Aging In Place Today- Tacoma Washington

What Is A Mini-Stroke? What Is A Transient Ischemic Attack (TIA)?

2009-09-17T10:36:00.001-07:00

What Is A Mini-Stroke? What Is A Transient Ischemic Attack (TIA)?

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Caring for Parents Versus Caring for Children in Tacoma, Washington

2009-08-22T09:51:00.000-07:00

Here is a great article for those who are caring for aging parents from www.Agingcare.com. If you need help for a loved one in the Tacoma WA area, visit www.heartwarmingcare.com.

Caring for Parents Versus Caring for Children: 10 Ways They Differ

by Marlo Sollitto

Nearly 10 million boomers are now raising kids while at the same time, caring for at least one aging parent, according to the Pew Research Center reports. The term “Sandwich Generation” is used to describe this demographic – and lots has been written on it.

But what is not as frequently discussed, is that the strategies and techniques that are effective when caring for parents are very different from those that work well with children.

Here are 10 ways that caring for parents differs from caring for children:

Continue reading HERE.

Depression and the Elderly in Tacoma, Washington

2009-08-15T14:40:00.000-07:00

I found this article at Agingcare.com and decided to share it with you. If you need help for an aging loved one in the area, visit www.heartwarmingcare.com.

Is Dad Okay? Or Is It Depression?

by Mikol Davis, Psychologist

You’re visiting your elderly Dad, and notice that he just doesn’t seem to have his old “spark.” He speaks slowly. He doesn’t want to go out. He spends his time watching TV or falling asleep during the day. He isn’t eating much. You’re worried. Is Dad okay?

Recognizing the signs of depression in the elderly

Depression is the most common of mental conditions, which can be treated, but among the elderly, it is one of the most overlooked. Sometimes, it’s because physicians don’t recognize the signs and symptoms. Sometimes it’s because of an overall attitude of society that perhaps feeling low is just part of getting old.

The danger in overlooking depression is twofold. First, quality of life that could be improved isn’t, and unnecessary suffering goes on. Second, the alarming fact of elder suicide looms.

Depression is an emotional state with a physical component. The physical component is triggered by brain chemistry, and can be helped. When it is, physical symptoms tend to lessen.

Continue reading full article HERE.

Senior Home Care Benefits in Tacoma, Washington

2009-08-07T12:56:00.000-07:00

Here is a great article that illustrates the many benefits of home care for seniors. Visit www.heartwarmingcare.com if you need help with an aging loved one in the Tacoma WA area.

Senior Home Care Services Has Many Benefits Over a Nursing Home
By Chuck Parsens

As the United States people age, the focus on the number of looked for services will have to line up with the quality of the care rendered. For many years a spotlight has been placed on how well residents who reside in a nursing home are treated. Some understand that the level of care an individual obtains is dependent on how much family members are involved. Some mature children have trouble with placing their senior parents in a nursing home because of the negative press. Price is also a part in making this choice. An alternative to nursing homes is senior home care services, which allow a person to stay put in their home and receive the level of care that they will need.

Along with determining the price and care, the types of elderly home care services are chosen based on an individual's situation. Insurance companies have sought ways to trim down the costs of hospitalization and therapy services, which has opened the door for service providers who concentrate in giving these services at an individual's home. This reduces health care costs and allows an older adult to remain in their homes. The home care landscape has grown into a cutthroat business, giving greater options for people to choose from.

The advantages of having home care services rather than staying in a nursing home cannot be miscalculated. The intellectual portion of being able to keep some level of liberty can go a long way to improving the excellence of life for numerous elder adults. Most elderly only require assistance with regular, daily activities which may include transportation to doctor's appointments, grocery shopping, or bathing. Still, others may require more steady care, depending on their disease and how far it has developed.

A person who receives senior home care services can have more private attention than someone who lives in a nursing home. In a nursing home, a partial number of personnel must attend to a number of different people with varying degrees of needs. Receiving care at home can cost less than it does in a nursing home because of equipment costs that are factored into nursing homes. The annual costs of a nursing home differ by state, but in most cases, the costs far go above and beyond the median income of many older people. Those with Medicare soon find out that it only covers a little portion of long-term care, and that treatment is limited to the sort and number of days. The people that cannot come up with the money to supplement the costs of a nursing home could want to give home care services serious thought.

The topic of elderly home care is very broad in nature and I enjoy looking at all the aspects of it. Feel free to look at my other post about the options of senior home care services for your loved ones.

Article Source: http://EzineArticles.com/?expert=Chuck_Parsens

When Mom and Dad Move In:

2009-08-07T09:45:00.000-07:00

Pre-planning can help bring those tough-to-discuss topics to the table.

1. Discuss everything in advance.
2. Talk about all the issues; create an atmosphere of mutual respect.
3. Clearly establish the “house rules” as tactfully as possible, and agree on each person’s responsibilities and limits within the home.
4. Consider your children, if they still live at home. Your children need to be considerate of their grandparents, but the grandparents also need to step back and let you discipline your own children when necessary.
5. Make sure everyone has some privacy.
6. Figure out what goes where.
7. Work out a budget. Will your parents be contributing some of their pension money to cover household expenses, or will you be paying for everything? Never make assumptions, especially when it comes to finances.

8. Let your parents help around the house if they want to and are physically able.
9. Encourage your parents to maintain their independence and to stay active.

Be patient - it can take a while for the rhythms of the household to re-establish themselves after such a big change.

Amanda Ford’s article on website www.ehow.com

Visit www.heartwarmingcare.com if you need help with a loved one in Tacoma, Washington

Family Reunion--a Good Time for Family Planning in Tacoma, Washington

2009-08-01T13:31:00.000-07:00

Summertime brings a lot of family time. With family reunions, picnics, weddings and other events, long distant family members travel to gather together. It is also the perfect time to do some planning for the future. With parents aging and their health and lifestyles changing, children need to discuss some changes and decisions that will be needed in the near future. Parents should take the time to tell their children where important documents are kept and what their wishes are in the event of needing health care directives or experiencing long term care needs.

For those children who live away, the change they see in their parent's health and mental capacity may be alarming -- whereas siblings that have daily contact are working with these issues constantly. Here is the chance to compare notes and work together as a complete family in the long term care planning process.

For you parents who are well and active, this is a good time to hold a family meeting and share with your children your plan for long term care. Tell them where financial and legal documents are located. Review health care directives, living wills and long term care alternatives.

Experience has shown that even families that are close can quickly grow angry, jealous and hostile towards each other when an aging parent begins to need long term care. If a sibling moves into the parent's home, others can easily be suspicious of ulterior motives and fear losing their inheritance. On the other hand, the child providing the elder care becomes bitter and feels there is no support or help from siblings. Pre-need meetings for the purpose of making a plan, before eldercare becomes imminent, avoids these types of conflicts.

In its book, “The 4 Steps of Long Term Care Planning,” the National Care Planning Council provides guidelines and checklists for family planning meetings. Here's an excerpt from the book:

“The first step to holding a meeting, and perhaps the most difficult one, is to get all interested persons together in one place at one time.

If it's a family gathering, perhaps a birthday, an anniversary or another special event could be used as a way to get all to meet. Or maybe even a special dinner might be an incentive.

The person conducting the meeting can be a parent or one person of a couple who are doing their planning, years before the need for care arises. A meeting on behalf of someone already receiving care or needing care in the immediate future could be conducted by that person or by a member of the family, by an adviser or a friend.

The agenda could be formal or informal. If you want a formal agenda, we suggest using our care planning checklist as the agenda. Copies of the care plan should be prepared prior to the meeting and presented to those attending. Discussion is encouraged and we recommend that the person in charge not dictate but encourage input from everyone.

After a thorough discussion of the issues and the presentation of the solutions to the problems that will be encountered, there should be a consensus of all attending to support the plan. If the plan needs to be altered to meet everyone's expectations then by all means do so if that can be done. But it is not always possible to please everyone so there must sometimes be compromise.

The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan.

GET IT IN WRITING! All good intentions seem to be forgotten with time. It may be years after this meeting before the long term care plan begins. If there are vocal commitments to help with transportation to doctors, give respite to the caregiver or other commitments, write them down on the care agreement. You can even have each person put a signature to his or her commitment if you think that is important.”

“The 4 Steps of Long Term Care Planning ,” by The National Care Planning Council

The U.S Department of Health and Human Services states:

“No one wants to think about a time when they might need long-term care. So planning ahead for this possibility often gets put off. Most people first learn about long-term care when they or a loved one need care. Then their options are often limited by lack of information, the immediate need for services, and insufficient resources to pay for preferred services. Planning ahead allows you to have more control over your future”.

http://www.longtermcare.gov

"Whether you plan a formal meeting with an agenda or informally gather for a discussion, when the family is together make it a point to start the long term care planning process.

There is a lot to learn and many decisions to make concerning finances, health issues and legal work. It may take research and a lot of time to put a plan together, but if everyone is involved it will work, and be worth it." National Care Planning Council, www.longtermcarelink.net

Visit www.heartwarmingcare.com if you need help with a loved one in Tacoma, Washington.

15 Tips for Stroke Caregivers in Tacoma, Washington

2009-07-23T16:01:00.000-07:00

This is a very informative article for anyone who has a loved one recovering from a stroke. If you need help for an aging loved one in the Tacoma WA area, visit us at www.heartwarmingcare.com.

15 Tips Caregivers Should Know After A Loved One Has Had A Stroke

The following is being issued by American Stroke Association:

1. It's better to find out than miss out. Be aware of the medications that have been prescribed to your loved one and their side effects. Ask if your home should be modified to meet the specific needs of the stroke survivor. Ask a doctor, nurse or therapist to clarify any unanswered questions or to provide written information that explains what occurs after the stroke and during recovery or rehabilitation.

Continue reading this very important article here: http://www.medicalnewstoday.com/articles/147785.php

Elderly Stress in Tacoma, Washington

2009-07-15T08:55:00.000-07:00

Stress and the Elderly

Contrary to what we’ve been led to believe, senior living isn’t always the way it’s portrayed in glossy sales brochures and magazine advertisements. Rather than being a carefree period of life spent on the golf course and traveling around the world, for many of today’s seniors those “golden years” are incredibly stressful times.

What causes seniors so much stress? Change is a huge trigger for stress and seniors definitely experience plenty of change. It can be in the form of declining health, death of friends and loved ones, moving, a bad financial investment, and the list goes on. Here are some other reasons why senior living is stressful.

Continue reading here:

http://www.thehomecaredirectory.com/home_health_care/related_articles/stress_and_the_elderly/13/

If you need help with an aging loved one in the Tacoma WA area, visit me at www.heartwarming care.com.

Putting Home Care in Tacoma, Washington in Perspective

2009-07-09T12:44:00.000-07:00

The Evolution of Home Care

In the first century of our country's history there was no such thing as nursing homes or assisted living. Society was mostly rural and people lived in their own homes. Families cared for their loved ones at home till death took them. In the latter part of the 1800's because of an increasingly urban society, many urban families were often unable to care for loved ones because of lack of space or because all family members including children were employed six days a week for 12 hours a day. During this period many unfortunate people needing care were housed in County poor houses or in facilities for the mentally ill. Conditions were deplorable. In the early 1900's home visiting nurses started reversing this trend of institutionalizing and allowed many care recipients to remain in their homes. Nursing homes or so-called rest homes were also being built with public donations or government funds. With the advent of Social Security in 1936, a nursing home per diem stipend was included in the Social Security retirement income and this government subsidy spurred the construction of nursing homes all across the country.

By the end of the 1950s it was apparent that Social Security beneficiaries were living longer and that the nursing home subsidy could eventually bankrupt Social Security. But in order to protect the thousands and thousands of existing nursing homes Congress had to find a way to provide a subsidy but remove it as an entitlement under Social Security. In 1965 Medicare and Medicaid were created through an amendment to the Social Security Act. Under Medicare, nursing homes were only reimbursed on behalf of Social Security beneficiaries for short-term rehabilitation. Under Medicaid, nursing homes were reimbursed for impoverished disabled Americans and impoverished aged Americans over the age of 65. It has never been the intent of Congress to pay for nursing home care for all Americans. The nursing home entitlement for all aged Americans was now gone.

Over the last 40 years, there has been a gradual change away from the use of nursing homes for long-term care towards the use of home care and community living arrangements that also provide in-house care.

With Proper Planning People Could Remain in Their Homes for the Rest of Their Lives
We are seeing a trend towards working conditions like those in urban America in the early 1900's where both husband and wife are working and putting in longer hours. We are also seeing a return of the trend in the early part of the 20th century where outside visitor caregivers are becoming available to replace working caregiver's and allow the elderly to receive long-term care in their homes. In addition there is a significant trend in the past few years for Medicaid and Medicare to pay for long-term care in the home instead of in nursing homes.

Given enough money for paid providers or government funding for the same, a person would never have to leave his home to receive long-term care. All services could be received in the home. Adequate long-term care planning or having substantial income can allow this to happen.

We only need to look at wealthy celebrities to recognize this fact. Christopher Reeve, the movie star, was totally disabled but he had enough money to buy care services and remain in his home. President Ronald Reagan suffered from Alzheimer's for many years but received care at his California ranch. He was also wealthy enough to pay for care when needed. Or what about Annette Funicello or Richard Pryor? Income from their movie careers allowed them to receive care with their multiple sclerosis at home. We will be willing to bet that Mohammed Ali, who is severely disabled with Parkinson's disease, will probably never see the inside of a care facility, unless he chooses to go there to die. With the proper planning and the money it provides, most of us could remain in our homes to receive long-term care and we would never have to go to an institution or a hospital.

The Popularity of Home Care
Most of those receiving long-term care and most caregivers prefer a home environment. Out of an estimated 8 million older Americans receiving care, about 5.4 million or 67% are in their own home or the home of a family member or friend. Most older people prefer their home over the unfamiliar proposition of living in a care facility. Family or friends attempt to accommodate the wishes of loved ones even though caregiving needs might warrant a different environment. Those needing care feel comfortable and secure in familiar surroundings and a home is usually the best setting for that support.

Often the decision to stay in the home is dictated by funds available. It is much cheaper for a wife to care for her husband at home than to pay out $2,000 to $4,000 a month for care in a facility. Likewise, it's much less costly and more loving for a daughter to have her widowed mother move in to the daughter's home than to liquidate mom's assets and put her in a nursing home. Besides, taking care of our parents or spouses is an obligation most of us feel very strongly about.

For many long-term care recipients the home is an ideal environment. These people may be confined to the home but continue to lead active lives engaging in church service, entertaining grandchildren, writing histories, corresponding, pursuing hobbies or doing handwork activities. Their care needs might not be that demanding and might include occasional help with house cleaning and shopping as well as help with getting out of bed, dressing and bathing. Most of the time these people don't need the supervision of a 24/7 caregiver. There are, however, some care situations that make it difficult to provide long-term care in the home.

Please note from the first graph below that a great amount of home care revolves around providing help with activities of daily living. Note from the second graph below that the average care recipient has need for help with multiple activities of daily living. Finally, it should be noted from the second graph that well over half of home care recipients are cognitively impaired. This typically means they need supervision to make sure they are not a danger to themselves or to others. In many cases, this supervision may be required on a 24-hour basis. (Graphs were derived from the 1999 national caregivers survey, courtesy www.longtermcarelink.net.)

It is precisely the ongoing and escalating need for help with activities of daily living or the need for extended supervision that often makes it impossible for a caregiver to provide help in the home. Either the physical demands for help with activities of daily living or the time demand for supervision can overwhelm an informal caregiver. This untenable situation usually leads to finding another care setting for the loved one. On the other hand if there are funds to hire paid providers to come into the home, there would be no need for finding another care setting.

Problems That May Prevent Home Care from Being an Option
Caregivers face many challenges providing care at home. A wife caring for her husband may risk injury trying to move him or help him bathe or use the toilet. Another situation may be the challenge of keeping constant surveillance on a spouse with advanced dementia. Or a son may live 500 miles from his disabled parents and find himself constantly traveling to and from his home, trying to manage a job and his own family as well taking care of the parents. Some caregivers simply don't have the time to watch over loved ones and those needing care are sometimes neglected.

The problems with maintaining home care are mainly due to the inadequacies or lack of resources with informal caregivers, but they may also be caused by incompetent formal caregivers. These problems center on five issues:

Inadequate care provided to a loved one
Lack of training for caregivers
Lack of social stimulation for care recipients
Informal caregivers unable to handle the challenge
Depression and physical ailments from caregiver burnout

In order to make sure home care is a feasible option and can be sustained for a period of time, caregivers must recognize these problems, deal with them and correct them. The responsibility for recognizing these problems and solving them is another function of the long-term care planning process and the team of specialists and advisers involved.

Adequate Funding Solves Most Problems Associated with Providing Home Care
None of the problems discussed in this article would be an obstacle if there were enough money to pay for professional services in the home. These services would be used to overcome the problems discussed in the previous section. If someone desires to remain in the home the rest of his or her life, adequate preplanning could provide the solution.

This planning must occur prior to retirement. The most obvious way to provide sufficient funds for home care is to buy a long-term care insurance policy when someone is younger, healthy and able to afford the lower premiums. If insurance is not an option, then money must be put aside early in life to pay for care in the future. The only other option is to be rich.

Unfortunately, very few people address the issue of needing long-term care when they are older. This leads to a lack of planning and in turn leads to few options for elder care when the time comes. Lack of planning means most people do not have the luxury of remaining in their homes and must rely on Medicaid support in a nursing home to finish out the rest of their lives.

If you need help with an aging loved one in the Tacoma WA area, visit www.heartwarmingcare.com.

Tips to Prepare for Aging Parents Care in Tacoma, Washington

2009-07-04T10:34:00.000-07:00

Here is a great article for anyone who is preparing for the care of aging parents. If you need help with an aging loved one in the Tacoma WA area, visit www.heartwarmingcare.com.

Baby Boomers and Aging Parents - Six Tips to Prepare For Their Care

By Katie B. Marsh

Although there is some debate over the exact age range of the Baby Boom generation, the US Census Bureau identifies most Boomers as those who were born between the years 1956 to 1965. In any case, whether you were born within that time frame or fairly close to it, chances are you are beginning to deal with end-of-life issues regarding your elderly parents. Your many considerations run the gamut from the practical to the spiritual and everything in between. So, where do you begin?

Caregivers. Imagine if we ended our lives as babies, completely dependent on a caregiver tending to all of our needs: loving us, feeding us, changing our diapers. Imagine now that we are not as cute as little babies but still have the same need to be cared for gently with love and respect. Who would you want to take care of you in this situation? Who do your parents want to care for them? This question should be posed directly to your parents. Don't assume you know the answer. What they may have said 10 to 15 years ago may not still hold true today as they are closer to facing their mortality.

Finances. As we know, in our society it's considered impolite to ask someone about their finances. Many adult children hesitate to inquire about the exact state of their parents' finances for fear that their parents will think that the real questions is about potential future inheritance money. But it's extremely important to have an honest discussion about finances at this point in life. First of all, you need to know if your parents have long-term care insurance. This is the only type of insurance that pays for future assistance that may be needed in the performance of activities of daily living. And, as the name implies, it helps cover the cost of long-term care usually for an undetermined length of time. Long-term care insurance combined with your parents' net worth, any financial assistance from family, and personal preferences will all factor in to determining where and how your parents live out their final years.

