Labor Day and the Home Caregiver

Senior care workers are on my mind as Labor Day approaches. I am reminded of the innumerable home caregivers and the protective legislation challenges they face.

2011 is known as the first year of the “age wave”, in which every eight seconds, an American will turn 65. And while an emphasis on aging well—keeping our brains and bodies fit—can help forestall the inevitable, there is no denying that that home care is one of our nation’s fastest growing industries.

Senior caregivers provide the essential care that allows seniors to age in place by providing aid and assistance in their own homes. Very broad U.S. Department of Labor regulations have ensured that home care workers are excluded from basic minimum wage and overtime protections. Exempt “companionship” services have morphed into the wholesale exclusion of workers in the home care industry.

The Direct Care Job Quality Improvement Act – a bill that would help create a “more stable, valued direct care workforce” was introduced to Congress on June 23, 2011 and would amend the Fair Labor Standards Act (FLSA) to include basic labor protections for home care workers.

Regulation revision suggests two significant reforms: (1) it should provide that workers employed by a home care agency or other intermediary are not exempt; and (2) it should narrow the definition of “companionship” and exclude workers who perform other types of duties such as providing assistance with activities of daily living (ADLs), or instrumental activities of daily living (IADLs).

This legislation takes major steps towards ensuring the “health, autonomy and well-being of more than 13 million Americans with long-term care needs today and an estimated 27 million by 2050”.

Labor Day, the national holiday observed on the first Monday of September, was first proposed by the Central Labor Union in 1882 to celebrate "the strength and esprit de corps of the trade and labor organizations" of the community and was intended as a workingman’s holiday. At that time, the industrialized workforce demanded “Eight Hours for Work, Eight Hours for Rest, Eight Hours for Recreation.” There are agencies and alliances who are now working toward the same for a growing labor force—the home health care industry.

Learn more about these national initiatives: National Domestic Workers Alliance and their Domestic Workers Bill of Rights, Caring Across Generations: a campaign to “transform long-term care in the United States, those who rely on the support of caregivers to meet their basic daily needs, the workers who provide the support, and the families who struggle to find and afford quality care for their family members.” The National Employment Law Project (NELP): Fair Pay for Home Care Workers: Reforming the U.S. Department of Labor’s Companionship Regulations Under the Fair Labor Standards Act are a few.

If you are a home caregiver and want to increase your viability and skill set, consider Caregiverlist’s 10-hour online certification training. Upon completion you receive a certificate and your name is added to the database registry of training certified caregivers. Elevate your skills. You are invaluable. Training can be your first step to a fulfilling career and your inclusion in a growing labor movement.

And from Caregiverlist, happy end of summer!

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Caregiver Award Nominations ($20,000 Award) Accepted Through Sept. 16, 2011

Senior caregiving brings constant challenges and the Rosalinde and Arthur Gilbert Foundation present the Innovation Awards to recognize excellence in Alzheimer's disease care and caregiver support in 3 categories:

  1. Creative Expression
  2. Diverse & Multicultural Communities
  3. Policy & Advocacy

The amount of each award is $20,000 and the application process is managed by the Family Caregiver Alliance.  The awards are given to exceptional senior caregiving programs for each of these areas.

You may find the award applications here:

Deadline for the Caregiving Gilbert awards are September 16, 2011.  You may learn more about Caregiverlist's senior care services by state to find quality caregiving programs near you.

Hurricane, Earthquakes Prompt Renewed Concern for Elderly

Hurricanes, Earthquakes and Senior Care

When a magnitude 5.9 earthquake shook the East Coast on August 23, my thoughts immediately went to my elderly aunt living alone in Manhattan. A lifelong denizen, she refuses to leave the island. You know the type—she declined to leave even after the September 11 attacks. I imagined buildings shaking around her, and although this episode wasn’t nearly as bad as it was in my imagination, I wondered how she would fare had it been worse.

I remember the plight of the elderly when Japan suffered its July 2007 earthquake. All of the 10 people killed were older than 65.

Life expectancy, according to the U.S. census, is projected to increase from 76 years in 1993 to 82 years in 2050. We’ve seen a dramatically greater rate of growth in the most vulnerable elderly population.  Over the last decade, the number of elderly (age 65+) with mobility limitations grew by 40 percent. The oldest old (persons 85 years old and over) is the fastest growing segment of the elderly population.

