A new report from the AARP says meeting the upcoming demands for workers in Long Term Care will be difficult without recruiting and retaining more workers. The report said that " low wages, low prestige and dangerous working conditions will have to improve to expand the number of workers who fill difficult tasks associated with LTC." At the website for the American Association of Retired Persons you can read their article titled Long Term Care Trends, Comparing Long Term Care in Germany and the United States: What Can We Learn From Each Other? The research paper is by Mary Jo Gibson, AARP Public Policy Institute, and Donald L. Redfoot, AARP Public Policy Institute.
The article said the United States has made progress in (1) shifting from institutions to home based care (2) "strong civil rights protections for people with disabilities, including protections against unnecessary institutionalization "(3) regulations and monitoring that has resulted in improvements in care quality and (4) innovation in areas such as assisted living.
In Germany progress has been made in (1) universal coverage based on disability not income, (2) consumer choice (3) support for family caregivers (4) relieving fiscal pressures on government while maintaining LTC spending similar to U.S. (5) and "developing uniform standards of quality."
Showing posts with label long term care. Show all posts
Showing posts with label long term care. Show all posts
Wednesday, October 31, 2007
Friday, September 28, 2007
Fewer in Nursing Homes - Home Health Services Increasing
I read two articles showing trends that are related. "Fewer Seniors Live in Nursing Homes" at USA Today says that about 7.4% of seniors 75 years old and older lived in nursing homes in 2006, down from 8.1% in 2000 and 10.2% in 1990. The other article, titled "In Home Health Care Services Increasing" at Medical News Today discusses "a new kind of medical practice is flourishing nationwide that offers to go where the patients are...to treat ailments."
In 2006 less than 16% of the population aged 85 years or more lived in nursing home facilities, according to the article in USA Today. These statistics refer to nursing homes, but do not include assisted care facilities. A nursing home, or skilled nursing facility, has licensed nurses while an assisted care facility does not require employees to be medically licensed.
According to Met Life Insurance Company said the cost of a nursing home runs from $67,000 to $100,000.
The article said the average resident in a nursing home runs out of money within 6 months and must go on Medicaid, according the CEO of the National Association of Area Agencies on Aging, Sandy Markwood. She explained this will bankrupt the individuals and the Medicaid system.
An article with a related trend discussed the increase in home health care services. At Medical News Today the article discusses a company called Inn House Doctor, founded by Walter Krause, which has 40 doctors who provide appointments in the home.
Rich Kellerman, president of the American Academy of Family Physicians, said in the article, "We have that perfect storm. The current system doesn't work well...More doctors are coming up with home practice models."
In my area, San Luis Obispo County, California, USA, there are not very many doctors who make house calls, but there are a few who are available and specialize in house calls. As a caregiver I have assisted seniors several times who are on programs with local doctors who make house calls. For a frail senior, when leaving the home is very difficult, having a doctor come to the home makes a big difference. I have also known doctors who make calls for appointments with seniors at residential care facilities.
Fewer seniors in nursing homes and an increase in home health care, and in home care (nonmedical assistance) reflect growing trends. Community based services continue to grow, and the majority of seniors say they prefer to avoid going to a nursing home.
With the aging of the population, and boomer generation coming along next, the needs and preferences of the future elderly seniors will continue to change senior care trends.
In 2006 less than 16% of the population aged 85 years or more lived in nursing home facilities, according to the article in USA Today. These statistics refer to nursing homes, but do not include assisted care facilities. A nursing home, or skilled nursing facility, has licensed nurses while an assisted care facility does not require employees to be medically licensed.
According to Met Life Insurance Company said the cost of a nursing home runs from $67,000 to $100,000.
The article said the average resident in a nursing home runs out of money within 6 months and must go on Medicaid, according the CEO of the National Association of Area Agencies on Aging, Sandy Markwood. She explained this will bankrupt the individuals and the Medicaid system.
An article with a related trend discussed the increase in home health care services. At Medical News Today the article discusses a company called Inn House Doctor, founded by Walter Krause, which has 40 doctors who provide appointments in the home.
Rich Kellerman, president of the American Academy of Family Physicians, said in the article, "We have that perfect storm. The current system doesn't work well...More doctors are coming up with home practice models."
