Marketing to Senior Citizens - Health and Fitness, the Growing Trend Amongst Seniors

Today seniors can't afford not to get moving! With all the hype around nutrition and exercise the aging population is well aware of the benefit of an active lifestyle.

Most seniors of the 55 plus group are keen to reap the rewards of healthy aging through a variety of activities. They are not newcomers to the gym so to speak. Most have kept active with some form of physical activity throughout their lives, whether it is hardcore workouts in the gym or a congenial round of golf on a summer's afternoon. Women of this age group have also managed years of multi-tasking, most having juggled full time careers, while raising families and still found time to fit in some form of exercise. These women became well acquainted with aerobics, step classes, strength training and power walking. Also, stress relievers such as yoga and pilates were embraced to combat tension and fatigue. In many cases these activities were their salvation of an overly busy lifestyle.

It is only natural then, that these baby boomers are looking to continue their active lifestyle into retirement. Quite possibly, with the time constraints lifted at this stage in life, it leaves them to focus more sharply on their health and wellness.

A huge opportunity exists for gyms and programming facilities to cater to this senior market. The number of seniors is set to skyrocket in the next five to ten years and if gym operators are to jump ahead of this curve, they should set their marketing sights on appealing to and attracting this demographic.

How to go about this? What are seniors looking for when it comes to staying fit? Firstly it is important to see a visual image that they can relate to. Marketing success is all about seeing yourself in the picture, being that person who is strong, fit and beaming with energy. If a beautiful twenty something image is smiling back, then age becomes a handicap in the mind of the senior, derailing their good intentions, making them feel like they can't compete. The perfect image that will empower the market they are trying to impress is an attractive fit senior pursuing the exercise of his or her choice. An ad such as this will pop with the 55 plus market, creating a role model with whom they can immediately identify and connect. Seniors like everyone else need to be able to put themselves into that ad campaign and honestly believe that it could be them looking out. This puts the wheels in motion for a positive mindset and a "can-do" attitude.

Seniors are only as old as they feel. Once again we come back to the mind-set, which is a very powerful tool. Boomers today are constantly fighting the aging stereotype that has depicted seniors in the past. Seniors in their sixties often look, act and feel ten to fifteen years younger than their actual age. Advertising should play up to this pretense which promotes this healthy reversal known as "turning back the clock".

Another means of promoting fitness is to educate the senior who wants to get moving and who wants information as to how this will benefit them and enhance their life. They need to know the positives, what they can expect, and can look forward to as a result of embarking on the fitness journey that the marketer proposes. The campaign needs to encompass every aspect of their life, proving that properly presented, seniors will understand that an opportunity to change is being offered which will impact and alter their lifestyle. It's within their reach, all that remains to be done, is to get out there, set realistic goals with realistic time frames and make it happen.

This brings us to another point. Marketers should focus on the enhancement of senior life overall, as a result of engaging in exercise and activities, rather than the promise that, if you join up you will achieve this enviable body or snag that hot date. The quality of life and the heightened enjoyment of everyday activities which seniors can have as a result of exercise need to be highlighted.

Marketing programs should also contain testimonials and feedback from actual seniors delighted with their progress and accomplishments, similar to that of "before and after stories of weight loss". Seniors want to hear how it has enhanced and changed other people, who are just like themselves. They want to hear the successes, for example, how exercise lowered blood pressure, how strength training enabled other seniors to do more, how medication was reduced, how endurance was stretched. It all gives the feeling that anything is possible, if they can do it, then I can as well. It sends a message and an incentive to become a joiner.

Seniors often prefer to sample a program on a trial basis to see if it's going to be the right fit for them. Offering special programs geared to this group is smart when limiting them to one or two classes. Fitness activities can be offered at many different types of senior living facilities. Places such as retirement communities and nursing homes already recognize the need and benefits of fitness and nutritional programs. Approaching these senior residences is an effective strategy of marketing to large groups of seniors. There are also many senior assisted living residences that do not have organized fitness classes or programs in place yet, but they will soon. Visit these places and offer a free class or program, if these programs are successful you will know that this appeals to seniors and if the need is strong enough to continue. This will help to target the senior market, zeroing in on what works and what doesn't.

Marketers of fitness need to alter their sales approach to seniors. This age group is not impulsive and will appreciate a thorough, softer sell approach. Seniors need and want information and prefer patience. This in turn builds trust, instilling confidence in the senior contemplating buying a membership. It basically reaffirms that they are doing the right thing in taking this first step to join.

Seniors as consumers hold certain expectations that need to be met for fulfillment. As part of the packaging of the programming, seniors also need and crave socialization and to be part of the group. They need leadership, to have an instructor to safely guide them through the program, with an eye to protecting them from injury and awareness of ailments like arthritis and osteoporosis in the participants. They look for convenience, with minimal stairs and easy entry, or even better brought to their home. Lastly they want value and attention, to feel like they are progressing and that their state of well being is something that is noted.

As with any market, the sales approach needs to be geared to their age defined needs and preferences. In the year 2010 and in the coming years the greying of the boomers market will keep growing by leaps and bounds. There will be an even greater emphasis on slowing the effects of aging and possibly the reversal through movement and exercise. This, the marketers realize is what it's all about at any age. Seniors, like everyone else, want to maintain a high quality of life and that definitely includes exercise to make it happen.

Decisions For Elderly Home Care

In the early 1900s, elderly who were unable to care for themselves, became a product of an Almshouse, or a poor farm. The poor farms began as a place to house paupers who were caught in the act of stealing. Eventually the under privileged were placed in the same facilities with those who had stolen. The poor farms were improperly furnished for elderly home care and many of the old people died due to unfavorable conditions and poor nutrition.

In the 1930s President Roosevelt signed a bill into action for the elderly to begin receiving Social Security, those who were already registered into the homes for the indigent would not, be eligible for the payments. Soon after payments began for those who were eligible, homes began opening to supply better treatment to the older folks. The proprietors took the checks from the elderly to pay for their upkeep.

In the fifties, the government stepped in and ordered that the homes were not to take the Social Security payments from the residents, leaving them with nothing. However, the care did not change, and the elderly fell at the mercy of the government.

In the Sixties, a law was passed that prohibited the low level of care people were receiving in nursing homes. They also stopped the fraudulent activities taking place in the majority of homes across the nation.

The nursing homes are not longer a welfare source who provides care to the elderly and strips them of their lives earnings. They are at present considered to be a part of the health care system, and must follow the same standards as hospitals are required to do.

The government has of recent years, restricted the homes from taking advantage of the patients income. The facilities are only permitted a percentage of the gross earnings. However, many of the nursing homes simply raise their prices for rooms in order to obtain more capitol.

Modern technology, therapy rooms, doctors office on the grounds and beautiful landscaped areas for the patients view. Yet, behind the entrance doors, some of the same treatment given to patients on the poor farms happen today. Malnutrition and abuse rank among the highest degree in homes across the country. Patients are afraid to speak out for fear of more abuse. The homes are understaffed generally, the caregivers are tired and overworked, and often take their revenge out on the patients.

For the elderly to remain in their own homes often times is impossible. For their own safety they require around the clock care. It is often difficult to utilize family to administer care, as usually the task falls solely on one family member who eventually becomes overly stressed. Around the clock professionals cannot be afforded for many, thus, the nursing home seems the only answer. Elderly home care is a very important issue. The older generation who once labored and made a way in life, now needs proper care and attention. Often times placing them in a care facility is the only resource, but many are placed in such places and forgotten.

Assisted Living Marketing Should Place The Consumer's Value On Services

Do You Fully Appreciate Your Own Services?

Management and staff members in assisted living repeatedly tell me how good they are at caring for seniors. However, their marketing often does not communicate that viewpoint in a way that the consumer needs to hear it.

For example, in a recent "Talk'in About Care" training session attended by representatives of many facilities, I asked the group if giving out medications to their senior residents was an innovative service. People hesitated and looked at one another. Finally, someone said they didn't think so, and that became the consensus of the room. The reasoning - common, expected, nothing special.

The logic seemed to be that if everyone in assisted living is giving out meds (and hopefully, they all do it very well), it would not be important to the consumer? So this "everyday" professional specialty is normally listed among services, but seldom highlighted.

The Eyes Of The Beholder

I then brought it to the group's attention that I just read an article in McKnight's Long-Term Care News that stated "Older adults make more than half of all trips to the emergency room for adverse drug interactions." My students were not surprised to hear this and agreed that it is a major concern for seniors and their family members. So my conclusion to them was that they have a target market that places a high value on a service they provide. At the same time, they feel it is a very important (but common) service and are proud of how well they provide it, yet they still undervalue this service...and neglect to claim its marketing advantages.

Common Marketing/Communication Mistakes

Assisted living companies and staff members often communicate value in their terms. This can lead to their target markets not understanding and/or relating to the message that is given or the value of the service being offered. Here are four mistakes that senior care providers frequently make.

1. Highly value what they do from an industry insider viewpoint. This tends to over value a service and/or not connect well with the consumer. Example: The salesperson raves about how their facility is just like home, while the prospect looks around and sees little similarity to their three bedroom, 2 bath home that is filled with 25 years of memories and provides feelings of comfort.


2. Undervalue what they do because they do it every day and take its benefits for granted. Example: Give out meds with set procedures that include checks and balances, but do not highlight a 10 Point Medication Management Program that is in writing and on their website.


3. Neglect to utilize a service they already provide to address an important issue of a target market. Example: Offer exercise and stretching classes, but do not relate or highlight how these services help those with arthritis to maintain or improve grip, balance and/or flexibility.


4. Neglect to package services together that they are already providing to address an important issue of a target market. Example: Sticking with the arthritis example above, do not promote an Easing Arthritis program even though they offer exercise and stretching classes, along with providing a menu and nutritional supplements that decrease inflammation, ice pack therapy, massage of stiff joints and medication management.