Disasters, natural and otherwise, make the challenges of an aging society become very apparent. I decided it was important to create a family “disaster” plan.

According to the American Red Cross, “forty-five states and territories in the United States are at moderate to very high risk of earthquakes, and they are located in every region of the country.” They post an Earthquake Safety Checklist. Go over it with your family members, especially your seniors living alone.

Make sure they know the safest place in their home for each type of emergency. Speak to your elderly family’s neighbors—perhaps someone would be willing to help them evacuate if necessary. If they need special foods or medications, be sure to have them store several days’ worth. Make sure they know to contact you to let you know that they are safe.

Post-disaster, seniors especially can fall prey to scam artists looking to take advantage of the misfortunes of others. Look for legitimate assistance for services through your family member’s State Agency on Aging.

And if you live a distance away from your senior loved one, you might consider hiring a Home Care Agency so that someone is nearby, knows your loved one, and is ready to help.

Many elderly need assistance even in normal times. In a disaster, they can become absolutely helpless. You can help by preparing them and yourself.

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Tennessee Basketball Coach Pat Summitt Diagnosed with Alzheimer's Disease

Basetball coach Pat Summitt, age 59, has lead the Tennessee women's basketball team to 8 national titles and has won more games than any major-college basketball coach.  She paved the way for women's basketball at the college level, starting her coaching career before the women's game was played in a national championship and before scholarships were given to women players.  She announces she has early-onset Alzheimer's diseae at age 59, bringing visibility to the challenges the disease presents as she also announced she will continue to coach as long as she is able. 

"Obviously, I realize I may have some limitations with this condition since there will be some good days and some bad days, she said in a video statement.  There is no cure for Alzheimer's disease.  Summitt began showing symptoms last season, when she would forget when meetings were scheduled and blanked out during games.  Now she has answers and by managing the disease's progression can also better manage the symptoms.

Alzheimer's disease progresses at different rates with each person.  More than 35 million people worldwide suffer from the disease.  Early detention definitely helps the senior as well as their family members better prepare for the emotional aspects of the disease which is often called "the long goodbye".

Find resources for Alzheimer's disease to be able to identify early signs.  You may also review caregiver training to assist with caring for those with memory loss, as these skills greatly benefit both the caregiver and the senior. 





Finding Professional Caregiver Training

Finding professional caregiver training can be a challenge.  Certified Nursing Aide training requires admission to a C.N.A. school and a couple month's course work which will include field in-service training (student will work at a hospital or nursing home).

As senior caregivers often have a wide range of schedules which may incorporate early mornings and evenings, finding a training program that they can attend can be a challenge.

Professional senior caregivers may now secure a certification training online, which meets the training requirements created by the department of health in a few states who now require licensed senior home care agencies to provide a minimum amount of training for caregivers.

Caregiverlist's 10-hour online training allows caregivers to take the courses at their own speed, reading and learning each training module and then taking the quiz.  Upon completion at  a pass rate of 80%, a certificate is granted and the caregiver's name is added to the certified caregiver database.  The caregiver certification, provided by aQuire Training, a leader in providing department of health approved certified nursing aide, caregiver and assisted living CEU training, provides a formal training program for senior caregivers.

Many caregiving jobs do not require professional caregiving experience but senior home care agencies do train caregivers to provide quality care, by understanding age-related diseases and the emotional issues, elder-abuse signs and professionally documenting care needs.



NAHC Annual Meeting 2011: Caregiverlist Presents

National Association for Home Care and Hospice (NAHC) provides educational and operational resources for home health care and hospice agencies nationwide.  As Medicare does pay for home health care and hospice services for seniors who qualify, the NAHC also has a lobby advocating for Medicare legislation in Washington, D.C.

NAHC's 30th annual meeting will be in Las Vegas at the Mandalay Bay Resort & Casino.  Caregiverlist CEO Julie Northcutt will present on sales, recruitment and training tools for the home health and hospice agencies on October 4th.

Senior home health care and hospice professionals may register for the meeting at the NAHC’s Meeting website.


