California Association for Health Services at Home Better Business Bureau Alzheimer's Association - Professional Education Training

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Recognizing the Need for Outside Help in Caregiving

Caregivers often don’t recognize when they are in over their heads until they reach a breaking point.  Short-term the caregiver can handle it. Long-term, help is often needed.

A typical pattern with an overloaded caregiver may unfold as follows:

  • 1 to 18 months – the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.
  • 20 to 36 months – the caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.
  • 38 to 50 months – Besides needing tranquilizers or antidepressants, the caregiver’s physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.

It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled loved one in a facility. Without intervention, the caregiver may become a candidate for long term care as well.

At Home Care Solution provides nurse case management, social worker case management, and high quality certified nursing assistants, home health aides and caregivers to assist when families become overwhelmed.  We provide care on an hourly basis and we specialize in high quality and affordable live-in care for 24 hour peace of mind.

With the holiday season upon us, caregivers feel even more stress — with planning, shopping and participating in holiday activities. This is a perfect time for family and friends to step up and provide some respite time and caregiving help.  Whether it is provided personally or arranged as a gift of services to be provided by a professional respite company or home care provider, it is a welcome gift.

An article in “Today’s Caregiver” states:

“Nearly one in four caregivers of people with Alzheimer’s disease and other dementias provide 40 hours a week or more of care. Seventy-one percent sustain this commitment for more than a year, and 32 percent do so for five years or more. One of the best gifts you can give someone caring for Alzheimer’s is something that relieves the stress or provides a bit of respite for the caregiver.
The Gift of time: Cost-effective and truly meaningful gifts are self-made coupons for cleaning the house, preparing a meal, moving lawn/shoveling driveway, respite times that allow the caregiver time off to focus on what he/she needs.”

It is also important to note that hiring professional care provider services can provide valuable ongoing support to an overloaded caregiver. A financial planner, care funding specialist or a reverse mortgage specialist may find the funds to pay for professional help to keep a loved one at home. A care manager can guide the family and the caregiver through the maze of long term care issues. The care manager has been there many times — the family is experiencing it for the first time.

An elder law attorney can help iron out legal problems. And an elder mediator can help solve disputes between family members. There are also cash benefits for Veterans, who served during a period of war, that pay for home care or assisted living.

If you are the one providing daily care for a loved one, you owe it to yourself to seek help.
Take care of yourself and your needs, both physically and mentally.  Seek out professional help that will ease your burden and look for community service organizations that offer respite help.

The National Care Planning Council’s website www.longtermcarelink.net contains hundreds of articles with tips and advice for caregivers and their families.  Take a few minutes to find the help you need and enjoy this holiday season.

Visit the At Home Care Solution website or call 888-634-8004 for a no-cost, in-home assessment of your needs by a registered nurse or a care manager.

At Home Care Solution Celebrates Unpaid and Family Caregivers

This past month At Home Care Solution teamed with Lorian Home Health Care, CVS pharmacy and other CAHSAH certified home care agencies in San Diego County to celebrate everyday heros in the home.

As part of National Home Care month, parties were thrown across San Diego County at various CVS stores and 8 family and unpaid caregivers were awarded a combined $4000. 

Christy Stevenson gives a five minute makeover.

 

At Home Care Solution helped to organize the party at the Encinitas CVS, where Christy Stevenson of Charisma by Christy donated her skills as a make up artist to give five minute make-overs.

Diana Harvey of Healing Hands donated chair massages, which led to big smiles and relaxed shoulders.

Diana Harvey of Healing Hands provides a much needed back break.

 

Denise Callas, Nursing Supervisor for At Home Care Solution, gave free blood pressure screenings.

It was a fun afternoon that gave a much needed break to men and women who typically give care and rarely get care for themselves.

The person recognized at the Encinitas party was Linda, a mother of four who is caring for her parents with chronic illness.  She was given a $500 prize and said, “Having just lost my car, everyday is a challenge, this money is so unexpected, thank you all.”

At Home Care Solution would like to thank CVS, Lorian Home Health, Christy Stevenson and Diana Harvey for donating their time and expertise to this worthwhile event.

If you or someone you love needs home care, remember to select a CAHSAH certified agency, such at At Home Care Solution.  CAHSAH certification means the agency screens and monitors its employees, has worker’s compensation insurance, general liability and employee bonding, puts rates in writing and gets each employee screened for TB.

