Senior Care Funding: Government Budgets and Private Pay

Most people do not want to think or talk about how to pay for senior care until the issue of needing a caregiver to assist with daily needs actually arrives.  Hire a senior home care agency or move to assisted living?  Recover in a nursing home or in your own home with skilled care provided by Medicare?

And what if you run out of money to pay for care yourself, do not have long-term care insurance and still need care services?  The good news is you can qualify for care as a Medicaid resident in a nursing home.  However, the number one factor in quality care is the staff to resident ratio in a nursing home.  This is why the Coalition to Protect Senior Care, representing dozens of healthcare groups throughout the country, is advocating for retaining Medicaid and Medicare funding for nursing homes at current levels and asking our government to consider the possibility of additional job creation through the funding of more frontline caregivers who provide the bedside care for nursing home residents. 

Some politicians are rightly concerned about the ongoing ability to fund senior entitlement programs.  But at the same time, all of us continue to fund these programs through our payroll deductions.  Former President Bill Clinton has been credited with passing the "look back law" which prohibits seniors from gifting their entire estates in order to avoid paying for long-term care.  Now the government can actually look back to see if any improper gifting has been done to allow a senior to have the government foot the bill for their long-term care.  However, regardless of whether the government or individuals are paying for the nursing care, adequate levels of caregiver staffing should be maintained.

Caregiverlist reports that nursing home staffing shortages contribute to lower quality care in nursing homes.  As Medicare does pay for short-term care in a nursing home, many of us will need to rely on their services, even if just for a few weeks after a hospital stay.

What can you do?  Call you Congressman and Senator's office and let them know your concerns.  Let them know that staffing in nursing homes should be a priority.

You can also visit President Barack Obama's website and let him know your thoughts as Congress begins discussing healthcare reform legislation on Tuesday.

Caregiver Positions

Senior care positions for caregivers include part-time, full-time and live-in companion care positions and 24-hour live-in positions for both companion caregivers, Certified Nursing Aides and Home Health Aides.

As the senior population continues to increase as America's largest generation, the Baby Boomers, grow older and live longer due to medical advancements, the need for senior caregivers will continue to increase.

Who hires senior caregivers?  Senior home care agencies, nursing homes and assisted living communities.

What are the typical duties for caregivers?  Duties include assisting with meal planning and preparation and cleaning the kitchen after a meal, assisting with personal care which may include helping with eating, bathing and toileting, assisting with light housekeeping, laundry, changing bed linens, monitoring medications, coaching exercises, running errands, organizing the weekly calendar and escorting the senior to appointments (especially if they are experiencing memory loss).  In addition, activities for socializing and exercising the memory may be included in the caregiving schedule.  Examples would be outings to community events, visiting a museum, attending a music or sporting event, creating a scrapbook or writing correspondence to friends and family members.

Seniors who are coping with an age-related disease such as Alzheimer's Disease, Parkinson's disease, or battling cancer may require more hands-on care.  In addition, seniors who have chosen hospice for their end-of-life care, may also require more assistance which may need to be provided by a Certified Nursing Aide or Home Health Aide.

You may learn more about training for these certifications and caregiving job descriptions on our website, and you may apply for a caregiving position in your area.

 

, ,

Caregiver Training

Caregivers often email us to ask about caregiver training programs.  Most senior home care agencies offer training programs to all of their newly hired caregivers through orientation and continuing education seminars.  Special training programs for caring for seniors with memory loss and providing hospice care are usually offered.

Family members are often pleasantly surprised to find a caregiver is successful in interacting with their parent when family members have not been.  Often this is simply because the caregiver has been properly trained in providing senior care.  Non-medical senior caregivers may now receive online caregiver training through a 10-hour course created by aQuire training solutions which will meet the requirements that have been created by the departements of health in some states.

Many hospitals and community programs offer training and support groups for senior caregivers.  The department of health in each state regulates caregiver certification programs which are required by the laws in that state.  All states administer certification for Certified Nursing Aides.  Some states also provide certifications for training as a Certified Home Health Aide and Certified Personal Care Assistant.  Many of these certification programs are offered through community colleges and hospitals.  Sometimes an employer will cover the cost of the program or offer reimbursement after the caregiver certification training has been successfully completed.

