Welcome ...

All too many times overwhelmed caregivers are physically and emotionally depleted and need to take time to rest and care for themselves. Believing in a holistic approach to caregiver stress and a strong commitment to helping our members find the right solutions, we created this blog to help you connect with others who, like you, may be facing the same eldercare issues and challenges. Feel free to comment, ask questions, and submit articles. Please forward the blog link to your family and friends. They'll be glad you did.

Warm regards,

Patricia Grace
founder & CEO
Aging with Grace

Friday, April 29, 2011

Finally, free Internet referral services come under scrunity...

Washington will be the first state to clamp down on the explosive growth of elder care referral businesses according to a report from the Seattle Times.

The providers help guide families through a range of options for their loved ones that can include assisting living or other senior housing that best fits their needs for free. In return, these companies can be paid as much as $3,500 per person by the facilities for providing them with a client.

Legislation sent to Governor Chris Gregoire will require referral companies to follow strict standards that include written disclosures of their commission rates. Washington is the first state to pass a comprehensive law to rein in elder-care referral companies, according to research by AARP, a senior organization that supported the bill.

Across the nation, lawmakers are studying the bill as a model for change in at least a dozen states, consumer advocates and legislators said.

“The inherent problem is that referral agencies aim to make a profit at a most vulnerable time in an elder’s life,” said state Ombudsman Louise Ryan. “Right now, there are no rules.”

The bill requires companies to meet the following minimum standards:

Obtaining a signed disclosure statement of fees and commissions.

Maintaining at least $1 million in liability insurance coverage.

Completing a standardized intake form that tracks a senior’s medical history and ability to pay for board and care.

Follow the state Consumer Protection Act, which gives the state Attorney General’s Office authority to investigate complaints.

Need another reason to Age with Grace? We DO NOT ACCEPT referral or click thru fees. a

Wednesday, April 27, 2011

Tai chi proves to be a great exercise for the elderly

Tai chi exercises might be able to help improve heart failure patients' quality of life, mood and confidence, new research finds.

People with heart failure experience shortness of breath, coughing, chronic venous congestion, ankle swelling and difficulty exercising due to the heart's inability to pump blood efficiently. The gentle movements of tai chi involve circular rotations, weight shifting and breathing techniques to promote balance and strength. Previous studies have shown it to be helpful in treating depression, hypertension and arthritis pain.

To study its effects on heart failure, scientists from Beth Israel Deaconess Medical Center and Harvard Medical School randomly assigned 100 heart failure patients 12 weeks of tai chi classes or educational sessions about heart failure. They found that both groups displayed similar oxygen use in six-minute walks, but the tai chi group exhibited better improvement with regard to quality of life. These patients also burned more calories each week and showed improvement in their mood.

The research was published in Monday's issue of the Archives of Internal Medicine.

Tuesday, April 26, 2011

Medicare Part D - prepare to do your homework

The following is an excerpt from an article in SmartMoney Magazine, written by Glenn Ruffenach

Medicare Part D

Spending on prescription drugs in the U.S. totaled about $250 billion in 2009, more than six times the $40 billion spent in 1990. Here are some of the reasons why:
Increased use and demand. From 1999 to 2009, the population grew 9 percent, but the number of prescriptions purchased jumped 39 percent.

*Types of prescriptions written. The best-selling prescriptions are newer, higher-priced brand-name drugs, which have replaced older, less-expensive drugs.
Price increases. Retail prices for prescription drugs increased an average of 3.6 percent annually between 2000 and 2009, versus an inflation rate of 2.5 percent.
Research and development. Only one in five drugs in clinical tests reaches consumers. Manufacturers try to recoup R&D costs for drugs that make it to market—and those that don't.

Picking the right drug plan under this program could save you a bundle—if, and this is the key, you stay on top of changes in your plan.

Typically, you sign up for Part D when you first enroll in Medicare. Ideally, the plan you select will be one that covers the medications you take at the most affordable prices. (Each Part D plan, offered by private insurers, covers different drugs with different premiums and co-payments.) The problem: The plans can (and do) change, dropping drugs here, adding others there, and raising or lowering fees. If you fail to notice, for instance, that your plan no longer covers one of your medications—and if you don't take advantage of the annual opportunity to switch plans—your nest egg takes a hit.

