Tuesday, February 15, 2011

15 Questions to Ask When Interviewing a Home Care Worker on Your Own

If you're hiring an in-home health care worker without going through an agency, these questions should help you find a reliable match for your loved one. Involve the person you're caring for in the interview process as much as possible. It's his interview, with you asking the questions for him (if he's able to ask them himself, even better). 
Be prepared with questions!
  1. Will you take care of all required payroll paperwork for my parent's worker?

    A significant amount of paperwork is involved when employing someone, covering such matters as taxes, Social Security, and disability. One plus to hiring from an agency (and the reason it's usually more expensive than hiring independently) is that it normally does this for you. Still, it never hurts to double-check.
  2. Are you Medicare certified?

    Medicare certified agencies are eligible to be paid through Medicare, the government's health coverage for people over 65. To become Medicare certified, an agency must meet federal standards for patient care.
  3. Can my parent and I interview candidates and give input on the choice?

    The more control you and your parent have over choosing a home health worker, the better you'll feel about the person. Agencies approach this differently, so you'll need to ask.
    1. What kind of background check do you do on your workers?

      It's increasingly common for employers to do criminal background checks on potential employees. Since trust is critical when hiring someone to help your parent in a home setting, these checks are valuable screening tools.
    2. Do you check your workers' driving record and driver's license?

      If you need someone to drive your parent, even occasionally, it's important to know what kind of driver you're getting. Car insurance requirements, by the way, differ state by state. Check with your local Department of Motor Vehicles (DMV) to see what's required in your state. And if the worker will be driving your parent's or your car, check with the insurance company to find out how to include new drivers.
    3. Are your workers bonded?

      If someone is bonded, her work is basically insured, and your parents will be covered if she breaks the washing machine or steals something. Bonding coverage varies, so ask for details. It's a level of reassurance that can make a difference but isn't essential.
    4. Do you provide any training for your workers?

      If so, ask the agency whether training is done once or on an ongoing basis.
    5. Are the healthcare workers your employees or independent contractors?

      Some agencies function more like job referral services, linking independent workers with jobs rather than managing their own employees. With independent contractors, you'll likely be required to do more paperwork and supervision. It's a good idea to be clear about this from the start.
    6. What kind of supervision do you provide?

      Does the agency check in with its workers daily or weekly? Is someone available to provide expertise or extra assistance if needed?
    7. How do you handle a worker's sick days, vacation days, and holidays? Will you automatically send a replacement worker?

      Will you automatically send a replacement worker? Everyone needs breaks and time off, especially home health workers, whose work is physically and emotionally demanding. Find out how agencies cover for worker absences and what's required from your end.
    8. What's the turnover rate of your workers?

      Do you think they like their jobs? Do you offer benefits? It's always hard to know if you'll get an honest answer, but it never hurts to ask. A simple truth prevails: People who are happy with their work make better employees. See if you can get a reading on this.
    9. How do you handle conflict between a client and worker?

      It helps to know how much support you'll get from an agency should a conflict arise -- and it probably will. Does the agency mediate conflicts, and if so, how? Is it flexible about changing workers if things don't improve?
    10. Do you have customers I can talk to about their experiences?

      Ask for several references. This is one of the best ways to get a sense of how an agency performs over time.
    11. Do you accept payment from insurance companies?

      If your parent has, say, long-term care insurance that pays for the cost of in-home care, you'll want to make sure the agency accepts this kind of payment. If not, you're probably better off using one that does.
    12. What kind of service agreement is required?




Tuesday, February 8, 2011

Can Meditation Increase Your Pain Tolerance?

One scientist from the University of Montreal seems to think so. When performing a study on long-time Zen meditators, Joshua Grant and his colleagues discovered that their tolerance for pain far outweighed the tolerance of the subjects in the control group. This was a result of the thicker layer of gray matter in the area of the brain that processes pain sensory, most likely the result of sustained activity of the brain – much like working out a muscle. Not only does old age work against the thickness of gray matter, but also the lack of mental activity for those in their middle ages. Therefore, seniors who are consistently doing things like meditation, crossword puzzles and other “thinking games,” have improved memory and mental capacities.

According to a study conducted in 2008 by a team from Harvard Medical School, additional benefits of daily meditation include lower stress levels, eased blood pressure and added cell protection from aging.

Therefore, try adding meditation to your daily to do list. Whether it’s an exhilarating AM wake-up call or much needed time to unwind, meditation offers irreplaceable health advantages. Not to mention, it is also a nice bonding experience for you and an elderly loved one.

Friday, February 4, 2011

Common Sense Care Giving

In general, women are our society’s caretakers.  From the time that they are little girls, they are caring for their dolls and perhaps even their pets.  As women grow into adulthood, they care for their spouses and are generally the ones who provide the primary care for children (down to providing the sustenance that helps children grow and thrive).  As their children grow and become self-sufficient, many women end up caring for their parents (and sometimes even their in-laws) as they age and need assistance in their daily living tasks.

