VA Aid & Attendance Benefit - Friend Or Foe?

As much as the VA Non-Service Connected Pension Benefit (more commonly referred to as "Aid & Attendance") is useful in offsetting the high cost of eldercare, it can significantly affect a person's ability to qualify for Medicaid in assisted living after their assets are exhausted. As welcoming as the additional income might be, it is NOT always in the best interest of the person applying, especially if they might need Medicaid before they need a higher level of care. Keep in mind, once the additional income is awarded the Veteran or surviving spouse cannot stop the benefit in order to qualify for Medicaid.

Recently an Aging with Grace Eldercare Specialist received a call from a frantic daughter whose mom was living in a Florida memory care assisted living community owned by one of the largest assisted living providers in the country. Sixteen months ago, the assisted living provider paid an organization to assist the family with obtaining the VA surviving spouse aid and attendance benefit. This increased the woman's monthly income to $2600.00/month and provided the additional funds, along with her 50K in savings, to move in into this lovely community.

Now with less than 10K in savings, she will be unable to continue to pay the $3850.00 each month. Even if this provider did participate in the Medicaid waiver program for assisted living, this resident would not qualify since the additional $1057.00 from the VA puts her over the state's Medicaid threshold of $2022.00. Although long term nursing home care is not needed at this time, her income may leave her with no other alternative. In this particular situation, the benefit representative "hired" by the assisted living provider never addressed or didn't recognize the possible need for Medicaid after her assets were depleted.

With independent and assisted living providers introducing the VA benefit to potential residents for this additional monthly income, we are seeing more and more people in the same situation. Not only is it a violation of the federal guidelines for an "interested" third party (such as a provider) to pay a fee on behalf of a Veteran family for this type of service, the providers can and have found themselves in liable situations.

Federal Regulation 38 CFR 14.636: Payment of fee by disinterested third party. (i) An agent or attorney may receive a fee or salary from an organization, governmental entity, or other disinterested third party for representation of a claimant or appellant even though the conditions set forth in paragraph (c) of this section have not been met. An organization, governmental entity, or other third party is considered disinterested only if the entity or individual does not stand to benefit financially from the successful outcome of the claim. In no such case may the attorney or agent charge a fee which is contingent, in whole or in part, on whether the matter is resolved in a manner favorable to the claimant or appellant.

It is critical that our veterans and their families work with individuals who are knowledgeable about both the VA benefit and Medicaid with an understanding of the potential impact the additional income can have. By offering a free pre-qualification analysis, a consultant can determine a client's potential eligibility and identify possible conflicts. Fees paid by the Veteran family are strictly for pre-filing consultation to assist them assembling the documentation needed for a well developed claim.

By anticipating all of the documentation requirements that are necessary and submitting them with the original application, the time from submission to a decision is shortened. Certified veteran benefits consultants are private practitioners and are not connected with the Department of Veterans Affairs. They comply with federal statutes and regulations governing the preparation, presentation and prosecution of any claim for veterans' benefits with the U.S. Department of Veterans Affairs.

Taking a Personal Support Worker Course

Are you looking for a fulfilling career? Do you want to help people? A personal support worker career may be what you're looking for.

With the increased average age of the national population, personal support workers are currently one of the most in demand healthcare workers in North America, and this is expected to continue for the foreseeable future.

Personal support worker courses are designed to prepare students for these tremendous career opportunities. Graduates of Personal Support Worker courses can find employment in nursing homes, hospitals, private homes, non-profit organizations and agencies.

Some of the best PSW courses will even help students find a placement for you following your in-class training. Job placements will give you the opportunity to apply your theoretical skills in a professional setting that will help you gain confidence through hands-on training, and practical experience in a real work setting.

PSW courses prepare students for careers in a wide range of healthcare positions, facilities and settings. Typically these programs include the following areas of studies:

• Individuality of the Patient (each patient has different needs)


• Role of the Personal Support Worker


• Development of Interpersonal Skills


• Safety Standards


• Assisting a Person with Mobility


• Abuse Recognition and Required Action


• Household Management and Meal Preparation


• Optimal Support Requirements


• Care Planning


• Personal Hygiene Assistance


• Assisting the Family/Coping Mechanisms


• Cognitive Impairment and Mental Health Issues


• Assisting the Client in Managing their Ongoing Condition


• Medication Assistance/Administering and Educating


• Assisting the Client Who is Dying


• Practicalities of Daily Living, Use of Specific Support Devices


• Diagnostic and Treatment Procedures


• Arranged Nursing Home Placement and a Community Placement


• CPR / First Aid (included)

The life of a personal support worker is varied and full. Some or all of the following duties performed by a PSW include:

• Answering call signals; serving meal trays, feeding or assisting in feeding of patients and assisting patients with menu selection; lifting, turning or massaging patients; shaving patients prior to operations; supervising patients' exercise routines, setting up and providing leisure activities for patients, and accompanying patients on outside recreational activities; and performing other duties related to patient care


• Taking patients' blood pressure, temperature and pulse; reporting or recording fluid intake and output; observing or monitoring patients' status and documenting patient care on charts; collecting specimens such as urine; administering suppositories, colonic irrigations and enemas and performing other procedures as directed by nursing and hospital staff


• Transporting patients by wheelchair or stretcher for treatment or surgery


• Carrying messages, reports, requisitions and specimens from one department to another


• Making beds and maintaining patients' rooms


• Maintaining inventory of supplies


• Performing maintenance tasks such as assisting with the set-up and maintenance of traction equipment, cleaning or sterilizing equipment, maintaining and repairing equipment, and assembling, setting-up and operating job-related equipment.

How Much Compensation For Tinnitus Claims?

How much compensation for tinnitus?

If you are suffering from tinnitus and someone else is to blame then you do have the right to pursue compensation. When you are considering making a claim it is normal to want to know how much you will receive.

Calculating your claim

Tinnitus claims can range from 瞿4,850 to 瞿30,000. Calculating exactly how much you will receive is not an exact science, generally because every case is unique but estimates can be made based on the following:

• The amount you have spent on medical treatment, such as private nursing care or disability aides
• The length of time it has taken you to recover
• Any loss of earnings as a result of your injury or suffering
• How the tinnitus has affected your life long-term

General damages

Tinnitus can often appear alongside other hearing related problems such as deafness, vertigo, sleep disturbances and nausea. Sufferers can live with any number of these symptoms on a daily basis. The calculating of your claim will bear these factors in mind and how much your quality of life is affected.

Loss of earnings

Your loss of earnings covers future loss as well as past and if you have been rendered unfit for your previous job then you could be looking at a large compensation amount. Having tinnitus can mean that you have severely psychologically affected too. Receiving treatment from psychiatrists, cognitive behavioural therapists is not unheard of and the costs associated with that will also add on to your final settlement fee.

Employer's duty of care

The constant ringing or buzzing sound in the ear/s which indicates tinnitus, can range from mild to severe in terms of noise level. At times it is referred to as 'noise induced hearing loss' or 'industrial deafness' and is often brought on by loud and persistently noisy working environments.

Your employer can sometimes fail to protect you by not carrying out health and safety procedures or supplying you with ear protection. If this is the case then your employer has not carried out it's legal duty of care and you could be entitled to make a claim for any losses you have experienced.

Making A Claim For Tinnitus

If you feel you may have cause to make a claim for tinnitus compensation then you should contact an accident claims solicitor or personal injury lawyer to discuss your case in more detail.

How to Prove Abuse or Neglect: Surveillance Techniques for Your Family

Undoubtedly, there are people you know and trust enough to allow them to babysit your children or care for a vulnerable adult in your home. Sometimes that trust is based on personal knowledge, and other times it is based on the process one presumes a professional agency utilizes to screen employees. Unfortunately, that trust is far too often misplaced, resulting in abuse and neglect that goes undetected, often for months or even years. Caregiver abuse is difficult to prove, since bruises and other injuries can and do happen even with the most careful and attentive workers, and often the child or vulnerable adult is unable to accurately express what did or did not happen.

Traditionally, there have been few options for people who wanted some way to ensure that their loved ones are safe and being adequately cared for. Recent digital advances and the trend towards ready availability of affordable surveillance equipment have made it possible for nearly anyone to take steps to protect their loved ones and put abusers behind bars. One such case involved parents in Jacksonville, Florida who had suspected their long-time sitter of abusing their child. They installed a hidden camera and turned the footage over to police for prosecution. If you hire sitters, a nursing service or individual caregivers to work with children or vulnerable adults in your home, you should face the reality that yes, it could happen to your loved one, in your home - and you have the right and the duty to protect them in whatever legal way that you can.

We have some tips for using home surveillance to record abuse/neglect:

1. Check the laws in your state or consult a reputable attorney to ensure that you do not violate state or federal law. Then check again to be sure!

2. Decide what risks are apparent and try to think of others that might not be so obvious. Consider neglect as well as abuse, and pay heed to the red flags that you may have dismissed as an overreaction.

3. Try to identify locations in the home where abuse may occur, or where neglect would be apparent and pick one or two places where a camera would record the activity or lack thereof. Also, try and think about the type of equipment you are setting up, how big or small it is, and what aspects, such as wires, you will need to hide.

4. Think about the time the equipment will need to be in operation -- an evening? a full workday? a weekend? Depending on your budget and/or time restrictions, you may need to make some difficult choices.

5. Few people need or want to have color high-definition video, with audio, of every square foot of the home 24/7. Consider using audio surveillance without video or video without audio. For audio, consider background noise, distance to source, need (or lack of need) to record low voices or whispers, etc.

