Finding Quality Senior Care: First Understand Medicare vs. Medicaid

Seniors usually do not plan ahead for senior care.  Anyone in the senior care industry already knows this fact and I remember one time a larger senior home care franchise group shared with me that they had paid a significant amount of money to an advertising agency to research how seniors plan for senior care.  The answer? They don't plan for it at all! 

This means that the loved ones of a senior - their spouses, children and relatives, are quickly searching for the right senior care option after a medical emergency happens. Where should the senior go for rehabilitation after a stroke? What option is right for them? A nursing home? Assisted living community? Senior home care?

The very next question that is asked is what does Medicare cover? 

Family members must first understand the difference between Medicare and Medicaid and learn which option their parents or another relative they are assisting to find care currently has a coverage plan.

All seniors in the U.S.A. go onto Medicare health insurance but, if they qualify, on the basis of having a very low income and few assets (usually under $2,500), then they will receive Medicaid health insurance.

The biggest difference between Medicare and Medicaid is that Medicaid WILL PAY FOR ONGOING CARE IN A NURSING HOME. Medicare DOES NOT PAY for ongoing senior care.

Learn about the differences between Medicare and Medicaid and plan ahead for your senior care option.


Caregiver Duties for Professional Caregivers May be Companion Care (No Nursing Aide Training Required)

Senior caregivers continue to be needed to keep up with the staffing for senior care.  Many seniors require part-time caregiving to maintain a healthy lifestyle in their homes as they age.  Senior care companies are constantly recruiting trustworthy individuals to work as senior caregivers.

Caregiverlist's Career Center connects senior care companies with pre-qualified senior caregivers.  Many companies hire from 5 to 10 new caregivers each week.  As many people think you must be a nurse to do caregiving, we want to explain the caregiving positions that are available.

Anyone with a caring personality who appreciates the needs of an older adult, can become a senior caregiver.  Seniors with memory loss, for example, often only need a companion caregiver.  Other seniors may be battling an age related illness such as arthritis or diabetes and simply have difficulty with daily tasks and only require a companion caregiver.

Caregiver Duties for Companion Caregivers include:

  • Assisting with Meal Preparation
  • Organizing Appointment Calendar
  • Light Housekeeping
  • Engaging in Mental or Physical Stimulation
  • Keeping Household Needs Scheduled
  • Monitoring Medications
  • Companionship
Sometimes adult children who live far away from a parent simply want to know someone is checking in on their parent regularly. All of us will experience some memory loss as we age.  A companion caregiver can be there to make sure the senior can safely age-in-place. Companion caregivers are also often hired when a spouse passes away. 

Anyone interested in becoming a senior caregiver may take this online course to learn the basic caregiving skills.  Refer-a-Friend to a caregiving job on Caregiverlist or apply now if you are interested in fulfilling part-time or full-time work in your area. The number of seniors will nearly double in the next decade and this can be an ongoing career.

Online caregiver training can be taken at your own pace and meets new requirements mandated in California (AB1217), Illinois, Georgia and several other states that now require caregiver training.  More than 30 states still do not have legislation mandating senior caregiver training although they often do require licensed senior home care agencies to provide basic training.

American Public Health Association Annual Meeting in Chicago this Week

Caregivers for seniors often forget to take the time to care for themselves.  The emotional aspects of caregiving stay with us throughout the days and nights and this is why senior caregiving really does go beyond the pay.  The American Public Health Association works towards keeping all of us healthy which includes considering environmental issues.

Chicago will host the APHA's annual meeting this year, bringing together thousands of professionals working towards good health for all Americans, including seniors and senior caregivers.  They are sharing this infographic to showcase that along with health eating habits, clean air, water and energy also are important to maintain good health.  In addition, Caregiverlist adovcates for planning ahead for senior care needs, in order to know how to pay for senior care (no, Medicare does not pay for long-term senior care) and what the different options may be for senior home care services and assisted living. In addition, there is a need for more senior caregivers to care for the growing number of older Americans.  

infographic describing the health impacts of climate change

Caregiver Jobs Available Nationwide and Increasing: Apply and Refer-a-Friend to Assist Seniors Near You

Caregivers for seniors are needed.  While 10,000 seniors turn age 65 every day, this is not the only reason more professional senior caregivers are need for part-time and full-time job openings.  Social demographics have changed in the U.S.A. and couples are having children later in life and pursuing activities and careers which allow them to relocate from the town where they grew up.

