New York Nursing Home Abuse

Nursing homes are meant to be a safe place for the elderly where help is provided to those who cannot attend to their own daily needs. Whatever the best intentions of staff and nurses are, often patients fall through the cracks. Unfortunately abuse in skilled nursing facilities is a somewhat common occurrence. It has been reported that there is a rise in the number of abuse claims in many nursing homes within New York.

Hospitalized senior citizens often become victims of abuse, incompetence, and neglect. In some cases, patient records in nursing homes have been doctored in order to hide problems. The increase in New York elder abuse is the same as throughout the country: large corporations expect large profit from nursing homes yet provide less care for patients. These facilities are often understaffed and their nurses and nursing assistants underpaid. These problems are typical throughout the nursing home system. Larger cities often bear the worst level of consequences for patients in elder homes.

Instances of Abuse of Elderly in New York

Typical examples of elder abuse are cases where the elderly patient suffers from bed sores. When neglected and treatment not given for an issue such as this, the sores become so infected the bedsores reach the level of residents' bones, causing infection and pain for the patient. These sores are painful and rather difficult to treat and cure, and arise mainly because of insufficient staff or poor care, leading to inadequate care of the patients' daily living needs. Other areas of concern are personal hygiene, adequate food and hydration and response to patients' daily needs.

In more severe cases, elderly residents' have also become victims of rape, physical abuse and other violence in nursing facilities. Although rare, these situations arise when staff are not properly screened during employment interviews, poorly trained or poor quality staff are hired due to low wages for the position. There are times these types of cases go unnoticed or undocumented. Family members may contact their local Ombudsman who act as a liaison with the nursing home and the state to deal with severe staff and patient problems. Family members must be proactive when addressing this type of abusive situation. Documentation of events by family members can then be discussed with the New York local Ombudsman and a nursing home abuse attorney may be brought in to advise and prepare litigation if needed.

Corporation Profit vs Insufficient Nursing Staff

Skilled nursing facilities are often understaffed with workers who are underpaid for the amount of work they do. Even the best intentions by CNA's (certified nursing assistants) go by the wayside when severely understaffed. When time constraints happen CNA's must provide care to eight to fifteen patients at a time. This can result in less care taken when feeding a patient, dressing and daily care of patients. As some skilled nursing facilities cut down on staff to increase their profits, the existing staff does not have sufficient time to ensure all their residents get fed, bathed, clothed, gotten up from their bed to their wheelchair or taken to social acitivities. A lack of hygiene can mean bedsores for an elderly resident. Overworked and underpaid staff at times equate to poor quality care for elderly patients.

Patients Medicated to Keep Quiet

Another issue that may happen in these facilities is inadequate medical care. Doctors do not always visit the patient on a timely basis. Registered nurses (RN's) are stretched thin as they too are usually understaffed. The lack of time for quality medical care at times leads to more medication to quiet the patient. Over medication is elder abuse and should be addressed with your attorney.

New York Nursing Home Provider Associations

Nursing home provider associations often have helpful information about skilled nursing facilities that are their members. Here is a list of New York organizations focused on assistance to elderly care.

County Nursing Facilities of New York
111 Pine Street
Albany, New York 12207
Phone: 518-465-1473

Greater NY Healthcare Facilities Association
360 W. 31st St., Ste. 303
New York, New York 10001
212-643-2828

Greater NY Hospital Association
555 West 57th Street
New York, New York 10019
212-246-7100

Healthcare Association of NYS
1 Empire Drive
Rensselaer, New York 12144
518-431-7600

Intercounty Health Facilities Assoc.
1615 Northern Blvd. Suite 306
Manhasset, New York 11030
516-627-3131

NY Association of Homes and Services for the Aging
150 State Street, Suite 301
Albany, New York 12207-1698
518-449-2707

NYS Health Facilities Association
33 Elk Street, Suite 300
Albany, New York 12207-1010
518-462-4800

Southern New York Association, Inc.
39 Broadway, Room 2805
New York, New York 10006
212-425-5050

With so much going on behind closed doors of New York nursing facilities, the families of elderly residents must turn to civil litigation for justice. It is often difficult to prove abuse with elderly in a skilled nursing setting. Working with an attorney who is knowledgable about New York state regulations for the elderly is advisable. Contact a reputable New York elder law attorney who specializes in these types of cases.for advice on how to proceed with litigation.

Health Care Providers Should Hang on Tight - ZPIC Audits of Medicare Claims Are Increasing

The first half of 2010 has been hard on health care providers. With Recovery Audit Contractor (RAC) audits ramping up around the country, many providers have found that while RAC audits may be on their way, a more pressing concern is represented by the Zone Program Integrity Contractor (ZPIC) responsible for auditing Medicare providers in their "zone." ZPICs are but one of the commercial contractors hired by CMS to conduct the medical reviews of Part A and Part B health care providers. Over the last year, ZPICs have been taking over where Program Safeguard Contractors (PSCs) left off. While our firm is still handling a number of cases that were initiated by PSCs, all of our recent cases have involved ZPICs.

As PSCs and ZPICs have been so quick to point out, they are not paid a percentage of the Medicare overpayments identified like their fellow medical reviewers - Recovery Audit Contractors (RACs). Nevertheless, as you will soon see, they are handsomely paid for their efforts, albeit in a different fashion than are RACs.

It is essential to keep in mind that both RACs and ZPICs are designed to "find and prevent waste, fraud and abuse in Medicare." Further, like their RAC cousins, ZPICs look at billing trends and patterns, focusing on providers whose billings for Medicare services are higher than the majority of providers in the community (e.g. their peers).

ZPICs are responsible for conducting:

• Medicare fraud investigations, including referrals to law enforcement;


• Medicare data analyses (discovery, detection, investigation, and overpayment projection);


• Medical reviews to support fraud case development, including coverage and coding determinations;


• Reviews, audits, settlements, and reimbursement of cost reports, and conducting specified audits;


• IT systems activities for case and decision tracking and data warehousing;


• Interface services with Medicare contractors, the medical community (outreach & education), and law enforcement; and


• Medicare / Medicaid data matching program safeguard work for each state in their particular zone.

ZPIC Extrapolations of Alleged Damages:

Over the years, we have gone up against PSCs and ZPICs numerous times, challenging their interpretation of LMRPs / LCDs and assessing the methods they utilized to engage in a statistical extrapolation of the alleged damages in our client's cases. To give these companies their due - the statistical experts they employ are smart, aggressive and do not hesitate to respond when their methods have been challenged. We like that - it keeps us sharp.

With the help of some of the best statisticians in the country, in many cases, we have been able to show that their extrapolation of damages has not complied with applicable requirements, and is therefore invalid. To be fair, every extrapolation is different, both in terms of facts, the methodology employed, and in the associated calculations conducted. As attorneys, we work with our experts to break down and assess the ZPIC's calculations. Perhaps they handled it appropriately - or maybe they didn't. There really isn't any way to know if it was handled properly without a complete copy of their file (including associated work papers and calculations) so that we can fully assess their actions.

Over the last year, we have seen a marked increase in Medicare ZPIC contractor participation (as "participants" not as "parties") in ALJ hearings. Their experts have consistently been professional, concise and ready to answer any questions posed by the ALJ. Our recommendation - both counsel and their defense expert better be prepared. It's never to early to start thinking about how to best contest the extrapolation that has been conducted. As a final point, we are aware of a number of instances where a provider (or their representative) has chosen to ignore the extrapolation as a contestable issue. In other words, they just accept the extrapolation as a foregone conclusion and focus solely on the claims. We strongly disagree with that approach. If we identify deficiencies with the extrapolation, we aggressively challenge its application.

AdvanceMed's Medical Reviews:

Once a provider has been identified as an outlier (or identified as a possible problem through a variety of other mechanisms), a medical review of their claims is often conducted by a ZPIC.

A number of year ago, Kevin Gerold, CMS' former Acting Deputy Director for Program Integrity was quoted as saying that the agency had revamped its approach to claims processing in an effort to better "grasp the experience of the patient encounter." Mr. Gerold was further quoted as saying that CMS was going to "let medical reviewers assess a claim's legitimacy based on the big picture of the patient encounter, not on a nit-picking slavery to perfect documentation." Unfortunately, in our humble opinion, many ZPIC medical reviews have conducted have been extremely technical - resulting in the denial of many claims based on minor omissions, technical deficiencies and / or the contractors' own peculiar spin regarding the application of an LCD.

In responding to a ZPIC's reasons for denial, it is essential that you obtain each and every reference relied upon by the contractor when denying the claims at issue. We have identified multiple instances where a contractor (not necessarily AdvanceMed) attempted to apply an LCD retroactively. Moreover, it is important to examine the underlying statutory authority to determine whether the contractor's interpretation of a coverage provision is consistent with the underlying law or regulation. Finally, it isn't enough to merely "poke holes" in the ZPIC's reasons for denial - we like to go one step further - show that the particular claims at issue do, in fact, qualify for coverage and payment. Should you learn that your practice or clinic is under review, we recommend that you immediately contact an experienced attorney to represent your practice and handle your defense.

The Must-Have Traits of a Pharmacy Technician

Job opportunities for pharmacy technicians are increasing. The reason for this is that pharmaceutical services are expanding and scientific advancements are continuing. Also, pharmacists are having a more active role in providing direct patient care. As a result, pharmacy techs are taking over some of the duties performed by pharmacists. However, they will still work under the supervision of a licensed pharmacist. Another reason pharmacy tech career is booming is the fact that people in the US are living longer resulting in an increasing demand for health care services. And because many companies are exploring new medical treatments, pharmacists need qualified technicians to assist them in handling some of their obligations. If you are considering a career as a PT, you should strongly consider certification.

Required traits

Not all individuals can work as a pharmacy technician. There are certain skills required to get a job in this position. The following are the required traits you must have to qualify for this position:

-Excellent communication skills

-A team player

-Can follow exact directions easily

-Highly organized

-Mentally alert

-Physically fit

-Able to interact with different types of people

-Compassionate with the health care needs of the patients

How to work as a pharmacy tech?

