CONNECTION ™
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Produced by the Culture Change Network of Georgia May/June
2011
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Dear Friends,
Please note that due to computer system changes and the transition from a
monthly to bimonthly edition, the
March/April Culture Change Connection™ is available in “Previous Issues” via
link at the end of this document.
We did not send it out via email.
We hope that you enjoy this information and that it is inspirational to
you!
CULTURE CHANGE
THROUGHOUT THE CONTINUUM
OF LIFE-LONG LIVING & LONG-TERM CARE
“A different world
cannot be created by indifferent people." ~ Horace Mann
Content Category
Shortcuts:
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Pioneer Network Names Dr. Peter Reed Executive
Director National Resource in the
Field of Aging and Long-Term Care Appoints Non-profit Leader and Recognized
Expert as Next Executive Director
Quality Leaders Named as Co-Chairs to Advancing
Excellence in America’s Nursing Homes Campaign: Dr.
David Gifford and Dr. Cheryl Phillips bring expertise to national quality
effort (Source: Advancing
Excellence)
Washington, DC – Bringing a wealth of experience in improving quality in long-term care, Dr. Cheryl Phillips and Dr. David Gifford were recently named co-chairs of the Advancing Excellence in America’s Nursing Homes Campaign (Advancing Excellence). The two were elected co-chairs by the Advancing Excellence in Long Term Care Collaborative Board. Their term is for two years, beginning January 1, 2012. “On behalf of Advancing Excellence and the Collaborative Board, we welcome the opportunity to work with Dr. Gifford and Dr. Phillips in their new roles,” stated Mary Jane Koren, MD, MPH, current chair of the collaborative board. “Advancing Excellence has a wide membership full of innovative ideas and deep knowledge about how to promote nursing home quality. Dr. Phillips and Dr. Gifford are well suited to ensure that the strides we have made will continue.” The mission of Advancing Excellence is to help nursing homes become better places to live, work and visit. The Campaign does this by supporting statewide LANEs or Local Area Networks of Excellence. The LANEs focus nursing homes on problem areas that the public cares about such as improved organizational workplace practices and clinical outcomes. The Campaign also provides nursing homes free and evidence-based technical assistance tools to accomplish improvement in the selected areas. Advancing Excellence works closely with other national nursing home quality initiatives to streamline efforts and maximize improvement. With 46% of all nursing homes in America taking part in the campaign since its establishment in 2006, there has been measurable progress in many significant quality improvement areas. The number of pressure ulcers and daily use of physical restraints have both decreased. In addition, the use of consistent assignment – the same person taking care of the same resident day after day – has also increased. “Advancing Excellence offers nursing homes a unique opportunity to set goals for improvement, measure that improvement and access numerous resources to help meet the goals,” said Dr. Cheryl Phillips. “I am honored to serve such an important initiative and look forward to working with Dr. Gifford and the entire collaborative board to make this unique partnership even more effective.” Dr. Phillips serves as LeadingAge’s senior vice president for advocacy. Previously, she served as chief medical officer for On Lok Lifeways, the country’s first Program of All-Inclusive Care for the Elderly (PACE) program. She also serves as chair of the board of directors and immediate past –president of the American Geriatrics Society and is also past president of the American Medical Directors Association, the physician organization for long-term care. “I am honored to serve with Dr. Phillips to chair the Advancing Excellence board ” stated Dr. Gifford. “The Advancing Excellence Campaign is a groundbreaking collaboration between patient advocacy organizations, long term care providers, health care professionals, and government agencies that are dedicated to helping all nursing homes achieving excellence in the quality of care and quality of life for the millions of elderly living in nursing homes throughout our country.” Dr. Gifford is the Senior Vice President of Quality and Regulatory Affairs at the American Health Care Association and National Center for Assisted Living (AHCA/NCAL). Previously, Dr. Gifford served as the director of the Rhode Island State Department of Health and was the chief medical officer for Quality Partners of Rhode Island where he directed the Centers for Medicare and Medicaid Services’ national nursing home-based quality improvement effort. To learn more, click here. The Ties
That Bind: Consistent assignment gives
residents a sense of security, family (Source: Article By Joanne Kaldy,
Provider Magazine, June 2011 – preview by Kim McRae) This beautifully-written article by Joanne Kaldy provides the benefits of consistent assignment from all perspectives ~ from the “business case” to real stories from “the inside” (CNAs, residents, families and providers): “A growing number of long term care facilities have embraced this concept and implemented it with great success, and the investment is reaping tremendous dividends – happier residents and families, fewer behavioral problems, greater staff stability and lower turnover, and more referrals. Staff, residents, and family members alike are so enthusiastic about consistent assignment that facility leaders are wondering, “Why didn’t we do this sooner?” “…Barbara Frank, MPA, co-founder of B&F Consulting, a Warren, R.I.-based company that works with nursing facilities and other organizations on staffing, culture change and quality improvement, says, “I hear all the time from CNAs that they can anticipate residents’ needs all through the day and respond to them promptly and proactively.”… “Consistent assignment lets your intervene in a way that is likely to produce positive outcomes. And staff have a real sense of personal accountability when they work this closely with their residents,” Frank says.” “The benefits of consistent assignment seem obvious. “The CNA gets to know the resident very well and is familiar with the person’s habits, routines, and behavior. If the resident’s behavior changes – however subtly – the CNA is the first one to notice,” says Sister Pauline, administrator, Teresian House Center for the Elderly, a church-affiliated long term care facility in Albany, N.Y… She adds, “The aides spend a great deal of time with families and residents, and strong bonds are created. I get beautiful letters from families about care CNAs provided to their loved ones.” It is also important to remember that consistent assignment is not just for nursing homes! The entire continuum of care, support and services can benefit from adopting this practice and implementing into the life of your organization. After reading this article you will have no doubt that consistent assignment is a “WIN-WIN” for everyone. This is a MUST READ! Thank you, Joanne Kaldy ~ both thumbs way up! Nursing Home Residents Dead After Missouri
Tornado: Fundraising efforts are
underway (Source: McKnight’s)
May 25 2011 - At least 10 nursing home residents and one employee were killed in a Sunday tornado that hit Joplin, MO. The storm killed at least 117 people, and may have caused up to $3 billion in insured losses to 10,000 buildings, according to a preliminary estimate released Tuesday by Eqecat Inc. Greenbriar Nursing Home, one of six skilled nursing facilities citywide, was directly in the tornado's path. A Los Angeles Times report describes a horrific scene at Greenbriar, where 10 nursing home staffers tried to protect 85 residents in the building's central hallway. One employee said several people were pulled through the roof by high winds that also tore off the building's roof. He told the paper that he could see cars being tossed around in the air above the building. Jon Dolan, executive director of the Missouri Health Care Association, visited Joplin Monday to survey the damage at five AHCA-member facilities, including Greenbriar. One Greenbriar resident remained unaccounted for on Tuesday evening. “Greenbriar was absolute devastation like I've never seen before, even when I was in my Army Service,” Dolan told McKnight's. Two additional Joplin nursing facilities sustained significant damage and are not habitable, although no one was killed. Dolan said residents in these facilities have been moved to nearby facilities. Dolan said it is a miracle that more people did not die. He said Joplin's first responders and individual nursing home operators who executed emergency evacuation plans saved many lives. While other parts of Joplin were wiped out, Spring River Christian Village, a CCRC, has remained fully operational, with a 120-bed skilled nursing department. Spring Village executive director Rick Keller told McKnight's that because the facility was not directly affected by the storm, it's been aiding Joplin's other nursing homes. Assistance includes taking in residents, and helping one facility with laundry services. The Red Cross has also brought in other Joplin-area senior citizens who were left homeless because of the storm. Keller took in four new residents Monday morning and was expecting six more as of Tuesday afternoon. “Of our staff of 205, at least 10 employees completely lost their homes and belongings, or they had major damage to their homes. It's been heart wrenching,” Keller said. Fortunately, the facility has a strong chaplaincy program, which Keller says will help support the staff and residents. Many of the residents also have family members who were affected by the storm. “We have one chaplain on staff, and eight chaplain students that are really going to help us out if we need extra support,” Keller said. Dolan says AHCA executives from Florida, California and Alabama have already lent financial assistance. Fundraising efforts are underway to provide help for employees of Joplin's nursing homes. In addition to staff that lost their houses, there will be financial hardship due to loss of income, he said. “What gets to me is the fact that for every great caregiver who saved a life, or helped a resident evacuate safely, they might not have a home or family member to go back to,” Dolan said. “But we take care of our own. It's important to get the word out that we have highly motivated employees and operators. We are very, very lucky that we can rebuild.” LINK HERE Feds to Probe Ouster of Florida's Nursing-Home
Watchdog (Source: By Kate
Santich, Orlando Sentinel, OrlandoSentinel.com)
The federal Administration on Aging will investigate the dismissal of Florida's top nursing-home watchdog, who left his post last month after what patient advocates say was illegal interference by Florida Gov. Rick Scott. The federal agency sent a letter this week to Voices for Quality Care, a Maryland-based consumer-rights group that had called for the investigation. The letter confirmed there will be a review of Florida's long-term-care ombudsman program, "including the circumstances surrounding [the] resignation" of the former head of that program, Brian Lee. Lee, who had held the post for seven years, was considered a strong champion of residents' rights. In recent months, though, he had had an increasingly contentious relationship with the industry and said he was ultimately told Feb. 7 that the governor had ordered him to resign or be fired by day's end. He chose to resign. Federal and state laws prohibit political
interference with and retaliation against the ombudsman. "This is the right course of
action," Lee said Thursday after advocates announced the investigation.
"It shows that they're taking a hard look at what's happening in Florida
and what needs to be done to correct these atrocities within the ombudsman
program." READ MORE
Home-like, BUT whose home? (Source: Tony Sexton,
www.midwestsenioradvocacy.blogspot.com)
. MI: Project lets people move out of nursing homes
and back into community (Source: By Robin Erb,
Detroit Free Press, AHCA / NCAL Gazette)
The
Nursing Facility Transition (NFT) program helped 261 Michigan residents move
out of skilled nursing facilities and back into the community in 2006 – it’s
first full year of operation. In 2010, 1,270 people moved back into the
community with the program’s help. The program helps redirect Medicaid
dollars to pay for personal care aides, nurses and even for renovations to
make residences more accessible. Mike Daeschlein, who manages the MI Choice
Waiver program said, "It isn't that we're trying to empty out nursing homes.
We're trying to give people choices. It's real clear -- people want to stay
in their homes." LINK TO
ARTICLE HERE |
Willson Hospice House Is the Only Healthcare Facility in the World to Achieve Audubon Certification
NOTE – Ila Burdette of
Perkins + Will is on the CCNG advisory group – This project won “best of show”
at the 2011 Environments for Aging Conference
Willson Hospice House, the only inpatient facility of its kind in Southwest Georgia, has become the first Audubon Certified healthcare facility in the world. Audubon International is a not-for-profit environmental education organization that was established in 1987. Willson Hospice House was part of an Audubon Signature Program, a program for new developments that helps create an environmentally sound project. Completion of this program led to certification as an Audubon Silver International Sanctuary.
In a letter received from Audubon International, Signature Program Director Nancy Richardson said, “Congratulations on a project which gives protection to the natural resources of the state of Georgia by successfully integrating an ecosystem approach to design, construction, and management of the development. Willson Hospice House now joins Audubon International’s family of environmentally sensitive properties around the world, demonstrating a commitment to sustainable development.” This certification not only ensures the building is designed to achieve both economic and environmental objectives, but also that sustainable resource management practices are applied in the long-term stewardship of the property.
“The focus of the certification on resource management and education will ensure the continued availability of the property as a resource to learn about the role of nature in our daily lives,” said Phoebe Senior Vice President of Facilities and Construction Management John Fischer. “The Audubon International Certification also recognizes Phoebe Putney Health System’s commitment to developing world-class excellence in its healing environments.”
A Resource Advisory Committee was established to focus on the project goals and was comprised of key individuals from the community, including an ornithologist, a botanist, wildlife organization representatives, a waste management specialist and a county extension agent. A Natural Resources Management Plan was developed and implemented to ensure best practices that include green building, best management and wildlife and habitat enhancement. A case study of the project will also be developed to showcase step by step how the project was completed in an environmentally friendly manner.
“It’s the right thing to do for the environment,” said David Smith, KLMK Group project manager. “A lot of what is required to become certified is trying to co-exist with the natural environment, conserving the land for the animals, while providing the community with a much-needed service.” The building was structured in a way that minimizes the human footprint on nature caused by construction and also promotes biodiversity. The Willson Hospice House provides patients and visitors with additional places of respite throughout the site, such as an outdoor chapel, serenity gardens, a walking trail, nature observation points, healing gardens, nature boardwalks and chapel gardens.
The design of the building, developed on only 12 of the nearly 210 acres, gives much access to the outdoors, promoting Willson Hospice’s emphasis on providing a calm and peaceful setting for patients and family members. The wood-framed building, designed in a Frank Lloyd Wright-esque fashion, features lots of glass to open views to the landscape and outlying gardens, creating a tranquil, quiet environment to help relieve stress for patients who are dealing with end-of-life issues and their families. LINK TO ARTICLE HERE
Florence Hand Adult Day Care is Godsend for Local Woman
(Source: By Natalie
Shelton, Associate editor, www.lagrangenews.com) La Grange News
‘Make other people grateful you’re
here’
Faith Kerzee would stay weekends at Florence Hand Home if the nursing home
facility and her family would agree to it. But unlike most of Florence Hand’s
residents, Kerzee visits there only during the day while her daughter and
son-in-law are at work. She’s one of five women who participate in an adult
day-care program offered by Florence Hand.
“When I first heard about this place, I didn’t want to come,” said Kerzee, who
has visited Florence Hand for the last 10 months virtually every weekday from
7:30 a.m. to 3:30 p.m. Now, she said she can’t imagine her life without it.
“I can’t see,” said Kerzee, who has been blind for about 20 years. “But here,
whenever I hold out my hand, somebody will take it and squeeze it.” She credits
resident Howard Hunt for teaching her to enjoy being at Florence Hand early on.
“He was the first person I met here,” she said. “I told him, ‘Go away. There’s
no need for you to hang around me. You’d be better off going on in your group
and leaving me alone.’”
To his credit, he didn’t. Instead, he gave her a wise piece of advice. “He said
something that still stays with me,” she said. “He said, ‘Try to make other
people grateful you’re here.’” And with her brightly colored outfits, her
neat-as-a-pin hair and her sharp wit, that’s what she has done.
Kerzee has never seen the state of Georgia. Originally from Hattiesburg, Miss.,
she was living with her daughter in Germany while her son-in-law served in
Desert Storm when her eyesight left her. They moved to LaGrange when her
son-in-law, Steve Downs, began working for Kia Motors. Her daughter, Kerry
Downs, works at Callaway Middle School. Kerzee used to go on solitary walks in
her neighborhood, Kerry Downs said, but after she had surgery and stayed
briefly in rehabilitation at Florence Hand, she wasn’t able to get around as
well outside or in her home. And with her family at work all day, she needed
more interaction. “She loves being around people, and she’s very talkative,”
her daughter said. “She feels like she does some good in talking with the
residents there, and she does do that well. If there are times when a resident
might not be very lucid, she has a way of making them calm down just with a
hand on their shoulder and some conversation.”
The day care is open 6:30 a.m. to 5:30 p.m. weekdays except holidays. It offers
relief for family caretakers, delays or prevents full-time nursing care and
improves older adults’ quality of life. Besides the social interaction,
activities include exercise, bingo and other games, arts and crafts, music and
movies. Kerzee’s daughter doesn’t have to work the entire summer because she works
at the middle school, and when she reminded Kerzee she’d be home a good portion
of the summer, her mother got tears in her eyes. “She said, ‘What am I going to
do? I need to see everyone,’” said Kerry Downs, who says because of that, her
mother will continue going to Florence Hand every day this summer even though
her daughter will be home.
Kerzee especially enjoys her time with Hunt, as well as with Martha Tucker,
certified nursing assistant, who heads the adult day-care center. “I hold onto
Martha because I can’t see,” Kerzee said. “Her arm’s probably sore because of
me. I know it’s a drain to drag me places, but I feel nothing but love here.”
She and Hunt aren’t a couple, she said, but they enjoy bantering humor and
conversation. They both love to talk. “I have to censor him when he talks,” she
said. “If I were taking shorthand while listening to him, I’d skip whole
paragraphs.”
He joked with her that she’s never revealed her age. “All I can say is that I
think I’m older than anyone I know,” Kerzee said. “I never was told to tell the
truth. I learned growing up that telling the truth gets you whippings.” She may
joke, but she said Hunt has been her lifeline. “He taught me to do things for
other people and forget yourself,” she said. “He helped me learn to love this
place.”
Natalie Shelton can be reached at nshelton@lagrangenews.com or (706) 884-7311,
Ext. 229. © lagrangenews.com 2011 LINK TO
ARTICLE HERE
The shows are produced by Action Pact and hosted by
For $99.00 per site, as many people can watch as you can get around
a computer monitor or in a room to see a projection of the show. Many teams tell us that having their whole
team hear the same up-to-date, innovative information in an encouraging conversation
format helps them dive into what fits their community.
Date:
Friday, June 17
Conversation
Topic: The Pharmacist's Role in Supporting Self-Directed Living
Guest:
Denise Hyde, PharmD, Eden Community Builder
Important!
This month's session will be taking place one hour later than usual - that is,
2:00pm Central time. Please plan accordingly.
Can you imagine a pharmacist who works for the Eden Alternative? Well, we found her. Denise Hyde is a very person-directed focused pharmacist with lots of ideas for pharmacists and for teams working with their pharmacist. We've invited her to discuss the pharmacist's important role in supporting residents to live a self-directed life in a nursing home or assisted living residence. Join the conversation to hear her great ideas.
