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If you?re acting as the caregiver for your aging or disabled parent, then you will probably notice the small changes in your parent before anyone else. Whether it is misplacing keys or forgetting names of people and places, or more noticeable changes in your parent?s personality or lifestyle, could you distinguish the signs between Alzheimer?s disease and dementia? Oftentimes forgetfulness and eccentric behavior is simply blamed on growing old, but how can you be sure?

Experienced home health care workers and family members of individuals suffering from Alzheimer?s can testify to the life-altering effects of the disease. Though the early stages of Alzheimer?s could in fact be mistaken for dementia, or even adverse side effects of medications, the incidences of forgetfulness will increase as Alzheimer?s begins to take its toll on your loved one. In the early stages, you may also observe significant changes in your parent?s personality or increased moodiness.

Alzheimer?s is a disease that progresses over time effecting your parent?s thought and intellect functions, ranging from forgetting how to perform simple daily tasks to experiencing difficulty in communicating with others. There are also certain noticeable changes in your parent?s personal hygiene and living environment that you should be aware of, not only in order to make a correct and early diagnosis, but also to ensure your parent?s safety.

In the last stages of Alzheimer?s, 24-hour supervision and complete care is usually required. This is especially the case if your parent becomes extremely anxious, has the mobility to wander away, or can no longer physically take care of him or herself. While a patient suffering from Alzheimer?s typically lives for six to eight years from the diagnosis to death, advanced or prolong cases may range from less than two, to over 20 years.

Dementia, on the other hand, is not a disease and does not take such a toll on an individual. Dementia is defined as a significant loss of memory capacity. Although providing care to a parent with dementia may prove to be a daunting task, it is usually less involved than caregiving to an Alzheimer?s care recipient.

There are several factors that can contribute to dementia. Aging is among the top factors. Dementia may also occur due to the symptoms of certain diseases or other physical illnesses. If your parent is suffering from memory loss, it?s important to visit a physician for an accurate diagnosis, especially if the loss of memory is due to another underlying health issue.

Acting as a caregiver to your aging parent can certainly be overwhelming and stressful at times, especially when you?re trying to determine if your parent?s memory loss and mood changes are due to age-related dementia or the early signs of Alzheimer?s.

There are many helpful resources and agencies that can provide you with information on how to recognize serious illness. Educating yourself as the caregiver not only provides your parent with the best care possible, but also reduces the worry and frustration you may experience as a caregiver.

Dana Sanders is the author of ‘Becoming Your Parent’s Caregiver’, a downloadable manual written out of her own experience which provides advice for the children of an aging or disabled parent. Please visit http://www.caregivingaparent.com for information to help you care for your parent.

I hope this article can help other people who are in the position of helping a loved one achieve mobility and their pride back. My mother, unlike my father when he was still with us, would stop at nothing to continue her daily walks and outdoor excursions. For the last 7 years my mother has been using a cane to walk as many mobility impaired seniors do. Her life was put on hold last year when she had a fall and broke her hip which threatened to put her out of commission for 6 months. On top of this she had to wait to have the hip replacement surgery she so desperately needed (she also found out she had Osteoarthritis which explained the pain in her right hip which is why she needed the cane in the first place). Her doctor told her that a hip replacement was necessary since the pain in her hip would continue because of the osteoarthritis and her mobility would continue to decline. For the 2 weeks she waited for surgery I could tell she was not her old self, and in fact she was becoming depressed. Luckily she was able to have her surgery 2 weeks after her accident.

For the 2 weeks she waited for surgery I could tell she was not her old self, and in fact she was becoming depressed. Her doctor recommended a walking aid to help her recover more quickly. We went to the local drugstore which sold canes, crutches and walkers. We ended up buying her a 4 wheeled walker with a seat, hand brakes and a basket (also known as a Rollator). At the time we had no idea what type of walker / rollator to buy and what would be best for my mother during her recovery process. Her doctor was not very helpful about the options of different walking aids other than to say she needed a walker after her surgery. Truth be told, I think her cane was not providing the support she needed any longer which may have led to her falling in the first place. In my mind, whatever solution we found for my mother was one I wanted her to continue to use once she was better so she could maintain her mobility with confidence and reduce the chance of another fall. After her accident she seemed fearful of walking even with the help of a walker.