Job opportunities are high if you have obtained formal training and certification. If you are really interested to pursue a career in this field, you should have an experience in this area. You should improve your written and verbal communication skills. Your mathematics skills should be strong enough for pharmacy computations. It is also ideal to obtain health related courses.

Understanding the duties required

-Receiving prescription requests

-Labeling bottles

-Counting bottles

You are also tasked to deliver the requested medicine after the licensed pharmacist has already checked its accuracy. Apart from that, you are also required to keep patients' records, maintain storage of stock and perform other administrative duties.

Required Training

The career of pharmacy technicians is very lucrative. However, those who underwent formal training are the ones who can enjoy higher salary rates. A formal education program for PT's can be taken within 2 years. The education training programs will cover subject areas such as:

-Pharmaceutical calculations

-Pharmaceutical record-keeping

-Pharmaceutical terminology

-Pharmacy law and ethics

-Pharmaceutical techniques

Depending on the school that offers pharmacy technician education programs, you can have the opportunity to gain actual experience working as a pharmacy technician.

In terms of work locations, pharmacy technicians work in a clean, safe environment. You can work in a retail or mail-order pharmacy, nursing homes, and assisted-living facilities. You can also apply to work in grocery stores and department stores that offer pharmacy-related services.

Group Insurance Benefits - Section 125 Plans

What are Section 125 Plans?

One type of group insurance benefits that may be offered by an employer are Section 125 Plans. These Section 125 Plans are also known as cafeteria plans, flexible benefit plans or mini-flex plans. The Internal Revenue Code Section 125 outlining these plans first appeared in the tax code in 1978, but didn't gain popularity until tax laws changed in 1986 and gave employees greater tax advantages.

The purpose of the code was to allow employers to have a separate written plan for their employees that provided them with an opportunity to receive certain fringe benefits on a pretax basis. All plans are strictly regulated by the IRS and must meet specific requirements and regulations that can and do change. The written plan must specifically describe all benefits and establish rules for eligibility and elections. Because of the stringent guidelines, many employers offering these plans have them administrated by an outside source.

How do Flexible Benefit Plans Work?

Each payroll through a deduction from their paycheck, the participant contributes money to a Spending Account. This money is not taxed. The participant is then reimbursed from this account by their employer (or outside Administrator) for those health care expenses not covered under a health insurance policy or by a health care provider.

The participant's expenses are reimbursed in full up to the maximum amount of their annual election at the time the claim is submitted. The expenses must be incurred during the plan year while they are covered by the plan. Any funds left in the Spending Account at the end of the plan year will be lost.

These plans run for a year at a time. At the beginning of the plan year, the participant chooses how much they are going to contribute - called the annual election. A participant can have two Spending Accounts; one for themselves (called the Health Care Account) and one for their dependents (called the Dependent Care Account). The Health Care Account and the Dependent Care Account are treated separately and so funds from one account cannot be transferred to the other account.

In deciding what the annual election should be, a participant should look at their health insurance deductibles and copayments, as well as uninsured medical, dental, vision care and hearing care expenses. The uninsured expenses covered must be "medically necessary" as determined by a doctor or healthcare service provider.

You may see some generalized expense categories listed when people talk about what expenses are covered. These may include things like:

> Non-reimbursed medical expenses resulting from charges due to hospital, physician, dental, orthodontia, vision, and prescription drug expenses incurred.

> Deductibles and copayments resulting from charges due to hospital, physician, dental, orthodontia, vision, and prescription drug expenses incurred.

> Rehabilitation services over a long-term period to include drug and alcohol addiction.

> Health care expenses that meet medical expense requirements for federal income tax purposes.

There is actually a lot more to the eligible expenses. Please see the detailed list at the end of this article for this year's eligible expenses.

Why are Flexible Benefit Plans Good?

From the employer's point of view, you are offering your employees an added benefit and helping them to save money on their taxes.

From an employee's point of view, you save taxes and you pay for health care expenses not covered under a health insurance policy or by a health care provider with money that has been set aside for you through payroll deductions. Thus, when these expenses come due, you don't have to pay for them from your daily cash flow.

Without a 125 Plan, you have no pre-tax deductions for premiums, child/dependent care or other out-of-pocket medical expenses.

So say you made $26,000 a year. Without the pre-tax deductions allowed by a 125 Plan, you would be taxed on the full $26,000. At a Federal Income Tax Rate 15%, a State Income Tax Rate of 3% and a Social Security Tax of 7.65%, you would be taxed a total of $6,669.00 on your income of $26,000 if you didn't have a 125 Plan.

If you had a 125 Plan and paid $1,000 for premiums, $5,000 for child/dependent care and $500 for out-of-pocket medical expenses for a total of $6,500 you would be taxed on $19,500 instead of the full $26,000.

At the same tax rates mentioned above, you would be taxed a total of $5,002.00 if you did have a 125 Plan.

And don't forget without a 125 Plan that you would still have those premium, child/dependent care or other out-of-pocket medical expenses of $6,500 to pay.

So what does that all mean to your net take-home pay?

Without the 125 Plan:

$26,000 = $12,831

With the 125 Plan:

$26,000 = $14,498

By participating in a 125 Plan, you would bring home an extra $1,667.

Finally, as promised, here is a list of this year's eligible expenses:

Acupuncture

Alcoholism treatment

Ambulance service

Artificial limbs

Artificial teeth

Body Scan

Braces

Birth control pills

Braille books and magazines

Car expenses for the installation of special hand controls or other special equipment for the use of a person with a disability

Chiropractor

Christian Science Practitioner

Contact lenses, solutions and insurance

Coinsurance

Corrective surgery to improve a deformity arising from or directly related to a congenital abnormality, a personal injury resulting from an accident or trauma or a disfiguring disease

Crutches

Deductibles

Dental fees

Drug and alcohol addiction treatment

Eye exams

Eyeglasses

Eye Surgery when performed to correct visual acuity; (example: laser vision correction)

Guide dog or other animal trained to assist persons with physical disabilities

Hair transplants as a result of a medical condition

Hearing devices and batteries

HMO copayments

Home improvement or special equipment installed in the home for the main purpose of medical care

Hospital bills

Immunizations

Inpatient confinement for mental or physical illness or injury

Insulin and glucose testing equipment and supplies

Laboratory fees

Lead-based paint removal from walls to prevent lead poisoning

Lifetime care fee for medical care only in a retirement home

Lodging expenses when primarily for and essential to medical care

Medical doctor fees

Medical information plan

Medical supplies prescribed for treatment of a medical condition

Medicines prescribed by a medical doctor, osteopath, dentist, chiropractor and/or optometrist

Mentally handicapped persons' cost of special home

Nurses fees

Nursing home medical care fees

Obstetrical expenses

Operations

Orthodontia

Orthopedic shoes

Osteopath

Over-the-counter medications such as allergy medicines, pain relievers and cold medicines, etc.

Oxygen

Podiatrist

Prescriptions (see Medicines)

Prosthesis

Psychiatrist

Psychologist

Smoking cessation program participation and prescribed medication only

Special schools and education for a mentally or physically impaired person

Special telephone and television equipment for a hearing-impaired person

Surgical fees

Therapy treatments for a medical condition

Transplant expenses including payments for surgical, hospital, laboratory and transportation expenses for a donor or a possible donor of a kidney or other organ

Transportation expenses primarily for and essential to medical care

Tuition at a special school for the handicapped

Walker

Weight loss program if prescribed by a physician (excluding the cost of food and/or supplements)

Well-baby and well-child examinations

Wheelchair

Wigs required as a result of a medical condition

X-rays

You should also be aware of the ineligible expenses:

Cosmetic surgery and dental expenses incurred for the general improvement of appearance including face-lifts, hair transplants, hair removal (electrolysis), liposuction, teeth whitening (bleaching)

Custodial care in an institution

Funeral expenses

Health club dues, fitness centers, YMCA membership, spas, massages, etc. for general health improvement

Household and domestic help

Illegal operations, treatment or drugs

Insurance premiums for Life, Accident and Long Term Care coverage

Maternity clothes, diaper service, etc.

Over-the-counter medications, herbs, vitamins and nutritional supplements purchased for overall good health.

Rogaine, unless prescribed for the treatment of high blood pressure

Social activities such as dance lessons or classes (even though recommended by a physician for general health improvement)

Special school for a problem child for anticipated benefits child may receive from the course of study and disciplinary methods

Uniforms

Section 125 Plans are definitely a good benefit for employers to offer their employees and a good benefit for those employees to take advantage of.

Choose Dumpster Rental for Your Next Major Cleanup or Cleanout Project

Maybe you re moving cross-country and want to get rid of all the junk that s been cluttering your home. Maybe you re transitioning an elderly relative into an assisted living facility and need to clean out his or her space. Or maybe you re renovating your building and need help getting rid of the construction debris. In these and other scenarios, dumpster rental is the ideal solution.

Most dumpster services allow you to rent a certain size container for one or more days. The rental company will arrive at the specified time with the dumpster in tow and leave it for you to fill as needed. At the end of the rental period, the company will return to tow away the container and dispose of its contents.

What are the benefits of choosing dumpster rental over gathering and disposing of junk, trash, and other debris yourself? Renting a dumpster can:

• Save you time: Imagine driving back and forth to the dump or the local recycling center with load after load of unwanted materials and items. Now imagine staying on your property and being done with those items the moment you toss them into a dumpster. Dumpster rental saves you all of that driving time, which can speed up your cleanup or cleanout dramatically.


• Give you a central trash area: In the case of large-scale cleanouts and cleanup projects, it can help for everyone to know exactly where the garbage or junk goes once it s out of your building or the construction/demolition area. Rather than stacking up black garbage bags along the curb or filling your lawn with items to be carted off, one by one, with dumpster rental service, all the junk goes to the same place. This can further speed up your cleaning process, as well as minimize collateral damage to your property.


