Saturday, September 5, 2015

Hallucinations vs. Delusions , & Confabulations

Hallucinations vs. Delusions in Alzheimer's from http://www.everydayhealth.com/alzheimers/alzheimers-hallucinations-and-delusions.aspx It is important that Alzheimer's caregivers understand the difference between a hallucination and a delusion. Each of these symptoms can affect your loved one in different ways:




Delusions. Delusions are false beliefs caused by the deterioration of cognitive processes in the brain of the Alzheimer's patient, and are often influenced by misunderstandings or misinterpretations. Patients might think they are being followed, or might accuse a family member of stealing from them or plotting against them.



Hallucinations. These involve false perceptions, and are also caused by changes in the brain due to Alzheimer's. Patients can literally “sense” — see, hear, smell, taste, or feel — something that isn't there. They might see and talk with old friends who aren't there, or watch ships floating through the sky outside the window, or smell foods they enjoyed as a child.



Confabulations are a major annoyance — when listeners take everything at face value, no matter how false their statements. The danger is when banks, adult protective services, police, friends, family, and other listeners take everything our loved ones say at face value and react based on the statements. Know that confabulating is distinct from lying because there is no intent to deceive. The statements can be coherent, internally consistent, and reasonable.



Be aware there are similarities between confabulation and delusions; e.g., both involve unintentional false statements. Realize delusions are frequently observed in Alzheimer’s patients may include beliefs about theft, the patient’s house not being his home, a spouse, is an impostor, belief an intruder is in the house, abandonment, spousal infidelity, and paranoia. visit http://en.wikipedia.org/wiki/Confabulation



Confabulating is distinct from lying because first there is no intent to deceive, second the person being unaware that the information is blatantly false. Confabulating can be coherent, internally consistent, and reasonable...despite clearly contradicting evidence. Your challenge: is what they say true?



we all Confabulate [http://en.wikipedia.org/wiki/Confabulation]. We make..verbal statements and/or actions that inaccurately describe history, background and present situations... {Confabulating is distinct from lying because there is typically no intent to deceive...} being unaware that the information is false... blatantly false information can also be coherent, internally consistent, and relatively normal...despite evidence contradicting it...



IMHO we all Confabulate make..verbal statements and/or actions that inaccurately describe history, background and present situations... {is distinct from lying because there is typically no intent to deceive ...} the source is unaware that the information is false... Blatantly false information can also be coherent, internally consistent, and relatively normal...despite evidence contradicting it...

Thursday, September 3, 2015

Care Consultation | Alzheimer's Association, Massachusetts/New Hampshire Chapter

Care Consultation | Alzheimer's Association:

Care Consultation  in person, by phone, or e-mail


Care Consultation is an in-depth, personalized service for individuals and families who are facing many decisions and challenges associated with Alzheimer’s disease and related disorders. 

The goal is for each family to develop a better understanding of the disease, make a plan to secure needed care, and develop strategies for the best possible symptom management and communication. Consultations are provided in person and by phone. Consultants are also available to answer questions by email.


Care Consultation may be the lifeline that can make a difference.

Need a Patient Advocate?


Do I Need a Patient Advocate 
by Barbara Hales, M.D. June 30, 2014


A patient advocate is someone who works for the benefit of patients and their families”. “A patient advocate can lend a helping hand when you need it most...”

“Individuals need an unbiased person to speak on their behalf

while providing guidance, friendship and emotional support. Advocates
help make choices and empower patients with access to relevant
information.”





*Patient Advocates/Navigators – The responsibilities of a
patient advocate are many and can include:



Medication reviews and coordinating various drugs


Explaining diagnosis and treatment options


Liaise between all the specialists that the patient is seeing
so they know what was diagnosed, which treatments were given,
and which tests were done or are pending



Assistance in monitoring in-hospital


Medical record reviews


Accompaniment to doctor’s appointments


Aiding in comprehension for the patient




*Health care Mediation and Conflict Resolution – A health
care mediator seeks to facilitate an agreement between all the
involved stakeholders, i.e. various family members, medical staff and
friends.





*Shared Decision Makers 





*Health Exchange/Marketplace Navigators 





*Medical Bills and Claim Reviewers.




*Senior/Legal Advocates 





*Statutory Advocacy 





*Hospital Patient Advocates or Representatives – Hired by the
hospital





*Health Coaches –








Patient advocates work for:




Hospitals – serving the patients while they are admitted


Social Service Agencies – for client outreach


Insurance Companies


Private/Freelance – serving the clients themselves



Read full article:


Wednesday, September 2, 2015

myhomehelper - award winning memory aid

myhomehelper - award winning memory aid
what is myhomehelper?

myhomehelper is the innovative new memory aid developed from the personal experience of assisting a family member living with dementia.

It is a 9.7 inch on-line digital display, specifically designed to support people living with memory impairment and learning difficulties in their own homes. myhomehelper helps to reduce anxiety and isolation and gives peace of mind, reassurance and confidence to family and carers.

    Features
    Calendar Clock
    Diary
    Timed and Random Reminders
    Photos
    News Headlines
    Auto answer Skype Video Calling
    Facebook Messages
    Night Mode
    Multi User Access
    SMS and e-mail system to carers
    Multi Language

Developed from ideas and feedback given from service users and carers in trials of the system over the last 3 years, the user centred design ensures that it is ideal for people with no computer or IT experience and requires no interaction from the user for it to work.
how does it work?

myhomehelper comes pre-installed on a tablet computer that has been configured to run the system optimally from the moment that you turn it on.

A simple set-up system can be accessed by family, friends and carers to tailor the system to suit individual needs via the myhomehelper website, from anywhere that has access to an internet connection - be that at home, work or even on holiday.

It has been designed as an "always on" system and once set-up only needs to be maintained when new activities, appointments or photos etc need adding. The end user does not have to do anything but look at the display occasionally to benefit from it - there is no other interaction required.
--
how much does it cost?

myhomehelper costs £333.33 (ex VAT) for the first year and then either £7.49 per month or £77.88 per year thereafter to continue using the on-line features.