Speak Their Value, Increase Move-Ins

Value in assisted living must absolutely start with the management and staff. However that value must be communicated to the consumer in a way that makes sense to the end user/caregiver/decision maker and will be seen as resolving their issues. Three ways to accomplish this are:

1. Providing innovative services that are seen as valuable to your target markets.


2. Packaging services and amenities into programs that address the needs of target markets.


3. Target and serve niche markets that have specific needs that match the benefits of your innovative services and programs.

When the consumer values an innovative service (or package) that addresses their need, the providing facility gains a selling advantage. In addition, that service often becomes a measure of comparison. So in the example above, facilities who do not offer their version of an Easing Arthritis program on their website and/or on their tour are immediately put at a competitive disadvantage.

These services do not have to be new (although new services can be a huge plus). They just have to provide important benefits to those who need them. Then work hard to improve your communication of that (consumer) value...and train your staff to relate that value. By doing so, recognition and referrals will go up, decisions will be made faster, and your move-ins will increase.

Pursuing a Workers' Comp Claim After MRSA Exposure

You may associate MRSA with just hospitals, but there are actually two different categories of MRSA-hospital-associated and community-associated. While healthcare workers are at a higher risk than most other occupations, the nature of the infection means any workplace could be a breeding ground for this common infection.

If you or a loved one has contracted MRSA, you should consider the possibility that the infection was contracted at work. MRSA only has a span of seven to ten days between infection and noticeable symptoms, so it should be relatively easy to track down if work was possibly the site of infection. If you were infected at work, you may be eligible for workers' compensation benefits for the time out of work and associated hospital bills.

I'm a healthcare worker with MRSA

While health care workers take considerable efforts to protect themselves from MRSA at work, the bacteria is becoming more and more pervasive in US hospitals, making it harder to avoid. Infection can still occur and healthcare workers have the right to file for worker's compensation.

Some states provide workers comp protection for healthcare workers, assuming that the infection was picked up at work and making the burden to prove otherwise fall on employers rather than employees. If you are a healthcare worker who has contracted MRSA, you should consult your state laws or a workers' compensation attorney.

I'm not in the health sector, but I think I picked up MRSA at work

But what if you don't work in the healthcare field but still think you got MRSA at work? You may still be able to receive workers comp for your injuries, but it may be more difficult to prove. There are several MRSA scenarios that could qualify for worker's compensation:

繚 You have a job with a lot of customer contact and the area where you work is not cleaned frequently enough.

繚 You suffered an injury on the job that led to a MRSA infection. For example, your job required you to move a sheet of metal. You were cut by the metal and subsequently developed a MRSA infection at the site of the cut.

繚 Your job required you to use certain equipment, such as steel toe boots or safety googles, and this equipment use led to MRSA infection.

If you attempt to file a worker's comp claim with your employer, it is likely the claim will be dismissed-your employer may say where you contracted MRSA cannot be proven or that you likely picked up MRSA elsewhere. In a case where the employer initially denies your claim, it is in your best interest to contact an attorney who specializes in workers' compensation and knows the workman's comp laws in your state.

MRSA is an infection that can affect you for the remainder of your life and regardless if you picked up MRSA while on the job in the hospital or on the job in the customer service department, you deserve workers' compensation. Talk to a workers' compensation lawyer as soon as possible to discuss your claim.

Home Health Aides and Personal Care Aides - Growing Career Opportunities

If you enjoy having a personal relationship with a person who needs your help, then perhaps you should explore a career as a home or personal care aide. Imagine the rewarding feeling you'll have when you assist an elderly or disabled person to lead a happier and healthier life.

Many people who are disabled, elderly, or ill, can continue to live in their own homes or in residential care, rather than in health care facilities or institutions. Home health aides and personal care aides work with clients who do not require an institutional health environment, but need more extensive personal and home care than family or friends can provide.

Some home and personal care aides work with discharged hospital patients who have relatively short-term needs, or with families in which a parent is unable to provide care for small children. Home and personal care aides do not provide medical treatments or assistance-that's handled by nursing, psychiatric, and home health aides.

What tasks do home health aides and personal care aides perform? They may clean clients' houses, do laundry, and change bed linens. They may also provide housekeeping and routine personal care services, and may plan meals, shop for food, and cook. Aides also may help their clients perform everyday tasks such as getting out of bed, bathing, dressing, and grooming, and may escort their clients to medical appointments or on other errands.

What's the career trend? The number of elderly people in the United States is growing. Inpatient care in nursing homes and hospitals can be very expensive, and so to keep costs down, patients often return to their homes from these facilities as quickly as possible. Elderly and recovering patients who need assistance with household chores and everyday tasks can often reduce their medical expenses by living at home. In addition, many people requiring care prefer to live in a familiar home environment, and may recover more quickly at home than in an institutional setting.

What kind of training do you need? Requirements vary state by state. Many states require formal training, which is available from community colleges, vocational schools, elder care programs, and home health care agencies.

Home health aides generally work for agencies that receive government funding, and so are required to comply with government regulations and work under the supervision of a medical professional. In contrast, personal and home care aides work for a variety of non-government-funded agencies and may perform their tasks under the supervision of a social worker or other non-medical professional.

The National Association for Home Care and Hospice (NAHC) offers national certification for personal and home care aides. Certification requires the applicant to master 17 skills for competency as assessed by a registered nurse, to complete a 75-hour course, and to pass a written exam developed by NAHC.

Check out the schools on a reputable career college directory, and you're sure to find one offering the program you need to prepare for a rewarding career.

How's the job outlook? There's very good news! According to the U.S. Government's Bureau of Labor Statistics, between 2008 and 2018 employment of home health aides is projected to grow by 50 percent, which is much faster than the average for all occupations. This occupation will be amongst the occupations adding the most new jobs, growing by nearly 461,000 jobs.

If you're looking for a career that allows you to help people feel better and lead happier lives-but without being involved in providing medical treatment-then training to become a home health aide or personal care aide may be perfect for you.

Are Nursing Homes Like Jail?

You've probably never heard of Charles Todd "Bud" Lee, although he was an award-winning photojournalist whose work has been published in "Life" magazine, "Esquire," "The New York Times Magazine" and even "Rolling Stone." His photo of a bleeding 12-year old boy in Newark, New Jersey, who'd been caught in the crossfire of a police shooting, graced the cover of "Life" magazine in July, 1967. Almost exactly 16 years later, however, Bud suffered a stroke that left him semi-paralyzed and landed him in a Florida nursing home.

It turns out that Florida law requires nursing home care for Medicaid recipients, rather than allowing them to live wherever they choose. Bud is still there, in the Community Care Center in Plant City, Florida, an involuntary resident, more than five years later--and he's really angry.

Last September, Bud's plight caught the attention of Matt Sedentsky, a writer for the Associated Press. Sedentsky's subsequent September 21st article, arguing that Florida nursing homes, fearful of losing money, have successfully pressured politicians to make such alternatives as in-home health care difficult for Medicaid recipients to obtain.

He reported that Bud Lee has filed a lawsuit in federal court on behalf of the approximately 8,500 Floridians who are similarly institutionalized. As Bud succinctly described his situation, "Most of the people come here to die, so you want to die. It is a prison. I can't escape it."

A recent study found that seniors fear moving into a nursing home and the loss of their independence far more than death. Indeed, according to the study commissioned by Clarity and the EAR Foundation, fully 89 percent of America's elderly want to age in place, and will use adaptive technology to stay independent. Their Baby Boomer children, the study noted, are equally concerned about nursing home care for their parents, and they're eager to support their parents in this quest.

More than one-quarter of the study's respondents cited as a fear a loss of independence, which is closely aligned with the fear of nursing homes. Moving from their home into a nursing facility is a fear of 13 percent of seniors, while a mere three percent of research study participants identified the fear of death.

These fears appear to be justified. A recent report by the Department of Health and Human Services found that about 17 percent of nursing homes had deficiencies that caused "actual harm or immediate jeopardy" to patients, including infected bedsores, medication mix-ups, poor nutrition, and patient abuse and neglect. In fact, approximately 20 percent of the complaints verified by federal and state inspectors involved abuse or neglect of nursing home patients.

Last May, the 18,000 residents of Albert Lea, Minnesota were shocked to learn that 15 residents of the Good Samaritan nursing home, all suffering with Alzheimer's or dementia, had been verbally, emotionally and sexually abused by local high school girls who were working at the facility. The subsequent report by the Minnesota Department of Health quoted one employee as saying that "When (the students) would do these things, they would pull the curtain enough, so when they heard a door open, they could stop. They were quite sneaky about what they were doing. The ones they were targeting were those that have Alzheimer's so bad, that they wouldn't be able to say it or remember."

The report found that the abuse involved spitting and putting fingers in mouths, poking breasts and nipples, touching and tapping genitals, sticking buttocks in faces, rubbing buttocks and penises, anal insertion, and restraining residents and teasing them.

Following investigation by state and local authorities, a 19-year old and an 18-year old were charged with gross misdemeanors, carrying a maximum penalty of one year in jail and a $3,000 fine for each count. One of the teens faces 11 charges; the other, 10, including abuse of a vulnerable adult by a caregiver, abuse of a vulnerable adult with sexual contact, disorderly conduct, and failing to report suspected maltreatment. Four of the others, all 17 at the time of the alleged abuse, were charged in juvenile court with failure to report maltreatment.

More than 1.5 million people live in the nation's 15,000 nursing homes, which are typically inspected annually. They are required to meet federal standards as a condition of participating in Medicaid and Medicare, which cover more than two-thirds of their residents, at a cost of more than $75 billion a year.

