Guest blogger David Tews, Ed.D., Clinical Director at Soft Landing Recovery, weighs in on the recent uptick in senior drug abuse. The last time we spoke to Dr. Tews, we discussed senior binge drinking. Here, he talks about the alarming increase in drug addiction in the elderly.

Drug abuse among seniors is on the rise. According to the National Institute on Drug Abuse (NIDA), the percentage of older adults (50-59) who reported having abused illicit and prescription drugs had more than doubled, from 2.7 percent to 6.2 percent in 2011. This is the number reported, so the actual percentage is probably much higher.

Why the rise in older adult substance abuse? We have seen more patients in this category during the past year, and there are several factors influencing the increase. Many patients experience painful events during this time in their lives, both physical and emotional. Some of the patients we see have become addicted to prescription painkillers, especially narcotics such as Vicodin and Darvocet. After time, they develop a tolerance to the drugs (needing to take more for the desired effect), and when they try to cut down or stop, they experience very uncomfortable withdrawal symptoms. It suddenly occurs to them that they are addicted to painkillers.

Many elderly patients who have used prescription medication for anxiety have found themselves in a similar dilemma, needing to take more medicine for the desired effect to the point that they are taking the maximum dose without significantly reducing their symptoms. Many patients use alcohol to relieve stress and anxiety (including social anxiety), and the increased use of this drug may increase as they retire, lose loved ones, or begin socializing more in circles which include drinking as part of the social setting.

Illicit and prescription drugs have long been used to help people cope with stress, loss, grief, and anxiety. The loss of a loved one is a serious factor as the loved one may have been the patient's only source of emotional support. An older person may be less likely to seek treatment because of pride or simply not wanting to be labeled an "addict."

Many older adults have other, very legitimate, physical and mental health issues for which they are taking medication. Mixing alcohol and prescription medication could have extremely serious consequences including death. Attempting withdrawal on one's own could also have dire consequences including death. When a person feels the use of a drug, prescription or otherwise, is out of control (tolerance and withdrawal), they need to ask for help.

As the population continues to age, and the baby-boomers continue to retire, it is safe to say the number of people with substance abuse problems will continue to increase. If you or someone you know may have a problem, seek help immediately.

Resources:  

• NIDA: www.drugabuse.gov
• Soft Landing Recovery: www. Softlandingrecovery.com
• Treatment Locator: www. samhsa.gov
• Your state's Department on Aging may be able to provide you with information regarding alcohol and drub abuse treatment and prevention programs in your area.

What do you think? Have you or a loved one ever experienced an unexpected addiction? How did you (or they) cope? At what point does one decide that eliminating real, physical pain trumps the risk of addiction?

Posted By: Julie Northcutt

End-of-Life care sparks opinions and contemplation for everyone, especially for those of us working in the senior care industry who have witnessed a variety of scenarios.  Hospice care was established to help families navigate through the details and emotions of saying goodbye to a lifetime of friends and family and.....assets.  It seems that time after time it is the assets that can cause problems for everyone for many years after someone has deceased.

Following estates and how they are divided and contested makes for fascinating reading.  The dramas can be better than the best movies and even become the material for movies.  Even when everyone thinks the estate has been firmly settled and legally structured, the heirs can bust a move to contest an issue.  Remember Lady Astor?  Her son seemingly (and a court agreed) convinced her to sign a new will after her memory loss had begun.  

Huguette Clark is the most recent heiress who has some relatives wanting more money from her estate.  A reclusive copper heiress, she collected dolls and found solace in playing with dolls as an adult and lived her last 20 years at Beth Israel Medical Center in New York.  She had no children, but her distant relatives did inherit some of her money and now they are digging for more dollars, filing documents in Manhattan Surrogate court that seem to show the hospital also begged Mrs. Clark for dollars.

