Extremely Important Questions to Ask at Nursing Homes That Most People Never Think Of

When you to make the decision that your loved one needs a nursing home, and you are not sure where to turn to for help, there are many options available but how do you know you are making the right choice?

Extremely Important Questions To Ask At Nursing facilities

When you are looking at the many options of nursing homes for your loved one there are some extremely important questions that you need to ask at Nursing Homes that most people never think of. It's not because you do not want the answers, its more to do with not knowing what the nursing home is like. Will it be suitable for your loved one?

Here are seven questions that you should ask when interviewing a nursing facility for your family member/friend.

1. What time of the day is my loved one woken up? Are they allowed to sleep in?


2. What are your privacy terms for my loved one? Do you have a policy about knocking on the door?


3. What are the rules and regulations in regards to meal times? Can my loved one choose from a home cooked meal and decide what he/she would like to eat or even choose not to eat?


4. How much care time will be provided to my loved one?


5. What about Medication? Must my loved one have to take Medicine if they don't want to?


6. Can my loved one say No to any of the care that is not suitable for him/her?


7. Is the staff all trained to show that the level of care will be meet?

There are many more extremely Important questions to ask at nursing homes that most people never think of and it is not until you have to make the decision to place your loved one into care that you soon realise that you need to know the answers. If you are too overwhelmed about the new decisions that you are facing, then it is advisable to have a note pad and pen, with your questions already written. Also be a great idea to have a friend that is not a family member attend the interview with you so that your friend can support you with any questions you do have.

Most Nursing Facilities now days keep to a minimum standard of care, but it is still good to ask as many questions as possible because when you think about it - the Nursing Staff will be looking after your Mum or your Dad, or your Sister/Brother/Uncle/Aunt/Parents-In-Law......Have you really thought about what goes on behind those closed doors of the Nursing Home?

Nursing Homes are there for looking after the aged. Yet finding one that will make you happy, and your loved one happy takes time. Ask your questions and decide wisely. The nursing home will be their new home and if you loved is happy then you are happy. If they are sad then your life will be soon affected.

Extremely Important Questions To Ask At Nursing Homes That People Never Think Of.....that list could keep on going and will be as long as you want. If you think seven questions will cover all you need to know then that is all you need to ask. If not ask more. Think about what you want to know and ask the nursing home, even go back with another set of questions if you are still needing answers.

To find out what other Nursing Issues occur in Nursing Homes go to Nursing Issues.

School Nurse Job Description

Responsibilities

School nurse is responsible for assessing health related issues of school community and making policies in certain issues like bullying. She has to give health advice to individual students and should keep it confidential. In tender age, children usually suffers from some sort of mental stress and needs counseling and care. Being a nurse makes you responsible for providing guidance and assistance for such children.

A school nurse coordinates immunization programs and helps parents to adopt good parenting skills. These also provide advice campaigns in secondary schools for children in need. Nurses make training and care sessions for students with long term disabilities so that they can re gain their confidence and work with their counter parts. These also provide advice for staff and parents on how to take care about children's problems and tackle infections and other problems.

Now a days nurses are keeping more focus on teenage that easily fall pray to sex and teenage pregnancy. Obesity and mental stress are most prevailing in today's youth and school nurses are there to suggest best diet plans for children in need. Alcohol and drug abuse are other problems which needs to be seriously dealt with.

Educational Qualifications

A school nurse needs to be a registered nurse to be able to work in partnership with any educational organization. She should have a bachelor, associate or certification degree from some reputed nursing home. There are various exams of licensure and certification for nurses and which make them eligible for job in a school.

School nurse job description calls for good communication skills so that you can establish a positive rapport with children you are treating. This domain has lots of career opportunities to explore. It will give you handsome salary along with satisfaction of serving future of nation

When Seniors Can No Longer Live Alone

My mother was 80 when my father died. She still drove, was relatively healthy, had an active social life, and had good friends nearby and a supportive church community. With a little help from her children and hired helpers she was able to manage the household and handle all the tasks of daily living. Two years later she voluntarily stopped driving. Then she had some health problems. Gradually her friends left the neighborhood. Then she fell a number of times, suffering minor injuries.

Friends and family did everything we could think of to improve her situation. We encouraged her to hire more help. We called and visited more often. We made small changes in her physical environment to make it safer: installed grab bars, removed throw rugs, signed her up for a medical alert response service, moved the microwave so she could reach it easier, etc. Still, she fell and fell again.

When she went into the hospital for a pacemaker, we started thinking about whether it made sense for her to return home after rehab. Over the years she had told us emphatically that she wanted to stay in her own home, and asked us to help her make that happen. How could we suggest to this fiercely independent woman, that maybe it was time to move? We tried to find more ways to ensure her safety and a good quality of life at home, and eventually decided to talk to her about our concerns.

How do you know when an elderly person can no longer live alone? Of course, there's no easy answer to this problem that is increasingly common as people live longer. There are, however, signs that families, caregivers, and the seniors themselves can look at in order to assess the situation, including:

• Uncharacteristic behavior
• Mental confusion
• Forgetfulness
• Falls
• Weight loss or gain
• Social isolation
• Depression, lack of interest
• Acute changes in appetite, energy level, sleep patterns, social interactions, housekeeping, or appearance
• Difficulty taking medication correctly and performing other health-related tasks

Evaluating a senior's situation and making a list of concerns makes it easier to take a rational look at this emotionally charged issue. Caregivers and seniors can go down the list and figure out if anything can be done about each concern. Social isolation might be lessened by time at a senior center, for example, where activities keep seniors engaged and active. A walker, handrails and "grab bars" in important places like bathrooms and hallways can reduce the risk of falling.

A list of concerns lets you take an orderly approach to the problem. When you can no longer match each concern with a viable solution, it may be time to consider other "aging in place" accommodations or moving to a fully supportive environment, like an assisted living community. It goes without saying that the senior needs to be an active participant in the process. Just because an elderly person is having difficulty performing certain tasks does not mean he or she is unable to think, reason, and make decisions.

The end of independent living is a major life transition; it's a process that takes time. Respectful communication between family members, caregivers, and the senior will help bring the discussion to a positive conclusion-but don't expect it to happen overnight.

Doctor House Calls at Assisted Living Facilities - How They Help Families and Residents

I'm here with Margie Veis, the Executive Director of Summerhill Villa, an assisted living facility in Santa Clarita, California.

KH: How long have you been doing this?

MV: I have been an executive director for ten years, all of them at Summerhill Villa.

KH: One thing I really liked about mom's gerontologist was he came here, actually making house calls. The fact that mom didn't need to go to his office was a real benefit to me and brothers. Is that a trend among doctors that have patients in assisted living?

MV: I know the few physicians that do that. I'm probably not knowledgeable enough to know if that's a trend or not, but I know in Santa Clarita there are a few and we utilize them.

KH: It occurs to me that having the synergy between the staff and the doctors watching out for the parent all the time is a huge plus.

MV: It's great when we have a good relationship with the physician that we know is going to answer our fax or answer our request when we pick up the phone and say: "We have these concerns. What do you think?" and work together to better treat our residents. It's a great benefit.

KH: Families might not get that at home - that constant awareness of what's going on with their parents.

MV: No, because if they're at home it's up to them. Here they have many different sets of eyes looking out for their parent. They have food servers, they have a nurse, they have an administrator, an activity director, a bus driver, the house keeper - everybody is looking out for their best interest versus it all just being on the family.

KH:: Or whomever they hire for home care.

MV:: Or whomever... Right... If they have a caregiver, it's only one perspective.

KH: And it's not 24/7.

MV:: Not unless you pay for 24/7 care.

Care Jobs Have That Little Something Extra Too

The baby boomer generation is just about hitting retirement age and with this comes the need to have places ready for when they are too old to take care of themselves. This phenomenon has also been exacerbated by the better health care available worldwide and by people taking care of themselves much better through good diets and exercise regimes. However, there is still need to have facilities where people can be looked after if they suffer from infirmity or ill-health. Nursing home jobs, therefore, are in abundance. A nursing home job not only gives someone a secure future, it also allows them to get onto a career ladder which should take them far.

There are obviously all kinds of positions which must be filled. Nurses and doctors are the norm for this kind of place, but the ancillary workers needed to keep the place functioning all have their roles to play too. Cleaners and guards, companions and general helpers all need to work in sync to ensure that the place runs very smoothly.

Older people generally like to be independent but when they find themselves unable to cope with the daily routines which we must all adhere to, they often get a little grumpy and ill-tempered. Impatience is not reserved for the elderly alone and even the workers helping them must be a little understanding, particularly if the patient or inmate is in chronic pain. Indeed, they often set up nice relationships to make sure that the patient is given all the love and attention that they need to have a fulfilling time in the last segment of their lives.

For this, even social workers are needed to unravel the psychological aspects of old age and how it affects the individual. Although most people will just need help with their daily routines, if the person has had some trauma or bad events in their lives, they may also need some counseling no matter what great age they get to.

Nutrition too is somewhat lacking for a lot of people since they will often be too tired or infirm to cook something hearty and wholesome for themselves every day. Although most people do not like the thought of lumping people in the same age group all in one facility, at least this way their needs are taken care of by professionals who know exactly what they need to see them through.

One benefit that people get from being employed in one of these places is that they often learn some new and interesting things from the elderly. For example, history comes to life when these dear people talk about what was happening in landmark times throughout history. Although it may well be OK to read about the assassination of a president, for example, those who were there at the time will be able to fill in more details of what was going on locally etc which adds some color to the stark reports in the archives. What better way than to spend time with people?

Small Businesses and Military Contracts For New Innovations - A Discussion

Many inventors and innovators come up with ideas and concepts that can be used by our military to become more efficient, protect our troops and help our nation. During wartime Americans wish to help their nation and thus, these innovators and small business entrepreneurs have their minds thinking for our country men in harms-way.