Although there are obvious acts of nursing home abuse-long-term over-medication, for example--others are more subtle, or as in the Albert Lea situation described above, difficult to detect because of the dementia of the patient. Consequently, these cases can easily be overlooked by family members. Following are some indicators of abuse:

Bedsores or open wounds are common instances of neglect or abuse. Nursing home personnel often claim that bedsores are normal among frail or immobile seniors. Unfortunately, concerned family members are duped by these explanations, and their parents and loved ones suffer pain and sometimes die from these sores. Experts say that almost all bedsore cases are caused by abuse or neglect. Guidelines require nursing homes to move patients regularly and ensure that sheets and clothing are kept dry. Should a family member find a bedsore, insist that the victim is moved to a medical facility for treatment.

Unexplained bruises, cuts, burns or fractures are often evidence that residents are being dropped or abused by staff personnel. This often occurs when the senior is in a medicated condition. Family members are urged to ask questions to get clarification about these situations, and vague or questionable responses often indicate abuse.

Torn, bloody or stained garments are the best evidence of sexual abuse, which, as described above in the Albert Lea story, frequently occurs in nursing homes, where victims are often medicated or suffer from Alzheimer's or dementia. Refusal to allow contact with a resident, or unexplained delays in making the resident available for a visit, indicate underlying abuse, that is, the nursing home staff is attempting to intimidate or prevent the victim's reporting of the abuse or neglect.

Modifications to the resident's financial documents, including wills and trusts, are cause for suspicion, particularly if these changes occur abruptly or if the resident cannot adequately explain why they occurred. Such changes suggest that the resident may have been coerced or threatened.

Each of these warning signs should spur action among family and friends, including reports to police. Suspicions of sexual or physical abuse require changing nursing facilities, as well as police involvement. Nursing home residents, who are frequent targets of abuse, nonetheless have civil rights that need to be protected, most often, unfortunately, by concerned family members and friends.

Duties of a CNA in Nursing Homes

There are many different duties of a CNA in nursing homes. You will keep quite busy throughout the day if you are working in a continuing care community. If you are a CNA working in a nursing home, you will help residents with a variety of different needs. The type of tasks that you complete throughout the day can vary depending on which wing of the nursing home you are working on. No matter where you are working, you will always do all you can to provide kind and compassionate care to your patients.

There are many patients in a continuing care community who need assistance walking or who need to me moved in a wheelchair from their room to the dining hall, activity room and other areas. Some residents will need help eating and with other activities of daily living. When working as a CNA in a nursing home setting, you will most likely be required to bathe many of the residents.

Some residents will need assistance with toileting. There will be residents who need to wear adult diapers and who will need to be changed. You will always help a patient to maintain their dignity. When working with patients who are not able to move on their own, you will reposition them in their bed every couple hours to prevent bedsores.

If you are working as a certified nursing assistant, you will help residents with their grooming needs. There are some residents who you will help to brush their teeth, comb their hair and to put on makeup. Some men will need your help to shave or will need to be shaved. You might be asked to paint a lady's fingernails or help to style her hair.

You might be responsible for changing a resident's linen on their bed or even to do some light cleaning in their room if you are working as a nursing assistant. You will be apprised of your exact duties in regards to housekeeping when you are hired for employment.

As a CNA, you might be asked to help to oversee a patient's exercises. If a patient is able to exercise on their own, you can watch them go through their range of motion type exercises. You will be there if they have a problem or need some assistance while exercising. This is not something you will take upon yourself to do but rather only as directed by your supervisor.

When you are working as a nursing assistant in a nursing home, you might take vital signs. This could include monitoring blood pressure and temperature. You might be asked to chart a resident's intake of food and liquids. In some cases you might even help to monitor blood pressure readings. If a patient is ill or injured, you will need to follow your facilities procedure for reporting their ailment and getting them the help that they need. When you are hired for employment at a nursing home, you will be provided with details on your specific duties.

7 Reasons to Become a Home Health Aide

A home health aide (HHA) provides caregiving services that allow patients to remain at home as opposed to being cared for in a medical facility. HHAs deliver basic caregiving services such as monitoring a patients' vital signs and medication schedule, preparing meals, personal grooming, light housekeeping, and companionship.

It can be a demanding job, and for that reason the turnover tends to be high. So why would you want to pursue such a career? Here are seven reasons this career may be right for you.

1. Job Growth

As baby boomers age, it is expected that more and more elderly will opt to "age in place," staying in their own homes, for as long as possible. This is driving demand for caregivers to deliver services in residential settings, assisted living environments, and adult day care programs. The U.S. Bureau of Labor Statistics rates the job outlook for home health aides as "excellent." In fact, it's the second-fastest growing occupation in the U.S. (following that of registered nurses).

2. Job Benefits

The job often comes with benefits such as paid vacation and sick time, medical insurance, disability insurance, and retirement programs. Benefits do vary by employer, however. Some employers offer only some of these benefits, others may offer no additional paid benefits but may provide access to employee-paid benefit programs.

3. Flexible Schedule

Home health aides perform duties that are required on a variety of schedules. This means you are frequently allowed the option for a flexible or non-traditional work schedule. For example, you may visit a client in their home daily, weekly, or on some other schedule. You could also choose to work overnight shifts for patients who require overnight monitoring. Home health aides can easily work part-time or full-time. This comes in handy if you are looking for work that allows you to accommodate childcare duties, continuing education, or if you have other commitments.

4. Employer Variety

Being a home health aide means you have different employment routes available to you based on your work preferences. HHAs are hired by home health agencies, assisted living facilities, adult day programs, nonprofit organizations, and private parties (families). You'll see a different level of benefits, support, and work environment based on the type of employer. Some caregivers prefer to be self-employed and do private-duty work so they have more control over their schedule and clients.

5. Gateway to Other Medical Professions

If you are considering a medical career, training to be a home health aide is a good entry point. This allows you to gain experience in the field, and even to continue working, while you pursue becoming a licensed practical nurse, registered nurse, or another profession in the medical field.

6. Local Opportunities

Typically there is sufficient demand in the local community that home health aides do not need to travel far for work, unless they so desire. If you would like to be able to easily relocate, the demand is such that you shouldn't have a problem doing so. However, training and certification requirements do vary from state to state so you will need to confirm you have the necessary training to meet local requirements.

7. Make a Difference

And, finally, but most importantly, this career allows you to do work that makes a supreme difference in the lives of the people you serve. If you are a caring person who values the opportunity to help people live their lives with dignity -- this is perhaps the greatest reason to become a home health aide.

As you can see there are some strong reasons to consider becoming a home health aide. Clearly, it will not be right for everyone, but if these seven reasons strike a chord with you, be sure to learn more about this growing health care occupation.

Nursing Home & Assisted Living Centers - Know What to Expect

Are you currently considering a nursing home stay for either yourself or a loved one? In either case, you would expect to receive the best care, especially for the very expensive prices nowadays, wouldn't you? Unfortunately, locating a facility that provides genuine quality care may be tantamount to finding the proverbial needle in the haystack. Know the truth about nursing home or assisted living facilities before you decide.

I have been involved with health care for more than 15 years as a Combat Medic in the United States Army, a Certified Nurse Assistant, Physical Rehab Aide and Occupational Rehab Aide in California and the suburbs of Illinois. My wife is a Registered Nurse with more than 11 years of experience, and like myself, the majority of the experience is in nursing home or assisted living centers.

1989 was the year I became employed in my first nursing home. One of the many duties of a CNA, or certified nurse assistant, is to help the residents of the nursing home with their morning routine. While assisting a certain resident, I noticed the sliding doors of her closet were broke and one of them wouldn't open without forceful tugging. After getting her clothes together, I opened a drawer for some socks and a few roaches crawled out from the haphazardly bundled clothing. I later discovered most of the rooms in this particular facility were in the same appalling condition.

Mysterious injuries to some of the mentally handicapped residents also created rumors of abuse. Yet, no one seemed to know anything about it. Through the Medicare and Medicaid programs, the federal government is suppose to conduct on-site inspections of nursing homes participating in Medicare and Medicaid and to recommend sanctions against those homes that are violating health and safety rules. Yet, this particular facility, on several occasions, somehow received a Five Star rating after "inspections".

I assumed I made a bad employment choice and the next nursing center would be better. I was wrong. Within three months of employment at a different facility, a couple of senior residents confided that a certain nursing assistant was handling them roughly. Being the young newbie to the status quo, I hesitated to act. I was aware the elderly could be quite fragile, so perhaps the manhandling they described was a misunderstanding. Then I witnessed this same assistant "person" placing a soiled diaper onto the face of a resident several times in a teasing manner. I had seen enough, I brought this to the Director of Nursing (D.O.N).

I was not aware at the time however, that both the nurse of that shift and the D.O.N were both friends of the abusive assistant. Therefore, when a meeting was finally convened on the matter about a month later, you can probably imagine what the outcome was. My heated defense of the residents fell on deaf, dumb and blind, ears. The so-called nurse defended the abuser and the D.O.N merely pointed a finger at this assistant and said, "You were wrong." and absolutely nothing else followed, not even a written reprimand. However, I became known as the "trouble-maker" shortly after the meeting.

Fortunately, there was some poetic justice; the abusive assistant was later fired for getting into a "fist-fight" in an elevator with another assistant. This was a "Holy" facility in the suburbs of Illinois.

A large man with documented psychological problems abused other residents at the last facility in which I was employed. Although there were several staff complaints and he choked a female caregiver at one point, his transfer to a more appropriate facility was continually delayed to maintain the profits of his stay. It therefore seemed unconscionable to hear the, oddly high-strung, administrator of this same facility was rumored to be embezzling holiday funds that were meant for the caregivers.

When I learned a new policy required completely untrained caregivers to pass medication to the residents, I began to update my resume, and when I learned that there wouldn't be a nurse at all for the night shift, I turned in my two weeks notice. It was an obvious attempt to save money by limiting or eliminating professional care. These facilities never mention to visiting family members that when the patient or resident census is low, the nursing assistance is often cut to save money. This practice can lead to neglect, which tends to create new issues, such as bedsores for the bedridden residents.