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Get Respite Help When Caring for an Elderly Parent

Family caregiving is growing in the United States.

According to a recent Gallup poll, 7 out of 10 working Americans say they are actively caring for an elderly parent over the age of 75. An average of 13 days per month is spent on errands and day-to-day chores such as doing laundry, going shopping, and providing transportation. And a typical day finds caregivers dedicating a whopping 5 hours (that’s per-day!) on basic supervision and companionship.

All this help takes its toll in stress and strain for the caregiver. Caregiver burnout is certainly a great concern.

Just as parents of children are encouraged to hire babysitters to get out of the house for an evening, the same is suggested for those caring for senior family members. But how does one find skillful respite care? We suggest utilizing a quality home care agency for your family’s intermittent care needs.

The best home care agencies will evaluate your family’s requirements and provide an appropriate level of care. This can range anywhere from simple companionship and homemaking help to nursing care, such as administrating medication, dressing and bathing. A quality agency will also do the vetting of respite caregivers by way of a thorough criminal background check. A senior home care agency, as an employer of the caregiver, will take care of all the payroll taxes as required by law. And an agency’s Worker’s Compensation Insurance will cover any on-the-job injuries, should the need arise.

The role of senior family caregiver is a challenging one and, although it can provide a great deal of personal satisfaction, it can be overwhelming. Although it may cause some feelings of guilt or anxiety, the family caregiver should seek out help for their own well-being.

If you find yourself in the position of caring for an aging parent, you can begin your family’s needs evaluation with Caregiverlist’s Checklist: Choosing a Home Care Agency to see how you can give yourself a much-needed and well-deserved break by bringing in some respite assistance.

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Starbucks CEO Brought Healthcare to Minimum Wage Employees and Now Asks for Your Voice to be Heard

Starbuck's founder and CEO Howard Schultz has always been an innovator.  I read his first book called Pour Your Heart Into It:  How Starbucks Built a Company One Cup at a Time and then decided I would be an advocate for health insurance for senior caregivers.  Many senior home care agencies do not provide health insurance benefits for caregivers.

This seems rather astonishing, right?  The caregiver providing senior caregiving does not receive health insurance for their own care needs.  But the reason is actually justified, to an extent, because of the way the current health care system works in the U.S.A.  Some senior home care agencies simply cannot find a health insurance plan to provide benefits for them as a small business.  Most people who have always worked for large corporations and always had health insurance as a company benefit don't realize that health insurance plans do not want to provide benefits for part-time workers and that they require 75% of the employees to participate in order to provide a health insurance plan.  Large companies will have employees who are young and single as well as older workers and will be able to more easily spread out the risk as well as garner enough health plan participation as the majority of their employees are full-time.

Senior care presents unique challenges for health insurance benefits.  Most senior caregivers are women.  Many work part-time.  This makes them a class of employees which is considered to be high-risk by health insurance companies because women of child-bearing age cost more to insure and because health insurance companies don't like the additional costs of paperwork for insuring part-time workers, who usually are shorter term employees, in company group health plans.  In addition, if a woman is already opting-in on her husband's health insurance plan, she won't want to participate in her senior care company's health insurance plan which makes it more difficult for the senior care company to reach the 75% employee participation rate requirement.

While some people are complaining about the current health care legislation that was passed, it is important to remember that it is very difficult to find affordable group health insurance plans for small businesses, to qualify for a group health insurance plan as a small business and it is also tough for individuals to be insured if they have pre-existing conditions.

This is why change in the current health care benefits are needed and while the current legislation is far from perfect, it is a start in the right direction.  Having health insurance exchanges is cool because that does bring competition to the mix and will result in preventive care.  Senior caregivers and medical doctors will tell you that many of their senior clients would not be in the poor health conditions they are in if they ate properly and exercised. Right now their is no incentive for preventive health care.  And having access to health insurance for all is also much needed and very much welcomed because many who want health insurance simply don't have access to it right now, including some senior caregivers.

