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.

Tags: Americare home care, elderly, in-home care

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Understanding Our Aging Loved Ones’ Medications: Important Information for Every Family!

By , January 31, 2010

As people age, the likelihood of taking medicines increases; studies show that the more medicines people take, the more likely they are to be taking a medicine they may not need. It is, therefore, important to take an active role in understanding what is being prescribed for you. In order to better manage chronic conditions, reduce the chance of harmful drug interactions and get the best value for your money, keep in mind that you are part of a team—along with your doctors and other health care professionals—working to make good health care decisions.

Medicine Record

To start with, it is important that you keep good track of all the medicines you are taking; this will also help to reduce your risk of harmful drug interactions. Make your own list of medicines by keeping a medicine record. Update your medicine record whenever you start on a new medicine or when you are no longer taking a medicine.

Include the following in your medicine record:

• Name of medicine

• What it is for

• Name of doctor who prescribed it

• How and when to take

• How much to take (dosage)

• Color/shape of medicine

• Any side effects or warnings

You can also take advantage of medication tracker software on your personal computer.

See http://www.consumerreports.org/health/medication-tracker/index.htm for help organizing and tracking your medicines, as well as other information to share with your doctor.

Talking to Your Doctor

It is important to get into the habit of asking your doctor questions about your medicines each time you receive a new prescription. If you receive prescriptions from more than one doctor, always take your medicine record with you and let your doctor know which medicines you are currently taking.

Questions to Ask About Your Medicines:

• Why do I take this prescription? Is it for long- or short-term use?

• How do I take this medicine (how often, with/without food, etc.)?

• What are its side effects? What should I do if they occur?

• Can I substitute a non-drug alternative or a generic?

• Does it duplicate any of the other prescriptions I am taking?

• What should I do if I miss a dose?

• If I cut a pill in half, will it be ineffective?

• Does this drug interact with any of the other prescriptions I take?

• How important is this prescription given my finances and overall health?

• Does my health or age make this drug unsafe for me?

Don’t Forget to Mention. . .

• Any over-the-counter (OTC) medicines you are currently taking such as pain relievers, antacids and laxatives; be sure to include any herbal, vitamin or dietary supplements as well.

• Any research you have done.

Go to http://www.CRBestBuyDrugs.org to download simple reports featuring comparisons of drugs by medical condition or drug class.

Keeping Up with Your Medicines

• Keep medicines in plain sight in a cool, dry place like a kitchen counter or desktop.

• Do not keep your medicines in the refrigerator, unless told to do so by your doctor, pharmacist or the instructions on your medicine bottle.

• Do not keep your medicines in a bathroom where they can become damaged and less effective from shower steam or moisture.

• Set timers and reminders to take your medicines, if needed. Program clocks for when you are at home, and cell phones and watches when you are traveling.

• When flying, carry your medicines with you; do not pack them in your checked luggage. Check with the Transportation Security Administration (TSA) for the most current information about traveling with medicines at http://www.tsa.gov or 1.866.289.9673.

• Avoid having to make last minute refills. Mark your calendar in advance or look into a mail-order pharmacy, which can be less expensive.

The best way to keep up with your medicines is to keep your medicine record and bottles within easy reach.

Overcoming Some Medicine Hurdles

Sometimes people avoid taking prescribed medicines. If you are one of these people, ask yourself if any of the following apply to you:

I have trouble affording it — If a medicine is expensive, you may decide not to get the prescription filled. Talk to your doctor about the cost of a drug to see if there are less expensive generic medicines.

I don’t feel any different when taking the drug, or, my symptoms have gone away — Sometimes it is hard to tell when a medicine is working; many medicines work as a “preventative” by preventing your symptoms or conditions from getting worse. Understanding which medicines work to prevent your symptoms from getting worse will help in following your drug routine.

My symptoms are worsening, or, I’m having side effects — Due to changes in your body as you age, prescriptions you have taken for years may begin to affect you differently; signs of memory loss, irritability or loss of coordination can be due to drug interactions rather than medical conditions. It is important to record any change in symptoms or side effects, and share this information in detail with your doctor immediately. This may result in taking a lower dose, changing when you take the prescription, or taking a different medicine altogether.

My medicines are complicated to take — Especially when managing several medicines, it becomes more difficult to observe all of the rules required for each medicine. Getting organized with your medicine record is the easiest way to get into the habit of taking your medicines successfully.

The most important aspect of your drug routine is that it is manageable.

Getting the Best Value for Your Medicines

Review your needs every year

Evaluate your prescription drug plan and compare it with your needs every year. There can be major changes in the pharmaceutical and insurance industries each year that will affect what benefits are being offered and what drugs are covered (and at what prices).

Look into your medicine choices

Doctors do not know what prescriptions are covered by your insurance company. Ask your insurance company for a copy of your drug plan “formulary” (which is a list of all medicines covered by your insurance company) and bring it to your doctors’ appointments. Together, you can evaluate the choice of medicines that will be most effective.