There was a certain focus prevalent among the many facilities in which both my wife and I were employed and apparently, nothing has changed. They all claimed the well-being of the resident is the primary concern; some even placed impressively framed statements or plaques on the walls with their creeds of care. There was no fine print however, that stated the true primary concern above all else was Money. Making money and saving money. A single resident brings in five to eight thousand dollars a month and in "special care units" such as an Alzheimer's unit, it can be $10,000 a month. Thus, everything, and I do mean EVERYTHING else, is of lesser importance. What makes this statement all the more outrageous is that it may actually sound naïve to some, in today's corporate controlled world. "Of course it's about money, what else could it be about?"

It should be mentioned the examples given above are extreme and may not necessarily occur in all nursing centers. However, the Centers for Medicare and Medicaid Services (CMS) on February 5, 2008 named 4,037 nursing homes whose pressure sore and/or physical restraint rates it says have targeted them for "improvement". Thus, anyone who is considering a nursing home or assisted living facility stay, for either a loved one or themselves, should consider and understand the reality of these facilities and the possible measures that can be taken to promote better care.

So, what can you do if you believe extended assisted living or nursing care is needed for you or a loved one? Here are some suggestions and options you might want to consider.

- If distance is not a major concern, you may be able to locate a decent facility via the Senior Housing Net.com site. After choosing a place, if you have the means, research the facility. Find out what you can about it before you visit it. Perhaps you can check for recent complaints, or any history of lawsuits, with the Better Business Bureau online. If this is not an option, arrange a visit and ask the residents about the care, their rooms, the food, etc.

- Notice if you can detect urine when you enter the facility. If there is no one in the immediate area and the odor is very noticeable, we suggest that you turn around and leave. It is a telltale sign of poor sanitation and or possible neglect of bedridden patients.

Most assisted living centers are modeled impressively to give a beautiful "Home-like" appearance and most new residents agree it is much better than the sterile-looking hospital appearance of many nursing homes. However, do keep in mind; it is not necessarily an assurance of superior care. In other words, appearances can be deceiving.

- Ask about the training background of the CNAs (certified nursing assistants) or caregivers, they will be assisting you or handling your loved one the majority of the time. Many assisted living centers do not require their caregivers to be certified assistants, choosing to hire untrained or inexperienced caregivers who are then asked to attend an in-service or two.

- How many caregivers or CNAs are assigned to each unit? How many nurses are there to a unit? Is the ratio to patients or residents adequate for dependable care?

If you must stay at a facility of questionable quality, try to arrange any of the following:

- If possible, have a lawyer present when filling out the admission forms. Some may say it is an unnecessary waste of money, however, nursing facilities abhor any possible legal action against them and a lawyer intimidates much like a wooden cross does when held up to vampires.

- Arrange periodic unannounced visits from family or friends. This serves more than one purpose. First, it provides witnesses to any neglect or problems. Second, it helps keep the staff on their toes regarding your care. Should any incidence of abuse occur, a quick internet search provides a long list of nursing home abuse lawyers.

- If you are a visiting family member and your loved one is in bed most of the time, check for any bedsores on the heels, hips, buttocks, back or elbows. It is your Right to thoroughly question any injuries and be certain they have been properly documented and the doctor has been informed.

- If it is within your budget, you may choose to hire a reliable private sitter to provide one-on-one assistance or care within the facility. Many families prefer this option as it provides not only constant personal attention but companionship as well. Facility staff appreciates it for the relief it can bring during a high census. As an experienced private sitter, I can attest that it is much more preferable to care for one patient than to juggle ten or twelve.

- Another option that may save you money is to hire a private home sitter. Many patients obviously prefer this because it allows them to stay in their home with a caregiver to assist them. A nurse will often be required to make periodic visits as well for any medication that must be administered. There are many agencies to assist you with this.

Although there are many negative stories about nursing facility care, it does not mean you, or a family member, will have the same negative experiences. Believe it or not, there are plenty of satisfied residents, or patients, who do not regret their move into an assisted living or nursing home and who have made new friends.

So, now that you have been given some worst-case scenarios, here's hoping you are prepared for the worst but experience the best.

How to Choose the Best Homecare Agency For Your Loved One

When it comes to caring for your elderly loved ones, you expect and they deserve the best care available. Many local families depend on homecare agencies to provide a high level of in-home help. Homecare companies offer a wide variety of services, such as dressing, bathing, toileting, cooking, housekeeping, championship, and running errands. Not surprisingly, homecare has become a popular option to care for people who are well enough to remain in their familiar surroundings rather than face the challenges of nursing homes and assisted living centers.

Choosing the right homecare companies for your loved one is certainly one of the quintessential requirements in making sure he or she gets only the best service and protection.

Why Homecare is the Way to Go
A homecare agency is essentially a company that's well equipped to perform non-medical elderly care. If you require qualified and experienced homecare services, it's important to research local homecare companies so you can make an informed decision. After all, you're placing your loved one's care and well-being in the hands of a caregiver that you have to be able to trust.

What to Look For in a Homecare Agency
There are many factors to consider as you search for the best homecare agency. The following tips should help narrow down your options:

• A homecare agency should be able to administer services that are thorough and competent. Without these two essential traits, the company is ill-equipped to handle the ongoing and evolving needs of your loved one.

• A good homecare agency also supervises its personnel and is responsible for any liability that may arise from a caregiver failing to administer the proper care.

• It is also good to know how long a particular Long Beach homecare agency has been in business. Choosing a company with ample experience and a long track-record of exceptional care and service will help you-and your loved one-rest easier.

• Another factor to consider is how well homecare providers can provide you with information about their history, areas of expertise, and people and processes. Are they able to comprehensively explain their services and fees? Are they able to furnish you with a complete outline of the rights and obligations from their end and yours? Can you interview the caregiver they will be sending to the house? Will your loved one have the same caregiver or will different caregivers be providing services? These are just some of the most common questions they should be able to readily answer for you.

• Last but not least, a Long Beach homecare agency should be licensed and meet the requirements set forth by the state.

Making the Final Choice
As with any major decision, it is helpful to seek referrals from trusted sources who have already gone through the process. Furthermore, there are various organizations out there that list and rate reputable homecare companies.

Along with the aforementioned tips and creditable referrals or recommendations, you're sure to choose the right homecare agency for your loved one's needs and lifestyle.

Top Ads From Toronto

Toronto is Canada's biggest city, and it is also the financial heart of the country. It is no surprise that many of the world's top advertising agencies have offices in Toronto. But Toronto is also the home and headquarters of some homegrown agencies that are attracting international attention. With many fantastic business colleges with courses in marketing and advertising, Bloor Street is an ever-increasing rival of Manhattan's Madison Avenue, with King, Queen and Yonge also housing many great firms.

Some of the world's best agencies that have offices in Toronto include: DDB, TBWA, Publicis, Ogilvy & Mather, CP+B, and the Grey Group, and many more. These are some of the biggest names in the ad game and have been around for decades with offices all over the world.

Some locally-based agencies include John St., Trapeze Media, Mijo Corporation, Agency 59, and Fat Free Communications, to name a few, and they are making headlines for themselves beyond their city borders.

If you are aiming for a career in marketing or advertising and want to get a job with one of Toronto's many cutting-edge agencies, there are definitely certain advantages to undergoing a professional education in the big city. Getting used to the hustle is only a small part of it. All forms of business training in Toronto will especially cater to the types of companies and firms that operate in the city. It is also a great way to begin making many professional connections and build up one's network of potential employers, clients and partners.

Regarding the specific business and creative mind fostered in the city, one can expect some top-notch ad campaigns that are both specific to Toronto, but could also have a universal appeal. Here are two examples:

DDB Toronto recently did a public service announcement encouraging people to not be afraid when it comes to reporting crime. The idea is to emphasize the personal privacy and anonymity of anyone doing the reporting. An unmasked armed robber walks into a convenience store, only to discover the clerk, other shoppers, and every other witness are wearing ski-masks. The robber gets scared and leaves. A big city like Toronto will have its share of crime but also responsible citizens, therefore the usefulness of such a PSA.

TBWA Toronto produced and amusing print ad campaign for Visa to promote their sponsorship of the Stanley Cup Playoffs. It shows a happy family portrait, with mom, dad, daughter and young son all sporting playoff beards. This campaign knows to take advantage of Toronto's (and the rest of Canada's) love of hockey, while also touching on family values.

Here we have examples of both serious and comedic marketing campaigns. Marketing and business courses train the future ad man for the effective use of each style, as well as different mediums like TV and print. Just as important, they provide the right background and context for living and working in Toronto, Canada's advertising and business centre.

Senior Living - An Ideal Place for Retired Seniors

Everyone wants to live in peace and happiness even in old age, and senior living options are available for these people. In such a fast-paced world, children usually don't have time to take care of their ageing parents. If they look for some retirement options, however, things could be easier. For all retired people, retirement communities are a great place to spend their lives in happiness and contentment. For most seniors, independence comes with a lot of difficulties, but for those who find it tough to accomplish their daily chores there are assisted living homes. When people get older and their children are unable to take care of them, there are a variety of senior living options.

Most seniors resist frequent change, so selecting a retirement community has to be done with great care. Most of the assisted living homes are set up so that the residents of the facility can have a better quality of life than they would experience in their traditional homes. It has often being observed that when it comes to elder care, the most important thing is to get exercise and have activities that enhance their lives and promote longevity. Improving the quality of life through senior living is a very real possibility, and this is the top goal of the assisted living homes. These facilities are there for all senior citizens, whether they are retired or not and whether they need assistance or not. After retirement, a lot of people tend to stop taking care of themselves as well and try to keep living on their own, but this stage of life ought to be the most enjoyable one. If you want to enjoy your life, then check into the best retirement community.