The price includes:

    a tablet computer configured for myhomehelper
    12 month myhomehelper subscription
    tablet stand
    18 month warranty
    on-line technical support



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Tuesday, September 1, 2015

Code of Federal Regulations Resident rights (§483.10) Admission, transfer, and discharge rights (§483.12) Resident behavior and facility practices (§483.13) Quality of life (§483.15) Quality of care (§483.25)

Quoted from:http://tinyurl.com/pmmrher December 14, 2013
Long Term Care Facilities: Are You Being Treated Right?
By CzepigaDalyPope LLC

The Code of Federal Regulations (herein either “the Code” or “CFR”) is a codification of rules published in the Federal Register by the departments and agencies of the Federal Government. Title 42 of the Code, Part 483, addresses public health requirements for long term care facilities.

Part 483 specifically addresses, among many other issues, the following:

Resident rights (§483.10)
Admission, transfer, and discharge rights (§483.12)
Resident behavior and facility practices (§483.13)
Quality of life (§483.15)
Quality of care (§483.25)

Most of the fundamental questions you have will be addressed, at least in part, in the sections cited above. Section 483.10, as one example, addresses resident rights and specifically provides for what a facility must do regarding issues that range from providing, for inspection, a resident with his or her medical records within twenty four hours of request, to prominently displaying information about how to apply for and use Medicare and Medicaid benefits.

Section 483.12, as one other example, lists the six permissible reasons to discharge a resident from a long term care facility. It is important to note, there are no other reasons for discharge beyond these six, any other purported reason for discharge that is not listed in §483.12 (a)(2) is a violation of Federal law.

 Reasons for Discharge

The transfer or discharge is necessary for the resident’s welfare and the resident’s needs cannot be met in the facility

the transfer or discharge is appropriate because the resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility

The safety of individuals in the facility is endangered

The health of individuals in the facility would otherwise be endangered

The resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the facility.

The facility ceases to operate

For those who live in long term care facilities, it is your home and you are entitled to certain rights within it. For those of you who visit a loved one in a long term care facility, if you begin to question whether your loved one is being treated appropriately, simply go online, type into Google “42 CFR 483,” and start getting your questions answered.

A trial attorney who handles these types of matters, can give you lots of help,
however, you would be surprised how effective Federal law is when properly cited during discussions with facility administrators and staff.

Posted in: Elder Law and Nursing Home Litigation

Caregiver Resilience: What It Is and Why It Matters for Family Caregivers | Griswold

Caregiver Resilience: What It Is and Why It Matters for Family Caregivers | Griswold


In Resilience, Steven Southwick and Dennis Charney (2012) outline ten ways that resilient people tend to cope with stress.  The good news is that these can be learned and developed.
1.      Realistic Optimism: Viewing life in a hopeful,

confident way. Anticipating a bright future.  Believing that good things

are coming and hard work will yield success.  Realistic optimism is the

foundation of resilience, and fuels each of the following resilience

factors.
2.    Social Support: Connecting with other people by

seeking out and accepting help that is offered, and also by giving help

to those in need.
3.   Facing Fear: Using thoughts and behaviors to triumph

over fear.  Acting in spite of fear to accomplish goals and become

stronger.
4.   Religion and Spirituality: Turning to God, or a Higher

Power.  Engaging in formal religious services or private spiritual

practices.  Finding inspiration in nature or the arts.
5.   Meaning, Purpose and Growth:  Finding strength and

courage by pursuing an inspiring goal.  Using adversity as a catalyst

for growth.  Actively serving a purpose that is greater than

self-interest.  Transcending traumatic experiences by helping others who

have been traumatized.  Choosing to be a victor, rather than a victim.  
6.  Moral compass/Altruism: Engaging in right actions and avoiding doing wrong. Thinking of and serving others.
7.   Role models: Imitating people who demonstrate positive

ways of handling adversity.  Identifying real people, living or dead;

fictional characters, famous individuals or historic figures.

 Replicating small aspects of their behavior that have led to positive,

desired outcomes.
8.  Training: Improve physical health and preventing or

diminishing the effects of chronic illnesses by keeping the body fit.

 Mastering physical challenges to also improve mental health and

emotional regulation.   
9.  Brain fitness: Focusing thoughts, and challenging the

mind so the intellect is sharp and continues to grow.  Regulating

emotions to eliminate feelings that undermine effective coping.
10.  Flexibility: Employing a variety of mental and

emotional strategies to handle adversity; accept what can’t be changed;

learn from failure; transform negative energy into positive energy; and

find opportunity and meaning in adversity.



Monday, August 31, 2015

Lifting and Transferring Techniques. - RESCUE_Lifting_Transferring_PDF.pdf

Lifting and Transferring Techniques. - RESCUE_Lifting_Transferring_PDF.pdf





http://www.stroke4carers.org/?tag=car-transfers





Gait belts can help you lift and move your loved one.

Gait belts are simply wide and soft belts that can be placed around your loved one’s torso (not under his/her shoulders).


Gait belts can help you lift your loved one by grabbing the belt.
Amputee Coalition. (2009). Body mechanics, positioning, moving, and transfers. inMotion, 19.




Retrieved from http://www.google.com/imgres?imgurl=http://www.amputee-coalition.org/inmotion/oct_09/positioning_moving_transfers_05.jpg&imgrefurl=http://www.amputee_coali




tion.org/inmotion/oct_09/positioning_moving_transfers.html&usg=__sZg5ShkoHA1n6817onRdS_CvSog
=&h=115&w=125&sz=5&hl=en&start=11&sig2=6cwxOIfAIqtBWARaSoj4eg&zoom=1&tbnid=QjtXcS4ay4




nx2M:&tbnh=83&tbnw=90&ei=hRWIUYroEseVyQG4rYDQAQ&prev=/search%3Fq%3Dphoto%2Btransf
er%2Bpatient%2Bpivot%2Bturn%26um%3D1%26sa%3DN%26hl%3Den%26gbv%3D2%26tbm%3Disc




h&um=1&itbs=1&sa=X&ved=0CEAQrQMwCg








Bailes




, H. (2010). Slide board transfer is a safe way to move people with disabilities. Retrieved from




http://www.youtube.com/watch?v=6x
-




qwtUaxXk


Caring Web Education and Support for Caregivers of Stroke Survivors. (2012). Safe transfer techniques. Retrieved from

http://caringweb.utoledo.edu/transfer.html

Dreeben Irimia




, O. (2011). Introduction to physical therapy for physical therapy assistants. Sudbury, MA:




Jones & Bartlett Learning, LLC.