In one e-mail, the CEO of Beth israel joked that a Manet painting Mrs. Clark donated the hospital did not bring as much as they would have liked at auction and joked that Mrs. Clark "didn't take the bait and offer a half dozen more."  Mrs. Clark gave the hospital more than $4 million dollars and stayed at the hospital until her death at age 104, in addition to the millions she privately paid to stay at the hospital.  She also donated another $1 million in her final, contested, will.

The fact that a hospital allowed someone who perhaps was depressed, but did not need acute medical care, to remain as a patient for 20 years raises ethical questions.  Might have there been a better environment for Mrs. Clarke to live in to address her emotional needs? The fact that the hospital did keep her for so many years and continued to ask her for donations is alarming.  The New York Times reports some of the more disturbing facts, such as the hospital sending staff out to research the Clarke family in order to better understand her wealth.  Mrs. Clarke paid the hospital $1,200 a day for her room.

Sometimes it seems, doing the right thing simply because it is the right thing to do, should take precedence.  A grown woman who watches the Smurfs cartoon and plays with dolls all day probably is not in the state of mind to make donations in the millions to a hospital and to decide she should stay indefinitely in a hospital -  it does not take a degree in medicine to know that.  It takes everyone to be a watchdog for ethics, including senior caregivers.  The Inspector General's office can be one place to report senior abuse and instances of Medicare of Medicaid fraud.  It will be interesting to see how Mrs. Clark's heirs are able to gain some restitution from Beth Israel Hospital.

However, this scenario also begs the question:  where the heck were Mrs. Clarke's heirs during the 20 years she was staying at the hospital?

Research your senior care options ahead of time and plan for the costs of senior care and rehabilitation which often takes place in a nursing home.  This way, if you happen to have an uncle who was a copper baron from Montana, you may better be prepared for how to plan.  

Senior caregiving services continue to grow, as nearly 10,000 Americans turn age 65 every day and enjoy longer lives with the assistance of caregivers.  Two pioneers in senior home care services, Right at Home and Home Instead, are headquartered in Omaha, Nebraska.  The Omaha World-Herald reports today that Home Instead surpassed $1 billion in franchise-level sales in 2012 and features Caregiverlist in the report.

Caregiverlist provides the senior care industry's first and only career center for professional senior caregivers created by industry professionals, in an effort to provide high quality senior caregivers.  Currently, there is a shortage of caregivers in some areas of the country and recruiting more caring individuals to work as professional caregivers continues to be an industry initiative.

Barbara Eden, 78, donned her iconic “I Dream of Jeannie” costume for the Life Ball’s opening ceremony at the charity event in Vienna, Austria, on Saturday, May 25.

Rocking the infamous pink and red crop top and harem pants, the actress performed Jeannie’s signature move by crossing her arms, nodding her head and winking, — making her new “Master”, former president Bill Clinton, appear. Europe's biggest fundraiser for HIV and AIDS awareness included Elton John, singer Fergie and Olympic diver Greg Louganis.

Scandalous in the 60s, the costume caused a great deal of controversy with the censors due to its exposed midriff.

Before the event, Ms. Eden tweeted the following:

Here it is folks! The navel that put NBC on edge! Barbara Eden, Sat. night at the Life Ball! twitter.com/Barbara_Eden/s…

— Barbara Eden (@Barbara_Eden) May 26, 2013

In a 2012 interview with website Life After 50, Ms. Eden shared her secrets on aging well with exercise and diet.

When asked about her feelings about aging, the actress smiled and said, “My mother used to say it’s better than the alternative,” she said. “I just think we should do all we can to enjoy every day – every minute. I’m really happy to be here. I can still work, I can still spin, and I can still lift my weights. So I’m very lucky.”

"I Dream of Jeannie" ran from 1965-1970. In the series’ 139 episodes, Ms. Eden starred as the 2,000-year-old genie who falls in love with her reluctant master, astronaut Tony Nelson (played by the late Larry Hagman).

