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Caregiving - Elderly Care - Aging

The Caregiver Dilemma

The growing population of people that are in need of 24-hour personal care is steadily increasing like a slow moving tsunami that has no end. More than 44 million American Families are Caring for a Loved One at Home. By 2050, people 65 and over will comprise an impressive 21 percent of the U.S. population. 10,000 baby boomers turn 65 everyday in America, that's 3,650,000 every year. And if you add the number who turn 66 and 67 everyday, here comes the tsunami.

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Growing Old Hard Facts - Statistics

Elderly Person with a Caregiver 42 million Americans ages 40 to 60 care for an older adult, and those numbers are on the rise. March 2012, Nearly 10 million adult children are caring for aging parents. Alzheimer's disease is expected to triple by 2050, from 4.7 million patients in 2010 to 13.8 million by 2050. Alzheimer's is currently the sixth leading cause of death in the United States, according to the Centers for Disease Control and Prevention. 15 percent of the population 70 and older has dementia. There's only 1 specialist for every 20,000 older adults living with a severe chronic illness. There's only 5,150 hospice programs and 1,635 hospital palliative care teams in the U.S.. There's only 18,000 physicians focused on palliative care and hospice care. As many as 700,000 adults in the US with a disability like autism live with parents or another family member who’s at least 60 years old. What happens when those caregivers are gone?

We Need to Educate and Train a Caregiving Workforce of the Future, Starting Today!

Caregiving Training - Jobs

Palliative Care - End of Life Care - How I wish to Die

Avoiding Isolation and Alienation

Technology Tools
First Aid
Caregiving Definitions
White House Conference on Aging (gov)
Caregiving Books (amazon) - Resources
The coming Neurological Epidemic: Gregory Petsko (video and Interactive Text)
Evidence-Based Care (knowledge)
Music Therapy

Overmedication - Abuse

A National Profile of Family and Unpaid Caregivers Who Assist Older Adults With Health Care Activities. Estimated 42 million friends and family members who are the primary caregivers of adults and children who have disabilities, are recovering from surgeries and illnesses or are coping with Alzheimer's and other chronic diseases. Caregivers, who are primarily women and provide 37 billion hours in unpaid care to relatives or close friends.

A 2015 study by AARP found that 46 percent of family caregivers perform medical/nursing tasks, 78 percent of family caregivers manage medications, and 53 percent of family caregivers serve as care coordinators. The majority told researchers they'd received no training in those tasks.

Patient Confidentiality is a legal concept, related to medical confidentiality, that protects communications between a patient and his or her doctor from being used against the patient in court. It is a part of the rules of evidence in many common law jurisdictions. Almost every jurisdiction that recognizes physician–patient privilege not to testify in court, either by statute or though case law, limits the privilege to knowledge acquired during the course of providing medical services. In some jurisdictions, conversations between a patient and physician may be privileged in both criminal and civil courts. Private Information

Gerodiversity is the multicultural approach to issues of aging. This approach provides a theoretical foundation for the medical and psychological treatment of older adults within an ecological context that includes their cultural identity and heritage, social environment, community, family system, and significant relationships (Iwasaki, Tazeau, Kimmel, Baker, & McCallum, 2009). Gerodiversity encompasses a social justice framework, which considers the social and historical dynamics of privilege and inequality (Iwasaki et al., 2009). In addition to issues of aging, gerodiversity includes race, ethnicity, language, gender identity, socioeconomic status, physical ability or disability, sexual orientation, level of education, country of origin, location of residence, and religion or spirituality. Gerodiversity builds on the field of clinical geropsychology, which applies psychological and developmental methods to understanding the behavioral, emotional, cognitive, and biological aspects of aging in the context of providing clinical care to older adults. The goal is to develop culturally competent, scientific methods for the psychological and medical treatment of the aging population (Iwasaki et al., 2009). According to this perspective, in order to ethically and scientifically provide optimal care to older adults, clinicians must be aware of the cultural factors in health care utilization, including use of physical and mental health care. Moreover, from this perspective, clinicians must continually work to improve their multicultural knowledge base, skill set, and attitudes towards cultural diversity.

Gerontology is the study of the social, psychological, cognitive, and biological aspects of Aging. It is distinguished from geriatrics, which is the branch of medicine that specializes in the treatment of existing disease in older adults. Leonard Davis School of Gerontology. Nearly 90 percent of Americans 65 and older say they want to stay in their current homes and communities as they age, according to the AARP.

Aging in Place is the ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level." Administration on Aging (gov).

Ageing is the process of becoming older, when single cells within an organism have ceased dividing (cellular senescence) or to the population of a species (population ageing). Aging (gov).

Cognitive Decline - Alzheimer's - Entropy

Senescence is to grow old, the gradual deterioration of function characteristic of most complex life-forms, arguably found in all biological kingdoms, that on the level of the organism increases mortality after maturation. The word "senescence" can refer either to cellular senescence or to senescence of the whole organism. It is commonly believed that cellular senescence underlies organismal senescence. The science of biological aging is biogerontology, which is the sub-field of gerontology concerned with the biological aging process, its evolutionary origins, and potential means to intervene in the process. Muscle Loss.

Old Age refers to ages nearing or surpassing the life expectancy of human beings, and is thus the end of the human life cycle. In October 2016, a highly publicized paper claimed the maximum human lifespan is an average age of 115, with an absolute upper limit of 125 years, but the authors' methods and conclusions are controversial. Terms and euphemisms for old people include, old people (worldwide usage), seniors (American usage), senior citizens (British and American usage), older adults (in the social sciences), the elderly, and elders (in many cultures—including the cultures of aboriginal people).

Geriatrics is a specialty that focuses on health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults. American Geriatrics Society.

Age Progression is the process of modifying a photograph of a person to represent the effect of aging on their appearance. Digital image processing is the most common technique today, although sometimes artists' drawings are used. Age progression is most often used as a forensics tool by law enforcement. It can be used to show the likely current appearance of a missing person from a photograph many years old.

Longevity (living longer and healthier)

There are just too many people who do not fully understand what it means to provide a person, or loved one, with 24-hour personal care. And it’s not just providing the care itself, but more importantly, it’s understanding the struggle for the people who need this care and the long-term effects on the people who must provide this care. There is suffering on both sides of this issue.

Support Groups for Caregivers
Community Support
Support Groups (counseling)
Elder Helpers
Caregiver Tips
Stress Management 
Public Service (knowledge)
Healthy Aging
Caregiving Advocacy
Care Act Bill
Care Act (PDF)

The Silver Tsunami refers to the rise in the median age of the United States workforce, to levels unseen since the passage of the Social Security Act of 1935. It is projected that by the year 2020, about 25% of the U.S. workforce will be composed of older workers (ages 55 and over). While many factors contribute to the aging workforce, the Post-World War II baby boom created an unusually large birth cohort for the U.S. population, resulting in a large aging population today. This phenomena has many short-term and long-term implications, affecting many areas, including the U.S. economy, society and public health.

Educating the Public has to be a top priority. Increasing the amount of people who have the necessary skills also needs our full attention. If not, this problem will only get worse then it already is. I have heard too many nightmare stories about caregivers and seen too many family members struggle with their love ones. This affects everyone, so it’s just a matter of when. And it’s not just growing old but also the debilitating diseases, illnesses, injuries and the handicapped. You see the facts and figures about our aging population but no one is talking about how many need personal care. It's all about making our final days as comfortable as possible, and at the same time learn. 

Customizing Healthcare
Eric Dishman: Healthcare (video)

Doctors Ignorance stands in the way of care for the Disabled (NPR)


"Too Poor to Retire and too Young to Die

Clinical Geropsychology is broadly defined as the application of “the knowledge and methods of psychology to understanding and helping older persons and their families to maintain well-being, overcome problems and achieve maximum potential during later life"

Home & Community Based Services (HCBS) provide opportunities for Medicaid beneficiaries to receive services in their own home or community.

Senior-Friendly Home Remodeling

Stressful Work

Being a caregiver is a very demanding job, mentally and physically. Stressful, pressure, anxiety. Who’s going to take care of the caregiver? Caregivers don’t have normal relationships or do they live a normal life. Needing 24 hour care can be like prison for both the caregiver and patient. Caretakers are not perfect and they need support as well. And you certainly can't be a caregiver just for the money. You need skills, experience and be very compassionate, otherwise you will most likely suffer and so will the patient. The caregiving industry is one of the fastest growing and also the worst paid. Turnover is high and the labor shortage is a serious problem as the baby boomers age. How do caregivers protect themselves from becoming a Slave or an Indentured Servant?

People get stressed out just hearing about someone’s stressful experience. Health-care workers treating soldiers with post-traumatic stress disorder (PTSD) report that some soldiers’ partners and family members display symptoms of PTSD
despite never serving in the military. Empathy.

Family members are sometimes horrible caregivers. Family members need to have good relationships in order to be good caregivers. If a family member is abusive or disrespectable towards the other, then this toxic environment will be harmful and create more problems then it solves. There needs to be respect, there needs to be trust, and there needs to be an environment that everyone feels comfortable and safe in. If not, then you need to get another caregiver. Sometimes a stranger is better then a known family member.

Alarm Fatigue happens when people are constantly hearing alarms that they fail to recognize the real alarms when they happen. A sensory overload when clinicians are exposed to an excessive number of alarms, which can result in desensitization to alarms and missed alarms. Patient deaths have been attributed to alarm fatigue. Alarm Fatigue occurs when one is exposed to a large number of frequent alarms (alerts) and consequently becomes desensitized to them. Desensitization can lead to longer response times or to missing important alarms. Propaganda works in similar ways, when you keep hearing the same lies over and over, you may end up believing them to be true.

Always being on Alert can also have serious mental health consequences.
Alarm Fatigue Hurts Patient Care and Overwhelms Nurses
Nurses Reducing Alarm Fatigue

The Boy Who Cried Wolf (wiki) - Alarmism (alarmist)

False Alarm also called a nuisance alarm, is the deceptive or erroneous report of an emergency, causing unnecessary panic and/or bringing resources (such as emergency services) to a place where they are not needed. False alarms may occur with residential burglary alarms, smoke detectors, industrial alarms, and in signal detection theory. False alarms have the potential to divert emergency responders away from legitimate emergencies, which could ultimately lead to loss of life. In some cases, repeated false alarms in a certain area may cause occupants to develop alarm fatigue and to start ignoring most alarms, knowing that each time it will probably be false.

Compassion Fatigue is a condition characterized by a gradual lessening of compassion over time. It is common among individuals that work directly with trauma victims such as, therapists (paid and unpaid), nurses, teachers, psychologists, police officers, paramedics, animal welfare workers, health unit coordinators and anyone who helps out others, especially family members, relatives, and other informal caregivers of patients suffering from a chronic illness. It was first diagnosed in nurses in the 1950s. Sufferers can exhibit several symptoms including hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, sleeplessness or nightmares, and a pervasive negative attitude. This can have detrimental effects on individuals, both professionally and personally, including a decrease in productivity, the inability to focus, and the development of new feelings of incompetency and self-doubt. Journalism analysts argue that the media has caused widespread compassion fatigue in society by saturating newspapers and news shows with often decontextualized images and stories of tragedy and suffering. This has caused the public to become cynical, or become resistant to helping people who are suffering. Sensationalism - Fear Mongering.

Emotional Labor is the process of managing feelings and expressions to fulfill the emotional requirements of a job. More specifically, workers are expected to regulate their emotions during interactions with customers, co-workers and superiors. This includes analysis and decision making in terms of the expression of emotion, whether actually felt or not, as well as its opposite: the suppression of emotions that are felt but not expressed.

Emotional Exhaustion is a chronic state of physical and emotional depletion that results from excessive job and/or personal demands and continuous stress. It describes a feeling of being emotionally overextended and exhausted by one's work. It is manifested by both physical fatigue and a sense of feeling psychologically and emotionally "drained".

Vicarious Traumatization is a transformation in the self of a trauma worker or helper that results from empathic engagement with traumatized clients and their reports of traumatic experiences. It is a special form of countertransference stimulated by exposure to the client’s traumatic material (Courtois, 1993). Its hallmark is disrupted spirituality, or a disruption in the trauma workers' perceived meaning and hope.

