Ideals of Yoga

If one is to commence as a student of yoga one should be aware of the general purpose of the science and the sincere aims of the aspirant. Many people begin with only a fraction of understanding of what yoga is all about, all that is offered and all that it demands. It comes as a surprise to learn what a complete system of culture is offered through these teachings stemming from the ancient Vedic philosophy.

Yoga is considered by many to be the oldest natural science, teaching the laws of Nature and how to adapt them to the human art of living. Nature is to be respected and befriended. It is wrong to ever think of conquering Nature. To abide by natural law is to the yogi synonymous with God's Law. For each to live to the highest potential physically, mentally and spiritually is considered total human maturity and is a valid expectation and goal for all mankind.

Although the origins are obscured in antiquity, the prescribed techniques and guidelines are thought to be as old as mankind's history and culture upon the earth. It is generally conceded that Yoga as a system was developed in India and it is the Indians who have remained custodians of its wisdom. Although recognition of the Indian source is its due, Yoga teachings however, are not the province of any one culture or race. Being a natural science, it has no boundaries but is universally available to all.

Certain adaptations of the old techniques must be adapted to suit western modern cultural needs but the essence of the teaching remains. It is based upon self discipline and self culture within a framework of ethical and moral codes. It is to be expected that the physical and even psychological programmes of training will evolve and change but the singleness of spiritual purpose must be retained and the techniques for spiritual consciousness also, in order that exponents preserve the purity of the system.

The single spiritual aim is to consciously experience the release from limitations of life as an individual locked in the cell of his self conscious ego and to realise the spiritual limitless of his own source in God or Universal Life. Attuned to this power, he seeks then to live a constructive life of benefit to others.

Patanjali, the sage, was the author of the written yoga precepts which survive after about 2,000 years. Until his time, it is thought that the teachings were largely oral and transmitted without book learning but in an unbroken traditional line from Master to pupil, or from Guru to chela. To these sages of old, we owe our greatest respect as well as to the scholars and wise ones who have assisted us in interpreting and comprehending the ancient wisdom.

Although Yoga is most frequently practised in the framework of Hindu culture it is now commonly understood that there is no connection with any religion. Yoga advises the student to follow religious practises according to the sincere beliefs of the individual whatever religion is the natural to him and his native culture. But the highest aspects of yoga develop a universality which is beyond any one religion and it is usual to find that the yogi is at ease when at worship in worship in the church or temple of all the religions, or in none at all.

The aim of Yoga is to understand both the laws of Nature governing physical matter and the human body as well as those which affect the subtle psyche of man and the spiritual aspect of his being. The word "yoga" implies a union or integration of man with harmony within his whole being, body, emotions, mind and spirit - a state which is then represents "health". In a higher aspect it refers to the re-union of life of the individual with the Whole.

The healthy student who has successfully applied himself to the rigorous tests and exercises in overcoming his negative self and by controlling, developing, then dedicating his positive talents of his human nature has achieved the first aspect of Union or Yoga. The second phase is uniting his individuality to the Universal Energy Source in order that he may make a constructive and inspired contribution to the world around him.

Conscious understanding of himself, of others, of Nature and of the Universe implies an ever expanding development of his mind and realisation which stretches from the mundane world to infinity. The conscious experience of Universal Energy, the Source, or God is the ultimate spiritual reward.

The Indian sages and spiritual Western saints are known to us to exist both in historic times and in our own time. Some choose to work in retreat as recluses in ashrams and monasteries. Others elect to work directly amongst the people and can be found in the many and various roles played in human civilization. Wherever they function, these individuals act as human channels for energy of a type and quality dependent upon their individual spiritual development and their degree of Universality or wholeness.

In India some choose to reside on the plains and work amongst the people, teaching and healing in the ashrams, as does the priest in western countries. Others have sought mountain tops as their homes where they can transmit, unimpeded by worldly pollution of mind and matter, their highest quality energy to the world and to humanity.

Wherever man resides upon the earth, there are yogis or spiritually awakened ones. They have walked the earth in eastern and western countries and in all times and eras. Their message is always one of a reminder to us of the value of love, truth, beauty, kindness, in the human soul and their reminders are always such as to inspire us to further effort to cultivate these qualities.

Today we are very aware of the need for a return to these values and yet suffer by having few great teachers expounding, or exemplifying these qualities. We have to rely upon our own integrity. However, it is a natural law which allows that when humanity becomes unbalanced in its development and swings away from the spirit into materialism and decadence, a great teacher comes to point the way. Many people are hoping that the new century will bring us such a great teacher. Societies in all countries are showing signs of serious problems which deny peace, love, kindness, beauty and truth to flourish.

Practising the disciplines to maintain good health is our personal responsibility undertaken by those intelligent enough to comprehend it and in the system of yoga, this is known as Hatha Yoga, the commencement of training when the harmonising of the two main energies in the individual is achieved.

Undertaking disciplines to develop healthy emotions is less understood, but equally important so that emotional unease and distortions do not occur to plague us. Development of the love principle of devotion is known as Bhakti Yoga.

Mental disciplines to keep the mind clear of negative thoughts, destructive tendencies so that creative thinking can occur and the mind capable to realising truth is known as Raja Yoga. Mind training is becoming important and many teaching systems exist although there is more attention given to the principle applied to electronic computers than there is given to the human minds who use them.

But yoga reminds us that beyond the mind is the soul. We seldom use the term in everyday life and it takes a poet to help us recall this most vital part of ourselves. The churches remain un-enlightening and have neglected to educate us properly in this regard. For clarification of the term soul we describe the deepest and most profound part of our nature into which we withdraw at times of great distress or at times of great happiness. It is that which is beyond the personality of thinking, feeling and acting.

The spirit is higher again. The yogis call our spark of spiritual energy pure and of the qualities of light, as is our Atma. This spark in each one may not be defiled nor affected by all the other aspects of our nature. It is above our comprehension and our conscious reach except in unusual circumstances.

To live spiritually to the yogi, means to live with body, emotions and mind developed and under control so that one lives as a soul self, with the soul self inspired by the spirit - as one integrated and intelligent wholeness of being. Let us now clarify our terms and accept the aspirant as the Yoga student and reserve the term "Yogi" or "Master " for the one who has reached the goal of the man made perfect and who has of becoming a pure channel of Light to the world.

Following Yoga techniques can bring the reward of a healthier body, happier emotions, peaceful mental state and a successful life.

Discipline yourself to control the appetites, build a healthy body with natural God-given foods, control the thoughts and develop mental attributes so that the mind may be strong to steer you to your spiritual goal.

Elder Abuse and Nursing Home Neglect

According to Wikipedia, elder abuse is a general term used to describe certain types of harm to older adults. Other terms commonly used include: "elder mistreatment", "senior abuse", "abuse in later life", "abuse of older adults", "abuse of older women", and "abuse of older men".

One of the more commonly accepted definitions of elder abuse is "a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person."[1] This definition has been adopted by the World Health Organization from a definition put forward by Action on Elder Abuse in the UK.

The core feature of this definition is that it focuses on harms where there is "expectation of trust" of the older person toward their abuser. Thus it includes harms by people the older person knows or with whom they have a relationship, such as a spouse, partner or family member, a friend or neighbor, or people that the older person relies on for services. Many forms of elder abuse are recognized as types of domestic violence or family violence.

The term elder abuse does not include general criminal activity against older persons, such as home break ins, "muggings" in the street or "distraction burglary", where a stranger distracts an older person at the doorstep while another person enters the property to steal.

In 2006 the [International Network for Prevention of Elder Abuse (INPEA)] designated June 15 as World Elder Abuse Awareness Day (WEAAD) and an increasing number of events are held across the globe on this day to raise awareness of elder abuse, and highlight ways to challenge such abuse.

Symptoms of Elder Abuse and Nursing Home Neglect

NOTE: Although only one of these indicators may be sufficient to indicate abuse, neglect or exploitation, the presence of only one, or even a few of the indicators, do not necessarily determine such. However, the larger the number of indicators present, the more likelihood there is of abuse, neglect or exploitation. Clergy are, of course, encouraged to be alert for indicators in the elderly with whom they come in contact, and to report same to jurisdictional protective service.

Malnutrition
Dehydration
Frequent or multiple decubiti
Poor personal hygiene
Unclean clothes or bedding
Withholding drugs by caretaker
Over medicating of client by caretaker
Untreated physical or mental health problems
Inadequate heating or cooling
Multiple injuries, burns or bruises
Vague explanation or denial in view of obvious injury
Conflicting or illogical explanations of injury
Exaggerated defensiveness exhibited by caretaker
Over hostility towards client exhibited by caretaker
Has "imprint injuries" (i.e., bruises that retain the shape of traumatizing object). Note shapes of bruises similar to objects or hand/thumb/finger marks. Inner arm or thigh bruise are especially suspect as are injuries to the head, scalp or face.
Unwillingness to discuss problems or injuries with caretaker or in caretaker's presence
Fearful of caretaker, but anxious to please
Failure to meet basic subsistence needs despite adequate income
Reliance on client's income by caretaker for personal needs
Legal documents signed when caretaker is incapable of understanding

Online Nursing Assistant Training Programs

Patients in a variety of medical facilities have daily interaction with nursing assistants. In most instances patients and assistants build a strong friendship due to the constant contact. Learning how to perform job duties can be done through online nursing assistant training programs.

Enrollment in an accredited online learning program will help students learn about the daily activities of the workplace which can consist of working with patients by serving meals, making beds, helping them eat, dressing them, and bathing them.

