Dawn of the Planet of the Caregiverlist Blogger: My Top 5 Posts

I went to see Dawn of the Planet of the Apes this past weekend and it occurred to me that my maiden Caregiverlist blog post was about the first Planet of the Apes movie (James Franco, not Charlton Heston, thank you very much): Rise of the Planet of the Apes.

In August of 2011, that movie was the subject of my blog post because its premise dealt with the search for a cure for Alzheimer’s disease (and please don’t let the ensuing movie’s cluster-franchise discourage future Alzheimer’s and dementia research.) This sequel bypassed the whole Alzheimer’s angle but for one sentence in the exposition, so I can’t use this movie for blog fodder. However, I thought I’d look back on my last three years of contributions and highlight my top five posts, out of the hundreds I've written, based on number of eyeballs.

#5 Does Your Power of Attorney Include a HIPAA Release?
15. July 2014 19:17
This is a recent post in which I discuss the importance of legal due-diligence as it applies to medical issues. It all boils down to the fact that information is power. When it comes to the ones we love, we want to make sure no one tells us they can’t give us pertinent medical information because necessary paperwork wasn’t processed. Process that paperwork!

#4 Become a Certified Senior Caregiver
2. July 2014 16:09
Who doesn’t love a good infographic? Caregiverlist provides an at-a-glance look at the growing need for caregivers for an elderly population, caregiver skills and senior caregiver job descriptions, and caregiver salary and benefits. It also outlines the steps to becoming a professional senior caregiver. And it’s pretty.

#3 Caregiver Pay: Are You Living Paycheck to Paycheck?
19. April 2014 11:18
It sure is nice to know you are not alone, especially when you feel like you are living at the end of your rope. C.N.A.s are essential to society in helping the elderly age with comfort and dignity. Unfortunately, those who help others often find themselves on the short end of the recompense stick. HBO’s Paycheck to Paycheck: The Life and Times of Katrina Gilbert spoke to many of you who are trying to make a life while making a difference.

#2 Alzheimer's Disease and Dementia: What's the Difference?
24. June 2014 08:18
I’m not above admitting it—Bradley Cooper’s face would make me click on any link too. When I wrote about Alzheimer’s and dementia awareness as a cause celebre, the popularity of the post was proof. It just goes to show that these diseases touch all, regardless of wealth or station—no one is immune to memory loss devastation.

BradleyCooper

Bradley Cooper proudly promotes purple to #ENDALZ.


#1 Inspirational Quotes for Caregivers
24. August 2013 06:22
Caregivers, especially caregivers for the infirm and seniors, experience a tremendous amount of stress. It’s why Caregiverlist has made it’s mission to "care for the caregiver" especially. It’s no wonder then that my preeminent blog post was one that gave inspiration to the senior caregiver. Culled from a variety of sources, these inspirational quotes speak to why caregiving is the ultimate humanitarian calling. The takeaway: “They may forget your name, but they will never forget how you made them feel.” —Maya Angelou

If there is any topic that you would like to see me tackle in future, feel free to drop me a line at renata@caregiverlist.com. Thanks for reading!

Facts About Senior Care

So few of us plan for our long term care, yet the majority of us will need to avail ourselves of professional senior care at some point in our lives. By 2030, the U.S. population aged 65+ will exceed 70 million. According to the American Geriatrics Society, the vast majority of these older persons will have at least one chronic disease, and substantial numbers need assistance in performing basic and more advanced activities of daily living

There are a variety of professional senior care options to choose from, based on need and cost. Most seniors prefer to age-in-place, at home. If there is no family member to care for them, many times professional in-home care, provided by a trusted Home Care Agency is the go-to option. Residential options include Independent and Assisted Living Communities, and nursing homes. Nursing home costs vary widely based upon the state in which you live.

Our good friend, colleague, and elder law expert Ben Neiburger writes about the five key facts of long-term care.

