Golden Light in Wisconsin: Stress Relief Photo

The late afternoon sun sometimes casts a beautiful golden glow.  This week's stress awareness photo is of a fountain in Lake Geneva, Wisconsin, and was taken at the end of the day as the sun was getting ready to set. Caregiverlisinvites you to take a moment to enjoy the photo and inspirational quote and share it with loved ones. Thank you caregivers and certified nursing aides for caring for our seniors. Senior care training briefs help senior caregivers to understand various senior illnesses and keep up with the latest care techniques to relieve caregiving stress. We hope you can take some time to yourselves and have a great week. 

"Don't judge each day by the harvest you reap but by the seeds that you plant."

-Robert Louis Stevenson

Hospice is End-of-Life Care with Comfort and Dignity

For senior caregivers, the word “hospice” is a double-edged sword. Hospice is end-of-life care, so the inevitable is on the horizon. The care recipient is terminal and the focus of care shifts from extending the quantity of life to preserving the quality of life left.

November is National Hospice Month and a great opportunity to thank those who make the care recipient’s final months, weeks, and days comfortable and as pain-free as possible. As hospice care turns 40 this year, Caregiverlist invites you to learn more about this special breed of caregiving.

The National Hospice and Palliative Care Organization (NHPCO) defines hospice care as a specialized kind of care for those facing an end-of-life illness, their families and their caregivers that:

  • addresses the physical, emotional, social, and spiritual need of patients
  • provides care in the patient’s home or in a home-like setting
  • concentrates on making patients free of pain and as comfortable as they can be so they and their families can make the most of the time that remains
  • includes family members an essential part caring for the patient
  • stresses quality of life over length of time left

Hospice centers on caring, not curing. That care is delivered holistically by an interdisciplinary team that consists of physicians, nurses, in-home caregivers, therapists, counselors, and social workers. Their combined goal is to provide compassionate and comprehensive care that includes patient pain management and family support so the care recipient can die pain-free and with dignity.

The number of patients and families utilizing hospice has steadily increased over the last few years. In 2013, an estimated 1.5 to 1.6 million patients received hospice services. The median length of hospice service in 2013 was 18.5 days.

Who pays?
The Medicare hospice benefit, established 1982 by the U.S. Congress, is the predominate source of payment for hospice care. As of today, 42 states also offer Medicaid coverage for hospice. Private insurance and VA benefits cover this end-of-life care as well.

Few caregivers, especially family caregivers, are prepared to handle the events and changes that happen at the end of life. To that end, the Hospice Foundation of America has published a guide called The Caregiver’s Guide to the Dying Process. The booklet is designed to help the caregiver

  • address the needs of the dying by providing descriptions of the physical, emotional and spiritual changes occurring near the end of life
  • help to understand and recognize what is happening physically and emotionally to the terminally ill care recipient
  • suggestions for what you, as the caregiver, can do to ease distress and make
  • the dying person as comfortable as possible
  • information to help you, as the caregiver, communicate effectively with the hospice team
  • insight on how you might feel as the caregiver for someone who is dying ideas of how to care for yourself

My personal experience with hospice occurred with my good friend (and senior) Louie. Louie knew he was dying. At the time, he was in the hospital and asked to go home, where he could spend his last days surrounded by his family in the home he’d shared with his late wife and look upon the garden he’d tended for the last 45 years. Hospice brought a hospital bed into the greatroom, where he could look out onto the backyard and his garden. They eased his pain with generous doses of morphine so he showed no signs of physical duress as family and friends came to hold his hand and say goodbye. All the while, members of the hospice team were in and out, making sure everyone involved had all they needed to make Louie’s passage as warm and peaceful as possible. They made it possible for Louie to die at home, as he wished, listening to his favorite big-band music as they attended to his comfort. It was a beautiful and natural way to die and I will forever be grateful to them all for their inestimable services.

Join the NHPCO hospice community on Facebook and help ensure all Americans get access to quality end-of-life care.