• Medical related activities will have an assistant taking a patient's vitals, which includes temperature, blood pressure, and heart rate.


• Online training will prepare students to handle job responsibilities as well as the stress of working with and monitoring patients.


• Nursing assistants work primarily in nursing homes, assisted living homes, and hospitals.

Training is highly recommended because more employers are requiring their employees to be certified as a nurse assistant prior to being hired.

Students can take online classes prior to entering a program to prepare them for the skills they will need to know. A first aid and CPR course can help them succeed in a program. Certificate programs vary a little from college to college but the general education requirements are pretty standard. Programs will range from six to twelve weeks and include coursework on medical terminology, pharmacology, acute care, home aid, and more. A state only recognizes students as certified after 75 hours of official training. Upon completion of coursework and clinical experience a student will have to take a certification exam in order to gain their certificate. Nursing assistant education requirements are different for some states. Students should check state requirements so they can enroll in the correct program.

Online nursing assistant courses teach student's foundational concepts and procedures in areas they will directly work in. A certified nursing assistant theory course explores issues that relate to the daily activities a working professional will complete in their day-to-day work duties. Students will learn about hygiene management, infection control, and data collection. Medical basics will be learned by taking campus based courses in order to gain experience in taking blood pressures and drawing a patient's blood. In an acute care course students address practical areas of their work. Topics include the social, psychological, and physical demands of a patient. Basic nursing tools like problem solving, interviewing, and decision-making will be implemented. Probably one of the most effective and useful courses a student completes is their clinical course. Graduates of a nursing assistant program will have learned to work directly with patients under the direction of a registered nurse. Settings for learning include hospitals, nursing homes, clinics, and doctor's offices. These types of courses require an individual to recall the concepts and procedures learned in the online class and apply those skills to a real patient. Real work experience provides many students with the confidence they need to step into the profession.

Employment is expected to rise 18 percent over the next eight years. Gaining an online education in the field will pay off. Students should consider the growth rate and how that will positively affect their annual income when deciding if working through an accredited program in this area is for them. Accreditation comes from the Accrediting Bureau of Health Education Schools ( http://www.abhes.org/ ) and other agencies and is awarded to online nursing assistant schools and colleges that meet the criteria for a quality education.

DISCLAIMER: Above is a GENERIC OUTLINE and may or may not depict precise methods, courses and/or focuses related to ANY ONE specific school(s) that may or may not be advertised at PETAP.org.

Copyright 2010 - All rights reserved by PETAP.org.

Paranormal Experiences

Major studies show that one third of Americans polled believe in ghosts, haunted houses, and the paranormal. Many of those surveyed have had a personal paranormal experience, at some point in their life.

What is a paranormal experience, exactly? That is a difficult question. It can be any unexplainable occurrence; as individual as the person experiencing it. It may involve an uneasy sense of being watched, or bizarre electrical malfunctions; lights, and other appliances randomly turning themselves off and on. It can manifest as extreme variations in temperature, frigid bursts of air appearing on a hot summer day with no explanation.

Experiences with the paranormal may be as profound as hearing disembodied voices or seeing full bodied apparitions that suddenly vanish into thin air. Others are subtle and can easily be written off as a passing coincidence.

But, most agree that unexplainable incidents exist in the world today, and have since the beginning of recorded history. How people react to them depends upon many factors, including religious beliefs, cultural norms, superstitions, and personality traits.

Many people have never given the concept of the paranormal much thought one way or another until something happens that turns their attention in that direction. The first response, in general, is the age old; "fight or flight" stress response. The body reacts, and we either instinctively run from the stimuli we can't understand, or we stop to face it head on. That's how God made us!

Those of a more rational, scientific mindset tend to look at the world in a set of black and white facts and figures. Everything is compartmentalized neatly into its place and there are no gray areas allowed. They believe only in what they can see, touch and prove, giving no credence to the things they can't. True skeptics lack the capacity to recognize a spiritual event, even when right in the middle of one, and, therefore, will never experience a paranormal event. They rationalize it away, and go on with their day.

On the other end of the spectrum are the new age, mystical believers. They are open to all things, and enjoy a spiritual side of life without question. They love the whimsical and the fantastic. There are religious groups from Wiccans and spiritualists to born again Christians who spend time daily in prayer and communion to the spirits they believe in.

In the middle, are the everyday people that have experienced the paranormal; astounded and unprepared for the sudden interruption into their lives. Some are from a conservative background with fundamental religious beliefs; others may be liberals with no preconceived notions of an afterlife.

Those who react to the paranormal with fear and dread can suddenly be thrust into a whole new level of unknown territory. With it brings new fears of mental illness. Visual and auditory hallucinations are definite signs of mental problems and people must consider that possibility when they suddenly start hearing voices or seeing things that aren't there. Physical illnesses such as Dementia, brain tumors, hormonal imbalances also come to mind. Those particular worries can be more terrifying than the prospect of dealing with the paranormal.

But, not everyone is afraid of the unknown. Some embrace it, and view it with awe and curiosity. They have the ability to accept the things not easily explained and yearn to learn more about it. In many instances, staff of haunted hotels, or families living in haunted houses, learn to live in harmony with what they perceive as restless energy or spirits of past inhabitants. They have found that spiritual energy is not always scary. It can be warm and comforting, too.

I want to believe in the paranormal, and for the most part, I do. Life after death is something I believe in with all my heart and soul. Still, I have some skepticism about whether or not spirits of the deceased can communicate with the living.

But, I remain open to the possibility.

I'm not afraid of the spiritual side of the world. I'm a seeker, and I welcome any experiences that come my way. I do believe I've had a brush or two with the paranormal over the years, and they were extraordinary but not frightening. I hope to have many more, and when I do, I will remember the motto, My God is greater than my fear.

Or, in the words of my three year old grandson, "God is bigger than the boogie man!" He is always with us and we have nothing to fear!

Assisted Living Home Checklist - What to Look For When Searching For an RCFE

Overall Quality

o What is your impression of the residents and they're level of care?
o Are the residents of the home woken up on time and ready by a certain time?
o How are the resident's appearances? How do they look, smell, and feel?
o Are there specific plans for each residents care?
o Does the Assisted living home offer specialized care for special needs like dementia?
o Does the home offer visits or access to doctors, RNs, and clinics, etc?
o Do the caregivers drive residents to medical appointments and is there an extra fee?
o Is there a plan to respond to medical emergencies?

Caregivers & Other employees of the home

o What are the requirements for caregivers to work in the home?
o Make sure the caregivers interact nicely with the residents.
o How long has the manager been working at the home?
o How is the employee turnover in this assisted living facility?
o How many caregivers are working in the daytime, at night, and on the weekends?
o How many residents are there in the home for each caregiver?
o Do the employees speak and understand English or any other needed language?
o Does the staff know how to work with Alzheimer's, Parkinson's disease and dementia?
o Do the caregivers talk to residents in a friendly manner?
o Do the caregivers respond quickly to resident requests?
o How do employees respect resident's privacy?

Services provided to residents

- What is the system for distribution of medication?
- Is there a registered Nurse that comes on a regular basis?
- Does the home provide bed linens and towels?
- Does the facility provide laundry service?

Resident & Family Participation

- Are residents and their families involved in medical assessments, roommate approvals, and care planning sessions?
- What is the complaint process?
- Can residents select their favorite foods?
- Is there a Ombudsman Program poster and telephone number posted in the home?

Fun Trips and Social Interaction

- Do residents have fun and meaningful activities and events to take part in?
- Is there a activities director (mostly with larger facilities)?
- Are there trips outside of the assisted living home?
- Are there any religious or spiritual activities?

Breakfast, Lunch, and Dinner

- Is the food fresh?
- Do the residents get help eating and drinking?
- Are residents and their families involved in the food selection process?
- Do the caregivers meet specific dietary needs?
- Snacks?
- Fresh Drinking Water?

Living Space and Accommodations

- How is the overall look and feel of the place?
- How does the home smell bad?
- Climate control?
- Safety measures such as special showers, locked drawers.
- How is security?
- How much space is provided for the sleeping area, living rooms, and dining areas?
- Are the floors slippery?
- Can the home accommodate a wheel chair?
- Do they have backyards or gardens for resident gardening?
- Do they allow pets in the home? If so, what type of pets and are there additional fees? If not, are pets allowed to visit?

Licensure and Certification

- Is the residence licensed by the state?

Proximity Accessibility

- What is around the general area of the home?
- Is it easy for family members and visitors to find?
- How far is it for close friends and family?
- How far away is the resident's doctor and clinic?
- Is there a hospital nearby?
- What are the visiting hours?

Reputation & Vibe

- Are you able to talk to other resident's families and other references?
- How was the staff in showing you around and answering your questions?
- Are you able to envision you or your loved one living in this home?
- What was your overall gut feeling about the home?

Money

- What is included for the base monthly fee?
- Do they accept Supplemental Security Income (SSI) residents?
- How do their prices compare to the competition?
- Are there any hidden, or fees that need to be paid up front?
- Refund policy?

HIPAA For Activity (Quality of Life) Directors - A Crash Course!

Relax...

The good news is that HIPAA is not as scary as it has been made out to be. I have written this article specifically for activity (Quality of Life) directors and activity personnel. Since most of us are the makers of calendars, newsletters, banners, bulletin boards, etc., we need to know about the HIPAA policies.

The following article will hopefully ease your mind about HIPAA regulations. That way, you will be able to have your calendars, banners, bulletin boards and posters, while being in full compliance with all of the regulations.

What is HIPAA?

