The Need for Senior Living Jobs

For people currently looking at different career options, there are several things that you need to weigh. You need to pursue a career that you will thoroughly enjoy doing, that will allow you to help people, and that will pay you a decent amount of money. Senior living jobs are fall under all those categories, and they are in very high demand. There is expected to be a shortage of those working in the elderly healthcare industry, making it something that high school and college students should consider.

There are plenty of different types of senior living jobs, some that don't require any schooling after high school, to those that require a Masters degree or a Doctorate degree. In other words, you can essentially decide how much time you want to spend in school and choose your career helping seniors accordingly. Or, you can go to convalescent homes and apartments, as well as assisted living communities, and volunteer. You will be able to get a lot of experience working with the elderly, and they will enjoy the company quite a bit.

One of the best parts of working with the elderly, in fact, is how much that they enjoy the company of others. There are very few industries quite like the senior healthcare industry in that respect. The people that you are helping will be so happy to see you and so thankful for you every day. If that isn't enough to help sway your decision though, you will be happy to learn that the average salary of those in the senior living industry is between $40,000 and $60,000. That is not a bad amount of money to make at all, especially in the current economy, where jobs are scarce.

The other benefit to senior living jobs is the fact that you will be able to make your own schedule. Since there is a need for people working every hour of every day, that gives you a lot of flexibility with regards to when you will work. If you are someone that does not like the idea of working Monday through Friday from eight in the morning until five at night, then this is definitely something you should think about. In the end, you will find the senior healthcare industry to be a very rewarding road to go down.

Bed Rails That Kill

As attorneys, many of us have consulted with clients and their families as a result of a fall from a hospital or nursing home bed. These falls result in fractured arms, legs, and hips, and often even more serious injuries such as skull fractures. The patient’s (or family’s) immediate reaction to these unfortunate injuries is to blame the hospital, nursing home, nursing staff, or attending physicians for the failure to have bed side rails raised and in place to prevent such falls. This typical reaction is based upon the assumption that bed rails, when properly used, will prevent the patient/resident from falling out of the bed and suffering injury. However, bed rails are not benign safety devices and this article will address the dangers created by their use.

Bed side rails have been in existence for years and are manufactured by several different companies with numerous configurations and designs. A quick search of the Internet discloses a number of medical supply companies which manufacture and sell these products. The most common bed rail designs include full-length rails, three-quarter-length rails, half-length rails, quarter-length rails, and split-rail configuration (often the most dangerous design).

Bed rails are used extensively in hospitals and nursing homes. In hospitals, their use is typically a nursing decision rather than based upon a physician’s order. However, in nursing homes, Federal regulations require a physician’s order if bed rails are to be used, as the regulations recognize side rails as a form of restraint. Notwithstanding the requirement for nursing homes, physician’s orders are often not obtained because of the belief that bed rails are simply a safety device. This is a misconception: bed rails often cause injury or death.

There has been little study or publication about the risks and benefits of bed rails. However, the reports of adult deaths and injuries from bed rails on file with the U.S. Consumer Products Safety Commission (CPSC) (incidents from 1993 to 1996) provide significant information for attorneys investigating a potential negligence claim. The CPSC information reflects that seventy-four patients died as a result of the use of bed rails. Moreover, it in not unrealistic to conclude that the actual number of patient deaths far exceeded the reported deaths. Regardless of the true frequency of deaths, 70% of the reported patient deaths resulted from entrapment between the mattress and the bed rail such that the patient’s face was pressed against the mattress. 18% percent of the reported deaths were the result of entrapment and compression of the neck within the bed rails. Finally, 12% twelve percent of the reported deaths were caused by being trapped by the rails after sliding partially off the bed, resulting in neck flexion and chest compression.

The second source of significant information comes from the U.S. Food and Drug Administration. The FDA issued a Safety Alert in August of 1995 regarding the entrapment hazards and safety concerns which accompany the use of bed side rails. The Safety Alert was communicated to hospital administrators, hospital associations, nursing homes, risk managers, bio-medical/clinical engineers, and directors of nursing. The Alert was not specific to any one manufacturer or particular design of side rail but warned health care providers that the FDA had received 102 reports of head and body entrapment incidents involving side rails between 1990 and 1995. The 102 reports of entrapment resulted in 68 deaths, 22 injuries, and 12 entrapments without injury. These unfortunate events occurred in hospitals, nursing homes, and private homes. The majority of the entrapments involved elderly patients.

In part, the FDA’s Safety Alert recommended the following actions to prevent deaths and injuries from entrapment in hospital bed side rails:

Inspect all hospital bed frames, bed side rails, and mattresses as part of a regular maintenance program to identify areas of possible entrapment. Regardless of mattress width, length, and/or depth, alignment of the bed frame, bed side rail, and mattress should leave no gap wide enough to entrap a patient’s head or body. Be aware that gaps can be created by movement or compression of the mattress which may be caused by patient weight, patient movement, or bed position. Be alert to replacement mattresses and bed side rails with dimensions different than the original equipment supplied or specified by the bed frame manufacturer. Not all bed side rails, mattresses, and bed frames are interchangeable.

The entire FDA Safety Alert may be found at: [http://www.fda.gov/cdrh/bedrails.html]. In 1999 the FDA, in conjunction with representatives from the hospital bed industry, national healthcare organizations, and patient advocacy groups formed the Hospital Bed Safety Workgroup. The Workgroup’s goal was to improve the safety of hospital beds for patients in all healthcare settings who are most vulnerable to the risk of entrapment. In April of 2003 the Workgroup published the results of its research in an article entitled, “Clinical Guidance for the Assessment and Implementation of Bed Rails in Hospitals, Long Term Care Facilities, and Home Care Settings.” The guidelines published by the Workgroup are too lengthy to discuss in detail in this short article but do set forth valuable considerations with regard to patient choice, nurse training and education, policy considerations, and specific bed rail safety guidelines. The bed rail safety guidelines recommend:

1. The bars within the bed rails should be closely spaced to prevent a patient’s head from passing through the openings and becoming entrapped. 2. The mattress to bed rail interface should prevent an individual from falling between the mattress and bed rails and possibly smothering.

3. Care should be taken that the mattress does not shrink over time or after cleaning. Such shrinkage increases the potential space between the rails and the mattress.

4. Check for compression of the mattress’ outside perimeter. Easily compressed perimeters can increase the gaps between the mattress and the bed rail.

5. Ensure that the mattress is appropriately sized for the selected bed frame, as not all beds and mattresses are interchangeable.

6. The space between the bed rails and the mattress and the headboard and the mattress should be filled either by an added firm inlay or a mattress that creates an interface with the bed rail that prevents an individual from falling between the mattress and bed rails.

7. Latches securing bed rails should be stable so that the bed rails will not fall when shaken.

8. Older bed rail designs that have tapered or winged ends are not appropriate for use with patients assessed to be at risk for entrapment.

9. Maintenance and monitoring of the bed, mattress, and accessories such as patient/caregiver assist items should be ongoing.

For information about the Hospital Bed Safety Workgroup, see the FDA’s web sight at [http://www.fda.gov/cdrh/beds/]. If you are confronted with a serious injury or death as a result of a patient’s entrapment in a bed side rail, the information contained in the FDA Safety Alert as well as the guidelines established by the Hospital Bed Safety Workgroup are essential. Consideration should be given to naming both the hospital/nursing home facility as well as the manufacturers and distributors of the side rails as defendants if a personal injury or wrongful death action is pursued. First, nurses often receive little, if any, training on the proper use of side rails. Secondly, it has been this author’s experience that facilities often “mix and match” beds, mattresses, and side rails from different manufacturers leading to poor and unsafe integration of the various parts. Finally, the manufacturers have known of the dangers posed by bed side rails since the late 1980’s or early 1990’s and have taken few steps to make the bed rails safer or warn the end user of the danger. A quick search of Lexis or Westlaw will reveal prior litigation against the manufacturers.

Recognizing and Preventing Nursing Home Neglect

When our elderly friends and loved ones lose the ability to take care of themselves, we often do not have time to provide the loving care and attention that they need. Thus, many people turn to nursing homes and assisted living facilities as an alternative to home care. These facilities can be beneficial in providing a community for the elderly, but they can also become dangerous places if the staff neglects the residents.

While nursing home abuse is characterized by the staff going out of their way to physically, emotionally, and even financially torture the residents, neglect consists of the opposite. Residents who are neglected are ignored, and their needs go unrecognized and untreated. Sadly, the reason why most elderly are in assisted living in the first place is because they are unable to provide these needs for themselves. Thus, neglect can turn into life-threatening torment because residents may not be able to provide food and water for themselves.

Additionally, elderly neglect can also be financial abandonment. Older people at nursing homes are typically unable to work for themselves, which means that they may not have a steady source of income to pay for living in the facility. If a person agrees to pay for the assisted living, then refuses to do so, this can count as elderly neglect.

When an elderly person is neglected, he or she is restricted from access to life necessities. This can include food, water, shelter, safety, medical care, and clothing. Also, elderly often rely on other people to help them maintain their personal hygiene. Older people with mobility issues may not be able to get themselves out of bed, which keeps them from getting to the toilet. If nursing home attendants refuse to help the residents in and out of bed to go to the bathroom, they may be left laying in their own excrement. As gross as this sounds, it is also a safety issue since feces can carry diseases.