Seniors are living longer.  A child born in the U.S.A. today can plan to live to age 100.  This also means many people will choose to relocate when they reach retirement age.  When our lifespan was just 75 years old (when Medicare was created 50 years ago, the age of 65 was chosen because most people would only live another 10 years).  Now that we have another 35 years to live after we retire, seniors are moving to new locations to enjoy their retirement years.

Caregivers are needed part-time when a senior may be recovering from a major surgery or rehabilitating from a hip replacement or a fall.  Sadly, Alzheimer's disease has become a growing diagnosis and will continue to grow as the population of older Americans grows.

Another reason more caregivers are needed can be understood by reviewing just the care needs for those seniors with Alzheimer's disease.

Alzheimer's Disease in the U.S.A.

  • 1 in 9 Americans age 65 and older (11%) has Alzheimer's disease
  • About 1/3rd of people age 85 and older (32%) have Alzheimer's disease
  • 81% of people who have Alzheimer's disease are age 75 or older
Remember, our former President Reagan needed caregiving services for 10 years while living with Alzheimer's disease.
Caregiverlist advocates for quality senior care with caregiver training tools (online) and an interactive caregiver hiring platform for senior care companies. 

Senior caregivers or anyone with a caring personality who would like to become a senior caregiver may apply for a caregiving job on Caregiverlist's Career Center and be considered for part-time and full-time caregiver jobs and C.N.A. jobs in their area. If you know someone who would enjoy working as a caregiver, you may refer them to Caregiverlist's Refer-a-Friend program and be entered to win free caregiver training.

Retirees who are looking for a part-time income along with doing work that can be very fulfilling, can also apply for a senior caregiving job as a companion caregiver.  Read about the caregiver job description and think about people who may be a good fit as all senior care companies are constantly seeking trustworthy individuals to train and hire as caregivers. These caregivers do not do hands-on care assistance (such as assisting with bathing, toileting, dressing, and assisting bed-ridden patients). Instead, they are companions for seniors who may be experiencing memory loss or loneliness. These caregivers keep the senior's day on track and sometimes escort them to appointments and activities.

The labor department has targeted senior care as the top industry for employment growth in the next decade and when you see all of the different senior care options, this prediction makes sense.


Compassion & Choices Capitol Hill Briefing Thursday October 29th

Senior care involves assisting seniors with terminal illnesses.  While hospice care allows families to prepare better for the end, sometimes there is a need for a way to die with dignity when suffering from certain illnesses.  Anyone who has witnessed someone dying this way understands the movement that has gained momentum to help authorize medical aid in dying. Caregivers who have heard death rattles from a dying patient are changed forever by the experience and many are filled with compassion for how to better assist.

Compassion & Choices is the organization championing access to medical aid in dying. Oregon and West Virginia have passed legislation and bills are pending in another 25 states and the District of Columbia. California's governor recently signed a bill to also make this available in California. 

Caregivers who advocate for this right may call their U.S. Senator and Representative and ask them to attend Compassion & Choices' Capitol Hill Briefing:

Compassion & Choices Capitol Hill Briefing in Washington, D.C.

Thursday, October 29th at 2 p.m.

2226 Rayburn House Office Building

This briefing will include remarks from Dan Diaz, husband of Brittany Maynard, who recently spoke here in Chicago at Chicago Idea's Week.  He and his wife had to relocate to Oregon as her brain terminal progressed, in order to allow her the option of dying with dignity.  A move right before death is not something that most of us would welcome. Many medical doctors and registered nurses are champions for this legislation as they understand how both your body and personality can change with certain diseases as your organs are shutting down. The states that are passing these compassion laws do require individuals to be approved before receiving the medications.

Dr. David Grube, Compassion & Choices' national medical director and a few board members will also speak.

Seniors and caregivers who want to support this right to be available nationwide may contact their state Senator and their local Congressman to let them know they should attend too.