Now, how would one go about taking their invention to the US Military and why is that so difficult? Okay, let me talk off the record here for a moment and give you some thoughts from the entrepreneurial side of the game or from the innovator's or inventor's mindset, understanding both sides as you do, you might appreciate this dialogue; so here it goes:

With regards to the SBA and trying to get government contracts; I've often shaken my head at the way the various defense agencies fail to use the great resource of all the minds of the citizens. You see, when you contact a government website, or try to call in a suggestion, or an innovation or idea, they send you to some silly web form to fill out to get funding to start your own small business and then sell to the military. That is completely ridiculous.

Why you ask? Well, who says you want to start a business? Maybe you just want to give the idea and first, you need to know if anyone likes the idea. But if they are not allowed to talk with you, you cannot know. So, why would any entrepreneur bother to sign up to learn about an SBA loan to start a business, without any potential customer?

Besides, I've done a ton of government contracting in my life and it's just amazing the "Slow Boat to China" approach to the solicitations process; bureaucracy at its worst. Further, the US Government, and yes the military too, pays its bills so slow, you have to be a bank to finance your own contract? So, in essence you are not getting a contract, you are buying one. Well, that is if you actually win the solicitation.

In fact, if you come up with an idea, the government has to send it out to bid with the specifications. So, you give them the "how to" and then you have to bid against a total low-baller to get the contract that was your idea, your innovation, your invention; that sounds rather silly. So who loses, when you do not get the contract? Well, the US Taxpayer, the small business garage "do'er" entrepreneur and the US Military. So, that's just a messed up process in an insider's game.

Perhaps, the procurement folks can tell us otherwise from their point-of-view. That might be interesting, and if not, it is certainly something to think about, as I believe we can do a lot better.

New Jersey Long Term Care Partnership Program

New Jersey is the second most expensive state for assisted living facilities and fourth for nursing home, according to Genworth Financial's 2010 Cost of Care Survey. However, the state has the least expenditure for Medicare-certified home health aide services. Meaning, New Jersey residents are laden from sustaining institutional care although it is widely needed.

The long term care scenario in New Jersey is as complex as other states: many of these seniors have to spend large chunks of cash that devastate their entire family, and most of them depend on Medicaid as last resort. The ever-increasing long term care costs can afflict emotional and financial stress to many seniors and their loved ones. Medicaid is the only program meant to address long term care issues, but its reserves are not enough to dole out millions of American seniors and the disabled.

Through the years, paying for long term care has been a topic that seniors choose to neglect because it could make them hapless and, otherwise, they prefer to face death rather than become impoverished. There are private LTC insurers, but only few residents consider this option. From middle-income to low-income groups, most of them turn to Medicaid for assistance but to no avail. Medicaid accommodates individuals below poverty line to prevent the rich and privileged from taking advantage of the program to extend their assets. The stringent rules in Medicaid resulted from the extravagant budget that had been allocated for long term care alone that caused some budget deficit throughout the country.

The New Jersey Partnership for Long Term Care is a program designed to address Medicaid's asset limit that would help residents protect their assets and preserve a dignified living as they age. The federal deficit Reduction Act of 2005 modified the Medicaid rules and ratified the partnership program in four pioneer states - New York, California, Indiana, and Connecticut. The Centers for Medicare and Medicaid Services or CMS approved the New Jersey partnership program on February 12, 200 which is made effective on July 1, 2008.

The most substantial feature of partnership policy is the "asset protection" or disregard for Medicaid eligibility process that allows individuals to keep amount beyond Medicaid's asset limit, or continue coverage even after they have exhausted their insurance benefits. Therefore, policyholders can qualify for Medicaid and save the assets allocated for their heirs and families.

The New Jersey Division of Insurance on December 6, 2006 outlined the following features that should reflect in all partnership policies:

• The product name should be indicated and the word "Partnership" must be included
• The first page should contain the issue date
• There must be a statement that clearly declare that the policy adheres the requirements or definition of "qualified long term care insurance" as stated on section 7702B(b) of the Internal Revenue Code
• There must be a statement that shows the inclusion of Inflation protection. Policies are required to include compound inflation protection for individuals below 61 and some degree of protection for individuals age 61-75.
• There must be a statement that only approved or certified agents are allowed to sell partnership policies.

Evidence of Nursing Home Abuse

Every day families have to put loved ones in the care of nursing homes or assisted living facilities. And while no one would willingly place their loved ones in an environment that could potentially cause them harm, the sad reality is nursing home abuse is a common occurrence. People place their parents and grandparents in these facilities with the intention to provide them with quality care and an environment free from harm, but many times the exact opposite happens.

Trusting your loved ones with complete strangers is a very difficult thing to do and with so many facility choices out there, it is virtually impossible to tell in just a few visits if it is a safe place for your loved one. There are thousands of reports of nursing home abuse every year, from physical abuse to emotional abuse and trauma.

Elder Abuse Warning Signs

If your loved one in a nursing home does not tell you or someone else of the abuse he or she is enduring out of fear of repercussions, these cases may go unnoticed until it is too late. However, there are some warning signs you can look for that should raise alarm. These include:

• Unexplainable physical injuries


• Staff that refuse to allow you in certain parts of the building


• Staff members not letting you speak with your loved ones alone


• Disoriented actions due to overmedication


• Signs of withdrawal because of recent trauma

Suspecting or finding out your loved one is being abused at his or her care facility is extremely difficult, and you may not know where to turn. It can be difficult to make a case without proof, so you may need the help of a legal professional.

Care Homes Benefit From Self Printed Door Signs

Recently care homes have been opting for door signs showing their patients names, and with an optional picture, as opposed to the traditional room number. This is due to the fact that residents are helped greatly by having their own name on their door to reassure them they have found their own room. Pictures also aid fellow residents of retirement homes who may be suffering from memory loss and therefore have trouble with names.

Door nameplates - personalised easily

Care homes are increasingly attracted to this option where the resident's name, and perhaps their photograph, can be printed onto a piece of paper which is then inserted into a frame. The frame can then either be screwed or stuck to a patient's door (or secured alongside the door) and the contents updated easily without taking down the frame. Thus residents do not have to remember which exact room is theirs, or which is occupied by any of their friends. This is also valuable for visitors.

A picture alongside the name will also help them if friends' names are forgotten making these frames a perfect option for the dementia sector of the care home industry. It also means that in a setting where either residents and/or staff are temporary, carers and support workers will be able to learn resident's names quickly, or will be able to look up the name as entering their room.

Changed in a snap

A simple name sign is also an economical option price wise as certain products such as an Edge Snap Door Sign are under four Pounds each. This is a small door sign which uses two snap up and down sides at either end to secure information in place under a clear plastic face. Sizes vary from 2in x 6in up to 4in x 12in, with an intermediate size of 4in x 6in known as A6 size. It is a simple yet smart looking answer to discreetly helping a patient with room identification. The larger versions are recommended when a picture is to be incorporated.

The information can be printed in house, with a standard office printer and a small amount of ICT knowledge in applications such as Microsoft Word or PowerPoint. This is ideal for a nursing home situation as it means that these door signs can be printed quickly, easily and cheaply. When patients are only in on a temporary basis this form of displaying information is convenient as the nursing home can simply remove the paper slip showing the previous patient's information and reprint a new sign with the new patient's information.

Comparing customised door sign options

Certain businesses do offer custom made door signs with a person's name already printed onto this sign, however this is less financially viable in an environment where residents or patients may be changing rooms or leaving regularly. The price of these signs are high, they can retail at over twenty Pounds each and the names in them are not changeable; therefore unlike a product such as an Edge Snap Door Sign, they are not reusable. This could mean throwing away a twenty Pound sign every time a patient left. It may take a while to take delivery of these pre-printed signs and with a patient who is only on a temporary stay they may have left before their sign has arrived.

These customisable door signs are also very useful in more permanent situations where personal nameplates are required on a restricted budget. Amongst the many existing users of this method of signage is the Royal Hospital Chelsea, home to the Chelsea Pensioners who are former members of the British Army, who have purchased Edge Snap door signs from Green Magic Company.

The Top Ten Reasons Why People Need Long Term Care Insurance

10. The government isn't going to pay for long-term care at home, in a nursing home, or in an assisted living center. Medicare pays 100% of long-term care for 20 days and all but $95.00 per day for the next 80 days--after that nothing. However Medicare only pays for skilled care and most long term care is not skilled care.

9. The national average cost for nursing homes is approximately $105.00 per day. Assisted living ranges anywhere from $50 - $90 per day. If you live on the Eastern Seaboard you can easily spend $50,000 to $80,000 for a year's stay in a nursing home. These costs are perfectly capable of wiping out a lifetime of savings-not to mention the emotional effect long-term care has on a family.

8. A Harvard University study showed that 69% of single people and 34% of married couples would exhaust their assets after 13 weeks in a nursing home. 13 Weeks = 91 days!.

7. At age 65, a woman has a one out of two chance of spending some time in a nursing home. A man has a one out of three chance. In the case of men, mortality catches up with morbidity.

6. Medicaid kicks in only after a person's assets and dignity are gone. In many states the eligibility threshold for single people is $1,500 in assets. After all Medicaid is WELFARE.

5. Children would like to help, but children often have children of their own. They certainly can't quit their jobs to care for their parents.

4. Health rarely improves with age.

3. People can't buy long-term care coverage at crisis time or when they are ready to use it.

2. American's have access to the best health care in the world, if they can pay for it.

1. Most People want to choose where they go instead of having to go where they are taken, and if independence is important to them, they will need to have either a big estate or adequate insurance.

Information quoted directly from:

* A Shopper's Guide to Long-Term Care Insurance , National Association of Insurance Commissioners.

