friends and family. As a caregiver you are at risk of having feelings of sadness, stress, anxiety, anger, guilt, grief and frustration. Keep in mind that these are normal feelings, but it will help to talk with others who are going through the same thing. It might also help to make a list of the things your loved one can still do. Finally, take time to celebrate the positive things each and every day, take one day at a time, keep your sense of humor and pat yourself on the back for the good job you are doing.

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Senior Living

Joe Benter

2008-12-01 14:19:00

Answer: Informal care is defined as “Ongoing assistance with a broad range of tasks, such as personal care, household help, and activities of daily living, from family, friends, and others who are generally unpaid.” Today, family members assume most of the responsibility for the care of chronically disabled family members, typically with limited or no help from services agencies or paid providers. Most people with chronic disabilities could not continue to live outside of institutional setting without the help from informal caregivers According to a national survey on non-institutionalized persons with chronic disabilities, 83% of those under 65 had help exclusively from family members. In 1997 the estimated economic value of informal care was $196 billion, compared to $83 billion spent on nursing home care and $32 billion spent on home health care. Women are more likely to provide personal care assistance, with an estimated 59% to 75% of caregivers being women, whereas men are more likely to take on more instrumental tasks such as financial management. Moreover, women often have multiple roles in addition to care giving responsibilities, including hands-on health care provider, care manager, companion, surrogate decision maker and advocate. Informal caregivers also act as gatekeepers, intermediaries, care managers, facilitators and advocates functioning as partners with service providers. Being an informal caregiver often has health consequences since caregivers are less likely to adhere to an exercise schedule, get enough rest, and watch their diet. Additionally, caregivers are more likely to be depressed than their age-matched counterpart and often suffer financial and work related stress as a result of providing care over a long period of time. However, there are also positive effects from being a caregiver. For example; giving meaning to a person’s life, gaining a sense of mastery over the challenges faced and the enhanced relationship that is reached with the care recipient. Frequently there is a degree of personal growth that can come with the satisfaction and pride a caregiver takes in the fact that the recipient can remain at home and out of a nursing home. During the past 25 years there has been tremendous growth in caregivers’ services and support, as well as federal and state policy changes to benefit the caregivers. Programs like training in care giving techniques, web sites for caregivers, problem solving and time management methods, communication skills training, in home respite, adult day programs, payment for caregivers, home modifications and adaptive/assertive devices for safety and monitoring. Informal caregivers are one of the most unrecognized, yet most needed people we have in our society and to them I say thank you! For more information on caregiver support contact your local Area Agency on Aging.

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Senior Living

Joe Benter

2008-11-01 12:01:00

Question: What’s going on with the financial markets?

Answer: Anyone who has been watching the news lately is well aware of the turmoil in the financial markets. The national news is promoting doom and gloom while here in Wichita, we hear that our local economy is doing pretty well. So what is it really? A lot of that depends on your own personal situation of course, but the reality of the situation is almost every one of us has been affected by the current economic crisis in some way or another. Much like life, there are always two ways one can look at the same situation. Personally, one of my favorite sayings is one I learned from my daughter. One day I asked her whether she saw the glass as half full or half empty and her response was “ It’s neither half full or half empty, it’s just the wrong size glass.” Don’t you just love the mind of a teenager? Ok, whether we do or we don’t have money invested right now, we have certainly been affected by higher gas and food prices along with many other consumer goods and services that have increased over the last few months. What does this mean to the economy? Well folks it’s all about consumer confidence. As prices go up you have less discretionary money to spend so consumer spending drops on things like entertainment, vacations etc. and less money goes into the economy. Then as prices drop we spend more, retailers are happy, we’re happy and everybody feels better. Of course, this is way over simplified but I think you get the idea. So now back to Wall Street. One of the biggest rules when it comes to investing is that each person has the right investments for their risk tolerance and stage in life. For most retirees your focus should be on the preservation of your assets more so than growth. As Will Rogers once said, “The return of my money is more important than the return on my money.” For others this financial downturn can be a huge buying opportunity. Whatever stage you are in, here are a few tips that should help. First, if you are still in the workforce, make sure you are paying yourself first. By this I mean use payroll deduction to put money into your retirement funds on a regular basis. Now is a great time because your monthly dollars are going farther. Second, make sure you are in the right investments for your age and risk tolerance. The biggest mistake most people make is putting too much emphasis on return and not enough on preservation. Third comes by good advice from my mentor. Make investment decisions based on fact not emotions. This of course is one of the hardest things to do when dealing with your money and is why sometimes having a neutral third party to bounce ideas off of is very critical. Finally, if you haven’t made any changes to your portfolio by now, it’s probably too late. There’s a good chance that the worst is already behind us. Remember the old saying “This to shall pass.”

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Senior Living

Larry Nanny

2008-10-01 15:56:00

Question: What is new in skilled nursing care?

Answer: There have been some therapeutic modalities developed for our aging population that a lot of skilled nursing facilities are now using. These modalities previously have been used for athletic and orthopedic injuries. Although Electronic Stimulation and Ultra Sound are not new to skilled nursing, these modalities have been further developed to enable us to enhance the quality of life for those we serve. Electrical stimulation can be used for pain management, increased blood flow, spasticity management and muscle re-education. Ultrasound treatments generate deep heating, facilitate the relaxation of contractures, reduce pain from Rheumatoid Arthritis and accelerate the healing of soft tissue. It can be used in thermal or non-thermal mode. Shortwave diathermy uses radio waves to increase the extensibility of Collagen Tissue, reduce inflammation, Osteoarthritis pain reduction, and increase local blood flow. Many patients who have not been responsive to standard therapies are improving with the use of these modalities and treatment methods. Therapists have seen patients recover more quickly than they might have with conventional therapies alone. As a result, patients enjoy increased independence and improved quality-of-life. These modalities have enhanced our pain management programs, wound programs, incontinent programs and range of motion programs. If you have further questions about these programs please call me at Lakewood Senior Living.

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Senior Living

Larry Nanny

2008-09-01 15:06:00

Question: What is a Skilled Nursing Facility?

Answer: A Skilled Nursing Facility has Registered Nurses and Therapists who provide 24-hour care to people who can no longer care for themselves due to physical, emotional, or mental conditions. A licensed physician supervises the care of each individual and a nurse is always on the premises. Skilled medical care includes services of trained professionals that are needed for a limited period of time following an injury or illness. Examples of this type of care include wound care, IV antibiotics, Physical Therapy to correct strength and balance problems, Speech Therapy following a decline due to a stroke, and Occupational Therapy to help a person regain independence in the areas of dressing, grooming and eating. When an individual enters into a Skilled Nursing Facility following an injury or illness, the goal is for nursing and therapy to work together to help this individual reach their prior level of functioning so they may return to their previous living arrangement prior to going to the hospital. The most common type of injuries or illnesses we see in a Skilled Nursing Facility are a broken hip, knee replacement, stroke and heart and vascular problems. To qualify for Medicare to cover this type of service you must have been hospitalized for three days, and you must enter the facility within thirty days of this hospitalization. Medicare will cover the first twenty days at 100%, then there is a daily deductible which may be covered if the patient has a co-insurance. There is a 100 day maximum that Medicare will cover, although this is not guaranteed. To continue to receive “Skilled” services covered by Medicare, the patient has to continue to make progress towards their prior level of functioning. If the patient reaches this level or ceases to make progress then Medicare will not be able to continue picking up the bill.

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Senior Living

Pam Pirotte

2008-04-01 12:10:00

Question: Is it just me or has this been one of the worst cold & flu seasons? And what are some thing’s I can do to help from getting ill?

Answer: What Can You Do to Prevent a Cold? • Stop smoking. Smokers are terribly vulnerable to respiratory infections of every kind. • Colds are extremely difficult to prevent entirely. The following suggestions may help: -Avoid close contact with people who have a cold, especially during the first few days when they are most likely to spread the infection. -Wash your hands after touching someone who has a cold, after touching an object they have touched, and after blowing your own nose. -Keep your fingers away from your nose and your eyes to avoid infecting yourself with cold virus particles that you may have picked up from doorknobs, counter tops, etc. -Put up a second hand towel in the bathroom for healthy people to use when sharing space with someone who is ill. -Adjust the humidity in your home so that your sinuses don’t dry out. Dry air actually puts a person at risk to develop a respiratory infection. -Do not inflict your cold on others! Cover your nose and mouth with a tissue when you cough or sneeze, then throw the tissue away and wash your hands. Use your sleeve at the elbow to muffle mouth and nose. This area never sees contact with others. Stay away from people who are most vulnerable, including anyone who has asthma or another chronic lung disease. • You should NOT get the flu shot if… -You are allergic to eggs or any component of the vaccination. -You have a history of Guillain-Barre Syndrome. -You have an acute illness and a fever. -You should not get a flu shot until you are getting better. • Alternative/Natural Ways to Prevent and Treat Colds & Flu •When you’re in the midst of the flu, besides plenty of rest, fluids, and good nutrition, there are some additional alternative medicine approaches that some experts recommend. -Noted alternative practitioner Andrew Weil suggests daily doses of vitamin C, garlic, Echinacea and the herb astragalus, to help boost the immune system during flu season. -Italian researchers also found that ginseng, when given throughout the season to people who had flu shots, reduced the cases of flu, and raised the activity rate of immune cells that fight infections. • The most often recommended treatment is a natural product known as Sambucol, which is Elderberry Extract. -Elderberry apparently works by strengthening the cell membrane so a virus cannot penetrate it. It also appears to inhibit the enzyme that viruses use to weaken the membrane. • The other highly recommended natural treatment is Vitamin C. Some experts believe that as much as 1 to 6 grams of Vitamin C per day may help reduce the duration of flu virus. The suggested dosage would be 1000 mg every 2 hours, unless diarrhea or indigestion occurs. • Other key natural remedies for flu include: -Zinc Lozenges – Over-the-counter zinc lozenges can help reduce the effects of a flu or cold. -Vitamin A – Some experts recommend 25,000 IU four times daily for at least three but not more than five days during the acute phase of flu or colds (provided you weigh at least 120 pounds and do not have a liver problem). -Garlic – Garlic has natural antibiotic effects, and some experts suggest ten capsules a day of a high allicin content garlic in the first six hours of symptoms, to diminish duration and severity. -Echinacea – Take the maximum recommended dose when symptoms are acute. -Olive Leaf Extract – Can help combat a flu or virus.

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Senior Living

Pam Pirotte

2008-03-01 09:38:00

Question: I am newly single again after 30 years; how can I cut down on the junk food merry-go-round?

Answer: The first thing you do to stop eating fast food, is to stop putting yourself in a situation where you say to yourself, “I don’t have time,” or “there is nothing that is quick.” Set time aside once a week to make a list of groceries to buy. Buy only what is on your list. Do not go grocery shopping on an empty stomach, you’re more likely to grab more than you need and the purchases will most likely be high-fat snacks and desserts. Be sure to limit the amount of fresh fruit you purchase. It is very hard to keep fruit fresh for more than one week. After you get home, prepare all of your groceries as described below to help your groceries last longer: (1) Before freezing raw hamburger, chicken, or any other meat, portion one serving into bags. (This could mean ¼ pound of beef, or one chicken breast.) Tie and label them, then freeze. Thaw one portion for quick and individual meal preparation. (2) When chopping up part of an onion or green pepper for a recipe, chop the entire onion or green pepper and then freeze the remainder in a bag for later use. (3) When preparing spaghetti sauce or other sauces and soups, put the unused portions (cooked or not) into a plastic container, label it, and freeze for a later meal. (4) Freeze your bread. Put half of a fresh loaf in a bag in the freezer so it won’t go bad before you can eat all of it. (5) Place wax paper between tortillas and freeze them so you can use them individually as needed. (6) Fresh veggies like broccoli should be prepared and placed in zip lock bags for easy access. Baby carrots are ready to eat out of the bag. If you PREPARE your portions ahead of time, then there will not be that excuse of….”I didn’t have time.” ….or “there isn’t anything that’s quick.” • Now it is just a matter of throwing the chicken breast in the skillet and making a simple tossed salad or baked potato to make a complete meal. • You will find that the actual preparation time is much shorter than waiting in a fast food line at rush hour. You will feel good because you are eating healthy. And you will know what is in the food you consume. Try this recipe: Macaroni and Cheese for One 1 T. butter ¼ tsp. Worcestershire sauce 1 T. flour ¼ tsp.. Mustard ½ tsp.. salt ½ tsp.. chopped onion Pinch pepper ¼ cup (dry) macaroni noodles, cooked and drained ½ cup milk 2 saltines crushed 1/3 cup shredded cheddar cheese In a saucepan, melt 1 T. butter; stir in flour, salt and pepper. Whisk in milk until smooth. Cook and stir for two minutes. Reduce heat to low. Add the cheese, mustard, worcestershire sauce, and onion; stir until cheese is melted. Add macaroni. Transfer to a greased 1-cup baking dish. Sprinkle with crushed saltines. Optional: Macaroni and cheese can be eaten without baking, as long as it is heated thoroughly in the saucepan. (Saltines are optional). Bake uncovered at 350° for 15 minutes or until heated through. Yield: 1 serving. Other general ideas: •Make a crock pot of soup or stew-individually freeze single servings. •Grill several chicken breasts or hamburgers on the grill and freeze single servings. •Make a batch of home made cookies and freeze single servings. •Make a batch of taco seasoned hamburger. Freeze in single servings. Thaw and place in a tortilla with cheese, lettuce, salsa, etc. Be Creative. Be Smart. Feel Better.

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Senior Living

Pam Pirotte

2008-02-01 11:16:00

Is Asthma a condition that affects adults?

Answer:Thousands of Americans, both children and adults, die from asthma attacks. Every one of these tragedies is unnecessary and avoidable. Asthma is characterized by swollen airway passages and the production of large amounts of thick mucous. (Although there are many other names for this condition, they are simply names for asthma). Asthma attacks aggravate the already vulnerable airway and can completely close it. This is incompatible with life. Emergency drug administration can usually open the air passages, but sometimes, when the process goes too far, such efforts fail. Any person who suffers from asthma should have a physician directing their care with a medication/lifestyle program. Medication routines fall into 3 categories: • Those that are taken daily, which allow a normal level of activity, including athletics, and uninterrupted sleep. • Those that are inhaled during an unexpected episode of shortness of breath. (No more than 2 times per week). • Those that are taken for a few weeks when signs of an asthma flare-up have occurred. Lifestyle issues are: • General wellness (good diet, minimizing exposure to infection). • Clean house, clean doorknobs, tables, countertops. • Avoiding dusty environments. • Avoiding pollen exposure—or treating during pollen exposure. • Identifying and avoiding triggers: - Mold - Animal dander - Roach and dust mite debris - Any allergen The primary lifestyle challenge is determination of triggers for each individual client. These, then, can be avoided or treated. • If a beloved animal is a trigger he can be bathed frequently or shaved. • If pollen is a problem, special meds may be taken in that season. • If grass (or other common plants) are triggers, allergy shots may be taken. • Bedding should be allergenic and frequently washed. When the asthmatic person: • recognizes and avoids triggers that precipitate signs of illness, • takes their maintenance medications as ordered, • follows a healthy general lifestyle, • discusses symptoms/concerns with their doctor, • steps up their program at the first symptoms; they virtually eliminate the incidence of critical episodes. How wonderful to know that breathlessness need never occur! Here’s a little asthma trivia It is common to use inhaled quick reliever medication for sudden shortness of breath. An asthmatic person should never be without it. • There are 2 things in that tiny canister: airway medicine and the propellant that causes passage into the lungs. • There is more propellant in the canister than there is medicine. • If you don’t keep track of your usage you are inhaling propellant only, for the last 10-20 uses. That’s a bad thing! • The spacer, which may be separately purchased for use with inhaled meds, is not a frill. It increases the amount of medicine actually received during administration. Failure to rinse with water, after use of inhaled steroids, puts the user at risk for a fungal mouth infection. This is an absolutely necessary step. Powdered medications that are inhaled should never be kept in the bathroom. The humidity there causes the powder to cake and decreases effectiveness of administration. This information is part of a nationally recognized Asthma education program. The aim of this program is to call asthma what it is, teach asthmatic persons how to handle it, and thereby eradicate death dealing asthma attacks. And that’s a good thing.

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Senior Living

Shelly Lunsford

2008-02-01 10:12:00

My mother is elderly and lives alone. My sister and I both know that she is not taking proper care of herself. Any time we approach the subject of placing her in an assisted living, she begins to cry and questions our love for her. We immediately quit talking about it and feel guilty for even bringing the subject up. We both have full time jobs and are not able to spend the time with her, making sure that she is cared for. We have tried home health, but she needs more than they offer. Where do we go from here?

Answer: First of all, let me begin by saying that you are not alone. Many families have come to me with the same scenario. It is very difficult for anyone to give up their home and their life as they know it. Change is not easy for most of us. Perhaps your mother is also fearful that she will be giving up her independence as well. Fear of being accepted by the other residents is another concern for many. Whenever we admit a new resident, I try to remember how scared I was my first day of high school. It is the fear of the unknown that typically scares us. Those are undoubtedly some of the same feelings your mother is experiencing too. Assisted livings are the answer for many because they are able to give as much or as little assistance as needed, yet still allow residents to maintain their independence. Residents furnish their apartments with their personal belongings; continue seeing their own primary care physicians and family and friends visit, just as before. The added benefits of choosing the right assisted living is that you will have peace of mind knowing that your mother has twenty four hour assistance, if needed. In addition, she will be assessed by a competent nursing staff that will alert both you and her physician if any changes in her medical condition should arise. One of the greatest benefits that I see in facilities is the socialization aspect. You have seniors who spend most of their day watching television and never interact with other people. Then when they come to assisted living, they start participating in activities, dining with other seniors, forming new relationships, and their outlook on life takes on a new meaning. Placing a loved one in a facility is an agonizing decision. However, it is also one of the most courageous and selflessness acts that you can do for a loved one needing more assistance with the activities of daily living. Making the decision to move your mother into an assisted living is actually the easy part. Choosing the right assisted living takes time and effort. My suggestion would be to start out by bringing in brochures and information about assisted livings in your area. Perhaps your primary care physician or minister would also assist you in approaching this subject. There is strength in numbers. You could start by touring assisted livings with your mother. Call ahead and ask to share a meal with the residents and staff. Watch and see how your mother reacts to the different facilities. Is the staff friendly and helpful? Is the Administrator or Director available to answer any questions? Is there a beauty shop in the facility? What activities are offered? Talk to the other residents. Ask them if they are happy living there. If your mother still refuses to move and her safety is of concern, then I would try a compromise. Ask her if she would be willing to “try out” an assisted living on a trial basis. Many assisted livings also have furnished apartments available with short term stay rates. Good luck in finding the best assisted living that meets your mother’s needs.

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Senior Living

Shelly Lunsford

2008-01-01 14:23:00

I have been checking prices for an assisted living for my mother. How can they have such huge variations in monthly rates from one facility to another? Also, will Medicare pay for any of her assisted living expenses?

There are different ways that a facility can charge residents for their rent and the services they receive. One way is referred to as the “all –inclusive” method. This means that the rent and any additional services are included in a set monthly fee. Another method charges residents a flat rate for a certain set of basic services, and then charges an additional fee for any extra services. This option is sometimes referred to as “a la carte” pricing. Be careful and know exactly what costs are included in the monthly charge quoted by each facility. The facility may have a schedule of charges for each service used by the resident. Ask if it includes everything – bed, board, nursing care, medication administration, meals, housekeeping, laundry, and maintenance? Or are there extra charges? What about telephone charges and cable television? So at first glance, one facility may seem lower priced than another. That is, until they start adding the services on the base rate. In addition to the monthly rent and services, some facilities may charge a security deposit. Others may charge a non-refundable entrance or “community fee.” Some deposits might not be refundable even if the resident moves somewhere else. Many facilities charge an additional fee if payment for rent and services is received late. Be sure you know what is included in your payment before you sign your contract. Most importantly, ask the director/administrator questions about anything that you are unsure of. They want you to feel comfortable with what you are signing. Assisted living is largely a private pay business. Most residents living in assisted livings pay for expenses from private money sources. These sources can include income from pensions and retirement, as well as savings and investments. Some families help cover the costs. In other cases, the sale of real estate and personal property is used. Long term care insurance is also an option that is being used to help with funding. The insurance usually pays a certain sum of money for a certain period of time. The Medicare program is a federal health insurance program for people 65 and over and certain disabled people under 65. Eligibility for Medicare requires that either the individual or spouse has worked enough months to qualify for Social Security Benefits. Medicare covers home health care, and the same Medicare rules apply whether the individual is at home or in an assisted living. The Medicare program can pay for home health care only if the person is “homebound” based on the reasoning that a resident who is NOT homebound could travel to a hospital or clinic for routine health care. An assisted living resident is considered homebound if leaving the facility is a difficult process. The Medicare benefit generally requires a need for skilled nursing care, physical, or speech therapy. Nursing care is considered “skilled” if it requires the expertise of a licensed nurse (wound care or giving an injection). Bathing a resident or helping a resident get dressed do not qualify as skilled nursing and do not qualify for Medicare. Therefore, generally speaking, Medicare does not cover the day to day expenses of an assisted living.

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Senior Living

Pam Pirotte

2008-01-01 11:17:00

How can I make the holidays less stressful?

Christmas is typically one of the most stressful events of the year. The expense of buying gifts, the pressure of last minute shopping and the heightened expectations of family togetherness can all combine to undermine our best intentions. Some practical suggestions can help you reduce your ‘Christmas stress’. For many of us, the Christmas aftermath includes massive credit card bills that can take months to clear. Christmas doesn’t have to be a financial headache if you plan ahead. • As early as you can in the New Year, work out a rough budget of expected Christmas costs. Don’t forget ‘hidden’ expenses such as food bills and overseas telephone charges. • Calculate how much disposable income you have between now and Christmas. A certain percentage of this can be dedicated each week (or fortnight or month) to covering your expected Christmas costs. Don’t be discouraged if the amount seems small. If you save $5.00, $10.00 or $20.00 per week over a year, it can provide you with a hefty nest egg. • If your nest egg isn’t enough to cover your estimated expenses, perhaps you may need to refigure your Christmas budget to a more realistic amount. • If you have trouble keeping your hands off your Christmas nest egg, consider opening a ‘Christmas Club’ account. If you have a large circle of extended family or friends to buy gifts for, it can be very costly. You might be able to reduce the stress and cost of Christmas for everyone if you suggest buying presents only for the children or limiting the dollar amount to be spent on each present. Make a list, shop early and take advantage of the post-Christmas sales. If you are cooking lunch at home, delegate tasks, and have everyone bring a covered dish. Don’t wait until Christmas Eve to shop—plan ahead and avoid the rush. The little extras Other ways you might be able to reduce the stress include: • Write up a Christmas card list and keep it in a safe place so that you can refer to it (and add or delete names) year after year. • Plan to write your Christmas cards in early December. Book a date in your diary so you don’t forget. • Christmas cards with ‘Card only’ marked on the envelope can be posted at a reduced rate during November and December. • Overseas mail at Christmas time takes longer to arrive. Arrange to send cards or presents in the first half of December, to avoid disappointments (and long queues at the post office). • For great savings, buy Christmas necessities (such as cards, wrapping paper, ribbons and decorations) at post-Christmas sales. General health and wellbeing Some other ways to keep your stress levels down include: • Try to be moderate - it may be the season to be jolly, but too much food and alcohol is harmful, and drunk driving is a real danger and illegal. If you can’t (or don’t want to) step off the social merry-go-round, at least try to eat and drink in moderation. • Get enough sleep - plan for as many early nights as you can. • Keep moving - keeping up your regular exercise routine can give you the fitness and stamina to make it through the demands of the festive season. Have a wonderful New Year!

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Senior Living

Shelly Lunsford

2007-12-01 10:04:00

My brother was recently hospitalized and upon his release his doctor told us he would never be able to return to his assisted living residence. After we moved him out, he was terribly depressed.

We make all of our decisions based on assessments. After each assessment, it is then determined whether or not the resident can stay. However, there are a few points that I would like to stress. All assisted livings are not created equal. Each assisted living has their own set of guidelines by which they assess. For instance, in one facility a resident may be refused because they are an elopement (runaway) risk. A different facility may welcome that resident and have a care plan in place to keep them safe, which would typically include a locked down facility and possibly an alert band. Another point to keep in mind is that the idea of “assisted livings” can bring to mind different meanings to many people, even to the professional medical field. Assisted livings have changed over the past few years, with more and more assisted livings taking on heavier resident care load than in the past. One must also bear in mind that assisted livings offer physical therapy, speech therapy, occupational therapy, home health and hospice. Aging in Place is a concept that is becoming more popular with assisted livings. This simply means, “growing older without having to move.” The main focus is to not have to move from place to place and being familiar with the surroundings and other residents, allowing the individual to “age in place”. This allows residents to produce more favorable outcomes and also reduces relocation stress syndrome. The best solution for your brother would have been a “team” assessment between the assisted living director and nurse, the physician and care coordinator of the hospital. Only then would you know if the assisted living could have met his needs.

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Senior Living

Pam Pirotte

2007-12-01 09:11:00

What is MRSA?

**image1:left** Answer: MRSA stands for a drug resistant staph infection, which can kill. It can attack skin, deeper tissues, blood and the respiratory system. The Associated Press reported that 90,000 Americans get infected each year by this bacteria, MRSA. According to a study published in the Journal of the American Medical Association this past week (November 2007), the incidence or frequency of infection is astonishing. Researchers found the worst infections were contracted by patients in the hospital, those who had recently had surgery, and those on kidney dialysis. Deaths tied to these infections exceed AIDS deaths, according to a public health expert commenting on the study (17,000/year for AIDS, nearly 19,000 for MRSA). Contaminated medical equipment was identified as a major source of infection. In addition, the germs are now found in the community, prisons, everywhere. Healthcare workers who are not ill themselves may be carriers of the staph bug (on their skin and in their nasal passages). This can be true of anyone who has been in contact with the bacteria, from doorknobs, handrails, countertops, etc. Non-institutional cases (contracted at school or in the neighborhood) are usually manifested by skin eruptions. Some infected persons experience a progression into their blood and even their bones. Most life threatening cases occur in surgical or on-going health care consuming patients. A 17 year old Virginia High School Senior died Monday, November 5, 2007. Doctors said the germ had spread to his kidneys, liver, lungs, and the muscles around his heart. The article did not state how it began. Once a person is infected, the chance that any antibiotic will cure the problem is dramatically reduced. The germ enters through broken skin, or mucous membranes (eye, nose, mouth, etc.). Prevention is essential. If you are hospitalized, insist that everyone who touches you washes their hands first. The gloves healthcare workers wear to provide your care are not sterile. At least insist that they put on new gloves in front of you. (Don’t allow them to enter your room with “old gloves” on. Wash your hands immediately upon entering your home. If you get a breakout on your skin, immediately apply milk of magnesia. The germs cannot live in the presence of alkalinity. If your rash isn’t MRSA it won’t hurt to do this. If it is MRSA, it should resolve quickly.

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Senior Living

Pam Pirotte

2007-11-01 10:18:00

Why is bowel health in the news lately?

The research community is coming to recognize that bowel health is essential to the well being of the entire body.

Some voices in the health care field say that the intestines are the seat of disease resistance. There are common assaults to bowel health to which most of us are subject: Chlorination, which kills bacteria in our water supply, also kills the good bacteria which should populate the bowels. Antibiotic therapy for earaches, acne, respiratory infection, bladder infection, kills the good bacteria which should populate the bowel. Refined sugar intake promotes the growth and overgrowth of yeast parasites in the bowel—which is a bad thing. Yeast overgrowth has been linked to a whole list of health problems. High fat intake has been linked to cancer of the bowel.

Sometimes a symptom of poor bowel health, sometimes a cause of further health problems, constipation is a very bad thing.

For many years it was commonly held that bowel movements happened when they happened and that was all normal. Even a person who only had a bowel movement once a week was normal.

The bowel gurus are now saying oftener is better. Food shouldn’t remain in the digestive tract for more than 24 hours. Three bowel movements a day is great. At least one large bowel movement is essential. Old intestinal contents harm the intestines themselves. Some say that an overstuffed large intestine causes toxins to leak across the bowel wall into the bloodstream and cause arthritis.

So how do you get your bowels in tip top shape? Eat whole foods. If it’s white, don’t eat it. Drink plenty of water—chlorine removed. Take probiotic supplements to restore healthy bowel bacteria. Take good quality multi-vitamins and multi-mineral supplements. Folic acid has been shown to be protective against colon cancer.

A high fiber diet has also demonstrated protection from gastro-intestinal cancers, 32 grams of fiber a day is recommended. A high fiber intake lowers the risk of developing: heart attack, stroke, diabetes, high blood pressure, or gastro-intestinal cancer.

Soluble fiber lowers cholesterol and blood glucose levels. Examples are: oats, dried beans, barley, flax seed, oranges, apples, carrots, psyllium, or broccoli.

Insoluble fiber increases bowel movements and promotes regularity. Examples are: whole wheat, bran, all fruit skins, beets, spinach, blackberries, or kiwi. Get your bowels into good shape. Keep them that way. Then, the rest of yourself has a jump start toward functioning at its very best.

 

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Senior Living

Pam Pirotte

2007-10-01 11:09:00

Do senior citizens fall more frequently than younger people?

Answer: Falls are usually a result of health issues which become more common as we grow older. The “fell and broke a hip” story is generally a misrepresentation. Many times a hip fracture is the reason for the fall. Gradual decalcification of the bone finally results in a fracture. The fall happens after the fracture. (This is one of the reasons we don’t want to have osteoporosis). Of course, there are many other reasons for a fall, and whenever a fall occurs, the resulting injuries are potentially life threatening. So, we don’t want to fall if we can help it, and if we fall, we want to know why, so we can fix the problem, and avoid falling again. • Some medications cause dizziness, according to the literature. Some interact with certain other medications to cause dizziness. Some people react in unexpected ways to a medication which doesn’t usually affect balance. If you are the one whose balance is affected, even if you’re the only one, get off the drug. Your pharmacist can review your meds for such issues. • Eye changes can affect balance. A new eyeglass prescription, trifocal line, an error in production of your glasses, can affect sight, causing tripping or dizziness, resulting in a fall. • Cardiovascular drugs for blood pressure, aching extremities, water retention can cause dizziness when moving from lying, to sitting, to standing positions. This effect may signal a dangerously low blood pressure. You should record your blood pressure at such times, and report to your cardiologist. • Being dehydrated due to a recent illness, or sweating, or because water pills are too strong, can cause lightheadedness. Have your doctor check sodium and other trace minerals. • Low blood sugar affects balance and can even cause a loss of consciousness. • Newly developed neurological problems which result in blackouts, small strokes or TIAs (temporary strokes) may be the cause. Get a thorough workup from a neurologist, if you suspect any of these. • If oxygenation problems exist, many times they are slow to develop and the person affected does not feel short of breath. Your physician may have an oxymeter machine which is an easy way to check. Values lower than 93% should be investigated. A pulmonologist is the doctor to see for lung problems. • Unmanaged Hypertension can result in blackouts. Check your values 3 or 4 times throughout the day, and note the time of your last dose of medication. If your blood pressure is high any time of day or night, your blood pressure is not under control. Maybe your cardiologist can help. • Ear infections, loss of hearing, wax buildup, antihistamine drugs for allergy management, can cause balance problems. Check it out. Take charge of your life. Don’t fall, or at least, don’t fall again!

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Senior Living

Shelly Lunsford

2007-09-01 09:59:00

My friend moved into an assisted living six months ago. Last month she was diagnosed with terminal cancer. She was referred to Hospice and was moved into a nursing home immediately after that. Do assisted livings allow terminal residents or hospice in their buildings?

Answer: That is an excellent question and one that comes up quite often. Of course I don’t know the facts in your particular situation, but Hospice can be called in to the assisted living residence just as if it were your home. In fact, your loved one is in better hands because you have both the facility staff and the Hospice staff working together as a team to care for your loved one. Staying in their residence is like having the best of both worlds. Ordinarily, there is no reason for the resident to move into a nursing home except under special conditions. With that said, Hospice and the assisted living staff should work together to provide the best course of action for your loved one in order that he/she gets the best possible care. Often times staying in the assisted living is better for your loved one because they remain in their familiar surroundings with their familiar care givers. Many residents have already formed meaningful bonds with other residents and staff and to suddenly take that away from them causes them to grieve not only about their physical condition, but also about their loss of relationships. Our goal is to give the resident what they want most, which is typically to stay in their home, while giving them the best care possible. Before choosing both a Hospice and an assisted living residence, be sure to ask questions regarding terminal illnesses and their policies. Their first concern should always be your loved one.

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Senior Living

Pam Pirotte

2007-09-01 09:59:00

: I am newly diagnosed with Diabetes. How can I keep track of medicine, food restrictions, and schedule?

Question: I am newly diagnosed with Diabetes. How can I keep track of medicine, food restrictions, and schedule? Answer: Whenever a person is taking medication to control blood sugar, she should keep these things in mind: 1. The medicine always lowers blood sugar. • Your food intake must “dance” with your hypoglycemic agent. • If the food consumed is not enough to balance the medicine taken a low sugar episode will occur. • Unplanned exercise (a long walk, chasing a child, etc.) can result in an episode of low blood sugar. • Low blood sugar can be fatal. The victim becomes unable to think or act on her own behalf when blood sugar goes too low. • Always carry food in case of such an event. • Eat at least 6 small meals per day (every 2 hours) about 250 calories for women, 300 calories for men. (Adjust up or down according to individual need). 2. You must determine, by careful observation, a level of balance for yourself. • Blood sugar beyond normal range (maximum of 120) harms the heart, blood vessels, kidneys and eyesight. • Diabetic instructional guides or professionals, who say that now diabetics can have ice cream and other sweets, are misleading their clients. • Every diabetic meal or snack should consist of protein (fish, chicken, beef, pork, egg, cheese) and complex carbohydrates (unprocessed vegetables and whole grains). • Fats are usually adequate, either within the protein source or salad dressing. • These proper foods result in gradual blood sugar elevation (a good thing). • When you are eating every 2 hours, you are never full and never hungry (a good thing). • “If it’s white, don’t eat it!” Refined carbohydrates (all sugar, all purpose flour, rice, potatoes) cause sharp sugar elevations (a bad thing). • Fruit and fruit juices are not good for diabetics. • Very small amounts of fruit (1/4 of an apple) with a protein source (cottage cheese, etc.) may be eaten. • When blood sugar is controlled the complications of Diabetes are avoided. • Eating like a diabetic person should eat, is good for anybody—everybody. It isn’t a punishment. • Good Health!

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Senior Living

Larry Nanny

2007-08-01 11:27:00

Answer: For the person who is about to enter a nursing facility, and for caring family and friends, the days just before and during the move can be traumatic. Anticipation, fear and guilt -- often combined with illness or the recent loss of a loved one -- mean that the individual faces the future with fear and doubt. This is not unusual. With love, understanding, help and planning, the uncertainty of entering and adjusting to life in a nursing facility can be greatly minimized. Though not always possible, the involvement of the resident in selecting a nursing facility can make a critical difference in the final adjustment. If able, the resident should have input into choosing a nursing facility that fits the resident’s personal style of living. As far in advance as you can, begin planning for the move. To the extent possible, plan the move with the help and participation of the resident. Remember, the professionally trained staff understands your concerns and is eager to help you make this period as calm and positive as possible. It’s a good idea to get a head start on paperwork and financial details. Before admission day arrives, fill out the forms to the best of your ability, making note of any questions you and the resident may have. Provide a complete medical and personal history for the resident. Check on Medicare and Medicaid eligibility requirements. Review your understanding of payment, money management and other details. Don’t hesitate to ask questions. It is the resident’s right to make decisions. Family input is welcome, but ultimately the resident has the final say. Should the resident be incapable of making key decisions, the legally designated responsible party makes decisions. It is this individual’s responsibility to communicate information to other family members. If you have questions about handling the decision making process, or deeper questions about advance directives, guardianship, or powers of attorney, contact the nursing facility administrator or your family attorney. On the day of admission, family and close friends should plan to spend several hours in the facility helping the new resident set up the room, learn his or her way around, and meet some of the staff and residents. Family and friends might also plan to attend the first meal or a planned activity. When family members depart from the facility, they may be faced with an emotional reaction from the resident. Assure the resident that family will call and visit often and soon. Remember that when you make plans, you should make every effort to keep them. It is never our goal to spend time in a nursing home. But if you take some of these things into account and do as much pre-planning and research as you can to assure your loved one is in the right place and receiving appropriate care and services, the stress will be minimized.

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Senior Living

Ange Aubrey

2007-08-01 11:27:00

: Who are typical Lifeline subscribers? Answer: Allison is an artist and she lives alone. Her art work has been her livelihood and since retiring is now her hobby. She has a friend and bowling partner who was in good health and active like herself. Her friend had a serious fall, and was unable to get up. Her friend’s incident was the stimulus for her to get Lifeline. She hasn’t had to use the service, but she feels secure knowing she has it. This subscriber represents the number 4 in our concept – she has the service but hasn’t yet had a need to press her personal help button. Glen is a retired gentleman, who lives with his wife. Gardening is his passion. One day he was in the garden when he tripped on a garden hose and fell. He was unable to get up and called out for his wife. His wife didn’t hear him, so he pressed his Lifeline personal help button. His wife heard the Lifeline Response Associate through the speaker of the unit in the house. They told her they had received a signal. She went out to the garden and helped her husband up. Having Lifeline gives this subscriber the support he needs to continue to enjoy his gardening passion. This story is representative of the 3, in our 4-3-2-1 concept. He pressed his button, Lifeline called a responder to assist. The situation could have turned out very differently without the Lifeline assistance. Wanda is a diabetic and has lost circulation and sensation in her feet, affecting her balance. Her daughter subscribed to Lifeline for her because of her risk for falling. She lives with her daughter who works full-time so she’s alone quite a bit. She did in fact fall on the stairs once before, pressing her Lifeline personal help button and her daughter came home to assist. After the incident an occupational therapist gave her instruction on how to be safer and prevent falls, and instructed her in walking down the stairs utilizing the stair railing. She’s fiercely independent. Having the security of Lifeline allows her to maintain her independence. Wanda’s story represents another case where the subscriber pressed her button and a responder was called to assist. Carl suffers from congestive heart failure. His hobby is carpentry and his workshop is in the basement. Clim

Answer: The one way to remember how Lifeline Subscribers use the service is by understanding that on average, for every 4 Lifeline subscribers, 3 will need to press their button for some assistance and 2 will require Lifeline send a responder to assist. For example: a subscriber may fall, not be injured but need help getting up. Lifeline will call a neighbor, friend or relative to come and assist. Or, a subscriber who is on oxygen calls because their oxygen tank is getting low and they need a responder to assist. One subscriber will press their button and the situation requires rescue services. For example: the person may be having a stroke or heart attack; or they had a serious fall and need to be transported to the emergency department. So remember the 4-3-2-1 concept. Question: Who are typical Lifeline subscribers? Answer: Allison is an artist and she lives alone. Her art work has been her livelihood and since retiring is now her hobby. She has a friend and bowling partner who was in good health and active like herself. Her friend had a serious fall, and was unable to get up. Her friend’s incident was the stimulus for her to get Lifeline. She hasn’t had to use the service, but she feels secure knowing she has it. This subscriber represents the number 4 in our concept – she has the service but hasn’t yet had a need to press her personal help button. Glen is a retired gentleman, who lives with his wife. Gardening is his passion. One day he was in the garden when he tripped on a garden hose and fell. He was unable to get up and called out for his wife. His wife didn’t hear him, so he pressed his Lifeline personal help button. His wife heard the Lifeline Response Associate through the speaker of the unit in the house. They told her they had received a signal. She went out to the garden and helped her husband up. Having Lifeline gives this subscriber the support he needs to continue to enjoy his gardening passion. This story is representative of the 3, in our 4-3-2-1 concept. He pressed his button, Lifeline called a responder to assist. The situation could have turned out very differently without the Lifeline assistance. Wanda is a diabetic and has lost circulation and sensation in her feet, affecting her balance. Her daughter subscribed to Lifeline for her because of her risk for falling. She lives with her daughter who works full-time so she’s alone quite a bit. She did in fact fall on the stairs once before, pressing her Lifeline personal help button and her daughter came home to assist. After the incident an occupational therapist gave her instruction on how to be safer and prevent falls, and instructed her in walking down the stairs utilizing the stair railing. She’s fiercely independent. Having the security of Lifeline allows her to maintain her independence. Wanda’s story represents another case where the subscriber pressed her button and a responder was called to assist. Carl suffers from congestive heart failure. His hobby is carpentry and his workshop is in the basement. Climbing the stairs causes him to have shortness of breath. He’s also at risk because he uses sharp tools. He did get Lifeline because he recognized his risks for needing emergency help. One day he was in the basement in his workshop and found it very difficult to breath. He pressed his Lifeline personal help button. He knew Lifeline would contact a responder. When the responder arrived at the house, the subscriber was unable to speak and was in considerable respiratory distress. The responder asked Lifeline to call emergency services and Carl was transported to the emergency department. Carl represents the “1” in our 4-3-2-1 concept – the 1 out of 4 subscribers who need emergency rescue services.

