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
caring for a
loved one at home
long care facilities
. By 2050, people 65 and over will
comprise an impressive 21 percent of the
U.S. population. 10,000 baby boomers turn 65
, that's 3,650,000 every year. And if you add the number who
turn 66 and 67 everyday, here comes the silver tsunami.
Growing Old - Hard Facts and Statistics
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
are caring for aging parents
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
United States, according to the Centers for Disease Control and
Prevention. 15 percent of the population 70 and older has
. 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!
Caregiver Job Descriptions
- End of Life Care
- How I wish to Die
- Aging In Place
- Alarm Fatigue
- Music Therapy
- First Aid
White House Conference on Aging
(amazon) - Resources for Caregiving
The coming Neurological Epidemic: Gregory Petsko
(video and Interactive Text)
- Point of Care
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.
- Have a technology question? Call the National Senior Planet Hotline:
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
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.
What does Growing Old Mean
is the process of becoming older
, when single
cells within an organism have
experience cellular senescence
Aging also refers to
the population of a species and population ageing.
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
is to grow old, the
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
, which is the sub-field of gerontology concerned with
the biological aging process, its evolutionary origins, and potential
means to intervene in the process.
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).
is the state of being weak in
health or body, especially from old age. Moral weakness.
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
. It can be used to show the likely current appearance of a
missing person from a photograph many years old.
(living longer and healthier)
- Elder Wisdom
prejudice or discrimination on the grounds of a person's age.
Understanding self-directed ageism
. Normal age-related changes in how
we think, perceive and reason may increase the risk of older people
viewing themselves through a negative and ageist lens, research suggests.
Older people are regularly exposed to ageism such as negative assumptions
about their worth, capacity or level of understanding, as well as jokes
about older age.
is the study of the social,
psychological, cognitive, and biological aspects of
. 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
. 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.
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".
is the multicultural approach to
issues of aging
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.
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
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.
Demographic Time Bomb
is a sizeable
population of older adults who retire and age out of the workforce,
younger people are having fewer kids. It's setting up a ticking
demographic time bomb, readying to explode when there aren't enough young
people to care and pay for what the older generation needs. A predicted
shortage of school-leavers and consequently of available workers, caused
by an earlier drop in the birth rate, resulting in an older workforce.
Doctors Ignorance stands in the way of care for the Disabled
Too Poor to Retire
Senior-Friendly Home Remodeling
Home & Community Based Services (HCBS) provide
opportunities for Medicaid beneficiaries to receive services in their own
home or community.
Right to Fail (full
film) | FRONTLINE
(youtube) - Following the lives of former group home
residents who are now on their own, FRONTLINE and ProPublica investigate
New York’s effort to let people with mental illnesses live independently.
Thousands of New Yorkers with severe mental illnesses won the chance to
live independently in supported housing, following a 2014 federal court
order. FRONTLINE and ProPublica investigate what’s happened to people
moved from adult homes into apartments and find more than two dozen cases
in which the system failed, sometimes with deadly consequences.
Left to Fail
- People have the right to be
independent, but only with a proper support system that a person needs to
succeed. Supportive housing, coordinated care, adaptive care. What happens
if a person refuses care?
in medicine is the functional deterioration of a
structure or system that had been previously working with the help of
allostatic compensation. Decompensation may occur due to fatigue, stress,
illness, or old age. When a system is "compensated", it is able to
function despite stressors or defects. Decompensation describes an
inability to compensate for these deficiencies. It is a general term
commonly used in medicine to describe a variety of situations.
means to lose the ability to
maintain one's state of mental health, typically due to some kind of
stress. The word decompensate is most often applied to someone who is
having a breakdown in their mental health mechanisms, especially someone
who has an existing mental illness or psychological condition.
Growing Old Can Be Like a Prison Sentence for some
Federal Court Monitor
- Federal courts supervise many defendants and
convicted offenders in the community, either before trial, after release
from incarceration, or while serving sentences that do not require
imprisonment. This section describes only the federal court system’s use
of location monitoring. Location monitoring
is a court-ordered alternative to incarceration. Individuals may engage in
limited, supervised activities in the community, with electronic
technology to help verify compliance. Today, location monitoring (formerly
known as electronic monitoring) relies on three distinct technologies.
Radio frequency units transmit a signal verifying that a person is at home
during required hours. RF units do not monitor individuals once they move
outside the device's tracking range. Global Positioning System units
require users to wear transmitters at all times. A signal enables officers
to track a person’s location outside the home. An alert also is sent if a
person under supervision tampers with the device or attempts to remove it.
GPS provides more comprehensive and real-time information than other
location monitoring technologies. A less frequently used technology is
voice verification. Individuals periodically check in by telephone,
leaving a message that can be checked against a voice “fingerprint” to
verify their whereabouts. Voice verification is intended to target low
risk defendants and offenders. When a federal judge orders location
monitoring, supervising officers
: Check to
make sure offenders and defendants are adhering to their approved
schedules. Check monitoring equipment to make sure that it is working and
to look for signs of tampering. Respond to and
, including: Unauthorized absence from home.
Failure to return home after an authorized absence. Leaving home early or
returning home late. Entrance into or near an unauthorized area. Step in
to control and correct the situation
people on location monitoring: Don't adhere to their approved leave
schedule. Go to an unapproved location. Tamper with equipment. Otherwise
fail to comply with the program rules or their release conditions.
Location monitoring allows people on supervision to remain in the
community and begin to rebuild their lives. They can attend school or get
and hold down jobs during their period of supervision—important factors in
rehabilitation. Community supervision also costs much less than
incarceration. Location monitoring reduces risks by limiting a person’s
movements and opportunity to commit violations. GPS technology also can be
used to verify that an individual is in an authorized location, or is in
or near an unauthorized location. This increases the chances that officers
can intercede either before or while a violation or new offense is
occurring. Even when an offense is committed, GPS technology can help
provide last location information to law enforcement officials trying to
locate a fugitive. No body hardly ever dies from
old age or natural causes
, we are slowly killing ourselves.
Death by Natural Causes
are not even defined accurately, or even
We are mostly dying from things that we can avoid
Death by Natural Causes
, there's nothing natural about dying. Define the cause?
Stress on Caregivers
is a condition that strongly manifests exhaustion,
anger, rage, or guilt resulting from unrelieved caring for a chronically
ill patient. Although it is not listed in the United States' Diagnostic
and Statistical Manual of Mental Disorders, the term is often used by many
healthcare professionals in that country. The equivalent used in many
other countries, the ICD-11, does include the condition. Almost 66 million
Americans are providing care to those who are ill, aged, and/or disabled
for an average of 39.2 hours per week. Over 13 million caregivers provide
care for their own children as well. Caregiver syndrome is acute when
caring for an individual with behavioral difficulties, such as: fecal
incontinence, memory issues, sleep problems, wandering, and aggression.
Typical symptoms of the caregiver syndrome include fatigue, insomnia and
stomach complaints with the most common symptom being depression. Some
ways to improve this syndrome have been agreed upon by experts and include
the following suggestions: Expanding the support system for the caregiver.
Finding help in various sources for caregiver tasks. Educating caregivers.
Paying caregivers salaries competitive with those paid to professional
healthcare providers doing similar tasks, thus allowing them to retire
from salaried jobs for companies where management is willfully ignorant of
or unsympathetic to their workers' family caregiving burdens. Encouraging
the growth of telecommuting jobs that enable caregivers to work at home
while caring for their patients. Providing full medical benefits for
caregivers and their patients. Providing nursing and medical advice when
needed, including home visits. Providing respite services on demand.
