Posts by LukeFantaty91688:
Sibling Gift Ideas
October 2nd, 2011When you get an invitation to a baby shower, your thoughts probably immediately focus on what to get the new baby. Decisions range from what you should get that will be useful, such as bottles, personalized baby gifts, diapers, burp cloths and bibs to more extravagant items like a highchair or a bouncy seat.
Then there is the mom to be. Many shower goers realize that mom should be pampered during this time. A gift certificate for a massage, body lotions and bath salts, all sorts of items that will help her relax after the baby is born. Mom will be so happy to receive something for herself. She may not use it right away but eventually she will definitely take advantage of this.
What about the siblings? How do they feel about having a new brother or sister? Many children are indeed excited but still feel they may be forgotten about once the new baby arrives. It’s an excellent idea to not only have wonderful gifts for the baby and even mom to be, but for the siblings too.
When deciding on sibling gifts, take into consideration the age of the child or children as well as their likes and dislikes.
Personalized baby toys: If the child is young, a stuffed animal or soft cuddly baby doll is an excellent sibling gift. It makes them feel ass though they too have someone new to care for.
Educational toys: Instead of getting a random toy you think they would like, pick out something fun and educational. Mom and dad will appreciate the fact that you took the time to find something purposeful.
Personalized tee shirts: This is a common gift but it is still a hit. Have tee shirts made that say, “I’m the big brother” or “I’m the big sister” –they will love wearing the tee shirts on the day the new baby arrives.
Offer a play day: If you are close to the family, offer a few days of one on one time. Take the kids to a fun even t such as a movie or maybe even an amusement park. Do something with them that focuses on them only to make them feel special. If you are a grandparent, you can offer to take the kids for a week at a time. A week long vacation at grandma and grandpa’s house where all the attention is on them is a great idea!
Getting a sibling gift is also a wonderful gift for the parents. They will appreciate the fact that you took the time to think about their other child or children. While the focus is usually always on the new baby, it is also on family as a whole. So many people forget that a baby shower is a family even t and everyone should be included in the celebration!
When going to a baby shower, remember to have personalized baby gifts in hand for the new baby, a gift basket full of pampering goodies for the mom to be and something for the siblings.
Author Kali Winters never goes to a baby shower without personalized baby gifts and Personalized baby toys for siblings in hand! She gets the best deals online at BabyStuffGifts.com
How to Start the “Big Talk” With Your Aging Parents
February 21st, 2009If you’re one of us—somebody born between 1946 and 1964—and if either of your parents is still alive and still living at home, there’s a challenge waiting for you: mom or dad is probably going to have to consider a change of circumstances, which might include a transition from the family homestead to a much different kind of place—a senior apartment, perhaps, an assisted living facility, or even a nursing home. Unlike previous generations that automatically brought an aging parent or two into their homes, many of us don’t have that luxury. We’re still earning a living, which prevents us from being the best caregivers even on a part-time basis.
Worse, we don’t like to think about aging. We much prefer denial, which means we tend to delay this conversation about a potentially unpleasant course of action until we’re forced to do so by mom or dad’s sudden health crisis. Now, calculate the emotion and tension they add to the conversation and you are far more likely to make mistakes, hurt feelings and carry the burden of the resulting guilt.
How comfortable are you with the reality of initiating the conversation with your parents about the need for their possible lifestyle change? You may perceive they need more help to live at home or you may think they have to move somewhere with medical oversight, but do you know what they think? Are there other family members who need to be part of this discussion? The earlier you have a talk–or a series of talks–the less difficult it will be.
While mom and dad are still healthy, the Big Talk is really about who they’ll become when they get “old.” At the time that mom breaks her hip and her physician tells the family that she cannot go home, you are forced to make a decision in the midst of a crisis. Serious business, indeed, and one for which few of us are prepared.
This is an ideal time to think about your children. Why not tell them all the things they need to know? This is a great generational exercise, wherever you are on the family tree. Fortunately, others have gone before us and dropped breadcrumbs along the way as a guide.
Starting Out. Nobody wants to talk about getting older, the inevitability of aging and what lifestyle changes will be necessary for the elderly parent. Worse, it’s particularly difficult when the truth-telling comes from the children.
The most important part of most relationships is the ability to actively listen to each other. “Active” listening is a term that is tossed about at work, one that’s highly recommended when dealing with a teenager or a best practice in a good marriage, but what does it really mean to “listen actively?”
Active Listening. Simply put, “active listening” is a way of listening that’s intended to improve mutual understanding. When you actively listen, you focus your entire attention on the person who is speaking. You try to block out other distractions and thoughts–especially those about your own beliefs and what you are going to say next.
You often check with the speaker to make sure that you understand what is being said. You might respond by saying something like this: “What I hear you saying is…” This works very well in emotionally-charged situations where the parties do not necessarily agree. It gives them the chance to internalize and process the other’s position and make clear that they have heard–and understand–his or her perspective. The listener focuses, not merely on the words being spoken, but also on the body language and conversational tone that’s being used. So, responses might also be, “You seem to be frustrated (unhappy) (angry) (sad) right now; can you tell me what that is about?” This type of listening can help to resolve current problems and ward off future conflicts.
Here are some suggestions for getting started talking to parents about their future and what it might hold:
Refer to someone else’s unfortunate experience. Many of our parents have recent and unpleasant memories of the difficulties that friends or relatives have had in this situation. Maybe it was the elderly cousin whose health precipitously deteriorated and required the nieces and nephews to scramble to get him into eldercare. Perhaps it was the neighbor who broke her hip and her son in Australia had to take a month away from work to solve the problem without any guidance.
Considering the situation as a necessary conversation for your own peace of mind is essential. The family—not just the parent, but also you, your spouse, your siblings and the extended family—shares this challenge. This approach broadens the focus of the discussion and preserves mom’s or dad’s dignity.
Newspaper or magazine articles can be used to start the conversation. We are usually able to find a related letter in a Dear Abby or other advice column in our local paper. You might begin like this: “Gee, Dad, I guess I don’t know anything about what you’d want me to do if you discover that you’re unable to live at home. I’d feel a lot better if you would tell me, so I won’t have to guess.”