* Long Term Care Companion Consumer Guide, Transamerica Occidental Life.

Truck Driver Responsibilities

The trucking industry in general plays a very important role in all of our daily lives. From the groceries we buy to the products we purchase at the local mall, they were all most likely shipped to these facilities by large commercial trucks. The chances of you driving beside a commercial truck on a daily basis are very high. As long as passenger cars and semi-trucks share the road, there are bound to be some type of accidents that will occur. But where does the responsibility fall when it comes to auto accidents that involve a passenger car and a commercial truck?

The majority of auto accidents on the road that involve a semi-truck are a result from negligence on the truck driver's part. This, coupled with recklessness, is a deadly combination for those driving passenger cars. Drivers, regardless of what type of vehicle they are driving, make mistakes on the road every day. However those driving large commercial trucks can't afford to make even the simplest mistakes. A commercial truck can weight in the neighborhood of 80,000 pounds, while a common passenger car can weigh approximately 3,000 pounds. This weight discrepancy can mean the difference in life and death. When a truck driver makes a mistake while driving a semi-truck, the results can be catastrophic. Below are a number of reasons semi-truck drivers make mistakes while driving.

Fatigue

Truck drivers work long hours and are expected to arrive at their destination on-time. There are guidelines in place for truck drivers indicating how many hours they are allowed to drive and how many hours they are supposed to sleep during the day, but not all follow these rules. When these rules are broken, fatigue can set in which can result in deadly auto crashes.

Alcohol and Drug Abuse

All drivers can become impaired due to the drugs and alcohol put into their bodies. When this occurs, a driver's judgment is impaired often leaving them making decisions that can become fatal. Drunk driving coupled with heavy commercial trucks results in an alarming number of fatalities each year.

Lack of Experience

Although truck drivers are required to attend "Driving School" in order to obtain the necessary amount of training from qualified teachers, it doesn't necessarily mean they will always avoid costly mistakes. Nothing can ever take the place of experience, especially when operating heavy equipment like a semi-truck. Inexperienced drivers, no matter how much training they have under their belts, can make deadly mistakes on the roadway.

Truck drivers have an enormous responsibility not only to themselves and their family, but to everyone else they share the road with. If you have been involved in an auto accident that involves a semi-truck, talk to a reputable injury lawyer about protecting your rights.

Caring and Fun-Loving Jobs - Making a Difference in Someone's Life!

There are many jobs that can make a difference in someone's life, be it taking care of the elderly or showing love and care to the children. Here are some of the ways to make someone's life different and earn an income at the same time:

Home Companions

They are also known as personal attendants who are highly valued and are caregivers to the elderly, handicapped or convalescent people. They often provide good companionship to them and at the same time prepare and serve meals, keep the house tidy, take them to medical appointments and many more.

What it takes: All you need is compassion, empathy and patience to qualify for this job. Besides that, you have to be safety conscious at all times and basic first aid skill is required. Since you are apt to be doing a lot of lifting and carrying, you ought to have good amount of physical strength. A talent for organisation will also come in handy.

Where the jobs are: The best way to find this kind of job is by word of mouth. Ask around for any home bound person who could use some help or inquire at places like nursing homes, senior centres, convalescent centres, or organization for the chronically ill. Another good place to find these jobs would be Help Wanted ads in the newspaper.

What this job could lead to: You could pursue a career in health care as a nurse, doctor, occupational therapist, nutritionist, physical therapist or hospital administrator.

Nurse's Aides

They perform a significant role in hospitals and nursing facilities. Besides helping nurses, they also offer cheer and warmth to patients who are either in pain, afraid or just plain bored. They are also considered members of the care-giving team, along with the nurses, doctors and physical therapists.

What it takes: To be an outstanding nurse's aide, you must have a strong desire to help others who are in need. You should be able to work well in a team, possess good communication skills, and be able to endure repetitive tasks. Some other highly valued skills include patience, understanding, emotional stability, dependability and good listening skills.

Where the jobs are: These jobs are often available in hospitals, nursing homes and personal care facilities. Therefore, flip through the Yellow Pages and find them today!

What this job could lead to: This is an excellent way to see if you are suitable and would like to pursue a career in the medical field. If everything goes well, you might become a nurse, medical technician, doctor or pharmacist.

If any of the jobs above appeals to you, start looking for them today! You could just make someone life different and might even be successful in your work!

Shared Home Care Leads or Exclusive Home Care Leads? The Answer to the Question

There are an increasing numbers of Home Care Agencies and Assisted Living Facilities who are using internet leads as their one of their primary marketing tools because they believe in the power of the internet to reach their target market and to increase their client base.

Seasoned elder care marketers and even new elder care marketers are interested to know if an exclusive home care lead marketing (or assisted living lead marketing) program will really make a difference in their sales....or would it be better to purchase standard shared leads (ie eldecarelink, service magic etc).

To help you decide which one is better, here are the advantages and disadvantages.

The cost of an exclusive lead program can, on the surface, appear to be more expensive than standard shared leads programs. However, the closing ratio is usually much higher with an exclusive lead.

Of course, this is not guaranteed because there is still a dependency on your delivering and selling skills.

Exclusive lead programs give the elder care marketing professional or home care agency owner an advantage because there is less competition, less wasted time, and higher Return on Investment (ROI).

Exclusive Lead Marketing Programs should include the following solutions. Missing any one of these could lead to a failed program.

1. A lead capture website- specifically designed with your target market in mind, these sites are designed to get the prospect to take an action- either make a phone call or fill out a short form.

2. Complete search engine optimization on your lead capture website for every local city/town/municipality that your home care agency or assisted living facility might service.

3. Natural search engine rankings (not just pay-per-click) on page #1 of Google for dozens of keyword phrases.

4. A minimum of weekly blog posting, 2x per month video production.

5. Call tracking and recorded phone number that dials straight through to the office.

6. A professionally managed Google Adwords campaign for more competitive markets that minimizes job seekers and increases quality leads. This campaign should be run by an organization that understands the nature of the research and buying process of the elder care market, not by a "generalist" organization who serves plumbers, roofers, car dealerships and construction companies.

Of course, there is still competition even when you purchase an exclusive leads program because the prospects may still shop around.

Here's a sample scenario:

• Sue the Home Care Agency Owner is buying 30 shared leads per month at a cost of $18.00 per lead.


• $18x30= $540 per month. These are shared leads.


• Three other Home Care Agencies in her area are also paying for these leads and marketing to these consumers.


• Sue closes, on average, 1 lead per month from this marketing strategy.


• She's paying $540 for one close per month.


• Some months none of the leads close.


• Her average client signs up for 8 hours per week.


• She charges $21.00 per hour for a total of $168 per week in billing.


• It takes her about 3.2 weeks to break even.


• The cycle starts all over again.


• Sue isn't making much money in the formula.

What if Sue's scenario looked like this:

• Sue the Home Care Agency owner spends $1050 per month on her own exclusive lead marketing program.


• $500 is for pay-per-click campaign clicks (ie Google AdWords Clicks, managed professionally at no additional charge), and the other $550 is for a completely optimized website designed for home care lead capture, weekly blogging, videos 2x per month, and within a short time her new website is on the first page of Google for several of her local towns for various keyword phrases.


• Sue gets 10-15 REAL leads per month, exclusive to her.


• These leads are usually phone calls to her office, and sometimes they come in via a form filled out on her website.


• Of those leads, she closes 3 each month.


• Her average client signs up for 8 hours per week.


• She charges $21.00 per hour for a total of $504 per week in billing.


• It takes her about 2 weeks to break even.


• She enjoys a profit each month, and the cycle continues, and gets better.


• Each week she watches her website move up the ladder in the search engine results because she is not relying solely on pay-per-click to attract leads.


• She is eventually seeing more exclusive leads because she dominates natural search.


• She can decrease the cost of her Pay-per-click campaign as she sees increasing natural results.


• Sue also has a built in e-newsletter that automatically follows up with all of her inquiries, even 6 months later.

Scenario #1 looks like the least expensive option, but the reality is that it doesn't do Sue much good at all. She has not made an investment in her own website, her own content, and her own internet presence. She running on a wheel that doesn't help her business very much at all.

Your scenario may be similar to one of these, or completely different.

Just remember that although a shared lead cost at $18.00 per lead sounds cheap, but at the end of the day, they may be more expensive than you think.

Invest in your own internet presence. Build a program that will benefit your business for years to come. One that you can help manage and direct, but that is completely done for you. Get back to working ON your business instead of FOR your business chasing shared leads every month.

Invest in you, and reap the rewards!

Domestic Abuse - It's Not Your Fault

Domestic abuse is more widespread than many people would like to admit. Have you noticed how your neighbor had her face covered after last night's row? But, before going further I would like to correct a popular misconception. Men are also victims of the violence. Sadly men inflict more physical injuries on their partners than there women but a majority of the violence is give-and-take. Intimate partner violence and spousal abuse are commonly used to describe situations involving domestic abuse. Also the abuse can be non-physical through acts of mental and emotional torture, intimidation and control.

Domestic abuse is a serious issue that there are government-funded programs that aim, to assist the victims and the perpetrators. There are support groups, call lines, social programs that are there to help. These allow both parties to come to terms with what has happened and give them the support as they embark on rebuilding their lives. So recognize that you need help and contact someone. These people are professional and will always maintain the details you supplied with confidentiality.

Domestic abuse also has a history of being cyclic. The couple will reconcile, and then over a period the tension will build before it is allowed out in an act of abuse. Also there are many explanations as to why people are driven to abuse their partner. Stress, childhood experience, the need to be in control and mental illness have been attributed among the reasons for the abuse.