Heart & Stroke Foundation. (2010). Mobility, positioning, and transfers. In Tips and tools 2010 (section




9). Retrieved from




http://www.heartandstroke.on.ca/site/c.pvI3IeNWJwE/b.6194819/k.FEB1/Tips_and_Tools__2010.htm




Stroke4Carers. (




n.d




). How to assist the person in and out of a car safely. Retrieved from




http://www.stroke4carers.org/?tag=car
-
transfer

DIY Feces And Diarrhea Stain Removal from carpet and Upholstery

Clean off the feces or diarrhea, or urine, as possible.



For a diarrhea stain cover with an absorbent, such as cornstarch or baking soda and let it soak in

Vacuum up the cornstarch or baking soda.You may need to repeat this step

Make a solution of  cool water,  a little dishwashing liquid, and white vinegar.

Using this attack the stain.

Repeat  until the stains are removed.

Rinse carefully with plain cold water then dry.



If this does not completely remove the stain apply 3% hydrogen peroxide to the stained. Test this stain removal method in an inconspicuous area to make sure it does not cause harm.



Carefully rinse with plain cold water {cloth and sponge on upholstery} then dry.

Seniors staying in their homes more instead of moving to assisted living centers

Seniors staying in their homes more instead of moving to assisted living centers
"Samah Assad/SAssad@MorningJournal.com


 Samah covers Oberlin, Westlake, Sheffield, and crime and cops. She loves all things Cleveland. Reach the author at sassad@morningjournal.com

or follow Samah on Twitter: @SAssadMJ.

John Schlotterer, left, of Elyria has been the full-time primary

caregiver for his 85-year-old mother Helen. They have recently begun

utilizing the Home Instead Senior Care office that serves Lorain County"

 Karin Wolff, a registered nurse and owner of the Home Instead Senior

Care office, which helps seniors and their caregivers in Lorain County

prepare older adults for aging, said 85 percent of seniors have not

educated themselves as to dangers they could face in the home. The

center’s caregivers primarily visit homes and provide transportation,

housekeeping and personal care for seniors.








LED light Strips

{Quote}LilyLEDs.com The LED lights  Most Versatile Lighting In The World. Besides the numerous advantages of LED lights themselves, such as extremely low power consumption, very long lifespan, eco-friendliness, durability and the low cost of maintenance.

Strip lights – unlike fluorescent tubes – can be dimmed too, and the beam of light deriving from a source can be strengthen by placing more than one lines next to each other.

Strip lights are great sources of any additional light, nearby the table or even within the reach of children.
{End Quote}

Elder Community Care | Marlborough, MA 01752

Elder Community Care | Marlborough, MA 01752

Elder Community Care a team of trained social workers & mental health clinicians

Elder Community Care is a network of agencies working together to serve elders in their own homes. We provide comprehensive assessment and counseling services to elders and their families in Metrowest. We provide comprehensive assessment, counseling and referral services.

Day Trips for Caregivers - Visiting Nurse Service of New York

Day Trips for Caregivers - Visiting Nurse Service of New York: Day Trips for Caregivers Nature Getaways within 2 Hours of NYC

People who spend time outdoors, particularly around trees and in gardens, have better physical and mental health, and the benefits can be immediate. One recent study at Stanford University found that volunteers who walked in a park-like section of the university’s campus were less anxious, less likely to dwell on negative things, and performed better on short-term memory tests than those who walked near a highway.

Arrange for a day of respite care and plan your escape! Here are day trips in the Hudson Valley, on Long Island, and in New Jersey that can help caregivers recharge. If you can only steal a few hours, we’ve also included ideas for NYC.





Saturday, August 29, 2015

It takes just one person to encourage setting up Night-Care respite for those with dementia.

If YOU are using or involved with a assisted living facility, senior services, day-care, caregivers, senior center, or area agency discuss Night Care programs with your peers.

Over-Night Care: Night programs serving individuals with Alzheimer's

Over-Night Care: Night programs serving individuals with Alzheimer's: Over-Night Care: Night programs serving individuals with Alzheimer's

Carers often experience chronic sleep deprivation. At the onset of nighttime. The demons of anxiety, anger, fear, hallucinations and paranoia come out. Night time can be unpredictable, up and down cycles.We need All-Night Care all night respite programs. 

Friday, August 28, 2015

The Top Two Misconceptions about ADA Compliance at Your Senior Community | Senior Housing Forum

The Top Two Misconceptions about ADA Compliance at Your Senior Community | Senior Housing Forum: “But our resident units are accessible.”

While your resident units are accessible, you must remember that ADA accessibility is also about accommodating the general public and your employees.

This means all public accommodations at your senior care community, inside and out, should be in compliance.

“What often gets reported are violations that occur outside of the resident dwelling units, such as the lobby, public restrooms or parking lots,” said Greg. “Many senior care providers often forget that these areas need to be compliant, and since they have never received a complaint or violation, they continue to operate under the assumption that nothing needs to be changed.”

And don’t forget, you should also be cognizant of your employees’ work areas, such as the staff break rooms and bathrooms, which also need to be accessible.

Hospice is likely to be the most important health care decision we make. by Joy Loverde

Hospice: I had no idea | Eldercare Blog: Families have a choice in hospice programs.

Hospice is likely to be the most important health care decision we make. For a long time, we could assume that every hospice provided high-quality care. That assumption is no longer safe. Families must shop around. To start the process, request a home visit for patient assessment and a customized Q & A. How receptive a hospice is to the following questions is an indicator of the quality of their program:

What do others say about your organization? Get references.

