Alzheimer’s Prevention Overshadows Detection

By AmeriCare, April 18, 2012

It’s natural to get excited when we learn about a new breakthrough in our understanding of Alzheimer’s, as with the FDA’s recent approval of a new medical procedure that allows for early detection of the disease.

But how helpful is it to learn that your future will be afflicted with this debilitating disease if there isn’t currently a cure? Given the heightened attention around Alzheimer’s detection, we thought it would be an appropriate time to focus on methods of prevention.

Following are 10 proven tips, as offered by renowned Alzheimer’s author, Jean Carper, that can help maintain cognitive integrity and keep Alzheimer’s at bay.

1. Take a hike: Nothing beats walking for boosting memory and flooding your brain with chemicals that create bigger neurons. Take a brisk 30-minute walk, or three 10-minute sessions on a treadmill. A “nature” walk through a park also improves memory.

2. Eat an apple or two: Apples stimulate production of the neurotransmitter acetylcholine, which is what the Alzheimer’s drug Aricept also does, say University of Massachusetts researchers. You get the same benefits from two eight-ounce glasses of apple juice.

3. Drink a few cups of coffee: “I try to drink five cups of coffee a day,” says Gary Arendash at the Florida Alzheimer’s Disease Research Center. He says the caffeine blocks build up of Alzheimer’s brain toxins. In one study, drinking three to five cups of coffee a day cut Alzheimer’s risk by 65 percent.

4. Treat yourself to a little dark chocolate: It can boost blood circulation in your brain, lower blood pressure and inhibit stroke damage, all important in preventing Alzheimer’s and other dementias. Be sure cocoa content is at least 70 percent. Even a half-ounce of rich dark chocolate a day may be enough.

5. Surf the internet for an hour: Yes, a good Google search can stimulate an older brain and possibly improve thinking and memory. So can playing video games, and doing certain online brain games.

6. Do something new: Your brain cells are stimulated when you think of or do anything new. People who do novel mental activities reduce their risk of cognitive decline. Important: you must make a mental effort; breezing through crossword puzzles doesn’t count.

7. Eat a cup of berries: If you want to make forgetful old lab animals “younger and smarter,” just feed them blueberries, strawberries, raspberries, blackberries or cranberries, say Tufts University researchers. How much? At least a cup a day.

8. Take a multivitamin: It can slow brain aging, especially if it includes high antioxidants, such as C, E and alpha lipoic acid. Be sure to get 500 mcg B12, 800 mcg folic acid, 20 mg B6 a day–doses found to reduce brain shrinkage up to 50 percent in people with mild memory problems.

9. Have a Curry Meal: A constituent of curry spices known as curcumin blocks Alzheimer’s-like brain damage and boosts memory in animal and lab tests. India, where curry is a staple, has a very low rate of Alzheimer’s.

10. Get together with friends and family: Make it a point to yak it up today, the larger your circle of friends and family, the better. Extroverts with high “social engagement” have less cognitive failure as they age. Being married or having a significant other dramatically cuts your odds of developing Alzheimer’s.

Alzheimer’s is a cruel disease we know all too well. If someone in your family is suffering with Alzheimer’s, or other forms of dementia, feel free to contact us to discuss our premier home care services. Our goal is to help your loved one live as independently as possible, from the comfort of their own home.

Tags: Alzheimer's, AmeriCare, home care, senior care

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The Importance Of Exercise For Seniors

By AmeriCare, April 11, 2012

The benefits of regular exercise are boundless. It is the closest thing we have to the fountain of youth. Exercise not only helps improve our physical health, it helps improve our mood, mind, and memory as well. It can also prevent future injuries from falling, and help us maintain our independence at older ages.

Being a senior citizen, you may have limitations, but that should not preclude you from pursuing an exercise program. Just be sure to scale the effort based on your abilities. Here are a few tips to get your started.

Consult your doctor

Always check with your doctor to make sure it is safe to start an exercise program. Any kind of pre-existing conditions may require alterations to your routine. A doctor’s visit can also provide a good benchmark for progress. Over time you may see significant improvements in key health measures, such as cholesterol and blood pressure levels.