Date: Friday July 15
Conversation
Topic: Culture Change in Dining and
Regulatory Compliancve
Guest: Linda Handy, RD, Retired CA Surveyor, Author,
Training
Linda Handy is a student of culture change and regulatory compliance in dining and has figured some things out. An hour won’t be enough but she will dip into her recently published book with the same title and give insights into liberalizing diets and the resident right to self-determination. She is watching what is happening around the country and will tell you a true story of Tag F 151 Resident Rights cited due to the facility’s failure to honor a person’s right to not have a tube feeding. And Linda keeps up with the latest in research and resources which she will share.
SAGE LGBT Technical Resource Center Webinar
Date: June 16, 2011
Time: 1:30 PM ET - 2:30 PM ET
Type: Webinar
Are you aware of the specific concerns, needs, and resources available to your community’s lesbian, gay, bisexual, and transgender (LGBT) older adult population? In partnership with 10 organizations, including the National Institute of Senior Centers, and with funding from the U.S. Administration on Aging, SAGE (Services and Advocacy for GLBT Elders) launched the National Resource Center on LGBT Aging with the overall goal of improving services for LGBT older people. Learn about the unique needs of LGBT older adults, the National Resource Center's services, and suggestions on how to best meet the needs of LGBT seniors. Register
Pioneer Network's
2011 National Conference August 1- 4, 2011
St.
Charles Convention Center ~ St. Charles, Missouri
REGISTER NOW
It Takes a Village
TEAM! “Teams are essential to the process of culture change wherever
and whomever is striving for self-directed life. Whether one person and
their care partner or a team of experts from all disciplines, it is the many
minds and hearts working together that create true home.”
- Megan Hannan, Pioneer Network Board President
SPECIAL TEAM PRICING: We have heard from many conference attendees that having a team attend enhanced their experience. Some mentioned that when they attended sessions together they could "brain storm" and make joint suggestions for change upon their return. We know change is hard work and it takes a team approach to make it happen. So, we are bringing back our Culture Change Team Special Price. CHECK IT OUT AND REGISTER HERE
SAVE THESE DATES for Upcoming
Pioneer Network Conferences
August 6 – 8,
2012 in Jacksonville, Florida
August 12 – 14,
2013 in Bellevue , Washington
(near Seattle
Planetree Annual Conference October 30 – November 2, 2011
Nashville, TN
Eden Alternative
For a listing of recorded ON-DEMAND webinar events available for
purchase, click here.
SAVE
THE DATE: 6th Eden Alternative
International Conference
Navigating the Way Home: Guiding Change Along the Continuum of Care
May 30 – June 1, 2012 in
Grand Rapids, Michigan
Consider the
Conversation: A Documentary on a Taboo Subject to be released June 18th
on PBS
Consider the Conversation: A Documentary on a Taboo Subject will be released to PBS stations nationwide via the National Educational Telecommunications Association (NETA) on June 18th. Here's how you can help ensure it gets broadcast in your city:
Consider the Conversation: A Documentary on a Taboo SubjectLook up your local PBS affiliate using this link.
- Visit the station's website to identify the Director of Programming.
- Send that person an e-mail encouraging them to air the film.
- In the context of that e-mail, share the following link which provides an opportunity to view the first five minutes of the film and read the program offer: CLICK HERE .
WATCH THIS!
Changing the Conversation: How Americans talk, think and feel about aging
(Source: By Bruce Chernof,
M.D., McKnights)
In my 25 years as a physician, I've never heard anyone describe themselves as a “functionally impaired patient with chronic multiple conditions,” a “long-term care recipient” or a “dual eligible.” Yet these types of terms are used every day among healthcare professionals, policy wonks and advocates to describe the very people on whose behalf we work. The result of using this vernacular is that we talk at people rather than with them, effectively turning living, breathing human beings into obscure concepts. Dehumanizing the most human of processes – namely, growing older with health needs – breeds fear and apathy among the public at best, and at worst, alienation from a healthcare system that is perceived as too cold to care, too complicated to understand, and nearly impossible to navigate.
Over the past year, The SCAN Foundation has embarked upon a process to renovate the way we talk about the care needs that most of us will have as we grow older. The dominant phrase, “long-term care,” poorly describes the vast network of supports and services that older people rely upon for assistance, ranging from transportation to and from a doctor's visit, to help in the home with basic living needs, to care delivered in an institution. Currently, there are not enough services to meet the needs of today's seniors, let alone the impending aging boom. Yet reform has been elusive largely because the vital role that these services play in allowing individuals to age with dignity and independence are unknown or misunderstood. Most people tune out when they hear the words “long-term care” for fear that it only means nursing homes.
For elected officials, the phrase “long-term” sounds too expensive. “Long-term services and supports,” a common alternative, is a mouthful and jargon-laden. In order get the public and policy makers to connect with a growing need for support as we grow older, the key questions are what do people call this kind of care when they need it and how do we help people to talk about it without eliciting fear or indifference?
To seek these answers, we began listening to people nationwide talk about aging, from the heart and in their own words. Through focus groups with diverse Americans ages 40 and up, we heard highly personal, detailed stories of caring for a parent, spouse or other loved ones, including the challenges, the joys, the fears and the indignities. Then they were asked to envision life as a healthy, robust older person proceeding to a time when they needed help with at least two daily living tasks, such as getting dressed or getting out of bed. Even with experiencing caregiving first-hand, most were unable to see themselves ever needing this level of support.
We then informed people that 70% of people who reach age 65 will need some form of daily support as they grow older. When faced with this reality along with their own personal experiences, people used words like independence, options, choice and dignity to describe attributes that are particularly important to them when thinking about a time in life when they might require help from others.
Almost as important as what words were used are the words that were not used: hospice, palliative, geriatric, advance, dependence, death, specific diseases, legal phrases (e.g., advance directives or durable power of attorney) or anything else with those Latin or Greek derivations so beloved by the medical and other professional communities. People focused on their independence and the quality of life they want to retain, not functions that would be lost. What emerged was a model of wellness based on people's needs, preferences, and desires, not the traditional medical, sickness-based, paternalistic model.
Through several rounds of polling work, including a 2010 poll of California voters, we found that Americans are not prepared and do not know how to plan for having their needs met as they grow older. Most are also unsure about the availability and affordability of services that can be provided in the home or community. While the majority of Americans are not aware that they will likely need support as they age, they want to ensure there is a system available so loved ones are not left in isolation without a network of supports and services. They want this system to be more responsive to individuals and families who find themselves needing care. And most importantly, they are willing to vote for candidates who champion improving the system of care for people growing older with health and daily living needs.
Based on what we've learned, we will keep working to build a new
lexicon for growing older with needs that reaches people through both the head
and the heart. Focusing on older people
as “people” instead of patients and emphasizing choice and self-direction even
for those with severe limitations, these are the keys to a new public
discussion about aging with dignity and independence.
Bruce Chernof, MD, is president and CEO of The SCAN Foundation, which
is dedicated to creating a society in which seniors receive medical treatment
and human services that are integrated in the setting most appropriate to their
needs. The SCAN Foundation Perspective Series serves as a venue for opinions
and observations about transforming the way in which we age.
Imagine a World with Thousands of Homeless Alzheimers Patients
You might think this
is far fetched or that it can’t happen. Think again…
(Source: By Bob DeMarco,
Alzheimer's Reading Room)
You cannot turn on the television these days without hearing from politicians that want to cut Medicare benefits and cut back Medicaid. I feel confident when I say this. The draconian talk of cutting Medicare benefits will lead to a larger and larger number of Alzheimer's patients that are destitute. They will run out of money before they die.
If you cut Medicare, Alzheimer's patients will go broke sooner rather than later. As should be obvious, there will be a greater and greater number of patients suffering from dementia as the Baby Boom generation ages.
Today, once you exhaust most of your savings and assets you entire the Medicaid system. If Medicare benefits are cut more people will reach the Medicaid threshold sooner.
If the proposed draconian cuts in healthcare were to be enacted it will surely create a domino effect. As benefits continue to be cut it is likely that corporations will leave the Medicare system and Medicaid system. Corporations won't be able to make a profit. If you cannot make a profit the result is simple. Bankruptcy and closure of memory care facilities. The system will be overwhelmed with patient with nowhere to go.
Today I am reading about New Jersey Governor Chris Christie. He wants to cut 23,000 New Jersey residents out of Medicaid system. He will accomplish this by lowering the eligibility level from $24,645 to $5,317 a year. Not for one person, but for a family of three. It appears the Governor believes that a family of three making over $5,317 is too rich to receive Medicaid.
Imagine the number of sick people that are going to end up in the hospital when all they needed was some medication. Medication that they can't afford, and medication that they can no longer receive from Medicaid because they are no longer eligible.
If the current trends continue, and if this kind of legislation is passed, I see a future with Alzheimer's patients living under bridges along with the homeless.
I have to ask myself. Are we going to return to dreaded past. The path that my father knew (born in 1915); and that, my mother knew (born in 1916). The dreaded "home".
You might recall me writing about Dotty and how she would scream at me, "You are not putting me in home, I'll kill myself first". It must have been very ugly in a "home" when my father and mother were children and young adults.
We are clearly poor little sheep who have lost our way.
The United States of America was built on "shared prosperity". The next Presidential election will more likely than not be decided on issues like Medicare and Medicaid. Of course, and please pardon my language here, it is possible that every politician in this country will bend over so that they can keep their job. Or, will someone have the courage to stand up and say, "Enough is Enough".
I see a future, right now, where many of the Baby Boom generation are heading for a "home"; or worse, homelessness.
One way, or another, we will get back to caring about, and for, each other via "shared prosperity".
Of course, it is impossible to predict how low we can go before we come to our senses. It is impossible to know when the pendulum will start to swing back in the opposite direction.
These thoughts and opinions are my own. LINK HERE
Over 90 & Loving It
A segment from Susan Polis Schutz's new documentary film "Over 90 & Loving It" from IronZeal Films, showing American Public Television (PBS). Featuring Fran & Marlo Cowan (married 64 years) who have over 7 million views on youtube playing the piano in the Mayo Clinic atrium. (SEE WESITE) A documentary featuring people in their 90s and 100s living extraordinary and passionate lives. Filmmaker Susan Polis Schutz has interviewed some of the most incredible people you can imagine, people who aren't aware of chronological age at all, but live as though the future and youth spring eternal. WATCH HERE:
‘How We Age’ poetic, respectful look at the aging process
(Source: by Carol Bradley Bursack, Editor-in-Chief, www.eldercarelink.com)
As I read “How We Age,” by Marc E. Agronin, MD, I couldn’t help but think that that he should be held up as a role model in the medical profession. His dedication to understanding the process of aging, his respect for those experiencing the indignities that aging can bring, along with his recognition that the aged also have hopes and dreams, are worthy of the highest praise. He manages to get across all of these concepts, and much more, in “How We Age.”
Agronin begins his tale with descriptions of his medical school training. At first, Agronin was worried about becoming desensitized to the humanity of the corpses he and his fellow students were assigned for their training purposes. His description of the way many medical students adjust to the fact that they spend a huge amount of time cutting up a preserved human body is so vivid that the reader can almost smell the formaldehyde. Agronin writes, “I was particularly worried about how my growing lack of sensitivity toward the corpse could easily creep one step back to the extremely debilitated, aged patient.” He needn’t have worried. His sensitivity to human dignity seems to have been inborn. Rather than becoming hardened to the realities of the aging process, he has immersed himself in the complexities we face as time takes away from our physical selves, yet experience gives us each unique gifts. His experience working with elders at a nursing home helped his understanding that frail elders are still functioning human beings. He writes, “Unfortunately, we often fail to see the positive elements in the lives of our elders because we are so focused on the physical or mental decline of aging.”
Though Agronin learned early on that many of his fellow doctors saw little glamour in working with our aging population, considering nursing homes “God’s waiting room,” he followed his calling and is now the psychiatrist at the Miami Jewish Health Systems, the site of one of the largest nursing homes in the United States. “How We Age” is divided into five parts and is well organized, however Agronin never lets simple organization overshadow the emotional impact of his writing. He’s a storyteller who illustrates his points with human experience.
Agronin continues to wrestle with the same question many families and clinicians face – when to give up “treating” an elder – when to quit trying to “cure” that which can’t be cured. He states that his own “bias” is that we often stop treating too soon. In the section titled, “The Seamstress,” Agronin says, “We certainly cannot reverse aging, nor can we effectively treat many of the illnesses encountered in our older individuals. However, we can do something about the concerns that often drive them toward choosing death: loss of autonomy, loss of dignity, and loss of life-affirming activities.”
Agronin quotes poets and philosophers throughout the book in a manner that lends the grace and beauty of a well written novel to a book about the ultimate fact of life – that our bodies age and we eventually die. “How We Age” is available online and in book stores. READ MORE HERE
Our Irrational Fear of Forgetting
(Source, By MARGARET
MORGANROTH GULLETTE, www.nytimes.com)
IN our hypercognitive society, fear of forgetfulness has made deep inroads into the psyche. Misplacing car keys, once considered mere absent-mindedness, is now a clinical symptom. Technological ineptitude in the prime of adulthood is ascribed to memory failure. The mere whiff of perceived memory loss can have terrible consequences in an insecure economy in which midlife workers are regularly (and illegally) laid off on account of their age. This epidemic of anxiety around memory loss is so strong that many older adults seek help for the kind of day-to-day forgetfulness that once was considered normal.
Greater public awareness of Alzheimer’s, far from reducing the ignorance and stigma around the disease, has increased it. People over 55 dread getting Alzheimer’s more than any other disease, according to a 2010 survey by the MetLife Foundation. The fact that only 1 in 8 Americans older than 65 has Alzheimer’s fails to register. Is the prospect of the disease so horrifying that it should prompt someone to consider suicide? A writer I know whose mother had Alzheimer’s told me she is stockpiling pills. An academic told me he has found someone who will help him die “before I lose my mind.”
Advocacy groups, manufacturers of so-called anti-aging products and the news media have, for varying reasons, tended to inflate the number of sufferers and the horrors of the condition. Doctors, too, have been complicit: some use “cognitive impairment” as an argument for ending dialysis or other life-sustaining treatments. And some voices in our culture amplify these alarming sentiments.
Tony Kushner links Alzheimer’s to suicide in his new Off Broadway play, “The Intelligent Homosexual’s Guide to Capitalism and Socialism With a Key to the Scriptures.” His 72-year-old hero, Gus Marcantonio, a retired union organizer, tells his assembled family that he has guessed he has Alzheimer’s, and wants to sell the family house and kill himself over the weekend. Gus has no symptoms that the audience can see except once losing his place in a voluble, earnest and moving speech.
In the Korean director Lee Chang-dong’s film “Poetry,” which won the award for best screenplay at Cannes last year, the graceful and empathetic heroine, who is 66, is given a diagnosis of Alzheimer’s. She too has no symptoms other than once forgetting the word for “bus station.” Yet in the film she jumps off a bridge. The characters have other motives besides fear to end their lives — guilt, mainly. So why is Alzheimer’s brought into these plots so conspicuously? Perhaps because no other motivation seems as plausible to an audience as a reason to kill oneself.
Despite the prevalence of Alzheimer’s in our national conversation, diagnosing the disease is actually difficult. There is no test that can predict whether forgetting names or words like “bus station” is an indicator of the onset of a degenerative disease. Many older people lose the ability to remember proper nouns but then never progress to losing any other part of speech.
Most forgetfulness is not Alzheimer’s, or dementia, or even necessarily a sign of cognitive impairment. And yet any prophecy about impaired cognition — whether it is fulfilled or not — harms people’s sense of self. They begin to be treated like children, patronized with baby talk or avoided. At the assisted living facility where my mother lived until she died last year at age 96, the nursing director told me that some people think Alzheimer’s is contagious. Victims of misdiagnosis — or, just as devastating, self-diagnosis — dread being shunned, rejected by their offspring, going into debt, becoming a “burden,” losing selfhood.
It needn’t be this way. People with cognitive impairments can live happily with their families for a long time. My mother was troubled by her loss of memories, but she discovered an upside to forgetting. She had forgotten old rancors as well as President George W. Bush’s name. We sang together. She recited her favorite poems and surprised me with new material. We had rich and loving times. Suicide didn’t cross her mind. The mind is capacious. Much mental and emotional ability can survive mere memory loss, as do other qualities that make us human. In fact, a revolution in care-giving might be slowly taking root, at least among those aware of alternative narratives of memory loss.
Thomas Kitwood, a British psychologist who was a pioneer in the field of dementia care, died in 1998, but his books, which emphasize personhood instead of debilitation, remain influential. “Making an Exit,” a memoir by Elinor Fuchs, a drama professor at Yale, explored the conversational patterns of her mother when she was in an advanced stage of Alzheimer’s. Anne Basting, director of the Center on Age and Community at the University of Wisconsin, Milwaukee, who wrote a play from poems created by people with Alzheimer’s, has a slogan: “Forget Memory. Try Imagination.”
What a difference it would make if everyone began to share these attitudes. We could make cognition-related fear-mongering shameful and rare, make debates about end-of-life care less searing, improve treatment protocols, reaffirm our collective compact with older people, ease our relationships with people of any age who are cognitively impaired, and enable adults to look forward to getting older with hope instead of despair.
Margaret Morganroth Gullette, a scholar at the Women’s Studies Research Center at Brandeis University, is the author of “Agewise: Fighting the New Ageism in America.” LINK HERE
NOW READ ANNE BASTING’S
RESPONSE:
Coping With Alzheimer’s
(Source: By Anne Basting, New York Times)
To the Editor: Re “A Portrait of the Ravages of Alzheimer’s” (letters, May 29) and “Our Irrational Fear of Forgetting,” by Margaret Morganroth Gullette (Op-Ed, May 22):
The pain of experiencing Alzheimer’s, from the inside or the outside, cannot be covered with a Band-Aid of pithy phrases. Families and friends try everything to reignite the spark behind the eyes of a loved one wrestling with dementia. But when language is crumbling, “Remember when?” and “Remember me?” cannot make a person whole again. In fact, trying to rebuild memory can reinforce the pain of loss.
When I say “Forget memory, try imagination,” as reported in the Op-Ed article, it is not a pithy Band-Aid over an unhealable hurt. It is a guidepost, drawing family and friends to find one another again by simply removing the expectation to “remember.” The open, poetic language of improvisational storytelling, movement, music or visual art can reconnect us in deeply meaningful ways.
