Divestment - Understanding Legal Alternatives

With nursing home costs now averaging close to $80,000 per year, it's no wonder many seniors need the help of Medical Assistance or Medicaid when they hit a major health crisis. But the Medicaid program is designed to pay certain medical expenses for individuals who cannot pay those expenses themselves. That's why there are complicated rules in place to make sure those who can afford to pay their own expenses do so, without making a spouse or certain other relatives impoverished.

Unless you've somehow planned for long-term care, through saving or insurance, you'll likely find you significantly deplete most of your assets before qualifying for any assistance. That reality has led many people to explore reducing assets that might be available for their long-term care. If the reduction is made to avoid having to pay for your own impending long-term care needs, that is known as divestment. Divestment is defined as disposing of assets for less than fair market value in order to qualify for Medical Assistance or Medicaid. It's a prohibited practice that carries penalties.

If you're one of those couples caught somewhere between the ability to self-pay and the poor house, understanding the rules surrounding Medical Assistance can help you find legal alternatives. Although Medical Assistance is a federal program administered by the states, the rules in each state vary. Following are the general rules for Wisconsin.

Assets

Medical assistance allows people to retain some assets while exempting some others.

Exempt assets for both single and married persons include:

• Life insurance with a face value of $1,500 or less, and


• Pre-paid funeral and burial expenses, including plot, headstone, casket, vault and up to $3,000 in an irrevocable non-refundable burial trust.

In addition, single people may keep a residence so long as equity in the property does not exceed $750,000 and the nursing home stay is temporary or the property is listed for sale. The only exceptions are for situations where (1) the homeowner's child lived in the home for at least the past two years and the arrangement delayed the need for nursing home care; or (2) a disabled child lives in the home. Single people may also maintain one vehicle if needed for medical care.

Married couples have a few additional assets that are exempt. Exemptions that apply to married couples include a residence, one vehicle of any value, retirement accounts of the community spouse and most household and personal items, except those held for investment purposes such as gold, silver or collectible art.

One common planning tool is to maximize the exempt assets by:

• purchasing a life insurance policy with a face value of $1,500 or less;


• pre-paying funeral and burial expenses or purchasing a burial insurance policy (with most companies willing to issue a policy up to $15,000).

If you're married, you can also:

• make improvements to the house, such as replacing a deteriorating roof, upgrading an outdated air conditioning or furnace system, installing a ramp or making other changes to increase the accessibility for the community spouse;


• trade in an unreliable car for a new one.

If you're single and a child is willing and able to move into your home to assist you and thereby delay your need for long-term care, that would not only improve your quality of life but may also eventually mean the house could be transferred to the child without affecting eligibility for Medical Assistance.

In addition to exempt assets, an "institutional spouse" may have assets of no more than $2,000 and still qualify for Medical Assistance. The "community spouse" may keep a resource allowance ranging from $50,000 to $109,560, depending on assets.

Income

People receiving Medical Assistance, whether single or institutional spouses, are allowed to retain $45 per month in income. Community spouses are allowed a maintenance needs allowance of between $2,428.33 and $2,739, depending on shelter expenses.

One more option

When it comes to Medical Assistance, spouses are required to use their assets for the support of one another. Even a prenuptial agreement can't stop that obligation. The only way to at least partially protect the assets of a community spouse is for the couple to divorce. This is a sad step to take, but it doesn't have to change the relationship. It just changes their legal status. Divorce is a difficult decision for couples, particularly at such a time when the health of one is compromised. Some couples take this step; many don't. Even a divorce is not necessarily a solution, since the couple would still have to address a division of property and alimony or maintenance.

Divestment

When you apply for medical assistance or Medicaid, the government will want to look back for a period of time to see if and how you have disbursed assets. If you have divested, the government will hold you responsible for paying those amounts toward your health care needs before medical assistance kicks in. Gifts given prior to 2009 are subject to a look-back period of three years; gifts given since 2009 are subject to a five-year look-back period.

Insurance

Of course, one way to avoid the whole divestment debate is to invest in long-term care insurance.

Wisconsin now has a program called the Wisconsin Partnership. For any qualified long-term care policy purchased since the program's inception, insured parties may put away for family members one dollar for every dollar paid from the insurance for long-term care. That money saved for family members then is not considered a divestment.

Most people begin considering long-term care insurance in their 50s. If you're among them, keep in mind that statistics indicate only 16 percent of us will need to be in a nursing home for more than 90 days. Also, it's important to remember there are many options to consider before nursing homes, including in-home care and assisted living, both of which are far more affordable than nursing homes.

Right or Wrong Answers

One final issue to consider is that medical assistance is designed to pay the care for people who cannot afford it themselves. The question is whether all of us should expect the government to pay for that care. There is no right or wrong answer. Just remember that you have more choices when you pay yourself, and that may be the best reason of all to plan not to need government assistance.

Want to Sell More Life Insurance? Focus on the Lesser Known Benefits

There's a myth out there that life insurance (and selling it) is fairly simple: If someone pays the premium, his or her beneficiaries get the benefit when they die. But there are many other ways that life insurance can provide extra coverage and protection - ways that most of your prospects probably aren't aware of. Explaining these hidden benefits is a great way to convert "I'll think about it" prospects into "I'll take it" customers.

Make sure your prospects understand that:

• Term and group life policies can be converted to permanent life policies - Prospective buyers of term life and group life policies may be reassured by the fact that many of these policies can be changed into individual permanent life policies - usually without the need for additional medical exams or underwriting. This will cost the insured additional premium, of course. But in cases where the insured experiences a severe medical condition, the security of continuing life coverage when the term policy expires can be invaluable.


• Some life insurance policies can cover long-term care - Some insurance carriers are now offering "long-term care riders," which allow the insured to take immediate payment benefits to cover nursing homes, assisted living homes, and other long-term care. These payouts are then deducted from the death benefit to beneficiaries, but can save the insured and their families substantial out-of-pocket expenses. Long-term care riders are usually added to a policy at the time of purchase.


• Life insurance can provide immediate benefits in case of terminal illness - Some policies include what's called "living benefits" or "accelerated death benefits"; other policies allow these to be added as a rider. Either way, they allow the insured to receive payments to cover medical bills or other immediate expenses in the event that he or she is diagnosed with a terminal illness.


• Life insurance can pay its own premium - Think of the peace of mind some prospects will find in a "waiver of premium" rider that covers the cost of policy premiums in the event of disability, financial hardship or other circumstances.


• Permanent life policies can provide cash in tough times - Having just been through a tough recession, prospects may want to know that the money accrued in permanent life policies can be available to them in emergencies - a great alternative to running up credit card debt to get by in tough economic times.

Yes, the basic "premium for death benefits" value proposition of life insurance is pretty straightforward. But for many prospects,the added value that life insurance can provide while they're still living can be the deciding factor in closing the deal.

As independent agents, it's our job to help clients understand all of the options available to them. Explaining these hidden benefits of life insurance provides a great service - and helps close more sales. It's truly a win-win for you and your clients.

Pressure Sores in Nursing Homes Lead to Closure

Once a person is sick we do our best to alleviate whatever pain he has. We seek for professional care. When we are too busy with a lot of responsibilities, we depend on those professionals and their skills to better our patient's condition. But what happens when we find out our patient developing pressure sores in nursing homes?

Pressure sores are deadly. They are not simple lesions that can be found on the pressure points but they can cause further infection and complications. According to some cases reported, severe pressure sores can lead to amputation and death. This is the reason why some families of victims do not just accept settlement negotiation from these facilities. For a patient to develop pressure sores in nursing homes is a manifestation that there is negligence among those health care professionals. So why is still there a room for negligence?

According to some studies,elderly facilities sometimes give poor health care because of the following reasons:

Lack of staff. SNU-Skilled nursing units need to have enough skilled health care providers. Due to a rapid growth of this industry, it has been tough for those which are having poor income to keep up. Competitive salary can't be offered to skilled health care providers. Thus, the facility cannot attend to every patient well.

Lack of training among staff. For this industry, it is very important that all of the staff receive training on the latest medical updates. Most of the cases handled by pressure sore lawyers include lack of training as the main reason for sores to develop. They lack training and updates like how often a turning is needed for a specific patient condition.

Lack of good health care facility. This includes not just the medical equipment used but also beddings and bed foams. There is already a new technology that can prevent pressure sores from happening. This is using an air bed that has air chambers to evenly distribute pressure. Some nursing homes are already using this, however this can be expensive.

Lack of proper sanitation. Patients develop sores because proper sanitation is not implemented. Patients are found to be sitting in their urine which makes them more susceptible to bacteria.

Those points should be considered by elderly facilities to keep their license active. A significant number of nursing homes lost their license due to neglect of providing good health care. As more and more family members of patients do not just accept money to settle any lawsuit that is filed against them and hire pressure sore lawyers to make sure that the nursing home pays their due.

The Assisted Living Option For Seniors

The demographic studies provide a clear picture of our population. The simple fact is a majority of the population is aging quickly and beginning to fall into the category of seniors. As this demographic evolution continues, assisted living is becoming a popular residential option.