Caregivers employed with senior care companies know the realities of caregiver stress. Caregiverlist invites all family caregivers and professional caregivers to take a moment for relaxation with our photo of the week and inspirational quote. Take a moment to look into clear calm waters full of pretty waterlilies. Thank you for caring for our seniors. Remember more caregivers are needed, please refer your friends to apply for part-time and full-time job positions on Caregiverlist.com and visit our career center for additional career tools. 

"Go the extra mile, it’s never crowded."

Executive Speechwriter Newsletter

Memorial Day, like so many American holidays, has evolved to become a 3-day weekend and a time to connect with family and friends.  Older Americans, however, very often do feel the true meaning of Memorial Day as they are reminded of all the friends and family members who have passed away.  Caregivers will experience the added challenges of caring for the emotional aspects of aging which includes dealing with the loss of loved ones.

The healing process of grieving takes time and even though professional therapists counsel that grieving a loved one takes 2 years, there will always be triggers that can spur more emotional memories.  In addition, some seniors are grieving the "long goodbye" of a loved one who may be living but no longer be emotionally available because of Alzheimer's disease or Parkinson's disease.

Losing loved ones when we know they are diagnosed as terminal is actually the healthiest way to say goodbye.  But how do we help someone who is recovering from the death of a friend, spouse or family member?  

Listen and let them talk about their memories and what they miss about the person.  Allow them to cry and to laugh and to share.  Encourage them to find a way to celebrate the memories.  The ritual of visiting the cemetery to place fresh flowers on the grave markers on Memorial Day is a healthy way to celebrate the memories of a loved one.  Asian cultures make a shrine to their loved one which they keep in their homes.  They will light candles and celebrate the birthdays and holidays while remembering and honoring their deceased loved ones.

Senior caregivers can also share their own memories of loved ones who have passed on.  One caregiver who recently won a scholarship from the California Association for Health Services at Home shared the story of how caring for her grandparents who both died while in hospice care, inspired her to become a professional senior caregiver and go on to nursing school.

Everyone has a story of a loved one they have lost and still hold the memories in their hearts.  Let Memorial Day be a day to share the memories. And if you meet anyone who may be considering a career as a senior caregiver or who would like to just assist others and work part-time, refer them to a senior caregiving job.

Caregiverlist's team celebrated Nurses’ Week recently, a week recognizing the field of nursing which culminated in the birthday of Florence Nightingale.

Every nurse and Certified Nursing Assistant (and almost everyone else in the world) has heard of Florence Nightingale, who established the Florence Nightingale School of Nursing & Midwifery at Kings College London, the first official nurses’ training program, in 1860. The oldest professional nursing school in the UK, it is still in operation today. She also acted as a consultant for the John Hopkins School of Nursing, one of the first nursing institutions in the United States, in 1889.

In honor of Ms. Nightingale and nurses everywhere, I decided to take a look at Notes on Nursing: What it is, and What it is Not, by Florence Nightingale — the first nursing handbook, published in 1898 and made available free online at Project Gutenberg as an ebook and for Kindle.

At a time when two in every five children in London died before their fifth birthday and the average life-expectancy was 47 years, the book was of vital importance and was the first of its kind ever written on the fundamentals of caring for the ill. It elevated the views on nurses and nursing.

If, then, every woman must at some time or other of her life, become a nurse, i.e., have charge of somebody's health, how immense and how valuable would be the produce of her united experience if every woman would think how to nurse.

I do not pretend to teach her how, I ask her to teach herself, and for this purpose I venture to give her some hints.

The table of contents shows the following topics for advice and recommendations:

• ventilation and warming
• 
health of houses
• 
petty management (how things are done by others when you must be away)
• 
noise

• variety (environment)

• taking food
• 
what food?

• bed and bedding
• 
light

• cleanliness of rooms and walls
• 
cleanliness (personal)
• 
chattering hopes and advices (the false assurances and recommendations of family and friends to the sick)

• observation of the sick

Notes on Nursing proposed that “Of the sufferings of disease, disease not always the cause.” Pure air, pure water, light and ventilation, cleanliness and fresh bedding, all stand the test of time in their assistance with patient care and recovery. She was also one of the first to write about the power of positive thinking.

