Caregiver Meltdown

by Amy Goyer

There I was in the middle of Sky Harbor Airport in Phoenix, when I was told I was 8 minutes too late to check my bag for the flight. I was trying to get to Indianapolis for a memorial service for my uncle. Missing a flight would upset any traveler, but my reaction surprised even me.
Total and complete meltdown.
You know the kind — sobbing uncontrollably to the point where the airline attendant had no idea what to do.
I sat down on one of those hard plastic chairs, but people began to stare, so I went into the bathroom, locked myself in a stall and sobbed with great abandon.
As I cried (and it was an all out snort-cry as my friend, Mary, calls it) and talked to my sister on the phone, I knew people could hear me far and wide. I didn't care. I was way past the point of embarrassment.
How did I get to this point? Can you say "stress?" Oh yes. Let me tell you about the prior week…..
As you know, I am caregiving for my parents.  Shortly before my airport meltdown, I'd been on a business trip that kept me away for two nights. During that time, my Mom fell and my Dad developed an abscessed tooth. On top of all that, Mom developed a bad intestinal flu AND shingles!
I had stayed with them almost 24/7 all week, and we had two more emergency squad visits because my mom fell two more times,  both with transport to the hospital, one at midnight and the other at 3 am. Both trips resulted in all-night ER stays and no sleep. Thankfully, no broken bones or hematoma for Mom!
One of her falls happened literally 1 minute after I left her alone in the bathroom after having gone over and over the use of her walker, always holding on to something etc. But she had gone to get something out of her closet and didn't use the walker…and fell as she turned.

Mom – always a good sport even in the ER
I felt terrible! I think I was so tired that I didn't make the best choice at that moment…a typical caregiver's lament.
She said she'd done it so many times before and it was automatic — she just didn't think about her walker. And she was so tired and depleted it's no wonder she wasn't thinking well either.
Well the good news is, I finally stopped crying at the airport, got a flight the next day…and got some sleep.
Mom is getting better, and I arranged for help from my niece and sister and my wonderful concierge, Debbie. So I went off on another business trip…so far no more falls or ER visits! Mom is gaining strength and Dad is minus 3 teeth now. He's still got a great grin.
And I am a whole lot lighter after my big meltdown!
My experience brings home the point that as caregivers we need to take care of ourselves…if we don't, we will drive ourselves to the breaking point…and perhaps cause a bit of a stir in an airport!
Next time we go through a crisis week like that (and I'm sure there will be more of them), I will do things a bit differently…especially prioritizing getting more sleep – and more help!

http://blog.aarp.org/2011/07/20/caregiver-meltdown/

"Learn About Senior In Home Health Care in Ann Arbor Michigan Senior Helpers Provides Many services in the Ann Arbor, Michigan area. We provide a full array of Home Care services for seniors and the elderly living in the area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check. If you need Home Care services in Ann Arbor, Ypsilanti, Saline, Brighton, Howell, Jackson and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Ann Arbor Home Health Care Company. "

National Research Council Wants Better Training for Home Caregivers

National Research Council Wants Better Training for Home Caregivers
By Kathleen Doheny

Home health care is a growing trend, allowing many people in need of medical services to avoid hospitalization and nursing homes. But improvements are needed to be sure that care at home is safe and effective, according to a new report from the National Research Council.

"There is a great opportunity to provide quality health care in the home for any of a variety of people in our population, from the very young to the very old," says David H. Wegman, MD, emeritus professor of work environment at the University of Massachusetts, Lowell. He chaired the National Research Council committee which issued the report.
"But to do this safely and effectively, we need better management and information about technologies as they are used in the home, and better training for both formal health care providers and the large informal pool for how to use these technologies in the home safely and effectively," Wegman tells WebMD.
Wegman says he is talking about medical devices from as seemingly simple as a home blood pressure monitor to more complicated oxygen delivery systems and other devices.
The report, "Health Care Comes Home: The Human Factors," was released today.
One in four U.S. adults, or more than 61 million Americans, cared for an adult family member, partner, or friend with a medical condition or disability in 2009, according to another report, also issued today, by AARP. It put the value of all this care at $450 billion in 2009. That is up 21% from the total in 2007. The AARP report is titled "Valuing the Invaluable: The Growing Contributions and Costs of Family Care giving, 2011 Update."