Perceived Organizational Support is the degree to which employees believe that their organization values their contributions and cares about their well-being and fulfills socioemotional needs. POS is generally thought to be the organization's contribution to a positive reciprocity dynamic with employees, as employees tend to perform better to reciprocate received rewards and favorable treatment.

Perceived Psychological Contract Violation is a construct that regards employees’ feelings of disappointment (ranging from minor frustration to betrayal) arising from their belief that their organization has broken its work-related promises and is generally thought to be the organization’s contribution to a negative reciprocity dynamic, as employees tend to perform more poorly to pay back PPCV.

A person being "waited on hand and foot" expects others to do all the work for them and to always be looking after their personal needs.

Old-People Smell is the component of body odor that only manifests in older individuals. Term for the smell is nonenal, the scientific term describing that unpleasant odor. Tips on how to eliminate stains and odors.

Stress (occupational)

Computers - Smartphones

Effectively Utilizing our Technologies we can give elderly their freedom, and at the same time, give caregivers and loved ones peace of mind. Technologies can also make communication a lot easier.
Voice Activation Technology

Technology is a great tool to help people with disabilities, like water that automatically shuts off, a stove that automatically shuts off (over boiling), lights that automatically shuts off and on, heating and cooling that automatically shuts off and on, and so on.

Computers for Senior Citizens
Seniors Guide to using Computers and Software (the Need to Learn is greater then ever)
Internet Resources

Having an internet connection where you care for someone is extremely important. The caregiver can keep in contact with friends and love ones using video chat and social networks. This helps ease the loneliness and isolation of caregiving. Having the internet is also good for the patient because you can look up important information on medications and treatment alternatives. The internet can also be used to help keep the patient active with news, TV shows, games and cognitive tests to keep their mind active. Patients can also use the internet to keep in touch with family by video chatting and e-mail. Then of course any Laptop Computer or Smartphone can also help with monitoring health issues and educating the patient to be more aware of their physical health.

Health Monitors

Pulse-Oximeter that Connects to Smart Phone
Check-my-Temp: More Than A Wearable Thermometer
New Hexoskin Smart: World's Leading Smart Shirt monitors and records your heart rate, breathing, and movement whether you're awake or asleep.
Wearable tattoo sends alcohol levels to your cell phone
Bioelectronics is the convergence of biology and electronics. Biological materials and biological architectures for information processing systems and new devices. Medical Sensors
Wearable Electronic Health Patches May Now Be Cheaper and Easier to Make
iBeat Smart Watch 24/7 heart monitoring smartwatch that can immediately notify your family and 911 in an emergency.
Fast, stretchy circuits could yield new wave of wearable electronics

George Whitesides Affordable easy Tests (video)
Eric Topol: The Wireless Future of Medicine (video)
A Cradle and App Turn Smartphone Into Biosensor (youtube)

Smartstones Communicate by Touch
Home Health Monitoring Devices
Health Monitoring Apps - Video
Pebble 2, Time 2 + All-New Pebble Core heart rate-enabled smartwatche
Figure1 Clinical Image Sharing App for iphone
Qardioarm: Read Blood Pressure from Smartphone
Cor: Health Tracker measures your blood chemistry at home and delivers personalized, actionable health insights.

Emergency Alert Device - I've fallen and I can't get up!

Environment Monitors (another set of eyes) - Bio-Monitoring

Voice Activated
Voice Control Virtual Assistant Apps
ivee: Voice Activated Assistant
Vinci - First Smart Headphones with AI Voice-controlled headphones and personal AI, with smart noise cancelling and immersive 3D sound.

Myle Tap Wearable Thought Catcher
Touch-Free Smartphone, Sesame Enable
Neptune Suite: your computing life now seamless
Evenflo SensorSafe generates a series of tones
Hiris: The first wearable computer for everyone
Embrace Watch Designed to Save Lives

Nimb: Smart Ring Calls for help when you’re in trouble
Rufus Cuff Smartwatch

Live Athos Wearable Technology
Mobile Healthcare Technology
Portable Ultrasound Unit
Handy Sana 210
Pulse Point
Cell Scope
Wanda Connects a Medical Devise to a WiFi Network - Thaw

Sleeping Aids - Sleep Monitors
Smartphone Technology Tools

Medical Aid App (youtube)
Health Symptoms Checker
Wireless Medicine
Health Apps
Robots (robotics information)
Medical Questions
Kinsa Health
The Wellbe
Hiris Wearable Computer
Wearable Sensors (health monitors)

Stroke Riskometer (app)

Arrhythmia and Electrophysiology Diagnostic Performance of a Smartphone Based Photoplethysmographic Application for Atrial Fibrillation Screening in a Primary Care Setting.

Heart Info

Apps for Smartphones

Smartphone Vital Signs Checker
Medical Apps
Cognitive Testing
Google Disabilities Impact Challenge
Lightfreq Square2 Smart Light bulb Speakers Intercom
Mobile Health Wearable's - Philips’s CareSage suite Predictive Analytics

CareZone App helps caregivers keep track of medical information by organizing medication, allergies, insurance cards and ID
cards all in one place. Helps caregivers manage their personal stress, navigate family conflict and reach a 24/7 helpline.

Symple keep track of your loved one's symptoms like anxiety, fatigue and pain over long periods of time. The app allows you to track up to 10 individual symptoms, recording how your loved one feels and documenting any possible contributing factors to mood or health shifts.

Pacifica mindfulness app that aids in relief of anxiety, depression and stress. Users can track their moods and health, while also keeping track of moments during the day that trigger mood shifts. The app has in-app exercises, too, which help reduce stress and anxiety. Mindfulness app that aids in relief of anxiety, depression and stress. Users can track their moods and health,
while also keeping track of moments during the day that trigger mood shifts. The app has in-app exercises, too, which help reduce stress and anxiety.

CaringBridge app connects you with the support of friends and family when its needed most. CaringBridge for Android makes it simple: create a website, visit a friend’s page, add updates or encouraging notes, and share your story.

Stay Warm

Hot Water Bottle is a container filled with hot water and sealed with a stopper, used to provide warmth, typically while in bed, but also for the application of heat to a specific part of the body.
Heating Pad is a pad used for warming of parts of the body in order to manage pain. Localized application of heat causes the blood vessels in that area to dilate, enhancing perfusion to the targeted tissue. Types of heating pads include electrical, chemical and hot water bottles.
Hand Warmer are small packets which are held in the hand and produce heat on demand to warm cold hands.
Electric Blanket is a blanket with an integrated electrical heating device usually placed above the top bed sheet.
Bedding - Blankets


The First Heated Down Jacket & 6X Mobile Charging
Flexwarm Smart Jacket
Ravean Down 2.0 Heated Jacket
Heacket: The World’s Most Durable Heated Jacket
Fyre: Temperature-Regulating Cardigans and Hoodies
Clothing (natural)

Body Temperature Knowledge

Home Monitoring Systems

Smart Home Monitoring Systems for the Elderly
Smart Homes
Smart Home Systems
Halo: The World's Safest Smartest Smoke Alarm
iSmart Alarm Spot Smart Home Camera that detects smoke alarm sirens, sends notifications, and records video.
Clinical Guard
Simplisafe home security wireless technology, no annual contracts.
Mobile Health News

Energy Monitors - LED Lights
Use of local intelligence to reduce energy consumption of wireless sensor nodes in elderly health monitoring systems
Protonet ZOE - Smart Home Hub of the Free
The Internet of Things

Who's at the Door?

Skybell: Answer the Door and See who's there using your Smartphone
dbell live: Smartest Video Doorbell & Security Cam HD live video doorbell allows answering the door from Smartphone and Mon/Rec from PC, Mac & TV.
Hi! your connected Butler, internet video doorbell
Professional Outdoor Security Camera
Butterfleye: Smart and Versatile Monitoring Camera
Korner Home Security
Xchime Video Doorbell & Motion Detect Smart Alerts. App Enabled Video Doorbell w/ Live Stream, Motion Detection, Garage Door Controls & Online Storage.

Video Monitors

Orbii: A Mobile Home Security Robot with HD Video
Oco2 Home Monitoring Camera with SD Card and Cloud
Reolink Argus Wire-Free Security Camera, weatherproof, 1080p Full HD.
Ring Floodlight Cam motion-activated HD security camera with built-in floodlights, a siren alarm and two-way talk. App-controlled camera, Smart zoom with panning. Live View streaming video and audio, iOS, Android, Mac and Windows 10 compatible.
Invidyo: World's Smartest Child Monitor
Ohmni: is a moving monitor.
eufy EverCam: The Wirefree Security Cam with 365-Day Battery: Face-Recognizing Alerts | Motion Detection | 1080p Full HD | No Monthly Fee | Free Local Storage | Night Vision | Weatherproof (IP66).

Surveillance Concerns - Privacy

Door Locks

Ultraloq Smart Lock: Simplify Your Safety
OVIO PairLock - Lock System with One Key for all Locks.
Smartphone House Key
Gate: The First All-In-One Connected Smart Lock enhances your deadbolt with a motion activated camera, keypad, and 2-way audio.
The Westinghouse Nucli Smart Lock
Friday Smart Lock
Oomi Smart Home
Sensor-1: The Tiny Powerful Security System
SENS8: Smart All-in-One Home Security System
Simpli Safe 24/7 Protection 
Get Safe
WiFi Alarm System and HD WiFi Camera by Smanos DIY, no contracts, no monthly fees, and FREE Motion Detector with each purchase.
K Kit: Smart home made simple
Presence Security Pack

Remote Controls

Sevenhugs Smart Remote: The Remote for Everything.
Switchflip: The Ultimate Lighting Accessory Customize your lighting and use the switch you already have with switchflip!
Smartphone Remote Apps
Android TV Remote Control app
AnyMote Universal Remote +WiFi
Twinone Universal TV Remote
IR Universal Remote
ASmart Remote IR
iRBeacon - smarter remote for a smarter home
Hayo: Augmented Reality for the Connected Home 3D scans your room to use hand jesture to control devices in your home. Transforms the objects and spaces around you into a set of virtual remote controls.
Klik Universal Remote Control



For Patients who wonder off

Itraq: Cellular Tracking Device
Ping - The World’s Smallest Global GPS Locator Global range, long battery life & instant locating for kids, pets, luggage – or anything that moves.
The 1st Motion Tracking Smart Home Security Camera
Stilla Motion get instant alerts if something moves when it shouldn’t.
Trackr Bravo Thin Tracking Device - Trackr-Atlas
Wireless Key Locators
GPS Trackers - GPS Collars
Pebblebee Stone Tracker
Kenneth Shinozuka: My simple invention designed to keep my Grandfather Safe (video)
Buddy. The Dog Collar Re-Imagined
TAG: GPS Tracker with Functional Design & Style
4 premium item trackers, by Philippe Starck
Walli - The Smart Wallet

Alert with one touch button
Revolar: GPS alerts to get help. Check-ins to be in touch. Step tracking to stay active. All with 1 button. you can get any help you need at the click of a button.
Flic: The Wireless Smart Button one touch button to easily activate important actions like text your loved ones of your location if you’re in distress, turn the lights on or off, call a cab, locate smartphone, turn on music, open front door, and so on.
Trak Taag Tracker - 80 Year Battery & SOS Button No more losing things & buying batteries. One button makes SOS Calls & takes Videos, Pictures, Audio.

Motion Sensors (amazon) 
Health Monitors

Home Remodeling for Disability and Special Needs

Music Therapy

Alive Inside
Music and Memory
Music on the Brain ABC TV Catalyst (youtube)
Music for the Elderly
The Musical Brain
Music Therapy
Laptops for Seniors

Pet Therapy

Cats and Seniors
Canine Caregivers for Alzheimer’s and Dementia Patients
Pets for the Elderly Foundation
Animal Therapy
Dogmanship is an individual’s ability to interact with and train dogs. Good dogmanship involves best practice in dog-human interactions and has a fundamental role in the success of dogs as companions and co-workers.
Operation Fetch Service Dog Education and Awareness.