RSVP to Attend


Senior Caregiver Employee Need Will Keep Growing with America's Changing Social Demographics

Senior caregivers are in demand. Why? Because not only are we living longer lives but our social demographics have changed as our culture has advanced to give women more rights, beginning in the 1970's. This means we are just now entering an era where in addition to the fact that the Baby Boomer generation has a lot of people, the rights of women have changed the fabric of families and made them often unavailable to provide caregiving.  Technology has allowed us to stay in touch with family members from anywhere but we will always need a human caregiver to provide for the physical and emotional care.  We will always need real live humans to perform caregiving. And we need to prepare to find more people to be trained to work as senior caregivers.

Did you know that prior to 1974 women in the U.S.A. could not get a credit card?  They could not run the Boston Marathon until 1972. Prior to 1978 women could be fired just for being pregnant. The Equal Opportunity Act of 1974 gave women the right to apply for credit (and credit cards) and the Pregnancy Discrimination Act of 1978 allowed women to keep their jobs while they were "expecting" a child. 

Remember when nobody was pregnant, they were just "expecting"? I remember a family dinner one Sunday when my father mentioned a neighbor was "expecting" and my brother said "expecting what?".  Exactly. We can talk about it now. Our society's culture continues to evolve and this fact leads to one of the largest reasons for the need for more professional senior caregivers. The large number of Baby Boomers (10,000 turn age 65 each day) and advances in medicine are just part of the reason we need more caregivers.  We need to recognize these facts in order to attract more workers to the industry of senior care or we will be faced with a shortage of professional caregivers to work in our nursing homes, assisted living communities and for licensed senior home care agencies.

Caregiver job openings are a constant in metropolitan cities nationwide, as well as in rural communities. Senior care needs are emotional as well as physical.  Aging can be a tough journey. Caregivers are needed to make living longer, while living safely, possible. Nurses and care managers are also needed to manage the care and coordinate with family members and medical professionals.

Retired seniors may also want to consider working part-time as a paid caregiver as more and more paid caregivers will be needed to keep up with the changes in America's social demographics.

Americans are also marrying later in life as marriages have evolved to be less about economic necessities and more about a union of shared passions and shared incomes. This means adult children are also more likely to be able to assist with paying for senior care services, if required, in order to maintain quality care and limit family drama that can escalate with the stress of caregiving (no, the Kardashian's are not the only family with interesting dynamics).

And this need is only going to continue to increase because of another factor: sandwich generation parents.  Women are waiting until they are older to begin motherhood which means they are more likely to have young children or school age children to care for and are not available to care for their parents.

Caregiver jobs will continue to increase, based on these simple social demographic facts. This means that the generations following the Baby Boomer will also continue to need caregivers. Perhaps both college students and retirees will be recruited to work part-time as senior caregivers to assist us to keep up with the demand for trained nursing aides and professional home health aides to work as caregivers.

See below from our friends at Pew Research:

In the 1990's

13% of newborns were to Teenager Mothers

10% of newborns were to Women Age 35+ 

41% of New Mothers had Some College Education


In 2008

9% of newborns were to Teenager Mothers

14% of newborns were to Women Age 35+ 

54% of New Mothers had Some College Education

This means we must recruit more caring individuals to be professional senior caregivers.  The Caregiver Training University assists anyone to learn the basic caregiver training skills through an online caregiver training course. There are many techniques that can make caregiving a more enjoyable experience, from understanding how to safely transfer a senior from their bed to a chair to a toilet, for example, to learning activities that can be helpful for a senior experiencing memory loss.

We will always need senior caregivers, no matter how much technology advances. Senior caregivers may submit their job application on Caregiverlist to be considered by hiring companies in their area as senior care companies hire as many as 5 to 6 new caregivers each week, in order to keep up with demand.

And as today kick's off baseball's World Series, a salute to another thing that will never change - the sound of the "crack of the bat"! Good luck to the Kansas City Royal's and New York Met's. 







California Senior Home Care Agency Training Requirement Regulation Begins in January 2016

Senior Home Care Agencies in California will be required to document the training they provide for professional senior caregivers based on the state of California's Assembly Bill 1217 which requires a minimum of 5 hours of entry-level training prior to presence with a client and 5 hours of training annually.

As more seniors are choosing to age-in-place in their own home, more states are establishing rules and regulations to insure both the seniors and the caregivers are protected and receive the insurance benefits and payroll taxes, as required by law. One of the benefits for caregivers working for senior home care agencies includes the payment of their Social Security, Unemployment and Worker's Compensation insurances.  This way senior caregivers are protected should the client pass away or get better and in the event they were to have an injury on the job. In addition, senior caregivers employed by senior home care agencies know that they are paying into all payroll taxes, including Social Security benefits and will be able to collect on this benefit for their own retirement.