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Senior Living

Rev Bill Shook

2007-08-01 11:27:00

It seems like there is so much information out there about what’s coming tomorrow, that few of us get the time to reminisce about what happened yesterday. How about a monthly column dedicated to memories of the earlier part of the 20th century?

Answer: Great idea. For many of us, the time when we were kids and growing up hold some of our fondest memories. Sometimes, just a reminder of dates and things that happened on these dates can be a wonderful stimulus for memories. Do you remember a man named David Daniel Kaminski? Okay, how about the name he was better known as, Danny Kaye? This month, let’s remember him. David Daniel Kaminski, also known as Danny Kaye, was born January 18, 1913. He was a garment center tailor’s son. He dropped out of school at age 13 to become a clowning busboy in the “Borscht Circuit” in New York’s Catskill Mountains. He later worked intermittently as a soda jerk and insurance agent while slowly getting ahead in vaudeville and nightclubs as a singer-dancer-entertainer. During the 30’s, he appeared in several two-reel film shorts for educational pictures. He made his Broadway debut in “The Straw Hat Revue,” with Imogene Coca In 1939. Early in 1941, appearing in Broadway’s “Lady in the Dark,” he stopped the show nightly with a song called “Tchaikovsky” in which he reeled off the names of 54 Russian composers, real and imagined, in 38 seconds. This type of staccato delivery of tongue-twisting lyrics would be his trademark in many subsequent stage, film, and TV appearances. In 1943, he was signed by producer Samuel Goldwyn. The following year, he starred in “Up in Arms,” the first of a highly successful string of lavish technicolor Goldwyn comedies that were tailor-made as showcases for the display of Kaye’s versatile talents. Easygoing and personable, Kaye enjoyed enormous popularity in the late 40’s, thanks to his sunny personality, broad pantomime, clever impersonations and vocal virtuosity. He combined these talents most admirably in “The Secret Life of Walter Mitty” (1947), a film that gave him the opportunity to caricature several different personalities. Kaye’s popularity was even greater in Britain, where he enjoyed huge success with record-breaking engagements at the Palladium in 1948 and 1949 and made personal appearances at the royal palace. In the late 50’s, however, his popularity on either side of the Atlantic decreased when he began devoting more and more of his time entertaining children in developing countries on behalf of UNICEF. In 1954 he was awarded a special Oscar for his unique talents, his service to the Academy, the motion picture industry, and the American people. During the Oscar ceremonies of 1981 he was the recipient of the Jean Hersholt Humanitarian Award. Kaye made only sporadic film appearances after 1960. From 1963 to 1967 he starred in his own hour-long TV variety program, “The Danny Kaye Show,” for which he won both an Emmy and a Peabody Award. In 1970 he returned to Broadway in the musical “Two by Two.” A talented musician, he appeared from time to time as a mock guest conductor with the New York Philharmonic and other symphony orchestras. He was a co-owner of the Seattle Mariners baseball club. Many of his songs and much of his comedy material was written by his wife since 1940, Sylvia Fine. Danny Kaye died in 1987 at the age of 74 of hepatitis and internal bleeding, the consequence of a transfusion of contaminated blood during quadruple bypass heart surgery in 1983.

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Senior Living

Shelly Lunsford

2007-07-01 16:13:00

I have been looking for placement for my aging mother. What are the differences between assisted, independent and skilled nursing facilities and what are some of the things I need to look for in finding the best placement for her?

Answer: Assisted Living facilities have rapidly developed through the years as a result of the health care needs in our community and the demand for quality senior living that falls between independent living and nursing homes. Assisted Living communities exist to bridge the gap between seniors that can live independently, those who require minimal help, and nursing homes, those who require a higher level of assistance and medical care on a continuous basis. Independent living is for active older adults who desire a maintenance-free lifestyle and who are capable of residing alone. Usually, they are looking to free themselves of the responsibilities of home ownership and maintenance and are capable of performing everyday tasks independently. They recognize their own health, medical, financial, and legal needs. Assisted living is a long term care alternative for seniors who need more assistance than is available in an independent facility, but who do not require the medical and nursing care provided in a skilled nursing facility. Assisted living offers residents all the benefits of independent living with the additional services to assist with the activities of daily living (ADLs). Assisted living provides assistance on an “as-needed” basis. Assisted living residents may require help with ADLs such as dressing, bathing, help with transfer, medication assistance, and nutrition. Assisted living includes three restaurant-style meals daily, weekly housekeeping services, medication management, a full array of daily activities, and all utilities except for cable and telephone. Assisted Living communities are closely involved in the health needs of their residents. They often have a person designated to oversee this called a ‘Resident Care Coordinator’. They coordinate the monitoring of health related issues involving medication, diet, personal hygiene, socialization and mental acuity to assist the senior and their family as they interact with health care professionals. If a decline is noted in a specific area, family and health care professionals are consulted by the Resident Care Coordinator to resolve issues. Often, because of their experience, unexpected emergency health issues are avoided, as signs of a decline are recognized and acted upon early. Residents can live at an assisted living for many years, even as their health declines considerably. Many offer hospice care and end of life assistance. There are many ways to choose an assisted living residence for your mother. Assisted living residences are regulated by the State and are surveyed yearly. The latest survey report is always available for public viewing. In addition, you should always tour the residence you are thinking of placing your loved one in and talk to many of the residents that live there. Ask questions. Go to the local fire department and ask them their opinion of the assisted living residence. Ask to have a meal at the assisted living to see what the food is like. Make a surprise visit to the residence. Ask about staff to resident ratio. Watch how the staff and residents interact while you are visiting. After a thorough investigation, I am sure you will find a great home for your mother.

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Senior Living

Pam Pirotte

2007-07-01 16:13:00

I have noticed that as I get older I am constantly getting confused. Does my confusion have anything to do with certain types of medical conditions?

Answer: Few symptoms are more alarming to an independent person 50+ than confusion or severe forgetfulness. Because of the fear of Alzheimer’s, this kind of problem may be kept secret by the victim. Such an approach is, at least, not constructive. The Good News: Never does Alzheimer’s appear suddenly. Interestingly, confusion is a very non-specific symptom! For some reason, elderly people will present with confusion when any number of medical conditions, in other parts of the body, are to blame! Here are some reasons confusion may present, and the tests which confirm the cause: • Bladder infection — urinalysis • Blood infection secondary to an injury — blood count • Depression with secondary loss of appetite (which results in dehydration/electrolyte imbalance) —blood chemistry • Dehydration and electrolyte imbalance from vomiting, fever, overheating (sun), diarrhea — blood chemistry • Medication reaction —medication review • Stroke — cardiovascular workup • Fall resulting in mild concussion — neurological workup • Blow to the head with subdural hematoma — neurological workup • Blood sugar abnormalities —blood chemistry • Systemic or viral bacterial infection — blood chemistry It is wise to enlist the support of close friends or relatives, so that if you or they notice changes in your mental character, medical care will be sought. Anticipate this possibility. Discuss it and agree to cooperate, if you are told you need to visit the doctor. Knowledge is power! Don’t neglect yourself. Find the cause – Fix the problem. Get back in charge. Amen.

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Senior Living

Ange Aubrey

2007-07-01 16:13:00

What are some of the services available to assist individuals in remaining more independent?

Answer: Living independently is the preferred choice for many older Americans. Living independently fuels a sense of physical, mental and emotional well-being. For many, staying in one’s own home is also practical from a dollars and cents point of view. A senior with chronic health problems (such as heart disease, osteoporosis, or diabetes) may be cared for at home by a spouse, an adult child or a paid caregiver. The caregiver may work, so finding or incorporating ways to stay connected to others is important even if you’re not living alone. Staying connected is important. Contact with others is vital for a sense of well-being and “connectedness.” Conversely, the less connected a person becomes, the greater risk of loneliness, isolation, depression, reduced appetite and less physical activity. Any of these conditions can, in turn, lead to a general decline in physical, mental, and emotional health and well-being. The bottom line: if you’re living independently, take steps to stay connected! Question: What are some activities older adults can do to stay connected? Answer: A wide variety of non-medical home support services can be obtained, including: Personal Emergency Response Service In- Home companion services Transportation Chore and personal care Housekeeping Meal programs Exercising our mind helps keep us sharp, and helps prevent depression and decline. Some suggestions are: •Enroll in a computer class at a senior center •Complete the daily crossword puzzle or Sudoku •Learn to paint •Learn a new language utilizing audiocassette tapes or CDs •Challenge yourself to learn something new every day If possible, go to the senior center or attend an adult day program. Invite others to your home or identify volunteers from local community or religious agencies to provide friendly visitation in the home.

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Senior Living

Larry Nanny

2007-07-01 16:13:00

How do I know when my aging relative needs help?

Answer: For many people, independence is something they fall in love with the very first time they experience it. Whether it’s a teenager left home alone for the first time or a college student finally leaving the nest, that first taste of independence can be a wonderful thing, something most people want to maintain the rest of their lives. Unfortunately, as people grow older, independence can often be a detriment to their well being, leaving their loved ones in a difficult position with respect to their care. Deciding to put a parent or an elderly relative in a care facility is never an easy decision, as chances are that person will want to remain independent. You may also feel guilty about the decision wondering if the facility can provide the best care. To help you make the correct call, here are some things to consider: Physical health. This is typically one of the more decisive factors in whether or not a nursing home is the right move for your loved one. Chronic disease, such as diabetes or arthritis, can greatly limit an elderly person’s independence, sometimes making it impossible for them to live on their own. If you cannot care for them adequately enough, a nursing home or another facility might be your only option. In addition, heart disease, stroke or cancer can also rob loved ones of their independence, meaning a nursing home might be the best option for sufferers of these diseases as well. Mental health. Typically, Alzheimer’s is a chief concern for relatives of the elderly. If your loved one appears disoriented most of the time or has regular feelings of confusion, professional help might be the best decision. Also, bouts with depression or anxiety can be difficult to deal with if you’re not trained to do so. While these conditions do not mandate you put your loved one in a home, it may be necessary if someone cannot be available round-the-clock to provide care. Medication use. Pay close attention to your loved one’s medication routine. If he’s forgetting to take his medication or taking too much, or even failing to remember if he took it or not, independence is no longer a legitimate option. Too little or too much medication can prove to be a fatal mistake. Daily living skills. While few elderly people can get up and go like they used to, exhibiting difficulty with some of the more routine tasks a day presents could be a sign that help is necessary. Struggles with bathing, dressing or even using the toilet indicate a dwindling ability to live independently. Similarly, such struggles might leave you worried about your loved one’s ability to cook and clean for themselves, which could lead to tragedy. Similar to other areas of concern, this should be looked at subjectively. If your loved one still has his mental health but might be struggling with some of the aforementioned tasks, perhaps having him move in with a younger relative or hiring someone to help him can help you avoid the nursing-home scenario. If no such support system is realistic, a home could be your best move. Knowing when the time is right to consider moving your loved one into some type of facility is never an easy one. If you are struggling with this decision please consider some of the things mentioned in this article. These are not the only things to take into consideration. You also will need to look at safety, finances, and support systems available as well.

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Senior Living

Greg Feldman

2007-07-01 16:13:00

As I become older how do I know that my home is safe to help prevent injuries such as falls so that I can maintain my independence at home?

As baby boomers plan for retirement years, they want housing and renovations that will allow them to remain at home as long as possible. Many are also caring for aging family members who continue to live at home. Falls are the number one safety issues facing seniors. Most falls occur at home. Each year 734,000 people over 65 are treated in hospital emergency rooms for injuries associated with stairs, bathtubs, furniture, carpeting and other products seniors live with and use every day. They account for almost two-thirds of injuries for which those over 65 are hospitalized, and 40 percent of admissions to nursing homes. Falls are also the leading cause of fatal injury among seniors. Stairs and steps considerations should be to make sure light switches are at both the top and bottom of the stairs. There should be enough light to see each step at the top and bottom landings. Install hand rails on both sides of the stairway and be sure to use them. Put non slip treads on each bare-wood step. Do not place loose area rugs at the bottom or top of stairway. Bathrooms are also a place that needs to be secured for safety. Grab bars should be installed on bathroom walls near the toilet and along the bathtub or shower. Place a slip-resistant rug adjacent to the bathtub for safe exit and entry and use nonskid adhesive textured strips on the bathtub or shower floor. Use a sturdy, plastic seat in the bathtub if you are unsteady or if you cannot lower yourself to the floor of the tub. Stabilize yourself on the toilet by using either a raised seat or a special toilet seat with armrests. The bedroom should be clear of clutter from the floor, a lamp and flashlight should be near the bed. Install night lights along the route to the bathroom from the bedroom or when ambulation is a problem place a portable commode at the bedside. Keep a telephone near the bed. In living areas, arrange furniture to create clear pathways between rooms and remove low coffee tables, magazine racks, footrests and plants from pathways. Install easy access light switches at entrances to rooms so you won’t have to walk into dark rooms to turn on the light. Secure loose rugs with double-faced tape or slip-resistant backing. Place carpeting over concrete, ceramic and marble floors to lessen the severity of injury in case of a fall. Loose wooden floorboards should also be repaired immediately. The kitchen also needs some attention to make sure it is safe. Remove throw rugs and clean up spills on the floor right after they happen. You should store food dishes and cooking equipment at easy to reach level. Use nonskid floor wax to bring down the risk of falling in an area that is already a large risk. There are various organizations that can assist with making the home safe such as the Department on Aging and the various home health agencies that employ occupational therapists who are trained in home safety. Equipment can be purchased from durable medical suppliers. Also resources such as medical alert monitoring, Life Line organization, and companies that will provide care givers in the home any where from 1 to 24 hours a day. The one thing to keep in mind when talking to these companies is that this service is not a way to take independence away but to help the senior to maintain independence at home.

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Senior Living

Rev Bill Shook

2007-07-01 12:34:00

Answer: Great idea. For many of us, the time when we were kids and growing up hold some of our fondest memories. Sometimes, just a reminder of dates and things that happened on these dates can be a wonderful stimulus for memories. This month I will take the first quarter of the year 1925, and list some of the dates events happened. The web site http://www.brainyhistory.com/years/1925.html was a lot of help in compiling this list. If you like this column, let us know and we will do more of it in the future. Some things that happened in the year 1925: January 1 - Norway’s capital Christiania changes name to Oslo; January 2 - Gorno-Badakhshan Autonomous Region established (now in Tadzhik SSR); January 3 - Mussolini dissolves Italian parliament/becomes dictator; January 4 - French psychologist Emil Coue brings his self-esteem therapy to U.S. “Every day in every way I am getting better and better”; January 5 - French Baseball Federation awards silver medals to John McGraw, Charlie Comiskey, and Hugh Jennings; January 5 - James Gleason and Richard Tabers “Is zat so?,” premieres in New York City; January 5 - Nellie Taylor Ross became governor of Wyoming, 1st woman Governor in USA; January 5 - Under Polish control, Danzig establishes Port Gdansk post office; January 6 - Paavo Nurmi, sets indoor record, 4:13.6 mile and 14:44.6 5,000m. January 7 - Musical “Big Boy” with Al Jolson premieres in New York City; January 8 - 1st all-female U.S. state supreme court appointed, Texas; January 9 - German Postal Minister A Hofle resigns due to corruption; January 10 - France-Saarland forms; January 10 - Miriam (Ma) Ferguson sworn in as Texas gov, nation’s 2nd woman governor; January 11 - Franc B Kellogg replaces Charles Hughes on as U.S. Secretary of State; January 12 - John Howard Lawson’s “Processional,” premieres in New York City; January 14 - Alban Berg’s atonale opera “Wozzeck,” premieres in Berlin; January 15 - Hans Luther forms German government, with DNVP; January 16 - Gen M Froense replaces Trotsky as People’s Commissioner of Defense; January 16 - Leon Trotsky dismissed as CEO of Russian Revolution Military Council; January 19 - Minus 48 degrees F (-44 degrees C), Van Buren, Maine (state record). January 20 - U.S.S.R. and Japan sign treaty of Peking, Seychelles back to U.S.S.R; January 21 - Albanian parliament announces itself a republic; Ahmed Zogoe pres; January 22 - Albania Republic proclaimed under President Achmed Zogu; January 24 - Moving picture of a solar eclipse taken from dirigible over Long Island; January 24; Sandler follows Branting as premier of Sweden; January 28 - Minus 46 degrees F (-43 degrees C), Pittsburgh, New Hampshire (state record); January 29 - British Liberals choose David Lloyd George as party leader; January 30 - Turkish government throws out Constantine VI of Constantinople ; January 31 - Premier Ahmed Zogu becomes president of Angola. February 1 - 1st national conference of KPD’s Rotfrontkampferbund in Berlin; February 2 - Belgian episcopacy rejects liberalism, communism and socialism; February 2 - Dogsleds reach Nome with emergency diphtheria serum after 1000-km; February 2 - NL holds Golden Jubilee Year meeting at same hotel where NL began; February 8 - Kaufman and Berlin’s “cocoanuts,” premieres in New York City; February 8 - Marcus Garvey enters federal prison in Atlanta; February 9 - German Minister Stresemann proposes security treaty with France; February 9 - Haifa Technion (Israel), opens; February 10 - 1st waterless gas storage tank put into service, Michigan City, Ind; February 10 - AL decides to alternate leagues for game 1 of World Series each year; February 12 - 1st federal arbitration law approved by Congress; February 12 - E Thieffry departs with Handley Page for the Belgian Congo; February 12 - Estonia forbids communist Party; February 13 - U.S. Congress makes Surpreme Court appeal more difficult; February 14 - State of emergency crisis in Bayern ends, NSDAP re-allowed February 21 - 1st issue of “New Yorker” magazine published; February 21 -Mass meeting of SPD’s Reichsbanner Black-Red-Gold in Magdeburg; February 24 - Thermit explosive 1st used to break up ice jam, Waddington, New York; February 25 - Glacier Bay National Monument established in Alaska; February 25 - U.S. Female Figure Skating championship won by Beatrix Loughran; February 25 -U.S. Male Figure Skating championship won by Nathaniel Niles; February 26 - Jihad-Saint war against Turkish government; February 27 - Hitler’s resurrects NSDAP political party in Munich; February 27 - Test Cricket debut of Clarrie Grimmett, who took 5-45 and 6-37 vs. England; February 28 - Congress authorizes a special handling stamp; February 28 - Longest win streak in Toronto Maple Leaf history (9 games); February 28 - “Tea For Two” by Marion Harris hit #1; February 28 - Theater Museum of Amsterdam forms. March 2 - Dutch Socialists demand drastic disarmament; March 2 Japan’s House of Representatives recognizes male suffrage; March 2 Nationwide road numbering system and U.S. shield marker adopted; March 2 - SDAP-Second-Faction of parliament demands drastic disarmament; March 4 - President Coolidge’s inauguration broadcast live on 21 radio stations; March 4 - Swain’s Island (near American Samoa) annexed by U.S.; March 7 - American Negro Congress organizes; March 10 - Walter Mittelholzer is 1st to flies over Demawend mountain, Iran; March 12 - British government of Baldwin refuses to ratify Geneva agreement; March 13 - NHL Championship: Montreal Canadiens sweep Toronto Arenas in 2 games; March 13 - Tennessee makes it unlawful to teach evolution; March 19 - Angelo G Roncalli (Pope John XXIII) becomes a bishop; March 21 - Edinburgh’s Murreyfield Stadium officially opens; March 21 - Iran adopts Khorshidi solar Hijrah calendar; March 23 - Tennessee becomes 1st state to outlaw teaching theory of evolution; March 24 - KSL-AM in Salt Lake City UT begins radio transmissions; March 30 - Stalin supports rights of non-Serbian Yugoslavians; March 30 - Stanley Cup: Vict Cougars (WCHL) beat Canadiens (NHL), 3 games to 1; March 31 - WOWO-AM, Ft. Wayne Indiana begins radio transmission (500 watts). That’s just a few things that happened in the year 1925.

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Senior Living

Larry Nanny

2007-06-01 09:43:00

What level of care does my loved one need?

Answer: Choosing the appropriate level of care or service for our loved ones can sometimes be a daunting task. There are so many options available to us these days. Most folks are unaware of what the differences are between Independent Living, Assisted Living and Nursing Home care. Most generally, the difference is the amount or level of care your loved one requires. The goal of all types of care is to keep the resident as independent as they are capable of. Today’s nursing facilities are designed to care for the young and old alike, both those who expect to recover fully as well as those in need of extended long-term care services. The goal of care in a nursing facility is to help individuals meet their daily physical, social, medical, and psychological needs and return home whenever possible. Nursing facilities provide skilled, 24 hour nursing care services. While not always the case, today’s nursing home patient is very sick, requiring 24 hour supervision and assistance with 4 of 5 activities of daily living, including bathing, dressing, transferring, toileting and eating. Many nursing facilities service special populations, such as patients with Alzheimer’s disease, Dementia, infectious diseases, etc. Assisted Living facilities are one of the fastest growing segments of long-term care and are an alternative for seniors who need more assistance than is available in a retirement community, but who do not require the heavy medical attention provided in a nursing facility. The philosophy of assisted living is to provide maximum independence in a home-like setting, with individualized assistance when needed. Assisted living communities are not staffed as heavily as a nursing home, as patients in this setting do not require as much care. Typically, assisted living facilities do not take on patients that are incontinent of bowel and bladder. Independent Living communities require even more independent residents than assisted living. In an Independent Living setting there is no medical care provided. The individual has to be independent with all activities of daily living. The individual also has to be able to manage their own medications, although home health agencies can help with that if necessary. The assistance that is normally provided in this type of setting is maintenance services, housekeeping, meals, activities and an emergency call light. This type of setting gives peace of mind to the families of these residents as they are in a more secure, yet independent environment. Choosing a place where your loved one will be happy and receive the services they require is a very important decision.

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Senior Living

Pam Pirotte

2007-06-01 09:43:00

I have always worked in nursing homes. What is the difference in working for clients at home versus the hospital or residential care facility?

Answer: There are a number of differences: • Scheduling: The caregiver chooses which assignments she will accept and how many hours she wishes to work. This can change from week to week. No institutional job allows such flexibility. • Housekeeping and Homemaking: Care of the environment is limited to bed making and cleanup of the immediate bedside in the institutional setting. In the home, meal preparation, dishwashing, vacuuming, laundry, and trash removal are almost always part of the assignment. Homemaking services are all that some clients request, when they are still able to attend to their personal care. • Independence: Although extensive guidelines govern caregiving behaviors at home, the personal responsibility and integrity of the worker, are essential in the home environment. Persons who do what they ought to, because they ought to, are most suited to such a job. • Reporting: In the home, caregivers are called upon to use their judgment about the condition of the client, the household, etc. and to report problems with the client’s safety and wellbeing. In no other area of nursing is the observational skill of the attendant so essential and valued. • Transportation: The car is the first tool of the home care provider. Errand running and client visits are multiple daily reasons the car must be reliable. Good mileage vehicles are, of course, most desirable under these conditions. • Flexibility: Home care calls upon the worker to “flow with” the unexpected; doctor appointments, family visits, hospitalization—these events may require rearrangement at the last minute. • Relationships: The in-home caregiver gets to know family, neighbors, etc. Collaboration with these people, for the benefit of the client, is a natural outgrowth of the environment where care takes place. • Commitment: The assignments a caregiver receives belong to her, much more than the beds on a hall of the nursing facility. The clients become attached and look forward to her visits. They are accustomed to their own attendant’s style of care. • Communication: The caregiver is an essential member of the health care team. She might be called upon to explain the physical therapist’s instructions to the family or to her own nursing supervisor. She must possess the judgment to pass on details which impact the client’s safety, security and independence. • Compassion: The need for tenderness and consideration in delivery of care is necessary in the institutional setting as well as the home. Persons who enjoy doing an extra little something, being gentle and kind, are much appreciated by their clients and the agency that employs them. Question: How does home care compare to the institutional setting for money and benefits? Answer: Rates of pay vary from $8.00 to $9.25/hour. Paid vacation is 1 - 2 weeks per year. Some companies pay performance bonuses. Most home care agencies do not provide insurance benefits.

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Senior Living

Larry Nanny

2007-05-01 16:21:00

Are Medicare benefits available in a skilled nursing facility?

Medicare is a federal health insurance program for people aged sixty-five and over, people of any age with permanent kidney failure, and certain disabled people under age 65. This program is administered by the Centers for Medicare and Medicaid. Almost everyone qualifies for Medicare upon reaching age 65 either through their own employment or through a spouse. There are two distinct benefits under Medicare guidelines, Part A and Part B. Part A is considered an entitlement program and does not require premiums to be paid. You automatically receive Part A after meeting certain requirements. Part B is an optional program, where participants have to elect a plan and pay premiums to receive benefits. Medicare as a payer source in a Skilled Nursing Facililty is designed as a short term benefit. To qualify for your Medicare benefit in a Skilled Nursing Facility you must meet certain requirements. First, you must need at least one of these “skilled” services, 1) Nursing Evaluation and Management, 2) Nursing Observation and Assessment, 3) Nursing and/or Rehabilitative Teaching or Training, 4) Direct Skilled Nursing Services, and 5) Physical, Occupational or Speech Therapy. Secondly, you must have had a consecutive three day stay in a hospital, not including day of discharge. Thirdly, there has been less than thirty days that have elapsed since a three day hospital stay. This would be a circumstance that a person went home from the hospital and then realized they could not make it at home yet. As long as you are admitted into a skilled facility prior to thirty days elapsing since your qualifying stay at the hospital you can use your Medicare benefit. Lastly, the physician has to certify that the patient needs skilled care. A patient that meets Medicare criteria for a stay in a skilled nursing facility is entitled to up to 100 days. The patient is not guaranteed these 100 days, that is the maximum benefit. The patient still has to meet the qualifying criteria of needing a skilled nursing service or skilled rehabilitative services. As soon as a patient reaches their prior level of functioning or has gone for a period of time with no improvements or progress being achieved they can no longer use their Medicare benefit. The facility is required to give the family or patient a three day notice that the Medicare benefit is coming to an end. Medicare will pay for the first twenty days covered at 100%. Days 21-100 requires a co-pay. This is where the Part B optional program comes into play. If a patient has Medicare Part B, their co-insurance will be covered. Therefore their stay will still be covered at 100% as long as they still need skilled services. If the patient does not have Part B, they are required to pay the co-insurance, which is $124.00 per day. Patients can qualify for a new benefit period after sixty days have elapsed since their previous hospital or skilled nursing. This is considered a “break of illness.” The patient will still need to meet other requirements mentioned previously. Medicare, as a benefit in a skilled nursing facility is a great benefit, but there a very strict guidelines that must be met by the patient, physician and the facility.

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Senior Living

Rev Bill Shook

2007-05-01 13:27:00

Answer: Great idea. For many of us, the time when we were kids and growing up hold some of our fondest memories. I will try and present a few of them I have found on the Internet for your reading pleasure over the coming months. Here’s a memory out of left field. Do you remember the tramps and hobos? From the 1880’s to the 1930’s, tramps were a familiar sight along the backroads and railroads of America. Some were men who felt the pull of the open road...they were always looking for that elusive “something” that lay just over the next hill. Others were simply down on their luck, looking for a better opportunity and a place to call “home.” Hobos rode the rails: they hopped freight trains and stowed away in boxcars, hoping that the “railroad bulls” and “yard bulls” wouldn’t find them and throw them off. Near railroad yards, hobos congregated in hobo jungles, where they boiled coffee in the shadow of a water tank and cooked up “mulligan” stews. Sometimes they stole chickens and were jailed. They begged for meals at the back doors of homes, and spent cold winter nights at relief shelters. Hobos communicated with each other by leaving markings on fences and gateposts. A simple drawing was enough to tell a hobo about the inhabitants of a house and what type of hospitality he could expect (or not expect) there. There had always been teenage hobos, but their numbers increased dramatically during the early 30’s. Known as “roving boys” and “boxcar boys” (and “boxcar girls”), their reasons for leaving home were as different as they were: some sought adventure, some were looking for work, while others were fleeing broken homes, orphanages and reform schools. For them, life on the road was dangerous....in addition to the usual perils, they were easy targets for criminals and sex-offenders. Some hobos were women, who frequently dressed like men. Life on the road was no picnic....each year, thousands of hobos were killed or injured while hopping moving trains. They often went for days without eating, and were prone to catching pneumonia. During the early 30’s, the number of hobos increased, thanks to the Depression. Misery knows no prejudice: black and white hobos were often seen traveling together. Many tramps repaid homeowners for their hospitality by giving gifts of their own handiwork. They made functional and decorative objects that became known as tramp art, and these objects have since attained the status of classic American folk art. Here are some hobo terms: bindle stiff - hobo who carries his belongings in a rolled-up bundle, catch out - to hop an outbound train reefer - refrigerator car gaycat - novice hobo dingbat - experienced hobo riding the rods - lying in the undercarriage of a boxcar near the wheels mulligan stew - a stew made out of anything that was edible (Source:http://www.angelfire.com/retro/lisawebworld/30slifestyle.html) More memories next month...

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Senior Living

Greg Feldman

2007-05-01 13:27:00

: I feel a great burden with my aging parents, as I am the primary caregiver. How do I begin the process of finding someone to help me?

Question: I feel a great burden with my aging parents, as I am the primary caregiver. How do I begin the process of finding someone to help me? Answer: For working children with responsibility for aging parents, not having short or long term care can create hardships. Without intervention from appropriate care services in the community, these hardships can cause serious mental and physical problems for an active family. Many active families feel guilty while trying to set up care for an aging family member. They feel as if they are the ones who must care for this relative. It is also sometimes just a burden to even start talking to the aging family member about their situation. Because of this, the feeling of failure from being pulled in so many directions also arises. Some issues that are common to arise from stress related mental health are physical and mental exhaustion or hypertension, just to name a few. To relieve the families from the additional stress of aging family members, respite care allows the primary care giver with relief from one to twenty-four hours a day to reincorporate into their life a dinner out or a weekend away. One of the first steps in the process is deciding when it is necessary for a care service to begin. Some typical signs that extra assistance is needed are sudden weight loss indicating poor nutrition, failure to take medications indicating confusion or forgetfulness, deterioration of personal habits such as hygiene, or just general forgetfulness such as not paying bills, missing appointments, or other regularly remembered information. Getting assistance soon can stop further problems from arising and relieve the extra burden of stress put onto the already overwhelmed family care giver. The next step is to talk with the aging family member. It is always best to be upfront and honest with them. Share with them their different options given their current situation and let them know what each option would fully entail. Explain to them your own personal needs and about your time and energy levels that come with working a full-time job and caring for them. An alternative way to talk with them is to suggest the smallest change so that the elderly parent can adjust to the changes and not become overwhelmed themselves, which could cause more guilt for the family care giver in an already stressful procedure. Just remember that your aging parent will have their own opinion as to what care they need. They want to maintain their independence. The best thing is to reassure them that this process is only going to help maintain their independence while helping the family care giver with some respite care.

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Senior Living

Pam Pirotte

2007-05-01 09:02:00

Question: How do I choose a home care agency for my husband while he recovers from a stroke? He will be finished with rehabilitation in 2 weeks.

Answer: These are the questions you should ask of Home Health Providers and what you should know about the answers you get. • Are your caregivers credentialed? Credentialed caregivers are trained and tested in the skills needed for bedside care. They are paid more than “non-medical” personnel. CNA (Certified Nurse Aide) and HHA (Home Health Aide) are the certifications required by the state for caregivers in the home. • What are the employment standards of the agency? There are many ways employees need to be screened. A KBI (Kansas Bureau of Investigation) check includes felonies and misdemeanors. The court docket and warrant check shows unsettled legal issues. The Motor Vehicle check gives evidence of irresponsible driving practices. Candidates should have excellent references from nursing systems where they have been employed. Drug free status is determined by urine testing. You want a worker in your home that is honest, accountable, not drug impaired, drug seeking, or supporting a drug habit. • How many hours of care will I need? Initially, many people call requesting continuous care. This is not necessary if the client can use a phone or a “lifeline” button. Ask the agency if they provide short shifts. This would mean that a worker could come for morning care/breakfast, return for lunch, return for supper and again to help with bedtime preparations. Don’t pay for more care than you need. • How much does care cost per hour? Care charges range from $14.00 to $20.00 per hour. At the low end you may be getting a person with no credentials (NMA). Sometimes that matters a lot. Ask about it. • What if the worker is absent? A caregiver who misses her visit should be replaced. Some agencies do not make provision for this. • Why can’t I hire my own caregivers? The screening systems are costly. Many people are uncomfortable with terminating a caregiver, especially for misconduct. Having backup for an absent employee is very challenging.The IRS expects a private employer to withhold taxes and match social security withholding. Probably the most important financial consideration is this: Agencies which fully employ the personnel they provide, protect your estate from worker’s compensation claims. A court judgment against you, for on the job injury, could result in the loss of your home and financial resources. • What about changing agencies? Cancellation is as easy as notifying the scheduler. From the time you cancel care, you will not be charged. Don’t be afraid to ask the tough questions. A quality agency won’t hesitate to answer.

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Senior Living

Greg Feldman

2007-04-01 16:42:00

My aging parents are in need of assistance to maintain their independence and stay in their home. Are services available to assist them and how do we access a reputible company?

ANSWER: There are a variety of services available to assist needs that arise for the senior population to allow them to remain at home. It is estimated that in 2007, 12.5 percent of the United States population is over the age of 65. For 2007, Kansas is estimated to have 13 percent of its population in that same range. According to the National Census Bureau, the number of citizens 65 years of age is expected to increase even more due to the aging baby boomers. With this increase in the senior population, people need to be informed about their options so that the best decisions can be made for the client and the family members. There are professionals and organizations that can assist you with information about these services. These include, but are not limited to, registered nurses, hospital and home health social services, Kansas Department on Aging, and the Alzheimer’s Association. The Kansas Department on Aging publishes a yearly report of Exploring Your Options, which lists many local care providers, who can be contacted directly. When choosing in-home care, some features should be considered. First, interview the company with questions such as: What is the background of the ownership or management? Are the companions or caregivers bonded, insured, and have criminal backgrounds been checked? These are important considerations that are not always thought about when hiring an individual to provide attendant care. It is a big step to place care in the hands of strangers, and all safety considerations should be addressed. Now for the care aspect, choose a company that provides flexibility and is there when you need them. Services can be provided from 1 to 24 hours a day, depending on the company. Respite care should be considered for the family caregiver so that they do not become ill from the stress of constant exposure and no relief. Many times a loved one is moved out of the home because the children, as the caregivers, don’t know where to turn for help. Services such as grocery delivery and meal preparation can help with nutritional deficiency, bathing and grooming can assist with good hygiene, transportation to and from appointments can provide a liaison and free up the need for missed work, and medication reminders can assist with on time schedules and avoid missed doses. Companion sitting from 1 to 24 hours can assist with all the activities of daily living or to allow the primary family caregiver time away. Light housekeeping allows for a clean, safe environment in which to live. Make sure to have a list of services for your caregivers and they will try to provide the best assistance for your loved ones to stay at home. Many of these Attendant Care Services are provided along with home health and hospice care. Home health and hospice provide skilled services by RN’s, LPN’s, and home health aides in shorter intervals of time. The most difficult part of any process is getting started. Make sure that you have explored all your options before making such an important decision.

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Senior Living

Larry Nanny

2007-04-01 08:09:00

What factors should one consider when choosing a nursing home?

ANSWER: Nursing facilities today are providing a wider range of services than ever before, from sub-acute care to rehabilitative care, to their more traditional role of long-term care for the chronically ill. Some people come to a nursing home following a serious injury or accident for short period of rehabilitative service and then are able to return home. In other cases, families seek nursing facility care when an elderly or disabled relative's condition declines to the point that they can no longer safely care for that person at home. Choosing a nursing home is a very difficult endeavor for most people. This usually comes at a time when a parent has had a debilitating injury or their long term illness has gotten to the point that they can not manage it in the home any longer. Here are a few tips to consider if you are ever burdened with this responsibility. The first thing to do is find out what nursing homes are in your area. You can get this information from your case manager at the hospital, Department of Aging, Area Agency on Aging, phone book and other senior resources. After you have this information you want to decide what location you may want. For example, if you live on the west side of Wichita and are not willing to drive to the east side to visit mom, you would probably pick west side homes, to make it easier to visit her. After deciding on a general location that would be acceptable, you need to start gathering information about these homes. I would start with a phone call to the facilities to get information as to the services that they offer to ensure they will be able to meet mom's medical needs. After getting this information I would narrow it down to about 3-5 homes to gather specific information and take tours. You should start by checking annual survey results. Nursing homes get an annual survey once per year and have to meet standard requirements to maintain licensure. You can get information from the latest survey at www.cms.gov. Go to nursing home compare and search by individual home or by zip code. The next thing you should do is take a tour of the facilities you are interested in. You should take a tour during the day when the administrative staff is in, and I would also suggest going in unannounced on an evening or weekend to ensure the same care is provided when the supervision is not in the building. Here are some things to look for; 1) Are the staff friendly to residents and guests? 2) Do the residents look cared for? Are they clean? Are the men shaved? Are their teeth brushed and hair combed? 3) Talk to residents and other family members that may be in the facility during your visit to see how happy they are. 4) Ask about fall programs or skin programs that may be in place to prevent accidents and skin break down, 5) What does it smell like? Does the facility look clean? 6) Ask other residents how the food tastes. Eat a meal yourself, as most facilities will invite you to eat a meal if you are there during meal time, 7) Are there any activities going on? Look at the monthly activity schedule. 8) Talk to someone about rates. What are the costs? Does the facility accept Medicare or Medicaid? Ensure there are no hidden costs that show up on a bill 30 days after admission that you were not prepared for. Choosing the right place for mom is not an easy task. Most folks usually do not know where to start because it is not something we have to do every day. Hopefully some of these tips will get you started in the right direction. Ensuring that mom ends up in a place where she will be happy and receive quality care is a very important decision and should not be made without having adequate knowledge.

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Senior Living

Ange Aubrey

2007-04-01 08:09:00

: What are the benefits of getting help quickly after a fall?

A true subscriber’s story... Elaine S. is an 85 year old female who suffers from congestive heart failure, lymphoma in remission, and diabetes. She lives alone… with no friends nearby, no neighbors, and no way of getting around. She has a wonderful, caring son and daughter-in-law who live 15 miles away but she wishes to remain as independent as possible and relieve them of the burden of care giving. Recently, she suddenly found herself shaking, light headed, dizzy, cold and nauseated. She slowly made it to the bathroom but then fainted and fell, hitting her head on the cabinet door under the sink. When she regained consciousness, she pressed her Lifeline personal help button she wears as a pendant around her neck. “I immediately felt calmer and my panic was gone. In a few minutes, paramedics were in the apartment and soon after I was taken to the hospital. So, you see how the Lifeline alarm I originally didn’t want saved my life! I might have passed out again and it would be many hours later when my son would realize I didn’t answer the phone and something was wrong. I strongly recommend this service to everyone. If you think you do not need the Lifeline personal help button, you are wrong!” Question: What are the benefits of getting help quickly after a fall? Answer: Nearly one third of persons over the age of 65 fall each year, and that figure increases to 50% by age 80. For seniors, falls in and around the home are the most frequently occurring accident. In fact, falls are the seventh leading cause of death in persons over 65. A study reported in The New England Journal of Medicine found that preventing falls and the resulting injuries can reduce or delay the need to move to a long-term care facility. After a disabling fall the longer you wait for help the greater the risk of serious complications and even death. Studies confirm that getting help quic kly after a fall reduces the risks of: Hospitalization by 26% and Death by over 80%

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Senior Living

Rev Bill Shook

2007-04-01 08:04:00

The other night my husband and I were talking, and we thought we would like to take his parents on a trip while they are still able to travel. Just wondering your thoughts about what all we should consider as we plan this vacation.