What is assisted living? It is independent living for seniors, but with a little help with the basic needs they have every day. This typically includes a couple meals a day, monitoring for general health and well being as well as housekeeping and personal care. These are generally known as "ADLs", which refer to activities of daily living. Assisted living does not include the providing of medical care for the senior in question.

The living arrangements for assisted living can vary a surprising amount. They can be as simple as a room shared with another senior to a suite with a kitchen in it. Regardless, the room tends to be smaller than one would expect if you were to just rent an apartment. It also comes equipped with many safety features such as hand rails in the shower and along walls.

Assisted living should not be confused with independent living. Independent living for seniors involves a senior only community. Independent living provides no assistance on a daily basis, whereas assisted living does. The assistance with some of the basic daily needs can make all the difference in the world.

What are the benefits of assisted living? It provides a very normal daily life so a person can feel independent. At the same time, the daily activities that become difficult when people age are taken care of, which provides less stress and more freedom. Essentially, assisted living is the half way point between no assistance and full nursing home assistance.

To this end, most seniors report one huge advantage to assisted living - the meals. Assisted living usually provides at least two meals a day and sometimes more. Seniors universally list this as a huge benefit because it takes the burden of shopping for food and cooking meals off of there...well, plate.

On the other end of the scale, we have the disadvantages of assisted living. There are two. The first is price. Depending on the area of the country, the cost can range widely from a couple thousand dollars a month to fifteen grand for pure luxury. This often has to be paid for personally. Some long-term care policies will cover it as well. Various states have individual programs that can help as well.

Assisted living is very popular these days because it fills a need. Most seniors do not need the full care found in a nursing home, but could use a bit of assistance with the typical needs of daily life.

Types of Atlanta Senior Housing

For seniors, Atlanta is a great place to live in. It has almost everything that a person can hope to have around when he or she grows old. This is one of the reasons why there are so many Atlanta senior housing facilities in the city.

Another reason is the large number of people above 55 years of age in the city. 17.1 percent population of Atlanta is 55 years old or older, according to the "Profile of General Demographic Characteristics: 2000" released by the U.S. Census Bureau. Of which, 9.7% people are 65 years old or older, and 3.3% people falls in age bracket of 60 to 64. In absolute terms 40,535 people are 65 or above in Atlanta.

This has led to opening of all kinds of Atlanta senior housing facilities in the neighborhood. If classified according to the level of care given or needed, the senior housing can be classified into three categories: (1) Independent living, (2) assisted living, and (3) nursing.

Independent living

An independent senior housing provides a good alternative to the person who wants to and can live independently without any external support. You will be given all the privacy you need, all the activities you want to participate in, and all the things you want to and can eat.

Independent senior housing is best-suited for those who do not want to take the burden of maintaining their houses, but want to live independently among like-minded peers. In this kind of setting, personal care is not provided, but meals, transportation, housekeeping, and planned activities are offered to the residents.

The cultural richness of Atlanta makes the city a nearly perfect place for this kind of living. To keep yourself entertained, you can visit any place you like, but

• If you are a live music lover then you can ask the management to take you and your friends to Fox Theater, the EARL, The Masquerade, The Star Community Bar, the Variety Playhouse, and the Tabernacle.


• If classical music is your choice then places like Metropolitan Symphony Orchestra, Georgia Boy Choir, Atlanta Ballet, New Trinity Baroque, Atlanta Opera, and Atlanta Symphony Orchestra are waiting to welcome you.


• And for the people with a taste for high art, Georgia Museum of Contemporary Art, Atlanta Institute for the Arts, High Museum of Art, and the Center for Puppetry Arts present a great opportunity to explore.

Assisted living

Atlanta assisted living arrangement is good for the person who can function properly, but wants a little bit of help in doing the activities of daily living (ADL)like cooking, driving, taking bath, and medication, etc. People opting for assisted living need a certain level of personal care every day, and they also require immediate medical attention from time to time. The facility needs to have well-trained and qualified support staff to help elderly live their life comfortably and peacefully.

Nursing

It is full-care Atlanta senior housing facility. People who needs round the clock care by trained and qualified medical staff should move to this kind of setting. In this kind of senior housing a proper monitoring of each resident is done, and it also has qualified staffs to fulfill all the medical and non-medical requirements of the residents. Nursing staffs assist a resident until he gets well and starts functioning properly on his own. In total, Atlanta has around 60 nursing homes.

One Atlanta senior housing is different from the other two in the level of personal care each one of them provides. You should assess your parent's need before going for any of the three. Do not decide in haste.

CAREGIVING Status Report - Four Emerging Trends

What does the future hold?

Four trends are taking shape, thanks to empowered Baby Boomers who challenge the status quo.

1. More funding and available resources.

Despite these challenging economic times, more organizations have provided caregivers with educational resources and assistance than ten years ago. Looking ahead, baby boomers' activism with President Obama's healthcare initiatives, will cast greater light on the needs of caregivers.

2. Improved doctor-patient partnership.

Years ago, patients were passive recipients of doctors' decrees. Even though caregivers lament that doctors still don't listen to or believe their descriptions of loved one's behaviors and symptoms, steps are taken toward patient-caregiver/doctor dialogue and creating a partnership of care.

3. Continuum of care options.

There are more assisted living communities and board and care residences that offer the complete continuum of care. For those who prefer staying at home, some neighborhoods are growing old together. As frail residents move out (or die), new and younger neighbors move in. A half decade ago, my husband and I moved into a rural foothill community at the northeastern edge of Los Angeles County. We younger neighbors are helping our older neighbors preserve their independence, so they can stay in their homes longer.

4. Living the Simple Life.

A few years ago, before the economic fallout, if you weren't acquiring things you were likely to be frowned upon. Today, consumers are saving four to seven times more, "green" is in, and we're trying to live more simply. As we shed our possessions and our focus on things, we'll embrace spending more time with people.

These are four of the trends I see. What about you? Where do you see us heading?

Also read: Six changes have shaped caregiving during the past ten years.

A Friendly Gesture Can Go A Long Way For Seniors In Assisted Living

How would you feel if someone greeted you with his or her arms folded across their chest and their lips scrunched up to one side of their face when you walked into a room? Most likely, you would predict that something was wrong and with scrutiny, that the person is angry with you for something you have done. The gestures alone speak confrontation. Experts believe that body language accounts for a much greater role in communication than actual spoken words, anywhere from 60 to 90 percent more so. Most people do not have to be a scientific researcher in the field of body language to sense anger, attentiveness, boredom or approval from a person who has not yet spoken a single word. The science of kinesics, the study of non verbal communication, provides clues as to the attitude or state of mind of people involved in an Assisted Living Los Angeles Facility. Body language can set the tone for a one on one conversation, interview or a group meeting.

Health workers dealing with patients in long term care settings such as Assisted Living in Los Angeles have double duty in being aware of their own body language and how it affects seniors. They have the responsibility of caring for the elderly who may be in pain, frightened, depressed or in some cases, cognitively impaired. A positive or negative body gesture given consciously or unconscientiously, can affect just about anyone, but has the potential for a much greater impact on a senior in a vulnerable state of mind. Although there are several common gestures that have been construed to communicate certain emotions, experts warn that there are number of circumstances that prove otherwise. It would be wise to keep an open mind when impacted by a certain body movement and consider all of the possibilities before jumping to conclusions.

A good example is the arms crossed against the chest signal. Generally interpreted to be a negative attempt to put an invisible barrier between themselves and others, but depending on the circumstances, could actually signal something entirely different. It could also mean that the person crossing their arms is cold which would be further clarified if the person is rubbing their arms or huddling. When the overall situation is amicable, it could mean that the person is thinking deeply about what is being said. In a serious or confrontational situation, it could mean that a person is expressing opposition, especially if the person is leaning away from the speaker.

Other non verbal signals can include eye contact or lack thereof. This can be even further complicated by the fact that eye contact can mean different things in different cultures. The importance of Elderly Health Care professionals understanding those differences is critical. Many Assisted Living California facilities are incorporating Cultural Sensitivity Training for their health care professionals. Lack of eye contact in American culture may indicate many things, most of which are negative. A physician or caregiver may interpret a patient's refusal to make eye contact as a lack of interest, embarrassment, or even depression. However, a Chinese patient may be showing the physician or healthcare worker respect by avoiding eye contact. A person can observe and interpret the body language of others to determine the silent message they are receiving or the one they are sending out to others. There are three common messages that occur in a broad range of situations and types of interactions and are particularly important in a healthcare environment when dealing with the elderly in an Assisted Living LA Facility. They are sincerity, familiarity and warmth.

Sincerity

Body language that conveys sincerity is much like that conveying honesty. It is characterized by steady eye contact, relaxed but poised body posture, and leaning toward or reaching out toward the other person or people. It is the type of message that most people deliver quite unconsciously and naturally, but other people may deliberately assume this kind of body language in an effort to influence another person. Typical examples might include a salesperson pitching a product or service, a child trying to convince a parent he or she really needs a certain toy, or even a close friend having a conversation that is particularly honest or difficult.