Senior Home Care Franchises Make Best Business (Dollars and) Sense

The verdict is in — senior in-home care is big business and four senior care franchises have snagged spots in Franchise Business Review’s “Top Emerging Franchises”. FBR surveyed more than 1,500 young franchise brands (operating for five years or less)  and asked them to rank their companies based on financial opportunity, training and support, leadership, operations and product development, core values (e.g., honesty and integrity of franchisor), general satisfaction, and the franchisee community.

Qualicare Family Homecare, FirstLight HomeCare, Amada Senior Care, and CareBuilders at Home were all represented on the list of top franchises. Amada Senior Care took fifth place, FirstLight landed third, and Qualicare Family Homecare walked away with the coveted first place spot of all top emerging franchises.

With no wonder. Senior care (especially in-home care) franchise opportunities have exploded in recent years. According to the Bureau of Labor Statistics, the home health-care sector is currently the fastest growing industry sector in America. In 2012, there were just under 1.2 million jobs in home health care. In 2022 it is estimated that there will be about 1.91 million jobs in the home care field. That’s an unprecedented increase of over 715,000 jobs. That translates to a compounded annual growth rate of 4.8 percent.

But besides providing jobs and having employment security, there are other, more personal reasons people find themselves in the senior care industry. Most come to the field after being a family caregiver to the elderly or disabled in their own households. For many, the satisfaction of knowing they are doing the great and important work in helping seniors age at home, with dignity, trumps the profit margins.

Teresa Yoder, Amada Senior Care, Santa Clarita, CA franchise owner tells FBR why she was attracted to her franchise:
My beliefs were in line with the business practices of Amada Senior Care, as it pertained to complete concern and attention to family and senior needs, and what was best for THEM, not necessarily just profit driven.

There are nearly 11,000 senior care agencies in the United States: 1,000 new agencies opened in 2012 alone. Recently, I wrote about Leeza Gibbons and her husband deciding to open a Senior Helpers franchise; it not only made financial sense, but they saw it as an opportunity to “provide trusted and dependable care and encouragement to seniors and families facing devastating illnesses such as Alzheimer’s and dementia.”

If you believe you have what it takes to run a Senior Home Care Agency, we suggest you do your due diligence and request information from top senior homecare franchises. You can learn about their operating models and marketing approaches, as well as the minimum cash required to open your own franchise.

President Obama Proclaims November National Family Care Month

Caregiverlist has been championing the senior caregiver for years. Many of us come from family caregiving backgrounds and know the difficult (but rewarding) work of taking care of parents or grandparents.

And so each year since 1997 when President Bill Clinton signed the first Presidential Proclamation, November is recognized as National Family Caregivers Month — a time to thank, support, educate and empower family caregivers.

Family caregivers, often called “informal caregivers”, perform the brunt of senior care, without pay. Here in the U.S., according to the Family Caregiver Alliance, 43.5 million adult family caregivers care for someone over 50 years old and 14.9 million care for someone who has Alzheimer's disease or other dementia (statistics based on numbers from November 2012.)

Most elderly prefer to age at home and, because of limited funds, many times family caregivers are their only option to do so. Family caregivers provided services valued at $450 billion per year in 2009 and since the aging population will only increase (some estimate that those aged 65+ will more than double between the years 2000 and 2030), the value of family senior care will increase exponentially as well.

Most family caregivers (by the way, the majority of whom are women), also work outside the home and many times care for children as well. Thus the term Sandwich Generation. That care has an economic impact on the family caregiver as well. Surveys show that caregivers overall reported missing an average of 6.6 workdays per year. They turn down promotions, arrive late to work and/or leave early, take leaves of absence, or quit work altogether to provide much needed care to family members. That loss of productivity is estimated at $304,000 in lost salary and benefits over a lifetime.

When PBS did a story earlier this year on the average American long-term care family caregiver, I was surprised to see that my personal situation is not all that unique. The profile of the average long-term caregiver in the U.S. is a 49-year-old woman who works outside the home and cares for her widowed mother for an average of 20 hours per week. Yup, that’s me in a nutshell.

