Saturday, October 26, 2013

Moving Your Loved One to Assisted Living: 10 Tips for a Smooth Transition


Two years ago my father-in-law had a small stroke. Family members hoped his mental faculties would return, but they did not. The stroke had caused more damage than we thought. Dad became increasingly forgetful, wasn't eating right, and wore dirty clothes. We worried about him constantly.

Before the stroke we tried to get Dad to move to an assisted living community and he refused. After the stroke he still refused, so we had a family meeting. The meeting focused on the benefits of assisted living: utilities, cleaning, linens, meals, transportation, recreation program, and personal safety.

After two hours of "spirited" discussion Dad agreed to move. Assisted living is a housing alternative for older adults who want or need assistance. My father-in-law moved into a community that is owned and operated by Mayo Clinic in Rochester, Minnesota. It is within walking distance of down town and has an excellent reputation.

Sorting Dad's things took about two months and the steps we followed are below. For more information on assisted living contact the Assisted Living Federation of America, the Consumer Consortium on Assisted Living, the National Center for Assisted Living, the American Association of Homes and Services for the Aging, and the American Seniors Housing Association.

As you go about your work keep this thought in mind: Moving a loved one is a labor of love.

1. FIND A COMMUNITY. There may be a community in your town or close by. If there isn't one log onto http://www.FindAssistedLivingCare.com, a free service that lets you search by state and name. You may also log onto Eldercare Locator, a U.S. Department of Health and Human Services website.

2. VISIT THE COMMUNITY. My father-in-law visited several apartments, the main dining room, corner grocery, and other places in the high rise. Give your loved one a chance to think about the visit before he or she visits it again. You may wish to have a surprise visit to make sure the community is a match for your loved one.

3. TALK WITH RESIDENTS. Because Dad knew many of the residents of the community he knew a lot about it. He had attended social functions there and sampled the food, which is excellent.

4. HIGHLIGHT SERVICES. Just the thought of moving upset my father-in-law. Dad had lived alone for years and didn't enjoy cooking. When we told him he wouldn't have to cook for himself his face lit up. "Good," he declared. He would have a complete kitchen in case he wanted to prepare meals.

5. GET A FLOOR PLAN. The assisted living community provided us with a floor plan. This plan helped Dad envision himself in a new place. Having the plan helped us to decide, with input from Dad, where to place his furniture. It also helped us to decide which furniture to keep.

6. SORT GOODS. My sister-in-law, one of the most organized people on the planet, did most of the sorting. Things were sorted into groups: large furniture, small furniture, kitchen things (dishes, silverware, pots and pans), books, antique books, photographs, linens, and artwork.

7. HIRE AN APPRAISER. A professional appraiser will help you determine selling prices and prevent family disagreements. Our appraiser divided Dad's things into two sub-groups, sell and give-away. He completed his work in two hours and it was a revelation. Some of the things we thought were valuable weren't and some of the things we thought were junk turned out to be valuable.

8. GIVE THINGS TO FAMILY. Though my father-in-law grieved as his home was dismantled, he found comfort in giving things to his sons, daughters-in-law, grandchildren, and great grandchildren. Keep a list of who gets what to avoid trouble later.

9. HIRE A MOVER. The assisted living community was close to the condo, so we were able to move many things ourselves. We hired a professional mover to move large furniture. To help Dad find things we put sticky notes (dishes, silverware, shirts, etc.) on doors and drawers.

10. MONITOR YOUR LOVED ONE'S HEALTH. Dad was never really happy in his new apartment, probably because the stroke continued to spread. There was too much space for Dad to worry about. After Dad walked into the wrong apartment (he was looking for towels) and exhibited other unsocial behavior, we consulted with staff and family. The collective decision - move Dad to a lower floor where his health and medications would be monitored.

Dad's new apartment is really a large room and overlooks a charming park. I put his dining table and chairs in front of the window. A wooden screen divides the sleeping area from the living area. Just before Dad walked in the door I put a bouquet of fresh flowers on the table. "This is really nice!" Dad exclaimed. His words were music to my ears.

Copyright 2006 by Harriet Hodgson

Should You Consider Becoming a Psychiatric Nurse?


Are you interested in a career in psychiatric nursing? Learn more about what to expect in a psychiatric nursing career, and if this role may be a fit for you. Psychiatric nursing offers an abundance of intrinsic rewards, but is not without significant challenges, including the stigma of mental illness and lack of public awareness. Other frequent challenges are non-compliance in patients with their medications and other directives, which sometimes may result in violent acts among patients or even towards staff. This doesn't deter nurses who are passionate about psychiatry, however. To these devoted nurses, the benefits of psychiatric nursing far outweigh the drawbacks of this often intensely challenging field.

Working with psychiatric patients is not for everyone. One of the greatest challenges for psychiatric nurses is when a volatile patient becomes violent. It doesn't happen often, and you learn to assess the verbal and non-verbal cues and signs to prepare for an outburst. This is a common fear that may deter some nurses from pursuing careers in psychiatric nursing. However, with teamwork and guidance from a strong nursing and management team, nurses learn how to prepare, and how to manage a potentially dangerous situation for a positive outcome.A patient's breakthrough is the ultimate reward. When a patient who hasn't spoken for a year, for example, suddenly says "Hi" and compliments your new haircut or asks for a hug, these are moments of utmost satisfaction. Psychiatric patients are often regarded poorly by society, so treating them with respect, as fellow human beings, goes a very long way.

Prospective psychiatric nurses must gain experience in medical-surgical nursing, because many psychiatric patients also have medical issues that are causing or contributing to their psychiatric condition.The promising job market includes a variety of employment options such as outpatient clinics, assisted living facilities, addiction/rehabilitation centers, and home health care.Psychiatric nurses must be willing and able to accept challenges and overcome them while maintaining a calm demeanor. Remaining calm under pressure is imperative, so as not to escalate the patient's mood. Empathy is another key trait - one must be able to put themselves in the patient's shoes and treat them accordingly.

Being a psychiatric nurse requires one to build a relationship with the patient. Unfortunately, mental illness affects all walks of life: all age groups, all races, creeds, and colors.As a professional nurse, it's always important to remain current in your field. Follow the latest practice trends, since new ideas and new treatment methods are constantly being developed to treat patients and their illnesses.Nurses should always remain compassionate and empathetic, while maintaining a certain amount of professional distance in order to provide the best care possible. It's also important that psychiatric nurses not allow themselves to become jaded or judgmental.

Psychiatric nursing is a calling - you either love it. or hate it. Each diagnosis is different. You don't see the same signs and symptoms for each case as you do in medicine. If you want immediate gratification, however, psychiatric nursing may not be the best fit for you. The progress takes longer to develop in psychiatric cases. Unlike an emergency room setting, where a person comes in with a broken bone or a ruptured appendix, and goes home "all better" after surgery or other treatment, psychiatric improvement often takes a minimum of three to five days.

Signs of Nursing Home Abuse and Neglect


One of the most excruciating decisions a family may be faced to consider is the need to put an elderly loved one in a nursing home. Not only is there the potential for feeling guilty because you can no longer care for the person who raised you, but you also have concerns or fears to entrust the health and well being of a frail, elderly person to the hands of strangers. So imagine the horror you would feel if you suspect a parent or grandparent is suffering abuse or neglect. If you suspect a loved one is being neglected or abused, check for one or more of these signs which may indicate neglect.

Signs of neglect

The reason you put your loved one in a nursing home was because they were unable to care for themselves in many basic ways:

• Maintain proper hygiene
• Feed themselves
• Take medicine properly

In addition, they may also suffer from limited mobility and memory loss. After you put them in a nursing home, you expect the staff to provide your loved one with those needs. When an elderly person is neglected, they show signs that those basic needs aren't being met:

• Bed sores
• Symptoms of dehydration or malnutrition
• Symptoms that their medicine is not being administered
• Smells of urine or feces
• Looking unkempt such as hair not being brushed or wearing dirty clothes
• Lack of basic hygiene such as bathing or brushing teeth

This list is by no means all inclusive. If it seems your loved one is not receiving a standard of care that a reasonable person would expect, you should investigate whether your loved one is being neglected.

Signs of abuse

If anything is worse than neglect, it is abuse. An elderly person has the right to be treated with dignity and respect. The elderly should never suffer any of the following forms of abuse:

• Isolation from the other patients
• Unreasonable restraints
• Screamed at, insulted, or threatened
• Hit, slapped, struck, bit
• Sexually assault
• Discriminated against for any reason
• Unreasonably medicated to control behavior

Furthermore, they definitely should not be inflicted with mental or physical pain or punishment. Some signs of this type of abuse are:

• Bruises or cuts
• Broken bones, especially broken hips
• Becomes withdrawn
• Wants to be away from other patients
• Starts biting
• Afraid to speak around the nursing home staff
• Shows nervous behaviors you haven't seen previously
• Sudden death

Like the signs of neglect, these signs are not all inclusive and limited to just these indicators. If you suspect that your loved one is being abused, don't hesitate to take action. You need to do everything you can to protect the life, health and rights of your loved one.

Getting legal help

You can file a complaint on your own and even try to change nursing homes. However, elder abuse and neglect is not only illegal, it violates the rights of a group of people who cannot defend themselves. A Minnesota personal injury attorney can help you get results, stand up for the rights of your loved one, and even get your loved one compensation for any injury they might have occurred. If you suspect nursing home abuse or neglect, don't hesitate to call a personal injury lawyer. Your love one's life might depend on it.