I have been noticing that Growing old sucks. But what sucks more is the fact that most of us will not get the care that we need. Dementia, bed ridden, Parkinson's, wheel chair bound, physical or mental disabilities. Doctors and pharmaceutical companies look at the elderly as a commodity, they don't see them as human. Families don’t want to talk about it and the media doesn't care, unless of course they can exploit it for their own personal gain. 

Standard of Care - Duty of Care

National Health Service and Community Care Act 1990 is to ensure that people who need community care services or other types of support get the services they are entitled to. Patients have their needs and circumstances assessed and the results determine whether or not care or social services will be provided. This also ensures that the people giving the care follow a certain set of rules called the care value base. Local authority resources can be taken into account during the assessment process, but if it is deemed that services are required, those services must be provided by law: services cannot be withdrawn at a later date if resources become limited. The act also split the role of health authorities and local authorities by changing their internal structure, so that local authority departments assess the needs of the local population and then purchase the necessary services from 'providers'. To become 'providers' in the internal market, health organizations became NHS trusts, competing with each other. Community care ensures that people in need of long-term care are now able to live either in their own home, with adequate support, or in a residential home setting. The Act Made provision for the establishment of Family Health Services Authorities in place of Family Practitioner Committees and for the establishment of NHS trusts.

Social Care in England is defined as the provision of social work, personal care, protection or social support services to children or adults in need or at risk, or adults with needs arising from illness, disability, old age or poverty. The main legal definitions flow from the Health and Community Care Act 1990 with other provisions covering responsibilities to informal carers. That provision may have one or more of the following aims: to protect people who use care services from abuse or neglect, to prevent deterioration of or promote physical or mental health, to promote independence and social inclusion, to improve opportunities and life chances, to strengthen families and to protect human rights in relation to people's social needs.

How I wish to Die

How you wish to Die is almost as important as how you wish to live. Life with Dignity is just as important as Death with Dignity.

How I wish to be Treated when on my Death Bed  -  Types of  Medical Treatments I will Accept  -  Exit Strategy

Judy Macdonald Johnston: Prepare for a Good End of Life (video)
Talk about your death while you're still healthy: Michelle Knox (video and text)
International Society of Advance Care Planning and End of Life Care (ACPEL) 
The National POLST Paradigm Physician Orders for
Life Sustaining Treatment End-of-Life Planning

Advance Health Care Directive or Living Will, is a legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. In the U.S. it has a legal status in itself, whereas in some countries it is legally persuasive without being a legal document. 

Advanced Health Care Directives-and-Living Will

Will and Testament
Trust Law
Living Trust (PDF)

Legal Guardian is a person who has the legal authority (and the corresponding duty) to care for the personal and property interests of another person, called a ward. Guardians are typically used in three situations: guardianship for an incapacitated senior (due to old age or infirmity), guardianship for a minor, and guardianship for developmentally disabled adults.

Power of Attorney - Executor

Guardianship: Last Week Tonight with John Oliver (HBO) (youtube) - It’s alarmingly easy for a total stranger to gain total control over the life of a senior citizen.

End of Care Options - Nurse Types

Do you have a Health Care Agent?
Choosing a Health Care Agent 

Health Care Proxy is a document (legal instrument) with which a patient (primary individual) appoints an agent to legally make healthcare decisions on behalf of the patient, when he or she is incapable of making and executing the healthcare decisions stipulated in the proxy. Once the health care proxy is effective, the primary individual continues making healthcare decisions as long as he or she is legally competent to decide. Moreover, in legal-administrative functions, the healthcare proxy is a legal instrument akin to a "springing" health care power of attorney.

How do I wish to Live?

End-of-Life Care refers to health care, not only of patients in the final hours or days of their lives, but more broadly care of all those with a terminal illness or terminal disease condition that has become advanced, progressive and incurable.

End of Life Factsheet
Good End of Life
End-of-Life Issues
End of Life Issues
Hospice End of Life Care
Hospice Network

Death Midwife, also known as Death Doula is one who assists an individual in their dying process. Most commonly these people are hospice nurses or those trained in caring for the terminally ill is a person who assists in the dying process much like a midwife or doula does with the birthing process. It is "a community centered response that recognizes death as a natural, accepted and honored part of life. One might say that death midwifery is to hospice palliative care as the slow food movement is to large scale agricultural practices, or as birth midwifery is to obstetrics." Practitioners "can help create death plans, some provide spiritual care, psychological and social support, and sometimes even physical care. They can help plan home vigils and home funerals, and offer guidance with respect to what your rights and responsibilities are in caring for someone who's died.

Dignity in Dying End of Life Care
Compassion and Choices
Do Not Resuscitate DNR
Respecting Patient Choices
Get Your Shit Together 
Ever Plans
Direct Care Alliance
Advance Directive End of Life Care Frailty
What types of Life Support will you accept?
Intensive Care Unit
Make-A-Wish Foundation
Ambulance Wish Foundation
Funeral and Burial Needs

75% of patients preferred to die at home. But among people 65 years of age or more, 63 percent die in hospitals or nursing homes, frequently receiving treatment that's painful, invasive and ultimately ineffective.

How would you like to Die Info-Graph

Palliative Care is a multidisciplinary approach to specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, physical stress, and mental stress of a serious illness—whatever the diagnosis. The goal of such therapy is to improve quality of life for both the patient and the family. Palliative care is provided by a team of physicians, nurses, physiotherapist, occupational therapist and other health professionals who work together with the primary care physician and referred specialists (or, for patients who don't have those, hospital or hospice staff) to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided as the main goal of care or along with curative treatment. Therefore, although it is an important part of end-of-life care, it is not limited to that stage. Palliative care can be provided across multiple settings including in hospitals, in the patient's home, as part of community palliative care programs, and in skilled nursing facilities.

American Academy of Hospice and Palliative Medicine
Get Palliative Care

Stories from a home for terminally ill children: Kathy Hull (video and interactive text)
Most of the children who die in the United States every year die in hospital rooms, surrounded by beeping machines and anxious, exhausted adults who have no other option but to say goodbye under those harsh, institutional lights and among virtual strangers. The United Kingdom has 54 hospice and respite centers, the United States has only two freestanding pediatric hospices.

A Video Game to Cope with Grief: Amy Green (video with interactive text)
Virtual Reality

Americans with Disabilities Act of 1990

Zen Hospice person-centered model in health care, the practice of mindfulness.

Art of Dying
The Conscious Dying Network
Chalice of Repose
Death Over Dinner Talking about Death

Assisted Suicide - Suicide

What is Death?

Should I write my own Obituary?
  -   Should I write my own Eulogy?

Obituary is a news article that reports the recent death of a person, typically along with an account of the person's life and information about the upcoming funeral. In large cities and larger newspapers, obituaries are written only for people considered significant. In local newspapers, an obituary may be published for any local resident upon death. A necrology is a register or list of records of the deaths of people related to a particular organization, group or field, which may only contain the sparsest details, or small obituaries. Historical necrologies can be important sources of information. Two types of paid advertisements are related to obituaries. One, known as a death notice, omits most biographical details and may be a legally required public notice under some circumstances. The other type, a paid memorial advertisement, is usually written by family members or friends, perhaps with assistance from a funeral home. Both types of paid advertisements are usually run as classified advertisements.

How To Write An Obituary - A Step-by-Step Guide
How to Write an Obituary - Legacy - Grieving
How To Write An Obituary – Tips and Ideas

Eulogy is a speech or writing in praise of a person(s) or thing(s), especially one who recently died or retired or as a term of endearment. Eulogies may be given as part of funeral services. They take place in a funeral home during or after a wake. However, some denominations either discourage or do not permit eulogies at services to maintain respect for traditions. Eulogies can also praise people who are still alive. This normally takes place on special occasions like birthdays, office parties, retirement celebrations, etc. Eulogies should not be confused with elegies, which are poems written in tribute to the dead; nor with obituaries, which are published biographies recounting the lives of those who have recently died; nor with obsequies, which refer generally to the rituals surrounding funerals. Catholic priests are prohibited by the rubrics of the Mass from presenting a eulogy for the deceased in place of a homily during a funeral Mass.

How to Write a Eulogy
Do you have a eulogy to write? funeral speeches step-by-step
Eulogy Examples - Sample Eulogy
How to Write a Eulogy
Eulogy Examples

No Body Hardly ever Dies from Old Age or Natural Causes, we are slowly killing ourselves.

Death by Natural Causes or Unnatural Death are not even defined accurately, or even understood correctly.

We are mostly dying from things that we can avoid. Death by Natural Causes is an Unnatural Death, there's nothing natural about dying. Define the cause?

Aged Based Allocation of Healthcare Resources

Age Based Rationing of Health Care

Resource Allocation is the assignment of available resources to various uses. In the context of an entire economy, resources can be allocated by various means, such as markets or central planning. In project management, resource allocation or resource management is the scheduling of activities and the resources required by those activities while taking into consideration both the resource availability and the project time.

Scarce Resources
Age Base
Pub Med

Can a family member be a good caretaker? Not from what I have seen. The relationship is not the same. Where does this knowledge and experience come from? And who educates the family members? Caregiving is s a stressful job. And if family embers don't get along, then this job will be even a more difficult then it already is.

Respite Care is planned or emergency temporary care provided to caregivers of a child or adult. Respite programs provide planned short-term and time-limited breaks for families and other unpaid care givers of children with a developmental delay and adults with an intellectual disability in order to support and maintain the primary care giving relationship. Respite also provides a positive experience for the person receiving care. The term "short break" is used in some countries to describe respite care.

Info - Responsibilities of Caregiving

Can Family members get paid for taking care of the Elderly Parents?

What are the dangers of Social isolation?

Care Giver Credit
The Family Caregiver
Aging Care
Planning your Doctor Visit

My first experience with an elderly person needing care was in 1975. My grandmother was ill so she came up from down south to stay with us in Danbury. This was my mother’s mother. I remember that she was very ill from smoking cigarettes most of her life. I was 15 and had no idea what an elderly person needs, especially a grandmother that I had only met twice in my life. I was also unaware of the strain that this had put on my mother. The relationship between my mother and my grandmother and was not the best. My grandmother pretty much just sat on the couch all day. The experience was confusing and not very pleasant. When my grandmother passed I was relieved that her suffering was over. But I was sad knowing that her last days were painful. I never got the chance to actually know her. Of course that one experience was not enough to fully open my eyes to a problem that is adversely affecting the lives of millions of people. That would sadly come 31 years later. All that time was wasted not educating myself. I wish I knew.

The next experience that eventually opened my eyes about caretaking started in 2006 when my 96-year-old cousin needed a
24-hour live in caretaker. My cousin, who was independent and living on her own, had injured herself and was found on the living room floor after spending 2 days on the floor without food or water. She was unable to move or cry for help. Luckily a neighbor had visited her and called 911. She recovered but this of course changed my cousin’s life from being independent to being fully dependent. Her life was saved but now her life would never be the same.

Care Giving Statistics
Social Security

After my cousin was released from the hospital she was not sent home. She was instead sent to a nursing home in Kent that was 30 miles from where she lived. It’s extremely important to know what happens to an elderly person when the State gets involved. People are going to make decisions for you whether you like them or not. And if your family is not involved, or if you have no one close to you who knows your needs, you will bed ridden and surrounded by strangers, with some of those strangers having very little experience or knowledge about what it takes to properly care for an elderly person. The Nursing Home in Kent, Ct. was turning her into a bed-ridding patient. It's hard for the family to understand how they are treated and how this affects their loved one. And on top of that the only way that the nursing home would release her was that the family had to agree to pay for a caretaker or visiting nurse.

Hospitals overwhelmed by Permanent Patients

Older People in Japan Some 420,000 senior citizens are waiting for beds in nursing homes.

Luckily my cousin’s family got involved. They were able to get her released from the nursing home in Kent. But it wasn’t easy. They would not release my cousin until the family provided care for her. They first tried just having someone visit for a few hours everyday but they soon found out that if she was left alone she was to vulnerable. Luckily they found a caretaker who was willing to move in a take care of her 24/7, but not without cost. The expenses are incredibly high and if you are not prepared your choices will be limited. This would be an absolute nightmare for any elderly person who does not have family or friends. My cousin had already written her will or living trust. The money she thought she was leaving to her family was now in jeopardy of being spent on her care. She was horrified at the cost of this care, which came to almost a $1,000.00 a week. $200.00 a week went to the placement service that found her the caretaker. After 5 years they are still paying that same placement service. So that’s almost $50,000.00 for a service who is no longer providing a service because the same woman has been with my cousin since the beginning without taking a single day off. This caretaker incredibly special and one of a kind.