1. Statistics
Nearly 41% of people under 65 and approximately 70% of people who live to age 65 will need some type of long-term care.
2. Medicare
Medicare covers skilled short-term medical care as well as short-term assistance with nursing home costs, but only if the circumstances meet strict requirements. However in most situations, this is simply not a viable long-term care option for most people.
3. Medicaid
Medicaid is a state-based program supplemented by Federal funds that provide health services to the poor and impoverished. Medicaid might cover your loved one, if he or she meets your state’s poverty criteria.
Many people attempt to spend down their assets to state-required levels or transfer their assets to family members to become eligible for Medicaid, but the state has the right to look back into your finances for 5 years before the date you apply for coverage, and may refuse to pay for your long-term care if you don’t handle your money “appropriately” during those 5 years.
4. Nursing Homes and other Long Term Care
Both Medicare and health insurance are intended to cover skilled, short-term medical care as you recover from an illness or injury—NOT long-term care. That means a health insurance policy rarely covers ongoing long-term care, especially if one is over 65.
5. Private Pay
Personal savings are one way to cover long-term care expenses. Keep in mind however, that in 2011, the national average annual cost of long-term care services in a semi-private nursing home room was $75,555. Since the average length of stay in a nursing home is 2.4 years, that would come to approximately $181,000 out of your savings.

We now know that, due to the longevity of our nation’s population, most of us will indeed need long-term care. Seniors once relied upon family members for elder care, and while there are many, many family caregivers (43.5 million of adult family caregivers care for someone 50+ years of age), many seniors will need to look to professional caregivers for their senior care needs.

Ways to pay for care that don’t include Medicare, Medicaid, or private pay includes long-term care insurance and reverse mortgages. Be vigilant in your research, however. Some long-term care insurance pays only for nursing homes and not for in-home senior care.
A reverse mortgage has its own pitfalls, making it an option of last resort.

U.S. veterans may be eligible for Veteran’s Aid & Attendance Benefit. For this benefit, you’ll need to apply and be persistent and patient. Those wheels tend to grind slowly.

Caregiverlist® understands the process involved in finding the right senior care can be arduous. Estate planning can assist you in determining your best options in how to pay for professional senior care for you or your senior family member.  

Ben Neiburger is an active member of the National Academy of Elder Law Attorneys (NAELA) and a member of the Executive Committee and Board of Directors for the Illinois Institute of Continuing Legal Education and through frequent speaking engagements and ongoing course work both locally and nationally, is in continuous pursuit of knowledge and insight to the laws and finances that affect our families and senior citizens. He brings this wealth of knowledge, his clear and common sense explanations, his patience, gentle humor and sensitivity to each of his legal consultations.To learn more about Elder Law, visit generationlaw.com.

Does Your Power of Attorney Include a HIPAA Release?

Seniors and family caregivers often find it difficult to discuss plans of action for when the elderly family member is incapacitated or no longer able to speak for themselves. It’s a challenging subject, but one worth tackling before it’s needed. If you don’t, the circumstances can be dire.

The Health Insurance Portability and Accountability Act of 1996, better known as HIPAA, was designed to protect a patient’s right to privacy by penalizing doctors and other healthcare providers who disclose "protected health information" about their patients. Whenever you go to the doctor, you’ll be prompted to fill out a federally-mandated form that reads, "HIPAA Notice of Privacy Practices." Patient confidentiality is generally a good thing. No one has the right to know my medical prognoses, see my prescriptions, or discuss my medical treatments unless they have my written approval. But what if a person can’t give that approval?

There are plenty of HIPAA horror stories out there. Imagine the story of the woman whose mother wound up in the ER after suffering a stroke. She approaches the nurse’s station, frantic about her mother’s condition and is met with a sympathetic shrug of the shoulders and, "I am sorry, I am not authorized to give you that information." By law, unless the woman and her mother had a Power of Attorney for HIPAA release, no one in that hospital can discuss her medical condition with outside parties—even the woman’s own daughter.

Caregiverlist®, in it’s ongoing mission to care for the caregiver and make life just a little easier for seniors and their families, has worked with Law Depot to provide you access to senior care legal documents to help facilitate elder care.

In the case of Power of Attorney for HIPAA Release, it is imperative to have all legal documents in place as, in most cases, the patient is not a position to give their verbal instructions. Do it in order to lessen the burden on family members during an already stressful time. In addition to the providing all medical professionals the “release of information” paperwork, it’s also important for the senior and their proxy to discuss and fill out a Last Will and Testament and a Living Will for end-of-life medical treatment requests.

Learn more about HIPAA at the Department of Health and Human Services’ Office for Civil Rights website at www.hhs.gov/ocr/hipaa.