Common Work Accidents in Various Types of Workplaces


Each type of workplace has a tendency to be prone to certain kinds of recurrent accidents. Like a construction site is prone to trip and fall, head injuries, etc. Each kind of injury has a different disabling effect on the accident victim. Here are some common accidents related to certain work sites.

Industrial accidents

Industrial manufacturing and production areas are highly prone to accidents. Protective gears are compulsory for all the employees here. The work is physically demanding and mandates that the workers are given proper breaks to refresh themselves. Lack of attention and faulty equipments are the two main reasons for accidents in such places.

Accidents from slips, trip and fall, faulty machinery, ladders, tools falling from a height, injury while lifting goods, injuries to eyes and ears causing blindness or deafness, head and back injuries are some common problems that are seen in a factory. All this are eligible for work compensation.

Chemical factories, Labs and health care facilities

Contracting diseases and hazardous substances are very common affair in chemical industry, hospitals and research & development labs. Working with harmful chemicals or biological substances may have immediate effect in some cases. However, in rare cases such as arsenic poisoning, asbestos, lead poisoning and biological agents such as HIV, the effects come out very slowly taking months and sometime years to reveal the injury or disease.

Proper masks and safety training should be provided to each and every employee in such workplaces. This way, they can not only safe guard themselves but also prevent others from contracting any deadly disease. It has been seen that carelessness is the main factor for accidents in such places.

Domestic workplaces and offices accidents

Domestic places present less opportunity for any kind of major injury, yet accidents do happen. These places are common for personal injuries such as Carpal tunnel, depression, neck injury, repetitive stress injury, etc. cuts, burns and lacerations are very common. Nothing fatal usually happens. But the possibility cannot be ruled out.

These injuries can be claimed compensation from the employer. The claim is usually covered under the employee's contract. The employee can claim for pain and suffering, loss of income and loss of pension.

Your compensation lawyer will calculate your claim by taking into consideration the loss of income, the medical and nursing care expenses you had incurred, multiplying all that with a pain factor. The pain factor is a value that determines the range of your compensation. This pain factor is between 1.5 and 5. The more severe the injury, the higher the pain factor and hence higher gets the range of compensation.

All compensations have a higher and lower range. To obtain the maximum benefit, you have to prove all the claims with an expert work accident claims solicitors.

Paid Training For Certified Nursing Assistant CNA


The certified nursing assistant CNA is a member of the heath care team that goes along with any medical care facility. Most of these facilities are for older patients but can include nursing home, clinics, hospitals, extended care facilities, and of course even the office of a physician.

There are many opportunities for paid training for certified nursing assistants. Many facilities will offer tuition reimbursement if staff members go out and earn their Certified Nursing Assistant credentials. It is an opportunity to truly become a professional member of the health care team and become registered with a national organization that certifies nursing assistants.

The job market for certified nursing assistants remains strong and will continue to remain strong with our growing elderly population. The CNA is often required to manage the daily care of the client at a medical facility.

They are responsible for a wide range of tasks to take care of the patient. They often receive good benefits and a good working salary with plenty of overtime work that is available to them. Because of the nature of the work there is a fairly high turnover rate and that is another reason why there are many employment opportunities that become available at any time and in every city and location.

The formal education for the certified nursing assistant does not take long. Most of the time you can take classes inside a year or even six months and be ready to sit for the state exams that are offered.

You also must complete an internship by working directly in the field at a local health facility under the supervision of an instructor. Because of the demand for these people you can often find paid training for certified nursing assistant programs at your local community colleges. Most of the time these classes are small and you will receive very personal attention as you work your way through the program. The rewards will be great and the satisfaction will be your motivation.

Now is the time to look into taking classes in a paid CNA training program that will lead you to a new job and a new and satisfying career. You can be a member of the very important health care team in a local facility near your neighborhood.

Begin to earn real money and enjoy the benefits of helping others. Programs are always forming and you can make an application for the next class that starts. Take advantage of this educational opportunity.

If you have always wanted to work in the health care field now is the time to investigate the opportunities with becoming a certified nursing assistant. What is even better is the chance that you may be able to find paid training for certified nursing assistant programs in your local area. It is the right time to grow professionally and join the thousands who are employed in the health care industry. Louis Zhang, Certifiednursingassistantonline dot com

The Benefits of Getting a Master's Degree in Nursing


There are many benefits of having a master's degree in nursing (MSN). If you're looking for more out of your current nursing career, you may just consider going back to school to pursue this training. With an associate's degree, a nurse has already obtained all of the necessary and basic skills vital to work as a registered nurse. With a bachelor's, a nurse is given a bit more authority. However, with a graduate level degree, a nurse has not only more skills, more knowledge, and even more power than a basic registered nurse, but a wide array of job opportunities as well.

Probably you were already aware of the fact that nurses in general are in high demand and are some of the highest paid professionals in the healthcare field. What you were not aware of is that nurses are provided more variety in relation to career than most any other job out there. Fortunately, with a masters', that level of freedom is expanded twice as much.

With a master's degree, a nurse can then go on to become a nurse anesthetist as well as a nurse practitioner. Each of these careers provides a huge boost in annual pay. A nurse practitioner earns approximately 120K per year, whereas a nurse anesthetist earns 160K per year.

There is also the opportunity to become a nurse administrator as well as a nurse manager, which also earn similar amounts of annual salary. If you are interested in teaching, a graduate degree in nursing can hold tons of opportunities for you as well.

If you're looking for a higher paying career with a higher level of prestige, a master's in nursing will certainly give you what you want. However, it is important to make sure that the college you attend is a good fit for you. This is because a registered nurse in general is very busy - usually working 12-hour shifts at a local hospital; it is very difficult to attend college to earn a higher degree. The last thing you want is a school that complicates your life more than it is already.

A master's in nursing also makes it easier to get a job. With only a few years of enhanced study, you'll be well on your way to a much better job. And there continues to be an increased need for nurses who hold a higher degree.

Another benefit of holding an MSN is greater understanding of how nursing is incorporated into the overall healthcare system. This degree provides more knowledge and recognition. In addition, it's also great for nurses who desire to obtain their PhD.

Physician's offices in particular find nurses who hold a master's very useful, as they are able to diagnose and treat patients, which ultimately can save money and allow physician's offices to work more productively toward getting their patient's treated in a shorter amount of time. Nurse practitioners are especially useful to doctor's offices that have a lot of patients. What this means is greater satisfaction for the patient and less time spent in the doctor's office.

A master's degree in nursing is perfect for a nurse who wants more out of their career. Although a job as a registered nurse is well-respected, a nurse with a master's degree is guaranteed a much brighter future.

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Friday, October 25, 2013

What Makes a Medical Assistant Such a Valuable Health Care Resource?


Most people are familiar with what doctors do, but not enough know what Medical Assistants (MA) do. This is a profession that is often overlooked in regards to its importance to the overall public health care system. They play an important and vital role. They are health professionals who work with and around traditional medical doctors. They work on administrative and other similar tasks to help support traditional doctors while they perform tests, tend to patients, and order drugs.

MA's have a wide range of responsibilities, but their main tasks include working with patients before the doctor arrives. That often means measuring these patients' vital signs, performing injections and other small medical procedures, recording information and then presenting it to the doctor, preparing the medical instruments for use by the doctor or other health care professionals, and collecting and or preparing the patient's bodily fluids or tissues.

MA's tend to work in care centers, urgent care facilities, as well as clinics. Today, they are finding more work in hospitals, both public and private, as well as assisted living facilities for the elderly and inpatient and outpatient facilities where doctors perform simple surgeries.

They also have many different names in the various countries where they perform work around the globe. They can be referred to as Medical Office Assistants, Clinical Assistants, Assistant Medical Officers, or Ophthalmic Assistants. What Medical Assistants are not are Physician Assistants. Physician Assistants perform many advanced medical procedures that Medical Assistants don't. Some of these advanced procedures include surgery and therapeutic options, which Medical Assistants aren't licensed to do.

MA's are a valuable part of the healthcare workforce, and they perform a number of jobs that make the health care professional's job easier. They work with doctors on a variety of issues and these make the overall level of care higher for patients everywhere. Without the work of MA's, the quality of care would go down and there would be a number of medical issues that might be missed.

MA's require education and training just like any other medical profession. Medical Assistants require formal training at postsecondary institutions such as technical institutes and vocational schools. Sometimes future Medical Assistants can get their education from online education programs or even community colleges. After these medical workers graduate from college, they have to become certified before they can be hired by health care providers. In the United States, four major organizations certify MA's. The certification test that is administered is usually the CMA. The American Association of Medical Assistants, or AAMA, is one of the four major organizations that offers certification to new graduates. The CMA can be taken online and is offered at different periods throughout the year. Another test that graduates may elect to take is the RMA, which allows them to become Registered Medical Assistants. The RMA certification test is administered by the American Medical Technologists, or American Medical Technologists.

Overall, MA's are a valuable resource for all medical professionals and their patients. Without them, the quality of care would drop and patients would get correct care less of the time. It's important for the Medical Assistantship career to keep growing over the years as the medical field continues to grow.

Elder Care Law - What is Life Care Planning? Part 2


Preparing for the possible costs of future impairment and long-term care is, regrettably, a task that everyone faces as they age. You may never need long-term care. This year, about 9 million men and women over age 65 will need long-term care. By 2020, 12 million older Americans will need long-term care. Four out of five older adults have a chronic condition. Losses in a person's ability to function day to day are a natural part of the aging process, and those losses become more severe as people get older.