HIPAA or the Health Insurance Portability and Accountability Act was enacted in 1996 to help the federal government regulate the transferability of health insurance and to empower the government to fight fraud and abuse in long term care.

So what does that have to do with Activities (Quality of Life)?

In addition to the issues of health insurance, HIPAA was initially designed to regulate "individually identifiable" health information that was transmitted electronically. Since then, the "Privacy Rule" that is defined by HIPAA has expanded that concept.
So basically, a large amount of information that is crucial to Nursing homes can now be covered under HIPAA(2). Since activities personnel deal with personal resident information, one of the areas for disclosure could be the activities department. In addition, the penalties for violating these rules are pretty steep ($100 to $25,000 per year, for each violation), so pay attention

Is your facility a Covered Entity? You decide.

The only facilities that will need to adhere to HIPAA are called Covered Entities. Covered Entities are defined as the following: Health care providers, Health Plans and Health Care Clearinghouses and Business associates. Each of these groups is expected to follow the guidelines that are described in HIPAA. Those groups that do not fall under the "Covered entities" description may not have to follow HIPAA.

Here it is in English. There are four basic groups that need to worry about the HIPAA regulations; in this article I will only look at one, the health care provider.
In general a health care provider is a nursing home, rehab facility, hospital or any other facility that provides skilled or intensive care.

Personal Health Information-The essence of HIPAA

In terms of HIPAA, the information that they are worried about is called "Personal Health Information" or PHI. It can be best described as: any information that identifies an individual, that is received or created by a facility that contains information about the past, present or future physical or mental health of an individual. PHI can also include information on payment for medical services-however; I am intentionally staying away from that topic in this article.

This information is normally found in medical charts and billing files, however, it can be found in bulletin boards, Photos, Calendars and Birthday Cards, Activity Rooms and Common Areas and Activity Progress Notes. It is the highlighted areas that I will address in this article specifically.

All other information that I do not address, should be covered by your facility, in its "Privacy Policy".

Each facility should have its own policy that is given to the resident on admission and to the staff who work at the facility. It is also not a bad idea for the activity department to follow a higher standard in regard to privacy, since we usually deal with the residents on a personal level, including but not limited to: family issues, special requests from the resident, newsletter articles, etc.

Please note: it is the responsibility of every employee to keep resident information confidential with regard to every aspect listed above. It is also the responsibility of each employee to know what types of information are covered under the HIPAA policy and under facilities' privacy policy. Please educate yourself to the specific information in those policies in addition to using this as an education tool!

Now that all of the legal stuff is out of the way...

Now, you are sure that your facility is a covered entity and you know the definition of PHI. There are several ways to keep your department and residents safe with HIPAA regulations. This is especially true when you realize that there are different ways to change medical information that are allowed under HIPAA regulations. First, let's look at the instances in which it is OK to reveal PHI.

Generally, the facility may provide PHI to family members, friends and clergy, such as:

1) The residents' name and room number
2) The general condition of the resident-(e.g.- Ms. Smith is having a good day today, she went to Bible Study on her own. Not: Ms. Smith is feeling good because we gave her a double dose of medicine.)
3) The residents' religious affiliation.

In the following examples, we will look at some ways, in which it is not allowed to disclose medical information

1) As you walk down the hall you hear 2 staff members- "I saw Mr. Jones last night and his delusions were really bad!" Besides being gossip, this is also disclosure of PHI and a violation of HIPAA.
2) As you are entering Care Plan information on your computer, you are called away; you leave the computer on with the information on the screen, Once again a violation, since anyone can come by and look at the computer.
3) You are expecting a fax from a hospital about an incoming resident; you do not pick up the fax until the day after. Once again, who can see the information? Remember, there are several ways to violate HIPAA regulations.

So let's recap...we know that there are several ways to reveal information about residents, but what about information that we use everyday in our activity plans, bulletin boards and other publications?

Well, let's take it piece by piece.

1) Photo's - most facilities have a standard form in which the resident gives permission to take their pictures and is kept in the chart. This allows us to use a basic picture for whatever we need. However, if you put the resident's name with that picture, you will be violation HIPAA. If you need to use a name (on a bulletin board for example) all you really need to do is ask the resident for permission and document it!
2) Calendars and Birthday cards- The best way to avoid the HIPAA regulations with regard to Birthday cards and calendars is simple. PHI can be de-identified by removing the birth year from any information. For example: Happy Birthday to Joe Smith -6/15! There is no other medical information that should be used on a calendar anyway so simply remove (diagnoses, dementia items, etc.) from the calendar.
3) Bulletin Boards and Miscellaneous- In almost every case with PHI if you take the proper steps to ask permission, you can prevent any confusion. If you have pictures, avoid putting names with them. If you must, get explicit permission and document. If you avoid using PHI with regard to residents you are in the clear.
4) Activity Rooms and Common areas- It is fine and dandy to use pictures of residents in your common areas. Please remember that no medical information can accompany the pictures. Do not identify residents by room or unit, especially if that resident resides on a memory/dementia care unit.
5) Activity and Progress Notes- All progress notes should be in the individual chart of the resident. If there is documentation outside of the chart, it needs to be shredded or placed into the chart itself. Pure and Simple...

In general, HIPAA is nothing to be afraid of for any Activity (Quality of Life) Director. The regulation was enacted to prevent privacy issues for residents of Nursing and Skilled care. If your activity department uses common sense to prevent improper disclosures you should be fine. Please feel free to use this article as a reference tool and double check with your administrator for individual questions.

Elder Abuse In Nursing Homes - Two Best Ways to Prevent It

Baby boomers are starting to turn 65 this year. They are doing so at the rate of 30,000 per month. This rapid influx of seniors into our retirement is placing an enormous strain on nursing homes, assisted living facilities, long-term care facilities and whatever you want to call them. Not only is there a shortage of beds but there's a shortage of qualified staff to take care of the influx of patients.

Recently there was a lot of publicity raised by actor Mickey Rooney who testified before Congress on some of the problems he had. He did that to raise awareness of a growing problem. The problem is actually twofold.

It is well-documented that six out of every 10 nursing homes have some type of elder abuse. That can be manifested in a variety of ways from verbal, physical, psychological-practically any way that you can abuse somebody, it happens in a nursing home.

The second problem and you're not going to believe this; nine out of every 10 senior facilities has one or more convicted criminals. That fact from a recent GAO report! Scary enough for you?

There are two ways that you might be able to prevent abuse of your parents in a nursing home or other facility.

The first seems pretty obvious but it's very effective. That is to visit your parents on a frequent and regular basis and get other people involved in the process. The more visitors you have to keep an eye on your parents the better. Make sure they know what to look for and talk to the elders about what's going on in their facility. Not only will that provide evidence of something that is going on but may serve as a warning to anybody who might consider harming them.

The second way is to install a hidden spy camera. This may seem far-fetched to you but recently there was a case in Alabama where the daughter of nursing home patient noticed unexplained bruises on her dad's arms. She installed a hidden camera that caught a caregiver repeatedly striking her father and removing her dad's oxygen mask without authorization.

If you think these are isolated instances you are dead wrong.

A spy camera is the most effective tool in the marketplace today at catching people doing things they shouldn't be doing. That's why the CIA, the FBI and other law enforcement agencies use them for decades as part of their undercover sting operations. News organizations use them for undercover "stings" that are some of the most sensational stories you see on TV.

Hidden security cameras work for them-they will work for you. When are you getting one?

Gerontology and How to Get a Job As a Gerontologist

Gerontology is a field that specializes in the study of the social, biological and psychological aspects of elderly people. By researching aging process of the elderly, gerontology can incorporate better rules and regulations to provide the elderly with a better quality of life.

Gerontologists are trained and licensed health care professionals who work with elderly people. They are equipped to analyze all aspects of aging individuals with the exception of disease and sickness. These healthcare professionals generally work in many different settings where aging individuals can be found. Nursing homes, hospitals, and other settings are where gerontology is practiced.

Gerontologists are required to educate and inform the older population by giving speeches, presentations and by providing resources such as writing books, articles and other literature that will increase the knowledge of the elderly individuals. People who pursue a career in this field will have a love of communication and be able to communicate effectively. He or she must be dedicated about the wellbeing of the older population.

There are many different kinds of gerontologists. There is the research gerontologist that researches and analyzes how the aging process affects people in different type of settings. They then use their findings as a means to understand and to enhance the lives of the senior citizens. Those in applied gerontology interact with the older people by communicating and providing assistance to them, their families and anyone they interact with on a daily basis.

In the area of administration, there are administrative gerontologists who are trained to provide management skills by creating programs and services that will be beneficial to the elderly. They help to keep the programs that are already in place running properly.

Gerontologists can have a degree in any related field. A degree in psychology, nursing, sociology, teaching and any other socially related degree can be used to enter this career.

Work Environment:

Gerontologists are able to work in many different types of employment places including nursing facilities, assisted living centers, hospitals, and health offices. They can also teach at schools and colleges and even with other professionals in the health industry to provide a better quality of life for the elderly.

Education:

For those who are interested in pursuing this career will need to take coursework in biology, geometry, algebra, and chemistry while in high school. Bonus courses would be English, psychology and any course that will better prepare you for making the transition from high school to college with a specialization in gerontology.

College Requirements:

A career as a gerontologist requires a high diploma or a GED. Training requires college and university coursework in any field that relates to sociology. A completion of a Bachelors and even a Masters degree is needed to become a gerontologist. Before becoming a licensed and practicing gerontologist a clinical internship may also be required.