More interesting to me was the advice indicative of the Victorian age — and that no one before Ms. Nightingale had the temerity to suggest that environmental changes would affect the health and well-being of those in need of care.

She championed the call to abolish slop pails and chamber utensils without lids, sounded the alarm regarding the burning of the crinolines (referring to the large, flammable underskirts all women wore in the name of decency, which would often catch fire,) and the refusal to believe that the extent of a patient’s illness was “in God’s hands.”

Her holistic nursing approach, of course, extended to food served to the sick. Here again, some truths are universal, some selections read like curiosities. Food like beef tea (clear soup?), homemade bread — good. Eggs whipped with wine? Not so much.

Because of its historical importance and ready availability, I urge you to read it yourself. Then let us know in the comments: Is this best considered an interesting read, or do you feel, as Joan Quixley, then head of the Nightingale School of Nursing wrote in her introduction to the 1974 edition, "the book astonishes one with its relevance to modern attitudes and skills in nursing, whether this be practised at home by the 'ordinary woman', in hospital or in the community. The social, economic and professional differences of the nineteenth and twentieth centuries in no way hinder the young student or pupil from developing, if he or she is motivated to do so, its unchanged fundamentals by way of intelligent thought and practice."?

One thing is true, then as now — caregiving is a noble calling. If you are considering it as a career choice, or if you are looking to increase your skillset, visit our Caregiver Career Center to get your caregiver certification training, build a resume, or apply for a caregiver job.

New technology continues to change our lives. Today almost everyone has a smartphone or knows someone who does. And now, technology will soon remind us when to take our medicines as well as eliminating lapses between refills, as missed pills and improper doses is one of the major causes of more health complications. To solve this problem, advances in medicine can eliminate harmful side effects that come with people misusing their medication. Digital drugs and digital bottles are expected to hit the market in 2014 or early 2015.

Pills with sensors, the size of a grain of sand, are in the process of development by Proteus Digital Health.  The sensor in the pill track who is taking the medicine.  The data transfers to a one-use strip worn on the taker’s skin and then sent to a mobile application.  At the user’s consent, their caregiver, doctor or family can access this information.

Seniors are a target market for the pills designed by Proteus Digital Health, notes chief executive Andrew Thompson.  Because older patients take multiple medications, these technologically advanced pills can help seniors stay organized and on schedule and avoid serious health consequences.

Digital medicine is the up and coming technology that will help caregivers juggle all their other tasks at hand.  With this help, no confusion will face the caregiver whether or not their senior has taken their medication.  For those that may be concerned about a digitalized pill, there are other options that help caregivers and seniors with notifications via bottle.

Medicine bottles that glow different colors have been created by AdhereTech Inc. When it’s time to take a dose, the bottle glows blue. When the user has missed a dose, the bottle glows red.  The company’s server can also remind the consumer via text.

Medication past the expiration date can be clearly indicated by bottles generated by the product-design firm IDEO.  When the pills are expired, the bottle starts to spot like an overripe banana.  This idea is still in the concept stage, but will surely help people know their medication is no longer safe to take.

Nursing homes can also take notice to all these developments in medicine. With aid by technology, nursing homes and assisted living staff members can easily keep track of who took their medication and whose medication has expired.  For those who are seeking assistance in nursing homes, Caregiverlist.com has a database of over 18,000 nursing homes with options to filter by Caregiverlist’s Star Rating system. Finding the right nursing home for your loved one can be made efficiently and very quickly.

-Kristin Kruk

A senior caregiver writes to us, "My CNA license has expired. Do I need to take a refresher class?" Another asks, "If I move to another state after completing school, will I have to retake my exams?”

