Nancy Reagan Falls and Breaks Ribs: Why Aging Naturally Brings More Falls

Nancy Reagan, the former first lady and widow of President Reagan, suffered a fall which broke a few ribs and it was just recently announced she has been recovering for the last 6 weeks. At age 90, Mrs. Reagan remains active in the Republican party.  See, it is not just the Baby Boomer generation that is staying active in their later years - Mrs. Reagan is even from a generation born before the "Silent Generation" which is 1922 - 1945.
As many were surprised to here Mrs. Reagan had fallen again (she has had a few incidents), this is a reminder for senior caregivers that falls can be a natural part of aging. And, after any health injury, seniors must allow time for the body to heal. The healing process happens more slowly as part of the natural aging process - just part of the gift of getting to grow older.
Falls in the elderly are usually not due to just tripping on something, as falls for younger people may be. Instead, vision and hearing loss can impact balance which in turn will cause more falls. There may also be a delay in response time because of slower moving muscles.
Rush University Hospital in Chicago held a learning seminar for those of us in eldercare a few years ago and one of the presenters had studied the cause of falls in the elderly. In an effort to demonstrate that falls are due to balance issues and slower firing muscles, they created a red-carpet runway and had both younger and older people walk down it (while filming). They presented an obstacle at various places on the runway and then watched to see who would trip and fall.
Younger participants were able to regain balance quickly and avoid falling and elderly participants were not able to do so and would fall (they did allow them to wear a harness so they could catch them). It was a bit difficult to watch this film but it did prove the point of their findings.
As we age, our balance can be impacted by many health conditions. Part of  the natural aging process means that our cells do not regenerate new cells. This means muscles and bones are not as strong. Because of this, even when an elder does want to stop the fall, sometimes they simply cannot. 
Removing rugs that can slide or cause a stumble and eliminating stairs or other obstacles that can cause anyone to be more likely to fall are the first steps in preventing falls for the elderly. All of us have stumbled down a few stairs at some point – it happens. I even missed stepping up on a curb once when crossing the street and wiped out, in broad daylight. Which leads to another way to prevent falls for seniors which is to make sure they are wearing comfortable shoes that are easy for walking (even now I sometimes stuff my heels into the bag and wait until I arrive to make the swap).
Caregivers should always escort a senior who has become more frail, when going out in public. The safe way to do this is to place your arm underneath the senior’s arm and around to their back. This way you can instantly stop a fall.
Senator Marco Rubio, R-Florida, did break Mrs. Reagan’s fall when she lost her balance while walking into an event at the Reagan Library last summer but he actually was only holding on to her elbow and was lucky he caught her without hurting her arm.
Senior caregivers can gain more caregiving safety skills by taking a 10-hour online Caregiver Certification training course. Professional caregivers are taught the basic safety skills for transferring a senior and assisting with walking when they begin working for a senior care company.  Those who would like to work as a professional caregiver should remember that Companion Caregivers only require personal experience (as often seniors with memory loss may require ongoing caregiving just to keep medications and daily activities on track).  Caregivers and C.N.A.'s may apply for a caregiving job in their area to begin a career in senior care.
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Caregiver Training: Sample C.N.A. Test Demonstrates Skills Taught

Senior caregiver training involves learning skills to monitor vital signs, safely assist with physical care and interact with compassion to understand emotional and mental changes as someone ages.  Certified Nursing Aides or Assistants, known as C.N.A.'s, must take a state approved nursing assistant training course which colleges and senior care facilities offer.  After finishing the course, the student must pass the state C.N.A. exam in order to become a certified nursing aide.

Companion caregivers may take a 10-hour online training course to become certified as a senior caregivers.  View the training modules to understand the caregiving skills taught - you'll quickly see that providing quality caregiving takes some training. 

Senior home care agencies must meet licensing requirements in their state and properly train the caregivers they hire and supervise the caregiver to follow a customized Care Plan for each senior.  As the necessary employment taxes and insurances are provided, this protects both the senior and the caregiver and makes sure the necessary systems are in place for high quality care to be delivered.   The caregivers also must pass a background check and reference checks and because of this, families can know they will receive professional caregiving services.

What are some questions that are asked on a Certified Nursing Aide and Caregiver Certification exam?

Sample C.N.A. Test Question:  All of the following are in the Resident Bill of Rights EXCEPT:

a.  the right to form militant groups in the facility

b.  the right to be free from sexual, verbal, physical or mental abuse

c.  the right to be free of corporal punishment and involuntary seclusion

d.  the right to choose activities

Visit the Sample C.N.A. test to find the answer and to see that becoming a C.N.A. requires many skills. 