Consider a generic

“Generics” are copies of brand-name medicines whose patents have expired (expirations occur after the drug has been on the market many years). Because a drug has been on the market for so long, it is proven. Generics are less expensive because the research has already been done and the drug has already been tested by the original manufacturer. Makers of generic drugs are not allowed to copy the exact look of the original brand-name drug so a generic drug may look different than the original brand-name medicine, but all generic drugs must maintain the same chemical make-up as the original.

Shop around

Consider all of your drug plan’s preferred pharmacies and compare prices. Ask about pharmacy discount cards and senior citizen discounts; ask your insurance company about online or mail-order pharmacies.

Help Paying for Your Medicines

After reviewing ways to save money on your medicines, you may find that you are still having trouble paying for them. Here are some websites that can provide additional assistance:

• Medicare Extra Help Program provides information about the Social Security assistance program and application process for the Medicare Part D Subsidy: www.ssa.gov/prescriptionhelp.

• State Pharmaceutical Assistance Program (SPAP) provides information about any available state-funded assistance programs for prescription drug costs: www.medicare.gov/spap.asp.

• Pharmaceutical Assistance Program (PAP) provides information about pharmaceutical companies that offer assistance programs for the drugs they manufacture: www.medicare.gov/pap.

Finding Answers

There are community experts who can help you evaluate your needs for the best prescription drug plan for you. To find a AAA or SHIP near you, call the Eldercare Locator at 1.800.677.1116 or visit the website at www.eldercare.gov.

AmeriCare home care services provide medication reminders and assistance with transportation to doctor’s visits. Keeping our seniors safe and healthy is our priority. Find an AmeriCare office near you by visiting http://americareinfo.com, or call 1-800-610-2029.

Tags: aging loved ones, caregiver, companionship, in-home care, in-home care provider, medication reminders, medications, mental condition, new mother, respite care

Posted in: Americare home care, aging, aging loved ones, elder care, glaucoma, home care, medication reminders, medications, senior care, seniors

Senior Care – Knowing When and How to Get the Best Service

By Vicktoria Baylor, October 29, 2009

Many concerned family members feel like they can only watch from the sidelines as they observe the gradual deterioration of the health of an elderly loved one.  Seniors often receive a reputation for stubbornness and an unwillingness to compromise.  Can you really blame them?  Coming to terms with old age is something everyone will put off as long as they can.  Some folks have no choice but to relocate to a nursing home when critical health issues arise.  Sometimes the issues are stealthier though, and appear very gradually.  How do you know when the time comes to look into senior care options before an accident actually occurs?

 There are a few tell-tale signs of needed senior care that can reveal themselves to you in the form of daily struggles that require assistance.  Such difficulties could include the inability to complete chores or even a complete negligence of them.  A change in behavior that includes going from being a neat freak to one who could care less about the cleanliness of their home could be much more than a simply behavioral change.  They could be losing the ability to complete chores but resist telling anyone the truth about it because they fear the nursing home life.  More seriously, it could be the onset of a mental condition that causes them to forget or simply not care about the things that used to characterize their behavior.

The other sign that it is time to look into senior care is if tasks like bathing and dressing become overly difficult or even dangerous.  A classic mishap is an elderly person slipping in the tub, hurting themselves and being unable to call for help.  If you want to prevent a disaster like this from happening, catch it before it becomes too difficult of a task to complete independently.

An ongoing, time consuming medical condition can put strain on a family who cares for a senior.  Perhaps before it becomes unbearable to manage you should look into senior care options.  You are almost guaranteed to be the one who must make this decision as the elderly are often not attuned to their own issues or they are too prideful to admit they need assistance.  Educate yourself on the differences between varying housing options or in-home care.  Depending on the issues faced specifically by your elderly loved one, you may want to look into different senior care options with differing levels of medical and custodial care.

AmeriCare Homecare provides the best in-home care options available. Contact a local office for more information about services provided.

Tags: elderly, homecare, in-home care, mental condition, nursing home, respite care, senior care

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Compassionate Approach to Discussing In-Home Care

By Sally Price, AmeriCare Franchisee in Northern CA, August 11, 2009

Discuss before hiring

When considering an in-home care provider, your parents should be a part of the discussion. Recognize that your parents may be experiencing tremendous amounts of fear once they realize that they are not functioning well on their own. They fear losing their freedom or their home. Respect their feelings and always approach the topic of in-home care with compassion.

Begin Slowly

Most elderly parents respond to in-home care by saying, “There’s really nothing for the caregiver to do.”

 Suggest they give the caregiver a try with basic housekeeping, such as laundry, changing bed linens and cleaning. Or the caregiver can perform errands such as grocery shopping or accompanying your parents to doctor appointments. Keep in mind that as the caregiver takes on these smaller tasks your parent will most likely begin to feel more comfortable trusting them with larger and perhaps more personal duties later. 

 Most importantly remember to reassure your parents that in-home care is NOT the beginning of the end, but an active step to prolong their ability to remain in their home. Having an in-home care provider is another form of preventative medicine. Like exercising or taking vitamins, in-home care can help your parent’s lead healthy, active, and happy lives.

Tags: care provider, caregiver, home care, in-home care, in-home care provider, parents

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