Hospital Readmission: Revolving Door for Some Seniors

Part 1: Hospital-to-Nursing Home-to-Hospital

My mother always believed that if she ever found herself in a skilled nursing facility, she would never go home again. That’s a scary prospect for a senior, especially since nursing homes have become an extension of a hospital stay, with Medicare footing the bill for the first 100 days. That stay includes rehabilitation services. Lucky for my mom, she breezed through her post-hip replacement surgery nursing home rehab and made it back home with plenty days to spare. But her fear is not unfounded; here are some startling facts:

  • 1 in 5 (20%) Medicare patients are transferred from hospital to skilled nursing facility to complete their treatment and/or rehabilitation.
  • 1 in 4 (25%)  Medicare patients will be readmitted to the hospital within the first 30 days of their nursing home stay.

Hospital readmissions from a skilled nursing facility (SNF) can be disastrous for elderly and frail individuals. Complications can arise due to hospital infections. Constant hospital readmission can be distressing for the resident and family, causing patient delirium. Some patients even find it stressful to assimilate back to the nursing home after being released from hospital yet again.

Medicare could also begin cutting reimbursements to nursing homes they deem to have high rates of “avoidable”, “preventable”, and “unnecessary” hospital readmissions.

The American Health Care Association, has introduced an initiative to reduce hospital readmisssions. There are a few programs within their Quality Initiative that are assessing and attempting to correct the phenomenon of rampant hospital readmissions.

INTERACT (Interventions to Reduce Acute Care Transfers) is a program designed to improve the early identification, assessment, documentation, and communication about changes in the status of residents in skilled nursing facilities. By implementing strategies on a daily basis, the goal of the program is to reduce transfers of nursing home residents back to hospitals.

CHATS (Communicating Health Assessments by Telephone) is a program designed to help nurses and physicians communicate the status of a patient. Good communication can lead to prevention and treatment within the SNF.

LTC Trend Tracker is a free web-based tool that enables long term care providers to access key information to benchmark and examine their ongoing quality improvement efforts.

While some hospital readmissions are inevitable, some are preventable. Indicators show that progress has been made. According to the AHCA website, as of the end of third quarter 2013,

  • AHCA members have reduced 30-day readmissions by 3.3%.
  • Over 2,000 member centers achieved a 15% reduction in their hospital readmission rates since the launch of the AHCA Quality Initiative
  • About 26,400 readmissions in AHCA member centers were prevented, saving the health care system roughly $270 million.

We at Caregiverlist® recommend the book Ending Hospital Readmissions: A Blueprint for SNFs for Skilled Nursing Facility administrators. This book shows the financial consequences of the “revolving door” and provides strategies and tools to help minimize unnecessary transfers. With education and staff involvement, not only can costs be reduced, but residents’ quality of life can be enhanced. It’s a win-win for everyone.   

States React to AARP Scorecard

Much has been made of AARP’s released report 2014 State Long-Term Services and Supports (LTSS) Scorecard. In fact, I covered the results in a recent blog.

Since the report’s release, state politicians and policy makers have been scrambling to either issue statements strongly urging for their state’s commitment to long term care improvement or stridently patting themselves on the back for a job well done.

Louisiana’s Times-Picayune article on nola.com about its senior population being over-institutionalized. Louisiana ranked 37th of the 50 states and Washington, D.C. in its overall long-term care policies. In that state, aging seniors are (predominantly) either placed in nursing homes or cared for at home by unpaid family members. And it ranked dead-last in effective transitions—meaning that a high number of nursing home residents are hospitalized because they’re not receiving the care they need. Funny, the same report found that there are a high number of nursing home residents with low-care needs. No doubt it is because of the lack of alternatives such as adult day care and other home and community-based services.

Not surprisingly, vociferous Louisiana AARP advocates call for increased funding of alternate care choices in an attempt to acquiesce to the majority of older Louisiana residents who wish to age in place, at home. Ironically, despite the article pointing to so many calls-to-action, they conclude optimistically, pointing out that “Louisiana's ranking in 2014 improved slightly from the 43rd slot, when scorecard was last issued in 2011.”

On the flip-side, Minnesota’s Office of the Governor Mark Dayton was quick to issue a press release extolling their number one spot on the scorecard for long term care access, choice, quality, and caregiver support. The release also pointed out that Minnesota ranked in first place on the 2011 Scorecard as well.

