Health care is constantly evolving and there is always room for improvement. Home care continues to grow in part due to the conditions in nursing homes. It is well known that nursing homes are severely understaffed and as stated in a previous blog, elder abuse is increasing. This is happening across the USA, but what is happening in other countries?
China plans to restructure their elderly care system by 2025. Wang Songsong of China Daily reports: “A recent survey revealed 99% of elderly in Beijing polled prefer home-based care and less than 1% would opt for institutional care.” China enacted a one-child policy in 1980 and didn’t end the policy until 2015, which means for over three decades families were very small. Small families mean less people available to care for their aging family members. The Health World reports that many nursing homes in China are currently unaffordable for many elderly due to small pensions and public options are often not suitable or desirable to live in. However, new facilities being built will be done in accordance with government standards and current facilities will be renovated. According to China’s National Health Commission, there are 280 million people living in China that are at least 60 years old, this number is expected to almost double by 2035. Currently, there are 8 million beds available in nursing homes, but by 2035 there will need to be at least 40 million beds to accommodate the growing elderly population. By 2025, China would like to have improved basic elderly care services and better resources for the vulnerable aging population. Guidelines for improving elderly care include creating a list of basic elderly care services based on economic, social development level, and financial factors. Services will include material assistance and nursing/caregiving and will be required to provide visiting services for those living alone and for families facing financial hardship. Each province is also required to “improve the basic pension system service and implement a long-term care security,” reports The Health World. Additionally, due to the growing popularity among Beijing’s oldest citizens, Beijing is piloting a home-based model in certain neighborhoods with the aim of expanding into all urban regions. Home care has a place in many countries and is becoming increasingly desired among the elderly all over the globe. If you have any questions about home care for your loved ones, you can contact us. You can also check out the rest of our blog posts on our website. Written by Madison Chalmers
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Imagine this: Your elderly loved one begins experiencing memory loss and symptoms of dementia. You and your family decide that it would be best for this person to transition into a nursing home since they no longer able to care for themselves independently. You and your family believe that they will have all their needs met including having three meals, having medical care, and most importantly, safety and security.
However, that is not the case for an increasing number of elderly people in nursing homes in New Jersey, as many are being attacked by other residents. NJ.com explores this issue further. In the dementia unit of a South Plainfield nursing home, multiple residents were injured by other residents; one ultimately died from the injuries. Another example can be found at a Camden County nursing home, where a resident had multiple altercations with others. And another incident occurred in a nursing home in Burlington Country in January 2021, when a nursing aide walked into a “scene of violence.” Violent outbursts among residents are becoming less rare, and many perpetrators have caused injury to more than one resident. As more people are showing signs of late-stage dementia, the more incidents are occurring. For example, in 2022, incidents nearly doubled, and have steadily increased since 2020. Families looking into nursing homes, for their loved ones will have a difficult time finding information on resident abuse. “The data does not show up on federal nursing home report cards,” according to NJ.com. “Often, incidents of violence involve people whose mental acuity has been ravaged by dementia and may go unreported unless a family speaks out — or if someone dies.” Dementia is an incurable disease that shrinks the parts of the brain responsible for personality and mood. This causes those with dementia to become very paranoid and believe that everyone is out to get them, which ultimately, leads to them becoming aggressive and sometimes violent. To prevent residents from experiencing aggressive and sometimes violent episodes, it is important to ensure all their needs are being met, separating them from other residents when they start to show aggressive behaviors, and utilizing anti-anxiety medication as a last resort. It is also important to note that even though most nursing homes are operating at about 75% capacity (5% lower than pre-pandemic), many are severely understaffed. This means that there is a higher patient-to-staff ratio than in the past. Home care is becoming increasingly popular for a myriad of reasons. One benefit of home care is that you will know who exactly who will be with your loved one. And they will be at their home which means that there are no other residents to worry about. If you have any questions about home care for your loved ones, you can contact us. You can also check out the rest of our blog posts on our website. Written by Madison Chalmers
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We have all heard someone refer to their pets as their “fur-babies.” Pets become part of the family, so what happens to pets when their owners get older? Often, the elderly are forced to give up their pets without knowing what will happen to them.