How long has the hospice been in operation?

Is the hospice Medicare-certified?

What is the expectation regarding the family’s role in caregiving?

Is there anything currently being done for the patient that you would not do?

(Make a list of specific family needs.) How will you address these needs?

What extra services are offered?

Is your availability 24/7?

How rapid is crisis response?

Do patients ever get transferred to inpatient care? Under what circumstances? And where do they go?

Is family respite care available? What kind? Under what circumstances?

Are your MDs/RNs certified in palliative care?

How are family complaints handled?

What kind of emotional support do you provide – now and after?


Wednesday, August 26, 2015

HebrewHome at Riverdale, All-Night Care for Alzheimer’s Restless Minds

Mr. Pomeranz at the , Hebrew
Home at Riverdale
, Took the day program and ran it at night.
The activities mirror those done during the day: arts, crafts,
exercise, and holistic remedies like meditation and pet therapy.

{quote} Participants are fetched from
their homes by vans and spend 7 p.m. to 7 a.m. painting, potting
plants, dancing and talking — or, for those immobilized by their
disease, relaxing amid music, massage and twinkling lights. The
patients rest as they need, for a few minutes or a few hours, and
return home the next morning fed, showered and, usually, tuckered
out. {end quote}

It takes just one person to encourage
setting up Night-Care respite for those with dementia.






If YOU are using or involved with a
assisted living facility, senior services, day-care, caregivers,
senior center, or area agency discuss Night Care programs with your
peers.

Tuesday, August 25, 2015

No Dial Phones, TELco Dial Lock, incoming calls only, controlling calls

Amazon.com: Scitec, Inc. No Dial Single Line Phone: Electronics: Scitec, Inc. No Dial Single Line


250047-VBA-NDL Red desk no dial by Cortelco


No Dial Desk Phone Ash Built-In Volume Adjustable Ringer Hearing Aid by Viking Electronics


IMHO, you can take cover off any phone and remove the wires from the dialing unit.

from Yahoo:
There is a feature that most large home phone companies have called "Dial Lock" The way it works is: you have to put in a pass code to be able to dial information, since it is a pay per use feature, as well as long distance calls. So, you can still make your long distance calls to friends & family by putting in the pass code, and those who don't have the pass code can not. It does have a monthly cost, but I'm sure it would be cheaper then paying for high long distance calls, that someone else is making on your phone. Call your local phone company to see if they have this feature, that sounds like just what you need.

Sunday, August 23, 2015

New techniques to move patients safely





 Patient transfer

medicaresystem.net/company/distributors

Medicare System  
Manufacturer
Address: Abad Escarré, 15, 08302 Mataró, Barcelona, Spain
Phone:+34 937 57 00 48

 InnoCare Health Corporation is a leading supplier of AEDs and related products and accessories across the United States. We are a family-owned and operated company and we pride ourselves on our ability to combine the most competitive pricing with outstanding customer service.

Saturday, August 22, 2015

Codependency: Caretaking vs. Caregiving


In a Caregiver Support Forum discussion group the question was asked: 


How can I begin to think positive about being a
caretaker?




I came across Elizabeth Kupferman a counselor in Southlake,
Texas (Dallas/Fort Worth area) dedicated to helping women overcome
depression, grief, and anxiety so they can find happiness and achieve
their dreams.







She has an excellent site with great information,which I
quote  (material quoted was authored by
Elizabeth Kupferman ):


http://www.expressivecounseling.com/codependency-caretaking/




{begin quote}


Codependency: Caretaking vs.
Caregiving




Codependency is a group of behaviors that cause us to have
unhealthy relationships.  Caretaking is one of those behaviors,
and what we want is to replace caretaking with caregiving.
There are crucial differences between caretaking and caregiving and
you will notice: the healthier and happier your relationship, the
more you are caregiving rather than caretaking.




I view caretaking and caregiving on a continuum.  We usually
aren’t doing both at the same time.  The goal is to do as much
caregiving as we can and to decrease our caretaking as much as we
can.  Caretaking is a dysfunctional, learned behavior that can
be changed.  We want to change so we can experience more peace,
more contentment and more fulfilling relationships.  The people
in your life may resist your healthier actions, but modeling
caregiving is a huge gift you are giving to your loved ones





Here are some key differences between caretaking and caregiving:



  • Caretaking feels stressful,
    exhausting and frustrating.  Caregiving feels right and feels
    like love.  It re-energizes and inspires you.


  • Caretaking crosses boundaries.
    Caregiving honors them.


  • Caretaking takes from the
    recepient or gives with strings attached; caregiving gives freely.


  • Caretakers don’t practice
    self-care because they mistakenly believe it is a selfish act.


  • Caregivers practice self-care
    unabashedly because they know that keeping themselves happy enables
    them to be of service to others.


  • Caretakers worry; caregivers take
    action and solve problems.


  • Caretakers think they know what’s
    best for others; caregivers only know what’s best for themselves.


  • Caretakers don’t trust others’
    abilities to care for themselves, caregivers trust others enough to
    allow them to activate their own inner guidance and problem solving
    capabilities.


  • Caretaking creates anxiety and/or
    depression in the caretaker.  Caregiving decreases anxiety
    and/or depression in the caregiver.


  • Caretakers tend to attract needy
    people.  Caregivers tend to attract healthy people.
    (Hint:  We tend to attract people who are slightly above or
    below our own level of mental health).


  • Caretakers tend to be judgmental;
    caregivers don’t see the logic in judging others and practice a
    “live and let live attitude.”


  • Caretakers start fixing when a
    problem arises for someone else; caregivers empathize fully, letting
    the other person know they are not alone and lovingly asks, “What
    are you going to do about that.”


  • Caretakers  start fixing when
    a problem arises; caregivers respectfully wait to be asked to help.


  • Caretakers tend to be dramatic in
    their caretaking and focus on the problem; caregivers can create
    dramatic results by focusing on the solutions.

  • Caretakers us the word “You” a lot and Caregivers say “I”
    more.