Memoirs. The written word is a way for us to live on beyond this lifetime. Encourage your parents to share their unique stories on paper. My great grandfather actually typed his life story and had it bound in leather and embossed in gold leaf. My brother, sister, and I cherish it and each wish we had our own copy.

Legal Instruments. A living trust is a very important instrument for any family with assets to bequeath. Its main purpose is to avoid probate. Much of a family's estate can be lost through probate; setting up a living trust is a way to prevent such a loss. It is best to hire an attorney to set up a living trust tailored to your family's specific needs.

The next consideration is to find out to whom your parents have given or intended to give power of attorney. Power of attorney assigns power to an individual to act on your behalf to handle all of your legal and business matters in the event that you are unable to do this for yourself.

Lastly, an advance directive is a legal instrument prepared in advance by an individual. It gives health care instructions to your care providers in the event you are unable to conduct such matters on your own. A living will, power of attorney, health care proxy, and Five Wishes are all forms of an advance directive.

Possessions. A Last Will and Testament is the instrument to be prepared by your parents to assign care for their dependents, if any. This can include pets as well. Also, this is the legal mechanism through which they can identify one or more persons to manage their estate and provide instructions for the distribution of their personal possessions. This includes everything from real estate and expensive jewelry to the simplest sentimental items. Funeral and burial instructions can also be outlined here. Although this is a legal document, completing one can give great comfort to your parents, giving them control and certainty over one aspect of their lives.

Final Messages. Encourage your parents to write letters to each of their children if they feel comfortable doing so. Some families even make audio or video recordings of their elders. It can be about anything - a full life story, funny anecdotes, family stories, or loving good-byes to each of their children. My husband's grandmother came to this country from Armenia and she recounted her tumultuous life on CD. He cherishes it and plans to share it with our children when they are older.

Your parents are entering a time of life where many people feel particularly vulnerable. This can be especially difficult for parents who are used to being in charge and may not be comfortable at all with the reversal of roles. Please keep that in mind as you gather information from them and help them create a plan for the future. If done tactfully and respectfully, this time of life can bring you closer to your parents than ever before.

Katie B. Marsh is co-author of The Birth of Dying: A Sensitive Workbook to Help You Broach and Explore End-of-Life Issues with Your Terminally Ill or Elderly Loved One http://BooksForSharing.com/

Article Source: http://EzineArticles.com/?expert=Katie_B._Marsh

Tacoma Washington Seniors Learn How to Live Longer

2009-06-24T14:33:00.000-07:00

“Making it to 90 years old is awe-inspiring in much of the world. But on a tiny Greek island in the North Aegean Sea, nonagenarians barely merit a second glance.”

Here is a terrific article about an island where people live longer! If you have any questions or need help with an aging loved one in the Tacoma WA area, visit www.heartwarmingcare.com.

Link to article: The Island Where People Live Longer

http://www.npr.org/templates/story/story.php?storyId=103744881&sc=nl&cc=es-20090531

10 Easy Ways to Prevent Seniors from Falls at Home in Tacoma Washington

2009-06-20T11:05:00.000-07:00

Here is a helpful article with simple tips to keep seniors safe at home. If you need help with an aging loved one in the Tacoma WA area, visit www.heartwarmingcare.com.

10 Easy Ways to Prevent Falls at Home

Safe home tips for seniors to prevent falls and accidents

By Gina Roberts-Grey

According to a new report released by the U.S. Centers for Disease Control, about one in six Americans age 65 and older will suffer a fall in the next three months, with about a third of those people sustaining serious injuries, such as a broken hip. The critical takeaway point is that most of these falls are preventable.

About half of the tumbles that seniors experience occur in their homes. It only takes a few simple modifications and improvements to your home, however, to eliminate many of the common hazards that can cause such disabling, even fatal, falls. Armed with the pointers below, you (or a caregiver or family member), along with someone who's handy with a few power tools, can accomplish these safety modifications over the course of a weekend. These adjustments can make your home safer for not only an older person, but also for everyone who steps inside — especially grandchildren who often fail to watch where they're going!

Continue reading here:

http://www.everydayhealth.com/longevity/future-planning/prevent-falls-at-home.aspx?xid=nl_EverydayHealthHealthyAging_20090613

Baby Boomer Generation Fears Dementia, Alzheimer’s and Memory Loss in Tacoma Washington

2009-06-13T09:38:00.000-07:00

Baby Boomer Generation Fears Dementia, Alzheimer’s and Memory Loss

“The words dementia, Alzheimer’s and memory loss instills fear of aging in the retiring baby boomer generation. Scientific research now shows that the causes of memory loss can be prevented or delayed. The studies also confirm that memory loss is not a normal process of aging.”

Follow this link for the complete article: http://www.aginghomehealthcare.com/baby-boomer-generation.html

Visit us at with any questions at www.heartwarmingcare.com, or if you need help for an aging loved one in the Tacoma WA area.

When Your Loved One Resists Care in Tacoma Washington

2009-06-04T08:22:00.000-07:00

Here is an article I found that is very helpful for caregivers who are struggling with the loved one they are trying so hard to care for. It offers other ways to look at the behavior to try to understand what our loved ones are trying to communicate to us. If you are a caregiver, and need help with an aging loved one in the Tacoma WA area, visit me at www.heartwarmingcare.com.

“How many times has your mother refused to change her clothes? Has your father resisted getting out of bed? Has your wife pushed you away when you tried to brush her teeth? Many times a caregiver will be particularly frustrated by her loved one’s refusal to help himself. At times she can’t help but think that the person she cares for "36 hours a day" is going out of his way to make her miserable! The increasing irrationality of individuals with dementia makes it even harder on the caregiver.”

Continue reading article here: http://www.thehomecaredirectory.com/home_health_care/related_articles/when_your_loved_one_resists_care/147/

Senior Fraud Prevention in Tacoma Washington

2009-05-27T14:24:00.000-07:00

“Seniors can make easy targets for fraud, whether it’s for unbelievable investment returns or fraudulent sweepstakes prizes. Fraud on seniors can happen by phone, mail, in person, or, less commonly, the Internet (because seniors are online in smaller numbers). It can happen to wealthy seniors, and those of limited means. According to the Federal Trade Commission, studies show con artists are more likely to target senior citizens than other age groups because they believe seniors are more susceptible to such scams. The FTC reports that fraudulent telemarketers direct from 56 to 80 percent of their calls at seniors. The need for senior fraud prevention has become greater than ever.”

Follow the link below to read the rest of this very informative article. If you have any questions or need help in the Tacoma area, visit www.heartwarmingcare.com.

http://www.thehomecaredirectory.com/home_health_care/related_articles/senior_fraud_prevention/49/

Why In-Home Care May be Right for You in Tacoma WA

2009-05-23T11:06:00.000-07:00

I found a great article that talks about the many positive aspects regarding the use of In-Home Care for an aging loved one. If you have any questions at all about Home Care in the Tacoma area, please visit www.heartwarmingcare.com.

“In-Home Care is rapidly becoming the most commonly asked for service among today’s aging population. In-Home Care involves a network of service providers who deliver personal care and maintenance right to the home. These service providers handle routine tasks including light housekeeping, meal preparation, errand running, mail sorting and a whole lot more. If desired, they can also provide assistance with personal care. Besides the elderly, In-Home Care is a wonderful service for new mothers and those with a short-term disability or illness.”

Continue Reading the article by clicking the following link: http://www.thehomecaredirectory.com/home_health_care/related_articles/why_in-home_care_may_be_right_for_you/30/

Keeping Mom and Dad Safe at Home in Tacoma, WA

2009-05-15T15:17:00.000-07:00

Generally, elderly parents want to remain living in their own home. However, remaining in the home becomes a concern when children see their parents slowing down, perhaps even having trouble with handling stairs and doing general daily activities. Yet, with parents' mental and physical health currently not creating problems, there seems to be no imminent need to search out support services or other accommodations for aging parents.

This is now the time to evaluate the home to make it safe and secure for your loved ones -- now and in the near future -- in anticipation of aging disabilities that may occur. Help and support are available. The nation as a whole is more aware of elderly needs and services and products are becoming available at an outstanding pace.

The Bureau of Labor Statistics states,

“Employment of personal and home care aides is projected to grow by 51 percent between 2006 and 2016, which is much faster than the average for all occupations. The expected growth is due, in large part, to the projected rise in the number of elderly people, an age group that often has mounting health problems and that needs some assistance with daily activities.” Bureau of labor Statistics-Occupational Outlook Handbook, 2008-09 Edition

This growing need for aides and services also encompasses

home remodeling services -- making a home more serviceable to the elderly;
safety alert systems and technology;
motion sensors to monitor movement;
telehealth services -- using home-based computer systems for the doctors office or a nurse to monitor vital signs and
even a pill dispenser that notifies when it is time to take medication.

Where do you begin to make sure your elderly family member is safe and managing well in his or her home?

Visit often and at different times of the day and night. Make note of daily activities that appear challenging and where changes might be made to add safety and convenience. Remove rugs that slide -- causing a fall -- and move furniture with sharp edges. Set the water heater at a lower temperature. This will protect their older sensitive skin from scalds and burns. Be sure smoke detectors and carbon monoxide detectors are in place.

Bathrooms are a hazard area for the elderly. Grab bars by the toilet and shower are a must to help prevent falls. There are easy to install bars at your local hardware store if you want to do the work yourself. Another item that is good to have is a shower stool or chair.

If you are not sure of what needs to be done, consider hiring a professional. There are companies that specialize in home remodeling and accommodation for seniors. Michelle Graham of Accessible Design by Studio G4 says about senior home remodel projects,

“The main thing we incorporate in all of our projects is a careful study of needs and potential needs that may develop throughout a client's lifespan.”

Keep in mind what future home adjustments might be needed for your parents to “age in place” in their home.

Home safety or medical alert companies provide GPS-based bracelets or pendants to track the elderly at home who tend to wander. Or the companies may provide alarm devices such as pendants or bracelets which allow the elderly to alert someone if there has been a fall or a sudden health-related attack. In the event an alarm has been triggered, a 24 hour monitoring service will alert the family or medical emergency services or call a neighbor depending on previous instructions. In addition there are companies that will install motion sensors in the home to monitor the elderly on a 24 hour basis.

Don't forget your parents' community as a valuable resource for helping them stay in their home. Take Margaret Muller as an example. At 82 years of age, Margaret lives alone in her small home. She manages very well with the help of her local Senior Center. The Center's “Senior Companion” program sees that Margaret is taken to the store for groceries and other needs and checks in with her often to see how she is doing. Once a day, the Senior Center delivers a hot healthy meal to her door. Having these services and visits gives Margaret the help she needs and peace of mind that she is not alone.

Neighbors, local church groups, senior centers and city centers are some places to look for assistance. Most of the time there is little or no cost for these services.

Your state aging services unit is a valuable community resource. The National Area on Aging website www.aoa.gov states:

“AoA, through the Older Americans Act and other legislation, supports programs that help older adults maintain their independence and dignity in their homes and communities. In addition AoA provides funding for a range of supports to family caregivers.”

Some of the programs the site lists are:

Supportive Services and Senior Centers
Nutrition Services
National Family Caregiver Support Program
Grants for Native Americans
Nursing Home Diversion Grants
Aging & Disability Resource Centers
Evidence-Based Disease Prevention
Long-Term Care Planning
Alzheimer's Disease Grants
Naturally Occurring Retirement Communities

A few thoughts on hiring home care aides or live-in care givers.

The classifieds are filled with people looking for work as aides to the elderly. Many of these aides are well-qualified, honest people who will do a good job; but, of course, there will be some not so reputable. If you are looking to hire someone, be sure you interview and check references and qualifications. You will be responsible for scheduling that person and doing payroll and taxes as well. Be very sure you hire someone trustworthy, as the elderly seem to trust these helpers more than they should and therefore can easily be taken advantage of.

A professional home care service will eliminate your employment concerns. Professionally-provided aides are usually bonded and service is guaranteed. Home care companies take care of the scheduling and payment of their employees. Home care companies cater to the elderly in their homes by offering a variety of services. The National Care Planning Council lists many of these companies throughout the country on its website www.longtermcarelink.net

These providers represent a rapidly growing trend to allow people needing help with long term care to remain in their home or in the community instead of going to a care facility. The services offered may include:

companionship
grooming and dressing
recreational activities
incontinent care
handyman services
teeth brushing
medication reminders
bathing or showering
light housekeeping
meal preparation
respite for family caregivers
errands and shopping
reading email or letters
overseeing home deliveries
dealing with vendors
transportation services
changing linens
laundry and ironing
organizing closets
care of house plants
24-hour emergency response
family counseling
phone call checks
and much more.

Thomas Day, Director of the National Care Planning Council states,

“Care in the home provided by a spouse or a child is the most common form of long-term care in this country. About 73% of all long term care is provided in the home environment typically by family caregivers.”

As their caregiver, you can make the difference in the quality of life for your aging parents and if staying in their home is a possibility, you have the resources to make it happen.

There’s No Place Like Home For Growing Old in Tacoma Washington

2009-05-14T08:39:00.000-07:00

“The stairs are getting so hard to climb.”

“Since my wife died, I just open a can of soup for dinner.”

“I’ve lived here 40 years. No other place will seem like home.”

These are common concerns for older people. And, you may share an often-heard wish—“I want to stay in my own home!” The good news is that with the right help you might be able to do just that.

Click on the link below from the National Institute on Aging to read more. The tips there will help families know what to do first, the kinds of help available, where to start and what the costs are. If you have any further questions, or need help with an aging loved one in the Tacoma area, visit www.heartwarmingcare.com.

Here is the link: http://www.nia.nih.gov/HealthInformation/Publications/stayinghome.htm

Seniors and Baby-Boomers in Tacoma WA Keep Their Brains Young When They…..

2009-05-08T20:10:00.000-07:00

Reading, Crafts Help Keep the Brain Young

Original Link: http://www.alzinfo.org/newsarticle/templates/newstemplate.asp?articleid=346&zoneid=10

More good news on the neurobics front: Reading books, playing games or engaging in computer activities or crafts like pottery or quilting helps keep the brain young into old age, according to a new report. And while reading was good for the brain, watching too much TV seemed to be bad for it.

The findings, to be presented at the American Academy of Neurology’s 61st Annual Meeting in Seattle in late April, add to a growing body of evidence that mental challenges, or “neurobics,” like crossword puzzles and word games help keep memory and thinking sharp.

The research, from the Mayo Clinic in Rochester, Minn., involved a random sampling of 1,321 men and women in their 70s and 80s. Among the participants, 197 had mild cognitive impairment, a form of memory loss that sometimes precedes Alzheimer’s disease. The remainder had no memory problems.

Both groups filled out questionnaires about their everyday activities during the previous year. They also answered questions about what they engaged in during middle age, when they were in their 50s and 60s.

The researchers found that during the later years, those who regularly engaged in mentally-stimulating tasks like reading, crafts and computer activities were 30 to 50 percent less likely to suffer from serious memory loss compared to people who did not do those activities. People who watched television for less than seven hours a day as seniors were 50 percent less likely to develop memory loss than people who watched TV for more than seven hours a day.

People who participated in social activities and read magazines during middle age were about 40 percent less likely to develop memory loss than their less social peers or those who read less frequently.

“This study is exciting because it demonstrates that aging does not need to be a passive process,” said study author Yonas Geda, M.D., M.Sc., a neuropsychiatrist at the Mayo Clinic. “By simply engaging in cognitive exercise, you can protect against future memory loss.”

The researchers warned that these kinds of studies, which depend on participants’ recall of long past events, can be unreliable. But a growing body of evidence points to the benefits of mental stimulation in helping to ward off memory loss. Such activities may help to preserve and strengthen connections between brain cells in areas of the brain critical for memory.

Visit ALZinfo.org, the Alzheimer’s Information Site, to learn more about keeping the brain sharp and prevention of Alzheimer’s disease. And for thought-provoking games and word puzzles, subscribe free to the Fisher Center’s “Preserving Your Memory” magazine.

By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.

Source:

Yonas E. Geda, Rosebud Roberts, David Knopman, et al: “Cognitive Activities Are Associated With Decreased Risk of Mild Cognitive Impairment: The Mayo Clinic Population-Based Study of Aging.” The American Academy of Neurology.

Visit www.heartwarmingcare.com if you have any questions, or need help with a loved one in the Tacoma area.

HBO Miniseries Sheds New Light on Alzheimer's Disease - Tacoma, WA

2009-05-06T15:12:00.000-07:00

HBO Miniseries Sheds New Light on Alzheimer's Disease

INSIDER TIP:Caregivers can find new perspectives on the Alzheimer's condition and treatment with an HBO-original documentary miniseries that is available to everyone.

Beginning May 10th, HBO will broadcast a new miniseries based on the accounts of those with Alzheimer's disease and those whose lives are touched by their condition. The 4-part miniseries is the cornerstone in an overall effort to raise awareness and increase public understanding of the disease that will also involve a public awareness campaign and book. HBO is ensuring that the series can be viewed by all-even if a person does not have HBO. Cox Communications for digital cable subscribers can find it On-Demand for free. Portions of each show will appear on YouTube, iTunes, MySpace and Facebook -and the entire series will be available on HBO.com in installments beginning May 8. The series is also available for purchase. Each episode will approach Alzheimer's disease from a different perspective:

The Memory Loss Tapes. This introductory episode presents the stories of several people with Alzheimer's, shedding light on the disease by showing it through the unique perspective of the person living with the disease.

Grandpa, Do You Know Who I Am? Hosted by Maria Shriver and based on her book, What's Happening to Grandpa?, this segment aims to help children and teens to cope with Alzheimer's disease in their families and understand how it can affect their loved ones.

Caregivers. This segment presents five stories of caregivers working with seniors in various stages of the disease.

Momentum in Science. This two-part installment is the hopeful core of the series, spotlighting various clinics and laboratories to showcase the latest advances and research in Alzheimer's treatment and the search for a cure.

The material for the miniseries is drawn from recent research, personal accounts of the disease, and a new HBO-commissioned Alzheimer's Survey inspecting the impact of Alzheimer's disease in America.
Refresher: HBO's new documentary series offers new insight on Alzheimer's disease for today's caregivers and future generations.

HBO air dates and times
Sunday, May 10 at 9 p.m. ET
THE ALZHEIMER'S PROJECT: THE MEMORY LOSS TAPES

Monday, May 11 at 7:30 p.m. and 8 p.m. ET
THE ALZHEIMER'S PROJECT: 'GRANDPA, DO YOU KNOW WHO I AM?' WITH MARIA SHRIVER
THE ALZHEIMER'S PROJECT: MOMENTUM IN SCIENCE (Part 1)

Tuesday, May 12 at 7 p.m. and 8 p.m. ET
THE ALZHEIMER'S PROJECT: CAREGIVERS
THE ALZHEIMER'S PROJECT: MOMENTUM IN SCIENCE (Part 2)

I thought this might be of interest to you as well! Visit me at www.heartwarmingcare.com if you have any questions. or need help with an aging loved on in the Tacoma, WA area.

How Can Social Support Ease Caregiver Stress in Tacoma, WA?