6. If you have decided to purchase your own equipment, shop for equipment that will work in the locations you identified - there are many "nanny cams" on the market, hidden in everything from teddy bears to radios. Audio recorders without video are also widely available in a variety of shapes and sizes. Be sure to purchase equipment that will provide good quality, useable recordings. Remember - you get what you pay for, and far too often you get something less. If you're creative and/or handy, consider purchasing just the recording equipment and installing it yourself in an item or place that is already in or part of the room.

7. If you don't have time or are hesitant to install surveillance equipment yourself, contact a reputable, licensed private investigator. They make recommendations on where and how to set up surveillance, as well as the best equipment to use for your particular circumstances. Many will rent you the equipment and/or install it for you, as well.

8. Don't let on to anyone that you've installed surveillance equipment --children, the elderly and loved ones with limited cognition may inadvertently reveal the surveillance verbally, through behavior changes or even by just looking repeatedly in the direction of the recording equipment without realizing it. And view recordings in private, without the child(ren) or vulnerable adult present.

9. NEVER confront a suspect based on video or audio evidence. If you feel that terminating the person's services is necessary, do so promptly and with as little explanation as possible (consult an attorney if you are unsure of what is required of you). Of course, ensure that the child/vulnerable adult receives thorough medical and/or psychological assistance as soon as possible.

10. If the incident appears to involve a violation of law, consider all the circumstances and proceed in whatever way is best for the victim(s), keeping in mind that in most states, there are some crimes you are required by law to report. Check your state's laws or consult an attorney if you are unsure what is required in your state.

11. If you are not required to report the incident(s), you can certainly choose not to do so, but keep in mind that there may be others the suspect has abused or neglected, and that there may be more if you decide not to report.

12. Local law enforcement should assist you in preserving the audio/video evidence. Most departments and/or prosecutor's offices have Victim/Witness Assistance programs - if you're not referred by the officer, ask how you can get in touch with V/WA.

13. If the suspect has a license or permit, consider reporting the incident to the licensing agency. In situations where a report to law enforcement is not mandated, this can be in addition or an alternative to a report to law enforcement.

14. In most states, you cannot be successfully sued for making a good faith report of abuse or neglect to law enforcement or other appropriate agencies - consult an attorney in your state to find out your rights and what protections the law provides to you.

15. If serious harm has been done to your loved one, consider requiring those responsible to pay for your loved one's medical and counseling costs. A qualified, experienced attorney can explain your alternatives and help you with any claim you or your loved one(s) may have.

How to Qualify for Medicaid and Protect Your Assets

In today's world many people can spend their entire life savings on home health care and nursing home costs. However, with proper planning this does not need to be the case.

In fact, it is possible to receive assistance from the Government for health care costs associated with long term care. Medicaid qualification could be the answer but knowledge of the rules is key.

How To Qualify For Medicaid

Income and Assets are primarily the two categories Medicaid considers for qualification.

Marital status is the other consideration. The maximum amount of income and assets you may have and still qualify is dramatically different based on whether you are married or single.

However, there are still some steps a single person can do to help protect some assets and still qualify.

Qualifying For Medicaid If You Are Married

Income Considerations:

Under most circumstances a married Medicaid Applicant (the sick spouse) can allocate some or all of his or her income to the well spouse remaining at home. Medicaid's term for this is the Minimum Monthly Maintenance Needs Allowance or MMMNA for short.

When the Medicaid application is made by the sick spouse, the rules separate the income of each spouse and review the incomes independent of each other.

This is vital information as if the sick spouse's income is too high (approximately $2000 per month in most states) then he or she will not be qualified to receive Medicaid.

For example, let's assume Harry is the sick spouse and his income is $2500/month while Sally is the well spouse and her income is $1200/month.

Harry's application for Medicaid would be denied because his monthly income exceeds the maximum limit of $2000 per month. The sad fact is most families do not know the Medicaid Rules. They do not understand how to qualify and therefore end up spending down the majority of their monthly income as well as potentially all their retirement savings on nursing home costs!

Knowledge of the rules and the strategies to apply are key because not only could you qualify in the example above but a significant portion of income can be shifted to the well spouse so that their lifestyle can be maintained.

Asset Considerations:

Regardless of whose name is on the asset the Medicaid rules look at both spouses' assets as one. In effect, all the assets go into one bucket.

Medicaid places the assets in the three following categories:

• Exempt Assets: $2000 in cash, the primary home, one car, personal property, funeral/burial contracts, IRA's (in most states protected if in well spouse's name)and up to $1500 in cash value life insurance


• Unavailable Assets: an interest in someone's estate or real estate that cannot be sold


• Countable Assets: cash, CD's, stocks, bonds, mutual funds, IRA's, 401(k), 403(b), tax-deferred annuities, 2nd car, buildings or land owned

The well spouse is then permitted to reach into the bucket of assets and begin pulling out assets for their use.

From list above the well spouse is allowed to begin pulling assets out of the bucket such as the primary home and one car. Medicaid rules only allow the well spouse to pull out a limited amount of assets in addition to the house and car. In most states that limit is approximately $109,000.

Obviously it would be easy for most middle income families to easily reach the $109,000 upper limit. When the well spouse has more than $109,000 in total assets a major problem ensues. The well spouse would be forced to spend down all remaining assets greater than $109,000 unless they were aware of the rules and were able to apply proper asset protection strategies.

Most families can protect up to 100% of their assets if no one is in the nursing home and between 50% - 60% of the assets even if one or both spouses are already in a nursing home!

Giving From Your Heart

Giving back to your community is a powerful way to share your skills, talents and blessings with others. Even though you might not have anything of monetary value to give others, if your intention is to make another person's life more enjoyable simply by your kindheartedness and helping hand, you have given more than money can buy.

The encouragement and care that you are able to give is infinite and caring for another is more significant when it is done through the kindness of your spiritual self. Contributing to the life of another person will deepen the desire to make the world a better place as you strengthen your connection to your spirit.

Being of service to others not only makes one feel valuable, it also is a way to share the abundance of your joyful heart. Volunteering to help in a community center, assisted living home or doing something for people in your neighborhood can give you a feeling that your skills, talents and blessings are contributing to the betterment of others' lives as well as deepening your sense of connectedness with people. While you are helping other people, if you keep in mind that your help is simply an extension of the universal spirit that connects us all, you will find what you do is more meaningful, not only for yourself, but for those you help. When you give from the heart, your energy vibrates at a higher level, and is experienced by others as warm, nourishing and energizing to them.

Paying For Care - Assisted Living Homes

More and more elderly people are opting to spend their golden years in an assisted living facility in lieu of living in a nursing home, with a family member, or at home, alone. One drawback to assisted living for many people who are interested in this type of living arrangement in the elder years is the financial burden of paying for care. In many cases an older adult has prepared well for their future and money may not be such a huge concern, unfortunately that scenario is not as prevalent as it should be. In too many cases the elder adult did some preparation but by far not enough and money is a concern.

There may come a time when an elder adult cannot live on their own any longer they need some help with day to day living activities. Assisted living homes are usually the perfect answer. Of course they are not free and require money to pay for.

Where to Find the Money for Assisted Living Homes

If the elder adult is a homeowner the home can be sold to raise capital to pay for the assisted living home, if they are not there are other options that are available. It can be a combination of financial backing that can be pooled together to pay for the residency.

There are some insurance policies that will cover for part of the care that is provided in adult group homes. Primarily the medical end of things will be covered. If the elder adult was fortunate enough to have some foresight and opted for an extended care option on their policy, then more services will be covered.

To pay for the rest of the care that insurance does not cover, retirement income can be used. Many folks get a check each month from retirement investments that they made with the company they worked with before they retired from. This can go toward the monthly payment as well. In almost every case even if there is not a retirement check coming in there will be some type of government check that is paid each month, this can also help to supplement the costs.

Liquefying assets are another way to find money to pay for this type of care. Selling off stocks and bonds, even selling off cars can raise the money that is needed to keep this option going for a while.

Family Members

In many cases the family members of the elder adult can kick in some money each month to help to offset the cost of paying for the assisted care homes. If there are multiple family members that can help with the costs, then the financial burden would be lightened considerably.

Paying the costs for assisted living homes can be met by pooling resources the cost can easily be met. It is well worth the cost and the effort to find a way to meet

How Long For A Medical Negligence Claim To Settle?

Clinical negligence, also known as medical negligence compensation is when a patient has suffered pain, injury or discomfort as a direct result of a medical professional's mistake. They can take a long time to complete, often up to a few years. This is largely down to a number of medical and legal protocols.

Your claim could be against an NHS organisation, a private clinic, a GP or surgeon. Examples include incorrect treatment, an error during surgery or a failure to diagnose a condition.

Cases vary in complexity and therefore length of time; the more involved a case is then the more time-consuming it will be. The dependency on third parties, like medical experts, also plays a large part in adding extra time to a case.

First things first

To ensure your claim is as swift as possible, it may be an idea to make a complaint, your lawyer may be able to help you with it.

The below timeline outlines the necessary stages that personal injury lawyers have to take you through to ensure your claim is dealt with properly. Its purpose is to demonstrate the reasons for the length of time of a medical negligence claim. Use it as a rule of thumb as cases can vary significantly.

Background

First and foremost it must be established that the medical practitioner or medical body is to blame for your pain/injury or suffering. You will need to have an in-depth discussion with your personal injury lawyer where you will discuss the validity of the claim. Details of the injury/pain sustained and how it was the fault of a third party will be fully examined and considered by your specialist medical negligence lawyer.

Funding

There are several ways in which your claim can be funded. Your lawyer can discuss these options with you. One option may be working on a no-win, no-fee basis with your solicitors.

Evidence

Once your case has been taken on by a personal injury lawyer the following must be carried out:

Medical records - these sometimes hefty documents, will need to obtained from your GP or hospital. Due to the Data Protection Act, these can be sent up to 40 days following a request.