Other signs of nursing home neglect include:

Malnutrition

Dehydration

Bed sores

Unsafe living conditions

Presence of dirt, fleas, lice, etc.

Infections

Untreated illness

To help keep your loved ones safe, you should check out several different nursing homes before you settle on an assisted living center. Try to take tours of all of the facilities, and interview mentally capable residents about their experience there. Also, be sure to visit your elderly person regularly to check and see if they are being treated properly.

Sadly, nursing home abuse is all too real. If you or someone you love has been mistreated by nursing home attendants, you should speak with a personal injury lawyer today about your rights. For more information, contact an experienced personal injury attorney at the firm of Habush Habush & Rottier, S.C., today.

Hard to Detect Forms of Nursing Home Abuse and Neglect

Most often, when people think of nursing home mistreatment, they think of the kinds of abuse that are dramatic and easy to spot. There are other types of abuse that are very hard to spot, however, and they are sometimes some of the worst types imaginable. Consider, for instance, when elders are deliberately isolated from other people at their facility or when they're denied food or recreation time. These forms of psychological abuse can be more insidious because the scars that they leave are internal and shame is oftentimes enough to ensure that the victim doesn't say anything.

While senior abuse does sometimes include outright physical violence, it's far easier for an abuser to engage in mental torment. These acts are hard to spot and, given the fact that many elders are in a position where they're very dependent upon others for care, there's plenty of opportunities for an abusive individual to become a tyrant to the people they care for. There are elders who suffer dementia and other conditions that can make them behave in a rather childlike way and that require that they get a lot of instruction to make sure they're safe. Adults, however, always deserve the dignity of being treated as such.

For an older person, being harassed, bullied or singled out by an abusive nursing home staff member is sometimes embarrassing enough that they won't want to talk about it. After all, if they were 20 years younger they'd probably put the person in their place themselves, but when they depend on that staff member to attend to some of their most personal needs there's a power difference that can be exploited by people with a mindset just sick enough to make them enjoy tormenting people who have no way to retaliate. Unfortunately for these abusers, there is a way to retaliate.

First and foremost, an abuser has to be removed from any situation where they're empowered to victimize. After you've taken care of this, it's time to contact a nursing home lawyer. There's absolutely no good excuse for a nursing home to allow abuse to go on and, when they do, the law may provide you with an option to sue. Many good nursing home abuse lawyers offer free consultations. Consider taking them up on the offer if your loved one has been abused in a nursing home.

Home Care Explained - Everything You Need to Know About Home Care

Homecare - Who needs it?

Everyone needs care at some point in their lives; from little babies to centenarians and everyone in between. Most of the time when we need care, our families and friends provide it. However some people require more care than family and friends are able to provide. Often in these instances the person requiring the care (care recipient) may be a new mother, have a disability, be frail aged, have a severe illness or a mental health issue. Depending on the needs of the person, particular home care supports will be put in place to assist them to live or manage at home. Many people who receive home care would need to live in a nursing home, hospital or institution if that support was not available. Other terms such as 'home health care' and 'domiciliary care' are often used interchangeably with home care - but can refer also to care provided by a health professional.

Homecare - What is it?

There is a wide range of services and supports that fall under the banner of home care. In short, the type of care provided is what the person is unable to do for themselves. Listed below are some of the main ones with a brief description:

• Personal Care - Refers to all care that addresses the personal hygiene of the care recipient. Personal care support can include; assistance to shower or bath, to dress, to use the toilet, to change continence aids, to shave, apply lotions and cosmetics, brush hair and brush teeth.
• Domestic Assistance - refers to all housekeeping and cleaning tasks. Services can include; cleaning the house, doing the dishes and laundry.
• Transportation- This can be driving the person to appointments and can also include accompanying them if required.
• Shopping- This can involve driving the person to the store and assisting them to do their own shopping, or the home care worker can do the shopping with a list.
• Respite- This type of support involves remaining with the care recipient while the usual carer has a break.
• Nursing Care- refers to the home care that needs to be provided by a registered nurse. Can include: medication monitoring, wound dressing, injections and nursing assessments.
• Case management - Case management involves a comprehensive assessment and the development of a care plan in conjunction with a case manager. Case management can be short or long term depending on the needs and requirements of the care recipient.
• Social Support - refers to services that focus of the social needs of the client. This type of service can include companionship, visiting and community access.

Homecare - Who pays?

Depending on the country you live in there may be government funded programs that assist in paying home care costs. Some health insurance can cover some of these costs - check with your insurer for more information.

There is also a wide variety of home care agencies that can provide you with a home care worker for a fee.

Homecare - Who provides it?

In most instances friends and family of the care recipient are able to provide them with home care. However in those cases where family and friends cannot do so, or where the care recipient prefers; a professional care giver will provide the care. Professional care givers can also be referred to as: support workers, carers, community workers, personal care aides and assistants and nursing assistants. The terminology will vary between countries. The level of skill and qualifications required for professional care work will also vary depending on country. It's best to check with your care provider to find out the minimum requirements in your area.

Things to Know in Selecting In Home Caregiving Services

Caregiving for a loved one is a demanding, challenging job and no one is outfitted to do it alone. For many, the challenges of caring for a loved one are part of daily life. If your senior loved one has difficulty living independently, you have options other than a nursing home, assisted living or other senior care facilities. With home care services, your loved one can receive 'round the clock' or hourly assistance to help them live life according to their needs and on their terms. Even for seniors who only need a little help in their daily living, in home care services may be a good option.

Live-In Home Care

Live-in home caregivers stay for multiple days at a time in the senior's home. They are expected to provide the senior with full-service, day and night care as needed. Live-in caregivers are able to give their complete attention to sustaining a well-conditioned and positive environment for your loved one. When selecting a live-in home care provider, make sure you choose someone who has enough experience and staff to give senior clients proper safety, care, companionship, and emotional support.

Hourly Home Care

Many elderly people do not need 24-hour or live-in care, and so they use their care providers on an hourly basis. For example, they may need assistance and appropriate care only during the morning evening, on Saturdays and Sundays, or when they visit their doctors or other appointments. With this choice, elderly people can get the appropriate care they need, in the proper place and at the right time.

By obtaining help as required, seniors are able to maintain their normal day-to-day schedules as independently as possible. Thus they can thrive by being in their familiar surroundings, with their own possessions and pets as they are given the help they need.

When searching for an hourly, or "come and go" caregiver, you should look for someone with the same expertise as a live-in home care provider. This includes the agency or the caregiver you may hire. Like a 24-hour or live-in caregiver, the hourly person should also be able to provide safety, emotional support, and companionship to their senior clients. They should also be devoted to the well-being and protection of their clients.

Care Outside Home

During hospital admissions caregivers can also be used for providing companionship and monitoring to your loved one. They may also accompany seniors on vacations or travel to insure their comfort and safety. Now you can have your much needed peace of mind knowing a reliable, professional caregiver is there for your loved one.

Here are some things you may want to consider when preparing to find an agency that will provide quality care to your loved one:

Working with agencies

- Conduct an in-depth appointment interview with each selection. Screening applicants on the phone should always be followed with a face-to-face personal interview. Initially this interview will be with the agency management, but later you will want to meet their proposed caregiver(s).

- Be particular of all the tasks, abilities, and daily activities that are required for your situation.

- Discuss compensation and payment schedules. Do not pay for services in advance. Payment should never be made directly to the caregiver, but instead the agency should issue invoices for payment.

- Ask for several work and personal reference sources, and then check them thoroughly. Confirm the information provided, and ask all sources about experience, credibility, punctuality and the care provider's capability to deal with stress and difficult tasks.

- Demand the highest levels of general and professional liability insurance coverage.

- Hire only an agency that has properly background checked and credentialed all of their proposed caregivers. Additional credentialing should also include health screenings, drug testing, proper licensing and training.

Be sure to ask the following questions:

- How are your employees screened?
- Do you guarantee a compatible "fit" of your proposed person with the client?
- Is your agency licensed, and by whom?
- Does your agency have any special accreditations, such as the Joint Commission?
- Are your proposed personnel payroll employees of your agency, or independent contractors?
- Can I see a copy of your business insurance coverage's? Does this include bonding of your employees?
- Do you require an upfront deposit or length of service commitment?
- What are the training programs and standards of experience for your personnel?
- Will you provide specific competency training to meet our unique family needs?
- How, and by whom, are your personnel supervised? Do you charge for these management services?
- What are your processes for emergencies or caregiver cancellations?
- Is your agency licensed and insured to provide medical services as well as basic in home care services?
- How do you include the extended family in the provision of your services?
- Does the program offer transportation, meal preparation, laundry and light housekeeping?
- What is the cost of services? How do you handle invoicing arrangements?

Using these criteria are a great starting point to define the agency and caregiving services that will be required for your situation. Doing this level of homework will protect the client at a critical point in their lives when they need care at home. Doing all these things will allow you to start care with the confidence that you have done your best to select the highest level of care for your loved one. After the start of services, ultimately the real determination about the effectiveness of your decision will come down to the level of the actual care provided in the home, and the relationship that develops with the agency, caregiving staff and the client. This dynamic should be reviewed regularly by the family and adjustments made as necessary to insure continuation of the best possible care for their loved one.

