Hiring a Caregiver

When a senior needs extra assistance with their care, because of memory loss, an age-related illness or mobility issues, it becomes necessary to evaluate the best way to provide for the care needs.

The senior care industry refers to these basic care needs as "Activities of Daily Living".  This includes assisting with walking, bathing, toileting and meals.  Nursing Aides and Home Health Aides (each state sets requirements for certification for nursing assistants) are trained to properly provide for senior care needs.  Certification classes usually take 4 to 8 weeks (depending on if it is a part-time or full-time program).  Nursing facilities and hospitals are usually required to have a minimum level of certified nursing assistants on staff based on the number of residents and patients.  Senior Home Care Agencies may staff companion caregivers, as well as nursing aides, depending on the care needs of the senior.

It is important to consider the toll caregiving will take on a spouse or relative.  The physical work required can be substantial and when this is combined with the need to interact with a loved one as a caregiver, the relative can quickly become exhausted and sometimes even depressed.  This is because they are most likely missing out on many of their own daily activities which they now no longer have the time to enjoy.

Many families have told me that hiring a professional caregiver was the best decision they ever made.  The cost is really minimal when you consider that it will allow relatives to spend quality time with their loved one.  Many times the health of a spouse who is performing the duties of caregiving will also decline significantly.  Caregiving is not easy work.  However, it is a little easier when the person performing the care is not a relative or friend and is able to come to work refreshed and leave to go back to their own life.

Caregiverlist does provide quality standards for Senior Home Care Agencies who provide information on their rates and services for our users and you can learn more about the benefits of hiring a senior home care agency from our home page.

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Computerization of Health Records Benefits Seniors

President Obama's stimulus bill has passed and now we must hope that it is implemented with some oversight and accountability (the same accountability we want the banks and others receiving bail out dollars to uphold).

As with all bills that pass the House and Senate, this one too will include many items that cannot please all of us.  But one item I am happy about in the Economic Stimulus bill, and think all seniors and caregivers should celebrate, is this one:

"Making the immediate investments necessary to ensure that within five years, all of America’s medical records are computerized."

Many seniors and their family members have walked into the office of a new doctor - usually a specialist for a new diagnosis such as cancer, Alzheimer's Disease or Parkinson's Disease, only to find they must fill out pages and pages of paperwork to provide information about their medical history and insurance.  And we are the country that invented the internet?  We can drive past a toll booth without tossing a dime into the basket because of technology and we can pay all of our bills with a few clicks on a computer.  But walk into a hospital and they have no way to access your medical records, no way to find out what medications you are taking and no idea what Medicare insurance plan you are on.

It is time for our medical care to get up to speed with technology.  It is possible to do this in a safe and secure way (we transfer millions of dollars a day from one bank account to another via online bill payment).

This seems especially important knowing the senior population will more than double within the next 20 years.  With many industries already communicating information via cell phones, it is time for health care to at least be able to communicate via computers in preparation for a wired society.  This will be a massive benefit for seniors and their family members who often do not live in the same city and need a way to monitor the care.

You may learn more about the health care initiatives included in the stimulus plan on the White House website.  Definitely check in with your local Congressman and Senator to share any concerns you may have with them.  Corporations know that when you track all of your activity, you increase profitability and performance ---- definitely healthcare will benefit in many ways beyond just convenience by the computerization of medical records.

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Caring for the Caregiver

Many times when a family member develops medical conditions which require extra care, relatives will step in to assist with caregiving.  Then, either because the care needs progress or becasue the family members must go back to work, it becomes necessary to hire a professional caregiver.

Regardless of whether the caregiver is a paid professional or a family member, it is important to consider the care needs of the Caregiver in order to have a successful care relationship.

What is the number one injury for caregivers?  Back injuries.  Just as many Registered Nurses suffer back injuries, so do caregivers.  This is because transfers from bed to wheelchair to toilet can become more complicated when a senior does not feel well or is suffering from memory loss.

Senior Home Care Agencies provide professionally managed caregivers which includes providing for a daily routine for the care and necessary insurance coverages (which means Worker's Compensation insurance covers any back injuries).