ANSWER: This month will conclude the series concerning ideas for vacations when traveling with your husband’s parents. We have talked about possible destinations, modes of travel, the importance of healthy eating while on vacation, exercising while traveling, and travel safety. This final article will explore a unique concept and idea which may or may not be appropriate, but it is the idea of a “volunteering” vacation. Volunteer short-term vacations have been increasing over the last 20 years and have been an avenue for expanding, embracing, and harnessing interests and abilities of adults at the different stages of their lives up through the 80s. Combining volunteer service opportunities with travel has expanded in popularity in recent years because of the convenience and easy travel destination access that is now available. However, while serving abroad for six months to a year may appeal to those younger, seniors’ agendas take quite a different form. Seniors usually prefer such a volunteer vacation for only about one week or they might even choose to take two or more different volunteer vacations during the course of a year. Non-profit agencies and charitable organizations will attest to the fact that because of such enthusiastic seniors giving of their wealth of experience and financial support, they have been able to move their projects and services from being just dreams to actual realities. It appears that older adults generally volunteer their services for one of three reasons or a combination of these: (1) they have an intense interest in a certain cause or project that is related to an earlier hobby or career; (2) they have a desire to actually become part of the way of life in a region of the country or world which cannot be obtained by just being a traveling visitor; or (3) they wish to give something significant back to the world, realizing they have been well provided for economically and physically in earlier years. The seniors that are drawn to this type of vacation are usually those who have attained a high degree of education and were highly motivated task-oriented individuals. Although there are some seniors who like to arrange their volunteer travel plans themselves, by and large the majority of them like to be involved through a small-group. Thus this may be just the thing for the four of you experiencing this together. A recent example involves the many small groups which have provided help through different churches and other organizations to the Katrina victims. In fact, one of my senior friends spent three different weeks down in New Orleans serving as part of her church team in “mudding out” damaged homes, being involved in the rebuilding efforts, assisting with cooking for the volunteer workers, and distributing food and supplies to the yet unemployed New Orleans citizens. She related how both the young and old worked together in achieving the common goal of a rebuilt community. She confirmed the importance of knowing that she was not going to be the only older person there – that there would be others of her own age. It was a “senior-friendly” project and offered the opportunity of not only working together with but also sharing conversations between the different generations. This was a refreshing change from the usual societal artificial and uncomfortable communications that exist between the young and the old. It is hard for some to understand the attraction of the hundreds of thousands of older adults who have chosen to become part of this “voluntourism” effort – paying to work hard as a vacation. Such volunteer opportunities include among others such diverse activities as teaching English overseas to Chinese students; tracking Borneo orangutans in the rainforests; discovering and uncovering the bones of dinosaurs in the ruins of an archaeological site; building block houses out of concrete in totally impoverished regions of the world; taking a sea voyage and conducting marine research; assisting in the disease-ravaged HIV population of Africa, or caring for orphanage children in the Dominican Republic. One aspect of this “voluntourism” bug is that those whose budget is tight can yet be involved because the costs are most always less than for a traditional vacation. Usually people helping out are housed in dormitories or rooms in host family’s homes where they share accommodations such as bathrooms. They might have camping facilities and either eat cafeteria style or ethnic prepared food. The lady who volunteered in the Katrina effort paid $100 for the week, ate food which had been donated, and stayed in a refurbished church with the privacy of only sheets hung up in the bathroom stalls and cold water shower trailers. Yet each time she returned she shared about the unmatched rewards of her week of service. There are sometimes accommodations like air conditioning and private rooms, but since this is unusual it would be wise to find out this information prior to planning such a trip if comfort is important to your husband’s parents. In the evenings sometimes there are informative lectures or organized group tours to explore surrounding areas. I know as part of the New Orleans volunteer week, on Thursday the group only worked until noon and then the volunteers took the afternoon to explore the famous parts of the city as well to drive around the area to see the yet visible vast devastation. Even though all four of you may have a spirit for adventure, I would encourage you to ask a lot of questions of the group sponsoring the activity and even talk with others who have previously volunteered to make sure this is something you all can handle. I think the most important part of this proposed vacation for the four of you is spending the time together, no matter what you decide to so. This will be a special event that you all will remember for many years. You will learn more about each other than you ever probably knew before. Perhaps your husband’s parents will share stories of their childhood that never rose to the surface until this special time. It is even possible that your husband’s parents will smile more than you have ever seen them smile in a long time. The precious moments and the memories you may capture from this vacation with them will be an unforgettable experience, so enjoy!

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Senior Living

Rev Bill Shook

2007-03-01 12:52:00

The other night my husband and I were talking, and we thought we would like to take his parents on a trip while they are still able to travel. Just wondering your thoughts about what all we should consider as we plan this vacation.

ANSWER: Last month I shared some ideas concerning possible destinations and modes of travel. There are several other items important to consider when traveling with seniors, and I will give some insight into those areas in this issue. Along with seeing new sites and shopping, eating is one of the favorite parts of a vacation. Especially while traveling, seniors need foods that provide healthy energy levels while at the same time adhering to proper nutritional balance. Others not yet seniors can sometimes get by eating unhealthy foods for a week or so without imposing any long-term harm to their bodies. However, your parents' bodies have important nutritional needs even while on vacation. Here are a few guidelines to keep in mind when ordering at restaurants along the way. If you are going to eat Chinese food, request less oil to be used in cooking foods like fried rice or fried noodles. If you are going to order chicken dishes, ask them to remove the skin before cooking or certainly remove it before eating. Even though gravy can be flavorful, a wise choice would be to leave it behind or ask for just a little. This effort alone can help to reduce the saturated fat in that meal by as much as 50%. Another seemingly small thing to do but yet powerful is to use less sugar and creamer in tea and coffee. Also, order smaller portions or, if you have high fat foods such as a Denver omelet, order two of them and share them amongst all four of you. Lower fat items such as soups, plain rice, and vegetables can assist in filling you up without extra fat. How do you find good restaurants within a new area? Ask the local people. Remember, they eat there all the time and can fill you in on good bargains and/or good tastes. The mistake many travelers make is choosing a restaurant after they are already tired and hungry from traveling. It is a real temptation at that point to head to a restaurant chain name that you recognize just because you are so hungry. With a little preplanning each morning, you can find places to experience new culinary tastes that evening. It would be a shame to pass on this adventuresome part of the trip. When staying at hotels along the leg of your journey, you can also ask the hotel's concierge for dining recommendations. Part of their professional expertise is in not only knowing good places to eat, but also assisting you in reserving a table. If you know exactly where you will be staying, surfing the web is an efficient way to find new restaurants. A buzz word I learned that describes this search is "foodie." When I went on the internet and typed this in, there were over 3 million listings. Many of the websites contain reviews of places that would otherwise be off the beaten path. Of course, major cities usually offer their own city magazines, available at conveniently located newsstands. These offer comprehensive restaurant listings. All in all, whether you dine in a famous gourmet restaurant or an out-of-the-way café, there is nothing that will end an evening more perfectly in a new city than to enjoy a great meal where the food and atmosphere is just what you were looking for. There are two additional areas for consideration as you travel with your parents, and those are exercising and travel safety. Whether you are in a train, car, or plane for long periods of time in confined areas and without the ability to move about freely, it is important to do exercises. This is wisdom not only for seniors but for you and your husband too. This will guard against a condition known as DVT (deep-vein thrombosis). When your legs are immobile for a significant amount of time, blood clots form in the arteries. Heart attacks are actually caused by these clots breaking free and entering the bloodstream. The majority of these blood clots are small and harmless, but do you want to take that chance while on vacation? If your legs began to tingle, that is a good sign to stop the car or get up while on the train or airplane and walk a bit. You can also continually move your toes around and wiggle your fingers. This is a good practice in our daily lives as well; and while it takes just a couple of minutes, it could actually add years to our lives. The final few tips have to do with safety for not only seniors, but really for all of us as well. As sad as it may seem, people around you may not be at all concerned with you and your parents' well being.

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Senior Living

Larry Nanny

2007-03-01 12:52:00

Do I have Alzheimer’s disease?

Having occasional memory lapses does not mean that you have Alzheimer’s disease. Forgetting where you put your car keys occasionally is normal; not remembering that you have a car is not. Classic signs of Alzheimer’s disease may include an inability to recognize objects or newly formed friends, forgetting to turn off the stove, close windows or lock doors. Not remembering how to use simple tools such as a pen or pencil. Unusual behavior caused by poor judgment or memory and agitation may also be indicative of Alzheimer’s disease. When these behaviors become progressively worse and cause worry or threaten the safety and security of self or others, it may indicate the need for professional assessment. Consulting your physician is the best first step. The physician’s assessment will likely include a history focused on family and personal behaviors, a complete physical examination, and functional and mental status examination. Adult Care Facilities that specialize in dementia care use the Mini Mental Status Screening examination. The Physical Self Maintenance Scale and Geriatric Depression assessments are reported to the physician along with recommendations for care options. By cooperatively working together with the physician and the family the care staff can provide the appropriate plan of care for residents with Alzheimer’s disease.

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Senior Living

Ange Aubrey

2007-03-01 12:02:00

What should one expect from a personal emergency response service?

Friendly, caring support allowing individuals to receive immediate assistance in a medical emergency or when help is needed. Established in 1982 by Dr. Cramer Reed, Wichita Lifeline, Inc. is the only non-profit, personal emergency response service in Wichita. This service has provided help to the elderly, disabled and individuals whose health is at risk to remain living at home with the security of knowing help is only a button push away. Subscribers are monitored 24-hours a day, seven days a week. Because help is available at the push of a button, family members have peace of mind in knowing their loved one will be able to receive help when they are not able to be there. Emergency response service builds strong vital networks between families, caregivers, community agencies and health care workers within Wichita and 48 surrounding communities. Subscribers wear a lightweight, waterproof button around their neck or on a wristband at all times. When help is needed, the button is pressed and a signal is sent to the Lifeline communicator which is connected to the land line phone in the subscriber’s home. The communicator is programmed to dial a toll free call to a 24-hour response center. A trained Response Associate establishes voice contact with the subscriber through a speaker in the communicator which is heard throughout the home. If the subscriber verbally responds and indicates assistance is needed, the subscriber’s responders are contacted by the Response Associate by phone. A subscriber’s responder usually consists of family members, friends, neighbors, caregivers, or a combination of these individuals. If necessary, emergency medical services will be dispatched to the home. The team at Wichita Lifeline, Inc. currently provides the Lifeline service to over 2,120 people and is committed to providing the highest level of customer service. The team enjoys meeting people and always extends an open invitation to visit the Lifeline office located at 149 S. Ridge Rd. or contact by phone at 265-1700. Fees for the service are $35.50 per month with a one-time installation fee of $60.00. Office hours are Mon.-Fri. 8am to 5 pm.

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Senior Living

Rev Bill Shook

2007-02-01 16:23:00

The other night my husband and I were talking, and we thought we would like to take his parents on a trip while they are still able to travel. Just wondering your thoughts about what all we should consider as we plan this vacation?

ANSWER: It is good to start planning such a get-away as far in advance as possible. That way you can encounter any problems early on rather than unexpectedly at the last minute. This also allows your parents time to anticipate the trip as well as establish peace of mind for themselves as they see the itinerary in advance. Perhaps you already have a destination in mind, but, if not, this will need to be your first decision. Since you didn’t mention about the time of year that you will be taking this trip, it is a good thing to remember that with seniors, warm climates which are designed to be senior-friendly are some of the most popular. Will you be traveling in the U.S. or other dry, sunny and mild locales such as Ireland, The Greek Islands, the south part of France, or England? Have your parents traveled around much during their lives? They may feel they have been everywhere and that there is nothing yet to see. Some seniors just enjoy going, not necessarily even far away, where they can play a number of rounds of golf over a period of days. Others enjoy going where they can get back to nature and do even such a simple and enjoyable activity as bird watching. You can also include with either of these hotel accommodations that have varied adult-only spas, hot tubs, circulating waters, healing spas, heated swimming pools, etc. For some seniors whose muscles have become achy over the years, this simple treat is pure enjoyment. Sometimes it is relaxing and fun just to drive and stop as you come to each town and see what quaint shops, scenery, nature parks, or walking paths each holds. As you can see, simple experiences can still be peaceful, relaxing, and fulfilling. It has been said that certain destinations have more of a “senior quotient” than others; in other words, more senior-friendly than others. Seniors have actually “outgrown” some activities and yet have room to “grow” in others such as opera, well-known art museums, and fine wines. Let’s look at some specific spots to consider; maybe the Northeast part of the U.S. would be good. How about visiting Saratoga Springs located between the scenic Hudson Valley and the beginning of the Adirondack Mountains? It is just several hours from New York City. It is known for its thoroughbred racing fame in July and August but also includes fine dining restaurants as well as is known for the New York City Ballet and the Philadelphia Orchestra. If you are thinking about a vacation in the autumn time-frame, it is breath-taking to experience the beauty of the fall foliage tours specifically in the New England area? The mountainsides are covered with at least fifty shades of yellows, reds, and greens. Depending upon your parents’ agility, perhaps you could even try a gentle hike under the autumn leaves in the Appalachian Mountains near the White Mountain National Forest where it seems there are unending forests of brilliant falling leaves. Or maybe you are considering visiting overseas? Ireland has long been popular because of its history and culture. Walking, unique shopping experiences, and terrific food are all a part of this potential great experience. Dublin might be the place to enrich your parents’ experience of literary appreciation like Oscar Wilde and Yeats, Shaw and Joyce. There are many activities centralized within a small area making it an easy city for seniors to visit. It seems that most tourists like to visit Dublin between December and March even though it is cold and wet and the days are shortest then. So April through June might be a good choice of timeframes in order to avoid the huge crowds of traffic. Rain is prevalent there, so be sure and take rain gear for whenever you decide to visit, if you decide that is the place. Or, maybe you would prefer the south part of France where you will find sunshine, warm and friendly people, ancient Latin recipes for surprising wines, and exciting Mediterranean food. Lodging there ranges from the deluxe to reasonably priced. The ancient Romans believed that a deep red wine called Mulsum maintained youth. Mulsum contains parts of cinnamon, pepper and thyme and is very delicious. One of the places you could try this experimental creation is a winery located about halfway between Arles and Nimes. Another interesting place overseas which you might want to consider is what is called the South Downs Way. This is located south of London and provides a 99 mile walk across the English downs where tourists can stop at interesting historic towns and villages along the way. This, Britain’s oldest public footpath is considered senior-friendly because of excellent railroads, bus, and taxi accommodations along the way. Pastures and meadows full of poppies and many varieties of wild flowers would make this an excellent choice for a short or a long hike. The next decision you need to make is the method of transportation you will use. Of course, going by air is the quickest but it is also the most expensive mode of travel. It is usually the method of choice if you are going to travel across the country or overseas. Within the continental United States, it is possible that the train would be a good choice. There are people who travel this way as a means to reconnect with the beauty of America and yet be free of the hassle of driving. As you ride the train you will also have more time to meet new people and talk with them about where they have gone and where you have been. You might even make new friends that will last beyond the trip. There is also quite a difference in the cost of transportation via train as opposed to the airline, so check it out. Some of the trains also offer a senior citizen discount, which would be helpful to you. Of course, the automobile allows you to take your time and see the sites at your leisure. This is definitely one of the most popular ways to travel around the United States. For safety reasons, it is best to drive during daylight hours. Don’t plan to get too far in one day. Remember the purpose of traveling in the automobile is to have a relaxed trip, and it is always important to get out and stretch along the way. Allow enough night hours to get plenty of sleep so that you are refreshed and ready to go the next day. Hopefully this will give you some ideas of new places to visit. Because there are more and more seniors, more and more senior-friendly destinations are opening up all the time making for new possibilities. This can be a very special time for all four of you as the focus can be on yourselves rather than in years past when it was all for the children. If these ideas do not seem to “ring your bell,” there are many additional sources on the internet through a simple search for “senior-friendly vacations.” Your local tourism bureau will also have additional literature. You will probably find that you receive extra special treatment as you do travel with your parents since in lots of cases it is only the seniors who can truly afford to travel, and the people in the travel industry need their business in order to stay afloat. There are many exciting travel options for seniors in this day and age. Do your homework and research thoroughly, then pick your place and enjoy yourselves. There are several other items important to consider when traveling with seniors: finding good restaurants, staying fit while away, eating healthy while traveling, and, also, travel safety. We will share about these subjects in our next issue.

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Senior Living

Larry Nanny

2007-02-01 14:25:00

One of the most devastating health problems for seniors is the risk for falling. It affects over 30% of people over 65 years of age. Falls in this population of adults result in a significant number of emergency room visits, and surprisingly, 60% of falls occur in the home. Assessing the risk for falling can prevent disability in the elderly and the expense of hospitalization. The assessment for the risk of falls may include hazards such as a cluttered environment, and includes a check for lighting and environment free from throw rugs and electrical cords. Also, it is important to assess personal mobility, muscle strength, balance and visual acuity. Fear of falling has a negative impact on the motivation of individuals and has a debilitating effect often due to the impact of reduced activity. An assessment of confidence in activities of daily living is essential. Skilled Nursing Communities should be proactive to enhance the resident’s health by assessing fall risk factors. Included in a comprehensive assessment are the psychosocial assessments and physical assessments noted previously. In addition, a medication review, hydration and bowel and bladder program may be necessary. An appropriate plan of care can then be formulated to manage the risk for falls. Communication with the family or sponsor is essential and provides the support a resident may need. Reinforcement in the use of assistive devices and maintaining a safe environment are part of a plan, as is initiating regular checks and observations. A strengthening and exercise program may be included to improve mobility, balance and endurance. Involvement in community activities is essential to the development of a feeling of confidence and well-being.The decision to move to an adult care facility is a difficult one. The fall prevention program mentioned above is an important consideration.

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Senior Living

Rev Bill Shook

2007-01-01 16:20:00

I've noticed that my mother who lives with us is getting more confused as time goes on. I don't know if it is Alzheimer's, but I do know that if it is, there will probably be a time when we can no longer care for her in our home. In the meantime, however, I was wondering if you could tell me some things I might do to assist in preserving her memory.

ANSWER: It is personally hard to see those we love begin to be confused and experience memory loss changes. There are medications which can help to slow down the process, but there are also some things you can do right at home to help her keep the memory she still has. Even though the next several are common knowledge, I would be remiss if I did not mention them. Eating nutritiously will enable both her mind and her body to work at their peak possible level. Exercise is important for us all. If the weather permits, go along with her on a leisurely walk. Fresh air assists both mentally and physically. To deal with inclement weather, join a gym. Many of them have specific fitness programs for those who are aging. Her getting a good night's rest will do much to allow every brain cell to operate at its full capacity. I don't know if your mother consumes alcohol, but there are some studies to show it is important for her to limit that habit. Now for some possible fresh ideas. Insofar as daily activities around the house, encourage her to write a note to herself and/or to make a list each morning of the tasks she wants to accomplish during that day. Writing is a way to keep the mind working. You can provide her with some fancy stationery so she can write letters to family and friends. Reading is also a continued important hobby. Perhaps an afternoon visit to the local library where she can pick out her own books would be good. Pick up some crossword puzzle books at the local supermarket for her to work on. I would suggest one of the Sudoku puzzle books; however, those are a challenge for even those whose mental condition is tip top. Talk to her frequently and include her in the conversation. Say things like, "Hey Mom, can you believe it is already Wednesday, January 3?" Or, "Mom, look what time it is, 11:30 a.m. already?" Mention your own name, the names of her children, and the names of your children often. Talk in simple terms and rephrase anything your mother doesn't seem to understand. Keep pictures of her family and friends in a convenient place where she can look at them. Write names on the photos. Just seeing their name helps to pull that person back into memory. Talk with her about the fun activities and times she shared with that person. Help her understand that those activities will remain cherished memories forever. Describe events that have already happened and those that are scheduled to happen that day and in the future. Here is an idea that will keep your brain cells fresh also. Come up with suggestions that will assist her in remembering words. An example I read about recently is someone who came up with the first letter of each of the Great Lakes to help their loved one remember the word HOMES: Huron, Ontario, Michigan, Erie and Superior. Place labels on drawers and shelves that will identify what is in and on them. You may even need to draw words or pictures on these labels. Since you may already make many decisions for your mother, this may not be an issue but, insofar as possible, eliminate the need for her to make decisions. Probably the most important thing to remember is to avoid frustrating her. Thus, if you need to make any changes to your mother's daily schedule, do it in a gradual fashion. If you are going to be apart from her, whether someone is coming in or you are going to take her someplace else, be sure to allow time for her to mentally process that change. Probably the hardest part of all of this is to be patient and supportive. You, yourself, may need some group or counseling assistance in order to be able to do this, so remember to also take care of yourself.

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Senior Living

Rev Bill Shook

2006-12-01 09:28:00

What tips do you have for older folks and the holidays?

ANSWER: During the holidays, it is common for families to gather at a given time and enjoy being in an environment where they are loved and accepted. Some of the happiest moments experienced by families are gathering at the home of grandparents or parents for a meal made up of those special and favorite foods prepared by people we love. This gathering is more than enjoying a delightful meal and sharing in non-stop conversation. It is a spiritual experience. We reach back to recall our common history and remember anew both the difficult and happy moments of our family’s life. The meaningful traditions which have been established over many years speak eloquently of the joy of being home for the holidays. As these gatherings are carried out from year to year, we begin to notice our parents and grandparents are experiencing several changes which cause them to redefine what the holidays mean to them. Their generation of family members and their very good friends are dying. Some have become widows or widowers and they have become more isolated from their peers. The adult children seek to fill this void with an invitation to their home but this transition is difficult, Instead of hosting the family, the older adult becomes one of the guests. Some are very satisfied to turn the work over to other members of the family while other older family members wish to experience holidays the way it used to be. Obviously, the holidays will not be the way they used to be in terms of the setting and the experience. Perhaps the one constant in this transition is continuing to celebrate the holidays in terms of a spiritual experience. I would encourage the elders of the family to share their stories regarding past holidays and provide details of how the family gathered to celebrate. It is important to share both the joys and the sadness in these stories. This sharing is more than a few facts. It is a legacy which our children and grandchildren need to experience. Recently I talked to several older adults regarding their feelings of happiness or sadness during the holiday season. They spoke of the difficult moments in their personal history and how these experiences influenced their feelings regarding the holidays. But they agreed the key to a meaningful celebration of the holiday season was being with other people. They would prefer to be with family members but the emphasis was being with other people. The older people I talked to told me loneliness represented a very significant fear for them as the holiday season approached. Based on these comments I would suggest older people who live alone and will not be with their family, seek a friend with whom to share the holiday season. Several churches and social agencies offer this opportunity. Many families are separated by long distances and simply cannot gather as they did in the past. Older people should not be embarrassed because their family cannot be with them. Perhaps they need to take the initiative to reach out through their church or other safe programs to be a friend to someone.

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Senior Living

Becky Cook

2006-12-01 09:21:00

Will having in-home services help keep me at home?

ANSWER: Yes, having in-home services can help keep seniors or individuals with special needs at home but there are several important things you need to know. In-home care can mean many things. Services such as in-home nursing and therapy tend to address medical needs that individuals have after returning home from a hospital or recovering from an illness. Other in-home services are often referred to as private duty or attended care. These services can address a wide variety of special needs including personal care needs. Often, this kind of personal care in the home can help make the difference in maintaining a safe environment for individuals in need and help keep them where they call home. It also offers caregivers a much needed break from on-going care that can be so exhausting. Private duty services are available at multiple levels of care. Most companies provide care to individuals in their home, but can also provide one-on-one supervision in other settings such as hospitals and care facilities when a patient is confused or cannot be left alone. These services come at a cost, but when considering your needs please remember cost is not the only factor to consider. These services offer the security of knowing those in need won’t be alone when extra care is required. Two of the most common levels of private duty care are home health aides and companions. Companions are non-medical attendants providing services such as housekeeping, laundry, and meal preparation as well as transportation or running errands such as grocery shopping. Companions offer social stimulation and the opportunity to remain active with some assistance with the more difficult tasks of daily living. Home Health Aides (HHA) are certified individuals who complete training as a certified nurse aide with additional schooling to work with individuals/couples in their home. This level of care provides assistance with a wider variety of special needs, including all the tasks mentioned above, as well as; bathing, dressing, toileting, eating and transfers (assistance with getting out of bed or a chair). The HHAs can also assist with home exercise programs that a physical/occupational or speech therapist has instructed them to do. For higher levels of care such as ventilator care or frequent medications that are not taken by mouth, private nursing staff are an option. They offer comprehensive private duty care including companions, aides, private duty nursing and therapy. It is possible that you may qualify for home health or hospice services which would provide you with intermittent visits from a nurse or therapist under your medical insurance. Make sure to ask your insurance company what is available to you and how frequently. There are several companies that provide private duty care in the Wichita and surrounding areas. Make sure to shop around and ask the questions important to you. One important question to ask is whether or not a company completes background checks on staff. You want to be assured the caregiver being sent to your home has been trained and is licensed or certified to provide the level of care that meets your needs. Check to see if they do a free on-site evaluation for clients and family to help answer important questions, determine level of care and make a plan that meets the family budget. Have faith in your choice.

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Senior Living

Rev Bill Shook

2006-11-01 08:56:00

I am concerned about my parents’ lack of recreational activities as they have entered into their later years. All they do is to watch television. I have heard that the lack of using our minds allows them to atrophy and that this is one of the causes of Alzheimer’s. I want my parents to have a sense of usefulness all their days. One problem is that they live in a small community of about 2,500 people and, thus, don’t have access to the different activities offered in a large city. What can I do, and who can I go to get some value-added activities started in their community?

ANSWER: You are right in wanting your parents to experience a sense of feeling value to the world. I was in a seminar a couple of years ago with a 95-year old man doing the teaching. He said that as long as he had breath, he was going to serve for the good of the world. Indeed you do present a valid problem in the availability of programs in a small community and, as I am sure you know, that is mainly because of the lack of volunteers. So, let ’s start with something simple like exercise. It is a fact that lack of exercise and diet are the second largest underlying causes of death in the U.S. If your parents would just get up and move around a little bit, research shows that simple changes like taking an extra 2,000 steps a day will help stop weight gain and lead to a healthier lifestyle. I don’t know if you are aware, but more than 66% of older adults don’t engage in regular exercise. According to the U.S. Surgeon General’s report, a person is more likely to keep doing physical activity if there are activities they enjoy. What about a gathering in the community of anyone interested in increasing muscle strength, bone density, and flexibility with using hand-held and leg weights. It might be a fund-raising activity for some community group to provide these and then just someone (possibly caregivers of older adults who take turns) overseeing this innovative and fun way of people just getting together with others they know. It is possible that even if your parents are in a senior living facility that someone within (or again a family member) could come up with a unique walking and obstacle path right inside the building. Spreading out chairs for them to stop and sit on and then get up every so often or even like reaching up to touch a plaque on a wall – you know, simple things that would be fun and yet enable them to stretch some muscles that haven’t been stretched perhaps in years. Even if the following are not normally considered exercise in the broad sense of the word, the following would at least be opportunities that are safe and might get your parents up and moving. Perhaps someone in the area could start a chorale singing group of older adults in the area. Just the mere fun of singing with others, having weekly practices, and then performances given FREE to the community could be engaging, fun, and fulfilling. How about taking advantage of the years of experience of seniors by having an ad in the local paper call for those with talents in crafts, music skills, writing abilities, public speaking experience, etc. to come together and present a program a month for the community exposing their myriads of gifts and abilities. It is a well thought-out phrase from the past that it is important for the older to teach the younger. How about someone (perhaps company sponsored) offering a PC Learning Lab to seniors in the area? As we who are internet savvy know, there is a wealth of information through the internet that could fill hours and hours in your parents’ lives if someone would just expose them to computer basics. Perhaps a local paper could then begin to feature articles written by various ones in the community about subjects they have researched through the computer and what this new knowledge means to them in their senior years. Then there is the community holding a Wellness Fair where health & wellness professionals in the area could offer educational and entertaining exhibits to teach older adults about the seven dimensions to wellness: social, physical, intellectual, occupational, emotional, environmental, and spiritual. I have just become exposed to a movie source. This is an internet movie and documentary ordering program where a person can get unlimited movies one at a time for a month for a nominal monthly charge. A novel idea would be for the community to open a building and one of the not-for-profit, volunteer-driven organizations in the area arrange educational programs, stimulating tours and trips, actual movies, and documentaries to provide in-depth and behind-the-scenes learning experiences for almost every interest and ability: history, culture, nature, music, crafts, cruises, etc. These are a fun and exciting way to share new ideas, explore new places, and make new friends! These social events should be at no or a low cost. What about a 4-H club in the area adopting as one of their projects to have a cooking class once a month accessible to older adults where they could once again try their hands at measuring ingredients, mixing, rolling out cookies or spreading a cake mix in a pan, baking, and eating the delicious hot-baked goods right from the oven. The issue of access to activities which might be of value to your parents is very key to providing an answer to your inquiry. In a small community, the school and the churches are usually the source of social involvement for residents. The school could provide existing resources such as a lunch program, leadership and a meeting place. The local school board may have requirements which will need to be addressed. If your parents are members of a church, I would suggest you contact the leadership of the church regarding your concern. The church would provide an existing group of people who have similar needs and a place for meetings. The use of the church probably would have fewer requirements than the public schools. The resources to guide the development of such a program are numerous and are noted in this column. The leadership of such a program should come from the participants. This is important because the success of such a program evolves from the ownership the participants have of the program. I hope this has given you some new ideas. Your question definitely poses a valid area of concern. As the advanced age of our world population increases, it is imperative to provide stimulating activities so that we won ’t someday look back and realize all the minds that were a terrible thing to waste.

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Senior Living

Robert Miller

2006-11-01 08:42:00

What should I consider when deciding to care for someone in the home?

ANSWER: Caregiving is no longer an isolated role for a small few in the family. As the Baby-boomers age, we will need everyone’s time and talents to care for our growing senior population. The question of what to consider when deciding to care for someone in the home has many variables. For some, the answer is they would care for a loved one in the home at any cost; personally, financially, physically, and emotionally. However, caregivers must consider their commitment to care. Understanding one’s commitment is important in order to create balance between the needs of the loved one and the caregiver’s abilities now and in the future. A commitment to care requires honesty, nurturance, and review to ensure it is healthy for everyone. Even in familial relationships, we must create balance that affords time for the caregiver to re-energize. Those who are already caregivers understand the need for rejuvenation. New caregivers must know that open conversations about your willingness and abilities in regards to care are critical. Some of us can help manage incontinence or bathe our loved one. Others of us may not be able or so willing. That’s OK. Identifying one’s strengths in care includes discovering what you are comfortable with and physically able to do. Honesty is part of making a balanced commitment to care. Things to consider: What is your relationship with the person in need? What was your history with this person and has it always been reciprocal? What is his or her health condition and does it involve medical care? Is the individual going to live with you or in his or her home? Is he or she safe alone? Are there others who can help in the care or do they complicate the caring relationship? What financial resources does the individual have and are you managing them? By answering questions like these, you will be able to begin assessing the physical and emotional requirements of caring for your loved one. Once you have assessed the needs of the individual and yourself, you can look at which resources you need to utilize. Today, there are more community resources than ever before to help caregivers, including; home health services, hospice services, private duty services, Department on Aging services, and many more. It is important to remember to ask for help so that you don’t overload yourself. Remember, if you get sick or injured, your loved one looses their most valuable resource. A commitment to care is not just a promise of “in sickness and health” but a relationship that requires honesty between you and the one for which you are caring. If he or she is experiencing mental challenges or no longer has the ability to make decisions, this conversation will be much different. However, most of us have the opportunity to begin a conversation about care before a crisis occurs. Don’t allow a crisis to decide when to get involved. Start talking and planning now.

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Senior Living

Rev Bill Shook

2006-10-01 12:27:00

By Rev. Bill Shook

ANSWER: In the brief description you gave of your mother, I would suggest she seek residency in a retirement community which offers the following basic services: 1. Dietary 2. Housekeeping 3. Emergency 24 hour services During an assessment, the staff would assist the family and the prospective resident in determining the services required by the individual. For example, it appears this older adult needs to live in an apartment on the ground floor within a short distance of needed services. It sounds as if this prospective resident has a memory impairment, which does not compromise her health and safety. Based on this brief description, I do not think she needs to live in an assisted living environment but she does need an environment in which the specific services listed above are available. I would suggest the issue of driving be handled with the help of the Driver’s License Bureau by requesting she be called in for a test which includes a driving test. This approach places the responsibility on the regulatory agency and not on the family. She is not going to be happy but the family will be able to refer to the state requirements to be a licensed driver. To address your mother’s stubbornness, I would suggest you review the issues which makes living in her own home a threat to her health and safety. Do not argue but rather simply state the problems. If you feel yourself getting angry or upset, walk away. I would suggest you discuss a housing alternative the next time your mother’s health and safety is compromised in her home. If the adult children do not have influence with their mother, they should recruit assistance from someone who has influence such as the pastor, attorney or friend.

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Senior Living

Pam Crawford

2006-06-01 08:48:00

Question: Do I have a right to choose any agency for in-home care?

ANSWER: The aging process can create challenges to living independently in your home.  However, not knowing there are resources to help you remain independent can be the first challenge. Many people are unaware of what home health, hospice, private duty, and other services can do to help.  Once educated on these resources, the responsibility becomes the “right” to choose resources you or your loved one want. These are important choices that you will face when trying to prepare for the kind of health care you deserve. There may be occasions when it seems unclear what to do.  So it is critical to empower yourself when making these choices by beginning now to explore all the options you have for in-home services. Your community has many resources.  Here are a few tools you can use to explore and compare a wide variety of agencies and services: www.kshomecare.org, www.lifeproject.org,  www.cpaaa.com, www.sedgwickcounty.org, www.agingks.org   Now that you and your family have educated yourselves regarding resources in your community, let’s discuss your “right” to choose your own in-home services.  It is a Medicare regulation that you have the “right” to choose and make all decisions related to your health. This can include the following but is not limited to: home health services, hospice services, medical equipment, private duty services, hospitals, pharmacies, physicians (specialists as well), assisted living and long term care facilities. It is true that if you have private insurance they may specify the agency(ies) you can use based on being a part of their preferred provider network.  You may be able to choose outside of that network but you will most likely have a higher out of pocket expense.  For the sake of this article, we will focus on Medicare recipients and these recipients do not have any preferred provider restrictions. You can reference the Medicare website for more information on your “right” to make your own health care decisions at www.medicare.gov.  You may also make changes to your health care choices at any time. Faith Home Health & Hospice, LLC offers brochures on “How to Choose a Hospice Agency” and “How to Choose a Home Health Agency”.So, do you have the right to choose any agency in home services? The answer is yes! When it comes to making these important choices regarding in-home services and your health care – there are certain points to remember.  Your choice is the correct choice. At times you will receive feedback on these choices from physicians, medical professionals, your family and friends.  It is important to note that no matter what experiences others have had or who they may be affiliated with, the final choice is always yours.  Once you have made your decision, there is no reason for anyone to question your decision.  That is why you must know what is available to you in your community and how it serves you best.  An informed health care consumer is a much happier client.

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Senior Living

Roselyn Schmidt

2006-03-30 14:20:00

QUESTION: My mother was recently diagnosed with Alzheimer’s disease, and is progressively getting worse. I have heard somewhere that Alzheimer’s happens in stages-is this true? What can I expect...and when?

ANSWER: Alzheimer’s is a very difficult disease-both for patient and family member. It is difficult to prepare with this condition, but if you know the stages of Alzheimer’s, it makes the ordeal somewhat easier to cope with.A patient with stage one of Alzheimer’s shows no symptoms at all. A medical examination would show no signs, and the patient is considered of normal status. The next stage of Alzheimer’s would only be noticeable to the patient in his or her mind. The individual would have somewhat of a personal awareness that something is not right with their mental stability and functionality. Patients will begin to forget where they have placed everyday objects, and forget common words. Once again, this stage is usually only evident to the patient, and not to family and medical personnel.Stage three of Alzheimer’s is also considered the early period. This is when family and friends will start to notice some difference in the individual. Characteristics of this stage are most obvious in the workplace, as the patient has a harder time retaining names and has a more difficult time retaining material. The patient also might have performance issues in the workplace as well.Stage four is considered the mild stage of Alzheimer’s. A quality medical examination would be able to pinpoint the disease at this stage. A decreased memory of personal history and current events and an increased deficit in the ability to complete basic arithmetic would be prominent. Also, denial and a distressing mood would be another sign.Stage five is considered moderate Alzheimer’s disease, or early Dementia. This stage tends to become difficult for any family and friends involved with the patient. The individual will have trouble recalling details such as where they are, what day or season it is. At this point, the individual needs assistance getting by with day-to-day life.Stage six Alzheimer’s begins to become severe. The patient will have trouble recalling names of spouses and children. Their sleeping cycle will be disrupted, and incontinence will become an issue. They will need assistance in using the restroom, getting dressed and cooking. Personality changes become imminent, such as paranoia and repetitive habits. The individual will also begin to wander, and forget their surroundings.Late-stage Alzheimer’s, or stage seven, is the final stage of the disease. Patients lose the ability to control their own movement, and frequently lose speech. They lose the ability to walk, and the brain seems to have lost the control over the body. Assistance is mandatory. Though there is currently no cure for Alzheimer’s disease, knowing and preparing for all of the stages will make the process easier to deal with.

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Senior Living

Carla Shepherd

2006-03-01 10:52:00

QUESTION: Can in-home support provide care for Alzheimer’s and dementia patients?

ANSWER: Alzheimer’s disease and other related dementia disorders are among the most devastating of chronic conditions for the elderly.  Such a diagnosis can often trigger worst-case scenarios in the minds of senior citizens and their families.  However, with education, families can realize they are not alone and that care options are available. The face of Alzheimer’s disease has recently been made clearer through high profile cases.  For example, Supreme Court Justice Sandra Day O’Connor recently announced her retirement to care for her husband, John O’Connor.  John has been living with Alzheimer’s disease for several years.Caregivers of the 4.5 million individuals with Alzheimer’s and/or related disorders in the United States are no longer in the minority.  In fact, an estimated 60 to 70 percent of Alzheimer’s patients live at home.  According to the Centers for Disease Control and Prevention, 80 percent of America’s elderly are affected by one or more chronic conditions that limit daily activities and impact quality of life.   A diagnosis of a memory disorder, such as Alzheimer’s disease or related dementias, is overwhelming for many individuals and their families, people can begin to doubt their own abilities.  Families worry about safety, particularly if they live far away from the individual.  The first diagnosis of Alzheimer’s is a time to turn to family, in-home and other community-based supportive care services for care and peace of mind in a familiar and secure environment throughout the early to middle stages of these disorders.Memory loss can be frustrating for early-stage patients with Alzheimer’s or related dementias.  Caregivers can help structure the person’s day and help develop reminder systems to alleviate some of the difficulty.  Families should gather information from medical experts, community resources and caregivers to learn what local options are available.Individuals with Alzheimer’s and other related dementias can continue living relatively independent lives in the familiar environment of home with the support and supervision of a dedicated caregiver. Extra assistance in the home can help those with these and other chronic illnesses maintain the lifestyle they choose and a higher quality of life than in an institutional setting.

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Senior Living

Carla Shepherd

2006-02-01 15:22:00

Is it time to start planning for retirement?

ANSWER: This year marks a historic benchmark in America’s aging population as Baby Boomers begin turning 60.  Baby Boomers are expected to live longer than any previous generation of Americans.Baby Boomers are those adults who were born between 1946 and 1964, a period of increased birth rate during America’s economic prosperity following World War II.  Of the 3.4 million Baby Boomers born in 1946, 2.8 million are still alive.  Some of America’s more famous Boomers who’ll turn 60 this year: Bill Clinton, George and Laura Bush, Donald Trump, Susan Sarandon, Steven Spielberg and Sylvester Stallone.As Baby Boomers begin planning their lives after leaving the workforce, a growing number of them now face the additional challenge of finding care for their aging parents at the same time, because Americans are living longer.  In many cases, a Baby Boomer who is now 60 has parents who are 80 or older.Medical advancements are part of the reason people are living longer, into their 80s, 90s and even 100s.  These longer lives can mean the development of chronic conditions, such as arthritis and diabetes, Alzheimer’s disease or Parkinson’s disease in Baby Boomers’ parents.  These conditions make it difficult for these parents to perform some or many daily activities.At a time when most Baby Boomers are concerned about their own retirement, many also are faced with the fact that they have parents who are reaching a level where they need some type of care and assistance.  It’s a situation that will continue to grow as the Baby Boomers age.As the parents of Baby Boomers advance in age, their families will experience a “parenting the parent” situation, where adult children, who may be in their 50s or 60s, become primary caregivers.Baby Boomers who face the reality of caring for their adult parents are discovering:Retirement, a time typically associated with relaxation and less stress, becomes more stressful because of the additional care giving responsibility;A need now exists for greater financial planning, both for the Baby Boomers and their aging parents; There are now greater demands on the time of Baby Boomers to care for their aging parents, often meaning families need to bring in outside resources.  It’s very stressful for anyone to care for aging parents.  We now have an entire generation, one of the largest generations ever, facing that challenge. The good news is that help is available to aid families in providing care for seniors, and that Baby Boomers are becoming better educated on the issues of aging.

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Senior Living

Roselyn Schmidt

2006-02-01 14:37:00

What happens when someone gets Alzheimer's
disease?