Each state maintains a registry of those caregivers who have active certifications and requires continuing education or ongoing employment in order for the certification to remain active.  Renewals of certifications usually are required every 2 years.  All certification programs require caregivers to successfully complete criminal background checks and drug tests in order to be admitted.  Senior home care agencies, nursing homes and hospitals often require caregivers to be certified as this provides an additional guarantee that the caregiver has completed a background check, drug test, written exam, skills exam and has maintained all qualifications to remain active in the state registry (which includes not having formal complaints or disciplinary actions taken against them while employed as an aide).

Senior caregivers can also contact their local department on aging to find out about senior care training programs they may offer. 

Certified Nursing Aides are the hands-on caregivers in nursing homes and for senior home care agencies - they are often referred to as a nurse by seniors as they provide the care many people assume nurses provide.  Registered nurses do learn all of the certified nursing aide skills as part of their registered nurse education and are qualified to perform the care and many times do when hospitals and nursing homes are short-staffed.

Personal Care Assistants usually have at least 40 hours of training.

The CHHHA program is designed to provide a learning experience where students will be able to successfully obtain the entry-level skills necessary to obtain employment in the healthcare industry.

Some typical duties of a homemaker-home health aide include helping the patient take a bath, use the toilet or bedpan, and dress the patient. They also may prepare patient meals, do light laundering, straighten the patient’s room, run errands, and assist with exercise regimens.

The 76 hour curriculum mandated by the New Jersey Board of Nursing includes all components necessary (speech, occupational, physical therapy, CPR, dietary skills, etc.) to train participants to provide home care to the ill and elderly. . Students enrolled in this course will spend their time in classroom work, hands-on clinical practice, multimedia, lab skills practice and individualized student centered instruction.

The course is designed so that students will meet all requirements necessary to take the New Jersey Board of Nursing approved examination and become Certified Homemaker-Home Health Aide (CHHHA) upon the successful completion of this course

Certified Personal Care Assistant (CPCA):  Trained to assist the elderly and disabled with meals, toileting and items needed for daily living.  Usually around 40 hours of training, often this level of care is referred to as companion care.

Certified Home Health Aide (CHHA):  Entry-level training to begin working in the healthcare field and prepares individuals for training as a Certified Nursing Aide.  Training includes:  assisting patients with bathing, toileting, dressing, nutrition education and meal preparation and exercise regimens. Usually around 75 hours of training.

Certified Nursing Aide (C.N.A.):  Training to assist a registered nurse in a nursing home or hospital to administer the hands-on care, including both the emotional and physical aspects of care.  Training includes proper transfers, bathing, dressing, vital signs, catheter care, feeding tube care, hospice care and how to maintain cleanliness for all care procedures.  Usually 150 hours of training both in a classroom and clinical setting.

Caregiverlist provides tutorials for certified nursing aide training and home health aide training and lab skills, along with senior care briefs for specific care items.

 You may also join the Professional Association of Caregivers to receive 10-hours of online training for free with a certificate of completion when you pass at the 80% pass rate.

 

 

, ,

Caregiver Qualifications

What are the qualifications to be a senior caregiver?

Senior caregiving involves assisting seniors with their activities of daily living, or "ADL's".  What are these activities?  Anything required to function throughout the day as a healthy adult:  eating, bathing, toileting, shopping, cooking, household cleaning and managing scheduled appointments.  Socializing and exercising are also considered important activities for healthy aging.

Learn about the skills required for non-medical caregivers and take an 10-hour online training caregiver certification program created by the leader in online training, aQuire Training Solutions.  You may join the Professional Association of Caregivers for ongoing support as a caregiver.

Some seniors who are recovering from a stroke, heart attack, or coping with cancer or an age-related disease such as Alzheimer's disease or Parkinson's disease may require more hands-on care by a Certified Nursing Aide or Home Health Aide.  Each state manages the licensing requirements for health care workers through their department of health.  Senior home care agencies, hospitals and nursing homes must follow the state regulations for hiring senior caregivers.