People need to first come to terms with the fact that abuse is occurring. Many times the victim is in denial and try to explain away the physical signs - "I fell and hit my hand".
Many signs exist that can point to an abusive relationship. A fear of the partner is the most obvious one. If you are inclined to tread very carefully around him/her and you are constantly careful about what you say and do to prevent an explosion you should admit that you are in a relationship that is unhealthy and abusive. A partner that belittles you and tries to organize every aspect of your life also point to signs of danger. Some of these things may seem harmless but domestic abuse is known to spiral up from simple verbal intimidation and yelling to physical assault.

Also one of the most common and misguided conceptions among the victims is that "I am at fault. He\she was only trying to show me my mistake". No. No action on your part justifies the abuse. It may true as told about the violence being reciprocal, but refrain from accepting you are to blame. It is the other party that is doing the abusing, so it is clearly their fault.

Once you recognize you need help - please contact the above organizations. On rare occasions both partners are known to visit such a program for help together, though sadly it was precipitated by a serious event, causing both parties to recognize that they need help to keep the good things going.

Remember domestic abuse is something that can and should be overcome.

Nursing Home Abuse and Neglect is Physical and Emotional

Nursing homes are places that are meant to be an area of comfort, rest, and relaxation for the elderly. A lot of people nowadays would opt to bring their parents or grandparents to a nursing home believing that they would be taken cared of better. However, there have been so many reports that a lot of elderly are being abused by the caregivers in nursing homes. These abuses are either physical or emotional.

Physical abuse, as the term denotes, means bodily harm inflicted on an elderly. This can be direct physical abuse such as hitting or slapping, and can also be an indirect abuse which consists of food deprivation and not receiving the right kind of medication as prescribed by a physician. These abuses often lead to a lifetime trauma that could render an elderly utterly dysfunctional.

One of the most obvious signs that an elderly is being physically abused is a bruise. This may appear on any part of the body such as at the arms or legs. You may also need to look out for scars and welts. You cannot simply imagine what pains the elderly goes through whenever caregivers give them this kind of treatment. A small bruise usually hurt younger aged-people but an elderly who has a frail body, weak bones, and thin skin will surely be hurting all the more.

Other signs that an elderly is physically abused are broken bones, dislocations, as well as sprains. Bones in the hip area usually get dislocated due to shoving and pushing from a caregiver, which often results to a fall on the floor. Shoulder injuries are also results from rough handling of caregivers and other nursing home personnel. At times, a resident may have broken eyeglasses, which often results from a force applied on the face directly, causing the eyeglasses to fall. Some signs of restraint such as rope marks on the wrists can also be a determinant of physical abuse. The suspicious behavior of the caregiver, when he does not want you to see your mom or dad alone, is also a sure giveaway.

The other classification of nursing home abuse is the emotional abuse. This usually involves the language that is used by the caregiver in communicating with the elderly. Foul language may be hurled at the elderly, which may bring about a low self-esteem. Emotional abuse is also done through threats and intimidation. These would often leave elders with skittish behavior and they are usually afraid and wary about their surroundings. You can always notice fear from the way they move and from the look on their faces. They are also most likely to exhibit behavior that is prevalent with persons suffering from dementia such as sucking or rocking. Any of these symptoms are warning signs of elderly abuses.

Know the Signs of Abuse in a Nursing Home

No one ever wants someone they love to have to live in a nursing home, but there are times that it is necessary. While it may be the best option for loved ones, there have been many cases of abuse to the elderly in nursing homes. If someone you love is being abused, but aren't sure what the signs and symptoms are, learning is the first step. Some residents of nursing homes who are being abused won't say anything about how they are feeling or what has happened, but may still show some of the classic symptoms.

The first and easiest to notice are physical symptoms. There a couple different forms of physical symptoms that depend on the type of abuse. For physical abuse, the person may have bruises, pressure marks, cuts and scrapes, burns, and even broken bones. These can be signs of more than just physical abuse, but also neglect or mistreatment. Signs of neglect can also be bedsores, poor hygiene, unusual weight loss, and unattended medical needs. Elderly who are in these types of situations may also suffer from sexual abuse. There are a few physical indicators that show that there has been sexual abuse, like bruising around the genitals and/or breasts. Sexual abuse can come from not only the care takers or workers at the residence, but it can also come from visitors and even other residents. Physical abuse isn't the only form of abuse found in some nursing homes.

Verbal and emotional abuse are often found in nursing homes that have a problem with patient abuse. These are both a form of psychological abuse and rarely leave any physical evidence. This form of abuse is used against the resident causing harm to their self-esteem and outlook on life. This may include cursing at the patient, ignoring them, intimidating or humiliating, threatening, insulting, demeaning, criticizing, and belittling the resident. This is a very common form of abuse especially in nursing homes that are understaffed, over-populated, and have a stressful work environment. The signs that someone has been verbally abused can be shown through several different behaviors like the person being emotional, upset, angry, withdrawn, anxious, and in some cases they may be ignoring, threatening, frightening and even insulting towards their loved ones.

Another common form of abuse is the exploitation of the resident's finances. This happens when a resident's finances are either used against their will, without their permission, or is used wrongfully. Financial exploitation is defined as the wrongful use of an individual's finances or property for another's advantage. This can happen to a lot of senior citizens, not just those who are in nursing homes. If you have control over the persons finances, or have knowledge of what it should be and you notice that the persons bank account seems abnormally low or there have been a lot of checks cashed, they may be a victim of exploitation. This can also mean that someone is forging the resident's signature, stealing money or possessions, or even selling their possessions without the persons consent.

Elderly abuse is very common and can possibly lead to wrongful death. If you notice that someone you love or know is experiencing any of these signs or symptoms, you will want to act fast. You will want to contact a lawyer, preferably one who specializes in nursing home abuse. If the abuse is physical or emotional, or really any kind for that matter, you may seek to move them out of that nursing home or senior care facility as soon as possible to prevent anything worse from happening. Elderly abuse is a very serious issue, if you see any signs of abuse, call authorities and speak to a lawyer.

Elder Care - Dealing With Difficult Siblings

One of life's biggest challenges, I think, is providing care for our elderly parents. As more and more people become care-givers for their parents we see more and more arguments erupting between siblings with different ideas about how their parents should be cared for.

Some may wish the elderly parent be placed in a nursing facility as they do not have the time to give the necessary care. This is often a choice that is not palatable for other siblings. Yes, we all have busy lives, especially if we are still raising our own children, but finding a suitable nursing home for your parent may be more time-consuming than you realize. After all, and this is not to demean the health care facilities in general, but we see stories daily about the unsatisfactory care many elderly receive at the hands of inexperienced or uncaring professionals.

Keep in mind that no matter how caring and respected a hospital or nursing facility is, they are in business. Your parent is a stranger. NO ONE will give the quality of care a family member will simply because they do not have a personal connection.

That said, however, there are some good quality nursing facilities available and if you are dealing with a parent or other elderly person with advanced dementia or Alzheimer, you may wish to consider this as an option. But, your siblings may not agree.

When Siblings Disagree on Elder Care - Find a Compromise

In my family there are five daughters. Each of us has varied ideas about how our mother should be cared for. When mom first fell ill is was fairly simple for my sister, whom she lived with, to offer the limited care she needed. She was not working and was able to take mom to doctors and outings with little difficulty. But things soon got worse for mom and then the arguments began.

I quickly recognized that mom's appetite was failing her. She just didn't want to eat. No wonder when many of her medications came with side effects that were unpleasant, to say the least. When I would visit mom I would take her special 'goodies'. These were usually fruit and other things I knew she liked but did not get regularly. My sister doesn't cook. Period. They go out to eat and would bring mom a meal from their favorite restaurants, usually fast food. Bless her, but my sister had no concept of the fact that it was perhaps the food offerings that turned mom off.

Not the time to fight. After talking to my sister and discussing this with her she was quite upset. She had no idea how to cook the foods mom needed, BUT, she was adamant about mom staying with her. So, a creative solution. I cook every night so I would make something for mom and take it to her daily. At least she got one good nutritional meal a day. Not the best solution, but a compromise.

Later as mom's mental health declined it became clear that my sister could no longer handle her. Other sisters wanted to put her in a facility as they were out-of-town and busy with their own lives. I do not condemn them. But I could not see doing leaving our mother in the hands of strangers. It just didn't sit right with me and I was not happy with the facilities available to us.

While this is not the best solution for many, for us it worked out. At the time I was in college and able to rearrange my schedule so that I could be home with mom a lot. My husband was also able to help out and I was able to enlist the other two sisters who lived locally to give one day a week to being with her. This allowed us to juggle her care in such a way as to allow each of us to offer what we were best at. I cooked and made sure she ate well. Another sister brought the laughter and was very good at getting mom laughing. They had great visits.

The second sister was the one she had previously lived with. She brought the news and gossip that mom loved. She also brought encouragement, over and above what we offered, and was able to keep mother's mood positive. Difficult sometimes, but she knew what buttons to push to get mom to stop feeling sorry for herself.

By finding ways to compromise we were able to give mom home care until her passing. This was important to us. After all, she gave everything to us when we needed it; we wanted to give back to her.

These are just a couple of examples of how we five were able to reach solutions for our mother's care. Your situation is quite different, I am sure. But the bottom lime is that someone needs to recognize the problems and seek a solution that can satisfy everyone. Often that is the eldest sibling, but not always. Communication with your siblings is the vital key. Don't ever feel that you have to take the first solution that presents itself, and if you are certain you do not want your parent to go to a facility, then talk to your siblings and try to work something out.

If you cannot reach a solution, then work together to find the best possible facility. Be sure to verify any and all recommendations. Go for an unannounced visit when you can. Is all as you expected it to be? If not, tell your siblings of your concerns. You can always open a new discussion and make changes.