Requirements do vary according to which discipline of gerontology you are majoring in; it is best to check with your school to make sure you are fulfilling the requirements necessary for your career.

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How to Recognize Signs of Neglect in a Nursing Home

So your family member, loved one, friend is in a Nursing Home and you are paying a visit? You have put all of your faith and trust into the facility and assume that they will take good care of your Mum/Dad/Relative/Friend but you start to see some signs that alarm you.

How To Recognize Signs of Neglect in a Nursing Home

When the time comes for your loved one to enter into a Aged Care Home you are giving the facility the trust that they will look after your family member the way you would - with love, respect, kindness, caring, and embracing them as a person with feelings. So it will be upsetting to see that the chosen facility is not meeting your standard of care, or even the minimum level of care that all Nursing Homes are expected to meet according to the Aged Care Accreditation team. But do you really know How To Recognize Signs Of Neglect In A Nursing Home?

Aged Care Nursing Homes Care and Services

Each Aged Care facility has to give a level of care according to the Accreditation Standards to receive Government funding. This Aged Care Standards cover such things as health, personal care, lifestyle, safety and quality of buildings and surroundings, and even ensures that the management team fall in line. Once the Home is awarded the accreditation then each year they must go through checks and pass all test to up keep their awards and funding.

If you start to Recognize Signs of Neglect in a Nursing Home that your loved one is living in then you are able to step in a take the matter further by going to The Aged Care Complaints Resolution Scheme. It is best that you first try to resolve the matter within the Facility but if you feel like the neglect is still occurring and is not resolved then taking the matter is in the best interest of the Resident/your loved one. For more information about Aged Care in Nursing Homes go here.

7 Signs Of Neglect In A Nursing Home:

1. You are visiting your loved one the second time that week and you notice that the resident is still sitting by themselves and have no buzzer near by, nor a drink within reach


2. Your family member is wet upon you arriving with incontinence of urine, and no carer is aware of your loved one being left to sit in their own urine


3. The room your loved one in has a bed that is not made, covered in urine and faeces and smells stale


4. Upon arrival of entering the facility you notice a smell that goes from room to room


5. The bins of rubbish and linen have not been emptied and are sitting in the corridor and its late afternoon.


6. You loved one has come up in a few bruises and there is no explanation for them


7. After hugging your loved one you notice that they have lost a fair bit of weight, and you start to ask questions but no one has noticed that your loved one is not eating... therefore losing weight.

If you feel like the neglect is dangerous for your loved ones safety then you need to discuss the situation immediately. Even if you suspect that their has been an elder abuse situation then you need to contact the police. It is better to known exactly what has happened then to ignore and find out later that there was a dangerous situation that could have been reported and prevented from occurring again. There more ways to Recognize Signs of Neglect in A Nursing Home - with in many departments.

Senior Care - Assisted Living Facilities

As we progress into the later years of our life, taking care of ourselves becomes harder and harder. This is why there are many senior and elderly care organizations that are available for our use and to provide assistance. Usually the most common and most convenient way is assisted living for senior care. There are many assisted living facilities that are set up just for this cause. The function and aim of these many facilities is to provide help and aid to people that need help in performing the chores and tasks of daily life. Who are these arrangements ideal for? These arrangements are set up for people that are unable to perform some of the needs and chores that are necessary to survival, such as bathing or grooming themselves, or even doing some of the simple housework. People who fall in these categories can consider assisted living facilities in which they are helped out thoroughly with all their needs. Keep in mind that these facilities are not really meant for people that need constant medical care and attention. There are many costs that are involved with assisted living facilities, but do rest assured, they cost a lot less than the amount for nursing homes. The costs are generally between $1500 and $2000 a month give or take a few. This number does depend on the individuals themselves as well. There may be some additional fees added for individual requirements. There are some extra fees for people with other medical needs and disabilities.

With that being said, what do assisted living facilities provide:

1. Assistance for daily tasks such as grooming, eating and bathing - and even more


2. Regular meals, usually 3 times a day


3. Help with exercise and staying fit and healthy


4. Housekeeping and laundry


5. Transpiration help


6. Recreation activities, such as bonding, cultural and church activities.


7. Around the clock service. People living here will always be tended to and will have their needs fulfilled usually without delay

There are many financial aid organizations and other financial aid that is available for such people who are not able to afford a facility like this. The cost of a facilitated living home is a lot less than the cost of nursing centers. Planning ahead and saving money for after retirement and such is very helpful. Assisted living facilities fulfill the many needs that senior may need, without giving up privacy or being totally detached from their previous life.

55+ Communities: The Difference Between Nursing Homes, Continuing Care Retirement And Active Living

If you're approaching retirement age, you might be wondering about the difference between the types of housing options for seniors. From continuing care to 55+ communities, there are a number of options to help seniors, no matter what they're looking for. Living in one of these places can provide seniors with a variety of activities to keep them busy, but how do you know which is right for you?

55+ Communities

These are specially planned areas with seniors in mind. They're typically in warmer weather climates and offer amenities like fitness centers with pools, spas, tennis courts, bocce courts, golf courses, meeting rooms, ball rooms, arts and crafts centers, dancing lessons, on-site restaurants and more. Residents can choose to live in their own home or apartment and many offer gated security that's available 24 hours a day, seven days a week. Although these 55+ communities are for people as they live out their retirement years, they are not retirement homes. They do not have nursing staff or other medical personnel on site and are not intended for residents with serious medical conditions that require constant care.

55+ communities have age requirements that must be met before residents can move in. Consideration is made if one member of a couple is over 55, however many have restrictions on the length of time guests under 55 can stay in the community. This sometimes mean that other family members need to stay in a hotel for an extended visit, so check on these restrictions before buying a home if you expect to have long-term out of town guests.

Some 55+ communities that offer active living lifestyles offer special weekend getaways for people who are thinking of moving to the area. If you're interested in trying out the active living lifestyle before committing yourself to buying a home and moving in full-time, consider one of these weekends. This will let you try out a number of 55+ communities to make sure you've found the one that's right for you.

Nursing Homes

Nursing homes provide round the clock care to residents. They're ideal for people who need continuous care like physical, occupational or other therapies. Nurses and other staff will help residents bathe, get dressed, eat and more. Once someone goes to live in a nursing home, they often stay there for the rest of their life, although some residents can be rehabilitated to the point where they no longer require long-term professional care.

Continuing Care Retirement Communities

A continuing care retirement community blends aspects of active living with the care available at a nursing home. They're the ideal situation for seniors who require daily assistance, yet do not need the constant, round the clock care of a nursing home. Seniors can live independently, yet move into assisted living as it's necessary. These typically don't offer as many amenities as 55+ communities.

Choosing where to live after retirement can be a big decision. Many seniors have active living lifestyles before retirement, and want to continue this lifestyle afterwards. Knowing the difference between these types of housing options can help you make a knowledgeable decision on the one that best fits your needs.

Exploring a Variety of Nurse Practice Settings

If you are currently in a nursing school program and wondering where you will apply your skills upon graduation you should know that the sky is the limit. Nursing is a helping profession that allows for application of skills in many different settings. Unlike other professions, nursing is very versatile and there is always a need for qualified nursing professionals across a broad spectrum of areas. Finding your nursing niche may take some time but there is definitely a practice setting to suit anyone considering or pursuing the field of nursing.

One of the main practice settings for a nurse is the hospital. Most people are introduced to the hospital nursing setting while in a nursing school program through a clinical. The hospital setting is considered by some to be formal. It is also one of the few practice settings that allows a nurse to experiment with a variety of specialties. In one hospital alone you can gain experience working in neonatal or pediatrics, medical/surgical, the emergency room, the operating room and even the intensive care unit.

Nurses who work in a hospital setting work a variety of different shifts including weekend only options that give them the entire week off if they agree to work Friday, Saturday and Sunday. Hospital practice settings offer lots of overtime and opportunity to advance but can be somewhat stressful given the nursing shortage.

An additional practice setting is a nursing home or a hospice. Nurses who work in nursing homes and hospices are usually devoted to providing quality care to patients who are older and/or stricken with illness. One of the main concerns may be to provide comfort to these patients while they are on their last days. Many of these nurses also work a variety of different shifts available 24/7 and in the nursing home setting you will also find certified nursing assistants who are of valuable help to these particular nurses. Nurses who work in the nursing home or hospice practice setting must be able to have a great amount of compassion and sympathy and the willingness to deal with issues of death and loss. Many of these nurses are available on an on-call basis to deal with sudden deaths or urgent care matters for particular patients.

For those who love interacting with students using your nursing skills in a school may be the practice setting for you. Some consider school nurses public health nurses because they are not working in a clinical environment and many focus on the prevention of disease. School nurses can be found in schools both public and private from kindergarten to university level. Their main job is to ensure the health of the students and the school staff. Many administer immunizations and keep track of these records. Some also provide education on sexually transmitted diseases, promote nutritional programs and provide medical attention to the student body when necessary.

Assisted Living and Independent Living Differences

Assisted Living and Independent Living have huge differences and adult children make mistakes because they are not familiar with those differences. If I were a person looking for a place to have one of my parents live I would first consider what is known as Independent Living. It offers so much more in the conveniences of life to the average person with some eye, bone or other medical problems. Life is more rewarding in fun communities.

No question we need assisted living properties, but there are more people that do not need assisted living that are moved there by children that really have not realized the differences between assisted living and independent living. Their parents can function very well in an environment with services that fit their lifestyle. Services that include freedom to sleep in, freedom to exercise, socialize with others of their same age, enjoy a more active entertainment package, concierge services, theatre and Spa. I would always try independent living as a first choice of where to help parents relocate when the chores around the house become too much for them.