ANSWER: The disease sets in so gradually that changes are nearly imperceptible, typically several years pass before a person is brought in for evaluation. The rate of progression from milder to more severe states is gradual and differs from individual to individual. People who have a relatively early disease onset (say in their 50s) often deteriorate more rapidly than those later in life. Alzheimer's disease is characterized overall by progressive memory loss and the decline of other mental functions such as attention, language and reasoning ability. The only reliable way to diagnose Alzheimer's disease is to examine brain tissue under a microscope and this can only be done upon autopsy.Misdiagnosis or 'over diagnosis' of dementia is also common because of misinterpretation of mild brain scan findings and inaccurate diagnosis. With careful diagnosis and use of modern techniques and assessments, the diagnosis of Alzheimer's disease can be made in the doctor's office with nearly as much certainty as it can be made on autopsy findings. A careful medical history is the most critical part of the initial evaluation. The physician will generally perform a thorough physical and neurological exam. The patients should be given a chest X-ray to rule out lung diseases and electrocardiogram to rule out the presence of ischemic heart disease, and laboratory urine and blood tests. An EEG,  (electroencephalogram) measures the electrical activity of the brain. Mental status testing is used to help the physician determine the extent of cognition and behavioral impairment. A Brain scan (neuroimaging) provides images of the brain structure like ET scans; MRI and PET scans. These should be routine steps in the diagnostic work-up of someone with symptoms of dementia. Eventually, however, complete care may involve the advice and expertise of a variety of professionals, including lawyers, accountants, social workers, nurses, counselors, physical therapists and clergy. 

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Senior Living

Carla Shepherd

2005-12-29 10:13:00

: Is Senior Care continuing to increase nationwide?

ANSWER: If you provide care for an aging loved one, or plan to offer care for one in the future, national statistics show you are not alone. As adults live longer and Baby Boomers approach older ages, the number of Americans who need in-home care, or will require such care in the coming years, continues to rise.National numbers are showing that Americans are living longer lives, and because of this, in-home care is quickly becoming a necessity. However, many American families can easily feel alone when they find themselves in a senior care situation. They don't always know where to turn for help.Besides living longer, aging adults often find themselves living alone after the loss of a spouse. Oftentimes, their children have moved out of the area or state as society becomes increasingly mobile. When these and similar situations occur, aging adults are often in need of additional care, either from the family or an outside provider.In-home care continues to increase, due to the number of chronic disease patients, for example.  According to the Center on an Aging Society at Georgetown University, nearly 100 million Americans have chronic conditions. An increase in elder care also has resulted from the number of Americans living with Alzheimer's disease. According to the Alzheimer's Association, 6 million Americans will be diagnosed with Alzheimer's disease by 2010. That number is expected to jump to 10 million by 2035.When adult children find themselves in these situations with aging loved ones, they often need to make a decision about the best care available for that person. In several cases, the care comes from a family member on a full-time basis or from an in-home care provider. The adult in need of care, however, does not want to become a burden to their family members. They seek a high quality of life that allows them to remain independent and living at home as long as possible.All senior care should offer in-home supportive care and assistance to seniors and other adults to help them continue to live independently. Remember that all direct employees of a direct care provider, should be bonded and insured, and carefully pre-screened prior to their entering a client's home. Another very important item to consider is making sure that all ongoing care is monitored and supervised. Some may even provide medical home healthcare as well.

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Senior Living

Judy Montague

2005-11-01 16:19:00

: I am helping my parents decide on senior living options. They are still very active, enjoy travel and social events. Their concern in finding a senior living facility is that they will be separated as their health needs change. Is there a system that will keep them together regardless of their health?      

ANSWER: A major question for those who are considering an independent living community is how to meet their future health care needs. It is important to have a specific plan covering various contingencies. Continuing care retirement communities (CCRCs) offer seniors long-term contracts that guarantee lifelong shelter and access to specified health care services. CCRC residents enjoy an independent lifestyle with the knowledge that if they become sick or frail, their needs will  be met. Most CCRCs provide a variety of residential services, which may be covered by monthly fees or be available at extra cost, depending on the contract. Services routinely offered include meals, recreation facilities, apartment cleaning and maintenance, grounds maintenance, prescribed diet, transportation, utilities, and special care during illness. The continuum of care offered in a CCRC typically begins with independent living in an apartment or cottage and proceeds through increasing levels of care, including personal care (or assisted living) when it is needed. Independent living communities are residential communities for active older adults who want an enjoyable lifestyle free of the worries and trouble of home maintenance. They are similar to any apartment, condominium, or single-family development, except that they provide special services, including security-an important consideration for many residents. Residents can leave home for extended periods of time knowing that their living quarters will be safe. Many independent living communities provide a full range of activities that promote social contact among residents. Shopping trips, outings to cultural events, and organized gatherings are typical activities. Most offer a variety of meal plans, including the option of preparing meals in your own apartment.In the case of your parent's concerns about remaining together, many of the CCRC communities are strategically designed so that if one person's health concerns determine that they need to move to another level of service, the spouse can remain in their independent living area which is in close proximity, or move to the next level of care as well. When choosing a CCRC with your parents, request an information packet from every CCRC you are considering. Read it carefully. Visit each one. Dine with residents; talk with staff; read the residents' handbook. Assess the management's philosophy and its relationship with residents, keeping in mind your parent's own needs.

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Senior Living

Carla Shepherd

2005-11-01 16:19:00

: Are there signs to look for in Elderly Depression?

ANSWER: According to the American Association for Geriatric Psychiatry, 15 out of every 100 Americans over the age of 65 have depression. Although it is normal to be sad for the loss of a loved one or while coping with a chronic illness, clinical depression affects a person's mental and physical activities for a prolonged period of time and should be given careful attention.Many seniors are struggling with loneliness and isolation - a major contributor to clinical depression.  Isolation often is due to: children moving away, spouse and/or friends passing away or a lack of transportation.Even with family care, seniors can become more isolated and less active. Families are encouraged to seek assistance through senior centers, local community groups or in-home care.The following are signs to look for with senior depression:• Lack of energy.• Weight loss or poor eating habits.• Lack of interest in activities.• Withdraw from family or friends.• Excessive sleep or fatigue.

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Senior Living

Carla Shepherd

2005-11-01 16:19:00

: Can a holiday gift of care benefit senior citizens year-round?

ANSWER: Most senior citizens already have access to the material possessions they need, such as clothing, bath towels, bedding and small kitchen appliances. Rather than replacing these items as gifts thisholiday season, senior care experts suggest family members give the gift of care - a present that will benefit senior citizens year-round.When a senior citizen receives in-home care for a few hours or on a regular basis, that individual is able to live a happier and healthier life in the comforts of his or her own home.  This gift not only benefits the senior citizen, but the family members, as well. Such care can reduce stress on the entire family. This type of care also allows more quality time between the loved one and his or her family members.Families can establish a set dollar amount to spend on care. They also can determine how much care is needed for their loved one on a regular basis, such as visits by the caregiver once a week or even once a month. When in-home care is arranged for an individual, that person can receive help around the home, with tasks such as washing the dishes, light cleaning or doing laundry. The caregiver also can run errands for the senior citizen and even assist with meal preparation on a regular basis.The amount of care given to the individual can certainly vary; senior citizens and their families can work together with caregivers to determine just how much assistance is necessary. That way, the senior citizen will retain control of his or her life while still living at home.The US Department of Health and Human Services agrees that in-home care can yield a healthier life for senior citizens. The department states that promoting the healthy lifestyles of older Americans is vital inhelping them maintain health and functional independence.  Coordinating care can be an introduction to in-home care for family members and their loved ones, seniors may be reluctant to seek out such care for themselves, so the family's purchase of this care can ease that transition.All senior care should offer in-home supportive care and assistance to seniors and other adults to help them continue to live independently. Remember that all direct employees of a direct care provider, should be bonded and insured, and carefully pre-screened prior to their entering a client's home. Another very important item to consider is making sure that all ongoing care is monitored and supervised. Some may provide medical home healthcare, as well.

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Senior Living

Roselyn Schmidt

2005-11-01 16:19:00

: What are the causes of Alzheimer's disease? Is it curable?

ANSWER: You may have discovered that many names have been given to the symptoms of memory loss and loss of thinking and reasoning capacity in adults. Commonly used terms include, organic brain syndrome, senility, hardening of arteries and chronic brain syndrome. Your doctor may say, "Alzheimer's disease, multi-infract disease, senile dementia, or pre-senile dementia".Alzheimer's disease is the most frequent cause of irreversible dementia in adults. The name "Alzheimer's" comes from the man Dr. Alzheimer, who, through brain autopsies, discovered the damaging and degenerative impact of the disease on the neuro-structures in the brain. The cause of the illness is not presently known and physicians do not yet know of any way to stop or cure it.Getting medical help for the impaired person is extremely important. Physicians, neuro-psychologists, social workers, nurses, recreational, occupational and physical therapists are all highly trained and have skills which complement those of the others. They can work together first to evaluate the impaired person and then to help with ongoing care.We all look forward, with good reason, to an end to the war, in the form of a cure, against Alzheimer's disease.

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Senior Living

Judy Montague

2005-10-01 14:59:00

: What is an Long Term Care Ombudsman?

ANSWER: An Ombudsman, defined, is one who advocates for another. Although many may not be aware of the duties he/she performs in the lives of a long-term care resident, the Ombudsman plays a very important role.The Ombudsman is an employee of the State of Kansas. As an advocate for residents of long-term care facilities; including nursing homes and assisted living facilities, the Ombudsman serves as a problem solver to concerns of the resident and their families; as an educator offering resources; and as an objective investigator to protect the rights of the resident in the event of a concern, question or complaint. If a resident of a long-term care facility or the family of a resident feel that any of their rights have been violated, the Ombudsman is contacted.  The Ombudsman helps long-term residents obtain the highest quality of life. In the event that a resident and/or their family suspect that their rights have been violated, contact the Ombudsman immediately. He/she will come to the facility or contact the resident or family member who has expressed concern. No concern is too small or too large to go unreported.   The staff of a long-term care facility can also benefit from the Ombudsman. He/she can help the staff and administrators to understand how to best meet the needs and concerns of a resident and reach an equitable solution to problems and concerns.All Residents Have the Right:• To be treated with consideration, respect, and dignity.• To exercise rights as a resident and as a citizen.• To voice grievances without fear of reprisal.• To be free from mental and physical abuse and to be free from chemical and physical restraints.• To have privacy in care and treatment and to associate and communicate privately with whomever they choose.• To manage personal and financial affairs; to make choices and independent decisions. • To keep and use personal belongings and to maintain a secure place for those possessions.• To participate in planning of care and treatment.• To participate in social, religious and community activities; to participate in the resident council.• To be discharged or transferred only for medical reasons, personal welfare or that of others, or for non-payment.To contact an Ombudsman write: Kansas Office of the State Long-Term Care Ombudsman, 900 SW Jackson, Suite 1041, Topeka, KS 66612. Or call toll free at (877) 662-8362, or email ltco@state.ks.us

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Senior Living

Carla Shepherd

2005-09-01 11:27:00

QUESTION: How can I protect my elderly parents from scams without invading their privacy?

ANSWER: Scam artists often target senior citizens for their trusting nature and honesty. Whether through phone calls or direct mail pieces, senior citizens are one of the most sought-after groups by thieves.The Federal Bureau of Investigation reports that senior citizens are often the targets of such scams because they have financial nest eggs; they own their homes and they have excellent credit ratings. Scam artists often focus their efforts on individuals who are in a position to make expensive purchases, the FBI reports.The best advice is the same advice you have heard for years, "If it sounds too good to be true, it probably is." By remaining aware of who is contacting senior citizens, family members can reduce the risk of financial fraud. You have to know who is working with your family member or who is involved in his or her life on a daily, weekly or even monthly basis. When you talk with your loved one, listen for any suspicious conversations they have had with unknown parties over the telephone. Diligence is one of the ways fraud is often caught. Review bank statements and other financial documents that arrive in the mail. Speak with your family member and find out who they're talking to. Discuss the issues of identity theft and fraud. Remind them not to provide Social Security numbers or bank account information to strangers over the phone, strangers who come to the door or to Web sites on the Internet.Suspicious activity should be immediately reported to police, bank officials or other authorities. Obtain as much information as you can from your loved one. Senior Citizens may not want to report the incident because they feel ashamed or embarrassed. If it happened to your family member, it most certainly has happened to someone else. The only way to combat this type of crime is to report it.

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Senior Living

Carla Shepherd

2005-09-01 07:39:00

: When  should families consider in-home care for senior citizens

ANSWER: For families - especially those with young children - who provide in-home care for senior-aged loved ones, schedules become even more hectic during the fall. As students return to school, days quickly pass with sports practices, recitals and other activities. As a result, the care provided to senior-aged family members may cause stress for families and seniors.According to the National Alliance for Caregiving, one in every four American households is involved in the caregiving of an adult age 50 or older. With such high numbers, families should make an honest assessment of the care they can provide - and the assistance they possibly need. Families should examine the level of care their loved ones need, and the assistance they can realistically provide. In some cases, families will feel a sense of guilt if they cannot or do not do everything. Once they utilize outside help, however, the family is put at ease and the senior citizen obtains consistent care.In many cases, families often find themselves "parenting a parent," in addition to caring for their own children.  Several tasks, such as meal preparation and cleaning, are completed in two homes. Outside supportive care for the senior can relieve families of this stress.Families may benefit from in-home supportive care if they:• Have difficulty making sure their loved ones are eating proper meals.• Miss family activities and events because they're providing care.• Spend the majority of their time concerned about their senior-aged loved ones.• Feel overly stressed from the care they currently provide others.• Consistently receive calls from senior citizens that require immediate attention.• Regularly take time off work to care for senior-aged loved ones.• Put off routine household chores to complete chores for the senior.When families utilize in-home supportive care for loved ones, they are able to spend a higher quality of time with these individuals. Instead of washing the dishes or administering medicine, these families can chat with their loved ones without disruption or distraction. Families need to learn it is healthy and acceptable to relinquish such care to an outside party. In doing so, families can still remain active in the care of their family members.Society conditions us to provide vigilant care for our parents as we age. We need not feel guilty when we ask for help, especially when trying to maintain two households.

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Senior Living

Roselyn Schmidt

2005-08-01 16:15:00

:  How does Music Therapy help residents of Assisted Living homes?

ANSWER:  Having fun and enjoying life is important for everyone. Seniors residing in Assisted Living facilities, especially those with dementing illness, are every bit as entitled to enjoy life! It may mean that caretakers need to make special efforts to discover things that the individuals find pleasure in, such as music.As an illness progresses, it may become more difficult to find things that person can still enjoy. Elderly people or people with dementia often lose the ability to entertain themselves; therefore, music can become a delightful resource. Senior residents, especially those severely impaired, seem to retain the capacity to enjoy old familiar songs. Some will sing only when someone sits close by and encourages them, and others may be able to use a simple tape deck or radio for their music pleasure. Some are still able to play the piano and sing if they learned this skill earlier in life.Group music therapy has a special affect on individuals, especially with dementia, on agitation and cognition. Also emphasis is placed on validation and redirection through music. Residents' emotions are validated through permission to express emotions with songs or emotional playing of musical instruments. Rhythm and tempo can match their repetitive movements and pacing. Redirection occurs when music is used to change moods or to provide comfort and relocation which can interrupt a preservative pattern. A variety of remembered and new skills; sensory stimulation, reminiscence, comfort and renewed communication are outcomes of this experience.

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Senior Living

Carla Shepherd

2005-08-01 09:54:00

QUESTION: In-home supportive care has been recommended for my elderly father-in-law. How is this different than hiring an in-home nurse to care for him? Do I need both?

ANSWER:  The decision to consider in-home care for a senior citizen is rarely made quickly and without question. Today's families are asking more questions - and receiving more answers in return - when taking the proper steps to establish in-home care.Supportive care offers a variety of services at the home of the loved one. Trained staff members can provide assistance with laundry, meal preparation, medication reminders, light housekeeping, and errands. These types of services are 'hands off' care. The care can be on a short-term basis, from a few hours each week to around-the-clock assistance. Medical In-home care also provides support from a trained caregiver to senior citizens in the environment where the senior is most comfortable and secure. Senior citizens are able to remain in their homes, while receiving 'hands on' assistance with their ADLs (Activities of Daily Living). Some of these services include bathing, dressing, toileting, and transferring. During the past decade, a growing number of families have sought in-home care to supplement what they provide their senior loved one. There are several levels of care offered by senior care services. It is important to first evaluate the health situation of your family member and determine what type of care he or she needs. In doing so, you'll have a clear understanding of what levels of care organizations can provide you and your loved one.When considering in-home care, speak openly and honestly with potential caregivers. Each family's situation is unique and requires special attention. What works for one family may not work for another family. By taking the time to find the appropriate care for your loved one, you'll have greater success and peace of mind. A good care company - which employs only trained and insured caregivers - will continuously work with you and your family to determine the best care for your loved one. They will personalize the in-home care program to best fit your family's needs.

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Senior Living

Roselyn Schmidt

2005-07-01 11:46:00

: My wife is being placed in Special Care due to Alzheimer's disease, but I'm remaining in our home. How can I best interact with her during visits at her care center? And, can she come home for visits?

ANSWER: As a person begins to develop a dementing illness, he or she may begin to have difficulty managing independently. The first step to make changes in a person's independence is to get an evaluation. That will dictate if a move needs to be made to a Special Care Facility for Memory Impaired residents.Changes are frequently upsetting to people with dementing illnesses. This does not mean the end of family relationships. The family member should continue to be a part of the impaired person; therefore, it is important that visits be part of their life. Even if the person does not recognize you or does not seem to want you there, your regular visits help at some level to sustain his awareness that he is valued and is a part of a family.A family member can help orientate the impaired individual to his or her new home by reviewing daily routines; try to involve the individual in family outings, go for rides or shopping. Help the impaired person to remain part of special family events; telephone calls between visits should not be forgotten. Music is a wonderful way to share; sing old familiar songs, take along tape recordings of the family or the children, make a personal history scrapbook. Do show that you are interested in her new home.Sharing family life and loving a person who is in an institution and who is in the late stages of a dementing illness are not easy, but perhaps you will find your own meaning in doing so. This reminds me of a memorable quote I once read, "I've grown in these visits."

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Senior Living

Carla Shepherd

2005-07-01 10:35:00

QUESTION: How can I divide the responsibility of caring for my elderly parents between my siblings? I seem to shoulder most of the responsibility and worries.

ANSWER: When a senior citizen needs either minor or extensive care from his or her family, it's important that all family members be alerted of the situation and become involved in the process. The topic of family members caring for loved ones is nothing new. According to the National Alliance for Caregiving (NAC), nearly one-quarter of households in the United States are involved in care giving to individuals age 50 and older. A typical caregiver in the United States is a 46-year-old female who spends more than 20 hours per week providing care to her parent, according to the NAC. In fact, more caregivers in the United States are women (61 percent) than men (38 percent), the NAC reported.The care of an aging family member shouldn't rest on the shoulders of one family member. This leads to stress, not only for the family, but the caregiver as well. Keeping the family lines of communication open can make the situation less stressful on everyone involved. And the family members will be more knowledgeable of the situation when additional decisions need to be made in the future.If families have members who live in another city or state, it's important to keep those individuals involved in the senior's care as much as possible.• Alert and discuss the senior's needs with all family members;• Divide responsibilities among the family, where possible;• Establish regular communication via meetings, conference calls or group e-mails;• Research additional resources to provide care when the family cannot;• Give the primary caregiver a break as often as possible.When all family members live in the area, include them in meetings with the senior's primary care physician or other medical specialist. When family members have a say in the care of their loved one, they're more likely to remain active in the senior's care.Should families choose to seek support from care agencies, the agencies should work directly with families to fill in the gaps of care. Families should not only provide input on the type of care their loved one receives, but they also should be kept informed with family care reports. A quality agency will issue family care reports. These regularly scheduled reports frequently update the family on the status and care of the senior citizen. It's an easy way for the family to remain involved in the care, and the time commitment is significantly reduced.

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Senior Living

Melody Claassen

2005-06-01 09:50:00

: I see motorized scooter wheelchairs everywhere. Are these a basic form or transportation now? Are they still designed for people with limited mobility?

ANSWER: There are two types of power operated mobility vehicles. One is a power chair, often known as an electric wheelchair, with a hand control that looks like a joystick. These types of chairs allow for better turning radius and can be used in and outside the home. The other type is a scooter that has a steering wheel or handles bars. Typically, these vehicles are best used outside the residence. There are several factors that come into play when determining the best power chair to meet your needs based on your height, weight, your everyday lifestyle, and the extent of usage. Although we are sometimes referred to as a "Lazy Society", I don't think we're to the point yet, of using power operated mobility vehicles for basic transportation. Electric wheelchairs have been around for a number of years and have provided thousands of people with the mobility they need to get from one place to another. The development was a result of seeing paraplegic veterans return from World War II in need of a form of transportation. The first electric wheelchair was made essentially with a typical wheelchair and then a small motor attached to the wheels. The chair was restricted by a small joystick placed at the proper distance on an armrest to allow ease and comfort of use of the stick for directing the chair. Innovations have been made in many different areas of electric wheelchairs since the early days of strapping a motor to a regular chair. The chairs built today have a superior mobility than any before. Some have the capacity to climb over limits along the side of the road and one can even climb up a set of stairs.Motors have become more and more powerful, offering greater speeds of travel while remaining safe and greater distances that can be traveled on a fully charged battery. The seats have been modified to provide the best comfort possible to the occupant that will spend many hours in it. When it comes to choosing the appropriate wheelchair for you, there are many options and models of electric wheelchairs available based on your desired look, comfort ability and budget of course.The type of medical coverage you have will determine what insurance filing procedures you will need to follow. If you have Medicare, you will need a prescription from your doctor in addition to having a certificate of medical necessity. From that point, your claim will be forwarded to Medicare for approval. Some companies will pre-qualify you for a power chair or scooter and will provide the equipment to you before Medicare approves your claim. Medicare covers 80% of the power-operated vehicle and the other 20% can be covered by a secondary insurance. However, the remaining 20% can be waived if you qualify for financial hardship otherwise the balance is an out-of-pocket expense. If your coverage is a private insurance, qualifications may vary but most insurance companies follow protocol similar to Medicare.

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Senior Living

Carla Shepherd

2005-06-01 09:50:00

QUESTION: My senior parents are still living in their home, and I think they're doing ok, but how can I be sure without offending them by asking?

ANSWER: One of the most important decisions people can make in planning for the future is about the care and assistance they will need as they age.  The growth in the senior care industry has provided people with many more options to live the lifestyle they choose, including the ability to remain safe and comfortable in their own homes.Today, people are living longer and healthier and the senior care industry is changing in response to that trend.  While not all seniors require the intensive supervision and skilled medical care of a nursing home setting, many can use assistance with one or more activities of daily living to retain their independence.  Some seniors shy away from asking for help because they do not realize there are options that do not require them to leave their home.The National Center for Health Statistics defines activities of daily living as those related to personal care, such as dressing, bathing or showering, getting in and out of bed and eating.  Instrumental activities of daily living, a more detailed measurement, describe more intensive activities related to independent living including meal preparation, shopping for groceries, paying bills and light housework.  Studies have indicated that approximately 20 percent of the elderly population has difficulty with one or more of these activities.An honest assessment by a family member or a senior care professional of how well a senior is able to complete these activities of daily living is a good indicator of the amount of assistance he or she requires.  In-home or community-based services are viable options for those who have difficulty with a handful of these tasks, but don't require round-the-clock supervision.Seniors and their families should evaluate their abilities in the following areas as a first step in determining if additional supportive care is needed:• Living area:  Is it unkempt or cluttered?  • Diet and nutrition:  Is there a concern the senior is not eating properly?  Are they able to get to the grocery store on a regular basis?• Medication:  Is it being taken as prescribed?  Are doctors' appointments being missed or rescheduled?  • Personal Hygiene:  Is there a decline in personal hygiene of the senior?  • Memory:  Are there signs of confusion or short-term memory loss• Driving:  Are there signs of diminished driving ability?  While these signs are a cause for concern, they don't necessarily mean a senior is nursing home-bound.  However, they can indicate that assistance is needed to ensure the safety and continued well-being of the senior.  If a family notices any of these signs, they should consult with a senior care expert to discuss services that are available.

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Senior Living

Roselyn Schmidt

2005-06-01 09:50:00

: I hear many terms used to explain assisted living homes and the services available in each. I recently heard the term ‘aging in place’.  What does this mean?

ANSWER: The term that you're referring to, ‘aging in place’, means a consumer can select an assisted living facility and reasonably expect to live there until the end of his or her life, regardless of changes in health or physical and cognitive functioning. In reference to assisted living facilities, only a very small percentage offers the option of ‘aging in place’. The problem lies with accurately defining Assisted Living. Originally developed as a Scandinavian model of residential care, Assisted Living emphasizes the importance of the social aspects of care and departing from what is generally termed a ‘medical’ model or organization of the care setting. Assisted Living is still new enough that the business offering it and the states that license it, do not agree on a precise definition. Although undefined, the ‘average’ Assisted Living Facility (ALF), have some generalized terms and services.• The average ALF bed size in the U.S. is 53 beds. Most offer a range of options in terms of private or shared accommodations. Only 27% of ALF's offer private rooms. A small number offer private apartments and private bathrooms. • Fewer than half ALF's (44%), are willing to admit residents who need assistance with transfers such as assistance in getting in or out of bed, a chair or a wheelchair. • 72% of ALF's will not retain a resident who needs nursing care for more than 14 days.• Only 40% have a full-time registered nurse on staff.  A couple of terms that you may hear which aid in separating the average ALF from others are ‘High Privacy’ and ‘High Service’. A high privacy facility must designate at least 80% of their units as private. Nationwide, only 31% of the ALF's meet this standard. A high service facility is defined as having a full-time registered nurse on staff and providing nursing care, as needed, with facility staff, as well as providing help with at least two ADL's (Activities of Daily Living), 24-hour staff, housekeeping, and at least two meals per day.If the ALF does not have the options/services listed above, they are called either ‘Low Privacy’ or ‘Low or Minimal Service’ facilities. 59% of ALF's in the U.S. fall in this category. Only 11% of all ALF's are both ‘High Privacy’ and ‘High Service’ facilities. Only these that offer assisted living, limited skilled care, dementia care, independent living, and employ professional nursing around the clock in order to serve a broad spectrum of consumers are able to offer ‘aging in place’.

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Senior Living

Carla Shepherd

2005-05-01 09:03:00

QUESTION: Are there any guidelines for a severe weather emergency plan to help seniors?

ANSWER: Having a plan is critical to keeping senior citizens safe when severe weather strikes, whether you live down the block or across the country. Senior citizens and our other aging relatives need to be a priority during severe weather.  Seniors must take the proper steps to stay safe, before severe weather creates a dangerous situation.  For families, knowing a beloved senior is out of harm's way can lessen a stressful situation.The best way to ensure seniors are cared for during severe weather is to plan ahead.  The American Red Cross suggests preparing an emergency kit in the event of severe weather.  The kit should include: bandages; antibacterial ointment; a few bottles of water; a flashlight with extra batteries; a battery-powered radio with extra batteries; and a blanket, to cover one's head in the event of flying debris. When a severe weather watch or warning is issued - or when a natural disaster strikes - senior citizens should receive a call from a family member, friend or neighbor, alerting them to the current weather conditions.For families with several children, it is often helpful to establish a calling tree to prevent all children from calling Mom or Dad at the same time.  In the event that a weather-related injury sends a loved one to the hospital, it's important to keep vital information on the individual- such as date of birth, social security number, home address, phone number, vehicle make, model and license number- in the event medical personnel need this information. It's also a good idea for families to continually check in with elderly relatives throughout periods of severe weather.  Unless they are watching TV or listening to the radio, they may not know about the threat.  The more time they have to plan for severe weather, the safer they'll be.For adult children or other caregivers who live a long distance from a senior citizen, it's vital to have contact information for those individuals close at hand. It also is important for senior citizens to have contact information for their family members. For adult children who live far away from their parents, it can be helpful to locate someone in the area who can check on senior citizens during severe weather.  It's also important to establish safe places the senior can find shelter if they are forced to leave their homes.Hopefully your family never needs to utilize emergency plans and information.  However, a severe weather situation is not the time to search for this information.

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Senior Living

Linda Day

2005-05-01 09:03:00

: What questions should I ask when I begin my search for a Senior Living Com-munity for my parents?

ANSWER: Don't be afraid to ask any and as many questions as you feel necessary. Deciding on a facility to help take care of your parents is one of the most important (and difficult) decisions you will ever have to make. First of all, take the facility's marketing tour and observe the upkeep and safety of that facility; is it clean and are the grounds maintained? Are there appropriate hand rails or grab rails in the bathing areas and hallways? Are the sprinkler systems and fire extinguishers easily accessible?  Talk to the individual giving the tour about the staff. What type of training is given to new staff members and is there ongoing training offered to the staff. Ask to see the training policy and procedure manuals to make sure that the facility does indeed train the way it says it does. Find out whether the facility uses volunteers and what type of training they receive. Ask if the facility does national criminal background checks on staff and new applicants? Some only do local or state background checks. Also, what type of pre-employment drug screening does it do, and is drug screening ongoing?  Compare the number of staff available on various weekday, weekend, and holiday shifts with other facilities you are considering. Find out about the types of food choices offered and whether it is able to accommodate special dietary needs. If the facility offers, sample a meal during mealtime while in a main dining area and observe the current residents and staff.  Ask about the range of activities on site and off site, and see if they meet the senior's needs. Are there activities off site at least twice a week? Does the facility offer activities such as religious services, lectures, discussion groups, and arts and crafts classes on site?  Check out the facility's wellness center if they have one, and the availability for use. Does it meet clinical needs such as memory impairment services or weight control and blood pressure checks? Also, how close is the nearest hospital in case of an emergency?  Depending on the health and mental awareness of your loved ones, look for a facility that offers Independent Living, Assisted Living, and possibly a Special Care, Skilled Nursing or Dementia Area. The longer your family member can remain in a familiar setting with familiar staff and residents, the more comfortable they will be with their lifestyle change.

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Senior Living

Linda Day

2005-04-01 10:41:00

: Concerning Senior Care, can you explain the difference between Independent Living, Assisted Living, and Nursing Home Living?

ANSWER: Independent Living in a retirement community is when you are able to cook, clean, ambulating with or without assistance of any device, independently. You or your loved ones are responsible for your own medical management, financial management and overall care in daily living. You can choose to join in a meal or activity with others at the assisted living facility or cook for yourself.  Assisted Living is allowing a person to live within a senior facility and receive as much care or little care as they choose.  For instance they can cook for themselves or eat in a group dining room. Meals may be delivered if the resident becomes ill or in the case of inclement weather. Residents have the freedom to do their own laundry or have it done for them. The same options are offered with medications. If a resident is unable to monitor their daily medications, assistance is offered. Activities such as shopping, billiards, musical entertainment and outings are offered. Some folks still drive and enjoy getting out for their leisure. In the event that emergency medical treatment is needed, staff will contact the resident's M.D. and/or family as well as providing needed transportation. Most assisted living facilities will not allow residents to stay if their needs can not be met. In other words, if your loved one tends to wander and their safety is at risk, they usually don't qualify for assisted living. Some assisted living facilities offer a special care unit that provides assistance in a safe indoor and outdoor facility. Staff stays in this area and provides toileting, dressing, feeding, and assistance with ambulation. Nursing Home living is for the people that require more care than can be given in an Independent or Assisted environment.  Also, if the Nursing Home is Medicare certified, they can receive skilled care and Medicare can be billed for that service. Nursing Homes usually have rooms rather than apartments.

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Senior Living

Carla Shepherd

2005-04-01 09:21:00

QUESTION: My mother has Parkinson's disease. What adjustments can be made to her home to boost her independence?

ANSWER: The special challenges resulting from a diagnosis of Parkinson's disease often mean making adjustments to one's lifestyle and home, particularly as the disease progresses.  But with a little help, individuals with Parkinson's may continue to enjoy the independent lifestyle they choose.  Family, friends and community-based services can all be valuable resources in assisting those with Parkinson's with their daily activities and helping ensure a safe, healthy home environment.While there is no cure for Parkinson's at this time, doctors, patients and caregivers experienced with the disease have learned to manage it using various lifestyle modifications that take into account the unique characteristics of Parkinson's.  Learning more about Parkinson's disease can help identify ways to improve quality of life for those affected. Changes in physical abilities mean that objects such as rugs, decorative tables and electrical cords can become dangerous tripping hazards when movement becomes limited or stiff.  Learning to recognize these home safety hazards and helping remove them enhances in-home safety. Maintaining good nutrition is especially important for those with Parkinson's in sustaining energy and countering some of the effects of Parkinson's, such as sleep disturbances or poor digestion.  Having someone provide assistance in preparing a few meals a week can help when energy is flagging or symptoms make meal preparation difficult.Getting enough exercise is also vital in maintaining balance, mobility and flexibility.  Walking, gardening or other exercises can be done as recommended by health care professionals.  A caregiver can help fill in the gaps and complete tasks that are difficult.  Having another person around to lend a steady hand or assist with range-of-motion exercises can give the individual the confidence to keep moving, too.  Taking medication on time is crucial in dealing with the disease.  After discussing the schedule with a doctor, a caregiver can set up a reminder system for pills, even if it's just to have someone place a reminder call or hand them to the person at the same time every day.  Keeping up with doctors' appointments is equally important, and options are readily available when Parkinson's symptoms interfere with driving or taking public transportation to get to them.Finally, a few hours of in-home supportive care can help an individual with Parkinson's accomplish fine motor and light housework activities such as dusting, laundry and personal grooming that may be hindered by symptoms.  Whatever the individual's needs, in-home supportive care is a viable option that can be tailored to specific abilities and budget to maintain a secure, independent lifestyle.

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Senior Living

Carla Shepherd

2005-03-01 10:09:00

QUESTION: I live clear across the country from my elderly parents. How can I help with their care giving from so far away?

ANSWER: Today's families are more geographically spread out than they used to be. With many seniors choosing to spend their retirements in warmer climates or their adult children relocating to jobs in other areas of the country, caring for family living far away is a growing concern for many in the United States.  Current estimates show that up to seven million Americans are currently providing long-distance care to an elderly loved one. In the past, the expectation was that family members would always be there to take care of family members. Every day, we see the frustration of men and women who live too far away to help their parents or other seniors in their lives as much as they want to.Fortunately, many more options exist today to allow families that are geographically separated to help care for seniors. The first challenge families may need to overcome is that many seniors, for generational, emotional or cultural reasons, are reluctant to accept help from people other than family members. You need to take into account your senior's concerns in discussing the need for assistance. An honest conversation is in order to assess the needs of the senior and to find out the kinds of activities they are finding difficult on a daily basis. Explain that some extra help will allow them to remain independent and that there are so many different levels of care available, starting with a few hours of help around the house each week. Keeping seniors involved in determining the level of care they need, will help ease some of their anxiety.  Once a need for care is established, the first step families should take is to be prepared before the need for care arises. Research community-based services in your senior's community, such as local agencies on aging, in-home supportive care providers and senior centers, so you have a list of resources you can turn to. You can find this information on the Internet or by picking up a copy of a phone book from your senior's local area on your next visit. Also, be prepared with specific medical, legal and other personal details that pertain to your senior such as having the names of doctors, medications, insurance policy information and legal counsel to help you make well-informed decisions quickly and efficiently if you suddenly find yourself in that position.Another way for families to stay involved across the miles is to get creative with their use of modern technologies. With your senior's permission, you can ask for e-mail updates from his or her doctors or caregivers. Better still, ask to be conferenced-in via telephone for medical appointments so that you have first-hand understanding of what is going on with your senior's health, or have a caregiver attend with them.

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Senior Living

Jennie Maison

2005-01-01 09:20:00

: How does one know when to stop providing care for a senior loved one and allow a professional to take over?

ANSWER: Certainly there is much to be said for families who provide care for elderly loved ones. As our aging population increases in number and need, the demand on and for caregivers escalates. In a survey performed by the National Center for Health Statistics in the 1980's, 45% of persons age 65 years and older not living in institutions were found to have some degree of limitation in daily activities. In the year 2000 that number increased to 68%, and as our society continues to prolong the lives of people through advanced technology and medical treatment, the numbers will continue to grow.Function is impacted by psychological, biological, and social issues. Multiple chronic medical problems, depression, cognitive impairment, or lack of social supports or financial assets, either alone or in combination will seriously impact an older person's ability to carry out daily functions. The complex needs of the elderly have initiated the search for competent daily caregivers. For a spouse, son or daughter to act the role of primary caregiver for an elderly relative becomes a multi-dimensional, multi-faceted decision-making process.Elder care has become an entity all its own; books have been written on the subject and line the shelves in libraries and bookstores. Following a few basic guidelines will assist you through the process and guide you toward a workable solution. One issue is safety, for the caregiver and the elder. Safety involves fall prevention, environmental factors, and elopement. If the elder has some degree of dementia and requires constant supervision, keep in mind how limiting that situation can be for the caregiver. Abuse and neglect are often the result of resentment, fatigue, and stress suffered by the caregiver. Seek assistance from professional resources at the first symptom of this syndrome. Maintaining a healthy, loving relationship with the elder is important. You need breaks from each other.A second factor is one of physical ability and health. As a caregiver you may be required to lift, bathe, dress, and toilet the elder. Are you able to transfer the loved one from chair to bed alone? Do you have medical ailments that may be exacerbated by this type of activity? If the answer is no, you can not lift, bathe, or transfer, and yes, you do have medical issues, seek professional caregiving assistance. When the physical, mental, or emotional health of the caregiver deteriorates, the quality of life for everyone is compromised. Remember such deterioration may be secondary to the stress caregiving challenges induce. The same deterioration may also be observed in the elder as they feel the stress too, and experience their own depression, grief, and anxiety.A third consideration is the financial feasibility of providing the primary care for an elder. Young people are struggling to juggle home and work; often the need for both parents to maintain steady employment is paramount. Home care does not provide health care insurance, retirement plans, social security benefits, or paid time off for illness. Take a serious look at financial obligations and how they will be met before you consider becoming a primary caregiver.There is never a wrong time to ask for professional assistance with caregiving. The health care arena offers a plethora of options. Boundaries are not well defined and many of the resources overlap. Explore your options and make an informed decision. Optimal quality of life for you and your loved one is the ultimate goal, and health care professionals in all venues are available to aid in obtaining and maintaining that goal. When, where, who, and how? Choosing the course that is right for your own situation requires thought, discussion, and research. Discuss with the elder what they prefer; there are those who do not wish family members to provide primary care. Do not allow guilt to interfere with the decision to call the pros. We respect your individual needs and will provide services accordingly, promoting optimal quality of life for everyone. Contact the KS Department on Aging for information about Health Care Resources, support groups, long term care facilities, and assisted living facilities.

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Senior Living

Carla Shepherd

2005-01-01 08:51:00

QUESTION: What is a ‘Senior Care Plan’?

ANSWER: These days, people are living a lot longer and in better health than they used to. As a result, many people put off thinking about the care they might need as they get older.  Experts in the senior care industry advise, however, that the better prepared you and your family are before the need for care arises, the less stress everyone will feel when that time comes. There is no crystal ball that can tell families when they or a senior loved one may need help, or even how much help they will need. The best thing families can do before the need becomes a reality is to sit down and discuss senior care options and requirements, and then research the options that fit their desired lifestyles. A recent survey commissioned by Metlife found that nearly two thirds of Americans don't have enough understanding about long-term care options to make a decision about their needs. More than half of the respondents between the ages of 40 and 70 associated long-term care with nursing homes alone. Families should be mindful of various scenarios when developing their senior care plans. Natural changes associated with aging, such as diminished eyesight and physical strength can mean that routine tasks such as driving and lifting laundry baskets can become more difficult. Some seniors might live too far away from family and friends who could lend a hand around the house or take them to the doctor when they aren't feeling well. For those seniors, there are community-based programs and services that can aid seniors in accomplishing daily living activities with just a few hours of help per week. Some seniors are afraid to admit they need help because they assume they will end up in a nursing home. However, just by contacting a local office on aging or in-home supportive care agency, seniors can get the help they need to continue living independently at home.There are some situations when extra care for a senior may be helpful in the short term.  Families should plan for what they would do if their elderly loved one breaks a wrist or sprains an ankle and needs a few weeks to recover. Another situation families should be prepared for are major health changes that may require seniors to be cared for in a facility that provides more intensive supervision or skilled nursing care. Strokes, heart attacks and serious accidents can happen suddenly. Having a good idea of the quality and capabilities of the facilities in your area ahead of time and a plan in place to deal with this type of scenario can help ease your decision-making process during these very stressful times when a decision needs to be made quickly. Being prepared to handle care decisions before the need arises ensures that you and your family can receive the care you desire and deserve on your terms. Know all your options by gathering information on all the types of care available in your area. This will help you meet both your short- and long-term care needs and provide your family peace of mind.

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Senior Living

Roselyn Schmidt

2004-12-01 09:19:00

: Tell me what it takes to make a health care provider so special?