Walker Challenges:

The walker we purchased was the type you see everyone using, the type that folds like a pair of scissors and looks like an A from the side view. The walker itself posed its own challenges! We didn’t know at the time of purchase how hard it was going to be to get the walker in and out of the car which proved to be the biggest obstacle for her achieving her freedom and mobility. According to the brochure the weight of the walker was about 12 lbs which was the lightest one we could find thinking that would be beneficial for my mother so she could lift it herself after her new hip healed. The walker had a backrest to rest against when seated; however, this was an obstacle when she tried to put the walker / rollator in the trunk of her car as it was always in the way.

After 2 weeks of owning the walker the frame became very loose. When we first purchased the walker the frame would hold together well when folded, however, after it had been folded and unfolded 4 times a day for 2 weeks, the frame became floppy (she usually went in the car twice a day ? each trip required her to lift the walker in the car and back out of the car when she returned). The frame design reminded me of a pair of scissors in the way scissors are stiff when you buy them and over time they flip open easier. She would pick up the walker to put it into the car and the frame would flip open and cause her to struggle and many times she had to set it back down and start over which was very frustrating for her. Even though the walker only had a weight of 12 lbs it felt more like 25 lbs to my mother because of how uncooperative the frame was. She couldn’t do this very well herself so I had to take her places when she needed to go to the doctor or for shopping.

Luckily I live close by and was able to help her because I work from home, but many people don’t have that luxury. Don?t get me wrong, the walker was still a godsend to my mother and she was able to walk again and strengthen her hip muscles which helped her through the 3 months of healing, but if she was really going to be independent she needed something easier to get in and out of the car by herself. She wasn?t getting any younger after all.

Over the next 3 months (post operation) I noticed other challenges. The cables used for the hand brakes were getting caught on door knobs, obstacles in the car and her purse would snag on the cables when she would stand after being seated. I even heard her mutter a few expletives when the cables would get caught on something (this was very shocking to me). She also started to complain about things such as how the basket was banging into the doorways in her home. I looked around her home and saw ding marks on every door frame at the same level as the basket. The basket was out in front of the walker and it was apparent that the turning radius was limited because of this which is why it was hitting into the frame of every doorway. I began to watch her use the walker more closely over the next couple of months.

I went for a walk with my mother one day, around her neighborhood, and made some further observations. The 8 inch wheels on the front of the walker (the ones that swivel to allow the walker to turn easily) seemed to flutter as she walked on sidewalks and pavement. I found this strange since one of the selling points was it was better for outdoor use because of the big wheels. I could tell the walker was jiggling too much like you see with shopping carts and hospital beds. I asked her what she thought of that and she said she wished they wouldn?t flutter as it made controlling her movement more difficult and she also said she would be able to walk faster if the wheels didn?t flutter.

My mother has lived in an Assisted Living Center close to where I live for the last 5 years since my father passed away. Whenever I would visit her over the 3 months during her recovery from surgery it always seemed her walker / rollator was in the way especially now since she was no longer using it inside her home. After she regained her strength, and the pain in her hip subsided, she found it easier to walk indoors and clutch the furniture and railing to get around and the walker became a very useful tool to help her walk outdoors each day and when she went in the car. Folding it up didn?t help because whenever it?s folded it lays on the floor taking up more space than if she left it unfolded in the hallway

After 3 months of using her walker / rollator it was clear we needed to find something better that would offer the independence she so stubbornly desired. But every medical supply store offered a similar walker as the one my mother used just with a different company name on it. I asked myself; why would all these companies manufacture the same product with the exact same design flaws? We saw about 5 different brands that were all the same just different colors and different seat pads or different size wheels. It was clear to me if I was going to find something better I?d have to look beyond our local market. I turned to the internet to search for something better.