Senior care is not at all like child care, as you can see.  Senior caregivers must be trained to properly provide services for elders and understand how to report changing conditions to medical professionals.  This is why the field of senior care continues to grow and there continues to be a need for professional caregivers to work for senior care companies, hospices, assisted living communities and nursing homes.  There will be ongoing employment avaialble in senior care as departments of health do require a minimum number of Certified Nursing Aides to be on staff at all times and licensed senior care facilities.

Caregivers may begin a career by applying for a job as a companion caregiver with a professional company through Caregiverlist's Career Center - all professional senior care companies will provide training for new caregivers and you can also take the 10-hour online course to be prepared.


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Nurses' Rally Kicks off NATO Summit Protests

Nurses rallied together on Friday, May 18, in what was called “the first official protest of NATO” in Chicago’s downtown. More than 3,000 nurses, nurses aides and activists assembled to call for their "Robin Hood Tax" — a small sales tax on Wall Street transactions. With up to hundreds of transactions conducted every minute, the nurses said that the $350 billion per year generated by the proposed tax could help alleviate healthcare and education problems in communities.

Members of National Nurses United, organizers of the rally, dressed in nurse scrubs and green Robin Hood caps were joined by members of the Occupy movement in calling for equal taxation. The rally was predominantly peaceful, and the nurses stayed on message throughout the demonstration. Former Rage Against the Machine guitarist Tom Morello performed during the last 30 minutes.

It was Morello’s performance that threatened the NNU permit request because of the city’s concern that his appearance would push rally attendance at Daley Plaza over its capacity. Negotiations between the Nurses’ Union and the city resulted in a shortened rally — from five hours to two. The nurses made sure to make those two hours count.

“It's time for Wall Street to start paying what all the rest of us pay,” said Karen Higgins, Boston RN and co-president of the NNU. Advocating for the people the families for whom they care, the nurses carried placards calling for “Healthcare for All, Jobs with Dignity, Quality Public Education and A Healthy Environment.”

You can watch a part of the demonstration here:

The solidarity and caring shown by the nursing community was truly inspiring. As the need for caregivers continues to increase, training as a CNA seems to be a great first step to a fulfilling job and career.

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Costs of Senior Care

Caregiver Credits have been one suggetion for a solution to creating fair Social Security payments in retirement for those individuals (usually women) who have had to step out of the workforce for a period of time in order to provide senior caregiving for a family member or child caregiving.  The reason is that if the government would have to provide for this care, it would be even more costly.

How much does senior care cost?  Nursing homes can cost as much as $150 to $400 per day.  And this will not include a one-on-one caregiver.  Usually one Certified Nursing Assistant works with as many as 15 residents.  Caregiverlist's nursing home directory includes the daily costs of nursing homes nationwide.

Senior home care provides the security of professional care plans and an active management by Care Managers who implement a Care Plan and train and supervise professional caregivers.  Caregiver training includes learning how to document care services and observe changes in health conditions, both mental and physical.

Senior home care costs between $18 and $25 per hour, in most areas of the U.S.A., depending upon the care services needed.

Assisted Living costs at least $2,500 per month.  It is important to research the additional costs for caregiving services and extra activities when looking for an Assisted Living community, as these services will be in addition to the monthly rent.

Learn about the total costs of senior care and to effectively plan for your own care needs.  Find out the Medicaid financial requirements for qualification in each state, too, as Medicaid is the back-up plan for seniors when they do not have the financial resources to pay for senior care.

Many seniors will want to remain in their own homes as they age and it is important to plan ahead and find quality senior home care agencies to provide services for these seniors.  Medicare does not pay for long-term senior care.  Request rates and services of a senior care company near you.


Senior Hunger in America

When I saw my mother this Mother’s Day, I made sure to ask all the right questions: Was she taking her medication? Did she get out to see friends often? Was she getting enough to eat? A quick check of her fridge assured me that she was in no danger of malnutrition, but it got me wondering — how many seniors can say the same? Her elderly neighbor, for example, would be actively fighting hunger if it were not for Meals on Wheels.

On May 8, 2012, TV Icons Linda Evans of Dynasty and Linda Gray of Dallas joined Congresswomen Rosa L. DeLauro (D-CT) and Jo Ann Emerson (R-MO) at Capitol Hill for MoWAA’s second annual Mother’s Day Event, “Meals for Mom”. The Congresswomen are honorary co-chairs of the newly created National Alliance of Women Against Senior Hunger (NAWASH). Joining them were other members of Congress, who signed Mother’s Day cards for constituents, which were delivered along with nutritious meals by Meals On Wheels program volunteers in their Congressional districts.