For more information, visit CAHSAH online.

 

 

Managing Pain at the End of Life

“I found that when I didn’t have pain, I could forget I had cancer” – Cancer patient

Chronic or excessive pain does not need to be part of aging, healing, or dying, a fact that Timothy Corbin, M.D. expressed to a crowd of nurses and social workers who gathered to learn more about alleviating pain. 

“Sometimes pain relief medications have scary names, which makes family members or patients want to avoid them,” explained Dr. Corbin.  But the fear is needless, he commented.

left to rt: Aviara's William Adams & Connie Garcia, Timothy Corbin, MD, Lauren Reynolds, At Home Care Solution & Aviara's Ana Morfin

Dr. Corbin is a hospitalist and palliative care consultant with Scripps Memorial Hospital, Encinitas, and he’s also Regional Medical Director of The Elizabeth Hospice.  He spoke at a continuing education seminar for nurses, social workers, fiduciaries and nursing home administrators.  The seminar was held at Aviara Healthcare Center in Encinitas and was sponsored by Aviara and At Home Care Solution.

Dr. Corbin explained that pain is the most common symptom of illness, and that unrelieved pain interferes with healing and diminishes quality of life. Sadly, he said that many dying patients continue to suffer from unrelieved pain during their last months  of life.  He also pointed out a 2007 Meta-Analysis which found pain present in 64% of patients with advanced cancer.  Additionally, he sited a JAMA study which said that 25% of long term care patients who complain of pain receive no treatment.

The good news is that most pain during the terminal phase of life can be controlled relatively easily.  Dr. Corbin cited prescribing Morphine on a 24 hour schedule as one of the basic techniques of pain control in a palliative setting.

One common concern about morphine at the end of life is a fear of addiction, which Dr. Corbin called an undue concern.  He pointed out that physical dependence is an expected result of long term use but should not be confused with addiction.

He recommended increasing the dose of pain medications if they don’t start working within a short period of time and said that the types of medications given should increase in strength if the first options do not provide relief.

The nurses, social workers and fiduciaries in the audience appreciated learning about how to advocate for their patients and clients who are suffering with pain.  

At Home Care Solution is a California approved provider of continuing education.  We would like to thank Aviara Healthcare Center, Dr. Corbin, and The Elizabeth Hospice for providing this important information as a service to our community.

At Home Care Solution is Proud Bronze Sponsor of the Walk to End Alzheimer’s

More than 35 hundred participants turned out this past Saturday to help raise money for Alzheimer’s research.  At Home Care Solution, one of only three local home care companies certified by the Alzheimer’s Association for dementia care, was proud to be a Bronze corporate sponsor of the event.

Lauren Reynolds with At Home Care Solution (left) with Betsy Evatt, Senior Care Management

The Walk to End Alzheimer’s, held in Balboa Park, was a big success according to organizers with the San Diego/Imperial chapter of the Alzheimer’s Association.

Alzheimer’s is now the sixth leading cause of death in the county and the third leading cause of death in San Diego. Roughly 53,000 San Diegans are living with Alzheimer’s.  In California more than 588,000 people are believed to be living with Alzheimer’s.

At Home Care Solution founder and C.E.O. Lauren Reynolds joined Betsy Evatt, care manager with Senior Care Management to provide information about in-home care and health advocacy.

At Home Care Solution provides quality hourly and live-in care for people with varying medical, social and psychological needs.

Senior Care Management, run social workers with decades of experience in geriatric care, provides coordination of care including medical issues and appointments, safety assessments and referrals.

For more information on Alzheimer’s or the walk,  visit the Alzheimer’s Association website. 

At Home Care Solution Earns Alzheimer’s Certification

At Home Care Solution is proud to announce that we have been awarded Certification through the Alzheimer’s Association. 

Laura Printy of the Alzheimer's Association and At Home Care Solution C.E.O. Lauren Reynolds

“Our mission is to provide the very best care from the most professional caregivers, and this certification demonstrates our continued commitment to that mission,” said Lauren Reynolds, At Home Care Solution Founder & C.E.O.

This designation is rare among home care companies in San Diego County.  Of the hundreds of companies which offer home care, only 3, including At Home Care Solution, have earned certification from the Alzheimer’s Association.