Solution:

I did a search on Google.com with the search term ?Rollator?. I went through 4 pages of links for companies selling walkers / rollators just like the one my mother already had. On the 5th page of links I found a company called Dana Douglas Inc. based out of Ottawa, Ontario. When I clicked the link it took me to their rollator page where the first product shown was called ?neXus Series? - Our prayers were answered!!! The neXus was the exact product we wanted and it was made in Canada vs. made in China for the one she owned. Here?s the link to make life easier for you if you or a loved have had similar experiences to my mother:

http://www.danadouglas.com/products/rollators.htm

The best thing about this product is the way it folds. If you are familiar with wheelchairs and how they fold then you will understand how the neXus folds. One lift of the red handle which is sunken into the seat and the neXus folds to only 9? in width and it stands when folded so my mother would be able to fit it in her front closet and her rollator would not be in the way in her small apartment. The basket way mostly under the seat so it would not bank into her door frames. The neXus boasted a ?Cable-Free/Maintenance free? braking system that had a 6 year warranty. I knew my mother would love having no cables to catch on things. The weight was 13 lbs which made it a little heavier than the one my mother owned but its claim was that it was the easiest rollator to fold and get it inside the car or to stow away. I wanted to see one and try it out with my mother and see if she liked it. I went to the store where we bought the other walker and asked if they heard of this walker which they did not but they knew the company name so that was a good start. I told the lady their about the neXus and that I would like to buy one if it met my mother needs. She was a little reluctant to order it at first but when she called Dana Douglas they said if we didn?t like it the product could be returned for a credit so the lady was willing to give it a try. She ordered the neXus and it arrived 3 days later. I didn?t tell my mother it was a little heavier (only 1 lb heavier) instead preferring to get her feedback when she went to put it in the car. My mother was overwhelmed at how the product was so much easier to use. First she rolled around the showroom and her first comment was ?The wheels don?t seem as sticky?. Apparently this is the only rollator with 2 steel bearing per front wheels so the wheels turn easier.

This became very noticeable when she walked outside to her car with the neXus and she was able to walk on the pavement and the wheels didn?t flutter and jiggle which allowed her to maneuver better. The handles were much easier on her hands, the basket was bigger to carry more goods but the biggest thing was how it folded. She lifted up on the red handle and put the neXus in her trunk with ease. We later learned that the rollator could stand upright behind the passenger side seat which made it even easier for her. She said the neXus was lighter than her other rollator because she didn?t have to struggle with the frame flipping open on her. Another great thing we found out was that the neXus could pass through narrow doorways which didn?t matter to my mother but her friend lived in an older home with narrow doorways. She showed it to her friend and her friend went to the same store and bought one the next day.

My mother has been using the neXus now for 6 months and has regained her independence and freedom. I know she feels better not having to ask me for help because she can move around on her own and travel in her car without worry of the struggles she had with her old rollator. The only bad part was the other rollator started to collect dust in my basement. I sold it on Ebay.com just a few weeks ago lol! I went to the store last week where we purchased the neXus and the same lady said it?s now their best selling rollator so I guess everyone?s a winner.

I hope you find this article helpful if you find you are suffering the same issues as my mother. Good luck with you journey of independence!

Stewart MacMillan

Do you know an amazing person in your life? Do you know a handicapped person - old or young? Has this person inspired you to achieve your goals in your life? If the answer is yes to any of these questions, read on.

I am going to tell you about a wonderful friend of mine named Emma. I have actually adopted her as a mother. She lives in her own mobile home and lives alone.

She has Macular Degeneration and this disease struck her in her early 60’s. She has a postage stamp view out of her eyes; she sees only at a distance and can not see anything up close.

This amazing lady lives alone, does her own laundry, cooks all her own meals, and even goes grocery shopping with her daughter. She once told me she likes to pick out her own food.

She loves to go out for lunch and go clothes shopping. She has a huge closet in her bedroom and it is jammed with clothes and shoes. I do not know how she does it but when she dresses herself, her clothes are always neat, clean and match.