It's a pain in the neck, but you have to do the homework—every year. "A mistake here, depending on how long you allow it to go on, could cost you thousands of dollars," says Joseph L. Matthews, coauthor of Social Security, Medicare and Government Pensions.

*Kaiser Family Foundation

Monday, April 25, 2011

Caregiving and the Family Circle

Today’s guest post comes from SeniorsforLiving.com’s Michelle Seitzer.

Before committing to life as a full-time freelance writer, Michelle spent 10 years in the senior living and advocacy world, serving in various roles at assisted living communities throughout Pennsylvania and Maryland, and leading the charge for Alzheimer’s as a public policy coordinator for the Pennsylvania chapters of the Alzheimer’s Association. She has blogged for SeniorsforLiving.com since November 2008 and currently resides in York, Pennsylvania, with her teacher husband and two Boston Terriers. Follow her on Twitter and Facebook.

“When our relatives are at home, we have to think of all their good points, or it would be impossible to endure them.” - George Bernard Shaw

Ah, family. Even those of us with small families can identify with George Bernard Shaw’s words, can’t we?

And no matter how much you love them (or not), little else in life tests the family boundaries and challenges your sanity quite like caregiving.
Taking care of another human being is already difficult work for a number of reasons. It can be physically challenging, emotionally demanding, financially taxing, and psychologically draining to be a caregiver. The responsibility can take a toll on your relationships with co-workers, your spouse, friends, and other acquaintances. Throw in the family wrench, and things can really get ugly.
Becoming a caregiver changes things. Caregiving for a family member, and at times, doing so in coordination with other family members, takes this already life-altering change to the next level.

Before I go any further, I must offer this disclaimer: Caring for a family member in this manner isn’t always a recipe for disaster. In fact, if you and your relatives have the level of maturity, acceptance, flexibility, and compassion necessary to approach the situation with grace, then caregiving for a family member can be one of the most rewarding journeys your family has ever embarked on together. It can truly be a time of bonding, growth, and honor. Always keep this in mind as you embrace this new stage in your family’s development – especially in those tense moments that are sure to come.

Wednesday, April 20, 2011

New guidelines for identifying Alzheimer's diseae

By MONIFA THOMAS Health Reporter Chicago Sun Times

Medical experts have issued new guidelines for diagnosing Alzheimer’s disease that, for the first time, attempt to identify the hallmarks of the disease before symptoms occur.

The original guidelines, published in 1984, dealt only with diagnosing Alzheimer’s once a person started showing signs of dementia.

Since then, new discoveries have shown the disease can cause changes in the brain a decade or more before symptoms appear.

The new guidelines — being published online today by the National Institute on Aging and the Chicago-based Alzheimer’s Association — are the first to include the use of brain imaging and measurement of certain proteins in the blood and spinal fluid to spot changes that could be due to Alzheimer’s.

More people will likely be diagnosed with Alzheimer’s — or told they are on the road to developing it — as a result of the recommendations. An estimated 5.4 million Americans have the disease now.

There are no approved treatments to slow or stop the progression of Alzheimer’s. But establishing standards for detecting it earlier will allow scientists to test potential treatments that eventually could be prescribed to people at risk, experts say.

“We believe that it’s critically important when we have more effective drugs to intervene as early as possible,” said guidelines co-author Dr. Reisa A. Sperling, of Brigham and Women’s Hospital in Boston. “The whole goal of the field is to begin to find ways to identify people earlier so that when new treatments are available, we can use them.”

For now, the guidelines won’t have much impact on how primary-care doctors and geriatricians evaluate patients with suspected Alzheimer’s, since new tests to identify the pre-symptomatic stages of the disease are to be used primarily in a research setting, Sperling said.

The guidelines describe Alzheimer’s as a continuum of three stages: preclinical disease, mild cognitive impairment and Alzheimer’s dementia.

In the preclinical stage, changes in the brain can be present but there are no obvious signs of dementia. Mild cognitive impairment occurs when progressive declines in memory and mental ability are noticeable but not severe enough to interfere with daily life.