I had absolutely no idea what it meant to have a caregiver. My 96-year-old cousin was reluctant and refused several caretakers before she accepted one. I’m glad she did even though I also had my doubts. Mostly because I lacked the necessary information and knowledge that was needed to understand the situation. But thanks to my inquisitive nature that was about to change.

During my visits to my cousin’s house I became friends with her caregiver. She turned out to be an incredible woman.
She educated me and opened my eyes to the needs of the elderly, and also what it meant to be a caregiver. This was a new career for her. It was just going to be a fill in, but she ended up moving in.

Another thing I learned is the hospital does not have enough qualified people who are skilled enough to care for the elderly. Hospitals need to expand their training and skills. But sadly most hospitals are ignorantly driven by money when they should be driven by care and compassion. I knew of an elderly person who had to go to Danbury Hospital were the treatment was horrific. Like they never saw an elderly person before. The caretaker had more experience then the nurses. There is a huge gap in the way we are training and educating hospital staff to take care of a growing segment of human population that increases everyday. On top of that there was very little communication between hospital workers. There was no patient chart at the end of the bed so you had no idea who is doing what and when and what medication is being given. My cousin said some one gave her a pill in the middle of the night but no one had record of who or what the pill was. I'm disappointed in hospitals, they kill more people then they save, and not just with their infections but with their extremely high cost of treatment that sends more people into bankruptcy and foreclosure then any other public service known to man. And you wonder why we needed Healthcare Reform. Then on top of that there is so much corruption and fraud in healthcare that most of the money is being wasted. 

Hospitals are Less Safe than we think

And this is not just my opinion of course. I have talked to many people in Hospitals and have heard the same nightmare stories about the horrible service they received. The corporate mentality has no place in public service, it has no place any where.

Tableware for People with Special Needs

Designing Clothes with Style and Function for People with Disabilities

At least one-third of hospital patients older than 70 leave more frail than when they arrived, and many become too weak to go home. Nursing home care or rehabilitation often are needed, and even then, research suggests more than two-thirds remain weaker a year after being in the hospital.

Informant Questionnaire on Cognitive Decline in the Elderly (wiki)

Psychiatric Rehabilitation is the process of restoration of community functioning and well-being of an individual diagnosed in mental health or mental or emotional disorder and who may be considered to have a psychiatric disability.

Cognitive Maintenance
Cognitive Science
Cognition Tests

Elderly people with high cognitive function have more of a certain type of brain cell called Spindle Neuron, also called von Economo neurons (VENs), which are a specific class of neurons that are characterized by a large spindle-shaped soma (or body), gradually tapering into a single apical axon in one direction, with only a single dendrite facing opposite. Other neurons tend to have many dendrites, and the polar-shaped morphology of spindle neurons is unique. A neuron's dendrites receive signals, and its axon sends them. Spindle neurons are relatively large cells that may allow rapid communication across the relatively large brains. Although rare in comparison to other neurons, spindle neurons are abundant and large in humans.

"There are not enough trained people who know how to help people with disabilities, or mental health issues, beyond just giving them food and shelter. Some Healthcare workers are even seeing some people with disabilities as being beyond help, they say nothing can be done for them, which is a lie. You just haven't figure out a way to help them just "Yet". There is always a way in, but you have to learn how, because people in need can't explain it for you."

Luckily Some Hospitals are Improving

Acute Care for Elders (ACE) at the San Francisco General Hospital and Trauma Center (SFGH) is an interdisciplinary model of care for hospitalized older adults with a focus on maintaining and improving physical function and returning patients to a community setting.

Acute Care For Elders Units Produced Shorter Hospital Stays At Lower Cost While Maintaining Patients’ Functional Status
Hospitalization-Associated Disability “She Was Probably Able to Ambulate, but I’m Not Sure”
Hospital management of older adults nosocomial complications and adverse drug reactions

Bowl Movements, Diapers and Sponge Baths....Oh My...

When to say no and when to say yes?  When do you let patients have their way?
When do you have to do what's right for the patient even when they complain?
How much sleep does an elderly person need?
When should you allow an elderly person to sleep?
When should you make an elderly person get up and move around?

Walking Around Is the Simplest Way to Shorten Hospital Stay, Study Finds

What are some of the Responsibilities of a caregiver?  
Fecal Incontinence

Should my patient carry a Medical Alert Device?  

Home Health Monitoring Devices
Wireless Emergency Alert Pendant
Silver Alert
Medical Alert Service
Home Health Monitor Systems

If and when should a Patient take their Medication?
Should a Caregiver keep a daily record of what their patient eats, their activities, therapy performance, their moods, theirs medications and doctor visits?
What is the right type of Wheelchair or Adjustable Bed?

4 things that are almost worse than Death
Needing a breathing machine
Needing a feeding tube
Needing care all the time.


As many as 2 million seniors are abused, exploited or neglected every year, but there could be many more. Some research indicates that 1 in 10 seniors have suffered some form of abuse at least once and most abuse is at the hands of relatives.

Adult Protective Services
Adult Protective Investigators
Families for Better Care
Drug Abuse
Money Exploitation

I have also heard about the drug abuse and drug problems of Care Givers. I have also heard about care givers stealing. I have also heard about  women from other countries that are exploited and abused by people who send these women to homes with patients, with some of these caregivers being abusive towards their patients. So shopping around for a good caregiver is extremely important. A Live in Caregiver is a lot cheaper then a nursing home. Some nursing homes cost as much as $12,000 a month.

Cost of a Live in Caregiver
Care Rates
Paying for Senior Care
Center on Elder Abuse

I have also heard that some caregivers are taking their patients property. How and why I'm not sure. But that is not as bad as Banks and Towns stealing homes from the elderly for property taxes as little as $400.00. Outdated state laws allow big banks and other investors to reap windfall profits by buying the houses for a pittance and reselling them, The National Consumer Law Center said in a report. If the owner fails to pay all the costs, investors can sell the home at a big profit compared with the cost of buying the tax lien. Tax Lien Sales differ from most Foreclosures, which happen when people fall behind on mortgage payments. In many states, homes sold because of tax debts can be sold for only the amount of back taxes owed. That means a $200,000 home might fetch only $1,200. In the process, homeowners can lose thousands of dollars in Home Equity that they have built up by making monthly payments.  

Health Insurance Portability and Accountability Act (wiki)

You were disgusted when you heard about the torture in Guantanamo, how about the treatment of the elderly and the ill at the hands of inexperienced caretakers and hospital workers. Will they ever understand their pain, their suffering, their loneliness?   

Nursing Home Abuse (youtube) 
Nursing Home Abuse Center
Nursing Home Abuse Support

Employees who take demeaning photographs and videos of residents and post them on social media. Inappropriate Social Media Posts by Nursing Home Workers, Detailed Details of 47 incidents since 2012 in which workers at nursing homes and assisted-living centers shared photos or videos of residents on social media networks. The details come from government inspection reports, court cases and media reports.

Elderly Inmate Population Soared 1,300 Percent Since the 1980s. The population of aging and elderly prisoners in U.S. Prisons exploded over the past three decades, with nearly 125,000 inmates aged 55 or older now behind bars, according to a report published Wednesday by The American Civil Liberties Union.

More than $16 billion is spent annually by states and the federal government to incarcerate elderly prisoners, despite ample evidence that most prisoners over age 50 pose little or no threat to public safety, the report said. Due largely to higher health care costs, prisoners aged 50 and older cost around $68,000 a year to incarcerate, compared to $34,000 per year for the average prisoner.

"About 60 percent of nursing home residents harmed by their treatment wound up back in the hospital as a result; such injuries likely cost Medicare about $2.8 billion a year, officials say. And that's just the hospitalization cost. It doesn't account for extra doctor visits and longer nursing home stays that also result from patients' injuries."

"Most elderly agree that prisoners are treated better in prison then the Elderly are treated in nursing homes."

What is a Vulnerable Adult? Vulnerable adults are people who by are unable to independently provide for their own basic necessities of life due to: Age, Disability, Disease or Developmental disorders. Vulnerable adults also includes: Adults who reside in long-term care facilities such as nursing homes, adult family homes, boarding homes or assisted living facilities or those who receive health care or other assistance in providing for the basic necessities of life while residing in their own home. Examples of abuse, neglect and financial exploitation include: Pushing, hitting, punching a vulnerable adult. Shouting at, berating, intimidating, or threatening to harm an elderly person. Taking financial advantage of one who is lonely, vulnerable or has memory lapses. Taking money an elderly person needs, “borrowing” money with no intention to pay it back, tricking someone into buying something they have no use for. Failing to provide goods and services that are necessary to meet the physical, medical or emotional needs of a vulnerable adult, when a person has an oligation to do so. Neglecting an elderly person’s physical, medical and emotional needs or Allowing an older adult to neglect their personal needs. What to look for: Unexplained injuries, bruises, burns, puncture wounds, cuts, sunken eyes and/or welts. Excessive fears, withdrawal, agitation. Sudden inability to pay bills, buy food or personal items. Changes in appetite or unusual weight gain or loss. Poor personal hygiene. Does not know personal finances or unexplained changes in health. hat is self-neglect and what are the signs? Hoarding. Failure to take essential medications or refusal to seek medical treatment for serious illness or injuries. Leaving a burning stove unattended. Poor hygiene. Not wearing suitable clothing for the weather. Confusion. Inability to attend to housekeeping or dehydration. Ways that families and friends can help: Respect and honor your elders. Report suspected abuse/mistreatment or self-neglect. Find sources of help and use them. Visit regularly monitor the well being of elderly neighbors. Keep track of medication and doctors’ visits. Volunteer to help. Realize abuse can happen in your family or neighborhood. Speak up when something looks or sounds wrong. Warnings for older adults: DO NOT live with a person who is violent or who abuses alcohol or drugs. If you are abused, mistreated, neglected, please tell others - such as your doctor, the clergy, a friend or family member. DO NOT leave cash or valuables out in the open. DO NOT give friends or family money if you need the money to live on. Ask someone you trust to read a document before you sign it. DO NOT allow anyone to keep details of your finances or property away from you.

These are commonly reported types of abuse received by Adult Protective Services agencies: Physical abuse: may include slapping, hitting, beating, bruising or causing someone physical pain, injury or suffering. This also could include confining an adult against his/her will, such as locking someone in a room or tying him/her to furniture. Emotional abuse: involves creating emotional pain, distress or anguish through the use of threats, intimidation or humiliation. This includes insults, yelling or threats of harm and/or isolation, or non-verbal actions such as throwing objects or glaring to project fear and/or intimidation. Neglect: includes failures by individuals to support the physical, emotional and social needs of adults dependent on others for their primary care. Neglect can take the form of withholding food, medications or access to health care professionals. For more information on neglect, click here. Isolation: involves restricting visits from family and friends or preventing contact via telephone or mail correspondence. Financial or material exploitation: includes the misuse, mishandling or exploitation of property, possessions or assets of adults. Also includes using another’s assets without consent, under false pretense, or through coercion and/or manipulation. Abandonment: involves desertion by anyone who assumed caregiving responsibilities for an adult. Sexual abuse: includes physical force, threats or coercion to facilitate non-consensual touching, fondling, intercourse or other sexual activities. This is particularly true with vulnerable adults who are unable to give consent or comprehend the nature of these actions. Self-neglect: involves seniors or adults with disabilities who fail to meet their own essential physical, psychological or social needs, which threatens their health, safety and well-being. This includes failure to provide adequate food, clothing, shelter and health care for one’s own needs.
If you witness a life-threatening situation involving a senior or adult with disabilities, dial 911. Contact your local Adult Protective Services agency any time you observe or suspect the following: Sudden inability to meet essential physical, psychological or social needs threatening health, safety or well-being. Disappearing from contact with neighbors, friends or family. Bruising or welts on the skin, especially those appearing on the face or lateral and anterior region of the arms (physically abused elders are much more likely to display bruises than seniors injured by accident). Fingerprints or handprints visible on the face, neck, arms or wrists. Burns from scalding, cigarettes, or in shapes of objects such as an iron. Cuts, lacerations or puncture wounds. prains, fractures or dislocations. Internal injuries or vomiting. Appearing with torn, stained, bloody clothing. Appearing disheveled, in soiled clothing or inappropriately attired for climate. Appearing hungry, malnourished, disoriented or confused.