She loves to listen to books on tape. These books are mailed to her from the Center For The Blind. Emma belongs to a card club. The women meet twice a week at each other’s home.

Her mobile home is always neat and clean. You never see anything out of place. Her hair is always nicely cut and styled and she is too amazing for words.

I hope when I am 90 years old I can do half of what this amazing lady can do. She has a great out look on life and I hope she lives forever.

Thank you for reading my article. Please feel free to read any of my numerous articles.

Copyright 2006 Linda E. Meckler

Linda is the author of her first children’s book “Ghost Kids Trilogy.” Christy, 12 and her Brother Brad, 16 moves into an old house on top of a mountain and meet two Ghost Kids. Become involved with all the characters and all the adventure and mystery.

Then we have a mysterious, magical Blue Vase with Uncle Charlie the villain is trapped. He wants out of the Blue Vase and exchange he will tell Christy and Brad where Pirates’ Treasure is Hidden.

Take a walk with Christy and Brad down a dark hall hunting for Pirates” Treasure. You will think were you there right there with them.

Love, Family Values and Charity burst off the pages.

Check out my website http://www.lmeckler.com

Coming soon to my website 3 E books How To Appeal Medical Claims - Appeal and Collection Letters for Medical Providers - Boost Your Self Esteem and Blossom.

Cultural Identity What defines a culture is the ways in which human needs are satisfied and whether we can allow for more adequate satisfaction of the entire system of needs depends on how we organise our social and economic systems.

There is basically one culture remaining on this planet, the Industrial Culture. All others seem doomed to disappear. One of the most important tenets of the industrial culture is the belief in the eternally growing economy. However the spirit of industrialism is rapidly losing its grip. The doctrine of material growth has signally failed to provide people with any lasting ideals or values. The social order is expending all its’ creative energy on just maintaining the status quo.

We are now an overpopulated and overconsuming society that is pressing the carrying capacity of the global ecosystem.

There is no connection between increased living standards (beyond sufficiency) and happiness/contentment. There can be no doubt that material living standards in Australia have increased since 1960. However consider the rate of murder and other violent crime, the increase in drug and alcohol abuse and suicide. It would appear that we live in a less happy society in 2006 than in 1960. It is difficult to draw a line between sufficiency and extravagance, however it is certain that in Australia we are dying of the stresses of abundance rather than the stresses of scarcity.

Thanks to science and achievements in the health field we can all look forward to longer lives and therefore a longer period of our lives in retirement. The wonders of modern medicine have given us much greater life expectancies. If you retire in your fifties you may still have half of your adult life in front of you. Men and women of 60 are just beginning middle age. We can expect to live … and be productive … for another twenty or more years. We can be active, contributing members of society for years to come. We are the best educated generation in history. It would be ironic that when science says we can continue to be active, contributing members of society for years to come, we fail to benefit from the technology created by our own generation.

They say there are two certainties in life – taxes and death. Well there is a stage that in most cases comes before death – its called The Golden Years. It is the time when the body doesn’t move quite as fast as it used to, when the mind doesn’t work quite as well as it used to and where both of these facts don’t matter as much as they used to. For most of us it is a time which will inevitably arrive – but which could be a less than golden time if we don’t understand and address the issues involved. Human beings need social contact. This is a major issue amongst our older population, as their friends and partners die, so goes their support networks. Also these days children don’t live nearby as they have had to leave the home town to earn a living elsewhere. So a lot of elderly people are left without family or friends and are desperately lonely as a result

Communication is a two way process. Once receiving a letter from a friend or loved one was commonplace and eagerly anticipated. More recently the telephones was the accepted means of communication. Many today enjoy close personal global networks using new technology. Email, sms, personal messaging, blogging are some of the ways they maintain communication with friends and loved ones. The rest of the world hasn’t retired and will continue its relentless pace. One needs to keep up to keep in touch. The most productive purpose of computers is to facilitate communication. Unfortunately, present practice tends to use computer technology as the sole conduit for communication. We realize that these technologies do not replace older means of communication like face-to-face meetings, telephones, or newsletters, but supplement and support the communications process.