Familiarity

Body language that conveys familiarity has a strong influence on overall behavior. When someone displays relaxed, comfortable, and even casual body language, it lets the other person know they feel a strong degree of comfort and familiarity with him or her. Deliberate use of this kind of body language may help put a new acquaintance at ease in a group or communicate a higher level of affection for another person. In general, the more familiarity conveyed to others, or perceived in others, the more likely the communications will be open, honest and relaxed.

Warmth

Body language that conveys warmth is similar to that of familiarity, but does not necessarily signify intimacy with a person or situation. Relaxed posture, open body position, sitting or standing close together are common ways of showing warmth. Retailers sometimes make use of this kind of body language by having their employees mingle with customers rather than have them stand behind a counter. In Assisted Living LA environments, it could help put family members at ease in what might be a stressful situation for them.

Keeping Context and Environment in Mind

Any effort to convey a certain message from one's body language should always include an evaluation of the situation. As a general rule, the more formal or conservative the environment, the more restrained and cautious the messages could or should appear. Otherwise, the gestures may be considered out of place. Conflict or uncomfortable feelings can occur when two or more people have different perceptions of the context or environment of the situation. These kinds of different perceptions are a major cause of miscommunication, misinterpretation, and general misunderstanding of both conscious and unconscious body language.

Why Having a Medical Alert System Makes All the Difference in Elderly Citizen Care

For senior citizens, staying alone can be a tough task. Since the elderly have a tendency to suffer from chronic illnesses, sudden injuries, and other serious physical conditions, giving them timely help and assistance when they need it is crucial. They may also feel more vulnerable to other threats, such as an unwanted person's entry into their home or in cases of fire or theft. Installing a medical alert system in a senior citizen's home can offer protection against unforeseen events that can endanger their health and safety.

How Medical Alert Systems Work

Most medical alert systems come with a pendant and a console, each of which has a button on it. When the user faces any emergency or suffers a fall, he or she can push the button on either the pendant or the console, depending on which one is closer at that given moment. This will immediately put them in contact with a 24 hour emergency medical monitoring center. The customer care representative will have access to the individual's home entrance and contact information and if necessary will quickly dispatch the right person to help based on the gravity of the situation - whether it's a friend, family member, neighbor, doctor, ambulance, or even the police. The representative will remain connected with the elderly individual to monitor the situation until the appropriate help arrives.

How Medical Alert Systems Can Improve an Elderly Person's Life

1. Get access to help quickly in case of a fall: Studies show that more than a third of all senior citizens suffer from injuries due to a fall. Though in many cases no serious injuries are sustained, it can sometimes be an uphill task for individuals to get back up on their own. To make matters worse, lying there unattended can worsen minor injuries or lead to the development of other physical problems.

However, when an individual has access to the medical alert system, they can push the button and seek help immediately after a fall. The customer service representative will not only send help the elder's way after determining the nature of the emergency, but will also check to find out which loved ones should be notified.

Many seniors restrict their movement and limit their activities since they fear that an active life may increase the likelihood of suffering from a fall. However, such an approach limits their physical fitness and mobility, which in turn actually escalates their risk of falling. A medical alert device can offer the perfect solution to such a situation. Once the elderly individual starts using a medical alert service, they will be able to enjoy living independently at home, knowing that help is close at hand whenever they need it.

2. Get help in serious cases: If a senior citizen suffers from a heart attack or a fall that renders him unconscious, he may not be in a position to push the alert button, which is why some medical alert systems, typically worn on the body, will require regular check-ins from the senior citizen. If the system believes there is a problem, it will then alert the call center to dispatch the necessary help, without requiring any action from the senior citizen.

3. Round-the-clock-monitoring: Several medical alert systems do periodic system checks to ensure the base unit is working correctly at all times. In case of a non-response, the monitoring center will be notified immediately to therefore resolve the issue.

4. Peace of mind: Medical alert systems enable the elderly to have a protected and safe environment at home. These not only help immensely in cases of medical emergency, but can also offer protection in the event of a fire, theft, or other crises. Since they usually cost less than the fees charged by senior care facilities and are quite simple to install and operate, many senior citizens are able to safely live on their own without worrying their loved ones.

5. Make use of additional features: Medical alert systems also offer other ways to enhance the lives of the elderly, such as a lock box outside the home where a house key intended for emergency responders is placed, a standby battery which keeps the console functional even in cases of a power outage, hallway and bathroom buttons, and alerts to remind them to take medication.

6. Tech-team and 24/7 customer service: Most medical alert system companies have customer service personnel and tech-teams working round the clock. So, whether a customer faces problems while operating the unit, has pressed the emergency button by mistake, or experiences other technical issues, the problem can be quickly resolved at any time by an actual human being.

For senior citizens who do not wish to turn to care facilities or retirement homes, or for the relatives of such elders who are worried endlessly for their health and safety, medical alert systems make for the ideal solution. It is no wonder then that such devices are in great demand for senior citizens and their families all over the world.

Hiring Boilers for Care Homes and Nursing Homes

To ensure these temperatures are kept up, it is essential that the fixed boiler in each home is reliable and regularly serviced. But the reality is that so many of these boilers are old and often defective, particularly boilers that have been in place for decades in a mature property. This means that a drop in room and water temperature (or no hot water or heat at all due to a complete boiler breakdown) is something numerous homes experience each year. For residents and patients, this can be a potentially fatal situation.

The good news is that hiring boilers from a specialist boiler rental company is quick and easy to do. And it is not only in the event of a boiler failure that specialists can help...

Supplementing an existing hot water supply

During a particularly cold spell when a hot water and heating supply at a care home or nursing home can prove insufficient, the option to hire additional boilers (to supplement a fixed boiler that is probably running over and above capacity) can prove invaluable. 100kW to 550kW mobile boilers (and multiples thereof) are most commonly supplied. They can also be coupled together to meet higher requirements.

Heater hire will also be available

As well as mobile boilers, portable heaters can be rented from most boiler hire specialists, to boost the existing heating provision, and also where a catastrophic boiler failure occurs at a home. In such situations, small rented heaters (e.g., oil-filled radiators, 3kW DE-25 units...) are usually best as they have simple controls, are safe and unobtrusive, and are easily powered.

About specialist boiler rental companies

Specialist boiler rental companies recognise the importance of sufficient hot water and heating provision at care homes and nursing homes in winter, and so will do their utmost to provide a stop-gap boiler solution until a fixed on-site boiler is repaired and operating fully again.

At their depots located nationwide, boiler rental specialists will have a wide range of portable boilers in stock, and will know which hireable boilers are best for a care home or nursing home environment.

So many benefits to hiring boilers

As well as being the ideal emergency back-up option, hired portable boilers are energy efficient, and can be:

- Rented on a short contract basis

- Used immediately (for both dual circuit hot water and heat)

- Run on diesel or mains gas (with gas being the much cheaper option)

- Rented during planned servicing or maintenance work to a fixed boiler at a home

- Added to an existing boiler solution when a boosted hot water (and heating) supply is required

- The perfect stop-gap between the removal of a fixed boiler system at a care home or nursing home, and the installation of a new one

What is more, managers at care homes and nursing homes can enjoy peace of mind by safeguarding themselves against the consequences of a boiler failure in winter. When formulating a contingency plan with a boiler hire specialist (during the autumn months), a site survey can be performed by the specialist who will consider crucial factors, such as:

- Their fastest possible response time in the event of an emergency call-out

- Building access (and available space there)

- Best positioning on site (noise and diesel fumes can be a factor, so a boiler rental expert will always look to position mobile boiler units away from any open windows)

- Available power supply (and if connections to the main boiler system are readily available as an emergency connection point can be installed at a home in readiness for a boiler crisis.)

- Budget

With all this information clearly logged (and quickly accessible), the boiler hire specialist team will be fully prepared and primed to respond immediately to an emergency call-out to a care home or nursing home, should 'the unthinkable' suddenly occur.

Avoid Nursing Homes By Planning Ahead

Most people see long term care insurance as nursing home insurance when if fact it is the opposite. Long term care insurance provides options to avoid nursing home placement, unless a nursing home is where an individual prefers to live. And please do not misunderstand, nursing homes have changed significantly over time and many are now very clean and nice facilities. However, a nursing home is usually not where an individual would choose to remain for the final days or months of their life unless there are no other options.

Long term care insurance is becoming more popular as consumers realize it provides options for independence. Many studies indicate that two thirds of individuals over age 65 will require a long term care stay. A long term care stay is a nice way of saying nursing home or skilled facility stay. And over forty percent individuals over age 65 will experience a long term care stay lasting two or more years. This is a long time if you are in a facility in a shared room -- not a private room, with a roommate you dislike. Think back to those college years and consider how you might like to be in a similar situation at age eighty.

And surprise, Medicare will not pay for a long term stay. Medicare usually covers days 1-20 if medically necessary and progress for rehabilitation occurs. On days 21-100 the individual pays an insurance co-pay of $128 per day (in 2008) and after 100 days, the individual is totally responsible for one hundred percent of the cost which averages between $175-220 per day (in 2008). As with anything these costs are expected to increase each year by 3-5% percent.