Nursing Home Patients Bill Of Rights

All U.S. residents of nursing homes have specific legal rights, detailed in the Nursing Home Reform Act of 1987. Some of the most important rights include: The right to be free from physical or mental abuse, corporal punishment, involuntary seclusion, and any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident's medical symptoms. The right to confidentiality of personal and clinical records. The right to current clinical records of the resident upon request, and to get those records within 24 hours (excluding hours occurring during a weekend or holiday) of when the resident or a legal representative makes the request. The right to choose a personal attending physician, to be fully informed in advance about care and treatment, and to be fully informed in advance of any changes in care or treatment that may affect the resident's well-being. Also, the resident (or a legal representative) has the right to participate in planning care and treatment or changes in care and treatment. Finally, psychoactive drugs (including antipsychotics as well as drugs for depression and anxiety) may be administered only on the orders of a physician and only as part of a written plan designed to eliminate or modify the symptoms for which the drugs are prescribed. Such drugs may be given only if, at least annually, an independent, external consultant reviews the appropriateness of the drug plan of each resident receiving such drugs.
Source: Cornell University Law School Legal information Institute

Nursing Home Resident's Rights (wiki)
Americans with Disabilities Act of 1990 (wiki)

Nursing Home Residents being Evicted without warning and Discharged Involuntarily.
Nursing home residents have a lot of rights guaranteed in state and federal law. And nursing homes rarely pay a price for illegally evicting residents. Resident Rights and Protections (PDF)

California Long-Term Care Ombudsman Association protect the aging and dependent adults in their communities.
Legal Advocacy for the Rights of Older Persons
RHF provides affordable housing for seniors, low-income families and persons with disabilities.

Top of Page

Too Many Drugs - Drugs being Wasted

Over medicating that's driven by greed and ignorance

Substance Abuse among the Elderly
Elderly Drug Abuse
Overmedicating the Elderly
Over Medicating
Over Prescribing Medication
Drug Interactions Checker
Managing Multiple Drugs (PDF)
Multiple Medications Dangers
Overmedication (NPR)
Nursing Home calms troubling behavior without risky drugs (NPR)
Nursing Homes rarely penalized for over sedating patients (NPR)
Seniors & Drugs - NCADD

Senior Citizens Addiction Rehab - Addiction Help

Number Needed to Treat - Consent

Polypharmacy - Poly-Users

Pharmaceuticals Awareness and Info

iPharmacy Pro App to easily identify medications, check for any potential drug interactions, and track prescriptions.

Every year Nursing Homes nationwide flush, burn or throw out tons of Valuable Prescription Drugs. Every week in Des Moines, Iowa, the employees of a small nonprofit collect bins of unexpired prescription drugs tossed out by nursing homes after residents died, moved out or no longer needed them. The drugs are given to patients who couldn’t otherwise afford them.

Elderly Fraud - Abuse and Exploitation of Old People

National Center on Elder Abuse
Prevent Elder Abuse
National Adult Protective Services Association
Center on Elder Abuse
Nursing Home Abuse Guide
Financial Crimes Against the Elderly
NYC Elder Abuse Center
Elder Justice Coalition
Stop Fraud
Crimes - Victim Assistance
Fraud Victims - Consumer Protection

Older Americans Lose $2.9 Billion A Year To Fraud

Financial or Material Exploitation is defined as the illegal or improper use of an elder's funds, property, or assets. Examples include, but are not limited to, cashing an elderly person's checks without authorization or permission; forging an older person's signature; misusing or stealing an older person's money or possessions; coercing or deceiving an older person into signing any document (e.g., contracts,  Will or Trust); and the improper use of an Executor, Conservatorship, Guardianship or Power of Attorney.   

Financial Crimes against the elderly share some characteristics with other crimes. Related problems requiring separate analysis and responses include
* identity theft,     Consumer Protection
* Internet fraud,
* check and credit card fraud
* prescription fraud.

Financial Exploitation of the elderly may also occur in concert with other types of elder abuse, including:
* physical abuse,
* sexual abuse,       Abuse Info
* emotional abuse   What is Emotional Abuse?
* neglect.

Legal Help for the Elderly - Elder Law - Attorney Help

National Academy of Elder Law Attorneys
Elder Law Answers
National Elder Law Foundation
AARP Free Legal Assistance
Connecticut Law Help
PBS Finding Legal Help
Nursing Home Abuse

Legal Help Websites - Lawyers - Law Knowledge

Living Wills Advance Health Care Directive
Choosing how you wish to die on your terms

Caregiving Training Courses - Jobs


Caregiver Manuals
Caregiver Alert Information
Caregivers Handbook
Long Term Care Link
Elder 411 App - Practical information for caregivers all in one place.

Care Transitions Training Program
Preparing Patients and Caregivers to participate in care delivered across settings: the Care Transitions Intervention.

Employment Forecast (jobs)

Patient Care Training Videos

Transferring a Patient from Chair to Bed (youtube)
Patient Transfer Techniques with Ergotrans (youtube)
How to Care for Aging Parents (dailymotion)
The hidden role informal caregivers play in health care: Scott Williams (video and text)

Why I Train Grandmothers to Treat Depression: Dixon Chibanda (video and text)

National Council for Therapeutic Recreation Certification
Recreation Database

Objective Structured Clinical Examination

Care Giver Training Institute
Frontier Nursing University - Distance Education from the Birthplace of Nurse-Midwifery and Family Nursing in America.
Caregiver Training
Red Cross - First Aid
CNA Training
Senior Caregiver Certification
Home Care Training
Caregivers Training Videos
Caregiver Training

Patient Lift is an assistive device that allows patients in hospitals and nursing homes and those receiving home health care to be transferred between a bed and a chair or other similar resting places, using hydraulic power. Sling lifts are used for patients whose mobility is limited. They could be mobile (or floor) lifts or overhead lifts (suspended from ceiling-mounted or overhead tracks). (May be either a sling lift or Hoyer Lift, a brand name, or sit-to-stand lift, patient hoist, jack hoist, hydraulic lift).
The sling lift has several advantages. It allows heavy patients to be transferred while decreasing stress on caregivers while also reducing the number of nursing staff required to move patients. It also reduces the chance of orthopedic injury from lifting patients. Another kind of sling lift, which is called a ceiling lift, can be permanently installed on the ceiling of a room in order to save space. Mistakes using patient lifts may result in serious injury and some injuries that have been caused by improper use or malfunction of Hoyer lifts have led to civil lawsuits.

Mechanical Slings - Patient Lifts Equipment

Training caregivers to use technology like computers and smart phones could help home aides monitor and record things, such as physical and mental changes, reactions to medications and so on.

Films - Caregiving and Elderly Care Videos

Nursing Home Abuse (youtube)
Joan Halifax: Compassion and the True Meaning of Empathy (youtube)
The Unspooling Mind (youtube)
The Price of Life (vimeo)
Intro to 1963 Move The Caretakers (youtube)
Alexis Abramson (youtube)
The New Method of Swallowing (youtube)
Aging Parent Movies (amazon)
Mental Health Videos

Special Needs

Companion Services Should Include:

Friendly Conversation and participation in Recreational Activities.
Assistance with phone calls and Correspondence.

Computers for Senior Citizens

Assistance with maintaining medication schedules.
How to Administer Oral Medications

Transportation to physicians, shopping or recreation.
Light Housekeeping and Laundry.

Supervision of dressing and Bathing, and assistance with general mobility.
How to Dress and Undress Others (youtube)

Meal Preparation, meal planning, and food shopping....Sounds a little like Parenting.


Exercise for Seniors
Exercises that are modified for the Elderly and for those with injuries.
Chair Exercises and Limited Mobility Fitness
Elderly Exercise
Senior Fitness
Elderly Exercises
Cane Masters
Exercising for Life

Exercise Knowledge and Information

Please view the services to learn more about which home care option is right for your loved one:

Personal Care Attendants
Live-In Companions
Alzheimer's Care Companions
Specialty Care
Special Events Attendants

Visiting Angels 

Health Visitor are professional individuals engaged in public health work within the domestic setting, predominantly found in countries with state-funded health systems. They are distinct from district nurses, who provide clinical healthcare, domestically. In the UK, since 1945, health visitors are required to be Registered Nurses or Midwives who have undertaken further training to work as part of a primary health care team.


The Emotional Survival Guide for Caregivers: Looking After Yourself and Your Family While Helping an Aging Parent (amazon)
Eldercare For Dummies (amazon)
American Medical Association Guide to Home Caregiving (amazon)

"We look at children as being our future, but the elderly are the future too, and not just our past."

Caregiving Jobs

Companions and Homemakers Employment
Home Care Aide Jobs
Caregiver Jobs
Be a Property Caretaker

Home Health Aides & Personal & Home Care Aides Employment Projections

From 2016 to 2026. The Bureau expects the job of “personal-care aide” to grow faster than any other, with about 750,000 additional jobs; “home-health aide” is fourth on their list of fastest growers, adding an additional 425,000 jobs to the economy. Both jobs involve assisting people with diseases and disability, usually the elderly, as they continue to live their lives at home—the major difference being that home-health aides can legally offer some medical services. These jobs would go from 2.3 million of all US jobs in 2016 to about 3.4 million in 2026, accounting for 10% of all jobs created over the next decade. Among the fastest growth rates at 47% and 37%, respectively. “Solar installers” and “turbine technicians” are the only two occupations the Bureau expects to grow faster. In 2016, the median hourly wage for elderly-care aides was $10.66, compared to $17.81 for
the average job. US News & World Report rates these jobs as above average in stress level and below average in flexibility.
Elderly-care aides jobs are generally filled by women, people of color, and those with a high-school education or less. Nearly a quarter were not born in the US.

Care.com find temporary, qualified care for your loved ones — including caregivers specializing in the needs of people
with disabilities and aging populations — with just a few taps of your finger.

Specialized Skills that Some Caregivers Might Need
Caregiver Support
Respite Care Strategies
Child Development

Stories and Info I found on the internet........

The research materials are collated from web based resources.

The Census Bureau reports on July 1, 2004, 12 percent of all Americans were 65 and over.
By 2050, people 65 and over will comprise an impressive 21 percent of the U.S. population.

In observance of Older Americans Month 2005, the U.S. Census Bureau has compiled some revealing statistics about America's aging population.
Population · 36.3 million -- The number of people 65 and over in the U.S. on July 1, 2004. This age group accounts for 12 percent of the total U.S. population.
Between 2003 and 2004, 351,000 people moved into this age group.
86.7 million -- Projected number of people 65 and over in the year 2050.
People in this age group would comprise 21 percent of America's total population at that time.
147% -- Projected percentage increase in the 65-and-over population between 2000 and 2050.
By comparison, the population as a whole would have increased by only 49 percent over the same.

The number of Americans age 55 and older will almost double between now and 2030 – from 60 million today (21 percent of the total US population) to 107.6 million (31 percent of the population) – as the Baby Boomers reach retirement age.
During that same period of time, the number of Americans over 65 will more than double, from 34.8 million in 2000 (12 percent of the population) to 70.3 million in 2030 (20 percent of the total population).

The most rapid growth in numbers is among the "oldest old." According to the U.S. Census Bureau, there are currently 66,000 Americans older than 100, which is 20 times the number of centenarians who were alive in 1960. The Bureau estimates that there will be 214,000 centenarians in the U.S. by 2020 and 834,000 by 2050.
The next generation of retirees will be the healthiest, longest lived, best educated, most affluent in history:

Americans reaching age 65 today have an average life expectancy of an additional 17.9 years (19.2 years for females and 16.3 years for males). The likelihood that an American who reaches the age of 65 will survive to the age of 90 has nearly doubled over the past 40 years from just 14 percent of 65 year olds in 1960 to 25 percent at present. By 2050, 40 percent of 65 year olds are likely to reach age 90.

