Caregiving for Hospice Patients

Senior caregivers sometimes assist seniors who have decided to take advantage of a hospice service for their end-of-life care.  Hospice services do provide a Certified Nursing Aide caregiver, when the senior qualifies (by needing additional assistance with bathing and care which a C.N.A. has been trained to provide).  However, as the hospice C.N.A. only visits the senior for the approved hospice service period (usually a few times a week, up to daily, as needed, an additional private duty caregiver is often hired to assist.

Medicare does pay for hospice care services and a anyone who has been given 2 years or less to live can begin hospice care, although most people do not begin until they have 6 months or less to live.

Not all caregivers are able to adequately provide for hospice care and many times the end cannot be adequately predicted.

Some people leave the hospital to begin hospice care and pass away the next day and others live for 2 years or more.

How do you know if you will be able to care for a hospice patient?

  • Learn about hospice care by attending a training course through a local hospice agency
  • Understand the emotional, as well as the physical challenges the patient is experiencing
  • Discuss the specific care needs with the Care Manager before you begin the assignment
  • Realize you are making the patient's last days easier by assisting them with their care

If for any reason you are not interested in caring for a hospice patient, just say so - this type of caregiving is not appropraite for everyone.  It is sometimes very fulfilling to care for a hospice patient if you have experienced a loss of someone close to you but at the same time, some caregivers do not want to be reminded of the loss they experienced.  Because of this, many caregivers prefer to do hospice caregiving ongoing, while others prefer to not provide this type of care.

Healthcare Legislation Update: Senior Caregivers Will Have Health Insurance

Many senior caregivers who work part-time or who work for smaller senior care companies do not have health care benefits.  However, the health care legislation which recently passed the House of Representatives and now is up for consideration by the Senate, would provide a program where all employees would receive health care.

Impact to Caregiving Employees of the Recently passed health care bill in the House of Representatives:

  • Employers will be required to cover all of their employees for health insurance
  • Employers will be required to pay 72% of the single premiums and 65% of the family premiums
  • Low-income employees will receive subsidies to purchase coverage
  • There will be no pre-existing condition clauses
  • The insurance rate difference between young and old employees will be less (rating bands will be shrunk)
  • Costs projected to be $1.2 trillion dollars (paid for via savings to Medicare and taxes on the wealthy)

The Senate debate continues, with most negotiations happening behind closed doors.  The Senate vote is expected after Thanksgiving or possibly in 2010.  The proposed health care changes would not take effect until 2013.

Find out about current caregiver employment benefits and training programs on Caregiverlist's Career Center.


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Caregiver Application

Interested in assisting seniors as a companion caregivers or nursing aid or home health aid?

Many positions are available for caregivers to work for senior home care agencies, assisted living companies and nursing communities as part-time or full-time caregivers.  Senior care companies provide benefits, including payroll tax contribution (this means you can retire someday and collect social security benefits yourself), worker's compensation insurance and usually health care benefits for full-time employees.

You may fill out a job application as a caregiver to reach professional senior care companies in your area, as new positions become available each day, as seniors are discharged from the nursing home, assisted living communities and hospitals.

You may also learn about pay, policies, certified nursing aide programs and view caregiver training videos.



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Senate Passes Veterans and Caregiver Support Bill

Last night the Senate passed the Veterans and Caregiver Support Bill. The House of Representatives will vote on the bill next year, after the holiday break.  The bill passed the Senate with a voice vote of 98-0, so it looks like this bill will sail through the House with an affirmative vote.

What is it?

The Caregivers and Veterans Omnibus Health Services Act of 2009 contains provisions to provide:

  • Caregiver Assistance to Wounded Veterans
  • Telecommunications with VA Doctors and Specialists for Wounded Veterans in Rural Areas
  • Travel Benefits for Caregivers to Travel with the Veteran for Hospital and Rehab Care
  • Caregiver Education, Training and Counseling
  • Oversite of Caregivers via Home Visits
  • Respite Caregiving Services
  • National Survey of Family Caregivers

The main focus of the bill is to provide better care for both the veterans who have been wounded while serving since September 11, 2001, and their caregivers.  As medical technology in combat has advanced, more soldiers are surviving after losing limbs or having serious head injuries, but they must have ongoing care for the rest of their life.


C.N.A. Job Description

Certified Nursing Aides (C.N.A.'s) have completed classroom and field training programs which are regulated by each state's department of health.  After graduating from a nursing aide or assistant school, they must pass the state's certification exam to be hired as a certified nursing aide.

Senior home care agencies hire both companion caregivers and certified nursing assistants.  Sometimes care assignments require the skills of a nursing assistant but do not require the certification to be active.  Other times, the certification must be valid and long-term care insurance companies may require a copy of the certificate in order to pay for the claim.

While companion caregivers can assist seniors with memory loss or with housekeeping, errands, meal preparation and scheduling of appointments, a caregiver with nursing training is required to assist senior's who require more hands-on care with their activities of daily living (ADL's).

Certified Nursing Aide Job Description

  • Monitor daily health:  temperature, respiration, blood pressure
  • Assist with bathing
  • Assist with transfers
  • Assist with bathroom visits (catheter care)
  • Assist with meals (feeding tubes, liquids, purees)
  • Assist with exercises
  • Document care and daily activities
Many more skills are taught in nursing aide training programs.  You can take a sample nursing aide test or a practice test to learn more and find C.N.A. training programs in your area.