For retired people, there are a number of senior living options that can be chosen depending on the needs of the individual. The two main choices after retirement are living with family or moving to a retirement community. The choice of these senior homes depends on the overall health, independence, and mobility. If the aged person does not like going very far, then assisted living homes that are located near shopping areas would be best. As we get older, we try to find activities that will keep us engaged and happy. A lot of senior living facilities organize events for elderly people to share their thoughts.

Active seniors who are independent in their daily lives can opt for a regular retirement community which serves their individual needs. Senior citizens need to understand that staying in senior living is not a social stigma, but is a way to enjoy retired life to the fullest without being dependent on anyone. The ideal place for retired people among all the senior living options is the retirement community because it really caters to the needs of retired people.

Professional Recruitment for Nursing Homes Improves When the Operation Does

Andria, a frustrated Plymouth, Michigan based social worker remarked: "If she gets one more call asking her to consider employment with what she considers to be the sloppiest nursing home chain in America she may drive to their corporate offices and vomit in the lobby."

Those remarks are a bit extreme but reflective of the thoughts of even the unemployed social worker, nurse and nursing home administrator who are thinking twice before accepting employment with nursing homes whose reputations are full of regulatory and operational blemishes.

An example of how bad some are rests with reports of patients pressing call buttons and seeking help only to wait an hour or two for someone to respond. In some of the instances we reviewed for this week's article, patient family members sat there and waited just to observe how long the response would take. In other instances training and development of staff is never innovative and limited to the bare necessities.

A review of public reports commonly finds fire safety, building hygiene and food handling violations. As a result, even the newly budding professional has to think 2 or 3 times before allowing themselves to be recruited into an organization whose approach to customer service and regulatory compliance is lackluster at best.

How can it get better? Four, (4) key operational principles can be of benefit.

A. Budget for Systems Inspector in at Least Every 2 Homes

This may not be the regional manager or regional vice-president. This can be a less expensive professional or para-professional whose sole job it is to examine and correct all non-clinical systems in operation including cleanliness, furniture safety, general maintenance, odor control and more. This could be a position for administrators in training and others with an eye for detail and who are willing and able to learn systems and protocol, while understanding they do not belong in the clinical side of the business.

B. Do Not Limit Training to Clinical Necessities

For every minute we spend teaching and reiterating important principles of protecting against blood borne pathogens, we could also be teaching staff the value and importance of how the right customer service approach affects nursing homes. We then tie it to their specific job performance and description and use innovative tools such as videos and live webinars, conference calls and other presentations available for nursing home personnel. There are even orientation presentations available, as brief as 20 minutes that nurse aide and others can sit at a computer and enjoy.

Topics include maintaining a patient's dignity, techniques for heightened care delivery safety and a host of other meaningful subjects.

C. Seek More than Credentials; Seek Maturity and Discernment

Polished personnel who may have helped a nursing home thrive for decades and helped make it a staple of care in the community in which it exists are moving on claiming their corporate employer is hiring inexperienced, cocky and excessively money focused young professionals who assign no value to the contentment of the patient being served.

D. Improve the Admissions Process

Allow your admissions process to go beyond verifying what insurance will pay. Take the time to schedule a conference with the patient's designated representative immediately upon admission, discuss discharge possibilities, ask questions about prior living arrangements, ensure they know what deadlines may apply, offer help to apply for veterans or other benefits or introduce them to private case managers.

What happens is all of this can combine to create a rather stellar operation and when packaged up will help recruit really committed professionals. The opposite side of the coin is being the laughing stock of the long-term care community and when that happens, very little else matters.

Will you follow these steps to improve your recruiting?

Thanks for allowing us to share.

How Will Assisted Living Help My Parent?

It's not easy but the time will come when they have to decide if your parent needs to have help with their daily activities. If your parents don't need full assistance you won't want to put them into a nursing home. With an assisted living facility your parent or parents will be able to live a bit more independently but will get help with such things as eating, bathing, laundry, dressing, and medication.

These assisted living facilities also have medical care centers in the same building. However it may only be for the small problems and a regular doctor or hospital may have to be visited for the larger problems. When you put your parent into the assisted living facility a plan will be made that will detail the specific things that your parent may need help with. This will also ensure that your parent will receive the correct care that they need. Other names may be used for assisted living facilities, like residential care, supported care, board and care, adult foster care, sheltered housing, and adult homes.

Don't think of assisted living as a nursing home because it is not. In a nursing home your parent will have a lot less freedom. A lot of people think that assisted living is the same as a nursing home. However nursing homes are used for people who can't care for themselves or are too sick or frail to be in an assisted living facility. Where assisted living is used for a person who is more or less capable of taking care of them selves but may have problems in a few areas of taking care of themselves.

Most of the time a facility may have not only assisted living but also independent living and nursing home facilities all in one, this way a person can move to the different areas when they become worse and need to receive more care. Or a person from the independent living may be moved to assisted living when they aren't able to do all things anymore. When these facilities are combined a person can take advantage of services such as meals that may be prepared in a cafeteria.

If you put your parent or parents into a facility you will find that you have a choice of three types of contracts. They are extensive, fee for service, and modified. The three choices all include shelter, services, emergency care, and amenities. The difference in the contracts will be the fees per month. While if you choose the extensive contract it will include long-term care, and no increase will be notice in your monthly fees. While a modified contract will cover only specific things, while fee for service is as it sounds you will be charged for the different services that are used on your parent or parents.

This is never an easy choice as your parents get older to make but when you begin to notice that your parent seems to be having more problems with some of the daily things they need to do you will need to make that choice. At least with putting them in an assisted living facility you will give them sort of freedom but still gives them the help they need. Some parents may be a bit argumentative when it comes to placing them in a facility but all you need to do is be persistent and understanding and do what is correct and right for them.

Share the (Elder) Care: 6 Steps

"My sisters/brothers don't lift a finger; I do everything for dad!" and "My mother's become my child!" Common cries among adult children caring for elderly parents at home. I ask in return, "Why are you the caregiver?" It's an admirable job; after all they raised you and loved you as you were growing up; now it's your turn. Or is It? Why only you and not your siblings? Is there another way to care for them and still show your love? There is a high incidence of caregivers' health failing before their loved one goes.

It is a stressful job. It's often a 10 hr/day, 7 day/wk job, if not 24/7, without breaks, days off, vacations, or even pay. It is one that involves chef and shopper, chauffeur, self-care manager, social events and appointment scheduler, bath aide, nursing attendant, laundress, companion, financial manager, and.... Then mom complains because you don't do right. And that's just your job with her. What about your own life?

When siblings stop by to visit they see the two of you sitting there saying "everything is fine". Or they hear you complain, but see that everything looks in order and mom tells them she is "fine". From their point of view it looks like a pretty cushy job; how hard can it be staying at home all day?

These issues can lead to family strife and conflicts that permeate throughout the rest of your lives.

The "50-50 rule" developed by Home Instead Senior Care network refers to the age when most people start planning for, or are caring for elderly parents, as well as the necessity of sharing that care among family members. Remember, the jobs get more complex as your loved one declines.

1. Plan ahead. Who is best suited and most willing to be the primary caregiver. Consider your relationship with your parent and with your own family. All family members including your parent should be a part of these discussions, as well as share the care.

2. Divide the duties: what's needed and who can take it on? Can the money-savvy sister take on the bills and banking? And handle insurance issues? Who can take mom to the doctor, drop her off at the senior center, grocery shop, or pick up prescriptions?

3. Food preparation: can a sister or other family member prepare meals ready to eat or for the freezer several times a week of month?

4. Care for the primary caregiver: who can spend the day, or weekend with dad to give her a break? If not family members, is there a student aspiring to be a nurse, or a retired nurse/caregiver at the church? No one can be expected to do a 24/7 job, especially one this stressful.

5. Outside resources: who will contact the senior center or other organizations to find out about activities, services, and senior lunches? An outing for your parent a couple of times a week, or every day will give the primary caregiver a few hours break to handle his/her own life. And check out respite care and caregiver support groups when the going gets tough.

6. Reduce the risk for falls: modify the house for safety by using a room-by-room safety checklist (see a comprehensive one in the book Dad's Home Alone); provide grab bars, shower seat, and a high toilet or raised toilet seat, for bathroom safety. Don't forget a medical alert pendant or wristband. In case of a fall help is just a press-of-the button away. Falls can't be prevented. Gravity is the same whether in a nursing home, at home, or standing next to a loved one.

Remember, elderly people, just like you and me, want to remain as independent as possible. Respect who they are and make sure your parent weighs in on the decisions. But also, know that they may not be as realistic about their safety and care needs. You are there as their safety net, not their "parent".

The Senior Life - How to Throw a Luau Party for Elderly Guests!

Everyone loves to have a party, no matter what the age, parties are a great way to get together with friends and family and just enjoy good food, good conversation and fun. Parties can be especially important to seniors, especially those that find themselves in a retirement home or an assisted living facility. Summer time especially is a good time with the good weather and the ability to have a party outdoors. A really fun theme to consider when planning a party for seniors would be the Luau.

When you plan for one of these types of parties you need to concentrate on the decorations, to really pull off the Luau theme you need to make sure the decorations really express the Luau and the feeling of being in the tropics. So make sure you decorate with really colorful tropical flowers.

They don't have to be real flowers, although that would be a nice touch, just as long as they are flowers that represent the tropics, like Bird of Paradise, Canna Lilies, Hibiscus, and Orchids. Make sure that the table clothes that you pick have bright colors, they can be plain or they can be floral.

You should also make sure that as each guest arrives that you have someone greeting them at the door or the entrance to the backyard with leis. You can buy these at any party center or if you are energetic you and some friends can make your own from tissue paper.

You can also provide the women with a tropical flower to put in their hair, the best would be a Lily, Hibiscus or Orchid. If the Luau is mainly outdoors, make sure that you light the entire area up with tiki torches and to keep the mosquitoes away add citronella candles to all of the tables. You can paper lanterns around the luau area as well.

