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.

 

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Caregiver Interview Questions

Senior Home Care Agencies have created systems to effectively hire quality caregivers.  Nursing homes and Assisted Living communities also have hiring systems for Certified Nursing Aides.

Beyond the usual questions about experience and previous jobs you have held, hiring companies need this information to more quickly process your application:

1) Copy of Certificates for any specialized training (Certified Nursing Aide, Home Health Aide)

2) Copy of your identification: Driver's License, State I.D., Social Security card or Passport

3) Names and phone numbers of at least 3 personal references and 3 business references (can be a manager or colleague)

4) Names and addresses of former employers along with valid phone numbers for each

Note:  you may obtain non-medical caregiver certification through an approved 10-hour online caregiver certification course.

Caregiverlist receives many questions about the hiring process and most of these questions are answered on our FAQ's.  And, what do we think is the most important question for both the hiring company and the caregiver?  Finding out the reason the caregiver was attracted to working as a caregiver.  There are many types of work which will pay more than caregiving and the best caregivers are doing senior care for many reasons beyond a paycheck.  By finding out what these reasons are, you will learn more about the caregiver applicant and gain insight about their personal values.

 

 

 

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Economic Stimulus Addresses Nursing Shortage

Reportedly, President Obama was shocked to learn that one of the barriers for delivering quality healthcare in the U.S.A. is the shortage of trained nurses.  Lawmakers agreed that meaningful healthcare reform must address ways to solve the nursing shortage.  The economic stimulus bill includes $500 million to address the shortages of health care workers.  About $100 million of this will be targeting the nursing shortage.  One of the issues is not just the shortage of nurses for jobs a hospitals and nursing homes, but the shortage of nursing faculty to teach at college programs.

If you are considering a career in nursing, considering obtaining more education as a Certified Nursing Aide, Licensed Practical Nurse or Registerd Nurse, contact nursing programs in your area to find out if scholarship or grant programs are available.  Many community colleges will assist you in obtaining reimbursement for your education through employment at local hospitals who will agree to pay for your tuition as long as you agree to work for them for a certain amount of time. 

If you are a senior caregiver, you may want to explore becoming a Certified Nursing Aide, especially if you are able to have a community program foot the bill for your tuition.  Your additional caregiver training will assist you to be at the top of the list for job applications and receive higher pay.

 

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Medicare Coverage for Caregivers?

Former first lady Barbara Bush just exited intensive care at the Texas hospital where she received a new aortic valve for her heart.  At age 83, she will be able to recover and continue to enjoy an active life as an American senior.

This is a perfect example of why there is a continued need for caregivers for seniors.  Medical technology, combined with the Medicare insurance benefit which most seniors qualify for at age 65 (you or your spouse will need to have paid into the program through your payroll tax deductions for at least 10 years to qualify, which is another reason Caregiverlist advocates hiring senior caregivers through a senior home care agency so that the caregiver will receive proper payroll tax benefits and be able to receive social security and Medicare benefits when they retire).

Medicare Part A insurance provides seniors with:
  • Inpatient hospital care, for up to 90 days per benefit period and 60 lifetime reserve days

  • Skilled nursing facility care, for 100 days following a hospital stay of at least 3 days

  • Skilled Home health care, for up to 100 visits following a hospital stay of at least 3 days (PT, OT, ST, RN)

  • Hospice care in the home

  • Inpatient psychiatric care, for up to 190 days during a beneficiary's lifetime

Medicare Part B insurance provides:

  • Physician services (including doctor office visits, surgeries, consultations)

  • Medical equipment such as wheelchairs; lab, diagnostic, and screening tests

  • Outpatient hospital services

  • Physical therapy, speech therapy and occupational therapy

  • Outpatient mental health services
Medicare does NOT pay for non-medical caregivers to assist the senior at their home or for long-term care in a nursing facility (non-medical caregiver means companion caregivers and Certified Nursing Aides - they are considered non-medical as they are not  medical doctors or nurses but  they are the people who provide the hands-on care in a nursing home and hospital and provide home care. About 39 million seniors are currently covered by Medicare.

Maybe it is time for Medicare to begin providing at least a few weeks of coverage for a caregiver?  Especially since Medicare is willing to pay companies many times the wholesale rate for a power wheelchair, for example.  I do hope that President Obama's health care team will take a good look at where the dollars are going for Medicare benefits and perhaps find a way to include caregiving services, which are often the most needed services after recovering from major surgery or while coping with age-related illnesses.





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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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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