Make sure you talk to your Caregiver about any specific needs or requests they may have to make sure they are able to provide quality senior care.  Remember, caregiving can be emotionally and physcially exhausting so just taking the time to ask your caregiver how they are doing can make all the difference in the world.

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Certified Nursing Aide

One of the first questions a senior will ask when needing additional care services is:  what duties does a Certified Nursing Aide perform?

My answer is always that the Certified Nursing Aide is the person who performs the "hands-on" care in a nursing home or in hospitals.

The department of public health in each state creates their own nursing aide certification guidelines.   Schools must receive approval to offer a Certified Nursing Aide program and nursing aides working in licensed nursing facilities must be certified.

There are many little details for providing care which can make a huge difference in the quality of the care - nursing aides learn these details as a student in a nursing certification program.

Skills include:  transfers, bathing, dressing, bed pan and catheter care, range of motion exercises, checking vital signs, decubitus ulcer care (bed sores), feeding tube, oxygen tank, hearing aide care, understanding age-related medical conditions and how to interact with a variety of patient personalities (including combative patients).  Making sure sanitary conditions are always maintained are also taught.

Tuition for Certified Nursing Aide training is usually from $500 to $1,000 and many times reimbursement is available through employee programs at nursing centers and hospitals or through city or state incentive programs.

Harold Washington College, a city community college in Chicago, Illinois, charges a $629 tuition fee for their Certified Nursing Aide program.  The Spring semester runs from January 19th and runs for 12 or 13 weeks depending on if it is the day or evening program.  The day program meets Mondays and Wednesdays from 8am to 4pm and the evening program meets Thursdays and Fridays from 4pm to 9pm.

Upon completion of the course, students take the state exam and then may begin working as a Certified Nursing Aide.



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January Unemployment at 7.6% but not for Caregivers

Although the unemployment rate for January has been reported as 7.6%, the good news is that jobs actually increased in the healthcare industry. 

Medicare does not provide for longterm care in a nursing home and because of this, more and more seniors are making the decision to receive one-to-one care by their own professionally managed caregiver at home, rather than rehabilitating from a stroke or hip replacement in a nursing center which may often only provide one nursing aide for every 12 to 15 senior patients.  This prevents the aid from being able to adequately interact and motivate each elderly patient adequately, especially if one patient has a mishap which requires more time. 

In fact, staffing is sometimes inadequate enough in many nursing homes that even those seniors who are rehabilitating in the nursing center while Medicare is paying for their care will hire their own private senior caregiver to assist them. 

Working as a senior caregiver or Certified Nursing Aide or Home Health Aide will pay between $8.00 and $16.00 per hour, depending on what part of the U.S.A. you live in.  In addition, you receive professional training and benefits.  Companion care may not require formal training beyond what a senior care company provides and usually pays 50% to 100% more than minimum wage.

In addition, senior caregiving delivers a fulfilling career, as you know you truly made a positive difference for someone when you go home at the end of the day.  As caregiving sometimes require 24-hour around the clock staffing, there are many opportunities for weekend and evening hours for those who are seeking extra income or a part-time job while studying for a professional career.  Many times nurses and social workers will work as companion caregivers while in school studying for their prerequisites for nursing school or while an undergrad.

Caregiverlist's Career Center provides information about working as a caregiver and connects applicants with hiring senior care companies in their area. You can also read stories from other caregivers to learn about their experiences working as a senior caregiver.

 

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Nursing Home Inspections and Nursing Home Violations

The government has been advertising the Medicare.gov website to let seniors know the nursing home inspection reports are available online (they also allow other websites to download this information and Caregiverlist also provides it).  I have been hearing the ads on NPR and elsewhere.

The nursing home inspection reports are a nice starting point  for seniors and their family members when evaluating a nursing facility for a short or long-term nursing stay.  But it is important to realize that these nursing home inspections are only performed once every 15 months.  Ask any Certified Nursing Aide who has worked at a nursing home (working at a hospital or nursing home is required as part of their certification training) and they will tell you that most nursing homes have an alert "code" that goes out when the nursing home inspectors walk in the door - - - it could be just announcing on the P.A. that "Minerva is on line 1".  This means everyone is on their best behavior.  It reminds me of elementary school when parents sat in on the classroom - even the bullies were nice to everyone on those days, including the teacher.