In the release, Gov. Dayton cited the following efforts that assist Minnesotans in “providing our parents, grandparents, and people with disabilities the best possible care.”

  • New incentives for providers to increase quality
  • More help for people who want to move from nursing homes and other congregate settings to homes of their own
  • More comprehensive information and referral services for individuals and family caregivers
  • Support for core community services that help people stay in their homes
  • More flexibility for consumers in choosing supports tailored to their needs
  • Promotion of competitive employment for people with disabilities
  • A stronger adult protection system; and
  • Own Your Future, an initiative that encourages Minnesotans to plan for their long-term care and is now exploring new ways Minnesotans can finance this care.


We at Caregiverlist® not only care for the caregiver, we advocate for seniors and their families. I hope that the Long-Term Care Scorecard elicits more than one-upmanship between states. It’s a great opportunity to see where your own system may be lacking and examine and adapt those state policies and approaches to long term senior care that appear to be working best.

Senior Care Opportunities in an Aging World

I’m often asked if senior care, specifically in-home senior care, is really the fast-growing employment opportunity that we always say it is. Consider this:

  • The percentage of the U.S. population in 2010 aged 65 and over was 40.3 million. In 2050, is it projected that nearly 21% of the entire population of this country will be over 65 (up from 4.1% in 1900.)
  • Over 38% of those aged 65 and over had one or more disabilities in 2010, with the most common difficulties being walking, climbing stairs, and doing errands alone.
  • Medicaid funds for long-term care have been shifting away from nursing homes. Funding for home- and community-based services increased from 13% of total funding in 1990 to 43% in 2007.
  • The top ten states with people aged 65 and older in 2010 were also the top ten states with the oldest old, aged 85 and over. The top four states were California, Florida, New York and Texas.


These are just some of the highlights from the U.S. Census Bureau report, 65+ in the United States: 2010, released in June 2014. Prompted by the Baby Boom generation, those born in the years following World War II (from 1946 to 1964), the report examines the social and economic implications of an aging majority population.

The U.S. is not the only country to experience the Baby Boom. Western countries that experienced relatively low birth-rates in the thirties and subsequent high birth-rates in the 25 years after WWII include the Scandinavian countries, Germany, Austria, Belgium, France, Luxembourg, the U.K. and Switzerland. In fact, in 2010, 50 countries had a higher proportion of people aged 65 and over than the United States. According to the report, by 2050, that number is projected to reach 98, or almost half the countries in the world. And, of course, developed countries will experience a greater number of the oldest old (age 85+) because undeveloped countries have a lower life-expectancy.

Eldercare policies in not just the United States but around the world will have to accommodate this worldwide growing segment of the population.

This is the perfect time to become a professional senior caregiver. An expert in this field will have worldwide opportunities in the coming years. How does one start? At Caregiverlist®, we provide you with everything you need to become a professional senior caregiver. First, see if you have the temperament for senior care and you are aware of what the job entails.

Check your state’s minimum training requirements—Caregiverlist’s® basic training meets most state requirements. If you pass a criminal background check, you can begin the application process by using our free resume writer and attach it to our 5-minute caregiver job application.

Once you become a senior care professional, your opportunities for mobility are only as limited as your imagination. Whether you decide to work in the fastest-aging South and West regions of the United States or in aging-friendly countries like Sweden, Norway, or Germany, the universal truth is there will be no lack of senior clients in the near future.

USCensusWorldAge

Become a Certified Senior Caregiver

It takes a special kind of person to become a professional caregiver. Many start as caregivers to aging family members and they experience first-hand what a difference compassionate care can make in the life of a senior. However, caregiving is much more than a fulfilling vocation; those who decide to become certified caregivers find it is career that offers competitive pay, flexible scheduling, and an expanding job market. Most of all, those working in senior care often tell us that they make meaningful connections with elderly clients and their families. It truly is a job of which they can be proud.

For those interested in learning more about caring for elderly adults, Caregiverlist® presents The Home Caregiver Career Overview infographic. We've culled information from various reputable sources, internal and external, to show you just why senior caregiving is The Career That Keeps on Giving.