• Ensure proper disposal: Do you know the laws regarding disposal of appliances, furniture, construction debris, and garbage in your area? If you tackle trash removal yourself, you might unknowingly dispose of items incorrectly. Improper disposal can lead to fines plus the possible frustration of having to return to fetch those items and take them to their rightful resting place.

The cost of dumpster rental will vary based on the type of junk you have to get rid of, how much that garbage weighs, and how long you need the container on site. It might not be cheap, but if you consider that you re likely to finish the cleanup faster than with DIY disposal, spend less money on gasoline, and avoid fines, dumpster service can be well worth the cost. And don t underestimate the emotional benefits. When you call to schedule dumpster rental, you ll feel relief that a frustrating, overwhelming, or just plain long cleanup might be finished hours or even days sooner. As you watch the dumpster drive away, you ll have peace of mind that the junk is out of your hands and out of your life.

How Much Does a Certified Nursing Assistant (CNA) Earn?

There are so many great reasons to become a Certified Nursing Assistant: plenty jobs available; choices in work environments; the opportunity to make a difference in people's lives every day; and the ability to earn a good living. The average annual salary for a CNA is almost $30,000.

Training can be completed in as little as two weeks through a hospital or nursing home, or take up to 3 or 4 months through a community college training program. Once training and licensing is completed, a Certified Nursing Assistant can  see an average starting salary between $11/hour and $14/hour.

Exactly how much a Certified Nursing Assistant earns will vary somewhat, depending on geographic location, workplace, experience, and other factors. A CNA working in a hospital in New York, for instance, will earn approximately 8% more than a similar position in  Arizona. Generally speaking, salaries follow COA's or "Cost Of Living" indexes. The more expensive area's such as the Northeastern US generally pay higher wages than the mid-West.

The type of position will have a bearing on earnings as well. Hospitals are usually the highest salary, followed by nursing homes, then patient homes. Even within a hospital, pay will vary by department: a nurse assistant working in ICU - the Intensive Care Unit - will often receive a slightly higher wage than a nurse assistant in a lower-stress department.

A working CNA can also expect their pay scale to go up with experience. As a profession, nursing - and Certified Nursing Assistants in particular - have a fairly high 'burn-out' rate. As the job often carries with it a great deal of physical and emotional stress and exhaustion, some people find they don't want to stay in the field. One result is that the numbers of CNA's with experience diminishes. Another result is that there are plenty of jobs in the field available.

In addition to base pay, most nurse assistant and medical assistant positions offer benefits, such as health coverage and retirement savings plans. While some nursing positions are filled through agencies, and those typically do not have the same types of benefits, most medical facilities and institutions such as hospitals, nursing homes, medical clinics, and such do offer excellent benefits packages to their employees.

The medical and health care fields are virtually recession-proof. Even in the toughest economic times, a properly licensed Certified Nursing Assistant rarely has difficulty finding a good-paying job. There were estimated to be over 500,000 individuals employed as nursing assistants, medical assistants, etc. in 2008.  As a profession, nursing assistants are ranked well above average in the field for job growth, job sustainability, and potential. It is expected to remain one of the market's fastest-growing jobs for years to come.

According to the U.S. Bureau of Labor Statistics Office of Occupational Statistics and Employment Projection, the projected growth rate for nurses aides and nursing assistants is expected to grow by a combined 28 percent. This is even faster than the medical health care field in general, far outpacing the expected 14 percent growth of LPNs (Licensed Practical Nurse) between the years 2006 and 2016.

By becoming a Certified Nursing Assistant, you take the first steps towards a rewarding and fulfilling career, unlike any other. As a medical professional, you will earn respect, personal satisfaction, job security, and financial safety.

Neglected Loved Ones In Nursing Homes

It is a sad reflection of the state of humanity when one reads about nursing home abuse and other forms of elder abuse that are happening in this nation and around the world. For most people, the idea of abusing senior citizens in any way is appalling, to say the least. However, it does happen and the best thing that can be done is to be aware of it, know the signs and then know what to do when it is recognized.

Signs of Neglect: Neglect may sound like an inadvertent, benign form of nursing home abuse, however it is even more dangerous. Unlike out and out physical abuse, neglect can take weeks, months or years to leave its mark and when it is finally recognized, it can sometimes be too late. Here are some signs to be aware with regard to neglect:

- Hygiene - Seniors should have proper personal care and cleaning, appropriate clothing and an adequate amount of nutritional food.

- Supervision - Nursing homes must provide effective supervision of patients, particularly in cases of dementia or other related illnesses.

- Medical - Patients must have access to all required aids, medication, teeth/partials, walkers, glasses and not be simply confined to beds.

- Safety - Cleanliness also applies to the patient's room or home, which must also not be in disrepair and contain safety, fire or clutter-based hazards.

Signs of Abuse: When abuse is recognized in senior patients it is particularly troubling. Family members, nursing staff and others who work with these patients on a daily basis need to be aware of these signs to ensure the safety of the patient. Here are some signs of psychological, emotional, physical and sexual abuse to be aware of:

- Behavior - Changes in involvement with day-to-day activities, withdrawal from social situations, altered mood, level of alertness, etc.

- Physical Evidence - Bruises, sores, cuts, burns, welts or bone fractures that are unexplained or seem suspicious even after explanation.

- Sexual Evidence - Patient is diagnosed with sexually transmitted diseases that cannot be explained.

What You Can Do: If you suspect that a patient or family member is being abused or neglected in some way, your best course of action is to seek legal counsel. A professional can help determine whether there is a case and can guide you through the required steps to protect the patient from their abuser. Stick up for your loved ones and get the care they deserve. Don't leave them to fend for themselves.

Day Care Negligence

Many parents struggle with the decision to use a day care service for their children. They may be concerned with leaving their children for extended periods of time, or may wonder if their children are safe in the hands of the staff. Unfortunately, these concerns are not unfounded. Sometimes child care accidents occur because of negligence, possibly leading to physical injuries or emotional trauma. If your child has been harmed because of day care negligence, consider consulting with an attorney to discuss your legal options.

Examples of Negligence

Everyone knows that sometimes, children get hurt when they play or decide to do something they were told not to do. Learning through experience is an important part of growing up. However, sometimes children are hurt in avoidable accidents that are caused by someone else's negligence. In these cases, the negligent individual or business may be liable for any injuries or harm caused to the children. Some examples of day care negligence include:

• Leaving children unattended


• Failing to supervise and intervene in a dangerous situation


• Failing to render first aid to an injured child


• Exposure to unsanitary conditions


• Physical, verbal, or sexual abuse


• Permitting or promoting bullying

What You Can Do

When day care staff fail to address conditions that could harm a child, they are guilty of negligence and could be held responsible for a child's injuries or emotional distress. If you suspect that your child has been harmed while at day care, consider consulting with a personal injury attorney to discuss your case. An experienced lawyer can investigate the situation and determine who is responsible for any harm caused to your child. You may have grounds to recover compensation for medical bills, lost income from taking time off of work, recovery costs, and pain and suffering.

For More Information

To learn more about day care negligence and what you can do if you suspect that your child is a victim, visit the website of the Harrisburg personal injury lawyers of Lowenthal & Abrams, P.C. today.

Jobs For People Who Have A Nurturing Disposition

Sometimes it seems that certain people are just cut out for certain jobs. As a customer or patron, you may deal with a professional that leaves you feeling good about your exchange. In other cases, you may come across a person who is a terrible fit for their profession and you find yourself thinking the person chose poorly and their job is not a good fit for their personality. A lot of this depends on how nurturing a person is and whether they have chosen a nurturing profession. If you consider yourself nurturing and you feel rewarded by caring for others, there are a lot of job opportunities available to you. Health care is one of the best professions for caring individuals. Nursing jobs like caregiver jobs and CNA jobs are perfect for those with nurturing personalities. Health care requires that a person not just understand illness and disease, but that they understand human nature and be able to empathize with those experiencing health problems. The best healthcare professionals are nurturing, caring people.

Another option for caring people is to work with the elderly. As we age, many of the skills we once had diminish and we may need help with everything from grocery shopping to home maintenance. There are also times when we just want support and companionship. If you are a nurturing person, you can assist the elderly with their daily needs and work with them to keep them company and help them feel good about their lives in later years. Home care companions and working in an assisted living facility both offer opportunities for working with the elderly population.

Those who love working with children and who have compassionate personalities can work in childcare centers. While the inclination may be to go into teaching if you love working with kids, childcare allows you to have a more social relationship with children. You can work with younger children in childcare. Infants and toddlers truly need nurturing when they are left in a childcare environment most of the day without parents. Caregivers substitute as parents during the workday, a role traditional school teachers only partially play. Childcare teachers must have a willingness to show physical affection to children and if you have a desire to teach and guide, as well as give hugs and bandage skinned knees, working in a childcare center may be the right choice for you.

Customer support is often one of the most under-appreciated fields in business, but the best customer service representatives are nurturing, compassionate people. While it can make you weary listening to the complaints of people all day long, if you can offer a client a comforting experience, it will go a long way in making a good impression on behalf of your company.

Finally, one of the most important fields requiring compassion and a nurturing spirit is counseling. Great counselors possess a combination of knowledge and experience, as well as the desire to care for people. If you have a nurturing personality and personal experience with life's challenges, you may want to consider a career in counseling.

Nursing Home Admission Scenario Number Two

The first scenario involved admission to a nursing home because of an unexpected medical condition that made such an admission a necessity. [This seems a bit repetitive; this may not be necessary.] Our next scenario is a planned admission. This is the hard part.

You may have noticed some subtle changes in your loved one's behavior, nothing too bizarre or dangerous, but changes that cannot be ignored. For example, there may be evidence of some minor forgetfulness, perhaps personal hygiene has diminished, hair is not washed, there's body odor, fingernails are uncut, never polished, or just dirty.