Participation. The online world is a wholly constructed environment, it is worth considering what features, constraints, and challenges of the physical world might be introduced into virtual worlds and what ones can be overcome. Some 84% of Internet users have at one time or another contacted an online group. Tens of millions have joined communities after discovering them online. And many are using the Internet to join and participate in longstanding, traditional groups such as professional and trade associations. Furthermore, many people are using the Internet to intensify their connection to their local community. Government services are now largely delivered online as is banking and many forms of shopping and education. Tax returns have been submitted electronically for the past 5 years and the 2006 Census is also capable of being lodged online. We do not expect people to leave their homes to make phone calls anymore, why should they not have access to modern communications from home?

Approximately 60% of people who use the internet consider it important or very important to their decision making. The movement towards provision of services through electronic means does not acknowledge the different levels of access between different population groups. Such differences have implications for the ability of certain groups to use these tools for communication purposes which can have an impact on levels of social connectedness. Those without access or have limited access are disadvantaged.

Lew Spratt an Australian Social Physicist with a background in banking and finance, community and industry development, social welfare and technology. Now seeking to engage modern Information and Communication Technology to support and assist older people and people with disabilities.
http://www.goldenagenet.tk

Coping with my mother’s forgetfulness was easy in the early stages of her dementia. Things changed after she started to hallucinate. I was taking my mother back to her apartment in an assisted living community when she described one of her hallucinations.

‘Last night four people came into my apartment and asked to live with me,’ she began. ‘I told them it was my apartment and they couldn’t stay. I could see them clearly and then they slowly disappeared. It took me a while to realize they weren’t real.’

I didn’t want to upset my mother. What should I say? ‘It’s a good thing you figured that out,’ I replied. Mom agreed with me.

Her hallucinations marked the start of sundowning - late afternoon and evening confusion in people with memory disease. Unfortunately, sundowning isn’t one behavior, it’s many: hallucinations, confusing dreams and reality, irrational ideas, agitation, wandering, and shadowing (following closely). The Alzheimer’s Association of Los Angeles says sundowning people ‘may become demanding, suspicious, upset or disoriented, see or hear things that are not there and believe things that aren’t true.’

My mother had all of these behaviors. She thought people were robbing her while she slept. She confused my childhood neighbors with her childhood neighbors. She started shadowing me, following me so closely I could feel her breath on my neck, and asking the same questions again and again. What are the causes of sundowning?

Physical and mental exhaustion are two causes, according to the national Alzheimer’s Association. Fading afternoon light and poor indoor lighting also contribute to sundowning. Daytime naps are another cause. (If you sleep half the day you’re awake at night.) And Mayo Clinic’s website says sundowning ‘may be related to the flurry of activity during shift changes.’ Caregivers may take steps to prevent sundowning behaviors.

REVIEW MEDICATIONS. Prescribing medication for people with memory disease can be tricky. Some medications may contribute to sundowning, so the person’s physician should review all medications, prescribed and over-the-counter. Staff members should be informed of any harmful drug interactions. The patient’s physician may prescribe a sleep aid to prevent sundowning.

DISCOURAGE NAPPING. Naps may be replaced with walks, pet therapy, and group activities. After my mother lost the ability to read she enjoyed listening to stories. One reader chose a mystery. ‘I can’t tell you what the book is about,’ my mother said, ‘but it’s very exciting.’

ENCOURAGE EXERCISE. Nancy L. Mace and Peter V. Rabins, MD, authors of ‘The 36-Hour Day,’ think ’sufficient exercise seems to help confused people sleep at night.’ If the person can’t walk he or she may be able to stretch while seated. My mother participated in seated ball activities, but wasn’t impressed by them. ‘They asked me to throw and catch a ball,’ she said. ‘I’m not a kid.’