When the elder's needs for long-term care can no longer be met either inside the home or without the intervention of paid providers, the elder enters what I call the long-term care maze. The elder, and the elder's family, are now embarking on an arduous journey through murky waters. The journey begins with the observation that the current system in our country for addressing long-term care is a non-system, a hodgepodge of services that fails to meet the needs of the elderly and disabled in the variety of long-term care settings. It is economically inefficient and it fails to assure the quality of services that are provided.

Currently, elderly people finance long-term care services from a variety of sources, including private resources, like personal savings, care donated by friends and family, and long-term care insurance and public programs, including Medicaid and Medicare. Medicare pays for health care, such as the Part A hospital benefit and the Part B physician's benefit. Many of our clients begin their initiation in the long-term care maze with a stay in the hospital, which Medicare pays for. Hospitals are under increasing pressure to shorten inpatient stays. Patients who are not ready to go home may instead be discharged to skilled nursing facilities, under Medicare's limited skilled nursing facility benefit. As a result, most people either stay for a short period of time in Medicare skilled nursing care or exhaust the benefit during the course of their stay. Many of our clients and their families believe that Medicare pays for all long-term care. Medicare pays for health care, not personal or custodial care and it is strictly limited in duration. Medicaid pays for intermediate care in a nursing home provided that the individual meets certain income and asset levels and exemptions. Veteran's benefits pays for health care and some long-term care costs depending upon the facility and the status of the veteran or the veteran's spouse.

A person preparing for possible long-term care needs has several options from which to choose. One option is to self insure by setting aside personal savings and assets and then supplementing those personal resources with the donated, or free care of family and friends. In fact, the majority of impaired seniors rely solely on donated care and their own savings. An individual who self insures retains maximum flexibility and control over his or her savings and assets, but must bear the full financial risk of impairment, which will depend on the extent and duration of functional losses. According to the Congressional Budget Office, seniors in general are not well prepared to pay for their long-term care needs.

Although long-term care insurance can be available to pay for long-term care, spending from long-term care insurance accounts for only about 4% of total long-term care expenditures. When it comes to paying the cost of long-term care - whether in a nursing home, assisted living facility, or community home based care - there are really only two choices for most people, private wealth or public benefits. These are not mutually exclusive. Seldom will the public pay all of the costs of someone's care, at least not for an extended period of time. In fact, most public benefits programs in the United States have a cost sharing or co-payment component. For example, Medicare's skilled nursing facility benefit pays all of the costs for the first 20 days; for the 21st to 100th day, the patient pays a co-payment that changes annually and in 2008 is $128 a day. In 2009 it will increase to $133.50 a day. Medicaid requires that the nursing home resident pay all of their monthly income to the nursing home, less certain allowable deductions, such as the personal needs allowance.

Most health care systems are ill-equipped to address the needs of the aging populations they are meant to serve. Modern health care systems were founded on the principles of acute care and are dominated by a focus of growing specialization, efficiency, and expediency. It is a system that is focused on curing the patient's immediate illness and reacting to health care crises. Yet older patients presenting with chronic illness and comorbidities require continuity of care that bridges across traditional medical boundaries and care settings. Three basic flaws exist in the acute care model of health care. First, it does not support people in the day-to-day self management of their chronic illness. Second, it does not coordinate or advocate for good chronic illness care. Third, it does not provide the necessary support and financing for other than acute care or nursing home care.

Life Care Planning is an innovative approach to elder law that helps families respond to all of the challenges presented by long life, illness and disability. Peace of mind for the elderly and their families is the goal of every Life Care Plan.

Home Nursing - Pros And Cons


The American health care industry is certainly undergoing a change - a change from the traditional hospital health care environment to other emerging models mainly in the form of home care, ambulatory care and day surgery. Thus, the new trend involves both nurses, doctors and other paramedical staff shifting base from or sharing base with the traditional hospital work routine. Other non-health and medical personnel are also involved in the new scenario - family members, friends, baby boomers, et al, who now play caregiver roles and health promotion and management personnel. Currently, there is an estimated number of 16,000 profit and non-profit nursing homes in the United States with about 2 million inmates as well as government owned ones.

One of the major factors responsible for the increase in the United States and other developed countries has been traced to the increasing disenchantment of nurses with the traditional hospital practice as a result of certain factors ranging from job strain and heavy schedule to lack commensurate salary and allowances which are forcing more and more nurses to quit hospital practice for other nursing environments such as home and ambulatory nursing. Another factor is the situation where most nursing professionals as well as their families are too busy with other work and businesses, and therefore often have to put their relations in the care of some older or elderly members of their families.

Another important factor for the increase in nursing homes is that many of them provide lots of the basic facilities in a traditional hospital such as gyms and other therapeutic and in-door recreational facilities. Some even have swimming pools. Other factors include the many advantages associated with home nursing among which is the sense of comfort and security of home during sickness or when one is recovering from an illness. Medical research has also suggested that home nursing can be the best option for better physical and mental well being for people with chronic diseases.

Other benefits are the sense of freedom, dignity and personalized care on the part of patients as well as a sense of independence on the part of the care-giver. Home nursing also allows family members to stay together with their sick member as regularly as they wish especially when the nursing home is close enough to their home, thus providing the sick with a lot more emotional support than in a hospital setting.

They also provide round-the-clock care and attention 24 hours day by professionals which most families can hardly be able to provide in addition to a sense of safety, security and well being of their loved one on the part of family members.

There are also disadvantages of home care, major among which is the risk of various forms of abuse including physical, sexual and financial abuse. Increasing cases of abuse by caregivers have been reported in recent years leading to the closure of many nursing homes. These abuses can take the form of verbal abuse, physical harm, sexual abuse or even death by punching or strangulation and usually triggered by anger on the part of caregivers either at the slow actions, awkwardness and clumsiness of their patients. Some cases of abuses have been inflicted by fellow inmates especially those of them with criminal records. In 2008 alone, it has been reported that over 37,000 abuse complaints were received out of which about 7,000 had to do with abuse and neglect of patients.

For several years, nursing home abuse has been a subject of much discussion in the United States with particular reference to the state oft California where some of the most serious cases of nursing home abuse have been recorded. Other places with high record of abuse cases include San Diego and Los Angeles. This can and have often resulted in long term or permanent physical and emotional wounds of victims. Unfortunately, many victims of abuse are physically unable to inform their loved ones of the abuse while many who have dared to do so have been threatened by the abusive staff or resulted in more injuries, abuse and more pain.

Established or suspected cases of abuse can be reported to a personal injury lawyer for redress. A good number of nursing home employees have been convicted of hitting, kicking, punching, and attacking the residents for which they are hired to care and protect. Family members who suspect that their loved ones are victims should not hesitate to contact a personal injury lawyer right away.

There is also the issue of inadequate facilities in some nursing homes in terms of qualified and insufficient staff to meet all the basic needs of the home such as bathing and dressing of inmates and other support services like cooking, shopping, housekeeping etc. Also most nursing homes are not sufficiently equipped to respond to certain emergency situations which will need to be referred to hospitals.

Further, some inmates often suffer a sense of abandonment, depression, frustration and stress which can worsen their health conditions arising from the inability of family members to maintain regular contact or visit as many families are constrained by other pressures which make regular visit to their family members in nursing homes near impossible.

Leading Organizational Change


As leaders we often find ourselves directing team members to change. As a leader we understand that business and society is in a constant state of change. Our employees however may not be so aware. In fact they may find a great deal of comfort in the predictability of their situations and anyone that causes a disruption is met with conflict. Therefore it is important that we not make arbitrary changes to work schedules and routines. Any change should be well thought out and reasoned. Keep in mind that even when change may be good for those affected by it, people will often rebel against it. It takes skill to navigate change effectively the following guidelines will help.

Loss Analysis

When leading change it is important that you asses each person or groups of people involved in the change. Your assessment should be based on looking for what people have to loose when the change occurs. If you can identify those who have something to loose you may be able to work with them to make the change easier.

Talking

One of the key leadership tasks when conducting change is to get people to talk about the change. The process of discussing the situation will assist them in accepting the change. Give them some time to gripe in a controlled situation, and then guide their conversations to more positive areas. Many times people have unrealistic fears, or they have misinformation. By giving them a forum to speak you can uncover these issues and address them.

Listening

It is important that people feel as though they have been heard and their concerns are taken seriously. As a leader you must take the time to actively listen to people. Good listening means that you hear and see the words, body language, and the context of the message. A good method to use to make sure that you clearly understand what is being shared with you is to mirror back the message in your own words. This gives you confidence that you understand, and it lets the team member know that you understand their position. This does not mean that you have to agree, or commit to their requests; it simply means that you hear and acknowledge their point of view.

Force

People are more likely to go with a change if they feel as though it is not something being forced on them against their will. One thing true of most of us is that we do not like to have things forced on us. This however is necessary at times and the astute leader will anticipate and act appropriately.

Build a Tribe

A good leader will know which people on their team they can rely on for support. Before the change process you must build your Tribe and use them to help make change. Give them the most critical assignments. Use them to help role model behaviors that you want to encourage. Do not treat others unfairly, but reward behaviors that move the change effort forward.