2009-04-30T15:22:00.000-07:00

Here is a great article I found that I wanted to share. The original article can be found at http://www.alzinfo.org/alzheimers-caregiving.asp#3. If you have any questions, or need help please visit www.heartwarmingcare.com.

How can social support ease caregiver stress?

Two important contributors to caregiver stress are lack of social support and the caregiver's assessment of the behavior of the patient with Alzheimer's.   

Social and family support. Caregivers who lack sufficient or appropriate social support from family and friends are often put under heightened stress. Family conflicts, isolation and loneliness further exacerbate the stress of caregivers. While social support may not affect the primary stress caused by the disease, it can change the caregiver's response to the illness. Feeling supported by family and friends can improve psychological responses to stress and boost the caregiver's sense of well-being.   

The relentless downward course of Alzheimer's disease can have devastating effects on the structure and functioning of the family as well. The person with Alzheimer's gradually relinquishes his or her previous role in the family, and other family members must step in to fill the gaps. In addition, other family members may not recognize that a husband or wife who acts as a primary caregiver has now lost a major source of social support -- the spouse on whom they previously relied.   

When talking about improving social support, the quality of the support is much more important than the number of people who are available to the caregiver or the frequency of contact with members of the caregiver's social network. Family conflict about how and where it is best to care for the patient can be can be very stressful for the primary caregiver. Many caregivers feel resentful of other family members for not providing them with the kind of help they want, although they may not know how to ask for that help or accept help when it is offered.   

Caregiver appraisal. Another source of stress is sometimes referred to as caregiver appraisal. If the caregiver misunderstands the cause of the patient's behavior and interprets it as intentional rather than due to the illness, the caregiver may react with anger, feel rejected or become depressed. If other family members do not understand the disability of the patient, they may criticize the reactions of the caregiver rather than be supportive.   

Caregiving, in and of itself, can become tedious, frustrating and isolating. An important aspect of helping the Alzheimer's caregiver is to make caregivers and other family members aware of the availability and value of formal support. Caregivers can benefit from formal support services such as in home respite or day care programs for the patient and support groups for themselves in conjunction with the informal support of family and friends.

Who’s Responsible for Care After Stroke in Tacoma, WA

2009-04-24T14:43:00.000-07:00

I found this post online, and thought it was important to share...very informative! Visit me at www.heartwarmingcare.com with any questions!

The original article is at: http://www.post-gazette.com/pg/09090/959412-51.stm

Next Steps: Who's responsible for care after stroke?

By Jan Warner and Jan Collins

Q: My father was hospitalized in mid-February after a stroke that left him paralyzed on the left side and unable to talk. His doctors began the therapy process almost immediately and, after 10 days, began discussing discharge for continued therapy. My mother does not understand what happens next or who pays for what.

My father is 71, has Medicare Parts A and B, and a supplement policy from his former employer. My parents have minimal assets and live on a fixed income. I am sending this by e-mail so that, hopefully, you can reply to us as quickly as possible as I work full time, my husband was just laid off, and we need a "down and dirty answer."

A: When a person loses bodily function, even the simplest activities become difficult. The rehabilitation process is time-consuming and can be frustrating for both the patient and family. Based on the description you give, your father will probably need physical, speech and occupational therapies -- called "PT," "ST" and "OT" -- which are delivered by trained professionals in various settings.

Assuming the best result from these therapies, your father may be able to return home; however, your family must be prepared for the potential that he may need to continue to be institutionalized. At a minimum, these therapies are needed to prevent your father from further deterioration and to preserve the functioning he has retained.

Who pays for these therapies can be a complicated issue. With certain limitations and so long as the therapy meets the "reasonable and necessary" test, Medicare will generally pay for PT, OT and ST in the hospital, in a skilled nursing facility for up to 100 days, in the home setting under specific circumstances, and at special therapy facilities. There must be either a reasonable expectation that your father will improve or that these services are needed to maintain him and not allow him to deteriorate.

In 1997, because of billing abuses by nursing homes and rehabilitation centers that charged Medicare $600 per hour for therapy services they contracted for $25 per hour, Medicare placed limits on the amount that would be paid for therapy outside the hospital; however, in 1999, these limits were removed for the years 2000 and 2001. If you really want to get confused and see your government at work, check out cms.hhs.gov/TherapyServices.

Because of the importance of the discharge planning process and because of the complexities of the payment issues, we urge anyone whose family member is being discharged from the hospital for therapy or rehabilitation to take an active part in the discharge-planning process. Because most families will not understand all ramifications until it is too late, we believe that it is wise to include a private geriatric-care manager or case manager in the planning process.

Taking the NextSteps: We suggest you read all you can, and then get professional advice. Generally, Medicare Part A will pay for these therapies for up to 100 outpatient centers.

Learn more information about elder care law and write to the authors at nextsteps.net.

Jan Warner is a member of the National Academy of Elder Law Attorneys and has been practicing law for more than 30 years. Jan Collins is editor of the Business and Economic Review published by the University of South Carolina and a special correspondent for The Economist. You can learn more information about elder care law and write to the authors on nextsteps.net.

Know thy parent's medicine cabinet - Tacoma, WA

2009-04-24T13:23:00.000-07:00

Familiarize yourself with the medications your parent takes: what each one is for and how often he takes them. Make sure you notify each doctor your parent visits of all the medicine he takes, including over-the-counter products. Ask what side effects you might observe from each medication and whether it's potentially dangerous if your parent takes them together. You also want to tell the doctor whether your parent drinks alcohol or caffeinated drinks and whether he smokes, as these substances can affect some medications' efficacy and safety. To recognize which medications might cause the symptoms your parent experiences, check out drugscanmakeyousick.com .

I thought this might be of interest to you as well! Visit me at www.heartwarmingcare.com if you have any questions. or need help with an aging loved on in the Tacoma, WA area.

Treating an Illness Is One Thing. What About a Patient With Many?

2009-04-15T13:54:00.000-07:00

The New York Times recently posted an article that relates to many seniors and aging loved ones. I thought this might be of interest to you as well! Visit me at www.heartwarmingcare.com if you have any questions, or need help with an aging loved one in the Tacoma, WA area.

“Yet people with multiple health problems — a condition known as multimorbidity — are largely overlooked both in medical research and in the nation’s clinics and hospitals. The default position is to treat complicated patients as collections of malfunctioning body parts rather than as whole human beings. “Very often, there is nobody looking at the big picture or recognizing that what is best for the disease may not be best for the patient,” said Dr. Mary E. Tinetti, a geriatrician at the Yale School of Medicine.

Here’s the link to the whole article: http://www.nytimes.com/2009/03/31/health/31sick.html?_r=2&th&emc=th

Are Caregiver’s Responsible for Their Parent’s Debt in Tacoma Washington?

2009-04-09T11:24:00.000-07:00

I’m sure many adult children of aging parents and caregivers think about this question a lot. Recently, this article appeared at AgingCare.com, so I thought I would pass it on!

I was recently asked “Am I responsible for my parent's debt? What if as a caregiver, I recently discovered that my father has several thousand of dollars of debt. Are parent debts transferable?"

Click HERE to read the full article:

http://www.agingcare.com/Featured-Stories/133807/Are-Caregivers-Responsible-for-Their-Parent-s-Debt-.htm?utm_source=Newsletter&utm_medium=Email&utm_term=April+08%2c+2009&utm_campaign=Newsletter%2B-%2BApril+08%2c+2009

Any questions? Visit me at www.heartwarmingcare.com.

30 Reasons Your Loved One May Need a Caregiver in Tacoma, Washington

2009-04-02T12:26:00.000-07:00

I found this article, and decided to pass it on to you. It provides extremely helpful information that may help you with your decision to choose home care for an aging loved one in your family. The original article can be found at http://EzineArticles.com/?expert=Rebecca_Sharp_Colmer. As always if you have questions or need help, please visit our website www.heartwarmingcare.com.

30 Reasons Your Loved One May Need a Caregiver
By Rebecca Colmer

There are approximately 37 million people over the age of 65 and 5.3 million people over the age of 85. Each year millions of older people start requiring some sort of assistance to carry out their routine daily activities. Family members (family caregivers) provide most of the help.

It is not always easy to know when to intervene. It may seem like your loved one is in a gray area somewhere between competency and incompetence.

Your loved one can have a behavior that is not life threatening but still very serious. Making an assessment is the very step.

Here are some clues that your loved one may need some extra help:
1. Disheveled clothes
2. Stained or dirty clothes The same outfit worn everyday
3. Unkempt hair
4. Poor hygiene
5. Bad breath
6. Body odor
7. Having trouble walking
8. Having trouble sleeping
9. Dangerous driving
10. Extreme clutter in the home
11. Can't do light housekeeping
12. Items not returned to drawers or cupboards
13. Clothes strewn about or left on floor
14. Medication bottles left open
15. Medications taken out of original containers and mixed up
16. Not much food in house
17. Spoiled or rotten food
18. Unpaid bills
19. Penalties for overdue bills
20. Unopened mail
21. Put on or lost a lot of weight that is unexplained
22. Signs of confusion
23. Signs of forgetfulness
24. Signs of isolation
25. Signs of depression
26. Drastic mood swings
27. Extreme sadness or loneliness
28. Loss of interest in favorite hobby
29. Stopped doing things they used to enjoy like gardening, reading, going to church, seeing friends
30. Can't cope with everyday stress

If you do not live near your aging parents, ask a neighbor or friend to keep an eye on your parents and notify you if they notice any changes in their behavior.

Even if you determine that your loved one needs some assistance, keep in mind that they may be resistant to your help. Be gentle and compassionate when asking them to accept help.

It may take several tries before they start to accept your help. There is a big difference in offering help and completely taking away all of their independence.

However, if your parent's life is in danger and you can't find a way to intervene, call Adult Protective Services, which is a part of the Department of Social Services. They will send a nurse or social worker to your parent's home to determine the risks and find ways to protect your parent.

The caregiver role is complex and differs for everyone depending on the needs of the care-receiver. Many times, in the beginning, there may only be a few needs, such as providing transportation or helping with shopping or cooking. Over time, needs increase, requiring additional services, until the care-receiver is fully dependent on the caregiver.
Rebecca Colmer is an Eldercare Advocate, Author, Speaker, Publisher, and Caregiver Expert. You can find more caregiving tools and resources at her website: Caregiving Tools Article Source: http://EzineArticles.com/?expert=Rebecca_Sharp_Colmer

Know the Difference Between Hiring Private Caregivers and Using a Home Care Agency in Tacoma, WA

2009-03-28T09:15:00.000-07:00

I found this article in the Wall Street Journal and decided to pass it on to all of you. If you are considering hiring home care services, it's important to know what the family's legal and financial responsibilities are when it comes to private caregivers. Ultimately, in may be a better option to hire a home care agency. See link to the Wall Street Journal article below, and as always if you have questions or need help, please visit our website www.heartwarmingcare.com.

http://online.wsj.com/article/SB123742280124379005.html

Quality Questions-Home Care in Tacoma, Washington

2009-03-18T10:32:00.000-07:00

If you or a loved one is recovering from surgery or need long term care for a chronic illness, you may be interested in home care services. Home care agencies provide services that range from home support such as cleaning, cooking and running errands to help with transportation to MD appointments and more.

The best place to receive ongoing care may be in the comfort of your own home. But to receive quality assistance, it's important to know what questions to ask so that you hire the home care agency that's right for you.

To help you sort through your options, ask questions to help you evaluate the services. There are several facets to home care, and asking the right questions up front can help you choose the best agency for your needs.

Quality of care
• What is the professional training of the staff?
• Will the agency provide you with the services of nurses aides, CNAs or therapists? Will they work directly with you, your family members or your doctor?
• Are the caregivers bonded and insured?
• Does the agency provide a supervisor to evaluate the quality of home care on a regular basis?
• Does the agency have references on file for home care staff?
• Do employees seem friendly and helpful?

Visit me at Heart Warming Care for all of your home care questions.

Elder Care Issues - Having a Family Meeting in Tacoma Washington

2009-03-12T20:26:00.000-07:00

In an ideal world, all family members would share the responsibilities in caring for their elderly parent (s) when that parent can no longer care of themselves or needs assistance in doing so. Unfortunately, in the real world, inner family conflicts, emotional and physical distance, or other interferences prevent such meetings from taking place. In the end, one or two members of the family are left with all of the responsibility and burden of long term care for their parents.

In our case, our family "meeting" involved emailing our brother who lives in Northern California and talking to him when he comes down to visit with his family. Though there are six of us in our family, unfortunately, not all six of us are fully on board with the situation. Why? Read the above paragraph again. You'll probably find some similarities with your own family. If by chance, you are one of the lucky few who are able to gather all of the important figures together, you all have to come up with viable solutions to your parent or parents' needs. Where do you start? What do you talk about?

First rule of thumb, don't expect to have ANYTHING solved with 1,2 or 200 meetings. Circumstances change, people change, feelings change. The purpose of the meeting really, is to enlighten the others on the situation your parents are facing.

Assigning Duties: Probably the most important issue in conducting a meeting would be to decide who is responsible for what. How do you decide who will be responsible for what? In our case we have to put on many hats, because it's just the 2 of us. However, since my sister has an extensive financial background in her previous occupations, she has taken over their finances. Since my dad's stroke 8 years ago, I have been the primary "medical" person. I have taken both he and my mom to most of their doctor's appointments and have a thorough knowledge of their medical histories. Our brother offers input on different subjects from time to time and has offered financial assistance when the time calls for it. Our other sister has taken over nursing duties for our mom when our main caregiver takes her days off. Not all of this has been easy, and we still struggle, but we are working towards a goal and that is to make sure they live the rest of their lives peacefully and that we keep our sanity.

Things to Consider Topics to discuss and to consider are listed below.
• Latest Medical History and needs
• Emotional Needs
• Fears: both shared by parents and children about dying, being overwhelmed, changes in family dynamics after the death of a family member
• Daily Caregiving Needs: should they move in with someone, stay at home, or a facility?
• Safety?
• Financial Concerns
• Legal Concerns
• What type of support do they need? How will it change if their illness progresses?

There's a lot more to consider, but these are good areas to start if not, the most important areas. Think about what may be specific to your family situation too and hopefully, with proper planning, preparation and cooperation, your parents and your lives should run as smoothly as possible.

http://www.caring-for-mom-and-dad.info
Article Source: http://EzineArticles.com/?expert=Rose_Broyles

Brought to you by www.heartwarmingcare.com.

When is A Good Time to Consider Home Care in Tacoma, Washington?

2009-03-07T11:40:00.000-08:00

Here’s a great link to an article that is helpful to anyone considering starting elder care, home care, or geriatric care management services for an aging loved one.

Just click on the link below, and as always if you have questions or need help, please visit our website at www.heartwarmingcare.com.

My Mother’s Memory is Failing…..

http://donigreenberg.com/2009/02/28/dear-j-mother-memory-something/

Heartwarming Care Presents an Innovative Elder Care Community Education Series for Consumers in the Tacoma Area

2009-03-02T10:15:00.000-08:00

Tacoma, WA March 2009: Heartwarming Care's Owner Randy Walden is now offering an exclusive innovative elder care community education series at no charge for any group, employer, or organization.

"We are so proud to offer this exclusive program. Consumers in our area now have access to six important presentations that will assist them with almost any elder care situation. We get so many questions from our clients, we knew that providing this series was not just important, but critical for adult children of aging parents, caregivers, and seniors," said Randy Walden, Owner of Heartwarming Care.

Heartwarming Care Elder Care Community Education Series includes six presentations, each lasting about 30 minutes or less. Randy Walden is available upon request to schedule any or all presentations for any organization in the Pierce County.

Topics include:

1. Having "The Talk" with Our Aging Loved Ones About Long-Term Care Options.
2. Taking Away the Car Keys: When Seniors Should No Longer Be Driving.
3. Understanding the Cost of Elder Care and How to Pay for Care.
4. A Little Fall is a Big Worry for Seniors: Fall Prevention Program for the Home.
5. Understanding the Types of Elder Care Available.
6. Safety In and Around the House- Keeping Seniors Safe.

For more information contact Randy Walden at randy@heartwarmingcare.com (253) 460-1574.

About Heartwarming Care: www.heartwarmingcare.com

Randy Walden is the President and CEO of Heartwarming Care, LLC, in Lakewood - a rapidly growing company that specializes in home care for the elderly with a specialty in Alzheimer's and dementia care. Randy's passion for seniors and their families is evident in the development of Elder Care University, which fills a void in our community for quality education about our ever-growing aging population. Randy Walden is the author of "The Senior Solution: Secrets to Maintaining Independence and Choice for Life".

5 Ways to Pay for Home Care In Tacoma, Washington

2009-02-27T06:53:00.000-08:00

1. Privately paying for long-term care means paying for care out of your own income, investments, savings and assets.

2. Long-term care insurance will pay for in-home care, assisted living, and nursing home care. This is the most appropriate and needed form of insurance protection available to us today. Long-term care insurance should be termed “lifestyle” insurance (it’s NOT nursing home insurance!). If your vision of your later years includes sitting at home in your own recliner, with your own remote control, watching your own TV….well, you should be planning for that future with long-term care insurance.

3. Reverse mortgages (Home Equity Conversion Mortgages) have become one of the most popular and accepted way of paying for many different expenses, including the cost of long-term care. Reverse mortgages are designed to keep seniors at home longer. A reverse mortgage can pay for in-home care, home repair, home modification, and any other need a senior may have.

4. Government assistance should be a last resort when considering how to pay for long-term care. This type of assistance refers to relying on the Medicaid system. Medicaid will pay for long-term care for seniors who cannot afford to pay for care themselves. Keep in mind that Medicaid is an under-funded and over-burdened system, therefore Medicaid resources are limited. This means that in many areas Medicaid beds in nursing homes are difficult to find. Families may end up driving long distances to visit their loved ones. Traditionally, Medicaid resources for in-home care are extremely limited, which means most seniors who apply for Medicaid end up in a nursing home type setting. The Deficit Reduction Act 2005 makes qualifying for Medicaid even more difficult for most families. Planning ahead is really the only viable option for families today.

5. VA Aid and Attendance Pension Benefit: The Veterans Administration has established a pension program whereby your purchase of personal care and attendant home services may be paid for through your acquired pension. If you are a Veteran or the surviving spouse of a Veteran who has served at least 90 days or more on active duty with one day beginning or ending during a period of war, and you are in need of assistance at HOME due to your disabilities, you may be eligible for VA's non-service connected disability pension.

Brought to you by http://www.heartwarmingcare.com/.

2009 Family Caregiver Training - Tacoma, WA

2009-02-25T11:17:00.000-08:00

Caregiving today includes learning the skills necessary to provide care, accepting the fact that you can't do it alone, and being aware of the need to take care of yourself while you are a caregiver.

Participants can attend just one class or all of them - whatever fits their needs. All classes are free of charge. The classes are provided as a cooperative effort of Pierce County Aging and Long Term Care and Heartwarming Care.

Sessions are designed to help you learn the skills and knowledge you need to provide safe and confident home care. The course includes video instruction, lectures, demonstrations by the class teacher, and hands-on-practice. Handouts include Key Points and Definitions, Reducing Personal Stress, and Course Evaluations.

Participants will recieve a complimentary copy of the book Quick Tips for Caregivers to use as your textbook.