Providing psychological counseling or psychiatric intervention for stress
management. Collecting data documenting savings for the national
healthcare system made possible by home caregivers. Although previous
studies indicate a negative association between caregivers' anger and
health, the potential mechanisms linking this relationship are not yet
fully understood. Services that may be helpful to caregivers include:
Health services in the home. Companion or chore services. Day care centers
for adults. Respite care, time out at nursing homes, or assisted living
facilities. Counseling. Legal advice. Money management. Support groups.
Psychotherapeutic programs. educational programs.
Support Groups for Caregivers
- Last Words
- Stubborn Patients
Care Act Bill
There are just too many people who do not fully understand what it means to provide
24-hour personal care for a person or loved one. 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.
Eric Dishman: Healthcare
Educating the Public
has to be a top priority. Increasing the amount of people who have the
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.
Alarm Fatigue - Stress
Being a caregiver is a very demanding
, mentally and physically.
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
, experience and be very
, 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
People get stressed out just hearing about someone’s stressful experience.
Health-care workers treating soldiers with
(PTSD) report that some soldiers’ partners and family
members display symptoms of PTSD despite never serving in the
Family members are sometimes horrible
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
happens when people are constantly hearing alarms
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.
occurs when one is exposed to a large number of frequent alarms (alerts)
and consequently becomes desensitized to them.
can lead to
longer response times
or to missing important alarms.
similar ways, when you keep hearing the same lies over and over, you may
end up believing them to be true.
- Tuning Out
Always being on
can also have serious mental health
Alarm Fatigue Hurts Patient Care and Overwhelms Nurses
Nurses Reducing Alarm Fatigue
Cycle of Panic and Neglect
people ramp up efforts when there is a serious threat,
then they quickly
, which leaves people vulnerable.
The Boy Who
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.
from constantly helping people in need and working
directly with victims who are suffering from disasters, trauma, or
illness, especially in the health care industry, sometimes leading to a
diminished ability to empathize or feel compassion
for others. People who experience compassion fatigue may exhibit a variety
of symptoms including lowered
, numbness or feelings of
lack of self-satisfaction,
, aches and pains, or work absenteeism. Individuals working
in other helping professions are also at risk for experiencing
. These include child protection workers,
veterinarians, teachers, social
, palliative care workers, journalists, police officers,
firefighters, animal welfare workers, public librarians, health unit
coordinators, and Student Affairs professionals. Non-professionals, such
as family members and other informal caregivers of people who have a
chronic illness, may also experience compassion fatigue. The term was
first coined in 1992 by Carla Joinson to describe the negative impact
hospital nurses were experiencing as a result of their repeated, daily
exposure to patient emergencies. It is sometimes referred to as secondary
traumatic stress (STS). According to the Professional Quality of Life
Scale, burnout and secondary traumatic stress are two interwoven elements
of compassion fatigue. Journalism analysts argue that news media have
caused widespread compassion fatigue in society by saturating newspapers
and news shows with decontextualized images and stories of tragedy and
suffering. This has caused the public to become
or resistant to helping people who are suffering.
Tips for Managing Compassion Fatigue
. Find someone to talk to.
Understand that the pain you feel is normal. Exercise and eat properly.
Get enough sleep. Take some time off. Develop interests outside of
medicine. Identify what’s important to you.
Don’t blame others
look for a new job, buy a new car, get a divorce or have an affair. Don't
fall into the habit of complaining with your colleagues. Don't hire a
lawyer. Don't work harder and longer. Don't self-medicate. Don't neglect
your own needs and interests.When I hear
, sometimes it's not the only alarm that's going off. We
have many internal alarms and external alarms that we tend to all the
time, and sometimes, we eventually we stop hearing those alarms.
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
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. Burn
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
is a transformation in the self of a
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.Stress
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.
Computers - Smartphones
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.
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
Need to Learn is greater then ever)
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 - Measuring Vitals
with Medical Sensors
is the most effective and most efficient way to care for elderly who want
to live at home.
Laptop PC Benefits
: Based on the
current foods, spices and ingredients that you have on hand, you have
these options for easy to prepare meals. Based on your physical and mental
activity, we suggest this meal. Based on the number of people eating, we
suggest this meal. Based on the types of foods that you consumed in the
last 7 days, we suggest this meal. Based on your current physical weight
and the food that you already consumed today, we suggest this meal dosage.
Based on you hydration needs, you need to drink this much filtered water
today. This is your current medication schedule and Dosage. These are
explanations of the medications and why you are taking them.
Biomarkers of Aging
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
rate, breathing, and
whether you're awake or asleep.
Wearable tattoo sends alcohol levels to your cell phone
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
George Whitesides Affordable easy Tests
Eric Topol: The Wireless Future of Medicine
A Cradle and App Turn Smartphone Into Biosensor
Smartstones Communicate by Touch
Home Health Monitoring Devices
Health Monitoring Apps
Pebble 2, Time 2 + All-New Pebble Core heart
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!
(another set of eyes) -
Voice Activated Controls
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
Athos Wearable Technology
Portable Ultrasound Unit
Handy Sana 210
Wanda Connects a Medical Devise to a WiFi Network
Smartphone Technology Tools
Health Symptoms Checker
Hiris Wearable Computer
Arrhythmia and Electrophysiology
Diagnostic Performance of a
Smartphone Based Photoplethysmographic Application for Atrial Fibrillation
Screening in a Primary Care Setting.
Apps for Smartphones
Smartphone Vital Signs Checker
Google Disabilities Impact Challenge
Lightfreq Square2 Smart Light bulb Speakers Intercom
Mobile Health Wearable's -
Philips’s CareSage suite Predictive Analytics
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.
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.
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.
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.
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
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
are small packets which are held in the
hand and produce heat on demand to warm cold hands.
is a blanket with an integrated
electrical heating device usually placed above the top bed sheet.
The First Heated Down Jacket & 6X Mobile Charging
Flexwarm Smart Jacket
Ravean Down 2.0 Heated Jacket
: The World’s Most Durable Heated Jacket
Fyre: Temperature-Regulating Cardigans and Hoodies
Body Temperature Knowledge
Home Monitoring Systems
Smart Home Monitoring Systems for the Elderly
Halo: The World's Safest Smartest Smoke Alarm
iSmart Alarm Spot Smart Home Camera
that detects smoke alarm sirens,
sends notifications, and records video.
security wireless technology, no annual contracts.
Mobile Health News
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
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
Orbii: A Mobile Home Security Robot with HD Video
Oco2 Home Monitoring Camera with SD Card and Cloud
Wire-Free Security Camera, weatherproof, 1080p Full HD.
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
is a moving monitor.
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).Door Locks
Ultraloq Smart Lock: Simplify Your Safety
- Lock System with One Key for all Locks.
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
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
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
Trackers - 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
The 1st Motion Tracking Smart Home Security Camera
get instant alerts if something moves when it shouldn’t.
Trackr Bravo Thin Tracking Device
Wireless Key Locators
Pebblebee Stone Tracker
Kenneth Shinozuka: My simple invention designed to keep my
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
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
Trak Taag Tracker - 80 Year Battery & SOS Button
losing things & buying batteries. One button makes SOS Calls &
takes Videos, Pictures, Audio.