As with changing any behavior, becoming aware of it is the first
step.  Watch yourself next time you are with someone and ask
yourself where you fall on the continuum.  It will take some
work to change and you may experience some resistance and fear in the
process — but what is on the other side is well worth the struggles
of transformation.



I recommend the work of Melody Beattie who is a groundbreaker in
codependency education.  If you find yourself in relationships
with people who have addictions or if you struggle with your own
addictions, I recommend Codependent
No More:  How to Stop Controlling Others and Start Caring for
Yourself
(also Al-Anon, which is a 12 step group).  If
you aren’t in relationship with someone who has an addiction or if
you do not suffer from an addiction, I recommend her new book The
New Codependency:  Help and Guidance for Today’s
Generation
.”


Reference:  Beattie, Melody (1991).
Codependent No More:  How to Stop Controlling Others and Start
Caring for Yourself.


{end quote}



Please note:


Elizabeth Kupferman is a counselor in Southlake,
Texas 


the great information,which I was
authored by Elizabeth Kupferman :



http://www.expressivecounseling.com/codependency-caretaking/








Can You Cancel a Will? - AgingCare.com

Can You Cancel a Will? - AgingCare.com

Note that a well-drafted will should always include the statement “hereby revoking all prior wills signed by me,” or words to that effect. This is to make it clear that your new will is not deemed an amendment to an existing will, but is a complete replacement to any prior wills.

  , Expert
Attorney, author, Medicaid asset protection planning

Friday, August 21, 2015

A Guide to Coping with Alzheimer's Disease - Harvard Health

A Guide to Coping with Alzheimer's Disease - Harvard Health

 This Special Health Report includes in-depth information on diagnosing
Alzheimer’s and treating its symptoms. Because caring for someone with
Alzheimer’s continues to be one of the toughest jobs in the world, the
report includes help for family members and caregivers, as well as for
the individuals with Alzheimer’s.

Prepared by the editors of Harvard Health Publications in collaboration with John H. Growdon, M.D., Professor of Neurology, Harvard Medical School, and Director, Memory and Movement Disorders Unit, Massachusetts General Hospital. 53 pages. (2015)

Wednesday, August 19, 2015

In the hospital? Are you a hospital inpatient or outpatient?

In the hospital? Are you a hospital inpatient or outpatient?     May 21, 2014 by Wendy Shane




May 21, 2014 by





May 21, 2014 by

 Why does this matter to patients?

When hospital patients are classified as outpatients on Observation Status, they may be charged for services that Medicare would have paid if they were properly admitted as inpatients (for example, medications, so you may want to bring medications with you).

Most significantly, patients will not be able to obtain any Medicare coverage if they need nursing home care after their hospital stay. Medicare only covers nursing home care for patients who have a minimum 3-day inpatient hospital stay. Observation Status doesn’t count towards the 3-day stay.







Why does this matter to patients?








When hospital patients are classified as outpatients on Observation

Status, they may be charged for services that Medicare would have paid

if they were properly admitted as inpatients (for example, medications,

so you may want to bring medications with you). Most significantly,

patients will not be able to obtain any Medicare coverage if they need

nursing home care after their hospital stay. Medicare only covers

nursing home care for patients who have a minimum 3-day inpatient

hospital stay. Observation Status doesn’t count towards the 3-day stay.



- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf







Why does this matter to patients?








When hospital patients are classified as outpatients on Observation

Status, they may be charged for services that Medicare would have paid

if they were properly admitted as inpatients (for example, medications,

so you may want to bring medications with you). Most significantly,

patients will not be able to obtain any Medicare coverage if they need

nursing home care after their hospital stay. Medicare only covers

nursing home care for patients who have a minimum 3-day inpatient

hospital stay. Observation Status doesn’t count towards the 3-day stay.



- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf



Why does this matter to patients?








When hospital patients are classified as outpatients on Observation

Status, they may be charged for services that Medicare would have paid

if they were properly admitted as inpatients (for example, medications,

so you may want to bring medications with you). Most significantly,

patients will not be able to obtain any Medicare coverage if they need

nursing home care after their hospital stay. Medicare only covers

nursing home care for patients who have a minimum 3-day inpatient

hospital stay. Observation Status doesn’t count towards the 3-day stay.



- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf




Why does this matter to patients?








When hospital patients are classified as outpatients on Observation

Status, they may be charged for services that Medicare would have paid

if they were properly admitted as inpatients (for example, medications,

so you may want to bring medications with you). Most significantly,

patients will not be able to obtain any Medicare coverage if they need

nursing home care after their hospital stay. Medicare only covers

nursing home care for patients who have a minimum 3-day inpatient

hospital stay. Observation Status doesn’t count towards the 3-day stay.



- See more at: http://lcdne.com/aging/are-you-a-hospital-inpatient-or-outpatient#sthash.pcIuTJej.dpuf

Saturday, August 15, 2015

EMR vs. EHR – What is the Difference?

EMR vs. EHR – What is the Difference?: EMR vs. EHR – What is the Difference?

Posted by Matthew Smith on Tue, Jan 14, 2014 @ 12:21 PM

 What’s in a word? Or, even one letter of an acronym?

Some people use the terms “electronic medical record” and “electronic health record” (or “EMR” and “EHR”) interchangeably. But at the Office of the National Coordinator for Health Information Technology (ONC), you’ll notice they use electronic health record or EHR almost exclusively. While it may seem a little picky at first, the difference between the two terms is actually quite significant.The EMR term came along first, and indeed, early EMRs were “medical.” They were for use by clinicians mostly for diagnosis and treatment.

In contrast, “health” relates to “The condition of being sound in body, mind, or spirit; especially…freedom from physical disease or pain…the general condition of the body.” The word “health” covers a lot more territory than the word “medical.” And EHRs go a lot further than EMRs.





Wednesday, August 12, 2015

Hospice Drugs are Covered under Medicare Part A NOT Part D

Hospice Drugs are Covered under Medicare Part A NOT Part D

Hospice programs must provide individuals under

hospice care with drugs and biologicals related to the palliation and

symptom management of the terminal illness as defined in the hospice

plan of care. The only drugs covered by the hospice program are those

used primarily for relief of pain and symptom control related to the

individual‘s terminal illness. However, because hospice care is a

Medicare Part A benefit, the drugs provided by the hospice and covered

under the Medicare per-diem payment to the hospice program are not covered under Part D.