Advice for the Elderly...

Decide what kind of future you envision for yourself.
Create a plan that will help you achieve those goals.
Share that plan with the important people in your life.
Next Avenue

These days I’m seeing more and more people needing 24-hour personal care.

You read about the statistics of how many Americans are over 65 but theres nothing about how many are in need of 24-hour personal care. People are more worried about the quality of their retirement then they are about the facts about an aging body and the facts about our decaying world.

If you are an ill person or and elderly person in need of care today, you are extremely lucky if you have a caretaker. And extremely lucky to have an experienced caretaker who actually cares. You would not be so lucky if you are placed in a home were you’re lucky if someone even talks to you anymore, like you’re still a human being. Almost discarded like trash. You are basically at the curb waiting for the garbage man.

When I go to a convalescent home "Skilled Nursing Facility" or "SNF" or nursing home I want to be smiling, friendly and compassionate. But inside I’m crying at the state they are in. Knowing that the horrific reality of their care. physical, occupational, and other rehabilitative therapies following an accident or illness. Residents may have certain legal rights depending on the location of the facility.

Basic Care: Patients are paying for private nurses as NHS staff are failing them. Elderly patients are choosing to pay for private nurses in National Health Service Hospitals to provide them with basic care such as help with being fed and washed. New reports from nursing agencies and The Patients Association show that elderly NHS patients are being neglected as NHS nurses do not have the time to provide them with basic care. The association has received accounts from eight families in the past six months who have turned to private nursing help for elderly patients while they are in NHS hospitals.

Aging Parents and Elder-Care
Caring for an aging parent, elderly spouse, domestic partner or close friend presents difficult challenges – especially when a crisis hits and you are suddenly faced with the responsibilities of elder care. Perhaps your aging mother has fallen, is hospitalized with a broken hip and needs to go to a rehab facility or nursing home to recover. Caregiving can also begin as a result of a series of unsettling mishaps and warning signs that indicate a need for long term senior care. Perhaps your elderly spouse has wandered off and gotten lost several times. Or a long-time friend has lost a lot of weight and rarely leaves home. You may be the only person to step in and become the caregiver, or you may be the linchpin of a network of family members and friends willing to help care for your elderly senior. Whatever the situation, you are not sure of the next step, or even the first step.

How to care for elderly parents is a major concern of many Foreign Service families. Our concerns mirror those of other American families, but how to ensure good health care, find the right living situation, and handle legal questions is often complicated for Foreign Service families by being posted abroad. The distance involved makes it harder to get information and help so contingency planning is essential.
Often Foreign Service families only have short visits during R & R or on home leave and hate to spend the precious time with their parents talking about serious business or unpleasant possibilities. Or we may be caught up in hectic preparations for an overseas assignment and not want to take the time to do contingency planning with parents. While it is difficult to discuss the issues of aging, the family who has discussed the options and agreed on plans will be better able to handle whatever happens. It will be worth the time taken, if there is an emergency.
The ideal situation is when the parents take control of their own situations and make decisions in advance of an emergency.
They should investigate the types of retirement options and decide which is most appropriate, make informed decisions about life-sustaining medical care, and make sure that documents, instructions, and powers of attorney are available to those who must take responsibility in an emergency. The American Association of Retired Persons recommends that elderly people use a document locator list (scroll to bottom of this page) to make sure their papers are in order. This list can then be given to the person(s) who will be responsible for them should an emergency arise. Going through the list with your parents should ensure that their wishes are understood.

Communicating with Elderly Parents

Talking with our elderly parents about their living situations and the possible need for change is not always easy. A successful conversation depends to an extent upon the relationship we have with the parent, as well, of course, as on the parent's mental, emotional and physical condition. While many people put off serious conversations to avoid conflict or awkwardness, both parent and adult child may lose an opportunity for closeness, understanding, access to information that may affect the decision, and optimum peace of mind. To the extent possible, talk with your elderly parents gently and honestly about their wishes, their abilities and their options. Far more often than not, these conversations are helpful and put the adult child in a better position to make decisions later when the parent may not be able to do so. The following are suggestions for conversations with your elderly parent:

* Share your own feelings, and reassure the parent that you will support them and can be depended upon to help them solve their problems.

* Help the parent to retain whatever control is possible in making his or her own decisions. Respect and try to honor their wishes wherever feasible.

* Encourage the smallest change possible at each step, so that the parent is more able to adjust to the change.

* Educate yourself on legal, financial and medical matters that pertain to your parent as background for your conversations, including current knowledge on the aging process.

* Respect your own needs - be honest with your parents about your time and energy limits.

If this kind of conversation seems impossible or the situation and relationship with the elderly parent become overwhelming, professional counseling may be very helpful. You may also consider using the Department of State's resources to approach this delicate issue somewhat indirectly. Filling out FIVE WISHES for yourself and sharing your decisions with your parents may encourage them to open up on the subject. You may also wish to raise the subject of long-term care insurance as a practical matter. (For more information about FIVE WISHES and Long-Term Care Insurance, see below).

When a Lifestyle Change May Be Necessary
Physicians and geriatric social workers warn that there are a number of danger signs that indicate an elderly person needs extra help or a change in living arrangement. Any marked change in personality or behavior should be heeded. However, no change in lifestyle should be made without discussions with the elderly person, other family members, and doctors or other health professionals.

Danger Signals

* Sudden weight loss could be an indication that the elderly person is simply not eating or not preparing foods.
* Failure to take medication or over-dosing may indicate confusion, forgetfulness, or a misunderstanding of the doctor's instructions.
* Burns or injury marks may indicate physical problems involving general weakness, forgetfulness, or a possible misuse of alcohol.
* Deterioration of personal habits such as infrequent bathing and shampooing, not shaving, or not wearing dentures could be the result of either mental or physical problems.
* Increased car accidents can indicate slowed reflexes, poor vision, physical weakness, or general inability to handle a vehicle.
* General forgetfulness such as not paying bills, missing appointments, or consistently forgetting name, address, phone number, and meal times could be a signal.
* Extreme suspiciousness could indicate some thought disorder. Your parents thinking that their neighbors, friends, family, doctor, and lawyer are all conspiring against them would be an example. Intense ungrounded fears about dire consequences may be a danger signal.
* A series of small fires could be caused by dozing off, forgetting to turn off the stove or appliances, or carelessness with matches. They may indicate blackouts or dizzy spells.
* Bizarre behavior of any kind could be a warning sign. This behavior could be dressing in heavy gloves and overcoat in 90 degree weather or going outside without shoes when it's snowing. Watch for uncharacteristic actions or speech.
* Disorientation of a consistent nature may indicate a need for help. Examples include not knowing who one is, where one is, who the family is, or talking to people who are not there.

Elder Care Options

If you see danger signals in your parent's behavior, it is important to discuss the changes and do some research. (See IQ: Information Quest below for information about the Department of State's free resource referral service.) There are many housing options available to the elderly. Choosing the best one will depend on the elderly person's preference, age, health, and financial condition. Death Wish

Aging in Place

Under this option, the elderly person continues to live in his/her own apartment. Many elderly people live in Naturally Occurring Retirement Communities (NORCs), apartment buildings, condominiums, or cooperatives not designed as retirement communities but where at least 50 percent of the residents are 62 years old or older. These buildings often have amenities such as grocery stores, pharmacies, limousine service, or shopping services.
Recent technological advances often make aging in place easier: Velcro fasteners, lightweight wheelchairs, devices to control appliances and dial telephone numbers. There is even a "walk-in bathtub" for people who have difficulty climbing into an ordinary bathtub. Many services are available to help the elderly person stay in his/her home. Information about them can be obtained from contacting IQ: Information Quest (see below) or your local Area Agency on Aging.
Aging in Place is a resource hub for seniors and their families to learn more about the specific aspects of aging in place.

* Home care services are available in many communities, providing appropriate, supervised personnel to help older persons with either health care (giving medications, changing dressings, catheter care, etc.) or personal care (bathing, dressing, and grooming).
* Meals and transportation are available to older people to help them retain some independence. Group or home-delivered meal programs help ensure an adequate diet. Meals-On-Wheels programs are available in most parts of the United States. A number of communities offer door-to-door transportation services to help older people get to and from medical facilities, community facilities, and other services.
* Adult day care is similar to child day care. The elderly person goes to a community facility daily or 2 or 3 days per week. Activities include exercise programs, singing, guest lectures, and current events discussions. Cost varies and there are often long waiting lists at such centers.
* Respite care brings a trained person into the home to give the full-time caregiver time off to get a haircut, visit the dentist, or take a vacation. Service is generally offered through area Departments of Social Services and is based on a sliding fee scale.

Other Housing Options

There are several types of Retirement Communities that provide living arrangements and services to meet the needs of both independent seniors and those who need assistance. Large hotel corporations are in this field and other facilities are set up for members of a certain organization (retired military, Elks, etc.)

It is important when investigating these housing options to understand completely the services provided and the cost.

Adult Congregate Communities are designed for the fully able-bodied, 55 and older. Residents buy co-ops or condominiums and pay a monthly fee for grass mowing, leaf raking, and snow shoveling. A pay-as-you-go medical center is on site and a nurse is on duty 24 hours a day to make home visits in emergencies. Leisure World is the most famous example of an adult congregate community.

Assisted Living Communities are rental retirement communities for independent seniors who need some assistance. A homelike atmosphere, three meals a day, maid, linen, and laundry service, availability of a registered nurse, and many personal care services are provided in the all-inclusive rent.

Rental Retirement Communities with fee-for-service nursing units charge residents an entrance fee plus a substantial monthly rent. When the need for nursing care arises, residents pay an extra daily fee and stay in a nursing unit, usually located on site or nearby.

Life Care or Continuing Care Communities provide a continuum of care from independent living to nursing home care on the premises. The individual must be independent when s/he enters the community. These communities require a substantial entrance fee and monthly service fee. Residents get one meal a day in a dining room, maid service, linen service, maintenance, transportation to shopping and cultural events, travel planning, and a pull cord to an emergency nurse. If nursing care is needed, it is provided at no extra cost.

Personal Care Homes (board and care) are licensed in many communities to provide shelter, supervision, meals, and personal care to a small number of residents.

Subsidized Housing for the Elderly is an option for the elderly poor in reasonably good health. Subsidized by Department of Housing and Urban Development, income limits apply. No round-the-clock care is provided but nurses come in to check blood pressure and assess a resident's functioning. Residents take meals in a dining room and may have use of a library, recreation area, or beauty shop.

Nursing Facilities or a nursing home, convalescent home, skilled nursing facility (SNF), care home, rest home or intermediate care provides a type of residential care. It is a place of residence for people who require continual nursing care and have significant difficulty coping with the required activities of daily living. Nursing aides and skilled nurses are usually available 24 hours a day. Residents include the elderly and younger adults with physical or mental disabilities. Residents in a skilled nursing facility may also receive physical, occupational, and other rehabilitative therapies following an accident or illness. Some nursing homes assist people with special needs, such as Alzheimer patients. Residents may have specific legal rights depending on the nation the facility is in.

If the elderly person is not capable of Independent Living, a nursing home may be the appropriate option. Nursing homes offer two levels of care - skilled nursing and intermediate care - depending on the patient's needs. Most nursing homes offer both levels of care on a single site.

Skilled Nursing Facilities provide 24-hour nursing services for people who have serious health care needs but do not require the intense level of care provided in a hospital. Rehabilitation services may also be provided.

Intermediate Care Facilities provide less extensive health care than skilled nursing facilities. Nursing and rehabilitation services are provided but not on a 24-hour basis. These facilities are for people who cannot live alone but need a minimum of medical assistance and help with personal and/or social care.

Paying for Long-Term Care

It is important to understand the different types of insurance that are available to older people. Many people believe that Medicare will cover long-term care needs. It will not. 