Medical expert - your solicitor will get in touch with a medical expert and supply him with your statement and the medical records. Using this evidence, the expert will then write a report which will decide whether or not and to what extent medical negligence has occurred. It is important that medical experts have up to date clinical knowledge and will often be working within the NHS. They may be heavily sought after for their opinion by others and therefore their reports may take some time to complete.

Further examination

On completion of the report by the medical expert, his/her findings will be discussed with you.

Once a report on whether there has been a breach of duty has been carried out it is normally necessary to get a second report from an expert to show the breach of duty has caused you some injury, only after reports are obtained both in relation to breach and what is called causation - a report linking the breach to the cause of the injury, will a report on quantum or ('how much') be obtained. Details of your income will have to be provided and further exploration into your injuries will need to be done.

Your solicitor will send a formal letter to the defendant explaining the claim made against them. Their reply will state whether or not they accept blame and the defendant has 4 months within which to return a response to the claim. Often cases are vehemently fought by defendants.

If your claim is defended by the medical body or professional then your solicitor may be able to take your claim of negligence to court, depending on the evidence. This in itself can be time consuming (it's possible it may take years) as several expert witnesses with demanding schedules will need to be brought together.

Your medical condition

The medical condition of the claimant is often instrumental in the time it takes for a claim to progress. For example, some complex conditions are reliant on the availabilty of specialist surgeons to carry out important operations which will then allow patients to recover and their condition stabilise.

Stable medical conditions are required to assess a case fairly. A medical report confirming the exact condition of the patient is usually not given until a condition is 'stable' or has reached a point whereby there is likely to be no improvement. You have up to 3 years to make your medical negligence claim starting from the time you received the poor quality treatment. It is possible to legally protect the claim if your situation has still not stabilised after 3 years. Your solicitor will advise you on this process.

Settlement

A final compensation amount can be awarded following either negotiations between your solicitor and the defendant or when a Court rules in your favour and awards you compensation after a hearing.

Your medical negligence claim

Do not be put off by the length of time your claim may take, many people succeed in medical negligence claims. If you do think that you have a claim then you should contact a personal injury lawyer or medical negligence claims solicitors.

Housekeeping in a Nursing Care Facility

Proper medical care and nutrition are very important to monitor when a loved one is in a nursing care facility. Another area to keep a close watch on is the housekeeping department. How they clean rooms, lobbies, bathrooms, and other areas determines how good the care actually is at a nursing home. Even larger facilities should employ enough staff to ensure the building is clean and remains that way.

The truth is than many nursing facilities in an effort to save money, will only hire enough people to cover the shifts. This means when a person is absent or quits, it is then the nurse's job to clean rooms. With many nursing stations understaffed, housekeeping can sometimes take a back seat. When visiting a loved one, there are a few items to check to make sure at least a minimum amount of cleaning is being performed.

o Clean bathrooms are a must. Elderly people will sometimes have trouble using the bathroom. Clean bathrooms that are sanitized are essential to keep bacteria from being spread.

o Use of gloves. When changing a resident or cleaning up the bathroom, it is important that housekeeping and nursing staff use gloves to prevent the spread of bacteria.

o Clean sheets. Another way to keep bacteria from spreading and a way to keep residents comfortable.

o Make sure the staff is wearing clean uniforms. Nursing and housekeeping should always wear clean uniforms before each shift.

These are just a few items to look at when paying a visit to a nursing facility. Since the elderly are prone to catching colds easily, living in a clean space will help keep them safe and healthy.

Nursing Home Abuse - Warning Signs Of Silent Injustice

With much of the "baby boomer" population having reached middle age, the number of people entering retirement communities and then nursing homes over the next few decades is expected to steadily increase. This will undoubtedly spur the development of new facilities as well as the growth of those that already exist.

Some of these new residents will have more financial flexibility than others, which will likely play a role in the type of service and atmosphere they are able to acquire. Even facilities with minimum accommodations can be considerably costly to live in, which makes the nursing home industry one with plenty of profit potential for those running the homes.

It is, however, an unfortunate reality that some nursing homes have found ways to put their own profit before residents' well-being. Instances of nursing home abuse are disproportionately higher in the lower-cost facilities. This is largely because these residents often have less financial freedom, making it difficult to leave the home for a better one. And when there is less freedom to leave, reporting the abuse to those outside the home only puts the resident at risk of further abuse for having spoken up.

For those who may be entering a nursing home in the future or who have a parent or loved one who is considering or already living in a home, it is important to note that what nursing home abuse actually entails is somewhat misunderstood by the majority of the population. Cartoons and sitcoms depict caricatures of abuse, in which residents are forced to knit socks for long hours with no breaks for prune juice.

This is obviously an exaggeration. In reality, nursing home abuse is far more complex and can take many, many different forms. By better understanding the different types of nursing home abuse described below, you can help keep both yourself and your loved ones from becoming victims of these crimes.

Forms of nursing home abuse:

1. Physical abuse. This includes not only violence, but also physical force or coercion, inappropriate physical restraint, and physical punishment of any kind. Look for bruises, cuts, broken bones, broken eyeglasses, and signs of restraint.



2. Medical negligence, malpractice and neglect. This includes dehydration and malnutrition, improper administration of medication, untreated bedsores, unsanitary living conditions, and failure to report significant changes in health to the resident's doctor.



3. Sexual abuse. This includes any type of non-consensual sexual contact, and may be perpetrated by a worker, another resident, or a visitor to the home. Look for bruises or bleeding around the breasts or genital area and torn or bloody underclothing.



4. Emotional or psychological abuse. This is any verbal or nonverbal act that causes the patient to experience anguish or pain. It includes such things as insults, threats and humiliation, and also includes intentionally isolating the patient from people or activities or ignoring the patient.



5. Financial exploitation. This is taking advantage of the resident's condition or situation by using their funds, property or other assets. This means such actions as stealing from them, forging their signature, forcing them to sign documents, or charging them for services they do not receive.



6. Self neglect. This is one of the least understood types of nursing home abuse. This is when a resident imperils their own health or safety and nothing is done to help them. If a resident stops eating or drinking, performing personal hygiene, maintains unsafe or unsanitary living conditions, or wears inadequate clothing.

These are, of course, just some examples of each of these types of nursing home abuse. Often they are not reported by the resident, so it is important for family members to be aware and involved and to ask questions.

Indications of an abusive living situation also include a resident's sudden change in mood, refusal to speak about life at the home, and the home denying the family opportunity to be alone with the resident. A good rule of thumb is that if something seems wrong, it probably is.

5 Major Mistakes New Entrepreneurs in Assisted Living Make - And How They Can Be Avoided

Some of the most well meaning professionals contact our offices or one of our affiliates wanting to increase their personal income and serve society by entering into the assisted living business - sometimes on a small-scale (6-12 beds) and often much larger. These special programs provide clinical competence, quality shelter and personal care assistance for some of the most vulnerable among us including the catastrophically injured and the medically fragile elderly who do not belong in a nursing home.

Those who contact us seek direction on program models and types or they look for valuable information from our paid webinar or conference call sessions (which are conducted early mornings and late evenings for the convenience of busy professionals). Some of you look to engage others in your business plans, i.e. relatives or existing business partners and would like direction on how to do it.

Having assisted in the establishment of or the refining of more than 200 programs, we delight to help people enter the business correctly. After all, America was built on entrepreneurism.

However, there are even more people who enter the business having made some critical, avoidable mistakes and end up having to pay us to clean it up. We are happy to do it, but it makes our job harder. So let us discuss some key ingredients associated with a pattern of success by enumerating those five, (5) most commonly made mistakes:

I. Wrong Real Estate

Those who engage the technical advisor/consultant early in the process have quality direction in advance of purchasing real estate. Since real estate should be selected based upon how best it can serve the needs of the intended population and not just due to its reasonable price, professional insight in this area is meaningful.

II. Wrong Interim and Initial Personnel

New entrepreneurs are quick to align themselves with people who have worked in care. Often these are individuals who have provided direct care to a population with grave illnesses. Perhaps they have performed well in the clinical end of care. For some, thanks to meeting the requirements of one, (1) year of experience and completion of high school, they qualify to act as the administrator of record for the newly licensed program based upon currently published licensing guidelines.

Problem: This same person, while a high quality direct care deliverer, is not a trained, effective or savvy marketer. Their contacts with referral sources may leave them feeling as though they are completely out of their league. As a result this new entrepreneur in the business of care has set-up a good person to fail as a result of asking them to perform tasks they are not qualified to undertake and the initial impression to the long-term community at large may be a bad one to start.

This same person - on whom the new entrepreneur in care has latched - is not a technical writer. They may also not be trained in the professional development of plans of care, contract negotiation with community mental health agencies, responding to insurance issues affecting payments from no-fault insurers for a catastrophically injured person or the management of a clinically competent care environment. All of this underscores the need to be discerning in the selection of this initial staff member, especially management.

Ask yourself: Are they a certified brain injury specialist? Do they have clock hours learning what is involved in plan of care development? Do they have an advanced degree? Is their experience limited to simple, small-scale home management and direct care delivery or have they successfully swam with the sharks of long-term care?

Sentimentality cannot be allowed to override good judgment in this process. You need the right people.

III. Ignoring Regulatory Requirements

Every state of the union has clear, concise guidelines for determining what program models require licensure. Some attempt to render services without adhering to these guidelines resulting in licensing authorities seeking injunctions in circuit courts and even worse. Often a cursory review of licensing guidelines is not enough to consider oneself literate in this process.

Refusal to accept the value of regulatory compliance can be a fatal mistake on multiple levels.