There is a lot of research that confirms the benefits of owning a pet including:
Margie Maccoll of Noosa Today explains the purpose of Companion Animal Network (CAN) in Australia. The mission of CAN is to gain support from the “federal government to include pet support in its home care packages and is encouraging more residential care providers to welcome pets with their owners.” CAN has found that less than 10% of all in-home care providers, in Australia, offer a pet friendly service. This is where CAN comes in; CAN wants more home care providers to begin offering pet friendly services to preserve the bond the elderly have with their pets. In doing so, it will create a smoother transition for older adults receiving extensive care. The goal is to have the Australian Federal Government acknowledge what pet owners need and want in the In-Home Aged Care Program. Currently, many older adults give up most of their belongings -- including pets -- to move into residential care facilities. However, there is one residential care provider that is proving how beneficial pets can be in the lives of the elderly. Lifeview, a facility in Victoria, allow residents to have pets under certain policies. Residents or their families must care for the pet, the pet must remain in the resident’s room, and not disturb other residents. When the resident is no longer able to care for the pet, other arrangements must be made. Maccoll explains that there are older adults that are refusing to transition to residential care solely because they are unable to bring their pets with them. If you’ve ever had a pet, you understand how attached you can become and how difficult it would be to have to rehome them. CAN is making it so more older adults will be able to stay united with their pets for as long as possible, even when they need care. Although the article written by Maccoll is focused on Australia, it can be easily translated to the United States. According to the American Veterinary Medical Association, millions of Americans own pets. For example, about 38% of households have dogs and about 25% have cats. It is important to remember that older adults go through enormous amounts of changes, especially when they are no longer able to care for themselves independently. Allowing them to keep their animals may allow for an easier transition. Additionally, in the USA there is the Senior Paw Project which focuses on “Honoring the bond between caregivers and their pets, the Senior Paw Project provides critically needed pet food, veterinary care assistance and foster/respite care to senior pet owners struggling to keep or care for their animals.” If you have any questions about home care for your loved ones, you can contact us. You can also check out the rest of our blog posts on our website. Written by Madison Chalmers
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Would you give your baby adult medication or any drug that you weren’t aware of how it would impact your baby? I think it’s safe to assume that most people would say no. Medications impact everyone differently and some medications are safe for some and not others.
In a recent article on US News, Payton Sy explains how medications can affect the elderly. She explains that as we age, the way the body metabolizes medications changes, which can lead some medications to become stronger and others weaker. Sy explains that the following are reasons why medications react differently in seniors:
Medications that are typically less effective in the elderly include:
Medications that typically have stronger effects in the elderly include:
The reason medications are less effective in the elderly is due to the stomach getting less acidic as people get older; certain medications require an environment with a higher acidity to be metabolized properly. Medications that have stronger effects typically act on the central nervous system. Long term use of these medications can lead to:
Sy also explains that certain health conditions can present differently in older adults. For example, a symptom of a urinary tract infection can be confusion instead of painful urination. I sat down with Twin Lights Home Care Case Manager Donna Chalmers to discuss her thoughts on this topic. I began by asking Donna how common it is for adverse drug affects and health conditions to present differently in the elderly. “Health conditions present differently in older adults a lot. It’s very common.” Donna says. “Many clients I have worked with have gone to the hospital for a UTI without realizing that is what it was.” Donna continues by explaining how families will be concerned when their loved one begins to act confused and agitated with no explanation. “They bring their loved one to the hospital and are told they have an untreated UTI,” Donna explains. “It’s so common, but when your loved one begins acting differently, thinking they have a UTI is not the first thing that comes to mind.” At first, families can be very confused as to why certain health conditions present drastically different in their older loved ones. However, after experiencing it the first time, families and caregivers are better equipped and educated to deal with such things. When caring for older adults and administering medication, it is important to have open communication with the individual’s doctor(s) and to monitor any side effects. If you have any questions about home care for your loved ones, you can contact us. You can also check out the rest of our blog posts on our website. Written by Madison Chalmers
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More than 7 million people in the United States are living with Alzheimer’s disease and other types of dementia. In 2022 alone, Medicare spent over $1 billion dollars on people with Alzheimer’s disease, and Medicaid spent over $60 billion dollars on nursing home care.
