The Daycare Center's Board of Directors

There are many Special Interest Groups that operate within the early childhood program. All these Special Interest Groups, and their needs, eventually end up at the center director's office. The director you see, acts like a traffic cop, and guides a program toward realizing its Mission Statement. It's imperative that the director understands who serves in each special interest group and how these interest groups function and how they interact with other interest groups at the center.

The experienced director has learned to identify these various groups, learned how to interface with all of them, and learned how to interact with all of them. Hopefully the director has developed this skill early in her career because it is usually the Board of Directors who hires, and terminates the director. Developing a strong and positive line of communication with the Board of Directors as well as all other interest groups will help the program runs smoothly.

The Board of Directors is made up of people who generally have been invited to serve on the board for various reasons. The invitation may have come from the daycare center owner, another board member, or the director. Board members bring unique expertise from their professional field and apply it to the child care situation. They come with valued experience and connections. For example, a pediatrician can advise on health care issues at a center, an attorney can advise regarding legal issues, a tax accountant can advise on tax issues, and an educator can advise regarding curriculum. Board members often come with "deep pockets" or money they willingly contribute to the program to make it a success. A well-balanced board will have complementary members so that their decision making process can draw on many disciplines.

This broad base of experience is important for it is usually the board that is legally responsible of ensuring that the center operates within the law and remains financially solvent.

While some board members may receive payment for service, most do not. Members serve on a board as an expression of their civic interest. At child care facilities, most board members have made it in their career. They no longer need child care but they remember when they did need child care. Now they want to improve child care for others. In return for serving on a board, members receive public recognition for their work while having an opportunity to shape a program.

Board members usually have little day-to-day contact with the child care facility, its staff, or its children. Their interests in the program and influence over the program can be long reaching and must be respected. A great and dedicated board can make a strong child care center program.

Medicare Alzheimer's Coverage - Are Nursing Home Costs Covered?

Alzheimer's disease is a form of dementia that affects older adults. It is a progressive disease characterized by declining memory and cognitive ability. Although some medications may help to alleviate or delay the progression of symptoms, there is no cure.

According to a 2008 report released by the Alzheimer's Association, an estimated 5.2 million Americans currently suffer from the disease. It is the most common form of dementia, afflicting 1 in 8 persons over the age of 65.

Medicare, a federal health insurance that covers people age 65 and over, provides limited coverage for Alzheimer's patients.

Prior to 2002, all Medicare beneficiaries diagnosed with Alzheimer's had been automatically denied reimbursement on the grounds that the disease was incurable, and medical treatment was ineffective.

Thanks to a governmental policy change in 2002, Medicare no longer denies claims for mental health services, home health care, or hospice care for these patients.

However, Medicare coverage for the care of Alzheimer's patients is still restricted. Medicare does not cover assisted living, senior housing, adult day care, or long-term nursing home care.

Medicare Part A (Hospital Insurance) will pay a limited fraction of the cost of care in a skilled nursing facility, but only if several requirements are met. First, the patient must have been hospitalized for at least three days for a medical condition. Second, the patient must be admitted to the skilled nursing facility within 30 days of being discharged from the hospital. Third, the patient must be admitted to the skilled nursing facility for the same condition for which he or she was admitted to the hospital. If all of these requirements are met, Medicare will pay in full for only the first 20 days in the skilled care facility. Days 21 through 100 will require a co-payment of up to $128 per day, and after day 100, Medicare payments will cease altogether.

Coverage of home health care is similarly restricted. Medicare Part A may pay for up to 100 visits, but only if the patient is also covered by Medicare Part B (Supplemental Health Insurance). To qualify, the patient must have spent at least three days in a hospital or skilled nursing facility, and be discharged within 14 days of the start of home health care services. The patient must be confined to home under a physician's orders.

Hospice care is covered if the patient is terminally ill and expected to have less than 6 months to live. Medicare initially covers two periods of 90 days, followed by an unlimited number of 60 day periods.

A Short Speech Before Filing A Medical Malpractice Lawsuit

Nursing home is the place where extra attention is taken care of by the highly skilled nursing and care unit to ensure that the patients get that extra attention and care they needed the most in order to get cured at a faster pace.

But, my friends, in this word where taking care and helping the ones in need is considered as an extra burden, several nursing homes don't show of the proper care and affection that are seriously required from them.

So many news and events do come out at the newspapers that show and ensures us about the medical negligence occurring at the nursing homes and abusing of patients by the nursing home units and staffs.

It has also been observed that the maximum number of malpractices and medical negligence always occur the most in these privately owned nursing homes. Wrong predictions of diseases are a very frequent thing that occurs at these so called the most capable places to get cured.

Most of the times, wrong predictions happen not because of the doctors don't have sufficient knowledge to handle the case but due to the fact that they don't want to predict for the right disease.

So, a definitive question occurs, "Why will the doctors do such thing?"

The answer is due to sheer greed for money. For example, suppose a patient has been affected with a disease that doesn't require enough tests and expensive medicines. But, unless prescribed the patient with expensive medicines and encourage the patient to do some expensive tests, the doctor will not get the big commission amount that if prescribe will be at the doctor's desk in no time at all.

This is purely a case of nursing home abuse and medical malpractice. Several patients from all over this entire so called beautiful world fall victim under this dangerous medical malpractice services offered by the medical bodies.

However, the time has come to rise up from your seat and join hands to protest against these ill deeds shown by the medical bodies and practitioners.

The most obvious thing you can do to show these evil people that you are ready to protest is to file a medical malpractice lawsuit against this medical bodies or nursing home units.

But you are required to proceed through the proper steps while filing the lawsuit against medical bodies that are quite influential or may have a lot of added knowledge of handling and facing these cases with ease.

So, you need to consult some professional as well highly experienced medical malpractice attorneys about the proceedings and steps required to handle the case. The best option is to appoint one such experienced attorney for handling your case of injustice.

These medical malpractice attorneys know the proper steps that are highly required to move through the proceedings after filing the lawsuit against the medical bodies and will try their level best to bring back the justice, which you truly deserve, before you.

Assisted Living Marketing Should Be Driven by Strategic Care

The formula seems pretty simple for the business of assisted living. The senior population is growing, so the need for senior care is growing. All a company has to do is to offer that care and they will have a growing (and successful) business. If only it were that simple.

Caring is actually a necessary part of success in assisted living, and all forms of senior care for that matter. However, just because a company offers good (or even great) care does not mean people will find them, then trust them enough to make a commitment and move in. That is where "Strategic Care" plays a critical role.

Strategic Care allows for the right people to recognize that a company really does care and helps those consumers to place the highest value on that expertise. It drives the 3 R's of assisted living marketing - Recognize, Remember and Rave about the company...and the care. It creates trust and motivates "move-in" decision-making. It leads to an increase in census and profitability.

This concept is not that difficult to execute. It just takes a business culture that allows, encourages and trains staff members to tie their actions to a desired business/marketing result, along with the desired care result. And this innovative approach can easily be integrated into various areas of the assisted living business that touch the consumer.

• Face-to-face meetings.


• Systems of operations.


• Collateral materials.


• Advertising and PR.


• Community outreach.


• And even websites.

The Progression From Mediocre To Great Marketing

Here's an example of how an everyday, polite occurrence (sometimes requirement) can be turned into a Strategic Care marketing tool that places high value right into the hands of the consumer.

So many times I have heard "This is our Activity Director, Maria" or something similar when being toured through an assisted living facility. It is polite and it accomplishes a caring function - an introduction. However, it misses an opportunity to communicate higher value, which is a key element of Strategic Care. So the function is completed, while the marketing is mediocre at most.

To add some Strategic Care, that same person could say "Here comes the Game Guru." (Maria will be encouraged to respond in a favorable way.) "I'd like you to meet Maria, our Activity Director. She has an amazing knack for helping seniors with cognitive problems to enjoy playing games."

In this case, value has been placed on Maria as a person. Plus, the fact that the issue of cognitive problems was mentioned will also add recognition and value to the services being offered, in this case Activities. Of course, this would work best when speaking with someone who has a loved one with dementia (the "right people" mentioned in the definition of Strategic Care above.)

This simple change creates much better marketing and positioning. Yet it can be taken to a higher level. The emotional introduction can be enhanced by adding a (true) story which includes more value, along with evidence of care being provided. "Maria always gets embarrassed when I brag about her, but Resident Bob's family thinks she is a magician. When Bob came to us, he wasn't very social. It took patience, but Maria allowed him to stay in his comfort zone and just watch everyone else have fun. Then, little by little, she helped him increase that zone. Now he's one of the first people to line up to play. I think your Mom and Maria will be best friends."

By incorporating a supporting story, more value was placed on Maria as a humble person and on her professional expertise. In addition, the value placed on her by other people was also included - an endorsement or testimonial. To take it even another step further, technology can add more power to this Strategic Care. For instance, "If you want, I can print you a photo of the Game Guru in action, so your Mom can become familiar with seeing her face before making the move to Oak Tree Assisted Living. Or, I can e-mail the photo, if that is convenient for you."

Drive A "Nice" Increase In Business

In the end, a "simple" introduction turns into a marketing and positioning bonanza that provides lots more value to the assisted living consumer, which can help to ease some of the pressure in their decision-making process. Look at all that is accomplished in this example.