Managing change in an organization can be confusing and frustrating for all involved including the leader. However it is up to the leader to understand the principles of change management, team building and organizational behavior to effectively bring about the change they would like to produce.

Building Self Esteem in Elderly Nursing Home Patients


Building self esteem in elderly nursing home patients can benefit all that are involved with the aged person, from the Nursing Staff to the Kitchen Staff to even the cleaning Staff. Then there are also the Elderly family, if the aged person is happy with the Nursing Home then the Patient will show signs of being satisfied. Then the family will be reassured by their loved one's voice that they have chosen the best place for their loved one to reside in. It is like a snow ball effect...one is happy and then all are happy.

Building Self Esteem

The Elderly are very vulnerable when they are at the mercy of a Nursing Home. If the Elderly are used to living at the Home and have a strong personality then they will feel reassured about speaking out and having self-esteem. But if they are new to the Nursing Home, or have a change in their care plan needs because of their own health then it is most likely that their Self Esteem will need to be reassessed.

To take away their independence and to take over their care takes time for the aged to adjust to their new way of life. It is a lot sometimes for the aged person to get used to. Most times the Elderly person was very independent at home and moving around freely but then end up needing care because their health changes, their eyesight changes or they have a fall and break bones. Once they feel like they are no longer able to take care of their daily living then their self-esteem is soon affected. It will become obvious that they have low self-esteem, and it will become very important for the aged well-being to have their Self Esteem Built back up.

Five Easy Steps To Build Self Esteem

  1. Ask the Elderly to help make decisions about their day-to-day living as much as possible. So instead of making choices for them, ask how the aged how they would like to be assisted.

  2. Give them a small tasks that they are able to complete. Even something as basic as folding the face washers or the towels make the Elder feel important.

  3. Ask the aged person what they used to like doing. Did they like gardening? Or painting? Or maybe sewing. Set up activities that the person is able to take part in and enjoy. You will soon see their Self Esteem boosted.

  4. Show the person you care about their thoughts, opinions and their history. Get involved in their earlier life and share their memories. If they have photos of their life then ask if you can sit and look through the photos together.

  5. Use the Elderly person name every time you speak with them in a conversation. Try to remember that person name so that they can feel important and loved.

Building Self Esteem in Elderly Nursing Home Patients takes time and team work. From the top of the management team to the AIN, EEN, RN, kitchen staff, laundry staff and also the cleaning staff. If the same view-point comes from the top of the staff to the bottom of the staff then it will shine through to all at the Nursing Home. The Patients will feel safe, will feel the love among the staff and will have their Self Esteem in tact.

There was a study carried out to see the effects of Self Esteem on Nursing Home Residents which you can read by going to this page Geratic Nursing

Keeping Self Esteem High

Once you have the Self Esteem back on track for the Elderly then it is just as important to keep the Self Esteem High. If one of the members of the staff start to speak in a voice that has no respect for the Elderly then all the staff need to pull together to turn the situation around and address the Elderly in a way that shows the person feels loved and cared about. It is important for our aged generation to feel love, to feel peace and to know that they were once an important person in society.

For more topics about Aged Care Nursing in Australia go to Nursing Issues - where one Nurse talks about lots of topics covered within Nursing Homes and the Nursing staff.

Thursday, October 24, 2013

Helping Families and Loved Ones Identify Nursing Home Abuse and Neglect


One of the most difficult decisions a family can make is to place a loved one in a nursing home or other long-term care facility. Although such facilities can provide a level of care and supervision that many families cannot give on their own, poor care can sometimes worsen a resident's condition, or even hasten his or her death. Most nursing homes are staffed with caregivers who want to provide the best care, but the work is difficult and many facilities have high staff turnover. This can lead to facilities that are understaffed or have poorly trained or inexperienced workers.

Families often must select a nursing home quickly when a loved one is injured or ill and suddenly needs full-time care. Family members want to be assured that the facility they've selected has an excellent record, but even with web sites such as Medicare's "Nursing Home Compare," the task can be daunting.

A study by Wisconsin's Milwaukee Journal-Sentinel highlights the difficulties in finding accurate and specific information on nursing home violations, as the article's authors had to manually compile information from thousands of pages of records. The 2008 study revealed that over a recent three-year period, 359 nursing home residents in Wisconsin were subject to violations that "put patients in jeopardy." Surprisingly, many families were unaware that their loved ones' injuries or deaths later resulted in citations against the nursing homes.

Against this background, it is easy to see why many instances of nursing home negligence and neglect are unknown, even to family members.

Detecting Injuries That May Be Signs of Nursing Home Abuse or Neglect

Bed sores, also known as pressure sores or decubitus ulcers, are among the most common signs of neglect. They form as a result of a lack of blood flow to areas of the body with significant pressure, such as the backside of a person confined to a bed or wheelchair. Although they can be avoided by simply moving the person every two hours, the infections they cause can be life threatening.

Other injuries that should be red flags include:
• Broken bones or fractures
• Bruises
• Infections
• Internal bleeding
• Malnutrition or weight loss
• Dehydration

Asking the Right Questions

Having looked up to parents, grandparents and other relatives for so many years, family members concerned about nursing home abuse or neglect may find it difficult to ask what seem like very personal or even embarrassing questions of loved ones in nursing homes. If they have concerns, however, family members should not be afraid to question the staff and loved ones.

These are warning signs to look for during visits:
• Does the staff deny or delay your visit?
• Do you get enough "alone time" with your loved one?
• Does there seem to be enough staff on hand when you visit?
• Is the staff following the orders of the doctor and family?
• Have there been errors in medication?
• Is the facility using what seem to be unnecessary restraints on your loved one?
• Do you see signs of poor hygiene, such as soiled bedding?
• Are changes in the patient's condition reported to you and the doctor promptly?
• Have there been any unusual banking or financial transactions, or changes to wills or life insurance documents?
• Have any of your loved one's personal items disappeared?

Some forms of nursing home abuse can be more difficult to detect, such as verbal and mental abuse and sexual abuse . Often, patients do not report them for fear that the abuse will get worse or they will face reprisal. If your loved one shows signs of depression or anxiety, talks of wanting to move to a different facility or mentions caregivers whom he or she dislikes, it may be a cry for help.

Seeking Legal Help

Just as placing a family member in a nursing home is an important decision that should be made carefully, the decision to seek legal help following an injury or death of a loved one can seem daunting for many families - particularly those who are grieving.

It is important to remember, however, that even outstanding facilities can face some of the same problems as poorly equipped or poorly staffed facilities. Even if you selected what appeared to be excellent care for your loved one, it is possible that the actions, or inactions, of the home's staff are the cause of your family member's injury. An attorney who has dealt with nursing home abuse can help you determine your legal options and help cut through administrative red tape.

If you have questions about nursing home abuse or neglect, it is important to not be silent. Talk to your loved ones, talk to the staff, and if your questions are not resolved quickly and to your satisfaction, talk to an experienced attorney.

How Assisted Living Can Improve Sleep Habits


Many senior citizens suffer from sleeping problems, but new research indicates that more than half of all seniors report sleeping for 7.5 hours or more per night. This is great evidence that sleeping habits do not necessarily need to change as we age. Sleep is extremely important for people as it helps reduce stress, recharge our immune systems, and keep us mentally healthy. These points are extremely important because as we age, all of these things can become worse, especially when it comes to the immune system. Senior citizens will naturally see their ability to fight off sickness and infections decrease as they get older. Staying healthy should be a big priority and getting the right amount of sleep can help here.

If you suffer from sleeping problems, you might be able to correct them by moving into an assisted living facility. Being in a structured setting can help you stick to your routines more easily, and this includes going to bed at a reasonable hour. When you are in a group of people, it becomes a lot easier to do the little things that will keep you healthy. Assisted living can help you eat healthier, get more sleep, and get more exercise-all of these things will be big steps toward improving your overall health levels. Think about it this way, when all of your friends retire for bedtime, you are more likely to go to bed too.

Assisted living might take a few days to get used to, especially if you have grown accustomed to being on your own for many years. Once you adjust to the changes in your lifestyle, you will most likely be much better off. Assisted living can help you to reduce your stress levels-this might be the root of your sleeping problems. If you don't have to worry about cooking meals, doing laundry, and cleaning up after yourself, you can focus on the things that you really enjoy. Once these stressors are taken care of, you might be able to nod off at a reasonable hour and start getting healthier amounts of sleep.

There are also some mental benefits to living in assisted living, and these also can help with the improving of your sleeping habits. When you are less stressed and around your friends, you are less likely to suffer from depression. Depression has a nasty reputation for ruining sleep habits-it can make you sleep way too much or way too little. Both of these things are unhealthy. But when you are happier, sleep is more likely to come in healthy doses. For these reasons, the mental health benefits created by assisted living are pretty hard to duplicate outside of the facility.

Enhance Memory Fitness And Brain Performance With Gary Small - Q and A Session - Part 2


Question: How do we encourage patients, and people in general, to have hope without encouraging "false hope" (and quack medicine)? Answer: Omega-3 fish oil use is associated with better cognitive and heart health, as well as improved mood. The Amer. Heart Assoc. recommends people eat fish 2X per week, and the Amer. Psychiatric Assoc. recommends fish oil capsules for people who are depressed.

Question: Can you say more about the UCLA Memory Training programs? Who is involved? How do you assess success? etc. Answer: I think the best way to help people separate hype from hope is to translate the science into every day language so people can grasp the significance and limitations of findings for themselves.