Maybe your loved one is showing signs of short temper or aggression, striking out at you or others. You may have noticed visible weight loss or bruises on his or her arms and legs. A neighbor may have called you at work to inform you about finding your loved one roaming the streets.

Until recently, your loved one may have been an immaculate housekeeper or always well dressed. His or her mail may now be piling up unopened, or there may be an unusual number of packages arriving from QVC. His or her checkbook may have far too many checks written to unknown agencies or lotteries from overseas. His or her car, formerly in good condition, may have unexplained dings and dents or the police department may have taken his or her driver's license. By now, perhaps you have your own additions to scenario number two.

So, what do you do? First, I suggest that you keep a journal as these things begin to happen. Make sure to record the date and time of each event. At some point, your level of comfort with your loved one being alone or with your ability to provide care will reach its limit. Because you've recorded the events in detail your physician or other caregiver will be in a better position to make an appropriate recommendation for the benefit of your loved one. Some of the options may be adult day care, home health care, or a companion.

You may have wonderful memories of your loved one being healthy, vibrant, active, and engaging, but that is not what you are seeing and experiencing now. You are determined to do anything necessary to avoid nursing home placement and to provide the care required, but there is a danger in that.

The danger is that many times the caregiver's health and financial resources fail. In some cases, the excessive energy required to care for a loved one results in the premature death of the caregiver or divorce of the adult child (usually the daughter) taking care of an ill, aging parent. You must not sacrifice your health, your family, or your financial resources to care for a loved one.

Two of your goals should be to protect your loved one from self-neglect and to improve his or her quality of life. That's why we are going to learn how to find a great nursing home.

Career in Nursing Administration

Wikipedia defines a nurse administrator as a professional whose core responsibilities include policy making, staff administration, and financial decision-making in a healthcare environment.

The core job of a nurse administrator includes planning work schedules, assigning duties to the staff nurses and supervising their work, establishing budgets, and maintaining medical records and supplies inventory. She is also responsible for recommending and implementing policy changes, ensuring effective patient care, and driving constant improvements in the health care delivery system.

Is Nursing Administration for You?

Anyone aspiring for a career is nursing needs to have the basic qualities of a caregiver such as a passion to help others, patience, compassion, perseverance, dedication, and the ability to keep calm under extreme conditions such as medical emergencies.

In addition to these characteristics, a nurse administrator should demonstrate leadership qualities, interpersonal and communication skills, and attention to detail as her job revolves around managing the junior staff, extensive record keeping, stock taking, and acting as the agents of change. Nurse Managers or administrators should also be emotionally stable, so they can support and advise patients and their families.

Education path

Most licensed nurses begin their careers with a Registered Nursing degree, while some enter the profession armed with a diploma. They start as staff nurses and are able to move up the ladder to hold managerial positions after years of experience.

Some institutes also offer a bachelor of science in nursing administration that prepares RNs for supervisory roles. However, with the Department of Labor reporting that management-level nursing positions increasingly require a graduate or an advanced degree in nursing administration, the prospects are best for RNs who complete their Master of Nursing Administration program.

A master of nursing administration degree trains RNs in advanced nursing theory and practice concepts as well as non-clinical and administrative aspects of health care. RNs learn important subject areas like Health Services Economics, Health Services Financial Management, Health care Information Systems, Health Services Marketing, Nursing Leadership, etc as part of their curriculum.

Many top-level institutes and universities also offer RNs opportunity to earn their nursing administration degree online, which means they can study at their own pace and work out their own schedule around their jobs and family commitments.

Employment opportunities

Nurse administrators can find employment in a variety of health care units such as hospitals, home health care services, nursing care facilities, offices of physicians, or even government and non-profit agencies. According to the U.S. Department of Labor, nurse managers can advance from the level of assistant unit managers to head nurses and then to more senior administrative positions like assistant director, director, vice-president, or chief of nursing.

The paycheck of a nurse administrator depends to a large extent on factors such as experience, education, geographic location, and the type of health care facility they work in, but a first level nurse manager can expect to earn anywhere between $80,000-$110,000 per annum.

Future Outlook

The Department of Labor has projected a faster than average growth in the employment of both Registered Nurses as well as health services managers, which means that nurse administrators are likely to enjoy excellent job prospects.

While the employment of RNs is expected to grow by 22 percent by 2018, employment of health service managers is projected to increase by 16 percent over the same period.

As the health care industry continues to expand, the need for medical administrators with experience in health care and strong business management skills is only going in one direction and that is northwards.

If you are a practicing RN looking to move ahead in your career, the time to think has passed. Act now and enroll yourself in an advanced nursing administration degree to set your career on wings.

Improving Home Healthcare Through Telemedicine

The Centers for Medicare and Medicaid Services reported that in 2009 US healthcare spending increased 5.6% to $2.47trillion and represented 17.3% of the US economy. The increase from 2008 to 2009 is the largest jump in healthcare spending since 1960, and it is remarkable that in a year in which the US economy contracted by 2.4% healthcare and the federal government were the only sectors to show an increase. This growth is also occurring from a high base, starting at a level 30% to 50% higher than most industrialized countries, and is unsustainable.

Part of the healthcare cost problem is the way that most healthcare services are provided. Hospital Care represents 31.1% of all healthcare costs and is notoriously expensive. The average cost for 1 day in the hospital in 2002 was $1,290, nearly double the average cost from 1990 and since 2002 hospital costs have increased by more than 50%. Professional Services, which in the Center for Disease Control (CDC) data includes Physician and clinical services, Dental services and other professional services represents another 31.3% of total healthcare costs and Nursing home care a further 5.9%. All of these services are provided onsite, in facilities and environments that are costly to maintain and where costs are increasing rapidly and represent more than 68% of the total healthcare expenditure in the US in 2007.

Cost however, is only part of the problem with this centralized model of healthcare delivery. Hospitals, clinics, Doctors offices and even nursing homes are notorious for spreading disease. According to a February 2003 article in The New England Journal of Medicine between 5% and 10% of all patients admitted to an acute-care hospital acquired one or more infections. The CDC estimates that there are 1.7million hospital acquired infections each year resulting in approximately 99,000 deaths, various sources have estimated that these terminal cases alone result in over $6billion in healthcare costs each year. These economic costs pale in comparison to the pain, suffering and loss of life resulting from these infections.

The centralized model also provides a setting that is at best impersonal and often dehumanizing. By design the institutional feel of hospitals, clinics, Doctors' offices and nursing homes can increase the physical discomfort of patients through raised levels of anxiety, disorientation, helplessness and even depression. Also the very nature of such institutions entails interruptions at odd hours by staff and other patients and a constantly changing cast of care providers that further add to the discomfort of the patient.

Treating patients in the home is much less costly and provides a familiar setting for the patient. It is also usually an environment that is more comfortable, lowers the risk of spreading infection and adds to the patient's sense of control over their treatment. The difficulty is that up until now much of the technology for cost and accessibility reasons needed the centralized model to be effective.

Telemedicine involves the use of telecommunications either through traditional phone networks, cell phone networks or the internet to diagnose, treat and monitor patients across large distances. Early use has focused on telecardiology and teleradiology where EKG and X-Ray information is transmitted over communication lines and monitored and analyzed at locations remote from the patient. Recently, new procedures now allow surgeons to perform certain procedures remotely and many hospitals have implemented remote nursing stations that can monitor patients from many facilities from one centralized location.

Telemedicine is also being used in the home healthcare setting to provide emergency alerts through personal emergency response systems and the monitoring of patients vital signs such as heart rate, blood pressure, cholesterol and glucose level. The latest advances in home healthcare telemedicine have been in the area of medication management, which given the costs of poor medication compliance represents an enormous opportunity to not only save costs but to also greatly improve medical outcomes and save lives.

Over 50 million people in the US are on three or more prescriptions. While many of these medications are critical to improving the health of the patient the average compliance rate with their medication regime is only 50%. Poor medication adherence according to the Center for Disease Control represents a significant healthcare problem resulting in increased costs and poor medical outcomes. The current poor rate of medication adherence results in 10% of all hospital admissions (30% of all hospital admissions for elderly), 22-40% of all Skilled Nursing Facility admissions, 125,000 deaths per year and from $150billion to $300billion in annual cost/waste.

And this problem will only get worse as longer life spans and relatively low birth rates increase the nation's average age over the coming years. The older we get, the more medications we require and as the number of prescriptions increases so too does the amount of non-compliance. As a result, the cost to the health care system due to poor adherence is rising significantly.

There are a number of ways to improve compliance that have been tested by the medical community. Adherence rates can be significantly improved through better education, the monitoring of patients in the home, and improved medication management. Medication management devices help by organizing dosages, providing reminders to take pills and sending alerts to care givers when dosages are not taken. Telemedicine based medication management devices significantly improve compliance rates by utilizing all three of these strategies.

Personal Injury Law in Oklahoma Has Changed - Limiting Oklahoma Citizens Rights

Last year, the Oklahoma Legislature, with the passage of the Comprehensive Lawsuit Reform Act, changed the way damages are awarded in personal injury cases in Oklahoma. This act substantially affects the rights of Oklahoma citizens when it comes to personal injury claims. Therefore, all Oklahoma citizens should be made aware of the changes in the law.

This new law places a cap of $400,000 on non-economic damages in any suit where bodily injury has been alleged. Non-economic damages for example would be in the nature of damages for physical pain and suffering, mental pain and suffering, physical impairment and disfigurement. This new law negatively affects the rights of a large portion of Oklahoma's citizenship including minor children, retirees and individuals who are unemployed. The reason being is that these individuals have no loss of income claim. Therefore, their damages may be limited to medical expenses and up to $400,000.