As anyone who has been a caregiver can attest, it takes a toll on you emotionally and physically.  Giving so much of yourself to another is a tremendous gift to them but it can literally zap your energy and take away your ability to think clearly and logically. In giving so much of yourself to others, you often stop caring for yourself (especially if you are doing what thousands of women are doing by working at a job while performing caretaking duties). 

As you plan for your life in retirement, have you stopped to think how your life in relationship to those you care for will change? If not, it’s time to consider these possible changes.

The first change can be a double-edged sword, positive and negative. Once you are retired from your job, you can spend more time in care giving to others.  This can be wonderful for them because they get much-needed attention that enables them to continue to function and it can be a positive for you as well because you feel like you are making a positive difference for someone else. Having more time to care for others can also quickly lead to burn-out (for you and sometimes the person you are caring for). 

When you retire, consider talking to the person for whom you are caring and ask them for alternatives and what they want to do in this new situation. Sometimes, insurance will provide respite care. In some areas, community-based are provides an alternative to family care. Before you are burned out as a care giver, make sure that you have explored all of the alternatives.

The second change will be your control over your daily schedule. Just like when you worked, it is a good idea to keep a written or electronic schedule. By allotting time to certain tasks, you can make sure that you are giving time to others as needed but you can also pencil in time for yourself as well.  The time for yourself is vitally important to help you rejuvenate and recharge your batteries for yourself and others.  You can also see where you are over scheduling yourself and correct the problem before it gets out of hand.

The third change (or enhancement) is to schedule time just for you. Exercise is especially important because folks sometimes gain weight when they go through a milestone in their lives (and retirement definitely fits this category). Even treat yourself to a manicure/pedicure or massage. In many cities, a beauty or massage school has a greatly reduced price in return for a bit slower service. (I don’t know about you but I have never complained about someone being too slow during a massage!). Being kind to yourself doesn’t have to cost much but it definitely does have to happen on a regular basis.

The bottom line is that you must care for yourself as much as you care for others now and after you retire.  By doing so, you are maintaining the ability to give others what they need while retaining your health and welfare. To coin a phrase, it’s a “win-win.”

Thursday, February 3, 2011

Simple Prepared Meal Delivery Services for Family Caretakers Of Seniors


Almost all daughters and sons who take care of their older parent, or elderly parents, usually do not imagine themselves as caregivers. They just consider themselves as attending to their parents. A caregiver is defined as somebody that provides support for another person who may not be able to reside on their own as a result of bodily, psychological, financial, or mental limitations.

Caregivers are likely to be thought to be specialists or volunteers who stop by the home of the person they may be looking after as needed. In situations where an expert will not be necessary, the duty will most likely drop on the siblings of the family. This could consist of errands, housekeeping, yard maintenance, managing finances, food shopping, and cooking meals in advance.

Surveys differ, but as many as 80% of all caregiver services in the U.S. are provided by family members. This adds up to practically 50 million men and women, and approximately a third of every U.S. family has an unpaid caregiver attending to the needs of an older parent in some capacity. 86% of caregivers are family members, and 66% tend to be female. The average family caregiver can assume this obligation for as long as nine years.

While there are several jobs and commitments a family caretaker will expect, 65% of all services consist of cooking food, and 40% are maintaining specific nutritional diets. 75% of family caregivers state food shopping is often a regular part of their duty. Senior citizens make up the largest percentage of people in society who need diabetic, weight loss, low sodium, and heart healthy diet programs. Preparing meals in advance for parents is usually a significant task in itself. Preparing meals regarding special diets, calls for further expertise with respect to both food shopping, and cooking.

Family caretakers who reside nearby will have a much easier go regarding cooking and taking care of their aging parents compared to those that live further away, or perhaps in another state. With the fast paced routines of employment and rearing their own families, it is no surprise 40% of family caregivers find caring for a mother or father, or parents, can be a burden. 32% say it is a excessive responsibility and results in emotional tension, but when it comes to taking care of an aging member of the family, it is usually a labor of love.

Prepared Meal Delivery Solutions

Nourishing an aging parent, or parents, can be one of the most frequent, and time intensive responsibilities a family caregiver can provide. Having prepared meals delivered, in some capacity, is often a potential option that helps both the family caregiver and the parent. Menus can be as simple as one dinner a day, to a comprehensive selection of breakfast, lunch, and dinner. Most companies that offer premade meals ship their meals frozen allowing it to easily be heated up in a microwave oven.
  • DineWise is a nationwide meal delivery service that delivers frozen senior meals across the country. They have a substantial choice of foods, and offer nutritional options for individuals with diabetic, weight loss, and low sodium requirements. Repeated food deliveries may be booked for any time frame, as well as any budget. DineWise meal costs average $12 per meal.
  • HomeStyle Direct is a service that accepts medicaid for residents who live in Idaho, Michigan, Montana, Nevada, Utah, or Wyoming. Their menu offers significantly less selection and does not cater to specific nutritional diet programs, but they do offer less expensive cost option. Their average meals will cost around $6 each.
  • Meals On Wheels is a local service which provides hot meals to homebound senior citizens, typically more than 60 years old. Restrictions, qualifying criteria, and rates, in the form of contributions, varies depending on the county you live in. The service is not offered nationally. These agencies are usually financed through charitable efforts and local governing bodies.
National prepared meal delivery service corporations give family caretakers the ability to reduce stress and lower the burden of taking care of an aging parent, or parents. They also offer a benefit to the elderly in that they are simple to reheat, and enable seniors a sense of remaining self-sufficient. They may be bought in just about any volume, and optionally planned for regular shipping and delivery dates. Having precooked meals on hand also offers convenience for family caregivers in situations where they go away, or cannot attend for their parent, or parents.