Question: Does training people to use memory enhancing techniques has the same effect on everyday memory as brain training using memory, attention games, etc.? Answer: We have several programs at UCLA - Memory Training is a 4-week program taught by volunteer trainers. Memory Fitness is a 6-week program designed for assisted living facilities. Anyone interested in obtaining an institutional or individual license should visit longevity.ucla.edu. Also, Dr. Karen Miller published our most recent study performed at Erickson Living in the Am. J. Geriatr. Psyschiatry.

Question: According to news.scotsman.com, an Edinburgh University study, just published in the journal Nature, "showed that brain cells are genetically different to other cells in the body and are genetically distinct from each other." If this is the case, what might be the implications for brain fitness research and techniques? Answer: I think that in order for people "transfer" their memory techniques to everyday life, they do better if they are provided specific exercises in this method. It depends, Jeanette, on how the cells in the brain differ. Our research has found that new mental activities will stimulate neural circuitry throughout the brain and when people become familiar with a mental task, their brain cells become less active but more efficient.

Question: The current environment in education seems to be on teaching to the test and the focus is on the "average" learner. Do you have any recommendations for maximizing learning potential, specifically memory, in children? This question suggests an important dimension: how do we intervene earlier in life in order to prevent bad events later on? A big part of health promotion. Answer: Lindy, I think that we need to individualize training. A recent study found that when training of working memory in pre-teens was too challenging, there was no improvement in fluid intelligence.

Question: What is the point of brain training for children without deficiencies? Aren't they training their brain everyday at school and in life in general? Answer: Alvaro, I say it is never too early to start training the brain. We tend to wait until people have symptoms. The brain fitness strategies for middle-aged and older adults should be adapted for a younger audience.

Question: What intervention strategies should we be recommending for people earlier in life- beyond individual differences? Answer: Pascale, Yes, young people are training their brains; however, today the average young person spends 11.5 hours each day with technology (computers, smart phones, etc.). That may have a negative effect on important mental skills involving face-to-face communication.

Question: This is fascinating because it's somehow counter-intuitive. Does it mean that physical exercise or social connection is more important than working on the computer (in terms of brain health)? Answer: Alvaro, I suggest a few skills for young people: -specific memory techniques -face-to-face communication skills (eye contact, non-verbal cues during conversation)

Question: What is the neuro evidence that technology actually changes the brain, structurally and/or behaviorally? Answer: I think physical exercise, social connection, and computer skills are all important, but we need to maintain a balance in our lives.

Question: We have less than 15 minutes left. If you have questions, be sure to send them in soon. The MEMORY BIBLE now has been out for a while now. What's the big development or insight you'd point to that's happened recently that readers need to know about? Answer: Our study "Your brain on Google: Patterns of cerebral activation during Internet searching" (American Journal of Geriatric Psychiatry 2009;17:116-126) showed that Internet savvy older adults had significantly greater neural activity searching online compared with internet naive controls. Our follow up of this study showed that after one week of searching, there were significant increases in brain activity in the previously naive subjects.

Question: What mnemonic technique would work for the occasional lapse of recall of a word, a common word that one uses every day? I teach a memory improvement class-mostly seniors-and this is one issue I'm not sure how to approach. Answer: I think that people are concerned not just in improving their memory ability, but also in lowering their risk for developing dementia. Drug development thus far has been disappointing, but some of the lifestyle strategies described in The Memory Bible also appear to delay the onset of dementia symptoms. In "The Alzheimer's Prevention Program" we describe a technique specific for these tip-of-the-tongue memory lapses. It involves writing down clues to the word when you can't think of that word; looking it up later; and then using basic mnemonic techniques to restore the word's place in memory.

Question: what is your opinion on acetyllcarnitene, phosphatidylserine; phosphosterycholine; and coenzyme Q10 as memory or brain enhancment supplements Answer: Michelle, Controlled trials of phosphatidylserine have demonstrated short-term benefits in people with normal aging. I am not aware of similar clinical trial evidence for the other supplements you mention, although they have been found to have antioxidant and other properties that may be brain protective.

Question: Gary, you've worked many years in this field. Let us in on the secret. What do YOU do you, personally, to promote your own brain fitness? Answer: I try to get at least 30 minutes of aerobic conditioning each day; try to minimize my stress by staying connected with family and friends; generally eat a brain healthy diet (fish, fruits, vegetables), and try to balance my online time with my offline time. Which reminds me, I think it is almost time for me to sign off line.

Question: You're right about timing, Gary. Good advice for all of us. We want to thank everyone for participating in today's most interesting session. In particular, we thank Answer for sharing his scientific expertise with our audience. Answer: Thank all of you who participated for you excellent questions.

Evaluating an Assisted Living Home in Phoenix, Arizona


In Arizona, there are over 1,500 assisted living homes to choose from which can be quite overwhelming when needing to locate a quality adult care home. Thankfully, most people don't have a need for continuous skilled care that is provided in a nursing home as they grow older. However, many seniors do need help with day-to-day activities like bathing, dressing, cooking, cleaning and shopping, and Phoenix residents have some great choices when it comes to assisted living homes that bridge the gap that exists between living independently at home and living in a nursing home facility.

Seniors, including those who are in the beginning stages of Alzheimer's disease, can still maintain some of their independence while being assisted with activities that are becoming more difficult for them by moving to a Phoenix, Arizona assisted living home. Phoenix adult group homes offer private rooms as well as common areas that residents can use for recreation, planned activities and socializing - all supervised by trained staff, 24/7/365. Meals, support services, housekeeping, transportation to appointments and errands, help with managing medicine, and more are all offered to residents of long term care homes in Phoenix. Choosing the right senior care provider can be challenging, and all are certainly not created equally. Let's look at how to best evaluate assisted living facilities.



  • Cost. Cost. Medicare, unfortunately, pays none of the cost of staying in an Arizona board and care home, and Medicaid pays very little either. Private insurance may cover the costs for care services - check your individual policy to make that determination. Creating a checklist with all the fees can help eliminate unwanted surprises in the future, for example transportation or hair perms by a visiting hair dresser are usually not covered in the original monthly cost. However, since the monthly cost of staying in a Phoenix assisted living home includes lodging, meals, and more, this type of housing is usually more affordable than nursing homes or hiring an in-home care agency.





  • Location. Once it has been determined how much you can afford, you will want to find an adult care home that is nearby so that you and others can visit with your loved one often. Assisted living homes located closer to a Phoenix hospital like John C Lincoln or Mayo Clinic have a greater benefit when your loved one will need to go back and forth to doctors appointments. Choosing a care home that is near you, a hospital, senior center and other places your loved one will be visiting will prove to be very beneficial.




  • Services. Assisted living homes in Phoenix, Arizona are licensed by the department of health to provider care in all levels of care from personal care to direct care. Some group homes only specialize in a specific area of care even if they may be licensed to provide all levels of care. Be sure to inquire on the areas of specialty, what special needs their residents have or that they have cared for in the past like Alzheimer's Care, Dementia & memory care, Parkinson's, Diabetes care, stroke care or others.



    The ideal facility offers the right amount of care and support for the needs of the resident while still encouraging them to remain as independent as possible, for as long as possible. Consider future needs as well; for example, your loved one may not be incontinent now, but if they become so in the future, how does the facility handle the condition? Would you need to go through the trouble of moving them again? The ideal care home would allow the resident to age in place and offer more care when needed. Consider all possibilities as your loved one will likely need a higher level of care later on down the road.




  • Tour the facility with your loved one, and ask to see more than just the public areas of the building(s). Visit resident rooms, if possible, and ask if you can stay for a meal. Stroll through the facility unsupervised if possible, which will allow you to experience the assisted living home without any "sales" talk from the staff. Take a few moments to talk with current residents - you should ask them what they like about the facility and what aspects have room for improvement.

While making the decision to move to an assisted living home is one of the hardest things in life to do, there are some top-notch adult care homes in Phoenix that can allow your loved one to have a true "home away from home" while getting the care and supervision that they need - without the indignities that sometimes accompany moving to a nursing home.

Senior Community Classifieds Unite Seniors Online


Retirement Listing Service is the first to offer, Online Senior Community Classifieds targeting all aspects of senior life. This idea is intended to unite the growing number of internet users within the senior community. The on slot of baby boomers moving into their senior years is shifting market trends from the "teeny bopper" era of dominance to the "zoomers" who are slowly taking control of marketplaces around the world. Due to the workplace many "boomers" moving into their elder years, already have extensive knowledge of the Internet, and are actively surfing online everyday. This shift in consumer trends will result in an increased number of senior living related businesses and more importantly a new way of advertising to the senior community, online.

Senior life as a whole involves many different wants and needs, from the active healthy seniors who have interests in sports and activities, to others in need of assistance or constant care. Senior Community classifieds offer a centralized place online which includes all areas of this diverse spectrum. Based on the "Free Classified Community" structure which gained widespread popularity due to the success of websites such as Craigslist and Kijiji. Retirement Listing Service has a simplistic approach with a one page design and user instructions clearly visible, allowing for seniors with all levels of computer knowledge. The website allows seniors to easily navigate through online classified listings, in their area, pertaining to senior living.

Written forms of media are most used by advertisers looking to reach senior consumers. On the other hand, reports suggest that the percentage of new computer users is highest amongst the elderly population. The implementation of computers into almost every senior home, seniors center and community complex directly relates to the shift in market trends. With the progress of time and computer savvy "boomers" moving into their elder years, it is increasingly apparent that the Internet will soon be the best resource for not only seniors but every age group in North America.