IV. Refusal to Accept the Necessity of Effective Marketing

Many feel they have entered the business once they have a house. This is far from the truth. That house has to be converted into a workable, marketable, community responsive and clinically competent program with expert management. Holding title to the structure is by far not enough.

A similar situation would be present if this line of thinking existed as often occurs when you have the wrong personnel. Nice house - but no long-term profitability.

V. Absence of Operational Protocol

A business needs clear, enforceable guidelines to govern the work of its employees. An assisted living business needs routine and general policies and procedures to ensure there is a daily protocol that is not abandoned in the execution of services to residents. Staff must be trained in wound prevention and management, medication administration guidelines and so much more. Without it, no business can exist and thrive.

Want to avoid these pitfalls? Employ the right technical advisor/program manager who will hold your hand every step of the way. After all, a little leadership can be the recipe for avoiding tons of headaches down the road.

I am hopeful all of this will be extremely helpful to you and I thank you for allowing me to share.

Activities of Daily Living For Elderly and Handicapped - Home Accessibility

Every human being that exists on planet Earth must engage in specific daily duties. From working to recreational activities, it is quite obvious that humanity has a need to be very busy. Personal obligations must be executed. Sometimes they are as simple like brushing your teeth or taking a bath and sometimes they are difficult. These actions that must be carried out on a daily basis are typically referred to as "Activities of Daily Living " or simply ADLs.

Unfortunately, there are millions of people that cannot function with the simplest of tasks because of an elderly age or some type of disablement. The performance of personal hygiene, occupational responsibilities, recreational activities, etc. is curtailed as a result of these impairments. ADLs is a reoccurring term used in healthcare circles to refer to daily self-care activities within an individual's place of residence, in outdoor environments, or both. The inability to perform ADLs is sadly all too common for millions of people worldwide. This lack of functional status of the individual necessitates some sort of assistance and without it depression can set deep within the psyche of the individual. Depression can cause devastating results. People can lose the will to live because of this debilitating emotional disposition.

ADLs are typically categorized within two compartments:

1. Basic ADLs - Includes eating, dressing, getting into or out of a bed or chair, taking a bath or shower, and using the toilet. In essence, Basic ADLs have to do with the fundamental necessities of life.

2. Instrumental ADLs- Activities related to independent living and include the ability to use the telephone, get to places beyond walking distance, go shopping, prepare meals, do housework, do laundry, take medicine, and handle money. In summation, Instrumental ADLs deal in particular with actions that are not necessarily required for the "essentials" of existence.

As one ages impairment reaches greater levels as they are illustrated in a rising disability over time for those in their 60s and for those in their 70s. Activities of daily living (ADLs) are "the things we normally do" in daily living including any daily activity we perform for self-care (such as feeding ourselves, bathing, dressing, grooming), work, homemaking, and leisure.

This impairment is not relegated strictly to geriatric individuals but as well to those who have been injured in some type of accident or individuals who were born with genetic abnormalities.

Because there are millions of people that are in dire need of some sort of assistance to carry out ADLs there must be something to help them. Mobility aids are specific devices that can ensure that the elderly and the disabled can carry out their daily activities with dignity. Mobility aids include but are not limited to the following:

Walking Aids- includes assisted canes, crutches, and walkers. These devices improve stability by providing additional points of contact as the individual endeavors to traverse horizontally. Additionally, they help to reduce lower limb loading and assist in generating movement.

Wheelchairs and Scooters -These vehicle type instruments substitute for walking by providing a wheeled device on which the user sits. Wheelchairs may be either manually propelled (by the user or by an aide) or electrically powered. Mobility scooters are electrically powered.

Stairlifts - A stairlift is a mechanical device for lifting people and wheelchairs up and down stairs. Sometimes special purpose lifts are provided elsewhere to facilitate access for the disabled.

Bath lifts - They are designed to help people get in and out of the bathtub safely. They gently lower the body into the tub and after the person enjoys a relaxing bath, they gently raise them to the top. There are so many types of bath lifts in the market, that it is a difficult choice for the buyer. However, it certainly helps knowing what is available, helping one decide what they want. Different ones cater to different needs.

As long as mankind lives, he or she must engage in some sort of activity. This is vital for survival. From the mundane to the complex, existence requires many types of actions to be carried out in a functional capacity. This is what "Activities of Daily Living" (ADLs) are defined as. It is unfortunate that multitudes of individuals that exist on planet Earth cannot execute these activities in particular. Fortunately, mankind has developed these wonderful mobility aids to assist these individuals in their time of consternation and depression. Happiness, contentment, and self-esteem can once again be restored to the elderly and the disabled.

Visit Home Accessibility For Aids to Assist in ADL's

All About Cardiac Care Nursing

With nearly eighty million Americans now suffering from some form of heart disease, and almost a million and a half heart attacks occurring each year, nurses who specialize in cardiac care have seen an ever-increasing demand for their services. Early and comprehensive care of such ailments as high blood pressure, stroke, and coronary disease are essential elements of life-saving medical treatment, and cardiac care nursing plays a critical role in providing that treatment.

In many hospitals, the cardiac care nursing staff is a part of the intensive care staff. Their training and experience places these nurses on the front lines of response to cardiac emergencies, as well as in the development of long-term cardiac care treatment plans. They are also responsible for much of the interaction that takes place with the families of cardiac patients, as well as providing care information to the patients in their charge. Their assistance in the early detection and treatment management of cardiac conditions has a direct impact on the high survivability rates of cardiac patients in the United States.

Most cardiac nursing care is performed within a hospital setting, where patients with life-threatening cardiac conditions undergo surgery and intensive levels of care. There are, however, other environments in which these professionals provide critical services as well. One such environment is a rehabilitation facility. Cardiac care nursing is vital in these facilities to assist patients in making the transition of lifestyle necessary to ensure improvement in their conditions. Nursing homes with residents who have a history of heart problems often receive regular visits from cardiac care nurses who monitor the health of the facility's residents, and assist in treatment needs. There are also cardiac nursing personnel who provide in-home visits to patients who require frequent monitoring.

Cardiac care nursing is a specialty that requires the basic registered nurse (RN) degree, and sometimes requires the four year bachelor's degree in nursing as well. Before being recognized as a cardiac specialist, many nurses pursue additional accreditation in more advanced cardiac techniques, and also receive extensive hands-on training in a critical care ward. In addition, this field of nursing requires advanced communication abilities to ensure that written and spoken directives are properly delivered and understood by patients and families. In the care of people with heart conditions, even the slightest miscommunication can have disastrous consequences.

These communication skills also come in handy as cardiac care nursing skills are used on a daily basis. Due to the amount of interaction between the care nurse and the patient, the nurse is often the first health care providers to recognize that a patient is demonstrating signs of depression. Due to their training, those in the cardiac care nursing field are well-equipped to not only recognize these signs - common in those who have suffered a heart attack or stroke, but to discuss the problem with the patient and contact the necessary psychological staff when necessary. In this way, cardiac care nursing specialists provide care that goes well beyond the basic physical treatments, as their broad base of expertise assists patients in achieving recovery in every area of their lives.

Choosing a Nursing Home - 3 Steps to Finding the Right Facility For Your Loved One

Choosing a nursing home is an important decision, and it is vital to ensure that the facility you select will provide the highest quality of care for your loved one. There are three main steps you can take to find the nursing home that offers the services, environment, and lifestyle options that best suit your loved one's needs and preferences. Planning ahead, taking the time to analyze your options, and carefully researching several facilities before making a decision will help to ensure that the nursing home you choose will help your loved one maintain health, happiness, and dignity. Review the steps listed below as you begin this critical decision making process.

Step 1: Find nursing home facilities in your area.

- Ask people you trust, like your doctor, family members, friends, neighbors, and clergy if they have had positive experience with a particular nursing home Keep a list of the names of these facilities and look up contact information for each using the phone book or internet.
- Call your Area Agency on Aging (AoA). This telephone number should be listed in your local telephone directory or you can find it online by visiting aoa.gov. The local AoA can provide information about nursing homes in your area.
- Call the Medicare Eldercare Locator at 1-800-677-1116 for information about nursing homes in your area.

Step 2: Find out how nursing homes compare in quality.

- Nursing homes are certified to make sure they meet certain Federal health and safety requirements. To find out how nursing homes compare in quality in your area, look at http://www.medicare.gov on the web. Select " Nursing Home Compare." You can compare the State inspection reports of the nursing homes in your area and look at other information, like resident characteristics and staffing levels.
- Ask friends and other trusted community members if they are or were satisfied with the quality of care.
- Call the local office of consumer affairs for your state. Ask if they have information on the quality of nursing homes. Look in the blue pages of your telephone book for their telephone number.
- Call your state's health department. Ask if they have information on the quality of nursing homes. This phone number will also be listed in the blue pages of your phone book.

Step 3: Visit the nursing homes you are interested in.

- Before you make a decision, visit the nursing homes you are interested in. This will give you the chance to see the residents, staff, and facility. It also allows you to talk with nursing home staff, the people who live and get care at the nursing home and their family members. Be sure to call the nursing home office and make an appointment to tour the nursing home before you visit.
- Ask about the types of services and activities the nursing home provides for residents.
- Ask about the cost and fees for care. Find out if there is an extra charge for any special medical needs your loved one may have.
- Ask to see a copy of the most recent inspection report for the facility. Ask if the deficiencies noted have been corrected.
- Revisit the nursing home a second time, on a different day and at a different time of the day than when you first visited. Staffing can be different at different times of the day, and on weekends.
- Don't be afraid to ask questions. Find out if the nursing home is Medicare/Medicaid certified, if there is a waiting list, and what their visiting policies are.