Baby boomers are aging. By the year 2030, approximately 20% of the American population will be 65 and over. The majority of seniors (our research estimates it at 90%!) want to age at home with the help of in-home caregivers. If you thought quality caregivers are high in demand now, just wait a few years—home healthcare is one of the fastest-growing industries and is projected to grow by nearly 50% from 2012 to 2022.

Non-medical home caregivers provide home and health services, help with activities of daily living (ADLs), and sometimes most importantly, companionship.

Senior home care agencies lament that there aren’t enough quality caregivers to fill all available positions. Talk about job security! As we showed in our 2013 Senior Care Employment Index, there are nearly 11,000 senior care agencies in the United States and 1,000 new agencies opened in 2012 alone. In addition to benefits (such as medical and dental insurance and retirement plans) and flexible hours, home care agencies regularly pay their hourly caregivers significantly more than minimum wage.

Becoming a certified caregiver requires that you meet your state’s minimum training requirement and pass a criminal background check. Then you are on your way to a career that offers the rewards and personal satisfaction that few others can provide.

Senior Caregiving Jobs

 Please feel free to share this Caregiverlist® Home Caregiver Career Overview infographic on your own blog or website. When you do, please give credit and link to Caregiverlist.

Seniors See Health Benefit from Soccer

Oh FIFA, what have you done to me? USA vs. Belgium, Netherlands vs. Mexico—it seems I just can’t get enough of 2014 World Cup Brazil. Watching those men run up and down the soccer pitch had me wondering, is this just a young person’s sport?

Apparently not.

A recent Danish study shows that its never too late to start playing what the rest of the world calls football. Researchers from the Copenhagen Centre for Team Sport and Health at the University of Copenhagen recruited 27 inactive men, ages 63 to 70, and had them take part in either football training, strength training, or no training at all. After four months of twice-weekly one-hour workouts, tests showed quite a difference between groups regarding aerobic fitness and muscle strength.

For those who practiced and played soccer, maximum oxygen uptake increased by 15 percent, muscle function was improved by 30 percent and bone mineralization in the Femoral neck (of the thigh bone) increased by 2 percent.

senior soccer

Image courtesy of tungphoto / FreeDigitalPhotos.net

“Our study shows that intense training such as football can change the lives of elderly men,” said study leader Professor Peter Krustrup, in a press release.

And 70 is the new 30 if you’ve been playing soccer all your life. Krustrup added, “Our previous studies have shown that 70-year-old men with lifelong participation in football possess a postural balance and rapid muscle force that is comparable to that of 30-year-old untrained men.”

The benefits of soccer enhance life off the field as well. Playing soccer has been shown to reduce high blood pressure in the elderly and also reduces the risk of falls and bone fractures.

Caregiverlist® has always believed that senior fitness is a major component of healthy aging. Caregivers can learn about fitness and nutrition in order to help seniors live their best possible lives. Caregiverlist Basic Training, powered by Caregiver Training University, provides easy-to-access online caregiver training for professional and family caregivers.

Alzheimer's Disease and Dementia: What's the Difference?

It happens almost imperceptibly — a misplaced wallet, a forgotten word or name, short-term memory loss. These incidents can be normal blips in memory, but sometimes they can be indications of a more serious cognitive degeneration. The fear of being diagnosed with Alzheimer’s disease can keep a person in the state of denial. In fact, new figures show half of those who are diagnosed with dementia waited at least six months before seeing their doctor.

The Alzheimer’s Association says that of more than 6000 people surveyed, nearly a quarter of list Alzheimer’s disease as the second most frightening condition they most fear getting, behind cancer. More than 80% believe that the disease is a normal part of aging, and nearly 40% of people believed that only those with a family history of the disease could be affected.

But Alzheimer’s disease is not a normal part of aging. It's a disease that causes brain cells to malfunction and ultimately die. Neurons are the chief type of cell destroyed by Alzheimer's disease. That causes memory changes, erratic behaviors and loss of body functions. It’s a sad fact that Alzheimer’s has no survivors. The disease is the 6th leading cause of death in the United States.

June is Alzheimer’s and Brain Awareness Month. The Alzheimer’s Association is asking everyone affected by the disease to show their commitment to the cause by wearing purple and posting to social media sites like Facebook. As they say on their website, “Everyone who has a brain is at risk to develop Alzheimer's—but everyone can help to fight it.”