The idea of senior community classifieds accommodates two groups, senior citizens who surf the web, and those who want to reach them. It is safe to say that everyone wants to easily find whatever they may be searching for online, but with such a diversity among seniors, combined with minimal computer skills, it can prove to be a hard task. Respectively, it is expensive to get useful online exposure, due to the amount of competition, which in many cases does not even fall into the same category. Both sides win in this situation as senior community classifieds are easily to use, free and targeted to the senior population. This idea aims to bring seniors and the surrounding community closer together, resulting in the betterment of senior life as a whole.

Senior Citizens are a diverse group of people with many different needs. The sections found on almost every other classified site do not embrace senior life even closely. Change is needed! The difference is senior community classifieds incorporate relevant categories which pertain to all levels of senior living, such as nursing homes, assisted living facilities and home care. One could also find on the same page, seniors activities, senior jobs and personals. Other changes include a buy and sell section comprised of senior products, such as wheelchairs, diabetic supplies and medical equipment. The senior services section requests a seniors discount, and the travel section is meant for seniors exclusively. Retirement Listing Service attempts to combine the needs of all in the 65+ or older age bracket, helping to make searching online easy and enjoyable, while providing an inexpensive way for advertisers to promote related products and services.

Advertising can be a costly expense for any business, but it is essential for reaching new and potential customers. Community classified websites were built on the free posting approach. This idea remains unchanged with Senior Community Classifieds! As a result, everyone can get involved within the senior community and also offers an online presence for those who may not have one already in place. For some, a combination of free and inexpensive advertising is all that is needed to establish a growing customer base. Senior community classifieds are specific, targeted and free to use, inexpensive to say the least.

The biggest benefit in having a centralized location for seniors online lies in the old adage, "strength in numbers", meaning that those who offer quality in service, care or products will gain good reviews thus attracting others who trust the words of another senior. Those who do not, will have an opposite effect and reviews will help to save other senior citizens from potential scams, bad services or poorly run care facilities.

5 Ways to Detect Nursing Home Abuse or Neglect


While some acts of nursing home abuse are blatantly obvious (such as a loved one kept in an over medicated state for no reason), others are more subtle and may be overlooked by family or friends. If your loved one displays the following characteristics while residing in a nursing home facility, chances are he/she has been the victim of abuse.


  1. Bedsores or Open Wounds- Nursing homes often insist that bedsores are natural and to be expected among frail or immobile residents. Sadly, many families believe this lie and watch helplessly as their loved one experiences pain and sometimes fatal complications as a result of these sores. The truth is that 99% of bedsore cases are the result of abuse and negligence. Nursing homes have strict guidelines that require them to move patients every 2-3 hours and keep their sheets/ garments dry to prevent moisture from irritating the skin. If your loved one has a bedsore, it is likely that this regiment was not followed by the staff. Upon detection of a bedsore, family members should insist that he/she is moved to a medical facility for treatment and contact an attorney to discuss your rights against the nursing home.

  2. Unexplained bruises, cuts, burns or fractures- While it is true that accidents may happen among weak and frail nursing home residents, families should be suspicious of any injury sustained at the facility. Sometimes residents are dropped or abused while in a medicated state and therefore do not remember what happened to them. Family members should not be afraid to ask questions about the situation. If the nurse or aid seems to hesitate or offer a vague explanation, chances are your loved one is being mistreated or neglected by the staff.

  3. Torn, Bloody or Stained Garments- If you notice torn, bloody or stained clothes, there is a good chance that your loved one has been the victim of sexual abuse. Sexual abuse is prevalent in nursing homes, especially among residents who are heavily medicated or have short-term memory problems. Unexplained venereal disease or genital infections are other signs of sexual abuse. Again, if you are not given a satisfactory reason for torn or stained garments or what seems to be a genital infection, remove your loved one from the facility immediately and report your suspicions to local authorities.

  4. Refusal or Delays to Visit the Resident- Family members should be immediately suspicious if the nursing home staff stalls before allowing a visit or openly denies a spontaneous visit in the absence of a medical reason. Family members should also be suspicious of any nursing home that will not allow the resident to have a private visit with a family member. This is a way to intimidate or prevent the resident from reporting the staff for any abuse or neglect that they have experienced.

  5. Abrupt changes in the resident's financial documents or will- While a resident has the right to amend personal documents, family members should be suspicious if these changes happen abruptly or if the resident does not remember making such changes. The resident may have been coerced into changing the documents or giving out account numbers while under the influence of medication or after threats of physical harm.

If your loved one has displayed any of the warning signs listed above, you must act immediately to ensure the situation does not get worse. In the case of neglect, call every three hours to make sure the resident has been moved, groomed, bathed, etc. If you suspect sexual or physical abuse, consider moving the resident to a different facility. On the other hand, if you know for a fact that such abuse is taking place, move the resident immediately and contact an attorney to file suit against the abusive staff member and nursing home facility.

Most importantly, get involved in your loved one's treatment and daily care. Family members make the best advocates for nursing home residents. When family members visit often and ask questions, staff members will be hesitant to engage in abusive activities or provide substandard care. Residents have rights, and involved family members will ensure that those rights are not violated by predators or careless staff.

Wednesday, October 23, 2013

Training to Become an Interventionist


When the decision is made to become an interventionist, it pays to become certified. A certified interventionist undergoes a two day (or sometimes more) of programing that teaches the individual about the various skills and traits that will be needed to lead a successful intervention.

In training the interventionist learns that there are a lot of self destructive behaviors out there, including excessive drinking, drug use, anorexia, extreme gambling, and seniors needing assisted living. The interventionist only needs to have caring friends and family of the affected individual so that an intervention can take place and the addict or other individual can receive the car they need.

An interventionist learns that the process needs to be done with the utmost of respect and care for the individual being intervened upon. There should be as little conflict as possible and it is the job of the interventionist to keep everyone calm and focused on the specific issues at hand. The certified interventionist learns the best ways to give the addict the courage it takes to take the first steps toward recovery. It is important to be trained on the traps that can wreck the entire process and learn how to get out of them, or avoid them altogether.

The certified interventionist learns to replace the frustration of this harsh process with the concepts of hope and positive action toward getting better. He or she is quick to decide who best should be involved in the intervention and who could make things worse. The interventionist must navigate the difficult aspects of inviting some people to the intervention while excluding others.

The interventionist helps determine the consequences of failing to enter treatment and helps the addict understand those consequences. There must be some negative consequences to not attending treatment and the interventionist must get those things across to the addict during this time. It is important to focus on the need to enter a facility because that is ultimately the most helpful for the addict.

The certified interventionist knows when to go ahead with the intervention and when to abort the entire thing. If there is not readily available treatment, it may be best to intervene after the individual has a treatment program to go to. A good interventionist also learns how to keep control over the situation, even if the addict acts inappropriately or does not seem interested. All in all, every person involved in the intervention must leave feeling satisfied that it was worthwhile. Training to be a certified interventionist Is a diverse job that takes a special set of skills, but it can also be rewarding for all involved.

Basic ACFI Training Guide to Follow


One can easily understand a teaching when he or she has an experience about it. Indeed, in every experience there's a lesson being learned. In every action, there's a principle behind it just like in providing medical care and support to the aged citizens. It is very important that you know and understand what you do. When you are assigned to take good care of a sick and old patient, you must possess the right skills and sufficient knowledge. You can only become a competitive care giver and service provider if you know how to follow the basic principles of your job. Comprehensive ACFI training is defined as Aged Care Funding Instrument and it must be taken up before you expose yourself in the actual field.

It is true that constant practice makes perfect results. This principle can be applied in taking up a health course. Of course, you must master your profession because your work is to improve patients' physical condition. You have to remember that the type of your work is seriously important. Although there are difficult things that you will encounter, you can still make it through with proper practice and extensive learning.

ACFI or Aged Care Funding Instrument is not just a program that supports patients financially but it has also other objectives aside from funding. This program also provides healthcare and aged care facilities, useful equipment and apparatuses to the nursing homes and health centers. Because of the broad vision, there are so many things to be learned and understood. Care givers must have enough training and complete comprehension regarding proper facility management. There are rules or policies that need for the staff to abide. It is the welfare of the elderly is the main concern in this kind of service. Healthcare centers, nursing homes, and hospitals should employ well-trained and adept employers in order to have error-free operations.

Moreover, Aged Care Funding Instrument program must be properly documented and monitored by the assigned staff. They must see to it that the funds allocation is correctly done. The elderly residents need not just financial support but an intensive care as well. In order for you to have a deeper understanding regarding ACFI, search for basic user guide over the web.

Managing an aged care facility is not as easy as you think. It needs a group of competent staff in order to successfully manage the facilities, funds, documentations, and many more. Though it seemed to be costly because of the facilities being used, everything is still working out positively. This is because the government and other private sectors help in funding for aged care services.

Do Americans Despise Our Elderly?


A woman from Riverside, California was arrested for elder abuse. She had left her mother outdoors for days facing the elements. The mother was found on a chaise lounge, soaked in urine, covered with feces, and bleeding with bedsores when transported to an Orange County hospital. The 47-year-old daughter was arraigned on felony charges.