ANSWER:  Let me answer by telling you about one of our valued employees, Judy Montague, and I think you will see just what makes health care providers so special. Originally from Medicine Lodge, KS, Judy and her husband Frank have three children and five grandchildren. Judy calls herself a late bloomer in referencing her career, but her hands-on training began long before her health care provider title. Judy stayed at home to care for her children until they were out of school, and then began working as a Nurse's Aid. Judy and Frank's oldest daughter, Michelle was born Down Syndrome. Judy found that caring for a daughter with special needs, while also caring for her mother who lived with them; was silently preparing her for a career as a health care provider. After working as a Nurse's Aid in a small nursing home, Judy pursued her goal of becoming a Certified Nurses Aid (CNA), then on to becoming a Home Health Aid, and finally securing a position as a Certified Medication Aid (CMA). Four years ago, Judy became a Licensed Practical Nurse (LPN) and currently serves as the Assistant Director of Nursing at Chaucer Estates, owned by the Schmidt family. When asked if she had any plans to retire, Judy quickly replied, "I haven't been in this field long enough to consider quitting!" Judy joined the Schmidt family in the early 1990's at Colwich Health Care, and traveled with the Schmidt family to begin their new facility, Park West Plaza in January 1997. Her most memorable experience in nursing came Nov. 1st, 1998 when heavy rains led to flooding and the eventual evacuation of the residents of Park West. "I was listening in the morning to KFDI at home, and following the news of the rising water. I heard about the flooding in the Park West neighborhood and headed there to see if I could help. When I arrived, the water had just begun entering the facility, and was just a couple of inches deep. We (the Schmidts and staff) waited and watched as the water continued to rise, praying that it wouldn't continue to rise in the building, which it eventually did. Firefighters and volunteers began arriving with boats and equipment. Our only thoughts were to get the residents out and to safety with as little stress to them as possible. Rose Schmidt, wading through the rapidly rising water, was the first to jump in a boat, helping to transport a 101 year-old resident, shivering in a blanket, to safety. This routine continued, loading residents in boats, transferring them to waiting vans, and transporting them to Chaucer Estates, clear across town. I remember one resident who was 90 years-old and this was her first boat ride! It was absolutely amazing the strength and resilience this group of elderly residents displayed. After all residents were evacuated, our attention turned to retrieving medical charts and throwing them into big trash containers to transport to Chaucer. We had to gather medications, resident medication schedules, and patient charts. All would need to be straightened out immediately in order to ensure the health care of the residents by bedtime…which was another immediate need. Chaucer Estates was only a few months old at the time. It had approximately 30 residents, and here we were delivering a hundred more, cold and scared. Mattresses and beds were being donated and delivered from as far away as Salina. The Red Cross was there with food for residents and volunteers. It seemed like the entire community answered our call for help. It was 12-14 hours after I had heard of the flooding that we finally had everyone settled in. By the next day, families of the residents were allowed to return to Park West to retrieve some personal belongings for their loved ones, as Chaucer Estates would became their home away from home for the next 4-5 months. After complete renovation, most of the residents returned to Park West, but some chose to remain at Chaucer." The flood of 98' was Judy's most memorable experience in nursing, but the event also solidified her relationship with the Schmidts. When they decided to end their partnership at Park West to concentrate solely on Chaucer Estates, Judy chose to go too. "I've learned to appreciate working in a private family owned facility." Using the Schmidts as an example, Judy continues, "Family owned businesses pay close attention to details, they offer a personal touch and adhere to higher standards. The level of care is the very best you will find. The Schmidts honor me, as well as the rest of the staff, with complete ownership in our positions. If we see something that needs to be done, we just do it, because that's the way Rose and Don (Schmidt) would handle it. They love the assisted living industry, they love the residents, and they share the love and pride of the facility itself. I've learned to live my career with the Schmidt Family Philosophy, 'The resident always comes first.'"

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Senior Living

Carla Shepherd

2004-12-01 08:49:00

QUESTION: Can you give me some holiday gift ideas for seniors?

ANSWER: At this time of year, many children, grandchildren and friends struggle to come up with ideas for the seniors on their holiday gift lists. As people age, their tendency is to pare down their possessions, leaving gift givers searching for presents that won't create clutter or work for their senior loved ones.Seniors appreciate simplicity in their lives. Practical items seniors can use every day, a homemade coupon book for sharing some quality-time activities and even arranging for an extra helping hand around the house are smart choices for the seniors on your gift list.There are many products on the market that are specially designed to meet the needs of seniors. Telephones and remote controls with large buttons, subscriptions to large-print versions of favorite magazines, cuddly lap blankets, soft-handled garden and kitchen tools and gripping devices to help seniors reach items on high shelves help seniors accomplish and enjoy everyday activities safely and comfortably. Other safety-themed gifts can include smoke and carbon monoxide detectors, non-slip rugs and bath mats, flashlights and fire extinguishers.Personal, homemade gifts are popular with many seniors. Photo albums and scrapbooks can become treasured keepsakes. Setting aside time to create them with your senior loved one serves to make the gift even more memorable. You can even bring along a tape recorder to develop an audio history as the story of each image or item is added to the pages.Gifts of time, companionship and assistance around the home are valuable to seniors as well. Families and friends that live nearby can offer to give rides around town, schedule time for working on crafts and hobbies together, liven up a living space with a fresh coat of paint, or offer to help with spring cleaning.For time-crunched families or those that live at a distance, arranging for an in-home supportive care provider to come in for a few hours to help with household chores, hiring someone to shovel snow or mow the lawn, or paying for a grocery delivery service can take care of the tasks they wish they could.However, some of the most valuable things families and friends can do for seniors cost nothing at all. This holiday season, we ask that people remember that patience, understanding, laughter and the joy of their company is what matters to seniors the most. The simple gift of time shared together is truly the one way to show a loved one you care.

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Senior Living

Roselyn Schmidt

2004-10-01 15:07:00

: How do I go about getting involved (volunteering my time) with residents in care homes? How much of my time is expected?

ANSWER: If any of these words describe you: generous, compassionate, devoted, caring, and energetic, then you have the characteristics of a volunteer. Volunteering in a long-term care facility, whether it is a nursing home or assisted living, is a very rewarding experience. To find the home that will best fit you, contact the Administrator or Activity Director of a facility you wish to volunteer at. They can give a good insight what a volunteer could do in their facility. A volunteer can set his/her own time and pace. It could be as many hours or days a volunteer would want to offer. Any and all time is appreciated, as a volunteer can offer many a helping hand with tasks that are not nursing related:  There is always time for visiting with residents; helping with outings, arts and crafts, entertainment, bingo, floral arranging, watering plants, involvement with music therapy, playing piano, singing, helping with ice cream socials, parties, special lunches, church services, card playing, delivering mail, and the list goes on and on. Volunteers provide valuable services to the senior living community. They can provide residents companionship, support, assist in letter writing, and lead activities. Some gratuities that facilities will offer (because there is no salary given) are special gifts, a nice meal, or maybe a recognition plaque. A special thank you and the appreciation from staff and residents go a long way with volunteers in long term care facilities. In becoming a volunteer, you have the opportunity to learn new skills, develop lasting friendships, and take pleasure in knowing you are helping others.

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Senior Living

John Morris

2004-10-01 15:07:00

: My parents are coming to live with us, and my Father has arthritis so on occasion he uses a walker or a cane, is it possible to provide a safe and economical way for my parents to access all parts of our house.

ANSWER: Generally speaking, yes, it is very possible. As the baby boomers age, more and more people are requiring assistance in many ways to many different parts of their homes. Stairs no longer need to be an obstacle or a boundary. It doesn't matter if you use a walker, cane or are restricted to a wheelchair, your entire home can still be yours to use.Many companies now manufacture accessibility equipment such as stairway lifts, and vertical or inclined wheelchair lifts. This equipment can usually be installed in just about any home with very little, if any, modifications to the home, and can be removed later on if necessary leaving no trace it was ever there. These lifts do not require any special electrical provisions, a simple receptacle or plug-in located near the stairway is all that is needed. Most stairway lifts can be installed in just a few hours and the most complex wheelchair lifts can be done in a day or two. In fact some dealers will even sell direct to the customer for a do-it-yourself installation. While it is possible, I strongly recommend that you have this type of equipment installed by a trained professional for a variety of reasons, not the least of which is safety.If you are thinking of building a new house, but are hesitant to build multi-story because of accessibility issues, you may want to consider installing a residential elevator. This may seem like quite an extravagance or even an unnecessary cost, but if the elevator is incorporated into the design from the beginning the cost is minimal. The builder essentially builds closets on top of one another and the electrician runs power to the shaft and the elevator is ready for installation. Looking back, not all that long ago, an automatic dishwasher was a luxury only available to the affluent. Whereas today, virtually no home is built without one. With the population aging, people tend to want smaller pieces of property, meaning less lawn to maintain, however they still want larger square footage in their home. This means houses must be multi-storied to fit on a smaller lot and still provide the space. An elevator actually makes good sense. As we grow older, and navigating stairs becomes more difficult, an elevator allows us to stay in our home indefinitely.Depending on your needs and situation, there are options available to you. Call an accessibility specialist and have them visit your home. Most will do this for no cost and can provide you with possible solutions to your problem.

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Senior Living

Roselyn Schmidt

2004-10-01 15:07:00

: Can you explain the different types of Arthritis and their symptoms?

ANSWER: As many as 36 million people in the United States have some form of arthritis or joint inflammation. It is a major cause of lost work time and serious disability for many people. Although arthritis is mainly a disease of adults, children may also suffer from it.In order to understand arthritis and its effect, it's important to look at the body's anatomy. A joint is where the ends of two or more bones meet. For example, a bone of the lower leg, called the shin or tibia and the thighbone, called the femur, meet to form the knee joint. The hip is a ball and socket joint. It is formed by the upper end of the thighbone - the ball-fitting into the socket, which is part of the acetabulam. The bone ends of a joint are covered with a smooth material called cartilage. The cartilage cushions the bone and allows the joint to move easily without pain. The joint is enclosed by a fibrous envelope called the synovium which produces a fluid that helps to reduce friction and wear in a joint. Ligaments connect the bones and keep the joint stable. Muscles and tendons power the joint and enable it to move. One of the body's normal reactions to injury or disease is inflammation. In an injured or diseased joint, this results in swelling, pain, and stiffness. Inflammation is usually temporary, but in arthritic joints, it may cause long-lasting or permanent disability.There are more than 100 different types of arthritis. The most common type of arthritis is osteoarthritis. It is seen in many people as they age, although it may begin when they are younger as a result of injury or overuse. It is often more painful in weight bearing joints such as the knee, hip and spine than in the wrist, elbow, and shoulder joints. All joints may be more affected if they are used extensively in work or sports, or if they have been damaged from fractures or other injuries. In osteoarthritis, the cartilage covering the bone ends gradually wears away. In many cases, bone growths called "spurs" can develop in osteoarthritic joints. The joint inflammation causes pain and swelling. Continued use of the joint produces pain. Some relief may be possible through rest or modified activity.Rheumatoid arthritis is a long-lasting disease that can affect many parts of the body, including the joint. In rheumatoid arthritis, the joint lining swells, invading surrounding tissues, and producing chemical substances that attach and destroy the joint surface. This commonly occurs in joints in the hands and feet. Larger joints such as hips, knees, and elbows also may be involved. Swelling, pain, and stiffness are usually present even when the joint is not used. Rheumatoid arthritis can affect people of all ages, even children. However, more than 70% of people with this disease are over 30 years old. Many joints of the body may be involved at the same time.The goals of treatment are to provide pain relief, increase motion, and improve strength. Treatment may include: medications, joint protection (such as canes, splints, walkers, etc.), and/or surgery.At present, most types of arthritis cannot be cured. Researchers continue to make progress in finding the underlying causes for the major types of arthritis. In the meantime, orthopedists, working with other physicians and scientists, have developed many effective treatments. For more information on arthritis, visit the national Arthritis Foundation website at: http://www.arthritis.org/ and link to your local chapter.

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Senior Living

John Morris

2004-09-01 12:08:00

: We are thinking about moving my mother into our home, but the room we have in mind is upstairs, and she doesn't climb stairs well. Is there an affordable lift of some kind that will work without a lot of construction, and still allow the rest of the household access to the stairs?

ANSWER: Installing a Stair-Chair is an economical way for someone to regain access to his or her whole house. There are several Stair-Chairs on the market that can solve your problem.If you have a straight stairwell, there are different models available for under $3,000, installed. Most units today are even battery powered, allowing them to be used in the event of a power failure. The batteries last for 3-4 years, and are cheaper than a car battery to replace.Stair-Chairs can be installed in almost every home style, from split-level to curve, or multiple landing stairs. The units have a swivel chair allowing easy access on and off of the chair, and they fold up when not in use permitting normal foot traffic. Most models attach directly to the stair treads, so installation time on a straight unit usually takes less than 4 hours. An electrical outlet close to the stairs is required, to provide power for the unit or the charger, depending on the model. Most dealers will give free in-home visits to measure the stairs and prepare an accurate estimate.

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Senior Living

Roselyn Schmidt

2004-09-01 12:08:00

: I've heard a lot about Former President Reagan's battle with Alzheimer's and the need for Stem Cell Research to prevent this disease. What is Stem Cell Research and what is the big debate?

Question: I've heard a lot about Former President Reagan's battle with Alzheimer's and the need for Stem Cell Research to prevent this disease. What is Stem Cell Research and what is the big debate? Answer: Stem cell research may provide useful insights that could be helpful in finding ways to prevent and treat Alzheimer's disease, even if it is not likely to lead to specific treatments in the near future.Science is the only place we can turn for clues and eventual answers to Alzheimer's. We are approaching a breakthrough in understanding and treating the disease; that is if Congress continues its support and increases funding for general research into Alzheimer's and if scientists are allowed to pursue all the promising leads that are beginning to develop.Within its mission to eliminate Alzheimer's disease, the Alzheimer's Association opposes any ban on federal funding for human stem cell research, provided that appropriate ethical and oversight guidelines are in place.Since Ronald Reagan's death, the search for a cure for Alzheimer's has been rejuvenated and efforts are pursued in Congress to expand stem cell research; however, President Bush's policy will remain in place, and that is, he is against using embryos for stem cell research. President Bush says: "We need to balance the interest in science with moral issues".Scientists say research on human embryonic stem cells holds the potential to cure Alzheimer's, Parkinson's disease, spinal injuries, diabetes and other conditions. Stem cells are a kind of master cell from which the body grows new organs and other tissues. Embryonic stem cells grow into every kind of cell or tissue. But living human embryos are destroyed to produce stem cells. Opponents say that is an immoral ending of life. An effort to find a middle ground must be found. President Bush believes that "we should not create life for the sole purpose of destroying it" however, he states adult stem cells can be used.As scientists learn more about stem cells, they also gain a better understanding of how embryos develop all the cells, tissues and organs needed to sustain life. And, they learn more about how certain diseases and conditions develop. Scientists must overcome a number of obstacles before they learn how best to use these cells to improve your health.

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Senior Living

Roselyn Schmidt

2004-08-01 09:19:00

: What happens when someone gets Alzheimer's disease?

Question: What happens when someone gets Alzheimer's disease?Answer: The disease sets in so gradually that changes are nearly imperceptible, typically several years pass before a person is brought in for evaluation. The rate of progression from milder to more severe states is gradual and differs from individual to individual. People who have a relatively early disease onset (say in their fifties) often deteriorate more rapidly than those later in life. Alzheimer's disease is characterized overall by progressive memory loss and the decline of other mental functions such as attention, language and reasoning ability. The only reliable way to diagnose Alzheimer's disease is to examine brain tissue under a microscope and this can only be done upon autopsy.Misdiagnosis or 'over diagnosis' of dementia is also common because of misinterpretation of mild brain scan findings and inaccurate diagnosis. With careful diagnosis and use of modern techniques and assessments, the diagnosis of Alzheimer's disease can be made in the doctor's office with nearly as much certainty as it can be made on autopsy findings. A careful medical history is the most critical part of the initial evaluation. The physician will generally perform a thorough physical and neurological exam. The patients should be given a chest x-ray to rule out lung diseases and electrocardiogram to rule out the presence of ischemic heart disease, and laboratory urine and blood tests. An EEG,  (electroencephalogram) measures the electrical activity of the brain. Mental status testing is used to help the physician determine the extent of cognition and behavioral impairment. A Brain scan (neuroimaging) provides images of the brain structure like ET scans; MRI and PET scans. These should be routine steps in the diagnostic work-up of someone with symptoms of dementia. Eventually, however, complete care may involve the advice and expertise of a variety of professionals, including lawyers, accountants, social workers, nurses, counselors, physical therapists and clergy.

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Senior Living

Roselyn Schmidt

2004-07-01 09:14:00

: Does pain management always have to include medications?

ANSWER:   While there will always be  something out there that works in some situations, medications can, and do, play a major role in pain management.The International Association for the Study of Pain defines pain as the sensory and emotional experience associated with actual or potential tissue damage. Pain includes not only the perception of an uncomfortable stimulus, but also the response to that perception. Experiencing pain is influenced by a great number of interacting physical, mental, biochemical, and physiological, psychological, social cultural and emotional factors. There are different signs of pain: acute and chronic.In treating pain, it is not unusual for analgesics to be administered in accordance with the time specified to have elapsed between doses. Pain characteristics should be evaluated to determine the location and radiation, quality, severity on a scale of 1 to 10, temporal qualities (onset and duration) and associated symptoms experienced.

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Senior Living

Roselyn Schmidt

2004-05-01 16:34:00

:  I hear many terms used to explain assisted living homes and the services available in each. I recently heard the term "aging in place", what does this mean?

ANSWER:  The term that you're referring to, "aging in place", means a consumer can select an assisted living facility and reasonably expect to live there until the end of his or her life, regardless of changes in health or physical and cognitive functioning. In reference to assisted living facilities, only a very small percentage offers the option of "aging in place." The problem lies with accurately defining Assisted Living. Originally developed as a Scandinavian model of residential care, Assisted Living emphasizes the importance of the social aspects of care and departing from what is generally termed a "medical" model or organization of the care setting. Assisted Living is still new enough that the business offering it and the states that license it, do not agree on a precise definition. Although undefined, the "average" Assisted Living Facility (ALF), have some generalized terms and services.• The average ALF bed size in the U.S. is 53 beds. Most offer a range of options in terms of private or shared accommodations. Only 27% of ALF's offer private rooms. A small number offer private apartments and private bathrooms. • Fewer than half ALF's (44%), are willing to admit residents who need assistance with transfers such as assistance in getting in or out of bed, a chair or a wheelchair. • 72% of ALF's will not retain a resident who needs nursing care for more than 14 days.• Only 40% have a full-time registered nurse on staff.  A couple of terms that you may hear which aid in separating the average ALF from others are "High Privacy" and "High Service". A high privacy facility must designate at least 80% of their units as private. Nationwide, only 31% of the ALF's meet this standard. A high service facility is defined as having a full-time registered nurse on staff and providing nursing care, as needed, with facility staff, as well as providing help with at least two ADL's (Activities of Daily Living), 24-hour staff, housekeeping, and at least two meals per day.If the ALF does not have the options/services listed above, they are called either "Low Privacy" or "Low or Minimal Service" facilities. 59% of ALF's in the U.S. fall in this category. Only 11% of all ALF's are both "High Privacy" and "High Service" facilities. Only these that offer assisted living, limited skilled care, dementia care, independent living, and employ professional nursing around the clock in order to serve a broad spectrum of consumers are able to offer "aging in place."

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Senior Living

Roselyn Schmidt

2004-05-01 15:16:00

Question:  Can you help me understand more about Alzheimer's?

ANSWER:  You may have discovered that many names have been given to the symptoms of memory loss and loss of thinking and reasoning capacity in adults. Commonly used terms include, organic brain syndrome, senility, hardening of arteries, or chronic brain syndrome. Your doctor may say, "Alzheimer's disease, multi-infract disease, senile dementia, or pre-senile dementia.”Alzheimer's disease is the most frequent cause of irreversible dementia in adults. The name "Alzheimer's" comes from a doctor whose name was Dr. Alzheimer and through brain autopsies he discovered the different structure changes in the brain. The cause of the illness is not known and at present, physicians know of no way to stop or cure it.Getting medical help for the impaired person is extremely important. In the course of the illness special skills of a physician, neuropsychologist, social worker, nurse, recreational, occupational, or physical therapist is necessary. Each is highly trained; whose skills complement those of the others. They can work together first to evaluate the impaired person and then to help with ongoing care.We all look forward and with good reason, to an end to this war in the form of a cure for Alzheimer's disease.

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Senior Living

Bill Ward

2004-04-01 16:41:00

:  My sister is in a care facility and I would like to take her out for day trips.  Is this allowed or does it depend on the facility?

ANSWER:  In most cases, family outings are not only allowed, but are encouraged. It may even be determined that a family activity would be therapeutic and beneficial to the resident's care program.  Each care center does have its own policies for these kinds of family outings.  Customarily, and depending on the type of program in which your loved one is participating, all that is asked is that the family member or resident notify staff of their plans - when they will be leaving and when they expect to return.  Some facilities do have a curfew as a security measure, both to protect against unwanted after-hours intruders and to help ensure that everyone is home, safe-and-sound each evening.The main factor to be considered is the level of care your sister is receiving.  For example, assisted living residents, by definition, have more control over their own activities than those persons requiring more advanced care, such as persons with Alzheimer's or residents on oxygen and those requiring a high level of nursing care.In addition, a resident's care program may call for periodic or episodic evaluation of the feasibility of outings.  This is especially true for those residents who are receiving nursing care, Alzheimer's or other dementia care.  A family outing may require some advance planning and special arrangements.  Ideally, the family member who is planning an activity will be able to contribute to this evaluation, along with the resident and staff.Another consideration is what special needs your sister may have when leaving the care center where you will both be without the benefit of the staff support to which your sister may have become accustomed. Personal needs such as portable oxygen, nebulizers and other breathing aids; time-critical medications, dietary restrictions and other aides such as a cane, walker or wheelchair must all be considered.  Staff will most likely ensure that you are made familiar with those needs and can assist with them if necessary. If you feel you will need further guidance or information to ensure a safe and enjoyable day, you should not hesitate to ask more questions of the center's staff.Occasionally, you may wish to take a family member for an overnight visit - to your own home, or for a special, long weekend.  Again, it is important to work closely with the center's staff to be certain you are prepared to provide necessary care and assistance for your sister so you both can enjoy the outing.Good communication between you, your sister and the professional staff is the key to success.  Make it a point to visit with the caregivers at your sister's community.  Ask questions and prepare yourself with information in advance of planning any kind of special outing. Last, but not least, have a great time and be assured such trips will add greatly to your sister's well-being and create pleasant memories, not to mention some lively conversation with others at the care center, that last beyond the visit.

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Senior Living

Doug Stark

2004-04-01 13:46:00

Question:  I have my kids and friends telling me I can no longer care for my wife.  We’ve been married 65 years this coming June!  I don’t know what to do.

ANSWER:  This is obviously a very emotional if not gut-wrenching situation faced by many, when the balance of providing the health care needs of a beloved spouse finally tips the other way.  The guilt laden process and decisions (commonly referred to as 'tough love' decisions) that one must face can be quite difficult to reconcile, particularly when the elderly care giving spouse is under the mental and physical stress of providing 24/7 care for their loved-one, is frail themselves, or in some cases are dealing with medical needs of their own.The reality for most is to hold on out of love and commitment for your spouse, and also out of fear of how they or you will react to the change and separation.  In some there is a financial component to conserve financial resources for as long as possible if long-term care policies are not part of the picture.  But for whatever the reason, the time comes in many households where the care giving needs exceed the abilities of the care giving spouse which many times becomes detrimental to one or both parties involved.In your case as the caregiver, if the daily routine or load begins to wear its toll on you, you could find yourself facing serious health issues of your own, up to and including death.  And obviously you cannot be an advocate for your spouse if you are not here, or, are incapacitated for some reason.  I cannot tell you in relation to caring for those with Alzheimer's disease over the last ten years how many husbands or wives I have met with that knew they needed to transfer the care of their loved-one to someone else, but just couldn't bring themselves to do it.  I have seen that decision met with less than optimal consequences.The issue is whether it is best for you to remain the primary caregiver on a 24/7 basis or let your wife receive care in a professional setting, thus allowing you to resume a more normal and healthier schedule.  This puts you in a position to hopefully spend quality time with your wife with 'batteries charged' as opposed to just trying to get through the week as a caregiver.  I have had many over the years come back to me after finally making the tough decision to place their loved-one and say something like "I shouldn't have put that off so long…… I now have my life back and my wife is receiving better care".Depending on the health, health care needs, home environment (i.e. ranch home vs. two-story) etc., of the individuals involved, each situation is different and needs to be looked at objectively.  Sometimes this is difficult when the participants in the process are so subjectively involved.  This is where a consultation with your physician, a call into the Department on Aging or one of the many non-profit agencies like the Alzheimer's Association (if that is what you are dealing with) may be a good start in getting an objective assessment and advice.  Another really good move is to contact one of the elder care case managers here in town.  These are people that are familiar with all of the local providers of care and for a fairly nominal fee will assess your situation and then discuss with you what would be appropriate options.  They are able to draw on their experience in dealing with other families and will help you determine what most likely will work in your situation and what probably won't.  Finding the phone number for an elder care case manager can sometimes prove difficult as there is yet to be a category in the yellow pages.  Again, most of your non-profit organizations, the Dept. on Aging or Senior Services can probably put you in touch.  It may be that simply a few hours of support by a home health agency or one of the fairly new companies that provide in home help and assistance on either a daily basis or a few times a week might just do the trick.  These companies can help with housekeeping, run to the grocery or do other necessary errands, or they can cover for you as caregiver for a few hours so you can get away and have lunch with friends, play a round of golf, or just spend some personal time clearing your mind.  There also are options in adult day care and others that can be incorporated into a care plan that might allow you to put off the need for placement outside the home.On the other hand, it may be that long-term placement is actually the best option in your situation.  Today there are many new and improved options to the often feared, institutional nursing home approach.  Whatever you do, these are profound decisions that rank up there with other life changing decisions you have made like getting married, having children, and changing careers.  What is difficult is removing enough of the emotional component so that you can actually figure out what is truly best for you, and your spouse.

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Senior Living

Doug Stark

2004-04-01 09:19:00

Question: What are the rules when bringing your children to see the elderly?

ANSWER:  I am not aware of any universal rules regarding bringing children to visit the elderly but obviously each care environment whether it be a long-term care facility, a residential adult care home or a hospital has the right to impose whatever rules they seem fit to protect their residents or patients as the case may be.Having said that let me say that in the long-term care arena, having children in the homes is an absolute blessing to most elderly.  It is true that if not handled correctly children can be disruptive and can agitate the elderly, but for the most part the elderly love interacting with children.  Many times you will see the entire atmosphere in a home change when children enter the room, particularly younger children and babies.  Who doesn't love to hold a cute little baby… and aren't they all cute?For the elderly who spend their days in a long-term care facility predominantly with other elderly except for caregivers and nurses, it is a refreshing change to see the smiling face of a child who has come to visit. Many elderly tend to feel a sense of worthlessness or purposelessness as if they are no longer important since they cannot do what they used to.  Moral is raised and value is added to the life of the elderly when a child or children come and share some time showing a real interest in their life.  Actually isn't it important to all of us at any age to feel as if someone wants to spend some time with you?Things to consider though regarding taking a child to visit, is the current health condition of both the child and the elderly to be visited.  Another consideration needs to be the cognitive level of the residents and the level of stimulation the child/children will provide.  In addressing the first issue, many frail elderly have immune systems that are compromised by either their age, a disease process or both, leaving them highly susceptible to becoming ill from germs brought in from outside.  A cough, runny nose or low-grade fever common to children can potentially be life threatening to the elderly.  It is always a good rule not to let children, or for that matter anyone visit the elderly when showing signs of illness.In relation to stimulation, for most elderly whose minds are still sharp, over stimulation is generally not an issue.  In fact they may appreciate getting revved up a little.  But for the cognitively impaired that may be suffering from severe confusion, anxiousness and paranoia, it is very easy for these Residents to become way over stimulated which obviously is not of benefit to them.  When dealing with memory disorders it is very important that children try to remain calm and behaved. Unfortunately, kids will be kids and because of their chasing throughout the house, jumping on furniture and wrestling around we have seen it cause adverse effects on one or more of the residents which defeats the purpose of the visit.Usually good common sense will direct you in planning and carrying out your visit.  When is the individual you wish to visit at their best, do they have a usual naptime?  Many times it can be good to have a little plan in mind as far as an activity that the child or children can do with the elderly Resident.  Reading out loud, doing a puzzle, playing the piano, or having the Resident tell stories that relive some of their greatest vacation experiences can all be very therapeutic and enjoyable to the Resident.   As I said at the beginning, generally the enthusiastic reaction you get when a cute little kid/s or a baby drops in to visit… well the reaction as the Visa commercial says is priceless!  Take a few moments and go visit the elderly.  You will be glad you did.

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Senior Living

Anna Dove

2004-04-01 08:46:00

:  My poor dad suffers so badly from Arthritis. He's tried every product on the market to find some relief from the pain. I've heard of special exercise programs designed especially for arthritis sufferers. What's the scoop?

ANSWER:  One in every six people, or over 43 million Americans suffer from some form of Arthritis. Arthritis is joint inflammation, affecting one or more aspects of the joint depending on the type of rheumatic disease, of which there are over 100. Rheumatic diseases are inflammation or degeneration of the connective tissue structures in the body, especially the joints and structures, such as muscles, bursae, tendons, and fibrous tissue. Symptoms vary from person to person depending on the type of disease and degree of involvement but the common symptoms are pain stiffness and limited motion of the joint. Arthritis is the leading cause of disability in America.It was thought for many years that if you had arthritis you should not exercise because it would damage your joints. However, research has shown that exercise is an essential tool in managing arthritis as well as other ailments. Exercise reduces joint pain and stiffness, builds strong muscle around the joints, and increases flexibility and endurance.  It also helps promote overall health and fitness by giving more energy, muscle and bone strength, cardiovascular fitness, endurance, aiding in weight control, improving appearance, posture, balance & coordination, circulation, function, increasing the ability to perform daily and recreational activities, quality of sleep, and a sense of well being and self esteem with less stress & depression. Furthermore, exercise can help stave off other health problems such as osteoporosis and heart disease.Starting an exercise program can seem like a daunting proposition. An exercise program can include anything from walking around the block, taking a yoga class, or playing a round of golf. The important thing to remember is to start slow and make it fun. It is always good to start with flexibility exercises, which are basically stretching exercises that will improve the range of motion. Range of motion exercises help maintain or improve joint movement and flexibility and relieve stiffness. They target all tissues of the joint; each joint can be moved in a defined distance in specific directions. For example, the elbow moves to bend, straighten, and rotate the forearm (pronate and supinate). People with arthritis should try to move each joint function to minimize stiffness. Joints that are inflamed or damaged by arthritis often have limitation in range of motion. Arthritis sufferers may experience increased pain as they move especially at the extremes of joint movement, due to shortening of the tendons, muscles, and ligaments around the joint. Ranges of motion exercises are performed in a steady rhythm for ease of movement and mobility, and to increase flexibility. These exercises are passive, active assistive and active.Being in pain may lead to reluctance to exercise. A water exercise program is a great place to begin. In the water the body's buoyancy reduces stress on hips, knees and the spine. Water exercise programs help develop a better range of motion for joints and include muscle-strengthening exercises as well.With any exercise program, always consult with your doctor before starting out. Two other types of health professionals that can help develop an exercise program to fit specific needs are a physical and an occupational therapist. A physical therapist will demonstrate the proper techniques and precautions when performing certain types of exercise. An occupational therapist can assist in learning to perform daily activities without putting additional stress on joints. They can also provide splints or assistive devices that can make working out more comfortable.

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Senior Living

Bill Ward

2004-03-01 16:02:00

Bill Ward Question:  I recently visited my grandmother in a nursing home and she was convinced I was my mother. I allowed her to talk to me as such and her nurse showed some concerns as though I should have corrected her. I am not a trained professional in dealing with the elderly. Could you tell me for my own peace of mind whether I did the right thing?

ANSWER:  It can be alarming the first time a family member doesn't remember you or calls you by another name. Don't take it personally. In no way does it reflect how important you are to your grandmother. Whether your grandmother has a temporary memory loss or memory loss caused by Alzheimer's or a related illness, confronting her when she misidentifies you has the potential to agitate or upset her. By simply "going along" with your grandmother when she insists you are her daughter, you essentially meet her where she is at that point in time.To improve the chances she will remember you next time you see her, try to visit in the morning. This is usually the best time of the day for persons with memory loss. When entering her room, announce who you are and that you are her granddaughter. If she forgets again and says you are her daughter, gently remind her who you are. If she continues to believe you are someone else, talk about that person. Ask who, what, when and where questions such as, "Can you tell me about your daughter?" or "What did you used to do with her?" These might help redirect your grandmother back to reality. She may actually turn to you and say, "You're not my daughter." If your grandmother becomes agitated, but is comfortable with you touching her, a reassuring hand on her arm, or holding her hands while lightly massaging them can be calming.Make your visits special by reading from a favorite book each time, or by looking at picture books filled with things she once enjoyed, such as gardens, farms, food or children. Put together a memory book for her that includes photos and newspaper clippings of family and friends. Looking at family photos may provide an opportunity for your grandmother to share memories and put family members in context.Many people with memory loss cannot recall recent events, but may remember what happened decades ago, especially their childhood.  If she is receptive, record your grandmother telling family stories that otherwise might be lost over time. Take a walk together in the hallways or outside if the weather is nice. If the nursing staff says her diet will allow it, bring her favorite sweet, such as a milkshake. If she forgets you have visited her, take photos of the two of you together and hang them on a poster in her room. Consider creating a videotape of yourself or another family member talking directly to your grandmother, as if she were there. Hold up an old family photo in the video, and talk about what was happening at the time. She can watch this video time and time again. Leave a guest book on a table for other guests to sign so you and the staff who work with her can point these out to remind your grandmother of other visitors.Keep your departure as low-key as possible. Tell your grandmother you are looking forward to your next visit, perhaps marking it on her calendar if you know you can keep the commitment. If possible, call her on the phone between visits. Staff can help redirect your grandmother's attention if she becomes concerned or agitated when you leave.Talk to someone you can confide in, if visiting your grandmother becomes emotionally challenging. I would encourage you to keep visiting your grandmother, since both of you will benefit from the interaction. The good memories from your visits will last a long time and give you comfort for years to come.

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Senior Living

Doug Stark

2004-03-01 14:01:00

:  Who should the family call first for assistance?  ANSWER:  It depends. Typically the best place to start is with the doctor, particularly if the relationship is strong and over a number of years.  Again, a geriatric care manager is also a great first step because although you will spend a little money for the expertise and service, they can assess the entire physical as well as psycho-social situation for the older adult and make objective recommendations.  The assessment takes place in the person's home so that the living environment is evaluated also.  The nice thing about this approach is that the geriatric care manager can offer objective opinions outside that of the family relationship that the older adult might be more inclined to accept.  You may find that unless you are dealing with an obvious danger such as driving skills that put your loved-one and others at risk, you may be forced to take it slow.  You may have to implement some limited services to begin with in order to give the older adult time to adjust to the help.  Racing to implement major changes can overwhelm and be very counterproductive.It is very important that someone has a Power of Attorney for Health Care Decisions or a Living Will that gives a trusted family member or friend the authority to step in and make decisions that will meet with the wishes of the older adult, or at least are in their best interest should the need arise.  And so there is no mistake, there are Power of Attorney documents that are limited to conducting business transactions on behalf of an individual that have nothing to do with healthcare decisions.  You need to make sure your POA (many times referred to as a Durable Power of Attorney or DPOA) covers healthcare decisions, and of course it needs to be signed, witnessed and notarized when the individual is of sound mind and is mentally/emotionally prepared to.  Waiting until the older adult is feeling threatened of loosing their independence or worse yet, develops a disease that leaves them cognitively impaired and incapable of entering into a DPOA agreement can be a real mess as you then are many times forced to go through the court system to accomplish the task.                                                                               &nb

ANSWER:  This is often heard from caregivers, "Mom is becoming more frail. What do I do?"  There is typically not a dramatic single event that signals the shift from daughter/son to caregiver. It is a process. Some older adults resist the need for services and help. As you begin the process, here are some suggestions:• Sharing your concerns with the older relative.• Involving the rest of family (strength in numbers).• Getting advice from the Department on Aging, Senior Services or organizations like the Alzheimer's Association to help you develop an understanding between "normal" aging vs. not normal or disease related aging. • Contacting a geriatric care manager (sometimes it is easier for an outsider to discuss these sensitive issues with the older adult).  A care manager will assess the risks faced by the older adult. The care manager will look at: A) available social supports; B) self-care ability; C) physical condition and a potential need to get a doctor's opinion and/or assessment; D) emotional/ mental/cognitive impairment, etc.• If the older adult is thinking cognitively (is sound of mind) you should listen to their preferences.  It will help if the older adult feels he/she is being listened to.  You may want to suggest help for a "limited time" to help the older adult get used to the idea of assistance.• Talk to the older adult's doctor.  Most people are predisposed to listen to their doctors advice.  Many times it carries more authority than the opinion of family members.• As a caregiver, you may have to take things slower than you would prefer as many times you will face resistance to change as a result of feeling that independence is being removed.  QUESTION:  Who should the family call first for assistance?  ANSWER:  It depends. Typically the best place to start is with the doctor, particularly if the relationship is strong and over a number of years.  Again, a geriatric care manager is also a great first step because although you will spend a little money for the expertise and service, they can assess the entire physical as well as psycho-social situation for the older adult and make objective recommendations.  The assessment takes place in the person's home so that the living environment is evaluated also.  The nice thing about this approach is that the geriatric care manager can offer objective opinions outside that of the family relationship that the older adult might be more inclined to accept.  You may find that unless you are dealing with an obvious danger such as driving skills that put your loved-one and others at risk, you may be forced to take it slow.  You may have to implement some limited services to begin with in order to give the older adult time to adjust to the help.  Racing to implement major changes can overwhelm and be very counterproductive.It is very important that someone has a Power of Attorney for Health Care Decisions or a Living Will that gives a trusted family member or friend the authority to step in and make decisions that will meet with the wishes of the older adult, or at least are in their best interest should the need arise.  And so there is no mistake, there are Power of Attorney documents that are limited to conducting business transactions on behalf of an individual that have nothing to do with healthcare decisions.  You need to make sure your POA (many times referred to as a Durable Power of Attorney or DPOA) covers healthcare decisions, and of course it needs to be signed, witnessed and notarized when the individual is of sound mind and is mentally/emotionally prepared to.  Waiting until the older adult is feeling threatened of loosing their independence or worse yet, develops a disease that leaves them cognitively impaired and incapable of entering into a DPOA agreement can be a real mess as you then are many times forced to go through the court system to accomplish the task.                                                                                                                     QUESTION:  Tell me about hospital discharge procedures and appropriate questions to ask hospital social service staff. ANSWER:  Hospitals must develop a "safe discharge" plan. The discharge planner should determine the older adult's needs after he/she leaves the hospital.  Who is the caregiver? Can he/she transfer independently? Who will get the meals?  Do you have transportation to get to the pharmacy, doctor?  Do you have running water, heat? Do you want additional services?  Hospital social workers do a great job but they are limited because they do not work in the home. They must rely on the information given to them by the older adult or the family/friend agent. They do not have time to verify support systems that might help in the transition. vvv Doug Stark is president of ComfortCare Homes, Inc.  ComfortCare provides long-term care for the memory impaired at all levels of care and function in elegant, single-family residential homes.  Born out of the Stark family's experience with Alzheimer's they have grown to 25 homes with 8 in Wichita and 17 in Nebraska and Virginia.  A native of Wichita, Doug attended Wichita public schools and the University of Kansas.  He served for 12 years as a Big Brother and has been a member of Wichita Rotary for 19 years.  Doug can be contacted through his office at 7701 E. Kellogg, Suite #490, 67207, by calling (316) 685-3322, or by sending an e-mail to comfortcarehomes@aol.comBy Doug Stark

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Senior Living

Doug Stark

2004-02-01 16:25:00

:  My mother is beginning to act strange.  She is becoming forgetful and she is not attentive to detail.  Is this simply a sign of aging or is it time to think about a caregiver?