Take It Slow

You don’t have to start working towards a marathon right away.  Begin by walking around 15 minutes a day to get the body accustomed to physical activity. Working in your backyard, washing clothes, or performing other housework can qualify as exercise as well. It’s all about staying active.

Get Pumped

Weight training improves muscle mass as well as strengthens your bones. People of all ages can lift weights if carried out with proper technique. Be sure to consult a physical therapist or someone experienced in weight training before loading up the barbell.

Cardiovascular Exercise

Cardio exercise helps improve performance of the heart and lungs. There are plenty of ways to get the heart pumping and the lungs working. Dancing, walking, swimming, and sports activities, like tennis, are just a few. There are even some great online workouts, such as through the Stronger Seniors YouTube video page.

Don’t Be Discouraged By Disabilities

Just because your disabled doesn’t mean you can’t exercise. There are plenty of chair aerobic exercises for chair-bound seniors. Swimming and water aerobics also allow people with disabilities to get excellent workouts. As always, be sure to exercise with a partner, especially when in a pool.

As a home care provider we know how important maintaining one’s independence can be for many seniors. Engaging in regular exercise is the best way to stay healthy and independent for as long as possible.

Tags: AmeriCare, home care, senior care

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Tips To Improve Memory Retention

By AmeriCare, April 4, 2012

As we age, our memory begins to fade. Once familiar words become elusive, we walk into rooms and forget what for, grandchildren’s names become interchangeable. We like to think these memory lapses occur because of all the wonderful knowledge we’ve accumulated over our many years. There’s only so much wisdom our minds can manage!

Regardless the cause, here are some simple activities that can help boost brainpower and keep our memory sharp.

Stay Active

Exercise benefits your brain as well as the rest of your body. Increasing blood flow to the brain reduces brain shrinkage and lowers the risk for Alzheimer’s disease. Take the stairs, park at the far end of the lot, and go for an evening stroll around your block. Every step adds up.

Take Naps

Memory storage happens while you sleep, which is why it’s so important to get the proper amount of sleep. Even a six-minute nap can aid short-term recall, while longer naps can accelerate the process that helps the brain retain long-term memories.

Play Brain Training Games

Brain games such as word puzzles or Sudoku help strengthen cognitive function, which aids memory development and retention.

Drink Coffee Or Tea

Tea has a positive effect on memory by activating enzymes in the brain while the caffeine triggers concentration. People who drink moderate amounts of coffee have lower odds of developing dementia later in life.

Eat Vegetables

Deficiencies in folate and vitamin B12 increase one’s risk of developing dementia. Great vegetable sources for folate include romaine lettuce, spinach, asparagus, turnip greens, mustard greens, parsley, collards, broccoli, cauliflower and beets.

Stay Organized

Your memory requires some familiarity to keep your life functioning smoothly. Place certain essentials, such as your keys and glasses, in the same place every time. Write yourself reminders, if needed. The act of writing yourself reminders will keep your mind active.

Volunteer

Retirement reduces many of our daily decision-making opportunities, exercises, and problem-solving requirements. Volunteering can supplant many of these mind-stimulating activities.

Keeping the mind engaged is an essential way to maintain cognitive acuity. So, remember to stimulate both the mind and body in order to stave off dementia and keep your precious memories intact.

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Convincing A Parent To Accept Home Care

By AmeriCare, April 3, 2012

From the day we are born, we are driven to pursue a sense of independence. It is one of our most inalienable rights, which is what makes it so hard to give up. Unfortunately, as we age, it becomes increasingly difficult, and, often, altogether impossible, for us to care safely for ourselves. At this point, the family of an aging loved one is faced with a difficult decision:

• Allow the parent to continue living alone and risk injury, or worse;
• Move the parent into a assisted living facility;
• Arrange for temporary, or full-time home care services.

Oh, but this can be such a dreadful conversation. We’ve seen it so many times before. And we understand why: it is a perceived affront to one’s sense of independence, something many seem willing to die before they willingly resign.

Most families will face the dilemma of trying to convince an unreceptive parent of the need for care assistance at some point. In fact, we will likely find ourselves on the receiving end of this unpleasant conversation later on in life. So, we’d like to provide some tips that can ease the conversation and help the parent accept the type of care that will allow him or her to live as independently as possible, preferably in the comfort of their own home.