One step at a time. Some parents will be outraged at the very thought of giving up their home and moving into a strange environment. That’s perfectly understandable. After all, the emotional attachment to home—“There’s no place like home.” “Home is where the heart is.” “The green, green grass of home”—runs deep in all of us. Sometimes, it is just a matter of processing on the part of everyone involved.
The state of denial is overcrowded and it’s possible that it’s not just the parent who lives there. You may find that siblings or other family members find aging and the inevitable change it brings difficult to accept. As in most relationships, this may be an exercise in negotiation and compromise.
Everyone has a solution in mind, and we all think that ours is best. Try to begin with an open discussion about perceived problems and possible solutions. In your early discussions a small victory may simply be a recognition that a problem exists. Only then can you move on to consideration of likely solutions. The focus must always be on your parent’s health, safety and happiness.
Open the parties to possibilities. If you, your siblings and parents each believe that there is one solution to a perceived problem–and it is his or her solution—you’ll make little progress. Be open to the consideration that more than one good option may exist, and it’s just a matter of finding one that works best for your parent and the family.
Take whatever time is necessary for everyone to get used to the idea that change is imminent. As we age, many of us tend to be increasingly risk-averse. Our sight, hearing and body may begin to fail, and the world around us starts to shrink. Familiarity is comforting and change is scary. So start out by simply exploring possible alternatives.
Many of us have discovered that convincing our parents to experiment with the idea of senior living (“Let’s drive over there for a few minutes just to see what it’s like”), rather than trying to steamroll the decision, pays off. Perhaps a visit can stimulate real interest that will in turn motivate a change. After you’ve had a visit or two to a senior facility, ask for impressions. What is it they want? What are their interests? What are their needs? Do they perceive that a move could improve their life?
Now, given what you learn, you are better prepared to determine the best way to proceed. Many residents of assisted living facilities tell us that they were staunchly opposed to a move until they were hospitalized and needed to recuperate in a transitional facility. It wasn’t a permanent move, so they discovered that they were pretty open to the experience. They learned, much to their surprise, how much they liked the environment. After the healing and the return home, it was actually the parent who initiated discussions about a permanent lifestyle change.
It’s said that lawyers never ask a question to which they don’t already know the answer. That may be exactly what you are doing. If you are blindsided and/or encounter seemingly insurmountable resistance, seek help. Third-party experts can be blended into the experience. Sympathetic strangers—clergy, experienced friends, geriatrics experts, compassionate health care workers—can defuse the situation and provide useful guidance.
Next Steps.
Now that you’ve got the conversation underway, what are the questions you’ll want to ask to prepare for the housing transition? Let’s start by examining the elder’s current living situation.
•“Mom, do you want to live where you are as long as you can? Are there some improvements to your house we should begin to make so this will be possible?”
•“I know you love your home, but even with the kids mowing the lawn and taking you shopping, are you finding the other chores more work than you want to tackle these days? What would you think about moving into a more manageable place—a condo or a smaller apartment–at some point?”
•“When you feel living at home is no longer a good option for you, would you want to live with me, or someone else in the family? Would some form of senior housing be an acceptable option for you? What do you know about senior housing, say, assisted living, and those kinds of options? Maybe we could make a list of the things that are most important to you and see if we could find a good match. Does that sound like a good idea?”
Turning to questions about health:
•“Dad, do you find you still have the energy to do the shopping, prepare meals, do laundry and personal care, and still continue to keep up the house and yard?”
•“Do you feel comfortable driving or taking public transportation to do the things you need to do?”
•“Are you having any trouble doing the exercises your doctor has recommended? Are you remembering to take your medications?”
•“Would you be willing to let us talk with your doctors about your health? Could we go with you to your next doctor’s appointment to find out more about your medications and any problems you’re having?”
•“Have you made any decisions about the kind of medical care you may want in the future? Would you want someone else to make these decisions for you if you are unable to do so for yourself? What are your thoughts about assistive devices—ventilators, feeding tubes, for example—to keep you alive? Do you have records of the decisions you’ve made? Where do you keep them?”
We know that the world is an imperfect place where many concerned adult children find themselves up against a brick wall in these situations. When they attempt to start the conversation, the response is something like this: “Oh, sweetheart, why do we have to talk about those kinds of things now?” Or the parent simply changes the subject or becomes really angry.
Put yourself in their shoes. You, too, would hate the idea of getting old or of having some disease ravage your perfectly good body–and you probably wouldn’t want to talk about it. So, don’t lecture, but don’t avoid the issues forever. If you decide to back off for the moment, that’s okay. Just don’t quit. Go at it again, on a different day, soon.
If you are in a crisis situation, you may not have the luxury of time. Get any help you can from your parent’s “influential circle”–compassionate health care providers, ministers, and friends–someone your parent will listen to.
During this struggle, remember that the only person you can change is you. Dad isn’t going to have a life-changing epiphany at his age. And if you continue to try to change him it will only frustrate both of you. Seek an accommodation that, if not perfect, is at least palatable and most important, one that you and your parent selected together.
And remember this, too: others have successfully navigated these rough waters. You’ll do so as well.
Laurence Harmon is a principal of http://www.greatplacesinc.com, a website dedicated to helping the Baby Boom generation, 76 million strong, and the largest in U. S. history, who are increasingly finding themselves responsible for their aging, often infirm, parents’ care while continuing to have responsibilities for their own children. The website provides comprehensive, timely information about senior housing, nursing homes, adult day care, and a host of other topics of interest for senior caregivers.
Assisted Living Is Seniors’ Top Long-term Housing Choice
February 7th, 2009Assisted living facilities are a good option for seniors who need ongoing help with personal care and typical daily activities, yet who wish to retain their independence to the maximum extent. Here’s more:
As Baby Boomers enter their retirement years, it’s inevitable that some might start to need assistance with day-to-day activities. But they’re understandably reluctant to forfeit their independence. If they have been accustomed to managing a business–or a family–they could have a difficult time acknowledging that they occasionally forget to take their medications, or even need help getting bathed and dressed. Because they don’t need daily medical care at this point, assisted living might be a good housing option.