AVOID CAFFEINE. People with memory disease should avoid caffeine: coffee, tea, caffeinated colas, and chocolate. They also shouldn’t drink alcohol. Marilyn Larkin, author of ‘When Someone You Love Has Alzheimer’s,’ thinks even small amounts of alcohol ‘may contribute to the physical and mental deterioration of the person with Alzheimer’s.’

IMPROVE LIGHTING. Wandering people may be looking for the bathroom, so make sure all hallways are well lit. Night lights will also help the person find the bathroom and return safely. If you leave the bathroom light on make sure it doesn’t shine in the person’s eyes.

REDUCE BACKGROUND NOISE. Blaring television, loud radio, and crowd noise upset people with memory disease. Television and radio may be replaced with soothing CD music. Many nursing care facilities have a community volunteer who comes in to play the piano for residents.

BE REASSURING. If the person is worried about hallucinations tell them they are in a safe place.
Displaying photos of loved ones is also reassuring. The person with memory disease may prefer to sleep in a favorite chair instead of his or her bed. Caregivers may also reassure the person by offering to get them an extra blanket or robe.

Copyright 2006 by Harriet Hodgson.

http://www.harriethodgson.com

Harriet Hodgson has been a nonfiction writer for 27 years and is a membe of the Association of Health Care Journalists and the Association for Death Education and Counseling. Her 24th book, ‘Smiling Through Your Tears: Anticipating Grief,’ written with Lois Krahn, MD, is available from http://www.amazon.com A five-star review of the book is posted on Amazon. You’ll find another review on the American Hospice Foundation website under the ‘School Corner’ heading.

“I knew the day was coming. But it always seemed like it was
further away than today. I’ve made up my mind and have decided
on my new, future home. I’m glad I followed all of those tips
that I saved from that article I read. I’ve made a good choice.”

The above is a fictionalized account of an event that occurs
everyday. Isn’t this the conversation you want your loved one
to have on the day they move into their new home? Will this be
the way it sounds? It will be if you plan ahead, make informed
choices and follow a few easy tips.

Finding a good nursing home for your loved one is not much different than finding one for yourself. As a matter of fact,
the conversation you just read, might just be you talking to
yourself one day. While there are probably many steps to the
search, the first step might be to look for a future nursing
home like you were going to move there. Be selfish. Think about
yourself and the things you would choose about a home. It will
prepare you for when it comes time to choose a home for those
closest to you; who can no longer care for themselves.

Depending upon when you need to make the choice, get as much
information as you can, as soon as you can. You are reading
this article. This is another step to the search. The choice
you make is not only important for your loved one, but for
yourself. Look at everything as if you were choosing for
yourself. Your happiness has to be considered too.

Here are seven sources of where to find an ideal home. You
might think of others:

1. Your loved one’s friends
2. Your loved one’s doctor
3. Agencies in your area that care for the aging
4. The Internet
5. Social workers or staff at your local hospital
6. Magazine or newspaper ads
7. The local long-term care ombudsman. This individual is as
an advocate for residents of any adult care facility. They
visit homes on a regular basis, and since they do, they’re
able to observe the conditions of a particular location,
and the care the residents receive. To find one in the U.S.,
call 1-800-677-1116. (This is the Administration on Aging’s
Eldercare Locator. Ask for the local ombudsman program.)

Your loved one’s friends are probably the best source of
information, since they either are already in a nursing home
or are considering one. Check the agencies in your area who
already care for the aged as they often have deficiency
reports that are filed when a home does not meet area
standards or conditions. Check these out carefully - they will
contain other things to look for that you had not considered.
Some areas have these reports on the Internet, so do a search
there too.

You may have seen an advertisement and thought you had found
the answer to the nursing home problem. Maybe. Look at the
ad closely. If it is in the newspaper or a regional magazine,
tear it out if you can. What appeals to you about this
advertisement; about this home? Use the advertisement to
start a check list of things to consider. Does it mention
the size of the rooms? What about the size of the bathroom?
Are all rooms handicap enabled? Are rooms shared or single?
What about activities for residents? Is smoking allowed
everywhere or just in designated places? You are getting
the idea. Put it all on the check list.