Long term care insurance not only will pay for these long term care stays, it will pay for care to be provided at home, which is where most individuals prefer to live as long as possible. It also pays for day care, assisted living, home modifications and other services depending on the policy.

Many individuals mistakenly think that long term care is too expensive. As opposed to what I ask you? As opposed to $6,000 per month in a long term care facility? Compare a monthly premium of $200 to the cost of $200 PER DAY in a long term care facility and tell me if long term care is too expensive?

Many are shocked when the cost of one year in a long term care facility at $75,000 eats up most of their retirement savings. Or when they have to "spend down" to qualify for public assistance called Medicaid. The government has determined that with the increasing numbers of baby boomers who will require medical care in the future that there is no possible way that the government can fund this care.

Thus the Debt Reduction Act of 2005. This Act states that individuals wishing to qualify for Medicaid assistance will need to spend all of their assets prior to qualifying for Medicaid. And there is a five year look back period to ensure that assets like homes and money were NOT given away to family members in an attempt to avoid the government receiving these funds. When money or resources are given away, the government imposes a penalty equal to the financial amount given away divided by the cost of one month in a long term care facility. So for example, if your parents gave away $60,000 today and wish to qualify for Medicaid in 2009, Medicaid will accept the application and penalize them for ten months of care. This means that they cannot receive services through Medicaid for a period of ten months from the date of their Medicaid application. Which means that if the care is truly necessary, children and other family members will pay personally for the care.

Even more reason to consider long term care insurance not only for yourself, but purchasing a policy for your parents if they cannot afford the premiums. The question is will they pay now or will you pay later for your parent's care. Caring for parents and the emotional and financial stressors significantly impact the retirement prospects of children. Parents always assume that their children will take care of them but do not consider the impact on employment, retirement income and even marriages and children.

Don't put yourself, your parents or your children in a situation of requiring care and not having a back up plan on paying for care. Because we will all pay for care one way or another when we are older. It's inevitable. We will pay because of our ability to have long term care insurance that ensures we decide about our care. We will pay because our parents require care and they have not prepared financially for the cost. We will pay because we did not prepare financially for the cost by having to receive care through public assistance called Medicaid.

Unfortunately the probability that we will all die is one hundred percent absolute. The question is how do you want to spend the last years of your life? In a manner you choose or in a manner chosen for you?

Gifts for Senior Women With Mobility Devices

As the holiday season approaches you may be looking for a practical gift for a mom or grandma who is using a mobility device such as a power chair, medical scooter or walker bag. If this is the case consider bypassing impractical gifts that probably won't get used very often and opt instead for stylish and practical carryall bags for mobility devices. Made from high quality fabrics and trims, featuring feminine designs and available in a wide range of patterns and colors, designer walker bags make for terrific gifts for women who use mobility devices.

As women get older it becomes increasingly difficult to shop for them. They really don't have much need for expensive gowns, fancy perfumes and glass figurines. Also, when women age they go through a process of downsizing and the last thing a woman who is moving into assisted living or a nursing home needs is more stuff. What they do need, though, is a practical and fashionable bag they can attach to a walker, power chair, transport wheelchair or mobility device that can carry all her important medical records, medications and personal belongings.

With a designer walker bag, women who use mobility devices get to regain their individual sense of style with fancy and attractive bags that feature vibrant floral patterns and contemporary silver and onyx damask designs. Before the advent of designer walker bags and carryall bags for mobility devices women had no choice but to either struggle dangerously with a traditional handbag or use dull utilitarian bags one would expect to find in a hospital geriatric ward. In addition to being bulky and impractical these bags only made adjusting to life with a walker or transport chair even more difficult since it simply highlighted the user's disability.

However, when women use designer walker and power chair carryall bags they instantly feel a sense of their style being restored and can move about with pride knowing that people will take notice of the stylish bag and not just the walker or power chair. Just because women have trouble walking doesn't mean they have to sacrifice their individual style. It's hard enough accepting the use of a walking aid without having it compounded by being forced to use an ugly bag that only makes women feel older. With a stylish and functional walker carryall bag, women not only have a practical bag for their personal belonging but also a stylish mobility device accessory that adds a unique sense of her character that will life her spirits as she goes shopping or visits with family and friends.

Caring For Aging Parents Long Distance - 8 Tips to Make Your Life Easier

If you're not just a hop-skip-and-a-jump away from Mom or Dad, you can still find an elder care solution that gives your parent independence and gives you peace of mind. Here are eight ways to make long-distance care easier:

1. Be ready - If you need to consult with Mom's doctor over the phone or through email, make sure you have important information at hand. When caring for aging parents, get the contact info for their family doctor, specialists, and pharmacists, as well as a list of the medications your loved one is taking. You may also want a copy of your parent's medical history.

2. Give your parent the info they need - Provide a printed sheet-in large print, if necessary-with important phone numbers, including those for doctors, pharmacies, and emergency personnel. Make sure it's posted near a phone and is easily visible.

3. Make copies of critical documents - From a will to a power-of-attorney, make duplicates of important documents, so you have easy access to the information you need when a caring for aging parents.

4. Have a back up plan - Part of any effective elder care solution is knowing how you'll deal with the unexpected. What happens if your planned trip to drive your mother-in-law to the specialist is derailed by a car repair? Enlist family and friends to act as backups for times when you can't be there for your parent.

5. Use technology - Your elder care solution should include the use of technology that makes life easier for you and your loved one. Consider investing in pill dispensers that provide audio and visual reminders or devices that automatically shut off a stove. Elder care solutions might become even easier in the future-tech companies are developing robots that would be stationed in a senior's home. A doctor, family member or other caregiver would be able to see and communicate with the elderly through a camera and a microphone mounted on the device.

6. Give mom the tools she needs - When caring for aging parents, invest in whatever tools your loved one needs to get through the day. Does Dad have arthritis? Purchase an automatic can opener. Is the glare from night driving too much for your mother? One elder care solution is to purchase glare-reduction glasses.

7. Take advantage of local resources - Contact an agency on aging in your parent's neighborhood. These groups can connect you to Meals on Wheels and other resources that provide help for families separated by distance. If there isn't an aging agency nearby, look for resources through local churches or community groups.

8. Consider hiring an in-home care service - These companies are the must-have elder care solution for many out-of-town adult children. In-home care companies will provide assistance with the everyday tasks dad might need help with-from grocery shopping to shaving. Some services will even offer companionship, such as playing poker with your dad or reading to your mom.

Advantages of Assisted Living Facilities For the Elderly

Assisted living facilities bridge the gap between self-sufficient living and living in a nursing home. People who choose such facilities are ones who are not able to live completely on their own but at the same time do not require continuous care either. Assisted living facilities proffer assistance to the aged people with daily tasks such as, laundry, housekeeping, eating, dressing, bathing, medications, and the like.

Remember, assisted living facilities are not a substitute for nursing homes, but are a great midway stage of unceasing care required by many seniors. There are many advantages of these communities. Here are some of the rewards offered:

Takes care of all the needs while giving the elderly a sense of freedom

Assisted Living Facilities proffer timely and well-made meals, periodic housekeeping facility, assistance with medication, and even helping to manage finances for the old. This form of assistance is excellent when the aged decide that they cannot live on their own completely, but do not want to give away their freedom.

TIP: The best way to find out good Assisted Living communities is by surfing online.

Provide health care and personal assistance

These Facilities provide excellent health care and medical assistance for people who do not need constant health care. They have enough expertise and backup for a senior citizen who may require immediate medical attention for major or minor reasons. These facilities accomplish this goal by having medical centers connected with their community. This way an elderly is given a substitute to nursing homes, which they usually dread because of their dull living environment.

Very Organized and Strategic

These living facilities are highly organized and strategic. They plan a separate strategy for every residence depending upon the needs and requirements. Moreover, they ensure great-customized personal services and care. These should definitely be a consideration when elders want to hand over some of their personal responsibilities to the professionals.

However, although they may not give the same independence as living alone in a house, but still they make life fairly simple. Moreover, I feel, in this, fast, demanding, corporate world, children hardly have time to take care of their parents. This leaves them feeling guilty, as they do not like the fact that their parents are being neglected. These Living Facilities are set up for this cause alone. It enables the children to live their lives while their parents get the help that they need. Since well-qualified professionals take care of all the medical and personal requirements of the parents, children get to spend a lot of quality time enjoying their company.

6 Things You Need to Know About Rehabilitation in a Skilled Nursing Facility

Many times you learn of a parent's medical crisis from an unexpected phone call. The change in your parent's health and abilities sets in motion a journey for both you, as caregiver, and your parent through the health care system. During a hospitalization, you learn the realities of elder medical care. Hospital stays are much shorter, and your parent most likely will detour through a skilled nursing facility before returning home.

Here are some tips to help navigate a rehabilitation stay in a skilled nursing facility:

1. Hospital stays are minimized. When your parent no longer needs medically necessary services in a hospital environment, he will be discharged due to Medicare restrictions. If your parent has been hospitalized for a minimum of 3 days, the doctor may write orders for rehabilitative services in a skilled nursing facility.