Hospice programs are specified in section 1861(dd) of the Social Security Act and in Federal regulations at Part 418.

Saturday, August 8, 2015

4 Essential Caregiving Lessons from Home Care Nurses - AgingCare.com

4 Essential Caregiving Lessons from Home Care Nurses - AgingCare.com


Working in home care enables you to see certain elements of an

elder's life that may fly under the radars of their doctor, their

friends and, many times, even their closest family members.


The

people caring for your loved one—home health aides, registered nurses,

social workers, etc.—witness some of that individual's most vulnerable

moments as they handle real-time critical issues related to a senior's

health and well-being

Friday, August 7, 2015

Tips for avoiding scams | Loving Hands Group

Tips for avoiding scams | Loving Hands Group: Scams are perpetrated by phone, mail, e-mail, text message, social media and door-to-door contact. Scammers are very good at making their targets feel guilty about saying no. They typically act very friendly, call you by your first name and pretend to care about your family and your health situation, while making you feel guilty for not trusting them.

Scammers also try to confuse you into accepting their offer. They will talk fast, avoid questions, give incomplete or confusing explanations and pressure you into accepting immediately. If you are not completely clear about and comfortable with what they are proposing, either say no or tell them you need time to think it over. Always consult with a trusted friend or family member before you decide.
--------------

Scammers are hard at work.  Apr 18 2015
Received a phone call from a man saying he was Michael Collins comptroller at Publishers clearing house. Notifying me I had won millions of dollars. All I need to do is call 866 996 5997 register my winners number, pay a delivery fee for something and PCH will show up and deliver a million dollar prize and car etc etc.  I was told the IRS had already taken out their 15%, but Federal Taxes were still owed.....

A quick check on the Net http://info.pch.com/consumer-information/tips-a-warning-signs and found this  was an on going scam.

If only I had won Glad I was online and could do vetting.


He was very very convincing


Dave

Thursday, August 6, 2015

Learn what it takes to become a CAREGiver

The Heart of a CAREGiver    info@homeinsteadinc.com

Caring for seniors is a labor of love that requires a special person with just the right touch.
The Home Instead Senior Care® network is looking for dedicated CAREGiversSM who share its passion for caregiving to provide non-medical in-home care assistance to seniors.

 http://caregiversnewsbasket.blogspot.com/ 

Tuesday, August 4, 2015

Senior Fall Prevention: Help for Caregivers

Senior Fall Prevention: Help for Caregivers: Caregivers can help seniors reduce their risk of falling and remain independent in several proven ways.

Regular exercise is essential in helping seniors improve balance and gain strength. Check in with local senior centers and community groups to find out about fitness classes, such as Tai Chi, for older adults. Even seniors with limited physical fitness can increase their abilities over time.

It's important for caregivers to offer gentle support if seniors push back against a new exercise regimen. One way to get your aging loved one on board while also deriving benefits for yourself? Join in their routine.

Also, take time to fall-proof your aging loved one's home. Cords, wiring, newspapers, and other debris are hazardous when underfoot. Living spaces should be free of clutter with clear, well-lit pathways between rooms. Grab bars, railings, and other assistive devices further protect seniors against falls.

Monday, August 3, 2015

Caregiving Criticism and Unsolicited Advice From Family - AARP

AARP Home » Home & Family » Caregiving »How to Handle Criticis...

How to Handle Criticism While Caregiving

Well-meaning advisers try to help but some can cause hurt


by Barry J. Jacobs, PsyD., AARP, December 29, 2014




Take it from whence it comes


Caregivers would be well-advised (there's that word again) to not

just react to the message being given but to consider the background and

intentions of the messenger. Advisers often have a sincere desire to

help, because they truly are caring and invested. They just don't have

enough information and understanding to know how to actually be helpful.

They are also unaware that their good ideas may come across as

critical. If you express appreciation for their caring, they will

usually feel satisfied that they are making a difference and stop

pressing specific recommendations.





Some people, though, use pieces of advice as thinly veiled barbs. Out

of competitiveness or their own misery, they consciously or

unconsciously mean to take caregivers down a peg. They should be kept at

arm's length. It is seldom worth debating them or giving them the

satisfaction of having caused hurt.



 Caregiving Criticism and Unsolicited Advice From Family - AARP

Friday, July 31, 2015

advice for payingforseniorcare.com | Scam check for payingforseniorcare.com is payingforseniorcare.com safe?

advice for payingforseniorcare.com | Scam check for payingforseniorcare.com is payingforseniorcare.com safe?
Scamadviser.com is a FREE website allowing people to quickly check a website they are about to buy something
from. Allowing online shoppers to find out those facts they really should know before using their credit cards.

 High Trust Rating. This Site Looks Safe To use.

Wednesday, July 29, 2015

Power of attorney: It’s easily abused - Elizabeth O'Brien's Retire Well - MarketWatch

Power of attorney: It’s easily abused - Elizabeth O'Brien's Retire Well - MarketWatch: It’s a standard part of estate planning. It’s also, according to experts on elder fraud, a license to steal. It’s the power of attorney, a legal instrument designed to give a trusted individual the authority to handle financial or health matters for the person creating it.

As their own parents grow older—and, in many cases, lose the capacity to make their own financial and medical decisions—growing numbers of baby boomers are beginning to wrestle with the intricacies and pitfalls of the power of attorney. And of course, the day may not be too far off when they themselves may have to trust someone else with those powers. “They have great value and opportunity to misuse,” said Randy Thomas, a former police officer in Columbia, South Carolina who lectures nationally on elder financial abuse.