What is an assisted living facility? These facilities provide care for seniors who need some help with activities of daily living yet wish to remain as independent as possible. They essentially serve as a middle ground between independent living and nursing homes.
Assisted living facilities aim to foster as much autonomy as the resident is capable of. Most of them offer 24-hour supervision and an array of support services, with more privacy, space, and dignity than many nursing homes—at a lower cost.
There are approximately 33,000 of these facilities operating in the U.S. today. The number of residents living in a facility can range from several to 300, with the most common size being between 25 and 120 individuals.
An assisted living facility helps seniors with personal care, such as:
• Bathing
• Dressing
• Toileting
• Eating
• Grooming
• Getting around
Daily contact with supervisory staff is the defining characteristic of an assisted living facility. Medical care is limited, but it is often possible to contract for some medical needs.
Here are the key characteristics of assisted living facilities:
Activities of daily living (dressing, personal care): Comprehensive assistance provided.
Community activities (social events, outings, golf, etc.): Some activities offered.
Community services (laundry, cleaning, etc.): Many / most services provided.
Health dervices (medications, nursing care): Some services provided; not skilled nursing, however.
Environment (personal freedom):Residents are somewhat independent.
Overall health (physical, emotional): Residents have average health problems.
A recent Prudential Insurance report found that the average daily cost for an assisted living facility is now more than $100, or $3,241/month.
Although the report examined both assisted living and nursing home costs, it found the largest increase in cost of care in assisted living, spiking about 13 percent since 2006.
By the year 2030, the number of Americans aged 65 and older is expected to reach more than 71 million, or almost 20 percent of the entire U.S. population.
As the population ages, of course, the need for care is projected to grow correspondingly. Not surprisingly, recent studies continue to show increases in the cost of long-term care throughout the country.
The Prudential findings are similar to those from this year’s Genworth Financial Cost of Care Survey, which can be found at http://www.communityed.com/blog/administrative-concerns/do-you-measure-up_05-12-2008.
The Genworth survey found that the national average monthly rate for assisted living housing is $3,008/month.
You can find more information about these studies and their findings at
www.communityed.com/blog/administrative-concerns/prudential-cost-of-care-report-assisted-living-rates-continue-climb_08-19-2008
Laurence Harmon is a principal of http://www.greatplacesinc.com, the leading provider of essential information for Baby Boomers, the generation that is becoming increasingly involved in their aging parents’ care.
Assisted Living, The Top Choice Of Infirm Seniors
February 7th, 2009A recent study conducted by the Coalition to Protect Choice in Senior Living found that an astounding 84 percent of Americans over 50 expect that, within the next 10 years, at least one member of their immediate family will move into a senior living community, and that nearly one-quarter of those over 65 anticipate that they will do so as well.
There’s more. More than one-half of younger Americans–Baby Boomers, 76 million in number, the largest generation in our history–believe that their own parents will be relocating from their single-family homes into a senior housing project within the decade.
As might be expected, the study found that cost and quality of care will be the most important factors as these Boomers and seniors evaluate the various long-term housing options.
Prospects will be very budget-conscious as they consider assisted living or nursing home care. They intend to keeps costs at a minimum. Fully 78 percent of the study’s respondents agreed with the statement, “It is difficult to find the quality you desire at the price you can afford.”
Here’s how prospective assisted living residents and their family members ranked the most important attributes for a facility:
76%: Personal care quality;
76%: Residents’ personal safety;
74%: Cleanliness; and
68%: Staff and management (57%) quality
Assisted living facilities are a relatively new housing phenomenon. Although they were extremely rare even ten or fifteen years ago, they’ve become the fastest-growing and most popular elderly residential product type. Although actual numbers are sketchy, an estimated one million seniors currently reside in approximately 40,000 assisted living facilities, as compared with only 600,000 who did so only ten years ago, when there were about one-quarter of these projects nationwide. And looking ahead, experts estimate that by the year 2020, 14 million of us will require this kind of housing, double the number who do so today.
Perhaps not surprisingly, as their popularity has grown, assisted living facilities have been subject to criticism because of the health and healthcare issues that some residents have experienced. The typical assisted living project provides private or semi-private rooms, meals and housekeeping services. Many of these facilities also provide some social activities.
What may be surprising to some, however, is the fact that, unlike nursing homes, only approximately one-half of assisted living facilities are staffed by registered nurses. A recent study in the Elder Law Journal, published by the Illinois College of Law, summarized the differences between assisted living and nursing home facilities:
“In contrast to assisted living facilities, nursing homes are subject to federal guidelines because they rely on Medicaid and Medicare funds. A second major difference between assisted living facilities and nursing homes is their respective costs. Assisted living facilities typically cost less than nursing homes. However, this cost (differential) is misleading because assisted living residents use private funds to pay for their expenses while eligible persons can use Medicaid to cover nursing home costs.”
The study surveyed the type and extent of state-level assisted living regulation. Unfortunately, many of these facilities had shortcomings in rules enforcement and routine inspections. The most glaring deficiency, however, was the lack of on-site training, which the study found was the case in many states.
Indeed, Maryland, one of the states critiqued in the study requires a mere three hours of training as a prerequisite to working in one of its assisted living projects. Perhaps as a consequence, patients in these facilities were found to have significant signs of neglect, including untreated bedsores and hypothermia.
As states increasingly wrestle to balance their budgets, it is likely that annual inspection of assisted living facilities will be a target for cost-cutting. In California, for example, as state that previously required annual inspections, now requires inspections only every five years. Alabama lawmakers recently slashed the budget for these inspections, reducing funding from $5.5 million to inspect 244 facilities in 2002 to $500,000 for 330 of these projects last year.
The purpose of the federal Nursing Home Reform Act in 1987 was to require some minimal level of service. In addition, it established a bill of rights for nursing home residents.
The Illinois study found that the law has favorably impacted the quality of nursing home life, including reduction in the use of physical and chemical restraints, as well as reducing hospitalization rates. The study concluded that extending federal regulation to assisted living facilities, and particularly, requiring improved personnel training, would be desirable.