In my area, San Luis Obispo County, California, USA, there are not very many doctors who make house calls, but there are a few who are available and specialize in house calls. As a caregiver I have assisted seniors several times who are on programs with local doctors who make house calls. For a frail senior, when leaving the home is very difficult, having a doctor come to the home makes a big difference. I have also known doctors who make calls for appointments with seniors at residential care facilities.
Fewer seniors in nursing homes and an increase in home health care, and in home care (nonmedical assistance) reflect growing trends. Community based services continue to grow, and the majority of seniors say they prefer to avoid going to a nursing home.
With the aging of the population, and boomer generation coming along next, the needs and preferences of the future elderly seniors will continue to change senior care trends.
Thursday, September 27, 2007
Utah Lawmakers Propose Freeze of Funds for Long-Term Care Facilities
I just read yet another article from one of this week's newspapers about long term care. Author James Thalman writes about elder care in the Deseret Morning News , Sept. 20, 2007, in an article titled "At Home Elder Care Touted" and a subtitle "Lawmakers propose freeze on state funds for long-term care facilities". This week articles in the The New York Times and the San Luis Obispo Tribune also focused on long term care.
The article says that Utah senior advocates, government agency representatives, and care providers want a freeze put on government funds spent on public funds that are used for long term care facilities.
Alan Ormsby, director of the state division of Aging and Adult Services is quoted in the article. He said, "This is simply recognizing that the traditional skilled nursing as a care center model of caregiving is on the way out...When you can provide safe and more effective services at home and at a sixth the cost for most seniors, we have to at least begin moving in that direction."
The article goes on to describe the transition that has been taking place for 10 years in Utah, where a variety of in-home services, and day care have been used as part of a nursing home placement diversion program.
I was puzzled by this article. In the article it also said the "average cost of in-home services was $3,700, the average nursing home cost is $72,000." The amount of $3,700 for a year's worth of in-home services seemed pretty low to me, and some other things were also puzzling.
There were eight comments listed that readers had posted. One comment said that "it cost a lot more than $3,700 to care for a loved one at home". I agree, and am wondering what is included in the $3,700.
Another said, "Has anyone given any thought to how much of a burden this puts on the families?"
The article says that Utah senior advocates, government agency representatives, and care providers want a freeze put on government funds spent on public funds that are used for long term care facilities.
Alan Ormsby, director of the state division of Aging and Adult Services is quoted in the article. He said, "This is simply recognizing that the traditional skilled nursing as a care center model of caregiving is on the way out...When you can provide safe and more effective services at home and at a sixth the cost for most seniors, we have to at least begin moving in that direction."
The article goes on to describe the transition that has been taking place for 10 years in Utah, where a variety of in-home services, and day care have been used as part of a nursing home placement diversion program.
I was puzzled by this article. In the article it also said the "average cost of in-home services was $3,700, the average nursing home cost is $72,000." The amount of $3,700 for a year's worth of in-home services seemed pretty low to me, and some other things were also puzzling.
There were eight comments listed that readers had posted. One comment said that "it cost a lot more than $3,700 to care for a loved one at home". I agree, and am wondering what is included in the $3,700.
Another said, "Has anyone given any thought to how much of a burden this puts on the families?"
New York Times Series - Nursing Homes: More Profit, Less Nursing
I just read an article in The New York Times dated Sept.23, 2007 titled "At Many Homes, Less Nursing, More Profit" that describes what happened when a group of investment firms purchased about 48 nursing homes. This article happens to appear during the same week when a front page article in my local paper, the San Luis Obispo Tribune asked "Is the Quality of Elder Care in Jeopardy".
The San Luis Obispo Tribune also had articles on "Finding Quality in Long Term Care" and another titled "County's Worst Residential Homes Are Cited After Repeat Violations."
The New York Times article describes the steps the investors took at one of the homes purchased to reduce costs The residents at the Habana Health Center, in Tampa, Florida saw changes that meant they were "worse off" according to the article.
The article says the number of registered nurses was cut by one-half and budgets for supplies, resident activities and services fell. A series of incidents showed that the residents were suffering, according to the regulators.
The New York Times says the investors did well financially but the situation for the residents went downhill. Regulators "repeatedly warned that staff levels were below mandatory minimums."
The article describes the situation when nursing homes are purchased by investors, costs are reduced, profits go up, and the homes are sold for a profit.