(amazon) - Health Monitors
Home Remodeling for Disability and Special Needs
- Music and Memory
- Music on the Brain ABC TV Catalyst
Music for the Elderly -
Laptops for Seniors
Cats and Seniors
Canine Caregivers for Alzheimer’s and Dementia Patients
for the Elderly Foundation
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.
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.
- Duty of
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
, 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
Life with Dignity is just as important as
. A little more than
Famous Last Words
offers a reflection on the imminent death that is often coupled with a
meaningful observation on life, but some
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
Talk about your death while you're still healthy: Michelle Knox
Society of Advance Care Planning and End of Life Care (ACPEL)
POLST Paradigm Physician Orders for Life Sustaining Treatment
Over half of the people
who have died, died when no one was around
Lots of people die when no one is there or when no one is watching. If no
one is there to witness your death at the end of your life, does it mean
that you died alone
? Who would you want by
your side the moment you die? How many people have lived when there was no
one watching? Is it worse to live alone
than to die alone? I guess
Unclaimed bodies of people who died
. One percent of all deaths result
, which would mean that last year, when 3.4 million
Americans died, they were alone.
Advance Health Care Directive
, 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
Don't Take it to your Grave
means to reveal the truth about
something before you die, or to tell someone that you love them and
appreciate everything they did for you, or to reveal a secret about
something that you were afraid to tell people. Before you die you should
give away your possessions or distribute your possessions to family and
friends, like with a trust fund. If you die before you make peace or die
before you make plans and put your house in order, it will be too late,
which means that the people you leave behind will have to deal with the
mess you left behind.
Circling the Drain
means that someone is very near death and has
little time to live. The phrase can also describe a project or a plan or a
campaign that that is on the
brink of failure
Ordering up more tests and
surgeries for dying patients is easier than getting patients the
end-of-life care they deserve.
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
Power of Attorney
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
End of Care Options
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
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
End of Life Issues
, 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
is a legal order, written or oral
depending on country, indicating that a person
does not want to receive cardiopulmonary resuscitation
that person's heart stops beating. Sometimes it also
prevents other medical interventions
blocks certain types of
. The legal status and processes surrounding DNR
orders vary from country to country. Most commonly, the order is placed by
a physician based on a combination of medical judgment and patient wishes
and values. (DNR).No Extraordinary
means that a person has requested that no life-sustaining
treatment be administered that will only prolong the process of dying when
death is imminent, but excludes palliative care to a terminally ill
refers to the treatments and techniques
performed in an emergency in order to support life after the failure of
one or more vital organs.
Intensive Care Unit
cater to patients with severe or
life-threatening illnesses and injuries, which require constant care,
close supervision from life support equipment and medication in order to
ensure normal bodily functions.
Respecting Patient Choices
Your Shit Together
Direct Care Alliance
Advance Directive End of Life Care
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
receiving treatment that's painful, invasive and ultimately
How would you like to Die
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
is a type of
health care that focuses on the palliation of a terminally ill patient's
pain and symptoms and attending to their emotional and spiritual needs.
Hospice care has a palliative focus without curative intent. Usually, it
is used for people with no further options for curing their disease or in
people who have decided not to pursue further options that are arduous,
likely to cause more symptoms, and not likely to succeed. Hospice is for a
patient deemed to have fewer than six months to live. The for-profit
hospice industry has grown, allowing more Americans to die at home. But
few family members realize that "hospice care" still means they'll do most
of the physical and emotional work. According to the National Hospice and
Palliative Care Association, hospice is now a $19
, almost entirely funded by taxpayers. But as the
business has grown, so has the burden on families, who are often the ones
providing most of the care. Hospice care is a lucrative business. It is
now the most profitable type of health care service that Medicare pays
for. Medicare paid the hospice agency $60,000 in the first 12 months for
one patient that was on hospice.
Hospice End of Life Care
What is a Natural
?Grand Mal Seizure
type of seizure that involves a loss of consciousness and violent muscle
contractions. A grand mal seizure is usually caused by epilepsy, but may
have other triggers, such as very low blood sugar, high fever, or a
stroke. The seizure has two stages. Loss of consciousness occurs first and
lasts about 10 to 20 seconds, followed by muscle convulsions that usually
last for less than two minutes. Many people will have only one such
seizure in their lifetime. Others may need daily anti-seizure medications
to prevent recurrence.American Academy
of Hospice and Palliative Medicine
Stories from a home for terminally ill children: Kathy Hull
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
person-centered model in health care, the practice of
The Conscious Dying Network
- Talking about Death.
What is Death
Should I write my own Obituary - Should I write my own
is a news article
that reports the recent
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 Step-by-Step Guide
How to Write an Obituary
Write An Obituary Tips and Ideas
is a speech
of a person(s) or thing(s), especially one who recently
retired or as a term of endearment. Eulogies may be given as part of
. 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
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
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.
someone highly in
speech or writing.
How to Write a Eulogy
How to Write a EulogyElegy
is a mournful
or a poem of
typically a lament for the dead
is a word or phrase used to address or describe a
person, animal or inanimate object for which the speaker feels
or affection. Terms of
endearment are used for a variety of reasons, such as parents addressing
their children and lovers addressing each other.
Do you have a eulogy to write? funeral speeches step-by-step
Eulogy Examples - Sample Eulogy
Make a Goodbye Video for the Death of a Loved one
EyesFamous Last Words
What would be your last words to friends and family if you knew you were
going to die soon? What would you say in those last few moments? Would you
say things that you always wanted to say, or would you just say the right
Things to say...Thank You, I always loved you, I'm Proud of
You, I appreciate everything you have done, Please Forgive Me for my
mistakes and my short comings.
Take time to think about what you want to say
and who you want to say
it to. You'll have different goodbyes
for different people and different
circumstances. Don't wait till the last moment or delay saying what you
mean. Find closure and let bygones be bygones
Have those real
now when you can. A heart to heart
can have lasting impacts, and also reduce doubt and the
“Go on, get out, last words are for fools who have not yet said enough” –
are from people who didn't have enough time to think of
something good to say before they died.
“How beautiful is
, when earn’d by
End of Life Summary
- A Goodbye Biography:
I did not
have a perfect life, but I had a good life. Sometimes incredible and
sometimes truly amazing, but overall, I was extremely lucky. Even though there were
many sucky moments, and even though there were a lot of people who were total assholes
and scumbags, I remember that most
people were good, which I am totally thankful for and grateful for. But to all
the scumbags, I hope you die like Mr. Dufus. But of course, I don't like
to wish bad things to happen to anyone, not even
. I would rather
have a bad person educate themselves and learn how to stop being an
asshole, than to see them suffer or to see them pay for their
. Mr. Dufus died a slow and
painful death yesterday. He died screaming in agony to the very end. He
died in a gutter on the side of the street near were he lived. He was
surrounded by total strangers and people who never really liked him or
appreciated him in any way. So he will not be missed or remembered. And
there will be no funeral or burial. The family has requested that instead
of gifts or flowers, that everyone should instead spend more time
educating themselves and educating other people, so eventually we can have
less assholes in the world and less ignorant morons causing problems.