On the other hand, Daniel R. Levinson, inspector general of the Department of Health and Human Services reports that, just last year, and despite the Nursing Home Reform Act cited above, more than 90 percent of nursing homes were cited for federal health and safety violations.
Indeed, nearly 20 percent of these facilities had deficiencies that, in the words of the inspector general, caused “actual harm or immediate jeopardy” to patients. These problems included infected bedsores, medication mix-ups, poor nutrition, and abuse and neglect of patients.
In fact, about 20 percent of the 37,150 complaints that were inspected, 39 percent were found to be valid and approximately 20 percent of them involved patient abuse or neglect.
There are approximately 15,000 nursing homes in the U. S., housing more than 1.5 million seniors. They’re typically inspected annually, and, to qualify for Medicaid and Medicare participation, they must meet federal standards. These federal programs, which cost more than $75 billion a year, cover the expenses for more than two-thirds of nursing home residents.
The inspector general’s report found deficiency rates varied widely, ranging from a high of 76 percent in Rhode Island to 100 percent in the District of Columbia, Alaska, Wyoming and Idaho.
Laurence Harmon is a principal of http://www.greatplacesinc.com, a web-based information source for Baby Boomers who are increasingly responsible for their aging parents’ needs–including housing, caregiving, legal and insurance issues, and many more.
Are Florida Nursing Homes Really Jails?
February 7th, 2009You’ve probably never heard of Charls Todd “Bud” Lee, although he was an award-winning photojournalist whose work has been published in “Life” magazine, “Esquire,” “The New York Times Magazine” and even “Rolling Stone.” His photo of a bleeding 12-year old boy in Newark, New Jersey, who’d been caught in the crossfire of a police shooting, graced the cover of “Life” magazine in July, 1967. Almost exactly 16 years later, however, Bud suffered a stroke that left him semi-paralyzed and landed him in a Florida nursing home.
It turns out that Florida law requires nursing home care for Medicaid recipients, rather than allowing them to live wherever they choose. Bud is still there, in the Community Care Center in Plant City, Florida, an involuntary resident, more than five years later–and he’s really angry.
Last September, Bud’s plight caught the attention of Matt Sedentsky, a writer for the Associated Press. Sedentsky’s subsequent September 21st article, arguing that Florida nursing homes, fearful of losing money, have successfully pressured politicians to make such alternatives as in-home health care difficult for Medicaid recipients to obtain.
He reported that Bud Lee has filed a lawsuit in federal court on behalf of the approximately 8,500 Floridians who are similarly institutionalized. As Bud succintly described his situation, “Most of the people come here to die, so you want to die. It is a prison. I can’t escape it.”
A recent study found that seniors fear moving into a nursing home and the loss of their independence far more than death. Indeed, according to the study commissioned by Clarity and the EAR Foundation, fully 89 percent of America’s elderly want to age in place, and will use adaptive technology to stay independent. Their Baby Boomer children, the study noted, are equally concerned about nursing home care for their parents, and they’re eager to support their parents in this quest.
More than one-quarter of the study’s respondents cited as a fear a loss of independence, which is closely aligned with the fear of nursing homes and assited living facilities. Moving from their home into a nursing facility is a fear of 13 percent of seniors, while a mere three percent of research study participants identified the fear of death.
These fears appear to be justified. A recent report by the Department of Health and Human Services found that about 17 percent of nursing homes had deficiencies that caused “actual harm or immediate jeopardy” to patients, including infected bedsores, medication mix-ups, poor nutrition, and patient abuse and neglect. In fact, approximately 20 percent of the complaints verified by federal and state inspectors involved abuse or neglect of nursing home patients.
Last May, the 18,000 residents of Albert Lea, Minnesota were shocked to learn that 15 residents of the Good Samaritan nursing home, all suffering with Alzheimer’s or dementia, had been verbally, emotionally and sexually abused by local high school girls who were working at the facility. The subsequent report by the Minnesota Department of Health quoted one employee as saying that “When (the students) would do these things, they would pull the curtain enough, so when they heard a door open, they could stop. They were quite sneaky about what they were doing. The ones they were targeting were those that have Alzheimer’s so bad, that they wouldn’t be able to say it or remember.”
The report found that the abuse involved spitting and putting fingers in mouths, poking breasts and nipples, touching and tapping genitals, sticking buttocks in faces, rubbing buttocks and penises, anal insertion, and restraining residents and teasing them.
Following investigation by state and local authorities, a 19-year old and an 18-year old were charged with gross misdemeanors, carrying a maximum penalty of one year in jail and a $3,000 fine for each count. One of the teens faces 11 charges; the other, 10, including abuse of a vulnerable adult by a caregiver, abuse of a vulnerable adult with sexual contact, disorderly conduct, and failing to report suspected maltreatment. Four of the others, all 17 at the time of the alleged abuse, were charged in juvenile court with failure to report maltreatment.
More than 1.5 million people live in the nation’s 15,000 nursing homes, which are typically inspected annually. They are required to meet federal standards as a condition of participating in Medicaid and Medicare, which cover more than two-thirds of their residents, at a cost of more than $75 billion a year.
Although there are obvious acts of nursing home abuse—long-term over-medication, for example–others are more subtle, or as in the Albert Lea situation described above, difficult to detect because of the dementia of the patient. Consequently, these cases can easily be overlooked by family members. Following are some indicators of abuse:
Bedsores or open wounds are common instances of neglect or abuse. Nursing home personnel often claim that bedsores are normal among frail or immobile seniors. Unfortunately, concerned family members are duped by these explanations, and their parents and loved ones suffer pain and sometimes die from these sores. Experts say that almost all bedsore cases are caused by abuse or neglect. Guidelines require nursing homes to move patients regularly and ensure that sheets and clothing are kept dry. Should a family member find a bedsore, insist that the victim is moved to a medical facility for treatment.
Unexplained bruises, cuts, burns or fractures are often evidence that residents are being dropped or abused by staff personnel. This often occurs when the senior is in a medicated condition. Family members are urged to ask questions to get clarification about these situations, and vague or questionable responses often indicate abuse.