Classes are held at:

Times: 6:00 p.m. to 7:30 p.m.
(Third Tuesdays of each month - Starting Feb. 17, 2009)

Heartwarming Care
10209 Bridgeport Way W.
Suite C-6
Lakewood, WA 98499

For information or registration call (253) 460-1574

Topics in the 2009 Family Caregiver class include:

Prepare Yourself & Your Home
The Importance Of Communication
Taking Care Of The Caregiver
Infection Control
Daily Home Care Activities
Home Care Services
How To Manage Medications
Nutrition
How To Help Someone Who Uses A Wheelchair
Fall Prevention
Fire Safety
Elder Neglect & Abuse

* If you are in need of classes for held in a community, church or organization?s location, please call heartwarming Care at (253) 460-1574. Arrangements can be made for a convenient time and location for your group.

Hospice Care - Tacoma, WA

2009-02-23T10:58:00.000-08:00

Hospice care has been around for 30 years. It is a valuable service and is generally underused except for terminal cancer patients. Most families wait too long to have their doctor prescribe hospice from Medicare. Many doctors or family don't often consider this care alternative for Alzheimer's, degenerative old age or other debilitating illnesses where a person is going downhill fast. Hospice involves a team approach using the following providers.

Family caregivers
The patient' s personal physician
Hospice physician (or medical director)
Nurses
Home health aides
Social workers
Clergy or other counselors
Trained volunteers; and
Speech, physical, and occupational therapists, if needed.

The purpose of hospice is the following:

Manages the patient's pain and symptoms;
Assists the patient with the emotional and psychosocial and spiritual aspects of dying;
Provides needed medications, medical supplies, and equipment;
Coaches the family on how to care for the patient;
Delivers special services like speech and physical therapy when needed;
Makes short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time; and
Provides bereavement care and counseling to surviving family and friends.

A person can receive hospice from Medicare if he or she is

Eligible for Medicare Part A (Hospital Insurance), and
The doctor and the hospice medical director certify that the person is terminally ill and probably has less than six months to live, and
The person or a family member signs a statement choosing hospice care instead of routine Medicare covered benefits for the terminal illness, and
Care is received from a Medicare-approved hospice program.

Although hospice is an outstanding service, Medicare typically does not provide enough supportive care for many patients. For those who have long term care insurance, there may be additional money available to buy more time from in-home aides. If there is no insurance, family members often pay out of their own pockets to bring in more help.

video Paying for Home Care Tacoma, WA

2009-01-19T11:06:00.000-08:00

FAQ 3 Heartwarming Care Senior Care Tacoma WA - kewego
http://www.heartwarmingcare.com Home Care Videos: Heartwarming Care, Tacoma, Lakewood, WA, 98499 253-460-1574

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video Heartwarming Care Tacoma, WA

2009-01-14T11:01:00.000-08:00

Home Health Care Tacoma WA 4 - kewego
http://www.heartwarmingcare.com Home Care Videos: Heartwarming Care, Tacoma, Lakewood, WA, 98499 253-460-1574

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Video from rwalden1

National Glaucoma Month - Tacoma, WA

2009-01-06T11:02:00.000-08:00

What Is Glaucoma?

Glaucoma is a group of eye diseases that gradually steal sight without warning. In the early stages of the disease, there may be no symptoms. Experts estimate that half of the people affected by glaucoma may not know they have it.

Vision loss is caused by damage to the optic nerve. This nerve acts like an electric cable with over a million wires. It is responsible for carrying images from the eye to the brain.

There is no cure for glaucoma—yet. However, medication or surgery can slow or prevent further vision loss. The appropriate treatment depends upon the type of glaucoma among other factors. Early detection is vital to stopping the progress of the disease.

It was once thought that high pressure within the eye, also known as intraocular pressure or IOP, is the main cause of this optic nerve damage. Although IOP is clearly a risk factor, we now know that other factors must also be involved because even people with “normal” levels of pressure can experience vision loss from glaucoma.

Are You At Risk For Glaucoma?

Everyone is at risk for glaucoma. However, certain groups are at higher risk than others.

People at high risk for glaucoma should get a complete eye exam, including eye dilation, every one or two years.

The following are groups at higher risk for developing glaucoma.

African-Americans

Glaucoma is the leading cause of blindness among African-Americans. It is six to eight times more common in African-Americans than in Caucasians.

People Over 60

Glaucoma is much more common among older people. You are six times more likely to get glaucoma if you are over 60 years old.

Family Members with Glaucoma

The most common type of glaucoma, primary open angle glaucoma, is hereditary. If members of your immediate family have glaucoma, you are at a much higher risk than the rest of the population.

Family history increases risk of glaucoma four to nine times.

Hispanics in Older Age Groups

Recent studies indicate that the risk for Hispanic populations is greater than those of predominantly European ancestry, and that the risk increases among Hispanics over age 60.

Asians

People of Asian descent appear to be at some risk for angle closure glaucoma. Angle closure glaucoma accounts for less than 10% of all diagnosed cases of glaucoma. Otherwise there is no known increased risk in Asian populations.

Steroid Users

Some evidence links steroid use to glaucoma. A study reported in the Journal of American Medical Association, March 5, 1997, demonstrated a 40% increase in the incidence of ocular hypertension and open angle glaucoma in adults who require approximately 14 to 35 puffs of steroid inhaler to control asthma. This is a very high dose, only required in cases of severe asthma.

Eye Injury

Injury to the eye may cause secondary open angle glaucoma. This type of glaucoma can occur immediately after the injury or years later.

Blunt injuries that “bruise” the eye (called blunt trauma) or injuries that penetrate the eye can damage the eye’s drainage system, leading to traumatic glaucoma.

The most common cause is sports-related injuries such as baseball or boxing.

Other Risk Factors

Other possible risk factors include:

• high myopia (nearsightedness)

• diabetes

• hypertension

• Central corneal thickness less than .5 mm.

Types Of Glaucoma:

• Primary Open Angle Glaucoma

• Angle Closure Glaucoma

• Normal Tension Glaucoma (NTG)

• Secondary Glaucoma

• Pediatric Glaucoma

• Overview

• All

The two main types of glaucoma are primary open angle glaucoma (POAG), and angle closure glaucoma. These are marked by an increase of intraocular pressure (IOP), or pressure inside the eye. When optic nerve damage has occurred despite a normal IOP, this is called normal tension glaucoma. Secondary glaucoma refers to any case in which another disease causes or contributes to increased eye pressure, resulting in optic nerve damage and vision loss.

Early detection, through regular and complete eye exams, is the key to protecting your vision from damage caused by glaucoma.

It is important to have your eyes examined regularly. Your eyes should be tested:

• before age 40, every two to four years

• from age 40 to age 54, every one to three years

• from age 55 to 64, every one to two years

• after age 65, every six to 12 months

Anyone with high risk factors, should be tested every year or two after age 35.

Four Common Tests for Glaucoma

Regular glaucoma check-ups include two routine eye tests: tonometry and ophthalmoscopy.

TONOMETRY

The tonometry test measures the inner pressure of the eye. Usually drops are used to numb the eye. Then the doctor or technician will use a special device that measures the eye’s pressure.

OPHTHALMOSCOPY

Ophthalmoscopy is used to examine the inside of the eye, especially the optic nerve. In a darkened room, the doctor will magnify your eye by using an ophthalmoscope (an instrument with a small light on the end). This helps the doctor look at the shape and color of the optic nerve.

If the pressure in the eye is not in the normal range, or if the optic nerve looks unusual, then one or two special glaucoma tests will be done. These two tests are called perimetry and gonioscopy.

PERIMETRY

The perimetry test is also called a visual field test. During this test, you will be asked to look straight ahead and then indicate when a moving light passes your peripheral (or side) vision. This helps draw a “map” of your vision.

GONIOSCOPY

Gonioscopy is a painless eye test that checks if the angle where the iris meets the cornea is open or closed, showing if either open angle or closed angle glaucoma is present.

Optic Nerve Computer Imaging

In recent years three new techniques of optic nerve imaging have become widely available. These are scanning laser polarimetry (GDx), confocal laser ophthalmoscopy (Heidelberg Retinal Tomography or HRT), and optical coherence tomography (OCT).

The GDx machine does not actually image the optic nerve but rather it measures the thickness of the nerve fiber layer on the retinal surface just before the fibers pass over the optic nerve margin to form the optic nerve. The HRT scans the retinal surface and optic nerve with a laser. It then constructs a topographic (3-D) image of the optic nerve including a contour outline of the optic cup. The nerve fiber layer thickness is also measured. The OCT instrument utilizes a technique called optical coherence tomography which creates images by use of special beams of light. The OCT machine can create a contour map of the optic nerve, optic cup and measure the retinal nerve fiber thickness. Over time all three of these machines can detect loss of optic nerve fibers.

Your intraocular eye pressure (IOP) is important to determining your risk for glaucoma. If you have high IOP, careful management of your eye pressure with medications can help prevent vision loss. Recent discoveries about the cornea, the clear part of the eye’s protective covering, are showing that corneal thickness is an important factor in accurately diagnosing eye pressure. In response to these findings, the Glaucoma Research Foundation has put together this brief guide to help you understand how your corneal thickness affects your risk for glaucoma, and what you can do to make sure your diagnosis is accurate.

Corneal Thickness

In 2002, the five-year report of the Ocular Hypertension Study (OHTS) was released. The study’s goal was to determine if early intervention with pressure lowering medications could reduce the number of ocular hypertensive (OHT) patients that develop glaucoma. During the study, a critical discovery was made regarding corneal thickness and its role in intraocular eye pressure and glaucoma development.

WHY IS CORNEAL THICKNESS IMPORTANT?

Corneal thickness is important because it can mask an accurate reading of eye pressure, causing doctors to treat you for a condition that may not really exist or to treat you unnecessarily when are normal. Actual IOP may be underestimated in patients with thinner CCT, and overestimated in patients with thicker CCT. This may be important to your diagnosis; some people originally diagnosed with normal tension glaucoma may in fact be more accurately treated as having regular glaucoma; others diagnosed with ocular hypertension may be better treated as normal based on accurate CCT measurement. In light of this discovery, it is important to have your eyes checked regularly and to make sure your doctor takes your CCT into account for diagnosis.

A THIN CORNEA—THE DANGER OF MISREADING EYE PRESSURE

Many times, patients with thin corneas (less than 555 µm) show artificially low IOP readings. This is dangerous because if your actual IOP is higher than your reading shows, you may be at risk for developing glaucoma and your doctor may not know it. Left untreated, high IOP can lead to glaucoma and vision loss. It is important that your doctor have an accurate IOP reading to diagnose your risk and decide upon a treatment plan.

A THICKER CORNEA MAY MEAN LESS REASON TO WORRY ABOUT GLAUCOMA

Those patients with thicker CCT may show a higher reading of IOP than actually exists. This means their eye pressure is lower than thought, a lower IOP means that risk for developing glaucoma is lowered. However, it is still important to have regular eye exams to monitor eye pressure and stay aware of changes.

PACHYMETRY—A SIMPLE TEST TO DETERMINE CORNEAL THICKNESS

A pachymetry test is a simple, quick, painless test to measure the thickness of your cornea. With this measurement, your doctor can better understand your IOP reading, and develop a treatment plan that is right for your condition. The procedure takes only about a minute to measure both eyes.

Family Caregiver Training Offers Valuable and Insightful Information

2009-01-02T11:28:00.000-08:00

By Andy West

We are a nation that is aging rapidly, with the largest generation, Baby Boomers, growing near to retirement age. Because of this, there will be many Americans in need of medical care in the next three or four decades, more so than in previous years. This means that more and more children and other relatives will be called upon to take care of their aging relatives. The economy in its current state has financially ruined hundreds of thousands of people, and this will undoubtedly affect the retirement of our Baby Boomers. In home health care and family caregiving, some predict that many of us will become do-it-yourselfers. That doesn't have to be a daunting prospect if you have the right outlook and family caregiver training.

Nurturing those who nurtured you during your early years will give you pride in your familial relationships, not to mention the fact that you will be spending the last days caring for your relatives. The bonds shared during this time will give you memories for a lifetime after they're gone. You'll be helping your family in one of the best ways imaginable. It's a noble calling, but you've got to be prepared in order to do it right. One of the best ways to prepare is by purchasing and watching training DVDs on the subject of elderly home care. Some of the material on training DVDs may already be common knowledge to most, but much of the material may be new to family members who've never had to care for a parent, disabled friend or elderly relative. A variety of videos are available on the market that will assist you in everything from the very basic to the very detailed and concise.

For instance, it's vitally important to know what to do in cases of emergency, such as a home fire, or if the person you're caring for has a heart attack, a stroke, a seizure, or a fall. Falls can have devastating consequences for the elderly, so you need to know what to do so that you can act quickly and calmly. Some efforts taken within the first five minutes of a serious event can save a life. Knowing what to do in family emergencies will enable you to take appropriate action quickly. You will be prepared and know not to panic, or just make plain bad choices. Getting the proper training in family care giver techniques will help you to preserve the life and health of your important loved ones for years to come.

It's not only important to know how to cope with emergencies; you must also know how to assess a person's quality of life and know how you can assist. You may be required to carry out the common day-to-day tasks that caring for an elderly and infirm person demands. Some of them are simple things like knowing how to do laundry efficiently, iron, clean, help with showers and general hygiene. It's also important to understand the value of good nutrition. Your needs may be completely different from your 90 year old aunt. She may need calcium, low sodium, low fat, nutrient enriched supplements, just to name a few. Being able to prepare a variety of different, tasty, nutritious meals is essential to caring for another person, especially when appetites are low. It is essential that the person you are caring for eat regularly, so they can maintain a good quality of life.

Being a good housekeeper, a good cook, and good training all make a great caregiver. With the current prices of medical care and the state of our economy, it's no question that caring for your family will soon be more of a responsibility for the younger generations. Be prepared with family caregiver training, and get your siblings and cousins to join your efforts. You won't soon be disappointed.

Andy west is a writer for Medifecta, is dedicated to enhancing the well-being and knowledge of professionals through family caregiver training. For more information contact Randy Walden at Heartwarming Care 253-460-1574, a provider of the Medifecta “National Family Caregiver Training”.

If you have a friend or a loved one who could use some extra assistance, be sure to tell them about in-home care by Heartwarming Care. Contact Randy Walden at 253-460-1574 for more information, or visit us on the web at www.heartwarmingcare.com.

Take Charge of Your Vision!

2008-12-23T12:01:00.000-08:00

By Dr. Bruce P. Rosenthal

Age-related Macular Degeneration (AMD) is the leading cause of legal blindness in Americans over 50, yet a disease that few talked about until recently.

For years, many assumed vision loss was a natural result of aging. We are learning that this isn't the case. Much can be done to preserve vision through prevention, early detection via regular eye exams, treatment, vision rehabilitation, support services and research.

AMD is an eye disease that causes loss of central vision, leaving only peripheral vision intact. Possible warning signs of AMD include difficulty in distinguishing colors, blurry images, straight lines that appear distorted or wavy and central vision blocked by dark or empty spaces. Those affected by AMD often have trouble reading a book, driving a car and distinguishing faces and traffic signs.

An estimated 6 million Americans have vision loss from AMD and approximately 13 to 15 million Americans have pre-symptomatic signs of AMD. Some form of AMD affects 25 to 30 million people worldwide, and that number is predicted to double in the next 35 years.

Smoking is the only proven risk factor for AMD. Other possible risk factors include genetics, cataracts, hypertension, sun exposure, farsightedness, light skin or eye color and a diet low in vitamins, minerals and antioxidants.

Despite the prevalence of AMD, awareness remains quite low. A study commissioned by the AMD Alliance International revealed that only 3 percent of Americans surveyed think AMD is the leading cause of severe sight loss among adults 50 and older and 79 percent are not aware of any treatment options for the disease. (Research Source: Survey among representative samples of 6,591 adults from Canada, France, Germany, Italy, Spain, United Kingdom and United States commissioned by AMD Alliance International, May 1999).

Every week, new AMD patients arrive at LIGHTHOUSE INTERNATIONAL claiming they were "dismissed" by their regular doctors with the words, "There is nothing more I can do for you." This is absolutely wrong. The field of low vision is advancing daily, and there are many ways to make the most of remaining sight.

Follow these initial steps, along with others recommended by your eye care provider, to take charge of your vision.

Regular Eye Exams: It is imperative that regular eye exams and tests (Amsler Grid) and early detection are a priority especially if there is a family history of this condition. This enables your eye care provider to discuss available options for treatment, rehabilitation and support services, as well as other recommendations for your specific lifestyle, diet and circumstances.

Treatment: Talk with your eye care provider to learn more about the two treatments that currently exist to treat some forms of wet AMD—photodynamic therapy and laser photocoagulation—as well as research on the horizon.

Vision Rehabilitation: Counseling and training help people with vision impairment to function independently. Discuss tools such as low vision aids and magnifiers, lighting, computer enhancements, large print publications, "talking" devices like books, watches and microwaves and practical daily living skills for reading, cooking, sewing and more.

Support Services: Reach out to find support groups of patients and vision experts in your local area.

Life does not end with a diagnosis of AMD. Today, it is possible to see better and live an active and rich life despite the loss of central vision.

If you have a friend or a loved one who has AMD or any other vision problem and could use some extra assistance, be sure to tell them about in-home care by Heartwarming Care. Contact Randy Walden at 253-460-1574 for more information, or visit us on the web at www.heartwarmingcare.com.

Dr. Rosenthal is chairman of AMD Alliance International and chief of Low Vision Programs at Lighthouse International. He is also an executive council member of the Low Vision Section of the American Optometric Association. He has written and lectured widely on visual impairment.

Pills Not the Best Choice for Sleepless Seniors

2008-11-15T12:22:00.000-08:00

Tacoma, WA - Heartwarming Care

Seniors may want to think twice before taking a sleeping pill to help them sleep through the night. While these pills can help you fall asleep and stay asleep, in the elderly they cause pronounced daytime side effects, including memory problems and falls.

"Older people are more sensitive to the side effects of sleeping pills," says Dr. Daniel Kripke, co-director of sleep research at the Scripps Clinic Sleep Center in San Diego.

For the 60 million Americans who suffer from insomnia, sleeping pills like Ambien and Lunesta have become increasingly popular. Since the rate of insomnia tends to increase with age, seniors, too, have been turning to these drugs for help. However, several studies have shown that the side effects and drowsiness caused by sleeping pills tend to linger longer for seniors—with major consequences.

Researchers from the University of Toronto have recently found that people over the age of 60 are almost five times more likely to have a memory or cognitive problem after using sleeping pills. Additionally, seniors who use sleeping pills are almost three times more likely to suffer a fall and four times more likely to report feeling tired during the day.

Part of the trouble, says Kripke, is that as people age, their metabolism slows down and the body processes drugs more slowly. This can cause a sleeping pill that is designed to last only overnight to remain in the body for much longer in an older person. Additionally, since elderly people are, in general, more frail, falls caused by grogginess after taking a sleeping pill can lead to bigger problems, like broken bones.

Getting Some Rest
As people age, they tend to need less sleep. While teens may be able to stay in bed for hours on end, adults generally need only seven or eight hours of sleep to feel rested. After the age of 60, the number of sleep hours may decrease even more.