The United States has 1.8 million certified nursing aides (each state also requires nursing aides to update their certification, similar to a driver's license renewal, to maintain an active certification).  As the population ages, the need for senior caregivers will continue to grow, making caregiving a career where you will always find employment (even in a slow economy).

The basic qualifications for a companion caregiver are:

  • 18-years-of age
  • Caring personality
  • Interest in senior care demonstrated through volunteering or personal experience providing care
  • Communication skills:  able to speak English clearly and record care plan updates
  • Cooking skills:  able to prepare meals including oatmeal, soup, meat and vegetables
  • Dependability:  able to arrive to assignments on time and be easily reachable by phone
  • References:  must provide business and personal references - usually 3 references are required
  • Background Check:  must pass a criminal background check
  • Driving Skills:  sometimes required, if driving a senior in their car or in your car

Senior home care agencies will provide training for each assignment.  In addition, most senior home care agencies provide training through their new caregiver orientation along with ongoing training sessions for hospice care, memory loss care and labs for testing nursing aide skills.

Caregiverlist provides you with a Caregiver Quiz and Home Health Aide and Certified Nursing Aide lab skill worksheets.  If you are interested in becoming a Certified Nursing Aide, look for programs offered through your local community colleges and hospitals.

, ,

Preventing Elder Abuse

Several cases of alleged senior abuse have crept up across the nation during the past month. On March 30, 2009, a 31-year-old former nursing home employee in Oklahoma was accused of abusing his senior patients and videotaping it, according to a Fox 23 news report.

Experts say many of these crimes against the elderly in long-term residential care are never reported to law enforcement or to the state and say it’s imperative for us to always be vigilant if we have a loved one in long-term care,” reported Kaci Christian of FOX 23.  The article describes the shock a family felt when they discovered their 60-year-old female relative, who was living in a nursing home and suffered from Alzheimer’s disease, “badly beaten, with her face swollen and discolored."

There are many ways to reduce the risk of senior abuse. First, consider home-care options that allow more control over the caregivers who are in contact with your loved one.

The process of selecting home care can be overwhelming, with more than 5,000 senior home care agencies nationwide.

The Caregiverlist Checklist for standards of quality care for senior home care agencies is a resource that outlines requirements for safety and consistency in care, making it easier for families to make an educated decision. Regardless of what long-term care option is best suited for your loved one, it helps to be aware of some less obvious warning signs of abuse. The following warning signs are part of an extensive list compiled by the The National Center on Elder Abuse:

  • Broken eyeglasses
  • Physical signs of being subjected to punishment or signs of being restrained
  • Senior’s sudden change in behavior
  • Caregiver’s refusal to allow visitors to see an elder alone
  • Senior acting extremely withdrawn and non-communicative
  • Senior displaying unusual behavior usually attributed to dementia, such as sucking, biting, rocking

If you suspect senior abuse, call the NCEA hotline at 1-800-677-1116. The NCEA web site offers a host of additional information on identifying elder abuse.

, ,

Caregiver Employment

As the population ages, the U.S. Bureau of Labor Statistics projects the personal and home care aide job category will more than double in the next ten years.  If you are looking for job stability, becoming a senior caregiver could be the career for you.

While advances in medicine are enabling seniors to live longer, additional care services are often required.  For instance, the risk of developing Alzheimer's disease increases dramatically for those over age 65.

According to the UCLA Neuropsychiatric Institute, about 40% of people aged 65 or older have age associated memory impairment (about 16 million people in the U.S.A.). Only about 1% of them will progress to dementia each year.  Although patients with mild cognitive impairment are able to continue to live independently, they show objective memory  impairments similar to those seen in people with very mild Alzheimer's disease. And about 10% of people aged 65 years or older have mild cognitive impairment, and nearly 15% of them develop Alzheimer's disease each year.

These are just the statistics for Alzheimer's disease care needs.  The likelihood for heart disease, stroke, cancer and Parkinson's disease also increase as we age.  Another interesting statistic:  the number one risk for women to develop breast cancer is living a longer life - the older we are, the greater the risk. 