Currently, there is no cure for Alzheimer’s disease. When thinking about treatments for Alzheimer’s disease and other forms of dementia, many think about drug therapies. However, Judith Graham of the Philadelphia Inquirer explains that there are dozens of programs that can improve the lives of people living with memory loss diseases. Judith Graham states that these programs are not just support groups, but “comprehensive dementia care” services that seek to assess needs, link families to resources, and create care plans. These programs are not widely known or broadly available due to low funding, especially compared to what the budget is for drug therapies. Additionally, there are low numbers of health care professionals trained in dementia care. In 2021, more than 11 million unpaid and untrained Americans provided more than 80% of the care to family members and friends with dementia. These caregivers have proven to have a higher burden of psychological and physical stress when compared to properly trained caregivers. However, access to “comprehensive dementia care” programs can assist untrained caregivers with caring for their loved ones. Research has also shown that these programs:
The hope in the future is for comprehensive dementia care programs to be widely accessible for those that need them. Currently, dementia advocates are lobbying Medicare to launch a pilot project to test a new model to pay for one of these programs. Additionally, the Alzheimer’s Association is advocating for a pilot project to be adopted “Medicare-wide” where comprehensive dementia care programs would receive between $175 and $225 per month for each patient enrolled. Which over 10 years would save Medicare and Medicaid about $21 billion dollars. A few examples of current programs for dementia caregivers include:
Caring for the elderly and those with dementia is no easy task. Caregiving can be mentally and physically exhausting, especially with how little resources are available. If you have any questions about home care for your loved ones, you can contact us. You can also check out the rest of our blog posts on our website. Written by Madison Chalmers
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There truly is no place like home, which is why many elderly people are opting to stay at home rather than go to a skilled nursing facility. Recently, former president Jimmy Carter chose to begin home hospice care which has become the more a popular choice among aging Americans. Over the last several years WellSky, a healthcare technology company, has seen a 20% increase in referrals for home care. Ron Southwick of Chief Health Care Executive reports that “From January 2019 through September 2021, hospitals saw a 10% increase in home referrals and an 18% drop in referrals to skilled nursing facilities.” Lissy Hu, of WellSky, attributes the growing popularity of home care to the pandemic. During the pandemic, many people were hearing horror stories about things happening in nursing homes. Many people do not want to be away from their families. However, Hu emphasizes the importance of care coordination. In a nursing home, patients can have all their health concerns addressed in one place. When opting for care in the home, it is important to have all members of the treatment team on the same page. Typically, primary care doctors have been used for referrals to other doctors and hospitals, but in the future primary care doctors will need to have more communication with community and home-based services. Hu describes home health services as “very fragmented” components in healthcare delivery. The hope is in the future, primary care providers will fill in the gaps. Additionally, hospitals are going to play a greater role in ensuring that patients opting to receive care in their homes will be able to have all their needs met. Jimmy Carter starting that he is starting home hospice care does not come as a surprise with the growing number of people opting to stay in their homes. There are many moving parts to this (i.e., who will be providing care, how will it be paid for?). However, more acute care programs at home are being developed and companies are beginning to focus more on at-home care (i.e., CVS Health acquiring Signify Health). If you have any questions about home care for your loved ones, you can contact us. You can also check out the rest of our blog posts on our website. Written by Madison Chalmers
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Millennials want to take care of their parents, but at what cost? An article recently posted on Yahoo News explains the financial burden that is placed on millennials taking care of their aging parents.