California senior home care agencies can easily comply with this training mandate by providing an online training program. Caregiver Training University provides training meeting the state department of health requirements nationwide.  Individual caregivers may also purchase training and be added to the caregiver certification registry on Caregiverlist.  

Private duty senior home care agencies may request a sample caregiver training and a demo by contacting: susan@caregiverlist.com or calling 312-669-8821.



Nursing Home Senior Care Costs

Many seniors and their family members do not realize that nursing homes care is not covered for ongoing stays by Medicare. This confusion arises because many times a senior will know another senior who is receiving a long-term stay in a nursing home through Medicaid, the program for low-income seniors with few assets.  Medicaid will pay for nursing home stays when a senior qualifies for this level of care. 

However, perhaps the senior receiving Medicaid benefits is someone who you know had plenty of savings and would not be considered low-income.  Here is what happens:  seniors can quickly "spend down" to qualify for Medicaid because of the high daily cost of a nursing home stay.

Seniors should plan ahead to understand the costs and ratings of nursing homes in their area to be prepared should a major medical incident occur as many times hospitals will discharge the senior directly to a nursing home for rehabilitation.  Below are some examples of the average daily nursing home costs in some states. As you can see, with the daily cost of a nursing home being as much as $300 per day, a senior can quickly burn through their assets to qualify for Medicaid benefits.

Nursing Home Average Daily Costs

Alaska:  $666

Arizona:  $184

California:  $203

Illinois:  $158

Louisiana:  $133

Massachusetts: $299

Texas:  $115

Wisconsin:  $197

As these are just an example of the average cost, it is easy to see how a senior can spend-down to qualify for Medicaid, with a monthly stay at a nursing home in California costing $6,090 per month and if a senior lives in Alaska, well, perhaps they can consider moving South as there are less than 10 nursing homes in Alaska and the average cost results in $19,980 per month.

Seniors and their family members may reserach nursing home costs and ratings in the Caregiverlist Nursing Home Directory, the only resource with this trademarked information. As many times hospitals will discharge a senior directly to a nursing home for rehabilitation, families should plan ahead to choose the nursing home they would prefer.  

Some seniors prefer to stay at home to receive professional senior care services and pay an hourly rate for senior home care which can range from $18 to $26 per hour, depending on the location, and includes all the necessary liability and worker's compensation insurance protections and includes payroll taxes as required by law. Seniors may request a care plan to find senior home care agency options in their area and learn about the costs for senior care.









California Senior Caregiver Training Created to Protect Seniors and Caregivers

California joins several other states, such as Illinois, New Jersey, Washington and Florida to create specific laws to regulate senior caregiver training and the background check process for professional senior caregivers. California's law, titled the "Home Care Services Consumer Protection Act of 2013" was officially signed into law by Governor Jerry Brown in October of 2013 and enforcement of some of the specifics of the law, such as caregiver training, begins in January of 2016.

Senior care companies needing digital training to meet this requirement may contact Caregiverlist at 312-669-8821 for information and a custom digital training resource.

California Assembly Bill 1217 Requires:

  • Licenses Customized for Home Care Organizations as Businesses
  • New Home Care Aide Registry to List all Professional Caregivers Working as Home Care Aide
  • Home Care Aides Must Renew Registration Every 2 Years
The new guidelines mandated by California's 1217 bill has been named the "Home Care Services Consumer Protection Act".
The California State Department of Social Services will administer and enforce the requirements and this is why the legislation delays enforcement until January of 2016, in order to build the bureaucracy around it.

California senior home care agencies will now have their business license a bit more customized for senior home care, by requiring:

  • General and Professional Liability Insurance in the amount of at least $1 million dollars per occurrence and $3 million dollars in the aggregate
  • Worker's Compensation Insurance 
  • List of Registered Home Care Aide Workers and Validation Aides 
  • Initial License Fee for 24-Months (2 Years) for a New Home Care Services Company
  • 2-Year Renewal Fee based on Number of Full-Time Employees (FTE's)
  • TB Test for Home Care Aides within 7 Days After Employment and then Every 2 Years
  • 5 Hours of Entry-Level Training for Newly Employed Senior Home Care Aides
  • 5 Hours of Annual Training for Employed Home Care Aides
The California Home Care Services Consumer Protection Act identifies the specific caregiver training required for senior home care aides in section 1796.44 of the legislation under Article 8 titled Affiliated Home Care Aides.