• Shared kindness, as well as a feeling of inclusion to a visitor.


• Provided evidence of expertise in senior and dementia care.


• Demonstrated a willingness to serve and to go the extra mile.


• Provided an endorsement of the consumer's peers.


• Showed an understanding of the transition process a senior with dementia will most likely go through.


• Made the employee feel special and motivated them to continue to take great care of their residents.

Too simple to be this rewarding? Isn't this just being nice and caring for others? Absolutely! However, when care is combined with strategy, it becomes innovative marketing and very good business. When Strategic Care is incorporated into the selling process, communications mediums and business culture of assisted living companies, this powerful concept will increase sales.

Alzheimer's - How Can Caregivers Manage Patient Anger?

Alzheimer's patients express their anger by yelling, swearing, pushing, shoving, waving their arms, and in some instances, throwing things. These behaviors not only disturb others, they are threatened by them. Caregivers must learn how to manage anger to ensure the safety of all. I learned this when I was my mother's family caregiver.

For nine years, I felt like my mother was dying right before my eyes. The intelligent, sensible, calm parent of my childhood became verbally and physically aggressive. Her conversation was peppered with swear words and I was shocked when she yelled, "Go to hell!" I was astonished when the assisted living staff told me she was involved in a fist fight. I was embarrassed when she stole someone's teddy bear.

Who was this person?

Gradually, I learned to tell the difference between the anger of confusion and the anger of self-defense. According to "Anger Management Therapy for Dementia Patients," an article on the Answers 4 Alzheimer's website, some patients become so angry they stop talking. Others yell and gesture excitedly when they become upset. Anger management therapy, the ability to understand consequences and redirect anger, helps some patients.

But the problem with anger management therapy is that the person has to remember it. My mother could barely remember her name. From the caregiver's perspective, anger management may look like futile effort. Though the therapy may be only partially successful, the article says "any progress is undoubtedly helpful."

Anger may be a sign of sundowning, the late afternoon mood changes, agitation, fear, pacing and rocking that many patients experience. After my mother threatened to run away her doctor transferred her to nursing care. Mom thought I had put her in a mental institution and was furious. When I visited her one afternoon I observed her sundowning behavior. She paced back and forth and looked out the window nervously. Later conversations revealed that she was having hallucinations.

Similar behavior is described in an article, "Sundowners Syndrome," published on the Alzheimer's A Place for Mom website. Caregivers can dispel anger by sticking to a routine, monitoring diet, controlling noise, opening curtains to let light in, and turning on more lights. Redirecting the person (reading to him or her, playing soft music, giving them a glass of juice) may also help.

Exercise also helps to quell anger, according to "Managing Common Symptoms and Problems, an article on the Help Guide website. But it has to be regular and purposeful exercise. My mother did not like the exercise activities, yet she participated in them. One activity involved sitting in a circle and throwing a ball. "Don't they think I can catch a ball?" she asked.

In the later stages of the disease Alzheimer's patients may become belligerent and aggressive. Caregivers have to protect Alzheimer's patients from harming themselves, the article notes. Provoked as you may be (and my mother certainly provoked me), do not answer accusations, confront the person, or discuss angry behavior. "The person with dementia cannot reflect on their unacceptable behavior and cannot learn to control it."

Get some help if the patient is overly aggressive. You may also say, "I have to leave now, but will come back later," and walk away. Caregivers need to remain calm and look for aggression patterns, such as the anger of sundowning. Remember, anger comes comes from the disease and not the person.

Copyright 2010 by Harriet Hodgson

What You Need to Know About Helping Senior Citizens

Introduction

The baby boomers is the population which haven taken birth after second world war till 1965 when there was a tremendous increase in birth rate due to the social and economic development in the USA. Now this population is going into the old age and thus bringing a burden to the nation as the country has to take care of not only the food and shelter but also the medical care. Rather medical care is in a way more important as they are prone to many diseases not only infectious because of their lowered immunity but also non -communicable ones such as Diabetes Mellitus, Myocardial Infarction, Stroke, etc. not to speak of those other mental disorders such as Depression, Parkinson's disease, Alzheimer's disease, etc.

Current problem

There is more than 35million population in USA that is more than 65 years as per the latest Census Bureau report. This is nearly 12 % of the whole population and this is supposed to more than double in the next 50 years or so requiring the nation provide for their well-being. At present, it is said, that the disabled and elderly account for only around 20% of Medicaid spending but they account for more than 75% of the Medicaid spending on the prescription medicines. There is yet another set of problems. There is a progressive decline in the renal function of the elderly. The enzymes needed to metabolize the drug are less and have they have sensitivity towards certain drugs. They also have lesser free fluid volume. These and many other factors make the elderly especially susceptible for drug toxicity. Also adverse drug reactions are much more common in the aged population than others.

Buying cheap drugs

There are certain federal and other non-governmental plans available that help the senior citizens to buy the drugs cheaper. These are:

1. Medicaid

When president Lyndon Johnson signed the Medicare and Medicaid act in 1965 it marked a new era for the health care in USA. For a minimum amount, which is called a co-payment or some deductions, one can avail this facility. Nearly all states provide this facility to their population. You just have to fulfill certain their requirements.

2. Drug store discounts

Certain seniors are allowed a discount on their prescriptions, which can help them majorly.

3. Medicare drug discount cards

This is available for that elderly population who are not entitled for benefit under the Medicaid program.

4. Medicare prescription assistance programs

This type of program is available in nearly all states although they may differ in the eligibility requirements.

5. Online buying

People may buy the drugs online through the Internet but the only drawback is that they have to rely on the seller and in that process they may get duped by getting second grade items or by their money.

6. Buying from Canada

Some people prefer to buy their medicines from Canada, which has health policy a bit different from that of USA and hence provides a market for cheaper drugs. FDA does take it seriously if one buys them in small amounts.

7. Charities

There are certain charitable institutions, which help the elderly and the destitute in having their medicines, which at times they, give free of cost.

8. Others like state prescription fund, LCD, prescription drug credit program, subsidies, PAAD, PACENET,

Options available besides drugs

Besides the above options available for getting cheaper drugs there are other options like living in an extended health care facility or long term care facility or assisted living where people can not only live a normal healthy life but also get treatment if the need arise.

Top 5 Nursing Jobs - From Home Health Nurses to Floor Nursing Careers

Nursing is more than checking vital signs at regular intervals. The nursing field is full of opportunities for the new and experienced nurse who doesn't want to be limited in his or her choices. Here are five of the top choices in the nursing profession.

Once you graduate from nursing school, take a deep breath. The hard part is over and the fun begins. Now, you get to choose where you want to start your nursing career. The hospital floor is not the only choice out there anymore.

1. Home Health Nursing - People are living longer. With that comes the issue of care in the home. More seniors are opting to stay in their primary residence and take advantage of the home health benefits of their insurance plans. One popular nursing job is that of a home health nurse because they have the benefit of making their own schedule. They can take on as few or as many patients as they can handle. Home health nurses aid in bathing, wound care and dressing, general health assessments, and any other issues that the patient may have. There patients can be invalids or ambulatory folks that don't get around so well and seek a nurse that is willing to tend to their care within the home setting. Home health nurses are well paid for their skills and friendly bedside manner.

2. Nursing Assistants - Nursing assistants are an integral part of the nursing profession. They are not registered nurses but they provide patient care that falls under the category of the nursing profession. Nursing assistants are not only found in nursing homes. They work in hospitals, senior living communities, home health, psychiatric facilities, and other facilities where their care is needed. They care for terminally ill patients including children. Nursing assistants provide the care that others shy away from such as changing bedpans, bathing patients that can't bathe themselves, and feeding those patients whose disabilities prevent them from doing it for themselves. They bring respect to the area of nursing care and dignity to their patients. Nursing assistants see, on a daily basis, how their jobs impact the quality of life of their patients and their families. As patients get older, nursing assistants will be needed in big numbers.

3. Emergency Room Nursing - Have you been to an emergency room lately? You have a few doctors that see patients, but the majority of the staff is comprised of nurses. Nurses assess the patients and triage them according to injuries. They monitor them while they wait for a doctor or transfer to another department in the hospital. Emergency room nursing is a fast-paced and stressful atmosphere that satisfies the adventure junky in some of us. Nurses that think fast on their feet would get quite a bit of enjoyment from this area of nursing. There is no shortage of accidents on the road, in the home, and in the air. The job of these nurses is critical to the survival of patients that are hanging on by the thinnest thread.

4. Floor Nursing - There is a wide variety of options in this area. Floor nurses have the options of maternity, critical care, orthopedics, telemetry, surgical, geriatric, and pediatrics. Within these general categories are also oncology and burn units. A nurse can gain lots of experience working within one or several of these areas during their nursing careers. Floor nurses are responsible for a certain number of patients each shift. Patients have the comfort of getting to know their nursing staff and the staff has the pleasure of taking care of them.

5. Operating Room Nursing - Nurses work in the surgical area as well. Nurses can pursue careers as a circulating nurse in the operating room suite, surgical first assistant to the surgeon, and nurse anesthesia care. Nurses that provide anesthesia have at least two years of critical care experience and have attended a nurse anesthesia school for training. Circulating nurses are responsible for everyone in their operating room that day. They function as patient advocates--making sure that the patient being operated on is the correct patient and that the doctor is performing the correct procedure.