I Hate It Here, I Feel Like I'm in Prison!

That is always a wonderful thing to hear out of a resident's mouth, especially in the middle of a tour. I am, of course, being sarcastic. However it is pretty common. And rightfully so. We all think we've done our mom a wonderful justice by helping her move into an assisted living where she is getting the care she needs and is safe 24/7. That is always the intention, doing what is best for our loved one. So why would they feel this way? Well there could be many reasons but mostly it's the amount of change and how rapidly it happens.

The truth is they probably do hate it. Nobody ever imagines themselves to "end up" in an assisted living requiring help with caring for themselves. Let alone being cared for by strangers! They are grieving the loss of a home, their independence, their identity and dignity. That's not even mentioning their dream of how their "golden years" would be. I always tell families give them 90 days to adjust, especially if they are resistant at all to moving into assisted living.

The first 30 days you will get phone calls about everything from how awful dinner was to the crazy old man she saw in the hallway. And OH THE NOISE! "I hate it here, get me out of here." There will be complaints about the staff and how they do things or don't do things. It's an adjustment she is going from living alone or with you to living with 70 strangers. If your loved one needs any assistance with care, these first 30 days are so tough. Imagine having a stranger help you toilet, or shower. Of course they hate it. Change is difficult for everyone, but even more so for the elderly.

Usually by day 45 the phone calls to you are less and she is relying on us more for care. By this time mom has gotten to know the care staff and has finally settled in with her table mates. She has made some friends but she still wants to go home. She is "feeling much better now"and believes she can handle things at home again. You see she is doing so much better indeed. So you begin to think maybe going back home isn't such a bad idea. STOP RIGHT THERE. Why do you think she's doing better? Could it be because she is getting three meals a day, her medications are given in a timely consistent manner, and her apartment is being cleaned weekly? That would be a giant YES! Now is a good time to gently remind mom of that and if you need help ask a trusted staff member to help you with that conversation.

By day 90 there is usually no longer discussion about going "home" because she feels she is there. She knows the staff and their routines, she has friends and is involved in activities. Sometimes I even here "why didn't we do this sooner?"

The only time this isn't the case is with loved one's who have some sort of cognitive impairment. Change is particularly hard for people with dementia or the like. I encourage families to try their hardest to recreate the most familiar space to their loved one. Sometimes it's that simple. Sometimes it's a fight tooth and nail and when that happens we have to talk about possible relocation to a secure memory unit, especially if their loved one is going to leave the building to "go home". We never really know the degree of people's dementia or inability to care for themselves until they move into an assisted living. People are really good about hiding their inability to care for themselves or how much they don't remember, especially in their own environments.

In closing, the worst thing you can do for everyone involved is panic and second guess yourself. Remember there are two sides to every story and because she is telling you she hates it here there is a good possibility that she's exaggerating. Also remember she is your mother and she knows how to play the guilt card. She is telling you how she hates is meanwhile she is telling everyone else she loves it. That happens so many times. The best thing you can do is re direct her to call the care staff to take care of her needs. She has to be able to form a relationship of trust with the staff. I am not by any means saying to ignore your mother's complaints. I am just asking you to please don't expect the worst. You too have to trust us or else this relationship is not going to work.

Why Should You Keep A Diary?

Do you ever feel like your life is whizzing by you to little consequence? Do you ever feel like you can't even remember what you did last weekend let alone last year? Do you every worry that your life is moving along - and that nobody, not even you, is really noticing?

I picture myself at the end of my life, living at an assisted living home or with one of my yet-to-be-born adult children, and long after the talking heads and soap operas on television have lost their allure, I picture myself in the emptiness of those moments. What I would most like to remember and reflect on in those hours - in that final twilight of my life - is how much fun I had, who mattered to me and why. I want to remember all the things I did and places I went - I want to feel that my life mattered.

Enter the diary or journal - a great way to keep track of your life now at the midsummer of your life. It's a terrific way to record the little occasions, the anniversaries, the weddings and the kids' birthday parties.

Diaries are a terrific way to record today the things that will matter to you tomorrow as you look back and reflect on the special moments that have been part of your unique and special life.

Diaries and journals across the ages have been used for various purposes from simply recording what happened over the course of a day to a form of therapy where people write their deeper reflections on their spirituality, marriage, family relationships, job aspirations and so on.

Personal journals or diaries have played important roles in human existence from the earliest days of recorded history. The earliest record of personal diaries date back over two thousand years - the pillowbooks of Japanese court ladies and Asian travel journals are some of the earliest surviving examples of this kind of writing. The 9th century scholar Li Ao, for example, kept a diary of his journey through southern China. In more modern times, Lewis and Clark kept a detailed account of their travels across the United States and Charles Darwin's "Beagle Diary" recounts his travels over the course of 5 years around the world. And of course, I would be remiss not to mention the bestselling and ever-popular "Diary of Anne Frank" - the diary of a young Jewish girl whose family was forced to hide from the Nazis in the attic of an Amsterdam apartment.

These important works and many others like them have taught us a great deal about the experiences and struggles of a variety of people across the ages but a personal diary doesn't - and shouldn't - speak to a future generation or an entire society. The greatest value a diary can offer is what it offers to us personally. For more the most important legacy we leave behind is the legacy we leave for ourselves.

Over the months and years, the endless parade of activities, events, parties, conversations, vacations, and news both national and personal can quickly become overwhelming. As such, we really need one place where we can keep track of it all and simultaneously process how we feel about it at the same time. We all need a place to record the significant - and mundane - happenings in our life so that when we look back in one, ten or fifty years, in the haze of our later years, we will have some comfort in knowing that it all did really happen. And that it was amazing.

Geriatric Social Workers - Working With the Elderly Population

A geriatric social worker is an exciting and challenging career working with senior citizens. Many social workers in the geriatric field have to deal with clients that are experiencing depression, memory issues, anxiety and schizophrenia. The clients can have many challenges due to health issues as well as death of loved ones as well as facing their own mortality.

Many social workers in the geriatric field have a bachelor degree as well as a two year degree from a masters program that gives them the msw degree. The training for this field will provide thorough knowledge of mental health and aging such as medical knowledge, patient care and communication skills. There are opportunities available for both the bsw and msw degrees. If you are working in an assisted living facility, you generally need the master's degree in social work. For private practice, be aware that many people are on fixed incomes and have medicare so it is important to apply to be a medicare provider and get the npi number.

Some settings to work with the elderly include community organizations, assisted living facilities, senior residential centers, hospitals, state psychiatric centers and family service agencies. Some home health agencies now hire social workers to go into homes because many senior citizens are able to live alone in their home but require counseling, discussion of their concrete needs and companionship. Elderly clients often don't want to burden their children with their concerns and a counselor can help the person recognize it's important to let their kids know of their needs or contact them.

Some other job options for those with msws in the geriatrics field include the organizing and planning of programs for senior citizens. People who work in this field must have a strong love for working with the elderly and be able to deal with the multiple issues, worries and moods of their clients. This position requires a mature and compassionate person to work in this field.

In addition, this service is very helpful to seniors that don't have a lot of help from family members. The main goal of a geriatric social worker is to help elderly clients to become comfortable with aging and live a productive lifestyle.

Elderly in Home Care Doesn't Mean a Lack of Socialization

While the vast majority of seniors prefer to age in one place, many seek assistance from home health companies and assistant living services because of an increased need for personal assistance or in home care. Numerous studies have been conducted that show that seniors having social connections through family members, friends, social organizations, even companion animals is directly linked with their overall good health, prolonged survival from serious illness, and longevity in general. As seniors age, the need for socialization is even more important to help maintain overall good health. Evidence of the connection between a strong social connection and good health include:

o Studies show that people who are able to get out and interact and spend more time with people during cold/flu season actually get fewer colds and illnesses than those who spend most of their time alone.

o People that have companion animals to interact have fewer illnesses that people who do not have a companion animal.

o People who use words such as "I', "mine", and "me" often during casual conversation are more susceptible to heart attacks than those whose conversations don't focus on themselves.

o Our immune system has natural killer cell activity that is negatively affected by a lack of social support.

o Our natural killer cells are more sluggish if we are lonely.

o Feeling grateful for what we have in life is associated with better physical and emotional health. The elderly can be at risk of isolation, which can directly affect overall health and longevity. If one spouse becomes ill, the other spouse tends to be the primary caregiver, which can consume much of their time. Caring for an ailing spouse can lead to isolation from the people and activities that were once enjoyed together on a regular basis. Seniors may also face the loss of a spouse. This event often further isolates you from some of the activities that you might have once enjoyed as a couple, as well as isolation from some of the friends that you interacted with together. Seniors are also at risk of decreased socialization as they age if they can no longer drive. Giving up driving for many means giving up on independence and access to the people and activities they rely on for social support. It's critical to take into account the importance of socialization as we age. Getting the personal care that is needed doesn't have to eliminate the opportunity to maintain social connections.

Most communities have resources for seniors to foster good health and social connections. Many towns offer a variety of activities through local seniors' centers, support groups, libraries,religious organizations and active retirement communities. For those unable live independently, assisted living communities and home care companies offer a variety of services. Seniors should be encouraged to participate in assisted living community activities and outings. Those living at home should be encouraged to look for the right home care company-one that recognizes the value of a support network and social connections. The elderly no longer need to sacrifice socialization for quality senior care.