Potential nursing home residents should be involved in the decision-making process if possible. However, cognitive ability, emotional issues, current state of mind, and physical status may limit a senior's ability be an active part of the nursing home selection process. It is important to be honest, forthright and supportive with your loved one during this time. Don't forget to keep visiting once your loved one has been admitted in order to ensure that he or she is handling the transition smoothly and that the care is of the quality that you expected.

How to File a Health Insurance Claim

There are two methods for getting a claim under a health insurance policy in India:

1. Cashless Hospitalization

2. Non-cashless Hospitalization

In case of Cashless/planned Hospitalization

1. In case of planned hospitalization inform the Third Party Administrator/insurance company about the date of admission in the hospital quoting your policy number and health ID card at least 4-5 days in advance.

2. The form for intimation to Third Party Administrator and obtaining previous authorization for cashless claims services is available with the admission counter of the hospitals.

3. The patient must fill up the form carefully as any incorrect information may lead to rejection of previous authorization.

4. The medical condition of the patient or the requirement of any surgical procedure is filled up by the doctor attending the patient. Be sure that the doctor is briefed correctly about the patient's history, otherwise it may again lead to rejection of previous authorization by Third Party Administrator.

5. In case of new policies all previous existing diseases are excluded. At the time of signing previous authorization form check that doctor has not mentioned anything about condition which may lead to assume it for existing previously.

6. The filled up form is then sent by the hospital authorities to the respective Third Party Administrator of the company for granting of previous authorization of amount for hospitalization.

7. The Third Party Administrator carefully scrutinizes all the details such as policy number, validity of policy, Sum assured, waiting period, preexisting diseases etc and after being satisfied sends the authorization of amount directly to the hospital.

8. After satisfying itself the Third Party Administrator will issue a previous authorization letter/ guarantee of payment letter to the hospital/nursing home mentioning the sum guaranteed as payable and also the ailment for which the person is seeking to be admitted as a patient.

9. The Third Party Administrator has the right to deny the previous authorization if he is not satisfied with the documentation.

10. Unless the Third Party Administrator gives the previous authorization letter to hospital, the hospital will not treat it as cashless claim. So the insured must vigorously follow-up with the Third Party Administrator for giving the authorization letter.

11. If the letter from Third Party Administrator is not received or if they deny then the insured must first pay for the expenses from his pocket and then lodge a claim to the Third Party Administrator/insurance company.

12. In case of planned hospitalization it is easier to get previous authorization since the insured has ample time to followup with the Third Party Administrator. The problem comes in emergency hospitalization.

Here time is of essence. The hospital will not start treatment unless he receives authorization from Third Party Administrator or cash from the insured.

13. This creates a panic situation and many times the insured are forced to pay from their

pocket and thereafter claim the amount from Third Party Administrator/Insurance Company in normal course due to emergency. In many cases it has been seen that Third Party Administrator's delay the process of authorization so that the customer pays from his pocket and then claims reimbursement.

14. Generally the Third Party Administrator's grant authorization for a particular amount. If the cost of treatment exceeds that amount the patient must give it from his own pocket and then claim reimbursement from the Insurance company if it is within the policy limits.

In case of Non-Cashless Hospitalization/Emergency Hospitalization:

In case of Non cashless Hospitalization the insured must give preliminary intimation about the claim within 7 days of hospitalization (The intimation period may vary from company to company) to the Third Party Administrator/Insurance Company.

The notice would include the following:-

1. Particulars of Policy number

2. Health ID card number and copy

3. Name of Insured Person

4. Address

5. Name of attending doctor

6. Name of Hospital

7. Nature of illness/injury

After the insured is discharged the final claim must be submitted to the company within 30 days from the date of discharge. The period of intimation may vary in insurance companies.

The following documents must be attached along with the prescribed claim form of the company:-

1. Original prescription of Doctor

2. Prescription of doctor advising for hospitalization/tests.

3. Original reports of all diagnostic tests along with the original bills like X-rays, ECG, Scan, MRI, Pathology etc.,

4. Detailed itemized bill from the hospital for bed charges, OT charges, medicines, and details of any other charges that the hospitals have levied.

5. Surgeons certificate stating nature of operation along with bill.

6. All bills for medicine purchased during the previous 30 days before hospitalization and

after discharge.

7. Hospital Receipts / bills / cash memos in Original (Copies of charge slips if payment is made by credit card) duly stamped.

8. Discharge certificate from hospital

9. Certificate from the doctor that the patient is fully cured and is able to resume his work

10. In case of domiciliary hospitalization a report from qualified nurse who attended the patient in his residence supported by a certificate from medical practitioner.

11.Copy of current insurance policy and previous policy.

12. F.I.R. in the case of accidental injury and English translation of the same, if in any other language.

13. The claim form must be filled correctly and there should not be any overlapping of information otherwise it may lead to rejection of claim.

14. Since all the original documents are submitted along with the claim form the policyholder must keep a copy of the claim form and all the original documents submitted along with the claim form. At the time of submitting the claim form he must obtain an acknowledgment from the insurance company about the receipt of the documents to serve as a proof of submission.

15. The policyholder must followup with the insurance company about the status of the claim after some time as the insurance company may require some other documents or clarifications from the hospital about the charges.

16. The insurance company if finds everything in order shall make payment for the claim. Many times it deducts some amounts from the bill which are not authorized under the policy or which may seem to be in excess.

Video Surveillance and Surveillance Laws

The dependability and prevalence of video surveillance cameras has increased dramatically in the past decade. Numerous home and business owners have integrated video cameras into their security systems to ensure safety, crack down on regulations, and catch criminals in the act. Surveillance is considered covert when the cameras are hidden or aren't identifiable. Security Cameras are largely legal in the United States, as long as it doesn't directly infringe on a person's fourth amendment right to privacy.

Uses of Covert Surveillance

"A picture is worth a thousand words." This saying rings true in court. According to a recent study, when a jury is presented with surveillance footage, it is twice as likely to convict as when not shown video surveillance evidence. The strategic placement of covert surveillance cameras aid in the detection and prosecution of vandalism, theft, child abuse, elder neglect, stalking, and harassment.

Some of the more common places to use covert camera surveillance are: Homes, Casinos, Police Stations, Nursing Homes, Construction Sites, Prisons, Hospitals and Retail Stores.

Monitoring the activities of nannies and household help with covert surveillance cameras is a growing trend. Due to recent advances in technology, cameras are now small enough to be hidden in many home items such as teddy bears, house plants, clocks, and wall paintings.

Surveillance Laws

Most camera surveillance is legal in the United States. The majority of surveillance laws concern the invasion of privacy with the use of covert video surveillance. The use of covert surveillance is particularly controversial in areas in which a high level of personal privacy is expected, such as: locker rooms, dressing rooms, bedrooms, and bathroom stalls. There are some general guidelines to follow to ensure the legality of your camera surveillance system.

Covert surveillance is illegal when: Audio surveillance is also taking place, without the consent of those being monitored and the person being monitored by the video surveillance has a reasonable expectation of privacy.

Covert surveillance may be illegal when: The video surveillance encourages an illegal activity and the subject under video surveillance has a right to counsel, as when being questioned by law authorities and the person in charge of the premises have not given permission for video surveillance.

If you opt to incorporate a covert video surveillance system into your home or business, consult with a lawyer or your local law enforcement agency to ensure your compliance with local, state, and federal video surveillance laws.

Many independent studies in the United States and United Kingdom have suggested that video surveillance acts as a powerful deterrent, stopping crimes before they happen. Studies also show strong evidence that video surveillance systems can be an extremely effective tool in detection and prosecution.

Job Outlook for Nurses Is Outstanding According to the Department of Labor

Registered Nurse Report
This comes from the US Department of Labor and is their 2010-2011 Occupational Guide. Here are highlights of the report:

• Registered nurses (RNs) constitute the largest healthcare occupation, with 2.6 million jobs.


• About 60 percent of RN jobs are in hospitals.


• The three typical educational paths to registered nursing are a bachelor's degree, an associate degree, and a diploma from an approved nursing program; advanced practice nurses-clinical nurse specialists, nurse anesthetists, nurse-midwives, and nurse practitioners-need a master's degree.


• Overall job opportunities are expected to be excellent, but may vary by employment and geographic setting; some employers report difficulty in attracting and retaining an adequate number of RNs.


• Employment of nurses is expected to grow by 22% much faster than the average of all occupations


• Nurses with a bachelor's degree are more sought after than nurses without one

One of the most interesting things about the job outlook is that they say that growth in nursing in hospitals will be much lower than in other places like working in doctor's offices, nursing homes, home healthcare and in other parts of the medical field. Just because it is growing slower doesn't mean that there still isn't quite a significant growth in jobs in the hospital setting.

Other interesting things in the report are that in some areas of the country they are having such a difficult time attracting nurses that employers are offering relocation assistance (money to relocate), signing bonuses which are cash bonuses when you officially agree to work for them, family friendly scheduling and other incentives to attract qualified candidates.

In 2008, here were the median wages of nurses:

• Employment services (those who work as head hunters) $68,160


• General medical and surgical hospitals 63,880


• Offices of physicians 59,210


• Home health care services 58,740


• Nursing care facilities 57,060

The report also talks about the types of jobs that nurses have and their responsibilities and the opportunities for advancement. Here are some of the interesting points about registered nurse advancement:

• Most RNs start out as staff nurses in hospitals


• Many RNs go on to become advanced practice nurses such as nurse practitioners, nurse anesthetists or nurse midwives


• Many nurses in the hospital environment find advancement opportunities in management and supervisory positions in the hospital


• Many nurses move their career into the business side of healthcare. It isn't uncommon for nurses to go academically to get an MBA degree and enter the business world and it is not unheard of that nurses go on to become lawyers.