Finally and perhaps most importantly

Never criticize your siblings on how the may be caring for an elderly parent or family member. When you criticize the defenses go up. Try to find ways to encourage the sibling for the things they are doing that is helping and play down the things that do not. Be ready to offer your help. While the primary caregiver may tell you they are find, truth be known they can certainly use help. Be open to opportunities to talk to your siblings, express your concerns in a positive way, and offer suggestions or solutions that are considerate of your siblings feelings and current efforts.

When I offered to help my sister by providing fully cooked meals for mom it took a lot of the stress from her. I also provided frozen meals that could quickly be heated and served if I could not deliver something fresh for some reason.

Some times it is the little things that are overlooked when you are dealing with an elderly person. Things like what are they actually eating, setting a table and sitting with them for a meal, or taking time to talk to them.

Communication is one of the vital keys that is often abandoned in the heat of family arguments. While siblings may have the same parents and similar values, they certainly will have developed their own ideals. Your idea of care may not be the same as your sibling. Who is right and who is wrong is not the issue here. There really is no right or wrong answer. You must work together to find a solution that works for you, your family, and your elderly family member.

We lost our mother a few years ago, but working together to care for her as her health declined brought us closer and allowed us to grieve together rather that begin blaming each other for contributing to her failing condition. It was well worth the effort.

DISCLAIMER: I am not now, nor have I ever been a medical professional. I have supplied this example from my own life experience and offer it only as encouragement. Please discuss any necessary care options with the patient's doctor.

Gifts For Assisted Living Residents

Giving gifts to older people in assisted living homes can sometimes be a bit perplexing. Often the space may be limited and many seniors have chosen to scale back on their personal belongings. However, many items can make great gifts for your friends or family in these communities. Think of items that are useful, or are consumed on a regular basis.

Print media products can provide a wide range of ideas for gift giving. To keep someone up on current events, a subscription to a favorite newspaper or magazine would be nice. Try getting the newspaper from their hometown, especially if the person had to move a distance away. Go to antique shops and search for magazines and newspapers of the era when they were younger. It can be quite fun to reminisce about the frivolous news as well as the serious events.

Pictures are a great gift. Grandchildren can put a conventional album together creating a special present. For a new twist think about giving a digital frame it becomes a photo album in a picture frame. If the photos are available, represent different periods, this will most likely produce a story or two.

If email is not their favorite way of communicating with family and friends, think about putting together a correspondence box. Include a variety of cards for different annual events. Buy a current calendar and write in the family's birthdays and anniversaries. For those who love to write, providing stationary with envelopes and postage is a thoughtful gesture. Don't forget to include some writing utensils too.

Having the ability to create a mood or elicit a memory is easily done with music. Find out the favorite bands, singers, and specific songs of the person to whom you will be giving the gift. Depending on the type of player they have, provide the music in that format. Adding to their collection should be easy.

A person's body tends to get cold more easily when he or she gets older. Presents to help keep a person warm can be an extra blanket for their bed or a small throw to keep on their laps. A nice sweater and warm socks can keep them toasty too. Hats, scarves, and gloves may be just the right gift for most any season, depending on where the community is located. New Jersey may need them autumn, winter, and spring. Whereas, in southern California, these items may only be appropriate in the winter.

Comfort items like lotions, creams, or a nice robe and slippers can give a sense of feeling a bit pampered. Most everyone appreciates being nice to themselves. Find out if they have a preference of scents or, maybe, no scent at all. Also, be mindful of any allergies they may have.

Presenting items that while away the time may be a good thought. Gifting of board games, decks of cards, or dice might inspire some afternoon game dates. Dice or dominoes can provide other possibilities for enjoyment. Think about what hobbies the person has had or still enjoys. If they are into bird watching, buying a bird feeder that attaches to the window or hang a hummingbird feeder near a window, either of these may bring hours of enjoyment right to their home.

Giving gifts becomes easy once you learn what a person likes. When giving goodies to an older person who may have limited housing space, be mindful of what you choose for them. Buying a large reclining chair may not be the best bet. However, providing something small and useful like a nice blanket will bring warmth to their lives day after day. Visit your friend or family in their assisted living community and don't forget a gift.

Student Loan Forgiveness for Nurses

Every list that rates the fastest growing job opportunity industries rate the healthcare field as number one. Nursing jobs rank high on the healthcare jobs that will experience growth in the next few years. Nursing is a rewarding field of work, and the shortage of qualified nurses almost guarantees job security.

Education for Nurses

Most nurses must have a bachelor's degree in nursing to qualify for the top nursing jobs. In tough economic times, many potential nursing students may hesitate to incur the debt of a four year degree. But, there are opportunities to obtain the nursing degree, work in an industry with high job satisfaction, and have portions of the loan forgiven. Even nurses already working might qualify for a student loan forgiveness program.

Student Loan Forgiveness for Nurses Programs

The College Cost Reduction and Access Act of 2007 makes it possible for nurses working full-time in public service jobs to qualify for forgiveness of their eligible student loans. The nurse must have already made 120 monthly payments on their loan while they are employed. After those 120 payments have been made, the nurses working in public service jobs will have the remaining amount of the loan forgiven and will not be responsible for repayment.

Types of Loans Eligible for Forgiveness Programs

Any loan that has not entered into default would be considered eligible for loan forgiveness. These types of loans include:

• Federal Direct Stafford/Ford Loans


• Federal Direct Unsubsidized Stafford/Ford Loans


• Federal Direct PLUS Loans - for parents and graduate students

Other types of loans may also qualify under the student loan forgiveness program if they are consolidated into a Direct Consolidation Loan. One caveat is that any payments that were made before the consolidation will not count towards the 120 month payments that must be made before the loan is forgiven.

Nurse Eligibility

A registered nurse will be considered eligible if they have completed their training and received a nursing diploma, associate's degree, bachelor's degree or graduate degree and is licensed in their state of employment. The degree must be conferred from an accredited school in the United States.

Eligible nurses must be employed full-time, working at least 32 hours per week at either a non-profit facility or as a faculty member of a school of nursing. The nurse has to be a United States citizen or a National and Lawful Permanent Resident.

Non-profit facilities that are considered include:

• Hospitals


• Federally Qualified Health Centers, Indian Health Centers, Rural Health Clinics, Native Hawaiian Health Centers


• Nursing Homes


• Hospice Programs


• Home Health Agencies


• Skilled Nursing Facilities


• Ambulatory Surgical Centers


• State or Local Public Health or Human Services Departments

Potential Nursing Students

If you want to embark on a career of helping people but are uncertain about the high cost of education, entering a nursing school and giving back two years to work in a qualified medical facility might be right for you. Through the Student Loan Forgiveness for Nurses Program a substantial portion of your loan would not have to be repaid. Plus, you would be helping vulnerable populations in need of care.

A Leader's Area of Focus

One of the key areas in which the leader must focus is the nurturing and development of future and current leaders. Your focus must be on the areas that are by their very nature difficult and uncertain. You must be comfortable and confident with your own company. Because others will shy away from, if they think your assignment may fail. Sometimes you will be a majority of one. Even when all around you doubt you and think you're crazy for taking such a big risk. As a leader, you must go into the areas where there is the greatest risk of failure or the greatest need for success. Embrace your fears and move forward. Lead from the front and others will follow.

As a point to begin a discussion these are my thoughts on Leadership, which can best be described using an acronyms.

Vision: Seeing the big picture, knowing where you are going, why you are going there, and how you'll get there is essential. Reasons come first answers come second. Let nothing that doesn't violate a law or your character keep you from your goal.

Optimism: Having a sense that everything will work out and exhibiting that to staff is essential. Looking for the good and doable in every situation is reassuring to staff. All eyes are on the leader when things are difficult. You are both guide and cheerleader.

Trust: It is difficult at best to earn the trust of staff and once lost it can never be regained. Without the trust of your staff you have nothing and are ineffectual as an
effective leader. Trust is an all or nothing proposition. People must know what you stand for. Trust must be earned.

Expedite: Doing things when they need to be done is important, regardless of their pleasantness or unpleasantness. You must act quickly and not wait for all the data to come in. Go with seventy percent of the information needed.

In many ways the leader of the future will be a kin to the ancient Samurai, skilled with weapons music, painting, poetry, and a master at reading the environment that surrounds him/her. Miyamoto Musashi, in his classic guide to strategy "The Five Rings" offers the following guidelines for leadership.

1. Do not think dishonestly. (good character)

2. The Way (success) is in Training.

3. Become acquainted with every art. (organizational skills)

4. Know the Ways of all professionals (working knowledge of all departments in your organization.)

5. Distinguish between gain and loss in worldly matters (data).

6. Develop intuitive judgment (trust your gut feeling) and understanding for everything

7. Perceive those things which cannot be seen (trust your senses).

8. Pay attention even to trifles. (small details)

9. Do nothing which is of no use (keeps you from your goal).

Cross training is critical to your success. If you are a generalist find a specialty, if you are a specialist become more of a generalist. Everything you have learned in life you will draw upon as a leader.

It you are experiencing fear about deciding to be a leader, laugh your fears away by following this simple plan. Kenneth E. Strong, Jr, and Professor John DiCicco can help you eliminate those fears and give you the confidence to lead.

Download you copy of "Leadership Is A Choice" today at http://www.decidingtolead.com

Feel free to use this article, in your publications, newsletters, blogs, e-zines and web sites in its entirety provided you include the following: Copyright 2008 All rights reserved. Kenneth E Strong, Jr. http://www.decidingtolead.com Front Row Connections, LLC, Virginia beach, Virginia.

What Are Old People For?

"What Are Old People For?" is actually the title of a book, which in full reads: "What Are Old People For? How Elders Will Save the World" by William H. Thomas M.D. Dr. Bill Thomas is one of those people who could be referred to as Elder Heroes. Not that he is particularly old, but as a geriatrician himself, he is promoting a new way of revisioning old age, or perhaps a remembering of the possibilities of aging that we have culturally always known, but that have succumbed to our fast-paced dementia.