"Not all people need eight hours of sleep," reminds Kripke, who explains that many seniors who seek out sleeping pills don't have a sleep disorder at all and are simply overly-concerned by shorter nights of sleep. "There are two kinds of older people," he says. "Those that wake up at night and worry, and those that wake up and don't worry."

Therefore, before reaching for a prescription bottle, Kripke reminds seniors that there are other options to help you sleep through the night, cut down on the frustration of early waking and feel rested during the day.

First, many seniors spend too much time in bed. Often, simply going to bed a little later helps seniors stay asleep through the night. Also, if you wake up in the middle of the night and don't feel like you're going to fall asleep again, "get out of bed," says Kripke. He suggests moving into another room to read a book or watch television until you feel tired again.

If sleeping problems linger or are caused by pain or shortness of breath, be sure to see a doctor. It is possible that a more serious problem, like sleep apnea, underlies your insomnia.

Long Term Care -- An Impending Crisis for the Elderly

2008-11-10T15:44:00.000-08:00

Tacoma, WA - Heartwarming Care

If we were to ask an older person what his or her most important concerns or wishes for the future are, we would probably get a variety of different answers. But according to surveys frequently conducted among the elderly, the most likely answers we would receive would include the following three principal concerns or wishes.

Remaining independent in the home without intervention from others.
Maintaining good health and receiving adequate health care.
Having enough money for everyday needs and not outliving assets and income

Although the elderly are definitely concerned about the need for long term care it is not high on the list of concerns. To address these concerns or wishes and maintain the quality of life wanted in the elder years, it simply takes a little preplanning. Unfortunately, as a rule, that is not happening.

For seniors the need for eldercare is probably the most catastrophic unexpected event that could happen to them. This is because the need for care typically removes any level of security an older person may have with the three major lifestyle concerns mentioned above.

With the need for long term care the older person:

Loses independence
Has experienced a loss of good health
Uses up remaining assets and income

No other late-life event can be as devastating to the lifestyle the elderly are so concerned about maintaining. No wonder many seniors, who are receiving eldercare, withdraw, become angry and suffer from severe depression.

Ironically, older people painstakingly scrape together $100-$200 a month to buy Medicare supplement insurance to cover a risk about equal to their yearly premiums. Or they will go without and sacrifice food, recreation and activities in order to hold on to the last few dollars in their savings accounts.

Yet very few elderly spend money or time to plan for the event of long term care. It seems a paradox that someone would be more concerned about buying insurance for a home fire when the risk of needing eldercare is 600 times more likely. Or what about the cost of insuring for an auto accident when the risk of long term care is 120 times more likely and is potentially 20 times more expense? Or why the overwhelming concern to buy Medicare supplement insurance when without it Medicare would still cover the bulk of their health needs after deductibles and co-pays? We're not recommending going without insurance coverage we're simply using it as an example of how people refuse to deal with the issue of long term care.

No one knows why people beyond age 65 are not more concerned about preparing for long term care. Perhaps they have seen it in their family or among friends and seen the effect that it has. Or because of the unsavory aspect of receiving long term care, perhaps the elderly prefer to ignore it rather than embrace the need for it. Perhaps they mistakenly think the government will take care of them. Or they are assured that family and friends will provide the care when needed, but don't know how difficult it really is for loved ones to provide that care when the time actually comes. Whatever the case, without proper planning, the need for eldercare can result in the single greatest crisis in any elderly person's life.

In addition, this lack of planning will always have an adverse effect on the older person's family. It usually results in great sacrifice or financial cost on the part of the spouse or children. Or for those with no immediate family, long term care can be a burden to extended family members.

We urge our readers who are planning for retirement or in their retirement years and who have not prepared for long term care to do so. As Benjamin Franklin so aptly put it "an ounce of prevention is worth a pound of cure."

Holiday Blues - Depression in the Elderly - Home Care, Tacoma, WA

2008-11-06T10:18:00.000-08:00

The holiday season is quickly coming upon us. If you are a caregiver for an elderly loved one, you may notice a change in your loved one's mood as the holidays approach. Perhaps you are one of many, who visit elderly parents and family during the holidays who live a distance away. When you visit you may notice that loved ones are not as physically active, or they show symptoms of fatigue or sadness and have no interest in the holiday or in their surroundings.

According to the National Institutes of Health; of the 35 million Americans age 65 or older, about 2 million suffer from full-blown depression. Another 5 million suffer from less severe forms of the illness. This represents about 20% of the senior population -- a significant proportion.

Depression in the elderly is difficult to diagnose and is frequently untreated. The symptoms may be confused with a medical illness, dementia, or malnutrition due to a poor diet. Many older people will not accept the idea that they have depression and refuse to seek treatment.

What causes depression in the elderly?
It is not the actual holiday that causes depression, but the fact that holidays tend to bring memories of earlier, perhaps happier times. Additional contributing factors that bring on depression may be the loss of a spouse or close friend, or a move from a home to assisted living, or a change with an older person's routine.

Depression may also be a sign of a medical problem. Chronic pain or complications of an illness or memory loss can also cause depression. In addition, diet can also be a factor when proper nutrition and vitamins are lacking.

As an example, Selma’s husband passed away, a few months before Christmas. Her family lived close by and would call or drop in often to check on her. Selma seemed a little preoccupied and tired, but this was to be expected as she had been the caregiver for her husband for many years. It wasn’t until the family noticed that her holiday decorations were not out and her yearly routine of Christmas card writing was not happening that they began questioning her mental and physical well being.

A trip to her physician confirmed depression, caused by not only the loss of her spouse, but a vitamin B12 deficiency. There were both mental and physical reasons for her depression.

Symptoms to look for in depression might include:

Depressed or irritable mood
Feelings of worthlessness or sadness
Expressions of helplessness
Anxiety
Loss of interest in daily activities
Loss of appetite
Weight loss
Lack of attending to personal care and hygiene
Fatigue
Difficulty concentrating
Irresponsible behavior
Obsessive thoughts about death
Talk about suicide

How do you know if it is depression or dementia?
Depression and dementia share similar symptoms. A recent article on Helpguide.org gives some specific differences:

In depression there is a rapid mental decline, but memory of time, date and awareness of the environment remains. Motor skills are slow, but normal in depression. Concern with concentrating and worry about impaired memory may occur.

On the other hand, dementia symptoms reveal a slow mental decline with confusion and loss of recognizing familiar locations. Writing, speaking and motor skills are impaired and memory loss is not acknowledged as a being problem by the person suffering dementia.

Whether it is depression or dementia, prompt treatment is recommended. A physical exam will help determine if there is a medical cause for depression. A geriatric medical practitioner is skilled in diagnosing depression and illnesses in the elderly. If you are a care taker of an elderly person it may be beneficial for you to seek out a geriatric health care specialist. For more information on senior health services go to http://www.longtermcarelink.net/about_senior_health_services.htm

Treating depression in older people.
Once the cause of depression is identified, a treatment program can be implemented. Treatment may be as simple as relieving loneliness through visitations, outings and involvement in family activities. In more severe cases antidepressant drugs have been known to improve the quality of life in depressed elderly people. Cognitive therapy sessions with a counselor may also be effective.

As a care giver or family member of a depressed older person, make it your responsibility to get involved. The elder person generally denies any problems or may fear being mentally ill. You can make the difference in and remove the Holiday Blues from seniors suffering from depression.

The Geriatric Mental Health Foundation offers a “Depression Tool Kit.” To read more about the tool kit and depression in the elderly go to http://www.gmhfonline.org/gmhf/consumer/depression_toolkit.html

To find a Senior Health Care Services in your area on the National Care Planning Council website go to http://www.longtermcarelink.net/a7seniorshealthservices.htm

The National Care Planning Council supports the work of geriatric practitioners and their services to the growing senior population. If you are a geriatric practitioner and would like to list your services with the NCPC please call 800-989-8137.

What Is Long Term Care?

2008-11-04T15:40:00.000-08:00

Tacoma, WA - Heartwarming Care

When a person requires someone else to help him with his physical or emotional needs over an extended period of time, this is long-term care. This help may be required for many of the activities or needs that healthy, active people take for granted and may include such things as:

Walking
Bathing
Dressing
Using the bathroom
Helping with incontinence
Managing Pain
Preventing unsafe behavior
Preventing wandering
Providing comfort and assurance
Providing physical or occupational therapy
Attending to medical needs
Counseling
Feeding
Answering the phone
Meeting doctors' appointments
Providing meals
Maintaining the household
Shopping and running errands
Providing transportation
Administering medications
Managing money
Paying bills
Doing the laundry
Attending to personal hygiene
Helping with personal grooming
Writing letters or notes
Making repairs to the home
Maintaining a yard
Removing snow

The need for long-term care help might be due to a terminal condition, disability, illness, injury or the infirmity of old age. Estimates by experts are that at least 60% of all individuals will need extended help in one or more of the areas above during their lifetime. The need for long-term care may only last for a few weeks or months or it may go on for years. It all depends on the underlying reasons for needing care.

Temporary long term care (need for care for only weeks or months)

Rehabilitation from a hospital stay
Recovery from illness
Recovery from injury
Recovery from surgery
Terminal medical condition

Ongoing long term care (need for care for many months or years)

Chronic medical conditions
Chronic severe pain
Permanent disabilities
Dementia
Ongoing need for help with activities of daily living
Need for supervision

Long-term care services may be provided in any of the following settings:

In the home of the recipient
In the home of a family member or friend of the recipient
At an adult day services location
In an assisted living facility or board-and-care home
In a hospice facility
In a nursing home

Older people need to work at keeping their mental skills sharp

2008-10-31T10:33:00.000-07:00

Tacoma, WA - Heartwarming Care

One of the nice things about getting older is that many people get a chance to relax. The only drawback is that the mental stimulation they get in their every day lives may decrease. However there are many ways to keep physically active and mentally fit. If a sport is important, then it's necessary to keep playing the sport. To keep driving skills sharp, games on the web or driving simulators can keep coordination up to par. Staying mentally active can mean doing a crossword, taking a class, attending museum lectures or even playing cards with friends. Whatever the activity, it's important to make the efforts to keep yourself both physically and mentally keen.

Tips For Healthy Aging: Become a Life-Long Learner

Using a Specialist to Prepare Financially for Long Term Care

2008-10-27T10:18:00.000-07:00

Tacoma, WA - Heartwarming Care

Long Term Care Insurance Specialist

Increasingly we see insurance agents or financial advisers that are specializing solely in the sale of long term care insurance. Not only is long term care insurance a complicated product but companies are constantly coming out with new products as well. A person selling long term care insurance also needs to have an understanding of what long term care is in order to make suitable recommendations to people buying the insurance.

Most insurance agents and financial planners simply don't have the time to keep up with these issues and that is why some practitioners have specialized exclusively in long term care. Here are the advantages of using a specialist.

The specialist often represents more than one long term care insurance company and can find the company with the best benefits and the best price.

The specialist often has experience with a number of companies and can recommend those that are good at paying claims, are expected to continue selling long term care insurance or are prone to rate increases.

The specialist has experience with medical problems involved in the issue and underwriting of long term care insurance and he or she can find the right company for underwriting or help to get the insurance through the underwriting in a chosen company.

Specialists are generally experts in understanding long term care issues, especially those specialists certified to sell partnership policies. Because of this knowledge, the specialist can recommend the best coverage to dovetail with the insured's assets, income and desires for care settings and services.

Many specialists work with a team of eldercare advisers such as care managers, pre-need funeral planners, elder law attorneys, home health providers, retirement financial planners and reverse mortgage specialists. This allows them to help the pre-retirement generation with long term care insurance and retirement planning and also help the parents of those people with elder care needs.

Elder Financial Advisor

A financial planner or advisor who works with the elderly is going to understand how to invest assets for that age group. This person will also understand how to use assets and income when there is a need for long-term care.This person will work closely with an estate planning or elder law attorney to make sure all arrangements for the estate, for disability, for loss of capacity, for medical treatment and for long-term care are covered.An elder financial advisor is also likely to work with a team of eldercare advisers such as care managers, pre-need funeral planners, long-term care insurance specialists, reverse mortgage specialists and home health providers.

Saving Seniors from the Winter Chill

2008-10-23T15:19:00.000-07:00

Tacoma, WA Heartwarming Care

It’s cold outside. And as you bundle your child into his or her heavy winter coat, hat and gloves, are you forgetting to take care of the other important loved ones in your life?

The wintry chill brings more than just a need for extra layers, for the elderly it also brings additional worries over heating costs, slippery surfaces and general safety. But seniors are especially prone to hypothermia, when their body temperature drops to dangerous levels.

The good news is that there are steps seniors can take to prevent a cold-weather catastrophe:

Staying Warm Inside

Keep the Heat On. The thermostat should not be set to a temperature lower than 65 degrees, even when you are not at home. This will prevent pipes from freezing and keep the house warm enough to prevent hypothermia.

Block Drafts. If heating bills are an issue, cover the windows with heavy plastic sheets and caulk the windows to avoid drafts.

Check Smoke and Carbon Monoxide Detectors. Fuel-burning heaters and appliances emit carbon monoxide, a potentially deadly gas. These appliances pose an even greater hazard in the winter, when windows are closed and ventilation is poor. Smoke and carbon monoxide detectors should be checked once a year to ensure that they are still functional.

Protect Your Skin. Skin tends to get dry and crack in the dry heat created by furnaces, so use heavy creams and lotions to keep your skin soft.

Eat a well-balanced diet. Food provides your body the energy to stay warm. Avoid alcohol. While alcohol may make you feel warm inside, it is not truly raising your body temperature in a meaningful way.

Staying Safe Outside

Dress Warmly. It may seem like a no-brainer, but even for a walk down the block, make sure to protect yourself against the cold. And always wear a hat, 30 to 50 percent of your body heart is lost through your head, so this is the best way to keep your body warm.

Don’t Over Do it. Shoveling snow takes a lot of strength and since the cold weather puts an additional strain on the heart, it may be too much for seniors. If you do shovel, stretch beforehand and take frequent breaks. Even better, ask the kid from the house across the street to do it.

Avoid Slips and Falls. Wear thick, rubber-soled boots and replace the rubber tips on canes and walkers to prevent them from slipping out underneath you.
Winterize your Car. Add snow tires, make sure they are correctly inflated and keep your fuel tank full.

How to Overcome Bathing Difficulties - Alzheimer's

2008-10-12T15:12:00.000-07:00

Tacoma, WA - Heartwarming Care

Helping individuals with bathing-the entire process of undressing, toileting, washing, drying and dressing-often poses great challenges for caregivers and these challenges may intensify as the individual's illness progresses. Challenges often arise from a person's resistance, fear, embarrassment, distress or disorientation, as well as symptoms of the disease that cause the person, for example, to forget how to undress or how to communicate that the water temperature is uncomfortable. The following are a few strategies to assist with the process:

Try to stick to the old routine. It is best to try to maintain the individual's previous bathing preferences such as time of day and frequency, but to make modifications if the individual, for example, wakes up soiled in the morning or tends to exhibit sundowning behaviors towards evening.

Safety first. Take precautionary measures to ensure the individual's safety such as never leaving the person unattended, installing no-skid surfaces and grab bars in the showers and bathtubs, adjusting the hot water heater to prevent scalding, always approaching the individual from the front and eliminating distractions.

Keep it comfortable. Adjust the room temperature so it is comfortable for disrobing. Following the bath or shower, have the individual stay in a warm room during drying and then quickly follow with dressing.

Think over communication. Try to use simple words and one-step directions. If the individual has trouble understanding try using non-verbal gestures to assist with instructions. Be patient, and reassuring while smiling and speaking calmly.

Maintain dignity. Give the individual as much independence as his or her abilities will allow, while always ensuring the person's dignity throughout the process. Speak directly and make eye contact.

Can Fruits and Veggies Keep Your Memory Strong?

2008-10-02T15:04:00.000-07:00

Tacoma, WA Heartwarming Care

Filling your plate with fruits and vegetables may not only be a good way to keep your body healthy, it can keep your brain going strong, too.

In yet another study uncovering the benefits of fruits and vegetables, researchers from Utah State University have found that elderly men and women who consume high amounts of these foods have better memories than those who skimp on the broccoli, spinach, apples and pears.

Dr. Heidi Wengreen, a lead investigator of the study, said that this research is the first of its kind to look at diet as a means to prevent dementia. The findings were presented at the Alzheimer's Association International Conference on Prevention of Dementia.

For the study, researchers tested the memory of over 5,000 seniors up to four times over an eight-year period. At the beginning, the participants also answered questions about their eating habits. The group of seniors with the highest intake of fruits and vegetables, five or more servings a day, scored higher on the test than the rest of the participants. Moreover, those who nibbled on plenty of veggies and fruit were able to maintain their memory over time.

"It appears that higher intake of fruits and vegetables may protect against memory loss in older adults," said Wengreen.

Previously, the same research group also found that taking daily vitamin E and C supplements also cuts the risk of Alzheimer's. However, since the data was based on the dietary information given at the beginning of the study, Wengreen said that she is unable to say if the seniors who consumed a lot of fruits and vegetables continued to do so as the years passed.

Additionally, Wengreen also noted that the current guidelines recommend that adults eat five-and-a-half cups of fruits and vegetables every day, which is far from the amount that most American adults eat.

"Many Americans fall short of the current recommendations…even though we know they are good for us," said Wengreen, "Eating more fruits and vegetables in your later years offers benefits to both body and mind."

An Holistic Approach to Seniors Health Care

2008-09-16T17:18:00.000-07:00

From: Heartwarming Care Tacoma, WA

Many health care practitioners who specialize in taking care of the elderly use a holistic approach. An attempt is made not only to treat the specific condition or conditions, but to make sure there are sufficient activity, proper nutrition and family support at home.

Practitioners work closely with family members to make sure their loved ones are taking medications properly and are reporting their symptoms. They require those watching out for the elderly to closely monitor health conditions and report any changes before things get worse. They meet with their patients regularly enough to monitor their health. This broad-based approach results in better health and in fewer visits to the emergency room because intervention for a worsening condition is achieved at an earlier stage.

A good example of this holistic approach is the Veterans Administration Health Care System. The VA system, over the years, has become the nation's largest geriatric care provider for older men. Almost all veterans are men and because most veterans hearken back to World War II, the Korean conflict and the Vietnam War most of them are older than age 60. Because of this the, VA has found it necessary to adapt its health-care to this age group.

VA schedules regular exams at least every six months or yearly depending on available funds and personnel. A health examination typically includes lab work. Screenings for cancer, cardiovascular problems, eye problems, hearing problems and many other conditions common to aging are a routine part of Veteran's Administration health care.

VA was one of the first health providers in the nation to require its local hospitals to keep their records on computer and in a central database. This allows health practitioners in the system to quickly and efficiently access all information and avoid misdiagnoses and possible drug interactions. By taking a hands-on, preventative approach to the treatment of older men, the system is able to keep its patrons healthier and avoid costly medical interventions due to lack of follow-up.

A significant problem with providing holistic treatment is many health insurance providers, including Medicare, will not pay for routine office visits without an underlying medical complaint. Some private health plans are starting to use so-called "pay for performance" or "outcome based care" where the overall health of the patient takes precedence over the procedures used to get there. But Medicare, up to this point, has not made this change. This makes it extremely difficult for the geriatric health care provider to monitor his patients and intervene before a health problem becomes bad enough to require hospitalization or major surgery. Doctors practicing this type of medicine have to be inventive in order to provide adequate treatment. Family of the elderly can also help in this respect by "finding" medical complaints to justify setting regular appointments with the doctor.