Recommendations for Home Health Care

The National Research Council report was requested by the Agency for Healthcare Research and Quality. The National Research Council is the principal operating agency of the National Academy of Sciences and National Academy of Engineering.
The National Research Council committee sought out experts. It also conducted a workshop on human factors in home health care before issuing the report.
Among the recommendations:

• The FDA should promote the development of new standards for labels on medical devices for home use. They should set new standards for the instructions that accompany the devices. The instructions should be easily understood.
• The FDA and the Office of the National Coordinator for Health Information Technology should work together to regulate, certify, and monitor devices and health information technologies. For instance, they should work together on a device such as a blood pressure monitor and the technology that relays the results to doctors and patients.
• The FDA should improve its existing reporting system for medical device problems. The system is known as MAUDE (manufacturer and user facility device experience). Wegman cites problems, including being poorly used.
• Training of home caregivers, both formal and informal, should be improved. Advocacy groups and professional practice organizations should take on this task, the committee says.
• Research is needed in many areas, including how to better coordinate caregivers and support services.
• Federal agencies such as the Department of Health and Human Services should help people who need home health care to modify their homes for caregiving when needed.

Wegman says the hope is that the FDA and others involved will read the recommendations and begin to implement them.
The recommendations are applauded by AARP, says Susan Reinhard, PhD, RN, AARP's senior vice president of public policy. She wrote the AARP report.
"We call it the new normal, this caregiving," she tells WebMD. And it is not simple.
In its report, AARP finds that home caregivers are asked to do more complicated services. This includes bandaging and wound care, tube feedings, managing catheters, and giving injections and operating medical devices.
"Some of the things that family caregivers do would make a first-year nursing student shudder," Reinhard says in a news release.
In an interview with WebMD, she says that the National Research Council report "supports our overall goal of helping people to live at home independently if that is their choice."

"Learn About Senior In Home Health Care in Ann Arbor Michigan Senior Helpers Provides Many services in the Ann Arbor, Michigan area. We provide a full array of Home Care services for seniors and the elderly living in the area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check. If you need Home Care services in Ann Arbor, Ypsilanti, Saline, Brighton, Howell, Jackson and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Ann Arbor Home Health Care Company. "

Senior Boom Creates A Demand For Home Health Workers

Senior Boom Creates A Demand For Home Health Workers By Jessica Marcy

WASHINGTON, D.C. - At her home health care agency here, Venus Ray quizzes 65 job applicants assembled before her: Can they cook? Do they know the right way to wash their hands? Can they safely transfer patients into wheelchairs? If they give wrong answers, speak English poorly or — God forbid — forget to turn off their cell phones, she asks them to leave.
By the end of the session, Ray has dismissed 42 of the applicants, almost two-thirds, even though she's in dire need of employees.
Ray is executive director of Health Management Inc., which employs about 410 people, including 395 home health aides. With business booming, she is constantly looking to hire more, and she holds group interviews once or twice a month.
"There's a huge demand, and it's only going to get larger as the years go by," Ray said. With the nation's aging population, she added, many people "will tell you that they are more comfortable in their home."
The demand for workers by Ray's company mirrors national trends and is fueled in part by stepped-up efforts to keep seniors and the disabled out of nursing homes. The growth is likely to pick up in coming years as the 2010 federal health law tries to reduce hospital readmissions and expands programs such as Money Follows the Person, which encourages Medicaid recipients to receive care at home.
But experts warn that a shortage of qualified labor is looming. Workers often lack the training and support needed to properly care for patients, and poor working conditions lead to high turnover, experts say. In addition, salaries are low: In 2009, the median national hourly wage for direct-care workers — a term that includes home health aides — was $10.58, substantially below the $15.95 median for all U.S. workers. Nearly half lived in households that received food stamps, Medicaid or other government aid, according to PHI, an advocacy group for direct-care workers.
In addition, experts say, regulations about training and background checks for direct-care workers vary across states, and often leave consumers without adequate protection.
"I see tremendous challenges on the care side and the consumer side," said Peggy Powell, national director of curriculum and workforce development at PHI, which is based in New York. "My fear, my deep concern, is that in this quick switch [to provide care at home], there is the potential for care to get worse and for the direct-care workers' job to get harder, with less support and training."
A Growing Force
There are several types of direct-care workers, and their titles often vary:

• Certified nursing assistants provide basic clinical care such as taking blood pressure and caring for wounds. They also help with the activities of daily living such as eating, dressing and bathing. They usually work in nursing homes or assisted living facilities and have at least the 75 hours of training required by the federal government for positions at a Medicare- or Medicaid-certified facility.
• Home health aides provide similar care but in private homes and under the supervision of a nurse or therapist. If they're employees of a home care agency, these aides also may need at least 75 hours of training because the federal requirement extends to agencies that serve Medicare and Medicaid patients.
• Personal care aides work in the home and help with everyday activities such as bathing and also perform light housekeeping and cooking chores. There are no federal requirements for their training, which is generally minimal. About a quarter of these workers are not employed by agencies, according to PHI.

In some states, certified nursing assistants and home health aides can administer medication, although some states require that they get extra training to do that. Personal care aides cannot.
More than 3.2 million people work in direct care, according to 2008 data from the Bureau of Labor Statistics. That is 52 percent more than in 1998. Jobs in direct care are projected to account for four of every 10 new health-care jobs between 2008 and 2018, according to PHI.
'What's Your Passion?'
Venus Ray begins her group interview by asking: "Why do you want to be a home health care worker? What's your passion?"
Many describe caring for a loved one, while others say they have been drawn to the field by their deep religious faith. Latreaviette Stewart, 21, says she decided to become an aide after caring for her grandmother, great-aunts and her mother's best friend, who recently died of breast cancer. She just completed a home health aide program at the Community College of the District of Columbia.
Pamela Nfor, a 34-year-old aide from Cameroon who has a child with disabilities, says she enjoys seeing how clients, even those who are depressed and can't go out, improve under her care. "I love the job and I hate the money," she tells other applicants, who erupt in laughter.
Emotions run deep during the morning's activities. One West African woman passionately describes how God revealed her vocation to be in home health care after she prayed intensely, while another woman nearly breaks into tears when she's asked to leave after her cell phone goes off. Both women fail to pass the interview process.
Later, Ray said that she once had to dismiss an entire group of 12 applicants after all of their cell phones rang.
The applicants provide a visual snapshot of national trends. Direct-care workers are disproportionately minorities, and 23 percent are foreign-born. Almost 90 percent are female. The average age is 42, but the number of workers older than 55 is increasing rapidly, according to PHI.
To ensure a qualified workforce, experts say, it's important to increase wages, improve training and beef up licensing requirements.
"It's really important to figure out how to build career ladders for these workers so that they can advance and see this as a real career," said Bob Konrad, a researcher at the University of North Carolina at Chapel Hill. "We have to turn these folks into really active and engaged people in the health policy world."

"Learn About Senior In Home Health Care in Ann Arbor Michigan Senior Helpers Provides Many services in the Ann Arbor, Michigan area. We provide a full array of Home Care services for seniors and the elderly living in the area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check. If you need Home Care services in Ann Arbor, Ypsilanti, Saline, Brighton, Howell, Jackson and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Ann Arbor Home Health Care Company. "

How Do I Select the Right Home Care Provider?

How Do I Select the Right Home Care Provider?

Once you acquire the names of several providers, you will want to learn more about their services and reputations. Following is a checklist of questions to ask providers and other individuals who may know about the provider's track record. Their insight will help you determine which provider is best for you or your loved one.