Now that you have started a check list, you need to make
some home visits. This is another step and it is very
important. Remember that each home is a business and all
businesses are trying to reduce costs where they can. One
of the major ways is by hiring staff that is under skilled
or where a background check is not as thorough as it
should be. Staff that is not properly trained could cause
your loved one more harm than good. Talk to the workers
and ask questions like, “Where would you rather work if
you did not work here?” Write down the answer - it might
give you clues about where else to look for the new home.
Can you share a meal with the residents? This will tell
you if the food quality is top notch. Do you like it?
Would you like to eat this every day? Remember you are
choosing this home as if you were choosing for yourself.

How far from where you live is the future home? Is it
close enough for friends and you to visit without
spending a lot of money on gas and driving? Is it close
to or on a bus route? What about other public
transportation?

Notify each home you would like to make a visit and bring a
flashlight. When you visit one of the rooms, check under the
bed with your flash light. Is it clean? Smell the towels in
the bathroom - you know that your loved one will smell these
towels every day. Do the towels smell fresh or sour? Take a
good look around the room - are window sills and curtains
clean? Are there dust bunnies behind the door? Check out
more than one room. The home might have a spotless room for
visits such as yours that is a show place but not the real
deal. Is this a place where you would like to stay if this
was your next home?

Can you visit and talk with the current residents? Try to
meet the people who live there now to get their opinions of
how well they like the meals, the staff, and surroundings.
These people will give you more information than the other
tips combined.

On your check list you should have these tips covered:
1. Licensed and inspection reports are current?
2. Site visit successful?
3. Clean and tidy? What about under the bed, places you
can’t see and the sniff test of the towels?
4. Employees are licensed, friendly and helpful?
5. Are any employees bilingual?
6. Are the residents happy with the home?
7. What is the distance from where you live? The price of
gas is not getting cheaper.
8. Can you visit you loved one when you want or only at
approved times?

You have a good start. These tips and sources of information
will help you find the right place for your loved ones and
most likely yourself when the time comes to choosing a
nursing home. If you discover other tips on your own that
are not mentioned here and would like to share, I’d love to
hear from you. If I use your tip, I’ll give you the credit
in a future article. Just send an e-mail to:
jim at selectanursinghome.com

If you would like to know more about nursing homes and receive
a free monthly newsletter with tips and resources, I would
recommend that you visit:
http://www.selectinganursinghome.com.

Jim Fortune is a freelance writer who writes about issues affecting the aged. He can be reached at http://www.selectinganursinghome.com. He is also a business to business copywriter; technical white papers are his speciality. He enjoys time off with his wife, and Kali, Sammy and Ricky and spends the rest of his free time fly fishing.

Although our focus is on elder care options it is important to remember that life-changing conditions that threaten independent living are not limited to the elderly. People of any age can experience challenging conditions due to illness or injury that interfere with normal activities of daily living. When a decline in function renders a person unable to live independently, there are many care options to consider in regards to the kind of care they’ll receive and who will provide it.

It is my desire that the following summary of care options will be helpful to those needing care.

Hospitals

Hospitals usually keep patients with acute medical conditions until the acute condition is resolved. However, this is not always long enough to allow the patient to become independent and safe enough to return home.

Hospitals serve an important function by saving the lives of those with life-threatening conditions, but when patients are medically stable they must move to another type of facility.

Because the present healthcare environment imposes tight funding restrictions on hospitals, it forces them to reduce the duration of a patient’s stay. The allotted time is rarely sufficient to return patients to their prior level of function. At this point, patients and/or their family members must decide what to do next.

The care option that’s right for your circumstances depends on availability, accessibility, price, expectations and the patient’s age, condition and recovery potential.

Swing Bed Programs

Progressive hospitals offer Swing Bed Programs. To move from acute care to Swing Bed is no more than a paperwork move. However, patients on the Swing Bed Program can continue to qualify for Medicare benefits as long as they make progress in physical therapy, and as long as they demonstrate good rehab potential.