People should be forever grateful that this person was not a relative of
theirs. But, to end on a good note, there is now one less person in the
world to irritate us. So thank you God. We would have listed the next of
kin or surviving relatives, but they did not want to be associated with
that person. We would have listed his accomplishments, but there was not
that many accomplishments to talk about, and there's no sense in listing
all the bad things that he did, especially when the scumbag news paper
charges people by the word, or inch or per line. So an average obituary
can easily be $200.00 to $500.00. What kind of scumbags would want to profit from grief?
News papers don't charge by the word when they print propaganda, they only
charge people who are trying to express their appreciation for their
diseased loved ones. The disease of ignorance is having devastating
effects and consequences everywhere. The Family wishes that everyone
remember the disease first and the person second.....Though he wasn't
a perfect man or a perfect father or a perfect husband or a perfect
employee, he was perfect in showing us what not to be. At times he was a
good person and easy to talk to, especially among strangers, and other times he acted insensitive or insolent,
which was mostly witnessed by family members. When
you can see both sides of a person, you can understand them more. And when
someone acts as a bad example, it's not all bad, because bad examples of
human behavior indirectly helps us to appreciate being good examples of
human behavior, but that only happens when you appreciate the good more
than being affected by the bad.
Aged Based Allocation of Healthcare Resources
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
allocation or resource management is the
activities and the resources required by those activities while taking
into consideration both the resource availability and the project time.
Age Based Rationing of Health Care
- Brain Fog
- Biomarkers of
Elderly people with high cognitive function
have more of a certain type of brain cell called
also called von Economo neurons (VENs), which are a specific class of
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... - Fecal Incontinence
When to say no and when to say yes? When do you let patients have their
When do you have to do what's right
for the patient even when they complain?
does an elderly person
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,
some of the
of a caregiver?
Should my patient carry a Medical
Wireless Emergency Alert Pendant
Medical Alert Service
Home Health Monitor Systems
If and when
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
or Adjustable Bed?
4 things that are almost
worse than Death
Needing a breathing machine,
Needing a feeding tube,
Needing care all the time.
Abuse of the Elderly
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
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
- Home Care
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, probably
the same way banks do
. 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
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
that they have built up by making monthly
Health Insurance Portability and Accountability Act
You were disgusted when you heard about the torture in
, 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
Nursing Home Abuse Center
Nursing Homes are illegally Evicting Elderly and Disabled residents who
Can't Afford to Pay
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
population of aging and elderly prisoners in
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
, 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
; 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.
prisoners are treated better in prison then the
are treated in nursing homes."
What is a Vulnerable Adult?
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:
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?
. 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.Ageism
is discrimination against middle-aged and elderly people.
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
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
Cornell University Law School Legal information Institute
Nursing Home Resident's Rights
Americans with Disabilities Act of 1990
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
California Long-Term Care
protect the aging and dependent adults in their
Legal Advocacy for the Rights of Older Persons
- Top of Page
- Stubborn Patients
housing for seniors, low-income families and persons with disabilities.
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 Prescribing Medication
Drug Interactions Checker
Managing Multiple Drugs
Multiple Medications Dangers
Nursing Home calms troubling behavior without risky drugs
Nursing Homes rarely penalized for over sedating patients
Seniors & Drugs -
Senior Citizens Addiction
- Addiction Help
Number Needed to Treat
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
Center on Elder Abuse
Prevent Elder Abuse
Adult Protective Services Association
Center on Elder Abuse
Nursing Home Abuse Guide
Financial Crimes Against the Elderly
NYC Elder Abuse
Elder Justice Coalition
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.,
and the improper use of an
Power of Attorney
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.
of the elderly may also occur in concert with other types of
elder abuse, including:
* physical abuse,
* sexual abuse, - Abuse Info
, * emotional
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
- Living Wills
Advance Health Care Directive. -
Choosing how you wish to die on your terms.
Care Assistance Services Explained - In Home Services
is a person who
another individual with
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.
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. Housing Options
are health care
who utilize evidence-based practice, research,
scientific evidence, and a holistic perspective to promote independence,
meaningful occupations, and patients' functional ability to fulfill their
daily routines and roles. OTs ensure their patient-oriented interventions
are effective. They have background training on the psychological,
, emotional, and social makeup. OTs also have immense training in
treating the whole body with the incorporation of neurological principles,
anatomical or physiological concepts, and psychological perspectives. They
support individuals across their lifespan to fulfill meaningful
, known as occupations, individually by using
. Occupational therapists work in a variety of fields,
including pediatrics, orthopedics, neurology, and geriatrics. The main
approach of occupational therapy is to assist individuals in regaining
skills as well as in increasing their abilities and decreasing limitations
or disabilities of any kind. OTs evaluate the individual as well as their
home and other immediate environments. Upon evaluating, they recommend, as
needed, adaptive equipment and training in its use, guidance, and
education for family members and caregivers. OTs determine a
with the help of the person's family, caregiver, and
doctor. OTs customize each intervention to improve a person's ability to
perform daily life activities and to reach his or her goals. OTs perform
outcomes measures to evaluate the person's abilities and to ensure there
is progress toward the goals. This outcome evaluation also helps the
therapist to understand if an intervention plan must be changed.
Therapists also work with clients on a large continuum of mental health
challenges, including clients with substance-use disorders, mental
illness, eating disorders, or stress-related challenges.
Skilled interventions with clients may include
Self-regulation and coping strategies (e.g. mindfulness, grounding).
Implementation of healthy habits and routines. Motivational interviewing.
Strategies to reduce stress. Sensory modulation-related interventions to
self-regulate. Behavioral interventions, such as cognitive behavioral
therapy (CBT) or dialectical behavioral therapy (DBT). Trauma-informed
care. Skills training with accommodations or compensatory strategies.
Mental health literacy. Lifestyle redesign, a preventative occupational
therapy intervention to promote wellness. Therapists also work with
clients on a large continuum of mental health challenges, including
clients with substance-use disorders, mental illness, eating disorders, or
stress-related challenges. Skilled interventions with clients may include:
Self-regulation and coping strategies (e.g. mindfulness, grounding).
Implementation of healthy habits
. Motivational interviewing.
Strategies to reduce stress. Sensory modulation-related interventions to
self-regulate. Behavioral interventions, such as cognitive behavioral
therapy (CBT) or dialectical behavioral therapy (DBT). Trauma-informed
care. Skills training with accommodations or compensatory strategies.
Mental health literacy. Lifestyle redesign
, a preventative occupational
therapy intervention to promote wellness. Occupational therapists are
trained in the administration of standardized assessments across the
lifespan from infancy to old age, although some standardized assessments
require an occupational therapist to gain additional certifications to
administer. Examples of the types of assessments
or skill areas Occupational Therapy Practitioners assess include
Sensory processing skills. Visual perception and visual motor skills.
Gross motor and fine motor skills. Handwriting. Hand dexterity. Cognition
and intelligence. School based evaluations. Developmental milestones.
Daily living tasks include dressing and feeding. Pain. Executive
Functioning. Occupational therapy is very beneficial to the older
population. Therapists help older people lead more productive, active, and
independent lives through a variety of methods, including the use of
adaptive equipment.Care Coordinators
facilitate conversations between interdisciplinary Care Teams (including
Patient Navigators, Care Coordinators, primary care physicians, and
additional health care providers) and expedite client services referrals.