The Meals on Wheels Association of America has made its mission to eradicate senior hunger by 2020. According to its latest research, 8.3 million seniors in the United States face the threat of hunger. The majority of those affected are women. For those living alone, and especially those without family, the volunteers for Meals on Wheels bring not only food, but may be these seniors’ only contact with the outside world.

Enid Borden, President and CEO of the Meals On Wheels Association of America, is calling for help in the form of volunteers and donations in order to help her reach her lifelong goal — making sure that no senior goes hungry, especially in this land of plenty. Check out the Meals on Wheels website to read about their initiatives and projects to check out the myriad of opportunities available for you to help.

In these times of government budget cuts, it’s more imperative than ever that we pull together as a community and make sure that no senior lives without proper nutrition or ever goes hungry.

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Women Serving as Caregivers Receive Less Social Security Than Men

Social Security benefits should be updated to reflect women serving as caregivers, say three national organizations who presented to Congress last week.  And, all senior caregiver employees should also receive Social Security benefits through their payroll deductions - - - all caregivers should make sure they are working for a licensed senior care company providing this benefit which will allow them to retire and collect Social Security benefits. 

Caregivers are usually women. This is not news for anyone. Senior home care agency owners can tell you that the majority of their caregiving employees are females. Nursing homes and Assisted Living communities will also agree that the majority of people applying for their jobs are women. Men simply are not as attracted to this type of work. My own brother has amazing talents from hunting to cooking to being very accomplished in his career - but he says he just can't take the hands-on care duties for our Grandmother. Yes, he'll plug her hearing aid into his ear and adjust it and make sure the batteries are working well, where I sort of am not attracted to doing that. But he isn't comfortable with assisting with caregiving duties such as bathing and toileting. Guys are just wired differently than women and science confirms this for us. We can accept this and play to our strengths. But not receiving the same pay and retirement benefits is not acceptable.


After a lifetime of lower wages and time out of the labor market for child-rearing and caregiving, women typically receive less pay from their Social Security check than men. Widows and women of color often fall into poverty in old age. This is a problem.


But what successful married man with children would not be half as successful in his career without his wife keeping the household running? My girlfriends and I joke about a board meeting of Venture Capital guys who were comfortable, in the company of women, bragging about being proud their wives were ‘stay at home’ because this meant their wives could do all of their chores and errands and scheduling for them. Yes, without a wife to do these things for them, they would need to use their own work hours, or after-work hours, to actually do these types of things. Or, they would need to hire a housekeeper or nanny to do these tasks. Even these professional men are admitting these duties are very needed and necessary in order for them to be successful.

I also heard Jack Welch, the former GE Chairman and CEO, speak once. He was on one of his book tours with wife #3, Suzy Welch (for the book titled “Winning”).  I will give him credit for being very honest when he was asked this question by an audience member: “how did you balance raising your kids while growing your career?” He answered:  “I didn’t. You would have to ask my first wife how she did that. I wasn’t around.”  He is trying to do the balancing act now with his third wife who writes his books with him and goes on book tours with him, so we'll also give him credit for this.


Life is a balancing act. Whether women engage themselves in a career or work in the home raising children, they are managing the household and part of a team. Social Security payments should honor this work and recognize this labor.


This is also why Caregiverlist advocates for all caregivers to only be hired as employees, through senior home care agencies, insuring they are receiving Social Security benefits and payroll tax contributions along with Worker’s Compensation Insurance and Professional Liability Insurance. This protects the senior and the caregiver and it is only right and fair that someone working as a senior caregiver will be able to collect Social Security benefits when they retire.

A team of leading advocates for women, including a UCSF social scientist, are seeking to correct the inequities through new proposals to reform Social Security - our nation's financial safety net for senior citizens.


Last Friday, May 11, 2012, their report was presented at a Congressional briefing in Washington, D.C. The authors represent three national organizations for seniors and women: the National Committee to Preserve Social Security & Medicare Foundation, the National Organization for Women Foundation (NOW), and the Institute for Women’s Policy Research.


“This is an urgent call for our retirement system to catch up with the changing needs of women,’’ said the lead author of the report, Carroll L. Estes, PhD, founder and former director of the UCSF Institute for Health & Aging. She is the chair of the board of directors of the National Committee to Preserve Social Security& Medicare and its foundation.