Now back to Howard Schultz, Starbuck's CEO.  When I owned a senior home care agency, after reading his book and learning that his family struggled with poverty as he grew up, simply because his Dad did not have health insurance benefits through an employer, I very much wanted to be able to provide health insurance for my senior home care agency's caregivers.  Howard Schultz made it his mission to make sure all Starbuck's employees had health insurance and I figured if he could find a way to do it, so could I.  Even though the Starbuck's employee pay was only around $8.00 and change for coffee baristas, when Starbuck's started out, he still made sure they received health insurance benefits.  Caregivers were paid more than this and there had to be a way to find a health insurance plan for the company.

I now realize how huge it was for Starbucks to offer health insurance as a benefit to all employees after finding out how difficult it is to find group health insurance for a small business with high-turnover in employees (seniors will get better or die and no longer need care so high turnover is a given and as high as 50% or more for the senior care industry) and with part-time employees.  I finally found a health insurance company that insured lots of restaurants and was experienced with part-timers and high turnover and basically would not audit the senior care agency for 75% participation rate in order for the senior care agency to qualify for the plan.  Opting-in for health insurance then became a benefit for Chicagoland Caregiver's caregiver employees.  But we were a rare senior care company in offering health insurance to caregivers.  Now I knew why.

Senior caregivers should have health insurance.  The job is demanding both physically and emotionally and there is also a great benefit in preventive health care.  Companies with health insurance can often receive discounted rates if they provide exercise programs, encourage walking on lunch breaks and provide educational clinics about healthy diets and exercises.  This makes life better for everyone.

A geriatric medical doctor once told me that I would be shocked if I knew how many seniors do not have health insurance until they retire and go onto Medicare or Medicaid.  He said imagine the health savings we would experience in Medicare and Medicaid if seniors would have had proper medical care their entire lives. 

Starbucks has stayed the course with providing health insurance, even when major shareholders complained about the costs.

We seem to forget that anyone can walk into the emergency room at a hospital and be treated, even if they can't pay for the care.  Everyone who has health insurance, who in the U.S.A. is mostly those individuals who are insured through their companies, is paying for this luxury of emergency room service through higher insurance premiums and health care costs.  There has to be a better way.  And we have to wonder how many people use the emergency room bandaid simply because they have no other access to health care.

Caring for caregivers should include health insurance benefits along with worker's compensation insurance benefits and all payroll taxes which include social security and unemployment insurance.  This way the caregiver will be able to collect unemployment benefits while they are looking for a new job if the senior passes away and they also have protection with worker's compensation insurance if they are injured on the job, which does happen.  Caregiverlist advocates for quality senior care and provides information on what to look for when hiring a senior home care agency, including meeting the licensing requirements in the state.  In addition, Caregiverlist provides a 10-hour online caregiver training course for senior caregivers which arms caregivers with information on how to manage the care safely and effectively.

Howard Schultz knew that his family was unable to live above poverty because they did not have health insurance to pay for his father's health care.  Starbucks spends $300 million per year on health insurance benefits for employees.  The company believes everyone shares in the success of the company and taking good care of your employees means they will take good care of your customers.  Senior caregivers deserve to be well taken care of by their employers too.

Schultz now is asking Americans to let their voices be heard to move legislation forward that does not just include the special interests.  Only around 41% of Americans who are eligible to vote did vote in the last mid-term elections. 

No matter what side of the table you are on, Schultz is right in that it is time to let your voice be heard in order for innovation to take place.  The deficit can be changed by slashing waste (there has been $6 billion in fraud in Medicare and Medicaid alone) and by adding taxes for those who haven't been paying.

Read and learn and let your voice be heard.  Don't just listen to the sassy tweets and sound bites which often leave out the real meat of the information.  Here is one of America's wealthiest individuals, Warren Buffett, asking the government to start taxing the rich more fairly.  He shares that he paid just 17% of his taxable income while his employees paid from 33% to 41% of their taxable income.  Remembering that there are usually hard-working employees behind anyone who is truly rich, it makes sense to ask them to pitch in and pay their share of taxes so that they can keep the government running smoothly for their employees so they can keep working hard and making them rich.

Send an e-mail to your Senator or Congressman and let your voice be heard.  You can find out the e-mail addresses of Congressman and Senators nationwide in this online Congressional directory.