Professional care coordinators may be called discharge planners, benefit
managers, case managers, private geriatric care managers, or some other
title. They may work in a: Health care facility such as a hospital,
outpatient clinic, medical practice, VA hospital or clinic, or primary
care doctor's office. Care management, at its core, focuses on high-touch
and episodic interactions; care coordination attempts to provide more
longitudinal or holistic care. Communicating/sharing knowledge. Helping
with transitions of care. Assessing patient needs and goals. Creating a
proactive care plan.Patient Care
Coordinator Qualifications and Skills
: Great customer and patient
service. Ability to work under pressure. Outstanding bedside manner.
Excellent communication skills. A caring and compassionate personality. A
healthy endurance and ability to lift 50 lbs.
Activities of Daily Living
is a term used in healthcare to refer to
people's daily self-care activities. The concept of ADLs was originally
proposed in the 1950s by Sidney Katz and his team at the Benjamin Rose
Hospital in Cleveland, Ohio and has been added to and refined by a variety
of researchers since that time. Health professionals often use a person's
ability or inability to perform ADLs as a measurement of their functional
status, particularly in regard to people post injury, with disabilities
and the elderly.
Younger children often require help from adults to perform ADLs
they have not yet developed the skills necessary to perform them
independently. Common ADLs include feeding ourselves, bathing, dressing,
grooming, work, homemaking, cleaning oneself after defecating
A number of national surveys collect data on the ADL status of the U.S.
population. While basic definitions of ADLs have been suggested, what
specifically constitutes a particular ADL for each individual may vary.
Adaptive equipment and devices may be used to enhance and increase
independence in performing ADLs. ADLs refer to the most basic functions of
living. The first sentence in the previous paragraph ends with "leisure, "
or more completely "ability to make use of leisure." It usually is easy to
make the binary choice YES/NO as regards "can someone feed themselves
though even here there are graduations. However, the question "can someone
make good use of leisure?" does not easily lead to a binary choice YES/NO,
and so the measurement of "leisure" is very problematic. "Employability"
is even more problematic. Clearly quantifiable ADLs refer to very basic
skills, while "quality of life" variables have not yet been quantified.
Basic ADLs consist of self-care tasks that include
Bathing and showering. Personal hygiene and grooming (including
brushing/combing/styling hair). Dressing. Toilet hygiene (getting to the
toilet, cleaning oneself, and getting back up). Functional mobility, often
referred to as "transferring", as measured by the ability to walk, get in
and out of bed, and get into and out of a chair; the broader definition
(moving from one place to another while performing activities) is useful
for people with different physical abilities who are still able to get
around independently. Self-feeding (not including cooking or chewing and
swallowing). Basic ADLs include the things many people do when they get up
in the morning and get ready to go out of the house: get out of bed, go to
the toilet, bathe, dress, groom, and eat. There is a hierarchy to the
ADLs: "... the early loss function is hygiene
, the mid-loss functions are
toilet use and locomotion, and the late loss function is eating. When
there is only one remaining area in which the person is independent, there
is a 62.9% chance that it is eating and only a 3.5% chance that it is
hygiene." Although not in wide general use, a mnemonic that some find
useful is DEATH: dressing/bathing, eating, ambulating (walking),
toileting, hygiene. Instrumental activities of daily living (IADLs) are
not necessary for fundamental functioning, but they let an individual live
independently in a community: Cleaning and maintaining the house. Managing
money. Moving within the community. Preparing meals. Shopping for
groceries and necessities. Taking prescribed medications. Using the
telephone or other form of communication. Occupational therapists often
evaluate IADLs when completing patient assessments. The American
Occupational Therapy Association identifies 12 types of IADLs that may be
performed as a co-occupation with others: Care of others (including
selecting and supervising caregivers). Care of pets. Child rearing.
Communication management. Community mobility. Financial management. Health
management and maintenance. Home establishment and maintenance. Meal
preparation and cleanup. Religious observances. Safety procedures and
emergency responses. Shopping.
is a systematic process that utilizes recreation
(leisure) and other activities as interventions to address the assessed
needs of individuals with illnesses and/or disabling conditions, as a
means to psychological and physical health, recovery and well-being.
Recreational therapy may also be simply referred to as recreation therapy,
in short it is the utilization and enhancement of leisure. The work of
recreational therapists differ from other professionals on the basis of
using leisure activities alone to meet well-being goals, they work with
clients to enhance motor, social and cognitive functioning
confidence, develop coping skills, and integrate skills learned in
treatment settings into community settings. Intervention areas vary widely
and are based upon enjoyable and rewarding interests of the client.
Examples of intervention modalities include creative arts (e.g., crafts,
, dance, drama, among others), games, sports like adventure
programming, exercises like dance/movement, and skill enhancement
activities (Motor, locomotion
, sensory, cognition, communication, and
is a variety of services which help meet both the
medical and non-medical needs
with a chronic illness or disability who cannot care for themselves for
long periods. Long term care is focused on individualized and coordinated
services that promote independence, maximize patients' quality of life,
and meet patients' needs over a period of time. It is common for long-term
care to provide custodial and non-skilled care, such as assisting with
normal daily tasks like dressing, feeding, using the bathroom.
Increasingly, long-term care involves providing a level of medical care
that requires the expertise of skilled practitioners to address the
multiple chronic conditions associated with older populations. Long-term
care can be provided at home, in the community, in assisted living
facilities or in nursing homes. Long-term care may be needed by people of
any age, although it is a more common need for senior citizens.
is a specialty area of psychology aimed at
maximizing the independence, functional status, health, and social
participation of individuals with disabilities and chronic health
conditions. Assessment and treatment may include the following areas:
psychosocial, cognitive, behavioral, and functional status, self-esteem,
coping skills, and quality of life. As the conditions experienced by
patients vary widely, rehabilitation psychologists offer individualized
treatment approaches. The discipline takes a holistic approach,
considering individuals within their broader social context and assessing
environmental and demographic factors that may enhance or impede progress.
is supportive care provided in the
. 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. Home
health services help adults, seniors, and pediatric clients who are
recovering after a hospital or facility stay, or need additional support
to remain safely at home and avoid unnecessary hospitalization. These
Medicare-certified services may include short-term nursing,
rehabilitative, therapeutic, and assistive home health care. This care is
provided by registered nurses (RNs), licensed practical nurses (LPN's),
physical therapists (PTs), occupational therapists (OTs),
s (SLPs), unlicensed assistive personnel (UAPs), home health
aides (HHAs) and medical social workers (MSWs) as a limited number of up
to one hour visits, addressed primarily through the Medicare Home Health
benefit. The largest segment of home care consists of licensed and
unlicensed non-medical personnel, including caregivers who assist the care
seeker. Care assistants may help the individual with daily tasks such as
bathing, cleaning the home, preparing meals and offering the recipient
support and companionship. Caregivers
work to support the needs of
individuals who require such assistance. These services help the client to
stay at home versus living in a facility. Non-medical home care is paid
for by the individual or family. The term "private-duty" refers to the
private pay nature of these relationships. Home care (non-medical) has
traditionally been privately funded as opposed to home health care which
is task-based and government or insurance funded. These traditional
differences in home care services are changing as the average age of the
population has risen. Individuals typically desire to remain independent
and use home care services to maintain their existing lifestyle.