Our Home Care Expert, Lewis Myers responds, “The answer to this question varies state by state. Generally , the CNA should never let their license expire. In the state of Maryland, the CNA would need to re-take the course and become re-licensed.”

If you need to renew your Certified Nursing Assistant license, or if you are looking to transfer your license to another state, Caregiverlist has put together information about Certified Nursing Aide (C.N.A.) License and Certification Transfer, but here’s a brief overview:

As a CNA, you are a medical professional. Therefore, your license must be up-to-date in order to practice. First, check your CNA Registry Status from the state in which you live.

Get to know your state’s Board of Nursing. You will want to obtain your state’s CNA application form. Each state has different requirements for renewing your CNA license. If it’s been a long time since you’ve worked, you may need to retake your CNA training. Take a Certified Nursing Aide sample test to make sure you are ready.

If your license is active and you are in good standing, once again contact your state’s Board of Nursing to see if the state to which your are moving has a “Reciprocity Agreement” with your current state. Many do. This would allow you to transfer your license without retaking the exam. You will still need to supply:

    •    social security number
    •    driver’s license
    •    present C.N.A or C.H.H.A. state approval
    •    most recent employment details
    •    educational proofs
    •    background check


If the states do not have reciprocity agreements, then you will have to take your destination state’s licensing practical and theoretical exam. Get in touch with your new state’s Nursing Aide Registry to get the most up-to-date information.

Being a CNA is a great career move. The need for qualified CNAs is on the rise nationally, as you can see by our Senior Care Employment Infographic. Make sure you can move to where the work is by following all the steps necessary to transfer your CNA license to make the most of the senior caregiver employment landscape.

Caregiver background checks are the first step in the caregiver hiring process.  But there is much confusion about the types of background checks and the information that is actually included.  The federal government passed legislation to guide employers on background checks as it is important to give criminals a second chance. The legislatures decided 7 years is the amount of time that should pass to have a clean slate and this requirement is part of a law called the FCRA (Fair Credit Reporting Act).

States, however, can pass their own laws governing background checks for employment.  These state background check laws will trump the federal law (over-ride it).  Some states allow looking back for more than 7 years if an employee will be working with a senior or a child.

Senior caregiver employers must follow the state background check requirements in their state and caregiver job applicants should also be aware of these requirements which you can find in Caregiverlist's Background Check Laws "By-State" section.  Caregivers may also want to purchase their own background check prior to applying to a professional senior care job to verify all of the information.  As a digital life is a reality now, identity theft and fraud have grown at a high rate and it is important to learn to check your information at least annually to be sure there is no inappropriate information attached to your name.  You should also be sure to only purchase a quality caregiver background check.

Minnesota senior caregiver employers now must follow a new law which Governor Mark Dayton just signed into law, nicknamed "Ban the Box".  This law prohibits employers from inquiring about a job applicant's criminal history or conducting a background check until the applicant has been granted an interview or job offer.  This new Minnesota law also requires removing the question of criminal convictions or arrests on initial job applications.  However, senior caregiver employers can still inform applicants that a criminal history could be a disqualifying factor for a particular job.

Minnesota first passed the "ban the box" law in 2009, applying only to public employers (state and local governments).  Minnesota Senate File 523 expands the law to include private employers and takes effect January 1, 2014.

Employers exempt from the law are those serving vulnerable populations and those employers who are not permitted to hire people with a criminal history.  The Minnesota Department of Human Rights is responsible for enforcing the law and employers will be assessed up to $500 per violation.

Caregivers for senior home care agencies, assisted living communities and nursing homes receive all benefits for employees, as required by law, including unemployment insurance, worker's compensation insurance and healthcare benefits. In order to offer these benefits, companies must hire caregivers who are legal to work and who pass criminal background checks.  Purchase a caregiver background check and apply to a senior caregiver job in your area.  You may also learn about caregiver job descriptions and requirements as more people are needed in the senior care field as the number of seniors in America continues to increase rapidly.