It’s great that there is national attention to this growing segment of the population — the family caregiver. While it’s true that families have always cared for their own, because life-expectancy is quite different than it was 50 years ago, family senior care can extend years, even decades longer than ever before. If family caregivers were no longer available, AARP says in a report, the economic cost to the U.S. health care and long-term services and supports (LTSS) systems would increase astronomically. It’s most certain that many elderly would find themselves in institutional settings like nursing homes, and the cost would be borne by the government, on both the federal and state levels.

It’s essential, therefore, that we as a society support the family caregiver in every way possible. It is essential to the well-being of our system of LTSS, our health care system, our economy, our workplaces, our families, and ourselves.

Because many professional senior caregivers come to the industry after spending years as family caregivers, Caregiverlist® provides some basic online caregiver training powered by Caregiver Training University to help the family (and professional) senior caregiver provide the best senior care possible.

And during the month of November especially, remember to celebrate and appreciate the senior family caregiver in your life, either by providing some respite care, taking them out for a relaxing evening, or by simply saying “thanks” (although I’m bucking for the night out!)

Do you have an issue you'd like to see tackled on this blog? Connect with Renata on Google+

White House Plans Conference on Aging in 2015

Americans are living longer than ever. One hundred years ago, in 1914, a man’s life expectancy was 52 years, a woman’s almost 57. If you are 65 years old in 2014, the Centers for Disease Control and Prevention estimates that as a man, you will live to about 83 and if you are a woman, your life expectancy is about 80 ½  years old.

In order to address the needs and concerns of an aging population, the White House is gearing up for its sixth White House Conference on Aging (WHCoA), to be held in 2015. The first conference was held in 1961, with subsequent conferences held each decade since.

Next year marks the 50th anniversary of Medicare, Medicaid, and the Older Americans Act. It’s also the 80th anniversary of Social Security. The 2015 White House Conference on Aging is an opportunity to look at these programs and see what public policies need to be implemented to understand the issues facing older Americans, their families and their caregivers.

WHCoA in 2015 will address four main issues: retirement security, healthy aging, long-term services and supports, and elder justice.

Financial security for retirees has changed in the last few decades, with fewer employers providing pensions. The future of Social Security is always in question and the need to protect that benefit is crucial to U.S. citizens retiring with dignity. Many older Americans have seen their retirement savings fall with the economy. The question of when to retire is being replaced with IF to retire. The conference will address “improving wages and benefits for all American workers—especially older workers—and ensuring opportunities for older Americans who choose to remain in the workforce, can provide additional avenues for income security in retirement.”

Healthy aging is made possible with better life choices including healthy eating, exercise, health screenings and supportive communities.

Senior care costs continue to escalate and it’s a fact that as we live longer, many of us will need assistance with the activities of daily living, whether it be through home care, assisted living, or nursing homes. Less than three percent of Americans currently have a long-term care insurance policy. WHCoA will explore new options to help Americans in preparing for their long-term care needs as they age.

The elderly are one of the most vulnerable segments of our society. Scam artists are just waiting to bilk people out of their savings. Physical and emotional neglect and abuse cut across economic, racial and ethnic lines, affecting seniors regardless of where they live.

Americans are encouraged to participate in the discussions. The White House is being more inclusive than ever before, bringing the conference online at www.WhiteHouseConferenceOnAging.gov, which will provide regular updates on Conference events and activities. You can get involved by signing up for weekly emails, or sharing your thoughts on elder issues or stories celebrating the contributions of older Americans.

Is Jibo Your New Senior Companion?

As you senior caregiver readers know, I’ve embarked on a mission to bring some technology into my elderly mother’s home so she can live independently longer, the way she wants to live. I made a list of her needs, the most important of which are keeping safe, connected, and engaged.

My mother is not alone in her needs. The 80+ age group is the fastest-growing segment of the world’s population. By 2050, it is estimated that there will be 392 million persons over the age of 80, more than three times the present. At the same time, there will be fewer caregivers for the elderly. Smaller and more geographically disparate families mean fewer family caregivers.  We are already experiencing a shortage of trained certified nurse assistants and home care aides. And, of course, ever-increasing senior care costs, whether in the home or in an institutional setting, means the entire system of elderly care needs to be rethought.