• How long has this provider been serving the community?
• Does this provider supply literature explaining its services, eligibility requirements, fees, and funding sources? Many providers furnish patients with a detailed "Patient Bill of Rights" that outlines the rights and responsibilities of the providers, patients, and caregivers alike. An annual report and other educational materials also can provide helpful information about the provider.
• How does this provider select and train its employees? Does it protect its workers with written personnel policies, benefits packages, and malpractice insurance?
• Are nurses or therapists required to evaluate the patient's home care needs? If so, what does this entail? Do they consult the patient's physicians and family members?
• Does this provider include the patient and his or her family members in developing the plan of care? Are they involved in making care plan changes?
• Is the patient's course of treatment documented, detailing the specific tasks to be carried out by each professional caregiver? Does the patient and his or her family receive a copy of this plan, and do the caregivers update it as changes occur? Does this provider take time to educate family members on the care being administered to the patient?
• Does this provider assign supervisors to oversee the quality of care patients are receiving in their homes? If so, how often do these individuals make visits? Who can the patient and his or her family members call with questions or complaints? How does the agency follow up on and resolve problems?
• What are the financial procedures of this provider? Does the provider furnish written statements explaining all of the costs and payment plan options associated with home care?
• What procedures does this provider have in place to handle emergencies? Are its caregivers available 24 hours a day, seven days a week?
• How does this provider ensure patient confidentiality?

In addition, ask the home care provider to supply you with a list of references, such as doctors, discharge planners, patients or their family members, and community leaders who are familiar with the provider's quality of service.
Contact each reference and ask:

• Do you frequently refer clients to this provider?
• Do you have a contractual relationship with this provider? If so, do you require the provider to meet special standards for quality care?
• What sort of feedback have you gotten from patients receiving care from this provider, either on an informal basis or through a formal satisfaction survey?
• Do you know of any clients this provider has treated whose cases are similar to mine or my loved one's? If so, can you put me in touch with these individuals?

"Learn About Senior In Home Health Care in Ann Arbor Michigan

Senior Helpers Provides Many services in the Ann Arbor, Michigan area. We provide a full array of Home Care services for seniors and the elderly living in the area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.

If you need Home Care services in Ann Arbor, Ypsilanti, Saline, Brighton, Howell, Jackson and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Ann Arbor Home Health Care Company.  "

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Long-Term Care - The Tool Kit

Long-Term Care -  The Tool Kit
By Gary Barg
Gramp was an extraordinarily brave and hard-working man.  In 1925, he jumped ship in  Baltimore Harbor off a Russian freighter to which he was consigned at the age of 17.  Later, he made his way to New Jersey where he started a contracting company and raised a family.  At the age of 35, when World War II broke out, he enlisted in the U.S. Navy.
By the early 1950's, he and his brothers owned four hotels on Miami Beach, but in the summer of 2000, he died penniless in a South Florida nursing home.  In only a few short years, our family had spent all of his significant savings, taking care of him and maintaining his long-term care needs.
Gramp was a craftsman and he firmly believed in using the right tool for the right job.  His old wooden tool kit was a world of wonder for his grandchildren. He never tired of explaining to us how each of the various tools worked and how each was best utilized.
If only Gramp had known before his illness that there was another kind of tool kit which needed to be assembled, a tool kit as important to his success as the old wooden one—a financial tool kit.
Gramp was like most of us.  He knew he needed to prepare for future needs and plan for adversity.  He had much of his financial tool kit filled with stocks and bonds, investment properties and an up-to-date will.  However, he realized too late that there was a staggering price to himself and his family for neglecting to prepare an appropriate long-term care program.
I have spent much of the last nine years, since founding Today's Caregiver magazine and caregiver.com, working to ensure that other caregiving families are not faced with financial ruin due to the increasing cost of caring for their loved ones, and that each caregiver's financial tool kit includes considering the option of long-term care coverage.
Caregivers understand what steps are needed to safeguard their loved one's physical and emotional health.  We must now become adept at learning the steps needed to ensure our family's fiscal health.  The lesson taught by the preceding generation and the one we must pass on to generations to come is that the tool kits you carefully assemble during your lifetime must include all instruments of preparedness to meet any situation.
Proper long-term care planning allows your loved ones financial flexibility and emotional security.
It truly is the gift of a lifetime.