It is important to remember that healthcare is a big business that hires many people who work very far from the patient's bedside. In many, many of these jobs, it is really important that the people have a real and tangible healthcare background. Nursing provides that background.

It is also worthwhile to keep in mind that there are several important factors that are driving the increase in the need for nurses. Firstly, the aging population means more sick people. The baby boomers are getting into their 60s and the need for more healthcare at that age increases dramatically. That means there is a need for more nurses. Secondly, whatever healthcare reform looks like, it will likely increase the access many people have to healthcare. People who couldn't afford healthcare or it wasn't a financial priority will be able to get healthcare under the new programs being discussed. This will drive the demand for more doctors.

Disabled Equipment to Aid Daily Living

Being unable to do something because of a disability is saddening, not to mention it hurts your self-esteem. Disability of the legs or the whole lower limb will compromise your ability to mobilise. There is a whole range of disabled equipment that aims to aid people with any form of disability. Basically, almost every thing or object we have is supposed to help us with something, but the disability equipment is to help maintain or regain the body's function. To keep the function closest to normal is the master plan behind this range of equipment.

Disabled equipment covers a wide-ranging list of products of all shapes and sizes. They are not limited to equipment which is tasked to help you mobilise or assist you in walking. They include all things that can aid people with any kind of disability. For example, a person who has a disability to see things vividly due to an eye condition like myopia, or even astigmatism, wearing a contact lens is a form of assistance.

As people can be exposed to situations which can leave them with different disabilities, more and more disabled equipment is being made to match people's preference and conditions. Items that are usually available are mobility aids like walkers, crutches, wheelchairs and gaits. These help with mobility problems which are usually caused by accidents of deformities of the legs. Other equipments are kitchen aids, bathing and shower aids, eating and drinking aids and writing aids. The purpose is to help every individual as much as possible to maintain regular routine activities as if they never had the condition leading to the disability.

There are a lot of providers of such disabled equipment. You can also ask your doctor what kind of equipment suits your condition. As these products are usually connected to your health condition, the doctor you have is sure to have answers and suggestions for your curiosity. Products in the market are usually modern, high quality, easy to use and are user-friendly. As it is built to help you on a daily basis, you can also cast your doubts aside durability wise. Also, it is often possible to trial or watch as walking or mobility aids are demonstrated, which helps to determine whether a particular product is most suited to your individual needs. Being disabled, or having a certain disability must not stop someone to lead a normal life.

How to Prove a Car Accident Liability Case

Who is liable after a car accident?

Car accidents can happen for many reasons.  The basic elements of a car or truck accident are similar to any negligence claim.  To prove somebody acted in a negligent manner causing recoverable damages (such as in an automobile accident), you must prove:

A Duty

Breach of the duty (negligence)

Causation between the duty and

Damages resulting from the breach of the duty.

 To prove that somebody was negligent (breach of a duty), it must be shown that the defendant failed use ordinary care - that which a reasonable person of ordinary prudence would have done under the same or similar circumstances.  We are all under a duty to use "ordinary care" in operating an automobile or truck.  In a personal injury claim involving a car or truck accident, negligence is generally what causes most accidents.  Some types of negligent behavior which can cause a car accident and personal injury include:

Failure to keep a proper lookout

Failure  to control their speed such as speeding or driving too slowly.

Following too closely behind another driver

Failing to yield right-of-way

Going through a red light or failing to stop at a stop sign

Failure to control the vehicle

Failure to use the brakes in the car

Failing to use the horn

Failing to use a turn signal correctly

Driving in an impaired state such as under the influence of alcohol or drugs

Driving on the wrong side of the road

This is not an exhaustive list as there can be many other ways that the car or truck driver can act negligently and cause injuries.  Furthermore, in many car accident cases, the negligent driver has failed to use ordinary care in multiple ways.

To prove that the negligent actions of the other car or truck driver is liable, you must show that they were the "proximate cause" of your injuries.  " Proximate cause" means that cause which, in a natural and continuous sequence, produces an event, and without which cause such event would not have occurred. In order to be a proximate cause, the act or omission complained of must be such that a person using ordinary care would have foreseen that the event, or some similar event, might reasonably result therefrom. There may be more than one proximate cause of an event.  In a car accident case, proximate cause is rarely an issue in a car or truck accident case.

Once negligence (duty, breach of the duty) and causation are established, it is necessary to evaluate the damages that can be recovered by somebody injured in an automobile accident.  The most common types of damages sought and recoverable in a car accident personal injury case in Texas are:

Past and future physical pain and mental anguish  

Past and future disfigurement

Past and future physical impairment

Loss of consortium

Loss of household services

Loss of past wages

Loss of future earning capacity

Past medical expenses

Future medical expenses

Punitive (Exemplary) damages in certain cases

Car wrecks can be the result of driver inattention, excessive speed, distractions and impairment.  Car accidents that are the result of driver impairment are quite common.  The impairment can be caused by many factors including drug and alcohol abuse.

In some cases, a claim for personal injuries from a car accident may also be brought against individuals other than the negligent driver.  If the driver was working for a company or individual, then the employer may be responsible for the driver's negligence and the resulting damages.  Furthermore, even if not working, the owner of the vehicle may be liable for the negligence of the driver.  This is known as liability for negligent entrustment.  Under this cause of action, an owner of a vehicle that allows another to operate it can be held liable for his or her negligent driving.  The owner - whether friend, acquaintance, parent, brother, sister, spouse or other relative - may be liable if they negligently entrusted the vehicle to somebody they knew, or should have know, to be a reckless, incompetent or unlicensed driver.

Hidden Camera Catches Elder Abuse in Nursing Home

The mere mention of a hidden camera can invoke thoughts of less than honorable people using hidden cameras in less than honorable ways. But despite the news reports of the misuse of them, one recent story of elder abuse in Haverford, Pennsylvania in April of 2012 lets us know with certainty that a hidden camera can be an invaluable tool for concerned family members.

So how can you tell if your elder family member is being abused? What can you do to help? What resources are out there? And if you're pondering whether or not you need to buy a hidden camera to protect a loved one consider the following.

According to the American Psychological Association more than two million older Americans are victims of elder abuse every year. Research suggests that elder abuse is significantly under reported and under identified. In fact, as few as 1 in 6 cases of elder abuse come to the attention of authorities, according to the National Center on Elder Abuse.

Elder Abuse is defined as intentional or negligent acts by a caregiver or trusted individual that causes, or can cause, harm to a vulnerable elder. Sharon Merriman-Nai, the co-manager of the National Center on Elder Abuse has stated that "Unfortunately from what statistical information we do have, most victimized people are abused by people they know and trust". Elder abuse can come in many forms; it's not just physical abuse, neglect, abandonment, psychological or emotional abuse, financial abuse and exploitation and even sexual abuse fall under the definition.

Many victims are reluctant to report abuse and the greatest difficulty is overcoming their resistance and fear of identifying the problem, so it's very important that you watch for signs of elder abuse. Often the best help that you can give is to ask questions, of your elder family member, their caregivers and even yourself.

A change in general behavior is a universal warning sign, if you notice that your elder loved one becomes withdrawn or now gets upset or agitated easily, it might very well indicate that it's time to start asking questions. And one important thing to remember is that if your loved one says something happened, take them seriously, Ms. Merriman-Nai also said "Sometimes, when older people suffer from dementia or some sort of cognitive problem, they may not be believed".

If you notice any untreated injuries, or an injury that seems inconsistent with the explanation given for its cause, it may be a sign of physical abuse. Also try to determine if your older family member is afraid of anyone, whether at home or in a facility, or whether they have actually been hit or slapped.

Greed is a contributing factor in many cases of financial abuse; the elderly may be susceptible to exploitation. Be observant, look for signs of missing personal belongings or credit cards, unusual bank account activity or checks made out to cash. Has your loved one redrawn their will at a time when they seemed unable to write one?

Emotional abuse can range from name calling to intimidation and threats. Ask them what happens when he or she and the caregiver have a disagreement. Are they being treated like a child, humiliated or threatened with punishment? Reluctance to talk about their relationship with a staff member, or demonstrating fear, anxiety or withdrawal when asked may be signs of emotional abuse.

In regards to the Pennsylvania caught on hidden camera incident, Delaware County District Attorney Michael Green said "The video depicts criminal activity directed at a senior victim in our county, it's abusive and it's the humiliation which is most difficult to watch on the video. No senior resident of a facility should be subjected to that kind of behavior, particularly from a health care provider".

There are many styles of hidden cameras available that can be discretely placed to blend in with the normal decor of a room, but be aware that although a hidden camera is a great tool for discovering the truth about the alleged abuse, it's not the only solution. With or without video evidence, if you have any reason to believe that an elder loved one is being abused or neglected, there are other resources to help. You can visit the National Center on Elder Abuse website at http://www.ncea.aoa.gov, for more ways to help your loved ones.

And if you believe that an elder is in a life threatening situation, call 911 or contact your local police department immediately.

When to File a Nursing Home Abuse Claim

Talking with a nursing home neglect attorney does not have to be costly. In fact, some of these lawyers will handle your case on contingency. This means that the lawyers don't get paid unless you win your lawsuit. It also means that you shouldn't hesitate to contact such a lawyer if you or a loved one has been the victim of abuse. There are a few varying forms of abuse, but they all include a violation of trust on the part of the nursing home staff. Some kinds are more noticeable than other kinds.

The simplest types of senior neglect to spot are usually the physical types. These may include assault, wrongful use of medicine, overmedication or sexual abuse. The signs are precisely what you'd most likely expect. Search for bruises, abrasions and cuts. Some very horrible individuals have been known to burn elders with cigarettes or find other ways to torture them to force the seniors to agree with demands. None of these wounds should be considered normal and all of them should be regarded with suspicion. Always have your eye out for the signs of physical abuse against an elder.