In addition to the inspections only being made every 15 months,  the nursing home violations are not included in the inspection report, and, actually, this is the information you really need to know when evaluating a nursing facility. 

If you really want to make sure you are going to be moving a senior into a quality nursing home, the best way to find out the quality of the care is to find out the number of nursing aides on staff per number of beds and to talk to the staff.  In addition, find out the monthly nursing home violation report in your state.  As you'll see from the June, 2008, violations in Illinois, many of the violations most likely happen because there just aren't enough caregivers to manage problem residents and to assist with bed sore management.

This is why more seniors are opting for care in the home by a one-on-one caregiver.  Senior Home Care Agencies provide in-home care for a cost of between $16 - $28 per hour, depending on what part of the country you live in, and this fee provides for all the payroll taxes, insurance protection and active management of the caregiver.

Nursing Home Violations For The Month Of June 2008

SPRINGFIELD, Ill – The Illinois Department of Public Health today announced the following type “A” violations of the Nursing Home Care Act were cited during the month of June. An “A” violation, which is the most serious licensure violation imposed by the state, pertains to a condition in which there is a substantial probability that death or serious mental or physical harm will result.

The statement of violation for each facility can be obtained by clicking on the facility's name.

Alden Alma Nelson Manor, a 268-bed skilled facility located at 550 S. Mulford Avenue, Rockford, has been fined $32,500 and notified of license revocation for failure to prevent and protect residents from abuse. Three residents were physically attacked by another resident. The facility has requested a hearing on the Department’s action. A status was held February 26 and settlement negotiations are underway.

All American Nursing Home, a 144-bed skilled and intermediate care facility located at 5448 N. Broadway Street, Chicago, has been fined for failure to maintain a sanitary kitchen and ensure proper food handling to prevent hazardous food borne illnesses. Kitchen staff was observed preparing food without washing hands or using gloves. The facility requested a hearing on the Department’s action. A hearing was held and the facility paid $1,200.

Allen Court, a 16-bed intermediate care facility for the developmentally disabled located 1650 E. Main Street, Clinton, has been fined $20,000 for failure to implement its own policies to prevent neglect of a resident. Staff failed to provide a thorough assessment of the resident’s symptoms and did not provide immediate medical attention after a fall. The facility has requested a hearing on the Department’s action. A status in the case was held February 25.

Belhaven Nursing & Rehab Center, a 221-bed skilled care facility located at 11401 S. Oakley Avenue, Chicago, has been fined $30,000 for failure to provide necessary care and services to residents to prevent pressure sores and treat new sores. The facility has requested a hearing on the Department’s action. A status in the case is April 16.

Blue Island Nursing Home, a 30-bed intermediate care facilities located at 2427 West 127th Street, Blue Island, has been fined $15,000 for failure to adequately supervise residents and monitor a resident’s consumption of alcohol and prevent the resident from physically abusing two other residents and a staff member. The facility requested a hearing on the Department’s action. A status in the case was held February 26 and settlement negotiations are underway.

Brother James Court, a 99-bed intermediate care facility for the developmentally disabled located at 52508 St. James Road, Springfield, has been fined $10,000 for failure to implement facility policy and procedure on Abuse and Neglect. The facility also failed to recognize the need for additional supervision of a resident after a sexual incident between two residents. The facility has requested a hearing on the Department’s action. A status in the case is March 31.

Cardinal Hill Healthcare, 90-bed skilled care facility located at 400 E. Hillview Avenue, Greenville, has been fined $55,000 for failure to provide adequate supervision to prevent a resident from choking which resulted in death. A resident took another resident’s sandwich without staff knowledge; was later found without vital signs and pronounced dead. The facility has requested a hearing on the Department’s action. A status in the case is March 31.