People with the flu are contagious for 24 hours before they have symptoms

2008-09-12T17:10:00.000-07:00

Tacoma, WA

People who are carrying the flu virus can spread it to others before they have started to feel sick. That's because flu symptoms such as a sore throat or headache are actually the body's way of mounting a reaction to the virus. According to the Centers for Disease Control and Prevention, adults who do have symptoms can continue to pass on the virus for three to seven days after their symptoms appear, and children can pass along the virus for more than seven days after the onset of symptoms.

You should not cover your cough with your hands

2008-09-10T17:06:00.000-07:00

The flu season is just around the corner...
Intercepting a cough or a sneeze using your hands might stop virus-laden droplets from flying through the air, but it may increase the chance you will give a cold or the flu to someone else if you touch their hands. When the recipient of a handshake with an infected person touches his or her face, eyes or mouth, that person can easily acquire the virus. Infection control experts say that if you don't have a tissue on hand to sneeze into and then throw away, you should use the crook of your arm. This way when you shake someone's hand you won't transfer germs. If you do cough or sneeze into your hands, wash them immediately or apply a hand sanitizer.

Caregiving - Talking With Your Supervisor

2008-09-08T08:00:00.000-07:00

Tacoma, WA

Three Point to Remember:

Talk to your boss as soon as you realize there may be a problem managing both your caregiving and your work.
Flexibility goes both ways. If you ask for a more accommodating schedule, consider what you can offer in return.
Remember that you’re not asking for a favor but seeking an arrangement that benefits both you and your employer.

Many caregivers are reluctant to discuss caregiving with their supervisor, fearing it will affect their job security or their prospects for advancement. Unfortunately, not all employers and supervisors understand or are sympathetic to your situation. But many employers are aware of caregiving’s effect on productivity, and some offer formal programs to address the issue.

Don’t wait for a scheduling crisis to develop. Set up a meeting with your boss as soon as you realize you’re having a hard time managing both caregiving and work. He or she may already be wondering whether you’ve been distracted by personal problems.

Before you meet, create a specific proposal, explaining your requests. For example, explain that flex-time would allow you to take your loved one to appointments during normal working hours. Think of ways you might be able to help your supervisor and coworkers in return, such as taking on an undesirable shift. If you ask to work at home two days a week, how can you reassure your boss that you’ll stay productive? Propose a trial period and follow-up meetings.

Keep in mind that your initial meeting may not go smoothly. If your supervisor hasn’t experienced caregiving first-hand, he or she is likely to underestimate the difficulty of your situation. It may take a few conversations and negotiations to find a plan you both agree upon.

Remember that what you’re seeking is an arrangement that will enable you to remain a healthy and productive employee. If your employer won’t agree to such an arrangement, you may need to consider hiring help in the home or taking your loved one to an adult day care facility. Adult day care facilities offer supervision, social interaction, and sometimes health services. Many even provide transportation.

If those options aren’t feasible, you might also start considering other employment opportunities, including part-time work. Be sure to carefully consider how a new job would affect your benefits and retirement plans.

This article is provided courtesy of...
Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
http://www.heartwarmingcare.com
(253) 460-1574
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 9849

Your Home -- Typically the Desired Setting for Elder Care

2008-09-05T11:25:00.000-07:00

Tacoma, WA

Most of those receiving long-term care and most caregivers prefer a home environment. Out of an estimated 8 million older Americans receiving care, about 5.4 million or 67% are in their own home or the home of a family member or friend.

Older people prefer their home over the unfamiliar proposition of living in a care facility. Family or friends attempt to accommodate the wishes of loved ones even though caregiving demands might warrant a different environment. Those needing care feel comfortable and secure in familiar surroundings and a home is usually the best setting for that support.

Often the decision to stay in the home is dictated by funds available. It is much cheaper for a wife to care for her husband at home than to pay out $2,000 to $4,000 a month for care in a facility. Likewise, it's much less costly and more loving for a daughter to have her widowed mother move into the daughter's home than to liquidate mom's assets and put her in a nursing home. Besides, personally taking care of our parents or spouses is an obligation most of us feel very strongly about.

For many long term care recipients the home is an ideal environment. These people may be confined to the home but continue to lead active lives engaging in church service, entertaining grandchildren, writing histories, corresponding, pursuing hobbies or doing handwork activities. Their care needs might not be that demanding and might include occasional help with house cleaning and shopping as well as help with getting out of bed, dressing and bathing.

Most of the time these people don't need the supervision of a 24/7 caregiver. There are, however, some care situations that make it difficult to provide long term care in the home.

It is precisely the ongoing and escalating need for help with activities of daily living or the need for extended supervision that often makes it impossible for a caregiver to provide help in the home. Either the physical demands for help with activities of daily living or the time demand for supervision can overwhelm an informal caregiver. This untenable situation usually leads to finding another care setting for the loved one.

On the other hand if there are funds to hire paid providers to come into the home, there would be no need for finding another care setting. By planning for eldercare in advance and providing the funding necessary to remain in the home, no one need go to a facility to receive long term care. With enough money, anyone who desires can remain at home to receive the necessary care.

This article is provided courtesy of...
Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
http://www.heartwarmingcare.com
(253) 460-1574
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 9849

Plan for Eldercare Now Before the Choice Is No Longer Yours

2008-09-04T15:31:00.000-07:00

Tacoma, WA

We spend our lives making plans and preparing for future events. From the beginning we plan and work towards education, a career, marriage and a family. We work hard and save, invest and build our assets. We insure to protect our home, automobiles, health and medical needs.

Retirement age comes and our plan is finally in place. Finances and time have come together to allow us to enjoy the elder years of life. This is where the planning ends. But life does not end at retirement. There is a portion of life that the majority of us will live through after the retirement years called "eldercare."

Very few of us plan for this part of our life, but yet it is as important if not more important to plan for it. If we don't, we are leaving our last years in someone else's hands. As much as children love us and mean to do right by us, they cannot possibly know what we want if they are not told.

Ruby, age 80, lost her husband. She had cared for him at home after his stroke. Understandably, she felt lost and depressed after his death. An inner ear infection caused Ruby to lose her balance and fall, breaking her hip. While she was in the hospital recuperating from surgery, Ruby's children were deciding her future.

Concerned for her health and safety they moved some of her belongings to an assisted care facility. Upon Ruby's release from the hospital she was taken to her new home at the facility. Between pain medication and the unfamiliar surroundings, Ruby never was herself again. She spent her last days asking what had happened to her home and belongings. Though her children had her best interest at heart, they did not know how Ruby wanted to spend her elder days.

An article on the AARP website titled, "Talking about Independent Living" states, "Research has shown that, as people age, they prefer to continue living independently, preferably in their own homes. While adult children often worry about their parent's situation, it can be difficult to know if parents really need, or want, help from their children."

Children and parents should talk about all these things.

What do you want your children, or friends to do on your behalf? When it comes time for them to help, you may not be physically or mentally able to execute your wishes. This is where your long term care plan comes into effect. You need to be the responsible person for your own personal care in the future.

The time to start planning is now. Don’t wait until the choice is no longer yours!

This article is provided courtesy of...
Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
http://www.heartwarmingcare.com
(253) 460-1574
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 9849

Caring for a Loved One at Home Can Be Challenging

2008-09-03T04:50:00.000-07:00

CHAPTER 22

Tacoma, WA

Informal caregivers are family, friends or volunteers who provide care for a loved one. Informal caregivers are rarely paid directly for their services. They may receive indirect payment through sharing a loved one's income or assets. Although informal caregivers may provide services in a facility, in most cases they are providers of care in the home.

Caregivers face many challenges providing care at home. A wife caring for her husband may risk injury trying to move him or help him bathe or use the toilet. The financial impact is another challenge. The financial burden depends on who the informal caregiver is. For a spouse there is typically no financial cost since income and assets will be the same with or without a need for care. However, if a spouse offering informal care is employed and has to quit his or her job to provide care there is a significant impact on that family's finances.

Despite the fact that there may be no significant financial impact on a spouse caring for the other spouse at home, there can be significant impact on the emotional and physical health of the caregiving spouse. Because of the strain and burnout often associated with caregiving, the healthy spouse may experience deteriorating health and eventually require long term care services as well. In some cases healthy spouses have succumbed drastically to the pressures of caregiving and died prematurely, well before their care recipients have died.

Another caregiver challenge may be the need of constant surveillance on a spouse with advanced dementia. Still another caregiving challenge could be a son living 500 miles from his disabled parents and constantly traveling to and from his home, trying to manage a job and his own family as well as taking care of the parents. Other challenges to home care may be caregivers who simply don't have the time to watch over loved ones and those loved ones are sometimes neglected.

Inadequate care provided to a loved one

Lack of training for caregivers

Lack of social stimulation for care recipients

Informal caregivers unable to handle the challenge

Depression and physical ailments caused by caregiver burnout

In order to make sure home care is a feasible option and can be sustained for a period of time, caregivers must understand the problems outlined above, deal with them and correct them. This often involves bringing in so-called formal caregivers such as care managers, home care companies or other long term care advisors. The responsibility for recognizing home care challenges and solving them is shouldered by the team of specialists and advisors that have been invited in to offer their help.

This article is provided courtesy of...

Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
http://www.heartwarmingcare.com
(253) 460-1574
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 98499

Understanding the Progression of Care Commitment

2008-09-01T08:45:00.000-07:00

Tacoma, WA

The chart below illustrates the relationship of informal care to formal care. As care needs increase, both in the number of hours required and in the number or intensity of activities requiring help, there is a greater need for the services of formal caregivers. Unfortunately, many informal caregivers become so focused on their task they don't realize they are getting in over their heads and they have reached the point where some or complete formal caregiving is necessary. Or the informal caregiver may recognize the need for paid, professional help but does not have the money to pay for it.

It is the job of a care manager or a financial adviser or an attorney to recognize this need with the client caregiver and provide the necessary counsel to protect the caregiver from overload. An overloaded caregiver is likely to develop depression and/or physical ailments and could end up needing long-term care as well. Or the consequences of not being able to cope with caregiving might even result in an early death for the caregiver.

Intermittent Care
This would require the occasional attention of an informal caregiver but there may also be a medical condition that may require expertise the informal caregiver does not possess. As a general rule most people receiving this kind of care would probably be in their own home and the caregiver would be living or working close by and stop only for occasional visits.

There is, however, a growing trend where the only family caregivers may be living hundreds or thousands of miles away from their loved one. In this case, a care manager would be hired to arrange for the intermittent care for the loved one.

Part Time Care
This could still be furnished by an informal caregiver assuming there is no extensive medical condition requiring frequent attention. It is more likely under this scenario the care-recipient and the informal caregiver would be living together. Or with no caregiver available a decision would have to be made whether it would be in the best interest of the care-recipient to receive formal care in the home or to go to a care facility. Oftentimes a care facility can offer a better environment at a lesser cost. On the other hand, many care-recipients prefer to remain in their homes at all costs. And for long distance caregivers, hiring a care manager is still the best option.

Full-Time Care
Full-time care can often be offered by informal caregivers living with the care-recipient. But this arrangement is not always in the interest of the caregiver. Because of the demand on a caregiver's time and attention, this arrangement will often result in the caregiver suffering from severe depression, social isolation and the development of medical ailments. Again, the decision is often dictated by the lack of funds to pay for professional care. But when the need for care has progressed to a fulltime basis, advisers or family should be looking to implement formal care delivery either in the home or in a facility. As with the other care options above, a care manager could prove invaluable in selecting the setting and the care providers.

Depending on what causes the need for long-term care, a care-recipient could start out at any point on the curve below. For instance a stroke, injury or sudden illness may result in the immediate need for part time or fulltime care. On the other hand the slowly progressing infirmity of old age, the slow onset of dementia or a progressively deteriorating medical condition may only require occasional help; beginning with intermittent care from an informal caregiver but gradually progressing to the need for fulltime, formal care.

This article is provided courtesy of...

Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
http://www.heartwarmingcare.com
(253) 460-1574
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 98499

About Caregiver's - Part 5

2008-08-29T08:41:00.000-07:00

Tacoma, WA

Formal Caregivers
Formal caregivers are volunteers or paid care providers associated with a service system. Service systems might include for-profit or nonprofit nursing homes, intermediate care facilities, assisted living, home care agencies, community services, hospice, church or charity service groups, adult day care, senior centers, association services, state aging services and so on. More detail on the services, availability and costs of nursing homes, assisted living facilities and home care agencies are provided in other sections of this site.

During 1998, in the U.S., 9.5 million patients were served by home health agencies and 576,000 by hospice care. This care was provided by approximately 13,000 agencies, nationwide. The percent distribution of disorders requiring home care were: diseases of circulatory system–25.2%, injuries and poisoning–9.9%, muscle and skeletal disease–8.8%, respiratory–8.4%, cancer–7.3%, endocrine, nutrition, metabolic, immune–5.4%, nervous system– 4.3%, others–balance of distribution. Of the patients served by hospice, about 76% had cancer or heart disease.

In 1997, there were about 17,000 skilled and intermediate term nursing homes in the US serving 1,609,000 residents. About 1,465,000, or 91% of residents, were age 65 and older. Out of those 1.5 million elderly patients in nursing homes in 1997, as a percent of the total, help was provided with 1 or more activities in the following categories: bathing or showering–96.2%, dressing–87.2%, using toilet room–56.2%, eating--45%, transferring to chair or bed–25.4%.

As of the year 2000, an estimate by NatWest Securities places the total number of assisted living beds nationwide at 1,387,836 beds with total revenue of $33.1 billion. Although assisted living facilities (ALFs) are regulated by the state health departments, data for utilization and cost don't show up in national statistics. And although Medicaid covers some cost for ALFs, the costs of numerous waiver systems used by states aren't shredded out separately.

The numbers of people using ALFs are included in those 9.5 million receiving care in the community. A 1996 survey by the American Health Care Association reveals that 59% of ALF residents are admitted from their homes and the other 41% come from nursing homes, hospitals or other ALFs.

Some ALFs have found a niche in providing care to Alzheimer's patients and many ALFs are exclusively dedicated only to Alzheimer's residents. This disorder requires constant supervision but not necessarily from the more costly skilled medical staff found in nursing homes. And since at least 5% of those over 65 and 46% of those over 85 suffer from mental impairment, this provides a potentially large market for ALF Alzheimer's facilities

Not all residents of ALFs need care or assistance. Many are there because they want a simpler lifestyle without the worry of maintaining a home and they seek the companionship of other people their own age. They have chosen assisted living because they may need some minor help with IADLs but they anticipate a time when they may need the more intensive care available with an ALF.

As of 1996, ALF residents who were independent with ADLs (needing no assistance) were as follows: eating--88%, transferring--84%, toiletting--78%, dressing--58%, bathing--49%. A recent survey of assisted living administrators estimated that 24% of their residents received assistance with 3 or more activities of daily living, such as bathing dressing and mobility. They estimated that about one-third of residents had moderate to severe cognitive impairment.

Informal Caregivers
Informal caregivers are family, friends, neighbors or church members who provide unpaid care out of love, respect, obligation or friendship to a disabled person. These people far outnumber formal caregivers and without them, this country would have a difficult time formally funding the caregiving needs of a growing number of disabled recipients.

Depending on the definition of caregiving, estimates of the number of informal caregivers range from 20 million to 50 million people. This could represent about 20% of the total population providing part-time or full-time care. The typical caregiver is a daughter, age 46, with a full-time job, providing an average of 18 hours per week to one or more of her parents.

Among adults aged 20 to 75, providing informal care to a family or friend of any age, 38% care for aging parents and 11% care for their spouse. About two-thirds of those caregivers for people over age 50 are employed full-time or part-time and two-thirds of those–about 45% of working caregivers–report having to rearrange their work schedule, decrease their hours or take an unpaid leave in order to meet their caregiving responsibilities.

A recent study estimates these people lose about $660,000 in wage wealth over their lifetime because of work sacrifices. And estimates of productivity losses to businesses because of time off for caregiving range from $11 billion to $29 billion yearly. The average amount of time informal caregivers provide assistance is 4.5 years but 20% will provide care for 5 years or longer.

This article is provided courtesy of...
Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
http://www.heartwarmingcare.com
(253) 460-1574
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 98499

About Caregiver's - Part 4

2008-08-28T08:38:00.000-07:00

Tacoma, WA

Does Medicare Cover Custodial Care?
Of course it does. Medicare routinely pays for custodial care in every skilled care setting for which it provides payment. Medicare will not pay for custodial care in the absence of a skilled care plan.

Medicare covered nursing home stay
A patient receiving skilled care in a nursing home from Medicare not only receives care from skilled providers such as nurses, therapists or doctors but also receives care from custodial providers such as aides or CNA's. This care usually consists of help with bathing, dressing, ambulating , toileting, incontinence, feeding and medicating. Medicare does not exclude the custodial services but pays the entire bill because custodial care is a necessary part of the skilled care plan in a nursing home.

Medicare covered home care
Custodial care is always a part of a skilled care plan for home care. The patient receives skilled care from a nurse or therapist and custodial care from an aide for help with bathing, dressing, ambulating , toileting, incontinence, medicating and possibly feeding. Medicare pays for both types of services.

Medicare hospice care
The hospice team consists of a doctor, a nurse, a social worker, a therapist when needed, a counselor and an aide to provide custodial care. Help with activities of daily living is provided at home or in a Medicare approved hospice facility. Custodial care is always a part of a hospice plan of care and Medicare routinely pays for these services.

Please note that there is no such thing as a custodial nursing home. All nursing homes are by definition skilled care facilities because they have nurses who are skilled care providers. Also be aware that not all states license intermediate care facilities which might provide less than 24 hour registered nursing care. "Skilled care patients" in nursing homes are referred to as such because they are receiving payment from Medicare or sometimes payment from private health insurance plans. Practically all nursing home residents have medical needs but Medicare and other insurance plans will only pay for patients that have certain acute medical needs where recovery is anticipated. Patients with chronic medical problems are typically not covered by Medicare but would be covered by Medicaid.

The confusion with understanding the term "skilled nursing care" probably comes from Medicare itself. To be a certified Medicare nursing home and receive payments from Medicare a nursing home must meet the Medicare definition of a "skilled nursing facility". This means there must be registered nurses on duty 24 hours a day, there must be a doctor on call at all times and there must be ambulance service to a local hospital. Medicare may also require additional staffing and facility arrangements to receive certification. It is unfortunate that the word "skilled" is used in this definition. All nursing homes whether they meet the definition of a "skilled nursing facility" or not provide services from a nurse, doctor or therapist and this meets the medical definition of skilled care. Many states have adopted the same federal criteria for licensing their nursing homes. In some states the "skilled" definition is the only option for a nursing home. But in some states facilities with lesser services can receive different licensing classes. These might be called intermediate care facilities or "small nursing homes".