Nurses have many career paths available to them. They can pursue any of these five areas or another that they feel drawn to follow.

Which Area of Nursing is For You?

If you are looking for a career in nursing you will probably know already just how large an area nursing actually is, so it is a good idea to know what each type of nursing involves. There are so many different branches to having a career as a nurse which can encompass things such as:

o Adult nursing - this focuses on meeting the needs of adult patients in various settings such as hospitals, outpatient clinics, care homes and in the patient's own homes. When you are a nurse for adults you will be expected to have a basic nursing qualification and then go on to further qualifications which are targeted in the area that you choose to work. For example if you choose to go on to become a midwife you will need to complete a midwifery course and gain the correct nursing qualifications. Some adult nurses like to branch out into areas which are specific to certain illnesses, for example becoming a cancer care nurse or a nurse that works with very elderly patients.

o Nursing in the mental health sector - this type of nursing focus is very much on the different needs that people with mental health problems can have. This type of work can be incredibly distressing for both the patients and nurses, so it is essential that you follow the correct mental health nursing program and gain experience in practical and theoretical treatments for people who are suffering from mental health problems. Some people who become a mental health nurse, go on to work in other sectors such as family services and even with the police in forensic departments.

o Learning disability nurses - this type of nursing looks at how nurses can help people with learning disabilities to care for themselves, improve their health, interact with their families and integrate themselves fully into society. This type of nursing requires that you have a practical understanding of the issues that surround learning disabilities and are committed to providing a service which helps those with learning disabilities reach their full potential. Once again this is a very rewarding yet sometimes challenging area of nursing and many nurses choose to go into the learning disability area as it is something that has a strong attraction for them.

o Children's nurses - this type of nursing often relates to caring for children who are in hospital for long and short stay. This can be quite technical and complex care and can often involve working in an intensive care setting. With this in mind and nurses then have the option to take a course which relates to the setting that they wish to work in for example, theatre nurses, accident and emergency nurses and intensive care nurses.

As you can see nursing can take place in a variety of different settings and working with a whole range of different people. It is essential to get a basic nursing qualification before moving on to a specific area which you can then focus on. For more information on this contact your local education authority.

False Imprisonment Claims

The world of torts is designed to protect a person from injuries to the self and to the property. These claims vary and involve a variety of different forms of liability but they all involve civil protection to the person and property.

Some of the protections offered to a person can apply in both the civil and criminal realms. One of the claims that has some sort of mirror in the criminal world is false imprisonment. False imprisonment is, according to Black's Law Dictionary, a "restraint of a person in a bounded area without justification or consent."  

In order to have a claim for false imprisonment, one must meet all of the elements of the claim. Because false imprisonment is an intentional tort, the plaintiff must be able to show that there was some form of intention to confine the person that was held or another person within the boundaries that were fixed by the defendant. For this type of claim, recklessness is sufficient.

Once intent has been proven, it is necessary to prove that there is total restraint of the individual. The claimant must have no reasonable way of escaping. So the door can be locked, etc. Jumping out of a window on a high storey does not count as a reasonable way of making one's escape. In other instances, an open door guarded by burly or threatening individuals may be enough to constitute confinement.

If a person is confined, he or she does not have to be actually aware of the confinement or even be harmed by it in order to have the claim. It is merely necessary that the confinement be actual, not that the individual be aware of the confinement at the time it is occurring.

False imprisonment claims can be filed against both private individuals, like kidnappers, or the government itself. Both groups are subject to liability if they hold someone unlawfully without consent.

In addition to the civil claim, if the imprisonment is severe enough, it can be raised by a prosecutor as a misdemeanor, in most jurisdictions. The criminal charges can be brought even if civil charges have already been filed. The same works in reverse. The two claims can be brought because they work in different realms of law. In addition, civil suits do not threaten a person's liberty and so there is no issue with double jeopardy.

False imprisonment is one of numerous personal injury lawsuits. It protects an individual's personal interest in being able to move from place to place as he or she sees fit.

Hiring Home Help For Seniors

At some point in the caregiving journey, most caregivers will feel they need help in providing care. You can enlist the help of family or friends, find some help from your local health system, or you can hire someone. If you are hiring someone you will most likely be hiring what is called a home health aide. Other names may be a companion, home care worker, Nurse's Aide or Care Aide.

There are three reasons for hiring caregivers:

1.Help with what are called the " Instrumental Activities of Daily Living (IADL)." These include shopping, housekeeping, laundry, and and meal preparation.
2. Help with "Activities of Daily Living (ADL)." These are personal care needs, such as dressing, bathing, toilet help, and mobility.
3.Companionship and monitoring.

Caregivers can be hired through an agency or privately. Some advantages to an agency are that caregivers are pre-trained and screened, their benefits are paid for, and there is back-up in case they don't show up. They have a supervisor who should be monitoring the care they provide. One disadvantage is the caregiver receives only a portion of the money that you pay. A second is loyalty may be more to the agency than to you.

Caregivers hired from agencies have various levels of training. These can correspond to the complexity of tasks they will be required to do. For companionship or housekeeping, you will not need a trained care aide. When you get into personal care tasks, you will. If you require medical tasks you might need a Licensed Practical Nurse (LPN) or Registered Nurse (RN). Make sure the caregiver's skills correspond to your needs.

You can find Home Care or Home Health agencies in the phone book or on line. You can ask your local health department, or the ombudsman, or even contact your local Alzheimer's Society.

If you use an agency find out about the agency's background. How long have they been in business. Who owns it? What kind of training does the agency owner have? Have there been lawsuits, or problems with it? Are they members of the Better Business Bureau? You might want to get references from them.

Some points on which to be clear with an agency:

1. What tasks you wish the caregiver to do--cooking, housekeeping, personal care, or others.
2. What kind of training will the caregiver have.
3. What kind of supervision will the agency do.
4. Ask for the same caregiver each week.
5. The skills you want--proficiency in English, or some one who is talkative, or someone who is experienced with the condition.
6. What you want to do if the caregiver days fall on a holiday, or if the caregiver has an emergency or can't make it. Do you want a replacement?
7. Do you want the caregiver to have a car?
8. Interview the caregiver first. This will cost you money, but you will be able to determine if the fit is good or not. Do not be afraid to say no if you do not think the person is appropriate..
9. Do not be afraid to interview caregivers from a couple of agencies. You do not owe loyalty to a company.

If you wish to hire a caregiver privately, you can find one online through a listing service such as Elderpost, a website specifically developed for caregivers, seniors, and providers of care and products. You can put an ad in a local newspaper, or again, ask the Alzheimer's Society. Adult Day Care centres often know of people, as may a nursing home.

Wherever the caregiver comes from, you should be monitoring what the caregiver is doing, or even if the caregiver is even showing up. They should sign in each time they come, and there should be some record of what they have done. You should go to the home while they are there and watch what they do and how they are doing it. Pay attention to the way they are interacting with your loved one/client. More important, watch to see how they are reacting to the caregiver.

Be sure to ask your loved on how they feel about the caregiver. He or she might not like anyone, or not like anyone coming into their home, but they may give you real clues as to what is happening when you are not there. Be aware of signs of abuse, emotional, physical, or financial.

You should be able to notice some improvement or changes from having a caregiver, which will correspond to the goals or reason for which they were hired. Is your loved one/client cleaner? Gaining weight? More animated? Are medications being taken at the rate they should be?

Finally--remember that is you do not like a home caregiver that you have hired, or that comes in, you can fire them or look for another agency. Try to work it out with the agency, but if you are not happy, you can walk.

Assisted Living Residents Reflect On The 50th Anniversary Of The JFK Inaugural Speech

"Let the word go forth from this time and place, to friend and foe alike, that the torch has been passed to a new generation of Americans." The insightful quote delivered by President John F. Kennedy in his inaugural speech fifty years ago on January 20, 1961 seemed as though it was tailor-made to fit the baby boomer generation. Baby boomers have now started thinking about Assisted Living Facilities and Skilled Nursing Facilities for their retirement. Even though the oldest boomers were only fifteen years old at the time, President Kennedy's words exuded among other things, optimism, a hallmark of the generation. The birth of some 70+ million baby boomers indeed made history, and may even be the reason why they are in their own right, idealists.

Born in the post World War II era between 1946 and 1964, the generation grew up in a time of prosperity and reform in the U.S. that gave them the advantage of believing they could make a difference in the world. They questioned out dated authority systems and challenged the status quo. Born of parents who suffered through the hardships of the Great Wars and the Depression era, Boomers quickly discovered that life for them had so much more to offer. Boomers, well educated and widely associated with privilege, affluence and influence. As a group, they are considered the healthiest, most educated and wealthiest generation.

Echoed in the words of JFK, "Let every nation know, whether it wishes us well or ill, that we shall pay any price, bear any burden, meet any hardship, support any friend, oppose any foe, to assure the survival and the success of liberty," the boomer generation believes in freedom, at home and abroad. Their beliefs in the importance of individual freedom and choice as Americans spurred the generation into making tremendous contributions to various social change such as the civil rights movement, gay rights movement, feminist movement, right to privacy and rights of the handicapped. Over the last five decades since JFK's inaugural speech, the generation has come of age and the majority of them have affirmed their commitment to establish and preserve these rights.