Start The Dialogue Early

There are certain essential conversations that we all look to postpone. Planning a will is one of them. But the earlier we begin having these conversations, when the need still seems ages away, the better. It removes the gravity from the situation. So, find time to casually ask your parents how they’d like to be treated in their elder years, should they require assistance to augment their independence. This way, you will already have a general plan in place when the time arrives.

Respect Their Dignity

It is not uncommon for a child-parent role reversal to occur at some point in a relationship. When this happens, the child often feels a heightened sense of responsibility for the parent. One may even begin treating one’s parent as they would a child of their own. Try and take a moment and put yourself in your parent’s position. Remember that resistance comes from a perceived assault to a senior’s sense of dignity and role as an independent parent. Be sensitive towards this response and treat your parent with the respect of a dignified adult, not as you would an obstinate adolescent.

Focus On Help With Remedial Tasks

Many seniors see care assistance as an invasion of privacy and the surrender of independence. They don’t stop and think about how liberating it can be to have help with basic, remedial household chores. Many people use a housekeeper, which doesn’t entail the same perceived stigma that may come with a personal caregiver. Present the scenario as assistance with basic chores, laundry, and meals rather than personal care. Then, the unfolding relationship between the parent and their caregiver will naturally allow for a greater degree of home care services, should the need arise.

Enlist The Help Of A Professional

Often times an elderly parent will be more receptive to the counsel of a professional, such as a trusted physician or clergyman, than that of a family member. Just be mindful not to make this meeting seem like an intervention, which may elicit a strong defensive response. If possible, work to have the meeting occur as a part of a planned appointment or during the parent’s natural routine.

Look For Signs Of Dementia

Trying to convince a parent suffering from dementia to accept home care is a more complicated scenario because their judgment may be impaired. If your parent displays behavior symptomatic of dementia, such as retelling the same story, forgetting appointments, becoming lost in previously familiar surroundings, or losing the ability to perform routine tasks, arrange a medical evaluation to determine if the condition exists.  Find out from the physician the extent of cognitive impairment and the level of assistance your parent may need. Educate yourself on the issue by contacting the Alzheimer’s Association or the NIH’s Alzheimer’s Disease Education and Referral Center.

Above all else, remember, you are ultimately doing what you know is best for your parents because you love them. Conduct these conversations through a place of love and work to find the perfect home care solution for your family’s unique needs. We’re happy to help if you need us.

Tags: Americare home care, Caregiving, senior care

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Loneliness Is Harmful To Your Health

By AmeriCare, March 30, 2012

One of the largest health risks associated with aging may surprise you. It is loneliness.

In fact, a recent study conducted at BYU in Utah revealed that social isolation can be as harmful to one’s health as smoking and alcoholism. It is unhealthier than abstaining from exercise and exceeds the health risks brought on by obesity. According to their study, having the support of family, friends and neighbors can increase one’s chances of living to a healthy old age by as much as 50 percent.

Dr. Julianne Holt-Lunstad, who led the study, said friends and family influenced health for the better by offering a “calming touch,” or by helping people find meaning in their lives.

“When someone is connected to a group and feels responsibility for other people, that sense of purpose and meaning translates to taking better care of themselves and taking fewer risks,” she said.

At AmeriCare, we are well aware of the inherent healing power of companionship. It is the cornerstone of our home care services. This is why it is so essential that we match each client with the most compatible caregiver for his or her unique care situation and personality type. We know that by making each client feel comfortable in their own home, we are alleviating stress that can exacerbate the symptoms of other health issues.

We are social beings. Often times kindness, compassion, and companionship are truly the best medicines regardless the ailment. So, always remember to make time to call, or visit, a loved one who may be feeling isolated. You never know, it just may save his or her life.

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Health Tips For Seniors This Allergy Season

By AmeriCare, March 22, 2012

Spring is in the air! And so are all of the airborne allergens that come with it. For allergy sufferers, spring can be a constant struggle with symptoms ranging from sniffling and sneezing to itchy eyes and overall malaise. To make matters worse, current medications used to treat allergy symptoms usually contain antihistamines, which can cause drowsiness and dizziness – side effects that can be especially dangerous for seniors.