Technological advancements are growing exponentially, just as is our elder population. It makes sense, then, that someone utilize the advances in technology to address the true needs of people. The Jetsons’ Rosie, Luke Skywalker’s C3PO, fiction is rife with examples of robot family helpers. Beyond the physical assistance these robots provided, they were also companions and assistants. Those imaginings are now becoming reality.

Jibo, the “world’s first family robot”, is the brainchild of MIT professor and social robotics pioneer Dr. Cynthia Breazeal. Dr. Breazeal saw the necessity for technology that supports the needs of the human being.

“I do this because I want to empower people to stay healthier, to learn better, to age with dignity and independence (my emphasis)”, Dr. Breazeal writes on the Jibo blog. “... to support more empathic and emotionally engaging telecommunication with those you love, to delight and surprise & entertain so that people laugh and experience joy and wonderment more often, and to make our lives just a bit easier with a touch of technological magic.”

For seniors, that means an “attentive companion that can help you live with greater independence and stay connected to those you love.”

Here’s what Jibo can do (from the Jibo website):
See
Two hi-res cameras recognize and track faces, capture photos, and enable immersive video calling.
Hear
360° microphones and natural language processing let you talk to Jibo from anywhere in the room.
Speak
Hands-free reminders and messages, so you'll never forget and can always be in touch.
Learn
Artificial Intelligence algorithms learn your preferences to adapt and fit into your life.
Help
Like a personal assistant, Jibo proactively helps you, to make everyday tasks simpler and easier.
Relate
Communicates and expresses using natural social and emotive cues so you understand each other better.

Here's Jibo in action:



The Indiegogo campaign to crowdsource funding for Jibo started on July 16 and ended on September 14, 2014 and raised $2,289,506, and astonishing 2,290% of its $100,000 goal. Those numbers make it the most successful technology campaign on Indiegogo to date.

Over 4,800 Jibos were pre-ordered at $499, 28% of which are Developer Editions and upgrades (new application development is ongoing.) 71 Jibos will be donated to Boston Children's Hospital.

What do you think about Jibo and the future of carebots? Is this something you would welcome into your home? Personally, I’d love to see it in action. And if the response on Indiegogo is any indication, Siri’s in for some stiff competition.

Seniors Online, Connected

America’s seniors may be late to the game, but are now finding their way online in significant numbers, according to the Pew Research Internet Project’s latest findings. The data also points to the fact that tech adoption varies within the senior population, with younger, more educated and affluent seniors using internet and at-home broadband at “rates approaching—or even exceeding—the general population.”
The study shows that  six in ten seniors go online, and just under half are broadband adopters. Once online, seniors make the internet a part of their daily routine. Many older adults that use social networking sites like Facebook to keep in touch with friends and family. Interestingly, those that socialize online are more likely to regularly socialize with friends offline as well, in person, or over the telephone.

In which I get my mom hooked up.

I wake up at four in the morning worried about my mother. She lives only 5 miles and 20 minutes away but I know she’s alone (by choice) and maybe lonely. When I voice my concerns, she assures me she wasn’t lonely, she was asleep, and I don’t need to worry about her as she “has gotten used to” living alone. She prefers to age at home, even if it means living a certain level of isolation. I wish I could see her. Today. Right now. Have breakfast with her (well, I’d wait until she was up.)

If only there was some sort of technology that would make it easy to look at the person to whom you were talking. It would be great if you could talk on a television-like device like they did in old sci-fi movies. Oh, right.

My 83 year old mother has Skyped.  She’s watched the videos I’ve posted of her grandchildren on YouTube. We’ve talked about getting broadband into her home to make it easier for her to connect with us and with her family in Europe. Over the next few weeks, I’ll share with you the process of getting my mom online.

First step: determine need and level of tech comfort.

The extent of my mother’s ownership of technology begins and ends with her cell phone (not even a smartphone.) She has used my laptop to Skype, so she’s comfortable with and enjoys that application. So in determining the best hardware to purchase, we have to look at what she will be utilizing and how. Let’s face it—she’s not creating spreadsheets and newsletters.