Dr. Thomas describes in terms of biology and evolution, that aging and elders, have made humans what they are, and culture possible. He promotes and advocates for a view of elder care which is radically different than the Long Term Care, what some have come to refer to as the "Nursing Home Industrial Complex" that has come to be. Here we have it, in our fast- paced- youth-obsessed-global society, we are obsessed with the new, the instant, the quick gratification, and spurn whatever takes time, or is slow, or requires long attention. The elderly are like a kind of illegal alien on the borders of our mainstream, that are segregated into nursing home ghettos, separated from nature, plant life, and animals, and all the diversity of the generations including childhood - like prisoners who don't belong and whom we don't want to see. Infirmity, the awareness of time passing, illness, and even death are to be banished in our society to somewhere out of sight and out of mind. Even in our political culture, while rarely referring to the elders themselves, the debate rages of how Medicaid is unsustainable, and behind this how the undeserving old are sapping the vitality of our nation.

Dr. Thomas' vision which appears new, but is actually age-old itself, is that elders deserve a different kind of re-spect (looking again,) and a caregiving different than society currently provides. In many traditional societies, the old have been revered. Particularly in Asia, and in those societies that practiced Ancestor worship, the edlerly were viewed and honored as being close to becoming the ancestors themselves, who were revered in death as lifetime guardians/protectors of the living. Even in Vietnam, a country torn by violence, north divided by south, when both sides often practiced involuntary inscription to the army, exemptions were allowed during that conflict for those who were at home caring for an elderly parent.

Mr. Thomas is not proposing going back or idealizing the past, but considering these outlooks to develop a manner of caring for the old that could only be relevant and possible for current times. He reviews the research that describes in evolutionary, biological terms, how the phenomenon of old age in the human species nurtured what we consider the best to be of human qualities, (such as curiosity, play, and kindness) and allowed for the development of such human societal attributes such as culture and civilization. The special link between the very young and the very old, and the nurturing that takes place between them is something unique among the species. The phenomenon of human longevity made possible a kind of nurturing not possible in the same way to other creatures. Grandparents and particularly grandmothers, having a special role, freed from the competitiveness and responsibilities of adulthood, are able to transmit a caring and a kind of attention to the young, that adults caught in the struggle to survive and prosper are unable to do. From the sheer perspective of time spent, the availability of grandparents as a branch of the family, allowed many other human pursuits, which were not possible in the strict pursuit and business of staying alive. Grandmothers in particular on the most concrete level supported the family by providing food and nurture to the very young.

Most animals don't have an old age, life is short, and our longevity has been made possible by some qualities that other species may share, but have been allowed to develop in us, in distinctly human ways. Others before Mr. Thomas have recognized this, the mythologist Joseph Campbell used to write how the old were the storytellers, the initiators, and transmitter of wisdom to the young. A psychologist Erick Erickson developed the idea of "generativity", as both a quality and as task applicable to adulthood and older adulthood. By fostering a sense of meaning though nurturing cultivating and honoring the young and culture, adults and elders promote the feeling "that it is worth it," that life is worth living, and pass it on, to other generations to come.

Dr. Thomas describes animal studies in which a behavior called "gentling" provides insight into evolution and the significance of aging for humans. Research has shown that infants and young that are handled by older individuals or grandparents are given a kind of tenderness and attention that is qualitatively different than can be provided by the adults. They are "gentled" and the studies have shown that individuals who are given this care prove to be better adapted, more flexible, and less prone to reactiveness and aggression than other animals. This kind of caregiving which has developed in a distinctly human manner, creates many other possibilities.

It is ironic that the stage of life which in many ways has contributed to distinct institution of human caring, creates and even demands such an opportunity for caregiving in its own right. But perhaps this is only fitting and part of the natural cycle. What Dr. Thomas offers is that what we provide now to the elderly falls so far short, that we are harming ourselves, and society. Segregated into Nursing Homes, which are environments that embody some of the worst aspect of our culture - busyness, isolation, depersonalization, lack of privacy, vacuity, and the incessant loud droning of roomfuls of televisions. Dr. Thomas calls himself a nursing home abolitionist, and is in the process of creating and advocating for care-giving institutions, such his "The Green House Project" that offer a radical alternative. He believes that elders should be honored and cared for in a way that views old age as another stage of life where growth is possible rather than a development to be despised.

That the old have both fostered and evoke a specific compassion in humanity is a quality that has been observed as among the most distinct and valued human achievements. Compassion in the Buddhist outlook is a prerequisite and very close to the attainment of enlightenment. The Dalai Lama speaks of a Tibetan meditation to foster compassion in which you would imagine that every person whom you encounter had been your mother in another life, who provided endless hours of nurturing and support for you when you were small and vulnerable and helpless. Perhaps with Dr. Thomas' insight we can extend this metaphor to imagine that every person has been your grandmother! As our elders reach the end of life, the observation of Dr. Elizabeth Kubler Ross on palliative care also seems pertinent. Working with many families supporting elderly parents through hospice, she often would advise, that the work was a great gift, an opportunity to give back to parents all the caregiving that had been bestowed on us as children, when we likewise were helpless and vulnerable.

Dr. Thomas in his book retells a parable from the Hasidic tradition which is both humorous and and worth pondering. There was an old man who lived in a house with his adult son, who had survived to very old age, and was very successful and prosperous. Throughout the house, in many places, he had hidden many bundles of gold. One day the son became concerned that his father was finally losing it. He was observed to carry a sack of the gold to the river, and to dump the contents into the dark swirling depths. Days went by, and day after day the son witnessed the father perform the same ritual, a walk to the river, and a toss of a sack of riches, sinking to the bottom. Concerned that the old man was crazy, and wasting his inheritance, the son went to the rabbi for support and advice. After describing to him the situation, the Rabbi pondered for a moment and asked: "Those sacks of gold must be very heavy for an old man, Yes? " and added:

"You are going to have to help him carry them."

Assisted Living Communities - What to Look for?

Being an elderly is going to be tough. There are things that we enjoy most doing but we can no longer do it, or worse, we are robbed of the opportunity to continue enjoying these things. It is therefore our mission to assist our parents in easing their way through senior years with less pain and depression. One way of doing this is by helping them look for the most convenient, friendly and affordable assisted living community that they can eventually move into.

No matter how much we want to keep them with us and care for them, our modern way of living makes this desire a bit impossible to fulfill. In fact, it may even be more devastating for them if we insist on taking care of them when they are much older, but fail to do so because we are just too busy attending to our own families. It may even cause more trouble and pain for both you and your parents, which can possibly lead to straining your relationship and good intention.

But we can do just the same by providing them with the most appropriate senior assisted living condition. And we can do this by putting in an extra effort to look for that one retirement home that will make their stay truly comfortable. There are quite a number of considerations in doing this and I hope that these tips will give you the right guidelines in searching for the best community from amongst the many assisted living centers available in Canada.

Tip # 1- Look for the cleanest and most organized center

You can easily spot if the management puts high priority on cleanliness, orderliness and sanitation. If from afar you smell a stench of urine coming from any part of the facility, then you can easily conclude that the place isn't clean. If they cannot maintain the center to be clean, then there is a very big possibility that your parents will not be kept clean at all times. This kind of special care is especially true for the most senior elderly. By choosing a well-maintained senior-assisted living home, you will have the peace of mind that your parents will not contract an infection because of unkempt facilities.

Tip # 2 - Security is always a good option

We can appreciate how elderly can feel a little insecure about their safety and protection; so, if they know that the centers where they will be staying maintain a 24 hour security system they will have better sleep at night. Choose an assisted living center that has highly reliable security system with top-of-the-line locks and alarms installed in all the entry points. It would also be ideal if they have cameras that monitor the move of their staff to ensure that they are performing their duties to the satisfaction of their guests. It will also be an added assurance that there won't be any mistreatment or better yet, quick response to any emergency situation.

Tip # 3 - Be sure that the staff are well-trained and trustworthy

When it comes to accommodation and service, nothing compares to a set of staff that are genuinely concerned about the elderly. It is one thing if they are only doing their job, but extending the courtesy and appreciation to all the guests are something that we want our parents to receive at all times. Make sure to choose a retirement home that will treat your parents with the same kind of care and attention as you would want to give if you are able to.

Nothing can be more rewarding than knowing that you did your best in making sure that your parents will stay in the most qualified assisted living home. You will not only have peace of mind but you will also feel the satisfaction in your parent's voice each time you pay them a visit.

Review of the Archimedes Bath Lift

There are a large number of individuals who are in dire need of some sort of assisted living because of some form of impairment. This number includes millions of elderly and the disabled that live in America. Sadly, these poor folk cannot take a bath. The effects of bathing are therapeutic, relaxing, and assures sound hygiene. Bathing is a necessary component of livelihood and the inability to bathe will produce results that are devastating to say the least.

Regrettably, the living quarters may have to be greatly altered or remodeled to assist the elderly and disabled. The remodeling of a bathroom can cost thousands of dollars to accommodate these people. Some of them will have to enter it into a hospital so that they can be taken care of just to take a bath! This experience can cause one to feel helpless and the feeling of helplessness can lead to depression. There have been cases that once these individuals reach the point of depression they lose their will to live. Unfortunately, their lives are cut short because of these sad scenarios.

What can be done to curtail this sadness, heartache and ultimately death? The Archimedes bath lift provides a tremendous answer to the consternation of the unfortunate. This outstanding bathtub lift will prevent the elderly and disabled from having to spend an enormous amount of money or entering into the foreign walls of an institution of assisted living. This type of bath lift is very unique with its many features and benefits.