2. A rehabilitation stay provides your parent with a daily regimen of therapies such as: Physical therapy, Occupational therapy and Speech therapy.


3. Speak with the doctor early in the week about his plans for your parent's discharge. The worst days to transfer to a skilled nursing facility are Friday, Saturday and Sunday, because therapies are normally scheduled Monday through Friday.


4. It is likely that your parent will need visits from you more when he is in the skilled nursing facility than he did when he was in the hospital. Although the nursing home resembles a hospital in both form and function, it does not provide the same level of care or have the manpower to answer all those calls for assistance quickly.


5. Nursing homes are in the business of making money. Even non-profit facilities expect to cover cost of care and have money to reinvest. Rehabilitative stays are quite lucrative for skilled nursing homes.


6. Make sure the facility you or the hospital social worker selects is certified by Medicare.

Continual communication with the hospital admitting doctor, social worker and the doctor in charge of your parent's rehabilitation helps ensure that your parent's needs and desires are remembered and followed. Even when you try your hardest to take care of all the issues that pop up, you will sometimes feel inadequate. Try to let go of any regrets and give yourself kudos for doing your best to support your parent when he needs you most.

Future Grads of PSW Courses: Our Ageing Population Needs You

Young people today contemplating their choice of careers should keep in mind the many ways in which the world is changing. Those who are interested in pursuing a career in health care may want to pay particular attention to something called the "greying" of our population.

The first of the baby boomers, born in the late 1940s, have reached retirement age, the age at which we are most likely to encounter long-term disability and require care from graduates of PSW (personal support worker) courses. Toronto is just one North American city that is already experiencing the effect of this demographic shift, but in other sectors, notably the real estate market, where there has been an increased demand for condos - thought to have been spurred, in part, by retirees seeking homes that require less upkeep.

Take your cues from the real estate market? For PSW courses, in North America, yes.

Take note, prospective students of PSW courses: Toronto, Calgary, Montreal, all these cities will need more graduates of this kind of healthcare training to provide proper care for our ageing population.

When choosing where to take PSW courses, major cities offer a particular advantage in that they are more likely to have a large, ethnically diverse population, which presents many opportunities to students enrolled in a PSW program.

Amongst the opportunities they present to graduates of PSW courses big cities offer ethnically-focused nursing homes, which provide, for instance, care in Cantonese or Mandarin to ageing members of the Chinese Canadian communities. If you are interested in healthcare training and speak another language, you may want to look into these kind of nursing homes as a potential career option.

In your PSW program, you may be presented with a work placement option. By choosing a school in a large urban centre, you will increase the number of facilities that you will have to choose from.

If life in the city doesn't appeal to you, don't worry. After your PSW program, Toronto, Vancouver, etc., will not be the only places with job options. Our rural populations are ageing as well - a phenomenon that is only underscored by the depopulation of the countryside as our rural youth move to the cities in search of employment. After enjoying a PSW program you can move to Madawaska Highlands or the Okanagan to pursue your career in earnest.

So, as you are reviewing your healthcare career options, keep in mind that demand for certain kinds of training - especially that provided in a PSW program - is expected to continue to rise. Future graduates of PSW courses, the big cities, are counting on you!

Estate Planning Tools: Lifetime Gifting Program - Seven Factors To Consider

An invaluable part of any estate plan can be the strategic and systematic use of the annual gift tax exclusion. By properly planning your estate distribution strategy over a number of years, you can successfully lower, or even eliminate, estate shrinkage from administration, death taxes and probate costs.

A lifetime gifting program can help you to pre-administer your estate in a way that allows you to control how and when your assets are distributed. The following seven factors should be considered carefully as you look at your own gifting strategies and how you can obtain the biggest impact for your efforts. For this article we will illustrate a retired couple with three children, all of whom are married and each has two of their own children.

Seven Factors To Consider:

1. Both Retirees Alive: While both retirees are alive, they can each give $13,000 to each of their children (2011 gift tax exclusion amount) annually, as well as their children's spouses and/or grandchildren. If we just use the children and their spouses, each parent could gift up to $26,000 for a combined $52,000 annually to each of their three children's families. That's up to $156,000 per year that they could gift from their estate to their children.

2. Establish Multiple Joint Accounts: What if you need money after it has been gifted away? First of all, a gift means that you give up all interest in the gift when it is received by your children. But if your children agree to open up joint accounts with each other and invest the gifts with the intention of leaving them alone until both retirees have passed away, just in case they are needed, this is an acceptable option.

3. Trusting Your Children: Of course this program requires our retirees to have complete trust in their children and their spouses. If you let them know you are making these lifetime gifts in an effort to pre-administer your estate, saving time and money and trust they will take care of you if you ever need assistance, this can be a great way to see the benefits of your efforts while you are alive.

4. Sixty Month Look Back: If something happens to one or both of our retirees and they need to be admitted into a nursing home, any gifts that were made within the prior five years or the sixty month look back period could be reverted back to the retirees, or the nursing home for payment of those costs. If our retirees still have enough assets and income to cover these nursing home costs, the previous gifts may not need to be reclaimed.

5. Death Of First Retiree: Upon the death of either of our retirees, the annual gifting amounts now will be cut in half. If our retirees haven't started gifting yet, the maximum that can be gifted is now $26,000 to each family unit for a total of $78,000 annually. It is never too late to begin this program and the sooner a parent begins, the sooner the sixty month look back period will pass.

6. Life Estates: Another tool to consider if real property is part of a parent's assets is to establish a life estate. This program allows the transfer of ownership of their real property to their children, but maintains their use of the property for the remainder of their life. This transaction is usually handled by a local real estate attorney and if our retirees would rather stay in their home instead of moving into an apartment or other living arrangement, it can be a great strategy.

7. Nursing Home Expenses: If nursing home care is needed and our retirees have gifted away all their assets over the years, it becomes very important to keep an accurate calendar of when the last gifts were made. If they were completed over sixty months earlier, they should not need to be considered, but if they were less than sixty months ago, you will need to review your options. It may be beneficial for the children to give back enough of the gifts to cover the monthly nursing home costs that would be needed to exceed the sixty month requirement. After that point, our retirees could qualify for public assistance. While their pension and social security income will be used to cover these costs, the remainder of their previously gifted assets should not.

Summary: A good lifetime gifting strategy can have many benefits if it is done properly. Make sure that you contact a good financial and estate adviser and begin planning your program today. It can be done in smaller amounts, over more years as long as the guidelines are followed. The peace of mind, time and money saved by using this program can be a great way to leave a wonderful legacy to your loved ones.

To discover additional estate, financial and income tax strategies, check out my blog or download your FREE Wealth Expansion Kit by clicking here. The first step to creating wealth is knowing where you are and then charting a path that will enhance your financial strengths and correct your weaknesses.

Nursing Homes - Putting the 'Home' Back in Elder Care

Many nursing homes around the country have gotten a face lift and not just a physical kind. For several elder care facilities they are ditching the regimented care in which people are housed like a hospital and required to take medication at a certain time in addition to having to wear 'lift belts' or use walkers 'just in case.' There is a movement that has these nursing homes listening to their charges and their nursing staff. The companies that own these facilities, and there are several around the country, are putting the 'home' back in nursing home.

The old nursing homes were modeled after hospitals and institutions with an emphasis' on efficiency instead of making a persons stay pleasant and calm. Most of these new elder care facilities seem more like large dorms or apartments for the elderly. There are typically 10 to 30 people to a section with a communal kitchen, dinning and living room areas. And no one is roused at 7 am for breakfast so they could be shuttled back to their room for an 8 am shower. People wake up on their own time and the nurses or a cook will make them something to eat. People are treated like individuals and with respect. Additionally, medications are given when they are suppose to be taken, but delivered to the patients room, no one has to line up to receive medications with everyone else.

Homey touches are all around in these progressive nursing homes such as visits from pets. Many people who enter nursing homes must give up their pets which can contribute to their overall depression about their new situation, but if they know their beloved companion could come and visit with them, this could help their mood immensely.

Having residents become active participants in their care helps give them a sense of purpose. Many residents will willingly help with preparing meals, washing dishes, sweeping or other communal room chores. Other residents may organize a 'help' campaign such as sewing cloth bags and filling them with pencils and notebooks for those children who don't have school supplies in an underdeveloped country.

And many of these 'new model' nursing homes have seen a decrease in the number of employee turnovers in the past several years, something that has always plagued traditional nursing care facilities. By having no more 'floater' employees - nurses who rotate throughout the facility - and instead have a 'consistent assignment' - caring for the same one or few patients everyday they are working - has also seen a decrease in the three major problems facing patients that could be related to the constant changes in caregivers - weight-loss, ulcers and falls. If a nurse sees a patient every three or four days, they may not notice a subtle change in their skin color which could be an early sign of a pressure ulcer from inactivity. Many elderly do not handle change well and having to deal with a different caregiver each day could have a negative affect on their system and psyche.

Modesto Assisted Living Info

Modesto is the 16th largest city in California, located in Stanislau County, Northern California, which is about 66 miles west of Yosemite National Park and 92 miles east of San Francisco.