“We are very proud to be among the minority of agencies which take the time and devote the resources for this distinction,” said Reynolds.

Over the past several months, At Home Care Solution caregivers have completed 8 hours of specialized training in the area of dementia care.  Caregivers learned not only the health aspects of dementia and the various causes, but they also practiced effective communication techniques.  They’ve learned how to always practice patience and empathy while understanding the best ways to calm and encourage clients with memmory loss.

If you or someone you love is living with memmory loss, see how our service sets us apart.  Call for a no-cost, in-home assessment at 760-634-8000. 

 

 

 

The Truth about Sex and Older Americans

More Seniors Seek “Friends with Benefits.”

Dr. Daniel Sewell, clinical professor and Medical Director at the Senior Behavioral Health at UCSD, first took an interest in researching sexuality in older adults when a nursing facility called him for advice.

“A man and woman living at the nursing facility had fallen and love and began a physical relationship,” he explained, “and the woman had a husband living elsewhere.”

The question about what to do sparked a research project and a lecture that now is in high demand.

“I talk on a variety of topics, but when I’m requested as a speaker [the topic of age, sex and dementia] is what people request.”

Lauren Reynolds - At Home Care Solution, Dr. Daniel Sewell - UCSD, Inan Linton & Shevonne Farrell - Belmont VillageThe UCSD professor spoke to two dozen elder care professionals including social workers, nurses, and case managers at a seminar sponsored by At Home Care Solution and Belmont Village in Cardiff.

“Sleep is important, appetite is important and sex is important.  Getting older or getting dementia doesn’t necessarily change that,” Dr. Sewell pointed out.

He said there are 5 primary drives of human behavior, thirst, hunger, pain avoidance, attachment, and libido or sex drive.    He said the last drive is one that is talked about the least when it comes to older adults.

However, there are a couple of studies he cited.  He had to chuckle when telling the crowd that one study considered older to be age 50 and upward.   It found that 20 to 30 percent of men and women are sexually active into their 80’s.

The biggest determinants of whether an “older” person will be sexually active is their relationship status and health.

“If you have a partner, you’re more likely to have sex, and if you are healthy, you’re more likely to have sex,” he said.

A newer phenomenon, he explained, was the fact that one out of 5 men is having sexual contact with a “friend” or “new acquaintance”, the “friends with benefits” as it’s called in media.

The percentage of women doing the same is less, but still significant, at 13.5%.  He suspected that this more casual approach to sex has to do with the fact that older adults don’t want to complicate their lives with second or third marriages, so they’re open to the idea of sex with a less rigid relationship structure.

The drawback is that this behavior puts older adults at risk for sexually transmitted diseases if they don’t practice safe sex.  Older adults may think that because birth control is not needed, protection is also not needed.

Another interesting fact is that 14% of men report using some kind of supplement to improve their sex life.

A 2007 study also found that adults age 57 to 64 had a 73 % prevalence of sexual activity, for those 65 to 74 it’s 53%, and 75 to 85-year-olds had a 26% prevalence of sexual activity.

Dr. Sewell pointed out that older adults are rarely asked about sexual issues by their doctors or case managers.  It’s a topic that tends to make people uncomfortable or blush, but he said that thinking needs to change since sex not only indicates good health but it also improves health.

He suggested health practitioners should first build a rapport with the patient and then should ask a simple open ended question such as, “Have you experienced any changes in your sexual life?”

Finally, he gave 8 tips for enhancing and maintaining a positive sex life, no matter the age.

  1. 1.)    Eat a heart healthy diet
  2. 2.)    Get adequate rest
  3. 3.)    Maintain good dental care
  4. 4.)    Take care of your skin
  5. 5.)    Avoid tobacco products
  6. 6.)    Minimize Alcohol intake
  7. 7.)    Exercise regularly
  8. 8.)    Correct hearing loss

Those in attendance found his presentation insightful, humorous and very much needed.

“In all my years of caring for patients, I’ve never had this topic discussed,” one social worker commented.  She plans to incorporate questions about sex into the list of topics she addresses when conducting patient assessments.

At Home Care Solution is a certified leading provider of non-medical, in home care and is a provider of monthly continuing education seminars for nurses, social workers and nursing home administrators.   Call At Home Care Solution at 760-634-8000 or go online to  www.thecaresolution.com.