The caregiver category is identified as professionals who help the elderly, disabled, ill and mentally disabled live in their own homes or in residential care facilities instead of in health facilities.

What type of jobs are available for senior caregivers? Nursing homes, assisted living communities, hospitals and senior home care agencies all hire certified nursing aides.  Usually certification can be obtained within two months and sometimes scholarships or grants are available from community programs. 

Caregiverlist's Senior News reports nursing homes will continue to need Certified Nursing Aides and provides information about the nursing aide programs in California and Illinois.

Have you worked as a nursing aide in a nursing home, hospital or for a senior home care agency?  We invite you to share with our site visitors which type of position you preferred.

, ,

Seniors Receive $250 Economic Recovery Payment

Most seniors who receive Supplemental Security Income or Social Security benefits will enjoy a $250 check in May as a result of the American Recovery and Reinvestment Act of 2009, which was recently signed by President Obama. 
But for some seniors, the money raises more questions than answers. It is important to communicate with them and make sure they understand that no action is required on their part.  Caregivers can assist by reviewing the information provided here and making sure seniors understand when to be looking for this payment to arrive.
Take a minute to review a dozen of the most commonly asked questions about the economic recovery one-time payments, as identified by Social Security Online, the official Web site of the U.S. Social Security Administration:
1) Who will receive a one-time economic recovery payment from Social Security?  Nearly 55 million Social Security and SSI beneficiaries will receive the payment.
2) When will the payments be received?  The government expects to process the checks at the end of May and also seniors should receive their payments the first week of June, 2009.
3) How will seniors receive their one-time economic recovery payment?  The payment will be made in the same way they currently receive their Social Security or SSI benefit.  If that payment is normally delivered by check, the stimulus payment will be sent the same way and if it is normally a direct deposit or debit card payment then that is how it will be delivered.
4) Are individuals who receive more than one benefit (Social Security and Veterans or Railroad Retirement benefits) entitled to more than one $250 payment?  No, individuals may only receive one payment.
5) If my spouse and I both receive Social Security or SSI benefits, will we each get a $250 payment?  Yes, each individual qualifies for the economic stimulus payment of $250.
6) If a senior became eligible for Social Security benefits in February, 2009, will they receive the $250 economic recovery payment?  No, only seniors who were eligible for Social Security, SSI, Veterans or Railroad Retirement benefits at any time during the months of November 2008, December 2008 and January 2009 are eligible for the one-time payment.
7) Do seniors need to do anything in order to receive the one-time economic stimulus payment?  No action is necessary.
8) Will seniors receive the one-time economic recovery payment if they have a delinquent federal debt?  The law requires the Treasury Department to offset the one-time payments to collect delinquent child support and debts owed to state and federal agencies.  The government will apply the payment towards the senior's debt to the government if they already owe a debt to a state or federal agency.
9)  Will the one-time economic recovery payment change the amount or delivery date of a senior's regular Social Security or SSI benefit?  No, the one-time $250 payment will have NO effect on the regular Social Security or SSI benefits and will be delivered as a separate payment.
10)  Will the one-time economic recovery payment count as income for SSI?  No, it will not.
11) Will the one-time economic recovery payment count as income when determining eligibility for Extra Help with Medicare Prescription Drug plan costs?  No, it will not.
12) What should a senior do if someone calls or e-mails them asking for personal information to process their one-time stimulus payment? Seniors should not provide personal information to anyone requesting it to process the one-time economic stimulus payment of $250.  To verify any phone calls from someone claiming to be a Social Security employee, you may call 1-800-772-1213 and you may always report suspicious activity involving Social Security programs and operations to the Social Security Fraud Hotline website or by calling:  1-800-269-0271.
You may visit the Social Security website for additional information about the economic stimulus and to have real time updates emailed to you.
, , , ,

Nursing Home Shootings

Yesterday, a Certified Nursing Aide's estranged husband entered a nursing home in Carthage, North Carolina, where she was employed, and killed 7 residents and a nurse during his shooting rampage. 

Usually the nursing home deaths which make the news are related to mistreatment of residents or improper care procedures which lead to death.  This is one of the reasons more people are opting for care in the home, instead of a nursing home, especially for short-term care needs, as a one-on-one caregiver can often deliver better care.

