Nursing Home Wrestling Incident: the Challenges of Memory Loss

Families who have needed to find care services for a senior suffering from Alzheimer's Disease or another form of dementia know the challenges of finding the right nursing community.  Many nursing facilities do not accept patients who have Alzheimer's Disease or dementia because they do not have proper facilities or staff to provide for adequate care.

The Minnesota incident of a former wrestler who mistakenly wrestled another resident, with injuries resulting in the eventual death of the resident, have brought to the table a new discussion about how best to provide for care for those seniors with memory loss.  There are no easy answers.  Fortunately, the wife of the resident who died also does not feel Minnesota wrestling legend Verne Gagne understood what he was doing.

Ask Caregivers who assist seniors with memory loss about the behaviors a senior with memory loss will act out and you will understand that it is not at all uncommon for someone to go back to performing a task they did many years ago.  And often it will especially be something that they performed over and over again in their earlier years.  And when these tasks are done in the wrong environment or with others, many accidents can happen.

When I owned a Senior Home Care Agency, one client with memory loss had the habit of going to his basement to work on his water heater because he had previously been an electrician.  Another client who was a bank teller was drawn to sorting papers constantly throughout the day and another client got up and dressed for work to go to the office every day - even though they never went anywhere. 

The Minnesota situation is very sad. Although at the same time, it is understandable that Mr. Gagne would go back to his wrestling days - he was very active in the industry and even helped launch the careers of pro wrestling legends Hulk Hogan and Jesse Ventura.  What do you think the best care options are for those with memory loss?

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Recession Provides Assisted Living Discounts

Today's Chicago Tribune features an interview with Caregiverlist's Senior Living Expert, Lisa Sneddon, discussing how the current economic downturn has resulted in new pricing values at Assisted Living Communities.  Since many seniors cannot sell their homes, their retirement plans to downsize and relocate to an Assisted Living Community have been derailed. 

However, there are now new options available for relocating to a senior community, from bridge loans until the senior's house is sold to waived move-in fees from the senior community. 

Lisa's service is paid for by the Assisted Living Communities as she will provide unbiased information to seniors and their families to give them the scoop on services and amenities at communities beyond just the costs - you know, if you are going to move in to a new community, it is the same as buying a house, you want to know a little about the neighbors and the community activities.  And, it is important to consider the care services that will be available as you age - from dementia care to nursing care.  Lisa will take the senior on a tour and will answer all the questions you might have been afraid to ask if you were shopping on your own.  She helps make sure the move-in will be a success and permanent.

Check out the Chicago Tribune story here.

 

 

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Caregiver Taxes

With a few of President Obama's cabinet nominations running into some tax issues (issues such as sort of not paying them), questions about tax requirements for household help are being asked.

Basically, just as companies must provide for payroll taxes for employees (the company chips in for part of the taxes along with the employee) to pay for Social Security taxes, Medicare taxes and Unemployment insurance taxes, the same requirement holds true for household employees.  This is often referred to as the "nanny tax" but if you have hired a senior caregiver or even an ongoing gardener, you must provide for these taxes.

Keep in mind that this is also a benefit for the worker, as when they go to retire, they will be able to collect a Social Security check and if they are out of work, they will be able to collect an Unemployment benefit check.  All of these laws were set-up to protect employees.

Another advantage of hiring a Senior Home Care Agency is that the agency takes care of all of these taxes (and you have the added bonus of Worker's Compensation Insurance to cover any caregiver injuries - if you were hiring the caregiver directly and an injury occurred, the senior would be liable and the Caregiver could ask the senior to pay for all medical expenses and ongoing care needs - all of the senior's personal assets would be fair game to cover these costs - you know, yummy stuff for the ambulance chasing lawyers.  Worker's Compensation protects senior's assets if an injury occurs).

Failing to pay these taxes is considered tax fraud.  It is also important to make sure the Caregiver is legal to work and in instances where senior's may have memory loss, it is vital to make sure the Caregiver has passed a multi-state criminal background check and has active management in place. Senior Home Care Agencies go the extra mile to take care of all of these issues to provide a quality caregiver.

Not paying taxes for a caregiver will also cause the caregiver hardship, including being unable to build a credit history because they cannot verify their employment and pay.

The Supreme Court is also hearing a case regarding illegal workers who use fake identity's because they do not have a social security card of their own and this issue has spiraled into a case of identity theft.

What is the old saying:  penny-wise but pound-foolish?  Truly, the few dollars someone thinks they are saving by not providing for a Caregiver's taxes really are a huge loss - a loss in insurance protection, and social security, Medicare and unemployment insurance for the Caregiver.

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New Laser Treatment Assists with Stroke Recovery

An experimental stroke treatment that sends laser beams into the brain may help patients with milder strokes lessen their crippling effects, based on the results of a recent clinical trial.  Seniors who suffer strokes usually always require a senior caregiver to assist them during the first year of recovery as they participate in therapy to regain their abilities.

Patients with moderate to moderately severe strokes improved after receiving the laser treatment called the NeuroThera Laser System administered in Carlsbad, California.

Stroke is the No. 3 cause of death in the United States and a leading cause of disability.  Usually seniors who suffer a stroke will have paralysis on either the right or left side of the body, depending on the type of stroke.  Movement can return if the senior participates in intense physical therapy, speech therapy and occupational therapy the first year following the storke.

There is one effective treatment for stroke which involves a clot-busting drug and must be administered within 3 hours of the stroke.  "We need something for patients who come in later than that," says Dr. Justin Zivin of the University of California San Diego, who led the study funded by PhotoThera.

The results of the study were presented at the American Stroke Association meeting. 

Caregivers and seniors interested in learning more can contact the American Stroke Association.

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Medicare Senior Caregivers

This is a question which constantly comes up when a senior needs care services:  Does Medicare pay for a caregiver to provide senior care services in the home?

The reason there is much confusion around this is because Medicare will sometimes pay for what is called "skilled care", provided by a Registered Nurse (RN), Physical Therapist (PT), Occupational Therapist (OT), Speech Therapist (ST).  And Medicare will provide these skilled care providers to visit a senior in their home.  A doctor must approve and prescribe the services and for the care to continue, the senior must show improvement (the idea is that this is short-term therapy to improve a condition, especially after a stroke or hip replacement, for example).

The services may be for as many as 3 visits per week but usually a R.N. is only approved if there is an open wound or medications such as shots must be managed and performed by a R.N.

Medicare's skilled home care does not provide for a Certified Nursing Aide or Companion Caregiver.  These services must be paid for privately or through long-term care insurance, unless a senior has started hospice care, which can provide for a Certified Nursing Aide to visit. , ,

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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