Torn, bloody or stained garments are the best evidence of sexual abuse, which, as described above in the Albert Lea story, frequently occurs in nursing homes, where victims are often medicated or suffer from Alzheimer’s or dementia.
Refusal to allow contact with a resident, or unexplained delays in making the resident available for a visit, indicate underlying abuse, that is, the nursing home staff is attempting to intimidate or prevent the victim’s reporting of the abuse or neglect.
Modifications to the resident’s financial documents, including wills and trusts, are cause for suspicion, particularly if these changes occur abruptly or if the resident cannot adequately explain why they occurred. Such changes suggest that the resident may have been coerced or threatened.
Each of these warning signs should spur action among family and friends, including reports to police. Suspicions of sexual or physical abuse require changing nursing facilities, as well as police involvement. Nursing home residents, who are frequent targets of abuse, nonetheless have civil rights that need to be protected, most often, unfortunately, by concerned family members and friends.
Laurence Harmon is a principal of Great Places Inc., found at http://www.greatplacesinc.com, the leading website providing advice to Baby Boomers, 76 million strong, who are increasingly responsible for their aging parents’ care. The Great Places website offers a national search engine for senior housing, including nursing homes, assisted living facilities, and many other senior housing types.
Elder Abuse In Nursing Homes
February 7th, 2009Albert Lea, Minnesota, wouldn’t make anybody’s Top Ten list of places where this sort of thing could happen. Bigger cities like Chicago, New Orleans, Detroit, maybe, but not Albert Lea. Nestled against the Interstate, 90 miles south of the Twin Cities, with a population headed south from the current 17,500, it’s a place that Minnesotans used to remember as the last pit stop before the Iowa border.
Not any more. Last May 16th, the Albert Lea “Herald” broke the shocking story that 15 residents of the Good Samaritan nursing home, all suffering with Alzheimer’s or dementia, had been verbally, emotionally and sexually abused by local high school girls who were working at the facility.
The subsequent report by the Minnesota Department of Health quoted one employee as saying that “When (the students) would do these things, they would pull the curtain enough, so when they heard a door open, they could stop. They were quite sneaky about what they were doing. The ones they were targeting were those that have Alzheimer’s so bad, that they wouldn’t be able to say it or remember.”
The report found that the abuse involved spitting and putting fingers in mouths, poking breasts and nipples, touching and tapping genitals, sticking buttocks in faces, rubbing buttocks and penises, anal insertion, and restraining residents and teasing them.
Following investigations by state and local authorities, a 19-year old and an 18-year old were charged with gross misdemeanors, carrying a maximum penalty of one year in jail and a $3,000 fine for each count. One of the teens faces 11 charges; the other, 10, including abuse of a vulnerable adult by a caregiver, abuse of a vulnerable adult with sexual contact, disorderly conduct, and failing to report suspected maltreatment. Four of the others, all 17 at the time of the alleged abuse, were charged in juvenile court with failure to report maltreatment.
The case drew attention from the national media, including the “Today” show on NBC, and the Associated Press circulated the story widely. Typing “Albert Lea Nursing Home” into the Google search engine produces more than 45,000 hits. How could teenagers from this nondescript Minnesota town emotionally, physically and sexually abuse these harmless, helpless people-and then, as the story claimed, laugh about it? Unheard of, you say? Hardly.
Seven months later, another lurid story of elder abuse stunned the residents of tiny Montevideo, Minnesota. In this case, according to a state department of health report, the nursing home aide stuck her finger in the cancerous vulva of a resident until she screamed, dropped another resident on her bed from four feet away feet, and tossed on the floor stuffed toys that a third resident thought were her children. The report also revealed that the aide gave lap dances to two male residents and bared her breasts to one or more of them. Sadly, as a recent “Newsweek” magazine article reported, charges against the aide are unlikely “because the victims’ dementia limits their ability to testify.”
Indeed, people suffering from dementia or Alzheimer’s are perfect victims, and not merely the most likely targets for abuse in a nursing home or assisted living facility: family members can abuse them as well. As the population ages, there is a corresponding increase in the number of those who can be victimized because of their age, vulnerabilities or familly relationships.
Perhaps in response to the appalling cases of nursing home abuse in her home state, Ramsey County (St. Paul) Attorney Susan Gaertner recently announced the creation of an elder abuse task force to prosecute these cases.
In making her announcement, prosecutor Gaertner cited recent examples of the kinds of elder abuse the unit will target:
A legally blind woman asked her bank to put her son’s name on her personal checks so that he could pay her bills. Instead, the son drained her bank account of more than $45,000. The woman learned of the theft only when her phone was disconnected, her medical insurance was disconnected, and her Meals on Wheels deliveries stopped.
Another woman gave her daughter power of attorney to pay her nursing home bills when a series of strokes left her disabled. The daughter bilked her mother of almost $22,000.
An elderly man, disabled by Parkinson’s Disease, had assets that disqualified him for Medicaid coverage of his nursing home expenses. He enlisted his nephew to select a Realtor to sell his home and pay his bills. Within two months, the nephew had looted the accounts and failed to pay the costs of the nursing home. The uncle was evicted and left homeless. The nephew could not be located.
The St. Paul elder abuse unit will comprise two specially-trained prosecutors to review the facts and make charging decisions; four trial attorneys to prosecute the cases; and a victim/witness advocate. The focus will be on crimes involving physical and sexual abuse of the elderly, financial exploitation and scams aimed at the elderly.
Prosecutor Gaertner recognizes the impact that changing demographics will have on her caseload, particularly the spike in population that will result from aging Boomers. “We will be seeing dramatic growth in this vulnerable population,” Gaertner says. “The baby boomers are going to be moving into this age group. They tend to be wealthier and live longer than the generations before and so we anticipate more and more of these kinds of cases.
A second, equally powerful reason for creating the unit is the deepening recession that has devastated the American economy. As Gaertner observes, “There’s going to be more and more of a temptation to exploit the financial resources of the elderly when their offspring or other younger relatives are losing their jobs and facing other economic problems.”
Although Gaertner cannot forecast the potential number of cases that will be developed by this new unit, she says “our sense is that we’re talking about dozens of cases in the coming year.”