Estate plans usually involve what’s known as a “durable” power of attorney. These allow the trusted individual—legally, the “agent”—to retain power of attorney even when the person who created the document—the “principal”—has become incapacitated. A general power of attorney expires when the principal has lost capacity; these are usually limited to a certain transaction, such as a real estate closing or the license-plate example above. All powers of attorney expire when the principal dies

Thursday, July 23, 2015

How To Get Up After a Fall – A Short Video from Learn Not to Fall

How To Get Up After a Fall – A Short Video from Learn Not to Fall: LEARN HOW TO GET UP

Review Your Risk Now
How to get up
How to call for help
In this short video, Dr. Dorothy Baker, RN PhD, explains the importance of knowing how to get up if you fall, and shows a senior demonstrating these techniques.A  printable copy (PDF) of illustrated instructions on how to get up is available
















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----


Alzheimer's Safety Proofing Households, Devices and Equipment

http://dandyfunk4.blogspot.com/



Follow : Dave's Knowledge Networks  http://tinyurl.com/ny62zh3

“The beautiful thing about learning is nobody can take it away from you.”   B.B. King

Sunday, July 19, 2015

6 Online Resources to Start Advance Care Planning Conversations | American Society on Aging

6 Online Resources to Start Advance Care Planning Conversations | American Society on Aging
By Judy Thomas, JD {Q}It’s never too soon to start talking about advance care planning. Talking with patients and their loved ones—or even your own family members—and helping them plan for future medical needs is the best way to make sure their wishes will be respected.{EQ}

Thursday, July 16, 2015

Strategies to Protect Your Money from Medicaid - AgingCare.com

AgingCare.com is not simply a website, but a community of caregivers facing the challenge of caring for an elderly loved one.
They provide a comfortable meeting place for the free exchange of ideas with knowledgeable professionals, responsive experts, and people just like you. They provide an excellent knowledge network, use it.

The following is extracted from AgingCare.com
{quote}
Too few older adults know and understand their rights and options regarding health care, particularly long-term care, which, to quote the New York Court of Appeals, is "ruinously expensive."

A Caregiver Agreement is an excellent strategy in many cases where extra services are needed or desired that would not be covered by Medicaid, and are outside the scope of what a nursing facility or home care attendants would provide.

The caregiver can be a son, a daughter or other family member, a friend, a geriatric care manager or a home care agency. The services can be paid for in advance, and the payment will then reduce countable resources, helping the person in need of care gain Medicaid eligibility. A family member can render these services, providing income for that person (who may have given up a job or taken time off from work), and reducing conflict with other family members who are unable or unwilling to help out.

If the caregiver is to be paid in advance, the keys to creating an agreement that will be accepted by Medicaid are:

    The contract must specifically define the services provided and hours to be worked by the caregiver.
    The lump sum payment must be calculated using a reasonable life expectancy and legitimate market rates for the services.
    A daily log of actual services rendered and hours worked must be maintained, along with written invoices.
    Upon the death of the patient, any unearned amounts must be paid to Medicaid, up to the amount that Medicaid paid on behalf of the patient.

Spousal Transfers and Spousal Refusal

An important feature of the Medicaid laws is that transfers between spouses are permitted, are not subject to the "look back," and thus do not result in any penalty. In the case of a married couple, one of the basic strategies is to transfer any assets that are in the name of the spouse who needs care to the name of the well spouse (also called the "community spouse" where the spouse who needs care is in a nursing home).

New York and some other states permit something called "spousal refusal." In these scenarios, the well (or community) spouse will refuse to provide support for the spouse who needs care.As a result, the spouse who needs care will be immediately eligible for Medicaid, and will receive services.

Once Medicaid provides services, it has the right to seek contribution from the well spouse. In some cases, however, Medicaid does not pursue its rights, and in other cases it is willing to settle at a discount. At a minimum, the well spouse will receive a significant benefit because any reimbursement to Medicaid will be at Medicaid's discounted rates, rather than at the private pay rates that the providers would have charged.

Unfortunately, the majority of states are "spousal share" states that do not permit spousal refusal. In these states, the resources of both spouses are counted towards the Medicaid eligibility amount, and the above strategy is therefore ineffective.

Elder Law attorneys are able to work within the Medicaid laws to produce favorable outcomes for their clients. Bear in mind that every case has its unique facts, and these strategies might or might not be the top five for you, given your circumstances. In any case, it's hardly ever too late to develop an effective strategy to obtain benefits, and protect at least some of your assets or income at the same time.

David Cutner is a former family caregiver and co-founder of Lamson & Cutner, a boutique elder law firm in Manhattan, known for its successful strategic planning and insights into the issues of today's elder law maze.

{End of Quoting}


I have no connection with  David Cutner the following contact information is my thanks to him.




















Lamson & Cutner, P.C.
9 East 40th Street
New York, New York 10016


























Contact Information:
Phone: (888) 618-3701

Fax: (212) 486-1600 Web Site: www.elder-law-lawyer.com
BLOG The Best Elder Law Blog



Tuesday, July 14, 2015

Impaired Hearing Resouurces

Questions to Ask About Durable Medical Equipment and Medical Supplies - AgingCare.com

Questions to Ask About Durable Medical Equipment and Medical Supplies - AgingCare.com

An article full of very helpful advice and information. A long article and you need to read from end to end to get full benefit
Questions to Ask About Medical Equipment and Supplies

Sample for discussiondisucssion:
Are the senior's needs and comfort periodically assessed?

Handling a dispute with the insurer or vendor:

Has the caregiver made frequent and careful inquiries?

Has all communication (in person, phone, mail, email) been well documented?

If the insurer disputes the need for particular equipment or

supplies or rejects a claim for a more costly but medically justified

item, will an appeal be necessary?

Does the caregiver know how to file an appeal?

Developed by, and made available with the permission of John J. Connolly, Ed.D., President and CEO of Castle Connolly Medical Ltd.,  America's "trusted" source for information on top doctors and quality healthcare.