Tests to identify both of these stages shouldn’t be used outside of clinical trials and research institutions because “there’s an enormous amount we still have to learn about them,” said guidelines co-author Marilyn Albert, of Johns Hopkins University School of Medicine.

Not everyone with preclinical disease or mild cognitive impairment goes on to develop Alzheimer’s dementia, Albert and Sperling noted.

The recommendations for diagnosing the third and final stage — Alzheimer’s dementia — were also revised to reflect that other aspects of cognition outside of memory loss, such as trouble recalling words and impaired reasoning and judgment, may be the first and most dominant sign of dementia.

The guidelines, which have been in the works since 2009, are being published online in Alzheimers & Dementia: The Journal of the Alzheimer’s Association. A preliminary version was released last year at an Alzheimer’s conference in Hawaii.

Thursday, April 14, 2011

BrightStar Care CEO to be featured on the CBS hit Undercover Boss

BrightStar Care, one of the fastest growing home healthcare and staffing providers in the country has more than 200 locations across North America, including offices in Anne Arundel, Prince George, Montgomery and Baltimore Counties. BrightStar Care is one of the few full-service healthcare agencies to offer both medical and non-medical homecare to clients of all ages within their homes, as well as supplemental healthcare staffing to corporate clients such as hospitals and nursing homes.

Shelly Sun, the CEO and Co-Founder of BrightStar Care, said of her experience, "I am grateful to have been given the opportunity to participate on ‘Undercover Boss.’ The experience deepened my appreciation for our caregivers and their relentless efforts to improve their clients’ quality of life and relieve the stress their families face on a day-to-day basis. I look forward to more people learning about BrightStar Care. Our company hires individuals who are passionate about serving, and care deeply about others’ well-being and happiness. We look for people who can embody that high level of dedication every day.”

Monday, April 11, 2011

When finances become a health issue for seniors

by Eileen Ambrose, The Baltimore Sun

Doctors are being encouraged to make sure elderly patients aren't victims of fraud.

We have a special relationship with our doctors. We trust them and tell them intimate details about our lives. And doctors who see us regularly are likely to notice changes from visit to visit that might signal that all is not well.

That's why some regulators and advocates for the elderly are reaching out to primary-care physicians, hoping they will use their unique position to help spot when older patients — particularly those with mild cognitive impairment — are victims of financial fraud.

About half the states so far have signed on to the Elder Investment Fraud and Financial Exploitation program that aims to train doctors on the red flags of financial exploitation and gives them the information they need to refer patients for help.

The program is run by the nonprofit Investor Protection Institute and the Baylor College of Medicine. Maryland regulators say they will be watching how the program develops before deciding whether to join in.

Read full article...

Friday, April 08, 2011

The darker side of Alzheimer's disease

The following is an excerpt from the CNN.com article written by Madison Park.

Alzheimer's patients are often vulnerable and fragile, but in rare cases, they can become the aggressor. About 5% to 10% of Alzheimer's patients exhibit violent behavior. It's unclear why the outbursts occur in certain patients.

"If you don't understand what's happening because your brain is not functioning, it can be scary," said Beth Kallmyer, senior director of constituent services at Alzheimer's Association. "It's normal human behavior. You might act out, become agitated, or violent if you don't know what's going on."
Before the Alzheimer's disease, Sam Cohen had never struck or hurt his family and his wife, Haya. Before the Alzheimer's disease, Sam Cohen had never struck or hurt his family and his wife, Haya.

Earlier this month, Cohen, who got an Alzheimer's disease diagnosis in 2010, got into a heated argument with his wife. He snatched a pot from the kitchen and smashed the glass of water his wife had been holding. The glass shards cut her hands and she called 911.

"We're at a loss," his son said. His father had never before behaved in such a way.

Read full article...

Tuesday, April 05, 2011

Home Health Agencies up in arms over new Medicare regulation

The following is an article written by Phil Galewitz Kaiser Health News.

Home health agencies, hospitals and consumer groups are complaining that a new rule intended to curb unnecessary Medicare spending will make it harder for senior citizens to get home care services.