The admiration for President Kennedy extended well beyond a generation of Americans, and never seemed as evident as when I saw his framed photograph on the library bookshelf of a Russian immigrant. The "puposka," as she liked to call herself, had left communist Russia with her elderly mother a few years after President Kennedy's assassination. I once asked her about it and she said that, "he was a great leader and his pursuit of liberty was something we continue to strive for as a people." So many of the inaugural quotes still ring true and hold credence today in our conflicted political climate. Some of the favorites are:

"So let us begin anew -- remembering on both sides that civility is not a sign of weakness, and sincerity is always subject to proof. Let us never negotiate out of fear, but let us never fear to negotiate."

"To those new states whom we welcome to the ranks of the free, we pledge our word that one form of colonial control shall not have passed away merely to be replaced by a far more iron tyranny. We shall not always expect to find them supporting our view. But we shall always hope to find them strongly supporting their own freedom -- and to remember that, in the past, those who foolishly sought power by riding the back of the tiger ended up inside."

"Divided there is little we can do -- for we dare not meet a powerful challenge at odds and split asunder."

Many Assisted Living residents fondly reflect on their fallen hero and his principles that still hold strong today. Some Assisted Living Facilities arrange story telling sessions so that children can learn about their residents' experiences during the times of JFK. The elderly citizens living in Assisted Living Facilities have a bonding experience with the children as they are able to pass on their stories and relive the moments of their life through their stories.

Long-Term Care Insurance - A Simple Explanation

Long-term Care Insurance can be an effective tool for protecting your assets and estate from the high costs of senior care. Though the average nursing home length of stay is significantly higher than most people believe, 2.4 years according to a report conducted by the National Center for Health Statistics, less than 20% of long-term care is nursing home care. Home care, home health care, adult day care, assisted living facility care and others constitute the overwhelming majority of senior care services. These services are covered under most Long-Term Care insurance policies.

Generally, the people who are in need of care are responsible for paying the costs. Long Term Care is usually not covered by your personal health insurance plan or by the policy you may currently have from a present or previous employer. Medicare usually pays for only a small percentage of skilled nursing costs while Medicaid provides health care coverage to Americans with lower incomes and can pay almost half of all nursing home costs.

It is likely that you will need long-term care in the future however, no one can predict the kind of care that may be needed or the exact costs involved. With Long-term Care Insurance, you can plan and budget for a known and quantifiable premium for a policy that can protect you from potentially large out of pocket expenses. It can be beneficial to learn about the different types of policies available to you in order to match the most appropriate policy to suit your needs.

Types of Long-Term Care Insurance Policies

The most common policy type is indemnity which pays a maximum fixed benefit. A benefit amount is chosen at the time the policy is issued and actual expenses, up to a fixed predetermined dollar amount, are reimbursed as they are incurred.

Integrated policies pool benefits are becoming more popular today. The provisions allow for a total dollar amount that may be used for various long-term care services with expense limits on a daily, weekly or monthly basis. Due to rapidly increasing long-term care costs, most policies offer inflation adjustments to help offset high anticipated future costs.

Long-term Care Insurance policies often take effect when an individual is unable to perform activities of daily living or becomes cognitively impaired from dementia or related illnesses. Home care services such as physical therapy, skilled and unskilled nursing care and home health aide support provided by licensed agencies are generally covered as are skilled, intermediate and custodial care services provided in licensed nursing facilities. It should be noted that if any conditions are preexisting, benefits often denied if care is needed within six months of the policy's issue date for that condition.

What to Consider Before Purchasing a Long-Term Care Insurance Policy

o Verify that the insurance agent is licensed to sell long-term care insurance in your state and is a Long-Term Care Specialist. It is to your advantage if he/she has additional education and training in Long-Term Care financing and planning (LTCP, CLTC).

o Review the ratings of the carriers to ensure that the insurance provider is financially secure since you will likely need the policy for years to come

o Determine exactly which services are covered, e.g., skilled nursing home care, unskilled nursing facility care, home health care, adult day care, etc.

o Examine the length of time benefits are provided for the various types of services covered, look for maximum lifetime benefit amounts

o Identify the length of time before preexisting conditions are covered

o Find out how long you must wait before benefits begin for services

o Inquire regarding coverage of Alzheimer's and other related illnesses

o Review any premium provision waivers

o Analyze cost requirements to ensure your ability to make policy payments during retirement years.

Elder Care: Elder Abuse - What It Is And How To Catch It

Maybe you've seen the statistics lately indicating that a baby boomer reaches retirement age every ten seconds. Those over 65 years of age will soon outnumber the less than 65 age group. These statistics give an indication of the pressure that is put on Social Security and on nursing homes, long-term care facilities and other facilities needed to take care of senior citizens in their final days.

And it isn't just the facilities that are in short supply. There is a shortage of nurses, nursing assistants and other healthcare workers who work in this specialized field.

The shortage is so bad for qualified personnel that a recent study showed that 90% of healthcare facilities had at least one convicted felon. Schools that train nursing personnel are booming in enrollment. There was an ad the other day that touted you can get a nursing certificate in as little as two weeks.

The point is, with the increased demand that seniors are putting on the system, the system is not doing a good job at keeping up in terms of facilities and personnel to care for them.

This leads to all kinds of elder abuse which can be manifested in physical, verbal and even psychological ways. A congressional study revealed that 60% of nursing homes had some kind of elder abuse. Many people are turning to alternatives to nursing homes and long-term care facilities such as home healthcare.

There is an absolute boom in home healthcare for seniors. That takes care of one of the problems - the facility - but not the other of qualified staff. If you use this alternative, you have to be especially careful because the person that is going to be taking care of your mom or dad in their house or yours is essentially a complete stranger. The vetting of personnel often goes by the wayside, which leaves the hiring of unqualified personnel with questionable backgrounds. This only exacerbates the problem of elder abuse.

So what can you do to help prevent or catch elder abuse? If you suspect it is happening with your parents, a hidden camera inside their room either in a nursing home, long-term care facility or especially in a home healthcare situation is a very viable solution. A hidden camera can be inside any common object that people are used to seeing in a home, office or business situation.

One of the most effective is the Projection Display Clock. It has a built-in DVR that records to an SD card. No one would ever suspect that an AM/FM radio is recording everything that's going on with the motion activation feature. It is just one example of many of the hidden cameras that can be used to document elder abuse of seniors.

It provides another set of eyes on a very sensitive issue. You can't be there all the time, so a hidden camera can provide documentation in an elder abuse situation or help document wrongdoing on the part of the home health caregiver.

Texas was the first state that authorized the use of a hidden camera to help catch and prevent elder abuse.

Be proactive in protecting your parents from elder abuse. A hidden camera is the best way to document an otherwise difficult crime to prove.

Reasons To Get Elderly Home Care

Home, no matter how humble or grand, is an oasis of comfort and privacy. It wraps its loving arms around its occupants and soothes with the familiar rooms, belongings and routines. Seniors live longer and happier aging in place. Elderly Home Care allows these senior citizens to stay safely in their homes and enjoy their freedom and flexibility. Specialized programs can be adapted to the needs of each individual. The three times to call these professionals are when someone needs help with general household chores, personal grooming or the day-to-day functions of living.

Concern about the well-being of an elderly loved one is a great reason to arrange for help. Hiring an aid to work a few hours a week assisting with harder household chores, shopping or accompanying the senior citizen on social outings are beneficial to both parties. The concerned person will get weekly updates on current conditions and senior citizens have someone to visit with and help with hard-to-do chores.

Extra hands for personal grooming offer security. Having someone help a person into a shower, wash their hair, do the laundry or prepare meals keeps people at home longer. They can continue to enjoy the neighborhood and the normal activities. This is an inexpensive alternative to retirement centers and assisted living.

Elderly Home Care allows frail or disabled people the luxury of staying in a place they love. This level of care may require full-time assistance. These professionals are trained in moving people from a bed to wheelchair, assisting with eating and bathing, following doctor's orders and dispensing medication.

Allowing senior citizens to remain in the comfort of their home longer is easy to do with Elderly Home Care. These programs can be customized to meet the requirements of each person and improve their quality of life while assuring concerned family members and relatives the loved one is safe.

Receptionist Training - What Will You Learn?

Most people who are drawn to receptionist training come already equipped with the people skills that their jobs on the front lines of bustling offices will require. But other receptionist skills must be taught! Here is an overview of the kinds of things a student can expect to learn at community college.

Introduction to Bookkeeping

Most receptionist programs at the college level provides students with an introduction to double entry bookkeeping. This will make you an asset to future employers!

Advanced Keyboarding Skills

Receptionist programs can also include courses that help refine your ability to type. Because receptionists today spend so much of their time sitting in front of computer screens, you may also receive training on how to position yourself so as to avoid injury. You may be asked to improve your typing speed.

A Refresher Course on the Internet

The Internet has become a part of our daily lives, but some receptionist training still includes a look at this tool from a professional perspective. What are the right names for the tools we use everyday? How can we troubleshoot when things go wrong?

Spreadsheets 101

Most receptionist programs includes information on such software programs as Microsoft Excel. As a receptionist, you may be required to create or use spreadsheets for your employer. The more you know about Excel, the easier your job will be.