People who are thinking of moving to a nursing home, or of moving a relative to one, need to find out what the options will be if they are not satisfied with the quality of the care. If the home is purchased by investors who reduce spending on staff, supplies and services, will the residents be able to move to another home?
An important question to answer is always "How many aides are on duty for each resident? Not just how many aides are on the schedule. After employees have called in with excuses to be absent, which happens especially often on weekends, how many aides are physically present for each resident?"
Other important questions include the following.
What does the local long term care ombudsman have to say about complaints and violations at the facility? Does the ombudsman, who investigates complaints and resolves them, recommend this nursing home?
Can the staff communicate well enough to read, understand, and follow directions for care and to write notes to keep track of changes?
Can the staff communicate well enough to provide quality companionship and interaction? Is the atmosphere conducive to good emotional health for your loved one, and do you feel comfortable when you visit there?
If a number of staff members cancel, as may happen on a weekend, is there a supply of trained replacement staff available at short notice or does the reduced staff just take on more residents per person?
If you visit the facility, especially on a weekend night, does the staff appear short handed and to be rushing from resident to resident?
If your loved one needs assistance, how long is the waiting time? How much time does the staff have to assist your loved one? Is the assistance accomplished in a hurry?
The San Luis Obispo Tribune also had articles on "Finding Quality in Long Term Care" and another titled "County's Worst Residential Homes Are Cited After Repeat Violations."
The New York Times article describes the steps the investors took at one of the homes purchased to reduce costs The residents at the Habana Health Center, in Tampa, Florida saw changes that meant they were "worse off" according to the article.
The article says the number of registered nurses was cut by one-half and budgets for supplies, resident activities and services fell. A series of incidents showed that the residents were suffering, according to the regulators.
The New York Times says the investors did well financially but the situation for the residents went downhill. Regulators "repeatedly warned that staff levels were below mandatory minimums."
The article describes the situation when nursing homes are purchased by investors, costs are reduced, profits go up, and the homes are sold for a profit.
People who are thinking of moving to a nursing home, or of moving a relative to one, need to find out what the options will be if they are not satisfied with the quality of the care. If the home is purchased by investors who reduce spending on staff, supplies and services, will the residents be able to move to another home?
An important question to answer is always "How many aides are on duty for each resident? Not just how many aides are on the schedule. After employees have called in with excuses to be absent, which happens especially often on weekends, how many aides are physically present for each resident?"
Other important questions include the following.
What does the local long term care ombudsman have to say about complaints and violations at the facility? Does the ombudsman, who investigates complaints and resolves them, recommend this nursing home?
Can the staff communicate well enough to read, understand, and follow directions for care and to write notes to keep track of changes?
Can the staff communicate well enough to provide quality companionship and interaction? Is the atmosphere conducive to good emotional health for your loved one, and do you feel comfortable when you visit there?
If a number of staff members cancel, as may happen on a weekend, is there a supply of trained replacement staff available at short notice or does the reduced staff just take on more residents per person?
If you visit the facility, especially on a weekend night, does the staff appear short handed and to be rushing from resident to resident?
If your loved one needs assistance, how long is the waiting time? How much time does the staff have to assist your loved one? Is the assistance accomplished in a hurry?
Dr. Mike Magee - Trends Toward "Home Centered Health Care"
The trend toward Home Centered Health is discussed at Health Commentary by blogger, physician, author, environmentalist, speaker and healthcare leader Dr. Mike Magee. He says the U.S. Administration on Aging has a study that shows 81% of the people over the age of 50 would like to avoid nursing home care in their future. Home Centered Healthcare for seniors as they age is a trend he says will enable them to spend their elderly years at home instead of in a facility.
Dr. Magee predicts that the home health industry, already an area of enormous growth, will skyrocket. Improvements to the home such as grab bars in showers and stair lifts will make homes adapted to the needs of elders. New technology will enable people who are at home to have their health monitored.
He predicts that part of the system of Home Centered Health will be having a home health manager, usually an informal caregiver in the family. Treatment and care will someday take place often at home by physician led, nurse directed networks.
The growth in the number of home care agencies, which provide paid caregivers, is part of the trend that I see for Home Centered Health. Already people are putting together a team of licensed medical personnel from home healthcare agencies and a team of caregivers to enable elders to remain in their home. Making the home safe, getting a medical alert system, and adapting the home are already trends that have arrived.