Fifteen years of research, practice and the glowing faces of people with dementia who rediscover their ability to make meaning again are powerful proof that creativity and imagination are largely untapped reserves of strength when dementia strikes.
ANNE BASTING
Milwaukee, May 30, 2011
The writer is director of the University of Wisconsin, Milwaukee,
Center on Age and Community and the author of “Forget Memory: Creating Better
Lives for People With Dementia.”
Financial Abuse of Older Americans has Increased since 2008, says Latest Data from Metlife Mature Market Institute
(Source: Metlife Mature
Market Institute)
Older Americans are losing $2.9 billion annually to elder financial
abuse, a 12% increase from the $2.6 billion estimated in 2008, according to The
MetLife Study of Elder Financial Abuse, released today from the MetLife Mature
Market Institute.
The study was produced in collaboration with the National Committee for the
Prevention of Elder Abuse (NCPEA) and the Center for Gerontology at Virginia
Tech. The study can be downloaded here.
NOTE THIS RESPONSE FROM Dr. James Bulot (Source: LinkedIn)
Dr. James Bulot • (Director, Division of Aging Services at Georgia Department of Human Services) Somewhat misleading -unless I am mistaken, it appears the data came from popular press/journal articles, etc. So of the crimes that were reported (or make the news alerts). ..there has been a 12% increase. We know that only a small percentage of the cases we work on ever make it into the news... I think the 2.9 billion is a gross understatement of the true loss.”
"Age Wave = Change Wave" Video
(Source: Eric
Schubert, Ecumen)
The future announces itself from the horizon. And look at the unprecedented statistics before us in this short video. The age wave is the change wave, an unprecedented opportunity for innovation.
Author calls ageism ‘unremitting and global’
(Source: By Susan Pigg, www.healthzone.ca)
“There was this huge divide in the country, where you had these very young, vital cities and you had a countryside where the older population was stranded,” says Fishman.
Out of that curiosity came Shock of Gray: The Aging of the world’s population and how it pits young against old, child against parent, worker against boss, company against rival, and nation against nation.
If you think the title is daunting, so is what he found — that age discrimination is “massive, unremitting and global.” And it’s bound to get worse as the first wave of baby boomers tips the scales in countries around the world from predominantly young to old.
Fishman, 52, believes the communities that will thrive are those,
like
He spoke to the Star from
You describe ageism as “omnipresent”
and say the old are treated like lepers. Why is that?
I think it’s fear and some despair — despair that we don’t really know how to spend the added third of life we now have (thanks to medical advances that have extended human lifespans), and the terror of infirmity.
It sounds like where you live
is going to have a big impact on how you age. Where is the best place to grow
old?
It’s not about geography — where the sun shines or doesn’t shine — it’s where you feel you have the most robust network of friends, where you’re familiar and comfortable with your environment and where you can stay active.
I was surprised to read that
living in big cities can actually prolong your life.
Some of the best cities to age in the world are the most densely populated
—
You talk about the coming
“epidemic of solitude,” which has already hit home in Japan, the “oldest”
country in the world. How is it playing out?
In a way that is enormously sad. In
So much of the burden around
aging is falling to women in their 50s who raised kids and are now caring for
ailing parents. Do you foresee a day when women rise in revolt?
They already are. In the countries that put the most demand on women to take care of children and elders, family size has declined most dramatically.
You say that life after
retirement is ripe with opportunities for reinvention.
One thing we’re seeing is a surge in volunteerism among older people, not just to give back, but for the very same reasons that young people do — to network, gain new skills and perhaps work their way into a new job.
Scientists everywhere are
working on a “cure” for aging — including researchers at Stanford University
who have found that old mice spring to life after being surgically co-joined
with young mice. Can you see this work ever being applied to humans?
I think that work can be applied to humans, but there are already many examples of human beings using other people as instruments to their own vitality. There’s a lively trade in body parts, often from low-income places to higher-income places.
There’s been so much written
about the huge gains in life expectancy over the last 100 years, but you say
today’s teenagers stand a good chance of having shorter lifespans than their parents.
That’s because of the huge epidemic of obesity, diabetes, strokes. You’re seeing diseases that are traditionally diseases of old age — hardening of the arteries, heart disease — now afflicting people in their teens. Most of this is because of (poor) diet.
Remote monitoring has been
touted as a fix for the coming “silver tsunami” — gadgets that will alert your
distant kids if you took your pills or fell on the bathroom floor. Is this
going to be enough?
It’s not enough, but it’s essential. There’s simply not enough money in the world for a comprehensive system of long-term care. You need to find economies of scale, and remote monitoring accomplishes two things: it allows you to cut down on labour, and allows people to age at home. But we will always need people as part of this. LINK TO ARTICLE HERE
Mean Girls in Assisted Living (And Throughout the Continuum)
“What
happens to mean girls? Some of them go on to become mean old ladies.” (And dare
I say mean old men)
(Source: By PAULA
SPAN, New York Times)
When Rhea Basroon’s mother moved into a New Jersey assisted living facility a few years ago, she found a good friend in a new neighbor named Irene. Her daughters, long concerned that their widowed mother had become isolated and depressed, were initially delighted.
“She and Irene were inseparable,” Ms. Basroon told me. “Whenever there was an activity, they’d both go. Whoever got there first saved a seat.” The two even discouraged others from joining them: “It was just her and Irene.”
Then, disaster. Irene was lured away by another resident, abandoning Ms. Basroon’s mother. “She was so lonely. There was no one else she’d bonded with,” Ms. Basroon recalled. “She was completely devastated.”
But wait! The third woman apparently eventually tired of her prize, or perhaps moved on to other prey. “She dumped Irene, and Irene came back to my mother,” Ms. Basroon said. They remained fast friends until Irene’s death several months later.
In senior residences, Ms. Basroon concluded, “it’s like junior high, with that cliquishness, that excluding” of others. This phenomenon, a sort of social bullying, apparently comes as no surprise to administrators of senior apartments, assisted living facilities, nursing homes and senior centers. “What happens to mean girls? Some of them go on to become mean old ladies,” said Marsha Frankel, clinical director of senior services at Jewish Family and Children’s Services in Boston, who has led workshops (innocuously called “Creating a Caring Community”) for staff and residents.
What sort of behavior are we talking about? Ms. Frankel and Robin Bonifas, an assistant professor of social work at Arizona State who has begun research on senior bullying, described various situations:
Attempts to turn public spaces into private fiefdoms. “There’s a TV lounge meant to be used by everyone, but one person tries to monopolize it — what show is on, whether the blinds are open or shut, who can sit where,” said Dr. Bonifas.
Exclusion. “Dining room issues are ubiquitous,” said Ms. Frankel. When there’s no assigned seating, a resident may loudly announce that she’s saving a seat, even if no one else is expected, to avoid someone she dislikes. In an exercise class, added Ms. Frankel, who has gathered examples from administrators at several Massachusetts facilities, “one resident told another, in a condescending way, that she was doing it all wrong and shouldn’t be allowed to take the class.”
General nastiness. “People loudly and publicly say insulting things. ‘You’re stupid.’ ‘You don’t know what you’re talking about.’” Ms. Frankel said. In a Newton, Mass., facility she observed, a resident actually discouraged her daughter from visiting, because the daughter was obese and her mother didn’t want her subjected to disparaging gossip. Racial and ethnic differences can also set off malicious comments.
Could all this be a consequence of cognitive impairment? Sometimes, Ms. Frankel said. Dementia can lead to disinhibition, and people say things they might once merely have thought.
But social manipulation and exclusion seem to have more to do with acquiring power, a feeling of control, at a point in life when older people can feel powerless. (Adolescence is another of those points, of course.)
“Perhaps people don’t have ways to get that sense of control in healthy ways, so it’s done by dominating others,” said Dr. Bonifas, a former nursing home social worker. “It gives them a sense that they’re important.”
Some intended victims can shrug off this petty tyranny, but others suffer. They withdraw from activities and social situations, perhaps experience anxiety or depression, want to move out. “It can get pretty nasty, and these are vulnerable people,” Ms. Frankel said.
She hasn’t found her caring community workshops very effective at getting mean seniors to behave better, since nobody considers himself or herself a bully, but they do appear to embolden the staff to intervene.
That can make a difference: At a Massachusetts class in conversational English, five of the regulars — all elderly Russian women with scientific backgrounds — turned on a less-educated newcomer from Hong Kong. They rolled their eyes when she spoke, and they sniped in Russian. The instructor, a social work graduate student and former teacher, finally announced that she would not tolerate abusive behavior in the classroom and threatened to end the session the next time it happened. “That worked,” Ms. Frankel reported.
But bolstering old people’s ability to stand up for themselves might also work. Dr. Bonifas has undertaken a pilot research program on bullying in two Phoenix senior apartment complexes and has noticed that, as with youth bullies, not everyone is equally likely to be a target.
She’s contemplating how to teach someone to say, “You’re not going to treat me like that. Every chair here is available to anyone, and I’ll sit where I want.” That way, she thinks, “the bully doesn’t derive power from the interaction.”
(She’d like to hear about your experiences, if you or your parent has encountered cliquishness and insults from other seniors. Please comment below.)
Perhaps it shouldn’t startle us that this behavior arises in senior residences — people are people, after all, wherever they live — but I’ll admit to some surprise. We all remember this harassment from the cafeteria, but we’d like to think that people learn something in the intervening seven or so decades, right?
“We have expectations that as we grow older we become more mature — the stereotype of the wise old person who knows how to conduct herself,” Dr. Bonifas said. “That’s not necessarily the case.”
Paula
Span is the author of “When the
Time Comes: Families With Aging Parents Share Their Struggles and Solutions.” LINK HERE
Tuning In to Patients’ Cries for Help: “The call bell is the patient’s lifeline.”
(Source: By TARA
PARKER-POPE, The New York Times)
Tom Kerr of Pittsburgh will never forget the long-distance call from his elderly mother, who was in a hospital in the Cleveland area with a broken leg. She phoned her son, more than 100 miles away, because no one in the hospital was answering her call button.
Mr. Kerr quickly called the hospital operator, tracked down the floor nurse and asked for someone to check on his mother. “She had to call me long distance, and then I had to call the hospital long distance,” he recalled recently. “I complained to the hospital about the lack of a response to her call button and received an apology. There was obviously no defense.”
Whether it’s a request for ice water, help getting to the bathroom or a plea for pain relief, an unanswered call light leaves hospital patients feeling helpless and frustrated. And for nurses, often the first responders to these calls, the situation is frustrating too: Short staffing and a heavy workload often make it impossible to respond as quickly as they would like. Now some hospitals around the country are starting programs to deal with the problem.
Presbyterian Healthcare Services, which operates three hospitals in Albuquerque, began focusing on improving the efficiency of its call light system after hearing complaints from focus groups of nurses and patients. The company discovered that requests could be handled far more efficiently if call-button calls were sent to a central operator. That operator can summon support workers via text message to take care of simple requests, like pillows or help with the television remote, freeing nurses to deal with bigger problems like pain relief or tangled IV lines. The hospitals now use the system in 13 units with a total of 400 beds, with plans to expand it further.
“We’ve really fundamentally changed the way we interact with our patients around their needs,” said Lauren Cates, the hospitals’ chief operating officer. “If you press a call light you have no idea if anyone is listening. Now we interact with the patient much more quickly.”
In national patient satisfaction surveys, Presbyterian has moved from the 40th percentile in call response promptness to the 75th percentile. And the company says it has seen a 92 percent reduction in patient complaints about lack of communication.
Moreover, of the 1,400 patient calls the system receives each day, about 10 percent are mistakes, caused by rolling over on the button or mistaking it for the television remote.
“Think about how much wasted time, with 140 errors a day, for our nurses who had to drop what they were doing and respond,” Ms. Cates said. “It’s made a real difference in the productivity of our staff.”
In one case, a patient gasping for air hit the call button, which the operator answered in a matter of seconds. When the operator heard the patient’s distress, she alerted an emergency response team, which rushed to the bed and performed CPR, saving the patient’s life.
At Montefiore Medical Center in the Bronx, a program called No Passing Zone trains all hospital workers — maintenance people, secretaries, volunteers, security officers and, yes, doctors — to stop what they are doing, if possible, and look in on a patient when they see the call light illuminated.
“The call bell is the patient’s lifeline,” said Jeanne DeMarzo, clinical director of nursing. “We need to act quickly and promptly to respond to the patient’s concern.” As the Albuquerque system found, many call-light requests can be handled by nonmedical staff. When the patient has a medical need, the responder immediately tracks down a qualified employee to take care of it. In addition, under a “rounding” program, a nurse, administrator or hospital aide must stop by each patient’s room once an hour, regardless of whether the call light is on. “Rounding proactively to address patient needs helps avoid use of the call bell,” said Joanne Ritter-Teitel, vice president and chief nurse executive.
Even doctors sometimes answer patient calls. “Bedpans are certainly one of the things I would happily reach for if a patient needed one,” said Dr. William Southern, chief of hospital medicine at Montefiore. “Call bells are something that me and my entire staff think it’s important to answer. It’s extraordinarily important to patients and their families.”
For patients, changes like these can’t come soon enough. Walter Rhett, 59, of Charleston, S.C., spent time in the hospital last year for thoracic surgery and needed assistance going to the bathroom after being given laxatives. The cord to the call button device was tangled in the various tubes connected to hospital machines. After ringing for the nurse he waited and waited, but no one arrived. Finally, unable to wait any longer, he soiled his bed and rang the nurse again to be cleaned up. That time, the nurse showed up quickly, he said.
When Liz Farrar, 30, of Austin, Tex., was trying to breast-feed her day-old son last year, she called the nurse repeatedly for help. Gestational diabetes during pregnancy had put the baby at risk, and when she did not get immediate help with breast-feeding and, later, a bottle, the baby’s blood sugar dropped and he wound up in the neonatal intensive care unit for five days. “After the first night, every nurse and doctor were very helpful,” said Ms. Farrar, whose son has fully recovered. “But it makes my temperature rise just thinking about the first night.
“Bottom line, never leave anyone in the hospital overnight by themselves immediately after a procedure or birth, even if they tell you it’s O.K.” LINK HERE
Peer Mentoring: A Tried and True Intervention for a Relationship Centered Culture
(Source: By Susan
Misiorski, BSN, National Director of Training
and Organizational Development at PHI, Western New York Alliance for
Person-Centered Care Blog)
Long-term care providers have the unique challenge of balancing the “culture of home” with the “culture of the workplace.” Long-term care employees, whether in home or residential care settings, are working inside people’s homes. This fact causes us to need to design interventions that have a clear and compelling impact on the employee’s experience of their workplace and the elder’s experience of home. Peer mentoring is an excellent example of one such intervention.
A mentor is someone who provides ongoing support that is not mired in the issues of positional authority that can sometimes accompany supervisory relationships. A mentor offers mentees a feeling of inclusion and connection, even in a workplace that may have cliques or subgroups that could otherwise cause a person to feel excluded.
The quality of relationships between employees will have a direct impact on the culture. A person can sense the difference immediately between the warmth that accompanies kind, respectful relationships and the coldness that follows in an environment where staff are not getting along. Employees in good relationship with each other are able to extend the same warmth to elders and family members. LINK HERE
CMS to toughen Nursing Home Compare website
(Source: James
M. Berklan, McKnight’s)
Federal regulators are undertaking major changes to the Nursing Home
Compare website and will continue to do so for five more months, officials
said. As part of the process, the Centers for Medicare & Medicaid Services
on April 23 began a six-month freeze of its Five Star Quality Ratings system
and quality measure data. Regulators will be collecting quality measure data
from the new MDS 3.0 resident assessment tool during that time. The website,
which was created to give consumers a place to compare nursing homes'
performance, also will be updated to allow consumers to more easily file
complaints against providers. Links to state complaint websites will be
included, while state fax and phone numbers will begin to appear more
prominently. CMS also will add a more visible “consumer rights” section to the
website, and a standardized complaint form for those who wish to file a
complaint by fax.
In another notable change, in July CMS will begin displaying information about
the number of substantiated complaints it has received, and the number of
enforceable actions, such as civil monetary penalties or denials of payment for
new admission, that have been imposed. Providers had lobbied against the
posting of unsubstantiated claims. LINK HERE
THE OTHER SIDE OF THE STORY:
This freeze plainly brings you a chilling
proposition
(Source:
James M.
Berklan, McKnight’s)
News that nursing home ratings would be frozen on the federal
website for consumer research for six months drew a lot of interest from
providers when regulators' plans were announced this spring. And it should
have. Not because the announcement was totally unexpected. It wasn't. Instead,
providers should be grimly resigning themselves to the fact that the screws are
tightening on them even more.
This is the lull before a storm hits for some providers: For better or worse,
your most recent Five-Star Quality Ranking currently remains frozen on the
Nursing Home Compare website. It's all a part of allowing consumers and critics
even more opportunities to treat you like a piñata.
When the Centers for Medicare & Medicaid Services first started posting
certain survey and ranking information on the Nursing Home Compare website,
much of it was simply too dense. Provider anxiety subsided quickly. The public
saw lots of numbers but could make little sense of them. And they didn't fuss
about it, either.
Now, however, one can rank a nursing home just like the latest movie release or
bistro down the street. Never mind that people's lives are at stake in one of
these categories but not the others. CMS began freezing quality measure data
and five-star quality ratings for six months on April 23. Those sickly looking
faces are from your fellow operators who had a bad previous quarter. By the
time the data are unfrozen, new quality measure data from MDS 3.0 will have
been collected. By then, the site also will be giving consumers better
opportunities to file complaints against you. “Consumer rights” will be placed
more prominently and the ability to fax in a standardized complaint form will
be available. “At least it's going to be an efficient execution,” some
providers must be muttering under their breath.