“Social Security is crucial to the future of our children and grandchildren,’’ Estes said.“It is there for Americans when catastrophic events befall them, such as 9/11 when about 2,600 children lost a working parent. We must keep the social contract that it represents, and improve the lives of women and other workers who have paid into Social Security for decades.’’


The report, “Breaking the Social Security Glass Ceiling: A Proposal to Modernize Women’s Benefits,’’ examines the changing role of women in the workforce as well as the smaller incomes women receive in retirement as a result of lower wages on average and time spent out of the labor market for unpaid caregiving of children and aging parents. Retired women of color are particularly vulnerable, experiencing two to three times the poverty rates of whites.


Social Security benefits may begin as early as age 62, however, the benefit amount will be reduced and you may wait until age 70 to begin collecting in order to receive the maximum benefit based on the amounts you contributed from your paycheck.


Social Security benefits are adjusted for cost-of-living increases and your benefit amount may be impacted by military service or pensions.


The Social Security Administration provides a “Retirement Estimator” tool on their website to allow you to calculate your expected Social Security check when you retire. The maximum benefit is around $2,100.00 per month, if you paid in the maximum amount for 35 years. The average monthly benefit is around $1,230.00 as of January, 2012.


Caregiverlist provides the daily costs of nursing homes nationwide along with senior home care costs to allow you to plan for your retirement care. You may view nursing home daily costs in each state and compare the nursing home ratings based on costs.

Caregiverlist's FindtheBest Comparison tools also allow you to compare hospitals, compare Medicare plans and more, to allow you to be ready for senior care needs.

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USA Today Article on Senior Care Ignites Caregiver Pay Conversation

USA Today reported earlier this week that the Franchise Business Review market research firm found senior home care agencies to be one of the most profitable franchises, even as the industry is fighting the Department of Labor's potential new rule which would allow over-time pay for senior caregivers providing live-in care services.

The senior care industry continues to grow, as seniors are living longer and prefer to age-in-place.  It is true that more and more franchise companeis are offering senior care services.  However, the profit levels reported in the article may not be exactly accurate.  It is important to remember the numbers are based on a survey and it is also important to remember that senior clients may pass away or get better and no longer need senior care services.  This makes the "lifetime value" of a client a very real scenario.  Unlike a Subway sandwich franchise, you will not win clients forever. 

This means there is a revolving door of clients and a revolving door of caregivers.  This impacts costs and profits.

The USA Today article also lead to some confusion by those commenting claiming the senior home care agencies were billing Medicare.  They do not.  Senior home care must be paid for privately or by long-term care insurance.  Because of this, you will not find any fraud - - - believe me, sweet elderly ladies and gentleman comb through every detail of their invoices and will make sure it is correct - - - it is too bad they are not working on Wall Street or for the banks in this country!

Medicare home health agencies are different from senior home care agencies.  Medicare home health has experienced a huge amount of fraud, even by public companies, partly because the Medicare home health services were set-up in such a fashion that fraud was easy.  However, this is changing.  Medicare invoices are going to be easier to read and there will also be more incentives for reporting fraud.

In the  meantime, it is important that senior caregivers receive benefits such as healthcare and fair pay for the work they perform.  WIthout quality caregivers, proper senior care cannot be delivered.  Senior caregivers should receive all the benefits of any employee, which includes Worker's Compensation Insurance, Professional Liability Insurance and Social Security benefits.

Learn more about working as a professional senior caregiver and share with us your feelings on how much caregivers should be paid.  You may also take a sample Certified Nursing Aide test to understand some of the skills trained nursing assistants learn.  Caregiverlist offers a 10-hour online caregiver training course for non-medical caregivers.

The Exemption to Overtime Regulations for Caregivers was set in 2007, allowing companion senior caregivers to be excluded from wage-and-hour standards which would provide for overtime pay.  The 18th Initiative in Obama's "We Can't Wait" campaign would over-ride this exemption.

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Navigating the Senior Care Maze: Free Webinar from American Society on Aging

American Society on Aging (ASA) is hosting a free webinar titled:  Navigating the Senior Care Maze, as part of the Family Caregiver Support Series.

Senior care can be overwhelming for both seniors and their family members.  Understanding the costs of care, the senior care options and keeping up with the latest medical care for age-related diseases can be a full-time job and is a full-time job for professional caregivers.

Navigating the Senior Care Maze webinar will outine the critical medical information needed, including document gathering and doctor and medication mnagement so that caregivers can better manage the senior's care and be prepared for potential emergencies.