Living through multiple recessions and bouts of inflation, most millennials are not ready for the extra cost of providing for their parents. The burden of providing financially for aging parents as well as acting as caregivers has left one-third of workers ages 62-66 having no retirement funds. “A Goldman Sachs report found that 79% of millennials expect caregiving to undermine their own progress toward retirement goals, while 72% predict that they will lose earnings and career momentum due to caregiving,” reported Yael Bizouati-Kennedy of Yahoo News. Financial planner Lemar Williams suggests that families get together once a year to discuss finances and plans for aging parents and how to manage their care and bills. RBC Wealth Management suggests five big expenses that come with aging:
Goldman Sachs also found that a third of millennials, on average, have only saved a little over $3,000 to cover the costs of care for their parents. Even with long-term care insurance, the financial burden can be quite impactful on individual goals (i.e., buying a house). With the rising costs of living and home care, it is important to be prepared for the inevitable. Millennials can help prepare themselves, for taking care of their parents, by having discussions with their parents regarding the expectations for financial support. Additionally, for those millennials that have had to begin providing for their parents, 43% reported that they had to take time off work and 64% stopped adding to their retirement fund and had gone through some of their savings. Bizouati-Kennedy explains that millennials can help themselves while assisting with their parents’ expenses by maintaining a good credit score. You can check out the rest of the blog posts on our website and contact us if you have any questions about home care for your loved ones. Written by Madison Chalmers
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I recently read an article on Home Health Care News regarding self-directed care. Patrick Filbin, the author of the article, talks about the pros and cons of self-directed care.
Pros typically include the following:
Cons include the following:
Afterwards, I spoke with Twin Lights Home Case Manager Donna Chalmers regarding her thoughts on where self-directed care fits in home health care. “One of the biggest challenges that families face when taking an aide private is finding a relief aide or someone to take over when the original aide needs time off,” says Donna. Donna explained that with self-directed care, she believes it would be difficult for families to manage their caregiver, even if the person were someone they knew well. Donna continued, “Unforeseen circumstances happen all the time. Your mother is relying on you for care, but maybe you got a flat tire on your way; now your mother is without care. What do you do?” Donna went on to clarify that when utilizing an agency, for your home care needs, it will always be the agency’s responsibility to find coverage if an aide is unable to come to work. There is more security when using an outside resource. Filbin explains that “self-directed care can sometimes lack the resources provided through a traditional setup.” “Just because you need care, doesn’t mean you should lose your autonomy or dignity,” explains Donna. A study conducted at the University of Kansas, found that the self-directed care model focuses on self-determination and choosing care to suit individual needs. Donna pointed out that there is “a science” to matching aides with clients. “It is vital to match the personalities of clients and aides well,” says Donna. “The goal is for the client to have as much control as possible and not to make them feel like they don’t have a say in what’s going on.” Filbin believes that self-directed care is going to continue to grow in home health care. However, it is believed that state regulations will need to become stricter to prevent fraud. Donna sheds light on how it may be comforting to family members to have a caregiver that they know well but warns about burn-out and coverage. You can check out the rest of the blog posts on our website and contact us if you have any questions about home care for your loved ones. Written by Madison Chalmers
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I recently read an article in the New York Times depicting how to make a caregiver plan so that it is ready when needed. Lynya Floyd, the author, describes a couple with a childless friend that needed end-of-life care, and the process was made easier by already having an established plan. The plan’s purpose would be to designate who would cook meals, do laundry, coordinate healthcare, and keep him company.
It is recommended that the caregiving plan include answers to the following questions:
However, even the most detailed caregiving plans will require additional effort to succeed. The New York Times article explains a situation in which a family member was discussing hiring a home health aide but experienced resistance from the ones who needed the care. Maria P. Aranda, a professor of social work and the executive director for the Edward R. Roybal Institute on Aging at the University of Southern California, told the New York Times that “the preferences, likes, and dislikes of the person receiving care should be at the forefront.” I can recount an experience that a close friend had gone through when her grandmother became ill. My friend’s mother became the power of attorney over my friend’s grandmother. From there, they had several conversations about how to continue forward as my friend’s grandmother’s condition worsened. My friend and her mother had to make the difficult decision to move the grandmother in with them, which initially upset the grandmother. I remember my friend telling me she was concerned about all the decisions being made and how they would impact her grandmother and her well-being. Floyd discusses ways that can springboard conversations about creating a caregiver plan. Firstly, Floyd suggests starting with goals and identifying how your loved one would like to be best supported. Secondly, Floyd explains how there will be a need for more than one conversation and how important it is to remember that everyone is on the same team and wants what is best for the one needing care. When having these conversations, it is important to remember the five questions stated above and designate who will be prepared to gather the information needed and implement the plan. You can check out the rest of the blog posts on our website and contact us if you have any questions about home care for your loved ones. Written by Madison Chalmers
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I started paying attention to statistics and studies on elder care more than five years ago, when my mother was showing signs of dementia and no longer was able to manage life at her condominium in Highlands.