It is eponymously named after Archimedes. Archimedes was one such individual that merits attention and respect. This brilliant scientist of yesteryear lived during the classical Greek period. Archimedes was a phenomenal mathematician, physicist, and inventor. He is famous for his work in geometry (on the circle, sphere, cylinder, and parabola), physics, mechanics, and hydrostatics.

The Archimedes bath lift is named after this distinguished expert in the field of science. It is a great choice for assisted bathing needs. The elderly and the disabled can enjoy the therapeutic and cleansing benefits of a warm bath free from slips and falls.

The Archimedes is one of the very best and desirable bath lifts for the disabled and elderly in the industry. This excellent product provides the user with an enjoyable bathing experience with its superb functionality, outstanding performance and great design. This accommodating bath lift is quickly becoming very popular among the public with the many features and benefits it offers.

This amazing bathtub lift is extremely lightweight which makes portability from one bathtub to the other easy. Since this product only weighs 22 pounds one can actually take it on vacation or while traveling.

For the taller person the Archimedes is the best in the industry. This superb bathtub lift has a high back rest and a longer seat for greater support. It provides the greatest leg room giving freedom and ease as the user ascends or descends in the bathtub.

Cleaning the Archimedes is executed in a trouble-free way. It simply breaks down into three parts. Either the caretaker or user can use a commercial bathroom cleaner to sanitize it. In a matter of minutes one has a fresh and clean bathtub lift ready to operate again.

It has a very attractive design that is sleek to behold. The Archimedes is made of a very sturdy construction to ensure proper durability and support. Furthermore, it comes in an all white color that looks appealing to the eye.

Fear of electrocution should never be a concern while operating the Archimedes bath lift. It is battery operated and all of the components are tightly sealed making water impenetrable to the electronics.

There are large flaps on the side to ensure an easy and safe transition as one sits on the Archimedes bath tub lift. All one has to do is simply sit down on the flap that is positioned on the edge of the bathtub and gently slide over. There is a single control that makes lowering into the bathtub and raising out of the bathtub a simple smooth transaction.

The Home Accessibility Store continues to be the leader in providing the public with assisted living. The Archimedes bath lift is just one of the many medical products that we offer. As evident in the above article this excellent product will give the elderly and the disabled hope, enjoyment, and a new outlook on life. Why would you enter into an assisted living institution or spend thousands of dollars remodeling your bathroom to give you the freedom to take a bath? For a very affordable price the Archimedes bath lift will give you the ability to bathe in dignity in the comfort of your own home. The Home Accessibility Store can provide you with this wonderful product, so contact us now and we will assist you with the utmost customer care. It's time to get your life back!

Long Term Care Insurance Planning for Nursing Home

Most family members feel disappointed when their parents have to move in a nursing home. This subject is definitely one of the problems the family would try to avoid as much as possible, but no matter how they try to, this situation is inescapable.

The question is why children fear sending their parents in a nursing home. Well, many nursing homes today cost around $80,000, and these figures go upward each year. Imagine how much savings you need to keep your loved one/s in the facility. And don't forget that your loved one might extend his or her stay there for few months or years that would eventually gobble up your savings. Therefore, financial planning is extremely crucial, and buying long term care insurance means a lot when considering nursing home care in the future.

What nursing home care? Why it is expensive? Nursing home care provides various services that can be a combination of personal care and skilled medical services. The extent of level of care depends on the person's needs and/or the request of the physician. Intermediate care is provided to patients with long-term medical condition. Skilled care, on the other hand, is much more costly because it provides 24-hour of health care assistance to the patient.

How do residents pay nursing home expenses? According to survey, a non-profit organization, a third of residents pay out-of-pocket expenses for nursing home care services, while only five percent purchases long term care insurance. Unfortunately, most of those residents fall heavily on either Medicaid Medicare assistance as their last resort, especially for low income families.

Many Americans boldly ignore private long term care insurance, hoping that Medicaid and Medicare will shoulder everything. While everyone seems so attached with Medicaid, please be reminded that this program is very limited in nature. Low income individuals are given priority to receive Medicaid benefits; thus, if you fall in the middle income group, you must meet Medicaid's asset limit. However, if you abide to this, you will just lose your savings for something that is not worth risking for. People with Alzheimer's are generally not covered in Medicaid because this disease is considered as mental disorder. There are also other mental impairment and health disorders that are not covered in Medicaid.

Medicare is another federal program that is available to all American citizens age 65 and older. Like Medicaid, Medicare does not provide modest long term care services because it covers up to 90 days only in selected facilities, particularly in hospitals. Think hundreds of times before jumping in either Medicaid or Medicare to avoid regrets.

As what has been mentioned earlier, very few people purchase long term care insurance because they are misled of the advantages of Medicaid and Medicare. Long term care insurance is the best financial investment intended primarily for long term care because it provides options and flexibility to meet your needs. This allows you to choose your preferred form of care whether at home or in a facility. You have the full control to determine your daily or monthly benefits and how you are going to use them.

Suggested Careers For Myers Briggs Test Personality Types

During times of a major economic downturn many people decide to change their career. Usually a major career change will require that you go back to school. Going back to school can be a tough decision especially if you have already started your career. To help decide which career type you should follow we have created a list of careers that are best suited for each of the 16 Myers Briggs personality types.

ESTJ
Military, business administrators, managers, police/detective work, judges, financial officers, teachers, sales representatives, government workers, insurance agents, underwriters, nursing administrators, trade and technical teachers, mafia dons. Natural leaders, they work best when they are in charge and enforcing the rules.

ISTJ
Business executives, administrators and managers, accountants, police, detectives, judges, lawyers, medical doctors, dentists, computer programmers, systems analysts, computer specialists, auditors, electricians, math teachers, mechanical engineers, steelworkers, technicians, militia members. Similar to the ESTJ, they have a knack for detail and memorization, but work more behind the scenes instead of up front as a leader.

ESFJ
Home economics, nursing, teaching, administrators, child care, family practice physician, clergy, office managers, counselers, social workers, bookkeeping, accounting, secretaries, organization
leaders, dental assistants, homemakers, radiological technologists, receptionists, religious educators, speech pathologists.. They do best in jobs where they can apply their natural warmth at building relationships with other people.

ISFJ
Interior decorators, designers, nurses, administrators, managers, secretaries, child care/early childhood development, social work, counselors, paralegals, clergy, office managers, shopkeepers,
bookkeepers, homemakers, gardeners, clerical supervisors, curators, family practice physicians, health service workers, librarians, medical technologists, typists. Tradition-oriented and down-to-earth, they do best in jobs where they can help people achieve their goals, or where structure is needed.

ESTP
Sales representatives, marketers, police, detectives, paramedics, medical technicians, computer technicians, computer technical support, entrepreneurs, comedians, agents, race car drivers,
firefighters, military, loan sharks, con men, auditors, carpenters, craft workers, farmers, laborers, service workers, transportation operatives. They have a gift for reacting to and solving immediate problems, and persuading other people.

ISTP
Police, detectives, forensic pathologists, computer programmers, system analysts, computer specialists, engineers, carpenters, mechanics, pilots, drivers, athletes, entrepreneurs, firefighters,
paramedics, construction workers, dental hygienists, electrical engineers, farmers, military, probation officers, steelworkers, transportation operatives, hit men. With the ability to stay calm
under pressure, they excel in any job which requires immediate action.

ESFP
Actors, painters, comedians, adult entertainers, sales representatives, teachers, counselors, social workers, child care, fashion designers, interior decorators, consultants, photographers,
musicians, human resources managers, clerical supervisors, coaches, factory supervisors, food service workers, receptionists, recreation workers, religious educators, respiratory therapists.. Optimistic and fun-loving, their enthusiasm is great for motivating others.

ISFP
Artists, musicians, composers, designers, child care workers, social workers, counselers, teachers, veterinarians, forest rangers, naturalists, bookkeepers, carpenters, personal service workers,
clerical supervisors, secretaries, dental and medical staffers, waiters and waitresses, chefs, nurses, mechanics, physical therapists, x-ray technicians. They tend to do well in the arts, as well as helping others and working with people.

ENFJ
Teachers, consultants, psychiatrists, social workers, counselers, clergy, sales representative, human resources, managers, events coordinators, politicians, diplomats, writers, actors, designers,
homemakers, musicians, religious workers, writers. They have a gift of encouraging others actualize themselves, and provide excellent leadership.

INFJ
Counselers, clergy, missionaries, teachers, medical doctors, dentists, chiropractors, psychologists, psychiatrists, writers, musicians, artists, psychics, photographers, child care workers, education consultants, librarians, marketeers, scientists, social workers.. Blessed with an idealistic vision, they do best when they seek to make that vision a reality.

ENFP
Actors, journalists, writers, musicians, painters, consultants, psychologists, psychiatrists, entrepreneurs, teachers, counselors, politicians, diplomats, television reporters, marketers,
scientists, sales representatives, artists, clergy, public relations, social scientists, social workers.. Very creative and fun-loving, they excel at careers which allow them to express their ideas and spontaneity.

INFP
Writers, artists, counselors, social workers, English teachers, fine arts teachers, child care workers, clergy, missionaries, psychologists, psychiatrists, scientists, political activists, editors, education consultants, journalists, religious educators, social scientists.. Driven by a strong sense of personal values, they are also highly creative and can offer support from behind the scenes.

ENTJ
Business executives, CEOs, organization founders, business administrators, managers, entrepreneurs, judges, lawyers, computer consultants, university professors, politicians, credit investigators, labor relations worker, marketing department manager, mortgage banker, systems analysts, scientists. They are born to lead and can steer the organization towards their vision, using their excellent organizing and understanding of what needs to get done.