Following are a few tips offered by the American Academy of Allergy, Asthma and Immunology on how to minimize symptoms this season:

1. Avoid allergens and molds as much as possible. Instead of walking outside in the park or on hiking trails, try walking in the local shopping mall. Most malls have walking clubs with mall businesses offering discounts. Plus you can enjoy the comfort of the air conditioning.
2. When you have to go outside try to avoid grassy areas (especially those areas with fresh mown grass) or areas with lots of foliage.
3. Keep windows closed at night to prevent pollens or molds from drifting into your home.
4. Use an air conditioner and dehumidifier to keep air clean, cool and dry.
5. Keep car windows closed while traveling.
6. Be aware of local pollen counts and avoid outdoor activity on days when it is high.
7. If you live in an area that has high smog levels, be aware of those levels and take appropriate measures such as staying indoors or limiting activity.
8. Plan your vacation at the beach rather than the mountains, pollen counts are much lower at the beach near the ocean.
9. If you must mow or rake – activities that stir up a lot of pollen and mold – wear a paper respiratory mask to lower your exposure.
10. Even though “line-dried” clothing and linens have a wonderful “fresh” scent, use the dryer, as pollens and mold can collect on items drying on the clothesline.
11. Take medications as prescribed in the recommended dosage. Even if your symptoms are severe, stick with the recommended amounts of medication.
12. Shower after being outdoors to remove any pollen and mold that may be left clinging to your skin and hair.

We hope these tips will help keep you symptom-free this allergy season and able enjoy the beautiful bloom of spring.

Tags: AmeriCare, home care, seniors

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Honoring MS Awareness Month

By AmeriCare, March 15, 2012

March is national Multiple Sclerosis (MS) awareness month, a time to call attention to this cruel and devastating disease. Many of our clients suffer from MS, relying on our caregivers to help them live happily and independently at home. We’ve seen the debilitating effects of this disease first hand, and are committed to helping spread awareness in the hopes that one day science will discover a cure.

Here are some suggestions from the National Multiple Sclerosis Society on how you can support the cause in your community:

• Change your Facebook and/or Twitter profile picture to their awareness badge found here.
• Make a pledge to tell 10 friends, and have those friends do the same.
• Join the online community.
• Register and participate in an MS Society event.
• Get the local media involved in the action.
• Ask local physicians and health care professionals to speak about the issue.

Please take a moment to spread awareness to those around you. Together, we can put an end to this debilitating disease.

Tags: AmeriCare, home care, Multiple Sclerosis

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Home Care “State of the Industry” Address

By , February 2, 2011

As the population ages, with more and more people joining the sandwich generation, we find ourselves entering a new era. A difficult one, perhaps, for some. An age where responsibility reigns, and we find ourselves caught in a tug-of-war for time and attention. A precarious balancing beam of selflessness without losing one’s sense of self. Tricky times, these.

AmeriCare was created to help alleviate these stressful situations, so that clients can receive the care they need from the comfort of their own homes, and family members can revert back to their more natural role of Mother, Father, Son, or Daughter; not Nurse.

This industry is constantly evolving, and we, at AmeriCare, felt like it was time to take a page from Washington and offer our own “State Of The Union” address. To talk about where we are and where we see the industry heading. Surely we cannot cover every pertinent issue in a single article, so our intention is to start a dialogue that will help guide the direction that Home Care takes moving forward, making it more relevant and useful to those who rely on our services. We hope you’ll become part of the conversation.

2010: A Year in Review

Following are just a few of the key observations and insights taken from the previous year:

1. Home Care is on the Rise. Home Care is one of the fastest growing industries in the country despite the worst economy in recent history. That is not to say that clients are spending indiscriminately. Everyone is watching their dollars, so it is up to the Home Care providers to earn clients’ business by delivering service that exceeds expectations.  

AmeriCare has been fortunate to enjoy steady growth during these difficult years, due, in large part, to our emphasis on personalized service. This includes:

• Assessing each individual’s care needs independently and working to find solutions that accommodate every situation.
• Providing a selection of caregivers that best fit a client’s needs, and allowing the client to interview and select the caregiver of his or her choosing.
• Identifying resources and financial aid to help families struggling to afford Home Care.