As mentioned in the study above, people prefer to stay in their homes. Long-term care insurance, mentioned in a recent post, is another trend, and can be used to pay for a facility or for home care, thus providing a choice.
Reverse mortgages, which can be refinanced again later, are on the rise as people use them to pay for care, or other expenses, in their elder years.
We can already see many of the trends Dr. Magee predicts taking shape. He says that with patient empowerment, a home health manager (often a family caregiver) and a team of home health professionals the Home Centered Health Care trend will be in the not so distant future.
I will add that today already many people adapt their homes to be suitable for later years. Going from the hospital to the home, with care from licensed medical personnel, such as nurses, physical therapists, and home health aides, is already often a part of the system.
Family caregivers or paid caregivers are also part of the team. The team leader is the family caregiver who acts as the home health manager or coordinator.
Dr. Magee predicts that the home health industry, already an area of enormous growth, will skyrocket. Improvements to the home such as grab bars in showers and stair lifts will make homes adapted to the needs of elders. New technology will enable people who are at home to have their health monitored.
He predicts that part of the system of Home Centered Health will be having a home health manager, usually an informal caregiver in the family. Treatment and care will someday take place often at home by physician led, nurse directed networks.
The growth in the number of home care agencies, which provide paid caregivers, is part of the trend that I see for Home Centered Health. Already people are putting together a team of licensed medical personnel from home healthcare agencies and a team of caregivers to enable elders to remain in their home. Making the home safe, getting a medical alert system, and adapting the home are already trends that have arrived.
As mentioned in the study above, people prefer to stay in their homes. Long-term care insurance, mentioned in a recent post, is another trend, and can be used to pay for a facility or for home care, thus providing a choice.
Reverse mortgages, which can be refinanced again later, are on the rise as people use them to pay for care, or other expenses, in their elder years.
We can already see many of the trends Dr. Magee predicts taking shape. He says that with patient empowerment, a home health manager (often a family caregiver) and a team of home health professionals the Home Centered Health Care trend will be in the not so distant future.
I will add that today already many people adapt their homes to be suitable for later years. Going from the hospital to the home, with care from licensed medical personnel, such as nurses, physical therapists, and home health aides, is already often a part of the system.
Family caregivers or paid caregivers are also part of the team. The team leader is the family caregiver who acts as the home health manager or coordinator.
Wednesday, September 26, 2007
Things You Might Not Know About Reverse Mortgages
These days some seniors say they seem to receive up to fifteen pieces of mail a day advertising reverse mortgages. It's true the ads are everywhere. I'm not on the market for a reverse mortgage, but today I learned some new information when I talked to a Reverse Mortgage Consultant at a Workshop at the Central Coast Seniors Center, Oceano, California.
Suzie Smith, of the Pismo Beach area Wells Fargo, provided statistics showing the leap in the number of reverse mortgages today compared to 5, 10 or 15 years ago. With the aging of the population, and with needs for long-term care in the home or in a facility, medical bills, or other needs, the number of reverse mortgages will continue to climb.
Funds from a reverse mortgage can be used for any expenditure, including food, paying off bills, or taking a long-dreamed-of vacation before getting any older. Sometimes someone uses the money to buy a second home.
A reverse mortgage can be refinanced again later, providing it is worthwhile and not just "churning".
For every reverse mortgage it is a requirement to see an outside mortgage counselor. This third party independent counselor can provide seniors with guidance.
The FHA sets lending limits for each county, with the higher limits being in the most expensive counties. If the property has a mortgage on it, the reverse mortgage can pay that off in addition to providing funds for other expenses.
To get a reverse mortgage someone must be 62 years old, and live in the house as a primary residence.
Suzie Smith, of the Pismo Beach area Wells Fargo, provided statistics showing the leap in the number of reverse mortgages today compared to 5, 10 or 15 years ago. With the aging of the population, and with needs for long-term care in the home or in a facility, medical bills, or other needs, the number of reverse mortgages will continue to climb.
Funds from a reverse mortgage can be used for any expenditure, including food, paying off bills, or taking a long-dreamed-of vacation before getting any older. Sometimes someone uses the money to buy a second home.
A reverse mortgage can be refinanced again later, providing it is worthwhile and not just "churning".