Surrounded by rich farmlands, it is ranked sixth in farm production among counties in California. Modesto has also been a "Tree-City Honoree" 29 times, as the city values nurturing the environment as an important aspect of caring for its people.

With its abundant farmlands and forests, the city provides a healthy atmosphere for Modesto senior living residents.

Modesto Recreation

Being home to famed film director George Lucas in his early years, Modesto celebrates summer with the revival of American Graffiti, the critically acclaimed 1973 movie of the famous filmmaker. "Graffiti Nights," the annual festival, is celebrated for the whole month of June and attracts thousands of car enthusiasts worldwide showcasing hundreds of antique and classic cars.

Seniors will likewise enjoy shopping at the Vintage Faire Mall, Vintage Commons and Plaza Parkway, all of which offer an assortment of shops and major department stores to residents in the area. Modesto also offers over 200 restaurants and dining establishments which will provide fun and activity for assisted living residents.

Modesto Activities

The Modesto Senior Citizens Center is the place where seniors gather for various services and activities such as medical programs, arts and crafts, dance clubs and other enjoyable programs.

The center also provides information and assistance on legal matters, insurance and other relevant issues.

The local government also provides educational courses for seniors, such as basic computer classes, that are designed to give them additional skills. These help Modesto senior living residents remain a valuable part of the community and provide them with a sense of accomplishment.

Modesto Medical Facilities

Healthcare is a critical issue for senior living residents and their family. One of the newest healthcare facilities in the region is the Kaiser Permanente Modesto Medical Center which provides state-of-the-art medical technology and utilizes the greenest technology in the USA. The Doctor's Medical Center is also another local hospital that specializes in acute care. Both hospitals offer various services such as cardiology, neurology, orthopedics, oncology and intensive care to ensure that Modesto senior living residents maintain their best health.

Modesto Transportation

There are three types of public transportation systems that serve Modesto residents: the Modesto Area Express (MAX), Stanislau Regional Transit (StaRT) and the San Joaquin Regional Transit District (RTD).

The MAX offers a paratransit "Dial-a-Ride" transportation service for seniors and the disabled around the city. This specialized transport service is available seven days a week, 365 days a year for people with disabilities and those 65 years and older. The MAX provides convenient service to residents of Modesto senior living communities.

Modesto is a great city where seniors can spend their years productively in comfort. It is a city that cares for the aged just as much as they care for the rest of the residents. To find assisted living for your loved one, visit our Modesto Assisted Living page.

Choosing Nursing Homes for Family Members - Useful Tips

People who have elderly or unwell family members eventually have to think of selecting good nursing homes to put these loved ones in so that they get the best possible care. However, this is not an easy task because there are many different things that have to be taken into account. The process of identifying and evaluating a nursing home has to be done very carefully so that the elderly or frail person is as comfortable as possible.

One of the most important things to be considered is the quality of service provided by the nursing home. If you have a family member who needs to go to a medical facility then you need to be certain that the place will look after your loved one well. For starters, it ought to be in compliance with public standards. Do not even consider putting your loved one in a place that is not because this could have dangerous consequences. In addition, the place should preferably be a part of Medicare programs. While this ensures that you do not have to pay a huge amount of money from your pocket (at least not for a specified time), it also indicates that the place is of acceptable standard.

Not only should the place have excellent medical and leisure facilities but it should also be staffed by the right kind of people. The best kinds of people to work in nursing homes are those who have a lot of empathy for patients in addition to a great deal of experience and competence at doing the job well. If the patient has a particular medical condition then the home and staff should be able to deal with it with properly. Before you commit to a particular home make sure you check the qualifications of the staff, especially if the aged person in mention has any medical problems.

Nursing homes for the elderly and the infirm should ideally be close to the homes of family members so that visits can be made without too much trouble. Regular visits from family and friends are very important for the overall wellbeing of the patient. In addition, it is a fact that people who get lots of visitors also get better care from the nursing staff. Of course, if there is no good facility in the vicinity of one's home then one should never settle for a bad place. These tips will certainly be of use when it comes to selecting a reliable place for your loved one to live in.

Homecare - The Differences Between Full-Service Agencies, Private Hire & Referral Agencies

Homecare, also known as in-home care, provides a caregiver to work in your home and help with activities of daily living (ADLs), instrumental activities of daily living (IADLs) and household chores. Some homecare aides accept clients who live in assisted living or skilled nursing facilities, and in those cases they work with their clients in the facility rather than the client's home.

There are three basic ways to go about hiring a professional caregiver. First, you need to decide whether to hire a private caregiver or go through an agency. There are two kinds of homecare agencies: referral and full-service. This article addresses the differences between all three options.

Full-service Agencies

Full-service homecare agencies take care of the major aspects of hiring a caregiver for you. It is in the best interests of these agencies to ensure that their caregivers are experienced, competent and a good fit for you, the client. Services normally include:

* Prescreening employees for a criminal background

* Checking multiple references

* Providing worker's compensation insurance

* Maintaining professional liability insurance or bond

* Covering all payroll taxes

* Supplying a caregiver when a hired one will be absent

* Replacing a caregiver who isn't a good fit

* Supervising caregivers

Before you start your search, read important questions to ask before signing a contract with an agency.

Referral Agencies

Referral agencies provide some initial screening and selection services, but once you hire a caregiver from a referral agency, your relationship with the agency ends. Referral agencies do not provide supervision of caregivers. Referral agency services usually include:

* Prescreening employees for a criminal background

* Checking multiple references

Your responsibilities, after finding a caregiver through a referral agency, will include:

* Paying the caregiver directly and covering any related taxes

* Insuring the caregiver and/or your personal items (Contact a local insurance agent to ask what protection an existing homeowner's policy offers. Ask for information about dishonesty bonds and worker's compensation.)

* Supervising the caregiver

* Finding a replacement caregiver if needed

Private-hire Caregivers

Private-hire caregivers are often hired by word-of-mouth recommendations. To get started, read tips on how to find, background check and interview a private-hire caregiver, review a downloadable Caregiver Employment Sheet and learn how to avoid fraud and abuse by in-home care employees.

Taxes and Private-hire Caregivers

Private-hire caregivers can work as independent contractors or as your employee. Tax laws change yearly; however, in 2006 any in-home employee who made less than $1,500 for the year is considered a contractor. Thus, a caregiver in this situation would use the IRS's 1099 form, which means that they are responsible for their own taxes at the end of the year. There is one exception: homecare workers who act as their own business with, for example, business cards, clients or a business license; even if he or she made more than $1,500, a person in this scenario would be considered a contractor. All other workers would be considered your employee and you would be responsible for withholding the proper amount of taxes from each paycheck. There is also a set amount for transportation costs ($105/month in 2006) and live-in costs, which are not calculated into the yearly sum.

Licensed Home Care - Benefits of Using a Full Service Agency

Choosing the right New Jersey home care agency for your elderly loved one is a crucial decision, not only for them but also for you. It may be difficult to consider placing your parents or relatives into an assisted living facility or nursing home, but you may also decide to hire an agency experienced in home care so that your loved one can stay in his or her home.

Finding the right home care provider should not be taken lightly as it may ultimately entail having someone live in your home. In this case, you want to be sure you have a caregiver who is qualified and professional in delivering assistance to your loved one. You may consider trying to find a care professional yourself, but you may benefit more by going to a full service agency that provides hourly or live in NJ licensed home care aides to you instead.

The benefits of using a full service agency are numerous:

• 
  Agencies take care of all the business details you may not know much about. For instance, your agency can provide comprehensive background checks on potential caregivers. It will also make sure your caregiver is certified in the area in which your loved one needs care. The agency also handles many of the bureaucratic and managerial tasks you may not have considered, like performance reviews, training, re-licensing, coaching, hiring and firing.


• 
  A full service agency also handles financial matters in home care such as employment taxes, insurance and licensing issues that come with hiring a home healthcare professional in New Jersey. Handling these time-consuming and complex tasks on your own will add to the stress of caring for an elderly loved one.


• 
  With an agency, you can also choose whether you want to get someone on an hourly basis or live in, whether you need a home health aide or if you need someone to act more as a companion for your loved one. If your parent or other relative has issues such as dementia or a terminal illness, he or she may benefit by having one specific caregiver at his or her side to fulfill all of their needs.

These are some of the many benefits that come with hiring a full service agency to help you find the right option in home care. Of course the greatest benefit is peace of mind for all concerned.

Elder Care - Instrumental Activities of Daily Living

Instrumental Activities of Daily Living (IADLs) should not be confused with activities of daily living (ADLs). If not familiar with ADLs, please see a previous article written by this author, Elder Care - Activities of Daily Living. These two categories are assessed separately but are actually very connected as far as ability to perform the activities.

This is why IADLs are important to elders and why they need to increase their knowledge on this subject. Understanding these actions may mean the difference between independent living and assisted living out of the home.

IADLs are any actions that we perform on a daily basis that requires the use of an instrument. The use of the word instrument throws most people off because of the multiple meanings. But there really is not a better word to describe all the different items that are included in this category. I'll explain. IADLs include: transportation, shopping, laundry, telephone calls, food preparation, handling finances, housekeeping and managing medicine. With a little thought it's apparent that there is an instrument involved in each one of these activities.