Then in July, CMS will start posting even more information for consumers to
salivate over. It will include the number of substantiated complaints received,
as well as instances of “enforceable actions” such as civil monetary penalties
and denials of payment or new admissions. If you think that's bad, remember
that provider advocates had to fight to prevent the publishing of ALL
complaints, not just substantiated ones. Maybe they're not all out to get you
after all. LINK HERE
Old People Aren’t Merely Problems To Solve
(Source: By Alexandra
Kloster, Pass the Hot Dish)
We are at war. It is a quiet war, imperceptible to anyone not fighting at the front. Battles are waged in tiny apartments or family homes that are empty and too quiet, guest bedrooms in a grown child’s house or assisted living communities, forever trying to reconcile the fragile balance of how to assist without sacrificing living. The enemy is what we value most, the thing we all want more of until it turns on us and betrays us. The enemy is time.
There was a death in my family this week. I guess at some point in my childhood my parents must have explained to me that Char wasn’t actually a blood relative, but it didn’t matter. Char and her husband, Bob, were our family. They were always there, and we loved them. Isn’t that family?
Tall, slender, with jet-black hair that eventually drifted into snow white, Char, with her extra long cigarette always dangling from her elegant hand, might have resembled a suburban Cruella De Vil if she’d had any meanness in her, but she didn’t. She chirped when she talked. Her words fluttered and floated in the air making everything she said sound like a friendly song. The only thing scary about Char was her Chihuahua, Poco, who guarded her with the ferocity of one those flying monkeys from “The Wizard of Oz.”
Poco died a long time ago, but I can still hear Char breaking into laughter as she reprimanded him for snapping at me. I don’t know if she even knew how to be angry. If she did, I never saw it. For the last two years of her life, Char waited for Bob to come home. Bob died 13 years ago. The last time I talked to Char it was a conversation in figure eights. She drifted in one direction and then another, always ending up in circles.
Alzheimer’s disease had invaded her mind. It was like watching someone fall down a hole in slow motion. It scared me. I didn’t know what to say, so I said nothing at all, and I listened to her beautiful voice become an echo of what it once was.
It takes a lot of tenacity to grow old whether you’re doing it in the midst of illness or just the passing of time. The only person I can think of who publicly celebrates longevity is Willard Scott. The rest of us run from it pausing only long enough to buy the latest cream, supplement or wonderberry that’s promising to stave off the effects of the most natural process we can experience. You know who understands how futile that is? Old people.
The elderly understand a lot. The cruel irony of building up the wisdom and experience of eight or nine decades is that it’s at that point when people usually stop asking you for your opinion. I’ve made that mistake. I made it with Char, and I’ve made it with others. The glare of disease or a walker or a wheelchair was so blinding that I didn’t see the person in front of me. I didn’t see the years of contribution or the longing for a purpose or the struggle to stay relevant.
Sometimes when I visit my parents I’m so preoccupied by the doctors appointments on the calendar or the medicine schedule in the kitchen that I forget to have real conversations with them. I ignore who they are because I’m so worried about protecting them from themselves. I forget that those two complicated, funny, smart people still have a lot to teach me, and sometimes, though I hate to say it, I treat them like problems to solve.
There are millions of people living among us who are struggling to
hang on to their identities and fighting against becoming invisible. A lot of
them are losing. Char became invisible even to herself. Maybe on Memorial Day
as we are remembering the people who gave their lives for our country, we can
also remember the people fighting this other war. We can help them win. By remembering that every one of them is a
unique and valuable person before it’s too late, we can help them win.
Five Ways to Manage Costs of Caring for
Aging Parent
(Source: By Sandra Block, USA TODAY)
Last March, Brad Veitch, 60, of
Veitch's mother lives alone in a small town in California's San Joaquin Valley, a five-hour drive from Moraga. For a while, he drove to her home every other week, usually for three days at a time. She doesn't own a computer, so Veitch couldn't use the Internet to search for a job while caring for her. He also worried that he would miss calls from potential employers while on the road.
Bradley Veitch, of Moraga, Calif., with
his mother, Marion Veitch, 91, outside her home in Taft, Calif.
"So much of job searching today is networking," he says. "When you connect with a person and they say they'll call you back, it produces anxiety when you realize (you're) going to be gone for three days." Veitch says he's been out of work before, but this time, "The burden seems to be much greater, and I think it is because my emotional reservoir is depleted. So much of it has gone to Mom."
Veitch feared he would need to hire a caregiver, something he knew his independent-minded mother would oppose. But a group of friends from his mother's church has helped him avoid that step. One friend stops by in the morning to make sure she's taken her medication, another stops by for lunch or dinner, and two check in daily by phone. Their aid has let Veitch, who hopes to be working soon, reduce his visits to once every three weeks.
"The church has really done the day-to-day care," he says. "If they hadn't been there, I'd be hiring somebody to do that." READ MORE HERE
Alzheimers Off the Top of My Head -- Get Your Head Out of the Sand
I have to start practicing my new 7 word speech -- Get your head
out of the sand...
(Source: By Bob DeMarco,
Alzheimer's Reading Room)
When it all started, I decided to move into my mother's condominium and keep her in her own home. I did this because I concluded after reading some of the literature, that moving her into a new environment would be too difficult and disconcerting for her. As a result, I ended up living in an over 55 community where a large fraction of the residence are 75 years or older. When it comes to Alzheimer's and dementia I have received an eye opening education.
One by one I watched friends and acquaintances of my mother fall into dementia. More often than not their children do little or nothing as the disease starts to progress. The children often watch the parent deteriorate until there is no alternative to full time care.
I watched as one person had one automobile accident, then a second before their children concluded there was something wrong. I tried to alert them before the first accident, and after the first accident.
I watched another go from mild dementia to full blown Alzheimer's almost overnight because nothing was being done by the family, or the personal care physician. I tried to do something. I failed.
I suggested to all of them that they get some memory testing, and a neurological or geriatric consult. They didn't listen.
In the future I will start adding this, I hope you don't regret your decision not to move on this now. I'll want to say more, maybe even shout, but I'll bite my tongue. I am not a doctor, just a friend.
It is only after you become a caregiver that you begin to understand the importance of early diagnosis. Believe it or not, as hard as caring for someone with Alzheimer's can be, it is likely to be much worse if you stick your head in the sand.
Hmm, there is a good idea. Maybe instead of reasoning with the children, or by explaining the signs, maybe I'll say, get your hand out of the sand. Just those few words. When they ask what I mean I'll say, you figure it out.
You might be thinking, Bob that is stupid. Well, so far using my usual communication techniques I am batting zero. So I can't do any worse.
I doubt that many people understand that not only are they hurting
the person suffering from dementia by failing to act -- they are hurting
themselves.
__________________________________
I learned, over these years, that most personal care physicians are
not good at detecting Alzheimer's or dementia. It is not their fault.
Alzheimer's is hard to spot under most circumstances. It is not easy to do when
you see a person for ten minutes every few months. Alzheimer's is a tricky little disease. My
mother, well past the moderate stage, could fool any doctor -- right now. She
could probably fool you if you are not a ONE. On the other hand, come on over
and spend a day with us. You will have no doubt. Now that I think about, she still fools me.
__________________________________
In the beginning, observing the children's lack of attention and
care for their parents made me very angry. Over time, I came to understand how
difficult this situation can be for children that are busy living their own
lives. Like I was, they are unequipped to understand Alzheimer's and dementia
when it strikes. As adults we are not
well equipped to become the parents of the parent. I never had that course in
college. The children of baby boomers are going to get one heck of an
education. The smart one's should start now -- get ahead of the curve.
__________________________________
I now believe the single biggest reason Alzheimer's sufferers fail
to get diagnosed early and get treatment is denial on the part of the children;
and, because personal care doctors are not properly trained. One in 8 people
over the age of 65 suffers from Alzheimer's disease or one of the other types
of dementia. Yo Doc, suspect it all the time. Look for it. Hunt. Be a doctor.
__________________________________
I know when the diagnosis comes, family and friends of the sufferer
often can't believe it, and often refuse to believe the diagnosis. I have
discussed this with many caregivers and many agree. It happened in our
case--with family and friends. They just can't comprhend or accept Alzheimer's
disease. This is now understandable to me. Alzheimer's is hard to understand
and comprehend even when you sit in the front row.
__________________________________
Alzheimer's and dementia are hard to comprehend. I use the word
comprehend with purpose. I recognized the situation with my mother, but it took
me more than one full year to begin to deal with the problem effectively. Keep
in mind, this was all I was doing day and night -- learning and assessing the
alternatives. At that time, there wasn't much good information available.
Fortunately, this has changed. I learned
on the job. Full time. I am now convinced that if I had not acted in the way I
did, when I did, that something horrible would have happened. I base this on
the fact that I have seen the horrible that comes with inaction and
denial. Keep this in mind, you are still
alive after experiencing the horrible. Think about it.
__________________________________
I now have a better understanding of why seventy percent of
Alzheimer's patients do not get diagnosed early. Many sufferers don't get
diagnosed properly until they need full time care. Until they "can't do it
anymore", or until something near devastiting happens. Automobile
accident, lost and wandering, scammed out of their life savings, or a
precipitous drop in health usually serves as a wake up call. But, not always. If you are related to someone over 75, you
really need to start getting educated now. If you know someone approaching 85,
I suggest you start reading the books on Alzheimer's now. Please know and try to understand
this---nearly one out of every two persons over the age of 85 suffers from
Alzheimer's or another type of dementia. If you don't know one, you will soon.
__________________________________
I bet if I told you that you were going to die if you didn't lose 50
pounds you would do something about it. I bet if I told you you were going to
live to be 95 years old, you still wouldn't do anything to try and prevent
Alzheimer's. Consider this. When your
brain starts dying you will lose the ability to do all these things: brush your
teeth, take a shower, put your cloths on, take a poop, and eventually you won't
be able to swallow. While this is happening your heart will still be working.
You will still be breathing. Brain death is ugly.
__________________________________
My mother is 94 and she is still going. We were lucky we got her treated early on. Nevertheless, all the things I described above are happening. Okay I have to go. I have to start practicing my new 7 word speech -- Get your head out of the sand.
Siblings Who Care More About The Inheritance Than Parents' Care
(Source: Carol Bradley
Bursack , www.agingcare.com)
"We don't want strangers taking care of Mom!"
"We promised Mom she would never go to a nursing home!"
"If you really love Mom, you should be able to keep it up for awhile longer, anyway."
Ah, siblings. Some are a joy. Some are helping the primary caregiver, as you struggle to find the right balance of care for your elderly parents. Some siblings don't help with caregiving at all. And some, maybe more than we'd like to admit, have a less than admirable motive for their comments. Some don't want Mom to have outside care, because outside care is expensive. And outside care will quickly eat up their parents' hard-earned money – the money the family was to inherit.
While I didn't have to battle siblings over money, I know first hand what happens to a senior parent's estate when outside care and nursing home care is involved. We, as a family, wanted the best care possible for our parents. And for much of the time, I was the best resource. However, the time came when a nursing home was the only option. I still was the primary caregiver, going to see them every day, making sure their wants and needs were personally taken care of. I was their advocate and watchdog, their hand-holder and errand runner. But their home was the nursing home, and everything they had hoped to leave the family, financially, ended up paying for their care. That's fine. It's not what they wanted, but their care came first, and their money paid for it.
Would my siblings and I have loved to have a little inheritance? Of course. My parents desperately wanted to leave us something. But that was not to be. That's okay. Mom had her private room. She had good care. Dad's care was private pay, as well. My siblings understood that this is how it needed to be. My continuing to care for them at home was no longer an option.
However, I get e-mails from people whose siblings are happy to let the one adult child, the one who steps up to the plate and takes care of the elders and does all of the work, continue on with it. Yet these same siblings won't allow the caregiver any money for respite care, or even nursing homes, without a fight. They couch their objections in phrases that show undying love for the elder. "No stranger will take the place of family!" is their indignant mantra.
How to Deal with Greedy Siblings
Your siblings don't show up at the door to visit Mom. They don't offer to take Dad to doctor's appointments. Heck, they don't even know the doctors' names. They don't know the medications. They don't care about the elderly parent's temper tantrums you, the caregiver, must weather. They don't care that you are the target for verbal abuse from the Alzheimer's afflicted parent. And they really don't care that the you haven't had a break from 24/7 responsibility, whether hands-on or helping with all the needs of an elder in assisted living or nursing home, for weeks, months or years. They voice huge concern for the elder, yet they aren't willing to get their hands dirty (figuratively or literally), or open their wallets to help.
You, the adult child that first took on caregiving because it seemed like the right thing to do, had no idea that this would go on for years. You had no idea that the elders' needs would eat up your whole life; that you wouldn't have time to attend your own children's school functions unless you hired help; that your siblings would fight you for every penny you wanted/needed to spend on elder care. You had no idea that you and your husband would not be able to have an evening out unless you paid for an elder-sitter (if you were lucky enough to find one) out of your own pocket.
You, the caregiver, could end up buying food for the elder, along with your own shopping. You may be buying adult diapers along with your own aspirin, at the drug store. All of these "little" expenses are such that your siblings may laugh or get down right angry if you try to get financial help from them, or even use your elders' money to pay for them. They want to preserve that inheritance.
They lay a guilt trip on you if you ask for financial help, or use your parents' money for your parents' care. They lay a guilt trip on you for wanting someone to care for the elders' for a weekend, so you can have a sanity break. You hate to admit, even to yourself, that your siblings care more about sparing the elders' cash and keeping it for inheritance than they care about the elders' quality of care, or about your health and sanity. It's ugly business.
When you tell your siblings that your parents are more than you can now handle, that Dad's Alzheimer's is causing him to wander and he is not safe at home, they tune you out. When you tell them that Mom's incontinence is at a point that you can't physically keep up with it, they respond by sulking, or even implying that you are bailing out on your responsibility. You took the elders' care on. You need to deal with the increasing problems. But don't even think of putting them in a home. They'd hate that!
Or would they? Would they really hate being in a place where they would have contact with peers? A good home where you could visit daily, refreshed from a little rest rather than worn to a frazzle from around-the-clock caregiving? Would they really hate being in a place where Mom could bake if she wanted to, and Dad could do some crafts rather than stare at the TV all day? A place where they would have choices of five meals a day and could go to church without having to brave the elements? Would they really hate it that much? Or is it that your siblings would hate to see all of their parents money go for their parents care?
Sometimes facing reality about one's family is hard. And money issues can turn what at one time seemed like a fairly normal family into accusative, mercenary monsters. When it comes to ugly issues like spending your parent's money on your parent's care, of giving them the best care possible and sparing your own sanity, sometimes you need to get professional help. You may even have to find an estate attorney to handle the details for you.
Somehow, you must stick up for yourself. Keep good records while you are caregiving. And if you need to buy your parents clothes, pay for respite care or get them into a care center, do it. If your siblings turn ugly; if they complain, threaten or manipulate the elder, then you may need counseling or even legal help. But you need to take care of yourself. No inheritance is worth your life. And no sibling worth having a relationship with would want you to sacrifice everything in order for them to get some money in the end.
Most families aren't this extreme, but my e-mail volume suggests that there are, unfortunately, quite a few like this. Be thankful if you are from a caring family that puts the elder and even you, the caregiver, above the money. But if you aren't so lucky, get legal help. You deserve it. LINK HERE
I couldn't live without...LifeBio
(Source: McKnight’s)
It's almost a given that most people love to talk about themselves,
and nursing home and memory care patients are no exception. LifeBio products,
which include conversation-starting story cards, electronic recording kits,
hardcover journals and more, are the perfect way to get the process started,
says Teresa Scott.
She's the vice president of advancement and marketing for Christian Care
Centers in Texas. She's used LifeBio products in one of the operator's three
long-term care facilities to great success. Knowing who residents were in the
past allows them to better serve their needs in the present and future, Scott
says.
“It is just amazing to hear the stories of those we serve. It has engaged our staff and volunteers with the residents. We are all anxious to hear their stories. I would recommend the program to anyone involved in senior living,” Scott says.
Resident stories
Everyone has a story to tell, and LifeBio products ensure that everyone, regardless of their technological capabilities, has a means of documenting it. Questions are provided to let the loved one create his or her memoir. LifeBio also gives an option of having the book printed. For more info: (866) 543-3246 or www.lifebio.com. LINK HERE
He's Tuned In To Resident Choice
(Source: Mary
Gustafson, McKnight’s)
When iPods, the popular portable music players, started to become
ubiquitous in about 2006, licensed social worker Dan Cohen Googled “iPods and
nursing homes.” He found no connection between the two anywhere on the
Internet. Surprised, he made a couple of phone calls.
Two weeks later, iPod and laptop in hand, he visited a nursing home in Long
Island, NY, and proposed making personalized play lists for residents. He was
curious to see if listening to familiar music had a soothing effect on nursing
home residents.
It did. Cohen then quickly launched a pilot program with the Institute for
Music and Neurologic Function, which allowed him to study using personalized
playlists as a form of music therapy for nursing home residents.
When working with a new resident, Cohen surveys her or his music preference
based on a list of genres and suggestions. The goal is finding a person's 100
most favorite songs. If a resident is too ill to speak, Cohen asks family and
friends what the person used to listen to when he or she was well. Once Cohen
fine tunes a resident's playlist, he says he can usually see behavior
improvements right away. For instance, he's seen Alzheimer's patients who
haven't spoken in months stand up and wave their arms in the air in time with
the music. Others have started interacting with other residents and staff more
frequently.
“If residents are no longer agitated, then the quality of caring improves,”
Cohen says. “It's great for staff morale, the people they care for are less
anxious and less depressed. It's a very simple approach that has potentially
very high impact.”
Cohen says he first based his iPod idea on preferences he'd have if he were
ever a long-term care resident. “If I'm ever in the nursing home, I want to
have all my music and movies with me. I would be happy,” he notes. LINK HERE
Study: Tai chi a useful depression fighter
(Source: Mary
Gustafson, McKnight’s)
Senior citizens with major depression experienced an improvement in
their quality of life when treated with a combination of a standard
antidepressant and weekly tai chi exercise classes, according to new research.
This is good news for nursing homes, where statistics show that 50% of
residents suffer from depression. Depression is linked to greater morbidity,
disability, mortality and increased cost of care.
“This is the first study to demonstrate the benefits of tai chi in the
management of late-life depression, and we were encouraged by the results,”
UCLA researcher Dr. Helen Lavretsky said. “We know that nearly two-thirds of
elderly patients who seek treatment for their depression fail to achieve relief
with a prescribed medication.”