However, the "saving grace", if you want to call it that, is that this law provides situations when the cap can be lifted. These situations are as follows:

1. A Plaintiff suffers permanent or substantial physical abnormality, disfigurement, loss of use of limb or substantial impairment to a major body organ or system.
2. A Plaintiff suffers permanent physical functional injury that prevents them from being able to care for themselves and perform life-sustaining activity.
3. The Defendants acts were with reckless disregard, grossly negligent, fraudulent or intentional and with malice.

As to personal injury suits against a physician, both the judge and the jury must find one of the conditions above by clear and convincing evidence. This is a higher burden to meet than the preponderance of evidence standard. In suits against non-physicians (all other suits; car accidents, truck accidents, motorcycle accidents, slip and falls, dog bites etc...), a jury must find one of the conditions by a preponderance of the evidence. Jurors will not be advised of the cap at any time during the trial. However, they will be asked to return a verdict with answers to questions based on the above 3 situations.

This new statute does not apply to claims under the Governmental Tort Claim Act; personal injury claims against governmental entities such as a fire department or police department and does not apply to claims for wrongful death.

It is important to note that this new personal injury provision, which became law on November 1, 2009, does not take effect until a Health Care Indemnity Fund is created and funded by the State. It is unknown at this time if and when a Health Care Indemnity Fund will be created and funded by the State.

In addition to the above, another notable provision is contained in this new law. Evidence of a persons failure to wear a seat belt will now be made part of the evidence in car accident and truck accident cases. Oklahoma's former law provided that a drivers use or non-use of a seat belt was irrelevant when it came to car accident cases. This new law provides that if an operator of a vehicle does not wear a seat belt and is involved in an accident, the failure to wear a seat belt may be used against that person in a car accident lawsuit. In essence, although the person did not cause the accident, he or she may be blamed for his or her own injuries because of the non-use of a seat belt. Therefore, it is now extremely important to wear a seat belt while operating or riding as a passenger in a car or truck.

Assisted Living Costs In Georgia

Long term care services at assisted living facilities cost about $3,000 a month on average in the state of Georgia. If you think that's steep, the cost for nursing care is almost double, costing between $5,000 and $6,000 a month on average.

With monthly costs so high, how can you plan to pay for these service if you need long term care?

It's expensive in Georgia to receive long term care, unfortunately there are only two choices available to most people. You can pay for the care services out-of-pocket, or you can buy long term insurance care which will probably cost about $50.00 a month whether you wind up needed the care or not.

Here is a view of the average cost of long term care in Georgia, Metro Atlanta, including Alpharetta, Augusta, Macon, and Savannah.

• Georgia: $2,400.00 mo


• Alpharetta: $3,750.00 mo.


• Atlanta: $3,451.00 mo.


• Augusta: $2,277.00 mo.


• Macon: $2,656.00 mo


• Savannah: $2,836.00 mo

The cost of assisted living in GA can vary depending on the needs of the resident. For most facilities there is a base monthly fee for the room then additional fees are added as needed. There could also be a one-time community fee at the time of move in.

Monthly Suite Fee: Up to $4500

The cost of the room at an assisted living community per month in GA includes housekeeping, maintenance of the room and common areas, some to all utilities, activities and limited assistance with daily activities. The costs vary for several reasons, but the main factor is location. You can usually (but not always) estimate this by the local real estate. A Buckhead community in Atlanta will be more than one located in Woodstock.

Additional Fees: $600 - $4500

Depending on the level of care needed for the resident, Georgia assisted living homes all have additional services to assist you or a loved one with daily or regular activities. The services vary in cost, and depending on how many are needed can start at $20 a day, and get as expensive as $100 a day. Daily medication reminders and distribution is the most used service and costs about $450 a month if not included.

Be sure to check each facilities cost plan for these services even if they're not needed at first, they can quickly cause the bill to escalate in the near future. The following services are widely offered throughout assisted living facilities in Georgia.

• Grooming


• Bathing


• Dressing


• Dietary


• Vision


• Hearing


• Speech


• Transfer


• Mobility


• Socialization


• Weight loss/gain


• Lab work


• Vital signs


• Skin Care


• Special requests

One Time Community Entry Fee

The entry fee is a one-time, upfront payment between one to two thousand dollars and is usually paid before moving in. Generally it's used for maintaining the building and grounds of the facility.

Community fee is usually paid for prior to moving in and it covers the general maintenance of the building and community areas within a facility. It varies from $1000-$2000.

Top 10 Considerations Before Choosing to Be Caregiver for a Loved One With Alzheimer's Disease

Choosing to become a caregiver for a loved one is a major life-changing decision. Here are some things to consider before making the commitment. Consider your options and learn as much as you can before making the choice that is best for you and your family.

1. Time Commitment: When your loved one begins to need help, it is natural to want to become their caregiver. Caring for a loved one is a more than a full time job. It's a twenty-four hours a day and seven days a week job. Don't forget about your own well-being too. The Alzheimer Society of Canada offers programs to help caregivers manage stress. They recommend setting realistic expectations and not spending every waking moment worrying about care giving duties.


2. Consider The Living Situation: At some point, your loved one will need more attention than a simply phone call or visit. Consider having them move in with you or you move in with them. It might mean moving them into an assisted living facility. Not sure what to do? Consider this. The care guide explains that moving them into a facility should be stress free, remind them of home and be an adjustment for everyone.


3. It Will Be Demanding: You could become physically, mentally and emotionally exhausted caring for a loved one.HomeHealthUnited.org mentions that caregivers sometimes injure themselves while caring for a loved one. This happens when a loved one has to be lifted or you must squat to help them. Maintaining good posture is important.


4. The Hardest Part is Letting Go: Try to accept that you will be caring for your loved one until the end. Caring.com has tips on coping with your loved ones changes in mood and attitude. They recommend focusing on being there for your loved one and communicating your love and understanding to them above everything else.


5. Figure Out The Money Situation: The bills will begin to stack up and taking care of someone you love isn't cheap. Equipment and modifications to a household make bills start to stack up. AgingCare.com includes many helpful guides about financial situations for the families of those with Alzheimer's. These tax tips also include what paperwork you need when you decide to become the primary caregiver for your loved one.


6. Find a Healthcare Service: You are not alone. Contact a local hospice or healthcare service to find caregivers to help you anytime you need it. WebMD gives a thorough overview of what hospice care entails and how helpful it can be. They have people available to stay with you 24 hours a day and seven days week. Find people to stay overnight and in the event of an emergency.


7. Get Some Training: It is important to learn methods like CPR or giving an injection. Affordable Home Health Care explains that becoming familiar with these methods will help you feel more confident helping with your loved one. The more you know, the more you will be willing and prepared to help. We Care Home Health Services also offers services to your home, workplace or community if you are needing additional help with these methods.


8. Don't Forget to Communicate: Keep all the your family members in the loop about what is happening. Even the one you are caring for. Talk about finances, living arrangements, medical care, etc. Caregiverstress.com suggests dealing with conflict before it becomes an issue. Make decisions together, ask for help, and leave grudges at the door.


9. Develop a Routine: Keep your loved on a schedule to help minimize confusion. Try to keep them active and aware, like engaging them in conversation. For example, the Alzheimer's Care Guide includes information about symptoms your loved one may express on a daily basis, so be prepared.


10. Plan activities for them: There are many activities a loved one with Alzheimer's can enjoy. ActivityTherapy.com mentions dozens of activities from walking to listening to music to cooking. The resource breaks down activities based on what level of Alzheimer's your loved one has.

About The Medical Arts Health Research Group:

The Medical Arts Health Research Group conducts clinical trials in the areas of Alzheimer's Disease, Rheumatoid Arthritis and Lupus among others. As a volunteer in a medical research study, a patient helps in the possible development of medical therapies that may offer better treatments and even cures for life-threatening and chronic diseases. People volunteer to participate in a medical research study for a number of reasons, including the advancement of science, hope for treatment that doesn't exist or improved medical care and to be involved in research that could help others.

Different Types of Elderly Health Care

Elderly health care helps many people in their old age manage their health and stay as active as possible in their advancing years. The term covers several different types of care arrangements, meaning that there are a variety of options for the elderly and those supporting them to choose from, depending on their individual needs.

Home Care

Home care services aim to make it possible for the elderly to stay in their own homes when their health or mobility deteriorates. Rather than move to a residential or long-term care home, home care providers render care and elderly support services in the client's own home. Depending on the individual this can be either professional health care services (therapy, medication, etc), life assistance services (assistance with daily activities) or a combination of both.

Assisted Living

This form of residential care is a middle ground between home care nursing and long-term care. Although it covers a broad range of arrangements, it describes when clients in need of more in-depth support but don't need the 24 hour medical care support of a client take up residence in an apartment or house in a property managed by a care provider. Basic nursing staff may be available at all hours in some facilities, yet for the most part assisted living providers are on hand to help with day-to-day living activities. Staff regularly help with chores such as changing sheets or washing laundry. Utilities bills are included in the arrangement and in many cases, residents have the option of having meals cooked for them or for staff to bring their groceries to them.

Long term residential care/Nursing homes

For those who need constant medical attention as well as assistance with daily activities, home care nursing homes represent a viable option for maintaining the best quality of life even as health deteriorates. Constant nursing care is on hand to provide treatment for conditions whilst non-medical staff are trained extensively in helping those unable to independently carry out many activities of daily living. Often these facilities have extensive support systems in place, such as 24 hour medical monitoring and occupational, physical and rehabilitative therapies.

Early Moving Worries: Are They Normal or Relocation Stress Syndrome?

In five years or so, my husband and I plan to move to a group living high-rise with assisted living and nursing care services. We paid our entry fee and it is earning interest. Many of our friends live in the high-rise and really like it. Though our move is years away, I find myself thinking about it and worrying about it.

What will we bring? What will we sell? What will we donate?

I had just written an article about Relocation Stress Syndrome, anxiety about moving to assisted living or long-term care. The symptoms of RSS include a reluctance to move, anxiety, confusion, helplessness, loneliness, withdrawl and pessimism. Thankfully, when I read the list of symptoms I realized I had only one -- occasional anxiety.