Government and Insurance providers are beginning to fund this level of
care as an alternative to facility care. In-Home Care is often a lower
cost solution to long-term care facilities. Home Care is also referred to
as domiciliary care, social care, or in-home care.
is an academic discipline and profession that concerns itself
with individuals, families, groups and communities in an effort to enhance
social functioning and overall well-being. Social functioning is the way
in which people perform their social roles, and the structural
institutions that are provided to sustain them. Social work applies social
sciences, such as sociology, psychology, political science, public health,
, law, and economics, to engage with client systems,
conduct assessments, and develop interventions to solve social and
personal problems; and to bring about social change. Social work practice
is often divided into micro-work, which involves working directly with
individuals or small groups; and macro-work, which involves working with
communities, and - within social policy - fostering change on a larger
scale. The social work industry developed in the 19th century, with some
of its roots in voluntary philanthropy and in grassroots organizing.
However, responses to social needs had existed long before then, primarily
from private charities and from religious organizations. The effects of
the Industrial Revolution and of the Great Depression of the 1930s placed
pressure on social work to become a more defined discipline.
is a social worker who is employed by a government agency,
nonprofit organization, or another group to take on the cases of
individuals and provide them with advocacy, information and solutions.
They are required by law to have a license in almost all states. Also, in
political arenas, caseworkers are employed as a type of legislative
staffer by legislators to provide service to their constituents such as
dealing with individual or family concerns and obtaining
through licensed professionals. British MPs and members of the United
States Congress often provide constituent services through caseworkers for
better use of their allotted funds.
Unlicensed Assistive Personnel
is a class of
paraprofessionals who assist individuals
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. While providing this care,
UAPs offer compassion and patience and are part of the patient's
healthcare support system. Communication between UAPs and registered
nurses (RNs) is key as they are working together in their patients' best
interests. The scope of care UAPs are responsible for is delegated by RNs
or other clinical licensed professionals. UAPs care for patients in
hospitals, residents of nursing facilities, clients in private homes, and
others in need of their services due to old age or disability. By
definition, UAPs do not hold a license or other mandatory professional
requirements for practice, though many hold various certifications. They
are collectively categorized under the group "personal care workers in
health services" in the International Standard Classification of
Occupations, 2008 revision.
Personal Care Assistant
is a class of
paraprofessionals who assist individuals with physical disabilities,
, 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
or 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).
is a job title describing a person who assists a
specific person with their daily business or personal tasks.
is a nurse with a key
responsibility to ensure that a patient is comfortable. Dressing, moving,
feeding and o on.
is an individual who provides
for one or more
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
, 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.
is a profession within the
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
Licensed Practical Nurse
or 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
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
Visiting Nurse Association
(Remote patient 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
. 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
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.
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.
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.
Duty of Care
, 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
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.
Elder Care Locations
Geriatric Care Management
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.
vs. Institutional Care?
Overnight Dementia Care Give Caregivers Rest
Abbott Patient Assistance Foundation
is the maintenance or
improvement of health via the diagnosis, treatment, and prevention of
disease, illness, injury, and other physical and mental impairments in
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.
is a branch of medicine
concerned with the diagnosis and management of life-threatening conditions
requiring sophisticated organ support and invasive monitoring.
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
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
Flatulence Odor Remedy
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
Caregiving Resource Center
Caring for Elderly Guide
Senior Living Guide
Caregiver Support Blog
The Care Givers Voice Blog
Association for Homes and Services for the Aging
Patient Protection and Affordable Care Act
Association of Professional Geriatric Care Managers
Senior Americans Association
Helping pays off: People who care for others live longer
Mental Health Websites -
Physical Health Websites
- More Resources
Can a Family Member be a good Caregiver, Not Always.
The family relationship is not the same as friendships or social
frienships. Where does this knowledge and experience
come from? And who educates the family members?
Caregiving is s a stressful job
. And if family members don't get along,
then this job will be even a more difficult then it already is. Family
relationships are sometimes complicated and
mostly because of the history and the experiences that family members
shared in their lives. Interactions can be very different when you compare
them to a strangers interaction, the same situation can be interpreted in
different ways. A stranger has no history with a family member or have
they had any previous bad experiences with a family member, so there is no
expectations, or bad memories. A stranger only sees a person for who they
are at the moment they meet. Having experience and knowledge about someone
can be very valuable, but it can also be very disrupting when the
knowledge and experienced is interpreted and used in a dysfunctional way
or in an ineffective way. They only way for a person to develop and become
more knowledgeable is to learn how to reassess the knowledge and
experiences that they have already had. This is why learning and educating
yourself is so extremely important. knowledge needs knowledge, information
needs information. you have the tools needed to learn, you just have to
effectively apply the tools that you have. Learn deliberately and always
have a goal when learning.
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.
- Responsibilities of
- Stubborn Patients
Can Family members get paid for taking
care of the Elderly Parents
What are the dangers of
Care Giver Credit
The Family Caregiver
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
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
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
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
.. 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
Tableware for People with Special Needs
Designing Clothes with Style and Function for People with
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
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
- Healthcare Aid
Physical Therapy - Caregiver and Companion
Assistance with maintaining
How to Administer Oral Medications
. Meal planning and
diet suggestions. Vitamins. Assistance with general mobility. Physical
Therapy. Breathing Exercises - Stethoscope. O2 and BP Monitoring and
Recording. Record Bedroom Humidity and Temperature. Supervision of
Dress and Undress Others
(youtube). Light Housekeeping in
Bedroom Only. Make sure bedroom is clean and report any unsanitary
conditions.Talking to the Patient and
How much coughing and hawking? Incontinence
issues? Breathing problems? Other problems? The Patient must agree to
answer questions truthfully and accurately. The Patient has to agree to be
responsible for their health and not refuse help and services that are
offered as preventive healthcare good practices. The Patient must agree to
keep doctor visits and be able to keep appointments. Once the Patient
proves that they can do things themselves, then they can justify not
needing anymore visits from health care professionals. The patient must
agree to be responsible for their health and well being, and not use
emergency medical services as a method of treatment. Going back and forth
to the Hospital is a clear sign that the patient can no longer live on
their own without a fulltime caregiver being present.
What a Live in Family Member Can Do
:Clean Clothes and do
. Clean Dishes. Vacuum and Clean House.
Take out Garbage.
. Cook Food and Prepare Food. Shop for Food. Pick
Drive to Appointments. Assistance with phone calls and Correspondence.
Mail Letters and Pick up Mail. Pay Bills and do Online Internet Payments.
Do online searches for Information. Make Repairs. Connect Electronic
Exercise for Seniors
that are modified for the Elderly and for those with injuries.
Chair Exercises and Limited Mobility Fitness
Exercising for Life
- Exercise Knowledge and
Please view the Services to Learn more
about which Home Care Option is right for your loved one
Personal Care Attendants.
Alzheimer's Care Companions.
Special Events Attendants.
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.
Books on Caregiving
The Emotional Survival Guide for Caregivers: Looking After
Yourself and Your Family While Helping an Aging Parent
Eldercare For Dummies
American Medical Association Guide to Home Caregiving
"We look at children as being our future,
but the elderly are the future too, and not just our past."
Companions and Homemakers Employment
Home Care Aide Jobs
Be a Property Caretaker
Home Health Aides & Personal & Home Care Aides Employment
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.
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
Respite Care Strategies
Caregiving Training Courses and Manuals
Caregiver Alert Information
Term Care Link
Elder 411 App - Practical information for caregivers all in one place.
Psychological First Aid training
could help improve care workers'
wellbeing. A new study has shown that
Psychological First Aid
, training originally created for people to
support others, can help healthcare workers in care homes improve their
own mental wellbeing.