As the industry continues to grow, it will be sure to attract people looking to take advantage of the upward trend; therefore, clients should be careful when selecting a Home Care provider. Don’t hesitate to ask for:

• Copies of the provider’s business license.
• The extent of its insurance coverage.
• Policies regarding recruiting and background checks.

Exercise caution when considering providers. Make sure you feel that they have your best interests at heart and are equipped to handle your most complicated care needs.

2. Technology is Playing a Part. There is no substitute for compassionate understanding and a genuine smile, but innovations in Home Care technologies are helping to enhance human care and contributing to the comfort and safety of our clients. At AmeriCare, we stay abreast of the most current technologies, such as Life Alert systems, digital medication reminders, and home monitoring services so that we can help our clients make informed decisions for their specific care needs.

3. Content is King. The Internet, with its myriad of portals and social channels, is providing a way for Home Care providers to communicate with current and prospective clients like never before. We are no longer simply service providers; we are content providers as well, offering everything from tips on how to organize a home for someone with Alzheimer’s to sharing inspirational stories to lift a caregiver’s spirits during difficult times.

At AmeriCare, we use our website to deliver useful information. We also foster a community of fans on Facebook and followers on Twitter: username @americare. We hope these outlets work to bring people with similar experiences together and offer tips and inspiration that will help make their lives a bit easier. We’re all in this together and we welcome you to join our virtual family.

2011: A Look Ahead

Many of the observations mentioned above will continue to influence the industry in the coming year, but following are a few specific issues that we see being particularly pertinent in 2011:

1. Avoiding Commoditization. As we’ve already mentioned, the dramatic growth experienced by the Home Care industry will lead to an increase in service providers and a greater degree of commoditization within the industry. This increase in competition will benefit discerning clients seeking higher levels of service and elevate the category-leading companies driven to evolve their service offerings to establish a clear point of difference.

Some of the steps AmeriCare is taking to stay ahead, include:

• An emphasis on personalized service.
• Better caregiver training.
• Increased specialization of care giving skills to cater to specific client needs (dementia vs. muscular dystrophy, etc.).
• Allowing clients to interview and choose their own caregiver.
• No minimum hour requirements.
• On-call caregivers for immediate responsiveness.

As new, lesser-experienced companies enter the industry, it is imperative for established providers to continue evolving and avoid becoming commoditized.

2. Continued Advancements in Technology. As mentioned in the year in review, technology will continue to play an important role in the coming years. While Home Care companies aren’t prepared to become sales reps for product manufacturers, we expect that providers may begin to advocate medical innovations that can improve a client’s comfort and safety. Some providers may decide to include these products as part of their care package.

3. Government Aid. Healthcare reform has been a touchy topic, and will continue to be so in the coming year. Currently, most of the financial aid options for Home Care clients are subject to state regulations. Non-medical care is a growing need for many Americans, and should receive more attention in the coming years. At AmeriCare, we strive to stay current on all financial aid options and to help eligible clients obtain all the aid available to them. Look for non-medical aid to become a bigger issue in the coming years.

Clearly, this is just the tip of the iceberg. The beginning of a conversation. We want to hear your thoughts regarding the state of the industry and where it’s headed. Please post comments here and start new conversation threads in the social-sphere. Together, let’s make the future of Home Care as bright as it can be.

Special thanks for this article goes to Doug Lueder, servicing the Metro Atlanta area. Give him a call if you’re an area resident with Home Care questions or needs.

Tags: Americare home care, Home Care Industry

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Siblings Caring For Elderly Parents

By AmeriCare, December 13, 2010

Families are wondrous entities, aren’t they? No two are alike, yet all share the same essential joys and frustrations. Many of  our most life altering moments will occur within the framework of the family unit. Meeting ones soulmate. Naming a child. The moment we realize and truly appreciate the sacrifices our parents have made for us. The moment we realize it’s our turn to return the favor. And when this time comes, it can test a family’s fortitude, forging fault lines in the form of anger and resentment, threatening to create chasms among caretakers.

Or, it can be a loving and caring experience; one where the family pulls together to collectively provide comfort for a parent during the twilight of their life.