The unit’s attorneys also will work with police, the St. Paul city attorney’s office, social service agencies and advocacy groups. An important component will be public education and awareness, Gaertner notes.
During her service as Hennepin County attorney, Senator Amy Klobuchar established an elder abuse unit, which continues to focus on financial exploitation, identity theft and abuse cases.
Gaertner asks, “Is there anything worse than stealing Grandma’s money so she can’t get medication or eat properly? That’s why we feel so strongly about doing this work.”
Laurence Harmon is a principal of http://www.greatplacesinc.com, the leading provider of essential information for Baby Boomers, the generation that is becoming increasingly involved in their aging parents’ care.
Seniors Hardest Hit By Housing Bust
February 7th, 2009“We are 71 and 75 years of age. Both of us have major health issues that could render us unable to help ourselves as we are able to do now, so it would be wise to move with that in mind. We think we should be considering finding an assisted living place. Or maybe we could live in a small house that is close to a doctor’s offices and services. But the problem is going to be selling our home in today’s market. We have a lovely brick home sitting on five acres in Northern Arkansas. It is actually prime property, but how can we sell it in this awful market? This is our predicament. We need to relocate right away while we’re still able to move ourselves out. Can you help us, please?”
The continuing downturn in the U. S. housing market has impacted many of us, but it’s perhaps been the most painful for those who are least able to wait for an upswing: some of the nation’s seniors, whose health and personal circumstances have made them desperate to make a near-term lifestyle change.
The current housing market has especially hit seniors like Arnie and Sarah. They’re looking for help, and they need it right away. These two really need to move into a senior facility, but they realize they’ll need to sell their current home and use the sales proceeds to be able to do so. They also realize that, as seniors, they’ll have to personally pay for most of their housing needs: federal programs, such as Medicare, are unavailable for these purposes, and Medicaid is an option only when the applicant’s personal assets have been exhausted.
Arnie and Sarah, however, are most likely unaware that the costs of many retirement communities—even those with few frills–can be staggering. For example, a recent study found that the average monthly cost of a nursing home stay is nearly $5,000! This means that, for most aging and disabled seniors, their ability to move will be contingent upon the sale of a single-family home at prices that are unavailable in the current market.
Facing what is perhaps the worst housing market since the Great Depression, most seniors will find it almost impossible to find buyers for their outdated homes. And, with the current glut of unsold houses in many markets, even reducing the asking price may not solve the problem.
The clogged housing market, coupled with the over-building of seniors’-oriented housing in many metropolitan areas, has resulted in rising vacancies in these facilities—particularly in those markets where the single-family housing market is most distressed. Tampa, Florida, to cite only one example, is experiencing a 12 percent vacancy in senior housing units, up dramatically from four percent from the previous year.
Some savvy retirement-home marketers who are trying to do business in these over-built areas have turned to real estate agents to help their prospective residents to sell their existing homes. The problem with this strategy, of course, is that elders’ homes are frequently antiquated or need substantial repairs and renovations in order to make them marketable. Outdated wallpaper, old appliances and poor maintenance, all characteristic of these houses, often deter buyers. In other words, these homes, which their owners logically considered would be their guarantee of worry-free living virtually indefinitely, are literally unmarketable as-is.
“The idea is that a senior has built up equity in [a] house, and this assures that they can have care for the rest of their lives,” says Larry Minix, of the American Association of Homes and Services for the Aging.
A 2008 survey by the American Seniors Housing Association found that nearly a quarter of seniors haven’t made any home improvements during at least the last decade, and nearly one-half reported that they won’t spend money to enhance the value of their property in order to attract a buyer.
Even worse, for many seniors, just as the real estate bust has depreciated the value of their primary asset–their homes–the value of their retirement accounts has recently plummeted as well.
What about Arnie and Sarah? They’re just two more victims of the disastrous sub-prime mortgage mess that has devastated the entire American economy.
Laurence Harmon is a principal of http://www.greatplacesinc.com, a web-based information source for Baby Boomers who are increasingly responsible for their aging parents’ needs. The Great Places website offers a national search engine for senior housing, including nursing homes, assisted living, adult day care, and many more seniors’-oriented housing types.
Should Seniors Choose Adult Day Care?
February 6th, 2009Senior citizens fear moving into a nursing home and the loss of their independence far more than death.
A recent study commissioned by Clarity and the EAR Foundation found that 89 percent of American seniors want to age-in-place, that is, continue to live in their homes as long as possible, and are willing to use adaptive technology that will allow them to maintain their independence.
The study found that their children—Baby Boomers born between 1946 and 1964, now faced with the responsibility of dealing with the housing care and other needs of their aging parents—share the same concerns and are willing to support their parents’ efforts. This means, of course that many of the more than 76 million Boomers have assumed the caregiving role for their aging parents. Most are unprepared for the cost, emotional toll, and health issues they face as caregivers.
Seniors rated loss of independence (26 percent) and moving from their home into a nursing home (13 percent) as their greatest fears. Death was listed as a fear by only three percent of the respondents questioned for the research study. “These findings tell us that, above all else, older Americans value their ability to live independently,” notes Peter Bell, president of the National Aging in Place Council.
Adult Day Care is a particularly attractive solution that can provide comfort to aging seniors, as well as their Baby Boomer caregivers. It’s true that these caregivers may be somewhat reluctant to use adult day care services because these services are unfamiliar to them, or because the elder is hesitant to try something new. The benefits of adult day careadult day care are these:
• Participants benefit from socializing with others and receiving the kinds of care services they need.
• Equally important, the caregiver benefits by getting a break from caregiving duties while knowing that their loved one is in good hands.
The fact is, of course, is that because life expectancy is continuing to rise, many, if not all of us may need assistance as we age. Help of all kinds is becoming increasingly available, and an especially valuable option is adult day care. It’s specifically designed for older adults who can no longer manage independently, or who are isolated and lonely.
What is an adult day care center? Adult day care is a planned program of activities designed to promote aging seniors’ well-being by means of social and health-related services. Adult day care centers typically operate during weekday daytime hours, offering a safe, supportive, cheerful environment. Nutritious meals that can accommodate special diets are typically included, along with an afternoon snack.