Transitions Training Program
Preparing Patients and Caregivers
to participate in care delivered
across settings: the Care Transitions Intervention.
Videos for Patient Care Training
Transferring a Patient from Chair to
Patient Transfer Techniques with
How to Care for Aging Parents
The hidden role informal caregivers play in health care: Scott Williams
(video and text)
Why I Train Grandmothers to Treat Depression: Dixon Chibanda
for Therapeutic Recreation Certification
Structured Clinical Examination
Care Giver Training
- Distance Education from the Birthplace of Nurse-Midwifery
and Family Nursing in America.
- First Aid
Senior Caregiver Certification
Home Care Training
Caregivers Training Videos
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.
Angry Nasty Patients that Sometimes Lose Control
Handling an angry patient
can be challenging. Keeping your cool when patients take their
frustrations out on you is not easy. Even patients who are normally calm
may quickly reach the boiling point when illness threatens their health,
mobility, and independence. Pain and fear can lead to increased stress,
anxiety, and frustration, which can result in anger and even loss of
control. But do you know how to spot your patient's anger early and defuse
it? Signs that indicate a patient's emotional
state is deteriorating
. Look for changes in body language,
including a tightened jaw, tense posture, clenched fists, fidgeting, and
any other significant change from earlier behavior. A talkative person,
for example, may suddenly become quiet. Observe the patient for additional
signs that his temper is rising. Is his voice raised? Is he demanding
excessive attention? If you detect any of these warning signs, you'll need
to act fast to help the patient vent his feelings in a productive manner.
Start by spending extra time with the patient. Although you might be
tempted to spend less time with him, doing so only increases your risk of
liability. Ignoring his complaints or, say, rushing him may prove
detrimental to his care. And if something goes wrong, dissatisfied
patients are more likely to sue. If, for instance, you work in a
healthcare facility, take time to ensure that he is thoroughly familiar
with his plan of care and the rationale behind it. Review the care he's
received so far, the progress he's made, and how long his recovery should
Some patients won't be soothed by your extra attention and
may become belligerent, demanding to know such things as, "Why can't you
start my therapy now?" "Why isn't my treatment working?" or "Why aren't my
medications ready yet?" Your calm approach in answering such obviously
loaded questions can prevent anger from turning into a behavioral crisis.
Rather than becoming defensive, you'd be wise to respond calmly to the
patient and treat him with respect. If a patient is uncooperative, try to
identify the underlying reason. A patient who balks, for example, when a
PT suggests replacing one exercise for low back pain with another may
actually be anxious about an upcoming procedure or the results of tests.
After you hear him out, reassure him that you take his concerns seriously.
Empathize with him, saying something like, "I understand how upsetting
this must be for you." Be sure, however, to calmly explain the
consequences of his refusal. In this example, the PT would need to
elaborate on the reason for the new exercise and explain that the
patient's unwillingness to cooperate will delay his recovery. If, on the
other hand, the problem is an administrative one--such as having to wait
too long to see a healthcare provider--speak to the appropriate person
about scheduling a time that's less likely to involve a wait.
Keep your cool.
If a patient is angry
enough to verbally abuse you, remain calm and professional. Keep some
distance between you and the patient and do not respond until the verbal
barrage is over. When it is, speak softly and call the patient by name.
For instance, an EMT confronted by a patient screaming that he doesn't
want to be touched should listen quietly until the patient is done. He can
then try to soothe the patient, saying something like, I know you're
scared, Mr. Smith, but I just want to take your blood pressure and make
sure you're okay. That approach may calm the patient enough to allow for a
more thorough examination. Should a patient become irrational, he's likely
to try to intimidate you. He may say things like, I'm calling my lawyer or
I'm going to sue. Trying to justify the situation or defend your actions
will only make things worse. Use active listening instead: Paraphrase back
to the patient what he's already told you, while at the same time
identifying the real feelings behind the words--fear or helplessness, for
instance. Keep your statements short and simple. Continue to treat the
person with respect and show accepting body language by letting your arms
hang loosely at your sides rather than standing with your hands on your
hips or with your arms crossed. If the patient blows up, he has lost
control and is so irrational he will no longer hear what you say. As in
dealing with a child's temper tantrum, your reaction may determine exactly
how long the fireworks last. Keep your cool and don't be
the patient's anger
. Never get angry yourself or try to set limits by
saying, "Calm down" or "Stop yelling." As the fireworks explode, maintain
eye contact with the patient and just listen. Try to understand the event
that triggered the angry outburst. When the person has quieted down,
acknowledge his feelings, matching your words to his level of anger.
Express regret about the situation, and let the person know you
understand. Try to find some point of agreement, perhaps acknowledging
that his complaint is a valid one. Ask for the patient's solution to the
problem. Use phrases like, "Can you tell me what you need?" or "Do you
have some suggestions on ways to solve this problem?" End the conversation
by trying to reach an acceptable arrangement. Offer options by saying,
"Here's how we could handle this." If the patient threatens you physically
or you fear for your safety, don't hesitate to contact security or the
police. For more immediate assistance, consider establishing a code phrase
that indicates when a staffer needs help. Regardless of the extent of the
patient's anger, documenting complaints--as well as attempts to resolve
them and the results of each intervention--can ward off frivolous claims
or help in your defense if a lawsuit proceeds to trial. If applicable to
your line of work, note administrative complaints in an incident report.
Document clinical complaints in the patient's chart. Dealing with
difficult patients will always be a challenge. But your finesse in
defusing and managing anger will keep the focus on getting the patient
healthy and protect you from unwarranted legal action.
Wisdom does not always come
Difficult patients - Mental Health Threats.
elp clinicians assess if a particular
case may be, or must be, reported, refer clinicians to the appropriate
resource, such as security, and de-escalate conflicts between a patient’s
family and the clinical team. Clinicians must still comply with state law,
which may not permit such reporting. “Therefore, clinicians should consult
with their legal counsel before making reports, clinician’s legal duties
are strongly weighted in favor of reporting. There is normally little risk
from over-reporting, but there is risk from under-reporting. Unlike other
mandatory reporting duties, such as with child abuse or elder abuse, the
trigger for breaching confidentiality and reporting mental health threats
is usually higher than “mere suspicion. Consequently, the risk of
unnecessarily disrupting a patient’s liberty and privacy is lower. Avoid
stigmatizing individuals with a history of violence. Speak softly and
refrain from having a judgmental attitude. Try to remain neutral, although
it may be difficult with an irrational patient. Put some distance between
yourself and the patient, and do not make intense eye contact. This could
set them off. Try to demonstrate control of the situation without becoming
demanding or authoritative; and Seek to smooth the situation over rather
than bully the patient into better behavior. Might just be another symptom
of the patient’s disease that requires medical attention.
is a serious disturbance in mental
abilities that results in confused thinking and reduced awareness of the
environment. Delirium is a state of worse-than-usual mental function,
brought on by illness or some kind of stress on the body or mind. Delirium
can have causes that aren't due to underlying disease. Examples include
intoxication or sleep deprivation.
Refusing Physical Therapy
. Some elderly people refuse to cooperate.