On the other hand, mental abuse can be much more difficult to detect. Many nursing home mistreatment claims involve numerous threats made by nursing home staff members and occasionally, severe verbal abuse. You should realize that this puts an elderly individual in a very difficult situation. While they're likely not strong enough to defend themselves against someone in their prime, they're also adults and being vulnerable is a blow to their dignity. This may be expressed as depression or a complete withdrawal from social activities. This doesn't have to be the case and there is no reason that anyone, young or old, should have to suffer being abused or degraded verbally.

Nursing home negligence sometimes means that your loved one isn't treated at all. The elder patient could be left in bed or sitting in a wheelchair being ignored for long periods of time. This is a form of abuse, even if it doesn't involve hitting or yelling. You should be aware of these signs of neglect, including poor hygiene. For example, the elderly individuals finger and toenails may be too long and unkempt, they might have extreme body odor, due to lack of bathing, and, in severe cases, diapers may not be changed as regularly as needed. No one needs to suffer nursing home mistreatment. If you have, you may be able to get compensation for you and for your loved one.

The Housing Market and Senior Citizens

The overall economy is not something that many people will talk about in the same sentence as senior care. These two topics are often considered to be unrelated, but in reality, they intermingle quite a bit. Take the housing bubble bursting back in 2008. You might not think of this at first, but this had a drastic impact on the senior community because of the fact that the building of many senior care facilities ground to a halt. The senior care sub-sector of the healthcare industry has been growing rapidly, but the 2008 housing crisis slowed down its progress. Finally, almost four years later, that trend is starting to revert back to its previous form.

Lending by banks has also begun to reappear. Since the Baby Boomer generation will desperately be in need of housing in the relatively near future, this is the key to a good outcome. The lending from banks can finance the construction of new senior housing facilities.

It should be acknowledged that the senior housing market has not uniformly shrunk. Many companies have remained healthy and growing, even during the down market we have recently been experiencing. This says a lot about the healthcare industry as a whole, which has been expanding consistently year after year-even during times of recession. The senior housing market has expanded still because of its ties to the healthcare industry.

Many buildings thrived because of their strong ties to their respective communities. This includes small to mid-sized senior care companies that have been able to persuade banks to lend them money. In many instances, buildings are able to be funded by individual investors renting the property out to the senior care companies.

The need for senior care housing is expected to explode over the next twenty years. When it does, these companies will be ready with the cheap buildings they were able to obtain during the housing market crash. Not only have these buildings been bought for a reduced price, there is a lot less competition currently in the housing market, making it much easier to get the most high quality buildings and rental units

Many companies have expanded their housing, but it is still not growing quickly enough to meet the overall demand in many areas. The elderly population is growing quickly and even though many new housing facilities have been constructed, the pace of construction is not necessarily keeping up. It's important that these facilities exist and that they receive the funding from banks and lenders to get them up and going. The larger the population gets, the more these new buildings are needed. With bed shortages at many nursing homes across the country, this need has become very apparent.

Professional Care and Supervision for Elderly People With Assisted Living in Facility

After a point of time elderly person at home requires special assistance which at times is not possible to be provided at home. Many people struggle to find the right assisted living facility to provide special attention to elderly or disabled member in the family. Before selecting an assisted living in facility there are number of factors that need to be considered. First an individual needs to ensure what kind of requirement the elderly person needs. If the person is physically dependent and needs assistance in undertaking day to day activities, the trained nurses and staff in home care will assist in personal tasks like bathing, attending nature's call, medicine management and will ensure the elderly person is having nutritious meal on regular basis.

Depending on the level of care required, retirement communities can be selected. One thing that can help elderly people in their transition from home care to assisted living facility is love and support from loved ones. Regular visit from family and loved ones can make senior people feel wanted, and help them in their desolation in a home care. Many a times due to lack of attention from family members the old age people feel socially isolated which could lead to possible depression and other health disorder.

The home care center provides extensive care and supervision to people in need. Assisted living facility provides number of amenities to make the inhabitants as comfortable as possible. There are number of benefits of senior housing. Primarily the professional staff provides personal care to elderly people especially to the people suffering from chronic illness and need round the clock medical assistance and intensive care. Another benefit of assisted living is liberty from mundane household chores. The staff takes care of all the activities like cooking, grocery shopping, paying utility bills etc.

An elderly person also gets the opportunity to meet people in their same age group going through similar circumstances. This helps them in bonding and getting close to their fellow mates. The elderly care undertakes number of group activities for entertainment and amusement of the elderly people. There are different senior care home offering different services. Before shelling out cash it is crucial to verify what kinds of services are offered by the organization. The price range will vary depending upon the care program offered by different home care institution. It is imperative that the senior assisted living home have qualified professional and in house nurses who can perform emergency medical aid if need arises.

Seniors today prefer to live out their old age in group homes for professional assistance as well as quality companionship from people in the same age group. There is considerable difference between home care facility and nursing home. Most seniors do not require high level of medical assistance provided in nursing home. Those seniors, who do not have the required means to appoint an in house assistant for every day activity, prefer the care of senior housing facility.

How to Know If Nursing Is the Right Job For You

There are more than 2.9 million registered nurses in the country, making nursing the largest healthcare profession. Nurses work in their discount urbane scrubs wherever people need care: in hospitals, schools, homes, community centers, workplaces, homeless shelters, children's camp, retirement communities, and so on. A little over 50% of registered nurses work in hospitals and the rest work in various settings. An estimate of 14.9% work in public health or community health, 11.5% in ambulatory care, 6.3% in nursing homes, and 2.6% in nursing education. Hospital unit settings are also varied including emergency rooms, intensive care, operating room, recovery room, step-down, outpatient units, a labor and delivery. Full-time staff nurses who work in hospitals have a median salary of about $56,880. Indeed, nursing is a very attractive career option, especially since it is predicted that there will be an increasing demand for nurses in the next 20 years; but still, it is not for everyone.

What makes a good nurse?

Before considering a career in nursing, you should assess yourself and determine if nursing is right for you-if you have the personality, skills, and ability to be a nurse. If you are naturally compassionate, love helping other people, and really want to make a difference in other people's lives then this line of work is perfect for you. It will also help a good deal if you are hardworking, passionate, and analytical-particularly if you pay attention to small details to get some clues about a person's general behavior, then nursing is a very viable career path for you.

What sucks about being a nurse?

Nursing is a high-intensity job where there is little to no idle time. For those who are easily stressed, they might experience burn-out early and be unable to handle the pressures of the job. Because there is a shortage of nurses, all nursing staff are maximized and utilized to the full of their abilities. As a nurse, you will be working in odd hours and assigned various shifts. Your schedule will be erratic and it could mean a significant decrease in your social life. You will be likely working during hours when your friends of family are off work. You may also be required to work weekends, week nights, and holidays. Even if you have a 40-hour workweek, you may not see your friends, family, spouse, or lover, that much. Also, nurses are usually requested even pressured to work over-time especially when there are too many patients and new admissions. Another downside is that you will be working in an environment that can generally be depressing. You will be surrounded with sick or dying people and their aggrieved families. Needless to say, a hospital environment can be high on emotions. You need to be able to deal with serious issues and communicating these with other people without breaking down.

Compensation

One of the best things about being a nurse is that you are compensated well for your hard work and efforts. The average compensation for registered nurses is between $43,000 and $63,000 per year, while the top 10% of high-paid nurses are earning more than $75,000 per year.

1,000 People A Year Cured Of ME Thanks To A Lightning Strike

Close to 1,000 people a year are recovering from ME and other similar debilitating conditions after taking a 3 day training program in North London.

It's not unusual for residents of Weston Park, Crouch End, to see someone wheeled down the quiet street in a wheelchair, and two days later see the very same person walking with ease down the road unaided.
The Phil Parker Lightning ProcessTM is a training program which is producing amazing results where other 'treatments' for debilitating conditions, such as ME, have failed.

Devised by Phil Parker, Osteopath, personal development coach and author, the Lightning Process is helping thousands of people considered 'lost causes', by the medical profession, resolve chronic back pain, headaches, migraines, digestive problems depression, anxiety, panic attacks and ME.

Esther Rantzen's daughter resolved her well publicized battle with ME after a three day trip to visit Phil Parker. Ex-England Rugby player Austin Healey has spoken of the joy he felt after his wife resolved five years of her debilitating fight with the illness which literally lays sufferers' lives to waste. Austin Healey says: 'We'd been searching for five years to find a cure for my wife Louise's ME. We found the Lightning Process delivered that cure. Louise is now completely recovered and our future is brilliant again. Having seen the Lightning Process in action, I'm convinced it is the most powerful way to make rapid and lasting changes in any area of your life'.

ME currently affects 250,000 people in the UK and it is generally understood by the Medical profession that there is no cure. Over 1,000 clients a year can attest that this is not the case. In fact, the Lightning Process has been so effective, a large number of former ME sufferers (helped by LP) have since retrained as practitioners and now teach the Lightning Process throughout the UK.

These 25 people all recovered from ME using the Phil Parker Lightning Process. Their combined number of years of illness was 330.

The Lightning Process was devised by Phil Parker and combines concepts from NLP, Hypnotherapy, Life Coaching and Osteopathy. Parker says: 'The Phil Parker Lightning Process is the result of my research over the last decade into why, when problems occur in people's lives, some of them hit a wall and get stuck and others seem to be able to deal with the difficulties in a different way and move forward.'