In another story, three siblings from Aurora, Illinois were charged with criminal abuse punishable by up to a ten-year prison sentence. Photos of the mother taken at the hospital indicated a three-inch-deep open wound on her tailbone and a right leg that was black from spreading gangrene. The leg had to be amputated. According to the Senior Services Associates, it is estimated that possibly about 76,000 Illinois residents over age 60 are abused or neglected in some manner. However, only about 8,000 victims are reported to the Elder Abuse and Neglect Program annually. Surely such estimates are similar in many other states.

Attitudes have been gradually changing toward the elderly in America for a number of decades. During the 1950s teen icons emerged such as James Dean, Elvis Presley, and others. More and more, television and other media began featuring young actors and less elderly ones. The economy fed increasingly into the quest for the younger markets.

As far back as the late 1700s the idea of mandatory retirement law began to spread. This may have initiated a growing implication that the retired elderly are rather useless. As the centuries passed, the senior was not as highly respected or considered as important to society. In fact, with the passage of time they're often viewed today rather as a drain on the family's resources. As people lived longer, they found the support of family and friends declining instead of growing. Living past seventy has become, for some, a rather bleak prospect-- a time of loneliness, financial struggle, and illness. A researcher named Atchley claims that society and the mass media increasingly lump all seniors under one label, subscribing to the idea that the elderly are "unattractive, unintelligent, asexual, unemployable, and senile." One only has to look at the growing array of derogatory terms about the aged to realize how they are often disrespected: old fart, geezer, battle-axe, old goat, gaffer, etc.

This brings us to the hotly debated final days of a senior's life. Physicians might be called the "masters of death:" they've sanitized death for the survivors. The dying person is separated from the family, sometimes in panic mode, receiving intense medical care until the very end. The senior does not know his/her rights in regard to how and where to die. Doctors often go to great lengths to prolong life, even when it is obvious that the dying is comatose, in great pain, no longer able to think or act. Of course, most doctors are simply trying to do what they think is best, what they think the family wants. And we recoil angrily from the opposite reaction of assisted suicide. But couldn't we allow our aged to die with dignity, in a comfortable place, in the presence of those who love them most? Some forms of hospice care definitely seem a step in the right direction.

Perhaps the baby boomer generation will finally help us to view aging and death in a more proper and respectful way. This generation has now begun to retire but many will still be active for decades to come, some continuing to work until well past retirement. They are largely young-minded and perhaps more adventurous than some generations. They are very well-informed regarding their rights. It is likely many of them will manage their last days in the way that is most comfortable and humane for them and their families. Our seniors deserve to live and to die in the way they wish.

Virtual Teams in Education


The future of business is not in brick and mortar institutions as historically viewed. The proliferation and miniaturization of communications mediums, cellular telephone, fax, Internet, personal data devices, and lap top computers, make offices available where people are – not where the office is.
Carpenter (1998) wrote the internet is more versatile for communication than any medium available today. People can interact with individuals or groups, they can identify by name, pseudonym, or be anonymous. She says the internet is “…a virtual community where people meet, engage in discourse, become friends, fall in love, and develop all of the relationships that are developed in physical communities” (pg. 1).

However, the internet may not be a panacea. The internet goes beyond technology into social interaction. Organizations face a dilemma of encouraging successful interactions and community building online. Statistics suggest almost ten million people work in virtual offices and that 40 percent of large organizations have policies on telecommuting. Yet, Carpenter (1998), cited above, says virtual employment equals only seven to ten percent of the work force.

Why hasn’t the virtual office flourished? Sociologists suggest it is the need for informal interaction – office banter. Organizations are stubborn to accept virtual teams believing team projects work best carried out over conference tables and virtual workers can only participate in individual assignments. Still other organizations believe virtual workers do not receive adequate supervision. However, is the problem supervision or trust?

Kohrell (2005), an adjunct professor at Bellevue University, is president of Technology As Promised. He is a specialist in developing virtual teams and addresses developing trust on virtual teams. He explains virtual trust in simple terms. Virtual trust is getting on an airplane, not knowing the air traffic controllers, yet trusting they are doing their jobs correctly. He explains building virtual trust through communication – frequently, with integrity, with certainty and predictability.

Other data, taken with Kohrell’s, also supports the economics of the virtual office. Verma (2005) offers some information that shows senior executives from Europe, Asia, and the Unites States report cost savings (69 percent) and increased productivity (64 percent) when using telecommuting. Verma cites comments of Joe Roitz, AT&T. Roitz said, “Telework alone generates over $150 million annually in productivity increases, real estate savings, and enhanced retention for AT&T.” These statistics suggest business recognize change and develop strategies for successful change.

Tucker, Kao, and Verma (2005) write there are trends in employment that organizations cannot ignore. One point they make is the work force globally is getting smaller. They also recognize that cultural norms are different now, more loose. Adding to the mix is more freedom for people to move globally. They point out there are personnel trends that organizations can count on
1. Smaller and less sufficiently skilled

2. Increasingly global

3. Highly virtual

4. Vastly diverse, and

5. Autonomous and empowered

They conclude that leadership focus within these trends “demand a new generation of talent management.” This new talent management has to take some strategic steps to manage the new work force in future oriented organizations. Those steps are:

1. Predictive Workforce Monitoring and Strategic Talent Decision Making

2. Flexible and Anticipatory Talent Sourcing

3. Customized and Personalized Rewards and Communications

4. Distributed and Influential Leadership

5. Unified and Compassionate Cultures

Computer-mediated Communication (CMC)

It is important to discuss CMC as virtual workers depend on – rely on – computer-mediated communication. Jones (1998) cites Patton (1986) in discussion about highway building as a means to connect people to one another. Patton observed that highways have not connected us rather increased our sense of separateness. Cities are divided, neighborhoods split, city intimacy destroyed. From this negative view, Jones concludes the internet may actually do what highways failed to do
Computer-mediated communication, it seams, will do by way of electronic pathways what cement roads were unable to do, namely, connect us rather than atomize us, put us at the controls of a “vehicle” and yet not detach us from the rest of the world. (pg. 3)

CMC offers new realms for social scientists to study. Traditionally, social scientists observed communities within certain identified boundary. However, new cyber societies exist without bounds and determination of membership in cyber society does not satisfy traditional categories given community.

Education in Cyber Society

What does this mean in terms of education? The United States Department of Education (US-DOE) provides a look into higher education statistics for twelve months 2000 to 2001. US-DOE figures from that period show 56 percent (2320) post-secondary two- and four-year schools had online courses. Another twelve percent desire to go online within the next three years. Finally, 31 percent said they would not go online. Clearly, two-thirds of colleges and universities have or want online educational opportunities for students. What does this mean for faculty? The following paragraph addresses that question.

The Higher Learning Commission accredits Bellevue University in Nebraska. It has an online presence offering 17 undergraduate degree completion programs online and 7 graduate degree programs online. The College of Professional Studies (CPS) of Bellevue University administers all of the undergraduate degree programs. CPS administers three of the seven graduate degrees, MBA and Master of Arts in Management reside in the College of Business, and MS Computer Information Systems and MS Management of Information Systems reside in the College of Information Technology. Although the College of Arts and Sciences administers no online degrees, it does administer several course clusters and individual online courses. Therefore, Bellevue University is an example of an institution highly oriented to the online student.

Online, mostly adult learner, students equal approximately 40 percent of the University population. Bellevue University also has both traditional four-year campus students and non-traditional in class adult learners making up the rest of the University student population. A boast made during the 2004/2005 academic year was that Bellevue University has students in all 24 time zones around the world and the North and South Poles.

CPS accounts for the largest number of faculty members. Of CPS faculty, about 150 are adjunct and one-third of those are faculty members at distant locations teaching online (information provided the Assistant College Administrator).

However, this is not unique to Bellevue University. A web search of colleges with online offerings returns dozens of institutions. Narrowing a web search to fully accredited schools with online offerings returns numerous hits. Well known in the online arena are University of Phoenix, Capella, Nova Southeastern, and Walden. Among these, University of Phoenix is very aggressive in both student and faculty recruitment. It is not unusual for students to transfer between online schools searching for lower tuition rates and/or more liberal credit transfer policies. In addition, it is likely an adjunct professor may instruct in multiple universities.
Online Faculty Interviews

Of the about 50 online distant faculty members at Bellevue University, five responded to invitations for phone or email interviews. Another interview with an online adjunct that lives in the Omaha metro area serves to validate other faculty comments. One distant faculty member does teach at two other institutions, one online, and one face to face. Finally, I will submit personal observations, my experiences, as an online adjunct, face-to-face instructor and one that taught in multiple institutions.

All those interviewed were unanimous in answering why they are adjunct college professors, they like teaching. The responses varied from “I like sharing what I’ve learned,” to “It is fun to see, through their postings, how they (students) grow and change over the year period of a degree program.” To follow up, they answered teaching online is new to them, an interesting way to link students, and a way to connect people geographically separate for a common goal (education).

One interviewee, a medical doctor in Indiana teaches healthcare administration at Bellevue University to “stay connected with nurses and other medical administrators. A hard lesson for doctors to learn is they don’t run anything.” In addition to teaching at Bellevue University, he developed a course adopted into the Master of Healthcare Administration in CPS. He shared that he also is a mentor for third and fourth year medical residents working to pass their medical boards. He does not teach in this role, rather facilitates medical residents’ leaning and board preparation. He related that this role requires developing a trust and trusting relationship between him and his mentored doctor. He said he always begins the mentoring relationship in a face-to-face environment before moving it to telephone or email. He told that teaching online and handling student problems and misunderstandings is much less trying than mentoring new doctors.