About Caregiver's - Part 3

2008-08-27T08:36:00.000-07:00

Tacoma, WA

CHARACTERISTICS OF CAREGIVERS

Custodial Care versus Skilled Care
Custodial care and skilled care are terms used by the medical community and health care plans such as health insurance plans, Medicare, Medicaid and the Veterans Administration. They are used primarily to differentiate care provided by medical specialists as opposed to care provided by aides, volunteers, family or friends. The use of these terms and their application is important in determining whether a health care plan will pay for services or not. Generally, skilled services are paid for by a health care plan and custodial services, not in conjunction with skilled care, are not covered. However, custodial services are almost always a part of a skilled service plan of care and by being included, custodial services are paid by the health care plan as well. Many people have the misconception that only skilled services are covered. This is simply not true.

According to the American College of Medical Quality:

" Skilled care is the provision of services and supplies that can be given only by or under the supervision of skilled or licensed medical personnel. Skilled care is medically necessary when provided to improve the quality of health care of patients or to maintain or slow the decompensation of a patient's condition, including palliative treatment. Skilled care is prescribed for settings that have the capability to deliver such services safely and effectively.

Custodial care is the provision of services and supplies that can be given safely and reasonably by individuals who are neither skilled nor licensed medical personnel. The medical necessity and desired results of skilled care must be clearly documented by a written treatment plan approved by a physician. A patient may have skilled and custodial needs at the same time. In these circumstances, only those services and supplies provided in connection with the skilled care are to be considered as such. The treatment plan must include:

• The applied therapies;
• The frequency of the treatment which is consistent with the therapeutic goals;
• The potential for a patient's restoration within a predictable period of time, if applicable;
• The time frame in which the prescribing physician will review the case for the purpose of evaluating a patient's status and before reassessing the medical necessity of ongoing treatment; or
• The maintenance, palliative relief, or the slowing of decompensation in a patient's status, if applicable.

Determinations of the medical necessity of skilled care must be based on the applicable standard of care."

Writers and advisers who are not part of the medical community often confuse custodial care and skilled care with specific care activities. For example help with the activities of daily living and many of the items on the list in the previous section are care activities thought to be by definition custodial care. Whereas the monitoring of vital signs, ordering medical tests, diagnosing medical problems, administering of intravenous injections, prescribing and dispensing medicine, drawing blood, giving shots, dressing wounds, providing therapy and counseling are all activities normally associated with skilled care. But many non-medical advisers and writers don't know that skilled and custodial refer to the people who deliver the care not the actual care given.

A skilled care provider can also provide services normally thought to be provided by custodial caregivers. Such things as help with activities of daily living and so-called instrumental activities of daily living are often furnished by skilled providers in the course of their treatment. Or a skilled care plan may call for services that can be delivered by a custodial caregiver but it would still be under the skilled plan of care for that individual. On the other hand people who deliver custodial services may from time to time perform those activities supposedly reserved for skilled providers. Such things as taking blood pressure, administering medicines, giving shots or changing wounds might be provided under certain circumstances by a custodial provider.

Please remember that the terms skilled and custodial do not refer to specific types of long-term care services but rather who delivers those services. Also the delivery of skilled services must be done under a written plan of care which often includes custodial care services.

About Caregiver's - Part 2

2008-08-26T08:33:00.000-07:00

Tacoma, WA

CHARACTERISTICS OF THOSE RECEIVING CARE

Those people requiring the assistance of a caregiver generally fall into 3 categories: Acute care patients, chronic care recipients and younger individuals with permanent mental impairment requiring supervision.

Acute Care
Acute care is often a rehabilitative recovery from a hospital stay or it may be a recovery from a serious illness or injury. With acute care, the individual is typically under the formal supervision of a nurse, physical therapist or nurse's aide. Recovery can be at home but is more likely to be in a hospital rehab wing or skilled nursing facility. Recovery time is usually a matter of a few weeks or months after which the person–even if not completely whole-- is typically capable of not needing a caregiver to function normally.

Acute conditions that may require the assistance of a caregiver might be recoverable brain damage or spinal cord injuries and orthopedic traumas or elective orthopedic surgery, especially to the back or feet, which are slow to heal. Other serious injuries from accidents may also require formal or informal caregiving. Serious acute circulatory conditions such as a heart attack, mild stroke or infectious diseases of the heart or blood vessels may require a caregiver. Cancers, especially the types affecting the abdominal cavity, may require a caregiver before death or recovery occurs. And many severe infectious diseases may result in a recovery period where the patient is too weak and needs a caregiver.

Chronic Care
Certain diseases, disorders, accidents or injuries result in disabilities that last longer than a few weeks or months. Many of these become permanent problems and although the disabled person may eventually adapt to take care of himself, a caregiver is often needed. The location of where this care is given, either in the community or in an institution and whether the care is provided by informal or formal caregivers is dependent on the nature of the disability and the ability of the caregiver.

Constraints on the ability of an informal caregiver to watch over a loved one are:

the amount of time needed to care for the disabled
the need to balance a job with the demands of caregiving
the need for medical supervision of the disabled person
the physical demands of moving the disabled
the issue of the dignity and privacy of the caregiver and the disabled over changing dirty diapers or helping in the bathroom with toileting and bathing.

Often an informal caregiver will attempt to provide this care perhaps out of love or a sense of obligation, but a better solution for everyone involved might be the use of a formal caregiver such as a home health agency or an assisted living facility. The nature of the chronic condition also dictates who gives care and where.

Many informal caregivers attempt to cope with care beyond their ability or expertise. Added to this pressure is the fact that the care recipient is often reluctant to give up the familiar environment of the home in favor of what might be better care and a more stimulating environment in an assisted living facility or a nursing home.

Chronic conditions resulting in permanent care might include permanent spinal cord or brain damage, disabling strokes, advanced congestive heart failure, various dementias such as Alzheimer's Disease, Parkinson's Disease, emphysema, various hereditary disorders such as Huntington's Disease, advanced diabetes, obesity-induced joint failure, disabling amputation, chronic disabling pain caused by injury or diseases such as pancreatitis, advanced osteoarthritis especially of the back, advanced osteoporosis with stress factors, AIDS and a host of slow-acting incurable cancers.

Many of the above problems are more prevalent with advanced ages and as a rule, caregiving is a problem associated with aging. But many people of all ages often develop disabling conditions requiring care. And many of these are progressive forms of auto-immune disorders such as type I diabetes, rheumatoid arthritis, multiple sclerosis, scleroderma, lupus, ALS, muscular dystrophy, myesthenia gravis, and many more.

Mental impairment developed early in life
Many of the roughly 5 million persons between the ages 18 to 65, requiring caregivers, are impaired due to mental retardation, autism, Down's Syndrome, mental illness or severe depression. Many will live an entire lifetime needing supervision and because they have such a long-term need their numbers tend to skew the data for age-related caregiving. Although no studies are available showing the incidence of first-time caregiving-–number of people per 10,000 needing care each year for the first time–-this incident rate would probably be very low for young-aged individuals and high for the old-aged.

For people over age 65, the average need for care is probably only 2 to 4 years before recovery or death. With the aged there is a constant turnover of new cases replacing those who die or recover. With the mentally impaired, the need for care may drag on for scores of years. There is less turnover due to death or recovery and these unfortunate people tend to accumulate in number.

Although many of these people are cared for at home under supervision of their family, many more are cared for in special facilities licensed for this type of care. Both formal and informal caregivers are supported by government programs to help relieve the financial burden this type of caregiving can impose.

About Caregiver's - Part 1

2008-08-25T08:31:00.000-07:00

Tacoma, WA

Caregivers provide assistance to other people who because of physical disability, chronic illness or cognitive impairment are unable to perform certain activities on their own. So-called informal care can be offered by family members or friends, often in a home setting. Or paid or volunteer professional care, so-called formal care, can be obtained at home, in the community or from institutions such as nursing facilities or government institutions.

Roughly, 11.1 million Americans of all ages are receiving formal or informal care at any given time. This represents about 4% of the population and is comprised of about 9.5 million receiving care at home or in the community and another 1.6 million residing in nursing or intermediate care facilities. About 25.8 million family caregivers provide personal assistance to individuals 18 years or older who have a disability or chronic illness. And nearly one out of every four households (22.4 million households) is involved in giving care to persons aged 50 or older. About 43% of those receiving care are under the age of 65 and are evenly spread between ages 18 to 64. Children under 18 and receiving assistance because of disability are often characterized under different criteria of caregiving.

Sometimes human caregivers can be replaced or assisted by mechanical devices. These might include special computer systems for communication, special locomotion equipment, remote vital sign monitoring devices or remote oversight monitoring. Continued technology advances may help relieve the time commitment of human caregivers.

Since the implementation of the Medicare Prospective Payment System in 1999, home health agencies have been looking for more cost-effective ways to provide care. Telehomecare is a more effective way to deliver home care under certain circumstances. Since it is a rapidly developing field, it's difficult to define all telehomecare applications.

It usually involves two-way electronic communication between the patient and the formal caregiver such as a nurse or doctor. Communication can occur with two-way radio, telephone or as is usually the case, two-way interactive video using a computer and phone lines or satellite downlink. This electronic face-to-face home visit also requires some means for the care provider--who might be hundreds of miles away-- to access patient vital signs and receive patient-initiated medical tests. The patient or her in-home informal caregiver has been trained to use electronic monitoring or test equipment that sends the relevant video snapshots or numeric data via phone line, or radio wave to the formal caregiver.

Telehomecare is not only more cost-effective but also in many cases it provides a higher quality of care. Here are some of the ways telehomecare is proving to be beneficial:

reducing number of visits to the emergency rooms
reducing unnecessary visits to physician's offices
avoiding unnecessary costly visits by health providers
providing education of the patient in early symptom management
monitoring vital signs on a 24-hour basis, therefore providing a potential for early intervention and/or prevention of repeat hospitalization

Although electronic monitoring of patients is also a function of telehomecare, it is also becoming a primary source of supplemental home care service not always involving the use of a home health agency. This area of assistance focuses more on the use of devices that warn of problems with homebound people who are often without caregivers for certain periods of the day. This may include 24-hour vital sign monitoring, video surveillance, emergency signaling systems or GPS locator devices for wandering care recipients.

15 Tips on Aiding People with Poor Eyesight, Tacoma, WA

2008-08-20T12:00:00.000-07:00

Fading vision is very common in the elderly, yet many seniors are unaware of the changes in their eyesight. Older people need three times as much light as young people. They have trouble seeing in dim light, and can't readily focus on moving objects or distinguish colors and shapes. The inability to see clearly can lead to a safety hazard. With a few adjustments, a person's daily living can certainly be brighter.

Here are 15 tips on how to help a person with poor eyesight:

Brighten the entire living area, especially stairways, hallways, and places where the person reads.
Distribute light evenly in all rooms.
Put night lights in the bedroom, hallway and bathroom.
Put reflector tape on the edges of stairs to make them easier to see.
Make sure light switches are at the entrances to all rooms.
Install lights that automatically turn on at dusk.
Write notes in large dark letters.
Suggest a larger television or an easier-to-view black-and-white TV.
Buy lubricating eye drops that help prevent dryness, which makes eyes itch and burn.
Wear bright colors when you visit.
Provide large-print books, newspapers, and magazines.
Decrease glare by covering shiny surfaces and adding blinds or shades to windows with bright sunlight.
Check to see that certain medications are not the cause of blurred vision.
For persons who are unable to enjoy reading on their own, provide books on tape.
Provide sunglasses with 100% UV protection to cut down on glare.

The Medicaid Dilemma, Tacoma, WA

2008-08-19T14:51:00.000-07:00

Medicaid and Medicare are two easily, and frequently, confused terms, so clear up a bit of the mystery. MediCARE is for medically-necessarily care; MedicAID is for aid or assistance with certain medical costs and custodial (long-term care, or LTC) costs for the truly poor. What IS the Medicaid dilemma?

Medicare is a largely federal program. Medicaid, on the other hand, is a state-federal partnership with the states having the main say in who gets covered, what the income and assets can be, and what types of care (nursing home-only, home care, assisted living, and so forth) are covered.

Qualifying for Medicaid Benefits for LTC

Many people assume that Medicare will pay for LTC. That is true in perhaps five percent of cases. Source for this statistic? Then they expect that Medicaid will pay these costs. That is true in about 49 percent of dollars spent. Source for this number?

The following rest of this paragraph and the next one need to be rewritten for greater clarity in explaining countable and noncountable assets. There also needs to be a simple summary sentence to introduce the concept that Medicaid eligibility depends on the total amount of your assets and income. Also explain “spend down” and “lookback.”

But, if your individual income exceeds your state’s limits (ranging from about $603 to $1,809, depending on where you live), you will have a hard time getting Medicaid to foot the LTC bill. There are also limits on assets, with certain temporary why temporary? exclusions such as the residence if a spouse still lives there. The amount of assets you – who is ‘you” -- the person who is institutionalized, or the community can keep changes each year and depends to some degree on your state’s rules.

You this excludes the single person – rewrite so this paragraph can apply to both married and single people qualify for Medicaid-funded LTC based on your joint assets and personal income, not your joint income. In addition, there are provisions that let a certain amount of the Medicaid-qualified spouse’s income be retained by the spouse not currently requiring care. Check with your advisor for details and specifics for your case.

If You Plan to Use Medicaid for LTC

If you go into LTC using Medicaid, here are a few things you should consider:

You can only keep about $60 per month for personal care (haircuts, Bingo, adult diapers, tissues, clothes, and so forth). All other pensions and sources of income in your name go to the Medicaid entity in your state.

Your personal assets must be depleted to $2,000 or less, depending on your state.

The house is left alone if your spouse or other qualified person is still living in it, or if you might return to it, but at the death of the last resident your state generally reserves the right to sell the house and use the proceeds to help reimburse the costs of your care.

You will not have full choice of care facilities. Some facilities don’t accept Medicaid patients; some confine them to one wing.

You will very likely have a same sex roommate—and often not one of your choosing.

Medicaid and LTC Planning

Some seniors and their advisors look at “Medicaid Planning,” what is Medicaid Planning? This is a controversial topic. Explain why. especially when you are just over the income or asset maximums or there are other mitigating circumstances. Others look to LTC insurance, or rely on personal assets, or assume their family will take over their care. The options are many, and planning is critical.

References and useful links:

The Georgetown University Long-Term Care Financing Project (January 2007): http://ltc.georgetown.edu/pdfs/medicaid2006.pdf. This is a very interesting and educational fact sheet covering a wealth of LTC concerns and considerations related to Medicaid.

About Medicaid Long-Term Care: http://www.longtermcarelink.net/eldercare/medicaid_long_term_care.htm An interesting consumer-focused site.

The Federal Government:
http://www.cms.hhs.gov/home/medicaid.asp

This article is provided courtesy of…
Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
http://www.heartwarmingcare.com
(253) 460-1574
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 98499

About Hospice Care for Pierce County, WA

2008-08-14T10:22:00.000-07:00

Tacoma, WA

It is unfortunate that many people who died in a hospital emergency room or who received heroic treatments to prolong life in a hospital or nursing home may have had the alternative of dying at home in familiar surroundings, with family or other loved ones at their side.

When someone is dying but there really is no hope for recovery, the family often calls 911 and starts a process which can result in great stress and great emotional discomfort. The loved one who is dying ends up in a hospital or nursing home in a strange environment, frightened and confused and tied to tubes and monitoring devices. This is not the ideal way in which to spend one's last hours on earth.

Attending to a dying loved one in the peace and quiet of the home with caring children and grandchildren surrounding the bed can be a spiritual experience for all involved. Hospice can allow this to happen. Memories of a loved one passing in peace can provide great comfort for family members in years to come.

When there is no longer hope for prolonging life, especially when this decision is made months in advance, hospice is a better alternative to other medical intervention.

Hospice is a form of medically supportive care for patients who are terminally ill. It allows for compassion and dignity in the process of dying. A commonly used definition for terminally ill patients is,

"patients who have a progressive, incurable illness that will end in death despite good treatment, and who are sick enough that you would not be surprised if they died within six months."

Hospice care is a valuable service and is generally underused except for terminal cancer patients. Most families wait too long to have their doctor prescribe hospice from Medicare. Many doctors or family don't often consider this care alternative for Alzheimer's, degenerative old age or other debilitating illnesses where a person is going downhill fast. They should.

Hospice involves a team approach using the following providers.

Family caregivers;
The patient' s personal physician;
Hospice physician (or medical director);
Nurses;
Home health aides;
Social workers;
Clergy or other counselors;
Trained volunteers; and
Speech, physical, and occupational therapists, if needed.

The purpose of hospice is the following:

Manages the patient's pain and symptoms;
Assists the patient with the emotional and psychosocial and spiritual aspects of dying;
Provides needed medications, medical supplies, and equipment;
Coaches the family on how to care for the patient;
Delivers special services like speech and physical therapy when needed;
Makes short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time; and
Provides bereavement care and counseling to surviving family and friends.

A person can receive hospice from Medicare if he or she is

eligible for Medicare Part A (Hospital Insurance), and
the doctor and the hospice medical director certify that the person is terminally ill and probably has less than six months to live, and
the person or a family member signs a statement choosing hospice care instead of routine Medicare covered benefits for the terminal illness, and
care is received from a Medicare-approved hospice program.

A person may continue to receive regular Medicare benefits from his or her customary doctors for conditions not related to the hospice condition.

Who are the Hospice Providers in Our County?
Franciscan Hospice & Palliative Care - (253) 671-7000 or (800) 338-8305
Good Samaritan Hospice - (253) 697-7600
MultiCare Hospice & Palliative Care (253) 459-8370

This article is provided courtesy of…

Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
http://www.heartwarmingcare.com
(253) 460-1574
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 98499

Who is taking care of your health? The professional behind the abbreviation.

2008-08-13T12:58:00.000-07:00

Tacoma, WA

Professionals in the health care field are well-known for using a jargon of acronyms and abbreviations. Every day HCWs (short for health care workers) face an array of hundreds of accepted word shortcuts that they use to communicate with each other.

For the consumer of health care, this abbreviation-laden language can be a minefield of confusion, as even those treating you abbreviate their titles. There is the MD, the PA, and perhaps a DO or NP.

Who is the professional behind the abbreviation?

MD: Most people know that MD is the medical doctor. The MD’s undergraduate education is followed by medical school and several years of residency. He or she is responsible for collecting medical histories, doing exams, ordering and interpreting lab tests, making a diagnosis, and prescribing the appropriate treatment. An MD may specialize in a practice area--one specialty is geriatrics, a focus on caring for older adults.

DO: According to the American Academy of Osteopathy, about 5% of physicians in the United States are Doctors of Osteopathic Medicine, also known as DO. Most commonly found practicing in primary care, the DO uses the same methods of treatment as an MD, but places special emphasis on the connection between the musculoskeletal system and disease. The DO has similar educational preparation to that of the MD, but the training programs are specifically geared to the teaching of osteopathic medicine.

Both the MD and Do must pass licensure exams in their respective states and, if desiring certification in a specialty, complete additional training and testing.