The daily activities performed using an instrument are measured very similar to the method used to evaluate general activities of daily living. The medical professional or case manager uses a chart with headings such as: Always, Frequently, Sometimes, Never. Now let's apply this categorizing to the actual IADLs.

Transportation - This does not mean there is or is not the ability drive. That's a possibility, but it could also mean a person has the ability to understand and use different types of transportation. It's important to understand that if a person is creative and informed enough to find an alternative to an IADL that they are starting to experience difficulty performing, it doesn't mean you have lost the ability; it's just done a different way. For instance, if using a bus instead of a car because a person no longer drives; they would be scored as always able to perform this activity as long as it's independently accomplished.

Shopping - Is the individual able to manage their way through the grocery store, push a cart, carry a basket, select food, and get through the check out process by themselves.

Laundry - In this case the instrument is the washing machine and dryer or clothes line.

Telephone calls - Using the telephone as we age becomes more and more difficult largely due to changing eyesight and advances in technology. There are ways to cope with both of these. Get a phone with bigger numbers; they're inexpensive and available everywhere. Don't let other people force a present of a new telephone with tons of gadgets for you to have to learn when you really aren't interested.

Food preparation - The stove, oven, microwave, refrigerator, and general small kitchen appliances are the instruments here. Again if any of these items start to become difficult to use, make adjustments. For instance, if your short term memory is giving your problems use a loud timer every single time the stove is used.

Handling finances - This requires the ability to calculate, write checks, use debit cards, handles cash, schedule and pay bills, and create a budget. Most people of all ages have some problem with this but specifically for elders the difficulty starts to arise with the short term memory. Use calendar. This is not trite, place a calendar where you can see it and put all of your bill payment due dates on it as soon as you receive the bill. Many elders pay a bill the minute they receive it because they are afraid they'll forget later. This is a really good way to get ripped off. Everything that appears to be a bill in your mail may not be so.

Housekeeping - The vacuum is the big instrument here. The act of vacuuming is difficult for anyone, much less a person who may become frail.

Managing medicine - The instruments in this category include the medicine bottle, medicine box, or an automated medicine box.

This is a very basic introduction to the instrumental activities of daily living; a discourse not only meant for elders but for everyone. Either you are an elder, know an elder, or are going to hopefully become an elder. If you want to stay at home as long as possible become educated on these types of issues.

Online Medical Assistant Programs - Overview

Online medical assistant programs involve a mixture of online virtual classroom instruction coupled with on-site clinical experiences at a nearby healthcare facility. These programs teach aspiring medical assistants the skills and knowledge needed to work in the field.

Online Medical Assistant Programs Overview

Courses

The information that makes up these programs is taught through video conferencing, discussion boards and email, via an online e-learning platform. These courses teach students how to administer injections, take vital signs and how to assist with a range of basic medical procedures, in order to prepare them for the clinical duties they will be required to carry out when working in the profession. Administrative skills are also taught, including: patient chart preparation, appointment scheduling and medical coding. Again, so aspiring med assistants are well prepared to carry out these tasks when they have found employment.

A single online course typically takes just eight weeks to complete. This is because these courses often provide the foundation needed to take an associate's degree in medical assisting. In addition to online study, students are able to acquire practical experience through clinical training, provided by local associated medical centers.

Training

Typically, online training courses take approximately ten months to complete. The courses are designed for individuals who want to start their careers as soon as possible, by equipping them with the knowledge and skills needed to hold entry-level positions in clinics, hospitals and medical offices. Common coursework includes: medical office management, medical ethical and legal guidelines as well as basic laboratory and diagnostic procedures.

While classroom learning is accomplished through email, video lectures, discussion boards and live chat, clinical training is completed at an administrator approved health care facility, under the supervision of a licensed health care professional.

Certification

Upon successful completion of the course, many training programs award students with an associate's degree or diploma. Completion of the course also means that the eligibility criteria to sit certifying exams have been met, which are offered by the NCMA, AAMA and AMT. However, this is only the case if an institution's online medical assistant program has been accredited.

This information can be found out by contacting the CAAHEP (Commission on Accreditation of Allied Health Education Programs) or the ABHES (Accrediting Bureau of Health Education Schools).

While aspiring medical assistants are able to apply for the certification exam online, the exam must be taken at an approved site, in person.

According to the US Bureau of Labor Statistics, employment opportunities are expected to grow at a rapid rate. This is thanks to medical technology constantly improving, and the increased need of health care for an aging population - both of which require an increase of medical assistants to meet demand. Therefore, if you are thinking of starting a career in the health care industry, you should certainly research all the online medical assistant programs available to find one that meets your needs and future career goals.

The Surgery Recovery Process for the Elderly

Unlike young people who tend to spring back from a surgery with ease and few complications, the elderly tend to have a much harder and slower time recovering from surgery. They are also much more likely to suffer complications.

Medical complications are common among elderly post-operative patients. Often prescription painkillers cloud the mind and cause visual impairment in the elderly. This can lead to an inability to read the print of pill bottles and the potential for mixing up medication. Elderly people who already have memory problems are also at risk for taking too many pain medications because they may take some and forgot they took it and take it again. A short term rehab center can make sure that medical regiments are followed.

Problems can also occur if your elderly loved one takes an oral medication (or medications) daily and cannot after surgery (some surgeries require fasting before and/or after the procedure). Make sure to let a doctor know if your elderly loved one is on a daily medication so that arrangements can be made for non-oral administration. Stopping certain medications abruptly (seizure medications, blood pressure medication) can be harmful. A short term rehab center can administer medications in a safe way. There is also the issue of day to day living during recovery. Elderly patients can be bedridden for long periods of time. Things like getting food, using the bathroom and other day to day functions can be difficult especially in the days after surgery. If you don't have the time to watch your elderly loved one you should consider a nursing home to care for them in the weeks after their surgery.

A nursing home has staffed experienced in geriatric patients. They know more about the recovery process of older adults than a hospital staff who sees hundreds of different patients in a day. A nursing home can also offer daily monitoring, unlike hospitals which will send you home and then re-admit you once a problem becomes apparent. Being monitored by doctors ensures problems are solved before they bet so bad hospital re-admission becomes necessary.

Rehab centers and nursing homes speed up the recovery process. No one wants to be bedridden, recovering from surgery. If that is the case, however, you want to do so as quickly as possible and under the most through supervision. Choosing the right short term rehab center or nursing home is an important part of the recovery process.

Nursing Home Activities Planned by Activity Professionals

Activity professionals conduct nursing home activities. The activities planned in these care facilities are to help improve the quality of life for the seniors' in long term care, and are designed to meet their physical, emotional and social needs.

It is the activity professionals' job to keep a record of activities used with the residents, for one-on-one, in-room activities as well as those used in group settings, and to gauge the ability levels of residents and determine some activities that may be more beneficial to them.

Monthly calendars are used to keep everyone informed of the planned activities. These help the residents, the staff, resident families and others know what is coming up and what to prepare for. Many of these activities are planned weeks in advance and are based around monthly themes that involve the holidays or other large events, such as Independence Day (in the USA), Canada Day (in Canada), Remembrance Day, Easter, Thanksgiving and many more.

It is a challenge for activity directors to keep things fresh and interesting for so many residents in order that they don't become bored and even irritated at activities that no longer present challenge or new and creative ideas. Activities need to attract individuals and be fun for groups as well. Where some residents may enjoy crafts and singing, they may dislike gardening and exercise. Others may love trivia and reminiscing, but this could become too repetitious for others.

The creative and fun parts of an activity director's job can help to balance for them some of the stress they deal with trying to come up with a variety of activities that please the most people. It can be particularly difficult to come up with, and always have readily available, activities to meet everyone's mood, whim or preference on a daily basis. So it is a formidable challenge to keep all the elderly satisfied.

When activity directors construct activities to involve more therapy, that looks more like fun than therapy, the benefits can be multiplied. For some later stage Alzheimer's and dementia sufferers sensory activities that stimulate and provide pleasure are most beneficial. An activity like this might be finger painting, or working with clay. Some Alzheimer's patients need only run the clay or paint through their fingers, feeling the texture, seeing the colors, watching it move through their fingers, to experience therapeutic benefits.

Parties are great fun for a facility to get many residents involved and introduce a theme on a larger scale involving decorations, game prizes, foods revolved around the theme, music and entertainers too. Some of the more popular party themes used in nursing home activities are the holidays like Christmas, New Years, Easter and Thanksgiving, but also Valentine's Day, Independence Day, Mother's Day, St. Patrick's Day and even luau's that are a wonderful break for those in the colder climates where the warm days of summer seem just too far away.

Nursing home activities that appeal to individuals as well as groups are games and crafts. Some of the more popular games that are liked enough to include quite regularly on an activities calendar are:

• Bingo

• Reminiscing activities

• Trivia

• Paper crafts

• Coloring pages

• Clay crafts

• Matching games

• Word games

• Puzzles

These can be activities easily adapted to residents of varying participation levels or used as in-room and one-on-one activities.