The local interview, conducted in person, was with the executive assistant to the university president. He used to teach in the classroom; however, schedule demands took him out of class. Teaching online lets him keep his connection to students while maintaining a busy travel schedule.

When asked why they applied to teach at Bellevue University, the answers ranged widely. One instructor, an Army retired Chief Warrant Officer, began teaching a year after graduating with a master degree from Bellevue. The university approached him rather than him initiating an application. Another, now teaching at the Atlanta campus of the University of Georgia, and previously at the U.S. Air Force Academy, applied to Bellevue because of the University’s close ties to military students. One respondent is an empty nester, disabled from her nursing profession, and wanted to stay active pre-retirement. There was not a consistent answer to this question except when tying it to their enjoyment of teaching.

All those interviewed are online instructors, therefore, virtual to their students. All reported using email and telephone as primary communication devices with their students. Additionally, they all use the Bellevue University Cyberactive® learning environment powered by Blackboard to conduct classes. They reported highs of 40 percent and lows of ten percent use of email for student communication. All reported using the telephone to contact students; however, telephone use was a low five to ten percent. Low telephone use is not unexpected considering the worldwide locations of BU students.

Probing deeper, email use is actually higher from instructor to student. Within the Cyberactice® environment there is a tab titled “Communication.” Within this link is an option to send an email to all or select users. All adjuncts confirmed this option is the choice they use to send messages to individuals, select groups, or an entire class. When probed, instructors agreed they use this email option regularly. After another query into percentage of communication by email using the Cyberactive® email option, instructors replied their email communication is higher, up to 50 percent. It is important to clarify that instructors did not directly associate email in the Cyberactive® environment with other email engines.

There were very broad concerns expressed by the interviewees and all were technical, from needing more technical support to wanting less technical support. This question needed more clarification. The respondents confirmed their meaning of technical support as surrounding the electronic classroom. Although all online instructors must complete the Online Facilitators Course, four of the five realized their attention to it was not the best possible. Challenged for why the four did not participate more in the facilitator course, they admitted to “filling a square” to teach online. All replied there are times when they all call or email the Cyberactive® Help Desk for assistance.

Another unanimous concern was how well prepared students are to enter an electronic classroom. Each respondent related at least one story of a student ill prepared to study online. Instructor receives a profile of each student in class, therefore a follow up question on student age suggested age was less a concern than students’ career and regular use of computers for email, topic research, and understanding of inter- versus intra-net.
Feeling as Part of a Team

The adjuncts all feel they are part of a work team. Specifically, they felt part of their work team, part of the Cyberactive® classroom group, but not closely connected to the University. The reason given is distance from the physical location – Bellevue, Nebraska. They did report steps taken by the College of Professional Studies as helping them become more connected. One example they all like is the weekly email of the campus bulletin, another is periodic email messages of faculty development seminars. Faculty development seminars are now video taped, converted to digital media, and available in streaming video online or DVD format mailed.

Supporting some of the research reported earlier, the respondents felt disconnected from the University and more connected if they could make trips to the campus, meet with program directors, deans, and fellow faculty members. Clarifying this point, they did not feel under supervised, rather did not feel a personal (personally) connected. An expectation was that those now adjuncts who were Bellevue University students would feel more connected. While the former students felt more connected, they too did not feel a close bond.

The discussion moved to questions of leadership. Specifically asked was how well do they know (know of) the University leadership team. All knew names and positions of the president, provost, deans, and program directors. They did not know any of the names associated with positions of senior administrative people and senior people outside their particular college. Asked if they knew any names of board members, each knew U.S. Senator Chuck Hagel is a board member. Others knew names of benefactors thinking they were board members.

Tying the interviews together, the discussion turned to specifics of communication. The focus at this stage was the level of interdepartmental communication compared to intradepartmental communication. Those interviewed commented that intradepartmental communication was good. Adjuncts knew, through email and/or telephone communication, their program director, some or all the department faculty. All reported a lack of knowledge outside their program area. An adjunct in healthcare administration is unlikely to cross-communicate with faculty from management or leadership. An instructor in business administration will not know anyone teaching in human resources or security management. Distant adjuncts in the College of Professional Studies seem isolated from faculty members of other colleges. Generally, faculty members in one college do not teach in other colleges.

The interviewees made recommendations to improve communication ranging from more email communication to making trips to the campus to meet the staff. Trips to campus from distant locations seemed impractical from a cost aspect because such a trip would not be at university expense. Asked how to improve electronic communication, all agreed more is better. Citing an example of missed opportunity, they said the university produces a faculty roster and places it on the server “shared drive.” However, distant locations do not have access to the internal system.
Personal Experience

Stated early in this paper, I am an online adjunct but live in the community the university calls home. This gives me a different perspective because I can personally interact with instructors from different colleges and programs. After five years in administration as a graduate enrollment counselor, I developed personal networks with many senior program directors and deans. For nearly the same period, I was an adjunct, first in the College of Arts and Sciences and now in CPS. I taught Organizational Communication in a face-to-face classroom and Leadership online.

Validating the interviewees’ comments, communication to adjuncts has been limited. One limiting factor was the capability of the university email server to support several hundred email addresses. This problem is resolved with the installation of a new larger email server. Another limiting factor was not all adjuncts had a “(name) @” university email address. An initiative of the Quality Council was requiring all adjuncts have an internal email address and remote access to the email server. This initiative is now complete with separate distributions for “all campus,” “all adjuncts,” and “all (college specific) adjuncts.”

An advantage to being an online adjunct in the same community where the university is located is proximity. With proximity, there is access to many in leadership positions and interaction with peers. A closer connection with faculty peers allows a support system to develop face-to-face that a distant adjunct cannot as easily develop. Proximity allows faster communication and reaction to communication. Closeness permits attendance to faculty development live rather than streaming video or DVD.

While the advantages of proximity seem favorable, there are some downsides. There are greater expectations that a local adjunct spends time on campus when there primary job allows. The faculty resource center offers an adjunct an office environment where one can have the office time expected. College meeting attendance by local adjuncts is not mandated; however, it is more favorable to attend. Those operating at a distance desire to attend meetings and cannot have it.
Conclusion

The interview process with adjunct instructors working at a distance offer supporting data to the statistics reported earlier in this paper. The adjuncts interviewed are part time virtual employees who feel less a part of the University team than someone local. They reported incomplete communication with and knowledge of many key leadership people.

Communication seems the center of disconnect. The Academic Quality Improvement Process also recognized this problem and implemented institutional change to tie all members to campus life. Although more effort is underway for broader communication, distant employees do not have access to local systems through remote means.

Considering these elements and considering the U. S. Department of Education’s statistics, online education is likely to flourish. Bellevue University attracts students from around the world with many of them earning degrees online from their home countries.

Despite the drawbacks, virtual professors as virtual team members are successful at Bellevue University because of the expressed desire to teach and watch their students grow and learn. The professionalism and expertise these professors exhibit in the online community of students supports the data from industry executives indicating improved productivity and cost savings.

Pfeffer (1998) identifies the use of sub-contractors in the work force. Adjuncts are sub-contractors. The adjuncts serve in non-traditional ways contrary to how professors previously served. It is apparent that education is no different from other industries using virtual workers. Virtual workers, like temporary workers, feel less connected – not given the same level of training.

In interview, establishing trust was critical to two adjuncts. In-person trust is much easier to develop than in virtual relationships. Bell (2002) says trust is a leap of faith and places trust below truth, “… caringly frank and compassionately straightforward… in pursuit of clean communication” (pg. 9).

An indirect conclusion from the interviews highlights that mentoring a virtual adjunct may help develop a sense of team participation through greater knowledge and understanding of the institutions vision and values. By developing greater emersion into the vision and values of the system, adjuncts may want to be more aware of those people filling leadership roles. Successful virtual workers need the same assistance and opportunity for growth as the worker inside the brick and mortar institution.

References

Bell, C.R. (2002). Managers as Mentors: Building Partnership for Learning (2nd edition). San Francisco, CA: Berrett-Koehler Publishers, Inc.

Carpenter, J. L. (Fall Semester 1998). Building Community in the Virtual Workplace. Online at http://cyber.law.harvard.edu/fallsem98/final_papers/Carpenter.html

David Kohrell (personal communication, September 18, 2005) noting virtual team performance.

Jones, S. G. (1998). Cybersociety 2.0: Revisiting Computer-Mediated Communication and Community. Thousand Oaks, CA: Sage Publishers.

Kohrell, D. (2005). Effective Virtual Teams [PowerPoint presentation]. PMI North Carolina: Technology As Promised.

Marilyn Urquhart (personal communication, October 3, 2005) noting total number of adjuncts and number of adjuncts teaching online from distributed locations.

Pfeffer, J. (1998). The Human Equation: Building profits by putting people first. Boston, MA: Harvard Business School Press.

Tuker, E., Kao, T., and Verma, N. (2005). Next-Generation Talent Management: Insights on How Workforce Trends are Changing the Face of Talent Management. Business Credit 107, 7. 20-27.

U. S. Department of Education (2001). Washington, DC. Online at [http://www.usdoe.gov].

Verma, N. (2005). Making the Most of Virtual Work. WorldatWork Journal, 14, 2. 15-23.