Family photos and videos
With family scattered all over the world, photo and video sharing is one way we can all catch up. Full screen, high resolution images make it possible for her to see without her glasses. Headphones or amplified speakers will make sounds easier to hear.

Video calling   
Like the aforementioned Skype, video communication would get a lot of use here. I would much rather see her when speaking to her. And since she’s not getting on a plane to her homeland anytime soon, it’s great when technology affords her the ability to see and speak with her 78-year-old baby brother.

E-books
She loves to read, but we are exhausting all the large-print titles in the library. An e-book reader, where font size can be increased to reading comfort, would open a whole world of reading that she would otherwise find impossible. And no more late fees!

Internet access
I’m not sure about how important this is. She’s used to getting her news and weather from television. It would be interesting to see if those habits would change if she had access to information online.

Social networking
Facebook, maybe. Twitter, no. Pew found that 46 percent of those 65 and older use social networking sites, although just 27 percent of internet users over 80 access social networking sites. Many senior websites including AARP have their own online communities, however, I think my mother would be most interested in socializing with family and friends rather than joining forums, but I might be wrong.

Senior caregivers, this is where I’m starting. I know there are stand-alone computers made especially for seniors, where the keyboard buttons are big and the set-up and operation is easy and stress-free. I’m going to start my research there and see what they have to offer. Next week I will let you know if a desktop model like Telikin or portable tablet like Claris Companion fits the bill for this family.

If you have any suggestions for hardware, software, or other technology for seniors, or want to share stories of getting your senior online, please leave them in the comments.

Leeza Gibbons Invests in Senior Helpers

Leeza Gibbons is an Emmy Award winner and a longtime champion for Alzheimer's care. After losing both her mother and grandmother to Alzheimer’s disease, she began her campaign to spotlight memory disease and help families and caregivers find the tools and information they need to best support those in their care.

Now Ms. Gibbons and her husband have decided to invest in and become franchise owners of one of the nation's largest in-home senior care companies, Senior Helpers.

Choosing a senior caregiver is, as she puts it, “a delicate decision” because they become like family. There is a great deal of trust that is placed in the hands of those caring for the elderly, who are some of the most vulnerable people in our society.

“Senior Helpers provides trusted and dependable care and encouragement to seniors and families facing devastating illnesses such as Alzheimer’s and dementia,” said Leeza Gibbons on the Senior Helpers website. “This is the precise type of care I wish my family and I had when my mother and grandmother were suffering from Alzheimer’s. That is why I am proud to invest in Senior Helpers franchised business, to ensure that the best in-home care is available to support, empower and uplift seniors and their families.”

Many senior care agency owners began their careers caring for senior loved ones. Seth Zamek Owner, Senior Helpers, Fort Mill, SC and one of our Senior Home Care Agency Experts decided to start his business in senior home care after both he and his wife and were caregivers for his mother-in-law during her battle with cancer, Caregiverlist’s own founder and CEO, Julie Northcutt, owned a senior care agency prior to establishing Caregiverlist.com

“This is just an opportunity that’s getting bigger and bigger,” says Ms. Gibbons. “It’s here and we all have to get on board and figure out how to deal with it.

Ms. Gibbons is also seeking to  convert a landmark home in Lexington County, South Carolina into a caregiver assistance facility. With area philanthropist Michael Mungo, Ms. Gibbons is planning to provide a center aiding people caring for others with major diseases and wants the center to offer free services for those coping with the stress of caring for someone with chronic or terminal illness.

More information about Ms. Gibbons and her decision is in this Entrepreneur article.

Caregiver Minimum Wage, Overtime Delayed

Home care workers who were looking to receive minimum wage and overtime protection may have to wait a little longer, as the Obama administration announced Tuesday that  it would delay enforcing the rule for the nation’s two million personal-care aides, home-health aides, and certified nursing assistants.