When I examined the source of this anxiety, I realized it came from a personality that always plans ahead. My mind was already working on sorting and moving. Still, I realized there were things I could do now to ease the transition. My proactive steps may help you.

1. Sell some large pieces of furniture. We had an antique roll-top desk and matching chair. As much as we loved this furniture, we knew it was too large for our next place. One of our friends is an antique dealer and he has a huge sale each year. Our lot, the roll-top desk and chair, china cupboard, music cabinet, child's desk and chair, were added to the sale and we made hundreds of dollars.

2. Check the condition of furniture on hand. Our family room couch was so worn the fabric was starting to fray. Though we could have purchased a slip cover for the couch, we decided to buy a new one. Choosing the fabric was easy, thanks to a computer program that shows fabric choices on the furniture.

3. Start a "Coming with Me" plan. Put this plan in writing. Right now, we plan to bring our existing bedroom furniture, a round kitchen table with four chairs, the new couch, two end tables, a china cupboard, a church pew, all existing lamps, and our computer desk. These plans may change after we get a floor plan of our new place.

4. Fix anything that needs fixing. I love the wing-back chairs we bought years go. While I have searched for new chairs, I haven't found any that are as pleasing as the ones we have. Newer chairs don't seem to be as sturdy, either. So I'm going to have the chairs re-upholstered in a neutral fabric.

5. Learn about space-saving products. In this sagging economy many Americans are downsizing to cut their monthly expenses. Manufacturers have picked up on this trend and developed space-saving furniture and storage items. I keep a running list of products that might be useful in the future.

Finally, it doesn't hurt to adjust your attitude. Small spaces can be attractive, too, and reveal your personality and interests. When we finally move, I'm going to make our new apartment as attractive as possible -- a little gem.

Copyright 2012 by Harriet Hodgson

Internal Burns

The majority of people are aware of burns to the external portions of a person's body. We all know that they are measured in degrees (usually 1-3 but also 1-6 for more severe burns) and can leave painful scarring. Many people also know that it is possible to receive chemical burns, electrical burns, sunburns, and scalding burns. What many people don't realize is that it is also possible to receive internal burns.

Just like the skin, a variety of internal organs can be burned due to exposure to extreme heat, electricity, or chemicals. These burns are typically very serious as they affect organs that are even less equipped to deal with damage than the skin is. Commonly injured internal organs include the esophagus and lungs. It is possible to burn other organs as well.

When smoke or some other hot air substance is inhaled, it is capable of burning the entire respiratory system. This can be because someone inhaled steam, was caught in a burning building, or just got a little too close to something burning. When this happens, the lungs are damaged and the individual is faced with a very painful recovery process.

Chemical burns can do the same thing. The difference being that the chemical is capable of eroding the organ, rather than just hurting it. For this reason, a lot of household products have very serious labels on them with instructions concerning what to do if the cleaner is swallowed. Acids, like those found in drain opener, can eliminate not just a person's esophagus but also the stomach and intestines.

Electricity can also burn the inside of a person's body if a high enough voltage is administered. Lightning is a cause of this in many instances. If the voltage is high enough, electricity can burn not only the external skin on a person but also the organs on the inside. In addition, electricity can permanently damage organs that are necessary for life. This includes creating arrhythmias in the heart as well as messing up the nervous system. The nervous system can be damaged by electricity because it works on tiny impulses going from nerve to nerve. A large volt of electricity through the body, basically, overloads the system.

As a general rule, it is much more difficult to treat internal burns. While the exterior of a person's body may look ok, the internal damage can be much greater.

Senior Care - In Home Care Or Assisted Living - Pros and Cons

As people age they often require increased assistance in everyday activities. Decisions on what is the best type of care for a senior can be difficult and often complicated. Here is help on how to decide between assisted living or senior care in their home.

The choices between assisted living professionally at a nursing home or relying on care in the home can be an agonizing choice for the family of a senior. There are pros and cons to both options and they should be carefully considered before an arrangement is in place.

One of the first considerations to make is why the care is necessary and whether degenerative conditions may eventually reach a point where in home care is almost impossible.

If so, then it might be worth considering an earlier move to assisted living when the senior in question can have some influence and power over the decision on where to go and services they would like to have provided.

Some of the advantages to in home care for seniors include their familiarity in the environment, the comfort of their belongings and space and the ability to hire nursing staff that can make in-home visits when you're not available.

There are disadvantages though and these include the limitations on family members who may take on a lot of the regular activities such as cleaning and cooking. There are costs associated with hiring nursing staff and limits to when they are available to come into the home. If there are no family members nearby then it can be difficult to ensure adequate care is taken and that the senior is remaining able to care for themselves when alone.

There is also the problem-what if the in home care person gets sick, quits or just doesn't show up one day?

Using assisted living options is an alternative if it is not appropriate to continue in-home care. There are a range of levels of care offered, from very minimal up to full care. If family is located away from the senior then assisted living options offer an immediate advantage in that there is always some level of care and protection being provided to the senior without the need for family carers to become involved.

In retirement villages, care is often quite minimal but the units offer a senior some back up in case of acute health issues. Most come with panic buttons in the main areas like bathroom and living areas, and offer social activities while providing a sense of privacy. However it is possible for this lifestyle to become quite insular, with the senior becoming less likely to venture outside the village. It's a really good first step in care but it has to be appropriate.

If your senior needs more specialized or regular attention then high level assisted living may be the option for them. This involves living within rooms which may be single or shared depending on the facility, and offer 24 hour nursing staff with doctors on call.

Overall you need to look at the immediate and expected future needs, and decide what options are going to work both now and in the future. Often families will employ in home care to begin with for a period of time until it is no longer appropriate but it can be important to have plans in place before the time comes to increase supervision and access to medical care.

For Many People Senior Retirement Living Will Be A Nightmare

Is their dream of senior retirement living becoming a pipe dream for many people? Are many of the elderly becoming a "forgotten generation"?

Increasingly living out your senior years is taking on some very disturbing aspects. As children relocate to new cities, countries and continents they are leaving behind their elderly parents. Traditionally parents have been revered and cared for. But shifts in populations and breakdowns in traditional family life, compounded by longer life spans have caused a severe dislocation in traditional family life.

In many third world communities, where children have met an early death, often through AIDS, the elderly parents are forced to become the mainstay of society supporting their grandchildren and other orphans. However the world focus is heavily biased towards the plight of children with very little focus on the dire hardships faced by the grandparents.

Families who have emigrated, or moved away looking for better opportunities have in many cases left their parents in old age homes. The stoic nature of this generation of elderly people makes them reluctant to admit that they are depressed and lonely. They are a generation that believes "it's all in your mind" and "you must pull yourself together" and so they try to survive the best way they can. But deep down they feel abandoned.

Their generation would rather keep family matters private. You do not "hang out your dirty washing in public"... so they suffer in silence. Thinking that to publicly discuss these issues would be disloyal and letting the family down. But it is very difficult to accept as without their family they don't have a lot to live for. They miss having their lives being enriched by the emotional support, and experiencing the ups and downs of life, of the younger generation.

Many families are moving because of the opportunities and quality of life offered in other countries. However the relocation of an aged parent is often a major problem as many countries won't easily accept them. They are potentially a financial drain on already limited resources. Countries may require sponsors to have a large financial backing which for families relocating is often not easy. Also there are often minimum residency periods before sponsorship is allowed.

This is a very sad, neglected generation because not only have they lost their family support system and contact they are also battling financially. Many have had their retirement funds trashed by poor money management, stock market crashes and lay-offs. This is now compounded by lower interest rates and rising medical costs and food inflation.

Emigration for job opportunities is a growing trend throughout the world. Taking its toll mainly on parents or grandparents who are left behind. In the worst cases the parents are left without any contact. In other cases the children provide financial support and in others the children provide both financial and moral support.

The older generation is finding it difficult to understand that their place in society is not recognised and that their contribution is not acknowledged. Their old age expectations are not being met.

So for many it will be a case of "grin and bear it" and do whatever you can to lessen the impact of the separation. New technologies, like Skype, are making it possible to maintain cheap contact with families spread out throughout the world. Being able to see and speak to your children and grandchildren can make a big impact.

Senior retirement living is moving into the new age where retirees may have to live out their lives on their own without the day-to-day support of their family. It is up to them to find ways to make the best of a challenging situation.

Elder Care Facilities: The Difference Between a Retirement Home and a Nursing Home

If you are faced with the challenge of choosing elderly care accommodation, either for your own care needs, or for an aged parent or relative, then you may need some help to differentiate between the types of elder care facilities available to you. There are some important differences between types of residential care for seniors.

Nursing Home

A nursing home, otherwise referred to as a skilled nursing facility (SNF), offers specialist medical healthcare and full-time nursing care by licensed nurses as well as general personal care. A nursing home has qualified nurses on the premises at all times to ensure adequate medical care can be administered. A registered nursing home will also have a licensed medical physician on staff, who will oversee patient treatment.

Nursing homes are often a required step for senior care following a hospital stay, where 24-7 nursing treatment, is still necessary. A place in a skilled nursing facility may also be the best option if your elderly parent has a degenerative medical condition that is going to require progressive treatment.

Retirement Home

A retirement home, or assisted living community, will not offer the same level of medical healthcare as a nursing home. These types of facilities more often cater to providing general personal and custodial care. Care assistants will help residents with things like dressing, bathing, toileting and moving around. A retirement home is a very social environment, where many activities are available to help keep an old person stimulated. Companionship can play a major role in a retirement home, where elders who have been living alone, have the opportunity to have company. The retirement home will not provide 24-7 medical healthcare treatment, but often will oversee the administration of routine medications, and will have licensed physician to call upon should the need arise.

A retirement home, residential home or assisted living facility is therefore more suited to an elderly person who is still fairly active and not suffering from any condition that requires specific daily medical treatment.