The centers can be public or private, non-profit or for-profit. The intent of an adult day center is primarily two-fold:
• To provide the elderly an opportunity to get out of the house during the day, and to receive mental and social stimulation; and
• To give the elder’s caregiver with a much-need break, which can be used to attend to other responsibilities or to rest and relax.
The National Adult Day Services Association (NASDA) estimates that there are approximately 4,000 adult day care centers operating nationwide. The proliferation of centers over the past two decades corresponds to what NASDA believes is the “mushrooming demand for home and community based services” to meet the needs of a rapidly-escalating elder population.
Good candidates for adult day care are seniors who:
• Can benefit from the friendship and functional assistance a day care center offers,
• May be physically or cognitively challenged but do not require 24-hour supervision,
• Are in the early stages of Alzheimer’s disease.
Adult day dare center participants need to be mobile, with the possible assistance of a cane, walker or wheelchair; in most cases, they must also be continent.
Adult day care is different than “adult day health care.” The latter usually requires a physician-performed health assessment as a precondition to admission into the program. Adult day health centers, which typically use the term “Adult Day Health Care” (ADHC) in their names, often provide physical, occupational, and speech therapy. ADHCs are usually staffed with a registered nurse, as well as other health professionals. There is a third type of day care that provides social and health services specifically for seniors with Alzheimer’s or a related type of dementia.
Services provided by adult day care centers. The mission of these centers is to maintain and build upon seniors’ skills, knowledge, and their particular abilities and strengths. Typical activities are these:
• Arts and crafts;
• Musical entertainment;
• Mental stimulation games;
• Stretching or other gentle exercise;
• Discussion groups;
• Holiday and birthday celebrations; and
• Local outings.
Some centers offer programs that include children and animals. Indeed, recent research has found that the availability of animals in these environments provide the following benefits:
• Improved sense of purpose and fulfillment.
• Reduced feelings of loneliness and isolation.
• Lowered blood pressure and cholesterol levels.
• Increased survival among heart-attack victims who own dogs.
• Improved blood circulation.
• Slowed loss of bone tissue.
One Australian study revealed that pet owners typically visit the doctor fewer times and use less medication; recover more quickly from surgery and illness; and deal better with stressful situations. Pets also have been found to relax us, entertain us and open up opportunities for socializing.
Besides recreational activities, some adult day care centers provide transportation to and from the center, social services including counseling and support groups for caregivers, and health support services such as blood pressure monitoring and vision screening.
Benefits of adult day care. The benefits of adult day care can be substantial and significant. Here are some examples.
• A safe, secure environment to spend the day;
• Enjoyable and educational activities;
• Improvement in mental and physical health;
• Enhanced level of independence;
• Socialization and peer support; and
• Nutritious meals and snacks.
When to opt for an adult day care center. According to ElderCare Online, you should seriously consider using adult day care when a senior:
• Can no longer structure his or her own daily activities;
• Is isolated and wants companionship;
• Can’t be safely left alone at home; or
• Lives with someone who works outside the home or who is frequently away from home for other reasons.
Finding the right adult day center for your family’s needs. The National Adult Day Services Association (NADSA) recommends you start by asking yourself what specific services both elder adult and caregiver most need.
• Are social activities the primary need?
• Is there a need for assistance with walking, eating or medications?
• Is mental stimulation required? Exercise?
• As a caregiver, do you need support? Some free time? Help with transportation?
The answers to these questions will help you determine which of the three main types of adult day care centers (social, health-focused, and Alzheimer’s/dementia oriented) will best serve you.
There are numerous references and resources that can help locate adult day care centers in your area, including http://www.greatplacesinc.com. In addition, you can also try:
• Your family doctor
• Local social services or health department
• Mental health centers
• Local senior center
• Area Agency on Aging (Call 1-800-677-1116 for the AAA in your area)
• Yellow Pages listings under Adult Day Care, Aging Services, Senior Citizens’ Services, and similar categories.
When you phone the center(s) you’ve decided to consider, ask the following questions:
• Who owns or sponsors the agency?
• How long has it been operating?
• Is it licensed or certified? (If required in your state)
• What are the days and hours of operation?
• Is transportation to and from the center provided?
• Which conditions are accepted (e.g., memory loss, limited mobility, incontinence)?
• What are the staff’s credentials, and what is the ratio of staff to participants?
• What activities are offered? Are there a variety of individual and group programs?
• Are meals and snacks included? Are special diets accommodated?
Next, spend a day at the center that sounds best to you, so that you can get a “feel” for the people and environment. Be sure to bring a site checklist with you. You may wish to go back a few times to see whether your experience on different days confirms your initial impressions.
Costs and financial assistance for adult day care. The cost for an adult day care center ranges from $25 to $70 or more per day, depending on where you live and the services provided (e.g., meals, transportation, nursing supervision). Professional health care services will mean higher fees. Many facilities offer services on a sliding fee scale, meaning that what you pay is based on your income and ability to pay.
Although Medicare does not cover adult day care, Medicaid will pay most or all of the costs in licensed adult day health care settings and in Alzheimer’s focused centers for participants with very low income and few assets. Be sure to ask about financial assistance and possible scholarships.
Private medical insurance policies sometimes cover a portion of adult day care costs when licensed medical professionals are involved in the care. Long-term care insurance may also pay for adult day services, depending on the policy. Additionally, dependent-care tax credits may be available to you as caregiver.
Laurence Harmon is a principal of http://www.greatplacesinc.com, a web-based information source for Baby Boomers who are increasingly responsible for their aging parents’ needs–including housing, caregiving, legal and insurance issues, and many more.
I Need To Move Into Senior Housing, But I Can’t Sell My Home!
January 20th, 2009“We are 71 and 75 years of age. Both of us have major health issues that could render us unable to help ourselves as we are able to do now, so it would be wise to move with that in mind. Although we prefer to remain in our own living quarters, we think we should be considering finding an assisted living place. Or maybe we could live in a small house that is close to a doctor’s offices and services. But the problem is going to be selling our home in today’s market. We have a lovely brick home sitting on five acres in Northern Arkansas. It is actually prime property, but how can we sell it in this awful market? This is our predicament. We need to relocate right away while we’re still able to move ourselves out. Can you help us, please?”
