Obama's Grandmother Passes

Regardless of your political choice for president, you can share in the sadness of Barack Obama's Grandmother passing away just a day before the election.  Madelyn Payne Dunham, 86, died peacefully in her Honolulu home on Sunday night, after battling cancer.  She chose to stay at home with care provided by a caregiver.

Hospice training teaches that emotionally, it is easier to go through the process of grieving when you are able to plan for the death and say goodbye ahead of time.  Barack learned this, he said, when he did not make it to his Mother's side before she passed away.  As he did not want that to happen again, he took time off from his historic campaign to visit his Grandmother a couple of weeks ago.

Still, death of a loved one is never convenient or easy, even with knowing ahead of time.  While visiting France one summer, I went to dinner at a small country restaurant.  The owners were a married couple who made the rounds to all the tables to chat with their guests.  Upon learning that I worked in senior care, they told me to be sure to visit the bathroom before I left.  There was a mural painted on the bathroom wall that included the 17th Century Nun's Prayer.  I later had my Mother write it in calligraphy and framed it for my Senior Care Agency's office wall.  Many caregivers who passed through the doors asked about it and requested a copy and now it is included as a resource on Caregiverlist.


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Free Memory Screenings at more than 2,000 locations

My Mother thinks that I am always keeping tabs on her memory. After working in senior care, I have seen first hand that early detection of memory loss can make a positive difference.  I have seen senior's memories improve after starting medications and developing a regular routine with a caregiver to guide them.  I have also witnessed the agony that memory loss can cause for the senior and their loved ones, especially when proper diagnosis of the type of dementia occurs too late.

It greatly helps family relationships when everyone understands what is happening when the memory loss first begins.  Sometimes during a conversation, my Mom will inform my Dad that I am really quizzing him on his memory.  My father has a better memory than I do and so far so good with Mom.  Her father suffered from memory loss, which was never formerly diagnosed as Alzheimer's Disease, although now, looking back, we are all sure that it was.  The early diagnosis and tests were not widely performed 20 years ago.  I remember that my Grandfather would "read" the Wall Street Journal upside down,- which actually might not be a bad idea with the recent market turmoil -a different view might be nice.  But that was just one example of some of the ongoing confusion he experienced.

On November 18th, the Alzheimer's Foundation of America (AFA) will offer free memory screenings at more than 2,000 local sites across the country as part of its 6th annual National Memory Screening Day.

This annual initiative is aimed at promoting early detection of memory problems and appropriate intervention.
The AFA encourages adults with memory concerns, a family history of Alzheimer's disease or a desire to establish a baseline score for future comparison to get screened and to pick up educational materials about memory concerns, successful aging and local resources.
Alzheimer's disease is now the sixth leading cause of death in the United States.
The face-to-face screening takes approximately five minutes and consists of a series of questions and tasks. Sites, spanning all 50 states, include the entire chain of Kmart pharmacies, senior centers, houses of worship, assisted living facilities and doctor's offices.
The results do not represent a diagnosis, and screeners encourage those with abnormal scores as well as those who still have concerns to pursue a full medical exam.
How are they able to pay for this?  The drug companies are sponsors - so another good reason to take advantage of the free memory screening since you are sort of paying for it anyway through your medication purchases.
If you are a caregiver for a senior, find out if there is a location in your area.
For information about National Memory Screening Day, including screening sites, visit http://www.nationalmemoryscreening.org or call 866-AFA-8484. 
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Advantages of a Senior Home Care Agency

Seniors needing additional care services provided by a Caregiver have the option of hiring a Senior Home Care agency to professionally provide the services or of finding a direct-hire Caregiver.

Caregiverlist.com only connects seniors with services provided by professional Senior Home Care Agencies.  This is because these senior care agencies meet the legal guidelines established in their states for providing senior home care and also meet Caregiverlist's quality standards.

Although it might seem like a cheaper option to go out and find a caregiver to provide the senior care services on your own, it rarely turns out to be the case once care begins.  When I owned a senior home care agency, over and over again we would begin care services for a client who first hired a caregiver on their own who did not work out because they either were not trained properly to provide the care, became burned out without management to vent to, started to charge the client for any services they deemed as "extra" from going to the grocery store to their travel time to get to the senior's house.  This is because senior care is very different from child care.  There is not a Mother and Father there at the beginning and end of each day to supervise the care needs and keep the checks and balances in place.   Seniors also are dealing with many emotions as they are accepting age-related illnesses, the deaths of friends and constant change.  Because of this, senior caregiving presents challenging days for a caregiver which can take an emotional toll.  Seniors may be resistant to care, too, even though they know the care is needed.  This resistance along with memory loss and emotional challenges all present the need for customized training and case management support.  I have seen situations where even wonderful caregivers can begin to take advantage of the situation when they do not have professional supervision and support.  Some seniors are difficult to care for - they may be unhappy, angry, pinching pennies and they then will take out all of their frustrations on the caregiver.  A professional senior home care agency knows how to step-in and professionally mange the care and the caregiver.  Agencies also have experience in understanding the best approach for each senior.