The important thing to consider if you are faced with the decision of choosing a care home for your loved one, is not just their needs now, but how stressful it could be to have to move them again should their condition worsen.

Many old people try to resist being placed in a nursing home as they feel it signifies their demise! However, nursing homes can be very homely and caring places for those seniors who do need around-the-clock care.

The Colors of Retirement

There are two colors for retirement: gray and silver.

What we assume about this stage of life is often the gray stuff. That comes from what happened to Mom and Dad or Grandpa. They retired and traveled. They retired and took up woodworking...or quilting...or golf. They retired and took a backseat to what was going on in the rest of the world. They retired and pretty much disappeared. Gray isn't very noticeable. Or very interesting. Eventually, they were gone but usually long after they'd been forgotten by the culture.

Is this approach unavoidable? Is it what's going on with people who retire now?

Only if they choose it. There are a lot more options than moving to Palm Springs or playing golf five days a week.

The traditional version of retirement is built on the concept of "the Golden Years" which was given to us as a culture by Del Webb in 1960 as part of the inaugural marketing effort for the first Sun City, a retirement community outside of Phoenix. It was a way to put a positive spin on a very negative situation. At that time, American workers were required to retire at a certain age and once they did, society pretty much forgot them. Webb and others turned this invisibility into the idea that retirement was time to play--that retirees have earned the chance to have fun all day every day. A life of 100% leisure.

To those still working, this sounds like Nirvana, but as a lifestyle, it can be grim. Not even children play all day every day. Not having a purpose or a way to contribute creates a vast array of health problems--both mental and physical--for the person and robs society of their talents and skill.

But this mindset continues because many believe:

* People old enough to retire are frail--in poor health, with no stamina, and physically unable to do much of what younger people can.

* They are short-term members of society; they will either die or enter a nursing home (and then die) in a few years or even months.

* They're inept--"Out of it" the vast majority of the time, with no idea what's going on in the world and no ability to do much about it anyway.

* They're irrelevant or worse, a burden--nothing they do has impact beyond their own lives. Many of them can't even take care of themselves.

This is the GRAY version of retired life. Lifeless, fading, dull. Also WRONG.

NONE of this is mandatory, necessary, or wise. Most of it is just plain baloney. The truth about people old enough to retire is much less limiting. But to get to where we plan using a better model, we have to embrace a new set of assumptions:

* AT THIS AGE, WE ARE STILL ROBUST. The vast majority who elect to retire are at the top of their game. Physically, they are in better shape than their parents were even at ten years younger.

* WE ARE STEPPING INTO A LONG-TERM STAGE OF LIFE. Those now retiring are likely to be around at least another fifteen years and more likely twenty-five to thirty. Those who retire at 55 could easily spend more time retired than they did in the workforce.

* WE ARE A SIGNIFICANT SEGMENT OF THE POPULATION. In numbers. In buying power. And if we take the time to plan for it, in the roles we take on and the challenges we step up to for our families, communities, and society as a whole.

* WE ARE ENERGIZED. The chance to do things we believe in with the flexibility to accommodate all the other things we value is revitalizing. This age group has the potential to recharge both ourselves and our communities--and whatever else we decide to take on. We can have "the good life" and "do good" at the same time. We are in a position to give but also to take the time to enjoy what life has to offer.

This version of retirement is SILVER--sparkling and full of energy. Retirement, using this set of assumptions, is the time of life when we really can have it all, do it all, be it all--on our terms.

What color attitude are you going to choose? WHY SETTLE FOR GRAY WHEN SILVER IS JUST A MATTER OF MINDSET? Which attitude are you going to embrace as you do your planning?

Home Watch Versus a House Sitter - More Than Just Semantics

If you have a property that is vacant or unoccupied for an extended period of time, you need someone to take care of it. There are four major groups of homes that would fall into this category:

- Snowbird homes that are seasonally unoccupied
- Properties For Sale
- Inherited homes or home in probate
- Houses where the owner has moved to an assisted living facility or nursing home.

In each of these cases, a valuable asset is sitting without care. Leaks, bugs, mold, mildew, sewer gas, and other disastrous consequences can cost you thousands of dollars and eat away at the value of the property. Many owners realize there is only one answer- getting someone to watch the house. Unfortunately, many of those seeking competent, professional services will confuse the two most commonly used phrases: home watch and house sitter.

A house sitter has evolved to mean someone who stays in the house in your absence. They are not really watching anything, they are merely living in the property much the same as you would. They come and go just as you would. They may or may not run appliances, check for leaks, change filters, and other tasks you would do as part of routine home maintenance. Many house sitters do not own their own homes and are ill-suited to do anything other than give your home a 'lived-in' appearance. If all you want is someone in residence, this may be your option. But you may forfeit your rights to occupy the property in this arrangement since you sign a contract for a period of time. There are several services that offer pairing between house and sitters, but keep in mind you are giving your precious home and valuables to a stranger for long periods of time. The choice is yours.

A home watch service, on the other hand, is a business that assumes responsibility for the health and welfare of an empty property in your absence. This business does not arrange for people to live in the house, which means you can come and go as you please. Most property owners do not want strangers in their unoccupied home, and a house watch service caters to this requirement. They are licensed and insured for this trade, and have the tools and experience to identify and mitigate problems before they become a huge issue. You are far away, but their local knowledge and communication will give you peace of mind that there is someone on scene whose sole purpose is to monitor all the systems and the general condition of the house. Using extensive checklists, they spend their time on-site looking for possible trouble before it happens. Their focus is entirely on the property and your peace of mind, quite different from a house sitter.

No matter which choice fits your needs, make sure you understand the difference. If you want someone to live in your property while you are gone, you are looking for a house sitter. If, on the other hand, you prefer the home to remain unoccupied except when you want to use it, but want a professional to monitor the structure, grounds, and all the supporting systems, you want a home watch service.

Important Facts About Professional Liability Insurance For Nurses

In the health care industry this is a must have for all nurses. This is actually your protection for yourself against and all unforeseen situations that you cannot avoid while doing your job. This insurance will protect you from costs of legal and board action, which can be unavoidable at times. You have to face the fact that legal actions, although unwanted, can be a part of every health care professional's career. It is something looming all the time because of the sensitivity of what you are handling: human life. There might be errors that you will commit (unintentionally) and this is what Professional Liability Insurance is trying to protect.

Although we know that employers provide a good amount of coverage for this type of insurance it is still strongly advised that you carry your own. It is a small price to pay to protect your career and save you from the huge cost of legal fees. There are some cases before that even though their employers guaranteed their nurses that they are covered with this insurance it was found out those employers were not properly paying the premiums. Or sometimes when the liability or the cost of legal action is too big, insurance companies refuse to pay the amount like what happened in a legal battle in Massachusetts. Although this is a unique case still we saw that this can actually happen.

What can really happen while you are performing your duties? Even simple everyday routine can be a cause of legal action. That is why health care professionals including doctors are very careful when it comes to performing their jobs.

-You can be sued if you make a mistake while observing a patient or if someone else thinks that you did. This may be very simple when you look at it but the course of action could be huge and expensive. You may be innocent but still you will be taken to court to prove that you are innocent of the charges.

-Someone claims (employer or other party) that you made a mistake in reporting or recording patient's details.

-A doctor will claim that you made an error or misunderstood his directions.

-A patient or a relative of a patient may claim that you have provided inadequate patient care or carried out a differently the instructions given to you by doctors or superiors.

-You are already off duty but you still helped someone with an injury or any health situation (even though you mean well)

There are several things that you should always keep in mind while doing your job and about Professional Liability Insurance. First, make sure that your employer is actually providing you with this insurance and that it stays active all the time. You can have them provide you with written verification that they do purchase malpractice insurance and provide you with the limits or what are included in that coverage. Next is you should also purchase your own insurance. You should get this depending on where you work or where you live and what your specialization is. There are many insurance companies out there. Make sure you shop around first before settling to one.

Another thing you should consider is the difference between occurrence and claims made. Briefly, occurrence refers to the actual time the alleged malpractice took place while claims made refer to the actual time the claim is communicated to you including retroactive coverage for prior activities. Make sure that what is included in your policy are the ones that you actually need.

These are just some of the things you should keep in mind while you are actively performing your job. What you should also remember is even f you are already retired from your job, law suits can still haunt you because of a mistake you made or allegedly committed when you were still on active duty. That is why making sure you are properly covered with Professional Liability Insurance is very important in the performance of your job as a nurse.

Recliner Chairs for the Elderly

In today's growing population of senior citizens, there is an urgent need to provide services and create innovative and affordable products that can allow them to be happy, healthy, remain social, and continue to contribute meaningfully to our society. Recliner chairs for the elderly specifically provide the mandatory comfort and help that most senior folks need for their everyday activities. For this reason assisted living services for the aged present such tools for use by their residents.

Elderly people require help and care that isn't always obtainable at home, which is why most of them opt to dwell in assisted living facilities, where they get their very own help to handle their daily needs. And the kinds of chairs they use are an essential part of their daily routines.

Advantages of Recliner Chairs:

- Comfort is imperative to improve the living conditions of elderly people. Since growing older comes with completely different issues, be it bodily or mental, seniors require extra things to achieve comfort. Recliner chairs are good for elderly folks, particularly since a whole lot of them have a hard time sitting on account of various musculoskeletal problems.

- Recliner chairs for the elderly present the mandatory help that aged people need. Since bones and joints are likely to deteriorate into weak and delicate ones as individuals age, it is advisable to offer the services that may make it easier for seniors to move around. Recliner chairs which can be designed particularly for seniors provide the mandatory heights and depths to enable them to sit down without having to crouch and to stand up without a lot struggle.

- Numerous recliner chairs could be adjusted with just a push of a button. There are additional controls to adjust the level of reclining and most varieties have assistance for the legs so that people are seated comfortably with their legs inclined, offering higher blood circulation.