ANSWER:  (Previously published Mar. ‘03, 2003).  Today with the heightened awareness and media attention (deservedly so) of Alzheimer's disease, many witnessing a lapse in the memory of a loved one fear the worst. Actually memory loss comes in various forms and as a result of multiple causes, many having nothing to do with this dreaded disease. Although Alzheimer's is the leading cause of profound and progressive memory impairment, many people experience declines in their ability to recall events, names and recent activities for a host of other reasons, some disease and some non-disease related. First, researchers say that your cognitive capabilities peak somewhere in your late 20's and that there is a steady decline from that point on. In many, the decline is never really noticed until you are very elderly, if ever. On the other hand it is not uncommon for people the age of your 85-year-old mother to experience some cognitive deficits that are noticeable. In answer to your question of 'can memory loss just be a normal part of aging' the answer is yes. Your brain, like any organ is affected by your general physical condition. If you are in overall poor health your brain and its ability to stay sharp can suffer with the rest of your body. Other maladies that can affect cognition are sleep depravation, a poor diet, or a vitamin deficiency particularly a lack of B-12. The digestive tracts of some elderly no longer absorb adequate amounts of B-12, which is necessary for normal brain function. In this case, supplements of B-12 or even B-12  injections from your doctor might help in clearing up memory. Some experience what is referred to as a vascular dementia due to an overall decrease in the circulatory system of many elderly. Exercise of some type that can improve your circulation might be helpful here. Adverse reactions or the side effects of some medications can also play a factor. Another issue that researchers theorize may be a leading cause of impaired memory is stress. Everyone knows that when you are really stressed you don't usually think very clearly. Research now suggests that a hormone secreted in the brain at times of stress may play a big part in this. For people that get acutely stressed on a regular basis, or those that have experienced a lot of stress over a number of years, this may be a cause of their impaired memory. Alcohol or drug abuse over a number of years can also be a cause. Obviously your mother's memory issues could be the result of a diseases process or as a result of little 'mini strokes' referred to as multi-infarct strokes or TIA's. The answer to your question of when should you have her checked out depends on how pronounced her memory loss is and its progression. Is she just a little forgetful or does she have serious lapses of memory? It certainly doesn't hurt to have your mother worked up by a physician for her memory decline because as suggested above, there may be a fairly simple cause and solution. A simple analogy that I heard someone use in discussing memory concerns and when you should seek medical attention is this: if you walked out of the mall or the grocery store and forgot where you parked your car that is fairly normal. You either have been there so many times that they run together, or you were concentrating on something else as you parked your car. If, on the other hand you forgot that you drove there .. you probably need to go see someone. Also experts say that the secret to your brain working at peak efficiency baring a disease process is regular exercise, a good diet and plenty of sleep. Have you ever heard that before? It is also important to keep your mind active, as your brain needs exercise also. Play bridge, do the crossword puzzle, read, audit a course at the University, or volunteer your time. Remember, there is some truth to the rule "use it or loose it".

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Senior Living

Bill Ward

2004-02-01 16:25:00

: Our mother recently fell and broke her hip.  She is going to need more care than we can provide.  She is 83 and other than the fall, she is in good health.  Her biggest fear is that once she enters an assisted living residence, she will never come home.  What can we tell her to help?

ANSWER:  Fear of diminished independence and particularly diminished ability to control one's day-to-day choices is not uncommon after experiencing a trauma such as a hip fracture. Your mother may assume that the activities and social interaction she once enjoyed will no longer be available to her. As one recovers from a hip fracture, it is important to receive sufficient support from capable professionals to attain and maintain one's highest practical physical, mental, and overall well being. Knowledge of the state of recovery often comes through assessments and plans of care developed during the individual's recovery period. Her physician and therapists can predict your mother's level of functioning after recuperating from the fracture, although her actual level of functioning may depend to a significant degree on her individual ability to recover.The way your question is phrased indicates that a determination has been made that an assisted living environment is the proper place for your mother to receive assistance and rehabilitative care. If this is not the case, and your mother really needs intensive rehabilitative care following a very recent hip injury and/or hip surgery, then more intensive care in a health care center (nursing home) or rehabilitation hospital environment might be appropriate. This answer will, however, be based on the assumption that an assisted living environment is the appropriate choice.Assisted living residences accommodate individuals experiencing functional impairment, as well as individuals who simply choose an assisted living residence environment because it can provide activities, social interaction, and it can be life enriching for those experiencing limitations due to physical impairment. Assisted living could well be viewed as addressing the individual need that your mother may have. If your mother requires support for daily activities, whether for a short period or for an extended period of time, the assisted living environment can serve to help through her recovery. In reality, assisted living residences strive to support an individual in achieving as much independence as the individual can achieve.If your mother's goal is to return home, and provided she is able to achieve that level of independence in her daily routine, an assisted living residence should be able to support her in achieving that goal. In the meantime, she may find the environment to be both supportive and enjoyable. Your mother should be able to continue her relationship with family, friends and neighbors during a stay in assisted living, as that continued interaction is encouraged.There are many resources available for more information about assisted living residences or other retirement housing:  Kansas Department of Aging (www.agingkansas.org/kdoa or 800-432-3535); Kansas Homes and Services for the Aging (http://www.kahsa.org/ or 785-233-7443), American Association of Homes and Services for the Aging (http://www.aahsa.org/ or 202-783-2242), National Association for Area Agencies on Aging (http://www.n4a.org/ or 202-296-8130), National Center for Assisted Living (http://www.ncal.org/ or 202-842-4444), AARP (http://www.aarp.org/ or 800-922-8716) and ElderWeb (http://www.elderweb.com/). Assisted Living Federation of America (http://www.alfa.org/ or 703-691-8100)

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Senior Living

Bill Ward

2004-01-01 11:40:00

: Our mother is quickly approaching a need for someone to take care of her. What are some things to consider before deciding whether it makes more sense for the family members to care for her or for a residence specializing in such care to provide the services?

ANSWER:  Take comfort in the fact that many adult children just like you have to make decisions about their parents' living and care needs. These decisions involve a great deal of planning, research and discussion with your loved one. Evaluate the costs and services involved in family care versus residential care. How comprehensive is your mother's insurance coverage? Also consider the emotional impact of both alternatives. Are you and your family prepared for the time and lifestyle changes required in having an aging parent at home? Juggling caregiver duties with your marriage, children and career is worth considering. On the other hand, do your mother's needs exceed what you can provide yourself? If so, an assisted living or continuing care retirement community may be the right choice. Here she can receive all the care she needs and maintain an active and satisfying life. As a caregiver, you will likely need assistance with her care. Research the adult day care, senior centers, home health organizations and transportation services in your community. While some fees may apply for these services, they offer invaluable help with your daily caregiving tasks. You can find this information at your local Area Agency on Aging or on the Eldercare Locator Web site at www.aoa.gov/elderpage/locator.html or call 1-800-677-1116. What about other family members, friends and neighbors? What help can they provide?Outside of your own home, where your mother lives will depend on the amount and type of care she requires. Assisted living residences, adult care homes and senior housing are possibilities - each has a different care level and payment structure. In contrast, continuing care retirement communities accommodate a range of care services in one place so that residents do not have to move if their needs become more advanced. Consider the location, cost, specialized services, social atmosphere, recent survey results, if applicable, and so on. Remember to include your mother in the decision and keep her concerns in mind as you research.Before you decide between family care or residential care, a professional assessment of your mother's health may be in order. Your mother's physician can provide health need insights (with your mother's permission). A geriatric assessment center or case manager can conduct a professional review of her abilities and make suggestions afterward. Your local Department on Aging will know of available services or the National Association of Professional Geriatric Care Managers is an excellent resource for this service. Visit them online at http://www.caremanager.org/ or call 520-881-8008.Other resources to help in the decision-making process: AARP (http://www.aarp.org/ or 800-922-8716); American Association of Homes and Services for the Aging (http://www.aahsa.org/ or 202-783-2242); National Association for Area Agencies on Aging (http://www.n4a.org/ or 202-296-8130); and ElderWeb (http://www.elderweb.com/). These organizations provide information, lists of services, questions to ask and even how to approach this discussion with your family and your mother.Planning for your mother's immediate and future needs will be time well spent to help you, your mother and your family feel confident you've made the decision in the best interest of your mother's well-being.

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Senior Living

Deborah Levering

2003-12-01 13:02:00

: How can I determine if my aging parents are in need of care or assistance?

ANSWER: It is not uncommon for the adult children of seniors to have some concerns about how their parents are doing.  This holiday season while you're enjoying the companionship of your family make good use of your visit to review your aging parents' and loved ones' living status.    Many holiday traditions tempt your five senses.  These five senses can also be used to evaluate the status of elderly family members. Families often overlook a variety of warning signs such as forgetfulness, lack of house cleaning or a decrease in physical appearance by writing them off to "old age". Below is a checklist using each of your five senses that lists key indicators or warning signs to help determine if your family members are in need of additional care or assistance:SIGHT - Looking at the senior's appearance can be a sign that they are being limited either physically or mentally from completing otherwise normal daily tasks.     Are they wearing clothing with food stains? Is their clothing appropriate for the weather? Is their hair completely combed?  Do their teeth appear clean?  Are there many different prescriptions?  Do the medications come from different doctors or pharmacies?  What about the expiration dates on the medications? Do they remember to take their meds?SOUND - Listening to what and how seniors speak can tell you a lot about their current mental status.  Don't assume that "old age" is causing these problems. Instead be alert to the possibility of declining health.   Do they call you by name?  Are they speaking normally? Is their speech pattern different?  Are they up on the news?  Do they participate in conversation? Do they respond appropriately? Do they seem to be depressed?SMELL - Using your nose as an indicator can help you determine if your family member is bathing properly, participating in otherwise normal activities (cleaning their house), or whether or not they are eating regularly (if they have spoiled food in their kitchen).    Does their living environment possess any unpleasant odors?  Does the refrigerator or cupboards smell?  Are the plants thriving?  Is there an unusual amount of garbage, clutter, dust, or dirt? Is the kitchen and bathroom sanitary?TASTE - Tasting their food and sorting through their refrigerator and cabinets can help you determine if they are eating healthy or even worse, eating expired or spoiled food.     Do they have fresh and stocked pantry items? Look at the expiration dates.  How does the food taste?  Do they eat regularly? Do they follow their dietary plan (if prescribed by their doctor)? Do they eat excess sweets?TOUCH - A simple hug could tell you that your family member is fragile, losing weight and putting him or herself in jeopardy of injury or even malnourishment from not eating properly.   Do they appear healthy?  Touch their skin - is it soft, supple and is the color normal? Do they have unusual tearing or bruising of the skin? Are they losing weight?  Do they need assistance when mobile?   If you sense a problem based on the above indictors, you and other family members should waste no time in taking the appropriate next steps. As difficult as the process might be, keep reminding yourself that by being proactive, as a result of your observations, you will not only provide safety for your family member, but will also keep them happy and healthy for years to come.

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Senior Living

Bill Ward

2003-12-01 13:02:00

:  How much care can one receive in an assisted living residence? When does the amount of care one requires necessitate moving to a nursing home?

ANSWER: Assisted living is for people who need some degree of assistance whether on an occasional or daily basis. Several levels of care are available based on an initial and subsequent assessments of the resident's health and needs to determine the appropriate level of assistance.    This assessment is called a Level of Care Assessment. It covers physical and mental abilities with the total score determining what level of assisted living is needed. In addition, the provider will request a physician's report to confirm a prospective resident's health status.The number of levels of assisted living care available depends on the procedure in place at a particular assisted living residence. Some assisted living providers may have only one level of care, while others may have four or five, with the highest level providing almost as much care as the base level in a health care center. The basic level in assisted living usually include housekeeping and laundry services, medication assistance, one to three meals daily, and 24-hour availability of licensed health care staff. The level of care increases, as more assistance is needed, with more daily hands-on assistance increasing correspondingly.   At its highest levels, assisted living can include daily help with dressing, walking, bathing and other activities. It also can include specialized nursing or other health services. A Level of Care Assessments is conducted on an ongoing basis in assisted living at periodic intervals or when a noticeable change in condition occurs. When the assessment score rises to a point where a move to health services is needed, the residence should contact the resident and/or the resident's family to come in and discuss with the professional staff.   Ideally, should the level of care increase to the point where nursing care is needed in a health care environment, it will be available in a continuing care retirement community at the same location or on the same campus where the assisted living resident currently resides.    It is important to be aware that Medicare does not cover assisted living. While health care may be covered, it is covered only for a limited number of days during a year. Some long-term care insurance plans include assisted living coverage as an option. For the most part, assisted living is currently a private pay arrangement. Medicare may cover nursing services provided if the resident qualifies. You will need to inquire about this with respect to your particular situation with any assisted living residence(s) you are considering.   There are variances in the type of assisted living residences available and the type and degree of care they can or will provide.  It is important to inquire in this regard when considering and comparing assisted living residences.

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Senior Living

Doug Stark

2003-12-01 13:02:00

: What is an Eldercare Consultant?

ANSWER: Eldercare consultants, or as sometimes referred to as geriatric case managers are individuals that are knowledgeable of the various care options that are available to the elderly, and usually for a very reasonable fee will help you access the appropriate services based on your individual needs.   When you consider that those 65 and above represent the fasted growing segment of our population and combine that with many advances in health care, there are simply many more elderly residents that are living longer with a wide variety of health care needs.     Because of this growing need there has also been a huge growth not only in health care service options but also in health care service providers.  So many things have changed in the last few years that it can be of benefit to have someone who is familiar with the various options and more importantly has experience with the providers and can lead you to the ones that are good and reputable and away from the ones that are not.  It can also be of benefit sometimes for someone to approach your needs from a third party and maybe more objective approach than family members that may be in denial of what the needs really are.   In years past much advice and direction on this subject came from an attorney that specialized in the needs of the elderly, a minister at the church or a call to the Department of Aging, and these avenues still exist and can be beneficial.  On the other hand there is a new segment of counselors or care managers the actually fall under the heading of geriatric care managers.  There is even a national organization known as the National Association of Professional Geriatric Care Managers.      One example of a geriatric care manager is Adult Care Management Services here in Wichita.  In talking to Tina Lott of ACMS, she charges her clients an initial assessment fee and then an hourly fee for time spent working on your case and bringing the appropriate options to you.    Serving for a number of years as the executive director of the Alzheimer's Association Tina has been in or around the health care industry for a long time.  The National Association of Professional Geriatric Care Managers has a web site you can go to at http://www.caremanager.org/.  Once on their site you can go to your state and access the names of the care managers in your area that belong to their association.

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Senior Living

Doug Stark

2003-11-01 15:24:00

: My 85-year-old mother is becoming more forgetful. We are all concerned that this is the first sign of Alzheimer's disease. Why can't her memory loss just be a normal part of aging? When should we have her checked by a Doctor?

ANSWER: Today with the heightened awareness and media attention (deservedly so) of Alzheimer's disease, many witnessing a lapse in the memory of a loved one fear the worst.  Actually memory loss comes in various forms and as a result of multiple causes many having nothing to do with this dreaded disease.  Although Alzheimer's is the leading cause of profound and progressive memory impairment, many people experience declines in their ability to recall events, names and recent activities for a host of other reasons, some disease and some non-disease related.     First, researchers say that your cognitive capabilities peak somewhere in your late 20's and that there is a steady decline from that point on.   In many, the decline is never really noticed until you are very elderly, if ever.   On the other hand it is not uncommon for people the age of your 85-year-old mother to experience some cognitive deficits that are noticeable.      In answer to your question of 'can memory loss just be a normal part of aging' the answer is yes.  Your brain, like any organ is affected by your general physical condition.   If you are in overall poor health your brain and its ability to stay sharp can suffer with the rest of your body.  Other maladies that can affect cognition are sleep depravation, a poor diet, or a vitamin deficiency particularly a lack of B-12.  The digestive tracts of some elderly no longer absorb adequate amounts of B-12, which is necessary for normal brain function.  In this case, supplements of B-12 or even B-12 injections from your doctor might help in clearing up memory.      Some experience what is referred to as a vascular dementia due to an overall decrease in the circulatory system of many elderly.  Exercise of some type that can improve your circulation might be helpful here.   Adverse reactions or the side effects of some medications can also play a factor.  Another issue that researchers theorize may be a leading cause of impaired memory is stress.   Everyone knows that when you are really stressed you don't usually think very clearly.  Research now suggests that a hormone secreted in the brain at times of stress may play a big part in this.  For people that get acutely stressed on a regular basis, or those that have experienced a lot of stress over a number of years, this may be a cause of their impaired memory.  Alcohol or drug abuse over a number of years can also be a cause.     Obviously your mother's memory issues could be the result of a diseases process or as a result of little 'mini strokes' referred to as multi-infarct strokes or TIA's.  The answer to your question of when should you have her checked out depends on how pronounced her memory loss is and its progression.  Is she just a little forgetful or does she have serious lapses of memory?  It certainly doesn't hurt to have your mother worked up by a physician for her memory decline because as suggested above, there may be a fairly simple cause and solution. A simple analogy that I heard someone use in discussing memory concerns and when you should seek medical attention is this:  if you walked out of the mall or the grocery store and forgot where you parked your car that is fairly normal.  You either have been there so many times that they run together, or you were concentrating on something else as you parked your car.  If, on the other hand you forgot that you drove there, you probably need to go see someone.  Also experts say that the secret to your brain working at peak efficiency baring a disease process is regular exercise, a good diet and plenty of sleep.  Have you ever heard that before?  It is also important to keep your mind active, as your brain needs exercise also.  Play bridge, do the crossword puzzle, read, audit a course at the University, or volunteer your time.  Remember, there is some truth to the rule "use it or lose it".

X

Senior Living

Deborah Levering

2003-11-01 14:34:00

: My elderly parents need help on a regular basis with housekeeping, meal preparation and errands.  I work full time and can barely manage running my own household.  Their needs for assistance are becoming a real stressor for me.  Are services available for families in my situation?

Deborah Levering Question: My elderly parents need help on a regular basis with housekeeping, meal preparation and errands.  I work full time and can barely manage running my own household.  Their needs for assistance are becoming a real stressor for me.  Are services available for families in my situation?Answer:  The number of families dealing with similar circumstances is growing, as the baby boomers reach middle age.  Adult children, even grandchildren, are finding themselves in the position of being a caregiver.  Usually, there is a long gap in time from when the elderly are totally independent and the time they can no longer live in their own homes.  These are the most challenging years for the extended family members.       The demands of working a full time job and managing one's own household are stressful enough.  The added burden of caring for elderly parents can become overwhelming.  It is common for extended family members to reach the breaking point before they ever consider seeking help.  Feelings of guilt and obligation are driving and powerful emotions that play on one's conscience.  It is difficult to admit that being your parent's parent is not what you had bargained for!      There is no shame in seeking alternatives to care for your parents.  Most people just don't know where to begin the search.  Eldercare is a growing industry and there are resources available in most communities.  First, identify the specific areas of daily living that your parents are requiring assistance with.  This will guide you to the type of service provider that you need.    The examples you have listed are limited to activities of daily living.  If housekeeping were the only need, then a bonded cleaning service would be my recommendation. However, you mentioned meal prep and running errands, as well.  Your best option is to contact a non-medical in-home care provider.  I suggest looking in the telephone directory under the listings for Home Health Agencies.  Look for the companies specifically identified as non-medical.     A non-medical in-home care agency can provide tailored services to meet the needs of each client.  For instance, some clients may not need transportation but they need help with housekeeping and assistance with dressing and grooming. Others may need respite care or standby assist when mobile.  Remember that your parent's needs and physical conditions may change.  They may develop a need for safety awareness and medication reminders.  It is best to choose an agency that can assess and meet those changing needs.   Ask to meet with a representative from the company you select.  They will conduct an in-home meeting with your family and help establish a schedule of services that will provide the care your parents need at this time.  Your parents will no longer feel like they are being a burden and you can revert to being your parent's adult child again instead of their caregiver.  You will find peace of mind in knowing that professionals who have been screened, bonded and insured are providing your parent's daily needs.

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Senior Living

Bill Ward

2003-11-01 08:09:00

: How is the fee determined at an assisted living facility? Is it negotiable?

ANSWER: In general, organizations operating assisted living residences determine a fee schedule based on the type of lodging (studio, one bedroom apartment) and the size or square footage of the residence. There may be several one-bedroom floor plans in a range of sizes. This "base" is essentially determined by the size of the living accommodations and the services provided as part of the basic package.   Because the cost of buildings vary and the type of services offered in a basic package may also vary, you'll find variations in the fees that are charged at different assisted living residences. This would be similar to differences found in apartment communities based on the size of the apartment and amenities offered.   In addition to this base rate there will be an additional charge based on the level of care. Most assisted living providers offer at least two additional levels of care, and may offer as many as four or more. Each of these levels of care is determined based on a thorough evaluation of the needs of the person who will reside in the assisted living community.   This assessment is called a Level of Care Assessment. It covers physical and mental abilities with the total score determining what level of assisted living is needed. In addition, the provider will request a physician's report to confirm a prospective resident's health status. A Level of Care Assessment is conducted regularly with the resident because needs are likely to change as a person becomes more or less able to care for him/herself.   While the fees are not negotiable in most instances, some of the services provided may be covered under Medicare. The assisted living community to which one applies will be able to assist a prospective resident in determining whether Medicare covers any services.

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Senior Living

Deborah Levering

2003-10-01 09:00:00

:  My father fell and broke his hip. He is recovering in a nursing home and we expect him to return home in a few weeks.  He will require a lot of assistance when he returns home. None of us kids live in the area and we worry about how we will find the right people to provide the needed services. Even if we do find people to help him, we will not be there to ensure the quality of the services. What are our options?

ANSWER:  Caring for a parent is difficult when we are nearby, but when relatives are separated by distance, caring becomes even more complicated.  More than seven million Americans are long distance caregivers. They face feelings of guilt and helplessness that they aren’t able to give their parents the help that they need. However, this situation is not hopeless and options are available.   You can begin by asking your father’s primary care physician to refer you to reputable agencies or individuals that may be of assistance. The local Department on Aging is a good starting point as well. Generally nursing homes have case managers, social workers, or discharge planners on staff who are involved in the patient’s care plan at the time of discharge. They may recommend a Home Health Agency for continued therapy and have names and numbers of those available in the area.  Also, there are companies or individuals who specialize in assistance with activities of daily living, such as: meal preparation, light housekeeping, laundry, medication reminders, bathing and grooming assistance and even transportation. Sometimes the use of both types of service providers is the best way to meet all of a person’s needs during recovery.   Your primary concern of ensuring the quality of care your father will be receiving is a valid one.  There are independent elder care consultants who will work with families that are in your position. They act as a client/family advocate and will monitor the care of the client. Or, you may want to discuss your needs with a concerned neighbor, church member or family friend who can provide valuable input.   The most critical decision is whether or not to go with an agency or an independent caregiver. Often finances must be taken into consideration and it is true that independents can be hired at a lesser rate. But, it should not be the sole determining factor when making this decision.     There are many unknown issues involved when selecting an independent person to provide care. There is no way for you to conduct a background check or have any real knowledge of the Caregiver’s skills and training. If the family directly hires an individual, an employer/employee relationship has been established and leaves your father most vulnerable.  Many people do not understand that they are required to with hold federal and state payroll taxes, Social Security, unemployment taxes and Medicare from the independent’s paycheck.    Worker’s Compensation must be provided for the independent as well. It is a common misconception that Homeowner’s Insurance would cover expenses in the event of an accident or injury involving the direct employee.  In fact, most policies specify that employees are excluded from coverage. When the independent needs time off, calls in sick, or just doesn’t show up for work, the consumer is left in a vulnerable situation. A contingency plan should be in place to cover your father’s care if this is your choice.    Selecting a professional service provider has definite benefits. Agencies that recruit, hire and train their caregivers are an excellent solution to your problem.  Choose an agency that conducts thorough background checks on their employees which includes a credit report and driving history. Ask if the company carries workman’s compensation and fidelity bonds on their employees. An agency may appear to be more costly, but they assume the responsibility of all taxes and liability for insurance and Worker’s Comp on behalf of the consumer. Utilizing a service agency eliminates the hassle for you and your father.   Don’t be afraid to ask for references from present and former clients.  Find out what process the company has for monitoring the performance and quality of care provided by their caregivers.  Good ones will have a Client Care Coordinator or supervisor who conducts unannounced drop-in visits. Another bonus is that agencies will automatically have additional staff to provide continuity of care, in the event the regular caregiver calls in.    Look for a company that is willing to contact you on a regular basis to provide status reports on your father’s recovery and condition. Your peace of mind should be as important to them as your father’s care.

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Senior Living

Deborah Levering

2003-09-01 15:40:00

: When and how, do I ask my aging mother to hand over her car keys?  

ANSWER: For most of us, our parents were always there when we needed them. They fed us, clothed us, and they tried to teach us everything they knew…including driving. With all the history and emotions you and your mother have, it's never going to be easy to tell a parent that it's time to hand over the car keys for good. Nobody wants to have that conversation, which is why people tend to put it off as long as possible.   But, as recent headlines in Santa Monica, CA show, there can be deadly consequences to continuing to drive when it's no longer feasible. Statistics show that younger drivers, from 16 to 24, still have by far the most crashes of any age group. But the problem of drivers with poor eyesight and slow reflexes is just going to get worse. In 1995, 1 of every 11 drivers in the United States was over 65. By 2020, 1 of every 5 drivers will be over 65, according to the National Institute on Aging.    The first step is simply to start the dialogue, and that's the hardest part. What should you say? First, be prepared:-Build your case. If you feel safe, and haven't done so in a while, take a drive with your mother to get a sense of whether your intuition is right or not. It may turn out that your mother is a safer driver than you suspected; but if your hunch bears out, you'll have at least one reference point to go to when you have your discussion. If driving with a parent isn't feasible, talk to relatives or friends, who may have anecdotes of near misses and fender-benders.-Steer the conversation towards recent headlines-national or local-that involve an elderly driver as the cause of an accident. Get a sense of what your mother thinks. You might want to ask when she plans on giving up driving. You may get an answer like; "Oh in five or 10 years," which will help you know what you're up against. Your mother may know exactly what you're up to with this lead in, but at least the conversation has been started.-Don't be afraid to use guilt. Ask your mother how she will feel if she ends up on the news for injuring a pedestrian.-Be gentle but firm; try not to be insulting or confrontational. If you make your mother angry or hurt, which may be impossible to avoid, she may be more likely to stubbornly cling to the idea that she should be on the road. -Rely on experts. Realize that it may be difficult for your mother to agree with you. Suggest that she visit her doctor or ophthalmologist to get an assessment on her reflexes or eyesight. Give her materials about older drivers. To receive the free publication, "Drivers 55-Plus: Test Your Own Performance," by the AAA Foundation, write to 1440 New York Ave. N.W., Ste. 201, Washington, D.C. 20005.   Most importantly, offer solutions to giving up the car keys. Volunteer to drive your mother to church or on errands. Since you can't always be there, consider turning to a professional caregiver or companion service. Your mother may not be so distraught about relinquishing her keys, and might even be relieved to know that when you're not available, someone else will be

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Senior Living

Doug Stark

2003-08-01 13:57:00

:  How does memory impairment care differ from normal care received in an assisted living facility or a nursing home?

Doug Stark Question:  How does memory impairment care differ from normal care received in an assisted living facility or a nursing home?Answer:  Memory impairment care, more commonly known as dementia care is very different than care found in most assisted living facilities and skilled nursing homes that cater to the cognitively intact: or at least it certainly should be.  Defining dementia explains why the care models are so different.       A person is considered to "have dementia" as a result of damage to the brain from an injury or a disease process to an extent that they can no longer survive without some assistance.  There are many causes of dementia that will be mentioned in more detail a little later.   An individual in early dementia may only be unable to recall major relevant aspects of their current lives, e.g., an address or telephone number of many years, the names of close family members (such as grandchildren), or the name of the high school or university they graduated from.     As cognitive abilities decline the person may not be able to name his or her spouse whom they are entirely dependent on for survival.  They are generally unaware of their surroundings, the year, the season, the ability to recognize and react to danger, etc.   They will require assistance with their activities of daily living as many become incontinent and require help with bathing and dressing.  Many times personality and emotional changes occur as the dementia deepens and can include delusional behavior, paranoia, obsessive symptoms like constant pacing, and anxiety symptoms including agitation and violent behavior, previously nonexistent.        Many people get Alzheimer's disease and dementia confused.  Alzheimer's disease as most know is very debilitating disease of the brain and is the leading cause of dementia, although there are many other causes.  Parkinson's disease usually also leads to dementia.  Pick's disease and multi-infarct strokes (TIAs) also are assaults to the brain that cause dementia, along with strokes, oxygen deprivation and others.     Most assisted living facilities, unless they have a separate and specialized dementia unit, generally are designed for the cognitively intact person who desires, or requires some assistance.  The typical assisted living resident resides in their own room or apartment surrounded with their own furniture and belongings.  They typically are fairly self-sufficient and are able to recognize when mealtime is and how to navigate to and from the dining room.       Assisted living facilities are ideal for the elderly looking for the autonomy of having their own space and things where they can lock the door if they want, but also enjoy the social interaction and bonding relationships of the other residents.  As wandering and elopement risks are many times a part of dementia, the lack of electronically secure entry and exit doors makes the general assisted living environment inappropriate.     Skilled nursing homes on the other hand are designed to provide a much higher level of care to those requiring much more in the way of intensive physical care, or those that have true skilled nursing needs.  Again, like the assisted living facilities, unless the nursing home has a secure dementia specific unit with dementia-trained personnel, generally a nursing homes population is fairly cognitively intact.     The bottom line is that the care needs, emotions and behaviors of individuals suffering with dementia can be substantially more difficult and taxing than caring for the lucid.   Dementia facilities need to be specially equipped designed and simplified to give appropriate care to the demented.  Care giver training for dealing with this population because of its many difficult behaviors is also very different.       In the traditional assisted living or nursing home environment, reality orientation is the key, whereas in a dementia environment, validation therapy is used to comfort  residents.   The overall theory being that due to the resident's dementia, we can no longer bring them to our reality, consequently reality orientation (clearing up their confusion) is not possible.  We must come to their reality and validate their feelings.   If, in the mind’s eye of an 85 year old dementia resident, he or she is looking for mom, validation therapy would teach one to join into the discussion about mom and help in the search, not to explain mom's absence, for if the resident were lucid they would not be looking for mom in the first place.

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Senior Living

Doug Stark

2003-06-01 16:04:00

: Are the same therapy treatments available in a licensed residential family care home as in an assisted living center or skilled nursing home? 

ANSWER:  The answer to your question for the most part is yes; it just depends on how the therapies are carried out and by whom.  No residential family care home, and for that matter, most assisted living centers, have on site set-up and the certified personnel to perform skilled therapy treatments such as physical therapy and rehabilitation, speech therapy, wound care, breathing treatments, etc.  But it does not mean that the residents of an assisted living center or family care home don't have access to these services, they are just performed by outside agencies like home health providers.  It is true that many of your large skilled nursing facilities that are designed after a medical model of care (as opposed to a social model) do have in house facilities and full-time or part-time personnel to perform the doctor's order for a skilled therapy treatment.  The fact of the matter is that larger more institutional facilities usually have anywhere from 90 to 160 beds or more and cater to a population more prone to receiving routine treatments, making it affordable to provide these therapies in house.  That is not what has driven the explosive growth of residential family care homes and assisted living facilities.  These two relatively new concepts were developed primarily after social models with the goal being to provide its residents a very natural, less institutional, home like environment.  The main difference between assisted living centers and residential family care homes is size and numbers.  Most assisted living centers have anywhere from 26 to 60 beds with some more, whereas family care homes are single family residential homes where between 5 and 8 residents share the home in a family-like atmosphere.  For many residents (like the memory impaired that live in one of our homes) the low stress familiar homey environment is in itself therapeutic, as they are dealing primarily with issues of over stimulation and behaviors, and are less in need of skilled care or therapies.  For the cognitively intact resident (or as some describe the frail elderly) who want the autonomy of having their own apartment with the ability to lock the door at night, yet desires the social community of living with their contemporaries and having their meals prepared in the dining room, an assisted living center is ideal.  In both of these environments if a physician should order a skilled therapy most likely a home health agency would be summoned to perform the service.  Since most home health agencies are Medicare certified and most family care homes and assisted living centers are not, another advantage is having the service billed to Medicare.

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Senior Living

Faye Graves

2003-05-01 12:08:00

:  I have just retired. My wife has been a homemaker all her life. I'm about to go nuts and I think I've already driven her there. It's only been 4 months. A fella' can only watch so much TV and go to the grocery store so often. What's the best way to get in the 'retired' frame of mind?

ANSWER:  Learn to enjoy your new found freedom. Many seniors regard time as the enemy; look at it as an asset. You're free to come and go as you please. Take control and find things that you enjoy.     - Make new friends. Visit a senior center. Join a card group. Go to church. Ask others out for lunch or dinner. Make yourself available by positioning yourself among people.     - Go to museums, theaters, and ball games     - Jog or walk your dog. Offer to walk a neighbor or friend's dog     - Go to a playground or park, feed the ducks     - Attend reunions     - Go to auctions      - Spend time at the library reading or volunteering     - Shop, especially bookstores or music shops     - Join an exercise group     - Get involved. There are many volunteer opportunities to help those less fortunate. Take a class. Many universities will allow you to attend at a discounted rate.     - Maintain your self-respect. Maybe now is the time to lose a few pounds. Make the most of the good times. Feel good about yourself.     - Take care of your health. Learn about the positive effects of proper diet and exercise. Find a fun gym or other facility to work off some energy. Swim, bowl or play golf.     - Get a job. Even though you've finished your career, take this opportunity to try something new on a part-time basis.     - Travel. Or, visit a town or attraction near your home. Some of the best trips are the short ones.     - Get involved in politics. You'll find a plethora of interesting people at the local, state and federal level.     - Use your imagination. Do the things that you never dreamed you'd do when you were working. Go to the places that you've only read about. Go, do, learn, and enjoy. You're a free agent.

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Senior Living

Chet West

2003-04-01 12:22:00

: My father had a stroke three years ago. I have been caring for him since. Lately he has developed dementia. It is getting worse. While he is presently receiving the care he needs, I am not sure I am making it as well as I should. What should I be doing for my health and mental stability?

ANSWER: You did not mention whether or not you have any help, are married or single, or have other resources available to you. I will respond the best I can.As a caregiver, you know any disease never affects just one person in a family. Your life has changed, too, from your social life and relationships to your goals and priorities. "Changed" probably isn't even the word -- you've gone through a total upheaval, the kind that splits a life in two. In the years before your caregiving, you may have worried about the lawn or local politics or today's kids. In this new era, you worry about getting through the day. As isolated as you may feel, you are far from alone. Millions of other caregivers are going through the same struggles. Like you, they are providing near-constant care and supervision to someone who doesn't always recognize what they are doing for them. Like you, they feel embarrassed if their loved one yells obscenities or does something like disrobing in public. They feel a deep sadness if they have to show their parent, grandparent, or spouse how to use the toilet. All of that hard work and frustration takes a toll. According to the Alzheimer's Association, 80 percent of all caregivers say they live with high levels of stress, and at least half suffer from depression. Such turmoil saps a person's strength, patience, and energy, making it even harder to give loved ones the care they need. Depression and stress also threaten a caregiver's health by weakening the immune system and raising the risk of heart disease, substance abuse, and many other disorders. The following 'Cardinal Rules of Caregiving' may be helpful: Staying informed is an excellent way to reduce the stress of caregiving. Books such as At the Heart of Alzheimer's, The 36-Hour Day, and Alzheimer's: A Caregiver's Guide and Sourcebook explain the course of the disease and provide invaluable practical advice. Knowing how to bathe, feed, and dress an Alzheimer's patient with a minimum of fuss and frustration will greatly ease your burden. Just as important, you'll learn to set realistic goals -- getting clothes on his body vs. getting him perfectly dressed -- and to take things one day at a time. These books also drive home the cardinal rule of caregiving: You can't do everything yourself. Even if you're physically capable of performing every task your loved one needs, your mind can't take the endless strain. There's no shame in asking a relative, friend, professional aide, or adult day care service to give you some time off. If you don't know anyone who can help, call your local chapter of the Alzheimer's Association for advice. Make sure to invest at least some of that free time in your health and peace of mind. Regular exercise will help revitalize your mood as well as your body. You should also get plenty of rest and make regular visits to your doctor. And take the time to join a support group, either in your town or on the Internet. Hearing about other caregivers' experiences and sharing your own will give you new knowledge and strength to cope with the illness.Don't wait till you snap. If you find yourself losing your temper regularly and yelling at your loved one, or doing other things that you regret, you have to get some help. It's not fair to the person with Alzheimer's or yourself to go on like that. You should always be on the lookout for signs of depression and stress. If you regularly experience any of these symptoms, see a doctor, therapist, or other expert for help.-Irritable mood-Feelings of worthlessness or excessive guilt-Suicidal thoughts-Sleep problems-Fatigue-Loss of interest or pleasure in usual activities-Difficulty concentrating-Unexplained changes in appetite and weight Finally, save a corner of your emotional life for yourself. Try to make sure your emotional life doesn't revolve entirely around your confused loved one. As a case in point, a woman whose father had early-onset Alzheimer's recalls a time in which her father's deterioration weighed on her so heavily that she lost interest in anything else. She relates the following dream she had during that period: Her father was in a car rolling slowly downhill, but for some reason he was unable to step on the brakes. Terrified, she ran after the car and grabbed the bumper, pulling backward with all her strength to keep it from rolling any further. But the car continued to roll forward, dragging her through thorny underbrush and forcing her to let go. Then she ran in front of the car and stopped it with her hands, straining to hold it in place, but it kept pushing forward until, in order to save her life, she was forced to jump clear. When she woke up, she said, the dream's meaning seemed transparent: The car rolling inexorably downhill symbolized Alzheimer's, and neither she nor her father nor anyone else could stop it from running its course. "Of course I kept on helping take care of my father," she said. "And I loved him just as much as ever. But I tried not to let the disease run me down and destroy me, too. I knew that's what my father would want me to do: jump clear."

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Senior Living

Chet West

2003-04-01 11:29:00

:  I hear people talk about Medicare and Medicaid. Are these different programs?

ANSWER:  Yes. Congress created both Medicare and Medicaid in 1965. The programs have different eligibility requirements and different benefits. Many people confuse Medicare with Medicaid because the names sound alike and the programs are available to some of the same groups of people. QUESTION:  How does eligibility for two programs differ? ANSWER:  Both Medicare and Medicaid are directed mostly to those age 65 or older and many younger people with disabilities. Medicare is available regardless of income and resources. Medicaid eligibility is available only to individuals who meet certain income and resource limits. Medicaid has many different programs. Each has its own income and resource limits. A Medicare beneficiary with limited income and resources may also be eligible for Medicaid assistance. QUESTION:  What is covered by Medicaid? ANSWER:  Medicaid is an assistance program that pays certain medical and health care costs for persons who qualify. Medicaid has many different programs. Benefits vary depending on the program. Some Medicaid programs pay for services not covered by Medicare such as prescription drugs, dental care, eyeglasses, hearing aids, and long-term care. Other Medicaid programs are more limited and pay only for Medicare premiums, deductibles and coinsurance. Generally, someone eligible for Medicaid does not need Medicare supplement insurance. QUESTION:  I need help and think I qualify for Medicaid. Where do I go to apply? ANSWER:  Kansas' Medicaid program is funded by the federal and state government and is managed by the Kansas Department of Human Services (DHS). To determine if you qualify for Medicaid, contact your local county office of human services. The phone number for your local office is available in the "local government" section of your telephone directory. To receive assistance in completing the paperwork, contact your local Area Agency on Aging. QUESTION:  What are the benefits under Medicare? ANSWER:  Medicare consists of two parts, Part A and Part B. Medicare Part A is hospital insurance and is free to most who are eligible for Medicare. Medicare Part B is medical insurance and costs $58.70 per month for 2003. Medicare covers medically necessary services for illnesses and injuries. Medicare rules determine how much can be charged for covered services. A Medicare beneficiary is responsible for deductibles, co-insurance, and services not covered such as prescription drugs, annual physicals, routine vision services or hearing exams. Most Medicare beneficiaries have supplemental insurance to cover some of these costs. QUESTION:  Where do I get answers to questions about Medicare? ANSWER:  Whether you are new to Medicare or have had Medicare for a long time, you may have questions about what is covered. Much information is available on the Internet at http://www.medicare.gov/. You can also get a free copy of the Medicare Handbook by calling the Social Security Administration at 1-800-772-1213. For coverage and claims questions on Medicare Part A (hospital insurance), that covers hospitals, skilled nursing facilities, home health visits, or hospice services; and Medicare Part B, that covers such things as doctors' services, ambulances and lab tests, durable medical equipment, such as a walker or oxygen equipment, go to http://www.medicare.gov/ QUESTION:  Does Medicare cover the cost of prescription drugs? ANSWER:  Currently, the answer is no. The Senior Health Insurance Information Program (SHIIP) may be helpful by helping you to find discounts on medications.

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Senior Living

Bill Ward

2003-04-01 10:46:00

:  How is the fee determined at an assisted living facility? Is it negotiable?