Option two sounds better, doesn’t it? So, how do families maintain their integrity while caring for parents who are no longer self-sufficient? How do siblings decide how to share the responsibilities fairly? How does one resist resentment when the responsibilities aren’t evenly distributed? Well, as each family unit is unlike any other, there is not one universal solution. There are, however, some general guidelines that can help maintain harmony through these challenging times.

The key is to develop the following critical skills: communication, empathy, and, above all else, patience. Here are some tangible tips that will help you apply these essential virtues.

Communication

Clear and open communication is imperative when assigning caretaking responsibilities. In many cases, the older child, or the one living closest to the parent, is often chosen as the primary caretaker. This method can be unfair, however, and cause sibling rivalry and resentment.

Hold a family meeting once its been determined that a parent needs ongoing assistance. Speak with a doctor to get a clear assessment of his or her abilities and limitations, then create a detailed list of the needs that will have to be cared for on a weekly basis. Create a budget as well, if some care needs exceed the parents’ financial means. Then, assign roles. If someone’s job allows for more flexibility than another’s, perhaps they assume more of the hands on responsibilities, such as companionship and cooking, while someone with a more rigid work schedule can provide more of the financial support, like arranging for a lawn service or a house cleaning crew.

If possible, don’t allow yourself to be forced into a role. Accept the role that you feel best equipped to handle and embrace it.

If you feel as though you’ve been stuck with the caretaking responsibilities, and that other members of the family are not contributing their share, voice your concerns. Keep a journal of the day-to-day and week-to-week duties and share it with the other family members on an ongoing basis. This is not to rub their noses in their neglected duties, it is intended to keep them informed and show them ways in which they can pitch in.

Also, don’t feel as though caring for your parents is solely the family’s responsibility. Reach out to friends, members of the community, and spiritual centers. Let people know how they can help. You may be surprised by how willing people are to volunteer their time.

Empathy

Imagine the kind of world we’d live in if everyone practiced more empathy. When times are tough, stop for a moment and put yourself in your parents’ shoes. Imagine that this may be you one day. How would you want to be treated, particularly by your children who you sacrificed so much for? Developing an empathetic attitude will help you act compassionately, and keep a healthy perspective, even when the demands feel like they’re beyond your current capacity.

If you are a family member who is unable to provide much of the hands on support, resist offering advise, and especially avoid criticism towards the primary caregiver. Instead, provide as much encouragement and emotional support as you can. If you feel like things could or should be handled differently, offer to help out in that area, don’t just give advice from afar.

Patience

This may sound paradoxical, but you should first apply patience towards yourself, not your parents. You’ve never done this before. You’re not always going to know what to do. You’re going to get frustrated. You’re going to feel overwhelmed. You’re going to wish your life would return to “normal.” These are all natural feelings. Don’t feel guilty about having them. Don’t feel selfish. Be patient with yourself, and understand that you’re not superhuman; there’s only so much you can do. Just do your best.

Be patient with other family members. This is new to them as well. They may be struggling with different emotions than you. They may need encouragement to get involved. They may need support; counseling. Be patient with resistant siblings, or other family members, as you work to integrate them into the program.

Finally, practice patience building techniques, you’ll need them. Breathing exercises, meditation, calisthenics; you may not feel like you have time for such activities, but they will save your sanity in the long run. So, make time.

Caregiving is one of the most challenging roles anyone can assume. And it’s not for everyone. Often family dynamics, personal relationships, individual personalities or present situations do not allow for caregiving to occur within the family. That’s what AmeriCare for. The last thing you should do is allow for a caregiving role to put a strain on a loving family relationship or begin to erode fond memories.

Give us a call if you are interested in learning more about our caregiving services.

We know what you’re going through and are always eager to help.

Tags: Americare home care, elderly parents, family caregiving

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Putting Home Care in Norcross GA in Perspective

By , February 7, 2010

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

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

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

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

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

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

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

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

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

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

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

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

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

1.    Inadequate care provided to a loved one

2.    Lack of training for caregivers

3.    Lack of social stimulation for care recipients

4.    Informal caregivers unable to handle the challenge

5.    Depression and physical ailments from caregiver burnout

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

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

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

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

If you need more information about caring for your loved one, please visit us at www.americarealliance.com.

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