Why would anyone want their mother or father to go to a place where most of the people living there are needs driven. If your parents are able to get around at home with only a small amount of help it is a good chance they would be more satisfied in a place where there is a higher level of activity.

Here are some subtle differences in Assisted Living and Independent Living.

Assisted Living--------------------------------------Independent Living
Medicine dispensed------------------------------1. Medical Alert System
 
Scheduled Dining--------------------------------2. Freedom to eat on your time
 
Bathing------------------------------------------3. Freedom to sleep in
 
Diet Control-------------------------------------4. Choice of food
 
Fitness Schedule---------------------------------5. Fitness Center
 
Small TV room-------------------------------------6. Large Theatre & Movie Screen
 
Small Apartments--------------------------------7. Large Roomy Apartments
 
Cost Raised After Entry Level Services----------8. Prices Raised Annually
 
Very little included after entry level------------9. Price all inclusive except phone
 
More severe problems--------------------------10. Problems manageable
 
Nurses aid on duty-------------------------------11. Managers or Concierges duty 24/7
 
Nurse on call----------------------------------- 12. Managers or concierges on call

This is just some of the differences and there is a huge difference in cost of what is entry level services. After entry level services assisted living costs raise very quickly and most times it costs over double that of Independent Living.

Most doctors are not even familiar with the quality of life of Independent Living community. They are not aware of all the services, care of the management and staff and how more and more things are changing in Independent Living.

How hard is it to pick up a phone and give a call to tour an IL property before placing a parent, family member or friend in a place they are not happy.

Care Plan 101 - An Introduction to Care Planning For Activity Professionals

Creating and implementing individualized care plans for residents in long-term care facilities is a very important responsibility of activity and recreation professionals. The activity assessment determines the content of the care plan. Not all residents will have an "activity-care plan", but most care plans should have "activity-related interventions" found in the comprehensive care plan. Care plans may be written regardless if a resident triggers on the MDS 2.0.It is important to set realistic, measurable goals, interdisciplinary interventions, and create care plans that are individualized and person-centered.

What is a Care Plan?
The RAI user manual defines care planning as, "A systematic assessment and identification of a resident's problems and strengths, the setting of goals, the establishment of interventions for accomplishing these goals."

Why write Care Plans?
- Document strengths, problems, and needs
- Set guidelines for care delivery
- Establish resident goals
- Identify needs for services by other departments
- Promote an interdisciplinary approach to care and assign responsibilities
- Provide measurable outcomes that can be used to monitor progress
- Meet federal and state requirements
- Meet professional standards of practice
- Enhance the resident's quality of life and promote optimal level of functioning!

What is a Care Plan Meeting?
A forum to discuss and review a resident's status including any problems, concerns, needs, and/or strengths.

Who usually attends a Care Plan Meeting?
- MDS Coordinator
- Nurse(s)
- CNA's
- Dietician
- Rehabilitation Therapist(s)
- Recreation Staff
- Social Worker
- Resident
- Family Member/Guardian

When are Care Plans written?
- A minimum of seven days after the MDS completion date
- Some care plans warrant immediate attention
- As necessary
- Must review at least quarterly

The Role of the Recreation/Activities Department
- Identify the resident's leisure/recreation needs
- Identify barriers to leisure pursuit and help minimize these barriers
- Identify the resident's leisure/recreation potential
- Provide the necessary steps to assist the resident to achieve their leisure/recreation goal/s
- Provide interdisciplinary support by entering a variety of recreation interventions on various (non-activity) care plans
- Monitor and evaluate residents response to care plan interventions

Components of a Care Plan
- Statement of the problem, need, or strength
- A realistic/measurable goal that is resident focused
- Approaches/interventions the team will use to assist the resident in achieving their goal
- Important dates and time frames
- Discipline(s) responsible for intervention
- Evaluation

Target areas for Recreation/Activities
- Cognitive Loss
- Communication
- ADLS
- Psychosocial
- Mood
- Nutrition
- Falls
- Palliative Care
- Activities
- Recreation Therapy
- Pain Behavior
- Restraints

Activity/Recreation Care Plan Samples
These are just a few samples. Remember, the most important aspect of care planning, is INDIVIDUALIZATION!

Statements (the resident's name is usually used instead of the word "resident")
- Resident has limited socialization r/t to depression
- Resident prefers to stay in room and does not pursue independent activities
- Resident is bed-bound r/t to stage 4 pressure ulcer and is at risk for social isolation
- Resident demonstrates little response to external stimuli r/t to cognitive and functional decline
- Resident enjoys resident service projects such as changing the R.O. boards
- Resident becomes fearful and agitated upon hearing loud noises in group activities r/t to dementia
- Resident has leadership abilities
- Resident prefers a change in daily routine and wishes to engage in independent craft projects

Goals
- Resident will respond to auditory stimulation AEB smiling, tapping hands, or vocalizing during small group sensory programs in 3 months
- Resident will actively participate in 2 movement activities weekly in 3 months
- Resident will remain in a group activity for 15 minutes at a time 2x weekly in 3 months
- Resident will accept in room 1:1 visits by recreation staff 2x weekly in 3 months
- Resident will socialize with peers 2x weekly during small group activities in 3 months
- Resident will respond to sensory stimulation by opening eyes during 1:1 sessions in 3 months
- Resident will actively participate in Horticultural Therapy sessions in the green house, 1x monthly in 3 months
- Resident will continue to assist other residents in writing letters on a weekly basis in 3 months
- Resident will exhibit no signs of agitation during small group activities 3x weekly in three months
- Resident will engage in self-directed arts and crafts projects 1x weekly in 3 months

Interventions/Approaches
- Provide a variety of music i.e. Big Band and Irish
- Utilize maracas and egg shakers to elicit movement
- Provide PROM to the U/E during exercise program
- Involve resident in activities of interest i.e. singalongs, adapted blowing and trivia
- Offer 1:1 visits in the late afternoon to discuss recent Oprah episode
- Seat resident next to other Korean speaking resident during groups
- Provide tactile stimulation i.e. hand massages and textured object i.e. soft baseball
- Provide olfactory stimulation i.e. vanilla extract and cinnamon for reminiscing
- Utilize adapted shovel and watering can during HT sessions
- Provide easy grip writing utensils and a variety of greeting cards/stationary
- Involve resident in small sensory groups i.e. SNOEZELEN and Five Alive
- Sear resident near a window
- Provide a variety of independent arts and craft projects
- Provide adapted scissors and paint brush

Exercise
Imagine that you are a resident in a long-term care facility and you are bed-bound for a health-related condition and are at risk for social isolation and inactivity. Write a goal and at least seven interventions/approaches that are relevant to you.

How the Wall Clock Hidden Spy Camera Saved Mom

As the population ages, nursing homes are becoming more popular and a real alternative to many seniors. My parents were both in one at one time. While most nursing homes and assisted living facilities are good to great, some are not. Financial constraints limit the quality of employee they can get leading to all sorts of problems.

It has been estimated that up to as many as two million seniors are victims of abuse of all kinds in nursing homes. Elder abuse is an under recognized problem with devastating and even life threatening consequences. Only one in six actual cases is reported because seniors fear reprisals from their care givers.

Elder abuse can occur anywhere - in the home, in nursing homes, or other institutions. It affects seniors across all socio-economic groups, cultures, and races. Based on available information, women and "older" elders are more likely to be victimized. Dementia is a significant risk factor. It is a big and growing problem.

Well my friend Bill's mom had been in a nursing home for less than two months. She had early signs of dementia. She liked where she was and said the care staff were all very nice. Bill could only visit once a week because his home was in another city. She had her room fixed up the way she wanted it but kept her personal mementos to a minimum.

On one visit Bill's mom related an issue she was having with a staff member who was threatening her over small things. Bill mentioned it to the floor supervisor who immediately came to the employee's defense. The supervisor chalked it up to the dementia and an active imagination.

Bill was still suspicious so he got his mom a nice new wall clock for her room. The wall clock had a hidden camera, microphone and DVR all in one neat looking wall clock. Bill aimed it in the direction he wanted, set the recording speed to the lowest setting giving him 144 hrs on an 8GB SD card.

Bill figured he could check it once a week and really see what was going on. The camera is motion activated so a minimum of down time. When you are ready to playback remove the SD card and insert it into your computer or alternatively use the RCA cable to your TV for easy no brainer playback.

There was nothing suspicious the first week he checked so he felt better. Week two was different though. An orderly was seen going through his mom's purse and an aide was verbally abusing his mom about medications.

He had the proof he needed to get those two employees fired and save his mom from further abuse. If you want a simple and easy way to record what is going on when you are not there-this is it!

Your Loved One is Dying - When the End of Life May be Your Call - You're Not Alone

My mother died last year at the age of 95, after a decades long descent into terminal dementia. I was her only nearby relative, although I was constantly in touch with my brother who was overseas with the State Department. He basically turned over the decision-making to me, the person on the spot.

Mom's last 2 weeks of life smacked me in the face with something I only read about in the papers, the great debate over the End of Life and health care rationing. Mom's health began to falter sharply, and she shuttled back and forth from the nursing home to the affiliated hospital. As the named person on her health Care Proxy, I was the one who had to make the calls.