Activities beyond games and crafts that can get seniors up and moving a little more are exercise classes, even chair exercises, wii bowling tournaments, and some other video games good for coordination building and movement. Activities like travel videos, sing-alongs on CD or DVD's, audio books and music programs to explore musical instruments, are also very welcome to most people looking to do something less ordinary.

Field trips can be some of the best activities to refresh the residents. Stretching their legs for a couple of hours in a shopping mall, or a park, zoo, museum or a local event can be all that's needed to cheer a brooding bunch.

The quality of life for seniors in care is important and the activities designed by activity professionals for the seniors to participate in to enhance their emotional, physical, mental and social well-being are usually always created with this in mind. Nor is this an easy thing to do, even being professionally trained, they can't possibly know every type of activity to incorporate. So they can be very challenged to keep things fresh and new for most, while still providing some old and faithful activities that many seniors have come to love and completely enjoy.

Nursing homes with activity professionals that have the means to carry out these diverse, therapeutic and enjoyable activities help improve the quality of life for the elderly, but also enhance the well-being of the care facility over all.

What to Expect From Nursing Assistant Training

Nursing assistant training is one of the easiest ways you can consider to become a certified medical professional and begin your career by working in primary care facilities. Some of the major duties of certified nursing assistants (CAN) include assisting the patients in daily activities such maintaining hygiene, dressing, feeding, administering medications, socializing etc.

The primary responsibility of a nursing assistant is to meet the patient's needs in a timely manner. Any slight change in health condition of the patient has to be reported to the nursing staffs or physicians. During the training, trainees will likely learn how to work in a high stress environment.

Nursing assistant training programs are offered in various local community colleges. A typical CNA study program will last only about six weeks. There are even training facilities that offer accelerated training for CNAs, but their cost is considerably high when compared to fee of community colleges. For instance, the overall cost of training offered by community colleges is only around $300; whereas an accelerated training program will charge you approximately thousand dollars. As the training principles are same for both programs, saving seven hundred dollars can be fairly equated to a pay check of two weeks.

Once an individual is enrolled for a nursing assistant training program, he or she is expected to study very frequently. A serious mistake that is commonly done by many people is not preparing enough to take up the state exam. Each and every state has its own set of requirements and method for analyzing the capabilities of students. Most of the states require the student to pass a verbal test simultaneously with a practical test where the trainees are required to demonstrate various medical procedures. For instance, during the training period, the students will be taught how to provide perineal care for patients. During the time of test, the students must state each steps verbally as they perform it. Most of the state requires the students to score about 90 percent or more in order to pass the test. Since nursing assistant training test is very strenuous, majority of CNA trainees cannot pass in their first attempt. But with good knowledge and self-confidence, you can pass test.

Since we live in a society which needs more and more nursing homes, CNAs will be in greater demands. For this reason, you don't really have to worry about getting a job after the completion of your nursing assistant training program.

Assisted Living Options Available to Seniors

For those that are unable to totally care for themselves in their own homes, there are assisted living options available to provide the care that they need. It can be very difficult for some to adjust to not being able to live alone. Due to baby-boomers retiring and getting old in age, senior care facilities are popping up everywhere.

The assisted living options that are available at these facilities include cooking, cleaning, shopping and assistance with other daily activities. They can also provide supervision ans administration of medicines for those that required it. Some even offer medical support that is on standby 24/7.

Facilities that offer assisted living options understand that most elder people have a hard time adjusting to having to depend on others for help with their daily tasks. They try their best to promote independence to their residents and help them as much as possible in the areas that they need help.

There are many, many different types of senior care facilities and visiting all of them that are in your area can be a daunting task. It is best to have someone that specializes in the research of these facilities to give you a helping hand. The will give you a list of the facilities along with the options that each offers.

By law, each facility has to be licensed and everyone caring for patients has to be certified to do so. Some assisted living facilities are like retirement communities. Some may do better than others at catering to individuals and make them feel comfortable and at home.

Church in a Nursing Home

I remember being bummed out on September afternoons after church in Minnesota. September was our church's month at the nursing home. I would think of a thousand excuses why somebody else should go. I'm sure my presence must have been something less than inspiring.

Nine years later, I understand something I did not realize back then: that many nursing home patients are mentally sharp, spiritually devout men and women, who are only a few years removed from full, active lives. And if they could, they would still be in church every Sunday morning. Our little half hour Sunday afternoon service was, for them, a way to connect with something deeply meaningful in their heart.

It is common for nursing homes to invite churches to put on mini services for their patients. It is not common, however, for churches to actually put their heart into that privilege. Indeed, for many it is a burden. Just like it was for me all those years ago. Why is that? Why do so many adults miss the fact that society's most vulnerable citizens desperately need what they have?

If we adults miss it, the good news is that our children don't have to. Last month, my daughters went to back to back services in our local town here in Oregon. They sang as our worship leader (our "go to guy," no less) led them in a few songs. Then they listened intently as someone gave a short message. After that, they did something else: They talked with the patients. They got to know their names, their stories. They prayed together. And now they look forward to seeing them again.

Religious services in nursing homes are optional, of course, for patients. But these services deserve to be treated with forethought, love and respect. If we value the patients, the least we can do is show them that they are worth our time.

Grandparent Rights to See Grandchildren: Solidarity Truly Is Power

If you've found yourself in the position of questioning your grandparent rights to see grandchildren, you're going to need all the help you can get. If you're very lucky, there's an amicable divorce and you have a child willing to make your visitation rights part of the divorce decree. If you're very unlucky, the parents never married and you are the paternal grandparents.

Each year many thousands of grandparents and their grandchildren find themselves just much collateral damage in the war of spite, revenge, drugs and/or alcohol addiction, or simply the desire to wipe the slate clean and start a new "nest". Where before there was genuine goodwill or respectable civility for the sake of the children, now there is ugliness and disdain.

When a parent denies a grandparent rights to see grandchildren - where long-term familial bonding has taken root - the effects are nothing short of earth-shattering. Grandparent Alienation Syndrome has been proven to have emotionally crippling and long-term, devastating effects on grandchildren.

So what can be done?

One of the strongest advocates for grandparents rights to see grandchildren is the American Association of Retired Persons. This powerful lobby boasts more than 40 million members. With many millions of baby-boomers retiring in record numbers, no organization in the country speaks with more authority on matters of elder issues.

Following are some of the ways this wise & powerful coalition makes a difference:

• Advocating for legal change. This is where the organization has proven itself over time. It has taken the lead in getting laws at the state level, favoring grandparent rights to see grandchildren.


• Strengthening social change for older Americans. The association advocates on matters pertaining to Social Security, access to affordable and reliable health care and laws protecting the aged in nursing homes and assisted-living facilities.


• Voter education. The group provides information to voters about how politicians are voting, as well as positions taken on various issues. They are a marvelous resource for determining where your state and federal politicians stand on issues like grandparents rights to see grandchildren.

Granted, joining a lobby group isn't the most glamorous of ideas. When a grandparent is in the throes of hopelessness and despair over lost grandchildren, this kind of advice is seems sterile and cold. Get involved anyway. Keep your mind busy. Make a difference. There are others out there who feel as you do. You can chat with them in online forums, or start a grandparent rights to see grandchildren support group in your own hometown. Do something. Take action.

Because your grandchildren - and their legacy - matters.

Assisted Living Considerations

How to take care of the elderly entails making difficult choices. Whether hiring home caregivers or taking the services of a specialized facility, there always has to be a balance between doing what is best for the senior citizen and what is suitable to their lifestyle. One of the most popular choices brings together the independence of living in their own home and the care provided by a nursing home. Assisted living homes offer this kind of compromise.

For those who are looking into the possibility of assisted living to provide elderly help then there are some elements that need to be thoroughly considered in order to get the best kind. Since these facilities exist primarily to ensure that the patients are safe and comfortable, the choice needs to be one that caters to these needs.

Practically speaking, budget plays a key role in choosing the assisted living home. The good news is that these kinds of home are more inexpensive compared to nursing homes. However, this does not mean that they come cheap. One of the best ways to ensure that the money is spent wisely is getting as many quotations as possible. Ask several facilities for the price range of their services and find out what are included in the packages offered.

Keep in mind that what is written in the brochure can be vastly different from what happens in real life. Take the time to visit the assisted living facility to see how the staff works and the kind of environment offered. One of the main things that should be considered is the quality of the food. It may not seem like a big deal at first but it is indicative of the type of service and attention to detail rendered by the facility.

Although assisted living homes are not as medical-centered as nursing homes, this does not mean that they are no less safe. A topnotch assisted living facility should have a medical team on call at all hours of the day. Some of the people that should be included in the staff are doctors, nutritionists, and even therapists to take care of the patients should any medical emergency come up.

Finally, look into other features of the facility. See if there are telephone services, gyms, or cable television. After all, the elderly should not feel deprived of any of the comforts that they have grown accustomed to. In addition to this, check to see if the assisted living facility is near the store, market, and hospital for their convenience.