The numbers were scary then. They’re even scarier now. An excellent article in the Wall Street Journal highlights the plight of “sandwich-generation” caregivers: men and women -- mostly women -- who simultaneously are caring for young children and elderly parents who no longer can perform “activities of daily living” such as preparing meals and bathing. The number of Americans shouldering such a burden has swollen to 9 million, according to the Journal. The article points to a number of demographic trends that help explain how we got here. Women are having children later in life. People are living longer, and more are developing Alzheimer’s disease and other forms of dementia. Families are smaller, increasing the burden on the “sandwich generation.” “All these trends are converging and intensifying the demands on those caring for generations on either side of them,” Journal reporter Clare Ansberry writes. A recent study by the National Alliance for Caregiving found most such caregivers are in their 30’s, 40’s and 50’s -- at the peaks of their careers both as professionals and parents. They devote an average of 22 hours a week to caring for an elderly parent, even as they work an average of 36 hours a week, not to mention the time spent raising their children. “It’s not hard to see how we are being squeezed and stretched like never before,” said Sarita Gupta, co-founder of the support group Caring Across Generations. And it’s only going to get worse. Consider that the first baby boomers will turn 80 in 2026. Consider, too, that about 60% of Americans 65 and older have at least two chronic health conditions, according to the Centers for Disease Control and Prevention. “Old age is very different today than it was 15 or 20 years ago,” said Anne Tumlinson, who started the support group Daughterhood.org. “Medical intervention keeps people alive long past the point when they can take care of themselves.” The Journal article profiles a number of women and men who are simultaneously raising children and caring for elderly parents -- cases that painfully illustrate the predicament so many of us are in. One example is Deanna Bautti, a 37-year-old small-business owner who drives to her father’s apartment twice a day to make sure he is fed and dressed. Because her toddler Roman accompanies her, Ms. Bautti tries to time the visits around his naps and meal times. “I feel very torn between my child and my dad,” she told the Journal. According to the article, one in three “sandwich caregivers” live in the same home with the parent who needs help. While that may be true nationally, the number is probably far smaller in wealthier areas such as Monmouth County, where many residents commute to high-pressure jobs in and around New York City. In many ways, the pressures on caregivers can be even greater under those circumstances. The Journal piece also powerfully illustrates the boundless love people bring to juggling their responsibilities as parents, professionals and adult children of an ailing mother or father. “My mom was mentally ill and dependent on me the entire time I was bringing up my three kids,” one “sandwich-generation” caregiver said. “I didn’t realize this until years later, but the life-affirming and loving messages my kids got from watching my husband and me care for someone taught them the really big lessons in life -- like the meaning of love. We all learned and grew from the experience.” If you’re a “sandwich caregiver,” the Journal offers some useful advice. Among the most important points: 1. Set boundaries: Be clear about what you can and can’t do and say no when you have to. 2. Prioritize: Drop non-essentials from the list and make sure the essentials really are that. 3. Enlist help: Ask relatives, friends and neighbors for help. Family members who can’t help with primary care can research support options and help manage finances or pay for housekeeping. 4. Plan: Caregiving can stretch into decades. Look into respite care, adult day care and in-home care. If you want to explore home-care options, Twin Lights Home Care is here to help. Written by T.J. Foderaro |
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February 2020
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