It is always nice to see someone with the success of Howard Schultz make a move to bring his leadership to other areas that are in need and perhaps with more voices being heard, innovation can begin to happen in the U.S. government too.  You may read about Schultz's email to Starbuck's employees here and how he is asking our elected officials to act like leaders.

As an advocate for quality senior care, Caregiverlist provides the premiere service connecting seniors and professional caregivers with the most reliable eldercare options, highest quality ratings and outstanding careers nationwide - find the daily costs of nursing homes in your area and apply for a caregiving job and share your caregiving concerns with a community of caregivers.








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Military Healthcare Tricare Provides Respite Care for Caregivers

Caregivers for military personnel are often long-term, caring for ill or wounded soldiers or service men and women.  Tricare, the health insurance program for active-duty and retired members of the military, now offers a respite care benefit for those who are wounded or ill during active duty.  If the injury has resulted in a physical disability or a challenging physical or psychological condition so severe that the active duty service members is left homebound, short-term care is available.

Caregiving can be stressful both emotionally and physically.  The military member's case manager, military medical support office or military treatment facility may approve respite care when the care plan includes frequent primary caregiver interventions which means more than two during the eight-hour period each day that the primary caregiver would normally be sleeping.

Respite care benefits are limited to:

  • Up to 40 respite hours in a calendar week
  • No more than 5 days per calendar week
  • No more than 8 hours per calendar day

To Qualify for Tricare Respite Care:

  • Must be Active Duty Service Member
  • Have Serious Injury or Illness Resulting in Physical Disability or Extraordinary Physical or Psychological Conditions
  • Have Care Plan Including Frequent Primary Caregiver Interventions

Respite care must be provided by a Tricare-authorized Home Health Agency (HHA). You can contact your regional health care contractor or Tricare Area Office for assistance finding an authorized HHA.

Authorized respite care does not cover care for family members or others who may reside with or visit you. To learn more about the respite care benefit, go to TRICARE’s website.

Reservists and National Guardsmen who are serving on active duty have the same medical benefits as regular military personnel.  As reservists have had a larger role in combat operations overseas, Congress has broadened their medical benefits.

Home Health Agencies who want to provide respite care for military personnel can apply to be a Tricare home Health Agency using the application for their Tricare region.

Caring individuals interested in becoming a senior caregiver can learn about the caregiver job description, access online caregiver training and apply for a caregiving job in their area.


Rise of the Planet of the Apes Film Spotlights Alzheimer's Disease

Rise of the Planet of the Apes has critics divided in their reviews. For me, more honestly disturbing than the images of an ape overthrow is the movie’s depiction of the ravages of Alzheimer’s disease.

John Lithgow gives a moving performance as genetic scientist Will Rodman’s afflicted father. James Franco is at his most real when interacting with Lithgow—portraying a son’s desperate attempts to return his father to the man he once was, and the painful realization that he cannot. Says Franco of his character, “His father Charles is suffering from dementia so he moves into his father’s house, which was once Will’s childhood home, to take care of him. Being a caregiver is a role Will has never had to perform before.” The film truthfully conveys the immense frustration experienced by both patient and caregiver.

Of course, the movie also gives us villainous Gen-Sys, a large pharmaceutical corporation that’s more interested in turning profit than developing a cure.

Perhaps the proactive movement toward Alzheimer’s and dementia prevention is prescient. While researchers continue to “race toward the cure” (with better results than the movie’s, one hopes,) there is a growing focus on risk reduction and brain protection.

Guest blogger and Geriatric Care Manager Charlotte Bishop neatly summarizes University of California, San Francisco’s report on possible Alzheimer’s reduction in her latest blog Preventing Alzheimer’s Disease?  Proponents say that by leading a brain-healthy lifestyle, you may even be able to prevent the symptoms of Alzheimer’s disease.

I hope this movie helps bring Alzheimer’s and dementia into the popular discussion. Charlton Heston, star of the first Planet of the Apes movie, himself suffered symptoms of the disease. And although Lithgow’s depiction is heart-rending, it cannot truly impart the relentless daily battle faced by those affected.

Caregiverlist has partnered with Terra Nova Films to provide training videos to support caring for seniors with memory loss, including Alzheimer's Disease.

Until a real cure is found, prevention and successful caregiving are the most effective tools we can use.

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