Parker developed the innovative Lightning Process and has gone on to help thousands of sufferers, including Vikki who was housebound for many years. (see Vikki's former life-story here: http://www.bbc.co.uk/kent/content/articles/2007/05/08/features_me_vikki_feature.shtml ) Vikki is now well and has just returned from her first holiday abroad in 18 years.

How can a self-development coach help 1,000's who've been failed by the medical profession?.

The story of the creation of the Lightning Process began with failure. Parker says: 'I had studied with some of the best personal development trainers in the world, read the most cutting edge books, become a highly respected authority in the world of change, and yet there were still some clients, who I felt I should be able to help because of my advanced skills and depth of experience but for whom nothing seemed to work.'

Many of these were ME patients and I began to dread treating them. It's frustrating as a practitioner to fail your patients. And for me, taking them on and not providing results was a failure.'

Parker took his worries to other professionals, and he says: 'This didn't surprise them, dozens of other professionals had tried and failed- they had become resigned to ME sufferers being a hopeless case. This in many cases also extended to patients suffering problems such as low self esteem, self-doubt and even self-hatred, anxiety and depression'.

Parker knew that while he could help many people resolve their issues, there was a hard-core element that weren't able to resolve theirs. Parker says: 'I kept wondering, "What was the difference?" and if we could identify this difference, could we retrain those people "stuck" in their own personal hell, to get unstuck.'

Understanding the mind/body link

The research undertaken by Phil Parker looked at how the brain and body become trapped in a number of damaging unconscious responses, which blight health and stunt lives. Using a powerful combination of techniques uniquely developed using the philosophies and research of NLP, osteopathy, self hypnosis and life coaching, Parker began to achieve amazing results with clients by training them to successfully replace old unhelpful responses and start to regain their health, their sense of self and their future.

How does it work?

Using the LP's technique of combining particular body movements and postures with a set of precisely targeted questions many people have got their health back into balance, quickly and successfully recovering from real illnesses that had troubled them for years.

The Process is specifically tailored to an individual's needs and abilities, and the trainee is supported and assisted by an experienced trainer throughout the seminar and afterwards as required.
The 3 day training program teaches, step by step, how to influence key body systems such as the immunological, neurological and muscular skeletal system.

Is it Positive Thinking? No, unfortunately Positive Thinking on its own is unlikely to make you recover from ME.

Understanding the Nature of Elder Abuse

Our nation's elderly are men and women just like us who have lived their life to the fullest. They are not just elder adults, they are people with feelings, emotions and self respect. Unfortunately, every year hundreds of thousands of elderly adults fall victim to the abusive behaviors of their caregivers, nursing homes and even family members.

Elder abuse refers to the knowing, intentional or neglectful act by a caregiver or other adult that causes harm to the elder adult or puts them at a serious risk of harm. Elder abuse is such a common, wide-spread problem that legislatures have enacted some form of elder abuse prevention laws in all 50 states. Elder abuse occurs in various forms including:

Neglect - Failure to ensure proper hygiene, proper feeding or nutrition, healthcare, or shelter.

Physical Abuse - Restraining the elder adult such as tying them to the bed rails, squeezing them, slapping, hitting, and punching, over medicating or unnecessary sedation.

Sexual Abuse - This entails any kind of non-consensual sexual contact, or forcing the elder adult to undress, or forcing the elder adult to watch pornographic material etc.

Emotional Abuse - This can refer to any kind of humiliation, verbal threats, derogatory remarks, social isolation or intimidation.

Financial Exploitation - Stealing the elder adult's personal belongings, taking cash, writing checks for the caregiver's benefit, withdrawing money from an ATM machine, identity theft, taking out credit cards in the elder adult's name etc.

Unfortunately, due to an elder adult's vulnerability or medical conditions, they often suffer in silence. As a close friend or family member it's important to stay alert if you suspect elder abuse. Common signs of elder abuse may include: sudden unexplained weight loss, poor hygiene, unclean living quarters, unexplained bruising or restraint marks, lethargy, bruising around the inner thighs or gentiles, arguments with the staff, or any sudden or strange changes in mood or behavior.

As a family member or loved one, often times we have to put our loved one in a nursing home, extended living care facility or we have to hire a caregiver to take care of them when we no longer can. Unfortunately, elder abuse is a large problem that cannot be ignored. If you suspect anything or something doesn't feel right, you should look into the matter. Often times nursing homes are over-extended and short-staffed. As a result, their patients receive subpar care and become neglected.

Other times the elder patients are victims of downright intentional abuse. Whether they are physically harmed, sexually abused or a victim of financial exploitation, their caregiver needs to be brought to justice so no one else gets harmed by this person's unscrupulous acts. If you suspect elder abuse, contact an attorney right away. They will be able to inform you of your rights and the proper legal procedures to follow. With proper protocol, you can help your loved one become free of their abuser so they don't have to suffer anymore.

Nursing Home - How to Choose the Right One

When a loved one gets infirm or older, sometimes the only alternative is to find them a nursing home to live out the rest of their days in relative comfort. Licensed nursing homes provide skilled care primarily to the elderly, and - hopefully - give peace of mind not only to the people living in them, but also to their relatives and friends.

These days, however, nursing home facilities provide homes not only for people who will live there for the rest of their lives, but also short- term accommodation for those recovering from an operation or hospital stay, especially Medicare patients.

If you are looking for a suitable nursing home for an aging parent or elderly aunt, the choice may be daunting - especially if you have never traveled down this road before. Here are a few tips to help you decide which nursing home is the best for you:

Start early. You never know when Auntie Hilda will suddenly take a turn for the worse, or when she suddenly gets fed up with living on her own. She might want help with daily living, or she may simply crave company. You don't want to force her to move into a place that doesn't meet her requirements. Give yourself - and her - time to nose around.

Shop around. Don't settle for the first available facility. It's best to look around and see what is on offer. Many nursing homes have guided tours in which both you and Auntie Hilda can participate. She might also want to spend an afternoon playing mahjong or canasta with the other seniors to see if she likes the feel of the place.

Check - and compare - the quality of the home. Even if Auntie Hilda loves the place, it's important to see how it adds up in comparison to other homes in the area. It's also a good idea to talk to residents and their families to see what they think of the services provided. Don't just rely on the official tour, as it can be misleading.

Have a set budget. Nursing homes vary considerably, and while you might have a top-of-the-line wish list, it's important to know what you can reasonably afford. This means not only looking at available cash and savings, but also seeing what will be covered by your insurance, Medicaid etc. If Aunt Hilda is unable to take care of herself, of course the costs will be greater.

Know Auntie Hilda's medical needs. Speak to her primary care physician to ascertain what is important for her continuing care, and if the nursing home in questions meets her needs. It's no use finding a facility that looks fantastic and has lots of activities, but doesn't provide sufficient medical care for someone like Aunt Hilda.

Prioritize what's important. The quality of care is most important, but other factors play a role as well. Does Auntie Hilda love to play bridge, does she want to be near her old neighborhood, does she like all her meals prepared in a certain way? If you are her only relative, she might want a place that is close to you and your family - or maybe somewhere that is miles away!

Other Options for More Independent Seniors

If a nursing home isn't the right choice for you, there are other options available to seniors who cannot - or do not - want to live entirely on their own, but who don't need the amount of care a nursing facility would provide. The four main ones, in alphabetical order, include:

Assisted Living. The best ones advertize themselves as a "home away from home", as residents have their own private living quarters as well as their own kitchens, bathrooms and sometimes even their own front doors. Residents are monitored regularly to make sure they are okay, and to provide assistance in

Activities of Daily Living (ADL) when needed.

Congregate Care. The best of both worlds. Seniors live in independent private living quarters but they have shared dining facilities and communal areas, along with a host of recreational activities which they can partake in or not, as they wish. Often some type of transport is also available, assisting with trips to supermarkets and the dentist or doctor.

Continuing Care Retirement Communities (CCRC). Housing, health services and skilled nursing are all provided, although the type of unit and level of care will vary with each individual. Seniors sign a contract which will allow them to stay in one place as they grow older and in need of more and more help.

Intermediate Care. This is for elderly people who need some assistance with their day-to-day functioning, but don't require specific nursing help. They might need help dressing, shopping or bathing themselves, but don't need the specific nursing care you would find in a skilled nursing facility hospital.

Care Outside the Home

Keep in mind that a nursing home may not be the right choice for Auntie Hilda at this time. If she chooses to live outside a nursing home, the community may be able to provide her with some of the services she would normally find in a nursing home environment. Examples include:

Meals on Wheels. Several organizations provide meals to seniors, the most well-known of which is Meals on Wheels. They bring hot, well-prepared meals directly to the door.

Community help with basic needs such as shopping and transport. Sometimes they're called Neighbor helping Neighbor programs, other times they're Adopt-a-Grandparent or care for the elderly.

Elderly visitor programs. Not having regular company is stressful and sad, making people feel isolated and alone. These programs match up individuals with volunteers who visit on a regular basis for a chat and perhaps a cup of tea or game of cards.

Senior community groups. Senior clubs and groups cater to a wide variety of interests and needs, from art, dancing or bridge to mountaineering and politics.

Adult day care. These are for people who are not ready for full-time care, or who have caregivers who need time off to work or rest. Seniors are assessed according to their needs and an active program and treatment plan is tailor-made expressly for them.

Legal assistance with everything from drawing up documents to paying the bills. Many volunteer organizations help seniors with simple things like paying their water bill on time to more complex issues such as selling a property.

Finding the right facility for a loved one is not an insurmountable task, but unless you're incredibly lucky, it's also not one that is accomplished overnight. Take your time and investigate as many possibilities until you find the best place you can. In the long run, taking the time to find the right home that provides the right care will make everyone sleep better at night - and feel a lot happier.