Researchers studied 112 seniors being treated for depression with the drug
Lexapro (escitalopram) alone for four weeks. Of these patients, 73 saw partial
improvement, continued taking Lexapro, and were assigned to 10 weeks of tai chi
therapy for two hours per week. The rest of the group was assigned to 10 weeks
of health education classes for two hours per week.
In the tai chi group, 94% achieved scores consistent with improved depression
symptoms, while 65% experienced remission. In the other group, only 77% had
improved symptoms and 51% went into remission. The study was published in the
American Journal of Geriatric Psychiatry. LINK HERE
Nursing home tries easing rules to improve lives of those with dementia
(Source: By Dawn Turner
Trice, Chicago Tribune. AHCA/NCAL Gazette)
Chicago area facilities Maryhaven, Villa Scalabrini Nursing and Rehabilitation Center, and Rainbow Hospice and Palliative Care took part in a 3 year study that had staff members step away from the traditional and more institutional methods of caring for Alzheimer’s patients. The staff members all participated in a 6 week training course and then implemented a wide-spread culture change in the facilities. "Alzheimer's is a terminal disease," said study co-author and palliative-care expert Jeannine Forrest, who carried out the study with colleague Dan Kuhn. "If your loved one has three months to live and wants to eat chocolate for dinner or sing 'Amazing Grace,' or wake up when they want, why not let them? We'd like to create ways so that we can make the advanced stages of dementia more comfortable and work with state regulators so that regulations aren't so rigid."
Alzheimer’s Speaks Radio - Lori La Bey
(Source: Alzheimers Speaks
blog)
Alzheimer’s Speaks Radio™ believes in giving voice to those afflicted with the memory loss and empowering them to live purpose filled lives. Our goal is to raise awareness, give hope, and share the real everyday life of living with Alzheimer’s disease. Please join our Host Lori La Bey of Alzheimer’s Speaks™ www.AlzheimersSpeaks.com; and our Channel Expert Rick Phelps, who has Early Onset Alzheimer’s Disease (EOAD). Rick is Founder of Memory People™ a closed group on Facebook. We look forward to you joining us for great conversation, learning, and laughter as we maneuver this rollercoaster called Alzheimer’s Disease. About our Host – Lori La Bey: Memory loss has been part of Lori’s life for over 30 years, ever since her Mother starting having problems. Lori’s Mom is now in her end stages of Alzheimer’s disease. This journey has taught her much and has changed her life. She now speaks and trains on Alzheimer’s disease and Caregiving. Lori believes we can shift society’s negative perceptions of memory loss through open communication and education. She said, “It’s time for the voice of Alzheimer’s to be heard and she wants to give those with the disease a platform to do so.” Lori’s believes by removing the fear, embarrassment, and judgment that cripples relationships; we can improve our connections with people we love and care for. About our Expert Living with Alzheimer’s – Rick Phelps: Rick has EOAD. Instead of fading away with this disease Rick has done something different by raising awareness about the disease and giving a face to it by making a video log of his life with the disease. Rick is 58 years old he lives in Coshocton County, Ohio with his wife Phyllis June, and his family and grandchildren nearby. Rick believes that Alzheimer's is not only a patient’s disease but a caregiver’s disease. read more
Researchers Find Achieving Goals Can Be Important to People with Alzheimer’s
(Source: by Carol Bradley Bursack, Minding Our Elders)
Most people find some satisfaction when a goal of some type, even a small one, is achieved. Why should people with Alzheimer’s feel differently? According to an article on Medical News Today titled, “Achieving Goals Empowers People with Dementia,” researchers at Bangor University, Wales found that “people who received cognitive rehabilitation felt their performance of daily activities improved. Carers (caregivers) of those receiving the treatment also noted an improvement in their own quality of life.” The results of this research were published in the American Journal of Geriatric Psychiatry. LINK HERE
Lakeview Ranch Model of Specialized Dementia Care: Appropriate Dementia Care IS Possible
(Source: Judy Berry -
Lakeview Ranch Inc., via Pioneer Network)
The Lakeview Ranch Model of Specialized Dementia Care™ has been developed over the past 11 years. By the successful development and implementation of a more appropriate model of Dementia Care that uses high staff ratios of extensively trained dementia specialists, ongoing staff support, and additional RN's to closely monitor each individuals changing needs, we have successfully restored dignity, choice and the highest quality of life possible to seniors with Dementia and a history of challenging/aggressive behavior. We have been able to use pro-active disease management and "Prevention" rather than ineffective costly treatments, hospitalizations and over medication to eliminate most all aggressive behavior. This model focuses on knowing each person as an individual, discovering and meeting all their emotional and spiritual needs in addition to their physical needs. Ongoing training that teaches a thorough and accurate understanding of the process of dementia, including Changing the myths about dementia of any cause, even Alzheimer's that often say the person with dementia is fading away, in the midst of the long goodbye, is only a shell of who they were, is losing their personhood. With development of the LR model we have learned it is critical to appropriate care that the care partner understand that dementia effects a person's ability to communicate BUT does NOT take away the person they are. In fact, they have intensified emotional needs as they walk this journey. They are frightened, confused, angry, sad, and those needs must be recognized and acknowledged and their personhood validated in order for them to develop trusting relationships with any of their care partners. Over 11 years we have provided this person centered care for 173 persons of whom 65% have been people who have had multiple de-admissions from other facilities, repeated behavior hospitalizations (sometimes 4-5 in the last year) and extreme over medication with psychotropic drugs in order to try to control their aggressive behavior. After admission to LR 98% of challenging behavior is eliminated along with significant reductions in Psychotropic drug use, they are validated as the person they always will be with the same emotions and feeling they had before diagnosis. We use extensive Animal Therapy, Music Therapy, Entertainment, and self esteem building activities to re-able them to participate in life to the fullest of their ability and we walk this journey beside them until their death. Appropriate Dementia Care IS Possible. - Judy Berry, Lakeview Ranch Inc, Minnesota LINK TO STORY HERE
Dementia Patients Get Relief from Occupational
Therapy. After just ten sessions of specially designed occupational therapy,
dementia patients experience improvement in their concrete and practical
skills. Their caregivers, too, feel a renewed sense of competence.
(Source: By Society of
Certified Senior Advisors, PR Log – Global Press Release Distribution)
Finding a way to alleviate the tough realities of dementia would bring relief to about 6.8 million people in the United States. Could Occupational Therapy be the long-awaited answer? In a 2006 study conducted by the British Medical Journal, 135 dementia patients were studied twice a week over a five week period on their cognitive abilities including motor and processing skills and deterioration of their daily activities.
Twelve weeks post therapy, 75% of these patients showed improved process skills and 82% needed less assistance with activities of daily living (ADLs). LINK HERE
(Source:
www.news-medical.net)
Many patients receive an incorrect dementia diagnosis. This is shown by a study carried out by neuropathology researchers in Lund, Sweden.
"It is true that we know of around 70 different types of dementia, but these findings are shocking. We believed more patients were diagnosed correctly when we began the study", say researchers Elisabet Englund and Hans Brunnström at Lund University.
The study included 176 patients, the vast majority from the cities of Lund and Malmö. All of them have been examined at specialist geriatric psychiatry clinics during the period 1996-2006 and been diagnosed with some form of dementia. After the death of the patients, the researchers have studied their brains under a microscope and been able to establish precisely which type or types of dementia the patients suffered from.
In 49 per cent of cases, the clinical diagnosis agreed with the neuropathological. In 14 per cent of cases the diagnosis was partly in agreement, which to some extent could be explained by additional neurological damage following the clinical diagnosis. In 37 per cent of cases, an entirely different diagnosis was made after the patient's death. The highest level of correct diagnoses was in patients with frontotemporal dementia, while the accuracy of the diagnoses was somewhat lower for patients with Alzheimer's disease, vascular dementia or dementia with Lewy bodies.
"These are unexpected figures, particularly considering that these patients have been examined and diagnosed by specialists. There is currently no cure for these diseases, but we must be sure that the patient has received the correct diagnosis in order to able to prescribe the correct treatment, such as medication to slow the progression of the disease and/or treat symptoms", says Dr Hans Brunnström, whose doctoral thesis includes the study. LINK HERE
The Battle Against Dementia: The Dark Descent of
an Unlikely Victim: What happens when a
beautifully sharp mind begins to unravel?
(Source: By Beth Macy, O,
The Oprah Magazine)
It's spring 2006, and a woman I vaguely recognize approaches me at a
party, her auburn wig askew and a glass of wine wobbling in her hand. She announces
cheerfully that, at 63, she has recently retired from the
"I have dementia, in case you didn't know!"
I didn't know. In fact, I don't even recognize her until she lifts her wig to
reveal a tamped-down mass of gray-brown curls. It's our paper's longtime copy
desk chief, whose reign of terror over young reporters and clunky sentences is
legend.
She was from the old school of reporting: If your mother says she loves you,
check it out—or
But on this day she is giddy, almost manic, and not at all uptight. The
wig-wearing
I expect
One Woman’s Fight Against Alzheimer’s Disease
Many
with early-stage Alzheimer’s disease are finding ways to maintain their quality
of life in spite of the progressive brain disorder. One of them is former
college professor Lydia Panero, who had to give up her career because of the
disease, but found fulfillment in performing onstage. Read on to learn how
she’s coping with her diagnosis and how she stays positive…
(Source: By Colleen Davis
Gardephe, Special to Lifescript)
Lydia Panero of Mamaroneck, N.Y., taught literature for 40 years at
Manhattan College. So when her language skills started to deteriorate in 2006,
she knew something was amiss.
At age 67, Panero was diagnosed with Alzheimer’s disease, a form of dementia
marked by memory problems, confusion, learning deficits and personality
changes.
“In class with my students, the first thing I noticed was that I was losing my
nouns,” Panero says. It’s not that she didn’t know what objects were. Rather,
“she just couldn’t find the words that identified the objects and ideas she was
trying to talk about with her students,” says 80-year-old Harry Grier, her
caregiver and husband of 46 years. At first, she coped by teaching fewer
classes. “Eventually, that became overwhelming,” Panero says. “I said to Harry,
‘I don’t think I can do this anymore.’” She left the career she loved.
But Panero now has turned her sadness into a determination to fight Alzheimer’s
disease, advocate for research funding and live a rich and joyful life. In this
exclusive Lifescript interview, the couple discusses Panero’s early-stage
diagnosis and the steps they’re taking to combat Alzheimer’s disease.
How soon after your symptoms surfaced did you receive an Alzheimer’s diagnosis?
Panero: It took about a year. I first went to my general practitioner, who
referred me to a neurologist. The [specialist] told me that forgetting the
names of objects was all part of getting older. [But] when things didn’t get
better, the neurologist did more testing and diagnosed me with frontotemporal
dementia [which affects the brain’s frontal and temporal lobes, areas that
govern personality, behavior and language].
Grier: That doctor suggested Lydia get a second opinion from
[neurologist] Karen Marder, M.D., at the Taub Institute at the Columbia
University Medical Center in New York City. Marder conducted more tests that
revealed Lydia had Alzheimer’s.
How did you feel about the diagnosis process?
Grier: It was very frustrating. Diagnosing Alzheimer’s disease [is] like
reading tea leaves.
Panero: It’s sad that doctors don’t know the full story until an
Alzheimer’s patient dies and then they examine that person’s brain. When I die,
scientists will get my brain to examine.
How did you first feel about the diagnosis?
Panero: I was devastated.
Grier: Lydia loved teaching poetry, plays and fiction to her students,
so she was understandably devastated when she had to give up her lifelong
career and passion. What brought you out of your initial depression after
the diagnosis?
Panero: What turned me around was participating in a play about what it’s
like to have Alzheimer’s, called To Whom I May Concern.
The play was created by Maureen Matthews (a psychiatric nurse researcher and
coordinator of the early memory loss program at the Stamford, Conn., Counseling
Center). Five of us read aloud letters we wrote to friends explaining what it’s
like to have Alzheimer’s disease.
I used parts of the letter I wrote to my dean explaining why I had to give up
my teaching post at Manhattan College. I started doing the plays in 2007 and
have been acting in several showings each year…
Are there any silver linings to having Alzheimer’s?
Panero: The upside is my friendships with people who have Alzheimer’s.
They’re great.
Grier: Lydia enjoyed introducing her friends and members of her support
groups to some of her favorite female authors – Gwendolyn Brooks, Joyce Carol
Oates, Adrienne Rich and Zorah Neale Hurston.
She also loved performing in the play To Whom I May Concern.
What is your big hope for Alzheimer’s disease?
Panero: That scientists find a cure for Alzheimer’s. Wouldn’t that be
great!
For more information, visit our new Alzheimer's
Disease Health Center.
How Much Do You Know About Alzheimer’s?
More than 5 million Americans have Alzheimer’s disease, and that number could
climb to 16 million by 2050. Women face a higher risk of developing it than
men, and are also more likely to become caregivers. Take this quiz to see how much you know about
Alzheimer’s.
READ THE REST OF THE STORE HERE
10. DISABILITY COMMUNITY
AARP Public Policy Institute Video Alert: More Older Americans with Disabilities
Living in the Community
AARP senior strategic policy advisor Don Redfoot discusses findings from two recent AARP Public Policy Institute reports on major trends revealed by the latest National Long-Term Care survey. PPI analysis shows an unanticipated increase in the number of older Americans with disabilities who receive care in their communities rather than in nursing homes.
Click here to
see this new video
Study: Family Caregivers Want Web-Based, Mobile Tech
(Source: By mmiliard,
Healthcare IT News) (http://www.healthcareitnews.com)
LAS VEGAS – A new survey sponsored by the National Alliance for Caregiving and UnitedHealthcare highlights the ways emerging technologies can alleviate the financial and emotional burdens on family members caring for sick or disabled loved ones. The report, The e-Connected Family Caregiver: Bringing Caregiving into the 21st Century, released Saturday, found more than two-thirds of family caregivers who have used some form of technology to help them with caregiving believe Web-based and mobile technologies would be helpful to them.
Family caregivers provide an estimated $375 billion worth of uncompensated care to loved ones annually. Previous studies have shown that many lack support systems and tools that could ease the burden financially and emotionally. The survey examined family caregivers' receptivity to technology and assessed how helpful 12 particular technologies would be in supporting caregivers or helping them provide care. It also explored perceived barriers to using technology, factors that influence family caregivers’ use of technology and sources of information about technology that caregivers trust.
“We know that our nation’s caregivers often put the needs of their care recipients ahead of their own, which can compromise their own health and create a stressful lifestyle,” said Richard Migliori, MD, executive vice president, business initiatives and clinical Affairs, UnitedHealth Group. “It’s encouraging to see that caregivers are open to incorporating technology into their caregiving routine as a way to make their jobs easier.
"As the technology and healthcare industries increasingly use these kinds of tools to improve care in hospitals and doctors’ offices, this survey is a reminder that these improvements could be equally helpful where care matters most – in the home," he added. "The use of new technologies can be a powerful tool to keep seniors independent as long as possible and support family caregivers.”
Technology to assist seniors and family caregivers in the home is one of the fastest-growing industries – some analysts predict it will be a $20 billion market by 2020. A report published by AARP in 2008 showed that both seniors and family caregivers are seeking new technology products as a way to keep their loved ones living in their home as long as possible.
“Caregivers know that technology can be used to help them understand their loved one’s conditions and find resources and even support,” said Gail Hunt, CEO and president of the National Alliance for Caregiving. “With this survey, we wanted to look at ‘what’s next’ with technologies that can be brought to bear to help caregivers focus not only on the health of their loved one but their own health as well.” READ MORE
Facebook and YouTube Help the Elderly 'Keep Their Brains Active and Reduce Stress and Depression'
(Source: By Daily Mail
Reporter, www.dailymail.co.uk)
Facebook and YouTube help the elderly keep their brains active and stave off memory loss, according to scientists. Pensioners who frequent social networking sites, and other online destinations, such as Skype - have more flexible brains than those who don't, a study claims. The Internet was also found to reduce symptoms of anxiety, stress and depression and helps pensioners to develop their social support networks.
Marco Trabucchi, chairman of the Italian Association Of Psychogeriatrics, which carried out the study, said: 'Social networks and IT technology keep the cultural curiosity of the elderly alive. 'It improves their cognitive performance and keeps their brains young, it stimulates their attention span, memory and perception. 'It keeps them young at heart.'
Young at heart: Elderly people who frequent social networking sites have more flexible brains than those who don't, researchers claim
Researchers studied elderly people living in two care homes in Cremona and Brescia in northern Italy. Residents were provided with laptops with a wireless Internet connection and given a tutorial in how to surf the web. They were also introduced to, and set up their own accounts on, social networking sites Facebook and Twitter and telephone service Skype. Those pensioners who embraced the modern technology had a much better memory and were much more alert than those who did not use the Internet, the researchers said.
Mr Trabucchi said: 'Facebook is a window to the world for our elderly residents.'It allows them to keep contact with younger members of their family. It keeps them alert and on the ball.' 'Over the past few years the number of pensioners going online and using social networks has increased by 80 per cent,' he added. 'About 8 per cent of people who have a profile on Facebook and MySpace are pensioners.' More than 1.5million elderly people have a profile on Facebook and regularly use Skype to stay in touch with friends and relatives. LINK HERE
They're Knocking ... Are You Answering?
(Source: James
M. Berklan, McKnight’s)
A private company with a website focused on family caregivers released survey results Thursday. They detailed how stressful caregiving can be for loved ones. Financial and emotional stress pound these people. Results of the caregiving.com survey couldn't have been a surprise to anyone keeping an eye on America's aging society. The company surveyed nearly 1,000 people in November and, among other findings, discovered: Three-fourths of the caregivers have either had to change their job or are not working; 69% said the caregiving is the No. 1 stressor in their lives; 58% spend more than 10 hours per week providing care and 22% spend more than 40 hours per week at it.
And half of the family caregivers surveyed have searched online for a senior living facility or in-home care. That's a lot of searchers. It fuels a powerful question: What are they finding? The survey didn't answer (or ask) that. But if long-term care providers aren't asking themselves the same question, something is seriously wrong.