INTJ -
Scientists, engineers, professors, teachers, medical doctors, dentists, corporate strategists, organization founders, business administrators, managers, military, lawyers, judges, computer
programmers, system analysts, computer specialists, psychologists, photographers, research department managers, researchers, university instructors, chess players. They have a particular skill at grasping difficult, complex concepts and building strategies.

ENTP
Entrepreneurs, lawyers, psychologists, photographers, consultants, sales representatives, actors, engineers, scientists, inventors, marketers, computer programmers, comedians, computer analysts,
credit investigators, journalists, psychiatrists, public relations, designers, writers, artists, musicians, politicians. Very freedom-oriented, they need a career which allows them to act independent and express their creativity and insight.

INTP
Physicists, chemists, biologists, photographers, strategic planners, mathematicians, university professors, computer programmers, computer animators, technical writers, engineers, lawyers, forensic researchers, writers, artists, psychologists, social scientists, systems analysts, researchers, surveyors. Highly analytical, they can discover connections between two seemingly unrelated things, and work best when allowed to use their imagination and critical thinking.

The Age Wave - Understanding the Diversity and Needs of Older Clients

Me work with older adults? Not if I can help it! That is frequently the attitude of students I encounter who think of the elderly as a boring and debilitated population residing in nursing homes or other institutional settings. While not saying so in such blunt terms, many clinicians in practice secretly share the same perceptions. The reality is that whether one has planned to or not, working with older adults is an increasing likelihood for all clinicians unless they limit their practice to children and adolescents. Even marriage and family therapists will find more of their caseloads taken up with adult children confronting problem parents (Should they be driving? Can they safely stay in the family home? Are they making bad financial decisions?) rather than problem children. Demographic data tell us that the fastest growing segment of the population is adults over the age of 75, with the over-85 group increasing more than six fold. As Baby Boomers age, the number of adults living well into their 80s and 90s will jump exponentially. Identification and classification of the aging population has proved challenging. For example, gerontologists traditionally identify persons aged 60 years and above as older adults. Researchers, however, often break old age into three categories: the young old (ages 65-75), the old (ages 75璽??85), and the oldest old (age 85+). Others have argued that health not age should be the criterion so that the young old are all those who are over 65 and healthy while the oldest old are those over 65 who are I'll or disabled. Much of this confusion in terminology is related to the changing character of aging in this country. Current generations of older adults are healthier and better educated than past cohorts. They enter old age with more old_resources and different expectations from those of earlier cohorts. The consequence is that as Baby Boomers age, they will be more psychologically minded and open to psychotherapy as a helpful process than were their parents and grandparents.

*Barriers to Working with older Adults* Unfortunately, the average counselor usually has had little direct contact or experience working with a large number of older adults. This lack of experience can limit the counselors interest in or comfort with this population. As a consequence, it is easy for societal myths about older people and inappropriate stereotypes to Impact the mental health professionals attitudes toward older clients. For example, a common misperception is that most older adults live in nursing homes or other institutional settings. However, the reality is that less than 5% of the elderly population reside in nursing homes. The majority of older adults never spend any time in a nursing home but rather live independently, successfully coping with their life situations. Another barrier to services is the myth that older people do not change or benefit from counseling. Multiple studies have consistently documented that psychotherapy is effective in overcoming depression and other mental health disorders in older adults. In fact, rates of Improvement and the extent of gains are often similar to those found among younger groups. In addition, interventions that focus on family members or on hospital or nursing home staff can result in significant Improvements even for patients who are unable to participate in traditional psychotherapy (such as dementia patients). Counselors must examine and challenge the stereotypes and misconceptions that limit their understanding and willingness to serve this population.

The reality is that older adults experience the same broad array of psychological issues and disorders that affect younger adults. To be helpful, counselors need to better understand the diversity of situations and needs of the hase clients and the wide range of issues and concerns confronting them. This is not a homogenous population. Often the only commonality among them is that they are over the age of 65. Differences in education, health status, economic status, and life experiences are often greater in this group than in younger clients and must be recognized and evaluated if effective treatment is to be provided. Working with older clients presents a challenge to mental health practitioners and demands that they acquire specific knowledge and skills needed to work creatively and effectively with this population. (Unfortunately, few have had even minimal academic or clinical training to prepare them to work competently with older adults.)

*Successful Aging* One of the most Important new trends in working with older populations is a de-emphasis on only negative aspects of aging and a growing emphasis on successful aging. Prevention and early intervention are playing larger roles in helping to optimize life satisfaction and quality of life in old age. There appears to be some truth to the wry observation of the elderly gentleman who commented, If Id known I was going to live this long, Id have taken better care of myself. A multidimensional approach is needed to achieve optimal quality of life for the elderly. It has been suggested that positive aging is associated with: avoidance of disease and disability; maintenance of high physical and cognitive function; and sustained engagement in social and productive activities. One of the most striking aspects of working with older adults is the need to go beyond an individual focus to develop a multidisciplinary approach that involves the medical, family, and social systems of the client. Christian counselors have a unique opportunity to enhance the hase multidimensional goals by providing an additional focus on clients spiritual and religious old_resources as well as drawing on the church community for support and care. A finding often ignored by mental health professionals is that religion plays a significant role in the lives of older adults. In fact, it has been reported that religious affiliation is the most common form of organizational participation among older adults, with 50% attending religious services weekly.

*What Mental Health Professionals Should Know about older Adults* The majority of older adults manage to face problems and overcome them effectively, but others will need help facing the challenges of aging. Depression and anxiety should not be considered normal conditions of the elderly. The hase are treatable disorders. In fact, older people evidence fewer diagnosable psychiatric disorders than younger persons. Only cognitive Impairment (dementia, delirium) shows a definite age-associated increase in incidence. What information, then, should counselors have to provide useful and competent help to older clients?

Normal vs. Pathological Changes of Aging It is critical to be able to differentiate the normal changes of aging from those that are indicators of pathological conditions. For example, normal physical changes in aging include mild to moderate hearing Impairment, visual changes such as slowed reading speed, difficulty seeing in dim light or reading small print, slower reaction time, high likelihood of having multiple chronic conditions such as arthritis, hypertension, cataracts, heart disease, and osteoporosis. In addition, the likelihood of needing personal assistance with normal activities of daily living increases with age (up to 50% of those aged 85 and older need some form of assistance). Cognitive changes in aging are highly variable from one person to another. In some older people, general patterns of normal cognitive change include: slowed information processing speed (which results in a slower learning rate and greater need for repetition of new information); decrease in ability to sustain attention; some decline in long-term memory (but often benefits from cueing); decline in word-finding or naming ability; decrease in visuo-spatial ability; and some decline in abstraction and mental flexibility.1 Little or no change is found in short-term memory, language ability (including verbal comprehension, vocabulary), and continued accumulation of practical expertise (or wisdom).

*Specific Challenges for Late Life Clients* The challenges facing older adults, such as chronic Illness, disability, and the death of a loved one, can occur at any time but are likely to pile up with greater frequency in the latter part of life. Loss is a common theme, but it will not necessarily be experienced in the same way by all clients. The counselor must explore the meaning of the experience for each individual client before rushing to provide an intervention. As with younger clients, older adults have vastly different psychological, social, and spiritual old_resources available for coping with the hase challenges. Respecting those differences and drawing on the unique strengths of each individual will best promote resiliency in the face of the multiple stressors of late life. One caution is that it is Imperative to assess suicide potential in depressed elderly clients. The highest rate of completed suicides is in the over-65 age group. In addition, marriage and family counselors need to be aware of the Impact of chronic Illness, disability, or change in work status (e.g., retirement) on marital and family systems. The hase changes can trigger crises for an individual or the family. For example, as adult children become aware of changes in their parents functioning, they must shift roles to become parents to their parents. Some of the stresses on the family system may be unexpected, such as the reappearance of sibling rivalries as adult children are forced to work together to make decisions about a parents care. In fact, the hase types of conflict are often more difficult to manage than the actual parent care itself. In addition, long term successful marital systems can be thrown into chaos when one spouse becomes disabled due to Illness or injury, thus disrupting set patterns of functioning. Another specific challenge of later life counselees is elder abuse. This includes physical abuse, neglect, and chronic verbal aggression, most commonly at the hands of a spouse, adult child, grandchild, or professional caregiver. It occurs at all economic levels and among all age groups in later adulthood. Abuse is much more likely to occur when the older person is experiencing physical, emotional, or cognitive problems. Persons with Alzheimers disease and other dementia disorders are at greater risk than others for elder abuse. Because medical practitioners may overlook signs of physical abuse, such as bruises or other injuries, or assume they are because of falls, it is Important for the mental health professional to question the cause of physical injuries. Christian counselors may find this a particularly sensitive area to assess due to the shame associated with acknowledging anger or resentment by Christian family members and caregivers. Helping caregivers including family members to recognize their negative feelings and develop appropriate coping responses is critical in preventing further abuse. Many states require reporting by health care, social service, or other professionals if abuse is suspected in the home. All states require reporting when abuse occurs in an institution.

*Knowledge of Community Resources and Services for Older Adults* One of the most unique aspects of working with older adults is the need to tap into the larger network of aging services available in the community. The difficulties facing older adults that threaten their quality of life and well-being frequently result from medical, physical, or economic circumstances that limit independence and functioning. Often, there are community old_resources that can meet some of thesis needs and thus enhance the quality of life for the client. At a minimum, the counselor should be familiar with the Area Agency on Aging, a federally mandated agency available in every city, county, or region of the United States that acts as a clearing house for all senior services available in that area.

*Conclusion* Counseling older adults presents a complex and challenging array of issues and circumstances with which the mental health practitioner must work. This can be rewarding for counselors who are willing to set aside negative societal stereotypes and engage thesis clients in the process of growth and healing. In addition, the experience of counseling older adults can also deepen counselors awareness of their own aging and, hopefully, generate a voice of care, compassion, and advocacy for the needs of this special population.