The senior home care agency fee will also take care of all payroll taxes, as required by law, and insurance coverages which will not be present in a hire-direct situation.

The news stories that you see about caregiver theft are not about caregivers working for senior home care agencies.  Senior home care agencies have proper systems in place to prevent theft and insurance coverage which requires them to implement policies and procedures for added protection.  A caregiver would never have access to a senior's bank account information nor the power to make purchases with the client's money.  A Supervisor would set-up systems for these purchases to be made by the home care agency and then billed to the client.

On Friday, the news media reported on a recent caregiver theft of $304,000 from a senior's estate - another hire-direct caregiver situation.  The Caregiver, Marilyn Fenderson, withdrew $304,000 from accounts the senior had intended to be for donations to three nonprofit groups in Sonoma County.  This caregiver was given power-of-attorney, another mistake which a senior home care agency would prevent.  Unfortunately, there are individuals who seek the hire-direct caregiving jobs in order to take advantage of these opportunities for theft.

Background checks come in many flavors.  It is good protocol to understand the various levels of background checks.  Run fast from a website that says they are providing "free" background checks as rarely will a free check absorb the cost of a multi-state criminal background check matching every past address of the applicant, along with name and social security number verification for past addresses.  Senior Home Care Agencies understand how to do background checks and screening which will go beyond the background check (if someone was given community service for a crime, which is very common for the first couple of offenses, it most likely will not show on their record)  and how to hire quality caregivers who will both provide care and protect a senior from anyone who would not have the senior's best interest in mind.  Caregiverlist also connects individuals seeking to work as caregivers with hiring senior home care agencies and other senior care companies in their area and explains all the necessary skills and requirements for working as a senior caregiver.

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Caregiving as a Career

As the financial crisis in the U.S. continues to unravel and we experience an increase in unemployment, it is relevant to note the ongoing shortage of qualified caregivers in many cities across the U.S.

If you are transitioning in the job market, or looking for fulfilling part-time work, you may want to consider working as a senior caregiver.

Senior Home Care Agencies, Assisted Living Communities and Nursing Homes hire part-time and full-time caregivers to assist seniors with Activities of Daily Living.  Many Senior Home Care Agencies also hire 24-hour "live-in" caregivers.  Live-in means the caregiver stays with the senior for a few days at a time, preparing meals and eating with the client, and sleeping over night but they do not actually permanently live with the senior client.  A minimum of two caregivers will staff a live-in client, rotating days during the week to meet employment law requirements. 

What experience is required?  Companion caregivers, Certified Nursing Aides and Home Health Aides are hired as Caregivers.  Some of the best professional caregivers gained personal experience first by caring for a family member or friend.  Many Senior Home Care Agencies provide caregiver training on senior care.  Caregiver training may include specialty training for stroke care, dementia care, hospice care and education on age-related diseases.

Certification as a Nursing Aide can be obtained from nursing schools or community colleges.  Sometimes social service agencies and health care companies sponsor certification programs.  The nursing aide certification requirements vary in each state.  Most nursing aide certification classes can be completed  in  6 to 12 weeks.

Caregivers earn from $8.00 to $14.00 per hour and from $90 to $140 per day for live-in care,  depending on the geographic location. The hiring company provides for payroll taxes and Worker's Compensation insurance and other benefits

Senior care delivers fulfillment beyond a paycheck.  If you enjoyed visiting your Grandparents and appreciate the wisdom an older adult can share, you will probably enjoy working as a caregiver.  A caring personality, patience and dependability are qualities which senior care companies look for in caregivers.  Caregiver job applicants will also be required to pass a criminal background check.

If you are interested in working as a caregiver, contact your local Department on Aging for names of local companies which may be hiring or fill out a Caregiver Job Application on Caregiverlist.  You may also want to look into volunteer opportunities through local churches and senior centers to gain experience.




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Social Security Benefits: Not Enough to Pay for Medications

Sunday's Chicago Tribune profiled 5 senior citizens and how they are paying for their living and medical expenses on Social Security and Medicare or Medicaid.

How much money will you receive each month on Social Security?

The maximum Social Security benefits in 2008, for seniors who have reached the maximum taxable earnings is:

$1,682 per month if retiring at age 62

$2,030 per month if retiring at age 65

$2,794 per month if retiring at age 70

Let's assume your home is paid for and that you have limited expenses.  This amount probably seems adequate but the challenges arise when a senior has additional medical expenses and caregiving needs.  Medications are not completely covered by Medicare and can be rather expensive. 