Under the requirement, which is to take effect Friday, Medicare beneficiaries will have to see doctors 90 days before or 30 days after starting home health services in order for the home health agencies to be reimbursed. Those face-to-face visits may be a burden for some home-bound frail seniors, as well as those who live in rural areas, the industry says.

Some Medicare experts have little sympathy for industry complaints.

"Home health is a benefit that is out of control," said Dr. Robert Berenson, a health policy expert at the Urban Institute.

Medicare home health care typically consists of services such as skilled nursing, physical therapy and speech therapy. Unlike most services in Medicare, patients don't have co-payments or deductibles. The services can be prescribed for 60 days at a time, although there's no limit on the number of times they can be renewed.
Medicare home health costs doubled to $19 billion from 2002 to 2009. Cases of Medicare fraud also have been rising, and federal officials have launched a crackdown that includes prosecuting home health agencies that bill for services that weren't provided.

Under current law, doctors must prescribe home health care for patients to receive services, but the physicians don't have to see the patients to make that determination.

Medicare advisers to Congress say the regulation doesn't go far enough to reduce waste and fraud because it allows patients to start getting home health services before first seeing doctors to ensure that they need it.

"Such a large window ... does not ensure that beneficiaries receive an examination in a timely manner before home health care is delivered," the Medicare Payment Advisory Commission wrote in a report to Congress this month. Berenson is a member of the commission.

The doctor-visit rule, which was included in the health care overhaul, initially was to take effect Jan. 1 and was to require providers to see patients within 30 days before or two weeks after the start of home care. In December, the Centers for Medicare and Medicaid Services delayed implementation until April because of complaints from providers, who claimed that the rule was too stringent and most doctors were unaware of the change. At that time, the CMS also announced that it was expanding the time frame for patients to meet with doctors.

Now a coalition of home health industry, hospital and doctor groups and the AARP is pushing for another three-month extension.

CMS spokesman Tony Salters said the agency was listening to concerns, but he refused to say whether another extension will be granted. Salters said the agency didn't have any data to show what percentage of Medicare patients now got home care services without having recent visits with their doctors.

"There is a lot of confusion out there, and patients may lose access to their care," said Nora Super, an AARP lobbyist.

Dr. Roland Goertz, the president of the American Academy of Family Physicians, said the new rule added documentation requirements for physicians. "It makes our paperwork burden even more onerous," he said.

Under the rule, doctors would have to fill out forms that certify that they or other health care providers such as nurse practitioners had seen patients for the specific purpose of determining the patients' needs for home care. This would be in addition to doctors' current duties of prescribing home health care and signing off on care plans, which the home health agencies typically develop.

"A home health face-to-face encounter contradicts the purpose of home health care," Hoosier Uplands Home Health Care & Hospice in Mitchell, Ind., a rural area about 85 miles south of Indianapolis, wrote the CMS last year. "This would impose on the patient the need to leave home for increased and unnecessary physician visits."

But the home health agency voluntarily has tried out the new rule over the past three months and found only minor problems, such as doctors not filling out forms correctly, said Melissa Jeremiah, the director of operations for Hoosier Uplands.

Rochelle Archuleta, a policy expert at the American Hospital Association, said her organization was "hearing concerns from providers ... and that tells us this policy is not ready for enforcement." Hospitals are worried that patients who are discharged may not be able to get home health services immediately and hospital-owned home health agencies may have trouble complying with the law.

Home health agency groups said they understood Medicare's need to reduce unnecessary care but that the new rule was too onerous.

"We want to make sure beneficiaries who really need the services are not denied it," said Peter Notarstefano, the director of home and community-based services at Leading Age, which represents nonprofit home health agencies

5 new Alzheimer's gene identified

Two new studies — which examined 50,000 subjects worldwide — have identified five new genes that are definitively associated with Alzheimer's, according to a study published in the journal Nature Genetics.

This discovery might provide some clues as to how these genes work together, which could quicken the development of new therapies for the neurodegenerative disease, Bloomberg News reported.

"These findings add key information needed to understand the causes of Alzheimer's disease and should help in discovering approaches to its treatment and prevention," said researcher David Bennett, an Alzheimer's researcher at Rush University Medical Center in Chicago.

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