A tough young social worker from the nursing home pulled me aside and said: "Schmuck, it's time you faced something - your Mom is dying. Are you planning to prevent that?" Only a friend can talk to a friend like that, and we had indeed become friends over a couple of days. She convinced me that a Final Care Committee (I think that was the name of it) be convened. The committee consisted of the hospital administrator, the head of nursing, Mom's attending physician, and my tough little social worker friend. There was even a person on the committee called an ombudsman, the guy in charge of serving as the advocate for my mother, the patient.

The discussion at the meeting had one goal: to assist me to decide the course of treatment for Mom; palliative care or regular care. Never once in the meeting did I feel pressure to make a decision one way or the other, but the right choice became clear: Mom should be made to feel as comfortable as possible, be given palliative care, and let nature take its course.

My comfort in having come to a decision didn't last long. When I visited her after the meeting the first thing I noticed was that she was off telemetry, that scary video monitor that shows pulse, respiration, etc. I raced to the nursing station to point out this glaring error. Trained to deal with strung out next-of-kin, the nurse explained to me, with the kindest diplomacy I ever encountered, that telemetry was irrelevant, because I had decided to "let Mom die."

Let Mom die. The very phrase filled me with coldness, because I suddenly had a power I never wanted, a power over life and death of my own mother. I could have been a completely self-serving idiot - and believe me, the thought occurred to me - and opted for regular care, meaning that heroic efforts would have been made to keep Mom alive. But the good folks at the hospital, as well as my wife and brother, helped me to make what I now know was the right decision: let Mom die.

My wife was faced with a similar set of circumstances with the lingering death of her 89 year-old mother 3 years ago. Lynda was an only child, so hers was a lonely perch indeed.

My decision had nothing to do with economics. Mom was on Medicare and Medicaid, so any financial thoughts would have been academic. Believe me, when your Mom is dying, you do not think about the economic impact of end-of-life care on the economy as a whole. But we should think about it, especially as baby boomers like myself continue to gray and fall prey to a rainbow of ailments. A statistic that never seems to change is that 30% of all Medicare dollars is spent in the last year of life. Medical technology now enables us to add months of life for a person stricken with any number of maladies, including cancer. Months.

The idea of government imposed health rationing, death panels in the heated rhetoric of the debate, disturbs me. But this article is not intended to engage the great debate, not here anyway. My purpose is to talk to you, who is probably reading this because the issues I'm talking about confront you now. No, I'm not looking to educate you - a term we hear often - I'm looking to reach out my hand to you, and share with you my trying experience, and let you know that you're not alone. Your loved one is just that; so make your decision with love, and you can't go wrong. Sometimes the best thing to do is to let Mom die.

Medical Alert Devices to the Rescue - A Well Written Article

"Medical alert devices to the rescue" is one of many articles recommending a medical alarm for consumers. However, the best way to decide which medical alarm company is right for you is to go with your gut-meter. Who treats you the best? Who provides the best customer service? No matter which company you chose, at the end of the day you are already making a great decision by choosing to obtain one. Obviously, this article recommends medical alert devices for seniors too because they provide the best protection money can buy for the independent senior.

This article may encourage seniors to get them but that doesn't always mean the seniors are excited to wear one. Sometimes the hardest part of this process is getting the seniors to accept the help. Many seniors mistakenly view the medical alert device as a leash and loss of independence. Often times, loved ones of seniors will call medical alert companies asking them the best way to jump over these hurdles when talking to their elderly loved ones about wearing a medical alert pendant daily.

When it comes to a medical alarm device, it's easy for seniors to immediately think of what they are losing and not what they are gaining. First of all, the only thing they are really "losing" is the ability to shower completely naked. Now, they will have to wear a medical pendant transmitter in the shower or tub. What else might they be losing? Not a thing. But the very idea of a medical alert system can make a senior feel like they are losing their freedoms. This is just simply not the case. An elderly person does not need to give anything up to use a medical alert service. Their only responsibility is to wear their medical pendant around their wrist or around their neck. That's it.

And what exactly is a senior gaining? For one, it is important to realize that by getting a medical alert system a senior is getting to keep their independence, not lose it. If a senior needs a medical alert device but refuses, chances are they will end up having to go into assisted living or take some type of measure that actually does take away their independence. Wearing a medical pendant transmitter can allow an elderly person to stay in their home alone and independent for years more.

This lifeline to emergency help also provides seniors with peace of mind. Sometimes just knowing that a first alert medical signal to 911 is there when they need it can make all the difference. No one wants to live with the anxiety that they may not be able to help themselves. A medical alarm system eliminates this worry. Not only do the seniors gain peace of mind, but their loved ones get peace of mind too. So often we worry more about our loved ones than ourselves. In this case, any elderly person who has a one is undoubtedly helping their loved ones to worry less. And that in itself is a wonderful gift for everyone.

Learn more about medical alert systems

An Old Folks Home Can Be A Great Place to Care for Your Loved One

The phrase old folks home is another name for nursing facilities that are made available for the aged and the elderly. There are various names associated with this facility and some of the common names are: retirement homes, elderly care homes and also homes for old folks.

In the past such homes were looked upon with disdain as these homes were not handled properly because they were understaffed and were neglected for quite some time. This is not the case now as a lot of people are now falling back to these homes thereby creating a lot of popularity for the homes all because in our world today the retirement homes are being well cared for by the government and also private individuals.

The old folks home that we have today has become a palace of sorts. This is because the inhabitants of the home receive pampering from the nurses like it was never done in the past. In the homes today there are varieties of social amenities that are made available to the residents. So many of the retirement homes that we have today is designed and built to fit the taste of the elderly. The construction of our elderly homes is built with the needs of our aged parents or family members in mind. Some of the options available include:

1. Full ownership of their own condos.

2. Life leases for those who don't want full ownership.

3. Rent-age of condos, houses or units depending on the taste of the elderly person or the taste of the family.

4. There might also be options of spas, swimming pools, indoor golf games and even exercise classes for the fit conscious elderly folks.

5. There are also caring hands on board to render help if the need arises.

Contrary to the popular belief that nursing is a thing of the past, it has been said that, a great way to care for your aged family members is to put them in nursing homes ( old folks home ). This is because there are caring hands on ground to care for them. They are not only caring they are also professionals and certified individuals who will do a better job of caring for your old folks in more ways than you can.

An Overview of Certified Nursing Assistants

Nurses are classified into various categories like Licensed Practical Nurse (LPN), Registered Nurse (RN) or Certified Nursing Assistant (CNA). They help patients under the supervision of an LPN and generally work in places like nursing homes, day care centers, nursing homes, assisted living places and personal homes. Although they perform and execute all the duties of a nursing assistant, there are some procedures that a CNA cannot perform owing to legal limitations.

Job Profile

The general job profile is to assist the patients under the supervision of a licensed or registered nurse. However, the responsibilities vary according to the place of work and area. Sometimes, they act as coordinators between numerous patients and the registered nurses. In other words, they act as a link between registered nurses and patients. They look after most of the patients' needs and keep a tab on their (patients') health. They gather all relevant information on the patient's health and report it to the registered nurse. Often, their workload makes their lifestyle hectic, fast paced and demanding. However, with a deep-set compassion towards suffering fellow human beings and the desire to help them is the driving force. Such feelings help the nurses see through their difficult days.

Training

Medical facilities, Red Cross, online schools and community colleges offer these courses. Such courses offered by institutions provide rigorous practical as well as theoretical training. They also enlighten you on the laws abiding the certified nursing assistants. If you want an on the job training, that is possible in clinics and hospitals. However, these are very rare and hard to find since normally clinics do not give trainings. Doing so is a huge responsibility on the clinic. At the end of the course, the CNAs must take an exam to become qualified nursing assistants.

Scope

Normally, nurses want to move up in their medical careers. Therefore, there is a constant demand for CNAs. In other words, it is easy to get a job as a certified nursing assistant since people who start their career from this point move to higher positions. The demand for CNAs is high especially in medical institutions and centers for assisted living of the elderly.

One of the major reasons why there is such a huge turnover for CNAs is the fact that once a CNA, it is easy to get higher education and become a registered nurse. This is possible owing to the Internet. With the advent of online classes, it is easy to continue studying while working as a can. There are many bachelor degree programs that these nursing assistants opt for to get better paying jobs in the field of medicine.

Salary

Normally, CNAs are paid on hourly basis rather than annual salary. Your pay therefore fluctuates according to the number of hours you work weekly or work on a fulltime basis steadily. Although on an average, the hourly pay is $15, however, it may fluctuate depending on the area and location of work.

On a concluding note, being a certified nursing assistant is a noble profession since you are helping the diseased and distressed. If you have a compassion towards the suffering fellow humans then this is the right field of choice for you.

Assisted Living Homes and the Retirement of the Baby Boomers

Baby boomers are the people born during the period 1946 - 1964, the era after World War II. They are unique from other generations in that they lead a tedious life, and prefer working even after retirement. Usually, the retirement age of the baby boomers is 65 and according to the calculations, many of those 77 million people are ready for retirement. They mark the social responsibility and have an impact on monetary issues of the nation. Even the women baby boomers are more educated and mature to make wise decisions.

The baby boomers get into a part time job or own businesses after retirement. The main objective to work even after the age of 65 is not money but something more than that i.e. motivation. They get the motivation to survive from new challenges they face in their work environment. This is why they lack their skill to plan and manage their retirement and psychological life. The baby boomers would usually get a stock of money from the 401K retirement plan, which enables the employees to transfer a portion of their income in a specified account, which is exempted from the tax payments.