Belmont Village is a premier independent, assisted and memory care neighborhood in beautiful Cardiff by the Sea.  Contact Belmont Village at 760-436-890, or visit online at www.belmontvillage.com.

 

 

Meet Dianne, Winner of our Above and Beyond Award

At Home Care Solution is proud to announce that one of our most compassionate and professional caregivers is the recipient of our Above and Beyond Award.

Dianne

Above and Beyond Award Recipient

Dianne learned to be an excellent caregiver through her own life experiences.  She first cared for her father-in-law who had Alzheimer’s disease and then provided around the clock care for another relative who was diagnosed with cancer.

Dedicated to always learn and grow, Dianne earned high marks in our proprietary training program and said it confirmed that she was using both common sense and compassion to address the toughest challenges of caring for those affected by Alzheimer’s or dementia.

Clients of Dianne praise her punctuality, responsibility, attention to detail and desire to go way above and beyond their expectations.  When Dianne noticed a client adding notes in the margins of a daily health chart, Dianne took the initiative to go home and redesign the chart.  She worked on her computer for hours to create the perfect template.  Her client was so pleased to have a simpler way to measure daily health readings.

Dianne’s clients have been both men and women, and she thoroughly enjoys improving the quality of their days with her.  Dianne is one of the reasons that At Home Care Solution is one of the fastest growing providers of quality home care services across San Diego County.

 

 

 

91 People in 8 Cities Arrested and Charged with Medicare Fraud

Those arrested include 10 doctors, nurses, and Medicare recipients

In a coordinated effort that was the largest single Medicare Fraud strike force take-down to date, 91 people were arrested this week for a Medicare fraud scheme totaling $295 million dollars.

The services involved included durable medical equipment, physical and occupational therapy, mental health services, psychotherapy, HIV infusion and home health care. The coordinated action took place in eight cities, including Miami, Houston, Baton Rouge, Los Angeles, Detroit, Chicago, Dallas and Brooklyn.

Those arrested include nurses, physicians, other medication professionals and various providers. They face charges of conspiracy to defraud Medicare, health care fraud, violations of the anti-kickback law and money laundering.

The arrests drew praise from the National Association for Home Care & Hospice, of which At Home Care Solution is a member.

“We agree that our policy must be zero tolerance for those who would steal from the public purse and thus undermine the care being provided to aged and inform, disabled and dying Americans,” NAHC President Val J. Halamandaris said in a written release.

According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare for treatments that were never provided or for treatments that were not medically necessary.  Documents show that patient recruiters, Medicare beneficiaries and others were paid cash kickbacks in return for supplying information that could be used to submit the false claims.

“The health care system is part of our nation’s infrastructure and we must do everything in our power to protect the integrity of Medicare and the system at large,” said FBI Executive Assistant Director Henry. “Working together as partners, we can stop criminals who seek to steal American taxpayers’ hard-earned dollars and we help ensure our nation’s health care system is there for those who need it.”

Since it’s start in 2007, the Medicare Fraud Strike Force, a joint-operation among government agencies and law enforcement, has uncovered nearly $3 billion in Medicare Fraud.

To read more about the investigation and arrests, visit the US Health and Human Services website. 

Top 10 Reasons People Avoid An Estate Plan

The idea of planning is to stay one step ahead of split-second decisions and crisis troubles, but still a large percentage of families are reluctant to tackle an estate plan.   This week a group of financial planners, retirement planners and fiduciaries sat down to discuss the most common reasons families avoid dealing with estate plans.

For this purpose, an estate plan is essentially a will and a trust, long term care insurance if needed, a power of attorney, power of health care directive and a Polst or DNR form.

Denial came up as #1 to avoid estate planning.   Few younger people want to face the idea that they could be here one day, gone tomorrow, whether due to accident or illness.  Older individuals tend to be better prepared, but that doesn’t mean they’re willing to talk about their end of life wishes, such as how much medical intervention they desire and when to access in-home care or assisted living options.

Often families think they don’t have enough assets for an estate plan, for example, those who are upside down in their mortgages right now.

The #3 reason to avoid an estate plan is procrastination.  It’s this idea that we know we need an estate plan, and we’re going to get to it as soon as we can.  Problem is, this lack of a firm timeline makes it possible to just continually kick the can down the road.