Caregivers with certification will enjoy ongoing employment as the senior population is projected to double in the next 50 years.

Free Memory Screenings Nationwide: Nov. 17th

If you are caring for a senior who you think may be experiencing some memory loss, or if you just want to make sure your own memory is functioning well, take advantage of the free memory loss screeings offered at locations nationwide on November 17, 2009, by the Alzheimer's Foundation of America.

Memory loss can sometimes be slowed, when diagnosed early, by the use of medications, brain exercises and meditation.  By discovering the type of memory loss, a senior can more effectively manage the challenges which will lie ahead.

National Memory Screening Day

Date:  Tuesday, November 17, 2009

Place:  Hundreds of convenient locations nationwide.  Click here to find a memory screening location in your state.

You will also be able to obtain information about early warning signs for dementia and you can find out about all senior services in your state on Caregiverlist's by-state information pages.

C.N.A. Training for Long-term Employment

Senior caregiving positions are available for both companion caregivers and C.N.A.'s (Certified Nursing Aides) and some states provide the additional training and certification exam for C.H.H.A.'s (Certified Home Health Aides). 

By becoming certified, more employment opportunities open up for a senior caregiver.  This is because nursing homes and hospitals must maintain a minimum staffing level of Certified Nursing Aides in proportion to the number of beds occupied.

Many times, long-term care insurance policies require the senior care to be provided by a C.N.A. in order for the policy to cover the care.

Types of Employment Opportunities for C.N.A.'s:

  • Senior Home Care Agencies
  • Assisted Living Communities
  • Nursing Homes
  • Hospices
  • Hospitals

Training Required for C.N.A.'s

  • Complete C.N.A. course program offered by colleges and community programs
  • Fulfill course requirements for graduation, including clinical assignments
  • Pass state C.N.A. exam
  • Pass Criminal Background Check

Learn more about the caregiver training provided to C.N.A.s, take a sample nursing aide exam and a practice exam and find C.N.A. schools in your area to decided if this is a certification you would like to pursue.


Employment Opportunities For Caregivers: Unemployment at 14% but not for Caregiving

October, 2009, the unemployment rate increased to 6.5% from 6.1%, the highest percent reported since 1994.  However, some sectors of the economy are still hiring, including health care.  As the population ages, career opportunities will continue in senior care.  Advancements in medical care and technology are allowing seniors to live longer, but often caregiving assistance is required to maintain the activities of daily living.

What positions are available in senior care?
Many seniors require part-time caregiving services while they are recovering from surgery, such as a hip replacement or when coping with an age-related illness, such as Parkinson's disease or Alzheimer's disease.  Companion Caregiver, Certified Nursing Aides, Certified Home Health Aides and Certified Personal Care Aides assist with caregiving services in senior's homes, in nursing homes, in assisted living communities and in hospitals.

What training is required?
Companion Caregivers usually only require in-house training provided by the employer.  Certified Nursing Aides, Certified Home Health Aides and Certified Personal Care Aides must attend a training program and pass the state exam to be officially certified.

How long does it take to become certified?
Most training programs are from 4 to 8 weeks long, depending upon if they are part-time or full-time.

How much do training programs cost?
Many times financial aid, grants and scholarships are available for nursing aide certification programs.  Sometimes an employer will provide reimbursement for the training.  Certified nursing aide and home health aide training programs usually cost from $400 to $2,500.

Learn more about becoming a senior caregiver by reading stories from other caregivers, finding a training program in your area, taking a sample nursing aide test or a practice test exam and reviewing caregiver training videos.  Apply for a job in your area to gain experience and begin your career.

Nursing Home Drugs: Report Shows Many are Unnecessary

The Chicago Tribune did an in-depth story this past week on the medications administered by nursing homes, many of which are not needed and not appropriate for the resident's medical conditions. 

Medicaid pays for medications - unlike Medicare - so it can be argued that Americans are actually better off if they are extremely low income and qualify for Medicaid which pays for all medications, as otherwise many seniors can pay $500+ per month just for the medications.

Nursing homes are only inspected once every 15 months.  Many nursing aides who have worked at nursing homes have shared that they always know when the inspection team arrives and that it is important to note that any inspection results are an indication of the best days at the nursing home, since they are aware they are being inspected.

The Tribune identified 1,200 violations at Illinois nursing homes involving psychotropic medications since 2001.  The actual numbers are likely far higher.

The misuse of psychotropic drugs is a nationwide problem  - - giving drugs to residents to keep them sedated is cheaper (goverment pays for the drugs) and easier than providing adequate nursing aide staff.

Read the Tribune's report. Let you congressman and Senator know your views - - why are we willing to pay for nursing home care forever and medications for extremely low-income seniors on Medicaid but not provide senior care in the home and pay for medications for all the other seniors, who have assets of more than $2,000?  Part-time and full-time care in the home provides better care and costs much less than nursing home care, which primarily guarantees a bed and meals, but not always adequate care services.

You may also find out about senior care programs in your state and view nursing home information on Caregiverlist.

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