The baby boomers have difficulty managing their stress and after retirement they would usually prefer assisted living homes. These facility centers can assist the aged in surviving their remaining life by helping them in carrying out their daily activities with ease and also engaging them in the communities and gatherings. These sexagenarians require good exercises for their bones and muscles. Hence, it is important that the assisted living homes provide facilities for better exercises and physiotherapy. Even after retirement, the baby boomers look for a new definition of life and engage themselves in different jobs. And many of them are even back to the colleges.

In order to keep up the energy and enthusiasm of baby boomers, the assisted living homes should organize more interactive programs. Moreover, the facilities provided to baby boomers would be much more improved in future, especially with regards to the aspects of technology and quality. This has been made possible because assisted living centers are studying the needs and tastes of baby boomers with regards to housing and activities. The technology like security and door locks would be much improved and communication with service providers and residents would be easier, hence reducing the response time of staff for an emergency call.

Allowing pets in the assisted living facility homes can also help the baby boomers in engaging in other activities and help them in reducing their stress levels. This would also help in increasing their capability of thinking smarter. The assisted living facility homes should make changes accordingly with the next baby boomer generation in the next 18 years with the base of current retired baby boomers thoughts.

What Should You Expect As a Nurse in a Nursing Home?

With baby boomers nearing retirement, the need for quality nursing homes is expected to grow by more than 500 percent within the next 8 to 10 years. With more long-term care facilities opening their doors to communities throughout the nation, the need for qualified health care professionals will proportionately increase. If you are a CNA, an LPN, or a RN, consider the advantages of working in a nursing home or long-term care facility. As the fastest-growing part of the healthcare industry, nursing homes offer an opportunity for advancement and increased earning potential. Before you start applying for a position like this you should understand what to expect in the work environment. Decide if this nature of work is right for you and start a meaningful and fulfilling career.

Nursing Assistants Must Be In Shape and Capable of Physical Labor

All nursing assistants must be able to work on their feet. In long-term care facilities, nursing assistants can expect more intensive labor than in hospitals. The primary reason why these positions are more intensive is because a majority of people in long-term care require assistance transferring. CNAs will help lift and transfer patients in addition to performing bed baths and changing bedding while it is occupied. If you are a CNA it is important to understand that CNAs must deal with heavy work and stressful working conditions. The stress and heavy work load are the primary reasons why turnover in nursing homes is so high. Many long-term care facilities will raise wages to encourage nursing assistants to stay as the need for CNAs grows.

Registered Nurses and LPNs

While CNAs do handle heavy lifting, RNs and LPNs may have to perform these duties if an assistant is not available. While the job does sound difficult and many people have the idea that nursing homes and long-term care facilities are depressing, many nurses enter this atmosphere and never want to leave. Nurses who have been in long-term care for more than a decade, state that their job has become their passion. One of the main reasons why registered nurses and LPNs love to work in nursing homes is because they are made part of an interdisciplinary team made up of social workers, physical therapists, dieticians, managers, activity directors and more. The entire team works together to discuss the plan of care for a patient. Compared to hospital environments, nursing homes make nurses an integral part of care for residents.

Another reason why CNAs, RNs, and LPNs find a passion in nursing homes is because of the residents. When you deal with patients who live at the facility you can build a relationship with them. This bond is what keeps nurses in their careers. While building a bond can be difficult in some situations, the friendships you make will create lifelong memories.

Nurses who are employed in nursing homes need to be compassionate and knowledgeable. If you are looking for a stable opportunity that could change your life, consider the benefits of applying for nursing home positions.

Get The Money You Deserve Through Litigation

Every day, there are so many small accidents that happen, without anyone anticipating it. Sometimes it could be something trifling like hitting your toe against a loose tile, or slipping and falling over a wet floor. But there is only a small difference between a small accident and a major injury. Sometimes it could be because the person is clumsy, but sometimes it happens because someone else has been negligent (for example, if you slip over wet floor because there is no warning sign). If the latter is true, then someone needs to be held accountable, and adequate compensation needs to be made.

There are a number of instances where an accident occurs because somebody else has been negligent. For example, if someone has left a crack in the floor unattended, and you trip across it and sustain injuries, then somebody will have to answer for it. Even though it is a trifling incident, it can lead to some serious damage. So how do you get compensation? Whom do you approach? How can you ensure that you are adequately reimbursed for medical charges? This is what litigation is all about.

Litigation is a complex legal process. In essentials, it involves engaging a lawyer or a law firm, which will then set about examining your case thoroughly and then coming to a decision as to who is responsible for your injury. Once a consensus is taken, the person or institution responsible is taken to court, and sufficient compensation is demanded from them. The process of litigation does not stop with just physical injury. It covers a wide range like medical malpractice, defamation, slander, violation of personal rights, intentional infliction of emotional hurt upon another individual and so on. You could have an accident while boating in a lake, or tear a ligament in the gym, owing to faulty machinery. No matter what, there are ways and means to get what you deserve.

There are a number of law firms that you can engage in helping you get your reimbursement, Some people are just looking for their commission out of the whole process, and will give you as much attention as is required to finish the case, and then will over on to the next client. However there are some conscientious law firms that will patiently sit and hear you out, and then do diligent research to fight your case well and make sure that the money due to you comes through.

Another very important and sensitive issue is that of sexual harassment. This is understandably a very trying time for both the person involved and the family. Something very important to be considered in such cases is the unwillingness of a large number (more than seventy per cent) of people to come forward and file for litigation, simply because it is such a sensitive issue. A lot of people would rather just keep it to themselves than have it thrown around in open court. However, if these people do come forward, then there are some law firms that will treat them with compassion and understanding, revealing only those details that are absolutely necessary to the general public.

Cost Segregation - Pay Yourself or the IRS?

Owners of commercial property and/or leasehold improvements can now legally redirect their Federal and State tax dollars back to their business. The alternative is to give your money to Uncle Sam to be managed...YIKES!! This process, known as cost segregation (A.K.A. cost seg or accelerated depreciation), is available to commercial property owners with holdings over $200k.

Cost seg is an IRS approved tax strategy allowing owners of commercial property to increase their cash flow and decrease their tax liability. A comprehensive study frontloads depreciation deductions into the early years of ownership, thus capitalizing on the time value of money.

A deduction today is always going to be worth more than that same deduction five or ten years from now.

Cost seg is the process of identifying, separating, and reclassifying costs in a commercial building from 39 year (or 27.5 year) property to 5, 7 and 15 year property.

• For example: The carpeting in a commercial building can be reclassified from 39 year property to 5 year property using cost segregation.

In general, an engineer based study can yield a tax savings of 8%-12% of the cost of any given property. A one million dollar property could yield a tax benefit of $100,000 or more.

So why isn't every owner of commercial property utilizing this tax strategy?

Many property owners are simply unaware of this tax strategy. Every year, thousands of commercial property owners overpay their taxes. Oh, and chances are your accountant is NOT "already doing that for you". A proper cost seg study is comprised of tax law/knowledge and engineering principles (cost estimating, construction, and blueprint comprehension). Most accounting firms do not specialize in this area; however, a good cost segregation company will work hand in hand with the property owner's accounting firm to make the final application of the study a turn key solution. A completed cost segregation study does not replace the important role an accountant plays in preparing tax documentation or determining tax liability.

Who qualifies for a cost segregation study?

Any property owner who has:

• Purchased or constructed a commercial building or facility after 1986


• Renovated, remodeled, expanded or restored an existing facility


• Paid for office or facility leasehold improvements


• Purchased commercial residential property such as an apartment complex/building

Cost segregation can benefit owners of apartment complexes, assisted living facilities, auto dealerships, banks, casinos, car washes, fitness centers, gas stations, grocery stores, hospitals, hotels, medical facilities (doctors, dentists, etc.), office buildings, storage facilities, restaurants, retail centers and more.

Think of the benefits of cost segregation this way: If you were given a check for a million dollars and had to choose to either cash it now or in 39 years, what would you do? Well, most people would cash it now, because the time value of that money is worth more today than 39 years from now. This is the same idea with cost segregation.

By not doing a cost segregation study, commercial property owners are basically giving the IRS an interest free loan of money they could be using TODAY for their own benefit! They could pay down debt, purchase more property, invest it, or take a vacation. Educate yourself on this tax strategy.

Nursing Homes Lack Expertise in Recommending Hospice Care Placing Your Family Member at Risk

Your family member, sick and in pain, is in a hospital or nursing home and no one is available to help because the person is the next room is in critical condition and the entire floor staff is rushing around to help this person. You empathize thinking that if you were in a similar situation you would want everyone rushing around to save you. What you really do not know is that this emergency is due in some cases to financial self interest or lack of staff education regarding critical or end of life care. Most individuals do not fear death as much as the experience of a painful death and many nursing homes and assisted living facility staff do not have the training or desire to educate family members about hospice and palliative care services.

How can we make the stress of having a sick loved one, piled on top of daily stress easier for all involved when hospitals, nursing homes and assisted living locations often provide end of life care? Whether you recently experienced the loss of someone you know or are currently experiencing the decline of a loved one there are steps that can be taken to ease the journey but you must be the one to ask questions because many facility staff lack training in hospice and palliative care.

According to research by Lisa Welch, Ph.D. few nursing homes or assisted living facilities have written procedures for regularly assessing residents' terminal disease status or eligibility for hospice care. Instead, many staff members base their timing and referral of hospice based on their ability to recognize decline, their personal beliefs about hospice services and their initiative in raising hospice as an option. What happens when facility staffs have little or no education relative to palliative or hospice care and family members rely on their level of experience to help their loved ones? The result is often family frustration, little or no pain assessment or management for the loved one and a painful death.