A number of celebrities have banded together to support Alzheimer’s awareness. Recently, actor and Alzheimer’s activist Seth Rogan spoke to congress about the need to allocate more funding to research and eradicate the disease that strikes so many, including his mother-in-law.

BradleyCooper

Bradley Cooper proudly promotes purple to #ENDALZ.

All Alzheimer’s disease is dementia but not all dementia is Alzheimer’s. Dementia is an overall term that describes a wide range of symptoms. Although Alzheimer’s is the most common form of dementia, there are a variety of other dementia types. These include Vascular dementia, or post-stroke dementia, which accounts for about 10% of all dementia cases. Dementia with Lewy bodies (DLB) sufferers are more likely than people with Alzheimer's to have early symptoms such as visual hallucinations and muscle rigidity. Parkinson's disease, frontotemporal dementia, normal pressure hydrocephalus are also types of dementia. Some of these diseases are treatable. Unfortunately, no cure or treatment slows or stops some of these progressive dementia diseases, like Alzheimer’s. But there are drug treatments that may temporarily improve symptoms.

Mild Cognitive Impairment (MCI) is often, but not always, a precursor to dementia. If you’ve been diagnosed with MCI, or are caring for a senior with Mild Cognitive Impairment, there’s a lot you can do to ease the ease and reduce the signs of MCI. For example, it’s been found that, coupled with a healthy diet, regular exercise can have a very positive impact on the brain and cognitive function.

Caregiverlist® urges if you are a senior caregiver whose family member or client presents any symptoms of memory loss, to seek the counsel of a doctor. Early detection is key in order to benefit from treatment and to plan for the future. Some dementia disorders are treatable — such as depression, drug interactions, thyroid problems, excess use of alcohol or certain metabolic disorders, such as a vitamin B12 deficiency .

If you or your beloved senior has Alzheimer’s disease or dementia, share your story with the world. Reach out to us on Twitter @Caregiverlist and don't forget to use #gopurple and #endalz to join the conversation. It’s time we destigmafy Alzheimer’s and other memory loss diseases.

Long Term Care Scorecard: Best and Worst States

When I was a kid, Florida and Arizona were the retirement states of choice. My parents and their friends decided that, after decades of Midwestern winters, the promise of warmth and sunshine, coupled with the notion of never picking up a snow shovel again proved too enticing to pass up. At their first opportunity, many of the “snowbirds” declared permanent residency in those sunshine states. Did they make the wrong move?

This week, AARP in conjunction with the Commonwealth Fund and the SCAN Foundation, released the 2014 State Long-Term Services and Supports (LTSS) Scorecard. In it, they rate states based on long-term services and support for the elderly, people with physical disabilities, and family caregivers. State performance was measured across five categories:

  • affordability and access,
  • choice of setting and provider,
  • quality of life and quality of care,
  • support for family caregivers, and
  • effective transitions

The report shows that in terms of quality of long-term care, Florida ranks in the bottom quartile compared to other states, although it fares better than Kentucky, Alabama, Mississippi, and Tennessee in affordability and transitions from nursing home care back to the community. This interactive map shows each state’s ranking:

The top-ranking states for long-term care and services are Minnesota, Washington, Oregon, Colorado, and Alaska; perhaps it’s not quite time to put those snow shovels on eBay.

It’s a well-known fact that few of us prepare for long-term care, although about 70% of people age 65 and up will need some sort of assistance with the activities of daily living. While most people would prefer to age at home, Medicare doesn’t cover the cost of home care provided by a Home Care Agency. Few of those in their 40s, 50s and 60s carry long-term care insurance and Medicaid is available only for low-income seniors with few assets. And before we all decide to retire to Minnesota or Washington, it’s important to note that long-term care is unaffordable for most middle-income seniors in all states.

The authors of the study see the need for a guide at the federal level to establish minimum long-term care performance standards below which no state should fall. No one anywhere in the U.S. should fear that their state cannot provide the needed level of assistance. Susan Reinhard, one of the study’s authors and senior vice president of Public Policy at AARP told Forbes magazine that she is optimistic in the incremental improvements she’s seen since a similar study was published in 2011, but admits all states can do better.

Caregiverlist® champions the need for change in the long-term care arena and urges you to contact your state legislature or your state’s Department on Aging and let them know how important it is to improve services in providing high-quality, well-coordinated, affordable long-term care.

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