Long-term Care Insurance (wiki)
Understanding the Financial impact


Medicare is a Federal health insurance program which helps defray many of the medical expenses of most Americans over the age of 65. Medicare has two parts:
(Part A) Hospital Insurance helps pay the cost of inpatient hospital care. The number of days in the hospital paid for by Medicare is governed by a system based upon patient diagnosis and medical necessity for hospital care. Once it is no longer medically necessary for the person to remain in the hospital, the physician will begin the discharge process. If the person or the family disagrees with this decision, they may appeal to the state's Peer Review Organization.
Medicare does not pay for custodial care or nursing home care. It will, however, cover up to 60 days in a nursing home as part of convalescence after hospitalization.
(Part B) Medical Insurance pays for many medically necessary doctors' services, outpatient services, and some other medical services. Enrollees pay a monthly premium.


Medicaid is a joint federal-state health care program for people with a low income. The program is administered by each state and the type of services covered differs. There are strict income requirements so it is necessary for the person to "spend down" all income and assets to poverty levels before becoming eligible. Medicaid is the major payer of nursing home care.
The Medicaid requirement to "spend down" all income and assets created a great hardship for the spouse of a person needing nursing home care. Changes in the Medicaid rules now allow the spouse to keep a monthly income and some assets, including the primary residence. The amounts allowed change, so you must check for current levels.  

Insurance Problems (misconceptions)

Other Insurance

Why buy other insurance? The purchase of additional insurance gives the policy holder access to a greater choice of facilities without dipping into additional financial resources. Medigap is the name given to privately-purchased supplemental health insurance. It is designed to help cover some of the gaps in Medicare coverage but does not cover long-term care. Study Medigap policies carefully to be sure they provide the protection needed and do not duplicate other health insurance.

Long-Term Care Insurance
is a private insurance that is usually either an indemnity policy or part of an individual life insurance policy. An indemnity policy pays a set amount per day for nursing home or home health care. Under the life insurance policy, a certain percentage of the death benefit is paid for each month the policyholder requires long-term care. Policies are priced differently depending on the age of the policyholder, the deductible periods chosen, and indemnity value or duration of benefits.

Effective October 2002, Federal employees, annuitants, and qualified family members (spouse, adult children, and parents may purchase insurance from Long-Term Care Partners, a consortium formed by John Hancock and MetLife.
Long-Term Care Partners will offer a choice of policies specially designed to meet the needs of the federal workforce at potentially lower cost than individual commercial policies. For more information on long-term insurance through the U.S. government, check with your HR officer or visit the Office of Personnel Management (OPM) web site at opm.gov  or ltcfeds.com

We shouldn’t have any unemployed people. There is just so much work that needs to be done. We are slaves to the Monetary System. We have no money for the things we need to do, we only have money for the wealthy that only want to do what they want to do and not what is needed. Money is just a tool and not something that tells us what we can and cannot do. When someone says they don’t have the money they are either a liar, a criminal or very ignorant. So listen to a politician the next time they say that they can’t do what is needed because of money, they are either a liar, a criminal or very ignorant...Stop using Money as a Weapon of Control...Please..It has never been about money. It’s more about knowledge. Money makes slaves and knowledge frees slaves. It’s time to ask our leaders what the real problem is.

Care Giving (definitions)

Care Giver is a person who Helps another individual with an impairment with his or her activities of daily living. Any person with a health impairment might use caregiving services to address their difficulties. Caregiving is most commonly used to address impairments related to old age, disability, a disease, or a mental disorder. Care Giving

Voluntary Caregiver or carer is an unpaid or paid person who helps another individual with an impairment with his or her activities of daily living. Any person with a health impairment might use caregiving services to address their difficulties. Caregiving is most commonly used to address impairments related to old age, disability, a disease, or a mental disorder.

Unlicensed Assistive Personnel is a class of paraprofessionals who assist individuals with physical disabilities, mental impairments, and other health care needs with their activities of daily living (ADLs) and provide bedside care—including basic nursing procedures—all under the supervision of a registered nurse, licensed practical nurse or other health care professional. UAPs must demonstrate their abilities and competencies before gaining any expanded responsibilities within the clinical setting.

Personal Care Assistant is a class of paraprofessionals who assist individuals with physical disabilities, mental impairments, and other health care needs with their activities of daily living (ADLs) and provide bedside care—including basic nursing procedures—all under the supervision of a registered nurse, licensed practical nurse or other health care professional. UAPs must demonstrate their abilities and competencies before gaining any expanded responsibilities within the clinical setting.

Personal Care Assistant (PCA) is a nurse who cares for people who are sick, injured, convalescent, or disabled. LPNs work under the direction of registered nurses or physicians. In the United States however, California, Vermont and Texas refer to them as a licensed vocational nurse (LVN).

Personal Assistant is a job title describing a person who assists a specific person with their daily business or personal tasks.

Nanny is an individual who provides care for one or more children in a family as a service. Traditionally, nannies were servants in large households and reported directly to the lady of the house. Today, modern nannies, like other domestic workers, may live in or out of the house depending on their circumstances and those of their employers. Professional nannies are usually certified in cardiopulmonary resuscitation, qualified in First Aid, and have a degree or extensive training in child development. There are many employment agencies that specialize in childcare and online services that aid in finding available nannies.

Nurse is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority. Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.

Certified Nursing Assistant (CNA)

Licensed Practical Nurse (RPN) is a nurse who cares for people who are sick, injured, convalescent, or disabled. A person can generally become an LPN with two years of training.

Travel Nursing is a nursing assignment concept that developed in response to the nursing shortage. This industry supplies nurses who travel to work in temporary nursing positions, mostly in hospitals. While travel nursing traditionally refers specifically to the nursing profession, it can also be used as a blanket term to refer to a variety of travel healthcare positions, including physical therapy, occupational therapy, speech-language pathology and even doctors and dentists.


Transitional Care refers to the coordination and continuity of health care during a movement from one healthcare setting to either another or to home, called care transition, between health care practitioners and settings as their condition and care needs change during the course of a chronic or acute illness. Older adults who suffer from a variety of health conditions often need health care services in different settings to meet their many needs. For young people the focus is on moving successfully from child to adult health services.

Companion may be a nursing assistant or similar professional who is hired to work with one patient (or occasionally two). Companions may be hired to work in a variety of settings, including nursing homes, assisted living facilities, hospitals, and private homes, and their duties range from advanced medical care to simple companionship and observation.

Domestic Worker is a person who works within the employer's household. Domestic helpers perform a variety of household services for an individual or a family, from providing care for children and elderly dependents to housekeeping, including cleaning and household maintenance. Other responsibilities may include cooking, laundry and ironing, shopping for food and other household errands. Such work has always needed to be done but before the Industrial Revolution and the advent of labour saving devices, it was physically much harder.

Handyman is a person skilled at a wide range of repairs, typically around the home. These tasks include trade skills, repair work, maintenance work, are both interior and exterior, and are sometimes described as "side work", "odd jobs" or "fix-up tasks". Specifically, these jobs could be light plumbing jobs such as fixing a leaky toilet or light electric jobs such as changing a light fixture.

Other Types of Help and Support

Ethics of Care is a normative ethical theory: a theory about what makes actions morally right or wrong. It is one of a cluster of normative ethical theories that were developed by feminists in the second half of the twentieth century. While consequentialist and deontological ethical theories emphasize universal standards and impartiality, ethics of care emphasize the importance of response. The shift in moral perspective is manifested by a change in the moral question from "what is just?" to "how to respond?". Ethics of care criticize application of universal standards as "morally problematic, since it breeds moral blindness or indifference.

Disabilities (special needs)

Duty of Care is a legal obligation, which is imposed on an individual requiring adherence to a standard of reasonable care while performing any acts that could foreseeably harm others. It is the first element that must be established to proceed with an action in negligence.

Care of Residents refers to long-term care given to adults or children who stay in a residential setting rather than in their own home or family home.

Home Care is supportive care provided in the home. Care may be provided by licensed healthcare professionals who provide medical treatment needs or by professional caregivers who provide daily assistance to ensure the activities of daily living (ADLs) are met. In-home medical care is often and more accurately referred to as "home health care" or formal care. Often, the term home health care is used to distinguish it from non-medical care, custodial care, or private-duty care which refers to assistance and services provided by persons who are not nurses, doctors, or other licensed medical personnel. For terminally ill patients, home care may include hospice care. For patients recovering from surgery or illness, home care may include rehabilitative therapies.

Elder Care Locations (gov)
Senior Homes

Geriatric Care Management is the process of planning and coordinating care of the elderly and others with physical and/or mental impairments to meet their long term care needs, improve their quality of life, and maintain their independence for as long as possible. It entails working with persons of old age and their families in managing, rendering and referring various types of health and social care services. Geriatric care managers accomplish this by combining a working knowledge of health and psychology, human development, family dynamics, public and private resources and funding sources, while advocating for their clients throughout the continuum of care. For example, they may assist families of older adults and others with chronic needs such as those suffering from Alzheimer's disease or other dementia.

National Health Service is the name of the public health services of England, Scotland and Wales, and is commonly used to refer to those of Northern Ireland.

Caregivers Library
Abbott Patient Assistance Foundation
Community Care Vs Institutional Care ?
Overnight Dementia Care Give Caregivers Rest

Health Care is the maintenance or improvement of health via the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings. Health Care is delivered by health professionals (providers or practitioners) in allied health professions, chiropractic, physicians, physician associates, dentistry, midwifery, nursing, medicine, optometry, pharmacy, psychology, and other health professions. It includes the work done in providing primary care, secondary care, and tertiary care, as well as in public health.

Intensive-Care Medicine is a branch of medicine concerned with the diagnosis and management of life-threatening conditions requiring sophisticated organ support and invasive monitoring.

Managed Care is used in the United States to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care ("managed care techniques"), for organizations that use those techniques or provide them as services to other organizations ("managed care organization" or "MCO"), or to describe systems of financing and delivering healthcare to enrollees organized around managed care techniques and concepts ("managed care delivery systems").

Long-term Care is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods.

Assisted Living is a housing facility for people with disabilities or for adults who cannot or chose not to live independently. The term is popular in the United States but is similar to a retirement home in the sense that facilities provide a group living environment and typically cater to an elderly population.

Nursing Home provides a type of residential care. It is a place of residence for people who require continual nursing care and have significant difficulty coping with the required activities of daily living. Nursing aides and skilled nurses are usually available 24 hours a day. (also know as a Convalescent Home, killed nursing facility (SNF), care home, rest home or intermediate care).

Skilled Nursing Facilities (help guide)
End of Life Care
Adult Day Care Centers (help guide)
Adult Day Care

Adult Daycare Center is typically a non-residential facility that supports the health, nutritional, social, and daily living needs of adults in a professionally staffed, group setting. These facilities provide adults with transitional care and short-term rehabilitation following hospital discharge. The majority of centers provide meals, meaningful activities, and general supervision. The care provided is often a social model (focusing on socialisation and prevention services) or a medical model (including skilled assessment, treatment and rehabilitation goals) provided in order to improve participants health and guide their progress in the right direction.

Adult Day Care Group
Visiting Nurse Association
Custodial Care and Baby Sitters

Independent Living is people with disabilities working for equal opportunities, self-determination, and self-respect. In the context of eldercare, independent living is seen as a step in the continuum of care, with assisted living being the next step.

Social Model of Disability is a reaction to the dominant medical model of disability which in itself is a functional analysis of the body as machine to be fixed in order to conform with normative values. The social model of disability identifies systemic barriers, negative attitudes and exclusion by society (purposely or inadvertently) that mean society is the main contributory factor in disabling people. While physical, sensory, intellectual, or psychological variations may cause individual functional limitation or impairments, these do not have to lead to disability unless society fails to take account of and include people regardless of their individual differences.