Thousands upon thousands of families are checking you out. That's issue No. 1. The second is that they're doing it online. That's opportunity. By all accounts, it's opportunity that will only grow. Or leave you behind your competitors. LINK HERE
Report: Patient monitoring worth $9.3 billion in 2014
And more reports
that we are headed in the right direction!!! Remote Monitoring is
minimizing hospital stays, saving money!!!
(Source: By: Brian
Dolan | GrandCare Systems Blog on LinkedIn)
According to a new report from TechNavio, the global patient monitoring system market will swell to $9.3 billion in 2014. TechNavio’s analysis focuses on the US, EMEA and APAC and concludes that remote patient monitoring is driving growth in the wider patient monitoring market. The price of these systems is cost prohibitive, however, the report found.
“Remote Patient Monitoring (RPM) is greatly minimizing hospital stays, resulting in a reduction of the cost of healthcare delivery. Thus, RPM helps healthcare centers reduce costs and increase business opportunities for healthcare service providers while integrating systems and providing necessary operational facilities. As a result, the Patient Monitoring Systems market stands to gain,” TechNavio states in a press release.
Earlier this year Kalorama Information predicted that the market for remote and wireless patient monitoring will grow about 26 percent annually through 2014. Kalorama said the market for these systems will grow by over $6 billion this year alone, which seems to put it at odds with TechNavio’s $9.3 billion by 2014 figure.
The disagreement doesn’t end there, of course. Plenty of opinions on market size:
Late last year in December, we reported on Berg Insight’s market size estimation for home health monitoring of what it called “welfare diseases,” which it pegged at about $10 billion in 2010. That figure included the market for chronic condition management for conditions including diabetes, cardiac arrhythmia, sleep apnea, asthma and chronic obstructive pulmonary disease (COPD).
Perhaps this kind of figure is more important: In 2010 we reported on Juniper Research’s estimate that by the year 2014 public and private healthcare providers may save between $1.96 billion and $5.83 billion in healthcare costs thanks to remote patient monitoring over cellular networks.
For more on the TechNavio report, read the press release below:
ROCKVILLE, MD — MarketResearch.com has announced the addition of Infiniti Research Limited’s new report “Global Patient Monitoring Systems Market 2010-2014,” to their collection of Medical Devices market reports.
Patient Monitoring Systems Market Witnesses Growth in Remote Monitoring Research conducted by TechNavio reveals that the Global Patient Monitoring System market will reach $9.3 billion in 2014. The report, which focuses on United States, EMEA, and APAC, indicates that the market is currently driven by the growth in remote patient monitoring.
“Remote Patient Monitoring (RPM) is greatly minimizing hospital stays, resulting in a reduction of the cost of healthcare delivery. Thus, RPM helps healthcare centers reduce costs and increase business opportunities for healthcare service providers while integrating systems and providing necessary operational facilities. As a result, the Patient Monitoring Systems market stands to gain,” report TechNavio analysts.
In spite of the demand for these systems, the high price of these systems hinders the growth of this market. However, the growth opportunities in Europe and APAC are expected to drive the market.
The Global Patient Monitoring Systems market is marked by the slow recovery of the North American market. This makes the study an important one for companies to fully understand the potential in the market and formulate their own strategy.
The report, Global Patient Monitoring System 2010-2014, is based on extensive research and inputs from industry experts, vendors, and end users. It examines the factors impacting the evolution of this market, including the key trends, drivers, and challenges. Further, it contains an in-depth understanding of the key vendors including a SWOT analysis for each vendor.
Companies mentioned in this report include: Philips Healthcare, GE Healthcare, Omron Healthcare, Drager Medical Gmbh, and Johnson and Johnson. For more information, visit here.
How Today's Tech Alienates the Elderly
(Source: By Stewart
Mitchell, PCPRO Magazine)
On Silver Surfer's Day, a UK academic has blamed unnecessarily complicated user interfaces for putting older people off joining the Government-backed Race Online. According to Mike Bradley, senior lecturer in product design and engineering at Middlesex University, efforts to be more inclusive are being undermined by software and hardware design that is exclusively targeted at younger users. The idea of looking after your user and understanding where they start from and allowing them to improve skills before you throw the big, heavy stuff at them is probably best shown in gaming. We caught up with Bradley, who is working on projects to design simpler interfaces, to find out why the current icon-based software interfaces are alienating older users.
Q. Is modern technology really any more exclusive than earlier generations for older people?
A.The older graphical user interfaces were, compared to today, a lot simpler. There was a lot less going on, the icons were simpler – with some designed to work in black and white, they tended to be more obvious. Also, if you look at the number of icons on each package and compare, say, Microsoft Word today to the first incarnation of Word, there's about three times as many icons. If you're a novice, that's much more difficult to get your head around.
For people like us who have grown up with computers, the change has been easy, it's incremental. But the developments have skewed most mainstream software packages towards the expert user. If you're designing an application you get feedback from customers who say – “I'd like this feature or that feature” and they stick it in, evolving it towards the needs of their current customers. It's good business practice, but the net effect is that packages get more complex. Unless there's a recognition and a reset they will get progressively more difficult for novices to master.
Q. Is there an argument for a tiered approach - one package with several interfaces?
A. It's been talked about in the research community, the idea of progressive disclosure, where you're not going to show the full functionality to people from the off, but you allow them to discover the basic and then move onto an intermediate level. I've not seen a good implementation of that in software yet. The idea of looking after your user and understanding where they start from and allowing them to improve skills before you throw the big, heavy stuff at them is probably best shown in gaming.
Q. Do developers of technologies such as smartphones take too much knowledge for granted?
A. They certainly do. In our research, we've been getting older people to use things like the Apple iPad and the Samsung Galaxy Tab. With both Apple and Android – they are much easier than trying to learn to use a PC, but you do get to a point where you have to understand iconography, and work quite laterally to complete tasks. In out study groups, I've asked people to set an alarm and although they can find the alarm icon, they're faced with a screen with a clock face and a plus sign icon, and they couldn't understand that you were “adding an alarm,” so they didn't click the plus sign to get through to that menu. Pressing the clock image takes you through to choices about how the clock is displayed, and it's not easy to get back again. So it's straight away skewed towards more competent people like us, because it requires an amount of experience to be able to navigate at the first attempt.
Q. With stripped down, basic technology for older people, isn't there a danger that we end up patronising them?
A. It's certainly a trap to fall into. We talk about older people in a general sense, but the reality is that there's a huge diversity in technical abilities among the older generations, much more so than with younger people. So you need to pin down what level of expertise we're talking about. An iPhone for some older people is absolutely perfect because they have the ability, but for others it's completely wrong because they need something far more basic that just does the simple things. To design one solution for that many users is extremely difficult, unless it is embedded in a touchscreen type device, where you can change the buttons and software and give people different displays depending on their level of ability. With a touchscreen device, you can customise it more easily than with hard key buttons.
Q. Could developers make more of touchscreens with better instructions and walk throughs?
A. That would help and the research we're doing will look at tools to help people. It can be useful, but one of the things we've learned is that for some older people, because with technology you need a different mindset, the process of learning certain things can be very difficult. There's some research regarding older people trying to learn traditional computers and some of them were going back week after week and really making no significant progress, because they just weren't learning, but tutorials work for people with the ability to learn. There's a space for a system that assumes nothing - no previous knowledge would be required to walk up and use the device without too much difficulty.
Q. Is there a danger of losing functionality with that?
A. There is a function and feature trade-off with usability
and most computing professionals will recognise that. What terrifies the
technology community is the idea that we're going to dumb down for people that
don't understand it, but I'm not advocating that. You need some devices that
are appropriate for people that are not technically minded and, in many
respects, that's a more difficult challenge than designing technology for
technologists. LINK HERE
(Source: By Bobbie J.
Clark, www.shreveporttimes.com)
Caroline Blewer (center) talks to Ed Benecke and Eileen Lafitte about BigScreen Live at the presentation of Caddo Council on Aging, CRUISE Online, LATAN (Louisiana Assistive Technology Access Network), and ResCare HomeCare where they announce learning opportunity for cutting-edge technologies to assist in the care of aging parents. / Henrietta Wildsmith/The Times
The first generation of approximately 78 million baby boomers turns 65 this year, and many technology companies have started to realize that the elderly are a vastly untapped market with the potential for limitless growth. In response to this emerging market, the Caddo Council on Aging, CRUISE Online, Louisiana Assistive Technology Access Network and ResCare HomeCare jointly held a workshop last week at CoHabitat in Shreveport to introduce an emerging industry to families with elderly loved ones. Over the last few years, many companies have harnessed the power of technology and applied it to elder care.
The workshop featured products and services like MyGait, which is a computer specifically geared to seniors. The interface is designed with large fonts, bright colors and a simple interface. There also are remote monitoring services enabling children to check on parents through webcams installed throughout a senior's home. There are even options that include a vital signs monitor that seniors can wear. They monitor heartbeats, blood pressure and can even tell when they fall.
Terri Rech, of CRUISE Online, said all they are doing is connecting technology with the aging process. "This type of technology is just now at the front of people's minds," she said. "Our area is just now embracing it." Rech and Jeff Crane started CRUISE in March 2008 to help families find solutions for taking care of their elderly loved ones. Over the last three years, Crane and Rech have seen the number of companies entering the sector increase exponentially. "Everything has been moving so quickly," Crane said. "The industry is growing and growing on a daily basis."
Shreveport City Councilman Jeff Everson, who helped facilitate the event, said it makes sense that the industry is growing so fast. "The baby boomer population will be there in a few years," he said. "Now is the time to jump into the market and develop something."
The Caddo Council on Aging hopes to make the event a yearly one. "Seniors equal big money," said Mary Alice Rountree, executive director of the Caddo Council on Aging. "This is a huge market, and we are excited about the potential." Rountree, who is a baby boomer, said her generation is the one pushing for this technology. They want to see how the technology works with their parents, so they will be familiar with it by the time they need it. She said baby boomers and their parents are fiercely independent and will try anything to hold on to as much of that independence as possible. "We want to stay at home," she said. "We're not scared of technology."
Like Rountree, many of the attendees at the workshop were baby boomers, looking for alternatives to nursing homes that will allow their parents and loved ones to live as independently as possible. "Who wants to leave their home?" said Bridget Miciotto, who was at the workshop with her sister, Janet Brooks. "People want to stay in their home to age." LINK TO ARTICLE HERE
Ten Senior Living Design Innovations: A look at the most significant changes in senior living design over the past decade
(Source: by Margaret P.
Calkins, PhD, CAPS, EDAC, Long-Term Living Magazine)
Courtesy of Gaius G. Nelson/Nelson-Tremain Partnership
Medical storage system at Creekview South, an Evergreen Retirement Community in Oshkosh, Wisconsin.
Design tends to be evolutionary, not revolutionary. Progress is typically made in incremental steps, tweaking what “is” to change what “will be.” Occasionally, a revolutionary idea comes along, one that makes us stop and reconsider what we thought we knew. So when I was asked to write about what I feel are the top 10 design innovations from the past decade, I let my mind wander over all the changes we've witnessed. There is now widespread recognition that things will be different as the Baby Boom generation moves, inexorably and generally unwillingly, into that category of citizenship we have, in the past, so easily called senior citizens. This is not a cohort that takes aging (or anything else for that matter) lightly. Many are already helping aging parents cope with later life changes, vowing that things will be different when they get to that stage. We are beginning to see that commitment in changes to nursing homes. It is heartening for those of us who have been in the industry for 25 or more years to see that people are increasingly unsatisfied with what we let nursing homes evolve into-staff-centric institutions that cared more for the body than the soul. I wouldn't yet call the culture change movement a tsunami, but it is certainly a significant groundswell, with enough traction to be more than a passing fad. Whether you refer to it as person-centered care, resident-directed care, or as I prefer, self-directed, relationship-based life, it is here to stay.
But there have been changes in other arenas as well. So let's explore the past decade. Some ideas are big-at the scale of the building or even the community-while other innovations appear in areas such as the small details of a handle grip. All make a difference.
Design of the times
(Source: Julie
Williamson, McKnight’s)
In today's senior housing market, many long-term care operators are
challenged to create attention-grabbing, residential-inspired communities that
satisfy residents' desire for comfortable, functional and aesthetically
pleasing surroundings. At the same time, limited capital and a lingering poor
economy require operators to spend their renovation and design dollars with extra
caution.
Seamlessly blending appealing, functional, yet budget-friendly, designs isn't
always easy. But some prominent — and even surprising — renovation trends
are emerging that are helping long-term care operators effectively merge those
two goals and stay one step ahead of the competition.
Existing facilities are being revamped, as opposed to undergoing sweeping
tear-downs and new construction, according to architect Randy Bremhorst,
project principal and senior living team leader for the planning, architecture
and construction firm Hoffman LLC in Appleton, WI.
“Our current economic environment requires everyone to be good stewards of
bricks and mortar,” he says. “For many, the limitations on capital make it
difficult to entertain the idea of all-new construction, so providers are
really looking at renovating existing spaces to remain competitive. And the
great thing about that is, when done correctly, even smaller renovations can
have a very big effect.”
Doing a renovation poses the difficult dilemma of determining just where and
how improvement dollars are best spent. It's a question frequently fielded by
architects and designers, and one whose answers are as varied as the
communities themselves.
In the past, design experts — and even long-term care operators — seemed
divided into two camps: those who focused most of their attention on common
areas and those who dedicated the lion's share of their renovation dollars to
resident rooms. Today, though, there's a growing trend to judiciously upgrade
both.
Some say divvying up the capital and spending it on some high-impact improvements can offer the biggest return on investment unless there's a fundamental design flaw that would dictate a more widespread redo, such as spaces that jeopardize resident safety or significantly limit one's ability to properly use a room. High-traffic, high-visibility spaces, such as lobbies, dining rooms and entertainment areas, are drawing more focused attention, says one design professional.
The right renovated look
“First impressions are critical, and a refreshed lobby area with new fabrics,
flooring and furniture invite potential residents, guests and current residents
alike,” says Michael Zusman, CEO of Kwalu, an Atlanta-based manufacturer of
furniture and wall covering products. He pointed out that “transitional” spaces
can have a positive impact on residents, families, visitors and staff.
“Thinking about the front garden as guests walk from the car or maybe providing
a café in the front area where guests can feel comfortable waiting — or an
employee lounge where staff can respite between projects — is critical in
overall design.”
Experts generally agree that common areas are getting cozier, with large,
sprawling and soaring spaces giving way to more intimate, defined areas that
support both socialization and privacy. If budgets don't allow architectural
separation of large areas through the construction of walls or partitions,
thoughtfully arranged seating areas are often the answer. Attractive, durable
and well-lit residential-style furnishings can create a similar effect, while
making residents and visitors want to take a seat and enjoy the space.
Color also can work wonders for visually constricting an overly large area.
Richer hues on walls can instantly convey coziness, and a strategically painted
ceiling can visually raise or lower its dimensions (darker colors will shrink a
room; lighter shades give illusion of height). Full, layered drapes are playing
a role in budget-friendly renovations and can instantly transform the
appearance of dated or poorly positioned windows. Older buildings with small
windows can appear larger by placing curtain rods higher and flanking the
windows in floor-length drapes.
Furniture arrangement also has a significant impact. Because not all residents
want to sit in front of a television, a room that offers multiple gathering
areas creates more intimate conversation or resting spots — an increasingly
important offering for residents who want some solitude outside their own room,
says Bremhorst. Maneuverability is also key. Regardless of how furniture is
arranged, it should allow for easy relocation.
Going big, going small
If an existing facility has many small or partitioned rooms, removal of some of
its walls can be beneficial. “Whether it's a smaller room or a large one, it's
about creating flexible spaces that feel more homelike and comfortable, and can
serve more than one purpose,” reasons Melinda Avila-Torio, IIDA, RID, LEED AP,
of THW Design in Atlanta.
Dining areas are a perfect example. More facilities are abandoning the dated
cafeteria-like dining model, and searching for wasted square footage that can
be turned into more intimate café and bistro dining areas.
Levindale Hebrew Geriatric Hospital and Nursing Center in Baltimore, for
example, is undergoing a massive renovation and construction project that will
incorporate a café and pub in the skilled nursing center's “town center” to
provide residents with more personalized dining and entertainment options. As
an Eden Alternative facility, Levindale is constructing neighborhood kitchens —
each shared by only 14 residents — with varying counter heights to accommodate
wheelchair-bound residents, as well as those who prefer to perch on a stool.
“It's about looking through the eyes of our residents and designing spaces and
options that really support our culture and provide the best quality care and
service for our residents,” says Levindale President and COO Aric Spitulnik. READ THE
FULL ARTICLE HERE
Comfort bathing
(Source: John
Andrews, McKnight’s - Sources: Sue Green, Karen
McLean and Annie Fellers, Summit Square, 2011)
Long-term care facilities are paying more attention to the
importance of resident bathing — especially when it comes to maintaining an
individual's privacy and dignity. Replacing a cold, bright and sterile room
with a warm, candle-lit environment, for example, has transformed the bathing
process from a dreaded routine to a relaxing, pleasurable experience for many
residents.
But creating this ideal bathing scenario isn't without its challenges. Nursing
homes are driven by regimented schedules, which makes slotting each resident's
favored time a little bit harder. Moreover, staff members are typically
stretched thin and workers can't always spend the time necessary for extended
bathing sessions.
So how can facilities optimize their operations to accommodate this new,
dignified bathing procedure? Bathing specialists recommend focusing on creating
a comfortable, soothing atmosphere for residents.
“To provide dignified bathing, a facility should focus on making the resident
as comfortable and safe as possible,” said Lewis Duff, director of business
development for Norcom of Tennessee, maker of Rane Tubs. “Giving residents
a proper bathing room environment with limited sight and sound distractions,
proper cleanliness, and safe and comfortable bathing equipment goes a long way
for a dignified bathing experience.”