ANSWER:  In general, organizations operating Assisted Living residences determine a fee schedule based on the type of lodging (studio, one bedroom apartment) and the size or square footage of the residence. There may be several one-bedroom floor plans in a range of sizes. The larger the residence, the greater the base rate at the outset. This "base" is essentially determined by the size of the living accommodations and the services provided as part of the basic package.Because the cost of buildings varies and the type of services offered in a basic package may also vary, you'll find variations in the fees that are charged at different assisted living residences. This would be similar to differences found in apartment communities based on the size of the apartment and amenities offered.In addition to this base rate there will be an additional charge based on the Level of Care. Most Assisted Living providers will offer at least two additional levels of care, and may offer as many as four or more. Each of these levels of care is determined based on a thorough evaluation of the needs of the person who will be residing in the assisted living community.This assessment is called a Level of Care Assessment. It covers physical and mental abilities with the total score determining what level of assisted living is needed. In addition, the provider will request a physician's report to confirm a prospective resident's health status. A Level of Care Assessment is conducted regularly with the resident because needs are likely to change as a person becomes more or less able to care for him/herself.While the fees are not negotiable in most instances, some of the services provided may be covered under Medicare. The assisted living community to which one applies will be able to assist a prospective resident in determining whether Medicare covers any services.

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Senior Living

Doug Stark

2003-03-01 14:09:00

: My 85-year-old mother is becoming more forgetful. We are all concerned that this is the first sign of Alzheimer's disease. Why can't her memory loss just be a normal part of aging? When should we have her checked by a doctor?

ANSWER:  Today with the heightened awareness and media attention (deservedly so) of Alzheimer's disease, many witnessing a lapse in the memory of a loved one fear the worst. Actually memory loss comes in various forms and as a result of multiple causes, many having nothing to do with this dreaded disease. Although Alzheimer's is the leading cause of profound and progressive memory impairment, many people experience declines in their ability to recall events, names and recent activities for a host of other reasons, some disease and some non-disease related. First, researchers say that your cognitive capabilities peak somewhere in your late 20's and that there is a steady decline from that point on. In many, the decline is never really noticed until you are very elderly, if ever. On the other hand it is not uncommon for people the age of your 85-year-old mother to experience some cognitive deficits that are noticeable. In answer to your question of 'can memory loss just be a normal part of aging' the answer is yes. Your brain, like any organ is affected by your general physical condition. If you are in overall poor health your brain and its ability to stay sharp can suffer with the rest of your body. Other maladies that can affect cognition are sleep depravation, a poor diet, or a vitamin deficiency particularly a lack of B-12. The digestive tracts of some elderly no longer absorb adequate amounts of B-12, which is necessary for normal brain function. In this case, supplements of B-12 or even B-12 injections from your doctor might help in clearing up memory. Some experience what is referred to as a vascular dementia due to an overall decrease in the circulatory system of many elderly. Exercise of some type that can improve your circulation might be helpful here. Adverse reactions or the side effects of some medications can also play a factor. Another issue that researchers theorize may be a leading cause of impaired memory is stress. Everyone knows that when you are really stressed you don't usually think very clearly. Research now suggests that a hormone secreted in the brain at times of stress may play a big part in this. For people that get acutely stressed on a regular basis, or those that have experienced a lot of stress over a number of years, this may be a cause of their impaired memory. Alcohol or drug abuse over a number of years can also be a cause. Obviously your mother's memory issues could be the result of a diseases process or as a result of little 'mini strokes' referred to as multi-infarct strokes or TIA's. The answer to your question of when should you have her checked out depends on how pronounced her memory loss is and its progression. Is she just a little forgetful or does she have serious lapses of memory? It certainly doesn't hurt to have your mother worked up by a physician for her memory decline because as suggested above, there may be a fairly simple cause and solution. A simple analogy that I heard someone use in discussing memory concerns and when you should seek medical attention is this: if you walked out of the mall or the grocery store and forgot where you parked your car that is fairly normal. You either have been there so many times that they run together, or you were concentrating on something else as you parked your car. If, on the other hand you forgot that you drove there .. you probably need to go see someone. Also experts say that the secret to your brain working at peak efficiency baring a disease process is regular exercise, a good diet and plenty of sleep. Have you ever heard that before? It is also important to keep your mind active, as your brain needs exercise also. Play bridge, do the crossword puzzle, read, audit a course at the University, or volunteer your time. Remember, there is some truth to the rule "use it or loose it".

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Senior Living

Chet West

2003-03-01 13:26:00

:  My sister and I are taking care of two different members of our family.  I have seen a 'Caregiver Bill of Rights' somewhere.  Can you provide a copy of it?

ANSWER:  Yes, here it is.  Often times, after one reads these, he or she needs to visit about some of them.  You may call me if you like. A Caregiver’s Bill of Rights-I have the right to take care of myself. This is not an act of selfishness. It will give me the ability to take better care of my loved one.-I have the right to seek help from others even though my loved one may object. I recognize the limits of my own endurance and strength.-I have the right to maintain facets of my own life that do not include the person I care for just as I would if he or she were healthy.-I know that I do everything that I reasonably can do for this person and I have the right to do some things just for myself.-I have the right to get angry, be depressed, and express difficult feelings occasionally.-I have the right to reject any attempt by my loved one (either conscious or unconscious) to manipulate me through guilt or anger.-I have the right to receive considerations, affection, forgiveness, and acceptance for what I do for my loved one as I offer these attributes in return.-I have the right to take pride in what I am accomplishing and to applaud the courage it has taken to meet the needs of my loved one.-I have the right to protect my individuality and my right to make a life for myself that will sustain me in times when my loved one no longer needs my full-time help.-I have the right to expect and demand that as new strides are made in finding resources to aid physically and mentally impaired older persons in our country, similar strides will be made toward aiding and supporting caregivers.

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Senior Living

Chet West

2003-02-01 08:16:00

: My father had a stroke three years ago. I have been caring for him since. Lately he has developed dementia. It is getting worse. While he is presently receiving the care he needs, I am not sure I am making it as well as I should. What should I be doing for my health and mental stability?

ANSWER: You did not mention whether or not you have any help, are married or single, or have other resources available to you. I will respond the best I can.As a caregiver, you know any disease never affects just one person in a family. Your life has changed, too, from your social life and relationships to your goals and priorities. "Changed" probably isn't even the word -- you've gone through a total upheaval, the kind that splits a life in two. In the years before your caregiving, you may have worried about the lawn or local politics or today's kids. In this new era, you worry about getting through the day. As isolated as you may feel, you are far from alone. Millions of other caregivers are going through the same struggles. Like you, they are providing near-constant care and supervision to someone who doesn't always recognize what they are doing for them. Like you, they feel embarrassed if their loved one yells obscenities or does something like disrobing in public. They feel a deep sadness if they have to show their parent, grandparent, or spouse how to use the toilet. All of that hard work and frustration takes a toll. According to the Alzheimer's Association, 80 percent of all caregivers say they live with high levels of stress, and at least half suffer from depression. Such turmoil saps a person's strength, patience, and energy, making it even harder to give loved ones the care they need. Depression and stress also threaten a caregiver's health by weakening the immune system and raising the risk of heart disease, substance abuse, and many other disorders. The following 'Cardinal Rules of Caregiving' may be helpful: Staying informed is an excellent way to reduce the stress of caregiving. Books such as At the Heart of Alzheimer's, The 36-Hour Day, and Alzheimer's: A Caregiver's Guide and Sourcebook explain the course of the disease and provide invaluable practical advice. Knowing how to bathe, feed, and dress an Alzheimer's patient with a minimum of fuss and frustration will greatly ease your burden. Just as important, you'll learn to set realistic goals -- getting clothes on his body vs. getting him perfectly dressed -- and to take things one day at a time. These books also drive home the cardinal rule of caregiving: You can't do everything yourself. Even if you're physically capable of performing every task your loved one needs, your mind can't take the endless strain. There's no shame in asking a relative, friend, professional aide, or adult day care service to give you some time off. If you don't know anyone who can help, call your local chapter of the Alzheimer's Association for advice. Make sure to invest at least some of that free time in your health and peace of mind. Regular exercise will help revitalize your mood as well as your body. You should also get plenty of rest and make regular visits to your doctor. And take the time to join a support group, either in your town or on the Internet. Hearing about other caregivers' experiences and sharing your own will give you new knowledge and strength to cope with the illness.Don't wait till you snap. If you find yourself losing your temper regularly and yelling at your loved one, or doing other things that you regret, you have to get some help. It's not fair to the person with Alzheimer's or yourself to go on like that. You should always be on the lookout for signs of depression and stress. If you regularly experience any of these symptoms, see a doctor, therapist, or other expert for help.-Irritable mood-Feelings of worthlessness or excessive guilt-Suicidal thoughts-Sleep problems-Fatigue-Loss of interest or pleasure in usual activities-Difficulty concentrating-Unexplained changes in appetite and weight Finally, save a corner of your emotional life for yourself. Try to make sure your emotional life doesn't revolve entirely around your confused loved one. As a case in point, a woman whose father had early-onset Alzheimer's recalls a time in which her father's deterioration weighed on her so heavily that she lost interest in anything else. She relates the following dream she had during that period: Her father was in a car rolling slowly downhill, but for some reason he was unable to step on the brakes. Terrified, she ran after the car and grabbed the bumper, pulling backward with all her strength to keep it from rolling any further. But the car continued to roll forward, dragging her through thorny underbrush and forcing her to let go. Then she ran in front of the car and stopped it with her hands, straining to hold it in place, but it kept pushing forward until, in order to save her life, she was forced to jump clear. When she woke up, she said, the dream's meaning seemed transparent: The car rolling inexorably downhill symbolized Alzheimer's, and neither she nor her father nor anyone else could stop it from running its course. "Of course I kept on helping take care of my father," she said. "And I loved him just as much as ever. But I tried not to let the disease run me down and destroy me, too. I knew that's what my father would want me to do: jump clear.

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Senior Living

Chet West

2003-01-01 11:22:00

: What are the different housing options for seniors and how do they differ?

ANSWER:  There are several in most every area throughout the country.  Here are the most common:Independent Living or Senior Apartments:  Designed for residents who can live independently and walk without assistance. Most senior apartments offer laundry and housekeeping services and provide meals and transportation.Assisted Living:  Designed for residents who need assistance with Activities of Daily Living (ADLs) - bathing, dressing, eating, mobility or toileting. Assisted living can also offer medication supervision/administration. Assisted living homes have 24-hour staff who offer personalized assistance, supportive services, and health care in a professionally managed group environment. For seniors who cannot live alone, the assisted living combination of residential housing, health care services, and assistance with activities of daily living expands their ability to live dignified, meaningful lives.Alzheimer's Care:  Designed for residents who have a tendency to wander, exhibit chronic confusion or have difficulty recognizing others.Nursing Care Facilities:  Designed for individuals who need medical care on a regular basis. They are staffed with professional health care attendants. These homes are designed for residents who cannot perform ADLs on their own, are unable to walk without the assistance of a wheelchair, walker or another person or need nursing or therapy services.Continuing Care Retirement Community (CCRC):  Designed for residents who can presently live independently. CCRCs allow residents to "age in place." These facilities provide the security of being cared for, when needed, throughout the aging process.Home Health Care:  Home Health Care provides many services similar to those provided at assisted living or nursing homes such as nursing care, assistance with activities of daily living, therapeutic care and may even assist in the administration of medicine. While Home Health Care permits the individual to stay in his or her home, an out-of-home facility such as an assisted living residence offers the benefits of socialization, activities, and 24-hour staffing that are generally not part of the in-home services.Hospice Care:  Provides medical, counseling, and social services to individuals with a terminal illness. Hospice services also provide emotional support to the family of the patient during this taxing time. The focus of hospice care is relief from pain and control of the symptoms, rather than cure of the condition or disease.Respite Care:  Provides temporary relief from duties for caregivers, ranging from several hours to days. Services may include personal care such as help with eating, dressing, toileting, or transferring. Meal preparation, general supervision, and companionship may also be provided by the respite care agency.Adult Day Care:  Offers daily structured programs in a community setting with activities and health-related and rehabilitation services to elderly who are physically or emotionally disabled and need a protective environment. As the name implies, care is provided during daytime hours, with the individual returning to the home for the night. An adult day care program provides a stimulating and caring environment that meets the needs of the senior, while providing some relief for family members and caregivers.

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Senior Living

Chet West

2002-12-01 17:35:00

: It seems like there are so many different types of ‘living’ today... what is meant by ‘Independent Living’?  Does it just relate to people with disabilities?

ANSWER:  Essentially, ‘independent living’ is living just like everyone else - having opportunities to make decisions that affect one's life, the ability to pursue activities of one's own choosing.Independent living should not be defined in terms of living on one's own, being employed in a job fitting one's capabilities and interests, or having an active social life, although these are aspects of living independently. Independent living has to do with self - determination. It is having the right and the opportunity to pursue a course of action. And, it is having the freedom to fail -and to learn from one's failures, just as nondisabled people do.There are, of course, individuals who have cognitive disabilities which may affect their ability to make decisions or pursue complex activities. For these individuals, independent living means having every opportunity to be as self sufficient as possible.Independent living isn't easy, and it can be risky. But millions of people with disabilities rate it higher than a life of dependency and narrow opportunities and unfulfilled expectations.Most Americans take for granted opportunities they have regarding living arrangements, employment situations, means of transportation, social and recreational activities, and other aspects of everyday life.For many Americans with disabilities, however, barriers in their communities take away or severely limit their choices. These barriers may be obvious, such as lack of ramped entrances for people who use wheelchairs, lack of interpreters or captioning for people with hearing impairments, lack of brailled or taped copies of printed material for people who have visual impairments. Other barriers - frequently less obvious - can be even more limiting to people with disabilities to live independently, and they result from people's misunderstandings and prejudices about disability. These barriers can result in low expectations regarding the ability of people with disabilities to achieve their goals.Millions of people all over America who experience disabilities have established independent lives. They fulfill all kinds of roles in their communities: employers, employees, marriage partners, parents, students, athletes, politicians, taxpayers, an unlimited list. In most cases, the barriers facing them haven't been removed, but these individuals have been successful in overcoming or at least dealing with them.

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Senior Living

Doug Stark

2002-12-01 09:46:00

:  In looking at various care options for my Aunt who has Alzheimer's disease we liked the group home environment the best, but our concern is how long a group home would be appropriate before needing to move her again to a nursing home?

ANSWER:  It comes as no surprise that you and your wife found a group home (more commonly referred to as a residential care home or personal care home) to be the most desirable model of care for your Aunt, particularly since she is dealing with an impaired memory disorder.   A residential care home (a single family residential home licensed by the State to provide care for up to eight residents) is a far superior option for someone that is cognitively impaired from Alzheimer's disease or some other malady.   For the memory impaired a small, familiar, easy to understand environment is simply better.   The regiment, complexity, long hallways, large dining rooms and overall activity level of most larger facilities can be overwhelming as well as over stimulating for someone that no longer has the ability to reason clearly.A residential care home (group home) offers the resident the opportunity and dignity of still living like a family in a neighborhood home.  Generally the care is more on a personal level fitting the schedule and desires of the resident, which is very important when dealing with the behaviors associated with this condition.  It can be difficult for the cognitively impaired to fit the rigid schedules that many times are necessary for the efficiency of larger providers of care.  Effective dementia (impaired memory) care is moving to the schedule of the resident's and not trying to bring them to ours, which is accomplished easier in a more intimate one on one environment.  In my opinion, if there were ever a time in a person's life where they needed a calm familiar environment, now is that time!  Also many homes have the added therapeutic benefit of family pets. The question of how long a person can stay in a residential care home depends a lot on the home's operator, the level of care they wish to provide, their qualifications, etc.  For example, electronic security that restricts a confused resident from wandering off is a must for this type of care.  Some operators are not really set up for, or even desire for that matter to deal with many of the behaviors that are part of dementia care in the latter stages.  Some on the other hand, focus their efforts solely on dementia care and consequently specialize in care for Alzheimer's and other memory disorders.Regarding the eventuality of having to move your Aunt from a residential care home to a skilled nursing facility, again, that depends partially on the set up of the operator and their qualifications to provide what is considered 'end stage' care.  It also can depend greatly on the care needs or potential unforeseen medical issues of the resident.  Many homes cannot care for a resident needing a two-person assist to go from the bed to say a wheel chair.  Some though, like our company are set up to care for individuals at most all levels, as long as there is not a need for skilled nursing procedures over an extended period of time.  This is done by staging homes from mild memory loss to total care in our Advanced Services Home.   Your best bet in choosing the appropriate environment for your loved one is first, facing up to the reality of the needs.  I bring this up because for many this is an emotionally wrenching time.  It is often difficult to objectively assess your loved ones condition, placing you in denial of what the needs really are.  Then go out and do your homework.  Visit the various providers.  Check out their reputation in the community by talking to medical professionals or calling the various agencies like the Alzheimer's Association or the Department of Aging.   Call the families of some of their current and past residents and assess their level of satisfaction.  Another very important indicator of quality operators is space availability, or actually lack there of.  You will usually find the better operators to be at near capacity or with a short waiting list.  I would suggest you take an extra long look if you become interested in an operator with a lot of availability.  Two things that go hand in hand with quality operators is they are not the cheapest and they are full most of the time. 

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Senior Living

Bill Ward

2002-05-01 15:03:00

Question: I am currently looking for assisted living for my mother. I am amazed at the prices. It seems as though there should only be the cost for normal rent and whatever assistance from a CMA one might need. Why is assisted living priced so high?

Answer: Senior health care providers could probably do a better job of informing the public on what "assisted living" means and the services assisted living provides. Assisted living means the resident is assisted in living as independently as possible with 24-hour-a-day availability of nursing care if help is needed. This provides a care "safety net" for the resident who may normally need only occasional assistance on a day-to-day basis.      An assisted living resident is paying for the various services provided weekly, daily or on whatever schedule is called for in the resident's plan of services. In addition, fees usually cover utilities, maintenance of the residence, housekeeping, meals, transportation, and available health and wellness services (i.e., screenings such as blood pressure checks). In most regular rental situations, utilities, meals, security systems, transportation and housekeeping are not typically part of the rent. This is why assisted living makes the distinction of referring to the cost as a monthly fee. Assisted living fee structures are often based on the level of care the resident required to help a resident. When the resident moves to a higher level of care, the monthly fee goes up.      Assisted living usually offers three levels of care, each one providing greater support for accomplishing what are called "activities of daily living." These activities include dressing, grooming, bathing, eating, walking, and so on. A combination of certified and licensed staff are needed to ensure that the resident is as independent as possible, but receives the necessary services to live safely.     Be sure to get a complete list of what is covered in monthly fees at the assisted living residences you talk with and visit. Very often, callers may only ask how much the monthly fee is, but this does not give you a clear picture of what is covered.     If you add up the costs to maintain a home, utilities, groceries/meals, maintain a car or a car with a driver, in-home assistance on a regularly scheduled basis, emergency assistance arrangements, and housekeeping, you will probably conclude that costs for assisted living are not as high as they may first appear. You have probably noticed that the monthly cost varies, depending on the residence and even the size of the city in which it is located.Assisted living also provides for activities to engage a resident cognitively and physically. Adult children have often seen a parent "blossom" in such an environment where before, staying at home, there was little to engage the parent during the day. There may be more opportunities to enjoy short trips around town as well as, socializing opportunities as a resident makes new friends.     Most often, when someone moves to assisted living, they sell their home because a point has been reached physically or mentally where the resident is no longer safe living on his/her own. Proceeds from the sale of a home help to generate income and pay monthly fees along with social security or other income. Some medical services provided may be covered by Medicare. Some long-term care insurance policies include assisted living coverage. If your mother has such a policy, it will be important to check with the insurance company to see if assisted living is covered.     If you are looking at assisted living because you are concerned for her well being and she could use the security of living independently with some help, you may want to take a piece of paper and write down the current costs of maintaining her home and the other items mentioned earlier. See what these add up to as it will give you an idea of what your mother is already spending monthly and what that will go up to with added services.      When assisted living is appropriate, the assistance provided is needed, and the peace of mind assisted living could bring both you and your mother, it can be a much better value than at first glance.

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Senior Living

Charlene Mathis

2002-03-01 17:49:00

Question:  What are the rights of nursing home residents in Kansas?  Who enforces these regulations?

Answer:  Older adults who live in nursing homes have the same rights as any other citizen of the State of Kansas.  Unless they have been adjudged incompetent, nursing home residents may vote, own property, handle their financial affairs, communicate with whoever they wish, and all the other individual rights of citizenship.  In addition, there are very specific federal and state regulations that protect the rights of nursing home residents.  The Kansas regulation states, "Each resident shall have a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the adult care home.  Each adult care home shall protect and promote the rights of each resident as set forth in this regulation."The following is a summary of the rights described in the regulation:· To exercise rights as a resident and as a citizen.· To be treated with consideration, respect, and dignity.· To voice grievances without fear of reprisal· To be free from mental and physical abuse and to be free from chemical and physical restraints.· To have privacy in care and treatment, confidentiality of personal and medical records, and to associate and communicate privately with whomever the resident chooses.· To manage your personal and financial affairs; to make choices and independent decisions.· To keep and use personal belongings and to maintain a secure place for those possessions.· To participate in planning your care and treatment, or to refuse treatment.· To participate in social, religious and community activities; to participate in the resident council.·  To be discharged or transferred only for medical reasons, your own welfare or that of others, or for non-payment.The rights of residents must be taken very seriously if we are to provide an acceptable quality of life for residents of nursing homes.   Loss of dignity, privacy, and all control of one's life can have a devastating affect on any individual, but especially for older, vulnerable adults.When a resident is adjudged incompetent, the resident's guardian or legal representative may exercise the rights of the resident on their behalf.The Kansas Department of Health and Environment is responsible for monitoring and enforcing compliance with Federal and State regulations.  The annual KDHE inspection process completed at every nursing home in Kansas directs considerable attention to the issue of resident rights.  Complaints are also investigated by KDHE.Residents or family members who feel that resident rights are being violated may file a complaint via the Kansas Department of Health and Environment "complaint hotline"  or they may contact the Kansas Long Term Care Ombudsman for their region and request intervention.  It is a requirement that the telephone numbers of both of these agencies be posted in the facility.

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Senior Living

Bill Ward

2002-03-01 16:32:00

Question: We recently placed our mother in a nursing home. There are four children and each lives anywhere from two to four hours from the home. We are all feeling guilty that we are not more involved in her care. Should we move her to a home closer to one of us? Should at least one of us take a leave from work to be available for her care? What is the right thing to do?

Answer:  Unfortunately, there is no easy or "right" answer. From the way your question is phrased you obviously are concerned that your mother is isolated from family and that you aren't able to spend as much time as you'd like with her. Knowing the consideration that goes into making a decision that it is time for one's parent to move into a health care residence, one may infer that this was done in your mother's best interest because her health and physical condition are such that having nursing care and assistance readily available is a necessity.In your question, you state "we recently placed our mother in a nursing home." If you feel that, of necessity, this really was more of a decision on your part to "place" your mother as opposed to a joint decision, shared in by your mother, that this was a good and timely move, this may be contributing to your feeling of guilt. However, this should not necessarily be the case. If all of you, as children reached a careful well-reasoned decision that this was a necessary move in her best interest then, even if she may have been a reluctant participant, you should take comfort in the knowledge that you have made a well thought out decision to provide the best possible care and living experience for your mother. The distance may be another question altogether and if being closer to one or two of you would allow her more time with you and more family support, you may be well advised to consider this.Perhaps you should first be asking questions of your mother, if you haven't already. Is she comfortable where she is? Does she find the staff friendly, considerate, and providing good care? Is she making new friends? How's the food? Would she like to see family more often, even if it might mean seeing only one or two of you more often and some less often? Another consideration is whether the nursing home she is in now is located in the community where she has lived for many years, and is near long-time friends who are still able to and do visit with her with some frequency.Often, our feelings of guilt regarding moving a parent into a living situation with available medical assistance are because we know our parents spent years taking care of us and we are concerned that we are unable to return that consideration and love when they need us. With all four of you feeling guilt, it would seem it might be a good thing to have a family conference, discuss your feelings and consider possible alternatives to the present situation. Be honest with each other. Do you have doubts about the quality of the care your mother is receiving? Are you feeling guilty because you aren't able to care for her at home? Is she happy where she is? Would she really prefer to be closer to at least one or two of you? If you choose to select a location closer to one family member, is it possible that actual or perceived expectations will be placed on that family member to visit more often and be more available as health care questions or crises might arise? If so, is that family member comfortable assuming that responsibility and are the remaining family members equally comfortable with and able to accept and appreciate the "extra" care and attention this sibling will be giving to your mother? Could a schedule be worked out whereby you take turns visiting, attending meetings at the care residence, or becoming more involved: if one of you is willing to take responsibility should your mother move closer to him/her how will that affect the ability of others to visit and spend the time that they would like? Obviously, an important consideration in a move would be the availability of a good option for health care in any new residence that might be selected. All things being equal, it would certainly be desirable for your mother to interact with her family on a reasonably frequent basis. How often that should be is a decision that you should reach after considering her feelings together with your own.Your very good question raises many more. It would be much simpler if there were a "right" or "wrong" answer. If you are making decisions with your mother's health, well being and happiness as the ultimate goal, and she understands you are taking her best interests into account, then you should be comfortable with your decision and secure in the knowledge you have reached the best possible result.

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Senior Living

Doug Stark

2002-01-01 13:32:00

Question:  I have heard that music can greatly aid in the care and comfort of someone afflicted with Alzheimer’s. Can you tell me more?

Answer:  It is quite true that for many afflicted with Alzheimer’s disease or other cognitive deficits, music can be very therapeutic.  For some in fact, in late stage Alzheimer’s who no longer can verbalize their thoughts, music is the only vehicle that stimulates and draws a reaction from the individual.   There are a couple of factors behind this.  As most know, your brain has two hemispheres.  The analytical left side of the brain controls... along with other dimensions... speech, reading, sequential ordering, and mathematical abilities.  Alzheimer’s disease most heavily affects this hemisphere of the brain.  Music appreciation is located in the non-dominant right side of the brain along with other characteristics like emotion, intuition, artistic expression and spiritual feelings.  From this comes the labeling that you may be a right or left brainer, based on whether your personality and interests place you closer to artistic, creative and emotional or more digital, analytical and structured.  The other reason music is so powerful and transforming is the emotional attachment that all of us have with it, particularly music that impacted our lives from around age 14 through 25.  These formative years include Jr. High and High School, your first love(s), for some, college or the military, marriage, etc., where music of the time was cemented into your memory with great emotion.  The strongest and most retained memories come as a result of events in your life that are tied to strong emotion.  Dr. Oliver Sacks, a noted neurologist speaks of the power of music as a way to communicate, to express feelings, to enliven rich memories that bypass the communication difficulties caused by the disease.  Appreciating, responding to, and becoming involved in music does not require the use of the areas of the brain that are usually damaged by the disease process, Dr. Sacks states.  In one study, the use of music during a reminiscence group resulted in higher measures of life satisfaction and a greater level of enjoyment, compared to a control group which did not use music (Bennett & Mass 1987).  Music can have a pervasive effect that facilitates movement, speech, and the reactivation of old skills.  However, both the music medium used and the response are very much dependent on the individual’s personality and history.  Often mislabeled the universal language, all types of music do not necessarily speak to every person.   Response is highly individual.  Beethoven’s Fifth Symphony may be uplifting to some and have no meaning at all to others.  Furthermore, it must be introduced with empathy, in order to meet individual therapeutic goals. Background music or a group sing-along can have recreational value for some, however in order to be truly therapeutic and promote individual change, the music and the delivery environment must be goal directed.  If you would like more information on this subject you can contact the American Association for Music Therapy at 1-201-379-1100, or the National Association for Music Therapy at 1-301-589-3300. 

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Senior Living

Dr Charlene Mathis

2002-01-01 12:30:00

Question:  Our mother is 87.  She had a stroke three years ago and uses a walker.  Lately she has shown several signs of memory impairment.  Her doctor agrees.  Mother isn't too excited about moving out of her home but she understands.  She has the resources to pay for her care.  Since memory impairment is a disease that advances, how do we know whether to seek assisted living, nursing home, or memory-impairment care at this point?  We do not want her to move again.

Answer:  There are several positive aspects of this particular situation.  A very interested family is attempting to address their concerns about their mother before they become a crisis and, apparently, your mother is being included in conversation and decision making.  The fact that your mother has adequate financial resources may allow for more choices.  You have taken a good first step in involving your mother's physician.  The fact that her physician supports your concerns gives you reassurance that you are doing the right thing for your mother.You have stated that you do not want her to move again.  Perhaps you should not set this goal as a first priority because it may eliminate attractive alternatives for your mother.  The placement that will be most successful for your mother is the environment that will provide her the best quality of life for a reasonable period of time, while providing support in the areas needed.  It is true that your mother's memory impairment will likely increase as time goes by; however, the rate of progression and the path that it takes varies with each individual.  The essential key to a good placement is an accurate assessment of your mother's physical, mental, and emotional status.   Think about what she manages satisfactorily and, very specifically, with what does she need assistance.  As you talk with admission personnel at prospective facilities, ask questions about the services they provide, specifically how they would meet your mother's needs, how will they address her needs as they increase, what the clientele they serve are like, what would be the expectation of your mother, and what are the boundaries of their program or what are the factors that would make your mother unsuitable for their program.  I would encourage you to be very frank about your mother's abilities.Sometimes bad placements are made because families may attempt to "cover" and their family member is placed in a setting where he/she is unable to cope.  This is a no-win situation for everyone, and most detrimental to the person being placed.Since your mother is now managing her daily activities in her home with some degree of success and it appears that her memory impairment is in the earlier stages of development, it seems reasonable to explore assisted living as a possible option.  The transition from home to assisted living will be the most acceptable for your mother, because she will have an apartment (although usually small) that can be made very attractive with her own familiar furnishings.  Many services are available - some included in her monthly base rate and others available at an additional charge.  Be sure to point  out the positive features of the move (ie.  not having to worry about grocery shopping or preparing meals, not having to worry about home maintenance and  housekeeping, always having someone available if she needs help, the social interactions with other residents, as well as assistance with  all of her specific needs such as bathing, medication administration, etc.).There is a possibility that your mother would need to move to a nursing home if her needs increase to the point that the assisted living residence could no longer safely care for her.    However, it is surprising how long residents can remain in assisted living because of the support services available.  If the need for a move became necessary, the assisted living staff would provide assistance with placement in a different setting.

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Senior Living

Bill Ward

2001-12-01 14:55:00

Question: What is respite care? Who provides it? Why is it different than any other type of care?

Answer:  Respite care is short-term, temporary care provided so caregivers can take a break and take care of themselves. Whether caregivers are taking care of an elderly parent or severely disabled child, they need a break from the daily routine. Respite care offers this break, whether it's for a day, a weekend, or longer.Planned and crisis respite care is intended to reduce family stress, support family stability and minimize the need for out-of-home placements (especially in the case of individuals with disabilities). Respite care can be provided in-home, or the individual to be cared for may receive care in a health care center or group home. The nature and availability of services in a given city or area may vary. Respite care involves circumstances in which a caregiver who needs a break or has to devote attention to some situation which requires them to be away from the person for whom they are providing care. While all respite care is not necessarily licensed care, for someone who needs the support of a health care professional, a licensed provider is appropriate and desirable. It is best to plan ahead, not only for instances where you may be planning a trip that will require entrusting the care of your loved one to someone else, but also in order to be prepared in case an emergency situation arises which requires you call in help. A good first step is to talk with your local area agency on aging or disabilities to locate respite care providers. Providers may be licensed or volunteer organizations. Often, senior retirement communities and health care centers offer respite care.As with any care service, you will want to contact available respite care providers to find out more about how they train their staff/volunteers, how care is provided, and cost of care. It is advisable to know the qualifications and reputation of your chosen provider and to check references. You will want to feel comfortable with the organization and the people and accommodations they provide to care for your loved one. If care will be at the respite providers' site, visit to see what the physical accommodations are and to evaluate the overall atmosphere, cleanliness and environment. Most respite care providers will have information for you to fill out and will ask for a doctor's evaluation so they can plan appropriate respite care and anticipate your loved one's needs.To use licensed respite care, you will also need to set up an appointment for an assessment visit so the respite care provider is prepared to provide appropriate care should you access respite care either on a planned or emergency basis. If you have planned in advance for respite care, it can provide peace of mind in the event of an emergency, allowing you to concentrate on taking care of the situation at hand, knowing your loved one has the attention and care he/she needs.

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Senior Living

Bill Ward

2001-11-01 17:33:00

Question: Please explain adult day care. What is it?

Answer: Adult day care is a service usually for frail elderly individuals or those with physical or cognitive impairments that make it unwise for them to be home alone. Designed to help enable family members who are caregivers to continue to work, adult day care provides some assistance with the physical care of the care recipient, or provides a caregiver with periodic freedom while a family member is in adult day care.There are three types of adult day care providers: social, medical and Alzheimer's. The day care provider may be affiliated with a medical provider or retirement community or may be a stand-alone provider. In addition, a provider may also offer respite care through overnight or weekend stays. In Kansas, an adult day care provider must be licensed as a long-term care provider, but there currently is no licensing process specifically for adult day care.In general, adult day care serves an older population, but may also serve those with serious disabilities. One of the greatest advantages of a licensed adult day care program is the opportunity for social interaction with peers and stimulating activities to exercise the mind as well as the body.While Medicare does not cover day care costs, Medicaid may cover care if provided in a licensed medical or Alzheimer's environment, and if the person served meets Medicaid's financial requirements. Private insurance policies may cover some day care costs when registered or licensed medical personnel are involved with the care. Some providers offer need-based scholarships and it is worth investigating whether you may qualify for Dependent Care Tax Credit by calling 1-800-829-3676 for IRS publications.Since there are different types of adult day care providers, you need to keep in mind the purpose for your family member attending such a program when you're asking questions. Some basic information you need to know is: transportation availability, professional qualifications of the staff, schedule of activities, types of meals, ratio of staff to individuals cared for, and cost. Be sure to find out what is covered by the daily fee and whether there are any add-on care choices and costs. If the program is medically based, find out about licensing for medication administration and medical care. When you visit, observe staff interaction with day care participants. You'll want to feel that the atmosphere is warm and inviting. Look to see if equipment and furniture appears in good and safe condition. Ask for references and talk with others who are using the program.In most instances, you will be asked to visit with your family member prior to his or her first day in the program for an evaluation and to develop a plan of care and activities that are appropriately tailored to the individual's physical and mental abilities.In some cases, effective use of adult day care may enable delay of the decision to move your family member into a more comprehensive care situation by as much as 18 to 22 months or longer. While the concept of adult day care has been in place for decades, there is limited availability of services, especially in some more rural areas. With projections that the ratio of frail parents to adult children will nearly double by the year 2030, it is likely demand will increase for adult day care services.

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Senior Living

Doug Stark

2001-11-01 14:58:00

Question: I read the other day that nursing home costs have increased at the rate of 3-½% per year for the last 30 years, but now they are increasing at the rate of nearly 7% each year, particularly in the area of memory-impairment care. If that’s the case, won’t this type of care be unaffordable for nearly all of us in the future?

Answer:  The question of whether long term care, and more specifically, specialized dementia care (care for the memory-impaired) will become unaffordable depends of course on the financial capabilities at the time of need of the individual or family involved.  The fact remains though, that long-term nursing care is very expensive and can be financially devastating to many families.  For example (and I am speaking to the costs of specialized dementia care, as that is the care we provide), care in the Wichita metro area currently ranges from $3,100 a month on the low end to $4,200 at the other.  Variables making up this range are the differences in facilities, the individual level of care necessary, private vs. semi-private accommodations, etc.  If you take the midrange of $3,650, the annual expense is currently $43,800 and rising.  To give you a recent perspective, just five years ago the midrange for this care was about $2,850.  That works out to a 28% increase over the five year period, or just under 6% a year.A continuation of this trend could mean for many that cost increases of long-term care would outpace the financial capabilities of most retirement nest eggs.  This doesn't mean that you will not have access to care, but it does mean that after your assets have been depleted, you will need to seek state assistance through the Medicaid program.  This limits your options of care providers.For the foreseeable future I don't see much to indicate that this trend will change.  There are many factors in place forcing costs to increase faster than inflation.  First, recent news stories you have been hearing concerning serious shortages of nursing staff and certified nurse aids are real.  There is serious competition between care providers for responsible caregivers, increasing labor costs through higher wages and benefit packages.  There also is a need by most providers to fill in staffing shortages by utilizing temporary service agencies at substantially higher per hour wages.  Also, changes in fire safety regulations along with state and federal operational regulations tend to force costs up as operator's work to stay in compliance.  For traditional skilled nursing homes with Medicaid beds, state reimbursement dollars many times lag behind the facilities increased costs.  This deficit must be absorbed and is passed on in increased cost to others.  All operators are facing along with everyone else, large increases in energy costs over the past couple of years.  The single biggest factor this year has been huge across-the-board increases in liability insurance premiums.  To give you an example, our premiums this year increased by 116% above last years rates.  My agent told me I should feel good about it, as it could have been worse.  Mind you, we have never had a claim in almost nine years of operation. The situation is a national trend.  Many insurance companies are no longer interested in writing coverage for the long term care industry and those that do, are demanding huge increases.  Some providers with a poor claim history are finding coverage almost unavailable at any cost.In any case it appears for now, that there are pressures in place that will force rates up over the next few years.  No one knows as time marches on if rates will increase at these levels eacg year.  Currently though, the bill for three or four years of dementia care would cost you in the neighborhood of $175,000.  What could that be ten, twenty, thirty years from now?  What can you do?  For starters, hopefully you will remain in good health and not have a need for long term care.  Although this would be everyone's goal, it may not be practical for many since advances in medicine are pushing the average age up every year.  Another option is to purchase long-term care insurance offered now by many companies.  Long-term care policies can be purchased to cover all or part of your nursing care costs assuming, at the time of purchase you can pass the fairly strict health requirements.  I am not in the business of selling insurance, but I can tell you that for our residents that took out policies a number of years ago... it was a good financial decision for them!

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Senior Living

Bill Ward

2001-10-01 17:43:00

Question: My husband is suffering from Alzheimer's. We have been trying to place him in an assisted living facility. Some will talk to us and others will not as they say he will need more care than they can give. We are now wondering whether the assisted living facilities that said 'yes' will be able to provide enough care. Is an assisted living facility going to provide enough care for him throughout his illness or should we be looking into a facility that is specifically for those suffering from Alzheimer's? 

Answer:  Assisted living allows for several levels of care based on an overall assessment of the resident. These levels are based on increasing medical support and can go up or down based on regular assessments. Some assisted living options can provide care for residents with Alzheimer's or other dementia symptoms. Often, they offer special training for employees to meet the needs of dementia residents. It is to the credit of the assisted living providers who advised you that they were not equipped to care for someone with Alzheimer's. Due to the individualized progression of Alzheimer's, and aberrant behavior that often comes in later stages, specialized Alzheimer's care residences were introduced in Kansas in 1986. Since then, the number and types of Alzheimer's residences have grown as more information has become available regarding caring for persons with dementia. Some residences offer an integrated setting where persons with Alzheimer's or other dementia are part of the general population of the retirement community. Other residences use a segregated approach by providing a designated set of apartments for their residents with dementia.Your question indicates you've taken the first step to develop a list of prospective residences in your area. Contact your local Alzheimer's organization, Alzheimer's support group (if you aren't already in a support group), Area Agency on Aging or other senior service organizations to connect with others who have gone through the assisted living residence selection process. From this, you'll develop a good list of top prospects.You should visit each of the prospective residences. There is no substitute for observing how employees interact with residents, the overall maintenance of the residence and the feeling you get when you're there. Good times to visit your prospects are late afternoon, mealtime and when the medical director makes his/her rounds. Late afternoon visits may give you the opportunity to see how staff interacts at a time of day when residents and staff may be a bit fatigued from the day's activities. Meal times will tell you about the way employees interact with residents, especially those who have difficulty feeding themselves. You may also observe the quality of the food being served. Additionally, observe to see if the foods served are appropriate for residents' abilities. That is, if a resident has trouble handling silverware, are they served finger foods to maximize their independence at meal time. Many residences will welcome you to join them for lunch or dinner along with your tour. Ask to eat in the dining room that serves the area in which your loved one will reside. If you're able to arrange your schedule to visit when the medical director is conducting rounds, you may have the opportunity to see how he/she interacts with residents when going through the halls and with the nursing staff.  Plan to make a second visit at a different time of day to those top two or three prospective residences.Your question indicates at this point, you may be mainly making phone inquiries. Asking some of the questions listed below will give you a better overall sense of how a provider approaches care and the provider's ability to furnish appropriate care for a person with Alzheimer's or other dementia.Things to ask an Administrator or Director of Nursing:Ask about licensed nurse staffing during the evening and on weekends. (If there aren't licensed nurses on duty at these times, this may indicate the residence may not be prepared to handle the potential problems such as wandering, that come with Alzheimer's and other dementia.)What kind of training do employees receive? What kind of continuing education do they receive as new information or methods are developed for assisting and supporting dementia residents?What is the staff turnover rate? How often are residents checked during the day?  How are medications monitored?What process is used to identify that a person is progressing into a new level of Alzheimer's in order to address whether care levels need to be changed?Is there a policy addressing residents with behavior problems? Does it include discharging the resident?What is the policy on wandering and how safe is the environment?  Does the environment allow for maximum autonomy and safety? Is there a safe, secure outside area residents can go to during the day when the weather permits? Questions to ask an administrator, marketing or admissions coordinator:What are the costs of care and what is included? Are there additional charges for special services, such as incontinence care, laundry, physical therapy, speech therapy or occupational therapy? What are your options for payment?Are there any limitations on when you can visit your loved one? Can residents bring furnishings from home? Ask to see an activities/events calendar to see the quality and quantity of planned activities for residents. In Kansas, all assisted living providers are licensed. Those providers that also have a health care residence are surveyed regularly. You may want to request a copy of the most recent survey. Free standing assisted living providers are not yet surveyed regularly, but this is being addressed by the state and will someday be available.As you visit each location, you'll be looking for interactions between employees and residents. Look for the level and quality of the interaction with the residents. Do staff appear to care about the residents?  Do the residents appear to be comfortably dressed in such a way as to maintain their dignity? Do people appear happy? Are residents restrained in any way? Does the building appear safe? Do you see cleaning equipment in the hallways where it could be hazardous?  Do you see grab bars and handrails appropriately placed? Does the building look and smell clean? What is the noise level - chaotic or sedate? Your tour should include seeing a typical resident's room. Does it look personalized or institutional? Ask for references you can contact and ask about their experience with the assisted living provider. As you're on tour, does the person who's giving the tour excuse herself to assist with a resident if needed?  Staff should be putting their residents first, but if it's happening constantly along the way, this may indicate a staffing problem.If your loved one is still in a cognitive state where they can participate in the decision, try to take him/her with you. Ask in which location he/she feels most comfortable. If there are other family members who should be part of the decision, be sure to include them either touring with you or in the discussion of the options for your loved one, in this case, your husband.Use your instincts. You know your loved one better than anyone who will care for him. Does the residence "feel" right?  Do you think he will be comfortable here? Do you get a good feeling about the place as a whole?Timing is a consideration. Often, the best care providers have waiting lists. Are you willing to make a decision now as a temporary solution and get on a waiting list for a residence that appears better able to handle later stages of Alzheimer's? You also need to look at costs. Which of your top choices can you afford?Ultimately, you and other family members, if any, need to be comfortable with the residence you select. Asking lots of questions, using first-hand observation, talking with others whose loved ones live in the residences you're considering, and tapping into your own feelings about the residence should enable you to make the best decision for your husband's care throughout the stages of Alzheimer's.