In my work, I have been personally told by facility staff that their administration does not want them recommending outside hospice services because that means that money leaves the building. Or, as the research mentions, if there is no family requiring support, hospice is not recommended and is instead provided by their own staff, lacking hospice background. In these cases, offering hospice becomes a territorial issue founded by concerns over money and staffing. How can family members trust health care providers when the concern for money and self interest overrides the care needs of their family members at an especially critical time of life? This choice should not be a decision made by facility staff but the decision of the individual or family member involved.

"Additionally, timing of hospice referrals is often delayed because staff members believe that hospice is appropriate only for the very end of life. There was often a discrepancy of weeks or months between when staff reported recognizing terminal decline and when referral to hospice occurred." It is clear that training needs exist for staff relative to recognizing declines and understanding the benefits of hospice services. In defense of facility staff, I have experienced instances where fear of breaking rules or regulations or chastisement by a superior prevents staff from doing the right thing. However in these cases mysteriously a phone call or recommendation is made and I become involved to help families navigate the situation.

Until the level of palliative and hospice care education catches up with the need, family members will have a greater level of responsibility navigating the care of loved ones experiencing declines in health. It's never too early to ask about palliative or hospice care; however it can be too late. Too late is when a loved one is days away from passing and has already likely experienced a high degree of pain and discomfort. In the instance you ask and it is not quite time for palliative or hospice care, at least you have been proactive in your own education and when the time does come you'll be more prepared and less reliant on others to recognize the signs or request assistance.

Welch, Lisa C. Ph.D. et. al. Referral and Timing of Referral to Hospice Care in Nursing Homes: The Significant Role of Staff Members. The Gerontologist. Vol 48, No. 4, 477-484.

Veteran Benefits That May Help Pay For Costs of Assisted Living

There are many veterans and surviving spouses of veterans who are currently either in assisted living or are looking to move into an assisted living community; however, the costs become such a burden on the resident and often times, the family has to keep their loved one at home due to the high costs of moving their loved one into an assisted living community. What many people don't know is that there is a benefit for veterans and surviving spouses of veterans. The benefit is called Aid and Attendance and is provided by the VA. For the actual veteran, he/she can receive up to nearly $2,000.00 each month as a reimbursement for his/her expenses in assisted living.

Now, I'm not the expert on getting you the benefit, but I am the expert on giving you enough information to know if it's something that you should be looking into and where you can get more information. For the surviving spouse, he/she may be eligible for close to $1,000.00 each month as a reimbursement for his/her expenses in assisted living. Now, you or your loved one is living in a skilled nursing facility and you're wondering if the benefit will help pay for those costs. The answer is, absolutely. Most (if not all) medical expenses in fact, are reimbursable up to the cap amount that was mentioned previously.

How do you know if you qualify? Here are a few tips. The veteran will have had to be on active duty at least one day during one of the major wars such as Vietnam, World War II, or the Korean War, etc. The VA will look at your current income also. If your income is less than your medical costs (and yes, every penny of the cost of assisted living is considered a medical cost), you will be eligible to be reimbursed up to the full amount of the benefit. For example, say your income is $1,500 per month and your medical expenses are $3,000 per month. You will be eligible for a reimbursement of up to $1500 each month. This amount is paid to the veteran directly and not to the facility. Will they take into consideration that the veteran still owns a home and has other assets? Yes, however, there are legal ways to move these assets around to become eligible for the benefit. I would use the professionals to help you do this to make sure you're doing it right.

Now, how do you get the benefit? There are two ways. You can either go to the VA yourself and do all of the paperwork yourself or you can have a company help you in the process. There are pros and cons to each. If you do the paperwork yourself and work directly with the VA, it may take a while as there are several forms to be completed and if you don't submit them just right, it may delay the reimbursement. If you use a company that specializes in this process, they'll know exactly what needs to be submitted and they'll help you submit it correctly the first time (allowing you to start getting the maximum benefit). These types of companies typically charge anywhere from $500-800 to help you complete the paperwork, but that will pay off after one month of reimbursement potentially. http://va.gov is the site where you can find more information about this benefit. Put in the key word "aid and attendance."

So how do you find a company that will help you in this process? I would call an assisted living community near your home and ask them. In Utah there is a company in Salt Lake County call Senior Care Associates that does a pretty good job at this.

One final and very important piece of information. With this benefit, it's not retro-active in one sense; however, there is a form called Statement in Support of Claim found at va.gov/vaforms/form_detail.asp?FormNo=21-4138. THIS IS SO IMPORTANT! Get this form in first. From the time that the VA receives this form from you, you will be reimbursed back to the date they received this (while you're taking some time to gather all of the other necessary forms and documents to get the benefit).

After jumping through all of the hoops, you'll be grateful to have know about this benefit. Now you need to share this valuable information with others who could benefit from it.

What Does the Average Nursing Home Cost?

Do you have any idea what the average nursing home costs where you live? Do you want to know? Are you prepared to pay a huge sum of money for one, two, maybe three years or more in a nursing home or assisted-living facility?

These are difficult questions to answer, for many reasons. One, we can't predict how healthy, or unhealthy, we will be ten years from now. Furthermore, as the current economic situation illustrates, we may even have a hard time predicting our own financial well-being. What used to be considered relatively stable - our earnings, home values and net worth - has undergone massive changes. Just a year ago we may not have thought twice about the notion of selling our home to pay for any long term health care issues. Now we're lucky if that home still has some semblance of value!

The American Association of Retired Persons website states that the average cost of a nursing home stay is roughly $50,000 a year. This is an optimistic number. Matter of fact, recent studies indicate the average cost is actually more like $70,000 a year, or nearly $192 a day! Of course, this number is going to vary widely depending on where you live; but nonetheless, it's a scary number to think about, and it is real, very real.

If we consider the average length of stay in a nursing home, which is roughly 2.5 years, that equals almost $170,000...in just TWO AND HALF YEARS. Let's do the math...wait, we don't need to. But what we do need to do is stop assuming that paying for such services is within easy reach. We can't depend on medicare or medicaid to pay for these costs either, as both have several limitations that may hinder the amount of costs covered in a nursing, or assisted-living facility.

What are the options than? How should the average person cover the average nursing home cost? First, take a hard look your current net wealth and try, to the best of your ability, predict how this is going to change in the next 10-20. It may also be time to look into long term care insurance, which, unlike medicare medicaid services, does cover costs of a nursing home (as well as assisted-living facilities.)

The internet is full of helpful resources on this topic. Do your research though and speak with an experienced and reliable representative.

Good Nursing Homes and How to Find One

Going to a nursing home is the last thing most people want to do. Studies have shown most people prefer to stay in their own homes, followed by going to live in the home of a relative. Sometimes, however, those choices are no longer practical options. Entering a nursing facility can be a positive experience, but that depends largely on the quality of the facility you choose.

What factors indicate a quality nursing home, and how can you find one? This question is hugely important to both frail elderly loved ones and their families and friends. It makes a difference in the health and happiness of their daily lives. There are several factors that influence quality in a nursing home, the first of which is the staffing.

Nursing homes are staffed with both professional nurses and caregivers, all day, every day. The professional nurses are responsible for medication administration and health assessment and coordination, among other duties. Caregivers, or Certified Nursing Assistants, provide most of the direct care to the residents. Two of the critical staffing issues are the staffing ratio of staff members to residents, and the turnover rate of the staff in the facility.

The staffing ratio means the average number of nursing hours each resident receives. An independent resident advocacy group recommends facility staffing at 4.04 nursing hours. Lower staffing levels result in a decrease in resident care. Many nursing homes staff at much lower levels. Staffing ratios of 3.2 of lower are not uncommon. At this level of staffing, one caregiver would be taking care of eight to twelve residents during her shift. Whether or not this level of staffing is adequate depends on the amount of care each of the assigned residents needs.

Related to staffing levels are the facility turnover rates. Turnover rates indicate how often nursing homes have to replace staff that quit. Many facilities have turnover rates that exceed 100%. The rate that care staff have to be replaced impacts resident care, as the residents must continually get used to different caregivers.

Cleanliness is another important quality to evaluate. This is different from the decor. Is the floor polished and the carpet free of stains? Are there unpleasant odors? The level of cleanliness indicates the pride the facility takes in itself and the respect it has for its residents.

The dietary department has a huge impact on quality of life for the residents. For many people, meals are the highlight of the day. The meals should be appetizing, nutritious, and built around resident preferences.

The activities department helps nursing home residents find stimulation, social interaction, and enjoyment. The activities should be diverse and planned for residents with varying functional ability. Special programs that bring the community into the nursing home and the residents into the community should happen frequently. Family and friends should be encouraged to visit, and visiting times shouldn't be limited.

How can you evaluate a particular nursing home to see if it meets these standards? The best, most objective resource in medicare.gov nursing home compare. This is where survey results are posted on the web. You can compare facilities side to side in such measures as overall quality, staffing, quality indicators, and more.

After narrowing down the choices, visit each nursing home you're considering several times. Visit at different times of the day and different days of the week, especially on weekends. Look at the latest survey report, which must be posted in an easily accessible location. The information on the website can be outdated, but the posted survey will be the most recent one conducted.

Notice how the staff interact with the residents, how many staff members are working, and the emotional atmosphere. Can you see your loved one living there? Culture change is the idea of care being centered around the resident and their preferences. Is the facility an adherent of a resident centered culture, or must the resident fit into the routine of the facility? Many nursing homes still function around a medical model of care. An awareness of the factors that contribute to a quality nursing home will help you make a decision you and your loved one can live with.