How to Find the Best Nursing Home

Even at a well-known, fully licensed nursing home, there is the possibility of abuse or neglect. That is why you need to make sure that a facility will provide your loved one with quality care.

Touring a facility is only the first step, because a scheduled visit is unlikely to reveal everything that is happening beneath the surface or when no one is visiting. Certainly, your goal is to assure quality care for your loved one, as well as peace of mind for your family. To accomplish this, it's helpful for you to take the following steps before selecting a nursing home:

• Talk with other residents at the nursing home that you are considering. You can simply walk the corridors of the facility, and speak with residents, including those who are bedridden.



• In addition, your own physical observations are extremely important. Do the residents appear well groomed? Do any of them have visible wounds or sores? How is their oral care? If you find several residents who seem confused and disoriented, you may be witnessing signs of neglect.



• Federal regulations require that all nursing homes have the latest state survey of the facility readily available for review. Ask the management for this survey, read it carefully, and ask questions. Be on the lookout for signs of any problems with basic care.



• Ask questions about the staff at the facility. What is the size of the staff during the different hours of the day and night? How many staff members are nurses? How many are nursing assistants? Are there social workers and clergy on the staff? Consider how the staffing of that facility compares to other nursing homes with a similar number of patients.



• Speak with the relatives of other residents at the facility. Have they observed any problems? Do they have any issues with the management or staff at the facility? You may wish to find out whether any of the residents' families use of web cameras (sometimes called "granny cams"). Although this cyber visitation is a new practice, some families who cannot visit their loved ones every day are placing special internet cameras in relatives' rooms to allow them to see what is happening at any time. If you see a "granny cam" at a facility, ask to speak with the family of that resident, to learn what they have observed. If possible, inquire if the facility would mind if you used this kind of device.



• When walking the halls of the facility, use your senses. One of the most effective methods of inspecting a facility may be your sense of smell. A nursing home should not smell of urine or feces. If it does smell, residents may not be receiving adequate toileting care. Often, this basic care is essential to preventing life-threatening illnesses, like urinary tract infections or bedsores.



• Watch as residents are being fed. Do many residents look underweight? How much of the food are they eating? Is staff helping residents who have problems feeding themselves? Do the aides who assist with the food seem overwhelmed? Are the aides spending enough time working with each resident during mealtime?



• If at all possible, visit the potential nursing home more that once and plan your visits at different times of the day and week. If you can only visit the nursing home once, go at night or on a weekend afternoon. Staff levels may be lowest during these "off" times.



• Is water easily available to all residents at the facility? If some residents are incapable of helping themselves to a drink, is staff offering assistance at regular intervals?



• When you attempt to look at the facility, are you deliberately steered to certain rooms or residents? If you feel that you are being denied full access to the facility, you should find out if there is a good reason.



• Ask to meet all of the key executive personnel at the facility. Speak with the administrative head, the medical staff administrator, and the nursing staff administrator. Ask how often physicians actually examine residents. Find out about the facility's staff turnover rate, including the average length of employment for nursing assistants and other primary caregivers.

Nursing Home Evaluation Checklist

You should be alert whenever you visit your loved one's nursing home. The following are questions to ask yourself during each visit:

• Do you notice signs that your loved one is suffering from dehydration (lack of water) or malnutrition (lack of food)?


• Have you noticed the resident is less active or less able to move about?


• Have you noticed emotional changes, mood swings, withdrawal, anxiety, or other fears?


• Are residents dressed appropriately for the season and time of day?


• Are the resident's living quarters clean?


• Are the resident's medical conditions being treated in a timely manner?


• Does the resident seem to suffer from chronic viruses and/or infections?


• Are all medications administered in a timely and appropriate fashion?


• Has the nursing home staff delayed reporting an injury or incident to a doctor or to the resident's family or guardian?


• Has the resident suffered frequent falls or broken bones?


• Does there seem to be adequate staff and supervision?


• Are the caregivers ignoring the resident or describing him or her as a burden?


• Does any caregiver react defensively to routine questions about the resident's care?

Nursing homes must provide good nutrition and hydration to residents. Poor diet and lack of water are among the most common forms of nursing home abuse and neglect. Some of the health problems associated with malnutrition and/or dehydration include:

• Increased risk of infections


• Confusion


• Muscle weakness (possible immobility and increased risk of falls)


• Pressure ulcers or bedsores


• Pneumonia


• Increased risk of becoming ill from exposure to bacteria or viruses

The Importance of Proper Nutrition and Hydration

Nursing homes should conduct regular nutritional assessments and provide residents with well-balanced, palatable meals. When you consider a nursing home for a loved one, you may wish to ask to sample a random meal at the facility. Also, ask to speak to the staff dietitian about the factors they use to develop meal plans for the facility. The following is a list of reasons why an individual may suffer from malnutrition and/or dehydration:

Personal causes of malnutrition:

• Illness


• Adverse drug effects such as nausea, vomiting, diarrhea, cognitive disturbances, or sleepiness


• Food and drug interactions that decrease the ability of the body to absorb vitamins and minerals


• Depression


• Swallowing disorders


• Mouth problems such as tooth loss, dentures that do not fit properly, mouth sores, and mouth pain


• Tremors or shakiness, which affect residents' ability to feed themselves

Environmental causes of malnutrition:

• Inadequate staff attention for residents who need help to eat


• Staff who lack training about malnutrition and the proper ways to feed residents who need help


• Reliance on liquid supplements


• Special diets

Signs that a resident is malnourished:

• Clothes fitting more loosely than usual


• Cracks around the mouth


• Pale looking lips or mouth


• Dentures that no longer fit


• Hair thinning or getting sparser


• Wounds that take longer to heal


• Confusion (which is unusual for that individual)


• Skin breaking down


• Sunken eyes


• Weight loss

The following questions may help you pinpoint the reason for a particular person's problems with nutrition or hydration:

• Can the resident feed him/herself?


• What is the resident's favorite meal of the day


• When and where does the resident prefer to have meals serve


• Does it take a long time for the resident to eat?


• Is the resident rushed through meals?


• Is the resident unable to finish meals?


• Does the resident seem to eat more when someone is there to help with the meal?


• Does the resident seem uninterested in food?


• Has the resident lost his/her appetite?


• Does the resident like the food at the facility?


• Can the resident choose from a menu?


• Are snacks readily available to the resident?


• Is the resident on a special diet?


• Has the resident started taking any new medications?


• Is the resident's weight monitored on a regular basis?


• Has the staff informed family members of weight loss?


• Has staff asked family members for assistance?

Are Your Nursing Assistants in the Know About Advance Directives?

How much do your nursing assistants know about advance directives? Are they aware of the difference between a living will, a health care power of attorney and a DNR order? Do they know that all clients must be asked about advance directives...and must be given the opportunity to create one? To make sure that your CNAs understand the basics, consider giving them the following important information:

What Is an Advance Directive?

As a health care worker, you've probably heard the term "advance directive". But, what is an advance directive anyway? It is a document that outlines people's preferences for medical care when, in the future, they are unable to communicate their wishes. It is particularly useful when someone is terminally ill, critically ill or has advanced Alzheimer's disease.

Advance directives are not just for people who are sick or old. Advance directives are something that all people should consider having. Keep in mind that having an advance directive is not a sign that someone has given up on life since it takes effect only when people can no longer communicate their own wishes.

REMEMBER: Advance directives give people a voice in their own medical decisions even after they have lost the ability to speak for themselves.

What Is a Living Will?

A living will contains written instructions detailing a person's wishes for end-of-life care to family members and to doctors. These wishes might include preferences about:

• CPR


• Tubes to provide nutrition and/or hydration


• Kidney dialysis


• Ventilators


• Blood transfusions


• Invasive procedures


• Pain medication


• Surgery


• Organ transplantation


• Chemotherapy


• Antibiotics


• Dying at home or at a medical facility

A living will becomes effective when it is determined that a person can no longer make his or her own decisions. As long as the requests in the living will are legal (and don't go against reasonable medical standards), doctors will usually honor them.

Living wills must be signed and dated. They must also be signed by two witnesses. Health care workers should never be witnesses to a living will! If a client asks you to be a witness, explain that it's against your workplace policy.

What Is a Health Care Power of Attorney?

The second kind of advance directive has a few different names, depending on your state. For example, you may hear it called a health care power of attorney (HCPOA, for short) or a health care proxy or a health care agent.

A HCPOA is a legal document that names a particular person to be in charge of future medical decisions. Many people choose their spouse or an adult child to serve as their health care power of attorney. Other people choose a close family friend or even a lawyer.

It is against the law for physicians or other health care employees to act as HCPOA for their patients. For example, Mr. Stone lives in a skilled nursing facility. He has a favorite nurse, Marsha, with whom he has discussed his end-of-life wishes. He says he trusts her the most and wants her to be his health care power of attorney. Marsha knows this is against the rules so she asks the social worker to discuss the matter with Mr. Stone. The social worker helps Mr. Stone choose an appropriate person to be his HCPOA.