For every reverse mortgage it is a requirement to see an outside mortgage counselor. This third party independent counselor can provide seniors with guidance.
The FHA sets lending limits for each county, with the higher limits being in the most expensive counties. If the property has a mortgage on it, the reverse mortgage can pay that off in addition to providing funds for other expenses.
To get a reverse mortgage someone must be 62 years old, and live in the house as a primary residence.
Long Term Care Insurance - A Reality for Boomers Planning Ahead
As the population ages members of the baby boomers generation are looking at Long Term Care Insurance as they plan ahead for the future. Today's family caregivers will be tomorrow's elderly seniors. A recent article by Gail Sheehy asked the question "Who will take care of the caregivers?"
Long Term Care Insurance is one of the ways the Boomers generation can take care of themselves.
I attended a presentation on Long Term Care Insurance today, held at the Central Coast Seniors Center, Oceano, California, with State Farm of Pismo Beach representative John Stobbe providing information.
Along with insurance for life, property, autos, disability, and medical people are adding long-term care insurance now to help prepare to age in their home if they wish or to pay for assistance in a facility.
Did you know the following:
Medicare Supplement Insurance does not cover long-term care expenses.
A Long-Term Care Insurance policy helps cover costs of long-term care in the setting you prefer, either home care or community care.
It helps you to avoid dependence on family and friends.
It preserves your assets.
Additional benefits included the following:
Coverage for a communication system in the home to summon medical help in an emergency.
Caregiver training for a family member or friend to provide the care you need if you choose to remain at home.
Respite Care to provide relief for a primary caregiver at home.
Long Term Care Insurance is one of the ways the Boomers generation can take care of themselves.
I attended a presentation on Long Term Care Insurance today, held at the Central Coast Seniors Center, Oceano, California, with State Farm of Pismo Beach representative John Stobbe providing information.
Along with insurance for life, property, autos, disability, and medical people are adding long-term care insurance now to help prepare to age in their home if they wish or to pay for assistance in a facility.
Did you know the following:
Medicare Supplement Insurance does not cover long-term care expenses.
A Long-Term Care Insurance policy helps cover costs of long-term care in the setting you prefer, either home care or community care.
It helps you to avoid dependence on family and friends.
It preserves your assets.
Additional benefits included the following:
Coverage for a communication system in the home to summon medical help in an emergency.
Caregiver training for a family member or friend to provide the care you need if you choose to remain at home.
Respite Care to provide relief for a primary caregiver at home.
Sunday, September 23, 2007
Tribune Article: Finding Quality Long Term Care
A third article relating to eldercare in today's San Luis Obispo Tribune is titled "How To Find a Quality Assisted Living Facility". To learn more about assisted living and long term care options for the elderly contacting your local ombudsman service is recommended. The article is relevant for people living outside of the area as well, because issues of finding quality care are universal.
Additional resources for information about long term care options and quality are listed and costs are discussed.
In San Luis Obispo County residential care homes are described as averaging $4,000 per month or more. A residential care home differs from a larger facility because the residential care home often has 10 beds or less and may be in an adapted house.
The residential homes often offer a warm, friendly family style environment. But, another article in the Tribune explains they may only be inspected once in five years unless there are complaints. Some of the homes are recommended as fantastic and others have had serious complaint issues.
The growth of the number of small residential long term care homes in the county shows the popularity of these smaller facilities. People who are looking for long term care can ask questions about the type of training the staff has received, the ratio of aides to residents, and the emergency response procedures. They can also ask questions regarding medication logbooks, daily care notes, care plans, and the amount of experience that the supervisiors and aides have had with caregiving.
If an employee calls in sick, what plan does the home have to provide for staffing the position?
Other questions might include asking how long a resident has to wait for help, and how much time per shift does the aide have for each person. Is this the aide's first job providing personal care assistance?
There is also the option of hiring paid caregivers from an agency to provide assistance in the senior's own home. Independent caregivers are available also, but as discussed in other posts, insurances, background checks, payroll and supervision will be the responsibility of the client.
Additional resources for information about long term care options and quality are listed and costs are discussed.
In San Luis Obispo County residential care homes are described as averaging $4,000 per month or more. A residential care home differs from a larger facility because the residential care home often has 10 beds or less and may be in an adapted house.