- Some aged folks become rather immobile, so that they are not able to do much, not even get out of bed. Recliner chairs for the elderly provide comfy seating for them every time they take their meals or watch tv without having to subject their backbone, bones, and joints to much discomfort.

There are plenty of advantages to getting recliner chairs for seniors, particularly since they spend most of their time indoors. These chairs will permit them to read, watch television, play games such as chess, or entertain visitors without being limited to lying down in their beds.

What You Need to Know About Pharmacy Technician Training

Thousands of Technicians are Hired Each Year

Pharmacy technicians are employed by a number of businesses. According to the United States Department of Labor, about two-thirds work in retail pharmacies. These retail businesses include drugstores, supermarkets and mass retail chains. According to USA TODAY, Walgreens, the nation's largest drugstore chain by sales and profits, employs nearly 39,000 technicians. CVS, the largest retail chain in terms of store count, employs around 41,000 pharmacy technicians. The remaining third of pharmacy technicians are employed by hospitals and other medical care facilities.

While pharmacy technicians are in high demand, technicians with formal training are in the highest demand. Over the next ten years, as the demand for healthcare needs in the middle-aged and elderly generations increase, employment of pharmacy technicians is expected to grow rapidly. Salary.com states that in 2007 the average pharmacy technician salary was $27,261, with the lowest 10 percent making less than $21,663 and the highest 10 percent earning more than $34,544. Employees with the greatest amount of training earned the most.

Technicians are Desperately Needed

Pharmacy technicians perform a variety of tasks, most often assisting the pharmacists, filling prescriptions, and performing various customer service tasks. Another common task includes directing patient questions regarding drug information, health matters or prescriptions to the pharmacist.

Filling prescriptions is the main duty for a pharmacy technician. Once an order is received, they must verify the prescription information is accurate and then count, pour, measure, weigh, and in some cases, mix the medication. The technician is also responsible for preparing patient insurance forms and maintaining patient profiles. Job duties will differ according to workplace. Other duties could include answering phone calls, handling money, stocking shelves and data entry.

Pharmacy technicians who work in hospitals, nursing homes and assisted-living facilities have different responsibilities than retail employees. Pharmacy technicians in the medical care field are responsible for reading patient charts, preparing and delivering medicine to nurses, who then administer it to patients. Technicians package and label each dose of medication by hand or packaging machines.

Technician Training Offers Real World Training

In the past, technicians have only received on-the-job training, but as the job market is becoming increasing competitive, employers are requiring professional training. Employers want their employees to understand the pharmaceutical business because it is becoming increasingly more complex. Formal training programs are comprised of a combination of classroom and lab work. Students often partake in internship programs where they obtain real world, hands-on experience. Most formal training programs result in a diploma, a certificate or an Associates degree.

Pharmacy technician training courses may include:

* Basic Medical Terminology

* Human Diseases

* Alternative Medicines

* Hospital and Retail Pharmacy Procedures

* Drug Classifications

* HIPAA

* Pharmacy Law and Ethics

* History of Medicine and Pharmacy

* Prescription Processing

* Body Systems

Certified Technicians Earn Better Wages

Once training is complete, students have the opportunity to take the National Pharmacy Certification Examination. This exam is not required in most states, but many employers prefer individuals who have passed the exam. Passing the exam makes you more valuable in the competitive job market. In order to take the exam, you must have a high school diploma or a GED and cannot have any felony convictions on your record.

It is important to note that certified pharmacy technicians must be re-certified every two years. In addition, they must complete at least 20 contact hours each year. Attending lectures, completing college coursework, and specialized on-the-job training are all ways to complete contact hours. Employers often provide employees reimbursement for their certification costs.

Now is a great time to get into the pharmacy technician field. The field is growing rapidly and employers are actively seeking well-trained employees. Training takes less time than traditional programs, so it is a great choice for people with busy schedules. After a few years in the field, many people choose to further their education and continue on to pharmacist school.

The Agnes Story

A modest white clapboard and red-brick fronted ranch house nestles on 4989 Hickory Signpost Road, a suburban street off John Tyler Highway, in Williamsburg, Virginia. The few dried leaves scattered about the yard are the only indication that the season is transitioning, for the white oak and ash trees still hold their leaves. Everything looks orderly on this mild, early October day, as we follow the driveway behind the house to park alongside the tired-looking Ford Econoline van and a pickup truck that clearly has seen some better days. A knock on the front door brings no response, but we are given a broad wave from the rear deck to come into the kitchen. Welcome to Martha's Place, a residential home for disabled adults.

In this family reside individuals with physical and intellectual disabilities, people with autism and those with impairments that need support to meet daily challenges. A tall, strongly-built woman, her hair tied in a brown floral kerchief that matches her caftan, greets us with a warm handshake and beaming smile, which belies the fatigue in her eyes. She bids us take a seat on one of the stools at the kitchen counter. She, however, alights only briefly, as there is a minor night situation to be resolved, morning food to be prepared, and a day to be organized.

Sr. Agnes hails originally from Nairobi, a family of eight children. The neighborhood that makes up Jolly Pond, her first home for disabled adults is a world away from her original intention of joining the cloistered, contemplative Dominicans. On a home visit, her father's encouragement to "do what you have to do" led her to the Little Sisters of St. Francis (LSOSF). At this point, Rose, a young client sporting new whitelaced black sneakers, bustles into the room, wanting to know when the hairdresser is coming to give her braids. Sr. Agnes, for the first of a dozen times, patiently explains all the chores and activities that must first be accomplished before the hairdresser will arrive. Rose hugs her and sits down for a few minutes before repeating the question. This is her birthday present, and she is particularly anxious.

Without pause, Sr. Agnes compares her spiritual and professional path to the seasons, how "one must plant, plow, and then harvest. But first you must prepare and create the rains; and don't forget the weeding." To prepare, she attended the University of Rochester and the National Technical Institute for the Deaf (NTID), where she lived with the Sisters of Mercy; and then Gallaudet University in Washington, D.C., where, with her background in special education, she decided that she could best serve God and her community through the opening of residential homes for disabled people. This realization has been a thorny process at times. Financial and visa obstacles had to be overcome. Her passion was not always embraced by others. "Some say I am crazy," she chuckles, "but they eventually came around, maybe grudgingly." She also says she prayed a lot. Sr. Agnes believes one person can make a difference, and she views the homes she has purchased and manages-sleeping on a nightly rotation in each one-much like the small scale farms back in Kenya, where the cow's milk nourishes the family, who are then able to grow the crops that feed the village.

The complexities of managing five homes, with more to come, has meant Sr. Agnes' circle of caring people has expanded, along with her own knowledge. Compassionate and enlightened individuals have offered wise tax, mortgage, and legal advice. She rolls her eyes at the term 'interest rates,' and acknowledges her deep gratitude towards others' expertise. Her vision is once again turning toward East Africa. Globalization has brought economic benefits, but other problems as well. Her face saddens as she recalls her youth, when neighbors casually visited back and forth. "There are fences now; people are busy; generations coming down the road will have it very rough."

Her indefatigable optimism demands a resolution, and so turns towards helping the children. This is much like planting a new crop. With the enthusiasm of her American friends and Sr. Agnes' understanding of her culture, there are plans to build an orphanage. The challenge is to build a home, to provide the psychological and emotional support-a family-that will create the cultural roots for those children who have lost parents to disease and war. "What type of spirit must we have?" she asks.

Sr. Agnes has planted roots that have brought forth greater community understanding. The residents of Jolly Pond, Martha's Place, Hickory Signpost, St. Charles of Lwanga Home, Lwanga "G" Home, Seaton House, and St. Michael's Day Support Program are our neighbors. They are not segregated in institutions, but are people achieving to the best of their ability. Sr. Agnes, the other sisters of the diocese, and those who work with these individuals are their advocates; they provide an abundance of support, from the daily logistics of cooking and cleaning to transportation. At times they nurse, teach, or listen. They remember holidays, favorite television shows, and birthdays. Sr. Agnes and her community model the success that comes from inspired action. She has taken a dream and with her strong faith and determination brought it to fruition. Now the hairdresser has arrived, and Rose will get her braids.

Information on Sr. Agnes' residential homes and day support services for adults with disabilities and the Franciscan Brethren of St. Philip in Virginia The Franciscan Brethren of St. Philip is a private, non-profit organization that provides residential and day support services to adults with disabilities. Our philosophy is that all people have an inherent dignity and each individual will be treated with respect, regardless of age, race, creed, color, financial status, or developmental/intellectual, mental, or physical impairment. We have two Intellectual Developmental Disability Waiver Group Homes and two Assisted Living Facilities. Each home is in a beautiful residential neighborhood and may only have six to eight residents. The home provides meals, medication management, laundry services, and twenty-four hour supervision and individualized training. We also offer an Intellectual/ Developmental Disability Waiver Day Support Program.

Sr. Anges Redisdential and Day Support Programs

1) Jolly Pond Residential Facility, Williamsburg, VA-26 acres

2) Martha's Place Group Home, Williamsburg, VA-1 翻 acres

3) Seaton House Group Home, Quinton, VA-25 acres

4) Lwanga "G" Home Assisted Living Facility, Williamsburg, VA-1 翻 acres

5) St. Charles of Lwanga Home, Williamsburg, VA-34 acres

6) St. Michael's Day Support Program, Williamsburg, VA-4 acres

Little Sisters of St. Francis, Friends and Volunteers Currently, the Little Sisters of St. Francis manage five homes for disabled adults in the Williamsburg, Virginia area. They were recently licensed to provide daycare support for disabled adults in the state of Virginia.

On the other side of the globe, The Little Sisters of St. Francis in Kenya and Uganda are involved in finding homes for orphans in Kenya and Uganda. Sister Agnes hopes to return home someday to continue their efforts and mission work in Africa.

This article was co-authored by Dolly Parker and Mary Lyons