Nursing home incidents which result in inferior care are usually connected to staffing issues.  Sometimes nursing homes staff only 1 nursing aide to as many as 15 residents.  This is why many times experienced Certified Nursing Aides will move into home care positions where they know they can provide quality care to just one client,.

Earlier this year, an Itasca, Illinois nursing home employee watched television for more than an hour and ignored the alarm that indicated a woman with Alzheimer's disease was wandering.  The elderly resident went outside in freezing temperatures and her frozen body was later found in the facility's courtyard.

The employee was charged with criminal neglect.

Senior Home Care Agencies provide professionally managed caregivers for seniors and these caregivers are usually highly qualified and experienced.  Home care agencies perform background checks on all caregivers and also train and actively manage the caregivers for each assignment.

You can learn about the background check laws in each state on Caregiverlist's "by state" information section (because as in the situation above, it is also important that companies do not hire someone who has demonstrated poor judgement in the past.  Most career caregivers want to receive high recommendations from their managers as they know they will need to be reassigned after a current client's condition improves or after the senior passes. And, as they have invested in training to become a professional caregiver, they want to continue to be employed).
, ,

Caregiver Jobs

Even with the economic downturn, there continue to be openings for caregiving positions with Senior Home Care Agencies, Nursing Homes and Assisted Living Facilities.

Why do there continue to be caregiver job openings?

One of the reasons is the aging population as the large Baby Boomer generation ages (the number of seniors over age 65 will double in the next 20 years) and their care needs develop as they grow older.

Lori Porter, a senior leader of the Coalition to Protect Senior Care says nursing facilities nationwide are challenged by staffing shortages, estimated to be at 110,000 for front line direct care workers in skilled nursing facilities.  With 3 out of 4 nursing facility patients paid for by Medicare or Medicaid, sometimes the facilities only staff one nursing aide for as many as 15 patients.  Because of this, there is high turnover by the aides as they often feel they cannot adequately keep up with the patient needs and become exhausted and frustrated.  At the same time, nursing aides may continue their education and move to other positions on the staff.

Because Medicare does not pay for long-term care in a nursing facility, seniors are also opting for care in the home which has created a new industry in recent years.  Senior Home Care Agencies provide professional care in the home and the caregiver provides care for just one client.  Many nursing aides will choose to move to positions in senior home care after working at a nursing facility because they prefer to provide one-on-one care for a senior.  Both long-term care insurance policies and the Veteran's Aide and Attendance benefit will pay for care in the home provided by a licensed senior care agency.  Many senior care companies have launched to provide for this care, creating an entire industry in just the last 10 years.

Senior Home Care Agencies hire both part-time and full-time caregivers to accommodate client needs, as new clients can arrive daily as they are discharged from the hospital and choose to go to their own home to recover.  In addition, many clients who develop memory loss will opt for home care to keep their meals, medications and personal care on track.

Caregiving positions may require specific training and usually a Senior Home Care Agency can assist caregivers with obtaining training through their own programs our through community programs.  Certified Nursing AIde classes are offered by community colleges and technical colleges and usually can be completed in 6 to 8 weeks, depending on if they are full or part-time programs.  Background and reference checks are required to work with seniors.

You may submit a job application on Caregiverlist to be connected with hiring senior care companies in your area.

 

 

 

 

, ,

Senior Care Daily Care Notes

A healthy daily routine assists seniors (and the rest of us) to enjoy a healthy lifestyle with physical and mental exercise and socialization.  But how do you keep everything on track when there is so much to do as a caregiver?  Each day often brings surprises for a caregiver and it can be a challenge to keep the care routine on track

Maintaining a daily log to document the care provided is one way to make sure medications are taken properly and activities are included in the senior's daily care routine.

Caregiverlist provides a daily care log which you may print out and use as a guide for tracking care services for a family member or a client.

Doctors and Geriatric Care Managers who are supervising care appreciate having documentation of the senior's daily routine.  This information can assist with managing side effects to medications, determining depression and monitoring diet.

 

, ,
Log in