The residential homes often offer a warm, friendly family style environment. But, another article in the Tribune explains they may only be inspected once in five years unless there are complaints. Some of the homes are recommended as fantastic and others have had serious complaint issues.
The growth of the number of small residential long term care homes in the county shows the popularity of these smaller facilities. People who are looking for long term care can ask questions about the type of training the staff has received, the ratio of aides to residents, and the emergency response procedures. They can also ask questions regarding medication logbooks, daily care notes, care plans, and the amount of experience that the supervisiors and aides have had with caregiving.
If an employee calls in sick, what plan does the home have to provide for staffing the position?
Other questions might include asking how long a resident has to wait for help, and how much time per shift does the aide have for each person. Is this the aide's first job providing personal care assistance?
There is also the option of hiring paid caregivers from an agency to provide assistance in the senior's own home. Independent caregivers are available also, but as discussed in other posts, insurances, background checks, payroll and supervision will be the responsibility of the client.
Friday, September 14, 2007
Free Senior Living Consultations RE: Long Term Care
Making decisions about moving from home to a facility can be made easier by using a consultant who has experience and information about the facilities in your area. Matching the needs of elderly seniors with the type of care and setting offered by facilities can avoid making a mistake that is regretted after moving. To read about consultants and what they offer you can go to seniorlivingconsultant.com or search for consultants in your own area on the internet.
After seniors have made a deposit at a long term care facility and moved from home it can be disapppointing to find that the facility is not a good match for their needs and preferences. The consultants I spoke to said they match seniors with care facilities. They will visit the facilities with you so you can make an informed decision. The consultation is free because the facilities pay a finders fee to the consultants.
Because they have current information about available space at the long term care facilities, and familiarity because they visit them regularly, the consultants can give you their impressions and recommendations.
You can check the internet and phone book for your area. In San Luis Obispo County, California, there is a company called Senior Living Consultants. They are located at 3164 S. Broad St., Suite 114, San Luis Obispo, CA 93401. The number is (805) 545-9501. Their Santa Barbara office is located at 18 W. Micheltorena, Suite C, Santa Barbara, CA 93101, and the numnber is (805) 963-6045. Whether you live in this area or elsewhere you can get some ideas about what a consultant can offer by going to seniorlivingconsultants.com.
After seniors have made a deposit at a long term care facility and moved from home it can be disapppointing to find that the facility is not a good match for their needs and preferences. The consultants I spoke to said they match seniors with care facilities. They will visit the facilities with you so you can make an informed decision. The consultation is free because the facilities pay a finders fee to the consultants.
Because they have current information about available space at the long term care facilities, and familiarity because they visit them regularly, the consultants can give you their impressions and recommendations.
You can check the internet and phone book for your area. In San Luis Obispo County, California, there is a company called Senior Living Consultants. They are located at 3164 S. Broad St., Suite 114, San Luis Obispo, CA 93401. The number is (805) 545-9501. Their Santa Barbara office is located at 18 W. Micheltorena, Suite C, Santa Barbara, CA 93101, and the numnber is (805) 963-6045. Whether you live in this area or elsewhere you can get some ideas about what a consultant can offer by going to seniorlivingconsultants.com.
Tuesday, August 14, 2007
Facilities Offer Assistance from Independent to Total Care
You can visit http://www.longtermcarelink.net/ for information about a variety of options for care.
A wide range of personal care assistance can be found at assisted care facilities. For example, independent living can offer living in a seperate apartment, condo, or studio with meals available at a central dining room.
Partial assisted living can offer personal care attendants who are available at the call of a button. A skilled nursing facility can offer licensed nurses 24 hours per day.
Some facilities have a variety of options at one location. If someone starts out in the independent living section a move can be made later to a section that will provide more assistance.
Small facilities or private homes that have been converted to assisted care might have half a dozen seniors or so and personal care aides in a home style setting.
A wide range of personal care assistance can be found at assisted care facilities. For example, independent living can offer living in a seperate apartment, condo, or studio with meals available at a central dining room.
Partial assisted living can offer personal care attendants who are available at the call of a button. A skilled nursing facility can offer licensed nurses 24 hours per day.
Some facilities have a variety of options at one location. If someone starts out in the independent living section a move can be made later to a section that will provide more assistance.
Small facilities or private homes that have been converted to assisted care might have half a dozen seniors or so and personal care aides in a home style setting.
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