The rule is effective as of Jan. 1, 2015, but the Labor Department won't enforce it until June 30, 2015. After that and until December 31, 2015, it will be at the discretion of the department to take action against employers who don’t show a good will effort to implement reforms. The rule states that home-care workers would have to receive the federal minimum wage of $7.25 an hour and time and a half when they work more than 40 hours a week.

Some senior home care agencies, along with Medicaid officials among others, have put pressure on the feds to delay minimum wage and overtime pay for home care workers, concerned that higher wages would translate into higher costs for the care recipient. The fear is that if home care costs increase, seniors and the disabled might be forced into institutional (nursing home) care. They also predict that smaller companies will be forced to hire workers part-time rather than full-time because of costs, in effect, causing wage loss among home caregivers.

Nonsense, say home caregiver advocates. Some states such as California and New York have already begun to implement changes, and they have the nation’s two largest Medicaid home programs. Twenty two states extend minimum wage to at least some in-home care workers, and 12 states have a minimum wage that is higher than the current federal minimum wage of $7.25 an hour.

Many home care agencies pay more than minimum wage, as well as overtime to its workers, even if it means seeing a smaller profit margin than their competitors who don’t. Those home care agencies believe that paying a higher wage results in a more professional and better trained workforce.

Home care workers have been excluded from protection since 1974, when the Department of Labor extended minimum-wage, overtime-pay to workers who perform "domestic service." At that time, caregivers for the elderly were, in the eyes of the law, providing “companionship services” and thus exempt from the wage protection — just like babysitters. Of course, as the population has aged, home care workers provide much more than simple companionship. The field has evolved to include other types of duties such as providing assistance with activities of daily living (ADLs), or instrumental activities of daily living (IADLs). These duties can include tube feeding, physical therapy, taking the correct medication and getting cleaned and dressed.

Senior caregivers are quite different from childcare workers, but the minimum wage affects both equally. Have you seen this Kristen Bell Mary Poppins parody? She doesn’t get those birds for free!


Caregiverlist believes that home care workers help the elderly age in place, at home, which is where most seniors prefer to age. We think that all senior caregivers deserve to be paid a fair living wage.

Do you have an issue you'd like to see tackled on this blog? Connect with Renata on Google+

Justice Department Launches Elder Justice Website

Elder abuse can take many forms. Caregiverlist’s own basic caregiver training helps caregivers recognize abuse and neglect, and learn the legal requirements for reporting physical, emotional, sexual and financial abuse.

Financial abuse of the elderly is a racket that takes in nearly $3 billion dollars every year and that figure rises annually. Because seniors are especially susceptible to scams and frauds, the the U.S. Department of Justice (DOJ) has recently launched the Elder Justice website.

At an outreach event earlier this week, Associate Attorney General Tony West stated, “The launch of the Elder Justice website today marks another milestone in reaching our shared goal of keeping older Americans safe from abuse and neglect.” He added, “The more we embrace our elders with respect and care, the stronger our society will be. This tool helps move us closer to that goal.”

The Elder Justice website will serve as a resource victims of elder abuse and their families, who often feel alone, embarrassed, and unsure of where to turn for help. Prosecutors, researchers, and professional practitioners who work with elder abuse will find a forum to share information and resources to fight elder abuse, scams, and financial exploitation in an effort to support older adults.

Nearly one in every 10 Americans over age 60 experience abuse and neglect, and those with dementia are at higher risk for abuse. Most (51%) of elderly fraud is perpetrated by strangers, although abuse by family, friends, and neighbors comes in second at 34%. Elder mistreatment by a known individual is especially prevalent because seniors are vulnerable and trusting in relationships with their families and caregivers.

There are two steps the DOJ along with the Department of Health and Human Services suggest communities, families, and individuals take in combating the epidemic of senior abuse:

  • Learn the signs of elder abuse. Take a look at the Red Flags of Abuse Factsheet, provided by the National Center on Elder Abuse, that lists the signs of and risk factors for abuse and neglect.
  • Report suspected abuse when you see it. Contact your local adult protective services agency. And, of course, make use of the new Elder Justice website.

Do you have an issue you'd like to see tackled on this blog? Connect with Renata on Google+

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