http://www.caregiver.com/channels/ltc/articles/LTC_toolkit.htm

"Learn About Senior In Home Health Care in Ann Arbor Michigan Senior Helpers Provides Many services in the Ann Arbor, Michigan area. We provide a full array of Home Care services for seniors and the elderly living in the area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check. If you need Home Care services in Ann Arbor, Ypsilanti, Saline, Brighton, Howell, Jackson and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Ann Arbor Home Health Care Company. "

Older drivers make mistakes, even when healthy

Older drivers make mistakes, even when healthy

Decline in brain functioning ability could affect driving skills for healthy, older population, study finds
By Amanda Chan
Aging is associated with an increase in crucial driving mistakes, even among healthy people with safe driving records, according to a new study.

The oldest people in the study, who were between ages 85 and 89, made four times as many critical errors in a driving test than the youngest people in the study, who were between ages 70 and 74, the study said.

Overall, 17 percent of the elderly drivers in the study made mistakes such as veering or failing to use check blind spots that caused the professional driving instructor accompanying them to hit the emergency brake or grab onto the steering wheel.

Aging causes declines in brain functioning ability, which could affect driving skills and the ability to ignore distractions while on the road, said researchers from Australian National University.
The study was published online this week in the journal Neuropsychology.
Testing driving skills
Researchers had 266 volunteers between the ages of 70 and 88 take some tests measuring how well their brain functions. None of the volunteers had any signs of dementia, they all lived independently and they all drove at least once a week

Then, the volunteers were taken out for a 12-mile drive. A professional driving instructor rode in the car with them and had access to a brake on the passenger's side of the vehicle, while an occupational therapist rode in the backseat to note critical errors, including speeding, veering, tailgating, sudden braking without cause and failing to check blind spots.
Among those who made the driving mistakes, the adults ages 70 to 74 made, on average, less than one critical error. But adults ages 85 to 89 made, on average, nearly four critical errors, according to the study. And the volunteers who had had an accident in the last five years were also the most likely to make a critical driving error.
Men and women made the same number of mistakes in the study. The most common mistake was failing to check blind spots, followed by veering across lanes of traffic and failing to use turn signals, the study said.
The finding shows that older drivers may need extra training or screening tests to ensure they can be safe on the road, said study researcher Kaarin J. Anstey, a psychologist who directs the Aging Research Unit at Australian National University.
Tips for elderly drivers
Elderly drivers ages 75 and older made up 7.5 percent of fatal car crashes and 3.1 percent of all car accidents in the United States in 2008. There were 30 fatal accidents for every 100,000 licensed drivers for people ages 75 and older, while there were only 20 fatal accidents for every 100,000 licensed drivers for people between ages 65 and 74, and 19 fatal accidents for every 100,000 licensed drivers for people between 55 and 64, according to the U.S. Census Bureau.
As the Baby Boom generation grows older, the more elderly drivers there will be on the roads. In 2009, there were 33 million people age 65 and older with a driver's license, according to the Centers for Disease Control and Prevention (CDC).
The CDC has some tips for older drivers to make sure everyone has a safe driving experience :

• Review medications with your doctor or pharmacist to make sure there are no side effects that can impair your driving ability.
• Get your eyes checked at least once a year, and always wear glasses or contact lenses while driving, if needed.
• Plan your driving route before you start driving.
• Don't tailgate; leave a large distance between you and the car in front of you.
• Avoid distractions such as cellphones, loud radios and eating.
• Consider public transportation if you don't feel safe driving.

Pass it on: Aging's effect on brain functioning could impact the ability of elderly people to drive.

http://www.msnbc.msn.com/id/43065601/ns/health-aging/

"Learn About Senior In Home Health Care in Ann Arbor Michigan Senior Helpers Provides Many services in the Ann Arbor, Michigan area. We provide a full array of Home Care services for seniors and the elderly living in the area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check. If you need Home Care services in Ann Arbor, Ypsilanti, Saline, Brighton, Howell, Jackson and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Ann Arbor Home Health Care Company. "