The Secrets of Microsoft Word

You may think you know Word, having used it at home on your personal computer, but there are many short cuts and tips that long-time users can teach you. If you are lucky, an in-depth look at Word will form part of your receptionist training.

Basic Punctuation

After receptionist training, you will find a job, where you will, in a sense, be a face of your organization. You will probably have to write emails on behalf of your organization, and you will want to avoid making grammatical mistakes. Taking the time now to review your writing skills can save you embarrassment later.

But that's not all that you will learn at receptionist training. You will probably get advice on how to dress appropriately for different kinds of workplaces. You may learn some tips for dealing with difficult personalities, whether on the phone, over email or in person.

If you are lucky, your receptionist training may also include a job placement program, that will help you land your first job out of school.

Other Perks of Studying to Become a Receptionist

Another perk of receptionist training is the camaraderie that can develop between fellow students. So enjoy your time at school!

What Is a Master's in Health Administration?

A master's degree in health administration is a unique degree. It is unique because it gives you a set of skills and knowledge that nobody else has. How? The United States health care system is extremely complicated, requiring people with very specific and unique knowledge. A master's degree in health administration is a crash course in the health care industry. By pursuing this degree, you will be able to move into the health care field with special skills.

In order to gain admission into a master's in health administration program, you will need to have an undergraduate degree. Most schools do not require a specific college major, however students with business, science, or liberal arts backgrounds are encouraged to apply. In addition, there are opportunities at some universities for an undergraduate degree in health care administration. These programs will get you entry level jobs, however they will not allow you to immediately begin in a challenging and high paying position.

Universities and colleges offer various formats for the master's in health administration degrees. One type is on campus programs. On campus programs are great for students that have the time and are able to go to a university. Those programs are normally offered at night and allow students to work at a nearby hospital or gain experience with internships.

However, there are numerous programs online that can be perfect for anyone no matter where they live. You can take courses and pursue your entire health administration degree online. This gives you a great opportunity to take classes at your own pace, pay a lower price, and get valuable experience. Really, you can work at the same time and gain a lot of experience.

In addition to an undergraduate degree, some master's in health administration programs require the GRE or GMAT. No worries though, as most programs do not. Often the residential programs require some sort of test. However, the online health administration degrees normally do not require this. The nature of the degree does not depend on a test score, but your willingness to work hard and succeed.

Online programs in general can offer a great experience because of the flexibility. Students enrolled in an online program can now put that on their resume and begin their job search. Most hospitals love students that have graduated with a master's in health administration, but will certainly hire someone pursuing the degree. If you are in the middle of a program, you can apply for all sorts of positions and begin making money. Once you graduate, likely you will receive additional professional opportunities and responsibilities. Mainly, you can use this degree as an opportunity to succeed in the fastest growing industry in the country. As the nation gets bigger, hospitals get bigger, and so does the need for students with a master's in health administration.

CNA Job Description Varies With Employed Position And Health Care Facility

You may have completed your nurse aide training program and earned CNA Certification, and now you must be aiming to start your career in the health care field. But, are you aware that as a certified nurse aide your CNA Job Description varies with the type of job you are employed and your job position.

As a certified nurse aide, you can get employment in a hospital, long term care unit, nursing home, adult homes, rehabilitation center, hospice, psychiatric care center or health clinics. It is also possible that you may work as a private duty CNA, home health aide, travel nurse aide, military nurse aide or school nurse aide.

Different types of Job Description need execution of specific nurse aide duties that are essential for that particular job. CNA Programs must have trained you for executing common and basic everyday routine cares, but the skill and knowledge gained from the training program needs to be executed differently for separate jobs. For example, if you work in a physicians office, you will have to perform separate set of duties than working as a home health aide.

Again, the position you are employed also needs execution of duties more related to that work. In same facility also you may be employed in different departments where your responsibilities also vary. Working in an OPD of a hospital needs performance of separate set of duties than working in an operation theater or intensive care unit.

Hospital Nurse Aide

If you work in a hospital, your job description is divided among different units of the hospital. You may work in the opd, intensive-care unit, operation room, neo natal center, neurology department, post-anesthesia care unit, neo natal intensive care unit, emergency department, pediatric intensive-care unit, cardiology or coronary care unit or hospital stores looking after medication and other hospital inventory supplies.

In an operation room of the hospital, your duties are more concentrated in assisting surgeons and specialized nurses during surgical operations. You may also have to sterilize operating knives, scissors and other equipments. It is also your duty to prepare the patient for operation and counsel him/her about the treatment and operation procedures.

If you are employed in an OPD of a hospital, you are required to attend incoming and outgoing patients, provide them medications as directed by the physician and perform other duties.

You must also remember that in a hospital, you are required to execute your duties and responsibilities under the direct supervision of a physician, registered nurse or licensed practical nurse.

But, suppose if you are working as a home health aide, your job description shows that you will have to offer care to patients who are recovering at home from long treatments or patients that are released from the hospital after certain period of time.

Home Health Aide

In the home of the patient, you may have to execute duties, such as count, measure and record vital signs, measure intake and output of fluids, measure height and weight, proper use of bed pan, dressing and undressing patients, cleaning and dressing wounds, clean the room and change bed linens.

In addition, you may also have to perform some house keeping, cook for the patient, assist in movements through wheel chairs and walking, supervise exercises, answer light calls and execute numerous other duties.

Therefore, your CNA duties are specified to units and positions you are employed. Even your CNA salary also depends on these factors and as a certified nurse aide working in an Operating room or Intensive care unit you earn much higher than working as a home health aide.

Becoming a Psychiatric Nurse

Psychiatric nurses are basically medical personnel who treat patients who suffer from mental disorders. Just like other fields of specialization, mental health is also an area of specialization. If you have interest to help people with mental disabilities, you can pursue a certification, degree or diploma in psychiatric nursing. Adopting education in this field gives you training in different ways of handling patients suffering from mental disabilities, counseling them and assisting them.

Psychiatric nurse courses
Medical schools offer courses for psychiatric nursing. Official approval has to be acquired for becoming a registered nurse in this field. There also medical schools that offer high education in this field.

There are two levels of education in this field,

Basic Level:
This level of education teaches the student to relate with patients and their mental disorders. The students are trained in diagnosing mental disabilities and taking care of such patients is also taught. This field of study can reward a student with a certificate, degree or a diploma.

Advanced Level:
This level teaches the student about complexities of mental disabilities and dealing with such patients. There are special courses offered that teach about diagnosing, evaluating and treating patients with mental disorders. The psychiatric nurses are also trained in knowing the problems that cause mental disabilities, the nurse is also able to deal with families and not only individuals. This level of education offers masters degree in psychiatric nursing.

Duties of a psychiatric nurse
Because the field of is vast and covers various areas of specialization, this is what anyone willing to become a psychiatric nurse should know. The sensitivity of mental illnesses differs as some are mild and some are complex. Depending on your area of specialization, you would have to deal with every patient depending on his or her condition. Some of the duties of a psychiatric nurse are:

- The nurse can be required to work as a consultant in the case of an individual suffering from mental disorder.
- Counseling, educating and informing families and relatives about issues related to mental health.
- Managing a patient's condition till the time of complete recovery.
- Ensuring that there is a treatment plan and making sure that the plan has been correctly applied.
- Providing emergency psychiatric services and care to patients.
- Providing assessment on those suffering from mental problems.

Different kinds of mental disorders handled by a psychiatric nurse

Depression:
It is low self esteem and changes in moods, lack of interest and appetite.
Dementia:

It is a condition that can affect people in old age, it involves refusal of cognitive functions.
Schizophrenia:

This type of disorder causes an abnormality, whereby a person's sense of reality does not function. These types of patients constantly become hallucinate and delusional much.
Bipolar disorder:

These mental disorders create a serious change in patient's mood. The patient can suffer from depression always stay sad.

The jobs in this field

As there are higher levels of education in the psychiatric nursing field, you can become:

- Research professor in mental institutions
- Hospital administrator
- Child youth mental health specialist

Houston: The Car Accident Capitol of Texas

Statistical data compiled by the Texas Department of Transportation (DOT) indicates that Houston is the city that consistently has the most total car accidents and the most fatal and injurious vehicle accidents annually. In 2011, there were 177 fatal crashes, 4,252 serious injury crashes, and a grand total of 38,538 crashes. These statistics mean that Houston not only surpasses, but far surpasses the car accident rates of most other cities in the state of Texas. What is the reason for such a high accident rate?

Since most car accidents are avoidable, the number one cause of motor vehicle accidents is driver negligence. Most car accidents occur because a driver was not paying attention or they were driving contrary to the laws of the road. While this is the overarching cause of most car accidents, there are many other more specific reasons why motorists are involved in collisions. One of the most common is driver distraction. According to the National Highway Traffic Safety Administration (NHTSA), distracted driving is anything that takes a driver's mind, eyes or hands off of the situation at hand.

Another common contributing factor to accidents in the Houston area is the busy roads and interstates. Houston is at the top of the list for having some of the world's most complicated interchange and highway systems. With roads sometimes spanning more than four lanes wide, accidents are more likely to occur than on rural or suburban roads. Houston is a busy metropolitan area, and those types of areas are statistically more prone to accidents.