No party is complete without some sort of music and when it's a luau you should stick to the theme and try to rent the services of a band that plays steel drums or get one that plays calypso. These would be perfect for a luau theme. If you can't afford a band then try and get recorded music that would fit this kind of theme. You might even ask those invited to the party what their favorite calypso music might be so you can compile a list of favorites to be played at the party.

You need to ensure that the menu is as close to the them as possible too. You should include a variety of tropical drinks that include the cute little paper umbrellas and these drinks can be both alcoholic and non-alcoholic so the guests will have a choice. It's going to be hard to have the typical meat for a luau which is a roasted pig but you can serve some roasted pork with pineapple and cherries as well as ham, cherry and pineapple all put on skewers for kabobs.

You can also make kabobs that have ham with a variety of different fruits on it. It's best to also stick with finger foods so have lots of tropical fruits cut in cubes and things like fried shrimp and even fried sweet potatoes. You can find a variety of different recipes online for luaus so do your research.

Don't forget about entertainment of some kind other than music. For those who are in decent shape make sure to include the traditional limbo contest with a prize for the person who goes the lowest. Also play a variety of different word games or other group games that everyone can get involved with.

Elderly Caregivers' Unknown Plight - Being Abused by the Elderly They Are Trying to Protect

It is an unfortunate situation that some elderly caregivers, especially family members who provide day-to-day services for their ailing mothers/fathers, are suffering in silence as they endure mental or psychological abuse from their elders who have become selfish, controlling, and manipulative in order to get what they want when they want it.

Some elderly people tend to become more self-centered and narcissistic as they age. This is somewhat understandable when one considers that older folks know that death may be imminent, they most likely have lost some mobility and/or use of other senses, and they feel control over their lives slipping away from them more and more each day. However, this does not entitle them to abuse or manipulate those family members who are trying to provide for and protect them from harm.

Here are some of the abuses to which the unwitting caregiver may be subjected:

Unreasonable Expectations

An elderly caregiver in her late 70s, providing for her aged older sister who wanted to remain in her own home until she died, was told no one else was allowed in the house to help out with caregiving duties which were becoming increasingly demanding. There was no room for discussion, no consideration for the failing health of this elderly Florence Nightingale, who had not only put her own life on hold but also had relocated and was living in her sister's home to help her out. Consequently, the only option left was to put this woman into a nursing home until she passed away.

Being Treated Like a Servant

Some elders feel entitled to get what they want at a moment's notice. This type of unrealistic demand can be the proverbial straw that breaks the camel's back for a person who is already providing essential medical and nonmedical care, especially if it is on a 24-hour basis.

Lies, Manipulation, and Sabotage

Unfortunately sometimes elderly people will lie to family members, friends, healthcare professionals, and social service workers about the care they are receiving at home. This can cause devastating results and permanently fracture relationships, especially if Social Services is contacted by well-meaning (or not so well-meaning) people who take this information at face value and do not bother to get input or any further information from the primary caregiver.

Manipulation is another powerful psychological weapon that elders can and do use. There are those who have perfected their manipulative ways, playing the martyr and victim to perfection, in order to receive the maximum amount of attention, sympathy, and pity they desire.

The best laid care plan can be sabotaged by an uncooperative elder who will not take an elderly caregiver's needs and limitations into consideration. Injecting other outside family members or friends into the mix can only increase the confusion and frustration.

Playing the Guilt Card

No matter how much quality of care is provided, there are elderly folks who just cannot be satisfied and will attempt to guilt their children into doing everything for them. It is essential for the well-being of the elderly person requiring care that he/she remain as active as possible.

Elderly caregivers need to be aware of these potential hazards. While it may be necessary to provide a safe, secure environment for elderly loved ones, that does not mean that one's physical, mental, spiritual and psychological needs must be sacrificed

Roadblocks to Assisted Living

There are many roadblocks in place that prevent senior citizens from going into as assisted living facility. Of course, these are mostly emotional or mental roadblocks. Many seniors believe that assisted living is a bad thing, or that it is simply not yet time for them to start worrying about these things. The fact is, many of the roadblocks are not major ones, and many of them are only misunderstood preconceptions. Senior living really is a helpful thing and it can enhance a person's life, but the senior involved must come to accept this on their own terms. Otherwise, they will still have these misconceptions in mind when they are in an assisted living facility and this can detract from an experience that should be enjoyable.

For starters, many seniors believe that it's just not time to start thinking about assisted living. There is no such thing as too much planning ahead, and having a plan in mind can help you to get the care you want in the event that you need it. Additionally, having a set plan in place will help your family to make sure that you are receiving the appropriate care levels later on down the road.

Another belief is that assisted living isn't necessary because they have family that will assist with their care. The problem with this is that our families are often busy with their careers and their children. Taking the time to care for an elderly parent is a big time commitment, and as much as they might want to care for us, unfortunately it doesn't always end up this way. This is a great plan, but you do need to have a contingency plan in place just in case your family is unable to care for you at the level you might need.

Some people simply don't want a stranger to help them out. In this case, you need to understand that sometimes, providing help for a family member can easily become overwhelming. Rather than stress out your loved ones with your care, it is easier to transfer that care over to someone who is a professional in the field. Having a family member as a caregiver is a good idea; it saves money on paying an in home care service and it ensures that you will stay comfortable with the person giving you the assistance. This doesn't change the fact that sometimes it can become just a bit too much for a family member, especially if they are untrained. Going with the fully trained people within an assisted living facility will enable you to get the high levels of care that you deserve.

Whatever your concern about assisted living is, it's probably something that can easily be fixed with further understanding of just what assisted living actually is.

Bathroom Safety Products

Bathroom is probably one of the most overlooked parts of the house if we're going to talk about safety and hazards. For sure, it might appear harmless for most people especially if it's ergonomically designed to suit our needs. However, research has consistently shown health hazards hidden within this structure and which highly deserve our full attention. In fact, studies have found out that in U.S. alone, an average of 640 people are estimated to get non-fatal to fatal bathroom-related injuries on a daily basis. And if you think this figure doesn't encompass people of all ages, you might be missing some important health information because in reality, both children and the elderly are high-risk to get this injury. So how are we going to prevent this accident from taking place?

This is when the need for bathroom safety products, and bathroom safety equipment comes into the picture. From shower chairs to grab bars, these essential safety items can help anyone beat the three major hazards of bathroom use, namely wet floor, heat and hard surfaces.

Bathroom Safety Products: What are these?

Bathroom safety products are among the most important items that anyone can find within different health care settings ranging from senior homes and clinics to major city hospitals. Incidents of falls are ubiquitous especially in places where safety equipments both beside the bed and within the bathroom are not available. For this reason, prompt installment of bathroom safety products, and bathroom safety equipment has long been considered as a wise move among hospital authorities. Thanks to these products, life-saving equipments are now within reach of people who need them the most. There are different categories of bathroom safety products and here's a rundown of some of the most indispensable items you can add either in a hospital or in your own home:

Bath Chairs and Shower Benches
Senior patients, people with disabilities, amputees and those who just came home after an operation will all benefit from bath chairs and shower benches. Providing both comfort and safety, these items are especially made for people who can't stand for a shower or are too weak to submerge themselves in a bath tub. Bath chairs come in different shapes, colors and sizes ranging from Lumex round bath stool which has a durable and rust-resistant aluminium frame to Lumex Bariatric bath seat intended for people with up to 600 lbs. of weight. Lumex bath seats are available either with or without a back rest but all have a seat height adjustable in 1", lifetime limited warranty, tool-free assembly and designed to meet the requirements of HCPCS code: E0245.

Grab Bars and Safety Rails
Balance is usually an issue among elderly and people who are currently taking medications but with the proper installment of grab bars and safety rails, the anxiety related to bathroom hazards can be safely put at bay. For example, you can choose to install Lumex Tub-Guard or Heavy-Duty safety rails in your bath tub (except for fiber glass tubs) if you want an easier and safer entry/exit to your bath tub. Lumex grab bars with sizes ranging from 12" to 32" care also available to prevent patients from slipping. And with its durable chrome plated steel and 250 lbs. maximum capacity, these grab bars can easily blend in with any bathroom decor.

Commodes
Bathroom commodes or simply commodes are basically movable toilets which don't utilize running water. A commode has wheels which can be locked to ensure safety of its user and a small container underneath which will be cleaned right after using the commode. This is an alternative for people or patients whose mobility are affected by a disease and so have difficulty going to the bathroom. By using commodes, people with special conditions can now perform activities at the bedside which they formerly do using a traditional bathroom. Modern bedside commodes come with different features including adjustable arm rest that provides both comfort and ease during a lateral transfer.

Raised Toilet Seats
Especially made for people with the inability to get up from the toilet bowl due to some mobility issues or back injuries, raised toilet bowls provide both comfort and maximum safety for its users. It is usually installed either as bubble-type raised toilet seat or raised toilet seat with adjustable knot, which is not intended for permanent installation as this type needs adjustments or re-tightening once per week.

Transfer Bench
If you have difficulty stepping over your bath tub, then a transfer bench might be the perfect product for you. Its special features include cushioned seat, water-tight backrest, durable and rust-resistant aluminum frame and adjustable seat height.

Bathroom Safety Products: Why you need these?

Bathroom safety products might just be another addition to your budget but if we're going to stick to what recent studies have shown, buying these products could be a life-saving choice for you. As a matter of fact, Centers for Disease Control and Prevention found that an estimated 234, 000 people in the U.S. ages 15 years and older were treated for bathroom-related injuries in the year 2008 alone. This figure translates into a staggering 640 people per day and it can even be more if we're going to collect the statistics recorded from all over the globe.