Many therapists have worked with patients who are difficult to engage in
. The reasons a patient may give: “I’m too tired, my family is
visiting soon, I’m afraid I’ll fall, It’s too hard, and I just had
therapy, I just don’t want to.” So how do therapists handle these
situations? If after modifications and changes the patient continues to
refuse treatment, remember that they do have the right to refuse and
manage their own care. In this event, it’s important to respect their
decisions and discontinue care. The physical therapist may again negotiate
a time later that day or the next day. The physical therapist may even
compromise on the goals (with the idea that some treatment is better than
none. Successful rehabilitation requires that patient's and therapist's
goals align, and this is commonly the case. However, occasionally,
physical therapists will come across patients who are competent but
reluctant to mobilize. This situation leaves the physical therapist in an
ethical quandary: either accept the patient's right to refuse proposed
treatment or utilize other strategies to encourage the patient to adhere
to treatment. Practically, physical therapists will use a range of
treatment pressures, including persuasion, offering incentives,
inducements, possibly threatening or coercing, and even explicitly
overriding the patient's wishes (compulsion). Deciding which treatment
pressure is ethically acceptable involves the physical therapist balancing
his or her therapeutic view of what is in a patient's best interests
against the therapist's ethical responsibility to respect patient
autonomy. This article evaluates some common strategies used by physical
therapists to influence, persuade, or perhaps pressure patients to adhere to rehabilitation.
Films about Caregiving - Elderly Care Videos
Nursing Home Abuse
Joan Halifax: Compassion and the True
Meaning of Empathy
The Price of Life
Intro to 1963 Move The Caretakers
The New Method of Swallowing
Aging Parent Movies
Mental Health Videos
Housing Options - Care Options out of Home
There are several types of
that provide living arrangements and
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
everything completely and the services
, and the cost.
Living in Place
- Care Types
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.
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
, and many personal care services are provided in the
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
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
are licensed in many communities to provide
shelter, supervision, meals, and
to a small number
of residents. (board and care).
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.
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.
elderly person is not capable of
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
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.
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
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) -
Adult Day Care Centers (help guide)
End of Life Care -
Adult Day Care
Adult Day Care Group -
Nurse Association -
Custodial Care and Baby Sitters
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.
Paying for Long-Term Care
It is important to understand the different types of
that are available to older people.
Many people believe that Medicare will cover long-term care needs. It will not.
Long-term Care Insurance
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
(Part B) Medical Insurance pays for
many medically necessary doctors' services, outpatient services,
and some other medical services. Enrollees pay a monthly
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.
: 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.
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.
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
We shouldn’t have any unemployed people
. There is just
so much work
that needs to be done
. We are slaves to the
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 Resources - Education for Care Givers, Parents and their Children
Senior Care Online
A Place for Mom
My Guardian Angels Homecare
My Guardian Angels Home Care
Polish Helping Hands
Parent Care Balance Blogspot
The Scan Foundation
Golden Girls Network
Care Giver Responsibilities
Care Giving Knowledge Base
Cooperative Home Care Associates
Medicare Caregiver Resources
Products and Services for Seniors.
Aging in Place
of Health Care Administrators
Health Care Association
Association of Health Care Assistants
California Health Plan
El Direct Home Care
Home Watch Caregivers
Right at Home
Superior Senior Care
Physician's Care Clinic
Johnson County Kansas
Elder Options of Texas
- Top of Page
Aging Parents: The Family Survival Guide
- 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.
: 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 -
Alzheimer's Association, Inc.
919 North Michigan Avenue, Suite 1000,
Chicago IL 60611
American Association of Homes for the
901 E Street NW,
Washington, DC 20004
American Association of Retired
601 E Street NW,
Washington, DC 20049
Partnership for Caring
Provides the following free
Miles Away and Still Caring (D-12748);
About Care in the Home (D-955);
A Path For Caregivers (D-12957),
Choice in Dying/Partnership for
1035 30th Street NW,
Washington, DC 20007
Tel: 202-338-9790 or 800-989-9455 -
Guide to Retirement Living
Free medical directives and living
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
555 13th Street NW, Suite 600 East,
Washington, DC 20004
Tel: 202-824-1600 -
National Association of Private
Geriatric Care Managers
Publishes A Consumer's Guide to
1604 North Country Club Road,
Tucson, AZ 85715
Tel: 520-881-8008 -
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
National Institute on Aging
Publishes Perspective on Aging,
a bimonthly magazine, and Family Home Caring Guides.
9000 Rockville Pike,
Bethesda, MD 20892
National Guardianship Association
1604 N. Country Club Rd
Tucson, AZ 85716,
Long-Term Care Link
A comprehensive web site with links
to eldercare services and insurance information. Updated web
site addresses for all State Agencies on Aging.
NIH Senior Health
Ultimate Guide to Rehab & Medicare
Assisted Living Regulation and Laws
Aging in Place
Administration on Aging
Administration for Community Living
Falling Risk factors for Older Adults
Senior Health Risk Calculators for Healthy Aging
Health Information for Older Adults
Aging Parents and Elder Care Reference Links
Adult Day Care
Aging – General
Air Ambulance Services
Assisted Living – Facilities
Assisted Living – General
Assistive Devices and Services
Benefits for Seniors
Books and Videos
Continuing Care Retirement Communities
Elder Care – General
End of Life Issues
Geriatrics Education Resources
Health - Medical Products
Home Health Care – Agencies
Home Health Care – General
Medical Alert Systems
Moving – Relocation
Nursing Home Abuse -
Nursing Homes – Facilities -
Nursing Homes – General
Other Health Resources -
Other Medical Conditions
Professional Journals -
Reading Aids -
Respite Care -
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
By 2050, people 65 and over will
comprise an impressive 21 percent of the U.S. population.
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.
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
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.
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
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
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.
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
* 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
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
* 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.
Aging in Place:
Under this option, the elderly person continues to live
in his/her own apartment. Many elderly people live in
Retirement Communities or 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
Granma Pod- Tiny House for Big Hearts
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 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.
"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
"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
"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,
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,
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
On Donating My Brain to
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
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
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
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
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
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
Why does Hair turn Grey
A persons hair turns grey when the
body stops producing the cells
, which helps create
in the hair
. 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
(Hair and Skin Care)
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
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
gray hair, is associated with activation of the innate
immune system in
mice. A direct link between MITF, innate immunity, and hair
Graying hair is not
always permanent. If whitening of hair or greying of hair
has happened because of external factors like stress, improper
diet, pollution, bleaching, etc., once these issues are
reversed, melanin may be restored and the color pigmentation
could return. So it's possible for grey hair to diminish and
almost return to its natural color. B-6 may help restore hair to
its original color following an illness or deficiency.
Para-Amino benzoic Acid and Pantothenic Acid are part of the
family of B-complex vitamins. Iron-rich foods or iron helps can
help to boost the production of melanin in your hair. the lack
of copper can also reduce the count of melanin in the hair.
Catalase is an antioxidant enzyme that prevents the growth of
grey hair and helps to restore the natural color of your hair.
Genetically driven graying hair can not
Study links 'stuck' stem cells to hair turning gray. Certain
stem cells have a unique ability to move between growth
compartments in hair follicles, but get stuck as people age and
so lose their ability to mature and maintain hair color, a new
Electrolysis is a one-way solution
for a more permanent and efficient method to remove grey / white
hair. It is the only FDA approved hair removal method, medically
recognized to be PERMANENT. Different from laser, it uses a tiny
probe that kills the cells from inside the hair follicle by
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
History of Eye Color - Eye Sight.
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
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
Even though there is a wide range of
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.