The idea is that the person named in a HCPOA will make the same decisions that the patient would have made if he or she were able. It is very important for people to discuss their end-of-life wishes with whomever they choose as their HCPOA. Good communication helps ensure that those wishes will be honored when the time comes.

Remember that clients who have completed a HCPOA form have not given up the right to make their own medical decisions. A HCPOA takes charge only if and when clients are unable to communicate their own wishes.

What Is a DNR Order?

Advance directives give important directions for medical care, but to be official, a person's wishes need to be put into medical orders. An important medical order that many people want when they are very old and/or terminally ill is a Do Not Resuscitate order.

A Do Not Resuscitate order tells medical professionals to suspend action even if someone's heart and breathing stops. This means that doctors, nurses and emergency medical personnel will not use emergency CPR to try to revive someone.

DNR orders are designed to help people who are in the final stages of a terminal illness, who suffer from a chronic serious condition, or who are old and ready to die. Often, the process of establishing a DNR order helps people begin to come to terms with death-whether it is their own or the death of a loved one.

DNR orders must be signed and dated by a physician. They may be written for people in hospitals, nursing homes, assisted living facilities-and, in most states, for people living in their own homes.

Generally, paramedics working in the community have a duty to perform CPR when a person's heart or breathing stops. For people still living at home, many states have a special DNR order-called a "Prehospital DNR", an "Out-of Hospital DNR" or a "Portable DNR". If you are a home health aide, you may see one of these forms. It is usually written on brightly colored paper and should be posted in an obvious place so that the paramedics know not to resuscitate the person.

Some states have portable DNR bracelets that alert paramedics that a DNR order has been written by the person's physician.

A Final Word about Advance Directives

As medical technology has become more advanced over the years, doctors have been able to keep people alive longer and longer. Many people have wanted to say "enough is enough"! This is where advanced directives come in. Living wills and health care powers of attorney give people control over what happens to them.

There are both federal and state laws about advance directives. The federal law, the Patient Self-Determination Act (PSDA), took effect in December of 1991. It requires that patients/clients/residents must:

• Be asked if they have advance directives on admission to a health care organization.


• Be informed of their rights to refuse treatment and to prepare advance directives.


• Have documentation of their advance directive status in their charts.


• Have their advance directives honored.

In addition, all health care organizations (that accept Medicare and/or Medicaid funding) must have a policy on advance directives. This policy must be available in writing to all people who are admitted to the facility/agency. And, all staff members must be taught about advance directives.

The public needs to know that it is a federal requirement that healthcare workers ask about advance directives. By doing so, you support the rights of every client to be involved in decisions regarding their medical care-whether it concerns a simple procedure or the end of life.

Parents' Medicaid Application May Be Affected by Gifts to Kids

As your parents get older, they may decide that keeping the large house is too much work and they may desire a change of lifestyle. They may sell their house and then they decide to give some of the net proceeds to their children. As time goes on, if their health declines, they may need nursing home care. Can the gift that mom and dad made be spent or must it be held for a certain number of years? How does this gift impact mom and dad qualifying for Medicaid in the event that they need nursing home care?

The gift that you received from mom and dad can be used by you in any manner that you wish. However, if your parents enter a nursing home, they could be left in a bind. This is due to the Deficit Reduction Act, which was enacted last February, which tightened the rules for qualifying for Medicaid help with their long-term care after making gifts to family members.

The basic rules for applying for Medicaid to assist in the payment of the bills for long term care are that an individual must typically use up all but $2,000 of their cash and investments. One way to accomplish this is for the parents to make gifts to someone else, usually to their children. There were limitations on this practice in the past, which included a three-year "look-back" period, in which any gifts made within three years of the date that the individual tries to qualify for Medicaid assistance may be used to determine if they have met the threshold. Under the past laws, a government regulator could examine gifts made in the past three years and assess a penalty. (If a parent spends down the amount for their regular living or medical expenses, the rules set forth in this article do not apply).

Under the new rules, this "look-back" period has been extended to five years. The regulators now can examine any gifts made within that five-year period and then determine if a penalty should be assessed.

What kind of penalty can be assessed? The penalty is a number of months that Medicaid will not pay for the long-term care that is necessary, such as nursing home care. If a gift was made of $18,000 about a year prior to the date of application for Medicaid and assuming that nursing home care is about $6,000 per month, the penalty period would be a three-month window in which Medicaid would not cover the nursing home care. Under the old rules, the penalty began from the date that the gift was made. Under the new rules, however, the penalty begins on the date of application for Medicaid assistance. This application date may be at a time when your parents are already in a nursing home and your parents do not have the funds to pay for the nursing home care.

One way to handle the penalty period is to have the recipients of the gifts pay for the nursing home care for the penalty period. While no one can force the kids to return the money by paying the amount of the nursing home care, this may be the only way under current law to have a parent cared for in a nursing home setting. Alternatively, while waiting out the penalty period, the kids may have to care for mom and dad in their own home. If your parents had thought ahead, they may have purchased long term care insurance, which may help in offsetting the heavy cost of nursing home care.

In making later life decisions, it is always good to plan far ahead. Now, you just need to plan even further ahead in making the decisions that will be right for you and your family.

Can Everyone Afford Assisted Living Costs? Compare Prices From Leading Facilities

Deciding on how much you are willing to spend on an assisted living facility for yourself or a loved one is a very crucial matter. Your budget will determine the kind of services available to you or your family member and the overall facility. Expensive doesn't necessarily mean excellent services; there are affordable costs that provide superior retirement care even beyond the standards of a pricier fancy senior home facility. Because of the wealth of choices for assisted living homes, taking time to take a personal tour or doing research and comparison of prospective choices should be considered by anyone who wants to find the most appropriate living facility to satisfy their personal, social and even medical needs.

If you have no time to personally visit facilities, searching for good retirement homes online can yield as much information and save a lot of time. Many websites can assist you in your search and can even match you to several assisted living homes that fit your budget and preferences including location and the type of dwelling. Just fill in the forms required in any of the sites including your budget range and the preferred location of the facility. The computer will search and match you with a listing of institutions in your preferred locality which have costs that fit your financial capability. You can get several quotes and compare the results of your online search to pick the best value for your money without sacrificing comfort.

On average, the daily cost of living in a facility is $ 1800 to $ 2400 dollars a day which includes only the standard amenities such as the room rent, electricity, water, laundry and meals. The basic cost may include housekeeping services such as putting fresh linens, cleaning the room and taking out the garbage.

Residents who require additional services such as personal attendants, participation in activities, parking and medical attention will have to pay for the miscellaneous charges which can range to an additional $300 to $1200 per month, which can translate to an average total of as much as $4000 per month.

In the United States, payment options for assisted care can be from Medicaid, long-term care insurance or straight from the pocket. Many facilities accept Medicaid, but they will cover the assisted living costs only if the assisted living care is medically necessary otherwise government assistance is denied. Long-term care insurance includes paying for as much as $3000 for annual premiums and one should apply while one is still well to be able to use it when the need arises. The long-term care insurance benefits can be determined on a per-day or per-month basis but when the maximum is reached, additional costs will not be shouldered by the insurance company.

When you want to get the best care for your loved one or for yourself on retirement, assisted living costs need not be too steep to deprive you of the comfort that you deserve. When comparing prices from leading facilities, take time to examine and compare the strength of a program before making a final choice. Assisted living costs can in reality be affordable in any facility that possess first-class service and provide quality home care all at the same time. Go online and find an assisted living institution that will match your budget and located in an area that you can call home.

How to Find a Suitable Car Accident Attorney?

Law is a complicated field. It has numerous branches and each branch itself has many branches further. One lawyer cannot specialize in dealing with all these branches and hence, they choose only one or two in which they specialize in their careers. Similarly, one branch of law is related to car accidents and a lawyer who deals with this particular field of law can be termed as a car accident attorney. As the name suggests, a car accident attorney deal with cases that involve a car accident in which persons may or may not be injured, but some damage definitely does occur to the automobile. If you are involved in a car accident, you should probably hire a car accident attorney to represent your case to make sure that no harm is brought to you. A competent lawyer will make sure that the damage to your car is paid by the insurance company as well as any other emotional or physical damage that you experienced during the car crash.

Car accidents are frequent; hence at any time the need can arise for you to hire an attorney. For this purpose, let us give you a few tips in this article regarding how you can find yourself a suitable as well as competent lawyer. First of all, when the need arises for you to hire a lawyer, the best place to begin your search is to start from your own social circle. Ask your friends, relatives and other acquaintances for any referrals. It is possible that some of them might have had an experience of hiring and working with an attorney. They can refer you to a few good ones and alongside give you information regarding, how a particular attorney work? What are his work ethics? How cooperative or hard-working he is? Such information can be vital for you to screen your search.

Secondly, you can also look through newspapers to start your search. Phone directories are also a good place to start your search. These sources will help you to make a list of all those attorneys that you think might be worth contacting for further information. Make sure that the attorney you choose to represent must have a strong past record, is highly experienced and has the ability to negotiate powerfully. The successful attorney will be the one who can settle the case without taking it to court. Your lawyer should also be able to avoid the court and must be able to arrive at a settlement without the mess of the court. However, if circumstances do not allow your attorney to keep the case away from court, then he should at least be able to arrive at a settlement at the least possible cost.