How can we prevent this? Do we have the choice to become more proactive in facing this issue? Well, the good news is YES, we have a great chance to prevent these small but serious accidents from happening. According to Judy Stevens, lead author of the research study and an epidemiological expert in adult falls, these bathroom-related injuries could have been prevented had those hospitals and nursing homes installed bathroom safety products such as grab bars both inside and outside the bath tubs.

The same study has revealed that falls and slips comprise almost 80% of bathroom-related injuries while the rest were said to be from minor cuts and bruises (more common among young children). Bathrooms can be a significant health hazard especially for older adults whose sense of balance and control are significantly affected by both medications and the ever-existing wear and tear phenomenon. Everybody is not safe from accidents nowadays so for better chances of survival, bathroom safety products should now be considered as indispensable tools for every health care institutions and homes alike.

Assisted Living Homes Vs Independent Living Homes

There comes a point in everyone's life, when you or a loved one realizes the repercussions of getting older and that a current living situation may not be the most practical. Whether you need assistance with everyday activities, or you just find yourself lonely and longing for companionship from people of your own age group, it may be time for a move.

As simple as it seems, these decisions can be very overwhelming to the individual and their families. There are many questions that need answering before deciding which housing situation will suit an individual best. What kind of home do I choose? A retirement community? A 55+ neighborhood? What if I need minimal assistance such as grocery shopping but I still consider myself active? What if my spouse needs more assistance than myself, is there a place that has both full time assistance that is also considered active living? These are just a few questions among a long list that families have to consider to ensure the most suited match for your needs. Here are some things to keep in mind.

The difference between a nursing home and an assistant living home

Commonly mistaken for one-other, nursing homes and assistant living homes are very different. Assistant living homes commonly provide an array of services available, such as, planned meals, housekeeping, transportation, wellness programs, and planned activities for social opportunities with other residents. Assistant living also provides help for those who require assistance with everyday living needs such as bathing, dressing, eating and so on. People who pick assistant living require very little to no medical care, however, often times assistant living facilities have special wings that deal specifically with Alzheimer's and dementia. Another thing to keep in mind is assistant living homes do not take Medicaid and are private pay only.

Nursing homes are ideal for residents that require 24-hour care from certified nurses. Often times these patients are bed bound, or have injury's that need regular attention. Unlike assistant living, nursing homes generally accept Medicaid as well as private pay, however Medicaid requires, often times, a lengthy waiting list before accepted into the pay plan.

Independent living and retirement communities

Retirement communities and 55+ neighborhoods can all be categorized under Independent living. Independent living is as it sounds, they provide communities that offer anywhere from apartments to free standing houses that are bought or rented. Independent living is a great option for those who require little to no assistance, however many places do provide things like cleaning services for an extra fee.

How To Choose A Good Nursing Home

With nursing homes costing anywhere from $3,500 to $10,000 per month (depending on your state), and with the average stay about 2 1/2 years, the total cost of a typical stay in a nursing home can be between $100,000 and $300,000. However, family members should not focus only on the cost but also on the care of their parent or spouse. How do you go about finding a good nursing home, one which will properly care for the emotional as well as physical and medical needs of your family member?

A good place to start would be the Consumer Reports Nursing Home Guide (you can find this online). This in-depth site is completely independent of the nursing home industry and can be relied on for giving you objective information. Here you can learn not only what to look for in evaluating nursing homes, but also review a state-by-state "Quality Monitor" that lists recommended homes and those to avoid. These lists are far from complete, but the general information on the site is very helpful.

Medicare itself has published a four-page checklist on its excellent website http://www.Medicare.gov that you would take with you when visiting a nursing home. One of the most important items on the list is whether or not the facility is "Medicaid-certified." Most people don't realize that many nursing homes do not accept Medicaid; if you think you may be applying for Medicaid at some point, then you probably should start out placing your family member in a Medicaid-certified facility, so that once your private pay money stops you won't have to move your family member, which can be very traumatic.

Another great resource is the Nursing Home Inspector at CarePathways.com, where for a small fee you can search their database of over 44,000 nursing homes and obtain detailed information about the performance and characteristics of every Medicare/Medicaid certified nursing home in the US.

Finally, you should check out the free reports available at MyZiva.net. MyZiva.Net claims to be a free, objective and easy-to-use nursing home resource for prospective residents, caregivers and healthcare professionals that can help you find and compare nursing homes. You simply enter the zip code of the area you are considering, and a comprehensive chart pops up from which you can link to reports on the facility's main focus, survey results, quality measures, and staffing. You can also check several facilities you are interested in and obtain a side-by-side comparison.

In all cases, you will have to follow-up any online research with phone calls to the facility and finally an in-person visit. Try to get a tour that takes you "behind the scenes." Does the staff look harried? Are the hallways cluttered? What about the food? You might consider having a meal there, yourself, with the residents. Bring your checklist and don't be shy about asking tough questions.

Moving a loved one to a nursing home can be an emotionally draining experience not just for the one having to move there, but for the entire family. A spouse of 65 years, separated for the first time; a parent who's always been there for you, that you now must take care of; the solid father and grandfather who now looks shriveled and worn--all these can exact an emotional toll on the family. Accordingly, you want to do your best job in locating a facility that you can feel confident about, and that will be a comfort and aid to your spouse or parent during the remaining years of their life. Hopefully the resources discussed above will assist you with that task.

A recent additional resource, The Baby Boomer's Guide to Nursing Homes, explains the many laws protecting nursing home residents and provides advice on obtaining the best nursing home care possible. It is intended for use by residents and their family members and friends, but also is a worthwhile reference for nursing home operators, attorneys, social workers, and others with a personal or professional interest in nursing home care.

For a different point of view on nursing home placement, see There's No Place Like A Nursing Home.

Selecting a nursing home for a loved family member can be a very difficult decision. However, once you are armed with the information from the above resources you should find this burden to be much less onerous. In any event, good luck!

A Summary of Virginia Medical Malpractice Laws

In many respects, Virginia has been more conservative about modifying the common law than its sister states. To the extent modifications have been approved, many restrict rather than expand the rights of the victims of medical negligence. For example, Virginia has adopted three major modifications of medical malpractice law: a damage cap, screening of proposed lawsuits by a medical review panel, and a state fund to compensate victims of birth-related neurological injuries. Much of the legislation specific to medical malpractice can be found in the Medical Malpractice Act, Va. Code Ann. §§ 8.01-581.1 to 8.01-581.20.

Statutes of Limitations

All medical malpractice actions for injury (as opposed to death) must be brought within two years from the date the cause of action accrued. Va. Code Ann. § 8.01-243(A). In § 8.01-230, a cause of action "accrues" at the time of injury: "the cause of action shall be deemed to accrue and the prescribed limitation period shall begin to run from the date the injury is sustained in the case of injury to the person... and not when the resulting damage is discovered."

This two-year limitation has long been applicable, and strictly enforced, in Virginia. Virginia is one of the minority states that use the "date-of-the-act" rule, which means that the plaintiff must file suit within two years of the date of the injury regardless of how obscure or undiscoverable the injury might have been. Exceptions to the two-year rule are (i) cases involving minors or mentally incompetent people who are in law regarded as unable to know their legal rights and (ii) cases where the injury was fraudulently concealed from the person.

The Virginia Supreme Court rejected the judicial adoption of a discovery rule, Nunnally v. Artis, 254 Va. 247, 492 S.E.2d 126, (1997), but held that "continuing treatment for the same conditions" tolls the statute of limitations until treatment ends. Grubbs v. Rawls, 235 Va. 607, 369 S.E.2d 683 (1988). The court defined "continuous treatment" as not "mere continuity of a general physician-patient relationship; we mean diagnosis and treatment for the same relating illness or injuries, continuing after the alleged act of malpractice." The court acknowledged, however, the rule would not apply to a single, isolated act of malpractice. Farley v. Goode, 219 Va. 969, 252 S.E.2d 594 (1979). In other words, when an act of malpractice occurred and that physician continued to see the patient over a course of years for an unrelated condition, the rule would not apply.

In foreign object cases (surgical sponges, needles, etc.) and cases of fraud or concealment (i.e., alteration of medical records) the statute is extended to one year from the date the object or injury is discovered or reasonably should have been discovered. However, this extension is subject to a ten-year limit from the time the cause of action accrued. Va. Code Ann. § 8.01-243(C).

In cases in which the health care provider's negligence caused the patient's death (Wrongful Death Claims), suit must be filed within two years of death. Va. Code Ann. § 8.01-244(B).

If a person entitled to bring a personal action dies with no such action pending before the expiration of [the two-year] limitation period... then an action may be commenced by the decedent's personal representative before the expiration of the limitation period... or within one year after his qualification as personal representative, whichever occurs later.

However, § 8.01-229(B)(6) states that:

[i]f there is an interval of more than two years between the death of any person in whose favor . . . a cause of action has accrued or shall subsequently accrue and the qualification of such person's personal representative, such personal representative shall, for the purposes of [the statute], be deemed to have qualified on the last day of such two-year period.

A parent's action for medical expenses caused by injury to a minor must be brought within five years. Va. Code Ann. § 8.01-243(B). A minor's medical malpractice action for injury or death must be commenced within two years from the date of the last act of negligence, unless the child is less than eight years of age, in which case the action must be brought by the child's tenth birthday. Va. Code Ann. § 8.01-243.1. The Virginia Supreme Court has upheld the constitutionality of this statute. Willis v. Mullett, 263 Va. 653, 561 S.E.2d 705 (2002). Incapacity (typically a substantial mental or physical handicap) also tolls the running of the statute of limitations during the period of incapacity. Va. Code Ann. § 8.01-229(A).

Contributory or Comparative Negligence

Virginia recognizes the doctrine of contributory negligence in medical malpractice cases. A plaintiff's contributory negligence may bar her recovery entirely, but the patient's negligence must be concurrent with the defendant's negligence. Sawyer v. Comerci, 264 Va. 68, 563 S.E.2d 748 (2002); Ponirakis v. Choi, 262 Va. 119, 546 S.E.2d 707 (2001).