Speeding drivers, according to the Texas DOT, are a major cause of all traffic fatalities on Houston and other Texas roads and highways. Speeding is a type of aggressive driving practice, commonly a contributing factor to not only accidents, but accidents with serious consequences. Other types of aggressive driving include tailgating and road rage. Sadly enough, the most common cause of fatal crashes in Texas is driving under the influence of alcohol. In 2011, there were 327 of these accidents.

When a driver fails to adhere to traffic laws, they may be issued a citation, but the victims of these accidents can also take civil action against them in order to recover financial compensation for injuries and other damages. If you reside in Houston or were involved in a car accident in the area, then consult with a personal injury attorney in your area for the best advice concerning the steps that you may be able to take toward financial compensation.

Maritime Lawyers Discuss - How Soon Should I Return to Work After My Offshore Accident?

Often, a Jones Act seaman or other offshore worker, dock worker or longshoreman will get injured and a maritime employer will immediately insist that the injured worker come back and do light duty work. Sometimes, the employer will even push an injured worker back out to an oil rig or a boat doing medium duty work.

Running back to work very quickly will be very bad for your case for a lot of reasons. When you are injured on the job, your company will have a lot of people watching you. You will be under maritime surveillance while you stay off of work and you will be closely looked at by everyone on the job if you go back to work. You'll be amazed that witnesses will come into court and testify they saw you doing very heavy activities out there once you went back to work, showing the court you were never really injured.

Many doctors, chiropractors, pain clinics and other medical providers that see you after you go back to work will think that since you are able to go back to work, you are probably doing well enough to work; therefore they will let you keep working. This means your treating physician will release you from care possibly sooner if an injured seaman can return to work on their own.

Of the many damages you are able to recovery in a maritime personal injury case, one of the largest will be your maritime wage loss claim and/or loss of earning capacity claim. Many people working within the maritime industry make good money, and when they get hurt, if they can't go back to full duty heavy labor they have the potential for a large amount of lost wages. When you go back to work, even if it's temporary, you are helping to prove the company's case against you. Your marine adjuster or maritime employer will look at the injured seaman's returning to work as proof that he or she can continue making as much money as before the accident.

A competent, experienced maritime lawyer will tell any injured offshore worker that he or she should never go back to work unless they believe that in their current medical condition they could be hired by another company. If your company offers you some sort of sheltered employment or light duty work that they are creating just for you, to accommodate your injuries, you want to ask yourself if in your current condition you could apply to work for another company and actually get a job. If you can't then you should not return to work.

For more information about your rights as an injured maritime employee, please email us today at SMSH Maritime Lawyers or call us at 1-800-282-2122.

Assisted Living in Los Angeles

CONTINUING-CARE RETIREMENT COMMUNITIES (CCRCS)

Continuing Care Retirement Communities are designed to allow seniors to "age in place". The senior resident can choice from many coordinated activities that are offered throughout the week. This type of community offers the resident a long-term contract that provides different types of senior housing options (Independent, assisted living and Nursing Care), usually all in one location. This type of community offers seniors that are currently living independently, the security of continuing elder care services for as long as their needs might change. Starting with living on ones own, then transferring to assisted living and later to Nursing care all onsite, not moving to another location. The retirement living community in Los Angeles may range from high rise apartments and condos to cottages and duplexes or sometimes single family homes. These Continuing-Care Communities require an entry or life-time commitment contract, regardless of their future needs. They are the most expensive type of senior housing long-term-care available and should be given much consideration before making a decision of the elder care cost.

Assisted Living in Los Angeles

Assisted Senior Living Facilities usually refer to a facility that is non-medical and provides elder care for seniors needing assistance with activities of daily living, but not the need for constant care as in a skilled Nursing Facility. Some senior assisted living facilities in Los Angeles offer medical care, (LVNS or RNS) but often it is not the same level of care that is found in a Nursing Home. Some places have trained staff on-site during the day hours and less at night (depending on the amount of residents).They are not required to have a nurse on staff. Some assisted living facilities have private or semi-private apartments. They usually have a small kitchen area, handicap accessed bathroom and are a self-contained unit or can have additional bedrooms.

In this type of senior retirement living a resident would not have to be concerned with having to prepare meals every day, these places usually offer three balanced meals a day served in a central dining room. Family members often visit and can dine with their family member with notice. As well as the senior resident visiting with others at the residential care home.

Most senior citizen housing offers assistance for persons who are able to care for themselves except for a few activities, such as preparing meals, cleaning, bathing. dressing, personal hygiene. They usually offer different levels of senior care (for a additional costs) depending on the needs of the resident.

What Is the Correct Home Health Care Franchise for Me?

There are over 14 different home health care franchises out there to choose from as a business opportunity. Which is the right one for you and what are the differences?

Right now, the home health care industry is booming but even without the boom it would still be a good business to get into. It has some features that are particularly good when looking at what type of business to get into. It has repeat customers, is recession resistant, has a management style business model, and has in-demand services.

Repeat customers are important aspect to any business. It is much easier to grow a business when you have a base to work with. You can provide good service to keep your current customers while you grow the business by finding new customers. Plus, with repeat customers, you have a better chance of an existing customer referring your services to someone else since they see you often.

The in-home health services are always going to be needed to some extent because it is based on the age of people rather than some fad.

Typically, you manage this type of business rather than do the physical work. Because of this, you can enjoy a white-collar style position. Also, it is easier to sell a business in the future if you manage as opposed to "being the business."

Right now, the home health care services are in demand and will continue to be in demand so the aging population can stay in their home while they age.

So what are the differences. The main differences are the services provided. Almost all provide non-medical services. In addition to the non-medical services provide, some will provide medical services, staffing services, and placement services.

Non-medical services may include light house cleaning, light cooking, companionship, transportation, bathing, dressing, grooming, repositioning bed-bound patients. Most non-medical services can be provided by a Certified Nurse Assistant or a Home Health Assistant but verify this with each franchise.

Medical services could include wound care, giving medication, physical therapy, blood sugar testing, IV hookups, catheters, etc. Medical services typically require a Registered Nurse to be a director with LPN's or RN's performing the work.

Staffing services are another revenue source that some franchises chose to add. Since you are already finding work for caregivers by getting your own clients, you could easily speak to hospitals, nursing homes, assisted living homes, etc to see if you can place employees into their systems. If you have an abundance of caregiver applicants, this seems like a great additional revenue source. Keep in mind, your main focus should be building in-home clients for your caregivers. Also, remember that there are companies that do just staffing for health care workers.

Placement services or assisted living placement services are another revenue source for many of the franchises. When your client becomes unable to live at their home, you can refer them to an assisted living home or nursing home if needed. You will receive a referral fee from the assisted living home or nursing home. You will have the referral agreement created with the homes before you start referring clients.

You may just want to focus on non-medical and/or medical and not worry about the other services. Or maybe you see the advantage of being able to offer those additional services.

Another aspect to look at when choosing the right one is what type of workforce do they have. Almost all the systems make their caregivers employees, while just a couple make them independent contractors. This model can make a substantial difference to your bottom line.

Also, you may want to find out if the franchise company works with Medicare and Medicaid. Some people view this as a positive because of the guaranteed payments while others know the hassle it creates and the lower payment produced by Medicare.

All of these are aspects to consider when you are looking at which home health care franchise to buy into.

We can help narrow down which one is best for you. We are franchise consultants that specialize in the home health care franchises. Our services are free to you, we save you endless hours of searching for the right one, we get you in contact with the appropriate people quickly, and we have other references and material to help you conduct your research.

Cluster Housing Environmentally Friendly, Socially Supportive

For the past fifty years, towns and cities in the state of New Hampshire have worked to impose zoning restrictions on lands within their borders, in large part to protect against overdevelopment. Some towns require building lots of anywhere from a half-acre to five acres for a detached single-family home. Unfortunately, an unintended consequence of this regulation has been that real estate developers have subdivided large parcels of land into smaller plots and leveled forested areas, filled in swamps, and generally degraded the ecosystem of the property in favor of rows of houses, all with their own little front and back yards.

Cluster housing, which is beginning to be considered in New Hampshire, uses a different approach. If a town requires that a particular piece of land have a two-acre minimum for building sites, a traditional developer would subdivide the land into ten units and build a home on each unit. A cluster development, however, involves concentrating those same ten houses in a single area on perhaps four acres of the land, leaving 16 acres relatively undeveloped, thus preserving natural wildlife habitats and forested areas that can be enjoyed by the residents.

The Nubanusit Neighborhood and Farm, a new housing development project in Peterborough, New Hampshire, takes the cluster housing concept one step further. Twenty-nine small single-family homes will be augmented by shared areas on the 113-acre site, which will also include a small working organic farm. The shared facilities offer places where the community's residents can interact. This co-housing concept, which originated in Denmark, offers community support while utilizing the land in an environmentally sustainable way.

The Peterborough project is a great idea, one that will hopefully spread throughout the state. The down side is that the housing units are expensive; according to a June 19, 2006, article in the Keene Sentinel, prices start at $278,000 for an 849-square-foot home and extend to $580,000 for a 1334-square-foot home - very reasonable considering the amenities, but far beyond the reach of many working-class families.