Make sure that he is honest in his dealings and openly discusses your case with you. He should keep you updated. If you can find a lawyer who is willing to take payment after winning the lawsuit, that will be a good agreement for you. If he agrees to such terms, make sure that no monetary matters are left unsettled. Whatever terms are agreed upon, make sure that there is written contract that you sign after reviewing it.

How to Stop Your House Being Used to Pay Nursing Home Fees After The Death of a First Spouse

Quite an emotive subject. We all know of someone who has lost their home to pay for Nursing Home Fees. All too often this means that the family home, which was meant to be the legacy to the children, is now swallowed up in the payment of Nursing Home Fees. What causes most upset is the fact that all this happens when a surviving parent is ill and the family are distressed. So can it be stopped?

Of-course it can, although not many people know about the process. It is fairly simple. Both parents write a Last Will and Testament and also a Trust. You only need ten pounds to set up a Trust. I like to call the Trusts, Family Trusts. This is how the system works:

1. Make sure that the house is in Tenancy in Common. Most houses are not. They have been purchased in Joint Tenancy. This is wrong! Examine your deeds or get your solicitor to examine your deeds to ensure that the family home is in Tenancy in Common. In other-words each spouse owns half the property.


2. Make a Will. Both parents must make a will each. The main component of the Will should be the Trust into which the property, valuables, stocks and shares plus money can be placed. Put as much in the Trust as you can. The main beneficiary of the Trust will be the surviving spouse and both parents can do what they want with the estate while they are alive because the Trust does not come into effect until the first spouse dies.


3. Make a Trust each. It a process known as Equalising the estate. It doesn't matter how big the estate is.

That is it! That is all there is to it! It really is that simple. Everyone should do it.

Now what happens is that on the death of the first spouse, their half-house goes into the Trust and not to the surviving spouse. Should that spouse then have to go into a Nursing Home at a later date then their half-house is assessed. The Inland Revenue regards a half-house as valueless as far as assessment is concerned. So on paper the surviving spouse who goes into a Nursing Home, does so without funds, and so avoids having the house sold to pay Nursing Home Fees while at the same time reducing potential Inheritance Tax.

Please remember that this system is at its best whenever a spouse goes into care following the death of the first spouse. It is approved by the Revenue and it has been done before.

So to recap:

1. You must have your jointly owned property in Tenancy in Common. This is vital.


2. You must each write a Will and begin a Family Trust.

Thank you for taking the time to read this short article.

How to Claim for a Personal Injury

First and foremost this article tells you everything you need to know about how to claim for a personal injury. It is important to note that any claim must be made within three years of the injury date. However, in some cases, such as a car accident, the injury may not become apparent until after the accident. Should this be the case, you have three years from the diagnosis date to file a personal injury claim.

Starting the personal injury claim process

If you are considering making a personal injury claim, the first step in the process is to hire a personal injury solicitor. A solicitor will be able to discuss the specifics of your case, such as how much compensation they think it could yield and the likelihood of the claim being successful. This information will then allow you to make a more informed decision about whether or not to go ahead with your personal injury claim.

Solicitors vary in terms of both expertise and experience. Therefore, when choosing a personal injury solicitor for your case it is recommended that you search for somebody who has experience dealing with a similar case and has also spent considerable amounts of time dealing with court cases should it go that far.
Once you have had this initial meeting with a lawyer, they can then make a claim against the other party on your behalf. See below for the 5 main steps in the injury claim process:

1. Your lawyer makes a claim against the other side
2. The other side chooses to either accept or reject the claim
3. You submit all evidence to the other party's lawyer
4. If the other party agrees, the requested compensation amount is paid and the case is closed.
5. If the other party disagrees or fails to pay then the case goes to court and is settled by an independent person.

When making a claim be sure that you are fully aware of all legal fees that you may have to pay both if you win or lose. Some lawyers operate on a no-win-no-fee basis meaning that if your claim is unsuccessful then you don't have to pay for their services. However, you may be liable for the other side's legal fees so it is worth finding this out before deciding to make a claim. The last thing you want is to be left with a hefty legal bill that you cannot afford to pay.

Respite Care - A Must for Care Givers

As a single parent years ago, I remember clearly the feeling that I had when the kids went back to school after a VERY long summer vacation. The truth is that by the end of the summer I was very much "over" the care giving responsibilities, and my behavior around the kids probably showed it. I would often go in to the bedroom, shut the door, and tell any of the kids that knocked on the door that I was on strike and wasn't sure when I would be ending my "strike". Then came my version of "respite care" -- the kids went back to school. For 5 or 6 hours a day I got a break and I didn't need to go on strike nearly as much.

Now that I am older and my wife and I have had the privilege of being a caregiver to both my father and mother, I realize the importance of having some time away from those responsibilities as well. Taking care of an elderly parent or spouse can be a heart wrenching and trying experience in the best of circumstances. Not only do you have the emotional trauma of seeing your loved one decline mentally and physically, but you also must deal with the increasingly demanding day-to-day needs they have like feeding, bathing, dressing, grooming, etc.

I won't belabor the need for respite care. If you are taking care of an elderly parent or spouse there is no doubt that you need a break from those responsibilities. The problem becomes how to find and choose the right respite care resources in your community. First we'll go in to how to find the different programs, and then deal with the possibly more difficult problem of how to pay for what you do find.

Types of respite care:

For an hour or two:

In addition to the obvious solution of asking family and friends to take over for brief periods, there are also private agencies that will send a person to your home for an hour or a whole day. Do a search for "in home care giving" and you will get an idea of just how many agencies there are that specialize in this type of short-term care. A lot of times you can find a private individual who is willing to provide services for your loved one for a little less money. A good resource for finding qualified caregivers is to go through a local Community College that offers Certified Nursing Assistant (CNA) training. They may have past or current students looking for work. Private individuals charge $10 to $15 per hour and for the agencies, expect to pay in the $15 to $20 per hour range.

For a day:

Different varieties of Adult Day Care programs can be found in most communities. The better ones offer appropriate activities and maybe even a meal. Typically, they are sponsored by churches or civic organizations and the cost can be quite reasonable. Make sure that the program director allows you to observe for a day so that you can see if there is a match between your loved one's needs and what they offer. Some programs are geared towards those with Alzheimer's and Dementia, and some programs only allow participants who do not have those diagnoses. Most counties have some type of agency that deals with the elderly and typically have knowledge of the types of Adult Day Care services available where you live. Click this link to find out the state and local agencies in your area http://www.statelocalgov.net or click the link at our website. Expect to pay $40 to $50 per day for a good program.

For up to a week:

Often overlooked as respite care possibilities are the Assisted Living facilities. These are not nursing homes, but are for people who may need someone to supervise and help with bathing, dressing, taking meds, etc. All of these facilities like to keep their beds full, and a lot of times you can negotiate with the facility director to allow your loved one to stay for a few days or a week at a time. The great part about this option is that you can have the peace of mind that your loved one will be taken care for the time you are away. Some facilities offer a few nights stay for free, and this becomes a great way to get a free getaway. Assisted Living facilities can be expensive, with some charging up to $200 per day. The key is to find a facility willing to negotiate with you. I have seen rates go as low as $450 per week for a high quality facility.

When considering any respite care program, make sure that you get as many references as possible from people who have actually used the program you are investigating. Churches and government agencies are a good place to start when checking out these programs.

How to pay for respite care:

Finding grants, scholarships, and other funding to help defray the cost of respite care can be frustrating. There really is no easy way around this. It just requires making lots of phone calls, talking with a variety of people in similar situations, and sticking with it until you find something that works for you. Joining local support groups or online community will put you in touch with people who have similar needs. All of you will be able to benefit from your collective experience in funding respite care as well as other needs that you have in common.

For funding of participation in respite care programs, check with county agencies serving the elderly, local Alzheimer's Association offices, churches, synagogues, and the programs themselves. Often the respite care program will have their own money they use as a type of scholarship to help fund participation in their program. Most importantly, don't give up. A friend who desperately needed respite care for her mother, but couldn't afford it, just received a grant from the local Alzheimer's Association. With the grant money she was able to pay for a week in an assisted living facility. There is money available, but a lot of times it takes digging to find it.

Finally, if you are looking for respite care for a wartime veteran or their spouse, the Veteran's Administration provides a benefit called Aid and Attendance, which can be used to fund respite care. Benefits range from about $1,000 to $1,500 per month. Click here for more information on aid and attendance for wartime veterans: http://www.vba.va.gov or click the link on our website.

Time away from care giving responsibilities is a must. Whether it is for an hour, a day, or a week, you owe it to yourself and your loved one to get away from your responsibilities for a while.

How To Become A Registered Nurse

For many young people considering nursing as a career, one of the first questions they ask is how can they become a registered nurse? The simple answer is that you have to complete a number of years of studies, undertake examinations and gain practical experience.

If you are seriously thinking about how to become a registered nurse (RN) one of the first things to do is to get your high school diploma with good science grades. This will give you a huge advantage in studying at an accredited healthcare school.

The next step is to decide whether to undertake a Diploma in Nursing, an Associate's Degree or a Bachelor's of Science degree (BSN). A diploma is the most basic certification.

This will enable to become a Licensed Practical nurse, which means that you can become a nursing aide or caregiver licensed to provide limited medical.