As 10,000 Americans turn age 65 each day, and life expectancy continues to climb upwards, senior care professionals have predicted that more seniors will prefer to age-in-place in their own home or in the home of an adult child.  Hospitals have also indicated that they believe that within the next decade, much of their care will be monitored in the home using technology to monitor vital signs and performing an equivalent of a Skype video call to allow the nurses and doctors to engage with the patient and daily intervals.

California's senior caregiver training law will most likely be joined by additional states soon.  The caregiver training and caregiver registry are the most valuable aspects of this legislation for seniors as most all senior home care agencies already followed the majority of the guidelines this new law requires.

The California Senior Caregiver will also now be called a Home Care Aide and this designation can be slightly different and called a "personal care aide" or "certified caregiver" as well.

Caregivers working in California most likely have already been trained in the skills mandated by Assembly Bill Number 1217. However, these caregivers will need to now have annual training consisting of 5 hours to show they are maintaining these skills.
Annual California caregiver training must relate to core competencies outlined by the legislation as:

  • Clients' Rights and Safety
  • How to Provide for and Respond to a Client's Daily Living Needs
  • How to Report, Prevent and Detect Abuse and Neglect
  • How to Assist a Client with Personal Hygiene and other Home Care Services
  • How to Safely Transport a Client (if Transportation is Required)

This caregiver training may be completed through an online program.  The Caregiver Training University Basic Caregiver Training does provide training meeting the California home care aide training requirements. Senior care companies in California can also subscribe to the senior home care agency caregiver training portal to easily train their caregiving staff and provide easy-to-use reporting. As more senior caregivers are already needed, anyone interested in working as a professional caregiver may take the online home care aide training course and apply for a caregiving job to be considered by professional senior care companies in their area who are always hiring.  Need easy-to-administer professional caregiver training? Email susan@caregiverlist.com or call Caregiverlist at 312-669-8821.





California Governor Makes Assisted Suicide Legal

Senior caregivers working as professional caregivers can share many stories of seniors and their families who have struggled with when to embrace hospice care and accept the process of dying.  Aging gracefully comes with accepting mental, emotional and physical health realities that do not arrive wrapped in gracefulness.  

America's seniors receive either Medicare health care or Medicaid (for low-income seniors with few assets). If a senior has been diagnosed with a terminal condition with two years or less to live, they may accept hospice care.  Hospice care respects the dignity of the senior to maintain their comfort as they journey through their illness, accepting their body will eventually be unable to function without assistance and accepting that they do not want additional assistance to remain alive.

As advances in medicine and technology are allowing us to live longer, the new questions arising are focused on how do we want these longer years to be?  The recent best-selling book "Being Mortal" by Atul Gawande, a medical doctor (and excellent writer), focuses on how we should begin the conversations with our loved ones on how we want to age.

California's law joins the law in the state of Oregon to give their residents the right to "death with dignity".  This week Governor Jerry Brown stepped forward to sign the bill his state's assembly had approved.  The governor accepted the opposition of some in order to respect the right for mentally competent adults who have been diagnosed with a terminal illness with six months or less to live to have the choice to accept lethal prescriptions.

Hospice caregivers who have been with someone dying can share stories of hearing the death rattle noises coming from a terminal patient as they lose their ability to swallow.  Doctors, nurses and hospice professionals who support the death with dignity movement bring an approach to care that supports caring for someone as they are dying by providing comfort, just as we try to provide comfort when caring for those who will recover from an illness.

Barbara Coombs Lee, a nurse who serves as the president of Compassion & Choices, shares the story of Brittany Maynard, who through her terminal cancer diagnosis stepped up to be the force behind the movement to change the laws in California to allow for residents to choose to die with dignity.  She wanted her family caregivers to know that she had planned ahead for a dignified death.

Brittany's video had 100 million views.  You can learn more about Compassion & Choices initiative to support death with dignity in additional states in the U.S.A. 

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