East Peoria Gardens Healthcare Center, a 103-bed skilled and intermediate care facility located at 1920 Springfield Road, East Peoria, has been fined for failure to provide necessary care and services to maintain health. In the case of 4 residents, the facility did not (1) perform cardio pulmonary resuscitation (CPR), (2) provide adequate supervision, and (3) monitor worsening medical condition. As a result, 3 residents died and a fourth suffered gangrene to a toe. The facility requested a hearing on the Department’s action. A hearing was held and the facility paid $32,500.

Mosaic Living Center, a 150-bed long term care facility for residents under the age of 22 located at 7464 N. Sheridan Road., Chicago, has been fined $10,000 failure to provide nursing care in accordance with a residents needs. Due to the facility’s failure to properly monitor a resident with a history of removing a feeding tube, the resident lost almost 30 pounds. The facility has requested a hearing on the Department’s action. A status conference was held February 8 and settlement negotiations are underway.

Moweaqua Nursing & Retirement Center, a 70-bed skilled care facility located at Maple and Macon Streets, Moweaqua, has been fined $50,000 for failure to supervise a resident at high risk for falls. The facility did not assess nor make changes to the plan of care for the resident, after repeated falls. As a result, the resident fell and died after suffering facial fractures and head injuries. The facility has requested a hearing on the Department’s action. A status in the case was held February 25.

Parents and Friends of the Specialized Living Center, a 100-bed intermediate care facility for the developmentally disabled located at 1450 Caseyville Avenue, Swansea, has been fined $20,000 for failure to implement a diet order for a resident at risk for choking. The facility did not monitor the resident who had received the wrong texture and consistency of food. The resident was hospitalized after choking. The facility has requested a hearing on the Department’s action. A status in the case was held February 25.

Regal Health & Rehab Center, a 143-bed skilled and intermediate care facility located at 9525 S. Mayfield, Oak Lawn, has been fined $25,000 for failure to adequately supervise four residents identified as unsafe smokers. Three of the four residents require continuous oxygen therapy. The lack of supervision resulted in one resident suffering burns to his face. The facility has requested a hearing on the Department’s action. A status in the case is March 5.

St. Anthony’s Nursing & Rehab Center, a 120-bed skilled and intermediate care facility located at 767 30th Street, Rock Island, has been fined for failure to develop and implement a plan to address a resident’s sexual behavior toward other residents. The facility also failed to implement effective interventions to monitor the resident responsible for sexually abusing two other residents. The facility requested a hearing on the Department’s action. A hearing was held and the facility paid $12,000.

Timbercreek Rehab & Health Care Center, a 202-bed skilled care facility located at 2220 State Street, Pekin, has been fined $20,000 for allowing two Certified Nursing Assistants with findings of abuse on the Health Care Worker Registry to work at the facility. The facility also failed to protect residents from abuse by one of the CNAs, who was later found to have broken the wrist of a resident. Both were terminated. The facility has requested a hearing on the Department’s action. A status in the case is March 3.

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Memory Exercises for Seniors and Caregivers

Just as exercising your body improves your muscles, exercising your brain also improves your memory capabilities, leading research shows.

A senior's 60-year-old brain will take in information two to three times slower than a 20-year old brain.  However, senior minds can learn new tricks as even older brains can grow new and stronger connections (this is why seniors who suffer strokes can effectively rehabilitate and regain their physical and mental capabilities again by retraining the brain through therapy exercises - but if they don't do the exercises, then they don't regain the movement, which why having a proactive and encouraging Caregiver is essential).

You can build your mental savings account while you are younger by continuing to involve yourself in activities which require thinking - play monopoly and scrabble, do crossword puzzles, join committees and boards which require active thinking and planning, develop new hobbies such as golf or playing a musical instrument.  And, even more important, don't stop becoming active when you retire from your day job.

Research shows you must exercise your mind regularly and be consistent (it really is the same as with physical exercise - you can't just show up and run the marathon without properly training for months).

Caregivers can bring along the crossword puzzle from the daily newspaper to do with their senior client or find a trivia book or a magazine article to discuss.  Anything that makes the mind think will work.