Rehabilitation is the key in these facilities. Patients are involved in therapeutic exercises, functional training, balance training, and gait training. The Swing Bed Program functions as a skilled nursing facility.

Regional Rehabilitation Centers

Qualifying patients may transfer from an acute hospital to a regional rehabilitation center. These patients receive intensive rehab that usually consists of a combination of physical therapy, occupational therapy and speech therapy.

Stays are typically one to three weeks, after which the patient must either transition to their home or to another care facility.

Nursing Homes

Nursing homes, referred to as care homes, convalescent homes, rest homes, and elder care centers, vary in size and type. Skilled nursing homes can, in some cases, carry on the rehabilitation the hospital began. If the patient is able to consistently show physical progress and good rehab potential, Medicare may reimburse for a certain number of days.

Physical therapy and occupational therapy can include therapeutic exercises and training in activities of daily living (bathing, dressing, grooming, etc). When patients reach a plateau in their progress, they are either discharged or sent to a non-skilled nursing facility. Medicare does not provide financial assistance for non-skilled facilities.

The best nursing homes provide restorative services. A restorative aide performs simple exercises and assisted ambulation with patients that do not qualify for the skilled services of a licensed physical therapist. Nursing homes are a good choice for individuals who require lots of care or who lack the rehab potential to progress to a rehabilitation facility.

Assisted Living Facilities (ALFs)

ALFs provide care for individuals who have a much higher level of independence than do those who require a nursing home. They usually have a private apartment-like setting where the residents can be reasonably independent. Meals and varying levels of care are provided.

Assisted living facilities are designed for those who have a good degree of independence, yet are not able to live independently in their own homes. ALF’s typically do not offer physical therapy, exercises programs or restorative therapy services, and Medicare offers no assistance.

Adult Foster Homes

These facilities offer a home-like environment and the best possible staff-to-resident ratio. The State allows a maximum or five residents in Oregon Adult Foster Homes. Other states vary. Residents are given home-cooked meals and activities that are relevant to their interests.

In Oregon, adult foster homes are licensed as level 1, level 2 or level 3, based on the experience and capabilities of the care providers. Level 1 foster homes provide for functional residents who require only minimal assistance in their activities of daily living. Level three residents require care in several activities of daily living and may even be bed bound.

Although adult foster homes specialize in elder care and retirement age residents, people of any age can live in them.

Family Caregiving

Sometimes, families want or need to care for their loved ones in their own home. This seemingly overwhelming task can be handled in two ways: One way is by hiring personal in-home caregivers to provide the needed care. Someone needs to coordinate the caregivers to ensure consistency. When 24-hour care is needed the expense can far exceed any of the above options.

A second option is to personally care for your loved one yourself. This could necessitate leaving your job. This ambitious task can be done if you take care of yourself to prevent burnout and to avoid falling ill. If you take this route you might consider having a personal caregiver come in once or twice a week to relieve you.

Transitional Care

Often, patients are not ready to return home after leaving the hospital. Various life-changing conditions, such as a hip fracture, knee or hip replacement or stroke can make it impossible to safely transition home. Even conditions like pneumonia or bowel obstructions can start the deconditioning process that makes a person less stable on their feet and puts them at risk for falling.

It’s imperative to maximize a patient’s level of function in order to ensure their safe transition home. Transitional care units have emerged to fill this gap. Transitional care units provide various degrees of rehabilitation that can include physical therapy and occupational therapy.

About The Author
Tom LeBlanc PT has been a physical therapist for over 30 years. His experience includes working in all of the above caregiving environments. He is currently developing a FREE TeleSeminar on Caregiver Secrets. He also hosts Home Entrepreneurs News (www.home-entrepreneurs.com), a site dedicated to helping entrepreneurs and business seekers find the business that is right for them. One of his “featured Businesses” is detailed in his article, Become a Personal Caregiver.
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