Flatulence Odor Remedy
Caregiving Resource Center
Caring for Elderly Guide
Senior Living Guide
Caregiver Support Blog
The Care Givers Voice Blog
Cognitive Assessment
More Resources

International Association for Homes and Services for the Aging
Patient Protection and Affordable Care Act
National Association of Professional Geriatric Care Managers
Senior Americans Association
Mental Health Websites
Physical Health Websites

Helping pays off: People who care for others live longer

Care Giving Resources

Education for Care Givers, Parents and their Children

Compassion Care
Masoni Care
CSI Caregiver
Caring Info
Best Senior Care Online
A Place for Mom
Caregiver List
Heavenly Caregivers
Care with Heart
My Guardian Angels Homecare
Foundation AARP
Constellation HS
My Guardian Angels Home Care
Polish Helping Hands
Parent Care Balance Blogspot
Obc Eldercare
Aging Care
Caring Parents
The Scan Foundation
Golden Girls Network

Care Giver Responsibilities

Care Giving Knowledge Base

Cooperative Home Care Associates
Medicare Caregiver Resources
Leading Homecare
Leading Age
Living Senior
Age in Place
Aging in Place

American College of Health Care Administrators
American Health Care Association
American Medical Directors Association
National Association of Health Care Assistants

California Health Plan
Reverse Mortgages

Aristo Care
Com for Care
Comfort Keepers
El Direct Home Care
Griswold Homecare
Home Helpers
Home instead
Home Watch Caregivers
Right at Home
Sarah Care
Superior Senior Care
Living Assistance

Physician's Care Clinic
Johnson County Kansas
Elder Options of Texas

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Aging Parents: The Family Survival Guide

Aging Parents - Consisting of a booklet and two videotapes, this guide is designed to help family members respond to eldercare crises and to plan ahead for long-term care giving. To order, call 1-888-777-5585 or order online.

Aging Parents and Elder Care - Articles, comprehensive checklists, and links to key resources.
The site is designed to make it easier for family caregivers to quickly find the information they need.

Elder Web: An Online Eldercare Sourcebook. Designed to assist older Americans, professionals and family members,
this web site covers eldercare and related issues with an extensive array of links.

Department of State Bureau of Consular Affairs Travel Tips for Older Americans.
(see Special Planning Considerations / Senior Travelers).

Academy of Elder Law Attorneys
1604 North Country Club Road
Tucson, AZ 85716
Tel: 520-881-4005
Fax: 520-325-7925

Alzheimer's Association, Inc.
919 North Michigan Avenue, Suite 1000
Chicago IL 60611
Tel: 1-800-272-3900

American Association of Homes for the Aging
901 E Street NW
Washington, DC 20004
Tel: 202-783-2242
Fax: 202-783-2255

American Association of Retired Persons
601 E Street NW
Washington, DC 20049
Tel: 202-434-2277

Partnership for Caring
Provides the following free pamphlets:
Miles Away and Still Caring (D-12748);
A Handbook About Care in the Home (D-955);
A Path For Caregivers (D-12957)
Choice in Dying/Partnership for Caring
1035 30th Street NW
Washington, DC 20007
Tel: 202-338-9790 or 800-989-9455
Fax: 202-338-0242

Guide to Retirement Living
Free medical directives and living will samples.
Douglas Publishing Company, Inc.
9302 Lee Highway, Suite 750
Fairfax, VA 22031
Tel: 703-536-5150 or 1-800-394-9990

Health Insurance Association of America
555 13th Street NW, Suite 600 East
Washington, DC 20004
Tel: 202-824-1600
Fax: 202-824-1722

National Association of Private Geriatric Care Managers
Publishes A Consumer's Guide to Long-Term Care.
1604 North Country Club Road
Tucson, AZ 85715
Tel: 520-881-8008
Fax: 520-325-7925

National Council on the Aging, Inc.
Provides free referrals nationwide and
sells a directory of members and managers

409 3rd Street SW
Washington, DC 20061-5087
Tel: 202-479-1200

National Institute on Aging
Publishes Perspective on Aging,
a bimonthly magazine, and Family Home Caring Guides.
9000 Rockville Pike
Bethesda, MD 20892
Tel: 301-496-1752

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1604 N. Country Club Rd
Tucson, AZ 85716
Tel: 520-881-6561

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A comprehensive web site with links to eldercare services and insurance information. Updated web site addresses for all State Agencies on Aging.

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Why does Hair turn Grey?

A persons hair turns grey when the body stops producing the cells called Melanocyte, which helps create color in the hair called Melanin. The older we get, melanocytes decrease in number. The result is less and less melanin, until none are present. Thus, we slowly turn gray. Gray hair is the result of less melanin within the keratin. The less melanin, the more gray your hair will be. White hair has no melanin at all. 

Human Hair Color (wiki)

Old Age is not the only factor that determines when a persons hair starts to turn grey. Some autoimmune diseases can cause premature graying, as well as smoking, Anemia, Poor Nutrition, insufficient B vitamins, your genes, and untreated thyroid conditions, to name a few. Gray Hair Linked to Immune System activity and Viral Infection. Researchers report that loss of hair pigmentation, or gray hair, is associated  with activation of the innate immune system in mice. A direct link between MITF, innate immunity, and hair graying.

Why Do Our Hair And Eye Color Change? (youtube)

When babies are born, their eyes and hair are one color, but change within the first few years of their life! Why do hair and eye colors change? Trace explains the process of inheriting certain traits from your parents, and discusses why the colors change!
History of Eye Color - Eye Sight

The OCA2 Gene (formerly called the P gene) provides instructions for making a protein called the P protein. This protein is located in melanocytes, which are specialized cells that produce a pigment called melanin. Melanin is the substance that gives skin, hair, and eyes their color. EYCL1, EYCL2, EYCL3 are human genes that influences pigment and hair, skin, and eye colors.
OCA2 gene mutation for Blue Eyes occurred between 6,000 and 10,000 years ago. Before then, there were no blue eyes. Why did we go from having nobody on Earth with blue eyes 10,000 years ago to having 20 or 40 percent of Europeans having blue eyes now?

Even though there is a wide range of hair and skin color, there are only two main types of melanin-eumelanin is what produces dark browns and blacks, and pheomelanin produces reddish/yellow. How these cells blend together will determine what color your hair will be. One gene, and its alleles responsible for red hair, have already been identified; known as MC1R.

"We're not getting any younger, but that doesn't mean you should be getting dumber. Since 2008 I've spent the last 6 years repairing the years of ignorance that I have accumulated since 1960, it's not easy, but it is being done. But you have to start, or you will never finish. Everyone has challenges ahead. So Keep experiencing life as much as you can, but more importantly, don't stop learning."

"I don't see old age as a slow decline. I see old age as a gradual rise in energy and awareness. The body may slow down a little but the mind is speeding up, becoming more aware, learning new skills, processing more information, seeing more and more each day. If you keep learning the right things at the right time you will never grow old, on the inside at least, which just happens to be the most important side. Creating a learning environment is easy, knowing what to learn is the hard part."

"I might be doing less as I get older, but I will be doing more with less. So instead of doing 100 important things in my life, I'll be doing just a handful of the most important things that my life has to offer, the cream of the crop."

"My last breath will not be the defining moment, just another moment."

When poet Robin Morgan found herself facing Parkinson’s disease, she distilled her experiences into these four quietly powerful poems — meditating on age, loss, and the simple power of noticing.

No Signs of Struggle
Growing small requires enormity of will: just sitting still in the doctor's waiting room watching the future shuffle in and out, watching it stoop; stare at you while you try not to look. Rare is an exchange: a smile of brief, wry recognition.

You are the new kid on the block. Everyone here was you once. You are still learning that growing small requires a largeness of spirit you can't fit into yet: acceptance of irritating help from those who love you; giving way and over, but not up.

You've swallowed hard the contents of the "Drink Me" bottle, and felt yourself shrink. Now, familiar furniture looms, floors tilt, and doorknobs yield only when wrestled round with both hands. It demands colossal patience, all this growing small: your diminished sleep at night, your handwriting, your voice, your height.

You are more the incredible shrinking woman than the Buddhist mystic, serene, making do with less. Less is not always more. Yet in this emptying space, space glimmers, becoming visible. Here is a place behind the eyes of those accustomed by what some would call diminishment.

It is a place of merciless poetry, a gift of presence previously ignored, drowned in the daily clutter. Here every gesture needs intention, is alive with consciousness. Nothing is automatic.

You can spot it in the provocation of a button, an arm poking at a sleeve, a balancing act at a night-time curb while negotiating the dark. Feats of such modest valor, who would suspect them to be exercises in an intimate, fierce discipline, a metaphysics of being relentlessly aware?

Such understated power here, in these tottering dancers who exert stupendous effort on tasks most view as insignificant. Such quiet beauty here, in these, my soft-voiced, stiff-limbed people; such resolve masked by each placid face. There is immensity required in growing small, so bent on such unbending grace.

On Donating My Brain to Science
Not a problem. Skip over all the pages reassuring religious people. Already a universal donor: kidneys, corneas, liver, lungs, tissue, heart, veins, whatever.

Odd that the modest brain never imagined its unique value in research, maybe saving someone else from what it is they're not quite sure I have. Flattering, that.

So fill in the forms, drill through the answers, trill out a blithe spirit.

And slice me, dice me, spread me on your slides. Find what I'm trying to tell you.

Earn me, learn me, scan me, squint through your lens. Uncover what I'd hint at if I could.

Be my guest, do your best, harvest me, track the clues. This was a good brain while alive. This was a brain that paid its dues.

So slice me, dice me, smear me on your slides, stain me, explain me, drain me like a cup. Share me, hear me:

I want to be used I want to be used I want to be used up.

The Ghost Light
Lit from within is the sole secure way to traverse dark matter. Some life forms -- certain mushrooms, snails, jellyfish, worms -- glow bioluminescent, and people as well; we emit infra-red light from our most lucent selves. Our tragedy is we can't see it.

We see by reflecting. We need biofluorescence to show our true colors. External illumination can distort, though. When gravity bends light, huge galaxy clusters can act as telescopes, elongating background images of star systems to faint arcs -- a lensing effect like viewing distant street lamps through a glass of wine.

A glass of wine or two now makes me weave as if acting the drunkard's part; as if, besotted with unrequited love for the dynamic Turner canvasses spied out by the Hubble, I could lurch down a city street set without provoking every pedestrian walk-on stare.

Stare as long as you need to. If you think about it, walking, even standing, is illogical -- such tiny things, feet! especially when one's body is not al dente anymore.

Besides, creature of extremes and excess, I've always thought Apollo beautiful but boring, and a bit of a dumb blonde. Dionysians don't do balance.

Balance, in other words, has never been my strong point. But I digress. More and more these days, digression seems the most direct route through from where I've lost or found myself out of place, mind, turn, time.

Place your foot just so, mind how you turn: too swift a swivel can bring you down. Take your time ushering the audience out, saying goodbye to the actors. The ghost light is what they call the single bulb hanging above the bare stage in an empty theater.

In the empty theater of such a night, waking to meet no external radiance, this is the final struggle left to win, this the sole beacon to beckon the darkness in and let the rest begin, this the lens through which at last to see both Self and Other arrayed with the bright stain of original sin: lit from within

This Dark Hour
Late summer, 4 A.M. The rain slows to a stop, dripping still from the broad leaves of blue hostas unseen in the garden's dark. Barefoot, careful on the slick slate slabs, I need no light, I know the way, stoop by the mint bed, scoop a fistful of moist earth, then grope for a chair, spread a shawl, and sit, breathing in the wet green August air.

This is the small, still hour before the newspaper lands in the vestibule like a grenade, the phone shrills, the computer screen blinks and glares awake.

There is this hour: poem in my head, soil in my hand: unnamable fullness. This hour, when blood of my blood bone of bone, child grown to manhood now -- stranger, intimate, not distant but apart -- lies safe, off dreaming melodies while love sleeps, safe, in his arms.

To have come to this place, lived to this moment: immeasurable lightness. The density of black starts to blur umber. Tentative, a cardinal's coloratura, then the mourning dove's elegy. Sable glimmers toward grey; objects emerge, trailing shadows; night ages toward day. The city stirs.

There will be other dawns, nights, gaudy noons. Likely, I'll lose my way. There will be stumbling, falling, cursing the dark. Whatever comes, there was this hour when nothing mattered, all was unbearably dear.

And when I'm done with daylights, should those who loved me grieve too long a while, let them remember that I had this hour -- this dark, perfect hour -- and smile.

Senior Citizen Stories

The Thinker Man