 

How Alzheimer's Disease Changes Behavior

Everyone forgets something now and then.  How many of us have left the house to go someplace and then remember we forgot to bring something along or wondered if we unplugged the iron or what time a meeting we scheduled weeks ago is suppose to start?  Sometimes we simply have too much information going in and out of our head to properly process it or we don't take the time to really listen and file it away while multi-tasking - regardless of whether we are a senior or not which is why we all have the so called "senior moment".

I am often asked how memory loss for those with Alzheimer's Disease is different than other types of memory loss.  One of the most common answers to this is that Alzheimer's Disease impacts a senior's decision-making ability ongoing and includes confusion of "person, place or thing".  Instead of just forgetting what time a meeting is scheduled for, they might also forget where the meeting is to be held and who is attending or they might confuse their sister for their mother.  Confusion comes into the picture along with the memory loss.

PBS has provided informative programming on Alzheimer's Disease and their website provides a chart showing what part of the brain impacts the various behaviors experienced by those with Alzheimer's disease and makes it a little easier to understand how this disease differs from other types of memory loss.  

Many times a senior may not have their memory loss properly diagnosed.  Because there are a few drugs which can slow the progression of memory loss and services available to help both a senior and their family members with the emotional aspect of dealing with memory loss, definitely make sure you visit a geriatric doctor who can provide a proper diagnosis.  Caregivers can provide better care if they are informed on the type of memory loss the senior has been diagnosed with as there are many tools available for exercising the mind and slowing the progression of memory loss.  It has also been shown that meditation - simply emptying the mind - can be very beneficial for those with memory loss, as well as relaxing.

 

 

 

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Caregiving: Very Fulfilling Work

Unemployment rates have continued to increase in the last few months, with California reporting a 9.3 percent unemployment rate in December, 2008. January numbers for unemployment are also expected to be at high levels throughout the country.

For those looking for employment, the good news is that there are still plenty of jobs available for senior caregivers.  Senior Home Care Agencies hire both Companion Caregivers and Certified Nursing Aides or Certified Home Health Aides (the Home Health Aide designation and certification is available in some states but still does not exist everywhere).

The job description for a senior caregiver usually includes assisting with personal care, meal preparation, light housekeeping, laundry, medication reminders, exercises, companionship and running errands or escorting to doctor's appointments.  For those seniors who are receiving hospice care or who are recoving from a stroke or hip replacement, more hands-on personal care may be required, including transfers from bed to wheelchair to toilet and assistance with bathing and eating.  Some seniors require mostly companion care because of memory loss.

Caregivers are usually assigned to individual senior clients, maintaining a regular schedule.  But as hospital stays have become shorter and more seniors prefer to stay in their own home with one-on-one care, Senior Home Care Agencies are constantly hiring Caregivers. Some senior care requirements will require no professional experience, other than a caring personality and other care assignments will require at least one year of experience.  In addition, background checks, reference checks and training must be completed before beginning a care assignment.

Caregiverlist provides information about senior caregiving jobs, including pay, benefits, training, interview tips and job descriptions - - just click on CAREGIVING JOBS in our top Nav Bar to learn more.

And, if you or someone you know is job hunting, submit an application on Caregiverlist to be connected with hiring senior care companies in your area for current and upcoming openings.

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Saving for Senior Care

With all the craziness in the financial markets of late, everyone is concerned about their savings - especially seniors who are living on a fixed income and who are perhaps watching their savings fall along with the market.

Here is the good news and bad news about senior care.  If you have "some money" you are going to need to foot the bill for any caregiving services.  But if you have no money, the government will take care of you for as long as needed, only this care will need to be in a nursing home.  But you will be fed and cared for as long as required.

Each state implements their own Medicaid program - Medicaid is the insurance program for very low income seniors.  Usually the state asset level for Medicaid qualification is around $2,000.00 in assets.  Caregiverlist provides details on each state's Medicaid program, complete with contact information, within our "by state" senior services section:

Find your state on Caregiverlist and learn about the Medicaid qualifications along with other senior services, including the senior driving laws, background checks and Senior Helpline.

 

 

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