An Associate Degree in Nursing is a two-year course that takes your career to a higher level. But if you are really serious about becoming a registered nurse, you should undertake a four-year Bachelor of Science degree at an accredited nursing school.

Once you have finished your training, you will be required to undertake the National Council Licensure Examination (NCLEX-RN) to obtain your nursing license. Whether you undertake an accredited nursing program at a nursing school or online, you will also be required to complete clinical internships that provide you with the practical skills to become a good care giver.

As you will be part of a team when you go to work in a hospital or medical clinic, it is important that you learn to to work closely with surgeons, physicians and other healthcare providers. A major part of your time when you study is learning good communication and teamwork skills.

Your care of patients is critical to their well-being. You will spend a lot of your day walking around wards, taking blood from patients, changing bandages and treating wounds and using sophisticated monitoring equipment.

You will also be required to administer medication to patients, help with the patient's rehabilitation and palliative care and also assist doctors when they are providing treatment or are in surgery.

Once you have qualified to become a registered nurse you will have a number of career paths that you can pursue. Your skills will provide opportunities in emergency medical care, neurology, cardiology and heart care, neonatal care, pediatric care, surgery, patient education and palliative medicine.

Nursing is a great career with good job prospects. With an aging population in the United States, millions of people are going to require healthcare in the next 20 years.

Look Out For These Common Signs of Nursing Home Abuse

Nursing home abuse and neglect can be very hard to notice. Not only are the perpetrators oftentimes very good at hiding the signs of what they have done, the elders sometimes are embarrassed by the abuse that they do not feel like talking about it. Unfortunately, this only serves to create a situation where the elderly attacker is given a safe place to continue taking advantage of the elderly. This abuse can be terrifying in its nature. Sometimes it is theft and exploitation; sometimes it's physical, mental or physical abuse. In some cases, it is simply incompetency.

Nursing facility neglect can be fatal. Elderly citizens are often times forced to depend on a lot of prescription drugs to stay healthy. When they're not given as prescribed, their conditions can go downhill very quickly.

This means that you have to be aware of your loved one's medical needs and be able to come to their aid if those needs are not being met. Talk to your doctor if something seems inappropriate. Physicians have ways of detecting abuse that require their experience and knowledge. If you think it is going on, the physicians will usually be more than happy to investigate it for you. Caring for others is what they specialize in, more than anything else, after all.

Nursing home abuse oftentimes happen simultaneously. A difficult patient will sometimes be abused and their treatments withheld. This could be because the nursing staff is clumsy or it may be because someone on the staff is simply cruel. If person is not receiving their treatments, there is a real danger of death. Don't be scared to ask the Nursing home staff questions. The truly professional homes want the families to be involved with your loved one's care. In reality, the fact that elders are often forgotten by family members is something that causes real caregivers a lot of concern.

If you are certain there's something going on, find a lawyer. Nursing home abuse attorneys are experienced with these cases and know how to proceed ahead with them. Remember that an abusive facility is a menace to your loved one's life and limb, so get them out of the facility as soon as conceivable. It may be expensive and difficult to do so, but, if you have a case, you also may receive financial recompense for pain and suffering.

The Top 5 Must-Haves for Seniors to Live Independently

Ideally, we would all love to allow our senior loved ones to continue living in their beloved home, the repository of all their most treasured memories, instead of forcing them to live in a nursing facility. However, letting seniors live independently does have its own challenges. The most obvious of such challenges are the issues of safety and security. All the common health problems an average senior faces can essentially transform their usually cozy abode into a haven of endangerment, with the constant threat of a fatal accident awaiting their every turn. But while challenging, it is not altogether impossible. There are many ways to senior-proof a home, but the following five are indispensable.

1. Modify your senior-loved one's home: The very first step you must do to ensure that your senior loved one can live not only independently, but also safely and comfortably in their own home is by ensuring that the house indeed is safe and comfortable. A huge percentage of fatal accidents involving seniors occur in their own homes, mostly due to neglect or failure to adjust the home situation to the changing needs of the senior. You may hire a professional to assess the senior's home and identify how to make it safe, or you can just visit the website of the American Association of Retired Persons, where you can find helpful information about how to do the modifications without spending a lot of money. Often, changing light bulbs with brighter LED ones can go a long way to reducing the risk of accidents.

2. Home Security Alarm System: If your senior loved one is living alone, ensuring the home's security is indispensable. There are several ways you can do this. The most basic, of course, is getting them a good guard dog, such as a Labrador retriever. Such guard dogs can also serve as guide for seniors with vision problems, especially when going out or crossing the road. However, you must be sure that the dog is trained to respond well to emergency situations, or at least, would not jump on the senior (and thus causing reckless endangerment) when excited. The other way to establish the home's security is by installing a wireless home security and video surveillance system. Contrary to what you may assume, even advanced home security systems are now affordable. And even if you have to spend about $500, that should still be a small amount in exchange for your senior loved one's security. Many alarm system packages, especially those manufactured by established and highly reputable companies such as GE and Honeywell or Ademco, can provide accurate round-the-clock security for only a couple of hundred dollars. For a few hundred dollars more, you can get a full system with digital video surveillance-some of these systems come with a digital video recorder that can store several months of video surveillance footage in their built-in hard drives.

3. Medical Alarm System: If the home security alarm system serves to guard the house, then the medical alarm system provides security on a personal level. Such a personal alert system almost always come in the simplest configuration consisting of a home base unit connected to the phone line and a wearable panic button (worn as a bracelet or necklace pendant) that communicates wirelessly to the home base unit. When pressed, the panic button instantly establishes communication to the base unit, which functions like a modified speakerphone that allows the alert system provider's monitoring center to be quickly on the line and communicate with the senior in distress. The monitoring center also has the capability to alert emergency alternatives should the senior is unresponsive, such as contacting and dispatching medical emergency personnel and notifying the nearest trusted neighbors and the senior's relatives. And the best thing about these alerts: they're inexpensive. With monthly fees ranging from $15 to $30, which is already inclusive of equipment rental and the 24/7 monitoring, it would be difficult to think of anything more valuable than the affordable service provided by such personal alert systems.

4. Automatic medicine dispenser or a similar service: Commonly, seniors have to take several medicines a day, and it can be confusing for them to remember all the pills and the right dosage. Buying an automatic medicine dispenser, which can store up to a month's worth of daily medicines, can help ensure that your senior never forgets to take their meds. Some personal alert system providers also offer this type of medicine dispenser as an accessory to their main products.

5. In-home care assistance: You should also get the services of an agency that provides visiting caregivers that can provide professional care for your loved one, especially during those times you're not around to care for them. The in-home care assistance service is usually flexible in terms of schedule and fees, and it is a great complement to the medical alert system.

Traumatic Brain Injury Poses Huge Risk to Senior Safety and Independent Living

Living independently is important for many of today's seniors. With the benefits of living alone though come plenty of risks. Protecting yourself from risks like traumatic brain injury resulting from fall related injuries is one way that you can greatly increase the length of your independence.

Did you know that falls are by far, the leading cause of traumatic brain injury? People over the age of 75 have the greatest probabilities of hospitalization or even death as the result of traumatic brain injury. Prevention of falls and fast access to care are the greatest weapons against permanent damage resulting from traumatic brain injury.

Symptoms of Traumatic Brain Injury

Mile TBI (traumatic brain injury) will often include these types of symptoms: low grade and lingering headache, changes in sleeping patterns, difficulty with concentration and memory, dizziness, blurred vision, increased or unusual sensitivity to light or sound, and a constant ringing in the ears.

Moderate TBI may include any of the symptoms of mild TBI as well as slurred speech, numbness in arms and/or legs, loss of coordination, seizures, pupil dilation in one or both eyes, worsening headache that will not leave, and nausea.

How Should You React if You Suspect TBI?

If you've fallen and had a blow to the head accompanied with the symptoms above it is a good idea to see your doctor right away. You should also see your doctor or emergency medical service provider immediately if you are taking aspirin, Coumadin, or any other blood thinners and hit your head (with or without any of the above symptoms).

When you see your doctor be sure to bring a list of all prescription and over the counter medications you are taking. Medications can have very dangerous interactions with one another in the best of circumstances. In the event of a traumatic brain injury those risks may be more profound.

Why does TBI Pose such a Great Risk to Seniors?

The problem with seniors when it comes to traumatic brain injury is that there are many times when they do not get the necessary treatment or care quickly enough. Many seniors live alone and are injured or disoriented enough that they cannot get to a phone and dial the numbers to get emergency medical attention immediately after the injury occurs. At a time when seconds matter, minutes can do irreparable damage, and hours can be more like days compared to the amount of damage that can ultimately be corrected or recovered from.

It is often the case that traumatic brain injury among the elderly isn't discovered until it is far too late to undo the damage that has been done because aging adults often live alone and frequently live very insulated and isolated lives. The other problem is that elderly or aging adults are at greater risks for these damaging falls whether by environmental hazards for tripping and falling or loss of coordination due to aging, medication side effects, or lack of exercise.

Medical alert systems can be an excellent first line of defense against permanent damage due to TBI that results from falls. You owe it to yourself or your loved ones to make sure that this line of protection is readily available.