The continuing downturn in the U. S. housing market has impacted many of us, but it’s perhaps been the most painful for those who are least able to wait for an upswing: some of the nation’s seniors, whose health and personal circumstances have made them desperate to make a near-term lifestyle change.
The current housing market has especially hit those seniors, like Arnie and Sarah, who recently wrote us here at http://www.greatplacesinc.com. They’re looking for help, and they need it right away. These two really need to move into a senior facility, but they realize they’ll need to sell their current home and use the sales proceeds to be able to do so. They also realize that, as seniors, they’ll have to personally pay for most of their housing needs: federal programs, such as Medicare, are unavailable for these purposes, and Medicaid is an option only when the applicant’s personal assets have been exhausted.
Arnie and Sarah, however, are most likely unaware that the costs of many retirement communities—even those with few frills–can be staggering. For example, a recent study found that the average monthly cost of a nursing home stay is nearly $5,000! This means that, for most aging and disabled seniors, their ability to move will be contingent upon the sale of a single-family home at prices that are unavailable in the current market.
Facing what is perhaps the worst housing market since the Great Depression, most seniors will find it almost impossible to find buyers for their outdated homes. And, with the current glut of unsold houses in many markets, even reducing the asking price may not solve the problem.
The clogged housing market, coupled with the over-building of seniors’-oriented housing in many metropolitan areas, has resulted in rising vacancies in these facilities—particularly in those markets where the single-family housing market is most distressed. Tampa, Florida, to cite only one example, is experiencing a 12 percent vacancy in senior housing units, up dramatically from four percent from the previous year.
Some savvy retirement-home marketers who are trying to do business in these over-built areas have turned to real estate agents to help their prospective residents to sell their existing homes. The problem with this strategy, of course, is that elders’ homes are frequently antiquated or need substantial repairs and renovations in order to make them marketable. Outdated wallpaper, old appliances and poor maintenance, all characteristic of these houses, often deter buyers. In other words, these homes, which their owners logically considered would be their guarantee of worry-free living virtually indefinitely, are literally unmarketable as-is.
“The idea is that a senior has built up equity in [a] house, and this assures that they can have care for the rest of their lives,” says Larry Minix, of the American Association of Homes and Services for the Aging.
A 2008 survey by the American Seniors Housing Association found that nearly a quarter of seniors haven’t made any home improvements during at least the last decade, and nearly one-half reported that they won’t spend money to enhance the value of their property in order to attract a buyer.
Even worse, for many seniors, just as the real estate bust has depreciated the value of their primary asset–their homes–the value of their retirement accounts has recently plummeted as well.
What about Arnie and Sarah? They’re just two more victims of the disastrous sub-prime mortgage mess that has devastated the entire American economy.
Laurence Harmon is a principal of http://www.greatplacesinc.com, a web-based information source for Baby Boomers who are increasingly responsible for their aging parents’ needs–including housing, caregiving, legal and insurance issues, and many more.
Introduction To Assisted Living, Seniors’ Top Long-term Housing Choice
January 9th, 2009Assisted living facilities are a good option for seniors who need ongoing help with personal care and typical daily activities, yet who wish to retain their independence to the maximum extent. Here’s more:
As Baby Boomers enter their retirement years, it’s inevitable that some might start to need assistance with day-to-day activities. But they’re understandably reluctant to forfeit their independence. If they have been accustomed to managing a business–or a family–they could have a difficult time acknowledging that they occasionally forget to take their medications, or even need help getting bathed and dressed. Because they don’t need daily medical care at this point, assisted living might be a good housing option.
What is an assisted living facility? Assisted living facilities provide care for seniors who need some help with activities of daily living yet wish to remain as independent as possible. They essentially serve as a middle ground between independent living and nursing homes.
Assisted living facilities aim to foster as much autonomy as the resident is capable of. Most of them offer 24-hour supervision and an array of support services, with more privacy, space, and dignity than many nursing homes—at a lower cost.
There are approximately 33,000 of these facilities operating in the U.S. today. The number of residents living in a facility can range from several to 300, with the most common size being between 25 and 120 individuals.
An assisted living facility helps seniors with personal care, such as:
• Bathing
• Dressing
• Toileting
• Eating
• Grooming
• Getting around
Daily contact with supervisory staff is the defining characteristic of an assisted living facility. Medical care is limited, but it is often possible to contract for some medical needs.
Here are the key characteristics of assisted living facilities:
Activities of daily living (dressing, personal care): Comprehensive assistance provided.
Community activities (social events, outings, golf, etc.): Some activities offered.
Community services (laundry, cleaning, etc.): Many / most services provided.
Health dervices (medications, nursing care): Some services provided; not skilled nursing, however.
Environment (personal freedom):Residents are somewhat independent.
Overall health (physical, emotional): Residents have average health problems.
A recent Prudential Insurance report found that the average daily cost for an assisted living facility is now more than $100, or $3,241/month.
Although the report examined both assisted living and nursing home costs, it found the largest increase in cost of care in assisted living, spiking about 13 percent since 2006.
By the year 2030, the number of Americans aged 65 and older is expected to reach more than 71 million, or almost 20 percent of the entire U.S. population.
As the population ages, of course, the need for care is projected to grow correspondingly. Not surprisingly, recent studies continue to show increases in the cost of long-term care throughout the country.
The Prudential findings are similar to those from this year’s Genworth Financial Cost of Care Survey, which can be found at http://www.communityed.com/blog/administrative-concerns/do-you-measure-up_05-12-2008.
The Genworth survey found that the national average monthly rate for assisted living housing is $3,008/month.
You can find more information about these studies and their findings at
www.communityed.com/blog/administrative-concerns/prudential-cost-of-care-report-assisted-living-rates-continue-climb_08-19-2008
Laurence Harmon is a principal of http://www.greatplacesinc.com, the leading provider of essential information for Baby Boomers, the generation that is becoming increasingly involved in their aging parents’ care.