Joint and Several Liability

Virginia imposes joint and several liability on joint tortfeasors. Va. Code Ann. § 8.01-443. Thus, any joint tortfeasor against whom judgment is entered is liable to the plaintiff for the entire judgment, regardless of the tortfeasor's degree or percentage of fault. For example, in a hospital setting, if the attending doctor and nurse are both negligent, then each one can be held responsible for the patient's entire injury even if part of that injury was caused by the other's negligence.

Vicarious Liability

Under the doctrine of respondeat superior, hospitals in Virginia are vicariously liable for the negligence of their employees but not that of independent contractors. McDonald v. Hampton Training School for Nurses, 254 Va. 79, 486 S.E.2d 299 (1997). Whether a physician should be considered an employee is a question of fact not to be determined by whether the hospital calls him one, but by the factors of selection and engagement, payment of compensation, power of dismissal, and (most importantly) power to control the physician's work. A physician's exercise of professional judgment in the performance of professional duties is a factor, but not the only factor, in deciding whether the hospital has the power to control his work. There is also authority for holding a hospital liable for the act of a physician on the theory of negligent credentialing. Stottlemyer v. Ghramm, 2001 Va. Cir. LEXIS 501 (Va. Cir. Ct. July 13, 2001)(affirmed at 2004 Va. LEXIS 99 (2004). In other words, a hospital can be held legally responsible for granting hospital admission and treatment privileges to an unqualified physician.

Expert Testimony

Except for rare cases within the common knowledge and experience of lay jurors, expert testimony is necessary to establish the standard of care, a deviation from the standard, and the proximate cause of injury. Perdieu v. Blackstone Family Practice Center, Inc., 264 Va. 408, 568 S.E.2d 703 (2002). To testify as an expert on the standard of care a witness must demonstrate expert knowledge of the standards of the defendant's specialty and have had an active clinical practice in either the defendant's specialty, or a related field of medicine, within one year of the date of the alleged act or omission. Va. Code Ann. § 8.01-581.20.

Damage Caps

Virginia imposes a cap (limit) on damages of all kinds in medical malpractice cases. For claims arising out of acts or omissions prior to August 1, 1999, the damage cap is $1 million. For acts or omissions on or after August 1, 1999, and before July 1, 2000, the cap is $1.5 million. The cap is increasing by $50,000 every July 1. Two final increases of $75,000 beginning in 2007 will bring the damage cap to $2 million for acts or omissions on or after July 1, 2008. Va. Code Ann. § 8.01-581.15. The Virginia Supreme Court has twice considered this legislation and held that it does not violate the U.S. or Virginia constitutions. Pulliam v. Coastal Emergency Services, Inc., 257 Va. 1, 509 S.E.2d 307 (1999); Etheridge v. Medical Center Hospitals, 237 Va. 87, 376 S.E.2d 525 (1989).

A settlement with one defendant reduces the maximum liability of the others, because the cap limits the total amount recoverable for an injury to a patient, regardless of the number of theories or defendants. FairfaxHospital System v. Nevitt, 249 Va. 591, 457 S.E.2d 10 (1995). This includes punitive damages. Bulala v. Boyd, 239 Va. 218, 389 S.E.2d 670 (1990). In cases arising prior to March 28, 1994, when the definition of "health care provider" was broadened in Va. Code Ann. § 8.01-581.1, a physician's professional corporation may be subject to uncapped liability. Schwartz v. Brownlee, 253 Va. 159, 482 S.E.2d 827 (1997).

Virginia limits punitive damages to $350,000. Va. Code Ann. § 8.01-38.1. This cap has also been determined to be constitutional by the Fourth Circuit Court of Appeals. Wackenhut Applied Technologies Center, Inc. v. Sygnetron Protection Systems, Inc., 979 F.2d 980 (4th Cir. 1992).

Statutory Cap on Attorneys' Fees

There is no Virginia statute setting a limit on attorneys' fees in medical malpractice actions.

Periodic Payments

Periodic payments or structured settlements are allowed, but not required in Virginia. A settlement agreement on behalf of a disabled person, including the situation where the plaintiff is a minor (under the age of 18) involving periodic payments must be reviewed by the court and secured by a bond or insurance. Va. Code Ann. § 8.01-424.

Collateral Source Rule

Virginia recognizes the collateral source rule, under which the plaintiff's receipt of collateral payments (health insurance, paid leave of absence from work, etc.) does not reduce his recovery. This protection is statutory for lost income (Va. Code Ann. § 8.01-35) but the courts follow the rule for all damages in tort cases. Schickling v. Aspinall, 235 Va. 472, 369 S.E.2d 172 (1988).

Pre-Judgment Interest

In Advanced Marine Enterprises v. PRC, Inc., 256 Va. 106, 501 S.E.2d 148 (1998), which was not a malpractice case, the Virginia Supreme Court reversed an award of pre-judgment interest on the unliquidated part of the damages, stating, "Generally, prejudgment interest is not allowed on unliquidated damages in dispute between the parties." This should apply to most medical malpractice claims. However, the decision also notes that Va. Code Ann. § 8.01-382 leaves the date from which interest should run to the sound discretion of the trial court. In Pulliam v. Coastal Emergency Services, Inc., 257 Va. 1, 509 S.E.2d 307 (1999), the court reversed an award of pre-judgment interest because it exceeded the damage cap, but did not comment on whether such interest should have been awarded at all. In cases where pre-judgment interest is proper, the rate is six percent. Va. Code Ann. § 6.1-330.54.

Birth Injury Claims

Virginia does not have a general patient compensation fund covering all medical malpractice claims. However, the Birth-Related Neurological Injury Compensation Act (Va. Code Ann. §§ 38.2-5000 to 38.2-5021), covers infants who suffer permanent, disabling damage to the brain or spine caused by oxygen deprivation or mechanical injury during labor, delivery, or resuscitation. This no-fault program is the exclusive remedy for such infants and their parents against participating physicians and hospitals, who must pay an annual assessment. Va. Code Ann. §§ 38.2-5001 and 38.2-5002. A claim filed under this statute proceeds in an adversarial fashion and the Virginia Attorney General represents the Fund in opposing the infant's claim.

If the claim is determined to be compensable, the Fund provides for lifetime medical expenses as well as one-half of the Virginia average weekly wage after the child reaches age eighteen. Va. Code Ann. § 38.2-5009. Many hospitals and physicians choose not to participate. In cases arising prior to April 1, 2000, a participating physician's professional corporation may be sued even in cases otherwise covered exclusively by the fund. Jan Paul Fruiterman, M.D. & Associates v. Waziri, 259 Va. 540, 525 S.E.2d 552 (2000). Although the legislature promptly closed this loophole by expanding the definition of "participating physician" in Va. Code Ann. § 38.2-5001, the Virginia Supreme Court declined to apply the amendment retroactively. Berner v. Mills, 265 Va. 408, 579 S.E.2d 159 (2003).

Immunities

Virginia has waived sovereign immunity in tort cases, subject to significant limitations. No claimant may recover more than $100,000 or the limits of applicable insurance, whichever is greater. In medical negligence cases, the immunity most often comes into consideration when there is a claim against the Medical College of Virginia or the University of Virginia Health System. For example, sovereign immunity has been applied to protect hospital administrators as well as surgical interns and residents at the University of Virginia Hospital. Lawhorne v. Harlan, 214 Va. 405, 200 S.E.2d 569 (1973), overruled on other grounds, First Virginia Bank v. Baker, 225 Va. 72, 301 S.E.2d 8 (1983); Hall v. Roberts, 548 F. Supp. 498 (W.D. Va. 1982). This immunity may extend to other physicians employed by the state, depending on the degree of control exercised over them, Lohr v. Larsen, 246 Va. 81, 431 S.E.2d 642, (1993), but never to independent contractors. Atkinson v. Sachno, 261 Va. 278, 541 S.E.2d 902 (2001). Virginia has not waived sovereign immunity for local units of government. Municipalities are immune for negligence in the performance of governmental functions, including the operation of a hospital. Edwards v. Portsmouth, 237 Va. 167, 375 S.E.2d 747 (1989) (dictum).

A charitable entity is not liable to its beneficiaries for the negligent acts of its agents if due care has been exercised in their selection and retention. Mann v. Sentara Hospitals, Inc., 59 Va. Cir. 433, 2002 Va. Cir. LEXIS 363 (2002) (discussing application of the doctrine to a medical faculty foundation). However, charitable immunity has been withdrawn from hospitals, except where a hospital renders exclusively charitable medical services, or where the patient signed an express agreement providing that all medical services would be supplied on a charitable basis. Va. Code Ann. § 8.01-38.

Medical Review Panels

The Virginia Medical Malpractice Act provides for a system of medical malpractice review panels to assess the validity of medical malpractice claims. At the request of either party, the Supreme Court of Virginia appoints a panel to review the claim, consisting of two doctors, two lawyers, and a non-voting judge as chairman. Va. Code Ann. §§ 8.01-581.2 and 8.01-581.3. The panel determines whether the evidence supports the conclusion that the health care provider failed to comply with the relevant standard of care and whether that failure proximately caused the injury. Va. Code Ann. § 8.01-581.7. The findings of the panel are non-binding and the claimant has the option of filing a lawsuit after the panel has made its ruling. However, any opinion of the medical review panel is admissible as evidence in a subsequent action. Both parties have the right to call panel members, except the chairman, as witnesses. Va. Code Ann. § 8.01-581.8.

Arbitration

Arbitration is a process by which potential litigants can resolve their dispute without resorting to the civil court system. In most arbitration cases, the parties agree to arbitrate their dispute after the event occurs and the claim arises. However, parties may also agree in advance of treatment to binding arbitration of any claim, so long as the patient has the option to withdraw from the agreement within 60 days after the termination of treatment. Va. Code Ann. § 8.01-581.12.