Many people don’t know how to start an estate plan, so they simply don’t start one.  A good place to start is with a financial planner or trust attorney.  There are also online resources that can help with basic preparations.   Even a simple hand written will is better than none at all.

The #5 reason to avoid a trust is conflict.  Many families end up arguing when financial or end of life issues are brought up.  One case study involving this was an elderly couple who had fought over money their entire 60 year marriage.  They never did agree on how to gift it upon death.  When both spouses died within four months of each other, with no children, their substantial estate ended up in probate court.

Given the current economic realities, many people right now are just in “survival” mode, not planning mode.  If someone is concerned about havign enough money to buy food, pay rent or the mortgage or pay high college tuition or student loans, they are less likely to be planning adequately for retirmement.

The #7 reason is that they just don’t understand the need.  Many people think that their assets will simply pass to the heirs of their choosing without considering squabbles, tax implications, the cost of probate court and any number of problems they can’t forsee.

Especially for those experiencing loss or health issues, depression may be a reason to avoid an estate plan.  That came up as reason #8.  When someone is experiencing emotional pain, it’s hard to care about what may happen that day, let alone at some random point down the road.

Cohabitation is another reason people may feel uncomfortable making big decisions about their estate.  Blended families, later in life marriages and multiple step-children and biological children can lead to conflict over wills and trusts.

Cost ended up the #10 reason to avoid an estate plan, as many people don’t realize plans can be worked out for a couple hundred dollars up to several thousand dollars, depending on the assets, the complexity and the amount of detail needed.  In these tight times, it may seem like a financial stress to create a good estate plan, but having a plan could end up saving everyone involved from the creater losses than come from not having one.

 

 

Elder Care Planning, Not Reacting

It’s been called the Silver Tsunami, a dramatic increase in the number of Americans who are 65 years or older.   Due in part to birth rates (the baby-boom), medical and scientific advancements, more people are living longer.

For the first sixty years of the 20th century, life expectancy grew by about 2.5 years.  But from 1960 to 2007 – life expectancy expanded by a whopping 4.2 years.  Currently, anyone fortunate enough to hit 65 has an average life expectancy of 18.6 more years.

Keeping on the statistics train, 1 in 8 Americans is now 65 or older.  That segment currently makes up 12.9% of the population, but it will jump to 19.3& of the population by 2030, according to the US Department of health and Human Services.

Many older people live alone.  Since olde women outnumber older men and have longer live spans, half of all women aged 75 and older live alone.

In California, 25% of all seniors live by themselves, and about of third of those seniors have some form of disability.

Being able to age comfortably, either in place or in a suitable assisted living environment, takes some planning, especially financial planning.   A recent AARP study found that 31.6 % of seniors have experienced a substantial decline in their home’s value over the last three years, and a quarter of all seniors have exhausted their personal savings.

Paying for in-home care, such as the care offered by my company, At Home Care Solution, can feel out of reach for some seniors.  Those with good long term care policies experience less stress when hiring in-home help.  I know of a 60 year old man who pays $300 a month for his long term care insurance.  His father had Alzheimer’s disease, so this man worries that within a couple of decades he’ll need subtantial care at home.  His policy will currently pay $300 a day for care, an amount that will rise over time.  That amount should cover his needs, whether he chooses a live-in caregiver in his home or a specialized memmory care community.

Reverse mortgages are another option for seniors with limited cash reserves.  They are available to people 62 or older who own their homes.  The amount of money available is based on age, current interest rates and a home appraisal.  The draw-back is the cost/fees involved, so be sure to consult a financial planner and someone experienced with reverse mortgages.  Beware of potential scams.

It’s always a good idea to identify someone who can have power-of-attorney, and power of health care directive.  Keep a will and trust in order.  A simple way to make sure an elderly person’s wishes are clear and known is what’s called a Polst form.  Normally printed on hot pink paper, this form alerts paramedics, nurses and physicians as to a person’s end of life wishes.  We provide these forms to our clients so our caregivers are also aware of how to react when there is a significant medical issue.

While many of these issues are uncomfortable to talk about, having a plan makes everyone feel better and takes away the pressure of making hurried decisions in a crisis for the elderly relatives we love.