One of the senior couples profiled by the Tribune were earning $3,000 per month in retirement income.  But when the husband was diagnosed with pancreatic cancer, the co-pays for medical visits and the costs of medications quickly amounted to more than their monthly income.  Fortunately the wife is able to serve as his Caregiver for free.  Another senior profiled lives on $800 per month from Social Security and another receives $998.  Unfortunately, when on a limited income, medications are typically the item the senior will do without as they will choose to pay their rent and buy food first.

A couple of these seniors found additional assistance through churches and social service agencies to help pay for their expenses.  There was no extra money to pay for Caregiving services, which also are not covered by Medicare. 

Regardless of who wins the upcoming election, I hope they will look at the need for affordable medications for seniors of all income levels.  It seems Barack Obama is a fan of affordable medical care for everyone, understanding the challenges his Mother experienced when she was diagnosed with cancer.  AARP supports more issues supported by Barack,and you can read more on their Voter Guide.  John McCain is a senior so should understand well the need for affordable medications.  This recent New Yorker article profiles Cindy McCain and her experiences with prescription medications.



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New Federal Exercise Guidelines

Today the U.S. Government released guidelines for physical activities that offer health benefits to Americans, including seniors.  This is a first from the feds.

And, the bar has been raised.  The guidelines suggest adults should exercise at moderate-intensity for 2 1/2 hours each week along with 1 1/4 hours of vigorous-intensity exercise to get the most health benefits.  Moderate-intensity includes brisk walking and vigorous-intensity means stepping it up a notch to running or swimming laps. Adults includes senior adults, which the guidelines refer to as "Older Americans".

This means both Caregivers and their senior clients can go for a walk each day to meet the guidelines, as older adults also will experience health benefits from exercising.

The guidelines suggest adults should include muscle-strengthening (resistance) activities at moderate- or high-intensity levels, which includes free weights, resistance bands, or exercises which use body weight such as sit-ups and push-ups.

Older Americans should follow the guidelines if they are able. If not, they should be as active as their physical condition allows. Exercises to improve balance are also suggested.

Physical exercise can also improve the emotional and mental outlook for seniors.  Caregivers can find these new guidelines on the government website.


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Flu Shots: Good Idea for Seniors and Caregivers

It seems it is finally time to accept that summer is over, and all that comes with that, including flu shots.  Such an unpleasant thought.  But getting the flu really is worse than getting the shot and there are plenty of vaccinations on hand (The U.S. has a supply of 140 million vaccinations and only used 113 last year).  The Center for Disease Control recommends flu vaccinations for pregnant women, people 50 and older, younger adults with chronic illnesses such as diabetes or asthma, health-care workers, people who come into contact with infants younger than 6 months, and people in contact with others at high risk of flu complications.

Caregivers can go along with their senior client to get a flu shot.  Many senior centers, churches and area departments on aging provide flu shots.  Some doctors offer flu vaccinations on certain days and many pharmacies host flu shot days.  Walgreens pharmacy will provide flu and pneumonia vaccinations at many of their pharmacies in October and you may find out when and where on their website.

Get the shot, not the flu.

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Gas: The New Affordable Luxury

"How much did you have to pay for gas?” is always the first question my Grandma Martha asks when I visit her.

I have always quickly changed the subject, having the attitude that there is no choice but to pay the price being charged.  And, since there are now taxes tacked on to gas, it is not possible to make a fair comparison to the prices she has paid over the last 70 years (Grandma Martha is 92 and still drives her car – she just passed her driver’s license renewal exam in April).

The thinking has always been that no matter how much money you make, there are certain little things you will always have enough extra money to buy – a candy bar or a cup of coffee at Starbucks, for instance.  Those are little luxuries we can all afford.

Gas, to fill the tank of your car, on the other hand, has always been a necessity. You pay your rent, you pay your utility bills and you fill your gas tank.

As the price of gas has doubled over the last four years, pay rates have not had the same increase.  This means the extra money that was spent on affordable luxuries is now needed to pay for gas.

Caregivers typically earn around $9.00 per hour. At 40 hours a week, this averages to $1,440.00 per month, before taxes are deducted.  This is something to remember when considering the cost for caregiving services. If driving is required, reimbursement for gas is necessary. In addition, if the location of the assignment requires excessive driving, reimbursement for mileage may be necessary to maintain a quality Caregiver.

The government reimbursement rate for mileage in 2008 is: 50.5 cents per mile. This is the reimbursement rate which the government estimates as adequate to cover all the costs of driving, from insurance to repairs to gasoline.

You can also research the best price for gas in your area.

And, if you are looking for a way to reward your Caregiver for a job well done, remember that any affordable luxury will be appreciated.

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