Caregivers can obtain professional caregiver training online, accessing a 10-hour online Caregiver Certification course that meets the training guidelines established in a few states which is the basic training for non-medical caregivers (caregivers who are not Certified Nursing Aides).  As more caregivers are constantly needed in the senior care industry, individuals may also learn about caregiving careers and apply for a senior care job near them.

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Alzheimer's Alone

Seniors prefer to age at home in familiar surroundings; it's a fact. The comfort derived from familiar routines and environs can be encouraging and reassuring. Many diagnosed with Alzheimer’s and dementia feel the same and choose to remain independent for as long as possible.

In March, the Alzheimer’s Association released 2012 Facts and Figures: Alzheimer’s Disease Facts and Figures, and includes a Special Report on People with Alzheimer’s Disease and Other Dementias Who Live Alone. According to the report 800,000 or 1 in 7 of those diagnosed with Alzheimer's disease lives alone.

Distance caring is the result of a mobile society — family members may live too far away to give sufficient supervision. Spouses pass away and the once tight-knit family disperses. Someone with early onset dementia or Alzheimer’s may find themselves alone.

While the desire for independence remains strong, the body may have other plans. An overwhelming aspiration to stay in one’s home and remain vital in one’s community can can turn even the most stalwart person into an ostrich, hiding their head in the sand from the disease.

The population is aging and we all need to consider that this could be our fate, or the fate of someone we love. An estimated 5.4 million people in the United States have Alzheimer's or dementia. That number is expected to reach up to 16 million by 2050. But if independence and home aging is a priority, there are things we can do to help manage.

Those who live alone, either by choice or necessity find they need to adjust their expectations.

Driving Miss Daisy. Until the self-driving car is readily available, a good choice would be to drive less. and when driving, perhaps keep drives short and to well- known routes.

Note to self: leave more notes to self. This is especially important when safety is a concern. A note by the stove with a reminder to shut off burners and oven, a note by the door with a reminder to lock, a note near the medicine cabinet with gentle reminders of which meds to take and when, could help prevent disaster.

Everything in its place. Designate a spot to place keys or sunglasses. If you ever see items that have strayed, return them immediately to their home.

Also, consider an id bracelet with address and a phone number of someone who will come to your aid. No one expects to wander off, but it happens.

The Alzheimer’s Society UK also provides a helpful factsheet with more information and suggestions on living alone with dementia.

It is important to begin to plan for the escalation of care. A quality Home Care Agency will work with finding assistance for your level of need — from simple companionship and housekeeping, to medication management to possible live-in care. A Geriatric Care Manager can consult with you to help determine the health markers that might indicate you should step up the level of care.

Early detection is so important, so discuss it with your doctor. Give yourself time to plan accordingly, especially if you intend to live alone with Alzheimer's or dementia, as so many others already do.

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Diabetic Seniors: Fraud Alert for Supplies

Diabetes involves many care needs, including supplies for glucose meters, test strips and lancets to prick the skin for blood sugar testing.  Seniors who need to monitor their blood sugar and take medication for diabetes may be targets by professional fraudsters.

The National Legal Resource Center (NLRC) has issued an alert for those seniors with diabetes to be aware of telephone solicitors who are really just looking to gain their personal information by pretending to be providers of "free" diabetic supplies.

What is the Diabetes Medicare Fraud Scheme?

Someone pretending to be from the government, a diabetes association or from Medicare will call the diabetic senior to offer "free" diabetic supplies.  The caller may offer a heating pad or foot orthotics in exchange for the senior's Medicare or financial information.  As the cost of these supplies can become an extra expense burden for seniors, many times there is temptation to accept the "free" items by exchanging the personal information to qualify.

Then the diabetic senior may receive items in the mail which they never ordered and the supplies are billed to Medicare under the person's Medicare number.  They are not free.

The Department of Health and Human Services, Office of the Inspector General, advises you about what to do if you or your aging parent receives one of these suspicious calls:

  1. Do not provide your medicare number or other personal information to anyone over the phone when they call with an "offer".  Medicare and other legitimate agencies do not call to solicit sales of supplies.
  2. Report the Call:  1-800-HHS-TIPS
  3. Check your Medicare Summary Notice and Billing
  4. Refuse Delivery of Items You Did Not Order

If you notice any items on your Medicare summary which you are not familiar with, you should always call to question them.

Senior caregivers should also monitor suspicious calls and provide another set of eyes to review Medicare statements.




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