Perhaps as the Nubanusit project succeeds other communities will learn from it and take the cluster and cooperative housing concepts into account when developing new residential projects. Combining low- and middle-income housing, both for families and single people, with elder and assisted living facilities makes sense, for instance, providing a community atmosphere for those who often find themselves isolated because of financial, age-, or health-related circumstances. Ownership of single-family homes could be augmented with small rental units or even a cluster of low-cost single-occupancy rooms with common cooking and living facilities, with the rent going to pay the expenses of the rental units themselves and possibly helping pay general expenses for the community.

Cluster and cooperative housing can potentially offer solutions to a lot of problems. Thoughtful cluster housing development may actually allow New Hampshire to sustain its recent growth while meeting the needs of all its citizens and preserving the natural environment that draws people to the state in the first place.

Find Your Niche In The Field Of Nursing!

Are you looking to make a difference in your life? Earn a degree that will take you far. Nursing is a multifaceted field that offers many benefits both personally and professionally. As the health care industry is rapidly changing and growing, there will be an even larger demand for nurses once health care is available to a substantially larger population.

In order to become a registered nurse and be licensed to practice, you must first obtain your Bachelor's degree in nursing. After you obtain your four year degree, you will need to pass a comprehensive certification exam in order to be a licensed R.N. Similar to attorneys who do not pass the bar, nurses who do not get certified are unable to practice.

For those that do not wish to obtain a four year degree, or who are earning their degrees slowly, there are certified nursing assistants that function at a level below registered nurses. They are employed is hospitals, nursing homes and hospices. Hopefully, after taking the certification courses and becoming a certified nursing assistant, you will enjoy the field so much that you will want to go back to school and progress into a registered nurse.

Advanced registered nurse practitioners (ARNP) are registered nurses that have earned their Master's degree in one of four specialized areas: 1) certified registered nurse anesthetists, 2) certified nurse midwives, 3) certified nurse practitioners, and 4) clinical nurse specialists. Before becoming an ARNP, the nurse must pass the NCLEX or, National Council Licensure Examination at an approved testing site.

There are several specialty areas that nurses can choose to enter. One amazing type of nurse is a neonatal nurse. Helping the doctor in the birthing suite and taking care of the newborns after they are born can be a very rewarding experience. There is nothing like welcoming a new life into the world several times a day! These nurses are met with disappointment if there are complications with premature babies. Oftentimes, newborns are forced to stay in the hospital for extended periods of time until they are healthy, or even pass away.

Hospice is a great program that provides comfort and care to those in their final days. Hospice patients that are living their final days in the comfort of their own homes still need special care. Nurses that travel from home to home providing essential medications and routine medical exams help the sick or elderly keep their dignity and enjoy their last days.

Plastic surgeons and cosmedical institutes are growing in popularity. The physicians in these places will need dedicated nurses who assist their patients after procedures and surgeries. This is a great environment for a nurse to work in if you do not want to see any patients that are severely ill or in a lot of pain.

What Facilities One Should Expect In an Assisted Living Center

An assisted living center offers seniors a residential option, helping them remain as independent as possible, while giving them access to help with certain daily needs, such as cooking, housekeeping, and health care and commuting to appointments.

Assisted living centers are part of retirement communities letting the elder live a peaceful life as they enter in a secure and safe place, enjoying their privacy and freedom.The personalized services takes into account the resident's present needs and is flexible enough to accommodate extra services where necessary. This is ideal for those who do not need round the clock care.

Licensing requirements vary across the United States and hence, services may vary.

Typically, an assisted living center offers the following services:

• Breakfast, lunch and dinner, usually in a common dining room with other residents
• If required, help with eating, bathing, dressing, visiting the restroom, walking, etc.
• Housekeeping
• Personal laundry including bed linen
• Pet care if there are pets
• Personal care and grooming including shaving, hair care, etc.
• Bathing and dressing help ranging from being available for help and actually assisting the process
• Help with local travel, as in keeping an appointment at the hospital or visiting with friends
• Health and medical care
• 24-hour security
• Emergency contact arrangements
• Programs for daily activity and staying fit
• Prescription medication management - storage, administration and replenishing
• Scheduling doctors' appointments and visits
• Laundry services
• Readily available staff, just a phone call away, both for regular needs, scheduled in advance or for emergencies.
• Constant companionship to help move around.
Based on the above basic services, while selecting an assisted living center, the following factors come into the picture:
• A friendly safe and comfortable place that is well maintained and clean
• Hobbies and activities
• Amenities like a gym, library, onsite place of worship proximity to one, a library, recreation club
• Quality of food in terms of nutrition, choices available and whether the center offers the facility to eat in your room
• Procedure for handling health issues, including process for handling emergencies. What is the system for hospitalization?
• Compliance with local regulations since this varies from state to state.
• Whether any complaints have been registered against the assisted living center
• Last and certainly not least, the rates charged

The size of these centers may vary depending on number of residents. The choice of housing may be a studio accommodation or a one bedroom apartment. The residents, individual or a couple have their own set of keys to enjoy the freedom of coming or going as they like. Although breakfast, lunch and dinner are served in a common dining room to promote interaction, some facilities may allow residents to eat in their own rooms. Some assisted living centers may have within the campus, a spa, fitness center, caf矇, theater and other activities to keep the residents engaged. Security is an important aspect.

It is important to remember that assisted living centers only offer a specific level of care and when that is not sufficient, different care settings may be required.

Retirement Living in Victoria BC

Although Victoria BC has shed its somewhat ill-mannered reputation as a home to "the newly-wed and the nearly dead" it remains a popular retirement destination for people from across Canada and further. Retirement living in Victoria offers much to today's active seniors, this vibrant city and the surrounding communities are home to a population diverse in ethnicity and demographics.

The temperate climate enjoyed in the Greater Victoria region is one major reason that people who are retired from the regular workforce relocate here. Compared with the rest of the country, Victoria offers more opportunity for people who have time to spare to get out and enjoy outdoor sports and activities.

Because Victoria BC has traditionally been a haven for retirees, the city has much in the way of services geared to mature people. There are a plethora of social clubs intended for this demographic and senior centers offering seniors activities and opportunities to meet your peers, which is conducive to aging happily.

There are many different types of retirement communities, including:

繚 Over 55 affordable housing;

繚 Over 50 gated neighborhoods;

繚 Over 55 luxury apartments, condos and townhomes, and

繚 Retirement communities offering various levels of assisted living, from

- Long term care homes;
- Assisted living, and
- Independent living;

For those who don't relish the idea of moving from the home they love or surrendering their privacy to live in a community of seniors there is the option of hiring a home-care service. These can provide a wide range of services to support seniors who prefer to remain in the family home.

Nowadays retired people and seniors are more active and healthier than ever before, because of advances in knowledge and geriatric care. We understand more about how diet and exercise can help us stay healthy throughout our lives, but for those who are facing challenges to their health, there are excellent treatment and rehabilitation services available in Victoria. Due to the number of retirees living in Victoria, there are more geriatric specialists and therapists practicing in the area that you'll find in most Canadian cities.

Seniors and younger retirees who are trying to figure out where to spend their golden years find that living in Victoria is very attractive. Where else in Canada can you find a large community of your peers, diverse options for housing at different levels of care, access to first-rate medical care, treatment and rehabilitation, and of course the temperate climate and beautiful surroundings that's offered to seniors who choose retirement living in Victoria BC?

CNA License Offers Eligibility to Work in a Health Care Center

In the United States of America, if it is your desire to get employed in a health care facility, you must earn a CNA License (or Certification) that offers you permission to work in a Health Care Setting. The federal OBRA-87 also mandates that a candidate aiming to get employed in a hospital, nursing home and long term care unit must be thoroughly trained through the approved nurse aide training program. The OBRA legislation further directs every state authority to evaluate the competency of the aspiring nurse aide candidate through the CNA Licensing test.

Steps Essential for Earning CNA License

• Complete the state and OBRA approved CNA Training Program, comprising of minimum 75 hours of classroom course instructions and clinical hands-on experience.

• Appear and pass the Certification Exam, which consists of the Written/Oral Test and Skill Test.

Once, the candidates clear the Licensing Exam, they are awarded with the CNA License and listing with the Nurse Aide Registry. The registration with the registry also awards these candidates a License No., which permits them to work legally in any type of the health care facility.

Validity of Nurse Aide Certification

The Nurse Aide Certification is valid for two years and you must get it renewed within 2 years, before it gets expired. You are required to submit a Completed Application and Renewal Fees to your state Nurse Aide Registry for the renewal.

CNA License Verification

On few occasions, working certified nurse aides forget to renew their certification and they are not sure if their current license is valid or expired. The Nurse Assistants are offered Online License Verification by the state Board of Nursing. You are required to provide your Serial Number to the Licensing authority and verify your certification online or by visiting the concerned authorities on their street address.

CNA License Transfer to another State

If you are moving from one state to another state for the CNA employment, you are not allowed to work in that state with your home state CNA License. You are required to complete certain basic requirements as needed by the state including:

• Reciprocity Arrangement between the states may exempt you from reappearing in the nurse aide exam and your licensing procedure continues in the same fashion as your License Renewal.

• If the states do not have Reciprocity Arrangement with each other, you may have to re-complete the state Nurse Assistant Training Program and reappear for the state CNA Certification exam once again.