Jennifer Mikula, administrator at Palm Garden of Ocala, FL, says the first step
in her facility's transformation was to canvass residents for input on what
they wanted. “It is important to ask your residents about their choice — when
they want to bathe and whether they prefer a shower or a bath,” she said. “You
should also ask them what it is about their current bathing experience and what
they would like to see changed. We did this, and the residents were more
than willing to talk about the institutional shower room.
“They spoke of the temperature in the room being too cold, the massive, ugly
piece of equipment that we called a whirlpool, and they referred to the sterile
feeling of the room with the spartan and bare tile walls. They also mentioned
that the room is used for storage of bedside commodes and shower wheelchairs.”
Based on the residents' input, Palm Garden created an environment designed to
let residents relax and enjoy their time in the tub.
A time to relax
“Bath time should be a time of calm, warmth and relaxation,” Mikula said. “The
surroundings should be inviting, with soft music, aromatherapy, heated towel
racks with plenty of warm, fluffy cotton towels. The room should be decorated
with soft, inviting colors and the bathtub should be one that is easy to get
into, comfortable, and with a non-skid floor so that your resident has a sense
of security and safety.”
Mikula acknowledged that the transformation took some time and effort, but that
persistence and persuasion have aided the new bathing program's success. A key
part was getting employees involved. “The biggest challenge for us was changing
the mindset of the staff. Their first response was, ‘We don't have anywhere
else to store all of this equipment, and no one really wants to take a bath in
that whirlpool … the residents are afraid of it,'” she recalled. “We then asked
the staff to put themselves in the place of the residents and what changes
they'd make. As a result, their minds exploded with thoughtful suggestions.”
Palm Garden worked with Piscataway, NJ-based American Standard to install
walk-in bathing equipment that the residents would find safe and comfortable.
The low entry threshold of the tub makes it very easy for the residents to
maneuver, the textured floor provides a safe transfer, and the seating area has
a curved back and headrest so the resident can relax comfortably amid the jet
massages, Mikula said.
Kalpesh Nanji, director of business development for American Standard, said
Palm Garden's new bathing environment has become an oasis in the facility.
“The residents of the center are thrilled with the spa-like services with the
heated towel racks, spa robes and slippers, soft music, light-touch hand and
feet massage, and of course, the bathing experience,” Nanji said. “What's more,
family members are amazed that their loved one has signed up for the spa three
to four times per week and brags to their adult children how they love the
pampering. When Jennifer gives tours of her center, there is usually
a comment from the guest that they would like to sign up for the
spas.”
Tub technology
Diane Buchanan, national sales manager for South Daytona, FL-based Gainsborough
Specialist Bathing, says that while it is up to the staff to determine how the
bathing schedule can be made more dignified, the manufacturer can help by
providing bathing equipment that makes the experience more soothing for the
resident and less stressful for staff members.
“A bath that adds a ‘spa-like' visual dimension can provide a calming aesthetic
for the patient who is uncomfortable or fearful of the procedure,” she
said. “Hi-lo baths that allow the staff to raise and lower the bath to a
comfortable working height while bathing the patient cause less physical stress
to the caregiver.
Baths that incorporate power seats to transfer the patient into and
out of the bath provide a level of dignity to the patient who can bathe
themselves once they are in the bath.
Somerset, WI-based Apollo Bath is working to prevent cross-contamination in
whirlpools and tubs, said product manager David Anderson. The company has
patented an ultraviolet light water purification system that purifies water
during the bath to help minimize the chances of urinary and respiratory
infections, keeping residents safer.
Using tubs right
Anderson says facilities need to be on guard for practices that could have
detrimental consequences to bathing systems. One such practice is washing
bedpans in the bathing system, he said.
“This puts an undue amount of harmful pathogens in the system, and can cause
cross-contamination issues,” Anderson said. “Additionally, I have seen
many brands of bathing systems become ‘storage areas' for a variety of items,
including shower chairs, slings, boxes, wheelchair parts and a host of other
items. All of these items can damage the gel coat or fixtures on a bathing
system.”
Kevin Farrell, director of marketing for Norcom of Tennessee, says one of his
company's top priorities has been to eliminate the “chill factor” for
residents.
“Selecting a bathing system that provides the right blend of safety and comfort
is critical,” Farrell said. “Many facilities utilize side-entry bathtubs to
help provide a safer transfer for the resident. But the design of some
tubs requires the resident to wait until the tub drains before exiting,
which greatly increases their chances of chill. A tub that employs an
upward swing door and the ability to pre-fill and recline can allow the
resident to exit while the water is still draining, reducing the chill factor.
Also, side-entry bathing systems can eliminate the need for lift equipment for
residents who still have limited mobility, thus helping preserve dignity.”
Bath time bonding
Executives at Summit Square in Waynesboro, VA, concede that finding enough
staff time to provide each resident with a leisurely bath can be difficult. But
the primary consideration for dignified bathing, they say, is for staff to
forge and maintain strong bonds with residents.
“We believe the best bathing experience involves a staff member with whom there
is already a level of comfort, trust and relationship — not just someone who
drops in for a bath,” organization representatives said in a prepared
statement. “We believe the relationship is formed and nurtured all throughout
the day and evening.”
Mikula agrees that bath time is the perfect time for staff and residents to get
to know each other. “So many times, staff bond with their residents over
bathing,” she said. “The regular caregiver actually enjoys spending this
quality time with the resident — it can be a time of quiet relaxation and small
talk.”
Education is critical for dignified bathing, Mikula said. She added that giving
staff an in-service on how to provide a positive bathing experience is
essential. “Caregivers must feel confident in the services that they are
providing and when they do, the bathing experience will go smoothly.”
Preparing a ‘dignified' bath
“Dignified bathing” is a fashionable term within the long-term care
industry, but what does it really entail? How can facilities ensure that they
are providing residents with a comfortable, enjoyable bathing experience?
Executives from Summit Square in Waynesboro, VA, put together the following checklist to ensure a positive bathing
experience for each resident:
—Maintain a warm environment (turn up heat in tub room).
—Use a decorative theme to make the area seem as home-like as possible (plants,
non-commercial furniture).
—Notify the resident about what to expect ahead of time.
—A strong relationship between the caregiver and resident is essential.
—Know resident preferences, such as shower-versus-tub and toiletry products.
—Use a large towel (such as a beach towel) to cover residents during the
shower; this is especially beneficial for residents with dementia, as it
lessens any stinging sensation.
—Honor the resident's routine for bathing: Wash face before or after; follow an
order for washing body parts.
—Allow the resident to wash as much as she/he can.
—For residents with dementia, use a hand-on-hand approach so the resident is
washing with the caregiver.
—Towel warmers provide extra comfort.
—Gel mats on the bottom of the tub offer added safety.
—Staff education and re-education are absolutely essential. Administration must
support this culture, and management staff must follow up.
LINK HERE
New Lives for ‘Dead’ Suburban Malls
(Source: By KAREN
STABINER, newoldage.blogs.nytimes.com)
The suburban shopping mall has fallen on hard times, and Ellen Dunham-Jones, co-author of “Retrofitting Suburbia: Urban Design Solutions for Redesigning Suburbs,” is thrilled, frankly.
“Every time we see a dead mall, it’s ‘Yay! Another opportunity to get it right,’ ” said Ms. Dunham-Jones, a professor of architecture at Georgia Institute of Technology in Atlanta.
Ms. Dunham-Jones sees in the faltering suburban mall an answer to a pressing question: How can aging suburbanites remain in their neighborhoods, as a vast majority of them prefer to do? With June Williamson, an associate professor of architecture at City College of New York, Ms. Dunham-Jones makes a compelling case that shopping malls are ripe for retrofitting in ways that make life a lot easier for an aging population. LINK TO ARTICLE HERE
13. NURSING HOMES
New Nursing Home Quality Measures Based on Resident and Family Surveys
(Source: by Matthew Ozga,
PHI Blog, PolicyWorks)
The National Quality Forum (NQF) has endorsed a slate of 21 measures designed to assess the quality of nursing home care. Three of the measures are based on survey data gathered from current and former residents as well as residents’ family members. Most of the other measures are quantifiable resident health outcomes that are known to correlate with care quality, including the incidence of pressure ulcers, moderate-to-severe pain, and urinary tract infections among residents. The 21 measures will be integrated into Nursing Home Compare, a searchable online database of more than 17,000 U.S. nursing homes. Nursing Home Compare is operated by the Centers for Medicare and Medicaid Services (CMS).
Survey Assesses
Person-Centered Care
One of the three survey-based measures uses responses from people who have resided in a nursing home for at least 30 days. That survey asks respondents to rank, on a scale of 1 to 10, the comfort of their surroundings and the professionalism of the staff. It also asks residents whether their facilities are person-centered by asking questions such as, “Can you choose what time you go to bed?” and “Can you choose what activities you do here?”
“These sorts of questions demonstrate that the concept of person-centered care has positively impacted nursing home care throughout the country,” said PHI Director of Training and Organizational Development Services Susan Misiorski. “We applaud NQF and CMS for advancing person-centered practices through their nursing home assessments.”
A second survey asks relatives of nursing home residents to give their impression of the care their loved ones are receiving. A third survey is designed to be answered by recently discharged residents and is administered by mail only. The surveys used in the NQF-endorsed measures were created by the Consumer Assessment of Health Providers and Systems (CAHPS).
Long-term care stakeholders who are dissatisfied with any of the 21 measures should notify NQF, via its website, by April 1. NQF is a nonprofit organization that establishes and disseminates voluntary standards designed to improve the quality of U.S. health care. LINK HERE
Nursing Home Allegation: Drugs Used to 'Chemically Restrain' Seniors?
(Source: BY SMA Staff, www.seniormarketadvisor.com)
A San Diego, Calif., news station is reporting the allegation that senior patients in skilled nursing facilities in the area are being given powerful antipsychotic drugs in order to control their behavior, a practice that has been called “chemical restraint.” Marian Hollingsworth’s father Keith Blair had been suffering from mild dementia, but after his rapid deterioration and death, she discovered he had been given the powerful psychotropic drugs Risperdal and Haldol without her permission. “It’s a way of controlling them. It keeps him in bed,” said Hollingsworth.
California Advocates for Nursing Home Reform, a nonprofit advocacy organization, has launched a campaign to combat the practice, which can be very harmful to their health. “Antipsychotic drugs are for the treatment of mental illness, not dementia,” said CANHR’s Tony Chicotel in an interview with KGTV news. “And now we’ve got studies that show just horrific outcomes for people with dementia who take these drugs.” CANHR has launched a website which tracks the number of patients receiving psychoactive drugs at skilled nursing facilities in California and reveals that that number does not always correspond to the number of patients with mental illness.
“When you see nursing homes that are above 90 percent of their residents are receiving a psychotropic drug, you’re wondering what the hell is going on there,” remarked Chicotel. For example, at Collingwood Manor in Chula Vista, 57 percent of residents receive antipsychotic drugs but only 17 percent of them have been diagnosed with mental illness. Granite Hills Convalescent Hospital in El Cajon and Vista Healthcare Center in Vista had a similar ratios, 51 percent to 11 percent and 43 percent to 16 percent, respectively.
Explained Chicotel, “I think it’s indicative of a culture, an internal policy of some facilities to use drugs as a last resort and other facilities to use drugs as a first resort.” LINK HERE
15. ADULT DAY
Adult day care perfect fit for local family's needs
(Source:
www.marshfieldnewsherald.com)
If dealing with Parkinson's disease isn't enough, try to care for a loved one with Parkinson's disease and balance a job at the same time. Companion Day Services, or CDS, adult day care can assist with balancing.
A Marshfield family shares its personal story: "CDS is a part of the Tiny Tigers Intergenerational Center in Marshfield and has been a wonderful place for my husband to attend. I find great comfort knowing that he is being well cared for while I work full-time. The staff takes pride in each person who attends and alerts me of any changes that takes place throughout the day. They are right there willing to help and offer suggestions in any way possible.
"They offer daily programming with a wide range of activities, which they gear to each person; meals and snacks are of nutritional value, plus others, which I call, amenities. Their hours are perfect, since my husband is an early riser, and it works out for my working hours. One other bonus is when the younger children come in to visit from the day care portion of Tiny Tigers. Al just loves that, since he is a grandpa of four.
"Al looks forward to going to CDS, and I have to commend the caring staff and volunteers. They all have the same mission in caring for each person and especially 'my No. 1 in life, my husband.'
"I truly believe CDS is a needed resource in Marshfield."
This story was written by a Companion Day Services participant's wife. The participant has attended CDS for more than 31/2 years. Sara Riedel is director of Companion Day Services. LINK HERE
Sometimes it takes a village to let seniors stay at home
(Source: By Gail Sheehy, Special for USA TODAY)
"Hell, no, we won't go!" That's the answer I hear most often from seasoned Baby Boomers when I ask if they're getting ready to move to retirement communities. For starters, they don't plan to retire before 70. And most want no part of the elder islands where their parents retreated from the hustle of city life into a largely sedentary, age-segregated existence.
The Village Movement is a popular alternative. The drivers of this movement are feisty professional women in their 50s and 60s who are determined to change the experience of aging by empowering and enabling adults to remain in their own homes or apartments to the end of their lives. The movement, launched eight years ago in Boston with Beacon Hill Village, has spread to Washington, Chicago, San Francisco and more than 50 other cities. Hundreds more are in formation.
Boomers now over 50 want to belong to communal families, networked into a virtual village. It's partly a resurgence of the commune spirit of the 1960s and a throwback to the villages of a pre-urbanized America, where people looked out for one another through good times and bad. Science tells us today that anyone who hopes to enjoy a happy, healthy later life needs to feel part of a larger group. Family members are not enough. We need to build new and diverse friendships with people younger and older than ourselves — relationships that are built on affection, not obligation.
Typically, the great majority of joiners in the Village Movement are women. "It's the women who see the value of socialization," says Bob Davis, the only male board member of the 9-month-old Ashby Village in Berkeley, Calif. "The men are happy in their workshops or reading or doing some solitary activity." Beneath this common divergence among couples is the fact that the women anticipate becoming caregivers. The men expect to be cared for by their wives.
But fate turned the tables on Davis. After his wife, Merle, a retired social worker, had a hip replacement, he became the full-time caregiver. Davis eagerly joined Ashby Village last October and in November was told he needed his arthritic ankle replaced. "I was off my feet for six weeks," he says. "We live in the Berkeley Hills, and neither of us could drive. We couldn't have survived if our church didn't bring all our meals. Now we'll have the village."
Laura Peck, a 61-year-old organizational consultant who works full time, was recruited into Ashby Village during a grocery store conversation. Her husband, Alan Stein, balked. Too young, he protested. He is 65. But Laura's mother, Thelma, a majestically erect octogenarian who also works full time, eagerly bought in for the annual fee of $750. "As long as I don't look in the mirror, I can be any age I want to be," she says impishly.
Both women were intrigued by a self-governing membership organization that offers a one-stop number to call, like a concierge, to ask for the professional services they may need in the future. For now, Peck is young enough to join the cadre of volunteers who can chauffer, walk the dog, cook a casserole to share with a convalescent or throw a potluck and poetry supper at her home.
People's reluctance to admit they are getting older is the greatest barrier to membership. "Great idea, but I'm not ready" is a common response. Don Langley, a member of San Francisco Village, bristles at this denial. "You don't wait until your house is on fire before you get fire insurance."
The appeal is even greater to the unpartnered. One out of three Boomers over 50 is not married. Paul Axelrod recently moved from Washington state to Berkeley to pursue a romance. He is a retiree who still skis and can handle driving and chatting while thumbing his iPhone for directions, but after attending his 45th high school reunion, he's not kidding himself anymore. "I didn't want to wait until I need assistance," he says. "I want to be able to be a part of the village while I can contribute." Journalist and lecturer Gail Sheehy is the author of 16 books about adult life stages, including Passages in Caregiving. LINK TO ARTICLE HERE
NEW FACT SHEET: Home and Community-Based Long-Term Services and Supports for Older People
(Source: By Enid Kassner,
AARP Public Policy Institute)
More than 5 million older
people need services and supports to remain living in their homes and
communities. Most receive help exclusively from family caregivers, but others
pay for services through public programs, out-of-pocket spending, or private
insurance. The primary source of public funding is Medicaid, but other sources
include the Older Americans Act and state funds. Residential alternatives that
deliver supportive services in a home-like environment also play a role in
helping older people avoid more institutional settings.
The term “home and community-based long-term services and supports” (HCBS) refers to assistance with daily activities that generally helps older adults and people with disabilities to remain in their homes. Many people with functional limitations or cognitive impairments need assistance with activities of daily living (ADLs) such as bathing, dressing, and using the toilet, or instrumental activities of daily living (IADLs) such as shopping, managing money or medications, and doing laundry.
Services such as personal care, chore assistance, transportation, congregate meals, or adult day services all constitute HCBS. People of all ages with disabilities who use these services live in a variety of settings: their own homes or apartments, assisted living facilities, adult foster homes, congregate care facilities, or other supportive housing.
Need for HCBS In 2009, about 10 million Americans living in the community needed long-term services and supports (LTSS), of whom more than half (5.2 million) were age 65 or older and 1.7 million were aged 85+. Those with LTSS needs comprised some 14 percent of the community-dwelling population age 65+ and 38 percent of those age 85+.1 LINK TO FACT SHEET HERE
An End-of-Life Lesson from the UK
(Source: By Howard
Gleckman, Caring For Our Parents)
More than 8,000 general practitioners in the United Kingdom will soon begin displaying in their offices seven ”end-of-life” promises to their patients. It is a great idea. According to an article in The Independent, every GP (much like primary care physicians in the U.S.) will post this end-of-life pledge on the wall of their waiting room.
The Charter for End of Life was created by the Royal College of General Practitioners and the Royal College of Nursing. Its goal is to ensure that dying patients’ remaining days are as comfortable as possible, and that physicians do everything they can to preserve patients’ independence, dignity and, personal control. It includes a promise that the doctor will help patients ”think ahead so as to identify the choices that you may face, assist you to record your decisions and do our best to ensure that your wishes are fulfilled.” GPs also promise to do ”their utmost” to help keep a patient comfortable and make sure she gets appropriate specialist care, as well as emotional and spiritual support.