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Senior Living

Bill Ward

2001-09-01 11:30:00

Question:  My parents are in their mid 80s. Their house is valued at over $150,000. They have no mortgage. Although they continue to take care of each other, we know the time is quickly approaching where this will not be the case. They do not have any long-term care insurance and probably could not qualify now for a policy. We have discussed them selling their home and taking the proceeds to move into an independent living situation where help would be available as they need it. The problem is, other than their home, their assets are less than $50,000. Their combined income is a little over $2,000 per month. They are afraid they will run out of money. Some time back I remember hearing about a program that allowed a couple to trade their home for guaranteed independent living and nursing care (if needed) for the rest of their lives. Can you tell me about it? If the program no longer exists, what would be your recommendations?

Answer:  To the credit of you and your parents, you are engaging in an important discussion. One we often want to avoid. It's sometimes difficult for us to admit our parents are reaching this stage of life and it is often difficult for them to recognize that they may need to look at their options for retirement living and health care.My first recommendation would be to investigate the continuing care retirement communities (CCRCs) in the area your parents wish to live.  CCRCs are retirement communities offering the full "continuum" of care including independent living, assisted living and health care (or skilled care). Many CCRCs also offer programs of care for Alzheimer's and other dementia in either a residential or medical model setting. Each CCRC has its own program for payment for services rendered. While I'm not aware of any retirement communities that "trade" independent living and nursing care for a house, that option may exist.Most commonly, potential retirement community residents sell their house and use the proceeds to finance moving into the continuing care residential situation they have chosen. Ideally, their initial move is into independent living. When the need for more service arises, this can be addressed through the use of home health services in their own CCRC residence, or by using assisted living or health care. In many instances, a specified sum of money is deposited with the CCRC up front. The amount of the deposit is determined by the rate schedule of the CCRC, which is based upon the type of living accommodations chosen by the resident, (i.e., apartment, duplex, fourplex, cottage, number of bedrooms, bath rooms and square footage). A portion of this deposit is normally non-refundable, such as 10% or 20%, and the balance is refundable if the resident leaves the CCRC or, in case of death, the refundable amount goes to the resident's estate. In some plans, the refundable portion of the deposit may be used, if needed, to fund assisted living or skilled care expenses. If the deposit is not needed for this purpose, or only partially used, the remainder is refunded to the resident, the resident's estate or to an appropriate designated beneficiary when the resident leaves the CCRC. Other financing options include a declining balance arrangement where the initial deposit made has a refundable portion, but the amount refundable declines by a percentage each month or year. When the refundable portion declines to zero, the resident is still entitled to remain in his or her residence as long as health permits, paying only the normal monthly fee, but there is no refund to the resident or resident's estate. Customarily, the deposit required in a declining balance arrangement is less due to the fact that the deposit declines in value to the resident. This may make it possible for someone to move into the CCRC who desires to, or needs to, make a smaller deposit. Some communities also have a monthly rental option that doesn't require any initial deposit and sometimes doesn't even require a long-term lease. In most instances, you'll find the monthly rental option is a higher monthly amount than if a deposit is made up front. This is because when either of the above deposit plans is used, there is interest and some specific portion of the principal deposited which can be used by the CCRC, in addition to the monthly fee, to help defray the expenses of the residence and services provided. How these programs work and which options are available depends, of course, on the system the community has in place.By entering a CCRC through independent living, your parents may have choices such as various apartment plans, duplex or four-plexes. In some CCRCs, they could even have the option of choosing a small house on the campus. Should they later need assisted living or health care, they would normally have priority admission to these levels of care within the CCRC. These services usually are provided for a basic monthly cost with an additional "level of care" charge. Size and amenities usually dictate the base monthly charge. You may want to discuss frankly what they can afford versus the size of residence they'd like to have.Be aware that not all retirement communities are continuing care. Many independent living retirement communities do not offer the additional levels of care. Nor do they offer all the basic services of a CCRC that make it possible for residents to live as independently as possible. This will be an important issue to discuss along with how the financing options provide for future services.A concern some people have about aging is that they may run out of funds, especially if they need to move into skilled care. While I cannot speak for the for-profit communities, many not-for-profit retirement communities have funds that are earmarked for assisting residents in covering costs if their financial situation is such that they can no longer pay for care. This is something you may wish to inquire about at any community you consider.Begin your search close to home with the Chamber of Commerce for the area where your parents want to live. In Kansas, the Kansas Association of Homes and Services for the Aging (KAHSA), offers a directory of not-for-profit retirement communities as does its sister organization in Missouri.If you want to become more informed on the different residential choices, here are some sites to get you started on the Internet:•  American Association of Homes and Services for the Aging............................... http://www.aahsa.org/public/ccrc.htm.  The link takes you directly to an article on selecting a continuing care retirement community. You'll also find a listing of member communities.• Continuing Care Retirement Community Information............................ http://www.eldernet.com/lifecare/lifecare.htm.  This site offers listings of available communities in each state.• Continuing Care Retirement Communities ............................................ http://www.bosbbb.org/lit/0029.htm.  This article contains some good questions to ask when choosing a Continuing Care Retirement Community.•  Continuing Care Accreditation Commission............................................. h.ttp://www.ccaconline.org/aflist.htm.  This site lists only those communities that have chosen to go through the voluntary CCAC process. You'll find valuable information on choosing a community. Keep in mind that a community need not be CCAC accredited to provide excellent services.When searching for information, you'll find several state and federal sites that may be helpful such as those hosted by your state's Department of Aging. Many of these are linked on the listings above. This list is only a starting point. Keep in mind that you'll find a number of sites that provide information based on who has paid to be listed on the site. That means you may find some valuable information, but may not find a complete listing of the available communities in the city or state you're searching.Long-term care insurance is a matter on which we do not counsel our residents other than to encourage them to investigate the options. Depending on the residence arrangement your parents choose, this may not be necessary, though it is always a sensible option to consider. Even at an advanced age, long-term care insurance can be a viable option if premiums fit the budget.A good place to start is with yours or your parents' insurance agent(s) for life, home and other insurance or with legal counsel. Many companies are adding or have offered long-term care insurance as an option to existing customers. In fact, your parents or yourselves (if you're over 50), may have already received literature by mail from some of the large providers who are very actively pursuing this business.You'll find many sites on the Internet to research long-term care insurance, so here are a few to help get you started:National Long Term Care Insurance Buyer's Advocate Alliance........................ http://www.longtermcareinsurance.org/i-faqs.html.  You'll find information on long-term care insurance and opportunities to obtain free quotes.Long Term Care Insurance Information.http://www.ltcinsurance.com/ltcquote247.html.  This site offers information and a free long-term care insurance quote.Of course, you'll find a multitude of insurance company sites that also offer premium quotes along with information on long-term care insurance.I hope this information helps you further your discussion with your parents. You have taken a valuable first step - talking with them to find out their wishes and express your concerns. Keeping the discussion honest and heartfelt, listening carefully to them and asking that they do the same with you will help you all come to the right decision. The trick is finding the choices and financing options that enable them to continue to live the way they want to live or as nearly so as their circumstances and condition of health will allow.

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Senior Living

Diane Frederick

2001-09-01 10:50:00

Question:  My mother is 84 and lives alone. I am single and work full time. She has a tax-qualified, long-term care policy. Recently she fell and fractured her left leg. She needs assistance with everyday activities while her leg mends. The problem is that we cannot get certification that she needs 90 days of continuous care, therefore her long-term care policy will not pay. Neither her or I can afford to pay the costs. What do we do?

Answer:  Your situation is not an easy one as you know. You obviously want the best possible recuperation time for your mother so that she will mend properly without further complications. There are a few options for you to look at:1.  Contact your long term care salesperson, and explain the situation to him or her. Long term care insurance representatives are specially trained in this area and may have suggestions as to how you can get your mother certification for continuous care in home. Keeping her at home is of course always the first choice. He or she may refer you to another physician who will certify her.2. Your mother may qualify for skilled nursing care through a home health agency. These services may be covered by her Medicare benefits. There are many reputable home health agencies in and around Wichita and it costs nothing to call a few of them and see if they will assess your mothers situation.3. There are services available through SRS that will pay for in home care.  There are financial restrictions but if your mother does not have the resources to hire outside care and she does not qualify for skilled nursing care through her Medicare policy it would be a good idea to call SRS at 316-337-6000 and talk to a case worker about the possibility of your mother qualifying for HCBS services.4. Finally, if your mother does qualify for Medicaid, she might also want to look into the possibility of a short term stay in a nursing facility. Many facilities in Wichita offer respite care and/or outpatient therapies. Please begin this process with your Long Term Care sales representative.  That person should be able to guide you so that you can use the benefits that you have been  paying for. If you are not able to contact your representative, find another one through a reputable insurance company. Good luck to you, please let us know how it turns out for you!

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Senior Living

Diane Frederick

2001-07-01 16:07:00

Question: I am a 53 year-old nurse.  I came to care for my parents a year ago and put my career on hold. My dad passed away in January, and I am left to care for my mom. Her benefits were cut after dad died. I am on limited funds. I had to hire a helper in April because my mom has Alzheimer's. My dilemma is that I can't work outside of the home because it takes two to be with her, and I feel very frustrated that funds are dwindling. Is there a program that will pay me for my services and help me out? I still have obligations also.

Answer:  Please accept our condolences on the death of your father.  We do understand your frustration as you try to take care of your mother, especially on limited funds.It is important that you know that there are numerous quality nursing facilities in and around the Wichita area that offer 24 hour care for patients with Alzheimer's Disease.If your mother has less than $2000.00 in non-exempt assets she will probably qualify for Medicaid insurance which will cover the cost of nursing home care.  Please call SRS at 316-337-6000 and make an appointment if you wish to pursue this avenue.If you want to keep her at home, again you will want to contact SRS at the number above and inquire about HCBS/FE waivers.  The FE (frail elderly) waiver will sometimes pay for a child to take care of a parent at home.  There are eligibility requirements.  Hours and pay will be determined after application is made.  Since you are a nurse, you would probably be able to make more money (and get benefits) if you were to go back to work.The HCBS/FE waiver can still provide outside help to come into your home and care for your mother.  Again, there are eligibility requirements and application should be made by calling SRS at 316-337-6000.Please let us know how this turns out for you.  We do care.

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Senior Living

Bill Ward

2001-07-01 16:07:00

Question: My wife and I are retired. In our travels, we have visited several 'retirement communities' in Arizona and Florida. When we visit 'retirement communities' here in Kansas, they seem different than the others. What exactly is a "retirement unity?”

Answer: You've rightly observed that in areas of the country where retirees, especially younger retirees tend to make their post-work home, a retirement community may look different than in Kansas. You'll be pleased to know that this is changing for the better in the Sunflower State. First, retirement community is a broad term that has come to mean "retirement housing." It is most often associated with a senior-oriented community providing apartments, duplexes, homes and other options for those who continue to live independently or with a Continuing Care Retirement Community (CCRC) which offers the full range of living options from independent through total care. About the only type of living accommodations the term doesn't apply to is those that only provide total care (most commonly known as skilled nursing care, health care or nursing home). As the available options continue to grow and change, the use of the term retirement community also continues to evolve.More and more, retirement housing providers are listening to what their future residents want. This is being driven largely by the first of the baby boomers reaching age 50. Since changes don't happen overnight, the industry as a whole is taking a serious look at what retirement living opportunities it will need to offer when this group is seeking independent retirement living and health care. In general, people over 50 account for 72% of RV trips, 70% of bus trips and 70% of cruise passengers. It is a lively group.Arizona and Florida draw retirees from all over the country for many reasons, including their progressive approach to retirement living. You've probably observed that many residents in these communities are "younger" and haven't slowed down much, if at all. The baby boomers anticipate a longer, more active life. For those who are looking forward to retirement, there are high expectations of the senior housing industry.At present, persons over 65 are 13.7% of Kansas' population. This is projected to grow to more than 19% by the year 2025. The average age of retirement community residents today is near 80. This is in part due to the independent spirit of the people of Kansas who wish to stay in their own homes as long as possible. It is also affected by the rural expanses where services are fewer and farther between. The group who sees the advantage of gaining more freedom by moving into a retirement community tend to be younger on average and make up a smaller part of the total population who have chosen retirement community living. You may have noticed, especially in and around larger cities such as Wichita and Kansas City, a greater array of housing choices. In most instances, they are developed with the realities of aging in mind to assure residents that as their physical needs change, there will be a place for them in the community. While the baby boomers think they won't have health problems (84%), the reality is that 25% of them will experience heart disease and 20% are likely to experience a chronic disability. However, the instances of chronic disabilities decreased significantly in the past 17 years from 25% to 20%. This is good news, and while a chronic disability may slow someone down, it doesn't mean the person will retire from life.If you are seeking a retirement community that offers you all the freedom you want with a hedge against what the future may bring, you're probably looking for a CCRC. They can be found in a variety of arrangements and prices. If you want to take tomorrow "as it comes," there are communities of apartments, duplexes or town homes for retirees, where you know everything is taken care of if you decide to pack up and go see the country for a month. People are living longer, healthier lives and it is a challenge to the retirement housing industry in Kansas to continue to grow and change to meet the demands of tomorrow's retirees. As you investigate retirement living options in our state, you'll find your choices are greater (some even rival the kinds of communities you see in Arizona and Florida), and that the future holds more growth for this type of community.

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Senior Living

Eric Legleiter

2001-05-01 10:25:00

Question: What is the difference between nursing home care and assisted living care?

Answer: As America continues to age, more and more seniors, as well as their adult children, are faced with the dilemma of choosing between a nursing home and an assisted living residence to serve as the primary care giver.  This is a time of anxiety, fear, helplessness and rejection.  This decision is never an easy one but as the assisted living industry has exploded onto the scene as a viable alternative to senior housing over the past decade, the decision-maker now has more options available.  Often the question is asked, "What is the difference between nursing home care and assisted living care?"  The answer is not one-worded.  Many variables come into play when searching for an appropriate care setting for a loved one; and no one wants to make a wrong decision about the selection of a residence as guilt is already at a premium during the whole process.  The assisted living industry started in the early 80's in what was dubbed "board and care" homes.  These were usually six to eight room houses that were converted by owners to care for elderly family members.  A small nominal fee was charged for those not of the family tree and the fee usually covered room and board as well as meals and nothing more.  As the idea spread throughout the country, momentum began to build for the need to provide an alternative to nursing home care.  In the late 80's to early 90's, several developers across the country formed companies whose sole mission was to build and manage free-standing assisted living residences.  Hence, the boom was on.  The assisted living model was built and developed on the philosophy of "aging in place".  Under the umbrella of aging in place were the philosophies of dignity, privacy, individuality, independence, choice, and a home-like environment.  These terms were the foundation by which the industry would use to replace the nursing home industry as the provider of choice. The answer to the question above is simple... money!  Care for the aging population in a nursing home setting is usually funded through federal funds while assisted living is still generally a private pay industry.  This reason alone can begin to explain the biggest differences in care that is given in both settings.  Usually, a nursing home is given "x" amount of dollars per day to care for a resident that is set forth by the state legislature.  Normally, the amount that is allotted per resident on a daily basis is not anywhere near what an assisted living residence will charge on a private pay basis to care for a senior.  This is the biggest reason why most nursing home rooms are set up for two residents with a shared bathroom.  Because of the lack of federal funding, the nursing home industry must double up residents in each room in order to receive maximum funding to provide staff and other expenses.  Assisted living on the other hand, usually charges a monthly fee for a private apartment complete with its own bathroom and usually includes a living room, kitchenette, and bedroom.  In addition to private apartments, which promote individuality, independence, choice, and a home-like environment, assisted living residences usually equip their residences with individually controlled heating and cooling units that are controlled by the resident, security coded entrances to promote safety, larger hallways to promote a home-like environment, carpeting throughout the building (other than bathrooms) to again promote a home-like environment, and several other amenities that separate them from the nursing home industry.  Once one tours an assisted living residence and compares that visit to a nursing home setting, assisted living will win hands down.The bigger difference between the two care settings is the amount of care that can be provided in that particular setting.  Most assisted living residences are licensed in the state in which they do business.  Usually through the state department of health and environment.  As opposed to nursing home regulations, the assisted living industry is regulated differently in each state, as there are currently no federal regulations to police the assisted living industry.  The federal government is reluctant to get involved in regulating the assisted living industry simply because of the fact that it is still primarily a private pay business.  This has benefits and drawbacks.  First, the benefits: because the assisted living industry is a private pay industry, it allows providers to charge market rates for apartments and care which allows them to include in that rate enough of a cushion to carry out the philosophies of dignity, independence, individuality, choice, and a home-like environment.  The amount of rent charged in a assisted living residence is usually enough to allow these providers to staff the building with the appropriate number of staff members to meet the needs of the residents and to provide the residents with an environment that is worlds apart from that of a nursing home setting.  Because each state regulates the assisted living industry differently, services that are provided vary from state to state.  Most states require that residents of assisted living are ambulatory if they choose to reside in that setting.  In addition, most assisted living providers cannot provide skilled services in their setting.  These are the services that are normally found in a nursing home setting.  Other than ambulation and skilled services, most assisted living providers offer a wide array of services which are usually more geared to the social needs of residents as opposed to the medical needs of residents which are served in a nursing home setting.  As the industry grows, the range of services that can be provided in an assisted living setting seems to be expanding.  Because the assisted living industry is strictly a private pay industry, it does not serve those who do not require the skilled services of a nursing home but do not have the funds to afford residing in an assisted living residence.  This caused the federal government, recently, to look at the feasibility of allotting federal funds to be used by low income seniors to supplement the cost of assisted living.  This decision has not had much movement on Capital Hill but many states have adopted waiver programs to assist these seniors in their respective states.  Again, the benefit to this is that many low income seniors are afforded the right to live in an assisted living residence, but most research has found that the amount of money that is allotted each month for these residences is not enough to allow the assisted living provider to continue to provide the same kind of services that it was intended to provide.  Look at the demise of the nursing home industry.  Most of these providers set out with good intentions when entering the nursing home business, but because of the lack of funds that are provided by the federal government, most of these facilities end up with low staffing ratios, unhappy staff, very few programs, and not much left to provide anything additional.  This has caused much debate as a recent study showed that 30% of all nursing home residents do not receive the skilled care needed to be in that setting.  Of that 30%, very few had the private funds to afford assisted living, even if it was available in their local community.  The assisted living industry would support a federally-funded program to assist low income residents with the cost of assisted living but they will not support it if it impedes on the providers ability to provide the kinds of services that have set it apart from the nursing home industry.  In addition, as with receiving any federal money comes a host of government regulations, which usually requires several staff members just to keep up with all the paper pushing that goes hand-in-hand with receiving Uncle Sam's money.  The assisted living industry stance is that by requiring the enormous amount of paperwork and the staff dollars required to keep current with this, it takes dollars away from programs intended to benefit a resident in an assisted living setting.  Among other reasons, this may be why the debate on allotting federal dollars to fund the assisted living industry is at a stand still.The assisted living model of care is based on providing assistance with activities of daily living (ADL's) and is not staffed to care for the skilled needs of residents.  Assistance with ADL's includes, but is not limited to, assistance with dressing, bathing, toileting, eating, mobility, ambulation, continence, assistance with the administration of medications, verbal reminders for meals or activities, and other non-skilled services.  On the flip side, assisted living providers can arrange for skilled services to be provided to a resident through a home-health agency of the resident’s choice as long as the service is ordered by a physician and that service is overseen by a registered nurse.  Most assisted living providers employ registered nurses but many do not do so on a full-time basis.  In addition, any skilled service that is ordered by a physician usually must be provided by a registered nurse and it is for this reason that assisted living providers help residents find a home health agency of choice to provide this service.  Assisting residents with arranging for appropriate care is at the root of the aging in place philosophy.  It is the intention of most providers to allow residents to utilize their services, complimented by skilled services provided by a home-health agency of choice, if needed, all under one roof so that a resident never has to move again.  Again, the amount of skilled services that can be provided and the frequency of these skilled services vary from state to state depending on regulations.  Because of the enormous success that many assisted living owners and providers have enjoyed over the past decade, many assisted living "'wannabees'" have begun to infiltrate the market.  Because of its private pay status, the assisted living industry is looked to as a "cash cow".  Simply meaning, many developers across this country have decided that they too can slap up four walls, hammer an "assisted living" sign in the front yard, and the cash comes rolling in.  Unfortunately, because of the lack of a uniform standard of regulating the industry, many of these developers have succeeded.  Most adult children looking for the appropriate care setting for a loved one need to be on the lookout for those providers who claim to know what they doing but do not have the operational experience to back up those claims. Adult children and caregivers must do their homework when shopping for an assisted living residence.  One wants to be sure to choose a residence that has a history in your community.  When hiring any new employee, an employer always checks references.  Choosing an assisted living residence is no different.  Start by contacting the social workers and discharge planners at the local hospital to gauge their opinion on a particular provider.  These health care professionals are the referral sources for many families once a loved one is to be released from the hospital and they will only put their reputation on the line for the select few providers who provide the highest quality of services to their residents.  In addition, be sure to check with the state licensing agency that has the authority and regulatory power over the assisted living providers in your state.  Any complaints against any licensed residence in your state is public knowledge and you have a right to know the regulatory history of any provider that you are thinking about choosing for a loved one.  Lastly, keep an eye on the staff interaction with residents while you are touring a particular assisted living residence.  How do they speak and treat the residents that they come in contact with?  Not every assisted living provider has a stellar record of performance but the majority of providers do a very good job in providing an alternative to nursing home care.As you have read, explaining the difference between a nursing home and an assisted living residence is not a short answer.  The differences between the two are numerous.  Bear in mind that nursing homes fill a particular need, a need that may or may not be for you.  Assisted living residences provide an alternative... one that should always be investigated.

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Senior Living

Diane Frederick

2001-05-01 10:25:00

Question: My wife recently fell and fractured her hip.  After she has completed rehab in the hospital I am going to have to find placement for her in a long-term care facility, because I am not able to care for her at home.  I don't know where to start.  Who do I call?

Answer: There are a few preliminary questions that need to be asked and answered to best help in this very difficult situation, for example: financial questions designed to determine if paying privately is the best avenue for your particular situation.  Depending on what your assets are, you may qualify for Medicaid, which is the state insurance plan that covers the cost of nursing home care.Your wife may also qualify for up to 100 days of skilled care paid for (in part) by Medicare Part A.  The criteria for meeting Medicare Part A requirements is often confusing and not all nursing facilities provide care under the Medicare Part A benefit.You may also have a Long-Term Care Insurance policy already in place.  Depending on how your policy reads, some or all of the costs of a nursing facility may be covered.There are other issues, besides the price and payment method that are very important when deciding what will best meet the needs of your wife and yourself.  •  Physical and occupational therapy programs and whether or not there are some that are available in a location of your choice•  Activity programs that are designed for your wife's special needs•  State inspection issues, with specific regard to a facility that you may be looking at • Employee turn over rates (a high degree of turnover, particularly in upper management may signal a facility-      wide or corporate problem)•  Prescription medication issuesIt is also very important that you obtain the legal right to make health care decisions on behalf of your wife, should the need arise.  A ‘Durable Power of Attorney’ guarantees your right under the law to make decisions for your wife if she is ever unable to do so herself.  Remember that an  aesthetically beautiful nursing facility does not always guarantee quality care, just as a facility that is a little worn around the edges does not always signify poor care.  Look around as you tour the building.  Are the residents clean?  Do they smile and seem happy?  Does the staff smile and interact well with each other and with the residents?  Is the building clean and does it smell good for the most part?  These are all signs of a quality facility, run by quality people.  Most important of all, be proactive in your wife's recovery and if at all possible, be a presence in the facility.

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Senior Living

Murl Webster

1969-12-31 18:00:00

Question: Can hypnosis be used to help in business?

Answer: Yes! Hypnosis can be used in so many ways to assist the business owner, and employees to be more successful. It can relieve stress, increase focus, decrease wasted time, insurance costs, and absenteeism, increase production, sales, and morale.. The list is almost endless. Most companies, whether they are a factory producing a product, or a service organization, have stress which decreases production. It may be the kind of stress that inhibits sleep, resulting in a tired, less focused, slower, less accurate employee. Maybe the stress results in attempts to nervously hurry on the production line, or to try to cut corners, resulting in more scrap. Maybe the stress causes the conscientious employee to transpose figures. Or maybe it just makes life miserable resulting in call-ins, tardiness, or just takes the fun out of what could be a good, fun, job. Hypnosis can be used to easily deal with stress. My employees are always under stress. They are expected to always be on the run, taking care of residents, while trying to comply with multiple conflicting rules from several different regulatory agencies. In short, they are overworked and underpaid. Their wages are indirectly set by governmental agencies, such as Medicaid, which again is cutting back on payments so they know raises will be minimal, if at all. They try to work extra to make up for the low pay and they get tired. Stress causes them to forget details, or to try to fit in an extra break, or not be able to be a good parent when they get home. I periodically offer them a stress relief workshop, where I teach them techniques for relieving stress. We begin the workshop by discussing how the techniques work, and then suddenly, they’re relaxed, as we teach them the techniques they can use for the rest of their lives to relieve stress of any kind. Most of them are totally shocked when they find a stress relief technique can take as little as 20 seconds while standing up right in the middle of performing their duties. I’ve never had a one of them attend and not come away amazed at the abilities they had developed in relaxing. We teach them twenty-second methods and we teach them methods which are a little more time consuming and a lot more fun.. I hear a lot from my staff about “stress-headaches” They never need to have another one after they attend my workshop. With a disproportionate number of staff members being single mothers, you can imagine the stress they are under while trying to work and raise a family at the same time. It really does my heart good when I can make their lives better. My greatest concern is that so many are so very busy taking care of others., they think they don’t have time to attend a stress-relief workshop for themselves. It really doesn’t matter where the stress stems from, hypnosis can help relieve it. Sometimes, self-esteem issues crop up in the workplace, keeping a person from doing their job. Hypnosis can help. Depression can seriously impact work and/or relationships with other employees. Hypnosis can help. Smoking is one of the serious impediments to getting work done. Most businesses who employ smokers will tell you they are sick more, miss more work and take more than their share of “smoke breaks.” For the person who wants to stop smoking, hypnosis can immediately end their desire for cigarettes forever. As I tell them. “It’s a slam-dunk.” In fact, the last time I checked, the IRS was offering direct tax credits for people who used hypnosis to stop smoking. (You might want to check with your accountant on that one and not take my word for it since IRS regs change all the time.) There is an epidemic of obesity in our country. With it comes increased illnesses, needs for expensive equipment and accommodations, slower motion i.e decreased production and increased absenteeism. Obesity costs business owners huge amounts of money every year. Hypnosis has long been known to be effective for weight loss. In fact, “O” magazine ran an article a couple of years ago about some tests they had run which showed people using hypnosis for weight loss, lost more weight and kept it off better. By the way, IRS also used to offer direct tax credits for these programs too, but you had to have a physician’s order for them before it worked. Again, it’s a good idea to check it out before depending on it Hypnosis lends itself very well to helping those who are in the business of sales. And in reality, what business doesn’t sell something. Whether its an item or a service, all businesses sell something. As Zig Ziglar, the guru of sales used to say. “Nothing happens (in business) until someone sells something.” Hypnosis can make that system work so much more smoothly. Too often, we think of salespeople as pushy, disgusting, plaid-coated antagonists who are out to separate us from our money with no benefit to us. Because of that attitude, which is prevalent among many, the sales person dreads trying to get through the door to make his sales calls, anticipating rejection if not outright hostility. The salesperson is nervous and tense when they begin their presentation. The voice may be higher pitched, and/or louder and often times they talk faster than normal, trying to make their point before being rejected. That situation tends to make me listen less and prepare more to tell them how busy I am and invite them to leave without a fair hearing.. Having been a salesman at one time, I am familiar with both sides of the desk and realize that most salespersons, while they are trying to get me to buy something, usually have a good product, whether it is appropriate for my needs or not. In reality, salespeople are service people. They are information centers that can help me with my business, However, if they rankle me when they come in, I am far less likely to give them a fair hearing, even though it may be a product that I need. Hypnosis for the salesperson, and for sales supervisors is a wonderful tool. It can result in the person coming through the door being a helper to the businessperson as opposed to an irritant. Most people in sales believe in their product. Otherwise they wouldn’t be trying to sell it. Of course, there are the charlatans out there who are just trying to get your money, but in reality they are few and far between. Then why is it, that sales people often seem so pushy or objectionable? In reality, it is usually because they are afraid. “What?” you say? “Do you mean to tell me that pushy, loud-mouthed, character who couldn’t understand a simple NO, was afraid?” Yes he was, and through hypnosis, we can find, isolate and remove that fear. Once the fear is gone, we can have conversations, rather than confrontations, and instead of a sales presentation, we have a discussion about needs and solutions. Of course, the fear is not just on the part of the salesperson. Usually there is a little subconscious fear in each of us that someone might take advantage of us. If we can allay that fear also, the conversations center on substance and solutions. The fear of public speaking in one of its many forms is usually the base fear of the sales person. Interestingly, a study a few years ago found that people were more afraid of speaking in public, than they were of dying. Now we know the people saying that “I’d rather die than be forced to speak in public” are probably telling the truth. However, they may also have had a fear of strangers instilled in them while they were very young. While that fear is no longer in their conscious mind, it has been submerged into the subconscious, which never forgets anything! The fear of strangers, while meant to protect the child from predators, now has become a fear which prevents success. Another operable fear is the fear of success, again, an imprint in the subconscious mind, usually there since childhood. Hypnosis, can be used to determine the origin of the fear and remove it enabling the sales person, or business person to do their job of helping others obtain what they want and need -- which is they goal of any business. While all of us know that businesses are intending to make money, they in reality only do it as long as they provide something that others want or need. As Earl Nightingale used to say. “If you just help enough people get what they want, you’ll get rich.” As a hypnotist, I like helping people in business help other people. Helping people get what they want is what I do. (“I’m waiting for the rest of Earl’s saying to come true!”)

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Senior Living

Carla Shepherd

1969-12-31 18:00:00

QUESTION: My father has recently retired after a very demanding career, which never allowed him time to pursue hobbies. Now he has nothing to do and I'm worried about him staying "sharp". How can I convince him that "you’re never too old" to learn?

ANSWER: The theory of "use it or lose it" when it comes to your brain is popular among senior health experts, and several recent studies support the idea.  Among the more effective means of keeping one's mind sharp are acquiring additional skills or exploring new hobbies.  The start of the New Year can provide just the motivation to try different activities and preserve their memories.For many seniors, now is the perfect time to pursue the interests they previously never had time for.  More importantly, learning something new can help improve memory and how well the brain functions. Scientists have found that seniors who constantly stimulate their minds by reading, playing music, and enjoying board games had lower rates of Alzheimer's disease and dementia.  In general, seniors who make the effort to keep learning tend to retain more of their mental abilities as they age.  Beginning a hobby or taking a class to learn something new is great ways for seniors to keep sharp. Computers, dancing, cooking, musical instruments and photography are popular options. Activities involving language and music are especially beneficial.  Recent research has indicated that people fluent in more than one language and those who devoted time to cultural interests performed better on demanding memory tasks.  Seniors can take advantage of discounts at local museums and galleries, or explore different musical genres by borrowing some music from their family and friends or their local libraries.Other important aspects of maintaining mental function are companionship and physical activity.  Interacting with others offers powerful mental stimulation, while exercise can help keep your brain physically healthy.  Why not combine them both?  Walking with a friend or caregiver, volunteering with young people, or participating in low-impact sports all contribute to improved memory.Whatever new activities seniors pursue in 2005, they should remember that with every learning experience comes the opportunity to improve their minds and preserve their memories.

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Senior Living

Jennie Maison

1969-12-31 18:00:00

: My Grandfather has Post Traumatic Stress Syndrome and is now showing signs of Alzheimer's. Are the two somehow linked?

ANSWER: Post Traumatic Stress Syndrome (PTSS) is a disorder in which an overwhelmingly traumatic event is re-experienced. This causes intense fear, helplessness, horror, and avoidance of stimuli associated with the trauma. In most cases the traumatic event will have occurred in childhood or young adulthood. People who suffer from PTSS "relive" the experience intermittently throughout their lives. These events are triggered by external environmental factors, internal physical factors, or another life-altering event. PTSS is a psychological disorder and can be treated.Alzheimer's disease is an organic disorder affecting the brain. Initially we recognize memory deficits, but the progression of the disease is both devastating and fatal. Increasing deficits in cognition are accompanied by changes in behavior and personality. Eventually, the patient loses the ability to perform the tasks of daily living, and finally, a complete inability to function.A patient experiencing PTSS may parallel Alzheimer's patients with episodes of depression that will render the PTSS sufferer unable to perform daily living tasks, but that inability is secondary to a lack of motivation initiated psychologically, meaning the ability to perform tasks remains intact-the desire to do so is lacking. In PTSS one may observe behavioral changes in an individual. Alzheimer's patients also experience behavior changes, but they are part of a physical disease process, whereas the changes seen in PTSS are of an emotional nature. Memory loss is another parallel between PTSS and Alzheimer's. Often the memory loss related to PTSS is an intentional suppression of past events. Alzheimer's patients have no intention of forgetting anything. Again, PTSS is a psychological process; Alzheimer's is an organic disease process.Physical debilitation is certainly a factor in both disorders. The severely depressed individual may not ingest food or oral fluids, resulting in malnutrition and dehydration. It is a choice made by that patient with PTSS in the darkest hours of his illness. Alzheimer's patients simply forget they need nutrition and hydration, and do not recognize hunger or thirst.The cause of PTSS is known to be a horrific event of some sort in the life of the patient; it can be treated when diagnosed and the event or series of events identified. We are blessed to have state-wide a multitude of counselors, social workers, psychologists, and psychiatrists to aid those who suffer from psychological disorders. Sadly, the cause of Alzheimer's is unknown, and currently there is no treatment modality offering a cure.Both PTSS and Alzheimer's disease are serious illnesses with devastating consequences. There may be mirror images of some of the by-products of the two processes, and certainly some parallels noted, but there is no physical "link" which unites to form one disease. In either milieu, patients and families require and deserve emotional support, compassionate caregivers, and professional expertise to promote the highest quality of care.

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Senior Living

Doug Stark

1969-12-31 18:00:00

: My father is losing his memory but how do you convince your parent that you know what you're talking about and they don't.  It hasn't become a safety issue yet but I feel that is the next step, what can I do?

ANSWER: The transformation or reversal of roles with a parent whereby the relationship with them moves to mirroring the relationship you have with your children of care and protection, is very difficult at best with most parents.  It just goes against all natural instincts for you to be in a position of correcting, directing or arguing with a parent about what the reality of a particular situation is.  Not only is it unnatural for your father to be told by you that he is wrong, but it is very frustrating for the children in this situation because in reality you so desperately want your parent to be back in a place that they never will be.   There are many causes behind loss of memory and gaining some understanding of the root cause behind the disease process may go a long way in helping you understand how to deal with your father, or if nothing else, relieve some of your frustration.  What needs to be understood first is that memory loss is not a normal process of aging.  It is diseased aging.  For those 65 and above approximately 10- 15% of the population suffers from some form of memory loss or dementia.  For those 85 and older the number climbs to 47.5%.   Alzheimer's disease (AD) is the leading cause accounting for 50 - 70% of those afflicted with dementia, but as I said earlier there are certainly other causes as well.     Without getting into a lot of complicated detail because the physiological changes that take place in a diseased brain are many, there is a little horseshoe area in the center of the brain known as the hippocampus.   And again, speaking in generalities the memory process starts in the hippocampus and other surrounding and closely related areas of the brain.  All input travels through this area where in the disease free brain associations are attached to specific events along with processing and forming the emotional components of memory.    Unfortunately this area is particularly ravaged by AD, consequently the formation of new thoughts or keeping track of current events becomes very difficult and at some point in the process, are virtually impossible.  When you combine this 'short circuiting' if you will where new information just never gets sent to the appropriate area of the brain for storage and future retrieval and combine it with the many other physiological changes taking place, the bottom line of how do you convince your father that you are right,  is that you need to come to the reality that at some point you can't.  Its not that your father just wants to be right or argue with you, he just can't engage in a logical discussion with a brain that is no longer processing information logically.   Between the hippocampus not processing the new information along with declines in other areas of the brain that affect reasoning, executive functioning, and many times their emotional state, you are fighting a loosing battle.  This as I said earlier is so frustrating because you feel that if you only approached it differently or said it another way, then surely he will understand.  It becomes even more frustrating when much of their memory of old events is still intact.  In the earlier stages of the disease process memory of the farm in Oklahoma from 50 years ago usually remains.  Remember, it is new memory (or often referred to as short-term memory) that is lost first.     In caring for the memory impaired as we do in our homes, there are two fundamental concepts, reality orientation and validation.  The basic idea behind reality orientation is that when dealing with someone that is confused about something, if by correcting them clears up their confusion and brings them at ease then you have help by essentially rescuing the individual by bringing them back to reality.  For example if your dad were to be getting ready for Sunday church and it is only Thursday, if through a simple correction of what day it is he is able to process the information, understand and thank you for setting him straight, then you continue to use reality orientation.  On the other hand for the reasons laid out above, at some point in the disease process logical discussions are not possible.     Validation therapy kicks in at this point whereby you validate what is going on in the mind of the memory impaired.  You simply can't bring them to your world because they are no longer able to process the information.  As you continue to try to make them understand they can get more agitated because the two of you are simply not on the same page, which can lead to an argument, raised voices, hurt feelings, etc.  The fact of the matter is that the problem lies with the cognitive individual trying to force a demented individual to understand!  They can't.  An example of validation therapy would be if one of our 85 year old Residents begins a search for their mother (which is a fairly common occurrence) our approach would be to engage them in a discussion about their mother, explore with them the love and feelings they had for their mother and not try to bring them to the reality that mom passed away a long time ago.  At some point what is in the minds-eye of an individual with dementia is their reality.  We cannot bring them to ours so we move to theirs by validating their feelings and knowing full well that they will most likely move on to another thought or subject soon.   As far as the issue of safety and what should you do, first I would suggest that you become educated about the disease process and what lies ahead.  A call into the Alzheimer's Association and a conversation with one of the four very informed individuals there at 267-7333 is a good start.  They have a family counselor by the name of Celia who can meet with you and discuss your particular situation, and they also have a library of books and videos regarding memory loss. The best advice I can give you if you think you are heading down the road of needing placement for your loved-one in a long-term care setting some day, it is always best to do your 'homework' early.  Many times facing a crisis situation is not the best time to start looking at your options.