CNA License Transfer to another State

If you are moving from one state to another state for working in a facility, you are not allowed to work in that state with your home state CNA License. You are required to complete certain basic requirements as desired by the state and these necessities include:

• Reciprocity Arrangement between states may exempt you from reappearing in the nurse aide exam, and your licensing procedure continues in the same fashion as your License Renewal.

• If the states do not have Reciprocity Arrangement with each other, you may have to complete state Nurse Assistant Training Program and appear for the state CNA Certification exam once again.

List of Questions to Ask When Looking at Assisted Living Facilities

There are many things to consider when looking at assisted living facilities. Of course, safety and security top the list, but there are many other factors to discuss. It's important to look at this decision with quality of life for your parents in mind.

In assisted living facilities, services typically include housing, meals and snacks, 24 hour monitoring, medication supervision, activities and socialization programs, transportation and assistance with activities of daily living such as bathing, dressing, grooming and mobility. Some assisted living communities offer a safe and secure area especially for people with memory impairments or other cognitive disorders. There are usually choices of size of rooms, from single room studios to 2 bedroom apartments.

With these general guidelines in mind, here are some specific questions to ask:

• How big is it? Large enough to have amenities, but not too large?


• Is it close enough for me to visit easily?


• Are the residents active and mobile? Are they happy and well cared for? ASK THEM!


• Are the common areas clean? The bathrooms? The carpet? Any bad odors?


• Are the floor plans easy to understand? Is the handicap accessibility adequate?


• Do you see family and friends visiting?


• Are there any outdoor areas? A patio? Courtyard with benches?


• Are there places for a resident to have some solitude other than in their room?


• What kinds of activities are offered and how often? Is an easy to understand list posted?


• Are there community rooms, hobby/activity rooms, exercise rooms, living rooms?


• Is there enough closet and storage space?


• How often are the rooms cleaned and the linens changed? Is laundry done?


• How are medications controlled?


• How much medical care is available?


• Does the facility have relationships with local doctors who make "house calls"?


• What are the minimum physical abilities residents must have?


• What kind of physical exam or evaluation is required before a resident is accepted?


• How well does the kitchen accommodate special diets?


• Does the facility have dementia care options?


• How long has the staff been there? Do the workers seem happy and glad to help?


• Does the staff seem friendly and caring? Are they clean and well groomed?


• How long has the Executive Director been with the facility?


• Who owns the facility? How long have they been in this business?

Be sure to trust your instincts. What is your "gut reaction" to the facility? Remember you are trusting this facility to take care of your parents and provide for their safety, security and maintenance.

The Role and Responsibilities of Nurse Managers

Managing a staff of nurses is a challenging career that requires nursing and managerial skills. A nursing management career starts with being a licensed practical nurse and working your way up through years of clinical practice and advanced education. They also participate in management training that addresses specific issues that deals with employees, behavioral standards, and handling of legal issues that is associated with the supervision of the people working in the hospital environment. Nurse Managers or what used to be called as head nurses handle specific departments such as the intensive care unit or pediatrics.

Duties of a nurse manager

• Nurse Managers are responsible for planning, organizing, and directing health services in their department to ensure that the goals and objectives are performed consistently and that the services provided to the patients is of the highest quality and standard.
  
  


• They select, mentor, motivate, and direct the development and evaluation of the staff nurses. They are responsible for establishing and keeping track of quality improvement indicators and other information that concerns the patient care and services. They ensure that resources are available in order to provide high quality service and the on-time performance that is consistent with the facility's standards. At times, they devise educational programs that are health related for the facility's non-professional and professional staff.
  
  


• They participate, consult and collaborate with other units and healthcare providers in developing long term plans for health care programs. They interpret and communicate policies and procedures that the agency or facility puts in place to establish areas of responsibility and assignments among departments and staff.
  
  


• They are also responsible for developing budget estimates and handle other information pertaining to financial concerns and requirements. They approve and monitor expenditures and purchases to ensure that the budget guidelines are complied to.
  
  


• They are responsible in the staff maintenance. They assign nurses to particular cases and oversee the patient care to ensure that it remains at a high standard. They are also involved in creating treatment plans for patients and to coordinate the efforts of the medical team. This is to keep everyone up to date of the progress in the medical care and condition of the patient.

Key challenges in nursing management

• Increasing nursing staff satisfaction and retention. One of the most challenging aspects of being a nurse manager is how to effectively address or reduce the effects of the continuing shortage of nurses especially in their respective facility or department.
  
  


• Planning and managing the unit's finances and resources. This requires proper planning and management on a shift to shift basis and in between shifts.
  
  


• Handling of labor and union issues. Labor unions are becoming more demanding in their efforts to affect the hospital's management decisions. Nurse Managers need to have the sophistication, skill and diplomacy in order to effectively address such concerns and issues.
  
  


• Creating a positive and performance oriented culture. A nurse manager has a great influence in establishing a positive and performance oriented culture by building an open communication with the staff and establish the standards of care, build an alliance with her staff and other members of the multi-disciplinary team and assure that each one feels valued and committed to organizational goals.

Computer Science Engineering or Information Technology

CSE is related with invention and development of of software and hardware whereas IT is related with effective use of already available software/hardware. CSE thinks about how can a new system be developed whereas IT thinks that how can an already available system be put for gainful commercial use. While implementing certain tasks,the CSE ask question about working of hardware & software but IT want to know about the working of office and business systems so that it can modify, improve and educate you to use existing software/hardware.

When you produce the system that control the Rockets, Machines, DVDs, Medical diagnostic instruments etc, that is called CSE and when you learn to improve, implement and manage the given system that is called IT. Computer Science is a subject in general dealing with computer hardware software. IT is a derived subject which is mainly involved in the management of information using computers.

Computer science (academically, CS, CSC or compsci) encompasses a variety of topics that relates to computation, like abstract analysis of algorithms, formal grammars, and subjects such as programming languages, program design, software and computer hardware. Computer scientists study what programs can and cannot do, how programs can efficiently perform specific tasks (algorithms and complexity), how programs should store and retrieve specific kinds of information (data structures and databases), how programs might behave intelligently (artificial intelligence), and how programs and people should communicate with each other (human-computer interaction and user interfaces). Good for jobs like software engineering, hardware engineering, computer science professor, programmer, etc.

While Information technology (IT) is the technology required for information processing. In particular the use of electronic computers and computer software to convert, store, protect, process, transmit, and retrieve information from anywhere, anytime. This is really good for individuals who don't like math because it offer less math courses. You can get jobs such as database administrator, webmaster, programmer, software engineer, telecommunications, management, computer security analyst, etc. The information technology course module has been designed with more of software part in the course whereas Computer Science includes more of computer hardware part like networking, chip level knowledge etc. Although some of the subjects are same in both the streams.

Also CSE is more math intensive than IT. Information Technology is the business side of computers - usually dealing with databases, business, and accounting. The cs engineering degree usually deals with how to build micro processors, how to write a compiler, and is usually more math intensive than IT. One way to think of it is one is dealing with information - data which would be the IT and the other is dealing with the "science" or "how to make it" of computers. So there is very thin line dividing the two streams. There is a lot of overlap in the two streams. In every tough It problem, there is a CS problem.

Why Hospitals and Nursing Homes May Not Mix

You may have heard about some surgical procedures that are considered risky, but did you know that a number of surgical procedures are even riskier for nursing home residents than they are for non-institutionalized older adults? Research reported by Dr. Emily Finlayson, a surgeon at the University of California, San Francisco, and her colleagues in The Annals of Surgery says exactly that. If you are a caregiver to an older adult, particularly one who may now live in a nursing home, you need to be an informed advocate on behalf of that person.

Dr. Finlayson and her colleagues used data reported by Medicare on patients 65 and older to compare surgical patients who lived in institutional settings and those who did not. The samples for each group were impressively large - nearly 71,000 nursing home residents and over a million 65+ year olds who did not live in a facility. The doctor matched both samples on their actual ages and the numbers of other chronic medical conditions they had prior to their surgeries.

Across all surgical categories the mortality of the institutional patients was higher than for their counterparts. For instance, surgery to repair a bleeding duodenal ulcer showed 42% of nursing home older patients dying versus only 26% of their age peers who did not live in nursing homes. For an appendectomy the difference was 12% mortality for nursing home patients against only 2% for the population of older adults at large. Gall bladder surgery was similar with 11 percent of nursing home residents dying compared with 3% of the other population.

And surgery is not the entire story. For institutionalized patients there were proportionately more subsequent interventions than there were for their counterparts. These residents were more likely to need mechanical ventilation to help them breathe, feeding tubes in their abdomens or even venous catheterization to monitor their hearts. Each follow-on procedure introduced more risk on top of what the surgical procedure itself represented.

And as if the story could not get worse, you have to remember that hospitalizations, especially those for surgery, involve a lot of down time. Patients who spend more time in a hospital bed also are likely to be exposed to infections, some of which can lead to pneumonia. For those who dodge that bullet, they will still have their performance status diminished by that time on their backs. The rule of thumb is that for every day in a hospital bed, an older patient will need two days to recover their stamina.

So, the lesson for caregivers is fairly clear based on concrete data: When a provider recommends surgery for the elder in your charge, always ask about non-surgical options. And check out the article in The Annals of Surgery.