It is something like a Hippocratic Oath to the dying.
Of course, putting up a sign is not enough. But it is an important beginning. It is a critical reminder to both patients and physicians that end-of-life care is as important as, say, prescribing medications or ordering surgery. It signals that, while not every patient can be cured, every patient is owed the best possible care, and that sometimes that care may involve help with end-of-life decisions. I especially like this idea because it creates on opportunity for patients and docs to discuss end-of-life long before there is a crisis. Imagine a 50-something patient who is in the midst of caring for a dying parent. Simply seeing that written pledge on the wall may be enough to open an important discussion.
In recent years, the National Health System in Britain has made a real effort to encourage doctors and patients to establish ongoing relationships. The goal is for patients to get to know their GPs and not see a different doctor every few months. This opening to discuss end-of-life is another way docs can build trust with their patients.
The U.S., sad to say, is miles behind the curve on this. During the debate over the 2010 health law, there was an effort to provide doctors with an additional Medicare payment for discussing end-of-life issues during routine annual check-ups. In one of the more shameful episodes in recent political history, Republicans charged these discussions were “death panels” and the Obama Administration abandoned the idea. Earlier this year, the Department of Health and Human Services tried to do this administratively but, once critics got wind of the plan, dropped the idea again.
A written pledge, or even additional compensation, is just a start. Physicians need to be trained to have candid end-of-life conversations with their patients. They need to learn that a dying patient is not a failure, and that–sometimes–things happen that are beyond their control. But posting a Charter for End of Life is an important start. We ought to try it. LINK HERE
‘Death and Dying’ Special Segment
US NATIONAL CENTER FOR HEALTH STATISTICS COMPENDIUM: _Health, United States, 2010_ (February 2011, .pdf and Excel format, 547p.). The special segment in this year's compendium is on 'Death and Dying'. LINK HERE
For-profit hospices select patients who require less care, study shows
(Source: McKnight’s)
For-profit hospices might be admitting more low-cost, lucrative patients, who require less skilled-care than non-profit hospices, a study released Wednesday suggests. Additionally, for-profit agencies average 20 days of care, compared to the 16 days covered by non-profit facilities, according to the study. LINK HERE
21. MEDICAL COMMUNITY
Hospitalization of elders traumatizing and
often unnecessary, according to study
(Source: by Carol Bradley Bursack, Editor-in-Chief)
My mother-in-law had lived in an excellent nursing home for a couple of years when she contracted pneumonia. Her personality, even before her dementia set in, was shy, anxious and extremely modest, physically. She didn’t like people touching her. With dementia, her anxiety became worse, which generally happens to people who understand less and less about their environment. She never wanted to leave the nursing home for any reason, even for a visit to family members.
I was at the time, and still am, very grateful to the nursing home staff members who made the call at the time she got sick to keep her in her comfortable, familiar room and treat her pneumonia there. They did so successfully, and she was not subjected to the anxiety of a hospital stay or emergency room visit. They could have saved staff time by passing her off, but they didn’t.
I have no doubt that the trauma of being whizzed off in an ambulance and taken through the admissions part of ER, to say nothing of the rest of the journey, would have left her emotionally shaken, at the very least. It’s entirely possible that her dementia could have worsened from the trauma.
A post by Paula Span on The New Old Age Blog at the New York Times, supports my feelings. Span’s article addresses a study about the hospitalization of dementia patients. In Dementia Patients Hospitalized Too Often, Study Finds, Span addresses the issue of dementia patients and whether they are better off being treated in the nursing home where they live, or taken to a hospital. LINK TO ARTICLE HERE
AACN Partners with Geriatric Nursing Care Leaders to Recognize Innovative Student Learning Opportunities in Nursing Homes
WASHINGTON, D.C., June 6, 2011 – Today, the American Association of Colleges of Nursing (AACN) announced a collaboration with the Hartford Institute for Geriatric Nursing at New York University College of Nursing and the Pioneer Network to create a new honor recognizing creative student learning experiences offered in a nursing home setting. This unique award will spotlight the innovative ways schools are using nursing homes to provide meaningful, real world learning opportunities for students enrolled in Bachelor of Science in Nursing (BSN) programs.
“In keeping with AACN’s long-term commitment to enhancing geriatric
nursing education, AACN is pleased to join with the Hartford Institute and the
Pioneer Network to celebrate the enterprising work underway to prepare new
nurses to care for our aging population,” said AACN President Kathleen Potempa.
“Nurse educators must offer clinical learning experiences in practice settings
that cater to older adults, including nursing homes, to give students
opportunities to utilize and sharpen their skills in providing quality
geriatric nursing care.”
Titled the BSN Award for Innovative Clinical Rotation in a Nursing Home,
this award will be given to a school of nursing that demonstrates excellence in
the three areas:
Collaboration with a nursing home to foster an exemplary clinical training site (e.g., structure/process, standards, research opportunities, interdisciplinary care)
Incorporation of the principles of culture change and person-centered care
Use of nursing home clinical experience to integrate content related to management of older adults with complex, chronic illnesses (e.g., cancer, heart disease, dementia/delirium, geriatric syndromes)
The 2011 recipient school will receive an award of $500 and be recognized at AACN’s Fall Semiannual Meeting in Washington, DC in October and at AACN’s Baccalaureate Education Conference in St. Louis, MO in November. Applications must be received by Monday, September 12, 2011. For complete details and to download the application..
“Nursing home clinical placements provide a unique opportunity for students to care for older adults with complex and overlapping illnesses over a period of time and to promote quality of life. With competition for clinical training slots growing more fierce among all the health professions, AACN encourages nursing schools to consider partnering with local nursing homes to enrich the learning opportunities for their students,” added Dr. Potempa.
This award is part of a larger project, Nursing Homes as Clinical Placement Sites, funded by the Commonwealth Fund and Picker Institute. For more details, click here. .
The American Association of Colleges of Nursing (AACN) is the national voice for university and four-year college education programs in nursing. Representing more than 670 member schools of nursing at public and private institutions nationwide, AACN's educational, research, governmental advocacy, data collection, publications, and other programs work to establish quality standards for bachelor's- and graduate-degree nursing education, assist deans and directors to implement those standards, influence the nursing profession to improve health care, and promote public support of baccalaureate and graduate nursing education, research, and practice. www.aacn.nche.edu
Since its start in 1996, the singular mission of the Hartford Institute of Geriatric Nursing (HIGN) has been to shape the quality of nursing care to older adults by assuring geriatric competency of America's nurses. The commitment to this mission exhibited by the dedicated Hartford Institute leadership, staff and affiliate organizations has made HIGN today a globally recognized geriatric nursing resource. http://hartfordign.org
The Pioneer Network was formed in 1997 by a small group of
prominent professionals in long-term care to advocate for person-directed care.
This group called for a radical change in the culture of aging so that when our
grandparents, parents — and ultimately ourselves — go to a nursing home or
other community-based setting it is to thrive, not to decline. This movement,
away from institutional provider-driven models to more humane consumer-driven
models that embrace flexibility and self-determination, has come to be known as
the long-term care culture change movement. Our partners and audience are
primarily engaged in some aspect of long-term care including long-term care
CEOs and administrators, consumers and family caregivers, doctors and nurses,
direct care providers, and others who care about, and care for, the aging. www.pioneernetwork.net. LINK HERE
Nurses stay too quiet about caregiver errors, report says
(Source: Mary
Gustafson, McKnight’s)
Too many nurses keep quiet when they observe a colleague making a
mistake that could harm a patient, findings of a study of 6,500 nurses and
nurse managers reveal.
The study, conducted through a partnership between the consulting company Vital
Smarts and the American Association of Critical-Care Nurses, reports that 58%
of the study participants said they didn't tell anyone when a colleague
violated a safety measure. Safety measures include checklists, patient handoff
protocols and automated drug-dispensing systems, among others.
The most frequently noted kind of errors cited were the result of a colleague
taking a “shortcut.” Fifty percent of the participants said they observed a
colleague making care-related shortcuts that could have had dangerous
consequences. However, only 17% shared their observation with other coworkers.
About one-third of the participating nurses saw a colleague exhibit what they
considered to be incompetence, but only 11% of the nurses confronted that
individual.
More than half of the nurses reported disrespect as the reason they couldn't
get other people to take their complaints seriously.
David Maxfield, expert and consultant from the research firm Vital Smarts,
suggests that the “culture of silence”
in some healthcare settings — even those that use safety measures — contributes
to nurses staying quiet. LINK HERE
GEN SILENT: Documentary about LGBT Seniors
Gen Silent is the new LGBT documentary that asks
six LGBT seniors if they will hide their lives to survive in the care system.
They put a face on what experts in the film call an epidemic: gay, lesbian,
bisexual or transgender seniors so afraid of discrimination in long-term/health
care or bullying by other seniors that many go back into the closet. See More
AARP Celebrates National Pride Month with Debut of New Online Home for Older LGBT Americans
(Source: AARP)
WASHINGTON, June 6,
2011 /PRNewswire-USNewswire/ -- AARP today announced the launch of a new online
Web portal-www.aarp.org/pride-dedicated to serving older lesbian,
gay, bi-sexual, and transgender (LGBT) Americans. The organization's first
online home base for the LGBT community reinforces the fact that pride comes in
all ages for LGBT members, friends and loved ones. The site features articles
on news, personal finance, relationships, travel and other topics of concern to
older gay Americans, and their family and friends, as well as a community
forum.
"We are proud to
provide diverse, expert voices on topics that are important to all Americans
50+, including members of the LGBT community," said Hugh Delehanty, SVP &
Editor In Chief of AARP's media properties. "AARP understands that
while all Americans 50+ share the same goals of aging with dignity and peace of
mind, each of the communities in our lives offers its own challenges,
opportunities and contributions towards helping us get there. We couldn't
think of a better way to celebrate national Pride month than to launch this
portal, which we hope will help members of the LGBT community and their loved
ones get access to important information and relevant insights from experts and
each other."
The new www.aarp.org/pride portal offers targeted news, trivia
quizzes and information on issues that especially matter to the LGBT community
in areas including healthcare, retirement planning, caregiving, taxation,
employment discrimination and more. Visitors can access AARP's groundbreaking
coverage of relevant topics, including an article from the latest issue of AARP
The Magazine examining-three decades after the emergence of HIV/AIDS--the
new face of AIDS: people over 50. The portal also features AARP's 20-part
multimedia package, The Stonewall Riots: 40
Years Later, A Milestone Anniversary, which won accolades from the LGBT
community and mainstream media for its comprehensive coverage of an important
chapter in the American civil rights movement. For more information, click
here.
LGBT
Referral Directory Includes Questions Consumers Can Ask When Shopping
SAGE of Metro St Louis
made a referral directory of "welcoming" / "affirming"
organizations that "agree to provide services and supports to LGBT older
adults, their family, friends and caregivers in a nondiscriminatory manner which
promotes the dignity, safety, and well-being of LGBT older adults. The
organizations also have the opportunity to receive LGBT Cultural Competency
Training and ongoing technical assistance from SAGE." The directory
includes questions consumers can ask providers when shopping around.
LGBT fear treatment in long-term care
(Source: Elizabeth
Newman, McKnight’s)
A majority of lesbian, gay, bisexual and transgender older adults
believe that staff at long-term care facilities would discriminate against
them, according to a new report. While not a scientific study, the National
Senior Citizens Law Center's “LGBT Older Adults in Long-Term Care Facilities:
Stories from the Field” includes data from 769 adults who completed an online survey
from October 2009 to June 2010. Nearly 300 respondents identified themselves as
LGBT older adults; the rest were family members, friends, legal and social
service providers.
Almost all — 89% — predicted that staff would discriminate against a LGBT older
adult, while 43% reported 853 overall instances of mistreatment. Twenty-two
percent said they could be open with facility staff.
“The fears aren't groundless,” says NSCLC spokesman Scott L. Parkin. “We
need to pay close attention to what people's rights are.”
In addition to instances of restrictions on visitors, refusal of medical or
basic treatment, and harassment, respondents reported 97 instances involving
provider power of attorney.
A Washington lawyer wrote of a client hit by a car, citing that the victim and
his partner had no healthcare provider power of attorney in place. “Brian's
family took over his care at the hospital, excluded his partner and tried to
convert Brian back to being straight,” she wrote. “Luckily, this couple had registered
as domestic partners years before in Kings County, Washington, and we were able
to petition for a change in guardianship. This case took litigation and a lot
of money to fix.”
Parkin suggests that long-term care operators can use the report to start a
conversation with their employees about residents' rights.
Among other laws, the Nursing Home Reform Act (NHRA) protects those in
federally certified nursing homes from being discriminated against based on
sexual orientation or gender identity. LINK HERE
When HIV moves into nursing homes
(Source: By Susan Pigg, www.healthzone.ca)
It was as he writhed in pain on the bathroom floor, his anxious dog curled up in a ball against his back, that the grim reality of growing old with HIV hit Jim Ayerst. “I’ve never been suicidal, but that’s the first time I thought, it’s not worth it. I just want this over. I considered jumping off my balcony — but I only live on the second floor.” A wry smile creeps across Ayerst’s weary face. He’s just 64 but feels 80.
These days he’s as terrified as when he walked out of a doctor’s office with a diagnosis and an apparent death sentence 20 years ago. “There are days now I wonder, what am I still doing here?”
More than two decades after modern medicine and toxic antiretroviral drugs seemed to stop HIV/AIDS in its tracks, Ayerst is the new face of a disease that almost wiped out a generation of young gay men. He is grey-haired and growing old at a rate 15 to 20 years faster than those without the virus. His body is wracked by a host of chronic conditions more often seen in the elderly. In the last four years, Ayerst has been hit with diabetes, asthma, an aneurysm, memory problems and a nerve condition that sends pain shooting up his left leg like an electric shock. He lives in a Charles St. co-op apartment with help from “a team of angels” — fellow longtime survivors, personal support workers, a nurse and social worker. But there’s one thing he fears more than death: being forced into a long-term-care facility where he might have to return to the closet in order to fit in. READ FULL ARTICLE HERE
23. VOLUNTEERING
What Makes a Great Older Volunteer Program?
Exceptional older adult volunteer programs are built on effectiveness, impact, sustainability, and replicability, according to findings from NCOA's Multi-Generational and Civic Engagement Initiative.
Click here to read about information about 6 different model programs courtesy of National Council on Aging.
Leading Man PSA (Meals On Wheels Volunteer)
(Source: blog.see3.net)
May is Older Americans Month. This year’s theme “Connecting the
Community.” Meals on Wheels most certainly does that with its outreach to
isolated seniors. This clip, which utilizes a twist on the celebrity
spokesperson, “stars” longtime volunteer Homer Gere (father of Richard) as a
meals delivery man. This clip effectively conveys the value of retirees
volunteering and making a real difference to home bound seniors.
24. INTERNATIONAL
|
|
The
Brain Bus is a revolutionary mobile therapy unit for people with dementias
such as Alzheimer's. It brings the latest in cognitive therapy, anywhere and
everywhere. Read more. |
Choir provides music therapy for Alzheimer’s patients
(Source: www.bbc.co.uk)
Singers in Norfolk are feeling the benefits of a choir with a difference, one that is brought to life by members of the public affected by dementia. The Alzheimer's Society, which backs the scheme, says that music therapy is having fantastic results on those taking part.
This report by Clive Lewis features Heather Edwards from the Alzheimer's Society and Maureen Guest, who is affected by Alzheimer's. WATCH CLIP HERE
Norwich shoppers taken by surprise as singers break out into song in John Lewis
Flash mob singing 'Oh What a Beautiful Morning' in John Lewis. Photo: Bill Smith
A Norwich department store was filled with the sound of people singing as awareness was raised of memory-loss conditions. Members of Come Singing!, singing groups in Norfolk for people of all ages living with dementia, their friends and families, took shoppers by surprise as they broke out in song in John Lewis on Saturday morning. More than 100 people joined in the spirited rendition of Oh What a Beautiful Morning, as singers sprung up from chairs in the mezzanine cafe bar, lined the balcony and emerged from behind shelves and stands downstairs.
The ‘flash mob’ event was held to highlight the increase in dementia and the need to help people who have been diagnosed to keep active. Dementia is recognised as one of the biggest health and social challenges in the country. In Norfolk, the number of sufferers is expected to rise by 62pc in the next 15 years – pushing the total to above 20,000. Heather Edwards, who organised Saturday’s event, said: “People with dementia should be active and involved with their friends. Singing is a great way of doing that. It’s very therapeutic because we do a lot of brain games but it just seems like fun.”
Go to www.eveningnews24.co.uk to see video footage. Find Come Singing! details.
25. ANIMALS, INTERGENERATIONAL,
PLANTS & ETC.
Little People, Little Miracles
This may
sound like we are painting with a large brush, but we have witnessed this
phenomenon many, many times over the years in all sorts of situations. It is
always the same; the young children and elders are drawn to each other...
(Source: By Tom and Karen
Brenner, Alzheimer's Reading Room)
There is a kind of magic that happens when we bring young children
and elders together. These two generations seem to understand each other. This
is not to say that older people are child like, rather it is that both groups
are innocent of hidden agendas, power plays, phony emotions.
With both groups, elders and young children, what you see is pretty much what
you get. They seem to understand and appreciate this lack of pretense in each
other and are amazingly comfortable with each other. LINK TO
ARTICLE HERE
Spending More Time - Say, Forever - With Your Pet
(Source: Associated Press)
HARTSDALE, N.Y. (AP) — More Americans seem to be deciding to be buried with their favorite animals — in pet cemeteries. One pet cemetery owner says the trend may be related to people getting used to the idea of cremation, which is generally required. Another thinks pet owners are less bothered these days by what other people might think. New Yorker Rhona Levy says she has signed up in advance because she never had children and her pets were her foremost love. She said she wants to stay close to them after she dies. At the Hartsdale Pet Cemetery in the New York suburbs, the number of humans interred each year has more than doubled recently. Many inscriptions reveal owners' sentiments about their pets.
26. PERSONAL
TRANSFORMATION
Change your words.
Change your world.
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Previous Issues:
October/November/December 2010