How To Land Your Ideal Nursing Job

After graduating or obtaining a degree in nursing, the next thing to do is to get ready for job hunting. On the other hand, if you are an experienced nurse the next step is to find for a challenging new place, such as a higher spot in the medical field. In spite of the range of your nursing background, the process of seeking for a new career is time-consuming and a bit exasperating. The main thing you need to consider in the entire job search procedure is finding for the vacant nursing positions.

Following are rules and guidelines created to cut career search problem and to give you proper idea on how to get your dream-nursing job.

Set an appointment and visit the recruiting agencies and departments of local hospitals, medical centers, and doctor's offices to find out the vacant positions available. If ever there are no open spot, ask if you can send your application or resume for future job opening.

Call recruitment and contract employment agencies and make sure to get in touch with a recruiter in the agency to give you information about several job openings, and even some not advertised vacant job. Through recruiting agencies, your chance of finding a job increase for you got the opportunity to apply for positions at multiple companies at the same time with single resume submission.

Search on major job boards online. You could visit job sites such as Monster.com and Hotjobs.com and get the chance to work on several available job vacancies. One piece of advice, keep in mind that due to a lot of number of applicants this kind of search would be very competitive.

Accept training or contract work for the mean time, for these chances sometimes serve as a good opportunity for a long-term career in the medical profession. Furthermore, this also provides you proper training on the field at the same time it gives you the time to test your skills before committing in the job for a full-time position.

Consider seeking a career to colleges and universities that offers nursing degrees, for often they have a record of vacant positions in the school itself. Connect with the career center advisory of the school to acquire more information on how to connect with other people in the industry that could give career opportunity.

Use your connections, the more connected you are with friends, family and casual acquaintances the number of chances you get to let them know you are aspiring for a job. Recommendation from a related friend or family member helps a lot especially if it gives you the chance for an interview with the particular company or institution you seek. If you have a close friend or relative working in a hospital or institution, you wish to apply. Do not hesitate to ask them for help. They can make the hiring process easier for you.

Research more on often disregarded nursing job possibilities including opening for school nurses, health department staff vacancies on other state or county, health insurance institutions, assisted living facilities and retirement homes, teaching career for nursing school programs at universities and colleges, mentor-ship programs, and programs for traveling nurse that assigns you on varied locations locally.

After covering the above mentioned job search suggestions on how to get your ideal nursing job, one last piece of advice is to keep on researching about the background of companies where you want to apply. Finally, make sure to customize your own resume as well as your cover letter for this could be the best weapon you could present aside the skills you could give once hired.

Nursing Home Owners: Top Reasons Why You Should Hire a Nursing Expert Witness

Nursing Malpractice and Nursing Expert Witnesses

Registered nurses are professionals who have sworn to provide their patients with utmost care until their recovery. But due to several reasons, a registered nurse can sometimes deviate from the medical standards. This deviation can sometimes be classified under nursing malpractice or negligence.

If you think that your nurse has turned away from the standard of care, hiring a nursing expert can help you determine whether your suspicion is correct. The expert will take his time to review the necessary medical documents, reports, and records to check if your claim has bearing. And if, according to the expert, your claim is valid, you can file a complaint and take the case to court.

Top Reasons Why You Should Hire a Nursing Expert Witness

But aside from providing a solid testimony to support your claim in court, a nursing expert witness can help you in a lot of other ways. These ways are related to the prevention of litigation cases that may be filed against you because of your nurse's negligence.

A nursing expert witness can help you determine whether your nursing home is malpractice-proof or not. He does this by making a thorough examination of all the equipment present in your nursing home, and all the procedures done to help your patients recover. He serves as an objective third-party auditor to check whether or not your practices are at par with the state's and the industry's standards. He will tell you what you need to work on and what kind of equipment need to be upgraded.

As a result, you will have proof that everything in your nursing home has been checked by a highly qualified individual. And in case one of your patients decides to file a case against you, you can confidently walk into the courtroom with a winning smile.

Hire Only an Experienced Nursing Expert Witness

When choosing your expert, set aside some time to do your research. When you flip the witness directory, you can find a lot of highly qualified nurses so it's tempting to pick the first person that appears on the list.

But you want to look for someone who has years of experience as an expert witness and as a practicing nurse. A highly experienced medical expert knows what the court needs including all the documents that needs to be prepared and submitted. He knows which of your practices will get you in trouble, and he knows which ones will get you rewarded.

Recourse and Non-Recourse Nurse Staffing Accounts Receivable Factoring: What's the Difference?

What is nurse staffing recourse factoring?

For the most part, recourse factoring is the most common and the most affordable nurse staffing financial help available to business owners. In this type of factoring arrangements, the accounts receivable factoring company will require an agency owner to buy an invoice back if the client does not pay within a specified amount of time. Moreover, the nurse staffing agency owner accepts full credit risk for any and all accounts receivables that it sells to the factoring company.

What is nurse staffing non-recourse factoring?

The other accounts receivable factoring option that owners have is non-recourse factoring. In a nutshell, non-recourse nurse staffing financing agreements hold the factor entirely responsible for an unpaid invoices if the following is true:

• If the hospital, nursing home or vendor management system (VMS) goes bankrupt during the time an agency owner's invoice was factored.


• If the hospital, nursing home or VMS goes out of business during the time an agency owner's invoice was factored.

It's important to keep in mind that non-recourse accounts receivable factoring does not cover the following situations:

• Very late payments when there is no insolvency


• Disputes/challenges with nurse staffing services


• General collections issues

Naturally, both options have pros and cons that an owner should consider before choosing which type of agreement to make. Typically, they will receive lower factoring fees and/or higher advance rates if they choose to enter into a recourse factoring relationship. On the other hand, a non-recourse accounts receivable factoring arrangement buys nurse staffing business owners' protection if a hospital nursing home or VMS goes bankrupt. Ultimately, agency owners need to review their accounts receivable factoring contract in detail with a lawyer to determine which type of arrangement, recourse or non-recourse, is the best fit for their agency.

The Benefits Of Home Nursing Care

Many seniors who are too sick or frail to live in their homes often think that the nursing homes are their only option either as their permanent residence or as a temporary facility during their recovery. However, many seniors who need nursing care would rather receive it in their own home while enjoying a familiar environment with their family and friends. Good thing there are community services and health care professionals who can provide him the home nursing care he needs. These professionals can come right to a senior's home to deliver responsible care.

Certified home nursing care services are available both for seniors and their families. In general, seniors who decide to receive in home nursing care services have better opportunities to live a healthy and productive life at home. By opting to hire home nursing care providers, they receive a lot of rewarding benefits, the most important of which is quality medical services which is personalized according to their individual's needs.

Deciding on Home Nursing Care

Deciding whether your senior loved one needs home nursing care or not can be difficult not only for the patient but for his family as well. Your healthcare decision mainly depends on recognizing important quality measures that will tell you whether such service is effective or not. With this in mind, you should consider the best agency or candidate that not only meets the medical review standards but are also able to offer services that are compassionate and compatible to the needs of seniors to help them live a quality life independently as long as possible.

A good healthcare agency should be able to provide excellent patient care. They should be able to offer healthcare services that are practical and effective. Keep in mind that home care should be able to save lives by proper medication administration, providing suitable ways of managing pain level and wound healing, and prevent chronic diseases. A good health care provider or agency should be able to provide this level of care to your senior loved one.

Senior home healthcare services generally include competent nursing care, personal assistance and health aids, and complete wellness programs. Skilled nurses are licensed clinical staff hired in order to maintain or improve an in-home patient's condition as well as to prevent more illnesses. Some of the services that skilled nurses provide are administering of medications, implement disease management programs, and execute advanced technology. Furthermore, skilled nurses help ensure that home nursing care services are fulfilled effectively and safely.

On the other hand, personal assistance providers and health aids, who are all non-professional medical staff provide assistance in the usual daily activities. More specifically, health aids assist seniors with such daily activities as bathing, eating, and walking. They may also provide assistance in monitoring bladder catheters or colostomy or in administering oxygen. The responsibilities of health aids are necessary in restoring the optimum level of health and function of a senior.

Modifying Your Home According to Your Senior's Needs

In order to ensure a comfortable lifestyle to your senior loved one while he's receiving home nursing care, you should consider modifying your home to suit his needs. For instance, you can make a bedroom out of any ground floor room to prevent your senior from using the stairs. It is also recommended that hand rails and other special equipment be installed in the toilet and bathroom to avoid accidents. You can contact an occupational therapist to help assess your home and recommend the necessary equipment or adaptations you need to make. You can also consult your community nurse or hospital for more help on home modifications.

In-home medical services provide many rewarding benefits to seniors and their families. Besides getting low-cost professional assistance, seniors are able to preserve a healthy well-being through regular socialization and communication with other people. Studies show that social interactions help seniors stay connected with the outside world and improve their social skills.

Skilled nursing services also give family members their much needed break. They also have peace of mind knowing that they are surrounded by professionals who are trained and ready to help them. Thus, family members are discharged of the responsibility and inconvenience of missing work or school to look after their loved ones. They can attend to their own personal lives without having to worry about their senior loved ones not taking their medications at the proper time or missing their meals. Indeed, home nursing care plays a vital role in the long-term health of senior patients as well as that of their family members.