Saturday, July 11, 2015

Alzheimer's and Dementia Care Must read books

 Kisses for Elizabeth: A Common Sense Approach To Alzheimer's and Dementia Care (Volume 1) by Stephanie -Large Print Paperback
also available as  Kindle Purchase

 Creating Moments of Joy: A Journal for Caregivers, Fourth Edition (NEW COVER) by Jolene Brackey (Sep 1, 2008) Paperback
also available as Kindle Edition

The 36-Hour Day, fourth edition: The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease, Other Dementias, and Memory Loss in Later Life, 4th Edition

Sunday, July 5, 2015

When Medicare Will Pay for Skilled Nursing or Physical Therapy - Howard Gleckman

When Medicare Will Pay for Skilled Nursing or Physical Therapy - Howard Gleckman:

 http://howardgleckman.com/author/hgleckman/

Two weeks ago, the government updated the Medicare manual—the
official guidelines for providers. And it has begun an extensive
educational campaign to help them understand the rules. Yet, it is
important that consumers know about this new interpretation as well.

What does this mean? Imagine you have a severe stroke. Before Jimmo,
most people thought Medicare would pay for physical therapy only as
long as that PT was helping you get better. For instance, Medicare would
pay if therapy helped increase the number of steps you could walk
without assistance. Now, Medicare will pay for PT even if it only helps
you maintain your current ability to walk

other restrictions still apply. For instance, Medicare will only pay for skilled nursing care after a patient has been hospitalized for at least three days. And, at least for now, a patient who is in a hospital for observation but has not been formally admitted does not qualify. Medicare will pay for no more than 100 days of skilled care after a hospitalization. And Medicare will not pay for skilled care if needed services can be provided by the patient herself, her family, or by home health aides.





Friday, July 3, 2015

Legal Issues – Revoking prior Powers of Attorney

From Jim Koewler's The Koewler Law Firm website

The agent named in a now-revoked POA may not be happy about being
replaced.  That deposed agent may use the authority in the old POA to
take actions with the principal’s assets.  The bank or investment office
or real estate agent (or anyone else, for that matter) has no way to
know that the POA has been revoked.  (Not many former agents would act
out in this manner, but those few that would certainly can hurt their
principals.)

To avoid an old POA being accepted as current, there are practical steps (in addition to the legal steps) to revoke an old POA.

The principal should try to retrieve all of the copies of the prior
POAs.  Retrieving all of them can be a daunting task if there are a
number of copies.  (Most POAs have a statement that a copy is to be
honored just like an original, so retrieval of copies is important.)

For advice, representation and peace of mind through these difficult issues, contact Jim Koewler of The Koewler Law Firm.

Legal Issues when someone has Dementia – Revoke prior Powers of Attorney |

Thursday, July 2, 2015

Options To Pay Off A Reverse Mortgage After Parent Dies | Bankrate.com

If the borrower was married, the surviving spouse might be able to remain in the home even if he or she wasn't a co-borrower, according to Sarah Mancini, an attorney at the National Consumer Law Center, a nonprofit advocacy organization in Washington, D.C.
That's important,
Mancini explains, because some borrowers remove a younger spouse from their home's title to secure a larger reverse mortgage, leaving that younger spouse vulnerable to eviction and foreclosure after the older spouse's death.

The rules that affect surviving non-borrower spouses are complicated, and surviving spouses and heirs may need to consult an attorney to interpret their rights and options if the spouse wants to continue occupying the property.

Mancini says,"There are serious legal issues, and possible grounds for a legal challenge if the lender forecloses while there is still a surviving spouse."

Read more: http://www.bankrate.com/finance/mortgages/pay-reverse-mortgage-after-parent-dies.aspx#ixzz3ekV3iYqn

Follow us: @Bankrate on Twitter | Bankrate on Facebook

Tuesday, June 30, 2015

HOME STAIR LIFTS, PORTABLE AND CUSTOM MODULAR WHEELCHAIR RAMPS

HOME STAIR LIFTS, PORTABLE AND CUSTOM MODULAR WHEELCHAIR RAMPS: Living Free Home, a division of Homecare America, is a leading provider of high quality accessibility solutions and products manufactured in the USA. We proudly serve customers throughout the tri-state area with our core commitment to 5 star service.

We specialize in a wide variety of accessibility solutions, from stairlifts, portable wheelchair ramps, modular wheelchair ramps, vertical and vehicle lifts, to Elegance, Heritage, Classic and Specialty lift chairs, wheelchair lifts and handicapped lifts.

Alzheimer's and Dementia: Global Resources

Alzheimer's and Dementia: Global Resources: Worldwide, at least 44 million people are living with dementia. To serve this global population, as well as their families and caregivers, the Alzheimer's Association has translated its most popular and unique online resources and tools.










Jean Dickinson
Vice President of Marketing & Communications at Alzheimer's Association, California Southland Chapter





























It's time to celebrate. Our group is now
20,000 members strong. This includes many members from around the world.
It's also indicative of the growing interest in Alzheimer's disease and
related dementias and the increasing number of people affected each
day.



The Alzheimer's Association has "gone global," too. Please take a moment to visit our new Web portal at http://www.alz.org/global/ It has information in many languages along with in-country resources. We encourage you to link to us!




Alzheimer's & Dementia: Global Resources

    Country-specific Alzheimer's statistics, research plans and local support services.

    Educational content covering risk factors, symptoms, diagnosis and treatment.

    An overview of the Alzheimer's Association role in funding critical dementia research.

    An interactive brain tour.

    A call to action for the global community to join the cause.



Content can be accessed by country or language.

Thursday, June 25, 2015

5 Steps for Dealing with Anticipatory Grief - Visiting Nurse Service of New York

5 Steps for Dealing with Anticipatory Grief - Visiting Nurse Service of New York: It might be the hardest part of caregiving: Watching your loved one slip away step by terrible step, knowing you can’t stop the decline and grieving the loss of the person you once knew, long before they’re actually gone. Psychologists call this process anticipatory grief, and it’s very common among caregivers and family members of those suffering from Alzheimer’s disease, cancer and other terminal illnesses.

“As a disease progresses, there is so much frustration and sadness associated with watching the person you once knew go away,” says Vince Corso, M.Div, LCSW, CT, Manager of Hospice Psychosocial Services, VNSNY. “It can be overwhelming.”