PA: The physician-assistant (PA) is licensed to practice medicine under the supervision of a physician. A position developed in the 1960s to help overcome a shortage of primary care physicians, some of the early assistants were Navy corpsmen who had received extensive medical training during the Vietnam War. A PA generally has a health care background and college education before enrolling in the study program, averaging about 26 months in length, according to the American Academy of Physician Assistants. The program, based on the medical model, prepares the graduate to conduct activities similar to that of the physician with whom he or she practices; complex cases are referred to the physician. Upon graduation the PA must pass a national certification exam to become eligible for state licensure

NP: Another product of the 60s, the nurse practitioner (NP) is an advanced practice registered nurse with specialized education and clinical training provided in a college or university setting. Most nurse practitioners have either master’s or doctorate degrees, and provide a range of services similar to that of physicians, from diagnosing and treating illness to lifestyle management. The NP practices in many settings including clinics, hospitals, nursing homes, schools, and public health organizations. The NP is licensed in the state of practice; most hold certification in specialty areas.

If you’d like to learn more about healthcare titles, abbreviations, acronyms, and medical terminology check out these resources:

Website sponsored by the American Accreditation HealthCare Commission. Healthcare worker abbreviations. www.caci.com/cacihealth/acronyms.shtml

A short course in medical terminology sponsored by Des Moines University, Des Moines, IA .www.dmu.edu/medterms/

Use for a comprehensive search of abbreviations or terminology. www.medilexicon.com

This article is provided courtesy of…

Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
(888) 927-6227
http://www.heartwarmingcare.com
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 98499

Caregivers After Nursing Home Placement

2008-08-12T04:32:00.000-07:00

Tacoma, WA

Author:

Christine Haran

Caring for a person with dementia is hard work. Not only are caregivers watching a loved one decline, they are bathing them, feeding them and otherwise meeting all of their personal needs. While a long-term care facility may be a good solution for an exhausted caregiver, new research suggests that the depression and anxiety associated with caring does not ease up after a relative is placed in a nursing home or other long-term care facility.

"We expected that since much of the stress of caregiving, particularly for dementia patients, has to do with the hard work of providing care and being vigilant there would be some recovery among caregivers when these stressors were removed. However, we didn’t see this," says lead author Dr. Richard Schulz, a professor of psychiatry at the University of Pittsburgh School of Medicine.

Schulz’s study was part of a larger study, published in The Journal of the American Medical Association (JAMA), that followed over 1,200 pairs of patients with Alzheimer’s disease and their caregivers for about four years. For many years experts believed that caregivers whose relatives passed away while in their care recovered remarkably well. However, Schulz and his team looked at the health and well-being of 180 caregivers during the in-home experience and after they placed their relatives in a nursing home. After following these participants for 18 months, they found that those who institutionalized their relatives were just as depressed and anxious after placement as they were when they were in-home caregivers.

Caregivers at Highest Risk
The transition to a nursing home was hardest for spouses, as opposed to the children of relatives in a nursing home. About half of the spouses tended to visit daily and continued to provide care, such as helping with eating and dressing. New stressors also cropped up, such as advocating for better care for the patient by working with the nursing home staff and administration. For some, the added burdens of traveling to the facility every day and the cost of care were additional stressors. Caregivers with inadequate support from friends and family also experienced more emotional turmoil, as did people who had found caregiving rewarding.

"When you look at at-home caregiving, people report that it’s highly burdensome but at the same time they’ll tell you that they get something positive out of it," Schulz says. The people who found the most meaning in caregiving and who were the most strongly attached to their relative had the most difficult transitions. Predictably, guilt was also a problem. "There is a universal consensus that being institutionalized is something to be feared and dreaded, and family members don’t want to do it," Schulz says. "Spouses, in particular, feel that they’ve abandoned or failed their relatives in some way."

Coping with the Transition
The researchers concluded that caregivers need to be treated for their emotional distress with counseling, support groups and/or antidepressant and anti-anxiety mediation. They also need education about how nursing homes work, so that they can figure out a role for themselves, especially if they enjoyed providing direct care. Also since their relatives are likely to die in the nursing home, caregivers should work with the nursing home staff on end-of-life planning, which will help them later with the bereavement process.

"We tend to forget about caregivers after the person goes into a nursing home, but we need to make sure they are supported," Schulz says.

Tips for Taking Medicines Safely

2008-08-11T14:18:00.000-07:00

Prescription drug errors are common. Here are five steps you can take to help make sure you get the right drug at the right dose, improve communications with your doctor and pharmacist, and get the support you need. See video...

Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
http://www.heartwarmingcare.com
(253) 460-1574
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 98499

A Visit to Your Doctor: Making the Most of the Time

2008-08-08T07:00:00.000-07:00

Tacoma, WA

“When did he say I should go back to see him?” “I forgot to tell her about the medicine I take at bedtime.” “I really should have told him about ….”

Is this a common scenario for you? You return from a visit to your physician, only to remember later numerous things you should have asked about, or perhaps you don’t remember exactly some of the instructions.

Here are some tips to help you make the most of your next visit to your healthcare practitioner:

Do your homework. Whether this is a special visit to discuss a new health issue or a follow-up visit for which you’ve seen your physician before, put your thoughts down on paper in advance. If there are new symptoms, list them. Be able to describe when and where they occur, how they feel, and what has worked or not worked to relieve them. Be prepared to tell about recent lab tests, and any consultations with other health professionals.

Bring along the bottles of all the medications you are taking, including prescriptions, over-the-counters, and herbals. Then the physician can see exactly what they are, their dosages, and when you are taking them. If taking the containers along isn’t feasible, be prepared with a list to show the doctor. And don’t forget to inform him of medications that other physicians have prescribed for you. Jot down any questions you have.

Bring your papers with you. Take all your notes along; be prepared to leave them with the doctor if asked. Tuck a pad of paper and pen in your pocket for jotting down answers to your questions. Don’t leave your insurance card home; the receptionist may ask for it, even if you have been there before.

Don’t go it alone. Companionship might be just the ticket for the visit. Having a family member or friend along gives moral support, provides another set of ears, reminds you of questions you have forgotten, and helps keep information in perspective for you if you’re feeling particularly stressed. If you’re uncomfortable having another person around for parts of the visit, the companion can wait in the reception area.

Don’t be shy. Sometimes we feel embarrassed mentioning certain things to the doctor. Don’t be -- there is probably nothing your physician hasn’t heard or seen before. After all, that is his or her job -- to deal with body functions. Your physician needs all the information possible to give you the care you need.

Ask questions. If the physician says something you don’t understand, ask for clarification. The same information reworded might make more sense to you. Brochures describing disease conditions or diagnostic tests may be available to take home. Have the physician write medical terminology down on your note pad so you can research it further on the computer or at the library.

Pick up the phone afterwards. Still have questions after you get home? Call the physician or his nurse. They may not be available immediately, so leave a message about when and where you can be reached, and the nature of your question.

For more tips on how to talk to your doctor, check out these resources:

www.aarp.org/health/staying_healthy/prevention/a2003-03-13-talkdr.html:AARP offers more detailed information about talking with your doctor in the “Checkups and Prevention” section of its web site.
www.ahrq.gov/consumer/quicktips/doctalk.pdf: The Agency for Healthcare Research and Quality (AHRQ, part of the U.S. Department of Health and Human Services) offers information and publications on a wide variety of topics, including how to talk with your doctor.

Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
http://www.heartwarmingcare.com
(253) 460-1574
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 98499

How In Home Care Caregivers Recognize a Stroke

2008-08-07T07:00:00.000-07:00

Tacoma, WA

Every 53 seconds, on average, someone in the United States experiences a stroke; 160,000 die of stroke each year. Stroke is the third leading cause of death behind heart disease and cancer. Stroke can happen at any age; however, 72 percent of all strokes occur in people over age 65.

A stroke is to the brain, as heart attack is to the heart. A stroke occurs when the flow of blood to the brain is disrupted. There are two kinds of stroke; one when a blood clot blocks one of the vital blood vessels in the brain, the other when a blood vessel in the brain bursts. Recovery from stroke and the specific ability that’s been affected depends on the size and location of the stroke.

There are certain factors that may increase the likelihood of stroke; age, race, gender, family history of stroke and your own medical history. The incidence of stroke increases with age. In fact, the incidence of stroke more than doubles with each decade for people over age 55. African-Americans are twice as likely as Caucasian-Americans to experience stroke. Men tend to have more strokes than women. However, women have more strokes than men at older ages. If your parent or siblings have had a stroke, your risk of having a stroke is much greater. You have a 14 percent greater chance of experiencing another stroke within 1 year if you have had a stroke or a transient ischemic attack (TIA), sometimes called a ‘mini-stroke’.

The key word to remember when looking for signs of stroke is ‘sudden’. Sudden numbness in the face, arm, leg or one side of the body, confusion, trouble speaking, seeing, walking or loss of balance or co-ordination may indicate a person is having a stroke. A few simple questions may be helpful in identifying the signs of stroke. Can the person smile? Remember to look for numbness in the face. Can the person speak a simple sentence, for example, “The sun is shining today”? Something this simple may help identify whether the person is coherent, or confused. Do they still have coordination? Are they able to raise both arms?

Knowing the symptoms of stroke, calling 911 immediately and getting to a hospital within 60 minutes of the on-set of symptoms can greatly improve the chances of minimizing the damage caused by the stroke. Don’t wait for the symptoms to improve or worsen; every minute counts! Making the call for medical help could make the difference in avoiding a lifelong disability.

There are several things you can do to help prevent stroke. First, don’t smoke. If you do smoke, stop. If you need help quitting, consult the American Heart Association or your doctor to increase your chances of success. Second, control your blood pressure. If you have high blood pressure, take your medication as directed, monitor your blood pressure and consult your doctor regularly. Third, if you are diabetic, follow your doctor’s instructions; monitor your blood pressure and consult your doctor regularly. Last, maintain a healthy lifestyle; exercise regularly, eat a healthy diet and maintain an ideal weight.

For more information on stroke, consult the following resources; The American Stroke Association at www.americanstrokeassociation.com and http://Health.MSN.com/Stroke.

Strength Training for Seniors: What Can It Do For You?

2008-08-06T11:14:00.000-07:00

Some of us are satisfied that we’ve met our workout goals when – four or five days a week -- we do a bit of stretching, then hop on the exercise bike or treadmill, or go walking.

Are we missing something here?

Absolutely, say the experts. We’re missing one of the key components that make our exercise sessions complete. We’re not getting strength training.

The best exercise program includes four different components, according to the National Institute on Aging (NIA): endurance (such as walking or cycling) to strengthen the heart and circulatory system and improve overall fitness; stretching to promote flexibility and keep limber, and to prevent injury during the endurance phase; balance to help maintain stability and prevent falls; and strength training to build muscle tissue and reduce age-related muscle loss.

We’re not talking about training to enter body building contests! We’re just talking about how strength training can improve your daily functioning. Sarcopenia, the technical term for muscle loss, can be noticed as early as the 40s and may result in a loss of muscle strength of approximately one percent per year. If nothing is done to counteract this decline, one potentially may lose as much as 20-30 percent of muscle strength by the 60s and 70s. So it’s small wonder that many seniors complain of difficulty opening jars, lifting items, or even getting up out of chairs.

Strength training works muscles against some type of resistance; this makes the muscles contract with greater force. Over time, the result is stronger muscles and in some cases, increased size. Many benefits come from this: improvement in muscle function and flexibility, increased bone density, reduction in symptoms associated with diabetes, heart disease and other chronic conditions, lowered body fat, and increased self-confidence in looking more fit.

A study conducted at Tufts University’s Nutrition Research Center on Aging

found that seniors with osteoarthritis taking part in a 12-week strength-training program increased their muscle strength by 14 percent and balance by 55 percent. They also reported considerable decrease in pain and improvement in flexibility.

So what does strength training entail? The NIA says that you should work all major muscle groups--the upper arm and back of the arm, shoulders and upper back, chest muscles and middle back, abdominal muscles, thighs, hamstrings and calves.

Just as important as doing the exercises is carrying them out properly and safely by stretching before the weight-lifting, starting slow, and repeating them two to three times per week, on nonconsecutive days. It’s especially important to consult your physician before beginning an exercise program if you have previously been inactive. Slight fatigue and soreness is normal after strength training but pain and exhaustion is not.

The equipment you use need not be expensive – you can purchase elastic bands, rubber tubing, or weights. The NIA suggests using soup cans as weights; other experts discourage the use of homemade weights. Or, you may wish to join a fitness club or YMCA.

This resource will help you get started:

http://medlineplus.gov: click on “NIH SeniorHealth” in the right column. On the page that displays, click on “Click to begin” to display a list of topics. Click on “Exercise for Older Adults” for a table of contents. Here you will get information about how much and how often you should exercise, exercises, safety tips and other things to help you improve your strength and overall physical health. You can also go directly to “Exercises to Try” by visiting http://nihseniorhealth.gov/exercise/strengthexercises/04.html and clicking on “Strength Exercises.”

Randy Walden, CSA
Certified Senior Advisor
Heartwarming Care, LLC
http://www.heartwarmingcare.com
(253) 460-1574
10209 Bridgeport Way SW Ste. C-6
Lakewood, WA 98499

The Elderly Defy Stereotypes, But Believe in Them Anyway

2008-02-04T14:15:00.000-08:00

Author: Eric Sabo

Going against their own stereotype, the elderly are more opposed than younger people to increased funding of Social Security and Medicare, a new study suggests. Such an unusual response, the researcher's state, makes sense if one looks at the potential reason: those who would seemingly benefit the most from these programs have a poor opinion of aging.

"They do not realize the stereotypes that make them oppose Social Security," says Dr. Becca Levy, an assistant professor at Yale who specializes in studying the elderly.

Concerns that the government will run out of money to pay for retirement benefits has put the now 70-year-old program at the center of a national debate. But the general perception that the elderly are a burden, she says, points to problems that go far deeper than demanding more tax dollars to care for the old.

In other studies Levy helped conduct, senior citizens who are pessimistic about growing old tend to have worse memories, more trouble getting around and respond less well to stress compared to elderly who are happy with their golden years. Believing the worst about old age may even weaken the will to live, she says. "Those who have a positive attitude live longer."

Most people, she adds, are not aware that they harbor bad feelings about their age. But these stereotypes can lead to self doubt, causing otherwise healthy senior citizens to limit their activities when there's really no reason to.

For her current study, which was published in the Journal of Aging & Social Policy, Levy reviewed a previous survey of nearly 1,500 people, including about 260 who were 64 years of age or older.

The participants were asked about who they thought would solve the country's problems: "the energy and fresh ideas of our youth or the experience and wisdom of the old?" They were then asked if they supported more funding for a range of government programs.

Overall, the elderly were more likely to oppose greater funding for programs that directly benefited them. Are older respondents simply more conservative, or do they believe in self-reliance more than younger generations? Perhaps, Levy says, but this doesn't explain why so many also supported more funding for welfare.

In fact, the most dramatic difference was seen between senior citizens who had divergent views about growing old. Just over 40 percent who thought the experience and wisdom of old age was an asset to them opposed more money for Social Security and other programs for the elderly. In contrast, 57 percent were against more funding if they felt that younger generations had the best ideas.

Is Television to Blame?
This lack of confidence is possibly caused by a lifetime of thinking that the best years are reserved for youth, Levy says. But she argues that such negative views are also reinforced by television.

In a separate study, Levy interviewed more than 70 people who were between the ages of 60 to 92. Regardless of the actual shows they may have watched, Levy found that the more television the elderly saw, the more negative their views about growing old.

Of course, most popular comedies make older characters the butt of jokes, which some saw as good, clean fun. But one 81-year-old man complained that his age group "shouldn't be the target of jokes so often."

Another common complaint, says Levy, was that there were few elderly television characters at all. "I feel like we're non-existent," said one 68-year-old homemaker who watched more than 45 hours of television per week.

Levy says that having a greater balance of older characters, both good and bad, would be an improvement. Recognizing that growing old has advantages as well as disadvantages can help people enjoy their life as fully as they can. Still, she admits that reversing negative images of the elderly will take more than a few good television shows.

"The stereotypes of being old are reinforced all the time," she says

What treatment is available? Part 5 of 5

2008-01-20T14:09:00.000-08:00

Although there is no cure for AD, there are treatments that can help with memory impairment and improve mental functioning and to help stabilize symptoms. Early intervention with medications can slow the cognitive decline and improve symptoms and thereby help delay admission to a nursing home.

How you can prepare for this discussion

Note the name, dosage and side-effect experience(s) you have had for all current medications
List all current symptoms and note any changes
List any drug allergies or difficulties with medications in the past

What changes in behavior or mental capacity can be expected over time? Part 4 of 5

2008-01-15T12:38:00.000-08:00

AD is a progressive brain condition, so it is likely that symptoms will worsen over time. AD gradually moves through three phases: mild, moderate and severe. Eventually every aspect of cognition¾thinking, judgment and behavior¾will be compromised. In the later stages, movement, speech, bowel and bladder control may be affected. Doctors use a measurement tool called a global deterioration scale to determine the level of impairment and to see if the disease is advancing.

How you can prepare for this discussion

Review results of prior cognition tests and note any changes
Keep all your medical records in a binder and bring it with you to all medical visits

Are there any early warning signs? Part 3 of 5

2008-01-10T12:37:00.000-08:00

People with AD may show mild impairments early on. Doctors refer to this as mild cognitive impairment (MCI). It is unclear whether people with this condition will go on to develop AD. But the medical community believes that people with these mild changes should be monitored closely. Presence of the following may indicate some form of cognitive impairment.

Forgetting important appointments, people's names or numbers
Finding belongings in unusual places
Difficulty in doing everyday things or simple tasks
Difficulty finding and getting to familiar places
Difficulty following a story or conversation
Retelling stories over and over
Asking other people to help you make decisions
Heightened vigilance or paranoia
Lack of interest in things you once enjoyed
Avoidance of social situations
Depressed mood
Complaints from family members or friends

How you can prepare for this discussion

Ask family member if they have noticed anything different about your behavior
List any events that may indicate a problem

How is Alzheimer's disease diagnosed? Part 2 of 5

2008-01-08T12:36:00.000-08:00

There are some medical conditions and medications that can cause changes in thinking, so your doctor will investigate any other potential causes of your cognitive problems. The only way to confirm AD is to examine brain tissue directly. Since this is not practical, doctors use interviews with the patient and a group of tests to determine the likelihood that the disease is present. This evaluation includes a detailed medical history, medication history, physical examination, and mental status and memory exams. Your doctor will perform some standard medical tests in addition to a series of psychological exams to see what is causing memory problems. Brain scans and blood tests will also be used to help rule out other causes of dementia.

How you can prepare for this discussion

List any past or current medical conditions and their treatments
List all the prescription, over-the-counter medications and dietary supplements you are taking
Gather any available medical records, laboratory tests and procedures reports performed in the past

What is Alzheimer's disease? Part 1 of 5

2008-01-02T12:34:00.000-08:00

What is Alzheimer's disease?

Alzheimer's disease is a brain disorder that causes problems with memory, communication, thinking and mood. Although the exact cause is unknown, protein deposits called "plaques" and nerve tissue "tangles" cause gradual loss of brain function. Some changes in memory are a normal consequence of aging, but when changes in memory, spatial navigation, and concentration are affecting activities of daily living, then you may be experiencing some type of dementia. AD is just one form of dementia and dementia is just one reason for changes in memory. AD may have a genetic component so your doctor may ask you questions about family members.

How you can prepare for this discussion

List examples of problems with memory or thinking
List activities that were affected by forgetfulness
Learn your family history of AD or other forms of dementia