Wednesday, February 2, 2011

Dance: the movement activity for the elderly ( www.bestlocalassistedliving.com )

Just gotta dance!!
Here is an all-purpose -- and inexpensive -- activity providing many benefits:

Dance equals the most vigorous of sport participation and it may provide the same physical exertion that sports and games provide with less space requirements. Dr. Kenneth Cooper, founder of the Aerobics Center in Dallas, states "ballroom dance is a fairly minimal activity, but if you can combine frequency per week with duration, you can get a nice training effect." Other possible physical benefits of dance for older adults include: improved balance, coordination and kinesthetic awareness, improved alignment with decreased arthritis difficulties, insomnia, neuromuscular hypertension, and low back pain. Dance also seems to maintain interest better than a regimen of calisthenics.

Dance may contribute to the physical fitness of its participants through versatile exercise that aids muscle tone, weight control, gracefulness, general body control, and health. In 1988, Sutton at the University of Minnesota found that middle-aged men who participated in moderate activity over a seven year period reduced the risk of fatal coronary heart disease incidence by thirty-seven percent. Simmons measured changes in the cardiorespiratory systems of older adults after participating in thirty sessions of dancing and no form of aerobic dance was used, only modified folk, couple, and square dances. Results identified that low to moderate intensity in a regular dance program did contribute significant improvements in predicted V|O.sub.2~ Max and resting systolic blood pressure. These findings support the premise that dancing is a legitimate aerobic workout for older adults.

Creativity

Dance provides for self expression, even if it's only shuffling movements, which still have some element of "creating one's own routine". Each individual shuffles their feet as they wish to. Though some dance forms such as square and folk have very structured steps and formations, ballroom and social dance allow individuals to be creative and try different steps and moves.

Dance has long been a rationalization for getting people together. Unlike other activities, dance allows participants to concentrate on each other rather than play to an audience or strive to meet regimented skill specifications. Dance may decrease isolation, loneliness and boredom, increase tactile support, cooperation and enjoyment, and it also gives participants something to do with their hands, feet, and body if communicating on a purely verbal level is awkward.

Other areas that dance may contribute to include:

Rhythm and coordination
Relaxation and escape
Recognition and understanding of one's own culture
Opportunity for adventure and new experience

Characteristics of the Aged

According to Shephard, there are two primary questions that the leader of an older adult dance program must consider. First, what movements and fitness demands are required to successfully perform this dance? Dances with slow tempos and very little locomotion involved should be chosen for those individuals with minimal fitness levels. As fitness levels improve the tempo and amount of space that steps cover may be increased.

Secondly, what is the skill complexity and cognitive demands of this dance? Older individuals need clear and concrete instructions and an opportunity to learn at their own pace. Begin with only the basic steps of a social dance or the most simple degree of difficulty for folk and square dances. Progression on step complexity should be slow with sufficient repetition for learning. The gradual loss of sensitivity in the feet will affect the older adult's sense of position and balance; therefore, steps requiring rapid change in motion or direction should be avoided.

Individuals should have a medical examination before participation in dance programs. After the examination the instructor then needs to assess the biomechanical capabilities and weaknesses to determine appropriate type and intensity of movement according to the need of each individual. There should be sensitivity to the variability of present fitness and mobility levels within the dances called. Traditional movements and their style of execution should be modified in response to signs of over-exertion. The risk of injuries, such as strains, and sprains increases with age, particularly after the age of 55. Furthermore, many older adults fear bodily injury during a movement activity, and for good reason, since an injury can be a serious blow to self-sufficiency and personal freedom.

In short, dance leaders should possess a sound understanding of these limitations and be able to teach the participants rules of safe participation.

Social/Emotional Characteristics

Motivation of the older adult to seriously participate in a dance program requires the leadership of a caring person who has a personality that assures the participant of success and well-being. The leader's ability to provide meaningful feedback that conveys an appreciation of the older adult's accomplishments will also be motivational.

Different types of dance can lead to different types of social interaction. Line and folk dances allow for simultaneous interaction among the group. Mixers allow for short acquaintances with everyone participating in the dance. Square dances provide interaction for a small group of friends. Social dances allow a couple to interact apart from the group, although the steps from the social dances can be performed in line formation without the need for separating into couples.

The Dance Routine

The first dances should always be chosen to slowly warm-up the body. The last dances should also be slow for a cooling-down effect. The routines between might alternate among fast, moderate, or slow tempos as long as continuous movement is sustained throughout. It is often helpful to end each class session with a short period of relaxation.

Any or all of these can be used to provide residents with exercise, social opportunities and fun -- and sustain and improve the independence they have remaining.